‘Can I see one surgery?’ my engineer brother queried when he once came visiting me. He had never been inside an operation theatre. Spending time in any profession except our own is always fascinating but nothing beats the experience of an actual surgery for a layperson. I rubbed my hands in glee. I looked forward to impress him so thoroughly that he comes out with a deep sense of respect and awe towards surgeons in general and myself in particular. He should feel guilty of all the bullying he gave his future illustrious younger brother in the growing years.

Anyway, I took him to see an operation for an appendix removal on a ten-year-old child. The surgery went off well, and I was casual during the time making jokes, singing songs, and whistling tunes to impress even more. My efforts could not have been more complete as I showed him the intricacies of the operating room, the discipline we needed to follow, and the different equipment which made surgeries possible. He observed everything carefully and silently from a healthy distance.

We came out of the theatre after the surgery and he had a suitably dazed expression on his face. As we were changing our clothes, I asked him, ‘So how was the experience?’

He answered, ‘Brilliant. It was indeed the most fantastic experience of my life. We do all this heavy engineering stuff but that amounts to nothing in comparison.’ I glowed deep inside. ‘So, what did you like about the operation,’ I asked him expecting some great compliments. He looked at me and said, ‘Anaesthesia is so fantastic. The anaesthetist was so absolutely brilliant and impressive.’

‘What do you mean by that? Nothing about the surgery?’ I was now all the more depressed because in the entire operation and my theatrics, the anaesthesiologist had not spoken a single word.

My brother replied, ‘Surgery was all right. But the experience of anaesthesia was so mind numbing. The screaming child came and the doctor gave some injections putting him to sleep immediately. The child did not move one single bit during your entire surgery and just as when you were putting the last stitch, the child started moving, the tracheal tube came out, and the patient became vigorous like before all within a few minutes. It was the biggest miracle I saw. This has to be the pinnacle of all medical achievements. In fact, I was watching him only with deep fascination.’

I looked at him dumbly. An understatement if I said I was crestfallen. My entire show flopped and the silent anaesthesiologist took away all the credit. But then came the epiphanous moment. My brother was saying the absolute truth. The anaesthesiologist does the job silently making possible for any operation in the world from an abscess drainage to a heart transplant. Most patients do not even bother to know the name of the anaesthesiologist as the surgeon walks away with all the glory. The stress which the former takes is beyond the imagination of most laypersons. There are a hundred things which can go wrong in the operation theatre. However, when a patient enters the theatre, he is not placing himself or herself in the hands of the surgeon but the anaesthesiologist. No doubt it is a team effort but the credits are disproportionate. Events happen within seconds; a patient suddenly collapses, and then the anaesthesiologist is the only God.

Sometimes, the surgeons have an exaggerated sense of importance which most other medical specialists are equally guilty of. I may be wrong but my perception has been that the anaesthetists are the sweetest and the humblest of the lot. There might one odd tough one determined to give you a hard time and who deserves strangulation with bare hands. Miniscule compared to the majority of bloated surgical specialists who deserve roasting in hot oil till eternity. Surgical specialities generally classify into three categories: dumb, dumber, and dumbest earning high, higher, and the highest respectively. Orthopaedics and neurosurgeons fall prominently in the last category. On the other end of the number line are the smartest and the cleverest Paediatric surgeons who make the least money. For most of these surgical specialists, ventilatory care and intensive support means mainly a box connected to the patient and some deep magic going on. They watch in amazement as many of the critical patients who have no business to be alive come back from the doors of heaven or hell. Anaesthesiologists mainly do this job across the world. It is one of the greatest ironies of surgical practice that the person deserving an equal, if not more, credit for the success of the surgery remains unknown to most patients.

All professions are great; all medical specialties are important; each has a role to play in the cosmic scheme of things. However, if there is a single profession with the narrowest margin of safety and maximum responsibility towards its subject, it has to be anaesthesia. No other profession or specialty, to my limited knowledge, comes even close. I am a surgeon and I have been a surgical patient too; hence I am qualified to speak on behalf of all the surgeons and the patients. So, a huge thank you to the wonderful anaesthesiologists all over the world for making the world a safer place to be in. God bless the wonderful breed forever.

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