When I transitioned from holistic medicine to anesthesiology, I felt there was no more radical shift possible. Holistic medicine is a field in which the physician becomes deeply involved in a patient's longitudinal healing process. Such a process unfolds only over time, and the length of that time is never predetermined.
The scope and duration of anesthesiology care, on the other hand, is clearly demarcated. The anesthesiologist assumes control of the patient's most basic life functions and keeps that patient alive and stable for a fixed period, usually no more than a few hours.
The perimeters of anesthesiology are concrete and defined. The practice of anesthesiology is perhaps the clearest and most vivid place to see the immediate interaction of biochemistry, physiology, and pharmacology. In anesthesia, effects and consequences are precisely described, and the physician's mode of response is a page from a textbook.
It was only when I began to immerse myself in the daily practice of administering anesthesia that I appreciated its less tangible aspects. Even as the control and regulation of the autonomic nervous system passes into the hands of the anesthesiologist, there is clearly another process beyond the physical that takes place simultaneously. The patient moves from this world into an etheric realm beyond any operating room (O.R.).
I recently decided to play Gurbani Kirtan (sacred music) in the O.R. during anesthetic inductions. A part of me was hesitant. I was concerned about comments from the staff or assumptions of appropriateness from others, including the patients. However, I followed my heart, and the response to spiritual music in the O.R. was wonderful.
The music I chose contained two pauris (verses) from Japji (Sikh prayer)—the 33rd and the 8th—both ethereally sung by Snatam Kaur. I selected the 33rd pauri because surgical patients often suffer from a lack of acceptance for what they must undergo. Many are deeply resistant to their surgery and its unknown outcome. This peaceful pauri and its invitation to release the ego and return to one’s divinity felt right.
The 8th pauri fosters insight to see beyond and rise above challenge. It is a celebration of listening and internal self-attunement. These two pauris together seemed ideal for the O.R.
The results of introducing the Japji pauris into a dehumanizing situation have been deeply gratifying. First, I am in a peaceful relaxed state from which I can respond rapidly and effectively.
Second, the patients are calmed by the Gurbani Kirtan as it soothes their fears. There is a shift in the patients’ presence as they slip into their own world, bathed in these celestial sounds. Their comments in the moments before the anesthetic takes hold are unlike anything I had been accustomed to. They may talk of prayer or offer a blessing to the staff in the room just before they fall asleep.
During the time that the patient is under the anesthetic, I find myself immersed within their awareness. I want to let them know that I am with them and awake or asleep they are deeply honored and protected by me.
In my experience, anesthesia is not so different from the holistic approach. There are immersion and subtlety in both. And the O.R. staff now request that I play Gurbani Kirtan when I administer anesthesia!