Counting Backwards: A Doctor's Notes on Anesthesia by Henry Jay Przybylo

Counting Backwards: A Doctor's Notes on Anesthesia

For many of the 40 million Americans who undergo anesthesia each year, it is the source of great fear and fascination. From the famous first demonstration of anesthesia in the Ether Dome at Massachusetts General Hospital in 1846 to today’s routine procedure that controls anxiety, memory formation, pain relief, and more, anesthesia has come a long way. But it remains one of...

Title:Counting Backwards: A Doctor's Notes on Anesthesia
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Counting Backwards: A Doctor's Notes on Anesthesia Reviews

  • Marika

    Anesthesiologist/author Przybylo takes readers beyond the forbidden operating room doors into the O.R. itself. In a calm, warm tone, the author details how patients are given anesthesia prior to medical procedures and the myriad of ways in which they differ. He deftly includes the history of anesthesia, from the discovery of ether to more modern ways of blocking pain and alleviating pre-surgery anxiety. Wonderful book for those skittish about undergoing surgery.

    I read an advance copy and was not

    Anesthesiologist/author Przybylo takes readers beyond the forbidden operating room doors into the O.R. itself. In a calm, warm tone, the author details how patients are given anesthesia prior to medical procedures and the myriad of ways in which they differ. He deftly includes the history of anesthesia, from the discovery of ether to more modern ways of blocking pain and alleviating pre-surgery anxiety. Wonderful book for those skittish about undergoing surgery.

    I read an advance copy and was not compensated.

  • Lynn

    This is a simple but fascinating memoir about the life of one particular anesthesiologist. The book provides pertinent history, medical knowledge, case studies and musings about the job and it's art. There is much more to the job than I thought. The anesthesiologist must examine the patient, decide on an anesthesia plan, put them out, keep them out, avoid mishaps, deal with emergencies, bring them back, and manage their postoperative pain. What I loved about the book is the author is humble, hum

    This is a simple but fascinating memoir about the life of one particular anesthesiologist. The book provides pertinent history, medical knowledge, case studies and musings about the job and it's art. There is much more to the job than I thought. The anesthesiologist must examine the patient, decide on an anesthesia plan, put them out, keep them out, avoid mishaps, deal with emergencies, bring them back, and manage their postoperative pain. What I loved about the book is the author is humble, humane, and honest with a great love for his job. I have been knocked out twice in my life and the experience was scary, weird, and interesting. Where does one go when you get to 97 and your conscious tether is released. This book gives you some clues but "going under" is still a mystery.

  • SibylM

    I won this book in a Goodreads giveaway, and an honest review was requested. Thank you to W.W. Norton for providing me this engrossing memoir! I absolutely love a good medical memoir, and this one delivered all of what I love: a smart, committed person with a real passion for medicine to narrate, a window into a new medical field I know little about, many interesting stories about patients (Tabibu was my favorite!) and excellent writing. I would recommend this book to anyone who has enjoyed memo

    I won this book in a Goodreads giveaway, and an honest review was requested. Thank you to W.W. Norton for providing me this engrossing memoir! I absolutely love a good medical memoir, and this one delivered all of what I love: a smart, committed person with a real passion for medicine to narrate, a window into a new medical field I know little about, many interesting stories about patients (Tabibu was my favorite!) and excellent writing. I would recommend this book to anyone who has enjoyed memoirs by Atul Gawande, Paul Kalanithi, or Damon Tweedy. I will say I don't agree with Dr. Przybylo's conviction that we all have a right to be completely pain free at all time in any circumstance -- I think that idea was invented and sold by opiate manufacturers and has been a big factor in the current opiate addiction epidemic -- but that's a minor quibble and it did not interfere with my enjoyment of this book at all. It is a very quick and engaging read, and it actually made me feel a lot better about the prospect of any future surgical procedure or hospital stay, which medical memoirs, quite honestly, rarely do.

  • Katie/Doing Dewey

    The sections on history and philosophy of anesthesiology weren't my favorite, but the fascinating, moving patient stories were fantastic.

    In his career of more thirty years, anesthesiologist Dr. Henry Jay Przybylo has administered anesthesia more than 30,000 times. His patients have included everyone from "newborn babies, screaming toddlers, sullen teenagers, even a gorilla." (

    ). As he shares his experiences with these patients, he also explores the nature of consciousness and the

    The sections on history and philosophy of anesthesiology weren't my favorite, but the fascinating, moving patient stories were fantastic.

    In his career of more thirty years, anesthesiologist Dr. Henry Jay Przybylo has administered anesthesia more than 30,000 times. His patients have included everyone from "newborn babies, screaming toddlers, sullen teenagers, even a gorilla." (

    ). As he shares his experiences with these patients, he also explores the nature of consciousness and the history of anesthesiology.

    The author led with some history of anesthesiology and his philosophy of how anesthesiology should be done. In these parts, he came across as somewhat self-important. For example, describing the gases he uses as 'my anesthesiology gases' instead of as 'the anesthesiology gases'. These little things that bothered me completely disappeared when he started talking about his patients. He clearly cares deeply for the well-being of his patients and told their stories with care and comparison. He's had some incredible experiences in his career, which were a pleasure to read about.

    His stories about his patients were delightfully varied. Some were funny, others heartbreaking. All were incredibly interesting. Topic transitions could be a little rough and I think I'd have enjoyed this book more had it been exclusively patient stories. These were the bulk of the book though and I'd definitely recommend picking this up for that reason. It was a quick, easy read and I think the engaging patient stories would make this a great pick even for someone who doesn't often pick up nonfiction.

  • Cynthia

    3.5 rounded up.

  • Dorie

    I would rate this book a 3.5 rounded up to a 4!

    I am always interested in any books related to the medical field and this sounded like a great one. I’ve had several surgeries and I’ve always wondered what it must be like to be the anesthesiologist, the one who really holds your life in his or her hand!

    What I loved about this book were his descriptions of interactions with his pediatric patients. He seems to have figured out a way to calm his patients so they aren’t so fearful about being “put und

    I would rate this book a 3.5 rounded up to a 4!

    I am always interested in any books related to the medical field and this sounded like a great one. I’ve had several surgeries and I’ve always wondered what it must be like to be the anesthesiologist, the one who really holds your life in his or her hand!

    What I loved about this book were his descriptions of interactions with his pediatric patients. He seems to have figured out a way to calm his patients so they aren’t so fearful about being “put under”. He has to deal with all sorts of children, some who have had multiple surgeries try to come up with a way to stop the procedure. There is a section about a little boy who tries to convince the doctor that “I had Cap’n Crunch” cereal, which of course is not allowed before the induction of anesthesia. Dr. Jay spent so much time trying to verify with the nurses that he had nothing to eat that morning only to find out later that the little boy had taken some cereal from another patient’s breakfast. Wow, dealing with kids has to be difficult!

    There were times where I did lose some interest in the book when he was talking about the history of anesthesia, how it all works, even the “philosophy” of anesthesia. Perhaps some of the technical parts of the book could have been shortened or omitted to make the book flow a little better.

    My very favorite part of the book, because I’m an animal lover, has to be the special case where he and his fellow physicians completed an operation on a gorilla, Tabibu, to be exact. She was very ill with a GI issue and would have died without the operation. Dr. Jay surprised his daughter, who dreams of becoming an animal nurse, and leads her into the recovery area where Tabibu was being cared for. His daughter was awed by the experience of being able to touch and stroke the gorilla and trying to comfort her. Dr. Jay stated "Most amazing to me, however, was watching Annie hold Tabibu and comfort this magnificent animal. It left me in awe. What joy." I should also mention

    that the doctors and care givers volunteered their time and the space because the zoo couldn't afford the care that the gorilla needed.

    I would recommend this book as a very good memoir, well written, about an anesthesiologist who cares deeply for his patients!

    I received an ARC of this book from the publisher and NetGalley.

  • Stephen Yoder

    This was a fun and fast read. Dr Przybylo is clearly a guy who is conversant in a very technical, high-stakes field of medicine but his writing isn't a thicket. It was darn clear. Anesthesia isn't a forgiving area, I suppose, and Dr Jay (as he calls himself) wasn't able to forgive himself for some earlier goofs in his career until those patients themselves showed some grace. High expectations are important, and yet they also can lead to painful moments after mistakes. This is what we want as pat

    This was a fun and fast read. Dr Przybylo is clearly a guy who is conversant in a very technical, high-stakes field of medicine but his writing isn't a thicket. It was darn clear. Anesthesia isn't a forgiving area, I suppose, and Dr Jay (as he calls himself) wasn't able to forgive himself for some earlier goofs in his career until those patients themselves showed some grace. High expectations are important, and yet they also can lead to painful moments after mistakes. This is what we want as patients, though, right?

    Now, if I had Dr Jay by my side I'd ask for some more nuance regarding removal of pain (one of the five A's, as he says, of anesthesia). Isn't some pain a helpful thing--a messenger of sorts? Perhaps there was some subtlety that I missed when he mentions that he wants to eradicate pain from patients.

    The sections about CP and the ways by which he endears himself to patients were very touching. How we relate & communicate with those around us is important, especially for those of us in positions of power. You never know who is listening, or who can understand, despite outward appearances.

    I'd recommend this book. I'm grateful I rec'd an ARC.

  • Gloria

    An interesting account about the history and use of anesthesia written by an anesthesiologist. I was interested in reading the book because of my fascination with the effects on the mind of anesthesia and drugs that induce amnesia. While the books did not go as deeply into this subject as I would have liked, there was a lot of interesting information. It was not particularly readable unfortunately.

    Thanks to the publisher and Netgalley for an eARC of this book.

  • Jen

    I'm always interested in medical history and autobiography, so I was very excited to read about an anesthesiologist's history and views on his profession. Too many of us take anesthesia for granted without a real understanding of what the practice entails.

    I found the historical background very interesting, especially how little really changes in the field. And I do admire his commitment to his patients.

    There were a few off-putting things for me. Parts of it felt like it had been written 20 or

    I'm always interested in medical history and autobiography, so I was very excited to read about an anesthesiologist's history and views on his profession. Too many of us take anesthesia for granted without a real understanding of what the practice entails.

    I found the historical background very interesting, especially how little really changes in the field. And I do admire his commitment to his patients.

    There were a few off-putting things for me. Parts of it felt like it had been written 20 or 30 years ago- he makes a repeated assertion that anyone in the U.S. has top-class healthcare available to them at any time, which we certainly know isn't true. And he seems to think that the U.S. is a world leader in access to healthcare for everyone, while ignoring that most of the developed world actually has some form of universal health care. And although the book was recently published, there was very little about the current opioid epidemic in the U.S., which for a doctor who deals with pain seemed very distant from reality. I was very glad to read of his journey towards understanding non-verbal patients.

    Overall I enjoyed it- please, let's have more anesthesiology memoirs!

  • Petra Eggs

    My late father had a triple bypass where the anaesthetic didn't work. As his muscles were completely paralysed as they have to be, he was unable to let anyone know that he was in excrutiating pain. Afterwards he repeated to the surgeon things he had said and the surgeon was very apologetic but that was all. (If he'd been American he could have sued!)

    I thought maybe this was a one-off but then last year I had surgery in the Bumrungrad in Bangkok, the world's 9th best hospital, so I expected top-

    My late father had a triple bypass where the anaesthetic didn't work. As his muscles were completely paralysed as they have to be, he was unable to let anyone know that he was in excrutiating pain. Afterwards he repeated to the surgeon things he had said and the surgeon was very apologetic but that was all. (If he'd been American he could have sued!)

    I thought maybe this was a one-off but then last year I had surgery in the Bumrungrad in Bangkok, the world's 9th best hospital, so I expected top-notch care. The anaesthetic didn't work on me either but I wasn't paralysed and could tell the surgeon who said he was sorry but he couldn't do anything about it as I'd had the maximum amount of drugs they could give, but he would give nerve blocks.

    You know those phenomenally painful injections they do in your mouth at the dentist? Well, every few minutes I had to have one or two of those for the duration of the operation. It was agony one way or another, just plain agony. I need to have a further procedure but cannot as Irma and Maria have screwed things up, so maybe next year. With full anaesthesia.

    My surgeon on the island, an English doctor of considerable reknown (as a world-class racing sailor though) used to use a magical form of anaesthesia. He used intravenous valium for a light sleep, ketamine (yes, the club drug but also the one used in road-side accidents where the pain or danger is too great for opioids) to take you away into another world, mine was always light and fluffy and filled with colourful hallucinations, and also those vile sharp-pointed needle nerve blocks, except I couldn't feel them being as I wasn't 'there'.

    He's not allowed to give ketamine any more. Sad that, you woke up from an operation feeling totally rested from a dream-filled sleep rather than nauseous and with a scratched throat from a general anaesthetic.

    I was interested then in the job of the anaethetist whom I had not really thought of as just the guy who keeps you asleep while the Really Important Doctor, the

    surgeon does their thing. However, the book explained that far from the person who keeps you (hopefully) asleep and (hopefully) pain free, the anaethetist is the doctor who is keeping you alive and is calling the shots on how and if the operation can proceed. It is fairly detailed as to layout of the anaethetist's area in the operating theatre, the gasses, tests, equipment and drugs used. That was interesting.

    Two things kind of got me about the book though. One he only ever heard of one patient (not his) who had woken up under anaesthesia, really? So my father and I were that rare? I don't think so. I think there is a lot of covering of mistakes going on. Secondly when the author dedicates himself to pain relief before, during and after surgery he gets guilty about the patients like ones with cerebral palsy who couldn't advocate for themselves. He said he figured they'd moan louder if it really hurt and that if they couldn't talk or control their muscles then they were unlikely to be any more aware intellectually. What????

    He saw a documentary where a CP sufferer using a computer generated voice said that having CP was like having a brain locked in a box. Then he saw the light. I had never presumed that someone physically disabled was necessarily mentally so too, I don't even see the correlation.

    My late uncle was, in his sphere as an anaethetist very famous. He took part in the UK's first heart transplant and the experimental surgery that led up to that, including the one where the pig (the subject) escaped and ran amok in the West End of London. He invented the concept of Intensive Care. I wonder if he ever had people wake up in operations and say, as I did to my surgeon, wow that was wonderful can I have some more ketamine please? (No, was the answer, you aren't in pain and there is only the sewing up to do. btw the sewing-up was done by a theatre nurse whose hobby was embroidery. Small island life...)

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