PUBLIC AWARENESS ABOUT ANAESTHESIA
16TH October 1946 was the landmark event when Dr W.G Morton anaesthetized the 1st patient Mr Gilbert Abbott using Ether. Since then  Anaesthesia as a branch of medicine has rapidly progressed to not only ensuring successful outcome for surgery but also as an Intensivist, Labour analgesia &  a pain consultant.
Public awareness is the general level of understanding about the importance and implications  of our profession be it in the Operation Theatre or outside , it  refers to the important role that community enthusiasm and knowledge has in building sustainable societies. Delivering knowledge to remote communities requires strategies for effective communication.
The available data suggest that speciality of ana­esthesia has not done all that it can to educate the pa­tients in particular and the public at large about the role of an anaesthesiologist. This can be explained by the fact that an anaesthesiologist gets to 'talk' with his pa­tient only during patient's preanaesthetic examination (PAE). Sufficient time should be given during PAE to educate the patient about anaesthesia and the role of anaesthesiologist. PAE is the only point of contact between the Anaesthetist & Patient before actually meeting in the Operation room. It is the right of every patient to  know what to expect once in the operating room, not just for medicolegal reasons but also allay the anxiety and have a relaxed patient before administration of Anaesthesia. Today , we are aware how many of us devote adequate time for PAE especially those in free lance practice.
Even though the first successful patient was operated in 1846 & the first Painless delivery was conducted in 1847 there was no qualified anaesthetist for a very long time and it was surgeons, dentists , midwifes, students or assistants in the O.T administering Ether/ Chloroform  to patients. Dr. (Miss) Rupa Bai Furdoonji was the first lady anaesthetist of the world. She had administered anaesthesia in the British residency hospital (present Sultan Bazaar hospital), Afzalgunz Hospital and Zenana Hospital, Hyderabad, in the years 1889-1917 A.D. . The expertise of Rupa Bai was highly appreciated. She was deputed to Edinburgh-U.K. in 1909 to gain more experience and knowledge about anaesthetics. As there was no separate qualification available in anaesthesia in those days, she obtained Diploma in Physics and Chemistry from Edinburgh University, because the knowledge of these subjects was found useful for the doctors (?) who handled anaesthetics. She had graduated as a HAKEEM in those days & her abilities as a good assistant was picked up by the surgeon and hence sent for training in Anaesthesia. By & by Nurses were being trained to administer ether or chloroform  anaesthesia & the most well known nurse anaesthetist of the nineteenth century, the ‘mother of anesthesia’ was Alice Magaw who in 1906 documented that she had performed more than 14,000 anaesthetics without a single complication attributable to anaesthesia. Launceston General Hospital Training School for Nurses listed ‘Minor Surgery – Anaesthetics’ as a subject in 1904. However, unofficially, in country areas where no other doctor was available, nurses gave anaesthetics under the doctor’s supervision.
In 1914, Dr R.W Hornabrook, Australia’s first full time anaesthetic specialist, had written: “The black list in the nature of deaths arising during operation or following on the faulty administration of anaesthetics is a very large one, it must total hundreds, if not thousands of cases, and it stands as a lasting memorial of which the profession cannot be proud.”
If a nurse could become an anaesthetist, and it required no special skill such as being a doctor for administration, obviously anaesthesia did not have a place in the forward march of medicine. This was at odds with how medical men saw anaesthetics progressing. During the 1st World war, anaesthetics had developed with immense benefit to both patients and surgeons,  while other countries used nurse anaesthetists as a matter of course, and others trained nurses in the latter part of the war, Australia’s medical profession did not support their employment. The key reason was that Australian doctors decided that anaesthetists could only be qualified doctors; and to maintain this status, excluded nurses. In addition, the changing nature of the war, the lack of trained theatre nurses, and the ability to send women further forward may have been contributing factors.
There are many studies that have convincingly proved that in our country knowledge about Anaesthesia is extremely poor & we are thought of as Technicians & not Doctors. Bhool wala  is the  usual mutter amongst relatives when we enter the O.T. Having attended quite a few discussions on how poor an image we have as consultants right from my post graduate days, I have had a varied thought process in my department in BJ Medical College, Pune way back in 1989-90 , and was vociferous about it. The nitty gritties of free lance practice only dawned on me after starting in 1991 and was aghast at working  conditions that prevailed .  Oxygen was a luxury & not a necessity in the O.T. Poor working conditions, lack of proper equipments, absence of monitors, poor remuneration all have an important impact on why Public awareness of Anaesthesia has a very important bearing on our profession. It should be imperative for the patient to decide & choose who, how & why a particular qualified consultant anaesthetist should administer him anaesthesia, just as he chooses his surgeon. Today we all know the importance of increasing the public awareness of our speciality  but very few of us take that extra effort to make our importance felt amongst the patients especially. I feel glad to inform all that last  year as President of our city branch We took a lot of efforts to reach out to the people at large & were  also the proud recipients of the Best branch for Public awareness at ISACON- 2013. I would like to highlight some of the efforts we took & feel very proud that our present president of ISA Dr Chakrarao has taken cognicance of our work & also made a presentation to that effect which has been circulated all round the country.
By highlighting our activities I hope some of you get inspired and even if 1 percent of you take home a few points, it will have served my purpose.
1-Have a grand installation ceremony as office bearers of ISA, call a VIP as your chief guest and publicise the event, we had invited the VC Of Maharashtra University Of Health Sciences.
2- Initiated public projects such as CPR Training for paramedical staff & public at large with publicity.
3-Started our own office & Library to increase comradership amongst ourselves & have regular meetings.
4-Initiated a 4 page  Anaesthesia specific Consent form and standardized notes performa, printed 50, 000 of these for free distribution to all hospitals with  anaesthesia related relevant information.
5-Set up minimum standards for operation theatres and highlight it in the media.
6-Celebrate World Anaesthesia Day enthusiastically using all available platforms in media. We had 20 of us continuousy on the radio, News paper articles & produced  a short movie  that was shown in all Cinemax theatres in Nashik for a whole month, before every show. This clip was also shared on all media platforms available today.
7-Organise major conferences regularly with public awareness exhibitions incorporated .
8-Organised PAINCON taking other associations under our banner probably first time in our country.
9- Designed, Printed & Pasted anaesthesia educative material on posters outside every operation theatre in the city.
10- Standardised Charges for every operation and displayed in waiting room or outside the O.T.
11-Street plays, publishing of booklets/ handouts, car stickers.
12-Most important is having a Anaesthesia Clinic & insisting on PAE for every patient, spending quality time with the patient, can go a long way in increasing awareness about our speciality.
13-Have a common uniform or atleast  wear a  T-shirt with our logo in public places, Branding of our profession.
14-Involve yourself in some social awareness campaigning, social work in helping the down trodden and get public recognition by your good deeds.
These are the points I would like to discuss upon. ISA can play a very major role in increasing awareness of our profession , and I feel more can be done especially for those who are free lancers who I see getting exploited at every level.Just as Rome wasn’t built in a day, our job is as difficult but  If we all take out our cudgels & try improving our work culture, we can definitely let people know more about us.

Dr PANKAJ GUPTA, (M.D) BJMC, PUNE-1990.  EX-PRESIDENT ISA NASHIK-2013-14,
ExPRESIDENT IME NASHIK-2007-08, Founder Chairman-HAL SCHOOL ALUMNI ASSOCIATION,
MEDICAL ADVISOR TO SUPER FIGHT LEAGUE ( Mumbai). http://superfightleague.com/pages/fightersafty