The BMW Club: Meet the Members

There are four of us. Three surgeons and one surgical assistant. All girls of course.

Once a month we meet up – Saturday early morning cafe breakfast, Sunday boozy brunch, Friday night at the bar, Saturday night at a pole dancing show, Sunday afternoon on a picnic blanket, Thursday night at the football game, you name it, we’ve done it. It is a ritual that has been going on for years between the four of us. It usually starts as a very civilised girls’ outing, then it deterioates into a BMW (Bitching, Moaning and Whining) fest.

About work, people at work, patients, headache cases, bad days, husband/boyfriend/lover, or the lack thereof. And as the drinks start to flow more liberally, the standard of conversation falls to the level of frank, graphic, rude basics.  There would be no subject which was forbidden and no detail that was left out. The aftermath is usually four dolled-up chicks in hysterics, rolling round in their seats, somewhere public.  Think Sex and City – without the airbrushed lens.

Sex and City2

The rules of the meetings were simple: dress up to impress (or to pick-up for the unattached in the group), no male accompaniment, no bitching between each other (but it’s ok to bitch about anyone else),  and if one person pulls out, the ‘meeting’ is cancelled (amazingly has not happened yet, considering that we all work in the field of surgery).

We are not all intimate friends with each other, initially it was a meeting of I-will-bring-my-friend and it-will-be-good-to-catch-up, but over the years, we have become a very close group. It is a group where we can safely discuss all our thoughts, fears and dreams, knowing we can receive honest, and most importantly, non-judgemental advice.

So, Sharon* plonked herself down at the bar next to me, ‘Goddamn patients.’ Obviously one of her patients is giving her grief. I looked at her in surprise, it seems we will be starting the BMW component early today. But then, that’s Sharon. She always sees the negative. If she wasn’t lamenting about her working hours, she was complaining about the patients, or proclaiming doom and gloom about the outcomes. When she’s done with her own misery, she will point out ours, in a sympathetic way, of course. I used to find her constant pessimism tiresome, but then I realised this was the way she needed to unload, because she sure as doesn’t do it at work to the patients.

Sharon is my age. She is tall, and has an eye for upper end designer clothes. Tonight, Her hands and wrists dribbled with BVLGARI jewellery, and her neck supported a Chanel diamond collar. She wore a bright red and gold wrap-around dress from DVF. She is single and lives with her parents. She dots on her nephews and nieces. She has travelled a lot despite a busy practice. She has connections with various famous surgeons around the world and often posts photos on facebook when she has dinners/meetings with each of them. One doesn’t say it out aloud, but we all know she is probably having long distance brief affairs with some of them.

Sharon and I went through surgical training together. We were like sisters, spending our working hours together, then the rest of our time studying together. She slept and ate at our house often and at one stage, our spare bedroom cupboard was filled her clothes and toiletries. We had a lot of fun times and hard times. The worst was when she failed her specialist exams and I had to be her boss for a year. It was hard for her to take clinical orders from me, and there were times when she took liberties which I had to reprimand her for. It really damaged our friendship, and it was because of her, that I decided I would never be ‘friends’ with any trainees and students who were under my team. Being ‘friends’ was detrimental to the ‘chain of command’ especially when it came down to patients whom I was responsible for. That was five years ago. We have since resolved our differences and sunk back to our old comfortable ways.

Sharon is a sophisticated sort. She loves art. She collects them, goes to all the gallery events, and takes art classes. She is also an avid amateur mixologist. She has an encyclopaedia of cocktails on her kitchen shelf with a whole cupboard of equipment, some of which looked questionable in function, but she assured me was for mixing exotic drinks. She regularly experiments on us, some creations went down smoothly like lolly water, others gave us unusual facial expressions which were eternally recorded on our iphones amidst drunken laughter. Once, she made a cocktail which blew our minds, literally, as she got the proportion of Tobasco wrong.  Sharon also loved her fashion, she was into classical fashion, that of Chanel, Gucci, BVLGARI and Prada. She obviously spends enough money at these stores that she regularly graces the social pages of the local news rags at some blah blah season launch.

“Hi Babes.’ That’s Emma*. She is the party-girl. She is on first-name basis with all the restauranteurs, chefs, club owners and bartenders around town. She is on the guest list of every boutique, restuarant, and club opening. She shamelesly name-drops at every opportunity and she can rattle off a description of the latest collection pieces from all the up-and-coming designers.  She is the epitome of all that is chic, trendy, modern and unusual. She wears impossibly high heels and revealing outfits, and that’s at work. Once we were in clinic together, and of my other colleagues looked at her outfit and whispered to me ‘Where’s the disco ball?’ I just laughed, and told him to wait until he’s seen her party outfits.

Tonight, she sashayed in with a tight blue Alexander Wang sheath dress highlighted by a plunging neck, Gianvito Rossi 150mm high pumps and her usual large rectangular cut ‘helicopter-platform’-size sapphire ring on her middle finger. This was her engagement ring. Emma is divorced. Five years ago, her husband (a fellow surgeon) came home one day from work and told her over dinner that he was having an affair with an anaesthetic tech, and that she was having his baby in 6 months’ time. Emma went on a bender then. She started drinking heavily and using crack. She was having an exhaustive series of one-night stands and experimented with various sexual adventures which we didn’t really want to know, but were not spared the details.

She and I have worked closely together for over 7 years. During her divorce, it was a very difficult time for both of us, she turned up to work so high on somedays I have had to send her home. She was reported to the Medical Board by a coworker and was then put on probation. Everyday, she had to be breathlysed, and urine tested before she could commence work. When she wasn’t sober, I had to make her call in sick so that she didn’t have to be tested, because one positive test at work meant being struck off the medical register. During those 18 months, I was carrying the load of two surgeons without a whimper, because I knew, by flying low on the radar, I was holding onto her job for her.

She has since recovered. Sure, she still drank too much on social occasions, and I am sure enjoys a bit of white stuff at some parties, but at least she is now reliable at work and has had a few selected relationships which lasted longer than a weekend. For all her sordid history, Emma is a good surgeon, she’s efficient, decisive and despite her outstanding competency has insight to her limitations. She maybe outspoken, opinionated and bitchy at times, but she has no qualms in standing up for what she believes in.  Unfortunately, she has a talent in attracting bad boys with terrible unresolved baggage and messy relatonships in general.

Many have commented on our unusual friendship, as we are like chalk and cheese with vastly different lifetyles. But Emma is a loyal, protective friend who, for all her bitching, will not say a bad word about those who stuck by her, and looks out for her friends at every turn. She once said to me, ‘You are just too nice, Tiff. You need a friend like me to tell people to f$@# off when they try to pile shit on you.’ And she does. She takes patients who give me grief off my clinic list, and then proceed tell them as it is when she sees them. She rings and tells me to sleep in because she has seen all my preops for the next morning and will get the operating list started for me. When my lists are overbooked, she will take off cases onto her list so that I would finish on time. For all her tough talk and party-girl image, Emma has a marshmellow heart. She lives alone with her dog whom has been lavished wth more luxuries than a baby, including a handmade dog collar, custom-made bed and matching cushions.

‘Where’s Lizzy?’ Emma asked. I frowned. It was not like Lizzy* to be late. She is often the first one to arrive. Lizzy is a surgical assistant with a nursing background, who assists several surgeons in town. She is the one exception I have made about having friends as employees. She works for me once a week as my assistant. Lizzy is the goody-two-shoes in our group. She is conscentious, hardworking and punctual. Although lately, there was a shift in her focus from work to a recent addition in her love-life. Lizzy has been single for many years. She had been quite an overweight girl who was intermittently on various unsuccessful miracle diets. Four years ago, she started personal training, and lost over 20 kg. She admitted to me months afterwards that the impetus which finally made her serious about losing weight was my wedding. The day before the wedding, all four of us were lying on the beach, reading magazines, enjoying cool drinks and having our final BMW club meeting before I was to become the only married woman in the group. Lizzy told me that it was the most disconcerting day for her. Sharon, Emma and I were all confidently lounging around in our bikinis, and according to Lizzy – we looked hot. It made her feel very self-conscious of her own body. It wasn’t that we said anything – in fact – we were all fairly comfortable with Lizzy, as we have always known her to be a big girl. It was then she realised that no one cared if she was fat or skinny, that if she wanted to lose the weight, she needed to do it for herself.

Lizzy started seeing someone 6 months ago. It sounded serious, with lots of sleepovers and talks of buying cars, furniture, looking at properties. Instead of being so focussed on her work, it was good to see her flourish in confidence and love. Lizzy herself will tell you she leads a very ‘boring’ life. She gets up early every morning to train at the gym, goes to work, grocery shops in the afternoon, hangs out at her boyfriend’s apartment most nights watching TV, visits her parents on the weekends and is usually asleep in bed well before 9 o’clock every nights. She is not naive, but she has led a very sheltered life. Although she is easily shocked and grimaces at some of the details we discuss, she always remain non-judgemental, and seemed to be more interested than horrified, especially when Emma starts going off on a tangent with one of her latest ‘adventures’.

Lizzy is a girl who valued friendships. She is the one who always make an effort to keep in touch. She remembers everyone’s birthdays, anniversaries, and anything that you have ever mentioned in conversation. She would ring to check if everything was alright if she knew you were sick, and text to find out if your dentist’s appointment went well. She brought over hot soups when you have a running nose, and offers to help you clean out your garage on weekends.

‘There she is,’Sharon groaned, ‘about bloody time, I am starving.’

On a lower income bracket than the rest of us, Lizzy’s wardrobe consisted mainly of pieces from Zara, H&M, and Cue. She was the queen of coordination, if it wasn’t matching earrings with bracets/necklaces, it was matching shoes, clutch or belt. The colours were always impeccably organised in her outfits. She never wore heels higher than 8 mm, although the youngest, she is also the tallest of the group. Lizzy is also rather well-endowed, and despite her weight loss, nothing shrunk from her chest wall, much to her disgust. Unfortuntely, being surrounded by three others who rely heavily on padded push-up bras, Lizzy’s bosom, at times, was fair game amongst us less fortunate.

‘Sorry, girls.’ Lizzy smiled. She had large sparkling brown eyes framed by sinfully long eyelashes. ‘I got held up.’ She blushed. We all gave her a knowing look.

As it is always the case when we are with Emma, a waiter appeared out of thin air as soon as she raised her hand. The waiter lead us towards the dining room, and sat us down. Champagne glasses were filled and raised.

The glasses clinked as our laughter echoed around the table.

‘Let’s start this meeting.’

 

*names were changed to protect pesonal privacy of individuals

The Doctor’s Handwriting

doctors-handwritingECG

Once upon a time, I used to have very neat writing, but medical school, surgical training, and the endless beauraucratic paperwork has beaten it out of me by the time I have become a fully qualified specialist.

My writing got so bad – that this week, when I left my husband a shopping list of things I needed urgently, I got a surprise in return. The list was:

  1. face wash
  2. moisturiser
  3. coffee beans
  4. shampoo
  5. conditioner

When I got home, I asked him whether he got the stuff I needed, and he said it was in the kitchen. I found the shopping bag sitting on the bench, I looked inside. And I found, face wash, moisturiser, coffee beans, shampoo and not one but two boxes of condoms. He must have thought all his birthdays and Christmases have come at the same time when he saw that on my list.

It is a good thing that most medical records are converted into electronic files, and doctors are no longer required to write, other than scribbling their signatures on printed reports, scripts and request forms. I was told once that the secret in writing doctor’s handwriting is to look at the first letter, and then the last letter. Look at the length of the line in between these two, and the brain should fill in the rest. To me, it’s a bit like deciphering an ECG (and for a surgeon, that is no small feat, as it is often the physicians who actually has the ability to read the subliminal messages in the wavy lines of an ECG). I would have a look at the squiggles, and see if at least one of the lines is recognisable. One can often decipher the overall meaning of an ECG (and a letter for that matter) once a something in the middle makes sense.

Even though now it is considered to be negligent if the writing in medical charts or communications is not decipherable, this has not stopped some hilarious misunderstandings due to bad hand-writing.

I was reviewing an inpatient with facial burns, whilst covering for a colleague. The patient asked me if he had to keep using the ointment my colleague prescribed him. I asked if he was getting a rash or reaction from the ointment. He said no, but he was getting bad diarrhoea and going to the toilet at least 4 times a day, usually after he has used the ointment. I looked at the notes to see what my colleague has written, and he wrote “Paraffin, top, prn” which basically means, vaseline topically to the burn wound, pro re nata (as required). I then looked at the medication chart, it was transcribed by the pharmacist into his medication chart as “Paraffin, 10g, PR” which means, 10g paraffin per rectum. Poor man was probably wondering why the nurses kept shovelling vaseline up his bottom when his burn is on the face.

Once, during a consultation, my patient handed me his referral letter from his doctor. He told me that he came to see me about his skin cancer. I nodded and read the short brief scribbled note.

“Dear Dr T, thank you for seeing this 46 year old man with a biopsy proven basal cell carcinoma over his right scrotal area.”

I stilled for a moment. Silently, I cursed my colleague, and wished he had sent this patient to a male surgeon. But I gave a mental shrug and got over it very quickly. I tried to make the patient feel comfortable by having a chat with him about his medical history, medications etc. Then I told him that if the cancer was small, I should be able to excise it under local anaeasthetic only, a bit like a vasectomy. I ignored his strange look. Finally, when I ran out of things to say, I asked if it was ok for me to call a chaperone so that I can examine him properly. He gave me another look, but shrugged ‘whatever you want, doc.’ I asked him to step behind the curtain, get undressed and lie on the bed.  He looked distressed, then said, ‘but doc, I just need to roll up my sleeve, it’s here.’ He stuck his right wrist under my nose. Over his scaphoid area, was a small skin cancer. (For the non medics – scaphoid refers to the area at the back of the hand, near the base of the thumb.) Yep. I was walking a close line to being reported to the medical board for inappropriate sexual harrassment behaviour.

Once I received a letter from a doctor working in the country, who has been dressing my patient’s wound at home. Mrs M was a 50 year old lady who had very bad ulcers on her legs, and her doctor felt that they have deterioated, so sent her back to my office. I got her onto the bed, and opened the handwritten letter while my nurse was undressing her wound.

“…..I would be grateful for your input in her wound management, as I feel it is worse. The woman is pregnant, so I have tried to use some topical antibacterial dressings. If you feel that she requires oral antibiotics……..”

I looked up at Mrs M and frowned. ‘Is there something you would like to tell me?’ I asked her. She smiled sheepishly and admitted that she’s put on too much weight since she last saw me. I thought, well there are women who are having babies in their fifties, so I said ‘Congratulations, so how many weeks are you?’ Mrs M looked up with a start, then started laughing so hard she couldn’t get her words out, but I eventually worked out she was denying her pregnancy. I told her that’s what her doctor wrote. She insisted on reading the letter, after which, she started on another fit of laughter, with tears running down her face. My nurse snatched the letter out of Mrs M’s hands, and squinted her eyes as she read it several times. Then she pointed to the sentence ‘The woman is pregnant’ and said, ‘I think this says, the wound is pungent?’ Yep. The wound did stink out my office when the bandages came off. Mrs M needed to be readmitted to hospital, for antibiotics and dressing on the surgical ward. Not the maternity ward.

When I was working in general surgery, I once received a patient  with questionable bowel obstruction transferred from another hospital. They were particularly concerned about him because he has not been able to tolerate any fluids orally. I was not convinced he had a true obstruction, but reluctantly accepted him despite the fact I was up for my second night on call in a row. He arrived through emergency with a hand written letter.

“….Mr XX has had ongoing retching for 24 hours, he last opened his bowels 3 days ago, and has farted since 6am this morning……”

I was livid. If Mr XX has passed wind, it meant he wasn’t really obstructed. He probably just needed to have a good enema. I couldn’t believe that I got woken up at 2am in the morning to see someone with constipation. I rang up the referring doctor and ripped through him (fuelled by lack of sleep) about unable to diagnose and treat constipation. When the poor man on the other end of the line got his chance to say something (because I stopped to take a breath), he said that Mr XX hasn’t passed wind for 3 days. I put on my self-righteous tone and referred to his letter. ‘No, no, no!’ the young doctor cried, ‘I wrote he has fasted since 6am’. Let’s just say, humble pie was not easy to eat at 2am after 48 hours of no sleep.

The best one arrived via fax. It was another handwritten referral letter I received from a local family doctor. Luckily, I was reading this before the patient came to her appointment. (Warning: I apologise in advance for the foul language you are about to encounter).

“Thank you for seeing Mrs Z, her cunt has been worrying her. she has tried many self-remedies to treat it  she has applied several different herbal salves, soaked it in methylated spirits, pricked it with a needle, and tried to level it with sandpaper. She’s so fed up with it, she would like to see you about having it cut out…..

Ouch. Ouch. OUCH?!?!

Nah, I thought. I must have misread something. So I re-read the letter again and again. I scruitinised the offending word. But it was as if I was hypnotised, once the word ‘cunt’ was in my head, I couldn’t possibly see another word within that particular scribble. The harder I tried, the more blinded I was to any other possibilty. There was a curve like a ‘c’, and an end that is definitely a ‘t’. I took the letter to my secretary and asked her to read it. She started, ‘Dear Dr T, thank you for seeing Mrs Z, her…’ she stopped suddenly. Go on, I urged her. She looked at me with pleading eyes and told me she couldn’t bring herself to say the word. I gave it to my nurse, she raised her eyebrows at me. I thought about ringing the doctor and get him to send her to a gynaecologist. But my curiosity got the better of me. When she came into my room, I asked her to show me her problem. She smiled, bent over in her seat, and took her shoe off.

Under her big toe, was a plantar wart.

I have to admit, I have always struggled with hand-written letters from my colleagus, and I hang my head in shame on behalf of my profession. But personally, I have a valid excuse. After all, English is my second language and I failed spelling when I was in primary school, so I am pretty much illiterate when it comes to reading letters anyway.

Guest Blog: Take it Like a Man

My very first guest blogger article – thanks to the awesome Women in Surgery blog site.

Women in Surgery

Oooh, exciting! This week we have a guest blog! The awesome Tiffany from Surgery at Tiffany’s (a blog which I can highly recommend) has kindly agreed to share her response to out post about whether or not women in surgery are less confident than their male counterparts.

If you are interested in guest blogging on this site some time, please get in touch. It would be great to make guest blogs a somewhat regular thing! But now, without further ado, here is what Tiffany has to say:

When I was accepted into plastic surgery training back in my mid-20’s, I was the only female plastic surgery trainee in the state. There was only one female plastic surgeon working in town, but she was trained overseas and imported into our hospital. She was my mentor and ally. She told me stories of her training and gave me valuable insight into…

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‘Doctor’ is my Job. Not who I am.

I hate travelling alone. Somehow or rather, I always end up having a conversation with whoever sits next to me. I don’t mind the conversation, but sooner or later, the ‘oh-so-casually-asked’ question comes up: ‘So, what do you do for a living?’

I always hesitate. I always consider lying about what I do. I just don’t want to say I am a doctor.

It took me a while figure out why. Apart from the fact that once people find out they are talking to a doctor, they lose all interest in talking about anything else. Anything else but every medical condition or surgery they have ever had. Then they move onto each of their family members and friends. In between, they give you their five cents’ worth of why they knew better than the doctor, and how Dr Google was so helpful. By the end of the flight, they would be asking for a free in-flight consultation as to what my opinion was in regards to dear old departed Grandpa’s gouty big toe.

I get that. I really do. I find myself doing the same when I talk to people in certain jobs. When I first met my friend who is an airline pilot, I told him about all my terrible flying experiences. I could literally see his eyes roll to the back of his head as I carried on. But he has no qualms in telling people he is a pilot. In fact, he loves it, because he says it is a great drawcard for chicks.

I don’t think it is a drawcard for me. You could see the interest dimmer in men’s eyes when I tell them I am a doctor, or the body language wthdraws when I mention that I cut people up for a living. Well, not exactly in those words. It is often hard to tell whether it is because they are intimidated or they are just not interested in female doctors. Of course, once they get over that fact – and they haven’t moved onto someone else with a greater one-night-stand potential – I get the low-down about their latest health problems over a beer. No Siree, there’s no flirting for the female doctor at the bar, It’s all serious talk about their latest health problems. When boys fantasize about playing doctors and nurses, I guess they just never really imagined playing the nurse.

People judge people by what they do. Assumptions are made- some are true, but majority of the time, it can be quite far off the mark. These are often based on stereotypes. So, when I tell people I am a surgeon, people usually presume that I am a smart, rich, arrogant, bossy, ball-breaking feminist. Some even assume that I am single. Interestingly, some people talk differently to me once they realised what I do for a living. It is almost insulting when people make comments like ‘You know, you are not like a typical surgeon. You are so normal and down to earth.’  Yep. I eat, drink, wee and poo like any other normal person.

But most of all, I hate telling people that I am doctor, simply because it is not who I am.

I am a surgeon, and yes it consumes my life, but it is still just a job for me. I would still be me if I was a teacher, waitress or cleaner. I would still have the same work ethic, the same standards and the same approach to my work. I don’t identify myself with what I do for a living, but rather, what I do in life.

I think it is a good thing.

It allows me to separate my personal life and work life better. In the time continuum, they do overlap. For instance, when I am out shopping for groceries, I get a phone call from work. But I don’t think of myself as a surgeon doing groceries, I identify myself with everyone else around me doing groceries, the only difference is I am getting a call about work when it’s a Sunday afternoon. When I have issues at work, I don’t bring it home to my personal life.  When I have problems at home, I deal with it like a concerned wife, not like a surgeon.

It is also good for protecting myself. When I get abused by patients, or complaints from colleagues, I find it easier to see it as a criticism of my work, and less an assault of me as a person. They don’t know me, not really, they are just angry at the doctor. This allows me to look at my work more objectively and find out what I may be able to change or improve, rather than get all upset because I feel incompetent, hurt and lose my self-confidence.

My husband likes it. He thinks that I keep the non-doctor part of myself only to those closest to me. He often chuckles when he hears me speaking on the phone to my colleagues at home. ‘You talk like you have balls.’ Not the most eloquent compliment he could bestow on his wife, but he loves the fact that as soon as I put the phone down, I revert back to the quirky chick he married. The one that snuggles up to him on the sofa and lets hm believe that she worships the ground he walks on, whilst taking a piss out of him all at the same time.

Most of all, separating my job and my identity allows me to have a life outside work. I have other interests, many of which are not exactly congruous with what I do for a living. I suppose most people think doctors play golf, sail, travel during their spare time. Me? I enjoy bashing up my Sensei and his gigantic sons during my karate training sessions (free medical care offered if I win).  Other weekends I go to the gun range and work on my not-so-perfect trap-shooting technique, in between cheese tasting with the large Italian community at my local gun club. I seriously think that I would be more comfortable calling myself a mediocre amateur trap shooter (who loves her chilli cheese), than I would a surgeon.

Discovering my identity outside my work gives me the opportunity to find out who I am, and confirms that I am not my work.  It gives me a purpose in life even if someone strips me of  my job and all the associated status it represents. It determines how I do my job.  How many times have I heard of senior colleagues continually postponing their retirement? It is because they are too afraid of retiring – they have nothing besides their work and they are at risk of losing their identity once they stop being a doctor.

I would hate to think my view is a reflection that I am not committed to my work or that I don’t love my work. In fact, I really believe that I make a better surgeon if I am also a regular human being. I hope that people don’t just see me as a ‘doctor’, but rather a kind, thoughtful, considerate, empathetic, intelligent, decisive and trust-worthy person. A person that they feel confident in as their doctor. Because that’s who I strive to be.

Back to the plane.

‘So, what do you do for a living?’

‘Oh,’ I would shrug, ‘not much. I am a lady of leisure.’ I wave my hands around elegantly like a practiced socialite. ‘but I am fairly busy,’ a sweet innocent smile thrown in here, ‘I go to lunches with my girl friends, I love a bit of shopping; I organise charity functions and I always attend my husband’s work-do’s, you know.’

Usually I get an indulgent smile. ‘Well, you lucky girl.’

I would give a very girlish giggle. ‘I know, my husband spoils me.’

The conversation takes a brief break as the air hostess wheels the coffee cart up to us. She bends over to me.

‘Dr Tiffany, can I offer you a coffee?’

Damn. Sprung.

May be there is a doctorate in home-decorating?

Diagnosis: I Don’t Give a S#@% about myself

One of the most frustrating things I encounter at work is trying to help people who doesn’t want to help themselves.

Here are the 10 top clinical signs (for the novice):

1. The beautifully tanned patient who is sunburnt all over, (looking like he/she has just spent their weekend on the beach), and is about to go into the operating theatre to have a melanoma excised.

2. An obsession with blenders. The lap band is tight to maximise weight loss, the patient is supposed to be on a portioned healthy vitamised liquid diet. Instead, he lives on a  ‘vitamised diet’ of Big Mac and French Fries, liquified via a blender. ‘I just don’t understand why I am not losing weight…

3. The dangerous oxygen tank. The patient who just had 1/2 of his right lung removed for cancer – so now he is dependent on oxygen – lighting up a cigarette in the hospital courtyard. Taking a drag on their cigarette in between inhaling a whiff of oxygen from their mask. Honestly – if you want to kill yourself, that’s ok, but to blow up the hospital???

4. An X-ray that shows a new fresh hand fracture through plates and screws over an old fracture. Excuse: ‘Well, punching my fridge is better than punch my Dad in the face, rght?’

5. The MIA patient. The patient was called for the operating room, but he couldn’t be found anywhere. Because he was outside for his ‘last smoke’ before having half f his lip removed for  lip cancer. ‘You only told me that I couldn’t eat or drink before my anaesthetic, you didn’t say I couldn’t smoke.’

6. Patients with bags of ‘unfilled’ medication scripts. One is really unsure as whether these patient don’t take their prescribed medications (for their heart disease, cholesterol, diabetes, infections etc), because they can’t be bothered, they don’t want to or they just ‘don’t believe in taking medications.’

7. DNA’s (did not attend). Patients who have appointments for their cancers to be assessed and removed do not turn up to their appointments despite multiple phone calls, or simply, they have important work-commitments or holidays and need to move their appointment to 6 months later when things are quiet (and the cancer will be inoperable.)

8. The broken plaster on a broken arm. Sometimes, the non-existent plaster on a broken arm. ‘I know my arm is broken, but it got so itchy I had to take the plaster off’.

9. The gigantic fungating cancers. It takes time for cancers to grow. When I see a very very large cancer, I wonder why patients don’t come in when it was the size of a coin. Once I had a patient with a skin cancer on his chest. It was the size of a dinner plate, and it had already eaten into his breast bone. I asked him why he left it until now to come, he said that he only came in because it was growing into his neck and he couldn’t hide it behind his business shirt and tie at work anymore. Did he know it was a cancer? Yes, but he was too busy at work to take time off for an operation.

10. The smoker with a cigarette dangling out of his neck. The throat cancer patient who had his throat removed now has to breathe out of his tracheostomy. He was found lighting up with a cigarette taped to his tracheostomy. A short-cut highway of delivering poisons directly into his lungs. Well, I guess he won’t get oral cancers from smoking this way.

The Differential Diagnoses:
1. I have a severe case of NFI (No F&%$* Idea)
2. I am so f$%#@ scared that I’d rather bury my head in the sand
3. My health is my doctor’s responsibility because that’s their job to fix it

But sometimes we just have to face the harsh diagnosis of: I don’t Give a Shit about Myself.

 

Things you shouldn’t say to your surgeon before your operation

I have had a very long tough day of operating, so please allow me some self-indulgence in writing this blog. I sincerely apologise in advance for the sarcasm and disillusioned humour to follow!

The last thing anyone wants is an annoyed surgeon operating on them. I mean, would you be obnoxious to your chef or the waiter that is serving you? (We all know they will spit in your food) Would you be an ass to your dentist just before he/she picks up the dental drill? So why, oh why, would someone piss their surgeon off just before being wheeled into the operating room?

‘I have been waiting for 2 hours since 8 o’clock.’

My answer: ‘Oh, that’s great, you arrived nice and early so you are now all ready to go in.’

What I really want to say: ‘Sorry, I just finished my 2-hour champagne breakfast, hic.’ or ‘Are you in a rush to go somewhere after your operation?’ or ‘I’d better go faster during your operation then, so you can get home sooner.’

‘Are you sure you have done this before?’

My answer: ‘More times than I can count, you will be ok.’

What I really want to say: ‘No, but there’s always a first.’ or ‘No, but I watched it on You-Tube last night, and I think I got the general idea.’ or ‘Yes, when I was a medical student, on a pig in the lab.’

‘How come this operation costs so much?’

My answer: ‘Because it is a major operation, it takes a lot of time and expertise to do.’

What I really want to say: ‘Because you have come to a surgeon, not the local butcher.’ or ‘You are free to shop around, maybe it will be cheaper if you get it done over the internet.’ or ‘I don’t do surgery because I love helping people, I do it for the money.’

‘Would I have a scar? Will it be ugly?’

My answer: ‘Yes, you will have a scar, just as we discussed before. It will fade.’

What I really want to say: ‘Of course you will have a scar, moron, you are going to be cut open and I may be good, but I can’t perform miracles.’ or ‘No, you won’t have a scar, because I do it all by telepathy.’ or ‘Yes and Yes.’

‘Please do a good job and don’t kill me.’

My answer: ‘Don’t worry, we will do our best to look after you.’

What I really want to say: ‘Ok, for once I won’t make a mess of it, but have you signed a will yet? You know, just in case.’ or ‘Do I get a bonus if you get to live through this?’ or ‘You are expecting too much from me, I don’t think I can handle it.’

‘If the operation doesn’t turn out to be what I wanted, can I get a refund?’

My answer: ‘No, but if that’s the case, I will do my best to give you a result you are after.’

What I really want to say: ‘Sure, if you want a refund, we will have to put the cancer back too.’ or ‘No, because I can’t take the implants out of your boobs when you’ve changed your mind and use it for someone else.’ or ‘No, because I have never learnt how to undo a facelift.’

‘Have you been working all day? Are you too tired to do my operation? Can you please pay attention when you are doing it?’

My answer: ‘This is a normal working day for me, I am fine and you will be fine too.’

What I really want to say: ‘I will be fine. My hands will be steadier once I have had a drink.’ or ‘Don’t worry, watching the tennis on my laptop during your operation will keep me awake.’ or ‘I am fine, my ADHD is under control, I have just had my 6 oclock dexamphetamine.’

‘Do I really need to have this operation?’

My answer: ‘Remember what we talked about before? I would not be recommending an operation unless you need it. You will be ok.’

What I really want to say: ‘Did you hear anything I said last week during your consultation?!?!’ or ‘No, you don’t need this operation, I just like cutting people open for fun.’ or ‘Yes, you really need this operation because I really need to save up for my Ferrrari.’

‘You look too young to be doing this, do you know what you are doing?’

My answer: ‘Oh, that’s so sweet, thank you. I am actually older than I look. I have done this for several years now, so I think both you and I will be ok.’

What I really want to say: ‘If you prefer to go to Old Shakey next door, you are welcome to swap surgeons.’ or ‘I have done heaps of this operation on cadavers during medical school. I graduated with honours last week.’ or ‘I only look young because you are so old.’

 

Ok. That last one was bad. I should stop here. I should go to bed, get some sleep.

Because come tomorrow morning, I have to find my professionalism, tolerance and patience. Again.

An Impossible Letter to the Health Minister

This is an open email distributed by the doctors working in the public health system of Queensland Australia.
The Queensland state government has presented new contracts consisting of ‘improved’ work conditions for its doctors.
These conditions include:
1. If a doctor resigns, 6 months’ notice is required, or paymentf 6 months salary to the hospital is required for leaving
2. On dismissal, there is no process for appeal
3. Doctors can be rostered to do any shift, with no specification on having available junior staff support
4. Work conditions (pay, allowances etc) can be changed without notice by adminstrators
5. Work hours, duties, locations can be changed by discussion, not agreement
 
It is a contract which several independent industrial lawyers have advised against signing.
It s a contract where the government will own the doctors’ livelihood. Doctors will be held hostage by their contracts, which may come in conflict with patient care, as they may have to make decisions to appease the administrators, rather than what’s best for the patient.
 
*Please note, I didn’t write this email, but I wish I did.
 
 
Date: 7 March 2014 10:48:17 PM AEST
 
Subject: Nothing here is impossible Mr Springborg

Dear Minister Springborg and Premier Newman,

We have been told that your legislative changes are irreversible, and the train carrying these individual contracts has already pulled out of the station, and cannot be stopped.

We sincerely hope that your talks with the SMO representatives around the concerning issues in the contracts result in a successful outcome for all.

If SMOs are not convinced that our ability to continue to practice public health medicine with safety is secured, then the state will be in grave danger of losing its’ brightest and best.

Please listen:    We say to you that nothing in your legislation, and the individual contracts, is irreversible. This train wreck can most certainly be stopped.

You are dealing with a group of people who understand what is truly irreversible and impossible, as they have stood in the face of death and tried to stare death down, bargained against time with their knowledge, skills, equipment and courage, and sometimes failed, and often times not.

When you have to tell parents that their child has autism and intellectual impairment and that their lives will forever be filled with difficulty and challenge, and watch their grief unfold – that is irreversible.

When you watch a child bleed to death before your eyes as you pump blood in their arm only to see it pour out of the gaping hole in their skull, where it has been sheared off from a motor vehicle accident – that is irreversible.

When you tell parents that their baby has cerebral palsy and will never walk or talk, or even eat independently, because their brain is malformed or damaged beyond repair   –  that is irreversible.

Nothing here with your individual contract legislation is impossible to change – we’ll tell you what is impossible.

When parents beg you to save a child’s life after a second failed bone marrow transplant for leukaemia, as you’re watching them die from an infection they have no white blood cells left to fight  –  that is impossible.

When you’re trying to bring back a heart beat in a child who has been pulled from the bottom of a pool, an hour after its heart beat stopped  –  that is impossible.

Don’t you dare sit there and tell us that this legislation is irreversible and that stopping this contract roll out is impossible. Because we know that all it takes is a show of hands in a parliamentary room, and the swipe of a pen across a piece of paper.

No fancy machines, no million dollar drugs, no transplanted tissues, no 12 hour operations, and no miracles of fate.

Just understanding and good will from your colleagues and yourselves. And if you’re up all night to achieve that, then welcome to our lives.

We have each others’ backs, us medicos  –  we always have and always will.

Because we have all stood there with the sick and the dying, and we know how lonely that journey is without colleagues at our shoulders, and support and resources at our backs.

So we will stand together, even if we have to walk away, together  – until you listen, and pull on the brakes, and stop this train wreck from playing out to its end.

Please enter the discussions with good will, and open minds and hearts, and leave your egos on the coat rack outside.

The health of the state is in your hands – please don’t throw it away.

Sincerely, Senior Medical Officers of Queensland Health.

Teaching by humiliation

This is not a blog about bullying. Just about teaching.

Last week, I witnessed a scene in an operating theatre.

Two doctors were operating on a patient. One was the senior consultant and the other, the junior resident. The tension in the room was palpable, and even the humming of the ventilator sounded like a jumbo jet. The operation was not going well. There was constant welling of blood in the body cavity they were concentrating on, and the sucker tubing gurgled continuously with bright red fluid. Stress was evident as expletives started to escape from behind the older doctor’s mask., directed at the younger man.  The junior resident was trying his best to help, but he was obviously straining under the other man’s diatribe, apparent in his worsening tremor and the inability to stop the blood from flooding the operating field.

Then, miraculously, the senior surgeon managed to control the situation, and it was as if everyone in the room released their long-held breath in unison. The older surgeon gave an arrogant laugh, ‘It would really ruin my numbers if that one got out of control.’ He daftly tied the loops around the bleeding arterial branch. The operation continued, but as it progressed, it was clear that the resident was starting to annoying the older surgeon with his scrutinised clumsiness. At times when the younger man got in the way, his hands were swatted away like a bothersome fly, accompanied by over-dramatic exasperated sighs from the senior surgeon.  When the resident missed a suture with his scissor, it was snatched out of his hand with an expletive, as the older man made a deliberate show of cutting his own sutures, to demontrate the younger doctor’s incompetence.

The tremor in the young man’s hands deterioated. By the time it came for him to close the wound, one could almost hear the instruments vibrating against the patient’s skin. Criticisms started with a few grunts, escalating into abrupt barks of ‘Don’t’ and ‘Stop’. Finally, the needleholder was grabbed from his hand roughly by the senior surgeon. The older man started to close the wound himself in angry jerky movements, at the same time, a barrage of insults descended on the young doctor.

‘Pathetic aplitude for surgery….’

‘You will never make a surgeon…..’

‘What were you thinking taking on this job…..’

‘I don’t know how you could have made it this far as a doctor…….’

‘you are useless…. It wouldn’t have taken me this long if it wasn’t for you……’

‘Why is it that I always get the most pitiable incompetent junior doctors….. ‘

It was as if the avalanche was unstoppable, hammering down at the young man whose head was bowed over his scissors, staring at the wound in concentration as if it was his lifeline. As the last stitch was cut, the older man threw down his instruments on the table and tore his mask off.

‘Put the dressing on and get out of my operating room, before you sabotage anymore of my operations, you worthless excuse.’ He marched out angrily.

The room was quiet. No one said a thing in the last two hours. Including myself. Why? You may ask. Because we were all too afraid, that if the attention was drawn away from the junior doctor, the torrent of abuse would only continue, just at a different target. We knew this from experience. Dr M* was well-known for his vicious disposition. Anger management classes and suspensions did not apply to him, as everyone knew that he was about to become the next Director of Surgical Services. Over the last few years, complaints about him mysteriously got lost, and disgruntled staff members seemed subdued when questioned.

But, it wasn’t the unfairness, or the endless onslaught of malice that shocked me, but the silent tears that were now running into the mask of my younger colleague as he carefully applied the bandages on the wound.

In front of me, was a grown man, reduced to tears.

I knew Peter* well. He was an eager young medical student when I was a first year training resident in surgery. It was an interesting time, with me trying to find my feet as a newbie in surgery while he took everything I did as gospel. Peter was like a curious sponge, everything I taught him, he investigated and researched until he fully understood all there was to know behind each surgical fact.

But that was more than 10 years ago. The man in front of us now was a final year trainee, about to step into the world as a fully qualified surgeon within 3 months. He was a husband to a fellow doctor and a father to 8 year-old twins. What would the children think, if they ever saw their father, standing with his shoulder slumped, his hands shaking, and tears pooling in his mask? It broke my heart. This was a grown man, broken, momentarily, by the maliciousness of another.

Awkardly, I walked over to him. I took the bandages from his limp hands, and I rested my hand on his back.

‘Three months, Peter. Three months. Just hang in there.’

He stared at the floor.

I gave him a gentle shove. ‘Go and write up your operation notes. Grab a coffee. You have another case to go.’

He seemed to gather himself. He took his mask off and swiped at his eyes. He nodded, then looked up. Like all surgical trainees – hard veterans of regular abuse – he reached deep inside himself, found his ultra-thick ‘surgical hide’, and threw it over himself in a protective shroud. Like a magical cape, the despair was suddently erased from Peter’s eyes as if the last 3 hours did not exist. Red rims and puffy eyelids were the only evidence that something may have been amiss. A lop-sided smile broke through. ‘I need something stronger than coffee.’ A self-depreciating laugh followed as he strolled out of the room, looking for all as if he had just accomplished a simple case without a hitch.

It is true that bullying is rife in the field of surgery. It may sound as if I am making excuses, but the stress and pressure can often result in unintended explosions of emotion – which majority of the time, is usually let lose at the most junior person in the room – and never in a positive way. The inferno is often directed at the person least powerful to fight back – which is our trainees or students. They are dependent on their senior surgeons for their assessments and recommendations. Not to mention references for future positions. Surgery is a small world, and a close one.  Reputations have a way of establishing itself as early as one’s training years.

It is such a cliché when I say that it was the way I was ‘brought up’ in the world of surgery, and I honestly believe, it made me tougher. A surgeon need to be able to withstand unforeseen stresses, make snap decisions in dire situations and be able to get on with the next operation even when the previous one has failed. I remember being completely accepting of the fact that when I signed up for surgical training, I was going to get abused, yelled at, bullied, hassled and most likely reduced to tears at the most inconvenient times. I remember the incredulous looks from my non-surgical colleagues when I said (tongue-in-cheek), ‘but there is no such thing as bullying in surgery. It is called teaching.’

I remembere being pulled aside by my mentor in my early years, who tried to warn me about a particular senior surgeon’s bad temper, and his love for torturing trainees with spiteful intimidation. I just shrugged, to her amazement, I was not concerned, ‘Well, the way I see it, is that he doesn’t have to teach me at all, but if he is willing to teach me, even if it’s by humiliation, I am willing to learn.’

Sure. I know I am tough. But I had to be. When I was training in surgery, I was one of the very few females in my specialty. I was determined not to give anyone an excuse to call me a girl – because I was a grown woman, and I was gong to be as good as any grown man around me. Some were harsher with me because they thought I belonged in the kitchen, some were easier on me because they were susceptible to a pretty smile, heels and pencil skirts. Constructive criticisms were given, some verging on bullying, whilst others just needed to be accepted with a stiff upper lip.

Now, don’t get me wrong. I don’t think it is right to teach by abuse, but everyone knows how hard it is for an abused child not to repeat the same life-cycle as his/her parent. I cringe everytime I hear myself say, ‘back in my days…..’

Because back in my days, if a trainee has not looked up an operation the night before the operating list, he would have been sent to the library for the remainder of the list until he knew how to recite the all the procedures back to front. Then, maybe, he may be allowed to hold a scissors and cut the sutures for the senior surgeon.

Despite the long-history of the harsh realities in surgical training, generation change has definitely brought new approaches to teaching. A trainee is like a trade apprentice. Except teaching only knowledge and skill is not enough. The importance of cultivating empathy, integrity, responsbility and collegiality all need to be incorported into the rearing of a good surgeon. And if we start with abusing them, none of these quality will get an opportunity to flourish. Not if their everyday aim was to survive the day without being reduced to tears, or feeling as small as an ant that is just about to be crushed under a surgical boot.

I remember vividly the first advice ever given to me.

You will become a good surgeon if you are a good person, but you aren’t necessarily a good person just because you are a good surgeon. When surgery fails, your integrity is the only thing that will lead you to make the right decisions.

Peter is a good man. He will one day make a great surgeon.

*All names have been changed to ensure confidentiality and protect personal identities.

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.