Twenty-Six: a story from a pediatric surgeon [PODCAST]

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In this episode, Yael Dreznik, a pediatric surgeon and author of the book Twenty-Six, shares her personal story and insights into the life of a surgeon. From the early morning rituals to the fear of making mistakes, Yael provides an inside look into the world of medicine. She discusses the challenges of being a female surgeon and offers advice for aspiring doctors. Yael also shares the inspiration behind her book, which chronicles her experiences during her residency and the lessons she learned along the way.

Yael Dreznik is a pediatric surgeon.

She shares her story and discusses her book, Twenty-Six.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome to the show Yael Dreznik. She’s a pediatric surgeon, and she’s the author of the book Twenty-Six, which we’ll talk about in this episode. Yael, welcome to the show.

Yael Dreznik: Hi, Kevin, and thank you very much. Well, my name is Yael Dreznik. I’m a senior pediatric surgeon at Schneider Children’s Hospital, which is the biggest hospital for children in Israel. I wanted to talk about the book Twenty-Six, which was a bestseller in Israel and now is available on Amazon, and I hope, and I think, it will be an interesting talk with you. I am 44 years old, I have two daughters, and that’s it for now.

Kevin Pho: All right, so we’ll talk about the book in a little bit, but tell us, what’s it like to practice pediatric surgery in Israel?

Yael Dreznik: It’s two years in general surgery, which I did at Sheba Medical Center, and then you proceed to four years of pediatric surgery, which is like a subspecialty. My interest is oncology, pediatric surgical oncology, like Wilms tumor and neuroblastoma. We do a lot of these surgeries at Schneider, and I intend, I think one year from now or two years from now, to go to a fellowship, maybe in the U.S., at CHOP or Boston Children’s Hospital.

From my point of view, it’s not general surgery. It’s easier to work with the kids, the prognosis is better, and I love them. But as a mother, it has its own thoughts. I also have two daughters, and when I operate on a child, I keep thinking of him after the surgery, and I get very attached to the families. I think it’s the best occupation that one could have.

Kevin Pho: Now, when you go through those difficult times, when a case doesn’t go as well as you think and you are already so attached to the patients and families, tell us, how difficult is that for you, and what are some of the things that you do to go through such difficult situations?

Yael Dreznik: What’s good about going to pediatric surgery instead of general surgery, without the pancreatic cancer and the gastric cancer and so on, is that although you see children with cancer, the prognosis is much, much better. But you’ve arrived at what you’re asking, because there are events that you just cannot forget. It’s like a scar in your heart. You cannot just go through it, and I have a lot of patients that I cannot forget. It’s hard, but most of the time it’s joyful. It’s lovely.

Kevin Pho: All right, so let’s talk about your book. The book is called Twenty-Six. Now, tell us, how did this book come together? I ordered my copy of the book here from Amazon.

Yael Dreznik: First of all, I think you must remember the days when we were young. I think it started when my uncle was a general surgeon. In those days, like 30 years ago, general surgeons used to work more than 35 or 40 hours per shift. They came to work on Monday a.m. and went home Tuesday at the end of the day. They didn’t sleep, and they had endless shifts. When I was a resident, I used to come to work at 6 a.m. and go home at about 2 p.m. the day after. It was very demanding, and I was very, very tired.

Lately in Israel, all the residents are doing 26-hour shifts, hence the name of the book. Although it is much better than in other times, it is still a lot of hours, and we don’t see it in other jobs, like pilots or drivers, where you keep doing a very stressful job for such long hours. Now in Israel the government has announced that it won’t be 26 hours, especially for internal medicine and for the ER. It will be much less, but still, the surgeons will have to do 26-hour shifts.

So the book tells, if you remember, there was a TV show with Jack Bauer, 24. Yes, 24 hours, something like that. It was a really good show. We used to binge it without stopping. I wanted to tell the story of us, the physicians who work from 5 a.m. until the next morning, and to tell the world how we can do it. So I started the book at 5 a.m., when I go to the hospital, and every hour something is coming: a patient from the ER, a bleeding patient, and then an accident, and then I’m up and running to suture a lady. Everything that happened to me in my professional life is written in the book. I mean, there is nothing there that is fiction.

A lot of residents and professors and nurses read the book and wrote to me about it, and told me that I actually told their way of life. So I thought, well, being a doctor is actually an occupation that is universal. I mean, what I have in my shift is similar to what a physician in New Zealand, or in Holland, in the Netherlands, or in the U.S. has also. We deal with sick people, we deal with appendicitis and appendectomies, and all of us feel the same. So I think that this book can express all of our universal feelings regarding this beautiful occupation.

Kevin Pho: Now, tell us one of these stories from the book, because those who aren’t familiar with the medical world often don’t know what it’s like to be on a 26-hour shift. So what’s a story from the book that you can share with us that really tells people who aren’t familiar with the medical profession what it’s really like?

Yael Dreznik: OK, so actually this book is dedicated to three persons, and it is written on the first page. One of them is my dearest patient, and the story is written as it happened to me. He was a 45-year-old patient, healthy otherwise, with no medical history. He came to the ER when he was a bit yellowish, and his bilirubin level was high, and we suspected choledocholithiasis. We didn’t think about other options. I really got attached to him and his wife. They were lovable. I really liked her. I liked them from the moment I saw them.

And we saw in the ultrasound that it was pancreatic cancer. Of course, he died about four months following the initial diagnosis, because it was stage four, with liver metastasis. The book is dedicated to him. I went to his wife, to her home. We are still in touch, of course, and I gave her the first copy of the book, and we just cried together and hugged. It is one of the hardest stories that is told in the book.

Kevin Pho: Why is it important for physicians to share these stories and really express themselves, in your case especially in a book? Why is it important to tell these stories?

Yael Dreznik: I think that all of us are doing the hardest job on Earth. I really think so. And my friends, we all find a way to express ourselves. Some of my friends are doing marathons, other friends are sleeping all the time when they are not on shift, and I write. I mean, this is how I fulfill, or just feel that my thoughts are being processed, if you understand what I’m saying. It’s like going to a shrink, but I just write down everything I have, and it’s a very good way to analyze my thoughts.

Kevin Pho: Now, after writing this book and telling these stories, you said that it helps analyze your thoughts. Has it changed you as a physician, telling these stories and writing this book?

Yael Dreznik: It’s a really good question. I think that I have come to the knowledge that to write and to talk is really my take-home message, as you said in your first words. I think that physicians who talk about things that happen to them, or who write, can accomplish two things. First of all, the patients see them and understand that we are also human, and the connection is much, much more. It’s better. The other thing is for us. I think it helps us to better understand our daily life, and I think I’m a better person than before.

Kevin Pho: All right, we’re talking to Yael Dreznik. She’s a pediatric surgeon. She’s the author of the book Twenty-Six. Yael, how did you manage to collect all these stories? Like, how did you know that you were going to write a book? Were these just stories that you kept as you were training? Did you just decide to sit down and think back through your medical career to all the poignant stories that you kept? So how did you come up with all these stories and experiences in the book?

Yael Dreznik: Well, I must thank the COVID pandemic, because in one of the weeks that I had to stay home, it allowed me to just write down all the stories that were kept in the drawer, or something, or in my computer. So I managed, in just four months, to write the whole story, from 5 a.m. to 8 a.m., like that.

Kevin Pho: And now that the book’s been released, what are some of the reactions of your colleagues and patients who’ve read the book?

Yael Dreznik: I’ve gotten hundreds of letters in Israel. The idea to translate it to English and to go to Amazon was because I got emails from friends, from Philadelphia, one friend from China, one friend from New York, and also from London. They came to me and said, “Yael, we cannot read it in Hebrew. We heard about your book. Can you please upload it to Amazon?” Then I started to do a revision and to translate it. So I really hope that not only medical students but people from around the world will see and will understand what we are going through. And I think it’s also a very interesting story, not because I wrote it, but because medicine is interesting.

Kevin Pho: Yael, my final question: For those new readers who are about to read your book, what are some of the main messages you want them to come away with?

Yael Dreznik: When I was a medical student, I read, like all of my friends, The House of God, if you remember the book. It’s like, before This Is Going to Hurt, The House of God was our book as medical students. I liked it a lot, but it was a bit cynical, you understand. My book is not cynical. It’s full of love for patients. And it’s not that I want to say something romantic. Of course, I am talking about my tiredness, and I’m talking about my family, and I’m talking about events that were very hard for me, like the death of a patient. But in the end, it tells us how to be compassionate to our patients and how to never forget that this is not a regular occupation. It’s a way of life.

Kevin Pho: Yael, thank you so much for sharing your story, time, and insight. Thanks again for coming on the show.

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