“Of Courage Undaunted”: 2010 AAST Presidential Address

摘要

To stand here as President of the American Association for the Surgery of Trauma (AAST) is the highest honor for a trauma surgeon. I thank you for this honor. However, I do not view this as a personal achievement. Rather, I view this position as recognition of our group at the University of Pittsburgh and what we have accomplished. My partners are truly my second family to me; I thank them for being my partners and friends. Sharon Gautschy and Tamara Jenkins have added so much to the AAST. I thank you both for making the year rewarding and enjoyable. Sally Tress and Erin Boland have attempted to organize me and protect me from myself at Pittsburgh; I thank you both for putting up with me and for enabling me to do the many things that my job demands. I am grateful to the AAST officers, the members of our board of managers, and all committee members who have contributed so much to the AAST. I owe my mentors a huge debt of gratitude. Dr. Mark Ravitch, for whom I worked as a resident, and I now have the honor of sitting in the Mark M. Ravitch Chair (Fig. 1). My 2 years at the New York Hospital/Cornell University Medical Center under Dr. G. Tom Shires and his laboratory established lifelong mentors and friends for me (Fig. 2). My thanks to the three chairman for whom I have served. Dr. Henry Bahnson, whose vision was the consummate clinical surgeon; he demanded technical excellence (Fig. 3). In 1987, Dr. Richard L. Simmons became Chair at the University of Pittsburgh and made Pittsburgh an incredible research enterprise. Dr. Simmons remains a dear friend, and our meetings continue to be times of great insight for me (Fig. 4). Over the past 10 years, Dr. Tim Billiar has made both the research and clinical programs even stronger; he chairs the best department of surgery in the country, and I am lucky to be part of it. Thank you, Tim (Fig. 5).Figure 1.: Dr. Mark M. Ravitch.Figure 2.: Dr. G. Thomas Shires.Figure 3.: Dr. Henry T. Bahnson.Figure 4.: Dr. Richard L. Simmons.Figure 5.: Dr. Timothy R. Billiar.The synthesis of this talk begins with my lifelong interest in history, as well as my foundation as a general surgeon and what we now call an acute care surgeon, starting in 1983. We have run such a service at the University of Pittsburgh for almost three decades. In addition to our leaders in the AAST, I have been heavily influenced by my dear friends in the Panamerican Trauma Society and the European Society for Trauma and Emergency Surgery. I feel lucky and blessed to have chosen this career path. I truly have as much fun today as I did 27 years ago when I began as an attending at the University of Pittsburgh. As Confucius wisely stated, “Choose a job you love, and you will never have to work a day in your life.”1 I stand here as well at a time when the AAST continues to grow and thrive. Under the program stewardship of Dr. Cioffi, Dr. Britt before him and their predecessors, the meeting has grown in quality and scope. Attendance continues to grow (Fig. 6). The AAST is the premier scientific organization for trauma.Figure 6.: Yearly attendance at AAST meeting.Today, we will talk of glorious, incredible opportunities. We will talk about enormous challenges, huge obstacles, and real danger. We will finally discuss options with these opportunities and potential solutions to the problems. To do this, we will use a grand analogy, looking to the infancy of our nation. The year is 1803. Just a few years earlier, it was not clear whether the United States could hold on to its existing territory between the Appalachian Mountains and the Mississippi River. England, France, and Spain still were attempting to add portions of the continental United States to their empires. With the Louisiana Purchase, America doubled in size overnight (Fig. 7).2–7 President Thomas Jefferson, the architect of the deal, has acquired this enormous piece of our continent in a remarkable real estate deal with the French. “The annexation of Louisiana was an event so po