Thank you for your readership and welcome to Update #59, the final issue in this Centennial Project series.  It has been a privilege to be able to provide you with insights into our department’s important contributions to the specialty and medicine, plus have fun with writing the long line of Mystery Photos stories.  In the future, additional historical insights, photos, and stories will continue to be placed into our department’s history website, Mayo Clinic | Anesthesiology | Anesthesia History Association 2025 Annual Meeting.  For those who want a quick reminder of our department’s proud history, I have prepared a very brief Mayo Clinic | Anesthesiology | Anesthesia History Association 2025 Annual Meeting. You are free to use any part of it (or all of it) for your own presentations.  It can also be found on our department’s history website.

This past June 6^th, I wrote a summary of a number of the key accomplishments and innovations of the department through 2000 (Centennial Update #40).  I’ve reproduced that list here with minor modifications:

• 1904: Alice Magaw publishes a series of 14,000 anesthetics without an intraoperative death, a remarkable and almost unfathomable achievement at that time.
• 1920: Gaston Labat joins Mayo Clinic and becomes the country’s leading advocate for the use of regional anesthesia and a founder of the original American Society of Regional Anesthesia.
• 1925: John Lundy develops the Mayo Clinic’s Section on Anatomy, using dissections to teach regional anesthesia techniques.
• 1926: Lundy coins the term “balanced anesthesia” and advocates for its use.
• 1929: Lundy pulls together 15 leading academic anesthesiologists from the U.S. and Canada; the Anesthetists’ Travel Club is formed.
• 1933: Lundy establishes the Mayo Clinic’s intravenous fluid, blood, and medication service.
• 1934: Lundy and Charlie Adams publish on cold storage of citrated blood; the nation’s first blood bank is established.
• 1935: Lundy reports the successful trial of sodium pentothal and advocates for its use; it becomes the leading anesthetic induction agent for more than 5 decades.
• 1935: Lundy and Charlie Adams promote a hemoglobin transfusion trigger of 10 mg/dl; although debatable, this value stands the test of time for more than the next half century.
• 1938: Lundy plays a leading role in founding the American Board of Anesthesiology, a sub-board of the American Board of Surgery at its founding.
• 1940: Lundy is the country’s leading advocate for the successful establishment of a Section on Anesthesia within the American Medical Association.
• 1942: Lundy starts the Mayo Clinic’s first post-anesthetic care unit (PACU) and advocates for PACU development across the U.S. and Canada.
• 1942: Lundy starts one of the nation’s “90-Day Wonders” training courses for new physicians to learn anesthesia during WWII.
• 1944: Ed Tuohy introduces the epidural catheter technique.
• 1948: Florence McQuillen, the Mayo Clinic supervisor of nurse anesthetists, joins the AANA and serves 22 years as the association’s executive director.
• 1950: David Massa produces the world’s first intravenous catheter, an innovation considered to be one of the greatest advances in medicine in the 20th century.
• 1955: Bob Patrick, Albert Faulconer, and Emerson Moffitt are part of the Mayo Clinic team that perfect the Mayo-Gibbons heart-lung machine and advance cardiac surgery.
• 1967: Kai Rehder discovers the metabolism of halothane and its connection to halothane hepatitis.
• 1968: John (Jack) Michenfelder coins the subspecialty name, “neuroanesthesia,” and leads advances in the field.
• 1972: Sait Tarhan describes the risks of perioperative myocardial infarction (MI) and advocates for 6 months between MI and general anesthesia for elective procedures.
• 1973: Gerry Gronert discovers the association between succinylcholine and hyperkalemia when used in patients who have burns, disuse atrophy, and neurologic disorders.
• 1979: Joe Wang and Lee Nauss report on the first use of intrathecal narcotics.
• 1980: Gerry Gronert highlights triggers and treatment for malignant hyperthermia.
• 1985: Alan Sessler is a founder of the Foundation for Anesthesia Education and Research (FAER).
• 1985: John (Jack) Michenfelder and Alan Sessler are founding directors of the Anesthesia Patient Safety Foundation (APSF).
• 1996: Bill Lanier’s decade of study of augmentation of ischemic brain injury by minor changes of blood glucose transforms perioperative fluid practices worldwide.
• 1996: Roger White gets defibrillators into the vehicles of first responders, leading to Rochester having the world’s best survival results of ventricular fibrillation/cardiac arrest at that time.
• 1998: Denise Wedel and Terre Horlocker lead the development of guidelines on the use of anticoagulants in patients receiving regional anesthetics.

I realize that there are many important contributions to the advances in the specialty made by our department and our colleagues that I have not been able to highlight in the 59 Centennial Updates.  Fortunately, our department’s compilation of historical information will continue far into the future within our website repository.  I encourage you to view the material that is already in the website (link in the paragraph above) and let our archivist, Alec Thicke (thicke.alec@mayo.edu) or me (warner.mark@mayo.edu) know of any suggestions or corrections that you might have. 

Our goal is to continually expand and improve the collection of stories related to our department in all sites.  For example, we plan on developing site-specific webpages, not only for our departments in Jacksonville and Phoenix but also for our Mayo Clinic Health System sites.  Please check our history website periodically and assist us with the collection of stories and information.  These will help future generations understand how our Mayo Clinic Department of Anesthesiology and Perioperative Medicine made so many outstanding contributions to the specialty and medicine in both its first century and upcoming decades.

Mystery Photo Contest Winners from Last Week and the Full Centennial Celebration

The winner of the Mystery Photo contest in Update #58 was Nicole M. Lenort, RRT.

The overall winner of the Mystery Photo contest for the entire series of 59 Updates is Susan C. Quering, CRNA.  Congratulations, Susie!  Amazing effort!  Susie correctly guessed 96% of the Mystery Photos.  She gets the top prize of a $100 Starbucks gift card.  It has been donated by a department supporter and grateful donor.

Mystery Photos from Issue #58 

Last week’s Mystery Photos were Daryl J. Kor, M.D.; Carlos B. Mantilla, M.D., Ph.D.; Alan D. Sessler, M.D.; and Mark A. Warner, M.D.

Daryl J. (DJ) Kor, M.D. was born on March 24, 1974 in Marshall, Minnesota and was raised in nearby Cottonwood, northeast of Marshall. He attended St. John’s University in Collegeville, Minnesota from 1992 through 1996. While there, he played football for the legendary Coach John Gagliardi, the winningest coach in American college football. He participated in the 1993 and 1994 NCAA Division 3 semi-finals games and his teams posted a 90% winning percentage over his 4 years of play. He was recognized as both an All-Minnesota Intercollegiate Athletic Conference and an Academic All-American running back in 1995. Definitely an underachiever. Ha!

After graduating from St. John’s University in 1996, DJ attended the University of Minnesota School of Medicine, earning his M.D. in 2001. He was an anesthesiology resident here in Rochester from 2001 through 2005. At that time, he became a Mayo Clinic Scholar and was a critical care medicine fellow for a year. He joined the Rochester staff in 2006. During the next decade, he was honored with Distinguished Clinician and Teacher of the Year awards from trainees in the Department of Anesthesiology and from the Surgical Critical Care fellows. Along the way, he earned a Master’s degree in Clinical and Translation Sciences, receiving it in 2014.

DJ’s academic career has followed several unique paths.

• Data, Analytics, and Information Management.
  He has played major roles in creating, expanding, and improving these three fields in the institution. Within the department he has served as the catalyst and medical director for creating our Perioperative Information Management, Implementation, and Analytics Program (PRIISM). This program is expanding to many other areas within the institution and providing data support that is extraordinarily helpful to our clinical practices and research efforts. The institution has recognized his success in clinical informatics by placing him in leadership roles such as medical director for our Center for the Science of Healthcare Delivery’s Clinical Informatics Program, the Unified Data Platform Oversight Group, and the Center for Digital Health Data Analytics program, as well as appointing him Dean of Research Data and Digital Solutions.
• Transfusion Medicine.
  DJ has been a leader in transfusion medicine within Mayo Clinic and in our specialty. He first obtained an NIH R01 grant related to transfusion practices. He subsequently gained institutional and national visibility in transfusion medicine. He has served as chair of Mayo Clinic’s Transfusion Medicine Committee and as chair of the ASA’s Committee on Transfusion Medicine. He’s been very involved in multiple committees of the American Association of Blood Banks.
• Leadership. As a former elite college football player, DJ believes strongly in teamwork, especially on specific projects and across Mayo Clinic’s three mission shields of clinical practice, research, and education. He has become an oral examiner for the ABA and the chair of both the Research Committee and the Education Committee of the Society of Critical Care Anesthesiologists. He is a frequent visiting professor to high profile academic medical centers and is in high demand to speak at annual meetings of the ASA and other specialty societies. In August of this year, DJ became our Rochester department chair. In this role, he oversees a department of approximately 1,400 staff members. We know that he will enjoy the role, and that the Rochester department will benefit from his extensive leadership experience.

DJ and his wife, Molly, have 3 sons ranging from 15 to 20 years of age. Hockey predominates as a family activity, with many weekends and most weekdays filled with events and practices in ice arenas. In whatever spare time they have, DJ and Molly love to travel, preferably to warm places that have sand, sun, and water.

Carlos B. Mantilla, M.D., Ph.D. was born in Medellin, Colombia but moved to the U.S. shortly after with his family. They were mostly in Nashville, TN where his late father pursued training in Pharmacology. His family instilled in him the importance of education from an early age. Upon returning to Colombia, they lived in Bogotá, where Carlos attended a high school founded by Benedictine monks from North Dakota. He distinguished himself in school academically and had the honor of being part of the mathematics Olympiad team representing Colombia in the International Olympiad in Warsaw, Poland during his senior year. He then attended medical school at the Universidad del Rosario, where he was awarded among several distinctions that of Collegian, a member of a council that in the tradition of the oldest Spanish universities elects the institutional governing body.

Upon completing medical school, Carlos went on to fulfill his social service year working as a general practitioner in the Amazon jungle. It was there that he met his wife, Pilar, who was working with the Office of the First Lady of Colombia on a joint project with UNICEF to serve women and children in the Amazon basin. After fulfilling his social service year, Carlos moved to Rochester and was followed by Pilar a year later to further their education.

Carlos became a resident in our anesthesiology program and completed his training in 1998. This was followed by a fellowship in pain medicine in 2001. During his fellowship he pursued research under the mentorship of our own Dr. Gary Sieck, earning a Ph.D. in Biomedical Sciences – Molecular Neuroscience in 2003. He studies the control of breathing, with the long-term goal to develop rational and effective therapies for the treatment of diseases that impair the ability to breathe independently. His work has explored the mechanisms behind aging-related susceptibility to respiratory infections and other complications, the restoration of mechanical ventilator independence following cervical spinal cord injury, and recently, the use of diaphragm muscle shear wave elastography to identify patients at risk for opioid-induced respiratory depression.

Carlos is a Professor of Anesthesiology and Physiology and a named Clinician-Investigator. He served as chair for our department from 2016 to 2024 and has maintained a long-standing record of extramural funding for his research work, including during his time as chair. He also has contributed to the institution in other roles, including service as director of the research programs for the Center of Clinical and Translational Sciences and member of the Research Committee. Carlos also has served the NIH as member of the Aging Systems and Geriatrics study section and as chair of the Respiratory Integrative Biology and Translational Sciences study section. He has a long-standing commitment to education and has served as Associate Program director for our residency and as director for the Ph.D. program in Biomedical Engineering and Physiology. He is a member of the Committee for Academic Anesthesiology for the American Society of Anesthesiologists and an oral examiner for the American Board of Anesthesiology. He and his wife have been founding supporters of the Alliance of Chicanos, Hispanics and Latinoamericans (ACHLA) in Rochester, including their math tutoring program “Juntos”.

Pilar and Carlos also have supported numerous patients being treated at Mayo for reconstructive and other needs following landmine injuries as part of a joint Mayo program with the United for Colombia Foundation. They enjoy traveling and spending time with family, friends and their dog, Vida.

Alan D. Sessler, M.D. was born on April 4, 1932, in Boston. After completing Boston Latin High School in 1949 and Dartmouth College in 1953, he entered Tufts Medical School in Boston and earned his M.D. in 1957. He entered an anesthesiology residency at Dartmouth’s Mart Hitchcock Memorial Hospital in Hanover, New Hampshire that year but his training was interrupted by 2 years of service from 1959 through 1961 in the U.S. Navy. He served as a medical officer at the U.S. Naval Hospital, Great Lakes, Illinois and aboard a heavy cruiser, the U.S.S. Des Moines in the Mediterranean Sea. Upon completion of his service in 1961, he moved to Rochester as a fellow in anesthesiology for a final year of training. He was appointed as a consultant in 1962.

Alan left a lasting imprint on our Rochester department, medicine, and our specialty.

• Education. Alan dramatically improved our residency training, implemented subspecialty fellowships, and expected all graduates to obtain ABA certification. This expectation led to Mayo Clinic having the highest success rate for board certification of graduates of any program in the U.S. for decades. He was a lifelong advocate for education, pushing for new programs, higher expectations of trainees, and support of certification. His love of education led to him serving on the ACGME’s Residency Review Committee for Anesthesiology and the ABA’s Board of Directors (president in 1988). He also became dean of the Mayo Clinic School of Graduate Medical Education, starting an anesthesia tradition within the school that led to Drs. Mark Warner and Steve Rose following as deans of the school. He was a trustee and president of his alma mater’s Dartmouth Hitchcock Clinic, Hospital, and Medical Center and, in that role, provided guidance and oversight on the college’s School of Medicine and other healthcare programs. In his final years of retirement, Alan served as a tireless advocate for our Rochester school system and was a leader of our Rochester Public Library, boosting efforts to improve literacy in the community.

• Practice. Within Mayo Clinic, Alan teamed with Dr. Paul Didier to develop the institution’s critical care services and fellowships. He strongly believed that anesthesiology should evolve from intraoperative to perioperative care in its many facets. He was encouraged by Dr. Albert Faulconer, his initial department chair and mentor, to push for expanded opportunities for anesthesiologists . . . and he adopted this approach vigorously for the remainder of his career. During his leadership as our Rochester department chair from 1977 through 1989, Alan steadily increased the proportion of our department’s efforts to expanded practices in pain medicine, critical care medicine, preoperative evaluation, and transfusion medicine. He envisioned a broader role for respiratory care and quietly influenced institutional leaders to open new practice opportunities (e.g., the pulmonary function laboratory, and the emergency and postoperative recovery room practices). He was an influential leader in the ASA and ABA in starting subspecialty certification and increasing the roles of anesthesiologists in pain medicine, critical care, transfusion medicine, pediatric anesthesia, and hyperbaric medicine.

• Research. While Alan was not an independent researcher, he supported expansion of anesthesia research within the institution and extramurally. He used his role as ASA Vice-President of Scientific Affairs to encourage the NIH to increase anesthesia-related funding. He played a major role in starting the Foundation for Anesthesia Education and Research (FAER), an organization that has provided today more than $70 million of funding to support new investigators in the specialty. He served as president as well as executive director of FAER for more than a decade and started many new programs to increase the number of medical students and trainees with interest in pursuing clinical and basic research in the specialty. Alan also was a founding director of the Anesthesia Patient Safety Foundation (APSF), an organization that, like FAER, have provided millions of dollars of support for trainees and junior anesthesiologists as they start their research careers in patient safety-related fields.

• Administration. In addition to serving as the department’s first chair of its Section on Critical Care, Alan was our department chair from 1977 through 1989. He was a member of the Mayo Clinic Board of Governors from 1988 through 1992 and dean of the Mayo Clinic School of Graduate Medicine Education from 1989 through his retirement in 1995. He served as a long-time director of the ASA and as its Vice-President of Scientific Affairs. He was a director of the ABA from 1977 through 1989 and president during 1988. He was executive director of FAER from 1995 though 2008. He received the ASA’s Distinguished Service Award and was an honorary fellow of the Faculty of Anaesthetists of Royal College of Surgeons in Ireland and the Royal College of Anaesthetists of the U.K.

Simply put, Alan was one of the country’s most influential anesthesiologists for more than 5 decades (1960-2010).  Our own Dr. Doug Bacon summarized his contributions in his elegant memorial tribute following Alan’s death on March 18, 2020.  Alan was even more than an incredible leader in our department and specialty; he was a mentor and sponsor for many of us.  As I note in a personal tribute I wrote about Alan, he was a parental figure, providing us with expectations for success and continual encouragement to excel and make those around us do the same.   Alan and his wife, Dr. Martha (Smith) Sessler, were proud parents of three children.  Martha completed her training in anesthesiology in Rochester in the Class of 1962 with Alan.  She currently lives in Charter House in Rochester. 

Mark A. Warner, M.D. was born in Greenville, Ohio on October 7, 1953 and was raised on a Jersey dairy farm with his family and grandparents. He graduated from Miami University in Oxford, Ohio in 1976 and entered the Medical College of Ohio (now the University of Toledo School of Medicine). At 7:57 AM on July 6, 1976, he met his future wife, Mary Ellen, as she stood on the medical school steps and unknowingly captured his attention on their way into their first class. After 6 months of relentless pursuit, Mary Ellen finally agreed to a first date.

During their junior year of medical school, they obtained ASA Preceptorship awards with the assistance of their mentor, Dr. J. Tom Martin, a former Mayo Clinic anesthesiologist and Rochester Methodist Division leader. Drs. Alan Sessler, Duane Rorie, Ron Faust, and Jim Prentice were their advocates during their two months in Rochester in Spring 1978. Mark and Mary Ellen married in their senior year, graduated in 1979, and moved to Rochester as new residents in 1979. The first two people they met in the department were Ann (Tvedt) Brumm and Donna (née Huntley, formerly Goetsch) Baxter, two of the secretaries in our St. Marys 4 Joseph department office. Dr. Faust was their program director and Dr. Sessler was the chair. Their first-year classmates included Drs. Bob Chantigian, Steve Rettke, Mark Martinson, and John Billings.

Mark completed his residency training in December 1982 and joined the staff. Two of the first new residents assigned to him in July 1983 were Drs. Brad Narr and Jim Eisenach. Of his clinical activities, he is exceptionally proud that the old General Section (now the Multispecialty Division at St. Marys Hospital) provided anesthesia for 225 consecutive children with severe mandibular hypoplasia (e.g., Pierre Robin and Treacher Collins syndromes) without any lost airways or tracheostomies in a time before pediatric fiberoptic endoscopy was available. Colleagues who were extensively involved in the care of these children with him included Drs. Steve Kunkel, Scott LeBard, Lynn Christianson, and Doug Bell and nurse anesthetists such as Mary Marienau, Curt Buck, and John Carter. By the mid-1980s, Mark and colleagues recognized the need for a unique team to care for the institution’s smallest children and formed the pediatric call group. This call group expanded their scope of practice to the evolving pediatric transplant services and postoperative pain management. Recruitment over time of key pediatric anesthesiologists such as Drs. Randy Flick, Bob Friedhoff, Greg Shears, and Bob Lunn rapidly escalated the skill set and size of the pediatric anesthesia group and tied the department closely to the overall integrated pediatric practice at Mayo.

For much of his career, Mark assumed administrative roles within the department and the institution. He was sequentially the chair of the General Section within the department at St. Marys Hospital, the inaugural chair of the Pediatric Council for the institution, the vice-chair of the institution’s Clinical Practice Committee, and the first chair of what is now the institution’s Hospital Practice Committee. He became chair of the Rochester Department of Anesthesiology in 1999 and continued in that role through 2006. Working closely with Drs. Brad Narr, his vice-chair of the practice; Steve Rose, his vice-chair of education; and Mary Ellen who developed the new, innovative Gonda ambulatory practices with colleagues such as Steve Jorgensen, Marla Judd, and Steve Osborn, he was able to watch the department thrive. The department grew in size and academic stature internally and externally. At two different points during his term as department chair, department colleagues served as presidents of 6 of the 8 primary subspecialty societies and Dr. Ron Mackenzie served as ASA president in 2000. He is most proud of the outstanding care provided by his colleagues, the department’s national visibility, and the leadership that colleagues throughout the institution provide for the advancement of specialty.

In 2006, Mark stepped down from his department chair role and joined the Mayo Clinic Board of Governors. He remained a director of that Board as it evolved to the Rochester Board of Governors. He also served the institution as Dean, Mayo Clinic School of Graduate Medical Education (MCSGME; 2006-2012) and Executive Dean of Education (2012-2016). Throughout his time as an education leader, he worked side-by-side with colleague Dr. Steve Rose. Steve was his vice-dean of MCSGME and then later dean of that school. His mentor, sponsor, and surrogate father figure, Dr. Alan Sessler, also provided daily advice.

Mark was involved in the specialty within Minnesota and nationally. He served as a director of the American Board of Anesthesiology from 1998 through 2010 and was president of the ABA in 2009. He also was president of the ASA in 2011, the Academy of Anesthesiology in 2015, and the Anesthesia Patient Safety Foundation from 2016 through 2021. He has received Distinguished Service Awards from the ASA and the Minnesota Society of Anesthesiologists, as well as a Distinguished Educator Award from Mayo Clinic and a Distinguished Alumnus Award from the Medical College of Ohio. He is an honorary fellow of the College of Anaesthesiologists of Ireland. His ASA Distinguished Service Award was announced by former Mayo Clinic Arizona department chair Dr. Dan Cole.

Mark and Mary Ellen have four sons and 10 grandchildren. Two of their sons, along with their wives, are anesthesiologists in our Rochester department. Mark’s first cousin, Dr. David Warner, is one of the recruits he helped to attract to the department. Both Mark and Mary Ellen continue to work clinically. They enjoy traveling, having stayed overnight in more than 100 countries, and visiting their grandchildren. They maintain a farm and spend their spare time caring for their land and contributing to the community.

Finally, a Farewell.

Best wishes to you all. On behalf of the Centennial Project Team, thank you for all you do to support the education of our students and trainees, the safety of our patients, and the success of our department, the specialty, and the institution.