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06 May, 2023
I had just come down from Boston to Nassau County Medical Center on Long Island, New York. I did not yet have a dorm room assigned, so I slept in empty hospital beds of opportunity. I had to go back to Boston in two days to pick up and move my belongings down. The medical intensive care unit (MICU), was adjacent to the surgical intensive care unit (SICU), separated by an open through passage. I was wandering about, getting the lay of the land and checking out the nurses, when I noticed the medical team resuscitating a patient in the late afternoon. He would arrest and they would get him back. This occurred numerous times over a few hours. Then they posted a chest X-ray on the backlit frosted glass x-ray reading boxes along the wall across from the patient cubicles filled with blinking and beeping machines punctuated by the slow crescendo swish of ventilators, separated by curtains.
05 May, 2023
As a Junior Surgical Resident at Massachusetts General Hospital we had a rotation through Lynn Hospital. I had just come up from my Shock Trauma Internship at the University of Maryland. A 55 year old male presented to the Emergency Room with a severe heart attack. Back in the early 70s, people routinely died from heart attacks in community hospitals. There were no cardiac catheterization services, CAT scans, MRIs, sonograms. There was only one trauma center in the entire country! I just came from it, at the University of Maryland. Open heart surgery was in its infancy. During my rotation in open heart at University of Maryland in 1973, mortality was 80% and worse at other times!
By Luis Villar 04 May, 2023
How I learned NOT ALL DOCTORS ARE CREATED EQUAL. Case #1 Two Minute ballet During my first week as Intern at St Frances hospital in Baltimore a 50 year old male presented to the emergency room with a gunshot to the heart. He was leaving a restaurant with his wife. A man demanded his wallet. He gave it without resistance and was shot through the heart. His pupils were fixed and dilated, but his heart was still fibrillating. I intubated him and started large bore IVs with fluid resuscitation. But what next? I called the Chief Resident. “I have a gun shot to the heart, fixed a dilated. Can you show me what to do if he came in still salvageable?” “Keep resuscitating”, he commanded. “On my way”. I feigned resuscitation on his brain dead body until the Chief Resident arrived.

I just came across a rare photo of James W May Jr.  He was my Chief Resident as a Junior surgical resident on the Massachusetts General Hospital plastic surgery service.


Tall, handsome, brilliant, bow tie, Brooks Brothers, consummate gentleman and master technician. Totally unassuming, modest, generous, and an unquenchable thirst for knowledge.


My first day on the plastic service, I was assigned to assist Brad Cannon, a senior master surgeon.  We were performing a breast reduction.  As the case proceeded, the breast seemed kind of square to me. I asked, “Why does the breast look square?” Brad explained, “when you pull the flaps down, they all come out square”.  At that point the scrub nurse fainted and started to fall. I wheeled around and got my gloved hand under her head before it struck the floor.  I lifted her legs and she recovered.  We had both broken scrub and had to leave the room to re- scrub.  Brad continued the surgery as if nothing happened.  “Get me a new scrub” he calmly ordered.

I returned immediately, scrubbed, and gowned to finish the case.  It was my first reduction. The breasts looked square. 

The original scrub nurse returned just as we were finishing.  “What happened dear?” asked Brad.  “It must have been the square breasts sir,” she smiled behind her mask with a wink to me.


My second case that day was a breast reduction with James.  We called him Jim.  He was performing an inverted T reduction.  I noticed that the breasts came out nice and round.  After the case, I inquired, “I just did one of these with Brad and the breasts came out square.  Yours came out round.  Why?”


Jim came up and put his arm around my shoulders.  He was tall and leaned over conspiratorially in a soft whisper as if this was to be a deep dark secret between us, “IF YOU CUT THEM SQUARE, THEY COME OUT SQUARE.   IF YOU CUT THEM ROUND, THEY COME OUT ROUND “.  He smiled that James May Jr. smile.


This was perhaps my first and most important lesson in plastic surgery!

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