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Bruce H. Campbell, MD FACS
Retired Head & Neck Surgeon | Author | Essayist

Bruce Campbell, MD FACS
A Fullness of Uncertain Significance
A Fullness of Uncertain Significance - Norbert Blei August Derleth Award

Most recent essay

Updated: Dec 31, 2022


When the pandemic hit in March 2020, Adina Kalet, MD MPH, the director of the Kern Institute, asked a small team of MCW faculty to create a newsletter that would keep our medical community connected during a very uncertain period in medical education. With the wonderful support of Kern Institute staff, the Transformational Times newsletter premiered in mid-March 2020 and has published weekly since then.



The birth and growth of the Transformational Times



The newsletter consisted of four to six (or more) essays each week, plus poetry, artwork, and announcements.


Although the focus was on innovative approaches to medical education, our team tried, as much as possible, to highlight the thoughts and efforts of underrepresented minority students, residents, and faculty. This became particularly important as 2020 unfolded, first with the murder of George Floyd and subsequently with the acute awareness of racism in America. More voices were added as the country churned through the lead up to the 2020 election, a need to talk about issues affecting women and reproductive rights, widening disparities affecting both urban and rural populations, veteran's issues, and the 2022 midterms. New national conversations emerged which affected, both tangentially and directly, medical education.


The team widened its roster to include students. We developed thematic issues. We coaxed more “reluctant writers” to share their work. Even though life seemed to be taking small steps back toward normality, we realize that our newsletter had developed momentum, a local/regional readership, and a mission.


It was also clear, however, that most of the previously published essays quickly disappeared into the internet ether. How might we get some of the most compelling writing in front of a larger audience?



Creating our first book


In May 2021, Dr. Kalet suggested that we create a book of selected essays during the newsletter's first sixteen months. Since I had published my own book through Orange Hat Publishing | Ten16 Press in nearby Waukesha WI, I facilitated conversations between Orange Hat and the Kern Institute. The teams agreed to work together to create a book of essays.


Working with Editor Jenna Zerbel, Art Director Kaeley Dunteman, and Publisher Shannon Ishizaki, we were able to go from a concept to a book in less than eight months. Character and Caring: A Pandemic Year in Medical Education was published in December 2021.


To create the content, we hired a reader who reviewed each of the published newsletters and sorted the essays by relevance to a wider audience. Once I had the list, I re-worked each of the essays, adding short summaries and editing them for clarity and consistency.


This process was not easy. While preparing my own book, I knew the essays already and had used (relatively) consistent styles of grammar usage, punctuation, and narration. With the new book—and although I had previously edited most of the essays—there was a lot of work to be done to make them consistent and readable. I also had to write the rest of the sections needed to create a book.


The process, though, was very rewarding. I enjoyed editing for others. I become more comfortable sprinkling commas and paragraph breaks into the essays. I tried very hard to leave intact what I could yet offered suggestions and alterations to improve clarity and readability. I incorporated changes that were consistent with grammatical rules and usage. It became a mission to perfect word usage, build arguments, and solve a puzzle. I was invigorated.


The book turned out well. The Kern Institute and MCW gave copies to several other schools and to each 2022 MCW graduate.



Creating our second book



In May 2022, Dr. Kalet suggested that we do another book, Character and Caring: Medical Education Emerges From the Pandemic, as a follow-up to the first volume. We started the process again.


The person who selected the essays previously was not available, so I spent several days culling through the newsletters that had been published since the cut-off date for the first book. I gathered essays into nine themes with each section introduced by one of Dr. Kalet’s essays.


I created a section of “Notes,” which amplified essays with references and information. I also created sections for “Contributors” and “Acknowledgements.”


After building one master document, I found that it was about 15% too long, so I cut several great essays and trimmed others that were to be included. Eventually, the book was down to about 65,000 words.


Two of the other editors, Kathlyn Fletcher, MD, MA and Wendy Peltier, MD, offered to create a study guide, selecting key essays from each section for discussion and reflection. That was a wonderful addition.


Again, Jenna Zerbel did wonderful work as the book's editor. She has a great and careful eye. The MCW faculty editors each reviewed the edited version and found only a few things that remained to be fixed. Kaeley Dunteman did a great job with layout and with identifying open access images to introduce each section. I even snuck one of my own photos from Kenya into the book to open the “glocal” section.


With all of the changes approved, the book went to the printer in late November 2022 and was back in time for the New Year. The book was another project that went from concept to completion in eight months.


Like the first volume, the editing process went well. Some of the essays required pretty extensive revision prior to publication, but most of the work again involved making the styles consistent throughout the volume. Because I have more experience and confidence, this volume went more smoothly than the first.



Next steps and challenges


We know now that we can create quality books, thanks to our partners at Orange Hat and the Kern Institute. Dr. Kalet, working with Kern Family Foundation, envisions creating the MCW_Kern Institute Press to publish at least two affordable, state-of-the-art medical education-related books each year. We are already in conversation with three groups with great ideas that deserve wider exposure.


We need to better understand how to get the word out and to get books into people’s hands. Mass marketing is expensive and low-yield. How do we reach our primarly market and "tell our story"? How do we best utilize social media? What is the optimal way to use discounts? Networking? Electronic formats? What are our targets? How do we get to the next level?


I enjoy writing but have re-discovered that I enjoy editing. These books, and our future projects, give me the opportunity to explore these twin passions. It should be fun.










 
 
 
  • Writer: Bruce Campbell MD
    Bruce Campbell MD
  • Jan 27, 2022
  • 3 min read

Updated: Jan 27, 2022

One day during my residency many years ago, an older man arrived in clinic with a large neck mass that had been growing for months. The mass, which by then was the size of half a baseball, wasn’t bothering him much, so he hadn’t rushed in. He finally made an appointment to see if anything should be done. “I only came because my family has been bugging me,” he said.


One of my fellow residents evaluated him. Standing behind the man as he sat in the examination chair, the resident cupped his hand over the mass and moved it side-to-side and up-and-down. It wasn’t painful and did not seem to be extending deeply into the tissues—those were good things. As the resident continued the examination, I am certain he was asking his fingers to tell him more. Maybe he was wondering, What does this mass represent? What scans and biopsies will I need to order? What’s going on here?


Suddenly, the resident and the patient yelped simultaneously. I heard the commotion and rushed to the room. The resident and patient were both wide-eyed. “It came off!” the resident exclaimed. “As I was palpating the mass, it just fell off!” He stood still, holding the mass tightly against the man’s neck in case he had torn any underlying blood vessels. The man looked surprised but, otherwise, seemed fine. There was no blood accumulating. I reached for supplies.


“Quick!” he said. “Grab some gauze!”


I opened a couple of gauze pads and got ready. The resident gently pulled the mass away from the man’s neck. Nothing happened. The circular area where the mass had been attached was red and a bit angry looking. The surface oozed, but only a little. Within a couple of minutes, we had cleaned the neck skin, stopped the small amount of bleeding, and taped on a dressing.


The man looked in a mirror and grinned.


“You’ve got magic hands, Doc!” he said. “Now, my family will leave me alone.”


The neck was, basically, back to normal. I picked up the mass and pressed against its surface with my hand before dropping it into a specimen container. It was firm, and the size and shape of an old-style paperweight. No harm, no foul, I thought.


There was more to the story but, given the decades that have passed since then, I don’t remember either the pathology or what treatment was needed. I do know that I never again saw a large, worrisome neck mass simply come off in the physician’s hand during a physical exam.



Using our hands for work


Our hands are central to what we do. When I have had to offer virtual visits over the past couple of years, I missed the “hands-on” of clinical medicine. With a patient in front of me, I can fill in the gaps in their story while performing the examination. I check for pulses, areas of numbness, muscle strength, and joint function. I palpate tissues and press my fingertips into tender areas. I hope that my patients will trust me to use my hands wisely as I search for masses, perform procedures, and remove cancers. In return, my hands offer a moment of connection with the patient and allow me to feel my own sense of purpose more intently.


Our hands, variously, bring healing, inflict pain, and provide comfort. If all is well, our hands might signal that everything is fine. If all is not well, they might offer solace.



Our hands are integral to our identities

Too often of late, we have been forced to trade our hands-on moments for virtual visits, Zoom conferences, and social distancing. In clinic, we bump fists or wave to patients and family members when, once, we would have shaken hands or, even, hugged. I miss the personal contact. Maybe that will change again soon. Our hands are not idle, of course, since our fingers must still complete the day’s medical record notes.


Philosopher Immanuel Kant noted, “the hand is the visible part of the brain.” This makes sense to me, confirming that our hands extend into the world to fulfill our missions and gather information from everything with which we come in contact. That might be why I remember that day in clinic when a big neck mass simply came off of a patient, and I held it in my wondering hand.




_____________


A slightly different version of this essay entitled, "Using our Hands for Medicine and Wellness," appeared in the January 28, 2022 issue of the Transformational Times, a newsletter of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.



 
 
 

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