Clinical indecision

This post isn't Cambridge-related, but I figured a blog is as good of a place as any to muse about career prospects. I just finished reading When the Air Hits Your Brain by Frank Vertosick Jr., MD. It's a fantastic book, by the way, and should be mandatory reading for anyone seriously considering surgery as a profession. Oliver Sacks, it's not. But for what it lacks in obscure-medical-mystery department, it makes up in the brutally honest, sometimes self-deprecating, descriptions of day-to-day life as a neurosurgical resident.

I've been searching for a book like this one for a while. You know, to beat humility and reality back into me. For the last two years, I've been idly entertaining the idea of becoming a neurosurgeon. I love the human brain—the three-pound universe between your ears. Love it, love it, love it. What better way to pass the time than being wrist-deep inside someone's cranium and saving their life? I've shadowed my dad's neurosurgeon multiple times. Rounding up on the post-op patients, talking with patient's families during clinic hours, conducting pow-wows with other specialties to decide on a patient's fate, being hyperfocused on a surgical procedure for hours... I can really see myself doing that for a living.

I must admit, however, that self-aggrandizement also plays a role—albeit a small role—in my desire to become a neurosurgeon. Thankfully I'm not alone in this regard. The very first sentence in Frank Vertosick's book reads, "Neurosurgery is an arrogant occupation." A fellow PLME student observed that all neurosurgeons exude some degree of overinflated self-importance. As for me, I enjoy envisioning myself strutting down hospital corridors with a slew of residents and interns in tow, kind of like that one scene in Kill Bill where Lucy Liu leads a pack of yakuza gangsters in style.

But alas, these are the siren calls of a profession guaranteed to exact a toll on nearly every other aspect of my life.

For one thing, I want a family. It appears that surgical residency, especially for neurosurgery, tends to preclude a happy domestic life for women (and for men, to a lesser extent). If you're spending 18 hours a day at the hospital, that leaves you 6 hours for sanity-saving sleep and not much else. Try carrying a baby to term on top of all that. I've heard that some female neurosurgeons plan a single pregnancy during the "research year" of their residency program, and then pass the baby off to a full-time babysitter. It's the only feasible option, besides paying exorbitant sums to hire a surrogate mother.

I'm also not sure if I would be resilient enough to handle 6-7 years of grueling residency. How do I know if I can handle the pressure of making life-versus-death decisions on the spot? How emotionally devastated would I be after making a stupid mistake that cost a patient's life? Would I eventually burn out and become an unfeeling surgical psychopath? What if I don't have what it takes to be a neurosurgeon?

Maybe I don't have what it takes to be a neurosurgeon. And I would be okay with that. Perhaps I would be better off as a war strategist and message decoder instead of risking my limbs on the battlefield. To appease my intellectual hunger for studying the human brain, I can still decide among plenty of medical specialties and sub-specialties that have "neuro" in their names. Neurology, behavioral neurology, neuroradiology, interventional neuroradiology, neuro-ophthalmology, neuro-oncology, and neuropsychiatry are all careers for which I would be more than happy to bear the name on my white coat.

BUT GAH, THE INDECISION.