Dr. Barry Friedberg, MD – Founder, Goldilocks Foundation

Barry L. Friedberg was born in Philadelphia, PA and grew up in suburban Norristown. His post-secondary education included getting his Bachelors in Natural Science at Muhlenberg College in Allentown, PA in 1970 and his medical degree from Temple University in Philadelphia in 1974. He traveled west to train in anesthesia at Stanford University in Palo Alto. Between 1975 and 1977, he gave anesthesia for heart transplant pioneer, Dr. Norman Shumway. He also met Dr. Thomas Fogarty, inventor of the Fogarty catheter for minimally invasive removal of blood clots in arteries. That meeting led to Friedberg’s admiration of the ability of technology to improve patient safety and care. During his four-decade career after his Stanford training, Dr. Barry Friedberg, has been an early technology adopter of technology for better patient safety.

Shortly after his Stanford years, Friedberg began with the AMR automated blood pressure device in 1978 to display patient blood pressure during surgery. The automatic display of ongoing blood pressures saved precious time to manually determine the effects of pumping large fluids and blood when that was needed to save low blood pressure patients.

He introduced Swan-Ganz cardiac output monitoring to the hospital heart surgery unit in 1981, allowing surgeons to know the differing contributions of cardiac output versus peripheral resistance made to patient’s blood pressure when coming off heart-lung bypass. The more correct treatment of blood pressure differs between output and resistance components. That numerical knowledge makes it safer when patients need to maintain their own circulation at the end of their heart surgery.

Nellcor pulse oximetry was introduced to his hospital by Friedberg in 1983 as soon as it became commercially available and seven years before the American Society of Anesthesiologists deemed it a ‘standard of care.’

In 1992 while beginning his office-based anesthesia career, Dr. Friedberg pioneered using propofol hypnosis prior to ketamine to create a safer, simpler, intermediate alternative to pure local and general anesthesia,’ i.e. propofol ketamine or PK, for elective cosmetic surgery. Friedberg made PK anesthesia numerically reproducible in 1997, when he was the first Orange County, CA anesthesiologist to routinely use a BIS brain monitor. This technological advance enables patients anesthetized with propofol to determine their individual dose requirements from the number derived their forehead. Patients would then receive neither too much nor too little, but only the precise amount of propofol (aka ‘Goldilocks’ anesthesia) to not them feel, hear or remember their surgery.

In 2004, Cambridge University Press commissioned Friedberg among the then 40,000 US anesthesiologists to author and edit the first anesthesia textbook on cosmetic surgery. 2007, ‘Anesthesia in Cosmetic Surgery’ was published and Friedberg received a US Congressional award to improving the safety of wounded troops at forward units in both Iraq & Afghanistan. In 2009, his textbook was translated into Portuguese for Brazil, and later in 2015, translated into Mandarin Chinese.

Also in 2009, the first mortality study was published showing one American death every day from anesthesia over medication, the standard practice when brain monitoring is not used. This shocking report inspired Friedberg’s creation of his 501c3, non-profit Goldilocks Anesthesia Foundation whose sole goal is making brain monitoring a ‘standard of care.’

One year later, ‘Getting Over Going Under, 5 things you MSUT know before anesthesia’ was written for the public to help them deal with anesthesia fears and create the necessary force to change anesthesia providers into routinely using brain monitors for major surgery under anesthesia. The book is available as a free, no obligation download from www.goldilocksfoundation.org.

Friedberg’s curriculum vitae lists his many original publications and subsequent references to his work in the literature as well as many other anesthesia textbooks including the highly prestigious Millers’ Anesthesia. Dr. Friedberg was a volunteer clinical faculty teaching anesthesia trainees at both the University of Southern California and University of California at Irvine. He currently spends time on social media to expose more worldwide anesthesia clinicians to hear his YouTube ‘Goldilocks anesthesia lecture.’

What Was Your Favorite Subject In School?

History was my favorite subject especially after hearing Santayana’s quote,

Those who do not remember the past are condemned to repeat it.

Nearly twenty years before Pasteur advanced the germ theory, both Ignaz Semmelweiz and Oliver Wendel Holmes had the same concept about the need for physicians to wash their hands before surgery. Because Holmes and Semmelweiz were on opposite of the Atlantic Ocean, neither man knew of the others’ thoughts. The biggest difference between Friedberg and Semmelweiz is the internet’s ability to spread ideas around the globe without travel.

What Was Your First Job?

Pricing merchandise in my father’s warehouse.

Where And How Did You First Get Into The Industry You Currently Work In?

I went to medical school and then took postgraduate anesthesia training.

How Have Those Jobs Prepared You For What You Do Now?

They gave me the basic understanding of my field that enabled me to innovate when problems not previously addressed arose.

Describe The Best Day Of Work You’ve Ever Had.

Every day I get to give another patient a Goldiocks anesthetic.

How Do You Keep Yourself Motivated?

My patients’ stellar Goldilocks anesthesia experiences keep me excited and motivated.

What Kind Of Business Ideas Excite You Most?

New technology or drugs that might hold the promise of safer patient care.

Have You Ever Tried Any Unorthodox Techniques To Attract Attention To Your Business?

The Michael Jackson murder trial afforded me the chance to piggyback the Goldilocks’ message of avoiding overmedication. I even included a chapter about Jackson’s death in ‘Getting Over Going Under’ to try to stimulate greater interest in the book.

What Personal Achievement Are You Most Proud Of?

Having my daughter back in my life and finding my soul mate in my wife.

What Wisdom Would You Have Liked To Share With Yourself When You First Started Out?

Never underestimate the resistance to change. Even if people keep writing about a problem like postoperative nausea and vomiting (PONV) or postop pain, it doesn’t mean they will listen to your solution. All new ideas are originally ridiculed, then violently rejected and ultimately accepted as self-evident. What could be more self-evident to stop over medication than measuring the organ (i.e. the brain) that anesthetics medicate? What is more self-evident to stop PONV than stop giving drugs that make people sick to their stomach? Lastly, what could be more self-evident than not hurting patients on the OR table if you want them not to hurt after surgery?