Saturday, January 11, 2014

Reflection 2 - work


Two years ago I made a decision that I was going to invest time in pursuing my hobby and passion of running. I had just finished medical school, in what many deem to be potentially the five most stressful years of one's life, of intense studying, burning late night oil, attending lectures after lectures, memorising terms, jargons and conditions which we dont use everyday etc. I thought maybe it's time to take a break from studying and spend time doing other things which I love. After all, if there is any period I can take a break from studying, right after med school is probably the right time to do it, since in specialist training years, it is pretty back the same old days of mugging and burying under books again, where we are put through countless vigorous hours of medical training.

It's a decision I didn't regret.

Now that I am almost finishing my short running career, it's time to start planning my next move - one which most likely will demand more of me than running does, and carries far-reaching implications and influences than anything that I have ever done with my life. My next goal in life is to train to be a surgeon.

As with anything, I will begin with big picture. My dream is to be a highly competent and compassionate general and trauma surgeon working with the top surgeons in the field from all around the world, being actively involved in research and discovering new treatment and therapy, participating in humanitarian and missionary surgical work in the war-afflicted and poverty-stricken countries, and in training and educating the next generation of doctors.

Dream will only remain as dream if we dream with closed eyes. Those who dream with open eyes, however, are dangerous, as their eyes will have its unwavering focus on what's ahead, to see what steps to take to get nearer to the goals, and to help evaluate the present situation and circumstances one is in. Whether or not my dream will be realized, it depends on how I can allow God to guide my every step and to open my eyes to see the truly important things.

To get to where I want to be, i need to start with little steps. I need to see as many patients as possible as possible, to learn how to assess them, practice my clinical skills so I can arrive at the correct diagnosis. I need to learn how to manage their conditions, to learn how to recognize the seriously ill and distinguish those who need urgent intervention from those who just need ongoing observation. I need spend a lot of time studying - especially in the subject of anatomy, physiology and pathology - for they form the foundation of surgery. I have noticed that so many surgical residents and trainees tend to neglect the basic, and want to dive straight into operating and journal reading. I firmly believe in building a strong foundation and knowledge for which other things build on. Besides, I also need to get myself out there, to meet the different surgeons, to learn from them, from the way they take history, to the way they operate on patients. Operating skill is an art which takes a lot and a lot of practice to master and perfect, and good hand-eye coordination, three dimensional thinking and precision are needed.

Traditionally surgical training programme is one of the most competitive ones out there, and rightfully so, because patients' lives are entrusted to the hands of surgeons. Before surgeons can earn the right to cut open patients' bodies, one needs to prove he or she has superior knowledge of the human bodies, pursuing excellence in everything she does, being subject to the most vigorous and stressful training, and has outstanding track record in academic and research work. Moreover, knowing the right people and having good network and connection with other surgeons are paramount to successful entry to the programme. These older surgeons have to have the confidence in you to train you.

Running has taught me many things. Amongst them is the ability to persevere in adverse and trying environment. Surgery is one such environment, where good and bad surgeons exist together. Traditionally surgeons are notorious for having the God-like complex, being inflexible and bullying others into follow his or her way only, and sometimes being downright rude and condescending towards other staff who are not quick to learn something. I am not saying you don't have problems in other medical specialties, it's just that the kind of personality that exists in surgery (which is the reason why they choose surgery as a career in the first place) makes you have to be on your nerve at all times. A stupid mistake or a wrong first impression can be disastrous, as I have seen in the career of some of my older colleagues.

Galen (year AD 157) attends to a wounded gladiator as the crowds bay for more blood
Andreas Vesalius  (1514-1564) - the father of human anatomy
A 'muscleman' illustration from Vesalius' De Humani Corporis Fabrica (1543) - alludes to his foray into body snatching
John Hunter (1728 - 1793) - challenged the traditional teaching of medicine started by Hippocrates and advocated careful observation and scientific method in medicine. A trip to London where his brother worked as an anatomy teacher and gynaecologist when he was 21 changed the course of his life as he took on an interest in human body
Walter Lillehei performs open heart surgery using cross-circulation in 1954. 
Dr Ben Carson (neurosurgeon) - featured in the movie Gifted Hands (2009) - a must-watch! He is well known for performing controversial procedures on the brain which others would not dare to and he is one of the first neurosurgeons who successfully separated a pair of siamese twins (joined at the head) in an operation which took 22 hours. 
Modern day surgery

I will miss running. I will miss following the news of the latest ultra and seeing the development of the sport. I will miss the thrill of toeing the starting line knowing you have done your best to prepare for a race and will demand nothing short of an honest and out-all effort. I will definitely miss the post-race camaraderie with other runners, discussing our race and training strategies and future plans.

I believe running has prepared me very well mentally and psychologically for what's ahead. To do well in anything, be it running, studying, playing a musical instrument, or being a salesman, one needs an incredible amount of inner motivation, a strong and fierce dedication toward excellence, lots and lots of hard work, and a good dose of wisdom in maintaining healthy work-life balance.


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