Anesthesia Arun

Anesthesia Arun

I'm on a flight to Bangalore via Paris. It's been awhile, maybe a year since I've got a blog entry in. Now that I have a girlfriend, Lalitha gets most of my free time, but I sincerely wouldn't want it any other way!
I reconnected with Arun Ganesh after he started anesthesiology residency at UNC. I affectionately nick-named him Anesthesia Arun. We were pretty close childhood friends in West Chester. He had 2 brothers, a big house with a finished basement, lots of toys and Nintendo games, and what seemed like an unlimited supply of energy. Every Sunday, we would often go to his house for Hindu Sunday class. In the mornings we sat through painfully boring lectures and learned Indian bhajans.

Then we would eat lunch and snacks, and run and play. That was by far the best part. His dad got a job in New York, so Anesthesia Arun left when we were about 9 years old. Our parents kept in touch. I heard that he and his brother went off to Ivy League schools. I of course, remained in Cincinnati until I finished med school and realized there wasn't much keeping me there, so it was on to Chapel Hill!

I never saw him again until we were 27. By then he was married to an ophthalmology resident at Duke. We tried to meet up for dinner, but had trouble with our busy schedules. When we passed in the hallway, we'd exchange a warm hello and continue on our way.

One evening, I asked him to hang out and have a beer. He texted me back with "In a kidney transplant, fml." Another evening I texted him to see if we could get dinner, and he responded that his wife just gave birth to a baby boy, Avi. I congratulated him. And then I paused.

We were at two very different points in life. He had a wife and kid and lived in a house in the suburbs. I had only recently started to make time to date again, lived in an apartment with steep student loans, and marriage and kids were barely even in my thought process.

On one instance, I got consulted to see a patient with altered mental status and new strokes who had coded the night before. On reading the chart, I saw that Anesthesia Arun intubated the patient the night before during the code. His work was done, it was a very linear path. I'm sure that my assessment and plan regarding that critically ill patient's altered mental status was not unique. My note probably said altered mental status is likely multifactorial from recent vascular insult. Would recommend considering infectious and metabolic causes and limit sedating medications.

And then I thought, wouldn't it be nice if I were Anesthesia Arun instead of Neurology Arun? It's got to be rewarding to successfully intubated people, place central lines, and do other procedures like epidural blood patches and occasionally place spinal cord stimulators for pain management. Not to mention, he gets to come home to a loving family in a large house, and he would surely land a lucrative job offer as anesthesiology is known to be one of the best life style careers. My dad always wanted me to do anesthesia for that reason. My career choice involved problems which rarely had a quick fix, long call hours, and needy patients who constantly request medication refills and disability forms.

Later towards the end of my residency, Anesthesia Arun and his wife Nisha kindly invited me and Lalitha to their house for lunch. Nisha had made a delicious Indian meal with mango pie for dessert. Their son Avi was adorable and just learning to walk. But Arun and Nia were tired. Anesthesia Arun was doing a pain management fellowship at Wake Forest the next year.

I told him it must be nice to do procedures all day and have virtually no outpatient responsibilities. But Anesthesia Arun told me that after doing procedures all day long you feel like a mechanic. He said that he needed a fellowship so that he'd be able to keep his skill set unique and so that he wouldn't get replaced by a nurse anesthetist. His wife took a job working part time in an ophthalmology private practice group so she could spend time with Avi.

Anesthesia Arun congratulated me for taking a position at a large private practice group in Cincinnati. He told me that I'd have no regrets because extended fellowships would just mean more years where my salary would remain small.

Well to each his own. Maybe the grass is always greener on the other side. Our paths separated and converged again briefly. I hope we meet again. As John Mayer says, "Don't stop this train. Don't for a minute change the place you're in." I know quoting John Mayer is cliché and he can be a dbag sometimes, but I like his music more than a little.