Guest Writer: Thoughts on General Surgery

--Greg, University of Colorado School of Medicine, Class of 2013

I'm two weeks into my general surgery rotation. We are up pretty early taking care of patients and luckily get a lot of surgery time during the day. It’s hard being a third year medical student in the hospital. We have to be at certain locations throughout the day, but they don't give us the clearance to get into a lot of the ORs and other places we need to be. This makes it quite frustrating at times and we have to be creative in navigating around the system.

Today in surgery, my attending allowed me to close up a couple of the incisions. For a third year medical student, closing up the incisions is a big deal, it’s exciting and we actually feel a little bit useful. In reality, closing up the incision is not a big deal at all, but we take what we can get. The whole time I was closing, a scrub nurse stood behind me looking over my shoulder, ridiculing my every move. "I can't believe how slow he is", "Oh my God, you're wasting so much suture," "This is ridiculous, its going to take him an hour to throw four stitches!" "This is bullshit, I want to get out of here," "If you want to learn, GO TO DENVER HEALTH!", etc.

Finally when it was all done and we were cleaning up, she came over looked me in the eye and asked if I was going to need therapy, in a poor baby sort of voice. I held my own the entire time, trying to focus on the task and not let my emotions get to me. Even though she made a big stink the entire time, I think I did a reasonable job, and it didn't take an eternity like she would like me to believe.

Comments like those experienced today are frequent events, but they are not usually that harsh or direct. I've come to find that there is this unwritten rule that the third year medical student is a living punch dummy, free to be abused by everyone and anyone associated in the hospital. Surprisingly, the surgeons are the least likely of all the staff members to be mean to us. They poke a lot of fun at us, but in a respectful, often humorous sort of way.

I seem to be able to brush off the humiliation completely when in the hospital. Unfortunately when I get home, nonproductive thoughts enter my mind. Thoughts questioning my abilities, questioning if I will ever find a niche and be successful in a career in medicine. Sometimes I question the whole profession altogether. How can such a beautiful thing, taking care of the ill, be laced with such arrogance, animosity and uncooperative behavior? The medical students may be a burden to the nursing staff, as we often don't always know what to do and we frequently just get in the way, but I wish they understood the pitted feeling of anxiety held within our stomachs throughout the entire day. We want to be useful, we don't want to be in the way, and most of all we don't want to make anyone angry at us.

I entered medicine because I felt it was a special profession, one where everyone was held to the highest standards and mutual respect and collegiality were not only encouraged, but demanded. I guess every profession that holds a human element is not exempt from the fallacies of our species. It was naive of me to think otherwise.

Looking at the big picture though, I am able to realize that this is just one small hiccup in my training. Tomorrow is a new day. I'll probably get yelled at and made to feel inadequate, but it takes a strong person to get to this level and I will persevere through this as I've demonstrated in the past.

I will probably not be a surgeon. I like procedures, but I do not enjoy the culture that has become ingrained in the OR. I like the idea of working in a small clinic where I can have more influence in setting the standards of behavior and developing the culture of my practice. We will see though; feelings and interests seem to change rapidly in this training. Two weeks ago I was thinking orthopaedics, today of all things I'm considering outpatient skin cancer surgery as a sub-specialty of dermatology!