A Message to Congress

 

I began the practice of critical care medicine in 1980 when the field was young and limited opportunities for formal training were available. I learned critical care primarily from apprenticeship with those who had acquired skills in mechanical ventilation, management of shock, post-operative critical care, nutrition in the critically ill and other ICU based skills through specialty training and experience.

Now I reflect back on the marked changes that have occurred in the field of critical care to include the formalization of multidisciplinary rounds, the fall of the pulmonary artery catheter, the protocolization of mechanical ventilation of acute respiratory distress syndrome, electronic medical records, intensive care unit performance improvement, the rise and fall and rise and fall and rise yet again of steroids for septic shock, the importance of compassion and now the controversy surrounding fluids and vasopressors for maintaining tissue perfusion in septic shock. My plenary at this year’s meeting is entitled “A lifetime of change in critical care: a personal reflection” and will allow me to reflect on these changes.

But one thing is for sure. Over almost 30 years, the practice of critical care remains the best of times for me and the overwhelming majority of my  colleagues.

It is my privilege to return to Sri Lanka for this 35th Annual Academic Congress of the College of Anesthesiologists and Intensivists. There is considerable critical care history in this great country and much for you to be proud of. I look forward to engaging you in January. And together we will plot a strategy to move our field forward.

“A genuine leader is not a searcher for consensus but a molder of consensus.”

Martin Luther King

 

Phillip Dellinger M.D. MCCM

Camden NJ USA