If you're going through hell
Keep on moving, face that fire
Walk right through it.
You might get out
Before the devil even knows you're there.
Rodney Atkins, "If You're Going Through Hell"
Now I conclude my series on why I chose anesthesiology as a career. It took years of self immolation to wake me up to the fact that I hated the surgical lifestyle. But if not surgery, what else should I do? I knew that I still didn't want to treat chronic diseases. That eliminated Medicine and other primary care fields as my next career move. I also knew I wanted to stay in the OR. But what kind of doctor works in the operating room but is not a surgeon? There really is only one answer--anesthesiologists.
Luckily for me during the late 90's it was relatively easy to find an open position in an anesthesiology residency. It was not the highly competitive field it is today. I was afraid I would have to hang out for a year to wait for a spot in a training program. But I was able to locate an anesthesiology residency nearby that had vacancies to fill and I could start immediately.
Anesthesiology was everything I expected residency to be and everything my old surgery program was not. The work was intellectually stimulating. The attendings actually seemed to care about the well being of the residents. The idea of getting breakfast and lunch breaks was a revelation. The other residents felt more like my kindred spirits, not competition ready to pounce at the slightest stumble. And of course anesthesiology residency allowed a much saner lifestyle. While the other anesthesia residents complained about taking five calls a month, I reveled in the luxury of having three of every four weekends off. Slowly I regained the self confidence I had lost after years of humiliation and abuse. I could see that I was not a worthless piece of human excrement. Nobody is perfect and anesthesia attendings didn't make me feel like s*** if I had a difficult day. I was finally able to enjoy living in Southern California, something I didn't have a chance to do in the years holed up in the hospital before. I went to the beach without concerns about how my patients were doing in the ICU or dreading another call the next day. I lost 30 pounds by the time I finished anesthesiology training. Life was good at last.
All those years of surgical training were not in vain. I had already placed hundreds of central lines and arterial lines as a surgeon so those presented no problems for me at all in anesthesia. I once impressed an attending when I was able to use a long alyce clamp to retrieve a broken tooth during an intubation (not my intubation). The one procedure I needed the most practice on was starting an IV. Never had to start one in surgery; either the nurse did it or we put in a central line.
I found that about 70% of my experiences in surgery were applicable to anesthesiology. The main things I had to brush up on ironically were all the different chronic disease processes an anesthesiologist is likely to encounter in preop. But that's okay because we only need to take care of these maladies for the duration of the case. Anesthesiologists don't have to follow the course of the illness for the patient's entire life, or even the duration of the hospital stay. Once the patient makes it safely out of the PACU the problems were no longer mine to deal with.
This is of course the main attraction of anesthesiology. At the end of the day, when the patients are safely out of surgery, I can turn off my pager and go home to enjoy time with my family. There is no need to worry about how my fifteen patients are doing in the hospital. I don't get awakened at 3:00 AM because somebody on the floor needs a sleeping pill, or my patient in the ICU is suddenly desaturating. I am not tethered to the hospital or the answering service. I can enjoy life without fear of getting called back to the hospital for an emergency. Freedom of mind far exceeds the so called prestige of being a surgeon.
So that is my story of why I chose anesthesiology as a career. I entered a dark tunnel in search of surgical glory and emerged into the light as an anesthesiology professional. Yes surgery was fun, but there is more to life than the hospital. I give kudos to doctors who can tolerate such a work environment but I belatedly realized that was not for me. I have now been in practice for nearly a decade and love my job more than ever. I make a decent salary and have a devoted family I can go home to every night. Hopefully the medical career you choose will be more straightforward than my circuitous path but ultimately you have to be satisfied both professionally and personally with your choice. It's alright to start over if you decide you went down the wrong road; there is no shame in realizing you made the wrong career decision. In the end it doesn't matter if you trained at a "prestigious" training program or authored fifty papers or make half a million dollars a year. If you can find job satisfaction, that is all that matters.