Explore the history of the Department of Anesthesia, Critical Care and Pain Medicine at Massachusetts General Hospital, including key physicians, discoveries and milestones that changed the field of anesthesia.
1846: First Demonstration of Ether
On October 16, 1846, the first public demonstration of ether anesthesia was performed at Massachusetts General Hospital by Boston dentist William T.G. Morton, making pain-free surgery possible. At Mass General, which opened its doors in 1821, only one operation a week was performed in the years preceding the ether demonstration. After this historic event, operations not only increased significantly, but Morton's work spread quickly throughout the world and forever changed the surgical experience of patients.
1917: Henry Isaiah Dorr
Henry Isaiah Dorr was designated the first chair of anesthesia in the world by Harvard Medical School (HMS).
1941: Henry Beecher, MD
In July 1941, the dean of HMS appointed Henry Beecher, MD, to the Henry Isaiah Dorr Chair in Anesthesiology, creating the first endowed chair of anesthesiology in the United States.
1955: Publication of "The Powerful Placebo"
Dr. Beecher published the groundbreaking publication, “The Powerful Placebo.” He advocated for the placebo effect to be tested in all clinical trials, in what he called double-blind placebo controlled studies (studies in which new drugs are tested against a placebo, and neither the doctor nor patients knows whether a patient is receiving a placebo or the drug being tested). His publication was widely hailed and laid the foundation for a new generation of medical trials and testing around the world.
1961: The Start of Critical Care
Critical care began at Mass General with the establishment of the first five-bed Respiratory Intensive Care Unit (RICU) in the United States. Today, Mass General has more than 130 critical care beds, which are organized into nine different intensive care units.
1966: Publication of "Ethics and Clinical Research"
Dr. Beecher published a landmark paper called “Ethics and Clinical Research” in the New England Journal of Medicine, which is considered to be one of the most influential papers written about experimentation involving human subjects. Beecher’s work laid the foundation for the Institutional Review Board (IRB) and guidelines on informed consent.
1968: Harvard Criteria for Brain Death
At Mass General, the definition of “brain death” had been debated for decades. In 1968, Dr. Beecher chaired an HMS committee on this subject and authored an article in the Journal of the American Medical Association (JAMA) in which he proposed a new set of criteria for brain death (which became known as the Harvard Criteria). Most of the clinical indications he proposed were the driving force behind the first formal enunciation of the criteria for definition of brain death and were subsequently adopted by the medical community.
1971: The Use of ECMO
The use of extracorporeal membrane oxygenation (ECMO) commenced in early 1971 under the leadership of Warren Zapol, MD. ECMO is a technique of providing both cardiac and respiratory support oxygen to patients with severe acute respiratory failure. Dr. Zapol submitted a National Institutes of Health (NIH) grant in support of a controlled study for the use of ECMO in the treatment of acute respiratory failure. The grant was funded in 1971.
1990: The Use of Inhaled Nitric Oxide Gas
The first use of inhaled nitric oxide gas for the treatment of Persistent Pulmonary Hypertension of the Newborn (PPHN) occurred on Sept. 16, 1990. The treatment was performed in the cardiac catheterization laboratory at Mass General. Jesse Roberts, MD, performed the treatment with David Todres, MD, chief of pediatric critical care, and Peter Lang, MD, who was a Mass General pediatric cardiologist at that time and performed the cardiac catheterization.
1992: Smart Drug Infusion Pumps
Smart drug infusion pumps were invented in October of 1992 by Nathaniel Sims, MD (with Mark Mandro and Alan Ford). The clinical deployment of the first commercially-successful smart drug infusion pumps occurred in 1997, with a multidisciplinary team from several departments at Mass General.
2001: NSAIDS on the Central Nervous System
Mass General researchers identified how common drugs called NSAIDS, which include aspirin and other anti-inflammatories, act on the central nervous system to reduce pain.
2013: Systems Neuroscience Paradigm
With research starting in 2010, Patrick Purdon, PhD and Emery Brown, MD, PhD, developed a systems neuroscience paradigm to describe how anesthetic drugs act in the brain to create the states of general anesthesia. Based on their findings, Drs. Purdon and Brown have developed a new educational program to teach anesthesia caregivers how to determine the depth of anesthesia by reading the electroencephalogram (EEG) signatures of the drugs.