I knew before I even started medical school that I as a physician, I wanted a career that involved complex problem solving in a high acuity environment with lots of technical procedures and an absolute minimum of ‘chronic’ patient care. I don’t just want, but Ineed to be independent. I have to confess that I have the attention span of a 5…no, a 3 year old! And, sick & sadly enough, I enjoy the pissin contests of the alpha-male dominance ritual. Essentially, these needs & my attributes steered my towards three choices: anesthesia, ER & surgery. Naturally, they ended up being my top 3 choices, in that order.
Honestly, I was completely taken by surprise by anesthesia. It was my second clerkship of my third year & only 2 weeks long. Historically, it was a blow-off elective here in Saginaw…the MSU-MD students usually signed up for it during interview season because there was generally no expectations. No shit, my first morning, the Anesthesia Chief gave me a tour, introduced me to a couple of attendings and told me that to pass this clerkship, I only needed to show up by 0700 every day. I could sit on my ass and watch TV or participate as much as I wanted. I could leave at noon or stay as late as I wanted. However, to pass I could nothing else other than show up by 0700 & watch TV/read/study until noon and then leave.
I countered with “I’m truly interested and want to learn”.
His response…"Yeah, been told that before"
I spent that first day in a simulation lab intubating and puttin lines into dummies – no, the plastic kind.
How did I handle this? I showed up at 0600 eveyr morning for pre-op rounds and actively chased down attendings to learn stuff. Within the first day or so, they figured out I was damned serious.
On day three, after a few intubations on day two and a lot of watching, one of the sneior attendings grabbed me and told me to follow him. He took me into the cardiothoracic OR suit and asked me, “How many IJs or Swanns have you put in?”
"well, you’re about to do one of each. Did you read about them?"
Luckily, “yes” – so, he proceeded to guide me through loosing my IJ and Swann virginity – he was rather gruff, but I knew that I was being given one shot, by a hard-ass, to earn my stripes. I clumsily, but successfully, got the IJ in – lots of blood (I was worried that the pt would need a transfusion!) and I was sweating my ass off I was so nervous!! Then, after I sewed it in…he handed me the Swann…which I promptly grabbed by the wrong end & contaminated my gloves! He smiled and handed me a new set of sterile gloves and I was rewarded by flawlessly floating my first Swann-Ganz catheter – which was truly truly a stroke of luck!!! I have floated a couple since, so I KNOW that the first one being so easy was hugely a luck thing!
Long & short, I showed up way early and stayed until 1700 or after every day…even until 2200 on several occasions. I proved to them that I was there and damned serious about it & was rewarded heavily by there teaching, patience and cumulative wisdom. They taught me to intubate smoothly, place central lines & manage airways at a far more in depth level than I ever had as a respiratory therpist.
I was hooked – big time! However, I did not want to simply marry the first chick I took to the prom; so I forced myself to keep my optionsopen – meaning, check out my surgery & ER clerkships to see if indeed Anesthesia would be my mistress!
At the end of my Jr/beginning of my Sr years, I lined up clerkships in eachof the three: ER, Anesthesia and Vascular surgery – I can now state, with confidence, that anesthesia is the way for me!
Hey, great story, Dave!
Although how anyone could do surgery rotation and not 'see the light'…heh heh.
Sounds like you and Anesthesia are a perfect match.
This is a great idea…folks relating how they came to find their true love in medicine. I'll post my story later, when I have some time.
All through the first two years of medical school I was never sure of what I wanted to go into, but I was QUITE sure of what I did not want to go into: surgery. Remember the back-stabbing gunners, in it only for themselves, arrogant, full of hooey students of your class? What did they always seem to want to be when they grew up? Yep, surgeons. Who in their right mind would want to work around people like that?
All year my husband and I planned strategies to help me survive my two month surgery rotation - a notoriously malignant rotation at my university. Relaxation techniques, weekend getaways…he offered to get up every morning and bring my coffee to me in bed to help me cope with the chronic sleep deprivation (a ritual which persists today - much to his dismay).
The first month of my rotation was off site - general surgery at a local community hospital. Amazingly, so unlike the environment at the big U, these people were relaxed, interested in teaching and interested in my welfare. The residents were happy, congenial, and seemed significantly better read and more knowledgable than their tired counterparts at the Mecca.
My first day, my first case was a bowel resection for colon cancer. I can only conjecture what his thinking was at the time, but the attending - having just met me - handed the scalpel across the table to me and said, “you’re going to open.” He and the chief resident good naturedly walked me through my clumsy opening of the layers of the abdominal wall, until the intra-abdominal compartment lay exposed. “See if you can identify the carcinoma,” he said.
I reached my hands in and…my god! It was warm! It was, in fact, body temperature (of course).
One of the true epiphanies of my life occurred at that moment. I thought - and may have even spoken outloud: my hands are INSIDE THIS PERSON’S BODY. The implications and the magnitude of that idea were overwhelming to me. The unique responsibility that that this patient, that all patients and that society have entrusted to a care provider in these circumstances; it seemed almost sacred.
The second thought that I had was that I never, ever wanted anything more in my life than to do this for the rest of my medical career.
I have a friend who was, at the time, a junior resident in neurosurgery. I listened one afternoon as he described to me his first time seeing a human brain during a craniotomy. The desciptors of awe, the far-off look and slack expression of wonderment on his face…I knew exactly what he spoke of.
The best surgeons, I believe, are those who, for whatever possibly pathologic reason, are inexplicably enamoured, thrilled, intrigued by the process and the idea of surgery. Listen to the passion in Natalie’s posts when she relates her experiences as a surgery intern. The sheer love of the game naturally results in excellence at your craft.
And that’s why I became a surgeon…