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Department of Anesthesiology
History of Anesthesiology
Did you know it started in Brooklyn?
Since you are contemplating anesthesiology as your chosen field, a brief history of this fascinating specialty should prove interesting and perhaps helpful in making this important decision.
The American Society of Anesthesiologists is unquestionably one of the most prestigious organizations in the medical profession, both nationally and internationally. Few, however, realize it had its origins in Brooklyn and even to this day remains a New York State corporation.
Dr. Adolph Frederick Erdman, in October 1905, gathered a group of nine area physicians who were practicing anesthesia as a medical specialty. They met at Long Island College Hospital -- the first medical school in the country -- and formed the Long Island Society of Anesthetists, whose purpose was to promote the art and science of anesthesia. Annual dues were set at one dollar.
By October 1911, interest in the society and its scientific endeavors had grown to the extent that a new constitution was instituted and the name was changed to New York State Society of Anesthetists. The first elected president was Dr. James T. Gwathmay. The dues had risen to three dollars per annum and the formal inauguration meeting was held at the New York Academy of Medicine. Although a state society in origin, it soon acquired nationwide prominence as membership requests from other states in the region poured in. In 1917, the New York State Society of Anesthetists, acting on behalf of its members, contacted the federal government to offer the services of organized anesthesia for the war effort.
Dr. Paul Wood in 1936 suggested the society become a national society to properly indicate its scope, and in December 1936, the American Society of Anesthetists became a reality. The Society was incorporated under the laws of the State of New York. In May of 1945, the term “anesthetist” was replaced by “anesthesiologist” and the American Society of Anesthesiologists (ASA) remains a New York State corporation to the present. On February 28, 1948, the New York State Society of Anesthesiologists (NYSSA) was incorporated as a separate entity and declared a component of the national society.
In the immediate post World War II period, there were three significant residency programs in Brooklyn: Jewish Hospital of Brooklyn, Maimonides Hospital, and St. Catherine's Hospital. Conspicuous in their absence were the medical school hospital (Long Island College Hospital [LICH]) and the College Division at Kings County Hospital. Anesthesia in the surgical operating rooms at the college hospital was primitive. Cyclopropane was administered for gastrectomies performed with cautery; the only precautionary measure taken was the ritualistic application of a wet towel along the patients breathing circuit. The surgical staff roamed the operating rooms in nonconductive, rubber-soled white buckskins. The Chief of Surgery (and Chairman of the medical school department of surgery) permitted (“supervised”) the administration of semi-closed ether in the presence of cautery. Difficult intubation fell to the surgical resident. The didactic portion of anesthesiology training for the medical student consisted of two lectures on pulmonary complications of anesthesia and their management.
In 1952, Merel H. Harmel, M.D. joined the staff of SUNY/Downstate Medical Center as Professor and Chairman of Anesthesiology. He immediately proceeded to recruit and train outstanding attending staff members. With him came many new and innovative techniques. State University Hospital of Brooklyn officially opened in 1966.
Along with providing quality patient care, the department introduced resident training, quality instruction of the medical students, research activities and, perhaps most important, the renaissance of quality assurance in the borough by strong meaningful affiliation programs with the major teaching hospitals. Case conferences, mortality reviews, and visiting professorships became part of an integrated continuing education program for all anesthesiologists of District I of the NYSSA long before CME and its mandates came into existence. The medical school department became the focus for all anesthesia related activities in District 1; it began what one might call the “Golden Age of Anesthesiology” for the district, both in terms of academic anesthesia and the politics of anesthesia.
Residency programs expanded, and medical students were permitted electives in anesthesia at affiliated hospitals. The College Hospital acquired a medical director as did Methodist Hospital and Coney Island Hospital. The Anesthesia Study Committee provided monthly case discussions at the Medical School, and this useful academic exercise was undoubtedly the forerunner of the quality assurance programs as they exist today.
Dr. Harmel was most fastidious and selective in his choice of resident and attending staff, many of whom carved their niche in the history of anesthesiology. Dr. Harmel left SUNY in 1968 to become the chair at Pritzker School in Medicine, Chicago. Many sought the appointment at SUNY, but Dr. Benton King was selected to replace Dr. Harmel. Dr. King first discovered the cardiac and cerebrovascular effects of anesthesics. Modern anesthesia ventilators and disconnect alarms were derived from department prototypes. When Dr. King felt he had his share of politics as chairman, he resigned the post but retained his professorship in the medical school and the department for many years. He served as Chief of Anesthesia at the Brooklyn VA Hospital until September 1990.
In 1979, Dr. James E. Cottrell, a noted neuroanesthesiologist, was recruited from New York University Medical Center to become Professor and Chairman, and to navigate the department through the changing tides of the specialty.
Since 1979, our residency program has grown from 13 to over 70 residents. Our graduates, who now number more than 800, practice in clinical and academic environments, ranging from rural areas to some of the most prestigious medical centers in the country. Research and teaching in anesthesia have flourished, adding to the prestige of the department.