You know you’re getting lazy when writing in your blog once a week seems like an awful lot.
Lazy butt aside, I’m back with another review, this time of my week-long anesthesia elective. I realize now that it’s not quite enough to be able to write a good, objective bit on an entire profession, never mind the sub-specialties within it. But imma try. Imma try good.
So here’s my (slightly abbreviated) stab at anesthesia:
(And happy Thanksgiving!!)
The where: Edmonton – Royal Alexandra Hospital
The good: Despite what I’d heard about OR politics and social rules, the vast majority of people I met were truly lovely. There was only one surgeon who was callous if not actually cruel to her medical student/resident person. My heart bled a bit for them. But honestly, most of the physicians and nurses you meet are kind, friendly, and have a decent sense of humour. Even if their taste in music is slightly questionable, tee hee.
Some of the anesthesiologists I worked with were phenomenal – they were quite keen on teaching not just their job but the basic physiology and pharmacology of what they do. In the words of Elizabeth Bennet, they “could not have bestowed their kindness on a more grateful subject.” Especially given the jump from family clinic to hospital and to the OR, it was fairly anxiety-provoking and I really did need that little touch of gentleness and lightheartedness or I might have had a miserable week.
On the procedure side, anesthesia is awesome. I’ve had the opportunity to intubate lots of people, use LMAs (laryngeal mask airways), start several IVs, see an epidural start, prep drugs for injection, even watch a GlideScope being used (essentially a laryngoscope with a camera on the end so you can directly visualize the difficult airways). And given that it’s not too difficult to do, almost all of my preceptors were more than happy to let me have a go.
Prevention of complications is also key in anesthesia. I appreciate that part; it’s about nipping things in the bud before they get out of control. They say the best anesthesiologists are the ones who are bored most of the time. They’ve done their homework far in advance and have got those vitals under solid control right from the get-go.
Hours. Oh, the hours are fabulous. Since you don’t have to round, most show up 15 minutes before surgery’s due to start (usually about 7:30) and can leave as soon as the patient’s been extubated and is comfortable (about 3:30-4:00). Plus you get time in between each surgery to chat, catch up on paperwork, or eat. And I do love eating. Plus call for staff is only a few times a month, maybe 1-2 of those is actually in-house call. And it’s not too terrible for residents, either, they do about 1 in 7.
The not-so-good: Not every preceptor is going to be keen to have you. Know that and don’t take it personally. Some just don’t like teaching, even though they’re quite happy to let you try an airway or two. And the bummer part about this is that I had a different preceptor every single day. You book yourself into a single OR the day before almost solely based on the number of surgeries and the type of anesthesia needed. I got to know some of the nurses better than I did the physicians, because they were the ones there consistently! It was quite a change from having the same preceptor for a month, so I was a bit disappointed with that. You build up a rapport and trust between you by the end of the day, but you have to start completely fresh the next morning with someone you don’t know.
Since anesthesia is focused mostly on the putting under and waking up parts of surgery, there tends tobe some boring bits, especially for students. Yes, you have to monitor the stats and adjust as necessary for pain control, etc., but as the student you don’t really get to decide when you’re worried about that mild drop in O2 sats.
The verdict: Not a strong contender for me without the aspect of follow-up, but worth considering for a 2+1! Students: if you want to book a “good room” for anesthesia, make sure there are lots of surgeries (5+ is nice), see if you can’t find out from a resident whether the preceptor likes to teach, try to get surgeries that are under general anesthesia, and avoid surgeries that are quite long since you won’t be doing much for the hour or two in the middle.
Next week – radiology!
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