Duty Fitness Outweighs Question of Aging

Kenneth W. Travis, MD

To the Editor

Whoa! Things are almost getting out of control. And, all this publicity could begin to go to my head because for one who debuted upon ft planet late in the fall of 1935 to be even tangentially linked to “callow youth” (1) is arguably more praise than damnation!

Let us lay to rest the youth vs. age business. The central issues are indeed fitness for duty (1) and the matching of interests and abilities with tasks. The operating room tasks of an anesthesiologist have been described, as have some common performance shaping factors.(2) Is advancing age with its measurable, but questionably significant decrement in sensory motor function (3,4) an important factor? Let us try to find out.

What seems to have emerged, at least so far in the APSF Newsletter correspondence, 1,1,1 is the following:

  1. Age is a sensitive issue; there are concerns at both extremes. (And, we must avoid “endocannibalistic” behavior (7)).
  2. The learning curve and the opportunity, if not obligation to teach, continues after residency. We are all students and teachers alike at all stages of our careers.
  3. Communication between academic training programs and ‘consumers’ largely private practicing anesthesiologists or groups can be improved to the benefit of all.
  4. Experienced, older clinicians constitute a valuable teaching resource.

If advancing age is judged to be an important performance-modifying factor, then appropriate planning by individuals during residency and for organizations, are appropriate in order to maximize the interests, talents, and capabilities of practicing anesthesiologists also to the benefit of all.

While we work through this (and other things) we may be helped by Voltaire’s observation that:

‘All of us are formed of frailty and error. Let us mutually pardon each others’ folly. That is the first law of nature.’ (Essay on Tolerance)

Kenneth W. Travis, MD

Assistant Professor, Anesthesiology Dartmouth-Hitchcock Medical Center Lebanon, NH

References

  1. Lees DE: Letter APSF Newsletter Spring 1994; 9:12.
  2. Wenger MB, Englund CE: Ergonomic and human factors affecting anesthetic vigilance and monitoring performance in the operating room environment. Anesthesiology 73:995-1021,1990.
  3. Craik FM, Salthouse TA, The Handbook of Aging and Cognition. Laurence Erlbaum Associates Hillsdale, NJ 1992.
  4. Dorfman LJ, Bosley TM: Age related changes in peripheral and central nerve conduction in man. Neurology 29:39-44,1979.
  5. Lawton TJ: Letter APSF Newsletter Spring 1994; 9:1 1.
  6. Travis KW: Letter APSF Newsletter Summer 1993;
  7. Pfifferling J-H: in AMA News, Jan. 10, 1994, p. 8.