Anaesthesiologists are truly modern medicine magicians

Carlie* sat in the wheelchair holding her baby tightly. She was finally going home after a roller-coaster ride in the last nine days. She could not believe that both her daughter and herself were alive.
Carlie was a senior manager in an organisation whose business spanned Eastern Africa. She had just flown in after setting up their new office in the region. It was a balmy Saturday and she was just two days shy of 35 weeks, the latest gestation that the airline would allow her to fly. The flight was uneventful and she counted down to her planned caesarian section.
Carlie’s husband Carlos* and teenage son Jorum* were at the airport to pick her up. It was late in the evening, but being a weekend, the city was still alive. They pulled into the highway, animatedly catching up as they headed home.
Suddenly, Carlos noticed the car approaching them from behind was significantly gaining on them with no intention of changing lanes. It occurred to him that the driver was going to plough into them if he did not move. He did not complete his thought; they got hit while trying to swerve out of the way.
The clanging of metal drowned out their screams before Carlie sank into unconsciousness. She briefly recalls being strapped down in an ambulance. 
Carlos woke me up in a panicked voice. He was babbling. All I got was that they were headed to the hospital we had agreed on for their delivery.
They say it takes an obstetrician 10 seconds to go from deep sleep to a fully alert state; they forgot to add that we will be fully dressed in 30 seconds. By the time the second ambulance was delivering Carlos and Jorum, I was in the hospital.
Thankfully Carlie was in the back seat with a belt across her lap but not across her belly. The force tossed her around but the belt helped hold her down, reducing the impact. Carlos and Jorum were shocked but stable. 
An urgent ultrasound scan was done, showing part of Carlie’s placenta had been forcefully separated from the uterine wall, causing her to bleed and putting her and the baby in danger.
Situation was worse
As the scan was being done, both the neonatologist and the anaesthesiologist had arrived and gone to theatre to prepare. Carlie was wheeled into the operating room within the hour. Baby Sifa* was urgently scooped out of a uterus that was quickly turning hostile and handed to the neonatal team. The situation was worse than the scan had shown. Carlie was in trouble as the uterine arteries bled
We called for help and the cavalry arrived. We tried all the tricks in the book without success. We sent out a colleague who had come to help to inform Carlos that we were taking it to the next level – taking out Carlie’s uterus to save her life.
We also asked the multitude of friends and family who had shown up, some in their pyjamas, to proceed to the lab and donate blood for their loved one. Carlos, understanding the implications of what was going on, did not hesitate. He sank back on the seat with a prayer for his wife.
In a few minutes, the uterus was in a steel bowl and Carlie had two units of blood running concurrently into both her arms. Now Carlie needed to show us that she was going to pull through. The fight now was to ensure her organs hang in there as her physiology was nudged back to normal. 
The anesthesiologist would titrate the blood against the intravenous fluids, medications to prevent the blood from losing its ability to clot and others to moderate her blood pressure. This was the defining battle in this war. 
Carlie was wheeled out of the operating room to the high dependency unit (HDU) for close monitoring. I knew the anaesthesiologist would be with her for a long while.
My surgical scrubs were soaked in sweat and my boots blood-stained as I ambled to the changing room. I still had to sit the family down and explain what had happened and what to expect. Everyone was grateful that the baby was fine. We parted ways with careful optimism.
Carlie weathered a few scares in the HDU, but five days later, she was wheeled out to the postnatal room. She was happy to be able to hold her daughter and breastfeed her. She wouldn’t stop thanking us for saving her life. However, she had a special thanks for her anaesthesiologist. She now understood just how important this silent, rarely spoken about person was in her battle to survive.
Many patients feel forever indebted to their surgeons when they have survived a harrowing surgical experience, few actually acknowledge the huge responsibility the anaesthesiologist carries in the process. 
Blood continues to circulate
Anaesthesiologists are the true modern medicine magicians. They literally send you to the edge of the next world and bring you back. They are the ones who hold onto you when you go over the cliff and hang in there until you scramble back onto the ledge.
When we are busy cutting you up, they are responsible for making sure your body continues to get oxygen and your blood continues to circulate. They may look easy going, seated at the head of the table in their flip flops, playing cool music and keeping the conversation going, but they are the first to alert us when things don’t look great.
In planned surgeries, you  have the luxury of meeting your anaesthesiologist prior. In emergency situations, the meeting may be a blur, or if you are unconscious, it may happen after surgery. 
These are the doctors who look after you in the critical care units, making sure your body chemistry is well-balanced as you fight off life-threatening disease or injury. Here on earth, these doctors intercede on our behalf.
Dr Bosire is an obstetrician/gynaecologist