Posts
My blog.
The learning curve nobody warns you about
The 10,000-hour rule is told by people who never counted. The hours are not linear — and the plateau is where judgement is quietly built.
What a fracture clinic is actually optimised for
A fracture clinic is graded on throughput. The patient experiences something else entirely. The gap between the two scorecards is where all the interesting
How a reverse shoulder cheats physics — an interactive explainer
Why putting the ball where the socket was lets a torn-cuff shoulder lift again. Toggle the geometry and watch the deltoid's moment arm grow.
Glenoid version, in your hands
Why a few degrees of retroversion matters — with a baseplate you can tilt yourself. Drag the sliders and watch the failure risk climb the curve.
The cloud is just someone else's computer — and your patient's data is asleep on it
Most clinical tools assume the data should live in someone else's data centre. For a great deal of what clinicians build, that assumption is quietly backwa
What live navigation actually changes in shoulder replacement
Navigation for glenoid baseplate fixation is usually sold as precision for its own sake. The real value is what it does to your worst cases.
Your femur is hollow, and it did that on purpose
A long bone resists bending far better than the solid rod it could have been — at the same weight. The reason is geometry, not material, and the skeleton w
Robert Liston and the operation with 300% mortality
The fastest knife of the pre-anaesthetic era, and the famous amputation that supposedly killed three people. The legend is irresistible. It is also, sadly,
What the checklist actually fixes
A reading note on Gawande's Checklist Manifesto. The list is not about memory. It is a device for flattening hierarchy just long enough for someone to find
The same easy 5k in three cities
Run the same slow five kilometres in three places and each one quietly tells you something the daytime works hard to hide: the pavements, the light, and ex
The rotator cuff is a set of guy-ropes, and that explains a lot
Why a torn shoulder still lifts the arm sometimes, and refuses other times. It is levers and angles, not magic. Drag the line of pull and find out.
Before the FRCS: what bone-setters knew
For centuries fracture care belonged to families of bone-setters, not surgeons. Some of what they practised survived peer review remarkably well — and one family changed surgery itself.
Trepanation: the operation that refuses to die
Humans have been drilling holes in living skulls for about 7,000 years, and a surprising number of patients survived. What the holes tell us, era by era.
How long does a new hip last? It depends who is asking
A joint replacement does not have a use-by date. It has a survival curve, and reading one honestly means asking who the patient is. Poke the curve and see.
Two clocks, one surgeon, and the case of the missing morning
Fly east, operate at dawn, and your body insists it is the middle of last night. A live body-clock dial of the best and worst hours to operate.
The first surgical textbook, and the first honest "I don't know"
The Edwin Smith papyrus is the oldest known surgical text. Its bravest cases are marked an ailment not to be treated — medicine's first honest limit.
I replaced an enterprise system with a laptop and a weekend
A single SQLite file did what a six-figure platform could not. Sometimes that is the right call, and sometimes it is a trap. Race the queries and decide.
Being Mortal: what "a good day" actually means
A reading note on Atul Gawande's Being Mortal — autonomy, the limits of medicine, and why a surgeon should ask what a good day actually looks like.
Why surgeons should build their own software
The tools clinicians are given are built by people who have never carried a bleep. The gap between workflow and software is a design brief.
Comping: what jazz taught me about taking a history
A good history, like good comping, is mostly knowing when to shut up. Tap out a phrase and watch something gentle answer in the space you leave.
Your screen is lying about colour, and that's the clever part
A phone screen has no yellow pixels, yet shows you yellow. That isn't a cheat — it's additive RGB and the quirks of your own eye, doing exactly their job.
How to find a significant result in pure noise (please do not)
p<0.05 does not mean what most people think. Keep testing the same nothing and a significant result will eventually appear. Watch the trap spring, live.
Everything films get wrong about an operating theatre
The flatline that beeps urgently, the chatter, the surgeon scrubbing then touching the door. Step through four movie OR scenes and spot what is wrong.
The Fermi paradox, for tired people
Where is everybody? The Drake equation is less a calculation than a row of knobs measuring our ignorance. Twiddle them; watch the answer swing wildly.
Nothing here yet — pick another topic.