May 22, 2011


In a flash, our one-month rotation in surgery is coming to an end. Even before I started clinical clerkship, various people from all walks of life told me I'm just not made for surgery. I myself reinforced the idea during lectures - usually abandoning surgery for more brainy subjects like internal medicine, firstly because surgery is too masculine (an euphemism for straightforward), and involves more skills than knowledge. Secondly, I couldn't comprehend the rigid sifu-apprentice system so often associated with surgery, attenuated especially in East Asia thanks to Japanese surgical advances.
I started my rotation in orthopedics. Needless to say the backbreaking work and straightforward wheeling every fractures to the OR didn't live up to my expectations seen in House M.D. Exhausted, I started colorectal surgery with my fun-loving money-minded attending. He revealed to me a glamorous world of surgeons - weekend parties (with pharmaceutical companies), karaoke, and 8,000 dollars for a 30-minute hemorrhoidectomy.
Unlike internal medicine, surgeons invade their patients - cut them open, take something out, close the wound up. It's medicine at its barbaric form, tracing from Babylonian times. Surgeons care very little about making the right diagnosis, they are paranoid about sterile techniques, wound healing, nutrition, and surgery duration. Very much like comparing the pride of masculinity, they love comparing how good they are with a certain procedure, and derives pleasure from publicly humiliating their colleagues. That makes the field itself choked with testosterone, sweat, and blood.

Plastic surgery then changed my mind. As good as the name sounds, they deal with things superficially. Perhaps the most suitable knowledge for a clerk without brains nor skills are superficial wound dressing and skin grafting. Much as I like to admit plastic surgeons do much more complicated things than liposuction and breast enlargement, many young aspiring surgeons are tempted into this field for superficial procedures as follows:

Much as I despise surgeons for their straightforwardness and lacking in thinking process, I must admit that surgery is the most straightforward and fastest way to solve the patient's problems. That is, if we discount the risks of surgery and anesthesia. It's the most elemental form of medicine, very historic, but still advancing rapidly despite many older surgeons complaining internists eating into their pie with catheterization and stents. Nevertheless, I still think it's not a field for me, the heat, testosterone, backbreaking hours and that. Surgeons generally live ten years shorter than their non-medical counterparts, have more than one wife, and retires with Parkinson's disease. That contradicts with my ideal retirement at 50 living in Maldives with my beagle (and lifetime partner?).