Gertie F. Marx, M.D., the “Grande Dame” of obstetric anesthesia, died on January 25, 2004, at the age of 92. Also called the “mother of obstetric anesthesia” in recognition of her pioneering contributions, Gertie was known and revered on practically every continent.

ASA Past President James F. Arens, M.D., (1989) presents the 1988 Distinguished Service Award to Dr. Marx.

Born in 1912, in Frankfurt, Germany, Gertie obtained her primary and secondary education in her hometown, and in 1931, entered the Medical School of the University of Frankfurt. With the rise of Nazism, Gertie was forced to transfer to the University of Bern, Switzerland, from which she received an M.D. degree in February 1937. She immigrated to the United States two months later.

Her postgraduate training began with a rotating internship at Beth Israel Hospital in New York City. Women physicians were not exactly welcome in those days, and Gertie was accepted only after a male candidate backed out of his contract at the last minute. Thus she became the only female among 24 interns. Her four-month rotation in surgery proved decisive in her career choice. Not being strong enough to hold retractors during surgery, she was promptly relegated to anesthesiology, which was an integral part of the surgical rotation.

Although her original goal was to become a pediatrician, Gertie fell in love with anesthesiology. She applied and was accepted into the newly approved residency program at Beth Israel. Following her appointment to the attending staff at the same hospital, Gertie introduced the technique of caudal block, which she learned from Robert A. Hingson, M.D. This was the beginning of her devotion to regional anesthesia in obstetrics. Four years later, she officially became the Director of Obstetric Anesthesia and remained in that position until 1955 when she moved to the brand-new Albert Einstein College of Medicine in the Bronx. The obstetric service had not opened yet, and Gertie worked full-time in the surgical unit. She was even instrumental in starting the anesthetic program for open-heart surgery.

Only one and one-half years later was she able to return to her “true love,” taking care of parturients, teaching residents and pursuing clinical research. She excelled in all these endeavors until her retirement in 1995. In dealing with residents and her numerous fellows, Gertie was a demanding taskmaster but always willing to help them in difficult life situations. With many, she developed a lasting friendship. Her colleagues appreciated Gertie’s forthright personality and scrupulous honesty.

Among the many contributions Gertie made, three had the most profound and lasting effects on obstetric anesthesia practice, namely, acute hydration for prevention of postspinal hypotension, studies of the aorto-caval compression and the use of regional anesthesia for emergency cesarean sections. Gertie authored or co-authored approximately 150 original articles and 30 textbooks and book chapters. In 1981 she became the first editor of Obstetric Anesthesia Digest.

Gertie received numerous honors and awards, including the Distinguished Service Award from ASA in 1988 and from the American Society of Regional Anesthesia (ASRA) in 1990. The one she was most proud of was a medal from the Royal College of Anaesthetists presented to her by Queen Elizabeth II in 1993.

Mieczyslaw Finster, M.D., is Professor of Anesthesiology, Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, New York.