Originally from southeastern Pennsylvania, Dr. Barry Friedberg has worked in freestanding surgery centers between 1986 and 1991. Since then, he has been a pioneering force in office-based anesthesia which began to take increasing importance in the early 1990s, especially for elective cosmetic surgery.
Friedberg created the non-profit Goldilocks Anesthesia Foundation to help create the force for change to get brain monitoring for major surgery under anesthesia as a standard of care. He also wrote ‘Getting Over Going Under, 5 things you must know before anesthesia’ to help patients ensure the use of the best available technology to avoid the rare death but all too common post-op brain fog.
What Is Your Hobby?
Trying to make other patients anesthesia experience better than the two dreadful ones I had prior to medical school. At 4, I had a tonsillectomy with open drop ether. It was like being smothered into unconsciousness with a pillow on one’s face. At 19, I had badly impacted third molars (so-called wisdom teeth) with a muscle relaxant that left me unable to breathe in the recovery room. That breathless sensation is not easily forgotten either.
Tell Us What You Love About It
Seeing the face of gratitude and amazement on my patients’ faces when they wake up realizing everything I told them preoperatively was true; namely, 1) you will not be over or under medicated and awaken mostly clear-headed and 2) we will not hurt you on the operating table. Today will not be the greatest day of pain from surgery. In about 12-24 hours your brain will realize it has been tricked during surgery but in that interval healing takes place.
Are There Any Groups You’re A Part Of Or Events That You Attend Related To Your Hobby?
I primarily go where my anesthesia teaching is more valued than by my anesthesia colleagues. That place would be the surgical meetings.
Have You Had To Invest In Equipment? If So, Please Share Some Of The Things You’ve Bought.
In 1978, I bought a Dinamap and separate printer. The DInamap was the tradename for the first commercially available automated blood pressure device. Those two devices provided me real time information during surgery wherein I was spending time pumping blood and fluids into patients whose clinical condition warranted that therapy to survive.
In 1998, I bought an Aspect Medical System bispectral (BIS) index brain monitor to measure patient response to propofol doses to protect patients from ketamine hallucinations. Ketamine allows the patient’s brain to be tricked by denying the brain the input of noxious painful signals like local anesthetic injection or skin incision.
Where Do You Buy Most Of Your Supplies?
I am very fortunate. My anesthesia supplies are purchased by the offices at which I provide anesthesia.
Are There Any Good Books For Beginners?
Beginners will profit by reading ‘Getting Over Going Under, 5 things you must know before anesthesia,’ available as a free download from www.goldilocksfoundation.org
How Has This Changed Your Life?
As a student of history, I have aspired to become a significant part of anesthesia history. With acknowledgments to both Virchow’s & Cushing’s Triads, I have advanced Friedberg’s Triad:
- Measure the brain
- Preempt the pain
- Emetic drugs abstain
as an answer to the persistent anesthesia problems of over medication, postop pain, and postoperative nausea and vomiting (PONV).
More than changing my life, this triad has changed my patients’ lives and the lives of other surgeons’ patients who I will never know. The change that I advocate for anesthesia care is like throwing a pebble into a pond. One never knows where the ripples will carry. Thanks to email, the internet & social media, I’ve already learned about some of those ripples that have reached around the world.
What Advice Do You Have For Others Starting Out With This Hobby?
Know that change is medicine is glacial. All people resist change. Physicians are notoriously resistant to change and anesthesiologists as a subset of physicians, are almost impossible to change. The hope I have for change is the public becoming aware of what the risks of major surgery under anesthesia WITHOUT a brain monitor are (i.e. 30% more drugs than needed with post opp brain fog, and rarely, even death) and knowing what to say when their anesthesiologist responds with ‘we don’t need a brain monitor.’ Prospective patients should answer. ‘With all due respect, it is not your needs I am concerned with. I have to live with the long-term consequences of your short-term anesthetic care.’ I liken this critical need for my anesthesia colleagues to change to that force for change which got fathers into delivery rooms to participate in the births of their children: public knowledge leading to public demand!
Are There Any Other Hobbies You Have?
Being the best husband and dad I can be as well as being the person my dog thinks I am.