Anthony Chin-Quee - Independence Day

 

 

All right. Okay. So, July 1st. This is the day that I, having just graduated from medical school, finally a fully-fledged doctor, right? [audience cheers and applause]

 

I was unleashed on the unsuspecting public. Now, on June 30th, I was nobody. Just a very ambitious but ultimately very useless little lap dog with an adorable short white coat. But on July 1st, I got that long white coat. It was crisp, and it had these pockets that were filled with stethoscopes and prescription pads and of course, the terror that I would be found out as an incompetent fraud. And that terror completely valid, primarily because of the unofficial intern year credo. We be fucking up. [audience laughter] When we're not fucking up, we are concerned with fucking up. 

 

Now, a little bit about me. I went to Harvard for university. It's the epitome of my Jamaican and Trinidadian immigrant family's American wet dream. And then, I went to Emory for medical school. After all that school, and the hundreds of thousands of dollars in student debt, I just felt like becoming a badass surgeon was the only way I was going to make it worthwhile. 

 

So, surgeons in intern year, we rotate through all different types of surgery for one to two months at a time. I started on the plastic surgery service, which was not as glamorous as it sounds. The days were filled with grimy skin infections, and hands that had gotten crushed in car doors and faces that had gone head-to-head with steering wheels and lost. 

 

Speaking of loss, that's how I felt most days lost and scared of pretty much everything. For example, where's my pager? I would lose it, like six times a day. Also, do I tell this patient that this is the first time I'm seeing their illness outside of a textbook? And did I get myself locked in the inescapable stairwell for the third time today? 

 

But nothing was scarier than July 4th, American Independence Day, and my first day on call. What that means is that I was the only representative for the plastic surgery service for the entire hospital from 07:00 AM to 07:00 PM. I was told that if I had any questions or concerns, just pick up the phone, call my senior resident, and they'd come in and help me out. But here's the thing with asking questions in residency training. You're only supposed to do it as a last resort. 

 

Now, most questions, you could figure out the answer if you did a little bit of independent research. And that was good. Because if you were to call your senior, they'd want to know that you'd at least tried to solve the problem or you get yelled at. So, take initiative, but don't be cavalier. Try to be independent, but don't be dangerous. Trying to find that balance on that first day by myself, terrifying. 

 

So, I sat in the call room wheeling my pager into silence for the rest of my life. And then, at 11:43 AM, that little Motorola box of horrors chirped at me for the very first time. It was the ER. So, I call them. And they say, “Hey, we got this 40-year-old guy. He was riding his bike and he fell off and he dislocated his right ring finger. We've had a couple of residents and a couple of attendings, the boss doctors try to pop it back in, but no luck. So, we wanted the hand specialist to come and help us out.” To which I replied, “Yeah, it sounds like y'all should totally do that.” [audience laughter]

 

To which they replied, “So, are you going to come down or--" Because plastic surgery was taking care of hand trauma that day, so the hand specialist in question was me. Great. So, hang up and then hop on the computer to look at the X-ray. Of course, holding my right hand up for reference as the number of hand X-rays I'd critically evaluated to that point in my life, equal to zero. Even with all of my inexperienced, I could tell one thing, that this guy's finger looked funny as hell. [audience laughter] 

 

Unfortunately, unhelpful, but luckily, anatomical vocabulary started flowing through me from some dusty med school corner of my brain. So, I was able to deduce that there were no fractures in any of the bones in the hand. The fourth metacarpophalangeal joint was indeed dislocated and seated dorsal to or behind the metacarpal bone, which makes up the palmar portion of the digitized. Nice.

 

So, step one, complete. Make sure the ER was not lying to me. Now, step two. Do something. But should I do something? I had never, like ever fixed a dislocated anything before in my life. Maybe it was time to just call my senior, just have come in and help me out. On the other hand, what was the worst that could happen? [audience laughter] I could try and fail like everyone else, mind you, and the dude's finger would continue to dangle in the breeze. So, no, there would be no call. That day, I would celebrate my Independence Day. [audience laughter] 

 

With that in mind, I decided to exercise one of the freedoms that my forefathers had fought, bled and died for. Access to the internet. I logged onto YouTube, and I typed in how to fix dislocated finger. [audience laughter] After 10 minutes of an intense and very academic rabbit hole on YouTube, I wouldn't say I was feeling confident, but I knew what my patient needed from me was for me to seem confident. 

 

So, I roll up in the ER. I'm just feeling real strong, like my white coat's just billowing out behind me. I pull back the curtain and I'm like, “Hey, I'm Dr. Chin-Quee of plastic surgery.” [audience laughter] The guy looks up at me and just relief floods over his face, because the specialist had finally arrived. [audience laughter] And that specialist, he looked like he knew what he was doing. So, he holds up his arm and he says, “All right, doc, do your worst.” [audience laughter]

 

Now, I've been running this procedure through my head multiple times over the last 10 minutes, right on down to my victory moonwalk out the door and how I was going to give the black man head nod to the first of my brethren I saw in the hallway. [audience laughter] It was going to be great. Right then, in that moment, I just froze up and very nearly ran away, because what was I doing, except masquerading in doctor's clothes. I couldn't do this. I couldn't do anything. But he was my patient and he was in pain, and this was the job. So, I had to find the strength from somewhere. 

 

And then, like a beacon in the night, I heard in my head the voice of Hollywood actor Bill Pullman as President Whitmore in the 1996 blockbuster film, Independence Day, [audience laughter] also starring Will Smith and Jeff Goldblum and a bunch of other true patriots who saved the planet earth from the July 4th invasion by ill-tempered aliens. 

 

Now, I love this movie and I also know every single word to this movie. Why the entirety of its screenplay takes up valuable space inside my head that should have otherwise gone to things like math, I will never know. But right then, I finally understood what those fighter pilots must have felt when their president rallied them to fly into battle against highly intelligent extraterrestrials with every tactical advantage. And it gave me life. We will not go quietly into the night. [audience laughter] 

 

Inject lidocaine into one side of that joint. We will not vanish without a fight. Injection into the other side. We're going to live on. Flex that wrist back. We're going to survive. Pull that finger hyperextend until today, we celebrate our Independence Day. Pop. So, I did it. [audience cheers and applause]

 

The dude knew I did it too. He started playing some air piano, and I realized-- I had not been breathing the entire time, so I'm trying to let that out real inconspicuously when he just wraps me up in this glorious embrace. I needed that hug, man. So, I held on maybe seven seconds longer than was professionally appropriate [audience laughter] and then I left. On the way out, I actually saw one of the ER attendings and I said, “Hey, everything's fine. Popped it back in. No problem. You call me if you have any questions.” [audience laughter]

 

I did some finger guns there, mostly because fake confidence was still a lot easier than the real confidence it would have taken for me to humbly tell him that I just learned to do that shit on YouTube. [audience laughter] 

 

So, time went on and I learned quite a bit. We have this adage in medicine, see one, do one and teach one. I saw quite a bit, like not just on the internet, but in real life. I ended up seeing so much that people started to encourage me to do the things that used to freak me out. The more I did those things, the more they became second nature. Ultimately, I was able to teach them to other people. It's the circle of mastery. I think it's pretty amazing. 

 

But what was even more fascinating to me was what I learned about how I felt that day, that feeling of being a fraud. I think there's something really important to hold onto from that is that feeling of being an imposter. I know I felt it, because I wanted to be the best I possibly could, but I just didn't feel like I had the tools to do that yet, so I felt like I didn't belong. 

 

As I got older, the kernel of that insecurity stayed with me. But the questions I started to ask myself changed. So, instead of wondering whether I was supposed to be there, I started asking myself, why am I still here? Do I still love this and am I doing this to the best of my ability for all these people who depend on me? I think that's what most people hope their doctors are asking themselves. 

 

So, eventually, I grew up. I became an ear, nose and throat surgeon. And that means that I pick your noses and pull Legos out of your children's ears professionally. I finally feel like I can give you some medical advice. So, here we go. If you are sick, please stay off the internet. Like, just it is terrible. It's the scariest and most vile cesspool of misinformation and just like, “Just don't do it.” Instead, go to the doctor, and leave the googling and YouTubing to the professionals. [audience laughter]