Questions for a Trauma Surgeon. #402

that stuff is secondary to being a surgeon . Really , that's kinda how I thought oh , I dodged a bullet there . I just say 10 years later I had to revise that , but very quickly , you just learned that , hey , in order to have a really good life at home , that's a bad way to look at life . I think you end up being lonely at the end and I changed .

Because my brother don't like to do laundry , you put your stuff in the machine at the hotel . You got the drawers , you put your stuff in the machine over there , and you never know if someone's gonna remove your stuff out of the washing machine . So I just pack up enough laundry . Here you go . Got about eight days of boxers and drawers Ready to go .

So I'm packing up right now , getting ready to leave . So in about an hour I'm about to be out of here .

Is it appendices or appendixes ? Ooh , that's a good question . I don't know Someone put that in the show notes or not . In the show notes , someone put that in the comments below . I don't know . I don't know any about that plural stuff with Xs and stuff , but I'm gonna say appendices , okay .

But I did all of that and I decided that I wanted to do trauma surgery and I decided to . Well , I matched at the University of Miami , which basically is the Grady of Florida or Miami , and I did a one year fellowship of trauma surgery and surgical critical care .

General surgery you know how to handle a whole bunch of different issues in the body right , like draining pus and opening up someone's abdomen , and doing things is a lot different than trying to get a bullet out of someplace or trying to sew up a heart or Do you really always have to take the bullet out ?

But no , actually , the majority of times I would say I do not take the bullet out , and it all depends on where the bullet is at Cause . If the bullet is , like freely in the abdomen , yeah , if you're going in and you're fixing things and removing some things , you might see the bullet and it might be time to take the bullet out .

But there are times where the bullet is in a place that if you go digging for it , it's gonna cause more damage , right ? So we have like some general rules that we follow .

Like , if the bullet goes through a piece of bowel , we try to get it , because it took , you know , bowel with it and some it's just really contaminated and it can cause a bad infection . So then we try to go after that . You know , obviously , if it's in the spine , then we try to get it out . That's one that we try to do .

If it's in joints , we try to get it out , but most other places , if it's gonna cause more damage to try to get it out , we just leave it alone . Well , okay .

They'll tell us the age , they'll tell us if it's a man or a woman , and then sometimes they may be able to let us know , like , what the mechanism is Like . Did they fall down steps ? Did they get hit by a car ? Did they get shot in the chest ?

And then we have , you know , time to either set up or we don't have time to set up , but either way it's really exciting because you don't know exactly what you're gonna get . Our fall down steps can injure so many different things and so many different people , right . Like somebody who's really old may just injure their head .

Somebody really young may injure their head and break their ribs , whereas another old person may just break their hip . You just never know . And that's the part to me that's really exciting about trauma surgery .

And then you throw on top of that I still do general surgery , right , so I do the stuff that you would normally think of a general surgeon doing , you know , and that part is really exciting the appendices , the appendices , the gobladels , the breast abscess , you know All of that stuff . That's the thing about trauma surgery that really I love .

It gives me so many different options and then I can do critical care . I can take care of people in the ICU also .

Do you ever take that stuff home with you ? Is it easy to just leave it at the hospital ?

And I think that like this is not like a regular job , right , where , like you're working at a store or you're working in an office and then when you're done , the work just stays there . I think that there's always got to be that time of Did I do the right thing for the patient ? Could I've gone faster ? Could I've ordered a CT scan quicker ?

Did the patient need a CT scan ? Do I need labs ? Do I should I've consulted someone ? Should I've gone to the operating room fast or did I go too slow ? I think while you're in the moment , that opportunity to reflect doesn't occur at that time , but I think when you walk away , you have no choice but to do it .

When you're in your car , when you're driving home , right before you know I open a door and and , and you guys are there or if I go to my hotel room , that opportunity reflect . That's always going on , mm-hmm . Now I do think like there are times where it may go too far where some people just don't know when to turn it off , like they can't sleep .

You know it's interrupting their family life and Some people can develop like an obsession about that . I don't have that issue , at least do I .

for the course . I think , for any Specialty , obviously yours is more traumatic . I think then most specialties , because you know yours is literally life and death , which you probably see more than Most specialties .

Some people may think that's an exaggeration , but I do think the majority of our patients who come in like that , if you don't make a decision is a possibility that they could die and . But I think that makes it easy , right , because it's like if you act then they will live , if you don't act then there's gonna be a problem .

So I think , in terms of himming and hawing , you know , being on the fence and deciding , ah , should I do something ? I should I not ? Like trauma is very algorithm based . If you see a , you do be . If you see be , then you do D or C or D , whatever it may be . That's what I like about it . And some people may say well , it takes out like the .

It takes out the ability for you to kind of think and and have your own judgment , and that's not true . There's a lot of surgeon judgment , there's a lot of decisions that we make that fall a little bit outside of the algorithm .

There's Denzel Washington , this ER , there's the Cosby show , this doogie howzer , this trapper John . Y'all know like to doctor shows were like it . It was big and I was watching those shows a lot and I said , okay , like this is what I want to do , but I had no clue how I was gonna get into it .

So by the time I'm like 15 , 16 , I'm like , yeah , I want to be a doctor , because that was the cool thing to say . But my , my . So when I was 17 , right before I went into college , my College , lehigh University , had this summer program for students who wanted to get acclimated to the university Earlier than when everybody else would start right .

So before my freshman year they had a summer program that you would go to . At the end of the summer program you got a chance to meet some you know , distinguished alumni . One of the alumni that I met , dr Jordan Garrison . Shout out to him if he's watching this . He's a trauma surgeon at University Hospital in Newark , new Jersey .

That was only like 15 minute bus ride from me . So when I met him I was like I ran up to my wife like yo , dr Garrison . Now , I didn't say yo , but I was like dr Garrison . You know , my name is knee dark . Oh , I want to be a surgeon , just like you , I want to be a trauma surgeon . Is there any way I can just kind of follow you around ?

And he's like , yeah , and he gave me the date and a time and just so you know , like this is in between , when I became a freshman at school , and , yeah , we said we agreed on the time and then my parents dropped me off that night .

They talked to dr Garrison real quick and the goal was just to stay there from like Maybe eight o'clock in the evening until midnight and I didn't know like I didn't know like the whole thing about Trauma surgery and how busy it was . I just knew that it was something really exciting . You go to the operating room a lot . Sometimes people get shot .

That's all I knew . So they dropped me off , they were gonna pick me up at midnight and then me and dr Garrison are like we're all in front of them , like where the ambulance drops people off . And I remember he said , look , man , just follow along . This is gonna be a really good experience and just let me know If you got any questions .

And as soon as he said that , I swear to God , where to God , I swear to God ? His pager goes off . He looks at his pager and I'm like , oh , he's like , yes , somebody is coming in , they're gonna need our help . Listen , I'm gonna put a yellow gown on you .

I want you to stand like right in this corner , right here , right in this corner , right here , and we're gonna be over there , everybody's gonna be there . You just stand in the corner , don't do nothing . So it's a guy , whatever . So I stand in a corner and I'm just watching and I see the am the EMTs .

They bring this guy in , who could have been maybe Three or four years older than me and he's just grown in and All of a sudden , like I remember them transferring him on to the onto the bed and they're examining him .

All of these people all in yellow gowns , nurses , and I didn't know who was a doctor , who was what everybody's like , at least like 10 people around this guy and Dr Garrison's at the foot of the bed and he's like telling people do this , do that , do this , do that . I know what none of that stuff meant . All I knew I was like don't move .

And at that point I'm assuming take him upstairs means go to the operating room . I couldn't go because I didn't even sign up to be a volunteer . I'm just literally just there . He's just hanging out , homie hanging out , even less than that .

So he takes him up there and he tells like the I guess the med students or the residents like just watched his little kid for a second . So I'm talking to these residents and like an hour goes by , two hours goes by , and they're like yeah , I think Dr Garrison should be out , I think he's out , let's go find him . And I'm like all right .

So we go and we find him . He's out of the operating room and he's hugging , I think , the mom and like he's letting her know that he's going to be all right . Patient's going to be all right . We had to do this , that , but he's going to be just fine . And the minute I saw that I was like that's it , I want to be a trauma surgeon .

I knew at that one moment , like this is what I wanted to be . But I'll be honest , I didn't know the specifics , but I knew that's what I wanted to be . I'm going to call a cap on you .

Yeah , I was the first year OB rep for the OB specialty , so you're just going to mess up Club at school . Yeah , I'm calling cap on you . That was me . That was you . Yeah , you were the what .

So once I got into medical school and , by the way , I applied twice Once I got into medical school I made a plan and I made a pact with myself that I didn't want to be like one of those gunners you know how they always talk about those gunners Gunners you just want to go into like orthopedic surgery or like derm or plastics or what have you .

I didn't want to be one of those people . So I told myself Ne , you got to give yourself an opportunity to enjoy other things . So , like me , saying I wanted to do OB was kind of dreams of wanting to be like Dr Huckstable . So I said , well , I'm kind of interested in OB . Maybe I'll go ahead and just tell people I want to go into OB .

But I made a pact with myself that I was going to give each specialty a chance before I chose surgery . And that's exactly what happened . So , yes , I was OB , I was the OB . What do you call it ? The OB first year breakfast . OB Ryan go to none of the meetings .

Even without travel . Right , it's a very busy lifestyle . You always hear about surgeons kind of just either in the office or in the operating room , whatever , but you're traveling . So how do you find time to spend with your family if you're always traveling ? I mean , how long are you going to wait for ?

. What you do is you spend as much time giving things that you prioritize or things that are important to you . You give them enough time that you try to give . So I try to spend as much time with my family . I learned some lessons really early on when I finished fellowship and started working at my first job .

Like two of the surgeons , two of my partners who I was working with were going through divorces and , yeah , they were in at least 20 to 25 years in deep in surgery and then all of a sudden , a divorce got sprung on them , or I don't know if it was vice versa , but they handled it well and since then I was just like man .

I really got to make sure that as a surgeon , we got a real big blind spot for divorce . I think because you spend a lot of hours in the operating room , there's a lot of things going on that wasn't yours . There really isn't a handoff to have , like if it's past your shift and you're still operating , well , guess what ?

You operate until you finish and you're also kind of handling those issues afterwards , post-operatively . Those are yours and it's hard to detach and I think , in essence , the personalities that surgery tends to let into its doors , let's just say he's not the friendliest .

My dad is from Ghana , so very typical immigrant dad-father relationship , but something that is extremely important to me and I wanted to make sure that I had the same type of relationship with my kids . Now , my dad was Is oh , my dad is .

Excuse me , shout out to my dad , hopefully he's watching this my dad is a very hard worker , worked on really large like check sorting machines right Like these big machines that back in the day when you wrote a check these machines would process the checks . He could fix all of that stuff Really really dope engineer and we had a really great relationship .

But I also remember like he would get pages in the middle of the night and have to fix these computers and these systems when they went down . But we always spent a lot of time together .

So that made me really fearful too . So I didn't want to be estranged from my kids also you think traveling helps you not be estranged from your kids .

There's no inbox . So the type of trauma surgery one of the best parts about trauma surgery is I think the majority of practices in hospitals nowadays are almost similar to ER , where you clock in and you clock out the patients that you operated on , you hand that off to somebody .

Somebody else will take care of your patients and they're going to take care of them like they did the operation .

And the same thing , like when I go and I start working tomorrow , all of the patients of the person , of the person , of the person that I'm relieving , I'm going to take care of her patient or his patients , like their mind , and that person can go and spend time with their family , go travel , go do whatever they want to do , go to a conference , take a

vacation . They can go and chill and relax for , for the next seven days . These patients are mine . I handle all the complications and I think that really leads to a much better , improved patient or sorry physician lifestyle . So that's the reason why I travel . I like that because it gives me that perspective .

So so we take this upstairs wherever you want to go .

I don't want someone , three or four days before the month comes out , telling me you're working this week instead of that week , so so . So with trauma surgery and with locums , I give them my schedule three to even six months in advance . That works for well for me and I know if I can make it .

If I can't make it , it's not somebody else , you know , making a decision for me . So that's why I like that . If I was full time , I think I'd be less in control of that , and anybody who knows me knows that I like to be in control . You're like Janice .

But you know the result is organs possibly being removed and you know significant amount of trauma and a significant amount of time in a hospital and a long time to recover .

And I think the public doesn't realize how much work not only from the physician standpoint but also from the nursing standpoint , from a physical therapy standpoint , occupational therapy , from a social work standpoint , rehab how much work it takes to get someone back to the point where they can either live at home , get back on the job , get back on to work .

That's a lot of work , it's a lot of work .

Was there a point that you thought that you would not get into medical school ?

That's when I was like oh snap , I don't know what I'm going to do because it's my senior year , I'm finishing up my senior year and I don't know what I'm going to do once I graduate . And there were times where I found a job at Sears . I was trying to get a job at Sears . I was trying to get a job at AT&T . Um yeah , I was really struggling .

So you know , you clean up your area , you make sure that the shoes and whatever you're selling is in order , but all the other times , man , I was shooting Jays , yo on the hoops , man .

And at that point I didn't even know that I should do some work afterwards to get my application better . All I was just thinking was , like maybe I need to take the MCAT again and then figure it out . But I didn't really have a plan . I didn't know where I was going to end up .

But I didn't know what I was going to do . So I ended up taking that position with the track and field cross-country team where I just would coach , I would make training plans , I would help recruit and then they would help pay for my graduate work . And I took courses like virology , I took like molecular biology , I took histology .

You don't look so enthusiastic about that , like if you master , if you graduate with a degree in biology , like if you're pre-med , they don't tell you like well , what happens if you don't get in ? What to do , right ? So I'm like , yeah , I got this degree in bio , I got to monetize it somehow . So that's what I was worried about .

I was like , how am I going to make money off of this , right ? So I was like I could be a teacher of some sort , maybe .

But what happens if you don't get into med school ? There's no branch for that , at least not built in to the system , right ? There's always this thing of okay , well , nobody really knows what to do next . There's no next best thing to do , unless you talk with somebody and then they help you .

But if you don't have a mentor or an advisor , then you're kind of screwed .

I think the one thing that I didn't expect and I always talk about this is I didn't like raising kids , making a relationship work what's it going to look like ? Like I didn't think about any of that stuff .

It was I'm going to be a surgeon , I'm going to work hard , I'm going to do the best I can , I'm going to have a wife eventually , I'm going to have kids eventually , and then I'll just figure it out from there . That's all I thought about . But now it's like , as I said in a previous episode , it's like color , right , like now .

It's like , well , like what happens if you don't want a nanny to raise your kids ? Who's going to sacrifice and spend time at home ? Right , obviously , the majority of times it's going to be the woman , like the woman . Those roles are kind of .

But I didn't also think that I would also be very cognizant of my lifestyle also and how that plays with my married life as well as being a dad that part . If you asked me that , even 10 years ago , I would have been like no , it's just , you know you were married 10 years ago Right but I didn't know right . I didn't know Right .

So 10 years ago I was married , but I just was married and I was just like , well , I'm just going to be a really great surgeon and whatever goes along with that and whatever goes along with being married and what goes along with being a family man , all that stuff is secondary to being a surgeon .

And , like I said , having those two , having two of my partners go through that , that's when I was like hmm , that's what you think was a pivotal moment for you Definitely , definitely .

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