My Experience Writing the CSA History of Anesthesia Essay

For as long as I can remember, I have always had an interest in history. In elementary school, my father introduced me to one of the greatest software applications created, a PC home encyclopedia called Encarta 95. I spent hours upon hours perusing the sciences, learning about religion and philosophy, and traveling the globe within Encarta's seemingly infinite database. As I advanced in the education system, my focus began to turn toward STEM subjects, leaving less and less time for studies in the liberal arts or humanities. Although I majored in biology at the University of Texas, I was fortunate enough to have taken a course, Perspectives on Science and Mathematics, which left an impression on me. I recall one of my final studies in the class was the Manhattan Project; we not only explored the development of the first atomic weapon, but also the ethics, values, and social background of the monumental scientific endeavor behind it. My education continued into postgraduate studies, but that was probably one of the last times I had substantial dedicated time to study the historical contexts of the advanced sciences.

When I began my residency at Stanford, I first worked with Jay Brodsky, MD, as a first-year anesthesiology resident in 2019. In the fifth decade of his anesthesia career, he remained an intimidating figure, especially to novices like me. He was a proud man, often backing his clinical reasoning with a well-referenced source from the literature, where I noticed his name frequently listed as one of the authors. When I first learned about the California Society of Anesthesiologists (CSA) History of Anesthesia Essay Contest, I wanted to submit a piece but had a hard time coming up with topics. Then the next thing I knew, the deadline had passed. The same email landed in my inbox the following year calling for submissions, and I had a glimmer of an idea after reading a recent article published by Dr. Brodsky describing the utility of Ryanodex, or dantrolene nanosuspension, versus conventional administration of dantrolene. Within the article, I found a lead that fulfilled the essay's requirement for a topic on a major contribution by a California anesthesiologist. Hence, I chose the intriguing topic of the first use of I.V. dantrolene in humans.

I am not a skilled writer by any means, having neither formal training in writing nor the natural ability to wax poetic. However, through years of forced practice, from grade school assignments to college essays to, more practically, personal statements for medical school and residency, I learned that one of the hardest parts of writing was just to get started. I requested an interview with Dr. Brodsky on one of my post-call days in summer 2021, on the eve of his retirement. However, I did not begin writing the essay until that winter, about a month before it was due. Doubt, procrastination, and impending deadlines beleaguered my process. The beginning was slow, but once I had something down, I was able to continue, revise, and eventually submit and wait. In early January 2022, I received notice that I had been chosen as the finalist in the 2022 CSA History of Anesthesia Essay Contest for a paper titled “Fortune Favors the Prepared Mind: The First Use of I.V. Dantrolene to Treat Malignant Hyperthermia in an Adult Patient” (asamonitor.pub/3jl4cwO).

William Flanary, MD, who goes by his popular online medical comedy alias Dr. Glaucomflecken, said it best in one of his talks to medical students that our jobs can easily take over our lives and that “given the chance, everything about [oneself] can become medicine.” It was honestly hard for me to pursue this interest while I was a resident for many reasons, but time was a large factor – something that seemed so abundant when I was a child exploring Encarta. As residents, we are required to work anywhere from 40-80 hours per week to fulfill clinical as well as scholarly duties and are compensated at a fraction of the salary our peers with professional degrees make. Serendipitously, a confluence of my background and exposure to the history of science in my formative years, help from my wife who I absolutely trust as my editor and constant source of encouragement, and the prospect of a modest amount of prize money supplied by the CSA gave me the pushes necessary to write the essay. The experience of exploring, investigating, and documenting the history of anesthesia was a fulfilling and worthwhile endeavor and reinforced what I already knew: throughout our careers, we all strive to maintain a personal life with friends, family, and loved ones and to keep up with hobbies and interests. Despite the difficulties, pursuing our passions outside of medicine, whether they are in the humanities, arts, outdoors, nature, or beyond, is paramount to sustaining ourselves firstly as human beings and also as healers in our field.