Case starting. Time to fire up the laptop.

We tell our medical students, residents, spouses, children how intellectually stimulating and wonderful anesthesiology is. But let's not kid ourselves; practicing anesthesia can be mind-numbingly boring at times. Granted, when it's boring it usually means the patient is doing well. I certainly wouldn't want to work everyday having to constantly stress about whether my patient is about to code on the OR table.

But I've walked into my colleagues' rooms and half the time (most of the time?) they are either reading their Wall Street Journal, surfing the internet on the laptop, or talking on the phone. It's no wonder surgeons do not see us as their medical equals. I saw this acronym from a medical student forum on what anesthesiologists do in the OR.

A--Airway
B--Book
C--Coffee
D--Doughnut
E--Eat
F--Funnies (read)
G--Go
H--Home

This unfortunately is how our behavior is noticed by the future generations of physicians. We then complain about our long hours and difficult working environments, which only sounds whiny to your internist or surgical friends. They are juggling an inpatient census of 20, office full of patients, pages from the floor and ICU nurses, and calls from the ER. The caricature of anesthesiologists is so bad that people believe it. One time I was watching my patient's monitor during a case. Though the patient was doing well, the surgeon kept looking over the drapes at me. I asked him if anything was wrong. He said he was worried because he rarely sees the anesthesiologist pay that much attention to the patient. He thought the patient was doing poorly based on my attention. He usually sees the anesthesiologist checking their email or reading a travel magazine.

I hate to admit it, but the temptation to do something else besides watching your patient is great. Today, I had two loooong cases. Both cases involved healthy patients with minimal bleeding or cardiovascular disturbances. At that point, it's hard not to nod off without doing something else, like surfing my laptop. Is that a crime? Is it better to have half the attention of an alert anesthesiologist than to have an anesthesiologist fall asleep (intermittently)? What's your best idea for staying alert in the OR without eating, drinking, surfing, talking on phone, texting, reading... Do we sabotage our image as medical professionals when we do this in the OR in front of the surgical and nursing staff?