Lost in the Ether: missing perspectives within anaesthesia

In March 2021, the Anaesthesia Heritage Centre undertook an oral history project as part of a wider Equality, Diversity and Inclusion project, which was funded by a Tackling Inequality Grant award from the Association of Independent Museums (supported by Arts Council England).

The Anaesthesia Heritage Centre includes objects, archive documents and library items spanning the history of the profession. It also contains an oral history archive of interviews with anaesthetists, but until now this has not been as representative of the specialty as it should be. The Lost in the Ether project has addressed this by collecting oral histories from female anaesthetists, those from ethnically diverse communities, the LGBTQI+ community and those living with health conditions or impairments.

We published a call to action across social media and NHS staff networks and created a short questionnaire for interested candidates that ensured a broad range of ages, locations, roles, representations, and positive and negative experiences of diversity. Eight people were selected, and between November 2021 to January 2022 Clare Gilliam, freelance oral historian, conducted the interviews.

“As someone without a medical background, my knowledge of the anaesthesia specialty was limited,” says Clare, “and I quickly learned that it extends well beyond the preparation of patients for surgery and includes obstetrics, pain management and intensive care, as well as working with trauma and cardiac arrest teams.”

“What struck me most about all our interviewees was their strong communication skills, their obvious compassion for patients, their self-awareness and their resilience in the face of some pretty tough personal challenges. Professor Andrew Hartle's account of depression following dismissal from the RAF on the grounds of his sexual identity, and Dr Jen Warren's harrowing story of medical negligence (actually within the anaesthesia specialty) resulting in PTSD and lifelong disability, were powerful stories honestly told.”

“As the project progressed, generational differences in attitudes towards discrimination emerged. The two retired consultants, both women, were cohorts at Guy's Hospital during the 1960s when females were very much in the minority. The difficulties of getting promoted did not strike them at the time as a barrier as such, but as patriarchal concern for their welfare. Male consultants told them that the work was unsuitable for women, they would probably want to leave and have babies, they would be 'unwell' once a month. Dr Anna-Maria Rollin did not feel that the unsolicited sexual attention and jokes to which she was subjected amounted to anything other than normal, and therefore acceptable, male behaviour: ‘A lot of them were very flirtatious. But never threatening. It was the way they behaved to young women, you know. It was OK’."

“In contrast, the second youngest interviewee, Dr Becki Taylor- Smith born in 1988, is exasperated when colleagues ask her when she's going to start a family and feels it's an intrusive question. ‘I think we could definitely have more creative conversations that don't centre around the fact that most women will have children and all we must be thinking about is when and how we're going to do that’.”

“Dr Sethina Watson, an anaesthetist in training, is frustrated by the assumption that, as a mother of four children, she doesn't have time to study, she must be less committed and that her CV must be less competitive. Being half Ghanaian, she also experiences both microaggression and overt racism based on her ethnicity, and is often mistaken for a cleaner at the hospital in which she works.”

All three gay men recall feelings of guilt and isolation whilst growing up and pushing themselves academically in order to feel more accepted. They discuss their experiences of toxic masculinity in the operating theatre and the fact that frequent changes in trainee work placements, and their desire to be open about their sexuality, mean that they have to come out to colleagues multiple times. "I'm forever coming out, almost on a weekly basis, because we move so often, you know, we might be in a place for half a year, or a year. And in those placements, you may meet sixty, a hundred colleagues" (Dr Jack Roberts).

The message that comes across in the majority of interviews is that anaesthesia is an inclusive, welcoming, accepting and progressive specialty that values diversity. Three interviewees feel there is still room for improvement. Lack of data about LGBTQI+ staff within the specialty is something that concerns Professor Andrew Hartle: "I think anaesthesia is slightly smug about how equal and diverse it is, with very little hard evidence to suggest that it's actually any better than other specialties." Dr Sethina Watson would like to encourage more black doctors into the specialty: "Patients need a workforce that reflects their society". Dr Jen Warren feels that disabled people are underrepresented across medicine generally: "(Disabled people) are actually really passionate and they're probably the person that you want in that specialty, not the one you want to drive away, but unfortunately society has driven us away in the past. And it's about time that the tables were turned."

The project is already proving its worth. Interview clips were shared on social media throughout LGBT+ History Month, a new booklet for museum visitors includes a QR code linking through to the oral histories on our webpage, and a small pamphlet containing written clips from the interviews was created and disseminated at the Engineering UK’s Big Bang Fair in June 2022. The Anaesthesia Heritage Centre is on a journey to become more representative and inclusive and this is certainly a good start. We hope to make further use of the interviews as we progress with our plans to diversify our audiences though outreach and heritage programming.

Find out more

This article is based on one published in Oral History, the journal of the Oral History Society (2022; 50 Issue 2 Autumn).

Caroline Hamson
Heritage Manager, Anaesthesia Heritage Centre, Association of Anaesthetists

Clare Gilliam
Freelance Oral Historian 

Twitter: @Assoc_Anaes; @Anaes_Heritage