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Editorials

The Challenge of "Tending the Bridge"

Division of Cardiothoracic Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada

^_* Address correspondence to Dr Chiu, The Montreal General Hospital, MUHC, Suite C9-169, 1650 Cedar Ave, Montreal, Quebec, Canada H3G 1A4 (Email: ray.chiu@mcgill.ca).

The first 300 words of the full text of this article appear below.

There is nothing new about the challenge faced by surgeons who wish to apply cutting edge science to benefit patients. Decades ago, Francis D. Moore stated: "A surgical investigator is a bridge tender, channeling knowledge from biological science to the patient’s bed-side and back again. He traces his origin from both ends of the bridge. He is thus a bastard and is called this by everybody. Those at one end of the bridge say he is not a very good scientist, and those at the other say that he does not spend enough time in the operating room. If only he is willing to live with this abuse, he can continue to do his job effectively" [1].

Half a century later, the gulf is deeper and tending the bridge is much more challenging. The American Association for Thoracic Surgery is encouraging its members to alert the National Institutes of Health to the decline in research funding for cardiothoracic surgeons. However, as one who had served on the National Institutes of Health’s grant review committees for many years, I have often sensed the putative lack of cutting edge scientific sophistication in many of our proposals to be a major culprit. Likewise, a bridge tender who submits a translational research paper to a high-power basic science journal may be advised that the scientific concept or technology presented is not sufficiently novel, although such an article may be of interest to clinical-oriented journals. However, when it is submitted to a clinical journal, although the clinical importance may be readily recognized, the basic scientists invited to help review such a manuscript may demand use of more sophisticated basic science techniques to confirm the underlying science, because it is still considered controversial. Consequently, the proposed article was rejected by both journals, denying further . . . [Full Text of this Article]