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O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | S E P T E M B E R 2 0 1 5
Block Time Blues
Dedicated OR time is hard to get and harder to hold.
W
hat's more valuable and
precious than gold, Super
Bowl tickets and a free
lunch to any surgeon? Block time!
Scheduled block time is what surgeons
aspire and fight for. It's hard to get and,
once attained, it can be even harder to
hold on to. As a sage and wise anesthesiologist once advised me:
"Block time is earned, not freely given."
All surgeons have to take some shots early in their careers in order
to ascend to the elusive peak known as dedicated time. As a young sur-
geon, my starting times averaged 1 p.m. (Greenwich Time). My cases
were bumped more than a Times Square pickpocketer, and the head
nurse liked to place my cases after the vascular surgeon who was so
slow that the circulator kept a diary. When you follow another sur-
geon, anything can happen. The quick lap chole can morph into
Nightmare on Elm Street replete with extended open incisions and
frantic attempts to control bleeding. Four hours, 3 drains, 5 vascular
clips and 2 units of packed red blood cells later, my calculated 2 p.m.
start has transformed into permahold status.
In those early pre-block-time days, my wife (Saint Marie) never
knew when I would return home. At the start of the day, she didn't
know whether to pack my lunch or pajamas. I used to get home so
late I kept Conan O'Brien waiting.
Slowly, I earned dedicated 7:30 a.m. start times, and, after years of
apparently demonstrating reasonable proficiency, attained the Holy
Grail of every surgeon: 2 rooms. However, it's just as challenging to
maintain 2-room block time as it is to attain it.
C U T T I N G R E M A R K S
John D. Kelly IV, MD
