Liquid Dreams

With each day’s worth of musings, I get a clearer picture of what I want to do with my life:  Anesthesia.  What I will be doing for people will be what I do best myself:  Sleep.  Like putting together my morning cup of coffee to keep me moving like the Energizer bunny, I will become a master of the sleeping cocktail:  ease in the midazolam (oh the beauty of benzos!), breathe in a whole lotta oxygen (you know you like O2 when you go swimming), pump in the milky propofol (works like a charm!), spice up with some fine fine fentanyl (very strong opioid), jazz up with a little lidocaine (local anesthetic), top off the opening act with a pinch of vecuronium (muscle relaxant), and add a continuous whiff of sevoflurane (inhaled anesthetic), and your patient is in another universe.  Now you have a fully sleeping patient probably cruising halfway to Hawaii already.

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This past month and a half, I’ve been having long, constant pondering sessions on what I want to do for the next 30 plus years,  Emergency Medicine vs. Anesthesia.  Amidst my inner mental battles, I also have to figure out my 4th year schedule and away electives at prospective places I may wish to do residency.  But of course, both these plans hinder on me having a rock solid idea of what field I’m going into.  I run a daily list of pros and cons. I chat with residents and attending physicians day in and day out.  I consider lifestyle, because I need to eat/cook/sleep/watch dramas/read/exercise/vacation/yada yada … I also factor in the murky future for physicians and the general unknown world of health care we must accept, thanks to Obamacare.

Clearly, I’m in high stress mode these few months.  I have to make a career-changing decision, STAT.  In a couple of years time, I will have a job, albeit a five-digit figure, barely enough for life’s sustenance for the amount of work I’ll be scutting.

And you know what happens to me when my brain is on overdrive?  That’s right, I start having funky dreams.


Last night, I had a dream I was in the operating room.  I was on the anesthesia side, behind the curtains with the fancy monitors and gadgets, gases, and medications.  One of the crucial intraoperative tasks of an anesthesiologist is to monitor vital signs … and input/output.  Input is how much fluids (or blood) is going into the patient, while output is measured by how much urine is coming out (and blood loss).  Typically, patients under general anesthesia have a Foley catheter to the bladder, and urine is collected and measured.  In the case the container fills up, the urine gets emptied out.  Usually you do not expect much urine because patients going in for surgery are kept NPO (no food or drink at least 8 hours before the operation). Except in my wet dreams…

FoleyIn my dreams, the patient on the table kept peeing out the Foley catheter, and I was mysteriously knighted the responsibility of emptying the containers under the table.  So much pee was flowing through the tube and container that I just could not keep up!  I was panicking, blubbering and shaking.  There were jugs and coolers filled with pee!!!  I was on my hands and knees under the sterile drapes trying to maintain pee control!  Where was the anesthesia resident to help me?!  Was the surgeon above the table yelling at how inept I was?  I heard nothing:  no surgeon cursing, no anesthesia to the rescue… Oddly enough, there was also no spillage and flooding onto the floor, or splashes to my face o.O   It was like the calm of a storm, the eye of a hurricane.  I turned back to the container in front of me, pushed down on the release button (like those spigots on the giant jugs you see for football games), and collected the continuously flowing pee…

And then I woke up before I could remotely make sense of this bizarre setting.

What a baffling dream?!  There was just a free-flowing fountain of pee coming out the Foley, rather benign now that I think about it.  Perhaps I have a subconscious fear of doing other people’s dirty work, such as cleaning up bodily excretions, which typically are left to the nurses, not the doctors anyway.  Perhaps I hate starting off at the bottom with the scutwork.  Who knows?!

What’s next to haunt my dreams, a patient going into anaphylaxis?  A patient waking up and popping up in the middle of surgery?  Laryngospasm during extubation (this actually happened a few weeks ago)?  What if I was the patient on the operating table and all of the above happened, plus more of the unthinkable? … {Shivers}

Uh Oh - Ice Age

Do I still want to Anesthesia?  Absolutely.  I loved my clinical experience, and would love it as a job I would want to wake up to every morning!  No bizarre dreams will deter the clear and solid path I have settled on.

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