By Moncef Jendoubi
My journey as an anesthetist or Technicien Supérieur en Anesthésie et Réanimation started on 8th November, 1979 at the Aziza Othmana Hospital, located in the heart of the historic Medina of Tunis. I was received by the Hospital’s director to begin my practice as an anesthetist in the service of gynecology and obstetrics. We delivered, on average, 12,000 women annually including 20% by caesarean section. Other surgical procedures included outpatient surgical procedures, laparoscopies, and other gynecological procedures are performed daily. Only 3 anesthetists (technicians) managed all the anesthetic activity and resuscitation for all the surgical activity, previously described, and emergency cases, before my arrival and I was the fourth anesthetist!
After one week of orientation, I started working alone in the operating room, but also the only anesthetist on duty at night, on Sundays and holidays! There were no physician anesthetists (there were 5 or 6 for the whole country, but none in our facility). It took ten years before the first anesthesiologist appeared.
Back then “monitoring” (this word did not exist yet in our medical language) equipment consisted of an armband of blood pressure and a stethoscope! Like many hospitals and private clinics of that time, some operating theaters were not equipped with anesthesia respirators; it was necessary to ventilate manually, during all the intervention (manual ventilation)!! To verify the good oxygenation of the patient, the patient’s skin was stained; as a sign of hypercapnia, we had sweating. There was no ventilatory mode, the respirators were pre-formatted volume relaxers (volume mode), or pressure relaxers (pressure mode)! There were also no specialists including neonatologist pediatricians! The midwife had no alternative but to call me, or another Anesthetist, to “revive”, reanimate, and ventilate, for babies who are born in bad condition. It was necessary to resuscitate the baby and keep them “alive” until we found a place for them in a specialized service!
How far have we come from 1979 to today! When I see all the monitoring we have today, the growing number of nurse anesthetists and anesthesiologists, all the specialists who surround us, all the assessments, the x-rays, the scanners, etc. It’s beautiful all that…… It’s all very useful! But somewhere, it creates “barriers” between us and the patient. There is a growing tendency to look more at the monitor screens than the patient himself. Our ears are more concerned with alarms than with the patient’s complaints. The stethoscope is being used less. The pulse is being felt for less. Anesthetists are getting more satisfied with the numbers displayed on the monitors. Daily caricature, anesthetists focused on the numbers and curves of the monitors, and the patient behind their back!
Yesterday, tomorrow and today, I adore ANESTHESIA … Happy Anesthesia Day to our speciality and to us too!
