[This is first post in a series that are to come soon to inform people about the lovely branch of Anaesthesiology, educate people regarding surgery and Anaesthesia related risks in the simplest language, to make everyone aware about the options they have to get anaesthetized safely, various gadgets we use to keep you safe during surgeries and our role in critical care ICUs.]
Many times I get asked by patients, friends and relatives as to what is my specialty as a doctor?
I answer them that I am an anaesthesiologist and critical care specialist. I usually end up getting a vague disinterested look (I can read their mind thinking as what the hell is that and what should I ask next!!!) After a pause almost invariably they question again “Ohhhh you put chloroform and put people to sleep right?”
My usual answer is YES you are absolutely right and then I pity that most people including the highly educated ones and shockingly most Interns after their MBBS course know so little about this highly dynamic and efficient specialty.
I asked myself what exactly is the reason for people being so ignorant of this branch? After a lot of thought I could briefly answer my question into few key pointers:
1. We as anaesthesiologists are to blame! We consider patients coming for a surgery to be under tremendous stress and anxiety and surgery as one of the most traumatic experience of his life. We do our best to erase the experience inside operating theater by giving some medications that relieve anxiety and cause amnesia (erasing experience of the operating room from his memory)
So once patient is shifted out of the Operating room he won’t remember Who was holding his/her hand and making her calm down (I have got patients who held my hand so tight that they dig their finger nails into my hand, but I feel proud that I was there for them when they were at their most vulnerable moment)
Who was constantly talking to them about the progress of the procedure and their condition. Who exactly was monitoring their each heart beat and each breath like an eagle to avert any mishaps: yes surgeries are not smooth sailing just because we remove your pain. It’s same muscle cutting, bone breaking, heavy bleeding, that you will associate with a patient who underwent a road accident but you only consider that as emergency because the person is in excruciating pain. If someone relieves the pain that doesn’t mean he is not bleeding(for your information a adult human male has about 5 litres of blood approximately and that goes out very fast during accident as well as in surgical procedures).
2. In India usually anaesthesiologists are not good communicators. We are not trained to develop good communication (but that’s practically true for all branches in medicine, if someone is a good practitioner and gets a lot of patients its because he is a good communicator.) ANAESTHESIOLOGIST go to the patient for a pre surgery checkup and never explain themselves or their role in the upcoming surgery. They silently visit, take history and order few tests and they are done. And on the day of surgery they try their best to remove everything from their memory.
Going off topic: I have seen many academically brilliant doctors having no patient input because they never focussed on communication. Even though medical science now boasts of being a highly scientific and evidence based branch but we have to agree that there’s something with having a positive vibe and a patients will-power to get healed which comes with trust on his/her doctor.
3. Their is always the doctor doing the surgery trying to take all credit from their patients that they have been the saviour of a very bad condition of the patient. This is how their practice will get word of mouth publicity. But thinking logically: fixing a bone, repairing a ruptured intestine, or most surgeries in a stable patient and unstable patient requires same skill!!! Isn’t it????(but nothing to take anything away from our surgery colleagues, they develop skills after years of rigorous hardwork and discipline)
Then what exactly is the risk??
Here comes the fine print that you are not informed or are not aware to witness:
An average Anaesthesiologist never goes out of his way to inform patient or relatives that if patients blood pressure is low then we will pick it up for you, if patient is bleeding then we will transfuse blood when indicated, if patient stopped breathing then we will ventilate you to keep you alive, if patient heart stops we will make it restart it and bring you back from arms of death,
“BASICALLY WE CARE WHEN YOU ARE NOT AWARE”
So whenever a surgeon explains you life risk of a surgery, IMMEDIATELY ASK FOR YOUR ANAESTHESIOLOGIST, get a detailed explanation of patients condition and risks involved. Be familiar with your or your relatives SAVIOUR.
So by now you got a basic idea of what we do inside the closed walls of a Operating theater. There will be times when you will see your surgeon blaming anaesthesiologist for a delay in surgery as they (anesthetists) are reluctant in taking up a case. If that’s the scenario do meet the anesthesiologist and get detailed explanation regarding the problem. You will come to know that the primary aim of any anaesthesiologist is to bring you into Operating room safely and bring you alive safely out of the Operating theater. Unless it’s your life at stake we won’t postpone or delay a case.
We are perioperative physicians whose role is to optimize your physical status before surgery itself so that you can safely withstand the physical trauma of surgical procedure and then maintaining the body after surgery to recover faster.
The motto of an anaesthesiologist is eternal vigilance inside theater and overall patient care and well being.
So in next posts I will explain, how exactly we anaesthetize you and various options you have for undergoing a surgery with minimal discomfort. I will briefly explain the gadgets we use. Will inform you some basic information regarding regional versus general anesthesia. Terms like sedation, monitored Anaesthesia care, and many more topics so stay tuned for further updates.
Dr Ayaskant Sahoo
(Your friendly Anaesthesiologist)
DISCLAIMER: I don’t want to degrade the importance of any other branch of medical science, I consider every other branch as beautiful and indispensable to saving a human life but I love my work passionately so may be I have taken few liberties. Extremely sorry if I hurt anyone, will surely consider editing it. Please point out in comments below.