Final Thoughts: Surgery

 My first clerkship of third year (surgery) has come to an end...

• 10 weeks, 60 days, 529 hours of work in areas ranging from Trauma, to Surgical Oncology, to General Surgery in a rural area. 
• Working at my medical school's hospital, I averaged over 69 hours/week.
• Working at the rural hospital averaged 28 hours/week. 
• I enjoyed 10 days off in the last 70 (that's 1 day/week).
• I completed 3 nights on call, which entailed working about a 30 hour shift each time.
• I studied surgery outside of work a total of 166 hours.
• My total work in surgery over the past 10 weeks is: 695 hours in 10 weeks (69.5 hrs/week...10hrs/day).

What I LOVED about surgery:

• Being able to fix someone's problem in a very short amount of time is so rewarding.
• Physically taking cancer out of a patient's body.
• Short rounds on very grateful patients.
• A great deal of respect is given, based upon the surgical hierarchy (med student < intern < junior resident < senior resident < chief resident < attending < chief of surgery). I like that you must earn respect, and it is slowly given as you prove your worth.
• Free food and drink in the surgeon's lounge just because you are, well, a surgeon.
• There are only like 10 medications you need to know - a few pain meds, a few antibiotics, and a few anesthetics (Percocet, Vicodin, Ancef, Bactrim, Metronidazole, Clindamycin, Cefotetan, Lidocaine/Epinephrine, Zofran, maybe a few others...).
• There can be a huge variety of problems you see on a day-to-day basis, so every day is different (even if you do 8 cholecystectomies in 1 day, no two surgeries will be the same)

What I DIDN'T love about surgery:

• Surgery = Life. 
• Mistakes happen. Even the very best surgeons can make a mistake and the results can be dire. 
• Even if there are no mistakes and the surgery goes perfectly well, some patients will develop problems due to the surgery and may never recover.
• It's a hell of a lot of pressure, it is really life-or-death work.
• Unbelievably male dominated...it kind of feels like you've stepped back in time to the 50s, when men ran the show. The younger surgeons are less like that, but the older ones are still very much "alpha males".
• Ridiculous amount of hours worked.
• Skipping breakfast...lunch...then dinner because you're in a complex surgery.
• Putting my hands in a Hep C or HIV positive abdomen (My thoughts during the entire case are something like this: "I hope double-gloving is enough to keep his blood away from the cut I have on my hand...I hope I don't get a needle stick...Please, don't drop that scalpel near me...that surgical nurse better hand things to me absolutely perfectly so nothing comes near my skin...Is this eye mask really enough to keep a squirting artery from hitting my eye?...I don't think I'll ever be able to scrub hard enough or long enough to feel properly clean after this case...") And while those thoughts continue to flood my mind, I have to pretend like it doesn't bother me in the slightest, or the surgeons will think I'm a total wuss.

I ended up liking surgery so much more than I thought I would! I came into this rotation thinking that I'll just get the worst out of the way first, because I'll be so excited to see patients that I won't mind the hours and the surgeries as much. Turns out I enjoyed the surgeries, and even the hours ended up not being that bad. I don't think it's the career for me, but I enjoyed my time and have a lot more respect for surgeons now that I have somewhat of a feel for what they have to go through to get where they are.