Saturday, April 29, 2006

Why I won't be a surgeon

A comment on a previous post reminded me of why I am not going to be a surgeon. I loved surgery, at least, the surgery part of it, and I could see myself enjoying the job. But two things keep me from it: surgeons, and needles.

Now I'm not really afraid of needles in the generalized, five-year-old-getting-a-shot sense. Getting my own blood drawn, I'll offer to help the phlebotomist. I like to watch, and one day I'll probably try putting in my own IV, just for the heck of it.

Ok, maybe not, that's kinda gross.

But the point is, in the abstract, needles don't bother me in the slightest. What bothers me is getting stuck with needles that have already stuck someone whose Hep C/HIV status you don't know, or worse, you do know, and don't like.

This has happened to me, on three separate occasions. The first was my own fault, I pricked myself while suturing, a fairly common occurence, and one I've seen experienced surgeons replicate. Once I saw a surgeon, the eminent aforementioned Dr. Harb, stick himself not once, nor even twice, but four times, in the same operation. Just a bad day I guess. But I digress.

The second time was scary, and an opportunity I missed to practice Christian charity. A tech stabbed me with a huge, bloody, CT-1 needle loaded with 2-0 Vicryl suture as he was trying to take it off the field. Very much his fault, and even the surgeon told him to watch what he was doing. I didn't take the opportunity to do anything but glower at the tech over my mask, proving that my temperment is malleable in all the wrong ways in a given environment. I still regret that.

Third, the real charm, was during a c-section, though not a crash one. The attending was pimping the chief resident during this operation, and his increasingly impolitic observations on her performance riled her up. She started making huge, dramatic movments with both scissors and needle, and in one of her exasperated flourishes, she stabbed me.

After these incidents, I had to go down to Occupational Health, fill out a bunch of forms, and then go get my blood drawn, as another team drew blood on the patient. I guess none of my patients were considered "high risk" so I never took the antiretroviral drugs and interferon which are sometimes given to hapless individuals in this situation. In hindsight, it makes me angry I wasn't given the drugs, since the status of two of the patients was unknown. Fortunately though, all the tests came back negative, and I didn't develop a disease which would kill me.

Waiting for the results of tests ensuring neither I nor the patients had HIV or Hepatitis C was horrible. An experience I don't want to repeat.

So I pooled my thoughts. I realized that the stress of the job, and the people I worked for, had changed my personality into someone I didn't like. I knew coming into medicine the risk of getting seriously ill or dying from patient contact was not zero, but I also realized that 2 out of 3 times something potentially life-threatening happened to me, it was the fault of another person, in the OR. I decided right there that surgery was not the best path for me.


gloria jean said...

HepC is scary. Two years ago I got pricked by a needle from a HepC heroin addict. So freaky. Thank God I'm okay.

Nathan said...

Indeed. I admire your choice of profession...I think nurses get stuck more often than docs do.

medstudentitis said...

You'd better cross ER off your list too... and anesthesia...

I think people just need to be more conscious of what they're doing when they're using needles. Even in surgery people shouldn't be getting stuck. I must admit I haven't been in on a lot of surgeries yet, but the ones I have nobody has been stuck and I think it's the surgeon's job to keep it that way. There's a reason surgeons use needle drivers instead of their bare hands and a reason for the no-re-capping rule for syringes. If someone's getting stuck then someone else isn't doing their job properly. I don't think anyone goes into a specialty being ok with getting stuck. I for one, who want to be an ob/gyn, hope it never happens to me!

Nathan said...

Oh anesthesia was never on the list. And I agree wholeheartedly that if someone gets stuck it's because someone isn't doing their job. But it's like I said, I'd prefer the someone whose job it is be me, because I can rely on myself. When it's some 18 year-old tech just learning his job who literally has you life in his hands, I'm not ok with it. Or some 28 year-old chief resident with an attitude problem and bad surgical technique. People should definitely be more conscious of what they are doing with needles, but "should" and "are" are worlds apart here.

But I've already decided on internal medicine, and then probably cardiology or GI.

By the way, I also hope it never happens to you. I wouldn't wish that anguish on anyone.

genderist said...

I've started my own IV twice - and always have to help the phlebotomist. You've got to try it at least once!

And another reason you shouldn't be a surgeon? Because you're a nice guy. :)

zhoen said...

Good grief, I have worked in surgery for over ten years, and I have never seen such callous disregard for safety. Four times poking himself in one surgery? Not a bad day, gross incompetence, and I would have alerted the head of surgery of possible drug/alcohol abuse. That tech should have been pulled away by a preceptor, or out and out fired.

The gyn, though, doesn't surprize me as much. They don't go through a surgical rotation, and are terrifying all over.

I have noticed that surgeons who are happy are both meticulous, and absolutely love the work. They elicit an aura of calm pervasive competence in all around them.

Sorry you have had such scary experiences, but I assure you, it is not always like that.

tmm said...

Hi. Freaky about the needle thing. That would bother me, but I'm not sure if it would bother me more than residency. I thought I had it bad as an engineer until I met some of you guys... gosh...

Btw. Thanks for the post on my blog. I am planning on responding to your comment about intelligent design not being science, either on that same thread or with a new post.