As I sat in a very long and tedious brain surgery case, I pondered the pros and cons of the other surgical subspecialties I might choose: reproductive medicine, vascular surgery, and ophthalmology. Reproductive Endocrinology and Infertility (REI for short. This is not where the outdoor equipment company gets its name.) falls into the field of the seemingly miraculous. It is a subspecialty of OB/GYN that medically and surgically helps women who cannot have a baby, to have a baby. What a gift! I really enjoyed my two-month OB/GYN rotation. Sadly, after it, I was no longer attracted to women. I’m pretty sure that’s offensive to somebody, and for that, I apologize. Just trying to be real here. REI was out because I’d have to be an OB/GYN first and it turns out that would make me asexual. (Again, sorry.) Some of the best doctors and husbands I know are OB/GYNs but I couldn’t do both (husband and doctor).
Vascular surgery is basically sewing blood vessels together. It is like being a seamster who wears latex gloves. A big part of why I didn’t feel like I’d like it is because you have to do a five-year general surgery residency. This is almost entirely abdominal surgery on stomachs and livers and colons and gallbladders. There are great men and women that live for general surgery. As a medical student, that world was more about surviving than thriving. I made it through fine, but the residency is even more brutal. Legislation was passed to protect patients by only allowing residents ￼￼￼￼￼￼to work 80 hours a week. However, in practice the 80-hour work week law is obeyed kind of like the speed limit. Everyone knows what it is and then does whatever they can get away with. To say to a surgery attending, “I’ve worked my 80 hours already this week,” would be equivalent to saying, “I’m wearing footy pajamas to work tomorrow.” On top of all this, I didn’t want to sew blood vessels together for the rest of my life.
That left ophthalmology. However, for unknown reasons, the Internal Medicine and General Surgery types that run med schools don’t hold ophthalmology as a priority, so I knew only slightly more about ophthalmology than I would have if I weren’t in medical school. I had one half-day of it a year previous. Optometry, optical technician, and ophthalmology were separated by very fuzzy lines. But, the more I researched into it, the more I got hooked. Not only was it microsurgical, it was beautiful. I have a journal entry from my first elective month-long rotation in ophthalmology that thankfully I’ve lost, but I do remember it describing seeing all these eye parts under a microscope in oddly romantic terms. Then I found out, wonder of wonders, the attending physicians in ophthalmology were happy! The patients were happy. And most astonishing of all, the residents were happy. I had stumbled into Eden. It took exactly one month for the push factor out of neurosurgery to be dwarfed by the pull factor into eye surgery.
My only concern before becoming an ophthalmologist, and I am ashamed to admit this, was that I wouldn’t get to tell people I was a brain surgeon. As it turns out, it is way, way better to love what you do than to love telling people what you do. So to this day, if someone asks what I do, I look them in the eye and say, “I’m a brain surgeon.” Because how are they going to know?