………………………………………………………………………………………….. …………………………Why would you go to medical school to put someone to sleep? A reflective account

“WhY WouLd YoU go To MeDicaL ScHool to

PuT PeopLe tO sLeEp?”

A reflective time that comes to mind would be on my anaesthetic rotation. I shadowed a speciality registrar (ST5) in anaesthetics and an ACCS trainee, and the day started off well. I got involved in a range of cases, learning about specific anaesthesia, various conditions, and their management. I felt part of a team.We went into the last case of the day, where there was a specific note to 'have a consultant anaesthetist present' from the very beginning. The consultant anaesthetist for the day was very busy with other procedures and supervising other theatres but quickly judged that the ST5 was competent enough to carry out the procedure. This was then communicated with the consultant ENT surgeon, and everything seemed to go smoothly. The main reason a consultant anaesthetist was required for this procedure was that the patient had Turner's syndrome. Turner's syndrome is a genetic condition that presents with various manifestations. The first noticeable one was that the patient was challenging to intubate due to her internal anatomy; she had multiple comorbidities, making it tricky to cannulate her. In fact, I tried and failed to cannulate the patient, with the ST5 having to quickly take over. They also had to put an arterial line in the patient. This created what others would call a 'delay' but what anaesthetists would call 'adequate safety time'. Ultimately, the patient was anaesthetised safely. It was only until bringing the patient into the theatre that there seemed to be a problem. The consultant ENT surgeon loudly proclaimed that he wanted a "f***ing reason why this took so long". The registrar initially laughed - thinking this was a joke. Still, the surgeon carried on with his outburst of expletives, stating that we've "wasted his time" and he needed to attend a "parent's evening". The room began to descend into chaos. The registrar clapped back, stating that this was a difficult patient to anaesthetise. Again, the surgeon rebutted and said, "well, the consultant should have done it". Then, like clockwork, the anaesthetist walked in, coming to the defence of the registrar and taking control of the situation with her professional manner. I stood in the corner and watched this whole ordeal, shocked and unsure of what to do or how to even help. Did I contribute to this delay? Instead, the assisting surgeon, an ENT registrar, used this as an opportunity to teach me some basic ear anatomy. I was almost dismissed from the anaesthetic team as they seemed so focused on getting through the procedure. The ENT registrar called me over to look at the procedure the consultant was performing. It felt like he wanted to appease the situation. However, he did make a sly pass at anaesthetists, saying that "why would you go to medical school to put people to sleep?" The same could be said for his own infatuation with ears. Nevertheless, I still managed to stay focused and listen attentively to his teaching. I didn't end up staying for the whole thing. The room started to get packed with more budding ENT surgeons - as this was, I heard a "fascinating procedure", but with the last event still fresh in my mind and the clock hitting 4:30 pm, I decided to call it a day. I thanked the team and quickly asked the ST5 to sign my logbook, which he happily did. I left and felt an element of shock with what I witnessed. I have never seen a doctor act so unprofessional toward his colleagues. That poor communication ruined the environment, making it toxic and silent. I vowed from that day to always try to keep my emotions in check when speaking to colleagues. It's something I do anyway, but understandably, when it comes to being a Dr, I sense I'll have many things thrown at me that could dampen my spirit. But in this instance, I thought: Would my outburst make things go quicker?

Written by Adewale Kukoyi