Portal de Periódicos da CAPES

Just in time

1984; Elsevier BV; Volume: 1; Issue: 3 Linguagem: Inglês

10.1016/0741-5214(84)90073-9

1097-6809

Géza de Takáts,

Until recently, vascular surgery withered on the vine for over 50 years. During the 1920s the establishment of a few vascular clinics in several centers in this country allowed assembly of a group of patients suffering from peripheral vascular disease. “Peripheral” at that time meant the vessels of the extremities, and these clinics were the first attempts at improving the care of patients with extremity vascular problems. Assembled around the group of patients were members of preclinical and clinical departments who were highly stimulated by an interchange of diagnostic and therapeutic information and methods. It was too good to last for long. Vascular disease became medical, surgical, cerebral, cardiac, renal, or intra-abdominal, as well as peripheral. Only recently has the fact that the entire vascular tree responds to hormones, enzymes, and the autonomic nervous system in the same manner been slowly and reluctantly admitted. Added to this divisive concept of regionalization of vascular disease was the fact that vascular surgery suffered from being a stepchild of spectacularly growing cardiac surgery. This preempted operating rooms, house staff, and available bed space. Then, help for vascular surgery came from several sources. The development of prosthetic grafts and innovative surgical techniques extended arterial reconstructive procedures to every corner of the body. The understanding of thrombosis and the biologic activity of endothelial cells provided a sound basis for improving care of vascular patients. Vascular laboratories appeared, with ingenious and highly accurate measurements of blood flow and pressure. These measurements replaced the skin thermometer, oscillometer, and venous occlusion plethysmograph used in earlier clinics. Around these new laboratories a group of dedicated surgeons, internists, biophysicists, nurses, and technologists congregated. A technocracy that received strong industrial support appeared, and vascular surgery flourished. It grew away from cardiac surgery while retaining its ties with general surgery. The Journal of Vascular Surgery marks the emergence of a new specialty. Now, combining the skills of nurses, technicians, biomedical engineers, internists, and vascular surgeons should lead to a good partnership, not to the dominance of technocrats over clinical judgment. Uncontrolled technocracy, after all, may lead to a “sorcerer's apprentice syndrome,” the inability to control the tide of technologic flow. This journal, together with the recent certification of vascular surgeons and the approval of training programs in vascular surgery, fulfills the dream of vascular surgeons. It constitutes a real milestone in the development of vascular surgery. Per aspera ad astra! It is appropriate that this editorial was written by Geza de Takats for this issue of the Journal of Vascular Surgery, the contents of which consist mainly of contributions from the Midwestern Vascular Surgical Society. He and his vascular practice flourished in the Midwest. From this base, he became President of the Society for Vascular Surgery, President of the North American Chapter of the International Cardiovascular Society and of the International Cardiovascular Society, President of the Chicago Surgical Society, and President of the Chicago Heart Association. He was a founding member of the Midwestern Vascular Surgical Society, and now, at age 91, he attends the meetings of the Society whenever he can and always attends the vascular symposia of the Northwestern University Medical School in Chicago. He works every day in the library at the Skokle Valley Hospital or at Rush-Presbyterian-St. Luke's Medical Center. Last year, Dr. de Takats published a paper on selective triphasic prevention of thromboembolism in Surgery and an article on monitoring perioperative hemostasis in Vascular Diagnosis and Therapy. In addition, he presented a nonscientific paper on hyperosmia at the Annual Meeting of the Chicago Literary Club. None of this would be important were it not for the fact that Geza has retired from his surgical practice, ostensibly to devote more time to his lovely wife Carol and his hobbies of music and the writing of short stories and limericks. As the accompanying editorial testifies, Geza retains a sharp mind, continues to be an accurate observer, and, in addition, possesses two rare scholarly attributes: brevity and wit. John J. Bergan, M.D.