Sweet Dreams

You might assume that a profession with access to the finest controlled substances under the sun would know how to throw a party. The sort of party that would make a hustling B-grade celebrity desperate to crash the doors. Well October 16 is National Anaesthesia Day in Oz. You might think that such an occasion is so momentous anyway that woodland nymphs will emerge into the streets to dance and frolic but the Australian and New Zealand College of Anaesthesia has plans. Big plans. Check out just how exciting they are right here.

That’s right people, they have balloons and posters. Rock on. Even for a gas tragic like me, it’s a little hard to get pumped about but I get the intent. Anaesthesia is commonly experienced but poorly understood by many. And maybe there’s a few anaesthetists sick of needing to remind patients they didn’t get their qualifications from a cereal box. The advent of this branch of medicine fundamentally changed not just medicine but even the way we think about pain and consciousness.

Morton surprising pretty much everyone by getting his ether dose right on October 16, 1846 [via www.general-anesthesia.com]

Morton surprising pretty much everyone by getting his ether dose right on October 16, 1846 [via http://www.general-anesthesia.com]

Flashback Territory

If you were a patient in the early 1800s, surgery was a thing to be feared. Not because of bills. Not because of waiting lists. It was the surgery itself. These were the days before modern anaesthesia. Fanny Burney, a writer at the time gives a pretty good snapshot of what an operation of the time was like, recounting the story of her mastectomy, closing her eyes as she was surrounded by seven men in black wielding steel:

When the dreadful steel was plunged into the breast – cutting through veins – arteries – flesh – nerves – I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision – and I almost marvel that it rings not in my Ears still! so excruciating was the agony . I then felt the Knife [rack]ling against the breast bone – scraping it! …. When all was done, and they lifted me up that I might be put to bed .. I then saw my good Dr Larry, pale nearly as myself, his face streaked with blood, and his expression depicting grief, apprehension, and almost horrour.

She was so traumatised she added vowels to the retelling years later. Surgery was not something done lightly. Major teaching hospitals would do 2 or 3 operations a month. This changed from October 16 ,1846 (and explains why that date was chosen for the super awesome balloons). On that day William TG Morton, a dentist by training, administered ether to a young man named George Abbott in Boston. He provided anaesthesia sufficient that he didn’t experience discomfort while John Collins Warren removed a vascular tumour from his neck over a few minutes. With this fairly surprising success (surprising in the sense that it didn’t go wrong) Morton’s demonstration changed medicine.

In about 2 months ether had made it to the UK and was in Australia by June the next year. Anaesthesia allowed surgery to advance beyond a demonstration of rapid carving skills. It allowed proper management of blood loss, and better practices in sterility. Without anaesthesia, there’s not a lot of long surgery for removal of tumours, transplants or operations on hearts. Anaesthetists have been at the forefront of enhancing patient safety and new monitoring technology. The profession is even finally starting to take on the issue of safer anaesthesia for all, through projects like the Lifebox project to provide equipment and training to enhance patient safety wherever they’re having surgery.

More fundamentally, it changed how we view our relationship with pain. For the Victorians pain no longer represented a cleansing ritual, or something you could expect to endure with any minor procedure. So fundamentally did it alter our perception of what is acceptable, that a procedure without anaesthetic would be considered a barbaric act. Just look at the coverage of this in the context of military hospitals during the uprising in Egypt. Anaesthetists may commonly be thought of as anything but a doctor, but there’s not many signing up for surgery requesting that we pack up and head home.

So it’s probably fair enough to try and raise a bit of a profile for one of the greatest advances in modern medicine (I’m not quite putting it up there with antibiotics or vaccination, but it’s still massive). It’s probably fair enough to point out we go to Uni and train for ages to hand out the good drugs. And that we don’t all like avoiding patient contact and working on crosswords.

So take this chance to commemorate the day with a sleep in. Or by finding someone to give you controlled substances in a super safe environment (actually probably not that one). Maybe just find an anaesthetist and give them a random hug. Or just give out a random hug and dedicate it to a sleepy person somewhere. And next time you hear of someone needing an operation, say a quick thanks for the wannabe entrepreneur dentist who got lucky with the gas.

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