“No Anesthesia = No Surgery”

I hate my height. Ask me why. We’ll get into that later in the journal. Today was my very first day of clinical rotations. I have never had the chance to shadow any doctor before today so it was quite a “first” to start with anesthesiology. What I learned with anesthesia is that although their weeks can get really busy there is a lot of waiting between patients. Raquel and I got to the hospital pretty early to give ourselves enough time to change into clean scrubs and to have enough time to get lost a few times. When we made it to the surgery department all geared up we were given directions to the anesthesiologist office. We sped walked to our destination because we were filled with excitement for our day and also because everyone else looked like they too had somewhere to be. When we got to the office, we introduced ourselves to all the physicians there and since they were all busy prepping for their day, we were just listening in on their conversations. It was a waiting game for about 40 minutes until operating rooms were ready for the need of anesthesia. Raquel was assigned to Dr. Dodge and I followed the director of the department until he had to leave. I saw one patient who was getting something done related to hernia. The second room I got walked into was solely for the purpose of watching a fascinating surgery. The director left and I was left in the room by myself. I stood right behind the patients head while there were a surgeon, a resident, and a surgical first assistant working on the patient. At this point all I could see and smell were fumes coming from the patient’s direction. I knew they were cutting into the patient at that point and I wanted to see what was happening so badly that I kept going on my tiptoes. I even asked if I could move to the side behind the plastic sheet at one point and I got turned down. Then, Dr. Davis, the cardiac surgeon, ordered for the table to be lifted all the way up and I definitely couldn’t see anything then. All I wished for at the time was to be a few inches, okay let's be real, a few feet* taller. Finally, they lowered the table and I was able to go on a stepping stool and there it was….a pumping heart.

Needless to say, I was in awe. Coming into this surgery, I didn’t know how I would react to anything. I get queasy looking at a paper cut, mind you looking at open flesh. Surprisingly, I was not all affected by looking at this scenic sight. In fact, all I could feel was my heart rate skyrocketing because of my excitement and disbelief of what I was witnessing. This surgery is known as a CABBAGE, which is a coronary artery bypass graft surgery. This was an elderly patient who dealt with chest pain due to the coronary artery blockage that was due to his chronic high blood pressure and cholesterol. Simultaneously while Dr. Davis was prepping the chest area; the resident was operating on the patient’s leg to extract part of the saphenous vein and make grafts of it to use for the coronary bypass. I believe Dr. Davis also extracted the left mammary vein to be used for the same purpose as well.

It was so surreal watching the team come together to make such a complex thing happen. Most of the time there wasn’t any communication between the surgeon and his team but they all knew exactly what came next. From the anesthesiologist, to the scrub techs, to the OR nurses, to the surgical assistnad, to the resident, and finally the surgeon, they all came together wonderfully.

From the media, I gained such a false expectation of what the OR would be like. I knew it would be a high stress environment with an incredibly efficient team but this experience showed me a new way that efficiency was possible. Apparently, music was a vital piece to any OR room that I walked into today. When the surgeon got the heart he asked to turn the music up. He also took a phone call mid-surgery… In addition, Dr. Davis’ co-workers would come into the OR room just to say hi and have a mini catching up session about what the weekend plans were looking like, again mid-surgery. At one point, Dr. Davis was showing my the vein they were implanting and it splattered all the blood on his assistant which was pretty funny to watch.

Raquel and Dr. Dodge came in the OR I was in and we both walked to the one next door. And before you know it, another pumping heart was before my eyes. This time around, I stood on the opposite side of the patient to get a new view of what takes place during a cabbage surgery. I got to appreciate the rest of the team by watching all of the things they have to be careful of. I learned that everything needs to be reported during surgery, like the amount of cloths used on the body or the urine excretion.

After a very exciting morning, we finally went to lunch. My feet were hurting so we sat down for about an hour and then we were on our way back to the OR! We got to know all about Dr. Eugene and Dr. Oeser and more about their roles as anesthesiologists. Anesthesiologists are considered hospitalists of the OR; meaning they monitor the patient's health and assess whether or not they are ready for surgery. One thing that stuck with me is when Dr. Eugene said “we won’t tell the rest of the care team we aren’t doing surgery; but we will tell them we are not operating the anesthesia if the patient is not ready.” This goes to show the importance of an anesthesiologist role.

I learned so much and could probably write on this amazing experience forever so I will conclude this here by talking about whether or not I see myself doing this. I think anesthesia is so vital in the OR and understand all the benefits that come with this role, however, I couldn’t picture myself doing this in the future.

Can’t wait for tomorrow!!