Monday, September 19, 2016

Anesthesiology and Critical Care

"Love. You can learn all the math in the 'verse, but you take a boat in the air that you don't love, she'll shake you off just as sure as the turning of the worlds. Love keeps her in the air when she oughta fall down, tells you she's hurtin' 'fore she keels. Makes her a home." - Serenity (2005).

This will be my last post about medicine. I might have some lingering thoughts about other facets of this strange life we live, but for now, I think I have accomplished what I wanted to with this blog, and it's time to step back. I started writing here on September 1, 2006, when I knew nothing of this ship I was boarding. It was the day before orientation for medical school. Ten years later, I have written over twenty two hundred posts, most of which are essays on becoming a physician, musings on the inner workings of medicine, reflections on the emotional and subjective experience of medicine, and stories of my life during medical school, residency, fellowship, and (hopefully) the beginning of a career. There is no way to summarize this, and while I want to make grand sweeping statements on what this means with flowery and literary-device-laden language, it's really not necessary. Someday, I might highlight those blogs that I am most proud of, but for now, I let this website speak for itself.

This is the path I chose, from the many I could traverse. It has been harrowing, lonely, exhausting, dangerous, frightful, upsetting, and profoundly sad. But it has also been enlightening, inspiring, heartening, beautiful, transformative, and dare I say it, fun. As a career, I am so happy to be an anesthesiologist and intensivist. My day-to-day and week-to-week work life is filled with moments of sheer wonder, great pride, meaningful connection, poignancy, and growth. I can think of no other vocation I would instead choose.

I thank all of you who have read this blog, and I apologize that it is coming to an end. I hope I have shared some glimmer of the magical and miraculous world I see every day. I hope to continue writing in the future and contributing to the literature of medicine in different forums and settings. Like every other incredibly difficult decision in my life, I have very mixed feelings about this, as evidenced by my lollygagging in saying good night. But here it is: please contact me (you can always post a comment) if you'd like to continue the conversation on medicine. I greatly appreciate your patronage, and I hope you have enjoyed reading. I have loved every facet of this. Good night.

In ancient Greece, the Asclepion was a healing temple dedicated to Asclepius, the God of Medicine. Asclepius learned the art of surgery from the centaur Chiron and had the ability to raise the dead. The rod of Asclepius is a roughhewn branch entwined with a single serpent.

With respect, love, and passion,


Patrick said...

Thanks so much, Dr. Chen! Although I'm sad to see you go, because I've long read your weblog, I hope you the best!

Anonymous said...

You say it is your last post about medicine...will you continue blogging on a differnet topic, here or elsewhere?

Craig Chen said...

Thanks for the comments! There have been a lot of changes in my personal and professional life that necessitates this. I'm starting many different projects which will take up an unpredictable amount of time. I might linger on this blog for a bit writing about other subjects in my life, but probably not for more than a few weeks. I don't plan on starting a new blog, but if I do, I'll make a post on this one. I'm sorry to lose my readers, but with time comes change.

kim said...

I'm so sad you are leaving--had just recently come across your writing and so much resonated with me. Good luck with your future endeavors.

Anonymous said...

I've been following your posts since 2009 when I was a medical student a couple of days after the world of Anaesthesia had just piqued my interest. Your posts just fed the passion and provided words for what I went through on a daily basis. I am now in my final year of Anaesthesia residency in Australia. Your posts have been something I've looked forward to on a weekly basis. I will definitely miss them, and almost as instinct I'm sure I'll still venture onto your bookmarked page and reconnect with your previous posts. Good luck in your future endeavours!

Ricky said...

Really appreciated your blog. Will be starting anesthesia residency at Stanford in July. Looking forward to treading where you've tread, but also to new adventures of my own. Thanks, and hope you continue to write!

Craig Chen said...

Thank you all for your heartfelt notes - I am always so moved to hear that people are going into medicine, anesthesia, and/or critical care around the world and at places dear to my heart. Good luck in all your endeavors!

Anonymous said...

Thank you Dr. Chen for your weblog! I'm sorry I'm coming to you late, but I hope you're still able to respond. I'm a med student very much interested in anesthesiology and critical care. But my fear is I'm an introvert, though I generally get along with most people and don't appear socially awkward at all (though inside I'm a bit reserved or maybe shy). Do you think introverted personalities can function well in anesthesiology? Thank you!

Craig Chen said...

Thanks for your comment! That's a really great insight, and personality is certainly one of the factors that should go into deciding on a specialty. As you rotate through the various medical specialties, you'll get a sense of the "culture" of each field and how it resonates with you. I think that kind of gut feeling is really important in choosing a specialty. If I were to generalize, I'd say that anesthesiology has a pretty diverse range of personalities, and most of us (including me) happen to be introverts. I don't think it's a problem at all.

Anesthesiology (and critical care) does require several things including the ability to make a connection and build trust with a patient who has never met you (including children). That can be challenging, but it's not really something that requires extroversion. You have to maintain professional relationships with surgeons and nurses, but that's easy. One challenge is being able to speak up when it's important for patient care. This can be really difficult as an introverted medical student or resident but I've found that when you've become an attending, it's really easy. There's mutual respect between surgeon and anesthesiologist and if you decide to cancel a case, take extra time to place a central line, tell a surgeon you need to transfuse etc., it's not an issue.

That being said, there is a business side of anesthesiology which I don't know well. Especially in private practice, surgeons bring the business, so in some settings you have to build amiable and trusting relationships with them. In the same way, groups have to develop strong relationships with hospital leadership to enhance care, provide value, etc in order to keep renewing contracts.

Hope that helps!