Diary of an Attending Pediatric Anesthesiologist

by Mitchell Phillips, MD & Samantha Gibson

Dr. Mitchell Phillips, MD, is a board-certified pediatric anesthesiologist in Orlando, Florida. Dr. Phillips is passionate about providing high-quality, safe care and positivity for pediatric patients undergoing surgery and their loved ones. Dr. Phillips is a wonderful mentor to medical students and residents alike and is committed to helping trainees reach their full potential. We hope that by sharing his day with the ASA Medical Student Community, more students are inspired to enter the highly fulfilling and engaging field of pediatric anesthesiology. Below, he has kindly let us into a day in his life as a pediatric anesthesiologist.

0545: Alarm goes off. I slip on my bike shorts, say a silent prayer to the weather gods, and quietly tiptoe past the minefield of toddler toys on the way out the door.

0610: Bike commute begins. I am dodging potholes like a Mario Kart boss while mentally reviewing today’s OR schedule. Debating whether the 6-month-old with a URI sounds more like a rhinovirus or allergies...

0630: Arrive at the hospital sweaty, drop my bag in the call room, change into scrubs, and grab an aggressively large hospital coffee. 

0700: Pre-op time. First patient is a 2-year-old who instantly recognizes me as the enemy. I smile and offer her a cotton candy scented mask.

0730: First case starts, which is a myringotomy and tube under general anesthesia because children cannot lie still unless unconscious or bribed with the promise of unlimited Paw Patrol. 

0750: Next case is a tonsillectomy and adenoidectomy. Surgeon asks for deep extubation. I nod and pretend like I haven’t been burned before. The child emerges beautifully… then coughs once, twice, thrice. I feel a drop of sweat run down my back. Surgeon gives me that look. I give positive pressure like I’m trying to win an Olympic medal.

1200: Lunchtime. I scarf down a protein bar and a salad. I try to meditate for 3 minutes in the call room before getting called back for a sedated PICC in a 7-year-old who’s already scared off three nurses. I respect his commitment.

1600: Final case of the day is general anesthesia for an inguinal hernia repair in a preemie. I perform my pre-op huddle with surgical, nursing, and NICU team. Everyone nods. I feel calm. I love my job. The case goes smoothly. I text my spouse that I'm a genius and to hold dinner.

1700: I bike home. The adrenaline rush fades, but endorphins kick in. The climb up the final hill reminds me I’m not as invincible as I felt a minute ago.

1730: My sweet toddler greets me as if I have returned from war. We build a tower out of Mega Bloks. He knocks it over. I pretend to cry. He laughs maniacally.

1830: Peloton time. The instructor shouts at me through the screen, and I shout back.

1930: Dinner time. My toddler eats four grapes and one bite of a chicken nugget. I eat cold leftovers and a slice of humility. We read a bedtime story about trucks for the hundredth time, but he’s still mesmerized, like it’s the first. It will always be endearing how his eyes are glued to the page, as if he has not seen these pages or heard these words dozens of times.

2030: Finally on the couch. TV on. Brain off.

2100: I pass out. Another day of keeping tiny humans asleep and safe.

30 more years of this, and I’d still do it all over again.

Given that many medical students do not get the opportunity to rotate through the field of anesthesiology, let alone pediatric anesthesiology, we thought sharing a day in the life could provide value and pull back the curtain of the field of pediatric anesthesiology for other medical students. As a medical student interested in pursuing pediatric anesthesiology, Dr. Mitchell’s day makes me feel excited and inspired. For one, I am drawn to the opportunity to both strengthen my skills and think critically, taking into account the diversity in patients’ personalities, families, histories, and presenting medical and anesthetic concerns. The pediatric world is one of innocence, magic, and intellectual stimulation, from the tiny neonate undergoing neurosurgery to the teenager undergoing orthopedic surgery for sports injury from the ED. In my experience, pediatric anesthesiologists are very happy, fulfilled, and inspiring. Having rotated through pediatric anesthesiology and worked with Dr. Philips, not only was he an amazing teacher, but he also genuinely enjoys his career. This experience reaffirmed my passion for helping our pediatric patients and their families through their scariest and most vulnerable moments while getting to learn critical physiology and pharmacology to keep them safe. In all, it is important to seek out exposure to both the field of anesthesiology and its subspecialties, given the challenges in exposure in some medical school settings. Hopefully, you will enjoy it as much as I have.