Neurosurgery Poker

Despite my efforts to be a great upstanding doctor/physician/surgeon or even human being for that matter, the people that really know me will tell you that one of my greatest vices is my love for poker. It was more of an addiction during medical school when the paucity of required classes and countless hours dedicated to studying/research but otherwise unaccounted for would lend itself to me making a trek to the casino to play a few hands of cards. OK so it wasn't a few hands, as there were definitely nights when my buddies and I would leave as the sun was coming up. Still, I thought of it as training for my future in neurosurgery. If I could focus and stay awake for that many hours in one place, I was obviously training myself for the long surgeries and nights on call. I never imagined it could work the other way around.

There were parts of poker that had always appealed to me, relying on the ability to read the intentions and emotions of others to make your next move, being able to guard and secure your own feelings to control the stage of the game, knowing which battles were worth fighting and which retreat was actually winning, and then being rewarded for your mastery of these skills. Poker was an extension of the finer emotional gauntlets of life, and life just another extension of texas hold'em.

In neurosurgery, or maybe it's just residency in general, I've found that it's oftentimes a very similar hand of cards. Having to tell patients that their prognosis is still uncertain, that there might be hope, despite your short but sufficient experience telling you that they only have months to live. Delivery with confidence, cool, and reassurance is key so they do not despair or abandon any further tests that are needed for future treatments that may not ultimately affect their life expectancy. One has to be agreeable despite the occasional cockamamy plan of the attending surgeon, and then convincingly convey to the patient that this is the best course of action despite one's own beliefs (oftentimes in line with the resident team). Moreover, one must perceive the emotional status and intent of nurses as well as the patients to know if there's a firetrap on the horizon and how to best appease their wishes. Fighting with either of these parties is like fighting with the dealer, and will only get you expelled from the table, and usually with no winnings. I do not wish to suggest that neurosurgeons are deceiving swindlers that manipulate and scheme. Quite the contrary, I feel that our role is to create hope where there is none (in the face of certain death, wouldn't you want that chance at life?), maintain tranquility in a place where stress and suffering occasionally unearths the worst in people, and promote faith in the doctors that are treating them (despite idiosyncracies and ideological differences).

Or, it may just all be BS and I had a great night at cards this weekend despite my residency training. Who knows...