The Dystopia of General Surgery Residency
*Published first on Dr. Wood’s prior blog, Mod Med on March 17, 2020.
———
August, 2019 (7 weeks into intern year):
I sit here on a warm Sunday morning with a cup of coffee in hand, curled up on my balcony thinking I about going back to work tomorrow. ‘Welp, back to reality.” My new reality– now confined to the four walls of the hospital that suppress any thoughts about the world outside. 7 weeks in and I have already forgotten that this is not reality. It is a dystopia where you’re forced to ‘just bend over and take it,’ as I was advised— the mindset you just have to live in as a surgery resident.
And while we are treading water in our new dystopian life, our patients are experiencing a different type of altered reality. We monitor their every move down to how many farts they have day. They come to the hospital vulnerable to complete strangers– to the zombies of the hospital that seem to function without water, food or sleep– trusted to quite literally cut people open and put them back together again.
And that kind of trust we certainly don’t take lightly, but we do take for granted how intimate and raw it is– how amazing it is to have a job to get to experience that daily. We get disillusioned and we don’t see it that way far too often. I am convinced that this dystopian process that is general surgery residency morphs you into a different species all together. The time, the pressure and the hostile environment leaves no room for it not to. The weekends I do have off are my saving grace, but even after only 7 weeks of residency, I find my emotions are blunted and my mind quite literally blank. Where it used to be filled with thoughts about anything and everything, and the curiosity to read and the excitement to write, there is just nothing. My passion for life is noticeably diminished. It creeps back through towards the end of the weekends I am not on call (hence me writing this on a Sunday). But it’s slow to return and that scares me. And while I am spending my one weekend off recovering and digging myself out of this surgeon’s ditch, I am expected to be studying for ABSITE and training my brain to only think about the operating room.
Even with all that being said…I love operating. But I love the way operate in the world more. Luckily for me there is indeed a specialty in medicine that parallels my interests outside of medicine– varied and wanting to do it all. A specialty where I can do everything from procedures to delivering babies and treating HIV patients to venturing to the top of Mount Everest. But even more importantly, a specialty where treating humans, not just patients is at the heart of its practice. But for now I will take on this year with two challenges: 1) to learn as much about surgery as I can, and 2) to maintain my passion for life through the forces that are against me.
Edit: (9 months later)
I feel myself becoming a surgeon– and I both love it and hate it. I love operating and I love medicine– the Hippocratic method of diagnosing and treating someone, the blend of science and art– I love it even more than I thought was possible. It puts me in a trance of amazement, even through the midst of the torture of being a surgery intern. But I am still convinced that you can’t become a surgeon without becoming a surgeon. More so, a female surgeon. When we speak up, we are seen as bitchy where our male counterparts are seen as strong. When we make decisions and don’t back down from them we are seen as aggressive and bossy where our male counterparts are seen as assertive and competent.
And experiencing this while we work our 16-24+ hour shifts 6 days a week really gets into your head. This is after all your new reality and you learn to be feisty or fail. And with that your passionate feelings that you used to have about the world get blunted because all of your time and energy is spent surviving in the shark tank. It’s not emotionless like I originally thought. The emotions are definitely there– a lot of rage, compassion, fight, and excitement. But all expended in the hospital. You go home and you feel nothing. You sit at your computer with a glass of wine and try to write like you used to love so much and your mind feels as blank as death itself. You think back to past relationships and put on songs that were always so sure to make your heart flip and absolutely nothing happens. You’re becoming a surgeon.
This year has definitely changed me. Permanently? It’s hard to say, but probably yes. But that is life. You don’t go backwards to the person you used to be. You take the experiences that you have and are shaped into your future self. There are so many things that I want to take with me that this year of “becoming a surgeon” has given me. But at the end of the day, I really don’t want to be a surgeon. I want to be the doctor that will never allow myself to become completely jaded by the system. The doctor that treats every patient as a person and sees the work as part of my life, not my patients as part of the job. I will keep the surgeon’s confidence, but I don’t want the aura of a surgeon attached to me. I want my patients to feel my competence by my confidence, but more than that I want them to know they have a doctor who listens– to her patients, to her colleagues, to everything that is happening and impacting the world. One who fights the cog-in-the-wheel ideal that the system pushes. And one who always remembers that the heart of medicine lies in the raw love for humanity.
And again… only the weekends bring a slow return to these thoughts.
