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Table of Contents
Year : 2020  |  Volume : 36  |  Issue : 3  |  Page : 423-424

Art, science, and aequanimitas: Pillars of modern anesthesia practice

1 Department of Cardiac Anaesthesia, Cardiothoracic Centre, CNC, All India Institute of Medical Sciences, New Delhi, India
2 Department of Cardiac Anaesthesia, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi, India

Date of Submission12-Jan-2020
Date of Acceptance14-Mar-2020
Date of Web Publication26-Sep-2020

Correspondence Address:
Dr. Poonam M Kapoor
Room No. 8,7th Floor, Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joacp.JOACP_12_20

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How to cite this article:
Karanjkar A, Magoon R, Kaushal B, Kapoor PM. Art, science, and aequanimitas: Pillars of modern anesthesia practice. J Anaesthesiol Clin Pharmacol 2020;36:423-4

How to cite this URL:
Karanjkar A, Magoon R, Kaushal B, Kapoor PM. Art, science, and aequanimitas: Pillars of modern anesthesia practice. J Anaesthesiol Clin Pharmacol [serial online] 2020 [cited 2021 Apr 19];36:423-4. Available from:

Dear Editor,

Anesthesia is undoubtedly a scientific boon to humanity and a holistic specialty of medicine reaching out to all the possible clinical domains ranging from perioperative services to the care of critically sick and pain alleviation. Therefore, the modern anesthesiologist needs to meticulously manage these diverse clinical settings affecting the lives of patients spanning from the dawn of a new life to providing comfort at the termination of life.

Anesthesia can be envisaged as a perfect blend of balanced proportions of art and science.[1],[2] The art or rather craft of the specialty connotes the slick and effortless technical capability, skillset, multitasking and intuitiveness, conventionally attained through practice and experience. The foundation of the art in our branch emanates from the motivation of becoming physicians, promoted by the empathy and altruism for the sufferers. At the same time, as caregivers of medicine, our empathy and altruism should be translated into actions driven by the understanding of science. Science essentially encompasses knowledge based on natural laws, refined by the experiences of the practical experiments and observations. Therefore, it is characteristically dynamic and an integral part of systematic evolution of any medical specialty. The extent of contribution of art and science to modern day medicine is often debated, with many young practitioners proposing science as the cornerstone of the current practice. However, both are indispensable with the perioperative medicine embodying as the practice of art, premised on science.

As the modern anesthesiology practice continues to become challenging in the 21st century, it demands the perioperative physicians to sculpt the quality of imperturbability or equanimity. Sir William Osler, a Canadian physician and 1st Baronet outlined these attributes in one of his legendary essays and most definitely summed it all up in a single word, Aequanimitas, while delivering a valedictory address at the Pennsylvania university way back in 1889.[3] The importance of the classic statement that he articulated: 'in the physician or surgeon no quality takes rank with imperturbability' fails to fade despite the passing decades.[4] Imperturbability broaches the concept of the utmost presence of mind and composure amidst the most difficult scenarios, maintaining the clarity of judgment. Cultivating the aforementioned virtue enables the highest form of authority on the medullary centers conferring the advantage of ensuring the mental equilibrium aimed at the most appropriate decision making.

Despite the present era endorsing the trend towards organizing patient care with specific uniform algorithms and the advent of the pursuit of the goal of artificial intelligence, the modern-day anesthesiology practice mandates a perfect concoction of the attributes of art, science and equanimity to cope with the current social, academic, and performance pressures on 'today's anesthesiologist'.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Eisenach JC. Without science there is little art in anesthesiology: 2015 Rovenstine lecture. Anesthesiology 2016;124:1205-7.  Back to cited text no. 1
Nadaraja S. The art of anaesthesia. Lancet 2001;358:1110.  Back to cited text no. 2
Pratt JH. Aequanimitas. Arch Intern Med (Chicago) 1949;84:86-92.  Back to cited text no. 3
Sokol D. Aequanimitas. BMJ 2007;335:1049.  Back to cited text no. 4


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