Douglas R. Bacon, M.D., M.A.

his year’s distinguished Lewis H. Wright Memorial Lecturer will be Douglas R. Bacon, M.D., M.A., Professor of Anesthesiology and History of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota. Dr. Bacon graduated with a B.A. in History and a B.S. in Medicinal Chemistry from the State University of New York at Buffalo (SUNY AB) in 1981. He received his medical degree from the State University of New York at Stony Brook in 1985. In medical school, Dr. Bacon became interested in anesthesiology while doing a summer preceptorship sponsored by ASA. He returned to Buffalo to complete his residency in 1989. After graduation, he joined the faculty at SUNY AB as a cardiac anesthesiologist. In 2000 he left the cold winters of Buffalo for the colder winters of Rochester, and he settled at an institution full of historical overtones, the clinic founded by the Mayo brothers.

As a junior staff member at SUNY AB, Dr. Bacon was awarded three Paul M. Wood Fellowships at the Wood Library-Museum of Anesthesiology in Park Ridge, Illinois. A paper he presented at the Anesthesia History Association Meeting in 1990 became the cornerstone for a master’s degree in history from SUNY AB. His thesis was titled “American Anesthesiology in the 1920s and ’30s.” While at SUNY AB, Dr. Bacon’s scholarly work looked at clinical topics such as “Adriamycin-Induced Cardiomyopathy” and “Epidural Postoperative Analgesia in Cancer Patients.” He also became intrigued with the founding fathers of American anesthesiology: John S. Lundy, M.D., Ralph M. Waters, M.D., Emery A. Rovenstine, M.D., and Henry K. Beecher, M.D. These men not only trained many anesthesiologists, but they trained many leaders in anesthesiology.

This year’s Wright Memorial Lecture is titled “From the Crow’s Nest — Reflections on 100 Years of ASA History.” It takes its name from Dr. Bacon’s monthly column in the ASA NEWSLETTER as NEWSLETTER editor since January 2004. The talk will highlight certain critical events in the history of ASA and show how these events shaped both anesthesiology and the practice of medicine. On October 6, 1905, Adolph Frederick Erdmann, M.D., and a group of nine men met at the Long Island College Hospital. In Dr. Erdmann’s words: “There are a few physicians practicing anesthesia in the area and these men ought to get together and form a society … thus is born the Long Island Society of Anesthetists, (from which stems the ASA and organized anesthesia in this country) … the object of the new society is to promote the art and science of anesthesia … eligibility is accorded any local or visiting anesthetists, or any other regularly qualified physician whose particular interests are centered in anesthetics … a nostalgic fee of $1 is set for annual dues.” Today there are more than 40,000 ASA members!

During World War II, ASA and its members played a significant role in preparing the military medical corps for combat duty. General physicians were taught the basics of anesthesia. A generation of surgeons and patients grew to appreciate the importance of a skilled and specialized physician anesthetist. From this turn of events, residency positions in anesthesiology became popular well into the 1950s.

The 1960s saw two significant events in the history of ASA: the creation of the anesthesia summer preceptorship for medical students and the development of the Relative Value Guide (RVG). By the early 1960s, there was a decline in medical student interest in anesthesiology. Out of this need, the anesthesia summer preceptorship was established. This program paid medical students a stipend to work with an anesthesiologist during the summer break. The RVG was formulated to reimburse anesthesiologists for both the procedure units and time units. Prior to this, an anesthesiologist’s fee was calculated as a percentage of the surgical fee. Eventually other specialties adopted and modified this fee schedule. In the late 1970s and early 1980s, the Federal Trade Commission challenged the RVG by claiming that it generated a monopoly and represented unfair trade practice. After a lengthy legal battle that culminated in a lawsuit in federal court, a decision was made in favor of ASA. Today the RVG has become one of several resource-based relative value scales used for Medicare billing.

In the 1980s, two new foundations were established, the Anesthesia Patient Safety Foundation in 1985 and the Foundation for Anesthesia Research and Education in 1986. With the Wood Library-Museum and the Anesthesia Foundation already in place, ASA could now claim it was a well-rounded organization with formal groups dedicated to the advancement of patient safety, the support of residents, the study of anesthesia science and education, and the guardianship of our beginnings.

The Wood Library-Museum is honored to have Dr. Bacon as the 2005 Lewis H. Wright Memorial Lecturer. The lecture will be held from 12:50 p.m. to 1:50 p.m. on Tuesday, October 25, in the Morial Convention Center. His research in anesthesia history has helped us to understand the development of essential instruments such as the laryngoscope and techniques such as the epidural blood patch. In the end, though, Dr. Bacon’s most significant contribution has been his encouragement of young residents in their academic pursuits. Eleven residents he mentored have won history research fellowships, essay contests and presentation prizes. Many other medical students chose a residency in anesthesiology in part because of his teaching.

As we celebrate 100 years since the founding of ASA, we thank Dr. Bacon for helping to preserve our past and prepare for our future.

Susan A. Vassallo, M.D., is Anesthetist and Assistant Professor of Anesthesia, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.