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| I’ll be seeing you in all the old familiar places…. The National Air and Space Museum was the setting for the opening reception of the 75th AANS Annual Meeting in April. Exhibits traced development of flight throughout the 20th century to the present, and (above) the Neurosurgical Jazz Quintet performed all-time favorites. Pictured are (l–r) Philip Weinstein, MD; Donald Quest, MD; and James Rose, MD. In the background are Theodore Schwartz, MD, and Michael Scott, MD. |
“This year’s meeting was a monumental success,” said 2006–2007 AANS President Donald O. Quest, MD, who presided over the meeting. “Attendance at the meeting was the highest ever with a thousand registrants more than any previous meeting.”
A grand total of 8,379 people, 3,497 of them medical registrants, were in attendance, and 241 companies participated in the exhibit hall, an 18 percent increase over the previous year. While these figures are impressive, numbers alone do not reflect the depth of planning or the excellence of execution involved in producing a premier event such as this.
Of the many individuals involved in creating this event, the Annual Meeting Committee formed the planning core. Committee members were Dr. Quest, Jon Robertson, MD, Annual Meeting Chair Mitchel Berger, MD, Sander Connelly, MD, local hosts Kevin McGrail, MD, and Lisa McGrail, and Scientific Program Chair Timothy Mapstone.
The comprehensive scientific program included 39 practical clinics, 21 general scientific sessions, 79 breakfast seminars, 146 oral abstract presentations and nearly 500 poster presentations. Twelve topics that reflect a wide range of neurosurgical research and that were deemed of interest to the general public were selected by the AANS Public Relations Committee for release to the media. Novel gene therapy for Parkinson’s disease, partial neurological restoration after spinal cord injury, and stereotactic radiosurgery for trigeminal neuralgia and metastatic spinal tumors were among the topics chosen this year.
The scientific releases generated considerable media attention, with print and broadcast media reaching an estimated worldwide audience of 881 million and counting. The Associated Press article on Parkinson’s disease research appeared in major daily newspapers and online publications and generated 335 million in circulation. Other major print media included The New York Times, USA Today, Atlanta Journal-Constitution, The Washington Post, Los Angeles Times, San Francisco Chronicle, and U.S. News and World Report. Notable online publications covering the meeting included MSN, AOL, Yahoo! News, Reuters, HealthDay, Discovery Channel, iVillage, and Forbes.
Over the Moon
The National Air and Space Museum was the setting for a stellar opening reception
on Sunday evening. Throngs of revelers were entertained in the cavernous space
by exhibits that traced development of flight throughout the 20th century to
the present, a period that parallels the development of modern neurosurgery.
Guests of all ages may have met actors portraying historic characters such
as Amelia Earhardt and Orville Wright or enjoyed “immersive” presentations
of “Roving Mars” in the IMAX theater and “Cosmic Collisions” in
the planetarium. High spirits, fellowship and music complemented an expansive
buffet topped off with diamond jubilee-inspired desserts. The Neurosurgical
Jazz Quintet, led by Dr. Quest on trombone, played (and occasionally sang)
jazz standards such as “Sentimental Journey” and “I’ll
Be Seeing You.”
Those in the audience for Dr. Quest’s Presidential Address know that aviation was a theme that carried over to “Naval Aviation and Neurosurgery: Traditions, Commonalities and Lessons Learned.”
Serendipity played a major role in Dr. Quest’s experience with the U.S. Navy. Inspired by the cinematic WWII heroes of his youth, he applied for and received a Navy scholarship as well as a four-year commitment to the service, having never yet seen the sea. Through trial and error (including the discovery that he was seasick on an “ocean that was flat as a pond” and that “sleeping on the ground, eating K-rations out of a tin can, shooting blanks and running around in chaos at night” were not for him), he found himself on course to become a Navy pilot.
The intensive and deliberate training required for neurosurgery also is required for earning one’s wings. “How can you land on an aircraft carrier? How can you clip an aneurysm? You don’t do it on the first day — you practice and practice,” said Dr. Quest.
Neurosurgery can learn lessons from aviation in the areas of simulation, robotics, continuing education and maintenance of certification, and improved communication, he said. While a neurosurgeon, like a pilot, functions individually, excellent communication and teamwork are required for success of the mission, and this is especially true for the pilot in armed conflict.
“When you sign up for the military especially in peace time, you don’t think you’re going to fight,” said Dr. Quest. His squadron entered the Vietnam conflict in 1964 to provide close air support in South Vietnam, interdiction of supply routes and suppression of fire during rescue efforts for downed pilots in North Vietnam. The work was “grim, deadly, and terrifying” but it inspired a sense of duty, honor, loyalty, purpose, pride, and camaraderie, ideals that he said apply well to neurosurgeons.
Ralph Dacey Jr., MD, introduced Dr. Quest, describing him as a combat pilot, skilled surgeon, learned professor, wise mentor and counselor, compelling leader of a specialty, and a nurturing family man. “I think most of the neurosurgeons in this room want to be just like you,” he said.
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| The passing of the gavel. At the Joint Annual Business Meeting of the AANS and the American Association of Neurosurgeons on April 16, Donald O. Quest, MD (right), who presided over the 75th AANS Annual Meeting, passed the gavel to 2007–2008 President Jon H. Robertson, MD. Dr. Robertson took office at the close of the annual meeting. |
Invited lecturers continued the aerial theme, which Sally Ride, PhD, the first woman astronaut, carried into the stars.
“What we have here is a rocket scientist talking to brain surgeons,” Dr. Ride joked as she inaugurated the Louise Eisenhardt Lecture, which was established to honor the first editor of the Journal of Neurosurgery and thus far the only woman president of the AANS. The president and CEO of Sally Ride Science, a company dedicated to supporting girls’ interest in math, science and technology, said shetook full advantage of the opportunity offered by her space travel for capturing wondrous images. “The thin blue line is earth’s atmosphere,” she noted, and showing a stunning sunset seen from space she drily added, “every astronaut has this picture.”
Her path to becoming an astronaut began when she saw a NASA ad in the Stanford University paper. “NASA went to a lot of trouble to seek out qualified women for the astronaut corps,” she said. The women were to be as qualified as the men, and they were to undergo exactly the same training.
Her primary message: Encourage young people, especially women, to enter scientific fields. “It’s important to show women and girls that careers in science are available to them, to put female faces on these careers,” she said. “It’s up to all of us to inspire and assist younger women to reach for the stars and achieve their dreams, too.”
Lisa Randall, PhD, took the audience from the stars into another dimension. The particle physicist and Rhoton Family Lecturer discussed the multidimensional universe in “Warped Passages: Unraveling the Mysteries of the Universe’s Hidden Dimensions,” which also is the title of her recent book.
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2007 Annual Meeting Awards and Honors Cushing Medal — Robert O. Grossman, MD The premier honor given by the AANS was bestowed upon Dr. Grossman for his many professional accomplishments, including his continuing work as chair of the Scientific Advisory Committee of the Neurosurgery Research and Education Foundation, and for his dedication to the field of neurosurgery. He credited his mentors, colleagues and family with supporting him in his work and expressed his deepest appreciation for the honor. Distinguished Service Award — Mary Louise Sanderson Humanitarian Award Recipient — Benjamin C. Warf, MD Honorary Members |
Of the many new results in theoretical physics, she said that some of the most exciting involve extra dimensions of space. Her area of focus, theoretical particle physics, string theory and cosmology, attempts to understand relationships among physical quantities. “Einstein unified space and time, but we’re talking about space with string theory,” she said.
She stressed the importance of imagination in her field in order to comprehend entities that can’t be seen. For example, to understand how a hypersphere would appear if it passed through our universe, she advised imagining slices, like those inmedical imaging.
Her field now includes the study of branes, which she described as membrane-like objects in higher dimensional space. Branes represent an extension of string theory as well as a new concept of our place in the universe, she said. With branes, “infinite extra dimensions are possible.”
“Washington, D.C., is brain dead,” announced Cushing Orator Thomas L. Friedman, a leading author and journalist perhaps best known for his column in the New York Times. He made this perhaps not uncommon assertion during his discussion of globalization in reference to the fact that national leadership seems to be ignoring a new economic reality brought about by the advent of the Internet.
“You know you’re out of power when your Hungarian cab driver has his own Web site in Magyar, German and English,” he said.
“We’re in a transition to ‘horizontalization,’” he said, a euphemism for the idea that “the world is flat.” Friedman offered two rules that govern this new global environment: (1) whatever can be done will be — the only question is will it be done by you or to you; and (2) the biggest competition is not between countries or companies, it is the competition between you and your imagination on this new platform.
He described the world’s three great eras in terms of iterative software releases. In version 1.0, 1492 to the late 1800s, countries were globalizing; in version 2.0, the late 1800s to 2000, companies were globalizing; and in version 3.0, 2000 to the present, individuals are globalizing, a circumstance that he called “new, exciting and terrifying” because it “empowers, enables, and enjoins them to globalize themselves and to think of themselves collaboratively with others.”
“I used to be a free trader,” he said. “Now I’m a radical free trader.”
Globalism in neurosurgical education was the subject of Johannes Schramm, professor and chair of the Department of Neurosurgery at the University of Bonn, in his Van Wagenen Lecture, “Curiosity and the Atlantic Divide — A Neurosurgeon’s Perspective.”
Highlighting the importance of the Van Wagenen Fellowship requirement that the country of study must be different than the country of residence, Dr. Schramm discussed the role of intellectual curiosity and “maybe a little ambition” in neurosurgical education. He described the learning process as a positive feedback loop from curiosity to learning to rewards. “The curious surgeon will repeat the pattern of traveling to learn,” he said.
Nobel laureate Eric Kandel, MD, Fred Kavli Professor at Columbia University, director of the Kavli Institute for Brain Sciences, and a senior investigator at the Howard Hughes Medical Institute, delivered the Hunt-Wilson Lecture, “Mice, Men, and Mental Illness: Genetic Models of Human Psychiatric Disorders in Mice.”
He noted that animal models are coming of age in the study of mental illness while the pharmacological approach to treatment of psychiatric disorders has been very disappointing, with up to 50 percent of people being inadequately treated. Research on learned fear, which contributes to stage fright, post-traumatic stress disorder and phobias, particularly shows promise for human therapies. Just as fear can be learned through training, safety can be learned as well. “Knowing something about fear and misery allows us to look at happiness,” Kandel said. “Learned safety mediates components of true happiness.”
In “The Split Brain Revisited,” Theordore Kurze Lecturer and neuroethicist Michael Gazzaniga, PhD, of the Sage Center for the Study of Mind at the University of California, Santa Barbara, discussed the new field of neuroethics with respect to neurodeterminism, the law and personal responsibility.
He explained that while personal responsibility is a learned social rule arising out of group interactions, the brain, a decision-making device, is determined: Brain scans now can predict which decision a person will make before it is made. However, because many factors influence behavior, he is of the opinion that neuroscience should stay out of the courtroom. “This is a changing world and you are dead center in all of these decisions,” he cautioned.
Complicating matters, brain scans now can map individual differences such good or poor reading or math skills or athletic ability. “This will be a living part of your clinical experience within 10 years,” he predicted.
In the Richard C. Schneider Lecture, L. Nelson Hopkins III, MD, professor and chair of neurosurgery, professor of radiology, and director of the Toshiba Stroke Research Center at the University of Buffalo, recounted the progress of endovascular surgery from Luessenhop as the first neurosurgeon to perform an endovascular procedure to the present.
He recounted the detente with radiologists that allowed neurosurgeon Bob Ojemann and the AANS to negotiate an endovascular training pathway for neurosurgeons that in 2000 received approval by the Accreditation Council for Graduate Medical Education. Endovascular training for neurosurgeons in the future will encompass a core curriculum, simulation, and collaboration with radiologists, he said. “Sharing and learning from our mistakes works across boundaries.”
Socioeconomic Programs Focus on Practice Matters
For the 75th AANS Annual Meeting, socioeconomic programming was expanded from
a single Thursday morning session to afternoon sessions Monday through Wednesday.
These programs addressed the complexities of social and economic issues that
impact how neurosurgeons practice every day and offered a question and answer
session, a feature attendees took advantage of particularly with respect to
Medicare’s pay-for-performance initiative and Emergency Medical Treatment
and Labor Act enforcement.
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| A competitor in the Neurosurgical Top Gun contest for residents and fellows tries his hand at a simulator. The 2007 Neurosurgical Top Gun prize went to Carla Sofia Reizinho, MD, a first-year neurosurgical resident at Hospital Egas Moniz in Lisbon, Portugal. |
The seemingly intractable problems of neurosurgical emergency care delivery were the subject of the Tuesday program. Moderators John Kusske, MD, and Alex Valadka, MD, led discussion of EMTALA’s current impact as well as how emergency care issues impact those in private practice and academic practice differently. Models for fixing the emergency medical system as well as possible legislative and regulatory remedies were offered.
Neurosurgeon-owned facilities and ancillary services, the focus of the cover section in this issue of the AANS Bulletin, was the focus of the Wednesday session. In addition to the topics included in the cover section, Gary Bloomgarden, MD, and Troy Payner, MD, monitored discussion of benefits associated with building a patient-centered multispecialty neurosurgical practice, engaging a practice administrator, and owning an ambulatory surgery center.
The Thursday morning session, moderated by Gregory Przybylski, MD, and John Wilson, MD, offered oral presentations on socioeconomic topics, including those by recipients of the Robert Florin and Cone Pevehouse awards. The respective topics were improving resident work hour compliance through a computerized system, and analysis of U.S. patients treated for spinal pathology.
Plan Now to Attend the 76th AANS Annual Meeting
The 2008 AANS Annual Meeting will be held April 26–May 1 in Chicago,
Ill. The abstract center, available at www.neurosurgery.org/abstract_center.asp,
closes Aug. 31, and registration and housing information will be available
at www.AANS.org in the fall.
Manda J. Seaver is staff editor of the AANS Bulletin.
| For Further Information ■ 75th AANS Annual Meeting photos, www.lagniappestudio.com/aans2007 Commemmorative Book: History of the American Association of Neurological Surgeons: Seventy-Fifth Anniversary, https://marketplace.aans.org/Portals/3/AANS75thAnnivBook.pdf ■ 2007 Annual Meeting Audio Recordings, https://marketplace.aans.org/Portals/3/07_audio_sessions_form.pdf ■ 2007 AANS Annual Meeting Press Kit, www.neurosurgerytoday.org/media/press.asp |