My grandparents had beach cottages at Nags Head, on the Outer Banks of North Carolina. We went there almost every summer while I was growing up. Mostly, I remember playing in the surf and watching the adults play long, spirited games of Monopoly. There was always a trip up the beach to Kill Devil Hills where the obelisk of the Wright Brothers Memorial sits atop a small dune, and to the museum with tools and models of their early planes, which they tested in the winds off the ocean.
When the historian David McCullough published a biography of the brothers this year (The Wright Brothers), I quickly bought a copy. The first part is a detailed reconstruction of their time growing up in Dayton, Ohio, their growing obsession with flight, and the detailed mechanical and mathematical studies they undertook to achieve manned flight. They learned from others, discovered crucial mistakes, redid the work, built a small wind tunnel in their bicycle shop to test their ideas, and dragged prototypes via rail to Kitty Hawk to test them in real conditions. Eventually, they met success. [Many of you will remember a wonderful reception at the-Wright Patterson Air Force Base Museum at the 2008 ABC Summer Meeting in Dayton.]
The relevance for us is the success they were able to pull from the chaos of current knowledge. Many were working on the problem of manned flight, but the Wrights turned out to be the best at figuring out what was wrong and needed to be fixed, and at devising workable solutions.
Today feels chaotic in transfusion medicine. We are talking simultaneously about five- or seven-day platelets, pathogen reduction, platelet additive solutions, point-of-release testing, buffy coat platelets, statistical process control, etc. There is a variety of plasma products – FFP, PF24, PF24RT24, thawed plasma, liquid plasma, AB plasma, low-titer A plasma. Everyone apparently needs O negative red blood cells, and are debating over young or old ones. (There are five articles on red cell storage changes in the current issue ofTransfusionbut still no large clinical studies showing the inferiority of older cells.)
As collectors and guardians of our indispensable resource, we will have to sort it all out, moving toward solutions guided by science, good medicine, regulations, finance (see a recent Transfusion article by Brian Custer and colleagues on health economics and risk-based decision-making), and experience. This experience, reflected in our data, will be our Kill Devil Hills. The dunes are all taken.
Susan Rossmann, MD, PhD, Board President, firstname.lastname@example.org