Bulletin 118, November 2019

From the Editor, Dr David Bogod

Welcome to the November issue of the College Bulletin

Back in the mists of the time, I was asked a question during a viva in my Final FRCA (as it then was) which went, as I recall: ‘Why was Dr Guedel riding a woman’s bicycle along Brighton sea front in 1943?’ Questions like these used to mean either that you had already passed or that your performance to date had been so abysmal that all hope was gone. In any event, I never found out any more about Dr Guedel’s obviously chequered life and career, but his airway lives on and, if Dr Harrop-Griffiths is right in his latest Soapbox article, it does so largely in the hands of trainees who like to slot it in as soon as the patient’s eyes close. Is there a relationship between the age of the anaesthetist and the number of Guedel airways he or she uses annually? Does anyone fancy doing the study?

My early trainee years were also marked by completely failed attempts to invent new and better kit. My revolutionary coaxial, switchable Lack-Bain breathing circuit (‘ideal for both the spontaneously breathing and the ventilated patient’) was trumped by Dr Humphrey and his ‘ADE’ system (younger readers will have to look it up). And my brilliant insight that the addition of a third wavelength of light to the newly developed pulse oximeter would allow a beat-to-beat measure of haemoglobin to be displayed was totally ignored for about 10 years until it was introduced de novo by a Japanese manufacturer. It is therefore gratifying to read Dr Young’s guest editorial about the successes of the Clinical Entrepreneur Training Scheme. If only this had been around in the 1980s, you could now all be using the Bogod breathing system, and I could have a little place in the South of France. 

Anne Meaklim, a trainee from Northern Ireland, has gifted us a complex and philosophical piece about how we might better manage ‘fragility’ in our professional development. She questions our reliance on ‘resilience’ – essentially the ability to take the hard knocks of life as a clinician without flinching, and instead proposes the concept of ‘anti-fragility’. The ‘anti-fragile’ individual not only absorbs the slings and arrows of outrageous fortune but also uses them to become more flexible and thus better able to adapt and bounce back from setbacks.

Philosophy being a topic rarely explored in the pages of the Bulletin, the College’s resident brainiac, Professor Jaideep Pandit, has kindly appended a commentary to Anne’s article which seeks to make it more comprehensible to those of us who struggle with the metaphysical. I find it easier, when pushed to my limits, to resort to cliché, on the grounds that nothing can be so complex that it can’t be condensed into a motivational aphorism on the wall of a student’s bedroom. Thus, I am tearing down my metaphorical ‘Bloody but unbowed’ WE Henley poster, and replacing it, much to my own surprise, with Nietsche: ‘What does not kill me, makes me stronger’.

Be strong, readers, and prosper over the festive season!