Courses Don’t Make Experts, Practice Does
There is a quiet but persistent myth in modern professional life: attend a course, receive a certificate, and emerge somehow transformed into a competent practitioner. … Read more
ReadThe blog
Notes from both theatres.
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Trauma education, medical school guidance, and reflections from twenty-five years at the sharp end — written the way he teaches: plainly, and from experience.
What Future Conflict Will Really Look Like
We tend to imagine the next war using the language of the last one. Frontlines. Forward operating bases. Evacuation corridors. Protected rear areas. Helicopters lifting … Read more
ReadExpertise Is Earned With Your Hands
There is a particular confidence that comes from having done the thing yourself. Not read about it. Not watched someone else do it. Not quoted a … Read more
ReadWhy the Four-Person Expeditionary Surgical Team Is No Longer Optional
For decades, military medicine has been built around a comforting assumption: that there will always be a place behind the fight where casualties can be … Read more
ReadEvery Curve Ball Is Still a Ball: Lessons From the Trauma Table
In trauma, unpredictability is not an anomaly, it is the environment. You can be as prepared as any human being possibly can be: your drills … Read more
ReadThree Worlds, One Team: Preparing for Contingency, Humanitarian, and Kinetic Deployments
There is a quiet truth that every experienced deployable clinician eventually comes to understand: we do not train for one type of world, but for … Read more
ReadFrom Frontline to Killzone: How Modern Warfare Has Erased the Middle Ground
Because the battlefield has changed, and pretending otherwise gets people killed. The Frontline We Used to Know There was a time, and it’s not ancient … Read more
ReadThe Calm in the Storm: What Trauma Really Demands of You
Because when everything is falling apart, someone has to hold the centre. Trauma Is Noise – Deafening, Unforgiving Noise Alarms blaring. Monitors screaming. People rushing. … Read more
ReadKeeping a Level Head: Lessons I Learnt the Long, Hard Way
If I’m honest, controlling my temper was never something that came naturally. Not at the beginning. Not even halfway through my career. It has taken … Read more
ReadDoing the Right Thing vs Doing Things Right
Because perfection without purpose is just noise. The Subtle Difference That Changes Everything It sounds like wordplay, doesn’t it?Doing things right versus doing the right thing.But in trauma, … Read more
ReadThe Edge of Hope: How to Speak When They Might Not Survive
Because sometimes, you have to hold someone’s hope without lying to them. The In-Between There’s a particular kind of silence in trauma, the one that … Read more
ReadThe Hardest Words: Breaking Bad News in Trauma
Because all the training in the world doesn’t prepare you for this. The Longest Walk There’s a moment, after the adrenaline, when the monitors have … Read more
ReadThe Hidden Wound: Managing Duodenal Trauma
Because when the duodenum is injured, it doesn’t bleed, it waits. The Quiet Saboteur The duodenum sits there, tucked away behind the liver and stomach, … Read more
ReadThe Silent Killer: Understanding Blunt Abdominal Trauma
Because sometimes, the most dangerous injuries are the ones you can’t see. The Calm Before the Collapse Blunt abdominal trauma rarely announces itself.There’s no arterial … Read more
ReadThe Hollow Fury: Managing Gastric Trauma
Because a hole in the stomach is never just a hole. The Setup Blunt trauma loves the liver. Sharp trauma loves the stomach.And when the … Read more
ReadThe Quiet Traitor: Pancreatic Trauma and Its Deadly Neighbours
Because the pancreas doesn’t shout when it’s injured, it whispers, waits, and then destroys. The Lie of First Impressions Pancreatic trauma rarely looks bad at … Read more
ReadWhen Pressure Wins: Post-Trauma Abdominal Compartment Syndrome: With and Without Laparotomy
Because sometimes, the abdomen becomes the enemy. The Silent Strangler Abdominal Compartment Syndrome (ACS) is one of trauma’s cruellest tricks.The bleeding stops. The repairs are … Read more
ReadDamage Control Laparotomy: When Seconds Save Physiology
Because sometimes the victory isn’t closing, it’s coming back tomorrow. Start With the Truth Definitive surgery is a luxury.Damage control is survival. By the time … Read more
ReadAbove or Below the Line: Managing Stab and Ballistic Trauma to the Right Upper Quadrant
Because the liver isn’t always the only thing bleeding, sometimes air is rushing in where it doesn’t belong. The Trap of Focus Right upper quadrant … Read more
ReadDamage Control Resuscitation: Beating the Clock and Bleeding With Plasma and Whole Blood
Because in trauma, every minute without control is a negotiation with death, and death doesn’t bargain. The Most Important Clock in the Room We talk … Read more
ReadBorrowed Time: The Story of Liver Transplantation After Trauma
Because sometimes the only way to save the liver is to replace it, and sometimes, even that isn’t enough. When the Liver Crosses the Line … Read more
ReadWhen the Spleen Leaves the Table: A Trauma Surgeon’s Guide to Splenectomy
Because sometimes, preservation isn’t an option, and hesitating costs lives. The Reality in the Trauma Bay The spleen doesn’t leak; it gushes. When it tears, the … Read more
ReadControl First: Pringle, Aortic Control, Mobilise, Pack, A Practical Playbook for the Bleeding Liver
There are two certainties in hepatic trauma: the liver bleeds like it means it, and physiology dies much faster than technique saves it. When the … Read more
ReadWhen the Liver Fights Back: Managing Post-Traumatic Bilomas, Necrosis, and Abscesses
Because the liver doesn’t forget, it just waits for its moment to remind you that trauma doesn’t end when the bleeding stops. The Morning After … Read more
ReadWhen the Duct Fights Back: Managing Extrahepatic Biliary Trauma
Because even after you stop the bleeding, bile finds a way to remind you the job’s not over. The Wound You Don’t See Right Away … Read more
ReadThe Pentagram of Death: Where Physiology Turns on You
Because in trauma, the body doesn’t die from injury alone, it dies from its own biology spinning out of control. The Moment It Turns You … Read more
ReadGhosts in the Parenchyma: Managing AV Fistulas and Pseudoaneurysms After Liver Trauma
Because sometimes, the liver heals, but not without leaving a few traps behind. The Quiet Trouble After the Storm The bleeding stops, the packs are … Read more
ReadRemember Who’s on the Table
A reflection on why the patient is never just “the patient.” The Numbers Never Tell the Story We talk in numbers all the time age, … Read more
ReadThe Persistent Bile Drain: When the Liver Won’t Let Go
A reflection on those maddening post-trauma bile leaks, the slow, sticky reminders that the liver heals on its own time, not ours. You Know the … Read more
ReadThe Atrio-Caval Shunt Myth: Why the “Heroic” Move Was Never the Hero
In the chaos of a shattered liver and a bleeding retrohepatic vena cava, the atrio-caval shunt has always been the stuff of legend, but legends, … Read more
ReadThe Spleen Always Gets the Last Word: Lessons from the Trauma Table
The Unexpected Invitation to Chaos No one ever schedules a splenectomy. It’s never on the calendar, never part of the plan.It happens when a car … Read more
Read“The Liver Has a Temper: Reflections from the Trauma Bay”
It always starts the same way. The trauma pager goes off, some garbled voice shouting about a “stab to the right upper quadrant” or “high-speed … Read more
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