In memoriam: John J. ("Jack") Downes

Myron Yaster MD

We lost a giant this week, Dr. John J. ‘Jack’ Downes (1930–2021), the anesthesiologist-in-chief at The Children's Hospital of Philadelphia (1972–1996), passed away on Friday after a long illness.  If there was such a thing as a Mount Rushmore of Pediatric Anesthesia, and/or Pediatric Intensive Care Medicine, Jack would be a prominent figure carved into that stone. Despite his enormous contributions he remained remarkably humble and was a gracious mentor, colleague and friend. Even as a visiting medical student, Jack took me aside and said “call me Jack, not Dr. Downes.  You are student today but we’ll be colleagues in the future”.  That’s just the kind of person he was.  He made numerous contributions to pediatric anesthesia and critical care medicine through a broad portfolio of clinical care and research on chronic respiratory failure, status asthmaticus, postoperative risks of apnea in premature infants, and home-assisted mechanical ventilation. Indeed, one of his former students, colleagues, and friend, Dr. Mark Schreiner, interviewed Jack shortly before his death and we posted that interview “Remembering the Classics: Chronic respiratory failure in the infants in the November 18th PAAD (I will repost this week).  During his tenure as the anesthesiologist-in-chief at CHOP, he and his colleagues trained an entire generation of pediatric anesthesiologists and intensivists and set a standard of care and professionalism that continues to the present day. Quite frankly I don’t think there would be the profession of pediatric anesthesiology as we know it today without him.  Christine Mai and others interviewed Jack for one of the first History of Pediatric Anesthesia articles published in the J Pediatric Anesthesia(1).  I would urge all of you to read this article and view the accompanying video (available at the Wood library).  It is a first-person account by Jack on his career, a career that advanced pediatric anesthesia and critical care medicine and the development of that first pediatric intensive care unit at The Children's Hospital of Philadelphia.  Indeed, according to Jack “the defining moment of my career occurred in January 1967, when The Children's Hospital of Philadelphia inaugurated its pediatric intensive care unit—the first of its kind in North America”.

Jack touched so many of us, I am asking any of you who would like to recount a story that you’d like to share send to my email (myasterster@gmail.com) and I will publish as a special reader’s response at the end of this week.  Myron Yaster MD

1.           Mai CL, Schreiner MS, Firth PG, Yaster M. The development of Pediatric Critical Care Medicine at The Children's Hospital of Philadelphia: an interview with Dr. John J. 'Jack' Downes. PaediatrAnaesth 2013;23:655-64. PMID 32371640