I always think to this lovely comic by Michelle Au when I think about specialties. I wish she’d make a panel for ENT but I’m not sure what it would say…Probably something about ear wax and boogers.
Close to the end of Third Year, and closing in on the time when I will need to choose a specialty, I realize that I’ve come to judge each specialty based on what seems to bring people job satisfaction. It is unfair to talk about all the physicians of a given specialty in broad strokes but I cannot help but come to some prejudices.
For example, this past month I was on neurology – a subject that I have never been particularly interested in from a basic science standpoint. So many people are “fascinated by the brain” but for some inexplicable reason, I am not one of them. My disinterest was further elucidated this past month, when, for the nth time, I sat around a round table, debating again the localization of the stroke based on the exam before and after viewing an MRI that stood in defiance of all the tricks of the physical exam. Following this was another hour long conversation about whether to use aspirin or Plavix or both, even though our poor patient was not represented by the inclusion criteria of any of the 3-10 major trials in the past decade, each of which shows that the risk of stroke was decreased by mere percentage points. We know too little about the human brain and while some people find this fascinating, I find it a huge obstacle in the way of patient care.
It wasn’t that I couldn’t appreciate the need to prevent strokes, or that I could not identify with the physicians I worked with – on the contrary, I found the residents and attendings charming, thoughtful, as well as extremely thorough in their work. It’s just that I didn’t get the same “job satisfaction” from their daily tasks.