Today is a remarkable day for me. I’m officially leaving private practice after almost 18 years, to return to academic medicine with a faculty position in a highly regarded California department of anesthesiology. Why would I do that? There are many positive reasons. I believe in the teaching mission of academic medicine:  to train the anesthesiologists of the future, and the scientists who will advance medical care. I enjoy teaching. The years ...

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“For some must watch, while some must sleep.” – William Shakespeare, Hamlet I admit, I was taken aback at the headline that ran in the Houston Press today: "Going under:  What can happen if your anesthesiologist leaves the room during an operation." It’s bound to make the curious reader wonder why the anesthesiologist would leave the operating room in the first place. Of course, reporter Dianna Wray explains that in many hospitals, one ...

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It’s amazing how quickly my role changed from physician to patient, thanks to a silent assailant: osteoporosis. I went to the gym in the morning before work 12 days ago, as I often do now that my children are all grown up and out of the house. First, a couple of light sets of leg exercises served as a warm-up, and then I started a set with a barbell on my ...

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Did it ever occur to some of today’s physicians that many people work awfully hard and complain a lot less than they do about “burnout” and “work-life balance”? Did it ever occur to them that “work-life balance” is the very definition of a first-world problem, unique to a very privileged class of highly educated people, most of whom are white? Every day, I go to work and see the example of the ...

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shutterstock_265206557 In case you were wondering -- robots won’t replace anesthesiologists any time soon, regardless of what the Washington Post may have to say. There will definitely be a place for feedback and closed-loop technology applications in sedation and in general anesthesia, but for the foreseeable future we will still need humans. I’ve been practicing anesthesiology for 30 years now, in the ...

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shutterstock_138554978 Dr. Margaret Wood, who chairs the Department of Anesthesiology at Columbia University Medical Center, has published a wonderful article titled "Women in Medicine:  Then and Now," in the journal Anesthesia and Analgesia. I think I speak for many of us in admitting that Anesthesia and Analgesia doesn’t occupy a prominent place on my bedside table. Many readers may have missed Dr. Wood’s article. ...

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The best way to avoid being sued for malpractice is to make certain that all your patients are happy and all their outcomes are good. Reality is seldom so rosy. Patients aren’t necessarily happy even when their clinical outcomes are as good as they can get. In the event of an undesired outcome, an unhappy patient may easily become a litigious one. A 2011 study in the New England Journal ...

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Termites are endemic in southern California, and we’ve had spot treatments several times over the years at various sites in our house where little piles of sawdust have appeared as evidence of termite activity. Finally, it became clear that the termites were winning, and more aggressive treatment was in order: tenting. This is the process of hoisting a big, brightly-colored tent over the whole house and putting an end to ...

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shutterstock_131910137 American anesthesiology reached a significant milestone last year, though many of us probably missed it at the time. In February, 2014, the number of nurse anesthetists in the United States for the first time exceeded the number of physician anesthesiologists. Not only are there more nurses than physicians in the field of anesthesia today, the number of nurses entering the field is ...

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“Twilight! She has to have twilight,” insisted the adult daughter of my frail, 85-year-old patient. “She can’t have general anesthesia. She hasn’t been cleared for general anesthesia!” We were in the preoperative area of my hospital, where my patient -- brightly alert, with a colorful headband and bright red lipstick -- was about to undergo surgery. Her skin had broken down on both legs due to poor circulation in her veins, ...

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