Going under general anaesthesia is more than just taking a nap, and there is usually only one person standing between you and death's door.
* Anaesthetists do far more than 'put people to sleep'.
* They take complete control of a patient's vital functions during surgery, including breathing, heart rate, blood pressure and biochemical physiology.
* General anaesthesia is remarkably safe in modern medicine, with life-threatening complications occurring in only about 1 in 100 000 healthy patients.
When patients go in for surgery, the last face they see before drifting off isn't the surgeon's - it's their anaesthetist's.
The anaesthetist won't be holding the scalpel, but will be holding something far more important in their hands: the patient's life.
Patients may not remember their anaesthetist, but these are the doctors who keep them alive during surgery.
Most people meet their anaesthetist for the first time only minutes before surgery. They might barely catch the name before their eyes close, but while they drift into controlled unconsciousness, the anaesthetist begins the most demanding work in medicine: guarding their life.
They literally take control of the patient's heartbeat, breathing, biochemical physiology and general safety.
What do anaesthetists actually do?
Most people think anaesthetists "just put people to sleep", but anaesthesia is far more complex. General anaesthesia is a medically induced, reversible coma.
During surgery, the body cannot protect itself. Patients don't breathe, cough, swallow, or respond to pain as they usually would while awake.
Someone must take over those critical life functions. That responsibility lies with the anaesthetist.
The surgeon focuses on the operation. The anaesthetist focuses on keeping the patient alive.
Before patients enter theatre, their safety is already being planned.
General anaesthesia: What happens while you nap
Once patients are wheeled into theatre, anaesthetists attach monitors to their bodies to track heart rate and rhythm, oxygen saturation and blood pressure.
The anaesthetist talks to patients, because this moment may make them feel vulnerable. Surgery gowns don't exactly boost confidence.
The anaesthetist begins the induction of anaesthesia by first giving oxygen via a face mask, then injecting medication into the drip. Within seconds, eyelids get heavy. Patients might hear: "You're doing well, keep breathing..." and then - nothing. Total unconsciousness. No thoughts. No fear. No pain.
A muscle relaxant is then injected into the drip, which completely paralyses every muscle in the body.
A breathing tube or alternative airway device is then inserted, and the patient is connected to a ventilator. This machine temporarily takes over the work of breathing to ensure adequate oxygen and ventilation throughout the procedure.
Surgery begins - the body is now under the anaesthetist's full supervision.
Throughout surgery, machines record information about the body, but the real monitoring is done by the anaesthetist, constantly interpreting these results, adjusting ventilator settings and administering medication appropriately.
Operating theatres are not chaotic. They are carefully choreographed environments. Anaesthetists are trained for worst-case scenarios: airway obstruction, allergic reactions, bleeding and cardiac arrest. They prepare, prevent and, when needed, act in seconds. They are the calm minds in critical moments.
There is a saying in the profession:
After surgery, the anaesthetist reduces the anaesthetic and reverses the muscle relaxants. The patient's breathing returns to normal. When patients open their eyes, the anaesthetist is right there, saying: "You're all done. The surgery went well."
How safe is general anaesthesia in SA?
General anaesthesia today is remarkably safe.
In healthy patients, life-threatening complications are extremely rare (estimated at one in 100 000 cases). Safety depends on the patient's health, the quality of preoperative assessment, equipment availability and the skills of the anaesthetist.
These are temporary and treatable. Honesty during the preoperative medical interview with the anaesthetist helps reduce risk even further.
Recovery matters as much as surgery. Good pain control postoperatively speeds up recovery and reduces complications.
Anaesthetists take it seriously.
A final word to South African patients
In a country where many people fear hospitals, fear pain and fear "not waking up", anaesthetists want to reassure patients: they are there for one purpose - to protect life.
Patients may fall asleep to the sound of monitors. They may never see the anaesthetist's face again after leaving the operating theatre. But, throughout surgery, they are never alone.
Patient and anaesthetist meet as strangers, and within minutes patients trust the anaesthetist with their lives. That's a privilege anaesthetists never take lightly.
Their work happens behind the drapes, behind the machines, behind the scenes - but it matters. Because, while the surgeon performs the operation, the anaesthetist is there to keep patients safe.
Patients may not remember their anaesthetists, but anaesthetists will remember them.