I returned to work as a disabled anaesthetist | Association of Anaesthetists

I returned to work as a disabled anaesthetist

I returned to work as a disabled anaesthetist

This article was adapted from Anaesthesia News, March 2011.

After changing into theatre scrubs, another day of anaesthetic work ahead of me, I go to the anaesthetic room to start preparing my drugs. Not too long ago, all this looked impossible. Five years ago, I awoke at around 4:00 on a Sunday morning feeling uncomfortable. I had good reason, because I could not move the right side of my body. About to turn 40 years of age, I had no risk factors for ischaemic stroke, so it had to be an intracranial bleed, but the absence of the typical splitting headache was puzzling. 

Whilst the doctor in me was carefully considering the differential diagnosis, my scared, but more practical self, woke my husband, and told him to call an ambulance. 

As my level of consciousness rapidly deteriorated, I was spared the memory of the headache and sickness that terrified my children. My self-diagnosis was, indeed, correct. After I was rushed to the nearest hospital with a Glasgow Coma Score of 3/4, a CT scan confirmed a subarachnoid haemorrhage. I ended up with a burr hole occupying a neurosurgical intensive care bed. 

After a successful operation, apparently evident from the neurosurgeon’s grin, I was wheeled from theatre back to the intensive care unit, where I would wake up again as the same, and yet an altogether different, person.

Is she fit to work? 

I had previously moved from Italy, with my husband and two kids, to take up a substantive consultant post in London. 18 months later, I (the main breadwinner) was in a wheelchair, and four months after the bleed, was still a hospital inpatient receiving intensive physiotherapy. Desperate as I was to get back to work, I did not know whether I would be physically and, perhaps more important, mentally fit to practise anaesthesia ever again. 

Going back to work was easier said than done.

My starting point on the road back to work was a visit from the hospital’s head of occupational health, who chatted with me for about an hour. She listened to me, an anaesthetist sitting in a wheelchair, and one who wanted to return to work. Then a little miracle happened. Instead of declaring me insane, she suggested that I should start with a cognitive assessment following discharge. 

Two sessions of cognitive function tests followed. Performing them early in the wake of a neurological life threatening event, and a five-month, mind-annihilating hospital stay, was certainly less than ideal. 

However, an unequivocally clean bill of cognitive ability was an essential first step, and I was determined to undergo the tests as soon as seemed reasonable. What in other circumstances could have been an entertaining exercise was anxiety laden, a nightmare where you have lost your identity badge and have to convince some stranger that you are, in fact, who you say you are. I was relieved, more than proud, to be fully cleared – only to learn that there was uncertainty about the route back to work. 

On the right foot

Going back to work was easier said than done. Despite my certified cognitive fitness, my intention must have appeared a little unrealistic to anyone watching me walk awkwardly with my Zimmer frame. However, my perseverance in nagging some open-minded colleagues in key roles, led to the discovery that the London Deanery could fund my retraining for a period of six months. 

My physiotherapists kept working quietly in the background, relentlessly pushing the boundaries of my capabilities further. Those extraordinary people never promised miracles, but saw potential in my crippled leg and spastic arm. They were investing in me, with their dedication and unshakable optimism, and I paid them back with commitment and hard work. After the Zimmer frame, I had to juggle two sticks, something I have to admit that I never quite mastered. Then there was just one, and eventually I could walk unaided, at least on even ground.

With a phased comeback to clinical activity, finally I was ready for the anaesthetic room, although now in my habitual standing position. 

I was determined to show that I could be a reliable anaesthetist again, and not to be put off by the aura of scepticism I inevitably sensed at times.

However, I was in for another surprise when I started to gauge the real impact of my disability on my day-to-day working life. Complex anaesthetic skills actually could be delivered with minimal or no adaptations, whereas trivial physical tasks, like negotiating my position at induction, had to be planned ahead. I wondered whether my supervisors would tune in, or keep worrying about logistics that, in fact, represented no problem to me. Or was I so blinded by my resolve that I would not see the impact of my disability on my performance? The whole matter could only work with mutual trust. I needed fair and unprejudiced allies who shared my vision – or, indeed, my folly. Overall, I learned to work around the adaptations needed, fortunately only a few, by being honest about my new limitations. 

As an anaesthetist with patient safety at heart, it was business as usual for me. I was determined to show that I could be a reliable anaesthetist again, and not to be put off by the aura of scepticism I inevitably sensed at times.

Dr Fossati is a consultant anaesthetist at St George’s Hospital. 

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