Medicine has always lived in the tension between science and art. The science evolves, sharpens, and multiplies; the art requires something far rarer — presence, intuition, and the ability to read a human being in real time. As an anesthesiologist, I stand at the intersection of physiology, psychology, pathology, pharmacology, and trust. I hold the responsibility of guiding a patient through the most vulnerable moments of their life, moments when they surrender consciousness and control. No algorithm can fully capture that exchange. No business model can quantify it. And yet, the pressure to do exactly that grows stronger every year.

The shift is subtle but unmistakable. We are asked to move faster, document more, justify every decision in the language of billing codes and productivity units. The art, the part that depends on judgment, nuance, and the quiet calibration of experience, is increasingly treated as INEFFICIENCY. The human elements of medicine, once considered its core, are now framed as optional luxuries that must be squeezed into the margins between checkboxes.

Anesthesiology makes this tension especially visible. A GI Colleague thinks of Anesthesia preop time as something that eats at their productivity.

The monitors tell a story, but never the whole story. A patient’s anxiety, their breathing pattern, the way they hold their shoulders, the tremor in their voice... these are not data points in the EMR. They are the signals that guide the anesthesiologist’s hand. They shape the induction, the maintenance, and the emergence. They determine whether a patient wakes comfortably or in distress. They are the difference between treating a body and caring for a person.

But the modern system rewards what can be counted, not what can be felt. It rewards throughput, not presence. It rewards documentation, not discernment. And so, the art of medicine, the part that depends on the clinician’s cultivated intuition, is slowly being crowded out by the machinery of business.

This is not nostalgia. It is a warning. When medicine becomes primarily a business, the patient becomes a product, the clinician becomes a cost center, and the relationship between them becomes transactional. The danger is not only moral; it is practical. A system that undervalues clinical judgment will eventually lose it. A system that treats physicians as interchangeable labor will eventually produce interchangeable care. And a system that prioritizes efficiency over humanity will eventually forget why it exists.

Yet the art is not gone. It persists in the quiet moments: the hand on a shoulder before induction, the decision to pause and listen, the instinctive adjustment of a plan because something in the room doesn’t feel right. It persists in the anesthesiologist who refuses to become a technician, who insists on being a physician, someone who sees the whole patient, not just the vital signs.

The art survives because clinicians keep practicing it, even when the system doesn’t reward it. It survives because patients still need it, even when they don’t have the language to ask for it. And it survives because medicine, at its core, is not a business transaction. It is a human covenant.

The challenge now is to protect that covenant. To speak openly about what is being lost. To resist the reduction of medicine to metrics. To remind ourselves — and our institutions — that the most important things we do cannot be captured in a spreadsheet.

The art of medicine may be under pressure, but it is not dead. It lives in every clinician who refuses to surrender their humanity for the sake of efficiency. It lives in every anesthesiologist who still believes that caring for a patient is more than managing physiology. And it lives in every moment when we choose connection over convenience, presence over productivity, and wisdom over workflow.

The art is dying only if we let it. And some of us are not done fighting.

Rita Guttersen, MD, is an Anesthesiologist, specializes in keeping patients safe, surgeons amiable, and operating rooms calm as they should be. Fluent in pharmacology, physiology, and the subtle eyebrow‑based language spoken across the drape, she brings a steady presence and a suspiciously accurate sixth sense for impending chaos.

She remains devoted to medicine as an art - the intuition, the nuance, the human connection - even as the world tries to turn healthcare into a corporate theme park or patient satisfaction scorecard.

She is an airway whisperer, a crisis‑prevention specialist, and the unofficial OR therapist. Rumors persist that she can restore order with nothing but a steady voice and a well‑timed dose of Propofol; these rumors have never been disproven...and she has witnesses.