People who influenced my practice

BMJ 2005; 331 doi: (Published 30 June 2005) Cite this as: BMJ 2005;331:33
  1. John Lunn, retired academic anaesthetist
  1. Chepstow

    Many doctors influence what we do by what they teach us. A few have disproportionate effects because they do not necessarily intend at that moment to instruct. This has happened to me on more than one occasion, and at least one affected my lifetime practice.

    In the days when rigid bronchoscopy was current (the marvels of the flexible instrument had yet to be developed) the late Dr R Machray taught a method, ghastly to contemplate now, of local anaesthesia. He had just supervised my administration of cocaine to a conscious patient. The bronchoscopist, with whom he worked regularly, was Sir Clement Price Thomas, a doyen of both thoracic surgery and of bronchoscopy, who was, I thought, unlikely to need support from a tyro anaesthetist.

    I therefore left the operating room, but Dr Machray hustled me back with his never to be forgotten words, “Make encouraging noises, my boy, make encouraging noises.” From this I learnt that, to be successful with regional anaesthesia in a conscious patient, it is important to maintain contact with the patient, and thus sustain their confidence.

    That lesson is simple and widely practised today. But it was his phraseology that struck me and has never left me since.

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