Despite the occasional depressing posts, I actually loved my two months on cardiac anesthesia. These are ostensibly some of the biggest surgeries on the highest risk patients, and the challenge is thrilling. I've never been bored in a pump case. The management engages all my technical, cognitive, and problem-solving skills as I plan each case, tailor the anesthetic to the patient and the disease, select and place my invasive monitors, and support a patient and family members through a huge surgery. And each case is different; changes in the surgery force me to adapt, anticipate, and intervene. As each case unfolds, I learn more and more about the human body, how it responds to surgery, and how we mitigate the stress with our medications.
The teaching was outstanding, and I became much more comfortable with the extremes of physiology, the most potent of drugs, and the techniques of intraoperative echocardiogram. The teamwork with the surgeons, perfusionist, and nurses was key to keeping the patients safe. The hours were long but the days flew by. As I near the end of this academic year, I begin thinking about post-residency training and a fellowship in cardiac anesthesia intrigues me.
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