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The day I decided surgery was for me…never looked back.

Authors: Zi Qin Ng; General Surgery Trainee; Department of General Surgery; Royal Perth Hospital; Perth, Western Australia; @kentng10

I am almost at the end of my general surgery training, yet it is just the beginning of another journey. I am in my final 6-month rotation in a new hospital. I was about to leave late in the evening on a third day of consecutive on-call. I received a trauma call (which was an infrequent event as this wasn’t a trauma hospital). I dashed through to the resuscitation bay in the Emergency Department (ED) and witnessed a chaotic scene with CPR ongoing. I heard briefly that the patient had a stab injury to the chest. The ED physician just did a left finger thoracostomy and blood was just pouring out. I took over and performed a resuscitative thoracotomy. I delivered the heart and repaired the penetrating injury, followed by cardiac massage. The patient miraculously survived.

The next day upon reflection of the event, I recalled how I decided surgery was for me. It wasn’t that long ago; I was still in my second year of medical school and the cardiovascular system was first taught to us. I thought cardiology was my main interest. I followed that interest with an elective in cardiology but felt the intricacies of ECG and pathological heart sounds were too hard to comprehend. I then came about surgical pathology which I thought was very simple and logical. The following summer, I decided to do my electives in general surgery. I was introduced to this Professor of Surgery (still currently practising in his 70s in Malaysia) who essentially was a generalist, and who was skilled to perform any operation. He was a paediatric surgeon by training, then later picked up adult general surgery with a focus on surgical oncology. In one of the ward rounds, I remember we saw a patient that he had just performed synchronous resection of the primary colon cancer with liver metastases. He was so passionate in explaining to me (then a third-year medical student) about the volume augmentation techniques in liver surgery which made a lot of unresectable disease became resectable. This was very inspiring to me given the fact that my late grandfather died from metachronous colorectal cancer with lung and brain metastases in the late 1990s. At that time, the only effective chemotherapy was 5- FU and other newer regimens were recently released. I remember him undergoing metastectomy for a brain metastasis due to raised intracranial pressure.

This was where I was introduced to the beauty of surgery – the ability to offer hope, and I decided that surgery was my chosen path. Along my surgical career, my patients continue to inspire me in different ways. It is no doubt a privilege to care for them, to be trusted to perform their operation and to be an advocate for them in their sickest moments. People often talk about regrets with the retrospect-o-scope. For me, through the lenses of the future-o-scope, I don’t think I will ever have any regrets about the day when I decided surgery was for me.


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