Anaesthesiologist: The Captain of Sinking Ship

Dr Balaji Asegaonkar Aurangabad

He (Anaesthesiologist) got an urgent call from the coronary care unit to attend to one post-angioplasty patient who was deteriorating.. He rushed in… Patient was almost gasping with Blood pressure of 80 mmHg.. He immediately intubated him and started his work… Being cardiac Anaesthesiologist, he was well versed with echo.. He just put an echo probe on the patient chest and found a huge pericardial effusion. He informed the cardiologist and instructed staff to prepare patient for pericardiocentesis( putting drain into pericardium to drain fluid)… by that time cardiologist reached and inserted the drain… there was massive blood gushing out from the pericardium…

Anaesthesiologist immediately put a large bore cannula into a central vein and started autotransfusion. He took charge of the situation immediately.He was now the captain of that sinking ship.Patient was almost arrested… He started resuscitation but even during these efforts,he was giving instruction continuously…

• Open cardiac theatre….
• Give call to cardiac surgeon and perfusionist ….
• Give call to one more anaesthesiologist for help…..
• Do cross matching and tell blood bank to supply blood and blood products
• Give bicarbonate, calcium ….and so on……

Within minutes patient wheeled into cardiac OT and cardiac surgeon using all his skills opened chest…. There was blood everywhere… he immediately put patient on bypass machine…

The anaesthesiologist was busy in protecting brain by giving Pentothal and instructing the perfusionist to cool the patient…

There was right ventricular perforation which was bleeding profusely… surgeon skillfully sealed leak….bleeding stopped…. The patient came out of bypass reasonably well and shifted to cardiac surgical recovery for further management.

Still, fingers kept crossed as no one was knowing about the status of his brain function….

Anaesthesiologist waited there till patient showed signs of intact higher function… After 4 hours, the patient was again reassessed and to everyone’s surprise… he was following oral commands… patient was ventilated for twelve hours and was extubated the next day….

On 7 th day, anaesthesiologist went to the cardiology ward to see one pre operative patient in the morning. To his surprise, a huge celebration was going on there… everyone was celebrating the recovery of that patient….

That patient was personally distributing sweets and saying thanks to all doctors and nurses in the cardiology unit.
Someone noticed the presence of anaesthesiologist and introduced him to the patient “This doctor was your anaesthesiologist…” Patient smiled at him and gave some sweets…anaesthesiologist just looked at him with inner satisfaction.. Only GOD and he himself was knowing the actual role played by him which was much beyond anaesthesia…..

Highest level of karma is when beneficiary didn’t know what favour he receives and from whom ..… “One who performs action by mind, intellect and senses without attachment or ego is most close to me” said lord Krishna in BHAGWATGITA…. As an anaesthesiologist he was walking on these principles of BHAGWATGITA may be unknowingly.

By the time he started eating sweets, there was a frantic phone call from the operation theatre that he needs to attend to one emergency there… He just stopped eating and rushed to OT to play again one more role of CAPTAIN of the SINKING SHIP….