2026/02/26 by Todsaporn “Bob” Rodbumrung, Deborah A. Roy, Anuj Aggarwal · 1 voice
Arts and Humanities · Medicine · #Medical History and Innovations #History of Medical Practice #History of Medicine Studies
paper · doi:10.1097/01.asm.0001181336.27304.c5
openalex publication_date 2026/02/26 · openalex created_date 2026/02/27 · openalex updated_date 2026/07/23
In every generation, a few physicians transform not only how anesthesia is practiced but also what medicine itself can imagine. Among them stands Peter J. Safar, MD, the “Father of CPR,” whose life bridged ORs, intensive care units, and city streets. He taught us that resuscitation is both a science and a moral imperative, redefining anesthesiology as a continuum of life support beyond the OR. In an impressive career, what may stand out most about Peter Safar was his response to the tragic death of his 11-year-old daughter, and his vow to use his knowledge and training as an anesthesiologist to prevent the same fate from befalling others. Born in Vienna in 1924 to two physicians, Karl and Vinca Safar, his studies were interrupted by World War II. During those years he witnessed starvation, infection, and the limits of compassion under totalitarianism, experiences that forged his lifelong pacifism and reverence for human life (Careers in Anesthesiology. 2000; Resuscitation 2001;50:17-22). After earning his medical degree from the University of Vienna in 1948, he trained in surgery at Yale and in anesthesiology under Robert Dripps at the University of Pennsylvania. “Surgery,” he later recalled, “would not advance without better life support – and you learn life support in anesthesiology.” That insight would guide the rest of his career (JAMA 2003;289:2485-6). At Baltimore City Hospital (now Johns Hopkins Bayview Hospital) in the 1950s, Dr. Safar began experiments that would forever change emergency care. Collaborating with anesthesiologist James Elam, MD, a U.S. Army researcher and chief anesthesiologist of Roswell Park Cancer Center in Buffalo, New York, he proved that mouth-to-mouth ventilation was superior to contemporary methods, testing the technique on curarized volunteers long before institutional review boards existed. He combined this airway maneuver with external chest compressions rediscovered by engineer William Kouwenhoven and his colleagues at Johns Hopkins to create the now-familiar “ABC” of resuscitation: airway, breathing, circulation.Peter Safar, MD (1924-2003). Image courtesy of the Wood Library-Museum of Anesthesiology, Schaumburg, Illinois.When Norwegian toy maker Åsmund Laerdal heard of Dr. Safar's work, he partnered with Safar and Norwegian anesthesiologist Björn Lind to create Resusci Anne, the mannequin that would carry CPR training to millions. By 1960, modern cardiopulmonary resuscitation was born, and Dr. Safar's research, funded by the U.S. Army and published in JAMA, became the cornerstone of global life-support training. Dr. Safar's vision extended well beyond resuscitation. At Baltimore City Hospital, he created the first physician-staffed ICU in the United States in 1958, integrating continuous ventilation and fluid resuscitation for postoperative and comatose patients. When he moved to the University of Pittsburgh in 1961 to found their Department of Anesthesiology and Critical Care, he transformed a primarily nurse-based anesthesia service into a university system of physician anesthesiologists, fellows, and researchers. Out of Pittsburgh grew America's first critical-care training program, a new multidisciplinary field that he, Max Harry Weil, MD, PhD, and William Shoemaker, MD, MCCM, FACS, later formalized as the Society of Critical Care Medicine in 1970 (Resuscitation 2002;55:3-7; Crit Care Med 2003;31:2571-3).Resusci Anne mannequin. Image courtesy of the Wood Library-Museum of Anesthesiology, Schaumburg, Illinois.Perhaps Dr. Safar's most socially transformative endeavor was the Freedom House Ambulance Service, founded in Pittsburgh in 1967. After the death of his daughter Elizabeth from an asthma attack, Safar vowed to close the deadly gap between medical crisis and hospital arrival (Careers in Anesthesiology. 2000). Partnering with community leaders, he began training residents of Pittsburgh's predominantly Black and underserved Hill District as the nation's first paramedics, capable of advanced life support at the scene. Freedom House not only saved countless lives but also became a model for modern EMS, merging clinical innovation with social justice (Prehosp Emerg Care 2004;8:76-9). Dr. Safar's scientific curiosity never waned. In 1979, he founded the International Resuscitation Research Center, later named the Safar Center for Resuscitation Research, where he and protégés Patrick Kochanek, MD, MCCM, and Samuel Tisherman, MD, explored cerebral protection, hypothermia, and “suspended animation.” His laboratory demonstrated that rapid deep cooling could preserve the brain after cardiac arrest or exsanguination, work that later informed both civilian and military trauma research. The Brain Resuscitation Clinical Trials, coordinated through the center and funded by the NIH for 15 years, were among the first international randomized studies in critical care medicine (Careers in Anesthesiology. 2000; Resuscitation 2002;55:3-7; Crit Care Med 2003;31:2571-3). As a mentor, Dr. Safar inspired loyalty through compassion and rigor. His students recall being challenged to “think big, question convention, and consider things from a global humanitarian perspective.” Many went on to found academic departments, EMS systems, and ICUs across the world. Over 500 fellows trained under his leadership at Pittsburgh, and countless more trace their intellectual lineage to his example (Prehosp Emerg Care 2004;8:76-9). Dr. Safar described “humanism” as the true foundation of medicine, and his professional and personal lives stand as testaments to his values. A gifted pianist devoted to Gustav Mahler and Anton Bruckner, he often hosted chamber music evenings with colleagues and after long days in the laboratory, even performing at the first International Symposium on the History of Anesthesia meeting. He and his wife Eva, a constant collaborator and department builder, were known for their warmth and partnership over five decades. A lifelong pacifist, Dr. Safar saw medicine as an act of peace. He was active in the Physicians for Social Responsibility, the International Physicians for the Prevention of Nuclear War, and the World Federalist Association, arguing that “saving one life is an act of peace.” His advocacy helped inspire what he called “peace medicine,” the use of medical collaboration across borders as a bridge between nations (Crit Care Med 2003;31:2571-3). By the time of his death on August 3, 2003, Dr. Safar had authored more than 1,200 publications, received three Nobel Prize nominations, and influenced every domain of acute care, from the American Heart Association's life support guidelines to modern ICU architecture. His legacy endures not only in resuscitation algorithms but in the generations of clinicians who approach the dying patient with both scientific precision and moral conviction. When asked what he hoped to be remembered for, he replied: “For having touched many lives; for having led from scratch the development of America's largest department of anesthesiology; for having co-initiated new medical fields and for having found meaning in life” (Prehosp Emerg Care 2004;8:76-9). The ASA Monitor celebrates Peter J. Safar as a true Giant of the 20th Century – an anesthesiologist whose curiosity defied boundaries, whose empathy redefined our profession, and whose scientific contributions continue to save lives every day.Todsaporn Rodbumrung, MD, Clinical Assistant Professor, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California.Deborah A. Roy, RN, MBA, Student, Program in the History of Medicine, University of Minnesota, Minneapolis, Minnesota.Anuj Aggarwal, MD, Vice Chair, ASA Abstract Review Subcommittee on History and Education, and Clinical Associate Professor, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California.