Alice Magaw administered more than fourteen thousand anesthetics at the Mayo brothers' hospital without a death attributable to the anesthetic, and — the part that mattered — published the numbers.
Rochester
Magaw was born on November 9, 1860 in Coshocton, Ohio, and trained at the Women's Hospital School of Nursing in Chicago from 1887 to 1889.
In 1893 she went to St Mary's Hospital in Rochester, Minnesota as anesthetist to William and Charles Mayo, and stayed until 1908.
Anesthesia in the 1890s was not a medical specialty. It was a task, generally handed to whoever was least needed elsewhere — a medical student, a junior surgeon, an orderly. American hospitals had begun giving it to nurses instead, on the reasoning that a nurse would stay at the patient's head and watch, which is the whole of the job and the thing a distracted student would not do.
The method
Magaw used open-drop ether: ether dripped onto a gauze mask over the patient's face, the depth controlled by the rate of the drops and by continuous observation of breathing, colour and pulse. There was no monitor and no measured dose. The technique is the observation.
She combined it with what she described as talking the patient down — a running, calm, suggestive commentary through induction, keeping the patient cooperative and reducing the amount of ether needed. Less ether meant fewer overdoses, and overdose was what killed people.
The publications
Between 1899 and 1906 Magaw published six papers, beginning with "Observations in Anesthesia" in the Northwestern Lancet and culminating in "A Review of Over Fourteen Thousand Surgical Anæsthesias" in 1906.
Publishing case series was what physicians did. A nurse doing it — reporting her own outcomes, in numbers, in the medical press, and inviting the profession to check her — was close to unheard of, and it is why nurse anesthesia had an evidence base before medical anesthesiology existed as a specialty.
Surgeons came to Rochester to watch her work and took the technique back with them. Charles Mayo called her the mother of anesthesia.
Afterwards
Magaw left in 1908 on marrying Dr George Kessel, and returned to practise at Mayo in the early 1920s after they separated. She died on February 17, 1928 in Hudson, Wisconsin, of complications of diabetes.
Nurse anesthesia is now the oldest and best paid of the four advanced practice roles, with its own certification since 1945 and mandatory continuing education since 1978, both well ahead of the rest of nursing. See certified registered nurse anesthetists. The American Association of Nurse Anesthesiology has given the Alice Magaw Outstanding Clinical Practitioner Award since 1998.
Related
Sources
- Alice Magaw, for the chronology, the publications and the Mayo years. Accessed September 9, 2026.
- History of AANA. American Association of Nurse Anesthesiology. Accessed September 9, 2026.
- "A Review of Over Fourteen Thousand Surgical Anæsthesias", Alice Magaw. Surgery, Gynecology and Obstetrics, 1906. Accessed September 9, 2026.