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Distinguished Service Award
American Society of Regional Anesthesia and Pain Medicine
San Diego, April 4, 2003
Mr. President, Ladies and Gentlemen,
I feel very privileged, honoured, and in fact deeply touched by being the recipient of the 2003 Distinguished Service Award at this year's ASRA meeting in San Diego.
I'm very privileged indeed, to have had the opportunity to see over the years so many friends who are interested in a mutual hobby, which of course is Regional Anesthesia.
I see my professional career as a long way with many successes, thanks to the contributions of many, with as the red file, regional anesthesia and pain therapy.
It all started long time ago, when I did my first steps as a resident in Turnhout, Belgium, where a lot of time and effort was devoted to Regional Anesthesia. After two years, I became a resident of the late Bruce Scott, the first President of ESRA. Also, Tony Wildsmith was one of my teachers. Bruce worked in the European Mekka of Regional Anesthesia, the Royal Infirmary of Edinburgh in Scotland. In both institutions obstetric anesthesia plays an important role. That was the reason I did my Ph.D.- thesis in obstetric anesthesia. We were the first to use the very low dose-low concentration epidural technique, a technique which is now accepted world-wide. "Every dose given in obstetric epidural anesthesia can be a test dose", was the answer of the long time question of what should be "the epidural test dose". Another feature in the thesis was the RAM-test (rectus abdominus muscle-test) to evaluate the abdominal muscles in vaginal deliveries, which is according to Philip Bromage, even a better test than his own test, which evaluates the muscle strength of the lower extremities.
Pain relief became a passion and it happened that I was one of the founders of the Pain Section of the Dutch Society of Anesthesiologists. I'm proud for that, because nowadays, many invasive techniques for pain relief are widely practiced in the Netherlands.
In the late 1980's I learned to know a very dear friend, Gerry Ostheimer, from Brigham & Women's in Boston. In fact our first meeting together was in Oulu, Finland somewhere high above the North Pole circle. It was in August, but with almost freezing temperatures. As nothing really happened in Oulu city, we left early for Helsinki. It was there that Gerry and I became friends, during a dinner served in a special room in a restaurant, run by Russians. Vodka and reindeer were the main ingredients on the menu. From that moment onwards, a very intense correspondence and cooperation developed. Gerry was President of ASRA in those days and Editor-in-Chief of the journal, Regional Anesthesia. He asked me to join the editorial Board of Regional Anesthesia, and later I was even promoted to Associate Editor and still later to Editor. I could convince the ESRA board to accept that Regional Anesthesia also became our official ESRA journal. Later Gerry and I could realize that the other two sister societies, LASRA and AOSRA accepted the same Regional Anesthesia journal as theirs, so that there really is now only one RAPM journal worldwide.
Gerry and I had many plans. He suggested to Dr. Ben Covino, Chairman at Brigham & Women's in Boston, that I be invited as a visiting professor. That gave me the opportunity to intensify our mutual project, i.e. a textbook on OB Anesthesia, with a very special touch, namely with an input from OB anesthesiologists from all over the globe. In fact more than 100 contributors wrote chapters with specific accents and views from different countries. Helas, the very last page that I had to write for the book was an obituary, as my dear friend Gerry died far too soon and he even never saw our textbook finished.
Albert van Steenberge, together with Bruce Scott, the fathers of ESRA, asked me to become the Secretary-General of ESRA. At first, I was reluctant to accept this, afraid of the consequences this position might have. But as both my mentors told me that they would help me, I accepted. This offer gave me enormous benefits, as it resulted in so many contacts worldwide and numerous projects were developed.
In 1992, I was asked to be the President of the third joint combined meeting of ASRA and ESRA, organised in Brussels, Belgium. In 1984, the first joint ASRA-ESRA meeting took place in Vienna Austria (President Tony Wildsmith), and the second in Williamsburg, VA (President Benjamin Covino). The Brussels meeting certainly was a real highlight in my life. The first real intercontinental scientific meeting I ever organised, with the help of many. All the big names in Regional Anesthesia were there. This meeting again brought ASRA and ESRA closer to each other. A strong link existed in those days between the ASRA Executive Secretary, Mr. John Hinckley and myself as the ESRA Secretary-General. I thank John for the wise advice he often gave me and I wish his son Stewart all the strength to carry on in his father's footsteps. Without the Hinckleys, ASRA would have been a regional anesthesia society with only one arm.
The joint meetings finally also included LASRA and AOSRA, resulting in ISRA congresses in New Zealand and Québec. By further globalizing we were convinced that we could organize a world congress with everybody's support. And yes, the First World Congress on Regional Anesthesia & Pain Medicine in Barcelona, Spain, last year, was the best ever attended Regional Anesthesia meeting. As President of that meeting I could welcome more than 2,000 participants.
ESRA is really fortunate to have many active meetings. In this overview you can see that we had in 2002, next to the annual meeting, many zonal congresses, attracting in total more than 5,000 anesthesiologists in one year. Don't calculate that ESRA is now very rich. No, many of these zonal congresses are sponsored by ESRA, mainly to Eastern European countries. But it is the aim of ESRA to spread the message of Regional Anesthesia throughout Europe.
This also, is in the light of: What are the aims of professional scientific societies? Scientific societies have to set up and maintain standards, organize meetings to distribute knowledge and postgraduate education. Societies should develop scientific pathways and stimulate new research. But above all, their duty is to share and exchange knowledge. Where better can this be done at a congress, where enthusiastic anesthesiologists, passionate for Regional Anesthesia & Pain Medicine find knowledge to satiate their hunger?
Effective medicine, a post World War II phenomenon, experienced a massive expansion of medical facilities in the last 30 yrs, with an outburst of health care providers and facilities. Regional Anesthesia has a large impact on pain relief and the perioperative care of the patient. It has been clearly demonstrated that regional anesthesia provides a better outcome for the patient than general anesthesia in many situations. A better understanding of anatomy, physiology and pharmacology has resulted in better tools, better drugs and more appropriate techniques, resulting in better pain relief and outcome for our patients.
I was lucky to be able to help in achieving these goals, and tried to contribute in organizing meetings, scientific publications and lectures. I hereby want to thank the numerous people who have contributed to the realization of this.
Areas were I tried to contribute to further scientific matters were: IMRAPT, another official publication of ESRA which celebrates this year its 15th edition; Highlights in Regional Anesthesia and Pain Therapy, which I started in 1992 and this year we will have the 12th edition. These books are well received. ESRA endeavours to realize many other things: The Bruce Scott scholarship, the ESRA Fellowship in Regional Anesthesia, Training centers in Regional Anesthesia, and the cadaver workshops.
ESRA has brought me so many things. After being the Secretary-General for ten years, I was asked in 2000 to become the President of this society. My term will end in Malta next September. I'm proud to be the president of the European Society.
Ladies and Gentlemen, we're living in a world which also affects our meetings, e.g., the first gulf war in 1991 affected the Athens meeting, an earthquake in Istanbul, Turkey took place just before our annual meeting, the Warsaw meeting was held in the wake of September 11, and now again the war in Iraq may affect our annual congress in Malta. But we never gave up and we never cancelled anything. Each time we proceeded with our meetings.
This year the annual ESRA congress will take place in Malta, just South of Italy in the Mediterranean Sea. Here you will find more than 7,000 years of history. I hereby send you our most welcome invitation to join us on our 22nd annual congress in September 10 to 13, 2003.
ESRA gave me on top of all friendship, from the ESRA Board of Directors, its members and all the others in and out ESRA.
I cherish the friendship of one person in particular, the actual Secretary-General of ESRA, Narinder Rawal. We really can feel what the other wants, together we're a hell of a team.
Obstetrics, Regional Anesthesia, Pain Therapy, congresses, societies, publications, relationship between societies, and most of all friendship, from people from all over the globe, they all have a place in my heart.
Often you hear doctors complaining about workload, problems with personnel, waiting lists, etc. I think we should be proud to be a doctor - we should be proud to be an anaesthesiologist - we should be proud to be able to relieve pain in patients and to guide them safely through an operation. I certainly feel very proud today to be one of these doctors.
Thank you, Mr President and the ASRA Board of Directors for offering me this award.
Prof.dr. André van Zundert
President ESRA
San Diego, CA
April 4, 2003
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