Douglas R. Bacon, M.D., Editor

Celebration and Remembrance: The Price of Freedom?

uly always conjures up images of a midsummer’s celebration. For those of us in the United States, July 4th is Independence Day, a celebration of our cutting ties with the mother country and striking out on our own. It is one of three great patriotic holidays celebrated — the others being Memorial Day, when those who have fallen in defense of our country are remembered, and Veterans’ Day, which memorializes those who have served in the armed forces. Yet in the American conscience, it is July 4th, on a warm summer’s eve, with a picnic preceding fireworks, that leaves lasting images in our collective experience. As a child, it was an anticipated holiday that confirmed school was out and summer was here.

A Birthday Not Taken for Granted
The July issue of the NEWSLETTER also is a celebration of the upcoming Annual Meeting. This year we have much to celebrate, as this is the official 100th birthday bash of ASA! Detailed within the pages of this “massive” issue are all the elements that make the Annual Meeting an event. Previews of the panels and scientific papers, the lifeblood of education, are detailed in this issue. Short biographies are printed in the articles covering the Rovenstine and Wright lecturers as well as other notable presenters who are introduced to the ASA community through these pages. The many interesting things to see and do in our host city, New Orleans, Louisiana, were outlined so wonderfully by Mack A. Thomas, M.D., in the June NEWSLETTER. Can you think of a better city in which to celebrate your birthday?

Summer also often means a family vacation, leaving behind the cares of the day and relaxing. We are free to roam throughout the continental United States, Alaska and Hawaii without the hassle of informing the government of our intentions. We can travel abroad, especially to Canada and Mexico, with ease. Only within recent memory is a passport required, especially for our friendly neighbor to the North. Yet summer may indeed be the best time to remember the cost of our freedom. From the Memorial Day holiday, which traditionally “kicks off” summer for those of us north of the Mason-Dixon line, until the middle of July, media outlets are concerned with remembering that which has made this country great. Commemorating those who fell in defense of their country, the real purpose of Memorial Day, is often a melancholy business. As the first week of June approaches, D-Day and the invasion of “Fortress Europe” is recalled. This past year celebrated the 61st anniversary of that day; tales of unimagined carnage, bloodshed and heroism were recounted. On the Fourth of July, the tone turns lighter, and the great strengths of the United States are celebrated with loud fireworks, parades and family celebrations, all of which reaffirm the freedom that we Americans so love.

So Annual Meeting aside, what does this have to do with anesthesiology in general and ASA in particular?

ASA Centennial
The centennial provides an opportunity to reflect upon the Society, its institutions and the manner in which we conduct the business of anesthesiology both inside and outside of ASA. Are we, as ASA and as individual anesthesiologists, reflective of the American traditions of democracy, and do we fully express and take advantage of the freedoms that so many have died defending?

On the surface, ASA mirrors the federal government in being a representative democracy. Any member can become an officer if he/she is willing to put the time and effort into the affairs of the Society. Elections are held by secret ballot, and our President is chosen by duly-elected representatives of the membership, just as the Electoral College elects the President of the United States. An individual member has input in at least three venues: first, through his/her ASA district and state Society; second, through the reference committees where any member is free to comment about the business of the Society, and third, through letters to the editor of the NEWSLETTER. This kind of open dialogue occasionally means that the work of a committee or a committee chair is criticized by a member in print. While this policy may be disapproved of in an organization that relies so heavily upon volunteer time and effort, each judgment is a chance to educate and to illuminate the processes and ideas behind the critiqued action. In those rare instances that change is needed, the venues available to create a new pathway are, and will always remain, democratic.

Sacred Principles
In large part, ASA, and the United States for that matter, remains a viable organization because of two interrelated principles. The first sacred principle, that democracy prevails, ensures the ability of the membership to have an active voice in the choice of their leaders rather than have them appointed through political or familial connections. The voice of the membership is always respected, and occasionally the ASA House of Delegates has overturned the work of the ASA Board of Directors, not unlike Congress overturning a presidential veto. The second principle, that everyone respects the outcome of the democratic process, is equally critical. Losing an election is a terrible blow to the ego, yet ASA has always been able to close ranks and support the winner. Without the ability to close ranks, the Society would soon evolve into a fragmented, ineffectual organization.

Supporting Our Defenders
Finally I believe we must support the action of Americans now defending our freedom in the far-flung posts of the world. Read the article about what our brave troops are doing in Iraq on page 11 of this NEWSLETTER. Anesthesiologists working at the front have greatly reduced mortality on the battlefield. Injuries which would have been fatal in any other conflict have been treated and the soldiers returned quickly to the United States for definitive treatment. All providers working with these courageous individuals deserve some of the credit, but the innovation of our military colleagues is remarkable. A request has come forth that each Friday a piece of red apparel be worn in support of our troops, mostly in Iraq, but also around the globe. Regardless of how you personally feel about the conflict, it is our duty to support those who are putting their lives on the line so that the United States remains free. Criticize the policy and the policymakers if that is your political belief, but do not fail to support the men and women ordered to a faraway land.

I spent five and one-half years working as the Chief of Anesthesia Service at a Veterans’ Affairs Medical Center. Each day as I drove in past the main entrance, there was a sign that stated, “The Price of Freedom Is Visible Here.” Caring for the veterans was in many respects an honor; working within the Veterans’ Administration system was frustrating. The best way we can honor those who have paid the price for our democratic system is to participate in our government. For us as anesthesiologists, that means we need to be involved in letter-writing campaigns to our elected officials and to work with ASA, especially the Washington Office, to secure a bright future for our specialty. ASA members also must support the ASA Political Action Committee (ASAPAC), for it is the only PAC with one objective, improving American anesthesiology. This may mean that the PAC donates to a politician whose views outside our specialty are in conflict with your personal beliefs. That is not a time to withhold funding; rather it is a time to increase your donation to ensure that all politicians hear our message for support on issues of grave importance to our patients and our specialty. More on the ASAPAC’s goals and efforts are outlined on page 32.

Get Involved!
Involvement is the best way to preserve our democratic process, both within ASA and the United States. The dialogue between different points of view remains an essential part of the growth of our nation and our specialty. Strong participation encourages that dialogue and will help us to guard against those who look to abuse their office for whatever reason. To do any less is disrespectful to the veterans who have served our country and the generations of anesthesiologists who have built our specialty.

— D.R.B.

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