Counting Backwards: A Doctor's Notes on Anesthesia

by Henry Jay Przybylo MD

Overview

“An engaging and illuminating exploration of the invisible medical specialty that is anesthesia.… Counting Backwards pulls back the veil on the very act of being alive.” —Danielle Ofri, MD, PhD, author of What Patients Say, What Doctors Hear

For many of the 40 million Americans who undergo it each year, anesthesia is the source of great fear and fascination. In Counting Backwards, pediatric anesthesiologist Dr. Henry Jay Przybylo delivers an unforgettable account of the procedure’s daily dramas and fundamental mysteries. Przybylo has administered anesthesia more than 30,000 times over his thirty-year career: on newborn babies, screaming toddlers, sullen teenagers, even a gorilla. Filled with intense moments of near-disaster, life-saving successes, and simple grace, Counting Backwards is for anyone curious about what happens after we lose consciousness.

Product Details

ISBN-13:	9780393356427
Publisher:	Norton, W. W. & Company, Inc.
Publication date:	11/20/2018
Edition description:	Reprint
Pages:	256
Sales rank:	1,043,604
Product dimensions:	5.40(w) x 8.20(h) x 0.70(d)

About the Author

Henry Jay Przybylo, MD is an associate professor of anesthesiology at Northwestern University School of Medicine. He also holds an MFA in creative nonfiction from Goucher College. He lives in Chicago.

Table of Contents

Introduction ix

Chapter 1 A Deep Sleep 1

Chapter 2 Command Center 16

Chapter 3 The Five A's 31

Chapter 4 Railroad Tracks 47

Chapter 5 Fear of the Mask 57

Chapter 6 Nothing by Mouth 81

Chapter 7 Heartbeats 97

Chapter 8 A Most Unusual Patient 115

Chapter 9 Errors Everlasting 132

Chapter 10 In Wait 149

Chapter 11 Paper Cranes 161

Chapter 12 A Brain Trapped in a Box 181

Chapter 13 See One, Do One, Teach One 191

Chapter 14 Reentry 211

Chapter 15 Safe Travels 219

Acknowledgments 229

A Note on Sources 231

Editorial Reviews

It is difficult to write an exciting book about modern anesthesia but Przybylo is thoughtful and workmanlike in his production, as he is, it is quite clear, when administering his anesthetics.

The New York Times Book Review - Henry Marsh

★ 08/21/2017
Przybylo, associate professor of anesthesiology at Northwestern University School of Medicine, weaves an enjoyable narrative out of personal anecdotes from the wealth of experience he has gained over more than 30 years in a field that’s “ubiquitous but largely invisible.” He displays an ever-fresh wonder at and faith in “the gas” that makes invasive medical procedures possible, as well as a determined drive for perfection: “I am striving for pinpoint skill,” he writes. Przybylo meticulously cares for patients and their families, who often don’t meet “Dr. Jay” until they’re on their way to the operating room. He recounts an array of stories, including that of an impish four-year-old whose preoperation snack nearly caused disaster and a lifesaving operation he performed on a baby gorilla. After observing a young patient’s hospital agony during a life-altering trip to China, Przybylo says he defined his goal: “to wipe away all pain.” Przybylo exalts in his triumphs and learns from his mistakes, taking none of it for granted. He ponders how future generations may judge his field: “Will they view my career as barbaric, as I view the barber-surgeons of the nineteenth century?” Przybylo offers a rare and thoughtful look behind the scenes of this crucial yet arcane specialization. (Nov.)

Publishers Weekly

"I stayed up late to finish this book. In clear, direct prose, Dr. Przybylo offers a fascinating tour of the world of an anesthesiologist. Beautifully written, insightful, and informative, Counting Backwards is a great contribution, highly recommended."

Jennifer Michael Hecht

"An engaging and illuminating exploration of the invisible medical specialty that is anesthesia. We may seem to float effortlessly into an ether-world of unconsciousness during anesthesia, but Dr. Przybylo gives us a cockpit view of the human hands that pull the levers of our physiology. Counting Backwards pulls back the veil on the very act of being alive."

Danielle Ofri

07/01/2017
Przybylo (anesthesiology, Northwestern Univ.) offers a stirring account of his 30-year career as an anesthesiologist. He tells tales of the first person he ever anesthetized, his experience of working on a baby gorilla, and the time he wasn't allowed to perform anesthesiology on his own son, all interspersed with the history of anesthesiology and the trials and tribulations its early practitioners encountered. Przybylo also goes through his daily process of administering anesthesia and gives amusing and heartfelt anecdotes of his successes and failures. His passion for his work is felt through his stories, and while his admitted quest for absolute perfection may come off as arrogant to some, Przybylo ultimately allows readers a rare peek into the world of one of the more underrated and mysterious procedures in modern medicine. VERDICT Medical students will appreciate Przybylo's enthusiasm, and casual readers will find his description of his line of work engaging and educational. A solid addition to any nonfiction shelf.—Tyler Hixson, Brooklyn P. L.

Library Journal

2017-08-21
A veteran anesthesiologist probes the origins and mysteries of medically induced unconsciousness.Przybylo (Anesthesiology/Northwestern Univ. School of Medicine) shares anecdotes and personal impressions of his career, during which he has "administered anesthesia more than thirty thousand times." Specializing in the pediatric arena of his field, the author cares for more than 1,000 children in an average year, and he offers profiles of many of them in this vividly written, candid exploration. In many ways, Przybylo considers himself a faith healer since so many patients and their families put their trust in his expertise with the drugs he administers. He retraces the curious history of how painless surgeries were eventually achieved in the 1800s through the meticulously measured inhalation of ether, though the process itself was considered sacrilegious at the time. A compassionate, patient caregiver, the author describes how he empathizes with (and medically alleviates) his young patients' anxiety, fear, and confusion. The author discusses his lengthy tenure in medicine, which molded him into a highly controlled professional "always searching for ways to improve my care." Przybylo is also honest enough to include the medical blunders he has experienced during his career, and he provides a personalized walk-through that intriguingly describes the highly specialized equipment he uses, the "Five A's" of his comprehensive care, and why an empty stomach is essential to anesthesia success. Several of the cases he recalls embody the "dark side of medicine," but they are striking in content and quite moving. They include a high school sophomore basketball player who must endure a heart transplant and, surprisingly, a lethargic 2-year-old gorilla with a life-threatening infection. What may particularly resonate with readers, however, is the pharmaceutical gray area that still confounds Przybylo and the industry at large, as he admits to being "no closer to explaining the mechanism by which the gas I provide anesthetizes." A fascinating tour of a mystifying, unnerving, yet precious medical necessity.

Kirkus Reviews