Saturday, July 12, 2008

surgical triple play

i've heard that when you go under general anaesthesia, some nurses ask you to take deep breaths and count backwards from 100, and you wake up after the surgery still counting from 87. those hours are hours donated to a team of people you have no choice but to trust, and every other second you have to yourself after that is no replacement for the time you spent under sedation. of course, it's a fantastic deal to trade a couple hundred minutes in exchange for an extension to your expiry date but it's time that was taken from you without you even knowing it. still counting backwards. 87, 86, 85.


the thing i like most about hopkins is in the opening credits when a resident says, "the odd thing is they call me doctor. i don't even know what i'm doing."

i had a case presentation yesterday with the head of surgery. he breezed through the corridors like he owned the place (well, he sorta does, if you think about it), showing us the cases he personally felt were interesting and had good learning points. he rattled off differentials in the order of likelihood, based on facts from journals and experience. he had confidence, a great sense of humour, just the right amount of sarcasm - enough bite to make me wanna study till 3am every day, but not make me feel like the scum of the earth - and passion for his profession.

i'm relieved that residents have their moments of doubt, even when they're obviously brilliant (johns hopkins? hello?) but i am encouraged to see what 16 years of experience can produce.


surgery is not my cup of tea. it is a field of contradictions. it's brute force, going right into the warzone to deal with the offending tumour, ulcer, aneurysm, fracture. yet in the operating theatre, it's an elaborate dance of passing, moving, clamping, incising in silence. it's focused but you cannot neglect the person as a whole. only a bad surgeon would immediately "refer to medical". the decisions lie with the surgeon, but he/she cannot possibly function without a cross-disciplinary team. it's about having priorities and continuously changing them. it's administrative work with tonnes of informed consent required - blood transfusions, procedures, surgeries - but it's also scut work. icky gooey secretions. groans of pain.

the only thing that could potentially change my mind is the immense amount of respect surgeons get. they deserve every single bit of it, anyway. but no, surgery is not my cup of tea. not at this moment, no.

lishun at 7:58 AM