The football “Carniball” is on with all frenzy and all eyes are on Brazil. The world is watching their favorite 2014 Fédération Internationale de Football Association (FIFA) World Cup Football after a long wait of 4 years.[1]It happens every day… in our theatres.The game… surgery.The teams… neuro, uro, ortho, plastic, gastrointestinal, obstetrics and gynecology, dental and many others, alongside the team of anesthetists.The venue…operation theater.The spectators…the world.The stakes… Life, the lives of many.
Game Preparation
Training… structured postgraduate program and continuing medical education.Practice sessions… simulation based training sessions and hands on clinical work under supervision.Mental practice… development of systemic mental imagery that simulates crisis scenarios and builds up sensory and motor skills robustness.Time frame… years.
The Game
The ground rules of the game are strict discipline, unchallenged teamwork and constant 360° monitoring (including audio-visual); and an unblinking eye on the other teammates (cannot term them as opponents). The only way the system works smoothly is because of strict protocols developed by the anesthesia-surgical or the football team. Everyone learns them, practices them and follows them, and does that at all time.Communication is the keyword for a sure shot win. Constant and meaningful communication among the members of the team is very important for a successful outcome.[2] Imagine Lionel Messi taking the ball towards the goal, all by himself without communicating and passing on to the others! Argentina will never let it happen. So is the scene in our theatres. A surgeon, or may be sometimes an anesthetist, cannot sail through any case entirely on his own. Everyone needs a team - a team that works together, a team that understands each other, a team that plays to win. In this issue, Answine and Lamberg have also highlighted the issues of “communication over the drapes, especially for a young anesthesia provider” with respect to administering neuromuscular blocking agents.[3] They have suggested meaningful communication with the surgical colleagues as one of the important points in order to prevent pulmonary complications because of residual neuromuscular blockade. Considering inter-patient variability and inconstant progress of some surgeries, it is imperative to have constant monitoring, clear understanding and good communication with the surgical colleagues.Decision-making is another very crucial aspect that decides the outcome of the game or the surgery, as the case may be. The decision can be deliberate or intuitive, or both; cognitive or emotional, or both. The most crucial decisions usually have to be taken very fast, in a very short time thereby increasing the risks-to-outcome numbers and the scope for errors. We know this and there is an extensive thinking and research dedicated to minimize this “human factor” to the errors made on the field (read “theater”).[4]There are brilliant strokes, there are precise incisions. There are injuries in the game; there are adverse effects of the drugs. There are mistakes, there are drug errors. There are challenges, there are solutions. The game never stops…
The Aim-only Win, No Loss
All the teams sweat for just one thing-the goal, the patient's well-being, his/her life. Loss is unacceptable. The stakes are very high and the training is targeted for the win only.
The Difference
Well, when all is same, something is different. There are no opponents or opposing teams in the theatre (or so we would wish to believe!) and all teams can share the same goal. “We are One” by Pitbull, Jennifer Lopez and Claudia Leitte, the official song of 2014 FIFA World Cup, All in one rhythm™ and “One Love, One Rhythm,” the official album exemplifies it all.The World Cup in the theaters now… the world is watching.