Beacon to greatness
Anesthesiologist Richard Kitz became a renowned leader at the birthplace of his specialty, with a little help along the way
Even the most accomplished physicians have humbling moments that stay with them forever. For Richard J. Kitz, MD ’54, one of his most memorable came about 20 years ago while lecturing Harvard Medical School students on the pharmacology of anesthetic drugs. At the conclusion of his talk, a very strange thing happened – the whole class rose and clapped.
“I was nonplussed,” said Dr. Kitz, who, in retirement, holds the title of Henry Isaiah Dorr Distinguished Professor Emeritus at Harvard Medical School. “That had never happened to me before. I had been doing this for years. Students get up and they leave, but clapping? So, I left the podium and returned the favor. I told them they were the best group I ever had.”
That’s when one of the students raised his hand and explained the ovation was in gratitude for Dr. Kitz giving the shortest lecture of the year. Call it a humorous chapter in a storied career that spans more than half a century. His journey has taken him from Wisconsin to New York to Boston, not to mention an influential detour with the Navy. If academic medicine had a hall of fame, Dr. Kitz would be elected on the first ballot. For his extraordinary achievements in anesthesiology and leadership in medicine, Dr. Kitz was selected as Alumnus of the Year by the Medical College of Wisconsin/Marquette Medical Alumni Association.
“It was something I really wasn’t anticipating,” the Wisconsin native said of the award. “When you’re 80, you’re way over the hill, and these things typically don’t happen to a kid from Oshkosh! At least they’re not supposed to happen, and I’ve been fortunate to have a number of honors. But the distinction of being nominated as alumnus of the year from the Medical College is unique because it’s my alma mater.”
Although the most recent, the award is just one in a series of remarkable events that have shaped Dr. Kitz’s career through serendipity, ingenuity, or, in some cases, sound counsel. As he says his wife, Jeanne, often reminds him: “The one thing you have done your whole life is listen to people who know more than you do.”
An academic anesthesiologist of international acclaim, Dr. Kitz nearly pursued a different field altogether, on an opposite side of the country from where he forged his career. He thinks it is likely he would be a neurosurgeon in Colorado if not for the intervention of then dean of the Marquette University School of Medicine, John S. Hirschboeck, MD ’37, MS ’41.
Dean Hirschboeck, not without some consensus from noted anatomy professor Walter Zeit, PhD ’39, recognized Dr. Kitz’s potential for academic medicine, something he hadn’t previously considered. With Dr. Hirschboeck encouraging him to immerse himself in the best learning environment available at the time for his general surgery training, Dr. Kitz chose the east coast rather than a western relocation after graduation. His was the first class to go through the national residency matching program, and he accepted a surgical internship at Columbia University College of Physicians and Surgeons in New York.
His studies were interrupted, however, in the aftermath of the Korean War, and Dr. Kitz entered the Navy, where he was assigned to the Third Marine Division in Japan and Okinawa as a medical officer. Upon his return to the U.S., his orders changed in a surprising way – he was named chief of anesthesia, a decision he found inexplicable since he had absolutely no previous experience. The compulsory change, though, precipitated a shift he later made entirely on his own. The exposure to anesthesiology had taught him something about this field and his own interests in medicine.
“I had a full month of anesthesiology and appreciated the basic science aspect of it that is fully applicable to patient care that might not be so with other specialties,” said Dr. Kitz, who did complete another year of his general surgery residency. “Back in neurosurgery, I had second thoughts about what I wanted and whether it would be an appealing career in the long run. The clinical career is not nearly as immersed in basic sciences of pharmacology and physiology as anesthesia. It was a profound decision to change.”
Dr. Kitz not only went on to complete an anesthesiology residency at Columbia, he joined the anesthesiology faculty in 1960. He would spend nearly a decade at Columbia as a teacher, clinician and researcher, but he wasn’t there long before experiencing considerable success in the laboratory.
Some people know what they want to accomplish in their research, and it happens that way, but you have to be prepared for discovery, said Dr. Kitz, who thought he had an error, not a eureka moment, in what turned out to be a major research finding. Time and again, his results did not support his hypothesis, but in reality, he had discovered something altogether new. He became the first to describe how certain drugs used in anesthesia inhibit acetylcholinesterase, an enzyme critical to the mechanisms by which nerves communicate with muscles and each other.
Most research is derivative, building on another’s discovery. This independent finding early in his career was the most rewarding he experienced in the lab, except perhaps for watching his research fellows have their own successes.
“The whole idea of discovering something that has never been identified, repeating it to verify with people looking over your shoulder to make sure you did it correctly, and publishing it in the literature is a very fulfilling experience,” he said.
His most fulfilling professional experience of all, however, began while he was on sabbatical from Columbia in 1968, serving as visiting faculty at the Karolinska Institute in Stockholm. A letter arrived from overseas from a search committee at Harvard Medical School, asking if he would consider becoming a candidate for Anesthetist in Chief at Massachusetts General Hospital (MGH) and the Henry Isaiah Dorr Professor of Anaesthesia at Harvard. While flattered, he turned down the invitation. He was happy at Columbia, he said.
This prompted a phone call five days later from his chief at Columbia, Dr. E.M. Papper, who outlined the opportunity he had declined – the first endowed chair in anesthesia in the world with appointments at Harvard, MGH, and later at Massachusetts Institute of Technology. Dr. Papper made Dr. Kitz promise to toss his hat back in the ring, which he did. On April 1, 1969, Dr. Kitz accepted the post as anesthetist in chief at MGH and the Henry Isaiah Dorr Professor at Harvard.
“It’s an opportunity I should have never turned down,” he said. “The first public demonstration of ether as an anesthetic took place at Mass General. It is the birthplace of the specialty of anesthesiology. That by far is the highest accolade I have ever had in terms of my professional career.”
Legacy in academia
For 25 years, Dr. Kitz served as chief and helped Harvard’s anesthesia department become one of the largest in the world and an international clinical and research training center. Under his leadership, the department produced more than 70 heads of departments worldwide. It also established the first acute care laboratory and the first respiratory therapy department in the U.S. at MGH.
His research interests spanned study of the central nervous system, basic cellular mechanisms, pain management, the action of new drugs, anticholinesterases, and technology for anesthesia safety. He contributed to the design and study of new compounds and received several patents.
Dr. Kitz has also been an enthusiastic teacher. As director of MGH’s anesthesia residency program from 1969-94, he focused on creating leaders among the next generation of physicians.
In 1994, Dr. Kitz stepped down at MGH to become Faculty Dean for Clinical Affairs for Harvard Medical School. In this position, he oversaw the changing relationships between patient care, research and educational efforts of the Harvard clinical faculty at affiliated hospitals. He retired in 1999, though he still serves on several committees for the school and holds honorary appointments.
Whereas most physicians focus on the care of ill or injured patients, Dr. Kitz followed a path defined by teaching, research and improving the well-being of society by enhancing medical care. When he reflects back, not only on his career, but on his discipline as a whole, he pleased with the progress he witnessed and, in many ways, cultivated.
“What has happened is the maturation of the specialty of anesthesia, now sitting comfortably at the high table of academe, and that’s not how it was when I started,” he said. “What fills me with great satisfaction is to see the specialty I chose mature and become a true academic specialty in all academic medical centers.”
Learning the skills to succeed
Through his undergraduate and medical education, Richard J. Kitz, MD ’54, honed the qualities that served him well as he rose in academic leadership at Columbia University College of Physicians and Surgeons and Harvard Medical School. The two qualities with which he emerged from Marquette University School of Medicine (The Medical College of Wisconsin’s predecessor) that have stood him in the best stead, he said, are prudence and lifelong learning.
Higher education is not only about learning a discipline but also about acquiring good habits, Dr. Kitz said. Learning how to make wise decisions has been important throughout his career.
“When you think about being chief of a huge service, responsible for people’s careers, you’re making decisions all the time,” he said. “I learned how to make right decisions at Marquette – how to look at questions, make hypotheses, test hypotheses, look at data to see if hypotheses are supported or not. Those habits have stayed with me.”
Medical school also instilled in Dr. Kitz the habit of continuing to work, to learn and to be curious. As he progressed in academic medicine, this notion was underscored by the critical thinking always taking place among students, residents and faculty.
“You’re swept along by faculty members and very inquisitive students who don’t just take you at your word, but they want to know why you think what you think,” he said. “You need to answer and make sure the information supports what you’re saying and doing – what they now call evidence-based medicine.”
Even in retirement, Dr. Kitz continues to learn and stay abreast of new information in medicine. As far as good decision-making – he said he has learned to (occasionally) say “no.”
View the entire summer 2009 issue of Alumni News. (opens as a pdf)