We’ve been friends for more than a decade. We met not in a hospital, but in an Orlando kitchen, competing in Iron Chef-style cooking battles with our families. That friendship, forged over food and wide-ranging conversations, has since followed us into the operating room, where we work together to serve patients in some of the most intricate and critical surgical procedures.
And while it’s not necessary for a surgeon and anesthesiologist to be close friends to deliver excellent care, we’ve found that our relationship — built on trust, communication, and mutual respect — has made us better at what we do. A recent study backs this up: researchers found that when surgeons and anesthesiologists work together regularly in what is known as a dyad team, patient outcomes can improve in certain situations.
Brain and spine surgery is among the most delicate and dangerous procedures in medicine. The stakes are high, with a razor-thin margin for error. In these moments, we rely on each other completely. Many cases are emergencies, with bleeding in the brain. Anticipation and communication between team members is especially important in those dire situations, as seconds tick by.
Dr. Ravi Ghandi
For instance, anesthesiologists finely tune the patient’s blood pressure to manage blood flow to the brain. The team has to proactively communicate the need for more or less blood flow. If Ravi is dissecting deep into the brain, Arun may reduce blood volume to minimize swelling. If Ravi is clamping a vessel to isolate an aneurysm, Arun may increase flow to protect surrounding tissue.
This kind of coordination doesn’t happen by accident. It’s the result of years of shared experience, of knowing each other’s next steps and anticipating adverse events before they occur in order to prevent them. We’ve had cases where patients have experienced significant blood loss, like one woman with a rare arteriovenous malformation that bled uncontrollably. The surgery lasted nearly eight hours. While Ravi worked to stop the bleeding, Arun and the anesthesia team managed a complex transfusion protocol to keep her stable. She survived and is thriving today.
We’ve also had quieter moments; cases where a quick text before surgery clarified a surgical approach or flagged a concern that changed the anesthetic plan. That kind of pre-op communication is natural when you’ve established a strong working relationship. It’s easier to ask questions, to challenge assumptions, to speak up when something doesn’t feel right.
Dr. Arun Moorjani
Pre-surgery in the operating room, we chat about restaurants, sports and our kids. But when the moment demands it, we shift instantly into clinical focus. That fluidity, that ability to move between the personal and the professional, is part of what makes our partnership work. It keeps the room calm, even when things get tense.
Of course, not every surgeon-anesthesiologist pair needs to be close friends. But surgery is a team sport. Surgeons, anesthesiologists, nurses, techs all play critical roles. And the better we know each other, the better we perform.
We’re not suggesting that every surgical team needs to go out for drinks or host dinner parties. But we are saying that investing in relationships, through shared training and open communication can make a real difference.
We are glad to see the data confirm what we know about the value of surgeon-anesthesiologist teams. If our story can help other teams work more closely, more effectively, and more compassionately, we know patient outcomes will benefit.
Our patients trust us with their lives. We trust each other to honor that responsibility. And that trust, earned over years, reinforced every day, is what makes our work not just possible, but powerful.
Dr. Arun Moorjani is an anesthesiologist with U.S. Anesthesia Partners of Florida, Inc. Dr. Ravi Gandhi is a neurosurgeon with Orlando Neurosurgery. All views expressed in this article belong solely to the authors and do not necessarily represent the views of any affiliated organizations.
