Annie, are you OK? Or: L’Inconnue de la Seine and how she’s saving lives.

Yours truly during a teaching demonstration in 2019
Yours truly during a teaching demonstration in 2019

Act 1 - 1950s, Stavanger, Norway

The toy maker Åsmund S. Lærdal experiments with a new plastic material. He calls it PVC and intends to use it for dolls and other children’s toys that need pliability and need to be easily cleaned.

Åsmund S. Lærdal, Peter Safar and Bjørn Lind
Åsmund S. Lærdal, Peter Safar and Bjørn Lind

His first doll is “Anne,” a toy that sells so well, it is named “Toy of the Year.” News about this reach the Norwegian military and it commissions a set of natural looking wound plastics for training.

A Norwegian anesthesiologist, Bjørn Lind, who had trained with Lærdal’s wound plastics, mentions the properties of those plastics during dinner with his friend, the Czech-Austrian anesthesiologist Peter Safar.

Safar, together with James Elam and Nancy Caroline, the mother of modern pre-clinical Emergency Medicine, had just revised his greatest endeavor: Cardio-Pulmonary Rescuscitation, CPR. In recent months they’d added evidence-based recommendations on head tilt and chin lift, and simplified many steps of his original work into the now world wide “A B C” approach. His revision was so simple, even laypeople could do it.

There was, however, a snag: to train those lay people, Safar relied on paralyzed human volunteers. A mechanical device had to be made, to do the same, and it had to be as lifelike as possible.

This is, where Lind’s doll material comes in. Lind, Lærdal, and Safar set out to make the most lifelike, most anatomically correct, CPR training doll possible. In honor of Lærdal’s world wide hit “Anne,” they named it “Resusci Anne.”

Act 2 - 1875, Paris, France

L'inconnue de la Seine (or is she?)
L'inconnue de la Seine (or is she?)

A young woman dies of Tuberculosis. She is barely 16 years old, and probably the daughter of an upper-middle class tradesman who commissions the painter and caster Jules Lefebvre to fashion a death mask of his child.

Once completed, the mask casts such a beautiful face, Lefebvre, against code and ethics of the time, decides to keep a copy. As a teacher of more than 1500 students during his tenure as a professor at the Académie Julian in Paris, he often uses the cast as a teaching tool, fashioning more casts and countless paintings of the young girl.

So numerous are those pictures and casts, they soon become a staple of French and even some American upper class household displays. A sign that one had had training with the grear Lefebvre.

At the same time, the myth begins, that the girl is indeed not a sixteen year old who had died of Tuberculosis but l’Inconnue de la Seine, an unknown girl who had committed suicide in the Seine river over being rejected by her lover. It just fit better into the morbidly love-centered culture of 1890s Paris.

Yet, the move from myth to “fact” would have to wait until Muschler’s 1934 book “Die Unbekannte” (“The Unknown Woman”), in which he tells the story of Madeleine Lavin, an orphan, who fell in love with a British diplomat (Lord Thomas Vernon Bentick), and committed suicide after losing her virginity to the already engaged man.

Act 3 - 1958, Oslo, Norway

Searching for the perfect face for his new Resusci-Anne doll, Lærdal pages through a coffee table book of models. He is worried, that male trainees would be put off by having to “kiss” a male doll, and looks for an androgynous-yet-female style. Models of the 50s often had this look, so that’s where his hopes lie to find something.

One of the notes mentions L’Inconnue de la Seine as the inspiration for one photographer’s directions, spurring his interest. Luckily, French nude photographer Albert Rudomine had taken pictures of the initial cast of the mask in 1927, which had since been lost.

Lærdal sent the picture to Emma Matthiasen, a Norwegian sculptor living in the Kristiania Commune in Denmark. In late 1959 Matthiasen returns a cast that has all of Lærdal’s required features, including a more androgynous look.

Act 4 - 1960, Stavanger, Norway

Peter Safar and James Elam drive to Norway to see Lærdal’s first finished doll demonstrated at the First International Symposium on Resuscitation. Excited, they commission thirty dolls and start revising the design and features of Anne.


“Annie, are you okay?
So, Annie, are you okay?
Are you okay, Annie?
Annie, are you okay?”

In 1987, Michael Jackson releases “Smooth Criminal,” one of his most successful and iconic songs. The chorus directly references Resusci Anne and the then-used “Annie, are you OK” call-out used during first responder trainings. The radio edit runs at 118 beats per minute and is thus usable as a rescuscitation metronome.

Since that fateful day in 1875s Paris and the 1960 First International Symposium on Resuscitation, countless lay responders, medical students, physicians, nurses, firefighters, police officders, and pretty much anyone ever getting a drivers’ license in most modern countries, has trained on Anne. Making her “the most kissed face on the planet,” but also the greatest trainer of life saving techniques in the history of medicine.

🌱 Nov-11-2021 - added Norwegian-Danish sculptor Emma Matthiasen’s role in the production of the mask.