Tag: anaesthesia

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Ha Ha

Anaesthesiologist (Age 73 years),  Patient (Age 60 years). Ages of the surgeon, surgical residents and the anaesthesiology resident do not matter

A: Aunty, open your eyes, the surgery is over
No response from “aunty”

After a lot of waiting, and adequate pharmacological reversal of anaesthetic agents we gave up and sent her to the ICU with the tube in….

If I was Mrs. M I too would have kept sleeping…..

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Bring In The Expert….

The fat one lay placid like a lake. Barely visible from her resting place. Lazy yet beckoning.  The thin one was more like a stream in summer, snaked her way down her place of rest. I studied both of them carefully as a few beads of perspiration streaked down my forehead. Which one? was the question on my mind.
I looked at the staff nurse who had all the armamentarium to secure venous access. The venous cannulaeof varying sizes, tapes, cotton swabs, tourniquet all neatly arranged on a tray. She was all set for a “Difficult Venous Cannulation” and had called me, the so called expert Anaesthesiologist for the procedure. She looked at me with a look that said….”Do this fast and for good, I hope I can trust you.”
Tourniquet tied, fist curled I tapped the fat one first. She was barely a blotch of blue and refused to fill up. Arrogance. And thats what made me want to cannulate her even more. The thin one was barely a blob under the skin of the inner side of the wrist. Yet she screamed “Try me” . “Nah I said, you shall take a small cannula while what we need here is a large bore. Fattie wins” The Fat one was nonchalant. “Here I come” and I took a bold prick. No flash of blood. Advance the cannula. No blood…..withdraw the cannula. Blood spills to the skin. “You rascal” I said. “The staff nurse must be pitying me the expert and mocking me at the same time. Or upset I shall now give up.” The thin one was popping out even more now. “C’mon. you are thin and crooked. I cannot see the rest of you after that blob where you dip deeper into the skin! Its a waste to even try you. Still I shall, now that I have a cannula in my hand and my image at stake”. Bold prick no. 2. Flash of bright red. Wow! Slide the cannula. Glides in effortlessly. Stretches the thin one on its way and wow, the vein is secured! Suddenly I’m the hero, who saved a patient from dehydration and more pricking and poking. 
Ah the joys of being an Anaesthesiologist! And the pleasure of cannulating a seemingly impossible vein. 




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The Mourning

Being an anesthesiology resident in the Obstetrics and Gynaecology OT at Nair Hospital was no mean job. There was the routine OT list, the emergencies and the cranky surgeons and sometimes even crazy seniors to handle. But the job has to be done, right and that too with a smile, and we did it.


December 2009, while the routine OT is still on, we get a call, ‘Emergency Laparotomy for an unruptured ectopic gestation in the fallopian tube’ which means an emergency surgical exploration of a lady who had conceived, but unfortunately the fetus was outside the uterus in the fallopian tube. Fallopian tubes are the tubes which transport ovum or the embryo from the ovary to the uterus. I went to the waiting area to see this lady pre operatively. She looked distraught and strangely familiar. I could not place her, but she was familiar nonetheless. She was past 35 years, and had undergone a tubal recanalisation surgery few months ago. I noted down the rest of her medical history, did a quick physical examination and explained the surgery and anesthesia to her. She knew her baby could not be salvaged, being in a place where there is neither nutrition nor enough place for her baby to grow. The whole point of the surgery was to save her life, lest the tube rupture.


After taking her consent I did something I had never done before, I asked her a question that was too personal– the reason why she had undergone a recanalisation surgery, or a surgery that involves reversal of a tubal ligation. The answer was obvious… she had undergone a tubal ligation which is, for all practical purposes, a permanent method of contraception. Then for some reason, she wanted to have a child again so late in her life. I was curious to know the reason.


“I lost my son to brain cancer” she said with a few tears in her eyes.


I was starting to figure out why I knew her…. still I persisted


“Where was your son admitted and how long ago did he die?”


“He was here, at the same hospital… He passed away last November”


“His name was Aditya?  I asked her to which she did not reply but broke down into tears instead. I did not pacify her, I broke down with her too into a discreet few tears.


I remembered Aditya very well. He was a 10 year old boy operated for a malignant brain tumour and had died in the ICU a few months after the surgery. He had died while I was posted in the ICU and was on duty. And he was probably the only patient whose death and the suffering prior to that had affected me so deeply,  probably because of his tender age. I remember having shed a few tears for him after seeing his grandmother break down once in the ICU. She was the one who mainly cared for him, with his sister and mother visiting on and off.  While I cried for him when he lived, I somehow did not mourn his death when he died in my arms, in front of my eyes. And I mourned for him the day I met his mother once again, a year after his death.


Being doctors who see death and suffering so often does make us tough but some incidents like these do break our tough outer layers and touch our hearts and make us cry. 


Disclaimer: The kid was not named Aditya. The name has been changed to protect the identity of the child and his family.



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Randomness

Currently posted in ECT…that is for the past 2 weeks and two more weeks I shall be providing short General Anaesthesia (Short GA) or TIVA (Total Intravenous Anaesthesia) to patients undergoing ECT or Electro convulsive therapy, the so called “shock therapy”

No, shock therapy is NOT as scary, greusome as shown in films and soaps on TV.
1) The patient is well sedated, rather anaesthetised and doesn’t remember that he underwent shock therapy

2) He/She is relaxed and does not convulse like “oh-my-god-he’s-going-to-die”

3) After the procedure, in 5 minutes flat, te patient walks out of the ECT room to his bed, on his own

Ward 1 is our Psychiatry ward. Secluded from the rest of the hospital, this ward has a mix of patients. The ward (thankfully) has staff who is EXCELLENT…..all in caps. Patient with their patients, efficient, with a decent amout of sense of humour…all that you need to survive in a ward of so called “mad” people (Its a CRIME to call them that)

There’s a girl who’s violent, one who is so quiet that it hurts, one who sings aloud and dances all over the ward, when she is not crying for her “mummy”, two schizophrenic brothers……They all make me wish I had taken up psychiatry as my field of specialisation. Though I’m not too sure I would have been able to digest their sorrow, heal their pain, face the fact that I may never be able to treat them and live peacefully inspite of and amidst all that…….

Whatever…..

Came across a nice blog of an Anaesthesiologist from Boston…. Notes of an Anesthesioboist.

Inspired by her old post I too would love to make a list of what I would have loved to be if I wasn’t an Anaesthesiologist (read studying to be an anaesthesiologist)

1. Psychiatrist
2. Ophthalmologist
3. Pastry Chef
4. Own a Coffee shop
5. Classical Music Performer
10. Stage Actor
20. Preprimay teacher
50. General Surgeon
100. Dentist
5,000. General Practitioner
1,00,000. Spiritual Guru (Heh heh, suggest me a good name)
3,99,999. Ob Gy
4,00,000. House wife