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Harvard medical alumni bulletin PDF

60 Pages·1998·6.9 MB·English
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^^^^ ^^^1 ^ V-.''t'i;v>"."''' i.fr ; r '.. »: "\1 5*1^ A*fTl M N U L L E T N N I I in J *t0^ 4: / ' :.4''l jJjJJij/y j^uiJJjijjjj [JJjjjiDjj Taylor, Sweet, Brown, Snow, Bates, Teter, Fahl, MacLeod, Gorlin, Angle, Fulton, Evarts, Connolly, Vail, Mond The future's leaders, 50 years ago: the editorialstaffof the 1^48Aesculapiad Harvard Medical Autumn 1998 Volume 72 Number 2 ALUMNI BULLETIN 10 CLASSDAY Departments 3 President'sReport jf;" m ** s*;^a 16 AddressingtheFuture byRobertS. Lawrence byHillaryRodham Clinton 4 Pulse 22 OnCall Newclinical dean, Armenise- by 'Kemi TokunboBabagbemi Harvard conference, affirmative action celebration. CoverphotobyLizaGreen 24 WhatI ReallyLearned In MedicalSchool 6 Benchmarks byAnthonyhamarMitchell Cell Death Research by Gabrielle Strobel 26 Unconventional Paths byJaneBuchbinder 8 BookMark TheSpiritCatchesYouandYouFall 30 ALUMNI DAY: Down:A HmongChild, HerAmerican Preservingthe Environment Doctors, andthe Collision ofTwo forMedicalStudentsand CulturesbyAnne Fadiman; Resident Education reviewedby WilliamIraBennett 35 Change BringsChallenge 56 Alumni Notes byEricB. Larson 58 An Historical Endeavor 38 ProsandConsofProfit by GeorgeS. Weber '57 byDavidBlumenthal 61 Alumni Profile 42 The Pediatric Predicament DavidM. Sensenig '^y bySharon B. Murphy 62 InTributetoCliffBaiter: 43 ATributetoGerald Foster ASilence Broken byStefan P. Kruszewski 44 ANovel Residency byAnnaBerkenblit 64 Death Notices 44 The RockyPathto Professionalism 48 REUNION REPORTS Inside hmab Harvard Medical BULLET A L u M N The oath ofthe Class of 1998 (see page 13) sets a dauntingly high Editor-in-chief WilliamIraBennett'68 standard for physicians entering medicine at the end ofits great- Editor est century. The oath embodies an ideal much threatened by the EllenBarlow emerging realities ofthe century to come. The promise to serve AssociateEditor "all in need," taken literally, is impracticable in a nation without JaneBuchbinder universal health insurance, let alone in a world ofstaggering AssistantEditor SarahJaneNelson economic inequalities and political turbulence. The sacredness ofthe bond between doctor and patient, the absoluteness of BooleReviewEditor ElissaEly'88 confidentiality in their communications, the primacy ofthe — EditorialBoard patient's dignity and autonomy all ofthese are undermined by CarlAschkenasi'oi ElissaEly'88 contractual obligations imposed on both parties by insurers and RobertM.Goldwyn'56 employers, and they are increasingly the target oflegislation JoshuaHauser'95 PaulaA.Johnson'84 meant to regulate the ways people are born, give birth or prevent JenniferKim'01 VictoriaMcEvoy'75 a birth, and die. Not all ofthese contracts or laws are bad things; JamesJ.O'Connell'82 GabrielOtterman'91 they exist partly because the relationship between physician and DeborahProthrow-Stith'79 patient cannot be isolated from economics or politics. GuillermoC.Sanchez'49 J.GordonScannell'40 We could hardly ask for or even want to hear an oath that was EleanorShore'55 JohnD.Stoeckle'47 properly hedged to take account ofall the social and moral We DesignDirection complexities ofmedical practice. cannot imagine that the SametzBlackstoneAssociates,Inc. students drafting this oath were unaware ofthe ambiguities they AssociationOfficers did not address. Oaths must embody ideals and must be taken GeorgeE.Thibault'69,president SharonB.Murphy'69,president-electi for oneselfand not others. Yet they must also be understood as CharlesJ.Hatem'66,president-elect2 StephenG.Pauker'68,vicepresident a commitment to goals that can only be achieved ifwe as a DavidD.Cakes'68,secretary profession strive for them concertedly, not as soloists. The era JamesB.Field'51,treasurer ofthe soloist is past. Councillors ClaireV.Broome'75 * * * PaulFarmer'90 B.LachlanForrow'83 With this issue Ellen Barlow leaves her position as editor ofthe DavidP.Gilmour'66 LaurieR.Green'76 Bulletin. For eleven years, Ellen has both navigated and GeraldT.Keusch'62 MichaelA.LaCombe'68 anchored this publication. Gordon Scannell '40 and I have been AlisonG.May'91 privileged in our association with an editor who has brought so MDoerbotroanhNJ..OSywaerrtz'8'747 much energy, professionalism, warmth, and imagination to the DirectorofAlumniRelations pages ofHMAB, Ellen leaves us to pursue other journalistic and DanielD.Federman'53 writing interests and to spend more time with the two delightful RepresentativetotheHarvardAlumniAssociation sons who were born during her tenure here. We will miss her Chesterd'Autremont'44 steady hand and sharp eye, her generosity as a colleague, and IDStatement: TheHai-uardMedicalAlumniBulletinispublished her good humor. quarterlyat25 ShattuckStreet,Boston,MA02115 ©bytheHarvardMedicalAlumniAssociation. William Ira Bennett '68 Telephone:(617)432-1548.Emailaddress: [email protected] paidatBoston,Massachusetts.Postmaster,sendform 3579to25ShattuckStreet,Boston,MA02115, ISSN0191-7757.PrintedintheU.S.A. HarvardMedicalAlumni Bulletin President's Report byRobertS. Lawrence The springmeetingofdie Harvard The paucityofunder-represented As HMS prepares forthe nextcen- MedicalAlumni Council openedwith minorityfacultymembers appears to turyofleadershipin medicine, I a dinnermeetinghonoringGerald S. be a combination ofinadequate num- believethatthe initiatives described Foster'51 forhis 16years ofservice as bersin the "pipeline,"whichmaybe abovewill growin importance: dean foradmissions. Manywho had the resultofa lackofadequate role recruitingfor diversity, educatingfor served ontheAdmissions Committee models, the financial incentives ofclin- diversity, and appointingand promot- under Gerry's leadership gathered for icalpractice, and some ofthe same ingfor diversity.Muchhas been dinneratthe downtown Harvard Club barriers identified as gender-based accomplished, and the alumni canand tohonorhis outstandingservice to careerobstacles forwomen. Dean mustprovide counsel and financial HMS andhis leadership inselecting, JosephMartin affirmed the impor- supporttohelp create an institution fromthe thousands ofqualified appli- tance ofthe diversityprogram. thatfullyreflects ourdiverse nation. cants, a series ofclassesunmatchedin Discussion then turned to the chal- theirdiversityin thetwo centuries of lenge ofglobal diversityand the RobertS. Lawrence '6^ isan internist, Harvardmedicine. opportunities atHMS forlearning andprofessorandassociatedeanforprofes- The theme ofdiversitywas contin- aboutinternational health. Guillermo sionaleducation,JohnsHopkinsSchoolof ued the nextmorningatthe council Sanchez '49 and Guillermo Herrera HygieneandPublicHealth. meeting. William Silen, dean forfac- '57 joined the council fora discussion ultydevelopmentand diversity, ofprograms outside the United States. described the diversityprograms at About 25 students ayear are involved HMS and led the discussion ofcouncil in overseas research projects. Another members reportingonsimilar efforts 35 studentsparticipated lastyearin atthe UniversityofWashington, communityservice projects and clini- John Schott, M.D. Northwestern University, the cal experiences. All told more than40 UniversityofMichigan andJohns countries have hosted Harvard medical HMS '66 Hopkins University. Commonthemes students. Reciprocally, 89 students InvestmentAdvisor prevailed. Despite the dramatic from 35 countries studied duringthe Managed accounts, improvementin the numbers and per- pastyearatHMS. This created an arena retirement accounts, centages ofwomen and under-repre- inwhich students could share their family trusts sented minorities enteringmedical broad range ofperceptions about school, seniorfacultymembers remain health and disease and culturalvalues, Dr. Schott provides highly disproportionatelywhite and male. in addition to their approaches to personalized investment Although adequate numbers ofwomen diagnosis and managementofclinical management to individuals, arejoiningfaculties ofmedicine, many problems. families and institutions donotadvance on the promotion lad- Since 1971, Dr. Herrera's course. His unique approach and der, inpartowingto gender-based Medicine 518, has provided about400 established record merit your careerobstacles forwomen, such as fourth-yearstudentswithintensive consideration lackofmentoring, failure to provide Spanish language instruction followed • facultydevelopmentassistance, bya two-month clerkship in Schott Investment reduced access to rewards such as Guatemala, Colombia, Bolivia, Corporation salary, recognition and promotions. Venezuela, Ecuador, Puerto Rico or PublisherofTheSchottLetter Dr. Silen described several elements of Texas. In evaluations, a high propor- 120 Centre Street the HMS programin diversitydesigned tion ofthe students have said thatthe Dover, MA02030 (508) 785-9996 to remove these obstacles. Faculty coursewas veryimportantto their developmentand more effective men- education as a physician; itshaped RegisteredInvestmentAdvisor toringare central to the program. theirattitudes towardsworkwith SECandCommonwealthof Massachusetts under-privilegedpopulations, and increased their "cultural competence." Autumn 1998 Pulse NewClinical Dean CareGroup, Dana-Farber, Children's ized, theunderlyinggoalwas always "This is a great age forclinical Hospital and Harvard Pilgrim. The the same: to find patterns thathold research, with excitingopportunities program, however, mustpass several true fordifferenttypes ofcells, tissues, to betterunderstand the fundamental additionalhurdles to prove its feasibil- and organisms. nature ofdisease and then translate ityand determine its scope. Ifgiven a For example, the scatterfactors these advances into genuine benefits go-ahead, itis expected to be up and described byPaolo Comoglio, ofthe for ourpatients,"said Raphael Dolin runningwithin ayear. Institute for Cancer Researchin '67, a leadingexpert onviral infec- Dolin has extensive research and Turin, areneeded for developmentof tions. "And Harvard is a greatplace to clinical experience ininfectious dis- manytypes oftissue. In mammalian make this happen." eases. Mostrecentlyhe has focused on embryos, theycontrol branched mor- — Dolinhas been appointed faculty the developmentand clinical evalua- phogenesis inwhich cells break dean for clinical programs byHMS tion ofHIVvaccines, and he hopes to away, migrate, become polarized, and — DeanJoseph B. Martin. Currentlythe continue thatworkhere. His clinical form tubules innormal tissues chairofmedicine atthe Universityof appointmentwillbe atBrigham and includingnerve, muscle, bloodvessels, Rochester and physician-in-chiefat Women's, where he expects to have and bone. Additionally, Comoglio's StrongMemorial Hospital, Dohn will one clinic aweekandwill serve as pro- lab has demonstrated thatcertain begin his newrole mid-September. fessorofmedicine. pointmutations in these specialized The newappointmentis in factors can transformhealthygrowth response to a decision byRichard Kitz, Armenise-Harvard ResearchersSpeak into mahgnancy, showingthatthey the currentfacultydean forclinical international Language playa role inpathogenesis, aswell. affairs, to step down from the position While the Italian soccerteamwas In a presentation thathelped thathe held halftime since 1994. In an competingforthe World Cup in Paris, explain theworkings ofwhole organ- expanded role Dolinwill handle a a meetingroom on Cape Cod was isms ratherthan tissues, Charles portfolio broadened in large partby crowded with 130 basicresearchers, Weitz, assistantprofessor ofneurobi- the launchingofan extensive clinical one third ofthem fromItaly. In the ologyatHMS, described the molecular trials programbyHMS and its major frontrowsat Count GiovanniAuletta mechanisms ofendogenous, self-sus- affiliates. Armenise, flanked byDeanJoseph tainingclocks that have been foundin The clinical trials efforthas been Martin and former dean Daniel everything from bacteria and fungi to under discussion fornearlyayearand Tosteson. Like everyone else, they plants, invertebrates, and humans. was approved to begin a business plan- watched mesmerized as a culture of Onlyayearago, researchers at ningphase bythe administrative and epithelial cells, prodded bya dose of NorthwesternUniversityidentified medical leadership ofPartners, extracellular"scatter factors," sprouted the firstmammalian circadian gene. branchedprocesses as elaborate as Weitz andhisHMS colleagueshave deerantlers. Thevideo was grainy, since found thatthis gene'sprotein, RaphaelDolin blackandwhite, and onlythree min- CLOCK, forms a heterodimerwith a utes long. Yetfor this group, itspoke secondprotein, BjMALi, to turn on a an international language more com- well-known circadian gene calledper. pellingthan sport. Furtherexperiments indicate that The SecondAnnual Symposium of teamworkis the key. Together, CLOCK the GiovanniArmenise-Harvard and BMALi have 10 to 15 times the Foundation, whose firstprogramwas transcription activityofeitherprotein held in Chatham onJune 22 and 23, actingalone. Now thatitis clearthat broughttogether foundation-spon- these two proteins turn onper, Weitz sored investigators fortwointense said, the nextchallenge is to figure out days oflectures, posterpresentations, whatturns the gene offduringnormal andnetworking. Sessions centered on circadianrhythms. neurobiology, cellmembrane traffic, Speakers ata session onplant gene transcription, cell signalingand defense and pathogenesis tookan even cycling, and plantdefense andpatho- broaderview, blurringtraditional genesis. Although each presentation boundaries bydemonstratingthatthe was tightlyfocused and highlyspecial- animal andplantkingdoms are more HarvardMedicalAlumni Bulletin ARecommitmentto Diversity A celebration of30years ofaffirmative action atHMS and HSDMbegins this fall with a series ofprograms reviewing the historyofdiversityatHMS. The first eventwill take place on Friday, October 2, with an openingreception in theMEC atrium from4:00 to 4:30 followed bypresentations in the amphitheaterbyPresidentNeil Rudenstine, DeanJoseph B. Martin, and Donnella Green (MD/phD candi- date/HMS '99). The discussionwill focus onpresent CountGiovanniAulettaAmienise accomplishments, future goals and the strongcommittmentofHMS to alike, in atleastsomeregards, than diversity. previouslythought. FrederickAusubel, The second eventwill take place on professorofgenetics atHMS andMGH, December 11. Everyone iswelcome to described hownovelpathogensmade attendthe series. Formore informa- in his lab can cause disease in certain tion call432-2159 or432-0469. model plants, flies, nematodes and mice. Strains thatare especiallyviru- lentin plants, Ausubel said, are often even more pathogenic in animals. Felice Cervone and Giulia De Forthe year 2000, an issue on 'T"! Lorenzo, plantbiologists fi-om the Future UniversityofRome, made the case thatplants, like animals, readilyiden- tifynonselfmolecules thatmaypose a Medicine threatto them. The scientists are OF investigating a familyofproteins that appearto have immunologic functions inplants. AtHMS, theArmenise-Harvard The editors of The Harvard MedicalAlumni Bulletin invite science centers are in cell signal trans- essays from people of all ages who expect orjust dream duction, directed byMarcKirschner; thatthey will one day go to medical school and become structural biology, directed byStephen a physician. Children, friends, spouses, partners: write Harrison; neurobiology, directed by what you'd like. We hope the results will point the way to Gerald Fischbach; and human cancer the new millenium of medicine. viruses, directedbyPeterHowley '72. Send manuscripts to: Programs in plantbiologyare directed byFrederickAusubel atMGH. The HarvardMedicalAlumni Bulletin Patricia Thomas 25 Shattuck St. Boston, MA 02115 fax: 617/432-0013 phone: 617/432-1448 [email protected] Autumn 1998 — 2 Benchmarks Cell Death Research Adds Life wise linearchains ofcommunication. Yetsome common themes emerge. to Theory and Practice For example, naturewas atonce opulentand fiingalin designingapop- A tosis. panoplyofinsults can trigger by Gabrielle Strobel cell suicide, amongthemfree radicals, the dried-up supplyofa growthfactor needed to sustain aneuron, oroxygen Probing Caspase Proteins levels depleted bya stroke. Yetthese Itmayseem almostcountercultural diverse signals soon converge on the that altruistic behaviorshould so caspases, a single familyofproteases stronglycapture the imagination of thatacts atseveral stages alongthe researchers in a societythatrewards cell's tightlycontrolledroadto self- — go-getters scientific and otherwise destruction. more amplythanquiethelpers. Butso itis. Since the early '90s, Caspase Behavior when biologists began to realize thatin Yuan divides the caspases into instiga- species afterspecies, cells routinelykill tors and executors. Some caspases themselves forthe greater good ofthe incite cell deathbysplittingthem- organism, scientists have been rushing selves into two activated iragments, into theyoungfield ofprogrammed which in turn activate other, down- cell death, orapoptosis. stream caspases. The ensuingcascade JunyingYuan Thebasic research on this funda- ofprotein cleavage andsignalamplifi- mental phenomenon is nowfocusing tosis contributes toAlzheimer's and cation resembles thewaythe immune on the caspase familyofproteases, the Lou Gehrig's diseases, multiple sclero- system's complementproteins spring proteinspivotal to apoptosis in all tis- sis, and aging. into action. Finally, when the cellhas sues studied so far. Itis advancingso exhausted all checks and balances, cas- quicklythatscientists atHarvard and MechanismsofCell Death pases assistin takingit apart. elsewhere have moved fromvaguely Amajorpush inYuan's lab is tryingto These multifarious functions ofone — implicatingapoptosis in disease to find outhow"triple repeats" three- protein familyhave inspiredthe studyingthe mechanisms atworkin letterunits ofDNAthatare mysteri- curiosityofotherresearchers studying — specific examples and to testingearly ouslyrepeated as ifin a stutter might complexprotein-protein interactions, treatmentapproaches in animals (see interactwith the apoptosis machinery whichwill be keyto a trueunderstand- theaccompanyingstoryon stroke). ina group ofdiseases thatincludes ingofhowcaspaseswork. Forexam- "Apoptosis is importantin avariety Huntington's and fragileXsyndrome, ple, GerhardWagner, the Elkan Blout ofdiseases," saysJunyingYuan, HMS a form ofmental retardation. ProfessorofBiological Chemistryand associate professor ofcell biology. Researchers in the field spentthe MolecularPharmacologyatHMS, is Yuan opened the field to genetic stud- pastfiveyearsworkingoutthe signal elucidatingthe molecularstructure of ieswith herdescription, in 1993, ofa transduction pathways bywhich a cell one componentofan apoptosis cas- worm gene and its homologyto a interprets signs ofstress inits environ- cade. mammalian gene thatbecame the first mentand, once ithas "decided" to So far, scientistshave discovered 1 memberofthe caspase family. Since self-destruct, dismantles itself, leaving caspases, several ofwhich theyhope then, "Junying's manyseminal discov- behind remnants thatare quiedy will make good targets forfuture erieshavehad a tremendous impacton engulfed byitsneighbors. drugs. The challengenow, saysYuan, the field," says RajivRatan, assistant In a reviewin Genesand is teasingouteach caspase's particular professorofneurology atBethIsrael Development, Yuan and a co-author function in specific tissues andits roles ^ DeaconessMedical Center (BID). assemble these studies into aweb of in disease. Ratan, who directs the Neuro- molecularinteractions underlying protectionLab atBID, is one ofseveral apoptosis. Thisweb is repletewith Harvard researchers studyingthe mol- feedbackand crosstalkbetween other- ecularpathways throughwhichapop- HarvardMedicalAlumni Bulletin

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Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.