Dr Anthony Singh – Last night a DJ saved my life

Surgery is a lot more common than it once was. Modern medicine has found ways to make previously inoperable conditions operable, and elective cosmetic surgeries are no longer reserved for the wealthiest or the vainest.

Of course, major surgeries require keeping patients sedated through the use of general anesthesia, all initiated under the planning and supervision of an Anesthesiologist. It’s a vital role, one often overlooked by outside observers, and even by the patients themselves. Anesthesiologists, by the very nature of their services, are almost never the primary physician a patient will speak with – they are there to support the surgery, not conduct it.

“We are medical specialists, with many years of training, but we have traditionally been accustomed to remaining in the background,” says Dr. Anthony Singh, a Melbourne anesthesiologist who’s been practicing for over 20 years.

Reducing the stress of a high-pressure environment

Playing a “background” role involves no less pressure than the lead surgeon, and how to reduce stress on surgeons and anesthesiologists during lengthy high-risk procedures has been of interest to Dr Singh for more than a decade. One powerful way, he says, is to introduce background music into the operating room.

At St. Vincent’s Hospital in Melbourne, Dr Singh has forged an unusual musical collaboration with Dr. Ramin Shayan, a popular plastic surgeon – and scientific researcher – who’s made it his own mission to make patients more comfortable during surgery.

Drawing on their shared love of popular music, the two physicians have designed special song playlists with soothing rhythms and tones guaranteed to bliss out even the most-anxiety-ridden patients during their surgery.

Dr Singh says he and Shayan introduce music at the outset of the operation to set a certain mood, and then move through a sequence of different songs – often from completely different musical genres – as the surgery develops.

“We have been likened to operating room DJs,” Dr Singh says. “We’re using music to try to get everyone in the room to focus and move to the same rhythm. But safety is paramount, and the music is strictly background.”

Music’s especially helpful during the most critical parts of an operation, including high-stress and unpredictable “micro-surgical” procedures that can make the difference between success or failure, Dr Singh says.

One example?  “Say there’s a blood vessel that Ramin’s trying to connect with tissue that’s had previous radiotherapy. It’s very fragile, and the patient may also have some clotting problems,” Dr Singh says.

“When Ramin’s succeeded, the clamps are released and the blood flows across the patient’s body into this bit of tissue, which starts to bleed and pink up.  So, I might put the first part of ‘Back in Black’ on,” Dr Singh says. [The song has a steady uplifting beat that’s infectious.

“It’s a sign that we’re back in the groove and can relax a bit.”

Choosing the playlist comes naturally to the two doctors, says Dr Singh’s anaesthetic nurse. “It’s great for the staff and for the patients.”

“It’s an intuitive, passive process for the most part,” Dr Singh says. “For operations where the patient is lightly sedated, we choose music with a beat and a rhythm that the patient can focus on to distract them from the stress of the surgery.  Of course, we avoid songs with lyrics that might offend or agitate someone.”

And how do their patients react?   “They’re calmer, more relaxed, and less anxious. They perspire less. And we often see the positive effects in their blood pressure levels and other vital signs,” Dr Singh says.

As with all medical procedures, there are inherent risks with general anesthesia, especially for patients with pre-existing health conditions such as heart disease and diabetes. Minimizing that risk starts well before the surgery – with the anesthesiologist assessing the all variables that are specific to each patient. They will also be stationed in the operating room monitoring the patient’s vital signs every step of the way, and responding quickly in case of an emergency.

Dr Singh’s practice varies widely depending on the needs of area hospitals. One day he might be assisting a reconstructive plastic surgeon, another day a doctor tending to a patient with multiple injuries from a car accident, another day a cancer patient in critical care.

“Regardless of the patient or the type of operation, there’s an extraordinary degree of care and attention involved,” Dr Singh notes. “Anaesthesia, administered properly, is very safe. You have to administer medications in precise dosages, at the proper intervals, and closely monitor patient vital signs during the surgery.”

The role of an anesthesiologist is most important when the patient receives general anesthesia, which is common for complex procedures involving major organs, such as cardiovascular surgery. If the patient is advanced in age, is a smoker, and already has a history of heart trouble, the risks of complications multiply, Dr Singh says.

“I always try to project a calm atmosphere, because everyone in the room is counting on me. But there’s no cause for panic during an emergency if you’re prepared.”

– Dr Anthony Singh