"Surgeons rock out in the operating room..." and more, by Omar Mesina'14

For the past month I have been shadowing Quirurgica, a private team of general surgeons in Barcelona, Spain. In the past few weeks I have had numerous experiences that have both informed and cemented my aspirations to pursue medical school and hopefully, surgery. Any undergraduate in the pre-medical track will attest to the fact that there is an overwhelming desire to partake in memorable medical or scientific research while in college. While I do believe that this sort of passion is what fuels discovery, I am also of the belief that simply observing, and taking in what the career you envision yourself in entails is as equally rewarding. I knew the importance of medical shadowing but it never revealed to me as an experience I would want to undertake for a whole summer.

Over the course of five weeks I have observed and scrubbed in to multiple surgeries: thyroidectomies, laparoscopic cholecystectomies, colectomies, various hernia repairs, and hemorrhoidectomies to mention a few. Aside from shadowing in the OR I also spend a significant portion of my week in clinic with the surgeons, sitting in on patient visits and have gotten to witness numerous cases from the very first visit to the post-operation appointment. Below are some of the reflections I have had over the past few weeks:

1. To the patient, this is a huge deal. No matter how many thyroidectomies or gallbladder removals the surgeon has done, the patient is experiencing one of the most significant and scariest events in their lives. In my seven weeks with the surgeons I have learned a lot about the symptoms, diagnostic tools, surgical procedures and post-operative treatment for many of the cases they treat. I have seen many patients come in with nodules on their thyroid that is easily treatable (albeit trough a very invasive way as it involves total extirpation of the gland). To the uninformed patient, the moment he or she hears “tumor” it is quickly associated with cancer. In order to provide care appropriately it is vital to see things from the patient’s perspective. It is easy to forget that what may seem like something insignificant to the doctor is really a big deal to a patient.

2. Surgeons rock out in the operating room. Yes, they listen to music---Queen, Beatles, even Taylor Swift. The first day in the OR, I expected to be in an intense place where all I would hear is the beeping noise of the anesthesia machine. Much to my surprise, as the surgeon began to make the first incision for a thyroidectomy he asked the rotation nurse to turn up to the music and “Don’t Stop Believing” came on---probably the most ubiquitous, overplayed song ever written. Of course, there are times during the procedure when the surgeon will ask to turn the music down, but generally music can make the procedure calmer for the surgeon---much like any student who may enjoy doing their problem sets to their favorite tune.

3. Operating rooms can be scary. Patients may arrive in surgery nervous and scared. Therefore, the time when they are wheeled into the operating room is a very sensitive time. Most of the time the duty of comforting the patient falls upon the anesthesiologist, who calms and soothes the patient into unconsciousness. If anything, anesthesiology is one of the most important fields in medicine. Historically, most of the life-saving procedures undergone today were not possible without the proper handling of anesthetics. Having the knowledge and skill set to comfort a patient and not have them feel a single thing while they’re being cut into must be fascinatingly rewarding.

4. Surgeons (and residents) don’t eat. Most days I shadow my mentor surgeons all day, sitting in during patient visits, going around hospital rounds, and scrubbing in to the OR. After a few days the realization came as a shock: an unbelievable hunger on most afternoons. To truly thrive in this setting you must be able to disregard your natural body necessities, and ignoring hunger is definitely one of them. Surgeons and residents and other hospital staff do not necessarily have a scheduled meal break and must find time to quickly do so. Most pre-medical students are aware of this fact but it’s a different story to experience how uncomfortable it is to be hungry almost all day. These past few weeks I’ve realized that this will be an inevitable part of pursuing medical school and that as obvious as it may seem it could definitely be a deterrent for anyone who is not expecting it.

5. Being a surgeon is like being a detective. A patient may arrive to the surgeon’s office with certain symptoms and diagnostic tests pointing to a certain pathology, but there may be a piece of their medical story that might not completely fit in. My favorite part of my summer experience is listening to the surgeons discuss their week’s most difficult cases in their weekly team meeting. Each surgeon presents his or her case, the procedure that was undertaken and asks for advice or suggestions on how to follow-up. Just this week my mentor surgeon had a case of a woman with medullary thyroid carcinoma (MTC), who had alarmingly normal calcitonin levels. Normally, the biochemical activity of MTC is increased production of calcitonin. Cases like these are extremely rare and there are very few published; the surgeons are hoping to publish this case in the near future. It was such a privilege to be present during this case and I’m continuously awed at how knowledgeable they are, which has personally served as an impetus to keep working hard towards medical school.

6. Surgeons thrive in seeing an immediate palpable positive outcome. My mentor surgeon has repeatedly told me that the reasons he enjoys his career so much is because he is able, within a span of a few weeks involving pre-operational, operation, and post-operational care, to improve a patient’s health. Luckily, I’ve been a witness of this account. During my time with him this summer I have journeyed with patients from their very first visit, to the OR, and finally to their post-operation appointment. A surgeon is able to bring an immediate improvement in the health of the patient through his or her own efforts.

My experience this summer has been truly amazing and I want anyone who is considering medical school to reach out and shadow physicians in fields you are interested in. I learned first-hand this summer how vital the shadowing experience is both to your own reflections on why you want to pursue medicine as well as to your medical school application.