If I Were Reborn, I'd Be a "Dermatologist" | Yoshino Choichi (Dean of the Faculty of Nursing and Medical Care)
2005.07.28
Just as I was dreading it might be time, I received a message from the editor. The theme this time was, "What do you want to be if you are reborn?" The following sentence was attached (including the ellipses, exactly as written): "Since July has Tanabata...... please feel free to write about what you would want to be and do if you were to be reborn."
While I was thinking of asking the editor what being "reborn" has to do with Tanabata, the deadline, as usual, arrived. Tanabata is, of course, a once-a-year rendez-vous, and for someone like me, with only the meager life experiences I'm about to describe, it's difficult to connect it with being reborn. I would someday like to know the true meaning of the six dots (......) included in the editor's original text. Since this is the editor who has saved me from numerous difficulties, I'm sure there must be some sentiment not between the lines, but between the dots.
After 40 years in the business of being a surgeon, I've lived solely in a world of "pure" materialism. Therefore, I've come to realize anew that for these past few decades, I've been in a world diametrically opposed to pure fantasy, like the question "What do you want to be if you are reborn?" In other words, I had completely forgotten about this wonderful world of imagination. While I think it's a shame, it has also been very helpful for my self-awareness of being someone who cannot transcend reality.
If I, who am so poor at fantasizing, were to dare to answer "What do you want to be if you are reborn?", my extremely realistic answer would be, "I'd still want to be a doctor." However, I would want to avoid specialties that are directly involved with life and death. This is because in such fields, you are inevitably woken up at night, forced to work on holidays, and find yourself at odds with enjoying your own life. So, I guess that means something like dermatology.
Even so, the general surgery I have practiced has been the absolute worst in this regard. Emergency calls come in without hesitation, day or night, on holidays, during Obon and New Year's, to my home and cell phone. This is where the tragedy for general surgeons and their families begins. A prime example: on New Year's Eve about a quarter-century ago, when my daughters were in elementary school, we were all set to go skiing in Shiga when suddenly, a dreaded call came from a senior surgeon. "A surgery alumnus had an operation at another hospital, but his condition is extremely poor. Please help him somehow. Just come and take a look."
With that, not only was the ski trip canceled, but our New Year's holiday was completely ruined. This is what it's like even when working at a university hospital; it's even more intense when working at a frontline hospital in a regional area. Many young surgeons rotate through hospitals on a yearly basis and are provided with lodging on the hospital grounds. Their joy at the stylish and comfortable living space is short-lived, as they are tormented by the sirens of ambulances at night and on holidays. General surgeons, who are expected to handle just about anything, are called in to treat patients arriving by ambulance with overwhelming frequency. Therefore, general surgeons are the stars of frontline hospitals. But it's tough.
Let me look back on my four years as a general surgeon in Germany. From Monday to Friday noon, it was surgery after surgery, day in and day out. However, aside from one weekend day on-call and two weekday on-call shifts per month, I could completely leave the hospital after 5:00 p.m. Therefore, unlike in Japan, once an operation was finished, I could leave the patient in the care of the doctor on duty and go home immediately. I remember a German colleague telling me at the time: "The divorce rate among doctors is high, and among them, that of general surgeons is even higher. This is the only way to avoid it."
To become a fully-fledged general surgeon—many of whom specialize in gastroenterology—requires at least nearly 10 years of dedicated training in the field. Most reach that level around the age of 35, and the subsequent 15 years until their late 40s can be considered their peak. After that, although their surgical skills may mature, the progression of presbyopia and a decline in physical stamina come to the forefront, making it difficult to maintain concentration for long periods. In other words, the peak period for a general surgeon is considerably shorter compared to doctors in other specialties.
From the late 20th century, the number of aspiring general surgeons has plummeted in almost all developed countries, including Japan. The reasons should be clear from what I have written so far. In addition, in surgery, which is based on operations, it is extremely difficult to open a small private clinic.
And so, I decided to write that in my next life, I'd be a "dermatologist."
But the allure of general surgery—the most "surgical" of all surgery specialties, being the star of frontline hospitals, the feel of a single incision stretching tens of centimeters—is something that cannot be fully described. (The End)
(Date of publication: 2005/07/28)