In times of change learners inherit the earth. The 1997 presidential address.

Abstract

Neurosurgery, as traditionally practiced, is changing. Eric Hoffer observed, "In times of change learners inherit the earth; while the learned find themselves beautifully equipped to deal with a world that no longer exists." Historically, learners have possessed certain attributes. They anticipate rather than react to change. They become essential facilitators within their altered environment. They are effective advocates for principled behavior and ethical practices. They skillfully communicate the new and technically arcane with a common touch. Learners also understand the lessons of history. The potential of process technology, illustrated by Morton's 1846 application of already well-understood science, in essence, to transform the profession of surgery by making painless operations possible, is one example. Voluntary professional associations such as organized neurosurgery can also learn from the contrasting experiences of the Donner Party and the Utah Pioneers as they made their way down the same canyon of the Wasatch mountain range during the summers of 1846 and 1847, respectively. Group dynamics during those two episodes differed strikingly. It was the vanguard party of Utah Pioneers who exemplified the characters of learners. They acted with unity, common purpose, and careful preparation designed to benefit those who followed them. Years from now, how will the current individual and institutional behavior of neurosurgeons and their associations be judged? An interval assessment is suggested at the April, 2012 American Association of Neurological Surgeons Annual Scientific Meeting. From that perspective, will it be determined that the neurosurgical discipline acted presciently, as would those Hoffer describes as learners? Will neurosurgery be said to have understood and thereby profited from the lessons of history? These are pertinent questions. The answers, considered as a proposed progress report 15 short years from now, could accurately predict the scientific and professional position that neurological surgery will occupy in the future. Deserved long-term success based on the effective, far-sighted behavior exhibited by learners is my confident expectation.