A surgeon is incomplete without an anaesthetist. I cannot perform surgery without one, I cannot concentrate on what I do without knowing that there is someone looking after my patient. A surgeon and anaesthetist are like husband and wife, yin and yang, each half of a twin, right and left hand……
The success between a surgeon and an anaesthetist is based on complete trust. The anaesthetists trust us not to harm our patients during an operation and we have implicit trust in them to keep our patients alive and stable while we perform the necessary tasks. As much as we love to be-little each other in jest, we are completely cognizant of the fact that we couldn’t do without each other; as I said, like an old married couple.
Often, conversations flow during a procedure, particularly long operations. This could range from clinical discussions, to personal relationships. These conversations are like those when one is lying in the dark with one’s best friend, where deep personal thoughts are said out loud, and honest responses are given. These earnest dialogues take place over the top drapes separating the anaesthetic corner from the surgical field. – so-called ‘blood-brain barrier’ – because the anaesthetists are the ‘brains’ or the smarter doctor (so they think) and we are often jokingly known as the bloody butchers. It is not uncommon to have my anaesthetist’s head peering over this drape, reassuring me when I become hesitant in an operation, comforting me when I lament on difficult patients, encouraging me when I am struggling with a particularly challenging procedure, and humouring me when I rant and rave about injustices in my personal life. But not all of our verbal exchanges are serious, often well-aimed insults are fired regularly across the patient, in an attempt to evoke witty repartees.
Last week, I lost my anaesthetist. She wasn’t just my other half, but she was my friend, my confidant, my rock, and part of my life. We started our careers in private practice together, we supported each other through some difficult times in our profession, and we shared many stories, experiences and challenges in our personal lives together.
It is difficult for me to accept that she is gone from my life. She was like a pair of comfortable old shoes, someone who knew me, someone I didn’t have to pretend with, an old friend whom I could just pick up an old conversation where we left off a week ago. Her sense of humour and directness fitted my moments of moodiness, her logic and reasoning soothed my indignant outbursts. She gave me sympathy when I needed it and empathy when I got frustrated.
She put my patients to sleep safely and efficiently, many times anticipating what I required in the anaesthetic without asking me. She never doubted my judgement or questioned my requests; she knew when to speak up and when to pipe down. She knew that in times of emergency, the last thing I needed was to have to spell out specific instructions to her, whilst trying to deal with my own stresses.
She had traits that frustrated me, and yet made me laugh at times. She had no sense of direction. Sometimes I would walk past her on my way back from the recovery unit, and see her wandering towards the change rooms. When I asked her if she was going off on a toilet break, she would say she was heading out to see the next patient in the holding bay (which was in the opposite direction). It didn’t matter that she had been working with me in that theatre complex for the last 5 years, from time to time, I still had to physically steer her towards the correct corridor, and the right direction.
She had a thing about firearms, which was amazing considering the fact that she was from South Africa and was given her first pistol at the age of 18 as a birthday present. When I took her to the local gun club to trial clay pigeon shooting, she was nervous and afraid, she pulled the trigger even before the clay pigeons were being flung! There were a few holes in the walls of the trap house where her gun was pointing at. At the time, even though we both laughed so hard at her inept attempts, I was particularly proud of the fact that she overcame her fear to give it a go.
One of the things I admired most about her was her ability to do as she pleased without worrying what others thought of her. She didn’t care about unflattering photos on Facebook. She didn’t mind dressing up as the dorkiest bride at a friend’s party celebrating Prince William and Princess Kate wedding. She tried everything and anything without judgement and reservation. She did her best for the patient even if it meant hassling or inconveniencing other colleagues. She did what was right even if it meant she had to take the long way round or spend extra money. She talked about her life and her opinions openly, without fear of being judged for what she believed in.
She was generous. And she was considerate. She bought me a pair of expensive padded theatre shoes because I was complaining of shin splints and calcaneal spurs after being on my feet 18 hours a day. She ordered coffee for everyone in the operating theatre whenever we were having a particularly long day. She would tell me to un-scrub and take a break if I was doing a long case.
She treated everyone the same. She knew all the anaesthetic nurses’ family members by name. She never failed to ask about their pets. She would treat the orderlies with respect, and she would tell me off if I had inadvertently offended her. She spent the time and energy teaching new nurses and technicians, and she would patiently explain her particular preferences even though she had been working at the same place for the last five years. She gave her best clinical skills to the thief who came into the emergency theatre after crashing a stolen vehicle, and to Nelson Mandela when he had eye surgery in 1994.
She was passionate. She loved the wild, and her homeland. She travelled to South Africa regularly to visit her family, and to spend time at her beloved chimpanzees and gorillas reserves. She was forever posting links about wildlife conservation and the cruelty of game hunting. She was constantly reminding us not to become complacent in protecting species that were less fortunate than us in protecting themselves.
Most of all, she was prepared. One could never pull the wool over her eyes. She saw reality as it was, life and death as it happened throughout her career. She saw cancer patients younger than her daughter, and accidents that changed young men’s lives forever. She and I often lament about how life is too short to bear grudges, to hold back and to be afraid. She wanted to protect those she loved, as we all found out when she passed. She had prepared an envelope for her most trusted closest friend, just for an unexpected time such as this. Her affairs were organised down to the last detail, and her will was legality iron-clad with no contestability. The fact that she took such pains to stipulate everything as the way she wanted, not the way she was expected, showed that she was a realist, with the foresight and consideration for those around her.
She was 59. One year short of the big 6-0. She didn’t look her age, because she lived her life with the enjoyment of someone who was experiencing everything for the first time. She was taken away from us too soon. Too unexpectedly. We are all still in shock, as to how it could happen to someone who was so full of life.
I am finding it difficult to grasp, that she is now gone.
When I walked into my operating theatre today, you weren’t there. Even though I went through the motions and completed my list without a hitch, I felt lost.
I felt lost because you weren’t there.
So I cry, because I know you will never be there with me again.