Cardio God

This week has been a week of ups and downs. I started off the week with much stress, listening to MTAS conversations and coming to the conclusion that my future might be, perhaps, bleaker than I had ever imagined.

Then I decided it was possibly too late to lament any longer and decided to pro-actively try and be more involved in whatever clinical rotations I still had left before deciding my fate next year.

Much of what I discovered about myself this week was probably not very pleasant in many ways. Admittedly, I am not as nice a person as I would like to be, and can be rather opinionated, very evidently, about personalities that tick me off. And one of those are, perhaps, medics who are in the field for the completely wrong reason. Recently, a friend voiced his opinions to me about venturing into Investment Banking and Finance after having sat and passed some Surgical specialist exams. At that point, I was rather apprehensive of the idea, and said exactly so.

And then I realised that I was perhaps being unjustifiably judgmental about people's futures and their lives, when who in the world was I to say anything. I had learnt a very long time ago that the world was just becoming increasingly fake and more superficial from year to year, and I could possibly be one of those too in the near future. And as sincere and passionate as I would like to think myself out to be, I am not entirely sure that I REALLY am. Especially at this point in time.

Sometimes I really just wish I could get married after qualifying and be a Chronic SHO forever.

HAH.

On a perhaps, happier note, today is one of the days I would like to remember, simply because it was a whole 2 years ago that I last watched an open heart surgery at IJN - and that has definitely been too long.

Prior to some warning that previous students had been increasingly told off for appearing after 8 am and not having clerked the patient in theatre beforehand, I attempted to locate the patient yesterday afternoon to clerk - only to be told that no one had any idea what time they would be turning up, be it afternoon, night or early this morning.

Did NOT want to mess up my only chance of watching a cardiac surgery (only one theatre day for CT Surgery out of the Cardiology placement), so I stumbled into the still dark hospital at an unearthly hour to try and clerk the patient beforehand. Bumped into this woman in stiletto heels and a white coat and made the mistake of not recognising her as the Cardiac surgeon doing the operation, and got told off severely for trying to clerk the patient before the surgery, hence potentially stressing the patient out - and that I should have done this yesterday.

Decided not to argue, because I felt that she did have a point, but she turned out to be alot nicer in the end. She was demonstrating a Mini Aortic Valve Replacement (different from the standard AVR in the sense that they were not doing a full sternotomy) to about 20 other surgeons / anaesthetists present that morning via video conferencing, and she said we could watch but couldn't go into theatre because it would probably be overcrowded.

Fair enough. Turned out to be amazing!! The view was better than any I could have asked for. And there was no way any CT Surgeon was going to let a medical student scrub in on his/her major open heart surgery anyway, so I figured there would not be any point going to stand in theatre and try to disappear behind into the walls.

My firmmate, who was initially extremely ticked off for not having been able to actually go into theatre today, ended up seeing the bright side of things just as I did, and agreed that this was possibly alot more useful than having been there physically. Fair enough, the jargon of Cardiothoracic Surgery remained. Arterial, venous cannulas for bypass, where to place holding sutures, what retractor to use, which situations to be wary of.....and when the patient when into resistant VT/VF towards the end, my firmmate was on the edge of her seat because the multiple attempts to defibrillate did not work - and yet much of me felt SO in awe of Prof J because she hardly batted an eyelash. In the end I think the anaesthetist gave the patient Amiodarone which settled, but it was definitely a bit of a hairy moment.

It is strange, when I reflect back, how a whole pool of people (larger than I would have imagined), have written me off as a Cardiothoracic surgeon wannabe. When I was 13, I distinctly remember filling in 'Neurosurgeon' as my 'type of Doctor I hoped to be'. By the time I was 18, after a bunch of wide-eyed, innocent, 'taster' medical attachments, I guess I was sort of thrown into the Cardio ocean by default, simply because I spent the most time there, because it was the easiest to just follow my uncle around.

Who knows, maybe familiarity stems interest? Maybe ignorant attachments do sort of influence the kind of affinity you have towards a specialty, because I still maintain that Ob Gyn horrifies me to this day (we'll see when I do that rotation for real next year). 2nd year 'electives' after that saw me doing Cardio again, simply because my initial plan failed. Again, no regrets. Cardiology was amazing. I loved the Reg I was with. Cardiothoracic Surgery, even more. Perhaps it had to do with the fact that the CT Surgeon became my best friend towards the end, but generally my experience with Cardio has been generally good.

I do maintain that I am biased, though. Mind over matter. Most of my good experiences have come from good teaching and camaraderie with teams I have worked with in the past. My first Gen Med consultant was a Rheumatologist, but that was probably one of the crucial moments that I realised I was more of a Medic than a Surgeon.

I sing no praises for my Cardio rotation. Georges has apparently one of the biggest Cardiothoracic Units in the South West of London, but the nicest thing I can say about the timetabling and the rotation is that it could be less haphazard, at the very least. And yet my preference for it has not faltered one bit. I wish I could have been allocated more clinic slots. I wish there were less people being rotated around and chucked into different things on different days. I wish I could have brought my murmur-identifying skills that much further. But I will just have to make do with things and lament less.

As a renown Cardiologist I know likes to say, "Do more, speak less. Prove by action."

Will do, will do.

Here's to Gen Surg next week. I'm sure it will be good.