This is No Humbug! is a collection of thirteen memoirs written by senior faculty of the Massachusetts General Hospital Department of Anesthesia, Critical Care and Pain Medicine. It tells many stories that together describe a rich, diverse and challenging culture of the hospital from which the gift of anesthesia was introduced to the world. The book is available by download, free of charge: This is No Humbug! (PDF)
Watch video: The History of Anesthesia
The Department of Anesthesia, Critical Care and Pain Medicine (DACCPM) at Massachusetts General Hospital traces its roots to October 16, 1846, when Boston dentist William Thomas Green Morton, in front of a crowd of skeptical onlookers, including the eminent Boston surgeon John Collins Warren, administered diethyl-ether vapors to a patient about to undergo a surgical operation. Moments later, the surgeon raised a scalpel and made an incision in the patient’s neck. To the audience’s astonishment, the patient did not scream. “Gentlemen,” the flinty Surgeon-in-Chief later stated, “this is no humbug.” At Mass General, which opened its doors in 1821, only one operation a week was performed in the years preceding the ether demonstration. After that historic event, surgery flourished as a field with new and complex operations.
In 1938, Mass General Chief of Surgery and Homans Professor of Surgery at Harvard Medical School (HMS) Dr. Edward Churchill decided to grow an academic Department of Anesthesia at Mass General. He sent a young Mass General surgeon, Henry Knowles Beecher, to Copenhagen with the support of a Moseley Traveling Fellowship to work in the laboratory of the Nobel Prize winner August Krogh. Churchill, whose own progress in operative thoracic surgery was limited by a lack of understanding of anesthesia and respiratory physiology, had sent Beecher to Krogh’s famous laboratory to learn about capillary gas exchange and the treatment of patients suffering from shock.
Beecher returned to Mass General on September 2, 1936 and was appointed Chief of the Anesthesia Service. Beecher proved quite a successful service administrator at Mass General, accepting his first resident in anesthesia in 1940. In July 1941, the Dean of HMS appointed Beecher to the Henry Isaiah Dorr Chair in Anaesthesiology, and created the first endowed Chair of Anesthesia in the United States. In 1943, Beecher went abroad for service with the US Army in the Harvard Medical/Surgical Unit, while Dr. Julia Arrowwood remained the acting Chief of the Anesthesia Service.
After Beecher returned from the war in 1945, the Department grew steadily. It remained a private practice and the Anesthesia Service was a component of the Department of Surgery. In October 1966, the Department established the first respiratory care unit in the United States, with Dr. Henning Pontoppidan, an anesthesiologist, serving as the Director. He pioneered therapy with prolonged mechanical ventilation, which led to major advances in postoperative care including an understanding of the physiological effects of positive end expiratory pressure. A cardiac anesthesia subspecialty group was established in the late 1960s.
In 1968, at Beecher's behest, Mass General administration created an independent Department of Anesthesia. In December 1969, the Departments of Anesthesia at Harvard (including the Beth Israel, Children’s Hospital, Peter Bent Brigham Hospital and Boston Lying In Hospital) were united into an independent Harvard Medical School Department of Anaesthesia.
Dr. Richard John Kitz was recruited from Columbia University to chair this department and held the post from September 1, 1969, until March 1994. Under his leadership, there was rapid growth from about 20 staff in 1970 to 80 staff in 1993, and the research, teaching and clinical areas of the Department flowered. He attracted many of the finest residents and clinicians to our Department, developed their leadership skills and produced 35-40 Chairpersons of Anesthesia in the country and the world, including approximately one-third of the oral examiners of the American Board of Anesthesiology.
Research into the pharmacology of the neuromuscular junction and the mechanisms of anesthesia action prospered at Mass General. Two endowed HMS chairs were added, the Edward Mallinkrodt Chair and the Reginald Jenney Chair. The hallmarks of the clinical staffing changes under Kitz were the further growth of subspecialty teams and the development of strong clinician team leaders. These teams include the cardiac, thoracic, general surgery, pediatric anesthesia, orthopedic, neuroanesthesia, and urology areas. Most of the anesthesiologists working in these areas are well known to the surgeons practicing these specialties and have learned the appropriate specialized skills. Problems of scheduling, perioperative preparation, and the like were often solved at the team level.
On April 1, 1994, after a national search, Dr. Warren M. Zapol became the third Chief of Anesthesia at the Mass General while holding the Reginald Jenney Professorship of Anaesthesia at Harvard Medical School. In 1996, the name of the Department was changed to the Mass General Department of Anesthesia, Critical Care and Pain Medicine. On April 1, 2008, Dr. Jeanine Wiener-Kronish became the fourth Chief of Anesthesia to lead the department. In June 2009, the department name changed to the Department of Anesthesia, Critical Care and Pain Medicine.