A week in my . . . job as an anaesthetist at Sligo General Hospital

Sleeping, waking I often say that in my “day job” as an anaesthetist, I put people to sleep, and in my other job, with Get Up and Go Publications, I wake people up. What I want is for all people to be as healthy as possible, both mentally and physically, so we can enjoy the best life possible. A healthy mind in a healthy body is truly the recipe for a wealthy life.

My interest in medicine grew partly out of a family story that was a favourite of our dinner-table conversation for many years. My dad had TB as a young man and was in hospital for three years before he enrolled in the first streptomycin drug trial.

Unlike his father and two young brothers, who sadly succumbed to the disease when my father was an infant, Dad had survived long enough for a cure to be found. My mother was his nurse in hospital, and after he recovered, they met again on a bus. The rest is history.

I qualified from University College Dublin in 1982 and have since practised medicine in the UK, Africa, Canada and Ireland. All this developed my passion for travelling, and I have managed to experience (albeit very briefly at times) life and living conditions in more than 60 countries, giving me a fairly unique perspective on the world. It is an aspect of my education for which I will be forever grateful.

Although I have been a specialist anaesthetist since 1991, I have also worked in other areas of medicine, including general practice, psychiatry, geriatrics and obstetrics, in a career of more than 30 years.

My work as an anaesthetist at Sligo Regional Hospital began in 1995. I fell in love with Sligo and, after completing a two-year advanced fellowship in Toronto, I returned as a permanent consultant on a half-time contract in 2004. My weekly commitment at the hospital consists of two and a half days per week, plus an on-call commitment of 24 hours, once every 14 days.

In my practice I cover all general theatre specialities, from general surgery, orthopaedics, ear nose and throat, gynaecology and obstetrics, paediatrics, opthalmology, intensive care, A&E, and my own area of special interest, the pre-anaesthesia assessment clinic. As an anaesthetist I work closely with all the other specialities and, of course, the nursing staff. A collaborative team approach and good communication are essential to achieving the best outcome for patients.

Vigilance

People often joke that an anaesthetist can take a break once the patient is asleep, but I can guarantee that the only person “sleeping” in theatre is the patient. My job is all about vigilance and paying attention at all times to everything that is happening throughout a surgical procedure. In an extended operation, this includes monitoring blood loss and replacing fluids and electrolytes.

The machinery and monitors are now very technologically advanced, and the medications we use tend to be a mixture of anaesthetic vapours, intravenous sedatives, strong painkillers, muscle relaxants and anti-nausea drugs.

Our job is to ensure that patients are safe throughout their operations, that they do not feel sick or in pain when they wake up, and we provide optimal operating conditions for the surgeon.

I have always loved my work and take great satisfaction in guiding my patients, often with multiple complicating conditions and medications, safely through their operation and immediate post-operative care, often in the intensive care unit.

I also really enjoy meeting patients in the pre-assessment clinic, where I can educate them on perioperative risk reduction, which often involves weight loss, smoking cessation, medication management, and lifestyle choices to do with nutrition and exercise, so that they come for their surgery in the best possible condition.

The downside, unfortunately, is that modern medicine does not always provide a miracle cure – there is not always “a pill for every ill”. Some conditions are not amenable to surgical correction, and sometimes unforeseen things happen and the outcome is bad.

These times are thankfully rare, but when they happen they are difficult for everyone involved.

I am an ordinary person trained to do a skilled job in a challenging environment. It is not for the faint-hearted, as there is little forgiveness from the outside world when things go wrong, despite all our best efforts.

There is also the added stress of being on call. There are more than 250,000 people in our catchment area and anything can happen out of hours.

It can be a lonely place at 3am when you get a call saying there is a bad road-traffic accident with multiple injuries coming into A&E, or there has been a serious house fire, or a child is not breathing, or a woman in labour has gotten into difficulty, or the intensive care unit is full and a bed is urgently needed for someone suffering a brain haemorrhage.

The Lord is good when two or more of these events do not occur simultaneously.

Get Up and Go

Which brings me to my involvement with the Get Up and Go Diaries. It’s all about balance. The stress of my anaesthetic job is counterbalanced by the pragmatism, optimism and general commonsense required to compile a product that is intended to help others deal with the challenges of modern life by seeing often complex situations and circumstances from a different, often simpler, and healthier, perspective.

In the early 2000s, I had been using a lovely diary which had helped me survive the challenge of separation and divorce in my own life.

This Irish Survivors Diary was started by Glenda Devlin, who moved to Ireland from her native South Africa in 1999 to start a new life. Sadly, not long after she moved here, her beloved husband Tommy was diagnosed with a terminal illness, and she nursed him for four years until his death. She began putting helpful and encouraging thoughts on to paper every day to support herself in a simple yet effective way to deal with the new realities of her life. She began physically publishing the diary when she realised that this approach might benefit others.

Partners Myself and Glenda, who also lives in Sligo, decided to go into partnership together after meeting in 2006. The diary was transformed into The Irish Get Up and Go Diary and with the involvement of my partner, Brendan Sands, Get Up and Go Publications was formed in 2008.

We have since developed a diary for teens and young people, and a homework journal for schools. Just recently, we held our hugely successful inaugural Get Up and Go conference.

Our diaries, which are available in bookshops around the country, are filled with motivational quotes, inspiring stories and powerful messages, which are designed to have a positive impact on the minds of readers.

We believe that when the right words are followed by committed action, great results can be produced in all our lives.

Eileen Forrestal is expressing her own personal views in this article and does not speak for her colleagues, nor for her employer.