Molly follows in her Dad’s footsteps to become a doctor
Enjoy her latest blog that chronicles surgery training at Oregon Health and Science University.
“Here. What do you feel?” The surgeon guided my hand to the bottom of the surgical field. I cautiously reached down and felt something pulsating against my fingertips. “That must be the aorta.” I had seen and touched an aorta in anatomy lab during first year, but feeling it pulse beneath my fingers in a living person was different. The aorta is the largest artery in the body and any damage to it is an emergency. I had just spent the previous month in the emergency room (ER), where it was drilled into me to always rule out injuries to the aorta. To have my fingertips on someone’s felt oddly powerful.
I have talked about privilege in medicine numerous times before. Every provider carries some degree or privilege. Being entrusted with people’s vulnerabilities, performing intimate exams and asking about deeply personal histories are some of the regular tasks of a physician. Surgeons and proceduralists have the additional privilege of performing what would be considered assault and battery if done without proper consent.
When a patient consents to major surgery they are trusting that:
- The anesthesiologist will keep them alive.
- The surgeon isn’t going to kill them.
Any time you go to the doctor, it requires that you trust your provider is knowledgeable in their field and are able to make the best decisions for your care. They follow appropriate guidelines and perform the necessary work up of your symptoms. Any mistakes can indirectly lead to minor, or sometimes major, health consequences. Any mistakes during surgery, however, have a very direct impact on your health.
Scrubbed in and standing next to the operating room (OR) table for the first time, I was acutely aware of just how little I knew about surgery. Luckily, my only role as a medical student that day was to provide suction and irrigation. Textbooks did not prepare me for the involuntary emotional response I had to looking at an amputated arm or staring at the bowels deep in an open abdomen. No anecdotes from my peers could prepare me for just how exhausting it is to stand and retract tissue for 6 hours straight. And no amount of suturing practice could prepare me for how hard it is to close skin with all of the OR staff staring at me impatiently.
I was on an Acute Care/Trauma Surgery service, so our patients came to us through the ER, usually in terrible pain. In the OR I watched as the surgeons dealt with the diseased tissue, and then when the patient woke up, despite some expected post-op pain, they felt great. I got to watch patients go from lying in the fetal position on a gurney in the ER, to doing laps around the ward a day later.
Unfortunately though, not all my patients woke up. I also had to watch as the attending surgeons agonized over whether or not taking a patient to the OR was the right decision. I watched one surgeon sit outside a patient’s room in the ICU for an entire shift, doing everything he could to keep this woman alive. The next day I watched him explain to this woman’s family that her organs were failing faster than any interventions could keep up with, and it was time to consider transitioning her to comfort care.
Despite the emotional and physical exhaustion, including my first 26-hour shift with a 2 a.m. case, surgery remains one of the coolest things I have experienced. Because, after all, how many people can say they’ve had their fingertips on an aorta? And I can confirm, surgery is nothing like the TV show Grey’s Anatomy would have you believe.