PGY-3 urology · written mid-training
Most surgical teaching comes down from mastery. This is the other vantage — topics, essays, and research written from inside the climb, while not-knowing is still fresh enough to be useful.
Field card
Writing
An autobiography, told through the oldest story about strength. Hercules was born strong, but strength was never what made him a hero — the labors were, and the service they were for. A life measured the same way.
Read essayAn essay on the solitude no one warns you about. The gods sentenced Sisyphus to roll his stone up the mountain alone, forever, and called it the cruelest thing they could imagine. I think they were describing residency.
Read essayA ureteric stent at the bedside — no fluoroscopy, done solo, and watched the whole way in. On taking an old operation apart and rebuilding it for a new room, and the seniors who hand you the reason instead of just the steps.
Read essayAn essay on training, told in the shape of a circle. The serpent that eats its own tail is four thousand years old. I think it was always a drawing of residency.
Read essayTeaching topics
A young man, sudden scrotal pain, and a clock that started before he reached you. Why the OR is the investigation and Doppler is the tiebreaker, never the verdict.
A rigid, painful erection past four hours is a compartment syndrome of the penis. One needle is both the diagnosis and the start of treatment — and the corpora are dying while the patient sits in the waiting room, often too embarrassed to say why.
Flank pain, a fever, and a stone the urine can't get past. This is one of the few things on a urology service that can quietly kill a ward patient overnight — and antibiotics alone are not the treatment.
Necrotizing fasciitis of the perineum, where the skin lies about how sick the patient is. Pain out of proportion, septic physiology without an obvious source — and a mortality that climbs with every hour you wait for a scan.
The patient who can't find a position that helps, a CT that takes four minutes, and a decision tree that hinges on two numbers: how big and how high. Most stones pass on their own — your job is to know which ones won't, and which 'stone' is an aneurysm in disguise.
Lower urinary tract symptoms are common, the prostate is the usual suspect, and the whole art is matching the size of the gland and the size of the bother to the right step on the ladder — without missing the cancer, the stricture, or the bladder that has quietly given up.
Peer-reviewed work
Original research, systematic reviews, case series, and surveys — every paper indexed on PubMed, described for a reader.