Careers in Anesthesiology: Autobiographical Memoirs. Vol. 6 (review)

The Wood Library-Museum of Anesthesiology's series of autobiographies of notable anesthesiologists began in 1996 to commemorate the sesquicentennial of the first public demonstration of surgical anesthesia; its purpose is to document the development of modern anesthesiology through personal stories. The participants in this volume are B. Raymond Fink (University of Washington), Luke Kitahata (previously chair of anesthesiology at Yale), J. Roger Maltby (University of Calgary), and Thomas T. McGranahan, a private practitioner in Oregon.

In many ways, this is the best volume to date. The geographic range of the book is extraordinary, moving from England, Belgium, South Africa, Japan, Nepal, and Canada through North Carolina, New York City, and the rural U.S. Northwest. The profound effect of World War II on everyday lives and on the development of anesthesiology, even as late as the mid-1960s, is a common theme. The topics covered in the individual stories are wide-ranging also, including the evolution of the larynx, the American bombing of Tokyo at the end of World War II, the joys of playing the violin, the development of modern medicine in Nepal, Sherlock Holmes and anesthesia, the rise of outpatient surgery, and "surgeon-bashing." As was the case in previous volumes, chance events led the authors into anesthesia. Two of them entered the field after experiencing problem cases: While working at a mission hospital in South Africa, Dr. Fink operated on a young girl who died of airway obstruction postoperatively; her mother's scream when she learned of the death remained with him throughout his life, and led him to anesthesiology to try to prevent such deaths. A brilliant research career followed, often focused on the airway. Dr. Kitahata was a neurosurgeon in Japan who experienced difficulty with his patients' anesthesia, due to the primitive state of Japanese anesthesia post-World War II. An incident with a very demanding and very obese visitor from Germany led him to an anesthesiology residency in New York, with the plan to return to Japan to improve anesthesia there; American licensing laws led to a delay in his return to his home country, and others were working to improve Japanese anesthesia by then, so the Japanese came for training in the outstanding department he chaired at Yale. Dr. McGranahan saw a movie short on a famous anesthesiologist as a child, and remembered it when an incident took place during a student rotation on urology; he then decided on anesthesia. Dr. Maltby left general practice seeking to specialize, and chose anesthesiology because it required a wide range of medical knowledge.

This volume documents very well the personal lives of these anesthesiologists and the complex systems in which they worked. As an anesthesiologist myself, I greatly appreciated these stories by very dedicated physicians who all worked in a wide variety of very difficult situations and who strove to advance anesthesia through education and research. Dr. Fink's chapter is especially enjoyable. He was a true intellectual and one of the most brilliant researchers in anesthesia, but he was extremely modest and hardly ever talked about his many accomplishments; but because he died before his chapter was complete, it was finished by his wife and daughters, who gave us a full accounting of those accomplishments. Dr. Fink, who began this series and who served as its editor until his death, leaves us an important legacy in these personal stories by those who made anesthesiology the vigorous and scientifically based specialty it is today.