From the Editor

Robert Groom

The title of Doris Kearns Goodwin’s monumental book No Ordinary Time seems an appropriate description of this past year, a year marked with significant troubles (1). There were more than 400 natural catastrophes, most attributable to weather extremes, resulting in a total loss of more than 150,000 lives and more than 50 billion in dollars. The earthquake on May 12th of this year in the eastern part of Sichuan Province in China accounted for more than 69,000 lost lives. Shortly after the earthquake, I contacted a friend in China to ask him how they were coping with the devastation. His response was, “It is very sad, everyone in China will help; everyone can do something, and we will overcome.”

This year, we saw the surge of oil prices and record downturns in financial markets around the world. These events will make the years ahead difficult for developed countries; however, the effects could prove to be more pronounced to the world’s bottom billion with the aftershock of falling demands for exports, slowing capital flow, and the impending threat of reduced developmental aid (2,3). There are some, however, that see these crisies as a moment of opportunity and affirmation of our commitment to the poor. This could rather be an awakening that leads to the globalization of economic opportunity and could usher in an era of broad participation by developed nations in helping other nations to prosper.

What of our own microcosm, the world of cardiovascular healthcare delivery? The challenges seem insurmountable. Recently, Christo Tchervenkov, President of the World Society of Pediatric and Congenital Heart Surgery, reported that there are nearly one million children born each year with congenital heart disease and only about 10% have access to appropriate medical and surgical care. Tchervenkov says a paradigm shift is needed. We need to take steps to extend care to the 90% that are suffering and dying from lack of treatment. There is much work to be done and it will require broad participation of professionals from regions that have the resources to teach and support professionals in less developed countries. If you want to learn more about this effort, visit The World Society of Pediatric Congenital Heart Surgery (http://www.wspchs.org/). The American Society of ExtraCorporeal Technology’s effort, Perfusion Without Borders, attempts to leverage opportunities by linking available manpower and supplies with needs around the world. The Society’s weblink provides a means to post the needs and availability of equipment, disposables, and time that perfusionists may donate (http://amsect.societyhq.com/perfwob.iphtml).

Recent research findings reported at the American Heart Association on November 12th, exposed the growing challenge at the other end of the age spectrum (4). The prevalence of heart failure is rapidly growing. Thirty-seven percent of Medicare spending and 50% of all Medicare inpatient costs occur for patients with heart failure in the United States. Improvement in palliative care and advanced treatments for patients with heart failure are needed to relieve the burden of suffering and to curb the enormous strain on healthcare resources. The authors state that these findings highlight the complexity of treating heart failure patients who often have serious co-morbidities. They stress the importance of developing comprehensive and coordinated care (4).

No Ordinary Time is a story about the people of a nation, during one of the most volatile and resource poor periods in their history. It chronicles the revitalizing role of determination in overcoming incredible odds to lead the world and to redefine themselves. This same determination was expressed by Clement Hiebert in his presidential address to the New England Surgical Society (5) in 1988.

“To find fulfillment, you must lose yourself in something larger”… “Disease, pain, and suffering are the enemy; we fight back with hands, head, and heart.”

So it seems, in these times, we would do well to engage the enemy together with hands, head, and heart.

“A hundred times every day I remind myself that my inner and outer life depends on the labors of other men, living and dead, and that I must exert myself in order to give in the measure as I have received and am still receiving.”

—Albert Einstein