Bulletin 128, July 2021

From the Editor, Dr Helgi Johannsson

Welcome to the July edition of the Bulletin, and I hope you’re enjoying the summer as we are (hopefully) emerging further from lockdown and enjoying a few more freedoms. The spring has been eventful for anaesthetists throughout the UK. After dealing with the surge earlier this year, we are now realising quite how colossal will be the task of returning the NHS to providing an efficient service for the people of the UK. We still harbour the fear of a third wave in which we will again have to expand our critical care capacity, while many of us (including me) haven’t quite reached an even emotional keel after the experiences of the winter.

The last year has brought many inequalities to the forefront, with discussions on race, economic deprivation, and everyday sexism. After the murder of Sarah Everard many of my female friends and colleagues talked openly about the discrimination they face every day, both overt abuse and very subtle innuendo. In this issue I am pleased to introduce Dr Rebecca Barker, who writes eloquently about the challenges women face in the workplace, and I hope this will spark further discussions and a real change in attitudes (page 14).

In my last editorial I touched on how the career progression of our anaesthetists in training has been devastated by the COVID-19 pandemic, and this was certainly borne out in the ST3 recruitment round in May, where more doctors than ever were unable to secure a post. I am glad to read the message of support from Professor Ravi Mahajan in his last President’s View (page 4), and I want to thank him here for his support and vision through his presidency. We will be welcoming Dr Fiona Donald to the post of president in September, and I know she will continue the College’s campaign to increase training capacity and ensure those who were unable to secure an official training post can still make their experience count towards their training, or a CESR equivalence.

Our anaesthetists in training and SAS members have taken a big hit during the pandemic and worked hard, intensive shift patterns – with the exhaustion that comes with it. I urge you to read my colleague and mentor Professor Harrop-Griffiths’s piece Forty Years On (page 40), in which he describes accurately the misery of 56-hour shifts where he was paid less than the cook serving his food in the canteen. Although things were beginning to improve in my training, I certainly remember the sheer exhaustion you felt on a Sunday afternoon when you still had another 24 hours to go. Things really weren’t better in the old days, and no one should be asked to work like that.

Hospitals produce a lot of waste, and the operating theatres have embraced a culture of disposables with open arms. Gone are the reusable gowns, reusable laryngeal mask airways (which were really good, I do miss them), and instead even a minor operation now produces two to three rubbish bags’ worth of waste. The environmental impact of anaesthesia is also extremely large, with the anaesthetic gases at the forefront of pollution (page 38). I am slowly moving to TIVA for many of my cases and have given up desflurane entirely; I hope our eco-friendly agenda will continue a pace.

I am proud of this issue and hope you find it an interesting read. In the meanwhile I hope we continue to experience a low transmission rate, and I look forward to a day when I can see my colleagues and patients not just smile with their eyes, but with their whole face.