Evan Koch, CRNA, MSN
CRNA Since 1988
I first learned of nurse anesthesia on a hot summer evening in 1976. My roommate developed a stomach ache that would not go away. Then her temperature rose and she became nauseated. After a few hours I took her to a small nearby hospital. She was quickly diagnosed with appendicitis and scheduled for emergency surgery.
Fool that I was, I asked to observe the operation. Fools that they were, they allowed me in. I can clearly recall the sight of her head slumping as the pentothal took effect. My knees went weak at the thought that I might never see her again, but I managed to remain upright. All went well, and after the procedure, the woman at the head of the table wheeled my roommate on a gurney into a recovery area. I timidly followed.
“Are you an anesthesiologist” I asked?
Without skipping a beat, without looking up from her chart, and in a voice that made my knees shake all over again, she replied: “I’m a NURSE ANESTHETIST!” Her name was Eileen Tipaldi, and I am more than glad to remember her here. May her soul rest in peace.
Three or four years passed, I finished nursing school, and found work as a research associate in the Department of Anesthesiology at the University of California under Michael Cahalan and Edmond Eger, two anesthesiologists for whom I had the greatest respect. My job was to cajole residents and CRNAs into allowing me to randomly assign their patients to receive one of four different anesthetics: halothane, isoflurane, enflurane, or nitrous-oxide/narcotic. Together with another nurse research associate, I gathered outcomes on thousands of anesthetics. Principle investigators at ten participating hospitals then compared them. (Come to think of it, I wonder whatever became of that data?) At any rate, the job was self-limited. Not long before it ended, a CRNA named Brent Sommer ushered me to a payphone, inserted 35 cents, and dialed up John Garde, the executive director of the AANA. Brent spoke to John like he was a friend, and said (and this I also vividly recall): “John, I’ve got a live one here.”
On my final day at UC, I purchased a copy of Dr. Eger’s seminal book, Anesthetic Uptake and Distribution. He was kind enough inscribe it: “To Evan - For a relationship I have enjoyed. Good luck with your new adventure in anesthesia.” I was of course very grateful, but also perplexed. I had no idea what Dr. Eger meant by ‘adventure in anesthesia.’ In my mind practicing anesthesia was a grave undertaking, I felt unprepared.
He was of course correct. Anesthesia has proven to be a terrific adventure. I have practiced in academic centers, metropolitan and rural hospitals, office operating rooms, Indian reservations, and developing nations. I have enjoyed the challenge of working for my state associations (California and Idaho). I have worked for the AANA, and served on its board.
Without doubt, my greatest adventure has been cultivating the history of nurses' contributions to anesthesia. That adventure will outlive us all.