Last week I walked past him sitting outside of the OR. It was morning, before all of the first start cases, but he had been there all night. I already knew this. Two back-to-back transplants overnight. He, a surgical fellow, me, a critical care anesthesiologist who was a surgical resident over a decade ago. I could see the circles under his eyes that seemed to take up over half of his face. The weariness in his gaze. I jokingly looked at him and asked if he was questioning his life choices. He chuckled and said yeah, should have done anesthesia. We both laughed. I made that change. He didn’t.
Now both of us are here with our own biases, our own experiences, and our pain. Me begging to be respected and honored for my work; him being respected and honored for the work he does but holding the world on his shoulders. The classic surgeon/anesthesiologist relationship. One I study both intentionally and inherently as a former surgeon “who fell from grace” according to my surgical mentor. I write, think, and study how we circle each other, waiting for the first to strike; how we hold each other at arms’ length refusing to allow the other to see our weaknesses. We are always ready to blame. Always ready to talk about the other. Joking or not, it’s so pervasive it’s the reality.
But we both must have demands of excellence and professionalism on the other side of the curtain. So often, as anesthesiologists, we feel like we are not afforded respect, the ability to have an opinion, or even to be a valued member of the operative team. One of the leading causes of burnout for anesthesiologists is a lack of control. We don’t control much of anything, and when we do try to step in and ask questions or even push back on things, we are seen as a problem or merely a hurdle between a surgeon and their case. So we get defensive, snarky, and honestly detached and unengaged. We become apathetic and dejected. And we stop caring because when we care, we are at risk of pain, and day after day, that pain leads to quitting.