American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

YFA Newsletter Essay

No Man Is an Island

Claudia Emami, MD, MPH, FACS, FAAP

My intern year in general surgery was single handedly one of the most eye opening and challenging years of my life. I remember at times feeling like I was drowning. I remember feeling that I would come up for some air here and there and then have to dive back in. When I decided as an MS3 to choose surgery as a career, I had no doubt that I was doing the right thing. I knew no other specialty would make me happy the way surgery would. I was proud of myself for having such clear vision of what I wanted to accomplish as a surgeon and what I thought a surgical career would look like. However, what I didn’t realize or prepare for was what the training could be like in real time. It was for that reason that I found the intern year to be very disorienting.

I trained in a large residency, in a relatively hierarchical system that was going through its transitional years, as many others did over a decade ago. I was the first intern class at our institution to go through training after the hour restriction rules were instituted and the environment started to change. As a result, there was a lot of bitterness and frustration that trickled down from the leadership all the way through the resident ranks. In addition, the volume of work, compounded by lack of knowledge and, as a result, any control, was at times quite overwhelming.

For many reasons that one could imagine, being an intern in such an environment was not a pleasant experience. A few sentinel events during that intern year helped me carry through and finish the year. These events mostly had to do with random acts of support from fellow residents, many of whom probably don’t even remember them. These acts of kindness helped me, the drowning intern, carry on through to another day. There were many moments during that year when I asked myself if I had made the right career choice and whether it was necessary to endure what was happening in order to train to become a surgeon. I wondered whether what I saw around me truly was representative of surgeons and the world of surgery. Despite all the moments of doubt, I made it to the end and finished the year without having my emotional state affect my work and my performance. I chose to carry on and continued through my training. I still was a bit confused regarding my place in the world of surgery and my career choice, even though I was having a much better time after graduating as an intern and being called a resident.

There was one event and one experience that second year that, as we say, “set me straight” and got me back to that moment as an MS3, when I knew I wanted to become a surgeon. That event was attending my first American College of Surgeons (ACS) Clinical Congress in San Francisco, CA. I remember clearly every detail about that conference, the attendees, and the way I felt walking in and getting my badge. It was the first time since the beginning of my training that I could see, first-hand, what this path could eventually lead to and what it meant to be a part of this surgical community. I felt a sense of pride and a sense of purpose walking through the halls of the convention center. I felt validated, that I mattered and that I belonged. There was something special about walking in those halls and sitting through the talks and speeches. It spoke to the enormity and the influence of the field of surgery and all the people who were a part of it. I knew at that moment that even though the journey there may be rough, the destination is worth the hard work and the effort. I knew I wanted to be a part of this surgical community and that I had made the right choice.

The College was the place I gave my first presentation as a resident at the Surgical Forum. It is the place where I get to meet old residency friends and connect with new ones. As I moved through my fellowship and started focusing more on the events related to my specialty, I still made a point of always attending the ACS Clinical Congress and getting involved in my ACS Chapter. I have also made sure to recommend attendance to all the residents I have trained. I’ve shared the above experience with many of them and have gotten similar feedback from them regarding their first ACS Clinical Congress.

That feeling of belonging has only gotten stronger as the years have passed, and I have seen the College grow more diverse and representative of different voices, including mine. I was proud to become a Fellow of the College as soon as I could apply for it, and I carry my FACS title with a certain pride, reminiscent of the sense of pride I felt the first time I walked into the Clinical Congress. As John Donne famously said, “No man is an Island, entire of itself; every man is a piece of the continent, part of the main.”