History of Anesthesia and Introduction to the Specialty

Abstract

Welcome to the exciting and fast-paced world of Anesthesiology! As a medical student rotating through anesthesia, you are fortunate in being able to learn about anesthesia without having to give it on your own. In the past, despite having little or no prior experience, medical students were often the ones administering the anesthetics. The time honored tradition of “See one, do one, teach one” would not be invoked. Instead, a bottle of ether would be provided, and you would “pour one.” This is, in fact, what happened in 1894 to a third-year student at the Massachusetts General Hospital. He was called down from the seats in the famed hospital amphitheater, sent to a side room with a patient and an orderly, and told to put the patient to sleep for a surgical demonstration. Knowing nothing about the patient whatsoever, he proceeded the best he could under the orderly’s directions. The patient was finally brought into the amphitheater after an interminable amount of gagging. Once the operation began, there was a great gush of fluid from the patient’s mouth, most of which he inhaled, and he died. Despite this unfortunate turn of events, the operation was completed and was deemed a success. That evening, the student went to see the surgeon to atone for his sins – planning to then find a different occupation. He was told that he was not responsible for the man’s death, as he had a strangulated hernia, had been vomiting all night anyway, and that sort of thing happened frequently. The student was Harvey Cushing, who went on to become one of the world’s greatest neurosurgeons.

For maximum impact, it is recommended that the case study and questions found on page xvii are reviewed before reading this chapter.