• Christine L Mai, Mark S Schreiner, Paul G Firth, and Myron Yaster.
• Department of Anesthesia, Critical Care Medicine & Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. cmai1@partners.org
• Paediatr Anaesth. 2013 Jul 1;23(7):655-64.

AbstractDr. John J. 'Jack' Downes (1930-), the anesthesiologist-in-chief at The Children's Hospital of Philadelphia (1972-1996), has made numerous contributions to pediatric anesthesia and critical care medicine through a broad spectrum of research on chronic respiratory failure, status asthmaticus, postoperative risks of apnea in premature infants, and home-assisted mechanical ventilation. However, his defining moment was in January 1967, when The Children's Hospital of Philadelphia inaugurated its pediatric intensive care unit--the first of its kind in North America. During his tenure, 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. Based on an interview with Dr. Downes, this article reviews a career that advanced pediatric anesthesia and critical care medicine and describes the development of that first pediatric intensive care unit at The Children's Hospital of Philadelphia.© 2013 John Wiley & Sons Ltd.

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