The beauty of anesthesia

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These parents were so sweet. Sloane was their fourth baby, and they barely made it to the hospital. They left their camera at home and their cell phone just went to 0% charge. I asked if it was ok to use my cell phone and then send them pics so they could capture this special day. (In a hospital setting, permission and patient consent is everything). I love deliveries because the little babies are so precious… Innocence captured in such a happy moment.

Little notes from patients like this truly make my job incredible!

Keep calm: page anesthesia!

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Anesthesia is a pretty social field in medicine.  Even though you can be stuck in a room with no windows for hours on end, one can typically have good conversation with the people in the room (nurses, scrub techs, surgeons, assists, reps, etc.).  Typically, it’s a jovial atmosphere.  Well, while checking-in with our schedule runner (the czar) a call came through that someone needed to be intubated upstairs.  

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Luckily, I was in between cases and decided to run upstairs to assess the situation.  I see a rather obese gentleman appearing a bit mottled in color.  The vitals monitor said SpO2 90%.  The patient was on a bipap machine.  His belly was heaving up and down with each breath…making it appear that he was using a lot of effort for each breath.  I called for the intubation supplies.  Sadly, this gentleman had suffered from a cerebellar stroke a week ago and they had attempted an extubation a couple of hours prior to my arrival.  Needless to say, his respiratory effort was wearing me out…and I had already huffed and puffed my way up several floors of stairs (my preferred method of solo transport).  Once the supplies were ready, it was go time.  Labs checked out ok.  He seemed to be moving all extremities appropriately, despite his stroke.  All systems go.  After the drugs were pushed through his central line, I took a look and quickly suctioned his posterior oropharynx — there was mucus covering his glottic opening.  Once it was cleared, I skillfully maneuvered the endotracheal tube through the vocal cords and secured his airway.  The end tidal CO2 detector changed color appropriately and bilateral breath sounds were established.  For those crucial few minutes, everything around me seemed to halt.  I consciously let out a sigh of relief and thanked the RT and nurses who were present in the room for their help.  The beauty of my job is that it’s ever changing. One must be flexible enough to adapt to different types of cases as well as challenging anatomy and situations. Plus, I get to meet all types of people from all walks of life. Therein lies the reason why I love my job.

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Adversity

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After A While
by Veronica A. Shoffstall

After a while you learn the subtle difference between holding a hand and chaining a soul
And you learn that love doesn’t mean leaning and company doesn’t mean security.
And you begin to learn that kisses aren’t contracts
and presents aren’t promises
And you begin to accept your defeats
with your head up and your eyes ahead with the grace of a woman, not the grief of a child
And you learn to build all your roads on today
because tomorrow’s ground is too uncertain for plans
and futures have a way of falling down in mid-flight.

After a while you learn that even sunshine burns
if you get too much.

So you plant your own garden and decorate your own soul
instead of waiting for someone to bring you flowers.

And you learn that you really can endure
that you really are strong
and that you really do have worth
And you learn and you learn
with every goodbye you learn…

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When to let go

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I came across this blog post and was really struck by it’s honesty regarding the nature of medicine and death/dying. Back in 2011, I was faced with a very real scenario regarding my father’s health. Throughout medical school, we are taught to do no harm. However, there is a fine line between living and just barely surviving. Even as an MD and having been trained to deal with death and dying, I had to eventually come to grips with what was best for my dad. It has been said that medicine is both an art and a science. Practicing the art of compassion and empathy, I have learned a great deal from patients and their families as well as my own. Despite all of the advances of modern medicine, nothing helps more than listening to the patient.

The Greatest Act of Courage

Private practice

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I started my current job on August 22. It’s a very selective group of anesthesiologists with an M.D. only practice. This was exactly the type of practice I wanted!  My feeling is that I trained at the best residency program and completed a cardiac fellowship to do anesthesia, not supervise a nurse doing anesthesia.  I digress.

Private practice (pp) is a very different beast from academics. The pace is faster; people seem to be happier; there seem to be less attitudes (although you still get some jackasses); money seems to be a motivating factor (hence, faster pace)… I’m sure there’s many more.

I haven’t gotten a real paycheck yet.  But I anticipate it’ll be better than the ones I’ve received in the past.  I’m getting the hang of billing and paper charting. I now seek out cases instead of hiding out.  Support staff and nurses are all very kind and professional.  It seems that everyone is on the same page to get cases going. The surgeons are very nice and super quick!  So far, I’m really loving pp.