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November 8, 2012

Think Like An Anesthesiologist: No propellerhead residents, please


15 years of teaching the art and science — far more art than science, IMHO — of anesthesiology to fresh-faced residents at two major teaching hospitals — UCLA and UVA — left me with some indelible impressions and opinions.

They'll all be in plain view in my upcoming book, "Think Like An Anesthesiologist," but here's a little preview.


Gearheads and techies make terrible anesthesiologists. Why? Because they have Asperger-like tendencies which lead them to perseverate solving technical problems that invariably occur on a daily basis during surgery. Residents with an analytic, problem-solving bent tend to forget that there's a real live patient on the table five minutes away from dying in the event of an interruption of oxygen flow to the heart and brain. They turn their backs — literally — on their patient during surgery and instead focus all of their attention on trying to fix a monitor or display that's acting up. 

I enter the room and turn off the monitor, then physically grip the residents' shoulders and turn them 90° away from the array of screens so that they are facing the surgeon and the operative field. It's not rocket science. 

November 8, 2012 at 04:01 PM | Permalink


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Then there are the faculty meetings, and nobody to turn anyone 90°.

If it makes you feel any better, this sort of preoccupation has killed a lot of pilots who are fiddling with radios or nav equipment, leading to the exhortation "Aviate, navigate, communicate - in that order!"


Posted by: Scott | Nov 12, 2012 8:19:41 AM

Great insight. Many people in a variety of contexts have a tendency to be preoccupied with their instruments for seeing the world, and forget more direct modes of seeing the world. We're raising an entire generation that way. When the instruments fail, they're clueless. You could call that one of the many curses of modern life.

Posted by: Diana | Nov 9, 2012 8:42:46 AM

Pardon me! Patients first (do no harm!) is not an emerging issue!

KILL THE INSURANCE !@#$%^&*()_ is.

Where is Doctor Joseph-Ignace Guillotin when we need him?

Oh, yeah... he did some QC on his invention.

Posted by: 6.02*10^23 | Nov 8, 2012 10:26:24 PM

LOL, "Fix the patient, not the numbers" ought to be a mandatory tattoo on every resident's eyeballs.

Posted by: jim` | Nov 8, 2012 8:53:22 PM

Aww, makes one miss the old days. Cyclopropane, an ambu bag, some green gas, and a spark of inspiration!

Posted by: 6.02*10^23 | Nov 8, 2012 5:44:15 PM

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