Pump Class in the OT

After moonlighting in the ICU for a couple of weeks, it's time to go back to the refridgerator otherwise known as operating theatres for a bit of anaesthetic exposure.

I don't know why, but the white walls always looks sterile in the bland sense of the word, but not necessarily sparkling clean. We all wander around in our variably stained, variably washed-out blue scrubs. Recently they've even introduced disposable scrubs that have all the tactile pleasures of no-frills paper towels. I think they are more for our own protection than for the patient's, however whether it leaves integrity intact is another matter.

But somehow despite the far-from-ideal physical environment, they managed to breed a different type of medicos... the Anaesthetists. Freed from dealing with all-day ward rounds, extended conversations with patients and families, unsolvable social issues and disadvantage, they emerge with a dry sense of humour, generosity with teaching, and clear and sharp-minded about the fundamentals: physiology, anatomy and how to tinker with drugs to achieve what you want. Alas almost complete control.

It is Day 5, and I'm lucky enough to be in the same theatre with just one other senior doctor. She allows me to draw up medications from little glass ampoules before trusting me to attempt looking after a patient's airway whilst deeply asleep. I grapple with an obese middle-aged woman's overflowing neck to get a good seal with the oxygen mask and frown at my small hands and desperately weak pinkies. I break out a sweat and soon my arms are tremulous with the effort.

"I'm going to make you hold on for a bit longer..." my supervisor said with the air of a personal trainer, and that small hint of sadistic glee. I am now tensing and using my shoulders, neck and legs in un-ergonomic ways just keep that chin up and mask tight. "When I was training, we'd had to hold on for the entire case..." she adds, obviously enjoying the moment.

"I've been told I snore," I faintly recalled those dreaded words that the patient uttered in the anaesthetic bay, as I lift up those very obstructing structures with a strange instrument with my left hand, in an odd position using muscles I've never used before. Eureka, the vocal cords are seen and I insert the breathing tube down. Phew, what a narrow shave. My arms were just about to give up.

That adds another surprising impression (and respect) of the quiet anaesthetist in the background. Explains the massive biceps (twice that of mine) of the bosses, and my physical inadequacy to fill the shoes required for training.

My arms still ache at the memory...