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Ok, maybe not a chef...

I am realizing how much I admire surgeons. (The good ones. When they're not in a bad mood.) It really takes a strong character and brains to be a good surgeon, and I don't feel I have what it takes to be a good general surgeon. And I don't mean this in any self-negating way -- more like saying that I don't think I have what it takes to be a pilot, or a chemist, an English professor, or a politician -- you know, just not my thing.

Anyways, yesterday was a big day. I gave my presentation on breast cancer to a group of attendings and residents, and it went pretty well (although I put myself through so much misery while preparing for it). I was complimented by several attendings and residents, which, like, never happens. (How timely, Leila!)

And then, I got to see a super cool case -- so "cool" to the point of making me feel sick realizing how excited I was to see a case that involved nothing less than a tragedy.

It was an organ procurement case. A young girl had an accident that left her brain dead, which made her a candidate for organ donation. Procurement is a fancy word -- a euphemism, some would say -- for harvesting organs for transplants. Transplant cases never take place on a regular basis because you never know when you will find donors. I felt so lucky that I ran into the right people at the right time.

As soon as I walked into the O.R., however, I started to feel uneasy. I pulled out the donor's chart, and, although I won't describe it for the sake of patient confidentiality, it was a simple tragedy for the family. 

The patient -- the donor -- came into the O.R., hooked up to multiple wires and tubes that kept her heart beating and lungs expanding, even though all cognitive functions -- what used to make her a beloved human being -- have ceased. I was immediately reminded of a book on organ transplants and the shifting definitions of death, written by the anthropologist Margaret Lock. The author describes a scene where all the organs are removed and the procedure complete:

An ophthalmic surgeon is expected at any moment to remove [the corenas] for donation, and I find myself repelled by this last intrusion in a way that I had not expected. For me, it seems, removal of the eyes represents more of a violation than does procurement of internal organs. More likely it is simply that the tension in the room has entirely dissipated, and now that people are leaving, stripping off their surgical gear as they go, I am permitted to reflect on the enormity of what is, to them, a routine procedure.
--Margaret Lock, "Twice Dead" (2002), p.22 

I found myself feeling closer to a guest anthropologist in the O.R. than a future surgeon presiding over the case. I was undoubtedly excited to be part of such a huge case, but I couldn't help feeling uneasy for this excitement that I was experiencing when there were family members outside the O.R. grieving the death. Everything felt somewhat misplaced, incongruous, and messy -- as a member of the transplant team, it would be inappropriate to let the grief interfere with the work that will end up saving the lives of the recipients. I mean, can you imagine the transplant surgeon choking up every time he removes the heart, the lungs, the liver, and the kidneys? I choked up several times throughout the case, but I had to remind myself that it wasn't about me or my feelings, it's about the patients and the procedure. 

And this is precisely why I think I would not make a good surgeon. I find it extremely difficult to let go of these things that I simply notice about surgery. I often find myself a step removed, or feel uncomfortable when I do find myself completely occupied in a case to the point where it is, well, just a fun case, not a patient.

Perhaps a good, experienced surgeon is someone who is capable of dealing with complexities, one who can juggle with brutality, aggression, precision, humanity, empathy, life and death, all at the same time. And, to me, at this point, it seems like a daunting task that I do not know if I have the capacity to tackle...