Washington People: David J. Murray

From Saskatoon to simulators

David J. Murray, MD (center), works with Antonina Frolova (left), a medical student, and Maureen Alikah, an anesthesiology intern, in the Howard and Joyce Wood Simulation Center. “David Murray has developed that small simulation
center into one of the leading clinical simulation programs in the
United States,” says Alex S. Evers, MD, the Henry Elliot Mallinckrodt Professor and head of anesthesiology. “Along the way, he’s become an international
leader in the use of medical simulation and one of the premier
investigators in education research in the world.” (Credit: Robert Boston)

When the cold winter days get to be too much, don’t expect sympathy from David J. Murray, MD. He’s the Carol B. and Jerome T. Loeb Professor, chief of pediatric anesthesiology and director of the Howard and Joyce Wood Clinical Simulation Center, and Murray isn’t from St. Louis originally. He grew up in Saskatchewan in western Canada, where the average winter temperature is 12 degrees Fahrenheit.

Not only that, but when he completed initial training in internal medicine, he went to work as a general practitioner in northern Saskatchewan at St. Joseph’s Hospital in Ile a La Crosse, some 600 miles north of the Canada/North Dakota border.
“I was in a remote — we don’t even call it rural, we call it remote — part of Saskatchewan, which is what a lot of people do when they finish their training,” he says.

“It was the kind of town that was only accessible by air for much of the winter, and it seemed we were flying air ambulances out on a weekly basis. Whether it was an infant with meningitis or someone who’d had a motor vehicle accident, either I or one of the other two doctors in my practice regularly flew a couple of hundred miles so that critically ill patients could receive appropriate care.”

But aside from airlifting patients out of town, Murray says the pace of life in Ile a La Crosse was rather slow. He compares days in that remote part of Saskatchewan to the television program Northern Exposure.
“Except that for some reason, we seemed to have a lot more critical events than they ever showed,” he says. “I guess maybe it was more like a mix between Northern Exposure and ER.”
He went to that part of the world after earning a medical degree from the College of Medicine at the University of Saskatchewan in Saskatoon, where his father, Robert, was the dean. Later, his brother, Bruce, became the school’s head of pathology. Murray thought he might end up on the faculty someday, too.
During his time in northern Saskatchewan, Murray decided he needed to develop more medical expertise. He recalls being frightened by very sick children, obstetrics and critical-care medicine. Eventually, he decided that by pursing anesthesiology as a specialty, he could address his fears.
“I could do a lot of things, but never as an expert,” he says.

“In learning about anesthesia and critical care, I wanted to gain the confidence that if something bad happened, I could manage the very worst, no matter how bad it got, and where I was in northern Saskatchewan, the very worst often did present itself.”

South to Iowa
Next, Murray headed south. In Canada, only Toronto offered the type of anesthesia training he was seeking, but that city seemed a little too urban for him. So he opted to come to the United States and the University of Iowa.
Robert Murray often encouraged physicians to leave western Canada for training with the idea that, eventually, they’d come home. An ophthalmologist, Murray’s father himself had trained at Johns Hopkins University and practiced in the southern United States. Although Murray grew up in Saskatoon, he was born in Chapel Hill, N.C.
“I left Canada thinking I’d train in Iowa, develop the skills I needed and then go back,” he says. “But I met my wife in Iowa while she was working on her PhD, and she didn’t want to move to Saskatchewan, and I didn’t want to go to Texas where she was from, so we stayed in Iowa for 15 years.”
From left: David J. Murray; wife Nancy Tye Murray; and daughters Aubrey, 21 and Ellen, 23. (Credit: Courtesy photo)
Murray and his wife, Nancy Tye Murray, PhD, had two daughters in Iowa, but by the mid 1990s, the young family went a bit further south when Nancy was offered a job in St. Louis at Central Institute for the Deaf.
“Otherwise, I might never have left Iowa,” Murray says. “On the other hand, there were only five of us doing pediatric anesthesia there, so the chance to join a group here that was three times that size, and to work at St. Louis Children’s Hospital, a true, free-standing, pediatric hospital, was a big deal, just as CID was a big deal for Nancy.”
Clinical simulation
He also was looking forward to working with medical students and residents. He’d been vice chair of education in Iowa, and, in St. Louis, he planned to pursue both clinical work and teaching.
As it happened, he arrived in 1995, and the next year, the Department of Anesthesiology, the School of Medicine, Barnes-Jewish Hospital, Children’s Hospital and BJC HealthCare joined forces to open a clinical simulation center, and Murray was chosen as its director.
“That was another advantage of coming,” he says. “As an institution, we were going to embrace something everyone talked about, but nobody else really had done.”
And that, according to Alex S. Evers, MD, the Henry Elliot Mallinckrodt Professor and head of anesthesiology, is how Murray completed the journey from Northern Exposure to being one of the world’s leading experts in medical simulation.
“David Murray has developed that small simulation center into one of the leading clinical simulation programs in the United States,” Evers says. “Along the way, he’s become an international leader in the use of medical simulation and one of the premier investigators in education research in the world.”
Late-night ice

Although he may be a world leader, Murray hasn’t forgotten his roots. He started playing hockey at the age of 4, and he still plays once a week — though a broken leg slowed him a bit last winter.

He rates himself as only average by Saskatchewan standards, but that means his skills are closer to the elite level in St. Louis.

Hockey also helped connect his life in the United States to Canada as Murray closely followed the hockey careers of several native sons of Saskatchewan, many of whom came through St. Louis and played for the St. Louis Blues. There was Tony Twist, Kelly Chase and — the biggest star from Murray’s hometown — Bernie Federko.
“I was a couple of years older than he, but he was one of the people that you always knew was going to play professionally,” Murray says.
One surprise was that playing hockey eventually made him into a baseball fan.
“If you want to learn about the Blues or the St. Louis Cardinals, there’s nothing worse than hanging around with academic physicians all the time,” he says with a smile.

“I learned about St. Louis from the guys at the rink, playing games late at night. They taught me about the Cardinals, and, eventually, I really started enjoying baseball, which is something I never would have predicted.”

Fast facts about David J. Murray

Born: Feb. 3, 1954, in Chapel Hill, N.C.
Education: B.A., 1973, University of Saskatchewan, Saskatoon; MD, 1978, College of Medicine, University of Saskatchewan
Training: Internal medicine internship, 1978-79, St. Thomas Hospital and Medical Center, Akron, Ohio; anesthesia residency, 1981-83, University of Iowa
University positions: Carol B. and Jerome T. Loeb Professor; chief, pediatric anesthesiology; director, Howard and Joyce Wood Clinical Simulation Center
Family: Wife, Nancy Tye Murray, PhD; daughters Ellen, 23, and Aubrey, 21

Read more about David Murray, MD, and his work in the Howard and Joyce Wood Simulation Center in Outlook.