How did I get here?

The last two days have been consumed for our research team with a site initiation visit for a BARDA-funded project; I’ve previously alluded to my interest in platelet-rich plasma in the treatment of burns, and this project is part of that project complex.  As part of the visit, I was asked to give our visitors a tour of the burn unit, something I did proudly.  Our new burn unit that opened this past Fall provides the perfect home for our amazing team and our patients.

One of our visitors asked me how it was that I ended up in Burns, giving me the opportunity to share my story with their team.  I honestly did not start my surgical training expecting to end up in burns (nor did I start medical school anticipating being a surgeon, but that is a story for another day about “clerkship converts”).  My intention was to become a pediatric surgeon, and the key reason I came to Utah for my surgical training was to have the opportunity to work with Dr. Dale Johnson, a luminary in the field of pediatric surgery.  Over the first few years of my residency training, I realized that I still genuinely loved working with children…but I started to suspect that I would miss caring for adult patients.  I also found an interesting paradox in my clinical skills and interests:  while I loved the intellectual challenge and the decision-making demanded in the care of critically ill patients, I also found satisfaction in elegant, aesthetic-like procedures. As a young surgeon, you can see how this set of skills and interests might be confusing to manage.

My last clinical rotation of my third year consisted of three months as the “chief” in our burn unit.  I took care of children.  I took care of adults.  I worked some incredibly complicated physiologic puzzles.  I did some basic burn reconstruction, scar releases and the like.  I worked stupidly long hours (remember, dinosaur residency) and found myself eager to be there in spite of that.  I got to know Drs. Jeff Saffle and Steve Morris, men who would become my professional sponsors and practice partners, and realized that they were my people.  I found a home.

And in that home…stories that sealed the deal and changed my life.  The young man who sustained a 20-something percent burn from an electrical flash and who developed the most impressive acute lung injury I have seen someone survive- and whose ALI improved almost immediately when we excised his burn. He issued a challenge to himself and our team for him to be discharged prior to his 21st birthday, and with hard work on both sides we succeeded.  The father and two children whose home was destroyed in a propane explosion.  I have countless memories of holding the baby (who is now in junior high) upside down in my lap when I was finishing paperwork in the afternoons and evenings and Mom couldn’t be around.

In telling these stories, I was reminded- as I often am when I have a rare quiet moment to walk around our ICU- how truly privileged I am and we are to become part of these lives.  No, they don’t choose us; it’s a bit like our families, in which chance throws us together and the experience changes us all.

Burns?  I’m still not sure that I chose it.  It called me, and I keep answering.