'Occasionally one complex surgical procedure will take all day'

I am a consultant anaesthetist at the Royal Brompton Hospital, in London.

I anaesthetise patients for heart and lung surgery.

We are a specialist hospital so most of the procedures are major ones, which need to be carried out with an anaesthetised (asleep) patient. It is my role to anaesthetise and look after patients during their surgery.

We use either a combination of intravenous drugs or gaseous agents to ensure that the patient does not wake-up during the operation.

My work is mainly concerned with children having surgery to correct congenital heart disease.

The children range in age from a neonate (new-born) to a sixteen year-old and can have a variety of problems such as hole-in-the heart and abnormalities of heart valves or major blood vessels.

Knowing that parents are happy to continue to entrust you with the care of their child can be very satisfying Dr John Gothard

This is to anaesthetise children for heart surgery. At the most I will undertake take one or two cases a day.

Occasionally one complex surgical procedure will take all day.

Aside from the logistics of working in the modern NHS the hardest thing can be the stress of operating on small babies.

There is a small, but significant mortality associated with this type of surgery, which puts pressure on the medical team, particularly the surgeon. The general public often have unrealistic expectations of 100% success in these situations.

On the other hand even complex procedures become relatively straight forward for a well-trained team and as the babies have serious heart defects they often would not survive without surgical intervention.

You may meet some patients several times as they grow up and perhaps require further surgery.

Knowing that parents are happy to continue to entrust you with the care of their child can be very satisfying.

A young child is anaesthetised prior to surgery

I looked after one patient recently who I had first anaesthetised as a newborn baby 14 years previously.

I think it is reassuring for the patient and parents when there is this type of continuity of care.

Initially I wanted to be a GP.

I did various junior hospital jobs and then did a rotation in anaesthesia.

I realised then that anaesthesia was a very interesting speciality which combines the use of practical clinical skills and the ability to utilise one's knowledge of physiology and pharmacology.

Career prospects in anaesthesia were also very good at the time and I had good chance of getting to the top in the speciality.

Not necessarily.

I think if I had my career again I would choose anaesthesia, on the other hand there are other things I would have liked to have tried as well, perhaps even surgery!

Anaesthetists are doing more and more within the hospital environment.

Apart from providing anaesthesia services in the operating theatre anaesthetists are involved in resuscitation, intensive care, pain relief services and medical management.

We are also involved in transporting seriously ill patients by ambulance, air ambulance and helicopter.

CV - Dr John Gothard

1971: Qualified: St Mary's Hospital, London

1979:Appointed Consultant Anaesthetist, Royal Brompton Hospital

2000: Examiner: Royal College of Anaesthetists

2001:Chairman: Association of Cardiothoracic Anaesthetists (UK)