Wednesday, February 10, 2010

The perfect anaesthesia

Strange that after so many years, I only now ask myself, and repeatedly so, exactly what constitutes the perfect anaesthesia. Oh I know all that stuff about amnesia, analgesia, akinesia and altered sympathetic response. Lets face it, every single patient gets that ... I also know that there are anaesthetist factors, patient factors, and drug factors that all have a role in how the anaesthetic is going to play itself out. But what I don't get, is why it sometimes goes really brilliantly, and other times less so. Especially when the basic technique used is the same, with only some minor fine-tuning to accomodate individual needs.

With time one gets a feel for the job. Sort of like baking. Yeah, if you bake the same cake every day, it gets better, easier, and quicker. You also start to get a "gutt feel" for how your cake is going to turn out. And funny enough, even though you use the exact, same , unaltered recipe, the cake is sometimes yummier than other times. Why is that??

What freaks me out even more, is that when a dope feels sort of effortless, if one could call it that, it usually turns out close to perfect. ( I say close to perfect cause I think that absolutely perfect is an illusion ). And when meticulous planning with a lot of extra-careful effort is put in,
things turn out less than satisfying. By that, I mean there is something consciously or subconsciously irritating me.
Coughing, pushing, biting, waking too fast, waking too slow, too much gob, too little gob ...

Am I making any sense here?? I am way too young for a mid-life crisis, and way to old for neon-green-behind-the-ears syndrome. My better half is a pilot and I can't help feeling that some days, although I manage take-off and landing quite safely, it's almost as if I completely miss the runway!! Why, when according to science, everything has been done to ensure the, two-for-the-price-of-one, package-deal of "state-of-the-art snooze plus awake-up", is there no guarantee?
Add to that, the fact that this usually occurs with your least favourite of surgeons ... or when you really don't want it too ... or when you secretly want to show off your cool technique a bit ... or when you really don't expect it too ... and I ask again ... what is that something that I'm sometimes missing?

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