I would like to express my humble and most profound gratitude for the honor of serving this Society as president for the past year. I’ve approached this presidential address with some trepidation. What can I say that will be of interest that hasn’t already been said? I’ve sat through 22 previous presidential addresses, and reviewed several more in preparation for my own talk. I’m sad to say that I had forgotten the pertinent message of many of these speeches, a fact that I am prepared to accept that most of you will accord to mine today. A couple of addresses I distinctly remember because of their length; sitting through these talks I passed through all of the classic stages described by Elisabeth Kubler-Ross—denial, anger, bargaining with God, depression, and finally reluctant acceptance. I hope not to follow in this mold, and I’m going to attempt to finish at about the anger stage, or at least before the stage of depression that seems to characterize so many of today’s surgical meetings.

The title of my talk is “A Picture from Philadelphia,” and the picture I would like to use as a starting reference is the Thomas Eakins’ painting, The Gross Clinic. This work was completed in 1875, in anticipation of the American Centennial Celebration held in Philadelphia the following year.