A very special, specialty
Anesthesiologists hold your life in their hands. It’s a very underrated skill
One of my friends sent me an article from the medical satire website, gomerblog.com, in which an anesthesiologist put on a puppet show in the operating room. Everyone in the room enjoyed the show from behind the sterile drape before turning their attention back to the surgery. While the article is humorous, it brings into light a certain depiction of anesthesiologists.
If you asked a new medical student what anesthesiologists do, you would probably be met with a comment about Sudoku. In fact, I have been asked many times why I find the specialty interesting when it involves “just putting people to sleep.” Furthermore, there have been countless stories of patients confusing their anesthesiologist with their nurse or heaping praise upon their surgeon while ignoring the other half of the intraoperative physician team. If you asked the same question to students following their anesthesiology rotation, they would describe the anesthesiologist as a physician who is vigilant and prepared, and who can take over any situation should something go awry. Therefore, I ask: what is the reason behind this under-recognition of anesthesiology?
We live in a time where pace has become likened with satisfaction and fulfilment, and I would argue that this mindset is a factor at play. One of the great prides of an anesthesiologist is to ensure a patient’s comfort and safety. We see this through their preoperative assessments and meticulous medical optimization, as well as their close titration of their anesthetic technique. Following these efforts, the anesthesiologist is able to sit back to monitor that everything continues as planned. There can definitely be a lot of “action” if these steps are not taken. For example, the entire operating room would be caught in a fury if a patient were exposed to a medication they had a serious allergic reaction to. This fast paced frenzy can be equated to “excitement,” but at the expense of the patient’s safety. In fact, an anesthesiologist’s goal and the patient’s best interest is to avoid scenarios in which this pace is required.
A phrase that is used to describe anesthesiology is that it is “99 per cent smooth sailing and 1 per cent terror.” However, since one’s impressions are typically based on the 99 per cent, they may fail to appreciate the extent of an anesthesiologist’s skillset. With that being said, a complication will eventually arise, at which point the anesthesiologist can demonstrate the value of their training in saving the patient’s life through leading initiatives in airway management and resuscitation. Furthermore, most people are not familiar with the roles that the anesthesiologists hold outside of the operating room. For example, they are members of “code” teams that respond to critically ill patients. Having attended “codes” myself, I was able to catch glimpses of that one per cent — I can clearly remember someone yelling, “everybody calm down, anesthesia is coming” in a cry of relief, as the patient began to destabilize.
Finally, medicine is rarely about comas arising from a tropical insect bite, despite what television may suggest. Nevertheless, since the spotlight is pointed toward diagnosing and treating rare and complicated diseases, we often become more enamoured with learning about these “zebras” than about normal physiology. Part of this mentality results from our desire to know something “cool” and “unique” … or perhaps it stems from a belief that the physician’s only job is to determine what is wrong with a patient and treat them. Prescribers of this mentality may not feel as though the anesthesiologist’s role is in alignment with that of a physician, as they do not follow patients longitudinally to diagnose and treat specific conditions. What is lost here is that the goal of medicine is to improve health — something that is best achieved by preventing disease altogether. Anesthesiology is a specialty that focuses on and harnesses how the body works in both healthy and sick states to preserve a patient’s safety and help ensure that the procedure is complication-free. In a way, it is an ultimate form of preventive medicine.
At the end of the day, anesthesiology is a specialty with a unique skill set that is valuable both in emergencies and in guiding patients through surgery. For the one-time observer, intraoperative preventive medicine is rarely fast paced and the “exciting” emergencies fortunately seldom arise. As such, it is difficult to develop a true understanding of anesthesiology when one is only able to get a small glimpse of what it entails. The age-old adage is to never judge a book by its cover and the same can be said here.
Mike Hao is a 3rd year medical student at McMaster University. This article is an adaptation of an essay submitted to the Canadian Anesthesiologists’ Society Student Essay contest in 2017.