Choosing ENT

Part 3 of speech given at residency graduation. Organization and phrasing reflect oral presentation.

There are two kinds of medical students: those who enjoy every specialty, and those who hate all but one. I was the former, which made it difficult to choose.

In the middle of third year, I did General Surgery at a busy community hospital. I spent six weeks working everything to the limit. From the moment my attending pressed my hand onto a bleeder in a patient’s belly – urgently saying “Hold that!” – I knew operating was the most thrilling thing I had ever done.

But I didn’t want to be a surgeon! At the beginning of medical school, I planned on Family, Internal, or Emergency Medicine. I valued the rapport and relationships developed by caring for people throughout their lives or managing their toughest days, and at that time I didn’t realize that swift rapport and strong relationships were crucial to providing surgical care.

One night on my SICU sub-internship, the PGY2 and I admitted 19 trauma patients; we placed our 15th central line as the sun rose into view over the city. Later, I talked with the brilliant PGY9 trauma/critical care fellow about my difficulty choosing a specialty. She said something I’ve never forgotten: “Surgery is the coolest club around, but the dues are high and you have to decide if you want to pay them.”

When I did an Otolaryngology elective, I knew by the end of the first week that I had found my specialty: the perfect blend of medicine and surgery, gorgeous anatomy, patient stories and the instant gratification of fixing things. The first four weeks of my rotation were spent at our county hospital. We specialized in neck pus, due to an unfortunately high rate of IV drug use, facial fractures, a variety of cancer cases, and anything complex that was flown in from the surrounding underserved region.

One patient came in complaining of throat pain and hoarseness. A larynx (voicebox) mass was found on a scope. The biopsy showed cancer. The patient had endoscopic surgery to remove the tumor while I was on service. My mentor kept me apprised of her progress for quite a while after I moved away to residency. Our patient needed multiple surgeries for small recurrences over the next few years, but was alive, still had a functional larynx, and could eat by mouth last I heard. I hope she is still doing well.

N.B. To honor patient confidentiality, details are altered and multiple patients may be conflated. Please also note that portions of the speech-turned-blog-post previously appeared in post How I Became A Surgeon on this blog (first published as a guest post on #LifeofaMedStudent)