ENT: A Journey into the Depths of the Head and Neck

Saliva, copious amounts of ear wax, and the weird and wonderful stuff coming from the nose—forgive me if, before medical school, ENT was not something I was particularly interested in.

I am pleased to say I have completed my third-year exams and have now begun my clinical rotations, which should take me through to the end of medical school and into my career as a doctor. ENT was a block studied in the second year, and I was particularly apprehensive given what I have mentioned above. However, I was stumped. The anatomy of the head and neck is by far the most fascinating to me, spanning from the complexities of the cranial nerves to our abilities to hear, swallow, and produce sound—the core of how we communicate. ENT expands beyond this with complex hormonal organs in the region such as the thyroid, whose pathologies I believe present in weird and wonderful ways.

I was, therefore, overjoyed when I found out the first two weeks I would be placed in ENT. An unforgettable experience. It’s so easy as a medical student to feel excess to needs and try to hide in the background as doctors go about their day-to-day. So, you can imagine my shock as the consultant pointed to me to scrub in and assist in surgery.

The experience was surreal from the moment of changing into scrubs and entering the theatre, watching the nurses, healthcare assistants, and other members prepare for a hemithyroidectomy. It was something so normal for them but felt overwhelming and exceedingly daunting to me. No time to stand and admire, I needed to scrub in. Fumbling the surgical scrub and making a total mess, soaking my scrubs and repeating because I realized I had not put a mask on. Inevitably, the consultant had started scrubbing in after me and finished before me.

I stepped up to the table, and the surgery began as the first cut was made. As I retracted and was quizzed on anatomy throughout the procedure, I was in complete awe. The anatomy looked almost textbook. I had spent many hours in the anatomy labs with cadavers, but their vessels never sat there pulsating, the area being dissected was never warm, and the muscles were never tense and resistant. Of course, I had learned that in a thyroidectomy the recurrent laryngeal nerve was at risk, and there I was, face to face with it, tiptoeing around it.

The image of surgery is always one of the utmost delicacy. However, it’s much more complex than this. There are moments to be delicate and times where pulling and stretching the skin aids the surgery. When faced with a large thyroid mass, as I was, the surgeon was anything but delicate as it was yanked from the patient. I was almost sad to see the final suture be placed and the drain secured, marking the end of surgery.

I was completely out of my depth, yet more invigorated in that environment by what I was experiencing. I have no doubt that after doing hundreds of these, it probably becomes a little mundane as the consultant walked away and looked at his phone with very little expression or realization of what they had just done. It was an amazing experience, one that made me more excited for the future career I am attempting to build. I can only hope that feeling remains for as long as possible. Plus, ENT… You were very convincing.