About 2 years before I left of CoE, things were at a low point and morale was horrible in our department. While the causes were at least to me pretty obvious, the solution was to hire a consultant to find out what was wrong. I am not sure whether our department or the hospital paid for it. Anyway those of us who wanted to meet with him were allowed a one on one meeting which I enthusiastically signed up for. As most people who are earning $400 an hour are, he was quite pleasant. So for about 30 minutes I detailed everything I thought was a problem with the operating room, the surgical service and the anaesthetic department. At the end of this rant, he asked me, "why do you still work here?". I thought about it and said something to the effect that I had been there for 10 years, I knew the place, I liked most of my co-workers and that I really hoped that things would get better. I didn't say that I wasn't really sure I could get a job anywhere else, that the case mix at the CoE was so different from other sites that I wasn't sure that I could handle a different case mix and that I realized that the grass was not necessarily greener elsewhere. A report which I never saw was duly produced, some minor cosmetic changes were temporarily introduced, things continued to get worse and I decided that maybe in fact I could handle the case mix at another place and that the grass was greener elsewhere.
The one thing I remember about coming out of the meeting with him, was how good I felt having let it all out to somebody besides my poor wife.
But there are all lot of things about my work that make it all worthwhile. Not in order of importance by the way.
1. The sight of my hospital in my rear view mirror at the end of the day. (Okay it gets better.)
2. Being part of a team. Sometimes we don't feel like it but we are part of a team and we can't function without each other. That doesn't mean we always get along or have to get along but it is great to work towards a common purpose every day. It is great when for example we get a heavy urology list and we all work through it together, finishing on time or when we all work together on a really sick or dying patient.
3. OR nurses. I have worked with these men and women for 30 years now counting my residency. I still find it incredible the way they can handle multiple surgical instruments, and complex electronics flawlessly, anticipating the surgeons' next moves. On call I find it amazing that the same team of nurses can flawlessly go from a complex Ortho case, to a general surgery case and then to a urology case all with radically different equipment and requirements. Or if I ask for a piece of equipment I maybe use once every 3 years, they can usually find it.
4. The jokes. OR humour is probably the funniest and most inappropriate humour around which is why I can't give any examples.
5. Patient contact. We don't get much of it in anaesthesia but we get more than we are given credit for. I really like talking to patients pre-op going over their history and explaining things. I know I am sometimes brief and perfunctory. I even like the stupid patients or the ones who clearly aren't paying attention to me.
6. Hitting the sweet spot. The time when every thing goes right, when you ask the patient to open his eyes as the dressing goes on and he does; and he seems comfortable and not nauseated. Or when you get the spinal first pass. Doesn't happen every case or it wouldn't be special.
7. My co-workers. I already mentioned the OR nurses. I get to work with a great group of anaesthetic colleagues and while the only time we get to work together is when the shit is hitting the fan, I really appreciate the support and cameradery we have. Sure the surgeons really piss me off sometimes but I do know that some of the stunts they pull are done with the patient's best interest in mind. I should also mention all the other nurses, techs, clerks and orderlies I work with most of whom are great to work with.
8. Recovery. Should have mentioned these nurses earlier. Doesn't get the glamour of places like ICU, but the way these nurses can anticipate problems, pick up problems early and move quickly when the shit hits the fan is positively amazing. They have saved my ass so many times.
9. Being an anaesthesiologist. Within a month of my residency starting, I knew this is what I was born to do.
10. My lifestyle. OK the surest way not to get an anaesthesia residency is to mention that we have a good lifestyle. But we do. No start up expenses, low overhead, fixed start to the day, when you are finished for the day you are finished for the day. Easy to work part-time. Sure there are specialties that have a nicer lifestyle but we have the satisfaction of doing a good job while we are at work.
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