Ask most patients who saved their life during surgery, and they’ll name the surgeon. Few will remember the person standing at the head of the table, watching every heartbeat, every fluctuation in blood pressure, ready to intervene the instant something shifts. That invisibility is precisely what makes anaesthesiology one of medicine’s most quietly demanding specialties, and it’s exactly where Dr. Sajan K. Sebastian, newly appointed HOD of the Department of Anaesthesia at KIMS Hospital, Thrissur, has built a career defined by vigilance rather than visibility. As he himself puts it, “I may not hold the scalpel, but I’m still in the room where it matters most.” In a field where recognition rarely matches responsibility, Dr. Sebastian’s specific mastery, cardiac and difficult-airway anaesthesia, along with his efforts to decentralise that expertise across Kerala through teaching and hands-on training, is exactly what places him among the country’s most respected anaesthesiologists this year.
A Redirected Ambition
Dr. Sajan K. Sebastian’s path into medicine began not in a classroom, but on an operating table. At 14, he underwent surgery for an ASD closure, and what stayed with him wasn’t the procedure itself, but the calm, steady composure of the doctors he encountered throughout his hospital stay. He initially set his sights on becoming a cardiac surgeon, but a lifelong limitation in his right hand redirected him toward a non-surgical path. Anaesthesia wasn’t his first choice during his postgraduate entrance, but once inside it, the old pull toward cardiac medicine resurfaced, this time as cardiac anaesthesia. Unlike general anaesthesia, which he describes as largely predictable once induction is complete, cardiac cases keep him on constant alert, tracking every undulation in heart rate and blood pressure in real time. Years in, that thrill hasn’t dulled, if anything, aortic aneurysm cases now give him the sharpest adrenaline surge of his career.
A Discipline of Constant Recalibration
What distinguishes Dr. Sebastian is his range. Beyond cardiac cases, he administers anaesthesia across paediatric, obstetric, neurosurgical, and orthopaedic surgeries, each demanding an entirely different mindset. What ties it together, he says, isn’t a fixed protocol but a mental checklist he runs before every case – who is this patient, what is their physiology telling him, and what could go wrong, and how fast. It’s this discipline of adaptability, more than any single technical skill, that has kept him intellectually engaged across two decades in the OT.
The Cases That Shaped Him
Dr. Sebastian is candid that not every case ends well, and one in particular still stays with him, where a 60-year-old woman with oesophageal cancer compressing her trachea, where a routine re-intubation attempt failed entirely, a tumour had filled her airway completely, leaving nothing to secure. She couldn’t be revived. He calls it a hard lesson, one that taught him more than ten successful surgeries combined, reinforcing his belief that imaging closer to surgery, not a week prior, is essential when tracheal involvement is even a possibility.
Another case, a 65-year-old woman with an acute MI, related to a member of his own hospital staff, tested him differently. Mid-surgery, her heart rate crashed into sudden bradycardia as surgeons began direct cardiac massage. In the chaos, Dr. Sajan K. Sebastian noticed something easy to overlook, a pressurised IV bottle with an air column that, once the fluid ran low, could push air directly into her bloodstream, a possible embolism. The team stabilised her; she went home six days later. Since then, he’s made it a personal rule to use collapsible IV bags rather than semi-rigid bottles, a small habit born directly out of five of the most tense minutes of his career.
Building Expertise Beyond the Operating Room
As Secretary of the ISA Thrissur City Branch, Dr. Sebastian has spent years organising CMEs, including hands-on difficult airway management workshops run in partnership with the Airway Management Force. He’s extended this training to anaesthesia technicians as well, on the belief that safety in the OR is a team competency, not a solely medical one. Beyond the profession entirely, as IMA Thrissur’s ELS Coordinator, he’s taught CPR to the public under the initiative “Every Citizen a Life Saviour,” recognising that the first critical minutes after a cardiac arrest often happen far from any hospital.
The Quiet Cost of Invisibility
Dr. Sebastian is direct about what he sees as anaesthesiology’s biggest challenge in India, not staffing or technology, but visibility and respect. Patients rarely ask who administered their anaesthesia, and that invisibility, he says, shapes everything from institutional support to compensation, and leaves anaesthesiologists disproportionately scrutinised when something goes wrong, even when the cause lies elsewhere entirely.
What Comes Next
Taking on the HOD role at KIMS Hospital Thrissur, Dr. Sajan K. Sebastian’s vision is threefold, including continuously sharpening his own practice, demystifying anaesthesia for the public, and training the next generation through the same hands-on formats that have defined his teaching work so far.
What Grounds Him
Outside the hospital, Dr. Sajan K. Sebastian finds quiet in driving and travel, though he’s honest about the cost of a career spent serving multiple centres, missed evenings and milestones at home. Taking on this new chapter, his hope is simple, more ordinary, unhurried days with family, the reason he concludes the writeup saying, “everything I do, everything I earn, means nothing if it isn’t for them. Family isn’t just part of my life, it’s the reason the rest of it makes sense.”
