LAUGHING AND CRYING ABOUT ANESTHESIA

First-time author and retired anesthesiologist Zeitlin elucidates the hands-on business of delivering sweet oblivion to surgical patients with as little risk as possible.

The Cambridge-educated son of a family doctor, Zeitlin concludes early on that coming to America—particularly in and around Boston, where he spends most of his Harvard-linked career—is the only way to avoid stagnation in the medical hierarchy on the other side of the pond. He retains so vivid a memory of his early days that, more than half a century later, he can recall whole conversations verbatim—or so his liberal use of quotation marks would suggest. But the author’s intellect, huge fund of subject knowledge, and high purpose more than compensate for any stylistic faults, such as his tendency to become unstuck in time as he relates anecdotes that range freely from the near-present to long ago. He beautifully captures the challenge and allure of his high-stakes craft: observing and, as much as possible, controlling the real-time response of the human organism to a variety of pain-obliterating anesthetics, whose merciful workings even now remain somewhat mysterious. His disturbing account of a young female patient’s unexpected response to anesthesia is brutally candid, right down to his abiding regret over never speaking to her family on his lawyer’s advice. The book’s greatest and most scholarly strength is its decade-by-decade recitation of advances and missteps in anesthesiology. There was, for example, the era of cyclopropane, a drug so explosive that static electricity could ignite it. The author also touches on the status-based frictions between rock-star surgeons and anesthesiologists, who are more apt to get the blame than the glory. As an offset, Zeitlin provides a short list of anesthesiologist heroes and what they accomplished. In the end, the author says, vastly improved monitoring devices deserve much credit for safety advances, but split-second judgments by “gas men” still make the difference.

A sometimes rambling but more often incisive memoir from a retired top-rank anesthesiologist looking back on a long career.