I knew from the beginning that Anaesthesiology would be an incredibly difficult rotation for me. It is nothing like Medicine and nothing like Surgery, yet it encompasses both.
I’ve given patients medicine before, but never had to use complex equations to do so. I’ve done lumbar punctures, but never had to inject something into the spinal canal. I’ve administered nebulisations, but never a vapour that would render my patient unable to maintain his basic life functions.
Basically, I’ve done tiny things but never really anything with major risk to the patient. Never really anything with so many factors that come into play. Never really anything where I had to take charge.
My friends will tell you that I was an emotional wreck for the past three weeks. I don’t know why this rotation scared me so much. Thousands of students at my school have done and survived this rotation, and so would I, surely.
I think everything before this has always kind of felt natural. Taking a good history is difficult at first, but at least talking is easy. Physical exams have some logic to them (inspect, palpate, percuss, auscultate). Even IV lines are easy to figure out. You need very little brains and just a little common sense to do those things as a medical student. Anaesthesia, even though I quite enjoyed the theory last year, just doesn’t come as naturally.
As part of our assessment we had to do solo cases. I think this was what freaked me out. I don’t want to cause a patient’s demise (obviously). I also know it’s imperative that I know how to do these things properly, because they are expected of us during housemanship and community service.
The thing is though that being a rock star can’t be taught in a few weeks.
Well, I did the cases. One spinal and one general anaesthetic. I don’t know yet how I did, but my patients did well during and after, so that is a good thing. I think I will be able to administer anaesthetic in uncomplicated cases with reasonable confidence in the future (in other words, I’ll still be peeing my pants with worry but at least I’ll know I am able to do it).
I think it is probably necessary for this rotation to be high-stress, but has been a while since I was so thoroughly dunked in the deep end and I think I nearly forgot how to swim. At least today, on my last call for the rotation, the registrar commented that we were now functioning on houseman-level. Which is good, since that is what we will be very soon.
This rotation taught me that I need to exude confidence even when I don’t feel it (“fake it till you make it”). It taught me to be stronger. Even though I dreaded the rollercoaster days, I resisted calling in “sick”. And I learned what it is like to fly solo. To take matters into your own hands and not freak out about it. To trust your knowledge and to heed your gut. I would like to think that I’m a little tougher now. A little more ready for the other difficult rotations coming my way in the next year. That in the coming rotations, I’ll be a little less likely to doubt myself.
Whispers Unto the Aether 
Hello and thanks for what you do and inside notions and feelings a doctor has.
Good job! We are all very proud of you (seriously).
I do enjoy your posts… getting a little inside info on the learning curve of a future Doctor I find extremely interesting… not sure this last rotation could have been the most enjoyable, yet I remember a film from many years back where medical students administered drugs to each other to take them to the edge and then brought each other back again… sure nothing like that happened amid your year…
Hah! No, we didn’t do anything like that, if only because they are so strict with the access to drugs these days! But I actually read something similar to that film: med students who would take muscle relaxants and then see who could run the furthest before collapsing! It’s from Hospital Babylon and it is set in the UK, but a really cool read 🙂
Oh my goodness, that sounds terrifying! Wow, your training is WAY more hands-on than ours. I know very few students who have done even one LP by the time they finish medical school, and we DEFINITELY were not allowed to administer anesthesia. My anesthesia rotation was actually one of the most laid-back . . . the only real hands-on experience I got was attempting a few intubations and putting in some lines.
Pardon my ignorance, but do you have an equivalent of our residency years? What does your training overall look like?
Our training is actually known around the world for being so hands-on, but’s probably like that because we have such a shortage of doctors that we need to be able to do all these things the moment we graduate as doctors. It has its cons too, I think. We still struggle obviously, I mean intubations are HARD and you only really get good at them with practice and more practice. I think I managed to do one without any help, the rest I needed some assistance in.
We do have an equivalent to residency, we call them our “registrar years”, but we can’t go straight into them after med school. It’s kind of a convoluted route, but I’m in the process of writing a more detailed post about our training, which will go up in the next few days 🙂
One of our registrars called it “99% utter boredom and 1% pure terror.”
I’ve been sharing that with everyone I know – I love it, SO accurate.
Wait you actually took over a patient management. We only had Were supposed to “tell” what we do. Which method & how much drug , how to monitor etc. We did intubate loads of patients however.
Yeah, we did! It’s pretty exciting, the more I think about it. Obviously there was a consultant watching our every move, but yes, we pretty much had to do everything from beginning to end for two cases as part of our assessment. Not a lot of schools do it like that, it seems.