Becoming a surgeon

I used to hate surgery. Like, really hate it. Like – on my surgery day I would wake up filled with anxiety and stress, and would spend the whole day being nervous and anxious and feeling like I was about to make a fatal error. It’s understandable really, and super common in young veterinarians and human surgeons I’m sure too. You do, literally, have your patient’s life in your hands. That’s a big deal, and is not something that should be taken lightly. But….I also think it’s probably not real healthy to feel the way I felt about surgeries, and I certainly didn’t enjoy it.

In the past few months we have had 2 really amazing 4th year vet students shadowing with us, and both of these amazing, smart, and capable ladies have talked with me about their anxiety and stress about surgery. It is actually really laughable the amount of surgical experience we officially receive in vet school. We typically do just 2-3 procedures, or half of a procedure. Many students gain extra experience by taking a shelter rotation where they can shadow with the veterinarians there, or by doing externships at practices (like ours), where they might get to scrub in on a surgery or assist with a few there too. NO WONDER we are all graduating with a VMD (or DVM) after our name, but are riddled with insecurity!

You know how you get confident doing something? You know…we all know…repetition. Yet – here we are, graduating as doctors, with less than 1 official spay surgery under our belt being expected to jump right into surgeries in private practice. We spend hours and hours learning all of the ridiculous parts of the Kreb’s cycle and other very detailed parts of how the body work or how every drug under the sun works….but we get just 2-3 days with practical, hands on experience doing surgery. Oi. I think there’s something that could be done there, lol…but I digress…. The point of this blog is not to rattle on about how I think our education system needs to change – more it’s I want to tell the story of how I became confident in surgery.

I was forced into becoming a surgeon out of desperation. When Jen and I were starting up PRAH, one of the jobs I was able to find that was part-time and flexible was a ‘surgeon’ job down at the SPCA in the city. And yes, I’m putting ‘surgeon’ in quotes because – no, I was not a surgeon. But I guess that depends upon your definition of surgeon….if you define it as someone who knows HOW to do most routine surgeries, then sure, I was a surgeon. If you define it as someone who has extra training in surgery or enjoys the challenge of surgery, then no, I was definitely NOT a surgeon. But nevertheless, there I was being hired as a surgeon. I had received some good initial training at my first job out of school, so I had a good grasp on the general routine surgeries, but will still far from confident or happy in a difficult surgery. I will always remember that interview – where the head of surgery had me perform a cat spay while he watched me and timed how long it took me with his stop watch. It took me about 20 minutes, and he heavy sighed and said, ‘I guess that is good enough.’ And I was hired. Awesome.

The major thing I learned on that job was the reinforcement that even if you aren’t good at something, if you practice it long enough, you will get good at it, and your confidence will go up. I would routinely come into a packed schedule of 40-50 animals that needed to be altered in one day. Mostly spays and neuters, the occasional other surgery like an imbedded collar or laceration repair, and a few leg amputations here and there. In this time period, I then also was hired by a local high volume spay/neuter facility, and would alternate my days between driving to the SPCA in the city and either to Allentown or out towards Reading to do around 50 surgeries, and then in between these days I would spend my time seeing patients for PRAH or working on our business plan, or whatever other projects needed to be done as part of getting our business going. It was a wild time, lol.

I don’t necessarily recommend this style of forced, immersion training, to get more confident in something you hate. But damn, does it work. I dealt with every imaginable complication – post-op bleeding where I had to go back in, animals in heat, pregnant animals, cryptorchid males (where their testicles don’t descend and you have to go looking for them), hermaphrodites (yes, I have seen this…no, it was not fun), worms free in the abdomen (how, I have no idea), finding a foreign body during a spay that had to be removed too, dogs with bleeding disorders, the list could go on and on…..

Here's my take home point – how do I feel now? I feel confident. I have now done thousands of spays and neuters and feel good that I can deal with pretty much any complication. I am also FAST at surgery now – which is a benefit for me and for my patient – anyone will get fast doing that many surgeries! I will freely admit that I still do not LOVE surgery, but I definitely don’t hate it anymore and look forward to my surgery days. I still also get super nervous when I’m doing something I haven’t done before, or am dealing with a less common surgery, or in emergency situations. Like last week when I had to do 3 emergency surgeries in a 24 hour period – but that’s a story for another day. I think the day that you are doing something that there is another living creature relying on you, and you don’t have some level of nervousness or care, that is probably the day you should stop doing that thing. I think there’s a life lesson here – lean into the discomfort, find ways to get experience or time doing something that makes you uncomfortable, and practice, practice, practice – it’s really the only way we get better at anything! In surgery, as in all things, time and repetition, make a huge difference.