Bulletin 117, September 2019

From the Editor, Dr David Bogod

Welcome to the September issue of the College Bulletin

Much of this month’s edition is given over to the evolution of the Centre for Perioperative Care, hereinafter known as CPOC. This has been a project which has moved smoothly through from conception to completion, with much hard work being done on-stage by Council members and even harder work behind the scenes by College staff. My friend and colleague, Dave Selwyn, has been appointed as CPOC’s inaugural director, and within these pages he describes the task that he and his board face as this collaborative programme gets underway. CPOC could have a major impact on patient safety and the quality of the patient experience, and is a great example of proper multidisciplinary care involving a host of different specialties, including surgery, nursing, physiotherapy and, of course, patients themselves. In years to come, we may well look back at this as the moment that anaesthesia came out of its slightly nerdy and self-regarding shell and explained to the medical world what we do, how we do it, and how important it is.

Elsewhere, we feature an article by Drs Bhandari and Menon, looking at the rather tortuous process which has led to the licensing of cannabinoids in the UK for treatment of specific conditions, and why this does not seem to have produced the flood of prescribing that might reasonably have been expected. As anaesthetists, we are likely to encounter cannabis and its derivatives in two particular areas – chronic pain, and the interaction of these substances with our anaesthetic drugs. The authors draw some caution, quite rightly, from the current opioid dependency crisis affecting many countries, warning us that, once again, there is a risk of a drug embraced as a public benefit leading to unintended consequences.

Those readers with a bit of extra time on their hands, wanting to travel the UK and meet interesting people, should read the interview with Sian Jagger, the College’s Joint Lead Assessor for Advisory Appointment Committees. More AAC assessors are needed to cover the burgeoning number of consultant posts, and this is a great, and relatively painless way, to get involved in the work of your College. The only slight fly in the ointment, as I recall, is trying to find a parking space when you turn up mid-morning in most UK trusts, but you quickly learn to make friends in the Human Resources department with whoever has access to the reserved slots.

Finally, those of a nervous disposition or who have recently eaten may want to avoid Peter Featherstone’s ‘As We Were…’ article, which features one Henry Robert Silvester. Dr Featherstone highlights Silvester’s ingenious 1883 experiment with an inflated dog as a buoyancy aid for the rescue of shipwreck victims, this unlikely device being created with the simple use of (a) one compliant dog, (b) a small sharp knife to effect a subcutaneous puncture and (c) a straw or blowpipe to produce surgical emphysema. Wisely realising that a dog may not always be easy to get hold of in such a situation, Silvester went on to demonstrate that he could turn himself into a human lifeboat by the same method.

The Editor-in-Chief is happy to offer a bottle of finest burgundy to any reader prepared to try this one out and produce photographic evidence to confirm buoyancy.