Is Anesthesia for me?

[xtina0]

I'm currently a fourth year med student. I have my application ready to go, I will be applying only to anesthesia.

Anesthesia is my dream, I love everything about it. No other field of medicine is as exciting or rewarding to me than anesthesia. I'm into my second gas rotation and I absolutely love everything about the field and can't imagine any field fulfilling me as much as anesthesia does.

HOWEVER, I want to be realistic in what I can or cannot do mentally. I never want to jeopardize the life of a patient. I am afraid that my tendency to sometimes PANIC may hurt me if a case goes wrong or I'm called into a code as a resident and I let my anxiety take over.

I can pretty much carry myself just fine when things go smoothly but I find I can't think as straight when things don't go smoothly.

Are these normal feelings that can be overcome or is this a personality trait that will hurt me in this field?

---

Members don't see this ad.

 

[pgg]

I'm currently a fourth year med student. I have my application ready to go, I will be applying only to anesthesia.

Anesthesia is my dream, I love everything about it. No other field of medicine is as exciting or rewarding to me than anesthesia. I'm into my second gas rotation and I absolutely love everything about the field and can't imagine any field fulfilling me as much as anesthesia does.

HOWEVER, I want to be realistic in what I can or cannot do mentally. I never want to jeopardize the life of a patient. I am afraid that my tendency to sometimes PANIC may hurt me if a case goes wrong or I'm called into a code as a resident and I let my anxiety take over.

I can pretty much carry myself just fine when things go smoothly but I find I can't think as straight when things don't go smoothly.

Are these normal feelings that can be overcome or is this a personality trait that will hurt me in this field?

If you have a bonafide anxiety disorder, diagnosed by someone not on the internet, we're the wrong place to go for help or advice.

Otherwise, you'll do fine. Four years of residency will make you safe. Internship alone will probably beat the freeze out of you.

It's no different than the pre-med who has fainted at the sight of blood before, wondering if he can ever be a surgeon.

 

[IlDestriero]

You learn what to do when the stool hits the fan. You learn when you need to act and think and in what order.
If you really can't act under pressure for whatever reason, anesthesia is not for you.
We lost a guy after CA2 for that very reason. He wasn't dumb, he wasn't unskilled, but it was clear that when it all went south, he couldn't get the job done, and he wasn't going to "get it". He panicked and could not do what needed to be done.

 

[yappy]

You learn what to do when the stool hits the fan. You learn when you need to act and think and in what order.
If you really can't act under pressure for whatever reason, anesthesia is not for you.
We lost a guy after CA2 for that very reason. He wasn't dumb, he wasn't unskilled, but it was clear that when it all went south, he couldn't get the job done, and he wasn't going to "get it". He panicked and could not do what needed to be done.

Why didn't he alpha-up?

 

[BobBarker]

Don't be nervous in codes. The patient is already dead.

 

[IlDestriero]

Why didn't he alpha-up?

Why do you brother to post here?
He's an attending physician in another field, so I guess he "alpha"ed up enough.
And he likely makes more per hour in a relatively stress free job, so maybe he was the smart one after all.

 

[yappy]

Why do you brother to post here?
He's an attending physician in another field, so I guess he "alpha"ed up enough.
And he likely makes more per hour in a relatively stress free job, so maybe he was the smart one after all.

A lot of my interests are represented here.

 

[xtina0]

So basically if I have no true anxiety problems, which I don't believe that I do.

I will learn everything in residency and I should have no problem overcoming these feelings?

 

[IlDestriero]

So basically if I have no true anxiety problems, which I don't believe that I do.

I will learn everything in residency and I should have no problem overcoming these feelings?

Most likely. But you might not want to work in that kind of environment. It's not for everyone.
Everybody jokes that the job is easy, read, Sudoku, etc. When it is, it is, and when it's not all eyes are on you for the solution and leadership. The surgeon may or may not be helping, and more often than not is busy doing something else.

 

[deleted9493]

Most likely. But you might not want to work in that kind of environment. It's not for everyone.
Everybody jokes that the job is easy, read, Sudoku, etc. When it is, it is, and when it's not all eyes are on you for the solution and leadership. The surgeon may or may not be helping, and more often than not is busy doing something else.

Well said.

 

[inmyslumber]

We had a resident in my program who always looked like a deer-in-headlights when serious issues came up in the OR. Program was worried about his ability to deal with codes, massive bleed, etc.

Now, he is an Attending at another hospital and still appears to act the same way in stressful situations...however, to his credit, he gets things done somehow. It must be said that his look of panic does not inspire confidence in OR staff.

 

[yappy]

Do you guys think there is a way to develop this "grace under fire" demeanor if it doesn't come natural? I know it's fiction; but, the HBO series Band of Brothers comes to mind. How does one become a Winters when they're a Sobel?

 

[WholeLottaGame7]

Do you guys think there is a way to develop this "grace under fire" demeanor if it doesn't come natural? I know it's fiction; but, the HBO series Band of Brothers comes to mind. How does one become a Winters when they're a Sobel?

I think part of it is innate and part of it is learned. I don't think a Sobel can ever learn enough to be a Winters, but everyone can maximize their own development to a degree. Some people's max still isn't good enough, but I think that's probably a fairly small minority of people who can make it through medical school.

Also, we've all had attendings who panic in the OR and jack the anxiety up 10-fold, and they (presumably) all passed their boards.

 

[pgg]

Do you guys think there is a way to develop this "grace under fire" demeanor if it doesn't come natural? I know it's fiction; but, the HBO series Band of Brothers comes to mind. How does one become a Winters when they're a Sobel?

The $billion question that has stumped everyone from Marine Corps boot camp drill instructors to anesthesia residency program directors, and spawned generations of motivational speakers and professional coaches.


I'd say start off by being competent. Being graceful under fire is hard if you don't know WTF to do in the first place. The intern who doesn't know ACLS will look helpless at a code, because he is helpless. There's no masking incompetence.

Is there a difference between

a) "freezing" because you're nervous, and

b) "freezing" because you don't have a grasp of what's going on in the first place, or because your fund of knowledge is insufficient to come up with a differential?

Obviously this kind of competence is learned over time during residency, but at least in anesthesia (and most of medicine, really) we can always fall back on ABCs and BLS. If you're a new CA1 and you respond to your first OR crisis by checking the airway, checking ventilation and gas exchange, checking circulation, and intervening to fix those problems, you're most of the way home already.

I think a lot of people who "froze" at codes would've done just fine if they'd looked at the ACLS algorithms once in the preceding 3 months.

 

[gasattack3]

Don't be nervous in codes. The patient is already dead.

Funny, but so true. I recommend getting as many chest compressions on coding/dead people as possible during your MS years. Even as an intern. There's always a sweaty nursing aid dude who just can't get himself to ask for "help" and just compresses away, sweating away, with each compression getting less and less effective...... His machismo getting the better of both he and the patient....

Seriously though, I think you'll be o.k. You may even surprise yourself when the doo-doo hits the fan.