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Dr. Beam - Trauma/Burn/Critical Care Surgeon
45 Plays10 days ago
Dr. Beam had dreams of a career in music. Fast forward a "few years" and he is now a Trauma surgeon. Life is funny how we make plans and then we look back wondering how we got where we are. In this interview we discuss the long and tough journey to becoming a Trauma surgeon and all that comes along with this challenging, and rewarding career. We talk about how to prevent burnout, the importance of keeping your arrogance at bay, we discuss pay and education, as well as how satisfying it can be to see a patient make it. Dr. Beam is a great example of a steady and methodical approach under pressure. If a career as an emergency surgeon sounds interesting to you, this is one episode you will want to listen too. Thanks. Dr. beam!
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Transcript
00:00:01
The Jobs Podcast
Hey folks, you're listening to the JOBS Podcast. I'm your host, Tim Hendricks. And today we've got a really unique guest with us. He is a trauma burn and critical care surgeon. And he is Dr. Zachary Beam. Dr. Beam, thank you for joining me today on the JOBS Podcast.
00:00:17
Zach Beam
Absolutely. Thank you for having me.
00:00:20
The Jobs Podcast
So let's go ahead and you've got a pretty cool story. Let's let's give us a little bit of back backstory of some history about where you were born, your upbringing, and then we'll we'll walk through your education and your training.
00:00:31
Zach Beam
Sounds good. Yeah. So I, uh, was born and raised in ah small town in Southern Oklahoma, um, South of Norman. Um, and that's kind of where it's been much out the, we grew up out in the country, me and my younger brother and,
00:00:46
Zach Beam
ah eventually found my way to college um after completing high school. My path initially was going to be music.
00:00:56
Zach Beam
I played in bands and all that all throughout school, honor bands, etc., etc. So I and went to school with the intention of being, I guess, a band director of all things.
00:01:08
The Jobs Podcast
Oh, huh. hu
00:01:09
Zach Beam
I played percussion and I had some opportunities at smaller schools to do music, but I really wanted to be at the University of Oklahoma. And so I was fortunate enough to get an academic scholarship there and went to OU.
00:01:26
Zach Beam
And um the week before my freshman year started is when you had all the auditions for the music programs. And i I didn't make the cut. I was number three on a list that only had two spots. And that's the first time ever that I did not achieve what I wanted to in music. And so and was stuck um at Norman without being able to do the major I wanted to do. And so I had to kind of change trajectories there. So I just on a whim changed my major to microbiology because I thought, no, that sounds cool. like
00:02:06
Zach Beam
viruses and stuff as I all see what that's all about. And, uh, that's how I ended up kind of going that route. Um, I needed a job while I was in that that freshman year. So I, uh, I ended up looking, uh, at some opportunities and decided to take nighttime courses to get my EMT license. And so I did that my freshman year and, ended up getting a EMT yeah ER tech night shift job at Norman regional.
00:02:36
Zach Beam
And I held a full-time job there, working Wednesday, Thursday, Friday nights, until I graduated college and went to med school.
00:02:43
The Jobs Podcast
Man. So you worked the night shift in an emergency room in a pretty big city. That had to be kind of a trial by fire initially. Was that was that a bit of a shock to you?
00:02:55
Zach Beam
Oh yeah, it was ah it was a baptism by fire, if you will. I was a pretty naive a kid, you know, grew up in a religious household, and and then step foot into the yeah ER at night in a college town and you grow up real quick.
00:03:13
Zach Beam
But it was it was good. um My wife was also a college student at the time and she volunteered on Friday nights. She wanted to go to med school and was getting some volunteer hours there. That's where our first met her.
00:03:26
Zach Beam
um And all the doctors I worked with were DOs as well. They were all very sharp. no very smart and capable ER physicians. And as i as I spent my years there, and decided that that's something that I i myself wanted to do. i could see myself doing. So I decided to pursue the um the osteopathic medical school route because I wanted to be just like those guys and ended up going to the founding DO school up in Missouri, Kirksville College of Osteopathic Medicine, where
00:04:01
Zach Beam
I went there to with the intention of being an ER doctor.
00:04:06
The Jobs Podcast
That I find that folks that want to go towards the, there's the folks that just want to do like rotator cuff surgery at nine 30 on a Tuesday.
00:04:18
The Jobs Podcast
And then you have those folks that I want to be where the the action is. I want to be where it's hitting the fan on a regular basis. And is that an adrenaline thing? Is it an excitement thing? Or is the other stuff just boring because it's routine and run of the mill?
00:04:36
Zach Beam
You know, that's a good question. i'm I'm sure there are some people that are, that seek the excitement and the kind of the uncertainty of and of an acute problem or a true emergency. For me, um what I, what I really enjoyed about um the patient population I currently work with now was that they're really sick.
00:04:56
Zach Beam
They're really hurt. um And they they need attention like right then, or they're not going to have a good outcome. And what I learned ah over time was that even though ER physicians are certainly integral in helping with those patients for sure, like no doubt, ultimately a surgeon is who ends up getting involved in their care and in addressing that issue in the end.
00:05:20
Zach Beam
And um so going through medical school, I did not at all want to be a surgeon. It just yeah did not interest me whatsoever.
00:05:32
Zach Beam
And it wasn't until I did my third 30 year rotations out in Pennsylvania. did my surgery rotation, just absolutely fell in love with it. And so I changed into a pursuing general surgery with the intent of always doing a trauma critical care of fellowship to take care of those really sick and injured patients.
00:05:49
The Jobs Podcast
What was it that you said you had no interest in it and then you had an exposure and then you just changed your mind? Was there one particular moment that the switch was flicked or was there information that you didn't have that when you saw it firsthand and you were around it all the time, you realized this is different than I thought it was?
00:06:09
Zach Beam
I think, uh, I think for me, it was, you know, my, my experience with some of the surgeons was, uh, they were very intimidating, you know, very short to the point. Um, at times off putting, if you will, you know, your, your prototypical surgeon.
00:06:22
The Jobs Podcast
yeah
00:06:24
Zach Beam
Uh, but it's, you know, it's just by nature of training and also what you're dealing with.
00:06:24
The Jobs Podcast
Mm-hmm.
00:06:29
Zach Beam
You have to be short, concise, and to the point with your communication when seconds matter. And so. um Yeah, for me, it was just, I fell in with ah an attending surgeon in a group of residents as a medical student that took the time to invest in me and share their love for their profession and, you know, all the the good, the bad, and the ugly.
00:06:50
Zach Beam
And it was, you know, ah' something that just drew me to it, um kind of a calling, if you will. I never sought it for any status or personal gain or anything. It's just it.
00:07:01
Zach Beam
it's what I felt called to do. And, uh, that's, that's where I am currently. like
00:07:07
The Jobs Podcast
Where did the burn aspect come into your portfolio?
00:07:12
Zach Beam
So as part of general surgery residency, uh, you do have, uh, a component of burn, uh, treatment or or burn rotation.
00:07:18
The Jobs Podcast
Hmm.
00:07:20
Zach Beam
And that's, uh, I really, I really enjoyed that. just like the, you know how sick these patients are. There's your harder press to find someone more ill than a critically injured burned patient.
00:07:33
The Jobs Podcast
Hmm.
00:07:33
Zach Beam
And they are very, very sick. And so i was doing my rotation there at Tulsa at the Alexander burn unit that really got me interested in burns.
00:07:43
Zach Beam
And ah when I got time to apply for fellowship, you can do a critical care surgery fellowship in burn specifically, or you can do one that's kind of more trauma, general surgery geared.
00:07:56
Zach Beam
And I had to make a choice. And for me, I ended up choosing the the latter because I didn't want to get pigeonholed into just doing burn. um And so that's how I ended up with that. And then getting out of fellowship, I sought an employment opportunity that allowed me to get trained up you know fully in burn surgery and then practice as a burn surgeon.
00:08:19
The Jobs Podcast
You know, burns are one of those things where I'm sure a lot of us have burned ourselves on the stove and you get a blister on your finger. And it's surprising how much that hurts.
00:08:29
The Jobs Podcast
And then being in the fire service my whole adult career, I've seen people in various stages of, you know, being burned. It's one of the most painful ah injuries.
00:08:42
The Jobs Podcast
I can only imagine how it feels if you have 20, 30, 40 or more percent of your body burned. is there Has there been anything in your career like major advancements in the treatment of burns compared to even like 10 years ago as far as pain control and then treating the wound and recovery and things of that nature?
00:09:04
Zach Beam
Sure. As far as pain control, you know, the wars in Iraq and Afghanistan have kind of brought what was old back to to new again, such as tourniquets, whole blood.
00:09:14
The Jobs Podcast
Hmm.
00:09:15
Zach Beam
ah But ketamine is one of those things too, where it used to be kind of a, kind of a dirty drug, if you will, but it it works really, really well. We use that a lot in and burn surgery and debridements and also in the trauma bay.
00:09:30
Zach Beam
So as far as, a you know, analgesic considerations, that's ah that's a workhorse for us. But I would say probably of the newer advancements that have come along, ah there's there's kind of two things.
00:09:43
Zach Beam
And again, I'm i'm not shilling for either of these companies, it's just what we as a as a institution use.
00:09:47
The Jobs Podcast
Mm-hmm.
00:09:51
Zach Beam
There's a a material that is a skin substitute that and allows a a stratus or a bladder, if you will, for new tissue to grow up into wounds that have been debrided down past the dermis um and allows new tissue to grow up or granulation tissue.
00:10:09
Zach Beam
And after three to six weeks, um the the silicone backing on the back of that dressing falls off and we're able to skin graft on top of that. So you can get wounds covered, helps with pain control, helps with scarring, and it also allows a a clean wound for new tissue to grow up into.
00:10:26
Zach Beam
Another one is something called ReCell, and basically you're able to take a very small amount of skin and put it through several series of enzymatic processes and make essentially a liquid skin graft, and you're able to cover a lot more surface area with a small amount of skin, and it does very, very well, and we've had some very good results with that in our burn program.
00:10:50
The Jobs Podcast
The skin grafting, you've you've seen the but folks that will have a mark usually on their glutes, on their thighs, a hamstring area, whatnot, the large areas or their back where they take the skin grafts from.
00:11:03
The Jobs Podcast
Is that still kind of standard procedure when a graft is needed or have they come up with a synthetic graft or are they using like, you know, another animal like pigs? seem We seem like we take everything from pigs anymore these days, but...
00:11:16
Zach Beam
That's right. Yeah, you can use, uh, um, you know, animal graphs, but unless it's your own skin, it's not going to stay forever. Your body's going to reject it. And so those are used kind of as a temporary bridge to kind of the same concept to get that granulation tissue layer to form.
00:11:26
The Jobs Podcast
and Okay.
00:11:33
Zach Beam
But eventually you'll need your own skin to to cover that defect in the end. So yeah, so unfortunately, yeah, we still have to take skin from wherever we can get it with the dermatome to ah to get the wound covered in the end. But where that resale comes into play is that we can use a lot less skin, kind of a wider meshed graft, if you will, and fill in all the space with that liquid skin graft. It works really well.
00:11:57
The Jobs Podcast
If you use an animal skin, I know that you said it's temporary, but do you still have to use any kind of an anti-rejection drug or is that is that not needed for the temporary situation that you're in?
00:12:09
Zach Beam
Yeah, it's not, it's not really needed. Um, and in fact, you're pretty immunosuppressed if we're having to use that at that point in time.
00:12:11
The Jobs Podcast
Okay.
00:12:16
Zach Beam
Um, so once you're, once you kind of heal up and, and your immune system kicks back in, you you end up rejecting, but at that point in time, you have some granulation tissue and stuff that's formed underneath there.
00:12:27
The Jobs Podcast
How long does it typically take? And this may be an individual question based on the severity of their injuries. But if someone has their forearm that's, you know, k needing skin grafts, third degree burns kind of thing, has the recovery time changed at all? Or are you still looking at a pretty long term, a year or more recovery to get back to quote unquote normal?
00:12:50
Zach Beam
I'd say it's it's always going to be individualized. you know, each each person's different has their own underlying health problems. And also the degree, the depth and the the size of the burn, but
00:13:00
The Jobs Podcast
Yeah.
00:13:01
Zach Beam
once it's grafted, if everything heals, it's usually resurfaced within a couple of weeks. And then we just continue to monitor for any secondary issues that may arise, like scarring, things like that. So, um but yeah, we do follow burn patients for quite a long time, for a year, if not longer, to ensure that you know, they, they healed completely, no scarring, no, no secondary effects were identified, but yeah, it can be a pretty lengthy process.
00:13:33
The Jobs Podcast
Is infection still your, your main enemy in that treatment plan?
00:13:37
Zach Beam
It is, um, once we skin down, obviously that, uh, that really helps.
00:13:39
The Jobs Podcast
Yeah.
00:13:43
Zach Beam
Um, but in that acute phase for sure, um, not just, not just infection, but you know, once you get beyond that 20, 20% burn that's characterizes it as a major burn.
00:13:54
Zach Beam
It's a very inflammatory process and start having all of your organ systems involved by the inflammatory cascade. So, you know, major burn injuries are, are, are pretty serious. And like I said, you're hard pressed to find somebody who's sicker than than a person who's got about a 50% or greater burn.
00:14:13
Zach Beam
They're, they're very, very sick.
00:14:15
The Jobs Podcast
Yeah. The, I kind of jumped, I went down that rabbit hole about Burns. I appreciate you letting do that, but, uh,
00:14:20
Zach Beam
ah Sure,
00:14:22
The Jobs Podcast
The, let's jump back to your training. You have finished up medical school. You realize that trauma surgery is the lane you want to be in.
00:14:34
The Jobs Podcast
How were your first couple of years in training? Did you have any mentors or anybody that kind of took you under their wing and helped you fine tune the skills that you had learned so far?
00:14:44
Zach Beam
sure so I guess kind of taking a step back, just kind of big picture, the the pipeline or the timeline for me was um So that microbiology program was five years long, so it did five years of undergraduate, ah four years of medical school.
00:14:57
Zach Beam
General surgery residency is five years long, and then I did a two-year ah fellowship after that.
00:15:01
The Jobs Podcast
Wow.
00:15:03
Zach Beam
So we're looking at five, you know, what is that, 16 years after high school to just get done with the education component of it all just to start your real job.
00:15:08
The Jobs Podcast
My goodness.
00:15:13
Zach Beam
So that's how long it took. Any
00:15:16
The Jobs Podcast
I'm exhausted just hearing about all that education. Good grief.
00:15:19
Zach Beam
help? Uh, so yeah, so, uh, in medical school, you know, had, had some mentors that invested in me, kind of urged me to, you know, to pursue general surgery, you know, earnestly and then trauma and critical care.
00:15:20
The Jobs Podcast
So.
00:15:34
Zach Beam
Uh, and then was able to match into Oklahoma state university, uh, medical center for general surgery residency back in Tulsa. So I was able to move back, back home to Oklahoma to do the five years of general surgery and.
00:15:48
Zach Beam
Yeah, so you have your attending physicians that invest in you. You have your senior residents and then your co-residents of your year that you're all just kind of encouraging each other and training each other along the way.
00:16:03
Zach Beam
And um yeah, there's a lot of formative moments in there, both good and bad. and
00:16:09
The Jobs Podcast
Yeah.
00:16:09
Zach Beam
But there's there's several attendings that i that I still think extremely highly of and and keep in contact with from time to time.
00:16:18
The Jobs Podcast
What type of person, when they get that residency like that, they've gone through all of the training, now they're kind of where they're wanting to be, and now starts the ah special focus.
00:16:30
The Jobs Podcast
What type of person will do well from the start? what What kind of traits or approach can they take to start off on the right foot?
00:16:42
Zach Beam
Sure. So, um, you gotta be obviously pretty motivated and able to self-direct a lot of the learning. I mean, you're going to be sitting through lectures and they're gonna be walking you through how to do these procedures. That's why what it's five years long, you know, uh, 80 to a hundred hours a week for five years.
00:17:01
Zach Beam
You're, you're going through the process of graduated autonomy to learn how to do these surgeries safely and effectively, and also manage these patients as well. But there's ah there's a lot of information to cover and you have to be yeah to be determined and and dedicated and self-directing enough to go seek that out and make the time to learn that material.
00:17:22
Zach Beam
um You have to also have to have ah you know kind of that no-quit mentality of you're going to be tired, you're going be exhausted, you're going to have to sacrifice a lot along the way. um But it's worth it on the other side.
00:17:35
Zach Beam
had a lot of attendings tell me that. that were that were out. It's like, oh, I know this is bad right now, but it's totally worth it just to see it through. And when you're in the middle of it, you're like, yeah, right. This is this is awful.
00:17:49
Zach Beam
it's Like, this is the worst decision ever made.
00:17:52
The Jobs Podcast
Yeah.
00:17:52
Zach Beam
but But it is. Once you're at once you're done with it it, I've heard it said, and and it's it's very true, the the days are long, but the years are short. like they they can't stop the clock on you and those five years come and go so quick your your head spins and before you know it to the next phase so um but you got to be you know determined to put in the effort spending long hours kind of on little sleep from time to time um gonna have some thick skin as well and think the other thing too is a healthy dose of humility um to never lose sight of the fact that you're taking care of of an individual
00:18:32
Zach Beam
um When they're at their most vulnerable, you know, they're asleep, they're sick, they're injured, and it's you and your team, you know, taking care of them. And so just having that healthy dose of humility, leaving the hubris at the door and just doing your very best every single time.
00:18:47
The Jobs Podcast
You know, I've spent more than my fair share of time in hospitals. My son's had some medical issues, got a kidney transplant all that, the stuff that goes along with that. And I've encountered a number of doctors of various types and levels.
00:19:03
The Jobs Podcast
And the ones that have that quiet confidence are always the ones that I prefer to interact with because I want someone who believes in their skillset and they know what they're doing.
00:19:17
The Jobs Podcast
But I've also encountered a few, not many, where they walk in the door and the arrogance is just dripping off of them. And it's so, well, it's just unfortunate.
00:19:31
The Jobs Podcast
And as a parent sitting there, I don't care about your ego. Uh, I really want you to realize that I'm a parent sitting here going through something very unfortunate that I have no control over and I'm looking to you for answers.
00:19:47
The Jobs Podcast
And so when you have someone who can just come in and they understand they have empathy and they have that humility, but they're also cool and collected and calm and confident, that's like the perfect marriage for a surgeon.
00:19:59
Zach Beam
Absolutely. I would agree with that. And I try to embody that to the best of my ability every single day. um I'll tell patients that too. It doesn't cost anything to be a decent human being.
00:20:10
The Jobs Podcast
Sure.
00:20:10
Zach Beam
And so um just try to meet them in the moment.
00:20:10
The Jobs Podcast
Mm-hmm. Mm-hmm.
00:20:13
Zach Beam
And, you know, there's a difference between empathy and sympathy. try to have the appropriate amount of of both for my patients. But ultimately remembering too that this is now we try, this is my philosophy, if you will. I just try to contextualize it that this is what I do, not who I am.
00:20:30
Zach Beam
And this can be taken from me at any point, either by you know, injury, death, or or some sort of fiat. And so while I have this opportunity, I'm going to do it to the best of my ability. But that's not who I am. This is what I do. And and to try to have a healthy amount of respect and humility for that.
00:20:47
The Jobs Podcast
Is there a certain personality style that you see in most of the folks that are in your line of work? Are they usually very introverted, extroverted, detail-oriented, you know, or is it just kind of all over the map?
00:21:02
Zach Beam
Yeah, it's kind of all over the map. Trauma attracts, you know, ah lot lot of different personalities.
00:21:08
The Jobs Podcast
Mm-hmm.
00:21:09
Zach Beam
But yeah, I'd say the group that I work with, however, is pretty similar. We're extroverted when we need to be, but also introverted when we need to be as well. I'd say it's a healthy dose, a healthy mix of both.
00:21:24
The Jobs Podcast
learning how to read your audience is probably pretty key.
00:21:27
Zach Beam
Right, that social intelligence is very important. So yeah, read the room.
00:21:30
The Jobs Podcast
Hmm.
00:21:31
Zach Beam
There's a, there's a time and a place for it.
00:21:32
The Jobs Podcast
Yeah.
00:21:33
Zach Beam
And just, um, being able to discern that is, is, is an important skill to have.
00:21:34
The Jobs Podcast
I,
00:21:39
The Jobs Podcast
I think that the reading the room thing, I don't know if I've never met anybody that was necessarily born with that. I think that's something you just have to learn.
00:21:50
Zach Beam
It is, I think you had some people are a little bit better kind of out the gate with that. They have a little more of that intuition, but it's certainly a skill that you have to practice and hone over the years.
00:22:01
The Jobs Podcast
The is there any type of a well, and I'm going ask you a question, but I'm not. This isn't a ghoulish direction that I'm taking. And I'm coming from the place of in the fire service.
00:22:12
The Jobs Podcast
Fighting fire is fun. Now, when somebody hears that, they think, well, someone's house is burning down. Yes, it's not that I want that to happen. It's just that I understand that in the real world, bad things are going to happen from time to time.
00:22:25
The Jobs Podcast
And I hope that I'm there when it does so I can make a difference. and But also, it's exciting, and there is adrenaline, and it is hard work. So not being insensitive to someone's injuries, is there any kind of a ah call that you get to go see someone having a you know, they're in the ER or whatever?
00:22:50
The Jobs Podcast
and Is it trauma? Is it bones? Is it what really gets your creative juices? Like, wow, this is something I'm enjoying this case.
00:22:59
Zach Beam
Yeah, absolutely. and And I totally echo your sentiment too. We, we never want to make light of anyone's tragedy. You know, we, someone's tragedy is the reason i I have a job, you know?
00:23:06
The Jobs Podcast
Yeah. Yeah.
00:23:10
Zach Beam
Um, and so that's never lost on us, but to answer your question, yeah, I mean, there is, you know, you do need to enjoy what you do.
00:23:11
The Jobs Podcast
yeah
00:23:18
Zach Beam
You want to be passionate about it and that's how you stay engaged and stay at the top of your game. And so, um kind of to answer your question, I think like a penetrating injury to the chest with, you peri arrest or, you know, traumatic arrest, those are like, that's as real as it gets. And what you do or don't do is going to affect the outcome of of that case. And so those are, those are ones that always get your heart pumping your blood pressure up a little bit and gets the team really laser focused on what needs to happen next.
00:23:50
The Jobs Podcast
The word that you just used there, team, you you're obviously going to be working with the medics, bring them in. Then you have the nurses. You've got your counterparts of varying levels of being a doctor. what are your When a team is working and everything is just clicking, everything they're on all cylinders, you know were you hand me a tool before I even ask for it because I know you need this next kind of a thing.
00:24:17
The Jobs Podcast
What makes a good team in your line of work?
00:24:23
Zach Beam
First and foremost, it's going to be communication as with anything you you got to have clear, concise and effective communication.
00:24:26
The Jobs Podcast
Hmm.
00:24:30
Zach Beam
That's that's the most important thing. Right behind that is, you know, roles and everyone knows their role. So everyone has a job to do and then the competence to do that and do it effectively and efficiently.
00:24:45
Zach Beam
um when When all those things are are happening, not a lot needs to be said because everyone knows what the next step is and it just gets done And kind of the roles that trauma surgeon is kind of the kind of full circle almost, if you will, is kind of the The orchestra director of of chaos, you're directing the chaos towards a towards a goal of resuscitating and managing a very sick patient.
00:25:14
The Jobs Podcast
Is it difficult to turn a patient over when it's time for them to move to the next step of care? Do you feel like you want to walk them through or is there a point where I've done everything that I can for them now I need to hand them over to these folks that that's their area of specialty?
00:25:32
Zach Beam
I'm sure ah there's been a handful of cases where it's a little, I'd say more difficult, but for overall, no, because, you know, the goal is to get them outside of your care. you know That means you've done your job and you've done it well. They're leaving the hospital, one alive, but in better condition than when they arrived. So, in fact, it's a good thing when you have to hand them off because it's it's a job well done. they They're graduating, if you will, they're moving on.
00:26:01
The Jobs Podcast
Do you have doctors that are more senior than you that as they work their way up the the chain of command, for lack of a better term, is it difficult to transition into my hands aren't on the patient now, I'm more of an administrative type of a thing? Or do does every doctor kind of get to the point where it's been fun being in the trenches, but I've been doing this for decades now.
00:26:28
The Jobs Podcast
I need to shift gears and I would be better served up here.
00:26:32
Zach Beam
Yeah, I think that's going to be, you know, each individual surgeon has to make that decision on their own.
00:26:38
The Jobs Podcast
Hmm.
00:26:38
Zach Beam
Um, I know at some point if, if I'm lucky enough, I'll have to make that decision myself. Um, but, uh, the, the ones I know my senior partners, they've been doing this for a very long time and, um,
00:26:51
Zach Beam
And as I understand it, I mean, their intent is to continue to take care care of patients until the day they hang it up. And so some people are able to navigate and kind of transition into a more administrative role ah or, you know, kind of a part-time, less clinical role. But kind of the job we do, at least in this area of the nation, um it's all hands-on. You're doing this job until the day you stop.
00:27:20
The Jobs Podcast
What's downtime like? And i I preface it with you may not have much. I know that the ER can be kind of an ebb and flow of all of a sudden everything is going sideways and then there's the calm before the next storm.
00:27:37
The Jobs Podcast
Is the downtime typically used to prepare for the next wave? is that Is that how it typically goes? Or do you have the luxury of any downtime at all?
00:27:46
Zach Beam
we ah We do have a little bit of downtime, but lately there's not there's not a very lot there's not a lot of it. And so once trauma is over with, you're preparing for the next one. But kind of our our specialty, our group, we're the emergency general surgeons for the health system. We also cover burn, help with the, ah we manage ICU patients.
00:28:13
Zach Beam
And then obviously trauma. So there's if it's not a trauma, there's a general surgery issue that needs to be addressed or there's an ICU issue that needs to be addressed or a burn consult that needs to be staffed and seen.
00:28:24
Zach Beam
um There's something kind of ah fills almost every minute of your shift most of the time. You're kind of running and gunning, if you will. There's always something going on.
00:28:35
Zach Beam
But we do get, you know, your downtime is when you you clock out. And so, and you clock out when the work's done. So if you're in the OR and your shift's over, you don't pop scrub and leave. You're there until that case is done.
00:28:48
Zach Beam
So um ah eventually the work does end for the day and you can go home and get some rest and start all over again the next day.
00:28:57
The Jobs Podcast
Do you have any issues, not you personally, but your line of work? I can see burnout being sometimes something that you would encounter. You'll have multiple days where my shift technically ended three hours ago.
00:29:11
The Jobs Podcast
I'm exhausted and I still have another two hours to go before it's it's acceptable for me to hand it off to the next person.
00:29:20
Zach Beam
right
00:29:20
The Jobs Podcast
that There's got to come a point when i have to step back for a little bit because I'm just fried.
00:29:27
Zach Beam
Yes. Well, fortunately, i say fortunately, um, I think our model works pretty well. We, we work two weeks in a row and then we get a week off. So you're in the hospital for 12 to 14 days.
00:29:39
Zach Beam
Um, and then you're off for seven to nine. And so you least have that light at the end of your tunnel where It's just a grind that whole time. But then when that last day, last shift ends, your you're done. You get to go home and decompress finally. And yeah yeah apart from a small meeting here or there that you can call into, your time is yours. And so you get to to rest, recover, spend time with your family. that
00:30:10
Zach Beam
You still get you get time with your family daily, but you can actually spend intentional time with your family, kind of catch up. so it's a That's what I have to look forward to. you each Each person has to manage all that on their own. you know this This job isn't for everybody either.
00:30:27
Zach Beam
um ah There is a little bit of sacrifice, not only from you, but also your family and when you're on those two weeks. but um At the end of the day, though, I think it's if you have you have buy-in from your family, your spouse, or significant other, knowing that what you do um it matters, even though it doesn't seem like it, it does matter.
00:30:51
Zach Beam
um that That helps go a very long way. It makes a sacrifice not not that big to bear in the end.
00:30:58
The Jobs Podcast
You always have that light at the end of the tunnel. I just have to go a couple of weeks and then I'll have a break.
00:31:03
Zach Beam
That's right.
00:31:05
The Jobs Podcast
I can see that being mentally a way to make it easier to push through those those rough days to go. i just, it's not never ending.
00:31:16
The Jobs Podcast
It's, I just got to make it a couple more days and then I'll be all right.
00:31:19
Zach Beam
That's right. It goes back to residency, right? They can't stop the clock.
00:31:23
Zach Beam
So at some point I'll get to go home.
00:31:23
The Jobs Podcast
Yeah.
00:31:26
The Jobs Podcast
Yeah. What do you like most about your job? Is there one or two things that always kind of rise to the top in your mind when someone asks that question?
00:31:39
Zach Beam
Yeah, I'd say it's the variety. Um, no two patients are ever the same. No two injury patterns are ever identical. Um, the, The acuity of the issue is always fairly high, and it just keeps you on your toes. I mean, you're taking care of some very sick general surgery or trauma burn patients, and no two are ever alike.
00:32:02
Zach Beam
And so knowing that the next case that you get could be something that you've never seen before, and you know you get to you get to sort that out with your colleagues, and you come up with a treatment plan and you see it through and and then you see the the efforts of your labor, the fruits of your labor you know down the road and in a good outcome. So that's a big one.
00:32:25
Zach Beam
unless You never really know what's coming through the door. um And then, you know I'd say for me, too, just the the team that I work with, just a phenomenal group of men and women, PAs, nurse practitioners, and other surgeons, they're one of the big reasons why I get up and go to work every day. It's it's always a blast working with them. It's kind of that shared misery, if you will. you know So you're in the trenches together just getting it done.
00:32:53
The Jobs Podcast
yeah
00:32:53
Zach Beam
and everyone always puts the patient first. You know, everyone's dedicated to the clinical excellence and that makes it worthwhile to get up and and work with those people every day.
00:33:05
The Jobs Podcast
The other side of that coin is always, you know, an unpleasant question to ask, but what do you dislike most about your job?
00:33:14
Zach Beam
The same thing, ah you never know what you're gonna get and it can be, you know, a catastrophe, you know. that the thing with trauma surgery unfortunately is that uh you know when or when you win you win big right um when you when you pull somebody back from the brink of death and it sounds so cliche but i mean oftentimes it's exactly what you're doing if you and your team hadn't have intervened the patient would be in the ground um so that's exhilarating but at the same time um
00:33:44
The Jobs Podcast
Mm-hmm.
00:33:50
Zach Beam
there's, you lose a lot too. And, uh, you know, you, you learn to deal with that through residency and then fellowship and then even into your attending years. Uh, but you know there's a lot of tragedy that you come in contact with every single day. And unfortunately for us, it's not our personal tragedy that we have to live with the rest of our lives, but we share in that at least briefly in the moment.
00:34:13
Zach Beam
And that, uh, you that gets old after a while. You know, there's that's a lot to to come in contact with yeah every single day. but But again, it's an honor to be able to do that, to to help in that manner.
00:34:28
Zach Beam
So trying to strength save to focus on the positive side of that.
00:34:29
The Jobs Podcast
It's a...
00:34:32
Zach Beam
It's like, well, I was able to lend my help, lend my skills to try to help this person and this family. like
00:34:40
The Jobs Podcast
It's a tough... And I say wire because it's a fine line to walk where you have empathy and you do everything you can to help those people, but you keep your emotions in check because if you get emotionally invested in every person that walks through your door, you won't last very long at all.
00:34:59
Zach Beam
ah You'd be a wreck. You wouldn't be able to. No, you will not. No.
00:35:02
The Jobs Podcast
Yeah. Yeah.
00:35:03
Zach Beam
and And the other thing too is the next one's always coming.
00:35:06
Zach Beam
You know, like sure. i mean, everyone has their own way of coping with but certain situations. But at the end of the day, you got to pick yourself up and and carry on scrubbing.
00:35:06
The Jobs Podcast
Yeah.
00:35:18
Zach Beam
Get on with it because the next one's coming. You can't be having a pity party. The next tragedy is coming and we need you at your best. So.
00:35:26
The Jobs Podcast
It can be overwhelming, I would imagine, where it just feels like you never catch up. The shift that never ends is one after another after another. It's like, good grief. Will someone check out there and see what's going on? Because we need to stop.
00:35:42
Zach Beam
Yeah, well, just it is what it is. And, you know, we're happy to do it We're all little little different, I guess, for that.
00:35:47
The Jobs Podcast
Yeah.
00:35:53
Zach Beam
But we love the chaos and love to be the masters of it.
00:35:55
The Jobs Podcast
Yeah.
00:35:57
Zach Beam
So...
00:35:59
The Jobs Podcast
Has there been anything, you know, we talked earlier about burn treatment as far as the the changes, the ketamine use and the skin grafting and things of that nature. But as far as trauma surgery goes, in the last five or 10 years, or even something that's on the near future, that's going to be coming into your office, for lack of a better term.
00:36:20
The Jobs Podcast
Are there any changes, advancements in the medical field and trauma surgery as AI seems to be getting into every field these days in some facet? Are you seeing anything like that?
00:36:34
Zach Beam
As far as AI, not specifically, not yet anyway. I'm sure there's several journal articles out there about it that I just haven't read yet, so I'll plead ignorance to that.
00:36:45
Zach Beam
But nothing that I've been made acutely aware of here recently is AI getting involved directly with trauma surgery or anything like that. Big advancements again. i think what's old is new again.
00:36:59
Zach Beam
Making that shift back to whole blood has been a big thing of late. And and i'm I'm glad to see that coming to fruition again. your you know These patients are bleeding whole blood.
00:37:11
Zach Beam
they need whole blood back. And there's been data to support that time and time again. So seeing that advancement coming back into not only just the hospitals, but also in EMS and helicopter EMS services, administering whole blood in transit is going to save lives for sure.
00:37:30
The Jobs Podcast
The topic of failure is something that I always ask every single guest. I want to get their feedback on how they personally deal with failure and then if it's someone that is under them that works for them.
00:37:45
The Jobs Podcast
how do they advise them on responding to a failure? Now, your line of work, a failure, cannot be some, well, it could be something simple, but it's not just, well, we lost a little bit of money on this sale or the product was damaged and we have to fix it.
00:38:02
The Jobs Podcast
Yours could be extremely serious if a failure is made. What's the advice that maybe you've received or that you would give someone on how to deal with failure in your line of work?
00:38:16
Zach Beam
So first and foremost, um never forget that you're human. You're going to fail, the degree of which is different for each situation, in each person, but you're going to fail.
00:38:29
Zach Beam
time and again, but it's how you, how you meet that and rise above that. So recognizing that you're going to fail, um but realizing that that doesn't define who you are.
00:38:40
Zach Beam
And the important thing is to learn from that. So it was a pretty, pretty big failure. Well, drive some lessons from that, make yourself better for the next time around. And don't repeat that.
00:38:53
Zach Beam
Learn your lesson from it. And then hold your head high, you know, we're we're all going to make mistakes. We're all human, even in the medical field. one of my ah One of my senior officers in the military is a physician, and kind of jokingly, but and also somewhat seriously said this to a group of other military officers who are kind of combat arms, you artillery and armor and infantry, et cetera.
00:39:22
Zach Beam
he's like, I guarantee you I've killed more people than anyone else in this room. And so just realizing that, you know, you're going to make mistakes. You may never see the full weight of those mistakes, but that's the nature of medicine, unfortunately, throughout your years of training and There's so many touch points along the way to where things can go awry. But, you know, and the important thing is just learning from those mistakes, correcting them and make sure you never make them again.
00:39:50
Zach Beam
And so don't be too hard on yourself. But if it does happen, learn and don't make that mistake again.
00:39:59
The Jobs Podcast
The topic of pay is something that a lot of people want to know. And I think sometimes the focus on money is a bit too much. It's like, well, yeah, that job may pay well, but will you be happy doing that job? It needs to be...
00:40:13
The Jobs Podcast
ah you know, a multi-pronged approach, not just pay. And that's it because we've all worked for more money and realized, yeah, it's a nice paycheck, but I can't get that time back. So what, is there a general rule of thumb as far as what a trauma surgeon would typically make, like maybe right out of residency, if they've got their, their basic training and now they're starting to focus on this specialty? Yeah.
00:40:40
Zach Beam
Sure. Finding, finding, you know, medical specialty, you know, salary ranges can be a little tough. A lot of hospitals in groups keep that kind of tight to the chest kind of in a way of bargaining, if you will, you don't want to know that, Hey, if I take this job down the street, I'm going to make X amount of dollars more to do the same work.
00:40:52
The Jobs Podcast
Mm-hmm.
00:41:00
Zach Beam
They keep it pretty, pretty close to the chest, but, um, you know, on average, um, like your, your trauma surgeon makes around probably
00:41:11
Zach Beam
I don't know, $450,000 a year, give or take. um And that salary range can be you know well above that if they're producing a lot of revenue for a hospital or they're very busy. It can be you know quite lower than that too. And also depends if you went into private practice, hospital employed, or if you're an academics, typically an academic medical center, doesn't pay as much as a community hospital would.
00:41:40
Zach Beam
And also location geographically makes a huge difference too.
00:41:45
The Jobs Podcast
Yeah.
00:41:45
Zach Beam
You're working in New York City versus working in rural Montana where they can't recruit anybody out there to come do the job. So it varies, but that's probably like the ballpark kind of average there.
00:41:59
The Jobs Podcast
Are there, is it normal for a trauma surgeon to work in the yeah ER for a certain number of years and then I'm going to go work for plastic surgery. I'm going to go work for here or there. Do they typically stay in that realm or do a lot of them branch out and take their skills that they've learned and go into a different market?
00:42:22
Zach Beam
So all of your trauma surgeons are general surgeons first and foremost with with a few exceptions have gone and done on the ah the critical care surgery fellowship.
00:42:33
Zach Beam
So um some ended up branching out into, you know, they, you know general surgery side of the house.
00:42:33
The Jobs Podcast
Hmm.
00:42:40
Zach Beam
I do maybe bariatrics or, you know, complex hernias or wound care kind of as you're getting older, kind of taking less trauma call and doing more kind of straightforward if you will, easier endeavors, surgically speaking.
00:42:56
Zach Beam
um But yeah, no, as far as like going and then doing plastic surgery or going and then doing you know something else, once you do a residency, that's that's what you're doing unless you go back and do a residency again. so If I wanted to go do orthopedic surgery or, OB-GYN, I have to go back into another five year ortho residency or four year OB-GYN residency and then start all over. So kind of you're stuck.
00:43:22
Zach Beam
That's what you're doing. So choose wisely.
00:43:26
The Jobs Podcast
That's pretty good advice. I know that you mentioned early on that you wanted to originally you wanted to pursue a career in music. And now you're in the the job that you're in now.
00:43:40
The Jobs Podcast
Is there something else that you do on the side that maybe, you know, this is something that I might want to make a go of? Or is the surgeon thing your deal and then your off time is for for pleasure and enjoyment and hobbies and not looking for another revenue stream or another occupation in a certain number of years?
00:44:02
Zach Beam
Sure, that's a great question. That's a kind of briefly, yeah, my my time my time off is my time off. But ah I've got a lot of hats like a lot of us do, or just gluttons for punishment.
00:44:14
Zach Beam
So I joined the military and medical school and have been in almost 14 years now as ah as part of the National Guard. And ah deployed last year with a surgical team out to the Middle East.
00:44:22
The Jobs Podcast
yeah
00:44:26
Zach Beam
And so came back about this time last year, got back home. I started getting involved with the local ah law enforcement agency helping train their special response team, medics.
00:44:39
Zach Beam
So helped a couple of ER physicians that are doing that. offered me that opportunity to start getting involved with that. So I do that, starting to do that here recently. So something I've always wanted to do kind of get to the tactical medicine side of the house. And so and cultivating that opportunity right now. so A lot of my free time, unfortunately, has been preoccupied with these side quests, if you will, of military and tactical medicine. But ah I try to make the time that I do have off intentional with my my wife and kids and go to the gun range with my boy and play games here at the house with the girls. and
00:45:24
Zach Beam
spend a lot of time outside when I can and just try not to think about anything important for that those days that I have off, just really trying to decompress, let the weight of all of it go away.
00:45:26
The Jobs Podcast
yeah
00:45:37
The Jobs Podcast
The military side of things, I would imagine that spending time in the military, and I can see it especially when... I say at times of war or you know when we had Iraq going on and then Afghanistan and what like that, those kind of things, you can have a lot of experience dropped in your lap pretty quick. was Do you have a viewpoint on kind of how that affects your approach to medicine?
00:46:11
Zach Beam
Yeah, so, um i i like i said, I joined in med school. Actually, I tried to join at college. I was EMT, and it was right during the surge of Iraq and Afghanistan.
00:46:21
The Jobs Podcast
Mm-hmm.
00:46:24
Zach Beam
was 07 time frame. Yeah. time frameme And I really wanted to, I really wanted to serve. ah grew know telling I grew up in rural Oklahoma with my younger brother. We spent every day out with a some pellet rifles and a rucksack. And that's what we did my entire childhood. and we just trips through the countryside, shooting trees and shooting at birds and whatnot, playing army, you know.
00:46:50
Zach Beam
So the opportunity came and, uh, I went through the whole process of trying to enlist as a flight paramedic. There was a, there was an aviation unit not too far from my hometown.
00:47:01
Zach Beam
That's what I wanted to do. went through the process. I'd already been accepted to medical school at this time. And, uh, the recruiter was probably the best, worst recruiter ever.
00:47:12
Zach Beam
Um, essentially looked at me and said, why, what are you doing here? Um, I say, I'm trying to join the military, you know, I want to be a flight paramedic and say, well, what are where are you going after this? And I will go into medical school as I know you're not, not if you sign this down the line today, you're shipping out and you may or may not ever go to medical school. So,
00:47:34
Zach Beam
ripped up all my paperwork in front of me, said, get out of here and join when you're a medical student. When you actually step foot onto campus as a first day med student, join the military if that's what you want to do still. And that's what I did.
00:47:45
Zach Beam
And that's how I ended up in the National Guard unit that I'm sending them in now, through that process. and
00:47:52
The Jobs Podcast
wow
00:47:52
Zach Beam
So joined as ah as a medical student and became a and medical officer, and and here we are. so um But how it shaped kind of how I do my day-to-day job, um really it's just it all comes down to communication and then that the deployment kind of shaped things to where you're doing the exact same job you would as a trauma surgeon in the level one trauma center.
00:48:13
Zach Beam
but with limited resources in a forward environment and ah just really, really focusing on on the basics, you know, doing the basics right and perfectly is what's going to save your bacon. You can get all lost in the weeds with all the fancy bells and whistles and this, that, and the other, but really perfecting your team dynamics, your team communication, and making sure that you master the basics of your trauma resuscitation, it's going to set the tone for you to to intervene down the road. You've got have a live patient to to do surgery on. I
00:48:47
The Jobs Podcast
I may have watched too many episodes of MASH, but when you're in a forward unit like that, meatball surgery is probably a ah the incorrect term, but the name of the game is stabilization to get them to where all the high-tech equipment is and a team and whatnot.
00:48:56
Zach Beam
i think...
00:49:04
The Jobs Podcast
Is that is that a fair statement?
00:49:06
Zach Beam
Yeah, so the the technical terms for those are going to be damage control resuscitation and damage control surgery. So you're taking care of any acute bleeding, and stopping the bleed, stopping contamination, and resuscitating the patient, but you're not doing the full-blown definitive surgery.
00:49:14
The Jobs Podcast
Hmm.
00:49:23
The Jobs Podcast
Right.
00:49:24
Zach Beam
You're temporizing them and getting them to the next higher level of care. That's what you're doing.
00:49:30
Zach Beam
and And unfortunately for me, ah when i was my time out out in the Middle East was not very busy, so which is both a good thing and a bad thing. you know my own selfish pleasure was hoping to get some ah excitement out of it, but it's a good thing that if we didn't admit that our guys weren't getting hurt.
00:49:44
The Jobs Podcast
right
00:49:47
Zach Beam
So got to go have the experience and got to serve in that capacity, which was a long time desire of mine. I'm extremely grateful for that opportunity.
00:49:58
Zach Beam
Uh, it just wasn't very busy. wasn't my time. So that's okay.
00:50:03
The Jobs Podcast
If you're going to be in a place that's a lot hotter than Oklahoma, at least, you know, you want something, you want to be busy to take your mind off of the fact you're living in an oven.
00:50:11
Zach Beam
That's right. That's right. right we We did have some weights around, so we're able to work out quite a bit. So got in some of the best shape of my life while i was out there and it was great.
00:50:18
The Jobs Podcast
There you go.
00:50:21
The Jobs Podcast
I've heard that from a number of guys just to pass the time. They just lifted all the time.
00:50:25
Zach Beam
That's right. Drinking tons of protein drinks and lifting weights.
00:50:30
The Jobs Podcast
Yeah. Yeah.
00:50:30
Zach Beam
Water protein and bro-teen, you know.
00:50:34
The Jobs Podcast
What's the best compliment that you can get in your line of work?
00:50:41
Zach Beam
ah
00:50:46
Zach Beam
Honestly, I think it's just a ah sincere thank you. you know we Oftentimes what we do is kind of in the worst circumstances and you never really hear that and not that we expect it or need it if you will but it's a relatively thankless job for you know overall just given the the acuity and the events that are going on but You know, when a family or or even better, a patient, you know comes back after a catastrophic injury and they make it out of rehab and they come back into the into the hospital to see you and your team and and tell you thank you.
00:51:21
Zach Beam
like that's That's why you do it. That's why we do this job. And that gives you, know, you feel 10 feet tall, you know. It's like I can go for another and three years without another one, ah you know, hearing that again, and I'll i'll be okay.
00:51:29
The Jobs Podcast
Yeah.
00:51:36
Zach Beam
Like that's that's what it does to you.
00:51:39
The Jobs Podcast
That's gotta be something that is kind of it's gotta be rare. I know on the fire side of things, we'll, we'll take people to the hospital in a, ambulance and we drop them off and we may help in the yeah ER, just get them onto a gurney and then let the folks take over from there.
00:51:55
The Jobs Podcast
And then we never know what happens to them 99% of the time.
00:51:59
Zach Beam
Mm-hmm.
00:51:59
The Jobs Podcast
And so you don't, it's those little micro doses of a lack of closure of any kind where I don't know that person, but it would be nice to know that if what we did made a difference and then you're left just tiny bit, you're just hanging a tiny bit over and over and over again.
00:52:18
The Jobs Podcast
But you get that one family that stops by with cookies or donuts and they say, Hey, you know, my dad's in the hospital, but he's going to be getting out and you guys saved him. And it's just like, I mean, I know exactly what you mean when that you can ride that wave for a long time.
00:52:33
Zach Beam
Sure can. And that's what that does it for the team, too. You know, you see that and you're like, that's no matter how rough the day or the week or the month or the the season has been when that happens, you're like, right, that's that's why we do this job.
00:52:48
The Jobs Podcast
Yeah. Yeah.
00:52:49
Zach Beam
That's why we're called to this. And it makes you feel like a million bucks, you know.
00:52:55
The Jobs Podcast
Yeah, this has been a really interesting interview. i I appreciate you taking the time to lay it all out like that. it's i've I've rubbed elbows with folks in your line of work a number of times. It's always, I have my role and then I pass it on to the folks in your in your building and you guys take it from there.
00:53:18
The Jobs Podcast
But it's always nice to talk to someone to know i have better insight about what happens when we've left but hospital the with a patient. so
00:53:30
Zach Beam
Absolutely. Well, like I said, it's ah this is job isn't for everyone, but I love it, and I can't think of anything I'd rather be doing with my life as far as a profession than this.
00:53:42
Zach Beam
It's a long road to get there, but it's certainly worth it. There are many points of failure along the way that a lot of people don't even realize. you think getting into medical school is the hardest part.
00:53:53
Zach Beam
It's not. You've got to pass all your licensing exams. You've got to pass each year of residency. You've got pass your boards.
00:53:59
The Jobs Podcast
Yeah.
00:54:01
Zach Beam
And then every surgery, every patient you encounter is, you know, there's a potential for failure. So there there are many points of failure along the way, but you can't focus on that.
00:54:12
Zach Beam
You've got to focus on on the why that you're doing it. And for us, it's to use our God-given talents and skills to be at the right place at the right time to hopefully you know make a positive impact on somebody's condition in life and and let them see you know the following day.
00:54:29
Zach Beam
And it's an immense privilege to get to do it. Just you know always remain humble and be honest. you know Honesty is is the best policy.
00:54:43
The Jobs Podcast
yeah
00:54:44
Zach Beam
strive to be the best you can. Leave your ego, leave your heberus at the door and just be thankful for the immense privilege that it is to to be able to perform surgery. mitsa It's something else and it's it's definitely worth it.
00:54:57
Zach Beam
um I can say that it's worth it, making it through it. There's no better job in my opinion.
00:55:04
The Jobs Podcast
Well said. I'm glad you're in that line of work because it's nice to have folks that are passionate about what they do.
00:55:10
Zach Beam
Absolutely.
00:55:11
The Jobs Podcast
All right. Thank you very much.
00:55:13
Zach Beam
Yes, sir. Thank you.