49 Mathoura Road: Geoffrey Kaye’s Letters to Paul M. Wood, 1939–1955

GEOFFREY Kaye, M.B.B.S. (1903–1986), was “arguably the most influential anesthetist in Australia”¹  although he was at times difficult to understand.²  Before 1955, Kaye was a preeminent academic and political anesthetist. He helped start the Australian Society of Anaesthetists in 1934 and was instrumental in founding the Faculty of Anaesthetists of the Royal Australasian College of Surgeons in 1952. Kaye, a “man of many parts,”¹  published articles on mortality rates in Australian anesthetics³  and World War II military medicine,⁴  coauthored an anesthesia textbook,⁵  and developed various forms of equipment, including an anesthesia machine.

One of his longtime goals was to build a great “diffusion center” of information for the Australian Society of Anaesthetists. This center would house a library, museum, meeting spaces, apparatus, a journal of the highest caliber, and machinery and laboratory facilities.^1,6  In 1951, when the plans for the Faculty of Anaesthetists were approved, Kaye established the Society’s “center of excellence” at 49 Mathoura Road, Toorak, Melbourne (fig. 1). Kaye referred to the center as “49.”

By 1955, the promise of “49” had failed. Some scholars have attributed this failure to Kaye’s inability to understand “the situation of the ordinary anesthetist.”¹  Practicing physicians—in difficult economic times—were “trying to make their way in a new environment, with young families to support.”¹  To be sure, Kaye was unmarried, and he had the ability to teach, do research and engage in politics without significant familial and financial pressures. Kaye, however, did have some comprehension of the practical needs of the practicing anesthetist.⁶ 

Gwenifer Wilson, M.D., M.B.B.S. (Honorary Anaesthetist, Sidney Hospital and St. George Hospital, Sydney, New South Wales, Australia) (1916–1998), makes a more personal assessment of the failure of “49” in her book, One Grand Chain,²  the authoritative history of Australian anesthesia. Contrary to Kaye’s opinion, Wilson, Federal Secretary of the Australian Society at that time,⁷  felt that the Society tried to maintain “49” and was “blameless” except for permitting Kaye to control renewal of the Society’s lease.^* Kaye defined the agreement as a 5-yr lease to the Society giving the Society the entire ground floor and access to the ground and machine-shop for an annual fee of one shilling.⁶  Wilson attributed the failure to Kaye’s personality and the situation. For example, she suggested that members avoided “49” because when they used it, Kaye would descend from his upstairs living quarters to “either interrupt to talk, or demand assistance with some project of his own.”²  In a letter⁷  to Kaye in 1981, as she was researching her book, Wilson suggests that the project failed because it was too big for the Society.

Kaye took the failure hard. Wilson lamented that “the inveterate correspondence of this lonely man had led him to tell anesthetists round the world of his great project, and even more unfortunate that when the time of break-up of the headquarters came he again wrote to his world-wide circle, informing them of the deficiencies of the Society and Faculty which had led to this debacle.”² 

Previous historical writing on Kaye and “49” has relied on secondary accounts of the situation surrounding “49.”¹  This article describes Kaye’s contemporaneous views of the rise and fall of “49” based on correspondence to Paul M. Wood, M.D. (1894–1963, Librarian-Curator, Wood Library-Museum, New York City, New York). Wood, an American anesthesiologist, donated his personal collection of anesthesia-related books and apparatus to the New York State Society of Anesthetists in 1933.^8,9  Under his leadership as librarian-curator, this collection evolved into the eponymous Wood Library-Museum of Anesthesiology in 1950.^8,9 

We suspect that Kaye and Wood knew each other by 1930. It is likely their shared interests in libraries and museums fueled their relationship. Kaye’s letters to Wood from 1939 to 1955 likely represent some of the “inveterate correspondence” to the international anesthesia community to which Wilson referred. Kaye’s letters offer an important counterpoint to Wilson’s characterizations of Kaye as well as her assessment of the factors that ultimately led to the fall of “49.”

This article is based on 11 letters^10–20  Kaye sent to Wood between May 7, 1939, and April 19, 1955. The original 11 letters are located in the Paul M. Wood Collection at the Wood Library-Museum of Anesthesiology, and copies are located in the Archives of the Australian and New Zealand College of Anaesthetists. We were able to locate one of Wood’s letters to Kaye in the Australian collection, and it is our impression that there were additional letters, particularly during the gap between the three letters in 1939 and the eight letters from 1952 to 1955. Wood’s letter²¹  to Kaye, written on April 4, 1954, makes reference to the incorporation of the Wood Library-Museum but does not discuss “49.”

Additional sources include correspondence between Wilson and Kaye from 1981^7,22  to 1983²³  and contemporaneous documents, most notably a 1955 letter⁶  from Kaye to the President of the Australian Society of Anaesthetists. This letter echoes most of Kaye’s letters to Wood.

Kaye had a privileged upbringing. He was educated in the classics and enjoyed luxurious activities such as flying and collecting. His lifestyle was provided in part by his father, a successful businessman, who provided Kaye with “an independent private income.”¹  He received his medical degree from the University of Melbourne in 1926. He became interested in anesthesia when he was assigned to be a resident anesthetist as punishment for inappropriately assessing a patient for surgery.^1,24  Kaye enjoyed the experience, however, and pursued further studies in anesthesia. His experience reflected the overall status of anesthesia in 1920s Australia, which Kaye described as “suitable only for the physically unfit or unambitious.”¹ 

Kaye’s vision for Australian anesthesia developed during his 1929 through 1931 world tour of European and American anesthesia leaders.^1,24  He was moved by the state-of-the-art practices, including physician–anesthetists trained in the basic sciences, medical record-keeping, and continuous monitoring. Kaye maintained relationships with many of these leaders (fig. 2).

Francis Hoffer McMechan, M.D., F.I.C.A. (1879–1939), was one of these leaders. McMechan was one of the essential forces in the development of the profession of anesthesiology in the United States and was the founding editor of the longest continually published journal in anesthesia, Current Researches in Anesthesia and Analgesia, which became Anesthesia and Analgesia. In 1929 in Sidney, Kaye met McMechan, then Secretary-General of the Associated Anesthetists of the United States and Canada. In 1955, Kaye wrote that McMechan “virtually established organized anaesthetics” in Australia.⁶  In a paragraph titled Genesis in a 1954 letter, Kaye credited a death-bed meeting with McMechan with the origin of “49.” “Knowing himself to be dying, he [McMechan] gave me certain ‘orders’ in regard to the service of anesthetics in Australia. These orders I have tried to obey: they were, in a sense, the spiritual origin of “49.”⁶  Kaye later recounted the story in a 1981 letter to Wilson, characterizing the event as “I was summoned to the bedside.”²² 

The first letter, dated May 7, 1939,¹⁰  discussed early thoughts about a museum, using the museum that Paul Wood curated as a prototype. Kaye states, “Our Society, like your Society, proposes to have a museum to illustrate the evolution of anesthetic appliances.”¹⁰  Importantly, the extent to which Kaye spoke on behalf of the Society at this point is uncertain.⁶ 

Kaye discussed his equipment collection and sought help identifying a drip-feed ether inhaler and an inhaler fitted with a shank. He suggested that the American and the Australian Societies exchange equipment to improve their collections. Kaye offered Wood some of University of Melbourne’s donated Edward H. Embley’s, M.D., M.B.B.S. (1861–1924, Honorary Anaesthetist to the Melbourne Hospital, Melbourne, Victoria, Australia), laboratory glassware “which had been gathering dust and cobwebs since 1902.”¹⁰  Embley was an Australian anesthetist and glassblower who conducted early experiments on chloroform induction.²⁵  According to Kaye, while the glass left much to be desired, it was “the only worthwhile work in anesthesia that has come out of this country.”¹⁰  Those remarks about Australian anesthesia highlight his general sentiment, but his opinions are likely exaggerated. For example, one early Australian pioneer was Hubert Ingham Clements (1886–1969, Mechanical Engineer, Strathfield, New South Wales, Australia), a mechanical engineer who designed anesthesia apparatus, most notably an ether vaporizer in 1917 as well as portable suctioning machines with novel pumps and lubrication systems that were in use in Australia for more than 30 yr.²⁶ 

Kaye’s substantial investment of his time and resources, and his decision to stay in Australia in spite of numerous opportunities to practice abroad,^1,24  suggest that he truly believed that Australian anesthesia could one day rival its European and American counterparts. This promise of progress fueled Kaye’s enthusiasm.

Kaye’s letters dated July 14, 1939,¹¹  and October 11, 1939,¹²  focus primarily on equipment, such as early gas apparatus, ether and chloroform devices, and various models of inhalers.^11,12  On October 11, 1939, Kaye wrote about his commission to support the war effort.

Although a military commission meant Kaye could devote less time to writing, research, teaching, and collecting, he remained active in historical preservation. In fact, participation in the war meant more opportunities to collect anesthetic equipment and devices. After being commissioned, Kaye served in the Middle East and New Guinea campaigns. He taught, published about military medicine, and developed technology for the military. Even after his return to Melbourne in 1943, he continued to work with the military.¹ 

The Wood Library-Museum of Anesthesiology was formally incorporated in 1950.⁹  Kaye admired the American Society for being able to incorporate the museum during Wood’s lifetime. Kaye’s letter dated March 15, 1952,¹³  demonstrated his enthusiasm for the Wood Library-Museum, optimism for a similar Australian project, and frustration about the inadequate Australian research program. Kaye felt that America “having both a Journal (of the highest quality) and a newsletter (of purely domestic interest)”¹³  served the needs of the society well. Kaye then shifted toward the needs of Australia.

Kaye sought to establish a Faculty of Anaesthetists to formalize postgraduate training in anesthesia and to enable the education, research, and technological developments necessary for the growth of Australian anesthesia. In 1950, the Royal Australasian College of Surgeons approved plans to establish a Faculty of Anaesthetists. Kaye simultaneously started “49”—he immediately purchased a large mansion with private funds and began renovations for a meeting room, library, laboratory, museum, darkroom, and a living space for himself on the upper floor.⁶  “49” officially opened in March 1951. He financed “49” through his inheritance from his father in 1949. The cost was Kaye’s “entire fluid capital.”²² 

In the March 15, 1952,¹³  letter, Kaye reported that he was “heavily engaged in an examination” for the Diploma in Anaesthetics, and that he had earned the title of “ophido-anesthesiologist” for his work anesthetizing snakes for research. As for “49,” Kaye stated, “I have no great news. “49” provides an infinity of work in the museum, library, writing-room, workshop, and garden—it would be a whole-time job if there were nothing else to do.”¹³ 

The letter dated January 31, 1953,¹⁴  did not discuss “49.” In the February 2, 1953,¹⁵  letter, we start to see Kaye’s frustration regarding the status of Australian anesthesia and his enthusiasm and prospects for “49.”

Kaye’s February 28, 1953,¹⁶  letter discussed his laboratory work and his attempts to arrange a work position in the United States for a young member of the Australian Society. It did not mention “49.”

Kaye’s frustration was palpable in his January 28, 1954,¹⁷  letter. He began to express lack of appreciation for his work. Kaye had been the sole financier of “49.”

Kaye’s awareness of the differences between American and Australian resources did not ameliorate his frustration about the lack of Australian enthusiasm for “49.” In the same letter, Kaye corrected Wood’s complimentary appraisal of the Australian Society.

Members showed “49” to visitors, but did not use it. Members attended regular meetings at the facility, but only if others managed the logistics. Members were not interested in “making use of the darkroom or workshop, or assisting in the duplication and distribution of the newsletter, or keeping the grounds in order, nothing could be further from their thoughts.”¹⁷ 

Scholars have blamed Kaye’s inability to garner support for “49” to a lack of understanding of his Australian peers.¹  Kaye was unencumbered by financial or familial pressures and therefore “didn’t comprehend the real needs of the new breed of specialists of the time.”¹  But Kaye did articulate an understanding of the anesthetist’s plight and pondered a political solution.

Nonetheless, Kaye did not think these arrangements excused inactivity in advancing the historical, cultural, and scientific aspects of the specialty. Kaye sought small contributions from many young anesthetists, not large contributions from a few.

Kaye felt that the president of the Australian Society often excused members from Kaye’s requests. Members viewed “49” as Kaye’s hobby, which offended Kaye given his sizeable financial and personal investment in the center. Kaye wrote on May 11, 1954¹⁸ :

Kaye appeared resigned that “49” would fail.

Kaye also bemoaned the personal costs of “49.” “I have deprived myself of all fluid capital and all freedom of movement for 4 yr. I would be a fool to continue doing so.”¹⁸  In this same “ill-tempered letter,”¹⁸  Kaye wrote that he had given the Society a deadline of August 1955 to make “49” work.

His letter dated November 16, 1954,¹⁹  discussed the events that led to the termination of his experiment. At the August meeting, the Victorian State Section of Anaesthetists committed to improving the facilities at “49.” By November, no action had been taken.²⁷  Kaye described the “straw which broke the camel’s back.”¹⁹ 

In this letter, Kaye directly acknowledged the future. He described what will happen to the house and furniture, and then turned to himself.

“What I shall then do, I do not know: frankly, I feel at the moment rather like a deflated gas-bag. However, I shall doubtless end up with a job of work of one kind or another; and whilst one can work, one is never unhappy.”¹⁹ 

During the fall of 1954 and spring of 1955, Kaye received letters of support and appreciation from notables in anesthesia such as John S. Lundy, M.D. (1894–1973, Professor of Anesthesia, The Mayo Foundation for Medical Education and Research, Rochester, Minnesota),²⁸  Virginia Apgar, M.D., M.P.H. (1909–1974, Professor of Anesthesia, College of Physicians and Surgeons of Columbia University, New York, New York),²⁹  and John Gillies, C.V.O., M.C., M.B., Ch.B. (1895–1976, Reader in Anaesthetics, Department of Anaesthetics, Royal Infirmary, Edinburgh, Scotland).³⁰  Christopher Langton Hewer, M.B.B.S., M.R.C.O., F.F.A.R.C.S., M.R.C.P. (1896–1986, Consulting Anaesthetist to St. Bartholomew’s Hospital, London, England) best summed up the collective sentiment: “I simply cannot understand both the ineptitude and stupidity of the ASA.”³¹ 

The April 19, 1955,²⁰  letter began abruptly:

The letter suggested that Kaye derived satisfaction from the ultimate purchase of the center by the Australian Dental Association. He wrote that the experiment might not have been a total failure as it “did stimulate the A.D.A. to want a Centre, and may even have stimulated in part the expansion of your own show.”²⁰ 

Despite Kaye’s apparent acceptance over the ultimate fate of his experiment, he still felt that the Society needed the center and should have been able to establish one given his great sacrifice. Kaye may have viewed his own leadership as inadequate.

Kaye planned for the contents of the center to be shipped to London or New York, but the Society insisted that they be stored with the Australian College of Surgeons. This displeased Kaye, given his overarching purpose of establishing an independent discipline of anesthesia in Australia. But Kaye understood the need for a historical and cultural legacy in Australian anesthesia, and the Society left him with few options. Kaye ultimately took the path of unity rather than division, as “it seemed ungenerous to insist upon division, so I allowed the Society to take my collections as well.”²⁰ 

Kaye’s disappointment with his colleagues cannot be overstated. He feared too few Australian anesthetists would be able and willing to advance the profession of anesthesia. Kaye commented on the members that “descended in shifts upon “49” and packed the museum for transfer to the College. …It was an ironical thought that expenditure of a tithe of that energy, over the past 5 yr, would have rendered the closure of “49” unnecessary!”²⁰ 

As for himself, Kaye was clear: “I fear that my interest in anaesthetics in this country is practically defunct.”²³  He joined the Department of Electrical Engineering at Melbourne University and “was seen no more at meetings of anesthetists for many years.”^1,2  In 1983, Kaye helps explain his deliberate decision to get out of anesthesia practice in 1955: “I’d fired the one shot in my locker, and, when it missed, there was nothing more for me to do in Medicine [sic]… and so I went off to try to be an engineer.”²³ 

Kaye ended the discussion of “49” wistfully.

Kaye’s undoing may be attributed to number of factors, namely his grand vision for “49” as a center beyond merely a library and museum, especially during economically trying times.^7,22,23  Kaye was overly confident that if he built it they would use it, and he did not pay attention to perhaps wiser heads who counseled restraint. Although Kaye did not identify those “wiser heads” by name, he did however confess, “My American friends warned me of what might happen, but I wouldn’t listen.”¹⁸  Later, in 1981, Kaye noted that Macintosh, at the opening ceremony for “49,” predicted its failure to Kaye’s sister because the anesthetists were not behind it.²²  In the same letter, Kaye in part blames his anesthetist colleagues, declaring, “Certainly, those who entered the specialty at the end of the war were a pedestrian lot, looking for an easier life than in other forms of medical practice…”²² 

Although Kaye did express some level of understanding about the plight of the practicing anesthetist, we do not know if that translated into actions consistent with that understanding. Further, even if Kaye was wholly sympathetic with their troubles, the perception that he was not sympathetic contributed to the failure of “49.”

Wilson believed that people avoided “49” because of the presence of Kaye. Assuming this was true, whether Kaye did not have the insight to realize this or was too ashamed to acknowledge it is unknown, but he is not forthright about this interpersonal friction in his letters. When talking about “49” and his colleagues, Kaye sounded baffled; he was on surer ground when discussing more factual matters.

Kaye’s faults can in part be attributed to his deep and blinding love of what “49” could have meant to the Australian anesthesia community. Kaye felt that he was “gambling in ‘anaesthesia futures’ for heavy stakes.”⁶  Kaye took the failure as a personal one, and he withdrew from the anesthesia community.²² 

In fact, Kaye carried the anger for many years. In correspondence⁷  in 1981, Wilson suggested that Kaye took it too personally. Kaye objected “By thunder it was, and not without reason.”²² 

In the same 1981 letter, Kaye recounts decades-old slights. “I was the subject of wounding remarks in those years. One was an accusation of ‘election-rigging’.”²²  “Another accusation that hurt was that I was trying to ‘make myself the director of the ASA’.”²²  Indeed, Kaye recounts the comment from the Society’s president that “49” was “‘my hobby, as his was gardening’.”²²  Kaye also noted, “The nub lies in your remark about personalization, if we may use a noun so barbaric. Had the ASA of 1950–1955 been made-up of Dalys or McCauls, the scheme would have worked.”²² 

Although Kaye did not achieve his immediate goals, his goals for Australian anesthesia were fulfilled in the end. The Australian and New Zealand College of Anaesthetists, responsible for defining and awarding specialist qualifications, has more than 5,000 Fellows. In 1972, the Australian Society of Anaesthetists started publishing the well-respected academic journal Anaesthesia and Intensive Care. Fittingly, the Australian and New Zealand College of Anaesthetists, paralleling the eponymous Wood Library-Museum of Anesthesiology, in 1958 officially named their museum the Geoffrey Kaye Museum and then in 1987, the Geoffrey Kaye Museum of Anaesthetic History.

We do not know if the idea of “49” had an effect on the subsequent success of Australian anesthesia. Wilson seems to think so, writing in a letter to Kaye that “…the failure of the project had an effect of cementing the society.⁷  Or perhaps its most enduring legacy is the estrangement of Kaye. We can only speculate how that may have helped or hindered the development of anesthesia in Australia.

Support was provided solely from institutional and/or departmental sources.

The authors declare no competing interests.