"Each one can be extremely rare but of critical importance." The speciality is a broad church, so there is room for all personality types. The anesthesiologist provides pain relief before, during and after surgery, but they also fulfill a number of other important roles. Whether the anesthetic is routine and easy or emergent and life-threatening, the anesthesiologist is with the patient the whole time they are in the operating room. Anesthesiologists are medical doctors who specialize in the care of patients before, during and after surgery. During an operation, your life is in our hands. Being under a car in a ditch in the rain at 2am is very different from the bright lights of the operating theatre. I can see with each heartbeat what the patient’s blood pressure is in the operating theatre; on the wards, it might only be checked once every four hours. If they love travelling, I’ll talk about a white sandy beach, with crystal clear waters, a gentle breeze. There are painters, musicians, novelists, as well as some quite serious sports people. Some appear to have powers of extrasensory perception; I turn to ask for something and there it is in my hand. We say there’s a blood-brain barrier between the surgeon and the anaesthetist: they’re the blood, and we’re the brains. If there’s an emergency during an operation the team looks to the anaesthetist for leadership, as the surgeon is often too focused on fixing the immediate problem. We always work with an assistant, who might be a nurse or an operating department practitioner (ODP). We see every day the damaging effects of too little aerobic fitness, so we’re staving off our own mortality. Patients are usually nervous when they arrive in my anaesthetic room. We’re everywhere in the hospital. Many young, usually male, patients have commented as the drugs take effect that it feels just like a Saturday night. On the day of surgery deciding what anesthesia type the patient should receive, the plan of action is decided. Michael Sopher, MD compares the work of an anesthesiologist to that of an airplane pilot: “ Even though our work typically goes smoothly, we must prepare for a huge variety of adverse events," he says. Every anaesthetist will have their spiel, some small talk to distract the patient from their imminent surgery. Even after nine years I still get a frisson of nerves in some situations. Reassuring nervous patients, rendering labouring women pain-free with the magic of epidural analgesia and, of course, merciless surgeon baiting. I’ll ask if they need me to Google instructions for the operation, or if they’ll be finished before new year. We’ve embraced ideas from aviation and other high-reliability industries about how a team functions effectively. You know that if you get it wrong you might kill someone. We want to hear your candid accounts of what work is really like. Life of anesthesiologist: anesthinfo is unique site which includes A to Z information regarding anesthesia. I often arrive at 7.30am (30 minutes before my shift begins), so I can find space on the pre-op ward to see my patients in private, find out their history and take the time to address any concerns. We try to flatten the hierarchy in theatre so that the least qualified individual can raise concerns without feeling intimidated. There are so many gaps in rotas of doctors, nurses and the wider healthcare team, and the proposed junior doctor contract changes will only make this worse. Generally life of a doctor starts with that given day, but life of anesthesiologist starts with day before they come to operating room seeing or studying about the patient for tomorrow. The best bits? I’ve been asked how many GCSEs you need to be an anaesthetist. Today that meant no cases for me. Before my first unsupervised operating shift, I confessed to the ODP that I’d never worked alone before. I’ve also worked with many theatre colleagues with a wicked sense of humour. The very best of them could do my job without thinking twice, but they choose even greater anonymity than the anaesthetist enjoys. Some of my colleagues are real polymaths. It’s an exercise in trust to place your whole life in the hands of others. You have to get used to being invisible as an anaesthetist. If the patient is fit, it’s rare for them to come to harm from a general anaesthetic. By sharing episodes where a patient has nearly come to harm, we hope to address the causes and prevent actual harm from occurring in the future. Our postgraduate exams are renowned for being tricky but they are really a test of commitment. Many a time I’ve had my bacon saved by an astute ODP. The coffee room in the morning is the preserve of the middle-aged man in lycra. Courtesy: Dr. Michael Sopher. In fact our training is as long as that of a surgeon. Every anaesthetist will have their spiel, some small talk to distract the patient from their imminent surgery. This ability to offer a premium level of care is one of the reasons I became an anaesthetist in the first place. A large percentage of the public has no idea that we’re medically qualified. ou have to get used to being invisible as an anaesthetist. We assess people’s fitness for surgery, how likely they are to suffer complications, and support them through the operation itself and into the postoperative period. This makes it especially frustrating when patients come to harm after they leave your care because the rest of the system is struggling to cope. In fact our training is as long as that of a surgeon. The more nervous they are, the longer they take to go to sleep. I hide it though; it’s an important part of the job to stay calm at all times. In my spare time I’m a volunteer doctor for the ambulance service. Frustrations creep in to the job when the system fails. We’re experts in physiology, pharmacology, and physics; we have to know about everything from cellular respiration to how our drugs work, to the internal workings of a defibrillator. At the end of the day he came clean – he’d been doing the job for 20 years. In my practice the post-call people get the lightest schedule. The outlook for patients who suffer complications after surgery is determined not by the presence of the complication, but by how quickly it is picked up and dealt with. It takes seven years of specialist studies after you’ve already completed two years of basic general training; and that’s after five or six years at medical school. But despite the highly sensitive role we play, we are all but invisible to our patients, Last modified on Thu 16 Apr 2020 05.43 EDT. • Are you a private tutor, a plumber or a mental health nurse? On the wards each doctor will be responsible for up to 30 people a day, and even more at night. A large percentage of the public has no idea that we’re medically qualified. Our drugs stop people breathing and it’s our job to take over that function. He paused and stuttered that neither had he, it was his first day at work, being newly qualified. I look after one patient at a time. When you first start anaesthetising patients early on in your career it’s terrifying. Every anaesthetist has a secret weapon when working in the operating theatre. It is carefully discussed with… Read more But it’s still a hugely rewarding job. Anaesthesia is a very safety-oriented speciality; we’ve led the way in reducing patient harm by looking at human factors, using simulation training and reporting “near misses”. It’s an exercise in trust to place your whole life in the hands of others. There are no typical days, so I will describe a sample of what my days are like: Today (post-call): I had the day off. I ask them about family, talk about their favourite place to visit, what they do for a living. In theatre obviously, but also in intensive care, on the wards, in the emergency department, and in the pain clinic, with those who are really suffering. I’ve worked with colleagues who have a 10-minute ritual for putting in an intravenous cannula that had to be completed in the correct sequence. It takes seven years of specialist studies after you’ve already completed two years of basic general training; and that’s after five or six years at medical school. What does an anesthesiologist do? But given the precision involved there is perhaps a tendency to obsessive traits. I’ve also been asked if I liked to have sex in a vest – I decided not to pursue what he meant by that when he woke up. This simply can’t happen when workloads are too high. Anaesthesia can also become routine; it’s a far cry from the early days of the speciality when unpredictable drugs were used without monitoring. Find full details on submitting your story anonymously here, NHS 'in perpetual winter of Narnia' as waiting list reaches record 3.9m, The secret life of a truck driver: at the sharp end of what the EU means, I want out | Anonymous, ‘When you first start anaesthetising patients early on in your career it’s terrifying.’.
2020 life of an anesthesiologist