Indian Journal of Thoracic and Cardiovascular Surgery, 1987-88; 5 : 4-5

Paradoxes and Problems in the Pursuit of Excellence in Cardiovascular Surgery in India SOLOMON VICTOR"

the lives of patients requiring cardiovascular and thoracic surgery pleasant and comfortable.

"Whatever you can do, or dream you can, begin it. Boldness has genius, power and magic in it", said Goethe. Until one is committed there is hesitancy and chance to draw back. Let us all gear ourselves to this noble task.

Dr. Solomon Victor

Mankind is surrounded by paradoxes. Despite countless opportunities for pleasing, innocent amusements and constructive activity, we are exer- cising our intellect towards destruction at various levels. But this august gatherifig is different. Its collective wisdom will be utilised for a joint exercise towards an arduous but pleasing task of making

*President, Association of Thoracic and Cardiovascular Surgeons of India, 1987.

Presidential address delivered during the inaugural function of First Annual Conference of the Association, held at Madras in February, 1988.

"I want to be thoroughly used up when I die, for the harder I work the more I live. I rejoice in life for its own sake. Life is no 'brief candle' to me. It is a sort of splendid torch which I have got hgld of for the moment, and I want to make it bum as brightly as possible before handing it on to future generations", said Bernard Shaw.

"All means prove but a blunt instrument, if they have not behind them a living spirit. But if the longing for the achievement of the goal is powerfully alive within us, then we shall not lack the strength, to find the means for reaching the goal and for translating it into deeds".

Let us take a quantum leap to achieve equitable distribution of health care relating to our speciality by 2000 AD. Complacency, unproductive introspec- tion, inability to change the established routine, lack of funds and dearth in the number of centres are some of the hurdles in the pursuit of our goal; but let these not deter us.

In the Pursuit of Excellence 5

In our endeavour towards excellence, it would be worthwhile to ponder over a true incident. An old man went to my neighbour, a reputed neuro- surgeon. He was told that the doctor sees only brain problems. He came to our house and was told that I see only heart problems. My wife tried to help, examined him and gave him a prescription. "What can I do with this bit of paper", exclaimed the old man, "where are the good old doctors who used to talk, examine and give a boule of medicine?".

Today there is a risk of a patient for example with chest pain being whizzed through laboratory tests, catheterised, lysed with enzymes, dilated with balloons, rebored with lasers, fixed with a few grafts, perhaps reoperated and end up forgotten except as a number in a computer. While we need to avoid considering modernity with comtempt and treating ancients with idolatory, modern tools of medicine and therapeutic regimens should not be allowed to belittle the sharing, caring and the compassion of the good old doctors.

We also need to look at the rehabilitation of our patients. Handicaps such as loss of a limb jus- tifiably attracts sympathy. However it is time that we classified patients with internal handicaps such as heart diseases as handicapped and assist them.

The high traditions of ethics of medical pro- fession also need to be zealously guarded. As members of the medical profession we have been bestowed an unsurpassed opprotunity to alleviate human suffering, enjoy a life with incessant intellectual challenges, rewarding social status and reasonable financial return. It is our duty to pursue the path of excellence to ensure that the glorious advances in cardiovascular surgery are accessible to each and every one in our country.

Let us remember the words of our poet Tagore.

"Where tireless striving stretches its arms towards perfection

Into that heaven of freedom My Father, let my country awake".