THE DOCTOR WHO SINGS YOU OFF TO SLEEP … BY CONOR MAGEE MD FRCS, CONSULTANT SURGEON
W L
MEDICAL
THE DOCTOR WHO SINGS YOU OFF TO SLEEP … BY CONOR MAGEE MD FRCS, CONSULTANT SURGEON
Close your eyes. Now think of the word‘ surgeon’. What do you see in your mind’ s eye? Sir Lancelot Spratt from the Doctor in the House films, pinstripe suit and red carnation? Or do you see the American ER type surgeons, impossibly glamorous with movie-star good looks? Perhaps, you even think of the chap in the photograph above this article.
Now, concentrate a little bit more and think of the word‘ Anaesthetist’. Can you conjure a picture now? Are you entirely sure what an anaesthetist does? Open your eyes, let me take your hand and lift the veil on the unsung heroes of the operating theatre. It is a great shame that the depiction of surgery in popular culture focusses on the surgeon- almost exclusively male and with an ego of formidable proportions. Lots of shouting and throwing of instruments- and don’ t forget the attentive nurse swabbing the beads of sweat from the forehead! The operating theatre is still a theatre- triumphs and tragedies happen there every day- but it is a place where the most finely-tuned team comes works together with the sole aim of making you better. The surgeon may be performing, but they cannot do anything without the skill and dedication of the anaesthetist.
The anaesthetist( from the Greek‘ Without Sensation’) is the doctor who will sing you to sleep- make you unaware of all the unpleasantness of surgery allowing me to do my job swiftly and safely. It is true that there have always been surgeons throughout the ages but without anaesthesia the only operations we could offer would be barbaric amputations aided by a piece of bark to bite on and a stiff drink. The wonders of modern surgerytransplants, heart surgery, cancer surgery, joint surgery are only possible by the provision of anaesthesia. An anaesthetist establishes the‘ triad of anaesthesia’- a combination of analgesia( absence of pain), hypnosis( absence of consciousness) and muscle relaxation. This may appear simple but the anaesthetist takes over the monitoring and response of your body- your life is literally in their hands!
In order to do this, they must become ninja physiologistsspecialists in how your body works, how the heart and lungs work- how they need to be optimized and supported in complex surgery. Furthermore, to achieve anaesthesia they are also experts in drugs and specialized gas agents that bring on the triad of anaesthesia.
In America, they are called Anaesthesiologists- a term more fitting for the role they play. The training to become a Consultant Anaesthetist is long and arduous, with daunting exams designed to only let the best pass. There is an old joke that describes the blood-brain barrier,( in reality this is a specialized part of the human brain), in theatre it describes the drape between the surgeon and the anaesthetist!
Many patients worry more about going to sleep than their actual operation, however the skill of the anaesthetist is such that having an anaesthetic is incredibly safe. The reasons for this concern is usually the complete lack of control when you go to sleep- and of course the fear that you may not wake up. I recently had a general anaesthetic- I was worried, but more because of the revealing gown I was wearing in front of my colleagues! My general anaesthetic was given by a good friend of mine- and in exactly the same way as thousands of patients, every day of the week. First, a drip is place in your arm( just a small scratch), then you are given oxygen to breathe. Next, you are given some‘ gin and tonic’ into your drip. This completely chills you out and then you are asleep. And then you waken- a bit groggy but not in pain, maybe a bit uncomfortable. That is the magic of anaesthesia. The anaesthetists are the unsung heroes and heroines of the operating theatre- they rarely receive the grateful, thank you card or the well-received bottle of wine the surgeon does. In the most difficult and emotionally demanding cases they offer support, advice and sometimes the finest putdowns to keep me on my toes! They may not all sing very well- but they will get to sleep. And they will wake you up afterward with a welcoming smile.
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