Careers in Anesthesiology: Autobiographical Memoirs

Modern American anesthesiology began after World War II, when a small group of male physicians on the East Coast and in the Midwest dedicated themselves to building the critical scientific foundations and developing the needed manpower. These men were often interesting characters and charismatic teachers. The discovery of important scientific principles was sometimes the result of odd clinical cases, and a large political arena—complete with personal feuds and passionate fights over what modern anesthesiology should be. As a resident at the University of Pennsylvania in the mid-sixties, I heard many of these interesting stories and met some of the charismatic characters. These experiences added a new dimension to my specialty. This book will allow many others to hear some of these stories and meet some of these men.

This volume is the first of a series of autobiographical essays by noted American anesthesiologists. The Wood Library-Museum (WLM) of the American Society of Anesthesiologists (ASA) began the series to commemorate the 1996 sesquicentennial anniversary of the first public demonstration of surgical anesthesia. It supplements another WLM project of videotaped interviews, the Living History series. Essay authors were invited to describe and reflect on the formative events and encounters of their careers.

This first volume contains essays by three anesthesiologists who all entered the field as its modern period began. The selection of authors is geographically balanced: they are Drs. William K. Hamilton of San Francisco, Eli Brown of Detroit, and E. M. Papper of New York City (Papper’s section, 150 pages long, overwhelms the others in length). All were chairs of important departments (Hamilton at the University of California at San Francisco, Brown at Wayne State in Detroit, and Papper at Columbia University in New York City), and all went on to serve as leaders in various important specialty organizations such as the ASA and the American Board of Anesthesiology. All contributed significantly to the development of modern anesthesiology and so can document its transition from a “specialty,” such as it was, focused on service to surgeons and delivered by a hodgepodge of personnel (interns, general practitioners, nurses, and even janitorial staff), to a vibrant clinical specialty with an extremely strong basic science foundation—a specialty whose advances have allowed some of the critical advances in surgery, and have led the American public to expect pain-free recovery from surgery and pain-free obstetric deliveries.

All three men were introduced to anesthesia by chance, reflecting the lack of teaching of anesthesia in medical schools then. As a medical student, Hamilton happened to be standing by the telephone when a call came to give anesthesia in the clinic to a child with otitis media. While an intern, Brown was told to give anesthesia for a patient’s delivery, with no instruction in anesthesia at all; he—and the patient—survived, but he knew he had to learn more about anesthesia as soon as possible. As an intern at Bellevue, Papper was forced to rotate through anesthesia when another intern contracted tuberculosis; fortuitously, the Bellevue department was run by E. A. Rovenstine, a vital early leader of the specialty who had trained at the University of Wisconsin under Dr. Ralph Waters, the father of modern academic anesthesiology.

All three had exposure to critical early leaders: Hamilton to Stuart Cullen at the University of Iowa, Brown to Robert Dripps at the University of Pennsylvania while stationed at Valley Forge General Hospital, and Papper to Rovenstine, a charismatic leader and energetic teacher. World War II and its aftermath led to early opportunities for leadership for the three. For example, the war ended during Hamilton’s senior medical school year. Army service was still required, and after a rotating internship with no significant training in anesthesia, he was made chief of anesthesia at one of...