New Year Resolutions

It is quite befitting for an issue 1 to announce what is planned for the New Year. Many of us start it with the determined intent to make it a better one. So does The Thoracic and Cardiovascular Surgeon. Unfortunately, constant improvement can be a tricky thing—as recently witnessed by a well-known manufacturer of diesel engines. Yours truly has a couple of ideas up his sleeve which he hopes will meet the general approval of the journal's readers.

A very obvious alteration is the bulky Supplement which was mailed out together with this issue. It combines two supplements into one volume with a flip-over design. The reason is perfectly simple: The German Society for Pediatric Cardiology (DGPK) and the German Society for Thoracic and Cardiovascular Surgery (DGTHG) have decided to hold their respective annual meetings in parallel this year. This is thought to increase the scientific interactions between both and at the same time utilizes synergies of an organizational nature. One of those is the combined supplement. Here the requirement was to produce two clearly separate entities bound into one volume, emphasizing the individuality of both parts and being visually attractive at the same time. Combined efforts of the two organizing committees, the Professional Congress Organizer (PCO), and Thieme Publishers led to the current version which hopefully will appeal to the users. Any critique should, as usual, be addressed to the Editor-in-Chief. Positive feedback is also welcome.

Another innovation, already to be found in the first issue of the year, is the introduction of a new type of article which is a bit difficult to describe in conventional terms. This alludes to Gansera et al's report of six critical patients and the controversial debates that arose during their treatment.[1] It was published eFirst on June 2, 2015, together with four Invited Commentaries and received two more Letters-to-the-Editor thereafter. The Editor's original thoughts have been expressed in his Commentary already.[2] Therefore, in order not to be repetitive, here is the more general motivation to publish something like this:

Surgery is a highly individual and also highly personal medical discipline. A chaotic biological system which is heavily influenced by its social environment (commonly known as The Patient) is rendered even more chaotic by an unexpected disturbance (commonly known as The Disease) and then treated by another chaotic biological system which is also heavily influenced by its respective and totally different social environment (commonly known as The Doctor, here: Surgeon) in the form of a complicated sequence of mental decisions followed by complex manual courses of action (commonly known as The Operation). It is therefore not surprising that for the further development of such a system one cannot only rely on well-defined scientific laws and protocols but also has to take into account the most uncontrollable influences of all, oversimplifyingly called “social environment” above. For exactly that same reason, some readers will by now already be infuriated because human beings are described as “chaotic biological systems”—which is what they, purely physically thinking, are. Here the new format of article comes in. To increase insight and knowledge of problems which extend well beyond the basic medical facts, one needs opinions, lots of opinions, to help forming one's own. (This is, by the way, the main motivation of the serious world traveler.) Four commentaries built the platform and we were lucky to get another two so far. They are all very individual. The original authors have already prepared a preliminary reply to the opinions collected. It was the Editor's decision to withhold it for a while because our hope is to get some more letters after print publication now. In a way, this is a bit like a blog, but a reviewed one—which should theoretically guarantee a minimum of quality. Do feel free to voice your opinion: be it on the cases described, on the format as such and what to call it, or if you have a debatable subject yourself.

These are two innovations and there are more to come. Better keep watching this space and thank you for having done so all these years. Have a good 2016!

• References

• 1 Gansera LS, Eszlari E, Deutsch O, Eichinger WB, Gansera B. High-risk cardiac surgery in patients with intravenous drug abuse and/or active hepatitis C or HIV infection: an ethical discussion of six cases. Thorac Cardiovasc Surg 2015; 64: 2-14
• 2 Heinemann MK. Editor's Commentary. Thorac Cardiovasc Surg 2016; 64: 6