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emerson moffitt, 86 doctor

Emerson Moffitt in 1949.National Film Board

Emerson Moffitt took what he learned and ran with it.

On the learning side, the physician spent 18 years soaking up the best lessons an anesthetist could ask for, as he conducted clinical and research work at the renowned Mayo Clinic during a watershed period for his discipline. He worked with a group that took part in the first of many open-heart surgeries, specifically those that used a still new technology that pumped oxygen into the circulatory system and took over for the still heart being operated on. He also wrote numerous papers on the effects of anesthesia and cardiovascular surgery on the heart, which helped cardiac surgeons around the world improve post-operative recovery for their patients.

On the running-with-it side, "Moff" was an international star who came back to Halifax and helped build, from the ground up, anesthesia studies in Atlantic Canada. The findings of the provincial commission he chaired helped eventually to outfit regional hospitals in Nova Scotia with trained anesthetists. In the rest of the country he coaxed Canada's university anesthesia departments to confer and organized professional development for seasoned practitioners.

"He was a prolific scientist and clinician who made crucial contributions to medicine's understanding of the impact of open-heart surgery and anesthesia while at Mayo Clinic," said Mark Warner, a doctor at the Rochester, Minn., institution.

His resignation from Mayo, a place with traditionally little turnover, came in 1972, the year after his first wife died. Wanting his two teenage daughters to be closer to their relatives and with his climb up the Mayo administrative ladder seemingly stalled, he answered a year-long courting by his alma mater Dalhousie University and took up the call to teach, research and run a department.

Emerson Amos Moffitt died on April 30 in Halifax at the age of 86 of heart failure. Born Sept. 9, 1924, in Harvey, N.B., he was the second of three children of Amos Alexander and Ellen Selena (née Wilson) Moffitt. He grew up in the small railway town of McAdam, where his father worked as a railcar repairman for Canadian Pacific and his mother ran a boarding house out of their home.

Growing up during the Depression, the young Moffitt often worried that his father would lose his job, but his father remained employed at CP. He proved to be a top student and his parents began early to save for his education. He would become the only one of the three Moffitt children to attend university. He was also an active athlete and, when postsecondary studies began, he joined the University of New Brunswick's varsity hockey team, playing goaltender.

In 1944, he interrupted his pre-med studies at UNB by enlisting in the Fleet Army of the Royal Navy. He was stationed in England, where he trained as a pilot. When the Second World War ended, he returned home without having seen active duty.

After the war, he resumed his undergraduate studies at UNB and then went on to attend Dalhousie Medical School, interning at the Victoria General Hospital. He graduated in 1951, the same year he married Helen MacDonald, a nurse at the Victoria, and set up a general practice in her hometown of North Sydney, N.S.

It was during his time in the Cape Breton mining and port town that he began to see the wanting state of anesthesia. As a child, he had his tonsils removed on his kitchen table, and now he was expected to be that same kind of doctor, tending to all manner of care. At the hospital, he was performing general practice anesthesia, using an open drop method, where ether or chloroform was given to patients who inhaled it through a mask and usually experienced post-operative nausea and vomiting. Better anesthetic drugs were to come in the next decade, but it was the training of specialists that he saw was vitally needed, especially when he heard about the advances being made in the United States and the UK.

He decided to apply for anesthesia residency and chose the Mayo Clinic both because of its reputation and the fact that two of his former classmates had become medical residents there. He was accepted for postgraduate training and in 1954.

His observed the exciting advances being made to support open-heart surgery. Debates were taking place on how to sustain life during a surgery that actually had to stop the heart. Some hospitals were experimenting with surface hypothermia, putting the body into a state of hibernation, while others were hooking up a family member to receive blood from the patient and return it oxygenated. But a machine called a pump-oxygenator would win out.

"There was a lot of trial and error. It was a tense and exciting business," said Alan Sessler, a colleague now retired from Mayo.

In 1955, the first successful series of open-heart surgeries in children with congenital cardiac defects began at Mayo, using the pump-oxygenator. For his 1956 Master's thesis, Moffitt documented 45 of the first patients, measuring, among other things, blood flow, as well as oxygen, carbon dioxide and acid levels in the blood.

He arrived just before the departure of department head J.S. Lundy, who first introduced sodium pentothal to anesthesia, and worked closely with many other lions of the era, including surgeon John Kirklin, who was responsible for bringing the heart-lung machine into routine use, and a young physiologist, Jeremy Swan, who would later co-invent the ubiquitous Swan-Ganz catheter, which improved a surgeon's ability to monitor a patient's blood flow during surgery.

In 1957, Moffitt was brought on staff and became the go-to guy to provide information to his team on the effects of such an extreme trespass on the body. Three years later, he won a fellowship that allowed him to travel to six European cardiac surgery centres, bringing back that knowledge to Mayo and in turn presenting talks internationally about the work being done in the U.S. By 1966, he was head of anesthesiology at St. Mary's Hospital, the larger of the Mayo's two teaching hospitals. Between 1957 and when he left in 1972, he had 75 peer-reviewed publications.

"He laid down some foundations of the heart's response to all our anesthetic medicine and gases," said Adam Jacob, who, at the Mayo in 2007, gave a presentation of Moffitt's contribution to anesthesia.

Despite the productive years and significant contribution, his resignation letter hints of a bitterness, as he appears frustrated by not being able to rise further in the organization. "Professionally at the Mayo, I feel I have gone as far as possible in my areas," he writes. "Here, a challenge no longer remains."

If he was looking for a challenge, it could certainly be found in Nova Scotia in the early 1970s: The province had little anesthesia being taught and no specialists in the regions. For Dalhousie and the Victoria General, where he was welcomed back, he recruited anesthetists to teach, got operating-room staff to help collect research and had anesthetists giving pre- and post-operative bedside visits. He overhauled cardiac surgery and established cardiac intensive care and pediatric cardiac surgery.

In 1976-77, Moffitt chaired an advisory committee on anesthesia for the Nova Scotia Department of Health, which led to the first provincial guidelines for the practice of anesthesia in Canada. It was accepted by the province and emulated across the country.

In 1980, he spent six months on sabbatical at Cedars-Sinai in Los Angeles to work with his old colleague Jeremy Swan on the Swan-Ganz catheter, which he then put through several years of study. Despite his increased administrative roles, he continuously researched, working, for example, to better understand how to preserve the fragile oxygen supply to the heart muscle during and after surgery, part of a 10-year grant from the Heart and Stroke Foundation of Nova Scotia.

No description of his life can leave out his incorrigible need to offer up puns. "Always another pun in the oven," he said as emcee of a medical variety show that overflowed with groaners. In a recent letter about it, he signed off as a "retired corn producer."

His second wife, Phyllis Redden, died in 1987 and, in 1989 he married a nurse, once again. Isabel Vibert was the widow of Jim, one of his buddies who had been a resident at Mayo and whose presence there helped convince him to make that life-changing move.

He retired in 1991 and remained in Halifax. In the last couple of years, he began to suffer from Alzheimer's disease.

He leaves his wife, Isabel, his children Eric, Celene and Laurie, and five grandchildren.

Special to The Globe and Mail

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