A Eulogy: Personal Reflections on Dr. Peter Safar

David Crippen, MD

Disclosures

Introduction

Editor's Note: A giant of modern medicine, specifically emergency and critical care medicine, has been lost with the passing of Dr. Peter Safar on August 3, 2003. Although he was called "The Father of CPR" for developing and publicizing the life-saving cardiopulmonary resuscitation techniques, for many people who knew him, he was so much more. Dr. David Crippen, of the University of Pittsburgh Medical Center, worked with Dr. Safar and wrote about his association with this medical pioneer.

Dr. Peter Safar came alive for me sometime in 1978. I was wandering around browsing the bookstore at the facility where I was serving as a resident in surgery and a "Textbook of Emergency Medicine" leapt out at me. The reason this was such a remarkable incident was that emergency medicine was not yet a full-blown specialty at that time, more a mishmash of moonlighters and fractionated medical care. It looked interesting, I was curious, and so I purchased it.

Dr. Peter Safar (right) with Dr. David Crippen.

Shortly thereafter, the fundamental concept of emergency medicine -- reversal of the dying process -- crystallized in me. The chapters by Dr. Peter Safar, a person I had never previously heard of, blew me away. Imagine, a logical and forthright description of the pathophysiology of the dying process, and then how it can be effectively reversed! It was a totally new experience. I hung on every word. Some time thereafter, I applied for an emergency medicine residency, and ultimately ended up in critical care, the logical extension of Dr. Safar's principles pointed out so clearly in 1978.

I entered the postgraduate fellowship in critical care medicine at the University of Pittsburgh Medical Center in 1985. This brought me in physical contact with him for the first time. I ended up walking over to the International Resuscitation Research Center (IRRC), across the street from Presbyterian Hospital, looking for a position as a research assistant for my second year of fellowship. I got the brief tour of the facility and then was ushered into his office. He didn't like people to knock on his door; he preferred them to just barge in anytime and start talking. He would frequently talk to visitors and into the phone at the same time.

His office was a trip in itself. Dr. Safar was surrounded to the point of obfuscation with piles and piles of journals, books, papers, and reprints. I could barely find him. He carried rubber bands around his wrist to isolate sections of paperwork, all of which were redlined, underlined, circled, and arrowed. As he spoke about his work, he cited papers to illustrate his statements, found the right pile, isolated the right paper and rubber banded it to set it apart. He was an authentic character, but then so was I, and we formed a friendship that prospered on for 18 years.

A few years later, Dr. Safar was still acting as a staff anesthesiologist a few days a month, and he came in contact with my wife, then a Certified Registered Nurse Anesthetist in training. He routinely got away with nonlinear field expediency that became his trademark. After intubation, he showed her how to pin the ambu bag to the gown of the operating surgeon and reach up to bag it now and then while performing other duties. Over the next few years, I wrote two research papers with Dr. Safar and had the pleasure of following him around the world from Moscow to Rio de Janeiro presenting data from my studies with him.

He kept in touch with me as I became an ICU attending physician and came over to my facility up the street to visit and speak to the house staff occasionally. On one occasion, I picked him up in my Ferrari. He'd never seen one and brought his camera to take a full roll of film of it. Then, for the entire trip, he waved at passing vehicles, pointing to the Ferrari and grinning. He was like a kid with a new toy, and that's exactly what he was.

I have thought about his passing in a very positive manner. Dr. Safar was "different" in a very nonlinear way. His thinking processes encompassed ways of analyzing and solving problems that fell far outside the usual. Like Einstein, Gandhi, and other original thinkers, he effortlessly transcended limits imposed by the intellectual and intuitive gatekeepers of academia, but still managed to maneuver successfully within those same otherwise constrictive systems. The ultimate secret of success is not necessarily being the brightest. It's the ability to use social and academic platforms to allow brightness to work to its best effect. Dr. Safar possessed this rare quality, and it served society well.

It is appointed to all a time for life and a time to die. Manners of death are inconsequential; they are merely transitions of a nature we cannot conceive. What has meaning is manners of life. In his time with us, Dr. Safar lived a life of intense meaning to society, his friends, and loved ones. Those remaining behind must grieve, from homage and also from fear of our own mortality, but soon the time for grieving will be over and we will begin again. We will, however, return to the obligations of life engendered with his immortal spirit. There can be no greater monument than for those who grieve to go forth with enriched lives as a result of that memory.

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