William Lao

June 2019

Q1) It is your Chief year! Did you ever believe this year would come? How would you reflect on the journey overall thus far?

It is incredible how fast it went by. I don’t think the reality of this being my last year sank in until I started experiencing various “lasts”… Doing certain cases for the last time (potentially), doing my last call at a certain hospital, doing my last rotation on a certain service, etc.

Overall, residency has been an exhilarating journey of extremes. There were some moments that felt like hitting rock bottom while, at other times, I felt like I was on top of the world. I wouldn’t trade it for anything else in the world.

 

Q2) So what is next?  Where are you off to in July? 

One step closer to becoming a trauma surgeon! I’ll be moving to North Carolina for fellowship training at Duke University. Who knows where life will take me after that?

 

Q3) What are you going to miss the most about residency?

The friendships you make while in the “trenches” of residency. Over the years, you get to know a lot of amazing people around the hospital. There is something uniquely pleasant about calling for a CT scan, for a consult, or for an OR booking only to greeted by a friend at the other end of the phone. These situations make you feel like you are part of something bigger and not just an anonymous cog in the massive machine that is the hospital. Going to a new institution means I will have to rebuild that network from the ground up!

 

Q4) Where did you go to medical school and how did you come about the decision to specialize in General Surgery? Was it something you gradually got into or is there an “aha” moment from your background or training?

McGill University. During pre-clerkship, I was torn between anesthesia and general surgery. Both specialties involved procedures, working in the OR, being part of a team, and dealing with potential emergencies. At the end of the day, one crucial aspect that was missing in anesthesia was the ward and the long-term relationships you develop with patients. Once I started rotating through surgery and meeting some amazing mentors, there was no looking back.

 

Q5) Where did you grow up and what did you do in your life before medicine? Not just professionally, but did you have any hobbies or passions that you still pursue?

I grew up in Montreal and, at the risk of sounding like a stereotype, my two greatest hobbies are piano and martial arts. Classical music and Sh?t?kan karate were two of my biggest obsessions before residency. I haven’t had much time to practice either in residency, but I look forward to re-integrating them into my life once I have more free time… preferably before retirement.

 

Q6) What is the most memorable thing that you have done outside of surgery in the last five years?

I managed to maintain a long-distance relationship across 3 different cities. And before you ask: Yes, it is with the same person. She just moved further and further away from me. Ottawa-Montreal, Ottawa-Baltimore, Ottawa-Durham… Maybe I should’ve taken the hint? I managed to become an expert at packing efficiently and at navigating the labyrinthine airports. Anyway, we’re getting married in September, so it will all have been worth it!

Q7) What was your most memorable night on call?

I saw a lot of stories around here about insanely busy or chaotic calls, of which I’ve had my fair share. My most memorable night is quite the opposite.

I was an R1 and I had just finished tidying up a few leftover tasks from the day. Around 7pm, I went to my call room to lie down for a bit. It was only supposed to be a quick nap before the inevitable onslaught of pages and consults. The very last thing I remember was closing my eyes. Next thing you know, my senior is frantically calling my cellphone to make sure I was ok. It was 7am and I had missed morning handover! I panicked and called central locating to see why my pager had not been working only to be told that there had been no calls to general surgery overnight. I still think fondly of that unusually quiet call. It was like petting a unicorn for the first and last time.

 

Q8) What was the absolute funniest moment during your residency?

Like most good stories in general surgery, this one began with a rectal foreign body at 1am. After failing to retrieve it in the emergency department, we booked the patient for the OR. I made one final attempt at retrieving the foreign body once the patient was under general anesthesia. My attending, who was standing in the corner of the room, away from all the action, asked: “So Will, what’s your approach to rectal foreign bodies?” As I thought he was joking, I sarcastically replied: “Get the damned thing out before I run out of arm length…” A few chuckles and snickers emanated from behind the anesthesia curtain. I thought I was being pretty clever, but I soon learned that my staff was definitely NOT in a joking mood. He immediately shot back “Is this a joke to you? This could be on your Royal College oral exam!”

It’s funny now in hindsight, but at that very moment, all I could do was shamefully stare at the floor while contemplating every life decision that has led me to be elbow deep in another man’s rectum at 2am while simultaneously being scolded by my attending.

 

Q9) How about the scariest moment during your residency?

We were doing what was a seemingly routine appendectomy. At this point in the case, I had just transected the appendix when a small glob of mucus fell out of the stump. As I reached for the suction, the glob started wiggling and moving around. What I thought was a small appendicolith turned into a writhing, wriggling, terrifying mass of pinworms. Everyone who was scrubbed in simultaneously let out a high-pitched scream that scared the living daylight out of our circulating nurse and anesthesiologist.

I won’t lie, I was very tempted to just turn the cautery to 80 spray and burn everything. In the end, we painstakingly chased down every single one of those buggers. I took a long shower after that case and bleached all my clothes.

 

Q10) Do you have any call superstitions or routines?

Don’t say the “Q” word! Don’t go looking for trouble! And don’t piss off the nurses!  Not sure if the last one qualifies as a superstition, but I am a firm believer.

Q11) If you could give some words of wisdom to new Residents starting General Surgery (or to your past self on the first day of residency) in the light of everything we’re facing these days across Canada (limited jobs, duty hour restrictions, more and more specialization), what would it be?

“One foot after the other.” Residency can be a marathon and I know how difficult the junior years can be. At times, you feel like you can barely keep your head above water. Each day, you are pulled in every direction by competing priorities: clinical work, personal wellbeing, research, call, exams, studying, family, etc. I want you to know that it does get better. At some point in residency, things will come together naturally, but it will take years of effort. You must put one foot in front of the other and keep going. Do your best, stand up for yourself, don’t be afraid, but don’t be stupid. Fortune favors the bold (and prepared). It will all be worth it!

 

Q12) Rapid fire:

What do you listen to in the OR?  Personally, I am a big fan of movie and game soundtracks, but I will play whatever brings joy to everyone in the room.

What is the operation you dislike the most?  Lysis of adhesions in a hostile abdomen for small bowel obstruction. Doubly soul shattering if you don’t find a clear transition point.

What is the operation you like the most?  Emergently: Any major trauma cases, Electively: A straightforward lap chole or lap right hemi

What is your favourite medical TV show?  Scrubs, by far. It manages to be both ridiculously surreal and deeply human at the same time. There is definitely a marathon of all 8 seasons planned in the future. Season 9? Never heard of it.

What is your go-to surgery textbook?  Cameron’s and Sabiston’s for “general” general surgery, Top Knife and Mattox’s Trauma textbook for trauma, ASCRS textbook for colorectal

Favourite post-call activity?  Cooking, sleeping, playing video games, and watching documentaries

What is your favourite “go-to” food on call?  Whatever I managed to cook the night before.

White coat or hoodie?  Neither. I somehow keep losing both…

Single or double glove?  Double glove

Dry scrub or wet scrub?  Dry scrub

Trauma laparotomy or elective Whipple?  Trauma laparotomy. Get in there!

Inexperienced junior resident or inexperienced ER staff?  Inexperienced junior. Call together can be a learning experience for both of us. It’s where we all began!

Open inguinal hernia repair or laparoscopic?  Open

Monocryl or skin staples?  Staples

Perianal abscess I+D or ingrown toenail?????  Perianal abscess I&D. Put your face shield on and get the suction ready.