Articles

Reflection on Surgery: Rotation 5

In Uncategorized on March 18, 2013 by David

Have you ever had the feeling that the whole world is a blur? When I walk home from the library after a long day studying, my feet often feel clumsy and I seem dazed, unable to take in what’s before me. As if my eyes became deconditioned from studying, everything feels blurry and surreal.  Everything is the same, but also strangely foreign – like opening your front door after getting back from vacation and seeing your keys and junk mail scattered across the kitchen counter. It’s like waking for a long nap – but I are still tired. There’s nothing inherently uncomfortable about this feeling, but it feels foreign. That’s how I felt after finishing surgery. Life feels foreign. As I took my car in for an oil change and did minor shopping this past weekend, my feet felt clumsy and I seemed dazed.

Surgery.

This was the first rotation that I did not feel joy. I did well on this rotation, but even that does not make me to see the rotation through rose tinted glasses.  I’ve always felt a masochistic joy in working hard, in willing to bear more pain and suffer to be prepared and shine when the opportunity arrived, but this time was different. Not that I shied away from hard work or that I didn’t learn a lot, but I did not feel appreciated. In fairness, my sense of helplessness, of lacking joy in my work, was more psychological and self-imposed than due to external factors or particular circumstances.

I am an ambitious person, and this is just another example of how my ambition is not healthy – it drained the joy from my work. I knew that this rotation was my chance to make the cutoff for AOA consideration and to qualify for a good MSPE – to that end I worked myself hard. I worked in a way that was in some ways excessive, which took away the joy from tasks that I honestly would have enjoyed. Surgery is actually really fun – being in the OR is very empowering and it is satisfying to tangibly help patients. I really enjoyed the ENT cases, and the resident was both willing to teach and extremely kind to me. Working my hands, learning tangible skills, and becoming a craftsman are all admirable things, but things that got overshadowed by my need to look good in front of others. My hands were clammy and slow when the attendings watched me tie knots.   I got to first assist on a really exciting neurosurgery case –doing almost half of the cranioplasty, but in the end, I did not feel that my personal reward/benefit balance was met. There were definite momentary highs, but the caveat was long periods of drudgery and excessive hierarchy.

During this rotation, honestly small injustices festered in my mind. I put on a mask of joyful work, but there were some residents where I did not respect and whose work ethic I felt put patients in harm. Rounds often lasted just a few minutes per patient, while the resident just ran through the motions, barely glancing at the patient and ignoring me while I rushed though my presentation. It did not feel like the surgery residents did not like being in the hospital outside of the OR – they rushed to finish notes on the floor and skim through patients to run to the OR.  In my hopes of pleasing everyone and upsetting no one, I did not speak up when I felt injustice. They are clearly talented in the OR, but I found the peri-operative care lacking. Even when it was time for feedback, I was timid and did not say what I wanted to say – that you made me feel small, unappreciated, and not part of the team. For the sake of my ambitions, I kept quiet at the bottom of the totem pole. This was particularly discouraging to me, as I once thought and still believe that “the measure of a man is a how many uncomfortable conversations he can initiate.”

In honesty, I am too ambitious for what I want in life – I need nothing more than a good family, good friends, and good community – but I want to be respected and appreciated. Although sometimes I can mask it, I am socially awkward, and subconsciously try make up for that by excelling at work. Although it’s not true, I unconsciously feel that if I throw myself at my work and excel at a craft, then at least people will respect me. I do not mean to work so hard, but when the rewards of studying one extra hour is so tangible compared to spending time reflecting or hanging out with friends, I take the easy choice out.

Going to the mechanic reminded me how awkward I feel when I am out of my natural habitat, speaking with someone I don’t know. Not that I did or say anything awkward, but I just felt so out of my element. When asking for the price to get my oil changed and waiting in the little lobby while people worked around me, I felt borderline autistic – extremely uncomfortable at making eye contact and at a loss about current events. When was the Super Bowl again? Was the 49ers playing? Did we win or lose? Was I on call that weekend? It was strange to watch the person work, but it was also uncomfortable to stare at my shoes. I know nothing has changed since I checked my phone a minute ago, but I can’t help but flip through my texts and facebook. I’ve honestly forgotten what to do when I have nothing to do.

It seems strange to think that I now feel more comfortable in clinic than having nothing to do and walking around a shopping complex. Part of it comes from predictability and having pre-defined expectations about what I should be doing, but after a year of having my actions continuously evaluated – I am done with that. Third year has been a tremendous experience – one that I am still trying to unravel, digest, and evaluate – but as I take a step back, I cannot forget that there’s a world past school.

I have a goal for every month this year. March’s goal is to be more introspective – to reflect about my past actions and my future goals –  and to write an hour a day. I’ll report back on my literary progress at the end of the month.

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One Response to “Reflection on Surgery: Rotation 5”

  1. I liked everything about this, from the feeling of blur to the the “measure of a man” to your goals. Keep writing, and keep wrestling with those uncomfortable moments! Part of the refinement process.

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