The Academic Department of Surgery: Between Scylla and Charybdis

M EMBERS AND GUESTS of the Pacific Coast Surgical Association, ladies and gentlemen, one can aspire to no greater honor than the election by one’s peers to preside at the 76th annual meeting of our esteemed society. Recognizing the trust and responsibility implicit in this privilege, I thank you for your generosity and promise you my best effort. Most of all, Sandy and I express our appreciation for the friendship and professional fellowship we have enjoyed in your company during the 36 years since I presented my first paper to the Pacific Coast Surgical Association. I remember it as a rainy, bitter cold, February weekend at the former El Mirador Hotel, in Palm Springs, Calif. I think it must have been worthwhile, however, because soon after our meeting the hotel was converted to a hospital. To Dr Russell Williams, my gratitude for not only rendering a rather plain biography larger than life, and for telling the story so well as to make it almost believable. Dr Williams, you have been the most reliable and wisest of professional partners, a colleague whose judgment was sound and criticism considerate. During the past 25 years, Dr Williams has skillfully rescued, directed, and polished 2 university residency programs, graduating over 100 residents to become certified in general surgery and organizing the education of several thousand medical students in surgery. In our teaching, we have regarded surgery as an applied science that requires the practitioner to have a detailed knowledge and a working understanding of the underlying physiological principles supporting any operation. We have emphasized the importance of knowing what one can do successfully as a surgeon to relieve pain or effect a cure, but also knowing one’s limits and as a professional conveying them with candor; in other words, to have keen surgical judgment. We have taught our graduates to be ready to act when the results will be good and cautious when you have little to offer; to conduct an operation in a calm demeanor, with an efficient and precise technique that inspires confidence in your team. We have advocated constructive review of outcomes, not to blame but in the belief that continued improvement is possible for every operation. In resident selection, we have sought those applicants who find surgery a calling, neither an apprenticeship nor a path to comfortable affluence. Each of us has an obligation to contribute to surgical knowledge, which begins with the professor setting the example, as Dr Williams has with regard to education. Our reward is in the knowledge that the next generation will be safe in the hands of their surgeons. “Old Main,” the historic center of Wayne State University, Detroit, Mich, sits comfortably across Woodward Avenue from the Detroit Institute of Arts, affording the undergraduate students an opportunity to visit this superb, Beaux-Arts– style museum. The Diego Rivera murals enclose an atrium that creates a powerful expression of the might of prewar industrial Detroit. The Detroit Industry frescoes are surely “the finest example of Mexican muralist work in the United States,” and Rivera (1886-1957) considered them Samuel Eric Wilson, MD