Having The Courage To Cosplay Whoever You Want

Photo by Green House Photography

As a Puerto Rican girl from Philadelphia I have been told numerous times on what I "cant" do. It started early on in my childhood because I was told Hispanics could not accomplish anything. I was expected to drop out of school, join a gang, get pregnant at 16 and other stereotypes. I was even told I was brown eyed (even though my eyes are clearly green). Gender also played a part. I wasnt suppose to read comic books because I was a girl. I shouldnt be collecting action figures or wearing comic themed t-shirts. I was weak because males are the stronger sex. These criticisms often came from strangers, kids on the playground or classmates. Teachers have told me because I had "the face of an angel" I wasnt very smart. When I began costuming in 2006 I was told repeatedly by followers of cosplay (never from a cosplayer) that this was a hobby I should give up because there arent many Latinos in geekdom. I couldnt do it. Supergirl isnt Puerto Rican. There are no Hispanic Final Fantasy characters. There is no Latina Disney Princess. Once again, I decided not to listen and had the courage to cosplay whoever I wanted. Along the way, I have encountered other individuals who do not let gender, race or weight stop them from portraying their favorite characters.

Gender Swap Walking Dead Group at
Dragoncon 2014. Photo by
Project Radio. 

Recently a group of friends visited me from out of town. We had a blast hanging out and doing impromptu photo shoots with many different costumes. One of my favorite shots from the day is of me and Shemika Berry as Harley and Ivy. When I saw the photo, I thought it was a powerful statement on cosplay freedom and how it sends the message on not being afraid of costuming whoever you want. The photo features a Latina as Harley Quinn and an African-American woman as Ivy. And we look fabulous. Cosplay is about creative freedom. If you want to be a gender bender Steampunk Maleficent, go for it! Ethnic Zombie Disney Princess? Yes, please. Dont match the skin tone of the character you want to portray? So what! Plus size superhero? Done! Dont let anything stop you. At the 2014 Dragoncon convention I participated in my first gender swap group. The theme was The Walking Dead and I was Carl Grimes. I cant tell you how much fun and exciting it was to do something different and express our fandom at the same time. If I had listened to the haters, I would not have wonderful experiences such as that.


Let me tell you what this Latina did in the midst of the masses who said I couldnt do anything in life. I graduated High School. I took some collage courses. I have been paid to model. I have been published nationwide for modeling in publications such as Latina Magazine. I wrote an article for a national magazine on Bratz doll collecting. I have worked in Early Child Hood Education for many years. I have been a guest at shows. I write product reviews for my Blog. I started my own birthday entertainment business and I do princess parties. I started the Pennsylvania branch of the Heroes Alliance and manage a team of volunteers and together we do numerous charity events. I moved to the suburbs and am in a stable relationship and we have our own home (and two beautiful cats). I cosplay whoever I want.

Not bad for a Puerto Rican girl who was told she wouldnt amount to anything. My point, friends? Dont listen to the haters and have the courage to cosplay whoever you want and also, have the courage to do whatever you want in your life. It is yours after all :)  #cosplayequality

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Can a surgeon who is sitting perform abdominal operations

A loyal reader alerted me to news of a lawsuit brought by an obstetrician in South Carolina who is suing a hospital for suspending his privileges. He had performed a cesarean section while sitting on a stool because he had a foot fracture secondary to diabetes. Several witnesses said that the doctor "had been unable to properly view the surgical field, unable to properly handle the baby and unable to address hemorrhaging." The patient later developed a serious infection.

A seated surgeon can operate on the hand and arm. In fact, thats the way everyone does it. The surgeons knees easily fit under the small table holding the outstretched arm. Certain anorectal operations and gynecologic procedures done through the vagina can be done by a surgeon who is sitting, but abdominal and pelvic operations done via laparotomy cant be safely done that way.

The problem is that when a surgeon is sitting, she cant get close enough to the OR table and the patient to see way down into the abdomen and pelvis. If bleeding occurs deep in the wound, controlling it would be challenging to a surgeon who is sitting. Tying a secure knot in the pelvis while sitting might even be impossible.

With the exception of robot-assisted surgery where the surgeon sits a console remote from the operating table, a seated surgeon would have trouble doing both open and laparoscopic procedures. Even with a robotic operation, there can be problems. If the surgeon cant stand, an assistant would have to help insert the robotic ports. What if something went wrong and the abdomen had to be opened?

In a laparoscopic case, the video monitor could be seen by a sitting surgeon, but manipulating the rigid instruments would be difficult because of the angles created by the locations of the ports through which the instruments are passed.

As a retired surgeon, I sympathize with anyone who might be forced to quit operating because of illness or disability, but the safety of the patient comes first.

I hope that the suit is resolved quickly and we learn what the outcome is.

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How to get the answers you want from a survey

This isnt about religion or politics, two subjects I tend to avoid. This is about surveys and how they can mislead.

I received this survey in the mail last week. It is from CatholicVote.org and is touted as the "largest survey of Catholics ever conducted on the issue of ObamaCare."

CatholicVote.org promises that the results will "send a strong and clear message to every politician running for election or reelection in the 2014 midterm congressional elections, that the overwhelming majority of Catholic voters demand ObamaCare be repealed."

Judging from the way the questions are framed, I think the message will be clear.

Here are a few examples:

From Section B "ObamaCares War on Christianity and Morality"

Question #2: Do you think ObamaCare is violating the Constitutions First Amendment protections for freedom of religion and freedom of conscience by forcing pro-life Americans to purchase health coverage that includes abortion inducing drugs?

A) Yes, this is certainly a violation of the Constitutions First Amendment protections.
B) No, this is not a violation of the Constitution
C) Not Sure
D) Other

Question #4: As a state lawmaker in Illinois, Barack Obama voted twice to deny lifesaving medical care to babies born in botched abortions. What is your reaction to this fact?

A) I support President Obama on this.
B) I am horrified and angered by this.
C) Not Sure
D) Other

From Section C "ObamaCares War on Freedom"

Question #5: Do you think President Obama knew about the crushing cost of ObamaCare for families across America, and was just lying about the cost to get ObamaCare passed into law? Or do you think he shares our shock and dismay at the staggering cost of ObamaCare?

A) I believe President Obama knew about the crushing cost of ObamaCare for families across America, and was just lying about the cost to get ObamaCare passed into law.
B) I think he shares our shock at the staggering cost of ObamaCare and was just unaware of it.
C) Not Sure
D) Other

Question #6: How do you think the mass exodus of doctors from medicine will impact your ability to see a doctor and get the medical treatments you need?

A) A doctor shortage on this scale will certainly drive healthcare costs up dramatically and make it far more difficult for me to see a doctor and get the medical care I need.
B) I dont think well see much impact from this doctor shortage.
C) Not Sure
D) Other

Had enough?

I look forward to seeing the results.

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New 52 Wonder Woman and Trinity Set

In November 2014 a group of cosplayers and photographers gathered at my home for a Man of Steel/Trinity photo shoot (which can be seen HERE). We had such a great time shooting and loved the photography so much that we decided to follow up with a New 52 theme. Check out the gallery  below!

Credits

Superman: Jason Evans

Batman: Kevin D Cosplay

Photographers

Photos and Designs by Piera

Hero Hotties

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Applicants want to be a resident but don’t write good Here’s help

Thanks to a spammer trying to comment on some of my posts, I have been introduced to the world of online personal statement services.

On a website called internalmedicineresidency.biz, $54.09 (discounted to $43.27 if you order by June 30) will get you a 275-word personal statement. As the website points out, “Coming up with a personal statement internal medicine of this quality is far from easy, but it’s what our professional service is here to help you achieve.”

Under the heading “How to create a killer statement, item #2 is “Argue why you suit for the course.”

The site offers a sample personal statement that begins, “I’ve always admired those who work in the health care industry not only because my mother was one but the fact that these people are the ones who care for our well being.”

In case you are after bigger game, the same company offers similar services for obtaining a neurosurgical residency. This site says, “Getting a neurosurgery residency can give your career a boost which can have a positive effect at your future in this field.”

I must agree that if you want to become a neurosurgeon, failure to obtain a neurosurgical residency position is a definite disadvantage. In fact, I think it would pretty much preclude your becoming a neurosurgeon.

It may be more difficult to obtain a neurosurgical residency than one in internal medicine, but the price for a neurosurgery personal statement, at a mere $27.19, is much lower.

For some reason when you click on the Sample tab, the site displays a “Pre Med Personal Statement” followed by this paragraph:

Pre Med personal statement writing is nowadays proven as beneficial using online services. Nowadays, students are showing more interest for the pre-med programs because of its value and prospective value for the future medicine studies. There is a great competition every year for this program and thousands of students applying every year too. Here, it is indicating, how important it is to add your application with a personal statement. If you fail to satiate this factor, then admission success is hard to expect. Our service is definitely wise option here to come up with a neurosurgery residency personal statement and any winning personal statement.

If that doesn’t convince you to try this service, I don’t know what will.

A USMLE Forum lists 18 other websites that provide personal statement writing services. I wish I had time to check out all of them.

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So you want to be a Radiologist

A student writes, Ive been following some of your posts and noticed some of the comments by others mentioning that radiology residencies/jobs are drying up and even face the possibility of disappearing completely. Could you explain why? I am currently a senior pre-medical student whos taken a recent liking to radiology after following a few radiologists in a hospital, so I would just like to get some input.”

A colleague, Dr. Saurabh Jha, an Assistant Professor of Radiology at the Hospital of the University of Pennsylvania, has graciously agreed to respond. He can be followed on Twitter @RogueRad.

Should I go into radiology?

I used to be a surgical resident in the UK. One day, I was a little dispirited during a brutal call, and my senior resident asked “do you love surgery?”

“I like surgery,” I replied.

“If you don’t love surgery, love it unconditionally I mean – like loving your child – you will be unhappy.” He warned.

I really liked surgery. I like radiology. I’m happy as a radiologist. Radiology fits my temperament. You don’t have to love radiology like one has to love surgery, but you have to like it. It helps if you like it a lot.

The worst reasons to go in to radiology are to make lots of money and to avoid patients. The days of radiologists making $500 K + 12 weeks of vacation after reading 20,000 studies a year are over. Radiologists doing interventional, ultrasound, mammography and fluoroscopy (such as barium enemas) must speak to patients, and speak well.

Radiology is a tech-heavy field. If you’re excited by technology, you will like it. Radiologists are leading healthcare in IT. If you have an interest in health IT, then some programs will integrate informatics with your training.

Residency involves substantial reading. You have to master anatomy, radiological pathology, and physics, as well as have a decent knowledge of clinical medicine. Prepare for 20-30 hours of reading a week. Radiology is now 24/7. Calls are intense – 12 hour shifts are non-stop. But when you are off, you are off.

Believe it or not, international health – if you are into that – increasingly asks for radiologists. Although you won’t be parachuting in to Sierra Leone or quarantined in Fort Hood.

Will there be jobs when I graduate?

Like Yogi Berra I am reluctant to make predictions, particularly about the future. But radiologists have a poor record in making predictions about jobs. During Hillary care, we thought there would be a surplus of radiologists. We were wrong. During the Bush era we thought there would be a shortage of radiologists. We were wrong.

That’s 0/2. That’s worse than a coin toss.

Here is what I can say. American medicine will not do with fewer imaging tests. American population is not getting younger. Healthcare coverage is not shrinking. There are more lawyers who need something to do. Bottom line: demand for medical imaging will not fall suddenly.

There are emerging number of “empowered consumers” who want to pick up disease before symptoms. They will need radiologists, or someone who understands false positives, to keep their normal kidneys from the surgical pathologist’s slides.

Will residency positions be reduced?

They should but won’t be. That means you have the upper hand – because supply of residency spots exceeds demand. Beware though. The demand for good residencies has increased. The current first and second year residents at my institute are the brightest I’ve ever seen. They’re scary good.

Ask the program director how many of their residents had to do two fellowships before getting a job. Demand that information. You have a right to know how their residents fared in this competitive market.

What should I do to before residency to be a better radiologist?

Rule 1: avoid radiologists and radiology rotations. You’ll have a life time of us. And there’s only so much you’ll learn watching us stare at the screen and bark at the mike.

Improve your knowledge of medicine. Spend time on the ICU, in the ED, at the trauma bay, with the surgeons in the OR. Understand clinical decision making. Understand how doctors think. Understand the ill patient. Become a doctor. I don’t mean that in touchy-feely terms. I mean develop clinical acumen.

The radiologist with a sharp eye and no clinical acumen is a generator of differential diagnoses – though not as good as IBM’s Watson will be. The radiologist with common sense (read clinical acumen) and even a mediocre eye will prevail.

Any other advice?

Join radiology’s professional society – ACR – it’s free and has a vibrant section for trainees. Get yourself employment-specific disability insurance, if possible.

Get in to the habit of exercising or playing sports. You will not be walking as much as your clinical colleagues.

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How to rank surgical residency programs

In September, Doximity, a closed online community of over 300,000 physicians, released its ratings of residency programs in nearly every specialty. Many, including me, took issue with the methodology. Emergency medicine societies met with Doximitys co-founder over the issue and echoed some of the comments I had made about the lack of objectivity and emphasis on reputation.

I wonder if it is even possible to develop a set of valid criteria to rate residency programs. Every one I can think of is open to question. Lets take a look at some of them.

Reputation is an unavoidable component in any rating system. Unfortunately, it is rarely based on personal knowledge of any program because there is no way for anyone not directly involved with a program to assess its quality. Reputation is built on history, but all programs have turnover of chairs and faculty. Just as in sports, maintaining a dynasty over many years can sometimes be difficult. Deciding how much weight should be given to reputation is also problematic.

The schools that residents come from might be indicative of a programs quality, but university-based residencies tend to attract applicants from better medical schools. The other issue is who is to say which schools are the best?

Faculty and resident research is easy to measure but may be irrelevant when trying to answer the question of which programs produce the best clinical surgeons. Since professors tend to move from place to place, the current faculty may not be around for the entire 5 years of a surgery residents training.

The number of residents who obtain subspecialty fellowships and where those fellowships are might be worthwhile, but would penalize programs that attract candidates who may be exceptional but are happy to become mere general surgeons.

Resident case loads including volume and breadth of experience would be very useful. However, these numbers have to be self-reported by programs. Self-reported data are often unreliable. Here are some examples why.

For several years, M.D. Anderson has been number one on the list of cancer hospitals as compiled by US News. It turns out that for 7 of those years, the hospital was counting all patients who were admitted through its emergency department as transfers and therefore not included in mortality figures. This resulted in the exclusion of 40% of M.D. Andersons admissions, many of whom were likely the sickest patients.

The number and types of cases done by residents in a program have always been self-reported. The Residency Review Committee for Surgery and The American Board of Surgery have no way of independently verifying the number of cases done by residents, the level of resident participation in any specific case, or whether the minimum numbers for certain complex cases have truly been met.

So where does that leave us?

Im not sure. I am interested in hearing what you have to say about how residency programs can be ranked.

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