The Pursuit of Excellence: The 47th Annual Rovenstine Lecture
The Pursuit of Excellence: The 47th Annual Rovenstine Lecture
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追求卓越：第 47 届罗文斯汀年度讲座
DOI：
10.1097/aln.0b013e31819c72f9
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发表时间：
2009
期刊：
影响因子：
8.8
通讯作者：
Ronald D. Miller
中科院分区：
文献类型：
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作者：
Ronald D. Miller
我常常想，会有那么一天，罗文斯廷的讲师不会老到与埃默里·安德鲁·罗文斯廷（Emery Andrew Rovenstine，纽约大学医学院麻醉学教授，纽约，纽约; 1895-1960）有任何联系，但这一天还没有到来。今天是我第二次与罗芬斯汀直接联系。我的第一个未知的联系是在高中。正如马克·华纳在罗文斯汀的演讲中所指出的，罗文斯汀是印第安纳州拉波特的一名篮球教练。高中时，我参加了三次印第安纳州拉波特的州立高中高尔夫锦标赛，并在拉波特高中演奏了爵士小号独奏，离他可能担任教练的办公室只有几码远。所以这位罗文斯廷的讲师和罗文斯廷在时间和地理上确实有着密切的联系。在2008年5月的阿萨时事通讯中，我很激动地读到了保罗·奈特和大卫·沃蒂尔写的题为《正确的东西》的文章奈特和沃尔蒂埃提醒我们，约翰·斯诺（John Snow，英国伦敦的内科医生和外科医生，1813- 1858）非凡的好奇心和“调查之火”不仅包括氯仿麻醉，还包括确定19世纪中期霍乱传播的致病因素。太了不起了！我相信约翰·斯诺不仅示范甚至开创了促进麻醉管理的原则，而且对整个医学做出了重大贡献。约翰·斯诺是一个超越麻醉学界限追求卓越的麻醉师的例子。表1突出显示了这一原则的其他更现代的例子。想象一下彼得·萨法尔医学博士h.c.博士F.C.C.M.，F. C. C. P.（Safar Center for Resuscitation Research，University of Pittsburgh，Pittsburgh，Pennsylvania; 1924-2003），在心肺复苏术中抢救濒临死亡的人时使用过！在几个人的贡献下，约翰W。Severinghaus，医学博士（加州弗朗西斯科大学[UCSF]麻醉和围手术期护理系名誉教授，弗朗西斯科，加州）创建了一种途径，通过对动脉血气的密集分析，可以对患者，特别是危重患者进行监测。创建单独的单位，通过重症监护医学来照顾我们最严重的病人的演变是由许多人发起的，其中之一是亨里克H。Bendixen，医学博士（哥伦比亚内科和外科医生学院，纽约，纽约; 1923-2004），他最初来自丹麦，然后是波士顿，然后是加州大学圣地亚哥分校的第一任麻醉主席，然后回到纽约。John J. Bonica，医学博士（华盛顿大学麻醉学系，西雅图，华盛顿; 1917-1994），孜孜不倦地推广多学科护理治疗慢性疼痛患者的概念。令人惊讶的是，目前疼痛管理的概念包括了博尼卡博士在20世纪50年代和60年代最初推荐的所有方面。还有约翰·蓝迪医学博士（明尼苏达州罗切斯特市马约诊所麻醉科教授兼主任; 1894- 1973年），是在美国马约诊所建立血库的第一人。这些都是麻醉师超越麻醉学通常界限追求卓越的例子。可以肯定的是，这些人不仅负责增强麻醉，而且还被公认为麻醉师，因为他们对医学的贡献。
I OFTEN thought that there would be a day when the Rovenstine lecturer would not be old enough to have any connection to Emery Andrew Rovenstine (Professor of Anesthesia, New York University College of Medicine, New York, New York; 1895–1960), but that day has yet not arrived. Today is my second direct connection with Rovenstine. My first unknown connection was in high school. As pointed out by Mark Warner’s Rovenstine lecture, Rovenstine was a basketball coach in La Porte, Indiana. In high school, I played in three Indiana State High School golf tournaments in La Porte and played a jazzy trumpet solo at La Porte High School just a few yards from the office he may have occupied as a coach. So this Rovenstine lecturer and Rovenstine do have a close connection in time and in geography. In the May 2008 ASA Newsletter, I was thrilled to read the article by Paul Knight and David Warltier titled “The Right Stuff.” Knight and Warltier reminded us that John Snow’s (Physician and Surgeon, London, England; 1813– 1858) remarkable curiosity and “fire of investigation” included not only chloroform anesthesia, but also the identification of the causative factors regarding transmission of cholera in the mid-1800s. How remarkable! I believe that John Snow exemplified or even initiated the principle of not only facilitating the administration of anesthesia, but also making major contributions to medicine overall. John Snow is an example of an anesthesiologist who went beyond the boundaries of anesthesiology in the pursuit of excellence. Other, more contemporary examples of this principle are highlighted in table 1. Imagine the impact that Peter Safar, M.D., Dr.h.c., F.C.C.M., F.C.C.P. (Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania; 1924–2003), had when reviving people who were near death by cardiopulmonary resuscitation! With the contributions of several individuals, John W. Severinghaus, M.D. (Professor Emeritus, Department of Anesthesia and Perioperative Care, University of California San Francisco [UCSF], San Francisco, California), created the pathway that allowed patients, especially critically ill ones, to be monitored via intense analysis of arterial blood gases. The evolution of creating separate units to take care of our sickest patients via critical care medicine was initiated by many individuals, one of whom was Henrik H. Bendixen, M.D. (Columbia College of Physicians and Surgeons, New York, New York; 1923–2004), who was originally from Denmark, then Boston, and then was the first Chair of Anesthesia at the University of California San Diego before returning to New York. John J. Bonica, M.D. (Department of Anesthesiology, University of Washington, Seattle, Washington; 1917–1994), tirelessly promoted the concept of multidisciplinary care in the treatment of patients with chronic pain. Amazingly, current concepts of pain management include all of the aspects and more that were originally recommended by Dr. Bonica in the 1950s and 1960s. And John Lundy, M.D. (Professor and Head, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; 1894– 1973), was the first individual to start a blood bank in the United States at the Mayo Clinic. These are examples of anesthesiologists who went beyond the usual boundaries of anesthesiology to pursue excellence. To be sure, these individuals not only are responsible for the enhancement of anesthesia, but also were recognized as anesthesiologists for their contributions to medicine overall.