To help celebrate the centennial year of Mayo Clinic’s Department of Anesthesiology and Perioperative Medicine, Dr. Mark Warner, with the assistance of other department members and the Centennial Project Team, has been writing weekly updates that contain brief descriptions of articles or vignettes that highlight the department’s development, remarkable personnel across the spectrum of the department (e.g., respiratory therapists, nurse anesthetists, anesthesiologists, scientists, and administrators), and contributions to the specialty’s advances and recognition. Below you can read these updates. During the centennial year from April 2024 to April 2025 the six most recent updates will be listed on the homepage of this webpage and will be regularly moved to this section.
Update #1 - Sept. 7, 2023 "Initial Announcement"
Photograph 1: Mayo Clinic employee photograph of Dr. John Silas Lundy, undated.
Photograph 2: Alice Magaw Kessel, undated.
Initial Announcement
This is the first of 80 weekly email updates that you will receive as we celebrate the Mayo Clinic Department of Anesthesiology and Perioperative Medicine’s 100th anniversary over the next 18 months.
I am proud to announce that the Department of Anesthesiology and Perioperative Medicine will be celebrating the centennial anniversary of the department in April 2024. This date is based on the official designation on April 1, 1924, by the Mayo Clinic Board of Governors of the Section on Regional Anesthesia. The section was to evolve into our current Department of Anesthesiology and Perioperative Medicine. This Centennial Celebration will also recognize the 31 years of nurse anesthesia preceding the official recognition of the future department, the contributions of Mayo Clinic nurse anesthetists to the establishment of the field of nurse anesthesia, and the development of the specialty of anesthesiology, respiratory therapy and intensive care units at Mayo Clinic.
With the recruitment of John Lundy, M.D. from Seattle by Dr. William Mayo and Dr. Lundy’s start at Mayo Clinic on April 1, 1924, the new Section on Regional Anesthesia began what was to evolve progressively to the Section on Anesthesia, the Department of Anesthesiology, and now the Department of Anesthesiology and Perioperative Medicine. Dr. Lundy quickly added innovative advances to the nascent specialty of anesthesiology, both internally at Mayo Clinic and nationally. As described by our colleagues Drs. Terry A. Ellis, Bradly J. Narr, and Douglas R. Bacon in a 2004 article in the Journal of Clinical Anesthesia, Dr. Lundy established the first anatomy lab at the Mayo Clinic. He believed that the lab would serve as a useful tool for teaching residents as well as research into regional anesthetic techniques. To advance the science of anesthesiology, Dr. Lundy developed the concept of balanced anesthesia, pioneered the introduction of barbiturates (e.g., pentothal) to the practice of anesthesia, and developed anesthesia section services for the use of ventilators, ventilator vests, oxygen tents, and nasal oxygen supplementation. Remarkably, in 1935 he also established the nation's first blood bank.
For the next year-and-a-half, the Centennial Project Team will be sending you short weekly emails, with each containing very brief descriptions of articles or vignettes that highlight the department’s development, remarkable personnel across the spectrum of the department (e.g., respiratory therapists, nurse anesthetists, anesthesiologists, scientists, and administrators), and contributions to the specialty’s advances and recognition. These emails will contain links to either the articles directly or to these stories on our new History of the Department of Anesthesiology website. The website will be available to everyone, both those within Mayo Clinic’s firewall and those outside of the institution. I promise that you will find many of the articles and stories to be quick reads, interesting, and often entertaining.
For this Introductory update, I’ve linked two published articles that showcase our founders, Dr. Lundy and Alice Magaw. I also have attached a pdf file of an article by Scott Atchison, written in our 2002 department newsletter, describing our good friend and long-time colleague, Dr. Rungson Sittipong. I believe you will enjoy reading them.
- “Alice Magaw (Kessel): Her Life In and Out of the Operating Room" by Jeffrey E. Nelson, CRNA, MNA; Steve F. Wilstead, CRNA, MNA. AANA Journal 2009.
- "Developing a Specialty: J.S. Lundy Three Major Contributions to Anesthesiology” by Terry A. Ellis II MD; Bradly J. Narr MD; Douglas R. Bacon MD, MA. Journal of Clinical Anesthesia Volume 16, Issue 3, May 2004, Pages 226-229.
- “Our Friend Rungson” Mayo Anesthesiology Alumni Newsletter. September 2002, Vol. 1, No. 1
Mystery Photos
We’ll also have an Anesthesia History Mystery Photo each week. Everyone who sends me a correct identification of the person in the photo via email response (warner.mark@mayo.edu) within three days of us sending out the emailed update will be entered into a drawing for a $10 gift card to Starbucks. You will need to send me your name and contact information so that I can send out the card to the winner each week. Each person will be allowed a single win during the series of 80 updates during the Centennial Celebration’s 18 months.
This month’s mystery person, a remarkable leader:
I’ll provide more information in the coming months as we near the start of the 100th anniversary and throughout the year of celebration. On behalf of the Centennial Project Team (listed below), we hope that you enjoy reading about the amazing colleagues who developed one of the world’s outstanding departments of anesthesiology.
Update #2 - Sept. 14, 2023 "Origins of the Department"
Photograph 1: Mayo Clinic employee photograph of Dr. Douglas Bacon, 2023.
Photograph 2: Mayo Clinic employee photograph of Jane Post, undated.
Department History
Welcome back. I promised you updates that will be much shorter than last week’s (September 7th) introduction to the Centennial Celebration.
- “How Old is the Mayo Department of Anesthesiology?”: There is some debate as to the original start of the Department of Anesthesiology, at least as we know it in its present form. Doug Bacon describes this debate in one of our 2004 department newsletters.
- “A Conversation with Mrs. Jane Post”: Jane Post, one of our department’s lead office staff members, worked for our Legal Department’s Harry Blackman starting in 1955, four years before Mr. Blackman became a federal court of appeals judge and in 1970 became an associate Supreme Court justice). Jane interacted with John Lundy regularly and partnered with every department chair from Albert Faulconer in 1955 through Duane Rorie when she retired in 1994. Peter Southorn’s summary of her observations gives us great insights into the characters and characteristics of these department chairs.
Mystery Photos
Last week’s History Mystery Photo was Alan Sessler. Alan was department chair from 1977-89.
Here is this week’s Mystery Photo:
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #3 - Sept. 21, 2023 "Military Introduction"
Mayo Clinic employee photograph of Dr. Steven Rettke, undated.
Call for Military Information
Will and Charlie Mayo were strong supporters of the U.S. military. Their advocacy led to the creation of the U.S. Army Medical Reserve Corps and their intensive work during WWI led to a remarkable advance in the quality of care provided to our soldiers, sailors, and pilots both during the war and far into the future. Many Mayo physicians and nurses played important roles in the military in WWI and in conflicts since that time.
The Department of Anesthesiology’s personnel also contributed to our armed forces military readiness and responses. In the coming months you will be amazed by the stories of our department colleagues and their military contributions in every branch of service. Here are two short military-related stories that provide details on some of our colleagues and a program at Mayo Clinic that helped launch the specialty of anesthesiology as we know it now.
- “Military Profiles”: This 2003 summary describes the military experiences of four of our colleagues, with their actions involving WWII through Desert Storm.
- “The Mayo Clinic World War II Short Course and Its Effect on Anesthesiology”: The linked article from Anesthesiology, V 105, No 1, Jul 2006, showcases our department’s leadership in the creation and implementation of the WWII “Short Course” that rapidly produced anesthesia-trained physicians for WWII.
Steve Rettke, a distinguished U.S. Navy carrier fighter pilot and retired Navy captain, as well as long-time leader of our Methodist Hospital clinical practices, will be creating webpages on our new history website. This website is being created and will become fully operational on November 1st. In the meantime, you can read its interim homepage at Anesthesiology Department | Mayo Clinic | History and Heritage.
If you have served at any point in the U.S. Armed Forces, Steve is asking for you to send the following information to both him (Rettke.steven@mayo.edu) and Alec Thicke (Thicke.alec@mayo.edu). Alec is our department’s new archivist and major contributor to our Centennial Project. They will create a database and add this information and your stories to the webpages.
- Name:
- Service:
- Rank:
- MOS / Specialty:
- Deployments/ Assignments:
- Anesthesiology Department Association:
- Photos of your time in the military, if any:
Mystery Photos
Last week’s History Mystery Photo was Mary Marienau. Mary was director of our Rochester Nurse Anesthesia training program and took it through advances that led to Master’s and then DNP degrees for graduates.
Here is this week’s Mystery Photo:
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #4 - Sept. 28, 2023 "Centennial Year"
Photograph 1: Mayo Clinic employee photograph of Dr. Allan Sessler, undated.
Mayo Clinic employee photograph of Dr. Charles Restall, undated.
Centennial Celebration First Month Update
Thank you for your readership. We are completing the first month of our 18-month period of celebrating the Centennial Anniversary of the department. The first six months from now until April 2024 will be used to provide background information on the department. During the actual anniversary year (April 2024 through April 2025), there will be a variety of events and activities. These include:
- A gala celebration dinner.
- A series of visiting professors at all three sites who will speak about the history of the department and impact on the specialty.
- A special session on Mayo Clinic at the 2024 Anesthesia History Association’s annual meeting and co-hosting the association’s 2025 annual meeting in Rochester.
- A number of historical vignettes about Mayo Clinic in Anesthesiology through the Centennial year.
- Two department-specific presentations in the series of dinners sponsored by Mayo Clinic’s Fye Center for History of Medicine.
- Progressive development of an expansive Mayo Clinic Anesthesiology history website, hosted as a section within the Mayo Clinic Heritage website. This website, Mayo Clinic | History and Heritage, is available to be accessed externally as well as internally
- Support for any and all of us to research, present, and publish department history.
Regarding research, presentations, and publications about our department’s history, I would like to introduce you to Alec Thicke (pronounced “THEE-kee”) and, for those who may not know him, Doug Bacon.
- Alec Thicke is an outstanding medical archivist who joined us for this Centennial Celebration. Alec serves within Mayo Clinic’s Fye Center for History of Medicine and is a remarkable source for historical materials related to the department. Alec is a Rochester native, graduating from Mayo High School. He has been an archivist for the Wisconsin History Society in Madison and St. Olaf’s College in Northfield, MN.
- Doug Bacon, M.D., is one of the world’s leading anesthesia historians. He was recognized by the Wood Library-Museum of Anesthesiology as its Laureate of Anesthesia History in 2012. Laureates carry that honor for 4-years; Doug is only one of eight individuals so recognized in the first 3 decades of the award (Dr. Douglas R. Bacon - Wood Library-Museum of Anesthesiology (woodlibrarymuseum.org). Doug was a member of our Rochester staff, chair both the Section on Anesthesia History and the South Division, from 2000-2012. Subsequently, he has been chair of the Departments of Anesthesiology at Wayne State University and the University of Mississippi. Doug retired from clinical practice and his Mississippi department chair role earlier this year and is now assisting our department with the Centennial Project.
We hope that a number of our trainees and staff members work with Alec and Doug to develop historical projects during the Centennial Celebration and far into the future. Our department is and will remain one of the world leaders in anesthesia history.
Speaking of leaders . . .
I’ve attached two great stories form our 2004 department newsletter. The first is about former Rochester department chair Alan Sessler and the second about one of the department’s most memorable clinicians, Charlie Restall. I think you’ll find them to be interesting and even entertaining.
- “Profile of Alan Sessler”: This summary encompasses two stories, one written by Peter Southorn and the other a set of reflections written by Mike Marsh. Peter is one of our most active emeritus professors. He is an astute observer of his colleagues and a prolific writer. He served as our department’s newsletter editor and co-wrote and edited our department’s history tome, Art to Science. This book was published in 2000. In many respects, our new department history website will be the next version of the book except that the website allows far more flexibility and inclusion of materials such as oral and video histories, links to many supporting materials such as digitized publications, etc. Mike formerly was a great anesthesiology and intensivist for us before leaving in 1991 to serve as long-term chair of the Department of Anesthesiology at Wayne State University.
- “Fond Memories of Charlie Restall”: Written by Peter Southorn, this short summary provides hints into the amazing life of Charlie Restall. He was one of our many staff members who served in the military, with extensive action in WWII. He also is the subject of many of the department’s greatest, most humorous stories. He could be gruff and curmudgeonly as well as compassionate and soft as a teddy bear. Interesting reading.
Mystery Photos
Last week’s Mystery Photo was Jeff Ward.
Jeff served as the education coordinator for our Respiratory Therapy training program for more than 3 decades. During that period the program trained more than 350 respiratory therapists. Shirley Johnson partnered with Jeff during most of his time as overall education coordinator. Shirley served as the program’s clinical coordinator. Paul Didier and Dave Plevak were the medical directors of the program during most of Jeff’s time in his leadership role.
Here is this week’s Mystery Photo:
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #5 - Oct. 5, 2023 "Innovations: The Department and Neuraxial Opioids"
Photograph 1: Mayo Clinic employee photograph of Dr. Josef Wang, undated.
Photograph 2: Mayo Clinic employee photograph of Dr. Lee Nauss, undated.
Photograph 3: Mayo Clinic employee photograph of Dr. James Glenski, undated.
Photograph 4: Mayo Clinic employee photograph of Dr. Mark Warner, undated.
Photograph 5: Mayo Clinic employee photograph of Dr. Brian Dawson, undated.
Innovations: The Department and Neuraxial Opioids
Thank you for your readership and welcome to Update #5. And for those of you involved in guessing the people in our Mystery Photos, I sincerely appreciate your responses. We’ve had more than 150 responses to each photo thus far, with approximately 90% of them being correct.
We can be very proud of the multiple areas in which the department contributed to advances in the specialty and patient safety over the past century. Today and in the coming months, we will highlight a number of these innovations and the individuals who created them.
Our department played the lead role worldwide in establishing the safety and effectiveness of neuraxial opioids for pain relief. Peter Southorn provides a wonderful summary titled “The First Human Demonstration that Intrathecal Opiates Produce Pain Relief” of the work of Joe Wang and Lee Nauss in the late 1970s, with Joe initially studying the use of intrathecal narcotics in the laboratory and Lee administering the first dose to a patient. Their seminal paper “Pain Relief by Intrathecally Applied Morphine in Man” led to an international explosion of studies and the rapid introduction of both intrathecal and epidural opioid use in adults for perioperative analgesia into clinical practice.
In 1984, Jim Glenski, Mark Warner, and Brian Dawson took the next logical step and reported on a case series of children who experienced excellent pain relief with epidural opioids “Postoperative Use of Epidurally Administered Morphine in Children and Adolescents”. This was the first report of the use of neuraxial opioids in children.
Mystery Photos
Last week’s Mystery Photo was John McMichan.
John is originally from Melbourne, Australia and served as a critical care fellow in Rochester in 1976-7. After 10 years on staff in Rochester, he moved to Scottsdale to start the Department of Anesthesiology in Arizona. He served in that role for six years and has remained a strong advocate for the department in Phoenix and for the specialty. A special shout out to John for his leadership and service to Mayo and our department.
Here is this week’s Mystery Photo:
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #6 - Oct. 12, 2023 "International Care"
Photograph 1: Mayo Clinic employee photograph of Dr. David Byer, undated.
Photograph 2: Mayo Clinic employee photograph of Dr. Kelly McQueen, undated.
International Care
Will and Charlie Mayo traveled the world to learn medicine and surgery. They also invited international guests to Rochester for stays between 4 and 12 weeks. They purchased a house on 2nd Street SW, immediately south of the current Mayo Building and it sat in the green space between what is now the Hilton Building and the Mayo Medical School. This house hosted international guests from 1895 through 1915. Each workday evening during these two decades, either Will, Charlie, or other Mayo staff members would gather the visitors in the house’s living room and talk about a topic of medical or surgical care. The goal was to share their knowledge with physicians from outside the U.S. and improve care far beyond Mayo Clinic.
Members of the Department have participated in this noble venture of working to improve care worldwide, especially in low resource countries. Here are two stories that highlight different approaches by two of our alumni:
- “And Especially the Children of Africa”. David Byer worked in orthopedic anesthesia at Methodist Hospital for more than 30 years and served as the long-term Minnesota representative to the American Society of Anesthesiologists Board of Directors. David passed away from complications related to multiple myeloma in 2014 (Mayo Clinic Alumni Association | David E. Byer, M.D. (ANES ’73). His favorite motto continues to inspire many of us, “Live simply; give generously.”
- “So Much Remains to be Done”. Kelly McQueen is one of our country’s leaders of global health and anesthesia initiatives. She was a resident graduate of Mayo Clinic Arizona and a fellow in obstetric anesthesia in Rochester. Currently, she is chair of the Department of Anesthesiology at the University of Wisconsin. You may read more about her at Kelly McQueen - Wikipedia.
The department has many wonderful colleagues in our physician and nurse anesthetist ranks who care for patients in low resource countries. Our trainees have the option of pursuing grants to serve overseas in low resource countries through the Mayo Clinic Global Health Program. In addition, Peace Eneh, one of our new Rochester staff members, and members of our Mayo Global Anesthesia interest group have organized a one-month training experience in Zambia. This pilot project will start this year with several residents and fellows, plus staff anesthesiologists. Hopefully, this program will soon expand to all anesthesia trainees and staff members across the institution.
Mystery Photos
Last week’s Mystery Photo was Jim Harper.
Jim served in the U.S. Army Special Forces from 1967-1970, then attended medical school at the University of Arizona. He joined our Rochester staff in 1982 and moved to Jacksonville to start our Florida department. He was chair of the department for 8 years.
Here is this week’s Mystery Photo:
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #7 - Oct. 19, 2023 "Cardiovascular Anesthesia Leadership"
Photograph 1: Mayo Clinic employee photograph of Dr. Robert Devloo, undated.
Photograph 2: Mayo Clinic employee photograph of Dr. Emerson Moffitt.
Photograph 3: Mayo Clinic employee photograph of Dr. Roger White.
Cardiovascular Anesthesia
Mayo Clinic has been a leader in a number of surgical and anesthesia specialties. Today we will highlight the leadership roles of three extraordinary leaders in cardiovascular anesthesia: Drs. Bob Devloo, Emerson Moffit, and Roger White.
- Bob Devloo “A Pioneer in Cardiac Anesthesia”. Bob was from Belgium and experienced WWII during conflicts in India and Burma, learning how to deliver an anesthetic in the tropical heat for wounded soldiers. He trained at Mayo Clinic in 1948 and joined our staff in 1953. During his nearly 30 years on staff, he worked with John Kirklin, Dick Theye, Emerson Moffit, Roger White, John Tinker and others to establish one of the world’s finest cardiovascular surgery programs.
- Emerson Moffitt “A Pioneer in Cardiac Anesthesia”. Emerson was from New Brunswick, Canada and served in the Canadian Royal Navy before completing Dalhousie Medical School in Halifax, Nova Scotia. After a fellowship in Rochester, he joined our staff in 1957 and worked closely with distinguished scientists and clinician investigators such as Earl Wood, Jeremy Swan, and Dwight McGoon. His work helped the maturing field of cardiovascular anesthesia. He led our section of anesthesiology at St. Mary’s Hospital and was president of the Minnesota Society of Anesthesiologists. He left Mayo in 1972 to become dean of Dalhousie Medical School.
- Roger White “An Unsung Hero”. Roger is from Ontonagon, Michigan on Lake Superior and attended college and medical school at the University of Michigan. In 1965 he started his residency training in Internal Medicine in Rochester, but his training was interrupted by a 2-year stint in the U.S. Army. Upon his return, he joined the anesthesiology residency program and then the staff in 1970. He continues as an active, innovative leader now after 53 years as a consultant. Roger is one of the world’s leaders in emergency medical services and cardiac life support. His launch of an early defibrillation program in Rochester gained worldwide attention by producing the highest survival rate in the U.S. for out-of-hospital cardiac arrest.
Mystery Photos
Last week’s Mystery Photo was Virginia Hartridge.
Virginia was originally from Milwaukee and earned her M.D. from the Woman’s Medical College in Philadelphia. She served as an officer in the U.S. Army from 1942 through 1946 and while a medical student from 1946 through 1950. She transferred to the U.S. Navy after medical school and served as one of a small handful of navy women physicians on active duty. In 1953 she joined Mayo Clinic as an anesthesiology fellow and came on staff in 1956. She worked primarily in obstetric, general and orthopedic surgery, all at St. Marys Hospital, until her retirement in April 1982. Mary Ellen and I were privileged to share her retirement dinner with her on top of the Hilton Hotel in San Francisco at the annual meeting of the IARS, the last anesthesia meeting that she attended.
Virginia served as the director of our nurse anesthesia training program from 1956 through 1976. Like many other trainees who interacted with Virginia and as a young intern on an orthopedic surgical service, I knew her to be tough as nails. But as a young colleague during her last year on staff, I also knew her to be kind and gracious. Upon her death in 2001, she left most of her considerable estate to the Rochester Area Foundation to support women in domestic abuse situations and single mothers who struggle to raise their families. Her endowed fund continues to make an impact on these two areas today.
Last week’s contest winner was Bob Friedhoff.
Here is this week’s Mystery Photo. Over the course of the 80 weekly updates, the Mystery photos will vary in difficulty of recognition. I will note that this will be one of the more difficult photos for most alumni and staff to identify as he was in Rochester only a short time and quite a long time ago. However, his work at Mayo and elsewhere played a significant role in improving the perioperative care of children worldwide. It’s a very good story and worthy of highlighting with a Mystery photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #8 - Oct. 26, 2023 "Mayo Clinic Three Shield Logo"
Photograph of Sonja Dawson and her husband Dr. Brian Dawson, undated.
Mayo Clinic Three Shield Logo
The Department of Anesthesiology has exerted considerable positive influence on the institution over the century. Many of the influences improved clinical practice, education, and research. However, none stands out for its clarity and impact than a simple napkin drawing created by Sonja Dawson, spouse of Brian Dawson, one of our first pediatric anesthesiologists. Peter Southorn tells the tale as only he can in this very interesting short story from the department’s newsletter from 2002 titled “Sonja Dawson and the Prototype Design of the Mayo Clinic Three Shield Logo”.
Peter describes Sonja’s original idea that the three shields would represent William Worrell Mayo (center) and his two sons, Charlie and Will, at his sides. It is interesting that the Mayo Clinic Board of Governors did not approve these Mayo family representations but instead substituted Education, Research, and Clinical Practice as the three shields. It has often been said that the biggest (center) of the shields represents the large clinical practice. However, that designation was never made by the Board of Governors. In fact, it can be reasonably argued that education or research could be the core (center) shield in that it was the Mayo Foundation for Medical Education and Research (MFMER), established by the Mayo families in 1915 through a large endowment to the University of Minnesota, that firmly established “the Mayo Clinic” as the non-profit educational institution that has trained more health care professionals than any other academic center in the U.S.
Mystery Photos
Last week’s Mystery Photo was David Hatch of London.
David was a fellow at Mayo Clinic in Rochester in 1967 and 1968. During his time with us, he was involved in cardiac anesthesia, caring primarily for children, and in our fledgling intensive care units with Alan Sessler. Kai Rehder convinced David to stay longer with a six-month opportunity in pulmonary research and he became Kai’s first research fellow. Upon returning to London, he became Consultant at Great Ormand Street Hospital and the world’s first professor of pediatric anesthesia. David made many major contributions to our understanding of the perioperative care of children, especially those cardiopulmonary defects. You may read more about David’s in this biography.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #9 - Nov. 2, 2023 "Jack Michenfelder"
Mayo Clinic employee photograph of Dr. John Michenfelder, undated.
Neuroanesthesia
Once in a while, I will highlight exceptional individuals and characters who stand out in our department’s history. This week’s subject is Jack Michenfelder. In the accompanying article, Ron Faust describes Jack’s many contributions to both the specialty and the department. Jack is perhaps best known for coining the term “neuroanesthesia” and serving as the editor-in-chief of Anesthesiology. There was, however, much more to Jack. I believe you will enjoy this story from one of the departments 2004 newsletters titled “Jack Michenfelder and the Achievement of Professional Respect”. For more information on Jack’s career, please see his obituary.
Mystery Photos
Last week’s Mystery Photo was Bernie Gilles.
Bernie was born in 1930 in North Dakota and served in the US. Army infantry during the Korean War. He subsequently became an outstanding nurse anesthetist in our department. He was very involved in much of the early pulmonary physiology research in our department and served as the nurse anesthetist partner to Alan Sessler as they developed the St. Marys intensive care units during the 1960s and 70s. Bernie and Alan built our respiratory therapy program and Bernie served as our clinical director for respiratory therapy for more than 20 years.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #10 - Nov. 9, 2023 "Staff Hobbies"
Photograph 1: Mayo Clinic employee photograph of Dr. Keith Berge, undated.
Photograph 2: Mayo Clinic employee photograph of Renee Casewell,
Photograph 3: Mayo Clinic employee photograph of Dr. William Lanier, undated.
Hobbies
We’ve focused these first 10 weeks on department history and its role in the evolution of anesthesiologists, nurse anesthetists, and respiratory therapists. However, there is so much more to life than work. The following three stories provide a snapshot of the hobbies of three influential alumni/staff members.
- Keith Berge “Leading a Balanced Life”: Keith was born in Rochester and attended the University of Minnesota and Mayo Medical School. Steve Kunkle and I were able to convince Keith early in his ENT residency that he would love life better by working from the other side of the ether screen. Keith worked primarily in critical care and our neuroanesthesia division during his career in Rochester. He played a dominant national role in defining the risks of personal use of fentanyl and other narcotics by anesthesia professionals, making recommendations that have saved the lives of countless individuals over the years.
- Renee Caswell “A Stitch in Time”: Renee was born in Lindstrom, Minnesota and attended Moorhead State University and the University of Colorado College of Medicine. After residency and pain medicine training in Rochester, she joined our Rochester staff before moving in 1997 to Scottsdale. She was our Arizona residency program director from 2009-2016, associate dean of the School of Graduate Medical Education from 2003-2008, and recipient of Mayo’s Distinguished Educator Award in 2015.
- William Lanier “A Sporting Life”: Bill was born in Statesboro, Georgia and attended the University of Georgia and the Medical College of Georgia. After his residency training at Wake Forest, Bill was a Mayo Clinic fellow in neuroanesthesia and related research. He subsequently served as president of the Society for Neuroscience in Anesthesiology and Critical Care, was one of only a handful of “super-senior” examiners ever for the American Board of Anesthesiology, became the longest-serving editor-in-chief of Mayo Clinic Proceedings as it evolved to become one of the world’s most read and cited general medicine scientific journals, and received many honors during his career (e.g., the Mayo Clinic’s Distinguished Career Award).
Mystery Photos
Last week’s Mystery Photo was Richard (Dick) Theye.
Dick was from Ft. Wayne, Indiana, a graduate of Indiana University, and trained in anesthesiology in Indianapolis. After a stint in the U.S. Navy and a short time in private practice, he moved to Mayo Clinic and rapidly established his interest in clinical research, specifically pulmonary gas exchange, cardiac output, and regional oxygen uptake measurement during anesthesia. He became the first department staff member to be assigned dedicated research time and was instrumental in the research training of Jack Michenfelder and Kai Rehder. He served as department chair from 1971 through 1976 and was a director of the American Board of Anesthesiology. Sadly, he passed away from ALS in 1977 just as he was in the prime of his career.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #11 - Nov. 16, 2023 "Halothane"
Photograph 1: Mayo Clinic employee photograph of Dr. Kai Rehder, undated.
Photograph 2: Mayo Clinic employee photograph of Dr. Russell Van Dyke, undated.
Halothane
Halothane was the first halogenated hydrocarbon volatile anesthetic. It’s introduction to clinical practice in 1955 was a huge advance for the safety of anesthesia as it soon replaced the more flammable ether and chloroform anesthetics. Within a few years, clinicians began to report patients who had developed postoperative liver dysfunction or “halothane hepatitis.” Several national studies in the U.S. and Great Britain confirmed the existence of this potentially fatal syndrome. The search was on to discover the risk factors associated with halothane hepatitis and its etiology.
Our department played a major role in elucidating the etiologies that can be associated with halothane hepatitis. Kai Rehder and Russell Van Dyke (in the photos below on the left and right, respectively) worked separately on this issue before joining our department in the mid-1960s and then collaboratively while in side-by-side laboratories at Mayo. They sought to determine whether halogenated volatile anesthetics, including halothane and methoxyflurane, were metabolized and if those metabolites were toxic to human organs. Their findings led to the currently accepted knowledge that the liver was the primary site for this metabolism and that the metabolites were toxic to the liver (halothane) and kidney (methoxyflurane). Even today’s halogenated anesthetics (i.e., isoflurane, sevoflurane and desflurane) have metabolites that can produce liver toxicity, albeit at a much lower rate than halothane. You can read Rehder’s paper from 1967 titled “Biotransformation of Halothane in Humans” and Van Dyke’s paper from 1973 titled “Biotransformation of Volatile Anaesthetics with Special Emphasis on the Role of Metabolism in the Toxicity of Anaesthetics”.
Russ and Kai’s efforts influenced anesthesia delivery worldwide for more than 4 decades, with clinicians avoiding the use of halothane in patients with liver dysfunction and the use of methoxyflurane in patients with renal dysfunction. Their work also led to the development and production of isoflurane, sevoflurane, and desflurane in ways that reduce the percentage of metabolites in humans. It is not an exaggeration to project that their efforts have saved hundreds, if not thousands, of lives in the past half century.
Mystery Photos
Last week’s Mystery Photo was Denise Wedel.
Denise was born in Duluth, Minnesota and received undergraduate and medical degrees from the University of Minnesota. After her Rochester residency, she served as a regional anesthesia fellow at Virginia Mason Clinic in Seattle. She joined our staff in 1982. She recently retired as an emeritus professor. Denise was responsible for re-invigorating the use of regional anesthesia in our Rochester practices and became one of the leading voices for regional anesthesia and its safe use internationally. She served as president of both the American Society for Regional Anesthesia and the International Anesthesia Research Society. She also was a long-serving editor for regional anesthesia and pain medicine in Anesthesia & Analgesia. She published extensively in regional anesthesia as well as malignant hyperthermia. She and protégé Terre Horlocker published the seminal recommendations on neuraxial anesthesia and the management of anticoagulants, impacting and improving the safety of patient care worldwide.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #12 - Nov. 23, 2023 "Anesthesia in Rochester-the Early Years"
Photograph 1: Edith Graham in nursing school, 1887.
Photograph 2: Florence Henderson, circa early 1900s.
Photograph 3: Carte de Visite of Isabella Herb, circa 1890s.
Anesthesia in Rochester – the Early Years
Edith Graham was not the first nurse to administer anesthesia. That honor appears to have belonged to Catherine Lawrence at the 2nd Battle of Bull Run in the American Civil War. However, Edith started nurse anesthesia at what is now Mayo Clinic in 1889 when William Worrall Mayo (Will and Charlie’s dad) trained her to administer ether. She was essentially the sole anesthetist for Will and Charlie until 1893, the year she married Charlie and stopped practicing as a nurse and nurse anesthetist. Edith’s sister, Dinah, also learned to administer anesthesia in 1893 as she worked with Dr. Augustus Stinchfield, the first non-Mayo to join the St. Marys Hospital practice. Dinah provided anesthesia for a short period of time for Augustus and presumably several of his patients. He primarily left the performance of surgeries to Will and Charlie and cared for the St. Marys Hospital and Rochester patients who did not need surgery. Unfortunately, Dinah’s anesthesia efforts are not well-documented, and it is not clear if she provided anesthesia for the patients of Will or Charlie or only for those of Augustus.
An excellent summary about Edith, her relatively short time as a nurse and nurse anesthetist, and her remarkable life of achievements as Mrs. Edith Graham Mayo can be found in this article by our own Darlene Bannon while she was a student in our Nurse Anesthesia Program titled “Edith Graham Mayo: Mayo Clinic’s First Nurse Anesthetist”. This article also contains fascinating insights into the initial difficulties that William Worrall Mayo and his sons had in the first few years of St. Marys Hospital in enticing patients to be admitted. Recall that in the 1880s and 90s, hospitals had very high mortality rates and few patients wanted to enter them. It was the great care provided by the Franciscan nurses and the surprisingly successful surgical outcomes of the Mayos that eventually attracted patients to Rochester and St. Marys Hospital over the course of that initial decade.
Fortunately, before leaving nursing in 1893, Edith trained her Chicago nursing school classmate, Alice Magaw, who was newly arrived in Rochester. Alice became one of the most famous nurse anesthetists of her time and Charlie fondly referred to her as the “Mother of Anesthesia.” In 1906, she reported on her experience of more than 14,000 anesthetics without a death attributable to the anesthetic in her review titled “A Review of Over Fourteen Thousand Surgical Anaethesias”.
By 1899, Will and Charlie were performing more than 1,600 surgeries annually. This required more than one operating room and additional people to deliver anesthesia. In 1899, they recruited Dr. Isabella Herb to move from Chicago where she had administered more than 1,000 anesthetics. With the move, Isabella became one of Mayo’s first women physicians and you can read more about her career in Robert Strickland’s, M.D., article titled “Isabella Coler Herb, M.D.: An Early Leader in Anesthesiology”. Alice Magaw primarily provided care for the patients of Will, and Isabella took over the patients of Charlie. Isabella left Rochester in 1904, leaving an opening. Florence Henderson, a new nurse who had started working at St. Marys Hospital in 1903, was recruited and trained by the Mayo Brothers to give anesthesia for Charlie’s patients. Joan Hunziker wrote about Florence’s career in an article titled “Voice and Touch: Florence Henderson on the Skills of an Ether Specialist”. She was to give more than 13,000 anesthetics for Charlie’s patients before leaving Mayo.
Mystery Photos
Last week’s Mystery Photo was Neil Feinglass.
Neil was born in Miami, Florida and earned his medical degree from Vanderbilt University. He trained in anesthesiology as well as critical care medicine at the University of Florida. After a one-year cardiothoracic anesthesia fellowship at Texas heart Institute with Arthur Keats, he moved to Rochester in 1987. In 1988, he transferred to Jacksonville, initiated intraoperative echocardiography services and chaired the Section on Cardiac Anesthesia at Mayo Clinic Florida. In 1998, he became one of the nation’s first board-certified echocardiographers in anesthesiology.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #13 - Nov. 30, 2023 "International Education and Fellows"
Photograph 1: Mayo Clinic employee photograph of Dr. Matthew Crawford, undated.
Photograph 2: Photograph of Dr. Dennis Moriarity, undated.
Photograph 3: Mayo Clinic employee photograph of Dr. Edmund Carton, undated.
International Education and Fellows:
Will and Charlie Mayo often traveled overseas and strongly encouraged their colleagues to do the same. They understood the importance of learning from others and then sharing that knowledge when back home. Over time, they traveled abroad as invited guests, still learning, but now primarily teaching their colleagues overseas.
Their love and respect for education led them in 1915 to donate a significant amount of $1.5 million to the University of Minnesota to establish the Mayo Foundation for Medical Education and Research (MFMER). That donation would be worth more than $45 million in 2023. Proceeds from MFMER continue to support our medical and research education initiatives across the institution. These initiatives include funds that offset expenses of a number of national as well as international residents and fellows. Approximately 22% of all trainees in our Mayo Clinic School of Graduate Medical Education (MCSGME) across the institution come from outside the U.S. Our 25,000+ alumni of MCSGME have come from more than 180 countries worldwide. In a count performed in 2008, 84 of these countries had one or more alumni who had served as their prime ministers of health (or equivalent title).
The following stories from our department newsletters in 2007 and 2008 showcase three of our Department of Anesthesiology’s international anesthesia fellows, two from Dublin, Ireland and one from Sydney. Their contributions here within Mayo Clinic and back home highlight the continuing importance of working closely with our international colleagues in anesthesiology.
- Matt Crawford, Sydney: Matt came to Rochester in 1982 and stayed through 1985 as a special clinical fellow. He was a remarkable clinician, teacher, and researcher. His story titled “A Return Visit from Australia” from the department’s 2008 newsletter provides the highlights of his time at Mayo Clinic and describes his contributions to the evolution of pediatric perioperative care in Australia.
- Denis Moriarity and Ed Carton, Dublin: Denis came to Rochester in 1974 as a one-year fellow and was profoundly influenced by Jack Michenfelder, Kai Rehder, Rungson Sittipong, and Alan Sessler. Ed came to Rochester in 1988 as an outstanding liver transplant fellow. We were fortunately able to convince Ed and his wonderful wife, Louise, to stay longer. Ed completed a second fellowship (Critical Care Medicine) and then joined our faculty from 1990 through 1993 before he and Louise returned to Dublin. Both Denis and Ed have played major roles in Ireland’s anesthesia advancements and within the College of Anaesthesiologists of Ireland. You can read more about their accomplishments from a 2007 department newsletter article titled “The Rochester-Dublin Connection”.
Mystery Photos
Last week’s Mystery Photo is Tony Jones.
Tony was born in Anniston, Alabama and earned his M.D. at the University of Alabama, Brimingham (UAB) in 1982. After completing his anesthesiology residency in Rochester, Tony trained with Kai Rehder in the physiology of smooth muscle, with emphasis on mechanisms that are responsible for smooth muscle hypersensitivity and asthma. In 2006, Tony, Evelyn, and his children moved back to Birmingham where he was appointed to a named professorship and installed as chair of UAB’s Department of Anesthesiology and Perioperative Medicine. He has subsequently held many major leadership roles within the UAB Health System and its Heersink School of Medicine. He also has been at the forefront of leadership in U.S. anesthesiology as a member of the FAER Board of Directors and chair of the Board of Directors of the IARS. You may read more about Tony at Keith A. Jones, MD | AMGA and Meet medicine leadership in 2022, a series: Get to know Tony Jones, M.D. - Heersink School of Medicine News | UAB.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #14 - Dec. 7, 2023 "Anesthesia and Simulation"
Photograph 1: Mayo Clinic employee photograph of Dr. Laurence Torsher, undated.
Photograph 2: Mayo Clinic employee photograph of Dr. Paula Craigo, undated.
Photograph 3: Mayo Clinic employee photograph of Dr. Klaus Torp, undated.
Photograph 4: Mayo Clinic employee photograph of Dr. David Seamans, undated.
Anesthesia and Simulation
The specialty of anesthesiology has been a leader in the development of medical simulation, with anesthesiologists producing and introducing the first simulators in the context of resuscitation and subsequently intraoperative patient care. An excellent summary of the origin and introduction of anesthesia simulation in general can be found at Simulation Training and Skill Assessment in Anesthesiology - StatPearls - NCBI Bookshelf (nih.gov).
At Mayo Clinic, our department has played a major role in introducing simulation into all of our training programs, anesthesiology and otherwise, and has been a leader nationally in advances in simulation. In Rochester, leaders of our anesthesia simulation programs were Laurence Torsher and Paula Craigo. Laurence started our Rochester program in 2005. Their colleagues in Arizona and Florida were Dave Seamans and Klaus Torp, respectively. Dave started the Arizona program in 2010 and Klaus followed in 2011 in Florida.
Laurence has provided a brief summary of our department’s evolution of simulation “Simulation in Anesthesia at Mayo Clinic”. He also has written an excellent review of the use of simulation in medical education in general that provides more insights into the overall development of this education-related field “History of Anesthesia Simulation”. Note that our department was one of the first five in the U.S. endorsed for providing instruction in simulation to fulfill MOCA credits as required by the American Board of Anesthesiology. Laurence and Paula deserve our thanks and admiration for the remarkable efforts they put into achieving this distinct honor. Dave and Klaus made remarkable inroads to place our department in simulation leadership roles in Arizona and Florida.
Mystery Photos
Last week’s Mystery Photo is Martin Abel.
Martin is from Johannesburg, South Africa and earned his medical degree at the University of Witwatersrand. After training in anesthesiology at Charing Cross Hospital in London and a fellowship in cardiovascular anesthesiology at Mt. Sinai Hospital in New York City, he moved to Rochester as a Special Clinical Fellow in Cardiovascular Anesthesiology and Critical Care Medicine. He joined the staff in 1982. Martin introduced the use of intraoperative echocardiography into our practice and has been a long-serving member of the American Society of Echocardiography’s Intraoperative Council and ASA’s Transesophageal Echocardiography Task Force. He chaired our Rochester Division of Cardiovascular and Thoracic Anesthesiology for 12 years and moved in 2017 to become chair of our department in Jacksonville. In that capacity, he has nearly doubled the size of the department and led to the major growth of its clinical and academic activities.
Martin is a master clinician, recognized with multiple department clinician and teacher of the year awards. He is one of only three Rochester-based department members to have received the Mayo Clinic’s Distinguished Clinician Award (2005). The other two from Rochester were Sait Tarhan (1993) and Mary Ellen Warner (2010). Two of our Arizona-based department members have received this award, Joel Larson in 2005 and Terry Trentman in 2018. Roy Cucchiara received this award for his work in our Florida department in 2005.
Interestingly, 3 of the 5 recipients of the Mayo Clinic Distinguished Clinician award across the institution in 2005 were anesthesiologists from each site of our department (Abel, Cucchiara, and Larson). That year was very special for the department as it was also in 2005 that we had members who served as either the president, president-elect, or immediate past president of 6 of the 8 major anesthesia subspecialty societies. To my knowledge, no other department in the country has ever achieved that distinction.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #15 - Dec. 14, 2023 "Gonda and its Outpatient Procedures Centers"
Photograph 1: Mary Ellen Warner, M.D., undated.
Photograph 2: Marlea Judd, RN, CRNA, undated.
Photograph 3: Steve Osborn, RN, CRNA, undated.
Photograph 4: Brad Narr, M.D., undated.
Photograph 5: Steve Jorgenson, M.D., undated.
Gonda and its Outpatient Procedure Centers
In the late 1990s and early 2000s, anesthesia department across the country and abroad were being requested to provide an increasing number of non-operating room anesthetics (NORA). These new outpatient procedures were great for patients and proceduralists but difficult to staff from an anesthesia perspective. Often, several anesthesia professionals were needed to care for a single patient who had complex needs in a remote site. The rapid expansion of requests for NORA did not promote an efficient practice and was one that contributed to a shortfall of anesthesia providers everywhere, including Mayo Clinic in all sites. There were also major concerns about patient safety, especially in the early days of NORA expansion.
In Rochester, we were fortunate to have leaders such as Brad Narr and Mary Ellen Warner involved in the development of plans for the new Gonda Building. Although the initial plans did not include any space to consolidate outpatient procedure practices, we were able to convince the institution that we could ensure patient safety and improve surgical efficiency by integrating consolidated outpatient procedural practices into the building design. We were granted procedure centers on three levels of the building, an institutional decision that resulted in a very positive impact on Mayo finances, patient safety and satisfaction, and surgical efficiency.
Mary Ellen, Marlea Judd, Steve Osborn, Brad Narr, and Steve Jorgensen led the development of these procedural practices. They were able to take advantage of several opportunities that allowed new practice models, cost-savings, and increased patient and provider satisfaction. These opportunities included Minnesota’s decision to opt-out of Centers for Medicare and Medicaid Services (CMS) requirements of medical direction of nurse anesthetists; an agreement between our department and the Upper Midwest Medicare carrier, Blue Cross/Blue Shield to allow us to use a non-medically directed anesthesia payment model and receive strong compensation for our services; and a collaboration between our department and the Mayo Department of Nursing that allowed our department to directly hire the nurses who staffed these procedural centers. The latter promoted robust cross-training and work efforts between nurses, CRNAs, and our physicians, all leading to excellent satisfaction in the practices and high efficiency of throughput, room turnover times, etc.
The story about this remarkable transition and its start with a single procedural center on Gonda 7 was first provided by Mary Ellen in a 2007 department newsletter in an article titled “Gonda Outpatient Procedure Center”. The care models developed by the team triggered a rush of institutions to send representatives to Rochester to learn what we had done and how we had done it. More than 75 institutions worldwide visited the Gonda 7, 2, and 15 practices between 2003 and 2013 and all implemented either our practice model or modifications of it. Future Centennial Updates will describe the development of Mayo Clinic outpatient surgical centers in Arizona, Florida, and the Mayo Clinic Health System.
Mystery Photos
Last week’s Mystery Photo is Peter Southorn.
Peter is from northeast England near Newcastle upon Tyne. He attended undergraduate and medical school at University College in London. After extensive anesthesia training in London, he moved to Rochester in 1973 for a one-year fellowship. He returned to University College as a staff member before making his definitive trip across the Atlantic to join our Mayo staff in 1976. During his career he made major contributions to the evolution of our critical care activities, led enhancement of our intraoperative and ICU patient monitoring capabilities, and was very involved in the development of our solid organ transplant services. Peter played major roles in Mayo’s medical school (admissions committee) and the Mayo Alumni Association (executive committee member). A quiet leader, he was a founding member of the American Society of Critical Care Anesthesiologists (currently named the Society of Critical Care Anesthesiologists) and president of the Minnesota Society of Anesthesiologists.
To many of us, Peter is best known for his gracious demeanor, crooked surgical hat, ready smile, and willingness to help on any project. Peter, Alan Sessler, and Kai Rehder wrote our department’s history in “Art to Science.” That book will be revised in 2025 at the conclusion of the Centennial Celebration.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #16 - Dec. 21, 2023 "Mayo Clinic, the American Board of Anesthesiology, and the Evolution of the Specialty"
Mayo Clinic employee photograph of John Silas Lundy, M.D., 1934.
Mayo Clinic, the American Board of Anesthesiology, and the Evolution of the Specialty
In a previous Update, we discussed the evolution of anesthesia at Mayo Clinic and the remarkable achievements of our earliest nurse anesthetists. The physician side of anesthesia developed more slowly, with modest advances during the first decades of the 20th century. Our own John Lundy and the University of Wisconsin’s Ralph Waters, a 1926 Mayo alumnus, were two of the leaders who spearheaded efforts to have anesthesiology recognized as an academic specialty. They pushed hard to develop certification in anesthesiology. Specifically, they were able to convince the American Board of Surgery to provide anesthesia certification in 1937. This led to the incorporation of the American Board of Anesthesiology (ABA) the next year as an affiliate of the American Board of Surgery. In 1941 the American Medical Association’s Council on Medical Education and the American Board of Medical Specialties approved the ABA as an independent certifying board. John Lundy’s influence with the American Medical Association provided the push to get final approval.
Lundy was appointed as one of the nine founding members of the ABA. For the next 18 years he influenced the ABA as it guided the fledgling specialty’s evolution, establishing norms for the certification of individual physicians and setting standards in education and research for anesthesiology training programs. What he lacked in political finesse in the ABA and national specialty societies, he made up for with a dominant personality and tenacity. He and Waters often disagreed on how the specialty should develop. The early ABA directors fell into two cliques: those linked to John Lundy and those linked to Ralph Waters. Lundy recruited a number of former Mayo trainees to become ABA directors. These included alumni Ralph Tovell, Charles McCuskey, Ed Tuohy, and Albert Faulconer. His efforts started a cascade of Mayo Clinic alumni who have served as directors of the ABA for 75 of the 85 years of its existence. No other department has provided more directors to the ABA. In addition, more than 100 department alumni from Rochester, Arizona, and Florida have served as examiners for the ABA or participated in the development of the ABA’s primary and subspecialty certifying examinations. The department’s sustained support for the academic development of the specialty and the certification processes of the ABA is astounding.
Why is Mayo Clinic’s continuous leadership in the ABA important? The ABA is one of the most influential organizations in U.S. anesthesiology because it determines the criteria for board certification. Training programs, through standards established by the Anesthesiology Review Committee of the Accreditation Council for Graduate Medical Education (ACGME), need to adapt to the criteria set by the ABA. As a consequence, much of the academic progress of the specialty is guided by the ABA.
Here is a list of 11 Mayo Clinic directors of the ABA. Note that Mark Keegan currently is the ABA Treasurer (Mark T. Keegan, M.B., B.CH. - The American Board of Anesthesiology (theaba.org).
- John Lundy (1938-1955)
- Ralph Tovell (1938-1949)
- Charles McCuskey (1940-1953)
- Edward Tuohy (1950-1955)
- Albert Faulconer (1955-1969)
- Robert Patrick (1962-1974)
- Richard Theye (1969-1976)
- Alan Sessler (1977-1989)
- Mark Warner (1998-2010)
- David Warner (2010-2022)
- Mark Keegan (current)
Mystery Photos
Last week’s Mystery Photo is Pauline Bisel.
Pauline is from Co. Meath, Ireland. She was one of twelve children and grew up in the country 30 miles north of Dublin. Following her elementary and secondary education she completed a two-year program on the care of children at St. Clare’s Dietetic Hospital in Co. Meath. On completion of this she worked for several years at St. Mary’s Hospital for children in Baldoyle, Dublin. Most of the patients were children who had post poliomyelitis complications.
In her early twenties she decided to become a Catholic nun joining a community in New York State involved in the care of the elderly. After two years in this endeavor she realized she could not spend her life living with all women! She returned home to Ireland and after a short while travelled to England where she attended the Chelmsford School of Nursing in Chelmsford, Essex. While there she met and married her husband Steve who was serving in the United States Air Force.
Upon returning to the United States she worked for several years in various hospitals in different states gaining experience in multiple specialties including intensive care. During this time she and Steve were blessed with two daughters.
In 1979 Pauline applied to the Nurse Anesthetist program at Mayo Clinic, in Rochester, MN. As she drove to her interview in Rochester, she recalled first reading about Mayo Clinic in a book she discovered in her uncle’s house when she was 9 or 10 years old. At that time Mayo Clinic and Rochester, Minnesota were a very long distance away. The mere thought she could be there one day was absurd. At this interview she recalls meeting the esteemed Dr. Peter Southorn who impressed her with his warmth and sincerity.
She entered the Nurse Anesthetist program in September 1979 and upon graduating stayed on as staff anesthetist at St. Mary’s Hospital. The first two years were in Cardiac Anesthesia where she was very fortunate to be involved in pediatric cardiac anesthesia under the tutoring and mentoring of Drs Beynan and Raimundo. Pauline’s love for taking care of children was clearly met. In 1987 Dr. John McMichan invited her to join the anesthesia group going to Scottsdale, Arizona. It was a department of three MDs and one CRNA. This move created unique challenges. The local anesthesia providers were not welcoming CRNAs. However, over time and due to the excellent health care Mayo Clinic provided to the community acceptance was gained. Even though challenging this was also a very exciting time.
After eleven years Pauline stepped down from administrative duties to be a full time clinical anesthetist. For several years she travelled to Mexico and Haiti with a small Mayo group who were part of International Medical Assistance. This was a very rewarding experience. Pauline retired in 2013 after thirty-two years on staff. In retirement she continues aiding her neighbors to the south by being part of a small group of Mayo Clinic Colleagues offering mobile medical clinics in Ensenada, Mexico.
Here is this week’s Mystery Photo.
Update #17 - Dec. 28, 2023 "Our Mayo Clinic Department of Anesthesiology's Heritage Website"
Dan Cole, M.D., undated.
Our Mayo Clinic Department of Anesthesiology’s Heritage Website
First An Apology,
Upon reading Update #16 last week, I was aghast to learn that I failed to include one of my best friends and closest colleagues, Dr. Dan Cole, from the list of Mayo Clinic anesthesiologists who have served as a director of the American Board of Anesthesiologists. My sincere apology to Dan. Dan served as chair of our Mayo Clinic Arizona department from 2003 through 2014. Dan currently is my successor as president of the Anesthesia Patient Safety Foundation and Professor of Anesthesiology at UCLA. I have corrected this omission in an amended Update #16 as it will join the other updates in a compilation on our new department heritage website. While I made the initial mistake, it will be corrected when our colleagues access the updates into the future.
Our archivist, Alec Thicke, and I met this past week and reviewed the Phase One model of our new Heritage Website. It will be an outstanding site for archiving our department’s history. We hope to have initial public access to the Heritage Website by the middle of January. In it, you will find a compilation of the updates, as well as early entries into distinct webpages dedicated to audio and video recordings, information about our colleagues who have served in the military, photos, publications related to our department’s history, and a variety of links. As the website evolves over 2024’s centennial year, we’ll add a digitalized Art to Science, the department’s history book edited by Kai Rehder, Peter Southorn, and Alan Sessler. We believe this website will be the finest anesthesiology department website in the country, if not the world, as it evolves.
Phoenix, Arizona: Home to Many Mayo-Trained Anesthesiologists
Clearly, we’ve made significant advances and had huge growth of our Department of Anesthesiology in Arizona over the past 35 years. In Update #5 (October 5th, 2023) we highlighted John McMichan, our colleague who first chaired the department. We also highlighted Pauline Bisel in Update #16th (December 21st, 2023), our first nurse anesthetist supervisor in the department.
Our graduating residents have also made a significant impact on anesthesiology in “the Valley” in private practice. In this 2007 article from our department newsletter, Joe Sanders (Class of 1990) reflects on his time at Mayo Clinic in Rochester and comments on Valley Anesthesiology Consultants and the many Mayo alumni who served in that group at that time. Since that article was written, the dynamics and organization of anesthesia provision in the Phoenix area has evolved but we still have many alumni actively involved. Many of you will recognize the alumni noted in Joe’s article.
Mystery Photos
Last week’s Mystery Photo is Bill Oliver.
Bill was born in Panama City, Florida and attended school at the University of Alabama. He was probably the biggest booster ever of Coach Bear Bryant (and later Nick Saban) and the University of Alabama football team. He was a nice guy, regardless. Ha!
After graduating medical school in Birmingham, Alabama in 1983, he moved to Rochester as resident in our department. Bill went on to become one of our most respected and beloved anesthesiologists. He was legendary in his devotion and dedication to children with complex congenital heart disease. Even though personally limited at times by flare ups with cystic fibrosis, he had prodigious levels of energy and tenacity when it came to caring for “his kids.” His compassion was boundless. He received the honorary Humanitarian Award from the Mayo Alumni Association for his dedication to children who have congenital and chronic diseases. He trained many of us in pediatric cardiac anesthesiology and earned the academic rank of Professor of Anesthesiology. Sadly, Bill passed away at age 62 in 2018. Fittingly and not surprisingly, he was on call for the postoperative intensive care unit and its complement of congenital heart disease children that evening.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #18 - Jan. 4, 2024 "A Scandinavian Connection"
Photograph 1: Sten Lindahl, M.D., undated.
Photograph 2: Petter Steen, M.D., undated.
Photograph 3: Jukka Rasanen, M.D., undated.
A Scandinavian Connection
Ever since Will and Charlie started inviting international guests to Rochester, we’ve had visitors who have been interested in anesthesia delivery at Mayo Clinic. They started the International Surgeons Club in 1906 and purchased a home on 2nd Street SW, now immediately south of the Mayo Clinic Building and between the Hilton Building and Mayo Medical School. As many as 30 surgeons and medical leaders from around the world visited at a time for periods ranging from 2 to 8 weeks. They were able to observe daily patient evaluations and surgeries. As noted by Charlie, the Mayo institution should help develop with professional education “a system of medicine which will combine the best elements to be found in all countries.”
The professional education associated with the Surgeons Club provided great exposure of the visitors to evening lectures by the Mayo brothers and their colleagues. However, with the development and implementation of the Mayo School of Graduate Medical Education in 1915, in conjunction with the University of Minnesota, the need for the Surgeons Club dissipated and the club ended in 1916. At that point in time, departments served as the hosts of these visitors, with many departments creating visiting clinician and research positions.
Our department was very involved in accepting international visitors from around the world. Today, we’ll focus on three anesthesiologists from Scandinavia who joined us for various lengths of time and who have gone on to make major contributions to the specialty and medicine in general.
- Sten Lindahl (Sweden): Sten was born in Malmö, Sweden and received his M.D. in 1971 from the University of Lund. After 5 years of training in pediatrics, he completed a 4-year residency in anesthesiology. During his residency training, he also completed a Ph. D. He served as the head of pediatric anesthesia at the University of Lund during the 1982-1986 period and, during that time, spent 6 months in research with Mayo alumni David Hatch at Great Ormand Street in London and a similar period with Kai Rehder here in Rochester. Sten moved to Rochester in 1986 for three years and made major contributions to our understanding of thermogenesis in neonates and pulmonary mechanics in infants and toddlers. A story from our department newsletter in 2006, titled “Scandinavia and Mayo Anesthesia” describes his time in Rochester. He returned to Sweden in 1988 and, in 1990, was appointed chair of the Department of Anesthesiology and Intensive care at the Karolinska Hospital and Institute in Stockholm. He served multiple years on the Nobel Prize Committee on Physiology and Medicine, including several years as chair of the committee. He also has been president of the Scandinavian Society of Anesthesiology and Intensive Care.
- Petter Steen (Norway): Petter was born in Oslo, Norway and received his M.D. in 1972 from the University of Oslo. He also earned his Ph.D. in 1979 from the same institution. He came to Mayo Clinic in 1978 and worked primarily with Jack Michenfelder on cerebral ischemia studies. He also published cardiac studies with John Tinker and Sait Tarhan. After that year in Jack´s lab and his return to Oslo, he would return from Norway for a month each year for the next decade, often bringing research fellows from Norway with him. He returned to the University of Oslo and, in 1982, was appointed as chair of its Department of Anesthesiology. In 1992, he transitioned to the university’s Division on Prehospital Care and was appointed as a professor of Emergency Medicine. After a remarkably prolific academic career with multiple anesthesia-related publications, his focus shifted to resuscitation. He has served on the European Resuscitation Council, chaired the World Federation of Societies of Anaesthesiologists’ Committee on Cardiopulmonary Resuscitation, and as a member of the European Academy of Anaesthesiology. Petter co-chaired the International Liaison Committee on Resuscitation (ILCOR), a committee that publish the CPR guidelines with American Heart Association (AHA). Amongst other efforts and recognitions, Petter received a Lifetime Achievement Award from AHA and ILCOR; worked in Romania during its 1989 revolution and in a field hospital during the civil war in Kosovo; taught in Gaza, Lebanon and Syria; and ended up being knighted by the King of Norway. Today, his work has been cited more than 21,000 times, making him one of the specialty’s most influential researchers in Europe.
- Jukka Räsänen (Finland): Jukka was born in Lahti, Finland and received his M.D. from the University of Helsinki in 1978. After his anesthesiology residency at that same institution, he moved to Columbus, Ohio as a Critical Care Medicine fellow. He returned to Helsinki and directed pediatric critical care at the Children’s Hospital. In 1990, he moved to Tampa, Florida and joined the University of South Florida’s Department of Anesthesiology. During this time, he worked with John Downs, M.D. and expanded his research in respiratory mechanics in acute lung injury and the use of novel technologies to detect each pulmonary deterioration. We were able to entice him to come to Rochester in 1997. During his time until his retirement in 2013, Jukka served as chair of our Division of Multispecialty and did extensive work in our pediatric ICUs. He also served as medical director for Smile Train International. While at Mayo Clinic and in retirement, he has continued to be involved in multiple medical missions overseas.
Mystery Photos
Last week’s Mystery Photo is Roy Cucchiara.
Roy was born and raised in New Orleans. After medical school at Louisiana State University, he interned at Charity Hospital in New Orleans. He moved to Rochester and completed his residency and a fellowship in neuroanesthesia in 1973. He subsequently served two years in the U.S. Army at Walter Reed Army Medical Center in Washington, DC before returning to Rochester.
Upon his return to Rochester, he joined one of the country’s most prestigious and influential neurosurgical and neuroanesthesia practices, working (over a period of time) with luminary neuroanesthesia colleagues such as Jack Michenfelder, Joe Messick, Gerry Gronert, Ron Faust, Leslie Milde, and Bill Lanier. His surgical colleagues were also internationally recognized and included Collin MacCarty, Ross Miller, Thor Sundt, Burt Onofrio, Ed Laws, PJ Kelly, Ross Miller, Rick Marsh, and Fred Meyer. Together, they brought huge recognition to Mayo Clinic and were prolific contributors to our understanding of neuroanesthesia and neurosurgery.
Roy was a trainee’s dream educator. He could speak to any topic and always had time to teach anyone. He was an excellent educator, whether one-on-one at the bedside, in the classroom, or in front of 1,000 ASA members during his prolonged run of outstanding refreshers courses on neuroanesthesia at ASA annual meetings. He was an exceptional oral examiner for the ABA. One of his favorite philosophies was that you could be “good and slow or good and fast” . . . and no one was faster or better than Roy with assessing, inducing, and caring for neurosurgical patients with complex morbidities. His extraordinary clinical skills carried through his career. In 2005 Mayo Clinic honored him with one of only five Distinguished Clinician Awards throughout the institution that year.
He was chair of our Rochester Department of Anesthesiology from 1988 through 1991, then subsequently served as chair of the anesthesia department at the University of Florida (1993-1997) and interim chair of our Mayo Clinic Florida department (2003-2004) during his stellar career.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #19 - Jan. 11, 2024 "California, Here We Come..."
Photograph 1: John Pender, M.D., undated.
Photograph 2: John Hattox, M.D.
California, Here We Come . . .
Who would have thought that Rochester, Minnesota, and California would be two of the most alluring locations in the country for young physicians after World War II? OK, perhaps not alluring but certainly great locations in which to learn (Rochester) and practice (California) anesthesia. Today we’ll focus on two WWII veterans who trained and worked at Mayo Clinic during and after the war. Both went on to long, distinguished careers in California, one a leader of Palo Alto Medical Clinic and Stanford University Medical Center and the other the primary leader of Anesthesia Service Medical Group of San Diego, a group that at one time was the country’s largest anesthesia private practices.
- John Pender: John trained at Mayo Clinic from 1940 through 1942 before being pulled to active duty in the U.S. Navy Reserves from 1942 to 1946. At the conclusion of the war and his assigned duty, John returned to Rochester where he worked until 1954. Upon settling in 1954 in Palo Alto, he continued to be involved in academic anesthesia with his association with Stanford University. He also played major roles in academics and the specialty, including serving as Associate Editor for Anesthesiology, chair of the AMA’s Section on Anesthesia, a trustee of the Wood Library and Museum (WLM) of Anesthesiology, and president of the Academy of Anesthesiology. John was a strong supporter of anesthesia history and the WLM. In 2001, at his request, the Pender family established the “Mayo Clinic Room at the WLM”. The linked article also provides an excellent story about John’s life. In his honor, the foundation named its oral history collection after him (Living History Interviews - Wood Library-Museum of Anesthesiology (woodlibrarymuseum.org)). Mayo alumni who are highlighted in the Pender Collection include:
- John Lundy
- Charles McCuskey
- John Pender
- T. Harry Seldon
- Ralph Waters
- John Hattox
- John “Jack” Michenfelder
- Mark Warner.
- John Hattox: After completing an internship and three additional months in anesthesia training at the U.S. Naval Hospital in San Diego at the end of WWII, John was a little shocked to learn that his first assignment would be as chief of anesthesiology in the same hospital, one of the largest in the U.S. at the time with more than 1,000 beds. This is one of many great stories about John. Bob Adams; a 1971 graduate of our Rochester anesthesia training program, a former staff member from 1973-1974, and son of Charles Adams, the department’s second chair from 1952 to 1953; has written a wonderful summary of John’s contributions to the specialty in 2004’s department newsletter titled “John S. Hattox Jr., M.D.”. John was discharged from duty in 1948 and chose Mayo Clinic for his anesthesia training. After completing his training in 1950, John moved back to San Diego and joined a relatively new private practice group, Anesthesia Service Medical Group. In addition to providing outstanding leadership to what was to grow to be a group of nearly 200 anesthesiologists in the 1990s, he became very involved in anesthesiology professional organizations. John was president of the California Society of Anesthesiologists in 1967 and president of the American Society of Anesthesiologists (ASA) in 1980. He is one of 10 Mayo alumni/staff members to have received the ASA’s Distinguished Service Award. There have been 76 of these award winners, overall. The Mayo recipients include:
- Ralph Waters (1946)
- John Lundy (1948)
- Ralph Tovell (1951)
- Charles McCuskey (1953)
- Ralph Knight (1960)
- Jack Michenfelder (1990)
- John Hattox (1992)
- Alan Sessler (2001)
- Mark Warner (2018)
- Dan Cole (2020).
Mystery Photos
Last week’s Mystery Photo is John Tinker.
John was born in Cincinnati, Ohio. His father was, for a time, a tennis teaching professional, and John became one of Ohio’s best high school tennis players in the late 1950s. After earning his M.D. degree at the University of Cincinnati as valedictorian of his 1968 graduating class, he trained in anesthesiology at the Peter Bent Brigham Hospital in Boston where he excelled but also sparked controversy in a surgeon-dominated institution. This linked historical case report about John provides interesting insight into understanding John’s penchant to challenge authority and conventional wisdom (Anesthesia in the late 1960s at Peter Bent Brigham Hospital, Boston: A case report - ScienceDirect). To various degrees, he carried this attribute of challenging authority and accepted practices and behaviors through his entire career, primarily to push for improvements in patient safety but at times to the detriment of his career.
After a two-year stint in the U.S. Army reserves from 1972 to 1974, John moved to Rochester in 1974. For the next decade, he and Jack Michenfelder were arguably our department’s most visible members to the general anesthesia community as they gave refresher courses and other presentations at nearly every major anesthesia meeting. John was an outstanding cardiac anesthesiologist and a prolific investigator and writer. His work with Jack on issues such as nitroprusside toxicity and colleagues such as Sait Tarhan on perioperative myocardial injury and its epidemiology and etiologies dramatically improved patient safety, especially for patients with cardiovascular disease. He was chair of our Section on Cardiovascular Anesthesia from 1978 through 1983. John was a remarkable teacher. Many residents and students recall times he would sit on a patient cart outside of a cardiac operating room towards the end of a long day and spontaneously discuss any topic related to anesthesia (or his favorite hobby of fishing).
John left Mayo Clinic in 1983 to become chair of the Department of Anesthesia at the University of Iowa, a position he held until 1997. He subsequently moved to Omaha, Nebraska and chaired the University of Nebraska’s Department of Anesthesiology from 1997 through 2008. He passed away at age 74 in 2016.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos.
Update #20 - Jan. 18, 2024 "Historic Inventions by Department Members"
Photograph 1: Edward Tuohy, M.D., undated.
Photograph 2: John Silas Lundy, M.D., 1934.
Historic Inventions by Department Members
Members of our department during its first 100 years have made significant contributions to the specialty through innovation. While there are many I could select, let me start with just three important innovations associated with our department between 1926 and 1945. You may be surprised to learn of them and appreciate the positive impact they provide to modern perioperative care. Additional innovations will be highlighted in future Updates.
- John Lundy, Sodium Pentothal: Short-acting barbiturates became available in the 1920s and early 1930s. John Lundy was one of the first anesthesiologists who was motivated to learn if they would produce clinically useful anesthesia. He tried sodium amytal, sodium pentobarbital, and hexobarbital. Each one of them failed. For example, Lundy tested the use of pentobarbital (Nembutal) on his wife, Charlie Mayo, and even ex-heavyweight boxing champion Jack Dempsey and found that it was not appropriate to induce acceptable anesthesia. You can read more in the following paper by Asher Orkaby and Sukumar Desai titled “The Death of Sodium Pentothal: The Rise and Fall of an Anesthetic Turned Lethal”. It makes you wonder how they felt about its failure to induce suitable anesthesia, doesn’t it? In 1934 Abbott Laboratories provided him with vials of sodium pentothal (also known as sodium thiopental or thiopentone) to test. By early 1935 Lundy was convinced that sodium pentothal was safe and effective. He reported on his findings in the “1934 Annual Report of the Section of Anesthesia”. As with many innovations, there was early controversy as to origin. In this instance, the controversy was about who deserved credit for first using, introducing, and advocating for sodium pentothal’s use in anesthesia. Despite the early controversy, it is now generally accepted that Lundy’s clinical trial of the drug in patients was the first. His work was influential in introducing sodium pentothal to anesthesia and its use around the world.
- John Lundy, Citrated Blood, and Blood Banking: In 1933 Charlie Mayo asked John Lundy for the Section on Anesthesia to manage blood transfusion for children. By the next year, this was expanded to adult patients. In general, transfused blood at that time was fresh, with the need to have donors readily available. While citrate and glucose were first used in 1914 to preserve blood for transfusion and early preserved blood transfusions were made in World War I, there was not widespread use of citrated blood in the 1920s. When citrated blood was available, its preservation was measured in just a few days and not weeks. In 1935, Lundy found that citrated blood stored in an ice box could be safely and effectively used for up to two weeks. As described in “Mayo Clinic and the Origins of Blood Banking” by our own Jennifer Rabbits, Doug Bacon, and Greg Nuttall and Transfusion Medicine’s Breandan Moore here in Rochester, Lundy and colleagues such as Charles Adams and T. Harry Seldon established the country’s first blood bank.
- Ed Tuohy, Tuohy Epidural Needle and Continuous Spinal/Epidural Anesthesia: The use of regional anesthesia declined with the expanded use of sodium pentothal and ether, as well as other volatile drugs, prior to World War II. However, the use of general anesthesia in severely wounded, hemodynamically unstable soldiers, sailors, airmen, and Marines during the war, especially by individuals inexperienced in anesthesia, led to renewed interest in the use of regional anesthesia. Ed Tuohy trained at Mayo Clinic in the mid-1930s, was on staff in Rochester, and then was in the Army Medical Corps during the war. He understood the issues of both general and regional anesthesia and the opportunity that continuous spinal or epidural anesthesia might provide in the war setting. He used a previously designed needle with a curved end and a small ureteral catheter (a technique he learned with continuous spinal drainage at Mayo) to test continuous spinal and epidural anesthesia. There is a degree of controversy over the Tuohy needle’s name as described in this excellent article, “Edward Tuohy: The Man, His Needle, and Its Place in Obstetric Analgesia” by our own Josh Martini, Doug Bacon, and Gary Vasdev. Regardless, the Tuohy needle has become one of the most widely used epidural needles around the globe.
Mystery Photos
Last week’s Mystery Photo is Ron Mackenzie.
Ron was born in Detroit, Michigan and attended Alma College. After graduation from the University of Health Sciences Osteopathic School of Medicine 1967, he was a resident in anesthesiology at Detroit Osteopathic Hospital (2 years), Cleveland Clinic (1 year), and here in Rochester (1 year). He served many leadership roles in the department over his 43 years as a consultant, including chair of the former GYN/ENT (also known as the former South or current Jacobson) Division during Alan Sessler and Roy Cucchiara’s times as department chair. In addition he served as Vice-Chair of the department during Duane Rorie’s time as chair. Ron also led Mayo Clinic’s Equipment Committee for a number of years. He was an excellent teacher and was recognized multiple times by the residents as Teacher of the Year.
Ron was a wonderful advocate for young colleagues, nurse anesthetists, nurses, and just about all people in general. I don’t believe I ever met anyone who did not like Ron. Ron was a leader by example. He served as president of both the Minnesota Society of Anesthesiologists and the American Society of Anesthesiologists. Personally for Mary Ellen and me, Ron was a gracious friend and colleague throughout our careers. I started my first two weeks in anesthesia in July 1979 with him, one-on-one in old OR 16 at Methodist Hospital. He ended his career working day-by-day with Mary Ellen as they created and led the evolution of our creative new practices on Gonda 7. He worked clinically until age 77, stopping only to assist his beloved wife, Nancy, as they matured together.
Ron passed away far too early for us all on August 21, 2022. Here is a link to a farewell I wrote in the ASA’s newsletter.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #21 - Jan. 25 2024 "Our New Department Repository for History – Introducing “The History of the Mayo Clinic Department of Anesthesiology and Perioperative Medicine” webpage"
Our New Department Repository for History – Introducing “The History of the Mayo Clinic Department of Anesthesiology and Perioperative Medicine” webpage
After several months of preparation, we now have our “Phase 1” of the department’s new history webpage up and running. It comes as a webpage under the overall Mayo Clinic Heritage Website, which highlights the history of the Mayo Clinic as a whole. It is a great resource to access Mayo Clinic heritage films and other historical materials. If you have not yet seen any of Mayo Clinic’s heritage films, I strongly recommend watching the 2023 Heritage Film “Rising to the Challenge: The Mayo Aero Medical Unit in World War II”.
You will find that in the “Phase 1” release of our department webpage, there will be incomplete information in most of the sections. For example, more than 200 individuals influential in the development of the specialty, the institution, the department, or otherwise uniquely noteworthy will be described in some detail during the 18-months of the Centennial Project and its 80 weekly Updates. Much of this information and other materials are currently being compiled and the website will continue to be expanded. We will quickly be adding and modifying various sections and welcome your input and engagement in this celebration. The beautiful part of having a webpage for our history is that we can rapidly make corrections, adjustments, and additions. It is a “living document”.
The webpage will include, but is not limited to:
- The Centennial Weekly Updates.
- Newsletters from our nurse anesthetist alumni and our department newsletters during the 2000-2007 period.
- Department statistics for department, institution, and extramural society leadership.
- Additional stories and articles about our department.
- Photos from the past and present.
- Audio and video interviews from the past, with more being conducted in the future.
- A section specifically made to highlight our colleagues who have been in the military.
- Timelines, vignettes, etc.
- Digitalized books such as our 2000 “Art to Science” department history book.
- In the near future, sections specific for our Florida and Arizona sites as well as Respiratory Care.
More to come on the webpage. “Phase 2” of this webpage begins late this week. During the next few months, we’ll dramatically increase the information available on the webpage. Again, we’ll be seeking your suggestions, corrections, and ideas for improvement as we move forward over the next year.
Historic Inventions by Department Members, Part 2
Members of our department during its first 100 years have made significant contributions to the specialty through innovation. Continuing from last week’s description of the department’s involvement with the introduction of sodium pentothal into clinical practice, the development of the first U.S. blood bank, and the first use of the Tuohy needle for continuous spinal and epidural anesthesia, here is an important innovation associated with our department in the 1950s. Additional innovations will be highlighted in future Updates.
- David Massa, Intravascular Catheter (IV catheter): It seems so straightforward now, but prior to the 1950s giving intravenous fluid was problematic. Needles allowed vascular access but could become dislodged easily and couldn’t not be used for long periods without immobilizing extremities. Veins could be cannulated with cutdown techniques, but the tubing needed was not readily available, at least until the middle 1940s. It took a Mayo anesthesiology fellow, David Massa, in 1950 to develop the precursor of today’s intravenous angiocath. You can read more about this in this article “A Plastic Needle” and from this portion of the “Proceedings of the Staff Meetings of the Mayo Clinic” from 1950. He started by designing and testing prototypes in his basement and sterilizing the cannulas in his kitchen “The Massa or Rochester Plastic Needle”. As described by our own Peter Southorn and Brad Narr, the “catheter over a needle” concept was soon produced by the Rochester Products Company. Sales grew slowly at first but by the mid-1960s, more than 3 million of these needles had been produced. This innovation made a dramatic change in surgery and medicine and is noted by Atul Gawande, one of the country’s most preeminent surgeons, as an “ingenious creation” and one of medicine’s most consequential in his history of the first 200 years of surgery “Two Hundred Years of Surgery”.
Mystery Photos
Last week’s Mystery Photo is T. Harry Seldon, M.D.
Dr. Seldon was born on January 16, 1905, in Exeter, Ontario, Canada. He received the M.D.C.M degree in 1929 from Queen's University in Ontario. After completing an internship at Toronto Western Hospital (1929-1930), he was in private practice in Sharlot Lake, Ontario (1930-1936). He entered the Mayo School of Graduate Medical Education in 1936 as a fellow in anesthesiology and received the M.S. degree in anesthesiology from the University of Minnesota in 1940. That same year, Dr. Seldon was appointed a Mayo Clinic consultant. In addition to an interest in general anesthesia, he was very involved in the department’s growing work in orthopedic and plastic surgery. He also led the institution’s blood transfusion service.
Dr. Seldon was very involved in the evolution of the science and specialty of anesthesiology. He was president of the American Association of Blood Banks and the Minnesota Society of Anesthesiologists. He was especially active in the International Anesthesia Research Society (IARS).
- Member of the Board of Trustees, 1948-1976.
- Chair of the Board, 1955-1957
- Editor (in-chief) of the IARS’s Current Researches in Anesthesia and Analgesia (which became Anesthesia and Analgesia . . . Current Researches in 1957 and then Anesthesia and Analgesia in 1979), 1955-1976.
- Harry documented the early history of the IARS in 1971 on the 50th anniversary of Anesthesia and Analgesia.
- Recognized in 1983 by the IARS Board of Trustees when it established the T. H. Seldon Memorial Lecture in his honor.
- This keynote lecture opens the IARS Annual Meeting and brings renowned experts to spark important conversations on anesthesiology and beyond.
Dr. Seldon retired from Mayo Clinic in March 1970 and died in Rochester’s Charter House on October 22, 1991.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #22 - Feb. 1, 2024 "Books, Books, and More Books"
Photograph 1: John Silas Lundy, M.D., 1950.
Photograph 2: Jerry Dorsch, M.D., 1988.
Books, Books, and More Books
The Mayo Clinic Department of Anesthesiology was a major contributor to the education of nurse anesthetists and anesthesiologists through publication of scientific articles and textbooks. There have been many important texts from Mayo anesthesiologists. For today’s Update, I will address two of the classic textbooks written by our colleagues. These are John Lundy’s Clinical Anesthesia and Jerry and Susan Dorsch’s Understanding Anesthesia Equipment.
- John Lundy, Clinical Anesthesia: As John Lundy gained national visibility in the specialty during the 1924-1941 time period from his significant work in advancing regional anesthesia, advocating for balanced anesthesia, doing the initial clinical studies on sodium pentothal, starting an anatomy laboratory specifically for teaching regional anesthesia, developing the first blood bank in the U.S., and helping to found the American Board of Anesthesiology and the journal Anesthesiology, he also found time to write one of the country’s first comprehensive and most widely-read textbooks on anesthesiology. Clinical Anesthesia was used by a generation of physicians and nurse anesthetists as the fledgling specialty was evolving into a scientific field of study and educational programs. Many of the physicians who trained in 90-day anesthesia courses during WWII and subsequently played major roles in improving combat-related fatalities across the European and Pacific theaters of war used Lundy’s text as their primary source of basic anesthesia knowledge.
- Jerry and Susan Dorsch, Understanding Anesthesia Equipment: In 1969 while both were residents in anesthesiology in Pittsburgh, Jerry and Susan Dorsch set out to write what in 1975 would become one of the most world’s widely-read textbooks on anesthesia equipment. Since its first review and through reviews of its 5th edition in 2008, it has been repeatedly described as “the bible on anesthesia equipment.” Jerry and Susan wrote 5 additional textbooks, including their 2010 A Practical Approach to Anesthesia Equipment. This text is a simplified version of their much larger text and received outstanding reviews in Anesthesiology titled “Reviews of Educational Material A Practical Approach to Anesthesia Equipment” and in Anesthesia & Analgesia titled “A Practical Approach to Anesthesia Equipment Review”.
- Jerry was a member of our Mayo Clinic Department of Anesthesiology in Jacksonville from 1987 through 2003. Susan was in private practice. Here is an outstanding report on their careers, a wonderful photo of Jerry and Susan, and a note about their 2008 Wood Library-Museum Wright Lecture titled “Beyond Blue Lips: Advances in the Prevention of Hypoxia”.
Mystery Photos
Last week’s Mystery Photo is Sheila M. Muldoon, M.D.
Dr. Muldoon was born on July 6, 1935, in Kells, Ireland. She graduated medical school at the University College in Dublin in 1963. After initial postgraduate training at Mater Hospital in Dublin, she moved to Rochester and started her anesthesiology residency in 1966. During her training, she earned an M.S. degree in anesthesiology and physiology from the University of Minnesota while advised by Dr. Richard They. She was a staff member of our department from 1969 through 1977. While in Rochester, she worked clinically in our growing Respiratory Care Service. She received multiple research grants, including from the NIH, and worked closely with former department chair Dr. Duane Rorie and researchers Drs. Gertrude Tyce and Paul Vanhoutte.
In 1977 Sheila moved to the Washington, D.C. area and was one of the very first women appointed to the new Uniformed Services University for Health Sciences (USUHS) faculty. During her time at USUHS she identified growing military concerns about exertional heat illnesses, including the potential of unrecognized malignant hyperthermia (MH) in military personnel. She established what was to become one of the country’s leading MH testing and research laboratories, now designated as the “Sheila Muldoon Malignant Hyperthermia Diagnostic Center.” The center was one of a handful of muscle testing centers in the U.S. and provided testing services similar to those in our Mayo Rochester laboratory that was led by Drs. Jerry Gronert, Denise Wedel and Margaret Weglinski. Dr. Muldoon was very active in the evolution of Malignant Hyperthermia Association of the U.S. (MHAUS) and its MH Hotline. A wonderful summary of her contributions to MH research and MHAUS, written by MHAUS President Henry Rosenberg, M.D. can be found here.
Dr. Muldoon became chair of the USUHS Department of Anesthesiology in 1987, a position she held until 2001. An excellent summary of her contributions to the USUHS is found in this article about the institution’s early women pioneers.
Last week’s contest winner was Kai Rehder.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #23 - Feb. 8, 2024 "Our Department of Anesthesiology Innovations: Gaston Labat and the Rise of Regional Anesthesia at the Mayo Clinic and Across the U.S."
Gaston Labat, M.D., undated.
Our Department of Anesthesiology Innovations: Gaston Labat and the Rise of Regional Anesthesia at the Mayo Clinic and Across the U.S.
Mayo Clinic was thriving in 1920 as the world rebounded from the impact of World War I. The Mayo brothers and their colleagues, including our nurse anesthetists, continued to produce excellent surgical outcomes. Their contributions of Mayo Clinic personnel, and their personal involvement, in the war had increased the Mayo reputation in the U.S., Europe, and elsewhere around the world. However, Will and Charlie were never satisfied with the status quo; they wished for patient care to improve as medical practices evolved. To this end, they personally traveled across the U.S. and abroad to learn new surgical and diagnostic techniques and treatments. They also encouraged their colleagues to travel.
While visiting Victor Pauchet, a well-known professor of surgery in Paris in 1920, Charlie observed the anesthesia performed by Gaston Labat. He was particularly impressed with Labat’s use of regional blocks and recognized the potential of regional anesthesia to improve muscle relaxation and operating conditions, especially for intra-abdominal and intra-pelvic procedures. Labat had worked for three years as a medical student at the University of Paris with Pauchet. Pauchet was a strong advocate for the use of regional anesthesia. In 1914, Pauchet had published the first edition of L’Anesthesie Regionale. A revised second edition followed in 1917. Charlie promptly invited Labat to Rochester to teach the Mayo surgeons how to administer regional anesthesia.
Our own Doug Bacon provides an excellent summary (“Gaston Labat, John Lundy, Emery Rovenstine, and the Mayo Clinic: The spread of Regional Anesthesia in America Between the World Wars”) of Labat’s time in Rochester from September 1920 through October 1921 and the long-term positive impact of his Mayo connection on the growth of regional anesthesia in the U.S. During his stay, Labat produced his classic text, Regional Anesthesia: Its Technic and Clinical Application. It was published in 1922 after Labat had moved to New York City and was working at New York University and Bellevue Hospitals. His advocacy and the textbook led to the increase in enthusiasm for and use of regional anesthesia in the U.S. and elsewhere. His text was revised into a 2nd edition in 1928. Labat became a strong advocate for regional anesthesia and was a founding member of the original American Society of Regional Anesthesia.
Labat’s regional anesthesia textbook created controversy of its own as it was very similar to the earlier Pauchet text. Our own Annie Côté, Claude Vachon, Terre Horlocker, and Doug Bacon describe this controversy, with Labat never crediting Pauchet in their 2003 article titled “From Victor Pauchet to Gaston Labat: The Transformation of Regional Anesthesia from a Surgeon’s Practice to the Physician Anesthesiologist”. Mystery arises with Labat’s death in 1934 and the apparent “loss” of a third edition of the text, described by our own Claude Vachon, Doug Bacon, and Steve Rose in their 2008 article titled “Gaston Labat’s Regional Anesthesia: The Missing Years”.
Simply put, Labat was the primary catalyst for the rise of regional anesthesia in the U.S. His advocacy and textbook led to several generations of anesthesia leaders (e.g., Lundy, Ralph Waters, and Emory Rovenstine) who carried the enthusiasm for the use of regional anesthesia forward and across the country.
Mystery Photos
Last week’s Mystery Photo is Florence McQuillan, CRNA.
As described by the AANA (Profiles of Nurse Anesthetists/Nurse Anesthesiologists - AANA - American Association of Nurse Anesthesiology), she was born in 1903 in Mahtowa, Minnesota (25 miles SW of Duluth) and graduated from the Central School of Nursing at the University of Minnesota in 1925. She received her anesthesia education at the Minneapolis General Hospital in 1926. John Lundy invited Florence to join his staff at the Mayo Clinic in 1927. She worked closely with Lundy as chief nurse anesthetist, cared for the patients of the Mayo brothers, and served as a clinical instructor for new nurse anesthetists.
In 1936, Lundy asked Florence and Dr. Lloyd Mousel, a new resident, to select papers for presentation at a staff, resident, and nurse anesthetist journal club. Attendees were initially asked to review the papers and prepare reports for the journal club, an additional task that they resented. Within a year, Florence suggested to Lundy that an abstract for each paper be prepared by either her or our Mayo Section on Publications to reduce the burden on the attendees. This proved popular and in 1937 Lundy and Florence began publishing these abstracts in a new format, Anesthesia Abstracts. The journal Anesthesia Abstracts was produced from 1937 through 1966 and was widely read. It’s successor publication, Survey in Anesthesiology, was published through 2017. Florence also prepared abstracts for the fledgling Anesthesiology from 1940 through 1947.
In 1948 Florence resigned from Mayo Clinic and became the first AANA Executive Director (formerly Executive Secretary), a position she held until her retirement in 1970. In her 22 years as Executive Director, she was influential in virtually all areas of the AANA’s growth and expansion. Under her guidance, the US Department of Health, Education, and Welfare officially recognized the AANA’s authority to grant accreditation for nurse anesthesia programs and to grant certification for nurse anesthetists/nurse anesthesiologists. She also instituted the AANA’s voluntary continuing education program, which made the AANA the first professional nursing organization to recognize the need for continuing professional education; this eventually led to the adoption of a mandatory CE program. Florence received the AANA Award of Appreciation in 1970 and the Agatha Hodgins Award of Outstanding Accomplishment in 1981.
An excellent summary of her career can be found at Florence McQuillen (1903–1981), “Benevolent Dictator” of Nurse Anesthetists - Working Nurse.
Last week’s contest winner was Kelsey Nelsen.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #24 - Feb. 15, 2024 "Department of Anesthesiology Innovations: Preoperative Transfusion Triggers for Low Hemoglobin"
Photograph 1: Harriet Cronk, Noreen Robins, Dr. Lundy, Dr. Albert Faulconer, Jr., and Helene Romness checking supplies at Saint Marys Hospital before the Clinic Blood Bank moved to Mayo Clinic from Saint Marys Hospital, 1951.
Photograph 2: Daryl Kor, M.D., undated.
Photograph 3: Matthew Warner, M.D., undated.
Department of Anesthesiology Innovations: Preoperative Transfusion Triggers for Low Hemoglobin
Drs. John Lundy and Charles Adams, the first two chairs of our department in 1924-1952 and 1952-1953, respectively, worked closely throughout their careers. Both had a strong interest in improving patient care and safety. Adams joined the department as a fellow in 1935, the same year that Lundy established the country’s first hospital blood bank and used refrigerated, citrated blood. One of their common interests was preoperative anemia and its potential impact on the outcomes of surgical patients. Based on their clinical observations, they published a 1942 article in the Journal of Surgery, Gynecology, and Obstetrics (now known as the Journal of the American College of Surgeons) and highlighted the importance of transfusing blood when the preoperative hemoglobin was less than 8 to 10 grams per cubic centimeter of whole blood. Lundy also advocated for preoperative transfusions for anemia in his classic 1942 textbook, Clinical Anesthesia: A Manual of Clinical Anesthesiology (pages 380-381).
As with many new ideas, there was controversy around the issue of transfusion triggers. For example, Myhre noted in his work, “Clinical Commentary: The Transfusion Trigger-the Search for a Quantitative Holy Grail”, that Lundy and Adams presented no data upon which to base their recommendation. Nonetheless, their strong advocacy and, especially, Mayo Clinic and Lundy’s national visibility and credibility led to the general spread of using transfusion triggers in preoperative assessment of surgical patients. Lundy was particularly influential as his textbook became the official source for information used in the 90-day anesthesia training programs for physicians in WWII. Many of these physicians would become leaders of the specialty during the decades that followed the war.
Interestingly, our department continues to lead the country in evaluating and treating preoperative anemia. Drs. DJ Kor and Matt Warner currently oversee a large clinical research effort that includes many of our colleagues to evaluate and implement perioperative patient blood management strategies. Examples from their work have been published extensively this past year in journals such as JAMA, Annuals of Surgery, Anesthesia and Analgesia, and the Journal of Clinical Anesthesia.
Mystery Photos
Last week’s Mystery Photo is Bob Chantigian, M.D.
Bob was born in Philadelphia in 1951 and attended Temple University. Not content to be a typical college student, he was engaged in the university for a decade and graduated with not one but three degrees (B.A. in Mathematics, B.S. in Pharmacy, and M.D.). He came to Mayo in Rochester for his residency training in 1979, joining an incoming group of new residents that included Steve Rettke, Mary Ellen Warner, and Mark Warner. Amazingly, these four individuals have spent a cumulative 165 years in the department. By the time you read this Update, Bob will have retired as his last work day as a consultant is Wednesday, February 14th, a Valentine’s Day that many of us will associate with Bob’s retirement date.
After completing his residency program, Bob trained in obstetric anesthesia at Brigham and Women’s Hospital in Boston and then in pediatric anesthesia at Children’s National Medical Center in Washington, D.C. He joined the staff of Brigham and Women’s Department of Anesthesiology from 1983 through mid-1985 before returning to Rochester. Upon his return he became the department’s Director of Obstetric Anesthesia, serving in that capacity for 10 years and remaining a mainstay in that area for two decades.
Bob is a remarkable teacher and clinician. He has been awarded 10 Teacher of the Year Awards from the residents and student nurse anesthetists and is a member of the Mayo Fellows Association Teaching Hall of Fame. In 2013, the department recognized him with its Commitment to Education Award. He also earned Distinguished Clinician Awards from residents and colleagues.
In 1992 Brian Hall and Tony Jones wrote the first edition of their best-selling board examination preparation book, Anesthesia: A Comprehensive Review. They published a 2nd edition in 1997 before Tony left Mayo to become chair of the Department of Anesthesiology at the University of Alabama at Birmingham. With Tony’s move, Bob joined Brian in producing editions 3 through 6 in 2003, 2010, 2015, and 2019, respectively. Their text is one of the best-selling in the U.S. over three decades and has become an anesthesia library staple. They currently are working on the book’s 7th revision. They believe it will be available at the end of this year.
Last week’s contest winner was Monica Green.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #25 - Feb. 22, 2024 "Department of Anesthesiology Colleagues Who Have Served in the Military"
Steven Rettkee, M.D., undated.
Department of Anesthesiology Colleagues Who Have Served in the Military
For much of the Department of Anesthesiology’s first 100 years, our colleagues have contributed to the U.S. armed forces military readiness and responses. Steve Rettke, a distinguished U.S. Navy carrier fighter pilot and retired Navy captain, as well as long-time leader of our Methodist Hospital clinical practices, is creating a webpage on our history website that will be part of our overall department’s history repository webpage.
You will find Phase 1 of the military webpage development here on the webpage in the Mayo Clinic Military Anesthesia Statistics section. In the coming months, we hope to have a more comprehensive compilation of our military colleagues and their accomplishments. If you (alumni or department members past or present) have served at any point in the U.S. Armed Forces, Steve is asking for you to send the following information to both him (Rettke.steven@mayo.edu) and Alec Thicke (Thicke.alec@mayo.edu). Alec is our department’s archivist. They will create a database and add this information and your stories to the webpages.
If you are interested in learning more about Mayo Clinic and its role with the military over the years, there are two interesting films produced by the institution that you might find fascinating. You may find them on the Mayo Clinic History & Heritage website.
- Rising to the Challenge: Mayo Clinic and the Military. This film documents the remarkable Mayo Clinic project during World War II that led to the development of the G-suit and oxygen masks for our pilots, innovations that contributed to aerial warfare advantages and played major roles in the ultimate success of the U.S. in the war.
- Serving with Honor: Mayo Clinic and the Military. This film describes Mayo Clinic’s major contributions to our country’s military efforts during the past century. Our institution has been a leader in supporting our military and our colleagues who participated in these efforts.
Mystery Photos
Last week’s Mystery Photo is Leslie N. Milde, M.D.
Leslie was born in Rochester, NY and attended the University of Rochester. She served as the chief pulmonary function and senior clinical research technician in the Cardiovascular Research Institute of the University of California, San Francisco (UCSF) for five years before entering the UCSF School of Medicine in 1973. She completed her anesthesiology residency and critical care fellowship in 1981 at Massachusetts General Hospital, serving as an editor of the widely read MGH Handbook on Clinical Procedures of the MGH while in training. She subsequently moved to Rochester as a neuroanesthesia research fellow with Jack Michenfelder. She joined our staff in 1982 and rapidly rose to the rank of Professor of Anesthesiology in 1993, becoming our department’s first woman to attain that high rank.
Leslie was a champion of anesthesia education, receiving Teacher of the Year awards and serving as the anesthesiology residency’s program director. She served 16 years as an oral examiner for the American Board of Anesthesiology. She was very involved in leading the development of neuroanesthesiology, serving as treasurer of the Society for Neuroscience in Anesthesiology and Critical Care and a long-time editor of the Journal of Neurosurgical Anesthesiology. She also was chair of the American Society of Anesthesiology’s Committee on Experimental Neurosciences and a member of its Subcommittee on Neuromuscular Transmission.
Leslie moved to Arizona in 1994 and served as chair of our Mayo Clinic Arizona (MCA) Department of Anesthesiology from 1997 through 2003. While in Arizona, she made major contributions to the evolution of MCA as a member of the MCA Board of Governors and its Executive Committee and the MCA Executive Operations Team, serving as the Executive Operations Team for six years. In that role she led an Academic Development course for women physicians and an administrative course for administrative interns. She was the leader of Public Relations for MCA during that time period. She subsequently sat on the Board of Governors for the institution and was part of the group to redefine its administrative structure. She chaired a task force to integrate the three existing geographically-define Mayo Clinic internet entities into the one institutional internet site we have today. While on the Mayo Clinic Board of Governors, she simultaneously was a physician member of the Board of Trustees. An endowed travel grant for an anesthesiology resident research winner in MCA has been named in her honor. Although retired in 2010, she continued to provide anesthesia care through 2017 as a supplemental consultant.
Last week’s contest winner was Karen Hammell.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #26- Feb. 29, 2024 "Our Department of Anesthesiology and Its Role in Elucidating Succinylcholine-Induced Hyperkalemia and also Mechanisms of Malignant Hyperthermia"
Gerald "Gerry" Gronert, M.D., undated
Our Department of Anesthesiology and Its Role in Elucidating Succinylcholine-Induced Hyperkalemia and also Mechanisms of Malignant Hyperthermia
Members of our Rochester-based Neuroanesthesiology Division have made significant contributions over the years to our understanding of a variety of diverse clinical conditions, including brain protection strategies and mechanisms; perioperative air embolism and its prevention and treatment; cerebral blood flow; and many others. These will be addressed in future Updates. Today, we will focus on the work of Dr. Gerald (Gerry) Gronert. His findings related primarily but not exclusively to succinylcholine-induced hyperkalemia and mechanisms of malignant hyperthermia. They have dramatically impacted our clinical practices and improved patient safety worldwide.
Gerry wrote about his work in our department and also during a short stint in the Air Force in a summary that Peter Southorn placed in our department’s September 2006 Newsletter "Mayo ala Gerald A. Gronert". He was interviewed for his work on succinylcholine-induced hyperkalemia in 2009 by David S. Warner (no relation to me and a different person than our own David O. Warner). In the interview, Gerry provided additional insights into his research on this issue. His early work was shared with Dr. Dick Theye and related to patients with extensive burns. They then expanded this work to include models of denervated muscle and muscle disuse atrophy.
Along the way, Gerry became interested in malignant hyperthermia (MH). He worked extensively with MH-susceptible pigs and published the specialty’s most significant paper to date on MH in 1980 in Anesthesiology. He was very involved in the early evolution of the Malignant Hyperthermia Association of the United States (MHAUS) Hot Line, as were Drs. Denise Wedel and Margaret Weglinski subsequently.
Gerry left Mayo Clinic in 1986, moving for the University of California, Davis. He worked at that institution until retiring in 1999. He passed away on February 7, 2020 in Eugene, Oregon (Gerald Gronert Obituary (1933 - 2020) - Sacramento, CA - The Sacramento Bee (legacy.com).
Mystery Photos
Last week’s Mystery Photo is Curt Buck, R.R.T., CRNA.
Curt was born in Winona, MN but graduated high school at John Marshall in Rochester. He began his Mayo Clinic career at St. Marys Hospital in its front lobby as a “bellboy” (honest, that was the job title) in 1971. After high school, he completed a 2-year nursing degree at Rochester Junior College (currently the Rochester Community and Technical College). Curt worked in the existing 3rd Alfred Surgical ICU at St Marys Hospital for two years, then joined our nascent Mayo Respiratory Therapy program’s second class. He worked as a respiratory therapist at St. Marys Hospital until 1979 before matriculating into our Mayo Clinic Nurse Anesthesia program. He completed his anesthesia training in 1981.
Curt spent most of his 11 years in our operating rooms in the old General Section (currently the Multispecialty Division) at St. Marys Hospital. Contemporaries in the General Section at the time included nurse anesthetists John Ahle, Christine Hendricks, Mary Marienau, Don Nelson, John Carter, Dan Schnell, Gloria Davis, Jack Hostak, Jan Miller, Margaret Sinclair, Bev Ondler, Pauline Bisel, Linda Buck, and many others. In 1992, Bernie Gillis, our director of Respiratory Therapy and a great nurse anesthetist, was severely injured in a car accident. Given Curt’s background as an RT, he was asked to temporarily fill in as director of Respiratory Therapy. As with many “temporary” Mayo appointments, this one turned out to be permanent. Curt held the position for 22 years. During those 22 years he worked with colleague intensivists such as Drs. Brad Narr, Mike Murray, Dan Brown, Rolf Hubmayr, Dan Diedrich, and many others.
Our Rochester Respiratory Therapy Division excelled under Curt’s vision and leadership. Curt and Dr. David Warner expanded our department’s small Perioperative Outcomes Group and created our robust Anesthesia Clinical Research Unit (now part of our Perioperative Information Management, Implementation, and Analytics Program, PRIISM). Brad Narr and Curt worked together to integrate our respiratory therapists into our new Preoperative Evaluation Clinic. Under Curt’s leadership, our respiratory therapists advanced the practice of respiratory care by first implementing therapist-driven ventilation protocols and then independent management of ventilation for many patients. Our Respiratory Care Division is now considered one of the most active and progressive in the country, with full credit to Curt and his respiratory therapy colleagues for their remarkably successful and innovative clinical initiatives and growth.
Last week’s contest winner was Lori Hanson.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #27 - March 7, 2024 "Remarkable Educators: This Week’s Feature on Dr. Ron Faust"
Photograph: Ron J. Frost, M.D., undated.
Remarkable Educators: This Week’s Feature on Dr. Ron Faust
The department, institution-wide, has been blessed with outstanding educators and leaders during its first 100 years. In the coming months, we’ll highlight a number of those leaders. These will include anesthesiologists who have led national and internal graduate medical education schools and initiatives (e.g., Alan Sessler, Mark Warner, and Steve Rose in their roles as Dean, Mayo Clinic School of Graduate Medical Education); nurse anesthetists who have been legendary leaders in education, program directors, and the nurse anesthesia program’s medical directors (e.g., Alice Magaw, Florence McQuillen, Ed Thompson, Bob Johnson, Mary Marienau, Erin Martin; Virginia Hartridge, and Beth Elliott); and anesthesiology residency program directors (e.g., Alan Sessler, Ron Faust, Leslie Milde, Steve Rose, Tim Long, Renee Caswell, Marie DeRuyter, and others).
This week we are featuring Dr. Ron Faust. For those who were residents in my generation, Ron was an outstanding program director and wonderful colleague. Ron was the son of a New Orleans anesthesiologist. He attended the Louisiana State University Medical School, graduating in 1969. What was to follow for the next four years is best described by Ron:
“I signed up with the Navy while a student at LSU Medical School in New Orleans in the class of 1969. My father, a physician, had signed up with the Navy the day after Pearl Harbor was attacked. An older brother of mine, an attorney in the Navy, was on a carrier in the late ’60’s.
Active duty for me started July 1970 at the end of my rotating internship at Charity Hospital. When my orders came, I was very surprised to read that I would be going to the 1st Marine Division; they were in Vietnam. The Navy Medical Corps provided all medical support to the Marine Corps. By July 26, 1970, I was on the ground as a ”Battalion Surgeon” in the 1st Marine Division in what was to later become South Vietnam. The area was still a combat zone and my Battalion Aid Station consisted of two small rooms under sandbags near the village of An Hoa. This was a rural base about 30 miles south of Da Nang. When a big Battalion operation was in progress, I would rotate out to camp on a hilltop called “371” in support of the Battalion Command. My tour of duty in that country ended in late March 1971.
For my second year of active duty, I served at Oakland Naval Hospital as a general medical officer in their out-patient “drop in” clinic. We saw Navy personnel and their family members. I completed my second year of active duty there in June 1972.
Advancing into inactive Naval Reserve, I returned to Charity Hospital in New Orleans that summer. I started first-year residency in general surgery on the LSU service. A year later I ‘saw the light’ and transferred to anesthesia residency at Mayo in July 1973.”
Ron worked clinically primarily in our Division of Neuroanesthesiology with colleagues such as Jack Michenfelder, Joe Messick, Roy Cucchiara, Leslie Milde, Bill Lanier, Don Muzzi, Tom Lasasso, Margaret Weglinski, Bill Perkins, and others. He dedicated much of his attention to our residency program. During his time as program director, 248 residents and fellows trained in our programs and the annual number of residents grew from 26 to 62. Ron was a national leader in anesthesiology education and served as president of the Society for Education in Anesthesia in 1991-1992. His book, Anesthesiology Review, is one of the specialty’s most successful and widely read texts. It was initially published in 1991; the 6th edition is now entitled, Faust’s Anesthesiology Review, with Editor-In-Chief Dr. Terry Trentman, former chair of our department in Mayo Clinic Arizona. More than 100 department members have contributed chapters to the series of the book’s editions.
In recognition of his outstanding contributions to education at Mayo Clinic, Ron was recognized with Mayo Clinic’s Distinguished Educator Award in 2000. Others in the department who have earned that recognition are:
- 2000: Ron Faust
- 2009: Beth Elliott
- 2015: Renee Caswell
- 2017: Mark Warner
- 2022: Beth Ladlie
- 2022: Steve Rose
Ron has a passion for cars. He wrote an article describing this passion for Peter Southorn in our May 2026 department newsletter titled “My Automotive Avocation May 2006”. Ron and his wife, Claire, have two daughters and a son. His son, Jonathan, is an anesthesiologist alumni of our department and currently practices in the Twin Cities area.
Mystery Photos
Last week’s Mystery Photo is Gary Sieck, Ph.D.
Gary was born in Seward, Nebraska, and together with his twin brother Jerry, they were the first in the family to attend college. Gary is a University of Nebraska Corn Husker through and through, earning his undergraduate degree in Lincoln and PhD in Physiology & Biophysics in Omaha. After a postdoctoral fellowship at the UCLA Brain Research Institute, Gary was appointed to the faculty in the Department of Anatomy & Cell Biology at UCLA and the Department of Pulmonary Medicine at City of Hope Medical Center. In 1987, Gary transitioned to the faculty in Biomedical Engineering at the University of Southern California.
He finally saw the light and returned to the Midwest, coming to Rochester in 1990 and joining our department as well as the Mayo Clinic’s Department of Physiology & Biomedical Engineering. From 1991-2002, Gary served as our Vice-Chair for Research. In 2002, he became Chair of the Department of Physiology & Biomedical Engineering, serving in that role until 2014.
Gary’s research focuses on cardiopulmonary physiology with an emphasis on neural control of breathing muscles. His research has been continuously funded by NIH grants since 1976. He has published extensively. Throughout his career, Gary has been incredibly active in education and mentorship. He has mentored more than 350 students and fellows. Many of his trainees have gone on to successful careers in biomedical research. In fact, two of his former PhD trainees are currently department chairs in our institution, Y.S. Prakash in Physiology & Biomedical Engineering and Carlos Mantilla in, of course, Anesthesiology & Perioperative Medicine.
Gary has received numerous honors for his research accomplishments, including recognition as a named professor and a Distinguished Mayo Investigator. Outside of Mayo, he has received the Rodarte Award for Scientific Distinction from the American Thoracic Society (ATS), the Distinguished Service Award from the Association of Chairs of Departments of Physiology (ACDP), the Distinguished Alumnus Award from the University of Nebraska Medical Center, and the Distinguished Advocate Award from the American Institute of Medical and Biological Engineering (AIMBE).
He has served as a member of the ATS Board of Directors, a member of the National Council of the American Lung Association, President of the American Physiological Society (APS) and President of the Association of Chairs of Departments of Physiology. He is currently a member of the Executive Committee of the International Union of Physiological Sciences (IUPS). In his spare time (ha!), Gary has served as Editor-in-Chief of both the Journal of Applied Physiology and of Physiology.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #28 - March 14, 2024 "The Department of Anesthesiology and the Creation and Evolution of the Foundation for Anesthesia Education and Research (FAER)"
Photograph: Alan D. Sessler, M.D., undated
The Department of Anesthesiology and the Creation and Evolution of the Foundation for Anesthesia Education and Research (FAER)
While the professional societies of the ASA and AANA have played major roles in advances in the specialty, a big boost to these advances came in 1984 when the ASA established and funded unique foundations to promote new knowledge in anesthesiology and patient safety. These two new foundations became known as the Foundation for Anesthesia Education and Research (FAER; Foundation for Anesthesia Education and Research (FAER) (asahq.org) and the Anesthesia Patient Safety Foundation (APSF; Anesthesia Patient Safety Foundation - That no one shall be harmed by anesthesia care. (apsf.org), respectively. The ASA has not wavered in its commitment to these foundations, supporting them with more than $80 million in today’s dollars in funding over the past 4 decades.
Many of the specialty’s finest researchers, including many in our department, have benefitted from FAER and APSF grants early in their careers. The dollars have been well spent. The early career investigators who received these grants have produced far more than their value in federal research funds and led to new knowledge that has resulted in advances such as the understanding of basic physiologic responses in disease processes, development of anesthesia simulation, improvements in perioperative blood management, reduction of postoperative hypothermia, diminished risk of postoperative neuropathies and vision loss, and other major safety improvements.
In a 2007 article from our department newsletter FAER and Mayo Anesthesiology, Peter Southorn and Alan Sessler describe the early development and evolution of FAER. Alan played major roles in establishing FAER and leading the foundation to one of the major contributors to the development of early career scientists in anesthesiology.
Mystery Photos
Last week’s Mystery Photo is Dr. Sait Tarhan.
Sait was born in Crimea in 1927 and at age 4 years he and his family immigrated to Turkey and settled in Izmir. He graduated from the Istanbul Medical School and trained in pulmonary medicine. After completing his training, he served in the Turkish Army on the country’s eastern front. After completing two years of service, he moved to the U.S. in 1958 and worked as a pulmonologist in the Cincinnati, Ohio area for 4 years. He then moved to Rochester, trained in our department, and joined the staff in 1965. He spent most of his career working in our cardiac anesthesiology section and also served as our St. Marys Hospital Division chair from 1975-1983.
Sait became one of the world leaders in cardiac anesthesia. Joining forces with Drs. Emerson Moffit, he published a seminal paper on myocardial infarction after general anesthesia. This JAMA paper led to an understanding of the impact of patient risk on perioperative outcomes and in decisions about scheduling patients for elective surgery. For more than 3 decades, this paper and a subsequent confirmatory paper by Petter Steen and Sait guided the world on surgical decision-making and perioperative management of patients with previously documented myocardial infarctions.
For his remarkable contributions to our understanding of patient risk factors and perioperative outcomes, Sait was recognized around the globe with honorary memberships in national societies (e.g., the Japanese Society of Anesthesiologists, the Association of Anaesthesiologists and Reanimatologists of the Republic of Kazakhstan). He received numerous awards, including the Recognition Award for Outstanding Contributions as a Pioneer of Cardiovascular Anesthesia by the World Association of Cardio-Thoracic and Vascular Anesthesia.
Sait never met anyone that he didn’t befriend and welcome. He was revered outside of the institution and admired within it. He received the Mayo Clinic’s Distinguished Clinician Award in 1993 in recognition of his lifetime of outstanding clinical care and his role in attracting and caring for many international patients who came to Mayo Clinic.
Here is this week’s Mystery Photo.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #29 - March 21, 2024 "Sioux Falls, South Dakota: “Mayo Clinic West” in Anesthesiology"
Photograph: Richard G. Belatti, M.D., undated
Sioux Falls, South Dakota: “Mayo Clinic West” in Anesthesiology
Dr. William Mayo was occasionally asked if he regretted making education such an important part of Mayo Clinic. For most of us who trained at Mayo, the question seems odd, and we ponder why anyone would have asked it. Education has always played an important role at Mayo Clinic. In fact, the Mayo brothers believed so strongly in the training of the next generation of health care providers that they donated a fair portion of their wealth to an endowment that sustains our educational programs even today. It turns out that people asked Will this question because they couldn’t understand why he and Charlie would train their future competitors. For the brothers, was not an issue that concerned them. They believed that many patients did not have access to excellent care and, therefore, they should help increase the quantity and quality of health care providers.
Their education initiatives extended beyond the training of new physicians. They consistently evaluated their practices, envisioned the types of health care providers that would be needed in the future, and created educational programs to train them. Examples of the health care fields that they started are nurse anesthesia, physical therapy, surgical assistants and technicians, and histology assistants. Their successors continued by developing the country’s first training programs for cardiac perfusionists, electro-neurodiagnostic technicians, and echocardiographic technicians. All in all, an impressive set of innovative new health care provider fields.
In many training programs, graduates leave our sites and go on to establish strong departments and groups elsewhere. Recognizing the quality of training that they received at Mayo, they subsequently reach back to our institutional programs and seek to recruit additional graduates to join them. These recruitment “pipelines” exist for many of our educational programs. Our best example in Rochester may be the pipeline of recruitment that led to anesthesia practices in Sioux Falls, South Dakota being labeled as “Mayo Clinic West.”
In 1979, Dr. Richard “Dick” Belatti completed his training in Rochester and moved to Sioux Falls where he joined Dr. Ed Daw, a 1960 graduate of our anesthesiology residency program, at Sioux Valley Hospital. Starting in 1983, Dick recruited Bill Horner (1983) to join him . . . and a cascade of Rochester anesthesiology resident graduates followed. Over time, a few of our graduates joined the anesthesia practice at McKennan Hospital (now Avera McKennan), the second Sioux Falls Hospital, and by 1995, more than 90% of the anesthesiologists in Sioux Falls were Mayo graduates. Today, 36 Mayo residency graduates have either worked or are now working in the anesthesiology practices of Sioux Falls. These include:
Sioux Valley Hospital (now part of Sanford Health)
- Ed Daw
- Dick Belatti
- Bill Horner
- Les Steidl
- Gary Halma
- Doug Bell
- Scott Atchison
- Steve Kunkel
- Arne Sorenson
- Tom Christopherson
- Kevin Ronan
- RJ Lunn
- Jack Gaspari
- Bob Grady
- Mac Sanders
- Mike Johnson
- Greg Hieb
- Barry Hein
- Casey Husser
- Marshall Holifield
- Steph Knight
- Loc Nguyen
- Brady Stocklin
- Matt Ulrich
- Ryan Rowberry
- Seri Carney
- Dan Thum
- Kelly Doolittle
Avera McKennan Hospital
- John Gray
- Scott Lockwood
- David Munce
- Dean Dewald
- Joel Farmer
- Dusty Thorpe
- Matt Naatjes
- Andy Mortensen
- Emily Fowler
Mystery Photos
Last week’s Mystery Photo is Dr. Tim Lamer.
Tim was born and raised in a small paper mill town in north central Wisconsin. After college and medical school at the University of Wisconsin, he moved to Rochester in 1983 to start our residency training program. He completed his residency as well as a Pain Medicine fellowship in Rochester and has been in the department ever since. He first split his time between the Pain Medicine Clinic and the operating rooms in Rochester. In 1991, Dr. Jim Harper recruited Tim to move to Jacksonville and help develop our Mayo Clinic Florida Pain Medicine practice and a fellowship program.
Tim was a leader in our Florida department during his 16 years in Jacksonville, starting as chair of the Pain Medicine Division and Director of the Pain Medicine fellowship program. In 1997 at the conclusion of Jim Harper’s term as department chair, Tim stepped into that role and served as chair until 2001. During that time period, Tim led the integration of the St. Luke’s private practice anesthesiology group into the Mayo department, opened an outpatient surgical center, and started what is now one of the country’s largest and most successful liver transplant anesthesia teams. He subsequently dedicated his remaining time in Jacksonville to the growth of our pain medicine practice, expansion of our fellowship program, and study of innovative techniques in pain medicine. The Pain Medicine Division became the Department of Pain Medicine in 2004 with Tim as its chair.
In 2007, Tim returned to Rochester and has dedicated his professional efforts to Pain Medicine both internally and externally. Tim has served on the editorial boards of Pain Medicine, the Pain Physician, and Clinical Journal of Pain. For the former, he is the current Section Editor on Neuromodulation and Minimally Invasive Surgery. He is a past president (2019-2020) of the American Academy of Pain Medicine. In addition, Tim has received numerous Teacher of the Year awards and was recognized in 1990 as our Rochester department’s Distinguished Clinician.
Last week’s contest winner was Michelle Ewy.
Here are this week’s Mystery Photos. With this Update #29, we will begin featuring two individuals each week for the Updates. To be placed into the Mystery Photo Starbucks contest, you will need to correctly guess at least one of the featured individuals. If you identify both of them, you will double your chances of having your name drawn.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #30 - March 28, 2024 "John Lundy’s Clinical Anesthesia Textbook: Unique, Controversial, and War-Worthy"
Photograph: John Silas Lundy, M.D., 1950.
John Lundy’s Clinical Anesthesia Textbook: Unique, Controversial, and War-Worthy
John Lundy wrote one of the country’s definitive anesthesia textbooks, Clinical Anesthesia, in 1942. It remained a major educational text in the specialty for three decades. However, it was not without controversy as his writing was based primarily on his observations in clinical practice. It was not well-referenced and contained ideas that were not universally accepted. In the excerpt below, Doug Bacon has summarized the textbook, its controversies, and its important value to the men and women who shouldered much of the anesthesia care in war zones and elsewhere during World War II.
In the late 1930s there was a clear need for an updated, “modern,” comprehensive textbook of anesthesiology. In discussion between Anaesthetists’ Travel Club members Drs. Emery A. Rovenstine and Arthur Guedel, the need was clearly acknowledged. The dilemma was over who would write such a book. Guedel was concerned that he was too old and out of touch. His good friend Dr. Ralph Waters, whose department at the University of Wisconsin could surely produce a “cutting edge” tome, had neither the time nor the interest to write. Guedel urged Rovenstine, the driving force behind academic physician anesthesia in New York City to write it. Emery demurred, procrastinated and when he was starting to compose the book, W. B. Saunders published Clinical Anesthesia. John Lundy had “scooped them all.” Did Lundy know of Guedel and Rovenstine’s plans? Was there discussion about a textbook at the Travel Club Meetings in Rochester, Minnesota (1938), New York City (1939) or Boston (1940)? What part did the conflict in Europe and eventually the world play in Lundy’s decision to write?
The 1942 publication is fascinating. The forward is written by William J. Mayo, M.D. who died in July 28, 1939. Thus, the book had to be well underway in 1938 or early 1939. Dr. Mayo writes, “In this book, Dr. Lundy presents in a practical form the place of anesthesia in modern surgery.” Realizing that the reader would know that Dr. Mayo had died, Lundy inserted a small footnote, “Dr. Mayo was much interested in preparation of the manuscript of this book. He wrote the forward after one of the many conversations with the author.” In the preface Lundy describes his method for creating the book, basing it largely on clinical cases. He built in redundancy so that busy military physicians could easily find the necessary material without consulting the index.
As the 90-day courses for physicians in anesthesiology rolled out during World War II, Clinical Anesthesia was touted as the textbook to study. Clearly clinically-aimed without considerable theoretical discussions, the book was comprehensive enough for the novice. Regional anesthesia was extensively covered, an inclusion that proved to be a lifesaver in combat anesthesia. But at 771 pages, it might well have been difficult to transport for physicians near the front.
Perhaps the March 1943 review of the book in Anesthesiology by editor-in chief and fellow Travel Club member Dr. Henry Ruth best sums the book’s importance. It is remarkable for its polite but valid notations of potential controversial statements in the textbook, which Henry S. Ruth, M.D., comments on in a book review. He noted that Clinical Anesthesia was essentially a unique compilation of the personal experiences of a clinician with a wide and varied practice. Ruth also noted that there were few illustrations and references. Thus, the book was not structured or written in the format of the modern academic textbook. It never had a second edition and had one post-war second printing.
Mystery Photos
Last week’s Mystery Photos were Burdette (Bud) Polk, CRNA and John T. (Tom) Martin, M.D.
Bud Polk was our first nurse anesthesia supervisor in Jacksonville when he moved from Rochester in 1986. Bud was born in Independence, Iowa. He completed his nurse anesthesia training in Rochester in 1968. After one year working in LaCrosse, Wisconsin at Gunderson Lutheran Hospital, he was recruited back to Rochester by Dr. Emerson Moffitt, chair of our Division of Cardiac Anesthesia. He served as the supervisor for our cardiac practice, working closely with Emerson and others in the operating rooms and on research projects. Things were soon to change for Bud, though.
Our intensive care units (St. Marys Hospital and Rochester Methodist Hospital ICUs) were established in 1966 by Dr. Albert Falconer (chair of the department from 1955-1969). Dr. Paul Didier, with Renee Caspersen, CRNA, developed the Methodist Hospital ICU and Dr. Alan Sessler, with Bernie Gilles, CRNA, developed the St. Marys Hospital ICU. Bud joined the expanding Section on Intensive Care in 1972 as the new supervisor of our intensive care services at RMH. Other key members supporting the growing number of intensivists and critically ill patients included Myron Ricks, CRNA (1970), Lester Clapp, RT (1971), and Tom Holtackers, PT (1972).
In 1982, Bud transitioned back to the operating rooms, working closely with Steve Schmidt. Four years later, he decided to move to Jacksonville. He was joined by colleagues Drs. Jim Harper and Tim Shine and nurse anesthetists Linda Buck, Alicia Cassabar, and Phil Klineschmidt. These six individuals provided the anesthesia care for the Mayo Clinic patients who were receiving their care at St. Luke’s Hospital in south Jacksonville. They were joined by others in 1987 and, by 1988, they were appointed as a group to be the Department of Anesthesiology at Mayo Clinic in Jacksonville. Jim Harper served as the department’s first chair. Parenthetically, the department cooperatively worked with the pre-existing private practice anesthesia group at St. Luke’s Hospital for a decade until the department took over full provision of anesthesia services for all patients in 1996. Bud served as the supervisor for the new department during its first 5 years before Linda Buck, CRNA succeeded him in the role in 1991. From 1991 through 2003, Bud provided care for cardiac patients and joined the nascent liver transplant service.
Bud retired in 2003 and lives today in Palm Coast, Florida. Palm Coast has 26 miles of saltwater canals connecting to the ocean, fitting Bud’s love for boating. In fact, he was a yacht broker for a period of time after his anesthesia career.
Tom Martin was the first mentor that Mary Ellen and I had when he was chair of the Department of Anesthesiology at the Medical College of Ohio in Toledo. It was Tom who sent us to Rochester for our ASA Medical Student Preceptorships in 1978 and introduced us to Drs. Alan Sessler, Duane Rorie, Jim Prentice, Ted Janossy, Mark Sperry, Gary Baggenstoss, Charley Rich, and so many others great anesthesiologists and residents. Ann Brumm, Jane Post, and Donna Baxter worked in the department offices at that time and made sure we knew how to get to our daily assignments. In those assignments, nurse anesthetists such as Alice Johnson, Jeanne Tiemans, John Carter, Mary Marienau, Jack Hostak, and others graciously tolerated our ineptitude and lack of knowledge and taught us how anesthesia care was provided at Mayo Clinic.
Tom was born in Cleveland, Ohio but grew up primarily in the Cincinnati area. His mother, Clara Martin, worked at Miami University in Oxford, Ohio and started the student boarding system and food services in that institution. Today, Martin Hall is one of the university’s primary dining halls and one that I used my first year at Miami. Tom met Marion, his wife of 59 years, in high school and they became a dynamic couple on the music scene during their time in Rochester (1958-1972). Marion was a master pianist and Tom was extraordinary as a trombonist. Tom was a member of the Mayo Clinic Notochords stage band, the Rochester Symphany Orchestra, and the Rochester Park Band. He also served as president of the Rochester Civic Music organization.
Tom was drafted into the military in 1944 and was the first graduating US. Air Force anesthesiology resident at Lackland Air Force Base (Wilford Hall) in 1948. Tom served as the Air Force’s residency program’s director until moving in 1958 to Rochester to join our department. He was the division chair downtown when the Rochester Methodist Hospital was being built and designed many of the elements in the hospital’s new operating rooms. The hospital opened in 1966. In 1972, Tom moved to New Orleans as chair of the Ochsner Clinic’s Department of Anesthesiology. After a short 2-year stint in that role, he moved to the Medical College of Ohio (MCO), joining Dr. Lucien Morris and colleagues. At MCO, he succeeded Dr. Morris as chair, served as medical director of intensive care and president of the MCO Faculty Senate.
Tom gained international recognition for his reports, presentations, and book dedicated to patient positioning. His text, “Positioning in Anesthesia,” was the primary authority of patient positioning during surgical procedures for more than 3 decades. Tom also was very involved in pre-hospital care training. He was the medical director of the northwest Ohio emergency medical technician program and paramedic training. He continued our department’s leadership of the International Anesthesia Research Society by serving as president of its Board of Trustees from 1979-1981. He was an editor of Anesthesia & Analgesia from 1966-1977. Tom passed away in 2005 in Toledo, Ohio. I was honored to speak at his funeral.
Mystery Photo Contest Winner
Last week’s contest winner was Tom Murphy.
Here are this week’s Mystery Photos.
Reminder: We are now featuring two individuals each week for the Updates. To be placed into the Mystery Photo Starbucks contest, you will need to correctly guess at least one of the featured individuals. If you identify both of them, you will double your chances of having your name drawn.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #31 - April 4, 2024 "Mayo Clinic Expands in the Midwest . . . and the Department of Anesthesiology in the Midwest Grows Dramatically"
Photograph 1: Brad Narr, M.D., 2015. Photograph 2: Natalie Caine, undated. Photograph 3: James Hebl, M.D., undated. Photograph 4: Marlea Judd, APRN, CRNA, DNP, undated. Photograph 5: Carlos Mantilla, M.D., undated. Photograph 6: Pam Bowman, MBA, undated. Photograph 7: Jams Ottevaere II, M.D., undated. Photograph 8: Darlene Bannon, RN, CRNA, undated.
Mayo Clinic Expands in the Midwest . . . and the Department of Anesthesiology in the Midwest Grows Dramatically
In the late 1980s and early 1990s, managed care gained momentum as a preferred health care model in the Upper Midwest, specifically in the Twin Cities area. In 1993, the Hiliary Clinton-led “Task Force on National Health Care Reform,” advocated strongly for managed care models. Although the Clinton Health Care Reform recommendations ultimately failed to advance through Congress, the task force’s advocacy for managed care increased enthusiasm for this model of care. Managed care models in the Twin Cities of Minneapolis and St. Paul led to many mergers of independent providers into rapidly growing health care systems such as Allina Health and Health Partners. This consolidation of practices and limitations on patients who wished to get their health care outside of their health systems restricted patient choice in the Minnesota market and raised the specter of reduced Rochester visits from Minnesota patients. In addition, the Clinton Health Care Reform proposed barriers between states, potentially reducing inter-state competition, an action that would have negatively impacted the number of potential patients who could travel to Rochester by choice.
In response, Mayo Clinic formed its own health system in 1992, initially called the Mayo Health System. The name changed in 2011 to its current Mayo Clinic Health System. I had the privilege of serving on the initial institutional committee that considered opportunities to secure our Midwest future by forming our own health care system. Led by Dr. Michael O’Sullivan (Department of Laboratory Medicine & Pathology), the committee discussed which hospitals and practices within 150 mile radius of Rochester might best augment our Mayo missions, benefit from Mayo Clinic support and resources, and protect our referral interests. I specifically mention our Mayo missions as our clinical schools (i.e., medical school, graduate medical education school, and health sciences school) were growing and more clinical experiences were needed for the increased number of trainees. A summary of the growth of the Mayo Clinic Health System can be found at Mayo Clinic Health System - Wikipedia and in a Mayo Clinic Proceedings article from 2003.
There initially was no mandate or even encouragement for hospital-based departments such as anesthesiology and radiology to engage with our growing new partners in the health system. However, over time our department began providing support for our anesthesia colleagues in Austin, Albert Lea, Red Wing, and other sites. Our electronic ICU practice started to provide services across the system. Preferential referrals for pain medicine followed. In February 2014, Dr. Brad Narr created a Division of Community Anesthesiology within the department. Dr. Jim Hebl was appointed as chair of the division and Marlea Judd, CRNA was appointed as the division’s nurse anesthesia director. Mirroring the overall health system, the Division of Community Anesthesiology organized into 4 regions.
- The Northwest Wisconsin Region was overseen by Dr. Richard Belmont and Gram Cotton, CRNA
- The Southwest Wisconsin Region was overseen by Dr. Peter Schams and Michael (Jake) Jacobson, CRNA
- The Southeast Minnesota Region was overseen by Dr. Jennifer Goins; Ryan Sportel, CRNA (River Corridor) and Alice Schrad, CRNA (I-90 Corridor)
- The Southwest Minnesota Region was overseen by Dr. Tim Murray and Steve Ydstie, CRNA
The Division of Community Anesthesiology was initially comprised of 46 anesthesiologist and 108 nurse anesthetists. The division sought to evolve to implement a single operational and strategic structure that would align with the remainder of the institution-wide Department of Anesthesiology, including major initiatives and clinical protocols involving quality and patient safety and outcomes. Integration was a major challenge at times. As one example, in 2015/2016, we had 18 unique paper anesthesia records in the health system sites as we sought to transition to a single electronic record system.
Dr. Sandy Kopp succeeded Jim Hebl as division chair in 2015. Jim became the Regional Vice-President of the Southwestern Region of the overall health system and is based in Mankato. Today, the division has 66 anesthesiologists and 129 nurse anesthetists. An additional 9 anesthesiologists in Rochester support the community practices. Dr. Jim Ottevaere of Eau Claire currently chairs the division. Darlene Bannon, CRNA, becomes the division’s CRNA director this month.
The anesthesiology sites in the health system create many opportunities for educating our many trainees. All four regions train student nurse anesthetists from our Rochester and LaCrosse programs. Mankato and Eau Claire have resident rotations at this time. Most of our sites teach paramedic and EMT students from local community schools as well as nurse practitioner and physician assistant students. Without our sites in the Mayo Clinic Health System, we would fall short of our educational needs in our Rochester anesthesiology residency and two nurse anesthesia training programs. All of our division anesthesiologists and CRNA leaders hold academic rank in the Mayo Clinic College of Medicine and Science.
The 2014 leadership of the Department of Anesthesiology in Rochester and its Division of Community Anesthesiology: Brad Narr, department chair; Natalie Caine, department administrator; Jim Hebl, division chair; and Marlea Judd, CRNA director.
The 2024 leadership of the Department of Anesthesiology in Rochester and its Division of Community Anesthesiology: Dr. Carlos Mantilla, department chair; Pam Bowman, department administrator; Jim Ottevaere, division chair; and Darlene Bannon, CRNA director.
Mystery Photos
Last week’s Mystery Photos were Steve Rose, M.D. and Karen Hammell.
Steve Rose was born in St. Paul, Minnesota. He graduated from “the most prestigious public high school” in Valley City, North Dakota (population 6,000+). Our own Drs. Niki Dietz and Kami Anderson are also graduates of Valley City High School. Steve moved on to Concordia College in Moorhead, Minnesota and Mayo Medical School before completing his anesthesiology residency at Mayo Clinic. With help from Dr. Martin Abel, Steve spent a year as a Senior Registrar at Groote Schuur Hospital in Cape Town, South Africa and several months in London, England as a Mayo Foundation Scholar before joining the Mayo faculty in 1985.
Steve was an outstanding athlete in high school, a talent that paid dividends during his training. He played as an all-star on various intramural, departmental, and community flag football and broomball teams. In one of the most shining successes in his training, he resuscitated a fellow broomball player from a cardiac arrest on the ice. Today, he and his wife, Dr. Beth Elliott, continue to participate in sports as avid, expert downhill skiers and frequent swimmers.
The focus of Steve’s non-clinical career has been medical education. He served as residency program director from 1994-2007 and as the department’s Vice Chair for Education from 1994-2009. He was the Mayo Clinic School of Graduate Medical Education’s (MCSGME’s) Associate Dean for Surgery and Surgical Specialties from 2003-2009; Vice Dean from 2007-2012; and Dean from 2012-2021. He also was the school’s Designated Institutional Official (DIO) from 2007-2022. As DIO, he oversaw and governed nearly 200 accredited residency and fellowship programs that trained more than 1,900 residents and fellows annually.
Steve was appointed to the national Accreditation Council for Graduate Medical Education’s (ACGME’s) Institutional Review Committee in 2017 as served as its chair from 2020-2023. This is one of the country’s most important leadership roles in graduate medical education. He is the first Mayo physician to serve in the role since an earlier version of it was established by Dr. Louis Wilson, one of Mayo Clinic’s pioneers in pathology and education. In 2022, Steve received two of the highest honors for a physician in education, the Mayo Clinic Distinguished Educator Award and the ASA’s Excellence in Education Award. This article summarizes his many educational accomplishments.
Three of six MCSGME Deans have been members of the Department of Anesthesiology. Dr. Alan D. Sessler was the inaugural Dean. He served as a mentor to Dr. Mark A. Warner and to Steve (the second and third department members, respectively, to serve in this position).
In clinical practice, Steve works in our Central Division at St. Marys Hospital, caring for patients undergoing complex orthopedic, spine, and thoracic procedures.
Karen Hammell was born in Rochester and attended school in Chatfield. After completing studies as an administrative secretary, Karen joined Mayo Clinic, working with the Mayo Clinic School of Graduate Medical Education (MCSGME) for 5 years. She subsequently worked within our institution’s Legal Department before joining our department in 1991 as the Education Program Coordinator for our residency. Her program director partners during her 31 years of stellar time as the residency coordinator have been Drs. Leslie Milde, Steve Rose, Tim Long, and Bridget Pulos.
Karen has been a primary contact for our trainees during her three decades with the residency program in Rochester. She’s been remarkably successful and respected. She was recognized in 2017 with the MCSGME Education Program Coordinator Award in Surgery and Surgical Specialties, the institution’s highest recognition for that position. In 2023, she was recognized by the Mayo Fellows Association with its Fellow Award. The award is given to exceptional individuals who are extraordinarily committed to our residency and fellowship programs and their success.
Karen will retire in June this year after more than 3 decades of service to our residency program in Rochester. She has 7 grandkids in the St. Charles and Plainview areas who will benefit from her new-found time. Best wishes, Karen!
Mystery Photo Contest Winner
Last week’s contest winner was Karen Nase.
Here are this week’s Mystery Photos. Reminder: We are now featuring two individuals each week for the Updates. To be placed into the Mystery Photo Starbucks contest, you will need to correctly guess at least one of the featured individuals. If you identify both of them, you will double your chances of having your name drawn.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #32 - April 11, 2024 "Department of Anesthesiology: Exemplary Humanitarian Efforts"
Photograph 1: Gary Boeke, M.D., undated. Photograph 2: Phil Boyle, M.D., undated. Photograph 3: Lorrie Bennett, CRNA, undated. Photograph 4: Tom Spackman, M.D., undated. Photograph 5: Jack Bagby, M.D., undated. Photograph 6: Richard Olson, M.D., undated. Photograph 7: Jill Hardy, CRNA, undated. Photograph 8: John Gray, M.D., undated. Photograph 9: Matt Ritter, M.D., undated. Photograph 10: Chris Martin, undated. Photograph 11: Cathy Cook, CRNA, undated. Photograph 12: Tera Wenzel, CRNA, undated.
Department of Anesthesiology: Exemplary Humanitarian Efforts
In Update #6 (October 12, 2023) we read about humanitarian medical efforts led by Drs. David Byer and Kelly McQueen. In this Update, Anesthesiology alumni Gary Boeke (1983) and Phil Boyle (1984), as well as Plastic Surgery alumnus Paul Schultz (1985), provide a summary of their efforts and many other Mayo physicians, nurse anesthetists, and operating room personnel in Guatemala for more than the last three decades. As a department, we are blessed that many of our colleagues are involved in humanitarian medical efforts. This summary provides an excellent example of many of our alumni and staff coming together in a sustained effort to help others.
“Guatemala is a beautiful country known as the “Land of Eternal Spring.” The indigenous Mayan people have a rich heritage. From 1960 until the peace accord in 1996, Guatemala was embroiled in a civil war. As a result of war and poverty, HELPS International was organized as a relief/development organization dedicated to assisting the indigenous population. An integral part of this effort has been to bring medical-surgical teams to the needy.
Central Minnesota was the first HELPS medical team to volunteer in Guatemala in 1988 and 1989. Mayo alumni on those teams were Drs. Gary Boeke (Anesthesiology 1983), Philip Boyle (Anesthesiology 1984), Paul Schultz (Plastic Surgery 1985), Paul Heath (Plastic Surgery 1983) and James Smith (Plastic Surgery 1983). Subsequently, other medical teams were established over the years from around the US. For the year 2024 there are 9 medical teams scheduled to serve. The original 1988 team only had 7 volunteers; several of the current teams have 80-90 volunteers. The teams and the care they provide are self-funded. Central Minnesota has continued to field 2 teams per year for the last 36 years. Most medical teams provide 3-4 surgical sites along with medical clinic and dental staffing. The most frequent operations performed are hernia repairs, cleft lip and palate repairs, cholecystectomies, burn scar revisions, and gynecological surgeries. Ophthalmological services may also be provided when available. Lack of basic medical care in Guatemala makes for challenging cases. Most teams perform 130-180 surgical cases during their trips.
Other Mayo Clinic alumni have volunteered and continue to serve on HELPS teams over the 36 years of the program. They include Drs. Tom Spackman (Anesthesiology 1980), Jack Bagby (Anesthesiology 1983), Chris Martin (Anesthesiology 1994, Pain Medicine 1996), Dick Olson (Anesthesiology 1984), John Gray (Anesthesiology 1984) Matt Ritter (Anesthesiology 2005, Critical Care Medicine 2006), Chris Schmidt (Surgery 1992) and Mike Sarr (GI Surgery, 1980). Mayo volunteer nurse anesthetists include Lori Bennet, Jill Hardy, Tera (Cox) Wenzel, and Cathy Cook. Several Mayo Clinic nurses and OR technicians have also joined the teams.
HELPS is also involved with community development. This involves providing stoves (over 300,000 installed), a corn micro-loan program, water filters and educational sponsorship. The medical experience in Guatemala has been very rewarding for the many involved. Quality care is given, and gratitude returned. Instead of monetary remuneration, hearts are filled. The opportunity has often allowed families of team members to be involved and share in the joy of medicine and serving. The experiences have impacted the vocations of many. Lives are changed, both the people served and the people serving.”
Mystery Photos
Last week’s Mystery Photos were Beth Elliott, M.D. and Allan Gould, M.D.
Beth Elliott was born and raised in Kentucky. After medical school at the University of Louisville in 1981, Beth moved to Rochester to begin her training in Anesthesiology. Her fellowship year in Rochester focused on Regional Anesthesia/Pain and Neuroanesthesia. She joined the staff in 1985, originally working at Rochester Methodist Hospital with the Vascular and Gynecologic surgeons. Beth eventually moved to St. Marys Hospital to join the Ortho Anesthesia group where she was integral to the development of the Acute Pain Service and the use of epidural analgesia for thoracic surgery patients. She also helped cover chronic pain consults at St. Marys Hospital, creating a busy block practice in addition to her work in the operating rooms. In 1995, Beth was named Division Chair of the Ortho Anesthesia group where she promptly led an effort to rename it the Central Division. She continued in this leadership role until 2005. She was awarded the Clinician of the Year award by her peers in 2007.
As a visiting medical student in 1980, Beth had the serendipitous opportunity to care for Dr. Virginia Hartridge as one of her first patients. Dr. Hartridge was the longtime medical director for the Nurse Anesthesia program at Mayo. This led to her initial interest in the nurse anesthesia program, triggering an educational pursuit that became a major part of her stellar career. Beth succeeded Dr. Bob Lennon as medical director for the nurse anesthesia program in 1991 and has held it to this day. Along with her CRNA colleagues, program directors Ed Thompson, CRNA and Mary Marienau, CRNA, she helped guide the program over the ensuing decades in the transitions from a Certificate program to a master’s degree program to the Doctor of Nurse Anesthesia program that it is today. In recognition of her long-term commitment and contributions to the education, Beth was awarded the Distinguished Educator Award from Mayo Clinic in 2009. This award is Mayo Clinic’s highest recognition in education.
Anyone who sees Beth away from the OR (meaning not wearing scrubs) knows that she loves scarves and can be seen wearing one almost every day. Her collection of Hermes scarves goes back many years, adding to her travel adventures and making friends across the USA and Europe.
In addition to her scarves, Beth enjoys quilting and needlepoint. She and her husband of 33 years, Steve Rose, are avid skiers and still spend several weeks a year chasing the perfect powder day at Vail. Beth holds a unique distinction of having not just one . . . but three (!) holes-in-one on various golf courses around Minnesota. She is as skilled on the golf course as she is in clinical practice and education.
Dr. Allan Gould was born in Buffalo, NY and grew up in Piqua, Ohio. After college at Ohio State University, he attended Jefferson Medical College in Philadelphia, graduating in 1952. Within a week of graduating, he married Marilyn Buxton, his wife of 52 years. He served in the U.S. Army after an internship in Philadelphia and the first year of his anesthesiology residency training at Mayo Clinic in Rochester. He joined the Korean conflict as a physician in a Mobile Army Surgical Hospital (MASH) unit. He often chuckled at the humor and simultaneously shook his head in disbelief at the way movies and television shows depicted MASH units. He described his time in Korea in a department newsletter article written in 2003.
After the conflict, Allan returned to Rochester to complete his anesthesia training and joined the staff in 1958. He had a distinguished career as a remarkable clinician. In his retirement year of 1991, Allan was recognized by his colleagues with the department’s Distinguished Clinician Award. For 8 years from 1972 through 1980, he chaired the Section of Anesthesia at the Rochester Methodist Hospital. Extramurally, Allan served as an ABA oral examiner, an editor of the ASA Newsletter, chair of the ASA Annual Meeting (twice!), and a member of the ASA’s Board of Governors. He also was president of the Minnesota Society of Anesthesiologists.
Allan was widely admired by his colleagues. He and Marilyn enjoyed their five children, 8 grandkids, and 5 great grandkids during their retirement. They found great joy in working with the walnut trees they planted on their Fillmore County farm in southeast Minnesota and watching birds. Allan passed away on October 14, 2014.
Mystery Photo Contest Winner
Last week’s contest winner was Dr. Joe Messick.
Here are this week’s Mystery Photos.
Reminder: We are now featuring two individuals each week for the Updates. To be placed into the Mystery Photo Starbucks contest, you will need to correctly guess at least one of the featured individuals. If you identify both of them, you will double your chances of having your name drawn.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #33 - April 1, 2024 "Department of Anesthesiology Alumnus: The Outstanding Dr. Jim Eisenach"
Photograph: James C. Eisenach, M.D.
Department of Anesthesiology Alumnus: The Outstanding Dr. Jim Eisenach
There are few alumni who have been at the forefront of anesthesiology research and advances in the specialty more than Dr. James C. (Jim) Eisenach. Jim graduated from the University of California, San Francisco School of Medicine in 1982. After an internship in that city, he came to Rochester for his residency training, entering what was to be the graduating class of 1985 with future academicians such as Brad Narr, Beth Elliott, and Tim Shine. A great summary of Jim’s time in Rochester is found in Reminiscences, his short story written for our May 2005 department newsletter.
Jim left Rochester in 1985 and served one year as a fellow in obstetric anesthesia at Wake Forest University in North Carolina. He had left Mayo with a newly written NIH proposal in hand . . . and the start of nearly 40 years of continuous NIH funding in which he systematically studied selective spinal analgesics. He is a rare recipient of an NIH MERIT Award. He quickly rose to professor rank and holds the Francis M. James, III, M.D. Professorship of Anesthesiology. Jim was very involved in the American Society of Regional Anesthesia (ASRA) leadership and served at the ASRA president in 2003. ASRA recognized his contributions with its 2005 John J. Bonica Award, its 2008 Gaston Labat Award, and its 2012 Distinguished Service Award.
Jim’s excellence in research put him on a path that led to his becoming one of the most influential anesthesiologists in the country. Jim served as Editor-in-Chief of Anesthesiology from 2007-2016 and president of the Foundation for Anesthesia Education and Research from 2016-2023. He was inducted into the National Academy of Medicine in 2015, received the American Society of Anesthesiologists’ Excellence in Research Award in 2013, and gave the ASA’s Emery Rovenstine Lecture in 2015 and its John Severinghaus Lecture in Translational Science in 2021.
Best of all, Jim is a really great person and a strong advocate for Mayo Clinic. Congratulations, and thank you for all you’ve done for the specialty, Jim.
Mystery Photos
Last week’s Mystery Photos were Dan Cole, M.D. and Albert Faulconer, M.D.
Dan Cole was born in Washington, D.C. and raised in Michigan. After graduating from Andrews University in Berrien Springs, Michigan (20 miles northwest of South Bend, Indiana), he earned his M.D. from Loma Linda University, 60 miles east Los Angeles. He also completed his anesthesiology training there. Dan subsequently was a neuroanesthesiology fellow at the University of California, San Diego. Dan was a faculty member at Loma Linda University from 1986 through 2003. During his time in California, he rose within the California Society of Anesthesiologists’ leadership, serving as president in 2001-2002. He also was president of the Society of Neuroscience in Anesthesiology and Critical Care from 2001-2002. It was obviously a very busy year.
Dan moved to Phoenix in 2003 and became chair of our Mayo Clinic Arizona Department of Anesthesiology. During that period, he worked with Dr. Renee Caswell and started our residency program and led a time of departmental growth which included the addition of a cardiac transplant and assist device program, and expansion of non-operating room anesthesia. He also served as the Vice-Dean of our Mayo Clinic School of Continuous Professional Development. Dan moved to the University of California, Los Angeles in 2013 as vice-chair of its Department of Anesthesiology. A prolific author and investigator, he currently is Professor of Anesthesiology at UCLA.
Dan is one of only 17 anesthesiologists who have served as president of both the American Society of Anesthesiologists and the American Board of Anesthesiology. While with the ABA, Dan was its Executive Director of Professional Affairs for 4 years. He also has been a director of the Foundation for Anesthesia Education and Research. In 2021, Dan became president of the Anesthesia Patient Safety Foundation and holds that position currently. Dan initiated the ASA’s Perioperative Brain Health, one of the specialty’s major initiatives to improve patient safety in the past 4 decades. He was recognized in 2020 by the ASA with its Distinguished Service Award, joining 6 other Mayo Clinic colleagues as a recipient of that award.
Dan and his wife, Cristine, have two sons (Steven and Andrew) and live in San Monica, California.
Addendum: Although Dan has experienced many memorable events over the years, I am pleased to report that one of the better ones occurred during a summer visit to Rochester when I invited him to speak to our local colleagues and residents. Since it was a social event, I took Dan to lunch with a small group and we sat outside at Famous Dave’s restaurant. Yes, I was being frugal with our Mayo budget. Unfortunately, Dan sat in a large dollop of the restaurant’s famous BBQ sauce. His light tan pants were colorful, to say the least. Knowing that he had an upcoming presentation in the later afternoon, we rushed to my home to wash his pants. Dan is fit, in shape, and weighs less than two-thirds of what I do, so the substitute gym shorts I could provide as a temporary substitute were a little on the large size. A nice piece of rope as a belt fortunately saved the day until the dryer had completed its task. To be fair to Dan, I am not sharing any of the funny photos from that afternoon.
Albert Faulconer was born in Arkansas City, Kansas, south of Wichita near the Oklahoma border. He graduated from the University of Kansas Medical School in 1936. After a general internship and medicine residency, plus several years in clinical practice, he came to Rochester in 1943 as part of the 90-day “short course” anesthesia training for physicians who would subsequently play a major role in caring for injured soldiers/seaman/marines during WWII. After the war, he returned to Rochester, joining the anesthesia staff after only 6 months of clinical anesthesia training during his abbreviated residency. He was an exceptional research talent, developing an acoustic gas analyzer as part of his master’s degree thesis. The department almost lost him to Boston’s Harvard programs but a reportedly impassioned plea by Dr. John Lundy to the Mayo Board of Governors resulted in him being hired as a consultant before completing his training.
Albert became a major force in anesthesiology research during his career. An excellent summary of his career and legacy has been published by our own Drs. Peter Southorn, Mary Ellen Warner, Alan Sessler, and Kai Rehder. He used EEG techniques to determine the impact of both inhaled and intravenous anesthetics on the cerebral cortex. He demonstrated that nitrous oxide worked as an anesthetic . . . an assumption that was not universally accepted in the late 1940s and early 1950s. At that time, there was a prevailing wisdom that nitrous oxide worked through diffusion anoxia of the brain. He used a pressure chamber to give percentages of nitrous oxide greater than 80% but ensuring sufficient oxygen to volunteers who were in 2 atmospheres of pressure. He used EEG monitoring of the brain to detect changes depicting levels of anesthesia but not cerebral hypoxia.
His experience with EEG techniques led him to the concept of intraoperative cerebral monitoring to estimate depth of anesthesia. From that and work he did to show that anesthetics, especially intravenous anesthetics, lost their cerebral effects by distribution to other tissues in the body, he developed a computer-activated model to predict uptake and distribution of anesthetics. This then led him to use the model to test a servo-controlled anesthetic machine and a similar intravenous anesthetic infusion device. He soon found that a “closed-loop” computer approach to delivering anesthesia was not going to be successful without the input of trained anesthesia personnel. However, his work formed the basis of today’s processed cerebral monitors to estimate depth of anesthesia.
Albert’s outstanding and novel research earned him a position for 11 years (1950-1961) on the National Research Council’s Committee on Anesthesia. The Research Council was and continues to be the operational arm of the National Academy of Sciences. He was a founder of the Association of University Anesthesiologists and its president in 1956. He also was a director and president of the American Board of Anesthesiology during the 1955-1969 period. In 1953, he was appointed as chair of our Section of Anesthesiology and Intravenous Therapy. He led the section through several name changes, including 1970 when it was renamed as the Department of Anesthesiology. He stepped down as department chair in early 1971. He was a member of the Mayo Clinic Board of Governors from 1963 through 1969. Albert died on December 10, 1985.
Mystery Photo Contest Winner
Last week’s contest winner was Dr. Marie DeRuyter.
Here are this week’s Mystery Photos.
Reminder: We are now featuring two individuals each week for the Updates. To be placed into the Mystery Photo Starbucks contest, you will need to correctly guess at least one of the featured individuals. If you identify both of them, you will double your chances of having your name drawn.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #34 - April 25, 2024 "Department of Anesthesiology Innovations: The Anatomy Laboratory"
Photograph: Hugo Raimundo, M.D., undated.
Department of Anesthesiology Innovations: The Anatomy Laboratory
Dr. John Lundy came to Mayo Clinic in 1924 with a vision for the specialty’s evolution. Far ahead of nearly all other early leaders of the specialty, he looked into the future and dreamed of ways that he and the colleagues he would recruit could have a positive impact in medicine beyond the operating rooms. One of his first steps was to expand the scope of anesthesia through the education of surgical (and subsequently anesthesia) fellows in anesthetic as well as surgical techniques. With the support of Drs. Will and Charlie Mayo, he developed an anatomy laboratory in which trainees could perform procedures and dissections on cadavers, in essence establishing one of the country’s first simulated surgical programs. His anatomy laboratory evolved into today’s Department of Anatomy at Mayo Clinic and its two major programs, the Microsurgery Training Center and the Clinical Anatomy Lab. His concept of anatomic training (i.e., cadaveric simulation) has been widely adopted in health science programs, medical schools, and graduate medical education across the U.S. and internationally.
Our own Drs. Terry Ellis and Doug Bacon summarized Lundy’s remarkable vision and actions in establishing the anatomy laboratory in their excellent 2003 Mayo Clinic Proceedings article.
The Passing of Dr. Hugo Raimundo
Although the Centennial Updates are written to provide historical information and context on the development of our department and the important innovations and leadership roles of department members, it seems appropriate to use the Updates to share news that will match with the interests of many of our Update readers.
In this instance, it is the passing of Hugo Raimundo. He was a major contributor to the strong and successful pediatric cardiac surgical program in Rochester. The following is taken from an obituary dedicated to him.
“Dr. Raimundo died peacefully in his Phoenix home near the Mayo Clinic Hospital on March 7, 2024 following a courageous battle with idiopathic pulmonary fibrosis.
Hugo was born in 1937, in Panaji, Goa, India, which at the time was a Portuguese Colony. At the age of 17 he left Goa, traveling by boat across the Arabian Sea and through the Suez Canal to Portugal. He settled in Oporto where he went to medical school and interned at Hospital de Sao Joao from 1954-1961. He served mandatory time in the Portuguese Armed Forces as a medical officer from 1961 – 1965 and was in the horrific fighting within the jungles of Angola for much of that time. In 1965, Portugal remained under the dictatorship of Antonio Salazar and it was necessary for him to arrange travel to the United States, under cover, where he arrived with one suitcase containing all of his earthly belongings. He interned at Robert Packer Hospital, Guthrie Clinic in Sayre, Pennsylvania from 1965 – 1966. - He entered the Mayo Graduate School as a resident in general surgery in January 1967 and transferred to anesthesiology in 1969. He was appointed Consultant, Department of Anesthesiology, Mayo Clinic Rochester in 1972, specializing in cardiac anesthesia, with a special interest in pediatric cardiac anesthesia. He retired on December 31, 1999.”
Mystery Photos
Last week’s Mystery Photos were Duane Rorie, M.D. and Emerson Moffitt, M.D.
Duane Rorie was born in Yellville in the north central region of Arkansas in 1936. He completed his undergraduate and M.D. degrees at the University of Arkansas, then earned a Ph.D. in anatomy from the University of Mississippi. He subsequently moved to Rochester for his anesthesiology residency and joined the staff in 1970. With the initial class of the new Mayo Medical School entering in 1972, Duane became the school’s first anatomist and taught clinical anatomy for 10 years as well as working in our department and obtaining his first NIH grant in 1977. He continued his success with a string of NIH grants until 1999. His grants focused on understanding the mechanisms and impact of anesthetics on norepinephrine and other neuropeptides, specifically how anesthetics attenuate sympathetic vasoconstriction. His clinical research was directed towards the anatomic considerations of regional anesthetic techniques.
Duane served as the chair of our department’s Division of Anesthesiology at Rochester Methodist Hospital from 1980 through 1991. He advanced to chair of the department and continued in that role until 1999. He was an examiner of the American Board of Anesthesiology and a member of multiple honorary societies within the specialty. His excellence in research and education was recognized by the institution when he was appointed as its Reuben Eisenberg Professor in 1991. He is one of only 4 department members to be recognized as a named professor. Upon completing his role as department chair, Duane was asked to serve as the medical director of Mayo Clinic’s Procedural Skills Laboratory. His appointment brought the department full circle as the anatomy laboratory was first started by our own Dr. John Lundy in 1925 (see section above on the anatomy laboratory’s origin). Duane’s return to clinical anatomy leadership was defined by his refinement and expansion of the Procedural Skills Lab (Clinical Anatomy Lab – RST (mayo.edu) as well as his advocacy for a new Microsurgery Training Center Microsurgery Training Center (mayo.edu).
On rare instances, Duane would tell of the start of his rise within the Mayo Clinic hierarchy. He delighted in telling the story of his first committee role at Mayo . . . and as its chair, no less. He was asked to lead the institution’s Meal Policy Committee by Dr. Gene Mayberry, chair of our Board of Governors at the time. Candidly, there are only a handful of committees lower on the rung of Mayo’s committee ladder. One of those is the Surgical Scrub Suit Policy Committee . . . which was my first committee assignment as a chair (thank you, Bob Waller, successor to Gene Mayberry). Both chair roles were challenging (and a little painful) because few personnel affected by the policies of these two committees are happy about them. Duane and I shared more than a few laughs at how these assignments launched our careers, nearly derailing them right from the start.
Duane passed away on March 7, 2014. His obituary in the Rochester Post-Bulletin may be found at Dr. Duane K. Rorie — Rochester - Post Bulletin | Rochester Minnesota news, weather, sports. Dr. Stephen Carmichael, emeritus professor of anatomy, wrote a tribute about Duane’s contributions to Mayo Clinic. Duane had a wonderful wife of 50 years, Carolyn, and two daughters.
Emerson Moffitt was born in New Brunswick, Canada in 1924. He went to the University of New Brunswick in Fredericton, although his undergraduate studies were interrupted by WWII and service in the Canadian Royal Navy Fleet, Air Arm. He graduated from Dalhousie Medical School in Halifax, Nova Scotia in 1950 and entered general practice in North Sydney, Nova Scotia near Cape Breton Island. During his three years in general practice, he delivered hundreds of general and spinal anesthetics, triggering his desire to pursue further anesthesia training. In 1954 he moved to Rochester as a new resident working with John Lundy and others. He became very interested in the launch of the institution’s first cardiopulmonary bypass use in March 1955. Under the mentorship of Dr. Jeremy Swan (of Swan-Ganz catheter fame) and working with colleagues such as Drs. John Kirklin (CV Surgery), Earl Wood (Physiology), and Bob Patrick (Anesthesiology), he studied the physiologic effects of cardiopulmonary bypass and the management of anesthesia, anticoagulation, transfusion, and electrolytes during bypass. His work at that time, augmented by further studies with fellow anesthesiologists Drs. Dick Theye, Bob Devloo, Alan Sessler, and Dick Lundborg, led to the specialty’s fundamental understanding of cardiopulmonary bypass and management of cardiac surgical patients. Our own Drs. Adam Jacob, Doug Bacon, and Hugh Smith wrote an outstanding, well-referenced summary of Emerson’s contributions in 2007. Dr. Peter Southorn also wrote a wonderful, more personal story in 2004 about Emerson’s time at Mayo Clinic in our department newsletter.
Emerson chaired the department’s Division of Anesthesiology at St. Marys Hospital from 1966 through 1971. In 1971, Dick Theye was chosen to succeed Dr. Albert Faulconer as chair of the newly renamed Department of Anesthesiology. Two other valued candidates for that position were Emerson and Dr. John (Tom) Martin. That transition, coupled with the early death of Emerson’s wife in 1972, triggered Emerson to decide to return with his two daughters to Nova Scotia. He was offered and accepted a position as chair of his medical school alma mater’s Department of Anesthesiology. His work in Nova Scotia and his ascent as Dean of Clinica Affairs at Dalhousie are well documented in David Shephard’s excellent summary.
Here are this week’s Mystery Photos.
Reminder: We are now featuring two individuals each week for the Updates. To be placed into the Mystery Photo Starbucks contest, you will need to correctly guess at least one of the featured individuals. If you identify both of them, you will double your chances of having your name drawn.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #35 - May 2, 2024 "The Department of Anesthesiology: The Start of the Anesthetists’ Travel Club and the Evolution of the Specialty"
Photograph: Anesthetists' Travel Club, 1933.
The Department of Anesthesiology: The Start of the Anesthetists’ Travel Club and the Evolution of the Specialty
In 1929, Dr. John Lundy invited leading anesthesiologists from the U.S. and Canada to Rochester to form the Anesthetists’ Travel Club. This club would meet annually until the start of WWII. The founders shared ideas and clinical practices. Most became leaders in their national organizations and greatly influenced the evolution of the specialty. Our own Drs. Ron Mackenzie and Doug Bacon wrote about the influence of Drs. Will and Charlie Mayo on the organization of the Travel Club. The article provides remarkable insights into the influence wielded by Will and Charlie in U.S. surgery and by John Lundy and his Mayo colleagues (i.e., Charles McCuskey and Ralph Tovell) on U.S. and Canadian anesthesia.
Mystery Photos
Last week’s Mystery Photos were Ralph Tovell, M.D. and Theresa (Terre) Horlocker, M.D.
Ralph Tovell was born in Sydenham, Ontario, Canada in 1901. He earned his M.D. degree from the Queen’s University in Kingston, Ontario in 1926. He immediately moved to Rochester as one of Dr. John Lundy’s first fellows. He remained in Rochester until moving in 1939 to become the chief of anesthesiology at Hartford (CT) Hospital. Several wonderful, brief summaries of Ralph’s contributions to the specialty’s development may be found at Ralph M. Tovell, M.D.* - Wood Library-Museum of Anesthesiology (woodlibrarymuseum.org) and Dr Ralph Moore Tovell | The Royal College of Anaesthetists (rcoa.ac.uk). For brevity, let me summarize several of his remarkable key accomplishments:
- 1938: Helped found the American Board of Anesthesiology.
- 1939: Chief of Anesthesia, Hartford (CT) Hospital, remaining in that role until 1963.
- 1940: Became a U.S. citizen.
- 1940: Appointed as Associate Editor, Anesthesiology, a position he held until 1955, becoming Editor-In-Chief at that time.
- 1941: President, American Society of Anesthesiologists.
- 1942: Appointed as Senior Consultant in Anesthesia for the U.S. Army, European Theatre of War, discharged at the rank of Colonel.
- 1947: President, American Board of Anesthesiology.
- 1948: Chair, AMA Section on Anesthesia.
- 1951: Recipient, ASA Distinguished Service Award.
- 1955: President, Academy of Anesthesiology
Two examples of Ralph’s contributions are his advocacy that led to the adoption of the Pin-Index safety system for gas cylinders and his contributions to developing safer anesthesia care during WWII.
He died on January 7, 1967. Dr. David Little, another early leader in the specialty, wrote his obituary in Anesthesiology.
Terese (Terre) Horlocker is a native of Rochester, born in St. Marys Hospital on April 2, 1959. She likely has the lowest Mayo Clinic number of any active member of our staff. Terre graduated from the University of Minnesota and Mayo Medical School and then completed her training in anesthesiology here in Rochester in 1989. Classmates in her residency class who worked on staff in the department included Mark Ereth, Bob Friedhoff, Mike Johnson, Tom Losasso, Bill Perkins, Kevin Ronan, and Margaret Weglinski.
Terre has become one of the leading anesthesiologists in the world in regional anesthesia, with special recognition for her work in understanding the risks of anticoagulants and the use of neuraxial anesthetic techniques. Soon after joining our staff in 1989, she began working closely with Dr. Denise Wedel on projects to define the risks of regional anesthesia and especially neuraxial anesthesia. Early papers with Denise and hematologist Dr. John Heit led to our understanding of anticoagulation risks and her leadership in developing guidelines for their use with regional anesthesia. These guidelines have been used worldwide for more than a quarter of a century, a remarkable testimony to their value and appropriateness.
Terre has been a leader in regional anesthesia and the department and institution. Examples of her leadership roles and awards include:
- 1998: Chair, FDA Anesthesia and Life Support Drugs Advisory Committee
- 2000: Chair, Division of Methodist North Anesthesia
- 2003: Chair, ASA Committee on Regional Anesthesia
- 2004: Section Editor (Regional Anesthesia), Anesthesia and Analgesia
- 2005: President, American Society of Regional Anesthesia (ASRA)
- 2008: Chair, Mayo Space and Remodeling Committee
- 2009: Recipient, ASRA Distinguished Service Award
- 2011: Recipient, ASRA Gaston Labat Award
- 2011: Recipient, Minnesota Society of Anesthesiologists’ John Lundy Award
- 2020: Recipient, ASRA Trailblazer Award
An excellent story about Terre, told by her, is found in the 2020 ASRA Newsletter about Women in Regional Anesthesia.
Terre will retire this May. Her humor, stories, wit, and knowledge will be sorely missed.
Mystery Photo Contest Winner
Last week’s contest winner was Tibor Mohácsi.
Here are this week’s Mystery Photos. Reminder: We are now featuring two individuals each week for the Updates. To be placed into the Mystery Photo Starbucks contest, you will need to correctly guess at least one of the featured individuals. If you identify both of them, you will double your chances of having your name drawn.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #36 - May 9, 2024 "The Department of Anesthesiology: The Miraculous Superhero Professor Roger White"
Photograph: Roger D. White, M.D., undated.
The Department of Anesthesiology: The Miraculous Superhero Professor Roger White
Few people have made a greater impact on medicine that Dr. Roger White. His expertise in cardiac anesthesia, understanding of cardiac rhythms, treatment of cardiac arrest, and leadership of Emergency Medical Services have resulted in numerous awards. More importantly, they have saved many lives.
Roger was born in 1939 in Ontonagon, Michigan. A neat trivia question about Ontonagon: What incorporated U.S. town or city is the furthest west of any that use the Eastern Time Zone? It is just east of the Porcupine Mountains Wilderness State Park along Lake Superior and an hour’s drive SW of Houghton, Michigan in the Upper Peninsula. It’s remarkable that a young man from Ontonagon has become one of the world’s most recognizable names in cardiac resuscitation.
Roger graduated from the University of Michigan and its medical school. After an internship at Henry Ford Hospital in Detroit in 1965, he moved to Rochester to start as a resident in Internal Medicine. His residency was interrupted by a 2 year tour of duty with the U.S. Army during which time he received on-the-job training in anesthesiology. It was a career-changing event as he returned to Rochester and switched his residency training to our specialty. It was our win and Internal Medicine’s loss. He went on to start working in cardiac anesthesia, a subspecialty in which he has worked for 54 years on the Mayo Clinic staff . . . and counting as he still continues to work clinically as well as on research projects.
This description in the October 2, 1970, Mayovox announces the start of his time on staff in Rochester:
During his career, Roger has advocated for emergency medical services. He played a major role in establishing Rochester and southeast Minnesota’s emergency medical services. During his second year on staff, he wrote an excellent article describing the importance of physicians as leaders in pre-hospital emergency care. He became deeply involved in introducing advanced cardiac life support training into our Mayo Clinic hospitals and emergency medical services and instituting cardiac telemetry, radio communications between emergency services and physicians, and the use of resuscitation intravenous medications in pre-hospital settings.
Examples of Roger’s incredible contributions to emergency medical services include the 1990 introduction of early defibrillation in Rochester (defibrillators in fire trucks, ambulances, and police cars). At that time, the program reported the highest survival rates in the U.S. from out-of-hospital cardiac arrest and ventricular fibrillation. In 2008, Roger and 5 colleagues authored the American Heart Association’s recommendations on “hand-only” (“chest compressions-only”) cardiopulmonary resuscitation techniques. In 2011, Roger oversaw the 96-minute resuscitation of a man in cardiac arrest in Goodhue, Minnesota. He survived neurologically intact; it is believed to be the world’s longest successful resuscitation from cardiac arrest. Here you can read a case report and watch a video about this resuscitation. In recognition of his contributions, Roger was inducted into the Emergency Medical Services (EMS) World Hall of Fame in May 2022. Mayo’s Discovery Edge (Winter 2012) turned Roger and his team into superheroes in their description of their work . . . perhaps the best way to describe hyper-achievers.
There is so much more that can be said about Roger. He taught many of us who are left-handed how to cannulate the right internal jugular vein before ultrasound was introduced into routine practice. He led many Rochester department members annually through modified CPR training and dazzling us as he taught us how to recognize common as well as rare rhythms. Nearly every Rochester department member reached out to Roger for advice on how to interpret ECGs in the perioperative period. Less known is his classic ambulance collection.
An excellent video documentary about Gold Cross Ambulance, featuring Roger’s narrative, will be posted online at the National Emergency Medical Services Museum later this month (Virtual National EMS Museum - EMS Museum). Here is a photo from that video:
Congratulations, Roger, on an outstanding career. And for many more years that we can lean on your expertise.
Mystery Photos
Last week’s Mystery Photos were Joseph Messick, M.D. and Michael Geisler, CRNA.
Joe Messick was born in Wilmington, Delaware in 1935. After college at Wesleyan University in Middletown, Connecticut, he earned his M.D. degree from the University of Virginia School of Medicine. He was a resident in anesthesiology at the Presbyterian Hospital in Philadelphia, one of several hospitals affiliated with the University of Pennsylvania, from 1961 through 1964. He then spent two years in the U.S. Navy. Upon completion of his military duties, Joe moved to Rochester for additional training in anesthesiology and earned his Master’s degree from the University of Minnesota. His mentors for his thesis were Drs. Dick Theye, Albert Faulconer, Ward Fowler, and Jack Michenfelder, a pretty star-studded group. His thesis was directed towards understanding the impact of common anesthetics and adjuvant drugs on whole body and cerebral oxygen consumption rates.
Joe was integrated into what was then, and was to remain, one of the most productive and visible neuroanesthesia groups in the world. He joined colleagues such as Drs. Jack Michenfelder, Kai Rehder, and Gerry Gronert. He was initially assigned to the cardiac group, but when Gerry was drafted into the Army, he was asked to transition to neuroanesthesia. Drs. Roy Cucchiara, and Ron Faust soon followed as members of the group, as did Drs. Leslie Milde and Bill Lanier. It was a remarkable period of discovery in neuroanesthesia. Drs. Thor Sundt, Ed Law, Frank Sharbrough, and others in neurosurgery and neurology contributed. Joe chaired the Section on Neuroanesthesia from 1978 through 1984. During that period he led the introduction of routine use of mass spectrometry into neuroanesthesia in Rochester, a project he and Dr. Duane Rorie expanded to all Rochester operating rooms during the mid-1980s when they chaired the Divisions of St. Marys Hospital Anesthesiology and Rochester Methodist Hospital Anesthesiology, respectively. Their strong support for mass spectrometry and the installation of pulse oximeters into every operating room during their division chair tenures led to advanced intraoperative monitoring that transformed the specialty and patient safety at Mayo Clinic.
Joe served as chair of the Division of St. Marys Hospital Anesthesiology from 1984 through 1988. He earned Teacher of the Year recognition in 1988 as he transitioned his clinical activities and leadership to the management of in-hospital pain. He was indefatigable in that role, starting a pain medicine fellowship and in-patient services at both Rochester hospitals. He chaired the Division of Pain Medicine until his retirement in 1997. He retired as a Professor Emeritus.
It is worth noting that Joe was a wonderful and gentle soul with an amazingly gracious bedside manner. That characteristic served him well throughout his career, whether in patient care or administrative leadership roles. He was president of the Minnesota Society of Anesthesiologists in 1977-1978. He currently resides in Rochester.
Mike Geisler completed his nurse anesthesia education at the Mayo School of Health Related Science in 1984. Before that, he worked at Rochester Methodist Hospital as an RN in the old "11-1 Unit" (Respiratory ICU) and then as the Head Nurse of the Plastic Surgery Unit. Mike's father served our country as a member of the Defense Intelligence Agency of the US Army, which influenced Mike's childhood by living in numerous places around the world. He and his family lived in Tehran, Iran, for three years, in Bangkok, Thailand, for four years, and in Frankfurt and Stuttgart, Germany, for eight years. He spent most of his childhood in other countries, exposed to various cultures and languages. Mike was fluent in Thai as a toddler.
Mike and his family returned to the US in time for him to complete his senior year of high school in Southern Pines, North Carolina. Two years after graduating from high school, in 1972, Mike received his military draft notice. He enlisted in the US Navy and served as a Corpsman with the US Marine Corps. As a corpsman, he became aware of the profession of nurse anesthesia by watching Navy CRNAs at work in the operating room. This exposure led him down his professional career path, which he enjoyed for 38 years.
In 1997, Mike was asked by Dr. Jeffry Steers, a Liver Transplant surgeon in Rochester, to assist him in organizing and educating a new Liver Transplant team for Mayo Jacksonville. Mike was an integral part of the Rochester anesthesia team and participated, along with Dr. Steve Rettke, in the first liver transplant in Rochester. When Dr. Steers approached Mike about relocating to Jacksonville, the Mayo Department of Anesthesiology in Jacksonville was comprised of approximately 10 CRNA's and 8 anesthesiologists. A short time after the formulation of the Liver Transplant Team, he was asked by Dr. Tim Lamer, Chair of the Department of Anesthesiology, to assume the position of Chief CRNA. As a result of the Mayo Jacksonville Liver Transplant program and subsequent heart and lung transplantation, the nurse anesthesia component of the Anesthesia Care Team grew to approximately 34 CRNAs. Mayo Jacksonville’s Liver Transplant Program evolved into the nation's most extensive and successful liver transplant program.
Mike has been recognized for his clinical expertise and contributions beyond the boundaries of Mayo Clinic. In 1999, he was awarded the American Association of Nurse Anesthetists’ Clinical Practitioner of the Year Award. Mike remained in the Chief CRNA position in Jacksonville until 2002. He subsequently followed his desire to return to clinical practice, retired from the Chief position, and returned as a staff member in the department. He retired from Mayo in 2007 but not from the practice of nurse anesthesia. In 2007, Mike and his wife Deb formed an anesthesia staffing group that provided anesthesia services to local surgery centers, oral surgery groups, and hospitals. In recognition of Guedel's teachings, the group was named "Stage II Anesthesia."
Mike continued providing anesthesia services until his retirement in 2022. He currently lives in Jacksonville, FL, on the Intracoastal Waterway within view of the Mayo Clinic campus. He enjoys fishing, sailing, playing guitar, and spending time with family, including three lovely grandchildren.
Mystery Photo Contest Winner
Last week’s contest winner was Sandy Simonson.
Here are this week’s Mystery Photos. Reminder: We are now featuring two individuals each week for the Updates. To be placed into the Mystery Photo Starbucks contest, you will need to correctly guess at least one of the featured individuals. If you identify both of them, you will double your chances of having your name drawn.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.
Update #37: - May 16, 2024 "The Department of Anesthesiology: Our Administrators"
Photograph: Jeff Korsmo, M.D., undated.
The Department of Anesthesiology: Our Administrators
The Mayo Clinic partnership between physicians, nurses, and other providers in leadership teams with administrators has proven to be a key reason for the institution’s long-term success. In essence, our medical leaders develop ideas to improve clinical care, education, research, and patient safety and satisfaction, sharing these ideas with our administrative partners. Our partners, with their broad wealth of knowledge about practices, personnel and financial issues, and healthcare delivery, bring their insights and projections to these developing proposals and work collaboratively to finalize them. Once approved, our administrative colleagues partner with our medical leaders to garner the appropriate resources and implement the proposals. The bonds our medical leaders form with our administrative partners often last a lifetime and spur others to work together.
Examples of key administrative leaders who have achieved the highest administrative roles in the institution after their time in our department include:
Jeff Korsmo. Jeff went on to serve as the Chief Financial Officer for Mayo Clinic Florida, executive director of the Mayo Clinic Health Policy Center, and Mayo Clinic’s Chief Administrative Officer, partnering with Dr. Denis Cortese in this latter role.
Bob Brigham. Bob went on to serve as the Chief Administrative Officer for Mayo Clinic Florida, partnering with Dr. George Bartley in this role.
Steve Jorgensen. Steve went on to serve as the Director and Chair of Education Administration, partnering with Mark Warner in his Executive Dean role.
Gwen Amstutz. Gwen continues to serve the institution, has been the administrative leader of the institution’s Surgical and Procedural Committee partnering with Dr. Brad Narr, chair of the Division of Surgical Administration, secretary of the institution’s Clinical Practice Committee, and currently is the administrative leader of the Harwick Project.
Natalie Caine. Natalie continues to serve the institution, has been chair of administration for the Department of Internal Medicine and currently is the Chief Administrative Officer in Rochester, partnering with Dr. Gianrico Farrugia.
Roshy Didehban. Roshy continues to serve the institution, has been chair of Practice Administration for the institution and currently is the Chief Administrative Officer in Arizona, partnering with Dr. Richard Gray.
Ajani (AJ) Dunn. AJ continues to serve the institution and currently is Chief Administrative Officer in Florida, partnering with Dr. Kent Thielen.
Mystery Photos
Last week’s Mystery Photos were David L. Brown, M.D. and Jeffrey J. Lunn, M.D.
David Brown, M.D. was born in Ames, Iowa and raised in Wayne, Nebraska. He received an appointment to the U.S. Military Academy to play football but turned that opportunity down to attend Iowa State University. It was clearly a good decision as Dave met his wife, Kath, while at Iowa State. He subsequently graduated from the University of Minnesota Medical School in 1978. He did his residency at Wilford Hall U.S. Air Force Medical Center in San Antonio and spent 11 years in the Air Force. During part of that period, he served as a flight surgeon with 319th Bombardment Wing of the Strategic Air Command in Grand Forks, North Dakota.
After his time in the Air Force, he joined the Virginia Mason Clinic in Seattle, Washington where he became chair in 1987 until he left in 1990 to join the Mayo Clinic. He spent seven years in Rochester and practiced both in the pain clinic and orthopedic group at Methodist Hospital. He left our institution in 1997 to become Professor and Chair of Anesthesia at the University of Iowa. During that time he rebuilt the department with additional staff and renewed energy in education and research. The same pattern occurred when he left the University of Iowa in 2004 to become Edward Rotan Distinguished Professor and Chair of the Department of Anesthesiology and Pain Medicine at the University of Texas, MD Anderson Cancer Center in Houston. Rebuilding academic anesthesia programs was in , and the pattern repeated again in 2008 when he accepted his final Chair position as the Professor of Anesthesiology, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. After reflecting on his institutional leadership changes, he came to believe what he enjoyed was the excitement of turning a department around.
During his academic time, Dave completed a number of books, one of which, Atlas of Regional Anesthesia, was awarded the Anesthesia Foundation book award in 1994; it is now in its 7th Edition. His research focused primarily on pancreatic cancer pain control, and he spent five years as Editor in Chief of Regional Anesthesia and Pain Medicine. ASRA also provided him opportunity as its president, and awarded him the Labat Award, and Distinguished Service Award. He also served in leadership roles for the American Board of Anesthesiology, the ACGME, the RRC for Anesthesiology, the Association of University Anesthesiologists, and FAER.
He retired clinically and academically in 2015 from the Cleveland Clinic to form a healthcare startup, Curadux. This provided individuals with advanced illness the benefit of a physician care guide walking alongside their consequential health decisions. The firm closed in 2020.
He and his wife, Kath, split their time between a small ranch in Texas, and the lake in Hayward, Wisconsin. He currently spends time addressing substance misuse on a local Ojibwe reservation and leads a small home church – Solid Rock Church.
Jeff Lunn, M.D. was born in 1952 in Bismarck, North Dakota. His primary interest in high school at Bismarck High related to sports. Jeff went to the National Junior Olympics in Knoxville, Tennessee in 1968 and ran in the 100-yard dash (yes, he is in an age group that came before track in the U.S. switched to the metric system). He also earned athletic recognition in football and basketball. Despite his obsession with sports in high school, he did graduate and go on to North Dakota State University, graduating in 1974. After completing medical school at the University of North Dakota and a surgical internship at the University of South Dakota, Jeff moved to Rochester and was an anesthesiology resident from 1980 through 1982. He then spent a year working with Dr. Duane Rorie as a Special Clinical Fellow in Duane’s lab. In addition to being certified in anesthesiology, he also holds a certificate in critical care medicine.
Jeff joined our staff in Rochester in 1983 and then subsequently joined Mayo Clinic in Arizona in 1992. From 1992 through 1998, Jeff served as the chair of the Department of Anesthesiology during its transition from working at Shea North Memorial Hospital (currently HonorHealth Scottsdale Shea Medical Center) to the new Mayo Clinic Hospital on the Phoenix campus. He also served as the chair of the Department of Critical Care Medicine at Mayo Clinic Arizona from 1996 through 1998. During his time in these leadership roles, Jeff and colleagues established our Preoperative Evaluation Clinic (1995) and the Department of Critical Care Medicine (1996). For the latter effort, he partnered closely with Dr. Joel Larson, his best “wing man” ever. While in Phoenix, Jeff was chair of the Mayo Clinic Arizona Clinical Practice Committee from 1994 through 1997.
In 2007, Jeff moved to Kingman, Arizona and joined the Kingman Regional Medical Center. It serves as the primary center for northwest Arizona and was one of the first medical centers to join the Mayo Clinic Care Network thanks to Jeff and his partnership with Jim Anderson, one of our leading administrators in Mayo Clinic Arizona at the time. While at Kingman, Jeff helped start the hospital’s cardiac surgical program and served in multiple leadership roles, including as Chair of Surgery, Vice Chief of Staff, and Chief Medical Officer. Jeff theoretically “retired” in January 2023 but still works intermittently in critical care medicine on contract.
Jeff and colleagues from Kingman Regional Medical Center formed a non-profit foundation in 2010. “Live Now.” This foundation provided surgical services at multiple locations in Tanzania. In addition, they became involved in the area near Lake Eyasi, Tanzania located at the southern border of Serengeti National Park and immediately southwest of the Ngorongoro Crater. Live Now has helped built a medical center and other facilities for members of the indigenous Hadzabe, Datoga, and Maasai people of that area.
Jeff and his wife, Barb, have finally returned to a lake home in northern Minnesota.
Mystery Photo Contest Winner
Last week’s contest winner was Marcia Belau.
Here are this week’s Mystery Photos. Reminder: We are now featuring two individuals each week for the Updates. To be placed into the Mystery Photo Starbucks contest, you will need to correctly guess at least one of the featured individuals. If you identify both of them, you will double your chances of having your name drawn.
Please email your response at warner.mark@mayo.edu within 3 days of this update. I will also need your name and contact information. All correct responses will be placed into a Monday morning drawing for a $10 Starbucks card. Only one winner per individual over the 80 weeks of Mystery Photos. If you win a weekly drawing, however, please keep submitting your responses. An overall winner (with the most correct responses in the series of 80 Updates) will receive a $100 Starbucks card.