anonymous

BEHIND THE CURTAIN - 2

BEHIND THE CURTAIN - 2

DR SATEESH R. GUPTE

I started learning anaesthesia in one of the North England hospitals. Three senior consultants used to teach us during the day. I was quite serious about my studies and would wait till the last operation got over. But once the three seniors finished the day's work, the department was left in the hands of two anaesthetists, one Irish and the other Polish. Both were middle-aged and had years of experience behind them. Neither had bothered to acquire any post-graduate qualifications. They had, as help, two or three junior Residents like me. And some help we were! These two gentlemen were to look after all emergency work as the seniors did not want to be called at odd hours of the night. The Irishman, bless his heart, would spend the evening hours at the pub across the road and would return to the hospital only after the pub closed at 10.30 p.m. with fish and chips wrapped in a newspaper, happily swaying from side to side. He was of medium-build and looked harmless.

The Polish doctor was very stocky, muscular and looked every a wrestler. He would have scared the wits out of me if I met him on lonely road at night! He also had a bad temper to boot. He had come to England during the war as a refugee and had stayed on. He was a terror.

Their work habits, too, were scary! No matter what case came at night, the two would summon one of us juniors and instruct us to  administer all manner of drugs to the patients to keep them quiet during anaesthesia. The patients, we would say, lived in spite of us!

And so it happened one day. There was only one operation more to do when the Polish anaesthetist suddenly decided that it was time for him to leave. I tried in vain to persuade him to stay on, especially considering that my anaesthesia experience was hardly of a fortnight's duration and I had very little idea of how to manage the case. But to no effect. He merely gave me some orders on what to do and left me to my own devices.

The patient was an elderly man, obese, diabetic and suffering from hypertension. Worse, he had a short neck, a difficult proposition altogether, even for an experienced anaesthetist.

However, I proceeded to do as I was told. Specific doses of drugs had been clearly prescribed which I administered as ordered. I then placed the mask on the face, to give oxygen, nitrous oxide and halothane. I found it very difficult to keep the airway clear and the patient's breathing was getting more and more obstructed and noisy as a result. Then I noticed that the patient's face was turning a ghastly blue. The blue becomes very noticeable among the white race than among brown people. To say that I was frightened to death would be an under-statement. This was my very first case and I was messing it up. A nurse who watched my plight and realising what I was going through volunteered to call anybody available in the Department. Luckily she met a Junior Consultant by name John who came running to the Operation Theatre. He quickly intubated the patient with an endotracheal tube and the patient's normal colour gradually returned. John stayed with me till the case was over. After the list was over, I ran back to my room and prayed before the picture of god Gurudatta I had hung on the wall and thanked him for saving me in the nick of time from killing my very first patient! All alone in a new hospital, without any close friends to confide in, I was quite depressed all evening. I went and thanked John for his instant help and told him that I had decided to give up anaesthesia as a speciality.

John was a very kind and understanding man. He came with me to the doctor's mess, made sure that I had some food and talked to me for nearly two hours. He told me that what had happened to me has happened to practically every anaesthetist some time or other in his career and that to run away from a difficult situation was to accept defeat. "You have no reason to despair!” he told me gently, "fight the good fight and go on to become a good anaesthetist!".

To cheer me up further he told me that it was wrong on the part of my two seniors to let me handle a case like this and said that should I ever be confronted with similar situations in future, I should feel free to call him at any time of the day or night. I learnt a lot from John and this in turn has taught me to help juniors in years to follow when they were confronted with problems.

Compilation of professional reminiscences of specialists - edited by M.V.Kamath and Dr.Rekha Karmarkar