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The Making of a Surgeon in the 21st Century is a highly personalized description of one individual's experiences during a five-year residency in general surgery at a major university hospital. It describes the personal challenges and rewards, the drama of triumph and tragedy, the agony of indecision and the thrill of success. Residency is the most profoundly life-altering sequence of events in a surgeon's life.
What does it take to make a surgeon?
It takes a college degree and a medical school education, followed by a residency. And it takes a willingness to subordinate one's personal life to acquiring the skills and knowledge which a surgeon must possess. This sacrifice takes its toll - on families, on mental health, on life-style. A surgical trainee may not get out on his own until well in his thirties - living, in the meantime, a meager existence at best.
Post-graduate training in surgery is longer than that of any other medical specialty, five years at least. Tortuous on-call schedules often demand exceedingly long work hours - 100-hour work weeks being the norm. Compounding the problem are very high stress levels, the burdens shouldered by the resident's family in his frequent absence and often an enormous educational debt.
Nevertheless, every year hundreds of fresh medical school graduates compete for the few available positions. They are consistently the very best of their classes.
Why would otherwise intelligent, highly motivated individuals actively seek such a miserable existence?
Surgeons have, of course, been glorified in the mass media as the swaggering, brilliant, fiercely independent cowboys of the medical profession. Their compensation has also been great. But beyond this is a personal quality best defined as decisiveness. They want to make the difference, in no uncertain terms. In surgery, when the patient enters the operating room he is suffering from disease. Thanks to the surgeon, he may be wheeled out cured. It doesn't happen every time, of course, but the possibility is there (in other disciplines of medicine "cure" is, unfortunately, an unusual event). Who wouldn't want to be such a healer, making a palpable, tangible difference?
Endorsements
"Honest, hard-hitting and tremendously entertaining ... an unvarnished look at surgery residency." Louis M. Messina, M.D., Professor of Surgery, University of California, San Francisco
"Terrific stories ... we [surgeons] live through this every day but it hardly ever comes out like this ... [Dr. Miller] got it right." Phillip Caushaj, M.D., Chief of Surgery, The Western Pennsylvania Hospital
Table of Contents
Preface
1. The Internship Year-Batten the Hatches
2. The Internship Year-See the Man Run
3. The Internship Year-A Little Knowledge...
4. The Second Year-Perchance to Sleep
5. The Second Year-Don't Do Nothin' Dumb
6. The Second Year-Plastic People
7. Strange Problems
8. The O.R. Team
9. Hands and Hans
10. Mistakes
11. Publish or Perish
12. The Third Year-On the Hot Seat
13. The Third Year-Chops
14. The Senior Year-Little Problems
15. The Senior Year-Glorified Plumber
16. M&M-The Crucible
17. Danger
18. Death
19. Trauma: Life in the Big City
20. Chief Resident
21. Farewells
22. The Making of a Surgeon
Epilogue
Excerpt
Mr. Colson was in trouble.
Bathed in sweat, he was lurching about on his hospital bed, wracked with waves of nausea and intermittently vomiting up pints of partially-digested blood from what seemed to be an inexhaustible supply. The bloody vomit covered Mr. Colson, his bedclothes and most of the room-including his panicked nurse, whose page had summoned me to the scene. I stood transfixed, alternately trying to gather my wits and dodge the brick-red plumes which spewed from Mr. Colson. What should I do?
It was the evening of July 1, 1994, and my first day of surgical residency was drawing to a close. My first night on call was just beginning....
In the United States--and most industrialized nations--medical school graduates must comp
- Sales Rank: #344835 in eBooks
- Published on: 2013-01-21
- Released on: 2013-01-21
- Format: Kindle eBook
From the Inside Flap
"Honest, hard-hitting and tremendously entertaining ... an unvarnished look at surgery residency." Louis M. Messina, M.D., Professor of Surgery, University of California, San Francisco
"Terrific stories ... we [surgeons] live through this every day but it hardly ever comes out like this ... [Dr. Miller] got it right." Phillip Caushaj, M.D., Chief of Surgery, The Western Pennsylvania Hospital
About the Author
Miller is co-founder, Administrative Director, and a therapist for the Christian agency, MASTERPEACE Center for Counseling and Development, in Tecumseh, Michigan. For twenty-two years he has helped people through counseling, writing, public speaking, and his radio talk show.
Most helpful customer reviews
14 of 14 people found the following review helpful.
A Colorful and Interesting Account
By C. Middleton
Medical memoirs have become a popular genre. Most are quite revealing as to the virtual hell a four to five year resident must experience to become a qualified practitioner. The resident surgeon's experience has to be the most hellish in terms of the amount of hours worked, (100 hour weeks) the pressure brought to bear from the attending staff, sometimes extremely sadistic, abrasive and demeaning, not to mention the continuos mental strain from lack of sleep and the stress on the residents family, some families, unfortunately, disintegrate at some point along the way. Craig Miller's book clearly expresses all these things, however it is the spirit in which he communicates these experiences that makes his memoir worthwhile reading.
A better word would be a colourful account of his experiences as a resident. He not only explains the program in easy to comprehend prose, it is his anecdotes, describing the many characters that make-up this world that is entertaining as well as intriguing. About halfway through the text, I wondered if he had changed the names of the attending staff, nurses, and fellow surgeons that he profiles, because his characterizations are really, for the most part, quite scathing. In some cases the descriptions bordered on the libellous, smelling a legal suit some time in the future. However I'm sure his editors took this into consideration before publication. I certainly hope so.
The most revealing and educational part of the book was Miller's explanation of the standard step-by-step procedure (the Advanced Trauma Life Support protocols) when working in the ER, the initial steps of trauma management. Interestingly it is broken down simply so that the attending staff do not have to "think", but sequentially run through this procedure of "A is for Airway, B is for Breathing, C is for circulation, D is for Disability and E is for exposure." (P. 207) Miller is extremely annoyed how TV dramas as well as `reality' documentaries give the wrong impression to add to the pathos. In fact the ATLS protocols, following the A, B, C, D, E standard procedure avoids the chaos, ensuring the best for the trauma victim. This section of the text was extremely informative.
By the end of Miller's Chief Residency, he had the confidence and the confidence of his teachers to forge on alone, and realized he had truly become a surgeon. Having read the book in an afternoon, his writing was such that I felt his relief and sense of accomplishment by the end of his five-year residency. This has to be one of the most difficult and gruelling training out of all the professions, physically, intellectually and emotionally. In the Epilogue, Miller expresses his ambivalence about the current residency system in terms of its viciousness and amazing effectiveness in producing top-notch surgeons. The system hasn't changed since the 19th century. The process certainly takes its toll but for a price and is the price worth it?
A recommended read for anyone interested in the education of a surgeon.
10 of 11 people found the following review helpful.
A natural follow up to Dr. Nolen's book
By Julian Guitron
The world of surgical training has changed tremendously over the past few years. As little as 5 years ago, the rule in surgical residency training was 110-120 hour-work weeks and even some rotations demanded 24 hour in-house coverage for several weeks at a time. This "old school" period is brilliantly narrated by William A. Nolen in "The Making of a Surgeon", but today's reality, significantly different, was captured splendidly by Dr. Miller.
Dr. Miller comes through with what feels like a natural follow-up of Dr. Nolen's work. There are interesting comparisons of several features of our current training as opposed to that of Dr. Nolen's era.
This book was very entertaining, critical and even funny. Suitable for both the non-health system related reader, as well as medical students and residents as a way of comparing our own training. Dr. Miller managed to explain technical terms in a very simple and short fashion that doesn't interrupt his rhythm even for the expert surgical readers.
I highly recommend this book particularly to medical students contemplating a surgical career. If you don't find yourself laughing at Miller's humor, then surgery might not be your most suitable future!
9 of 10 people found the following review helpful.
For anyone seeking to better understand the world of surgery
By Midwest Book Review
The Making Of A Surgeon In The 21st Century is the memoir of medical research award-winning career surgeon Craig A. Miller, M.D., and presents the unvarnished true story of what it is like to train as an extreme specialist. Presenting a world of gruelling 100-hour work weeks, gallows humor, harsh realities, and severe pressure at every turn with human lives literally hanging in the balance, The Making Of A Surgeon In The 21st Century is an absolute "must-read" for anyone seeking to better understand the world of surgery and the people who perform it, as well as a taste advised for those considering this demanding career path - so that they can better know the challenges they will confront.
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