Books: What Happens When You Go Under

By HENRY MARSH JAN. 3, 2018

Christopher Silas Neal

ANESTHESIA 
The Gift of Oblivion and the Mystery of Consciousness
By Kate Cole-Adams
400 pp. Counterpoint. $28.

COUNTING BACKWARDS 
A Doctor’s Notes on Anesthesia
By Henry Jay Przybylo
240 pp. W.W. Norton & Company. $25.95.

As the anesthesiologist Henry Jay Przybylo explains in “Counting Backwards,” the word “anesthesia” means “without feeling,” but a modern general anesthetic is about much more than just rendering a patient unconscious. It also involves analgesia, the prevention of pain; anxiolysis, the relief of anxiety; and amnesia, the obliteration of memory. The latter is necessary because it is by no means certain that patients are fully unconscious when anesthetized — a problem explored at length in Kate Cole-Adams’s book “Anesthesia.”

Despite the central role that anesthetic drugs play in medicine, very little about how they work is known for certain. Equally remarkable is the fact that ether, the first agent to be used as a general anesthetic, was shown by Paracelsus in the 16th century to put chickens to sleep. He wrote that it “quiets all suffering without any harm and relieves all pain…” It remains mysterious as to why 300 years were to pass before it came to be used as a general anesthetic. Some would point to Kuhn’s scientific paradigms and argue that medicine wasn’t ready for such a shift in thinking, others that it reflects the entirely unscientific nature of premodern medicine and the blinkered self-confidence of doctors. There are, of course, many similar examples in the history of medicine — perhaps the most egregious being the failure of the medical profession to exploit Leeuwenhoek’s invention in the 17th century of the microscope and his discovery of microbial life, as discussed in David Wootton’s book “Bad Medicine.

Full Article by Henry Marsh

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