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Adaptation to change
Journal of
Cardiothoraci¢ and Vascular Anesthesia VOL 9, NO 5
OCTOBER 1995
EDITORIAL Adaptation to Change A FEW MONTHS, THE JOURNAL will mark the start of its tenth year. It seems like only yesterday it was just Ian Nidea seeking expression. As I said in the first issue, "THE JOURNAL has been started to continue the expansion of knowledge and to help consolidate and disseminate information to all interested in the field. ''1 Obviously, it has succeeded! Recently, Murray and Ebersole documented that THE JOURNAL is the most frequently used publication for articles dealing with cardiopulmonary bypass written by anesthesiologists2; in fact, from 1989 to 1992, THE JOURNAL published 23% of all papers by anesthesiologists dealing with cardiopulmonary bypass. Anesthesiology, Anesthesia and Analgesia, and The Journal of Cardiovascular and Thoracic Surgery published a smaller percentage of these types of papers, subsequent to the introduction of this JouRNAL. In January 1996, THE JOURNAL will introduce a seventh issue each year, which will be called its "Special Scientific Issue." This first issue will be edited by John Murkin, MD, FRCPC, and is entitled "Protection of the Brain During Cardiopulmonary Bypass: Diagnosis, Etiology, and Therapeutics." The format will be a wide-ranging review of the basic science and clinical aspects of an important area of the specialty. The topics in this first special issue will include neuropsychological outcomes after cardiac surgery, preoperative and postoperative cerebral vascular assessment, circulatory arrest and perfusion techniques, and surgical aspects of caring for the high-risk patient. These articles will be written by anesthesiologists, surgeons, perfusionists, neurologists, and researchers from the United States, Canada, and Europe. This annual issue will consist mainly of in-depth scientific articles and will not have all the other educational sections found in the six regular issues of THE JOURNAL each year. I am sure the Special Scientific
Issue will further expand the contribution of THE JOURNAL to the medical literature. In the January 1996 issue of THE JOURNAL, our first readership survey will also be included. I hope you will look for it, complete it, and return it to us. The Editorial Board looks forward to reviewing your comments about THE JOURNAL, its value to you, your thoughts on its sections, and what else we can do to make it more useful for you and your colleagues. Comments on the Special Scientific Issue would also be appreciated. Finally, a well-known cardiac anesthesiologist recently stated his opinion of the future of our subspecialty. 3 To paraphrase him, he said that cardiac anesthesiologists face less rewards and joy, more fatigue and stress, a sharp reduction in morale, and a decreasing desire to advance one's education. A psychologist would say he is in the Impact and Disorientation stages of the adaptation to change cycle. 4 During these first two stages of adaptation, one feels anxiety, shock, anger, and depression. Hopefully, all anesthesiologists who feel this way will quickly move to the latter stages of Recovery and Reorganization, where they will learn to adapt and accept the new health care system and experiment with new ideas and challenges. THE JOURNAL will continue to do its part to further expand your educational opportunities so that you will be able to provide the level of care needed for high-risk patients undergoing cardiac, thoracic, and vascular surgery. This should continue to be both exciting and stimulating for all of us and help to reinforce our desire to continue to advance our education and skills.
Joel A. Kaplan, MD Editor-in-Chief
REFERENCES
1. Kaplan JA: Cardiothoracic anesthesia: The subspecialty speaks out. J Cardiothorac Anesth 1:1-2, 1987 2. Murray TR, Ebersole TF: Anesthesiologists and cardiopulmonary bypass communications: Recent publishing trends. Anesth Analg 80:70, 1995
3. Howie MB: In my opimon. Soc Cardiovasc Anesth Newsletter (Spring): 6, 1995 4. Kraines GA: Stress in the workplace. Directions Psychiatr 11:1-7, 1991
Journal of Card/othoracic and Vascular Anesthesia, Vol 9, No 5 (October), 1995: p 485
485
Cardiothoraci¢ and Vascular Anesthesia VOL 9, NO 5
OCTOBER 1995
EDITORIAL Adaptation to Change A FEW MONTHS, THE JOURNAL will mark the start of its tenth year. It seems like only yesterday it was just Ian Nidea seeking expression. As I said in the first issue, "THE JOURNAL has been started to continue the expansion of knowledge and to help consolidate and disseminate information to all interested in the field. ''1 Obviously, it has succeeded! Recently, Murray and Ebersole documented that THE JOURNAL is the most frequently used publication for articles dealing with cardiopulmonary bypass written by anesthesiologists2; in fact, from 1989 to 1992, THE JOURNAL published 23% of all papers by anesthesiologists dealing with cardiopulmonary bypass. Anesthesiology, Anesthesia and Analgesia, and The Journal of Cardiovascular and Thoracic Surgery published a smaller percentage of these types of papers, subsequent to the introduction of this JouRNAL. In January 1996, THE JOURNAL will introduce a seventh issue each year, which will be called its "Special Scientific Issue." This first issue will be edited by John Murkin, MD, FRCPC, and is entitled "Protection of the Brain During Cardiopulmonary Bypass: Diagnosis, Etiology, and Therapeutics." The format will be a wide-ranging review of the basic science and clinical aspects of an important area of the specialty. The topics in this first special issue will include neuropsychological outcomes after cardiac surgery, preoperative and postoperative cerebral vascular assessment, circulatory arrest and perfusion techniques, and surgical aspects of caring for the high-risk patient. These articles will be written by anesthesiologists, surgeons, perfusionists, neurologists, and researchers from the United States, Canada, and Europe. This annual issue will consist mainly of in-depth scientific articles and will not have all the other educational sections found in the six regular issues of THE JOURNAL each year. I am sure the Special Scientific
Issue will further expand the contribution of THE JOURNAL to the medical literature. In the January 1996 issue of THE JOURNAL, our first readership survey will also be included. I hope you will look for it, complete it, and return it to us. The Editorial Board looks forward to reviewing your comments about THE JOURNAL, its value to you, your thoughts on its sections, and what else we can do to make it more useful for you and your colleagues. Comments on the Special Scientific Issue would also be appreciated. Finally, a well-known cardiac anesthesiologist recently stated his opinion of the future of our subspecialty. 3 To paraphrase him, he said that cardiac anesthesiologists face less rewards and joy, more fatigue and stress, a sharp reduction in morale, and a decreasing desire to advance one's education. A psychologist would say he is in the Impact and Disorientation stages of the adaptation to change cycle. 4 During these first two stages of adaptation, one feels anxiety, shock, anger, and depression. Hopefully, all anesthesiologists who feel this way will quickly move to the latter stages of Recovery and Reorganization, where they will learn to adapt and accept the new health care system and experiment with new ideas and challenges. THE JOURNAL will continue to do its part to further expand your educational opportunities so that you will be able to provide the level of care needed for high-risk patients undergoing cardiac, thoracic, and vascular surgery. This should continue to be both exciting and stimulating for all of us and help to reinforce our desire to continue to advance our education and skills.
Joel A. Kaplan, MD Editor-in-Chief
REFERENCES
1. Kaplan JA: Cardiothoracic anesthesia: The subspecialty speaks out. J Cardiothorac Anesth 1:1-2, 1987 2. Murray TR, Ebersole TF: Anesthesiologists and cardiopulmonary bypass communications: Recent publishing trends. Anesth Analg 80:70, 1995
3. Howie MB: In my opimon. Soc Cardiovasc Anesth Newsletter (Spring): 6, 1995 4. Kraines GA: Stress in the workplace. Directions Psychiatr 11:1-7, 1991
Journal of Card/othoracic and Vascular Anesthesia, Vol 9, No 5 (October), 1995: p 485
485