#anesthesiology

I love when you’re in the prep area and they come in to ask you questions. Ask me about my life, my habits, my family and medical histories. Tell me about the prep, the procedure, and the recovery. Type notes on your computer, gloved fingers flying across the keyboard. Then have the surgeon come in and let’s do it all again.

I love when the next nurse comes in to start your IV. First she pulls on tight gloves, then she holds your hand and pokes your wrist until she finds the perfect vein and wipes it clean. She turns to pick up the IV and tells you “big pinch.” You look away. “Fuckfuckfuckfuckfuck” repeats on a loop in your head. And then it slides into your vein. It’s no big deal. You feel a little foolish for letting her reverse psychology work on you.

But you also know at this point, you’ve lost the fight. They have full access to you, your body, your soul. You’re going under. It’s a matter of when, not if.

I love the versed. The anesthesiologist comes into the prep area with a big, clear syringe in her breast pocket. Hot. She reaches in with one of her gloved hands and tells you she has a cocktail for you. She holds it up to the light, ensuring a perfect dose, then removes the cap, inserts it into one of the ports on your IV line, and pushes it quickly. The chemical calmness, anxiety reducer, the liquid weighted blanket enters your system. Everything looks a little brighter, sounds a little softer, and you feel weightless like you’re floating on a cloud.

I love the move to the OR. You have someone pushing your bed from behind, and a nurse by your side. They chat with you to distract you further, but the versed is kicking in so you already don’t care. The square ceiling tiles roll by and the OR doors open with a hiss. As you roll in, nurses are snapping on gloves, filling syringes, and setting up for the procedure.

They stop you right next to the table, lower the railing, and have you scoot over. Your gown gets caught underneath you, and you try to fix it, but you can’t because you’re sitting on it. You lay down without caring because you’ll be out cold in a couple of minutes and it’s not your problem, they’ll fix it if they need to. And you’ll never know either way.

I love the prep. You’re lying on the table. It’s cold, just like the room, and the gown offers little protection. Gloved hands are moving quickly, but with measured precision, all around you. One nurse is adjusting your IV fluids. Another is placing Velcro straps around hour wrists, securing them to the arm of the table. Someone lifts your hand to put a pulse oximeter on your pointer finger.

The anesthesiologist is lifting your gown at the neckline to place heart monitor stickers on your chest. She uses her left hand to hold the gown up while the right hand goes in. The first sticker goes way on the left. As she puts it down you feel her gloved fingertips on your skin, and as she takes her hand away, she drags her fingers across the sticker to make sure it stays in place, but then you feel her fingers again once they reach the other side. She gets another sticker and repeats the same process in the middle of your chest, and then again for the final sticker on the right.

I love when the anesthesiologist puts the oxygen mask on. Before that, she turns around and starts fiddling with the anesthesia machine, making sure all the heart monitors and the pulse oximeter are working properly.

Then she starts turning valves for the gas. She picks up the mask in one hand and turns towards you, corrugated tubes following. She uses her other hand to lightly tap under your chin as she says “Chin up, please.” In your versed-induced high, there’s no option but to listen to the request that’s really an order. As you tilt your head back, she holds the mask up high and says something like “This is just oxygen.” as she lowers it over you. As it gets closer, the mask and her gloved hand start to look bigger. When it’s almost on you, you start to hear the air hissing through the tubes.

As it settles softly on your face, a few things happen. 1) Her gloved hand is resting delicately on your face. Her thumb and pointer finger are on top of the mask, supplying a mild pressure to create a tight seal, causing pressure on the bridge of your nose. Her other three fingers are wrapped gently around your chin, with her palm resting on your check. 2) You smell the plastic, which isn’t very pleasant. 3) She tells you to take some deep breaths, and you inhale the cleanest air you’ll ever breathe. You take several more breaths and it’s really refreshing.

I love the feeling of propofol. There are a few different ways you can be induced too.

The first is that the anesthesiologist pushes it. Sometimes she’ll leave the mask resting gently on your face, other times she’ll have another nurse hold it. Either way, she starts with the small syringe of lidocaine to minimize the burn of propofol. Then she gets the massive, milky-white syringe, clicks it into the port, and pushes it. She’ll say “Pick a nice dream.” or “We’re going to take great care of you.” or “See you in a little while.” or, if she’s fun, “Start counting.”

The second is that she keeps holding the mask, her hand resting delicately on your face, maybe even both hands covering almost your whole face if you’re lucky. One of the nurses, usually out of view, will sneak in the lidocaine and propofol. You won’t see it coming, and sometimes you don’t feel it either.

The third, and by far the most rare, is that she lets you push it! She puts the syringe in your hand and tells you to push it. This usually requires her help because as you get towards the bottom, you lose strength as it starts to take effect. She’ll put her hand around yours and push with you. So hot.

Whichever way it happens, the punchline is the same. Warmth floods your veins. Metallic taste in your mouth. Your vision starts to blur. Your eyes unfocus and roll back into your head. Lights pulsate, sounds fade into the distant, and then you’re out cold.

I love knowing that the anesthesiologist has her hands all over my face, it’s so intimate. After the anesthesia wins as it always does, she’s going to run her fingers along my eyelids to check for reflexes. She might even open the eyes completely. Some open the jaw too. I love the idea of a nurse playing with my limp face.

No reflexes means I’m out like a light. Then she’s going to tighten her grip on the mask with one hand, really digging into my face and chin. The other hand will grab the breathing bag and start squeezing, rhythmically breathing for me.

As this happening, the gown is being ripped open so the surgical team can begin prepping for the procedure.

I love the idea of being out cold and intubated, a short break from all the worry and exhaustion of the world with all your basic needs being carefully monitored. A nurse is going to start by putting things on your chest. A breathing tube and a blade will be needed for this. Once it’s time, the anesthesiologist will put the bag down and remove the mask.

Then, she’ll put one hand on your head and tilt as far back as possible, opening the airway as much as possible. With her other hand, she’ll slide the blade with a camera on it down your throat, illuminating it with the light and getting a clear view of your vocal cords on the screen. She’ll hold up her free hand and the nurse will hand her the breathing tube, which promptly goes down your throat and through the opening in your vocal cords. The nurse will fill a syringe with air, attach it to the hose coming off the tube, and inflate the cuff so it stays in place.

Then they squeeze the breathing bag a few times as the anesthesiologist gets her stethoscope and listens to your chest. If the breathing sounds good, the tube is secured with tape.

I love knowing that my eyes are lubed and taped shut. I wonder what that feels like when you’re awake.

The left eyelid is pulled back and lube squirted onto the eye before the lid is shut and pressed to spread the lube around. Then the same thing happens with the right eye. The nurse is ripping pieces of tape to cover both and they are applied to cover the entirety of each eye. This not only protects the, it keeps them moist.

Beach day. You can imagine the kinds of... interesting situations that can lead to⚕️

Today I found one of my favourite chairs in one of the ORs, and the rest of the ORs didn't have my favourite chair in them, so I dragged it along with me for the rest of the 12 hour shift