The update, which took effect Oct. 1, 2025, has also been adopted by the CDC. The goal was to facilitate healthcare providers in the United States to not only deliver a more conclusive diagnosis but to track and more precisely study the syndrome.

CHS is an increasingly recognized complication of chronic cannabis use, characterized by severe abdominal pain and recurrent episodes of nausea and intense vomiting. As the potency of cannabis has increased over the last few decades, so too has the prevalence of CHS.

Several published studies speak to the scope of the problem (JAMA Netw Open 2025;8[11]:e2545310), as well as detail a sharp rise in CHS-related emergency department visits in the United States (JAMA Netw Open 2025;8[7]:e2520492). The study reported a 49% annual increase among individuals aged 13 to 21 years between 2016 and 2023.

Reports of fraudulent medications include opioids, cancer drugs, erectile dysfunction medications and weight-loss medications. As such, both the FDA and the FBI have posted warnings of counterfeit medications, such as Ozempic (semaglutide, Novo Nordisk).  

"I unfortunately got to meet a patient taking a counterfeit for Ozempic. And in researching this patient I discovered that this is not only a problem here in the United States, but it's a problem worldwide," said Peter J. Papadakos, MD, a professor of anesthesiology and perioperative medicine, and the director of critical care medicine at the University of Rochester Medical Center, in New York. "You name a class of drug, and if it's expensive, it's being counterfeit and sold on the internet."

According to the agencies, many of these illegally manufactured “medications” contain no active pharmaceutical ingredients (or correct ingredients in the incorrect quantity), whereas some contain illicit ingredients, including fentanyl and methamphetamine, which can result in overdose and death.  

A few things stand out that seemingly most Americans can agree upon. Things cost too damned much. It is truly difficult to get a timely appointment with a primary care physician, and the wait is worse if you need a specialist. And profits for many health insurers soar while patients get denied vital coverage, and reimbursement to physicians tanks. There’s a lot of well-deserved anger and frustration out there, and one has to ask: When and how will any of this end?

As the vast majority of supplies that hospitals depend upon to safely operate are imported (such as gloves, gowns, machines, medicines and IV supplies), the tariffs will undoubtedly increase costs at every level. Additionally, the tariffs are likely to have a significant harmful impact on the country’s pharmaceutical supply chain, particularly in the generic space, and could exacerbate existing drug shortages. A significant portion of active pharmaceutical ingredients (APIs) and finished medications are manufactured abroad, with a substantial percentage of APIs originating from India and China—countries that are being hit with major increases in tariffs. 

"The general practitioners, the anesthesiologists, the entire medical community needs to be educated in occupational medicine and the lessons that we've learned in occupational medicine in dealing with massive exposure," said Peter J. Papadakos, MD, a professor of anesthesiology and perioperative medicine, and the director of critical care medicine at the University of Rochester Medical Center, in New York.  

"I think that when I look at this that it’s one of the largest environmental and health catastrophes that has befallen our country─if not the world─in terms of the amount of people that may have been contaminated, and those who may become contaminated once they go back to where their homes were."

Prior to  COVID-19, one in 10 elderly adults in the U.S. experienced elder abuse. A major review in 2017 of 52 studies from 28 nations reported that 15.7% of people over 60 were subjected to some form of abuse. In 2020, this number doubled to one in five—a nearly 84% increase. A study by the Administration for Aging stated that hundreds of thousands of seniors were abused, neglected and exploited by family and others.

The following is an excerpt from a related Time Magazine article:

"What is even more disturbing is that in 90% of cases, the abuser is a member of the family, based on findings in the study. In fact, two-thirds of the abusers were adult children or spouses. We, of course, find this to be a shocking statistic; since the dawn of recorded history the elderly have been given great respect and were cared for by both the family and the community as a whole."

As such, it’s critical that anesthesia providers in small hospitals and ambulatory surgery centers receive training in Advanced Trauma Life Support to augment the local response. Additionally, communities need to develop a response plan that includes all of the local medical resources, such as ambulatory centers and urgent care facilities, in the event of an attack.

Finally, we should advocate for the public at large to participate in the American Red Cross’s STOP THE BLEED program to increase the pool of first responders who are able to treat severe bleeding. We should stockpile bandages and tourniquets in all potential target areas. Working together, we may be more able to respond to these horrific events in a more effective way, and ultimately save more lives.  

We as health professionals need to address this crisis. To do so, the causes must be analyzed and solutions developed. Some issues, such as salary lines and child care, can easily be addressed. Others, such as professional burnout due to electronic medical record systems, which have taken professionals away from patient care—essentially making them data entry clerks—should be addressed, and jointly with technology companies. The bottom line is that all of us must focus on this crisis or it will lead to a marked decline of the American healthcare delivery system.

“The beauty of podcasting is that it allows the speaker to talk on a specific topic to a narrow audience. That way you can expand on a topic that may not be appropriate for a large population of people, but in that small niche, there is a lot of enthusiasm.” 

“This podcast is about my personal journey as an anesthesiologist in gaining understanding and being more involved with societies and committees in charge of maternal mortality and morbidity. My interest was sparked by my passion for obstetric anesthesia, and my new role as a division chief of OB anesthesia at UT Houston. Reviewing bad outcomes and thinking of ways of reducing such events was very eye-opening to me, and I hope to inspire others as well.”

A 55-year-old man with obesity presented for elective surgery for a chronic nonhealing ankle fracture. The patient reported a long history of loud snoring and type 2 diabetes. He was administered a general anesthetic and had no issues during the case. The patient recovered and was admitted to the hospital overnight, and it was noted that he had marked bouts of hypertension overnight while sleeping; the patient had no past history of hypertension. The staff also noted evidence of sleep apnea patterns of sleep and snoring. The patient was then discharged home. Three weeks later, the patient presented with a large embolic stroke and was admitted to the neuro-ICU. He was discharged to a rehabilitation facility with marked cognitive issues.  

This case illustrates how important it is for anesthesia providers to screen patients for OSA and educate patients about the major risks of OSA. There were also some key incidents during this admission that support the need for staff education. The episodes of hypertension during sleep and not while awake are a key sign of the cyclic sympathetic outflow that occurs during OSA. This also supports cyclic release of mediators that occurs during severe OSA that can affect the endothelium and cause activation of coagulation cascade. The snoring can also cause direct vibratory trauma to the carotid blood vessels, and also cause endothelium damage on the interior of those vessels that can generate a clot.  

We as anesthesia providers should be at the forefront of identification of OSA and have a protocol to educate patients and refer them to sleep specialists for testing and proper treatment. This can be a major public health contribution of our specialty.  

Citizens 65 years of age or older have a cancer incidence rate that is 10 times higher than among younger people, while the mortality rate among older cancer patients is 16 times greater than among younger patients. However, cancer is no longer considered a terminal disease. With the implementation of effective cancer prevention education programs, widely available screening programs leading to early diagnosis, and the advent of effective biologic and immunotherapeutic modalities, the profile of cancer is changing to a chronic medical condition.

There are more than 20 million cancer survivors currently living in the United States alone. Of the nearly 20 million new cancer cases worldwide in 2021, more than 80% of cases will need surgery, some several times as curative resection is essential for global cancer control, particularly for patients with solid tumors. It is estimated that by 2030, over 45 million surgical procedures will be needed globally for cancer control. Furthermore, both patients with cancer and cancer survivors will continue to need the services of our specialty in the perioperative setting well beyond their primary cancer care.  

As most of the diagnostic and interventional procedural care for patients with cancer is provided in the community setting around the world, this textbook, “Perioperative Care of the Cancer Patient,” will serve the educational needs of anesthesia providers in all settings globally. Each of the chapters is authored by international experts in the field and discusses the current understanding and practices, current controversies and unanswered questions, and the direction for future studies.  

I believe this is an exciting time for anesthesiology and perioperative medicine as we continue to partner with oncology and other specialties to break down silos and work together to improve postoperative outcomes and increase disease-free survival.  

It was through his work as an anesthesiologist for a plastic surgeon that he ended up meeting Michael Jackson, of all people, who immediately liked Dr. Ratner and his rock-and-roll roots.  

His rock music and medicine careers enjoyed some precipitous highs but also significant lows, all of which he candidly details in his book “Rock Doc.”

Perhaps surprisingly, however, our interview with Dr. Ratner is mostly not about his rock-and-roll past or his work doing non-OR anesthesiology, but instead about what he is up to today: serving as a kind of public health announcer for a radio station in, fittingly, Woodstock, N.Y. His work interpreting medical news—particularly as it relates to COVID-19—for the station (WDST; 100.1 MHz) has made a difference in the public’s understanding of the complicated issues brought about by the pandemic.

In the fall of 2019, a new synthetic opioid named isotonitazene made its debut in the U.S. and Canada. The drug, which is not a derivative of fentanyl but is equally as potent, is legal to export from China and was not initially banned in North America or Europe despite not being an approved pharmaceutical product anywhere in the world. However, the DEA has now issued an emergency temporary order placing isotonitazene as a Schedule I drug.

Isotonitazene is a derivative of benzimidazole, an opioid analgesic. It is 500 times more potent than morphine and has slightly more potency than fentanyl with respect to causing relaxation, euphoria and respiratory depression. In March 2020, isotonitazene was found in counterfeit hydromorphone tablets sold on the streets of the United States and Canada. There are also reports that this is being mixed with other street drugs such as cocaine. Isotonitazene is a growing public health risk and a real danger to those who misuse drugs, especially users of heroin and cocaine. Street names of this drug including nitazene or ISO may be volunteered by patients and other involved parties.

Another major issue for us in the ER and neuro ICU may be that normal toxicology screens do not identify this drug. Luckily, however, the drug is responsive to naloxone. It may be important for us to collect blood samples from patients responsive to naloxone but who tested negative for narcotics in our facilities and send it for analysis to help government agencies track the distribution of this drug. I also suggest that blood samples be sent for patients who present with hypoxic brain injury with unclear causes, especially individuals at risk.

According to Steve Garber, MD, a practicing obstetric anesthesiologist for more than 30 years, moms are eating earlier, up and around quicker, and ready and willing to go home earlier. The patient in this case study, who had a myomectomy 20 months earlier, essentially had a very similar surgery to a cesarean delivery. The incision was the same, the uterus was operated upon and the patient remained in the hospital. Her post-op course, as related to Garber and her husband, was vastly different in regard to her narcotic usage and how she felt. She was “out of it” for two to three days, and these were days she was home already. She felt dizzy, wasn’t able to concentrate and was in moderate pain, which is to be expected for the extent of her procedure.

So now, we get to compare the experience for the same patient, having essentially a very similar surgery, with a different post-op pain protocol: the ERAC protocol. Of note is the extent of the hemorrhage that occurred, the overnight stay in the ICU, Bakri balloon intervention and the patient didn’t require any narcotics for pain throughout her stay. The patient was amazed how well she felt post-op day 1, back in her private room with her newborn.

“Cesarean delivery is the most commonly performed major surgery in the world, with 1.3 million performed in 2019,” Garber said. “Unfortunately, every year 26,000 women become persistent opioid users after cesarean delivery. With a robust ERAC protocol, the reduction of opioid use is quite significant.

“If you look at our patient, if no ERAC protocol was used, she would have felt the same, or probably worse, than after her first surgery. Lethargic, out of it, dizzy, and would have been expected to bond with and take care of a newborn. The first hours and days with a newborn are so precious, and I believe all the moms should have the ability and opportunity to experience it with little to no narcotic use.”

And now, for the final episode of the series, various experts share their thoughts on how to best recognize and manage burnout, as well as how to strive for an optimal work‒life balance. These aren’t instant fixes, but rather takeaways for anyone, regardless of whether they are struggling or not. There has been no shortage of thought-provoking quotes throughout this investigative series, but the one that has most resonated with us is one that we hope you also hold onto: “When I think about wellness, the first thing that comes to mind is the old cliché of being on the airplane and being told, ‘Put on your own oxygen mask before you help those around you.’ So certainly, in the long run, one cannot be an effective doctor, caring for one's patients, if one does not also care for oneself. However, it’s equally as important that physicians work in environments that support their ability to do that.” Translation: Management can't simply prescribe yoga when the reason for burnout is staffing shortages.

Researchers recently found that 62.8% of physicians had at least one manifestation of burnout in 2021; and while the pandemic's peak is over, supply chain issues and staffing shortages still continue. Substance use disorder does affect anesthesiologists, as we know. This might be due to the ease of access to intravenous opioids, propofol and other anesthetic drugs. More sobering is the fact that every year in the U.S., roughly 300 to 400 physicians die by suicide. The ASA has a comprehensive webpage highlighting various help resources, including suicide and physician support lines, well-being apps, a burnout calculator and guides for doctors facing adverse outcomes and malpractice litigation. However, the most important thing to know is that you are not alone. Despite what you may think, many of your colleagues have previously gone through or are even currently experiencing many of the same feelings of burnout. So create a buddy system and know that there's nothing wrong with confiding in a peer, friend or even a trained professional.

While your focus is predominantly and perpetually on taking care of patients, it's okay to think about yourself for a change. Because as a former AMA president once said, "The most important patient we really have to take care of is the one in the mirror."

Stay tuned for the final episode of Anesthesiology News presents The Etherist, where a variety of experts share their thoughts on how to make the situation better, both at an institutional and an individual level. We hope that their experiences can inspire you. 

Additionally, stay tuned for episode 3 of Anesthesiology News presents The Etherist where various other experts discuss issues in the well-being realm, including managing stress and dealing with the cognitive workload as a resident. We also hear from a European anesthesiologist about cultural differences in the specialty.

Although “burnout” has historically been defined in several different ways, the term is generally characterized by three distinct components: emotional exhaustion (feelings of being overextended and depleted), depersonalization (having cynical and detached attitudes toward one’s work), and reduced feelings of personal accomplishment (involving a negative self-evaluation of one’s own effectiveness and worth).

So, what are the main causes of burnout and how can physicians foster a greater sense of well-being? Unfortunately, like any complex problem, there is no single solution. It’s a multifactorial condition that’s rooted in everything from schedules to culture. Anesthesiologists are often treated more like cogs in a wheel than professionals on which the system depends. And that’s what it’s mostly about, right? Simply wanting to feel valued, to be acknowledged as essential rather than expendable.

Nevertheless, there’s no scarcity of areas that require change. Do you curse the existence of the electronic health record? If you do, you are not alone. What is basically a billing system (one not designed by physicians) was forced on physicians, with virtually no input from physicians. It changed the way anesthesiologists worked; it changed how they thought; and it changed how they interacted with patients.

Additionally, in the push for volume-based care over value-based care, anesthesiologists are often asked to manage not one, not two, but three and even four ORs simultaneously. The expectation to simply get everything done, and as fast as possible, further cultivates this sense of depersonalization. It’s no longer Mr. Pizzi undergoing a total knee replacement; it's just another knee replacement. There’s an undeniable yet indefinable loss of personal achievement without that vital patient connection. Deprived of actually getting to know your patients, a profession that you once loved and maybe even felt a calling to, can slowly erode to feeling like a series of tedious tasks.

And without any say in what time a surgery begins or how long it goes on, the inability to dependably plan one’s personal time and achieve a sustainable work‒life balance only further highlights two recurring stresses: lack of control and a feeling of being marginalized.  

From institutional to legislative reform, there are countless opinions on how to stabilize the specialty’s turmoil. Yet the one prevailing sentiment is that if there isn’t significant change in healthcare, as well as the way anesthesiologists are viewed and treated, then the mass exodus will not only continue but even accelerate.

So, what can you personally do? Is the touted yoga and meditation combo the true salvation? For those listening to this right now, from medical school onward, did anyone actually teach you how to take care of yourself—walk you through the key elements for self-care and self-preservation? The focus is solely on taking care of patients, which obviously is critical, but as a former AMA president once said, "The most important patient we really have to take care of is the one in the mirror."

Join us as we speak with leaders in the physician well-being movement, and learn from their unique perspectives on achieving work‒life balance and personal fulfillment. In this first episode, we feature a true rock star: Amy Vinson, who among many other things is the chair of the American Society of Anesthesiologists Committee on Physician Well-Being.

This is episode 1 of season 4 of “Anesthesiology News presents The Etherist.” Episode 2 will be available on November 3, 2022. It will delve deeper into defining just what burnout is, how quickly it can creep up, the unexpected toll it can leave behind, and why being mindful of it and your well-being are paramount.

Sponsored by Masimo.

Join us on this journey as we speak with several leaders in the well-being field. And since we know that many of you are frankly burned-out from talking about burnout, please skip your mindfulness seminar and tune in, and maybe even find your happy place in the process.

This new season of The Etherist will be available on Thursday, October 20. The first episode will feature a true rock star: Amy Vinson, MD, who among many other things is the chair of the American Society of Anesthesiologists Committee on Physician Well-Being.

Sponsored by Masimo.

Agarwal is a clinical professor of anesthesiology at Stanford University School of Medicine, in California. She is also the past president of the Society for Pediatric Pain Medicine. She has been working on the efforts to pass legislation on dental anesthesia delivery since 2015.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

Links Mentioned:

• Caleb’s Law
• Disagreements Persist Over Safety of Dental Anesthesia - Anesthesiology News
• Link to Interview with Peggy Seidman, MD, a SmileMD anesthesiologist

Take Our Listener Survey!

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Goyal is an anesthesiologist from Columbus, Ohio. He started OFFOR Health to address the problems with patient access to anesthesia care in his community. Agrawal, who is also a Columbus native, spent 10 years working in Silicon Valley gaining experience in building startup-style companies. Goyal and Agrawal now run OFFOR Health and SmileMD, which provide office-based anesthesia care in Ohio, Illinois, Kentucky and Tennessee.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

Links Mentioned:

• Link to OFFOR Health
• Link to Interview with Peggy Seidman, MD, a SmileMD anesthesiologist
• Link to the ASA’s Difficult Airway Guidelines

Take Our Listener Survey!

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Frost was the original clinical editor of The Frost Series, which bears her name in honor of her contributions to the art of the case study. And she will be the guest editor of the series again in the May and June issues.

In preparation for her return to editing the series, Prudden, our editorial director, caught up with Frost to discuss some of the highlights of her career in treating and writing about unusual cases.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports about what it was like to experience those clinical situations and why they decided to write about them afterward.

Links Mentioned:

• Link to The Frost Series
• Link to Submit Your Own Case Report

Link to listener survey

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Rosenblatt is a professor of anesthesiology and otolaryngology at Yale School of Medicine, in New Haven, Conn. He developed the Airway on Demand program to provide educational resources on airway management. He was also a co-author of the ASA’s guidelines.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

Links Mentioned:

• Sign up for Going ROAG seminar

• Revised Difficult Airway Guidelines Broaden Scope – Anesthesiology News

• ASA Updates Difficult Airway Guidelines - Anesthesiology News

• Link to the ASA’s Difficult Airway Guidelines

• Link to presentation by Tim Cook on “no trace, wrong place”

• Send us an email submit a case for The Frost Series

Take Our Listener Survey!

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Stewart comes on the podcast to discuss the details behind the case as well as how she and her team were able to determine the right diagnosis despite the uniqueness of the case.

Stewart is a senior instructor of anesthesiology at the Denver Health Medical Center, and the director of Diversity, Equity and Inclusion in the Department of Anesthesiology at the University of Colorado, Denver.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports about what it was like to experience those clinical situations and why they decided to write about them afterward.

Link to listener survey!

Other Links Mentioned:

• Link to Case Report
• Link to Submit Your Own Case Report

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

“On the Case” is a review series that features the authors of our popular case report series. We hear the behind-the-scenes story on the most unique clinical case studies published in the magazine directly from the professionals who managed them. The first episode of this new season features an interview with L. Jane Stewart, MD, JD, MPH, who co-wrote a case report about a patient who experienced a unique complication from a scopolamine patch.

“Ask the Experts” is an interview series that features leading anesthesia experts on topics ranging from airway management to medical mission work and the future of anesthesia practice models. The first episode of this new season will feature an interview with William Rosenblatt, MD, who was a co-author of the new American Society of Anesthesiologists difficult airway guidelines.

These episodes will be published later this month. And new episodes from both of these new series will appear every month.

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

In previous episodes, we reviewed how the pioneers of anesthesia were able to successfully use ether and chloroform without the full knowledge of those drugs that we have today. In that spirit, we explore whether there is untapped potential in our current scientific expertise that could help improve the delivery of modern-day anesthesia.

This season of the podcast began with the retelling of the origin story of anesthesia use. We revisited the classic tale of Ether Day with the benefit of hindsight and almost two centuries of clinical advances. But the stories about William T.G. Morton, Simpson Young and John Snow are also just chapters in a much larger story of medical progress. It is our story, too. While this season of The Etherist is ending, the story of anesthesia continues, as does the push for clinical progress. In this episode, we try to answer the question: What will be the next chapter in the story of anesthesiology?

This is the fourth and final episode of season 3 of “Anesthesiology News presents The Etherist.”

Sponsored by Masimo and Medtronic.

Suggested Reading

• Brown EN, Lydic R, Schiff ND. General anesthesia, sleep, and coma. _N Engl J Med_. 2010;363:2638-2650.

• İnce R, Adanir SS, Sevmez F. The inventor of electroencephalography (EEG): Hans Berger (1873–1941). Childs Nerv Syst. 2021;37:2723–2724. https://doi.org/10.1007/s00381-020-04564-z
• Gibbs FA, Gibbs LE, Lennox WG. Effects on the electroencephalogram of certain drugs which influence nervous activity. Arch Intern Med. 1937;60:154-166.
• Glorfeld J. Hans Berger has a real brainstorm: accident inspires a career and the invention of EEG. Cosmos. November 20, 2020. Accessed November 16, 2021. https://cosmosmagazine.com/health/hans-berger-has-a-real-brainstorm/
• Mets B. Waking Up Safer? An Anesthesiologist’s Record. SilverWood Books; 2018.
• Purdon PL, Sampson A, Pavone KJ. Clinical electroencephalography for anesthesiologists part I: background and basic signatures. Anesthesiology. 2015;123(4):937-960. doi:10.1097/ALN.0000000000000841
• Science News. Electric currents picked up from head show brain action. Science News Letter. 1935;719(27):35. Accessed November 16. https://www.sciencenews.org/archive/electric-currents-picked-head-show-brain-action
• Sanders L. How Hans Berger’s quest for telepathy spurred modern brain science: instead of finding long-range signals, he invented EEG. Science News. July 6, 2021. Accessed November 16, 2021. https://www.sciencenews.org/article/hans-berger-telepathy-neuroscience-brain-eeg

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

John Snow was a doctor and scientist in London when he first witnessed a demonstration of ether anesthesia. Even though he was not credited with the discovery of ether or chloroform, he became a leader in the advancement of modern medicine in England.

In fact, it was Snow’s forward-thinking mentality that laid the foundation for the spirit of the specialty of anesthesiology: the idea that there is always a better answer to the problem than the one we have now. To do that, Snow developed the first ever anesthesia practice standards to guide his colleagues in the use of anesthesia.

In this episode, we turn our attention to our future, and explore how understanding Snow’s original ether anesthesia practice standards was just the first chapter in a 175-year story of anesthesia innovation. We will also discuss the current outlook of our modern research into the development of more targeted anesthesia drugs and more.

This is episode 3 of season 3 of “Anesthesiology News presents The Etherist.” The fourth and final episode of the season will be available on Nov. 23, 2021.

Sponsored by Masimo and Medtronic.

Suggested Reading

• Fenster JM. _Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It._ Perennial; 2002.

• Knight PR III, Bacon DR. An unexplained death: Hannah Greener and chloroform. Anesthesiology. 2002;96:1250–1253.

• Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.
• Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.
• Richardson BW. Memoir of the Author: John Snow, Chloroform and Other Anaesthetics. London: John Chruchill; 1858.
• Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.
• Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

From October 1846 to November 1847, anesthesia providers used ether to ease pain in surgery and it might have seemed as if a golden age in medicine was just beginning, but tragedy would eventually strike the growing specialty of anesthesiology. Hannah Greener’s experience with the use of chloroform anesthesia as a patient would mark a major crisis point for the early advocates of anesthesia.

This season of the series is about revisiting the history of anesthesiology while also reimagining those events based on what we know today. But that story can’t be told without also diving into the dangers of the use of anesthesia. It is perhaps the most important piece of knowledge that we possess now, that those early anesthesiologists were not sufficiently aware of at the time.

This is episode 2 of season 3 of “Anesthesiology News presents The Etherist.”

Sponsored by Masimo and Medtronic.

Suggested Reading

• Fenster JM. _Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It._ Perennial; 2002.

• Knight PR III, Bacon DR. An unexplained death: Hannah Greener and chloroform. Anesthesiology. 2002;96:1250–1253.

• Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.

• Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.

• Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.

• Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

The discovery and public demonstration of ether anesthesia was not a sudden achievement, though. In fact, it was the results of incremental scientific gains by dozens of scientists from Raymond Lully, the Spanish alchemist who first distilled sulfuric ether in 1275, to Joseph Priestly, the English researcher who developed nitrous oxide in 1774, and finally to Morton.

But there is more to the story than those early pioneers could have known. This season we will be retelling and reimagining the story about the dawn of anesthesia use with a slight twist. We will also dive into the latest research into the mechanisms of anesthesia’s effects on the brain—knowledge the early innovators in anesthesia could not have realized in their time.

This is episode 1 of season 3 of “Anesthesiology News presents The Etherist.” Episode 2 will be available on Oct. 26, 2021.

Sponsored by Masimo and Medtronic.

Suggested Reading

• Fenster JM. Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It. Perennial; 2002.
• Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.
• Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.
• Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.
• Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

In the 1840s, an important scientific breakthrough changed the course of medical history—the discovery of anesthesia. However, over several decades leading up to that historic discovery, the potential for less painful surgery existed without anyone managing to connect the dots between a series of scientific developments with nitrous oxide and the need for anesthesia in surgery. Those decades presented a stark missed opportunity for all surgery patients of the time, and a true conundrum affectionately known as “laughing gas.”

In the prologue for season 3 of “Anesthesiology News presents The Etherist,” we delve into the decades-long conundrum of the coexistence of anesthesia—in the form of nitrous oxide and ether—and the continuation of painful surgery during the early 19th century.

Episode 1 of The Etherist will be available on Oct. 16, 2021—175 years after the original demonstration of ether anesthesia, now known as Ether Day.

Sponsored by Masimo and Medtronic.

Suggested Reading

• Fenster JM. Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It. Perennial; 2002.
• Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.
• Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.
• Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.
• Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

We will revisit those early days of discovery and innovation and the people who made it all possible, but we won’t stop with the history of anesthesia. This season we will also dive into the emergence of new research that has revealed the basic effects of how anesthetic drugs work in the first place.

Join us on this journey into the past as we uncover what those early pioneers of anesthesia knew and didn’t know as they made one of the most significant medical discoveries in history.

This new season of The Etherist will be available on Oct. 16, the 175th anniversary of Ether Day.

Sponsored by Masimo and Medtronic.

Suggested Reading

1. Fenster JM. Ether Day: The Strange Tale of America’s Greatest Medical Discovery and the Haunted Men Who Made It. Perennial; 2002.
2. Mets B. Leadership in Anaesthesia: Five Pioneers of the Deadly Quest for Surgical Insensibility. Cambridge Scholars Publishing; 2021.
3. Mets B. Waking Up Safer?: An Anesthesiologist’s Record. SilverWood Books; 2018.
4. Snow SJ. Blessed Days of Anaesthesia: How Anaethetics Changed the World. Oxford University Press; 2008.
5. Sykes K, Bunker J. Anaesthesia and the Practice of Medicine: Historical Perspectives. 1st ed. CRC Press; 2007.

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Kuhlman is an anesthesiologist in Calhoun, Ga. She has also partnered with IntelliGuard in a joint effort to advocate for better drug diversion practices and awareness in hospitals around the United States.

“Anesthesiology News Presents” is the podcast network for Anesthesiology News including “On the Case,” a behind-the-scenes look into the popular case reports published in the news magazine; “Ask the Experts,” an up-close and personal conversation series with some of the leading experts in the field; and “The Etherist,” the flagship series that delves into the key stories shaping the specialty in the past, present and future.

Links Mentioned:

Link to article in Marie Claire

Link to panel discussion with Intelliguard

Send us an email submit a case for The Frost Series

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Vaida is the clinical editor of “The Frost Series” for Anesthesiology News. She is also a professor of anesthesiology and obstetrics and gynecology, the vice chair for research, and the director of obstetric anesthesia in the Department of Anesthesiology and Perioperative Medicine at Penn State Health Milton S. Hershey Medical Center.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

Links Mentioned:

• Link to The Frost Series

• Link to IMDB page for Zorba the Greek

• Link to Zorba the Greek, in paperback

• Send us an email submit a case for The Frost Series

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Papadakos is a professor of anesthesiology, surgery, neurology and neurosurgery, and the director of critical care medicine at the University of Rochester, in New York. He is also a member of the Anesthesiology News editorial advisory board.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports about what it was like to experience those clinical situations and why they decided to write about them afterward.

Links Mentioned:

• Link to Case Report

• Link to Kratom Commentary in Anesthesiology News

• Link to Submit Your Own Case Report

• Tell us what you thought of the first season of “On the Case”

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Seidman is a board-certified pediatric anesthesiologist, practicing in Cleveland. She partners with SmileMD, a mobile anesthesia services company founded by anesthesiologists, to provide anesthesia services for local dental procedures.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

Links Mentioned:

• Link to Dr. Seidman’s commentary

• Link to resources on anesthesia for children’s dental work

• Link to SmileMD

• Send us an email to submit questions for future guests

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Shachner is an anesthesiologist in the Department of Anesthesiology at the Anesthesiology Consultants Exchange, P.C., in Cleveland, Tenn.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports about what it was like to experience those clinical situations and why they decided to write about them afterward.

Links Mentioned:

• Link to Case Report
• Link to The Malignant Hyperthermia Association of the United States (MHAUS)
• Link to Submit Your Own Case Report

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

In this episode of “Ask the Experts,” Cheryl Gooden, MD, joins us to discuss some of the challenges that she encounters with pediatric airway management. She also talks about her work in medical mission work around the world from India to Peru.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

Links Mentioned:

Link to Plasticos Foundation

Link to The Orbis Flying Eye Hospital

Link to Maya Angelou Quote

Send us an email to submit questions for future guests

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

In this episode of “On the Case,” Steve Garber, MD, discusses his case report on a 39-year-old woman (gravida 5, para 4), at 36 weeks’ gestation, who was diagnosed with COVID-19 pneumonia after presenting to the emergency department with shortness of breath, cough and myalgias three days after her COVID-19 diagnosis.

Dr. Garber in an anesthesiologist at Saddleback Medical Center, in Laguna Hills, Calif.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports what it was like to experience those clinical situations and why they decided to write about them afterward.

Links Mentioned:

• Link to Dr. Garber's Case Report
• Submit Your Case Report for Consideration!

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

In this episode of “Ask the Experts,” Karen Sibert, MD, joins us to discuss the future of anesthesiology and the evolving role of anesthesiologists in modern health care. She also explains her reason for giving up on Twitter as a way of communicating her ideas and opinions about the specialty.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up-close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine.

Links Mentioned:

Link to article comment for question 1

Link to tweet for question 2

Link to interview with Karen Sibert, MD, in “The Etherist” Season 2

Send us an email to submit questions for future guests

Follow Us:

• Our Website
• Apple Podcasts
• Spotify
• Google Podcast

Find Us on Social:

• Twitter
• Facebook
• LinkedIn
• Instagram

Greensmith is an associate professor of anesthesia and critical care in the Department of Anesthesiology and Perioperative Medicine at Penn State Health Milton S. Hershey Medical Center, In Hershey.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports what it was like to experience those clinical situations and why they decided to write about them afterward.

Links from the episode

Link to case report: The Rise, Fall and Rise Again: Navigating the History of Chloroprocaine In Ambulatory Surgery

Link to other reports from The Frost Series.

Link to submit a case report: AnesthesiologyNews.com/CaseSubmission

Link to study on isobaric spinal mepivacaine.

Link to study comparing spinal 2-chloroprocaine and lidocaine.

Link to study on spinal chloroprocaine solutions.

Link to study on mepivacaine and transient neurologic symptoms.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up-close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine. 

Links from episode

Link to tweet in question 1

Link to tweet in question 2

Link to tweet in question 3

Resources from Myths

Myth 1: “Anesthesiology should be popular among women medical students.”

• www.aamc.org/data-reports/workforce/interactive-data/acgme-residents-and-fellows-sex-and-specialty-2015

Myth 2: “If women don’t choose our program or practice, we can’t help it.”

• pubmed.ncbi.nlm.nih.gov/31199206/
• www.ncbi.nlm.nih.gov/pmc/articles/PMC5131263/
• weli.pedsanesthesia.org/wp-content/uploads/2020/04/Motherhood-and-Anesthesiology.pdf

Myth 3: “If residents were allowed to graduate by just achieving their milestones, maybe it would be easier for women to take maternity leave in residency without making up the time.”

• jamanetwork.com/journals/jamainternalmedicine/fullarticle/2607209
• jamanetwork.com/journals/jamanetworkopen/fullarticle/2768342

Myth 4: “It’s a good thing harassment doesn’t happen in the hospital or OR anymore.”

• link.springer.com/article/10.1007/s12630-019-01333-8

Myth 5: “We need to flatten the hierarchy and call women by their first names.”

Myth 6: “The only reason there’s a pay gap is because women work less hours and don’t negotiate.”

• weli.pedsanesthesia.org/wp-content/uploads/2020/04/Closing-the-Gender-Wage-Gap-and-Achieving-Professional-Equity-in-Medicine.pdf
• pubs.asahq.org/anesthesiology/article/123/5/997/12599/Regional-and-Gender-Differences-and-Trends-in-the

Myth 7: “It’s easy to have kids in medical school/residency/practice.”

• journals.lww.com/obstetricanesthesia/Abstract/2020/12000/Motherhood_and_Anesthesiology__A_Survey_of_the.33.aspx
• www.ncbi.nlm.nih.gov/pmc/articles/PMC5818808/
• CBS News report on birth rate: www.cbsnews.com/news/birth-rate-declining-younger-generations-crisis/

Myth 8: “Mothers going part time are the reason there’s a physician shortage.”

• www.aamc.org/download/498034/data/aamcstatementtothehousesmallbusinesscommitteeregardingmedicaled.pdf
• www.aamc.org/download/484890/data/2017annualaddressofthephysicianworkforce.pdf

Myth 9: “There’s a shortage of women leaders and professors because historically they were not as well represented in medicine.”

• www.aafp.org/news/blogs/leadervoices/entry/20200228lv-diversity.html
• www.forbes.com/sites/lipiroy/2020/02/25/its-my-calling-to-change-the-statistics-why-we-need-more-black-female-physicians/#7f17e21a56a5
• www.bjanaesthesia.org.uk/article/S0007-0912(20)30010-6/abstract
• www.scholars.northwestern.edu/en/publications/status-of-women-in-academic-anesthesiology-a-10-year-update-2
• www.aamc.org/data-reports/faculty-institutions/report/state-women-academic-medicine
• twitter.com/JulieSilverMD/status/1176123023348383745/photo/1

Myth 10: “Women have several deficiencies they need to fix in order to be successful.”

Link to interview with Amy Pearson, MD, in “The Etherist” Season 2: www.anesthesiologynews.com/Multimedia/Article/10-20/The-Etherist-Podcast-Season-2-Episode-3-A-Perfect-Match/60710

Reading Recommendations From Amy Pearson, MD

On Attrition

www.statnews.com/2020/01/16/black-doctors-leaving-faculty-positions-academic-medical-centers/comment-page-3/

On Life Coaching

janetatansey.com

thecareerlauncher.com/careerrx-certified-coaches/

Brene Brown (Daring Greatly) 

To submit questions for our next guest, Karen Sibert, MD, email us at ANPresents [at] mcmahonmed.com.

Lo is a clinical assistant professor of anesthesiology in the Department of Anesthesiology and Critical Care Medicine at Children’s Hospital Los Angeles, and the Keck School of Medicine of USC, also in Los Angeles.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We interrogate the authors of those case reports what it was like to experience those clinical situations and why they decided to write about them afterward. 

Links from episode

Link to case report: https://www.anesthesiologynews.com/Clinical-Anesthesiology/Article/03-21/Pediatric-POCUS-to-Diagnose-Treat-TransfusionAssociated-Circulatory-Overload/62701

Link to POCUS training: https://www.asra.com/events-education/event-item/2021/11/06/default-calendar/introduction-to-perioperative-point-of-care-ultrasound

Rosenblatt is a professor of anesthesiology at Yale New Haven Hospital and the Yale School of Medicine, in Connecticut. He is the president of “Airway on Demand” and a past president of the Society for Airway Management.

“Ask the Experts” is a conversation podcast series from the “Anesthesiology News Presents” channel. It features up-close and personal Q&A interviews with leading experts in the field of anesthesiology on topics such as difficult airways and women in medicine. This is the first episode of the series, and new episodes will be published every month. 

Links from episode

Link to video in question 1: https://www.anesthesiologynews.com/Policy-and-Management/Article/09-20/Airway-on-Demand-Cricopharyngeus-Muscle-Contraction-During-Video-Laryngoscopy/59603

Link to video in question 2: https://www.anesthesiologynews.com/Multimedia/Article/07-20/Airway-on-Demand-Oxygen-Insufflation/59061

Link to video in question 3: https://www.anesthesiologynews.com/Multimedia/Article/02-20/Airway-on-Demand-Sleep-Apnea-and-a-Snoring-Airway/57338

Link to video in question 4: https://www.anesthesiologynews.com/Multimedia/Article/01-21/Airway-on-Demand-Specialized-Intubation-Via-Supraglottic-Airways/62325

Watch more “Airway on Demand” videos at https://www.anesthesiologynews.com/Multimedia

Link to “Airway on Demand”: https://www.airwayondemand.com/

Book recommendation from Dr. Rosenblatt: https://www.timothysnyder.org/books/our-malady

Twitter follow recommendation from Dr. Rosenblatt: https://twitter.com/JohnCSakles?s=20

To submit questions for our next guest, Amy Pearson, MD, email us at ANPresents [at] mcmahonmed.com.

Kim is a regional anesthesiology and acute pain medicine fellow at Stanford University School of Medicine, in California.

“On the Case” is an interview-driven podcast series, in which we take a behind-the-scenes look at the popular case reports that are published in Anesthesiology News. We discuss with the authors of those case reports what it was like to experience those clinical situations and why they decided to write about them afterward. This is the first episode of the series, and new episodes will be published every month.

Links from episode

Link to case report: Just in Time for Halloween: Hemolacria, or Blood in Tears

Submit your case report here: AnesthesiologyNews.com/CaseSubmission