VA

I had a couple weeks of general OR anesthesia at the VA. Coming back year after year is a really interesting experience. Since I started my residency at the VA, it has a special nostalgia. I remember coming in so early each morning to set things up, poring over patient charts, calculating doses before each anesthetic. But now as a senior resident at the VA, it's such a different experience. It's fun to have a wide case diversity; in a week, I will do orthopedic, ophthalmic, plastic, ENT, urology, and general surgery cases. It used to scare me as a new resident as I was learning a new thing each day, but now I take it in stride. I used to work to keep up with the pace, but after seeing other environments, I realize the VA is quite laid-back and I often have lots of free time between cases. The faculty are outstanding and I can see the change from close supervision to distant observation. The anesthesia techs, surgeons, and staff there are a true pleasure to work with. As I wrote yesterday, I love the patients, though medically, they can be complicated. Our veterans smoke, drink, have tried drugs, have hypertension, hyperlipidemia, diabetes, coronary disease, suffer from dementia, peripheral vascular disease, COPD, struggle with reflux, BPH, and cancer. Few patients are truly healthy, a challenge to providing safe anesthesia. But vets are hardy folk, and every day the medical challenges are manageable and even fun. Although some aspects of the VA OR drive me crazy, I also enjoy it as a relaxed environment with all the bread-and-butter cases in sick patients.