Two’s Company, Three’s a Crowd


For the most part, we anesthesia folks tend to find ourselves alone behind the drapes in the OR.  We only really see each other in fairly circumscribed times, maybe giving sign out or in the break room between cases.  It’s a rare occasion and usually not a great scene when we actually have the privilege of working alongside one another — for example, in a ruptured AAA or a trauma or perhaps a crash C-section.  But even in these tough circumstances, I think anesthesia folks secretly relish the moment when two or three or sometimes more of us are all working as one organism, thinking and doing for the most part without speaking.  There’s a definite kinship that we share in those moments…to be sure, we could all manage quite well on our own, but what the hell took you guys so long to get here!???!

Enter the 1st of July and the new anesthesia resident fresh out of internship… This is a time that is fraught with bewilderment — new resident in a new place with new people, doing something completely new…and as if that weren’t enough:  being evaluated for it.  It should be an exciting time for taking book knowledge and applying it to hands-on clinical scenarios.  It should be a reaffirming time when you finally feel like you’re doing what you invested all this time and schooling to do.  But oftentimes it’s none of these things.  Excitement turns to fear and loathing, investment turns to feelings of worthlessness, and true growth as a person stagnates.

As an anesthesiologist and oftentimes attending to anesthesia residents, I see the line that residents teeter along between success and failure on a daily basis.  Those who can’t wow with enthusiasm make up for it with a winning work ethic.  Those who fall a little short on fund of knowledge compensate with a personable attitude.  And those who cant get the tube in or start the IV or miss the spinal…they just have to get back on that horse over and over again.  It’s what we all do:  residency is a trial by fire that we in anesthesia have all run or walked or even crawled through if we had to.

So the point I’m trying to make here in such a roundabout fashion is that anesthesia residents actually have a lot in common with the attendings that are placed in their way, sometimes with seemingly no apparent purpose other than to dash their dreams.  To wit, I’ve never met an attending who wished failure on any resident.  It’s quite the opposite really.  We want every one of you to be that person that shows up in the room when all hell is breaking loose.  We want you to be part of that single thinking and doing organism that kicks into action without a second thought.  And at the end of the day, a kinship is only a kinship when we recognize each other, when we teach each other, when we support each other and balance our strengths and weaknesses to leverage our skills in order to help a human being in need.  That’s the god honest truth.

In Part Two of this continuing train of thought, we’ll explore some ideas that might give you a leg up on the peskiest of attendings.  So stay tuned!  In the meantime, perhaps you have a deep dark fear of residency that you’d like to send out into the internets.  Or maybe you have a sad or funny story about an attending you encountered.  Or even better, share something special about yourself during your residency that up-and-comers might find inspirational.  The comment boxes are below for your usage!  I’ll be sure to give a shoutout to anyone who takes the time to participate, and I DO take requests.  Who knows…the next topic I tackle might be inspired by YOU!

Read Part Two: Starting Off On the Right Foot

4 thoughts on “Two’s Company, Three’s a Crowd

  1. Just found your blog. I’m starting my crna program in January and I really appreciate the thought and tips you discuss in your blog. I’m kind of terrified and want to be as prepared as possible once I reach my clinical portion of school. Can’t wait to read more!

    Liked by 1 person

    • You’ll do great! By the time clinicals roll around, Ashley, I think you’ll be so looking forward to it and ready to hit the ground running! I’m putting Part Two of this article up soon, so just know that I’ll be writing it with you in mind. It’s all about mindset and letting the learning happen! Enjoy the next couple of months before school starts!


  2. Hi Ashley, Thank you for your comments. It is exciting as well as terrifying to go to clinical on your first day. I can still remember my first day. You will do great. Just be yourself and preceptors don’t usually expect much of you since you are brand new. Just show that you are eager to learn and that’s all they are looking for.


  3. Pingback: Two’s Company, Three’s a Crowd | Bracken S. Kolle, M.D. ⚕

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