Below are a chest X-ray and CT-scan view of a patient with metastatic testicular cancer. The patient had shortness of air and orthopnea:

One does not see this everyday.

OK, I am no more superstitious than the next person but come on, if you give heparin and your ACT reads….

….isn’t that kind of spooky?

The case was rocky but we got the patient to the unit in one piece.

Every anesthesia provider loves the calm, cool and collected surgeon who does not bark and yell at every and anything around him/her. They stay calm through thick and thin and are so level-headed.

However, their lack of excitement can be a negative.

We as anesthesiologists can’t always see what is going on in the surgical field and so we depend on feedback from the surgeon, the sound of blood being sucked up or welling on the field or the expletives emanating from the surgeon.

If the surgeon is so level-headed that he/she never gets rattled, how does one know if something is going badly? it is worsened by a taciturn and level-headed surgeon.

So, colleagues, appreciate a surgeon who curses and swears. Like a fire alarm, they have their use.

A 90-year-old woman shows up in your Emergency Room with a ruptured abdominal aortic aneurysm (AAA).

The patient is known to the Vascular Surgery team. She was diagnosed with a AAA five years earlier. She has been refusing treatment since saying “I am too old”. Now she wants surgery to repair the aneurysm!

BTW, the aneurysm is such that it is not amenable to endoscopic repair so it has to be done open.

What do you do?