The parental drive to protect your child is passionate, and learning that your child needs surgery is jarring at best and terrifying at worst.  As her guardian and provider, your instinct is to prevent harm to her at all costs, and even if you know that surgery is ultimately in your child’s best interest, the thought of her going through an invasive procedure, combined with the presence of illness or injury, can shake you to the core.

I understand all of this; I am a parent.  I recognize the overwhelmed and terrified look in your eyes as I meet you before your child’s operation.  But, I want you to know that as he undergoes surgery, he will be taken care by someone else who is passionate about protecting him, a pediatric anesthesiologist.  I usually don’t get to meet you in person until the day of surgery.  I only have a few minutes to earn your trust, answer questions, and convey important information about your child’s operative experience.  So, let me take this opportunity to tell you a bit about who I am and why I am so passionate about taking care of your child, before we meet.

I am a doctor.  This may seem basic, but many people do not know that anesthesiologists are physicians.  After medical school and residency, I received specialized training in providing the best care throughout the perioperative period, specifically for children.  Aside from being able to deliver anesthesia, this also involves specific training in diagnosing problems and quickly and effectively managing emergencies when they arise.

I work with your child’s entire health care team.  We frequently do not get to meet until the time of your child’s surgery, and she leaves my care after the operative period.  But, I am still connected to her surgeon, pediatrician, nurse, pharmacist, and respiratory therapist.  My job as an anesthesiologist relies on each of them, and the care that I provide allows these members of the team to have their best success, as well, with all of us working towards the well-being of your child.

My primary job is to protect your child.  Yes, I will be ensuring unconsciousness, proper breathing and circulation, and treating pathology as it arises, but ultimately this can be summarized as providing protection to your child during an extremely vulnerable time period.  General anesthesia renders him unconscious and completely defenseless, to the point of being void of protective reflexes like coughing and blinking.  So, in addition to providing the means for unconsciousness via general anesthesia, I will protect him while he cannot protect himself.  I will stand beside your child each moment that he is asleep, and I will obsess over numbers related to his breathing, heart function, circulation, and temperature.  I will painstakingly arrange each line and monitor so that it does not rest on his skin.  I will use only enough tape to keep important lines and tubes in place, but no more than is needed, because I know how sensitive a child’s skin is.  Also, as a parent, I understand how something that may be relatively small in the large scheme of things, like two IV attempts before a major surgery compared to just one attempt, even if he is unconscious, is major to you.  From big things like hypotension, hypoxia, and anemia, to relatively small things like redness from skin tape and two IV attempts, I will stand beside your child, monitoring, and intervening to prevent them to the best of my ability.

I am not trying to be mean.  If I insist on something that seems harsh or brutal, like having an IV or gastric tube placed before your child is under general anesthesia, please know that I am only doing so because I feel very strongly that it is in the best interest of your child.  I would not do so otherwise.  There are certain times where the risk of losing consciousness without the ability to give IV medicines or with a full stomach is just too great, and the degree of harm that your child could suffer is greater than the discomfort she will feel by having the IV or gastric tube placed while awake.  I know what complications can occur if these things are not taken seriously, and I will do everything in my power to minimize these, even if it seems mean or uncaring.  It actually springs from a great level of care for your child.

Thank you, and thank you again.  I cannot express how honored I am at the privilege of taking care of your child. I understand how your entire world changed the moment he entered your life, and how scary it is to have his health threatened or compromised.  I realize how monumental it is to entrust your child to my care, especially during this extraordinarily unsettling time.  I do not take this privilege lightly, and I am eminently grateful for your trust.

As a field we are not perfect, and no healthcare practitioner is perfect, but I am doing my best.  We have learned a great deal about anesthesia and pediatric physiology over the last 20 years, and we continue to learn as individuals and as a field.  I and my colleagues need to keep working hard to ensure that we provide the best care possible.  We need to keep researching and learning, because work is being done each day to help us know exactly what is best for your child.  It is my responsibility to keep learning, and I am doing the best that I can.

I chose to become a pediatric anesthesiologist because it combines my maternal instinct to protect and nurture with my skills as a physician.  As a parent, I understand how fierce the instinct is to protect your child.  While she is under my care as a pediatric anesthesiologist, I am driven by a similar passion.  I will take care of her as if she is my own – working to protect her and doing my best to minimize the pain, uncertainty, and anxiety inherent in having anything wrong physically, let alone your precious child needing surgery.  I will take care of her as if she is my own, because while she is there in the operating room, she is.

Emily Knipper is a pediatric anesthesiologist.

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