I detested head and neck anatomy, even in first year. Why do I need to learn the five layers of the scalp? What’s inside a nose and why should I care about it? Why do all the tubes going down through the chest look exactly the same when they’re in there? It was a nightmare and I’m pretty sure if I could find my lacrimal gland, you’d have found it empty at every turn.
It wasn’t until my fourth year of medical school, in the throes of clinical clerkship, that I was first exposed to Ear, Nose and Throat (ENT) or otorhinolaryngology (ORL) as a specialty rather than simply a graded subject. While my time in ORL was only a week, it left a huge impression in its wake – so much so that I could not shake the feeling that that’s where I belonged for a very long time. So how (and why) did someone go from hating head and neck anatomy to wanting to perform thyroidectomies?
#1 The outpatient setting was so much fun
Do you remember those cartoons of doctors with the giant mirror lamps on their forehead in the comics? I never thought those were real. When I got to ENT, I realized that they were not only real, but totally true to size! They look and feel comical, but honestly, learning how to use them was the coolest part! The outpatient setting allows you to meet a wide variety of patients with a large number of various problems, and you get to learn how to use tools that aren’t used in any other specialty! Definitely a breath of fresh air!
#2 The marriage of diagnostic and therapeutic makes your world go ‘round
It wasn’t vertigo that had my brain spinning during my time in ENT, but the vast scope of practice! One of my favorite moments in ENT was when we had a patient come in for vertigo and we performed a maneuver to help diagnose it – known as the Dix-Hallpike maneuver. Within minutes, we had her diagnosed and performed a second maneuver, the Epley maneuver, which essentially cured her of the debilitating vertigo that she came in with! While in many specialties, we are able to follow patients throughout their course of disease, I loved that in ENT that our patients could walk in sick and walk out essentially cured!
#3 Is it medical or is it surgical? Either way, it’s the best of both worlds
There were days that we spent in the clinic, assessing and evaluating patients, but in the same breath, we could find ourselves in the operating room or in a procedure room performing maneuvers to help someone with benign paroxysmal positional vertigo, or performing a thyroidectomy on a patient with a large goiter! In a single day, the difference you make in these patients’ lives is tangible and I thought that it was cool to see patients in the clinicas, operating rooms, and back for follow-up, with real progress being seen every time!
#4 The gadgets, the toys, oh me, oh my!
ENT specialists get the coolest gadgets. From the toys we get to use in the OPD to the scopes and surgical modalities, this field is at the top of its technological advancements and they are not afraid to play! With operating fields as small as the back of the throat or inside a nostril, the tools they use are akin to magic and it’s so amazing to see how much they can achieve in such a small area. If you love technology, progress, and enjoy its applications in medicine, you truly have to look no further!
#5 The people
While it’s difficult and extremely dangerous to typify all specialties by their well-known stereotypes, I have to say that ORL far exceeded any of my expectations. Initially afraid of being bullied by residents, questioned about anatomy in the operating room, or yelled at in the hallways, instead, I was met with extremely passionate individuals who enjoyed teaching and really reveled in sharing their knowledge with us! They also never balked at buying their clinical clerks some ice cream, or making sure we had enough to eat for dinner!
I could never work in general surgery because I don’t have what it takes and I didn’t like cutting people open as much as my aspiring surgeon friends. My internal medicine rotations I found both draining, monotonous, and exhausting despite the large amount of knowledge I gained from the cases I was exposed to via my patients and the information shared by my attendings and residents.
ENT is the perfect balance. We follow our patients from day one in our clinics, can diagnose and treat many of their acute issues as outpatients, and on occasion, engage in a cool surgery or two using the most amazing technology. If you’re thinking you can’t decide between medicine or surgery, look no further because I know that ENT is right for you.