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Why Trauma Surgery?

Trying to figure out what kind of doctor you should become? Wondering what specialty you should choose? Then SheMD's Why Specialty Series is perfect for you! We're bringing you female physicians sharing WHY they chose their specialty. Today's post is on why Dr. Culp chose the field of Trauma Surgery and why she believes that Trauma Surgery is a great field for women.

I was just 8 years old when I decided that someday I would become a doctor. I wavered only twice—once because I thought I might want to be an attorney and another time because maybe I wanted to be a veterinarian. My dad was a veterinarian, and I had grown up watching him become the best he could possible be for himself and for his clients and patients.

My third year of medical school, surgery was my LAST rotation. Yet my first week I fell in love. I loved losing all track of time in the operating room. I loved making people better—immediately better (most of the time). I loved being there when people needed to trust physicians the most—when giving up all control to another human being.

At some point in medical school, you will probably hear someone joke that “you’re either a cutter or you’re not”. They are not referring to suicidal thoughts, they are referring to enjoying time in the OR and seeing body parts on display in unnatural ways. And it is largely TRUE.

Around my third year of residency, I really started to enjoy the amount of trauma I was exposed to as a resident. I enjoyed the complexity of their arrival, their operations, their ICU care, all of it. However, I had no intention of extending my training. At the time.

After a year of bread and butter general surgery and then a year of working the equivalent of ten 24-hour shifts a month, I stepped back to do my surgical critical care fellowship and left my husband behind to cover his and MY shifts. Whoa. (Well, he returned the favor a year later.)

After fellowship, while covering those extra shifts, I went through some intense burnout, but I’ve really come to enjoy my job again. Don’t let the burnout thing scare you, we are likely all going to go through it at some point. And if you try to do EVERYTHING and be EVERYONE, you’ll set yourself up for it. Once you start outsourcing, life gets better. At the point, you can be the best version of yourself at the best times.

I now cover 7-10 24-hour shifts a month for two trauma centers. I am serving as the Interim Vice Chair of Surgery at my main hospital, and I’m still a mom, and a wife. Going back to medical school, I remember my mom thinking I was crazy for giving up the dream of a 9 to 5 job in dermatology for the craziness of a life in surgery. However, I think women are doing a fantastic job of changing the field of surgery to better fit the lifestyle of our patients and ourselves. Similar to emergency medicine, trauma/acute care surgeons are often scheduled for “shift work”. The nice part about that is that when your shift is over, you don’t really have to take work home with you—other than the repercussions on your emotions. You’re not likely to even get paged—because your partner is there and readily available. In fact, our group doesn’t even have an answering service. So when you get home, you download your day to someone that’s willing to listen, and then you can be a mom, you can be a sister, you can be a friend. You can let it all go.

The other beautiful thing about trauma/acute care surgery that I truly enjoy is that you really can make someone feel better. Whether it's a shattered spleen, busted ribs, or appendicitis, you have the skills to manage their pain, control their bleeding, and rid them of their infection within minutes to days. It’s not weeks to months that you’re waiting for results or to follow up to ensure your patient is better with their latest medication or intervention. It’s pretty much immediate, and I am not the best example of patience.

Also, if you’re a cutter then you really do love time in the operating room. I love that I can leave my whole world at the door of the OR and lose all track of time. I love the camaraderie with anesthesiologists and CRNAS and surgical techs and nurses. I love the actual technical skill that comes with being a surgeon. I love the difference in everyone’s anatomy. I love that surgery is constantly bettering itself with new techniques and tools while also finding ways to manage patients less invasively. This is especially true for trauma where interventional radiology plays a large part in saving people’s lives.

Most trauma surgeons are natural leaders in one way or another. Whether it's leading with calm fortitude or being assertive and forthright, trauma surgeons are the quarterback of the team that it requires to get these people home. Yes, orthopedic surgeons fix the broken spines, arms and legs, and cardiothoracic surgeons, and neurosurgeons, and interventional radiologists are all intimately involved. BUT, at the end of the day, its the trauma surgeon that places a life-saving chest tube, performs an emergent airway, tells IR to embolize the spleen, and then manages the patient’s resuscitation from the moment they hit the door until discharge. We are the ones that get paged at night when a patient has a downturn—not the consultants. And if a consultant does get a call, it's usually from the trauma surgeon. The plays don’t happen without us.

As a trauma surgeon you complete at least one year of surgical critical care fellowship, and sometimes a second year of training more directly in trauma/acute care surgery. That means that after training, you are a critical care physician AND a surgeon. You end up with many skills that many general surgeons are uncomfortable with and the ability to manage the sickest of the sick. We are often the Hail Mary pass, and that is a pretty exciting responsibility.

I should have known with how much I loved what my dad did in the operating room on dogs (helping resuscitate puppies after c-sections and watching as he saved dogs that had been injured). I also loved how he cared for the entire animal, all the time. He might consult others, but the ball stopped with him, and that’s what I truly enjoy about trauma/acute care surgery. It’s an enormous responsibility, but it's also an honor to try to make the worst days in some people’s lives just a little bit better.

My advice is to try to gain exposure to as many fields as possible before choosing a specialty. I wish I had known more about emergency medicine, orthopedics, and even ENT before I chose. Also, if you don’t love the OR, get through your surgery rotation and then don’t go back. Don’t be miserable there. It’s a hard room to escape from when things go poorly, but a great place to escape to if you love it. Lastly, don’t let someone else’s opinion of what you might do in the future change your own heart.

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