
Author’s Note: This is the text of the Leffingwell Honorary Lecture delivered at the annual meeting of the California Society of Anesthesiologists on April 9, 2022. Slides are available on request.
It is truly an honor to be here, and I want to thank Dr. Ronald Pearl and the California Society of Anesthesiologists for your kind invitation to speak. I was quite surprised to receive it. I’m neither a department chair nor an eminent researcher. I find the concept of being a “thought leader” or an “influencer” frankly horrifying. Physicians aren’t sheep, and we don’t need to be led to think.
What I am is a well-trained writer. I owe that to my college professors and my editors at the Wall Street Journal, who were pitiless with their red pencils and equally quick to point out poor writing, or sloppy thinking, or both.
Since I never wanted to become a department chair, or a politician, or ASA President, I haven’t hesitated to say what I think about the sad state of healthcare – or really, anything else. I mean, if no one disagrees with you, have you said anything worth hearing?
Alexandr Solzenitsyn was right: “Truth seldom is pleasant; it is almost invariably bitter.” You may not agree with some or any of the ideas I’m going to talk about today, but if that’s the case, I hope you’ll be inspired to come up with better ones! I’m going to zero in on some of the hard truths about our profession and offer some thoughts about what we can and perhaps should do going forward.
Now I’ve never for a moment regretted becoming a doctor. I wanted to be a doctor since I was a kid and read a book my father gave me, published in 1960, called “All About Great Medical Discoveries.” It had a horrifying and yet fascinating chapter about how terrible surgery was before anesthesia was invented, and how anesthesia made modern surgery possible.
In the 40 years – yes, 40 years — since I graduated from medical school, I’ve never regretted going into anesthesiology. It’s a wonderful field. We have the honor of being with patients and safeguarding them through some of the most critical moments in their lives.
There are amazing young people entering our field, I’m happy to say, so from that point of view, the future is promising. In this year’s match, I believe there was only ONE unfilled position. But there are storms and riptides threatening our profession, and that is why we need – urgently – to rethink, redesign, and reimagine the practice of anesthesiology.