Presidential Address: Dr. Organ, how are we doing?
Steven Charles Stain M.D.
, a, 
aDepartment of Surgery, Albany Medical College, 47 New Scotland Avenue, MC 61, Albany, NY 12208, USA
Received 4 June 2008;
Article Outline
I would like to thank the Society for the privilege of serving as your thirteenth president. This is a distinct honor, privilege, and responsibility, which I take very seriously. When first selected as President-Elect 2 years ago, I immediately started thinking of giving this talk today and having to give this talk, wondering if I could come up with something interesting to say. Giving a presidential address is a daunting task. How many times have you sat through a presidential address and asked yourself: When will it end? Well, as I have matured, or at least gotten a little older, I have actually come to enjoy presidential addresses, and now as I attend surgical meetings, make certain that I am present for the address, and as my eyes have gotten worse, even sit in the front of the room, so I can actually see the slides and better understand what the speaker is trying to convey. Presidential addresses are an opportunity to speak about whatever is on one's mind, without the confines of a program committee deciding what is important, and also to impart some wisdom or particular point of view to the audience. What follows is a reflection of what I believe is important for you to know, and hopefully will inform you about what is important to me.
Through a quirk of the calendar, I have had the opportunity to give 2 “presidential addresses” within a year. In August, I ended my term as the Chair of the Surgical Section of the National Medical Association (NMA), and spoke about the “Changing Face of the American Board of Surgery.” In that talk, I used a picture by Gilbert Young, entitled He ain't heavy, which is the longest selling work of art by a living artist, selling more than 2 million copies. The picture depicts one man who had made it over a wall, and is reaching out to lift someone else over the wall he has already scaled. I first saw this picture in Eddie Cornwell's home, and continue to be inspired by it as the image that best explains what our Society has been about.
I have titled my Presidential Address: The Society of Black Academic Surgeons: Dr Organ, how are we doing? I have been at every SBAS meeting but one, including twice when my wife was 9 months pregnant with my daughters, and when my son was only 1 month old. As is true for many of you in the room, this meeting has been a tremendous source of support, education, and mentorship. It is times like this, when I especially miss Dr Organ, and much like my late father, I wish I could call and ask for advice, or share some accomplishment (not knowing that behind the scenes had a hand in my feat). So for the next 30 or so minutes, I would like to impart to you a little about the history of our Society from my perspective, by describing what have been some of the most important developments in our 19 years as an organization.
I would like to briefly describe a few of the major milestones for SBAS during our first 19 years of existence. This is the point in the talk, where L.D. Britt, our executive director shows the slide that he uses in almost every talk that shows a train track going in to the distance, and points out that to know where you are going, you have to know where you have been. In my brief search, only 1 SBAS presidential address has been published: “Seven Exemplars and the College—Lest We Forget” was published by Lasalle Leffall in the American Journal of Surgery, 1998.1 I would hope all future SBAS presidents publish their presidential addresses. In Dr. Leffall's presidential address he relates the story of 7 of our surgical forefathers, and their relationship to the American College of Surgeons: Daniel Hale Williams, Louis T. Wright, Frederick D. Stubbs, William Sinkler, Matthew Walker, Charles R. Drew, and Samuel L. Kountz. Much of this history of these 7 individuals is available in the book “A Century of Black Surgeons, the USA Experience,” published by in 1987 Dr Organ and Margaret Kosiba.2 It is out of print, but you can find almost anything on http://Amazon.com. I recently sent a copy of the book to Carlos Pellegrini as a gift and I was surprised to find there were only 5 copies of the book available. If you do not have a copy, I would encourage you to get one, because it is a rich source of history.
Daniel Hale Williams was the first Black Fellow of the American College of Surgeons (ACS). He was a graduate of Chicago Medical School of Northwestern University, was founder of Provident Hospital in Chicago, and is reportedly the first person to successfully perform a thoracotomy for a stab wound to the chest. Although he became a Fellow of the College in 1913, the year the ACS was founded, he was not considered a charter member, and was almost denied admission. It took 21 years for the College to accept the second Black surgeon, Louis T. Wright. Dr. Wright, a graduate of Harvard was the first Black certified by the American Board of Surgery in 1938, but was also denied listing as a founding member of the American Board of Surgery (ABS). Frederick Stubbs was a magna cum laude graduate of Dartmouth, a cum laude graduate of Harvard Medical School, and did his internship and thoracic surgery fellowship at Cleveland City Hospital. He went on to become a thoracic surgeon at Philadelphia General Hospital. It took 4 years for the ACS to grant him fellowship. Matthew Walker was Chair of Surgery at Meharry Medical College for 29 years where he trained 64 surgical residents, and influenced an entire generation of Meharry medical students. Charles Drew, whose image is on the SBAS logo, was Director of the American Red Cross, a Surgical Fellow at Columbia under Alan O. Whipple, and ultimately became the legendary Chair of Surgery at Howard until his untimely death. Samuel Kountz is not known as well known as some of the other surgeons because he died at an early age. He did his residency at Stanford, where he assisted Roy Cohn in performing the first nonidentical twin kidney transplant. He rose to the rank of Professor at UCSF, was President of the Society of University Surgeons, and served as Chair of Surgery at SUNY Downstate. These 7 pioneers paved the way for an organization such as SBAS, and as Dr Leffall stated: we are well aware that progress in academic surgery did not begin with those of us currently in the scene but rather our paths have been made smoother by those who have gone before us.
The Society of Black Academic Surgeons can trace its origin to a historic meeting in New Orleans, LA in October of 1987.3 Present at that meeting were Drs Arthur Fleming, Claude Organ, Onye Akwari, Eddie Hoover, and Steve Aichele of Davis and Geck. This meeting was arranged to address the role of African-American surgeons in academic surgery. It was abundantly clear that few blacks were involved in academic surgery, there was no organized network of African-American academic surgeons, few young surgeons pursing academic careers received tenure, and graduates from surgery residency programs other than Meharry or Howard could not easily identify African-American surgeon role models to inspire them to pursue academic careers.
The initial meeting was planned for 1989 to assemble as many African-American surgeons as possible to discuss the essentials of building academic careers. Seed funds were given by the American Surgical Association and Davis and Geck, a suture company that was ultimately bought out by Tyco Healthcare. The American Surgical Association committed $5,000 per year for 5 years, and Davis and Geck committed $25,000 per year for several years. Dr David Sabiston, the James B. Duke Professor and Chairman of the Department of Surgery, agreed to host the meeting at Duke University School of Medicine, and Dr Onye Akwari served as the local arrangements chairman. For the younger SBAS members here, Dr Sabiston was arguably the most powerful Chairman in the country, and the Department of Surgery at Duke was the most prominent department in the country. It was the Department of “a decade with Dave,” and Dr Sabiston remains a legendary figure who trained a generation of department chairs. The meeting took place April 12–15, 1989 at the Washington Duke Inn and Duke University Medical Center. The program was an invitational workshop with invited guest faculty from throughout the United States.
Among the guest faculty were chairmen of major medical school surgery departments including Drs Haile T. Debas, of the University of California at San Francisco, Arthur J. Donovan, of the University of Southern California; Arthur W. Fleming, of King-Drew Medical Center; Eddie Hoover, of Meharry Medical College; Bernard M. Jaffee, of SUNY Brooklyn; R. Scott Jones, of the University of Virginia at Charlottesville; LaSalle D. Leffall, Jr, of Howard University; John C. Norman, of Marshall University; Claude H. Organ, Jr, of the University of California, Davis-East Bay; Hiram C. Polk, of the University of Louisville; Walter J. Pories, of East Carolina University; David C. Sabiston, Jr, of Duke University; Seymour I. Schwartz, of the University of Rochester; George F. Sheldon, of the University of North Carolina; G. Tom Shires, of Cornell University; William Silen, of Harvard University; James C. Thompson, of the University of Texas at Galveston; Andrew S. Wechsler, of the Medical College of Virginia; and Samuel A. Wells, of Washington University, St. Louis.
To this day, that meeting remains the best faculty development meeting I have ever been to. I challenge you to name another society meeting (outside the American Surgical) that had that many Chairs in one room for a meeting. I will never forget the session when, after Dr Organ gave his talk on faculty development, Dr Polk who followed him, said: “his slides were better than mine, put his carousel back on, I'll use his slides for my talk.” He did not miss a beat. In my opinion, that meeting epitomized the essence of our society, a unique opportunity to interact with the leaders of American Surgery, and as we have grown up, more of our members have become the movers and shakers in American Surgery. Who would have thought that 2 of our members present at that initial meeting in 1989, Dr Leffall and Dr Organ, would ultimately become Presidents of the American College of Surgeons?
On the SBAS website, Dr Organ is listed as the founder of SBAS, but others were integral to the early development of our Society, and played pivotal roles in our evolution. Some of them you see in the slde, courtesy of the SBAS archives and Fred Cason, including 3 others that should be considered as our cofounders along with Dr Organ: Eddie Hoover, Onye Akwari, and Arthur Fleming. It is a special privilege for me that Dr Akwari is here today. I credit Dr Akwari for my going into academic surgery. Dr Akwari is a graduate of the University of Southern California School of Medicine and we first met at the USC Department of Surgery cocktail party at the American College of Surgeons Clinical Congress. This was October of my Chief Resident year, and it was my intention to be a private practice surgeon. To paraphrase Dr Akwari, “too much had been invested in me to not go into an academic career.” Maybe he knew more than I did, because no one had offered me a job at that point, either private practice or academic. Three months later, Arthur Donovan offered me the position as Resident Supervisor, or Super Chief, which eventually led to my first faculty appointment at USC. There are several other noteworthy individuals that are recognizable in this picture, including: Asa Yancey, David Jacobs, Eddie Cornwell, Verna Gibbs, Ken Ford, Brian Organ, Steven Stain, Vernon Henderson, Lynne Weaver, Nathaniel Matolo, Mitchell Spellman, Delford Williams, Maurice Jurkiewicz, Rollins Hanlon, David Sabiston, Arthur Fleming, and James Thompson (Figure 1).
| Full-size image (90K) |
Figure 1. Front row: Maurice Jurkiewicz, Rollins Hanlon, Onye Akwari, David Sabiston, Arthur Fleming, James Thompson. Second row: Eddie Hoover, Nathaniel Matolo, Mitchell Spellman, Cassius Ellis, Delford Williams, unidentified, Albert Duncan, Haile Debas. Third row: Claude Organ, Victor Garcia, Charles Tollett, Sr, Unidentified, Lynn Weaver, Anukware Ketosugbo, Ernst Vieux, Lynwood Koger. Back row: Asa Yancey, David Jacobs, Eddie Cornwell, Robert Rivers, Nnenna Akwari Okoro, Ken Ford, Brian Organ, Steven Stain, Vernon Henderson.
The first meeting, hosted by David Sabiston, was an impetus for other leading departments of surgery to want to host our meeting. This is our seventeenth meeting, as we quickly transitioned from semiannual to a yearly format. The departments that have hosted the SBAS meeting are an impressive group, and as host, the Department has the opportunity to highlight their own department's accomplishments through the local program, and bring attention to institutional efforts to promote diversity and mentorship. It is now a 3-year wait to host the SBAS meeting, with University of Washington, Duke, and University of Florida in line to host the meeting for the next 3 years. I must commend the local arrangements group here at the Cleveland Clinic for putting on our most well-attended meeting. We had an outstanding scientific program selected by Ken Davis and the program committee, and still retained the important components of mentorship, networking, and faculty development. I would like to again acknowledge the hard work of Anthony Stallion, the local arrangements Chair, and appreciation to Michael Henderson, the Chair of Surgery here at Cleveland Clinic who first made the request to host the SBAS meeting, and John Fung, the current Chair, who along with Dr Cosgrove has rolled out the red carpet for us.
The second SBAS meeting was held in 1991 at Harvard Medical School after being unanimously selected after an invitation to host the meeting was presented to the organizing committee from Mitchell Spellman, a member of the Harvard surgical faculty. The Chair of the local arrangements committee was William Silen, the Johnson and Johnson Professor of Surgery and Chief of Surgery at Beth Israel Hospital. This meeting was critical to the development of our Society, as a debate ensued regarding the meeting's format. Dr Silen argued that original scientific presentations were essential to the long-term future of the meeting. As a junior faculty member hungry for mentorship, I was much more interested in faculty development. Wiser heads prevailed, and the annual call for abstracts was instituted. The results have been profound, and just like other surgical society meetings, the distinguishing feature of our meeting has become the original work presented at our scientific sessions. As an example, this year there were 58 abstracts submitted, and the program committee selected 20 for podium presentation and for the first time, we had a poster session with 38 posters presented.
Coincident with the expansion of our scientific program has been the development of relationships with peer-reviewed journals. Walter Pories deserves credit for first offering to publish our abstracts in Current Surgery, and as the official journal of SBAS for more than 10 years, Current Surgery published all abstracts from our meeting. Two years ago the executive committee accepted an invitation from Kirby Bland, the Editor of the American Journal of Surgery, to submit entire manuscripts for publication and it became our new official journal. The American Journal of Surgery website states that it is the official publication of 8 major surgical societies: The Southwestern Surgical Congress, The North Pacific Surgical Association, The Association for Surgical Education, The Association for Surgical Education, The Association of Women Surgeons, The American Society of Breast Surgeons, The Association of VA Surgeons, Midwest Surgical Association, and The Society of Black Academic Surgeons. Last year, 8 of 11 SBAS papers submitted to the American Journal of Surgery were accepted for publication, and we hope all the authors will submit their work for publication in the American Journal of Surgery. This scientific work presented at our meeting is important capital to exhibit to the larger surgical world, the quality of our science, and the high standards required for abstract acceptance. Currently, manuscript submission if voluntary, but I personally hope we will move towards mandatory manuscript submission as is required by most major surgical society meetings. These 2 editors, Drs Pories and Bland, are both honorary fellows of our Society, an honor bestowed on 2 to 3 surgeons per year.
This year we will honor 2 new honorary fellows, Drs Raphael Pollock of M.D. Anderson and Michael Zinner of Brigham and Women's Hospital. As has become the tradition, they will each be presented for fellowship by a colleague or former trainee: Derek Beech, a Surgical Oncology Fellow under Dr Pollock, is now Chair of Surgery at Meharry Medical College, and Selwyn Rogers, who is currently Chief of the Division of Trauma and Critical Care at Brigham where he completed his general surgery training and critical care training. Currently, there are 32 honorary fellows selected for their service to fostering the development of SBAS and providing leadership and mentorship to surgeons in their own institutions (Table 1). From my involvement in SBAS, I have gotten to know almost all of these honorary fellows, and feel proud that the Society can call on them for assistance, advice, and friendship.
SBAS honorary fellows
| Judah M. Folkman, MD | James A. O'Neill, Jr, MD |
| R. Scott Jones, MD | Thomas E. Starzl, MD, PhD |
| Frank R. Lewis, MD | Dean Warren, MD (posthumously) |
| Olga Jonasson, MD | Kirby I. Bland, MD |
| Arthur J. Donovan, MD | Wallace P. Ritchie, MD, PhD |
| Lloyd M, Nyhus, MD | Courtney M. Townsend, MD |
| Hiram C. Polk, Jr, MD | Arnold G. Diethelm, MD |
| Walter J. Pories, MD | Thomas R. Russell, MD |
| Basil A. Pruitt, MD | Richard L. Simmons, MD |
| George F. Sheldon, MD | Edward M. Copeland, MD |
| William Silen, MD | John L. Tarpley, MD |
| James C. Thompson, MD | Andrew L. Warshaw, MD |
| Bernard F. Riberio, MD | Jeffrey B. Matthews, MD |
| Walter Lawrence, Jr, MD | Carlos A. Pellegrini, MD |
| Phillip R. Militello, MD | Raphael E. Pollock, MD, PhD |
| John S. Najarian, MD | Michael E. Zinner, MD |
Two initiatives that have paid dividends for our Society are the annual luncheon for our SBAS honorary fellows at the American Surgical Association and the institutional memberships. Along with Dr Organ, both annual events were ideas championed by Haile Debas. Dr Debas, another of our previous SBAS presidents, was Chair of Surgery and subsequently Dean of the School of Medicine at UC, San Francisco. You can tell from these initiatives that Dr Debas was thinking as a Dean, and the Honorary Fellows Luncheon has been an opportunity to reconnect with our fellows annually, network with them which has fostered continued goodwill for the Society. The Honorary Fellows are a special group of individuals that by their actions have embraced the foundations of SBAS: to stimulate, mentor, and inspire young surgeons and medical students to pursue academic careers.
The next milestone for the Society of Black Academic Surgeon was the annual solicitation to departments of surgery to commit funds to be an institutional member of SBAS. This has been an incredibly important statement by the department chairs, across the country to each contribute $1,000 annually to SBAS. It is recognition of the value of SBAS to help mentor minority faculty residents and students in pursuing an academic surgical career. Initially, there were 20 departments that supported this initiative, then 30, and over the last couple of years there have been 45 SBAS institutional members. This year we have 57 institutional members. Equally important has been the financial impact of these funds to our ability to provide an excellent scientific program, including state-of-the-art lecturers, meals and refreshments for the meetings and social events, and speakers for the black-tie dinner.
The last area I would like to cover relate to the finances of the Society. I had the opportunity to spend 6 years as the treasurer, and for me personally being on the executive committee was a great experience to see how a surgical society actually works. Before I became a member of any other societal executive committee, I was on the SBAS executive committee, and learned how to organize a meeting, keep society financial records, and run a meeting. While we are now considering increased meeting and society management by professionals, I would caution that involvement in these activities provide important skills for our members to master as we move into leadership roles in other organizations. When Robert McCauley was the treasurer, he made wise investments of our cash reserve 15 years ago, and now we have cash reserve of $100,000, which is nearly 2 years of operating funds for the Society. What these additional funds that allowed us to do, is to have a minimal meeting registration fees, only $50 for SBAS members here in Cleveland. As I learned as SBAS treasurer, $50 does not even cover the cost of today's lunch. More than 10 yeas ago, Rosalyn Sterling Scott negotiated a $50,000 gift from Pfizer Corporation, which funded the initial design and funding of our website. Today's decision to slightly increase the cost of meeting registration will allow us to continue to provide a high-quality program, even if the registration fee will not cover the entire meeting costs.
Lastly, I would like to commend 2 institutions that hosted SBAS meetings and subsequently made special gifts to our Society. Yesterday, on behalf of the Cleveland Clinic, Dr Toby Cosgrove, President and CEO, made a $25,000 gift to endow the Dr Claude H. Organ Jr Resident Award. This endowment will provide a cash award to the resident who gives the outstanding podium presentation at the SBAS meeting.
Three years ago, when SBAS met in Pittsburgh, the Children's Hospital of Pittsburgh made a $50,000 contribution to our society. This gift to SBAS was made in part to honor the impact Ed Barksdale had on their hospital and community of Pittsburgh. Through the efforts of Ed Barksdale and Selwyn Vickers, SBAS has developed the SBAS Leadership Training Institute. It has been an opportunity for institutional members to nominate junior faculty for a 1-day faculty development program to spend Saturday morning with surgical leaders. Today, we held our third Leadership Training Institute, and we continue our close relationship with the American College of Surgeons. The first year, R. Scott Jones, former President of the American Surgical Association, was our keynote speaker. Last year, Tom Russell, the Executive Director of the American College of Surgeons, was the keynote speaker, and this year Ted Copeland, past president of American College of Surgeons and former Chair of the ACS Board of Regents, spent the morning with the 10 junior faculty members and discussed how to be a successful academic surgeon. When I received Dr Copeland's bio to introduce him it was noteworthy that he proudly listed the 3 honorary fellowships he has received, the Royal College of Surgeons in Ireland, the Texas Surgical Society, and the Society of Black Academic Surgeons. In addition to the keynote speaker, the program has included talks by SBAS members, hospital CEOs, and other leaders to give junior faculty insight into how to remain academically productive and negotiate the academic ladder. This year, we have expanded the training institute from a single day to a 3-year program. In year 1, we will focus on Attributes of a Leader in Academic Surgery, in year 2, Building your Leadership Capacity, and in year 3, Academic Skill Sets and Business Skills for the Surgeons Leader. Selwyn Vickers deserves credit for putting together the grant application to fund this initiative.
I want to close with an announcement of the Claude Organ, Jr, MD, FACS Scholarship Endowment. The Organ family gave a generous contribution to set up an endowment through the American College of Surgeons. The family stated that the 3 organizations Dr Organ was most proud of were his association with the Surgical Section of the National Medical Association, the Association of Women Surgeons, and the Society of Black Academic Surgeons. The College and the family have agreed to fund an annual scholarship to a member of one of these 3 organizations. I have asked that the SBAS membership to donate to this initiative. You will be receiving solicitation from SBAS and the ACS to support the endowment. I hope Dr Organ is looking down on us and smiling. Looking at the strength of our scientific program, the fellowship of our meeting, and bright future for our Society, I hope he is proud.
References
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