Navigation in Uncharted Waters: Is Anesthesiology on Course for the 21st Century?

IT is an honor to join a group of distinguished colleagues who have delivered the Rovenstine lecture previously. Dr. Rovenstine has special meaning for me because he was a fellow Hoosier and graduate of Indiana University, my alma mater for both undergraduate and graduate medical education. However, I am humbled by this recognition, also. I am aware that there are many in this audience who possess more judgment and knowledge than I, and all of us would benefit from their wisdom on this occasion. Nevertheless, I accept the opportunity with enthusiasm, for I believe these are defining times for the specialty. The thoughts that follow are mine only, and they will benefit from group discussion and modification by collective wisdom. My purpose is to catalyze these discussions and stimulate action by both the leaders and the membership of this society. My title suggests an analogy between my vocation, anesthesiology, and my avocation, sailing. Both require careful route planning to reach a desired destination, so the analogy seems appropriate. My comments are divided into four sections, which are intended to define the current position of the specialty and plot a course for the future.