‘Doctors listen to soothing music during surgery’

Gaurav, a Consultant Anaesthetist in the Department of Minimal Access and Metabolic and Bariatric surgery, Max Hospital, completed his MBBS and MD from University College of Medical Sciences, Delhi University. In a candid chat, he talked about the role of schools in shaping his career, busted myths about anaesthesia, spilled beans on what surgeons talk about while operating on a patient, and more. Edited excerpts:

What are the key learnings from your school days?

Everything that I am right now is because of Apeejay Saket. The teachers used to constantly guide uncertain students to future goals and helped them reach their full potential. Importantly, they always encouraged us to try new things and experiment with fresh ideas. I am still in touch with my teachers through Facebook and chat with them from time to time.

What’s your message to the students?

Apart from studies, work on your team playing skills. In fact, teamwork is one of the most sought-after skills for almost every profession. It allows you to unearth creative ideas and share different perspectives and experiences. Your desire to learn and your willingness to explore new approaches will make you a better contributor, manager, or leader. To be a great team player, one must participate in extra-curricular activities. Sports and team activities give opportunities for participants to come up with a game plan and strategies to win.

Talking about your work, can you dispel the most common myth associated with anaesthesia?

Anaesthesia is a medical treatment that prevents patients from feeling pain during procedures like surgery, certain screening and diagnostic tests. Many believe that anaesthesiologists leave the operating room after the surgery begins.Nothing could be farther from the truth.Anaesthetists remain in the room till the surgery is over and the patient is conscious. In general anaesthesia, intravenous sedation is administered by sticking a needle into a vein, usually in the arm. As a result, the patient loses consciousness in just 30 seconds. Then we administer anaesthesia in gaseous form via a mask or tube.  During a surgery, an anaesthesiologist will check critical body functions such as breathing, temperature, heart rate, blood pressure, blood oxygen level, fluid levels, etc. Monitoring is the core job of an anaesthesiologist. From the operation there the patient is shifted to Post-Anesthesia Care Unit and if all the parameters are good only then the patient is shifted to the ward. During all these stages, an anaesthesiologist will ensure that a patient is making a smooth and comfortable transition from an anaesthetised state to an awakened state. In the same manner, while administering Local anaesthesia (medicine is injected to numb a small area) and Regional anaesthesia (in which the patient is awake, and parts of the body are asleep) we have to constantly be on our toes.

A common fear that patients have is that spinal/epidural anaesthesia causes back pain. How true is that?

Spinal anaesthesia has been commonly linked to low back aches especially in patients who have had a caesarean section. Back pain after spinal or epidural anaesthesia is mild in intensity and decreases with time. Less than 1 per cent of women complained of prolonged back pain following spinal anaesthesia and even this could be fixed by minimal physiotherapy and exercises. Regional anaesthetics are extremely safe for babies born by Caesarean section. Not many know that any form of Intravenous sedation can negatively affect the foetus. Hence, general anaesthesia is not recommended.

Is it possible for the anaesthesia to wear off before surgery is over?

It’s not possible especially with the high-tech equipment involved and continuous monitoring of the patient. I have not encountered any such case in my career.

Is informed consent an ethical obligation or legal compulsion?

Informed consent is when a healthcare provider explains a medical treatment to a patient before the patient agrees to it. This process of understanding the risks and benefits of treatment is known as informed consent. Informed consent is based on the moral and legal premise of patient autonomy.  You as the patient have complete freedom to make an informed decision about your health.    

What do surgeons talk about during surgery? Do you crack jokes?

For the most part of the surgery everyone concentrates on their task and the discipline is maintained. After all, lives are at stake. However, we do listen to soothing music during the surgery and occasionally exchange banter. The important thing is to create a healthy environment where everyone gives their best.