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The Stairs On Billy Buck Hill

Book cover, "The Stairs on Billy Buck Hill," Steven L. Orebaugh

A talented, devoted anesthesiologist, with a coveted academic position. A lovely, accomplished financial analyst with a glamorous social life, a high-rise apartment, and a dirty little secret. A chance encounter, a night of passion, a confessed preference for opioids…In this sordid tale of infatuation, temptation, and intoxication, Dr. Kurt McCain rises to a pinnacle of popularity and self-regard that he could not previously have imagined, only to realize that his pursuit of drug-induced euphoria has cost him nearly everything that he holds dear. His position, his profession, and his relationships with those he loves are destroyed, and the young physician finds himself at the lowest point of his life, disconsolate and alone. He must somehow summon all of his energies to overcome a dependence on opioids, while making a desperate attempt at the restoration of his practice, and for redemption in the eyes of those who care for him.

The nation is riven by a devastating epidemic that continues even as the COVID epidemic fades - opioids are killing Americans in unprecedented numbers. While physicians are often implicated among the many causes of this scourge, little attention is paid to the potential for doctors and nurses to become addicts themselves. Anesthesiologists and nurse anesthetists, who administer opioids with great regularity, are among the most susceptible providers. ‘The Stairs On Billy Buck Hill,’ a 100,000-word literary novel, relates one physician’s travails as he progresses from the carefully controlled, recreational use of opioid pills, to the brazen theft of fentanyl from his patients in the operating room, a treacherous descent that leads to the destruction of his career, his social standing, and very nearly himself.

The Stairs on Billy Buck Hill
Pittsburgh author and anesthesiologist Steve Orebaugh
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My Story

Steven L. Orebaugh is an anesthesiologist at an academic medical center whose position requires that he handle or prescribe opioid medications every working day. He has witnessed a number of ruined careers related to addiction among his peers, and has worked with trainees whose lives have been irrevocably altered by indulgence in the controlled substances that anesthesiologists administer to their patients. The Stairs On Billy Buck Hill illustrates the strong allure of these drugs, and how, once ingested, they create within the user a voracious appetite for greater indulgence, followed inevitably by ruinous consequences.

Most of his publications are related to his profession, with some 75 works in the medical literature, including peer-reviewed articles, textbook chapters, and review articles. In addition, he is the author of two medical textbooks, and has served as an editor or section editor for several more. In 2006, the Johns Hopkins University Press published his non-fiction book Understanding Anesthesia. This patient education manual, which explains the subtleties of operative anesthesia and pain management, empowers patients to ask appropriate questions about their perioperative care. Five years ago, his first fiction work, A Night in the Life, which describes the plight of a disenchanted emergency physician in a decaying urban hospital, was published by  Pocol Press.

Dr. Orebaugh practices anesthesiology at the University of Pittsburgh Medical Center and has a special interest in regional anesthesia, an important means of reducing opioid use for pain control. He is especially enthused to teach these methods to doctors in training.  

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My Books

The Stairs On Billy Buck Hill

A Night in the Life

Atlas of Airway Management

Understanding Anesthesia

My Books


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