From The Ancient Days: Where Pain was the plan for Anaesthesia to Now: Where Pain is the Lawsuit for the Anaesthetist!

 The history of anaesthesia is a blend of brilliance and accidental discovery—akin to your first time placing a spinal. Weirdly enough, it involved quite a lot of surgeons!

Long before anaesthesia as we know it, the best pain relief options were opium, mandrake root, or good old alcohol. In ancient Egypt, surgeons used poppy extracts; in China, acupuncture might have been the go-to for some relief. Meanwhile, in Europe, you’d be lucky to get a hearty serving of mead before someone started hacking away at your leg. Speed was the motto- hack away, my surgeon, my knight in shining armour, so my pain can later on go away… or more likely, I go away.

In ancient times, surgery was not so much a calculated medical procedure as it was a daring leap of faith with limited understanding of anatomy and a lack of antiseptic practices. Every operation was a risky affair. Death loomed over every incision, turning surgeries into high-stakes gambles for both the surgeons and the patients.

What about anaesthetists/ anaesthesiologists? Well, we were not yet born.

From ancient concoctions like opium and mandrake root to modern techniques, the road to painless surgery was as rough as an awake intubation for a difficult airway.

Who doesn’t remember their first time- all your articles and textbooks depict that ever so smooth procedure with the BIS(simply awareness level monitoring) monitoring and Dexmedetomidine/Remifentanil(Ahemm the good stuff!) infusion in the background and the fibreoptic intubation being a walk in the park.

Well, they so often forget to mention- it is usually the same as trying to push a pill inside your neighbour’s Amstaff mouth. With all the spitting, growling and possibly biting included, it turns out to be a gym session worthy of Ronnie Coleman, where you end up being just as sweaty shoving that tube in that throat as he was squatting to build those huge thighs and going on to winning Mr Olympia eight times! Yeah buddy!! Light weight baby!!

Let’s not forget 1846, when William Morton (Ether Dome event) demonstrated ether anaesthesia, marking the dawn of “sleepy-time science.” Before that, surgeries were more like a ‘Bondage’ scene: lots of screaming, lots of tying the person down and drama with moans and groans. Except here, the pain was not pleasurable- the pain was real. Imagine the level of CRPS, Complex Regional Pain Syndrome, you would have post-someone chopping at you without any form of analgesia or anaesthesia.

Then along came James Simpson, who, in 1847, discovered chloroform’s anaesthetic effects after testing it during a dinner party—because nothing says “fun night” like some weird drug you just discovered. Just imagine: Simpson and his guests inhaling chloroform around the table until they all passed out. When they woke up, they realized they had stumbled upon a potent anaesthetic. Chloroform quickly gained popularity, even becoming Queen Victoria’s choice for pain relief during childbirth.

Note: He was a Scottish Obstetrician. Amazing, isn’t it? A general surgeon once told me, Obstetricians recognise their patients without even looking at their faces. How? Well, think about it. Pretty derogatory you would think if you figured it out. Well, general surgeons and obstetricians are not the best buddies usually.

Anyway, unnecessary knowledge aside: Unfortunately, his legacy hasn’t been passed on to our Obstetricians peers-in-training nowadays, since they so often think ‘It is just a spinal, why is it taking so much time or give Tranexamic acid please (when the patient is bleeding out).’ Yes, my dear Sir/Madam, Tranexamic acid is not a wonder drug- it takes up to 15 minutes for the onset of action, so please, first correct the source of bleeding on your side. Merci beaucoup!

Fast forward to today, where anaesthesia has become a sophisticated balance of pharmacology, physiology, and keeping surgeons humble (Ahemm sarcasm at its finest- humble and surgeon rarely fit in the same sentence). Truly, we’ve come a long way from “bite this leather strap and hope for the best”!

Anaesthesiologist: The modern educated licensed drug dealer with the whole armada of ‘you name it-we have it’ pharmacological agents. The journey from ancient remedies to high-tech precision is as fascinating as it is amusing and sometimes panic-inducing, filled with equal parts ingenuity and chance.

We finetune the depth of unconsciousness, pain relief, and muscle relaxation. Monitoring tools and safety protocols made anaesthesia one of the safest fields in medicine today—though the jokes about “pressing the propofol button too soon” persist.

You are so often labelled as the surgeon’s assistant, sometimes even having their phone on your workstation so you can answer their calls while they are doing their magic and wishing you could just shove that phone in their mouth since it is ringing non-stop for the past hour. Well, someone invented a tiny device- thy name is a Bluetooth earbud. Behold!

Don’t get me wrong, most of us don’t even mind all this. We love the surgeons (Ahemm some of them at least) and we love our job- the specific part where you get the patient to sleep, set up everything including your monitor alarms etc (you don’t want to be caught off guard! Non non Monsieur!)  according to standard ASA protocols and then sit down and just think about life while the surgeon is sweating away at his own miseries.

So next time you induce a patient, take a moment to appreciate the remarkable journey of your profession and the technology at your disposal to, as some patients so often describe it, ‘Kill me and then you will bring me back to life again’. If they think, after all this, they will be making wine from water, well… they had too much to drink before the surgery. Yet if it happens, some will be glad to have a sip, especially if it is as old as around 30 AD, the Cana wedding.

My opinion- Well, get me the flasks, my dear Sir, and I can then just sell it off and work just for the fun of it! ‘Nectar-like well-aged from 30 AD’ wine like that- well, you will wake up every day pondering- And now, what should I do with the money today- A Bugatti, Maserati? Few moments later, you would be humming on the tunes of Britney Spears’s ‘Work Bxxch’. The only thing you would ever need to work for from that whole song is The Hot Body! Like the motto goes- No pain No gain!

If anyone asks you about the history of anaesthesia, just tell them it’s a story of science, courage, and one exceptionally wild dinner party hosted by an Obstetrician! If you are one of those narcissists that need some form of self-validation about how great you are and how life is all about you in the operating theatre- well think of yourself as Lord Tywin Lannister- Hand of three Kings! You are the one that can potentially control the King, you can be the one that can earn insane amounts of gold and money also. (You have no idea who this gentleman is? Dear old Google is here for you. Type away and be amazed at what you missed out on!)

Note to the narcissist reading this- The said Lord also dies with an arrow straight through him, from a crossbow aimed at him by his son, while he is sitting (and shitting) his life away on a glorious morning.

Moral of the story? There is no moral here. Be a good human being if you can, and if you can’t, well… God/ Higher Being has plans for you anyway. Anyway, nowadays- arrows are not the norm. You might end up with your bum looking like a vestigial organ depending on what new toy is aimed at you.

So, be nice. You never know what is lurking down there in the pants of the person you are being mean to (Pun intended).

Ahoy Matey!!!