Orthopedics

Orthopedics is back on my short list. For the first two years of medical school I was all about the orthopedics surgery option for residency. However, I really came to enjoy family medicine. I continued to like it the more I did and it became the top thing I was interested in. Part of this reason was because of the horror stories I heard about surgery from my classmates.
This attitude was only encouraged when I started my Surgery rotation. The surgical residents and some of the full-fledged physicians are demeaning to the medical students, they can be verbally abusive, and seem like very bitter people. The hours are also really long (you get up at 4:20 or earlier, get to the hospital by 5AM, and don’t leave until 7PM, you also have to be on call at the hospital every 3rd night and you don’t get much sleep) and the residency is 5 years long of this. Unfortunately, most of the general surgeons I have talked to LOVED their surgery rotation. I really hate my general surgery rotation and I thought this was a death knell for any plans for surgery that were still floating around in my head.
Thankfully my father was persistent in encouraging me to not dismiss surgery too quickly. He sat next to his cousin who is an orthopedic surgeon on a recent trip and when he got back he told me give him a call and chat with him. One of the most encouraging conversations I’ve had recently. He HATED his general surgery rotation. When he went into orthopedic residency he had to do a year of general surgery before he got going on his orthopedics training and he said that that year was probably the worst year of his life.
Although that may sound less than stellar, it’s actually the best news I’ve heard in a long time. I have hated my surgical rotation and the thought of doing it for 5 years is intolerable, but if I only have to put up with it for 1 year before getting into a cool residency with cool surgeries and nicer people…well it’s back on the list. The hours are still going to be very very long as an orthopod resident, but I think it’s something that I can like as much as my family medicine dreams.

Why surgeons are the way they are

I’m finding out on my surgery rotation that surgeons and family medicine (FM) doctors are worlds apart (as are many different types of doctors, but let’s compare these two). Surgeons don’t really spend a lot of time talking with their patients. They don’t really connect with them as readily as FM doctors. With this in mind, here are some thoughts on surgery and surgeons.
Surgery is a very interesting process. One minute I’m introducing myself to a 30-something year old lady who is worried about her upcoming surgery, answering her questions, and reassuring her I will have absolutely no part in the actual surgery, and the next she’s under anesthesia. We take off her flimsy hospital gown, put a Foley catheter in her so she doesn’t pee on herself during the surgery, start marking on her body where we’re going to cut, cover everything that we’re not operating on and suddenly…viola…she’s just a torso of meat that we’re going to cut on.
For the next 8 hours I’m fascinated with what the surgeons are doing, identifying which parts of her insides I can from anatomy, managing the laparoscopic camera and things like that. I totally forgot who she was as a person.
In a similar story, there was a lady who needed a really big catheter inserted into her femoral vein (big vein in the thigh). She was very nervous, jumpy, and the process took over an hour for what should have taken 15 minutes because she kept yelling that it was painful and jumping making the needle come out. She quickly became an annoying leg that needed a catheter inserted.
Overall, I think it’s good that surgeons view patients as warm living pieces of meat. They are going to do very uncomfortable and frankly extremely painful things to them. They are doing this to help the patient but things are going to get a lot worse before they get better.
Some surgeons are better than others at connecting with their patients, but surgeons don’t have a lot of time to talk because they are in surgery all day in addition to following up with patients after and before the surgery. If I were to break this article down, I would say that I respect surgeons for what they do and I don’t know where we would be without them, but I really like talking with people too much to be a surgeon.