Friday, April 9, 2010


On a lighter note.... As anaesthetists in private practice, we are often not unlike a travelling roadshow. In fact, in the distant past, the anaesthesia provider would travel armed with a big black bag containing his vapours and some method of delivery (generally a schimmelbusch mask.)

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We have come a long way from the old days of dropping volatile vapours onto unsuspecting patients, to sophisticated anaesthesia delivery systems. However, the travelling anaesthetist is as much of a reality today as in the past.

Last week, on my private practice day, I counted how often I changed clothes. I went to 2 hospitals (one of them twice) during the day. Including getting out of my pyjamas into my street clothes, and then back into my pyjamas at the end of the day, I changed clothes 9 times.

Pyjamas - street clothes - theatre clothes at hospital 1 - to street clothes for trip across road to hospital 2 - theatre clothes at hospital 2 - street clothes for trip back across road to hospital 1 again - theatre clothes at hospital 1 (again) - street clothes for trip home - going out clothes - pyjamas again. Phew....This makes Clarke Kent look like an amateur.....


One of the problems with being the anaesthetist is that often, I don’t know the whole story. Sometimes it is better this way, other times not.

Recently, I was asked to dope a young lady for an evacuation of the uterus. This usually involves curetting/scraping the uterus in order to clean out anything left after a miscarriage. So I go and see this 21 year old woman who is sitting with her fiance. We chat, I ascertain that yes, she is in fact the healthy specimen I was told about, and we whisk her off to theatre. I assume my sympathetic role, poor girl, she’s had a miscarriage etc..

As I am putting the monitors on, the scrub sister starts talking to the patient and asking about how many weeks she was, and the patient answers that she is 4 weeks pregnant. Now a little light starts flashing in the back of my head. She hasn’t had a miscarriage at all. (miscarriages tend to present later..) On further enquiry by the nurses, it appears that her wedding is in 2 weeks, and she isn’t ready to have kids yet. So now, I am doping for an abortion, and not an evacuation.

Is there a difference? From a technique point of view, no. From a personal point of view, yes. Would I have agreed to dope her if I knew it was an abortion? I don’t know. But I was uncomfortable that this decision was taken away from me. Personally, I disagree with the concept of abortion, and I am given rights in our constitution to reasonably refuse to be involved in that which I do not agree with. Please don’t get me wrong. I am not judging the patient. She too has the right to do what she wishes, and we are obliged to facilitate that. So my rights gave way to hers and we cracked on with the case....