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Very Short Introductions #313
Anaesthesia: A Very Short Introduction
Title: Anaesthesia: A Very Short Introduction Binding: Paperback Author: Aidan O'Donnell Publisher: Oxford University Press
146 pages, Paperback
First published June 1, 2012
About the author
Aidan O'Donnell
5 booksAidan O'Donnell is a consultant anaesthetist at Waikato Hospital in Hamilton, New Zealand, with a main clinical interest in anaesthesia for childbirth, where he works as part of the Women’s Health team. His other interests are in teaching and medical writing.
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Displaying 1 - 9 of 9 reviews
October 3, 2017
This was a good general overview of the proceedure and the effects of anaesthesia.
Enjoy and Be Blessed.
Diamond
Enjoy and Be Blessed.
Diamond
March 3, 2015
A book with a title like that might be expected to be a fairly potent anaesthetic in itself, but it turned out to be surprisingly readable as well as informative. With hindsight, this is not surprising. The author is himself a professional anaesthetist, and a big part of his job is making sure patients stay calm while they are going under, because one of the first effects of anaesthetics is to block the inhibitory pathways in the brain, in much the same way as alcohol*. He speaks in carefully paced and measured tones with the confidence of an expert, in deep, rich and soothing New Zealand accent (or so I imagine - he is a New Zealander after all).
*In fact, this is because alcohol is an anaesthetic chemical itself, albeit not a very useful one, as the anaesthetic dose is higher than the lethal dose.
Chapter 1: Suspended animation: concepts of anaesthesia
Chapter 2: Historical perspective
Chapter 3: Nuts and bolts
Chapter 4: Bells and whistles
Chapter 5: Anaesthetic drugs and fluids
Chapter 6: Local and regional anaesthesia
Chapter 7: The different branches of anaesthesia
Chapter 8: Side effects, complications and risks of anaesthesia
Chapter 9: Anaesthesia tomorrow
*In fact, this is because alcohol is an anaesthetic chemical itself, albeit not a very useful one, as the anaesthetic dose is higher than the lethal dose.
Chapter 1: Suspended animation: concepts of anaesthesia
Chapter 2: Historical perspective
Chapter 3: Nuts and bolts
Chapter 4: Bells and whistles
Chapter 5: Anaesthetic drugs and fluids
Chapter 6: Local and regional anaesthesia
Chapter 7: The different branches of anaesthesia
Chapter 8: Side effects, complications and risks of anaesthesia
Chapter 9: Anaesthesia tomorrow
November 25, 2022
Anaesthesia: A Very Short Introduction (2012) by Aidan O'Donnell is a readable account of the field's history and current practice. Having some background in chemistry, biochemistry, pharmacology, and/or medicine will let the reader get more from this. I can't really judge how a reader with no science background would fare, but I imagine few such people would start with this book. Presumably the typical reader is the sort of person who reads science books for the nonspecialist, and should have no difficulty.
As with many VSIs that survey a discipline, this one recounts the history of how things developed. Anatomically modern humans have existed for at least 100,000 years (maybe 200,000 or more), and for almost all of it, pain was a normal and largely unavoidable aspect of human experience. That only began to change in the 1800s, at least in the developed parts of the world, with the discovery of a steadily increasing armada of chemicals that profoundly modify human experience.
A human is a collection of molecules that somehow generates awareness, sensation, and experiences. As any human quickly learns, some of these sensations can be highly unpleasant. Pain evolved for the same reason any trait evolves: generally to increase the fitness of the organism. Pain goads us to avoid things that threaten our survival by damaging our bodies. For example, the prick of a thorn causes a sharp pain, but out of proportion to the minor damage it causes. From the standpoint of evolution that makes sense, because a plant with one thorn typically bristles with more. An animal that ignored the first thorn and kept pushing into the briar patch could quickly get some real damage. The sensation we get from a single thorn reflects the most probable scenario our ancestors experienced.
Pain evolved in an ancestral past before surgeons. Even when we consciously accept that surgery is to our benefit, we can't override our evolutionary past, when getting cut open normally signaled the presence of a predatory animal or a hostile fellow human. No amount of being convinced of the benefits of surgery changes the aware brain's response to it. Pain comes from a part of the brain whose mind is firmly made up and can't be reasoned with. The best available solution now is to shut the mind down for the duration of surgery.
Science hasn't yet adequately explained just what conciousness is or how the brain generates it. According to the author of Adieu to God: Why Psychology Leads to Atheism, the enduring mystery of consciousness is one of the main reasons why religion continues to exist despite having its core claims nullified by science. But while philosophers of mind continue to fret over just how a lump of matter manages to have sensations, anaesthesiologists have wasted no time learning how to switch consciousness off and back on again. Nobody can quite explain how consciousness happens, but anaesthesiologists have found some of the off-switches and control knobs. Although O'Donnell doesn't mention it, this creates some obvious problems for the anti-materialist: if consciousness isn't something purely constructed by the material brain, operating according to the known laws of physics and chemistry, then how is consciousness so easy to modify, control, and dial down and back up by the simple application of chemistry?
If a Stone Age hunter-gatherer were to find a modern smartphone, he might find it magical. But once he learned how to switch it on and off and back on again, he'd work out that it follows rules and can be controlled. That puts it squarely into the realm of other material things that follow rules and can be controlled. Things like that don't require the existence of a god to explain them, nor is there any need to propitiate the gods when you operate such things, although the hunter-gatherer hasn't gotten far enough along with science to know that yet.
Many people, when contemplating the mystery of mind, are still like that chap from the Stone Age, quick to evoke magic, or God, or perhaps something with a veneer of pseudo-technological sophistication like panpsychism. But it seems to me that to maintain a mystical concept of mind, one has to ignore what anaesthesiologists do thousands of times every day: temporarily assume control of minds via chemicals.
O'Donnell points out that we moderns take it for granted that pain, especially severe pain, is an experience we expect to avoid. It's easy to forget just how profound a shift that is, since most of us never had to experience the horror of the unremitting, untreatable pain that so often plagued our ancestors. The conservative mindset tends to accept the way things are, and then come up with pollyannish justifications for them. Accordingly, progress with anaesthesia often met with resistance, for example from people who considered pain to be God's way of talking to people. (One imagines meeting such a person, strapping them to a medieval torture device, and asking "What's God saying to you now?")
As science continues to reap the fruit of materialism, expect resistance as science gives people more control over their lives. For example, medications might someday provide relief from PTSD, by changing the way brains recall and process persistently traumatic memories. Amazingly, some philosophers and theologians have objected to this, by declaring that our memories are part of what makes us who we are. I wonder what those people do when they get cancer. That cancer is part of who they are; does that make them reluctant to part with it? Curing any disease changes what the formerly sick person was while being sick.
As with many VSIs that survey a discipline, this one recounts the history of how things developed. Anatomically modern humans have existed for at least 100,000 years (maybe 200,000 or more), and for almost all of it, pain was a normal and largely unavoidable aspect of human experience. That only began to change in the 1800s, at least in the developed parts of the world, with the discovery of a steadily increasing armada of chemicals that profoundly modify human experience.
A human is a collection of molecules that somehow generates awareness, sensation, and experiences. As any human quickly learns, some of these sensations can be highly unpleasant. Pain evolved for the same reason any trait evolves: generally to increase the fitness of the organism. Pain goads us to avoid things that threaten our survival by damaging our bodies. For example, the prick of a thorn causes a sharp pain, but out of proportion to the minor damage it causes. From the standpoint of evolution that makes sense, because a plant with one thorn typically bristles with more. An animal that ignored the first thorn and kept pushing into the briar patch could quickly get some real damage. The sensation we get from a single thorn reflects the most probable scenario our ancestors experienced.
Pain evolved in an ancestral past before surgeons. Even when we consciously accept that surgery is to our benefit, we can't override our evolutionary past, when getting cut open normally signaled the presence of a predatory animal or a hostile fellow human. No amount of being convinced of the benefits of surgery changes the aware brain's response to it. Pain comes from a part of the brain whose mind is firmly made up and can't be reasoned with. The best available solution now is to shut the mind down for the duration of surgery.
Science hasn't yet adequately explained just what conciousness is or how the brain generates it. According to the author of Adieu to God: Why Psychology Leads to Atheism, the enduring mystery of consciousness is one of the main reasons why religion continues to exist despite having its core claims nullified by science. But while philosophers of mind continue to fret over just how a lump of matter manages to have sensations, anaesthesiologists have wasted no time learning how to switch consciousness off and back on again. Nobody can quite explain how consciousness happens, but anaesthesiologists have found some of the off-switches and control knobs. Although O'Donnell doesn't mention it, this creates some obvious problems for the anti-materialist: if consciousness isn't something purely constructed by the material brain, operating according to the known laws of physics and chemistry, then how is consciousness so easy to modify, control, and dial down and back up by the simple application of chemistry?
If a Stone Age hunter-gatherer were to find a modern smartphone, he might find it magical. But once he learned how to switch it on and off and back on again, he'd work out that it follows rules and can be controlled. That puts it squarely into the realm of other material things that follow rules and can be controlled. Things like that don't require the existence of a god to explain them, nor is there any need to propitiate the gods when you operate such things, although the hunter-gatherer hasn't gotten far enough along with science to know that yet.
Many people, when contemplating the mystery of mind, are still like that chap from the Stone Age, quick to evoke magic, or God, or perhaps something with a veneer of pseudo-technological sophistication like panpsychism. But it seems to me that to maintain a mystical concept of mind, one has to ignore what anaesthesiologists do thousands of times every day: temporarily assume control of minds via chemicals.
O'Donnell points out that we moderns take it for granted that pain, especially severe pain, is an experience we expect to avoid. It's easy to forget just how profound a shift that is, since most of us never had to experience the horror of the unremitting, untreatable pain that so often plagued our ancestors. The conservative mindset tends to accept the way things are, and then come up with pollyannish justifications for them. Accordingly, progress with anaesthesia often met with resistance, for example from people who considered pain to be God's way of talking to people. (One imagines meeting such a person, strapping them to a medieval torture device, and asking "What's God saying to you now?")
As science continues to reap the fruit of materialism, expect resistance as science gives people more control over their lives. For example, medications might someday provide relief from PTSD, by changing the way brains recall and process persistently traumatic memories. Amazingly, some philosophers and theologians have objected to this, by declaring that our memories are part of what makes us who we are. I wonder what those people do when they get cancer. That cancer is part of who they are; does that make them reluctant to part with it? Curing any disease changes what the formerly sick person was while being sick.
October 29, 2014
great intro. good amount of detail, easy to follow, well written.
November 16, 2023
Perfect introduction to the miracle that is general anesthesia. The section on the history of anesthesia is fun. There is a early medieval manuscript that has a recipe for a drink that will make so deep a sleep a man can be cut on. Since it is a combination of herbal poisons and opioids, I imagine the death rate was high. It was standard for scientists in the 19th century who were searching for new anesthetics to try them on themselves or, in one case, passing a new compound around the table at a dinner party!
Michael Jackson's death was caused by propofol, an injectable general anesthetic, not sleeping drug. Total inappropriate use of the drug!
Michael Jackson's death was caused by propofol, an injectable general anesthetic, not sleeping drug. Total inappropriate use of the drug!
October 27, 2023
A relatively painless (haha) if terminology-dense writing.
June 3, 2025
A very nice VSI that felt both wide in breadth, approachable for the laymen, and with a keen sense of anesthesia's history.
March 14, 2017
It's a good overview of anesthesia as whole. There's some good sections on the history of anesthesia as well, which definitely helps provide some context as to how we got to where we are.
Not something I'd suggest reading unless you are interested in the topic or want layman's overview.
Not something I'd suggest reading unless you are interested in the topic or want layman's overview.
December 19, 2024
A very readable overview. Some funky historical tidbits
Displaying 1 - 9 of 9 reviews