Professional Documents
Culture Documents
)12### $34356#7898
T H E
P H A R O S
of Alpha Omega Alpha honor medical society Autumn 2010
Editor Emeritus
Designer
Editorial Board
Seattle, Washington
Lynchburg, Virginia
Councilor Directors
Philadelphia, Pennsylvania
Portland, Oregon
Stanford University
Student Directors
www.alphaomegaalpha.org
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Editorial
Endings are beginnings
4
Eric Pfeiffer, MD
32 Health policy
Cost of a life: Resource
allocation in the current health
care environment
Benson Shih-Han Hsu, MD Stroke in black and white
Srijita Mukherjee
34 The physician at the
movies
Peter E. Dans, MD
Extraordinary Measures
The Hurt Locker
12
39 Reviews and reflections
Dying for Beginners
Reviewed by Jack Coulehan,
A medical ear in the early morning
tennis group—when to advise and
MD what to say
On Being Certain: Believing You
Are Right Even When You’re Herbert Y. Reynolds, MD
Not
Reviewed by John L. Wright, MD Commentary
Technological Medicine: The
Changing World of Doctors Charles M. Plotz, MD, Med ScD
and Patients Herbert L. Abrams, MD
Reviewed by Frederic W. Platt,
14
MD
43 Letter
Page 4
Page 14
48 Commemorating the
fiftieth anniversary
of a medical
landmark
58 Index
Page 12
On the cover
Issue
See page 4
Attuning to equlibrium
AΩA NEWS
Physician as artist, artist as physician
Eliza C. Miller 44 Program announcements
2010 Edward D. Harris
Professionalism Award
18
2009/2010 Visiting Professorships
2009/2010 Medical Student Service
Project Awards
2009/2010 Administrative Recognition
Awards
2009/2010 Volunteer Clinical Faculty
Awards
One simple question can
change the world
George L. Spaeth, MD
50 Alpha Omega Alpha
members elected in
2009/2010
27 50
BACK
COVER
Richard L. Byyny, MD,
appointed Executive Director
of Alpha Omega Alpha
POETRY
Page 27 25 Wind
Sharon Maas
26 Echocardiogram
Paul Rousseau, MD
29 Hearing
Michael R. Milano, MD
33 Adwoa
Julia Geynisman
Page 18
60 Amanda’s Garden
Fredric L. Coe, MD
33
INSIDE Poppies
BACK
COVER Sara Parke
Dr. Tinsley Randlolph Harrison.
Photo courtesy of Dorothy Carpenter Medical
Archives of Wake Forest University.
4 The Pharos/Autumn 2010
Tinsley
Randolph
Harrison, MD
A legacy of medical education
K. Tinsley Anderson
The author is a member of the Class of 2011 at Wake , , to a sixth-generation physician, William Groce
Forest University School of Medicine. Harrison. Groce Harrison was more educated than most of his
nineteenth-century medical contemporaries, having gradu-
T
insley Randolph Harrison is a grand figure in the his- ated from Auburn University and studied at the University of
tory of medicine who touched many lives through his Nashville, with more academic instruction further afield in
teaching, philosophy of education, and personal care. later years. But his early medical education consisted mostly
He is important not only for such seminal works as Principles of lectures from local practitioners and a few examinations.
of Internal Medicine, but because he reached into the future Medical education in the United States in the later part of the
of medicine by establishing a model of internal medicine nineteenth century lacked anatomical dissections and much
departments and medical education that remains largely in- of the scientific instruction like laboratory work that would
tact today. Tinsley Harrison was destined to be a doctor. His come to characterize twentieth-century medicine. Groce
heritage in the medical arts prepared him to refine his skills Harrison recognized his educational deficiencies, and when
at several renowned institutions. After establishing himself money and time afforded, he pursued greater knowledge in
as a dynamic teacher, thought-provoking researcher, and re- his field. In , he enrolled in Baltimore Medical College,
markable physician in sixteen years at Vanderbilt University, his second medical school, and there learned of a new insti-
Harrison made the historic move to Winston-Salem to es- tution in the European model being set up nearby at Johns
tablish the Department of Internal Medicine at the newly Hopkins Hospital. At Hopkins, Groce Harrison met and be-
relocated and revamped four-year Bowman Gray School of friended William Osler, the man who would come to influence
Medicine (BGSOM, now the Wake Forest University School American medicine and the lives and careers of Groce and his
of Medicine). Harrison’s philosophy touched all aspects of descendants.1p26
medicine at BGSOM—medical student education, intern and Groce Harrison and William Osler kept in touch through-
resident schedules and instruction, the in- and outpatient de- out the years and Groce often wrote or met with Osler to ask
partments, research, and more. His model of medical instruc- career advice. In one such encounter, Groce asked for counsel
tion and student integration into the workings of a hospital about taking a chief of Medicine position in Mobile, Alabama,
shaped the future of every student’s experience and learning and giving up general practice. After discussing the young
at BGSOM and ultimately set a model for medical schools Harrison family’s finances, Osler instructed Groce to “get into
everywhere. a small subspecialty that does not involve exposure to all kinds
Harrison was in born in Talledega, Alabama, on March of weather. Go abroad and get a year’s training, if that is all you
Left, Dr. Harrison as full faculty member, bottom left, 1944. Right, the Bowman Gray School of Medicine cornerstone laying cer-
emony: Mrs. Bess Gray Plumly, sister of the late Bowman Gray, had the honor of laying the stone. From left to right: James A. Gray, Jr.,
Smith Hagaman (Superintendent of NCBH), Bess Gray Plumly, Governor Melville Broughton, Gordon Gray, Bowman Gray, Jr., Coy C.
Carpenter. Photos courtesy Dorothy Carpenter Medical Archives of Wake Forest University.
can afford. And train those boys [Groce’s sons] to be teachers up the chief resident position there in . His lifelong friend
of medicine.” 1p38 Though Tinsley later said that he had no Alfred Blalock accompanied him. Both served as junior fac-
knowledge of this encounter until after he took his first posi- ulty at Vanderbilt for sixteen years, arriving and leaving on
tion as chairman of Medicine at BGSOM, Osler was obviously the same day.
a great influence in the Harrison household. Of his childhood, At Vanderbilt, Harrison began his research career in
Tinsley later noted, “I believe that learning to distinguish be- earnest, focusing primarily on heart failure and the circula-
tween the synonyms God, Jehovah, Adonai, the Lord, and Dr. tory system. In he published Failure of the Circulation
Osler are my earliest memories.” 1p2 based on his own investigations. In it he promoted the idea of
Young Tinsley was a good student and his parents were qualitative investigation instead of the descriptive methodol-
willing teachers. From his mother he was imbued with scrip- ogy that had been the norm. After publishing a new edition
ture and Shakespeare; from his father, on their long walks in , he refused to write further editions because he had
together and home visits to the ailing, he learned about biol- no new data to contribute. Though some of his research is
ogy, astronomy, and certainly medicine. Tinsley’s interests not well known, he also made advances in basic science, such
were as varied as his parents’. Groce Harrison wanted only as proving that digitalis shifted potassium out of myocardial
the best education for his son, so Tinsley applied to Harvard cells. He was prolific in his sixteen years at Vanderbilt, ul-
College, planning to study law. He was accepted, but family timately publishing papers in addition to Failure of the
finances precluded his attending. Therefore, upon high school Circulation.2
graduation, he matriculated at the University of Michigan.
Osler’s and Groce’s influences were strong, however, and after The move to Bowman Gray
one year in Michigan Tinsley transferred to Johns Hopkins. When Bowman Gray died in , the former chairman
Unfortunately for Tinsley, Osler died in , the year Tinsley and president of R. J. Reynolds bequeathed , in stock
arrived in Baltimore.1p15 to Wake Forest University to convert its two-year program
Harrison’s early career was successful and notable for to a four-year medical school in Winston-Salem. The North
the friendships he made. He spent his first two years after Carolina Baptist Hospital was to expand from its -bed fa-
medical school graduation at Peter Bent Brigham’s hospital cility to beds to serve the school and to allow the program
in Boston, returning to Johns Hopkins for his third year of to grow to the more modern four-year model. Dean Coy C.
internal medicine training. Canby Robinson of Vanderbilt Carpenter of the Wake Forest University School of Medicine
University School of Medicine persuaded Harrison to take worked tirelessly for several years to appoint faculty and
arrange the structure of the new school. Dr. Herbert Wells, Harrison later said of the Grays, “They indicated to me they
soon to become professor and chairman of the Department were behind the school and were going to stay behind it.” 5p3
of Physiology at Bowman Gray, suggested Tinsley Harrison’s Dean Carpenter’s many appointments strengthened the
appointment to Dean Carpenter. Harrison seemed intrigued fledgling school’s reputation: Dr. Camillo Antom, a world-
when Wells proffered the idea: “I am thoroughly open minded renowned chemist, Dr. Wingate Johnson, clinical professor of
on the subject and the possible prospect of being able to start Medicine and chief of the Private Diagnostic Clinic, and Dr.
from the ground up and build a department . . . second to John Williams, a well-known researcher from Johns Hopkins,
none.” 3 among others. Dr. Rusty Holman, chairman of the Department
Harrison’s credentials were as strong as his desire to create of Pathology at the University of North Carolina at the time,
a first-rate school. Vanderbilt’s Dean W. S. Leathers had no said of Harrison’s acceptance of the position, “Now for the first
hesitation, except his unwillingness to lose Harrison, in rec- time, I know you are going to have a first class medical school
ommending him to Dean Carpenter. In a letter to Carpenter, because you’ve got Tinsley Harrison there.” 5p3
Leathers noted: “He is a conscientious and untiring worker Once he decided to take the job, Harrison worked unremit-
and at the same time possesses a degree of brilliancy that tingly to create his ideal department. He and Dean Carpenter
is unusual.” 4 But Harrison was not just an ideal physician. corresponded frequently in the months running up to the July
Leathers also commented, “The students tell me that he has , , beginning of the school year. After one conversation
remarkable ability as an instructor and presents his subject on December , , regarding plans for the school and the
enthusiastically and effectively. In other words, he possesses department for the next few years, Dean Carpenter suggested
marked inspirational qualities as a teacher.” 4 Harrison write him a letter summarizing the details. The next
After being tentatively offered the position of the chair of day, Harrison wrote a twenty-five-page letter detailing the
Medicine, Harrison and his wife visited Winston-Salem. Along outlines of the new department, from the minute to the gran-
with his desire to create a department to his own liking, the diose. Harrison wrote,
charming people the Harrisons met apparently sealed the deal.
Harrison said of Dr. Wingate Johnson, one of a few physicians Aim of the Department of Internal Medicine
who had already committed to be on staff, “The impression he To become the best department of internal medicine
made on me had a great deal to do with my decision to accept anywhere. This should be looked on as not just a praisewor-
the position.” 5p2 He also seemed to be swayed by the charisma thy Utopian dream but as an attainable although difficult
of the Gray family as well as their support of the new school. objective. The velocity of progress toward this aim will
Dr. Harrison in 1944. Photo courtesy Dorothy Carpenter Medical Archives of Wake Forest University.
naturally vary according to conditions, but the direction of new Bowman Gray School of Medicine, Harrison suggested
progress should not be altered under any circumstances. 6p2 a major change in the training of students and house staff.
Traditionally, most of the teaching in medical schools was
In this letter, he described salaries, educational philosophy, conducted by local practitioners who contracted with the
physical layout of the facilities, and much more. In subsequent schools but worked in their own clinics outside of the institu-
correspondence, Carpenter and Harrison discussed such trivia tions for which they taught.8 Harrison believed that proper
as the style of furniture and the color of the walls. Being wily instruction of the trainees required considerable time from
and aware of the limited funds of the school, Harrison was seasoned physicians who were faculty and primarily academic.
clever in his allocation of resources: In Nashville, he had noted the antagonism between the medi-
cal school and private practitioners; he therefore preferred
From a psychological standpoint it is probably better to that his faculty not practice outside of the school. With great
have very inadequate space for the Outpatient Department tact, he refrained from objecting to members of his depart-
rather than moderately inadequate space because in the ment practicing privately, but made it known that he would
former instance the defect will be so apparent that there will not. “The indigent patients will be my patients and I was
be more opportunity to obtain special grants to remedy it.7 happy with that decision and I never regretted it, because I
do not think I made a single enemy for the school during the
years I was there.” 5p5
Educational ethos Harrison also believed in the value of bedside teaching.
As Harrison and Carpenter discussed their plans for the He said, “Teaching was all with patients, so patient care and
Harrison. He wrote to the members of the class of , the misanthrope may become a smart diagnostician of organic
last class he taught at BG, disease, but he can scarcely hope to succeed as a physician.
The true physician has a Shakespearean breadth of interest
I still look back on the period in Winston-Salem as one in the wise and the foolish, the proud and the humble, the
of the peak periods of an academic life that has now lasted stoic hero and the whining rogue. He cares for people.1p8
nearly one-half century. The greatest thing about it was the
smallness of the classes which enabled me to know, person- References
ally, every one of you.12 . Pittman JA Jr. Tinsley R. Harrison, M.D.: Teacher of Medi-
cine. Subject file: Harrison, Tinsley. Winston-Salem (NC): Dorothy
He said Winston-Salem was Carpenter Medical Archives, Wake Forest University School of
Medicine.
the greatest community I’ve ever lived in. . . . The people . Dalton ML. William Osler’s influence on the career of Tins-
there, the friendliness, the open-armed attitude they had ley Randolph Harrison. South Med J ; : –.
toward our faculty. I’ve never encountered this anywhere . Harrison TR. Letter to Dr. Herbert Wells of October ,
like it was in Winston-Salem.5p25 . Subject file: Harrison, Tinsley. Winston-Salem (NC): Dorothy
Carpenter Medical Archives, Wake Forest University School of
Beyond BGSOM Medicine.
Harrison achieved much in his long career. Besides his . Leathers WS. Letter to Dr. Coy C. Carpenter of December
accomplishments at Vanderbilt, his remarkable influence as , . Subject file: Harrison, Tinsley. Winston-Salem (NC): Doro-
chair of Medicine at BGSOM, Southwestern Medical College, thy Carpenter Medical Archives, Wake Forest University School of
and the University of Alabama at Birmingham, he achieved Medicine.
many other eminent positions—president of the American . Morehead R. Oral History Interview No. with Dr. Tins-
Society of Clinical Investigation, founder and first president of ley Harrison, interviewed by Dr. Robert Morehead, February ,
the Southern Society of Clinical Investigation, President of the . Subject file: Harrison, Tinsley. Winston-Salem (NC): Dorothy
American Heart Association, founding member of the Council Carpenter Medical Archives, Wake Forest University School of
of the National Heart Institute, and recipient of the Kober Medicine.
Medal, one of the greatest honors an internist can receive.2 . Harrison TR. Letter to Dr. Coy C. Carpenter of December
Beyond these, his most well known contribution to medicine , . Subject file: Harrison, Tinsley. Winston-Salem (NC): Doro-
is Harrison’s Principles of Internal Medicine, first published in thy Carpenter Medical Archives, Wake Forest University School of
and now in its seventeenth edition. Arguably his greatest Medicine.
gift to medicine is the spirit and philosophy he gave to U.S. . Harrison TR. Letter to Dr. Coy C. Carpenter of December ,
medical education. His forward thinking ideas still propel . Subject file: Harrison, Tinsley. Winston-Salem (NC): Dorothy Car-
BGSOM’s current curriculum for students and house officers. penter Medical Archives, Wake Forest University School of Medicine.
His ethos of medicine still hums in the principles and objec- . Eddleman EE Jr. Tinsley Randolph Harrison: Medical investi-
tives of American medical education and in our personal and gator, physician, and educator. Clin Cardiol ; : –.
professional development. His words say it best, as he writes . Morehead RP. The contribution of a great man to Wake For-
in the introduction to the first edition of his seminal work: est University and its Bowman Gray School of Medicine—Tinsley R.
Harrison, M.D. N C Med J : : –.
No greater opportunity, responsibility, or obligation can . Harrison TR. Letter to Dr. Coy C. Carpenter of April ,
fall to the lot of a human being than to become a physician. . Subject file: Harrison, Tinsley. Winston-Salem (NC): Dorothy
In the care of the suffering he needs technical skill, scientific Carpenter Medical Archives, Wake Forest University School of
knowledge, and human understanding. He who uses these Medicine.
with courage, with humility, and with wisdom will provide a . Dalton ML. The friendship and letters of Alfred Blalock and
unique service for his fellow man, and will build an endur- Tinsley Harrison. Am Surg ; : –.
ing edifice of character within himself. The physician should . Harrison TR. Letter to Dr. John R. Ausband of December ,
ask of his destiny no more than this, he should be content . Subject file: Harrison, Tinsley. Winston-Salem (NC): Dorothy
with no less. . . . Carpenter Medical Archives, Wake Forest University School of
Tact, sympathy, and understanding are expected of the Medicine.
physician, for the patient is no mere collection of symp-
toms, signs, disordered functions, damaged organs, and The author’s address is:
disturbed emotions. He is human, fearful, and hopeful, seek- 1409 W. 4th Street, Apartment D
ing relief, help, and reassurance. To the physician, as to the Winston-Salem, North Carolina 27101
anthropologist, nothing human is strange or repulsive. The E-mail: tianders@wfubmc.edu
The Pharos/Date 11
A medical ear in the early morning tennis group–
when to advise and what to say
Herbert Y. Reynolds, MD
A
The author (AΩA, University of t our early-birds group times a week. Exercise is extolled as
Virginia, 1965) is Medical Officer in assembles to play tennis and the main reason for playing, but talk-
the Division of Lung Diseases at the talk. The exercise is invigorat- ing has increasingly crept in. It first
National Heart, Lung, and Blood ing and the tennis is quite good, given occurs as the group assembles in the
Institute of the National Institutes of some foot faulting with serving and clubhouse, then before the warm-up,
Health; Adjunct Professor of Medicine occasional confusion about keeping and during court changeovers on odd
at the Uniformed Services University the game’s score. Players are trim, with games. Conversation gets to the essence
of the Health Sciences in Bethesda, bags full of rackets, and often carry- of what is becoming more important as
Maryland; and Professor of Medicine, ing a cup of coffee or Gatorade; but a the years pass along. Individuals in the
Emeritus, at the Pennsylvania State closer look shows some with a wrist group are in academics, the professions,
University College of Medicine in support or a knee strap stabilizer. We and government leadership. There are
Hershey, Pennsylvania. are all older. The group, numbering seven other physicians, two of whom are
about twenty-three men and women, in clinical practice; two of us volunteer
has been together for almost a decade in free medical clinics.1 Thus, getting
with little turnover. Most play multiple advice or hearing opinions on a variety
Commentary
First of all, congratulations to Dr. direct answer is avoided. In the very tend to span the panoply of chronic
Reynolds for being part of a long-term rare instance in which you believe disease and more: osteoarthritis,
tennis group where “players are trim” that harm is being done, or about to heart disease, cancer, hips, knees,
BOE iUIF UFOOJT JT RVJUF HPPEw )F JT be done, it might be wise to remark shoulders, headaches, and general
far ahead of my game. that: “I guess that if it were I with that aches and pains. Should my wife
The tennis, however, is just a problem I’d get another opinion.” continue with mammograms each
symbol for any group of friends who year? My memory is going down-
Charles M. Plotz, MD, MedScD
meet regularly and include several hill: should I be worried? What will
(AΩA, State University of New York,
physicians along with a majority of become of the younger generation?
Downstate Medical Center)
XFMMFEVDBUFE MBZ QFPQMF )PX CFTU 4PNFPOF* GPSHFU XIPBOTXFSFE
Professor Emeritus of Medicine,
to respond when medical questions that question, “They’ll grow up and
SUNY Downstate
arise? This can sometimes be a deli- start worrying about the younger
Brooklyn, New York
cate problem. generation.”)
Some time ago, in The Pharos, I I try to respond to each and every
longed for a return to the Doctors’ medical question (and a few planetary
Dining Room where physicians from matters) as helpfully as possible, al-
varying specialties could cross- I can evade questions ways with a caveat: “I don’t give advice
fertilize with speculative conversa- to anyone based on partial informa-
UJPO 4VNNFS ðîîõ
QQ ñôoñõ
5IF without help; what I need tion. I will sometimes indicate what
Reynolds problem is quite different I would do if I were in your position.
since it involves predominantly lay is answers. More importantly, if this keeps both-
people in a non-professional environ- —John F. Kennedy ering you, see your primary physi-
ment. cian.” If it’s clearly a special problem, I
The problems Reynolds warns of don’t hesitate to name a doctor whom
are quite familiar to most physicians. The score is -, you’re changing I consider outstanding in that area.
Casually met lay people often ask sides and having a sip of water at My buddy with the prostate cancer
one’s specialty and then proceed to the net, and your tennis buddy says, had no symptoms, no palpable mass,
ask a question clearly personally re- i)FSC
* IBE B TMJHIUMZ FMFWBUFE 14"
and a normal bone scan. I went into
lated. Dermatologists in particular then a bunch of biopsies, and now, at some detail as to the options, the
are susceptible to the person in the the age of seventy-nine, they want to risk/benefit of each, age and prostate
next airplane seat rolling up a sleeve cut out my prostate. Whaddya think?” cancer, and the meaning of a PSA. I
and asking: “Doc, what do you think " WPUF PG UIBOLT UP )FSCFSU told him that if I were in his position,
this is?” (I myself insulate myself by Reynolds for articulating a question I would hold off on surgery, radia-
declaring myself a proctologist, thus that comes up every day across the tion therapy, and hormones, and en-
ending the questioning.) planet and evokes a different response joy his grandchildren, life in general,
It is almost always more prudent, from everyone who’s asked. and tennis in particular as central to
however, in a social situation such We have thirty-four fellows in maintaining his good spirits and good
as described here, to avoid anything our tennis group in Palo Alto, locally health. That was four years ago, and
which could be interpreted as specific known as the “Termites” because we he’s still hitting unreturnable drop
advice, positive or, worse, negative. used to play at Terman Park. The shots.
Always include the caveat that one median age is about seventy-eight,
)FSCFSU-"CSBNT
.%
should rely on the opinion of one’s the range sixty-five to ninety. Each
(AΩA, State University of New York,
personal physician. of us plays two or three times a week
Downstate Medical Center, )
In Dr. Reynolds’s enviable tennis at .
Professor Emeritus of Radiology,
club there are several other physi- The issues that arise cover the
Stanford University School of
cians, so it is easy to manage a diffi- future of the planet, the economy,
Medicine
cult question by passing it around and immigration, Afghanistan, and doz-
Palo Alto, California
creating enough multiplicity so that a ens of others. The medical questions
Dr. Langhorne (AΩA, Tulane Medical School, 1957) is in private practice in cardiology at Cardiology Consultants in Pensacola, Florida. His address is:
1910 Seville Drive, Pensacola, Florida 32503. E-mail: bardwhl@aol.com.
Wind
And so it has come to you too.
The winds of
death
brushed past your door;
scraped the
paint away.
Long shreds hang helplessly
Bare wood stares through
And I, who seek to
form my life
in the shape
of a shield
against the wind
I search for paint and brush
And find none.
Sharon Maas
The Pharos/Date 25
Echocardiogram
A caricatured performance reminiscent of an
old black and white movie
with an occasional Doppler rainbow
muscular walls thrusting with duty
valves fluttering like industrious butterflies.
Whoosh, whoosh, whoosh,
tricuspid I’m told, then pulmonic
followed by mitral and
lastly, the Grande Dame,
the aortic
like the mouth of a
puffer fish blowing human surf
without the ebb, just the flow.
Paul Rousseau, MD
26 The Pharos/Date
One$simple$question$can$
change$the$world
George L. Spaeth, MD
The author (AΩA, Harvard Medical School, 1959) is the well-dressed woman, “What are you doing to make the world
Esposito Research Professor at the Wills Eye Institute and better?” Her response was one of stunned amazement. Why
professor of Ophthalmology at Jefferson Medical College. would I possibly ask that question? The issue seemed never to
have crossed her mind. There was no answer. She immediately
M
any patients in my practice today are elderly, a started describing her visual symptoms. For the rest of the day,
good proportion of them are comfortable from a I asked every patient the same question, interspersed among
financial point of view, and many live in retirement other routine parts of history, such as, “Are you having any
homes. The overwhelming majority previously had a produc- trouble using the eye drops?” “Do you think your visual ability
tive vocation. In response to a question that is a routine part is the same, better or worse than it was when I saw you last?”
of my history taking, specifically, “What are you doing with and other routine and expected questions. The query, “What
your time now?” the answer is almost always, “Nothing.” Many are you doing to make the world better?” was presented just as
feel bored, and almost none are involved in activities directed if it were a usual part of history taking.
toward the well-being of others. A few people were so dumbfounded that they simply
These individuals could be doing much that would help our ignored the question. Most were doing nothing that they
world’s needs. Other people have had a similar thought, as a thought was making the world better; they justified this by
result of which there are a variety of opportunities for “retired” detailing the difficulties they were having in just taking care of
individuals to be active in a constructive way. themselves. A small portion mentioned volunteer work such
Several months ago, I asked an eighty-five-year-old, vibrant, as being “active in my church,” but on further questioning this
Cost of a life
Resource allocation in the current health care environment
Benson Shih-Han Hsu, MD
The author is a fellow in Pediatric failure. Knowing the overall poor prog- than enough suffering.
Critical Care at the University of nosis of this condition, I wondered if his Although numerous ethics consul-
Wisconsin School of Medicine and continued medical care was appropri- tants discussed the futility of JR’s care,
Public Health. ate—not from a perspective of futility I wondered whether his treatment was
but from one of resource allocation. This a just use of our limited health care
JR
had trisomy , a chromo- was the question I battled as I took care resources—a topic that was rarely, or
somal disorder affecting three of him over the next several years. even peripherally, discussed. No one
in , births. Patients with To have any chance for survival, JR wanted to consider limiting care based
trisomy possess a characteristic set of required repair of his cardiac defects. on an abstract view of scarce resources.
physical findings including small size, A study in the American Journal JR had been admitted over fifteen times
clenched hands with overlapping fin- of Cardiology reported that most tri- to the wards as well as the neonatal and
gers, short sternum, prominent occiput, somy patients undergoing cardiac pediatric intensive care units. He under-
low-set ears, micrognathia, and rocker repair averaged about four months old.3 went numerous operations and proce-
bottom feet. For the overall trisomy JR was thus discharged home to grow dures. He received consultations from
population, a recent case series from until cardiac surgery was more likely to more than eight separate pediatric ser-
Japan showed fifty percent mortality be successful. Unfortunately, given his vices. He suffered countless infections and
within one month and less than ten per- heart failure and feeding difficulties, was mechanically ventilated on several
cent survival within one year.1 Cardiac he suffered multiple medical setbacks occasions. He spent most of his life in the
abnormalities are the primary source of over the following eighteen months, hospital and the cost of his care exceeded
morbidity and mortality.2 undergoing several operations including that of most hospitalized patients.
JR was born with significant congeni- gastric and duodenal tube placements, JR was a beautiful child who brought
tal heart disease. His cardiac anomalies central lines placements, and pulmo- happiness to his parents and family. He
included a PDA, an ASD and a VSD nary artery banding. His postoperative was aware of his environment, with-
with left to right shunting. Secondary to recovery was constantly fraught with drawing from pain, having vital sign
his cardiac lesions, he developed severe complications as he developed mul- changes with stress, and even occasion-
pulmonary hypertension. The already tiple infections and respiratory failure. ally smiling. At the same time, JR was
dismal prognosis for trisomy became Despite the repeated setbacks, his par- one patient in a population of millions.
even worse once his cardiac anomalies ents maintained their resolve to not He had a dismal initial prognosis with
were diagnosed. Nevertheless, his par- limit his care. an incalculable but small chance for sur-
ents were clear that there be no limita- I continued to care for JR as I finished vival. Millions of dollars were spent on
tions on care. residency and began a fellowship in crit- his care. In treating patients like JR, are
I met JR within the first few ical care. When he reached eighteen we denying resources to others?
weeks of his life. I was a senior months, he was finally deemed medi- Health care economists try to quan-
resident on the wards when cally ready, and underwent the success- tify the best method for resource alloca-
I heard that a child with ful repair of his VSD and ASD. But after tion. Cost effectiveness analysis (CEA) is
trisomy was to be over four weeks in pediatric intensive one of the most commonly used evalu-
admitted for failure care with multiple failed extubations, ations. CEA defines the quality adjusted
to thrive and con- his parents decided to withdraw care, life years (QALY) saved for a given cost
gestive heart convinced that he had endured more of intervention.4 For instance, to justify
Adwoa
lation, rationing is based on who has . Graham EM, Brad-
insurance and who does not. Instead of ley SM, Shirali GS, et al.
determining what appropriate care is, Effectiveness of cardiac
we have created a class of uninsured cit- surgery in trisomies
izens who generally do not receive any and (from the Pedi-
type of health care outside of emergency atric Cardiac Care Con- (Born on a Monday in Ghana)
care.5 This leads to well-documented sortium). Am J Cardiol
Golden apples on a dress two sizes too big,
declines in overall health outcomes.7 ; : –.
Adwoa picks at her scab(ie)s.
JR was born in the United States, . Griebsch I, Coast
An illiterate girl
which lacks a nationalized health care J, Brown J. Quality-
An inaudible voice
system, so considerations of cost were adjusted life-years lack
Without currency to live in her bankrupt country.
not addressed in his treatment. I won- quality in pediatric care:
Like a doll that was left in the rain,
dered what would have happened if he a critical review of pub-
A drab child‘s toy—a troll
had not had virtually unlimited health lished cost-utility studies
with a round belly but no rhinestone gem
care. Would others have benefited? in child health. Pediatrics
in the center to wish on, just a fleshy pink diamond
Would the money and resources have ; : e–.
under the frayed edge of apples
been used to save another child who . Singer P. Why
from which children will ripen and fall
lacked care? We Must Ration Health
and return
Nationalized health care systems al- Care. New York Times
to the red dirt from which they came.
locate resources by determining what Jul . www.ny-
is appropriate before treatment starts, times.com//// Julia Geynisman
allowing equitable distribution of re- magazine/healthcare-t.
sources. In the United States, restricting html. Accessed July , Ms. Geynisman is a third-year medical student at the University of
Michigan. Her address is: 1607 South University Avenue, Ann Arbor, Michigan
treatment for one does not necessarily .
48104. E-mail: jgeynis@med.umich.edu.
lead to the gain of another. The re- . Merriam-Webster’s Photo courtesy of the author.
sources spent or not spent on JR’s care Collegiate Dictionary.
Besides the wrong age of the children, the actual scientist Oklahoman Jan . blog.newsok.com/okccentral////
Dr. William Canfield was a physician at the University of extraordinary-measures-takes-extraordinary-measures-to-rob-okc-
Oklahoma, not the University of Nebraska, which has every of-credit-for-scientific-breakthrough/?searched=extraordinary
right to be upset at the cheap shots taken by the filmmak- measures&custom_click=search.
ers. Whether they are or not, Oklahomans certainly resented
the way Canfield was fictionalized but Crowley was not, and The Hurt Locker
Oklahoma City and its pioneering lab were airbrushed out,
Starring Jeremy Renner, Anthony Mackie, and Brian Geraghty.
along with Canfield. Although described as being “surly” or
Directed by Kathryn Bigelow. Rated R. Running time 130 min-
“shy and quirky” at times, Canfield appears to be nothing
utes.
like the arrogant cinematic portrayal.2,3 If anything, it was
Crowley who was consistently described as arrogant, irascible,
and peremptory, much of which was excused because of his
concern about his children. Actually, it was Canfield who
T he film opens in Baghdad in , the worst period of the
Iraq war when improvised explosive devices (IEDs) were
the predominant means of killing American soldiers. The title
founded Novazyme in Oklahoma City and hired Crowley as comes from the expression for being injured and being sent
its CEO. Independently, Genzyme developed Myozyme (called to the “hurt locker.” The screenwriter (Mark Boal) draws on
“special medicine” in the film) and the two other prototypes in his six-week experience as an embedded journalist with an
collaboration with Dr. Y. T. Chen at Duke University1p27 and
Dr. Reuser at Erasmus Medical Center in the Netherlands.2
Jeremy Renner in the
Although unfavorably portrayed in the film, it was the medi-
Hurt Locker.
cal director at Genzyme, Dr. Hal Landy, who came up with CBS Films/Photofest.
the sibling study, not Crowley or Canfield.1p272 In addition,
Genzyme let Crowley retire with a generous severance pack-
age, including coverage of million in medical expenses
to supplement COBRA and what Bristol-Myers Squibb had
provided.1p301 All in all, not only did Crowley become wealthy
but he was treated very well by his employers, who hardly fit
the stereotype of ruthless capitalists.
Finally, the book gives a much more balanced picture of the
effects of this devastating illness on the family, especially the
older sibling and the mother who, in my opinion, is the real
heroine. She tolerated her husband’s behavior, which at one
point almost led to divorce, while being the primary caregiver
for two children on respirators, often with inadequate help un-
til a saintly woman named Sharon Dozier became almost part
of the family. Usually I agree that the deleted scenes provided
as extras on DVDs should have been deleted, but in this case
I do not, because they show the tough times and frustration
that the family suffered through and their inclusion would
have provided a realistic counterbalance to the heroic portrait
of Crowley and the “feel-good” storyline. Still, Nina Raben, an
NIH doctor who grew up in the former Soviet Union, summa-
rized the story best: “This is a very American story. It’s about
hope, it’s about will power, it’s about money, it’s about a belief
in happy endings.” 1p321
References
. Anand, Geeta. The Cure: How a Father Raised Million
and Bucked the Medical Establishment in a Quest to Save His Chil-
dren. New York: HarperCollins; .
. Genzyme website: Myozyme Product Information. www.gen-
zyme.com/pompemovie/.
. Lackmeyer Steve. Extraordinary Measures takes extraordinary
measures to rob OKC of credit for scientific breakthrough. The
this experience, he concludes, “Suddenly, The American whose action killed the
I find all my wounds are turning into peasant’s son would survive.
blessings.” This inversion of categories In another place, Clary writes about
is not an exotic, one-off event for Clary, taking care of patients from earthquake-
but a new way of looking at the world. prone and war-torn El Salvador.
It’s a perspective in which events in
the poet’s life, carefully observed and They say war is another kind of
described, suddenly reveal deeper mean- earthquake, worse,
ings that can only be expressed by meta- The real earthquake, the one that has
phor or paradox. For example, in “Days lasted years.p66
I Don’t Remember,” Clary reflects, “And
all my roads are turning into rivers.” p27 This earthquake can reach into your
Or, in “Meditation on the Pays d’Oc,” own home,
he observes, “Instead of dying, I cough
Dying for Beginners
up a butterfly, watch it/dry its wings in Bind your son with wire in front of you,
Patrick Clary the sun.” p74 Or the essential quietism of cut off
Lost Borders Press, Big Pine, California “That silence moving through our lives His genitals and stuff the organs into
2006, 86 pages was me” (“The Translator”).p33 his mouth.p66
The poet learned his first lessons in
Reviewed by Jack Coulehan, MD
dying during the Vietnam War, in which The Vietnamese peasant had lost one
(AΩA, University of Pittsburgh, 1969)
he served as a medic with U.S. infantry of his hands in the explosion. In a dif-
units. During “Orientation at Bien Hoa,” ferent poem (“Three Variations”), Clary
Yes, gentlemen
calls to mind his own hands
. . . square,
most of the poetry would focus on his This little war here Filled with themselves, professionally
clinical experience in the hospital and Exists only Tender on demand, but still uneasy
hospice. Vignettes of patients and their For one reason: At your easy tenderness.p35
families, for example, or didactic po- To give you all the pleasure
ems about the value of palliative care. You can handle.p10 The words “professionally tender on
After all, the title suggests a handbook demand” evoke his work in palliative
of sorts. Nonetheless, the reader soon He is also taught how easy it is to kill medicine, although the same words
discovers that Patrick Clary’s Dying for with an M rifle, which can could—and should—apply to medical
Beginners is actually a collection of vi- practice in general. But Clary recognizes
brant poems about life and living, about Put eighteen holes in that the human capacity for compassion
family, friends, music, loss, war, and Whatever you point it at is not inexhaustible. There will always be
love. The book’s title is more evocative Inside of two seconds.p11 a tension between the work that needs
than it initially appears, for it conveys to be done (“another pair of hands in the
the countercultural insight that dying Meanwhile, the human tragedy of emergency room” p63) and our limited
is an essential part of living. We only Vietnam takes place all around him. For reserves of kindness and empathy.
become fully human by coming to grips example, Vo Vanh Thom, a Vietnamese “Five Tasks Taught by Hospice
with our own mortality. Our engage- peasant whose son died in an explosion Nurses” pp72–73 is among the most mov-
ment with mortality emerges from love set off by a careless American soldier ing poems on love and death I’ve ever
and humor, as well as from pain and loss. who threw a match into the “firebase read. Dedicated to the poet’s brother
This is a lifelong project. Patrick Clary’s dump,” observes two bodies being who died in an accident, the poem con-
poems speak to what he has discovered loaded onto a Chinook helicopter: sists of five sections, each expressing
about himself, as a beginner to his one of the tasks of “successful” dying: say
fellow beginners. Though now they lay on the floor goodbye, express forgiveness, request
Clary’s route to discov- Of the gray Chinook together, forgiveness, affirm affection, and express
ery traverses Death Valley, The man with the match would be gratitude. In this case, Clary performs
where he undertakes a alive in each task in turn, as he reflects on inci-
retreat and vision America tomorrow, my child dead in dents in his and his brother’s lives. The
quest. In an open- Da Lat. p15 poem speaks with clarity, dignity, and
ing poem about compassion. True to the central theme
of Dying for Beginners, Clary affirms that tion of observing the mind in action.
forgiveness, affection, and gratitude are His “you must go on, I can’t go on,
tasks for the living, as well as the dying. you must go on, I’ll go on,” under-
He concludes, scores the paradoxical and philo-
sophically irresolvable relationship
Now I see: living is a kind of slow between thought and biology.p106
burning,
And love is what we salvage from the Finally, Burton contends that,
fire. p73
A stance of absolute certainty that
I can think of no better way to end precludes consideration of alterna-
this review than to quote a section of the most enjoyable and informative nonfic- tive opinions has always struck me
book’s eponymous poem, which refers to tion I’ve read in several years. It’s enjoyable as fundamentally wrong.pxiii
a chaplain’s visits to a dying patient: because the writing smoothly integrates
personal narrative, historical reference, These personal revelations, and the data
The engineer with end-stage cancer and anecdotes from literature and pop presented in On Being Certain, suggest
lived for their visits, culture, along with hard data from clinical that human beliefs span a bell-shaped
not only meandering with the chaplain medicine and laboratory studies; informa- curve with aggressive conviction on one
through memories— tive because it sheds light on the enor- end and dysfunctional ambiguity on the
his loving marriage, work well done, mous subjectivity with which we come to other. However, in his enthusiasm for
well-educated children— our opinions and decisions. As an example Godot, Burton seems to overlook the
he prized the weekly chance to scoff at of the latter, in a discussion of the role paralyzing stasis that the play also por-
angels and any possibility of heaven. of DNA and its influence on the way we trays.
His last word? “Wow!”p78 think about religion, Burton, comments on In the preface, Burton states his goals
his own “idiosyncratic world-view” p105 and in writing the book: () “I have set out to
Dr. Coulehan is a Book Review Editor for his “overwhelming existential bent.” p105 provide a scientific basis for challenging
The Pharos and a member of the journal’s He uses a personal experience from high our belief in certainty,” pxiv () “My goal is
editorial board. His address is: school to illustrate his belief that his mind to strip away the power of certainty by
Center for Medical Humanities, Com- is “programmed” to shun black and white exposing its involuntary roots,” pxiv and
passionate Care, and Bioethics answers for the most difficult questions. () “To dispel the myth that we ‘know
HSC L3-080 As a high school student, Burton what we know’ by conscious deliberation
State University of New York at Stony worked as an usher in a San Francisco . . . [by showing] how the brain creates
Brook theater that featured Samuel Beckett’s the involuntary sensation of ‘knowing’
Stony Brook, New York 11794-8335 Waiting for Godot, a play depicting the and how this sensation is affected by
E-mail: jcoulehan@notes.cc.sunysb.edu meaninglessness of man’s existence. everything from genetic predispositions
Burton writes of that purely accidental to perceptual illusions common to all
exposure, bodily sensations.” pxiii In other words
Burton is convinced that certainty (or
On Being Certain: Believing
I left the theater stunned. The res- the need for certainty) is a serious deter-
You Are Right Even When
onance was unnerving, as though rent to problem solving
You’re Not
Beckett had slipped inside my In two interesting chapters (“Neural
Robert A. Burton head and written what I hadn’t yet Network s and Modularity ” and
St. Martin’s Press, New York, 2008, 223 thought. Yes, this is how the world “Emergence”), Burton builds the foun-
pages is. The pleasure was profound and dation for a deeper understanding of
comforting, as though I’d discovered the individual neuron and its triggering
Reviewed by John L. Wright, MD
a kindred spirit.p106 impact on the vast neural network, such
(AΩA, Hahnemann Medical College,
that sensory input eventually emerges
1956)
And here again he writes seamlessly into the conscious mind. In
discussing the neural network, he uses
story on the back burner. Physicians The linkage of the external en- to relate to that person. And here’s the
could get closer to their key question vironment to health and illness is rub. If we don’t realize that we are doc-
and its key answer: where is the disease? innovatively, wisely, and elegantly tors for living persons, not injured joints
For the first time in history physicians portrayed in the Hippocratic work and ears, our patients may stop listen-
could learn something that the patient Airs, Waters, Places. It advised phy- ing to us, fail to follow our suggestions,
could not know. Not only would the sicians . . . to consider [the patient’s] and end up angry and dissatisfied. We
stethoscope distance patients from their situation, how it lies as to the winds forget George Engel’s remark that ours
physicians physically, but a metaphoric and the rising of the sun . . . whether is a unique profession in which the ob-
space would open, a space that physi- it be naked and deficient in water, or ject of our scrutiny is at the same time
cians today have difficulty bridging. wooded and well watered . . . and the scrutinizing us!
Laennec’s invention was not the first mode in which the inhabitants live, This is a fine piece of writing. Fun
technological step forward in medi- and what are their pursuits.p131 to read, with an aha! on every page.
cine, nor perhaps the most important, Would you have imagined that the fam-
but today we still carry, and sometimes Having edged into the twenty-first ily of obstetricians who invented the
use, variations on his little invention. century, it is difficult for us to realize obstetrical forceps managed to keep it
Nor is this the first time Reiser wrote that medicine had focused on the envi- a secret for almost a century? Might
about the stethoscope; he discussed ronment, the patient’s emotional style, you have expected that physicians ar-
it in a book, Technology and the and the four humors for almost gued mightily against Laennec’s simple
Reign of Medicine. Reiser even noted years. But it did. Then, around , wooden tube because it made them
that Laennec’s teacher, Corvisart, had largely through the work of Thomas more like mechanics and less like wise
translated a monograph by Leopold Sydenham and his colleagues, every- men? That every technological step for-
Auenbrugger, and that this translation thing changed. Sydenham thought we ward had both proponents and detrac-
prompted Laennec to create the first should classify diseases as we do other tors? Reiser’s prose is precise, lyrical,
stethoscope. entities of the natural world—plants or and entertaining. If I were asked to
Reiser discusses some of his favorite animals. He wrote: name a book that clarifies the heart of
technologies: the x-ray, the artificial kid- medicine, what we are really about, I
ney, the pressure ventilator, ultrasound, Nature, in the production of disease, would suggest Eric Cassell’s The Nature
the obstetrical forceps, and the medical is uniform and consistent; so much of Suffering and the Goals of Medicine.
record. Would you have considered the so, that for the same disease in dif- But if it is the history of medicine you
medical record a technological break- ferent persons the symptoms are for are after, if you want to come to under-
through? A mere hundred years ago few the most part the same; and the self stand how we got to where we stand to-
doctors kept written records about their same phenomena that you would day and what that stance looks like, the
patients. Our medical records have gone observe in the sickness of a Socrates very best might be Stanley Joel Reiser’s
through many generations since and are you would observe in the sickness of Technological Medicine: The Changing
now becoming computerized, to our a simpleton.1 World of Doctors and Patients.
benefit and despair. As you consider
the history of medicine, what would get From this he deduced that specific Reference
your vote as the most important step remedies could be found to treat those . Sydenham T. Medical Observations
forward? Antibiotics? Vaccines? The specific diseases. Aha! And what has Concerning the History and Cure of Acute
CAT and the MRI? Flexible endoscopes? happened in the ensuing years? Diseases. In: Latham RG, translator. The
Artificial knees and hips? My favorite is We have become experts at disease. Works of Thomas Sydenham. Volume I.
the disease theory itself. Prior to , We study the causation, diagnosis, pre- London: Sydenham Society; : .
vention, and treatment of disease. And
The idea of balance—among the medical education, all eight to twelve Dr. Platt is a general internist in private
basic constituents of the self, and of years of it, has become an education in practice and clinical professor of Medicine
the self with the essential elements disease. at the University of Colorado. His address
of the natural and social world—was But in the process we may fail to no- is:
the foundation of treating illness and tice that knees and elbows don’t come 396 Steele Street
preserving health.p132 into our clinic unless surrounded by a Denver, Colorado 80206
person. We may not care to learn how E-mail: plattf@hotmail.com
other’s freedom. I ask Dr. Radu, exactly Heidegger said the human experience
how would such a worldview promote consisted of being thrust into the world
“mutual understanding through our arbitrarily and ultimately accepting
different personal approaches”? p27 oneself as nothingness, a being-toward-
The author goes on to argue the death.3 Sartre said that “man is . . .
inadequacy of the Stoic and Epicurean forlorn, for he cannot find anything to
worldviews. I join him in his critique of depend upon either within or outside
these philosophies, but I fail to see how himself,” 1p34 and resigned himself to
existentialism solves the problems at- the idea that freedom is our great-
tendant in Stoicism and Epicureanism. est doom. Albert Camus said the two
For instance, Radu says that “the Stoic choices available to human beings are
misses the valuable lessons and pro- an absurd, meaningless existence on
Neither/nor found knowledge that can be gained one hand, and suicide on the other.4p144
In the Spring issue of The only through attachment and loss.” p29 These bleak remarks come from the
Pharos (pp. –), Andrew Radu The existentialist is concerned with existentialists themselves. Is that the
argues that existentialism has much how man should act in an absurd world kind of worldview that should direct
to offer the suffering patient and the in which he knows he will die, and he the physician-patient relationship?
treating physician, contending that this elevates the will over the intellect—do- Ultimately, existentialism is subjec-
philosophy liberates us to “create our- ing over knowing. As such, existential- tive, fatalistic anti-philosophy—what
selves as we go along, even when faced ism has no “profound knowledge” to C. Everett Koop and Francis Schaeffer
with suffering and death.” p33 offer either; it is concerned with the called “the modern irrationalism.” 4p145
However, despite its eloquent pre- will. Radu concedes as much when he If there is a worldview that exudes
sentation, the approach advanced in says that true knowledge is always ab- humanistic despair, it is existentialism.
Radu’s essay is unconvincing. He says stract in an existentialist worldview. We would do well to practice medicine
early on that “existentialism advises us Radu’s apology for existentialism independent of this philosophy that
to reach mutual understanding through refers to universal categories such as would leave us with our feet firmly
our different personal approaches “people,” “human beings,” and “whole planted in mid-air.
and to draw deeply from our subjec- persons.” But true existentialism de-
tive experiences.” p27 This statement nies the existence of these categories. References
is not only vague, it is antithetical to Sartre said, “[T]here is no human na- . Sartre JP. Existentialism and Human-
what existentialist philosophy actu- ture, because there is no God to have a ism. Mairet P, translator. London: Meuthen
ally argues. Jean-Paul Sartre asserted, conception of it.” 1p28 Sartre unwittingly & Co.; .
“Man is nothing else but that which invokes a universal called “man,” but . Sartre JP. No Exit and The Flies.
he makes of himself.” 1p28 This is the that contradiction aside, he definitely Gilbert S, translator. New York: Alfred A.
supreme existentialist presupposition. affirms that there is no such thing as Knopf; .
In the play No Exit, Sartre has his char- human essence for the existentialist. . Heidegger M. Being and Time. St-
acter Garcin declare, “Hell is—other Radu fails to grasp this. It is fortunate ambaugh J, translator. Albany (NY): State
people!” 2p61 Why is hell other people? nonetheless; a consistent existentialist University of New York Press; .
Because, in any universe containing would say that humanness itself carries . Schaeffer FA, Koop CE. Whatever
more than one person, individual no attendant dignity. Happened to the Human Race? Old Tappan
freedom is necessarily limited. Radu needs to be more critical of (NJ): Fleming H. Revell Co.; .
One person can do whatever existentialism. The most critical re-
Miles Otto Foltermann, MD
he will, but millions of mark he makes is, “Existentialism is
(ΑΩΑ, The University of Texas at
persons cannot do the often viewed as bleak,” p30 as though
Houston, )
same without in- such a critique is leveled from the
Houston, Texas
fringing on each outside looking in. Not so. Martin
B egun in as the Chapter of the Year award, this pro- MASSACHUSETTS
gram was intended to recognize outstanding contribu- Boston University School of Medicine
th Annual Haitian Health Career Seminar: Emergency
tions made by an AΩA chapter. In , the program became Preparedness, Relief and Beyond
the AΩA Chapter Development Award, aimed at encouraging
MICHIGAN
ongoing original and creative programs being carried out by Wayne State University School of Medicine
AΩA chapters. In , the program again changed to the Robert R. Frank Student Run Free Clinic (RRFSRFC)
AΩA Medical Student Service Project Award, available to any MINNESOTA
student or group or students at a school with an active AΩA Mayo Medical School
chapter. Winter Warmth Festival
Funds of up to per year, renewable for a second year MISSOURI
at and a third year at , are available to students to University of Missouri—Kansas City School of Medicine
aid in the establishment or expansion of a medical student Second Servings
service project benefiting a school or its local community. Washington University in St. Louis School of Medicine
One application per year per school is allowed, selected by Farmers’ Market Nutrition Program
the school’s AΩA councilor and dean from the proposals NEW YORK
submitted. Mount Sinai School of Medicine of New York University
The MedStart ProgramNew York Medical College
Medical Student Service Projects funded by AΩA during
NYMC Careers in Medicine WebsiteSophie Davis School of
the / school year were: Biomedical Education of the City College of New York
Health Fair in Harlem (renewed)
CALIFORNIA University of Rochester School of Medicine and Dentistry
Keck School of Medicine of the University of Southern California Cooking with the Community Volunteer
Long Term Education of Beauticians on Tanning Beds and Its Weill Cornell Medical College
Association with Melanoma Weill Cornell Youth Scholars Program (renewed)
University of California, Irvine, School of Medicine
OHIO
Medical Initiative Against Homelessness (MIAH)
Ohio State University College of Medicine
FLORIDA Be the Change Health Fair
University of Florida College of Medicine Wright State University Boonschoft School of Medicine
Mobile Gator (startup costs) Community Collaborative Spring Food Drive
ILLINOIS PENNSYLVANIA
Rosalind Franklin University of Medicine and Science/Chicago Medical Drexel University College of Medicine
School Accessibility Adventure Day
STEP UP
Jefferson Medical College of Thomas Jefferson University
University of Chicago Division of the Biological Sciences Pritzker Refugee Health Partners
School of Medicine
Project Brotherhood-SNMA Partnership Proposal (renewed) RHODE ISLAND
The Warren Alpert Medical School of Brown University
University of Chicago Division of the Biological Sciences Pritzker
Two Channels to Cambodian Patient Advocacy: Medical Student and
School of Medicine
Patient Education
Pritzker Community Service Fellowship
SOUTH CAROLINA
INDIANA
Medical University of South Carolina College of Medicine
Indiana University School of Medicine
COM Career Night
Taking Root in the Community—MS Class Service Project
University of South Carolina School of Medicine
IOWA Fall Giving Tree
University of Iowa Roy J. and Lucille A. Carver College of Medicine
Health and Nutrition Curriculum in Local Elementary Schools TENNESSEE
Vanderbilt University School of Medicine
LOUISIANA Shade Tree Family Clinic—Vaccine Outreach Program
Louisiana State University Health Sciences Center School of Medicine
in New Orleans TEXAS
Patient and Visitor Library Interim Hospital in New Orleans University of Texas Health Science Center at San Antonio School of
Medicine
Tulane University School of Medicine
BEST (Breastfeeding Education and Support for Teenage Mothers)
Covenant House: A community reproductive health center
University of Texas Medical Branch, University of Texas Medical
MARYLAND School at Galveston
Johns Hopkins University School of Medicine Stay Shady! (renewed)
The Student Preceptor Program
T he Alpha Omega Alpha Volunteer Clinical Faculty Award University of Maryland School of Medicine
Leonard Sowah, MD
is presented annually by local chapters to recognize com-
munity physicians who have contributed with distinction to MICHIGAN
University of Michigan Medical School
the education and training of medical students. AΩA provides Beth C. Kimball, MD
a permanent plaque for each chapter’s dean’s office; a plate
MINNESOTA
with the name of each year’s honoree may be added each year University of Minnesota Medical School
that the award is given. Honorees receive framed certificates. Charles Horowitz, MD
The recipients of this award in the / academic year
NEBRASKA
are listed below. University of Nebraska College of Medicine
Brian K. Buhlke, DO
ALABAMA NEW JERSEY
University of South Alabama College of Medicine UMDNJ—New Jersey Medical School
Leonard S. Rich Richard Levandowski, MD
CALIFORNIA NEW YORK
University of California, San Francisco, School of Medicine Mount Sinai School of Medicine of New York University
Albert Yu, MD, MPH, MBA Richard A. Skolnik, MD
DISTRICT OF COLUMBIA New York University School of Medicine
Howard University College of Medicine Neal A. Lewin, MD
Reginald D. Wills, MD State University of New York, Downstate Medical Center College of
The George Washington University School of Medicine and Health Medicine
Sciences George N. Braman, MD
Paul Schlein, MD State University of New York, Upstate Medical University, College of
GEORGIA Medicine
Morehouse School of Medicine Mitchell Brodey, MD
Lisa A. Counsell, MD Stony Brook University School of Medicine
ILLINOIS George L. Hines, MD
Rosalind Franklin University of Medicine and Science/The Chicago University of Rochester School of Medicine and Dentistry
Medical School Lawrence N. Chessin, MD
Melvin Wichter, MD Weill Cornell Medical College
University of Chicago Division of the Biological Sciences Pritzker Timothy C. Dutta, MD
School of Medicine NORTH DAKOTA
Richard Aronwald, MD University of North Dakota School of Medicine and Health Sciences
INDIANA Napoleon Espejo, MD
Indiana University School of Medicine OHIO
Todd R. Bagwell, MD Ohio State University College of Medicine
IOWA Danilo Polonia, MD
University of Iowa Roy J. and Lucille A. Carver College of Medicine University of Cincinnati College of Medicine
Nathaniel Meyer, MD Bruce Allen, MD
KANSAS PENNSYLVANIA
University of Kansas School of Medicine Drexel University College of Medicine
Jennifer Brull, MD Kevin Kasper, MD
KENTUCKY Jefferson Medical College of Thomas Jefferson University
University of Louisville School of Medicine Anthony J. Macchiavelli, MD
Michael Alt, DO University of Pittsburgh School of Medicine
LOUISIANA Veena Dhar, MD
Louisiana State University Health Sciences Center School of Medicine SOUTH CAROLINA
in New Orleans Medical University of South Carolina College of Medicine
Michael Kemp Amacker, MD James G. Ward, MD
Louisiana State University School of Medicine at Shreveport University of South Carolina School of Medicine
William Norwood, MD, FACS William C. Giles, MD
Tulane University School of Medicine TEXAS
Vincent R. Adolph, MD University of Texas Medical School at Houston
MARYLAND Daniel G. Corredor, MD, FACE
Johns Hopkins University School of Medicine
David Schwartz, MBBCh
Uniformed Services University of the Health Sciences F. Edward
Hébert School of Medicine
Adam Saperstein, MD
Alison Grazioli, Gowtham Jonna, Noreen Patricia Kelly, Dallas Kingsbury, Laura House staff: Constantine Farmakidis, Miranda Harris-Glocker
Longo, Caitlin Martin, Nicole Irene Montgomery, Erin Patricia Murphy, Molly Rose State University of New York, Downstate Medical Center College of
Nadelson, Chiti Parikh, Dupal R Patel, Shanon Thomas Peter, Julianne Pupa, Matthew Medicine—Eta New York
Douglas Saybolt, Danielle Marie Sciorra, Christopher Philip Sereni, Margarita Marie Students: Alexandre Paul Ancheta, Robert Brownell, Jeffrey Thomas Bruckel, Yair
Sergonis, Anjali B Sheth, Alan Sing, Neil Kanth Taunk, Julia Ham Terhune, Matthew Chaya, Ivanka Choumanova, Ilana Juliett DeLuca, Gregory S Dibelius, Fara Friedman,
David Treiser, Wan-Ju Wu Elizabeth A Gancher, Kelly James Givens, Jeffrey Gusenburg, Chenchan Huang, Sara
Alumni: Jeffrey Neil Bruce Elizabeth Kopple, Eugenia C Kuo, Timothy Connor Leupp, Elie Boaz Lowenstein,
Faculty: Anthony Tobia, Stephen Trzeciak Oleg Mironov, Franklin Nwoke, Susan E Pesci, Emily Lauren Robbins, Giorgio
House staff: Terrence Curran, Fedele DePalma Antonio Roccaro, Annaheta Salajegheh, Nicholas Spartan Santavicca, Dominick
UMDNJ—New Jersey Medical School—Beta New Jersey Santoriello, Guy Savir, Avraham Sofer, Sherwin Leu Su, Jennifer Sweet, Louise Marie
Students: Mafudia Abibatu Bangura, John Henry Bast, Chinmoy Bhate, Adam Chen, Truong, Alexander Volodarskiy
Isaac Chu, Brian Do, Summer Elshenawy, Eugene Daniel Festa, Michaela Grace Ibach, Alumni: Samuel Packer, Andrew Charles Yacht
Michael B Jacoby, Neil Kapadia, Mary Elizabeth Kelleher, Michael Klodnicki, Monica Faculty: Salvatore J A Sclafani, George A Vas
Koncicki, Timothy Meehan, Haresh Vijay Naringrekar, Kevin Paul O’Donnell, Joseph House staff: Graciela Beatriz De Jesus, Marina Kogut, Brandon George Smaglo
Benton Oliver, Laju M Patel, Shriji Patel, Chuanxing Qu, Nakul P Raykar, William Albany Medical College—Theta New York
Henry Rossy, Shannon Frances Scrudato, Amit Sharma, Douglas Michael Smith, Students: Alin Lina Akopians, David E Auringer, Jesse Tao Buedefeldt-Pollard,
Kathleen Sullivan, Nikhil Thaker, Ashley Gayle Winter, Ronald Zviti Erin Marie Cooney-Qualter, Justin Corey DeWillers, Erika Beth Ebert, Jeremy M
Faculty: Rajendra Kapila Esposito, Greg Everett Gin, Rashmi Jayadevan, Melissa Dawn Kivitz, Karilyn Theresa
House staff: Vadim Pisarenko Melanie Larkin, Tsang Lau, Frank S Lin, Lindsey Adair MacFarlane, Julia A Mathew,
Lindsey Ann Tillack, Amanda Marie Tower, Timothy Y Tran, Jenanan Prakasha
NEW MEXICO
Vairavamurthy, Mae Whelan, Jennifer Wootten, Edmund S Wu, Devin Stephen
University of New Mexico School of Medicine—Alpha New Mexico
Zarkowsky
Students: Sean Biggs, Jeremiah Manuel Bustos, Kenneth Michael Downes, Kathlyn
Faculty: John Hinty Burton, John W Simon
Joan Drexler, Coughi Camille Edens, Joshua Frederiksen, Heidi Hillesland, Michelle
New York Medical College—Iota New York
Rae Longmire, Jill Katherine Oldewage, Brandon Robert Peterson, Dustin Richter
Students: Kerry Apostolo, Timothy Paul Capecchi, Jessica Clima, Jacqueline Marie
Faculty: Martha Cole McGrew, Alan Garlett Waxman
Cook, Rachel Dahlborg, Matthew Dattwyler, Adam Ryan Demner, Ezra Detroy,
House staff: Pablo Garcia, Tony B Salazar, Selina Silva
Amanda Jane Fantry, James Felker, Patricia Fermin, Heidrun Elizabeth Gollogly, John
NEW YORK Patrick Curtis Gonzales, Jennifer Tome Higa, Shipra Hingorany, Miriam Kishinevsky,
Columbia University College of Physicians and Surgeons—Alpha New York Andrew Steffes Korson, Megan Rae Linnebur, Jessica May, Hristina N Natcheva, Nita
Students: Mohsin S Ahmed, Priya Batra, Mauer Biscotti, Alexandra Jane Borst, Laura Nayak, Jennifer Anne Nowak, Julie Rice, Daniel Ricotta, Jordan Isaac Roth, Jayne B
N Brenner, Adam M Buck, Alison B Callahan, Louisa Canham, Peter N Chalmers, Rozelle, Lauren Spring, Jamie Stratton, David Tian, Edward Yap
Elizabeth J Diver, Erica DaVonne Farrand, Magni Hamso, Kathie Kai Huang, Ryan Alumni: John Joseph Degliuomini, Joanna Pessolano
Michael Joshi Ivie, Michael Ma, Robert Allen McGovern III, Martha R Neagu, Kristen Faculty: Jay D Draoua, Ray Whitt
A Pastor, Ravi Pathak, Sara Plett, Alvin Rishi Rajkomar, Katelyn Smithling, Moeun Albert Einstein College of Medicine of Yeshiva University—Kappa New York
Son, Robert A Sorabella, Mary L Stevenson, Danielle Trief, Emily A Vail, Matthew J Students: Alaleh Akhavan, Lukas Robert Austin-Page, Revekka Babayev, Adam Finn
Weinstock Binder, Laura Eve Brown, Kathleen Mary Buchheit, Yu Chen, Larissa Ann Chismar,
Weill Cornell Medical College—Beta New York Matthew Czaja, Izak Faiena, Jonathan Ross Groden, Evan Kandler Grove, Nancy
Students: Konstantinos John Arnaoutakis, Wesley Hurst Clark, Audrey Diane Habib, Margo Shawn Harrison, Svetlana Sarah Kachan-Liu, David Khalil, Sameer
Crummey, Sandra Marie Demars, Narat Eungdamrong, Daniel Joseph Friedman, Kumar Kulkarni, Nicholas Kwaan, Brenda F Levy, Caitlin Patricia McMullen, Yolanda
Katharine Corbett Goheen, Jonathan Stanley Gordin, Erica Lisa Greenberg, Chloe Michetti, Troy Anthony Miles, Jonathan U Peled, Jennifer Ann Schaub, Jessica
Electra Hill, Michael Adrian Klufas, Sarah Lewis, Alison Brooke Santopolo May, Schreiber-Zinaman, Natasha Shapiro, Alan T Sheyman, David Greenfield Snetman,
Anthony Ehren Rosen, Sarah Hall Schaefer, Allison Raye Schulman Ari Spiro, Angela Mable Trinh, Danielle Justine Usatin, Roger E Wiltfong, Sarah
State University of New York, Upstate Medical University, College of Marie Yannascoli
Medicine—Gamma New York Faculty: Amy Emanuela Kesselman
Students: Sarah L Averill, Niladri Basu, Jeffrey A Belair, Caitlin Bernard, Douglas Mount Sinai School of Medicine of New York University—Lambda New York
Michael Hildrew, Quynh N Hoang, Katharine Driscoll Maglione, Sean Robert Students: Tara E Albano, Luke John Benvenuto, Mai-Khanh Bui-Duy, Justin Chan,
McMahon, Jonathan Naysan, Julie M Rombaut, Michael Francis Sorrentino, Charles Lora Rabin Dagi, Ralph Michael DeBiasi, German Echeverry, Naamit Kurshan
Nicholas Weber Gerber, Lisa Michelle Hammond, Jonathan Lee, Rebecca Lucy Luckett, Emily Claire
Alumni: Blanche Antionette Borzell, Joseph William Hinterberger McClung, Alexander James Millman, Courtney Nagel, Meghan Pearl, Andrea
Faculty: Kwame Sarpong Amankwah Schwartz, Sheryl Serbowicz, Maria Widmar, Lauren Zajac
House staff: Matthew Bryant Crowell, Pankaj Mehta, Sekou Robertson Rawlins Alumni: Daniel Caplivski, June Kim
New York University School of Medicine—Delta New York Faculty: Katherine T Chen, Edward John Ronan
Students: Marra Gillian Ackerman, Joshua Will Allen-Dicker, Alana Rose Amarosa, House staff: Edward Chan, Brian Marc Elliott, Ilene B Goldstein
Bradley Stephen Bloom, Arlene Sujin Chung, Thomas Michael Facelle, Ely Richard Stony Brook University Medical Center School of Medicine—Mu New York
Felker, Emily Ford, Benjamin Hairan Ge, Luba Gulyaeva, Elizabeth Price Gurney, Students: Kristen Ann Aliano, Yelena Bogdan, Kenneth Friedman, Sara Kalkhoran,
Robert Raymond Kule, Jesse Miller Lewin, Evan Seth Marlin, Michelle Mergenthal, Mahsa Hoshmand Kochi, Kevin Lai, Daniel J Lee, Lorena LoVerde, Amar Buddhadev
Ryan William Morgan, Rose O’Rourke, Carly Browning Oboudiyat, Rushi Parikh, Manvar, James E Miranda, Eugene Jon Pietzak III, Michaela Danielle Restivo, Mark
Derek Daniel Reformat, Kathryn Ross, Lourdes Maria Sanso, Jeffrey Shyu, Nathaniel Snyder, Brandon Scott Sprung, Ashley Ward, Benjamin Yam
Smilowitz, Emily Frank Stamell, Bobby A Tajudeen, Jolyn Sharpe Taylor, Vitaly Alumni: Scott Johnson
Terushkin, Patrick Robert Varley, Amelia Mackenzie Wnorowski, Edward William Faculty: William L Jungers, Daniel Yellon
Zagha
NORTH CAROLINA
Alumni: Fritz Francois, Burton D Rose
Duke University School of Medicine—Alpha North Carolina
Faculty: Iman Osman, Harvey I Pass
Students: Matthew Murray Crowe, Susan Emmett, McKinley Glover, Stephen
University at Buffalo, School of Medicine and Biomedical Sciences, State
Cannada Harward, Robert Andrew Henderson, Michael Hodavance, Elmer Philip
University of New York—Epsilon New York
Lehman IV, Wenjing Liu, Paula Pecen, Matan Isaac Setton, Lauren Rebecca Simel,
Students: Jessica B Badlam, Brian P Batt, Jamie Benway, Joyce Meng-Tin Chang,
Weiyi Tan, Richard Christopher Waters, David Alan Watkins, Tyler Steven Watters,
Samantha Chase, Angela Rose Girvin, Elizabeth Anne Gruber-Brem, Darren Michael
Caroline Eva Yeager
Huffman, Sara Hylwa, Jennifer Lee Jung, Anjum Faruk Koreishi, Allana Krolikowski,
Alumni: Edward Hecht Bossen
Evan Leibu, Allie Marie Massaro, Gina Matteson, Justin Mazzillo, Scott R Nodzo, Jeet
Faculty: Sharon Fridovich Freedman, Cynthia Shortell
Patel, Melissa Lynn Rayhill, Arsalan Q Shabbir, Lisa Marie Stabel, Jonathan J Stone,
House staff: Brent Allen Hanks
Ashley Wentworth
Wake Forest University Health Sciences (School of Medicine)—Beta North
Faculty: David M. Holmes
Carolina
University of Rochester School of Medicine and Dentistry—Zeta New York
Students: Timothy Bruce Alton, Hoyt Randall Beard, Joseph Charles Benjamin,
Students: Jennifer Rhoda Abrams, Joshua Burton Brown, Laurence Donahue, Tracy
Bradley Edward Bowen, Ashley Renee Brown, Michelle Lynn Bryan, Snow Daws,
Lynn Fuhrmann, Romeo Regi Galang III, Samuel Horr, Brian Paul Jenssen], Ajay
Michael Wayne Evans, Stuart David Ginn, Ilya Gorbachinsky, Matthew Ryan Grace,
Eapen Kuriyan, Andrew Hall Marky, Marlene Theresa Mathews, David Jonathan
Kathleen Harknett, Jessica Lynn Hata, Elizabeth B Hunt, Christopher Hunter, William
Mener, Christine Marie Osborne, David Henry Perlmutter, William Joseph Sauer,
P Huntington, Ida Sheevaun Khaki, Dylan Corey Lippert, Emily Myers Mann, Carrie
Jeremy Sinkin, Leslie Kathryn Vilkhu
Elizabeth Quinn McCloskey, Todd Peacock, Jeremy Webb
Alumni: Dennis Harry Kraus
Alumni: Gary Lon Morgan
Faculty: Rabih M Salloum
Gregory Scott Smith, Vikas Thondapu, Shannon Lisa Tocchio, Pollianne Ward, Jason Faculty: Wendy Renee Cornett, L Britt Wilson
Ben Winkler, Rosemary Yi, Shuhao Zhang House staff: John Andrew Goldsmith
Alumni: Carol L Carraccio, Donald M Yealy
SOUTH DAKOTA
Faculty: Bernard Abraham Eskin, Page Morahan
Sanford School of Medicine of the University of South Dakota—Alpha South
House staff: Katherine Anne Gargiulo, Chileshe Nkonde, Lauren Jodie Van Scoy
Dakota
Temple University School of Medicine—Epsilon Pennsylvania
Students: Kimberly Nicole Harer, Seth William Harrer, Ross A Miller, Carrissa Mae
Students: Daniel Joseph Ackerman, Sang Wook An, Bryn Anne Boslett, Robert
Pietz, Travis Scharnweber, Halie Marie Vosler, Emily June Winterton, Jesse Thomas
John Brenchak, Brian Campfield, Marybeth Rose Concannon, Samantha English
Young
Day, Leigh Anne DiCicco, Jonathan Finkel, Gurpreet Kaur Gill, Silke Heinisch, Amy
Alumni: Charles Joseph Kopriva
Elizabeth Hosmer, Lauren Elizabeth Krug, Andreas Michael Lamelas, Mollie Abigail
Faculty: Paul C Bunger
Land, Barrett Little, Kelly Loftus, Tiffany Kay Lonchena, Robert Andrew Miller,
House staff: Elizabeth Joanne Wheatley
Daniel Jon Mueller, Ann Marie Murray, Carolynn Joy Ainsworth Nassar, Adaobi I
Nwaneshiuu, Michael O’Malley, Kim An Quach, Hannah Ravreby, Nathan Chris TENNESSEE
Tiedeken, Marc Tolley, Porshia Marie Tomlin, Anne Hemphill Warner Vanderbilt University School of Medicine—Alpha Tennessee
Alumni: Joseph J Thoder, Jacob W Ufberg Students: Amir Michael Abtahi, Tiffany Nicole Suzanne Ballard, James Russell
Faculty: Gilbert D’Alonzo, Robert Stephen Fisher Bekeny, Jashodeep Datta, Elizabeth Anne Gordon, Courtney Hayes Harrison, Eve
Pennsylvania State University College of Medicine—Eta Pennsylvania Henry, Natalie Louise Jacobowski, Emily Ann Kendall, Brandon Richard Litzner,
Students: Steven A Azaravich, David Scott Baird, Annalee Morgan Baker, Jonathan Daniel Adam Mordes, Jared Martin O’Leary, Alanna Marie Patsiokas, John Gary
Scott Bassett, Lindsey Alison Beers, Levi Potter Benson, Garret Wayne Choby, Phillips, Miranda Danelle Raines, Johanna Nathania Riesel, Joshua Elliott Rubin,
Andrea Beth Conway, Christopher Edwards, Galen Toye Foulke, Elizabeth Ann Daniel Eidelberg Spratt, Sara Katharine Tedeschi, Eli Zimmerman
Westen Fountaine, Elisabeth R Garwood, Amanda Bird Gilmartin, Yan Ho, Christine Alumni: Sara J Patterson
Marie Homcha, Jessica Lauren Hootnick, Nathan C Hull, Seth E Ilgenfritz, Matthew Faculty: Mohana Bhalchandra Karlekar, Amanda Grace Wilson
Eugene Jansen, Afif Naji Kulaylat, Kelly Ann Laraway, Mark Joseph Masciocchi, Ryan House staff: Francine V Arneson, Ryan Donald Hollenbeck, Daniel Garvin Stover
Michael Mitchell, Erin Lindsay Murata, Charles Michael Pagana, Brandon Shane University of Tennessee Health Science Center, College of Medicine—Beta
Smetana, Bozho Todorich, Christina Jayne Tofani, Jordan Anthony Torok Tennessee
Faculty: Michael Jay Green, Thomas J McGarrity Students: Alkesh Ashwinkumar Amin, Leslie Paige Austin, Danielle Lynne Barnard,
House staff: Lillian Marie Erdahl, Jessica Lynn Henderson, Paul Howard Smith III Jonathan Raines Berger, Emily Marie Bratton, Maryanne Matinee Chumpia, Daniel
Haden Doty, Bryan Scott England, Curtis Shannon Gaylord, Mary Katherine Johnson,
PUERTO RICO
Emily Defur Joyce, Erik Michael Maryniw, Adam R Militana, Lawrence Kevin
University of Puerto Rico School of Medicine—Alpha Puerto Rico
O’Malley, Joshua P Parlaman, Jay Girish Patel, Brian Christopher Payne, Barry Joel
Students: Milliette Alvarado, Jose A Alvarez-Cardona, Idanis M Berrios-Morales,
Pelz, Ron Benton Pitkanen, Ian Craig Reinemeyer, Jerry Mark Smith, Byron Fitzgerald
Eduardo J Colom-Beauchamp, Nydia Ymar Colon-Irizarry, Hector Javier Diaz, Maria
Stephens
Eugenia Florian-Rodriguez, Stephanie Font-Diaz, Reinaldo Jose Fornaris, Jessica
Faculty: Rose Mary Sutton Stocks, Stephanie Ann Storgion
Gonzalez-Hernandez, Luis Saul Lizardo-Sanchez, Ronald J Lopez-Cepero Mulero,
House staff: Brian Emanuel Brocato
Akram Mesleh-Shayeb, Ana Maria Pabon-Martinez, Leilanie Perez-Ramirez, Sulimar
Meharry Medical College School of Medicine—Gamma Tennessee
Rodriguez-Santiago, Jose E Velazquez-Vega
Students: Ryan Bliss, Cassandra Bradby, Brittany Joy Brown, May Cho, Tiffany Latrice
Alumni: William Micheo, Carmen D Zorrilla
Clay, Jared Michael Davis, Maria Theresa dela Cruz Ramones, Tonya L Dixon,
Faculty: Yazmin Pedrogo, Sharee Ann Umpierre
Jeanene H Gabriel, Ikponmwosa Iyamu, Rosanne Leger, Brooke Louisa Morrell,
House staff: Keimari Mendez-Martinez
HaiThuy N Nguyen, Luis Horacio Ocampo Jr, Alexis L Rodriguez
Ponce School of Medicine—Beta Puerto Rico
Alumni: Barbara Alfreda Duncan-Cody, Howard Clarence Willis
Students: Joanne E Castillo, Daryana Cruz, Nathania M Figueroa Guilliani, Simone
Faculty: Millard D Collins, Ayodeji Ayoola Oso
Amanda Neuwelt, Leah Ailed Orta Nieves, Yahaira Ortiz-Munoz, Ana-Marie Rojas
East Tennessee State University James H Quillen College of Medicine—Delta
Sol, Wilson Rovira-Pena, Frances G Tardy-Rivera
Tennessee
Faculty: Idhaliz Flores-Caldera
Students: Maikel Ella Botros, David Dahl, Daniel Weston Hobgood, Laura Kristin
Universidad Central del Caribe School of Medicine—Gamma Puerto Rico
Howell, Ginger Lovingood, Charles Orton, Georganna Michelle Rosel, Eric Davis
Students: William Arroyo, Dorgam Badran, Luz Juliana Barahona, Daniela Carlos,
Smith, Jeanne Marie Young
Lisa Michelle Cruz-Aviles, Kelly Ughini De Souza, Jonathan Guerra, Sullafa Muftah
Faculty: Jason B Moore
Kadura, Alejandro Lopez Araujo, Nilsa De Jesus Rosario
House staff: Dinesh Sharma
Alumni: Wanda Ivelisse Torres
Faculty: Frances Lynn Garcia, Luis A Irizarry-Reyes TEXAS
University of Texas Medical Branch, University of Texas Medical School at
RHODE ISLAND
Galveston—Alpha Texas
The Warren Alpert Medical School of Brown University—Alpha Rhode
Students: Caitlin Gayle Andrews, Conor John Best, Bo Beus, Jonathan David Braun,
Island
Andrew William Chambers, Kelly Elizabeth Cline, Andrew Michael Courson, Adam
Students: Andrew Allegretti, Andrew M Brunner, Margret W Chang, Jonah M Cohen,
Djurdjulov, Paul Michael Evans, Jeremy Andrew Halbe, Michael Andrew Hames,
Vincent D Criscione, Michael Steven Gart, Isaac William Howley, Austin Larson,
Jacey Refaat Hanna, Adriane Floyd Haragan, John Clare Heymann, Paul Houghtaling,
Joanna V MacLean, Charles Mitchell, Natalie J Nokoff, Eric J Palecek, Terence Tai
Auris Onn-Lay Huen, Sharon Elizabeth Hughes, Titilope Adenike Ishola, Charles
Weng Sio, Mary B Sutter, William G Tsiaras, Juan Camilo Vasquez, Beverly Ray
William Kimbrough, Katie Lael Kucera, Jillian Whitney Lazor, Anthony James Lewis,
Young
Michaela Renee Marek, Robert Nathanson, Julie Nguyen, Matthew Brian Pavelka,
Alumni: Galen Vincent Henderson
Emiko Petrosky, Michael Leroy Rains, Sanjita Ravishankar, Eric Scott Rosenberger,
Faculty: Penelope H Dennehy, Kelly McGarry, John Teichgraeber
Jennifer Lynn Russell, Christopher Michael Sakowski, Ronald Jeffrey Schmitt, Adam
House staff: Alexander Phillip Edward Diaz de Villalvilla, Evangelos Messaris, Thomas
Joseph Schneider, Richa Shukla, Jacob Guia Thomas, Michael Wang
Murphy
Baylor College of Medicine—Beta Texas
SOUTH CAROLINA Students: Amir Aboutalebi, Sunaina Subodhkumar Bhuchar, Sydney Lane Boule,
Medical University of South Carolina College of Medicine—Alpha South Steven Siangkiat Chua, Mary Caitlin Dooley, Pamela Griffin Ferry, Gary Bryan
Carolina Fillette, Jennifer Rose Gatchel, Waqar Mohammad Haque, Michael James Holland,
Students: Christopher McAlister Ayers, Annie Wei-Ting Chen, Megan Shive Adam Brent Hollander, Gary Lloyd Horn Jr, Kelli Danielle Jones, Reva Kakkar, Ramiro
Cifuni, Daniel Bryon Cobb, John Clayton Crantford, Stephen Aloysius Cross, Jose Madden-Fuentes, Christopher Patrick Neumann, Roma Rajesh Patel, Lauren
Stephen Hughes Finley, Jacob Ross Gillen, Robert A Glass III, Robert John Hosker, Elizabeth Patterson, Christian David Albert Peccora, Christine Elizabeth Petrich,
Derrick Adam Huey, John Phillips Hungerford, Jason P Lockrow, Matthew Brian Craig Rodgers, Robert Donald Russell, Robert Lee Salazar, Amishi Yogesh Shah,
Christopher McDermott, John William Nance Jr, Allen Ernest Pendarvis Jr, Ashok K Fareesa Shuja, Emma Phyllis Whitcomb
Ramachandra, Eugene Ritter Sansoni, Roger Sullivan, Karin Whitlock Taylor, Daniel Faculty: John H Coverdale
Ryan Toms, Jenna Leigh Walters, Zachary Inskeep Willis House staff: Benjamin Davis Fox, Chad Michael Ruoff
Faculty: William John Hueston, Patricia Geraty McBurney University of Texas Southwestern Medical Center at Dallas, Southwestern
House staff: James Michael Allen, Paul Thomas Eberts Medical School—Gamma Texas
University of South Carolina School of Medicine—Beta South Carolina Students: Krista Ruth Alexander, Eric Arnold, Bryant Carroll Boren, Isaac
Students: Rose E Coady, Jonathan Ashby Davis, Trevor Michael Downing, April Alexander Bowman, Lyle Burdine, Shurong Chang, Joy Chen, Lee Warren Chen,
A Grant, Brittany Nicole Knick, Justin Marsh, Jeffrey Paul Radabaugh, Hector Sadia Choudhery, Mark Dalesandro, Jameson Cuyler Dear, Jamie Nella Frediani,
Rodriguez, Clara Eileen Sanders, Marion Morgan Swall Emily Gaddis, Kristina Liselotte Goff, Michael Graves, Elizabeth Ashley Hardin,
Alumni: Robert Carter Holleman Jr, Leroy F Robinson James Curtis Harms, Ana Kashfia Islam, Rachel Jamison, Megan Marie Johnson,
Harris ED Jr.
Index by author Alpha Omega Alpha/Association of American Medical Colleges Robert
Abbott C. Wear Something Red. Poem. Winter, . J. Glaser Distinguished Teacher Awards. Winter, –.
Abdulla S. See Floyd CT et al. Alpha Omega Alpha elects honorary members. Spring, –.
Abelson HT. The Candidate. Poem. Summer, . Consultations . . . going, going, gone? Editorial. Winter, .
Abrams HL. Commentary: Reynolds HY. A medical ear in the early morning Existentialism, the physician’s philosophy. Editorial. Spring, .
tennis group—when to advise and what to say. Autumn, . Minutes of the o meeting of the board of directors of Alpha Omega
Ambrose CT. Carolus Linnaeus (Carl von Linné), –: The Swede who Alpha. National and chapter news. Spring, –.
named almost everything. Spring, –. Haywood LJ. Selling Teaching Hospitals. Letter. Winter, .
Anderson KT. Tinsley Randolph Harrison, MD: A legacy of medical education. Hsu BS-H. Cost of a life. Health policy. Autumn, –.
Autumn, –. Huber W III. See Floyd CT et al.
Bales DW. Accelerating human evolution?? Letter. Winter, . Hudak CD. Undaunted. Poem. Winter, .
Basile MA. Christians in the Movies: A Century of Saints and Sinners, by Peter E. Ilgenfritz S. The Procedure. Poem. Spring, .
Dans. Reviews and reflections. Winter, –. Isenberg SF. A Simple Walk. Poem. Spring, inside back cover.
Berry J. Accelerating human evolution?? Letter. Winter, . Jacobs J. Re “Getting Drug Money Out of Doctors’ Offices.” Letter. Summer, .
Blaha J. Re “Consultations . . . going, going, gone?” Letter. Summer, . Jinwala F. See Floyd CT et al.
Blum A. Commemorating the Fiftieth Anniversary of a Medical Landmark. Kahn EN. The Gift. Poem. Winter, .
Autumn, . Kastor JA. An invitation. Health policy. Spring, .
Blum A. When I gets big. Poem. Summer, . Kastor JA. Will health reform reduce costs? Health policy. Winter, –.
Bowe C. Josiah. Winter, –. Kopen DF. The inadquacy of legislative procedures and the infirmity of physician
Brenner I. Re: “A Fatal Zest for Living.” Letter. Summer, –. organizations. Health policy. Summer, –.
Brillman JC. Worried Sick: A Prescription for Health in an Overtreated America, Langhorne H. Post Chemo Treat. Poem. Autumn, .
by Nortin M. Hadler. Reviews and reflections. Spring, –. Le J. Meditation on Surgical Masks. Poem. Winter, .
Buskirk M. Informal Education. Poem. Winter, . Lee TH. Health reform requires confronting myths. Health policy. Winter, –.
Cantrell L. Poems by Linda Cantrell. Poems. Autumn, –. Lockshin MD. Medical publishing: Will paper live on? Summer, –.
Cesari A, Mackowiak PA. A fatal zest for living: The all too brief life of Mario Lopez FA. Almost five years later: Hurricane Katrina, New Orleans health care,
Lanza. Winter, –. and the Louisiana State University Health Sciences Center. Summer, –.
Chase RA. One Breath Apart: Facing Dissection, by Sandra L. Berman. Reviews Maas S. Wind. Poem. Autumn, .
and reflections. Summer, –. Majmudar B. A One Bag, One Leg Lady. Poem. Winter, .
Chase RA. A Second Opinion: Rescuring America’s Health Care: A Plan for Mann A. Smoke. Poem. Winter, .
Universal Coverage Serving Patients Over Profit, by Arnold S. Relman. Reviews Marr JJ. Graft Rejection. Poem. Winter, .
and reflections. Summer, . Menkes JS. The right to sue. Letter. Winter, –.
Chesanow RL. A Voyage. Letter. Winter, . Michael H. See Floyd CT et al.
Claman HN. On Wrinkles (Hiding the Evidence). Poem. Spring, . Milano M. Hearing. Poem. Autumn, .
Coe FL. Amanda’s Garden. Poem. Autumn, . Miller EC. Attuning to equlibrium: Physician as artist, artist as physician.
Cooper RA. Expanding physician supply—An imperative for health care reform. Autumn, –
Health policy. Spring, –. Morrison W. Carotid. Poem. Winter, .
Coulehan J. Doctors in Fiction: Lessons from Literature, by Borys Surawicz and Morrison W. Snapshot. Poem. Spring, .
Beverly Jacobson. Reviews and reflections. Summer, –. Mukherjee S. Stroke in black and white. Autumn, –.
Coulehan J. Dying for Beginners, by Patrick Clary. Reviews and reflections. Muller D. Needlestick. Summer, –.
Autumn, –. Nagarkar PA. Getting drug money out of doctors’ offices. Winter, –.
Coulehan J. On Apology, by Aaron Lazare. Reviews and reflections. Spring, Nagarkar PA. Re “Getting Drug Money Out of Doctors’ Offices”: Mr. Nagarkar
–. responds to Dr. Jacobs. Letter. Summer, –.
Crawford GB. Quiet Snow among the Dark. Poem. Autumn, . Nissenblatt M. Summer, –.
Dale DC. Memorial: Edward D. Harris, Jr., MD: July , –May , . Palmore J. See Floyd CT et al.
Summer, . Parke S. Poppies. Poem. Autumn, inside back cover.
Dans PE. The physician at the movies Patterson RB. Commentary: Cantrell L. Poems by Linda Cantrell. Autumn,
Amelia. Summer, –. –.
The Curious Case of Benjamin Button. Winter, –. Pederson T. The Language of Life: DNA and the Revolution in Personalized
Extraordinary Measures. Autumn, –. Medicine, by Francis S. Collins. Reviews and reflections. Summer, –.
Gifted Hands: The Ben Carson Story. Spring, –. Pfeiffer E. Endings Are Beginnings. Poem. Summer, .
The Hurt Locker. Autumn, –. Platt FW. Technological Medicine: The Changing World of Doctors and Patients,
Julie and Julia. Summer, –. by Stanley Joel Reiser. Reviews and reflections. Autumn, –.
Night at the Museum: The Battle of the Smithsonian. Summer, . Plotz CM. Commentary: Reynolds HY. A medical ear in the early morning tennis
Taking Chance. Winter, –. group—when to advise and what to say. Autumn, .
Valkyrie. Spring, . Plotz CM. Medical hand-me-downs. Letter. Winter, –.
The Young Victoria. Summer, –. Quinn S. The effect of Gchat deprivation on medical student productivity.
Darby R. Ethical issues in the use of cognitive enhancement. Spring, –. Winter, –.
DeWitt D. The Challenge. Poem. Winter, . Radu A. Eudaimonia, existentialism, and the practice of medicine. Spring, –.
Elahi E. See Floyd CT et al. Raphael A. The ethics of cosmetic enhancement. Winter, –.
Floyd CT, Michael H, VanHoose JD, Elahi E, Abdulla S, Jinwala F, Reddy K, Solar Reddy K. See Floyd CT et al.
B, Freeman A, Huber W III, Palmore J, Sambasivan A. The winning photos Reid EE. Studying in the Afternoon. Poem. Spring, .
from the Web Site Photography Contest. Summer, –. Reynolds HY. A medical ear in the early morning tennis group—when to advise
Foltermann MO. Neither/nor. Letter. Autumn, . and what to say. Autumn, –.
Freeman A. See Floyd CT et al. Richards DD III. Semmelweis: Magyar warrior. Summer, –.
Garcia EE. What Would Heifetz Do? Poem. Summer, . Rousseau PC. Echocardiogram. Poem. Autumn, .
Geynisman J. Adwoa. Poem. Autumn, . Roy RC. Spring of My Dying. Poem. Summer, back cover.
Grubb BP. The Gaze. Poem. Summer, inside back cover. Sambasivan A. See Floyd CT et al.
Haddy FJ. Direct-to-consumer advertising. Health policy. Summer, –. Scherl ND. Reflections on a Photograph. Poem. Winter, .
en
Christians in the Movies: A Century of Saints and Sinners, by Peter E. Dans.
tk
Ai
Basile MA. Winter, –.
ica
Dancing at the River’s Edge: A Patient and Her Doctor Negotiate Life with
Er
Chronic Illness, by Alida Brill and Michael D. Lockshin. Williams RC Jr.
Spring, .
Doctors in Fiction: Lessons from Literature, by Borys Surawicz and Beverly
Jacobson. Coulehan J. Summer, –.
Dying for Beginners, by Patrick Clary. Coulehan J. Autumn, –.
Amanda’s Garden
The Language of Life: DNA and the Revolution in Personalized Medicine, by Late October and all is falling,
Francis S. Collins. Pederson T. Summer, –. to watch it fall is to watch an old
On Apology, by Aaron Lazare. Coulehan J. Spring, –.
On Being Certain: Believing You Are Right Even When You’re Not, by Robert man die by stages; are we not caught up
A. Burton. Wright JL. Autumn, –. in such a progress? Mark him, I told
One Breath Apart: Facing Dissection, by Sandra L. Berman. Chase RA.
Summer, –. my friend: last year, last month, even,
The Picture of Health: A View from the Prairie, by Richard P. Holm and Judith
R. Peterson. Trotter JA. Winter, –. he was able to that, or this, now lost;
A Second Opinion: Rescuring America’s Health Care: A Plan for Universal is this not movement in a sound direction,
Coverage Serving Patients Over Profit, by Arnold S. Relman. Chase RA.
Summer, . a deeper sinking into the white frost?
Technological Medicine: The Changing World of Doctors and Patients, by
Stanley Joel Reiser. Platt FW. Autumn, –. Are we happy in our hearts and cannot say
Worried Sick: A Prescription for Health in an Overtreated America, by Nortin that something about the progress of flesh
M. Hadler. Brillman JC. Spring, –.
Rhabdomyosarcoma. Poem. Spring, . is moral, and to watch it a secret thrill?
Richard L. Byyny, MD, appointed Executive Director of Alpha Omega Alpha. And, is it not a judgment of decency
Wilson DE. Autumn, back cover.
Semmelweis: Magyar warrior. Richard DD III. Summer, –. how he—the old man—squares his acts
A Simple Walk. Poem. Isenberg SF. Spring, inside back cover.
Smoke. Poem. Mann A. Winter, . with flesh’s motion toward surrender?
Snapshot. Poem. Morrison W. Spring, . The garden is without desire, without
Spring of My Dying. Poem. Roy RC. Summer, back cover.
Stroke in black and white. Mukherjee S. Autumn, –. sorrow, we believe, and scarcely care
Studying in the Afternoon. Poem. Reid EE. Spring, .
Tinsley Randolph Harrison, MD: A legacy of medical education. Autumn, –. for it anymore, however we waited on its growing,
Undaunted. Poem. Hudak CD. Winter, . but the old man holds our eye: is it fear?
Wear Something Red. Poem. Abbott C. Winter, .
Web Site Photography Contest. Staff. Winter, inside back cover. Is it our judgment of him? A cruel
What Would Heifetz Do? Poem. Garcia EE. Summer, . love of change? A love of the close of the year?
When I gets big. Poem. Blum A. Summer, .
Wind. Poem. Maas S. Autumn, . Fredric L. Coe, MD
Winner of the Submit a Photo Contest. Staff. Spring, .
The winning photos from the Web Site Photography Contest. Floyd CT, Michael
H, VanHoose JD, Elahi E, Abdulla S, Jinwala F, Reddy K, Solar B, Freeman A, Dr. Coe (AΩA, University of Chicago, 1961) is professor of Medicine and
Huber W III, Palmore J, Sambasivan A. Summer, –. Physiology at the University of Chicago. He is a member of the editorial board of
Winning poem of the Write a Poem for This Photo Contest. Staff. Winter, The Pharos and a previous contributor to the journal. His address is: Nephrology
–. Section, MC 5100, University of Chicago Pritzker School of Medicine, 5841 S.
The Woman with Everything. Poem. Valdrighi A. Winter, . Maryland Avenue, Chicago, Illinois 60637- 4930. E-mail: fcoe@medicine.bsd.uchi-
cago.edu.
T
he Board of and also ser ve as
Directors of vice-chairman of
Alpha Omega the Department of
Alpha is very pleased Medicine. After hold-
to announce that ing administrative
Richard L. Byyny, MD, will become Executive positions as Executive Vice-Chancellor at
Director of Alpha Omega Alpha and Editor of the University of Colorado Health Sciences
The Pharos effective November , . After Center and as Vice President for Academic
an extensive search to recruit a successor to Affairs and Research/Dean of the System
Dr. Edward D. Harris, Dr. Byyny was selected Graduate School at Colorado, Dr. Byyny
from an extraordinary group of talented became Chancellor of the University of
candidates. Dr. Byyny is quite familiar with Colorado at Boulder, serving from
AΩA, having served on the AΩA board of di- through . Now a Professor of Medicine
rectors from through . He received at Colorado, Dr. Byyny has “crowned” his
his undergraduate and medical degrees from distinguished career by devoting his efforts
the University of Southern California, where to health policy and to the development of a
he was elected to AΩA. mentored research tract in medical student
Dr. Byyny received his internal medi- education.
cine training at Columbia University and Dr. Byyny will be devoting most of his
completed an endocrinology fellowship at time and effort to AΩA and The Pharos.
Vanderbilt University. He served as Head He is looking forward to interacting with
of the Division of Internal Medicine and the boards, the chapters, and with students.
Director of the Internal Medicine training We are all very pleased to have him as our
program at the University of Chicago from Executive Director. Please join us in welcom-
through . He then moved to Colorado ing Richard L. Byyny, MD.
to again head up general Internal Medicine