By Celso F. Uribe II, MD

Expectation vs. Reality:

A Brief Look at My First Two Months as a Vascular Surgeon

By Celso F. Uribe II, MD

gave my son a kiss and hug after we sang happy birthday. It was cold, but not for the lack of affection. His first birthday was on February 16, 2021, and we were at the tail end of one of the worst winter storms in San Antonio history. My father-inlaw’s house had been without power for three days and the water had just sputtered out. With our luck, we had decided months ago to move our family and belongings to Texas in what would end up being the worst possible weeks we could have chosen. Our entire household was on a truck stuck on a frozen road in Louisiana, and the precious week I had taken off during fellowship to make this move now seemed

Iwasted. Again, as it happens so often in life, my expectations were upended by reality. I chose vascular surgery because I wanted to be the guy other doctors called for help. Whether it's an emergency in the operating room or a routine outpatient referral, I love helping my fellow partners in the medical community just as much as I love helping patients. Colloquially known as the “firefighters” of the hospital, vascular surgeons could be needed at a moment's notice, on any floor, in an array of urgent scenarios. Although this may not foster the best lifestyle, I knew it was for me early on in my general surgery training. Since 2015, my goal of becoming a vascular

surgeon in private practice was born, and has been built up with hours of daydreaming and high expectations over the past seven years. Now I’m finally here, albeit with just two months under my belt. So, what is it like? Well, I’ll do my best to explain.

As a trainee, I had been accustomed to working at one single hospital at a time, yet I suddenly found myself seeing patients at nearly every community hospital in Northwest San Antonio. My first couple of weeks on the job were dizzying. Four different badges, four different EMRs, seven different hospitals and staff to get acquainted with (in addition to our own offices and staff). Oh, and not to mention, my first job as a full-fledged attending practicing vascular surgery. In all honesty though, that has been the easy part. Everything else, however, has been quite an adjustment. But, before I knew it, I was able to quickly jump from hospital to hospital, navigating an impossible network of different computer systems, caring for the most patients over the biggest area that I’d ever had. Still, there were more things that were very different from before.

At the University of Virginia, where I received my surgical training, the pandemic was rough, but I’ve come to the stark realization that things were probably much worse here. In my first month, I saw several cases of COVID-19 related lower extremity ischemia that I had not been exposed to previously. More troubling was that some of its effects on circulation became clinically evident well after the initial infection. With the exception of acute thromboembolism to named vessels, I’ve seen multiple cases of COVID-19 related ischemic events that were isolated to the microvasculature of the feet. Unfortunately, this is where our specialty has the least number of surgical options for treatment. Cases like these, and the patients and families impacted by these circumstances, have affected me the most in this transition.

Luckily, help has been close by, thanks not only to the board-certified, highly-specialized surgeons who make up my team at Peripheral Vascular Associates (PVA), but also to the broader medical community of Northwest San Antonio. The level of camaraderie and support I’ve encountered has been crucial in getting my bearings and handling some of these difficult cases. Similarly, love for this city’s culture and diversity has boosted my morale. Being born and raised on the border in Laredo, the rich Hispanic culture of San Antonio always made it feel like a second home to me. Now back to speaking Spanish on a regular basis, consults sometimes feel more like happy visits with my “tios” and “tias.” The Big Red and Hot Cheetos in the physician’s lounges are a nice touch, too.

So, from moving across the country, to starting my first job outside of training, I think it's safe to say that I’m starting to get the hang of it.

Getting lost in the hallways at Main Methodist only happens once a week now, so progress is being made. Yes, I thought the transition would’ve been easier in my previous daydreaming, but expectations rarely match up with reality. With every challenge, whether it be surviving a freak blizzard in Texas, or trying to figure out computerized picture archiving systems, we inevitably grow and add to our experience. Fortunately, I’ve had a great support system from my family, my colleagues and our network of partners. I’ve quickly become captivated with the San Antonio health care community and the patients that are a part of it, and hope they will allow me to make them a permanent fixture of my life.

Celso F. Uribe II, MD is a vascular and endovascular surgeon at Peripheral Vascular Associates (PVA). He is a member of the Bexar County Medical Society.