One horrible and memorable day fifteen years ago I experienced sheer panic. Some say anaesthetics is ninety nine percent boredom and one percent panic. Maybe routine is a better word than boredom. ( I must have written this in my early 40s).

Anaesthetists put people to sleep, often paralyse them and breathe for them during an operation. They also look after the blood volume, the blood pressure and other such things. Once the patient is asleep and connected to the machinery and all vital signs are stable, it is a matter of sitting, watching and keeping records.

This day was routine, elective cases. We had operated on half a dozen people chopping out bits of their anatomy and sewing other bits together. The last patient of the day was Tim. A bright wee character and a healthy one at that.

He was eight years old, a blond haired blue eyed boy. He was pretty. He was with us to have a routine tendon operation on his right hand. It was likely it was going to take an hour or more.

“See if you can count up to ten Tim, you’ll be asleep before you get to ten”.

Off he went in a mood of total trust. He began counting and got to three. We wheeled him into theatre. He was set up with a simple mask and airway. I strapped his head to keep his chin up, keep his airway open. We put a tight rubberised bandage on his arm all the way up to the blood pressure cuff on his upper arm.. This was to squeeze all the blood out his arm. The cuff was pumped up and the bandage removed. His arm now had no colour to it.

The surgeon began to operate on Tim. Inside the incision things were bloodless, done to enable the surgeon to see clearly. I checked all his signs everything was okay. The bag was puffing in and out. He was breathing under his own steam. I checked the machine. Nitrous oxide or laughing gas and oxygen were flowing in the right proportions as was the halothane. I took a walk around the theatre. I was chatting to the nurses and the surgeon. I looked over and the bag was not moving. This often happens as sometimes the airway blocks due to the chin dropping. I wandered over pulled on Tim’s chin, nothing, no moving bag.

“There’s some thing wrong here”, I shouted at Bill,
“Like what?” He enquired.
“Hang on”. I was trying to find a pulse.
“There’s no pulse and he is not breathing. He has fixed widely dilated
pupils”.

I could feel the panic rising in me. I was starting mouth to mouth resuscitation. “God, if you are there, help me”, I whispered. Bill thought I was playing a prank. ” This kid is either dead or will be soon”, I
shouted at him. “Sister call the crash team please”.

By this time Bill had ripped off the gowns and was doing external cardiac massage. This was the first time I had ever done mouth to mouth for real. ‘Jesus, this mouth to mouth business really works’, I shouted within with delight as I saw Tim’s chest rise and fall with my efforts.

“Get me a number 6 endotracheal tube please and resus kit, nurse”. She came back with a tube the right size for a giant. I threw it across the room and swore at her. “Get the sister. There’s still no pulse Bill. Keep thumping”. The sister arrived with a tube. We got him all connected up.

Finally I heard a voice.”We’ve got a pulse”, He’s alive, thank God”. I had to wait for an hour for the operation to finish. “Will this kid be alright?” was running through thoughts. ‘Will he be brain damaged? God I could have produced a vegetable’. I waited with him in recovery. ‘Christ he’s taking along time. Jesus I’ve done it now. This is the end of my medical career. Struck off in my prime and deservedly so’.

“Hi doctor how did it go?” It was Tim, “How long before I can play my guitar?”

I ran off into a room on my own and cried with relief. I went back to check the machinery. People had been asked not to touch any thing. I looked in disbelief there was no oxygen flowing. I followed the line. It was lying on the floor disconnected. The all in or out socket had failed. They changed them all. Something similar happened again a year later. Not to me thank God.

Human beings are fallible. Machinery breaks down some times. Death can be a result.

A year after this, a similar event happened to one of my tutors. He was an obsessional keeper of records and checker of machinery. One day, for some reason, he slipped from his usual meticulous behaviour, A patient died. A switch in this case was not fully turned on. The patient was on a closed circuit ventilator with a mechanism for absorbing CO2. The CO2 wasn’t being absorbed. I think this is what it was.

I personally will not have a general anaesthetic unless I have no other option. Yup its super safe these days but…. and bad things seldom happen with everything monitored and alarmed, oxygen, CO2, vital signs etc. But I’d like to know there is a crash team somewhere nearby, just in case.

Obviously this sort of thing happens very rarely and once is too often.To err is human. Anaesthetists get little appreciation. If things go well that is to be expected. if they go wrong it is their fault. I don’t envy anyone in this line of work, They are welcome to it and I am glad some people are willing to take these sort of risk every day and be bored out of their brains at the same time. Good on you and thanks for being around in case I need you.

How long was the oxygen not flowing. I was not with him but I was around the operating table keeping an eye on things. Did someone stand on the oxygen line? How did this happen? Did he have a cardiac arrest? Don’t know for sure. He wasn’t on a heart monitor.

No cartoons for this story.