Book and media review

IN NOVEMBER 2009, THE HARVARD MEDICAL SCHOOL COMMUnity mourned the loss of one of its great leaders in modern medicine. Robert Moors Smith, former chief of anesthesiology at Children’s Hospital Boston, is considered by many to be the father of pediatric anesthesiology. Smith distinguished himself as a physician who cared for children, focusing on the finer aspects of pediatric care and recognizing that children are so much more than “little adults.” He was well known as an emphatic patient advocate and protector, exemplifying these importantroles foranesthesiologists throughouttheyears, from the days of his own contributions to developing anesthesiology as an independent medical specialty to today. Smith’s original book, Anesthesia for Infants and Children, was first published in 1959 and was written entirely by Smith through its fourth edition in 1980. The fifth edition, published in 1990, was the first to be multiauthored and to bear the great pioneer’s name. Now in its eighth edition and edited by Peter J. Davis, Franklyn P. Cladis, and Etsuro K. Motoyama, Smith’s Anesthesia for Infants and Children still demonstrates the dedication to excellent patient care and advocacy established by its namesake. Presentedin4partsand42chapters,withcontributionsfrom more than 103 professionals of diverse backgrounds, Smith’s Anesthesia for Infants and Children is comprehensive and one of only a small number of authoritative textbooks in the field of pediatric anesthesiology. Subjects are extensively covered; thethorough52-pageindexmakesspecific informationexceedingly easy to retrieve. Not so easily accessed are the complete references of articles used in writing the text. Readers wishing to refer to an original source must go online to find it. Considering the rising costs of printing and the increasing availability of the Internet through multiple modalities, this is an understandable, if less convenient, change to the eighth edition. One of the most conspicuous alterations to the newest edition is the extensive use of color. Nearly every one of the 1356 pages contains a color figure or table, and a colorbased organizational system is used throughout. The effect is not only visually engaging for the reader but also assists in rapid, easy access to desired sections and information. The DVD included with the previous edition has been replaced by access to a broad collection of Web-based supplemental material. Purchasers of the book need only register at the publisher’s site and use an activation code found inside the front cover of the hardbound book to receive access to a Web site providing a wealth of resources. Once there, the book’s owner may view video and slide presentations on a plethora of subtopics, including the pediatric airway, pediatric cardiac pathology, and regional anesthesia. Appendices not found in the printed text but available online are invaluable and include a table of pediatric drug doses as well as an index of syndromes and their anesthetic implications. The full text may be searched and read in this virtual format, and online chapter questions test the reader’s recall and reinforce learning. Changes in content to the new edition largely involve new authors, although some novel chapters are present. Additions of chapters entitled “Behavioral Development” and “Neonatology for Anesthesiologists” are new to this edition and display the authors’ and editors’ continuation of Smith’s devotion to helping others develop not only as anesthesiologists but as physicians who care for children. In light of the increasing complexity of pediatric cardiac surgery and the anesthetic considerations involved in the care of these particular patients, the outstanding chapters for congenital heart disease have been expanded and reorganized. With its many excellent new features, the eighth edition of Smith’s Anesthesia for Infants and Children is true to its prior editions and maintains the vital content that earned it the nickname “The Bible” more than 50 years ago. One favorite chapter left largely unchanged is “The History of Pediatric Anesthesia,” coauthored by Smith and Mark Rockoff prior to Smith’s death. Qualities like this make the book distinctive, encompassing the latest available information in an ever-expanding field while maintaining the perspective of someone who championed the care of unique patients even before the field had a name.