A moving exploration of the most common but most mysterious procedure in medicine.


For many of the 40 million Americans who undergo anesthesia each year, it is the source of great fear and fascination. From the famous first demonstration of anesthesia in the Ether Dome at Massachusetts General Hospital in 1846 to today’s routine procedure that controls anxiety, memory formation, pain relief, and more, anesthesia has come a long way. But it remains one of the most extraordinary, unexplored corners of the medical world.

In Counting Backwards, Dr. Henry Jay Przybylo―a pediatric anesthesiologist with more than thirty years of experience―delivers an unforgettable account of the procedure’s daily dramas and fundamental mysteries. Przybylo has administered anesthesia more than 30,000 times in his career―erasing consciousness, denying memory, and immobilizing the body, and then reversing all of these effects―on newborn babies, screaming toddlers, sullen teenagers, even a gorilla. With compassion and candor, he weaves his experiences into an intimate exploration of the nature of consciousness, the politics of pain relief, and the wonder of modern medicine.

Filled with intensity and humanity, with moments of near-disaster, life-saving success, and simple grace, Counting Backwards is for anyone curious about what happens after we lose consciousness.

“I stayed up late to finish this book. In clear, direct prose, Dr. Przybylo offers a fascinating tour of the world of an anesthesiologist. Beautifully written, insightful, and informative, Counting Backwards is a great contribution, highly recommended.”

— Jennifer Michael Hecht, author of Stay

“An engaging and illuminating exploration of the invisible medical specialty that is anesthesia. We may seem to float effortlessly into an ether-world of unconsciousness during anesthesia, but Dr. Przybylo gives us a cockpit view of the human hands that pull the levers of our physiology. Counting Backwards pulls back the veil on the very act of being alive.”

— Danielle Ofri, MD, PhD, author of What Patients Say, What Doctors Hear

“[Przybylo] weaves an enjoyable narrative out of . . . the wealth of experience he has gained over more than 30 years . . . [and] offers a rare and thoughtful look behind the scenes of this crucial yet arcane specialization.”

— Publishers Weekly (starred review)

“[A] vividly written, candid exploration . . . striking in content and quite moving. . . . A fascinating tour of a mystifying, unnerving, yet precious medical necessity.”

— Kirkus

“Stirring… A rare peek into the world of one of the more underrated and mysterious procedures in modern medicine.”

Library Journal