Surgeons hear about what's new at ACS

The year's major meeting of surgeons Oct 21 to 26 attracted more than 9,000 physicians to Chicago for a week of continuing education. The 65th Annual Clinical Congress of the American College of Surgeons (ACS), offered 400 hours of postgraduate courses, lectures, and sessions covering progress in research and clinical practice.

During the week, William H Muller, Jr, MD, FACS, assumed the presidency of ACS, suc- ceeding William A Altemeier, MD, FACS. Dr Muller is professor and chairman of the De- partment of Surgery at the University of Vir- ginia School of Medicine, Charlottesville. Rep- resenting AORN at ACS were Barbara Stanewick, president-elect, and Jerry G Peers, executive director. (See the President's mes- sage in this issue.)

Surgeons and guests line up to register at McCormick Place in Chicago, site of the ACS meeting.

Rounding out the week was the annual re- view, "What's New in Surgery?" Thirteen lead- ing surgeons summarized developments in their specialties, which are reported below.

Perspectives from outside the profession were offered by Norman Cousins, former editor of the Saturday Review, and Paul G Rogers, former congressman who served for eight years as chairman of the House Sub- committee on Health and the Environment. Cousins has just published a book, Anatomy of an Illness.

A believer that attitude has an important ef- fect on healing, Cousins observed that "at- titudes are not philosophical abstractions. Negative emotions are known to cause chemi- cal changes." Conversely, he believes pa- tients can benefit from positive emotions.

In his own illness, spondylosing arthritis, Cousins said he had found that "ten minutes of laughter gave me two hours of pain-free sleep." He called endorphins, a kind of natural

54 AOKN Journal, January 1980, Vol 31, N o I

Norman Cousins

morphine, the "body's own pharmacy," which can reduce the need for analgesics.

"The doctor is not the healer," Cousins told the surgeons. "The patient is the healer. The job of the doctor is to activate the healing capacity of the patient. The best doctors un- derstand this partnership."

Surgeons should create a "philosophical context" for surgery, he said, adding that the surgeon "doesn't treat the patient fully unless he creates that context." Telling the truth in a way that does not destroy hope is one way of building such a relationship. "No one knows enough to make a pronouncement of doom on another human being," he said. He is a senior lecturer in medical humanities at the University of California, Los Angeles.

Rogers, who was a health leader in Con- gress, has participated in passage of most re- cent major health legislation, including health planning, emergency medical services, and health maintenance organizations. In the last session, he presided over cost containment deliberations. He is now practicing law in Washington, DC.

Commenting on whether there is too much of the government's involvement in health is- sues, Rogers observed that the "federal gov- ernment is generally called on when there has been no action elsewhere or when there has been too much action, or abuse." For example, he said, Medicare and Medicaid were passed to take care of the health needs of the elderly and the poor "because we changed our pat-

tern of taking care of our own." He added that 60% of medical colleges had received financial distress grants from the federal government.

Tracing recent changes in Congress, he said that reform in the seniority system has decentralized decision making. Also, Con- gress is younger-with half of its members sitting only since 1974. Issues have changed too. During the Kennedy and Johnson Ad- ministrations, the trend was to accept new challenges and fund new projects. Now Con- gress is retreating and cutting back. Legisla- tion has become more regulatory in nature, he said, citing certificate of need and health plan- ning as two examples.

For the 1980s, budget will be the first con- sideration, he predicted. He acknowledged there has been "significant progress" in the Voluntary Effort for cost containment, adding that "if the Voluntary Effort can keep this cost level, I'm not sure Congress will insist on another program." The Administration had proposed federal controls if voluntary efforts fail. Rogers also said the mood of the public does not support a large federal plan for na- tional health insurance.

AORN Journal, January 1980, Vol31 , No I 55