General Surgery

As I held the hand of a 350 pound man while he got his epidural for his below the knee amputation, I couldn't help but see images of uncertainty, fear, tragedy, pain, death, all at once. Tragedy has pained human existence forever. The reality is that death used to be more normal. Or, that's what I envision. Death during giving birth, neonatal death, death due to pediatric infection, and then if you escaped those filters, death at around 40. Starvation, torture, rape, barbaric medicine, rabid infectious disease infestations. These all ran rampant in the past. The point, is that people are living longer now. The idea of me getting pregnant and having a risk of dying while giving birth to new life is hard for me to imagine (at least in this western world). My parent's having been dead by now is hard to imagine. But I think in today's society, we are dealing with a new kind of tragedy. Tragedy filled with starvation, torture, rape, barbaric medicine. Tragedy today is living until you're 60, but slowly and surely as the years go on, you lose pieces of yourself if you didn't live "right" in your earlier years. Today, people live until their 60, but with every year that passes, they may lose half a leg (diabetes), lose an eye (diabetes), lose the other eye, lose the ability to eat (cancer), lose your ability to exercise (heart disease, lung cancer), lose your brain (stroke), lose your personality (dementia, vascular dementia, psychosis, depression), until finally you can't remember anything or anyone. One by one, you begin to lose yourself. Is it better that we have all this modern medicine to somehow patch things up to 30% of their original working function to stay alive? Is that really what the most valuable thing is? To stay alive as long as possible while the medical bills, the aches, pains, the tragedy that our families live in are bound to our physical state? As I held this man's hand, I couldn't help but think of the tragedy of his life…diabetes, obesity, and soon to be an amputee. It hit me at my core, and I cried for him. I cried for his future and never being able to walk again. I cried for his family, who would now have to adjust to helping him in this new way of life. I thought about his leg, and how it must feel to lose a part of yourself…slowly, but surely, a disease that you can't see or feel, rotting you from the inside…the sad part is that a lot of patients don't take their health seriously until it's too late. Wow, that actually sounds a lot like me. I'm no different from them… I was thinking about this and the role of surgery in the world. Surgery is the end. When everything else has failed, surgery is the answer. And it's a scary answer bc whatever is fixed, will never go back to its original function ever again. It's scary bc with each and every patient, there is a risk that they will not wake up again. There's a chance they will die sooner bc we intervened with surgery. I now pray for each and every patient as we're putting them onto the table. I went into medicine and thought about surgery bc I wanted to make people better. But I'm seeing that surgery just makes people live longer, with less of themselves. While I held this man's hand, I realized I had to force myself to think about was how much I believed in him. How much I believed in his ability to stay positive despite his disease. He looked at me with warm brown eyes, and a warm smile when I asked him of his grandchildren. I began to imagine him as a loving grandfather. We spoke of the beautiful balloons his family had brought him to his room in the ICU. Just those small balloons show a huge gesture by the family. Some are not lucky enough to have family that visits. I cried underneath bc I was reminded of the power of the human spirit: that despite set-backs, disappointments, fears, tragedy, we do indeed find a way to bounce back bc there's no other option; besides death… As a surgeon, I promise to help my patients believe in themselves, to believe in hope. The meaning of life means so many things to many people, but one thing I do believe is that life is about enjoying what we have, to the best of our ability. To be grateful, full of joy, rejoicing always. Regardless of the pain, the hurt, losing parts of ourselves to nature, to disease, to medicine, joy will keep us going. It will keep us hoping. It will keep us dreaming. That is what I hope I can do for my patients now and forever. I believe this is why I have been called to medicine. To help all have joy.