Archive for June, 2010

Oh Surgery

June 22, 2010

After finishing my Emergency Medicine rotation a few weeks ago, I had a bit of a revelation that surgery is where I want to take my medical career.  EM was a lot of fun, don’t get me wrong.  But I always disliked how we never really fixed the sick patients.  If they were alright, we sent them home.  If they were really sick, we just held onto them until one of the in-hospital services could pick them up.  On my last day, there was a gentleman who was really very sick; he came in right at the turn of the shift, and so he had two shifts of EM docs working on him at the same time for almost an hour and a half to get him “stabilized.”  But then off he went to the MICU (medical intensive care unit), never to be seen or heard from again.  They paged a code to the MICU later that night, and one of the residents wondered aloud if that was our guy.  Who knows?  I found that aspect to be a little disappointing.

There are plenty of procedures in EM (I like procedures), and the shift-work lifestyle can be pretty awesome.  All the people I had the chance to work with were all very nice.  But you always give up your sick patients – you never really “fix” anyone, and the procedures are hurried, slap-together affairs because there are the other 20,000 patients out there waiting to be seen.  Plus there are the classic “emergency room specials,” the savory personalities that pervade every EM waiting room.

I appreciate that in surgery there is sort of a credo of personal responsibility.  Your incision, your patient.  And especially in critical care/SICU type work, the buck stops with you.  Patient goes from ER to the floor, and then if they’re too sick, they go from the floor to the ICU.  But once there, you gotta fix ’em.  No where else to put them.  And so they either get better . . . or they don’t.  :shrug:  That sort of mentality appeals to me.  I also love the feeling of cutting the sick right out of someone.  Peri-umbilical pain that turned into excruciating right lower quadrant pain a few hours ago?  Nausea, vomiting, fever?  Sounds like appendicitis to me.  Come on up to my OR and we’ll cut the sick right outta you!  And the mix of technical proficiency and medical knowledge.  Oh man.  Get excited just writing about it, lol.

So yeah.  It’s going to be surgery.  Get worried because of the hours, and the fact that I might end up like some of the people who come out of the process burnt out, angry shells of human beings.  But for the chance to do what they do . . . I think it’s worth the gamble.  We shall see.

In other news, I’ve been studying for the Step 2CK the last few weeks.  Kinda ready to get this over with, and move on to my SICU rotation in July.  oo rah!