"I suppose those of us between zero and ninety-three are blessed in our own way as well. We are here, swirling in a jumble of the inconsequential and consequential. We’ve enjoyed some of the world’s beauty and reserve the potential to experience more. Some of us will have longer than others, but perhaps we should focus on savoring rather than quantitating ...

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Two of the biggest hitters in the physician finance online world are both anesthesiologists (Physician on Fire and Passive Income MD).  Both of them are masters of side income by approaching money in completely different directions.  Is it sheer randomness that out of dozens of possible medical fields, both of these successful ...

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I am a voyeur of human anatomy. Not in a perverse sense, but rather as part of my profession. In a single day, I can watch a heart beating in its chest cavity in one operating room, walk two doors down to view an exposed brain, and then cross the hallway to an abdomen incised down the middle to expose the organs and viscera inside. I see joints replaced with ...

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"This pandemic presents a unique opportunity for senior anesthesiologists to see the benefit of accommodating the health care needs of our workforce. Just as I tried to avoid the teratogenic effects of certain cases when pregnant, we should consider the most effective ways to protect senior anesthesiologists from a life-threatening infection. When the pandemic has passed, anesthesiologists of all ages can ...

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The annual meeting of my profession’s national society last fall may have been the last old-school, convention-size, professional meeting I will ever attend. I could be wrong, but it may mark the end of an era. Disruptive change to the convention business model was inevitable, though hastened by COVID-19. This year, the leadership of many medical associations announced that their upcoming annual meetings would be virtual – if ...

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1. Change is slow. In fact, it's much slower than I ever imagined. Part of the issue is that people don't like change; another is that workplace culture often doesn't support new ideas. Tackling this issue: Shift your focus. Get to know people first. Be present. Changing perceptions and convincing people to change first requires that you know them, and they know you. 2. Patience is a virtue. ...

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I was listening to a podcast the other day about this woman who kayaked the inner passage from Puget Sound to Juneau, Alaska. She was describing the end of her journey, the day she paddled into Juneau, and she noted that it was so anticlimactic. She paddled in, after 66 days and there was no one to celebrate the end of the journey with, the harbormaster was badgering her to ...

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I have a major issue with MAC. To be more specific, I have a major issue with how we communicate the concept of MAC to our patients, anesthesia care team members, and proceduralist colleagues. MAC stands for "monitored anesthesia care," and we tend to throw it around and use it interchangeably with a lot of other terms:

  • Sedation
  • Procedural sedation
  • Conscious sedation
  • Twilight anesthesia
  • Light anesthesia
The fact is, these entities are not ...

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"As a physician anesthesiologist who has previously been on assignment for Doctors Without Borders in a resource-depleted region fraught with conflict, I’d like to say there’s little I haven’t seen. But now, after four weeks of staffing COVID intensive care units and emergency response teams throughout New York City, I struggle to distinguish between the exhaustion of a distant war-zone and ...

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1. Anesthesiologists are your protector Think about this: An anesthesiologist's job is to protect you from the harm your surgeon is causing.  Seriously. A surgeon's job, at its very essence, is to damage your body. Now undeniably, it is with the intention of causing greater good and/or fixing something that is already broken.  But in order for a surgeon to help a patient, they take a knife, saw, drill, or hammer, ...

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As a fourth-year anesthesiology resident, I opened up my email eagerly, awaiting the results of the pain fellowship match. It was official; I was heading to a major academic program in New York City. First came excitement and relief immediately followed by a rush of all-encompassing fear. I had grown up in Arizona my entire life, and the idea of living and training in New York City was daunting, to ...

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Have you ever felt completely overwhelmed both at work and at home? Perhaps you’re thinking, my job as an anesthesiologist isn’t anxiety-provoking enough; I should probably homeschool my kids at the same time. When’s the last time you uttered the phrase, “This is the most stress I’ve ever experienced” multiple days in a row? Come on over, COVID 2020 has got you covered! First, we’ll start with the existential threat of a global pandemic—one ...

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My mother gave years of her life to service in this hospital. I was born in this hospital. I volunteered here for years before I started my residency in this hospital. I grew up before the very eyes of this hospital. I owe my life to this hospital, but I don’t owe my death to this hospital. And neither does my mother.

I start my shift with ...

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I don my PPE in the hallway, while the patient is watching the increased commotion outside of their room. They see me enter their room, introduce myself, and then position myself behind their bed. They are covered with a plastic wrap or an intubation box to protect us from their cough and secretions. They feel a burning sensation in their arm as propofol enters, while the nurse is holding it, ...

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If you’ve had surgery before, you almost certainly remember who your surgeon was. You’ve probably thanked them countless times for getting you through a scary time. Whether they excised your cancerous tissue, repaired your ACL, or removed your inflamed gallbladder, you have likely sung their praise, time, and time again. But do you remember who your anesthesiologist was the day of your surgery? Probably not, and that’s okay. You may recall ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. There is a global anesthesia crisis: too few people trained to give anesthetics for surgery and obstetrics worldwide. The Lancet launched a commission to look at the needs for global surgery, which identified the issues starkly. While international disease control efforts have ...

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The room is half-lit from the sunset. Crowding around the bed, in almost saint-like postures, is the family of our patient who is in her last moments of life. I do my best to console the family, a light touch on the shoulder, and honest stare. Then, there’s the inevitable moment, the palliative extubation. Our patient, gasping for air, head turned to her side, the room in a quiet somber. The moment ...

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