All About Anaesthesia

John H. Gryfe is an oral and maxillofacial surgeon practising in
Toronto.

To many patients, the anaesthetist was the mystery person on the
surgical team. Rarely identified other than as “I’m Dr. So and So
and I’m going to put you to sleep” just prior to the initiation of
the procedure, the practitioners of this medical specialty remained a
misunderstood and elusive crew. In the 1980s, however, all of this
changed dramatically. Increasingly, the preoperative assessment became a
routine part of the planned procedure. Today, usually within a week of
the proposed treatment or investigation, patient and doctor meet face to
face for a frank discussion that includes a medical examination
stressing the patient’s cardiovascular and cardiopulmonary systems.
Routine explanation of the intended anaesthetic, including possible
complications or side effects, is provided to make both the specialist
and the patient comfortable about the approaching date, and the patient
is encouraged to voice any concerns he or she may be harboring. Safety,
trust, and a human presence have become paramount in the
anaesthetist/patient interaction.

The relevance of the book under review would have been unquestionable
in the pre-1980 period. The motivation behind All About Anaesthesia is
less clear today. Although accurate, the information it presents weakens
the bond of trust created by the current protocol. Why should we
encourage a return to a darker age? Complicating matters are the
repeated references to both Canadian and Australian standards, a
function of the authors’ nationalities. (Dr. Davies is a professor of
anaesthesia at the University of Calgary, and Dr. Westhorpe a
practitioner of pediatric anaesthesia in Melbourne.) While many of the
book’s topics (e.g., postoperative complications) would likely be less
intimidating or confusing in direct conversation, an appendix titled
“What You Can Do to Help” would be a fine stand-alone document to
give patients at the time of their preoperative assessment.