Innerviews: 'Epidural Bob' labors no more

Chris Dorst
Longtime anesthesiologist Bob Westmoreland makes a final visit to the operating room at CAMC Memorial Hospital before his retirement earlier this month. For 20 years, he specialized in obstetrical anesthesia then switched to all sorts of major surgery, everything except cardiology.
"I did obstetrical anesthesia by myself. ...
... I'd come to work and do what had to be done ...
... until I got too tired to work."
The image of a fledgling imperious boss is forever preserved in this snapshot of Bob Westmoreland as a young boy in Georgia.
Tooting a birthday horn as a 2-year-old foretells Bob Westmoreland's lifelong interest in music.
In 1977, Dr. Bob Westmoreland ran a 10K race in Winston-Salem, N.C.
CHARLESTON, W.Va. -- Women in labor loved him. They longed for him. "Epidural Bob" -- his email handle -- brought sweet relief.Bob Westmoreland spent most of his professional life as an obstetrical anesthesiologist.A trip to the dentist as a boy in Georgia taught him about the blessed benefits of anesthesia and triggered thoughts of a future in medicine.He loved to sing and play music. When he encountered those tough pre-med courses, he settled for a degree in music. Eventually, destiny prevailed, as it always does, and shoved him toward his boyhood dream.
Lured to CAMC in 1979, he rode a wave of dramatic change in the practice of anesthesia both in obstetrics and major surgery.Early this month, at 72," Epidural Bob" retired. Finally, he can indulge all those interests that tugged at him for years -- calligraphy, photography, bow hunting, cooking. Under those scrubs beats the heart of a Renaissance man. "I grew up in Griffin, Ga., a little town halfway between Atlanta and Macon. My father was a bookkeeper. He never went to college. When he married my mother, he borrowed some accounting textbooks her brother had from college. He basically taught himself. And he was very successful."My mother was from a family of four. All four went to college. Her father was a blacksmith. She taught school. She was a very smart and determined woman."Polio as an infant left her left side withered and worthless. She walked on crutches. Her brother taught her how to drive using a choke on the dashboard. She was able to do a lot of things."When I was about 6, my mother said we were going to the doctor. I didn't mind the doctor, but I had never been to a dentist. He shared a waiting room with the doctor. I expected to see my buddy, Dr. Jones. The door opens, and it is this dentist, Dr. Gold. He said he wanted to look into my mouth."There was a tooth he had to pull. He numbed my mouth and got his pliers and ripped out this tooth. I didn't like the dentist at all. The next time, they didn't tell me I was going to the dentist. When I got there, I figured it out."The doctor's nurse chased me around the office. I hid behind the couch. And she jabbed my butt with a syringe full of something that mellowed me out. They gave me some sort of gas to put me to sleep when they pulled my tooth. That was the beginning of my understanding of what anesthesia could do for you."My best friend's father was a surgeon. I was very impressed with him. I always thought I would like to be a doctor.
"As a teenager, I decided I wanted to work in the hospital. I got a job as an orderly in the operating room. I really liked the environment."And I really liked the two anesthesiologists. You can write on these scrubs, and they'd draw formulas about the medicine they were using and diagrams about what they were doing."I also read an article in the Reader's Digest during a polio epidemic about the unsung operating room heroes -- the anesthesiologist who could ventilate polio patients who couldn't breathe. The anesthesiology seed was planted early."There were some diversions. When I was young, I learned to sing sitting next to my mother in church. They had a youth choir, and I got to sing in that."The choir director had a son who was a good singer, and he and I and two other boys formed a quartet. We would go to music festivals and sing in church and for the school."I played trumpet in a dance band called the Moonlighters. We played dance music from the '40s and '50s.
"I played in the high school band and was first chair trumpet player in the Georgia All-State Band. I had a very strong inclination toward music."I got a band scholarship at Furman in Greenville, S.C., but I was still going to go through pre-med. My sophomore year, I had to take organic chemistry, physics, quantitative and qualitative analysis, calculus. I called the band director. I graduated with a B.A. in music. Then I looked at my fellow musicians and what they were going through. I wasn't going to do well as a musician.
"So I went back an extra year and got all the pre-med courses. I went to Wake Forest. Back then, it was called Bowman Gray. I thought I would do anesthesiology, but I had to do an internship, so I went to Emory for a straight medicine internship."At the end of my year, I told the head of the residency program that I was planning to go back to Bowman Gray for an anesthesia residency. He said, 'Why? We have the best anesthesia program in the South.' So I ended up in the anesthesia program there."The last year, I did obstetrical anesthesia. Bowman Gray had a wonderful obstetrical anesthesiologist, Frank James, one of my mentors."At the end of my residency, the Vietnam War was in full force, and they wanted general medical officers to go fight. They had a program, the Berry Plan, where you could finish your residency and, in return, you got to be whatever you were trained to do for two years in the Army. So I got the deferment for anesthesiology."I went to Fort Belvoir, Va., and did two years in a general hospital and didn't have to go to Vietnam. I decided I would go back to Bowman Gray and work on the faculty."I came here in 1979. There were four anesthesiologists, two here and two at General. The guy in charge was the first real anesthesiologist they'd ever had here, Chuck Reier. He had trained with Frank James. There was nobody here to cover obstetrics, and there was a huge obstetrical service."Reier asked Frank James to come lecture about obstetrical anesthesia to these obstetricians. Frank asked me to go. So I gave a lecture and got shown around, and Reier asked me to come start my own anesthesia program."He asked how much money would attract me. I was making $56,000 a year at Bowman Gray. I jacked that up to about $80,000 thinking there was no way he would pay me that. Months later, he called and said, 'What about $86,000?' I was going through a divorce. I thought maybe it was a good time to pull up stakes."I did obstetrical anesthesia by myself. I'd come to work and do what had to be done until I got too tired to work."Dr. Reier left. General Anesthesia Services, with whom I worked for 32 years, was formed. We recruited a cardiac anesthesiologist, neuro, pediatric. There are about 27 in the group."You cannot imagine how obstetrical anesthesia has changed. When we put the epidural and catheter in, we would re-inject periodically. In the late '80s, we began to use programmed pumps. So it became much more automated and technological."It freed us up, but it also increased our responsibility. If something is going on, we need to be available. When Women and Children's opened, we were the only part of our group that took in-house call 24 hours at a time."There were no ventilators on our anesthesia machines, so everything was done by hand. If you wanted to check a blood pressure, you had a blood pressure cuff. If you wanted to know how the heart was going, you had a stethoscope."Today, you have catheters and temperature monitors in every part of the body and EKG machines on everybody. It's a very high-tech process."We faced a lot of difficult patients to intubate. Five or six years ago, I got a glidescope with a TV monitor, a tiny thing with a camera on the end. You can put that in somebody's mouth and intubate just about anybody. That has revolutionized anesthesia."About 2002, I decided I'd done all the OB I wanted to do. I was tired of taking call. A couple of anesthesiologists here left. They needed someone to cover the non-cardiologist business, and I volunteered."I asked one of the anesthesiologists here what it was like working at Memorial. He said, 'Working at Memorial allows you to fulfill your anesthesiology potential. Whatever they throw at you, you've got to be able to deal with it.'"There was a learning curve for someone who had done epidurals for 20 years. Suddenly, I was doing major vascular, thoracic and pulmonary work, complicated general surgery, orthopedics. It took me two or three years to get up to speed."When I came here, I rehearsed for 'The Messiah' at Christmas. At the performance, they seated me next to a soprano who sang in the choir at St. John's Episcopal Church. I've been singing with them ever since."I've piddled with calligraphy. When I came to Charleston, a guy had a clock shop in the old Arcade. I had a grandfather clock that needed repaired and went to talk to him. In the display case was all this calligraphy stuff. His wife taught calligraphy. I signed up and learned just enough to be dangerous. Now I'm going to pick up on that."I bought a camera. I'm going to play with that. And I found an old archery bow I used in college. I'm going to get that going again."I like to cook. I told my wife I'm going to be the cook. She's still working three days a week, and I can fix dinner."One of the surgeons here went to Clarksburg to work at the VA. They have a small anesthesia department. When someone goes on vacation, they have to shut down. So I applied to work part time."We'll see how it all pans out. I'll have to try a few things before I settle into something that will keep me occupied." Reach Sandy Wells at or 304-348-5173.
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