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October 21, 2008
9:00 AM - 11:00 AM
Room Hall E2-Area D,
Ralph Waters and the Establishment of the Nuffield Chair of Anaesthetics
Mark E. Schroeder, M.D.
Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
The history of the founding of the Nuffield Chair of Anaesthetics at the University of Oxford is interesting and well known. Ralph M. Waters visited England in the summer of 1936, spoke at the British Medical Association (BMA) meeting held in Oxford, and met individuals prominently involved in the negotiations for the new chair in Anaesthetics. Waters' correspondence suggests his influence played a role in the founding of the new chair, although not all of his advice was accepted.

Hugh Cairns, a neurosurgeon at the London Hospital and later the Nuffield Professor of Surgery, submitted a memorandum expanding his proposal for a research-oriented postgraduate medical school at Oxford in May 1936. A copy of the proposal was given to William Morris (Lord Nuffield) in mid-July soliciting his financial support. While at dinner with Robert Macintosh and other doctors from Guy's Hospital, London, Nuffield outlined the scheme for chairs in Medicine, Surgery and Obstetrics. Macintosh's casual remark, “I see they have forgotten anaesthetics again” eventually resulted in Nuffield endowing a fourth chair in Anaesthetics despite significant opposition.

Noel Gillespie, an anesthetist at the London Hospital, suggested Waters as a speaker for the Section of Anaesthesia of the BMA meeting in Oxford in July 1936. He also served as host while Waters was in England. Waters' reputation and the unqualified success of his talks at the BMA and later at the Royal Society of Medicine made him a popular figure amongst anesthetists and surgeons during his visit.

Dr. and Mrs. Waters visited Macintosh's home for a luncheon, also attended by Hugh Cairns. The concept of an anesthesia academic center was discussed, but the specifics about endowment and location were not disclosed. In a letter dated November 11, 1936, Macintosh credits chatting with Waters at that lunch for his decision that a Professor of Anaesthetics should be appointed—a rank on which Nuffield later insisted.

Waters apparently did not appreciate that Macintosh was Nuffield's choice for the position. Waters' reply to Macintosh on November 24 suggests that Gillespie, “an Oxford man, [with] the Oxford tradition sincerely at heart, and...well grounded in science,” should be considered “for the job.”

Macintosh wrote to Waters on December 10, more than a month before the official announcement of his appointment. “About the anaesthetic appointment I am far from happy. We have no one who can fit it in a manner which approximates the term 'adequate'. It so happens that I have anaesthetized several connected with the scheme, and I have been offered and, rightly or wrongly, accepted the post.” He reports that his “income will be halved,” that Gillespie was considered for the job, and that he told Cairns “that you and Rovenstine are the only two…who could fill the post.”

Ralph Waters' visit to England coincided with discussions about the establishment of the Nuffield Chair of Anaesthetics at Oxford. His subsequent correspondence with Cairns, Macintosh and Gillespie indicates he significantly influenced those establishing the new chair.

[1] Beinart J. A History of the Nuffield Department of Anaesthetics, Oxford 1937-1987. Oxford University Press, 1987

[2] Waters Papers, University of Wisconsin Archives, Madison

[3] Gillespie Papers, Wood Library-Museum of Anesthesiology, Park Ridge.

Anesthesiology 2008; 109 A1362