A thank you to The Colonel: The day I decided to become a doctor

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“Surgeons are the jocks. You’re a jock. You’re going to be a surgeon, kid.”

-The Colonel

Every doctor has a story. A story about the moment the path they walked was demolished, put under construction for 6 months, and a roundabout was erected with only one exit: the life of medicine. Can you tell grew up in a city that became nationally renowned for its roundabouts? Can you tell I lived there while they were impeding traffic while being constructed?  Can you tell I’m still bitter about it?!

Let’s do the 5 W’s of my story. Who? Me. What? The day I decided to become a doctor. When? Spring break, 2010. Why? Because I think it’s a good story. How? Seriously why is how included in the “W’s”, and where was someone and what were they thinking when they decided that calling these all W’s was a good idea?!

This story is dedicated a man I will call The Colonel. He is the man who single-handedly changed the course of my life. While many factors that made me decide to attend medical school had brewed for years, it was him who took those things and connected them, showing me the world of being a physician. I haven’t talked to him in nearly 7 years, and I feel like he should know the role he played in one 18 year old IU student’s career choice. I’m going to send this to him as a way of saying thank you (and I hope he reads it, or at least the thank you email I am going to send) because often we don’t tell people the good they have done in our life until it is too late.

Time to develop our characters. At the time, I was 18 years old and plowing through my second semester of college at Indiana University. I was a political science major (basically just a placeholder), but had NO idea what I wanted to do with my life. I was thinking of working for some kind of government agency (like the FBI or CIA, which my uncle had tried to do back in the day), but was stuck. I was taking a broad array of classes that would satisfy degree requirements for any liberal arts degree, so I was in an okay place to graduate on time. However, there was a low pitched, droning crescendo in the background with the unanswered question, “What do I want to be when I grow up?” I had always been good at the STEM fields of study (I had a special talent for math above all else), and had the generic desire to “help people”. That sounds like a thrilling start, doesn’t it?

Way back in the day, when I was way more awkward that I am now (shocking, I know), I spent a lot of time as a patient. I had a smattering of surgeries to fix some sports injuries. They weren’t caused by accidents so much as disasters of clumsiness; I once broke my arm by tripping over my own feet. Oh, and did I mention this was when I already had another broken arm? Man, middle school was rough. At the time, I found a great curiosity about the things around me and the process of medicine. However, I promptly forgot about it once I was done breaking bones. Out of sight, out of mind. Either that or my thoughts were too occupied by chasing girls (see: staring awkwardly from across the room too afraid to say anything).

During my second semester of college, my most influential mentor mentioned he had a doctor I could shadow for a day, because I had said I wanted to explore that career path. My extended family has one nurse amidst a plethora of non-medical people (I need to come up with a word for “non-medical people”, because I use that term so often. I would use “muggle” cause that’d be hilarious, but then that would imply medical people are magical. I wish we were. We are not. Onward.), so I can’t say I had any exposure to medicine before this. When he told me this doctor was a urologist, I was only vaguely aware that meant he did stuff with urine. My first thought was, “Oh, so he’s a penis doctor.” Unfounded claims in hand, I happily accepted this offer, over my spring break no less. Because I was a super cool college freshmen, my spring break plans meant going back home and starting a binge on whatever video game was my flavor of the month. This would be a good change.

It was a pretty unassuming day, we’ll say it was a Tuesday. It was early, probably around 7AM. This was waaaaay too early for a college student on break to wake up. Considering my usual wake-up time would have been noon, this was clearly an important day. I showed up to the hospital in probably a polo t-shirt (my definition of “slightly more classy than a regular t-shirt”. I mean come on, it has a collar!), and walked to the front desk. This was back when I thought hospitals were on super-secret lockdown, and I was scared that I looked like I was soliciting in the lobby. I was told this mysterious doctor would meet me there. I stood around for maybe 10-15 minutes, having the classic introvert thought of, “Maybe I should just leave? That would make this awkwardness go away” due to the anxiety I was having. Out of nowhere, he came barging in. This is the man who will be henceforth known as “The Colonel”. I don’t remember exactly how he got the nickname, but it fit his demeanor and that is what he told me to call him.

My first thought was that I didn’t expect him to look like a linebacker. I don’t remember if he ever played football, but he sure looked the part. He was clean shaven, with short hair and one of the most intense pairs of blue eyes I have ever seen. There are two types of surgeons: those that move in slow motion and those that move like the Energizer Bunny, not out of being anxious, but out of a drive to complete tasks as efficiently and quickly as possible. He was the latter. He moved in a controlled frenzy with a constantly power-walking gait. His greeting was like a shot of whiskey: a firm handshake, a quick introduction, and within seconds we were on the move again.

In minutes, I had donned my scrubs, shoe covers, and blue bouffant cap. He explained that there was a full load of operations for the day, and we were off to the first one. Turns out he was one of the first people in urology to get on-board with da Vinci robotic surgery when it was first released, giving him an edge that not many other surgeons had. Him and his partner found that it had promise for removing the prostate (total prostatectomy), and thus he became part of the cutting edge of robotic surgery. We paused at the door to the OR. He told me in a stern tone to not touch anything blue, his singular warning for the day. We walked into the operating theater.

I hadn’t been in an OR, mind you, except for the times I was a patient. I was fascinated. The patient was already asleep, the laparoscopic cameras were hooked up, and the operation was already going. Turns out his partner and him shared the cases and bounced between two rooms, able to efficiently accomplish more than either could independently. Over the patient stood the hulking da Vinci robot. It is a 5 foot tall column with 4 independent arms. These arms have a myriad of interchangeable instruments. Essentially, it is a fancy way of doing laparascopic surgery. The surgeon sits at a type of virtual reality console on the other side of the OR, performing the surgery from the comfort of a stool or office chair.

To this day, as I near the completion of medical school, The Colonel sits at the top spot for the doctor who was invested most in me. By that, I mean it was evident that he not only wanted to get to know me, but wanted me to have a good time and teach me something. Every medical student has experienced all kinds of attending physicians along this spectrum, from the one who will buy you ice cream and ask about your life, to the one who doesn’t know your name even after working with you for a month. He took a real interest in me. I swear he knew my entire life story within a few minutes, asking me about high school, how college was, how I got there, and more. He pointed out the anatomy of the surgery on the monitor and narrated each step (that I promptly forgot). For the uninitiated, laparascopic surgery looks like an endless journey through a moist, tortuous yellow and pink cave. You can’t tell up from down. He then switched places with his partner and proceeded with the dissection.

He talked to me throughout the entirety of the case, which I now recognize as a sign he had complete mastery over the surgical technique; he could effortlessly talk and operate at the same time. He could have done that surgery blind. I stood next to the console, transfixed on the screen and everything around me. Despite have no idea what I was looking at, The Colonel kept me oriented. He had alternating moments of cracking jokes, explaining the dissection, and periods of intense concentration. In what seemed like 10 minutes (which was really 2 hours), he told me to grab a glove. Shortly after, he plopped a freshly removed prostate in my hand. It like a large, firm cherry. The shock over holding an organ that was very recently inside another person didn’t hit until later. It appears I was blessed to have an “iron stomach” that allows me to not instantly vomit at the sight of real life entrails.

In a flash, we were off to the next OR for the next case. It is a little bit odd as to the things I remember from a single day 7 years ago, but two completely random things stick out during this time frame of the day. One was that we went into an orthopedic surgery room, where he explained that the female surgeon there was doing some kind of additional training in orthopedic surgery (what I now recognize as a fellowship). She was all of 5 foot nothing, but I could tell she was the leader in that room. I remember thinking it was crazy to do more training after residency, because it was a long enough time in training (somehow I’m sure I’ll end up eating my words and doing a fellowship). The second thing was when we popped into a general surgery case, and he gave the surgeon there a hard time about only getting in the 99th percentile on his board re-certification instead of the 100th. The general surgeon went into the mathematical impossibility of getting in the 100th percentile and fired back a witty comebacks at The Colonel. The banter continued for a few minutes, then we left the room.

What was striking here is a quality that I observed with a select few physicians: the emphasis on the relationships that The Colonel had with each and every person in the hospital. From the other surgeons, to the nurses, to the scrub techs, to the janitors, The Colonel was clearly well liked and very clearly cared about everyone around them. A few other people I have met have exhibited this quality (my intern from my last post being another prime example, nurses would bend over backwards for him), and not only does it make their lives so much easier because people are more willing to help, it makes work so much more enjoyable. While he may have been gruff, it was clear that the people he worked with adored him.

Moment of reflection aside, we were in the next surgery, with the next patient, removing the next prostate. The da Vinci made it so that I could talk to The Colonel pretty easily, which would be hard in traditional surgery, as he would be scrubbed in. I still maintained a childlike wonder for the whole surgery. This time, he let me sit at the console for the robot at a point in the surgery, and under strict guidance to “be very careful”, I even got to move around the instruments inside of the patient. I was obviously terrified, so I moved them maybe 1-2 millimeters at most, but I was ecstatic. I was controlling something that was inside of someone else’s body! I was barely qualified to stand in the OR and breathe, let alone use the surgical robot!

After this procedure came the tipping point of the day. It was early in the afternoon, and I had been there for around 6 hours. The Colonel realized this and point blank asked me if I wanted to stay for the rest of the day or not. At the time, it seemed like a bit of a silly question. It was my first time shadowing a doctor and I was having the time of my life. Of course my answer was a very enthusiastic, “Yes!” At this, The Colonel smiled. He replied by saying that not only could he sense my interest, but also my willingness to stay would be worth my time. Often, in medical education, just like anywhere in life, those that take an interest in the teacher’s material will encourage the teacher to go the extra mile.

And go the extra mile, he did. The next case went off without a hitch, and The Colonel did something that carries a greater weight now than I understood back then. After the last case, he convinced the technician to set up the robot in the OR after it was cleaned; he found some of the training equipment for the robot and put it out on the operating table. He had arranged all of this without telling me, and sprung it on me right as we were walking back to the OR. He let an 18 year old kid who he had just met play with the million dollar surgery robot. I. Was. Floored. I remember how intuitive the controls were, yet how much I struggled trying to grab the suture needle and put it through the styrofoam. I remember him talking about a study done on the type of people who were best with the da Vinci without any training. The choices were athlete, gamer, and musician. I guessed gamer. The answer was athlete. Luckily, I happened to be all 3, so I remember becoming aggravated when I struggled mightily with the most simple of tasks. It’s almost like it takes 5 years of residency to train a technically competent surgeon…

Here’s a picture that my mentor dug up of me at the robot console. It’s kind of touching, it’s my first ever day in the OR on the day I decided to become a doctor:

colonel-image

After it was finally time to go, I walked out of that OR on a high. Never in my life had I experienced a career that I so instantly fell in love with. It’s as if I had went on date after date with dozens of women, created pro/con sheets, and obsessed over my choices only to fall in love with one at the drop of a hat. As we went back to the locker room to change, I asked him how people got a hold of pairs of scrubs. Turns out the ones I was wearing were hospital property. He turned to me and said, “Why do you ask, would you like some?” I grinned sheepishly and nodded. He shoved my pair of scrubs in his bag, we changed, and walked out of the hospital. Not only were these the first pair of scrubs that I would ever call my own, they were what I wore 4 years later during my anatomy dissections as a first year medical student. I remember pulling them out and fondly thinking of the day that changed my life.

The Colonel asked if I wanted to go for coffee after, and while I actually hated coffee, I went along because I didn’t want this day to end. I remember getting a scone and a small coffee that I tried to force down out of politeness. I burned my tongue. However, there was no way I was going to deny any of the kindness that The Colonel showed me. We talked about life, medicine, and more. When we were talking about the various kinds of medical specialties, it was here that he dropped this line, “I think general surgeons are the ultimate doctor, they can deal with anything”. Now I’d like to think that my own experiences and desires over the past 4 years led me towards general surgery, but this comment likely played a part. I liked the idea of being able to be very broadly trained in medicine and surgery.

At the end of our time at Starbucks, it was finally time to call this day to a close. The Colonel gave me his phone number, told me to call him with any questions, and we parted ways. I drove home elated, because I realized I had finally found my place in life. It was among the halls of the hospital, in the operating room and taking care of patients. When I returned to IU, I met with a premed advisor, switched my upcoming classes to start knocking out the requirements for medical school, and began learning more about the field of medicine. 7 years later, I am on the eve of graduation from Indiana University School of Medicine. Time flies, much like it did that day. When I got home from the hospital, I realized I hadn’t peed in 10 hours and didn’t even notice. Let that be a lesson: when you find something so interesting that you forget about your basic bodily functions, you’ve found your place. 

The Colonel came to me at a time in my life when I was lacking both direction and a father figure. He showed an intense interest in me that has seldom been repeated by someone who wasn’t my close family or friend. He took time to learn about me as a whole person and put in a whole lot of extra effort to make sure I had a phenomenal experience that day. He went to lengths that even attending physicians (whose job it is to teach) would likely not have done. He not only cared, he imbued me with a sense of purpose that I was the kind of person who would make a phenomenal doctor. In his words, “Surgeons are the jocks. You’re a jock. You’re going to be a surgeon, kid.” At a time when my own father was absent, he did more “fathering” that one day than most fathers do in a year.

This post is dedicated to The Colonel. I am sure he is not a perfect man, but he is an excellent physician and human being. I hope he reads this, so I’m going to end with this: Colonel, thank you. On that day so many years ago, you changed the trajectory of my life. I am now less than 3 months from graduating medical school on a track towards general surgery residency. I’ll let you know where I end up matching. Without you, simply put, I would not be here. You took my interests in science, human compassion, and sports and tied them together in this calling to be a surgeon. I have a sense of purpose and fulfillment in my life that I would not have found outside of medicine. If not for your initial spark, my fire for medicine would never have been lit. Thank you for the example you set as an outstanding surgeon, teacher, and man. I will never be able to thank you enough for the path you helped set me on. Hopefully, I can buy you a beer or two before I leave for residency. It’s the least I can do.

-Brandon

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