COUNTING BACKWARDS

A veteran anesthesiologist probes the origins and mysteries of medically induced unconsciousness.

Przybylo (Anesthesiology/Northwestern Univ. School of Medicine) shares anecdotes and personal impressions of his career, during which he has “administered anesthesia more than thirty thousand times.” Specializing in the pediatric arena of his field, the author cares for more than 1,000 children in an average year, and he offers profiles of many of them in this vividly written, candid exploration. In many ways, Przybylo considers himself a faith healer since so many patients and their families put their trust in his expertise with the drugs he administers. He retraces the curious history of how painless surgeries were eventually achieved in the 1800s through the meticulously measured inhalation of ether, though the process itself was considered sacrilegious at the time. A compassionate, patient caregiver, the author describes how he empathizes with (and medically alleviates) his young patients’ anxiety, fear, and confusion. The author discusses his lengthy tenure in medicine, which molded him into a highly controlled professional “always searching for ways to improve my care.” Przybylo is also honest enough to include the medical blunders he has experienced during his career, and he provides a personalized walk-through that intriguingly describes the highly specialized equipment he uses, the “Five A’s” of his comprehensive care, and why an empty stomach is essential to anesthesia success. Several of the cases he recalls embody the “dark side of medicine,” but they are striking in content and quite moving. They include a high school sophomore basketball player who must endure a heart transplant and, surprisingly, a lethargic 2-year-old gorilla with a life-threatening infection. What may particularly resonate with readers, however, is the pharmaceutical gray area that still confounds Przybylo and the industry at large, as he admits to being “no closer to explaining the mechanism by which the gas I provide anesthetizes.”

A fascinating tour of a mystifying, unnerving, yet precious medical necessity.