Thursday, February 18, 2016

Is Anesthesia Boring?

Not true, even though it may look like it.

Is anesthesiology boring? That is a question I sometimes get from medical students when they rotate through their anesthesia rotation. Isn't anesthesia a very monotonous way to make a living, injecting the same three syringes of drugs every time, all day, every day? Doesn't it get tedious doing the same thing over and over again for the rest of your life?

I guess if you put it that way, anesthesia does sound boring. But here's the thing. It is only dull if every patient an anesthesiologist encounters is exactly the same. But every human body is unique. Even though we may look like we perform the exact same process with each anesthetic given, in fact every patient gets their own sedation that is custom tailored to their specific needs. A patient with critical aortic valve stenosis undergoing a hernia operation would not get the same anesthetic as someone with severe mitral valve regurgitation having the same procedure.

Our patient population is as varied as any internist's patient list in the hospital. Nobody ever said internal medicine is boring. Or maybe they do. But somehow all the various comorbidities we deal with get overshadowed by the operation itself. Whereas the internist is a hero for ordering an ECG on a patient with new onset rapid atrial fibrillation, anesthesiologists do the same thing except we still need to make sure the patient can make it safely through an emergency small bowel resection. Who's the hero now?

Frankly there also isn't anything wrong with doing the same thing repeatedly until one becomes an expert at the job. Does anybody say Steph Curry is boring to watch because he practices his basketball shots thousands of times per year? Is Roger Federer's job boring because he makes his tennis shots look so effortless? There is no shame in doing something ten thousand times until it looks completely second nature. In any field of medicine, the key to its mastery is repetition. Surgeons become experts at doing appendectomies because they've done it thousands of times during their careers. Internists become lauded for their effective treatments of congestive heart failure because they've faced the same issue hundreds of times a year. So why should anesthesia be considered boring because we have the experience to make our jobs look easy?

So for all the medical students out there who thinks anesthesiology is boring, remember that every patient who enters a hospital is a potential candidate for the operating room. While the patient may have an army of subspecialists taking care of them on the floor, the anesthesiologist who will be overseeing the patient in the OR is doing the work of all those other doctors, but by himself while a surgeon is trying to cut and bleed them to death. Nothing simple or dull about that.

1 comment:

  1. That's a great answer. I decided to become an anesthesiologist because of mentors who described each case as a sort of like a Sherlock Holmes detective case, whereby you have to figure out the best way to get the patient safely through the surgery, given hundreds of variables. These include the underlying medical issues, the surgery, the length of the case, the potential for airway difficulty, etc., etc. We need to be experts in anatomy, physiology, pharmacology, cardiology, internal medicine,(not to mention human relations!),and have the hands on skills to perform spinals, epidurals, nerve blocks, a myriad of life-saving skills to rescue a bad airway, a trauma patient who is hanging on for life, resuscitations patients under very trying and stressful conditions. The stuff we do literally determines life and death. It's not just cerebral. All of this is what we do day and night. And the list goes in and on. Speaking as an anesthesiologist in a community hospital setting, my job night be mysterious to those on the outside, but it is anything but boring.