Walk a mile

By the title I am guessing you are expecting a post about a race or something. I don’t blame you for the mistake because you are right, I would probably be in a walking race because I’m not too hip on running right now. Sorry to disappoint, but you’ll have to suffer through another topic.

It has been over 2.5 months since I started pretending to be an anesthesiologist. I think now that I have about one month left, I am starting to get the hang of it. There is still so much I will never know but at least I don’t have horrible fear every time I bring a patient into the room. It’s just sometimes now.

I am beginning to think all surgeons should have to do their own anesthesia cases for awhile. It would be one of those, “Walk a mile in someone else’s mocassins,” kind of deal. I think this can be the most challenging part of an anesthesiologists job. How so, you may be asking?

When the patient is asleep and the surgery is about to begin, the patient is prepped. This means cleaning the area of the incision with iodine (or another cleaner) and laying sterile drapes. Usually a drape is hung by two IV poles to shield the anesthesiologist from any splatter. This also can feel a bit like you are the man behind the curtain (Wizard of Oz?), a little isolated from what is happening. Usually conversations are separated from one side of the curtain to the next—the surgeons keep to themselves and the anesthesia staff have separate conversations with themselves. Some surgeons seem very annoyed if you breach the curtain, even if it means asking questions relating to the patient’s care. For example, if you administer a muscle relaxant to the patient it can take an hour or more to wear off. It is like the kiss of death in anesthesia to re-dose this drug at the end of the case (delayed wake up). But sometimes you have no idea how far you are and if they aren’t relaxed you will get yelled at by some surgeons. Do you dare ask a time estimate?

The other issue of the curtain is, you are often addressed by the endearing term, “Anesthesia!” Even though my name is posted on every case and I wear a badge with name clearly showing, “Anesthesia” is often all they can muster. It reminds me of my days of “Hey twin!”

There are other times I have been yelled at by surgeons. The first time I was stuck in a challenging emergency case. I was very nervous and had a lot to think about. Suddenly, I hear the surgeon yelling, “Valsalva. Valsalva?!” When I realized he was speaking to me my heart started racing and I had to admit, “I’m sorry sir, but I don’t know how to do that.” I fully expected him to explain what he was asking (he has obviously been doing this kind of procedure for years), but he only yelled to get my staff in there right away. I called on the phone, with him still in the background yelling occasionally, “Valsalva!” as if that would help the staff magically appear faster. I was given instructions on how to perform the maneuver and the case moved on. I could later hear him muttering how ridiculous it was that I didn’t know how to valsalva, (remember the drapes?) as if I couldn’t hear him. When the patient woke up, my staff arrived and he made sure to tattle on my by telling her, “This girl doesn’t even know how to valsalva! Can you believe it?” Luckily, my staff stood up for me and told him it was only my first week. I’ve been yelled at since, usually for simple things and also for things that are out of my control, such as the intestines moving in the way of the surgery. Sorry.

It can be hard dealing with surgeon’s egos all day. I am going to try to remember my experiences in anesthesia when I am on the other side of the curtain.

 

P.S. Valsalva is when you “bear down.” I know how to do it on myself, but had never been asked to do it for someone else before.