Surgery senses the joy of nature and sciences

Dear reader,

thanks for allowing your beautiful eyes to scan these pages and to offer yourself an actual taste of this new issue of European Surgery. It all comes from the heart. It all dances to you via the senses of your tune tempered atmosphere and presents a rondo lined beautiful spectrum of themes and topics around the clock of general surgery, minimally invasive surgery and modern multi—disciplinary disease management. As a river runs, fruitful medicine roots within the well tempered soil of knowledge. Let us continue our path and find our future in 2023. Let us protect our values.

What have we achieved so far? Even today we are allowed to state that myth telling and surgery, story telling and science, publishing and medicine, affection and love translate images into treatable signs. As such we aim to handle the world (image), understand our environment (signs) and hope to watch out for a fruitful prosperity of our future. Let us drink the fruit of the clouds and eat the givings of the soil. Let us follow the swing of the birds. May caring eyes open up the horizons. As such we translate energy into life, motivation and joy. Here surgery becomes medicine and medicine becomes art. Within and aside clinical studies, life style finds the attention it needs to foster health and wellbeing. Nutrition makes us happy or sad, positive or sick. Selection counts. Please care about the selection of the foods and beverages you are going to run, flush and introduce into your body. Watch out for the fish in the sea. All fish dance within the pluripotent ocean of information. Where is that?

Ocean of information

The waves of the ocean know it all (Fig. 1). We aim to listen to the waves, to the sound of their hides and the tune of the air, which they are fostered to care and carry around (Figs. 1, 2, 3 and 4). We aim to trust the waves. The waves are around us all the time and tune and temper our modern life and orchestrate our decisions on a daily basis. This is the reason why European Surgery cares about the waves and aims to bring them to your attention. Listen to the score of novel physics and quantum theories. They even work for your high volume high end surgeries. Whatever you cut and resect follows a distinct orientation of a given quantum field fluctuation.

Fig. 1

This wild life optical biopsy cartoons the idea of the author that any perception equals the translation of an actual atmosphere, which decides on how and why we deliver any focus of interest. Immune staining has not been applied

Fig. 2

This optical biopsy cartoons the idea of the author, that we are the manifestations (i.e. boats) of the universal cosmic field, as outlined within the text. Image obtained at sea level

Fig. 3

This sea level optical biopsy cartoons the idea of the author, that life always aims to outbalance fascinating interests between conflicting states of affair (dualities), such as water (sea) and beach (land), as outlined in the text

Fig. 4

This optical biopsy cartoons the idea of the author, that differences motivate tensions. Art (medicine, surgery, story telling, musics etc.) aims to outbalance and harmonise these imbalances in order to foster health, wellbeing and joy, as outlined in the text

We all are part of the universal cosmic field, which waves and turns and tables and runs and fluids and tears and rocks and funs and brights out light of a majestical sound of force, power and thunder. The universal field takes, carries and transforms energies, and it does this continuously. Therefore the cosmos represents a continuous process of change, fuse and novelty. Gravitation formats the geometry of our fields, and it waves out in the form of our perceptions (Figs. 1, 2 and 3). The eye harbours the retina of our galaxies. Why? To observe the cyclic changes of energetic manifestations. The universe continuously translates one form of energy into an other, and we are allowed to be a good part of it. What a joy! What a decision! What a fruitful experience!

Going in line with our recent editorials, “It all is one” and the “All is one in all” equals the quantum corner stone of our house. Will for difference forces expansions and this drives the change, which in turn motivates life, nature and sciences.

As far as we can measure and tell, it all expands from one cell to many cells, from one single mutation to a great tumour, from one single quantum change up to the large scale hunter/gatherer race/competition of all life and all the moons, stars and galaxies around us. We are all made up out of this idea, this is why European Surgery cares about it. As such nature may note that we exist.

Going in line with modern science the story came across with new and novel terms to describe these fascinating phenomena. As such we read: it all is one (Heraclitus, Parmenides), one single energetic field (Schrödinger, Dirac, Wheeler, Feynman), entangled and waving and dancing around (Higgs, Zeilinger).

Depending on the technology to observe it and bring it to your perception, this single energetic field translates into the swinging and dancing playground of electromagnetism, space time, and strong and weak nuclear power (Bohr, Einstein, Heisenberg, Dirac, Schrödinger, Fermi, Pauli, Higgs, Rovelli, Zeilinger et al.). This helps to understand why we are around. We are around to transform information, to receive and send out information. Life and nature equals energy and translates into information. Even those who translate information are and equal forms of information. Nothing exists without reason. Any perception harbours information. This is why European Surgery wants to open your eyes for this fascinating and outstanding matter of fact. You and your surgery transform energy into information. This information may be red by others and as such evolves the great and beautiful knowledge of our times and sciences. Even the histopathology of a disease carries the information for its successful treatment. Ask the pathologist, she or he will tell you what it is about. Listen to their valuable words.

Ocean of positivity

There is a clear and strong forward reason, why you exist. You are out there to read the score, sense the energy and translate it into treatable signs. Let me tell you why you are around, as a surgeon, as a member of the faculty board, as a reviewer, as a member of the editorial board, as an author, writer, singer, teacher, educator, assistant, nurse, police man, lawyer, team player, editor, autistic song writer, as a part of this exciting story of medical sciences.

Your purpose is to spread out positivity, release joy and happiness: to spread out motivation and beauty in order to continue the story. Let your sun shine. Speak it out now: we are not the lobsters to be taken away and eaten up. We are the clouds for positive sunshine and rain of happiness. Let it shine for you and for those to whom it may concern. Allow joy! Enjoy! Rain drops and tears carry the beauty of a large spectrum of colours and possibilities.

And these energetic fields transform and transduce force and power into the form of energetic outbursts, tensions, particles, quanta and sensations. It all depends on the form of device you choose to translate the energy into your perception (light, noise, motion etc.). It verily seems that gravitation equals the paper on which electromagnetism writes the score. The light reads out the score of the universe and as such does man with CT, MRI, PET scan, robots and so forth. Conductors and players, hunter and gatherers, active and passive we are, as such we act, carry and exist. Why is that so? That is life.

At the end of the day the wise man closes the book of physics and lays back to watch the sunset and allow phantasy to rock his soul (Fig. 1). As such man creates the atmosphere to orchestrate and invent new touching concepts for a better understanding of the world (Fig. 2). As such surgery develops new strategies and ways to manage diseases. As such you and many other readers contribute to design the medicine, the surgery of the future. European Surgery aims to serve as the platform for the translation of these new concepts and strategies for the multidisciplinary diagnosis, treatment and follow up of diseases. This is why editorials published in European Surgery worry about these topics and themes. We have to care for the future of our minds. We have to open the eyes for limits, borders and tensions (Fig. 3).

Trust the waves (Fig. 4). They carry the memories of falling rains and fruitful sunshines (Figs. 1 and 4). Trust the way of your space time, trust the waves of your electromagnetic environment. These waves help you a lot. Without these waves you could not read these lines, you could not have have emotions and translate them into success, joy and happiness.

As drops we start, as rivers we learn to run, as ocean wide cosmic ideas we nourish the understanding of our science (Figs. 1, 2, 3 and 4). The liver harbours the roots of the biliary tree. Bile giving are the fruits of the hepatocytes. As such general surgery takes care about the thyroid within the retroperitoneal spacetime curving. Reach stents for rent teaches the pancreas. Guide wire men at work to eradicate the abdominal burn.

Robots invented turn tables without a needle. We do not need needles anymore, we cut and read out with the laser. Follow the cup and fit the soil sized memory at the end. Why? Oncology owns the masks of the show. As thus the story goes. Early staged cancer fosters better and longer disease free survival (p < 0.001). May artificial intelligence feed the robots for improved and more accurate diagnosis and cancer management. When our work is done we will spread our wings and fly home. Where is that?

Ocean of joy

Figure 1 depicts, what a man sees, when he watches the sun set within the dimensions of a fruitful horizon. Man hunts photons and gathers informations.

The man watching the sun speaks to the sun: Hey sun, do you remember me? As thus speaks the sun: How could I forget you, the funny guy who cuts and resects it all and eats up my photons.

The man replies showing good will: you warm up and close the space, you offer time and shut down winds, gaps, clouds and deserts, you create oceans, seas, rivers, mountains and thoughts. You foster life, as such we are allowed to treat and handle it. We owe you a lot.

Mindful the sun speaks: man made you are. In ion—contrast to that I am different. I am more fluently spoken a thought of your mind. Translations you are down there on earth, but do not make me a translation, let me be what I am. I am what I am. Continue to listen and learn, take care. Mirror my photon—rich manifestations.

The man sings: the beauty of the globe is delivered and given by you, the joy of the day is waving through you. There would be no beauty of sciences, no night shifts without you.

The sun mingles and minds: See man, shadows come and go, but much longer do I continuously have to shine, I do not know day and night, work and rest; I even do not know work/life balance. I simply shine for you and all others around, irrespective if and what they mind. And at the end I may blow up as a black hole, white hole and sow the future of novel suns and planets to come. As such I will carry you to the end of the universe. Holes always fix the plot. I simply smile, but you may not see it.

Here the man responds: I now hold you in my hands and bring you to the protection of my chest and guide you to my heart.

The sun states: Now dear man you start to understand: we are all brothers and sisters and beings and plants and diamond galaxies in mind; fruitful spirits of cosmic laughter; you and me and all around us. We all belong together. We are a big family. We are all the remembrance of a wonderful idea. Beautiful it is as it is, we just have to read the score, sense the lines and play the tune as it comes. How should I forget you? How should I leave you without a purpose. You aim to listen, learn and give it to all around you. Let them teach you. Let them guide you. As such I guide you and your brother and sister planets and your moons. As such I am guided by the great large hole in the middle of our galaxy. Where is that? In the middle of your actual thought and model of understanding?

There is one great possibility, continues the sun: Teach them humility, thankfulness and stay off greed, envy and hate. You are all beautiful people. Do not let others think for you. Resist bad habits inducing pride, self esteem and ignorance. Orchestrate your harmonic life. If you will not forget me, I will not forget you. No space waves without moons, stars and cosmic material. Stay tuned my son and let me watch out for your sisters and brothers on the other side of your planet.

There is an other possibility: go out for war, confrontation and destruction. But this will offer you pain, blood, sweat, tears, sorrows and crime. Therefore I would not recommend to take this way. This is not the way you should go. But it is up to you. Make up your mind. Before you decide please read the beauty of nature (Figs. 1, 2, 3 and 4). The cosmos knows: emergencies take many billions of years to come and go.

With these words the sun closes the speech and sets the day within the particular spacetime evolvement of actual electromagnetism. No more calculations are to be done for the moment.

Beloved wave yards of surgery

Then man watches the sun setting down over the sea (Fig. 1), clearing the heavens and preparing the skies for her brothers and sisters, the moon, the stars, and the zodiacs. Cosmic clouds of the milky way aim to claim to clean the vail from your eyes. Man is happy to be a surgeon and walks back home to meet his family, friends and to prepare new adventures and studies to come. Meals drive the digestion, data resist corruption, values argue motivations, calculations foster Higgs, hurry and particles. Get a paramount espresso CLE (central) before continue reading. Luigi borrows perfectly designed fermions to handle the LINX system around an Italian gullet tube against food induced gastro oesophageal reflux in Milano. Will for fashion, will for design matter and count. Taken together, suture to please and fit into memory.

Motivation is the order of the day. Illusions count and are necessary for a better understanding of the world: spacetime and electromagnetic phenomena translate into interwoven forms of energies (CT, MRI, ultrasound, physical tests, cardiogram, sound of burb and bowel movements). They help to explain the slices we are allowed (!!) to take. Contrast media run tubes, pumps and origins. Explode your lab and name it Tesla. Bell grade connection. Sounds great! Offers distinct diagnosis from brain to the toes, from liver to lung. PET the scan and you know it all. Almost.

Skies are clearing, while others hide. Emotions cook the pride of the winds. Openly spoken we search for a way to be happy and fine. What defines success, joy, happiness, satisfaction? What is joy? Something that does not hurt? A reality which pleases us, because it does not produce the sensation of pain? Joy driven excitements we are. From time to space, from quantum nourishing swings to better translations. Teamwork works. Leadership is essential. Great leaders are out there to be taken care of. Treat, nourish and orchestrate your teams with respect! Offer tolerance! Allow understanding, looking behind the scenes. Watch out for the beauty of our globe. Be beautiful. Allow passion. Passion is the given spacetime of the universe. And then we have these three types of holes: black, white and ….?! They are out there in every collection of rotating galaxies, stars and people (institution, university, government, team and so forth). Why is that so? Because these are the qualities of cosmic and human character, behaviour and action. How to get around with it? Balance out, harmonise and you will be the leader of a great successful team.

Do not stop to talk and communicate with each other. We are all connected, irrespective if we are aware of it or not. We are all continuously interwoven, because we are all within this fantastic cosmic field. Ideas nourish a better understanding of the beautiful world.

Why should this be of interest for a reader of European Surgery? Because the readers of European Surgery care about the essence of any perception. And what would be the essence of any perception? The essence of any perception is you and your actual state of atmosphere which translates your world into emotions and thoughts and decides on your actual selections and interests. Finally it all is the energy held together and rotates within the playgrounds of the fields described by physics and quantum theories. Get your guitar, play the violin and tune the strings and let them swing. Peter sky cough skiing within the rivers of BACH.

History is no mystery, if you are allowed (!!) to read the waves, if you are selected to watch out for the waves. So we should never take it for granted. Future and past are the secretions of our phantasy. We all arise upon the shoulders of our strong teachers. As such happens the development of a new theory of life, nature and beyond. Let us try to do so. Walk along the beach and listen to the waves as they mingle within the lines of your consciousness. Here we go.

If you can not find a beach, take the street of the city you are living in, or cross the side walk to meet a friend, a real friend. Here we are not talking about this superficial guy asking you: how are you? What else should you answer except: fine?! Only a friend knows your secrets. Black holes evaporate the images of their future. Spacetime expands polarity across the wave yard of our model based understanding of the segmented universe.

Reality develops within extremes. Desires carry the emotions of our future. Polarity counts and orchestrates the phenomena.

Duality of surgical science

Two extreme mind sets of confidence may describe the mutual existence of our life as surgeons, physicians, cosmic translators (artists) and lively beings.

The principle of duality models the world. Episodes form emotional fields within the two extreme poles of our understanding. Fields connect dualities to form and to describes a connective multitude. Multidisciplinary goes life.

One side of the tune models humility, peace and will for outbalanced harmony.

The other side of the tune describes hate, greed, hunger, fate, will for power and change.

Successful cost benefit calculation should outbalance these two extremes.

Between these two extremes happens life and may be remembered as history. Between these two extreme poles you recognise, you conduct your beautiful surgeries, assess your diagnosis and therapies intermingled between the interests of a boss, some industry driven interests and within the facts and matters coined by your colleagues, your beloved (!!!) colleagues. Carry on to survive. Feed the web. Pub the med. Simply be as you are. Shine! Do not hide your positivity!

While only a few individuals exist who are out there to teach and live outbalanced harmony, other hectic stressed outraging personalities carry the masks of others and slender the snow from the mountains down to city and into the bright artificial shine within the operation theatre. Assistant and nurse shiver and are afraid of mutual threatening emotional outbursts.

However, those actors are mandatory and create facts which are necessary and required to change the world, to foster success and to alter the conduct of reasoning and to push forward a new and novel mind set. It may be ancient but it shines as new novel aspects. We also have to repeat ourselves. The quiet and the loud, the planter and the cutter, the hunter and the gatherer, the giver and the taker, the shy and the prominent, they are out there to follow their determination. These are the characters and the qualities of life, nature and publication.

As such these characters may in fact induce and cause revolutions. Conceptually the term revolution describes moments turning/flying something back to the roots, to the very beginning, as it has been before at the very start: latin = revolare = flying/turning back.

Every single idea relies on the big bang of the universe. Even your actual idea, dear reader, relies on the big bang of the universe. As such we are all universally connected and formatted. Even your surgeries, your cases of the day: thyroid, stomach, liver, pancreas, large and small bowel, brain, paste, immune, roots, coils, stents, pushing in, out and back, ovaries, uterus, prostate, cosmos inflamed due to rapid galaxy cell cycle turn over and nerve cell mediated fuse of the muse.

So let them play the tune, let them feed the turn table. Galaxies are high speed turn tables, too. They are the turn tables of cosmic dust. Out of this dust originated our world, our existence. Any tumour that you resect, any liver that you transplant is made out of the cosmic dust generated by the cosmic turn tables all around space and time and powers of delight (!).

From Tis to T4, from N0 to any Nx, from M0 to any Mx you may consider, you may ask: which tumour is allowed to grow out of the margins of our universe? Stupidity? Ignorance? Both?

Which therapeutic phantasy is required to imagine the final cut of our ultimate R0 resection. Solid it seems, confluent it shines and again we recall our man talking to the sun. Light transports energies from one single matter (the sun) to an other (man) in order to carry information which takes 8 min to flow (Fig. 5). Take a pause, allow a break from your surgeries, for the twinkled opening and closing of your eye. May Fig. 5 foster positive remembrances of peace, love, happiness and joy.

Fig. 5

This image cartoons the idea of the author that spacetime and electromagnetism are the manifestations of cosmic energy. As such the photons follow the distinct geometrical field orientation of space time curving and electromagnetism to collect, transform and propagate quantum based entangled impulses of energy to interact with the retina of the observer (man, pathologist, physicist, reader, writer, etc.). As such appear world, life, nature and joy. May your surgery be a strong and positive part of it. Image obtained at sea level. Immune staining has not been applied

To an open minded surgeon, Fig. 1–5 teach the following treatable signs: let us enjoy the fact that it all is one, at least for the moment of this actual reading pause. No more envy, no more competitors, no more discriminating conflicts of war, may there all be harmony. At least for this little tiny moment. And then you may go out of the hut, welcome the day and do what atmosphere tells you to do. Carry on and be good, great and motivated. Clouds and shadows mingle with the positive light. Secrets hide what the universe knows. Duality is the basic rhythm of our perception (melody!!). Up and down, in and out and so forth. Relativity teaches invariance (Parmenides, Heraclitus, Einstein).

We have to respect those strong young women and men who aim to outbalance life and work for the benefit of their life quality and well being. A new and novel generation of leaders is at work to nourish life with positive energies and motivations. Get yourself together and respect what they do. Get yourself together and resist, if you think that they got it wrong. Go out to proof your theories. We all are at turn to foster the exciting future of our planet and our medicine. Think, live and act positive. Allow the revolution back to YOUR roots. Where are they? Africa? Solar dust? Milky way? Galaxy? Big bang? The actual present opening of an eye? The FIRST supper? Yes! Why?

We will get to this topic later this year 2023. Where? In Milano. Why? There will happen the next congress of the European Foregut Society (EFS) in the first week, November 2023. The team around Prof. Dr. Luigi Bonavina (president) and Prof. Dr. Sebastian Schoppmann (general secretary) will put together a fascinating and colourful “First Supper” of scientific news, motivations, novelties and attractions. More details and news will come to follow within the next issues of European Surgery. Why? We even care about the tube! Got it? Pronto!!! Da Vinci not only describes a robot! Pasta!!!

We also talk about the Magic Flute. Why? The upcoming congress of the Austrian Society of Surgery and the Austrian Society of Vascular Surgery will be held in Salzburg, June 14–16, 2023. Prof. Dr. Afshin Assadian (president), Prof. Dr. Albert Tuchmann (general secretary) and their team aim to orchestrate a fascinating and highly motivating multidisciplinary scientific Gesamtkunstwerk. More information is going to follow in the upcoming issue of European Surgery. Looking forward seeing you there. Do not forget to bring good ideas, posters and presentations. Finally, do not hesitate to offer joy, fun and happiness.

Exchanges happen, aspects twitter and translations we are. We will soon be the clients and the patients of those to whom we have to trust. It is all about the young surgeons! Did we adequately teach them? Did we foster enough education? Where are we going to be to abandon stupidity, uncritical reasoning and ignorance? Who is out there resisting uncritical group think and logistic regression (p < 0.001)? Who knows love? Who manages the fire? Only birds have their wings to escape. May that be true? Would you love to be a bird? Then fly and teach them how to outbalance conflicts between opposing interests. As such you will become a wanted, respected and delighted leader.

Ocean of clarity

Taken together, the world is beautiful as it shines. It is full of beautiful people and possibilities. Keep it calm, even as a market place. Our minds are allowed to be full of peace, love, happiness and joy. Positive thinking is the message of the day. Leaving out envy, hate and greed is the order of the day. Do not hide your smile! Let it out! Going in line with cardiac surgery: open your heart. No day without a smile! Respect!

War takes it all, peace offers the full spectrum possibilities of the beauty of life, even when you consider it in terms of an economical business model! And nowadays all is valued as a business model, even you, your medicine, your institution, your life! Any life serves the market place. This is the new form of slavery. As such it happens to cross our minds. History matters.

Verse

Verse From corn to rice we payed the price, from man to mind, of any kind, not in vain, sugar cane, took the boots, cut the roots, google way, hard to say, easy play, of the day, copy paste, all the waste, fly the sky, cry to try, find the hill, and the mill, greed the goal, envy the soul, hate your heart, taken apart, human story, lacks the glory of a breast fed baby’s tear.

As the zodiacs connect the dawns, let our eyes follow the beautiful colourful rays of the setting sun (Figs. 1 and 5), let our hearts unite and follow our desires, let our souls capture the positive vibrations of the globe (Figs. 2, 3 and 4). Take care. Watch out. Mind the gap. You are the mirror of the universe. It all watches you, looks out for you. Any disease harbours the capsule of its therapy. Be you and enjoy the new episode of your life. Protect your 2023. Thanks for reading those lines and supporting our project.

Sincerely, Martin Riegler.