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Presidential Address: Beyond Our Masks

      For all my years as an AANA member, I have always enjoyed our Annual Meeting and listening to the words of those who have led this organization. The passion of their commitment has been inspiring. We are here to celebrate AANA’s 40th anniversary and now, as your 40th President, it is my opportunity, no, my honor, to share my thoughts with you today.
      I stood on this very spot nearly 8 months ago. Before being a Program Chair of AANA and now President, I didn’t know that a site visit was even a thing! Yet here we stood, masked and practically bathing in hand sanitizer, amid the Delta Variant. It was a challenging time and even then, as we were hard at work planning this meeting—your meeting. In my mind I questioned whether we would be gathered here today. The day of that site visit was Saturday, September 11, 2021. Ominous in its own right. It forced me to take a moment to pause and reflect, recalling where I was 20 years ago, and then thinking of how far we have come since that fateful day. Today is Armed Forces day, a day to honor all our military, those who have sacrificed and those who serve today. We are thrilled to have many of our military and Society of Military Orthopaedic Surgeons colleagues with us. Thank you for your service. We were looking forward to hearing the Navy Surgeon General, Rear Admiral Gillingham as guest speaker, but unfortunately, coronavirus disease 2019 (COVID-19) prevented him from joining us. That loss did provide us the opportunity to get our AI/Machine Learning talk from Dr. Krogue back on the program, and it was so interesting to hear how our future may change. Thank you to Christine Nogal for opening the morning with your beautiful rendition of the National Anthem. AANA is 40 years young, and it is astounding that half of AANA’s storied history has taken place since 9/11 as well.
      AANA has seen enormous change and tremendous growth in that time. AANA’s story began at the 1975 AAOS meeting as the American Chapter of the International Arthroscopy Association. Through the vision of our pioneers, The Arthroscopy Association of North America was created and founded as AANA in 1981. At its inception, there were 150 members, and 40 years later we are 6,000 members strong.
      So many milestones, so many leaders. Such incredible innovation and growth. Much of that success can be attributed to so many of them who are in our audience today. I would like to ask any of the original 150 members here to please stand and be recognized.
      Ten years ago, we captured our history in a monograph. I want to acknowledge Ron Selby, MD for his outstanding work in creating the original “30 Years of Excellence.” It documented the inception of arthroscopy here in North America and around the world and outlined AANA’s pioneering work. Well, with the digital age, the growth since then has been exponential and it is again time to capture that history: and we’ve done it. Our 40th Monograph has just been published. I am so proud of this beautiful work.
      My vision for this edition took a different tack. I wanted a different feel, not like a textbook. As I speak to friends and family, some of whom are here today, I am often asked what is AANA and why do you do what you do. “It takes time away from your practice and your family…and you don’t get paid?” It is the “why” and I am often left trying to explain what AANA is and means to me. The 40th Monograph helps offer that answer. It’s a coffee-table book, lavishly created with many photos and chapters dedicated to the growth and successes we have had over the past 10 years. I hope you enjoy this and proudly display it on your coffee-table as I will.
      The creation of this exquisite book was a collaborative labor of love. Jon Ticker led the effort with his enthusiasm for the history of medicine and our society, and Michael O’Brien and J. J. Ryu coedited this comprehensive and inclusive piece. This production required an enormous effort, not only from our physician authors and editorial leaders, but from our outstanding AANA staff, especially Renee and Christine. Thank you to the exceptional Monograph team!
      This book will be a complementary gift to all AANA members. Such a gesture is certainly costly, but we wanted each of you to have it. We must recognize the enormous generosity of Past President Dr. Rick Ryu and DePuy Synthes Mitek Sports Medicine, who together provided the necessary funding to ensure the Monograph is widely distributed and enjoyed by all. Thank you, Rick, and Mitek!
      There have been many challenges throughout our 40-year history, although none, perhaps, greater than the COVID-19 pandemic. COVID-19 has wreaked havoc on the world and the medical community in so many ways.
      In 2019, our personal and professional lives forever changed. We watched the lethal virus move from Asia, through Europe, and eventually to our nation. By March of 2020, our lives in the United States were put on hold, especially here in California. We quarantined our families, our groceries, and even our mail. Our celebrations became creative. I was convinced that COVID-19 would have been over by now—not impacting us still in 2022—just a quick interruption in our hectic lives. First COVID-19, then the promise of the vaccine, then Delta, then boosters and then Omicron—then Omideltacron and BA2, 4, and 5. Now over 2 years in, the pandemic has changed everything. Fast forward to today, our program has been disrupted by the virus and much more disturbing is the fact that there have been more than 1 million deaths here in the United States alone and we continue to wear our masks each day.
      As surgeons, wearing a mask has always been an integral part of our daily lives. Before COVID-19, I never considered it intrusive. Rather, a part of our being, our culture, our persona—almost like a police officer’s badge. We spend 10 to 12 hours a day wearing a mask in surgery and never think about it. Now the worldwide community at large and even us as physicians have come to loathe donning our masks each time we leave our homes.
      Lindsey Grubbs and Gail Geller have addressed this in their poignant article, “Masks in Medicine: Metaphors and Morality.”
      • Grubbs L.
      • Geller G.
      Masks in medicine: Metaphors and morality.
      As they point out, we have never been so aware of masks. While the mask remains protective, the mask has become “an inflexible barrier to communication…concealing the authenticity and vulnerability…of all of us and our interactions and relationships.”
      Our masks protect us and others but have also created another consequence, and often we now find our experiences impersonal and cold. No smile at Starbucks or from the agents at the airport. We have become a hidden society, and the mask remains strongly politicized.
      Yes, we are hopeful that in the coming weeks mask mandates will continue to ease, but with each new variant, we remain on edge. However, who we are as a society, moving forward after the pandemic is critical. There are remaining concerns that we must address with the many metaphors behind the mask.
      What we do and where we go after the pandemic and beyond our masks will be vital to our success. To truly understand me and my motivation, we need to look back to my journey into orthopaedics. I thank Dr. Stone for his thoughtful introduction, and you may begin to recognize that it was challenging getting my orthopaedic start.
      I am truly blessed in so many ways today, and while I have had an outstanding career and only one job—a dream job—the adventure did not start out so well. I always excelled in school and assumed that life would reward hard work and dedication but I learned that is not always the case.
      Match Day 1989: To this day, it remains the lowest I have ever been. But for the love and support of my wife and family, I’m not sure I would be standing here today. I have always been driven, disciplined, and done the hard work to succeed. But 2 words in one of my letters of recommendation, likely my most important letter, changed all that: “apple polisher.” I didn’t even know what that meant. Google says it is: “someone who treats important people with excessive respect.” For those who know me well, I may be many things, but an apple polisher is not one of them.
      Yes, of course, I have always been respectful of those who I look up to. In society today, with all the mistrust and infighting, this should be a positive. In fact, before I started my remarks today, I checked to be sure that Will Smith wasn’t in the front row!
      Why even agree to write a letter then…was he antisemitic? I’ll never understand. Well, those 2 words nearly ended my dream before it had started. It was humbling, and I was devasted. Now what? I couldn’t understand how it could have happened to me…and yet, I had to decide what to do…in less than 24 hours…I needed a plan.
      I could have pivoted—anesthesia and general surgery had openings. But I was built for this specialty. Being an orthopaedic surgeon was all that I ever wanted. From age 16 I had a singular focus...maybe it was earlier…not just to be a doctor but to be an orthopaedic surgeon. John Wooden said “Things turn out best for the people who make the best of the way things turn out.”
      I moved to Boston for my internship with just a promise of rotating with the orthopaedic service. Why Boston—well, my mother-in-law grew up there and Boston University had an opening—That’s it! When scrambling, there is no time to get philosophical. Almost like closing your eyes and picking a spot on a map to visit.
      It was there that I met Bob Leach, Chairman of Boston University Department of Orthopaedic Surgery, the then–Editor-in-Chief of American Journal of Sports Medicine, an American Orthopaedic Society for Sports Medicine President and Hall of Famer, and to those here who knew him, a larger-than-life personality. Bob was a gifted surgeon, a pioneer in our field, and my personal hero.
      He saw the sparkle in my eye, recognized my passion, and gave me a spot in their Orthopaedic Program—an opportunity, The Opportunity! Our move to Boston was “Bashert.” That’s a Yiddish expression meaning destiny or it was meant to be.
      Once that door was opened, I rushed through with my dream intact. To be my best, I knew I had to learn from the best. The best surgeons and the best mentors. Fellowship was the next step and I still remember my Southern California Orthopedic Institute (SCOI) interview vividly. It was shortly after the massive Northridge earthquake that had ravaged northern Los Angeles. I recall driving near the office and seeing a 3-story condo building pancaked. Los Angeles seemed frightening—did I really want to live in an earthquake zone? But I was not deterred. I wanted to train at what was then called the Snyder-Fox Fellowship @ SCOI.
      Well, this time Match Day was a success. SCOI was my top choice and, as they say, the rest is history. My fellowship training was outstanding. As I was finishing the year, Dr. Snyder invited me to stay at SCOI. Now, 25 years later, it’s the only job I’ve had, and on Thursday I gave Steve the Lifetime Achievement Award. Wow!
      I’ve had a dream career, and I am privileged to practice with incredible colleagues and partners, mentors, and friends. With all SCOI’s talent and years of service and allegiance to AANA, I became the first SCOI surgeon to stand here today as a President of AANA. Thank you to my partners and professional mentors who have helped guide me on this path. As Sir Isaac Newton said, “If I have seen further, it is by standing on the shoulders of giants.” You all stand alongside me today. Each of you are true giants and I celebrate and thank you here now.
      We often say that the practice pays the bills, but it is through teaching and education, both at SCOI and through AANA, here and around the world, that has led to the true fulfillment in my professional life.
      AANA is the worldwide leader in promoting arthroscopy and minimally invasive surgery. The pandemic has certainly made the delivery of our educational services more difficult. Yet, we have shown great vision and want to recognize the important strides we have made over the past year. I share AANA’s COVID-19 successes by unveiling AANA’s MASK: Mastery of Advocacy, Surgical Skills and Knowledge.
      AANA excels with its advocacy work and we have had several wins this year. AANA was instrumental in the AAOS update of the OAK Clinical Practice Guideline (CPG). Advocacy Chair Eric Steifel and his team worked tirelessly and secured language in the Guideline to ensure that arthroscopic meniscectomy remains an appropriate treatment option for our patients.
      The CPGs are designed to serve as an educational tool and guideline. Surgeons must use their judgment when indicating patients for surgery. But these tools are viewed by our payors as well. It is vital that the guidelines are used by clinicians and not by third parties to limit access to care.
      However, we must be careful. Several articles have been published over the course of my career that have resulted in negative payment determination decisions, and I ask that all who do such research consider the importance of preserving our ability to allow the “art of medicine to remain.” Systematic reviews and meta-analyses should not result in noncoverage decisions—doctors should practice medicine and determine what is best for patients, not utilization reviewers!
      With innovation comes new procedures that may offer great benefit to our patients, yet we do not have Current Procedural Terminology codes to get paid for the work we do. To get paid, we need codes. To get the codes, we need data, and today to get a Category 1 code, the Centers for Medicare & Medicaid Services wants to see Level I data.
      To this end, the AANA advocacy committee has developed a new Level I research initiative. Our goal was to identify the need for new procedures and look at emerging technology. We then worked to create a research protocol that meets the standards for Current Procedural Terminology and CPG inclusion. Level I research is expensive, and we needed funding to produce unbiased high-quality results. I am pleased to announce today that we have secured a $500,000 grant from Trice Medical. Thank you. We have selected 2 sites to study percutaneous ultrasound tissue debridement, and if efficacious, we will work to get a new code added to the orthopaedic code set.
      “DocMatter” has been one of our most successful initiatives this past year. Launched in 2020 and spearheaded by Paul Caldwell, this online medical resource—think Meta or Facebook—has developed into an international medical community that has grown exponentially. A valuable member benefit offering high-quality clinical discussions among AANA members across the globe, it has become the ideal secure medium to share challenging cases and offer practice recommendations. The discussions offer great insight to real everyday challenges we all face treating patients. There are nearly 5,700 members on the DocMatter platform, with 73% engagement. There have been more than 800,000 discussion views this year.
      If you are active on DocMatter, thank you. If you have not yet accessed it, I encourage you to do so; you will be hooked. It is a wonderful community with great conversation and education.
      AANA is holding strong at 6,000 members worldwide, and we look to a future of continued growth and advancement. We added several new member benefits and of course, all members receive our monthly journals.
      Speaking of our crown jewel, the Arthroscopy “family” of journals have shown incredible growth with clinically relevant content that directly benefits surgeons and their patients. With more than 1,500 submissions to the Green Journal, Editor-in-Chief Jim Lubowitz and his outstanding team offer diligent and timely review leading to an outstanding product. Our Journal remains a shining example to others and has achieved an exemplary impact factor that ranks in the top 10 orthopaedic journals. Congratulations to Dr. Lubowitz.
      The journal remains critical to our society’s success and with cost-effective financial management, the 2021 net revenue to AANA was more than $1.3 million. I would like to thank the Journal Board of Trustees for your oversight and Dr. Sgaglione for your passion and leadership as the Chairman over the past 4 years. John Richmond will be assuming the helm, and I am confident he will collaborate with Dr. Lubowitz and his outstanding editorial and professional teams to grow our journals.
      Even with 6,000 members, we are still a largely White male group, not through the fault of any specific entity or mechanism. We now recognize the inequities and must work to improve it. It is time to do better.
      We will! Our Presidential Guest Speaker Alison Levine was incredible, and while we learned that we may need to take many breaths before we take another step forward, we must keep moving forward!
      Under the leadership of my predecessor Brain Cole, AANA established a Diversity and Inclusion Task Force, and we have developed many initiatives to be more inclusive. Mary Mulcahey, the current President of the Ruth Jackson Orthopaedic Society (RJOS), serves on our Board and is our Diversity Advisor. She will ensure that AANA remains sensitive to those under-represented in medicine. As the father of a son and two daughters and being surrounded by many strong women in my life, advancing diversity and inclusion has been an important focus, perhaps the sentinel focus, during my Presidential year. I wanted to ensure advancement for this critical issue. One year is so short when trying to accomplish far-reaching initiatives, yet we have made progress…real, tangible, progress and I am proud to share what we have done.
      Specialty Day is one of our Premiere events each year and a great opportunity for collaboration. I am the only AANA President who has had the opportunity to put on 2 Specialty day programs during my year thanks to COVID-19. I am most proud of the landmark event that recently took place this past March. AANA was the first American Academy of Orthopaedic Surgeons Specialty Society to share a Specialty Day stage with RJOS, a pioneering new direction in collaboration.
      Our program was groundbreaking and an important step in demonstrating our commitment to diversity, equity, and inclusion. More than 50% of the faculty were women who led insightful and educational discussions. We were supported by The Forum and Black Women in Orthopaedics, and Speak up Ortho was represented. The Innovation Lecture was delivered by Dr. Martha Murray from Harvard. She inspired us with how to achieve success with product development as physician scientists and innovators, bridging the hurdle of “the Valley of Death” from concept to commercialization. The true highlight of the day was the diversity symposium we hosted. We heard moving and emotional lectures on implicit bias and the imposter syndrome. We then experienced touching moments from our Black and Brown, male and female colleagues who shared their challenges and stories with us. The program was powerful and inspirational, and the audience was fully engaged. I am so proud to have brought this program to the stage. It was a small step forward for AANA and RJOS but a giant leap forward for improving diversity. When we look at the numbers, there is a glaring discrepancy. Orthopaedics is the single subspecialty where there is the widest gender gap. The Association of American Medical Colleges showed that 94.2% of our colleagues are male, leaving less than 6% women. Less than 18% of women are full-time orthopaedic faculty and less than 10% are full professors with less than a handful of female Orthopaedic Department Chairs offering few female orthopaedic leaders to influence our future generation.
      The issue starts well ahead of where AANA can make a difference. The lack of exposure to orthopaedic surgery and the paucity of female mentors makes women unlikely to select our field. In medical school, more than 52% of students are female yet they do not often pursue orthopaedics. The stereotypes of the past remain, and it will take years to see a significant change.
      And then, just yesterday, we were so fortunate to have Eric Carson present his diversity lecture to us. We heard first-hand of the difficulties he experienced during his training and throughout his career. It reinforced the take-away messaging from Chicago and echoed the biases that remain.
      So how can AANA help? It has become clear that to make an impact we must spend time with medical students well ahead of the inflection point, before their minds are made up, so they can at least consider orthopaedics as a career.
      It shouldn’t be a tough sell. Statistically, we enjoy great job satisfaction with mostly happy patients and let’s face it…we do cool surgery. What else can we do? The writer Joel A. Barker said, “Vision without action is merely a dream. Action without vision just passes the time. Vision with action can change the world.”
      I am excited to announce today that AANA has developed a new, visionary, actionable, and I hope groundbreaking program: “Futurescope,” an introduction to arthroscopy and orthopaedic surgery that will introduce our great specialty to those who traditionally have not considered entering our field. AANA will immediately begin to communicate with medical schools and offer an incredible opportunity to women students and those under-represented men in medicine who are open to considering a career in orthopaedics. We will make an impact! We will launch the inaugural and flagship program in Chicago on October 1st, and then with coastal courses to follow. A 1-day didactic and lab experience to expose first and second year medical students to arthroscopy and orthopaedics with a hands-on experience to pique interest and then offer mentorship to those who choose to pursue orthopaedics as their specialty.
      All expenses will be covered, and the program will feature diverse and influential faculty. You must recognize that this incredible undertaking takes significant resources. We needed a partner to make this vision a reality. I am proud to announce today that DePuy Synthes shares our vision and has agreed to support this incredible program with a $1 million grant to make this offering a reality! Thank you to Rajit Kamal, their Worldwide President of Sports Medicine, for providing this funding. We will begin immediately with a press release on Monday and are incredibly honored and excited to work alongside such a strong and dedicated partner.
      AANA is all about education, and education is a tough and evolving business. We must adapt and change, like our members, who want different forms of education and interaction at different times in their careers. There are generational changes moving from the baby boomers like me to Gen X and the millennials. There is a new imperative and the work/life balance is more vital today. COVID-19 has changed how members look to get educated. We launched Webinar Wednesdays and hosted 15 comprehensive Webinars. Even without our own annual meeting, AANA granted more than 15,000 hours of Continuing Medical Education this year. We grew our newly created Fellowship Series, making it a free member benefit that has been a great enhancement to AANA-recognized fellowship training programs.
      The AANA Fall Course, an important annual event in the history of AANA, was sunsetted some years ago, and we have missed that yearly academic offering. I am pleased to announce that we are launching a new Early December AANA meeting. We will host a boutique style meeting—much like the winter ski meeting—covering comprehensive topics each year. The inaugural course will feature Drs. Steve Burkhart, Jim Esch, and Steve Snyder, the “Three Amigos,” as our Masters and it will be both educational and fun! We will have morning programming, afternoon golf and recreational options, and then cocktails and conversations with these Godfathers of Shoulder Arthroscopy. Look for the registration in the coming days and be sure to sign up early to ensure your spot!
      Supporting AANA. Once again, we need to remove our masks and look into the mirror and recognize that it is our responsibility to ensure the future of AANA. We have relied on industry for decades and fortunately had many years of great support. However, there is a new reality and industry contributes less each year, as they are challenged by their own issues with inflation, supply-chain interruption, and staffing. It is up to us!
      Philanthropy is challenging. It is the responsibility of each and every one of us here to support AANA. We all have personal commitments and are at different places in our careers, yet we all can give something and giving back should make you feel good, knowing that you are supporting the future of our profession. You can made a difference and a gift to AANA will transcend how you feel.
      I would like to thank all the generous donors who have contributed to our 40th Anniversary Campaign. Our goal this year was “4 for 40,” $4 million in honor of our 40 years. Well, we surpassed that goal with the current gifts and pledges in April of 2021!
      Most of us remember those who started AANA. But with growth, comes change, and we are so fortunate to have Laura Downes as our CEO. She has reshaped AANA, made us more efficient, and we are a much stronger organization through her efforts. Christine Nogal, Vice President of Marketing and Operations, was instrumental and committed to seeing through all our initiatives this year. Kim Santianello, Vice President of Education and Research, leads the best educational platform, guaranteeing our compliance, and Dennis Siena, Vice President of Finance, ensures AANA remains fiscally sound. Frances Park, our Senior Meetings Manager, has worked tirelessly for this meeting and throughout my time on the Presidential line.
      Laura, you have assembled an incredible team that made my job as President so enjoyable and achievable while still having a “day job” at the same time. Thank you, Laura, and the entire AANA team.
      As we turn the page on this the final day of AANA’s 40th Anniversary, we need to look to the best of the past to help steer and power our future. Churchill said, “The farther backward you can look, the farther forward you are likely to see.” Well we can certainly look back at the last 40 years with great satisfaction. But we cannot rest, and we must look beyond the horizon to advance our society. We must nurture our bold young surgeons who will lead us into the next decade and beyond. At this meeting, we provided 42 resident scholarships. Every resident who applied received funding to interact with and learn from our incredible AANA faculty and attendees. Residents and Fellows are the lifeblood of our society’s future, and we must continue to provide these opportunities to encourage their engagement.
      The pièce de résistance of this year was just this week, hosting the AANA traveling fellows and Past President Rob Hunter as Godfather. We had a wonderful visit and from our time together, I can assure you we have 4 incredible future AANA leaders!
      I am honored to work alongside an outstanding Board of Directors. AANA is fortunate to have those visionaries at the table who will lead us to greater heights. I am so proud to have been a part of this Presidential line. Your new President, Jim Stone, will be a thoughtful guiding light and an exceptional leader. Then, “JT” Tokish will bring his charisma and encyclopedic knowledge to this society. I am beyond confident that AANA will enjoy tremendous growth and advancement under their stewardship.
      I must acknowledge and thank my SCOI team as well. First to Jenny, Sara, Katie, Jess, and Nate, I could not do what I do each and every day without your dedication and commitment to me and my patients. You are the A-Team, and I am so appreciative of you all. To my OR team at COSI, represented today by Keitha, Sheila, and Angel, you are the best of the best and I so look forward to my Wednesdays and Fridays. I often say that surgery is the least stressful thing that I do in my life. It is because I get to work with such a capable and dedicated team of professionals each day. Thank you.
      Somehow, she gets it all done. Eleanor O’Brien, our Fellowship Executive Director. You are unbelievably talented and our Fellowship would never have reached the heights that it did without you. Your 30 years of dedication, and tireless and unwavering support of me, my partners, and all the current and former Fellows. A million thanks.
      Kevin Bonner, where do I begin. Once I was elected second VP, my priority was to name my program chair. I knew immediately who I wanted and I could not have made a better choice. Your dedication, energy, and commitment to making this meeting special have been inspirational. This program has been outstanding and reflective of that and the attendance here in San Francisco has exceeded our loftiest expectation. Karen and I have so enjoyed getting to know you and Cathy, and I cannot possibly thank you enough for your hard work in creating this exceptional meeting.
      Throughout our lives and especially making a life in Los Angeles, particularly as we have navigated these past 2 years, Karen and I have been so fortunate to have such great friends and I am very thankful to have you here with us today. Our SCOI and our AANA friends are also like family. Thank you all for sharing this journey with us. Each of you make this so special. My family has been so supportive, and all of them live in south Florida. Despite the distance, we remain very close. We love you and we are so fortunate to have all of you as such important parts of our lives. Thank you to my nephew Andrew for arranging my walk-in mix.
      My Mother Linda is here with us today. We lost my father to his battle with Alzheimer’s over 7 years ago, and he too would have been so proud to have been here. Thank you for all the sacrifices you made for me, Marcie, and Debbie, to reach for the stars. You have always been so loving and supportive, and I am so glad that you are here with me today.
      To our children Nicole, Zach, and Jayme, you are the loves of our lives. Mom and I are so proud of you and your accomplishments and more importantly because of the warm, loving, and caring individuals you have become. And then of course there’s Riley-our four-legged child!
      When your children are young and you are trying to build a practice and at the same time teach and do research, the life work scales can get tipped in the wrong direction. I know I have been guilty of this at times but am so fortunate to have such a special relationship with each of you. The silver lining of COVID-19 was the opportunity to have all of you with us with the additions of Emily and Yaron. I never imagined that we would get so much quality time with all our adult children together. It has been the most incredible blessing through this pandemic. I love you all and thank you for your love and support.
      Karen. I know that everyone here who knows you, loves you and from your time as First Lady, let’s be frank, they expected you to charge the stage and give this address yourself. Just know that I love you so much more and would not be half the man I am and certainly would not be here today without your love, guidance, and support.
      My story exemplifies how individuals can do anything they want with passion, perseverance, drive…and, yeah…just a little bit of luck. The path was not always smooth. Yet, standing here now, I would not change one moment, as the entirety of this journey, has allowed me to fulfill my dream. I have made my own small contribution toward the advancement of this great society…it has been Bashert!
      Amy Poehler has said: “Find a group of people who challenge and inspire you; spend a lot of time with them, and it will change your life.” AANA has certainly changed mine!
      The future of AANA will one day look different, less White male, more diverse in gender, more diverse in ethnicity, and more welcoming to those in the LGBTQ+ community. It is my great hope that when we reconvene to celebrate our 50th anniversary, we will remember this 40th anniversary address, recognize the influential steps we made in 2022, and marvel at the growth and accomplishments that will have occurred since then. We will have grown so much, come so far…beyond our masks!

      Supplementary Data

      Reference

        • Grubbs L.
        • Geller G.
        Masks in medicine: Metaphors and morality.
        J Med Humanit. 2021; 42: 103-107