Graph from Northwestern University website  At the academic medical center where I work, when a physician reaches the age of 74½ years he or she must pass cognitive testing to retain their medical staff privileges. The testing includes a peer-conducted clinical skills assessment by three medical staff members, a comprehensive physical exam, and cognitive screening under supervision of the neuropsychiatry department, to address the applicant’s capacity to perform the clinical privileges requested. Should the President of the United States who is 82 years old, or his Republican opponent w ..read more

There’s an old saying in the medical profession: “To be an excellent doctor, you must have three things: availability, affability, and ability (in that order).”  In some specialties a doctor’s technical ability may be the least important of the three attributes, but this is not true in anesthesiology. If you want to gain a top-notch anesthesiology job, the order of the three A’s is instead: ability, affability and availability. Here’s why the three A’s are in a different order for anesthesiology: ABILITY: For an anesthesiologist seeking a high-paying job in a competitive region of the co ..read more

Anesthesiologists work with surgeons of every specialty. Remarkable surgeons made world-changing breakthroughs during the past 70 years. The top 10 surgical advances during this time included: • THE HEART-LUNG MACHINE • ARTHROSCOPY • HEART TRANSPLANTATION • THE FIBEROPTIC ENDOSCOPE • VIDEOLAPAROSCOPY • INTERVENTIONAL RADIOLOGY/ANGIOPLASTY/STENTS • LIVER TRANSPLANTATION • TOTAL JOINT REPLACEMENT • LASIK • TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR)   THE LIST IN ROUGHLY CHRONOLOGIC ORDER: • THE HEART-LUNG MACHINE AND OPEN HEART SURGERY. Inventor: Dr. John Gibbon (1950s). The heart-lung ..read more

Emma Stone in Poor Things   Daniel Kaluuya in Get Out     The movie Poor Things was nominated for the 2024 Academy Award for Best Picture. Poor Things starlet Emma Stone won the Best Actress Oscar for her role as a woman who received a brain transplant from an infant. The plot of the movie was impossible without the notion of brain transplantation, which was performed in the surgeon’s home. The 2017 Jordan Peele movie Get Out earned $255 million with its premise that a neurosurgeon was transplanting the brains of wealthy elderly humans into the bodies of young healthy Black ..read more

The Anesthesia Consultant was just named the #1 anesthesiology blog in the world by Feedspot. I’m  grateful for this distinction.  As of March 2024 we’ve received over 2.9 million clicks on The Anesthesia Consultant from over 100 countries. The website currently contains over 300 columns, opinion editorials, ranking lists and anecdotes. Half the articles are intended for anesthesia professionals, and half are intended for lay readers. Feedspot ranked a total of 25 anesthesia blogs/websites. Other anesthesia blogs ranked by Feedspot include these:   EdMariano.com Anaesthesi ..read more

I’m an anesthesiologist, and I like to tell stories. This one is true. If you wonder how much the anesthesia scene has changed significantly over the past four decades, check out this narrative: In 1986 I was in my second and final year of anesthesia residency training at Stanford, and I was looking for a job. The entire program was 24 months long in those days. We were all due to graduate from the residency on the 30th of June, and in the middle of the second year it was routine to begin searching for a full time job to begin in July. I heard about an opening with a busy private practice ane ..read more

Is your doctor an experienced anesthesia provider or a newbie? The list below chronicles the crescendo of growth of as I’ve witnessed it from a newly-trained anesthesia doctor to an expert practitioner. It’s a development of skills, maturity, and judgment over many years. As a patient, the only signs you’re likely to recognize are #1 and #2 below, but each of these differences are real. In my view, inexperienced anesthesia providers are more likely to: Be nervous/anxious. This observation is no surprise. Everyone is more nervous at their job when they’re a novice than when they’re experience ..read more

The state of Alabama executed inmate Kenneth Smith on January 25, 2024, by forcing him to breathe 100% nitrogen gas. It was the first known execution in the United States by this method. Smith was 58 years old. He was sentenced to death for his role in a 1988 murder. Smith’s lawyers had expressed that death by inhaling nitrogen would cause excessive pain and would be a form of torture. Appeals failed, and the execution went forward. The procedure occurred at the William C. Holman Correctional Facility in Atmore, Alabama. Smith was fitted with a mask, and that mask was connected to a device th ..read more

Anesthesiologists aren’t well known to most patients, but these specialty doctors have certain traits in common. Anesthesiologists are likely to have: A preference for being in an operating room rather than in a clinic. The practice of anesthesiology is the practice of perioperative medicine. Perioperative medicine has three phases: prior to surgery, during surgery, and after surgery. While the preoperative process may involve a preoperative clinic in university settings, in most community practices the anesthesiologist evaluates the patient immediately prior to surgery. This may occur via a ..read more

  CardioPulmonary Resuscitation in the Operating Room   The Stanford Emergency Manual has become an essential reference for anesthesiologists. The manual lists diagnostic and therapeutic steps to follow in 26 different emergency scenarios. When a Code Blue or a dire change in vital signs occurs in an operating room, the Manual directs the resuscitation team to the correct order of action at a time when minds are racing, thoughts have become jumbled, and near-perfect intervention is required. The Stanford Emergency Manual is now available in a 4¼ X 5-inch pocket version, suitable f ..read more