‘Residents’ Review’: YOUR Contributions Make Our Voices Heard

Michael S. Axley M.D., Co-Editor
“Residents’ Review”

s the time comes around for the ASA Annual Meeting, we are offered a good opportunity to take stock of the year from the viewpoint of the “Residents’ Review.” Just as we do when performing a busy anesthetic — sitting back and trying to take in the big picture can reveal ways to optimize the task at hand.

This column, the “Residents’ Review,” offers anesthesiology residents the most consistent vehicle for presenting their viewpoints within ASA publications. As such, it is important that the editorial schedule and the commentaries put forth in the column be decided upon and selected by the elected editors.

At publications where the stakes are high, different constituencies can sometimes act in ways that undermine editorial independence. In fact, I feel the stakes are of significant importance for the ASA NEWSLETTER. At the same time, it seems to me that great care has been taken to allow the resident editors to operate free from interference. We certainly appreciate the autonomy.

The staff at ASA headquarters has been extremely helpful. Communications Executive Assistant Karen Yetsky, in particular, helps to keep the trains running on time. Without her generous assistance, the column overall would have been a much poorer product.

This year there have been some really outstanding contributors. It is appropriate to use the column to discuss issues of political importance to residents — such as the Legislative Conference, governmental affairs, elections and the roles of different posts in the resident leadership. We had the opportunity to hear from the residents who participate actively in the anesthesia subspecialties as well. And, of course, it is of critical importance that medical students interested in the specialty have the chance to participate. But the column really shines when residents take it upon themselves to make submissions.

For example, residents from New Orleans in 2005 gave us a snapshot of what disaster preparedness might look like for us all in the future:

“Within a week of my return, power was returned to uptown New Orleans, and my neighbors began to move back home,” wrote Kristie D. Osteen, M.D., then a resident at Ochsner Health Systems. “With no trash removal service, the streets became cluttered with garbage. Because of the lack of refrigeration, many residents relied on a few operating restaurants for their meals. The lines at these restaurants were long, and they frequently ran out of food. It was unbelievable what had happened to this amazing city.”

Anthony R. Plunkett, M.D., writing about his work volunteering with a military mission in Ho Chi Minh City, offers us an experience of a type of practice many of us will never see:

“The anesthesia providers are very skilled at the paresthesia technique for administering regional anesthesia. They most commonly perform interscalene, axillary and femoral blocks. They use little to no sedation during block procedures. All patients are placed on standard monitors for block procedures. One of the main reasons for the continued use of the paresthesia technique is the cost and unavailability of nerve stimulators and insulated needles. This is rapidly changing as major regional anesthesia supply companies are taking interest in Vietnam’s emerging economy.”

Christina M. Reiter, M.D., supplied perhaps the most powerful column written this year. In it, she described the emotions one encounters when dealing with the repercussions of substance abuse by a colleague:

“Most days I don’t even think about those syringes I carry around in my pockets. They help me care for my patients by treating their anxiety and pain. They can be a nuisance when I forget to fill out my controlled substances sheet properly and get called back to the pharmacy. But today I can’t stop thinking about them. Today they feel like hot coals burning a hole in my pocket. I don’t want to carry them around lest they somehow leach out and poison me, ruining my career, my family and my life.”

As an editor of the column, I wish I could take credit for soliciting Dr. Reiter’s column. But I have to say the benefit goes to Anagh A. Vora, M.D., a very capable writer and editor. Unfortunately Dr. Vora has since decided to leave the field of anesthesiology and subsequently vacated his position as co-editor of the “Residents’ Review.” In his place, the Resident Governing Council has appointed Todd J. Smaka, M.D., a second-year resident at Oregon Health & Science University. Dr. Smaka brings a wealth of talent and life experience to the position, and both he and the incoming elected editor (as of the ASA Annual Meeting) will no doubt have plenty to offer.

I started as co-editor as a first-year resident two years ago. At the time, I wrote a column reflecting on resident training in procedures, “A Tempest in a Teapot?” The theme was intended to take after the ASA seal:

“…the pilot wheel, perfect circle, shield, stars, clouds, moon, ship, sea and lighthouse. The motto is VIGILANCE. The patient is represented as the ship, sailing the troubled sea with clouds of doubt, waves of terror, yet being guided by the skillful pilot (the anesthetist) with constant and eternal (stars), vigilance (motto) by his dependable (lighthouse) knowledge of the art of sleep (moon) to a safe and happy outcome of his voyage through the realm of the unknown. The perfect circle denotes unity of a closed group (the Society).”

I would like to thank the residents of anesthesiology for the opportunity to represent them in the happy and fruitful position as co-editor of this column.

Michael S. Axley, M.D., is a CA-3 resident at Oregon Health and Science University, Portland, Oregon.