RT Journal A1 Friedmann P T1 THe arduousness of excellence JF Archives of Surgery JO Archives of Surgery YR 1998 FD April 1 VO 133 IS 4 SP 354 OP 360 DO 10.1001/archsurg.133.4.354 UL http://dx.doi.org/10.1001/archsurg.133.4.354 AB I sometimes wonder what my life might have been like if I had grown up in Austria and if the cataclysmic events of the second World War had not taken place. Would I have become a surgeon and somehow followed in the footsteps of Theodor Billroth and Anton von Eiselsberg in the great tradition of Austrian surgery? That was not to be. In the aftermath of the Anschluss in 1938, 78% of the Vienna medical faculty were dismissed from their posts, and the university there was destroyed as a center of medical education and excellence.1 This and similar events in Germany prompted Abraham Flexner2 to write, "The love of knowledge has been subordinated to thievery and murder and shortsighted political eminence. A more catastrophic or volcanic overthrow is not recorded in human history." For my family, survival in Austria was highly problematic, and it would have been very easy to end up in Theresienstadt, as my grandfather did, or Auschwitz. Escape was arduous but ultimately successful, and the United States provided not only a home but the opportunities for education and a career. I am very grateful to this country for what it has done for me and countless others like me, who have sought refuge from ignorance and hate, from thievery, tyranny, and murder, and from man's continuing inhumanity to man.