anesthesiology

Let's see, what did I love about anesthesia?

Keurig Coffee. Hazelnut? Pecan Delight? Glazed Donut? Creme brulee? It's dessert and caffeination in 6oz amazingness! I've been told that department coffee machines should be the most important factor when deciding your specialty. Then again, I can guess why the anesthesiologists were giving me this advice. AND they even gave me time to drink it most days. A+.

Dancing. No, I did not dance in the OR while intubating someone. But I got to go out dancing two weekends in a row while on this rotation! Having a life? Honors. 

Procedures. Intubation, IVs, central lines (they actually let me try on the second one I scrubbed in on. I failed miserably. Apparently I wasn't poking "aggressively" enough into the huge vein in a person's neck. I know enough anatomy to know the big vein in your neck is kinda close to your brain...sorry I was a little frightened...), epidurals (I actually did one of these! And she didn't have a post-puncture headache the next day! Apparently I'm less afraid of spinal cords than veins. Success.)

Lunch. You actually get to eat when you're an anesthesiologist! A real 30 minute lunch! (Yes, you do detect a hint of sarcasm, but really, a 30 minute lunch of warm food is pretty amazing in the medical world... I assumed I would be eating nutrigrain bars and nuts for these 3 months on surgery) 

Patients being asleep. Sometimes, this was a huge sigh of relief. This isn't really about disliking interacting with people (although there were a few not-so-nice patients...) but more about how you can speak out loud about questions you have and medical problems that are going on without worrying about alarming the patient. One resident told me he liked being able to treat people immediately and seeing the results, compared to internal medicine where you often have to negotiate with patients and prescribe meds you think they will actually take - during surgery if a patient is hypotensive (has low blood pressure) then you just treat them. 

What did I dislike about anesthesia? 

Lack of continuity with patients. The two times I saw a patient after their surgery in this entire month is memorable to me. No one thinks of you as "their doctor." 

To be honest, lack of credit. I think anesthesiologists are often the person in the OR who is most concentrated on advocating for the patient and keeping them stable and comfortable. However, they are almost never recognized as having taken care of the patient at all, and surgeons were variably inconsiderate of the anesthesiologists. Some would let the anesthesiologist know when they were close to finishing the procedure, but most did not. After one surgical resident let us know he was readjusting the endotracheal tube, the attending actually chastised him, saying "You don't need to ask them permission! Just do it." My analogy is anesthesiologists are to surgery like sound technicians are to theatre. Without good sound, we could never have these huge performances with thousands of people in the audience. But unless there's some obvious blip in the sound, no one ever comments on that vital portion of the performance. Never have I walked out of a musical and said "Man, that sound quality was just so good!" Just like no patient has ever come out of surgery thinking, "Man, I'm so glad the anesthesiologist kept me comfortable that whole time!" We only notice when something goes wrong. 

Physics and Pharmacology. Not my cup of tea. Pretty important for anesthesia. That about sums it up. I would rate my interest level in these concepts at a "pass."

In sum, probably not my thing. But also something I don't think I would be unhappy doing. And now, on to Endocrine/Oncology Surgery. Which translates mostly into thyroid and breast surgeries. Which also translates into more work/longer hours, but I'm excited! I should get to suture and hopefully be more involved. I'm also excited to be working with the same team of people each day. Can't wait to see what coffee I get :)