John J. “Jack” Downes, the anesthesiologist-in-chief and director of the department of anesthesiology and critical care medicine at the Children’s Hospital of Philadelphia from 1972 to 1996, passed away peacefully on December 17, 2021. He was 91. 

Dr. Downes received a medical degree from the Loyola University School of Medicine, then interned at the Indianapolis General Hospital. He did two years of public service with the Indian Health Service in South Dakota and in Tacoma, Washington. He then came to the University of Pennsylvania for his residency training in anesthesiology from 1959 to 1963. The last two years of his residency were funded by a National Institutes of Health fellowship in pharmacology. In 1963, he was recruited to the Children’s Hospital of Philadelphia (CHOP) as an assistant professor of anesthesiology. Four years later, he inaugurated CHOP’s pediatric intensive care unit, the first of its kind in North America. CHOP’s pediatric intensive care unit and Dr. Downes’ leadership of it earned national acclaim. Dr. Downes was promoted to an associate professor of anesthesiology in 1971 and a full professor three years later. In 1972, he also became anesthesiologist-in-chief and director of the department of anesthesiology and critical care medicine at CHOP, a position he held for over twenty years. 

Over his career at CHOP, Dr. Downes developed a multidisciplinary approach to caring for seriously ill hospitalized children, whether post-surgery or with life-threatening medical illnesses. He and his colleagues inspired and trained multiple generations of pediatric anesthesiologists and intensivists, setting a standard of care and professionalism. 

Dr. Downes advocated for improving healthcare for children, and the Commonwealth of Pennsylvania launched a pioneering home care program for the care of disabled children in the 1970s, largely thanks to his efforts. He was the medical director of the Pennsylvania Ventilator-Assisted Children’s Home Program initiative for over 25 years. 

Dr. Downes received many awards for his work, including a 1995 award from Penn Medicine for distinguished teaching (Almanac April 18, 1995). In his award citation, a colleague described him as “undeniably the father of pediatric critical care medicine in this country. A productive and active member of the HUP/CHOP faculty for over thirty years, he has served as a beacon of enlightenment in the field of pediatric anesthesia and critical care medicine. His leadership has been responsible for the advancement of the academic and clinical practice in both these areas.” In 1996, Dr. Downes retired from Penn and took emeritus status. A portrait of him, painted by famous American artist Nelson Shanks, still hangs in the CHOP auditorium today.  

Dr. Downes is remembered as a kind teacher and a giant in his field. “If there was such a thing as a Mount Rushmore of Pediatric Anesthesia, and/or Pediatric Intensive Care Medicine, Jack would be a prominent figure carved into that stone,” said Dr. Downes’ former colleague, Ron Litman, a former CHOP anesthesiologist, in an online tribute. “Despite his enormous contributions, he remained remarkably humble and was a gracious mentor, colleague, and friend. Even as a visiting medical student, Jack took me aside and said, ‘call me Jack, not Dr. Downes. You are a student today, but we’ll be colleagues in the future.’” 

Another colleague, Alan J. Schwartz, said, “I reflect that I was blessed to have been Jack’s student and colleague and that he was a great ‘parent’ from whom I learned an enormous amount. Children worldwide have been and will continue to be the beneficiaries of Jack through his teachings.” Several other reminiscences of Dr. Downes’s kindness to students, patients, and colleagues can be found at https://ronlitman.substack.com/p/readers-response-jack-downes. 

In his free time, Dr. Downes was an avid skier and runner (often running charity runs with friends and peers). He was also known to serenade partygoers on the piano. 

A memorial service has yet to be scheduled. Dr. Downes was preceded in death by his wife and survived by their four children, Maggie Downes-Angus (Jeff), Kate Downes (Matt), John Downes, and Peter Downes (Ivana); eight grandchildren; and four great-grandchildren.