Surgery

I got a migraine the other day. Right in the middle of my first clinic with my vascular consultant. By the end of the afternoon, I was incapable of speech. I'm sure she thought I was a complete moron. She kept asking me simple questions that I knew the answer to, and I just. couldn't. answer. them. Oh well. Hopefully I will be a little more coherent next time I attend her clinic. It annoyed me, because she is really good at what she does and is interested in teaching. At one point in the afternoon, when she'd asked me a simple question about what the vertical scar on a patient's neck might mean and I suggested that he might have had some work done on one of his carotids, she said, "well now you're thinking." Um, yes.

I have only two more weeks to go and then I'm done my surgery rotation. It's been an interesting experience! I started surgery a little worried that I might fall in love with it. After all, I really enjoyed anatomy on the island. And every surgery is, among other things, a big anatomy lesson.

I have fallen in love with surgery. But have no intention of pursuing it as a specialty.

There are several things I have really enjoyed while doing a surgical rotation. As I suspected, I have really enjoyed the relevant anatomy. It made my first few months of medical school come alive in a very real way. As I retracted an important nerve, or had to keep the various planes of tissue retracted so the surgeon could suture the one just below the retractor blade it occurred to me (again) that very little of what I was taught in my first two years was irrelevant. (Although if you read posts from my first two years, you might think otherwise...ok, I was an arrogant stupid med student.)

I enjoy the immediate feedback and generally quick resolution of surgery. You have cancer, we can take it out. You have a broken bone, we can fix it (I really, really liked orthopaedics; especially hand surgery!). Unlike medicine, where there are many times when a patient has a chronic illness and won't be getting better any time soon, in surgery it is not uncommon to actually make a patient better.

I really enjoy the sense of ritual and cohesion that exists in a well-run operating theatre; how this large cast of highly skilled individuals work together to provide the best patient care possible. There is a feeling of age-old ritual, from the scrubbing and the gown tying dance to the patient-draping. And it has been instructive to see how an unpleasant personality can destroy that cohesion very quickly. (Thankfully, there have been very few moments like that!)

But there have been times when I really, really didn't enjoy surgery. I think mostly because of how brutal it is. My first few surgeries were, to put it bluntly, traumatising. Not because of the surgeons or the team (they all went out of their way to make me feel welcome and involved), but because of what we were doing to these patients. We were cutting them open, moving their insides around, putting them back together (sort of), and hoping for the best. I kept thinking of how much pain they were going to be in when they woke up, and how miraculous it would be if they regained some form of normalcy after this.

I wonder if I have a bit too much empathy. If my artist's training to explore the pain of another person is just a bit much for a surgeon. Of course, for those surgeries where I was scrubbed in with a job to do, it was much easier to focus on the relevant anatomy and not on the person I was sticking my hands into and suctioning blood out of.

I found myself standing in theatre, forcing myself to pay attention to what was going on in front of me, while having one ear focussed on what the anesthetists were doing; their sort of physiology-heavy medicine being endlessly fascinating. Perhaps that was a sign.

So while I have enjoyed many aspects of my surgery rotation, I know it isn't for me. I find myself at the end of these 12 weeks tired, sick, and very ready for a break (two weeks in France in the middle of nowhere with my sister). Until next time!