Someone once sent me a package to Dr. Alice, so when I called FedEx to explain that they couldn’t just drop a package addressed to Mr. John Brown, whom I don’t know, at my door, simply because the addresses are similar, the lady on the phone recognized that I was a doctor, and started chatting. She wanted to know what was my least favorite kind of surgery (so yes, silly of me to admit that I’m a surgeon; which actually suggests a whole other line of thought, about why doctors are secretive 1) about their profession 2) about their specialty; my father has a fairly sound theory that if you’re admit you’re a doctor, people assume you’re rich, and automatically start looking for ways to get money out of you; which, as a man with a large family, he couldn’t afford). Her question nagged me, partly because of course I couldn’t tell a stranger on the phone about my patient who just died after surgery, or how I hate cancer surgery because of the times when it doesn’t work, or how nasty dead gut is, or how I get stuck with the abscesses because I have no sense of smell, or the nightmare of burn surgery which I’ve pretty much blocked out of my memory; and partly because it reinforced my growing sense of surgeons as a separate species.
Which I’ve been thinking about on this rotation. We often end up having to tell people that they need a section of their intestines removed, for various reasons. People are attached to their body parts, oddly enough, and don’t react well to the proposition of losing some. “It’s good for you,” so we insist, and explain, and persuade, and eventually end up doing what needs to be done. But people give us these looks, like: are you crazy to suggest that? And I guess we are. We have crazy ideas, and do unnatural things, and we’re different from normal people.
Hopefully I’m just at an intermediate stage of development with this. To medical students, it doesn’t kick in, because they spend a relatively short time on surgery, and there are so many strange things going on that it’s all equally crazy. And to attendings, this is normal, because they’ve been doing it for so long. There’s just an awkward phase, where I still have a vague memory of normality, and haven’t quite adjusted to my new tribe. The other residents don’t seem to feel this way. Maybe they wouldn’t say anything if they noticed; or maybe I really am crazy. I criticize some of the interns, for having an off-kilter angle on reality; but maybe I’m off-kilter too.
And I’m not going to get to operate this month, so there’s none of that excitement to mask the oddity.
April 4, 2009 at 6:28 pm
I’m convinced that there’s a bit of mystery about the innards, and to be told, “You have a tumor and we have to remove 10cm of your intestines,” sort of pulls back the curtains on the holy place of the viscera and shatters the illusion that one’s insides are a demure collection of well-oiled clockwork. Such news causes the heart or the appendix or the intestine to compete with the head for the unequivocal seat of self-ness. So it’s weird. And I feel like that’s what you’re describing.
By the way, I read your first sentence three times and still couldn’t understand it. Was the package addressed to “Dr Alice” or to “Mr John Brown”?