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Anaesthetists and wicket keepers. ‘They also serve who only stand and wait’
  1. John Launer
  1. Associate Editor, Postgraduate Medical Journal, London, UK
  1. Correspondence to Dr John Launer, London, UK; johnlauner{at}

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The greatest English cricket captain of the last fifty years is generally reckoned to be Mike Brearley.1 He led England in 31 international test matches, winning 18 of them and losing only four, a record that no-one has ever exceeded. He famously returned from retirement to lead his country to victory in the 1981 match series against Australia, turning the result around from one that seemed beyond rescue. It made him a national hero even to those who barely followed the sport. His fame as a cricketer was in many ways unusual. He did not play for England until he was 34 years old, having taken time out for his other occupation as a university lecturer in philosophy. His record as a batsman was modest, with an average test match score of 23, less than half that of his contemporary Geoffrey Boycott. He never bowled at international level. He was lucky in the talents of his team mates and the circumstances in which he found himself. Almost uniquely among cricketers, Brearley’s genius was for captaincy itself. According to one biography, he had ‘a brain simmering with cricketing intelligence and a mind adroit in reading situations.’2 He could win matches with ‘tactics and strategy alone.’

In his formative years as a sportsman, Brearley played for a while as wicket keeper for Cambridge University. The role of wicket keeper is similar to being a catcher in baseball, and not usually associated with charisma or conventional leadership. It requires standing on the same spot, often for hours on end, without losing concentration for a moment, but ready to capitalise on any misstep by an opposing player. One writer has described how ‘the game continually circulates the ball through the keeper like blood through the heart… as if the keeper were really the ball’s home, the place to which it always returns.’3 The experience may have helped Brearley develop his powers of detailed observation of the way a match was going, and his characteristic style of captaincy based on bringing out the best in others rather than showmanship.

I have been lucky enough to meet Mike Brearley in person on two occasions, more than fifty years apart. The first was as a teenager at a county match at Lord’s cricket ground in London: I timidly asked for his autograph as he emerged from the back of the pavilion during lunch. The second time was at a dinner he hosted only a few years ago. He had become a distinguished psychoanalyst and a past president of the British Psychoanalytical Society. I was the society’s guest speaker that evening and felt a little less timid than I had in my teens. I could now observe at first hand his ease with other people. It was then that a chain of associations led me to think of the comparison between wicket keepers – especially the more self-effacing kind – and anaesthetists.

Movement and mood

I was doing quite a lot of educational work with anaesthetists around that time, which is no doubt why I made the connection. This work included watching their interactional skills in operating theatres and in breaks between operations. I also had some experience of training them in supervising juniors. Contrary to the joke among other doctors that anaesthetists are better at talking with people who are unconscious, I observed how well many of them were able to tune into others’ words and concerns. I noted their precise attentiveness to movement and to mood, and an ability to recalibrate their responses in an instant when the atmosphere turned from calm to crisis. I saw how the way they could commonly influence others, including surgeons with generally bigger egos, and modulate the emotional atmosphere around them. It occurred to me that much of their work – and indeed the lives of others – depended on this same kind of attunement, whether to the patient’s skin pallor and respiratory rate, or the scrub nurse’s level of anxiety. Good wicket keepers, Brearley has written ‘remain poised and ready to go either way’.4 They are ‘deft, shrewd, unobtrusive’ and ‘lift the side in the field.’ One could say much the same of many anaesthetists.

I haven’t come across any systematic research into the personalities and behaviour of wicket-keepers but, as one might expect, a reasonable amount has been carried out on anaesthetists.5 Unsurprisingly, the more successful members of their profession seem to demonstrate greater detachment, mental quickness, drive and determination, stability, high standards, self-sufficiency, openness and self-control.6 Patients would also probably find it comforting that experienced anaesthetists are more inclined to avoid harm and risk, and are less novelty-seeking than the general population, as well as being reflective, frugal, orderly and regimented.7 The other side of this reassuring picture is that boredom is a continual occupational hazard, with many anaesthetists having to do repetitive tasks day and in and day out, especially during ‘endless “cold” lists on straightforward patients’.8

There do not seem to be any direct studies of anaesthetists’ leadership roles and how they exercise these, although the literature on anaesthetic training emphasises the need for ‘non-technical’ skills in areas such as situational awareness, teamworking and managing stress and fatigue.9 It also advises seniors to impart their tacit knowledge and to harness the ‘informal curriculum’, whereby trainees often learn more by seeing good role models and having opportunistic conversations than through direct instruction.10

Beware of the spectacular

I would love to know whether professional wicket-keepers would recognise themselves in these findings as well, but I guess that many would. I suspect they also might appreciate the following down-to-earth advice to his colleagues from Italian anaesthetist Bruno Simini, if suitably adapted for a cricket: ‘Beware of the spectacular, gesticulate medicine poured out by the media; take heed of inveterate dogma; come not near industry representatives; have an eye to managers; trust not the voice of profit, mark well disenchantment; politicians love thee not’.11 I have little doubt that both professions would relate strongly to the closing lines of a well-known sonnet by the seventeenth century poet John Milton, ‘On his blindness’. Contrasting the limitations of his own life as an immobile writer with others who led busy lives of frenetic activity, he consoled himself that he could serve his creator just as well without this. As he wrote:

God doth not need

Either man’s work or his own gifts: who best

Bear his mild yoke, they serve him best. His state

Is kingly; thousands at his bidding speed

And post o'er land and ocean without rest:

They also serve who only stand and wait.12


I am grateful to Mike Brearley for comments on an earlier draft of this article, and to Professor Andy Smith and Professor Steve Yentis for advice based on their anaesthetic expertise.



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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.