The notion of burnout among medical specialists, while long-recognized, has become increasingly topical. Anesthesiologists are often quoted as a group at increased risk of this condition, and so this text would seem particularly timely and relevant to our specialty. Burnout, Fatigue, Exhaustion, the title of which reads like a list of ailments familiar to any busy anesthesiologist, delves deeply into the notion of burnout. It comprises a collection of essays that explore the history of exhaustion, fatigue, and burnout, as well as the significance of these pathological conditions in modern society. This book is designed to appeal to an audience spread across many disciplines including psychology, psychiatry, sociology, literature, and medicine. At 316 pages, it is a lengthy and detailed text, encompassing 14 chapters written by various authors. The book is also divided into 5 parts that provide welcome structure to the content: Cultural–Historical Perspectives, Exhaustion Syndromes, Exhaustion and Self Realisation, Exhaustion Discourses, and Exhaustion and the Social. The weight of information presented is such that I feel that this book is primarily aimed at the academic reader with an appetite for the minutia of the topic. However, its usefulness as a reference text for busy clinicians is apparent in several areas, such as the second part of the book, which is dedicated to “Exhaustion Syndromes: Concepts and Definitions.” Here, factual elements, such as definitions and classifications of fatigue syndromes, are nicely presented in table form. For example, this section provides useful information on differentiating chronic fatigue syndrome from depression. It also includes a detailed discussion on the phenomenon of “burnout,” including its diagnosis, referring to the “burnout triad” of emotional exhaustion, cynicism, and a sense of ineffectiveness. It provides a comprehensive analysis of the condition to aid clinicians in recognizing it and also how to differentiate between burnout and depression. The book is attractively produced, with some headings posing a question and the subsequent text aiming to answer the question in detail. The index is complete and helpful. The inclusion of some illustrations or information presented in graphical form would be a welcome addition to break up what is otherwise quite dense text. Burnout is often considered a modern phenomenon, and it is the way in which the authors put the condition into a historical context that is a most intriguing aspect of this book. The academic discovery of burnout is explained. The authors highlight historical texts that refer to the notion of burnout. This fascinating portion of the book refers to such wide-ranging works as the writings of William Shakespeare and the Old Testament. In this way, the book follows the evolution of our understanding of burnout. The book is carefully researched and up to date, providing an extensive review of scientific publications addressing burnout. The authors have included findings from their own research, including those related to the behaviors and attitudes associated with burnout. This is relevant to clinicians given that it is so well described that we are often slow to recognize the signs of burnout in ourselves or others. With this in mind, clinicians may be particularly interested in the section entitled, “Self Realisation Through Work and Its Failure.” Here, the author provides personal accounts from those who admit to self-medicating with cognitive-enhancing medication such as “Adderall” and “Ritalin,” to increase their focus, attention, and productivity at work. The section “Rechargeable Man in a Hamster Wheel World,” discusses balancing exercises, and the notion of a pause button, to reduce burnout. They refer to the worker who derives self-esteem entirely from their job versus those who are able to withdraw mentally after work into the company of family and friends. This section, which is very pertinent to anesthetists, offers an in-depth review of the importance of having the much sought after work-life balance. Burnout, Fatigue, Exhaustion addresses how mankind has discovered and dealt with burnout throughout the ages. It is a detailed and dense book, and for this reason, cover-to-cover reading may be best suited to those with a special interest in the topic. At the same time, it certainly has value as a reference text for those with a more casual interest in the subject. Exhaustion is a significant and underrecognized health problem, one which anesthesiologists are at increased risk of experiencing, and this book provides comprehensive information on all aspects of its form and formation. Martina Melvin, MBBCh, BAO, MCAI, FCAIAbigail Walsh, MB(HONS), BMEDSCI, MRCP(UK), FCAI, FJFICMIDepartment of AnaesthesiaSt Vincents University HospitalDublin, Ireland
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