Year : 2007 | Volume
: 18 | Issue : 2 | Page : 263--264
Anaesthesia and I
Formerly Professor of Obstetrics and Gynaecology, Damascus University Hospital, Damascus, Syria
Formerly Professor of Obstetrics and Gynaecology, Damascus University Hospital, Damascus
|How to cite this article:|
Pharaon S. Anaesthesia and I.Saudi J Kidney Dis Transpl 2007;18:263-264
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Pharaon S. Anaesthesia and I. Saudi J Kidney Dis Transpl [serial online] 2007 [cited 2022 May 23 ];18:263-264
Available from: https://www.sjkdt.org/text.asp?2007/18/2/263/32323
My story with anesthesia goes back to 1953, when we, as young residents, had to carry out anaesthesia in one out of two ways: with the first was the Ombredanne's mask, which gave ether and had a long induction time during which the patient experienced a horrible sense of suffocation and required two or more nurses to support till falling asleep. The second method was the open mask technique with chloroform drops, nicknamed "a la reine", which caused facial burns if any drop touched the face. Patients, especially with the first method, used to wake up hours after the end of the operation!
At the end of that year a visiting British anaesthetist, Dr. Scott from Aberdeen, came to our university hospital with a huge Boyle's apparatus and started practising modern anaethesia. He was my mentor, a marvelous, attentive and humane doctor. He used to spray the patient's throat with a "Xylocaine - equivalent" before tracheal intubation, and observe the patient all the time, a real novelty to us! Once the operation ended, Dr. Scott used to stop his nitrous oxide and immediately assure the patient who started to wake up on the operating table that thing went well!
As I knew English better than other colleagues, I used to talk more to Dr. Scott and inquire about all the steps: Nesdonal i.v., Succinylcholine etc., and developed an intense interest in his specialty. Although, I pursued later Obstetrics and Gynecology, I kept an intense interest and even worry about anaesthesia, and, therefore, silently elected to work with anesthetists who were well trained in my opinion. Every time operated in association with a bad anesthetist I used to remember Dr. Scott and how careful, kind and atraumatic he was!
A few years ago, I broke my leg and was transferred to hospital for operation. I spontaneously and defensively asked one of my best colleagues to come for my anaesthesia and he did and everything went well. Well, sometime later, I developed urine retention that required operation on my prostate. I was worried because I did not know the anesthetist and did not have the opportunity to evaluate him, but the urologist assured me of his good qualities. The operation went well, but I did not wake up for two hours and when I tried to talk I felt talking like a drunken man. I shouted and asked for help. It was a mild right hemiplegia due to a small clot in the side of the internal capsule. I was heparinized and went home with a limping leg and arm! I determined that I had to fight back to good health and motion and, I, thanks God, nearly achieved it.
Why did I have this misfortune? I asked the miserable anesthetist! He assured me that everything went well! We carried an ultrasound for the neck and discovered that there was a congenital loop at the origin of the left internal carotid artery! When sucking the secretions after the end of the prostate operation, the anesthetist must have excessively twisted my neck to the right side and for long time, and this caused partial twisting and even occlusion of that artery and a small clot formation!
Now, I remember, more than half a century back, the first book Dr. Scott lent me to read "Synopsis in Anaesthesia". In the first page the author defined this great branch of medicine as: "Anaesthesia is ATTENTION". Many colleagues might smile and think this applies to all branches of our profession. In fact, what matters is what we understand from the word ATTENTION. We, doctors, should always be attentive to every step and every procedure we perform and be self-critical how much good or bad was our work or prescription? How were the results: satisfactory or not? We should not always blame the "inborn errors of metabolism or in anatomy" for any mishap or complication as if it were Achille's tendon or the congenital loop of the Carotid. To the contrary, we should objectively discuss with ourselves as well as our colleagues the full circumstances of any morbidity.
To the memory of a fine mentor, humane and attentive anaesthetist: Dr. Scott, from Aberdeen, Scotland, UK, I offer these words with an everlasting sense of gratitude, friendship and affection.