Leadership in Anesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility

Abstract

Concerned by the skull grinning from the foreground of this volume’s front-cover illustration, I was reassured by the anesthetic antiques in the background. The back cover introduces the author, Dr. Berend Mets, the Eric A. Walker Professor and Chair of Anesthesiology at the Penn State College of Medicine. So, judging this book by its cover(s), why should readers bother paging through it? Here is why—many physician-authors have penned histories of medicine littered with lionizing biographies and little substance. Some of these writers have lamented having to wade through bogs of footnotes inked by “Ph.D. historians” who swim through the social milieu but rarely dive into analyses of clinical leadership. As an anesthesiologist with a Ph.D. in pharmacology, Dr. Berend Mets has staked out an unapologetic island between these authorship extremes with this remarkable new book. To readers, Leadership in Anesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility simultaneously offers meaty biographies and a leadership primer.Serving on the board of the World Federation of Societies of Anaesthesiologists after lecturing on six continents, Dr. Mets is clearly a global educator with something to say. Had I been wise enough to begin reading his book earlier in the day, I would have finished it in one sitting. Fortunately for me, this one-inch thick octavo fits easily in the pocket of my white clinical jacket. (So, I finished it on day 2.) This 341-page hardback is divided into eight chapters. Chapter 1, “Surgery Before Anesthesia,” races its way to the book’s wonderful second chapter, “A Brisk History of Leadership.” The latter starts by examining Aristotle, Plato, Machiavelli, and Napoleon for leadership concepts up to 1840. From that year forward, Dr. Mets fuses his own concepts with those authored by Drs. Peter G. Northouse and J. Robert Clinton to yield “Seven Ages of Leadership.” These range sequentially through the Ages of Great Man, Domination, Trait, Group-Goal, Behavior, Leadership versus Management, and finally Rapid Change.Chapters 3 and 4 focus on “Great Man Age” individuals by using Dr. Mets’ biographies of Boston’s William Morton and London’s John Snow, respectively. Morton was the narcissistic sociopath of a dentist who, after the world’s first successful public demonstration of surgical etherization, promoted the art of anesthesia. Sciences explored by physician Snow included both anesthesiology, as Queen Victoria’s chloroformist, and epidemiology, which he fathered while pinpointing sources for London’s 1854 Broad Street cholera outbreak. Chapters 5 through 7 are each a biographical gem including original archival research by Professor Mets into Dr. Arthur Guedel of Indiana and California, then Virginia Apgar of New York, and finally Bjørn Ibsen of Denmark. According to Dr. Mets, Morton crudely pursued the art; Snow, meticulously, the science; and Guedel, pragmatically, the practice of anesthesiology. Dr. Mets’ fourth biography subject, Apgar, assessed newborns using her namesake score to correlate outcomes. The final giant, Ibsen, “fathered” the intensive care unit.In his eighth and final chapter, Dr. Mets adds a seventh element to C. Northcote Parkinson’s six from that British naval historian’s Law of Delay to yield the following rubric for the art of leadership: Creative LEADER. This mnemonic captures the “seven key ingredients to successful leadership”: Creativity, Legitimacy, Emotional competence, Adaptability, Determination, Empathy, and Resilience. This handy tool also allows Dr. Mets to conduct a “leadership reckoning” of his biographees which proves quite fascinating.Remarkably, some professionals may order this book just as a primer in leadership, with all of this volume’s templates and analyses of what succeeded or failed for each of these heroes of anesthesiology. This book is certainly required reading for any aspiring anesthesiology leader or anybody hoping to maintain a leadership position. That is why I am ordering a copy as a gift for a dear colleague. A lot of facts and a load of wisdom are packed inside this volume. I am glad that I did not judge Leadership in Anesthesia entirely by its cover.