The first incision

An unexpected spark

The moment I realized it was time to decide on a specialty came from a place I didn't expect: my Women's Health course in second year.

That course felt different from the rest of the preclinical grind. It wasn't about memorizing pathways and obscure facts. It was built to prepare us for clinical rotations and the third-year shelf exam, and every lecture felt grounded in real practice. For the first time in a long time, I was excited. I could see the road ahead: patients, diagnoses, treatments. It wasn't theoretical anymore.

What stood out most were the OB/GYN physicians who came to teach us. They knew their material, but more than that, they were genuinely happy. You could hear it in how they talked about their work and see it in their stories. It was contagious.

For a moment, I seriously considered OB/GYN. A young patient population, a mix of elective surgery, clear algorithms that guide complicated decisions. Later I'd realize those were the same things that drew me to orthopaedics. But at the time, it shook a decision I thought I'd already made.

So I started shadowing again. It felt like déjà vu, revisiting a choice I'd thought was settled. But I needed clarity, and shadowing was the place to start.

A threshold I'd never crossed

Here's something I'm a little embarrassed to admit. Surgery had been my dream for as long as I could remember, and I had never once stood in an operating room.

Maybe that was a mistake. Maybe if I'd shadowed in an OR earlier, I wouldn't have felt like an imposter standing at the edge of something I had no business seeing.

I'd imagined my first case a hundred ways. Something orthopaedic. A clean fracture reduction, maybe a joint replacement. Something precise and mechanical.

Instead I walked into a scene that felt like chaos.

The case

The patient had preeclampsia and was having a semi-elective C-section. I didn't understand it at the time, but this was not a straightforward case. Two surgeons were scrubbed in, and that alone should have told me something.

And me? I was a second-year medical student pressed into the corner with another student, wide-eyed and completely unprepared.

The moment it unraveled

The moment they made the first incision, something in me started to come apart.

I still don't know exactly what set it off. Maybe it was realizing that one day I would be on the other side of that table, holding the scalpel. Maybe it was the sterile hum of the room, the smell of antiseptic mixed with something unfamiliar and human. Maybe it was a sudden, crushing doubt that I'd made all the wrong choices.

My mind raced. One day that will be me. What if I can't handle it? What if I freeze? What if I make a mistake?

Sweat pooled under my mask. My breathing went shallow and fast, and I wondered if I was hyperventilating. My vision started to tunnel. For a terrifying moment, I thought I was going to pass out, right there in the corner of my first OR. I remember thinking that would be worse than anything. Pull it together.

So I breathed. Deep, slow, controlled. In, and out. The whole world shrank down to that rhythm. It didn't make the moment smaller. It just gave me something to hold onto inside it.

The turning point

And then, the baby was out.

Something shifted. I wasn't going to pass out. I wasn't going to walk out. I wasn't going to let this moment decide who I was.

What I couldn't see then

Now, as a fourth-year medical student, I look back on that case and realize how wild it was. It's still one of the bloodiest cases I've ever seen. Hemostats everywhere. The surgeons moving fast to control the hemorrhage. The room tense, but practiced.

And there I was in the corner, barely hanging on, trying to make sense of any of it.

By the end of the case, the bleeding was under control. The surgeons were in control. And I was in control again too.

But I walked out of that operating room knowing one thing for sure: I had a lot to figure out.

Where it led

That day didn't end my path toward surgery. It started a more honest version of it. I'd come into medical school already leaning toward orthopaedics, after months of podcasts and videos about different specialties before first year. None of that had prepared me for what it actually feels like to stand in an OR.

That's the gap you can only close by showing up. You can research specialties endlessly, but at some point you have to stand in the room, feel what it's like, and see whether you still want it afterward. I still did. I just understood, for the first time, how much I had to learn.

What I learned

• Get into the operating room, or whatever room your specialty lives in, early. No amount of research replaces standing there.
• Feeling like an imposter in a new setting doesn't mean you don't belong. Sometimes the most useful thing you can do is breathe and stay.
• A wobble about your specialty isn't a failure. Revisiting the decision with an open mind is how you make sure it's the right one.