"peering over curtain" syndrome

[ALTorGT]

is anyone here affected by this. just like many others who post here, torn between surgery and anaesthesia as career choices. something that people from both sides mentioned was that sometimes in anaesthesia, because you're in the backseat, you might find yourself constantly peering over the curtain, left out of the action. Feeling like you're not really the A player.
How true is this.

After having done electives in both, I admit there is that niggling thought that you're being left out of the main action and denied the satisfaction of fixing the problem...But when your'e by the patient and holding that damn retractor for the 23rd time, you start wishing you picked something a little more cerebral.

ARGH! why is it so tough to make this decision. Vacillate between one and the other...so much...like trying to choose between a red ferrari or a loaded chaeuffeured Bentley.

How did you finally make that choice. Would you have still made the same choice if you were also given the opportunity at the same time to swap to ENT, Opthal, Ortho or Urology (no strings attached) as compared with the "horrendous lifestyle" general surgery option.

Goddamn life is hard.

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[Idiopathic]

I have not matched yet, but I made the choice after going through this debate and considering several options...it was not difficult, and it just gets easier the more time i spend on service.

Picture yourself as a general surgeon or a general internist. Your day is filled with: meetings, rounds, charts, operations/titrations, charts, more operations, charts, clinic, charts, and finally, rounds. Did I mention charts? Sure, I like to imagine myself tying off that bleeder or stenting that vessel, but do I really want to hold a retractor for three years to get there? Do I really want to chart on a patient twice a day? Or would I rather master pharmacology, physiology, cardiology, pulmonology, become good at procedures, experience medicine, surgery and acute care all in one setting, manage problems, see my actions take effect immediately? As a student on the gas service, I can learn something new every time I walk into a room, whereas on surgery service, after my 5th gallbladder, that was pretty much the long and short of it. Surgical specialties really just narrow the field, and I wanted a broader scope.

After you get through that, if you still aren't convinced, write down the facets of the training and the practice that intrigue you. If you get more on the surgery side than: "it looks cool" or "i like to work with my hands", maybe you should really consider it. I found all my interests were met in anesthesiology, whereas all other specialties left something to be desired. It is not that way for all, though.

Just the $0.02 of a fourth year med student, however.

 

[mdmccallum]

Peering over the curtain is a big part of it. You have to know what is going on at all times. You need to know that the sturgeon is about to cut that pumping vessel b/c he/she has the skills of a butcher. They don't always tell you that the belly is filling up with blood. You have to figure it out yourself. The sooner you see it the easier it is to fix/treat.
I know this is not your question, so here's my take on it. While I always peer over the curtain I do not find myself second guessing my choice. I watch as surgeons become more and more frustrated having to deal with so much crap besides operating. These guys want to operate and insurances and what not are making it harder and harder to find time to do this. In my opinion many surgeons are tired and fed-up with all the buracracy ( my opinion). They are also resentful at times with the anesthesiologists b/c we work shorter hours and in many cases make more $$$. If you think you can't live without being the center of attention then you might want to try surgery. But if you like have a good relationship with nurses and surgeon mostly, doing your job and then enjoying your life, and most importantly making patients feel safe, Then anesthesia might be the one.

 

[Justin4563]

not a tough choice at all

general surgery may seem glamorous but its a vicious field once you get out. the competition is fierce especially in bigger cities.. and its not that interesting if you think about it.. at least its not to me.. pus, draining pus, gallbladders, negative laps, hernias etc.. as an anesthesiologist i know what they need and want more than they know what they need and want..

 

[asdash]

Does anyone else persistently read the title of this thread as "Peeing over curtain" syndrome besides me?

 

[ThinkFast007]

Does anyone else persistently read the title of this thread as "Peeing over curtain" syndrome besides me?

 

[PassinGas]

I was choosing between ophtho and anesthesia. I chose anesthesia. After doing rotations in both fields, I just enjoyed myself more with anesthesia. I did a pro con list for each and ended up choosing anesthesia.

The thing is everyone has their own reasons for doing whatever, and there is no wrong answer if you are being honest with yourself about why you are choosing one field over another. You just have to figure out your reasons/priorities.

By the way, when I read the title to the OP, I thought you meant peering over the curtain in the other direction, because that's how I got interested in anesthesia in the first place. I was on gen surg and was bored with the hernia repairs etc. and began peering over the curtain at the anesthesiologist. To each his own, though. I have friends who went into ophtho and gen surg and you couldn't pay them to change their choices. Likewise with me.

Good luck with your decision...anesthesiology is just better than the other fields, period.

 

[Willamette]

I was choosing between ophtho and anesthesia. I chose anesthesia. After doing rotations in both fields, I just enjoyed myself more with anesthesia. I did a pro con list for each and ended up choosing anesthesia.

The thing is everyone has their own reasons for doing whatever, and there is no wrong answer if you are being honest with yourself about why you are choosing one field over another. You just have to figure out your reasons/priorities.

By the way, when I read the title to the OP, I thought you meant peering over the curtain in the other direction, because that's how I got interested in anesthesia in the first place. I was on gen surg and was bored with the hernia repairs etc. and began peering over the curtain at the anesthesiologist. To each his own, though. I have friends who went into ophtho and gen surg and you couldn't pay them to change their choices. Likewise with me.

Good luck with your decision...anesthesiology is just better than the other fields, period.

I got turned onto gas during my OB/Gyn clerkship. I was doing nightfloat, and the anesthesiologist and I hit it right off. I ended up participating in several epidurals, and getting a lot of questions answered about what anesthesiologists do. I was amazed to find out that they are intimately involved with the two basic sciences I liked best: physiology and pharmacology. Up until then I had no clue. What's more is all the hands-on stuff that goes on. I didn't know it at the time, but I was well on my way to being hooked.


Willamette

 

[ALTorGT]

Pro list: Phys, Pharm, Acute, minimal long term care, these are awesome

Con:
1) At beck and call of surgeon
2) Depend on them for business
3) Put up with their shananigans in private practice ala receiving pateints without workups
4) operating late because they stacked their list.
5) Conted with always making less money (less than 50%) than the surgeon for the same amount of time spent in theatre.
6) Not treating disease or fixing a cataract or putting in a knee joint - longer term you become a solid specialist in some niche area.

Appreciate if you could address these issues.

 

[CambieMD]

ALTorGT,

From your posts it seems that you may enjoy surgery more than anesthesia.
I think that most of the concerns that you listed are subjective. I followed anesthesiologist at a hospital for several months. I never witnessed them being belittled or bossed around by surgeons. Some individuals are easier to work with than others but this is true in all settings and specialties.

There was a lot of looking over the curtain but it was not wistful
gazing. The gas guy/girl was checking the progress of the case to plan his/her next move.

Anesthesiologist perform many important fuctions. I have come across many injured an ill patients as a pcp. The greatest concern of patients after insurance coverage is,"what can you do for my pain. Can this be done painlessly."

All specialties have their strong and weak points. Not fixing things is not a problem in anesthesia. Anesthesia folk fix things during every case they do.

I have said this before. The surgeon is not in control the patient is. It is the duty of everyone caring for a patient to strive to do everything in the best interest of the patient. Surgeons and anesthesiologists perform different taks as they execute their duties. you have to figure out what type of tasks you are best suited to perform.

CambieMD
p.s.
Ten days and counting.

 

[Dire Straits]

i have similar concerns as the OP and i'm currently on the fence about gsurg and anesthesiology. although i do find anesthesiology interesting there's still that nagging thought in the back of my mind that if i become an anesthesiologist i won't really be the doctor taking care of the patient's problem. i'll be more like one of the "assistants" helping the main guy (surgeon) do the "real work" (operating). does anybody know if this perception fades with time or does it still linger with some anesthesiologists.