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"This all makes anaesthesia as much art as science"

This is one of the most important parts of the piece. It is something that most people out side of healthcare are not aware.

Anaesthesia is very much an art.

Anaesthesia is unlike other medications, "take xx mg over yy days."

Anaesthesia effects can vary wildly from person to person. Weight plays a big role, but so does bed position, condition, sex, body part etc. There is a variety of confounding factors. There is no textbook dosage for a given situation.

Anecdotally, acknowledging this before any surgery with a simple bedside conversation, may improve outcomes with anaesthesia.

Anaestheologists move from patient to patient quickly. Recognizing how their job is more than just inserting the needle, will make you stand out from other patients.



That's really the case for medication, as well. I wish doctors would be better in this regard and pay more attention to individual needs. I understand that would be more difficult and would likely increase costs, but still.

The way it's done now is as you said, "take x mg at y interval" based on the tests done during drug development. If you don't respond to the medication the same way as the majority, you're in for a ride. If x drug doesn't work, try something else until something works. It's a pretty terrible approach, tbh.

It's rare to find a doctor who will keep in mind the many individual factors, often they have a lot of experience (to build that database of knowledge, which sadly is not shared) and actual interest in their work, a surprisingly rare thing.


That's well said.

Just because it is standard practice doesn't mean its the best approach. Its just the accepted approach.

Nassim Taleb has a quote on the subject that i love:

"The difference between medicine and poison... is dosage"


Nearly 500 years ago, Swiss physician and chemist Paracelsus expressed the basic principle of toxicology: “All things are poison and nothing is without poison; only the dose makes a thing not a poison.”


This is the role of the modern pharmacist in the clinical team.

Nurse is the care expert

Physician is the diagnosis and treatment expert

Pharmacist is the medication expert


Reminds me of this somewhat relevant post about the mysteries of Anesthesia

https://medium.com/@lukehollomon/anesthesia-works-on-plants-...




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