From Uruguay: Anesthesiologists and conflicts
Wednesday, February 16, 2011
A friend encouraged me to write some reflections on the conflict fellow anesthesiologists. I met many of the best, and I am friends with several of the old, many of them already dead. They were the pioneers who created the specialty professional stature and size in our country. For ordinary citizens and politicians in general (that will no rating) anesthesiologists are like anyone else, or as a doctor of the heap, that is frequently widespread. Frowns are claiming working conditions and demanding compensation, commensurate with the complexity of their work. But surely it is the ignorance, lies or ambition, if not cruel envy, this simplification leads to hasty. 
Anesthesia began to grow since 1846, when a dentist Morton used ether to sleep in a patient who had to make an intervention in the neck. Since then, remained in England, where Queen Victoria had its birth (not the first, but the following) from the birth of Prince Albert, under anesthesia, done by John Snow, who was also an epidemiologist who laid the foundations of epidemiology, through the analysis of epidemic ; cholera in London. Thus arose the technique of anesthesia to the Queen ", consisting of a wire strainer, the kind that are used for tea, with some cotton soaked in ether (Snow used it) falling drop by drop on cotton , which produces a mild sleep and relaxation median. Another midwife, Simpson, that of the forceps, a Scot, used chloroform instead of ether.
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Anesthesia began to grow since 1846, when a dentist Morton used ether to sleep in a patient who had to make an intervention in the neck. Since then, remained in England, where Queen Victoria had its birth (not the first, but the following) from the birth of Prince Albert, under anesthesia, done by John Snow, who was also an epidemiologist who laid the foundations of epidemiology, through the analysis of epidemic ; cholera in London. Thus arose the technique of anesthesia to the Queen ", consisting of a wire strainer, the kind that are used for tea, with some cotton soaked in ether (Snow used it) falling drop by drop on cotton , which produces a mild sleep and relaxation median. Another midwife, Simpson, that of the forceps, a Scot, used chloroform instead of ether.
But as time passed they realized that the hepato-toxicity of this agent was capitalized and turned the old sulfuric ether. In cowboy movies, it was classic see how a wounded man gave him a shot of whiskey and then extracted the bullet. Anesthesia that was current in the eighteenth and nineteenth centuries in the rural areas.
In the nineteenth and twentieth century, Uruguay, anesthesia Ombredanne the old device, a ball with a key that was more or less dropping ether on a mask which covered his nose and mouth patient, practitioners used it external, internal, or the Sisters of Charity, which abounded in public hospitals.
As was the same. A specialty did not exist, and surgery was the queen and mistress of all specialties. Then they were peeling off the ORL, the OFT, the ORT and traumatology, and paediatrics.
But Anesthesiology autonomy began to take after the 2nd. World War, and in our country after 1950, with some great teachers in his youth made anesthesia gases, such as Eduardo C. Palma, Helmut Kasdorf. One ended up being a professor of Clinical Surgery and great anatomist (author of the by-pass which were then common to René Favaloro, applied to other core areas, where Palma were made with saphenous vein for peripheral bridges) and another was the first Professor of Radiotherapy. Or Alfredo Pernin, who left the surgery to go learn anesthesiology in the U.S., or their followers, Walter Fernández Oria, Chertkoff León, Antonio Cañellas, and many other pioneers, who fortunately are still with us, as Henry Barmaimón Tabare Gonzalez, Martin Marx, Samuel Liondas, Mary Caputi Cavalli, etc.
Thanks to advances in anesthesiology, surgeons were able to make interventions more more complex and protracted, and so progress in abdominal surgery, neurosurgery, cardiac surgery, transplants
kidney, heart and liver, large long-term interventions, including surgical equipment change for different times, etc..
evolved also used anesthetic agents, muscle relaxants, and improving techniques and equipment, so today is a specialty of the most sought after in the world, not only because it gives security surgeons, but because it is so complex they could not make it and neither practitioners nor nuns. But above all, because a number of techniques for diagnosis and modern treatment, which have drawn the boundaries of knowledge and therapeutic possibilities are under anesthesia of different magnitude, but with control of an anesthesiologist (TAC MRI, PET, endoscopy of various kinds and various specialists from the Gastro-Esophageal-Duodenal-fiberscope to the Fibro-Colonoscopy, to ENT interventions when the patient is not intubated and bring a fiberscope , etc.).
Of all specialties, that has developed techniques for patient safety (and relative tranquility for the operator) is the world Anesthesiology. This is universally recognized. In this advanced are indisputable.
It has certainly been the big key surgical and medical advances.
But simplification based on ignorance and the ambition (or envy), both medical colleagues and managers of public, politicians and journalists improvised anesthesiologists believe that touch a button and sleep to the patient. Which then wakes up and goes so smugly.
Those who know about the phenomena of which we speak, we know that it is not. And to reach that level of excellence requires a long and laborious preparation, and updating and maintaining of knowledge which means investment, magazines, books, conferences and travel, not for hunting elephants or make sexual misdeeds, but to go to learn more advanced in places of excellence. And that knowledge is constructed and refined professional.
we lost sight of the Anesthesiologists are medical professionals. The professionalism impose certain rules of conduct, which generally are poorly known, even within the profession, because we have digressed too, driven by the consumer society and the ignorance and greed that abound in our time. The consumerism that can do everything, is killing the flame of professional soul in us all.
So when oversimplified, as in this case, it is thought that anesthesiologists only fight for pesos and it is not. Also fighting for decent working conditions that are as or more important than compensation. As with any doctor.
EVERYBODY agrees to work in worse conditions than ideal, is a matter of responsibility. But when required hygienic conditions of work, out of anesthesia from 8 hours to rest, away from the anesthetic agents that are hepatotoxic, and stress, what we seek is to live longer and better our colleagues in that specialty. As
have to worry that each specialty would do the same. Obvio ie whether to work recently, by the delicacy of its function, and not live exhausted to handle the risk of killing patients or leave them with serious consequences, distraction or fatigue, applies to any other specialty.
And that, unfortunately, we are aware.
If there are thousands of patients waiting their turn to be operated, it will be by neglect and failure of health managers, public and private, in every place have failed to solve the problems for decades complex health services face. Since I chiquito (Or rather, since I started working in 1964 at SMU) regularly know that there is no problem with the Pereira Rossell Hospital anesthesiologists, usually in the summer. I never knew how to solve, no anesthesiologists, but the authorities of the MSP, and now the ASSE.
reform role they want to pursue a set of wise monkeys, despised and ignored all these elements, and consequently, the mismanaged, with arrogance and malice. They think that discrediting a specialty, getting people stigmatize them as the bad guys film, do their role better.
That's part of the cross we must carry, unable to endure so many chairs perched on the ministerial and ASSE. Donkeys with title or not, that political accommodation will direct things that neither know nor seek to learn. We are not born knowing, but you can ask, find out and then decide. So go and tell the President this or that bolazo, and he speaks through any stupid goose. That such a President becomes more effective. And to be regarded as revealed truth.
So in summary: Anesthesiologists are right to demand better working conditions and pay. It is by working in a place with a certain remuneration, which in the eyes of the populace may seem high, but compared to what is paid elsewhere, unless there is low, which resolves the problem. Should be analyzed as a whole around the problem and search for anesthesiologists and other professionals (yes PROFESSIONAL) decent working conditions and pay.
is madness to continue working in 3 or 4 places, jumping from one to another site to most delicate things that require attention, concentration, rest and cool head to make decisions on important issues on which they depend. You can not keep doing 24-hour guards, which leaves one to enter another. Or leave a hospital and get on an ambulance. Or stop trading and do a clinic, or get into a CTI. Because here's all mixed up, and colleagues gather good pay, sometimes, gathering many pieces of different workplaces, where every one will pay more or less wrong, but that alone would not stop the pot, its family obligations and their necessary, involving investment of money and time. And yet, sometimes they destroy your life or your family.
So when I hear speak ill of anesthesiologists, I feel sorry for those who do, from the arrogance, envy or ignorance. Since its outmoded and outdated ideological positions, as "the old Carlos Quijano, but allow them to continue living speaking ill of others, disregarding the work of others, and to make matters worse, throwing piles of garbage on their own profession . Do not even know that is such but mistaken for a living.
In 1962 the election was won by the National Party to independent nationalists, grouped in the Democratic White Union (the UBD), which had as its theme: "O rises UBD or business as usual ". The UBD rose, but everything was as it was. And of those powders, came this sludge. Nobody had the courage or attributes to change things. And now that they want change, he had to make the most of the pack burros and have no idea what it is. They want everyone to take the hard way, reviling and reviled, destroying as if it were conquered land.
The 46 anesthesiologists have been in the past three years abroad, where they pay 4 or 5 times, they did so mainly looking for better working conditions for themselves and their families. Where they can live longer, healthier, have a family and make a more orderly life. And not as slaves of the soil, in a country where nothing is respected, and where it is more important to be a big fat INAU official where the boys will escape because they are corrupt criminals, to be a doctor, surgeon, orthopedic surgeon or anesthetist .
So we are flying lower each day until bury us in the middle of the mountain of garbage that we have allowed to build.
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