The Presidential Address of the International Brotherhood of Biliary Tract Workers

Ladies and gentlemen, it is now my pleasure to introduce our beloved president of the International Brotherhood of Biliary Tract Workers, our brother, President Anthony De La Torre. It is a high honor and a privilege to stand before you today as your president on the occasion of our 50th National Meeting. To all of our members, from those who simply drain the gallbladder, to those who descend into the depths of the common doubt, to those who hold their retractors, and to those who bypassed, to the laparoscopist and to the laparotomist, and yes, even to the the desolver and the pulverizer, I say thank you for your support. Brothers and sisters, I report to you today that our union is strong.

And what a year it has been. As biliary tract workers, our concerns are the concerns of all working Americans. career wages, good working conditions, and a pension plan consistent with our futures. But before I address the major issues of last year, let me tell you about a little girl I saw at her chapter meeting of the IBBTW Local 843 in Elyria, Ohio. Her dad had just begun working in the ducts.

He came home one day after retrieving a particularly nasty stone. It was his first time near the ampulla. And we all know what that is like. Daddy, the little girl said, why are you so tired? I was near the ampulla today, he responded, his face drawn and haggard.

Do you have to do this again? Daddy, the little girl said, yes dear. As long as there are bile duct stones, men and women will be expected to go down into those ducts and get them out. You see, honey, that's my job. I'm a biliary tract worker.

This meeting, a dedicated IVBTW brother had summed it all up. He had a burdensome workload, but he had the benefits that came from that hard work. This man and his family, due to our union, do not have to worry. The IBBTW is looking out for him and for that little girl in Ohio. Look at how this organization has helped its brothers and sisters over the last few years.

Look at what we've accomplished just last year. Number one, the Charcot House for biliary tract workers with bile abuse problems. The societal scourge of bile abuse has affected our union just as other drugs have affected the rest of the nation. We are particularly susceptible to its lure since we work around it every day. Let us never forget the overpowering attraction of clear, pure bile.

Work with it, suction it, but discard it. The black market in this valuable fluid has flourished. Bordeaux green has been our latest challenge. This French import, the result of all those heavy reduction sauces created by overpaid star chefs seems to have a particularly strong addictive potential. We have initiated the American Bile First program to eliminate this foreign competition.

I pledge to you that we will never outsource American biliary production. Number two, Luschka World, the home for retired biliary tract workers. What better place for a biliary tract worker to spend his golden years than at Luschka World? This beautiful facility, built at the base of the Bob's Quarry in Indiana, has a current census of 253 retired biliary tract workers. From the beautiful grounds, these retirees can look up and see stones, crevices and waterfalls, fitting reminders of their past careers.

Number three, Stricture House, the special facility for workers involved in ductal injuries. We all know the devastating effects of a ductile injury on a biliary tract worker. This retreat and rehabilitation area is up and running, thanks to the efforts of our dedicated brothers and sisters. Number four, the Mirizzi Home for the Laparoscopically Insane. The Mirizzi Home for the Laparoscopically Insane is a marvelous facility.

Mindful of the psychiatric effects of lengthy advanced laparoscopic cases, the Board recognized the need for intensive psychotherapeutic help for biliary tract workers involved in these long efforts. Staffed by a dedicated crew of psychiatrists, occupational therapists, and retired pharmaceutical representatives, this facility rehabilitates workers and returns them to the biliary workforce. All of these projects have been set up and maintained by the IBBTW pension fund, all for the benefit of biliary tract workers worldwide. Many of you remember the early days of this great union, forgiven old union war wars for reminiscing. We were there for the battle for better lighting. We want the line demanding better irrigation. We pushed through the Segura Initiative for better and safer retrieval baskets.

We've crawled on that duct. We've chiseled at that stone. While others talked and theorized, we descended into the Stygian depths of Biliary misery. We are truly the few, the proud, the International Brotherhood of Now the main issue that is trying to be in my part, and I refer of course to the impacted stone, we blast it, we chew it, we push it. The sweat of our collective union brown aims to remove it, and as your president, I can assure you that we will never give up this fight. The ERCP faction of our great union, that reactionary splinter group, was rightly stripped of its membership due to the courageous work of our board. They abandoned the basic goal of our union.

Their fate was sealed. They must live with their own vision of biliary work. I am glad that my late father is no longer here to see this abrogation of biliary responsibility. I would like to comment on the annual report of the Roux Committee. This committee now meets monthly, providing skilled expertise and counseling for our workers who have been involved in ductal accidents.

And I view these ductile accidents just as my colleagues in the United Mine Workers view their accidents. The comparisons are obvious: Mine workers are working deep in a hole with poor lighting. Ductile workers do the same. Mine workers work in teams, doctor workers also work in teams.

Mine workers must use drills, pulverizers, and explosives. Ductal workers do the same. Mine workers retrieve large chunks of rock, ductal workers also retrieve large chunks of rock. Mine workers bring a canary down the shaft, and when it dies they know they're running out of air. workers bring interns along and when the intern drops they know it's time to convert to an open case. Mine workers despite sophisticated geologic mapping may be misled and they may drill in the wrong location. Biliary workers, despite sophisticated cholangiography, and radiologists who probably majored in creative writing can be misled and can also wind up in the wrong location. Now you may have heard of some internal dissent on the Roo committee.

Yes, it is true that the anti-colics are warring with the retro-colics, but in the spirit of this union, we know that they will resolve their differences and will come to a fair, equitable, and isoperistaltic compromise, for through compromise results unobstructed bio-flow. Brothers and sisters of the The IVBTW today is a new day for biliary workers. Biliary workers have a bright future. The future is as bright as the light at the end of our laparoscopes. It is as bright as an operating room light. It is as bright as the flash of a laser beam on an impacted stone.

It is as bright as an argon beam glancing off the liver bed. And yes, it is as bright as the smile on a patient who says, thank you, doctor, may I have my stones. Now onto our greatest challenge, the issue for which we are reviled. That issue is our Waterloo, our Ductile Dunkirk, our Biliary Baton, our Gallipoli of Gaul, our sphincteric Stalingrad, a black and white memorial of our failure as a union. I refer, of course, to the retained common-duct stone.

Let me assure our members and the people of this great nation that the International Brotherhood of Blairite Tract Workers is doing everything possible to eliminate this problem. A basic design flaw in our work environment accounts for most of these stones. And yet, brothers and sisters, we press on, we irrigate, we film, we lavage, we gavage, we bake it, we Fogarty, we LaVeen, and Segura. On occasion, we macerate in horror. Still, we retain.

Eric Steinlauf, our union brother who has had so much experience with this problem, has worked with the board's public relations committee to explain to the American public how these stones can possibly be retained. Yet the public does not understand. But the public, brothers and sisters of the IBBTW, has never schlepped down a bile duct at 2 a.m.

The public has never had to grasp a rolling concretion with a flimsy wire as it is buffeted about by the erratic waves of pressurized air. and the public has never had to stand before a family in a surgical waiting room in wet sneakers. I say to the American people, form your stones, but if you should retain a stone, do not blame the hard-working members of the IBBTW. Put the blame where it belongs on the embryology of man. When the ectoderm migrated from the mesoderm, it took a left at the ampulla, angulating the lower end of the shaft in which we work.

It formed a hidden place, a sneaky, dishonest, nibbling cul-de-sac in which stones cower and hide. That, my brothers and sisters, is beyond anyone's control. And now a few words for our brothers and sisters in the IVPW, the International Brotherhood of pancreatic workers. As you know, over the years we've had an uneasy alliance with this group. We work on a conduit of digestion, just as they do. We share a common pathway and a common goal. But their responses have always been out of proportion to the injuries inflicted upon them. What Sonny was to the Godfather, the IBPW has been to the unions of America. Let me explain. We leave Bile.

They swell up and cause the entire organization to go into shock. They may change the color of our organization. They take away the life breath of our organization. We are somewhat slow and deliberative, but they have a hair trigger. We work with them, side by side, through inflammation and necrosis, through edema and liquefaction through poking and prodding, through catheterization and irrigation, sharing a common enemy, the impacted stone, and sharing a common exit, the impula of water.

Our similarities, though, are greater than our differences. These valiant, pancreatic workers, debrided, incangulated, pierced, and scanned, probed and aspirated, are our toughest comrades. They deserve our respect and cooperation. It is with pleasure that today I announce a new alliance between the IBBTW and the IBPW. It is the newly created IBBT-PW, the International Brotherhood of Biliary Tract, and pancreatic workers.

We will combine our unions and we'll work for a better biliodigestic future for all Americans. That future is our future. Our future decides the fate of the food of the world. From the lowest solitary grain to the medallion veal, from the matke to the loin of lamb, from the tortilla to the tenderloin, from the hummus to the ham hock, and from the kreplach to the kugel, from the manicotti to the marsala. Brothers and sisters, I will end my remarks with a short story.

Last Thursday, I visited our main office in Milwaukee, and I met with the board. We had lunch. The menu was a typical one for IVB TW workers. A Reuben sandwich, cheese blintzes, Philly cheesesteaks, and a side of Alfredo sauce followed by vanilla shakes in a buttered, low-fat cheese danish. A delightful platter of Gouda, Camembert, Stilton, and Valvida followed.

After lunch, I looked at those dedicated board members. None had abdominal pain. None belched. None was grabbing his upper abdomen. That picture of digestion, those satisfied postprandial faces, that is the essence of the IBBTW.

Brothers and sisters, it's been a privilege to serve as your president. Thank you, God bless you, and God bless the IBBT.