Nurse Anesthetists at the Mayo Clinic: A Look at the Women Who Contributed to Early Developments in Anesthesiology and Perioperative Medicine 

Published by Cecelia Coleman and Lisa Atkinson

This year, 2024, marks the centennial of the Mayo Clinic’s Department of Anesthesiology and Perioperative Medicine. The inauguration of the department is most often linked with the arrival of Dr. John S. Lundy to Rochester, Minnesota in April of 1924.¹ While history readily remembers individuals like Dr. Lundy for their contributions to advancements in anesthesia – and rightly so – often overlooked is the important role of women in the operating room. Early techniques for administering anesthesia were crude and required assistance to properly deliver the anesthetic of choice.¹ Those who were trained to administer anesthesia would come to be known as Nurse Anesthetists. The history of nurse anesthetists in the United States dates all the way back to 1871 when Sister Mary Benard, who worked at St. Vincent’s Hospital in Erie, Pennsylvania, became the first nurse to become specialized in anesthesia. The Mayo Clinic itself is a historically significant site in the development of the profession of Nurse Anesthetists.²

In 1889, Edith Graham became the first and sole Nurse Anesthetist at St. Mary’s Hospital. Returning to Rochester after completing her nursing degree at the Women’s Hospital of Chicago, Ms. Graham began working for Dr. William Worrell Mayo as nurse, bookkeeper, and secretary.⁶ One of Ms. Graham’s early responsibilities was to train the nursing staff. She instructed the sisters on housekeeping, meal preparation, dressing wounds, giving medications, inserting catheters and temperature assessment through informal lessons and observation. 

The eventual success of St. Mary’s Hospital rendered the capable Mayo surgeons unable to administer anesthesia themselves due to their workload. Dr. W.W. Mayo recognized the need to appoint conscientious and skilled providers – and he didn’t have to look far. Dr. Mayo found Ms. Graham to be intelligent and capable; over a period of about two months, Ms. Graham succeeded in learning the art of administering chloroform. Dr. Charles H. Mayo wrote a testament to Edith’s success with ether in a letter sent to her from Chicago, “ … maybe we should give you a week off to teach the interns in Chicago how to give ether.” Edith Graham served as Nurse Anesthetist until 1893, when she became Edith Graham Mayo after marrying Dr. Charles. 

Alice Magaw Kessel took over the responsibilities of Nurse Anesthetist at the Mayo Clinic and had a profound impact on the profession, earning herself the title of “Mother of Anesthesia.”^1,2 Due to her success as a Nurse Anesthetist, she was invited to speak to the Olmsted County Medical Society in 1899 and her lecture was then published in The Northwestern Lancet as “Observations in Anesthesia.”² Throughout her career, she published four more papers in medical journals on her observations of anesthesia practice.² The standards she set for safe, research-based anesthetic administration have endured to present-day.

Under Magaw Kessel, other Nurse Anesthetists were trained, including Florence Henderson, who began administering anesthetics in 1904.¹ With Magaw’s mentorship, Henderson became an ether specialist at the Mayo Clinic and held her position for 14 years before moving to California.³ Magaw and Henderson worked to refine open drop ether administration and disseminate their expertise through papers and presentations.³

The prevalence of female nurses working as anesthetists early on actually led to the belief that feminine qualities were important for anesthetic administration.³ Some of this attribution was due to power dynamics between surgeons and anesthetists, as surgeons were considered superior to other medical workers in the operating room.⁴ This narrative aligned with the gender roles of the time and the notion that women should be subservient to men.⁴ However, the psychological and social skills that were considered “more natural” for women to have were helpful for soothing patients prior to surgery.⁴ Both Magaw and Henderson were known for their excellent bedside manner.¹

Bibliography

1. https://history.mayoclinic.org/wp-content/uploads/2024/05/Edith-Graham-Mayo_-Mayo-Clinics-First-Nurse-Anesthetist.pdf
2. https://libraryguides.mayo.edu/historicalunit/anesthesiology
3. https://www.aana.com/about-us/history/ 
4. https://history.mayoclinic.org/wp-content/uploads/2024/05/Alice-Magaw-Kessel_-Her-Life-In-and-Out-of-the-Operating-Room.pdf
5. https://history.mayoclinic.org/wp-content/uploads/2024/05/Voice-and-Touch_-Florence-Henderson-on-the-Skills-of-an-Ether-Specialist.pdf
6. https://www.researchgate.net/publication/44631507_Anesthesia_as_Women’s_Work_The_Historical_Role_of_the_Female_Anesthetist

Photographs used with permission of Mayo Foundation for Medical Education and Research. All rights reserved.

Cecelia Coleman is a rising senior at Smith College in Northampton, MA majoring in Biochemistry with a Museums concentration and a summer intern at the International Museum of Surgical Science.

Lisa Atkinson is a Chicago-based composer whose work explores interiority through the tactile nature of live performance and the emotional context of gesture while examining issues of fragility, memory, and perception. As a writer, Atkinson’s music reviews have been featured in the publication Which Sinfonia.