Operation Hero

was pleased and amused to read your note about your hero, Richard N. Terry, M.D., in the July 2004 NEWSLETTER. I enclose a note about my relationship to Richard Terry, so many years ago. Dick Terry is also one of my heroes!

I was a junior medical student assigned to the anesthesia service at Buffalo General Hospital (BGH), and Dick Terry was to introduce me to the specialty. I gowned and was directed to an operating room where Dr. Terry had already induced a patient for a laparotomy. I shook hands with Dr. Terry and stood behind the drapes pinned to I.V. poles while he explained the details of the case to me.

While I was studying the patient’s chart, the surgeon said, “She’s a bit tight, Dick. Can you loosen her up a bit?” Dr. Terry whispered to me, “She’s loaded with curare and is fine,” but responded to the surgeon “OK, I’ll give her a little more curare.”

I was amazed to see him stick the needle of the curare syringe right through the rubber of the I.V. tubing and squirt some on the floor. He then stuck his head above the drapes and said, “How’s that?”

“Fine,” replied the surgeon in a moment or two.

I tried to restrain myself from collapsing on the floor in laughter but was reassured by Dick Terry that the curare already given had to have time to take effect. The timing was in his head and the patient’s veins! This delightful demonstration of pharmacology and surgeon control at one time was unforgettable. I had had no idea what fun anesthesia management could be until that moment.

After training I spent the next 34 years enjoying my role at the head of the table and the knowledge that I was only called when the patient needed me.

I was with Dick Terry for that brief few minutes at BGH, but he was an instant hero to me, and I never forgot the incident. May our heroes always be our heroes, and may they always have their own heroes!

Robert E. Ploss, M.D.
Vancouver, Washington

The Future Isn’t Bright

hat interesting issues the September and October ASA NEWSLETTERs were. The September issue looked at the past, and October looked into the future. The September issue was eye-opening in the accounts of where we had been politically. Mention was made of the Hess Report, released by the American Medical Association, which addressed the idea that hospital-based physicians should have equal rights on their medical staffs with other physicians.

What a novel approach that hospitals or entrenched physician groups could not hire a professional and legally skim off his/her income. I suspect in those days that new graduates understood private practice anesthesia groups did nothing to build their hospital, recruit their surgeons or their patients and therefore did not have the “right” to rip off new staff members with their salary and shady promises of “partnership.” Of course, today, the new graduate has few choices once he or she realizes that most “jobs” are controlled by local juntas with exclusive contracts. A job finder is forced to choose between group A, who will steal a lot, and Group B, who will steal a lot more.

Well, I could go on and on about the death of private practice in anesthesiology, as is currently unreported in the ASA NEWSLETTER; however, let me zip into the future with the October issue as my guide. Here we learn about new drug delivery systems and equipment makeover, training simulation and electronic educational systems. Did I miss something, or was there not one word about how anesthesiologists would regain private practice autonomy and their profession as a whole and control third-party payers and malpractice insurers? Of course this can only be done through a unified series of labor actions. The future of anesthesiology is on the labor front, when a group of us will wake up to the fact that the contract jockeys* and scam artists who have pervaded this very primitive profession should forever be wiped out, and we can rise above our second-class status.

Ronald F. Kloc, M.D.
Aurora, Illinois

* Holders of exclusive contracts who, in this case, ride their “stable” of anesthesiologists.

Editor’s Note: I respectfully disagree with Dr. Kloc. There was no mention of practice styles in either issue as they rapidly change over time. Indeed, in the 1950s, ASA took a stand against salaried positions for anesthesiologists, thus alienating a large part of the academic community. While there may be instances of the egregious practices that Dr. Kloc describes, there are many more where exclusive contracts have helped to secure the best possible anesthesia for that facility. Let us not condemn the entire specialty because of the practice patterns of some anesthesiologists.

— D.R.B.

The Ugly Face of Faceless IMG Debate?

lthough disturbed and appalled, I fully understand that it is sometimes healthy to debate a subject (any) openly. However, I feel strongly that letters written like “AMG/IMG Controversy Continues” (November 2004) by “faceless and nameless individuals” should not be published in the ASA NEWSLETTER. Hiding their names is cowardly and allows bigotry to take the upper hand in the debate.

I am an international graduate, and I am proud that for the past 30 years I have been able to help, train and graduate both American medical graduates and international medical graduates from a residency program that is well known both nationally and internationally and is considered to be one of the best residency training programs in the United States.

Please do not allow the members of ASA to be included in the class of “The Ugly Americans.”

M. Saeed Dhamee, M.D.
Milwaukee, Wisconsin