Speech to the Wannabes

Good evening. Thank you for giving me the opportunity to speak. I remember sitting in those very seats you are in now, back in the days when I was a medical student like yourselves.

I was asked two weeks ago, by your faculty Dean to give a talk to you all, on why I chose to do Surgery.

I thought very hard about it, maybe too hard. I thought of all the clichés I should throw in, like it’s satisfying, it’s challenging, it’s interesting. But what field in Medicine isn’t? Somedays, I catch myself envying my colleagues in their jobs, and somedays I walk away from a problem, glad I didn’t have to deal with it.  There are days I am appreciated by others for what I do, and there are days when I am belittled and teased about what I can’t comprehend as a surgeon.

So I have decided that, today, I will tell you why I chose not to do anything else.

I don’t think I could ever be a radiologist. I am afraid of the dark. In surgery, I am always working in a well-lit room. In fact, people around me will always move the light so that it is directed at me and my work. The operative lights are powerful, and for someone who loves being the centre of attention, I am constantly in the spot light.

I could never be a pathologist. They deal with dead people, or bits of tissue (which are also dead) removed from the body. I like to work with living people and living tissue. I also like the skills I possess to revive them under certain circumstances. I am sure findng the cause of death or disease is satisfying for the pathologists, but I figured that finding the cause and being able to fix it, is even more gratifying.

I would find it hard to be an anaesthestist, because then I would end up spending the majority of my time with people who are asleep. I already do that when I get home late from work, although occasionally I do get a grunt or two when I tell my husband about my day while he is slumbering. I am not very good at crosswords and sudoku either. I think if I had to sit there, listening to the steady beep, beep, beep for hours, staring at the squiggly lines on the screen, I’d find it hard to stay awake. Worse still, if I was an anaesthetist, I will have to stand there and be a spectator while the really exciting gory stuff is happening on the other side of the drapes. That’s just not me. I’d rather be the loud conquering hero, elbow deep in blood, than the quiet achiever behind the scenes.

I might have be tempted to become an Emergency physician. TV dramas always project them as exciting heroes, with challenges where they can save lives.  But when I did my ED term as an intern, I realised that these dramatic moments come rarely (which I guess is actualy a good thing). I spent plenty of my time in ED admitting little old ladies with pneumonia and falls, stitching up aftermath of drunken brawls, and sedating IV drug users whilst trying not to get spat at. Sometimes I think it’s awesome that the emergency doctors do shifts. That when they leave work, they don’t really carry further clnical responsbilities because they have ‘handed-over’ to the next doctor. I also found it frustrating, because I never found out what really happened to that 40 year-old man who came with babushka dolls in his rectum, as seen on his abodminal x-ray (because he fell on them, so he said). I felt like a traffic director because the responsibility ended when the patient has been referred on to the appropriate speciality for further management. So I never knew what was done to treat them, or if I even got the diagnosis right in the first place.

I don’t have the strength to be an Oncologist. It is probably one of the very few specialties where the doctor deliberately harm the patient with poisons, in the hope that it will treat or hold their cancers at bay. For the few that are saved, many benefit from prolonged lives, which sometimes, are accompanied by suffering. I think if I was an oncologist, I will have to be comfortable with the concept of Death. This would be hard, because in many fields of Medicine, death is viewed as a failure of the doctor’s abilities, even when we know there is nothing that can be done. I like successes, and I take failures too personally. I would not last in Oncology.

I love Paediatrics. It’s the parents I can’t deal with. There were days when I did paediatrics that I was tempted to prescribe sedatives for the parents, and gave my little patients vitamin C pills (also known as placebo for children), just so that the parents felt that I was doing something for their child. Dealing with babies, is like vetenary medicine. If the child doesn’t bark (cry), play, eat or poop, one had to figure out what is wrong with it, sometimes with almost no lead to follow. I am not that smart, I like my patients to tell me what’s wrong and what they want. And I need clues like sledgehammers.

I am a planner – my life is planned down to 15-minute blocks. Obstetrics would wreck havoc with my mental stability. Babies never book an appointment to appear. They come when they are ready, or sometimes, even when they are not ready. They also don’t book the length of their appointments, some want only half an hour and the others take their sweet time in getting to the point. Getting up at 2am to extract inconsiderate babies and performing an emergency caesarean to facilitate their wish to exit via the sun-roof, does not sit well with my planning tendencies. No, obstetrics would definitely antagonise the control freak in me.

I think General Practictioners are important. Family doctors are the crux of all communities and health systems, and they are family to many patients. They deal anything from simple cough and colds to complex medical dilemmas. Their knowledge has to be so broad as to include all possibilities in medicine. They also have to think about their patient’s social situations, and almost take on the role of a social worker. I have neither the acumen for broad general knowledge (I am always the weakest link on quiz nights) or the patience for complex social situations (I have serious foot-in-the-mouth syndrome), so I think I would score an epic fail in family medicine.  I know just about everything in my little specialty corner amongst the big wide world of medicine – so I think I will stick to what I know.

I can deal with a lot of gory things, like chopped off fingers, haemorrhage and fungating tumours, but there are a few things that make me gag. Phlegm and Mucous. I guess that ruled out respiratory medicine for me. Collecting and looking at gooey bubbly mucous in collecting pots brought bile to my throat. Subconsciously, whenever I hear a very fruity cough, I hold my breath to push down my gag reflex. I admire those who deliberately seek out rattling mucous in patient’s lungs with their stethoscopes. Ergh.

Physicians are smart. Like Sheldon in Big Bang Theory. Comprehending complex medical problems, working out multiple drug-interactions and ordering the right tests to solve confusing symptoms seem like second nature to them. They can’t fathom why anyone else haven’t worked it out yet and the looks of incredulous disbelief (or disdain) when a question is asked, is part of their usual demeanor. And yet, for all that incredible intellect, they are pathetic mechanics. They don’t seem to be able to grasp the physical aspects of the human body nor the common sense of surgically removing the cause of a problem.  Don’t ever try to quiz a physician on anatomy. They do know a lung, stomach or the brain when they see one, and they do know the rough whereabouts these organs lie, but they’d be hard pressed to know the origin and route of every blood and nerve supplies. Some even turn pale at the sight of blood, and becomes completely useless when anything remotely looking like a surgical instrument is placed in their hands. My mind is not geared like a physicist or mathematician. I cannot think like a physician. I don’t have the patience to wait and see whether a drug I have prescribed is going to work or not. I would much rather do something active about it. Even then, after surgery, I usually can’t wait for the patients to wake up and let me know if they feel better.

By now, you might think if I wasn’t committed to the world of insane, I would make a good psychiatrist. Wrong. I have lots of time for shrinks. In fact, I have spent a lot of time with mine. I remember thinking, as I went on and on about the stresses of my work and how pathetic I feel, painfully dragging it out into a full hour, why anyone would spend day after day listen to people whine about their problems. In fact, what was even more frustrating, was the fact that there was nothing he could do about my situation. He couldn’t make my bullying colleague stay away from me; he couldn’t tell the crazy patient to stop hassling me; he couldn’t give me two months’ worth of salary so I could take a holiday; nor could he try and change my husband into a domestic goddess. He was a sounding board, someone to make me see a different perspective of my life, and occasionally, fiddle with my medication. He has always told me that I would not get better, or cope with life, until I have decided that I can and  I will. I would find being a shrink so frustrating, because I cannot control how my patient feels, change their situations and be able to actively do something to help. For this one, I think I’d rather stick to my role as a patient.

Please don’t think I am bashing other specialities. In fact, I admire all my colleagues, and at times, I envy them. Because I know I can’t do what they do. But if you want a straight answer to why I chose surgery, here it is.

It is because I love it. I can make a difference in people’s lives, I find what I do exciting, and I know I can do it well.

But this is what every doctor will tell you about their specialty.

Don’t just chose surgery when you grow up, chose something that excites you and something that you are passionate about.

And if that happens to be Surgery. Then you have great taste. Like me.

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