Introduction:-
In October 2008 Dr. Ronald D.
Miller received the prestigious Distinguished Service Award from the American
Society of Anesthesiologists. Shortly before, he had announced his intention to
step down as Chairman of the Department of Anesthesia and Perioperative Care at
the University of California San Francisco in June 2009. It is thus appropriate
to have a retrospective examination of one of the most remarkable careers in
the field of anesthesiology. As a simple illustration of his contribution to
the specialty, his C.V. runs to 37 full pages, single-spaced, in 8 point font
size. The Department of Anesthesia and Perioperative Care at the University of
California San Francisco (UCSF) recently celebrated its 50th anniversary as an
independent department. For almost half of its existence Ronald D. Miller has
been the chairman of the department. Taking over as Chair in 1984, he faced a
daunting task; he was following in the footsteps of two giants in the field.
Stuart C. Cullen, the first Chairman, founded the department in 1948 and built
a solid foundation of clinical and research excellence. Such was his stature in
the medical school that he moved from Chair of the Anesthesia Department to
become Dean of the Medical School. William K. Hamilton, Cullen’s successor,
continued the progress begun under Cullen and further developed the clinical
and operational side of the department, including creating a significant
anesthesiology presence in the ICU. Ronald Miller rose to the challenge, and
under his guidance the department has achieved greater prominence and could put
forth a strong argument for being the nation’s preeminent department of
anesthesiology. This article gives a brief summary of the influence of Ronald
Miller on the Specialty of Anesthesia.
Background:-
Dr. Miller was raised in Indiana
and had his medical education at Indiana University in Bloomington. He still
maintains an Indiana medical license. He is also a gifted musician, and he
played both piano and horn in smoky bars to finance his education. When not
studying or making music, he was an avid golfer and on the varsity golf team.
From Bloomington, he moved to Southern California to an internship at Riverside
County Hospital. Following internship he moved north to San Francisco, was a
resident in anesthesia from 1965 to 1967, and a fellow in pharmacology from
1967 to 1968. He has remained at the University of California since 1965, with
the only break being from 1968 to 1970 while he served in Vietnam. Dr. Miller
was a staff anesthesiologist in the U.S. Navy. His first posting was in San
Diego, which preceded a tour of duty in Da Nang, Vietnam, where he was awarded
a Bronze Star with a combat V for meritorious Service. It was during this time
that he performed seminal research in blood transfusion, resulting in such
papers as “Effects of massive transfusion of blood on acid-base balance” and
“Coagulation defects associated with massive transfusion,” both published in
1971. This work was not only of academic interest, but, more significant,
helped to improve survival of those wounded in that conflict. During his tour
of duty in Vietnam, he perfected his skills in regional anesthesia. The reason
was simple—he needed to provide safe anesthesia for several trauma patients
simultaneously, when they were being supervised directly only by corpsmen.
Regional anesthesia was the solution to the problem. This experience made him
an early proponent of regional anesthesia and of the role of anesthesia in pain
control, and he is a charter member of the American Pain Society. One of the
many positions he held at UCSF was as director, from 1984-1987, of the nerve
block service, the progenitor of the pain service.
Source:-
https://www.csahq.org/docs/default-source/news-and-events-docs/csa-bulletin-docs/spring-2009/miller_58_2x.pdf?sfvrsn=71eac646_2
https://www.youtube.com/watch?v=3qf0ANQ-6lg