Douglas R. Bacon, M.D., Editor

Quiet Conversations

ovember is a month filled with quiet conversations. The House of Delegates has met, deliberated and set forth ASA’s agenda for the coming year. Implementation requires effort and communication, often quiet communication between committee members, the chairs and ASA officers. November is a time to reflect upon what we have accomplished and on the road ahead. The month is filled with two holidays — one celebrated with gusto, the other slowly fading into obscurity. Yet it is in the celebrations of November that another form of quiet conversation comes into play — that which takes place between members of extended family. Whether by blood or association, November’s holidays are a time to remember those who have sacrificed in our names and put their lives on the line for us. It is a time to be thankful not only to our veterans but to all our leaders and to ASA and all of our organizations that work toward making and regulating anesthesiology.

One of the lasting quiet conversations I have had was with a veteran. He was in his late 70s and had arrived in the operating room where the anesthesia and operating room teams were going about the pre-induction rituals in the heart room. The monitors were on, an I.V. in place, and the anesthesia team was preparing to put an arterial line when the patient was asked, “Are you scared?” The reply: “Hell no — you’re not trying to kill me like those Nazis on D-Day.” It was a poignant reminder of what this man had done for all of us in the room. He had laid his life on the line that we might enjoy freedom.

That same year, the film “Saving Private Ryan” came out. As VA physicians, we were encouraged to see the movie, and as an added inducement, continuing medical education credit was available for those who answered some questions about the content presented. For me, the movie’s ending moved me beyond words. In it, Private Ryan, now a grandfather kneeling at the grave of the captain who saved his life, asked his wife whether he was worthy of the ultimate sacrifice the captain had made for him. Survivor’s guilt was something that often lurked below the surface of the patients we cared for at the VA.

On November 11, we celebrate Veterans’ Day. Originally known as Armistice Day, the holiday commemorated the end of the mass slaughter known as World War I. In 1954, President Eisenhower, in recognition of the contributions of World War II and Korean War veterans, changed the name to Veterans’ Day — set to honor those who have or are serving in the armed forces.¹ In the United States today, unfortunately, this holiday has come to mean a day off from school and sales at the local stores more than a solemn commemoration of those who serve or served to protect the freedoms that we enjoy. At my current place of employment, we work on the holiday despite the fact that two of our founders were brigadier generals in World War I and that there were two hospitals whose staff were supplied by our institution in Word War II.

Another World War II veteran, Bob Curran, wrote a column for many years that covered local stories of interest and a weekly “mailbag” in The Buffalo Evening News, the paper of my youth. I will never forget the ending to his Veterans’ Day column — “May the words cleave to the roof of my mouth if I ever use the word courage to describe an act in a game boys play.” Mr. Curran had seen the worst of life in some ways, as a foot soldier during the Battle of Bulge. His description of a burning tank, with injured men screaming inside, was a recurring piece in his writing, and I suspect it haunted his dreams. I hope Mr. Curran would agree with the assessment that true leadership requires courage, not as dramatic or intense as the life and death decisions of the battlefield, but in some instances as dramatic and long-lasting.

Over the course of the past year, it has become apparent that there was a need for a major overhaul in the administrative structure of ASA. The triumvirate of President Mark J. Lema, M.D., Ph.D., President-Elect Jeffrey L. Apfelbaum, M.D., and First Vice-President Roger A. Moore, M.D., tackled this problem without reservation. It would have been easy to ignore the problem, to continue business as usual rather than engage experts to study the function and needs of our “home” office, our Washington Office, the membership and the strategic plan and make the necessary changes that will allow ASA to prosper in the 21st century. With this decision, there are and will continue to be growing pains and difficult issues, such as those concerning office space and parking at the Park Ridge office. These issues and more will need to be dealt with through quiet conversations and respectful deliberation.

One thorny space problem uncovered in the reorganization of the ASA Headquarters Office centers around the Wood Library-Museum of Anesthesiology (WLM), which is housed within the headquarters building and is the only ASA foundation with significant special needs. The George and Ramona Bause gallery exhibits some of the most interesting artifacts in the WLM collection. It also covers a quarter of the first floor of the building. ASA has generously supported WLM for many, many years and was thrilled to have such a wonderful space in which to display the collection WLM Trustees have worked so hard to collect and preserve. If this space is needed to further the mission of ASA, what will happen to the displays? With good leadership, which has already been proven on the ASA side, and the fortitude to trust each other, there is no doubt that the WLM will emerge stronger and better able to serve the needs of ASA members and the general public. Neither side can afford to be motivated by self interest or assume anything but the highest values in the other. Rather than taking the popular or easy course, it will take quiet conversations, built upon trust combined with wisdom, to do the right thing, which will be of mutual benefit in the end.

The strong, decisive leadership that the Executive Committee has demonstrated is something for which all of ASA should be grateful. The United States is among a handful of nations that set aside a day to give thanks for blessings received in the course of a year. The other November holiday is Thanksgiving. Stemming from the harvest traditions of England and the peace between the Wampanoag Indians and the pilgrims, the holiday evolved over time, with the State of New York celebrating an official day of Thanksgiving in 1817. Abraham Lincoln declared the last Thursday in November as a day of thanksgiving. Franklin Roosevelt declared the fourth Thursday in November a federal holiday, Thanksgiving Day, in 1939, and Congress agreed in 1941.²

As my extended family gathers in Rochester, I look forward to quiet conversations with everyone. My two eldest sons return home from college, and I am sure to be introduced to new ideas and concepts taught to them. It will be wonderful to have my mother to talk to, and my sister and brother-in-law, whose easy company is a far too infrequent blessing. As an anesthesiologist, I remain grateful for the strength of our Society and for the dedicated and determined leadership shown by our elected officers. Our Washington Office staff members remain tireless in their effort to further our cause on Capitol Hill, and they continue to monitor situations in many states. Our headquarters staff, while slowly expanding and evolving, remains the very best of any specialty society in the Untied States.

Indeed, we anesthesiologists are richly blessed. Take time this November to count your blessings, and engage in quiet conversations with your patients, colleagues and family.

— D.R.B.

References:
1. www.va.gov/opa/vetsday/vetdayhistory.asp. Accessed on September 12, 2007.
2. www.history.com/minisites/thanksgiving/viewPage?pageId=874. Accessed on September 12, 2007.

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