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Las Vegas Plastic Surgery , Jeffrey J. Roth M.D. F.A.C.S.
6140 S. Fort Apache Road #100
Las Vegas, NV 89148

(702) 450-0777
(702) 891-0796

Jeffrey J. Roth
Dr. Roth Featured in The County Line
Las Vegas Plastic Surgery

Dr. Roth Featured in The County Line

The Clark County Medical Society's regular journal, known as The County Line, has previously included writing contributions from Dr. Roth as the current president of the organization's board of trustees. In September, October, and November of this year, The County Line had further thoughts and contributions from Dr. Roth showcased in each month's President's Message.

In these articles Dr. Roth addresses the following topics:

  • Dedication and Commitment
  • Reflections on the Year Anniversary of October 1st, 2017
  • Being Prepared

September 2018

One story about a physician that truly stood out was a photograph and paragraph on the popular photoblog Humans of New York about Dr. Michael La Quaglia, which first appeared in 2016. Dr. La Quaglia is the Chief Pediatric Surgeon at Memorial Sloan-Kettering Cancer Center, and regarding his personal investment in patient care and surgical excellence, was quoted as follows:

“The absolute best thing in the world that can happen to me is telling a parent that their child’s tumor is benign. I live for those moments. And the worst thing that can happen to me is telling a parent that I’ve lost their kid. It’s only happened to me five times in thirty years. And I’ve wanted to kill myself every single time. Those parents trusted me with their child. It’s a sacred trust and the ultimate responsibility is always mine. I lose sleep for days. I second-guess every decision I made. And every time I lose a child, I tell the parents: ‘I’d rather be dead than her.’ And I mean it. But I go to church every single day. And I think that I’m going to see those kids in a better place. And I’m going to tell them that I’m sorry. And hopefully, they’ll say, ‘Forget it. Come on in.’”

This one paragraph says so much about physicians' dedication to the patients in their care. The quote is illustrative of medicine as a calling, more than just an occupation. Dr. La Quaglia speaks of the significant trust when a parent places their child's well-being in the hands of the physician. Dr. La Quaglia states that he has sometimes told parents prior to a surgical procedure, “Your daughter is now my daughter.” This personal commitment on his part is reflected in his strong words about the worst case scenario when trying to help a young patient. When something bad happens to a patient we are treating, we look inward as medical professionals, wanting to understand what happened, and how to be sure it doesn't happen again. It is a probing and very personal process of soul searching, one we are trained to see as a necessity in being able to provide our patients with the best service.

As medical practitioners, we are granted the privilege of benefiting patients, perhaps even saving their lives. This knowledge that we have made a difference in another’s life is what sustains us.

In this era filled with distractions from the fundamental tenets of medicine and surgery, we should all aspire to be like Dr. La Quaglia and stay mindful of our ultimate commitment to our patients

October 2018

The anniversary of the terrible events of October 1st, 2017 brings with it many thoughts. Among these is an acknowledgment of the preparation in place to mitigate the type of emergency Las Vegas citizens and visitors alike faced on that day. Plans years in the making were ready, as Las Vegas had long been viewed as a potential target for attack on a large scale. That preparation has been honed, and decision-making skills have been sharpened, over time. This, in no small part, contributed to people's ability to save the lives of the wounded, no matter what role they played as either medical professionals or support staff.

The dedication and response of everyone who answered the call, even those not on-call or scheduled to work, led directly to the survival of every person who was brought to the hospital with a heartbeat, despite the injuries totaling more than 850 people, with nearly half of those injuries being gunshot wounds.

Counseling was offered for free to victims and their families, in addition to the establishment of a support center and place where family members separated in the chaos could be reunited. The Clark County Medical Society reached out to other medical societies in communities victimized by similarly tragic violence, in order to learn what could have done better and how best to respond in the case of the Vegas attack. On that day the world found out about the outstanding medical community in Las Vegas. Local physicians now share their experiences from this harrowing incident across the country and the world.

First responders and trained personnel are expected to be the first people to arrive on a scene to help, but there was no shortage of ordinary civilians who rose to the occasion and rushed to the aid of those in need, as well as the overwhelmed medical professionals trying to keep up with the needs of the wounded. Some of these people neglected their own injuries to give first aid or evacuate people to safety, and some sacrificed their lives to save others present at the concert. There's no shortage of stories like this from that day.

In the aftermath, many people offered donations in the way of time, assistance, money, or blood, all of which were in desperate demand. The 58 people killed on 1 October were memorialized by cross maker Greg Zanis, who drove in with 58 white crosses to be placed by the iconic Welcome to Las Vegas sign. Ice hockey team the Vegas Golden Knights also paid tribute in their own way, retiring the number 58 from any future players' jerseys, as well as honoring a different first responder at each of their games. Through these inspiring actions, they have proven themselves to be a symbol of optimism and a permanent part of Las Vegas' cultural fabric.

Jewish burial tradition usually sees the deceased interred within 48 hours, followed by a mourning process known as Shiva which lasts for a week and finds family and close friends providing comfort to the bereaved within their own home, representing a period when the person in mourning is not supposed to concern themselves with the aspects and obligations of daily life.  After the Shiva period ends the transition back into regular life begins, even while acknowledging that it will take quite some time for the mourner to move on. A year later the headstone of the deceased is unveiled in a ceremony that is supposed to denote the mourner's ability to resume their regular responsibilities. At this point, the departed are remembered perpetually, as the memory of them becomes a guiding sign toward righteous acts on the part of those left behind.

This terrible adversity has proven to ourselves and to the world what the citizens of Las Vegas are capable of. Miraculous things can be achieved when working for the betterment of all of us.

November 2018

The reason that physicians train as hard as they do, for as long as they do is in the interest of always being prepared. The training, knowledge, and experience that we have accrued in both our schooling and, afterward, in our practice can be called upon at any moment and may prove to be the difference between life and death for someone in need of our medical expertise.

Even when the needs of a situation may seem to extend beyond the topic of study that a physician is immediately versed in, the expectation remains that the physician is knowledgeable and capable. Currently, there is some debate around the proposal to truncate the last year of medical school and to reconfigure residency programs. This expectation of our ability to handle a crisis is exactly the kind of training and experience that extensive, even arduous medical schooling provides.

A good example of this kind of scenario follows:

57 year old John Adams, known as "Santa" due to his appearance and good nature, began choking while out to dinner in a restaurant with a large party of family members. When the Heimlich failed to provide a clear air passage the manager of the restaurant ran to get Dr. Michael Colletti, a regular who the manager knew to be dining there that night. Dr. Colletti, a rheumatologist, thought back to his training and despite not being a surgeon, asked for a knife to use as a makeshift scalpel with which he made an incision in Mr. Adams' throat and placed a straw, a procedure known as a cricothyroidotomy. This fast action gave Mr. Adams an essential airway until paramedics could arrive with proper equipment, including a larger air tube, and Mr. Adams was able to be transported to St. Rose Siena Hospital. “I remembered how to do it from medical school,” Colletti said. “I never did it, but I remembered the lesson.”

Here is another scenario where medical professionals had to act beyond the range of their usual expertise:

Dr. Erik Pearson, a pediatric surgeon, and Dr. Michael Ciccolo, a pediatric cardiothoracic surgeon, were called upon on the night of October 1st, 2017 to help treat the wounded. There were no pediatric victims in need of emergency surgery, but an adult patient had a life-threatening gunshot wound to her aorta. In collaboration, the two pediatric doctors were able to successfully operate on the adult and, as a result, saved her life, despite the surgeons being accustomed to operating on children. This success was possible due to the long surgical training received by both men, which prepared them for whatever immediate, life-saving decisions they might be called upon to make. 

Physicians are constantly learning and one never knows when information taught to us long ago might come in useful while dealing with an emergency or other similarly unexpected situation, a good reason to always be prepared.

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