To the Editor
I am replying to your article in the APSF Newsletter and offering you my perspective on the issue. I am in total agreement that the image we project is important, and the image of Dr. Giesecke with his feet propped up on the anesthesia machine presents a poor image.
On the other hand, the level of sensory deprivation can be extremely variable in cases, and the ability to multitask varies among anesthesiologists. In the past, manpower was sufficient, and case volume was large enough that those in need of constant stimulation could just stick with open hearts, AAAs, and so forth. Today, we might do complex cases one day and the next be stuck in a dark room with an ASA 1 or 2 patient for 2-4 hours in a case with almost no potential for blood loss with only a minimal break from a sympathetic colleague.
Reading material downloaded onto a PDA from a site such as Avantgo® is much more discreet and can be done such that monitors can be still in the field of view, keeping someone used to multitasking in complex cases from being lulled into boredom. Useful PDA software such as ePOCRATeS® and other clinical applications make it a common device for clinicians to keep with them.
When I started practice, I only supervised residents and CRNAs in an academic setting and was a staunch opponent of any reading in the OR. In my current practice, I supervise some, but often do cases of varying complexity alone. This experience has caused me to soften my position on this issue.
Mont Stern, MD
East Amhert, NY