Surgery: In the OR

First of all, I LOVE surgery and will likely operate in some way for a career. They have a problem, then they work to solve it. And its fun.

Second, I am going to tell you a true story:

In my FIRST day in the OR, I am scrubbed in on a case (sterile) along with the resident doctor and the attending doctor (a BIG shot pediatric surgeon). Well, she is yelling at nurses about everything and just not happy about the scene in general (in really crazy ways, like expecting unreal things from them).

So, she is doing stitches and I am "following" her (holding suture and pulling as she goes). Suddenly, her hand is pulling a stitch through and she brings her hand UP BY HER HEAD to pull the string taut. I am standing there and get hit in the HEAD with her hand. I have not moved an inch. She flips on me - "get out of here! you just ruined the sterile feild - scrub out and dont even think about scrubbing back in!" I backed away, staying calm, then derobed and stood in the corner as she went on. It was awkward, but a great story (not doing it justice here I guess).

Funny thing is it never bothered me - it was kind of funny, kind of sad, etc. But none of it really bothered me other than it gave me a GREAT story to tell!

The next morning we had breakfast together and then did an operation together where she was really sweet to me. However, she tore a new nurse a new one over the culture tubes.

(full story is funny)

Long story short, I love surgery, even with these maniacs. We have a problem, we talk about, then we go fix it. And to boot the residents say hello to me and introduce themselves to me. Its actually a good atmosphere. No bullshit time wasting so far...

Anyways, to bed for me - we have 4 nonemergency cases tomorrow (which means with emergency it could be much more).

I am finally looking forward to getting up in the morning.

I spent today following a young intern around, and then his attending.

I hate this all. Here is why: when someone "outranks you" here they treat you like less of a person. For example, you will start a question like, "Ok, when I get back from this meeting, where should I meet you" and before it all comes out person outranking you has turned away and is talking to someone else. If I want to speak I have to wait to be achwkowledged (Which will not happen) or just want til he is done talking to the upper ranked person and try again. It's just hospital culture - you outrank someone so you treat them like shit. It is absolutely absurd. I feel bad for these people. Everyone treats everyone like shit here. I am done with it. These people do it bc they ve dreamed about being a dr and part of this special club since they were little...well turns out the special club treats each other like shit.

When you think your doc is being kind of a prick to you - think about this: you are seeing by farrrr his good side.

Of course there are some great docs AND great people, but they are rare. Also, for a long time one of our senior deans has asked "why are the students so nice as first years and full of ideas and energy, yet they leave apathetic, tired, and just obeying orders?"

The system does it. If given the chance I wouldn't do it again. Each day it chips a little more away from me and I have no idea how to hold on to who i am.

Fleeing the Madness

It has been over a month since I posted. In that month I grew to like medicine less and less. In fact, while the science of medicine is still my love, the actual practice of medicine has chipped away at who i am day by day. I find myself readjusting my goals in life each day. And it's hard to pin down exactly what is so difficult.

1. My expectations were way off. I thought it would be more about medicine, science and learning. Instead it's mainly about rank and prestige. It's actually quite sad cause now is the time we need good doctors.

2. Constant pressure from others telling me i need to "beat" my classmates. This surprised me. Why am i trying to beat them? Should we not be working together to some greater good? From all angles people are telling me, "all you need to do is make honors" on medicine and surgery to get a decent residency....Well, to make "honors" you need to be in the top 15% of the class or so. AND, this is based on eval letters from housestaff at the hospital and a final exam. Remember, this is 100 people out of 6,000+ that applied for our seats in med school. Its like taking the best player from each NBA team and putting them on one team and then saying "Now you 5 play together out there, BUT the one that scores the most points will get the big contract!"

It ain't exactly the best way to encourage team play....and this is in a hospital! So you get students sneaking out to go study, doing the least they can to "get by" with their patients...It's a disgusting way of doing things. Why in the world would you have grades at this point? It should be a final you have to PASS to demonstrate proficiency in the area and then comments/letters. The grade should simply be pass. It is all so absurd and simply engenders poor pt care. I learned VERY early NOT to look deep into the literature on my pts problems, but memorize a list of things from a book to spit back. That is what is encouraged. That is what they want.


No wonder health care fails here in so many ways. For as creative as we are in every other industry, medicine has failed to understand the value of good minds and creative people.

I wish I could change it, but I don't see how. It seems too big. My only vision is to start over with my own medical school.

In the last few days I started to readjust my goals in life a bit - perhaps to be outside of the madness that we call medicine in this country...