To the Editor:—

I read with great interest the erudite review 1of Holding Court with the Ghost of Gilman Terrace: Selected Writings of Ralph Milton Waters, M.D. , and I have a few comments. First, Waters developed the first academic department not only in the United States but also in the world . I base this statement on the knowledge that Sir Robert Macintosh, the first professor of anesthesia in Europe, who developed the department of anesthesia in Oxford, England, made his “first pilgrimage to Madison, The Mecca of anesthetists in the early 1930s” (quotation from Sir Robert) when he was in private practice and there was no interest in Britain in teaching anesthesia at the postgraduate level. 2 

Second, Waters’ department, even in its early days, incorporated all the ingredients of current successful academic departments. Teaching and research existed hand in hand with clinical service. The research included work in the laboratory and the operating room. The teaching included frequent departmental meetings. 2 

Third, I have been puzzled for years about the reason(s) for the lack of adequate recognition of this pioneer of our specialty. I know that since 1966 a Ralph Waters award and its companion lecture have been presented in a regional anesthesia meeting (The Midwest Anesthesia Conference), and a recent conference was held in Madison, Wisconsin, but are these adequate tributes for the  outstanding man of our specialty over the past century? When I started learning anesthesia, I became aware of the name Waters as associated with a “mysterious” (to me) city called Madison, Wisconsin. When I came to Iowa City, Iowa, I made the “pilgrimage” to the city of my hero, which I discovered to be within a few hours’ drive. Although a charming university town, I was disappointed by the lack of any tributes I could find to this giant of academic anesthesia and anesthesia in general. I have been told that his reclusiveness after he retired may have contributed to this state of partial neglect. Maybe someone in the future will research his life and his reasons for keeping his distance from the field of anesthesia after his retirement. Perhaps, it was axiomatic that Ralph Waters introduced John Snow, the father of scientific anesthesia, to our specialty in the 1930s. 3Now is the time to properly introduce Waters, the father of academic anesthesia.

Finally, the review stated elegantly that Waters’ thoughts, observations, and recommendations are as relevant to our specialty currently as they were in his time. I venture to add that they are even more poignant in the current crisis facing academic anesthesia.

Todd MM: Holding Court with the Ghost of Gilman Terrace: Selected Writings of Ralph Milton Waters, M.D. (book review). A nesthesiology 2003; 98: 1525–6
Macintosh RR: Ralph M. Waters Memorial Lecture. Anaesthesia 1970; 25: 4–13
Waters RM: Carbon dioxide absorption from anaesthetic atmospheres. Proc R Soc Med 1936; 30: 11–22