Anaesthetists and Wicket Keepers. ‘They Field.’ One Could Say Much the Same of Many Anaesthetists

On reflection Postgrad Med J: first published as 10.1136/postgradmedj-2021-140211 on 20 May 2021. Downloaded from unobtrusive’ and ‘lift the side in the Anaesthetists and wicket keepers. ‘They field.’ One could say much the same of many anaesthetists. also serve who only stand and wait’ I haven’t come across any system- atic research into the personalities and John Launer behaviour of wicket-keepers but, as one might expect, a reasonable amount has been carried out on anaesthetists.5 The greatest English cricket captain of was going, and his characteristic style Unsurprisingly, the more successful the last fifty years is generally reckoned of captaincy based on bringing out the members of their profession seem 1 to be Mike Brearley. He led England in best in others rather than showmanship. to demonstrate greater detachment, 31 international test matches, winning I have been lucky enough to meet mental quickness, drive and determi- 18 of them and losing only four, a Mike Brearley in person on two occa- nation, stability, high standards, self- record that no- one has ever exceeded. sions, more than fifty years apart. The sufficiency, openness and self-control. 6 He famously returned from retirement first was as a teenager at a county match Patients would also probably find it to lead his country to victory in the at Lord’s cricket ground in London: I comforting that experienced anaesthe- 1981 match series against Australia, timidly asked for his autograph as he tists are more inclined to avoid harm turning the result around from one that emerged from the back of the pavilion and risk, and are less novelty-seeking seemed beyond rescue. It made him a during lunch. The second time was at a than the general population, as well national hero even to those who barely dinner he hosted only a few years ago. as being reflective, frugal, orderly and followed the sport. His fame as a crick- He had become a distinguished psycho- regimented.7 The other side of this eter was in many ways unusual. He did analyst and a past president of the reassuring picture is that boredom is not play for England until he was 34 British Psychoanalytical Society. I was a continual occupational hazard, with years old, having taken time out for his the society’s guest speaker that evening many anaesthetists having to do repeti- other occupation as a university lecturer and felt a little less timid than I had in tive tasks day and in and day out, espe- in philosophy. His record as a batsman my teens. I could now observe at first cially during ‘endless “cold” lists on was modest, with an average test match hand his ease with other people. It was straightforward patients’.8 score of 23, less than half that of his then that a chain of associations led me There do not seem to be any direct contemporary Geoffrey Boycott. He to think of the comparison between studies of anaesthetists’ leadership roles never bowled at international level. He wicket keepers – especially the more and how they exercise these, although was lucky in the talents of his team self- effacing kind – and anaesthetists. the literature on anaesthetic training mates and the circumstances in which emphasises the need for ‘non- technical’ he found himself. Almost uniquely MOVEMENT AND MOOD skills in areas such as situational aware- among cricketers, Brearley’s genius was I was doing quite a lot of educational ness, teamworking and managing stress for captaincy itself. According to one work with anaesthetists around that and fatigue.9 It also advises seniors biography, he had ‘a brain simmering time, which is no doubt why I made to impart their tacit knowledge and with cricketing intelligence and a mind the connection. This work included 2 to harness the ‘informal curriculum’, adroit in reading situations.’ He could watching their interactional skills whereby trainees often learn more by http://pmj.bmj.com/ win matches with ‘tactics and strategy in operating theatres and in breaks seeing good role models and having alone.’ between operations. I also had some opportunistic conversations than In his formative years as a sportsman, experience of training them in super- through direct instruction.10 Brearley played for a while as wicket vising juniors. Contrary to the joke keeper for Cambridge University. The among other doctors that anaesthetists role of wicket keeper is similar to being are better at talking with people who BEWARE OF THE SPECTACULAR a catcher in baseball, and not usually are unconscious, I observed how well I would love to know whether profes- on September 26, 2021 by guest. Protected copyright. associated with charisma or conven- many of them were able to tune into sional wicket-keepers would recognise tional leadership. It requires standing others’ words and concerns. I noted themselves in these findings as well, but on the same spot, often for hours on their precise attentiveness to movement I guess that many would. I suspect they end, without losing concentration for and to mood, and an ability to recali- also might appreciate the following a moment, but ready to capitalise on brate their responses in an instant when down- to- earth advice to his colleagues any misstep by an opposing player. One the atmosphere turned from calm to from Italian anaesthetist Bruno Simini, writer has described how ‘the game crisis. I saw how the way they could if suitably adapted for a cricket: ‘Beware continually circulates the ball through commonly influence others, including of the spectacular, gesticulate medicine the keeper like blood through the surgeons with generally bigger egos, poured out by the media; take heed heart… as if the keeper were really the and modulate the emotional atmo- of inveterate dogma; come not near ball’s home, the place to which it always sphere around them. It occurred to me industry representatives; have an eye to 3 returns.’ The experience may have that much of their work – and indeed managers; trust not the voice of profit, helped Brearley develop his powers of the lives of others – depended on this mark well disenchantment; politicians detailed observation of the way a match same kind of attunement, whether to love thee not’.11 I have little doubt that the patient’s skin pallor and respira- both professions would relate strongly Associate Editor, Postgraduate Medical Journal, London, tory rate, or the scrub nurse’s level of to the closing lines of a well-known UK anxiety. Good wicket keepers, Brearley sonnet by the seventeenth century Correspondence to Dr John Launer, London, UK; has written ‘remain poised and ready to poet John Milton, ‘On his blindness’. johnlauner@ aol. com go either way’.4 They are ‘deft, shrewd, Contrasting the limitations of his own Launer J. Postgrad Med J June 2021 Vol 97 No 1148 407 On reflection Postgrad Med J: first published as 10.1136/postgradmedj-2021-140211 on 20 May 2021. Downloaded from life as an immobile writer with others Patient consent for publication Not required. letter- to- the- art- of- wicketkeeping- 1210430 [Accessed 21 Mar 2021]. who led busy lives of frenetic activity, Provenance and peer review Not commissioned; he consoled himself that he could serve internally peer reviewed. 4 Brearley M. On cricket. London: Constable, 2018. 5 Galea M, Tooze A, Smith AF. Anaesthetic risk: analysis his creator just as well without this. As © Author(s) (or their employer(s)) 2021. No and reassurance. Clin Risk 2004;10:92–6. he wrote: commercial re-use . See rights and permissions. 6 Reeve P. Selection of anaesthetists: Is there a better Published by BMJ. method? In: Lunn JN, ed. Quality of care in anaesthetic God doth not need practice. London: Royal Society of Medicine, Either man’s work or his own gifts: who 1984: 231–63. best 7 Kluger MT, Laidlaw TM, Kruger N, et al. Personality Bear his mild yoke, they serve him best. To cite Launer J. Postgrad Med J 2021;97:407–408. traits of anaesthetists and physicians: an evaluation His state using the Cloninger temperament and character Is kingly; thousands at his bidding speed Postgrad Med J 2021;97:407–408. inventory (TCI-125). Anaesthesia 1999;54:926–35. And post o'er land and ocean without rest: doi:10.1136/postgradmedj-2021-140211 8 Brine P. Presidential address. anaesthesia and the They also serve who only stand and wait.12 anaesthetist: status, boredom and safety. Anaesth ORCID iD Intensive Care 1979;7:109–13. John Launer http:// orcid. org/ 0000- 0003- 3833- 9352 9 Flin R, Patey R, Glavin R, et al. Anaesthetists’ non- Twitter John Launer @JohnLauner technical skills. Br J Anaesth 2010;105:38–44. Acknowledgements I am grateful to Mike Brearley REFERENCES 10 Smith AF. Reaching the parts that are hard to reach: for comments on an earlier draft of this article, and to 1 Chandler M. Mike Brearley – England’s greatest expanding the scope of professional education in Professor Andy Smith and Professor Steve Yentis for captain? Available: http://www. cricketweb. net/ mike- anaesthesia. Br J Anaesth 2007;99:453–6. advice based on their anaesthetic expertise. brearley- englands- greatest- captain/ [Accessed 21 Mar 11 Simini B. The two pillars of anaesthesia. Lancet 2021]. 1999;354 Suppl:SIV6. Funding The authors have not declared a specific 2 Brearley M. Available: https://www. cricketcountry. com/ 12 Milton J. Sonnet 19: when I consider how my light is grant for this research from any funding agency in the players/mik e-brearley/ [Accessed 21 Mar 2021]. spent. Available: https://www. poetryfoundation. org/ public, commercial or not-for -profit sectors. 3 Fiennes W. A love letter to the art of wicket-k eeping.

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