Who better than anesthesiologists? The 44th Rovenstine lecture.

I AM very honored to have this unique opportunity to honor Emery A. Rovenstine, M.D., D.Sc., and to offer my thoughts on anesthesiology and my dreams for its future. Dr. Rovenstine (Professor of Anesthesiology, New York University College of Medicine, New York, New York; 1895–1960) is well known as a leader who motivated outstanding young physicians and helped them develop into major contributors to our specialty. Not as well known about Dr. Rovenstine are his extraordinary athletic talents. His experiences as a high school basketball player would later influence his contributions to the development of our specialty. Let me set the stage. As reported by Solomon G. Hershey, M.D. (Professor of Anesthesiology, Albert Einstein College of Medicine, New York, New York; 1914–1992) in his 1982 Rovenstine Lecture and augmented by resources housed at the Dwight D. Eisenhower Public School District office in Chicago, Illinois, it is winter 1913 in Blue Island, Illinois, a southern suburb of today’s Chicago. Young Rovey (as he was affectionately called by his mentor, Dr. Ralph Waters, and others) is a high school senior and captain of his team. Late in the second half of a hotly contested game during which Rovey believes that he is repeatedly being hindered by the referee, he heatedly and “accidentally” butts into the referee. This ramming incident proves to be a mistake: The referee is considerably larger and stronger, picking up young Rovey and reportedly spanking him in front of the crowd. Oddly enough, it turns out that the referee is none other than Arthur E. Guedel, M.D., the distinguished anesthesiologist from the University of Indiana Medical School (Indianapolis, Indiana) who would subsequently describe the stages and planes of ether anesthesia. Ten years later, when Dr. Rovenstine returned from military duty as an Army 2nd Lieutenant on the front lines in France, and after 4 yr of teaching high school in La Porte, Indiana, he enrolled in the University of Indiana School of Medicine. He took every course offered by Dr. Guedel (subsequently Clinical Professor of Anesthesia, University of Southern California, Los Angeles, California; 1883–1956), and they became close friends. That Dr. Guedel had also served with the American Expeditionary Forces in France provided an additional common bond that cemented their friendship. It was Dr. Guedel who ultimately recommended Dr. Rovenstine for a training appointment with Ralph M. Waters, M.D. (Professor of Anesthesiology, University of Wisconsin, Madison, Wisconsin; 1883–1979), initiating what would become a warm personal and professional relationship between Drs. Waters and Rovenstine. Dr. Rovenstine remained a strong fan of basketball. Before enrolling in medical school, he even served as the coach of the LaPorte, Indiana High School basketball team, winning the admiration of his team members and other students. The LaPorte High School 1924 yearbook is dedicated to him. “To our loyal coach and athletic director, E.A. Rovenstine, through whose efforts clean sportsmanship has been continually maintained in LaPorte High School, we, the class of Twenty-four, affectionately dedicate this volume . . .” It is this unique blend of dedicated sportsmanship, teamwork, and leadership development that makes Dr. Rovenstine so intriguing, memorable, and deserving of recognition by this eponymous lecture. I would like now to describe my dreams for the future of this great specialty. The tragedy of Hurricane Katrina has resulted in a remarkable venue change of this meeting from New Orleans to Atlanta. Clearly, our celebration of 100 yr of the American Society of Anesthesiologists has been muted by Katrina. But our meeting remains a celebration of success—the 100-yr evolution of a medical specialty society that grows and thrives. Sadly, though, there are skeptics who question the ability of our specialty to survive, much less flourish, in the coming years. Several factors fuel this skepticism. Our country’s healthcare costs continue to grow and will soon exceed 15% of our gross domestic product, a level that may not be sustainable. How will our specialty excel when constrained resources limit our ability to produce new discoveries and clinical applications that improve the care of patients or that result in less enthusiastic physicians entering anesthesiology? There is a growing perception that modern anesthesia care is so safe that there is no longer any need for the National Institutes of Health (Bethesda, Maryland) and other funding agencies to share resources with anesthesiologists to develop safer drugs and better anesthetic techniques. We know This article is featured in “This Month in Anesthesiology.” Please see this issue of ANESTHESIOLOGY, page 5A.