Each working day at least 40,000 Americans undergoing surgery require general anesthesia: an anesthesiologist renders them oblivious. Fifty years ago when the author Dr. Zeitlin began giving anesthesia in the United Kingdom one patient in 1500 died as a direct consequence of the anesthetic. That number was sadly true all over the world. In 2011 mortality and morbidity from anesthesia is too rare to count accurately. Nevertheless the increasing average age of patients coming to surgery and the inventiveness of surgeons require the same or greater vigilance and sophistication that has led to this desirable change. In this book Dr. Zeitlin gives us a view of the difficulties and struggles that have led to this improvement. He recounts his own untutored, frightened early days in the operating room for six years in hospitals in and around London. He continues with illuminating and powerful stories about the remainder of his career both in academic and private practice in Boston, Massachusetts. The patient in the hands of nearly all other specialists is able to see what his or her physician struggles with in making an accurate diagnosis and planning treatment. Obviously the surgeon's patient in the care of the anesthesiologist knows nothing about what actually occurs in the operating room. We believe this is the first book that gives the reader an inside view of the actors on this stage. It is not for nothing that operating rooms are called operating theatres in the United Kingdom. Although he does not aspire to such literary heights the author would like to think that to a small extent he does for anesthesia what Dr. Atul Gawande achieved for surgery with his illuminating book 'Complications'. Dr. Zeitlin tackles difficult matters such as possible awareness during anesthesia, drug addiction, violence related to anesthesia, his own and others' mishaps and the struggle for recognition that anesthesia is the practice of medicine. The author believes that anesthesiology is the use of intensive care and monitoring in the operating room, the recovery room and in the pain clinic. Some of the stories are so harrowing that the author includes three 'Intermissions' to provide the reader with some intriguing speculations about anesthesia. The most important story Dr. Zeitlin tells is that about the Anesthesia Patient Safety movement. Many of the principal movers of this success story worked in Boston and the author was privileged to have known them all. The disciplines of safe patient care began with anesthesiologists and have now spread to all of medicine. Anesthesiologists introduced the use of simulators in accident prevention. The author does not dismiss the very important roles played in all this by cardiologists, surgeons, pre-and postoperative nurses, our medical industry colleagues and most of all our close collaborators, nurse- anesthetists.
About the Author: Dr. Zeitlin is a graduate of the University of Cambridge in England. After qualification as a physician in 1958 he became intrigued by the power of anesthesiologists in saving the lives of young patients dying of poliomyelitis. It struck him that although anesthesia was still a primitive mostly empirical medical non-science, that the potential for improvement was great. He began by doing 'locum tenens' jobs in peripheral hospitals. Shortly after this he obtained the postgraduate diploma of Fellow of the Royal College of Anaesthetists. The ladder to a 'top job' (a Consultancy) was very steep in those days. His Chief at the Middlesex Hospital, an important London academic institution, suggested a year in America. He traveled steerage to Boston and to his surprise found that his experience in the U.K. more than qualified him as faculty at Harvard Medical School at the Peter Bent Brigham Hospital. His wife loved America and the American ethos and restarted her career as a professional classical violinist. Later, Dr. Zeitlin moved to a high quality private practice near Boston but for the last 14 years of his career he returned to academia because of his love for teaching. Some of Dr. Zeitlin's later activities included the Presidency of the Massachusetts Society of Anesthesiologists, Delegate to the House of Delegates of the American Society of Anesthesiologists and as Principal Reviewer for the American Society of Anesthesiologists Closed Claims Project. He was graciously accepted by the American Board of Anesthesiology as one of its Diplomates in 1968. He has always been fascinated by the history of anesthesiology; the reader will know that it really began in Boston with the somewhat scurrilous dentist William T.G. Morton - whose grave in the Mount Auburn Cemetery Dr. Zeitlin visits twice each year. In recent years Dr. Zeitlin has published many articles about the 'stimmung' or aura of anesthesia - particularly its place in society. Three years ago he attended a lecture at Grub Street Writers in Boston titled 'Do You Have a Book?'. A few nights later he awoke suddenly and realized he "Did Have A Book". If anyone buys a copy they should feel extra righteous because Dr. Zeitlin will donate half the proceeds to the Foundation for Anesthesia Education and Research. This is the premier funding organization for young scientists in our specialty to find ways of improving even further your care in the operating room.