Careers in Anesthesiology: Autobiographical Memoirs Volume VIII. A. A. Spence, Julien F. Biebuyck, Richard J. Kitz, John W. Severinghaus. Edited by Donald Canton, M.D., and Kathryn E. McGoldrick, M.D. Park Ridge, IL, Wood Library-Museum of Anesthesiology, 2004. Pages: 273. Price: $60.00.

The eighth volume in the Wood Library-Museum's living history series Careers in Anesthesiology  presents the autobiographical sketches of four persons “… involved with the establishment of research as part of the clinical specialty of anesthesiology,” Drs. Alastair A. Spence, M.D., F.R.C.A. (Professor of Anesthesia, University of Glasgow, Glasgow, Scotland, United Kingdom), Julien F. Biebuyck, M.B., Ch.B., D.Phil., F.F.A.C.M., F.F.A.R.A.C.S, F.A.N.Z.A., F.R.C.A. (Professor and Eric. A. Walker Chair of Anesthesiology, The Pennsylvania State University, Hershey, Pennsylvania), Richard J. Kitz, M.D. (Henry Isaiah Dorr Professor, Harvard University and Anesthetist-in-Chief, Massachusetts General Hospital, Boston, Massachusetts), and John W. Severinghaus, M.D., F.R.C.A., Dr.Med.H.C. (Professor of Anesthesiology, University of California San Francisco, San Francisco, California). These authors, whose early careers in anesthesiology are identified with basic and clinical research, discuss the development of anesthesiology research and academic anesthesiology in the United States and Europe during the second half of the 20th century as they experienced it.

Consistent among the stories these four individuals tell is the role that “serendipity” played in shaping their careers and lives. Simple conversations with key individuals and often silent, behind-the-scenes promotion by more senior individuals led to promotion and positioning to facilitate the breakthrough discoveries that are the very foundation of anesthesiology practice to this day. It is also quite interesting to observe how the lives of these scientists traveled parallel but often intersecting paths during this crucial period in the development of the specialty of anesthesiology. What differs among each essay is the perspective from which each writes: Dr. Spence as the long-time editor of the British Journal of Anesthesiology , Dr. Biebuyck as the founder and chair of Pennsylvania State College's anesthesia department, Dr. Kitz as anesthetist-in-chief of Massachusetts General Hospital, and Dr. Severinghaus' esteemed research programs at the University of California, San Francisco. In this context, the use of these four individuals by the editors (Drs. Donald Caton and Kathryn McGoldrick) to develop the story of academic anesthesiology clearly works well and gives a broad picture of how research impacts the direction in which physicians' personal and professional lives travel.

The authors give varying amounts of detail on their research itself. Those readers looking to learn the specifics behind how these four individuals developed their landmark ideas (including, among many others, Spence's studies of hyperbaric medicine and pulmonary physiology, Biebuyck's development of a swine model of malignant hyperthermia, Kitz's discoveries of anticholinesterases and muscle relaxants, and Severinghaus' studies of high-altitude physiology and the development of the blood gas electrode and other anesthesia monitors) may be better suited to find other histories on these subjects. Likewise, the essays do not provide full autobiographies of the authors but stay mostly on the task requested of these authors to “… discuss [their] career … including the influences, education, and development of research in the author's career and [their] impact on a department, school, university, our profession, and even in some instances, science and/or medicine.” Consequently, this collection of autobiographies will likely appeal primarily to those who have developed an interest in the history of anesthesiology or those who experienced the postwar “maturation of the profession” themselves. However, the firsthand perspective on academic anesthesiology that this book provides will also appeal to younger investigators who might be surprised to learn that these great scientists shared many of the same insecurities and concerns common today and that even those giants on whose shoulders the current generation of academic anesthesiologists stand had their own giants.

In summary, the politics, economics, and individuals that shaped academic anesthesiology (and academic medicine in general) are well described through the personal stories of four individuals who contributed to this legacy. It is an excellent installment in the Careers in Anesthesiology: Autobiographical Memoirs  and should be a part of every academic anesthesiology department's library.

Mayo Clinic, Rochester, Minnesota.