why i chose Neurosurgery.

Whenever someone asks me why I chose Neurosurgery I often joke that it’s so I can wear scrubs for the rest of my life.

Wearing pajamas to work….where a machine magically spits out a freshly cleaned pair in case I spill coffee on myself (which is often)….not to mention the non-form-fitting nature of most scrubs is very effective at hiding last night’s chili cheese fries (and this morning’s donut)….scrubs are nothing short of divine.

Overall, they’re just comfortable and familiar and universally accepted.

Why would anyone not want to rock them day in and day out?

scrubs. so good.

And about 100% of the time I get a chuckle when giving this answer, I breathe a sigh of relief that I don’t have to justify my masochistic/lifestyle-damning choice any further, and the friendly banter continues until it fizzles out in a socially-acceptable manner. Although I always use this trick to misdirect away from my life and to coax a smile out of others there’s definitely a granule of truth within, because I’ve never really felt comfortable in suits.

barney_suit_upI’m definitely not a Stinson.

I often think about what make’s us, humans, uncomfortable — mostly because I’m a big proponent of stepping out of one’s comfort zone. I believe that’s how anyone grows. Mingle with a different crowd. Move out of your hometown. Stop getting that latte and try an iced tea. Even though this sounds nice and all (and disgustingly high and mighty somewhat), I can’t deny that I really like my routines and my usuals (just gimme the yoosh). I don’t want to rock the boat all the time….because being perpetually uncomfortable and off balance is not a good feeling either. Doing what is comfortable and familiar and universally accepted is usually easier.

Beliefs and ideals are fairly similar. Like believing in the easter bunny or santa claus it feels nice to hold onto thoughts that carry personal or sentimental clout….regardless of empirical evidence that says otherwise (yeah iced tea is probably healthier for me but I’m still getting that whole milk latte….and it’s going in my face no matter what you say). Routines are nice on the inside and the out.

These sentiments really came to the forefront for me this past week with one of my patients. It was a gentleman complaining of ear pain….and when I took a look it was apparent that his ear drums were irritated, which was concerning for an ear infection. The issue was that this patient had been on broad spectrum antibiotics for the past 5 days for a pneumonia — it should have been overkill for any run-of-the-mill ear infection. His developing a new ear infection on top of the pneumonia would be akin to something like starting a fire underwater or of me passing up free food….which is to say nearly impossible. Perplexed we called in the specialized ear, nose, and throat (ENT) doctors and to our relief there was no infection, he had just developed an effusion (fluid) behind his ear drum and the built up pressure was causing pain (a less pressing problem than a full blown infection). The world made sense again.

It was around this time that the lab was able to single out the bug that infected his lungs and we made plans to narrow down our antibiotics. I put in the order for the new antibiotic and went to check on him. As soon as I walked in he was smiling and thanking me profusely….that “new medicine” we had given him had completely taken away the ear pain!

Now I have to explain how this is entirely preposterous.
(and before your jerk-alarms go off let me explain)

Antibiotics are not like analgesics or anesthetics — they don’t treat pain….at least not directly. Even if he actually had an ear infection the nurse had just given him the antibiotic minutes prior and there’s no way it would have knocked out any bacteria that fast. At this point, I must admit, I was tired and hungry and honestly in some type of a robotic mood — I was extremely close to correcting him and explaining the (boring/heartless) pathophysiology of bacterial infections.

But I stopped myself. And am so glad I did.

Instead, I mentally spear-tackled myself and (also internally) gave myself a backhand to the face. Did I really need to shatter this man’s thoughts and hopes and newfound solace? No way. What was I thinking??

c45fe6c090894fc186cad46b866c35dfstap. just. stap.

I caught myself just in time and simply told him how happy I was that he felt better and that we would continue to watch and care for him. It was at that point, walking out of the room….relieved that I didn’t Godzilla-rampage through his world, that I realized how much of what we do as doctors is intangible and innocently human. And yes, the placebo effect can be substantial but I don’t even want to paint it in that light so much. If his pain was gone, that’s all that mattered in that moment. If the tooth fairy brings excitement and happiness to a child….who cares right then and there that the money actually came out of mom’s/dad’s wallet?

It’s nice to hold onto things….especially ones that help us get through a world that’s mostly unforgiving.

And it was then that I thought about my scrubs joke and how I tend to bypass the ‘Why?’ question when it comes to Neurosurgery. I’m slightly uncomfortable because I already know there are preconceived ideas even before I open my mouth. The thing is, I recognize one can’t live in a kind of childhood bliss wholly or eternally (we have to accept at some point, unfortunately, that Hogwarts is not real). And the fact is, I have a lot of serious reasons for choosing Neurosurgery….some might be surprising actually. But if it’s not going to change management (friendly banter is friendly banter….an antibiotic is an antibiotic) why choose an outcome that can potentially be uncomfortable over one where everyone is happy and lighthearted?

I will say that I didn’t choose Neurosurgery because I wanted to be busy and stressed out for the rest of my life. It’s actually for the complete opposite reasons. Ultimately, I’d be happy to go into exquisite detail….it’s just that everything has its ideal time and place.

imgresDear Neurosurgery. Sincerely Me.

By the way….Hogwarts is real….and so is Santa and the Bunny and Fairy.


wingardium leviosa!


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