Klein - book 2/8/2005 3:48 PM Page iii The History of Anesthesia in Oregon Roger L. Klein, M.D. Angela Kendrick, M.D. The Oregon Trail Publishing Company Portland, Oregon Klein - book 2/8/2005 3:48 PM Page iv Copyright © 2004 by Roger Klein and Angela Kendrick All rights reserved Printed in U.S.A. Library of Congress Catalog 2005920470 Text design by Sheryl Mehary This book may not be reproduced in whole or in part, by electronic or any other means which exist or may yet be developed, without permission of: The Oregon Trail Publishing Company and The Oregon Health and Sciences University Department of Anesthesiology and Perioperative Medicine Portland, Oregon Klein - book 2/8/2005 3:48 PM Page v Preface This book describes the history of the development of anes- thesia in Oregon. It covers the period from shortly after the intro- duction of anesthesia until modern times. We have attempted to provide an exhaustive compilation of available data, so that a repos- itory of information will exist for future medical historians. We have also attempted to make the book an enjoyable reading experi- ence for the average individual interested in medical history, in part by telling anecdotes about many of the people who had a role in this history. The book is divided into two parts. The first chapters describe the development of anesthesia in Oregon from different perspec- tives. These include the early period, the advent of anesthesiologists and the Oregon Society of Anesthesiology (OSA), the complete development of anesthesia delivered by nurse anesthetists (CRNAs), dental anesthesia, examples of types of anesthesia practice, and a historical perspective of Oregon anesthesiology, including brief biographical sketches of some early pioneers and some of the more influential anesthesiologists in the state. The second part describes formal anesthesia training, biographical sketches of the Oregon Medical School-Oregon Health & Sciences University (OHSU) Department of Anesthesiology Chairmen, and early teaching anesthesiologists. Personal accounts of individuals from the early years are also included. References for each chapter are located after Chapter 17. Extensive appendices with minute data precede the index. We have elected to present a short summary of the early history of Oregon in the first chapter. This was done to show how the fur trade industry, coupled with immigration along the Oregon Trail, provided the Oregon territory with medical facilities that would utilize anesthesia. These facilities did not exist in an otherwise isolated and backward western frontier. <v> Klein - book 2/8/2005 3:48 PM Page vi This history of Oregon is well known, and we have not included extensive citing of general references. Much of this infor- mation was gleaned from conversations and communications with archivists at national historical sites; Forts Vancouver and Nisqualie in Washington state; Jasper City Library in Jasper, Alberta; the Victoria, British Columbia Historical Library; The Sisters of Providence Archives Library in Seattle; the Oregon Historical Society Library in Portland; the Oregon State Library in Salem; and the Multnomah and Clackamas County Libraries in Oregon, as well as from various Northwest history texts. Some of these include F.W. Howay’s The Fur Trade in Northwestern Development, The Pacific Ocean in History by Morris, Stephens and Bolton, and the Encyclopedia Britannica. The specific historical information included in the first chapter is cited. This book also examines the historical interactions that have produced the controversies and conflicts that continue to exist between anesthesiologists and CRNAs. Our interpretation of the origins and continued differences between the two can be found in several chapters. The issues are vigorously, but we believe dispas- sionately, presented from both points of view. Hopefully future historians will have an opportunity to utilize the appropriate passages in order to more fully understand what the authors hope will eventually become an academic issue. There is some repetition. We found it necessary in order to present “the big picture” as well as the individual stories. Finally, relationships between anesthesiologists in the community and at OHSU can be inferred throughout several passages in different chapters. They have nearly always been mutually supportive. The only potential areas of conflict have occurred when competition between major health delivery systems may have caused some sense of competitiveness between anes- thesia personnel. Certainly cooperation and respect between “town and gown” has been far and above the norm with only a very rare conflict of interest. <vi> Klein - book 2/8/2005 3:48 PM Page vii Acknowledgements As primary author, I wish to acknowledge a number of indi- viduals who have provided considerable assistance in preparing this text. First, my co-author Dr. Angela Kendrick deserves my deepest gratitude for her invaluable assistance with research, written articles, interviews, insight and vision in recognizing the value of this enterprise. I also wish to thank Henry Clarke, DDS, and Suzanne Brown, CRNA, for agreeing to provide their contributions. We wish to express our appreciation to Dr. Jeffery R. Kirsch for providing department staff assistance and note that the manuscript preparation could not have been done without Joan Cossey and Michelle Greenberg. Thanks to Susan Beal for copyediting, Jane Henderson for indexing, and Sheryl Mehary for book design. Linda Weimer, former OHSU medical history librarian, gave us tremen- dous help with our research endeavors, identifying archaic journals and lending professional assistance with the oral history interviews. Drs. Gerald Edelstein, Larry Hagmeir, Donald Dobson, Robert Capps, Clare Peterson, Lucien Morris, Rex Underwood and Tim Brinton provided considerable information. The last two individ- uals also contributed unique stories of their early anesthesia days. We appreciate the information provided by various individuals or their families who are featured in the book. Various librarians and archivists, especially Marsha Weber at the Multnomah County Library, David Hanson, historian/curator of the Fort Vancouver Historical Site, and personnel at the OHSU Biomedical Information Center (BICC) deserve special thanks. The thanks also extend to Mary Botcheos at the OHSU Dental Library. Thanks also to Patrick Sim and Karen Bieterman and the staff at the Wood Library for graciously providing encouragement and a wealth of data. I also want to thank my wife Carol for her love, patience and understanding and for all those years of driving me to work so I could run home. Thanks too to my son Bill and daughter-in-law < vii > Klein - book 2/8/2005 3:48 PM Page viii Marla, for their assistance with the old Mac computer, and grandsons Carl and Eric for not bothering “Pops” while he was writing. Roger L. Klein, MD I feel privileged to have known and to have been trained by Drs. Bergman, Stevens, and Kingston. My interest in this historical record grew out of research into our department’s history for its 60th anniversary celebration. My husband, Brad, has served as sounding board throughout my career and his encouragement allowed me to devote the time needed to help assemble this material. Angela Kendrick, MD I would be remiss if I did not thank Roger Klein for providing the impetus for my working on this project. He did some of the very early research and kindly shared that with me. Several CRNAs have been most helpful. Kelly Sievers, once again, helped greatly with her editing ability of the document. Mary Diggles summarized the decade of the eighties, from which I drew the portion for this chapter. Yuri Chavez not only was responsible for navigating much of the legislative and regulatory maze to gain recognition, but wrote a detailed summary of the process. Many people took their time to share their memories and knowledge; I thank them all. Linda Huffman was the CRNA who introduced me to the state and national associations. I have been the recipient of many a wonderful friendship and educational experience as a result. Cherry Hoffman, the executive secretary for the OANA, has been great at helping me gather materials and information. Finally, I must thank my husband. He knows I am not a writer and still provided encouragement and a reality check for this project. Suzanne Brown, CRNA I would like to acknowledge the OHSU library staff: Mary Botcheos, Cindy Cunningham, Bonita Spreng and Dan Kniesner. Henry Clarke, DDS < viii > Klein - book 2/8/2005 3:48 PM Page ix We wish to make a special acknowledgement to the commer- cial providers of anesthetic drugs and equipment. Their contribu- tions over the last one hundred years have been invaluable. <ix> Klein - book 2/8/2005 3:48 PM Page x Klein - book 2/8/2005 3:48 PM Page xi We wish to thank and dedicate this history to Dr. Wendell Stevens who was such an inspiration to all of us. One of the many gifts he bestowed on us over the years was always being available to review our manuscripts. It is unfortunate that he did not live to help us complete this book. Klein - book 2/8/2005 3:48 PM Page xii Klein - book 2/8/2005 3:48 PM Page xiii Table of Contents Part I The History of Anesthesia in Oregon . 1 1. The History of Anesthesia in Oregon: The First 100 Years . 3 Roger L. Klein, MD 2. The History of the Oregon Society of Anesthesiology: The First 40 Years . 27 Roger L. Klein, MD 3. Nurse Anesthesia in Oregon . 53 Suzanne Brown, CRNA 4. Dentists and Anesthesia in Oregon. 89 J. Henry Clarke, DMD 5. Historical Oregon Community Anesthesiologists . 99 Roger L. Klein, MD 6. Anesthesiology Experiences at Sacred Heart Hospital in Eugene . 115 Tim Brinton, MD 7. Kaiser Anesthesia. 121 Suzanne Brown, CRNA 8. History of the Oregon Anesthesiology Group . 125 Angela Kendrick, MD Klein - book 2/8/2005 3:48 PM Page xiv Klein - book 2/8/2005 3:48 PM Page xv Part II Anesthesiology at the University of Oregon Medical School and Oregon Health & Sciences University .