The universal anesthesia experience...

Now that I have talked about delving into the whole process of general anesthesia, I want to begin by talking about an anesthetic experience most mothers in America have experienced, one where they are very much awake. That, of course, is the epidural, which for most young healthy women is (hopefully, for their sake) their sole exposure to the field of anesthesia. Being that the procedure is performed at such an intense point in a woman's life, both physically and emotionally, you can ask pretty much any woman who has had one about it, and they can probably tell you in exquisite detail about how it went.
"It worked great."
"It only worked on one side."
"The anesthesiologist got it in two minutes."
"It was 3:30 in the morning, my water had just broken, and I was 5 centimeters dilated. I was dying. It took the anesthesiologist a half hour to get it, and he had to try twice." Like in any emotionally charged moment, the details stick out clearly even years later.

Whatever the case, most of the women who got one end saying something along the lines of "it was awesome".

Surprisingly, to me anyway, not a lot of male anesthesioogists I have worked with in the past like OB anesthesia. I'm not sure why, because I enjoy it a lot. My wife and I have a son who was born at the end of my residency under some crazy circumstances, but that's a whole other story. I mention it because I remember how excited and, well, alive I felt around the time our son was born. It ranks as one of the most memorable days of my life, and for most people I see in the OB ward, it is that kind of day for them too. It's a really cool thing, in my opinion, to be a part of that.

Another reason I like OB anesthesia so much is that I'm impatient. Let me explain. When I walk into the room of a woman in labor, she's absolutely miserable, writhing in agony, cursing, screaming, grimacing, or all of those. If everything goes well, twenty minutes later, when I walk out of the the room, she's happy, smiling, comfortable, and really, really, really grateful. What's better than that? In my world of anesthesia, not much. It's immediate gratification in its purest form, and I have done something good for someone as well.

But just in case I start feeling a bit too good about myself and my epidural abilities, I remember this: my role in the whole childbirth process is not medically necessary. Of course, any woman who can remember how awful labor was might disagree, but the fact of the matter is that women delivered babies for thousands of years before epidural anesthesia. At Northwestern, where I trained, 90% of the women, conservatively, got epidurals. A lot of things are factored into that, such as the wishes of the obstetrician, and the patient population. We had a lot of well-to-do patients who pretty much expected the epidural to be a standard part of the birth experience. That was its own set of issues, good and bad, and that's a story for another time.

In future blogs I'm going to get into a little bit of the technical stuff about epidurals, (without trying to get too boring), and then I'll just give a list of useful advice for moms-to-be who are considering getting an epidural.