A Welcoming Rose

The merger with Yolo County is an opportunity to think about the name of our magazine, how it has evolved under different editors, and what it means to our readers.

A three-county medical community gets stronger and richer by unifying its efforts and diversifying its views. It will have a new name to signify its regional reach, but it will take lots more than a new name to keep the collegiality that characterized YCMS while welcoming the physicians who never felt included.

One path to inclusion and respect for diverse experience and interest is the organization's publication. Does Sacramento Medicine need a new name?

What's in a name? True, a rose by any other name would smell as sweet. Yet, the name itself evokes the essence. The name Sacramento Medicine evokes a tradition, a history and a character that has grown over the years, and a personality that has reflected each editor and Editorial Committee.

Richard Johnson edited Sacramento Medicine armed with an intimate and influential knowledge of local and CMA politics, and a ceaseless devotion to his patients and his colleagues. He forthrightly advocated for the practice of his day and vigorously protected the medical community from alien assaults.

Nevertheless, he candidly criticized the faults he saw in medical practice. He embraced private and government efforts to serve poor, elderly and mentally ill people, but lambasted petty bureaucrats, wherever he found them, who encroached on professional judgment. He blasted the engineers of the malpractice crisis for damaging health care and demanded the major tort reforms that eventually happened. Meanwhile, he nudged doctors to use better judgment in their relationships with patients.

When Del Meyer succeeded Dick Johnson, Del maintained close, if challenging, contact with the SEDMS Board and developed ties to CMA publications. He promoted Sacramento Medicine as a forum to help a fragmenting medical society overcome its differences by debating them.

He hoped the debate, served on a bed of shared values, would overcome the cynicism that was weakening medical society effectiveness-and making our country one of the least participatory democracies in the world.

To restore our sense of community, Del Meyer introduced a monthly focus meant to transcend our daily practice: women in medicine, academic medicine, geriatrics, pediatrics, mental health and public health, for instance. He devoted space to the arts and culture, books and tapes of medical interest, other medical societies' publications, the synapse between electronic communications and medicine. He extended our reach and fostered-even provoked-debate about the revolution in health care delivery. The debate sometimes became acrimonious, but it also located the core of medical values.

Jack Ostrich, who followed Del Meyer as editor, helped us laugh at ourselves. In the midst of our grief at losing our social and economic identities, our autonomy and self-respect, he offered a less doleful perspective while protesting the assaults on our profession. To help us smell the flowers, he continued the reflections that began on the Meyer watch and invited-but did not get-more fiction and poetry.

Each editor has exerted a lasting personal influence. Through it all, Sacramento Medicine has continued to try to inform, debate, entertain and unite.

Its reputation for well-written articles of, by and for its members has grown-even as rancorous rivalry has gnawed away at the cooperative competitiveness that had advanced our science, improved our art and strengthened our profession.

To hold the line on dues, the Society reduced many of its costs. That included cutting Sacramento Medicine from eleven issues a year to six. On Friday, fax, e-mail and internet could better deliver the instant information needed by members.

With or without a new name, Sacramento Medicine will continue to try to hear and reflect the diverse interests of an expanded membership living and working in a larger geographic area. Whatever its name, Sacramento Medicine will try to convey the richness of the cultures, practices, personalities and politics of its members while fostering community-building debate. It will try to enrich the instant information that cyberspace can deliver.

This year Sacramento Medicine has emphasized the local scene and physicians' successes and played down the ambient storms and daily frustrations. We have illuminated the debate on timely local health problems, such as STDs, medical errors, mental illness and drug dependence. We have shared our views of the local arts, books and tapes, and reflections on what is, what was and what might be.

In this issue, Sacramento Medicine opens a debate about long-term ethical implications of a local political decision that our medical society has strongly supported for years: enriching a public water supply to improve health.

When our Editorial Committee discussed this subject it created an unexpected stir. We decided to delay publication until we could get a balance of views in the same issue. We had to choose between timeliness and fairness and we chose fairness.

What we learned, though, is that those who differ are reluctant to reveal their differences lest they reveal schisms in our ranks that will whet the appetites of the sharks surrounding us. Alas, such voluntary stifling of debate is exactly what weakens us by depriving us of fair debate.

As we prepare for next year, some contend we have moved too far from timeliness and from "the trenches." (Is our partiality to military metaphors an evidence of our "violent culture?") Some say Sacramento Medicine has become "irrelevant"-a stylish presentation of "pap"! Others praise our candor, as in our roundtable on medical errors, and our attention to community health problems. Some commend and others condemn our literate ruminations and reflections.

More important than what we call ourselves is what we are.

What do you think? As always, we will only print what you give us permission to print, but we will take it all to heart.

Ed_Rudin@macnexus.org