Many physicians can look back in their life and find a pivotal point, an event that changed the direction of their lives. They may even have several such moments. It could be the day they decided to become a physician, or the day they picked their specialty. For me it was the day I decided to finish medical school and become a general surgeon. So on this Thanksgiving Day, I would like to say thank you to the man who created that pivot in my career. I might not have had a career in medicine if it were not for the influence of Dr. Donald D. Trunkey during my fourth year of medical school at Oregon Health and Science University (OHSU).
Our medical school curriculum was laid out to do the first two years in the class room learning basic sciences and the second two years in the surrounding hospitals and clinics. I slogged through the first two years awaiting the time when I could actually do the work of a physician. Physicians don’t just sit in lecture halls all day, they help make people well.
I started my third year with a three month clinical rotation in pediatrics. I spent that whole rotation sick. Every bug that came into the clinic was passed on to me. More than one of my weekends were spent hugging the toilet with projectile vomiting. Often the kids couldn’t explain what was wrong, leading me to feel like I was practicing veterinary medicine, where you have to rectify the problem without the help of the patient.
I was happy to move out of pediatrics into a different specialty. My next three month rotation was spent in OB/GYN. Working in OB/GYN, like pediatrics, was not an enjoyable experience for me. The smells in the delivery room as well as the clinic were not to my liking. And the redundancy became unbearably monotonous.
My third rotation, internal medicine, was at the Portland VA medical center. During this three month rotation the group of patients I saw kept coming back over and over again with the same problems. It seemed like no one was being healed. We saw patients with lung disease who wouldn’t stop smoking and diabetics who would return in crisis because they wouldn’t take their medications. I felt like I wasn’t making an impact on these patients’ lives because they weren’t getting better.
At this point I was beginning to feel like medicine was not what I thought it was, and what I had been doing was certainly not what I signed up for. I became discouraged. All this work, all those years, and all that money to become a physician, what I wanted since I was a kid, was seemingly not what I wanted after all. I was on the verge of quitting medical school. My heart was no longer in it, which reflected in my medicine rotation grade; marginal with recommendation for another 6 weeks of internal medicine. I was pretty down on medicine.
I had just recorded an album of original music which was a lot of fun. I began to compare the two options: Medicine vs. Music. But quitting medical school is a huge decision with some big consequences. I was on a military scholarship, so what would the Navy do if I quit? How would I feel if I quit? What would my parents think of me if I quit? Could I make a living as a musician? There were a lot of musicians that I knew who were better than me that didn’t eat very well and had to bum a ride to gigs.
I decided I would go ahead and start the next rotation which was my final required block, general surgery. I started on Dr. Trunkey’s service. Here I was on the verge of quitting and I had to do a rotation with the new Chief of the Department of Surgery. He had only been there for about a year at that time, after having been recruited from San Francisco.
As I started my general surgery rotation, knowing nothing about general surgery, I was assigned to my first day in the OR with Dr. Trunkey. Just the two of us. Can you imagine how I felt, as a medical student, who usually trained under residents or junior attendings, to be assigned to work with the head of
the surgery department? I prepared by reading about the case and I felt that I was as ready as I could be, but I was a little apprehensive that morning as I left my apartment.
I got to the operating room before Dr. Trunkey. When he arrived, the anesthesiologist was putting the patient to sleep. Dr. Trunkey seemed to be in a bit of a hurry. He looked at me and asked if I had ever put in a Foley catheter before. I said, “No.” I thought he would get on my case for that or snap at the nurse to get the catheter in so we could get going. But, that is not what happened.
The great Dr. Trunkey said, “Go get some gloves and I’ll show you how.” He walked me through the steps and I put in my first Foley catheter. I do
n’t remember anything else about that day. There is an enormous gap between a medical student and the chief of the department at a teaching hospital. When he took me under his wing and said ‘let me teach you what I know,’ it changed my life.
Maybe all my prior training was taught by a resident who was at the end of his rope, or a junior attending who was nervous about getting bad results, or a post call tired physician. As a medical student, you don’t often get to be the first assistant to a professor. There are just too many other residents and fellows wanting that spot. It was almost like I could hear music playing and angels singing. That day, I experienced what it was like to be a physician. I saw a true leader. I saw the physician I wanted to be.
My attitude took a 180 degree turn that day. The rest of my time on his rotation was one of the best times I had in medical school. On this service, we were fixing things and healing people. If someone came in with appendicitis, we took the appendix out, saved their life and they never had that problem again. If someone crashed their car and ruptured their spleen, we took it out, saved their life, and it would never happen again.
I discovered that I was a fix it man at heart. General surgery was just what I needed. My mind was made up, I would finish medical school and become a surgeon. My grades changed from marginal, to honors after that first day with Dr. Trunkey.
Now my student evaluations said things like: “Energetic, very interested student,” “Constantly came to the OR prepared by reading about the case in advance,” “Increasing fund of knowledge gained by a significant amount of outside reading.”
It is possible to go from being a marginal student to an honors student in only one day. I know because I did it with a simple change of attitude. I did it because one man took me under his wing and showed me what it’s like to be a great surgeon. I went on to practice general surgery for 23 years and now I am teaching other physicians to have a better life with better financial planning.
I don’t know how many medical students, residents, and junior faculty crossed paths with Dr. Trunkey over his career. He graduated from medical school in 1963 when I was only a year old. He stopped practicing medicine in 2007 at about the age of 70 when he was made surgeon emeritus and spent the next 8 years continuing to teach surgeons though lectures before fully retiring. Thousands of physicians were influenced by this one great man, not counting the hundreds of thousands of patients who were benefitted by his teachings in the world of trauma surgery. His influence also had a ripple effect to the thousands of patients I, and others like me, treated because of his influence.
Thanks, Dr. Trunkey, for changing my life and making it possible for me to have a rewarding career in general surgery.
If you would like to read other great stories on the lives Don Trunkey has touched, please visit dontrunkey.com.
Who should you thank for creating a pivot point in your life? I hope today you will remember those who came before you and paved the way for you to have a great and rewarding career in medicine. Maybe you could tell a story of such a person over your Thanksgiving feast today and encourage others to share as well.
Happy Thanksgiving.
I looked up Dr. Trunkey for the first first time since my car accident in SF 1985. Hit by a drunk driver , I was sent to SF General. My right bronchial tube blew off my right lung . Not many coukd do this surgury but he saved my life . If it weren’t for Dr. Trunkey I would not be alive today. He was a hero. Thank you for this post ! Amazing man .
Oh Dear, It was serendipity that Jane shared a joke and her message back never mentioning Dr T. So I googled, fearing lousy news, and that’s how I found that ‘Trunkey’ (as I knew him) had left us wayyy too soon. That disease robs one of everything and I’m sure he hated living with it. I was recovering from a femur fracture and was drugged for a few months including May. Like others, Dr. T got me into a career spanning 27 years, starting in the old Mish, as we called the old ER, run by Gladys Jones, whom we adored, in 1969. I was evaluating the suicide attempts in the rubber room, he was doing trauma early on, and as I saw patients in the med surgical units we became friends. When he one weekend snuck into the basement, where any drug one wanted was being dealt, and he brought a few funky beds and an old claw foot tub up to a really shabby closed ward and started a BURN UNIT, he asked me to meet with the nursing staff, who were having nightmares of the patient screams during painful debridement, and were threatening to leave. Sure, I’d have done anything he asked, and burns were a pretty challenging introduction to Trauma. I loved it and we truly developed a close knit family of nursing staff with consultants from St. Francis and his leadership. We heated food on old noisy registers, walked our patients into the tub room, and really had some awesome successes. Chasing little ones through the dark corridors was one of the most challenging creative things we did. Treating abused wee ones broke our collective hearts. But Trunkey brought out the best in staff, and we all wanted to be better, for him. When we moved into the new hospital we stocked the frig with Rainier Ale, one calorie per cc and tastier than Ensure. A brilliant Trunkey idea, and he taught us all that food was the best antibiotic. I’ve quoted him so often, and not just about antibiotics. We did a few burn meetings in New Orleans where not only were there oysters and jazz, but the most bawdy artwork in the back room of his favorite gallery. Trunkey was a great storyteller and loved showing his most gory slides at meeting and teaching house staff. An arrow to the head was a favorite. My favorite story probably happened in the new hospital where, besides telling new house staff they had best listen to the nurses, and ask questions because they knew more, he told me once when I knocked on the office door too bitch about some ‘youngster’ that asked was he Jewish (knew I had trouble with men much like I had grown up with, spoiled by mums) said he’d tell them there was room for only one prince or princess in our castle, and the job was taken. He always had my back, and I adored him. We all knew how much he ADORED Jane and the family, and couldn’t wait to get home to them, UNLESS a big trauma came in. He was bigger than life, and funnier, and truly loved trauma, teaching and doing. And didn’t suffer fools, so when he moved up to Oregon I got into trouble with a new burn plastics guy and moved up the floor to the Trauma ICU where I made a new fabulous home for myself, but quoted my buddy often and missed him always. Jane, ‘kids,’ you lost him wayyyy too soon. The last conversation we had several years ago was his hoping the College would figure out a way to test surgeon’s ability so he could work for lots longer, in the OR where he was happiest. If God needs any help choosing beers or wines, or maybe treating a burn from down below, he’ll be there to help. My heart breaks for you all. There will never be another Dr. Trunkey.
Hugs and much much love,
Carol Fink
Carol,
Thanks for your memories.
I love this!!
Thank you for posting your experience with my Dad. We will all miss him, his stories, jokes etc…
Kristi Jo
Kristi,
It was my pleasure. He changed my life. He will be missed by many. I’m sorry for your loss.
Cory
Nice story about my Dad. I’m trying to collect stories like this at dontrunkey.com . Would you be willing to write and entry. Contact info is there. Thank you.
Derek, what a great idea. I’m sure you will have many stories just like mine. Feel free to use my story.
A good physician can help a lot of people. A great one can help even more by expanding their reach through teaching, research, service development, and leadership. Sounds like Dr. Trunkey was one of these gems. From what you’ve written here and in your books, it is also clear that he taught you a lot more than clinical surgery.
In medical school onward, I was on a history of medicine kick and got to know Dr. Trunkey through his book recounting the history of San Francisco General Hospital (written with Blaisdell). I was awed by his accounts of that institution, which I rotated through as a medical student during the AIDS epidemic, as well as by his influence in trauma surgery. It’s wonderful to hear that in addition to being a compelling writer and pioneer, he was also a wonderful mentor to you.
That is a great post. Reflecting back, I had almost the exact opposite experience from you. I was terrorized in surgery by residents who picked on each other and on the hapless medical students. I could not move or see much at all while holding a retractor and endured questions mixed with verbal abuse that went on for hours and would not be tolerated at all today. I went from surgery as a broken 3rd year to internal medicine where I saw groups of residents and attendings researching and arguing among themselves, trying to figure out what was helpful and what would work to help patients. I had a fellow instruct us to interview a patient both to find out how this illness presented but also to find out how his life had shaped the decisions he made. The respect they showed to each other and to the older patients impressed me and I began to offer answers to questions by the end of the rotation. By pediatrics I had regained my equilibrium. There I witnessed genuine miracles in how antibiotics given quickly after a timely diagnosis saved lives in meningitis. Moribund children were riding tricycles down the halls 10 days after their first doses of Amoxicillin and gentamicin. Who could not want to participate in miracles? I fell in love with pediatrics in the capable hands of an 80 year old pioneer of pediatrics. He was kind, wise and thoughtful. He had stories of tetanus and polio and spoke of the miracles of antibiotics, vaccines and ventilators that he had witnessed. He watched us do exams, showed us how to use instruments with wiggly toddlers and how to listen to mothers for the things they did not say. Now I’m the older pediatrician with nursing and medical students. I want them to experience the courage of our patients and their families. I want them to have the curiosity to read and research and discover. It is an honor to be part of the river of medicine. So appreciative of all of the attendings and residents who took the time to teach me.
Thanks for your story Mom MD. Sounds like a great mentor crossed your path at just the right time.
Amazing at what a turnaround your life took because of a single rotation.
He sounds like a great man who really loved teaching and as you stated influenced so many people because of it.
Every now and then you come across a great individual like this and it is your duty to garner as much knowledge as you can from them like a sponge.
With your books and blog you are more than paying it forward to future generations
Happy Thanksgiving. Have a great one
I can look back and reflect on quite a few positive and negative “mentors” and experiences back in medical school that has shaped the way I practice medicine.
I remember that my first rotation during third year of medical school was inpatient Ob/Gyn. I had no idea what it meant to round on patients, what I was even presenting (why was everyone hospitalized, and I guess that preeclampsia is supposed to be normal?). I was very miserable and hated the specialty!
Fast forward when I had my son and finally came to understand the profession more fully. If I had to repeat my 3rd year ob/gyn rotation now, I would rock those presentations! 😉
What a nice post. I mainly remember negative influencers from medical school and residency. I guess influence can be in a positive or a negative direction.
Lots of great lessons here.
Like:
Listen to your inner voice.
Be thankful to those who gave of themselves to help you.
We all enjoy different parts of our work.
“The only way to heal is with cold steal.” LOL. Had to throw that in.
I’m so glad I have been involved in teaching and mentoring for my 20 years. It makes me think I made the world a slightly better place.
I’m also thankful that I resisted clicking on the ad in the middle of this article offering 100% financing up to $1.5M. Oh the irony.