In the Loupes: ‘This is what I am meant to do’

In the Loupes iconBy Alex Cuenca, M.D.

Though I’m not sure how I exactly got where I am today, I could probably trace it back to my father. In 1980, we lived in a growing city in the south of the Philippines. I can still remember sitting in my father’s office as a child. It was a medium-sized room that had a largish cherry-oak desk with matching bookshelves against walls painted the very standard and universal, clinic lime green that was pervasive in medical suites everywhere. A large, white stone encased in paraffin sat on my father’s desk. When my father entered the room after a case, I asked him about the stone. He told me a story about an indigenous man who was carried into clinic by his family, emaciated from infection and lack of nutrition, in obvious belly pain. When my father took him back to the OR, he found the largest bladder stone he had ever seen. The stone was probably the size of my father’s fist, and now sat on his desk embedded in paraffin. Knowing now what the clinical consequences of something like that are, I’m shocked that the man was able to tolerate such pain for so long.

My father had a special relationship with some of the rural town folk and we, his children, were often exposed to it. He would frequently provide them medical care for no compensation, but would sometimes receive gifts, like fresh fish or little “watches” made of palm fronds for his curious son that was seemingly always in his office. It was in these moments, spending time with my father, that I probably unconsciously decided that I was going to be a doctor and, more than likely, a surgeon. Though my father passed when I was a teenager, when I think about how much I enjoy taking care of patients and talking with families, I can only imagine that he felt the same.

However, when I was in medical school at the University of Florida, I did try to not bias myself towards surgery. In fact, because some of my early research experiences were with my first research mentor, Eduardo Sotomayor, M.D., a Hematologist/Oncologist, I thought for sure that I would follow in his footsteps. But when I rotated on the general services as a third-year medical student, I fell in love with the OR and critical care. I became infatuated with the idea that a surgeon could take care of most, if not all, medical problems if he/she needed to and worked within a team, both inside the OR and outside. I loved how my attending surgeons embraced this concept of “patient ownership” and could really see myself in their shoes more than in any other medical specialty.

Currently, I’m a 6th year surgical research resident about to complete my Ph.D. with a dissertation centered on neonatal sepsis. I will return to the hospital this summer in my third clinical year post graduation. I am more focused about my career goals and plan not only to be a pediatric surgeon, but also an immunologist with a focus on neonatal innate immunity. I “blame” my father, as well as my current research mentor, Lyle Moldawer, Ph.D., and my past research mentor, Dr. Sotomayor, for encouraging me. Though I’ve wavered on both ends of the spectrum as to whether or not I would be happiest doing only clinical work or only research, I always come back to center and realize that though it may be difficult, this is what I am meant to do. I also have explored clinical and translational research projects, and most recently won the American College of Surgeon’s Committee on Trauma (COT) resident paper competition at both the state and regional level for work investigating the role and applicability of laboratory research models to the human condition they are purported to study. I was also fortunate to be chosen to present this work to the National COT in March. I look forward to continuing on with these clinical studies, as well.

Now as a father myself, I look at my two sons and wonder if they will follow in my footsteps. I look at their hands and smile, secretly hoping that I’ll be able to operate or work in the lab with them, side by side. I wonder if my father ever did the same with me. Wherever he is, I’m sure that he is smiling and has at least partially, if not completely, approved of what I’ve chosen to do with my life — since he had such an instrumental part in it all.

“In the Loupes” is a monthly, online column meant to give readers insight into what it is like to be a surgeon today. Faculty members and residents from the University of Florida College of Medicine’s department of surgery write the columns based on their experiences in academic surgery. Views expressed here are not necessarily those of the department of surgery, the College of Medicine or the University of Florida.