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This box of Squibb ether has a "hot"
history, but managed to make its way safely onto the
shelf in Dr. Conlay's office where it sits today.
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Almost 100 years ago, Harvey Cushing, M.D., married the measurement
of blood pressure (BP) to the anesthetic record, giving rise to
the field of monitoring in anesthesiology. Of course, the merits
of this new technology were not immediately appreciated by everyone.
The Harvard departments of surgery, for example, following a thorough
examination, determined that "the skilled finger was of much
greater value for determination of the state of the circulation
than any pneumatic instrument" and that the new data could
at best only confirm other information already available from
palpating the pulse and physical examination.1,2
Perhaps it is worth pointing out that some of our esteemed colleagues
still hold to this line of reasoning today. Yet this field has
blossomed – from just a finger on the pulse to continuously
monitoring the very essence of life itself with newer and seemingly
more sophisticated devices each decade!
As most of you know, the September issue of the ASA NEWSLETTER
is traditionally compiled by representatives of the Wood Library-Museum
of Anesthesiology (WLM). It seems only fitting that we dedicate
this issue to the history of monitoring, thus celebrating this
most important anniversary within our specialty. In her new role
as president of the WLM, Kathryn E. McGoldrick, M.D., recently
queried individuals for suggestions regarding future directions
for the organization. In response, John J. Savarese, M.D., recommended
cataloging the developments that lead to the technological devices
in use today, and the theme "Monitoring: The Story Behind
the Story" began to take shape. In this issue of the Newsletter,
authors describe the stories "behind the scenes" of
the earliest monitoring of the pulse, respiration and eye signs;
the development of monitoring at the neuromuscular junction; and,
of course, the ASA "Standards for Basic Intraoperative Monitoring,"
which are so very much a part of anesthetic practice today. It
also contains a wonderful pictorial review of monitoring artifacts,
many of which are on display in the WLM in Park Ridge, Illinois.
My own recent experience with memorabilia relates not to monitoring
but rather to a certain scorched medicine box previously belonging
to E.R. Squibb, M.D. It all began at a Christmas party when a
senior staff member brought a gift for our department's historical
collection at Temple University. It was a 40-odd-year-old can
of Squibb ether, in its original box, now topped with a big, red
bow. Evidently, the box had been housed in the staff basement
for many years. Some of our colleagues (clearly not "dyed
in the wool" antiquers) thought it was a bomb and suggested
that we call the hazardous materials squad, lest we all be incinerated
on the spot. I, of course, took the can (with bow) into protective
custody in my office where it now sits in a hallowed spot in my
bookcase.
Word of the new acquisition quickly spread via Christmas cards
from senior staff members to an alumnus, who also is a consultant
to the WLM and an old friend of the donor. He relayed advice from
the WLM: "Tell your chair that it is really a very good idea
to keep the bottle of Squibb ether in her office. Particularly
if she wants to redecorate. You see, Dr. Squibb also had a fire
in his office, which was thought to be due to his storage of ether."
Hence the scorched medicine box – now in my office –
is a constant reminder of our history and, hopefully, what we
can learn from it.
The lesson here: the resources of the good folks at the WLM are
seemingly limitless. I hope you enjoy the issue.
References:
1. Hirsch NP, Smith GB. Harvey Cushing. His contribution
to anesthesia. Anesth Analg. 1986; 65:288-293.
2. Crenner CW. Introduction of the blood pressure
cuff into U.S. medical practice: Technology and skilled practice.
Ann Intern Med. 1998; 128:488-493.
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Lydia
A. Conlay, M.D., Ph.D., is Professor and Chair, Temple University
School of Medicine, Philadelphia, Pennsylvania. |
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