President's Column – September 2000 World Neurology

Rector Ion Pascu, University of Targu Mures, Romania, presents degree, Doctoris Honoris Causa, to WFN President Dr. James F. Toole, April 2000.

Continuing efforts by volunteers among our global membership have resulted in much progress in many areas of WFN interest. The reorganization of the Bye-Laws and Statutes, ably coordinated by First Vice President Kimura, has culminated in tentative approval by the 38 Delegates attending the WFN Council of Delegates meeting at San Diego in May 2000. However, we lacked a quorum, so that a final vote will be taken during the World Congress in 2001, in London.

A task force, chaired by Dr. Donna Bergen, has been commissioned for one year, to produce a strategic plan for future activities of the Research Group on Organization and Delivery of Neurological Services. The WFN Neuroethics Committee, chaired by Franz Gerstenbrand, is in formation. A mission statement has been produced and an agenda for activities is in preparation. Worldwide, there are fewer than 35,000 neurologists or less than one neurologist for every 200,000 people. Most neurologists reside in the more industrialised nations, leaving very large regions without help in this vital area. Dr. Matthew Menken and his co-workers, Ms. Mary Baker, Ms. Jill Fardell, Dr. Don Silberberg, Dr. Pavel Kalvach, and Dr. Johan Aarli, are working to publicise this unsatisfactory state of affairs and to remediate it. Their efforts need our support and those of you who would like to help in this effort may communicate directly.

In March, Mrs. Toole and I travelled to Israel for a medical/archaeological/ religious pilgrimage. During this time, I met extensively with members of the neurological community, particularly Drs. Amos Korczyn, Oded Abramsky, Natan Bornstein, and Vladimir Berginer, for planning future WFN and International Stroke Society activities.

I attended the American Osler Society, of which Past WFN President Lord John Walton and Dr. T. Jock Murray are members. The Oslerian tradition of bedside teaching of medicine and medical history survives in this group but is threatened by technological and scientific medicine which is replacing the interview and examination of patients in some fields of medicine. In my opinion, we neurologists must maintain traditional ways of examining the nervous system, making diagnoses based upon observation, and using imaging for augmenting but not replacing the proven methods for elicitation of history and physical findings. Senior neurologists trained in these techniques must continue to teach the necessity for correlation of symptoms and signs of nervous system disorder with ultrasound, CCT, and MR images, and not delegate our responsibility to others.

Mrs. Toole and I attended the European Stroke Congress, originally conceived and organized by Michael Hennerici and Julien Bogousslavsky. On this occasion, Professor Franz Aichner of Wagner-Jauregg University was the organiser of the XI Congress in Vienna, Austria. The meeting was outstanding with faculty who considered not only advances in stroke diagnosis and management but who also taught courses to bring the nearly 2,000 attendees up-to-date on new methods for diagnosis, intervention, and long term management. Thereafter, the EFNS sponsored a continuing education course in Targu Mures, Romania, organized jointly by Laszlo Csiba of Debrecen, Hungary and Ion Pascu of Targu Mures, Romania. These gentlemen coordinated a very complex activity, transporting F. Mechler, P. Dioszeghy, A. Alexandrov, R. Ackerstaff, F. Gerstenbrand, K-A Hossmann, Z. Nagy, P. Kalvach, L. Vecsey, H. Clonczowska, I. Szirmai, W. Gruninger, and D. Bereczki, where they interacted with approximately 150 neurologists from Moldova, Serbia, Ukraine, Hungary, Romania, Austria, and Bulgaria. This first such meeting was so successful that it can serve as a model for future teaching courses both for the EFNS and the WFN (see photograph below).

In order to gather funds with which to underwrite WFN activities, the Management Committee has formed a research and education foundation. This vehicle is designed for fundraising with which to continue the projects outlined above and others which we prioritize as being of immediate importance.

Dr. James F. Toole (standing in the centre) along with the delegates who attended the EFNS-sponsored Continuing Education Course in Targu Mures, Romania.