Anesthesiologists critical for maintaining safety

While the surgeon saves you with surgery, the anesthesiologist saves you from the surgery

This is it. Today is the day. You’ve seen your family doctor, you’ve seen your surgeon, and after months of aching and limping, you finally see yourself to the hospital to fix that pain in your hip.

As you ready yourself in the waiting room, you come face to face with a man who introduces himself as “the anesthesiologist.” He’s wearing a stethoscope, so you know he must mean business, and you need to make sure to pass his exam if you want to mingle with your surgeon. He asks you to open your mouth; easily done. He goes through your medications, but you planned ahead of time by never needing to take any. He mentions something about “malignant hyperthermia”; that sounds like cancer, which you’re pretty sure doesn’t run in you or your family, so you shake your head. After a few more questions, the man asks you whether you would prefer “spinal” or “general” anesthesia, and lists their pros and cons: it’s a lot to take in all at once, but given that a needle in your back can be considered a bad time, you go with your gut and opt for being put to sleep. An understanding nod is shared between the two of you, and several more minutes elapse before you’re led into the operating room and laid upon the table. The anesthesiologist pumps a mixture of drugs into your arm to immobilize and put you to sleep, all the while promising sweet dreams; as your senses lull, you smile, confident at the prospect of fending off mortal deterioration with the power of science and medicine at your side.

Tubes pass through your throat to help you breathe, tape covers your eyes to protect them from scratches, and sponge padding enshrouds you as the monitors you are connected to hum with life to the tune of your vital signs. The anesthesiologist scrutinizes you up and down, ensuring no appendages are misplaced or digits unaccounted for, before the surgeons march in to do their work. They are at once architects and sculptors of the human body, positioning your leg to pry apart your hip joint as they dig deep to reshape the bony marble within. Since neither sleep nor immobilization prevents you from feeling pain, your anesthesiologist must carefully time boosts of pain medications, administered in anticipation of particularly painful processes, to ensure that you don’t suffer in unconscious silence. An ear is kept open for the pitch and tempo of your heart monitors as a sign of your unconscious reaction to stimuli. An eye gazes discerningly at the levels of different gases circulating through your breaths; an assurance that appropriate ventilation and sedation are achieved. All the while, the surgeons hammer away to the beat of their music, and the anesthesiologist draws up more medications. Despite the differences in their scopes of practice, these two professions are not worlds apart: it takes two to tango, and just as many to administer comprehensive health care.

Eventually the surgery draws to a close. Your brain fog slowly wears off, and you gradually wake from your slumber. All that has happened up until now was not for you to see, for the promise of dreams had been made good on, and once more you find yourself on that strange table. As consciousness fades out and abruptly back in, you faintly hear a familiar and reassuring voice encouraging you to take deep breaths.

Recovery immediately after surgery may feel like its own battle to be fought and won, and it will be a conscious effort of processing pain, nausea and other uncomfortable consequences of surgery, especially between medication doses. Ideally, the discomforts you feel will be minor and easily manageable, especially when compared to all the possibilities that range from choking to difficulty breathing, and excruciating pain to worse. This prevention and minimization of bad outcomes is also the job of the anesthesiologist, whose subtle work is critical for maintaining patient safety and health. Remember, then, that while the surgeon is busy saving you with the surgery, the anesthesiologist is busy saving you from the surgery.