An Honest Journey to Medicine: An Interview with Dr. Steve Young

When given the assignment to interview someone in the position I hope to reach in the future, I was not quite sure who to ask. While I know I want to enter the medical field, I have yet to figure out whether I want to pursue medicine in an academic setting, do research simultaneously, or practice at a community hospital. And don't even get me started about specialities.

So, instead of trying to figure out my exact career plans, I decided to interview someone in the medical field who genuinely loves their work - Dr. Steve Young. Dr. Young is a surgeon at John Muir Medical Center where he has been practicing general surgery for the past 15 years, and I was honored to have the opportunity to interview him to learn more about his journey to medicine.

Q: What did you major in in undergrad and where?

"I went to UC Davis for undergrad. I majored in psychology and I had a minor in rhetoric and communications. I think I finished my psychology major early during my third year, and I just needed something to do for the extra year, so that's why I chose rhetoric and communications. It just seemed fun to learn about speaking and communication. I chose psychology just because I didn't want something too science-based, I wanted something a little bit more well-rounded, but I did get a bachelor's of science in psychology. I enjoy people and learning about people so it fit for me."

The most striking aspect of Dr. Young's answer to my first question was that he chose his path of study based on his interests and not according to what he thought was expected of him. While biology, biochemistry, and other science majors are very common for pre-med students, Dr. Young cared more about learning about people, leading him to choose psychology. Additionally, his minor did not come about due to thoughts of creating a more impressive resume, but simply because he thought it would be "fun". This response was inspiring because it showed me that following your interests can lead to your final goal, even if the path is not the most traditional.

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Q: Did you ever encounter any failures that dissuaded you from entering this field or any successes/triumphs that reaffirmed your career aspirations?

"Well, New York Medical College, had what we would call a traditional curriculum. So your pre-clinical years or during your first and second year, you had no real exposure to patients - it is all classroom work. My first semester was anatomy and histology, which I enjoyed very much because anatomy, you're dealing with the human body, but my second semester was biochemistry and physiology, and I actually struggled with that quite a bit...

With that struggle, I did question whether I wanted to be a doctor at that point, so I actually took a year off between my first and second year. My friend suggested I go out to Detroit, Michigan to a program that they had out there for medical students to get clinical experience. That actually helped me tremendously to reinforce the reason why I was going into medicine... And call it fate or whatever it may be, I met my wife, Betty, out in Detroit, Michigan, so there was a reason for all of that."

It was reassuring to learn that Dr. Young had faced a similar struggle as many other pre-med student, myself included. In my experience, difficult chemistry courses cause students to debate if they will be able to medicine in the future. Seeing how Dr. Young stepped aside from his classroom learning to gain relevant experience and reinforce his love for medicine was empowering as it showed me that a few challenges in coursework do not have to be the end of your dreams to become a medical professional.

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Q: How did you decide that medicine was the right path for you? How did you choose your speciality?

"Growing up, I always knew I wanted to be in the health field and most likely be a doctor. That's what every kid dreams about at the time. My parents were both pharmacists, so they were in the health field and they talked about work sometimes at the dinner table. So it just seemed kind of natural and I had a propensity for science and learning... I think what really influenced my decision to go to medical school is that I got into medical school.

... during my third year rotations in the hospital, my first rotation was OB GYN and I actually enjoyed it very much, especially the surgical part of that rotation. But then after that, I did pediatrics and I did family medicine. Before that, I thought I was going to go into pediatrics because I love kids, but then I did the rotations and I dreaded it, I wasn't interested anymore. So I was getting pretty discouraged and my very last rotation during my third year with surgery and I did at a community hospital. Everyone thinks, 'Oh, your surgery rotation is gonna be so hard, the attendings are so mean,' but I had a completely different experience. The surgeons I worked with were so collaborative, caring, teaching, and I just fell in love with it - being able to see a problem and then being able to fix it.

That's what I really wanted to do, opposed to just maintain someone on medicines or whatever it may be. Those are important aspects of medicine too, but I wanted to be able to fix people. The other thing that helped me with my decision was that someone once told me if I were ever, let's say stuck in the middle of Africa or India or wherever it may be, it's beneficial because you can really help people. Let's say you decide, you went to internal medicine and you go overseas and you're middle of Africa and you need to help someone with a surgical problem. You probably wouldn't be able to help them. So, that also influenced my decision, that if I were to ever do work overseas, I would have the surgical training."

One of the more common questions for anyone in the medical field is "Why medicine? Out of all the professions that exist, why become a doctor?" This question is one that I ask myself very often to ensure that I am still pursuing this career due to my passions, not due to any other influences, so I thought it would be interesting to see Dr. Young's reasons. I was glad to hear that it was a combination of interests and skills, and I enjoyed the honesty about him being able to pursue medicine largely due to the fact that he was accepted to medical school.

However, I was particularly fascinated by his decision to become a surgeon. I used to dream of becoming a surgeon, but stereotypes of surgeons being insensitive or treating patients like cases instead of humans made me hesitant about that career path. Hearing those ideas dispelled and learning about the wide applications of surgery brought the career back into my consideration, but I also believe I will not be able to decide until my clinical rotations during medical school. Additionally, I enjoyed the fact that Dr. Young continues to hope that he practices overseas, which shows that even within the field of medicine, there is always the opportunity to learn more and work outside your comfort zone.

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Q: Did you ever consider working in an academic medical setting or even having your own practice? Why or why not?

"I was never really interested in academic medicine because I didn't ever intend to publish or write papers or anything of the sort. I didn't intend to be teaching residents per se. I just wanted to practice and do the work, which was very hard. My first day of work, I was on a trauma call, which means you deal with any accidents or gunshot wounds or stab wounds that come into the hospital. In residency, you're used to working with an attending surgeon, you have your coresidents, whoever it may be, but the hospital I was working at, there were no residents, it's all you. The very first night I had a stab wound to the neck and I had gunshot wounds and automobile accidents and it was on me. So, it was a tough, I mean, it was a very tough first day, and it really threw me into the swimming pool, but I was able to do it. So, you know, after a while, I just loved practicing medicine and practicing surgery and yes there are people that are great teachers out there, maybe that is something that I could do, but I didn't really have the interest at the time.

I think it's always important even in practice to learn new ways, to do things, to be curious. Sometimes people do things and they say, 'Oh, this is the way I've always done it, but then is it really, truly the best way?', and I think through my practice... I find myself doing things differently and finding new ways to do things that people haven't published and it's more efficient. Then other colleagues may hear about me doing it a certain way and they catch on and they start doing it that way. Maybe I should be in academia so I could publish the way I do stuff, but I don't."

Upon hearing my goals to become a surgeon, one of my peers once asked me why I would choose to go into a field that does almost the same thing everyday, bringing up the idea that doctors would sometimes compete to see who could complete procedures the fastest. This led me to considering entering an academic medical practice due to the combination of constantly evolving research and clinical practice. However, Dr. Young's response showed me that it is crucial to be introspective and constantly work to improve existing techniques - it is a medical practice after all. While I learned that working at a community hospital did have variety in the daily activities, I only ended up with more potential career paths.

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Q: What is something that you think could be improved in the field?

"I can't think of anything that I would change for myself because I just enjoyed it so much. Actually, the majority of my training occurred before there were restrictions on a number of hours you could work per week. I think it was in 2004 when they changed it to 80 hours per week. Prior to that, there were times or a whole month where I would be working every other night, so I would be on for 36 hours straight and then maybe 12 hours off and go back to work. So that changed. As an attending, I was kind of used to those long hours, but over time it can be taxing. There has been a big movement recently to have a separate specialty for acute care surgery, because oftentimes you have to be on call, you may have to be even been in the hospital, and it's more shift work. You can see that as an improvement in some fashion, because for the provider, it's probably better in terms of lifestyle reasons and things of the sort.

However, I think there may be a loss in that providers may not have the same ownership of a patient over time. It's kind of hard to explain, but sometimes when you take care of a patient, you want to see things through. That's the kind of person I am cause I like to fix things and make sure that patients do well, but now, with shift work, you don't really get to follow that over time. At our hospital, we haven't quite transitioned to that type of model, but I think there is a push and I think there are benefits to that for safety - we don't want doctors that are tired. But I think there is something that's going to be lost and that's the whole process of seeing patients through from admission to discharge and even after discharge. You lose some of those things that I enjoy about surgery."

I was curious to see if there were any issues that could be improved from the perspective of an experienced surgeon. Dr. Young shared that he enjoyed his work and did not see the need to change anything regarding the field. However, he did mention a new program that would reduce the time surgeons need to work, which benefits the work-life balance for providers and can protect patients from errors from exhausted doctors, but shared how it did not fit with his treatment style and could negatively impact the patient-doctor relationship. I do appreciate the emphasis on working normal hours, but I believe that patient interactions will be one of the most important aspects of my work for me, personally, so I am interested to see how hospitals will adopt this policy in the future.

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Q: Is your job what you expected it to be?

"I think I'd never thought about the gratification that you get from saving someone's life. Especially when I used to do trauma, there were some great life saving measures we've done. One story I do remember is when there was a really sick patient in the ICU and the patient was so sick that they couldn't go to the operating room. One of the doctors called me down to take a look at them and I ended up having to explore his abdomen at the bedside. He was already intubated and sedated, and basically, I had to remove some bowel and [I] did the whole surgery right there in the ICU. Later on we were able to close up everything and he did well and got out of the hospital.

Five years later, I was in the hospital and this woman comes up to me and she says, 'Dr. Young, you're Dr. Young right?' and I said, yes. And she goes, 'Oh my, my father has to say hi to you.' So I follow this woman over to this older man that was sitting on the couch and he was playing with his grandchild and she reminded me that he was the person that I saved five years before in the ICU. So I just think about that. It's just an amazing experience, I wish that everyone could experience that feeling. It's always going to be different, whatever field you do, but in my field it is just one of the benefits that I would not trade for the world."

Hearing this story was incredibly heartwarming and reinvigorating. When going through school, it is easy to lose sight of your inner "Why?" Why do I have to study so much? Why should I join this extracurricular activity? The answer for most is stories such as this one. The ability to have such a profound impact on a patient's life is incredible and unique, and that is the "Why?" that I remind myself of whenever I am trying to prevent burnout.

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Interviewing Dr. Young was encouraging because I was able to learn about the challenges he faced on the path to becoming a surgeon. I often imagine doctors and surgeons as having been perfect throughout their life - always maintaining the best grades and never faltering in their desire to enter the medical field. However, understanding that this was far from reality reassured me that as long as I keep working towards my goal of becoming a doctor, I will reach be able to achieve it.