Why Did I Write a Book?

“We read to find out what we think. We write to find out who we are” -Rick Kreinbring

Writing is a way we gain a 3^rd person perspective of our own human experiences. The two themes common across all literature are love and death. Writing describes how we transcend these two limits of our biology: the basic drive to benefit ourselves at the expense of others and what happens to us after we die.

Love is the illogical emotion that binds us together. It seems to run in opposition to our evolution as biological organisms. Biologically, it shouldn’t exist. Humans would be more successful as individuals without love. We would probably be more efficient, reproduce more often, and make more money. Yet pure selfish people tend to not exist. People are almost always a mix of both selfish and selfless actions. They have illogical emotions, preferences, and habits that seem to be at odds with natural selection. Why is that? Writing about the things we love is a way for humans to understand the discrepancy between what makes logical sense and what we actually choose.

Death is the fundamental limit of the human experience. Because no one can come back to life after they are medically brain dead humans cannot know what happens after death. Instead they wrote myths and invented stories about how and why we die! The stories of Greek mythology and the Holy Bible have permeated almost every aspect of our moderns society. For every theme in modern literature involving death (especially Western Literature) there is a corresponding story from Greek Mythology and/or the Bible. Stories such as David and Goliath, Narcissus and the Reflecting Pool, and Cain & Abel are all as relevant today as they were thousands of years ago.

Writing, unlike people, can live forever as long as it is passed down from one generation to another. That means the most important ideas can be learned early by the next generation, giving them a head start in life. Anyone who sits down and writes unconsciously believes they have an accomplishment important enough to pass down to the next generation.

I want my knowledge and experience about anesthesiology to be available to the next generation of physicians. Anesthesiologists have found a way to successfully preserve human life against all odds! And we have the data to prove it. Anesthesia-related deaths in the United States—primarily from Black Swan events– have decreased from 640 per million anesthetics between 1948-1952, to 8.2 per million anesthetics between 1999-2005. This represents a >98% absolute reduction over 50 years. My book is the story of how that happened!

For perspective that means on average one patient dies every 120,481 cases. If I did 3 cases per day every day without taking any days off I would encounter a single death in 111 years. In 2020 that number is probably even lower than 8.2 per million cases. Furthermore, over the last 70 years patients became exponentially more complex, yet anesthesia became exponentially safer. It seems counterintuitive, yet our results speak for themselves.

I wrote my book to find out who I was an a doctor, an intensivist, and an anesthesiologist. Just as a physician is part historian, part practical scientist, and part craftsman my book contains historical anecdotes, explanations of scientific principles, statistical models, and philosophical questions. It combines both art and science to tell the story of modern anesthesiology and more importantly why that story can be used to manage and prevent the never-ending disasters that characterize our modern world.