Scrub Me Raw – A Day In The Life Of A Surgeon

 

Its all guts and glory? No. Its guts, and more guts. A few of us may remember Samuel Shem’s “House Of God”. Those who do? Re-read it. Those who don’t? Read it! It is one of the best books ever written about the reality of being a doctor and altough published in 1978 it is, with a few small moderations, in essence still as acutely true as it was then. When you read it (not “if”, when – I m trusting my readers to be intelligent people interested in a really good read!), you will come across quotes such as this: “It’s an incredible paradox that being a doctor is so degrading and yet is so valued by society”. Truer words……

Let’s not make this into a great literal story. Lets get this right, no frills, no sugarcoating. Let me take you on a factual ride on the 24+ hours of a typical day in a surgeon’s life!

5.30 a.m. Your alarm goes off. Its early yet but it is summer and so the temperatures are already in the low 70’ies and it is light outside. Thats good! Easier to motivate yourself to get up when its not pitch black like it would be in winter. As you get up, your feet hit the floor, you hit the shower your brain is already on that film roll of the upcoming 24+ hours. You have 45 minutes to shower, get dressed, drink your first two cups  of strong black coffee and pack everything you need to survive the coming day and night away from home – clothes, toiletry kit, food, snacks, drinks. Of course there is a cafeteria at the hospital where you work  – but you have no idea whether you will get to go there during opening hours so you want to be on the safe side rather than rely on the the vending machines and their very limited choices. Your brain is already working on overtime; you are still at home but your thoughts are with your patients, on the cases you have scheduled for today. Your family is still asleep. For now it is just you and the universe.

6.15 a.m. In your car on your way to the hospital, the roads are just starting to get busy. Listening to the morning news. Contemplating if you should drink coffee number 3 that sits in the travel mug beside you but – that will only make you need to pee. Not a good idea.

6.50 a.m. You park your car at what you hope is a safe spot; with the hospital entrance in plain view the feeling you have in one of elation – you get to save lives again today! – and one of dread – you are looking at 24+ hours of complete and limitless availability, likely no sleep, no food and loads of stress.

7.10 a.m. In your office. Your name on the door with the letters M.D. attached to it jumps out at you and for a second you feel like you are in the twilight zone. Is that really you? Can you really do everything expected of you today? As you shed your street clothes and put on scrubs and a white lab coat you go through a process of dissociation. The private “you” – the mom/dad, the spouse, the friend, the YOU with all your doubts and fears and insecurities is safely boxed, sealed and tucked away into some hidden corner of your mind. The professional “you” – the doctor, the surgeon, sure and confident and even a tad arrogant –  emerges. This is what is expected of you, after all. You are an attending surgeon. There is NO ROOM for doubt or hesitancy. With a straight spine, a strong gait and a winning attitude you start your day.

7.15 a.m. You step onto the ward and automatically you are envelopped in an air of hectic. The hallway smells antiseptic and faintly of puke or excrements, hard to tell. As you grab a cup of bad coffee you realize you need to pee. Well, tough luck. Later. You meet up with your residents and interns at the nurses’ station so they can tell you about the last night. You have only been gone from this place for 12 hours but a lot has happened. As you try to register and file away all the information thrown at you, automatically assigning residents to certain tasks for the day, an alarm goes off down the hall. Code blue. A patient in real distress. You push your half empty coffee cup at the next available intern and your feet hit the hallway running just as a dishevelled nurse appears in the doorway of said room screaming for your help. From that moment on everything is on autopilot. Everything fades away – the noise, the hectic, the chaos; the argument you had with your wife last night, the planning for an upcoming birthday party for one of your kids, the “To Do” lists in the back of your mind. Its as if everything falls out of focus but this.

7.19 a.m. The room looks like a war zone. 3 patients – two really scared and one not looking good at all. A femoral bypass revision surgery from the day before – which means that one of the arteries from the groin to the leg was replaced with an artificial one. Arteries are the vessels that pump blood from the heart into the body. If you have a blood pressure for example of 160 over 90 that means that there is enough pressure in your arteries to pump blood about 5 to 6 feet into the air from ground level. Thats a lot of pressure, folks. With patient X – lets call him Mr. Jones – the new bypass sutures ripped, the blood accumulating underneath the skin quickly tore the skin sutures and blood has squirted everywhere – the bed, the linen, the walls, the furniture, the floor, the nurse, even the ceiling (remember? 5 to 6 feet……). As a result, Mr. Jones has lost quite a bit of the 2 gallons of blood in his body in a very short amount of time and is coding – which means that he is unconscious with no measurable puls or blood pressure.

As you enter the room the energy shifts. Everyone – every single person – looks at you and to you. You have the answers, you have the solution, you are the saviour. Small wonder so many surgeons have a God complex! You have to make decisions and you have exactly 30 seconds for that. And suddenly, you are in the zone.

7.20 a.m. You throw away your lab coat now ruined, bark out orders for lab works, blood units and fluids to be administered, put on the gloves a nurse throws at you from across the room, give orders for medication, materials, to book an OR, to inform anaesthesia; you order an intern to your side and when he just stares at you blankly you just shout at him, bark, order to put his hands into the open wound and press and compress with his whole body weight while you start chest compressions. No point in trying to get the heart back to pump if it just pumps out blood at the groin, is there? Your “human intern plug” looks pale, slightly green and ready to pass out but you haven’t got the luxury to coddle or comfort him; you just tell him to man up and pull himself together or make room for someone who is up to the job. The intern looks at you across the bed, his eyes roll back and he faints. Blood squirts from the wound all over you – scrubs, arms, face. No time to wipe it. No time to think of protecting yourself while you have a life to safe. In a split second you make decisions, again. Heart beat is back so you climb on the patient and put your own hands into the gaping cavity and the groin, find the artery and compress with all you’ve got.

7.22 a.m. You should be on your way to the morning surgical conference. Instead you are sitting on your patient with you hands deep inside of him being rushed into the OR. You still need to pee – no time. You haven’t eaten and your blood sugar levels drop to a point where you feel nauseous yourself. Tough luck, for you don’t have the luxury of giving in to that.

7.32 a.m. In the OR. A nurse has taken over the compression and you scrub. Time to focus. The antiseptic runs in rivulets down your arms and it’s smell hits your nostrils. This, you know. This is home. This is where you belong. Your mask tight over your mouth and nose, your bladder and stomach ignored, your brain busy with solutions for Mr. Jones’ groin. As you step into the OR with your hands in the air and get dressed by the scrub nurse you are fully awake, hyper alert and totally focussed because you have to be. There is no room for failure or mistakes. Mistakes mean people die. This man on your table, Mr. Jones, you know him well. He is a father, a grandfather, a husband. You know his family. They are all relying on you to fix whatever is wrong. So nothing else matters, can matter now, but this.

7.47 a.m. Before the day has even officially begun, really. Just a flicker of a thought that your kids are just now getting ready for school, that your wife is making them breakfast or is under the shower, that you miss them. Then: “10 blade” holding out your hand, taking the knife and cutting. The show begins.

8.15 a.m. Your phone rings. One of the nurses answers and puts it on speaker. The resident who makes rounds on the ward with two PRESSING questions that can’t wait. You answer while your hands keep on working.

8.27 a.m. Phone. The resident again. He forgot your answer to question number 2.

8.39 a.m. Phone. Of course, the resident. You silently wish him a painful death. But you answer his questions, with all the patience you have left.

9.12 a.m. You have been at it for an hour and a half. Its touch-and-go. Your lower back is aching from standing at an ackward angle for too long; you STILL need to pee and abandon the thought as quickly as it came; serves you right for drinking 2 and a half cups of coffee! On you go.

9.47 a.m. Phone. You tell the nurse that if its the resident he can go fu** himself. Kindness and patience have flown out the window by now. But instead, it is the radiologist. He has an emergency – he perforated an artery while he was doing a radiological intervention. There is bleeding. Can you come take a look? Hmmmm…… let me think. NO?! Call someone else, I am busy.

9.59 a.m. Phone. Radiology. Everyone else is busy, too. What to do? You tell the nurse to call your best resident and send her and then call you with whats’ what.

10.28 a.m. Cold sweat trickles down your back. The XRay gear you wear is heavy and pulls on your limbs. You feel lightheaded. You stand up straight, crack your back, close your eyes for a milisecond, take a deep breath, then another, and continue. Your bladder wants to burst. Fu**ing hell.

10.43 a.m. Phone. Your resident. Patient Y – lets call her Mrs. Smith – from radilogy needs surgery; she will prep her to be the next in line.

11.12. a.m. Last stitches. Done. You step away from the table, pull off your coat and your mask and oh thank heavens the XRay apron. Here is what you look like to an outsider: there is a dark V of sweat covering your back and front. Splotches of blood are on your face, your scrub hat, your shoes and socks. Luckily, other people will clean up the mess. You walk to the locker room, slowly, as if there is lead in your feet. Everything hurts. You take off your bloody, sweaty clothes and finally PEE. And then just sit there, numb, for a minute or two, trying to process it all.

11.15 a.m. Locker room door opens. The head OR nurse tells you that Mrs. Smith is being put under right now. You have 10 minutes to clean up a bit, dress and eat. While you do that you call the secretary back, two residents and the admin.

11.28 a.m. You are scrubbed again and ready for round two. A text from your wife just came in that you should call her asap, something at school with one of your kids. Later. Now, focus. Mrs. Smith is waiting.

11.28. a.m. – 5.17 p.m. Back to back surgeries all day with just enough time in between to pee. You haven’t called your wife back, just texted : in surgery, will call when I can. She will understand. You hope.

5.32 p.m. You are back on the ward. Your resident waits for you to go on rounds with him. You do.

6.47 p.m. Rounds done, residents gone home except for the one on night shift. The nurses from the morning have long been replaced by those for the afternoon and will at 9 p.m. get relieved by the night shift. But you are still here. You are on call, after all. You fall down onto the uncomfortable chair in the kitchen on the ward after nuking the dinner you brought from home. On the table beside it stands an energy drink. You shouldn’t. Its bad for you. But well, screw it. You need to be awake. You yawn and close your eyes, tired and worn out, fatigue in every cell of your body. Finally, you text your wife back. Her answer is: never mind, sorted it already. Busy making dinner for the kids. Love you, have a good shift! And so it goes. Your life goes by, the blink of an eye, and a lot of it without you present. No time for regrets, though. Relatives of patients want to speak to you, the resident in the ER needs you to look at a patient and you haven’t dictated a single OR report of the day yet. So, you get up, throw away your half eaten dinner, chuck down your red bull and hope that even if it doesn’t give you wings a pair of feet that don’t hurt would be pretty awesome right now.

9.13 p.m. Night has fallen. You have been busy and have just taken your overnight bag to the on call room. Shower! Blissful!

9.25 p.m. Shower cut short, demented homeless guy in the ER with a possible leaking abdominal aneurysm – that is when your biggest artery, your aorta, gets weak and the walls slack so that it looks more like a balloon. Very dangerous and life-threatening.

9.31 p.m. The homeless guy doesn’t have an aneurysm – while you did the echo on him you found a) signs for gastroenteritis in his stomach and b) he threw up on you.

9.35 p.m. Under the shower again.

9.38 p.m. Shower again cut short. Patient with a gangrenous diabetic foot/ leg and sepsis in the ER. High fever, the shakes.

9.42 p.m. The foot is indeed a mess of puss and rotten flesh, so is the lower leg. Luckily whats left of it is covered in maggots which may just have saved the guy – maggots clean wounds! Still, he needs an emergency amputation.

10.01 p.m. Tried to eat an apple on the way into the OR; while you took a bite you saw a maggot crawling on the arm of your lab coat courtesy of Mr. Diabetic Foot. Gross. No apple then. Who needs food anyway?

10.36 p.m. While you are busy with the saw cutting off a man’s leg the phone rings. Its the ICU. A patient has died suddenly and unexpectedly. The relatives have been informed that they need to come to the hospital. Can I come talk to them? Sure. I will slip into the role of “preacher” as soon as I have finished being the “butcher”.

11.17 p.m. On the ICU. The Patient was 57 years old. She died post surgery from a sudden blot clot and pulmonary embolism. She looks peaceful, still in her ICU bed, with all the tubes and catheters removed. Her family is here, husband and two kids. They don’t know yet. As I walk out into the waiting room I know what I have to tell them as I have done on countless occasions during my professional life and I prepare myself for the onslaught of their emotions – anger, disbelief, grief. They see me, look at me with hope and just a hint of despair in their eyes. I take a breath, introduce myself, and say the words I need to say: I am sorry to tell you ….. despite our best efforts ….. sudden and unexpected….. nothing we could do. They hold it together until they see her. Then they fall apart, and I feel like coming apart at the seams, too. So I leave them be and walk away, the hospital halls quiet and semi-dark.

11.32 p.m. I do a last check-up on the wards where I am the attending surgeon before I retire for the night … nothing that needs my immediate attention and I could weep with gratitude for that.

11.47 p.m. In bed in the on-call room. Weary, I take a look at my cell phone and see two missed calls from my wife and eventually a text at a quarter to eleven telling me Good Night and that she goes to bed now. My eyes are gritty and tired; if I were home I would take out my contact lenses to give my eyes some rest; here I can’t of course – and glasses are out of the question; I hate to operate wearing glasses! Down the hallway I can hear the ever present beepings and sounds that characterize a clinic but it doesn’t disturb me, instead it has a rather meditative effect. In my scrubs, laying on the small cot, I am aware of every one of my 40 years, my aching back and shoulders, my stiff neck and my growling stomach. I am exhausted, mentally, physically and emotionally, and hungry. I let my eyes drift shut.

0.17 a.m. The phone rings loud, hard and unforgiving. I sit up with a start, fumble in the semi-darkness of the room for the light switch and the evil contraption Alexander Bell invented once upon a time. The ER. Obviously a guy has been brought in from a nursing home with a bladder tamponade – that is blood filling the bladder and not being able to flow out like urine because it is too thick – and the resident has been torturing the poor old man for half an hour trying to get a catheter past a huge prostate. I hear screaming and crying in the background and the nurse is a veteran whom I trust implicitly. There is no option to say “no” or “later” or “just let the resident keep on trying”. My ethic code forbids it and so does my conscience. I roll out of bed one aching limb at a time, pee (since you never know when you get the next chance!), wash my face, brush my teeth and slip on my sneakers and lab coat. Time to tackle the next round.

0.32 a.m. The ER is overflowing with sick people for all disciplines, mostly for internal and surgery. Since my hospital doesn’t have a urologic department, the surgeon on call covers those emergencies. The bay where the resident – lets call him Ali Baba – is tormenting Mr. Nursing Home reeks of UTI (urinary tract infection), shit (one look at the discarded diaper on the floor tells me why that is) and despair. My patient is thrashing almost wildly on the cot with his pants around his ankles and a crazy look on his wrinkled face with two nurses trying to hold him down while Ali Baba tries to push a hard plastic catheter the size of a pen through the opening in a small, shrunken penis into a urethra with the diameter of a hair. It’s almost 1 a.m. and I yell. I look at the scene and at the impersonated incompetence of my resident and take in the horrible degradation unfolding in front of me and I just lose it. I yell at the resident to stop RIGHT NOW whatever the fuck he is doing and at the nurses to let go of the patient. With angry, erratic movements I take off my lab coat, grab gloves from the wall dispenser and walk over to Mr. Nursing Home. I know from what the nurse told me he suffers from dementia but right now I need him to know he is ok, that I will take care of him, that he will be ok. So I ask him his name. I tell him that I am the doctor and I will make the pain go away but he needs to help me a little. I get a nurse to grab a blanket, cover his shivering body and take a hold of his frail hand with the too long dirty nails. He looks at me and I see a moment of lucid thought in his eyes. Jim. His name is Jim. Mr. Nursing Home is a human being, an old man in desperate need of help. He isn’t some rabid animal to be treated whichever way we want to. I look up and catch Ali Baba looking at me with disgust. Mistake. Then he opens his mouth to tell me with a heavy accent that the patient stinks and is revolting. Bigger mistake. And that he is SURE that even I won’t be able to get a catheter into this mess of a man. Biggest mistake. In the midst of chaos, I am calm. It is a character trait that has been helpful to me on so many occassions in my professional life. The crazier everything around me is, the calmer I get. So, calmly, I ask for a small silicone (really soft) catheter with a lead wire (a very thin but strong wire inside the catheter to help push is through smaller cavities), for pain medication to be administered through the vein and for a local anaesthetic gel I freely squirt all over the catheter as a lubricant. I tell Jim to trust me and try to relax. A nurse takes over holding his hand. I go to work gently and determined and within 10 minutes I have placed the cath, removed the blood in the bladder and have a rinsing system in place. Jim has fallen asleep during the procedure. I am glad. Outside of the bay I catch up with Ali Baba. I am telling him that I never want to see him treat a patient this way again, talk about a patient this way again or hurt a patient like this without any need to. I can see him wanting to sneer at me because after all, I am just a woman. I am a female surgeon in a world still dominated by men. I am used to this. And I have about 1000 come backs. I am also his attending surgeon so lucky for him, he thinks better of it and shuffles to his next head laceration or twisted ankle. The nurse coming out of the bay winks at me and says something in the sense of: whatever would we do without you Doc? Yeah. Well. Go on. You would go on and find another “me”. But I only think that. I am too tired for a philosophical conversation at this hour.

1.45 a.m. Back in the on call room. My scrubs still smell a bit like Jim but hell, I am past the point of caring. I just want to sleep. Shoes off, lights out.

2.17 a.m. Phone. Disoriented. Grumpy. A child with acute appendicits. Girl, 9 years old. I sigh. Pee. Shoes on, lab coat. ER.

2.33 a.m. The girl’s name is Larissa. She does have appendicitis. And two very frightened parents. She needs surgery and she needs it right now. She is brave, her parents just crazy with worry. I calm them, explain in detail what is going to happen, and that she is in very good hands. On the way up to the OR I wonder briefly if I have lied. The hands attached to this body are tired. The brain that needs to focus on this surgery is fuzzy and my eyes have trouble focussing. Then I think of my children and what if it was them? I splash cold water on my face. In the OR kitchen, while Larissa is being prepped, I raid the fridge, eat someone’s joghurt and left over cookies, drink two coffees and a cold coke. Showtime. I am awake, alert, here. I need to be. No other way.

3.45 a.m. Surgery went well, Larissa is being rolled to her room and I inform her grateful, relieved parents. They hug me. I am used to that, too. I smile at them and wish them a good night. Sleep. All I want is sleep!

4.44 a.m. I slept for almost 45 minutes when my phone rings, again. The ambulance brought in a young hooker who got sliced up by her pimp. Normally not something a resident can’t handle. But Ali Baba is running so far behind and patients are piling up that she would have to wait for three hours with her face cut in criss-crosses. I get up. Of course I do.

5.55 a.m. It has taken me the better part of an hour to suture the hooker’s face the way a plastic surgeon would and I am confident it will hardly scar. When I leave the ER one of the nurses asks me if I am headed back to bed. Nah, I say. No point anymore.

7.15 a.m. I have showered and seen all my patients from the night, have written up their orders for the day and have eaten a bowl of cereal; I am now meeting with the same residents on the same ward as almost 24 hours before. I have slept about an hour but I am awake and jittery. Fatigue will come later, I know. I do rounds, morning conference and look at a bunch of Xrays. Then I open my locker and prepare myself to switch personalities. As I put my labcoat on the coat hanger, pull on my shorts, shirt and sneakers and walk out of the hopsital I am me again. Just me. I feel great for everything I have accomplished; I also feel drained and a sense of freedom by leaving the clinic.

9.00 a.m. In my car, on my way home, with the windows rolled down for fresh air (otherwise I will fall asleep behind the wheel) and the radio on. I am looking forward to getting home!

9.45 a.m. Home. I park my park. Its Saturday morning. Our kids come running out of the house, excited and happy that I am home; they hug me and start talking a mile a minute about all the things that have happened yesterday, at school, with our animals and about everything they want to do with me / us on the weekend. The fact that I have hardly slept and worked for 26 hours isn’t new to them –  but its a foreign concept, of course. My wife smiles at me with a cup of coffee already in her hand and asks: Long night? I just grunt the affirmative and we hug for a good long minute – before the kids want in on the hug. Of course. Sigh. Over breakfast my thoughts are still partly at the clinic and I wonder how all my patients from the night are; but more than that I am happy to be home and I want to start my weekend with my family. Sleep? Who needs sleep? I can sleep when I am dead 😉 Or hopefully tonight when I drop dead like a lead weight around the kids’ bedtime.

 

I hope you have “enjoyed” the walkthrough of my day! I would love to hear from you so if you want to leave a comment it would be greatly appreciated! Thanks!

Deb

 

 

 

 

The Truth About Being A Doctor

One of the first things people will ask you in any social circumstance – whether you meet for the first time (online or in real life), your accidental seat buddy aboard a long-distance flight, your potential in-laws, your hairdresser – literally almost anyone you encounter – is WHAT DO YOU DO FOR A LIVING? Obviously, that is one of THE most important things about you; something that characterizes you; something that yes, LABELS you – because God knows, the human race just LOVES to label!

What do you do for a living sign

People’s reactions will differ depending on their own professions and social status, but also in respect to WHAT IT MEANS TO THEM. Seriously, your hairdresser couldn’t care less about what you do for a living as long as you can pay for your haircut; and the person beside you on the plane is probably just interested in a “good” and interesting conversation with great stories to pass the time, so they will be hoping you are a cop rather than a plumber. But your girfriend’s or boyfriend’s parents? To them it will really matter what you do because after all, you might be ending up at the altar with their kid and become a parent to their future grandkids.

At any rate, you can be damn sure and certain that most people will judge you by many standards – your clothes, your looks, your hair, your car etc – but one of the things that will really determine your “rank” on the social ladder is your job.

When you think about it – how sad is that really? How full of preconceived notions are we, how prejudiced, how full of bullshit that ANY ONE OF US would rather see our kid date a lawyer than a construction worker, a nurse rather than a stripper –  NO MATTER how decent the guy/girl is? Frankly, it sucks. We have learned and been taught that social rank means more than being a good, kind, reliable, decent human being.

I will tell you, though, that it’s not funny being on the other side either. So let me tell you a bit about that. As you will know if you are a regular on my site – I am a doctor. A surgeon, to be exact. Being a doctor will always – and I do mean always – get you a proper social ranking. People may not know ANYTHING about you – you could be a serial killer or a Republican 😉 – but as soon as you say the magic words “I am a doctor” they will give you the look. What look? The look of approval and respect. The “oh wow, oh really, good for you!” look. Then, inevitably, the next question: what kind of a doctor are you? That one is tricky. No one is really crazy about sitting beside a pathologist who handles dead bodies or an infectiologist who deals with worms and germs. But you can never, ever go wrong with “I am a surgeon”. And up the ladder you climb until you can actually ring the golden bell right at the top. Don’t get me wrong – I love that being a surgeon opens doors for me. Just as much as I hate it when people oohh and ahhhh because I am a surgeon if thats the only goddamn thing they know about me.Trust me I am a surgeon

I will be honest with you people. I have no earthly clue what kind of superhero demigod image people have in their heads or whether they actually think of all the years of school and university and residency you had to put in to actually become what you are – and therefore they are in awe. What I do know, though, is that most everyone I know (unless they work in the medical field themselves or know someone really well who does) has a completely wrong picture in their heads of what it is like to be a doctor. To be a surgeon.

Let me get something off my chest first before I blow your minds and destroy your fantasies 😉 – I love being a doctor. I love to help people, I crave solving the puzzles of disease and diagnosis, it’s awesome to be “in the zone”, at the table, all sterile, with your thoughts completely focused, holding out hand saying “knife” or “ten blade” or “scalpel” and actually cutting into human flesh, completely trusting your own abilities to cut, help and heal. And it is the absolute best feeling in the world when you know you have helped make a life better or you have even saved a life. It doesn’t get much better than that, folks. But those moments? Are rare. A surgeon’s, a doctor’s life isn’t all glory; its more all guts.

Here is the truth: being a surgeon means that more often than not you are too tired or too exhausted to actually enjoy being a surgeon. You go to school busting your ass to get good grades, excellent grades, so that you can go to medical school. Medical school will cost you an arm and a leg no matter where you are in the world; maybe you have rich parents or you have a scholarship or maybe you work 5, 6, 7 different jobs at the same time to be able to put yourself through school like I did. Don’t get me wrong – I loved med school. I loved hanging out with my study budies, I loved to learn about the human body, I loved to understand a little more every day how it all works; but those were also years in which I hardly slept, worked many nights, studied until I broke down in tears from exhaustion. Then finally, finally you are a doctor. OMG I will never in my life forget the feeling after my last exam when my professors came out after discussing my performance and they all shook my hand saying “congratulations, DOCTOR.” I felt on top of the world! A month later I was in my surgical internship – where 36 hours on, 12 hours off wasn’t the exception but the rule; you learned to live, breathe and be “the hospital”. And all of a sudden there is no more time or stamina for anything but this: becoming a surgeon. Internship and residency are tough. Really tough. You are in constant competition with your peers to get your surgeries; you work long hours; you are on your feet all day, all night; everyday you end up with different bodily fluids on you; you get thrown up on, bled on, peed on, pooped on. You learn to eat anything remotely edible running from the ER to the OR; you get introduced to the fact that as a doctor you may not feel disgusted; you may not think something or someone is too gross to touch.

I remember being on nightshift as a 3rd year resident when the ambulance brought in a homeless man, unconscious but breathing, and once he was transferred to an ER cot I could see something strange moving under his pant leg. I cut it open and looked at what must have been thousands of maggots happily feeding on his rotten flesh. One nurse screamed, another passed out – the surgical resident doesn’t have that luxury. You get to remove all one thousand and one maggot just so you can see whats hiding under them……and treat it. Seriously, though. I have lost lives, I have saved them. I have doubted myself, I have felt like I own the world. Being a doctor is about helping others and yet it is one of the most anti-social professions that you could choose. You will miss family reunions, birthdays, parties – because you are ON CALL. You will bail out on social engagements, dinners, movies, ball games because you are too freaking tired after the so many-eth night shift in a row. In your “free” time you can only think of one thing you really, really want to do: sleep. You get cranky and pale and relationships go down the drain a mile a minute. And then, miraculously, residency is over and …. things will get better 😉

‘Whew! Five surgeries in one day! Well, let’s try to make this last one end on a happy note!’

Better, but nothing like the “glory” most people connect you with. Having peoples’ lives in your hands day in day out never gets to be routine and you are always under pressure. Of course, you also always feel guilty toward your spouse, your kids, your friends because you never have enough time, because you miss soccer games and rehearsals and because when you are home, more often than not you are tired and cranky.

Being a doctor is a calling. It is not a “dream job”. And when you eventually get to a point where you earn a decent salary (and have paid off your student loans!) you actually do deserve every single cent.

The truth about being a doctor? It is one of the most gratifying professions that one can choose AND it is tied to a hell of a lot of sacrifices that you and the ones closest to you will have to make along the way. Is it worth it? In moments when I come out of the OR after many hours on my feet without peeing or drinking or eating or do so much as scratch my itchy nose but knowing I saved a life? Oh yeah, its worth it. Or when my son proudly proclaims to everyone waiting at the ER when he needed his arm get checked out after a trampoline fall: MY mom cuts people open! Yes, its worth it. And then, at moments when I am not the best spouse or mother or friend that I could be just because I am too tired to move my ass, no, its not worth it.  Would I choose to become a doctor again if I had that choice again? Absolutely. Because at the end of the day when someone asks me: So, what do YOU do for a living? And I can answer: I am a doctor – I feel proud. And it feels right.

Finally, I would love to hear about your professions – what people think of them, how they react and what the pro’s and con’s are! Please engage in comments below. Thanks!

Deb