No Pain Is Their Gain

Efficiency and camaraderie mark a day in the life of two Paoli anesthesiologists.

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Paoli Surgery Center’s Dr. Benjamin Jacobs (left) and his partner, Dr. Philip Bilello (Photo by Shane McCauley)It’s 11:15 a.m. Monday at Paoli Surgery Center, and Dr. Don Mazur is about to sing. Topping 6 feet in scrubs and clogs, his voice muffled a bit by the surgical mask, the orthopedic surgeon is shaving away rough bone inside a patient’s left knee. He gives the nod to one of the nurses who make up the full-time staff at the center, and she presses a button on a boom box tucked away in a corner. The doctor and his nurses join together in song.

A long, long time ago,
I can still remember
How that music used to make me smile …

More voices chime in—one coming from behind the surgical drape. It’s the patient, a woman of a certain age who likely has more grown-up memories to go with the song than her surgeon does. She’s joining in as Mazur plumbs the innards of her primary leg joint. Then the chorus comes around, and her voice rises along with everyone else’s.

So bye-bye, Miss American Pie.
Drove my Chevy to the levee,
But the levee was dry …

Don McLean’s “American Pie” is something of a tradition for Mazur and the surgical crew during his last operation of the day. Granted, other surgeons play music in the OR and likely even sing along. But what’s different at Paoli Surgery Center is that the patient is awake to join in.

Looking on from the sidelines, Dr. Benjamin Jacobs takes pride in what he sees: a great surgeon at work on a patient who’s wide awake but completely free of pain—one who will walk out of the building under her own power just a few hours after the procedure is over. At Paoli Surgical Center, Jacobs and fellow anesthesiologist Dr. Philip Bilello—not the surgeons themselves—are the ones in charge. As such, their interactions with patients begin long before they set foot in the waiting room.

Prior to their arrival, Jacobs and Bilello have reviewed their case, taking note of any health issues that might affect the ability to provide a safe, pain-free surgery. Should something arise, they notify the patient and surgeon themselves to either recommend a delay in surgery or additional care.

Jacobs, who lives in Haverford, earned his undergraduate degree at Haverford College before studying medicine at Wake Forest University. A few years behind Jacobs, West Chester’s Bilello graduated from Brown University before heading to New York Medical College. Both met at Yale University while Bilello was beginning his residency and Jacobs was working as an assistant professor after completing his. The connection later led to Bilello joining the staff at Paoli Hospital after Jacobs was named the hospital’s chief of anesthesiology.

The two were integral in both the creation and design of Paoli Surgery Center prior to its opening in August 1994. Eventually, they formed the two-man practice that now controls the center’s day-to-day operations.

At 7:15 on this morning, the waiting room is already filling up, and nurses are preparing the OR for the first surgery of the day. At the same time, Bilello is visiting with the first wave of four patients, going over their charts and joking with them to ease their stress. By 7:30, he’s inserting a spinal anesthetic into the first patient, a 69-year-old woman awaiting an arthroscopic procedure on her knee.

When most people think of spinal anesthesia, which stops pain but allows a patient to remain awake, they think childbirth. The layperson might assume that a more complex operation would require a general anesthetic, in which a patient is completely unconscious.

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