During 1977 I was a junior hospital doctor starting a short three month rotation in anesthesia. Like most people, including doctors, I had never expended much serious thought on the subject of anesthesia. Anesthesia was just there on demand — mundane and necessary — a low profile aspect of medicine. But then I became involved …
My first observations and initial experiences administering general anesthesia were of fascination, together with a profound sense of wonder. I saw each patient arrive in the operating theatre as a living, vital, conscious, speaking individual. Anesthetic drugs were administered, and suddenly the condition of this person was reduced to that of a biological mechanism. No longer a vital individual personality, the person became an unconscious vacant shell, a machine made of flesh and blood undergoing repair by a surgeon. Vital functions were maintained with machines, drugs, and fluids to maintain the unconscious body of this person in a functional condition, insensible to pain and the outside world. This condition was maintained until the end of the operation, upon which administration of some drugs was stopped, and other drugs were administered. Within a few short minutes consciousness and personality returned — the once apparently vacant shell, the body of that person became a living, vital, conscious, speaking individual again. I felt a sense of awe and wonder when considering the message contained in this sequence of events — general anesthesia surely must reveal something about the human mind … That was in 1977. My sense of wonder remains unchanged by a subsequent career as anesthesiologist. And each year, this same “wonder” is repeated worldwide upon tens of millions of people undergoing medical procedures requiring general anesthesia.
But anesthesia has somehow acquired very bad publicity in many modern Western countries. In my personal experience this may even be expressed in the rather extreme attitude; “It’s OK to die as a result of the operation, but it’s not OK to die as a result of the general anesthesia needed to make the operation possible!” A colleague of mine, Professor Anneke Meursing, also once expressed this attitude in a pithy little sentence; “The surgeon gets flowers, and the anesthesiologist gets sued.”
Many people also seem to think that general anesthesia is only administered by nurses, the hospital porter, or some semi-ignorant person — administered by a sort of surgical appendage, doing only what the surgeon wants, and when the surgeon wants it. Many people even believe general anesthesia and death to be similar conditions — accordingly, general anesthesia is considered by many to be an extremely dangerous condition indeed. This is really strange, because these same people believe this “dangerous” general anesthesia to be administered by some semi-ignorant and submissive underdog.
An anesthesiologist is a person who has studied medicine, and is qualified as a medical practitioner. For all manner of reasons, some of these newly qualified doctors decide to specialize in the field of anesthesiology, just as other newly qualified doctors decide to become surgeons, radiologists, internists, cardiologists, psychiatrists, venerologists, etc. The duration of the specialization in anesthesiology varies from one country to another, usually lasting from three to five years, at the end of which the aspiring anesthesiologist must complete a difficult examination in all aspects of the field of anesthesiology.
The task of the anesthesiologist is not only to anesthetize people so that they do not feel the pain of surgery, but also to keep the patients under their care alive in spite of their sometimes life-threatening diseases, and in spite of the blood loss and/or tissue damage sometimes resulting from major surgery. This is why well trained anesthesiologists possess a more than average practical knowledge of the functioning of the human body. Such knowledge enables anesthesiologists to accurately assess patients to determine their individual risk of anesthesia and surgery, as well as to choose the most appropriate anesthetic technique for the planned operation for each individual.
This site is intended to give interested readers more insight into how anesthesia works, to explain some popular misconceptions, to illustrate some of the more suprising experiences reported by people undergoing anesthesia, as well as to provide information to trainee anesthesiologists on subjects seldom, or inadequately discussed in most textbooks or during their training.
Readers using smartphones will see a standard menu with three stripes on the top right corner of their screens. This is the menu for the various pages. However, such menu’s are not always evident to all smartphone users, so I include the menu below to the other pages on this site for clarity.
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