Why I am a surgeon


An excerpt from Behind the Mask.

Why do you do it?

Do what? Get up in the middle of the night? Rush in to the hospital to patch mangled bodies, sew holes closed, stick my finger in a dike spewing blood and, hopefully, repair what’s broken and allow some unfortunate soul to live and love another day? A good question. I could have been a pediatrician, almost became one as a matter of fact, or a plastic surgeon, but I failed the ego test. No, I had to be a general surgeon. For glory? No.  For personal satisfaction? Maybe. For intellectual stimulation? Perhaps. For the money, definitely not. Then, why?

Why did I go to school for all those years? Elementary school, junior high school, senior high school, four years of college, four years of medical school, five years of residency, working a hundred hours a week. All for what? To be able to wrestle with an intoxicated man at 3am, trying to evaluate the stab wound to his buttock or fathom why a beautiful woman would decide, in a moment of severe, devastating depression, that she didn’t like her breasts and try to cut them off? Or why a distraught father failed to check behind his car as he pulled out of his driveway, just to pick up a container of milk, and inadvertently ran over his two year old daughter?

Why do bowels perforate, aneurysms burst, appendices rupture, arteries clog, gallstones form; why does anything bad have to happen? Why do the nicest people you could ever meet develop inoperable and incurable stomach cancer; why does anyone have to get cancer? Can’t we do something to prevent it?

You ask why I do it. Can anyone answer even one of these questions or a million other, similar ones?

But, every illness, all the injuries, all the misguided thoughts and actions, every trivial, little act that we wish we could take back, every moment that should never have happened, all these things that bring us to a doctor seeking a remedy, are they reason enough? The battle against disease rages onward, fought by doctors, nurses, technicians and therapists at all hours of the day and night; most of the time the battle is won, but the war always goes on, never ending. And if it never ends, if there can be no victory, what’s the point?

Is it enough to replace the look of overwhelming fear and distress, a look I routinely see on patient’s (and their family’s) faces, with a smile? Is the look of relief on the faces of worried family members when they are told that everything went well, that the lump was benign, that the injuries are not severe, that their son will be back on the basketball court in just a few weeks, is this enough reward?

I’ve asked myself these questions over and over again. Sometimes I have the answer; sometimes I just shake my head in bewilderment, but all the time I answer the call, do my best, and hope that those I try to help, the sick and injured, return to a normal life.

So I come to the hospital at 3am and probe and palpate and listen and probe some more. And then, I cut and dissect and clamp and tie and cauterize and sew and resect and reanastamose and bypass and sew some more. All of this so that, in the end, a person, broken by the struggles of life in this fallen world, can have a few more moments as a complete individual.

Why do I do it? Because of what’s waiting for me under those drapes. A patient, with a name and a family, who has entrusted me with their very being. But … do I deserve such trust?

David Gelber is a general and vascular surgeon who blogs at Heard in the OR and author of Behind the Mask.


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