Highlights of the 2013 Clinical Congress

Slide 1

Mr. McCullough delivering the Martin Memorial Lecture

Slide 2

Members of the Young Fellows Association Governing Council meet

Slide 3

Dr. Warshaw (left) and Dr. Pellegrini at the Annual Business Meeting of Members.

Slide 4

Exceptional Scientific Posters of Merit awards, from left to right: Drs. Duh, Rusch, Phillips, Ferguson, and Hawn.

Slide 5

Dr. Pellegrini gives his Presidential Address.

Slide 6

Oweida Scholarship recipient, Dr. Tan.

Slide 7

Dr. Roland (far left) and Dr. Milroy (far right) presented the Committee on Cancer Liaison’s Outstanding Performance awards to three State Chairs: Drs. Silbergleit, Jackson, and Dooley.

Slide 8

Joan and Julius H. Jacobson II Promising Investigator Awardee Dr. Haider (right) with David R. Flum, MD, FACS; and Saima Haider.

Slide 9

Surgeons participate in a hands-on flexible endoscopy workshop

Slide 10

Dr. Quick, recipient of the Resident Award for Exemplary Teaching (third from right), pictured with (left to right): Glenn T. Ault, MD, MSEd, FACS, Chair, Resident Award Program, Committee on Resident Education; Rebecca M. Minter, MD, FACS, Chair, Committee on Resident Education; Dr. Pellegrini; David B. Hoyt, MD, FACS, Executive Director; and Ajit K. Sachdeva, MD, FACS, FRCSC, Director, Division of Education.

Slide 11

Surgical Forum Excellence in Research Award recipients. Front row, left to right: Drs. Maclellan, Tapia, Vrecenak, Linden, Thirunavukkarasu, Rivard, and Pandit. Back row: Drs. Hamarneh, Sherman, Pontarelli, Kleiman, Dedy, Thompson, and Kirby. Not pictured: Dr. Mella.

Slide 12

A. Brent Eastman, MD, FACS, outgoing President, presents the Presidential Medallion to Dr. Pellegrini during Convocation.

Slide 13

International Scholars and Travelers 2013. Front row, left to right: Drs. Poon, Smith, Faraj, Tsoulfas, Wong, and Pastor. Middle row: Drs. Mshelbwala, Wakeman, Nigri, Del Chiaro, Chokotho, Ulloa, Satoi, and Schroen. Back row: Drs. Itoh, Heuer, Ademuyiwa, Howle, Norese, Adeleye, and Agarwal.

Slide 14

Dr. Eastman presents the Distinguished Service Award to Dr. Bass.

Slide 15

2012 NSC Surgeons’ Award for Service to Safety: Dr. Templeton (middle) with, left to right: Michael F. Rotondo, MD, FACS, Chair, COT; Michael L. Nance, MD, FACS, Chair, COT Quality Data Resources Committee; Raul Coimbra, MD, FACS, recorder, American Association for the Surgery of Trauma; and Don Teater, MD, medical advisor, NSC.

Slide 16

Drs. Pellegrini and Hoyt ceremonially marking the College’s 100th anniversary with the Centennial cake-cutting

Slide 17

ACS COT Meritorious Achievement Award: Dr. Sonneborn (center) with Dr. Coimbra (left) and Dr. Rotondo.

Slide 18

The processional at Convocation

Slide 19

Dr. Quick, recipient of the Resident Award for Exemplary Teaching (third from right), pictured with (left to right): Glenn T. Ault, MD, MSEd, FACS, Chair, Resident Award Program, Committee on Resident Education; Rebecca M. Minter, MD, FACS, Chair, Committee on Resident Education; Dr. Pellegrini; David B. Hoyt, MD, FACS, Executive Director; and Ajit K. Sachdeva, MD, FACS, FRCSC, Director, Division of Education.

Slide 20

Basic Science Research poster awards, left to right: Dr. Sachdeva; Andre R. Campbell, MD, FACS; Mr. Onwugbufor; Ms. Anderson; Mr. Ellis; Mr. Robinson; and Dr. Freischlag.

Slide 21

Audience members applauding Dr. Chen

Slide 22

The College celebrated its 100th birthday with a birthday card signed by meeting attendees

Slide 23

An ice sculpture commemorating the College’s 100-year anniversary. Playing in the background is the television episode of M*A*S*H that mentions the ACS.

Slide 24

Surgical Forum dedicatee Dr. Bland (center) with O. Joe Hines, MD, FACS, Chair of the Committee for the Forum on Fundamental Surgical Problems, and Mary T. Hawn, MD, FACS, who made introductory remarks at the presentation.

Slide 25

The exhibit floor

Slide 26

Dr. Chen delivering the Olga Jonasson Lecture;

Slide 27

The College celebrated its 100th birthday with a confetti drop at the Opening Ceremony

Slide 28

2013 NSC Surgeons’ Award for Service to Safety: Dr. Stewart (second from left) with (left to right): Dr. Rotondo, Dr. Coimbra, and Dr. Teater.

The 2013 Clinical Congress of the American College of Surgeons (ACS) provided surgeons, medical students, surgical residents, and other members of the operating room team with the opportunity to immerse themselves in a variety of educational experiences and to interact with their peers. Total registration for this year’s meeting was 13,367, including 8,857 physicians; the remaining registrants were exhibitors, guests, spouses, and convention personnel.

Centennial celebration concludes

Over the course of the last year, ACS Fellows have been commemorating the 100th anniversary of the founding of the College. Adding to the excitement of the 2013 conference were activities marking the conclusion of the Centennial celebration. Once again, a special exhibit, 100 Years of Inspiring Quality—An Interactive Timeline, was on display at the meeting with new features added to spotlight the lessons learned from the ACS Inspiring Quality Tour and other developments in 2012–2013.

The ACS leadership also hosted an evening of coffee, cordials, and conversation. During this social event, College leaders conducted a Centennial cake-cutting ceremony. The ACS International Relations Committee and Operation Giving Back also presented a Centenary International Reception in honor of the College’s milestone anniversary.

In a related activity, a new Surgical History Group held an organizational breakfast under the leadership of former ACS President LaMar S. McGinnis, Jr., MD, FACS. The primary focus of the new group will be the preservation of College’s historical resources. Furthermore, the ACS Foundation announced the official launch of the 1913 Legacy Campaign fundraising initiative. The campaign will secure gifts to advance programming that is critical to the College, while also recognizing the Centennial and looking forward to the next 100 years.


Although considerable attention was directed toward the ACS Centennial, the underlying focus was the future of the organization as exemplified by the theme of the 2013 Clinical Congress—“The Next 100 Years.”

Carlos A. Pellegrini, MD, FACS, FRCSI(Hon), The Henry N. Harkins Professor and Chair, department of surgery, University of Washington Medicine, Seattle, was installed as the 94th President of the ACS during the 2013 Convocation ceremonies on October 6. Dr. Pellegrini presented his Presidential Address, The Surgeon of the Future: Anchoring Innovation and Science with Moral Values, to the College’s 1,622 Initiates.

Two Vice-Presidents assumed office during the Convocation as well: Layton “Bing” Rikkers, MD, FACS, as First Vice-President, and John T. Preskitt, MD, FACS, as Second Vice-President. Dr. Rikkers is professor emeritus at the University of Wisconsin-Madison and Editor-in-Chief of Surgery News. Dr. Preskitt is a surgical oncologist at Baylor University Medical Center, Dallas, TX.

In addition, Honorary Fellowship was conferred on six international surgeons: Markus W. Büchler, MD, of Heidelberg, Germany; R.J. (Bill) Heald, CBE, MChir, FRCS(Ed)(Eng), Basingstoke, Hampshire, UK; J. Octavio Ruiz Speare, MD, MSc, FACS, Mexico City, Mexico; Prinya Sakiyalak, MD, FACS, FRCS(T), Bangkok, Thailand; Norman S. Williams, MS, FMedSci, PRCS(Eng), London, UK; and Cheng-Har Yip, MB, BS, FRCS(Glas)(Eng), Kuala, Lumpur, Malaysia.

Named Lectures

As always, Clinical Congress featured several Named Lectures, starting with the Martin Memorial Lecture, presented immediately after the Opening Ceremony on October 7. In honor of the conclusion of the College’s Centennial celebration, historian David McCullough, recipient of two Pulitzer Prizes and two National Book Awards, delivered the well-received lecture, Something New, Something Old with Renewed Force: The Role of History and Innovation in Medicine.

Other Named Lectures presented at the 2013 Clinical Congress were as follows:

  • Pauline W. Chen, MD, FACS, a transplant surgeon and New York Times columnist presented the Olga M. Jonasson Lecture: Conduct Unbecoming
  • Robert H. Bartlett, MD, FACS, professor emeritus of surgery at the University of Michigan, Ann Arbor, presented the John H. Gibbon, Jr., Lecture: Extracorporeal Life Support: Gibbon Fulfilled
  • Peter W. Carmel, MD, D. Med Sci, FACS, chair emeritus, department of neurological surgery, and professor of neurological surgery, New Jersey Medical School at Rutgers University, Newark, presented the Charles G. Drake History of Surgery Lecture: Neurosurgical Contributions to Anesthesiology in the Early 20th Century
  • Roy A. J. Spence, OBE, JP, MD, LLD(Hon), FRCS(Edin)(I), FRCS(Eng, Glas)(Hon), professor of surgery at Queen’s University of Belfast and the University of Ulster, Northern Ireland, gave the I.S. Ravdin Lecture in the Basic and Surgical Sciences: Reflections of a Surgeon in Troubled Times
  • Ian C. Lavery, MD, FACS, staff surgeon, department of colon and rectal surgery, the Cleveland Clinical, OH, presented the Herand Abcarian Lecture: How Health Care Reform Will Impact the Practice of Surgery
  • Mark A. Talamini, MD, FACS, professor and chairman, department of surgery, Stony Brook University School of Medicine, Stony Brook, NY, presented the Excelsior Surgical Society/Edward D. Churchill Lecture: Surgery and Technology: A Complicated Partnership
  • Ronald V. Maier, MD, FACS, the Jane and Donald D. Trunkey Endowed Chair in Trauma Surgery and professor and vice-chair, department of surgery, University of Washington, Harborview Medical Center, Seattle, presented the Scudder Oration on Trauma: A Century of Evolution in Trauma Resuscitation
  • Norman S. Williams, MS, FMedSci, PRCS, President of the Royal College of Surgeons, London, UK, gave the Distinguished Lecture of the International Society of Surgery: Attempts to Innovate in Coloproctology and Beyond
  • Bruce L. Gewertz, MD, FACS, the H. and S. Nichols Distinguished Chair in Surgery; surgeon-in-chief; chair, department of surgery; vice-president of interventional services; and vice-dean of academic affairs, Cedars-Sinai, Medical Center, Los Angeles, CA, presented the Ethics and Philosophy Lecture: Sustaining Fulfillment in Work and Life
  • Glenn D. Steele, Jr., MD, FACS, president and chief executive officer, Geisinger Health System, Danville, PA, gave the Commission on Cancer Oncology Lecture: Re-engineering of Care: Surgical Leadership

Awards and honors

Several surgeons were honored for their contributions to the ACS. Barbara Lee Bass, MD, FACS, the John F. and Carolyn Bookout Distinguished Endowed Chair and chair of the department of surgery at Houston Methodist Hospital, TX, received the ACS Distinguished Service Award, the College’s highest honor, during the Convocation. The Board of Regents presented the award to Dr. Bass in appreciation of her exceptional service to the organization for more than “20 years in noteworthy leadership roles,” as well as “her outstanding clinical and academic contributions to the field of surgery.”

The Fellows Leadership Society (FLS) of the ACS Foundation presented the 2013 Distinguished Philanthropist Award to Elias S. Hanna, MD, FACS. The award was announced during the 25th annual FLS Benefactor Recognition Luncheon in recognition of Dr. Hanna’s philanthropic contributions and service to the international community.

Other awards were presented to surgeons for their commitment to trauma care. John M. Templeton, Jr., MD, FACS, a retired pediatric surgeon in Bryn Mawr, PA, received the National Safety Council (NSC) 2012 Surgeons’ Award for Service to Safety at the annual ACS Committee on Trauma (COT) Dinner on October 7. The award recognizes Dr. Templeton’s “zeal for the care of injured children, his longstanding interest in injury prevention, and his generous philanthropic support of young investigators in the field of injury prevention.”

Ronald M. Stewart, MD, FACS, professor and chair, department of surgery, University of Texas Health Science Center, San Antonio, received the National Safety Council 2013 Award for Service to Safety during the COT Dinner. Dr. Stewart was recognized “for his commitment to the advancement of the care of injured patients in Texas through leadership in the organization of a regional trauma care system and outstanding trauma research.” In addition, the COT presented its Meritorious Achievement Award to Ricardo G. Sonneborn, MD, FACS, a retired general surgeon in Santiago, Chile.

Donald R. Laub, Sr., MD, FACS, a plastic and reconstructive surgeon, Redwood City, CA, received the 2013 ACS/Pfizer Surgical Humanitarian Award for his lifetime of service to patients in developing countries and for his development of a much-emulated model for providing surgical outreach around the world. Three surgeons received the ACS/Pfizer Surgical Volunteerism Award. Ingida Asfaw, MD, FACS, a cardiothoracic surgeon and clinical associate professor of surgery at Wayne State University School of Medicine, Detroit, MI, and chief of staff at St. Joseph Mercy Oakland-Trinity Health, Pontiac, received the Surgical Volunteerism Award for international outreach for his commitment to improving medical and surgical care in Ethiopia. Jerone T. Landström, MD, FACS, a general surgeon and Navy reservist, Tamuning, Guam, received the Surgical Volunteerism Award for military outreach in recognition of his contributions in the Federated States of Micronesia, Guam, the Philippines, and Afghanistan. Katrina B. Mitchell, MD, a general surgery resident at Weill Cornell Medical College, New York, NY, received the Surgical Volunteerism Award for outreach during residency for her contributions to improving surgical care and education in Tanzania.

Practicing surgeons, residents, and medical students were recognized for their contributions to advancing the art and science of surgery. The 2013 Owen Wangensteen Surgical Forum on Fundamental Surgical Problems was dedicated to Kirby I. Bland, MD, FACS, professor and chairman, department of surgery, University of Alabama, Birmingham, for his contributions to the science of surgical research, as well as for his years dedicated to mentoring surgical residents.

Residents honored with the Surgical Forum Excellence in Research Awards included: Elizabeth M. Pontarelli, MD; David A. Kleiman, MD; Mahesh Thirunavukkarasu, PhD;  Sulaiman R. Hamarneh, MD; Viraj Pandit, MD; Allison F. Linden, MD, MPH; Colleen Rivard, MD; Jesse D. Vrecenak, MD; Reid A. Maclellan, MD;  Nicole M. Tapia, MD; Nicholas J. Dedy, MD; Scott K. Sherman, MD; Juan Rodolfo Mella, MD, MPH; E. Will Kirby, MD; and Jonathan R. Thompson, MD.

Adil H. Haider, MB, BS, MPH, FACS, assistant professor, department of surgery, Johns Hopkins Medical School, Baltimore, MD, received the ninth Joan L. and Julius H. Jacobson II Promising Investigator Award. The award honors outstanding surgeons engaged in research, advancing the art and science of surgery, and demonstrating early promise of significant contributions to the practice of surgery and patient safety.

The eleventh annual ACS Resident Award for Exemplary Teaching was presented to Jacob A. Quick, MD, chief resident in general surgery at the University of Missouri, Columbia. The award is sponsored by the ACS Division of Education to recognize excellence in teaching by a resident and to highlight the importance of teaching in residents’ daily lives. Dr. Quick was selected by an independent review panel of the Committee on Resident Education.

The inaugural Jameson L. Chassin, MD, FACS, Award for Professionalism in General Surgery was presented to Justin P. Fox, MD, MHS, a chief resident in general surgery at the Wright State University School of Medicine in Dayton, OH. The award recognizes a chief resident in general surgery who exemplifies the values of compassion, technical skill, and devotion to science and learning. The award is administered by the ACS Division of Education and will now be granted on an annual basis. The ACS established the new award with gifts from the Chassin family, colleagues, and friends of the late Jameson L. Chassin, MD, FACS, who was a skilled surgeon, teacher, and scholar in New York City. Dr. Fox was selected by an independent review panel of the Committee on Resident Education.

Valerie W. Rusch, MD, FACS, Chair of the ACS Program Committee; Quan-Yang Duh, MD, FACS, Vice-Chair of the Program Committee; and Mary T. Hawn, MD, FACS, presented Best Scientific Poster Presentation Awards to Junior Investigator Winner Elizabeth A. Phillips, MD, Boston, MA, for the poster Does a Surgical Career Affect a Woman’s Childbearing? A Report on Pregnancy and Fertility Trends Amongst Female Surgeons, and to Senior Investigator Winner T. Bruce Ferguson, Jr., MD, FACS, Greenville, NC, for Image-Guided Surgery: The Impact of Intraoperative Imaging on Risk-Adjusted Quality Outcomes.

Furthermore, the following medical students were honored for their Basic Science Research posters:

First place: Alison A. Smith, Tulane University, New Orleans, LA, for The Use of Paracrine Factors from Reprogrammed Mesenchymal Stem Cells to Treat Biofilm-Infected Wounds in Vivo

Second place: Ryan J. Ellis, National Institutes of Health, Bethesda, MD, for Genome-Wide Methylation Patterns in Papillary Thyroid Cancer Are Distinct Based on Histologic Subtype and Tumor Genotype

Third place: Scott T. Robinson, Emory University School of Medicine, Atlanta, GA, for A Novel Platelet Lysate Scaffold Promotes Human Mesenchymal Stem Cell Growth and Invasion

The following medical students were recognized for their Clinical and Educational Research posters:

First place: Barbara J. Williams, University of California-Irvine School of Medicine, for Intravenous Infusion of Bendavia during Renal Revascularization Attenuates Cardiac Injury and Dysfunction in Swine Renovascular Hypertension

Second place: Michael T. Onwugbufor, Children’s National Medical Center, Washington, DC, for Myocardial Cytochrome Oxidase Activity Increases with Age and Hypoxemia in Patients with Congenital Heart Disease

Third place: Jamie E. Anderson, University of California-San Diego, for Cockcroft-Gault Equation Estimates of Nephron Mass and Need Can Predict Improved Outcomes in Expanded Criteria Donor Kidney Transplantation

The International Relations Committee welcomed the International Guest Scholars for 2013 and other guests at a luncheon October 8, including: Jensen T-C Poon, MB, BS, FRCS(Ed), FACS, Carlos Pellegrini Traveling Fellow; Stephen Ridley Smith, FRACS, ANZ Exchange Fellow; Walid Faraj, MB, BS, FACS; Georgios Tsoulfas, MD, FACS, Stavros Niarchos Foundation Scholar; George Kwok Chu Wong, MB, ChB, FACS, Elias Hanna Scholar; Carlos Pastor, MD; Philip M. Mshelbwala, MB, BS, FWACS; Christopher John Wakeman, MB, ChB, MMed(Sci); Giuseppe R. Nigri, MD, PhD, FACS; Marco Del Chiaro, MD, PhD, Dr. Abdol and Mrs. Joan Islami Scholar I; Linda Carolyn Chokotho, MB, BS; Jorge H. Ulloa, MD, FACS; Sohei Satoi, MD, PhD, FACS, Dr. Abdol and Mrs. Joan Islami Scholar II; Anneke T. Schroen, MD, MPH, FACS, ACS Traveling Fellow to Germany; Shinji Itoh, MD, PhD, Japan Exchange Fellow; Matthias Heuer, MD, PhD, German Exchange Fellow; Adesoji Oludotun Ademuyiwa, MB, BS, Baxiram S. and Kankuben B. Gelot Scholar; Julie Rina Howle, MB, BS, FRACS, Murray F. Brennan Scholar; Mariano Norese, MD; Amos Olufemi Adeleye, MB, BS, FWACS; and Rajiv Agarwal, MB, BS, MS, Louis C. Argenta Scholar.

The Commission on Cancer presented the State Chair Outstanding Performance Award to the following surgeons: Allen Silbergleit, MD, FACS, Michigan; Patrick Jackson, MD, FACS, District of Columbia; and William Dooley, MD, FACS, Oklahoma.

Amy E. Tan, MD, FACS, a general surgeon in Blue Hill, ME, attended the Clinical Congress as the recipient of the 2013 Nizar N. Oweida Scholarship. Additionally, Anees B. Chagpar, MD, MPH, FACS, director of the Breast Center-Smilow Cancer Hospital at Yale University, New Haven, CT, recipient of the 2013 Claude Organ Traveling Fellowship, spoke before the ACS Scholarships Committee.

Lastly, the Resident and Associate Society (RAS) of the ACS presented a $500 award to the winner of the 2013 RAS essay contestElisha G. Brownson, MD, a surgical resident at Boston Medical Center, MA. The theme of this year’s essay contest was How Surgeons Deal with Complications and the selected essays can be found in this issue of the Bulletin.

Annual Business Meeting

The ACS Annual Business Meeting of Members convened October 9 with Dr. Pellegrini presiding and the following officials presenting reports: Julie A. Freischlag, MD, FACS, Chair of the Board of Regents; Robert R. Bahnson, MD, FACS, Chair of the American College of Surgeons Professional Association political action committee (ACSPA-SurgeonsPAC) Board of Directors; Lena M. Napolitano, MD, FACS, Chair of the Board of Governors; and David B. Hoyt, MD, FACS, ACS Executive Director.

The election of the ACS President-Elect, Vice-Presidents-Elect, Regents, and Governors also took place during the Annual Business Meeting.

Andrew L. Warshaw, MD, FACS, surgeon-in-chief emeritus, Massachusetts General Hospital, and the W. Gerald Austen Professor of Surgery at Harvard Medical School, Boston, MA, was elected President-Elect. Jay L. Grosfeld, MD, FACS, Lafayette F. Page Professor Emeritus of Pediatric Surgery, Indiana University School of Medicine, Indianapolis, was elected First Vice-President-Elect; Kenneth L. Mattox, MD, FACS, Distinguished Service Professor, Michael E. DeBakey Department of Surgery, Baylor College of Medicine; and chief of staff and chief of surgery, Ben Taub General Hospital, Houston, TX, was elected Second Vice-President-Elect.

The Board of Governors of the ACS elected one new member of the Board of Regents: James Gigantelli, MD, FACS, professor of ophthalmology and assistant dean of government relations at the University of Nebraska Medical Center, Omaha. Reelected to additional three-year terms on the Board of Regents were: Margaret M. Dunn, MD, FACS, a general surgeon, Dayton, OH; Howard M. Snyder III, MD, FACS, a urological surgeon, Philadelphia, PA; and Michael J. Zinner, MD, FACS, a general surgeon, Boston. Dr. Freischlag, the William Stewart Halsted Professor, chair of the department of surgery, and surgeon-in-chief at Johns Hopkins Hospital in Baltimore, MD, will continue to serve as Chair of the Board of Regents. Mark C. Weissler, MD, FACS, Joseph P. Riddle Distinguished Professor at the University of North Carolina, Chapel Hill, will continue to serve as Vice-Chair.

The Board of Governors elected Gary L. Timmerman, MD, FACS, a general surgeon, Sioux Falls, SD, to serve as Chair of its Executive Committee; Fabrizio Michelassi, MD, FACS, a general surgeon, New York, NY, as Vice-Chair; and Lorrie Langdale, MD, FACS, a general surgeon, Seattle, WA, as Secretary. Newly elected to serve on the Executive Committee of the Board of Governors are Karen Brasel, MD, FACS, a general surgeon, Milwaukee, WI, and Joseph H. Tepas III, MD, FACS, a pediatric surgeon, Jacksonville, FL. In addition, James C. Denneny III, MD, FACS, a otolaryngology surgeon, Columbia, MO, and Sherry M. Wren, MD, FACS, a general surgeon, Palo Alto, CA, have been reelected to the Board of Governors’ Executive Committee. Governors-at-Large from throughout the world and Specialty Society Governors also were installed.

Clinical Congress 2014

Be sure to attend the 2014 Clinical Congress October 26-30 in San Francisco, CA. Details regarding the educational program, registration, housing, and transportation will be posted at www.facs.org.

For more information

This article contains information that is discussed in greater depth in previous issues of the Bulletin. The following is a list of where these articles can be found.

September 2013

Barbara Lee Bass, MD, FACS, selected to receive 2013 Distinguished Service Award, page 58
Fellows honored for volunteerism, page 68

November 2013

Carlos A. Pellegrini, MD, FACS, installed as 94th ACS President, page 46
Six prominent surgeons accorded Honorary Fellowship in the ACS, page 48

December 2013

Presidential Address: The surgeon of the future: Anchoring innovation and science with moral values, page 8
Andrew L. Warshaw, MD, FACS, is President-Elect of the College, page 54
New ACS Regents and Governors elected, page 57

Photos throughout this article by Charles Giorno Photography and Oscar & Associates Photography.

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