ABSTRACT
THE CASE It was dreary and dark outside. The mercury had dropped like a stone since last night, so I pulled my beanie firmly over my ears before mounting my bike. It was my third night. After tonight, just one more and my nightshift would be over. Cycling through the deserted city, my mind wandered to the previous years. After completing the MRCP examination after my junior doctor training, I chose plastic surgery as my specialty. It cost me a year to admit to myself that the romantic ideal I had nurtured did not fit my experience in the field. Strenuous working conditions, desultory supervision by consultants who made no effort to hide their disinterest in teaching me the ropes and, how can I put this, strange colleagues. Maybe it was just tough luck. Maybe it would have been a totally different experience elsewhere, but after a year it became abysmally clear to me that this was not my path to pursue. I set up an interview with one of the professors of anaesthetics. During the few surgical procedures I was allowed to participate in when the ward was under control, anaesthetics impressed me. In my training till then, I had not done any rotations within anaesthetics, so I had never actually given this field of medicine any serious thought. Other medical specialists frequently made evocative, or downright degrading, comments on the perceived qualities of anaesthetics in general and anaesthetists in particular: they don’t bear the burden of deciding which patients should be operated on, they’re never the doctor in charge, they drink a lot of coffee and waste theatre oxygen, etc. And the jokes of course. One I must admit made me laugh was the one where an anaesthetist is flying to a conference when a flight attendant comes running down the aisle, shouting, “Is anyone on board an anaesthetist?!” The anaesthetist raises his hand and announces his presence, and asks what the problem is, and whether anyone is sick. “Oh, no, no one’s sick, but there’s a surgeon up in first class who needs his table adjusted.” All this mockery had inadvertently influenced the image I had of anaesthetics. But in the operating theatre I experienced just how important anaesthetics is for the surgical outcome. How broad the speciality
really is and how skilful an experienced anaesthetist becomes in understanding and influencing physiology. It fascinated me. The professor of anaesthetics saw my enthusiasm and offered me a research position leading to a PhD thesis, after which I would be admitted to the specialty training. I jumped at the opportunity. This conversation took place 7 years ago, and I had not regretted my choice for a second since. I love it. It’s intellectually challenging, there is enough action and it provides a unique hospital-wide view on healthcare. The only issue is the nightshift. Yesterday, I was so dead tired it made me nauseous. I wondered if I would ever get used to it. I locked my bike and slipped into the hospital through the night entrance.
