Reflections on the anesthesia-neurosurgical alliance

This is an uncommon article for a modern scientific journal in that it contains no data, it is written in the first person, and it recounts only the personal experiences of a clinical neurosurgeon about the evolution of neurosurgery, anesthesiology, and neuroanesthesiology in Philadelphia from 1939 to 1988, when the surgeon retired from the operating room. The surgeon, Fred Murtagh, practiced neurosurgery during an extraordinarily formative time for American medicine and neurosurgery. He was on the faculty of Temple University for many years and currently is Emeritus Professor of Neurosurgery at the University of Pennsylvania. His observations are from the point of view of a man who has been in the operating room continuously since the early 1940s grappling with the practical problems confronting the neurosurgeon. In addition, he is a highly observant individual and considered by many to be an extraordinary teacher. With respect to the genesis of this article, the neuroanesthesia group at the University of Pennsylvania invited Dr. Murtagh to one of their monthly meetings. A tape recorder was placed in front of him and we were privileged to listen to 2 h of reminiscence about his career and relationships between anesthesiologists and neurosurgeons. Over a several year period, Fred Murtagh and D. S. Smith extracted that tape and wrote the following article. It is my belief that this article, despite its unorthodox format, contains observations of import to clinicians in general and to those who practice the subspecialty of neurosurgical anesthesia.