During the past fifteen years I have had the privilege to serve on the editorial board of the Journal in a number of capacities. Looking back on those early years I can easily reflect on how little I knew and on how expertly my misjudgments were being made. During that time I was fortunate to receive expert tutelage both from the previous editor, Phyllis Palmer-Stark, and from members of the editorial board. But interestingly, where I learned the most was from the authors who took the time to explain why they did not accept reviews they received from me (of course they were blinded to who the reviewers were so this was only achieved by reading their comments addressed to the editor). I did persist, however, and began to understand what Robert Frost meant when he said, “education is . . . hanging around until you’ve caught on.” It was through such ‘hanging around’ that I came to appreciate just how important the position of being the Journal’s Editor is, and why it is so seminally important that I step down and pass the responsibilities on. As the incoming President of AmSECT it is going to be critical that my attention is focused on the needs of the Society, which are changing at an unprecedented rate. The timing for this decision was made approximately one year ago, which culminated in a formal search for the new Editor of the Journal.
In March of this year a search was undertaken to identify individuals for the position and several candidates were approached and asked to consider running for the position. After receiving a number of willingness-to-serve forms written recommendations were solicited. These were sent to the AmSECT Board of Directors who voted in October with the outcome of Bob Groom, MS, CCP being elected as the new Editor of the Journal. There are few individuals as talented, less who are as dedicated, and none more prepared, to assume the Journal responsibilities than Bob. His devotion to the science of perfusion is well known to all of us who both study and practice this trade, and his contributions to the field are both significant and far-reaching. Bob’s ideas for improving the Journal, and positioning it as the primary portal for both collecting and disseminating information that will shape the future, are portentous. My anticipation for the future is only surpassed by an impatience to see what will occur under his leadership. So what does the future hold? Nietzsche once said “Our destiny exercises its influence over us even when, we have not learned its nature.”1 As perfusionists we look to the future with a certain degree of skepticism as we assess our options and focus on our opportunities. AmSECT has long served as the quintessential organization for perfusionists, and hence, must invigorate its membership to critically evaluate all facets of the profession, while keeping core values as the motivating force. It is with such a challenge that the stage is being set to perform in a manner that precedence eludes.
During the next several years several new initiatives will occur that will require input and participation from a tremendous number of individuals, in order to see to fruition. Methods on channeling the enthusiasm, seen as a response to the changing environment, will be developed and will focus on several primary areas. The first will be to revisit the perfusionist scope-of-practice to identify what opportunities are present in the face of a diminishing patient-base requiring extracorporeal circulation. The debate upon whether a diminution of case number will continue is not germane. The fact that being unprepared for an upsurge in need is far better than having to scramble to find cases for those practicing, or those wishing to practice, perfusion. Secondly, methods of identifying which techniques and technologies are best suited to improve the care we administer to our patients HAVE to be established. The use of an evidenced-based approach to establishing best practices in perfusion is being established across the profession, and is not constrained by either geography or political beliefs. The outcome is both far reaching and encompassing and the Journal will serve as the hub for this activity. Third, a renewal in emphasis on continuing education with outcome-based goals needs to occur. Perfusionists are awash with intentions on how to improve the techniques for administering care. The ‘show me’ message needs to be conjoined with ‘teach me’ so that methods which have proven to be effective can be made communal for rapid incorporation into practice. Meetings need to be structured in a way to permit attendees a means of challenging the presenters, and the content, through the critical evaluation of messages being delivered. Limiting, or omitting, speakers who are single focused because of conflicted interests or through vendor support, must occur or be duly disclosed. Fourth, attention must be immediately paid to the state of primary education at the university or hospital level. The decline in perfusion education programs, and perhaps more important, the regression in education away from the graduate level, is unnerving and will eviscerate the profession. We as perfusionists need to heed this portent of catastrophe and develop a means of objectively quantifying measures to assure that we do not regress any further. No other medical or allied health profession has suffered the fate with which we are tenuously prodding. And finally we cannot go this alone. Medicine knows no boundaries but becomes tethered to economic anchors that inhibit progress. The concept of ‘them that has, gets’ cannot be the rallying call by which we succumb our energies to, nor can we use geographical borders as a demarcation point. By making education priority one we position the Journal as the mechanism by which we unhitch the constraints which have impeded progress to date.
As the final editorial in this series I cannot leave without thanking the many individuals who have made my privilege of serving the profession a reality. I begin with Craig Vocelka who, as President of AmSECT, appointed me as Editor. Craig is normally an intelligent individual and his brief, and only, loss of sensibility provided me with the opportunity to pursue my vocation in a more formal manner. Ron Richards who, as current President, oversaw the recent changes in the Journal and supported me with wisdom and courage, cannot go unrecognized. Phyllis Palmer-Stark instilled in me the importance of seeing the individual behind each submitted paper and focusing on a rejected paper as a joint failure between author and editor. Section editors like Julie Wegner, Jeff Edwards, Rick Smith, Jeff Riley and Cody Trowbridge who were, and are, phenomenal resources, and were so giving of themselves in every task I ever asked of them. Our publisher, The Sheridan Press, and in particular one person— Carolyn Bowers—was instrumental in the early changes in style and layout that resulted in a much needed facelift for the Journal. The Managing Editor Judy Luther who helped with the transition of the ‘magazine’ into a Journal, and did so without a single utterance of ‘why fix what ain’t broke’ attitude. To Kay Stammers, the current Managing Editor, since there would not be a Journal without her. Her tenacity and her wisdom are what kept all of us on the editorial board in line. Of course it must go without mention the contributions from the numerous authors who have sustained the publication for the past 37 years. And finally to the entire editorial board, past and present representing 12 countries and numerous clinical and basic science specialties, your perseverance and unremitting devotion to the Journal can never be overemphasized, and any successes that have been realized are directly related to your efforts.
When I became Editor I set a goal of serving for 10 years. Although I have chosen to leave earlier, it is done without regret and without fear for the future. The leadership of the Society has heightened expectations for the Journal and the new editor will serve well in that capacity. I look forward to receiving my next issue and sitting, coffee in hand, to read of my future.
All things must pass.
None of life’s strings can last.
So, I must be on my way,
And face another day.
George Harrison, All Things Must Pass, 1970
Alfred H. Stammers, MSA, CCP
Editor
1 Friedrich Wilhelm Nietzsche from Human, All Too Human, 1878.