Harvard medical alumni bulletin

58 Pages·1996·5.3 MB·English

by  Harvard Medical Alumni Association

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Harvard Medical
ALUMNI BULLETIN SPRING 1996
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The
Virtual
Physician
THE TRAGEDY THAT
ISN'T
SHE HAS CANCER. THAT
IT'S
WHEN WAS
THIS PICTURE
WAS
TAKEN SHE MISSING
HER TREATMENT.
It's sad, but true.
You see, even
thoush medical
science has siven
more cancer
more
Datients
iope than ever
before, one of the
most
critical
challenses facins
these people
is
simply settins to
their treatments.
But you can help. And we hope you will.
Throush the American Cancer Society's Road To
m^.
Recovery prosram, you can volunteer to
drive a cancer patient to and from
J^-^
?^^^ treatment. And, in turn, help them
enjoy a fuller, lonser life.
To find out more, call your American
Cancer Society at 1 -800-ACS-2345.
Because the only thins sadder than
we AMERICAN
this picture is that have more of V
CANCER
them.
f SOCIETY'
THERE'S NOTHING
MIGHTIERTHANTHESWORD
Harvard Medical
Spring 1996
Volume 69 Number ALUMNI BULLETIN
,
14 TheNextGeneration 44 BraveNewInterviewer
byRobeitA. Greenes by WarnerSlack
Health care has metcyberspace and Thehistoryand dynamics ofusing
willneverbe the same. computers forpatientinteractions.
20 MedicineOn-Line 50 TheSeniorSetonthe Net
byJeromeKassirer by GeorgeRichardson
More revolutionarythan the Vistas andvalleys on the information
CoverphotobyStuartDarsch currentrestructuringinhealth care highway.
maybe cultural changes due to the
computer. Departments
3 Letters
22 SolitaireConfinement
by WilliamIraBennett 4 Pulse
Whatthis countryneeds as badlyas Geriatric education, newInstitute of
aV-chipis a G-chip to blockout Medicine members, second-year
seductive computer games. show, newprofessorships, HST 25th
TheGiantBrainstorm anniversary, HMS andJapan exchange
byEllen Barlow students, centerto studydrugabuse
and managed care, firstExcellence in
27 HMSSpinsaWeb MentoringAward, centerformini-
by TerriL. Rutter mallyinvasive surgeryopened,
The medical school's on-line face Howard HughesMedical Institute
to theworld. grant.
elicitTripThroughtheBrain
byEllen Barlow 10 President'sReport
GettingStarted byStephanieH. Pincus
by TernL. Rutter
11 OntheQuadrangle
32 Operatingin3-D HMS-BIHealthcare Foundation,
byEllen Barlow juncture oflaw andmedicine.
Real-time image-guidedsurgeryis
avirtual reality. 53 Alumni Notes
36 Tel-a-Doctor 59 In Memoriam
by TeiTiL. Rutter Alexander Bill
Telemedicine maybe creatinga Lewis Dexter
global medicalvillage.
62 Death Notices
40 Digital Clinic
byLuke Sato
Usingmultimediain case-based
learning and beyond.
Slightin Hand
by TeiriL. Rutter
Inside hmab Harvard Medical
BULLETIN
A L u M N
In the lastyear or so, several ofmy patients have said something Editor-in-chief
WilliamIraBennett'68
like the following: "I read about those drugs on the Web, and I
really don't want to take one ofthem" or "Do you think I should EEdlilteonrBarlow
take X? I read about it on the Web." Thus, what only recently
AssociateEditor
seemed futuristic to me is starting to lookvery much like the pre- TerriL.Rutter
sent. I don't suppose the essays in this edition ofthe Bulletin will AssistantEditor
SarahJaneNelson
be out ofdate by the time this issue reaches you, but I confess they
seem less visionary than when we first started reading the manu- EditorialBoard
ElissaA.Ely'88
scripts. MelindaFan'96
RobertM.Goldwyn'56
As Robert Greenes contends, information is becoming radical- JoshuaHauser'95
ly less centralized in the new world ofthe Internet. In manyways, VPiacutloariAa.JMochEnvsooyn''7854
this will doubtless be a Good Thing, though from time to time, it JamesJ.O'Connell'82
GabrielOtterman'91
may also be problematic. To pursue my humble example, most DeborahProthrow-Stith'79
GuillermoC.Sanchez'49
physicians are accustomed to having patients come in with infor- J.GordonScarmell'40
mation from a current best-seller (in my case. Listening to Prozac or JEolhenanDo.rSSthooercekl'e55'47
Driven to Distraction). It is quite a different experience when this RichardJ.Wolfe
information comes from a community ofpatients describing their DesignDirection
SametzBlackstoneAssociates,Inc.
experience on the Web.
There can be little doubt that the Web will increasingly ASstseopchiaatniioenHOf.fiPciernscus'68,president
"democratize" medical information.Jerome Kassirer, editor of The SuzanneFletcher'66,president-electi
RobertS.Lawrence'64,president-elect2
New EnglandJournalofMedicine, sketches a view ofhow this might RomanW.DeSanctis'55,vicepresident
NancyA.Rigotti'78,secretary
work, and ofhow medical care may overcome certain limitations ArthurR.Kravitz'54,treasurer
ofspace and time through the burgeoning capacity ofcomputer
Councillors
and network systems. KennethRolandBridges'76
DavidP.Gilmour'66
Other contributors to this issue ofHMAB describe various ways KatherineL.Griem'82
DanaLeifer'85
in which new computer technology is changing the reach ofour SharonB.Murphy'69
knowledge and understanding. For most, this takes the form ofa GilbertS.Omenn'65
BruceJ.SamsJr. '55
dramatic enhancement ofintellectual resources or mental capacity. JohnB.Stanbury'39
LorraineDudleyStanfield'87
(I offer a minor autobiographical exception to this trend.)
DirectorofAlumniRelations
With this issue ofHMAB we must say goodbye to Associate DanielD.Federman'53
We
Editor Terri L. Rutter. have greatly benefited from her prose,
RepresentativetotheHarvardAlumniAssociation
passion, vision and humor. Ms. Rutter has led us into the myster- Chesterd'Autremont'44
ies ofthe Internet, and she was the moving spirit behind the issue IDStatement:
celebrating 50 years ofwomen at HMS. Both in signed articles and TquhaertHearil-yuaatrd25MeSdhiactatluAclkuSmtnreietB,ulBloetsitnonis,pAuLb\l0i2sh1e1d5
We ©bytheHarvardMedicalAlumniAssociation.
in tactful editing she has helped to shape this magazine. thank
Telephone:[phone].Emailaddress:
her and wish her all the best as she moves into the next phase of [email protected]
paidatBoston,Massachusetts.Postmaster,sendform
her writing career. 3579to25ShattuckStreet,Boston,MA02115,
ISSN0191-7757.PrintedintheU.S.A.
William Ira Bennett ^68
HarvardMedicalAlumni Bulletin
Letters
John Schott, M.D.
HMS '66
InvestmentAdvisor
ObstructedView the seed moneyfor a largersum. In
Managed accounts,
The articles onthe topic ofHMOs and anycase, I remain confused byyour
retirement accounts,
so called managed care (Winter '96) assumption that$500millionwould be
family trusts were timelyandveryinteresting; how- required to renderHMS tuition-free.
Dr. Schott provides highly ever, somepageswereverytryingto Assumingthatin today's market
personalized investment read. Pagesprinted on a grayback- HMS could obtain a (tax-free) return on
management to individuals, ground ofvaryingdensitywere diffi- investmentofatleast 10 percent, 5
families and institutions cultto see clearly, especiallyunder percentwould generate $25 million,
artificial light. And lastly, "Changes in enough to more than equal the annual
His unique approach and
theAmphitheatre" in three divided tuition bills of1,000 students (HMS has
established record merit your
columns on each page added to the less than 700). I do notmean to befit-
consideration
frustrations oftrjdngto read my tle the taskofraisingsuch a sum; but
We
Schott Investment favorite alumnimagazine. older bymakingitunnecessarilylarge, you
Corporation alums have trouble enoughwith our inhibitanyserious discussion ofgener-
PublisherofTheSchottLetter sight. atingfunds forsuch a purpose.
120Centre Street Arewetttyingtoo hard to be However, when the total costofsup-
Dover, MA02030 trendy? porting astudentfor oneyear atHMS
[phone]
• AlbertP. Ley '^^B approaches the annual income ofthe
RegisteredInvestmentAdvisor averageAmerican family, novel solu-
SECandCommonwealthof Grammatical Error tions must be soughtand testedwith
Massachusetts Asentence in the recentissue (Winter real urgency.
'96, P56) reminds me ofthe oldNew Itis ironic thatin the same issue of
Yorkerquips: "Clementwas a psychia- theBulletin, theAlumni Councilis
tristwho specialized in the treatment described as searchingfor "creative
ofalcoholism on the staffofBuffalo ways to dealwith financial issues,"
General Hospital." withoutanyreference to the UPenn
Buffalo is a toughplace to live but... (oranyother) initiative. Further, HMS
EugeneE. Nattie '77 announces its pride in generatingfel-
lowships forjunior facultywho, more
CreativeSupport than likely, need the income to help
Iwasveryinterested inyourcolumn in payofftheirstudentloans!
the Winter '96Bulletin announcing Instead ofrepetitive solicitations of
the arrival ofCushing Robinsonto moneyfrom alumni/ae to help the
superintend the developmentcam- needieststudents from drowningin
paign forHMS. Iwas heartened that debtwhile forcingmore affluentfami-
HMS had chosen someonewith experi- lies to subsidize tuition for those
encewith the Universityof unable to pay, shouldn'tHMS allocate
PennsylvaniaMedical School's effort vigorous development effortto obtain-
to realizewhatyousarcasticallyrefer inghard moneyfor a permanent
to as the "pipe dream" ['a fantastic endowmentto defraytuition?
notion orvain hope....from the fan- In an era ofdeclining income
tasies induced bysmokingopium'] ofa expectations forphysicians (and
tuition-fi-ee medical education forall increasing physician/physicianmar-
students." riage), whatis Harvard teachingits
There was insufficientdetail to studentswhen itencourages them to
ascertainwhetherRobinson's $10 mil- aggravate theirindividual indebtedness
lion allocation atPennwas enough to bymore than $100,000, orforces them
generate the full tuition equivalent for to turn to theirparents to scavenge
24students, orwhetheritwas merely moneyfrom retirement funds orsib-
Spring 1996
Letters Pulse
lings' inheritances? Mixedwith the joy ABoostforGeriatric Medicine A$100,000 traininggrantfrom the
ofbecominga doctorwill be the bit- The geriatric education center, partof JohnA. Hartford Foundation inNew
terness ofprolonged financial hard- the HarvardMedical School Division Yorkwill assistthe school in the devel-
ship. onAging, is developinga model edu- opmentofthe education program.
Ifcreative thinkingornewinitia- cation program thatwill broaden the Levkoff, associate professorin social
— —
tives as well as funds are wanting, I scope ofgeriatric care. The program medicine, and Barbara Berkman, asso-
and otherHMS graduateswill always be will train advanced-degree students in ciate directorofthe geriatric education
eagerto help. ButIthinkthatperenni- an interdisciplinary approach to geri- centerand directorofsocialwork
allydunningus to offsettuition is atrics, includingprimarycare skills. research atMGH, will coordinate the
merelya stopgap measure. Ithas no Since 60 percentofall health care program's planningprocess.
more grace, and farless moralweight, users are olderthan 65, almost every Underthe grant, the geriatric edu-
thanassistingthe homeless. Itis time health care providersees elderly cation centerisworkingwith academic
to reconsiderourpriorities so that patients and, accordingto Sue Levkoff, and clinical facultywithin Harvard and
theyreflecta leadership role for director ofthe Harvard UpperNew at other educational institutions in the
Harvard with regard to the support, as England Geriatric Education Center, Boston area to develop and initiate
well as the content, ofmedical educa- physiciansneed topaymore attention fourproducts: a clinical teachingpath-
tion. to givingthis population adequate and way, an interdisciplinarycurriculum
Mark G. Perlroth '60 well-rounded care. forprovidinggeriatric care in the clin-
"The care ofthe olderperson ical setting, interdisciplinarycommu-
TooMuch Change demands this interdisciplinaryper- nication tools, and a model for
I have putoffthis note (alongwith my spective because ofcomplex health teachingpatients and familymembers
reducedyearly donation), because it care needs thatare exacerbated by to participate in planningtheirown
gives me great pain to compose this. social determinants and outcomes as care. Ethical issues ofgeriatric primary
While attendingmy 60th college well as environmental issues," says care will be emphasized in all aspects
reunion, I thoughtIwould revisit Levkoff. ofthis education model.
Vanderbiltand see howthingswere
going. Itwas like mywalkinginto
—
some EastAsian school no responses
to mygreetings and muchjabbering in BarbaraBerkman(left)andSueLevkoff
foreign tongues.
Then came the "MakingHerstory"
issue (Spring '95) and the coverphoto
awakened me (verysadly) as to what
was goingon atAlmaMater. I am not
prejudiced againstwomen as doctors,
but the takeover ofthe school byaffir-
mative action women studentsI can-
notstand.
Somethingisvery amiss among
thosewho guide the admissions policy
ofHarvardMedical School, and itis
high time for a reversal ofthis trend.
Ihad given a moderate sum to the
schoolinmywill, butIhavehad my
lawyer delete this. Iwillnotsupport
this conversion. This upsets mevery
much, butifthis is disloyalty, so be it.
Wm. NeilCampbellJr. '^8 <M
HarvardMedicalAlumni Bulletin
FeltonEarls RobertGlickman FerencJolesz DavidLivingston
Institute Honors Earls has been studyinghowsuch metabolism.
The Institute ofMedicine ofthe factors as poverty, social devaluation, Joleszhas advanced imagingtech-
National AcademyofSciences has physical and emotional abuse, and the niques used in neuroradiologyto guide
appointed three newmembers from breakdown ofneighborhood commu- various surgicalinterventions.
HarvardMedical School: FeltonEarls, nities can putchildren atriskformen- Recently, he spurred the development
HMS professorofchild psychiatryand tal and emotional disorders. He is the ofaninnovativemagnetic-resonance
HSPH assistantprofessorofhuman scientific director ofthe Projecton operatingenvironmentthatprovides
behavior and development; Robert Human Developmentin Chicago surgeonswith real-time images oftis-
Glickman, Herrman LudwigBlumgart Neighborhoods, a long-term studyof sues deep inside the brainand other
ProfessorofMedicine atHMS and 9,000 children and theirfamilies. organs. (See storypage 32.)
chairman ofthe Departmentof Glickman has studied the metabo- Livingston studies the DNAtumor
Medicine atBethIsrael Hospital; and lism and absorption offats and virus SV40 and howitpromotes the
FerencJolesz, HMS associateprofessor lipoproteins formorethan two cancerous growth ofmammalian cells.
ofradiologyand director ofthe decades. Gfickman and colleagues dis- Livingston's group has also isolated
Division ofMagnetic Resonance covered that the small intestine pro- and started defining the function ofa
ImagingatBrigham andWomen's duces apoproteins thatcoat thevarious familyofproteins thatcontribute to
Hospital. David Livingston, Emil Frei fat molecules as theytravel in the the growth ofmammalian cells; his
Professor ofMedicine atHMS and bloodstream. His workhas helped laboratoryis partofan international
chairoftheresearch executive com- reveal howfatmolecules make their effortto decipherthe basic biochemi-
mittee atthe Dana-Farber Cancer wayinto the bloodstream from the calmechanisms thatthe Rb protein
Institute, has been named to the diet, and underscores the important uses to maintain normal cell behavior.
NationalAcademyofSciences. role ofthe intestine in hpoprotein
TheSecond-YearShow
expressedfearsofdebtin
danceandsong:
WhentheNewtisinthe
SenateHouse
AndHMOsareontherise
MBAswillmoldhealthcare
Andwelfare'sswiftdemise.
Thisisthedawningofthe
AgeofIndebtedness.
Spring 1996
Pulse
JudithPalfreyandT.BerryBrazelton DeanDanielTostesonisflankedbyFritzBach(left)andAnthonyMonaco.
Three New ProfessorshipsFilled saidMonaco, in his tribute to the man HSTSilverJubilee
Withthe finale of 1995 came the cele- whose name hewill carryonhis pro- TheHarvard-MIT Division ofHealth
bration ofthreenewprofessorships fessorship. Monaco didnotpersonally Sciences andTechnology(hst)wel-
and the selection oftheir firstincum- knowMedawar, who died in 1987, but comed back43 graduates fora 25th
bents. Novemberwas a busymonthin he said thathe has pursuedMedawar's anniversarycelebration December 7
thefacultyroom, firstfeting two pro- line ofinquiryinto tissue transplanta- and 8, 1995. The HST SilverJubilee
fessors in transplantation surgery, tion and its therapeutic applications honored the division's founders, show-
FritzH. Bach '60 as the Lewis formore than 30years. Monaco is cased the achievements ofits alumni,
Thomas ProfessorofSurgeryand chiefoforgan transplantation atthe and anticipated the future ofthe divi-
AnthonyP. Monaco '56 as the Peter Deaconess. sionthrough discussionofits educa-
MedawarProfessor ofSurgery, both T. BerryBrazelton is ahousehold tional and research activities.
endowed bythe SandozPharmaceut- name forthosewho have children, and HSTis an interdisciplinarycollabo-
ical Corporation. Then aweeklater, his namewill nowgrace the third new rative effortofHMS andMIT estab-
Judith Palfrey, chiefofthe Children's professorship. Renowned forhis work lished in 1970 to focus science and
Hospital division ofgeneral pediatrics, in child developmentand forcreating technologyonhuman healthprob-
was saluted as the T. BerryBrazelton the neonatal behavioral assessment lems. "In 1970 combiningscience and
ProfessorofPediatrics. scale, Brazelton haswritten 26 books engineeringwith compassionand care
Bach, who is directorofthe Sandoz andmore than 180 scientific articles forpatientswas an untried idea," said
Center ofImmunobiology atthe New and chapters. He was chiefof IrvingLondon '39, the founding
England Deaconess Hospital, did his Children's Hospital's child develop- directorofHSTfor 15 years and apro-
internship and medical residencyat mentunitfrom 1972 to 1989 andis fessor emeritus atbothHMS andMIT.
NewYorkUniversity, where he said, professorofpediatrics emeritus. "We had to integrate two universities
"LewisThomas became myfriend and JudithPalfi-eyis apediatricianwho with differentstrengths and decidedly
mentor, who inspired byexample by has devotedherprofessional careerto differentcultures."
providingwisdom and encourage- improvingcommunityhealth care ser- HST students optamongprograms
ment." In 1964, underThomas's guid- vices forchildren. She recentlypub- thatlead to anMD, a combined
ance, Bach developed the mixed lished the book Community Child MD/phD orjustaPho. In the historyof
lymphocyte culture as a testfor tissue Health:AnAction FlanforToday. the program there have been 500
compatibilityfor transplantation, an "To be associatedwithT. Berry graduateswho receivedMDs (some of
assaythatis still used fortissue tj^Ding. Brazelton's name has gotto be the whom also earned PhDs) and about 70
Though famous forhis poetic essays, greatesthonor," said Palfrey. "This is who gota PhD alone. HSTis one ofthe
Thomas '37, who died in 1993, was an opportunityforus to listen and to five academicsocieties atHMS,
renowned also as a medical scientist putthe child backin the center, back although forthe firsttwo preclinical
whowrote prolificallyon avarietyof in the family, backin the community." years, HSTstudents attend separate
interests, manyconcerned with the courses, atbothMIT and HMS. They
hostresponse to infection. then join the restofthe medical stu-
The otherprofessorshipinsurgery dents on thewards for clerkships.
isnamedforPeterMedawar, apioneer The intentofthe HST curriculumis
oftransplantation science and Nobel to "educate leaders in academicmedi-
laureate forhis discoveries aboutrejec- cine and the biomedical sciences" and
tion and "privileged" times fortrans- to imparta "quantitative and molecu-
plantation. Though a zoologist, "Peter larunderstandingofpathophysiologic
Medawarwas driven in his researchto processes."As summarized in a previ-
help people solve clinical problems," ous course catalog: "Graduates appre-
ciate therelevance offluid mechanics
HarvardMedicalAlumni Bulletin