Douglas R. Bacon, M.D., Editor

The Editor’s Desk

e are well into our second year’s journey together. We — not the grandiose editorial we, but you, the readers, with me, the editor — are traveling together, hopefully working toward making anesthesiology a better specialty than when we started. It is an honor to be your editor, and it is a responsibility I take seriously. I promised you, and I promised myself, though, that I would write about serious issues in this column and try to do my part to make the ASA NEWSLETTER the best specialty publication in the world. Like all good jobs, there is much that happens behind the scenes, and I would like to use this month’s column to tackle some correspondence I have received but did not publish and to thank some folks for helping me hone my writing skills and gain a further appreciation for the subtleties of the “political” practice of anesthesiology.

Letters to the Editor
To the loyal readers of the NEWSLETTER, the letters to the editor make some of the most entertaining and informative reading of the entire issue. The official policy is that such letters and responses, where appropriate, should be no more than 300 words each. As editor I often violate the policy with the understanding that to fully develop an idea and communicate it to others takes more than this limit of words. When informed of this policy, I have had correspondents explain to me, with word counts, how I have violated it. Thus if I deem that the issue to be communicated takes more than 300 words, I will suspend the rule; this is the editor’s responsibility.

Within this issue, you will find a letter I received concerning the Residency Review Committee (RRC). I asked the chair of the RRC to respond to this letter for I did not feel qualified to answer the issues raised by Randall C. Cork, M.D., Ph.D. The response is considerably above the 300-word limit, but it was necessary to explain to our members the facts behind the issues raised by Dr. Cork. The RRC and its activities should be of interest to every anesthesiologist, for they regulate and endorse the training that constitutes the future of our specialty.

As you might have noticed in the February 2005 issue, the ASA policy of allowing writers to sign letters “name withheld by request” took quite a beating. My judgment was questioned, and rightly so, for publishing the letter titled “AMG/IMG Controversy Continues” (November 2004) on a “name withheld by request” basis. The reason that letter was published was to open a discussion about how we in anesthesiology view and treat our colleagues. I received another letter that expressed similar sentiments and had agreed to publish it, but the author pulled it at the last moment. In many ways, I applaud the author of this particular letter for clearly stating a position that has been whispered about for years in anesthesiology without it ever being brought forward in our ongoing political discussion.

The publication of this letter has offended a number of anesthesiologists who did not attend medical school in the United States or Canada, and I apologize, for it was not my intention to offend. However, I maintain that the issues raised are very real and worthy of debate. The American Board of Anesthesiology (ABA) directors who ran my orientation session when I first became an oral board examiner repeatedly emphasized that there was no dual standard for passing the examination. Candidates were to be evaluated without bias. Several colleagues who have served as oral examiners have cited examples of fellow examiners who were dismissed from the oral examination process because they appeared to be prejudiced. Yet ABA continues to report the results of the board certification process by American medical graduate (AMG) and international medical graduate (IMG) criteria. Why is this distinction important?

In looking at the leadership roles in U.S. anesthesiology, there is something of an IMG/AMG dichotomy. Several organizations such as the Society for Obstetric Anesthesia and Perinatology, the Society for Education in Anesthesia and the Society of Academic Anesthesiology Chairs/Association of Anesthesiology Program Directors have prominent IMGs in leadership positions. Neither ASA nor ABA, perhaps the most politically powerful organizations in anesthesiology, have an IMG in a prominent leadership role. George W. Bush, the “Republican conservative” — two political traits not usually associated with diversity and sensitivity — has developed the most diverse cabinet of any American president. Is it not time for ASA and ABA to follow his lead?

Obituaries
I have received letters that express concern that certain NEWSLETTERs do not include an “In Memoriam,” which lists the names of deceased ASA members. As editor I believe that it is critically important that every member’s death be announced within the pages of the NEWSLETTER. Space, however, is not always available depending upon what is in a particular issue. Like the letters to the editor, occasionally this feature does not appear in a particular issue. The names of the deceased, however, are always held over and published in the next “In Memoriam.” When notice of the death of a member is received by ASA within one year of that member’s death, that person’s name will be published in the NEWSLETTER. To make such publication a bit easier, the House of Delegates in October 2004 approved enlarging each NEWSLETTER to 44 pages if needed. The NEWSLETTER Editorial Board and staff will use those pages wisely, filling them when there is sufficient quality material to publish.

Formal obituaries are restricted to Past Presidents and winners of the Distinguished Service Award or the Award for Excellence in Research. Other members do not have their obituaries listed in the NEWSLETTER, although often I wish there were more space to include many more obituaries. Many anesthesiologists have led fascinating lives, and I believe that the membership would appreciate and benefit from reading about them. How these individuals would be identified, though, remains a problem.

Additionally, ASA staff, who become dear friends as we work together over the years, also are excluded. For example former Director of Communications Philip S. Weintraub, with whom I briefly worked as NEWSLETTER editor and for years on the Committee on Communications, died on January 28, 2005, after a long illness. Phil was full of life, with a heart as big as all outdoors, and he had a keen sense of how to present anesthesiology and anesthesiologists to the media. He will be greatly missed by all.

Thanks
There are many people who make this column possible. First and foremost is Immediate Past President Roger W. Litwiller, M.D., who chose me to be editor. Eugene P. Sinclair, M.D., asked me to continue in the job this year. Many individuals within ASA proofread the NEWSLETTER and offer suggestions. There are many people who have helped with ideas for this column, most notably Dale C. Smith, M.D., chair of Medical History at the Uniformed Services University, who has helped me to gain outside-the-specialty and historical perspectives on issues in anesthesiology. Several dear friends, especially Douglas A. Catalano, who has known me from time immemorial and is free with his criticism, has aided in refining both my ideas and my English, assuring me of clear communication. To my colleagues at the Mayo Clinic, who never fail to stimulate my thought with conversations often directed at or behind me, I thank you. To those who have read my columns and offered suggestions, among them Roger E. Hofer, M.D., Nicole E. Webel, M.D., W. David Mauck, M.D., Mark A. Warner, M.D., James Y. Findlay, M.B., Ch.B., and David P. Martin, M.D., Ph.D., my deepest thanks. The ideas and responsibility are mine alone!

No, I am not resigning. I believe in thanking people for their efforts. The biggest thank-you is to you the readers, for without you and your deep passion for anesthesiology, there would be no NEWSLETTER. The binoculars are up, and I am on duty in the crow’s nest, looking forward to the next 100 years of ASA history.

— D.R.B.

return to top