Resolute
II.IV.II
RESOLUTE
On most days while working at the Emergency Department (ED), I’d walk out of hospital with a huge smile on my face – the kind that comes about very rarely, usually when I’d be assisting on some cool surgery. But this was different. After even the most mundane shift at the ED, I’d step outside covered in goosebumps, knowing something had changed, knowing something in me was shifting.
If there was ever one constant since I decided to become a doctor, it was this: I wanted to be an extraordinary surgeon. From day one, that was it. Surgery. Not medicine, not paediatrics, not radiology or gynaecology. Surgery was as hardcore as it gets. The excellence, the adrenaline, the art of it. Everything else seemed to pale in comparison. It wasn’t a choice – it felt like destiny. I was meant to become a surgeon. I was completely resolute, one hundred percent sure of it.
Then I got into med school and started learning about the brain. To me, it was the most fascinating organ in the human body. Its shape, its countless pathways, its functions – everything about it drew me in. I was never one to settle for simple, so it felt only fitting that I’d fixate on the most complex organ of them all. Neurosurgery brought together two things I loved most: the brain and surgery. That conviction was only reinforced during my neurosurgery rotation. It was the toughest rotation I’d ever done, mostly because of the administrative burden, but by the end of it I was even more resolute. The road ahead would be long and brutally difficult, but I was sure nothing would ever get in my way.
And yet, after an ordinary shift at the ED, I’d walk out with a grin on my face and goosebumps all over. Was I, maybe, falling in love with emergency medicine?
For the first time in my life, I wasn’t entirely sure whether I wanted to become a surgeon or completely upend my plans and pursue emergency medicine. My mind was racing, trying to make sense of it all. I knew I’d like this specialty. The variety, the pace, the immediacy of it – being the first to manage patients. But I hadn’t expected to love it this much. Within a week, I felt more like a doctor than I had in nearly two years. And as exhilarating as that realisation was, it was also terrifying. This newfound passion undermined years of certainty. Was I being open-minded, or was I being fickle? Was reconsidering my path a sign of growth, or of weakness?
On one hand, I could clearly picture myself as a neurosurgeon. An expert in my field. Someone at the forefront of medicine, constantly pushing the boundaries of a highly specialised craft. A point of reference for colleagues and a source of hope for patients who needed my skills. Nothing had given me more satisfaction than splitting a skull open to help remove a brain tumour or evacuate a bleed. The brain fascinated me just as much as it had during med school – if not more, now that I was learning something new with every passing day. Plus, I’d get to follow in McDreamy’s footsteps and throw around lines like, “Hey, this isn’t neurosurgery.” And sure, the pay isn’t bad either, though that was never really the point.
On the other hand, emergency medicine appealed to something deeper and more personal. Its freedom. Its curiosity. Choosing a specialty means narrowing your world to one system, one domain, for the rest of your career. If I chose neurosurgery, I’d be living in a world of brains, spines, and nerves forever. But in emergency medicine? Everything was fair game. Brains and hearts, guts and lungs, bones and kidneys – the whole human body, in its entirety. I knew I’d never get bored. On top of that, emergency medicine opened doors. Expedition medicine. War medicine. Disaster response. All the things my adrenaline-junkie self secretly craved. And let’s be honest, McDreamy wishes he could be that cool.
But here’s the catch. In emergency medicine, o matter how good you are, how experienced or how skilled, you stabilise the patient and move on. You don’t get to finish what you started. You don’t fix the root problem. You don’t follow patients through their journey.
I’d still see my fair share of neurosurgical cases – tumours, bleeds, trauma – but I’d manage the acute phase and then hand them over to the specialists. I’d stand by the stretcher and watch the patient disappear into the operating room, where the real fixing happens. And that would be it. No skulls to split, no tumours to remove, no bleeds to evacuate. I’d be the jack of all trades, but master of none. Would I ever be okay with that?
Just like that, I was facing yet another impasse. One I never even saw coming. All those years it was just surgery. Now it was surgery versus emergency medicine. I would have a tough choice to make – one that would shape the remainder of my life. Despite my internal conflict, I was also aware that both specialties are deeply rewarding. I’d be lucky to work in either. They both demand long hours, intense training, and enormous sacrifice – as most specialties do. I didn’t want to make a choice just yet – and I wouldn’t have to. Not for the time being at least.
And so, I decided to keep an open mind. After all was said and done, I was certain of one thing. Whatever path I chose, I’d do an excellent job. Not out of arrogance or delusion, but out of sheer passion for medicine itself.