Becoming a surgeon while dealing with seizures

[Abdominator]

Hi everyone, I've never really posted here before, but I have a few questions. As a disclaimer, I'm a senior pre-med applying this year, but I figured you guys would have more information for my question than my fellow pre-meds.

My question is this: I want to be a surgeon more than anything (I have my heart set on ortho), but I also have a traumatic brain injury and a resultant seizure disorder. Are these things mutually exclusive?

The brain injury happened seven months ago, so I'm still working through some of the physical and cognitive rehab. The TBI itself was moderate, but I have had six other mild brain injuries throughout my life, so this one took a disproportionate toll on me. Several people have told me that I should just give up on medical school altogether, but I refuse to do that. I know that I can make it through and even excel. I'm making it through my upper-level hardcore science classes very well, with accommodation (time and a half and quiet location for exams and notetakers for lectures) while balancing several other serious responsibilities outside of school. Before the accident, I had an IQ of 165, so although I lost quite a bit of my cognitive skills, I still function around 130 on most things...some other things are significantly below average, but like I said, I am working through rehab and learning compensatory strategies. I know that pre-meds and med students work hard. I know that I'm at a disadvantage, but if that means that I have to work harder than anyone else, then that's exactly what I will do.

My larger concern is the seizure disorder. The seizures started about four months ago and I am still working to get them under control. I have an AMAZING neurologist who knows that I am pre-med, so I am very fortunate in that regard. So far I have tried two different AEDs so far - I had a paradoxical reaction to the first one, but the one I am on now has decreased frequency by about 70%. Of course my goal is 100% control, but I'm still working on getting there. I should say that I have only had tonic-clonic seizures while I sleep. the ones that I have while I am awake are partial, tonic, or myoclonic. The majority of those happen after 7:00pm and are directly related to stress and sleep deprivation.

So knowing this, are my dreams of being a surgeon unattainable? I can only imagine the devastating consequences that would be the result of even a partial seizure in the OR, but if over the next few years of med school, if I gain 100% control, then could I pursue a career as a surgeon?

I have also considered neurology and PMR as specialties since I have spent a lot of time as a patient in these areas and I think that as a physician I could offer my patients a unique perspective and sense of empathy from having to deal with the same struggles. But for many years before the accident, I have dreamed of being a surgeon.

So that is my question/problem. Any ideas or input is greatly appreciated.

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[Depakote]

I would focus on one thing at a time.

You need to gain acceptance to medical school and pass the first two years as well as your USMLE. Then you'll get to your clinical clerkships... most students find their choice of specialty shifting around this time.

In the mean time, I would focus on gaining better control of your seizures.

I'm going to be honest. You say stress and sleep deprivation are triggers. Those are predominant, especially in surgical specialties, even worse during surgical intern years. A seizure has the potential to be catastrophic in the OR and your disorder may be something that will preclude you from operating.

 

[ar2388]

i think that you can do medical school but it will be really hard... i cannot even call what i did in college "studying" when i compare to how much studying i need to do in medical school. it is beyond anything i could ever have imagined.
but i am one of those people who believes that anyone can do anything if they really set their minds to it work their @sses off.
however, the nature of surgery may preclude you from doing it. the long hours and crazy schedules and long long operations may put extra stress on your body and brain and that maybe will affect your seizure disorder. but i am not a doctor and i cannot say for sure, this is just what popped into my mind. also, the possibility of you having a seizure while performing surgery is probably the biggest issue and may also affect malpractice insurance drastically and whether or not hospitals want to take that risk.
just my 2 cents... but i dont think you cant do med school.

 

[Guillemot]

I would recommend that you not apply this year and take additional time for rehabilitation.

 

[MossPoh]

Heal up to the best of your abilities. Get into med school. Then worry about the other stuff.

It is a long road ahead to worry about whether seizures will impede you from surgery.

My opinionated response is that if you do get to that point and still have seizures, even if infrequent, it is unresponsible and putting your desires and goals before the patient's safety and needs. I know that sounds preachy, but would you want your loved one being operated on by someone who could be out from a seizure at any given moment?

I'm not saying you can't do it, nor do I think it is an unreasonable goal to have. When or if you reach that decision point is the time to really start posing those questions. Until then, just do your best to get things under control and get in somewhere. Baby steps.

 

[ACSurgeon]

I'm going to echo a few things:
1) you don't really know what you want to do until third year. You can dream all you want of different specialties, but reality is, you have very little idea what's out there, and what you really like.

2) What you can do will be determined by how well your seizure activity is controlled. If you get it to "100%" control on meds/brain surgery, assuming no motor side effects, than you can theoretically do anything. As I'm sure you know, it is too early at this point to tell if you're going to get there, and if so, how soon. You will have to take things step at a time, and IF you get accepted to med school, your condition as a third year student, combined with your step1 score and interest, will determine what you want to/can/should do for a career.

 

[fleetgoddess]

Well first and foremost,
You wont be the first or last medical doc who has a hx of TBI. I've met other docs, residents, etc with a history of TBI. There is an anesthesiologist who tours and talks about his and safe teenage driving practices. His seemed fairly severe from what he said on the website but its hard to tell as he doesn't go into details but I think he was in a coma for awhile. I can give you the link to his website and maybe you could email him as his email is on it. He talks about going to college with reduced work load and recovery a bit.

I had one as well. It sucks and is an up hill battle for awhile but I think you'll work through it. I actually took very little time off due to school pressure and having to repeat my semester and in retrospect that could have been dumb but ultimately it didn't affect me too much in the long run.

I'd assume it would be difficult to be a surgeon without having them under control. I do know of an ob gyn with tourettes though and he has upper arm motor tics which I think seems difficult to work with. He doesn't operate much but he got through residency with them.

 

[Abdominator]

Thank you everyone for your input.

I know you're all right. The first thing I need to do is get in to medical school. That's my biggest concern right now - MCAT and applications are all coming up soon, so I'm trying to focus my energy on that. In a few years, things will be a lot different and I will know better what I can or can't do or what I even want to do. I would never put myself in a situation where my own problems or actions could harm another person, but I've also never faced the situation where there might be something that I just *can't* do, despite my desires, motivation, or abilities.

I guess I'm just the type to plan things out - I like to have a long-term goal in mind and know where I'm going, even if that changes (I spent the first four years of undergrad as a serious, hardcore pre-vet). I'm sure a lot of you are the same way. Seems most pre-health professionals I know are as A-type as I am. If I don't have the next ten years of my life planned out, then I feel like I'm not prepared enough!

Right now I just need to know that what I'm working so hard for is, in the end, something that I'm actually going to be able to do.

 

[ACSurgeon]

Thank you everyone for your input.

I know you're all right. The first thing I need to do is get in to medical school. That's my biggest concern right now - MCAT and applications are all coming up soon, so I'm trying to focus my energy on that. In a few years, things will be a lot different and I will know better what I can or can't do or what I even want to do. I would never put myself in a situation where my own problems or actions could harm another person, but I've also never faced the situation where there might be something that I just *can't* do, despite my desires, motivation, or abilities.

I guess I'm just the type to plan things out - I like to have a long-term goal in mind and know where I'm going, even if that changes (I spent the first four years of undergrad as a serious, hardcore pre-vet). I'm sure a lot of you are the same way. Seems most pre-health professionals I know are as A-type as I am. If I don't have the next ten years of my life planned out, then I feel like I'm not prepared enough!

Right now I just need to know that what I'm working so hard for is, in the end, something that I'm actually going to be able to do.

#1 There is nothing you CAN'T do despite your DESIRE & ABILITY. Ability includes physical AND academic (among other things). So, if there is anything you desire, that you are able to do, you CAN do it.

#2 Be careful with that. It can deprive you of fully experiencing/enjoying the time that is currently passing you by.

#3 You are working hard to become a doctor. You will be able to work as a doctor at the end. Period.

 

[fleetgoddess]

[/B]

#1 There is nothing you CAN'T do despite your DESIRE & ABILITY. Ability includes physical AND academic (among other things). So, if there is anything you desire, that you are able to do, you CAN do it.

#2 Be careful with that. It can deprive you of fully experiencing/enjoying the time that is currently passing you by.

#3 You are working hard to become a doctor. You will be able to work as a doctor at the end. Period.

I wanted to second #2.

Becoming a doctor isn't about getting to the end point the fastest. You'll find you miss out on so many experiences if all your doing is planning how to get there. Becoming a doctor is a path filled with many different experiences. It shouldn't really be a let down if you need an extra year. You aren't a failure if you don't go right out of college.

A lot of people take time off between undergrad and med school or during med school. Travel, volunteer, do things that you won't be able to when your in residency. I think too often students focus on being happier TOMORROW. You know when you get done with training there isn't going to be just happiness sitting their waiting for you. Enjoy where your at and what your doing now or you'll never enjoy anything later either, there will always be something else you'll put it off for. I'll enjoy myself after med school, after residency, after i'm head of the department... when I'm retired.

 

[Abdominator]

Enjoy where your at and what your doing now or you'll never enjoy anything later either, there will always be something else you'll put it off for.

Thanks. I know this is true, but sometimes I forget it. It's easy to get caught up in the flow of things and think about how much easier life will be when I get to X, but in reality it's getting to X that really matters.

I've seen that in my life already. I'm in my fifth year of college and the first four years were spent as a pre-vet. I did everything that all the cracked-out, super-intense pre-vets do. I even applied to vet school. I didn't get in. And the strangest set of tragic and triumphant circumstances brought me to my life as a pre-med. Do I regret any of it? Not a chance. I wouldn't be where I am without those experiences.

I guess what I'm trying to say is that I know things work out the way they're supposed to, even if it's not how we envisioned it; but I'm not necessarily one to passively go with the flow so much as I am one to help the flow along in the direction I think it should go.

Thanks again everyone. Hopefully in a year or two I can join you in the ranks of being a real med student 🙂

 

[rachmoninov3]

I echo taking things one step at a time, but feel uniquely qualified to offer my $0.02

I had epileptic seizures as long as I can remember that were completely cured via a temporal lobectomy at age 16y. I could never have done medical school while taking anticonculsants. Between the sedating effects of the AEDs and the fact that much like you, sleep deprivation was a trigger, medical school would have been impossible. Then there are more practical things to consider: transportation, other unavoidable triggers such as surgical lights, and the social effects of epilepsy. Some things may be doable if you have an aura and time to excuse yourself but the social effects of having a seizure infront of attendings, residents and fellow medical students should be considered as well. Abortant medications such as benzos also run the risk of increased absenteeism (at least they did for me) which will not be looked kindly upon on a busy service.

There are other things that you may be able to do other than surgery: psychiatry/neurology, PM&R and pathology come to mind. Look at Charles Krauthammer, MD for inspiration.

The good news, as I understand it, is that seizures after TBI may get better or resolve completely. It sounds like you have a good neurologist, so continuing to work with him while you work on your pre-med/MCAT/application will be a big help.

Take things one step at a time, and despite what I or anyone has said:

Never, ever, ever, ever, ever, ever give up.