Medicine is amazing

Today was my last day of ENT. We performed a laryngectomy on a guy with recurrent laryngeal cancer. He had previously been radiated. This time around there was apparently some mets to his tonsil and lymph nodes. Not a good situation. We had to take out his larynx which includes his voice box and part of his trachea. The result is a permanent tracheotomy with an inability to speak for a time. We placed a tube that will allow air into his esophagus which with some training will allow him to speak. In the middle of this surgery I took a step back from the table to look at the guy in profile. It looked like we had almost decapitated the poor guy! We had him cut open from ear to ear with the incision dipping almost to his chest. The skin was dissected off from there up to his chin and then down to below the trachea. It's amazing how horrible something can look en route to the end result that everyone sees. A simple scar. I've never done a neck surgery before and let me tell you, it's pretty amazing. There are so many things that need to be taken into consideration while in the neck. There are arteries and veins going everywhere, not to mention nerves that control so many things. This was one of the most indepth surgeries I have been a part of to date. We started in the OR at 7:30 am and finally finished at 2:00 pm. All of this was accomplished without breaks. The only other surgery that came this close was a heart bypass I saw a few months back.

I've found another potential specialty to consider. Radiation Oncology. I spent a day doing that yesterday. We get little to no exposure to Radiation Oncology in either medical school or rotations, so I feel fortunate to have this one day. It's an amazing specialty. It's basically the ultimate combination of medicine and technology. They physics involved is even cool. That's saying a lot for me since my 2 semesters of general physics in undergrad was a somewhat painful experience.

You almost can't believe what they can do these days if you don't see it for yourself. The new machines can give radiation to tissues at incredibly precise levels. There is an incredible amount of time that goes into planning these treatments. You have to plot which structures you want to treat and which ones you want to avoid. You can actually treat one area and avoid giving any substantial radiation to an organ or tissue that is only a centimeter away. I love the combination of medicine and technology. I'm not sure I'm ready to jump into a specialty after one day in the field though. I am planning on doing a month in medical oncology. Hopefully I'll be able to spend a few of those days with the radiation oncologists to get a better feel for what they do. The good news is that if I decide to pursue it I am headed in the right direction. Internal medicine is one way to get into the program.

There are so many things out there that I could see myself doing. I have no idea how I am going to choose the one that is right for me.