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off to medical school , seeking to become a psychiatrist . After all , I was told I was a good listener , empathetic and I did like psychology . Hello reality : clinical rotations on the psych ward and the harsh realities of psychopathology soon convinced me this was not my real calling either .
Now I always had great admiration for those physicians who moved to exotic faraway lands to serve indigenous tribal people : Albert Schweitzer , David Livingston , Paul Brand – Africa or Amazonia or anywhere . A medical missionary is truly a noble calling and medical and surgical care would be life-altering for appreciative locals . But was it for me ?
Being always good with my hands with crafts and creations , I easily took to repairing lacerations and post-surgical wounds on my med school surgical rotations ( confession : I did not easily take to differential diagnoses and interpreting esoteric laboratory results … and I can be impatient while searching for the “ cure ”). I just needed to find the right specialty .
Memphis was the landing spot for an old-fashioned “ rotating internship ” and its multiple surgical experiences , a new specialty each month . It was here I became friends with some other doctors-in-training . We formed a rock and roll band , learning by ear favorite songs by The Beatles , Stones and other groups of the 70s . My pawn shop Fender Starcaster was mine to hold , strum and practice new chords . Maybe those cello lessons helped after all ! “ The Pacemakers ” would play a party for beer and a little applause ( we once recorded a tape of our “ top hits ” at Sun Studios , under the watchful photographs of previous session greats Jerry Lee and Johnny Cash … and Elvis ). Though we were residents , might we take our band to the next step , maybe opening for an established performer or even getting paid a little to supplement our meager resident salary ? R & R bands looked cool , and guitarists attracted the girls , didn ’ t they ?
But the realities of residency and later fellowship harkened . Opening a private practice focused on facial plastic surgery in Louisville and Southern Indiana was my destiny .
Now , 38 years later , I sometimes wonder what life would have brought had I seriously veered into a different pathway . Artist ? Photographer ? Guitar player ? Psychiatrist ? Medical missionary ? Following a bit of introspection and analysis , in some ways perhaps I did .
When I mend a face torn apart by a windshield or canine incisors , when I help reposition a kid ’ s protruding ears into a more socially pleasing place , and when I help surgically improve the form and function of a young woman ’ s outsized nose into one that she ’ s confident with , have I not taken the path of the artist ? Using scalpels , implants and fillers , dare I say sometimes even “ sculpting ” faces , all photographically digitally documented by me and my Olympus .
Before entering the surgical arena , the blueprint for each patient ’ s procedure is carefully composed but with the knowledge that it may need creative alteration due to unforeseen challenges . Elective aesthetic procedures are often designed using time-tested principles and proportions , as old as DaVinci ’ s geometric and facial architectural drawings . Cancer removal creates new defects of the flesh , often requiring skin tissue flaps based on meticulous geometric design . A badly traumatized facial injury is reconstructed using sequential architecturally sound and measured steps , following a composition based on the proven works of pioneering mentors . While not a symphony per se , in the surgical suite we players seek to harmonize together as one , each with unique skills and talents . Surgeon , assistant , anesthesiologist , CRNA , nurse : they all bring singular training and experience in “ playing their unique instruments .” With the tunes from my iPod in the background , it is a special space , even sacred , orchestrated with intentional care . Though our “ audience ” may be asleep on the table , we perform our best , praying their improvement and appreciation will soon follow .
As for psychiatry , we physicians are charged with careful listening to our patients , seeking to understand and offer pathways to improved health . Listen attentively and we become encouragers and trusted allies . I am not a trained psychiatrist , but do try to offer understanding , comfort , empathy and guidance .
Medical missionary ? My medical degree and surgical skills became the passport to rich and challenging short-term medical mission experiences in St . Vincent Island , Croatia , Borneo and Ecuador . Each experience is special .
I ’ ll never know what may have happened had I actually pursued a full-time career into the visual arts world , or taken a hiatus from residency to practice my guitar licks , or maintained my psychiatry training route or accepted a long term missionary assignment . “ If I weren ’ t a doctor ,” might would I have become the musician , or the artist or the medical missionary ? But perhaps I have , or at least do , inhabit just a small place in these unique and diverse worlds . This leads me full circle , and for these blessings I don ’ t think I would change a thing .
This essay was a submission to the 2024 Richard Spear , MD , Memorial Essay Contest .
Dr . Chatham is a facial plastic surgeon at Chatham Facial Plastic Surgery & Medical Skin Care .
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