All posts by kmjaremko

Why Anesthesia?

I went into medicine to help people in pain. I dove into neuroscience research to learn more about this complex “fifth vital sign” and I stayed in research to cultivate knowledge on how to treat it more effectively. It always made sense to me to choose a specialty that dealt with this morose part of the human condition, however I soon realized in medical school that it was prolific in nearly every specialty. A pain medicine fellowship, the only route to specializing in pain medicine that I knew, could be achieved through psychiatry, physical medicine and rehabilitation (PM & R), neurology, or most frequently anesthesiology. Early on in medical school I met and shadowed an anesthesiologist pain practitioner that would become a trusted mentor. By the numbers, a career in anesthesiology made logical sense but it wasn’t until further into my training that I regarded it as a clear path.

I was pipetting samples in my first thesis laboratory when I received the call that my mother had experienced a massive ischemic stroke. In a matter of moments, I began the drive to her bedside. This culminated in a six month leave of absence as I became the primary caretaker for my globally aphasic disabled mother. During this time, I learned to make rational decisions amidst a sea of emotionally charged chaos. Resourceful communication skills, improved teamwork, and profound resolve laid the foundation for our new relationship. These inadvertently honed competencies, on the other side of the white coat, served me well during clinical clerkships, especially anesthesiology where this skill set was demonstrated among the best anesthesiologists that mentored me.

A recurring theme emerged during my clerkships that has led me to pursue a career in anesthesiology. Whether it was during an apneic episode in a sedated patient undergoing minor surgery or an emergent craniotomy in the middle of the night, when the situation escalated the anesthesiologist assumed the role of leader. Anesthesiologists employ quickly calculated but premeditated algorithms while simultaneously communicating with clarity and composure to mobilize the team for action. This is the combination of interventional skills, leadership, and decision-making intensity that I seek. During the routine laboring epidurals and anxious pre-operative encounters, the unique trust-under-duress relationship between patient and anesthesiologist began to appeal to me. The crucial ability to put someone at ease in a time-limited situation is a requirement of quality medical care that I practice routinely with my mother and endeavor to improve upon throughout my training. In the OR every misplaced beep generates a differential diagnosis that requires a problem-solving mindset. This rapidly evolving step-wise approach to a solution is akin to my multitasking research-oriented thought process.

Planning and organization are the cornerstones of adverse event free practice but constant vigilance, quick thinking, and cool headedness were the crux of the good anesthesiologist when, despite optimal design, shit happened. Physiology-based differential diagnoses with pharmacological treatments in real-time are mixed with interventional techniques to treat and monitor patients. It was a perfect balance for me and had a “coming home” feel as the last clinical rotation of my MS3 year. The community within the ORs, professional societies, and annual conferences is extremely welcoming with a congenial personality and sharp intellect that makes me proud to become a colleague. Although the field has and will be evolving in the coming years I find the shift towards perioperative optimization both challenging and exciting. As I begin internship shortly, I am eager to join my anesthesia residency peers in a little over a year, with no regrets.

“Do you know what it means to relieve man of his pain and suffering? Anesthesia is the most humane of all of man’s accomplishments, and what a merciful accomplishment it was. For this great discovery we are indebted to Dr. W. T. G. Morton.” ~Joseph Lewis