Publications Update # 7

Publications Update # 7
Photo by Brad West / Unsplash

Non-Medical Article of the Week

If you are a trainee reading this newsletter, you might wonder why I am sending you an article titled 'Tips For Being Rich.' Trainees and, for that matter, many new attendings are anything but rich. Nevertheless, the tweetorial has some practical advice about money and life. The two I want to highlight are:

Tip # 1 (2/17) - Time is your limiting factor - not money! Hire help to make it possible for you to help others - i.e., your patients, your trainees, your staff, etc. Find someone to come and clean your house, get your car detailed, automate your groceries - use instacart, find someone who can cook a healthy meal and deliver - you get the idea.

Tip # 7 (8/17) - Spend money and time on your health - When you save time using Tip # 1, use that time on yourself - do what re-energizes you. Reading a book, going for a walk, spending time with your family .... it's worth it.

Want to go deeper in this topic?

The more significant question is, "Does money make you happy?"

The more straightforward answer you may have heard is - NO. It turns out it's not that simple. In 2010, Daniel Kahneman (Nobel Laureate) wrote a paper published in the Proceedings of the National Academy of Sciences (PNAS) had the following conclusions:

> Emotional well-being also rises with log income, but there is no further progress beyond an annual income of ~$75,000. Low income exacerbates the emotional pain associated with such misfortunes as divorce, ill health, and being alone. We conclude that high income buys life satisfaction but not happiness, and that low income is associated both with low life evaluation and low emotional well-being.

However, Daniel Kahneman collaborated with another team in a recent paper to revise their conclusions. More money can translate into more happiness for about 80% of the population. For the remaining, labeled as baseline unhappy people in this study, more money does not make you happier. The ceiling effect happens at about 500K. 

But ultimately, data strongly supports that PROSOCIAL spending (spending your financial resources to help others) correlates strongly to well-being.

Here is a link to this paper if you want to read it:  


Do you use a closing tray? There is a lot of confusion on this topic. Mayo clinic's SSI reduction bundle included a closing tray, and in colorectal surgery (see the image below), there is consensus to use the closing tray. However, a recent paper from Ohio State did not show any benefit in SSI reduction with closing trays. This new study does not apply to the US (enrollment was in low- and middle-income countries). Still, it did show the benefit of using a change of gloves and clean instruments when closing the abdomen to prevent surgical site infections.

Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection (ChEETAh): a pragmatic, cluster-randomised trial in seven low-income and middle-income countries
This trial showed a robust benefit to routinely changing gloves and instruments beforeabdominal wound closure. We suggest that it should be widely implemented into surgicalpractice around the world.