Alex S. Evers, M.D.

he Foundation for Anesthesia Education and Research (FAER) will present the fifth annual FAER Honorary Research Lecture at the ASA 2005 Annual Meeting in New Orleans, Louisiana. FAER has created this annual lectureship as a means of recognizing outstanding scholarship by an anesthesiologist in an effort to encourage young anesthesiologists to consider careers in research and teaching, which are crucial if anesthesiology is to maintain its reputation as a medical specialty continuously striving for excellence in patient care.

This year’s selection is Alex S. Evers, M.D., the Henry E. Mallinckrodt Professor and Chair of Anesthesiology and Professor of Internal Medicine and Molecular Biology and Pharmacology at Washington University School of Medicine in St. Louis, Missouri. For more than 20 years, Dr. Evers has made novel and important contributions in several areas of basic science investigation, most notably in the area of mechanisms of anesthesia. His early work focused on inhalational anesthetic binding to proteins. Using nuclear magnetic resonance (NMR) spectroscopy he provided the first direct observation and characterization of reversible anesthetic binding to specific binding pockets on model proteins. A decade ago, Dr. Evers narrowed his focus to anesthetic steroids (also referred to as neurosteroids) because their high potency and complex structures allowed him to use biochemical methods to study their binding to protein targets in the brain, rather than just to model proteins.

Working with a multidisciplinary group of investigators (Douglas F. Covey, Ph.D., Joe H. Steinbach, Ph.D., and Charles F. Zorumski, M.D.) and funded by a National Institutes of Health (NIH) Program Project Grant, Dr. Evers has shed considerable light on the interactions of the anesthetic steroids with their principal protein target, the GABAA receptor. Specifically they have identified detailed mechanism of biophysical action, delineated structure-activity relationships and demonstrated the existence of two distinct sites of anesthetic steroid action on the GABAA receptor. Most recently his group has identified antagonists of anesthetic steroid action and is narrowing in on the precise binding sites for the anesthetic steroids.

Dr. Evers was born on June 15, 1952, in New York City, where he spent his early years. In 1970 Dr. Evers matriculated at Yale University where he completed his B.S. with honors in biology. He subsequently attended New York University Medical School, receiving his M.D. in 1978. During his college years, he initiated his lifelong interest in research, working on fatty acid biochemistry and publishing several peer-reviewed papers in the area. In medical school, he continued his research activity, working with Gerald Weissmann, M.D., on the use of calcium-sensitive dyes to detect changes in intracellular calcium. After graduation Dr. Evers completed a residency in internal medicine at Michael Reese Hospital in Chicago and briefly practiced internal medicine in Chicago. An abiding interest in critical care led him to pursue a residency in anesthesiology and a fellowship in critical care at Massachusetts General Hospital (MGH), which he completed in 1983.

Following his training at MGH, Dr. Evers returned to laboratory science as a research fellow with Philip Needleman, Ph.D., in the department of pharmacology at Washington University in St. Louis. His initial efforts focused on lipid mediators of inflammation; his work in this area produced several important papers, including the initial demonstration that leukotrienes were endogenously produced by the heart and a series of papers defining major changes in atrial arachidonic acid metabolism resulting from ventricular infarction. Studies examining essential fatty acid deficient (EFAD) animals led to the observation that changes in brain polyunsaturated fatty acid composition produced alterations in inhalational anesthetic potency. This observation ultimately led Dr. Evers to his longstanding interest in mechanisms of anesthesia. Indeed his first NIH grant in 1986 was based on using NMR spectroscopy to examine anesthetic interactions with normal and EFAD brain tissue.

In 1986 Dr. Evers started his own research laboratory in the department of anesthesiology at Washington University and also became the Medical Director of the Surgical Intensive Care Unit. During the ensuing years, he developed a successful and productive research laboratory and built his academic career by combining clinical anesthesiology and critical care with basic laboratory research. As a faculty member, he has mentored the careers of numerous medical students, graduate students, residents, post-doctoral fellows and anesthesiology fellows. In 1990 he was promoted to Associate Professor of Anesthesiology, Pharmacology and Internal Medicine and in 1994 to Professor. In 1994 Dr. Evers was appointed as the Henry Mallinckrodt Professor and Chair of the Department of Anesthesiology at Washington University. As department chair, he has helped to develop numerous faculty careers in academic anesthesiology and has built one of the most successful anesthesiology research programs in the United States.

Dr. Evers also made numerous contributions to the specialty of anesthesiology. He served as a member of the editorial board of Anesthesiology for nine years and is on the editorial boards of the Journal of Clinical Anesthesia and the Journal of Anesthesiology (Japan). He serves as a reviewer and editorial consultant for nine additional journals and is a member of a host of medical and scientific organizations. He has served on numerous ASA committees and is past president of the Association of University Anesthesiologists. He has authored more than 60 original articles and chapters and has held grants from NIH, the American Heart Association and several pharmaceutical companies and foundations. NIH has continuously funded his research for the past 20 years.

Dr. Evers continues to be active in all phases of academic life. He runs an active laboratory program, teaches medical students and residents both in the classroom and at the bedside, maintains a busy practice in critical care medicine and has a major commitment to departmental and university administration.

In addition to his work, Dr. Evers is devoted to Carol, his wife of 24 years, and to his three sons, Samuel, Jacob and Joseph. He also is an avid student of history and politics, a hiking and fishing enthusiast and an aspiring triathlete.
Dr. Evers’ lecture, “Anesthetic Steroids: Sites and Mechanisms of Action,” will be presented on Monday, October 24, from 2 to 3 p.m. in the La Nouvelle Orleans B-C of the Morial Convention Center.

Ronald D. Miller, M.D., is Professor and Chair, Department of Anesthesia and Perioperative Care, University of California-San Francisco.