1800

This is the 1800th post! Perhaps I've done close to that number of anesthetics, which is a little mindboggling. Reflecting on this reminds of the real privilege of being a physician and an anesthesiologist. Even though things feel a little more routine and straightforward in my third year of anesthesia, I've also developed a real respect for what we do. General anesthesia has become so safe in the last few decades that it is easy to underestimate what it involves. Although we often use the metaphor of "sleep," it's really not a state of sleep. When we induce anesthesia, we render someone unconscious, devoid of their normal physiologic protective reflexes. In doing so, we take responsibility for their body, confident that we can weather them through a surgeon taking a scalpel and traumatizing the patient. With each anesthetic, there is the risk that we cause irreparable, irreversible harm. And each time I induce that state - a state dramatically affecting the patient's neurologic, cardiovascular, and pulmonary systems, I know that I am risking a patient's health with the confidence that my knowledge, skills, and medicine will be enough.