New people

New People Using the metaphor of the refreshment of an anemic circulation's oxygen-carrying capacity by transfusion, we often speak of the enhancing effect of "new blood" on an organization or enterprise. The new members of a board of directors on which I serve certainly stir things up with their ideas and suggestions. While it is true that many of the ideas have already been tried and failed, some of them are refreshingly bold and audacious and cause the rest of us old timers to take notice. The arrival of a new group of radiologic technology students is announced by the appearance of very young people in brand new blue-green scrubs, looking a little lost and wondering what is expected of them. Our quarters are cramped in the gastrointestinal section of the department, and we frequently bump into one another going from one examination room to another. The experienced techs have learned to glide in and out, slithering past one another and us at an angle without more than incidental contact, but the new kids haven't learned to hug the walls, and collisions are frequent. We see lots more double exposures on forgotten, unprocessed cassettes, but we also get an infusion of new and not-yet-jaded interest and excitement from bright young people who are full of questions and desire. New residents contribute little to the department's service obligations for some months after they arrive, and showing them the elementary ropes is not always stimulating work. But some bring energy and enthusiasm for their work that is contagious, and every section where they work is stimulated and elevated by their presence. A new group of senior medical students arrives each month for our clerkship; here's where our patience is really tested. It's sometimes difficult to get excited about presenting the same material each month, but each group is a pleasant surprise. This stuff is new to them, and they are greatly stimulated by finding out that much more than they imagined or yet experienced can be learned by c o r -

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rectly interpreting radiologic images. Their questions are numerous and provocative, sometimes requiring that I adjust my stance on certain subjects as I learn from them what's new and discard some of my old prejudices. Recently acquired faculty in our own and other departments frequently serve as gadflies, asking why we do or don't do things a certain way, turning upside down our cherished notions of the "right" way to conduct our affairs. New techniques and attitudes frequently accompany new hires, and we adapt and adjust to accommodate innovation and originality. A new chairperson is sure to bring changes that affect everyone in the department, and a few years are often required before the new boss is no longer thought of as new. But the emphasis on teaching, research, and patient care is certain to differ from that of the predecessor. Some of the changes will be appreciated as clever.and innovative, and some will be considered ill advised (other language may be substituted). But the departmental leader is a new person who matters, everyone will acknowledge. That is not so with new leaders higher up on the administrative ladder. A new dean is hardly noticed unless she or he insinuates an inquisitive nose too deeply into the department's affairs or aims the institution in a dramatically different direction. And the announcement of a new president of the medical establishment is an occasion for marking the passage of time but little else. Changes at the top of the parent institution (in our case, the University of Texas, in Austin) are learned about in the local newspaper a week after the fact. The new people haven't had time to become weary, discouraged, and pessimistic, and they actually believe that great things are possible. Given half a chance, they are probably right.

Melvyn H. Schreiber, MD University of Texas Medical Branch Galveston, Tex