American Society of Nephrology Presidential Address 2005.

“S cience is the most communal of endeavors,” wrote the late and eloquent Dr. Lewis Thomas, who was one of my esteemed professors at New York University Medical School in the 1960s. In a Foreign Affairs monograph, Dr. Thomas described how the building blocks of physics and biology in this century had been put together one piece at a time, by men and women whose identities have been forgotten. Men and women who made the greatest medical breakthroughs will have their names forever associated with their discoveries. In the same monograph, Dr. Thomas noted that “while few giants were gifted in being able to figure out where the key pieces would fit, the pieces themselves came from other minds and hands.” As I look around this large hall and see thousands of investigators, clinicians, and trainees in nephrology, I see an excellent example of precisely the kind of scientific communalism Lewis Thomas prized so highly. During my 35-yr career in medicine, I have become well acquainted with the joy and challenges of working with individual scientists to fit together pieces of our own complex puzzle. As American Society of Nephrology (ASN) president, however, I have been afforded the opportunity to piece together much larger puzzles on the broad, organizational level as well. Let me describe one of my fondest memories from my past year in office, which illustrates the potential of the communal endeavor. One cold day last winter, I met with Dr. Elizabeth Nabel, Director of the Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health’s (NIH’s) headquarters in Bethesda. There were others at that meeting, and Dr. Nabel looked around the conference room and posed a simple question that resonates with me still: “Who is at the table?” she asked. Who was at the table (Figure 1A)? Aside from myself as the representative of the ASN, I brought the president of the National Kidney Foundation, the president of the American Society of Transplantation, and the president of the American Society of Pediatric Nephrology. We had come to raise, in a single voice, an issue that the ASN has for several years deemed one of the most serious public health crises emerging in our time: The link between cardiovascular disease and kidney disease. That day, those at the table spoke of the urgent need for congressionally funded research to study this connection between cardiovascular disease and kidney disease and to make concerted efforts to raise public awareness. This concern, expressed in unanimity, impressed Dr. Nabel to the extent that she quickly agreed to establish a collaborative effort with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which in turn led us to prepare a request to Congress for appropriations. It was, to be certain, just an early step in bringing the matter to Congress’s attention as much more work needs to be done. Our organizations’ collegiality and the clarity of our shared goal made a powerful impression on NIH. Rather than display divisiveness and conduct the sort of territorial warfare that can politicize medical progress and confuse priorities, we all expressed our commitment to finding better ways to treat the silent killer that is kidney disease, and that has, in some populations, reached epidemic levels. The essential communalism in science, engaging each of our organizations’ unique strengths, is what it will take to move the pervasiveness of renal diseases to the forefront of public awareness, as has previously been done with high BP, stroke, and heart disease. And while the congressional initiative we asked for will progress slowly, the ASN is collaborating in a new way with the American Heart Association (AHA; Figure 1B). The ASN and the Kidney Council of the AHA are holding identical sessions on the cardiovascular-renal nexus, at the respective annual meetings of each. This is the first time in our history and theirs that identical sessions on a topic of mutual concern are being held at our most significant yearly gatherings. This kind of transspecialty collaboration comprises the “other minds, other hands” Dr. Lewis Thomas praised. I ask you to think of this ASN Annual Meeting as one enormous table, which we come to for the exchange of ideas and for discussions on discoveries that will advance our knowledge and practice of nephrology. This is what our society’s founders had hoped the ASN would do. I have little doubt that they would be enormously proud to witness the quality and quantity of science being shared during Renal Week 2005. The meeting we set before you this week, however, is largely the work of my invaluable associate Dr. Mo Sayegh, Program Committee chair, and a most distinguished panel of ASN members (Table 1). This year’s, American Society of Nephrology Program Committee has assembled a record 56 symposia in a full array of leading-edge topics in both the basic and clinical Published online ahead of print. Publication date available at www.jasn.org.