Teaching novice anaesthetists

An ‘imprecise idea’ about clinical anaesthesia in the general population of healthcare professionals is not just confined to the Indian subcontinent 1. During the past ten years as an anaesthetic consultant, first in the East Midlands, then the South West of England and now the South West of Scotland, I have found many staff to be vague on the objectives of anaesthesia when asked. A need to be unconscious, unaware or pain-free are the common answers. Whilst worthy objectives, I have never felt that they really get to the heart of the matter or cover all of the many areas anaesthesia is practised. A venerable ophthalmologist, lamenting the rise in popularity of orbital blocks, once challenged me: “The problem is that you anaesthetists don't give enough **** anaesthetics any more!” I have always felt he was somewhat missing the point of my endeavours. For some years, I too have used the model of patient, surgeon and anaesthetist with their different hypothetical requirements. However, I use this as a vehicle to introduce the ‘triad of anaesthesia’, as a way into discussing the pharmacology of a balanced general anaesthetic. It is very difficult to sum up what was once called ‘the dark art’ of anaesthesia in any pithy principles, but I too have had good feedback and hope that these might help illuminate some of what we do to the uninitiated.