Careers in Anesthesiology: Autobiographical Memoirs (review)

B. Raymond Fink and Kathryn E. McGoldrick, eds. Careers in Anesthesiology: Autobiographical Memoirs. Vol. 3: Stanley A. Feldman, "A Retrospective View"; Carlos P. Parsloe, "The Lifelong Apprenticeship of an Anesthesiologist"; Ephraim S. Siker, "Reflections"; John E. Steinhaus, "A Teaching Career in Anesthesiology"; Peter M. Winter, "From the Time of No People to the Time of No Money--An Expansionist's Tale." Park Ridge, Ill.: Wood Library-Museum of Anesthesiology, 1999. xi + 214 pp. Ill. $35.00 (1-889-595-02-0).

This is the third volume in a series of personal essays about their careers by leading anesthesiologists. ¹ The series is a project of the Wood Library-Museum of the American Society of Anesthesiologists and supplements its Living History project of videotapes of important anesthesiologists. Previous volumes in the series included only Americans; this new volume adds international perspective by including an Englishman (Stanley A. Feldman, Magill Chair of Anaesthetics at the University of London) and Carlos Parsloe of São Paulo, Brazil, former president of the World Federation of Societies of Anaesthesiologists. Two of the American authors were presidents of the American Society of Anesthesiologists, the national specialty society; one of these, Ephraim Siker, spent a year in England and so adds another international perspective. The third American author, Peter Winter, is a prestigious researcher in the areas of oxygenation and pressure and was chair of a huge anesthesia department with multiple hospitals, at the University of Pittsburgh.

Themes introduced in the other volumes continue here. The critical role of Dr. Ralph Waters and his program at the University of Wisconsin in stimulating medical students' interest in anesthesia and in anesthesia-related research appears in Parsloe's and Steinhaus's essays. The impact of war (now the Korean War instead of World War II, as in earlier volumes) and its stresses on those with little anesthesia training are clear from Siker's essay. The incredible difficulties of getting enough people interested in the specialty, of obtaining adequate reimbursement (especially in academic centers), and the political games played out in big hospitals and medical schools also show up again.

There is no coherent history of anesthesia, but numerous memorable stories help nonanesthesiologists understand the specialty's struggles to become what it is today. Siker writes of the first use of the first modern inhalation anesthetic, halothane, given while he was in England, and the marked hypotension that stopped the experiment--until they gradually figured out what the right dose should be. He also writes about the introduction of succinylcholine, the first rapidly acting muscle relaxant, and the vivacious personality of the man who did it, his mentor Francis Foldes. Carlos Parsloe gives a fascinating account of daily life in the operating room in South America. He also has written the only account of using the Ombrédanne inhaler, a French hand-held vaporizer introduced in 1908 that continued to be used in South America up to the Falklands War. The volume ends, appropriately, with Winters's account of the difficulties of teaching and working in a modern American academic medical center. After reading this, one has to wonder how American medicine has achieved as much as it has, and whether these past achievements can possibly continue.

The editor of the Careers volumes, B. Raymond Fink--an anesthesiologist-researcher-historian-humanitarian of the highest caliber--died recently. It is to be hoped that this series will continue to document the history of anesthesia through personal essays.

Selma Calmes
University of California, Los Angeles

 

Note

1. See the review of the first volume, Bull. Hist. Med., 1999, 73: 175-77.

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