Viraj's Weblog

I'm reading this book about medical specialties. I thought this description of an anesthesiologist was interesting:

From beginning to end, the practice of anesthesiology for each patient is similar to flying an airplane. As captain, the anesthesiologist first conducts a complete preoperative history and physical examination. Induction of anesthesia, using powerful drugs like propofol, represents the "take-off" into the flight of the procedure. This part is more than just pushing medications -- anesthesiologists have to set up the appropriate monitoring equipment and then intubate the patient. Once the patient is fully anesthetized, paralyzed, and breathing by a ventilator, maintenance has been achieved. Like a pilot, the anesthesiologist keeps careful watch over the patient, always adjusting physiologic parameters with pharmacologic agents as the case proceeds. Any operating room crises ("wind shear") require rapid interventions and quick thinking. The captain then lands the "anesthesia plane" by reversing neuromuscular paralysis, stopping anesthesia, and safely extubating the patient.

I have been through this "flight" two times in my life in the emergency room. It's strange, but both times even though I had only exchanged a few words with the anesthesiologist, this person stuck in my mind. They were both very caring and it almost made me feel nervous how much they cared. I realize now that their job requires this, as one wrong dosage and the patient will die.

I found it amazing how much control they had. I remember one telling me just before I was put out, "Ok, here comes the happy medicine." Then BAM! Immediately, before I could even laugh, I was out cold. What seemed like a few seconds later I was up in the recovery room. I was just fascinated at how powerful anesthesia could be. They are literally becoming a pilot of your body, and the above quote explains it well. It's an eerie situation. Think about it, you are so paralyzed that your body cannot even breathe, and you require a machine to do it for you. That's alot of trust you are putting into the anesthesiologist. I remember reading about one doctor that went down into the wrong pipe when intubating. He didn't realize it until the patient was already dead.