Sharing a lunch table in the hospital cafeteria I fell into agreeable conversation with a member of the chaplaincy staff. After discussion of matters metaphysical he said he'd always thought that it was rather a waste, having a physician giving anesthetics. I mean, all it is is a needle, right?
I stared at him, pale and slack-jawed. He might as well have said that, since planes now have an auto-pilot feature, we don't really need the pilot.
A great many people honestly believe that an anesthetic is like Disney's "Sleeping Beauty": a masked figure approaches with a sharp needle, and you disappear into oblivion, sleeping decorously for however long it takes to perform the miracle of surgery, at which point you are awakened by the surgeon (with a kiss?) and ushered back to bed.
It was a teachable moment. I gave him the laundry list of the procedures that follow the needle, of which he has been blissfully unaware, being unconscious.
If you were undergoing let's say, bowel surgery of any magnitude this is how I'd occupy my time while you slept:
Inject a muscle relaxant to paralyze you so I can place a sealed, leakproof plastic breathing tube into your trachea; tape your eyelids closed to prevent accidental injury or dry eyes; run a thin plastic tube through one nostril down into your stomach to keep it empty; supervise placing a catheter into your bladder to measure kidney function and keep the bladder out of the surgeon's way; start you on a calculated rate and depth of machine-controlled breathing with a predetermined mix of oxygen, maybe nitrous oxide, and anesthetic vapour; check all your vital signs (monitors placed before anesthesia include cardiogram, automatic blood-pressure monitor, pulse oximeter to make sure you have a nice high level of oxygen in your blood); drape a hot-air blanket over your upper torso and run a temperature probe into your nostril; start another, wide-bore intravenous as backup; find your internal jugular vein and ease in a long, wide-bore catheter to serve as a fuel gauge.
While I'm doing all this the OR nurses are removing your backless gown (yes, you'll be undressed for your operation, shocking though it is), getting you safely positioned and strapped securely to the table so that you won't fall off if the surgeon asks for head-down or sideways tilt.
Once the surgery's under way, it's my job to anticipate what the surgeon's going to do next, and tweak the anesthesia mix, or adjust the i/v to compensate. I don't get to sit down much. I stroll round the room checking on blood loss, watch your vital signs on one of the two monitor screens at my right side, and document a lot. The nurses and I will generate reams of paper that will form part of your hospital record, a souvenir of the day.
Towards the end of surgery I give you medication to help control pain after you're awake, and adjust the anesthetic so that you'll awaken at just the right time. We have a long schedule today, and any delays mean it will start to back up.
Oh, and if you're in fragile health I might start your anesthetic with an epidural, so that no pain stimuli get to the unconscious brain, and you'll have good pain control afterwards.
And you don't want a physician--or in the States, possibly a seasoned nurse anesthetist--looking after you?