A tornado, a devastating spiral, will uproot most anything in its pathway and bring it crashing down somewhere. Medicine finds itself in the midst of the tornado of bureaucracy, now spiraling as a political football to fall in the midst of chaos and diminished health benefits.

In 1972, the year I was elected Secretary of this illustrious organization, Dr. Walter Birnbaum spoke of the sigmoid curve. I would like today to project this curve into a spiral, a spiral being a "curve traced by a point moving round a fixed point in the same plane, while steadily increasing or diminishing its distance from it."

Perhaps the principal reason for my thinking of a spiral is the general reference to this type of curve in relation to our inflationary behavior, not only from the economic standpoint, but also from the point of view of practically every facet of life itself, beginning with the spiral of the DNA molecule, to the trajectory of the world around the sun. As we progress in our endeavors, we say we progress upwards, not downwards, nor in a straight line, but more commonly in a spiral; sometimes retreating, sometimes approaching, but always with at least some progress towards perfection. So it has been with medical progress through the years; we have had our dark moments, but most have been bright and shiny, just as our halos should be. Yet it is principally due to this progress that we must blame ourselves for our present situation. The American way of life has taught us to "help the underdog" and to refrain from "beating a man when he is down"; but in the heights we as physicians have achieved, we are an ideal target for anyone who would like to throw a missile our way. It is neither profitable nor edifying to degrade or deride an undefined or unfortunate person or group.