This study proves what many of us on the frontlines of health care intuitively know. Hospitals are not corporations. Applying corporate metrics to hospital operations does not necessarily translate into better outcomes. Clinicians are the key to hospital functions.

The new recruits for surgical waitlist reduction team have arrived. Do or do not. There is no try. #starwars #maythefourthbewithyou⚔️

“The death of truth is the ultimate victory of evil. When truth leaves us—when we let it slip away, when it is ripped from our hands—we become vulnerable to the appetite of whatever monster screams the loudest.” Mon Mothma. #maytheforthbewithyou #maythefourthbewithyou⚔️ #starwars

Wow This is amazing. Worth the watch. www.commondreams.org/news/lego-vi...

Life is not fair. Why do kids get cancer? Why do good people get hurt? Why do bad people become world leaders? Why do innocent families get bombed? Why do millions end up becoming collateral damage in a war of pride and ideology? I don’t know. Sometimes, all I can do is sit in the rubble.

Plastic bronchitis looks like this. Not sure about the NEJM AI photo.

Actual photo of bronchial casts. No AI here. These were retrieved from the tracheobronchial tree of a young child with congenital cardiac condition. These casts are made of lymph and mucous squeezed into the airway and coagulating together to critically block the airway tree.

There’s nothing wrong with doing research. The challenge is that AI tools like ChatGPT confidently present generic information that, depending on the prompts, may not be fully accurate, up-to-date, or applicable to the patient in front of me.

I complain about the weather and the traffic. My friend in Lebanon is a surgeon. She treats victims of war. Trauma and uncertainty are the constant in her life.

Thursday, 3.45pm, I was focused on the complex operation at hand. I did not realise that there were people observing my work. I’m just glad that the teamwork made the dream work. Of course this was AI generated. But how do you verify it? How do you check the validity of any online information now?

How much value would you place on expertise and experience? Increasingly, patients come with their ChatGPT research results. I respect an engaged patient. I also know that we have all been habituated insidiously to believe that AI output is infallible.

The International Society for the Study of Vascular Anomalies update their classifications and diagnostic terms regularly to include new pathologies, genetics and clinical information. The old terms and new understanding don’t always match. Not everything is a haemangioma.

Four astronauts in a capsule called Integrity and a Chicagoan Pope have restored my faith in faith, science and humanity.

Every instrument has been carefully designed for a purpose. Your talents and your gifts must serve a greater purpose than yourself.

#truth #surgery #surgeon #doctor

Christianity is not English, Italian or American. It did not start in majestic European cathedrals with organ pipes and high-pitched chants. Christianity began in the dust of Middle East Palestine, on the floor around communal meals, at a public execution site, and an empty tomb.

A story so incredible. A twist so unbelievable. A day that changed everything for many around the world. For those who celebrate and know that this day is the beginning of healing, #BlessedEaster. (This picture was taken in winter 2023 in #Hobart #Tasmania at a Dark Winter festival).

Death is part of the journey of humanity. Death to narcissism. Death to greed. Death to pride. Otherwise you might atrophy into a shrivelled bitter person.

How could a day marked with torture, blood, betrayal, deceit, mob injustice and violence be good? I had to investigate this myself and found that there’s so much more than the commercial packaging of the story of Easter.

Nasolacrimal duct cyst in a 1-week-old boy. The tear duct opens into the nose under the inferior turbinate. That’s why you sniffle when you cry. This one is blocked, causing nasal obstruction and teary eye. Once removed, the tears flow normally. #ophthalmology #entsecrets #surgery

Tumours can arise anywhere. The oncologic surgeon in me is driven to excise every tumour completely. The facial plastic surgeon in me is driven to leave the most perfectly inconspicuous scar possible. It’s ok to be a perfectionist sometimes, no?

A procedure to remove the tongue, or part of. Usually performed for cancer but sometimes partial glossectomy is performed for severe airway obstruction. There are many tumours that can grow on the tongue. Tailoring the procedure for the pathology is essential.

The Pitt is amazingly written and brilliantly acted. Every episode carries so much weight. There is a lot to unpack. I had to stop watching a few times because many of the storylines were deeply triggering to me. Watch and learn. #thepitt

What a multidisciplinary cancer surgery team looks like. One team does the resection, another prepares for reconstruction. This was more than 10 years ago in Canada. I was raising a radial forearm free flap to reconstruct an oral cavity cancer defect. We train like our patients’ lives depend on it.

Adults get cancer. Kids get cancer too. If something does not feel right or look right, please get yourself assessed by an appropriately trained medical professional. Check your clinician’s training and expertise.

I stood where the Tasmanian Symphony Orchestra would play. Beautiful hall with gorgeous acoustic and aesthetic. For these few days of ASOHNS26, this room was filled with science. Art and science together is beautiful symphony.

Cutting the throats of little children. The story of evolution of a specialty.

There’s a name for almost every bump, ridge, slit, fissure or opening. The intricate beauty of the bones that make up your head. There’s so much beauty under your skin. As a head and neck surgeon we get to immerse ourselves in the science and art of it all. #surgery #headandneck

Finishing prep for a talk to medical students interested in surgery. Anything I should share with these future doctors? #surgery #surgeon

Carving a rib graft. In #ENT Head & Neck #surgery we use the rib as a source of bone and cartilage that we can use to reconstruct the nose, the larynx or the ear. I love to do this as it truly is a creative craftsmanship. 1/2

Parotid #cancer. This is a rendered image from a real photograph of a patient of mine. There are over 40 tumours that can arise from the parotid gland. My youngest parotid tumour patient was less than 1 year of age. The oldest was over 90. #Headandneck cancer affects any age. #ENTsurgery #surgeon

I did my Advanced Head & Neck, Facial Plastic & Reconstructive Surgery training in #Canada. I love #Canadians. They lead the world in many things, especially in decency. We need kindness and decency in this world to resist the orange curse. May good people of this world stand up for truth & decency.

On a medical mission trip to West Timor many years ago. I remember vividly teaching a young doctor how to do a few operations knowing that when our team is gone, she’s the only doctor left to manage every kind of ailment in her region. What a huge responsibility. What would you do if that were you?

Have a look at the scan. And look again. You might think this is a tracheostomy patient, but it’s not. This is a sideway (saggital) view of the airway of a patient who has had a total laryngectomy. Direct airway into the trachea. No voicebox. #headandneck #ENTsecrets #headandneckcancer #surgeon

Big submandibular salivary stone extracted. Depending on size & location, this can be accessed through the mouth or through the neck. Sialendoscopy also works in smaller stones. #headandneck #saliva #ENT #surgery #surgeon

I started the morning with a 6am zoom call with UK, US & Netherlands to collaborate on a guideline for management of severe drooling (sialorrhea). Drooling is a modifiable condition that has medical, social, psychological & practical complications. Can you think of these complications?

It is finished.

The message of Christmas is joy, peace and rest entering a weary world. As a human being, I too, need to rest from all the major head and neck tumours, complex airway conditions, vascular anomalies & congenital malignancies that have kept our team occupied this year.

One of the harder things that I had to do this year was to write a letter with kindness and generosity when my raw emotion was anger and hurt. I wonder if you had to ever do a similar thing? How did it go?

The Team at Melbourne Ear Nose Throat & Airway Clinic says goodnight to 2025. It has been our privilege to serve you this year. Our office will open again on Wednesday 7th January 2026. May you have a restful holiday season.

Here’s an axial cross-sectional CT scan of a blocked nose. The septum and nasal bones are extremely twisted. Every blocked nose has a different cause: anatomical, allergic, sinugenic, tumour, etc. #ENT #surgery #surgeon

With 6 fingers and 6 degrees, the surgeon wields their scalpel. That’s not a knife. THIS is a knife.

Microscopic view of the vocal cords. Hoarseness/hoarse voice/dysphonia that is persisting could be a sign of something sinister. There are many lesions that can arise out of the vocal cords, from benign to malignant conditions. Get your dysphonia checked by a qualified expert. #ENT #surgery #surgeon

In the aftermath of the mass shooting at Bondi Beach, 50,000 Australians lined up to donate blood. Aussies literally went beyond thoughts and prayers and bled for the victims. Some of this blood donated voluntarily will go to the shooter in critical care.

My life was changed by a Jewish carpenter who would have celebrated Hanukkah with his community in the Middle East. I sit in the rubble & I stand with solidarity with my Jewish friends and colleagues here in Australia. Today the hospital paused to light the menorah in a beautiful ceremony of unity.

Thoughts & Prayers. And Actions: Donate blood, tighten gun laws, crowd fund, attend memorial services, light candles. Australia shows that you can retaliate with courage & kindness.

I know people who will walk into this Christmas season not with peace and joy but with pain and suffering. Quotes, abstract theology & applied science do not bring answers. Hope and healing need to be tangible through a person. We are wired for human kindness and connection.