The Real Poop
Zzzz. This career unit brought to you by NyQuil.
Look, we get it. You decided to become a doctor. You really do truly love people in, like, a humanity-type way. You know you have the smarts and the work ethic to really make a difference, and medicine seems like a worthwhile career.
But maybe it's just that the individual people are, well, hard to deal with. Or maybe you've always known your bedside manner leaves much to be desired. If that sounds like you, you're in luck: you (and your bank account) can shine in anesthesiology.
As an anesthesiologist, your goal is to help your patients skip out on feeling pain. Usually, this means putting them to sleep or knocking them out with chemicals. Since your patients will be insensate (you hope) most of the time, you won't have to spend much time at all polishing your conversational skills. That's great for you—all the more time to count your overflowing heaps of money. That's right; anesthesiologists enjoy an annual salary average of $300,000 (source).
As you might guess from the salary, the job of an anesthesiologist is slightly more complicated than just knocking people out. For starters, the exact method and dosage required to render a patient unconscious changes from one to the next. Anesthesiologists, like primary care doctors, work with patients of all sizes and shapes, and at every stage of life.
In order to understand how patients will react to painkilling drugs, they must have a working knowledge of medical specialties such as cardiology and pediatrics. And, introverts though they may be, they have to be able to talk to the patients and the other members of the medical team about what it is they're doing.
This pain-obliterating specialty has been around for as long as mankind has been hurting. Long before the wonder drugs of today that seem to work in nanoseconds, there was hypnotism, booze, opium, or, in a pinch, just doing the surgery—like really, really fast.
Legend has it early humans bopped each other on the heads with clubs in order to knock people out, so they wouldn't feel the pain of, say, a tooth extraction. (Okay, by "legend," we mean "what we learned from The Flintstones.")
Fortunately for all of us (but especially for those in need of surgery), medicine has improved a bit since then. Ethrane, Halothane, Forane, Penthrane, Pentothal, Brevital Sodium, Surital, Valium, Sublimaze, Inapsine, Inovar...
No, those aren't characters from Lord of the Rings, they're modern drugs—all of which double as poisons and become potentially lethal if taken in excessive dosages.
Yes, anesthesiologists have a big toolbox of stuff to deep-six your pain. There are three standard kinds of anesthesia: general, regional, and monitored. Typically used for major operations, general anesthesia puts the patient to sleep for the entire operation. Regional anesthesia blocks sensation on part of the body while the patient is awake (think epidural and childbirth).
Finally, there's the monitored kind, or MAC, which is local and induces moderate or deep sedation. MAC is good for things like cataract operations, where you can see the approach of the surgical instrument, but you and your body don't give a hoot. That said, when the drugs wear off, the pain is still there. Ouch.
Remember, these drugs don't really banish the pain. They eliminate a patient's ability to feel the pain that's still there throbbing away. Local anesthetics work by blocking nerve impulses to pain centers in the nervous system. No nerves, no pain.
General anesthesia is a bit trickier, and its exact mechanism is still mysterious, even though these drugs have been kicking around for more than 150 years. Basically, nerve transmission is reduced, which reduces the patient's awareness of and sensitivity to pain.
If this all sounds like your kind of party, you'd better brace yourself for the required preparations. You'll be spending the bulk of your young life in school. Undergrad is a must, of course, followed by medical school. After that, it's at least four more years of advanced training, in which you'll learn how to administer, manage, and/or manipulate an arsenal of pain-killing drugs—be they gases, intravenous agents, or injectables.
And that's not all. If you go into a sub-specialty you can expect to add another year to your education, during which you'll be steeped in critical care medicine (alleviating pain for the injured and sick), hospice and palliative care (for terminal illnesses), or pain medicine (think bad backs and cancer pain).
So what type of person goes into anesthesiology? Ideally, people who love science and discovering how the body works. People who truly, madly, deeply care about other people and their pain, and dream of ways to help them. Getting a kick out of playing around with chemicals doesn't hurt, either.