Digitized by the Internet Archive 2013 in http://archive.org/details/harvardmedicalal67harv ^ •.»•»«..«1>^. • •\»-^ ftf^^MI^' *i«- f^tm -^^ '*• . '^t. Leonardo could have qualifi FOR AIVIWA membership. Can you? The great Renaissance man could have made it film- and video-makers, writers, publishers, illustrators, and on the strength of his medical writing alone. a wide spectrum of scientific communicators to meet, talk, Or as an illustrator. and exchange ideas. And it publishes a journal that exists Or simply as a medical scientist. for one purpose only... to encourage and nurture concise, lu- But you can earn membership in the American cid medical communications. — AMWA— Medical Writers Association by being To learn more about how to join the rapidly growing AMWA any one of these. As well as by being a doctor, den- ranks of members who share your concerns, write, tist, editor, librarian, educator, medical photogra- call, or Fax the American Medical Writers Association, 9650 pher... or by being professionally involved in medical Rockville Pike, Bethesda Maryland 20814, (301-493-0003, communication. Fax 301-493-0005). AMWA The one inflexible criterion: you must share the Just because DaVinci missed out on member- conviction of AMWA's current 3,700 members that ship is no reason you should! clear, concise communications is a vitally important art to be cultivated and refined. AW AMWA To achieve that end, conducts work- shop sessions in a—variety of specialized facets of AMERICAN communications including explorations into the MEDICAL WRITERS latest electronic media. It holds local, regional, and ASSOCIATION national meetings that enable editors, physicians. Harvard Medical Summer 1993 Volume 67 Number i ALUMNI BULLETIN 14 Information Gap: HIVandthe Health- Departments careWorker by DaiidM. Bell Letters Experiences ofa CDc: epidemiolo- gist. 4 Pulse Ihe now-named Warren Alpert LostintheSilence Building, match day, Soma Weiss by TerriL. Riitter day, genetic flaw forHuntington's disease discovered, new methods to 23 Presidential Health, Pressand Politics e.xamine molecules, AIDS treatment. Balancingthe individual's right to privacy and the public's right to 10 Book Mark 1992DemocraticNationalConvention. know. Asymposium co-sponsored Stiiying Well: YuurComplete Guide to AP/WideWorldPhotos byHMS and theJFK School of Disease Prevention by HarveyB. Government. Simon; reviewedbyAlfredSommer. 30 Troubled Timesfor Patient-Oriented 12 OntheQuadrangle Research Division oi medical sciences, HMS /')' Ed-wardH. Ahrensjr. students in the community. Imperatives for savingan endan- gered method ofinvestigation. 51 Alumni Notes 34 Research: AnObligation NotanOption 62 In Memoriam /')' Patricia K. Doiiahoc Ciertrude Kllen Murray Those privileged enough to attend AlbertAnderson HMS have an obligation to serve humanity through research, says 64 Death Notices this investigator-surgeon. 36 Onthe PeripheryofHope by Danieli'eikia Lookingformalaria in a Somali refugee camp. 40 Heart Failure Apoem byAmy Lai 41 MoonflowerWine Asboitstoiyby George S. Bascofn — Inside hmab Harvard Medical ALUMNI BULLETIN This issue ofthe Bulletin is a miscellany. David Bell '77, chief Editor J.(jordon Scannell'40 ofthe niV Infections Branch ofthe Hospital Infection ManagingEdHor Program ofthe CDC, leads offwith a lively account ofhis Kllun Barlou experiences identifying the risks ofHIV infection to and from AssistantEditor health workers. Assistant Editor Terri Rutter adds an appro- lerriL. Rutter priate sidebar on the problems facing some 7,000 seroposi- EditorialAssistant SarahJane Nelson tive health-care workers. Then follows our cover story, the highlights ofan EditorialBoard GeorgeS. Bascom'52 HMS/Kennedy School forum co-sponsored by Dean Tosteson \\'illiamI. Bennett'68 E. LangdonBurwell '44 '48 and moderated by Marvin Kalb, entitled Presidential RobertAl. Gold\v\-n'56 Health, Press and Politics. The latest presidential election is JPoasuhluaaAH.aJuoshenrso'n94'84 a forceful illustration that it is no easy matter to balance the MichaelT.MyersJr. '85 GuillermoC.Sanchez'49 individual's right to privacy and the public's need to know. EleanorShore'55 We JohnD.Stoeckle'47 turn next to Pete Ehrens '41, professor ofmedicine, RichardJ.Wolfe emeritus at Rockefeller University, who warns ofdiminishing DesignDirection support and danger facing basic patient-oriented research SametzBlackstoneAssociates,Inc. clinical studies in patients ofthe mechanisms ofhuman dis- AssociationOfficers WilliamD.Cochran'52,president ease, research that our Fuller Albright, Soma Weiss, and RobertJ.Glaser'43b,president-elect i JohnD.Stoeclde'47,president-elect2 William B. Castle did so well. RichardHannah'66,vicepresident Furthering the cause ofresearch, Patricia K. Donahoe, SamuelL.Katz'52,secretan,' MitchellT. Rabkin'55,treasurer chiefofpediatric surgery at the MGH and first Bartlett Councillors Professor of Surgery, argues that for the majority ofthose DonaldM. Berwick'72 BernardF.Godley'89 privileged to attend Harvard Medical School, research is an VanessaP.Haygood'78 obligation not an option. LisaGuay-Woodford'83 DavidD.Cakes'68 We leave the academic grove to travel with Daniel Feikin JamesJ.O'Connell'82 CurtisProut'41 '93 to Kenya, in his search for malaria in Somali refugee AlanA.Rozycki'65 camps during the recent war; a short poem by Amy Lai '93; GeorgeE.Thibault'69 and finally an excursion to Kansas and another of George RepresentativetotheHarvardAlumniAssociation WilliamD. Gochran '52 Bascom's '52 delightful stories from Deep Creek country in DirectorofAlumniRelations "Moonflower Wine." WilliamV.McDermon'42 I'd hke to also thank Tim Guiney '66, who after 12 years ChairmanoftheAlumniFund is stepping down from our editorial board. DorisR. Bennett"49 TheHarcardMedicalAhminiBulletinispublished quarterlyat25 ShattuckStreet,Boston,.MA02115 J. Gordojj Scannell '^0 ©bytheHarvardAledical.AlumniAssociation. Telephone:(617)432-1548.Thirdclasspostagepaid atBurlington,\'ermont.Postmaster,sendform 3579to25 ShartuckStreet,Boston,.\L\02115, ISSN0191-7757. PrintedintheU.S.A. HarvardMedicalAlumni Bulletin — Letters Rural Doctoring there developed an interestin primary remote from battle. I was a lad of The Summer 1992 issue ofthe Bulletin care. seven when the town church bells and contained a group ofarticles after the Rural patients generallytend to be sirens exploded at4:00 am in Elagstaff, spiritof.\lbert Schweitzer. I was par- relatively poorand medically indigent. Arizona onArmistice Day, November ticularlyinterested in Patricia WTiite's There is a morale problem for physi- II, 1918. wwn is aboutfivewars back. — reference toherexperiences in cians who treat in this setting. There Mywife who had beenunderconsid- McClellanville, SC as an example ofthe mustbe a large numberofphysicians erable stress for 33 months all the time — "third world" in the United States. scattered over the countr\-who do I was away in \\"VMI watched in Thirty-five years ago I brought my theirwork quietly, almostunnoticed imtold anxietyas she twice saw a family to Georgetown, SC, where I bythe profession. Alost do notwrite iMarine Corps, officerwalkup our joined a New York BelKoie Hospital- letters to the editor(this is my first!). sidewalk to give us news ofour son in trained general surgeon. Ata popula- Each mustfind a reason fordoing Vietnam. Each timewe thoughtitwas tion of 10,000, this is aboutas small as whattheydo. toannoimce his death. Once itwas a town can be to support a hospital. One mustdraw a distinction because he had been wounded, and Ten to fifteen years ago, when between those ot us in private practice again, when he was cominghome, health planningwas more aggressive, a on the one hand and the staffs ofgov- emaciated and wordless. number ofrural health initiatives, such ernment-supported centers, such as St. The mostunwarlike ofpersons, I as St.James Santee in McClellanville, James Santee, on the other. Each has nevertheless thought thatthere is were established in an effort to restore its own strengths and weaknesses. The somevirtue inconsistency. SoI stayed convenientaccess to good care for rural clinic does a satisfactoryjob car- in theArmyReserve afterWWII. One people in remote areas. Iwas active in ing for its patients duringthe 9-to-5 weekend eveningI was drowsing a Health Systems Agencyfor a number dav. Only the private practitioners through a training film on the use of ofyears and for a time served as chair- cover the emergency rooms at night. nuclearweapons in artilleryshells man. These remote centers continue The physicians staffing the health clin- when someone tapped me on the to provide a needed service as Dr. ics usuallydon't stay longin these iso- shoulder and informed me thatI was WTiite has so ably indicated. She lated areas. The resultis thatsuch the new commanderofourGeneral invites the members ofourprofession educated persons and their families Hospital at the Oakland armybase. I to give ofourselves aswe can to make tend to have little impact on commu- commanded two otherhospitals before life a little better for those like she has nit)' improvement as a whole. reaching mandatory retirement age at seen. Possiblyyou are now ready for my 60. The problem ofphysician distribu- declaration that "in myyouth I gath- One ofmy painful duties was to tion has long been with us. I have pon- ered materials for a cathedral and in administerpunishment to our chap- dered the question foryears. A list ot myold age builta woodshed." I could lain, whowas drunkin a hotel the reasons explain physicians' reluctance feel that way, but I don't. There is entire two weeks ofsummercamp. He to settle in the rural areas. I have con- something about beinga partofthe later came back to thankme, saying cluded that a particular sort ofperson lives ofpeople in the low countryof that prior to my regime people had is required for this type ofpractice, South Carolina that has more than ful- alwayscovered up forhim, but that my and such an individual seems to have filled my professional expectations. treatmentforced him back to reality. relatively low market-value in the Jcmies W. Forrester "55 He gave up his parish and joined .V\. medical school admissionprocess; AlbertB. Crum's article on comparativelyfeware selected. A WarMemories Absolute Leaders illustrates the influ- school's survival understandably must You deser\'e the highestpraise for the ence oftestosterone on histon,'. Erom be linked to the attraction ofstudents Spring '93 issue ofthe Bulletin. It Alexander to Saddam Hussein, all have whowill one day have real impacton brings backa swann ofmemories. I also been AbsoluteMales. As I read the financially productive areas ofthe was in the Si.xth General Hospital the morningnewspapertoday I have health care industry'. The triad of alongwith Ed Bland, Claude W'elch no reason to believe thathumankind — research, teachingand clinical practice and Marshall Bartlett in Florida, will turn awayfrom wars anytime in has been emphasized bymedical Morocco and Rome. the future. school faculties. Onlvrecentlvhas War touches people in places SedgwickMead '^8 Summer 1993 Letters Pulse Praise and Reflection The New Research BuildingGets a Name Equities, Inc. and Warren Companies — The Spring 1993 Bulkmiyou label as Harvard iVledical School has received a which marketpetroleum and food — — \'nur"War and Peace" issue is a superb $20 million gift the largestsingle products do S600 million a year in — collections ofarticles. I could not help donation in IIAIS histor\' from the volume. but read every single one. You seem to W'arren AJpert Foundation for the "Warren .\lpert is a man ahead of have picked out the pearls from the school's new research building. To be his time," said Dean Daniel C. mass ofliterature covering the last half named the Warren Alpert Building, Tosteson '48 in acknowledging the centur\'. the five-ston,' facility, which opened gift. "He was one ofthe first friends of I was impressed particularly with last fall, houses laboratories ofthe Har\ard Medical School to recognize Jennifer Leaning's "New World departments ofgenetics, neurobiology', the value ofour New Pathway in med- Disorder." She poses many questions and patholog)', and the Center for ical education. And today, with his addressingourdilemma in dealing Blood Research. splendid generosity, once again with the rights ofthe individual In presentingthe gift, Warren Warren Alpert is leadingthe wayin against the rights ofthe group. This is Alpertexpressed his wish "to stimulate providing a home for the nextfrontiers an issue within our own .American biomedical research and encourage in biomedical research." societ)' as much as it is between scientific achievements thatwill allevi- Alpert donated $500,000 to help nation-states in the societyofman on ate human sufferingfrom disease....It launch the New Pathwaycurriculum, — this planet this world village. gives me enormous satisfaction to and sixyears ago, he established the I myselfam disappointed that as the know thatI am helpingmillions of Warren.Alpert Foundation Prize in world has become a "village," albeit a people around the world who will ben- biomedical research, which is adminis- huge one, the nation-states are assert- efit from the advances that will take tered by H.\IS and presented annually ing theirsovereignty' and indepen- place in the new building." to a scientistorteam ofscientists in dence. WTiat's more, within their Born in Chelsea, iMassachusetts, the United States orabroad. current boundaries, these entities are Alpert put himselfthrough Boston As Har\'ard PresidentNeil breakingup into even smaller, ethnic- University, where he graduated in Rudenstine commented at the dedica- oriented microcosms. Man has losthis 1942. He served in W^orld Wzr II, for tion ofthe WarrenAlbert Building in faith in God. which he was awarded the Purple May: "Manypeople give moneyaway, Even here in Hawaii, the "Native Heart, and in 1947 he graduated from but the mostintelligentand enlight- — Hawaiians" ofwhich there are fewer Harvard Business School. With practi- ened people give moneybecause they than 5,000 (outof 1.2 million people) cally no money, he then started his see somethinggood." who are "pure," full-blooded, because own business and today, Warren — ofintermarriage are now trying to assertthemselves and are demanding WarrenAlpertandDean sovereignty, i.e. lands, compensation DanielTosteson and political autonomy. I once thought the societ)' ofman might reach an Utopian "One World" under a parliamentofnationswith a world court and "world troopers" (police) who would enforce common — law modeled after the United States and its Constitution! Instead, itseems we are now headed toward self- destruction: each man for himself, each grouping for itself. J. Bryan Hehir, in the concluding article "Is ForceJustifiable?", is equally pessimistic. Frederick Reppini j(; HARVARDMedicalAlumni Bulletin