Nicholas Bullen

Apprenticeship
11 May 2009
Day One
Medicine is a large field, and one with many specialties. The one I chose is one of
the most basic, yet simultaneously one of the most specialized. Anesthesiologists man
most major surgeries, and yet they are not easily trained; MDAs require 13 years of
training post High School. They are, however, essential, for without them the patient
remembers, feels, and resists all that is being done to them, to the detriment of the doctors
and the patient.
Indeed without an anesthesiologist modern surgery could not operate, for
laparoscopic surgery requires that the muscles of the patient be relaxed so that it may
operate without breaking the skin. Anesthesiologists relax the muscles by paralyzing
them, by way of specific drugs (some anti-polar and non anti-polar). Thus, the surgeon
can access the vital organs, and operate on them, as I saw with the hernia patient today.
The anesthesiologist is also responsible for monitoring the patients overall
welfare, such as their blood pressure, pulse, and air content. When these are not at healthy
levels, anesthesiologists inject dilators or astringents depending on the circumstances.
The anesthesiologist will also change the air content to put the patient at ease, with
oxygen levels averaging 90% today.
The anesthesiologist orients body, that is whether body is on its back, stomach,
vertical, or inverted. This affects the position of the organs, and each position allows

certain procedures to be more easily completed. For example, during the hernia operation
today, Dr. Skrabat moved the patient up 10 degrees, thus allowing the general surgeon to
more easily access the hernia.
All of this is, however, after one of the most important aspects of an
anesthesiologists career; pre-surgery examination. Here, the doctor checks the
orientation of the larynx (to determine the ease of inserting breathing apparatus), assesses
bodily nutrient levels, and judges overall health to determine whether or not the patient is
capable of actually undergoing surgery.
In fact, if a patient has even had a cold recently can affect the anesthesiologists
job, for then the trachea is inflamed, making inserting the respirating tube more difficult.
All of these actions culminate in a healthy patient; but I also learned what doctors did in
the past, using ether, a more slowly acting drug.
Ether was the anesthetic of choice before the development of advanced
monitoring machines and newer drugs. The chief benefit of ether, as Bill the CRNA
explained to me, was that it allowed the doctor to observe the various signs of anesthesia,
the dilating of the pupils, contraction, etc.. This way of operating was much less
dependent on machinery; and besides, since all modern drugs are equated to ether, it is
good to know the actual effects of the substance. But, as Bill said, the last class using the
ether was phased out 15 years ago, so most graduating students are fully dependent on
our modern toys.
To conclude, today I learned quite a bit about the field of anesthesiology. I
rudimentarily learned the history, the preliminary actions, the respiratory regulation, and

the method by which anesthesiologists actually sedate patients. It is a growing field,

and ,as it turns out, one that I would remain interested in pursuing.