Hoorah! Celebrating our career in Anesthesia!

Author: Dr Richard Marks

We anesthesiologists are a proud bunch! We are delighted to have chosen our specialty, we take delight in the joys of being Gasmen (and Gaswomen), and we aren’t ashamed to share that. And so a group of us in London, England made a music video to beat the drum for our career and to highlight to the public the strengths and the skills we have.

Anesthesiologists have a bad, or non-existent, press. There are few heroic anesthetists in the realms of medical fiction, where their role is often marginalized and overshadowed by the surgeons. And yet we know that we are the doctors that get called whenever other doctors find themselves in trouble! In Surgery, in the ER, Pediatrics, and OB/GYN – when things get really hairy and scary the shout goes out: “Help! Call Anesthesia!”. And when we arrive everybody in the room heaves a big sigh of relief.

Hooray! The Gasman’s come!
To bring some morphine, ket and rum.
As soon as the stitching is done
They’ll take their purse and run.

Because as anesthesiologists, the use of tracheal tubes and facemask ventilation, cannulation centrally and peripherally, inotropes, neuromuscular blockers and potent opiates are all totally routine tools with which we are completely familiar. These skills, which were initially developed for surgery and for use inside the Operating Room, translate into life-saving manuevers that have application across medicine.

The specialties of Intensive Care Medicine and Perioperative Medicine both started as projects by anaesthetists who took a holistic and open view of their patients. Pain medicine, both in the acute and long-term setting was also an offshoot of our skills.

We get to see the immediate results of our treatments. There can be nothing more gratifying than to see the smile of a patient suffering in labour getting instant pain relief from an epidural, or the rapid improvement in oxygen saturation after a successful intubation in the Emergency Room.

We have the best gadgets, allowing us to monitor our patients intensively and increasingly non-invasively. And we also have the best training programs. Our training is organised to give a great deal of 1:1 consultant:trainee supervision and exposure. More importantly, the job that we do as trainees is very similar to the job that we do as attendings (not the case in many other fields of medicine) which forces our training to be relevant, up-to-date and highly practical.

Some members of the public are confused: are Anesthesiologists even doctors? A patient once asked me why as a doctor I had chosen to become an anesthesiologist, with the obvious implication that I had chosen to take a lower-status job. And yet in the next breath they told me that they were terrified of the anesthesia which was much more fearsome than the surgery, and that without doubt I was the most important member of the surgical team. I think they rather answered their own question. The plain truth is that we are higher than mere doctors!

Patients remember what we say to them. We come into contact with them at their most stressed and vulnerable times Our conversations are short but have a high bandwidth, we make a big impression!

Our work:life balance is good. Admittedly for all doctors there can be long and irregular hours, weekends, nights and shifts, but the nature of our work lends itself better than others to sessional and part-time working.

But we do put ourselves at personal risk in the job. During the Covid Pandemic we have been at the front line in treating and infectious disease. And as a group we have been highlighted as being at increased risk of suicide and addictions, with job stress, our intrinsic personality types and our easy access to lethal medications being possible contributing factors. The hands-on high-profile immediacy of the job, which is part of the attraction of the career, also brings a very big downside. Peer support is crucial in maintaining the wellbeing of our colleagues.

We set out to make a music video that would bring all of that together and to highlight our skills, the risks that we expose ourselves to at work and our pride as a group. Sea-shanties have been a novelty this year, so we took the tune from one and updated the instrumentation to make it into a dance number. What was important was to have an anthem for the refrain; we’re hoping that anaesthetists everywhere will chant “Hoorah! The Gasman’s come” whenever they arrive at the scene of a crisis.

We were lucky to have some excellent musicians – our keyboard player had been a professional musician before switching to a medical career – and we had some enthusiastic and extrovert dancers.

The use of the word “Gasman” proved to be a little controversial. For some, the term is inherently derogatory and demeaning. We used it in the video as a way of reclaiming the word from being pejorative to positive, to promote group solidarity and as a term of empowerment. I still regret, though, being unable to find a gender-neutral word that conveyed the same sense, nothing that we tried worked in the song.

The line “Take My Blood”, which the Gasman sings at the height of the crisis, was borrowed from a cardiac surgeon. A well-known paediatric surgeon who I worked with during my training, would occasionally experience difficulties post-bypass with haemostasis, and he believed fresh blood, rich in platelets and clotting factors, was beneficial. So he donated his own blood there and then. This was barely acceptable in the 1980s, let alone nowadays, but it was the inspiration for the storyline.

In the video the Gasman is called to help a surgeon; when the surgeon is unable to cope then they put the health of the patient as their first priority, they salvage the situation and then relax with a cup of coffee. Cool and calm in a crisis, totally committed to patient care, and more capable than the surgeon. That’s how we need to be portrayed. And with no cheese or soppiness either.

Check out “The Gassman’s Shanty” here on Youtube!

Dr Richard Marks is a practicing anaesthetist in the UK. He trained both in England and at Duke. He has been closely involved with the training and supervision of junior anaesthetists across London for much of his career and was Vice President of the Royal College of Anaesthetists. He is an unashamed techie, programmer and web developer. He can be contacted via https://www.schoolofanaesthesia.co.uk/author/richard-marks/

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