Ending in the GOR

I am finishing my last two months of residency in the general OR. In some ways, it's nice to return to the start. These are the attendings and cases that taught me anesthesia, and now, I can be completely independent and hardly break a sweat. Although the cases are challenging, I feel very well prepared to take them on. A man who is 5'11" and 400 lbs undergoes a kidney surgery. The intubation, extubation, and anesthetic management are all up to me. Morbid obesity once scared me because of the significant risks for airway loss, prolonged anesthesia, and PACU complications, but with the training I've gotten, I felt confident about handling this case. A pregnant woman in her second trimester needs an urgent abdominal surgery. I plan an anesthetic taking into account the physiologic changes of pregnancy, using an EEG monitor to titrate my anesthetic since the requirement is lower and I want to minimize exposure to the fetus. Talking to the obstetrician and surgeon, we decide on a plan for fetal monitoring and what to do if obstetric issues or problems arise. Although I get a surge of adrenaline from the airway, I manage to slip a tiny 6.0 tube through the vocal cords. It's an exciting case, and it's also a regular day in the operating room.