Wednesday, February 6, 2013

Anesthesiologists Need To Be Bendy

There is one qualification of being an effective anesthesiologist that is rarely discussed. It has nothing to do with how high your board scores were or whether you can recite Miller's Anesthesia cover to cover. It's not even listed in my 8 Simple Rules. No, one of the qualities of a capable anesthesiologist is how flexible he is.

Seriously, we need to be pretty pliable to do our jobs. My workspace behind the ether screen can be incredibly tight, sometimes barely wide enough to put a sitting stool in. Some spaces are so small that I can't open my anesthesia cart drawers without standing off to one side. I remember one operating room we had where there was just enough space for the operating table and patient gurney to sit side by side. Everything else had to be shoved as far into the corners of the room as possible. I couldn't even sit down for a case. Squeezing through a room like that made me feel like Indiana Jones trying to slither through an ancient labyrinth. Eventually that room was converted into an equipment closet, which was really what all that room could accommodate.

Because of patient positioning on the OR table I sometimes have to bend into extremely awkward angles to access the patient. I can't tell you how many times I've had to get down on my knees and duck my head under the drapes to check for train of fours or place an NG tube. When a trauma patient comes in, the surgical drapes are usually in place before I've had a chance to put in all my lines. Therefore it is a struggle to try to place an arterial line and a central line while working under the drapes and trying to maintain sterility of the field. My work space is barely a few square inches as I stoop deeply while I try to shove the drapes off the patient with my elbow and attempt to get that cordis into the internal jugular vein. All the while the surgeon is yelling, "Anesthesia, what's going on down there!" It is back breaking work.

Not surprisingly, most anesthesiologists I know are fairly slim. One cannot take up too much physical space in this job. Eventually it does take a toll as many of our older partners complain about back and knee pain. That's the price you pay for having one of the best jobs in America.

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