Pressure

I did the anesthesia for a robotic laparascopic prostatectomy, wherein the surgeon inserts a camera and various instruments into the patients abdomen through individual small incisions, and then manipulates the robotic instruments from a remote console that looks like an arcade video game. This method has many advantages, all of which are beyond the scope of my current post. Suffice it to say that it takes great expertise to perform such a procedure, and the surgeons are very skilled at doing so. It also takes special care by the anesthesiologist to understand the "robot" and it's implications on the patient's physiology, both the advantages and disadvantages.

We were listening to the 80s station when the surgeon was dissecting out the prostate. Billy Joel's, "Pressure," was playing.

You have to learn to pace yourself

Pressure

You're just like everybody else

Pressure

You've only had to run so far

So good

But you will come to a place

Where the only thing you feel

Are loaded guns in your face

And you'll have to deal with

Pressure

I am not sure when the song started playing, but when the bleeding became difficult to control -spurting like a geyser, if you will- the volume of the song seemed to get louder.

Two men out and three men on

Nowhere to look but inside

Where we all respond to

Pressure

Pressure

The surgeons worked furiously to stop the bleeding, but each time they thought they had it under control, another gush spurted. Meanwhile, I was keeping one eye on the monitor, one eye on the surgical field, opening my fluids wide open through two existing peripheral IVs, and calling for the blood bank to send two units of typed and crossed blood. There was about 7oo ccs in the suction canister. Patient's blood pressure was starting to fall, his heart rate starting to climb. So was my heart rate.

All grown up and no place to go

Psych 1, Psych 2

What do you know?

All your life is channel 13

Sesame Street

What does it mean?

The surgeons got the bleeding under control. The patient's vital signs remained within normal limits, and he was receiving replacement fluids adequately. We all breathed a sigh of relief.

I'm sure you'll have some cosmic rationale

But here you are with your faith

And your Peter Pan advice

You have no scars on your face

And you cannot handle

Pressure

I, like many other physicians, develop our skills the best we can. We formulate plans to prevent pathology (advising patients to eat right, exercise, don't smoke, get checkups), treat diseases (medications, surgery, therapy), and deal with disasters (emergency care, resuscitation). As hard as we work on these, things happen, patients make choices, and we are faced with life threatening situations every day that challenge our knowledge and skills. So although I take responsibility for my part in a patient's care, by devloping my skills, building up my knowledge base, taking care of myself and being vigilant, I always look to my higher power, and pray that my patients remain/become healthy and safe under my care.

Pressure

Pressure

One, two, three, four

Pressure