It looks like it’s never going to work – Dr. F has fingers like thick sausages, and he can’t lean any closer into the bed for his belly. “Come here and have a look down,” he says to me, kindly, grandfatherly. I lean in to look down the (apparently hopelessly oversized, and straight-bladed) larngoscope, and amazingly, find a textbook view of the ariepiglottic folds and vocal cords, in a patient who was allegedly a ‘Grade 2’ intubation. He (Dr. F, not my 2-year old patient) smells like a smoker – an anaesthetist who smokes?! He takes the new ET tube and deftly shoves it down the patient’s nostril. This is usually quite tricky, even with adequate KY jelly. “OK. Now you remove the oral tube when I say so.” He gives the signal. I tug on the freed tube, and he pulls the new tube down through the patient’s mouth with miniature Magill’s forceps. There is no way he can see what he is doing, I think to myself. His reading glasses are perched on the tip of his nose – at least he’s remembered those today, the nurse had said to me earlier. “Hmmph.” he snorts,”I’m not sure I saw that go in.” I grab a stethoscope and have a quick listen – excellent air entry on both sides. I say so. Dr. F looks pleased with himself. You can’t beat decades of experience.
I like Dr. F. He’s a proper old-school physician, the sort of consultant who turns up in a shirt and tie (and matching handkerchief) even when you call him in from home at 4 o’clock in the morning. Ketamine (which I’ve decided I quite like – for sedating patients, that is) doesn’t get his approval; he’s always pointing at the vials on the intubation trolleys and shaking his head. He likes thiopentone. He says “the day will come when vecuronium falls out of fashion, too.”