2025/08/21 by Julia I. Klein, Jane S. Moon · 1 voice
Arts and Humanities · Medicine · #Cardiac, Anesthesia and Surgical Outcomes #History of Medical Practice #Medical History and Innovations
paper · doi:10.1097/01.asm.0001162228.15047.72
openalex publication_date 2025/08/21 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/23
Anesthesiology, a truly modern field, coalesced as a medical discipline well into the 20th century. Emery Andrew Rovenstine, MD (1895-1960), a physician of breathtaking ambition, helped establish the scientific and organizational foundations of the specialty (Figure 1).Figure 1: Emery A. Rovenstine, MD (1895-1960). Image courtesy of the Wood Library-Museum of Anesthesiology, Schaumburg, Illinois.Dr. Rovenstine, or “Rovey” as he came to be known, was born in rural Atwood, Indiana, as the oldest of four brothers. From a young age, he was a star athlete with a fiery personality who dreamed of becoming a schoolteacher. His path to medicine was circuitous. After high school, he worked as an elementary school teacher before attending Wabash College on an athletic scholarship. There, he worked odd jobs to make ends meet and showcased his athletic prowess as a semiprofessional baseball player. After college, Dr. Rovenstine enlisted in the Engineer Corps of the Army during World War I and served in France. His exposure to battlefield injuries fostered his interest in medicine. Upon returning to the U.S., Dr. Rovenstine worked as a math and science teacher and football and basketball coach for four years before starting medical school (Anesth Analg 2020;131:1934-42). While at the Indiana University School of Medicine, Dr. Rovenstine took an elective course on anesthesia taught by Arthur Guedel, MD (1883-1956), a prominent early anesthesiologist who would become a close mentor. Upon graduating, Dr. Rovenstine started his own general practice, but administered anesthetics on the side. His strong desire to optimize patient safety under anesthesia, coupled with the economic downturn in the late 1920s, encouraged Dr. Rovenstine to pursue advanced training (Anesth Analg 2020;131:1934-42). Dr. Rovenstine reconnected with his mentor, Dr. Guedel, who introduced him to Ralph Waters, MD (1883-1979), chairman of the first autonomous department of anesthesiology at the University of Wisconsin-Madison. Enrolling as one of the department's two inaugural residents in 1930, Dr. Rovenstine trained under Dr. Waters for five years. His competitive nature and past teaching experience, along with Dr. Waters' unflagging support, positioned Dr. Rovenstine well for his professional pursuits. At age 39, Dr. Rovenstine moved to New York City to establish the first Department of Anesthesiology at Bellevue Hospital, where nurses had hitherto provided most of the anesthesia. The demands of this undertaking proved exceptional, with Dr. Rovenstine often working over 18 hours a day and sleeping as little as two hours a night (Anesth Analg 2020;131:1934-42). The mental burden was worsened by the loss of his wife to suicide during his first year. Despite these challenges, he reorganized the fragmented surgical system within a year and established his department as a premier physician-led group. He created an anesthesiology residency program at Bellevue as part of New York University (NYU) and trained many future giants of the field, including the notable Virginia Apgar, MD (1909-1974). A pioneer of organized anesthesiology, Dr. Rovenstine's leadership knew few boundaries. He helped establish the American Society of Anesthesiologists (ASA) in 1936, the American Board of Anesthesiology (ABA) in 1938, and the Post Graduate Assembly (PGA) in 1945. He helped create the journal Anesthesiology in 1940 and served as one of its first associate editors. The same year, he became Director of Anesthesia for the entire New York City hospital system. He also served as president of the American Society of Regional Anesthesia (ASRA) in 1937 and ASA in 1943. He received the International Anesthesia Research Award in 1938 and the ASA Distinguished Service Award in 1958 (Anesth Analg 2020;131:1934-42). Dr. Rovenstine was renowned for his exceptional discipline, unwavering passion, astonishing productivity, and strong ego. He struggled with the politics of the field and the publicity he received – including a three-part series in The New Yorker – and was often resented by his peers (Figure 2). However, his correspondence with Dr. Guedel helped keep him grounded. Dr. Guedel regularly reminded him to prioritize collaboration and the specialty's advancement over personal gain (Anesth Analg 2020;131:1934-42). Despite some harrowing rivalries, no one could deny that Dr. Rovenstine's clinical and research expertise, administrative skill, and commitment to anesthesiology's progress were extraordinary.Figure 2: Dr. Rovenstine was featured in a three-part series in The New Yorker in 1947. Illustration by Abe Birnbaum, The New Yorker. This image is in the public domain.He also shone in the nascent field of regional anesthesiology. An early advocate for nerve blocks, Dr. Rovenstine shared his knowledge broadly in publications and lectures at NYU and around the world. He expanded Bellevue's first nerve block clinic, established in 1936 by regional anesthesia pioneer Gaston Labat, MD (1876-1934), and wrote about his experiences and the history of the field in JAMA (JAMA 1941;117:1599-03). His copious research studies covered a range of topics: mepivacaine for regional nerve blocks, unidirectional spinal needles, local anesthetics for obstetric patients, and regional anesthesia in prostate surgery (Arch Surg 1962;84:680-5; Reg Anesth 1997;22:273-9). Physicians journeyed from all over the world to take Dr. Rovenstine's nerve block course. In turn, he traveled internationally to share his expertise on regional anesthesia and beyond. He accepted guest professorships at Oxford University in 1938 and the University of Rosario in Argentina in 1939. He also received visiting professorships in countries as diverse as Cuba, Japan, Mexico, and South Africa. He was inducted into the medical society of every country he visited and received numerous awards (Anesth Analg 1960;39:24-6). Dr. Rovenstine's contributions extended well beyond regional anesthesia. A true academician, he published over 200 articles and 15 book chapters during his career. He returned to the military during World War II, joining the Army Advisory Board and the National Research Council's Subcommittee on Anesthesia. He helped create a 12-week crash course in clinical anesthesiology, along with a manual, titled Fundamentals of Anesthesia, to prepare general practitioners to give anesthesia for the first time. Many of these “90-day wonders” would become full-time anesthesiologists after they returned from the war. Anesthesiologists throughout the world mourned Dr. Rovenstine's premature death from prostate cancer at age 65. Two of his former residents, Emanuel Papper, MD (1915-2002), and Solomon Hershey, MD (1914-1992), called his death “the end of the time of giants” and honored him for “the bringing of the scientific habit of thought to anesthesiology in a large and systematic way” (Anesthesiology 1961;22:318). Emery Rovenstine's tremendous legacy lies in his unparalleled contributions as a clinician, researcher, educator, and leader. To this day, his name remains deeply respected and lives on in the honorary Emery A. Rovenstine Memorial Lecture, a cornerstone of the ASA's annual meeting since 1962 and the PGA since 1971. Although Dr. Rovenstine reached the pinnacle of success, his path had its fair share of obstacles, detours, and setbacks. He was a deeply human figure whose profound commitment to overcoming challenges, both personal and professional, still inspires us today. Ultimately, Dr. Rovenstine's relentless ambition for a cause greater than his own – the modern field of anesthesiology – made him a pioneering giant in our field.Julia I. Klein, MD, Resident Physician, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.Jane S. Moon, MD, Chair, ASA Abstract Review Subcommittee on History and Education, Trustee, Wood Library-Museum of Anesthesiology, and Associate Clinical Professor, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.