Surgeons are known for the knots they tie. For Ramona Bates, that is doubly true: Not only is she a plastic surgeon, but she also has a passion for quilting. Lately she's been sharing her personal and professional interests at her Web site, Suture for a Living. I had the chance to correspond with Dr. Bates about the common threads between her work and hobbies.
Dr. Genes: You started your blog almost a year ago. What prompted this foray online?
Dr. Bates: I noticed the Grand Rounds preview on Medscape and checked it out. It was around the time when all of the controversy was beginning with blogging anonymously and the ethics of medical blogging. Several things, not sure how to weigh them, prompted me — desire to learn more about using computer technology (how to post pictures, how to post articles, etc), thinking I "could write," wanting to do more than just leave comments, not liking the way plastic surgeons are thought of (Nip/Tuck, Plasticized, Dr. 90210) — we're more than just cosmetic surgery.
Dr. Genes: Which came first: your interest in suturing or sewing?
Dr. Bates: My sewing interest came first. I used to beg my mother for needle and thread. I have been sewing since I was 5 years old. The only interest Barbie dolls held for me was the clothes I could make for them.
My grandmother quilted; I have 2 of her quilts. I made my first quilt when I was 16 years old, but looking at it now — let's just say that my skills have greatly improved.
In medical school, I used to beg to get to do the closures. I hated it when they wanted to use staples. It meant I would not get to sew.
Dr. Genes: How does blogging fit in your schedule? You seem to write every day. When do you run, and quilt, and see patients, and do all of the other things that make up your day?
Dr. Bates: I didn't think it would become a daily thing when I started, but you're right — it seems to have. I write when I find the time. Unlike surgery, you can leave a post unfinished and go back to it later. Some will take me several days to write — for example, the tendon transfer series. I walk or jog my dog every day no matter what the weather. Some days I get to sew or quilt in the evenings. Others I don't.
Dr. Genes: What are some of your favorite posts, and which ones do your readers seem to like most?
Dr. Bates: My favorites don't always seem to be the ones that get the most interest. One that seems to continue to get interest is the one I did on Inverted Nipples. I think I did a good job with the series on facial fractures (zygomatic fractures, eye exam in facial trauma, orbital blowout fractures, and Le Fort fractures).
I wish I was good at facial fractures. I am not. There wasn't enough volume of these cases when I was a plastic surgery resident, so I came into private practice not feeling comfortable with them. Then there wasn't much volume in the early years of my practice to gain a comfort level with them. Later, I began to avoid them. When EMTALA [Emergency Medical Treatment and Active Labor Act] came along, I decided to withdraw my facial fracture privileges from the hospitals where I continue to do unassigned ER call. I felt that this was my only way to protect the patient from my lack of skill or insufficient skill or however you want to put it. I continue to sew up the facial lacerations, but if there is a fracture associated with the laceration, the ER now has to call someone else.
Still, I continue to read the journal articles about facial fractures. Because I learn by writing these posts, I thought I would try to tackle this topic over several posts. It still won't improve my OR skill with them, but it might clarify some of my understanding of them. I hope you will indulge me and maybe learn with me.
Dr. Genes: We'll indulge, and learn a bit, when Dr. Ramona Bates hosts Grand Rounds. Join her as she "ties together" the best online writing from doctors, nurses, students, patients, and other healthcare personnel from around the world.
Reviewed by Dr. Ramaz Mitaishvili
