Anesthesia is an art based on science
The practice of anesthesia is very much a mixture of science and art, which has evolved well beyond rendering patients insensible to pain during surgery or obstetric delivery.
You might want to know some historical facts about Anesthesia:-
- Oliver Wendell Holmes in 1846 was the first to propose use of the term anesthesia to denote the state that incorporates amnesia, analgesia, and narcosis to make painless surgery possible.
- Ether was used for frivolous purposes (“ether frolics”) and was not used as an anesthetic agent in humans until 1842, when Crawford W. Long and William E. Clark independently used it on patients. On October 16, 1846, William T.G. Morton conducted the first publicized demonstration of general anesthesia for surgical operation using ether.
- The original application of modern local anesthesia is credited to Carl Koller, at the time a house officer in ophthalmology, who demonstrated topical anesthesia of the eye with cocaine in 1884.
- Curare greatly facilitated tracheal intubation and muscle relaxation during surgery. For the first time, operations could be performed on patients without the requirement that relatively deep levels of inhaled general anesthetic be used to produce muscle relaxation.
- John Snow, often considered the father of the anesthesia specialty, was the first to scientifically investigate ether and the physiology of general anesthesia.
- The Greek philosopher Dioscorides first used the term anesthesia in the first century AD to describe the narcotic-like effects of the plant mandragora. The term subsequently was defined in Bailey’s An Universal Etymological English Dictionary (1721) as “a defect of sensation” and again in the Encyclopedia Britannica (1771) as “privation of the senses.”
- Oliver Wendell Holmes in 1846 was the first to propose use of the term to denote the state that incorporates amnesia, analgesia, and narcosis to make painless surgery possible. In the United States, use of the term anesthesiology to denote the practice or study of anesthesia was first proposed in the second decade of the twentieth century to emphasize the growing scientific basis of the specialty.
As said by Dr. William Osler of Johns Hopkins Medical Center, father of modern medicine, “Medicine is a science of uncertainty and an art of probability,” and “The practice of medicine is an art, based on science.”
Art is a skill or special ability e.g. a skill at doing a specified thing, typically one acquired through practice, from the Oxford English Dictionary; or art is a skill acquired by experience, study, or observation e.g. the art of making friends, from the Merriam-Webster dictionary.
Processes during anesthetic care
Pre-anesthesia assessment is an important aspect of patient care. If a patient shows lack of interest during pre-anesthesia check-up or tries to rush through, it may result in incomplete history and general physical examination, compromising patient care.
The task of anesthetic care starts from pre-anesthetic checkup. It is the process of collecting detailed information of the patient. Obtaining thorough information is a skillful job. Pre-anesthetic assessment is an important aspect of patient care. If a patient shows lack of interest and cooperation during pre-anesthetic check-up or tries to rush through, it may result in incomplete history and general physical examination, compromising patient care. To overcome this, an anesthesiologist must be skilled enough to motivate the patient for their full cooperation. Especially in the pediatric cases the anesthesiologist must be able to play the role of an artist who can make the children free from fear of separation from their parents/guardians.
As mentioned above, we have to take care of all the systems of unconscious patient. In spite of modern sophisticated monitoring equipments, taking care of anesthetized patient requires high level of skill and knowledge.
Recovery from anesthesia is another vital stage of anesthetic care. There is no hard and fast rule or law in the recovery from anesthesia. Each individual physiologically respond differently. For this the anesthesiologist must be skilled enough to identify and treat accordingly.
The practice of Anesthesia requires coordination with other specialties, including surgery and its subspecialties, internal medicine, pediatrics, and obstetrics as well as clinical pharmacology, applied physiology, and biomedical technology. Recent advances in biomedical technology, neuroscience, and pharmacology continue to make anesthesia an intellectually stimulating and rapidly evolving specialty.
Like many large textbooks, Cecil's Textbook of Medicine begins with a discourse on medicine as an art. Its focus is the patient—defined as a fellow human seeking help because of a problem relating to his or her health.
My conclusion, in medical practice, the service provider as well the service seeker are both human being. So understanding each other, relying on each other to solve the existing problem is initiated with an art of natural phenomena.
But the difference is, a dancer can do mistake while performing dance but in medicine even a minor mistake can cause harm to the patient. Therefore, the medical practitioner must be a perfect artist.
Dr. Govind Joshi Gautam
Anesthesiologist
Dr. Govinda Joshi Gautam
MD (Anesthesiology/Reanimatology)
Consultant Anesthesiologist
NMC # 3055
Life member of Society of Anesthesiologist Nepal (SAN)
Life member of Nepalese society of critical care medicine (NSCC)
Life member of Ultrasound Guided Regional Anesthesia of Nepal (URAN)
