Opening Remarks: Richard Carmona, M.D., M.P.H., F.A.C.S., Surgeon General

Surgeon General's Workshop on Deep Vein Thrombosis

The Surgeon General of the United States, Vice Admiral Richard H. Carmona, M.D., was introduced by the Deputy Surgeon General, Rear Admiral Kenneth P. Moritsugu, M.D.

VADM Carmona commented that in the past he was a general vascular surgeon, subspecializing in trauma, burns, and critical care. In his practice of surgical critical care and the care of very sick patients, cases of deep vein thrombosis (DVT) and pulmonary embolism (PE) plagued him and his colleagues on an almost weekly basis. VADM Carmona observed that there were many cases in his career that confounded him, even though at the time he and his colleagues felt they were providing the best evidence-based practice.

He remembered one case in particular when he was a young attending surgeon of seeing a young boy "who had been at the wrong place at the wrong time" and had received multiple gunshot wounds. They had to resect his liver and fix his vena cava and heart. After about 3 weeks in the ICU, the boy went out to the floor and was doing exceptionally well, walking and eating. And the day he was discharged and being picked up by his mother, as he was walking out of the surgical floor, he collapsed with a huge saddle embolism and died.

VADM Carmona said DVT and PE are critical public health problems. The job of the Surgeon General, he explained, is to protect and advance the health, safety, and security of the nation, and that of the health care problems facing the country today, DVT and PE were among the most important and yet received so little attention. He appreciated that those at the workshop were willing to come together and offer their best ideas and thoughts as to how move the DVT agenda forward.

VADM Carmona asked those at the workshop to provide him with guidance regarding what messages he as Surgeon General needed to give to the American public about the problem of DVT and, he asked, what are the "next steps that we as professionals should take to move this agenda along." He concluded by saying that he looked forward to their recommendations and thanked them again for their participation in the workshop.