This is my second week of neuroanesthesia. So far, this has proven to be my favorite rotation of the year. The cases are long and interesting, and I usually get to start an arterial line at the beginning of the case. (I’ve had a good streak; right now I’m 8 out of 9 on arterial lines, and a few of them have been on awake patients.) I even got to do another fiberoptic intubation last week.
Maybe the biggest factor, however, is the surgeons. Residents and attendings have made the effort to know my name (imagine that, like I’m part of the team!). It’s a very pleasant work environment, and the neurosugeons at this institution seem extremely skilled at what they do.
Of note, yesterday I did my first “awake craniotomy.” Imagine, if you will, the skin on someone’s head sliced open and pulled back, a section of skull removed, dura cut away, and brain exposed for the surgeons to muck around in. And then imagine that the patient–whose head is pinned in place–is awake and talking to you! Pretty crazy! I gave enough sedation at the beginning, and the surgeons used plenty of local anesthesia, but its still weird that the part of the body where pain is “felt” and interpreted doesn’t really feel pain of its own.