Chris McCulloh, MD

General surgery resident. Pediatric surgery research fellow. Passionate about the intersection of technology and machine learning with healthcare. Person with a disability (spinal cord injury).

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Big (Computer) Brains

pathnet.png (Source: DeepMind PathNet)

I recently wrote a few thoughts on artificial intelligence (AI), primarily in response to Geoffrey Hinton‘s excellent short interview. There was one other concept in this interview that I wanted to touch on, which is the relationship between AI and our own intelligence.

In particular, Hinton concludes:

Eventually, I think the lessons we learn by applying deep learning will give us much better insight into how real neurons learn tasks, and I anticipate that this insight will have a big impact on deep learning.

To really appreciate this I think requires a very brief history lesson on the beginnings of machine learning (ML), AI, and neural networks.

In 1943, Warren McCulloch (who, funny enough, turns out to be a cousin of mine) and Walter Pitts proposed the first artificial neuron. It was known as the Threshold Logic Unit or Linear Threshold Unit. The

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Artificial Intelligence: When Computers Take Over

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(Kismet, the MIT Robot. Source: Chris Devers )

My path to medicine and surgery came after a career switch from technology. As an undergraduate, I studied computer science. It was a passion that began in my childhood, when I used to go to school early to mess around with them. Mainly to play Boulder Dash, really. I am fairly confident it was also the only time in my life in which I actually got to school early.

I spent many years working in information security and systems and software engineering before leaving to pick up a scalpel. That passion has not faded. I have developed software to analyze and process data as part of my research efforts, and on projects independent of medicine for my own enjoyment. Since last year, I’ve been studying machine learning (ML), an exciting subset of artificial intelligence (AI) which is already changing the world in ways many people aren’t

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Today’s Google Doodle: Thanks, Ed

If you didn’t notice it, today’s Google Doodle caught my eye:

ed-roberts-google-doodle.png

I can’t say I was familiar with Ed Roberts before seeing this, but I’m glad to have read about him and I thank Google for increasing awareness. In brief, Roberts was an early activist for disability rights. After a polio infection led to nearly complete paralysis, he fought for the right to live a complete life when that wasn’t the norm. He even had to fight to attend UC Berkeley after a dean there said, “We’ve tried cripples before and it didn’t work.” (Ref: Wikipedia) That was around the early 1960s.

It’s easy to forget how much things have changed and how how far we’ve come in that time. And how much farther we have yet to go. I’m able to live a productive, full life as a researcher and surgical resident because people like Ed Roberts fought tooth and nail for basic rights, like functional student housing and the

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Residency

I’ve been trying to think about how I’ll integrate writing into residency and having some difficulty. There are certainly a number of stories that would be worth sharing, but of course I can’t share any details of specific patients that would identify them. And some healthcare bloggers have gotten into trouble in the past for things they had written. Roughly one year ago an interesting survey was posted that looked into different things relating to social media that would get physicians in trouble. Most of them are common sense - don’t post patient narratives with identifiable information, don’t post photos of medical treatment without patient consent, don’t try to date your patients.

So rather than try to think about how to integrate writing into residency, I think I’ll just do it.

It’s hard to believe, but I’m already six months into residency. The entire program is five years

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MD

I’m going to interrupt the series I’ve started writing looking back on each of the four years of medical school for a minute. This weekend, I was able to drop the “Almost” from the blog’s description of “Almost MD.” I’ve made it. I’m officially a graduate. But as one of our lecturers said back in first year, you aren’t a physician just because you’ve graduated from medical school and have an “MD” after your name.

Do I feel like a physician now? No. But the ceremonies this weekend really did a great deal to emphasize the significance of the milestone that my classmates and I have reached. I was fortunate enough to attend an incredible medical school with incredible students at Case Western. At the very beginning of first year, before we even attended a single lecture, we received our white coats at the White Coat Ceremony. It’s akin to being indoctrinated into Skull and Bones -

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MS1: The First Year of Medical School - The Beginnings of A Transformation

This is is part of a series of reflections on medical school that I’m writing, with each new post being a reflection on each year. I’ve previously written an overview of what this series will entail.

All year, I’ve been facilitating a small group of first year medical students once a week as part of Case Western’s “Foundations of Clinical Medicine” program (FCM). Affectionately known as “touchy-feely Tuesdays,” it’s the component of our curriculum that deals with the doctor-patient relationship, and professionalism. During first and second year, Case students stick with the same FCM small group and discuss various issues each week. When I look at the classmates that were in my FCM group and what they’re going to do for residency, I’m not at all surprised by any of them. They are a fantastic fit for what they’re going into, based on what I saw those first two years.

More

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Reflections on Four Years in Medical School

I’ve been thinking a lot lately about the last four years. Two days ago marked the last day of my last rotation in medical school. I’m done. I have been officially informed by the registrar that I have been approved to graduate, so at this point, I’m just getting ready to move and transition to life as a resident in general surgery. Just waiting to put on that cap and gown and to begin changing all my website registrations from “Mr.” to “Dr.” And with that come many thoughts about these years and how they have changed me from the person who arrived at Case Western Reserve University School of Medicine just about four years ago.

The timing has been right for just this kind of thing, especially this last week: I was on my last rotation in medical school, and also continue to be involved in teaching medical students in other years. Over the past two weeks, I have had the fortune of

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Hey, that’s me on TV!

Aired today, on CBS’s The Doctors:

If the embedded video just above doesn’t play for you, head on over to http://thedoctorstv.com/videolib/init/8961 to watch it on their site via Flash.

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Kids Say the Darndest Things

As a person who uses a wheelchair, I get all kinds of comments: strange, funny, inappropriately personal, roundabout, and just plain baffling. And probably a whole lot more adjectives that I can’t think of right now. Some of my favorite encounters are with kids. One of the great things about children is their natural curiosity and inquisitiveness. They see the world through un-jaded eyes that haven’t been strangled by societal norms or biases. So I typically welcome and engage their questions, which might otherwise be strange or offensive from an adult who would be asking from a different frame of mind, in the hopes that I can turn the experience into one that helps them grow up with the idea that people who have different physical abilities are just like anybody else.

Several years ago, while working in a pediatric and adolescent clinic, I was examining a boy somewhere between

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Do we really need surgical masks and caps in the operating room?

Prior to one’s first surgical rotation in medical school, each student is required to attend training with the staff that oversees OR operations. That training includes what protective equipment to wear, how to scrub, and how to maintain sterility. Many, many students have had experiences during third year where they’ve been yelled at by OR staff for nearly contaminating some of the equipment. And in some cases, for actually doing so. But it’s all for good reason - ensuring the patient’s safety and protection.

One component of those protective measures is appropriate attire, including a sterile gown, sterile gloves, a face mask, and a cap on the head (the mask and cap are non-sterile). The goal of all of these items is to minimize the chance of any infection. I’ve seen attendings not involved in a case standing at the OR door to just speak to another attending, ten or more feet

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