New technology

Conclusion

A danger of aging is the temptation to look back without looking forward, probably because the latter prospect is so understandably discouraging. I would like to avoid this temporal hang-up.

When I began my residency, no valvular replacement, knee prosthesis, aorto-coronary bypass, carotid endarterectomy, hepatic transplantation, microsurgery, or uterine operation, to name just a few, had ever been done. For all of these, new specific technology was required. There was no effective chemotherapy; no ultrasonographic, CT, or MRI guidance; no knowledge of the role of DNA; no thought of mapping the human gene; and no prospect of gene therapy. Technology has made all these possible and surgery has enjoyed many of these advances.

The next 40 years will ineluctably bring similar advances. Surgery will be increasingly precise. The majority of operations will be done through small incisions with technology not yet dreamed of. Nevertheless, whatever science produces, certain immutable principles will remain: (1) We are in the service of the patient. (2) We preserve the convenant, sacred if you like, to cure if possible or otherwise to palliate. (3) We continue to be well trained and should be prepared to provide periodic proof of our proficiency. (4) We must always exercise professional responsibility. The availability of new technology can only magnify these principles rather than diminish their importance.