George Tolis @georgetolisjr Twitter profile

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George Tolis

@georgetolisjr

4 months

I emailed an ENT colleague in an affiliated hospital asking for a few minutes of his time to discuss a personal health issue. After some emails describing his world travels he suggested I call his office for an appointment. We are rapidly losing our collegiality as a profession.

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George Tolis

@georgetolisjr

2 years

It is quite funny how you can become an extremely successful and nationally recognized surgeon without being a good surgeon.

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George Tolis

@georgetolisjr

1 year

I did 22 pump cases in the last two weeks, but it is the stern email that my presence attestation statement in one of my op notes was delinquent and had to be done ASAP that really threw me off. Hard work is NOT the reason why physicians are burning out at alarming rates.

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George Tolis

@georgetolisjr

2 years

Dr. John Fox anesthetized his first cardiac surgical patient @Brighamanes in October 1981. Today I had the honor of working with John on the last two cardiac patients he will ever care for. He taught hundreds of residents while remaining loyal to his institution. Godspeed John!

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George Tolis

@georgetolisjr

2 years

One of the saddest realities of our time is witnessing a senior academic surgical figure being treated with pure disrespect by their younger bosses because of decreased financial productivity, disregarding their years of service and contributions to their institutions.

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George Tolis

@georgetolisjr

1 year

I viewed my residency years as a unique opportunity and privilege to be exposed to the maximum possible number of surgeries and clinical exposures and read about them at home while someone else was ultimately responsible for my actions. I never thought of myself as an employee.

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George Tolis

@georgetolisjr

6 months

It seems that in the absence of test scores and medical school grades, candidates are now flooding their application CVs with publications and presentations. Do we really want to encourage medical students to turn away from their textbooks and focus on meaningless research?

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George Tolis

@georgetolisjr

2 months

Cardiac surgeons involved in long cases should learn from our anesthesia colleagues and ask for another surgeon to come help us (or even temporarily take the case over) when things get tough. It is not a sign of weakness (unless the ego is fragile) and it is good for the patient.

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George Tolis

@georgetolisjr

1 year

We are clearly discouraging candidates interested in a clinical, non academic practice from expressing their preferred trajectory while interviewing for fellowship. Forcing candidates to pretend that they want to become surgeon scientists or global surgeons is disingenuous.

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George Tolis

@georgetolisjr

24 days

What was the norm when I trained has now become a federal offense. Attending discretion has been replaced by bureaucratic guidelines. Not sure patient safety is enhanced, but resident training definitely suffers and three highly reputable surgeons get dragged through the mud.

FBI Houston

@FBIHouston

25 days

#BREAKING Three heart surgeons at BSL Medical Center engaged in a regular practice of running two operating rooms at once while delegating key aspects of extremely complicated and risky heart surgeries to unqualified medical residents. More here: #HouNews

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George Tolis

@georgetolisjr

1 year

I have a group of 4-5 private practice colleagues who are over 20 years out and have performed thousands of cases over the years. We zoom once every three or so months and discuss cases that did not go as planned. More valuable than any meeting I have ever attended.

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George Tolis

@georgetolisjr

2 years

A CABG is the most humbling operation.

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George Tolis

@georgetolisjr

27 days

When your first born son gets ready to leave the house and start college in the fall, you revisit how you prioritized some things over the years and realize you can’t turn back the clock. Remember that the main reason to have a successful career is to better support your family.

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George Tolis

@georgetolisjr

3 years

The biggest threat to CABG is not stents, industry or the size of the incision and length of hospitalization and recovery. It is the substandard training and the fake case numbers that most programs offer these days leading to recent grads who can’t do the operation safely.

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George Tolis

@georgetolisjr

2 years

The decision to pursue cardiac surgery as a career should not take into consideration only the fascinating nature of the field but also the lifelong sacrifices and outside support required for continued success. We are doing a very poor job advising young doctors on the latter.

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George Tolis

@georgetolisjr

3 months

One of the best CT fellows I have ever trained is a DO grad. She subsequently turned down a job with us for a private practice job in the south. Everyone should be evaluated with an open mind when it comes to determining who will be given a chance for a post-graduate fellowship.

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George Tolis

@georgetolisjr

1 year

I strongly believe that if the true cardiac surgical giants from the 60s and 70s were working under today’s choking oversight culture, their achievements and contributions to our field would have been significantly curtailed.

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George Tolis

@georgetolisjr

2 years

I have the utmost respect for congenital cardiac surgeons. Not that any one life is more important than another, but the pressure of operating on kids (especially if you have some of your own) is something that I personally could not handle. Kudos to all of them.

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George Tolis

@georgetolisjr

5 months

I am strongly opposed to mandatory research in residency training-it contributes zero to a surgeon’s clinical acumen or maturity. I am also blessed to work in an open minded academic environment where my “heretic” opinion on this subject is respected and not used against me.

Allison Fitzgerald, MD, PhD

@allisonoconn

5 months

Tragic

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George Tolis

@georgetolisjr

2 years

A while back I met with the wife of a patient who had just undergone a routine CABG and found her devastated in the waiting room, worried about multiple low hematocrits and a cardioversion during the pump run. Real time access to online patient gateway is not always a good idea.

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George Tolis

@georgetolisjr

24 days

We are talking about someone who has written the book on aortic surgery, the premier minimally invasive surgeon in the US and the surgeon who got a 95 year old DeBakey through a type A dissection. Maybe they all know a thing or two about delegating duties in the OR. Just saying…

George Tolis

@georgetolisjr

24 days

What was the norm when I trained has now become a federal offense. Attending discretion has been replaced by bureaucratic guidelines. Not sure patient safety is enhanced, but resident training definitely suffers and three highly reputable surgeons get dragged through the mud.

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George Tolis

@georgetolisjr

2 years

When I was younger I used to admire surgeons who could flawlessly execute complicated operations. I now admire surgical leaders who are willing to do the right thing even if it comes with significant political cost. There is an abundance of the former, but a paucity of the latter

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George Tolis

@georgetolisjr

1 year

One thing that still keeps me up at night is thinking of specific patients that I lost early in my career that would have had a much better chance of surviving if I could do their operation today.

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George Tolis

@georgetolisjr

2 years

It must be a daunting task for an immensely successful and widely respected surgeon who is inevitably facing retirement in a few years to have to deal with the consequences of not having taken care of their family life for the last three or four decades.

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George Tolis

@georgetolisjr

2 years

Many trainees approached me at the Boston @AATSHQ meeting and asked for advice about what is the best way to hit the ground running once they graduate. I told them that they should learn how to do a CABG. That is the one procedure that you will be judged on more than any other.

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George Tolis

@georgetolisjr

1 year

Penalizing a surgeon for not using a diminutive IMA on an octogenarian or for reexploring a bleeding patient rather than transfusing them in the ICU until the bleeding stops ends up hurting patients. Scorecards that force surgeons to practice defensively should be revisited.

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George Tolis

@georgetolisjr

4 months

Becoming a doctor in the US is rapidly becoming a near impossibility for intelligent young men and women who are not independently wealthy and the medical establishment is doing nothing about it seemingly protected behind a fake progressive and politically correct facade.

Bryan Carmody

@jbcarmody

4 months

This is a surprising statistic: Only 23% of this year’s Stanford medical school class completed their studies in four years.

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George Tolis

@georgetolisjr

6 months

Some of the best residents that I have trained have gone on to take private practice jobs. I strongly disagree with comments similar to “unless you want to be an academic surgeon you should look at another program”. I am proud of training operators regardless of their h index.

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George Tolis

@georgetolisjr

1 year

Supportive bosses get out of their way to advocate for you in public, but are highly critical and brutally honest in private. Weak bosses are the exact opposite and won’t hesitate to throw you under the bus to others, yet will tell you how valuable you are for the team in private

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George Tolis

@georgetolisjr

3 years

My #1 take home message from AATS 2021 is that CABG is by far the most important operation that we do as cardiac surgeons. It is of utmost importance that we maximize BIMA utilization, completeness of revascularization and technical accuracy while teaching residents how to do it.

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George Tolis

@georgetolisjr

1 year

We also rarely discuss the long term superiority of open vein vs endoscopic vein, another example of sacrificing long term outcomes for short term benefit. This is a recent picture of two veins harvested from the same patient, one endo and one open. Guess which one is which…

Luis J Castro MD

@LuisCastroMD

1 year

CABGx3 on pump, performed 27 years ago (1996). All Grafts open, of course. Now, 93years old, needs TAVR. I’m so lucky to have learned from a true master, Vince Gaudiani. Perfectly prepared LIMA. Perfectly prepared vein. Devils in the details… @georgetolisjr @GianTorre610

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George Tolis

@georgetolisjr

2 years

I learn much more from private discussions with busy but nationally unknown colleagues than podium lectures of “giants” or their protegé(e)s who have not dealt with real cardiac surgical issues in a long time-if ever. The former should be given a platform to share their knowledge

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George Tolis

@georgetolisjr

2 years

I find the select and highly diverse group of FMGs that apply for residency positions to be more mature, motivated and accomplished than most US grads. Yet, many programs openly discriminate against them with remarkable impunity.

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George Tolis

@georgetolisjr

2 years

There are many successful colleagues I have encountered who silently wish they could turn the clock back and spend more time with their version of the folks in my picture at the expense of the society presidency or the endowed chair. I am thrilled I have not committed their error

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George Tolis

@georgetolisjr

2 years

Operating with an attending is so much fun and something academic surgeons should do once in a while. Partnering with a trusted colleague on a challenging case provides great care to patients and serves as a great work ethic example to residents.

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George Tolis

@georgetolisjr

2 years

Academic cardiac surgery has shifted its focus from advancement of the field to advancement of the careers of a tightly knit group of individuals who publicly have each other’s backs avoiding lateral criticism or accountability. The field and the working surgeons deserve better.

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George Tolis

@georgetolisjr

2 years

This is the only true annular +full LVOT enlargement. A pre-sewn double pericardial patch on a mitral prosthesis, with one patch acting as the new inter-atrial septum and the second patch adding circumference to the aortic annulus and no LVOT muscle underlying the aortic orifice.

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George Tolis

@georgetolisjr

1 year

Medical students who scrub for a dissection for the first time are awestruck. But when they don’t stay for the drying up part they only get a skewed view of cardiac surgery.

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George Tolis

@georgetolisjr

8 months

I have used bone wax in every single sternotomy I have done in the last 600+ cases and I have not had a single patient require bone debridement or a flap. Blaming bone wax for wound infections shifts the blame from a systemic institutional problem to an unrelated technicality.

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George Tolis

@georgetolisjr

8 months

Boston is absolutely gorgeous in the fall.

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George Tolis

@georgetolisjr

1 year

Building up a problematic surgeon (resident, fellow, attending, chief of division) to be something they are not in order to unload them from your environment and make them someone else’s problem is despicable at a personal level and also detrimental to our field, yet so common.

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George Tolis

@georgetolisjr

20 days

I do not practice simultaneous surgery. My institution does not allow it and it also makes me very nervous. Others do it very successfully around the country,expanding access to patients who need their life saving skills. OpNote billing lingo making it a federal offense is insane

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George Tolis

@georgetolisjr

2 years

The concept of a doctors’ or surgeons’ lounge may sound today like another long gone elitist concept of the past which fails today’s “inclusion” criteria; it was however a great, quiet place where you could unwind with colleagues who could understand your pain after a tough case.

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George Tolis

@georgetolisjr

2 months

One of the emptiest feelings a human can experience is seeing blood welling up behind the heart after an operation; only another heart surgeon can appreciate the angst this situation creates.

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George Tolis

@georgetolisjr

10 months

Brigham and Women’s Hospital has the best core of clinical, non-interventional cardiologists I have ever encountered. Their influence on the house staff is palpable. It is based on old school, patient-centered clinical excellence no fluff principles.

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George Tolis

@georgetolisjr

2 years

The biggest problem with cardiothoracic journal publications and meeting presentations today is that their primary purpose is not to share scientific observations and practice patterns but rather to achieve academic advancement in the authors’ institutions and academic societies.

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George Tolis

@georgetolisjr

1 year

This paper was published 37 years ago and is more interesting and relevant today than 95% of the garbage published in the current era. It was this stuff that got me interested in cardiac surgery, not diatribes about feelings, emotions and burnout mitigation strategies.

Faisal Bakaeen MD

@FaisalBakaeen

1 year

@djc795 @abadkhan2002 @Coronary4front @VictorDayan1 @rafasadaba @georgetolisjr @pomyers @JoeSabik @RuelMarc1 @GreggWStone @gbiondizoccai @ovidiogarciav @drmikefarkouh @mirvatalasnag @GianTorre610 @mmamas1973 @TulioCaldonazo Cooley’s experience

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George Tolis

@georgetolisjr

1 year

Did you do something in the 90s (or earlier) that would have gotten you fired on the spot today? I once wheeled a portable X Ray machine from radiology and took a patient’s CXR myself because it was taking forever for the tech to respond. I even said “X Ray, hold your breath”.

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George Tolis

@georgetolisjr

2 years

Burnout has nothing to do with hard work and long hours. It has a lot to do with being treated as a generic, non-unique and easily replaceable entity. Mitigation can only be achieved by non work-related sources-time for yourself and your hobbies, friends and family.

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George Tolis

@georgetolisjr

3 years

It seems to me that many of the “experts” or “life coaches” lecturing us on wellness and burnout originally held jobs similar to ours and quit them because they got burned out or just felt unwell. I am not sure about the efficacy of their advice. They do look well rested, though.

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George Tolis

@georgetolisjr

3 years

All great things have to come to an end. Thanks @MGHSurgery for trusting me with your patients but also with your residents, the most hard working, brilliant and driven group of young physicians I have ever encountered. Now on to an amazing opportunity at @BrighamThoracic !

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George Tolis

@georgetolisjr

1 year

I never pass up the opportunity to try out an unlocked @SteinwayAndSons in public display (this one @HarvardClub Boston), especially if it involves entertaining the great Duke Cameron! Mozart piano Concerto K414 in A major, first movement

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George Tolis

@georgetolisjr

2 years

The administrative burden surgeons face today is rapidly burning out the workforce. Younger grads are disproportionately affected and more underpaid, compounding the problem. Our Societies have to act now decisively, not with cookie Thursdays, life coaches and yoga instructors.

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George Tolis

@georgetolisjr

10 months

The phenotype of CAD has changed from mostly smoking-related, distinct proximal, large target disease to a diffuse pattern, metabolic syndrome/DM-related vasculopathy. The latter requires a higher complexity-intervention, both for PTCA and CABG with worse long term patency.

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George Tolis

@georgetolisjr

3 years

I have observed many surgeons who are amazingly engaging educators in a “wet lab” setting transform into intolerable tyrants in the operating room. I can only conclude that their reprehensible behavior is just a grossly mismanaged display of their crippling anxiety in the OR.

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George Tolis

@georgetolisjr

3 years

A previous cardiac operation is rapidly becoming a contraindication for open redo surgery in favor of percutaneous approaches. Unfortunately this is due to surgeons’ reluctance to do these operations which itself stems from lack of experience, poor training and outcome scrutiny.

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George Tolis

@georgetolisjr

1 year

It must be a very lonely feeling for a surgeon with a fabulous social media reputation and constant societal/meeting exposure but very limited surgical skills to apply (or even worse sign for) a high exposure job where they will have to do the occasional CABG.

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George Tolis

@georgetolisjr

1 year

The SVG for CABG, IABP for heart failure, heart transplantation and the Ross Procedure were all first done and reported in 1967. Cardioplegia and DHCA were introduced shortly thereafter. I envy the surgeons who used to attend the meetings in the 70s and 80s.

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George Tolis

@georgetolisjr

1 year

I don’t think we should be pursuing or rewarding 0% coronary mortality; many high risk patients who deserve a CABG will not be offered an operation. In my GS days, if you were 100% correct with acute appendicitis, you were sending too many patients home with the disease.

Coronary 4Front

@Coronary4front

1 year

Remarkably low CABG mortality rates. Is this sustainable with decreasing volumes? Can we effectively train the next generation when the median number of cardiac operations performed per surgeon is only 94 cases/year?

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George Tolis

@georgetolisjr

6 months

When I was a trainee in the 90s, the way to safely get rid of an underperforming surgeon was by blocking their academic promotion. Today, the safest way is to promote them to full professor and sell them as chief to a large tertiary center affiliated with an academic institution.

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George Tolis

@georgetolisjr

2 years

Do physicians realize the financial hardship they impose on many of their patients when they discharge them on Eliquis instead of Coumadin purely for the sake of their own convenience? The cost can literally drive some of the more vulnerable patients to the ground.

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George Tolis

@georgetolisjr

2 years

I think the biggest progress we have made as heart surgeons in the last 20 years is that we offer the same great operations that our predecessors perfected to older/sicker patients. Maintaining the same quality thus becomes of utmost importance, more so than the incision size.

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George Tolis

@georgetolisjr

4 years

The vast majority of “technical” issues with residents are actually “mental” issues created by well intended bad advice or downright malice and intentional intimidation.The majority of them can be intercepted and remedied, provided the teacher is willing to put the time to do so.

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George Tolis

@georgetolisjr

1 year

The in-situ skeletonized RIMA can often easily reach the mid LAD through the transverse sinus without crossing the midline if all mediastinal fat is resected from phrenic-to-phrenic, freeing up the LIMA (top of picture) for distal lateral wall targets, making future reentry safer

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George Tolis

@georgetolisjr

2 years

Again, not to sound like a broken record, but industry is so powerful that they can twist @NEJM editors’ arm to publish such a twisted conclusion. Industry and their conflicted authors should not be allowed to publish their outcomes on such prestigious platforms

Victor Dayan

@VictorDayan1

2 years

PROTECT TAVR. Must confess have not the ms (don’t have access). Great work. But awful conclusion. Never seen this. Authors are not to be blamed (Boston Sci funds study), @NEJM editor is to be blamed. Unforgivable.

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George Tolis

@georgetolisjr

3 months

CABG has worked great for five and a half decades with minimal improved iterations (LIMA and maybe BIMA). I don’t understand this insatiable drive to change it. Flushing toilets have not really changed much in more than a century and not much relevant research is underway.

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George Tolis

@georgetolisjr

1 year

@Coronary4front @American_Heart @ACCinTouch @JoshuaBeckmanMD @virani_md @GreggWStone @Drroxmehran @SABOURETCardio @HadleyWilsonMD @HollandTamis @ShariqShamimMD @CMichaelGibson @webmd11 CABG will never go away because it (by far) works better than any other intervention for chronic coronary artery disease. The biggest threat to CABG is a poorly trained new generation of surgeons.

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George Tolis

@georgetolisjr

2 years

Unsupervised simulation of a technical task can be a complete waste of a trainee’s time, leading to “learning” of the task in a very inefficient way. Even worse, it can lead to developing bad surgical habits that are very difficult to break on the surgical field.

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George Tolis

@georgetolisjr

10 months

I wish I had joined @BrighamWomens earlier in my career. This is the best professional and work environment for an entry level, mid level and senior cardiac surgeon.

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George Tolis

@georgetolisjr

5 months

Over the last 20 years surgical resident clinical exposure has decreased, (unofficially) required research years have become incorporated in training as have post-graduate subspecialty fellowships. This is program-selfish but unsustainable for non-independently wealthy trainees.

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George Tolis

@georgetolisjr

8 months

In the first 9 months of 2023 I have done 121 isolated CABGs. 53 of them had PCI in the past. CABG is changing rapidly; the quality of available touchdown points is deteriorating. Long term patency is likely to decrease as well, removing equipoise from the CABG vs stent debate.

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George Tolis

@georgetolisjr

10 months

The reason why many perfectly legitimate operations do not see widespread adoption is because they are not reproducible by the average surgeon, leading to excess complications such as postop MR (mini MVr), MI (OPCAB, BIMA) or death (Ross). Reproducibility is key to adoption.

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George Tolis

@georgetolisjr

9 months

In a few years, an open AVR will become a highly specialized operation with fewer surgeons able to safely perform it and TAVI will become the standard of care. Just look at open AAA and TAAA in vascular surgery. The industry forces are too powerful to be overcome by honest data.

The Society of Thoracic Surgeons

@STS_CTsurgery

9 months

STS and @EACTS have issued a joint statement in response to new TAVR/SAVR research on low-risk patients. Heart teams should exercise caution before translating these trials into clinical practice until additional data are available. Read more. #CTsurgery

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George Tolis

@georgetolisjr

1 year

I know I am getting old when I find myself criticizing the younger generation, but cardiology @BrighamFellows are absolute throwbacks. Hard working, clinically astute, collaborative beyond any surgeon’s expectations and true doctors to their patients.

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George Tolis

@georgetolisjr

10 months

Today I had the honor to help master surgeon Sary Aranki with a CABG. As the years go by and the number of surgeons with more experience than yourself is dwindling, these opportunities are not to be passed by. Wanted to do well… All the resident instincts are alive and well.

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George Tolis

@georgetolisjr

1 year

At $57.4/RVU that’s a whopping $689 (minus billing fees). No plumber will come to your house in Boston unless it is a $800 job or more, cash on the spot. The hospital however gets paid extremely well for the DRG. All this means is that although well paid, we are all employees.

Michael Cellini

@dr_cellini

1 year

Just had a surgeon tell me a cholecystectomy is 12 RVUs. Now THAT is ridiculous…

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George Tolis

@georgetolisjr

1 year

Every graduating cardiac surgery fellow should know how to harvest open vein.

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George Tolis

@georgetolisjr

2 years

Routine extubation in the operating room after a pump run doesn’t make much sense. Patients are cold, in pain, retaining CO2 and the ICU cannot use ventilatory mechanics to mitigate metabolic acidosis or venous bleeding. It is not surprising that it has not been widely adopted.

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George Tolis

@georgetolisjr

2 years

One of the most unfair and least discussed aspects of CT fellowship is that a hard working but technically challenged resident is afforded less opportunity in the OR and treated overall worse than a lackadaisical but technically gifted counterpart.

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George Tolis

@georgetolisjr

1 year

This is the third iteration of my personal journey training residents over the years. The previously published equivalence of 30 day and mid-term outcomes is maintained at the individual anastomosis patency level. Thanks to @JSurgEduc for hosting us!

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George Tolis

@georgetolisjr

5 months

Patient from several years ago with new onset heart failure two months after ascending aortic replacement-was told that his new murmur is a flow murmur that is normal after surgery. Aortic valve area was also normal as was AB index. What is the diagnosis?

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George Tolis

@georgetolisjr

1 year

It is the obligation of division chiefs or at least senior surgeons to take on the toughest cases and delegate the easier ones to their junior partners, not the other way around. Maybe the “giants” should dedicate a discussion of the above in one of our national meetings.

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George Tolis

@georgetolisjr

3 years

I accidentally left my phone at home the other day but had the best and most productive work day. Two cases,sit down lunch and check with office between cases, like the old days. When I got home, I had 136 emails and 13 texts.What has generated all of this extra unnecessary work?

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George Tolis

@georgetolisjr

2 months

In a national robotic mitral meeting last week, a speaker giving advice to up and coming robotic surgeons publicly advised them not to publicize their early failures because this way “you hurt all of us”. This is the crappiest advice and also the epitome of academic dishonesty.

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George Tolis

@georgetolisjr

2 years

This is still the culmination of every year, a time to forget about CABGs, root enlargement definitions and Prolene and by far the most fulfilling family outing of the year. Merry Christmas to everyone!

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George Tolis

@georgetolisjr

1 year

Has anyone else noticed that the most recent wave of cardiac surgeon rising giants/influencers/professors etc have achieved their fame by talking or publishing data about a procedure mostly done by cardiologists?

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George Tolis

@georgetolisjr

1 year

Despite what you may hear at national meetings I can tell you that 21 years into this business, the #1 reason why outside cardiologists call me is to refer a CABG. If you don’t learn how to do a CABG you will fail early in your career-unless you have a sweetheart protection deal.

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George Tolis

@georgetolisjr

1 year

Patients are pleasantly surprised-even amazed-that I round on them every day. They have unfortunately been exposed to a medical system which relies on shift coverage, physician extenders substituting for PCPs at home and the rounding hospitalist “du jour” when admitted in house.

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George Tolis

@georgetolisjr

1 year

It is time people stopped trashing saphenous vein grafts. They are extremely helpful-even life saving-in the short term and can display excellent long term patency if well harvested, are normal in caliber and are anastomosed to target vessels with great run-off.

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George Tolis

@georgetolisjr

1 year

Coronary endarterectomy is an extremely useful technique providing revascularization options to otherwise inoperable patients, but has fallen victim to public reporting, STS stats not giving it its own risk profile and overall surgeon risk aversion.

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George Tolis

@georgetolisjr

2 years

A patient with a 20% LVEF and a normal RV and low CVP is an entirely manageable candidate for CABG. A patient with 30% LVEF, moderate to severe RV dysfunction and cardiac amyloidosis is essentially inoperable. Risk adjustment models consider the first case higher risk…

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George Tolis

@georgetolisjr

10 months

Having just recertified in both General and Thoracic surgery, I feel that recertification is purely a money making business that does not test anything about knowledge on the field. It should consist of a secure written part or be abolished altogether (as was the case for years).

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George Tolis

@georgetolisjr

2 years

As tempting as it is to close a marginal patient’s chest after a long operation for the sake of future convenience,I have never been STAT called by the ICU at 3am to close a patient’s open chest.

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George Tolis

@georgetolisjr

6 months

Every doctor that I have operated on except for one has specifically requested that I do their operation myself and not help the fellow do it. The one who didn’t was a residency program/medical school clerkship director who asked me to use my judgment. I did his CABG skin-to-skin

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George Tolis

@georgetolisjr

2 years

The ideal boss is someone who wants you to unconditionally succeed and anticipates potential issues with your actions (justified or not) and intercepts their consequences. It is amazing how many successful-in paper or publicity-bosses lack these essential leadership traits.

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George Tolis

@georgetolisjr

1 year

The number of young CT graduates who were pushed through the training process despite lagging in their performance (often by no fault of their own) and are now unemployable and seeking advice about their surgical options is increasing rapidly. Most resort to doing ECMO or ICU.

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