The anaesthetist is sometimes an unsung hero of the surgical team. It would be near impossible for us surgeons to do our work without them. There are many subtle qualities of a good anaesthetist and I’m fortunate to have some great ones that I work with every day.

They often meet the patient in hospital before the surgeon has arrived and do a great deal to put a person at ease prior to their surgery. A caring and reassuring manner helps settle nerves. If nerves are too high they can even give a gentle “premed” to calm things down. They need to have excellent procedural skills in order to insert breathing tubes or intravenous lines and they have to be experts in the physiology of the cardiorespiratory and neurological systems as these are the main systems that are affected by the drugs that they use.

I often say that a good anaesthetist should be like a top cricket umpire. In any cricket match, if everything is running smoothly and the decisions are correct, you don’t even notice the umpire. It’s only when things go wrong do they become apparent. There are other subtle skills an anaesthetist needs in order to gel with the surgeon. They need to to know when to have a casual chat, when to crack a joke and when to be silent.

They have to be cognisant of the idiosyncrasies of the surgeon who is performing the operation. As a surgeon, I’m quite happy to chat casually through most surgeries but there are certain stages of a nephrectomy (kidney removal) or a prostatectomy (prostate removal) where I go into a zone of silence in order to bring total concentration to a critical stage. At these times, my anaesthetists know to be silent and help keep conversation amongst other staff down also. And they need to be lightning fast when things to do go wrong such as with a major drug allergy or a cardiac event.

Though they sometimes appear to be just doing Sudoku during a case, the anaesthetist is watching the numbers very closely. Three cheers for the gasmen and gaswomen!

In Health and Wellness