The trash cans near the outdoor benches are overflowing with McDonald’s bags. I wait at the crosswalk for a beat-up gold Nissan to pass as I walk to the student lot. The night air hits my face, welcome after many hours under a stale surgical mask.

 This is the longest day I’ve had in my professional career — my body hurts, my mind is tired — but, damn, I feel like I’m on top of the world. For the past seven hours, I’ve stood retracting a gentleman’s intestines and assisting in the removal of an infected hernia mesh that spanned his lower abdominal wall.

 I call my mom, and she picks up immediately. I tell her about the dichotomy of the rush and absolute peace I felt standing at the OR table.

 Since that day, I’ve thought a lot about why I love surgery. It starts with the order within an operating room. It is a well-oiled machine driven by the surgeon, but each part is needed, which creates an atmosphere of camaraderie, teamwork, and respect.

 It’s more than that, too. Most people enter the medical field because they want to help people, and I’m really no different. The kind of help I want to give, though, is the immediate kind. I enjoy the instant gratification that comes from knowing I have definitely made a difference. A patient comes to you with a problem and, as a surgeon, you can fix it. I like that.

 I grew up in rural Kentucky, surrounded by a tightly-knit family anchored by an Angus cattle farm. My aunts, uncles, cousins, and grandparents’ homes all dot the sides of the same road and break the monotony of the family farmland. From a young age, I realized that farm life is hard work, but worth it. I would get the blue bucket with the yellow handle and head down to the garden. The green beans stood tall above my head, their vines having climbed up old tobacco sticks. After the picking was complete, my great-grandma, my mom and I would sit under the carport and break the beans in preparation for canning.

 Working in the garden instilled a strong work ethic in me, establishing the no-nonsense attitude of, “You get in there, do what you have to do, and it’s okay if you get your hands dirty.”

 As pretty of a picture as that paints, life was not always idyllic. My mother is a strong lady who suffered the heartbreak of losing twins at childbirth and her mother to a drunk driver. When I was 12, she made the decision to leave my alcoholic father and, after, married a man who also drank too much.

 The way my mother handled tragedy molded me into the person I am today: challenges are simply a part of life that act like fertilizer on a garden. My mother’s strength gave me my resolve, which will serve me well as a surgeon. I am confident in my ability to make a choice, support it, and even defend it when needed.

 Choosing to go straight through in my schooling has left minimal time for hobbies, but one constant has been my love for cooking. I like working with my hands and cooking serves the practical need of having to eat.

 Having a great deal of experience in the kitchen became an unlikely asset in medical school. I joined the Humanity First Student Organization, which involved cooking meals at a food pantry. As the only executive board member who felt comfortable in the kitchen, I assigned the volunteers their jobs for the day, being sure to let each volunteer find their own footing in the kitchen. A common meal we prepared was spaghetti with marinara sauce, toast, and a salad. We had a minimal budget, but we found ways to elevate the basic ingredients we did have. I would grab the butter, soften it, and whip garlic powder, parsley flakes, and a dash of onion powder into it. We now had compound butter so that toast could become garlic bread.

 Providing these meals taught me I had no concept of struggling for a meal. I looked around at the tired, weathered people waiting, and knew I would never know exactly what they felt. My heart broke for them, but I found solace in that I was able to take the worry of hunger off their plate.

 I’m looking for two main qualities in a residency. First, I want to serve a high volume of patients so I can develop an unshakable confidence in my surgical skills. Second, I want a residency with a positive workplace culture. My passion for surgery is sound and combining that with a hospital I am excited to show up to daily is the perfect recipe for excellent patient care.

 In turn, I commit to showing up to work each day with my garden-grown work ethic, an excitement and eagerness to learn from my fellow residents and attending physicians, and maintaining my humility in remembering that I am in the infancy of becoming a general surgeon. I intend to treat each day as a clean slate so I may provide the best environment to promote the healing of patients. Which at the end of the day — whether that’s a 16-hour day; whether I’m removing a gallbladder or elbow deep in an open abdomen; whether that patient is young or old — is what it is all about.

It was a crisp October afternoon in East Tennessee. Water was tumbling over the rocks, flowing briskly around each bend, as the rainbow trout were gliding along the riverbed. The river was alive. However, our boat motor was not. A loud “shit fire,” followed by a “grab that tree,” came from my dad in the back of the 12-foot aluminum john boat and broke the tranquility of floating down the Clinch River. After a quick grab of a tree branch, tying the boat up, a mile hike along the riverbank, and floating to the next boat ramp, we had a good story to tell. 

This is one of many memories I have of times spent fishing with my dad and granddad, which, if I had to rank it, is my favorite thing to do. So when choosing my specialty, I wanted to select one that echoes this pastime. Otolaryngology represents the two different worlds of the Clinch River: the compassionate one inside of the boat filled with conversation and connection and the skillful hands-on world of fishing that lies just on the other side of the aluminum edges.  

 I am true to my southern roots when it comes to people. I like getting to know them and I like connecting with them. I can talk with anyone about almost anything, including chocolate cake. On the first day of my third-year otolaryngology rotation, I saw the surgical correction of a Zenker’s Diverticulum. The patient, a quiet man who let his wife do most of the talking, had presented to the clinic six weeks prior complaining of choking, coughing up food hours after meals, and losing weight. I saw the same patient four weeks post-op and he presented to clinic a different person. He was clearly happy and quick to exclaim that he could eat his wife’s homemade chocolate cake again. As a homemade baked-goods connoisseur myself, I understood his gratitude. At this moment, I felt as if the patient and I were inside of that 12-foot aluminum boat just floating down the river on a nice Sunday afternoon.   

 My passion for the OR began to surface as I faded out of college baseball. For years I was able to nurture this dominant, detailed-oriented side of my personality through pitching. When I was on the mound, all eyes were on me, the pace revolved around my tempo, and the entire game could be dependent on what pitch I threw and when. That energy is the same I feel when I’m in the OR (and, yes, while catching a fish). While holding a retractor, studying the surgeon’s presence, and observing each precise cut, I envision myself one day being at the head of the table. This vision is what ignites a new fire in me. The fire that wants to prepare for upcoming cases and to be called in the middle of the night to prove to myself I am capable when all eyes are solely on me again.

 According to my dad, there are many ways to catch a fish, but the only right way is his way. Although I can respect his dedication to the perfection of his craft, I do have to admit I enjoy variety. I use an assortment of lures and poles, appreciating the change of pace. Similarly, I enjoy the change of pace in otolaryngology. I am attracted to the fact that I can serve a wide spectrum of patient demographic. I can address their needs through medical approaches in clinic or surgical approaches in the OR. I appreciate being able to remove an earring-backing that a 3-year-old stuffed into their ear in one room, and then work up an elderly patient for hearing loss in the next. It provides flexibility and allows me to go deep into my tackle box to try out a different lure from time to time.

 The members of an entire residency program would not fit within the confines of my 12-foot aluminum john boat, so I am in search of a slightly larger boat but with the same family feeling when it comes to the next step in my training. As my dad and grandfather have been my captains, instilling confidence and knowledge in me, I am looking for the same guidance and mentorship in residency. I seek a program that provides training to empower and teach me how to become an autonomous physician. I seek an environment that enables my surgical and clinical skills to grow through hands-on experience and serve a high volume of patients to instill self-confidence.

 In turn, you will receive a resident who strives to not just meet the standard but exceed the standard. I will bring a determined, no-nonsense East Tennessee mindset to the team. I will support that team and be as open to stepping in as I will be to improving. And any time, day or night, I will be happy to talk fishing.

My dog Woody and I had 2,000 pounds of bean seed to plant. The sun was rising and the grass was still dew drowned from a Tennessee night. I checked the engine oil, hydraulic fluid, tire pressure, and made sure the hydraulic lines were connected from the planter to the tractor. Then Woody and I climbed into the Case IH 7250 and rode toward the sunrise.

I backed the planter into the corner of the field, activated the GPS system, and engaged the hydraulics to plunge the bean seed into the ground. I released the clutch and beans began entering the soil. This was a crucial moment, and I watched carefully. Were any of the seed tubes obstructed? Were the hydraulics inserting the seed to the correct depth? Was I planting the field without missing complete passes or double planting?

I’ve spent my whole life working on our family farm. The work is honest, hard but good. What I didn’t realize is those long days spent on a tractor were teaching me the vigilance that is so important for a career in anesthesiology.

I went to medical school with hopes of becoming a primary care doctor. However, I soon had to admit what I had known all along: I like working with my hands. During my family medicine rotation, I enjoyed the patient interaction in the room but found myself looking forward to taking the patient to the lab and performing their venipuncture. So, I thought maybe surgery would be for me. But while in the OR, I was curious about what was happening at the head of the bed behind the drape. Thereafter, a mentor persuaded me to schedule a rotation in anesthesia. The rest is history.

I will never forget my 17^th intubation. An obese, middle-aged woman had just been involved in a car accident. She had multiple fractured lumbar vertebrae and needed urgent neurosurgical intervention. I was in the room along with an attending anesthesiologist and CRNA. Sedation and paralytics were administered, and her eyes were taped shut. The patient’s respiratory reserve must have been minimal because as soon as I opened the jaw to insert the tongue blade, the daunting sound of a dropping O2Sat registered in my brain. As I advanced down the tongue, I could feel the tension in the room building as the pulse-ox pitch rapidly decreased. The CRNA was ready to step in and take over.

The week before I had been instructed, “If you ever see the vocal cords, do not take your eyes off the vocal cords.” Just then, I saw them. I verbalized I had a clear view and raised my right hand above my shoulder as I’d been instructed. I watched the endotracheal tube pass between the cords, inflated the cuff, and gave the patient some breaths. I will never forget that feeling.

After this, I knew anesthesia was the specialty for me. I got to work with my hands, enjoyed the physiology and pharmacology involved, and liked the immediate results. Each interaction had a beginning and an end.

Moreover, there was meaningful patient interaction, which is very important to me. I’m a people person and one of my greatest joys is visiting with Ms. Louis, an 86-year-old African American woman, an old friend of my late great-grandmother. Every time I visit home, I make sure to stop by her apartment with lunch from Legends Express. I stay in touch weekly by phone.

I also visit with Mr. Hoarse who lives across the street from Ms. Louis. I remember throwing baseball with him when I was young and have a watch he gave me that sits on the console of my truck. Mr. Hoarse spent 27 years as a boilermaker. We talk about the hard work he did helping construct massive navy ships and submarines. I always look forward to chatting with him.

These experiences seem far away from a patient’s bedside, but they are the ones that have steered me toward anesthesiology. I seek a residency that is strong both academically and clinically, as I want to be confidant in managing the sickest patients in the hospital. A medium-sized program with excellent trauma, transplant, and heart services will provide the training necessary to be competent in any setting I work in after residency. In addition, I hope to be surrounded by other residents who enjoy coming to work every day and with whom I can get together for studying, a round of golf, or visiting a local brewery. In return, I will be an honest, hardworking team player who does right by patients. I will support my co-residents and be happy to teach medical students or anyone who wants to learn about anesthesia. I am not sure what my future holds, but my options currently include private practice, a critical care fellowship, or a cardiac fellowship. I am excited for continued growth during these upcoming four years of residency where water meets seed and outstanding physicians are cultivated.