of all the specialities, i like the anesthetists the most. some of them are even my friends. this doesn't mean there isn't some degree of niggling that goes on between us.
during anesthetics there are two crucial times when things can go horribly wrong. the first is when the patient is put to sleep and the second is when the patient is woken up. during most operations the time between can be quite routine and even mundane. the patient can almost be put on autopilot and the anesthetist has very little to do except maybe catch up on a bit of reading (there are exceptions). yet strangely enough the one quality gas monkeys appreciate above all else in a surgeon is speed. somehow they seem to want to get through the stress free stage of the operation (for them at least) and move on to the part where things could potentially go frighteningly wrong. maybe they get bored, i don't know.
so the anesthetist thinks the surgeon is great if he gets the operation done fast and he also takes a certain amount of pride in waking the patient up moments after the operation is finished. this way the surgeon, who usually does not appreciate waiting around for anything, doesn't end op waiting around for changeover time. i suppose you could say we work fast to impress them so that they will work fast to get the one patient awake and the next one on the bed as fast as possible and thereby impress us. yet in my opinion there are things worse than waiting a minute or two longer between cases. i don't like working on awake patients. also for some reason that i can't fully explain if you finish the operation before the gas monkey is completely ready to wake the patient up, they tend to get the impression you are super fast.
then of course you get the two basic types of anesthetists. the first type shows an interest in the operation and knows when to start decreasing the gas. the second type has little interest in the operation and is possibly more dedicated solely to his craft. he will often ask for a heads up when the operation is nearing its conclusion (i once wrote about such an anesthetist)
if you put all this together, due to the fact that i can't always predict how far i am from the end of an operation and that i've had a previous nasty experience with patients moving while i'm trying to place the last stitches i tend to wait a while before i warn the gas monkey (that's if he asks) that things are coming to an end. so a typical conversation with a good gas monkey friend of mine would typically go like this.
"bongi, give me a warning five minutes before you've finished."
"sure." i'd answer, wondering how exactly i would know when five minuted before the end would be. then i'd go on merrily, secretly keeping one eye on my sandman friend to see if he was following the operation. if he was not i'd pretty much wait until i had only one more stitch to place. i'd then glance up and announce;
"five minutes to go." i would then bow my head and carefully place the last stitch. once i was happy with that stitch, i'd look up.
"finished."
i'd be lying if i said i didn't enjoy the reaction this usually elicits from my friend. he tends to go on about now having to wait for the patient to wake up, something i'm not overly worried by as i have said. i also enjoy the illusion it creates with him that i operate fast.
it is all done in a very good nature and our friendship is not at all affected by my possibly juvenile behaviour (i hope).
Can I ask you a personal question?... What made you want to go into surgery and at what point did you know that was the branch of medicine you wanted to do? medschooldream.blogspot.com
ReplyDeletekay, i answered that once here. http://other-things-amanzi.blogspot.com/2009/11/decisions.html
ReplyDeleteI enjoy reading about all the bantering that goes on within the O.R.. One thing that many people don't really get to appreciate are all of the conversations that hover above them while on the table.
ReplyDeleteI am quite amused to hear all of the nicknames that are used within the medical field. If you have any more, even ones about surgeons, I would love to know some. Possible post topic?
Love your blog...
Keep feeding me with your insight!
Thanks for sharing - it is very interesting to hear behind the scences stuff!
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ReplyDeleteI say good for you. The one and only time I've had surgery I woke up with everyone pushing me back onto the table. Apparently, I'd tried to sleep walk. I'd been dreaming that I was petting my cat at the end of the bed and I needed to stand up and walk out of the room. Go figure.
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