Puella cum Cultello

girl with a knife – the tired ramblings of a female surgeon-in-training

Tag: residency

The children’s ward

I’m not particularly looking forward to my pediatric surgery rotation.

It’s not that I don’t like kids, I actually do (well, when they aren’t behaving like banshees).  I’d even like to have one or two of my own one day.  It’s not that the diseases are uninteresting.  Congenital and childhood diseases are pretty fascinating, because they represent the intersection of nature (genetics) and nurture (development within a given environment).

Kids are like cute, funny, little test tubes.

Honestly though, I couldn’t enjoy outpatient pediatrics.  A waiting room full of sniffling, scared children isn’t very appealing to me.  Well-child visits and routine childhood illnesses are kind of boring.

Inpatient pediatric patients are incredibly complex.  But that’s not the issue I have with them.  No, the problem is that the interesting kids are the heartbreaking ones.

Seeing them stuck in a hospital ward is difficult – you begin to imagine them happily playing at home with their friends and loved ones, where they belong.  Sometimes, they’re too sick even to cry when they’re in pain.  They just look up at you with pleading eyes, hoping you won’t hurt them even more.

But unfortunately, no amount of wishing will restore them to good health immediately.  And sometimes, no amount of care can cure an innocent little munchkin.

So that’s why part of me would almost prefer to sleep-walk through the next few months.

The dark corners of my mind

Sometimes during residency, you encounter your deepest, darkest feelings in unexpected ways.  Last year, I faced one of my fears in the form of an elderly Asian woman.  Miss N. was a feisty little thing when I met her.  Over 90 years old and in assisted living, she insisted on taking the bus, alone, to all of her appointments.  She had come to us because of pain in her legs when she walked.  An ultrasound had shown that her tiny blood vessels were closing off, and she wanted to know if we could help her surgically.

As we talked, I learned more of her story.  Miss N. had been a skilled seamstress as a young woman but retired decades ago.  She had never married or had children, and though I was curious, I didn’t probe into that any further.  The youngest of eight siblings, she was the only one remaining.  She’d also outlived almost all of her other friends and relatives.   Only two kept in regular touch, a nephew who lived several hours away and a local woman who had known the family for many years.

We didn’t have much to offer Miss N. – she had a chronic vascular condition that wasn’t amenable to surgery.  Accepting our opinion without question, she went on her way.  But she didn’t leave my thoughts completely.  Over the next several months, I remembered her often.

Miss N. was obviously a survivor, but she in doing so, she had become profoundly alone in this world.  She’d managed to outlast everyone she was close to.  When she died, who would be left to miss her?  She had no children or grandchildren to dote on, no family of her own, no one to tell her story after she was gone.  Perhaps that was by choice – had she loved and lost?  Or had she simply never met someone worthy of loving?  At a stage in her life when she most needed to be cared for, she had no one, except people who were paid for their time.

She was the embodiment of my greatest fear – loneliness.

My own parents and two siblings live over a thousand miles away.  The rest of our relatives are half a world away, and I haven’t seen them in several years.  I’ve moved so many times in my life that I’ve never really set down firm roots anywhere.  I knew exactly one friend-of-a-friend when I moved to my current city for residency, and working 80 hours a week hasn’t been especially conducive to making or maintaining a strong social network.  And while I have good relationships with the other residents, they’re co-workers, not close friends.  Many of them have families nearby, and their free time is devoted to those obligations.

Right now, my parents are healthy, but I know that won’t last forever.  They’re getting older and no matter what I do, I know I can’t prevent the inevitable.  My brothers are much younger than I am, and though we do have good relationships, we aren’t very good at staying in touch.  Living near each other would be nice,  but it’s not something that any of us are particularly striving for.

My work can make it difficult enough to be a reliable friend, so I’ve invested even less energy into trying to meet someone and establishing a relationship.  Apart from having to live with me and my quirks, that person would also have to accept my unpredictable schedule, very limited free-time, and the knowledge that sometimes my work would come before my family.  They’d get the brunt of the responsibility of a home life, with little to show for it.  It’s not a deal that I would be eager to take.  And, indeed, the men I’ve met haven’t been thrilled with it either.

I chose my field with open eyes – I knew how disruptive my work would be to my personal life.  But actually living this way for the past few years has been much more difficult than I could have anticipated beforehand.  I wouldn’t want to be responsible for inflicting it on another person as well.

Since meeting her, I’ve often had moments where I wonder if Miss N.’s life is my future.  While I certainly hope it isn’t, I can’t shake the fear that it is.

Welcome to my office

This is a place for me to keep a journal as I resume my surgical training after some research time.  It’s certainly been an interesting experience so far – a mix of humor (often dark), anger, frustration, accomplishment, exhaustion, pain, upheaval, learning, absurdity, loneliness, and, occasionally, sheer terror.  I think I’ve grown a lot so far, but I’m sure there’s more to come.

Because I’ll be writing about real-life healthcare encounters, I’ll sometimes change the details of a story to preserve the privacy of patients – as well as myself and other staff.  However, I’ll be as honest as possible about my thoughts and feelings about the situations I see.  As a former English major, I’m sometimes prone to extensive edits and melodrama… you’ve been warned!