EDITOR'S PAGE
Summertime
Anthony N. DeMaria, MD, MACC, Editor-in-Chief, Journal of the American College of Cardiology*
* Address correspondence to: Dr. Anthony N. DeMaria, Editor-in-Chief, Journal of the American College of Cardiology, 3655 Nobel Drive, Suite 630, San Diego, California 92122 (Email: ademaria{at}acc.org).
I write this Editor’s Page in the midst of the summer "break." Specifically, this is the last week of July and the summer is almost half over. Here in San Diego the sun is shining, the ocean is warm, and the surf is up, the Padres are battling for first place in baseball, the local symphony is presenting a Masterpiece series, and my eldest grandson is in town visiting. This is going to be a short Editor’s Page.
Summer is probably the most unique period of the medical year. No major medical meetings are held, most local conferences are suspended, and committee meetings are few. Patients value vacation time, so elective procedures and visits are often put off. Demands on time are reduced and good weather is conducive to a variety of recreational activities.
Despite the foregoing conditions, many of us physicians do not look upon summer as a time to relax, but rather a time to catch up. Driven as we are to succeed, we view the extra time available as a great opportunity to finish tasks we are behind on or to undertake professional things that we have been meaning to do. I know of very few physicians who are accused of excessive vacationing. As my wife would say, it sometimes seems like we have trouble smelling the roses.
As in past years, I had a laundry list of things to get to with the new found discretionary time during the summer. One of my major goals this summer was to get more experience with multidetector computed tomography (MDCT) angiography. So I called a former fellow, Guru Gurudevan, who had acquired great proficiency with the technique, and arranged for a preceptorship. I must admit, it was an experience to have the student-teacher role reversed. Having mentored Guru in the past as his attending physician in the CCU and in interpreting echocardiograms, I was now sitting at his side and being mentored. There was, of course, great pride in his accomplishments. However, there was also the feeling that time inevitably was marching on. Guru was gentle in correcting my mistakes and in answering my many questions; I hope I had been equally gracious in addressing his. Just as it serves physicians well to have the experience of being a patient, it is useful for teachers to occasionally be students. I returned to San Diego with a great deal more compassion for the residents and fellows.
Being somewhat "chronologically gifted," I had interpreted thousands of coronary angiograms in the past and had assumed that this should readily qualify me to read CT angios. My experience, however, was quite a bit different. Although CT angios of totally normal coronary arteries are relatively easy to read, even these studies require skills in tracking and visualizing the complete course of the vessels. However, atherosclerotic disease can be very difficult to track, visualize, and quantify, particularly in heavily calcified vessels. I came away from my preceptorship with a great deal more humility and with the appreciation that the transfer of knowledge from conventional invasive coronary angiography to MDCT, at least at this stage of its development, is not straightforward.
Having checked MDCT off my list, I still have half the summer with the multiple tasks that I have wanted to get to. I have often thought of doing a refresher preceptorship with our electrophysiologists and being brought up to date on their latest concepts and procedures. However, I find that if I just sit still and relax, the impulse will pass. There are a bunch of journals that I am behind on reading. There is a great multicenter study I have wanted to organize, although it might be hard to contact potential collaborators during the summer. And then there is the new series I have wanted to initiate for JACC and the teaching conference for the fellows. The list goes on and on.
I am still in the mode of planning what to do with "all this extra time." Of course attending in the CCU will relieve me of much of this discretionary time. Other unforeseen situations will arise that will surely shrink the hours available. Associate editors will take vacation and I will have to cover their responsibilities. If this summer is like the others, I will likely enter the fall with a to do list that is nearly as long as the one I began with. Regardless of how much time there appears to be, it never seems to be enough.
The real issue, of course, is why I feel so compelled to put every spare moment to work in the first place. In this regard I do not believe that I differ much from most physicians. We seem to have this endless compulsion to be productive. Summer doesn’t just mean more time for family or recreation, but a time to get to all those things we haven’t gotten to before. Maybe it is the constant striving for perfection, or the years of competition we have been subjected to, or the culture of delaying instant gratification for subsequent success. Regardless of what it is that drives us, it does seem we have a hard time just relaxing.
Like my wife says, we physicians need to stop and smell the roses more often. So, I’m prepared to lead the way and take the first step. On this beautiful July day I’m going to close this Editor’s Page and go to the beach with my grandson. Undoubtedly I will be able to get to all those other tasks sometime in the future, maybe next summer.
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