Voices of Experience 2006

Provider of Distinction:
Lawrence Frank, CRNA

By Liz Wong, CRNA
CANA Trustee, Public Relations Committee Chair

I remember reading a reprint of an article published in the AANA Journal that was originally written in 1908 by nurse anesthetist Alice McGaw(1), where she admonished nurse anesthetists to pay attention to the preoperative evaluation of the patient, and to be vigilant to the color of the patient’s skin during the course of drop ether anesthesia:

“When a patient has removed a double set of artificial teeth, the tongue will often cleave to the roof of the mouth during the administration, and raising the jaw sets the gums so firmly together that most of the air is shut out, and this may not be noticed until the patient is cyanotic. We have found, in this class of cases, that if the jaw is held but slightly up and forward and the thumb of the same hand inserted between the gums, thereby holding the tongue down, faulty respiration will be corrected at once and the color restored.”

Being a modern certified registered nurse anesthetist (CRNA), meaning I graduated from a masters program of nurse anesthesia in 1997 with all of the current and most up to date monitoring technology at my disposal, I marvel at the fact that nurse anesthetists were able to give anesthesia with just their six senses, room air oxygen, and an ether dropper. It seems to me that every living CRNA has had the same advantages that I have had – you know that type of syndrome that is similar to the one that young people today suffer being unable to comprehend life before DVDs and IPODs.

As you may or may not know, advances in anesthesia delivery didn’t change over night. It took the entire 20th century for anesthesia evolution to occur. There are plenty of CRNAs currently practicing and recently retired that are living testaments to what it was like “then and now.” I met one of those CRNAs recently at a California Association of Nurse Anesthetists (CANA) meeting. His name is Lawrence Frank, CRNA, and he just recently retired from a career in nurse anesthesia that spanned nearly 5 decades.

Lawrence developed an interest in nurse anesthesia while working as the charge nurse at Rancho Los Amigos in Los Angeles during the polio epidemic in the 1950s. During this era the Salk vaccine was discovered, refined, and distributed to all school age children and adults. Lawrence and his nursing staff were worried about being out of a job. One night a friend came onto the nursing ward and told Lawrence that all of the experience he had taking care of polio victims would be perfect for a career in nurse anesthesia. The search was on for a program of nurse anesthesia.

In 1958, Lawrence entered the Sacred Heart School of Nurse Anesthesia affiliated with Gonzaga University in Spokane, Washington. Lawrence was one in a class of 7 aspiring nurse anesthetists who endured the rigors of an 18 month program. At the time Sacred Heart was the only nurse anesthesia program west of the Mississippi. After graduation Lawrence moved back to the Los Angeles area, working at Artesia Community Hospital. Afterwards, Lawrence went to work for a dentist and provided anesthesia at 8 major dental offices (traffic was nowhere as bad as it is today, and it was much easier to get from office to office without a problem). The anesthetic agent most commonly used was brevital. There were no pulse oximeters, so in order to check the patient for proper oxygenation Lawrence pressed the skin on the forehead and pinched the finger for capillary refill time. Vital capacity was ascertained by having the patient blow out a match.

In addition to maintaining a private practice, Lawrence was instrumental in the development of CANA. He served in various committees and held office positions such as treasurer. According to Lawrence it was much easier to hold a CANA meeting in the 1960s. About 35 nurse anesthetists attended each meeting and most meetings were held in private homes. (I bet the food served was a really good home cooked meal).

Lawrence’s dedication to CANA has endured from those early days. Even though he is retired and living in the Coachella Valley, Lawrence still attends CANA meetings to keep abreast of current practice issue and trends. Lawrence is the epitome of the saying “once a CRNA, always a CRNA.” Our thanks go to Lawrence and all those like him who have developed and maintained our practice and our profession, and provided patients with excellent anesthesia care for decades.

1. McGaw A. Review of over fourteen thousand surgical anesthesia's. Surgery, Gynecology, and Obstetrics. 1908. 795-799.