“Take Some Deep Breaths and Count Back From 10“
Anesthesiologist. Image Credit: Sergey Mironov / Shutterstock
Airway, Bagel, Coffee: The Motto of Anesthesiology?
Anesthesiologists are physicians who make sure patients are safe (and not moving) during surgery. The site’s title comes from a common stereotype that anesthesiologists manage the airway, get breakfast, then relax for the rest of the surgery. The real ABCs of anesthesiology are airway, breathing, and circulation. This website will take you behind the curtain into the hidden world of anesthesiology. The truth might surprise you…and don’t worry there are plenty of bagels for everyone!
I wrote a book about anesthesiology, uncertainty, and cognitive psychology called “Vigilance: An Anesthesiologist’s Notes on Thriving in Uncertainty” to be released no later than June 2021.
Anesthesiology is 95% planning for emergencies, 5% flawless execution, and 100% saving lives every day. Difficult airways can occur anywhere, anytime, and in any patient.
Anesthesiologists are the most knowledgable, experienced physicians in airway management. I’ll never forget a 5-year-old whose oxygen saturation dropped from 90% to 50% only 10 seconds after induction of anesthesia. I prevented life threatening hypoxia by placing a breathing tube in 5 seconds, a personal record.
Placing a breathing tube is only the first step. If oxygen cannot reach the lungs my patient will die! Diagnosed (and undiagnosed) problems can cause difficult ventilation.
I remember a 58 year old man who required emergency spine surgery for bilateral leg paralysis. After turning him prone (face down) we could not move air into his lungs! We diagnosed a heart failure exacerbation without any preoperative symptoms. Difficult ventilation is a race between my brain and the pulse oximeter: if I cant diagnose and treat the cause then my patient will…not do well.
Now that I can deliver oxygen to the lungs it has to hitch a ride on red blood cells to the brain! Circulation of oxygenated blood to the brain and major organs requires three things: a pump (the heart), blood, and a blood pressure. Every anesthetic drug causes problems with at least two of these three requirements. Much of my role after securing the airway is mitigating side effects of my anesthetic drugs.
We utilize inotropes, peripheral vasopressors, and IV fluids to make sure your brain receives oxygen.
In addition to a blog I have a book and am building a youtube channel
Anesthesiology BookExamination of Anesthesiology in the context of decision making under uncertainty, behavioral economics, and cognitive psychology. It will teach the reader how anesthesiologists think about life-threatening situations, solve clinical problems before they happen, and how those unique thinking patterns apply to expertise, media misinformation, and COVID-19. It will articulate a new way to think about modern problems.
I will partner with Scribe Media for their editing, graphic design, marketing, and distribution expertise. The book will be released in June 2021.
DocTalks Youtube ChannelDuring my third year of medical school on my internal medicine rotation my attending physicians would ask me to give “5 minute talks” about a relevant disease I saw that day. These “talks” were of immense educational value. I learned how to summarize important information in a simple, understandable manner. This channel is a series of 5 minute talks where doctors will connect their expertise with a problem outside of medicine. Topics will include cognitive biases, synergy, Black Swans, learning in wicked environments, and how to hedge against uncertainty.
Once my book release date is finalized I will start on this project. Right now I’m focused on publishing my book before residency is over!
The goals of my book, blog, and youtube channel are:
- Explain what anesthesiologists do every day and why they do it that way
- Demonstrate how anesthesiologists use philosophical, psychological, and statistical thinking to save lives every day inside and outside the operating room
- Advocate for the high quality anesthesia led by physicians
I’m not a Russian Bot!
Nabil Othman, MD is an anesthesiology resident at Cedars Sinai Medical Center in Los Angeles, CA. As a Michigan native he advocates calling carbonated, sugary beverages “pop”. When he is not an indentured servant in the hospital he enjoys CrossFit, telling everyone he meets about CrossFit, and attempting dangerous hikes in Hawaii with his college roommates.
This site is not a substitute for medical advice. It does not reflect the official stances of my past or future employers, my residency program, my medical school, or my undergraduate university. The ideas are mine and mine alone. Many of the stories are from my memory therefore may not be 100% verifiable without violating HIPAA.
I hope my theories and ideas are tested to determine what is true and false. Although doctors do not like to admit it we are not always correct…only 99% of the time!