Physician Outlook

The Hidden World of Anesthesia


An Anesthesiology Resident Explains All

Dr. Nabil Othman is a fourth-year anesthesiology resident at Cedars Sinai Medical Center in Los Angeles, C.A., who recently finished writing his first book, Vigilance: An Anesthesiologist’s Notes on Thriving in Uncertainty. He’ll be graduating from residency at the end of June before beginning a fellowship year in Houston, TX.

Born in Chicago and raised in Michigan, a career in medicine piqued Dr. Nabil Othman’s interest at a young age. In middle school, Dr. Othman spent time helping his grandfather, who elected to manage his heart failure at home instead of pursuing invasive medical treatment. “He elected to have a nurse come to his house and help him during the day and I would help him out in the mornings, and I really enjoyed that,” said Othman.

After finding joy and performing well in his science classes throughout school, Dr. Othman applied to medical programs and soon began to pursue his MD from Wayne State University School of Medicine in Detroit. He first began his career in medicine with an interest in trauma surgery, but realized his third year of medical school it was not what he was looking for.

It wasn’t until his fourth year of medical school that everything clicked for Dr. Othman, when he spent a day with anesthesiologists. “I couldn’t do a formal anesthesiology rotation until after the residency application deadline because I decided late,” said Othman. Although it was risky, he was confident in his backup plan to work in an Intensive Care Unit or critical care if he didn’t end up liking anesthesiology. “Critical care and anesthesia are so similar that the odds of liking both are very high,” said Othman.

Now, in his last year of residency, anesthesiology has become both a career and passion for Dr. Othman. This is what drove him to write Vigilance: An Anesthesiologist’s Notes on Uncertainty. “In almost every other specialty, there’s tangible evidence of what they do, but with anesthesia, you don’t tangibly experience anything,” said Othman.

Beginning to write the book was not an easy or simple process. Dr. Othman had to find both the time to write and words to express what he described as an abstract thinking process that patients will never see. “It’s hard to explain something conceptual that that they patients can never experience,” said Othman. He began the process by reading many books about cognitive psychology, behavioral economics, philosophy of perception, and decision-making and was able to use language from those books and apply it to his own knowledge to put his thoughts into words on paper.

An Opportunity to Write

Cancelled elective procedures as a result of the COVID-19 pandemic provided Dr. Othman with time to work on the book. His workdays were reduced, and Dr. Othman was doing anesthesia all day and writing all night, the pandemic gave him a solid head start. “It took me months of working on end,” said Othman. “I set out to write a book, and I wanted to do it well, writing 1,000- 2,000 words per day.”

Dr. Othman wanted to explain the importance of anesthesiology in medicine. “The things we master in the operating room affects things outside of it too,” said Othman. The years he spent in medical school, as well as his experience in the operating room served as inspiration for the book and drove Dr. Othman’s goal to help others better understand both the processes and passion behind anesthesiology as a profession.

The medical world continues to change and grow with the emergence of advancements in technology. Dr. Othman finds himself continuously impressed and excited about the evolving medical technology industry but does not see anesthesiology being an aspect of medicine that could rely 100 percent on it. ‘Black Swans’ is a term he uses in his book to describe the unpredictable events that occur in anesthesiology.

This unpredictability is why Dr. Othman believes in the necessity of a doctor. “There’s so much that patients don’t know about their medical care. That’s why you have a doctor there – doctors guide the technology and have it do what you need it to do,” said Othman. “It’s changed medicine for the better but it’s not a panacea. You still need experts to understand the technology and know when to use it and when not to use it. You want an expert in your corner to navigate that and give you the best outcome.” 

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