THERE are rare occasions in any field when the time, the environment, and a special person converge to produce an outstanding result. Fortunately, the time and the environment were right for Bryan E. Marshall, and the result will have a lasting impact on our specialty. (Figure 1).
Dr. Bryan E. Marshall was born in London, England, in 1935, and educated at Ravenswood and Daunteys Schools. His interest in anesthesia, which began while a student at the Leeds University Medical School, was solidified during a general medical internship, when he undertook his first research into the incidence of muscle pains after outpatient surgery. He became a registrar in anesthesia at the United Cambridge Hospitals and, after qualifying as a specialist in Anaesthesia and in General Medicine, was awarded an Elmore Research Scholarship at Cambridge University. Under the encouragement of Dr. Ronald Millar, his first major work concerned the factors influencing postoperative hypoxemia. A report of this work was awarded the prestigious Research Prize of the Association of Anaesthetists in 1964. Soon after, Dr. Marshall, his wife, Carol, and their two children, Leisa and David, moved to the University of Pennsylvania for what was intended to be 2 yr of research training.
At the University of Pennsylvania, Dr. Robert Dripps had assembled an extraordinary group of clinician-scientists that included James Eckenhoff, Henry Price, Harry Wollman, Craig Alexander, Peter Cohen, Ted Smith, Stanley Deutsch, and others, and Dr. Marshall thrived under their guidance. He joined the University of Pennsylvania faculty in 1967; by 1973, he was appointed a full Professor of Anesthesia in the School of Medicine and Professor of Comparative Anesthesia in the School of Veterinary Medicine. In 1983, the Horatio C. Wood Professorship was endowed to support his continued research activities.
Although a skilled clinician, teacher, scientific reviewer, and research administrator, the majority of his career has been committed to anesthesia research, where he has brought an extraordinary combination of dedication, brilliance, and expertise to questions of real importance to the specialty. His investigations have been devoted to understanding the causes of hypoxemia in the perioperative period, but this terse description does not capture his flair as a scientist. He has demonstrated a knack for seeing what others have missed and a willingness to learn whatever methods are required to advance a difficult scientific area. In the process, he has studied mitochondrial respiration, lung water balance, and shock, and his contributions have brought order and quantitation to areas previously dominated by opinion, conflict, and uncertainty. His publications, which span more than a quarter century of work in the area, represent the scientific basis that guides much of our current practice, teaching, and research regarding perioperative hypoxemia. His work of the last decade on hypoxic pulmonary vasoconstriction began with a paper that demonstrated why disparate data from different laboratories were entirely consistent when looked at from a new viewpoint, an approach typical of his vision and insight in research matters. From there, his laboratory embarked on a series of studies to identify and quantitate the important factors that influence hypoxic pulmonary vasoconstriction. Dr. Marshall created a computer model that combined this new understanding of the active regulation of pulmonary blood flow with existing concepts of gas exchange as a distribution of ventilation-perfusion ratios. The model is both powerful and realistic and is being tested as a bedside clinical assistant. Simultaneously, his research team began to focus on the basic mechanisms by which the pulmonary arteries sense local oxygen tension, and it is my understanding that they are close to a successful outcome here also.
Not surprisingly, Dr. Marshall has attracted a succession of outstanding collaborators and visiting scientists from some 15 countries to his laboratory. None have been more important than his wife, Dr. Carol Marshall, who, in 1979, brought her research talents to join those of her husband to evaluate the importance of hypoxic pulmonary vasoconstriction in perioperative pulmonary function, a collaboration that has been extraordinarily productive.
The enthusiasm, energy, and analytical approach that Dr. Marshall brings to his work have influenced many who have gone on to successful careers in anesthesiology and the basic sciences, including several who now hold leadership positions in the specialty. His interest in the scientific basis of our specialty continues unabated, and he serves as an excellent role model for future investigators in our discipline.
David E. Longnecker, M.D., Robert Dunning Dripps Professor and Chair, Department of Anesthesia, University of Pennsylvania, 4 North Dulles Building, 3400 Spruce Street, Philadelphia, Pennsylvania 19104-4283.