Desai, Manisha S. MD; Desai, Sukumar P. MD
Humans are unique in possessing an awareness of the past. Although a study of history does not directly impact clinical care, it does serve several important functions. It provides written documentation of great contributions from the past and allows us to ascribe credit to individuals who deserve such recognition. This matter is particularly important to anesthesia historians as we are still debating the question about which individual deserves most credit for the discovery of anesthesia. History teaches us the nature of progress; unlike what we observe in the geopolitical arena, we learn from the past since advances in science and medicine clearly rely on earlier findings. History instills a sense of identity in individuals, institutions, groups, societies, and nations. It may bring pride and humility as we understand actions of our predecessors. In turn, such knowledge motivates us to strive toward great achievements as we recognize struggles and difficulties of the past as being similar to those of our own, thereby appreciating our common humanity.
Learning habits of the newer generation of trainees have been studied extensively, and results indicate that much information is acquired from sources that might be considered nontraditional. These include Web-based resources, multimedia formats, and peer-to-peer discussions.1,2 Time requirements for formal didactic sessions and self-study make it very difficult to impose additional topics onto an overburdened curriculum. This task is made even more arduous for history of anesthesia (HOA) because it does not directly impact clinical care, and topics related to it are not covered in written or oral certification examinations.
A recently published survey examined teaching of HOA in residency programs throughout the United States.3 With a response rate of 35% [46 of 132 residency programs], the results showed that 45% of programs included HOA-related lectures, 54% of programs had at least 1 faculty member with an interest in HOA, and 83% of programs that did not include lectures would be interested in inviting a visiting professor to deliver lectures about HOA. Moreover, 74% of programs would allow residents interested in HOA to devote 1 to 3 months to perform a suitable HOA research project.
With these encouraging signs, we sought to determine how informal HOA teaching could supplement an existing didactic schedule. We have prepared a listing of sites that are amenable to tours in Northeast United States, Georgia, and California and provide detailed descriptions. Next, we explore the utility of using historical narratives from popular literature to enhance the learning experience in HOA. Furthermore, especially for individuals who do not reside in close proximity to sites related to HOA, we provide information about movies and video productions to supplement information about HOA. Moreover, we subject this proposal to the scrutiny of the 6-step methodology for curriculum development advocated by Kern et al.4
Fitting into Established Curricular Models
Educator David Kern4 has proposed a 6-step approach to curriculum development, a model that has been used at the Department of Anesthesiology at University of Massachusetts Medical School. A panel discussion during the recently concluded 2013 International Symposium on the History of Anesthesia in Sydney, Australia, focused on approaches to generate interest in HOA within the millennial generation of residents and young faculty members. The purpose of a curriculum in an anesthesiology residency program could be narrowly defined as being preparatory for board certification, but a more comprehensive approach would include the development of cognitive and technical skills of a consultant. This would allow not only coverage of history but also other attributes and knowledge not covered by board examinations. Problems and needs are identified in step 1 of Kern et al.’s4 program. The relative exclusion of HOA-related didactic teaching within the curriculum is an obvious place for corrective action. A targeted needs assessment comprises step 2: Needs of residents and faculty, and a determination of the learning environment to be used for the proposed curriculum. Younger anesthesiologists welcome acquiring information from each of the modalities we describe: Tours, historical narratives or novels, and multimedia and movies.1,2 Goals and objectives are identified and enunciated in step 3. Broad goals include increasing awareness about HOA, especially with exposure using the modalities we describe. Mentoring of residents and faculty, with subsequent involvement in research projects, comprise specific advanced goals of this educational exercise. Comprehensive coverage of the wide body of knowledge that comprises HOA is beyond the scope of this article, but the initial exposure provided by these modalities can easily be supplemented by self-study and further inquiry. In step 4, educational strategies are developed to identify specific topics and materials that should be included in a comprehensive curriculum and also the methods best suited to present such material.
In our case, we begin with book reading and a HOA-related lecture during grand rounds in early August of the CA-1 year, followed by lectures and HOA-related movies several weeks later. A history-related tour is conducted during the following month. The tours are different each year, but a comprehensive coverage of sites is offered during a 3-year curriculum. In step 5, the challenge consists of identifying resources in personnel, facilities, and funding that are necessary for successful implementation of such a program of HOA-related education. Support from the department chairman is critical since valuable time and resources are required. Books and video material can be acquired without much difficulty, but organizing tours require guides, transportation, and a commitment of time, usually during weekends. Challenges in step 5 include obtaining administrative support within the department and institution, securing resources, addressing and overcoming barriers, and finally introducing and implementing the curriculum. The success or shortcomings of the curriculum are assessed during evaluation and feedback, which comprises step 6. This could be formal or informal, especially since the curriculum proposed here is informal. An additional step is that of dissemination, where our activities are described at scientific and educational conferences, and with the publication of descriptive and analytic work in peer-reviewed scientific journals.
Table 1 shows the results of the efforts of HOA research teams at the authors’ institutions starting 2010. The 28 individuals supervised by the authors included 1 certified registered nurse anesthetist, 2 registered nurse educators, 1 high school student, 1 graduate student, 6 medical students, 6 anesthesia residents, 2 anesthesia fellows, 1 librarian, and 8 faculty members. This work was presented at meetings such as those sponsored by the Anesthesia History Association, the History of Anaesthesia Society (United Kingdom), the International Symposium of the History of Anesthesia, or the Annual Meeting of the American Society of Anesthesiologists. Articles were published either in mainstream journals dedicated to our specialty (e.g., Anesthesiology, Anesthesia & Analgesia, or Journal of Clinical Anesthesia), the Bulletin of Anesthesia History, or as a book. Published surveys have shown that few anesthesia historians have received formal training in history5 and that there are few opportunities for obtaining formal training in HOA.6 The work performed by teams in the authors’ departments has been greatly assisted by staff at Wood Library-Museum of Anesthesiology (WLM); and by librarians, archivists, curators, and history enthusiasts at other institutions.
Historical Narratives and Novels (Fig. 1)
Popular books offer a unique way of imparting information about historical matters, be it the Civil War, the existence of slavery in the United States, genocide and other atrocities during wars, or the struggle for human rights and independence in nations throughout the world. More than 12 books have been written about various aspects of anesthesia and related clinical topics. Included in this list are those of interest to children,7 early medicine,8,9 biographical works that recognize major advances in medicine,10,11 works about the conquest of pain and introduction of anesthesia,12–20 discovery of specific agents,21 contributions by a specific individual,22 a class of drugs such as neuromuscular blockers,23 or the beginning of social acceptance of analgesia and anesthesia during childbirth.24
The books vary in ease of readability, primary topic, accuracy, length, errors, viewpoint, and documentation of sources used. One of the books17 was the basis of the Hollywood movie, The Great Moment, discussed in the next section. Most of the books are easy and quick to read and transpose the reader to the realm of anesthesia history. Making these books a part of the library collection in academic departments of anesthesia would provide access to residents and faculty members. Most of these books are no longer in print, but they are easy to acquire in the used-book market.
Movies and Video (Fig. 2)
While enjoyment of and learning from books require active participation from the reader, movies and video representations, like spectator sports, allow for a more passive role. A Hollywood movie The Great Moment, directed by Preston Sturges, 1944, celebrates the discovery of anesthesia and specifically depicts the life and role played by William TG (WTG) Morton.25 The tone of the movie is occasionally comic, and some viewers may not like the portrayal of an extremely important part of our heritage. A shorter and more effective source is a television series “You are There,” which depicted many historic moments including the discovery of anesthesia. This resource is available from the WLM. The use of ether spread rapidly to Europe after WTG Morton’s successful demonstration on October 16, 1846. Notable Scottish surgeon Robert Liston (1794–1847) was the first to perform surgery under modern anesthesia in Europe, on December 21, 1846. At the conclusion of the operation, he commented, “This Yankee Dodge beats mesmerism hollow.”26 A documentary video Yankee Dodge, produced by WLM, and narrated by Leroy David Vandam, contains much general information about the discovery of anesthesia.27 Another video, Ether Monument, by Rafael Ortega, describes the beautiful structure located in Boston Public Gardens, a celebration of the discovery of anesthesia that avoids the controversy about who discovered anesthesia by not mentioning the name of any individual.28
The room where the first successful public demonstration of ether anesthesia took place on October 16, 1846, has been preserved in near-original condition, with only minor repairs and enhancements.29–35 The amphitheater came to be referred to as Ether Dome sometime after 1925, was designated a U.S. National Historical Landmark on January 12, 1965, and was added to the U.S. National Register of Historic Places on October 15, 1966.36 Of the more than 80,000 places listed on the National Register of Historic Places, only 2430 are designated National Historic Landmarks. Such designation assures protection from development-related needs of modern hospitals, and actions by Massachusetts General Hospital (MGH) in preserving this facility and making it readily accessible is a boon to anesthesia history enthusiasts.37–40 Seats in the tiers of the amphitheater carry small plaques with names of prominent MGH physicians, and behind the podium hangs a painting Ether Day, by local artists Warren and Lucia Prosperi.41 The room houses period surgical instruments, the only witness to Morton’s demonstration, Padihershef42–44 (the first complete Egyptian mummy brought into the United States and gifted to the hospital in 1823 by Dutch merchant Jacob Van Lennep)45,46 and a statue of Apollo43,47 (son of Zeus, and father of the Greek God of Medicine, Aesclepius). The statue was a gift to MGH from Edward Everett,48 famous local statesman, Harvard University President, and the grand orator at the consecration of the National Cemetery at Gettysburg on November 19, 1863. An adjacent museum is filled with memorabilia related to the public demonstration of ether.
A 15-minute walk from MGH, at Boston Public Gardens (established in 1837 as the first public botanical garden in the United States), is the Ether Monument.28,49 A gift to the city of Boston by merchant Thomas Lee, in celebration of the discovery of ether, this 40-foot monument makes no mention of Morton, although it clearly recognizes his efforts. Ironically, it was dedicated on June 27, 1868, <3 weeks before Morton’s death, and after the death of benefactor Thomas Lee. This granite structure, full of allegoric representations, is topped by a statue of the Good Samaritan and scenes depicting the triumph of science, a wounded soldier in a field hospital, the angel of mercy descending to relieve suffering, and a patient undergoing an operation in a civic hospital adorn its 4 sides.49
Francis A. Countway Library of Medicine
Boston artist Robert Cutler Hinckley created a masterpiece, The First Operation Under Ether, in 1893, but his work was not appreciated, remained unsold, and rested in basements and storage spaces for many years.41,50 Surprisingly, it is presently regarded as one of the most famous paintings depicting a medical event and now graces the entry hall of Francis A. Countway Library of Medicine.51 The library displays include scores of portraits, including those of Henry Jacob Bigelow and John Collins Warren who were participants on Ether Day, and Crawford Williamson Long, the first to use ether during a painless surgical procedure on March 30, 1842, in rural Georgia. It is also the home of the Warren Anatomical Museum, a collection of >15,000 artifacts donated by John Collins Warren, the surgeon at the ether demonstration, and one of the founders of MGH. Warren donated his own body to this museum, which also includes original surgical instruments used during the famous operation, a replica of Morton’s ether flask, and a death mask of another individual who sought credit for the discovery of anesthesia, Hartford, Connecticut dentist Horace Wells.
Mount Auburn Cemetery
Across Charles River in Cambridge, Massachusetts, lies Mount Auburn Cemetery, the first landscaped cemetery in the United States.52–54 Established in 1825 by Joseph Bigelow, physician and horticulturalist, this oasis of peace and tranquility is the final resting place of many individuals connected with the discovery of anesthesia. Inspired by the design of Père Lachaise Cemetery in Paris, this cemetery’s name is derived from Oliver Goldsmith’s poem The Deserted Village.55 This horticultural landmark includes graves, tombs, and monuments of WTG Morton, Charles Thomas Jackson, Jacob and Henry Jacob Bigelow, Oliver Wendell Holmes (physician, author, and the person who suggested the term anesthesia and anesthetic in a letter to Morton), Charles F. Heywood (witness to the demonstration, and the surgical house-officer who delivered an invitation to Morton to provide anesthesia for the famous demonstration), Augustus A. Gould (witness to the demonstration, and the person who suggested to Morton that to avoid asphyxiating the patient, he ought to incorporate 1-way breathing valves in the equipment), Charles Bulfinch (architect of the MGH building that bears his name and houses the Ether Dome), Mrs. Frances Longfellow (wife of poet Henry Wadsworth Longfellow, and the first woman to receive anesthesia for labor and delivery in America), Joseph M. Wightman (designer of Morton’s ether flask), and Mary Elizabeth (Sawyer) Tyler (of Mary Had a Little Lamb fame, and nursing superintendent at McLean Hospital during Charles T. Jackson’s final years).
In 1845, WTG Morton purchased a gingerbread cottage in West Needham, MA, and it was variously known as Etherton Farm and Etherton Cottage.56,57 It had many Gothic style peaks and decorations, and children of the time would often refer to it as “The House of Seven Gables,” the title of a famous novel by local author Nathaniel Hawthorne. This was his home for >2 decades, until his death in 1868. It was here that Morton had conducted experiments on the efficacy of ether on animals and himself in 1845 and 1846. He lived here with his wife Elizabeth and their 4 children. On the premises of this impressive property is a plaque recognizing Morton’s achievements, and a nearby street is named after him.
Morton Homes and Artifacts in Charlton
Morton was born at home in Charlton, central Massachusetts, and his birthplace is preserved in near-original condition and serves as a private residence. The structure was damaged in a fire but was subsequently restored to functionality. At 8 years old, Morton’s family moved to a larger home in the same town.58 This house was previously owned by a successful merchant who dealt in leather goods, Mr. Nathaniel Waters, and the home is now preserved as the Waters–Morton Home. This structure too serves as a private residence. A nearby barn was used by Morton’s father for a farm machinery business, and young Morton is known to have helped in this enterprise. These 3 structures: Morton’s birthplace, the Waters–Morton Home, and the Red Barn, have been immortalized in a set of 4 watercolors (2 separate views of his birthplace) by Harvard anesthesiologist Leroy David Vandam.59 The originals were donated to the WLM, and copies as well as notecards may be obtained from the museum.
Horace Wells practiced dentistry, and several sites related to Wells are open to the public.60 A bronze statue honoring Horace Wells was created by Truman Howe Bartlett (1835–1921) and erected in Bushnell Park in 1875.61 The Connecticut Historical Society has many items of interest. These include a death mask, Wells’ personal diary, original copies of his writings and manuscripts,62 and a large silver coat of arms presented by the Spanish Dental Society. Several original manuscripts and writings are also in the collection of Hartford Medical Society, located at the University of Connecticut, Farmington, CT. The chapel at Trinity College has a pew that has a wood engraving honoring Wells, while Center Congregational Church has a magnificent stained glass panel by Tiffany with inscriptions, honoring Wells and recognizing his achievements. Horace and Elizabeth Wells were originally buried at Hartford North Burying Ground, but in 1908, their son Charles Wells reinterred their remains to a magnificent memorial at Cedar Hill Cemetery, Hartford, CT.60 Other landmarks honoring him include a plaque at the site of his dental office and the existence of his greatest fan club, the Horace Wells Club, whose membership is restricted to 40 dentists from the Hartford area.
MUSEUMS RELATED TO HISTORY OF ANESTHESIA IN UNITED STATES
Crawford Long Museum
Crawford Williamson Long [1815–1878] deserves credit for being the first person to use ether as an anesthetic during a surgical procedure on March 30, 1842.63 He was born in Danielsville, Georgia, and received medical education at the University of Pennsylvania. He practiced medicine in Jefferson, Georgia, a rural community approximately 60 miles from Atlanta. The Crawford Long Museum was originally established in a 2-story brick building in Jefferson, in 1957, at the original site where Long first performed surgery under ether anesthesia on March 30, 1842.64 The wooden structure that served as his office no longer exists. The museum was operated for the first 17 years by the Georgia Historical Commission, after which local citizens and physicians formed the Crawford Long Museum Association and took ownership. The museum underwent major renovations in 1979, and again in 1987, supported by contributions from the Medical College of Georgia and also from the Georgia Society of Anesthesiologists. Two adjacent buildings allowed expansion of the museum, and in 2007, the association transferred all assets to the City of Jefferson, which in turn received a Rural Development Grant from the U.S. Department of Agriculture. After extensive renovations, the museum reopened in early 2010 and consists of a main gallery that contains displays about the development of anesthesia, the long gallery that contains family heirlooms, an Apothecary shop, and the Pendergrass general store. Artifacts of note include Long’s medicine case that contain packets labeled in his handwriting, an amputation kit, his pocket instrument case, and a gold pocket watch made from Dahlonega gold. The home in which he was born is located in Danielsville, about 30 miles away. Long’s burial site is located nearby in Athens, GA, and makes for a moving and memorable visit.
Wood Library-Museum of Anesthesiology, Park Ridge, Illinois
Recognized as one of the finest and most comprehensive repositories of materials related to history of anesthesiology, this institution was founded by Paul M. Wood, MD(1894–1963), who donated his personal collection of rare books, instruments, and artifacts. It was housed in various locations in New York between 1937 and 1963, when the collections moved to Park Ridge, Illinois.65 In 1971, the museum merged with the American Society of Anesthesiologists, and in 1987, it established itself as a nonprofit corporation dedicated to the historical, educational, and archival preservation of the heritage of anesthesiology. Its main library houses journals related to our specialty, and a collection of >13,000 books. Its John W. Pender Living History multimedia collection consists of hundreds of audio and video recordings that include interviews with leading anesthesiologists who have contributed much to the development of anesthesiology. The K. Garth Huston, Sr., MD, Rare Book Room, honoring this noted bibliophile-anesthesiologist, includes illustrations, letters, manuscripts, and related artifacts. More than 200 rare books have been digitized as part of an ongoing project, and the WLM website has undergone considerable enhancement to enable the most of its collections to be viewed online. Museum archives include collections from Paul M. Wood as well as those of the American Society Anesthesiologists. The museum has hundreds of items related to airway management, anesthesia machines, monitoring equipment, inhalers, pharmaceuticals, and other memorabilia. Moreover, its collections include articles of many noted anesthesiologists and anesthesia-related organizations. New American Society Anesthesiologists headquarters are currently under construction, and WLM will remain in transition until its move in 2014 to a more spacious and modern facility in Schaumburg, Illinois.
Arthur E. Guedel Memorial Anesthesia Center, San Francisco, California
Founded in 1963, the center celebrates the life of this pioneer anesthesiologist who moved to California in 1928, after having practiced medicine and anesthesiology in Indiana.66–68 Arthur Guedel (1883–1956) became Professor of Anesthesia at the University of Southern California in Los Angeles and performed clinical research and innovations to improve anesthetic equipment. The center was established due to the generosity of his family and the enthusiastic support of history enthusiasts, led by William Neff, Chairman at the Department of Anesthesiology at Stanford University, and Chauncey Leake, Professor of Pharmacology at the University of California, San Francisco, who had worked with Ralph Waters at the University of Wisconsin. In addition to journals and books related to history of our specialty, the center has a great collection of artifacts and videographic material related to Richard Gill’s (1901–1958) Latin American expeditions and pioneering work on curare.
International Museums Related to History of Anesthesia
Anaesthesia Heritage Center, London, United Kingdom
The Anaesthesia Heritage Center contains the archives of the Association of Anaesthetists of Great Britain and Ireland.69,70 Its library contains a complete set of the journals Anaesthesia and British Journal of Anaesthesia. In addition, it has audiovisual collections, pamphlets, and rare books. Its archives include personal collections and images of events and artifacts related to the history of anesthesiology. The museum has an excellent collection of early equipment used in anesthesia and resuscitation. Individuals wishing to explore buildings related to history of anesthesiology may take a brief walk around London and visit several sites described in a leaflet created by the Anaesthesia Heritage Centre. These include offices of Joseph Lister, famous for the concept of antisepsis, but also a strong supporter promoter of anesthesia and safety in the operating room. One may visit the home of Francis Booth, a member of University College Hospital’s Council, and the individual who first received word about the successful use of ether as an anesthetic on October 16, 1846. Booth informed surgeon Robert Liston about this, and also dentist, James Robinson. Robinson administered the first anesthetic for dental extraction in England on December 19, 1846, while medical student William Squire was the first to administer ether for a surgical procedure on December 21, 1846, when Robert Liston performed an amputation. The operation took place at University College Hospital.71 John Snow is recognized as the first physician to devote full-time service to the specialty of anesthesiology.72–74 Having figured out the source of contaminated water, he is also credited for determining the etiology of a cholera epidemic in London.75 A pump on Broad Street was implicated, and although John Snow was a teetotaler most of his life, a nearby pub is named after him.
Geoffrey Kaye Museum of Anaesthetic History, Melbourne, Australia
Geoffrey Kaye (1903–1986) played a major role in the development of anesthesiology in Australia.76 He was influenced by Francis McMechan who advocated the formation of professional associations of anesthesiologists throughout the world. Kaye formed the Australian Society of Anaesthetists and served as its first secretary. He was also a great collector of anesthesia-related equipment, and he established a teaching program for undergraduates at Melbourne University in 1946 and displayed his collection of historical equipment. In 1951, he established the society’s headquarters in Melbourne and set aside a room as a museum. Over the ensuing years, disagreements with other members of the society led him to sever all ties with it, but a rapprochement was reached decades later in 1984 The Geoffrey Kaye Museum of Anaesthetic History is located at the headquarters of the Australian and New Zealand College of Anaesthetists in Melbourne and holds an impressive collection of early anesthesia equipment, lecture notes, research material, and related artifacts.77,78 Kaye believed in using equipment displays to engage an audience of students, practitioners, and the lay public and develop in them an appreciation and understanding of anesthesiology. Equipment and displays adorn the museum, and in 2012, the Australian Society of Anaesthetists published a beautifully illustrated book about the many topics related to the development of the specialty.79
Horst-Stoeckel Museum of the History of Anaesthesia, Bonn, Germany
In 1974, Horst Otto Stoeckel (1930) was appointed as the first chairman at the Department of Anesthesiology at the University of Bonn. His successful work led to his being elected Dean of the School of Medicine in 1981. Although much of his research effort concerned pharmacology, he was a keen collector of anesthesia equipment, and he founded his museum in 1995 with 350 items. The museum was dedicated in 2000, by which time the collection exceeded 1000 items which were arranged in several dozen glass display cases.80,81 This collection is unique in that much of the equipment has been restored to functional status. The library includes 14,000 books and journals, and the museum has recreated an operating room from 1930. Many items from World War I and II are included in their display, as are many vials and containers with drugs. Monitoring equipment includes modern machines for total IV anesthesia and recording of electroencephalography signals.
Japanese Museum of Anesthesiology, Kobe, Japan
Opened on May 19, 2011, this museum was founded in Kobe, Japan, by Professor Akitomo Matsuki under the auspices of the Japanese Society of Anesthesiologists. It is located at the headquarters of the society and is divided into 3 sections: Archives, museum, and library. The archives preserve historical documents and photographs related to the Japanese Society of Anesthesiologists. The museum displays drugs, equipment, monitors, and other artifacts related to our specialty. The collections at the library include several thousand books and periodicals in Japanese and other languages. Most book collections have been obtained through the generosity of donors. The museum exhibits include a juxtaposed recreation of an older operating room alongside a modern one. Visitors are encouraged to manipulate controls of anesthesia machines that use compressed air instead of oxygen and nitrous oxide for reasons of safety. An unusual feature of this museum is a deliberate attempt at outreach into the community. This program includes regular visits from school children who learn about anesthesia and the history of its development in Japan. Their website and information brochures are in Japanese, and this article is the first coverage received by this museum in the English language.
As much from necessity as from the nature of the subject matter, history lends itself extraordinarily well to teaching outside the lecture room, be it during one-on-one discussions in the operating room, journal clubs, informal gatherings, or from the modalities presented in this article: popular novels, movies tours, or visits to museums. Each of these modalities exposes one to historical events and individuals from a slightly different perspective such that combining them results in a synergy that expands our understanding and appreciation of how events occurred in the past, and how individuals or institutions reacted to these events. Tours enhance this experience further by giving participants a real-life experience of structures and artifacts related to the individuals who shaped key moments in the development of our specialty. Unfortunately, sites related to the discovery of anesthesia in the United States are confined to New England and Georgia. The geographical barriers posed by this can be partly overcome by creation of high-quality video tours, similar to those created by documentary programs by a variety of media and nonprofit organizations. Were this to occur on a larger scale, enthusiasts could remotely experience virtual tours of sites in Jefferson, Georgia; Hartford, Connecticut; as well as those in Boston, Cambridge, Charlton, and Wellesley in Massachusetts.
Several scholarly publications provide a comprehensive overview of most of the major events that have shaped our specialty. One of the foremost was written by Thomas E. Keys, who served as Librarian at Mayo Clinic, Rochester, MN. His classic text and other informative works require dedication not to be found in the average trainee or clinician, wishing to get a brief exposure to the history of our specialty.79,82,83 A current research project that is beyond the scope of this article is intraoperative teaching of a variety of topics related to the development of monitors, airway equipment, gas delivery systems, and the many drugs we use routinely. Residents can be challenged to imagine how clinical signs were monitored when explosive agents were used, or how they would assess adequacy of circulation and respiration in the absence of pulse oximetry, capnography, agent monitoring, electrocardiography, or noninvasive blood pressure monitors. In addition, they could try to design a vaporizer that would deliver an accurate amount of a volatile anesthetic.
Our proposal to teach HOA using these modalities is only a small beginning that can be part of a more comprehensive program of education related to HOA. At University of Massachusetts Medical School, residents attend a lecture about HOA and are given a copy of Julie Fenster’s book Ether Day84 very shortly after commencing residency training. A month later, they view the movie The Great Moment. Several weeks later, they are taken on a history-related tour that covers some of the sites described here. The sites near Massachusetts and Connecticut are grouped into 3 separate tours, 1 held each year such that graduating residents would have had the opportunity to attend each of the 3 separate tour itineraries. These activities have been academically beneficial to members of our department who have participated in research projects related to HOA. Such efforts have resulted in presentations at scientific meetings at the regional, national, and international level and publication of articles in peer-reviewed journals.
The American Historical Association has published a book about teaching history using films and television, and museums are routinely used as a means of exposing school-aged children to history.85,86 Whether one studies history as an academic endeavor, or as a means to learn about how our specialty developed, or as a means of recognizing and celebrating major events and individuals related to the birth of our specialty, 1 fact remains clear: anesthesiology is the only specialty uniquely developed in America. Events related to its birth took place during a narrow10-year period in the 1840s, with most of the activity taking place in New England. We ought to be justly proud of these achievements, but the existential question persists—if we do not consider it fit to recognize the importance of these events and study them further, why should others?
Name: Manisha S. Desai, MD.
Contribution: This author helped design the study, conduct the study, and write the manuscript.
Attestation: Manisha S. Desai approved the final manuscript.
Name: Sukumar P. Desai, MD.
Contribution: This author helped design the study, conduct the study, and write the manuscript.
Attestation: Sukumar P. Desai approved the final manuscript.
This manuscript was handled by: Steven L. Shafer, MD.
1. Oblinger DG, Oblinger James L Educating the Next Generation. 2005 e-Book Educause
2. Prensky M. Digitial natives, digital immigrants. On the Horizon. 2001;9:1–6
3. Desai MS, Chennaiahgari SR, Desai SP. The teaching of anesthesia history in US residency programs: results of a nationwide survey. J Clin Anesth. 2012;24:101–3
4. Kern DE, Thomas PA, Hughes MT Curriculum Development for Medical Education: A Six-Step Approach. 20092nd ed Baltimore, MD The Johns Hopkins University Press
5. Desai SP, Buterbaugh J, Desai MS. The making of an anesthesia historian: lessons from a worldwide biographical survey. Anesth Analg. 2011;113:383–6
6. Desai KR, Desai SP. Training to be an historian of anesthesia: options at universities in the United States. J Clin Anesth. 2013;25:367–70
7. Shapiro I The GIft of Magic Sleep: Early Experiments in Anesthesia. 1979 New York, NY Coward, McCann & Geoghegan, Inc
8. Ellis ES Ancient Anodynes-Primitive Anaesthesia and Allied Conditions. 1946 London, UK Wm Heinemann Medical Books, Ltd.
9. Flexner JT Doctors on Horseback–Pioneers of American Medicine. 1939 New York, NY Garden City Publishing, Inc
10. Nuland SB Doctors-The Biography of Medicine. 1995 New York, NY Vintage Books/Random House, Inc.
11. Haggard HW Devils, Drugs & Doctors-The Story of the Science of Healing from Medicine-Man to Doctor. 1946 New York, NY Pocket Books, Inc.
12. Youngston AJ The Scientific Revolution in Victorian Medicine. 1979 New York, NY Holmes & Meier Publishers, Inc
13. Snow SJ Blessed Days of Anaesthesia, How Anaesthetics Changed the World. 2008 Oxford, UK Oxford University Press
14. Robinson V Victory Over Pain-A History of Anesthesia. 1947 London, UK Sigma Books Limited
15. Raper HR Man Against Pain-The Epic of Anesthesia. 1945 New York, NY Prentice-Hall, Inc.
16. Ludovici LJ Cone of Oblivion-A Vendetta in Science. 1961 London, UK Max Parrish and Co
17. Fulop-Miller R Triumph Over Pain: The Story of Anesthesia-Translated by Eden and Cedar Paul. 1938 New York, NY: Literary Guild of America
18. Fradin DB We Have Conquered Pain-The Discovery of Anesthesia. 1996 New York, NY McElderry Books
19. Fenster JM Ether Day. 2001 New York, NY HarperCollins
20. Bankoff G The Conquest of Pain-The Story of Anaesthesia. 1939 London, UK Macdonald & Co. (Publishers) Ltd.
21. Stratmann L Chloroform-The Quest for Oblivion. 2003 Gloucestershire, UK Sutton Publishing Limited
22. Baker R Dr. Morton-Pioneer in the Use of Ether. 1946 New York, NY Julian Messner, Inc.
23. Smith P Arrows of Mercy. 1969 Garden City, NY Doubleday & Company Inc.
24. Caton D What a Blessing She Had Chloroform. 1999 New Haven, CT Yale University Press
25. Preston Sturges (Director), Rene Fullop-Miller (Screen Writer), Joel McCrae (cast), and Betty Field (cast). The Great Moment (in Black and White). 1944 Universal Studios Ref Type: Motion Picture
26. Cock WF.. The first operation under ether in Europe. University College Hospital Magazine. 1911;1:127–144 Ref Type: Magazine Article
27. Leroy D., Vandam (Narrator). The Yankee Dodge. Wood Library-Museum of Anesthesiology. 1990 Ref Type: Motion Picture
28. Ortega R. Ether monument: a story of beauty and controversy. Wood Library-Museum of Anesthesiology. 2009 Ref Type: Audiovisual Material
29. Bull W, Bull M Something in the Ether: A Bicentennial History of Massachusetts General Hospital, 1811–2011. 2011 Beverly, MA Memoirs Unlimited
30. Bowditch NI A History of Massachusetts General Hospital (to August 5, 1851). 1872 Boston, MA Trustees from the Bowditch Fund
31. Barker FG 2nd. The Massachusetts General Hospital. Early history and neurosurgery to 1939. J Neurosurg. 1993;79:948–59
32. Washburn F The Massachusetts General Hospital-Its Development, 1900–1935. 1939 Boston, MA Houghton Mifflin
33. Unknown Memorial & Historical Volume, Together with the Proceedings of the Centennial of the Opening of the Hospital. 1923 Boston, MA Massachusetts General Hospital
34. Eaton LK. Charles Bulfinch and the Massachusetts General Hospital. Isis. 1950;41:8–11
35. Cabot RC The Achievements, Standards, and Prospects of the Massachusetts General Hospital: Ether Day Address, 1919. 1913 Boston, MA Massachusetts General Hospital
36. Leake D. First anesthesia site made national shrine. Anesth Prog. 1966;13:66–70
37. Larson EC. WTG Morton and Ether Dome. JAMA. 1965;194:1151–6
38. Siker ES. The Ether Dome: Robert C. Hinckley and the recreation of the first operation under ether. JAMA. 1994;271:1623–4
39. Newsom B. Sesquicentennial of the ether dome. J S C Med Assoc. 1996;92:441
40. Cummings CA. Illustrations of some of his (Charles Bullfinch’s) work: interiors of Massachusetts State House, University Hall, Harvard College, Massachusetts General Hospital. Architectural Review (Boston). 1894;3:18–21
41. Desai SP, Desai MS, Maddi R, Battit GE. A tale of two paintings: depictions of the first public demonstration of ether anesthesia. Anesthesiology. 2007;106:1046–50
42. Haynes J, Wilson RJ Padihershef: The Egyptian Mummy. 1984 Springfield, MA George Walker Vincent Smith Art Museum
43. Mifflin J.. Archivists and Artifacts: The Custodianship of Objects in an Archival Setting (Originally published in Archival Elements, Summer 2003). Archives and Social Studies. 2007;1:605–22
44. Unknown Exhibiting for the Benefit of the Massachusetts General Hospital. The Egyptian Mummy, Belonging To The Boston Medical College, Received from Ancient Thebes, Through Mr. Lee, British Consul at Alexandria. Presented by Messrs. van Lennep & Co., of Smyrna. 1823 New York, NY Wm. Grattan
45. Lennep MFvMF Het Leven van Mr. Jacob van Lennep/Door M.F. van Lennep (2 volumes, in Dutch). 1910 Amsterdam P.N. van Kampen
46. Schmidt J From Anatolia to Indonesia: Opium Trade and the Dutch Community of Izmir, 1820–1940. 1998 Istanbul Nederlands Historich-Archaelogisch Instituut te Istanbul
47. Marryat F A Diary in America: With Remarks on its Institutions. 1839 New York, NY W.H. Colyer
48. Frothingham PR Edward Everett: Orator and Statesman. 1925 Boston, MA Houghton Mifflin Company
49. Ortega RA, Kelly LR, Yee MK, Lewis KP. Written in granite: a history of the Ether Monument and its significance for anesthesiology. Anesthesiology. 2006;105:838–42
50. Wolfe RJ, Robert C Hinckley and the Recreation of the First Operation Under Ether. 1993 Boston, MA The Boston Medical Library in the Francis A. Countway Library of Medicine
51. Garland JE. Editorial: centennial salute to Boston medical library. N Engl J Med. 1975;293:874–5
52. Bigelow J A History of the Cemetery of Mount Auburn. 1859 Cambridge, MA James Munroe and Co.
53. Cooper B, Desai SP. Mount Auburn Cemetery and its importance to the history of anesthesia. Bull Anesth Hist. 2012;30:25–9, 32
54. Linden BMG Silent City on a Hill. 2007 Amherst, MA University of Massachusetts Press
55. Goldsmith O Poems, Plays, and Essays by Oliver Goldsmith. 1884 Boston, MA Thomas Y. Crowell & Co.
56. Morton, Elizabeth W. The discovery of anaesthesia. Dr. W.T.G. Morton and his heroic battle for a new idea-How painless surgery began fifty years ago. McClure’s Magazine. 1896;7:311–318
57. Hinchliffe EM Five Pounds Currency, Three Pounds of Corn-Wellesley’s Centennial Story. 1981 Wellesley, MA Town of Wellesley
58. Rice N Trials of a Public Benefactor. 1858 New York, NY Pudney and Russell
59. Van Dam SW Roy Vandam: Life and Art. Brunswick. 2006 Maine, ME Woodworth Associates
60. Aponte-Feliciano A, Desai SP, Desai MS. Sites and artifacts related to Horace Wells in Hartford, Connecticut. Anesth Analg. 2013;117:500–6
61. Ortega RA, Lewis KP, Hansen CJ. Other monuments to inhalation anesthesia. Anesthesiology. 2008;109:578–87
62. Wells H A History of the Discovery of the Application of Nitrous Oxide Gas, Ether, and Other Vapors, to Surgical Operations. 1847 Hartford, CT J.G. Wells
63. Taylor FL, Crawford W Long & The Discovery of Ether Anesthesia. 1928 New York, NY Paul B. Hoeber, Inc.
64. Mandabach MG, Wright AJ. On the Georgia trail of Dr. Crawford Long. Newsletter of the American Society of Anesthesiologists. 2010;74:34–5
65. Betcher AM. Historical development of the library-museum. Anesthesiology. 1961;22:618–35
66. Calmes SH. The past relation between the CSA, the Wood-Library museum, and the Guedel center. Bulletin of the California Society of Anesthesiologists. 1993;42(1):9–11
67. Calmes SH. History of the Arthur E. Guedel memorial anesthesia center. Newsletter of the California Society of Anesthesiologists. 2003;52(4):37–8
68. Calmes SH. Anesthesia Heritage outside the WLM: Arthur E. Guedel Memorial Anesthesia. Newsletter of the American Society of Anesthesiologists. 2007;71:25–7
69. Boulton TB. The association of anaesthetists of Great Britain and Ireland 1932–1992 and the development of the specialty of anaesthesia. Sixty Years of Progress and Achievement in the Context of Scientific, Political and Social Change. 1999 London, UK The Association of Anaesthetists of Great Britain and Ireland
70. Wilkinson DJ. A. Charles King: a unique contribution to anaesthesia. J R Soc Med. 1987;80:510–4
71. Ellis RH. Robert Liston’s letter to Dr. Francis Boott: its reappearance after 135 years. Anesthesiology. 1985;62:331–5
72. Ellis RH The Case Books of John Snow. 1994 London, UK Wellcome Institute for the History of Medicine
73. Shephard DAE John Snow: Anaesthetist to a Queen and Epidemiologist to a Nation. 1995 Cornwall, Prince Edward Island, Canada York Point Publishing
74. Ashcroft A John Snow-Victorian Physician. Medicine in Northumbria: Essays on the History of Medicine in the North East of England. 1993 Newcastle-upon-Tyne The Pybus Society for the History and Bibliography of Medicine:246–60
75. Vinten-Johansen P, Brody H, Paneth N, Rachman S, Rip MR Cholera, Chloroform, and the Science of Medicine: A Life of John Snow. 2003 Oxford Oxford University Press
76. Wilson G. Obituary: Geoffrey Kaye 1903–1986. Anaesth Intensive Care. 1987;15:107–9
77. Maltby JR. The Geoffrey Kaye museum of anaesthetic history-Geoffrey Kaye (1903–1986). Notable Names in Anaesthesia. 20132nd ed Gloucester, UK Choir Press:98–100
78. Penn HP. The Geoffrey Kaye anaesthetic museum. Anaesth Intensive Care. 1972;1:106–8
79. Ball CM, Westhorpe RN Historical Notes on Anaesthesia and Intensive Care. 2012 Edgecliffe, NSW, Australia Australian Society of Anaesthetists
80. Kovac A. Horst Otto Stoeckel: clinician, researcher, administrator, museum collector. Anesthesiology. 2011
81. Stoeckel HSchuttler J. The Horst-Stoeckel museum for the history of anaesthesia in Bonn. 50th Anniversary of the German Society for Anaesthesiology and Intensive Care Medicine. 2012 Berlin, Germany Springer-Verlag GmbH:83–6
82. Keys TE The History of Surgical Anesthesia. 1978 Huntington, New York, NY Robert E. Krieger Publishing Company, Inc.
83. Sim P The Heritage of Anesthesia. 2012 Park Ridge, IL Wood Library-Museum of Anesthesiology
84. Fenster J Ether Day. 2001 New York, NY HarperCollins Publishers Inc.
85. O’Connor JE Teaching History with Film and Television. 1987 Washington, DC American Historical Association
86. Marcus AS, Stoddard JD, Woodward WW Teaching History with Museums: Strategies for K-12 Social Studies. 2011 New York, NY Routledge