Surgicals vs Medicals: The Final Debate To Settle It All

We’ve seen a lot of unsettled debates over the years. Marvel or DC? The chicken or the egg? Cryptocurrency or peace of mind? YouTube or Instagram? (Correct answer to last one: neither). The world of healthcare also has had its own raging, ego-driven and passionate debate since the beginning of time: Medicine or Surgery? Which branch is better? Although we, at Lexicon, believe in the concept of “Every Doctor is indispensable”, we can’t help but stir up this debate once more in the faint hope of finding an answer, but mostly because controversy (other than Shah Rukh Khan) sells. 

Blue corner ready? Red Corner ready? Let’s go!

Once upon a time, someone wise, but probably not sober, said, “Surgery is like cake. It’s not that you don’t like it; it’s just that there’s too much of it.” Doctors pursuing surgical specialties may as well become good swimmers, as the job requires a strong back (consider the long-standing hours) and even more willpower (to pull through the cold temperature settings, breathing into a confining facemask). But surgeons at least get something done! Forget about diagnostic and analytical skills; photographic memory is the star of this show. So are varicose veins too, though. Surgical peers are definitely prepared to sacrifice more of their health, personal lives and non-medical interests compared to non-surgical doctors, which has oddly become a measuring contest in healthcare. Nonetheless, surgeons must be ecstatic after a gruelling day of performing surgeries that require expertise, excellent motor skills, patience (to not scream at others in the OR), stamina (of arguing with the anaesthesiologist), and a steady hand under pressure, all of which non-surgical doctors lack. Being required to stay fixated for a whopping 14 hours while staring at blood may be too much to ask from a physician, whose superpower might as well be fainting. The real question is whether you are a “hands-on” person, who enjoys repairing broken gear (cut-remove-anastomose-close on repeat fashion) or if you are more stimulated by detective work and the ‘rule out’ game until you reach the limits of your knowledge and rely on assistance from a specialist, or someone who likes to write “kindly correlate clinically”. Unlike in surgery, where unconscious people are your bread-and-butter, interpersonal skills are much of a requirement in internal medicine. Also, would you rather have patients with whom you’ve spent years working, befriended them, their families, and extended relatives, or spend long hours on a single patient from admission to surgery and post-operative care, all while ignoring your own needs? Now THAT is a tricky question. 

Grey’s Anatomy or House MD- which would you pick? Disgruntled, complex lives of the surgical interns at Seattle Grace hospital or the brilliance and arrogance of Dr House and his medical residents.

“Surgery is the highest form of medicine”- as said by Al-Zahrawi, the 11th century physician known as “father of surgery”. Sounds quite like something a surgeon would say, isn’t it? But the total number of lives saved by surgery are nothing when compared to bland tasting oral rehydration salts. And honestly, you would have to be completely myopic to believe that cutting someone open would amount to being the highest form of medicine! Surgery seems fascinating at first, but when you look at the indefinite consults for non-surgical problems and the jumbo list that keeps getting admitted to surgery floors, that is when the disconnect begins. I once talked to a surgeon who said that a major part of his field is knowing when to do surgery and when not to, which is why general surgery becomes a dumping ground for a whole lot of non-surgical psychosomatic surgical problems that medicine is not willing to touch. The reality is that most people in the initial years chose a field based on the coolest thing they do. So surgeons got into it because they love being in the OR, but the endless list of inpatients, following chronic patients and solving subjective complaints took all the fun away. Surgeons have picked up their poison – cutting is thrilling and the love for fixing stuff overrides the euphoria obtained from drugs! 

Just like most of us here, I got sucked into the world of Medicine thanks to the TV show ‘House MD’ and it’s been a roller coaster ride ever since. It’s an entire world in itself. It’s not just ‘internal medicine’ is it? It’s an amalgamation of multiple subjects. It’s the brain trying to understand itself and learn the workings of the other systems in the body and see what could go wrong with it and figure out how to rectify it. If that isn’t a handful as is already, the doctor needs to see what was wrong in the patient’s family as well. So it really is not a surprise to anyone when you see that stack of books on the table? And mind you, books the size that could crush you if need be, and if dropped on you from an appropriate height. Of course you absolutely can not forget to keep updating yourself. Must always keep revising Cefixime, Ceftazidime, Ceftriaxone and multiple other drugs that literally sound the same. And on the topic of things that sound the same, has anyone ever understood the difference between lymphangitis, lymphadenitis, lymphangiovarix on the first try? Whoever said ‘laughter is the best medicine’ certainly knew what he was talking about. I think it was just a medicine student staring at the vastness of medicine. Also, no one ever said “laughter is the best surgery”. So that’s, objectively, Medicine 1; Surgery 0. 

Clinician. Diagnostician. Internist.

Bright, smart, gallon of a memory, the whole world’s diagnostics on their shoulders like Atlas. Their books millions of pages, the knowledge irrefutably vast.

Soft, spoken like true Samaritans, their attitude is one of kindness and compassion. They know what to say, when to say, and how to say.

Regularly found sitting at a table, with too much internal math, equations with two-to-the power-whatever interactions, brand names on their tongue tips, drugs a dozen, trial-and-error reasoning for prescriptions; their approach is one of ease and magic.

Often bewildered at the ‘why’, looking at the ‘how’, and figuring out the ‘what’ – of the unknown, mystery of the unexplained – seemingly treating what they think it might be, or what they think it might lead to; they investigate, and inspect, when push comes to shove.

Their rounds: long and tiring, multiple blood pricks a day, analysing and over-analysing, correcting and retracting. Investigations are a favourite, the more, the merrier; encompassing a variety of them to call ‘routine’, till all they have to do is glance at them and know what is abnormal.

The first call when anyone, someone, anywhere, somewhere is sick. Family of family, friend of friend. Insulin, antibiotics, recommendations, leave certificates, OTC drugs – everything is their garden.

Everyone has a part to play. Overlap is inevitable. Ultimately.

Remove the tumour or analyse the human body.

Move your hands, stand long hours or sit comfortably and let your mind run.

Surgery or medicine – you choose.

Written by:

Geeta Sundar

Dr. Geeta is an introverted, independant, loyal, passionate nomad who lives in her own world of fantasies, romance and sci-fi. She is on a quest to be an author, a trauma surgeon who travels the world for work and makes friends with every animal she ever interacts with.

Swaralee Khedkar
I’m Swaralee Khedkar, a final year MBBS student, from SMBT Institute of Medical Sciences and Research Centre, Nashik. I’m an avid reader, a scuba diver and a swimmer. In my free time, you would mostly find me consuming content in the form of books, movies and series.

Mannat Bhatia

 I recently graduated from medical school. I am an ardent reader and writer with a passion for exploring and adventure. Passionate about research, advocacy, inclusive diversity and creating healthcare awareness.

Tejaswini Ashok

Throughout my medical career, I fell in love with research and evidence-based medicine. I’m an aspiring internist with a love for music. I look forward to keep pushing myself to new heights in order to broaden my horizons and help others in the process.

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