Adrenalin Junky's?

[badasshairday]

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So I always hear med students liking Anesthesiology because of they like Pharm/Physio, it is chill, lifestyle is decent, etc.

I am on my anesthesiology rotation, and today I saw **** Hit The Fan, big time. It is just insane how quickly things can get bad so fast. It was my first time seeing it. I mean, I've seen other acute issues on anesthesiology and through med school on other rotations, but nothing like today.

All I remember thinking was, this guy might die, like right freaking now. After things got under control, my attending looked at me and said, ""do you still want to go into anesthesiology? Think about it tonight when you go home. Today was nothing, you will see a lot worse."

I feel like a lot of med students go through there Anesthesiology rotation without seeing SHTF, like when you can't intube, you can't ventilate with mask/LMA, and the patient is turning blue in front of your eyes desatting to the 30s. They think anesthesiology is "chill." But it really isn't. It is frightening. I always heard the saying that "Anesthesiology is boredom interspersed by sheer ****ing terror." Now I've finally seen it, and truly feel like I have experienced anesthesiology.

My question to the residents and attendings: Do you guys like the rush?

 

[pgg]

Do you guys like the rush?

No.

There's satisfaction in handling a crisis well, or better yet anticipating and avoiding it altogether. But these are retrospective feelings; I can't say I enjoy the actual moments of a problem.


If anything I've become much much less of an adrenaline junkie since finishing med school. I'm much more risk averse now. Everything from the way I use power tools in my garage or put Christmas lights on my house, to the way I politely turn down offers for joyrides in military aircraft in war zones. Maybe I'm just getting old or something. 🙂

 

[jennyboo]

They think anesthesiology is "chill." But it really isn't. It is frightening. I always heard the saying that "Anesthesiology is boredom interspersed by sheer ****ing terror." Now I've finally seen it, and truly feel like I have experienced anesthesiology.

My question to the residents and attendings: Do you guys like the rush?

The older you get and the further away from training you get, the more you relish just a quiet regular humdrum day. Routine calm is our objective.

But the best of us also get a lot of satisfaction from handling tough and rapidly-changing situations well. As much as we will say "I am not an adrenalin junky" and "I don't enjoy moments of terror" the best anesthesiologist will also throw herself into these moments in order to navigate out of them. The whole purpose of your job is to avoid problems, but you can't be a good anesthesiologist if you run for the hills instead of engaging with problems directly when they occur.

Anesthesiology is not "chill." It often just looks "chill" because we act calm.

 

[Consigliere]

The older you get and the further away from training you get, the more you relish just a quiet regular humdrum day. Routine calm is our objective.

But the best of us also get a lot of satisfaction from handling tough and rapidly-changing situations well. As much as we will say "I am not an adrenalin junky" and "I don't enjoy moments of terror" the best anesthesiologist will also throw herself into these moments in order to navigate out of them. The whole purpose of your job is to avoid problems, but you can't be a good anesthesiologist if you run for the hills instead of engaging with problems directly when they occur.

Anesthesiology is not "chill." It often just looks "chill" because we act calm.

Word

 

[RT2MD]

Anesthesiology is not "chill." It often just looks "chill" because we act calm.

This is one of the things that appeals to me about anesthesiology. During my RT stint, whenever the poo was hitting the fan, you could always tell who the anesthesiologist was... they were the one that were calm, cool and collected while everybody else was losing their minds.😎

 

[periopdoc]

Anesthesiology is not "chill." It often just looks "chill" because we act calm.

qft

I enjoyed that aspect somewhat when I was a resident with no real liability, more when I was a medic with youth, a lack of understanding of how risky some of this stuff is, and even less liability.

Now, if my day is exciting, that means there is real personal risk involved and I don't particularly yearn for it.

Like flying an airplane, routine days are the best days.

- pod

 

[urge]

It gets old after a few years.


BTW, could you guys spell adrenaline correctly?

 

[pgg]

It gets old after a few years.


BTW, could you guys spell adrenaline correctly?

Isn't Adrenalin what those silly Brits call epinephrine?

 

[badasshairday]

Thanks for the responses. It was great, after the patient was stabilized my attending says to me, "Do you still want to do anesthesia? Think about it tonight when you go home. Today was nothing. You will see a lot worse." I was still shaken from what I had just witnessed. Anesthesiology is raw.

[YOUTUBE]http://www.youtube.com/watch?v=Z5HB-JXecjk[/YOUTUBE]

 

[Idiopathic]

#1 - that avatar belongs to someone else

#2 - this job is all about lighthouse work and "being ready". im usually very even-keel, which i think helps, and i typiclaly only get excited by a case after everything goes well. i dont think theres anything wrong with craving the rush of a disaster, but its a quick way to burn out, just like in anything.

 

[RT2MD]

#1 - that avatar belongs to someone else

Agreed... there for a bit, I thought that Venty was back with us... if only it were so.

 

[dhb]

Do you guys like the rush?

Something is wrong if you're having these rushes frequently.
The good outcome is the rush not the shtf.

 

[badasshairday]

Something is wrong if you're having these rushes frequently.
The good outcome is the rush not the shtf.

Yeah, that is what I mean. When shtf and you have a good outcome. Is that a draw to anesthesia for some people? Obviously you want to avoid these at all costs, but they do happen. Is successfully trouble shooting these scenarios and having that "rush" feeling afterwards a draw to anesthesia for some people?

 

[ucsfgaspain]

Yeah, that is what I mean. When shtf and you have a good outcome. Is that a draw to anesthesia for some people? Obviously you want to avoid these at all costs, but they do happen. Is successfully trouble shooting these scenarios and having that "rush" feeling afterwards a draw to anesthesia for some people?

I have to be honest with you. I do like the feeling of handling the **** when it hits the fan. Do I seek it out...not really...but I do the big cases that the old timers won't. Why? Strictly b/c I know I can handle it. Now that is not to say that I don't freeze up. I'm human, I do. I freeze less than most but human emotions are weird...you can make a connection with a patient over hobbies...people you know..etc. and that can make you freeze. I work best in crisis when I'm emotionally unattached. I seriously think of the person as a piece of meat in front of me when I work the best.

You want to know what case freaks me out? A cute 2 year old totally healthy going in for a T&A. Why? B/C nothing good can come out of that case...if everything goes great, it's what is expected....if it doesn't, how do you talk to parents and tell them that their kid is dead? Just my perspective.

I do think it helps that I do triathlons...and heli snowboard...I'm used to the tachycardia and the surge of your sympathetics going haywire.

 

[Bertelman]

You want to know what case freaks me out? A cute 2 year old totally healthy going in for a T&A. Why? B/C nothing good can come out of that case...if everything goes great, it's what is expected....if it doesn't, how do you talk to parents and tell them that their kid is dead? Just my perspective.

Agree. I did one of those awhile back. Mom was a resident I worked with. Case was fine, extubated, breathing for a min or two, then laryngospasm moving over to the crib. For about 30 sec, I'm thinking "This isn't happening, this isn't happening." Broke it as my attending was drawing up the sux.

Not cool. Somehow, those are always the cases I fear, when I know someone. I try my best to not do anything any differently.

 

[periopdoc]

You want to know what case freaks me out? A cute 2 year old totally healthy going in for a T&A. Why? B/C nothing good can come out of that case...if everything goes great, it's what is expected....if it doesn't, how do you talk to parents and tell them that their kid is dead? Just my perspective..

This, and OB. That's why I love cardiac anesthesia. People are more appreciative of the good outcomes when they have some frame of reference for and an appreciation of the risk going in.

- pod

 

[amyl]

#1 - that avatar belongs to someone else

QUOTE]

🙂 -- missing venty, hope he is well

-- being anesthesia is like always getting to be the good cop. the surgeon is the as---le, hot head with a temper and a scapel screaming at everyone trying to kill the patient at every turn.
I get to be the calm chill one with fentanyl and a smile.

i agree the SHTF stuff is fun if it goes well or if expectations are low... we lost a ruptured AAA who had been ruptured for like forever, life flighted in, blah, blah, blah... we tried to save him, we failed but still everyone was like good job.

i sometimes like the adrenaline rush but i can tell you after a week of doing the bad vascular cases -- like 10L blood loss on a third time redo fem revascularization or she will loose the leg on plavix cause the COPD, obese, DM lady with a bad heart just got a DES -- i was happy to be put in a basic case for once. i have seen enough, in my short anesthesia career, to say that the adrenaline rush can get old pretty fast.