When I decided to go to anesthesia school, a recurring comment that I heard from more than a few friends was, Why do you want to just take blood pressures all day long?
Hmmm – good question! Why would anybody want to do that all day long? Unless, of course, you were a well-trained monkey, or maybe the sales rep at Dinamapp, the blood pressure machine company – then you’d want Everybody to take blood pressures all day long. And all night long.
Giving anesthesia is such a BIG THING that it’s the WHOLE THING. The whole patient really. Every cell of the human body is connected to every other cell in the body, so what you (the surgeon, the bullet, your appendix, your boyfriend, your disease) do to one part of your body affects every other part. That’s the anesthesia purview in a nutshell. As anesthesia providers, we are responsible for every cell in your body while you are under our care, and everything that happens in your body impacts on how we deliver our care. And how we deliver our care impacts on every cell in your body.
Understanding all of this is the science part. Anatomy, physiology, pathophysiology, pharmacology – it is a lifelong endeavor of assimilating the mountains of data and research that endlessly flows through the pipes from our texts, journals, and fellow educators. All good providers dedicate their practices to varying degrees of keeping abreast and current. A certain poetry exists between the didactic and the clinical, like a reaffirmation of faith, that makes this anesthesiOLOGY so intellectually satisfying and absorbing as a science.
And then there is the art. As one of my anesthesia school mentors once so succinctly put it when I became frustrated with my green inability to intubate the trachea – Don’t worry about it. You can teach a monkey to intubate. Really? Probably not (I’ve yet to read about it in any journals), it ain’t that easy. But, done right, the pro’s make it look easy.
The art is all about the fine-tuning, and the tuning in. It’s about seeing beyond, no actually it’s about using ALL FIVE OF YOUR SENSES, including your sixth sense. The earliest anesthesia providers did not have all the fancy bells and whistles that we use today in our armamentarium of care-giving tools and equipment. Their best monitor was their one hand always on the patient’s face – truly a lost art form. That one hand could tell you if your patient was breathing, sweating, grimacing. The hand could feel the carotid pulse, get wet with vomitus or tears. It provided human touch and support.
The art of anesthesia care is built upon its own internal folklore – it’s handed down from and between providers. The little things that make big differences. Some call it the tricks of the trade. What works for me, does this work for you? Your experience, good and bad, never ceases to impact on my decision-making and care-giving. The art of our care is as intertwined and connected as the cells in our bodies.
Today, anesthesia care has NEVER BEEN SAFER, that’s a true fact. That is due to our scientists and artists. And taking blood pressures, too.