Greg's Journal: Trust Is Always Earned

Greg's Journal | Entry No. 12

One of the things that surprises people about my job is how quickly trust has to be built.

I usually meet a patient only a short time before surgery. Sometimes we've talked for ten or fifteen minutes in the preoperative area. Sometimes it's less.

During that conversation, I explain what anesthesia is. I explain the risks. The benefits. The alternatives. I answer questions.

And then, at the end of that conversation, I ask them to sign a consent form that says they're placing their trust in me.

Think about that for a minute.

In just a few minutes, someone you've never met before is trusting you to keep them safe while they're unconscious.

That's something I never take lightly.

The Walk Into the Operating Room

Most people are anxious when they come into an operating room. I expect that.

Their blood pressure is usually a little higher. Their heart rate is a little faster. It's completely normal.

The room is unfamiliar. There are bright lights. Monitors. Equipment. People moving with purpose.

For us, it's another day at work. For the patient, it may be one of the biggest days of their life.

That's an important difference to remember.

Creating Calm

As soon as the patient moves onto the operating table, my job changes.

Yes, I'm checking monitors. Reviewing medications. Looking at oxygen levels. Making sure emergency equipment is ready.

But I'm also paying attention to something else.

The atmosphere.

I try to make the room feel calm. The circulating nurse is helping attach monitors. The surgical staff is getting organized. I'm standing beside the patient.

I hand them an oxygen mask. Then I usually say something like,

"Take some nice, deep breaths. Breathe all the way in. And all the way out. I'm going to give you some medicine through your IV. It may feel a little cool going in. You're going to get sleepy. We're going to take excellent care of you. When you wake up, this will all be over."

I don't rush those words.

People remember calm.

Looking People in the Eyes

One thing I always do is look directly into my patient's eyes.

Some people close their eyes almost immediately. Most don't. Most of them keep looking at me until they're asleep.

I think eye contact matters. Maybe it's because I'm old-fashioned. Maybe it's because I believe people can tell whether you're sincere.

When I tell someone I'm going to take excellent care of them, I want them to know I mean it. Not because it's part of a script. Because it's a promise.

What I See

People ask whether I can tell what someone is thinking before they go to sleep.

Sometimes.

I usually see a little fear. That's natural. Nobody walks into surgery completely relaxed.

But I also see something else. Trust.

By the time they're in the operating room, we've already talked. They recognize my voice. They know my face.

When our eyes meet, I often see that moment when they decide,

"Okay. I'm going to let you take over."

That's a tremendous responsibility.

The Weight of That Trust

I've cared for thousands of patients. Olympians. Doctors. Teachers. Farmers. Business owners. People experiencing homelessness. Children. Grandparents.

Once they're on my operating table, none of those labels matter. They're simply my patient.

Every person deserves the same attention. The same preparation. The same respect. The same effort.

Illness has a way of making everyone equal. Healthcare reminds you of that every day.

The Part That Still Gets My Attention

People sometimes ask if anesthesia is stressful.

Most days, it's routine. But routine never means casual.

There is one thing that always commands my complete attention.

The airway.

Every anesthetist thinks about it. Can I help this person breathe if they can't breathe on their own?

Most of the time, the answer is straightforward. Sometimes it isn't.

When someone has a particularly difficult airway, I become even more methodical. More deliberate.

Not because I'm afraid. Because preparation saves lives.

I've learned that confidence doesn't come from believing nothing will go wrong. Confidence comes from knowing you've prepared for the moment when it does.

What Patients Never See

Patients see the conversation. The oxygen mask. The reassuring words.

What they don't see is everything happening behind the scenes.

The backup airway equipment. The emergency medications. The alternative plans. The constant calculations. The years of training that allow you to adapt if something unexpected happens.

Good anesthesia often looks easy.

It isn't easy. It's carefully prepared.

A Promise

Before every surgery, I make myself a quiet promise.

This person came here for help. They're trusting me.

They're someone's husband. Someone's wife. Someone's parent. Someone's child.

For the next few hours, they're my responsibility.

That's a responsibility I never become comfortable carrying. And honestly, I hope I never do.

Because the day I stop appreciating that trust is probably the day I should stop doing this job.

Why It Matters

People sometimes ask me whether putting people to sleep has changed how I think about sleep itself.

It has.

Sleep isn't weakness. Rest isn't laziness. Letting your guard down takes trust.

Every day, I watch people surrender control for a little while. And every day, I'm reminded that trust is one of the greatest gifts another human being can give you.

Whether you're caring for someone in an operating room, or simply sitting beside someone you love.

Trust is always earned. Never assumed.

That's true in healthcare. It's true in marriage. It's true in parenting. And it's true in life.

For the Quiet Hours,
Greg Wiggins, CRNA
Co-Founder, Bloomfield Schoolhouse Lavender