In the past few years, cannabis in Virginia has gone from a banished foe to an increasingly friendly acquaintance. Since the 1930’s it has been propagandized as the “demon weed” that could cause everything from teenage zombiedom to desperate prostitution. The D.A.R.E. campaign in the 1980’s likened cannabis use to one’s brain frying in a hot skillet like an egg. Despite these colorful past categorizations, cannabis, along with other Schedule 1 substances like psilocybin and LSD, has reemerged in the medical community because of its potential … [Read More...]
Main Content
Leadership Messages
Common Goals Don’t Eliminate Controversy
By Marie Sankaran-Raval, MD
President, VSA
The practice of medicine has always been fraught with controversy across all specialties. Examples include end of life care, childhood vaccinations, circumcisions, and genetic engineering, just to name a few. As anesthesiologists, we face controversial surgeries everyday such as organ transplantation, bariatric surgery, and abortions. Our goal, above all else, is to provide quality anesthesia care and keep the patient safe. As a practicing pediatric anesthesiologist at VCU Health, I have faced controversial situations, such as … [Read More...]
You’re Getting on My Nerves… But Isn’t That the Point?
Brooke Trainer, MD, FASA
Editor, VSA UPDATE Newsletter
Do I have your attention? Being triple - specialized in Anesthesiology, Acute Pain, and Intensive Care, I sometimes find myself thinking about patient problems in unique ways. For example, in October 2019 when a young patient in his 20s presented to the Neuro-Intensive Care Unit at UVA with Guillain Barre Syndrome, paralyzed and intubated on mechanical ventilation, in severe pain with autonomic dysfunction, my mind went to whether I could use peripheral nerve stimulation (PNS) as an alternative, non-pharmacologic, analgesic modality to get … [Read More...]
Pushing OSA Guidelines into the Next Decade: Integrating Patient Safety with Perioperative and Precision Based Medicine
By Daniel H. Gouger, MD
Resident Editor, VSA Update Newsletter
VCU Health Department of Anesthesiology
We’ve come a long way in anesthesiology since 1984, when movies like Sixteen Candles, Karate Kid, and Footloose were in theaters. But, the nostalgia of those also reminds us that that was only thirty-seven years ago. An effort at that time, between the University of Washington at Seattle and the American Society of Anesthesiologists, resulted in the Closed Claims Project to analyze closed malpractice claims and trends in anesthesia-related patient safety topics. Early data in the 1990s and 2000s showed claims transitioning from surgical a … [Read More...]
Opinion
Would I Do It Again?
By Paul Rein, DO
In 2008 there was a movie made called ‘The Curious Case of Benjamin Button’. It was a story of a man who ages in reverse. Interesting movie. I graduated from Osteopathic Medical School in 1972 with a debt of $20,000. Starting in 1974 I practiced as an old-fashioned general practitioner for six and a half years, including house calls, uncomplicated obstetrics, and minor surgery. Finally, in 1979, I decided to switch to anesthesiology and, in January of 1980, began my residency at MCV. I stayed on as an assistant professor before leaving in … [Read More...]
Theme – Controversies in Anesthesia
Friend or Foe: Legalizing Cannabis in Virginia
By Jeffrey Katra, DO
Addiction Fellow
University of Virginia
In the past few years, cannabis in Virginia has gone from a banished foe to an increasingly friendly acquaintance. Since the 1930’s it has been propagandized as the “demon weed” that could cause everything from teenage zombiedom to desperate prostitution. The D.A.R.E. campaign in the 1980’s likened cannabis use to one’s brain frying in a hot skil … [Read More...]
Reduce Pollution by Eliminating Anesthesia Gases
By Matthew J. Meyer, MD
Critical Care Anesthesiologist
Assistant Professor of Anesthesiology
University of Virginia
Charlottesville, VA
Disclaimer: Matthew Meyer serves as a member on the steering committee of “Virginia Clinicians for Climate Action”. The United States healthcare industry creates 8.5% of the United States’ carbon footprint.1 NHS (National Health System) UK estimates 2% of its carbon footprint comes from anesthesia gases.2 In a single hospital, anesthesia ga … [Read More...]
TAP Blocks, To Consent or Not To Consent
By Steven Bradley, MD
Assistant Professor of Anesthesiology
USUHS Graduate Fellow
the Maclean Center for Clinical Medical Ethics
Regional anesthesia has become more popular in recent years due to several factors. An increasing prevalence of enhanced recovery after surgery (ERAS) protocols, increased access to improved ultrasound technology, and a greater appreciation for their opioid-sparing effects have made regional anesthesia a mainstay for a variety of practices. One … [Read More...]
How I Became a Disabled Physician
By Stephanie Pearson, MD, FACOG
President, Pearson Ravitz Insurance
I was at the height of my career. I had just been asked to be the chairperson for our department. I was happily married with two small boys. I loved my life. We had plans to travel, to buy a bigger house, to live the dream. Then it all changed. I was called to the labor floor for a precipitous delivery. Baby number four. They should have fallen … [Read More...]
Healthcare in the United States is the Best in the World
By Khaled A. Dajani, MD, FASA; Shawn Y. Wang, BS; and Abhijith Atkuru, BS, MS
There is an aphorism that all budding entrepreneurs and grizzled veterans alike come to intimately understand: the market never lies. Americans have among the lowest life expectancy of high-income countries, 78.6 years versus Switzerland for example at 83.6 years. The adult chronic disease burden stands at 28% of the population, compared to an … [Read More...]
Medicolegal Reform in Virginia, and Why It Needs Your Attention
By Jack Craven, MD, JD
Anesthesiology Resident
Virginia Commonwealth University
If you imagine yourself as a trial attorney, it is easy to understand the motive behind reducing barriers to filing claims. Trial lawyers are all too familiar with the laws restricting suits and capping damages. It should come as no surprise that they have been seeking to “reform” prior medical malpractice statutes in Virginia. A bill was int … [Read More...]
Anesthesia Care Team Composition: CAA or CRNA, What’s the Difference?
By Nicole Cabell
VAAA President
AAAA Legislative Committee Chair
Certified Anesthesiologist Assistants (CAAs) are highly skilled health professionals who work under the medical direction of licensed physician Anesthesiologists to implement anesthesia care plans. CAAs work exclusively within the Anesthesia Care Team (ACT) model, as described by the American Society of Anesthesiologists (ASA). Also working … [Read More...]
Second Chances?
Written by a loving husband, a dedicated father, and an experienced anesthesiologist in Virginia Just as things were beginning to look more optimistic after a few rough years, I was let go again from a job, despite having an unblemished track record while employed there. My past was back to haunt me. I had been moonlighting at this hospital … [Read More...]
Members in the News
Dr. Cherayil Named VSA Northern Virginia Regional Director
By Gerald (Gerry) Cherayil, MD, MBA
Chairman, Advisory Board
Fairfax Anesthesiology Associates/NAPA
Anesthesia Director, OB Anesthesiology
INOVA Fairfax Hospital
Hello Everyone!! My name is Gerald (Gerry) Cherayil and I will be heading up the Northern Virginia Region of the VSA! I was born and raised in Milwaukee, Wisconsin, and did both my undergraduate and medical school in Milwaukee. After graduating from the Medical College of Wisconsin, I travelled to Boston to do my residency in anesthesiology and … [Read More...]
Meet Milly Rambhia, MD; Virginia Board of Medicine
I was first introduced to the exciting field of anesthesiology during the summer of my first year of medical school at the University of Maryland. I had signed up for a summer anesthesiology externship and was exposed to various sides of anesthesiology, from general operating room cases, to regional nerve blocks, to obstetric anesthesia. After … [Read More...]
The Arts
COVID Pandemic Anniversary
By Jaikumar Rangappa, MD, DABA, FACA
Retired Lt Col US Army
Desert Storm Veteran
Hampton, VA
WHO declared global COVID pandemic a year ago With remote online learning, students to school forgo With shortage of essential workers all did frown Republicans & Democrats in politics booed down. COVID virus spread everywhere like a wild fire As firefighters doused burning CA homes & tire Food and toilet paper were city people’s d … [Read More...]