Getting to know Anaesthetist, Dr Stephanie Fischer

Maboneng Heart & Lung Institute
Oct 24, 2017
4 min read

Dr Stephanie Fischer shares with us the teachings she has gathered after 13 years practicing as a consultant anaesthetist in both Cape Town and Johannesburg. Private practice has dominated the last decade of Dr Fischer’s life and the patients she has treated and encountered have taught her profound lessons of life and the substance that lies in human interaction and connection. “Anaesthetics is acute medicine - everything happens fast, that is something I enjoy and find stressful at the same time”. Take a glimpse at what lies behind the learnings and experiences that make up Dr Fischer’s life and fascination with Cardiac Surgery. In her own words: What is the most rewarding part about being an Anaesthetist?

I find patients are more and more aware of the importance of the Anaesthetist in the perioperative setting. It is satisfying when patients feel at ease and place their trust in me and then to have them wake up from major surgery, or even minor surgery, comfortably and hopefully pain free. In the case of paediatric surgery, to be able to hand the child back to the relieved parents.

I enjoy the variety of work that one is exposed to when doing Anaesthetics. We deal with different age groups of patients, with different surgeries and are often involved in the Intensive Care setting too.

Any quality do you believe has served you most profoundly over your career?

I enjoy interacting and working with people. I think what has helped me most is that I like working within a team. Advice would you give to aspiring Anaesthetists? Anaesthetics is a bit of a double edged sword. The patients “belong” to the surgeon and referring physician. As the Anaesthetist your period of interaction with the patient is usually only for the time of surgery and maybe a visit in ICU afterwards. The pro of that is no ward rounds, follow up clinics etc. The con, though, is that your role in the patient management is limited. Credit - and the blame - is commonly accredited to the surgeons. The Anaesthetist forms a far less evident part of the team. I would say as long as you are happy with not being the main player, anaesthetics is a good choice. Any advice you would give specifically to aspiring female doctors? I would say don't worry so much about what is the best choice for a female doctor but rather do what you enjoy. Bar a few, most specialities in medicine are going to interfere with normal life. You will make a plan to make it work. If you weren’t a Doctor, what could you imagine yourself doing? I could see myself doing many other things and being happy, but I am incredibly glad that i studied medicine.

Any aspect of your job that you absolutely love? I work mostly in Cardiac Anaesthetics. Both Adult and Paediatric Cardiac Surgery. Cardiac Surgery is one of those areas in medicine where you really need to approach patient management as a team. I love that about the job. A part of the Cardiac Anaesthetists role is to perform a perioperative echocardiogram (ultrasound of the heart) to confirm the diagnosis and to guide the surgeon when they are doing repairs or to guide drug management when coming off the heart lung machine. Playing this role in theatre is challenging and rewarding as it directly impacts on outcome.

Do you ever feel overcome with a specific emotion when you reflect on the fact that you are able to contribute to extending or giving someone a chance at life that they would not have had without the advancement of medicine?

I see my profession as a skill that I have learnt and try to perform to the best of my abilities - with pride and with humanity. Of course it is incredibly satisfying to see the patients doing well afterwards in ICU after major cardiac surgery and by the same token upsetting if they don't do well. Do different types of surgery require you to adjust the way you work/operate? Paediatric Cardiac Surgery is different to Adult Cardiac Surgery; day case surgery is different to a patient going to ICU afterwards. So yes, adjustments are always required depending on what we are doing. Has your career challenged the way you live life? Ie. has it brought you multiple perspectives about life and death? Can you explain/give an example Life is fragile. That's something we recognize because of our job but also as I’m getting older.

I have worked overseas where resources are extensive and I have spent some time working in a Paediatric Intensive Care Unit. Both these experiences have made me realise how difficult it is to know when persevering with medical management is worse than letting go. I have learnt that it needs to be an open process between doctors and the patient and their family to come to the best solution. None of us have all the answers.

Then the flip side of that is the worry whether it was the best we could do and whether we missed anything or could have done it differently. Any bad outcome will bring all of these questions into play.

Have your patients and experiences taught you anything about people and human connections? Being a doctor puts you in a special place as far as interacting with humanity - patients are in a vulnerable place and therefore interactions are often very real and honest. I appreciate that kind of connection with patients and their families. Has this insight enriched your life and the connections you hold dear?

It has made me realise even more that relations make up the substance of our lives.

Do you have a mantra/saying that you remind yourself of when things get tense in the OR? Not really a mantra. I try and remind myself to stay as calm as possible. Not always that easy! As an Anaesthetist you usually have plan A, B and C ready just in case!

Again it helps if the whole team operates together to solve the problem or crisis - everyone is crucial. Is there anything you still find challenging as an Anesthetist?

Yes, plenty! One never stops learning and it is important to keep growing in your profession.