Scalpel's Edge

A surgeon's notes

“Surgery? Really? Well, I suppose it makes sense from you.”

I never planned to train as a surgeon. My life-plan was clear. I wanted to work in a regional area as a generalist. Probably a GP with a mixed practice. Maybe even a paediatrician. But it was important that I would deal with the 80% of people that never see a specialist doctor. I wanted to treat the whole world!

My general surgical round was very early in my intern year. I knew about surgeons – they were the ones who don’t have to know medicine; who don’t have to weigh treatment decisions. They don’t have to understand what they are doing because they can just cut and plumb.

My rotation was the opposite of what I expected. I met patients who were fixed. Lots of them. They came back to clinic and said “Thanks, Doc, I feel much better.” And then I signed them out of the clinic. These were people I liked and respected, and I had helped make their lives better.

I was hooked.

It certainly helped that my Registrar was a great guy. I still consider him a huge influence on my life. And my consultants were lovely – friendly, caring and passionate about educating. I remember doing a PR exam on a guy with a rectal mass, and not being sure if it was cancer (having never felt one before). Instead of being made to feel stupid, my consultant said simply “That is a cancer. Think of that when you are feeling for cancers in the future.” It could have been embarrassing, and I could have been turned off, but instead, I took note.

Friends were surprised about my total turn-around on surgery. Their responses were less than encouraging, and slightly insulting.

Surgery? Really? I never thought one of my friends would do surgery. But I suppose it makes sense from you…

I deliberated over the decision to enter training with my husband. I knew that the life was not great – that’s what everyone tells you. But my husband simply said “You are in a much better mood when you are doing surgery. Do it. I prefer a happy infrequent wife to a grumpy, angry, available one.” Bless him.

As time goes on, I am confronted daily with the difficult decisions that are the core of surgery. How do you explain to patients that the investigation most likely to get to the bottom of their problem is a laparotomy – one of the most invasive things we can do? But also potentially one of the cheapest, if stacked up against ongoing morbidity, hospital stay and bewilderment. How do you advocate for the patient who is decided by others well enough for colonoscopy, but not for quick colectomy and stoma when perforated? Easy decisions are made difficult by the invasiveness of what you are doing, and the aversion of other doctors to breaking the skin.

I love surgery. It lights me up inside. I am thankful every day for the fall of dice that gave me a great rotation, early in my internship – an experience powerful enough to change my life.

6 responses to ““Surgery? Really? Well, I suppose it makes sense from you.””

  1. liz4cps says:

    Sounds like you found a career that really fits you — that’s wonderful and a little rare.

  2. admin says:

    Thanks, Liz. It feels like a great fit, but I am determined to be in control of my life, which means it is taking me a while to get there… (Surg training interrupted by PhD, interrupted twice by maternity leave)

  3. rlbates says:

    Dr Cris, I know what you mean. I am grateful to have “met” you via other blog friends on Twitter. Would love to actually meet many of you in person. Take care and keep writing.

  4. admin says:

    Thanks, rlbates. Meeting the medical twitterverse has been a great experience for me, too. It is great to connect with people who are thinking and dreaming similar things.

  5. […] Scalpel’s Edge features a post about the first time DrCris begins to seriously consider a career as a […]

  6. bongi says:

    nice post. nice career choice.

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