 Northwest for Thursday afternoon it's John Breslin with you until half past two. Now if you've ever had some surgery or procedure that requires an anesthetic, well you know the drill eventually you're given the count and start at ten and you get to seven or six you're doing well. But what happens from when you conk out and going to La La Land to when you come back again and I can look forward to the tea and toast. Well you know the person that put you on there so to speak and they just wander off and sit on their phone for an hour or two or or what do they do and why are they always asking about when you've eaten and sometimes what you ate. Well there's a new book anyhow that includes details on all of this observations of an anesthetist and it's written by dairy-born Dr Colin Black who is an anesthetist at Crumlin Hospital for children in Dublin and the book well it's serious obviously in the places but also it's very funny in other parts a very honest account of what goes on behind the scenes and I'm delighted now that Colin joins us on the line and we're streaming as well on Facebook. Colin how are you? Hi John thanks very much for inviting me on and very well thank you. Good good good now then what what does happen you I take it that you do actually stick around for the operation. Yeah so contrary to those myths we do actually have to stay there for the entire duration just to make sure that you're okay because our job doesn't finish once we put you off to sleep we have to actually keep you asleep and keep you safe during the operation so the old myth of us just heading off to the office with a copy of the the local paper this is not true there's actually a little bit more to the job than that so that's one of the reasons I wanted to write the book Gas Man was to sort of explain what happens beyond that because most people just meet us for a couple of minutes and they forget the rest but there's more to it than that. The title is Gas Man given that you wanted to initially to become a physiotherapist of our Premier League side you kind of missed a trick you could have called the Theatre of Dreams. That's actually that maybe that's the one for the follow-up that's that's pretty good that's pretty good yeah anyhow you and to start off the process it's about because you know I've had it a few times for various sports injuries and I suppose the the key is putting people at ease you go into that sort of anti-room if you like and yeah and it always seems to be cold in there but it's about putting people at ease and getting them to relax a wee bit. Well it is yeah I mean we try and give people an opportunity to ask us questions beforehand and you know sort of ease their tension a little bit but it's it's often not enough and people are terrified when they come in to see us for for good reason I think because it's it's a very strange scenario you find yourself in when you're used to making all your life decisions by yourself and having control of everything but you now have to I guess relinquish control of your your life to somebody who you've only met very recently so most people are quite nervous about it and then I work exclusively with children so obviously there's the added side of trying to get a child to comply with your whatever silly story I've made up on the day and actually take a mask and fall asleep so there's there's tension in adults but there's often a bit of chaos with with the kids. I can only imagine you know it's one thing to go in for a bit of routine knee surgery it's another thing entirely when it's you know a small child and it's life changing. Well it can be yeah I mean thankfully not every operation we do in a kid is a life and death thing you know they get minor ailments as well so we don't have to deal on it you know every single day with a life and death operation but they do happen most days of the week and it can be tricky you know with with working with kids it's not just the child that you're trying to put at ease or help them relax or help them go asleep it's often the parents that you're working the most to reassure and explain exactly what's going to happen because don't forget this might be the first time they've ever given their child or left their child with somebody that they they don't know so for those bigger operations there's certainly a lot of talking there's a lot of questions and there can be a lot of tears as well sometimes but most parents can keep the tears back until their kid goes asleep and then afterwards when they're unconscious it's it's fair game and the water works off and start which is fine as long as they're trying to remain a little bit stoic for the kid when they're going off asleep it makes my job a little bit easier. Yeah but I'm sure no two cases are the same and it adds another dimension entirely when it's children because you have a parent in the room when they've been put to sleep it's different when it's an adult it's just you and them and you can have that conversation and you can have the standard countdown to walk. Yeah well you can yeah so adults are you know you don't have to discuss your medical information with anyone else besides from yourself so we do have these conversations one on one with with patients in an adult atmosphere and you know sometimes I don't think they've asked all the questions that they want to ask you know they go asleep probably with another 20 questions that they wanted to ask you but when you're putting that moment and you see all the lights and the monitors being attached to your mind can go blank and you just forget what you wanted to ask and just go along with the flow. To me it's a bit like flying in an airplane you know some people get really nervous about flying and you just have to put yourself in the hands of the professionals and you know in in you we trust and and as a result because there's no saying except things cannot change and and therefore you may as well relax what is the point in being stressed? What has happened sometimes? That's true no well that's that's what I try and say to people you know and I'm trained to do this this is literally the only thing I do is look after people when they're asleep so it's like the pilot his only job is to fly the plane and land us you know and you you accept that risk and if you're on a bus the bus driver drives you around you know so if I you know I try and let people look at it that way I guess the only difference between those things and where those analogies fall down a little bit is you don't you're not getting assaulted with a knife from a surgeon when you go and sit on a plane or a bus so that's adds a little bit to it it's funny you mentioned the pilots and the airline industry actually because a lot of their safety data and procedures there's been lots of analogies with that and with anesthesia in terms of checks and all that sort of stuff and taking off and maintenance and landing so that's an analogy that's been made before so although we get a little bit sick of it because you know sometimes we take off with the wings on fire and sometimes there's there's shots being fired at us when we're asleep or when the patient's asleep so it's not quite the same but you know what I'm talking about no absolutely as I said earlier you know no two cases are the same whereas you know plenty of flights can be the same and you what you do in the book is you outline it's real life experiences and it's from from one year so this is real patience although you know you say you've changed names and stuff and and real real colleagues even though this is for the most part very serious there's a lot of lighter moments in there as well well yeah I mean if I wrote a book entirely about serious things or problems with health systems I don't think it would be very readable to be honest it would be pretty dull and like I wanted to get across the fact that you know an operating theater is our it's our workplace you know so I mean you sit in the background and you have the crack with your producers and the other staff we do the exact same thing you know it's we can't be serious and solemn all day every day because you just you'd run out of steam you know so you know I'm very serious when we're in the moment but aside from that that's what I tried to get across is just sort of my observations and things I noticed between interactions with the other staff in the operating theater because I don't think people appreciate just how many other people there are there you know like the other day we anesthetized a five kilo baby for a pretty big operation and there was 20 of us in the room looking after a small baby so you know people may meet an anesthetist and maybe a nurse or two but beyond that they're not sure who's there so I wanted to sort of explain that to people as well and on top of that I've thought you know I wrote it as a first year anesthetist I'm nearly three years into the job now but I also wanted to explain to people that you know demonstrate the consultants while you may be a consultant you know you can still second guess yourself you still ruminate about things so you don't have all the answers just as soon as you walk in the door as a consultant it's a constant learning process and I think that comes across in the book in that I think about things are ruminate quite a lot at the start of the year but I very much relax into the role by the end of it so there's a few facets to the book that I that I wanted to get across and I think I think those sort of things have come across pretty well in a way you sort of you give a lot away and have to in the book and sometimes I think it's a bit like a magician you just don't want to know what's behind the trick and sometimes you don't want to know what goes on yeah a lot of people when they're getting an anesthetic and they're going to put to sleep they have this fear about waking up and is that that's just like that just doesn't happen like because people might have this fear about you know waking up in the middle of an operation and and you know half of their stomachs lying beside them in a tray it doesn't happen it doesn't happen though that's that's great fodder for a horror movie for sure but in reality it doesn't happen I guess theoretically it probably could but if we're doing our jobs properly there's zero percent chance of that and that's that's what most people ask you know I've been asked strange things when people are going off to sleep and commonly it's am I going to wake up in the middle of the operation am I going to die and then sometimes people even ask me if I'm an actual doctor I had one chap who asked me did I have to do a night course to become an anesthetist but I told him I was actually a doctor and was a bit beyond the scope of a six-week night course but yeah on zoom I'm happy enough either way yeah exactly exactly and and do people I mean when you're out you're out you don't do any talking or rambling or do do people you know can you talk like oh god yeah yeah of course you can I mean the communication is a is a big part of the job you know an anesthetist and surgeons you know we've uh we've uh no I meant the patient does it with the patient ever talk like I like you no no no not at all no it's not the same as sleep so you don't you don't talk like that no no your um your brain's switched off you're not you're not doing anything you're perfectly silent yet and every patient is different so you you have to to judge you presume on like their their age and their gender and their their you know height and weight and stuff as to the the amount that you give them is that right yeah exactly yeah so you kind of when we go and meet a patient before an operation we try to you know we go through the list of their medical problems if they have any in their list of their medications and then we look at the operation that's going to happen and we sort of see okay so what's the surgeon going to do and how might that affect the person's overall um physical health and we kind of have to make adjustments based on that in terms of dosages or anesthetic plans or where somebody might go after the operation so we kind of take all those things together and come up with an anesthetic plan so I mean it's all it's all variation on a theme um but there are nuances to it depending on the patient and what operation they're having yeah you you're a specialist in an already sort of a specialist area in that you're you're a special interest in anesthesia for congenital heart disease yeah that's right yeah so you I went to a great Ormond Street hospital in London when I finished my anesthesia training in Ireland and I completed a fellowship in anesthesia for congenital heart disease um so you kind of once you're finished you've sub-specialized within an area and I found all that stuff absolutely fascinating um you've got things that or configurations in your heart that you would never think would be possible to survive with and yet people do and the operations we do for that are pretty unique so I worked over there for a year and a half doing things like heart transplants and various other cardiac operations and then came back to Dublin where we do pretty much all the same things covering the kids in the whole of the country um the only things we don't do are our heart transplants those kids still go to the UK for those but um yeah I found my little niche there and it's absolutely fascinating yeah a great hospital in Great Ormond Street because a sister who started out there did her training there worked there then went off and it was a pediatric nurse elsewhere and is starting back in Great Ormond Street actually in research in January so uh so um I'm not I wouldn't say well familiar with the hospital but most definitely aware of it and the great work that they do and the great work that you do up in Cromland as well and a lot of it is outlined in this book it's called Gas Man and you know some of it obviously very serious but some of it is laugh out loud and people just are going to be amazed by it but it's observations of an anesthetist and it's by Colin Black Dr Colin Black thanks to Millian for joining us lovely thanks for talking to you take it easy