Two words: Necrotizing pancreatitis.
There’s nothing like repeated trips to the operating room to scoop out bits of dead pancreas, trips sometimes so frequent that we leave the abdomen open to facilitate repeat visits, in patients who are about as sick as any patient you’ll ever see. There are few, if any, problems in general surgery more challenging, and saving such patients gives an enormous sense of accomplishment. It’s also one area that distinguishes general surgeons from all other specialties. There’s no other surgeon or internist who can handle these cases. When the pancreatitis really gets too bad for the gastroenterologists to deal with, general surgeons are the docs of last resort.
Unfortunately, I’ve learned that, at least in my case, taking care of such critically ill patients is not compatible with running a successful laboratory and maintaining its funding. If my funding ever lapses and I’m forced to return to my surgical roots, these are the sorts of cases that could be waiting for me.