A Blog About An Asian Medical Student. Yes that's redundant.

Friday, November 2, 2012

David Poon and the Road to Medical School: Driven

David Poon and the Road to Medical School: Driven

aka: How I Learned to Stop Worrying and Love the OR

aka: All Cars Should Be Bumper Cars

I cannot stand early mornings.

I think it evokes painful memories of me being 17, getting up at "it's still dark" hours to get to high school two hours before everyone else for an extra credit class called TOK, or Theory of Knowledge - a class where I've driven an icy, barren, labryinth of destitute Regina Saskatchewan streets to make it to a class where we discuss "what is thinking" to an extent that would make a PhD in Philosophy candidate groan from the self important curriculum aggrandizing.


Or maybe I'm just lazy.


The point is, early mornings are terrible.

In medical school, we are sent on a series of rotations. These are essentially a number of 6 week internships to expose us to a variety of specialties, to help us decide what type of doctor we want to be when we (if we?) graduate. It's quite an effective system, with just the right amount of length to inspire us if we're interested, and not long enough to torture us if we aren't.

Well, depending on how much we hate mornings.

The past six weeks I have been on my Subspecialty Surgery Rotation - this is when we learn about cardiac surgery (heart), otolaryngology (ear, nose and throat), neurosurgery (brain). The wondrous thing we really learn about surgeons?

Working an 11 hour day is actually considered light work.

A 6am to 5pm shift is when we are lucky.

And a 6am morning means AT LEAST a 5:15am alarm - which, given my well worn strategy of hitting snooze at least 4 times, leaves me about 15 minutes to rush to the hospital without forgetting my pants.


The orthopods, the bone doctors? They work the hardest. And I don't mean anecdotally, I mean given even the possibility of an alternate funding plan (AFP) where doctors usually work less for the same amount of money, orthopaedic surgeons actually work LONGER hours.

Which means earlier mornings.


The force that pushes the orthopods is incredible - the hours needed to see all their patients, the physical strength to pull a man's spine back together, and a special sort of determination that pushes them forward, that I could have never predicted.

In the short two weeks I spent in orthopaedics, I was ashamed at the frustrations I started to develop. Almost angry, as I, perhaps for the first time, felt patient's damned themselves to their own fates.

At about 11 AM, word came in of a severe MVC (motor vehicle collision) that involved three people. Alcohol was heavily involved, no seatbelts were worn, and all three people were thrown out of the car.

Only one survived to the operating room.

Spinal fracture, brain damage.

I had seen workplace accidents, falls from trees, bad turn signalling, and explosions and oil factories - but I had never seen such raw, self destruction. The complete devastation of life over a bottle, a key, and a bad decision.

I reflected on this as I watched my preceptor and chief resident - they remarked how sad it is, perhaps even had a moment of empathy before getting to the work. In the hopes of ensuring the patient would be able to walk again, they had to effectively, carefully, piece together a broken spine. During a a scraping of her spinal cord that had to be completed, her blood sprayed towards my face in what was clearly a great way to elevate my spirits.

I asked to walk away to wash up and cross my fingers that I didn't contract HIV or something.

Later that day, a many in my preceptor's hometown drives into a middle school. Three young students are pinned under his car. One girl, the most hurt, is sent the our hospital to the pediatric orthopaedic surgeon. Her broken body I can only imagine fought with every pulse to survive another moment.

She didn't.

I can't stand mornings. I can't stand the self destruction. I cannot face another alarm where its only beckon is the prospect of another day of misery.

And the surgeons press on. Persevere. To the next case. Another few hours. Answer the pager, help the next patient.

As people drive themselves into broken fates, the surgeon is driven to rebuild a delicate, fragile future.

And perhaps that is enough reason to get up in the morning.


My sister called me today. She was driving on the highway, spun out of control. As she describes it, she turned 180 degrees, facing down a semi truck.

Which stopped before it hit her.



I saw a patient last week. A 17 year old kid.

Getting up at the "its still dark hours" to drive an icy, barren, labyrinth of destitute Edmonton Alberta streets.

He slides on a patch of black ice.

His truck flips. 

In the OR, I see his spine. Fragile.


In assessing him post operatively, I find out he has lost all sensation in his lower limbs. He is paraplegic.

His 18th birthday is the next day.

He smiles at me.

He presses on.

We talk about video games. Netflix.

We talk about his birthday.

Driven towards a bright, new, morning.

- David

This was written as a Reflective Narrative Assignment for my Subspeciality Surgery rotation. For my reflective surgery assignment, I decided to create an Orthopedics related post for my blog. The topics on my website are based on my thoughts and reflections as a student of medicine, in a series I call “David Poon and the Road to Medical School.” They are all inspired by specific instances and observations during daily ward life. No confidential or identifying information is ever presented. The concept is similar to Parallel Charting, though in my case is as much an introspective on public perceptions of medicine than the medicine itself.