ERAS - Personal Statement

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Anesthesiology is a terrific combination of critical thinking and a large variety of

procedures. The ability to identify a patient’s problem and subsequently fix that problem within
minutes is incredibly satisfying for me.
I experienced a some this feeling during my first clinical rotation on Medicine. One of my
more memorable patients, MR, had been admitted for a new diagnosis of ITP. Her treatment
plan was made more complicated by her history of Diabetes. Every time we increased her dose
of steroids, her blood glucose values would skyrocket out of control. Our treatment regimen of
steroids and IVIG had only increased her platelet count up to 10,000 from an initial
measurement of <2,000. Optimizing her medications was exciting for me, but I found that the
pacing of hospital medicine meant that I could only spend a limited amount of time with MR.
This experience motivated me to pursue a field where I would spend more time providing direct
patient care at the bedside.
My Anesthesia elective followed Internal Medicine. I felt a difference right away. We still
discussed how a patient’s past medical history might affect management but I participated in
procedural medicine as well. Performing my first intubation, I was pretty nervous about getting
everything just right. Was I advancing my Mac blade too far? How much pressure should I apply
when lifting up the blade? I must have seemed nervous, but the attending anesthesiologist was
extremely supportive and had me make the first attempt. Surprisingly, I was able to visualize the
vocal cords and accurately inserted the endotracheal tube. I did have to be reminded to inflate
the cuff. I was extremely happy to have performed that intubation with some assisstance and
was congratulated by my attending. At this point I knew Anesthesiology was high on my list, but
I still had most of my rotations left so I kept an open mind.
Towards the end of my third year I rotated through Surgery. One day I worked with the
urology service to perform right total nephrectomy for possible malignancy. The patient was a
lovely gentleman, DW. I had chatted with DW before the procedure and had the chance to find
out about him and his family. He was understandably nervous about the procedure and the
possibility of cancer. I walked alongside him as we went to the OR, reassured him as final
preparations were made, and while he was being induced. The case went smoothly and
towards the end of the procedure, while we were closing, the anesthesiologist asked us if
anything unusual was happening on our end of the table. The patient’s blood pressures had
fallen precipitously. The anesthesiologist quickly rechecked pressures and the patient’s pulse
before asking for a code to be called. The next minutes felt like hours. The anesthesiologist
asked us to start compressions and I jumped in to help. A stat ECHO was ordered. The
anesthesiologist coordinated everything and ensuring that there was always someone ready to
relieve the person currently giving compressions. Even during this stressful situation, the
anesthesiologist remained calm and proceeded efficiently and effectively. I found that I could
still contribute to the resuscitation effort with a cool head and a sense that we were proceeding
in a controlled and deliberate manner.
The beauty of anesthesiology is that each day is filled with procedures that are critical to
the successful recovery of patients. Many decisions must be made on the spot during surgery,
and the results of these decisions have an immediate impact on patients. I have the clinical
curiosity to pursue complex medical problems but also the desire to provide hands-on, personal
care to my patients in these high-acuity environments which makes Anesthesiology the most
appealing field to me.

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