Something is burning

Early on in the medical education you realize that you're going to go one of two ways: you're either Surgical or you're Medical. I'm using capitals here because they're more than just words; they represent a higher order of one's makeup, personality, work ethic, and human relations-wise.

Surgical means you like discreet problem you can fix, get in, get out, be done with it; the patient says thank you, and you say see you later. You concentrate on one problem, and unless you subspecialize in something more cerebral, like transplant, you don't bother seeing the patient as a whole. You certainly don't bother with social issues like nursing homes, and most definitely avoid pontifications and indecisive trepidations. Surgeons get together at 5am so they can round on the floors, and then avoid the floors at all costs hiding out in the dungeons of the OR. They hire floormonkeys to work it upstairs: PAs, NPs, and interns. Past a certain point in your career, you lose the ability to concentrate on presentations that are longer than 1 simple sentence, and demand for everything to be in the form of bulletpoints. You wear your "I'm a surgeon" T shirt at all times, and acquire a serious attitude from all the long hours and fumes from the anesthesia station.

I was always Medical. Medical means you like to take your time making decisions. You roll in around 7 am, and past a certain point in your career, you're allowed to sip coffee and buy donuts for the team, stop to talk in hallways, and have distracted conversations about George Bush. You walk around all day thinking about things, talking it over with 8 or 9 different specialists and consultants, and at the end of the day, you decide to change the Lopressor from 25 to 50 as the big intervention of the day. Your problems are mostly chronic and have no cure, which gives you time to really think it out. You enjoy seeing the patient as a magical puzzle, and will seek out additional problems if there aren't enough (always ask, what ELSE is wrong with them), coming up with categories you didn't even know existed: Fluids, Nutrition, Electrolytes, prophylaxis, code, proxy etc. Generally, we're a friendly bunch, forgiving of errors, and fond of kissing ass of people who work for us.

Love what you do and you'll never work a day in your life!

GI is like being Surgical without the attitude, and Medical with an element of discreetness and "I can fix you"-ness.

That's my deep thought.

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