2019 John H. Gibbon, Jr., Lecture

Michael Mack, MD, FACC

Summary provided by Mohsen Shabahang, MD, PhD, FACS

In Michael Mack's lecture "Innovation: A Surgical Imperative," he lays out a cogent argument for innovation in surgery. He uses the field of cardiac surgery to lay out the argument as to why we need to be constantly open to new techniques and thoughts in the field of surgery. This is with the understanding of the fact that as stated by Dr. Cosgrove, we all fear change. Dr. William Pollard is quoted as saying "learning and innovation go hand in hand. The arrogance of success is to think that what you did yesterday will be sufficient for tomorrow." Dr. Friedrich Mohr is quoted extensively speaking of innovation being 1 percent inspiration and 99 percent commitment. According to him, innovation requires clear goals, a pioneering spirit, curiosity, strong will, endurance, and trust in oneself. Dr. Bavaria is quoted as stating that vision, strategy, tactics, and execution are necessities of innovation.

Dr. Mack summarizes the Gibbon Lecture with a few epiphanies. The first is that cross-fertilization among fields of surgery is essential to innovation. Less invasive surgery always beats more invasive techniques. Finally, innovation does not happen overnight. He uses the development of TAVR over two to three decades to illustrate the challenges of innovation. He states that innovation can illicit several reactions: one can throw rocks at it, one can stand on the sideline, one can put their head in the sand, one can fall asleep and pretend that it is not going to happen, or one can get in game. This talk is a great primer for any surgical innovation. Dr. Mack concludes the talk with the following quote from the 16th century treatise, The Prince, by Niccolo Machiavelli, "The innovator has enemies in all those who profit from the old order and only lukewarm defenders in all those who would profit from the new order."