A seeker of anesthesia's secrets

Anesthesiology is not just about putting patients to sleep.

``It's not just a service so that someone can have surgery," says Dr. Emery Brown of the Harvard-MIT Division of Health Sciences and Technology and MIT's department of brain and cognitive sciences. ``It's a compelling intellectual question."

What's more, sleep is only part of the definition of anesthesia. It also involves ``amnesia," meaning loss of memory; ``analgesics," meaning loss of feeling; a lack of movement; and ``hemodynamic stability," meaning keeping your body functions stable.

How anesthesia works is also the coolest question in neuroscience, according to Brown, who is at the forefront of research into how the brain performs under anesthetics.

While the techniques of ``putting someone under" for surgery are extremely evolved, we still don't know how the brain is affected by the experience. ``Very basic, fundamental knowledge is missing," says Brown. ``Anesthesiologists carry out a task they don't really understand."

Brown says that at present, science demands anesthesia for the whole brain. If we could pinpoint, for example, the parts of the brain that need to be affected in order to eliminate the feeling of pain, we could design more effective anesthetic drugs. In addition, we could better understand phenomena like hibernation and meditation. ``It could even help us understand consciousness."

At 49, Brown is trim, with a graying beard and serious spectacles. When he discusses his research, he's meticulous about crediting his peers and study volunteers (``Chris Moore, Nancy Kopell, Matthew Wilson . . . and the International Association of Laryngectomees. ``Without them we'd be at square one.") Laryngectomees are people who have had their larynx removed.

From his office on the Charlestown waterfront, Brown is very close to Massachusetts General Hospital, where anesthesiology was invented 160 years ago next month.

As the director of the Neuroscience Statistics Research Laboratory at Mass. General, Brown is now applying statistics to the question of how the brain processes signals. Dr. Warren Zapol, his supervisor at MGH, says: ``He's an extraordinary man with extraordinary insights. There aren't a lot of mathematicians who go into anesthesia and help us rethink how the brain works."

A native of central Florida, Brown grew up knowing that he wanted to be a physician. ``I know this sounds corny, but some of the best times I had were going to see my pediatrician," he laughs. From his early school days, Brown had a liking for sciences. ``There was a lot of emphasis on math and science when I was growing up." Then came Harvard, both undergraduate and medical school, and his first inkling of his life's calling. ``I came to anesthesiology during my third year at medical school," he says. ``It had a lot of things to recommend it intellectually. . . . And it's very hands-on medicine."

It also requires a calming presence. Anesthesia causes a loss of control that alarms people. ``There's that uncertainty," says Brown. ``What's going to happen to me while I'm under? Will I wake up?"

The answer is: Almost definitely. Only one in 250,000 patients suffers a fatal accident under anesthesia, but that doesn't dispel their fears. ``Often they're more afraid of anesthesiology than of the surgical procedure," says Brown. ``That's why you have to develop a rapport with patients in a very short time. You have to reassure them. In that way, it asks more of you than even general practice."

Brown sees his research as carrying a moral obligation as well as an intellectual challenge -- he wants to see if he can make the procedure even safer and more effective. ``It's a big question," he says. ``One that's sufficient to keep me occupied for a long time."

FACT SHEET

Hometown: Brookline.

Family: Wife Virginia Andradas, son Alejandro, 11, and daughter Elena, 8.

Hobbies: ``I spend a lot of time reading about African-American scientists." This is related to Brown's belief in the importance of role models for success. ``I'm interested in contemporary African-American scientist heroes. Someone like Wes Harris, the head of the aeronautics department at MIT. You won't hear about him in popular press. You're more likely to hear about Beyonce or Jay-Z."

Travel: Christmases are spent with his wife's family in Spain (Brown keeps a collection of bull-fighting postcards in his office). His family recently visited Yellowstone and the French West Indies.

On people's fear of anesthesiology: ``There's the loss of control and the mystery as to what it is. You can see why people would be afraid."