From the vantage point of the sharp end of the anesthetic care needle, the recent opinion letter from Drs. Monk and Giesecke generates a number of thoughts. Whatever the formal title, the person who lives within an arms length of an anesthesia machine usually spends 50% or more of his or her waking hours planted in a chair trying to create and maintain physiologic boredom. However, once this state has been achieved, this person must then deal with the very real, but underappreciated, stress of remaining vigilant despite little or no stimulus.
This is, with a quality anesthetic, akin to monitoring the curing of (admittedly precious) concrete. Music, conversation, moving about, and brief reading interludes all serve to energize the senses, and in fact I would submit increase, rather than decrease, situational awareness by prompting a re-scan of the data, rather than just staring at the colored numbers. However, while I am not swayed by the ethical resource of Bill Clinton, I realize that my view may not carry the day. If that is the case, realize that the reading time left at days’ end is precious, priorities must be set, and some items, such as this very newsletter, may not make the cut.
C.F. Ward, MD
San Diego, CA