Mayim Bialik may be the straw that broke the camel’s back once and for all for Anesthesiologists throughout the world. On Friday night’s Jeopardy during the meet and greet portion, Bialik referred to one of the contestants who is an anesthesiologist as “just an anesthesiologist”, and not a surgeon. 

Contestant, Dr. Yian Chen, was telling a story about how he became a doctor which involved trying to master the “claw” machine as a child when Bialik responded, “That’s pretty awesome, but you didn’t become a surgeon, just an anesthesiologist.“

Dr. Megan Mcgrath, head of The American Society of Anesthesiologists (ASA) was taking a break from developing more MOCA sims and watching Jeopardy live when the deathblow struck.  “That’s a wrap folks, we give up,” stated Mcgrath. Recent public surveys have indicated that 88% of the general population doesn’t think Anesthesiologists are physicians.  Another surveys demonstrated 93% of patients think the Anesthesiologist’s job is to “just get me off to sleep” and nothing else.

“Bialik reaffirmed this tonight and so it is probably time to just hang it up. We are all just wannaby surgeons who weren’t smart enough in anatomy lab or who didn’t play enough video games growing up,” a choking up Mcgrath tried to say.

The ASA will rebrand to the ASJA or The American Society of Just Anesthesiologists and will likely move towards working at Mattress Discounters operating bed controls for new customers in their showrooms.  Hospital administrators plan to fill the void with anyone working in or near a hospital that is wearing a white lab coat and scrubs.

The time is 1859 and pagers throughout the ICU begin to chirp. It’s time: Tube O’clock. This simple and easy protocol was designed to ensure each patient is tubed NO SOONER than five minutes before death or one hour after end of Nursing shift. All pending intubations will now take place at 0700 & 1900:

– 1900: Intern to approach nurse beginning shift report and state, “We are intubating patient right now”. Should nurse have questions, redirect to resident.

– 1903: Resident to answer on 8th call from nurse. Redirect nurse to Fellow should nurse have questions.

– 1904: Fellow to answer nurse’s call and immediately ask why Respiratory isn’t in room. Nurse may have questions about which meds to draw up or if you’re in the patient’s room. Give your first round of orders now, while briskly walking away from patient’s room and out of plain sight.

High Yield: Make sure you have a second round of orders to give when the team is gowned and in patient’s room.

– 1920: For fun, try intubating patient in ascending order of provider experience.

High Yield: Time is on your side!

– 1945: Page anesthesia overhead

– 1950: Patient intubated by anesthesia. Promptly depart to opposite side of unit; DO NOT replace your depleted phone battery until you have located graham crackers & peanut butter as your reward.

– 2000: Code 7/19 Complete! Make sure to ask the nurse you’ve been working with all day if he’s on Nights now, while he furiously charts said Code 7/19.

– 2001: Mentally prepare to be uninvited from next week’s potluck and for multiple pages requesting Tylenol orders.

Jose Prada M.D., a Pediatric Anesthesiologist at Miami Children’s has a reputation of being very laid back. But according to Dr. Prada, the key to acquiring the reputation of being laid back is to ask your residents and CRNA’s what to do before telling them what to do.

“You see, so many attendings make the mistake of just telling their residents how to induce a patient or how to manage post op pain. I always take the approach of asking them their plan 1st. After they tell me it, I then tell them how to induce and manage post-operative pain.”

Dr. Prada’s style in interacting with his adult learners and CRNAs goes past just crafting plans for intraoperative anesthesia. To him, he wants them to succeed. “I am always sure to tell my residents to apply monitors when we enter the room. Heaven forbid they forget to put on the blood pressure cuff. So when we enter the room with our patient I always say ‘put on the blood pressure cuff, put on the pulse oximeter, put on the temperature probe.’ I want them to succeed.”

Dr. Prada then goes on to make sure his residents are succeeding at charting. “I always remind them to make sure to chart all their medications. Make sure to chart fluids. And make sure to chart vitals. This is important stuff!”

“I love my trainees and I want them to succeed. That’s why I always ask for their input before telling them exactly what to do, when to do it and how to do it. And that’s why they love me.”

At press time, Dr. Prada’s resident was unavailable for comment as he was busy rewording the pre-anesthesia evaluation at Dr. Prada’s request.

New York, NY – The era of COVID-19 has pushed the envelope in hospitals across the world, challenging care delivery models and allowing one ventilator to ventilate 600 patients at once. At one New York medical center, intense clinical demands and provider fatigue
have inspired one anesthesiologist to push the boundaries of clinical medicine.

Dr. Mac “McGrath” Millerstein, a cardiothoracic anesthesiologist, has intubated countless patients with COVID over the last several weeks. “I’ve intubated four, or maybe it’s been sixty – I’m bad at counting. That’s why we have circulating nurses in the OR.” After
this rash of intubations, he decided to push the envelope with a recent urgent CABG.

“Those OB and regional folks are doing spinals all the time. I haven’t done one in two decades, but how much has changed? If the patient is numb, you shouldn’t really need more than that for a CABG – a spine is still a spine.” Dr. Millerstein taped an endotracheal
tube to the drapes to hide his experimentation from the surgeons, who would’ve immediately thrown a scalpel across the blood-brain barrier had they known.

“The case went perfectly for the first 30 minutes!” said Willing Accomplice, the room’s circulating nurse. “The patient tolerated incision well, was able to hold his breath when directed by the surgeons, and was able to be successfully placed on the heart-lung
machine.” Shortly after, the spinal anesthetic wore off and the patient was quickly placed under general anesthesia. The procedure was completed uneventfully after the surgeon, Dr. Annuloplasty, unscrubbed to sucker punch Dr. Millerstein. Millerstein ducked,
administered intramuscular ketamine to Dr. Annuloplasty, and a major crisis was averted.

“Apart from paralysis as a result of a spinal epidural hematoma, the procedure was a resounding success. Whoever would’ve known you can’t give 30,000 units of heparin right after a spinal? We did it all the time when I was a resident…” said Dr. Millerstein.

The paper was recently submitted to the New England Journal of Medicine for publication, and received a glowingly positive review. “We loved the ingenuity of this case, but we really love that it has COVID in the title,” said Dr. OldWhite Man, the editor-in-chief
of NEJM.

Update
5/25/2020: Dr. Millerstein has resigned his privilidges at Mount St. Presbyterian Israel Methodist Zuckerberg Medical Center as of noon today. Dr. Annuloplasty remains in a ketamine-induced haze in the corner of the operating room.

San Diego, California – Ronald Flackey, MD is not like just any Anesthesiologist.  In addition to the 4 years of medical school and 4 years of residency it takes to practice Anesthesiology, Dr. Flackey spent extra training in a regional anesthesia fellowship.  As a result, Dr. Flackey is a master at different regional blocks.  Interscalene blocks, infraclavicular blocks and TAP blocks are all a routine part of his day.  You name the block and Dr. Flackey can do it.

But there is one block that Dr. Flackey excels at; the cock block.

In a stunning turn of events, all it took was one global respiratory pandemic to recognize that anesthesia might not be to blame.

“Man, before it was so easy to yell at anesthesia for the table, the instruments, the patients. Heck, it was anesthesia’s fault when the dealer waxed my Porsche backwards. But even -I- can’t blame anesthesia for this one,” said renowned orthopedic surgeon Dustin Jones, DO

In fact, he suggested that anesthesia may have an answer to the COVID-19 outbreak.

“Just maybe, if anesthesia does anesthesia, the COVID patients can go back to Crossfit and needing me to fix their shoulders, hips, and knees,” said Dr. Jones, who is driving everyone around him bananas after the Surgeon General cancelled all his cases.

Anesthesia (who has a real name all along, turns out it’s Nicole) was nonplussed.

“For years, we’ve been invisible except when things went south, a convenient punching bag for everything that goes wrong. But now, just one little pandemic and the official word becomes “Everyone out of the room while anesthesia intubates.”

“Blame anesthesia now, buddy. I dare you. I’ll go on break and come back when I’ve found toilet paper and N95s. Go find an administrator to intubate – oh wait, they’re probably working from their second vacation home in Florida.”

But, she did put out a bright spot in response to ventilator hoarding by the ultra-rich.

“They might be billionaire oligarchs, but they probably didn’t hire a team of anesthesiologists or critical care nurses who could manage their home vents 24/7/365.

“Don’t worry, just treat us like professional colleagues, and we’ll keep showing up to work with you.”

St. Peter, MN – Physician on FIRE, an anesthesiologist and financial blogger, recently hit the magical goal of Financial Independence and Retire Early (FIRE) in his mid 40s. Once he achieved ‘FIRE status’ JACHO and hospital administration determined he was too much of a fire risk to be in the operating room.

“I’m sorry if you are over a fire risk score of 4 you can’t be in the OR,” charge nurse Jackie told reporters.

Last week during the pre-surgical time out the anesthesiologist or “Physician on FIRE” stated the fire risk score was “on FIRE!”

He then lifted a 20mL syringe of propofol in a horizontal fashion, and performed a “mic drop.” He then proceeded to provide anesthesia for the patient in a safe, effective manner until completion of surgery.

When the patient was transferred to the PACU he proceeded to moon-walk out of the hospital, to the envy of physicians everywhere.

“He can’t be in the OR anymore,” Jackie repeated. “He’s too much of a FIRE risk.”

Yes he is. He is on FIRE.

SCHAUMBURG, IL – Pandemic coronavirus, COVID-19. Hundreds of thousands infected. Sports suspended. Nations on lockdown. Social distancing. Markets crashing. And it’s only just begun. Yet somehow amidst all of this, Anesthesia is amazed they haven’t been blamed for any of this.

“It was only a year ago that if you misplaced your keys, tripped on the sidewalk, or got food poisoning we were the first to blame,” said yet-to-be-blamed anesthesiologist Dr. Andrew Hopkins. “Remember when we were blamed for the collapse of both the Falcons and I-85 in Atlanta? It won us the Nobel Prize for Blame. But so far in 2020? Nothing.”

Like many of us, anesthesiologists were paying attention to the developments of novel coronavirus when it first emerged in Wuhan, China in December 2019. It only started to become personal and real when they started experiencing dwindling sudoku supplies. They all knew it was a true, never-before-seen state of emergency when no blame came their way.

Fevers and respiratory symptoms? Blame COVID-19. Shortage of personal protective equipment? Blame COVID-19. A bear market after 11 years of stock market growth? Blame COVID-19. No hand sanitizer and toilet paper? Blame COVID-19. Every aspect of life has changed in 2020 and all of it can be blamed on COVID-19. For once, it’s not on Anesthesia.

In a weird way, says Hopkins, he and his colleagues miss the blame ole days.

“Everyone needs to step up and be smart: wash your hands, don’t touch your face, stay at home, and if you need to leave home to get food and supplies, stay 6 feet away from one another,” strongly advised Hopkins, who has erected a protective drape around his home and family. “If we can flatten the curve, we can get through this. And when we do, we look forward to the day and welcome with open arms all the blame you want to send our way.”

GREENEVILLE, TN – St. Indignant’s Health Care System has announced a new partnership with the U.S. Department of Health & Human Services to pilot an innovative drive-thru intubation clinic in the parking lot of their main campus. This new service is in accordance with new Centers for Disease Control & Prevention (CDC) guidelines for outpatient management of high-acuity patients in areas with limited available ICU resources. The new CDC guidelines also outline fashionable fabric and pattern recommendations for front line providers tasked with cobbling together their own personal personal protective equipment (PPE) for in hospital use (spoiler alert, plaid is out like beards!).

“Whelp, it’s here, well not where I’m at thank Jesus but where the hospital is- and it’s kicking our butts,” CFO Glenn Gilded reported via email from his vacation home in St. Martin when asked about the new initiative. “Frankly, it makes sense. We don’t have any ICU beds and so the patients are probably more comfortable and better isolated in the comfort of their own living rooms than some grimy hallway. Plus, we’d be using less of that sweet, sweet PPE! We’re always thinking about employee safety.”

“We originally intended to include portable ventilators with the service,” Gilded added. “But, turns out we’re reaaaally low on those too. So, we’re including a BVM and multiple ETT extenders in the care package so that patient can use their own thighs to squeeze the bag while they’re chilling on the couch and enjoying their paid vacation from work. They’ll live – and they’ll have shapely thighs on the other side of all of this.”

When asked what these patients should do for sleep, Gilded added “They can show a family member how to do it or something; it’s just squeezing a friggin’ bag every 5 seconds.”

As for a system to manage extubations after the courses of treatment are complete, Gilded offers that hospital administration doesn’t anticipate a significant need. “We’ll stay attuned to the needs of our community and partners in this time of incredible difficulty. If we get funding, maybe we’ll throw something together to get those tubes out, too. In the end, we’ll all get through it. And, we’ll throw a hell of a pizza party when it’s all said and done.”

With the COVID-19 outbreak, health systems worldwide are coming up with plans to maximize their resources in the face of this pandemic. With COVID-19 suspected of being droplet spread and the possibility of patients requiring long term mechanical ventilation, strategies for rapid airway securement are paramount. Many of the protocols call for the “most experienced person” to intubate the patient’s trachea. Traditionally, intubation was a hot topic between many specialties, all claiming to be very proficient in the skill. Apparently, a consensus has finally been reached.

ED attending Dr. Brock X. Rockclimber said, “When the Emergency Medicine Department heard that only the most experienced person should be exposed to this deadly disease, we knew our esteemed anesthesiologist, Dr. Thomas Ryan Xavier Smith-Jones was the only logical choice.”

Overhead pages are now, on average, 15 seconds longer as the operators call for COVID-19 Airway Support using the anesthesiologist’s full legal name and college nickname to summon them.

ENT surgeon Dr. Julia “Blue Rhino” Patel reported, “Oh, that whole ‘ENT docs are the masters of the airway’ thing was just a fun little joke. I have nothing but respect for anesthesiologist Dr. Sarah Ann Lynn Deborah Sally Waters-Lee and I know that she’s right person to take on this critical task.”