Translational research and the perioperative phenotype: University of Michigan.

1233 December 2013 I DO not believe in fate, but some things just make you wonder. In 1875, a senior resident completing his training in surgery at the University of Michigan presented his required senior thesis entitled: “Anaesthetics and their Use.” This 46-page neatly handwritten manuscript described the state-of-theart of anesthesiology in impressive detail. What was surprising to me is that his name was Robert Tremper and he left Michigan to practice surgery in Los Angeles, California. One-hundred and fifteen years later, I left Los Angeles to become the fourth department chair of anesthesiology at the University of Michigan. The University of Michigan Medical School advanced anesthesiology from a section of surgery to departmental status in 1949, making it one of the early academic departments of anesthesiology in the nation. Warren Wilmer, Jr, M.D., served as acting chair until Robert B. Sweet, M.D. (1917–1980), was appointed as the first permanent chair in 1952. Bob Sweet had completed a surgery residency program at Michigan prior going to Massachusetts General Hospital (Boston, Massachusetts) for his training in anesthesiology. He progressively developed an excellent clinical program to support a well-respected surgical department (they trained the Mayo Brothers in surgery). At that time, there were few formally trained anesthesiologists to recruit as faculty. In the 1920s, the Department of Surgery had a visiting exchange program for young surgeons with St. Bartholomew’s in London, United Kingdom. On behalf of Dr. Sweet, Frederick Collier, M.D. (1887–1964), the chair of surgery at Michigan, asked his colleagues at St. Bartholomew’s whether there were any young anesthesiologists who might be interested in spending a year in the United States. Consequently, in 1956, Thomas Bolton, M.D., F.R.C.A. (1925–), and his wife came to spend a year in Ann Arbor supported in part by a scholarship provided by Senator Fulbright. Thomas Bolton enjoyed the year so much he encouraged others to follow him—a yearly tradition that has continued till today. Dr. Sweet stepped down as chair in 1975 and a national search was initiated with the goal of finding an individual who would develop a more extensive research program. Dr. Peter J. Cohen, M.D., J.D. (1935–2010), became the second chair in 1976 and he recruited, among others, Paul Knight, M.D., Ph.D. (1947–) who ultimately became the director of research. After Peter Cohen stepped down as chair in 1985, I was recruited and found not only an extremely supportive dean and hospital director, but an especially supportive chair of surgery, Dr. Lazar Greenfield, M.D. (of inferior vena cava filter fame). My decision to come to Ann Arbor was based primarily on the encouragement and support of these three individuals. One of the reasons for selecting the University of Michigan to be highlighted in this issue is that we are a large U.S. public institution. Previous departments highlighted in the December issues were either private institutions or part of national health systems. Although public institutions receive state funding, the primary source of revenue is collections from professional fee billings. Most of the additional support received by departments in the United States is derived from their hospital, which is interested in clinical care, administrative duties, and the recruitment and training of residents. The common ground between the hospital director and the academic department chair is the desire for high-quality Translational Research and the Perioperative Phenotype