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Summer, Sutures, and South AmericaA Brazilian Surgical Oncology InternshipBy Alexandra Dulin, Junior, Center for Life Sciences EducationThe patient had been prepared, thenurse and surgical technologist waitedpatiently, and I was scrubbed in andlooking to the resident standing on theopposite side of the bed. He noddedencouragingly and I took a deep breath.I gripped the scalpel and made the firstincision on the right superior shoulder ofthe patient.Students on the pre-medicine trackwith hopes of specializing in surgeryalways dream about their first time operatingon their own. While the little detailsmay differ from one student to the next,all fantasize the moment one firmlystates: “Scalpel.” But this was no fantasy.At twenty years old, in the most southernstate of Brazil, I performed surgery. Underthe supervision of a resident, I removedmalignant melanoma from a man’sshoulder and stitched up the four-inchincision. While it may not have been themost glamorous moment, I became asurgeon with the first cut.What sounds like a fantasy was myreality for six weeks. During the summerof 2012, I lived out my dream of being asurgeon. I was treated like an intern andwas able to participate in every consultation,exam, and surgery. Even withoutany medical experience on my part,the doctors took the time to teach medifferent skills and held me to certainstandards. From my first day, I was inthe operating room scrubbing in. I wastaught how to place sutures, do skingrafts, intubate patients, insert catheters,and countless other procedures. I washeld responsible for rounds and checkingvitals of my attending’s patients. I learnedmore than I could have imagined.Outside of the operating room, Ilearned what only experience couldteach me. Interacting with patients ona personal level helped me understandthat what made the surgeons I wassurrounded by truly superb was theirdemeanor and their kindness. Theirextensive knowledge of the medicine,diagnosis, and treatment was impressive,but it was the way that they interactedeach and every day with their patientsthat set them apart. The relationshipsthat the surgeons had with their patientsmade fighting cancer seem that mucheasier, but had a difficult side-effect:saying goodbye. Having such personalconnections made it so that when aperson died from the terrible disease, themedical staff didn’t just lose a patient, butalso a friend.While these relationships are what setapart the medical staff from any I haveinteracted with before, it was impossiblydifficult watching the pain they feltwhen patients died. When working withoncology patients, dealing with death ispart of the job. Before working in Brazil,I believed that the best way to handle somany emotions was to become immune tothem and thus become robotic and unattached.However, after spending so muchtime with the patients and staff, I realizedthat it was impossible to do so. Indeed, itwas the worst thing I could do as a medicalprofessional. Attitude and outlook areeverything in medicine, andshutting those emotionsout doesn’t make onestaff member better thananother. Instead, it restrictshow large an impact theyare able to make on apatient and their familymembers.The most valuablelesson I learned wasn’t aprocedure or a skill, butinstead something I couldnever learn in a classroom.Spending all day in an operatingroom and activelyparticipating made mereevaluate whether or notsurgery was something towhich I wanted to dedicatemy entire life. Now, surgicaloncology is the only careerI can imagine. I am confidentthat when I graduatefrom medical school andam placed in my own operatingroom, I will be ableto handle it well. I haveevery confidence that I amdestined to be a surgeon.It is the only thing that I want to do withmy life.Further, this confidence has transcendedmy desires to go to medical school. It hasgiven me much more motivation in everyaspect of my life. I am able to slow downand enjoy each of my classes instead offeeling anxious and unsure. Most importantly,I have become more stringentlymotivated to do well in all that must comebefore. The decision to seek an internshipand go somewhere unexpected haschanged my life for the better.In 2012, Alexandra Dulin worked in HospitalSanta Rita in Porto Alegre, Brazil for sixweeks. She was under the tutelage of Dr.Felice Riccardi, surgical oncologist.www.quepasa.osu.edu Spring Semester 2013 11