The nouns that define us.

I am humbled by this Presidency. I love this organization. It has been good to me. More importantly, it has been good for patients with breast disease and breast cancer. The primary goal of my address today is twofold. I aim to encourage you, the members, in the pursuit of our missions. Secondly, I will offer some comments which may be perhaps taken by some of you in a more personal light. I am about to give you one person’s view of societal and personal priorities for the future. I do not claim to be Solomon; I am even sure that some of these things I espouse are not completely true, but some of them are. It is important that we as a society, and you as an individual, know who we are, and know that our missions are most honorable. From a moral perspective it is easy to do our daily duties. My dad and mother, who are here today, could not be more pleased to know that my work is to do the right thing, defined by myself and respected peers, in the best interest of my patients. You and I have the obligation of discerning and learning the clinical truth and applying it in a competent and compassionate manner. I implore you to also recognize that there is no compassionate care without the prerequisite competence. A few years ago my wife and I sat down and began to talk about the nouns that most accurately describe us. Are you first a surgeon, a father, a scientist, a leader, or a husband? You ought to consider the five or so most accurate nouns that describe you. This can be a meaningful exercise as I hope to illustrate. So what are the nouns that accurately describe me? I stand behind this podium honored as a great privilege. Some would say that this honor occurred in large part, by fate. Some, perhaps my mother, would say by divine intervention. But as Murray Brennan so eloquently and recently noted, a key factor is the right of birth. I was fortunate to have been born in America, the greatest country in history, and now the richest nation in the richest age. I am proud to be an American. Americans, from a global perspective, are responsible individuals. In 1997, I took a sabbatical to learn certain principles of business. The class was about 40% international. We Americans were derided, and even denigrated, with regard to our trade deficit, among other things generally viewed as American weaknesses. After 8 weeks of silence (and I know some of you find that hard to believe) I finally responded to their incessant jabs and ingratitude: “You claim we have no valuable exports. Our most important two you seemingly dismiss. The first is love. You have expressed your respect for the Chinese culture, and even revered their longevity and great legacy. Well, they have infanticide. We Americans adopt more children than any nation on earth. We are a land of immigrants. We are the land of opportunity for those same immigrants. Our second greatest export is peace. My friends have family who have paid for it with blood and taxes and I don’t want you to forget it; we Americans, true to the philosophy reaffirmed by Ronald Reagan, provide the world with peace through strength. Recognizing such, Americans have assumed the role of global peace keeper, made the sacrifices, and still make the hard decisions. It would be nice if you would simply say thank you.” Today we continue to make difficult decisions. We recently made hard decisions about Iraq. We did what we did with compassionate judgment, in my view, and I am proud of our country. I am proud of most of the decisions we make, but I know sometimes we are wrong. The global community can be reassured that Americans are the surgeon equivalent in the family of nations. As such, we will hold a vigorous “morbidity and mortality conference” to determine what we could have done better. And yes, maybe we could have handled some Iraqi relics differently. But you can be assured if we are faced with a similar situation, say in the Louve some day, we will get it right. In my view, Americans, through our sacrifices in the past century, have earned * Corresponding author. Tel.: 1-501-686-7874; fax: 1-501-6865696. E-mail address: Edwardsmichael@uams.edu The American Journal of Surgery 186 (2003) 317–320