Monday, October 20, 2008

Pilot of the Soul

I've been working in my new job now for a couple of weeks. It's been exhausting. The commute has only a minor part in this. The toughest part is being the "new kid" in the neighborhood: Becoming acquainted with the staff and the various functionaries is the most challenging part. Learning the local customs, less so. Basically anesthesia is anesthesia. The difference in technique and approach is really one of nuances. What doesn't change is one's attitude and professionalism.

This recent article in the online version of the Jerusalem Post describes the current shortage of anesthesiologists in Israel. But the article also reviews a fascinating book by my former boss and mentor Prof. Gabriel Gurman. The book is unique in that it is bilingual. That is, it was written in Hebrew, translated to English and both versions appear in the same volume. The book is called "Visionaries and Dreamers - The story of the founding fathers of Anesthesiology in Israel". Far from being a dreary history lesson, it is a portrait of the pioneers of the field in this country, who almost always worked in the most difficult of conditions.

Today's Israeli anesthesiologists have a great legacy to follow. Although it is a rather young specialty in medicine, it is also the oldest:

ויפל יהוה אלהים תרדמה על האדם ויישן ויקח אחת מצלעותיו ויסגור בשר תחתננה

"And the Lord God caused a deep sleep to fall upon Adam and he slept; and He took one of his ribs, and closed up the flesh instead thereof (Genesis 2:21)."

One of my colleagues describes anesthesia in the following way: It's a situation where one (the anesthesiologist) is standing with the patient at the edge of an abyss, then pushes the patient over, and then, at the last moment grabs the patient's hand and pulls him back. Although there is some truth to this dramatic notion, I prefer the interpretation of A.B. Yehoshua a prominent Israeli writer in his book "Open Heart". The following is a short review of the book by Lior Granot, Prof. Gurman's co-author in a personal note. She quotes:

"...The most important part of anesthesiology is not abandoning the patient. Think of the patient's soul, not just of his breathing. During surgery, while the surgeon is completely focused on one small part of the patient, the anesthesiologist is the only one thinking of the patient as a whole, not just parts put together. The anesthesiologist is the real internal doctor..."

Granot continues:

This is a quote of what Dr. Nakash, the anesthesiologist in Yehoshua's Open Heart says to Benji, the young resident... Dr. Nakash, a calm man with inner peace, calls the anesthesiologist "the pilot of the soul". He compares anesthetization to a plane taking off and the safe awakening of the patient to landing. "Think of yourself as the pilot of the soul, who has to insure that it glides painlessly through the void of sleep without being jolted or shocked, without falling. But also make sure it doesn't soar too high and slip inadvertently into the next world."

I rather like this spiritual approach. It provides a deeper meaning to what the anesthesiologist does, and reminds us that the crux of the profession is it's humanity.


Jeffrey said...

very true. without the anaesthesist's go ahead, the surgeon can't proceed.

nice insight on the oldest profession. never saw it that way.

A Soldier's Mother said...

My only personal experience with an anesthesiologist was a bad one - and I actually was abandoned. Basically, I donated bone marrow and after administering the dosage, he left the room. It didn't take effect as required and they had no option except to continue with the operation because they had to get the marrow on a plane leaving for NY and had no time to wait. The doctor was FURIOUS. I never did anything about it - figured it would only hurt the chances of others donating. They don't take bone marrow in the same way anymore, so I don't mind telling people now - but it was a terrible thing for the anesthesiologist to have done. I like the description of both pushing you off the cliff and saving you. I guess it's a question of dedication because in many ways it truly is one of the most essential elements of the operation.

rutimizrachi said...

Thank you, again, for providing insights into your profession that a lay reader can comprehend. Also, thank you for keeping your spiritual self at the forefront in your work. May Hashem cause you to be successful. May He help other anesthesiologists to get in touch with their spiritual selves, so that they will "invite G-d to the event."

rickismom said...

interesting. I don't like the pushing out into the abyss description... sounds too scarey....maybe because that sounds harder than landing a plane....(Which, for a private plane, is not that hard...)

Baila said...

I saw the article in the J-m Post and immediately thought of you.

I've had two surgical experiences that included general anesthesia. Both times the anesthesiologists were superb and reassuring. I think it is fairly common when "going under" to worry that perhaps you won't come back.

It was the best sleep I ever had. :)

T. said...

I have often thought of anesthesiology as a spiritual practice but had forgotten that passage in the book of Genesis! Thank you for that, and for this beautiful post.

Dragonfly said...

Awesome post.

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