Remembering Dr. Ron Litman on the 4th anniversary of his death

Henry Rosenberg MD

I had the pleasure of being a friend to Ron Litman for many years. He was one of the most dedicated, informed and committed anesthesiologists who helped improve safety in the practice of Pediatric Anesthesiology and Anesthesiology in general. I would travel to meet with Ron several times a year even after I moved to New Jersey. He was energetic, widely read, curious and indefatigable in so many ways that it would take many pages to cover the areas of his interest. I am sure that you know of his books on Pediatric Anesthesiology which I witnessed his education in electronic publishing. Books that are widely read and appreciated. In addition he coauthored or single authored articles on topics from airway management, drug pharmacology, easing the psychological trauma of anesthesia and surgery as well as many others. He developed an interest in MH in the early 2000s and lead the MH hotline for many years, often publishing on the lessons learned from MH cases. He advised MHAUS to turn over the leadership to Dr. Teeda Pinyavat in about 2000, a wise recommendation. If you read PAAD, you know Ron’s role in developing this widely read and valuable daily publication. Absolutely brilliant. Did you know that Ron was the first outside law to complete a new Master’s degree at U of Penn in law? He was absolutely dedicated to patient safety. He also served as the Chair of the FDA Anesthetic and Analgesic Drug Products of the FDA Advisory Committee and the medical director of the not for profit Institute for Safe Medical Practice.He served as a member of the Board of MHAUS and Vice Chair for Scientific Affairs of MHAUS.

In the late 90s when Ron moved from the University of Rochester tIo Children’s Hospital of Pennsylvania, because his medical degree was from an Osteopathic School, he was required to undergo six months training in an allopathic residency program even though he was the Chief of Pediatric Anesthesia at the University of Rochester. So much for idiotic administrative decisions. He had some interesting stories from that experience.

One of the activities that he loved most was working with medical students on research products and mentoring new faculty at CHOP. Where he found the time to do as much as he did, and I am only scratching the surface of his work, I cannot tell. His love and pride in his two boys was another highlight of his life as well as his love for his wife, Daphne.

I had the pleasure of collaborating with Ron on several publications, but one of awesome events that I witnessed was a debate at an ASA meeting where ambulatory anesthesiologists contended that dantrolene was not necessary for ambulatory anesthesia because inhalation agents were not used. What about succinylcholine? Yes, if there were an airway problem, Isn’t that a risk also? Well, that doesn’t happen too often they argued. But what if that triggered MH. Is that worth saving several hundred dollars a year was the response. What is a life worth? They were arguing with the wrong person. Reports from countries without dantrolene show an MH fatality rate of over 50%. Doesn’t Joint Commission require that for hospitals? Why not ASCs? I was in awe of Ron’s reasoning and legal reasoning.

Those who worked or trained with Ron could offer many more stories of his extraordinary abilities in and out of the OR. His work, reasoning and teaching legacies have, no doubt directly and indirectly improved patient safety. I thank Myron Yaster and the PAAD team for their dedication and work that Ron, in his humble and understated way promoted. We all miss him greatly. He was taken from us much too soon, but left so many lessons that most could not achieve in more than one life time. Rest in Peace, Ron.

If any of you have memories or thoughts you’d like to share, send to Myron who will post in a Friday reader response.

PS from Myron: One of Ron’s (and Henry Rosenberg’s) passions was (is) malignant hyperthermia and they were instrumental in developing and manning the MHA.US hotline. For those of you who are interested in a deeper dive into MH please check out this OpenAnesthesia summary on Malignant Hyperthermia https://www.openanesthesia.org/keywords/malignant-hyperthermia/?search_term=malig