Personal priorities and brain surgery
I mentioned on Twitter a little while back that I saw my first real, live, pulsating brain in the OR. I was watching a craniotomy on a woman who had fallen and hit her head the week before. She was bleeding and clotting too much for the space in her skull to handle. Her brain had shifted almost 18mm over the midline. The neurosurgeon cut out a hockey-puck sized piece of skull, carefully sliced and folded back the thick leather-ish brain casing and scraped, sucked and flushed as much blood out as he could. He then inserted a plastic drain tube and fitted the circular skull piece back in place.
The procedure was super cool. The patient recovery was astonishing. Brain surgery is nothing short of miraculous.
The surgery was emergently scheduled at 5pm on a Friday. A most inconvenient time of day for the operating floor that was in the process of cleaning up and shutting down. Also extremely inconvenient for the surgical technologists and the neurosurgeon who was meant to be on a plane to some convention on the sunny west coast. Bummer.
While we waited for them to prep the OR and patient, the neurosurgeon spoke candidly with us as he flipped through images of luxurious cars online.
“I was young and stupid when I chose neurosurgery,” he said. “If I had it to do all over again, I would marry my family instead of my job.”
This morning, I was reminded of that conversation when I read this post on Mothers in Medicine. It’s one in a series of “A Day In The Life” written by women doctors from a variety of specialties. This neurosurgeon mom finishes reminiscing about her day with the following paragraph:
Start wiping away tears as I think about what I’ve just written. I used to love my career, but I am realizing how sick and tired I am of this workload – of not seeing my family, not being ready for holidays, using weekends to catch up on charts… of being dumped on by partners and pushed around by insurance companies. I can’t remember what I used to do for fun, and I can’t figure out why I’m still getting out of bed for this, day after day. Why would anybody want to have a day like this, or worse, 5+ days a week? I know, it’s supposed to be hard, and the culture of neurosurgery is to suck it up and avoid asking for help, because that’s a sign of weakness. Maybe my fellow residents were right after all, and I’m just lazy. Maybe I just need to finally reconsider my options and decide whether this has devoured enough of my life.
Back to the neurosurgeon at our hospital: “I tell every single student I see that if there is anything, ANYTHING in the whole wide world that you can be happy doing other than medicine, do it.”
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December 11th, 2009 at 6:36 am
I cannot imagine the weight of responsibility on a neurosurgeon…seriously, I gotta give it up for those in the medical profession who bust their backsides every day…I can barely stand the sight of blood, being in an OR would have me passing out for a snooze from the sight of all that blood and such.
December 11th, 2009 at 7:56 am
Wow. Food for thought, huh.
I spoke with someone the other day and we were discussing how important it is to love what you do for work. I guess that also means to love what kind of freedoms it gives you – so while you may love your job, if it makes the rest of your life miserable, what’s the point??
Here’s hoping that we make good choices and cultivate our own (and others’) happiness!
December 11th, 2009 at 8:28 am
Fascinating advice from the neurosurgeons but totally unsurprising to me. In my mind entering the medical profession is about giving over your life to the service of others. (Not unlike becoming a priest or nun, but with differing circumstances of course.) Why else would you choose such a career? For the money? I don’t understand. The pressures of such work seem obvious to me as a bystander, or let’s say ‘patient’. Do these comments about pressure and workload come as any surprise? If they do then I’m even more surprised, I’m going to fall out of my chair!
Brains are the most amazing things for our brains to ponder! Cool.
December 11th, 2009 at 11:16 am
I have always been surprised at the number of people in the medical field who answer the famous “If you knew then what you know now” question with an absolute no. As a nurse for some time now I would have to agree. Do I love nursing? Yes, no doubt, but when I look at the cost of nursing to myself considering altered sleep, stress, emotional health, unsafe patient loads, and sacraficing a lot of time away from family and friends- I would not go into the medical field either. The majority of my fellow nurses and physicians I work with answered the same way. Kind of sad when you consider the amount of time and money put into med school and nursing school.
December 11th, 2009 at 12:11 pm
I am a nurse practitioner and specifically chose this route in order to be able to give to my family what they need. I work in an ICU and I see the sacrifices of Dr’s everyday. You must be willing to give all you have when you are on service or you do not give justice to the patient. I must agree it takes a ton of self-sacrifice on your part and your partner’s. Having a partner also in the medical field will be helpful because they will have an understanding of what you sacrifice
December 11th, 2009 at 5:32 pm
Neurosurgery must be so intense. My neurosurgeon operated on me at 8am on a Saturday morning (he was on call). On a checkup I asked him if he was married and be said “yes, to my job”. He had been a neurosurgeon for 28 years.
December 12th, 2009 at 4:44 am
That is sad to read that so many physicians feel as though they are married to their job. It is really important to try and make time for both. Jen and I will probably have it just as tough if not tougher because we will probably be in different fields and therefore have different schedules. It is nice however to think about the impact on humanity that we may have one day. Although, according to my mom, a lot of the doctors at the hospital where she works have a tough time making a relationship between them work because of the stress and hours so I am certain we will have to work hard everyday at both our job and our relationship.
September 9th, 2010 at 2:52 am
Being a brain lover and all, what did you think about the new ALS info????? I’ve been looking into this since Dr. McKee (Associate Professor, Neurology and Pathology, Boston University School of Medicine) testified in front of Congress but what was funny was there was a story on the Bryant Gumbel Show recently featuring Dr. Ann McKee and then right after Rush Hour 2 came on. At the end they show the “spoofs” and Jackie got hit in the head pretty hard and stated he “always keeps going”, just as one would in Soccer and Football and as Lou Gerhrig did over and over again. It made me think if these sports players are subject to ALS due to concussions then what about people in Martial Arts and if anyone more so wouldn’t it be Jackie Chan? Furthermore, what if due to diet as he resides primarily in Hong Kong where they eat fresher cleaner foods and partake in herbs and things we don’t in the West I wonder if ALS is less predominant there in that industry due to such a diet? Doctors say eat this and don’t eat that because it will give you this or that disease as if only certain foods have that power and no other foods do. Wouldn’t everything you put in your mouth? Where would external Amino Acids come into play in this ALS picture???? My mind is racing, what are your thoughts?
P.S. I don’t get this talk about sacrifice, loosing out on, missing things and being miserable because of this or that when everyone sacrafices and makes due everyday. You can sit with someone for hours and not say a word and sit with someone for minutes and just a look could say it all. It’s about quality, not quantity and how many hours a day are lost due to ridiculous stuff like television, texting, gossip, etc. that could really be used for quality time? I hear people tell me they have “no time” when they easily spend 5 hours a day watching TV or on the computer, which I do on rare occasions. “No time” is working 3 full time jobs, working 120 hours a week, averaging 11 hours a week sleep (on oxygen, not caffine) and not doing all that other stuff because you LOVE WHAT YOU DO. How miserable would it be to make a paycheck and waste your life away on a job that means nothing and has no value? As a Doctor, to have someone that cares that’s not just punching a clock like the guy at the grocery store is huge because it’s the difference between LIFE AND DEATH and many doctors don’t care and don’t listen, so hats off to you for not just caring but for your passion. If everyone could be so lucky to have a job they are passionate about. That’s how one gets through a long work week, day after day, month after month, year after year and quite possibly the answer is in the “workings of the brain” as to how it’s done!