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From surgery to psychiatry: A medical student reevaluates his motivations

In middle school, I asked for a neuroscience textbook for Christmas. I understood maybe a few pages, but I loved the pictures. In high school, I asked for a neuroanatomy atlas. I can still hear my mother going “Mhmmmm” when I’d tell her the brain area she used if she so much as moved her pinky. In college, I planned to transform this fascination into a career committed to the betterment of others. And so, I came to Stanford Medicine thinking I’d be a surgeon, bringing to life my neuroscience flashcards in the operating room.

Having now completed my surgery clerkship, that is unlikely.

As it turns out, donning scrubs, gloves and a mask to watch a surgeon is not the same as actively living the life of one. Coming in to observe the highs of a surgical case is not the same as scrambling to respond to an unexpected complication.

It’s not the same as the hours of training required, or the type of mental fortitude needed to work case after case. It’s not the same as spending so much time on your feet that they go numb. Years as a fascinated bystander failed to prepare me for the unique culture and mindset of the surgical world. While some of my classmates relished it, I was lost. Queue panic calls to friends and family who assured me everything happens for a reason. But, after every conversation I was left with a bitter taste — why couldn’t I let go?

I’ve realized my unrest was largely because my self-worth was linked too closely to the notion of prestige and the self-pride I’d derived by identifying as a future surgeon. I certainly garner personal fulfillment through other sources, but to deny the contribution of prestige is to deny my current reality.

Oddly enough, it’s in living the life of a surgeon that I’ve learned prestige feels good at the dinner table but falls short to sustain and cultivate my daily emotional and physical needs. It’s loud and proud when discussing job prospects with family and friends, yet silent when I’m so exhausted even blinking is hard.

And so, the last six months were spent reconnecting with the reasons I came to Stanford. I challenged myself to re-answer why I entered medicine and to do so, I was forced to reexamine where I’ve come from, who I am, and where I want to go. This complemented efforts to restructure my goals around these reestablished values and life objectives. The process was unnerving but resulted in a clarity I hope to bring to all my work moving forward — I now understand that personal fulfillment is better derived internally than externally. When we are internally fulfilled, when we provide to the world, we draw energy from who we are rather than what we wish we were.

It is with this understanding that I leave surgery behind and hope to enter psychiatry as a career. This is not to say anything about psychiatry or surgery as careers and is to say something about psychiatry and surgery as careers for me, taking fully into consideration the context of who I am, where I’m going and why I’ve entered medicine.

In living the life of a psychiatrist, I’ve learned it’s a field where the culture, mindset, and focus more suit what nurtures my own sense of fulfillment. It’s where I can bring to life my picture books and flashcards in the stories and lives of my patients. It’s where the patients may feel our efforts validate their lived experience, but it’s really they who validate ours. I see now that in living the life of a psychiatrist, the prestige isn’t gone, it’s just found a home in my heart rather than as a topic at the dinner table.

Jon Sole is a fourth-year medical student at Stanford. He loves neuroscience, quality improvement, technology, and anything remotely related to their intersect.

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