Spring is in the air! Temperatures are beginning to climb and Easter is right around the corner. We now have the Final Four and the NBA Finals are in clear view! Yes, it definitely feels like spring! And you know what spring means don’t you? That’s right, spring is the time of year to prepare for the busy summer season. Whether you are a client needing to cover those summer vacations or an Anesthesiologist or a CRNA looking for a hospital to cover for the summer, spring is the best time to book. As they say, “The early bird catches the worm”.
This issue of the “National News” contains some very interesting articles as well as a biography on Jill Binder on the occasion of her eighth anniversary with the Company. In part 1 of Who Really Discovered Anesthesia you will read about the contenders for this title. The article For Greater Pain Relief in Labor, Book Early shows just how important the time of day is in receiving a spinal-epidural injection. We have also included a very thought provoking poem called The Dash. Please take a few minutes to read it, you won’t be sorry! (You can also watch the movie at http://www.thedashmovie.com/ .)
A recent “behind the scenes” redesign of our website has eliminated the “Job Alerts” function, however current openings can still be viewed at

www.nationalanesthesia.com

These postings are updated daily so they are always current.
We are always looking for ways to make our newsletter fun, exciting and informative. If you have any ideas that might help us accomplish this goal please let us know. You may email your ideas to Nancy Baker at

nbaker@nationalanesthesia.com

Once again, thank you for allowing us to “Connect” with you through our Newsletter and I hope you will enjoy this issue.

Let’s Stay Connected!

Stephen Read, President
National Anesthesia Services, Inc.

THE EXPLOIT
Since the birth of the medical profession, surgery had been a brutally painful affair. For centuries doctors had sought ways to eliminate, or at least lessen, the pain experienced during operations. Induced temporary asphyxiation, freezing of surgical areas, hypnotism, inhalation of narcotic plant fumes, and alcoholic stupefaction had all been tried in an effort to combat pain. However, none of these adequately controlled pain. In 1839, the noted French surgeon Alfred Velpeau summarized current medical opinion when he stated, "The abolishment of pain in surgery is a chimera. It is absurd to go on seeking it today. Knife and pin are two words in surgery that must forever be associated."
Only a few years later, this bleak assessment was totally disproved. In America in the 1840's, two dentists and two doctors were experimenting with chemical agents that would lead to surgical painkillers. The advent of anesthesia--a word coined by Oliver Wendell Holmes, Sr., and derived from the Greek word meaning lack of feeling--was at hand, as was a controversy that has continued into the 20th century.

THE CONTENDERS AND THEIR STORIES
DR. CRAWFORD LONG (1815-1878)
The son of a well-to-do Southerner, Crawford Long was born in Georgia and attended the University of Pennsylvania, after which he practiced surgery in New York City. Although a brilliant young surgeon, Long was forced to return to Georgia because of family problems and assume a rural practice in the hamlet of Jefferson in 1841.
The 26-year-old doctor, a sociable and adventuresome man, became interested in a current craze--nitrous oxide sniffing. Long and several friends tried to obtain nitrous oxide, also known as laughing gas, and when none was available, Long suggested they try another gas, sulfuric ether, which they did. During these "ether frolics", Long noted that some of his friends severely bruised themselves, but felt no pain.
Long recalled this observation on March 30, 1842, when James Venable, a fellow ether-sniffer, came to him to have a growth removed from his neck. Long had Venable sniff ether and then cut out the tumor. Venable felt nothing. In his journal, Long recorded: "James Venable, 1842. Ether and excising tumor, $2,00." Over the next four years Long performed seven more operations while his patients were anesthetized with ether. In 1849, he published his results in the Southern Medical and Surgical Journal.
Of all the anesthesia-discovery claimants, Long was the one least involved in the controversy. He remained in private practice in Georgia until his death at the age of 62.

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“Hi, this is Jill Binder with National Anesthesia Services. I have a wonderful opportunity that I would love to talk to you about. ” Does my name ring a bell? I hope so; I have been reaching out to all of you for 8 years now! I began my career with National Anesthesia Services in 1999, after spending over 5 years in the advertising field. I left a position in advertising to focus on my family and home. After some time at home, I realized that I wanted to be back in the workforce and was fortunate to find National Anesthesia Services. It was quite a transition from advertising to staffing, but with the great leadership and training here at National, I realized I was good at making connections with providers and clients. I have enjoyed getting to know everybody on the phone and it is so fun to see you in person at the shows! My job here with National Anesthesia is very rewarding on so many levels; I get to find the perfect job for somebody, and in turn, find the perfect person for the job! I also have developed great friendships with my coworkers and feel like I am part of an extended family here!! Speaking of family, my spare time is spent with my 2 beautiful children, Julia (8) and Charlie (5) and participating in their activities. Yes, I’m the stereotype of suburbia— Minivan driving, soccer team coaching, Starbuck’s drinking-mom!! Fortunately, my family here at National has been supportive in my personal life and has been great with a flexible schedule so I can “do it all”. My husband loves the schedule as well; not only can I be with the kids, but I can also help support my “habit”!! No, nothing dark! Just a serious issue with shopping and vacations! It has been a great ride so far here with National and I intend to be around for while!!! Eight years, two kids and countless hairstyles later, I am just getting started-- I remain committed and eager to making more great connections with all of you! So, listen up for the next phone call. It will probably be from Jill Binder at National Anesthesia Services!

We act as though comfort and luxury were the chief requirements of life, when all that we need to make us happy is something to be enthusiastic about.-- Charles Kingsley

The amount of relief a woman in labor gets from a spinal-epidural anesthetic may depend on the time of day she gets the injection.
Given in the afternoon, the anesthetic appears to provide longer lasting relief than the same injection given in the evening, researchers have found.
The report, in the September issue of Anesthesiology, evaluated 70 women in labor with their first babies. The women were given on-demand spinal injections of fentanyl, a commonly used obstetrical pain reliever.
Those who asked for the medicine from noon to 6 p.m. were assigned to one group, and those who requested it from 8 p.m. to 2 a.m. to a second group. (The time periods were chosen based on previous research and on the logistics of the work schedules of hospitals.)
Then the scientists recorded how long the pain relief lasted.
Even though timing of the uterine contractions and cervical dilation were similar between the two groups, injections during the afternoon were effective on average 27 percent longer.
"Looking at this data will be helpful in the long run," said Dr. Peter H. Pan, who is an associate professor at the Wake Forest University School of Medicine and the lead author of the study.
But he said that more studies were needed on chronobiology and pain relief.
The authors did not study the entire 25-hour cycle, but they did demonstrate the significance of chronobiology in pain relief.
"We need to devise ways to administer medication taking into account the difference between pain during the day and pain at night," Dr. Pan said.

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By Nicholas Bakalar

I read of a man who stood to speak at the funeral of a friend. He referred to the dates on her tombstone from the beginning to the end.
He noted that first came the date of her birth and spoke of the following date with tears, but he said what matters most of all was the dash between those years.
For that dash represents all the time that she spent alive on earth and now only those who loved her know what that little line is worth.
For it matters not how much we own, the cars, the house, the cash.
What matters is how we live and love and how we spend our dash.
So think about this long and hard; are there things you'd like to change? For you never know how much time is left that can still be rearranged.
If we could just slow down enough to consider what's true and real, and always try to understand the way other people feel.
And be less quick to anger and show appreciation more and love the people in our lives like we've never loved before.
If we treat each other with respect and more often wear a smile, remembering that this special dash might only last a little while.
So, when your eulogy is being read, with your life's actions to rehash, would you be proud of the things they say about how you spent your dash?

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By Linda Ellis

General Disclaimer: The materials have been compiled by National Anesthesia Services. Inc. from internal and external sources. However, while we have attempted to provide accurate information in this publication, no representation is made or warranty given as to the completeness or accuracy of the Materials. In particular, you should be aware that the Materials may be incomplete, may contain errors, or may have become out of date. You should therefore verify information obtained from this publication before you take any action upon it.