What type of anesthesiologist are you?

[Noyac]

• "The professional artists," who get satisfaction by solving the complex physiological problems of their patients
• "The Samaritans," who gain satisfaction by relieving suffering
• "The servants," who enjoy playing a supporting role in satisfying the needs of others
• "The coordinators," who gain satisfaction by making the whole system work better

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[Consigliere]

"The Schemer." As soon as I walk in the door, I'm plotting my exit strategy.

 

[criticalelement]

"The Schemer." As soon as I walk in the door, I'm plotting my exit strategy.

I've already worked out my exit strategy prior to even walking in the door. Than it is do as little as possible to not receive the blame for any type of bad outcome.

 

[amyl]

• "The professional artists," who get satisfaction by solving the complex physiological problems of their patients
• "The Samaritans," who gain satisfaction by relieving suffering
• "The servants," who enjoy playing a supporting role in satisfying the needs of others
• "The coordinators," who gain satisfaction by making the whole system work better

all of the above. all my pts are ASA 3 and 4s so I guess the artist thing is everyday. samaritan... i do work for a charity hospital named this in fact (and I do OB - instant gratification), servant? yeah, i guess... surgeons ;-) coordinator? yeah, theres usually some drama with someone at work or a policy that needs revision or a process that needs updating.

 

[Noyac]

^^^ I thought some would identify with all the types.
I identify with the first two, mostly. I don't mind satisfying the needs of others but that isn't my main priority. And I hate trying to make the system better. Too many variables. I just focus on my needs, sort of like an only child. But unfortunately, I am the director of our group so I must work on making the system better for all.

 

[narcusprince]

If I had to boil it down to one I would say a servant. I enjoy seeing others happy. Next probably the coordinator currently I sit on 4 hospital committees and enjoy making the hospital run smoothly. My servant nature has hurt me too. At my previous gig my goal was to make everyone else happy even at my own expense. Took extra weekend call, always stayed late, closed my mouth when I should have spoke up. I have learned that being an attending is a growth process and I am still learning.

 

[BLADEMDA]

• "The professional artists," who get satisfaction by solving the complex physiological problems of their patients
• "The Samaritans," who gain satisfaction by relieving suffering
• "The servants," who enjoy playing a supporting role in satisfying the needs of others
• "The coordinators," who gain satisfaction by making the whole system work better

I just want to get through the day without any mishaps or complications. The longer I'm at the game the less I care about how or by whom it gets done as long as the result is good for the patient.

 

[Planktonmd]

I just want to get through the day without any mishaps or complications. The longer I'm at the game the less I care about how or by whom it gets done as long as the result is good for the patient.

Same here

 

[narcusprince]

What makes me the happiest is to see my patients at the gym, or at the island grocery store, or around the island, and they usually say Dr I am so happy to see you I was scared/nervous on my surgery day and you made me feel at ease. Acknowledgement to me is worth more then the money I make on the cases. It feels good to be appreciated and valued.

 

[cleansocks]

Professional proceduralist (rather than artist) and "summaritan" but in a different way. I derive most satisfaction from a post op block that works really well but not because the patient is relieved. More so because I know I did it really skillfully.

 

[OB1🤙]

I'm the first. I like working with surgeons who are the same. Which is why my favorite case in anesthesia is a minimally invasive mitral valve repair.

 

[nimbus]

I'm the first. I like working with surgeons who are the same. Which is why my favorite case in anesthesia is a minimally invasive mitral valve repair.

Agreed. Anyone can be an uninspired stool sitter. Or you can put your heart into it continuously refining your craft.

One of my favorite movies is "Jiro Dreams of Sushi", about a man who has been refining sushi of all things for 60 years! He doesn't get bored of it because he decided to love his work.

It shows if you love your work, it opens doors and creates opportunities.

 

[Direct Laryngoscopy]

I'm the first. I like working with surgeons who are the same. Which is why my favorite case in anesthesia is a minimally invasive mitral valve repair.

That is the on case i dreaded during my fellowship. I really disliked placing that SVC cannula and "securing" it Always was worried that it would come out and the pt would bleed out. But the mini mitral is a nice case.

Being my 1st year out, I would say I'm a combination of the 1st and 3rd. I like challenge of working on complex pts during the peri-operative period, while being an important (but quiet) cog on the team (analogous to the offensive linemen comparison @jetproppilot has made in the past). I'm quite sure that as I move along my career, I will stay the "professional artist," I don't know if I will continue to fit in the servant box. Time will tell.

 

[pie944]

Agreed. Anyone can be an uninspired stool sitter. Or you can put your heart into it continuously refining your craft.

One of my favorite movies is "Jiro Dreams of Sushi", about a man who has been refining sushi of all things for 60 years! He doesn't get bored of it because he decided to love his work.

It shows if you love your work, it opens doors and creates opportunities.

I love that documentary. Very applicable to medicine and life in general. One of my favorite quotes is at the market from the individual selling octopus.

"Even at my age, I'm discovering new techniques. But just when you think you know it all, you realize that you're just fooling yourself....and then you get depressed "

The guy laughs, followed by a straight face, followed by this look of melancholy.

 

[OB1🤙]

That is the on case i dreaded during my fellowship. I really disliked placing that SVC cannula and "securing" it Always was worried that it would come out and the pt would bleed out. But the mini mitral is a nice case.

Being my 1st year out, I would say I'm a combination of the 1st and 3rd. I like challenge of working on complex pts during the peri-operative period, while being an important (but quiet) cog on the team (analogous to the offensive linemen comparison @jetproppilot has made in the past). I'm quite sure that as I move along my career, I will stay the "professional artist," I don't know if I will continue to fit in the servant box. Time will tell.

Ah, you're placing a venous cannula from the SVC. I did that in residency for robots and also hated it. The ones we do here are via mini thoracotomy, with regular groin cannulation. But I have to put the coronary sinus catheter in from the neck, which is a Varsity procedure between the TEE and fluoro guidance necessary for appropriate catheter position.

The case also requires one lung ventilation, including coming off pump on one lung. There's also the usual mitral valve TEE assessment, which is one of those things in which we really, truly influence the conduct of the surgery.

Love these cases.

 

[OB1🤙]

I love that documentary. Very applicable to medicine and life in general. One of my favorite quotes is at the market from the individual selling octopus.

"Even at my age, I'm discovering new techniques. But just when you think you know it all, you realize that you're just fooling yourself....and then you get depressed "

The guy laughs, followed by a straight face, followed by this look of melancholy.

Great movie. I had the pleasure of eating at Sushi Mizutani in Tokyo, Mizutani is one of Jiro's former apprentices and features prominently in the movie. Incredible artistry. Dammit, now I'm hungry.

 

[bullard]

Interesting. Our mini-mitrals are also with groin cannulation. But the surgeons put the coronary sinus catheter in through their thoracotomy (with our echo guidance). One surgeon does not ask for one-lung ventilation -- he just asks us to hold ventilation as necessary and we just go on bypass if he needs more time for exposure. He says there's studies showing that OLV on these cases worsens outcomes. He gets great results. Didn't know you could do these without OLV until I met him. Another surgeon insists on a double lumen tube and bitches about the quality of the lung isolation. But we always comes off pump on two lungs (as I was taught in fellowship). Bitchy surgeon is quick enough that he could do it without one-lung ventilation like the first guy. Also gets great results.

Ah, you're placing a venous cannula from the SVC. I did that in residency for robots and also hated it. The ones we do here are via mini thoracotomy, with regular groin cannulation. But I have to put the coronary sinus catheter in from the neck, which is a Varsity procedure between the TEE and fluoro guidance necessary for appropriate catheter position.

The case also requires one lung ventilation, including coming off pump on one lung. There's also the usual mitral valve TEE assessment, which is one of those things in which we really, truly influence the conduct of the surgery.

Love these cases.

 

[sevoflurane]

There's also the usual mitral valve TEE assessment, which is one of those things in which we really, truly influence the conduct of the surgery.

Love these cases.

As opposed to my last gig where most received mitral and aortic valve replacements, I now work with a valve specialist who always elects for repairs. TEE in that room is always important in pointing out the particular segment of leaflet involvement and to classify what type of jet is seen (I,II,III a or b) and suggest what repairs may be needed.

Showing an en face view to the surgeon after acquiring 3d images is standard in that room.

No mini thoracotomies for valves... yet. I do wonder what the quality of a repair is with a mini thoracotomy approach. All I've done up to this point is robotic lungs and haven't really looked at the minimally invasive valve replacement literature in some time.

Cool stuff.

 

[sevoflurane]

To Noy's original question...

I think I'm a little of all the above... I'm def. a foot soldier that likes to work hard, do complex cases, administer the "art" of anesthesia all the while being a happy and positive figure within the walls of the big shop. I derive pleasure from helping patients and making things efficient for our surgical colleagues. Being positive day in and day out is important. After all, we are married to the people we work with.

Equally important to me is balancing my work with the many outside interests that I have.