EDITORIALS 409

principles. Thou shalt not worship speed for its own sake, for it is a false god. A quick surgeon never hurries, for speed is not made by over-haste; when you drive a car, a high average speed depends not on how fast you go, but on how slowly you don't go. Delay is due to indecision, which results from in­correct diagnosis, faulty planning, and lack of experience. The repetitive, unproductive movement should be avoided, as in time-and-motion study: the hand that puts down the scalpel picks up the artery clip—in one move­ment. Time is saved by attention to many de­tails, such as the position of lights, trolleys, and assistants, and by teamwork. Time is saved, therefore, by performing slow, delib­erate, economical movements, never unneces­sarily repeated. Thus, speed becomes the handmaiden of the surgeon and not his mis­tress.

T H E CARE AND NUTRITION OF T H E GUEST SPEAKER

Each year during the Academy meeting the International Association of Eye, Ear, Nose, and Throat Secretaries have dinner together and discuss the methods of improv­ing their local meetings. From Malaya to Little Creek to Belgrade the same questions arise, not the least of which are, "Who can we have to speak who doesn't live too distant, speak too abstrusely or tediously, who has something new to report (not a theme on exophthalmos again!), and won't use the same topic as the guest speaker of last year or last month?" Some societies apparently seek out only professors, believing that if his talk is not well received at least it is more likely a reflection upon his institution rather than the program committee. Others may emphasize youth, while other groups prefer an affable extrovert—a delight at joint meet­ings with the ladies' auxiliary, but not always a stimulating speaker after extensive hos­pitality.

A companion group, The Coterie of Peren­nial Peripatetic Guest Speakers, does not yet meet, but if they did perhaps their sessions

would be as interesting as the secretaries'. The various meeting rooms would be certain to be a provocative topic: the academies of medicine—frequently located in an older part of town with superb speaking facilities but dinner an austere repast in a basement dining room; the country club—much entertain­ment before dinner, a fine steak dinner—but usually no lectern and a tilting projector, ladies' night bingo competing in an adjoining room and transient members believing that the Greens Committee is meeting and depart­ing after several baffled inspections of the audience; the hotel—the tepid pot roast and cold peas, and the inability to start until the union sends a projectionist; the university— milk shake and a hamburger in the student lounge and "we will begin as soon as the classroom is free—didn't know the seminar was meeting this semester"; the large con­vention hall—all business, with an audience ebbing and flowing like the tide, as some realize this is not the Georgian Room and the lower backache section, and others pa­tiently reviewing their newspapers or college reunion plans as they await the next speaker.

The speakers, too, could exchange the stories which they use to fill in the minutes while a frantic search is made for an exten­sion cord so that the projector can be con­nected. They could discuss the even better filler material required when the only projec­tor bulb available burns out midway in the talk. Experienced speakers, too, could ex­plain how to prepare slides so that a pointer is never required since it is likely that none will be available until exactly two minutes prior to conclusion when an ingenious mem­ber will find a meter stick, a broken putter or a window pull-down pole.

An important topic is the use of colored slides. Commonly the projector is of such low wattage that any extraneous light suc­cessfully prevents the image from being seen on the screen. This is frequently an urgent signal for one of the audience to turn off all the lights in the room, including the cir­cuit for illuminating the lectern and some­times the projector, too.

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Experienced speakers could caution against betraying emotion in those communi­ties in which the audiences follow a suburban commuting schedule. The novice may be somewhat disconcerted as a third of the group arises to leave precisely at nine o'clock to catch the last train to Upper Broom-switch. The tyro must learn also to appre­ciate that the reduction of illumination is a signal for the departure of a few, even in those areas having no commuters. The ex­perienced speaker, of course, knows too well the problems of somnolence in busy practi­tioners who have arisen early, striven to compensate for a late arrival at the fellow­ship hour, and then had a heavy dinner. Simple charity probably demands that the speaker not be too insistent on full illumi­nation between slides.

A final topic for guest speakers could be the delicate one of expenses. Now that the Internal Revenue Department demands strict accounting of travelling expenses, this is a detail that certain conscientious treas­urers might well leave to federal control. Certainly a number of questions arise after the simple phase: "Just send a list of your expenses and the treasurer will send you a check." Is the treasurer in town or will the check arrive after he has returned from six months in the Near East? Does the society pay interest for the investment in travel ex­penses between the time of the trip and the payment of the expenses? Does the society permit the guest speaker to have his clothes pressed and shoes shined, or is simple aus­terity and rumpled bonhomie the order of the day? Possibly, the speakers might even resolve to urge their companion group, the secretaries, to have the check covering ex­penses given to the speaker while he is vis­iting their community. The size of the check will vary with a number of factors but it hardly seems proper to reimburse on the basis of the treasurer's opinion of the talk, as Clarence Day's father judged his preacher. If the treasurer would prepare the check for exactly the same amount he would

deduct from his income tax if he took a journey of a similar distance on a business matter, in all probability he would acquire a reputation for unparalleled generosity. Thus the agenda for meetings of the Coterie of Peripatetic Perennial Guest Speakers could be most impressive in range and interest. Other topics will be considered in future communications.

Lux LECTOR, C.P.P.G.S.

THE 17TH CLINICAL MEETING OF THE WILMER RESIDENTS ASSOCIATION

The Wilmer Residents Association is composed of former House Officers and Fellows of The Wilmer Ophthalmological Institute of The Johns Hopkins Hospital. The first clinical meeting was held on May 12, 13, and 14, 1938. The 17th meeting was held at The Johns Hopkins Hospital on March 28, 27, and 29, 1958. Approximately 350 ophthalmologists from the United States and Canada registered during the meetings. Thirty papers were read during the three-day session.

The program was opened on Thursday morning by the present resident, Jack S. Gans, who spoke on "Some techniques in ophthalmic plastic surgery." Dr. Gans stressed the importance of a carefully placed pressure dressing and described the useful­ness of a continuous locked running suture in skin closure. The second paper was by the director of The Wilmer Institute, A. E. Maumenee, who spoke on "A new concept of the pathogenesis of congenital glaucoma." Dr. Maumenee discussed the previous theo­ries of the pathogenesis of congenital glau­coma and then presented evidence to show that an abnormal insertion of ciliary muscle fibers to the trabecular network in front of the scleral spur was the cause of congenital glaucoma. Frederick Verhoeff of Boston who was present in his usual role of dis­senting minority stated that he thought that