Ready, SET, Go?

This year has been one of unexpected decisions. It's been one where, statements and beliefs long-held have been challenged and superseded by opposing views.

I didn't want to be a surgeon. I didn't want a life of blue scrubs, blood and glaring fluorescent lights. I didn't want a life of incisions and sutures, of extensive hand-washing and disappearing patients beneath the sterile field.

At the end of last year, I looked at my third year of medical school and its timetable - first stop surgery term. First rotation: Orthopaedics. And I groaned. I thought it would be the worst eight weeks of my life. I thought my already waning interest in medicine would be completely annihilated by this entirely unappealing start to my clinical years. I thought I would end up taking the year out. And never coming back.

But I didn't. 

I started my Orthopaedics rotation with trepidation. Sitting in the massive team meeting, surrounded by men in crisp suits and silk ties, I was completely uncertain of what I was meant to be doing. Or who was meant to show me the way. The team split and I stayed in my chair, uncertain of which half would serve me better. Then, from the doorway, came a loud voice. "Are you the medical student?" it asked. "Yes," I said, while nodding meekly and not really knowing what was going on. As he beckoned and we walked down the hall, the intern continued. "When I was a medical student," he followed, "often nobody looked out for me. I promised myself I would always make time for the students. You can come with us." And so it was. My interns, who joked with me and gave me tasks, who asked difficult questions and taught me theory when I had no clue. Who gladly accepted my phone calls begging for procedural tasks and tried always to include me. The interns who, when I stayed late or got in before them, laughed at my enthusiasm and reminded me that I should probably go home. Because, you know, one day you'll have to be here when you'd prefer to relax.

A few days later, deep in the fascination with bones, joints and muscles, I received an email. Over the preceding few months, I had gone through a rigorous process for a high-level volunteer diplomatic position. And I'd been obsessed with the idea of following my international relations dreams. But that day, when I got that email, I didn't mind that it said I'd been unsuccessful. I'd made it to the top ten. This time, near enough really was good enough. But I didn't really want an excuse to leave the hospital anymore. I had enough excuses between 6am and 9pm each day, but that didn't mean I used them. The idea of leaving theatre behind for a whole year...I didn't know how I'd cope. The weeks before had been filled with mentally planning how I could possibly include a tiny bit of surgery in a national tour... There was a sigh of relief to know I could always go to theatre at home.

A few weeks of surgery had me thoroughly hooked. I wondered what had happened to my dreams of working in general paediatrics and of being an adolescent health physician. I wondered what had happened to my desire to always be at social entrepreneurship events - and how it had been replaced by a thirst for theatre. And I knew that I'd rather be in those aseptic dungeons than almost anywhere else. 

Surgery is a challenge. It's a mental challenge - how do you manage a person's life needs, injuries or disease processes and their path of best recovery? How do you make sure you deliver them the best possible surgical result? The anatomy is beautiful - the sheaths of muscles and fascia compartmentalizing the body; the bony structures that once articulated with near perfect congruity now defiled by trauma or disease. The implants, bolts, nails and screws that ensure mobility may return and create new hope for those long suffering. The radiographs depicting the team's hard work. The strength of a battalion fighting the good fight, working in perfect synergy to hold, retract, pass and act. To nail and drive, to assess and recalibrate. The challenge of the long hours juxtaposed against the desire to be operating. The challenge of becoming part of the team, despite a lack of knowledge or skill. 

And the challenge won't stop there. There's the long and taxing process to preparing for applications to the College of Sugeons. There's the years trying to build a CV, fighting for as many of those difficult-to-win points allocated for a variety of achievements. There are the countless hours working - trying to soak up every piece of knowledge and experience, while being street smart enough to at least mildly impress your supervisors. There are sleepless nights and days and nights again. There will be days where something else - anything else - will seem like a better life choice, only to again find the joy of a good surgery. There will be the moments where the only thing desired will be sleep and the only option to continue working. Through it all, the carrot of the hard-earned surgical career dangles just ahead.

If you get on to the program - if you're one of the lucky ones - there's years of dealing with health system politics, exhausting hours, constant changes in training location and the pressures of the rest of your life. 

You have to really want surgery. It isn't the best career if you happen to like spare time. It's not the best career if you like being able to go home and leave your work behind. At the same time, it can be special to see how surgeons bring together the different aspects of their lives - the calls from home held via speakerphone in the middle of procedures, the stories of family adventures in what little time is left for the outside world. There are the times where your skills allow you to assist in acute care in other countries and there are the visitors here from overseas. There are the moments of relief when an injury is fixed and the sense of satisfaction when previously painful joints are replaced. You have to know that your sacrifices are worth it. You have to want to work your proverbial behind off, because 9-5 hours are entirely contrary to current clinical practice. You have to live it, breathe it, and be it.

But I have other dreams. Dreams that go beyond surgery. And I'm not ready to give up on them. I also know that surgery makes me happy. Totally and completely content. That it's one place where I know I will be completely focused on the task at hand, centred and living in the moment. I also refuse for that to take away my other dreams. I refuse to give up on my passion for public health, or education, or my passion for people. 

This morning, my friend told me that I mightn't be a workaholic, but I work furiously. I work as if time is constantly running out. And there have been enough people to say that I can make it all happen that I can believe the fire inside me that says the system can bend. And flex. And it'll eventually evolve. It'll change. And maybe I'll still work 100 hour weeks and still be exhausted. But I'll be doing all of the things I love. And maybe things will be missing from my life. Things tha other people want. The nine to five. The desk job. The routine and the stable location. 

But that's all years in the future. Right now, it's time to go back to the present. Because if I believe it's possible, it'll all work out the right way. Whatever that looks like.


Henry Woo said…
Great piece Brooke - enjoyed reading it as is the case with all of your blog entries. Much of what you have observed about surgery is true but even surgeons are now getting better at understanding work life balance. Don't write off a career choice in surgery over concerns about whether you can pursue all the other things (dreams) that you might wish to do. When I was a student, I initially thought that I would do pediatrics but once exposed to surgery, I could not shake off the calling and there has not been a single day that I have regretted my career choice - I feel very grateful to have been allowed the opportunity to follow what became my dream role in medical field
Brooke Sachs said…
Thanks, Prof Woo! I'm definitely not giving up on the idea of a career in surgery. It's also great to know that you switched from considering Paediatrics (where my head was at only a few months ago) to surgery. And you're definitely excelling with flying colours. I guess my concern is having a whole host of ambitions - to be a surgeon, to work in health policy, to do humanitarian work, to work both rurally and urban (and many more things, I'm sure). I'm not particularly good at letting go of my dreams - and I wonder if I really am able to make it all happen. It doesn't all need to be at once. I just refuse to believe that my dreams must stop with surgery.

Thanks for the thoughts - it makes me feel like anything is possible :)

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