Dr Morton Digby Leigh has been acclaimed as the 'Father of Paediatric Anaesthesia' in Canada. He made his important contributions at a time when a number of pioneering physicians had established the specialty, but most anesthetics were administered by untrained general practitioners, pediatricians or nurses. Although adult anesthesia was slowly evolving, few gave special considerations to dealing with children. In 1938, Dr Leigh joined Drs Wesley Bourne and Harold Randall Griffith in Montreal as the third, and youngest, member of the 'Great Triumvirate' of Canadian anesthesia. This group made an enormous impact on the future directions of the specialty: as a result of their dedication to clinical service, teaching and research, in the organization of professional societies, and by their publications in the specialty journals. They responded to the increased role for anesthesia in the wartime period and the need for a dramatic expansion of clinical services which followed. Throughout, Dr Leigh dedicated his career to the pursuit of the professionalism of anesthesia and gaining recognition for the sub-specialty of pediatric anesthesia.
Dr Leigh was born in Jersey, in the Channel Islands, on September 23, 1904. He grew up in British Columbia, Canada and obtained his baccalaureate from the University of British Columbia in 1927. He graduated in medicine at McGill University, Montreal, in 1932, and later became certified in Anesthesia by the Royal College of Physicians and Surgeons of Canada. He was honoured with certification as a Diplomate of the American Board of Anesthesiology in 1942, and Fellow of the Faculty of Anaesthetists, Royal College of Surgeons of Great Britain and Ireland in 1950. After graduation, Dr Leigh spent two years as an internist at Montreal General Hospital and began specialty training in pediatric surgery at the Children's Memorial Hospital in Montreal. For a time, Dr Leigh established a general practice in the city, but was encouraged by Dr Wesley Bourne to train in anesthesia. As a result, he went to the University of Wisconsin in 1936 for three years' anesthesia residency under the tutelage of Dr Ralph Waters.
In 1939 he returned to Montreal as a Research Fellow in Pharmacology before becoming the Anaesthetist-in-Chief at the Children's Memorial Hospital in 1940, when his predecessor, Dr HP Mitchell joined the armed forces. The newly appointed thoracic surgeon, Dr Graham Ross, was gaining an international reputation and insisted on having a well trained pediatric anesthetist. In Dr Leigh, he found someone who catalyzed the clinical, educational and research activities of the department. The safe use of spinal and local anesthetic techniques in children were reported, and Dr Leigh devised a non-rebreathing valve for pediatric use which remained popular for many years. It was adapted by his successors several times, and became known as the Stephen-Slater valve. Dr Leigh's individual style of teaching pediatric anesthesia was cajoling, humorous and provocative: delivered in a characteristic nasal twang and gaining him a formidable reputation as a teacher. He was responsible for instituting teaching programs to provide instruction in clinical anesthesia for McGill undergraduates, interns and clinical fellows.
In 1940, a two year course for theoretical and practical instruction in anesthesia, directed by Drs Bourne and Leigh and based at St Mary's and Children's Memorial Hospitals, was introduced. This was for graduates with at least one year of internship and "for those who wish to specialize in the rapidly expanding field". Dr Leigh later wrote to the librarian of the Wood Library Museum that "My first resident was sent by McGill University. Once a week this lone resident and I held a meeting to discuss our interesting cases. I invited other residents from the other hospitals to join us and some came.......about 1943, when the Canadian Navy, Army and Air Force decided to send physicians for training in anesthesia, I fortunately had the opportunity of developing a three-month training course.......each resident rotated about the different hospitals for a couple of weeks. The group expanded, so the Ciba Company was persuaded to let us use its lecture hall in the building downtown. Interesting cases were presented from all over Montreal. Dr Griffith then joined Dr Bourne and me. Anaesthetists from all parts of Canada came for longer periods of training and a three year Diploma Course was formed. Since we were not recognized by McGill University, Drs Bourne, and I formed the Montreal College of Anesthesia...." The meetings provided a forum for French and English speaking anaesthetists to meet regularly, and established the approach which McGill still takes to its continuing medical education lecture series. The wartime training for specialists in anesthesia developed into the three year diploma course in 1945, and this has remained the model for residency programs for the last fifty years.
Dr Leigh was an active member of the American Society of Anesthesiologists. He talked on 'Acidosis in anesthesia' at the society's annual meeting, held in Montreal in 1941, and became chairman of its committee on anesthetic films in 1946. The Montreal Society of Anesthetists elected Dr Leigh as Secretary-Treasurer of the Executive Committee in 1941, and he joined Drs Cousineau, Rochette, Wesley Bourne and Harold Griffith as a founding member of the Canadian Anaesthetist's Society in 1943.
Notwithstanding his stature and success in Montreal, Dr Leigh could not resist the career challenge of a move back West. In 1947 he returned to Vancouver as Director of Anesthesia at Vancouver General Hospital and Clinical Associate Professor in the Department of Surgery. His mandate was to reorganize the department with new equipment, introduce modern anesthetic techniques, and provide qualified clinicians and teachers to meet the fast paced developments in anesthesia. Also, a postgraduate training program had to be developed in preparation for the specialist examinations of the Royal College of Physicians and Surgeons of Canada. Plans for a new medical school necessitated addressing the needs of the medical student curriculum. His close collaborator, Dr Kay Belton, moved with him, and physicians who had taken the McGill anesthesia course while serving in the armed forces returned as specialists to staff his department. Two of the first graduates of the McGill diploma course in 1948, Drs DH McIntyre E Webb, also joined the staff in Vancouver.
Dr Leigh organized the University Department of Anesthesia from the existing clinical departments at Vancouver General Hospital and the Infants' and Children's Hospitals. Endotracheal intubation, muscle relaxants and spinal anesthesia had seldom been used and most relied on open mask ether, sometimes intravenous thiopentone for induction, Boyle Davis gag for tonsillectomies, avertin for neurosurgery and cyclopropane for thoracic anesthesia. He quickly replaced old anesthesia equipment in the nineteen anesthesia locations throughout the hospital, opened a recovery room and encouraged the introduction of updated anesthetic techniques. Dr Leigh greatly improved the standards of clinical care and began the medical student and residency training programs which continue today.
In 1948, Dr Leigh and his co-author, Kay Belton, published "Pediatric Anesthesiology", the first textbook devoted to the problems of anesthesia in children. In Current Researches in Anesthesia and Analgesia Dr JJ Carroll and he described the "Organization of a department of anesthesiology in a large teaching hospital" in 1949, and "The private group practice of anesthesiology" in 1953. However, after seven years in Vancouver, Dr Leigh became disillusioned about his academic prospects and had not achieved his personal goal to create a separate department of anesthesia. Consequently, in 1954, he accepted an offer from Los Angeles to become Director of Anesthesia at the Children's Hospital and Professor of Anesthesiology at the University of Southern California. He returned to full time pediatric anesthesia practice and continued making contributions to the pediatric literature. He authored at least forty publications on pediatric anesthesia topics such as endotracheal anesthesia with avertin for cleft palate surgery, and bradycardia following succinylcholine in children before his retirement in 1970.
Dr Leigh was the leader of a small cadre of Canadian physicians who made pediatric anesthesia both an art and a science. In his latter years he became seriously ill and died of cancer in Palm Springs on September 5, 1975.
Joan C Bevan, MD