Department of Anaesthetics Monthly Newsletter D.A.M.N.

Volume 26 No. 05 02 June - 30 June 2014 If you have an article, reference or any newsworthy exposé please forward to Natashia Nzama ([email protected])

WHY DOES ANYONE DECIDE THEY WANT TO

BECOME AN ANAESTHESIOLOGIST?

http://theanesthesiaconsultant.com/2013/0 exciting controlling a patient’s airway, hard for an office doctor to take 9/11/why-does-anyone-decide-they-want- breathing, and circulation. It’s exciting extended time away from their to-become-an-anesthesilogist/ having a patient’s life in your hands. patients. Many patients will find a Published 11 September 2013 Time flies. alternate doctor during a one month Richard Novak, Deputy Chief of 2. Patients like and respect their absence if the original physician is Anesthesia at Stanford University anesthesiologist, and that feels good. unavailable. This aspect of Hospital, the Medical Director at Maybe it’s because we are about to anesthesia is particularly attractive to take each patient’s life into our hands, some female physicians who have Waverley Surgery Center in Palo Alto, California, and a member of the ssociated but during those minutes prior to dual roles as mother and physician, surgery, patients treat and choose to work less than full- Anesthesiologists Medical Group in Palo anesthesiologists very well. I tend to time as an anesthesiologist so they Alto, California. learn more about my patients’ can attend to their children and personal lives, hobbies, and social family. A question anesthesiologists are history in those 10 minutes of 7. Anesthesia is a procedural specialty. commonly asked is, “Why did you conversation prior to surgery than I We work with our hands inserting decide to become an anesthesiologist? ever did in my internal medicine IV’s, breathing tubes, central venous clinic. IV catheters, arterial catheters, spinal Let’s assume a young man or woman 3. An anesthesiologist’s) patients are blocks, epidural blocks, and has the discipline and intellect to unconscious the majority of time. peripheral nerve blocks as needed. attend medical school. Once that Some anesthesiologists are attracted It’s fun to do these procedures. individual gains their M.D. degree, the this aspect. An unconscious patient Historically, procedural specialties they will choose a specialty from a is not complaining. In contrast, try to have been higher paid than long line-up that includes multiple imagine a 50-hour-a-week clinic non=procedural specialties. surgical specialties (general surgery, practice as an internal medicine orthopedics, urology, neurosurgery, doctor, in which every one of your CONDOLENCES cardiac surgery, ophthalmology, patients has a list of medical problems plastic surgery, ear-nose-and-throat they are eager to tell you about. surgery), internal medicine, pediatrics, 4. There is tremendous variety in family practice, dermatology, anesthesia practice. We take care of radiology, invasive radiology, patients ranging in ages from radiation oncology, allergy- newborns to 100-year-olds. We immunology, emergency medicine, anesthetize patients for heart surgery, and anesthesiology. brain surgery, abdominal or chest Why choose anesthesiology? I offer up surgeries, bone and joint surgeries, a list of the reasons individuals like It is with great shock and sadness cosmetic surgery, eye surgery, that we learned of the tragic deaths myself chose this specialty: urological surgery, trauma surgery, and organ transplantation surgery. of twins, Melissa and Geoff 1. Anesthesiologists do acute care Every mother for Cesarean section has Bosenberg. rather than clinic care or chronic an anesthetist, as do mothers for many As the beloved children of Professor care. Some doctors enjoy sitting in vaginal deliveries for childbirth. Adrian Bosenberg and Bev a clinic 40+ hours a week, talking Anesthesiologists run intensive care Bosenberg, we extend our deepest to and listening to patients. Other units and anesthesiologists are medical sympathy to their family. “Prof doctors prefer acute care, where directors of operating rooms as well as Bosie” as he is affectionately known, more exciting things happen pain clinics. is a legend of Paediatric Anaesthesia moment to moment. It’s true that 5. Anesthesiologists work with a lot of surgeons do acute care in the and has inspired many a budding cool gadgets and advanced anaesthetist throughout the world. operating room, but most surgeons technology. The modern anesthesia spend an equal amount of time in workstation is full of computers and Melissa, who qualified as an clinic, seeing patients before and computerized devices we use to anaesthetist at UCT was following in after scheduled surgical monitor patients. The modern her father’s footsteps and had just procedures. Chronic care in clinics anesthesia workstation has parallels to completed a Paediatric Anaesthesia can be emotionally taxing. a commercial aircraft cockpit. fellowship at Great Ormond Street. Ordering diagnostic studies and 6. Lifestyle. We work hard, but if an Melissa and Geoff will be greatly prescribing a variety of pills suits anesthesiologist chooses to take a missed and to Bev and Bosie: You certain M.D.’s, but acute care in month off, he or she can be easily are in our thoughts daily. operating rooms and intensive care replaced during the absence. It’s very units is more stimulating. It’s L Cronje to Scientific Group CMSA CONTACT DETAILS for sponsoring this This is just a quick note to let you know UPCOMING morning’s breakfast. that Anita Walker will be retiring from EVENTS the Colleges of Medicine of SA Congratulations to (CMSA) on Friday 30 May 2014 and STAFFING COMMITTEE Dr Saaliha Goga and this email address will be closed. Date: 01 July 2014 Dr Kim De Please contact either Sharleen Stone Time: 15h00 Vasconcellos on the Venue: IALCH (Seminar room) (her successor) on cmsa- Birth of their baby [email protected] or Antoinette Conning CONSULTANT MEETING boy. on [email protected] Date: 01 July 2014 Time: 16h30 Venue: IALCH (Seminar room) CONSULTANT MEETING The department Please be advised that the consultant COMBINED ACADEMIC would like to say meeting for June has been cancelled. Date: 20 June 2014 Farewell to Sipho Maphumulo and Time: 07h30 The next consultant meeting will be Venue: L5 Lecture Theatre, MS Ayanda Mthethwa who will be Tuesday 1st July 2014. leaving the Department in June.  RESEARCH MEETING We wish them all the best for the Registrar: Gibbs M ADVANCED AIRWAY Registrar: Asmal H for future. WORKSHOP - UPDATED  CLINICAL FORUM SASOS STUDY The Advanced Airway workshop is Topic: MGMH Consultant: Reddy S Proffessor B Biccard would like scheduled as follows: Date: 28 June 2014 (**New Date**) Topic: General to thank everyone in the Consultant: Samuel R department for the tremendous Time: 08h30 – 13h00 Venue: SMART Centre & Anaesthetics  REGISTRAR MEETING contributions you all made during Seminar Room, IALCH the SASOS recruitment week. You Enquiry: Dr R Naidoo - FCA PART II ANAESTHETIC have all certainly contributed [email protected] REFRESHER COURSE significantly to the success of this RSVP: Hannah – [email protected] The FCA Part II Refresher course study in KwaZulu-Natal. NB: Registration is free but limited to will be held as follows: 40 candidates. This workshop is CPD Date: 17 – 21 June 2014 SASA CME DURBAN accredited. Venue: The Colleges of Medicine IALCH of South Africa, Parktown Date: 07 June 2014 AIRWAVES CONGRESS Date: 20 - 23 June 2014 West, JHB Venue: IALCH Enquiries: Mrs Muriel Ndlovu – Venue: Gateway Congress SESSION 1. To register and for more information 011 933 9335/ 07:30 - 08:30 visit: www.airwavescongress.co.za [email protected] Email: [email protected] Register at: REGISTRATION AND TEA Tel: 031 568 1205 or 0 31 563 6804 http://www.joburganaesthesia.co.za 08:00 - 08:30 APPLICATION FORM FOR CPD Points: 26 CPD points for the full course Persistent postsurgical pain - S Bechan STUDY LEAVE WITHIN SA PLEASE NOTE: The Application and 08:30 - 09:00 form for study leave within SA is now 4-6 CPD points per day. Anaesthesia and the Child with a available on the department website. psychiatric diagnosis - G Redfern This form needs to be completed and FCA PART 2 09:00 - 09:30 submitted 3 months in advance. For MOCK OSCE DATES BURNS - N Allorto leave notice please contact Hannah The FCA Part 2 Mock Osce is 09:30 - 10:10 for leave applications. scheduled on the following dates: Anaesthetic Risk, What to tell the Day 1: Fri, 06 June 2014 patient - S Kransingh NOTICE FROM KEH HUMAN 14h00- 17h00 10:10 – 11:00 RESOURCES DEPARTMENT Day 2: Sat, 07 June 2014 SESSSION 2. Attention Registrars: 09h00-16h00 11:00 - 11:30 Registrars completing the programme at Hot off the press: an update on Venue: Medical School Boardroom the end of June 2014 and who are going Enquiries: Dr Nicky Kalafatis– postoperative delerium -E Hodgson to be exiting the registrar programme at [email protected] 11:30 - 12:00 the end of the month in the form of Anaesthesia and the Law - resigning from the public sector or AIRWAVES CONGRESS K Govender transferring to other medical posts in Date: 20 - 23 June 2014 12:00 - 12:20 King Edward Hospital or other Venue: Gateway Congress A Just Price for Specialist Fees?? Institutions must please report to room To register and for more information 31 or 27 in the HR Department at King T Naidoo visit: www.airwavescongress.co.za Edward VIII Hospital by Friday, 20 12:20 - 12:40 Email: [email protected] June 2014. Tel: 031 568 1205 or 031 563 680 Case Discussion - S Sewpersard

CROSSWORD Entertainment WHAT TO WATCH Across Down 4. Maintains grips on higher 1. Injured girl with sword Reviews: plane? (7) (7) Album Review: 8. the United Nations are 2. Lent car for middle (7) still rough (6) 3. Instruct to live as one 9. No amateur temple, but of a pair to advantage? (6) GRACE OF MONACO unconsecrated (7) 5. Hut on wrecked pier 10. Permit Prince Henry to was destroyed (8) be deadly (6) 6. Send over the edge to 11. Not a return for the displease? (6) unmarried (6) 7. Hang loose dunderhead 12. Top marine performer on corner (6) 18. Nude is upset at 13. The Utopain has his telephone call lasting (8) own catalogue of notions 20. Where the screen is for (8) showing, not hiding (6) 14. Inspire the fellow to 21. Maintain it stares around be a burning opponent (7) ’s (6) 15. Disturb it going in an 22. No wonder it’s cheap – entrance (7) ‘’ there can be no profit in it 16. He was pious but (7) unpunctual, and he Putting together Kylie Minogue‘s Genre: Drama 23. Bath, or place in washed his hands (6) 12th studio album Kiss Me Once (is Running time: 1hr 42min Tasmania (6) 17. What the hen pub now out) was, by the singer’s own Starring: Derek Jacobi,Geraldine 24. Hide in part of gave the mendicant? (6) admission, a long, arduous task.n Mediterranean island (7) 19. Firing into the air as a Somerville,Milo Ventimiglia,Nicole result (6) After ending her professional Kidman,Parker Posey,Paz Vega,Robert (Answers on next page) relationship with her longtime Lindsay,Roger Ashton-Griffiths and manager and switching those duties Tim Roth. over to Roc Nation early in 2013, CODEWORD Directed by: Olivier Dahan Minogue spent the better part of a Produced by: Amel Chopra,Pierre- year jetting back and forth from Ange LePogam,Uday Chopra R I C London to Los Angeles to work with Synopsis: a laundry list of writers and For the first two scenes of Olivier H O T producers, some of whom made the final cut for the album (Pharrell, Dahan’s peculiar hagiography of T E E Cutfather, MNEK, Sia, Ariel Princess Grace, the director shoots his Rechtshaid) and some of whom did heroine from the rear. Nicole Kidman manages a serviceable impersonation of not. How many words of four letters or more the former Grace Kelly in these can you make from the letters shown here? Whereas Kylie’s previous album sequences. The hair may not be quite In making a word, each letter may be used Aphrodite had a slick sonic through- right, but she’s recognisably human and once only. Each word must contain the line that ran from beginning to end center letter, and there must be at least one undeniably female. Then Kidman turns nine-letter word in the list. No foreign (thanks to executive producer around and begins to speak.It’s not just words; no words with initial capital, no Stuart Price), Kiss Me Once feels a that the actor’s current face, a sort of hyphenated words. beardless Fu Manchu, doesn’t match bit like a musical smorgasbord, Target: given the variety of both top name with Kelly’s softer, blonder features. Good 32; Very Good 39; Excellent 49. and up and coming musicians She seems to be making no effort involved. Lucky for us, it all pays whatsoever at the nouveau-patrician off in spades. If Kylie had any Pennsylvanian accent. If the film is to be believed, Her Serene Highness sounded, concern that, when all was said and in private, like chief treasurer of the 1 2 3 4 5 6 done, this album Sydney Bridge Circle. would be a bit all over Unfortunately, the film is dragged down 7 8 the place, she needn’t by the writers’ decision to focus on an 9 10 have worried — for incident in Monaco’s history that will while Kiss Me Once bore many viewers and turn a few more isn’t her most cohesive against the supposed heroes. It seems that, in the early 1960s, Charles de 11 12 effort to-date, it’s what many artists can only Gaulle had the nerve to demand that the prince’s subjects pay income tax to the hope for: A solid, feel- French government. A blockade good pop album that 13 14 15 16 developed before, greased by Princess

won’t let you off the Grace’s charm, the larger nation allowed 17 hook without repeat Monaco – less populous than Waterford plays. 18 19 20 21 – to keep hold of its millions. “Business for the sake of business,” Rainier argues in a speech less inspiring than any by Martin Luther King. Le boo! Le boo! 22 23 Still, for all its infelicities, the film does pass one unavoidable test. It is nowhere

near as awful as Oliver Hirschbiegel’s 24 recent Diana. Thank heavens for small

mercies.

CROSSWORD CRITICAL CARE CONGRESS – Across: 4 Upholds; 8 Uneven; INSPIRING ICU 2014

Profane; 10 Lethal; 11 Single; 12 Date: 27-30 November 2014 Venue: Baxter Theatre Centre, Cape Starfish; 18 Enduring; 20 Cinema; 21 Assert; 22 Bargain; 23 Hobart; 24 Town, For more information: Secrete. Critical Care 2014 Congress Down: 1 Cutlass; 2 Central; 3 Behalf; Office 5 Perished; 6 Offend; Dangle; 13 Tel: +27 (0)21 712 0571 Idealist; 14 Fireman; 15 Agitate; 16 Email:critcare2014@eventsmanagements Pilate; 17 Beggar; 19 Upshot. olutions.co.za

CODEWORD NEXT SUPER DAMN Fri, 27 June 2014 Cheerio choir chore coheir cohere coir core cote coterie cotter cottier echo Contributions to: echoer erotic hector hereto heriot hero Ayanda: [email protected] heroic hotter ichor ochre octet other Natashia: [email protected] otic otter recto reecho riot rochet rote Nelly: [email protected] THEORETIC thereto thorite throe tiro tocher torc torch tore tort torte tote tother trio troche trochee troth

7:15 FRIDAY MORNING MEETINGS – L5 LECTURE THEATRE, MEDICAL SCHOOL DATE TOPIC SPEAKER MODERATOR 30 May ICU Triage K Gordon D Muckart 06 Jun Anaesthesia for cleft lip and palate P Govender S Ramcharan 13 Jun Anaesthesia for robotic surgery M Govender L Drummond 20 Jun Combined Academic Meeting: Clinical Forum and Research Meeting

MON 15h00 FCA PART II TUTORIALS IALCH 02 June HAEME 2 2014 DIARY N Kalafatis CLINICALS N Kalafatis/ L Cronje CLINICAL COURSE, DBN: IALCH 15 – 19 September 2014

TUE 11h00 PMMH INTENSIVIST TEACHING PMMH CRITICAL CARE 03 June WARD ROUNDS CONFERENCE: CT 26 - 30 November 2014 WED 07h00 M & M MEETING: KEH KEH 04 June 07h00 M & M MEETING: IALCH IALCH DEPT WEBSITE

http://anaesthetics.ukzn.ac.za/Homepage.aspx 07h00 M & M MEETING: PMMH PMMH

14h30 FCA PART I TUTORIALS IALCH Respiratory mechanics, Control of BIRTHDAYS Respiration, Ventilators, Measurement Pressure and Flow Sunday, 01 June 2014 T Kisten Jonathan Invernizzi, Santosh Pershad THUR 07h15 OBSTETRIC ANAESTHESIA IALCH 05 June Monday, 02 June 2014 How would you manage local anaesthetic toxicity after topping up an epidural for Nokwanda Jaca, Sumesh Kassie caesarean section? Discuss intralipid in detail Tuesday, 03 June 2014 K Naicker Garth Horsten

FRI 07h15 FRIDAY MORNING MEETING: L5, MS Thursday, 05 June 2014 06 June Anaesthesia for cleft lip and Palate Jonathan Handley P Govender Thought for the Day! “Don’t worry about failures, worry about the chances you miss when you don’t even try." Jack Canfield