Protecting Sight #186: Therapy’s potential to increase the authenticity of happiness. Why EHR systems decrease happiness. Double phaco incisions, astigmatism, and revisiting groundbreaking phaco pearls.

Welcome to my daily learning journal. My daily goal is to watch one Ted Talk and one cataract surgery. I also plan to read one journal article and read/listen to a book chapter, podcast, or significant work.

Here’s today’s list:

1. Ted Talk – Emily Anhalt: Why we should all try therapy. “We tend to think of therapy as an approach to fixing problems — you go if you’re not happy, not when everything seems fine. Clinical psychologist Emily Anhalt shares her experiences as both therapist and patient to make a compelling case that therapy isn’t just a means to an end. “It’ll drastically increase the depth and authenticity of your happiness,” she says. ‘Making the necessary space for every feeling that lives in between.'” (

I enjoyed Dr. Anhalt’s narrative of being both a patient and therapist.

2. Cataract Surgery – Uday Devgan MD – Double Phaco Incisions to fix Astigmatism. Dr. Devgan writes in part, “There is some variation in the degree of astigmatic effect depending on multiple factors such as incision size, incision placement, incision position, incision tunnel length, patient age, corneal diameter and corneal pachymetry. For most of our cataract patients, the effect of these factors is limited, and we can come up with a reasonable and predictable nomogram to treat astigmatism.” Well done.

3A. Sinsky C. Advancing Practice Science With Electronic Health Record Use DataJAMA Intern Med. Published online December 14, 2020. doi:10.1001/jamainternmed.2020.7068

3B. Holmgren AJ, Downing NL, Bates DW, et al. Assessment of Electronic Health Record Use Between US and Non-US Health SystemsJAMA Intern Med. Published online December 14, 2020. doi:10.1001/jamainternmed.2020.7071

4. Mackool, Richard J. Phaco Tips: The First Ten Years (2002). Reviewed phaco tips 1-15. I visited Dr. Mackool twice in my early years of practice. Each time, he performed dozens of complex cataract surgeries with ease. He gifted me this book. The original pearls appeared in a monthly column and include superb observations to optimize cataract surgery.

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