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EditorialThe dreaded burnoutDavid P. HillEdward D. Harris, Jr., MDTwo words: poverty and depression. They are personaldisasters. Poverty is easier to recognize and treat than is depression.Recall the agonizing account of George Hurstwoodin Theodore Dreiser’s novel, Sister Carrie, whose descentfrom manager to tramp defines poverty with incisive detail.Alleviating poverty usually entails providing resources, suchas money. Depression, in contrast, is a black hole separatingone from life. John le Carré, in A Most Wanted Man, describesthe feelings of a man standing in the Ernst Barlach museum,viewing sculptures of mythic figures not easy to view: “eachfigure was as alone as he was, and . . . each was communicatingsomething; but nobody was listening, each was searchingfor a solace that was not available.” That is depression.Do you remember your years as a medical student? Oh sure,there was stress—the oral exam in biochemistry, falling asleeptrying to really understand renal clearance, suffering the arroganceof residents. But balancing and trumping those traumatictimes were the camaraderie of your classmates, the pizza andbeer that appeared late Friday afternoons, and the glimmeringcrescendo of certainty that when these trials were behind you,a career in the most respected of professions would be yours.There was idealism, too, although cynicism eroded away muchof what you had brought to medical school.Is it not confounding and perplexing, then, to read thatamong medical students, depression occurs in fifteen to thirtypercent, three times higher than the rate of depression in eitherthe general population or in age-matched peers? What ismedical education doing wrong? Or does this imply a link of adepressive trait to aptitude for science and a caring nature?Heather Finlay-Morreale was, as you were, in a bedeviledbut balanced and accepting state of mind before her classmate,Mike, in the first year of medical school, committed suicide.This was not an impulsive act on his part in the midst of a selflimitedcrisis. He chose to die by carbon monoxide inhalation,a method that requires step-by-step planning. Ms. Finlay-Morreale wrote about the impact of his death upon her inher essay, “And then there were eight,” for which she receivedsecond prize in the 2007 AΩA Helen H. Glaser Student EssayCompetition. Her essay was published in the Winter 2008issue (pp. 4–7). Her review of the literature found that onlyforty-two percent of medical students with suicidal ideationasked for help. Reasons for not seeking help included fears ofdocumentation on academic records, of unwanted intervention,and of lack of confidentiality. She found encouragementin recent efforts, including a consensus statement publishedin JAMA, to set up systems that recommend specific interventionsto reduce physician suicide. 1 These steps to cure,however, do not address causality. For Heather, the questionremains: Why? Why? Why?What causes the despair that can lead to full depressionand suicidal ideation or suicide among medical students? Onestudy published in the Annals of Internal Medicine in 2008by Liselotte Dyrbe and her colleagues attempts to relate theprevalence of suicidal ideation in medical students and its relationshipto burnout, demographic characteristics, and qualityof life. 2 Using the evidence that suicidal ideation is a directprecursor of a suicide attempt, they found a direct relationshipbetween suicidality and burnout, and a strong dose-responserelationship between burnout and suicidal ideation during thesubsequent year.But what is “burnout”? The investigators defined the domainsof burnout as: Within the group of 370 students meeting the criteria forburnout, twenty-seven percent were no longer burned out atone year follow-up. They had recovered! This group of “recovereds”were less likely than students with “chronic burnout”to report suicidal ideation in the subsequent year (7.2% versus18.2%). Burnout among medical students, then, can be reversible!The authors make logical recommendations:1. Require medical schools to have systems in place toidentify currently suicidal students2. Identify students with burnout—those at high risk forsuicidal ideation3. Implement “student support and wellness programs [to]optimize the learning environment, the organization of clinicalrotations, and the diversity of clinical experiences.” 2p340Could AΩA chapters help with these interventions? Onone hand, our students are not equipped to help with therapyof students with suicidal ideation, nor can we expect AΩA tohave a significant impact upon curricular reform. What AΩAcan do is to organize mentoring programs for fellow students.Mentoring is contact of one to another that is not teaching,not therapy, not role modeling. It is taking the hand of andguiding someone through the treacherous waters that thementor has already navigated successfully. AΩA is the nationalhonor medical society recognizing scholarly achievement, butproviding service to others can be a greater reward than theAΩA key and certificate.References1. Center C, Davis M, Detre T, et al. Contronting depression andsuicide in physicians: A consensus statement. JAMA 2003; 289: 3161.2. Dyrbe LN, Thomas MR, Massie FS, et al. Burnout and suicidalideation among U.S. medical students. Ann Int Med 2008;149: 334–41.The Pharos/Winter 2009 1
The Pharos • Volume 72Number 1 • Winter 2009In ThisARTICLES1 EditorialThe dreaded burnoutEdward D. Harris, Jr., MD4247The physician at themoviesPeter E. Dans, MDStagecoachThe Horse SoldiersReviews and reflectionsWhen the Air Hits Your Brain:Tales from NeurosurgeryReviewed by Michael Egnor, MDPatient Listening: A Doctor’sGuideReviewed by Frederic W. Platt,MDHenderson’s EquationReviewed by Jay Baruch, MD54 Letters526064DEPARTMENTSAΩA NEWS2008 <strong>Alpha</strong> <strong>Omega</strong><strong>Alpha</strong> Robert J. GlaserDistinguished TeacherAwardsNational and chapternewsWinners of the 2008 PharosEditor’s PrizeAnnouncing the 2009 PharosEditor’s PrizeInstructions for Pharos authorsLeaders in American Medicine<strong>Alpha</strong> <strong>Omega</strong> <strong>Alpha</strong>members electedin 2007/2008Judah Folkman, MD (1933–2008)David G. Nathan, MD, and Michael A. Gimbrone, MD4Be still, my (irregularly) beating heartMark D. Lo, MD10Samuel Johnson and ILeon Morgenstern, MD, FACS14Page 14Page 10
IssueIsabellaJames Reilly, MD18Maternal mortality and world history:The case of Princess Charlotte of WalesRoy Macbeth Pitkin, MD21Seishu Hanaoka, surgery, andanesthesia in feudal JapanDon K. Nakayama, MDPOETRY9Extracorporeal1321On the coverIllustration of a removal ofa breast tumor by SeishuHanaoka from Geka Kihai(1851) a treatrise by one ofHanaoka’s students, KeishuKamata.Image courtesy of Wellcome Images, London.See page 35MembraneOxygenation (ECMO)Sarah Cross, MDDo Old Men Dream?Eric Pfeiffer, MDNursing Home VillanelleBonnie Salomon, MD41 BridgeRadhika Sreeraman5859What Kind of Guy?Richard Bronson, MDShut UpMelvyn H. Schreiber, MDWelcome to AΩA63Daniel V. Schidlow, MD35 72 PalliativesVirginia AronsonInsideBack My Eye Doctor00 Cover Jenna Le0Back Breaking Good NewsCover Dean Gianakos, MDPage 35Page 18
Photo courtesy of the authors.4 The Pharos/Winter 2009
Judah Folkman, MD1933–2008David G. Nathan, MD, and Michael A. Gimbrone, MDDr. Nathan is President Emeritus of the Dana-FarberCancer Institute, Physician-in-Chief Emeritus of Children’sHospital in Boston, and the Robert A. StranahanDistinguished Professor of Pediatrics and Professor ofMedicine at Harvard Medical School. His recent book, TheCancer Treatment Revolution, was reviewed in the Summer2008 issue.Dr. Gimbrone is the Ramzi S. Cotran Professor ofPathology at Harvard Medical School and the Chairman ofthe Department of Pathology and Director of the Center forExcellence in Vascular Biology at Brigham and Women’sHospital in Boston. He was the first postdoctoral fellow inthe Folkman laboratory at the Children’s Hospital, Boston,from 1971 to 1972, and remained a lifelong colleague andfriend of Judah Folkman.At Ohio State University, Folkman came to the attentionof Dr. Robert M. Zollinger, Sr., a pioneering surgeon whobecame his early mentor. That relationship profoundly influencedFolkman’s career, further forging his nascent interestin surgery and inspiring him to take his medical education atHarvard, Zollinger’s alma mater. That decision conferred ahuge benefit on Harvard Medical School, Boston Children’sHospital, and the entire field of cancer research.From the dog lab tomedical schoolThe sudden catastrophe that stopped the heart ofJudah Folkman on January 14, 2008, robbed his familyof a loving husband, father, and grandfather, andprematurely terminated the career of one of the world’s mostproductive physician- scientists and leaders in modern academicmedicine.Moses Judah Folkman was indeed a remarkable man.Gifted with a keen intellect, engaging personality, andgenuine humanity, his creativity and energy were seeminglyboundless. Brought up in a highly religious Jewish family, hewas a source of intellectual ferment from early childhood.Like the elephant child in Kipling’s Just So Stories, JudahFolkman had “ ’satiable curiosity.” He combined his boundlessdetermination to find answers to difficult questions witha devotion to the betterment of the human condition. Theresult was his early decision to become a physician and surgeon.Folkman was a precocious medical student who immediatelycaught the eye of Dr. Robert Gross, the masterpediatric surgeon at Children’s Hospital and a man armedwith a sure taste for talent. Gross invited him into his dogsurgery laboratory where incredibly daring and creative newsurgical procedures to correct congenital heart defects werebeing devised. Folkman thrived in that environment, graduatedmagna cum laude from Harvard Medical School inthe class of 1957 (and was elected to AΩA in the same year),and went on to become an intern and resident in Surgery atthe Massachusetts General Hospital. The surgical service atMGH was then a fabled place. It was dominated by surgeonsof the quality of Richard and William Sweet, Oliver Cope,Edward Churchill, Robert Linton, Claude Welch, ArthurAllen, Marshall Bartlett, John Burke, and many others. Inthat rarified environment, Folkman performed exceptionallywell, but in 1960, after his senior residency, he was forced toThe Pharos/Winter 2009 5
Judah Folkman, MDinterrupt his training to answer the call to compulsory militaryservice.Before he took up his Navy commission, Folkman madethe smartest decision of his entire life. He proposed to PaulaPrial, a Wellesley graduate with a beautiful character, visage,and voice. Paula was accustomed to the medical lifebecause she was the daughter of a physician in Fall River,Massachusetts. They were married for less than a monthbefore they loaded a small trailer with their possessions andheaded for basic training and then Folkman’s assignment atthe National Naval Medical Center in Bethesda.The salutary role of the major military hospitals and theNational Institutes of Health intramural program in thedevelopment of modern academic medicine cannot be overstated.The Korean and Vietnam wars had many unintendedconsequences, most of them very negative, but the “doctordraft” that gave the opportunity for some of the very bestyoung physicians and surgeons to be awarded Public HealthService commissions and work in those excellent and wellequipped institutions provided a level of scientific trainingthat for three decades fostered the careers of a new breedof physician- scientists. Many of the advances in academicmedicine in the United States are owed to that draft.Indeed, Folkman’s posting to the National NavalMedical Center at Bethesda laid the foundation of his futurecareer. There he joined a cadre of like- minded youngphysician- scientists and began initial studies of the behaviorof tumor cells outside of the body, in the novel context ofisolated perfused organs. Along the way, he investigated thesemipermeable characteristics of silastic tubing, an inquirythat directly led to an efficient contraceptive device for use inthe underdeveloped world.Constantlyimagining, creating,coalescing thoughtsdiseases, and point the way to novel strategies for their treatment.Intrigued by the apparent abundance of blood vesselshe encountered during his attempts at surgical resection oftumors in the operating room, he became fascinated by thebasic question of how tumor blood vessels grow, a problemto which he productively devote his creative energies for therest of his life.Though Folkman was content with his clinical and researchactivities at Boston City Hospital, a seismic eventwas about to occur across town at the Children’s Hospital.Robert Gross, Folkman’s medical student mentor, decidedto retire, and an ad hoc committee to select a successor tothat giant of pediatric surgery was established. To the astonishmentof many, the committee, vociferously urged on bycancer researcher Sidney Farber, selected Judah Folkman.After a six-month special fellowship in pediatric surgery underthe watchful eye of Dr. C. Everett Koop at the Children’sHospital of Philadelphia, Folkman returned to the BostonChildren’s Hospital to assume his new leadership position asits surgeon-in-chief in 1968 at the remarkably young age ofthirty-five.Soon after the wunderkind arrived, those who wereamazed at the selection began to understand its wisdom.Folkman was a competent and careful surgeon, but his clinicalforte was differential diagnosis and, above all, teaching.Crowds of students and residents surrounded him on roundsbecause he could combine modern biology with clinicalpractice in a fashion equaled by none. His choice of descriptivewords was unique. He invented the term “chronophage”on one of those rounds to describe administrators and rulemakers who find countless ways to consume the time ofclinical investigators and rob them of the moments they needwith their patients and in the lab. His devotion to patientsand families was exemplary, and his respect for the opinionsof colleagues palpable. Despite the considerable burden ofhis new leadership role, he remained devoted to his missionas a physician- scientist and redoubled his research efforts inthe laboratory focusing on the phenomenon of tumor bloodvessel growth.Upon completion of military service, Folkman returnedto the Massachusetts General Hospital to serve as chiefresident in Surgery, an exalted post. Realizing that he wouldhave to leave the womb of the MGH to achieve independence,he then took his first faculty position as an assistantprofessor of Surgery on the Harvard Surgical Service at thethen Boston City Hospital. There, in 1965, in a tiny laboratoryin the basement of the Sears Surgical Building, he beganin earnest his career-long study of tumor blood vesselsthat would ultimately open up a new field in the biomedicalsciences—angiogenesis—and, in the process, permanentlytransform our thinking about the biology of cancer and otherTumor cells needblood vesselsfor growthBut the early going on the research front was challenging.Folkman’s initial formulation of the tumor angiogenesishypothesis consisted of three basic components:1. Tumor growth per se is critically dependent upon theingrowth of newly formed blood vessels from surrounding6 The Pharos/Winter 2009
host tissues.2. This is an active, not a passive process, mediated bythe production of tumor angiogenic factors (TAF’s) by themalignant cancer cells.3. The inhibition of tumor angiogenesis—antiangiogenesis—could arrest the progressive growth of tumors,representing a novel strategy for cancer therapy.This hypothesis, first published in the New EnglandJournal of Medicine in 1971, and now widely considered“transformative,” “brilliant,” “visionary,” and “prescient,” wasinitially met with considerable criticism and outright skepticismby the cancer research establishment. Indeed, the apparenthypervascularity of tumors had long been attributedto a reactive process of inflammation in the surroundingtissues, and the primary target of “curative” therapeutic approaches—toxicchemotherapies, ablation by radiation, andsurgical excision—was the malignant cancer cell population,not the benign vasculature. Angiogenesis as a process wasthought to be limited to the formation of new blood vesselsduring the development of the organs and tissues of the embryo,and was not believed to occur to any appreciable extentin the adult. Furthermore, no specific growth factors withactivities directed towards the cellular components of bloodvessels had been identified.Trained as a surgeon, but a physician- scientist by inclination,Folkman actually lacked any formal expertise inbiochemistry or cell biology. Nonetheless, he had an uncannyaptitude for asking penetrating questions and seekingtheir answers in unlikely places. He progressively attractedHarvard Medical School students, postdoctoral fellows, andvisiting scientists to work in his lab, and systematically beganto build the case for the tumor angiogenesis hypothesis. Akey experiment was performed in the rabbit eye, demonstratingthat tiny tumor spheroids implanted in the avascular,fluid-filled anterior chamber would remain dormant forextended periods of time, but then could grow exponentiallywhen allowed to contact the surface of the iris, from whichthey elicited the ingrowth of new capillaries. Published withhis first postdoctoral research fellow Michael Gimbrone inThe Journal of Experimental Medicine in 1972, this workprovided the proof-of- principle that the malignant growthbehavior of solid tumors was indeed dependent upon angiogenesis.Folkman’schallenge: Stoptumor angiogenesisThe Folkman laboratory then went on to establish a numberof very creative bioassays for observing and quantifyingthe angiogenic process: the corneal micropocket neovascularizationassay, the chick egg chorioallontoic membraneassay (with Robert Auerbach), and ultimately the culture ofcapillary endothelial cells in vitro (with Bruce Zetter andChristian Haudenschild). Each of these advances broughtnew insights into the biology of the angiogenic process,as well as the challenge of bioassaying putative pro- andantiangiogenic factors. Moving from initial experimentswith crude tumor extracts to the isolation and purification(collaboratively with Yuen Shing and Michael Klagsbrun in1983) of the first tumor-cell- derived angiogenic stimulator,basic fibroblast growth factor (bFGF), the Folkman groupestablished the second tenet of the original tumor angiogenesishypothesis. In parallel fashion, his team describedthe existence of a variety of naturally occurring substanceswith antiangiogenic activities, such as the fungal antibioticfumagillin (with Donald Ingber), angiostatic steroids (withRobert D’Amato), and endogenous proteins and protein fragments,such as angiostatin and endostatin (with MichaelO’Reilly and others). Each of these served to provide furtherinsights into the complex biological balance that controlsthe angiogenic process in cancers and other nonmalignant,angiogenic- dependent pathologies such as ocular neovascularization,hemangiomas and other vascular malformations,psoriasis, and atherosclerosis, as well as normal embryonicdevelopment. Indeed, several of these putative angiogenesisinhibitors have shown efficacy in animal models, and a numberhave found their way into human clinical trials in theUnited States and abroad. Perhaps the best studied exampleof a selective antiangiogenic therapeutic is the anti-VEGFantibody, bevacizumab (Avastin). Rationally designed to neutralizeone of the first angiogenic factors, vascular endothelialgrowth factor,* Avastin and related agents have foundapplication in the therapy of certain cancers, and have beenshown to be highly effective in the treatment of wet maculardegeneration, the most frequent cause of progressive visionloss and blindness in the Western world.As these studies unfolded, Folkman established a groupof creative and committed young colleagues, including BruceZetter, Robert Langer, Henry Brem, Michael Klagsbrun,Patricia D’Amore, Michael O’Reilly, Anthony Adamis, RobertD’Amato, and Marsha Moses, each of whom has gone onto define various dimensions of the field of angiogenesisresearch at the basic and translational levels. Some remainassociated with the Children’s Hospital Boston, while othershave created a network of angiogenesis research laboratories* VEGF was originally discovered by the laboratory of HaroldDvorak as a “vascular permeability factor”—VPF—and subsequentlycloned and characterized by Napoleone Ferrara at Genetech.The Pharos/Winter 2009 7
Judah Folkman, MDworldwide. Early in this process, Folkman enlistedthe collaboration of his close friend and colleague,the late Ramzi Cotran, who was appointed chairmanof the Department of Pathology at the adjacentPeter Bent Brigham (now the Brigham and Women’s)Hospital at approximately the same time Folkmancame to the Boston Children’s Hospital. Not only didthey collaborate scientifically (Folkman often referringto his Pathology colleague as “the conscienceof the surgeon”), but together they established theHarvard Medical Area Vascular Biology SeminarSeries, a weekly gathering that has for more thanthirty years been an open forum drawing students,young researchers, and emeritus professors alike. Upto the very week before his untimely death, Folkmansat in the front row, notebook in hand, and wasamong the first to ask a thought- provoking questionof the speaker.A much sought- after speaker himself at nationaland international meetings, Folkman’s style was spellbinding.His enthusiasm was contagious and his selfdeprecatinghumor a foil for the penetrating nature of hissubject matter. Always sharing his latest insights (and oftenunpublished data), he viewed fellow workers in the field notas potential competitors but as potential collaborators in thequest for the correct answer. Open to the input of others, heoften incorporated their criticisms into his working hypothesis.He had a remarkable influence on others. He was accessibleto the most junior of students and senior peers alike,and even the briefest conversation—in an elevator, for example—lefta positive impression. And, most importantly, hisaccessibility extended to patients and their families, to whomhe remained a constant source of hope and encouragement.In 1969, the terms “angiogenesis” and “endothelium”did not exist in the lexicon of the Medlars medical index.In 2007 alone there were more than ten thousand citationsrelated to angiogenesis, endothelium, and vascular biologyin the world’s medical literature. It is estimated that morethan a thousand laboratories worldwide are currently engagedin angiogenesis- related research. Folkman’s seminalcontributions were recognized by over one hundred nationaland international scientific prizes and more than a dozenhonorary degrees. He was an elected member of the U.S.National Academy of Sciences, the Institute of Medicine ofthe National Academy of Sciences, the American Academyof Sciences, and the American Philosophical Society. In 2006he received the Helen Keller Prize for Vision Research for hiscontributions to the cure of blindness—a wonderful byproductof his lifelong quest to understanding and combat cancer.Patients, colleagues, mentors, teachers, role models,friends—all who had the privilege of knowing JudahFolkman—have had their lives enriched in myriad ways. Hewill always be remembered as the father of angiogenesis,and, indeed, the godfather of a scientific generation that willcontinue to expand its boundaries and amplify its impact tothe benefit of humankind.Address correspondence to:David G. Nathan, MDPresident Emeritus Dana-Farber Cancer Institute44 Binney Street D1644Boston, Massachusetts 02115E-mail: David_Nathan@dfci.harvard.edu“Asking penetrating questions”It is true that Judah Folkman had “an uncanny aptitudefor asking penetrating questions and seeking their answers inunlikely places.” This aptitude was matched by his fascinationwith diverse phenomena in biopathology about which onewould have thought he had no interest.In 1969, Steven Krane and I, working at the MGH inBoston, hypothesized that rheumatoid synovium had characteristicsof a locally invasive malignancy. Judah Folkmansuggested that we implant pieces of this tissue (removed atsynovectomy) into his unique culture system. Its design wasthat of inverting segments of sterile rat gut over glass rods,and constantly nourishing them by slow- moving tissue culturemedium. Folkman could correlate the aggressiveness ofcolon cancers by the extent of invasion of the gut segmentsby explants. Sure enough, the synovial tissue invaded the gutserosa at a rate equal to that of cancer.Edward D. Harris, Jr., MDEditorPhoto courtesy of the authors8 The Pharos/Winter 2009
Extracorporeal Membrane Oxygenation(ECMO)Student on Pediatric SurgeryLearning to be a surgeon,the senior resident, in his cowboyboots and sea-foam scrubs, tries to explain ECMOin his Texas Spanish, impatient for the interpreter,in the neonatal intensive care unit.Only a few days old, the solid red mound of liver,had slipped up months ago in the dark.See, said the surgeon, up in the apexof the chest, her lung.I could only see a grey-blue fleck,like the still wing of the tiniest butterfly.We push the liver back in place, lashthe diaphragm—would-be mighty muscleof respiration—shut, and invade artery & vein tostream oxygen into the bloodourselves to buy time.Her chest filled with blood, she is openedagain. Then I am allowed to sewthe wound closed, between two ribsas soft as green twigs in spring,perhaps because it was futile,or perhaps small things heal well.Sarah Cross, MDDr. Cross (AΩA, University of Chicago, 2007) is a resident in theDepartment of Obstetrics, Gyneology & Reproductive Sciences atYale-New Haven Hospital. Her address is: 145 Willow Street #3, NewHaven, Connecticut 06511. E-mail: sarahcross@alum.swarthmore.edu.Illustration by Erica AitkenThe Pharos/Autumn 2008 9
Be still, my (irregularly) beating heartMark D. Lo, MDThe author (AΩA, University ofVermont College of Medicine, 2005) isan instructor in pediatrics at the Duke-NUS Graduate School of Medicine inSingapore.It was barely the end of my clerkshipyear. I had just driven home to visitmy parents for the weekend duringa call-free elective month in medicalschool. They were already going to bed,so I said goodnight to them beforeflipping open my laptop to check mye-mail.Ka-chung. My heart suddenly accelerated,like I had just finished a run.It didn’t slow down in the next fiveminutes, so I figured it was just somerandom adrenaline in my twenty-eightyear-oldsystem, or maybe the coffee Ihad just drained. It would be fine aftera good night’s sleep. But I couldn’t sleepmore than four hours that night, andI woke with the weird heartbeat stillthere.I puttered around the house, noticingthat I didn’t feel my normal energy level.No lightheadedness, but my breathswere rushed, even at rest. I’m sure it willgo away in a little bit, I told myself as Ithrew myself into bed. I’m just tired, andI can sleep this off. After a short nap,there was no relief from my symptoms.I finally took my quickened pulse, and itfelt “irregularly irregular,” an unwelcomeindicator of what my problem might be.Closing my eyes, I slipped on my stethoscopeand heard the confirmatory heartsounds of an arrhythmia, probably atrialfibrillation.“Damn,” I said out loud. Afib isn’t animmediately fatal disease, but certainlyis serious, even for younger people. Ihad heard enough of these arrhythmiasin older patients to recognize that Inow needed a hospital visit. I knewjust enough to know that I needed tostart with an ECG, and the only placeopen during the weekend was the localhospital emergency department. Iwrote my folks a note to tell them Iwould be in the ED, trying to use themost benign language I could think of.Stupidly, I then drove myself to the hospital,not realizing how risky that couldbe. I was secretly hoping that I would bewrong, that the ED would think I was aparanoid medical student and send meaway with a lecture on not adding tothe burgeoning costs of overcrowdedEDs. And I was somehow fantasizingthat I only needed an ECG, as my basiccoverage student health insurance plan+ emergency room visit = much poorerstudent. Maybe I could sneak off withjust “the basics.”I had never been to the ED for anythingmore serious than a sprainedankle. Walking in, I felt slightly embarrassedas I spoke with the desk clerk.“I don’t think this is emergent oranything, but, uh, I was wonderingwhere I could get an ECG this time ofday. Is there an after-hours clinic (read:cheaper)?”She assured me that I had come tothe right place, as it was the only ECGavailable. I explained the problem in theappropriate medical lingo.“Palpitations? Shortness of breathwithout syncope? Fill out these formsand we’ll see you right away!” she exclaimed.Three minutes later I washaving a nurse confirm my irregularheartbeat and take my blood pressure,which was dramatically elevated.“White coat syndrome,” she murmured.“Happens all the time.” I say that to myhypertensive patients, too, I thought.And I’m usually the one wearing thewhite coat.Ten minutes later, I was wearing aflimsy hospital gown for the first timein my life. It kept slipping off my shoulders.I had the ECG leads on, and theprintout confirmed atrial fibrillation.“Nice pickup,” said the nurse, but I wasalready running through the treatmentoptions in my head.I knew I wouldn’t be leaving anytimesoon, and the treatment might be moreinvasive than I wanted. Coming to theED meant the full workup automatically,and I couldn’t get away with my àla carte request. Labs were drawn, IVswere inserted, chest X-rays were taken. Iwas stunned at how painful the IV couldbe, jammed against a valve in my vein.I felt like a sham, as I squirmed in painwhen the nurse tried to flush it. I wasashamed at my reaction to this ubiquitousprocedure that I myself had subjectedso many patients to. Suddenly Iwas cognizant of the fact that although10 The Pharos/Winter 2009
The Pharos/Winter 2009 11
Be still, my (irregularly) beating heartwe medical students practiced insertingIVs on each other, we never stayedhooked up to them for very long, and nomedicine ever passed through the lines.A paper funnel was handed to me.“Urine sample!” chimed a differentnurse. I was getting confused betweenthe different people taking care of me,each with the greeting “I’m [insert differentname] and I’ll be your nurse.”Why didn’t they ask me for the urinebefore I was hooked up to the IV?” Igrumbled. Giving the sample with IVlines and monitoring wires all tangledup, I suddenly appreciated the fact thatit’s hard to move—much less undo azipper—without free hands.The patient in the bed next to mebegan moaning in pain, and I wonderedwhat was wrong with her. Her moansturned into yelps of pain, and throughthe curtain I could hear her family tryingto comfort her. They could also hearwhat my care providers were telling meabout my newly diagnosed arrhythmia.Being roommates with somebody elsepretty much obliterates any kind of privacy,I discovered.Almost two hours went by as I waitedfor the cardiologist to come see me. Ithought about how I always ended upmaking patients wait on me as well. Thenurses started me on an IV medicinein an attempt to convert me back tomy normal heart rhythm. I lay back onmy pillow, watching the monitor as themedicine dripped in for an hour, prayingto see P waves. It didn’t work—I stillwas in arrhythmia and I could feel it.Argh. I knew what was coming next.On cue, the cardiologist came bustlingin, looking every bit the professionalone could hope for. I wondered ifI looked like this when I saw patients asa student doctor—with me it was alwayspartly competence and partly me convincingmyself I really was competent.We chatted for a few minutes aboutmy history and presentation, and howthe medicine hadn’t worked. He thentold me what I had been expecting, thatcardioversion was the next option if Iwanted to avoid staying overnight inthe hospital.Cardioversion is the process of passinga couple hundred joules of energythrough the heart, effectively obliteratingany irregular rhythm. It is thenassumed that the natural pacemakingability of the heart will take over and aregular heartbeat will be re- established.In essence, cardioversion is just like onTV when the medics break out the paddlesand yell “Clear!” before deliveringthe electric shock to reboot the heart.Risks include the arrhythmia persistingeven after the shock, or the heartstopping and not remembering to startbeating again. The cardiologist wantedto sedate me and do this to me. In myhead, I knew that this was the normalprotocol and perfectly safe. In my heartof hearts (pun intended!) I thought thiswas nuts. I was now on the wrong endof a code situation.It might have been the first time inmy life that I truly had to trust doctorscompletely. In the end it came down tomy unwillingness to be hospitalized andwait longer, with the potential of weeksof anticoagulation ahead. I made surethat I talked to my loved ones beforegoing under sedation, and even drafteda quick living will. I wanted to clarifymy future medical wishes should I beincapacitated, and from the corner ofmy eye I thought I saw the cardiologistroll his eyes. But if my brief foray intomedicine taught me anything, it wasthat you never knew how things weregoing to turn out.My eyes widened as they broke theplastic lock to the code cart. The oxygenmask went on, and they tore openthe silver bag containing the adhesivepaddles. The sticky gel was cold, and Ifelt a slight tingle as they pushed morphineand midazolam. The cardiologistswitched on the defibrillator.“Hang on, hang on,” I choked out.“I’m still here, I’m still totally awake.”More midazolam.“Nope, still here, I think I need some,uh, uh, m-more . . .”My eyelids were closing of theirown accord and the edges of my visionblurred. The last sounds I heard werethe irregular beeping of the C-R monitorfading away . . .Zap.I awoke and immediately knew Iwas in sinus rhythm. I also immediatelywished I had just chosen hospitalization.Since cardioversion, I’ve beencleared of any cardiovascular issues. Itis thought that caffeine or the stress ofmedical school triggered an episode oflone atrial fibrillation. The experienceof being a patient in the emergencyroom brought home the reality of whatwe do every day. I was struck again byour effect on our patients, and how veryquickly even our own health can change.My many years of youthful invincibilitywere all taken away in a literal heartbeat,with no warning whatsoever. Forthe first time in my life I felt betrayedby my body, and for months afterwardsI wondered if every tiny chest pain ortachycardia or quickened breath meantthat something more serious was aboutto occur. I can still live my life happilyin the moment, but in the back of mymind there is a shadow lurking. Theshadow is the uncertainty of health, andunderstanding the tremendous speedwith which illness may come.As physicians, we do our best to safeguardour patients’ health, and to fightfor them when the illness does come.Atul Gawande writes of the doctor’sprofession, “We are for the moment thehealthy few who live among the sick.” 1My new insight to the experience of beingboth healthy and sick has convincedme once again that being a doctor is themost meaningful profession I could hopefor. As long as we are still healthy few,ours is the privilege to help the sick.Reference1. Gawande A. Nine Thousand Surgeons.In: Gawande A. Complications: ASurgeon’s Notes on an Imperfect Science.New York: Picador; 2002: 75–87.The author’s e-mail address is: mark.lo@duke-nus.edu.sg12 The Pharos/Winter 2009
Do Old Men Dream?he dreams of ridingdown a canopied highwayon his monster Harleyto the beach the beacha woman waits for himwith food and drinkthe Florida sunexploding in his headpelicans diving and divingand skimmers skimmingEric Pfeiffer, MDDr. Pfeiffer (AΩA, Washington University in St. Louis, 1960)is a member of the editorial board of The Pharos. His addressis 3120 W. Hawthorne Road, Tampa, Florida 33611. E-mail: epfeiffe@health.usf.edu.Illustration by Jim M’GuinnessThe Pharos/Winter 2009 13
IsabellaJames Reilly, MD18 The Pharos/Winter 2009
caps. Voice sounds are more important now. We talk constantly.“Careful, the table is narrow. We’ll put a seat belt on youso you don’t fall. This will feel cold and sticky.” The groundingpad slaps onto her bared thigh skin.Quickly now, she begins her transformation from personto inanimate object, as we gradually cease talking to her andbegin talking about her.“This is Isabella Montez, medical record number 34237.Date of birth is January 11, 1952. We’re removing a pelvic tumor.”Electronic boxes with flashing lights and digital screensdecorate the room, strange sculptures stacked on shelves.The room is harshly lit. Isabella seems deathly pale, such littlemass rising beneath the sheets that define her supine form.The paper- swaddled nurse in the corner hovers over rows ofsparkling stainless cutlery-like tools. She’ll have to fetch themquickly, and mistakes are not good.The patient gives up all controlto the doctorsIsabella is senseless now, consciousness gone. The drugsdo that, and now the anesthetist pries her mouth open andpeers in. The foot-long breathing tube slides in. She’s nowcompletely under our control, an almost inanimate object.Isabella has been losing weight for months. The selfishtumor takes her food for itself. I paint her abdominal skinwith the antiseptic fluid. The tumor hump pushes up againstthe sponge stick. We arrange the green and blue paper layerscarefully, hiding Isabella. Soon she’s gone. All that remains isthe square of sickly orange-brown skin centered on her navel.I cut her quickly with a knife, then move to a hot electric cautery.A sparking tip ignites her fat in a flash. Too hot.“Turn the Bovie down to 30,” I murmur. We go on. A cloudof vaporized fat and fascia rises from the wound. I’m in now,and my hand gropes deep, till I find what I want. The tumoris mobile, and I pull it up and out, into the light, an ugly facelesslump encasing and dimpling her colon, about softballsize. “Let’s take this out,” I say. I sound like a coach. And sowe begin.The author (AΩA, University of Pennsylvania, 1972) is directorof Surgery at the Kings County Hospital Center inBrooklyn, New York, and Professor of Clinical Surgery at theSUNY Downstate College of Medicine.Ipushed Isabella Montez’s gurney into the operating roomat first light. She shivered, “I’m cold.”“We’ll give you a warm sheet in a minute,” I replied.She sees no reassuring smiles, no bright teeth here; we’reall face-covered with paper masks and drug company-logoedA few days later, I stand outside her room with a crew ofyoung earnest surgeon types. A medical student begins, “Thisfifty-six-year-old woman underwent sigmoid colectomy threedays ago. She’s afebrile, her abdomen is soft, her wound isclean and dry. She had a BM last night.”“Good morning, Mrs. Montez,” I lead the group as wecrowd around her thin hidden form on the hospital bed. Herroommate seems asleep behind the curtain that separatesthe two patients, but she could easily hear every word. Thetwo women have talked about their kids, their spouses, theirPhoto by Gonzalo Cisterna SandovalThe Pharos/Winter 2009 19
Isabelladisease, their fears. They talk about the nurses and, especially,about their doctors.“May I see your incision?” I ask and begin stripping thetape and gauze from her abdominal skin. “Looks good. Dietas tolerated, staples out on POD 7, please.” The young surgeonsscribble notes. Then I notice. Isabella has put on a face,used some make-up, a bit of blush on her cheeks, and lipstick.She’s back from her trip in Charon’s boat, her visit to Hades.“The lipstick sign,” I intone. “Usually seen on POD 5. Ms.Montez, you’re ahead of schedule. You’ll be just fine.”Outcome: Back to normal, a lifelongscar . . . or worseSurgeons do terrible things to patients. In a cold harshly-litoperating theatre, we render them helpless, unconscious,and mercifully unfeeling. We strip them naked, and cut themopen, looking, grasping, moving things about, removingparts, replacing them, putting them back together. We givethem immediate suffering in exchange for a better future, analmost religious bargain. And we know there’s no going back.Once I start working, Isabella Montez will never be the same.She’ll most likely be better, I think, but different, for sure.She’ll wear my incision’s scar all her life and, if things don’twork out the way we both hope for, she’ll take it with her toa perhaps premature grave. That realization of irreversibilityhaunts every surgeon’s decision.Surgeons need some protection from this awful reality,and our defense mechanisms have to be robust, if notimpenetrable. We erect some walls of separation. We sometimesdepersonalize our patients, transform them from fleshand blood people, like us, with parents, loved ones, hopes,dreams, a future, into a body part, specifically, the one that’sacting up, misbehaving, the part that needs dealing with, tocome out and be done with. The nagging hernia, the stonefilledgallbladder, the ulcerated stomach, the inflamed orcancer- burdened colon.Surgeons experience surgery with shocking intensity.During an operation, every sense, tactile, auditory, and especiallyvisual, is acutely energized, laser- focused on the task,every tissue probed and cut, every bleeding surface, everystructure we disturb, and those we leave be. For days tomonths after an operation, I can recall the details of the procedurewith singular clarity, a mental videotape that rerunswhen I encounter Isabella recovering, and even in my dreams.This remembrance gives Isabella a new and singular dimensionthat is our shared secret. No one has seen Isabella as Ihave, explored her in this frighteningly intimate way. And so,when I refer to her as “the colectomy,” I’m describing her in adimension uniquely known between patient and surgeon.Isabella, while she’s stripped and vulnerable, lying abed inpain, nevertheless has high hopes for me. She prays I’ll bringher good news, tell her that the tumor is gone, promise herit won’t come back, reassure her that she’ll live. Sometimes Imeet these expectations, but too often I just bring more badnews. The tumor has spread, chemotherapy and radiation arenext. And no promises for a future.Under these circumstances, Isabella and I can’t get tooattached. So we focus on the task, on my craft, the opening,probing, taking-out, rearranging, sewing up. But no commitmentto the future, just the here and now.Other doctors do commit. The pediatrician expects tosee a child from birth through adolescence, to be witness togrowth spurts, runny noses and fevers, first day at school,maybe a broken bone or bad appendix. Internists watch theirpatients for years, to detect the blood pressure or glucose orcholesterol misbehavior, to counsel against those bad choiceswe all make and seek absolution for, and to witness and holdat bay the slow breakdown of form and function we all sufferas we age. Even an obstetrician gets nine months with his patients,and a singular joyful new person as a reward.Not so for surgeons. Our patients don’t want to get toknow us. Mostly our failures keep coming back, and they’reoften angry or sad at the predicament that keeps us together.My patients want nothing more than to hear me say, “You’redone with surgery for now. Let’s get you back to your doctor.”Or to the next specialist in chemotherapy or radiation therapyor rehabilitation. Just not more surgery, or surgeons.Introducing a patient to thebeginning of more living. . . or deathIsabella and her daughter came to my clinic two weeksafter surgery. She admitted to being fatigued, but was eatinggood familiar food, enjoying visits from attentive family members,and described in singular detail her bowel habits. Sheknew I’d want to know. I had some good news.“I have your pathology report. We got the whole tumor,and the lymph nodes were all negative. No tumor in thenodes. That’s good news.”She began to weep, but then thought better of it, wipedher eyes, and murmured, “Thank you, doctor.” Her daughterhugged her. Isabella put on her coat, gathered her bag, andleft arm in arm with her daughter. They’d be back in a fewmonths for a check-up.A few moments later, my resident introduced me to mynext patient, a forty-three-year-old woman with a stone-hardbreast mass, and a lump in her armpit. “May I examine you?”I asked. Her eyes filled with tears; she knew I would break herheart. I handed her a tissue, and we began to get acquainted.The author’s address is:21 E. 87th Street #9ANew York, New York 10128-0506E-mail: jjreilly@prodigy.net20 The Pharos/Winter 2009
Nursing Home VillanelleGravity shifts me to the ground.Mornings, I float down from dreams.Natural forces spark light and sound.Outside my head, again I’m boundBy drugs, routines, and patient screams.Gravity shifts me to the ground.TV voices rejoice: lost children found,Early morning talk show schemes.Natural forces spark light and sound.Breakfast chatter all around.Wrinkled lips smile at nurses’ teams.Gravity shifts me to the ground.Ageless atoms in the air surround:Everything is just what it seems.Natural forces spark light and sound.Dreams reside in a “lost and found”Where I find myself, till morning beams.Gravity shifts me to the ground,Natural forces spark light and sound.Bonnie Salomon, MDDr. Salomon (AΩA, University of Illinois at Chicago, 1987)is an emergency physician and a member of the editorialboard of The Pharos. Her address is: 139 Riverside Drive,Deerfield, Illinois 60015. E-mail: bonsalomon@aol.com.Illustration by Karen BrezsnyThe Pharos/Winter 2009 21
BridgeShe wouldn’t hear the words, yetRivers appeared on parched creeks,Traversing the hills and valleys of her face,Leaving behind a desert, more barren.She shivered now, in the silenceOf his permanent absence,Praying anxiously that he did not suffer,That his last moments held some element of peace.Her mind willed itself to Kashmir,To the soaring Chinar treesBeneath which they first faced each other,Memorizing details while sipping juice.Please consider, she vaguely heardThe doctor say, stepping back.This compelled her thoughts back to the blank white room asShe considered, questioned and contemplated.Does the essence of a treeRemain when it is fallen?If then, its leaves are shorn and branches severed?Her eyes moved past the hallway.Outside she saw the sidewalkGlistening in the onerous summer sunBeside the small patch of yellow yarrow.From the mud grows the lotus;From the ashes rises the grass;From neat, sliced logs comes the warmth of the fire.She turned to the doctor.Yes, she said, I will.Radhika SreeramanMs. Sreeraman is a member of the Class of 2011 at theUniversity of California, Davis, School of Medicine. This poemwon third prize in the 2008 Pharos Poetry Competition. Ms.Sreeraman’s address is: 4601 V Street, Sacramento, California95817. E-mail: radhika.sreeraman@ucdmc.ucdavis.edu.Illustration by Laura AitkenThe Pharos/Winter 2009 41
The physician at the moviesPeter E. Dans, MDDoctors in two John Ford filmsWhen Orson Welles, whose Citizen Kane is consideredby many to be the best film of all time, was asked toname the three best movie directors, he replied “John Ford,John Ford, and John Ford.” In Directed by John Ford, a masterfuldocumentary tribute to Ford first produced in 1971 andupdated in 2006, director Peter Bogdanovich interviewedWelles, Walter Hill, Martin Scorsese, Steven Spielberg,and Clint Eastwood. All acknowledged the debtthey owed to Ford. Calling him a “Catholic poet,”Hill went on to say that “what set him apartwas his sense of spirituality, his sense thatdeath is not the end.” Bogdanovich illustratedthis in such films as Young Mr. Lincoln, in which Lincoln(Henry Fonda) talks to Ann Rutledge at her grave and in SheWore a Yellow Ribbon, in which the Colonel (John Wayne) paysvisits to his wife’s gravesite to share the news of his retirementfrom the army.Paradoxically, Ford, whose pictures are suffused with theimportance of family, had a disordered one. He was profane,had affairs, drank heavily, and was far from a model Catholic,yet his films respectfully portrayed Catholics and their imagery.Although his films radiated warmth, he was often very cold andoff- putting in person. It sort of reminds me of my response toAmadeus, in which Mozart’s behavior is portrayed as hardlymatching the excellence and otherworldliness of his work. Tothe extent that the portrayal was true (and many dispute it),I say, “So what! Just enjoy the works and leave him to God’smercy where his oeuvre should speak for him.” The same holdsfor Ford. Indeed, nothing says it better than the line in Ford’sclassic The Man Who Shot Liberty Valance. Senator RansomStoddard (Jimmy Stewart), whose career was built on his beingthe hero who shot the evil Valance, admits toreporters that it wasn’t him but his friend TomDoniphon (John Wayne), who wouldn’t takeStagecoach, 1939, directed by John Ford (left), starring John Wayne andClaire Trevor.UA/Photofest ©United Artists
the credit. When he expresses dismay that the reporters won’tprint the truth, one replies, “This is the West. When the legendbecomes the fact, print the legend.”Stagecoach (1939)Starring John Wayne, Claire Trevor, Thomas Mitchell, andJohn Carradine.Directed by John Ford. Not rated. Black and white. Runningtime 96 minutes.Called by some the first adult western, Stagecoach was oneof the many classic films that has led 1939 to be labeledHollywood’s Golden Year. Other great films of that year includeGone with the Wind, The Wizard of Oz, Mr. Smith Goesto Washington, Ninotchka, The Women, Goodbye Mr. Chips,Gunga Din, Dark Victory, Young Mr. Lincoln, and Destry RidesAgain. Director John Ford, who had already received an Oscarfor The Informer (1935), and would go to on to win three more(The Grapes of Wrath [1940], How Green Was My Valley [1941],and The Quiet Man [1952]), oddly enough was never honoredfor his quintessential westerns. Nonetheless, his influence isindelible, no more so than in High Noon.This film is noteworthy for being the first Ford film shot onlocation in isolated Monument Valley, at the time 200 milesfrom Flagstaff over rough roads, and for making John Wayne,in his eightieth film, a star. Born Marion Michael Morrison,Wayne was a pre-law student at USC on a football scholarship,but when he injured his knee he could not afford to continue.Starting in Ford’s silent films in 1926 as an extra, stuntman, andgofer, he worked his way up to a starring role in the 1930 filmThe Big Trail, for which Ford had recommended him. When thepicture bombed, he became persona non grata with all the majorThe Pharos/Winter 2009 43
The physician at the moviesstudios. Reportedly, Ford didn’t talk to him for four years. Finallyafter working in B pictures for years at Republic and Monogramstudios (known as “Poverty Row”), Ford gave him the starringrole in Stagecoach, even though his presence led many producersto turn Ford down. Finally, Walter Wanger agreed to financethe picture and the rest, as they say, is history.Based on a Collier’s magazine article, “The Stage toLordsburg,” with some amendments courtesy of the shortstories “Boule de Suif” by Guy de Maupassant and Bret Harte’s“Outcasts of Poker Flat,” the film is more complex than theshoot-em-ups of its day. The picture is really a social commentaryon hypocrisy and a character study of redemption,a recurring theme in ’30s films. It’s also a low-key love story.Most of this is played out in the cramped quarters of the stagecoach,and the station stops along the way. Although the trailersemphasized the “action,” the confrontation with Geronimoand his Apache warriors who had left the reservation, as well asthe showdown between the bad guys and the hero, don’t occuruntil late in the movie.The film starts with the Lordsburg Stage arriving in Tonto,and the driver learning from the Comanche scouts that theirhated enemies the Apaches are on the warpath. The stagecoachfills with an odd assortment of characters. Two are being giventhe heave-ho by the Law and Order League. One is DoctorBoone (Thomas Mitchell), who had been honorably dischargedfrom the Union Army but whose skills had been underminedby alcohol such that his landlady claimed that “he can’t doctora horse” and that he hadn’t paid his rent (or his bar bill for thatmatter). A literary soul, Boone looks at her and, paraphrasingChristopher Marlowe’s reference to Helen of Troy in DoctorFaustus, asks, “Is this the face that wrecked a thousand shipsand burned the towerless tops of Ilium? Farewell, dear Helen.”Then he turns to the other outcast, Dallas (Claire Trevor), theproverbial prostitute with a heart of gold, and tells her, “We areUA/Photofest ©United Artiststhe victims of a foul disease called social prejudice, my child.These dear ladies of the Law and Order League are scouringout the dregs of the town. Be a proud glorified dreg like me.”Then taking her arm, he says, “Comtesse, the tumbrel awaits.To the guillotine.” And he ceremoniously leads her across thestreet before stopping at the saloon, where the bartender tellshim that if talk were money he’d be his best customer, and giveshim one for the road.Another passenger is Samuel Peacock (Donald Meek), awhiskey drummer (salesman) complete with a satchel full ofsamples that Doc commandeers to get him through the journey.Another is a former Confederate soldier and now “notoriousgambler” Hatfield (John Carradine), whose courtliness willalso belie his disrepute. There’s a southern belle, Lucy Mallory(Louise Platt), who is traveling to reach her husband who commandsthe local cavalry garrison, only to learn that he is onpatrol chasing the Indians. Another passenger, a presumably“upstanding” citizen, is the banker Henry Gatewood (BertonChurchill), who is given to statements that played to the discontentof ’30s audiences: “What’s good for banks is good forthe country.” The husband of the head of the Law and OrderLeague, he is absconding with $5000, the latest shipment byWells Fargo.The wagon driver Buck is played with comedic effect byAndy Devine. Strangely enough given his girth, Devine was areal cowboy who could handle the difficult job of controllingthe stagecoach’s six-rein team of horses. This became essentialwhen Yakima Cannut (born Enos Edward Cuniff), the greateststuntman of all time, doubled as an Apache and jumped onthe horses, and after being “shot” had to make two transfersthrough the rampaging team. He had only three feet to sparebetween the horses, and he timed it assuming the driver maintainedthe horses at a steady speed. See his Wikipedia bio tolearn more about all the films for which he did or arranged thestunts. Despite his fearlessness, he died in his bed at ninety. Hisson did the stunt doubling for Charlton Heston in the famousBen-Hur chariot race.The last member of the ensemble cast is Marshal CurlyWilcox (George Bancroft), who is anxious to get to Lordsburgwhere The Ringo Kid (John Wayne), who has just broken outof jail, is headed to kill Luke Plummer (Tom Tyler), who killedhis father and brother. He wants to make sure Ringo isn’t killed,not only because he likes him but also to claim the rewardmoney for capturing him.The Ringo Kid’s entry into the film, holding his saddle inone hand and twirling his Winchester in the other as the stagecoachrounds the bend, is considered one the most dramaticentries of a newly- minted star. Ringo joins the group as a captiveand later, when the stagecoach is threatened, he becomesan essential team member. At first, he and Dallas are shunnedas societal outcasts. He calls Dallas “a lady” and treats her assuch. As their relationship deepens, Ringo’s rendezvous withLuke Plummer (Tom Tyler) and his brothers looms over it. The44 The Pharos/Winter 2009
film illustrates three hallmarks of Ford’s films: (1) a pictorialstyle of filmmaking, (2) spare dialogue, and (3) the use of facialand body reaction rather than dialogue to advance the story.This is best shown by Ford focusing on Wayne, who sits in themiddle of the interplay of the characters, silently registeringresponses and reactions.Thomas Mitchell won an Oscar for best supporting actoras Doc, who is hardly a great advertisement for the professionof medicine. He smokes cheroots and drinks during most ofthe trip and calls himself “not only a philosopher but a fatalist.”We do learn that he fixed Ringo’s brother’s arm. When Ringoadds, “You did a great job even if you were drunk,” Doc replies,“Thank you, son, professional compliments are always pleasing.”Doc is like a lot of the stock characters in Ford’s films,a compulsive drinker but a good man at heart who can pullhimself together when needed. He does so on at least threeoccasions. The first is when he is reluctantly pressed into serviceafter Mrs. Mallory faints. He calls for lots of hot water aswell as lots of black coffee as he prepares to sober up for anemergency delivery, after which he says, “I brought hundredsof these fellas into the world and the new one was always theprettiest.” The second time, he saves the life of the whiskeydrummer, who is shot with an arrow. The third takes place beforethe climactic shootout. He’s not your prototypical doctoras paragon, but he’s a good man nonetheless.The Horse Soldiers (1959)Starring John Wayne, William Holden, Constance Towers, andAlthea Gibson.Directed by John Ford. Not rated. Running time 119 minutes.Unlike his protégé Wayne, John Ford was a liberal Democratuntil late in life, and although his movies tended to glorifythe military he was very critical of the effects of war on thesemen. Ford spent much of World War II filming in the heat ofbattle at Midway, the Normandy invasion, and other hotspots.On his return, he made one of the strongest anti-war films,aptly titled They Were Expendable. Even in the trilogy in whichhe vividly portrayed the U.S. cavalry, he shows a disdain forthose who impetuously and vindictively pursue war contraryto the advice of veterans who counsel peace with the Indians.This is best shown in Fort Apache, in which the wrongheadedcommander played by Henry Fonda refuses to listen to Wayne’scharacter and brings havoc on himself and his troops, but isremembered as a hero. In short, Ford conveyed a respect forthose who fought for their country out of a sense of duty, whilelamenting the waste of fine young men.The film starts with a typically striking view of the cavalrymensinging “I Left My Love” as they go out on patrol, reminiscentof the scene in She Wore a Yellow Ribbon. Althoughthe screenwriters drew on a novel by Harold Sinclair, the storyhas a basis in fact in Grierson’s Raid in April 1863 when theBattle of Vicksburg was at an impasse (see addendum). Grantand Sherman lament that “the war is not going well, not inWashington, not in the newspapers, not in the field.” Theydecide to send a patrol 300 miles deep into Confederate territoryto destroy the railroad junction at Newton Station supplyingVicksburg. Heading the mission is Colonel John Marlowe(Wayne) of the Michigan militia, a railroad section hand in civilianlife. He is assigned Colonel Phil Secord (Willis Bouchey),who is more interested in victories to help his political ambitions,and Major Hank Kendall (William Holden), an insubordinatemilitary surgeon who arrives out of uniform. Kendallis more concerned about casualties and how the men will becared for as they try to maintain the thirty-five-miles-a-dayplan. Marlowe responds that “we’ll move on. It gives yourpeople a wider opportunity for experimentation.” However,when they do suffer casualties, Kendall does agree to stop andsend the wounded back, reducing his strength. They skirmishover the duty roster and Kendall’s refusal to certify a malariapatient for duty. The latter is replaced by Sgt. Major Kirby(Judson Pruitt), the familiar drunken sergeant. During a halt,Kendall agrees to deliver a baby in a poor black homestead,and afterwards says, “As many as I have delivered, it never failsto awe me.” He then adds, “One born, one dies,” referring totheir first casualty. Marlowe tells him to confine his duties tothe troops.UA/Photofest ©United ArtistsThe Pharos/Winter 2009 45
The physician at the moviesOne needs to get past the hokey scene involving their comingupon a mansion inhabited by a Southern belle named HannahHunter of Greenbriar (Constance Towers) and her black maidLukey, played by Althea Gibson, a tennis star between 1950and 1958 who was called the Jackie Robinson of tennis (againcheck out her bio). Although the accents and the dialogue atdinner are cringe- producing, stay with it because there is a niceduplicitous twist at the end such that the two women are forcedto join the patrol on its march to prevent them from letting theConfederates know of their presence. Hunter adds some spice tothe movie, as she reinforces the doctor’s dislike for the Colonel.You also have to overlook Hunter being generally all madeupand well-coiffed except in the field hospital scenes, whenKendall operates without anesthetics and with little laudanumand copious whiskey. The benefits of a tree moss poultice thatKendall learned from a Cheyenne are extolled.After the confrontation at Newton Station, the Colonel isupset at all the casualties and starts drinking, and reveals toHunter why he has been so harsh on doctors. He says theysay, “Medicine is the most noble profession. Banners held onhigh—so high they won’t admit they’re groping.” He then tellshow he trusted the doctors when they told him that his wifehad a tumor. They operated and found nothing. “They saidthey were sorry; they made a mistake. They had something totalk about before their next experiment.”Although the mission is accomplished, Marlowe refuses toretreat and pushes on to Baton Rouge. Along the way they passa black church where they are saluted. The cadets at JeffersonMilitary Academy, none of whom are over sixteen, and theschool’s older reverend are pressed into service to delay theUnion soldiers until Nathan Bedford Forrest’s cavalry can reachthem. To Marlowe’s credit he refuses to fight them and turnstail and runs, leaving the cadets ecstatic. They recruit DeaconClump (Hank Worden), who was part of the UndergroundRailroad, to help them escape from Forrest’s men. Kendallstays behind to care for the wounded, knowing that he will beimprisoned. As he says, “Medicine is where you find it, even atAndersonville.” The latter is one of the film’s anachronisms, inthat the prison had not been built in 1863. Still, all in all, thisis a picture worthy of putting on your rental list, if only to seea favorable portrayal of a doctor in the era before we got to be“the bad guys.”AddendumAccording to Wikipedia and other sources, The HorseSoldiers is based on the April 1863 raid led by ColonelBenjamin Grierson, who, with 1700 men, traveled severalhundred miles from Northern Mississippi to disrupt the railroadfrom Newton Station to Vicksburg. The successful raid,which prevented troop reinforcements by General John C.Pemberton, was said to have been “remarkably bloodless.”Dr. Dans (AΩA, Columbia University College of Physicians andSurgeons, 1960) is a member of The Pharos’s editorial board andhas been its film critic since 1990. His address is:11 Hickory Hill RoadCockeysville, Maryland 21030E-mail: pdans@comcast.netJohn Ford and John Wayne on the set of The Horse Soldiers, 1959. UA/Photofest ©United Artists46 The Pharos/Winter 2009
Reviews and reflectionsDavid A. Bennahum, MD, and Jack Coulehan, MD, Book Review EditorsWhen the Air Hits Your Brain:Tales from NeurosurgeryFrank Vertosick, Jr.New York, W. W. Norton, 2008, 272pagesReviewed by Michael Egnor, MDIt is an aphorism among neurosurgeonsthat the community of neurosurgeonscan be divided into thirds. A third aretechnically inadequate as surgeons, athird are competent but unethical, anda third are competent and ethical. Ofcourse, neurosurgeons who cite thismaxim always consider themselves to bethe competent- ethical cohort. The aphorismis harsh, and not true, but there iscertainly an enormous spectrum of personalitiesand skills in my profession (I’ma pediatric neurosurgeon). There is suchan enormous spectrum in part becauseof the technical challenges inherent toperforming surgery on the nervoussystem, and in part because of theemotional stress—really thespiritual stress—inherent todoing neurosurgery for aliving.Neurosurgeon Dr. Frank Vertosickhas written a superb and honest bookabout his training in neurosurgery.When the Air Hits Your Brain, firstpublished in 1996, has become a classic.It’s been translated into five languagesand has appeared on the reading list ofseveral medical schools. It has been updatedand re- released, and is well wortha second (or first) reading.Dr. Vertosick recounts his journeyfrom medical student to his decision,based on happenstance as well as intent,to become a neurosurgeon.His account of the first neurosurgicaloperation he saw as a medical studentrecalls a scene painfully familiar to allneurosurgeons: a resident, hurried by hisfear that he will displease the chairman(who has not yet arrived in the operatingroom) by taking too long to drill througha patient’s skull, inadvertently plungesthe drill deep into the patient’s brain.[The chief resident] grabbed thedrill away from [the resident] andyanked it out of the patient’s head.A torrent of blood and some stuffthat looked like runny strawberrymilkshake poured from the smallhole in the bone. . . .. . . . [The chief resident said],“Hopefully, we just trashed the cerebellarhemisphere. . . . If we wentdown to the [brain]stem, we’re allscrewed . . . Lordy, lordy, just so thestem is OK, tell me the stem is OK.”The door swung open. The[chairman] again. “Is everything OK?. . . I SAID IS EVERYTHING OK?”“Yeah . . . ah . . . fine, sir,” Carlstuttered, “we just put a nick inthe cerebellum, I think . . . We’refine . ” p37The patient ultimately recoveredfrom the mishap, but the pain of Dr.Vertosick’s initiation into the reality ofneurosurgical practice—the thin linebetween healing and catastrophe—isunavoidable. All neurosurgeons mustcome to grips with it.Much of Dr. Vertosick’s story is awry account of residency training. Herecounts the “skull-o-gram” incident,in which a resident was left to close acraniotomy that had been performed byan attending who had annoyed the residentby not allowing him to perform themain portion of the surgery. After theattending had left the operating room,the resident engraved his opinion ofthe attending on the bone flap— “FREDSUCKS”— before wiring it back intoplace. The wound became infected a fewweeks later, and the attending, on reopeningthe incision, acknowledged the“skull graffiti” with a string of invectives.The enraged (and embarrassed) surgeonspent an hour drilling the message offthe bone before sending the specimento the pathology lab.Neurosurgical arrogance is sometimessardonic. Dr. Vertosick recalls adinner with his chief resident (Gary)early in his training:I was a Buddhist pupil seated in thepresence of the Enlightened Master.“The next five years of your life,The Pharos/Winter 2009 47
Frank, will be hard,” Gary continued,“but always remember this: Ifneurosurgery wasn’t hard, everyonewould do it. Look at those fleas[non- surgical resident doctors] overthere. Do you think they really wantto write prescriptions for Inderal forthe next forty years? Do you thinkthey wake up at night screaming‘Dialysis! I must dialyze one morepatient!’ . . . most of them wanted tobe surgeons but just couldn’t hackthe work it takes to be one. If a geniepopped out of their pizza right nowand said he could make them intoany type of doctor they would wantto be, . . . which one of them do youthink would say ‘Oh, genie pleasemake me a gastroenterologist sothat I could look up someone’s assall day and my office can be filledwith spastic colon patients wantingto show me Polaroids of their latestbowel movement.’ ” pp149–50But there’s much more than cynicismin Dr. Vertosick’s story. He shares storiesof tragedies; a young woman dying aftera car accident, talking to him while herbrain oozes out of her skull, and hisdread of telling her hopeful family in anearby waiting room that she is gone.He recounts the story of a baby with amalignant brain tumor and the child’steenaged parents who can’t comprehendthat their daughter is seriouslyill. The surgery does not go well, andthe child is devastated neurologically.The doctors convince the parents todistance themselves emotionally fromtheir daughter, so they stop visiting her.But she survives longer than expectedand becomes the daughter, in a way,of the hospital staff, who care for heruntil she dies. In another case, a youngmother in her late twenties was found tohave a malignant brain tumor when shewas pregnant with her first child. To theastonishment (and anger) of the treatingneurosurgeon, this mother refusesabortion or chemotherapy, in order togive her child life, even at the cost of herown. She faithfully videotapes messagesto her unborn son throughout her pregnancy,then dies of her tumor shortlyafter he is born.In a chapter titled “Nightmares, Pastand Future,” Dr. Vertosick expresses hisagony over a surgical error that leads toa brush with “emotional incineration.”He operated on a forty-year-old manwith an aneurysm on his middle cerebralartery. The man was neurologicallynormal prior to the operation, but duringthe dissection of the aneurysm, Dr.Vertosick accidently ruptured the thindome of the aneurysm, causing massivebleeding that could only be stopped byoccluding arteries to critical parts of theman’s brain. The patient had a massivestroke, was left paralyzed and unable tospeak, and ultimately died. Dr. Vertosickexplained the catastrophe to the patient’swife immediately following the surgery:“We . . . we had some bleeding. . . we were forced to put a cliparound the main blood vessels tohis left brain . . . He . . . he has had avery large stroke, I’m afraid . . .”“A stroke? Is he . . . alive?” Herhands began to shake and her eyesfilled with tears.“Yes. Yes, he is alive. But he can’tspeak or move his right arm or leg.I’m afraid that’s . . . permanent.”“Permanent! You mean he’s nevergoing to talk again?!”My eyes looked down. “Yes.Never. He may not even survive.”She began to hyperventilate, thenwent to a wastebasket and vomited.Collapsing in a heap on the sofa, sheburied her ashen face in her handsand began to weep softly.“Is there anyone I can call foryou? Friends? Family?” I knew thatCharles had no children from eitherof his marriages.“No, leave me alone. You’ve doneenough.”“It was a risk of the procedure . . .it was explained to both of you— ““Go away.” pp217–18The practice of neurosurgery is amix of bravado, elation, and emotionalincineration. But there is a connection,I think, between neurosurgical bravadoand the agonizing task of working thefine line between healing and catastrophe.Neurosurgeons insulate themselvesas best they can from the risks thatthey and their patients face each day.Neurosurgery contains a remarkable arrayof characters, most quite decent andtalented men and women, but a few, notso. But all neurosurgeons inflict seriousharm, at times, and all must come tosome kind of accommodation with thisagony of our profession. Each of us liveswith faces in our mind—faces of peoplewe’ve hurt, or even killed. Some of usaccommodate with cynicism and hubris.Some accommodate with a passionateeffort to master surgical technique, evenat the expense of other important butless technical medical and interpersonalskills. Some accommodate by restrictingtheir practice to types of operationsthat can be performed with minimalrisk. Some burn out and quit practice.Some devote themselves to money, sex,alcohol, or drugs. Some take up causes.Some become atheists and make up nihilisticstories about the lack of meaningin life. Some find faith in God. In oneway or another, all neurosurgeons accommodate.Dr. Vertosick has written a superbbook, an honest account, of how hebecame a neurosurgeon and how itchanged him. And one can see in hiswry narrative and engaging stories howhe has learned to cope with the dilemmaat the heart of neurosurgery. He copes,at least in part, by telling the truth aboutwhat it means—and what it costs—totake such enormous risks to heal.Dr. Egnor is professor and vice chairman ofNeurosurgery at the State University of NewYork at Stony Brook, where he has been onthe faculty since 1991. His address is:Department of Neurosurgery12080 Health Sciences CenterStony Brook UniversityStony Brook, New York 11794-8172E-mail: megnor@notes.cc.sunysb.edu48 The Pharos/Winter 2009
Patient Listening: A Doctor’sGuideLoreen HerwaldtUniversity of Iowa Press, Iowa City,Iowa, 2008, 174 pagesReviewed by Frederic W. Platt, MDHow do you create a poem? Do yousit at the keyboard (now a computer,no longer pencil and paper ormanual typewriter) until beads of bloodform on your brow? Do you stare at theceiling for inspiration? Loreen Herwaldt,an infectious disease physician at theUniversity of Iowa has a different approach.She selected twenty-four wellknownauthors, some but not all of themphysicians, and interviewed them atlength about their experience of illnessand their interaction with the medicalcare system. Then, from their lengthyinterviews she distilled short pieces thatomit all the unnecessary words. Shadesof Strunk and White! She calls them“Found Poems.”Herwaldt doesn’t want to claim herwork is poetry, but I have no idea whatelse to call it. Consider this little treasurethat deals with the common erroneousassumption that you have tohave worn the shoes of your patient toempathize with him or her. Well, sometimeshaving been in that very situationgives you a better understanding of thepatient’s reaction, but sometimes yourown reaction gets in the way. Here’sHerwaldt’s “Nightmare,” distilled fromTom Sleigh, who describes himself as apoet with PNH, paroxysmal nocturnalhemoglobinuria. In this piece Herwaldthas taken Sleigh’s prose comments andrendered them, boiling down the fat,into a lean and surely poetic form:NightmareMy mother arrangedfor me to see a doctor who had PNH.He wouldn’t transfuse me.His experience with PNH was you don’ttransfuse.It was so stupidand useless,and pointlessthat I was denied transfusionsbecause mydoctorhad been through this experience.He was a good man and a good doctor,but it was frustrating and infuriatingto deal with him becausehe didn’t have the detachment to stepawayfrom his caseand lookat my case.Everyone thought he would beso compassionate.But I could not get him to listen.He refused. He was adamant.He knew it had to be done his way.It would be a much smarter ideato have a hematologistwho did not havethe same disease I was suffering from.I talked to him two years ago.It was amazing, utterly amazing.He said to me,“Every time I have a hemolytic episode,I think, man, this is it.I’m convinced I’ll hemolyze down to 19and die.”His guard came down.It was touching and it delighted me.But on the other hand,boy, what a nightmareit wasto have him treat me. pp125–26Doesn’t that tell the story? Yes, I’ve hadpatients ask me how I could possiblyunderstand how they were feeling whenI never had gone through the sameexperience.“You’ve never been pregnant, haveyou?”“You’ve never lost a child, haveyou?”It is easy to back off and say thatI have never experienced that so, ofcourse, I cannot understand. But thearm that reaches out to others for usis our imagination, and we can alwaysreply, “No I haven’t, but I can imaginethat it is the worst loss a person canhave.” And having been in that person’sshoes doesn’t mean that they crimp inexactly the same places. I recall a femaleoncologist who told her patient, “Youmust be really angry to discover thebreast cancer.” The patient denied anyanger and the oncologist respondedwith “Well, I had breast cancer and Iwas plenty angry so you must be too.”What a nightmare! We need our doctorsto understand us, not just understandthemselves.Herwaldt approached numerous authors,some of them eager to contributeto her project and others reticent. In theend she narrowed down to twenty-fourinterviewees; some, such as RichardSelzer, Oliver Sacks, and Arthur Frank,were well known to me; others less so.A few use aliases, noms de plume. I findmany of the resultant poems wonderfuland others ho-hum, but it is Herwaldt’sprocess that seems most fascinatingand relevant to readers of The Pharos.After all, the big question is, “Of whatuse is poetry to doctors?” Here are fourof the many possible answers to thatquestion.1. Poetry can be fun. There are lotsof physician- poets out there who createpoetry that delights. You may be one ofthem. Give it a try. And it can also befun to read.2. You may end up with a poet ortwo in your practice, and they may bechamping at the bit to show you theirwork. Read it. The poems will help youunderstand them better than the prosethey speak and will likely be more succinct.3. Great poems can evoke andThe Pharos/Winter 2009 49
Reviews and reflectionsre- imagine the terrible experiences allhumans face better than anything writtenin any medical textbook. I wouldcite Auden’s “Musée des Beaux Artes”and Hopkins’s “To a Young Child.”Where can you find a better evocationof loss and grief than in these two shortpoems?4. Most importantly for physicians,we encounter powerful stories; hearamazing things from our patients. Wecarry those images and stories aroundwith us for days. Writing them downin a journal, or perhaps in a poem,helps us unburden ourselves, a formof healing. I remember the time apatient, who had once experiencedshock therapy for recurrent depression,told me, “It took away the memoryof my children’s childhood.” I carriedthat statement around for days until Ithought to write it down. Or the timean eighty-five-year-old woman toldme, “I’ve been sinking.” And when Iresponded as if this were a metaphor,she corrected me: “I swim half a milethree times a week, and last Fridaywhen I swam, I sank. I couldn’t floatany more” Once we discovered thepleural effusion that had taken awayher buoyancy, we were on the track toeffective understanding and treatment.I had to write that one down too.So I heartily recommend this bookto physicians, would-be- physicians,physicians-in- training, and other clinicians.(That’s a whole lot of us.) I recommendit because it offers a wealth ofunexpected poems to read and savorand because it opens a door for all ofus, a route into literary unburdeningthat will be comforting and joyous. Iinvite you all, do open that door. If youare lucky, you will end up with a piecelike Sekou Sundiata’s story, transmittedthrough Loreen Herwaldt’s abridgementto:Speaking Their LanguageI didn’t learn medical languageonly to communicate with doctors.It gave me a sense of power too.Using medical language with doctorswas kind of like using my high schoolFrenchwhen I went to Paris.Let me put it this way.Some doctors would encourage me,help me along.I felt they were open to my questionsbecause when they used words I didn’tunderstand,I would say, “Well, what’s that?”and they would explain.Then there were other peoplewho could tell, of course,that I didn’t know much and they wouldbe likealmost insulted that I would even try.It was as if they were saying,“Leave that to me.Leave that kind of talk to me.You just had swollen ankles.You didn’t have edema.Let me talk about edema.”That’s the way it waswhen I used medical language. p98Sekou Sundiata died in 2007 andHerwaldt dedicates her book to thatbrave person who had the courage tospeak medicalese like someone attemptinghigh school French in Paris. It is afitting tribute in a fine book.Dr. Platt is a general internist in privatepractice and clinical professor of Medicineat the University of Colorado. A leadingauthority on communication skills in medicine,Dr. Platt is the author of ConversationFailure, Conversation Repair and FieldGuide to the Difficult Patient Interview. Hisaddress is:396 Steele StreetDenver, Colorado 80206E-mail: plattf@hotmail.comHenderson’s EquationJerome LowensteinGadd & Company Publishers, GreatBarrington, Massachusetts, 2008, 304pagesReviewed by Jay Baruch, MDImust start with a confession: I dreadedacid-base balance in medical school.Comprehending the dissociation andmovement of ions, the creation of buffers,the arrows darting into and out ofblood, kidneys, and lungs led directly andimmediately, I believe, to my hair loss.Late at night, nauseated from too muchcaffeine, jittery with self-doubt, I’d torturemyself even further by considering thetruth of my predicament. I wasn’t intelligentenough to grasp fully the intimatedetails intuited and refined by LawrenceJ. Henderson. Unlike me, he didn’t needto check the answers at the back of thetextbook. I’d get depressed, then I’d eata pint of Ben & Jerry’s. Dr. Hendersonwas known to us only as a surname, atag attached to some seminal equationsthat described how the body used buffersystems to maintain neutrality withchanging acid concentration in blood.Now he appears in the flesh as a centralcharacter in Dr. Jerome Lowenstein’snovel Henderson’s Equation.I wish I’d had Dr. Lowenstein toexplain the beauty of Dr. Henderson’sintricate and provocative thoughts.The specific details by which the bodyregulates itself and maintains dynamicequilibrium through elegant bufferingsystems comes alive in this novel, partlybecause the ideas of “fitness” and therelationship of the organism to his or hersurroundings, and Henderson’s later applicationof his physiological principlesto sociological systems, takes on metaphoricalresonance.I don’t know how best to categorizethis work: novel, creative nonfiction,memoir? Maybe all three genres wererecruited to construct a story that feelsinnately personal and intellectually ambitious.The story centers around AaronWeiss, a young Jewish medical student50 The Pharos/Winter 2009
with roots on the Lower East Side ofManhattan. The book chronicles his developmentand evolution as a physician,son, husband, father, and friend againstthe backdrop of social and political unrestin the early twentieth century. Muchof Lawrence Henderson’s character isbiographically faithful to the real-lifechemist, physiologist, sociologist, andphilosopher. The novel draws a brilliant,complex man as seen through the adoringeyes of an equally brilliant student.Henderson is enigmatic, gracious, andquirky, but also a self- centered, elitist,and removed man of ideas.The breadth of Henderson’s ideas iswoven into the narrative. The readerfeels ionized and nonionized charactersdissociating and recombining, bufferingto achieve balance in their lives. Toquote Henderson: “Effective planningof one’s life was impossible and that theart of living was in great part the art ofadapting one’s self to the changing patternof external circumstances.” p89The notion of dynamic equilibriumresounds throughout this narrativework. How does a poor, working-classJew fit into the affluent Brahmin worldof Harvard Medical School in the earlytwentieth century? How does a physiciansquare courageous and oftenunflattering commitment to poor andvulnerable patients with the more detached,intellectually progressive, andreputation- building work in research?How does one measure his or her idealsand values when they’re tested in originaland unimaginable ways?The tender, tenuous, and volatile relationshipbetween Dr. Henderson andAaron casts a penetrating light on thementor/student relationship in medicaltraining. Interestingly, as Aaron advancesin his career, he doesn’t establishnew mentors in medicine. He constantlycraves his early mentor’s approval, andseems envious of and bitter about thesuccession of brilliant young protégéstaken under Dr. Henderson’s wing. AsAaron grows older, he begins to viewhis mentor differently, begins to teaseapart the contradictory elements in theman from his powerful influence. Thementor/student relationship is a mysteriousbond. I related to a young doctorconnecting with a rare, inspiring, andperhaps flawed teacher or role model,and holding him in his sights as headvances in his career. The mentor storylinealso speaks to the profound impactstudents and former students canhave on their mentors. The inspirationmoves in both directions, establishesa balance, a neutrality, and, if they’relucky, true friendship.Aaron’s relationship with Hendersonis situated alongside his sweet connectionwith DePodesta, a poor but skilledItalian carpenter and wood craftsman hemeets one summer working in his UncleMax’s factory in Brooklyn.Dr. Lowenstein has written a bookthat takes us back in time, but touchesupon timeless topics in medicine.Medicine is a complex system with multiplepowerful forces at work. Socialdeterminants of health, like poverty,working conditions, and access to healthcare, are increasingly relevant today.Now, more than ever, physicians mustthink about patients as individuals withsingular experiences, relationships, andworlds, not simply as diseases in a textbook.Dr. Weiss told Dr. Henderson:Working with patients, I seek theopposite. I seek the unique . . . eachpatient’s experience of disease isunique. The most important partof the relationship with a patientis the physician’s ability to respondto that uniqueness. This is what Iteach my students. And at the sametime, I teach them that the regulationof acidity in the body requiresan understanding of interacting variablesin a complex system. p235–36Towards the end of his career,Henderson directed his energies to thestudent/physician relationship. He said:“How do we teach students to becomecaring physicians when we do not understandthe basic system?” pp234–35 Thisbook could serve as a springboard for anynumber of larger discussions on healthcare systems, physician training, caringfor the poor and underserved populations,social determinants of health, andthe process of nurturing and negotiatingvaluable relationships in medicine.Medical training and the practice ofclinical medicine is a personality stresstest. If there are blemishes, opinions,biases, insecurities that had been safelyconcealed, the intense experience ofmedical school and medical practicewill eventually root most of those out.And this isn’t necessarily a bad thing.To study medicine, to be a careful andcaring clinician, to be appropriately sensitiveand humane, you must first studyyourself, and discover how and whereyou fit.Dr. Lowenstein is an accomplishedresearcher, clinician, educator, and medicalhumanist. The breadth of his expertiseis illustrated through work thatranges from the book Acid and Basicsto The Midnight Meal and Other EssaysAbout Doctors, Patients and Medicine,to his role as publisher of the BellevueLiterary Review. Henderson’s Equationadds to his wide- ranging contribution tomedical writing.Dr. Baruch is an emergency physician atWarren Alpert Medical School of BrownUniversity, where he also directs the ethicscurriculum for medical students. His bookof short fiction, Fourteen Stories: Doctors,Patients, and Other Strangers (Kent StateUniversity Press, 2007) received HonorableMention in ForeWord Magazine’s 2007Book of the Year Awards. His address is:55 Claverick Street, 2nd FloorProvidence, Rhode Island 02903E-mail: Jay_Baruch@brown.eduThe Pharos/Winter 2009 51
2008 <strong>Alpha</strong> <strong>Omega</strong> <strong>Alpha</strong> Robert J. GlaserDistinguished Teacher AwardsEach year since 1988, <strong>Alpha</strong> <strong>Omega</strong><strong>Alpha</strong>, in cooperation with theAssociation of American MedicalColleges, presents four faculty membersin American medical schools with theAΩA Distinguished Teacher Award. In1997, AΩA named the award to honorits retiring executive secretary Robert J.Glaser, MD. Nominations for the awardare submitted to the AAMC each springby the deans of medical schools.Nominations were reviewed by acommittee chosen by AΩA and theAAMC. This year’s committee memberswere: Paul Aravich, PhD; RobertB. Daroff, MD; Richard deShazo, MD;Steven L. Galetta, MD; Robert M. Klein,PhD; Virginia M. Miller, PhD; JohnNolte, PhD; Louis N. Pangaro, MD;Richard Schwartzstein, MD; James L.Sebastian, MD; Steven Spitalnik, MD;Michael Vergare, MD; Robert T. Watson,MD; Jeffrey G. Wiese, MD.Winners of the award receive $10,000,their schools receive $2,500, and activeAΩA chapters at those schools receive$1,000. Schools nominating candidatesfor the award receive a plaque with thename of the nominee.Brief summaries of the accomplishmentsin medical education of the 2008award recipients follow.Edward D. Harris, Jr., MDExecutive SecretaryPeter G. Anderson, DVM, PhDProfessor of Pathology, University ofAlabama School of MedicineDr. Anderson has a widespread nationaland international reputation forhis design and production, with colleagues,of the Pathology EducationalInstructional Resource (PEIR.net).Matching the increased use of webbasedteaching materials, this is oneof the most popular electronic resourcesfor pathology educational materials.At the University of Alabama,Dr. Anderson is a powerful and effectiveteacher, being nominated foror receiving the awards each year forBest Teacher, Best Course Director orBest Course. In 2003 he received thehighest teaching honor at UASOM,the President’s Award for Excellencein Teaching. He has been Coordinatorof the School of Medicine’s MedicalEducation (Curriculum) Committeesince its inception. He is chair of theUSMLE Step 1 Pathology ExaminationCommittee, and will join the NationalBoard of Medical Examiners in 2009.Within the University of Alabama, hisleadership skills have been recognizedby his election as chair of the UABfaculty senate. He has been well fundedby the NIH and other sources for hisresearch into the mechanisms of hypertensionand cardiovascular diseases.Dr. Anderson earned his DVM atWashington State University, and hisPhD in Experimental Pathology at theUniversity of Alabama at Birmingham.Daniel W. Foster, MD, MACPJohn Denis McGarry, PhD,Distinguished Chair in Diabetes andMetabolic Research, University ofTexas Southwestern Medical SchoolFollowing his fifteen-year tenure aschair of Medicine at the University ofTexas Southwestern Medical School, Dr.Foster became the John Denis McGarry,PhD, Distinguished Chair in Diabetesand Metabolic Research. Three qualitiesemphasize his teaching excellence:(1) Integrity, (2) a great intellect andsense of compassion and justice, and(3) devotion to his patients and students.Dr. Foster continues to be oneof the most popular attending physicianson the medical wards. He hasreceived twenty-six awards as a distinguishedteacher from medical studentsat UT Southwestern, as well asthe Upjohn Award for the outstandingPhysician Educator in the field ofDiabetes (1988), the Robert H. WilliamsDistinguished Chair of Medicine Award(2001), a Great Teacher Award from theNational Institutes of Health (2002),and the Eric Neilson, MD, DistinguishedProfessor Award from the Associationof Subspecialty Professors (2007). Dr.Foster’s interests outside of the labora-52 The Pharos/Winter 2009
t AAMC President Darrell G. Kirch, MD, with Glaser Award winners Daniel W. Foster, MD, MACP, Peter G.Anderson, DVM, PhD, David W. Nierenberg, MD, and Paul L. Rogers, MD. Photo courtesy of the AAMC.tory and teaching include leadershipand bioethics, civil rights, and religion,which culminated in his being named tothe President’s Council on Bioethics in2002. He is the host on “Daniel Foster,MD,” a weekly television series on PBSand the BBC.Except for two years as a clinicalassociate at the NIH, Dr. Foster hasspent his entire life in Texas. He earnedhis MD at UT Southwestern, graduatingfirst in his class and being electedto AΩA in 1954, and he stayed on forhis residency in Internal Medicine underthe direction of Donald Seldin. Heserves on the editorial board of ThePharos.David W. Nierenberg, MDEdward Tulloh Krumm Professorof Medicine and Pharmacology/Toxicology and Senior AssociateDean for Medical Education,Dartmouth Medical SchoolSince arriving at Dartmouth on thefaculty in 1986, Dr. Nierenberg hasbeen known as an “educational star”at DMS. He founded what remainsthe best course at Dartmouth, ClinicalPharmacology and Therapeutics, givento the entire senior class. In addition toa sound foundation in therapeutics, hehas modeled for students how to be freefrom influence from the pharmaceuticalindustry. Since 1992 Dr. Nierenberg hasdirected the Scientific Basis of Medicinecourse correlating organ system physiology,pathology, and clinical disease.Recently, he has worked on curricularrenewal, the New Directions plan utilizingproblem-based learning to developcompetency-based physicians. Hislongevity as a teacher is reflected byhis having received from the graduatingclass in 1986 the Clinical SciencesTeaching Award, with repeated awardsin 2000 and 2008. In 2005 and 2007 hewas given the Best Educator prize in theDepartment of Medicine. Second-yearstudents in 2005 and 2007 voted himtheir best lecturer, small group leader,and overall educator.Dr. Nierenberg arrived at Dartmouthfollowing his undergraduate and medicalschool experience at Harvard, wherehe was elected to AΩA in 1976, hisresidency in medicine at the Beth IsraelHospital, research training at UCSF,and chief residency and early facultyappointments at Stanford UniversitySchool of Medicine.Paul L. Rogers, MDProfessor, Critical Care Medicine,University of Pittsburgh School ofMedicineDr. Rogers has seven Golden Appleawards for Excellence in ClinicalEducation sitting on his desk, and sixawards as the Critical Care MedicineFaculty member of the year. Roundingout these recognitions are the Universityof Pittsburgh Chancellor’s DistinguishedTeaching Award (1996) and the Societyof Critical Care Medicine PresidentialCitation Award (1999). His dean callshim “the most highly regarded educatorat our school, both by students and bypeers.” Dr. Rogers has been a pioneerin the use of human patient simulationas a teaching modality for medical students.At the University of Pittsburgh,his innovations set in motion an institutionaldecision to embrace high-fidelitysimulation as an essential educationmodality. His excellent curricular developmentsfacilitated a decision to requirecritical care medicine as a componentof the internal medicine clerkship. Dr.Rogers conducts daily teaching sessionswith medical students before leadingbedside rounds in the ICU. He has receivedsubstantial research funding forhis work in experimental therapeuticsin critical illness.After receiving his BS at CenturyCollege and his MD degree at theUniversity of Arkansas, where he waselected to AΩA in 1981, Dr. Rogerswas an Internal Medicine resident atthe University of Virginia and CriticalCare fellow at the NIH. He joined theUniversity of Pittsburgh faculty in 1987.Distinguished teacher nomineesMurray Altose, MD, Case Western ReserveUniversity School of MedicineWilliam Anderson, PhD, University of NewMexico School of MedicineRonald Arky, MD, Harvard Medical SchoolDavid A. Asch, MD, University ofPennsylvania School of MedicineChantal Brazeau, MD, UMDNJ-New JerseyMedical SchoolPatrick Carr, MD, University of NorthDakota School of Medicine and HealthSciencesFrancis Counselman, MD, Eastern VirginiaMedical SchoolCraig Wilson Davis, PhD, University ofSouth Carolina School of MedicineThomas M. De Fer, MD, WashingtonUniversity in St. Louis School of MedicineDonna Elliot MD, Keck School of Medicineof the University of Southern CaliforniaGlen Gabbard, MD, Baylor College ofMedicineBertha Garcia, MD, University of WesternOntario Faculty of Medicine and DentistryErika Goldstein, MD, University ofWashington School of MedicineJoel A. Gordon, MD, University of Iowa RoyJ. and Lucille A. Carver College of MedicineJesse B. Hall, MD, University of ChicagoDivison of the Biological Sciences PritzkerSchool of MedicineThomas S. King, PhD, University of TexasMedical School at San AntonioArno Kumagai, MD, University of MichiganMedical SchoolAlbert Kuperman, PhD, Albert EinsteinCollege of Medicine of Yeshiva UniversityLinda Mottow Lippa, MD, University ofCalifornia, Irvine, School of MedicineFred A. Lopez, MD, Louisiana StateUniversity School of Medicine in NewOrleansBennett Lorber, MD, Temple UniversitySchool of MedicineSusan Masters, PhD, University ofCalifornia, San Francisco, School ofMedicineGary D. Plotnick, MD, University ofMaryland School of MedicineDavid A. Rogers, MD, Southern IllinoisUniversity School of MedicineMonica Shaw, MD, University of LouisvilleSchool of MedicineMyles Sheehan, MD, Loyola UniversityChicago Stritch School of MedicineJack T. Stern, Jr., MD, Stony BrookUniversity Medical Center School ofMedicineJohn Tarpley, MD, Vanderbilt UniversitySchool of MedicinePatricia Thomas, MD, Johns HopkinsUniversity School of MedicineThe Pharos/Winter 2009 53
Letters to the editorRe “Wrongful death”I read your recent editorial (Summer2008, p. 1) with the greatest interest: itrecalled a score of patients throughoutmy nearly fifty-year career as a hematologistand oncologist.You struck a marvelous balancewithout being stridently censorious . . .and it shined a light on homeopathywhich celebrates the dictum of “primumnon nocere.”Thanks for your successful efforts.George H. Porter, MD(AΩA, Duke University, 1958)President Emeritus, Ochsner ClinicFoundationNew Orleans, LouisianaI just read your editorial in therecent issue of The Pharos. Do youremember the band leader Kay Kyser,who had radio shows on NBC in the1940s?Some time in the mid 1940s heconverted to Christian Science to helphis “arthritis.” During his active days,he married late to a young singer inhis band, Georgia Carroll. He movedto Chapel Hill in 1951. They had twogirls. As a freshman in 1953, I rememberthe Kysers rolling the children in ababy carriage. We became friends. Mylate physician father had known Mr.Kyser when they were in undergraduateschool.I was a medical resident at the hospitalin 1962. One night, when I wason call, I stopped by the ER to seewhat was going on. Mr. Kyser wasstanding against a wall. I said,“Mr. Kyser, can I help youwith anything? He said,“Duncan, one of mydaughters is sickwith appendicitisand they want to operate on her.” I toldhim I would check on things. When Icame back to see him, I told him I hadchecked things out and she neededsurgery. He said, “Yes, I want her operatedon but I can’t sign for it becauseI’m a Christian Scientist, as you know.” Ifelt a chill go down my spine. Mr. Kyserthen said, “Georgia is not a ChristianScientist. She could sign but she’s visitingher mother in California.” Anotherspinal chill. After relaxing a few seconds,I said, “Do you have her phonenumber?” We had the hospital phoneoperator call the number and got Mrs.Kyser. I told her what was necessary,she said, “Yes,” as the phone operaterand another resident listened in.Years later, the other daughter developedovarian cancer, said goodbyeto her friends, and went off somewhereto die.I have never understood ChristianScience. I wish when I was a student atUNC School of Medicine they had Mr.Kyser come to a class or Grand Roundsand discuss it.Duncan S. Owen, Jr., MD, FACP(AΩA, Virginia CommonwealthUniversity, 1989)Richmond, VirginiaMy general practice was in LosGatos, California. I had an estimated150,000 patient encounters in fortyyears.One day out of the blue came aphone call from San Francisco, the producerof an excellent medical TV show.I don’t know how he got my name.“I have a niece who is a ChristianScientist, who is very ill in yourarea. Would you see her? She’s onlytwenty-eight and can’t get out of bed athome.” I phoned the home and said Iwas coming to see her. “Okay”—shortlythe husband called our office and canceledthe house call. I went anyway andknocked on the door, was treated courteouslyand shown to her bedside.I found a young woman lying onher side with a contracture of her hipdue to a ruptured appendiceal abcesspresenting in her groin. The husbandwould carry her to the bathroom. Hertemp was 101 and she was quite pale.She had been bedridden for threeweeks.The husband agreed to hospitalization,and there I got consultation frommy wonderful surgeon friend, who wasa gentle, quiet guy, not threatening inany way. Together we took her to theOR, drained the abcess, and startedantibiotics. Later, she walked out of thehospital.Some months later I got a letterfrom the patient, thanking me, andsaying that she was wrestling with herbelief in Christian Science and had notcome to a conclusion yet.So thank you for teaching me whatI didn’t know about the background ofMary Baker Eddy and Phineas ParkerQuimby.William W. Johnson, MD(AΩA, Northwestern University, 1953)Medford, OregonMedical illiteracyThe summer issue was superb. Everyarticle sparkled with elegant writingand pertinent new information (tome). But several of the essays left mewith a forlorn sense of angst. In mysimple- minded view, the historical andcontemporary popularity of alternativemedicine (CAM is an unfortunateeuphemism) is primarily related to the54 The Pharos/Winter 2009
dismal medical illiteracy of the public,a worldwide phenomenon. Far toomany are uncritical and uninformed,regardless of sophistication or level ofeducation—thus vulnerable to myth andhype. What is printed or spoken in themedia seems to be accepted as inviolate“truth”—despite tons of evidence to thecontrary. The Internet has had an ambivalentinfluence; most people are insufficientlycurious or critical to identifysources, even when such are available.One possible partial solution I onceentertained was to educate our youngabout the basic science and logical rationalityof the scientific method. Manyyears ago, when I first was retired frommedicine, I lived in a remote rural community.Just for fun, I undertook toteach “scientific method” to senior highschool students as part of their scienceclass. Among other things, I tried, inone lecture, in simplest language (withmetaphor and blackboard), to describethe mechanism and critical importanceof randomized controlled trials in medicine.I also expressed my professionalhumility at the vast area of unknownsin human physiology, the many uncertaintiesin medical knowledge, and theneed for all of us to be observant andcritical of many things we read andhear in the popular media—to insist onreasonable scientific “proof” before acceptingthings as “facts.”It was a disaster. Perhaps it was theclumsy technique of the pedagogue, butthe very few students who managed toremain awake seemed to grasp the basicidea that they should be critical of whatthey heard and read. Maybe that shouldhave been enough.I suspect that reasonable medicalliteracy, especially a sense of skepticismabout what is loudly (or subtly)touted in the media, may be impartedto students by those more skilled—butprobably not. Sadly, I suspect it is a lostcause.Robert H. Moser, MD(AΩA, Georgetown University, 1969)Green Valley, Arizona1955: Polio and the bombSamantha Williamson’s excellentwinning student essay, “TheCongressional Polio Vaccine Hearingsof 1955” (Spring 2008, pp. 13–21) describedthe role of Dr. Thomas Francisand awoke memories of my first monthof internship on the Tufts service at theold Boston City Hospital (BCH) duringJuly 1955. Dr. Francis, at the Universityof Michigan, was the influential epidemiologistfor the Salk polio vaccineprogram at the Congressional PolioVaccine hearings in the Spring of 1955.He also was the major architect for aproject in which I participated fourteenyears later; the second Francis Report,delivered later that year, established theepidemiologic basis defining the closedpopulations that would be examinedevery two years for health effects of theatomic bombs dropped on Hiroshimaand Nagasaki in 1945. Benefits of theSalk vaccine and the biennial examinationsof A-bomb survivors continuetoday.The wards of the BCH infectiousdisease building were virtually emptywhen I arrived. Before the end of thefourth of July holiday weekend, poliosuspects began to arrive. My co- internand I performed increasing numbers ofspinal taps, filled the empty ward bedsand learned quickly how to hand pumpthe respirator bellows when electricityfailed. Before the end of July more helparrived. There was no specific treatment,mostly isolation, hot packs (theSister Kenny method), and analgesicsfor myalgia and headache.The building housed mementos ofpast epidemics. The spinal trays wereporcelain with glass manometers. Theiron lung was not far from the beds. Afireman’s pole sped the on-call houseofficer from his bed on the second floorto expedite treatment of a choking childwith a mahogany obdurator to break adiphtheritic membrane.At the Atomic Bomb CasualtyCommission (ABCC) in Hiroshima andNagasaki, Japan, post-World War IIJapanese numbering more than 100,000are still being followed for their healthoutcomes after the A-bombs. Theseincluded pregnant women and childrenwho were exposed. The systematic observations,based on the template of theFrancis Report of 1955, have become themajor basis for current radiation protectionrecommendations. Major findings,particularly cancers and growth anddevelopmental effects in those heavilyexposed, have been widely published.The next generation is not affected.The two Francis Reports, aboutsix months apart in 1955, and theCongressional hearings that year affectedthe lives of many people worldwide,including me and my family. Mymarriage that year was sensational, buthad little global attention.I joined ABCC in 1969 as Chief ofMedicine for the next three years and,with my wife, Jane, and four childrenaged seven through thirteen, lived inItsukaichi, a suburb of Hiroshima, in anelegant Japanese house overlooking afishing boat harbor on the Inland Sea.Joseph L. Belsky, MA, MD(AΩA, Albany Medical College, 1954)Danbury, ConnecticutMore REAL doctors in themoviesI was glancing through the latestPharos and, as always, your moviereviews. I noted the question of actualphysicians in feature movies andwanted to reply. The Steve McQueenmovie classic Bullitt was, as I’m sureyou know, shot in San Francisco inabout 1967. A fair amount of the moviewas shot at the old San FranciscoGeneral Hospital and a number of physicians,mostly house staff, were in thefilm. Two of them I knew well. Theywere Louis Gilula (now a radiologist atWashington University in St. Louis) andLorne Elthrington (an anesthesiologistat Stanford and in practice in RedwoodCity, California). Both had speakingroles, which were highly prized as theroles paid $250, which you will rememberwas truly a windfall profit basedThe Pharos/Winter 2009 55
Letterson our house staff salaries in 1967. Louplayed an anesthesiologist in an ORscene (note it was Lorne who ultimatelybecame the anesthesiologist) andLorne, if my memory is correct, hadTWO speaking scenes! Part of my vividmemory of these details comes fromenvy. You see, both Lou and Loren weremy interns then when I was a first-yearresident (now called an R2) and THEYgot the parts and I didn’t. Envy is especiallygreen when others get the green.Gerald Charles, MD(AΩA, University of Colorado, 1966)University of California, San FranciscoThe summer issue of The Pharos issplendid, from cover to your thoughtfuland informative film reviews. Thequestion of doctors as film actors wasintriguing.Do bit parts count? While I was inmy four years of training for Pathology(1953–1957) at what was then the U.S.Public Health Service Hospital onStaten Island, New York, the head ofthe OB/Gyn division was a Dr. RobertB. Dorsen, an excellent obstetrician inthe old style, who eventually deliveredthree of our six children. Bob deliveredour son Douglas (1955) by the normalroute, despite a forecoming hand, withno harm to mother or baby. He wasjustifiably proud of avoiding a C- sectionby careful maneuvering during the birthprocess.Bob was also proud of having hada bit part as a public health officer inPanic in the Streets. It has been so longsince I viewed that film that I cannotrecall whether Bob had any spokenlines. At any rate, Bob will always havea special place in our hearts. I doubtthat he is still alive, but wherever he is,he deserves respect as a fine doctor . . .and actor!John L. Meyer II, MD(AΩA, SUNY Downstate, 1948)Rockland, MaineI am aware of at least one “real doctor”who had a somewhat memorablerole in a very substantial movie. DeanKent Brooks, MD, a 1942 graduate ofthe University of Kansas School ofMedicine, played the role of the ineffectualDr. John Spivey in One FlewOver the Cuckoo’s Nest. Dr. Brookswas Superintendent of Oregon StateHospital, where the film was shot, andhe gave co- producer Michael Douglasaccess to a vacant ward and the hospitalgrounds in 1975. Dr. Brooks came underfire for allowing Cuckoo’s Nest to befilmed at Oregon State Hospital and fortacitly portraying psychiatric treatmentin a harsh and technically incorrectlight for the time period (for example,anesthetics and muscle relaxants werein common use in 1975 even though thefilm shows Jack Nicholson’s characterreceiving ECT without such benefit).In fact, in the wake of a long history ofdocumented patient abuses, OregonState Hospital is being torn down andrebuilt. Dr. Brooks, who retired frompractice in 1999, is now ninety-oneyears old.Arthur Lazarus, MD, MBA(AΩA, Temple University School ofMedicine, 1980)Chadds Ford, PennsylvaniaRegarding physicians who werecast in feature films, I submit BruceGewertz, who was a year or two behindme at Jefferson. Bruce, a surgical departmentchairman in Chicago, playedthe department chairman at RichardKimball’s (Harrison Ford) hospital inthe movie version of The Fugitive. Youwill recall that movie also featuredmountains and a very large dam in theplains of Illinois.James E. Barone, MD(AΩA, Jefferson Medical College, 1970)Stamford, ConnecticutCalling Dr. Laennec!René-Théophile-Hyacinthe Laennecwas born on February 17, 1781, and diedon August 13, 1826. He invented thestethoscope in 1816 and reported its usein a paper entitled “De l’AuscultationMédiate ou Traité du Diagnostic desMaladies des Poumons et du Coeur,”published in 1819. Laennec found directauscultation of the thorax to be lessthan ideal under many circumstances.Stimulated by his observation of childrenplaying near the Louvre listeningto the end of a long piece of wood thattransmitted the sounds of a pin scratching,the following day Laennec rolled apiece of paper into a tube, tied it with astring and listened to his patient’s chest.Being a carpenter, Laennec fashionedhis listening device from wood, constructinga cylinder 25 centimeters longand 2.5 centimeters in diameter. Thusthe stethoscope was born. Laennec diedof pulmonary tuberculosis. His nephew,Meriadec, listened to his uncle’s chestand heard the fateful sounds of pulmonarytuberculosis. He used his uncle’sstethoscope to make the diagnosis.Laennec returned to Brittany fromParis following the diagnosis, whichwas a harbinger of certain death at thattime. While in Brittany, he wrote hiswill, in which he bequeathed his stethoscopeto his nephew.Recently I had a routine appointmentwith my doctor. A few days laterI accompanied my wife to a follow-upappointment with her oncologist.Thankfully both encounters resulted ingood news. At each of the two visits thepatient was examined first by a fellowand then by the attending physician.On all four examinations of the thorax,the physician listened through the patient’sshirt or gown, never raising theclothing to listen to the lung fields or,for that matter, to percuss the thorax. Icannot say that I was shocked by theseobservations, rather I was surprisedand disappointed. Having examined thechests of thousands of patients duringthe past fifty-five years in the specialtyof Thoracic Surgery, I learned that, atleast for my hearing process, applicationof the stethoscope directly to theskin yields the most dependable auditorytransmission.Like others of my vintage (MD 1953)I decry the decline and misuse of theHistory and Physical Examination,56 The Pharos/Winter 2009
which are the first and usually mostimportant steps in the doctor- patientencounter. It is more than the informationthat one can glean from theH&P that make them so important.Essential, too, are the bonding andrelationship- building that the H&Pimparts between the patient and thephysician. I do not minimize the importanceof new and sophisticateddiagnostic tests, such as the CT scan,MRI, and the PET scan. But theyshould supplement, not replace, aproperly planned and carried out H&P,which includes listening to the chestwith the stethoscope diaphragm or bellapplied directly to the skin.James B. D. Mark, MD(AΩA, Vanderbilt University, 1974)Stanford, CaliforniaBe careful of chicken soupIn your recent editorial (“Wrongfuldeath,” Spring 2008, p. 1), you comparedhomeopathy to chicken soupwith respect to their harmlessness. Iagree about homeopathy, but I mustcaution about chicken soup, particularlythe kosher type so famouslyextolled by the late Nancy Caroline inher now classic article. 1 Chicken soupprepared from chickens accordingto Jewish dietary laws (popular evenamong non-Jews) can often be deadlyfor patients with congestive heartfailure because of its extraordinarilyhigh salt content. Those who workin hospitals serving an elderly Jewishpopulation have long been aware of theepidemics of pulmonary edema followingPassover and other Jewish holidays.Over fifty years ago the cardiologistDr. Bruno Kisch published data showingthat the salt content of kosheredmeat can be reduced to its basic levelby three successive half-hour soaksin warm water. 2 This information hasbeen of great assistance to a numberof my patients who had previously sufferedfrom recurrent attacks of pulmonaryedema induced by chicken soup.References1. Caroline NL, Schwartz H. Chickensoup rebound and relapse of pneumonia:Report of a case. Chest 1975; 67: 215–16.2. Kisch B. Salt-poor diet and Jewishdietary laws. JAMA 1953; 153: 1472.Shimon Glick, MD(AΩA, SUNY Downstate, 1954)Beer-Sheva, IsraelHealth care reformI don’t know if it is even a considerationfor <strong>Alpha</strong> <strong>Omega</strong> <strong>Alpha</strong>, throughThe Pharos, to put forth a request forproposals for health care reform. Thiscountry is in desperate need of a comprehensiveFlexner-type report involvingcradle-to-grave medicine ratherthan just the educational aspect. Thiscould be divided into various componentssuch as, but not limited to, medicalschool prerequisites and admissionprocess, medical school curriculum,medical school indebtedness, postgraduatetraining, regulation of medicalpractice, liability issues/defensivemedicine, payment and funding issues,competency, paraprofessional involvement,etc. The intellectual prowess andlifelong commitment of <strong>Alpha</strong> <strong>Omega</strong><strong>Alpha</strong> members rendering opinion onvarious aspects of our medical systemthat need to be addressed and rectifiedmay help to extract ourselves from themorass in which our health care systemis bogged. It might be that a compilationof these essays could even serveas a basis for reform and perhaps evenhave some funding, given that CMS iswilling to pay for “quality” advice fromoutside consultants.A combination of legal threats, regulatoryobligations, payment schemes,and, paradoxically, technological innovation,has led to “medical care”beyond recognition of what had constitutedreasonable and customary in thepast. As a result, in the United States,health care has deteriorated to a pointof general mediocrity while simultaneouslygenerating costs to a a point ofbankruptcy. As current leadership bothpolitically and in medicine has beenunable to effect more than band-aidchanges to the system, perhaps AΩAcan at least begin a working model fordesirable change.Henri R. Carter, MD, FACS(AΩA, University of Arizona, 1981)Yuma, ArizonaPhysician-statesmenWe enjoyed reading the excellentPharos article by Davidson andDantas (Summer 2008, pp. 4–10)on three-term U.S. Senator RoyalS. Copeland, MD (1923–1938), whoserved for a decade as dean of NewYork Homœopathic Medical College(1908–1918). His work marks himas one of the top three of fifty-one“ physician-statesmen” in U.S. Senatehistory for spearheading the landmarkand enduring Food, Drug, andCosmetic Act of 1938. We are in favorof the idea that being a medical schoolacademician might qualify one for highelective office and hope Copeland’sbiography will inspire American medicalschool leaders to consider this option,as the United States might beenhanced by physicians joining lawyersin running our country. However, wenote that this essay avers that NYHMCremained operational only until 1938.In fact, its name was altered slightly in1938 by dropping “homœopathic,” butit continues vigorous and vibrant tothis day as New York Medical College,along with the other four survivingThe Pharos/Winter 2009 57
Lettershomeopathic- oriented medical schools:Boston University, the University ofMichigan, the University of Iowa, andHahnemann Medical College (since2002 Drexel University College ofMedicine) in Philadelphia, all committedto allopathic medicine but proud oftheir history when medicine was in adifferent stage of development.Robert A. Schwartz, MD, MPH(AΩA, New York Medical College, 1974)Councilor, UNDMJ-New Jersey MedicalSchoolNewark, New JerseyKarl P. Adler, MD(AΩA, Georgetown University, 1966)President and CEO, New York MedicalCollegeNew York, New YorkJames Harvey Young and medicaleducationI read Donald Marcus’s article“James Harvey Young, PhD (1915–2006): Historian of Medical Quackery”(Summer 2008, pp. 16–21) with delight.The content was good but the memorieswere priceless. Harvey Young wasfaculty advisor for my college honorsthesis. Visions of the then well-wornEmory University Department ofHistory building complete with Dr.Young’s dusty office stacked to theeaves with papers, books, and patentmedicine bottles—empty as Irecall—came back to me. I can seehis generous mutton-chop sideburnsand remember the calm guidance soneeded by his charge.As luck would have it, about a week58before this issue of The Pharos arrivedmy wife unearthed my old thesis. Itstitle was “Medical School Curricula:The Second Revolution, 1952–1972.”The work was a description of a periodof flux in medical education. What wasthen Western Reserve University beganto rethink the basics of medical education,striving to turn med school intoa “graduate school experience.” Here isthe first paragraph of the paper.In 1953 the Council of MedicalEducation of the American MedicalAssociation surveyed the curriculaof the medical schools then in operation.They found the first yearpredominantly filled with coursesin anatomy, biochemistry, andphysiology taught by the respectivedepartments. The second yearwas essentially an extension of thefirst, with pathology, pharmacology,bacteriology, physical diagnosis,and clinical laboratory instructiontaught in the same way. The sophomoreyear was intended to be transitionbetween the basic sciences ofthe first part of the curriculum andthe later clinical instruction; but atalmost every school, the first twoyears centered on long lecture sessions,grading was on an A throughF basis with many schools rankordering students to heighten competition,and the rigid “lockstep”schedule of courses did not allowstudents to assume a hand in theirown education.Re- reading this paragraph leavesme with at least two questions. First,wouldn’t it have been great to have hada word processor in college? Second,if I were a college student now writinga similar thesis, would my word processorproduce an opening paragraphsignificantly different from what waswritten in 1973?Frederick E. Turton, MD, MBA, FACP(AΩA, Emory University, 1976)Sarasota, FloridaWhat Kind of Guy?“He’s a bow tie kind of guy,”I heard her say,while waiting in a crowd.“I am a bow tie kind of guy,”I thought, then wonderedwhat that meant.It was not the color of the tiethat mattered,nor the pattern of the silk.Was it the Windsor knot,that hangman’s noose around theneck,the butterfly so much lighter?The choice was not comfort—then practicality?I was always needingto tuck the tieinside my shirt,for fear of dirtying it at work.That’s why I had wornpaisleys in the past.One day, it just happened—I discovered somethingabout myself.I am a bow tie kind of guy.Richard Bronson, MDDr. Bronson (AΩA, New York University, 1966) isdirector of Reproductive Endocrinology at StonyBrook University Medical Center. He is a memberof the editorial board of The Pharos. His addressis: Department of Obstetrics, Gynecology andReproductive Medicine, SBUMC, Stony Brook, NewYork 11794-8091. E-mail: richard.bronson@stonybrook.edu.
Shut Up“Shut up!” said teen-aged Will, and meant“You’re kidding!” or “No joke!”He hurt his grandma’s feelings,Not intending to provoke.* * *For ten years Will and his grandpaHad visited the world,And on the phone they talked each night,Youth and age unfurled.“You’re seventeen and don’t need meTo see through manhood’s lens,And I will understand if youWould rather be with friends.We’ll still connect from time to timeAnd find a way to chat.”“Shut up!” said teen-aged Will, and meantHe’d heard enough of that.Melvyn H. Schreiber, MDDr. Schreiber (AΩA, University of Texas Medical Branch,Galveston, 1954) is the Robert N. Cooley DistinguishedProfessor of Radiology at the University of Texas MedicalBranch, Galveston. His address is: The University of TexasMedical Branch at Galveston, Department of Radiology,Galveston, Texas 77555-0709. E-mail: mschreib@utmb.edu.Illustration by Jim M’Guinness
Winners of the 2008 Pharos Editor’s PrizeThe 2008 Pharos Editor’s prize has been awarded tofour authors: Andrew Bomback, MD (AΩA, ColumbiaUniversity, 2003) for his collaboration with Dr. Philip J.Klemmer on “Jack London’s ‘chronic interstitial nephritis,’” (Winter 2008, pp. 26–30); Andrew J. Schoenfeld, MD(AΩA, Northeastern Ohio Universities, 2003), for his historicalfiction piece, “The private remonstrance of DoctorBotkin, or Pharaoh’s Physician” (Summer 2008, pp. 22–24);Mani Mokalla, MD (AΩA, University of Minnesota, 2001)for his personal essay, “Searching for God below the vocalcords” (Winter 2008, pp. 34–35); and Madeline Leong,MD/PhD candidate at Duke University, for her essay, “Firstmonth on the wards” (Spring 2008, pp. 23–25).Dr. Bomback writes: I am currently the Doc J. ThurstonIII Fellow at the University of North Carolina at Chapel Hill.I have been writing fiction for the last decade. My shortstories have appeared in a number of literary magazines,and my first novel, You’re Too Wonderful to Die, was publishedin 2007. My senior author, Philip J. Klemmer, becameinterested in Jack London’s life after visiting the HuntingtonLibrary in San Marino, California. He suggested that I lookinto London’s mysterious death from renal failure given mydual interests in fiction and nephrology. London’s writingprovided a fantastically detailed patient history, and Dr.Klemmer’s expertise helped whittle down the differentialdiagnosis to the suspected case of mercury nephrotoxicity.Dr. Schoenfeld says of himself: Born and raised in NewYork City, I have been writing creative fiction since I wasseven. I am an Honors graduate of Kent State University,where I studied both history and creative writing. My interestsinclude Eastern European history, military history,Jewish history, and ethno- religious cultural mythology. Ihave published widely in the fields of orthopaedics andJewish history. Besides my involvement in academic research,I combine my historical and literary interests intoworks of fiction. My first novel, The Place of the Skull,which touches on many of the same topics addressed in“The Private Remonstrance of Doctor Botkin,” was releasedfrom Borders Publishing this fall. I am currently a fellow inspine surgery at Harvard Medical School.Dr. Mokalla says: I serve as a pediatric hospitalist atAndrew Bomback, MDAndrew J. Schoenfeld, MD60 The Pharos/Winter 2009
National and chapter newsMani Mokalla, MDMadeline Leong, MD/PhDMinneapolis Children’s Hospital. I am Iranian and marriedto a lovely Irish-American woman. We have twowonderful children. My life is rooted in a culture richwith storytelling. My parents are well established authors,and reading and writing has been a cornerstoneof my life. Living and studying in different cultures hasstrengthened this foundation. Medicine provides uniqueand ample opportunities for sharing stories. By sharingstories from my work I hope to convey the wide spectrumof human behavior in times of stress, and the idealscommon to all.Ms. Leong tells us: I am half-Chinese, half-Jewish andgrew up in New Mexico. When I was seven, my mothermade me keep a journal, and each entry had to be four sentenceslong. I complied as long as “Hi” and “Bye” countedas sentences. Then I started writing. It took me a long timeto find what stories matter, which ones bring you outsideyourself. When I wrote “First Month,” I felt overwhelmedby my first experiences in the hospital. And yet, the kindnessI saw in patients and doctors alike comforted me.Looking back, I think how lucky I was.Announcing the 2009 Pharos Editor’s PrizeFor the twelfth year, <strong>Alpha</strong> <strong>Omega</strong> <strong>Alpha</strong> is pleasedto offer up to four prizes of $1000, $750, $500, and $250to the author(s) of original nonfiction manuscripts publishedin The Pharos. Authors need not be members ofΑΩΑ, but must be forty-five years old or younger as ofDecember of the calendar year in which the paper is submitted.To be competitive for a prize, the paper submittedmust be in the standard format of The Pharos (seeInstructions for Pharos Authors immediately following),and not published previously in any form. Content shouldbe in the areas emphasized by The Pharos—medicalhistory and biography, ethics, professional issues, andpersonal essays. Essays submitted to the ΑΩΑ Helen H.Glaser Student Essay competition are not eligible for thisprize, nor are previous winners of the Editor’s Prize eligibleto compete. All manuscripts are subject to review ofPharos editorial board members. Judging will be on thebasis of style and composition, originality, scholarship,and interest and relevance to medicine.Instructions for Pharos authorsWe welcome material that addresses scholarly and nontechnicaltopics in medicine and public health such as history,biography, health services research, ethics, education,and social issues. Poetry is welcome, as well as photograph/poetry combinations. Photography and art may also besubmitted. Scholarly fiction is accepted. All submissionsThe Pharos/Winter 2009 61
National and chapter newsare subject to editorial board review. Contributors neednot be members of <strong>Alpha</strong> <strong>Omega</strong> <strong>Alpha</strong>. Papers by medicalstudents and residents are particularly welcome.Submissions must meet the following criteria:1. Submissions may not have been published elsewhereor be under review by another journal.2. Essays should have a maximum of 15 pages (approximately5000 words), and be submitted in 12-point type,double-spaced, with one-inch margins. They should beaccompanied by a covering letter, a 150-word abstract, anda title page with the word count (or page count), return address,and e-mail address. Papers exceeding the page countnoted will be returned to the author. References should notexceed 20 unique items (see below).3. Poems or photograph/poetry combinations should bein 12-point type, with one-inch margins, with the author’sname, address, and e-mail address on the first page.4. Send your submissions to Edward D. Harris, Jr. M.D.,Editor of The Pharos, 525 Middlefield Road, Suite 130,Menlo Park, California 94025. You may also e-mail them to:postmaster@alphaomegaalpha.org.5. After peer review, comments on the manuscript willbe sent to the author along with an editorial decision. Everyattempt is made to complete preliminary reviews withinsix weeks.6. The editors of The Pharos will edit all manuscriptsthat are accepted for publication for style, usage, relevance,felicity, and grace of expression, and may provide appropriateillustrative material. Authors should not purchaseillustrative material because the editors cannot guaranteethat it will be used.7. In accordance with revised copyright laws, each contributorwill need to sign an Author’s Agreement, which willbe sent with the edited galleys. Information on copyrightownership and re- publication of articles is detailed in theAuthor’s Agreement.Reference informationAuthors are responsible for the accuracy of citations andquotations in their papers. Once a manuscript has been acceptedfor publication, therefore, the author will be requiredto provide photocopies of all direct quotations from theprimary source material, indicating page numbers. (Pleasemark the quoted material on the photocopies with highlighter.)In addition, the editors will require photocopies ofall references: the title page and copyright pages of all bookscited, the first and last pages of book chapters cited, and thefirst and last pages of journal articles cited, as well as theTable of Contents of the particular issue of the journal inwhich the cited article appeared. The foregoing items willbe used to verify the accuracy of the quotations in the textand the references cited, and to correct any errors or omissions.The photocopies will not be returned.References should be double-spaced, numbered consecutivelyin the text, and cited at the end in the followingstandard form:JournalZilm DH, Sellers EM, MacLeod SM, Degani N.Propranolol effect on tremor in alcoholic withdrawal. AnnIntern Med 1975; 83: 234–36.BookHarris ED Jr. Rheumatoid Arthritis. Philadelphia: WBSaunders; 1997.Book ChapterPelligrini CA. Postoperative Complications. In: Way LW,editor. Current Surgical Diagnosis and Treatment, NinthEdition. Norwalk (CT): Appleton & Lange; 1991: pp 25–41.Each reference should be listed in the bibliography onlyonce, with multiple uses of a single reference citing the samebibliography reference number. Examples are available atour web site: www.alphaomegaalpha.org.Citation of web sites as references is discouraged unless asite is the single source of the information in question or hasofficial or academic credentials. Examples of such sites areofficial government web pages such as that of the NationalInstitutes of Health. Encyclopedia sites such as britannica.com are not primary references.Leaders in American MedicineIn 1967, as a result of a generous gift from Drs. DavidE. and Beatrice C. Seegal, <strong>Alpha</strong> <strong>Omega</strong> <strong>Alpha</strong> initiated aprogram of one-hour videotapes featuring interviews withdistinguished American physicians and medical scientists.The collection has been donated to the NationalLibrary of Medicine, which will maintain it for permanentuse by scholars visiting the library. Videotapes continue tobe available for loan from AΩA. A listing of available tapescan be found on our web site: www.alphaomegaalpha.org,or by contacting Ms. Debbie Lancaster at d.lancaster@alphaomegaalpha.org or (650) 329-0291. Please also contactMs. Lancaster to borrow tapes. Those wishing to purchasecopies may do so by contacting Ms. Nancy Dosch,manager, Historical Audiovisuals, History of Medicine,Building 38, Room 1E-21, 8600 Rockville Pike, Bethesda,Maryland 20891. Telephone (301) 402-8818, e-mail nancy_dosch@nlm.nih.gov.62 The Pharos/Winter 2009
Welcome toTo the tune of “La Donna e Mobile”from the opera Rigoletto by Giuseppe VerdiVerse IWelcome to AΩAYou’ve made it all the wayYou will not go astrayBecause you’re A-OKIt was just yesterdayThat you entered the entrywayTo med school’s alleywayFor your first study dayYou are now AΩATo you a big hoorayAnd let us all sayDrink ChardonnayAha, aha, drink ChardonnayAh . . . to AΩA!Verse IISoon you will graduateAnd likely relocateAnd start to activateA license to medicateRemember your identityWith joy and humilityWork with tenacityAnd keep your virtuosityYou are now AΩATo you a big hoorayAnd let us all say…Drink ChardonnayAha, aha, drink ChardonnayAh . . . to AΩA!!Daniel V. Schidlow, MDDr. Schidlow (AΩA, Drexel University, 2004) is professor andchair of the Department of Pediatrics and Senior Associate Deanof Drexel University College of Medicine. He sang this song atthe April 17, 2007, AΩA induction dinner there. His address is: St.Christopher’s Hospital for Children, Erie Avenue at Front Street,Philadelphia, Pennsylvania 19134-1095. E-mail: daniel.schidlow@drexelmed.edu.The Pharos/Winter 2009 63
<strong>Alpha</strong> <strong>Omega</strong> <strong>Alpha</strong> memberselected in 2007/2008Chapters are listed alphabetically by state, province, or country, then in order of charterThis listing is current as of December 11, 2008ALABAMAUniversity of Alabama School of Medicine, University of Alabama atBirmingham—<strong>Alpha</strong> AlabamaStudents: Laura Ellen Anderson, Donald Earl Baker, Wesley Michael Cleaves, ChadMatthew Corrigan, John Benjamin Crew, Phillip Jordan Dean, William BruceDonnellan, Michelle Elizabeth Downing, Justin Michael Hall, Stephanie WeikardIsrael, Bethany Ann Jackson, Katrina Ann Julian, Charles Anthony Khoury, MichaelJeffrey Lyerly, Kevin Tyler Nash, James Timothy O’Neil, Kristin Kelly Porter, Erin LeePrince, Virginia Stinson Radcliff, Leah Kathleen Rankine, Megan Danielle Seibert,William Richard Stetler, Cosby Allen Stone, Nicholas M Vetrano, Anup Amit Vora,Charles Graham Wells, Shad Atkinson Williams, Shelton W WrightAlumni: David Winston Kimberlin, Nathan Bert SmithFaculty: Jamy Darone Ard, Omar HameedHouse staff: Brandon Wayne Harden, Victor Wai-Da SungUniversity of South Alabama College of Medicine—Beta AlabamaStudents: John David Adams, Eugene Willis Brabston, Kate Minor Brown, ThomasE Foster, Paul Joseph Hannon, Anthony DeVan Hollman, Brett Agee Parker, SarahElizabeth Swyers Parker, Kathryn N Pettit, Ryan Christopher Pettit, Marat YanavitskiAlumni: Leslie Weyler Panus, Kevin Keith VardenFaculty: Elizabeth Ann Manci, Richard Marc ZweiflerHouse staff: Samuel Bennett Slade Hooks, Suzanne H MartinARIZONAUniversity of Arizona College of Medicine—<strong>Alpha</strong> ArizonaStudents: Matthew William Beal, Andrew Loren Blount, Munish K Chitkara, KylePalmer Edmonds, Benjamin Harold Feldman, Elizabeth Gobble, Charity LynnJackson, Travis Jones, Shaylona Kirk, David Michael Medina, Andrea Wolfrey Patton,Jeremy Dwight Rowlett, Larisa Sotinsky Speetzen, Ryan Andrew Stevens, Lisa AnneTarris, Long Trinh, Corina Joy Veatch, Justin Carmine WongAlumni: Noah M Tolby, Dale P WoolridgeFaculty: James E Maciuilla, Jeremy R PayneHouse staff: Rose Quy Do, Todd Jay Hofeling, Brian MadiganARKANSASUniversity of Arkansas for Medical Sciences College of Medicine—<strong>Alpha</strong>ArkansasStudents: Kaith Almefty, Lindsey Erin Bell, Jennifer Evins Bishop, Jacob OBoeckmann, Patrick A Brown, Cristyn Nicole Camet, William (Will) Royal Copeland,Joshua Daily, Darren Scott Freeman, Ashley Frith, Angela Virginia Pope Frost,Jennifer Hester, Kellie D Hughes, Ana Marie Liolios, Joshua Barton Morrison, MarkAllen Moseley, Brian D Norton, Ezekiel Elliott Shotts, Matthew Frank Spond, AmyCatherine Taylor, Bradley Alan Thuro, Phillippe Andre Tirman, Rocky Tsang, AndreWineland, Eric Jason WrightAlumni: Robert Leroy Archer, Ray K ParkerFaculty: Robert Hopkins, Eduardo R OchoaHouse staff: Robert David Pesek, Surya Prasada Rao Rednam, Jill E SandersCALIFORNIAUniversity of California, San Francisco, School of Medicine—<strong>Alpha</strong>CaliforniaStudents: Nidhi Agrawal, Amy Robin deIpolyi, Meredith Rebecca Dunn, RavinderSingh Gogia, Dana Elizabeth Myers Henry, Duncan Marshall Henry, Allison YuriIwaoka-Scott, Timmy Mathew Joseph, Hemal Kanti Kanzaria, Puja Kohli, BrettJames Ley, Kirk Ko Fong Lin, Angela Kelliher Mancuso Lipshutz, Kalyani AmeliaMcCullough, Tracey Ann McLean, Janina Lord Morrison, Pradeep Natarajan, LydiaEleanor Wiedel Pace, Alexander Wojciech Pastuszak, Vikram Ramnath Rao, JacobOwen Robson, Amit Jayant Sabnis, Zadok Jacob Sacks, Varun Saxena, Jennifer GraceWilsonAlumni: Anda K Kuo, Jody Ellen SteinauerFaculty: Nora Fox Goldschlager, Cindy J LaiHouse staff: Lawrence Adya Haber, Jennifer Ho, Michael Keith PickensKeck School of Medicine of the University of Southern California—GammaCaliforniaStudents: Tina Bhutani, Alexandra Bright, Steven Bennett Chinn, Katherine FannyD’Harlingue, Karla Friedman, Sarah Noranne Gee, Andrew Christopher Ghatan,Reyhaneh Hamidi, Sally Medhat Kamal, Vanessa Leigh Lauzon, Bethany Lehman,Marlowe Majoewsky, Michael Anthony Marques, Jennifer Lynn Martindale, ErinGregg Newman, Christopher James Ng, Sumit Hamendra Rana, Paola GiovannaRodriguez, Erik Quinn Roedel, Julie Schalhorn, Adam Seidl, Ketan Kiritkumar Shah,Allyson Akiko Spence, Ashley Brooke Sutton, Alicia Genice Turlington, Sean WilliamWilson, John Justin Workman, Eric John YavrouianFaculty: John W House, David H PengHouse staff: Cynthia Hsiao-Yun HoDavid Geffen School of Medicine at UCLA—Delta CaliforniaStudents: John Anderson-Dam, Yagil Barazani, Jori Felice Bogetz, Michael RyanBriseno, Jennifer Chang, Michael Carl Chen, Bryan Joseph Correa, Adam DeConde,Allison Marie Faucett, Kiran Gollapudi, Anna Leah Grossberg, Hannah HopeHolcombe, Jo Marie Janco, Sarah Sung Kim, Michael Aaron Lalezarian, MathewDouglass Longacre, William Charles Lorentz, Niraj Harendra Mehta, Allison AnnMorgan, Rupa Narayan, Oreoluwa Ogunyemi, Amy Paris, Steven Rad, MonikaSaeedian, Supriya Saha, Victor Sai, Madeleine Joanna Saran, Justin Robert Wallace,Aviva E Weinberg, Jonathan A Wu, Celia Ka Wai YauLoma Linda University School of Medicine—Epsilon CaliforniaStudents: Allison Danielle Bacon, Kelsie Janelle Bickley, Cassie Lee Booth, JonathanWilson Boyd, Ioana Flavia Brisc, Cody Allan Chastain, Carol Chiu, Sara Chiu,Andrew Lewis Cornelius, Annemieke Mattanja de Lange, Adam Fershko, TerryRobert Fleck, Gwen Ellen Gleason-Rohrer, Kelly Thomas Kieper, Victoria ValinluckLao, Rebecca Jean Larson, Samuel H Lee, Justin McLarty, Sharon Elaine McNeill,Brian Darryl Moseley, Amanda Munk, Tanya Sami Nino, Mary Elizabeth Ritter,Gillian Seton, Matthew Charles Shillito, Timothy Snelson, Astrid Ruth von WalterAlumni: Robert Thomas SmithFaculty: Francis Dick-Wai Chan, Darla Roye ShoresHouse staff: John Christian Gregorius, Brinda ThimmappaUniversity of California, Irvine, School of Medicine—Zeta CaliforniaStudents: Kristopher Troy Chiles, Allyson Estess, David Floriolli, Shahrouz Ganjian,Amandip Singh Gill, Marnie Granados, Allison Campbell Hill, Kristy Faye Hinchman,Shawn Keiji Kaku, Neil Kalra, Rupa Pugashetti, Lili Sheibani, Jesse Stondell, ErinMichelle Toole, Christopher Washington, Jeffrey Eric Wong, Tritia Reina YamasakiFaculty: Shahram LotfipourUniversity of California, Davis, School of Medicine—Eta CaliforniaStudents: Ashkan Ehdaie, Teresa Flores, Antonio M Germann, Robin Janet Gibbons,Amy Marie Harley, Emma Simpson Jacobs, Molly Bowen James, Dylan ChristopherKann, Raj Kullar, Diana Lap Ying Lam, Dennis Jung-Min Lee, Michaela Ann Onstad,Anabella Pascucci, Scott McIntosh Porter, Caleb Steven Siler, Raja KameswaranSivamani, Agnieszka Ewa WitkowskiFaculty: John Lee Dalrymple, Donald M HiltyHouse staff: Martin Nicolas LeeCOLORADOUniversity of Colorado School of Medicine—<strong>Alpha</strong> ColoradoStudents: Dale Alan Burkett, George William Chaus, Brian Matthew Christenson,Sarah Jane Yost Clutter, Robert Jackson Courtney, Amy Carol Drumm, AnthonyFoianini, Daniel Bruce Heppe, Shideh Majidi, Richard Jay McMurtrey, Kimberly DinhNgo, Lauren Nicole Puls, Emmett David Ratigan, Jordan Forister Schaeffer, ShabnamOmidi Showell, Jill Elizabeth Sindt, Kristina Steiniche Sowar, Joshua Bengtson Sykes,Michal Lee Taylor, Julie Elizabeth Thompson, William Chia-ching Yao, Grant RyanYoungHouse staff: G Ryan BergerDISTRICT OF COLUMBIAThe George Washington University School of Medicine and HealthSciences—<strong>Alpha</strong> District of ColumbiaStudents: Stephanie Michelle Aleskow, Omer Abdulrehman Awan, Nasir Akhtar Aziz,Noa Biran, Nicholle Daniel Bromley, Laurence William Busse, David Edward Conrad,Laura Hagen Dean, Shaun C Desai, Rachel Eve Ershler, Rebecca Ann Fausel, TrushaJayanti Govindji, Christine Marie Heske, Meghan Sri Karuturi, Benjamin WilliamMcClintock, Andrea Marie Morris, Cimmie Lynne Shahan, Rachel Glickman Shnider,Swati Singh, Joann Marie Spinale, Benjamin Eric Stein, Lorraine Chava Stern, KristinLoo Thanavaro, Frederick Ethan WeissAlumni: Peter S JensenFaculty: Peter HotezFaculty: Samir Shashikant PatelHouse staff: Seth Michaels Pollack, Juan A Reyes, Neil TannaGeorgetown University School of Medicine—Beta District of ColumbiaStudents: William Carl Anderson, Heather Marie Avedissian, Nicole Ann Chiota,Caitlin Joyce Crowther, Brian Paul Cullingford, Lindsay Anne Curtis, LindseyElizabeth Daggle, Lisa Anne DelSignore, Stephanie Lynn Fisher, Arden E Fredeking,Sean Matthew Gratton, Caroline Bennett Hobbs, Jonathan Eric Holtz, Keith LynnJackson, Daniel Gene Kang, Patrick N Lenaghan, Ilona Sinead Lorincz, Jennifer LLyons, Terah Jean Malette, Katherine Marie Mercy, Amy Lynn Nicholas, Alicia EveOgram, Alicia Katherine Peterson, Constantine George Saites, Grant CourtenaySorkin, Matthew Kirk Steehler, Brad Gregory Stevinson, Katherine Paisley Sullivan,Andrea Shirley WangHouse staff: Christopher Joseph Abularrage, Kiran Kumar Dhanireddy, ChristopherC WyckoffHoward University College of Medicine—Gamma District of ColumbiaStudents: Ifeanyichukwu Jude Ani, Adedoyin Olukemi Kalejaiye, Binyam Muluneh,Deepti Muraleedharan, Alero T Nanna, Khara M Simpson, Carlos A WilliamsAlumni: Richard J Derman64 The Pharos/Winter 2009
Faculty: William Bradford Lawson, Terry Lamar ThompsonHouse staff: Rabia CherqaouiFLORIDAUniversity of Miami Miller School of Medicine—<strong>Alpha</strong> FloridaStudents: Sarah Akerman, Ibrahim Alava, Christian Michael Andrade, Danielle AlyseBecker, Pooya Isaac Bokhoor, Stacy Marie Chimento, Nicole Marie Christin, JonathanColasanti, Christine Thuyvan Dinh, Christopher John Dy, Lauren Elizabeth Frost,Dalia O Girgis, Scott Mattox Haake, Andrew Stuart Krasner, Marlen Leon, AshleighLevinson, Ashleigh Laurin Levison, Nicole Desiree Martin, Christina Adel Michael,Nirmal Nathan, Matthew Rochefort, Leo Elliot Rosales, Reagan Lindsay Ross, ElissaM Schwartzfarb, Holly Katherine Marchiniak Thompson, Alexander TuchmanFaculty: Elizabeth Anne Ouellette, Richard Louis RileyHouse staff: Subha SundaramUniversity of Florida College of Medicine—Beta FloridaStudents: Richard Douglas Beegle, Jason N Crosson, Lori Anne Filichia, Daniel PabloFriedmann, Jonathan Graff-Radford, Elizabeth Russell Griffin, Leon Hatch, TenessaMorgan MacKenzie, Omayra Lizzie Marrero, Brett Miller, Ryan Wesley Nall, MarkWilson Newman, Alissa Orvis, Deidre Rachel Pachman, Brendan M Prendergast,Scott Keith Schultz, Neil Sengupta, Ankur Janak Shukla, Lindsy Nicole WilliamsAlumni: Jose LezamaFaculty: Matthew McKillop, Kerlan Peter WolseyHouse staff: Anil Kumar PuriUniversity of South Florida College of Medicine—Gamma FloridaStudents: Melanie Stacey Altholtz, Jason Robert Buckley, Rahul Narayan Chavan,Clarence Henry Clay, Seth Ian Felder, Sudeep Gaudi, Gregory Randell Hartlage,Kristin Walsh Houseknecht, Jason Michael Jennings, Jessica Boynton Johnson, LisaCaroline Klepczyk, Andrew Bryson Lemmon, Lisa Carolyn Moody, Shana RoseCoplowitz Okolica, Daniel Nathan Shippy, Kerry Lyn Thomas, Kathlyn Valleau Wilde,Daniel Eugene YoderAlumni: Charles Morgan EdwardsFaculty: Bryan A Bognar, Laurie J WoodardFlorida State University College of Medicine—Delta FloridaStudents: Erkan Alci, Ashley Nicole Bassford, Peter Jeffrey Bechtel, CharlesLeRoy Clark, Paola Ballester Dees, Adam Joseph Huddleston, Jessica Suber, CodyVanLandingham, Johnny Washington, Jeremy Lee WilliamsFaculty: Charles Christopher OuimetHouse staff: Michael Hernandez, Julia Mercer NiebauerGEORGIAMedical College of Georgia School of Medicine—<strong>Alpha</strong> GeorgiaStudents: Amir A Ahmadian, Thomas Cary Alexander, Anthony Joseph Anfuso,Brian Joshua Boyce, Dustin Joseph Calhoun, James Parker Callaway, Jeremy ScottCardinal, Ashley Snell Chaplin, Matthew Dale Chetta, Julie Lynn Colantoni, KristinTott Collier, Kelly Vlass Culbertson, Justin Dunn, Tunisia Vershaun Finch, DevonGhodasra, Corey Harkins, Daniel Thomas Huttman, Paul McPherson Johnson,Katherine Elizabeth Kasik, Katherine Elaine Kohler, Jimmy Kuo, Timothy JosephMoore, Mary Frances Pilcher, John William Schleifer, Clay Alexander Spitler, StevenMark Spitz, James Mattingly Stevens, Ching Yen Tsao, Meredith Cross UdellAlumni: J Mark Gresham, Daryl C WileyFaculty: S Marcus Fulcher, Kathleen Tarrant McFarlane McKieHouse staff: Bryce Nattier, Molly Szerlip, Jeremy Aaron WarrenEmory University School of Medicine—Beta GeorgiaStudents: Gabrielle Nicole Berger, James Ian Cameron, Michael Earl Egger, JeremyKeith Jones, Jill McConaughy Klein, Timothy Van Johnson, Schuyler DavidLivingston, Aki Morikawa, Margaret Frances Moscato, Claire Susan Nicholas, LeahAnn Palifka, Ateet Bhupendra Patel, Gaurav Pravin Patel, Sofya Tokman, Sarah AnneTwichell, Jennifer Eliece Vaughn, Charlene Alexis WongFaculty: David Abraham KoobyHouse staff: Raul Roberto Blanco, John P Hackett, B Robinson WilliamsMorehouse School of Medicine—Gamma GeorgiaStudents: Brittany Jamille Bivines, Nicholas Alexander Borm, Damayea Isatu Hargett,Aleeia LaMour Johnson, Nicole M King, Megan Nicole Manento, Kenneth ObinnaMatthew, CharlRe Ev Anthoni SlaughterFaculty: Eve J Higginbotham, Folashade Stella OmoleMercer University School of Medicine—Delta GeorgiaStudents: Neal W Burkhalter, Nicholas L Henson, Matthew D McLeod, Morgan MPinkston, Amy M Rodatus, Jonathan W Rutledge, Michael Neil WoodallAlumni: Edward H YoungFaculty: William F Bina, M Gage OchsnerHouse staff: Andrew L Foret, Jill Q Purdie, William Clinton StreetmanHAWAIIUniversity of Hawaii at Manoa John A Burns School of Medicine—<strong>Alpha</strong>HawaiiStudents: Mireille K Anawati, Jennifer Malia Akemi Kaya, Katy Rose MahealaniLinskey, Jon Yukio Narimasu, Jared Kiyoshi Oyama, Sebastian Sugay, Erica JaneWalshFaculty: Patrick Murray, Karen ThompsonHouse staff: Chelsea Ching-Endow, David ShaefferILLINOISUniversity of Illinois at Chicago College of Medicine—<strong>Alpha</strong> IllinoisStudents: Theodore Carl Bailey, Gabrielle Marie Baker, Bennett Barch, LisaLeilani Bayer, Henish Ashish Bhansali, Katherine Ann Binder, Frank ChristopherBohnenkamp, Ryan James Bolton, Tara Eileen Brennan, Wen Chen, Liz Dailey,Virag K Dandekar, Kaci Lyne Dinga, Matthew Elkins, Christopher Thomas Erb,Eric K Fanaee, Tracy Lynn Flood Bramall, Katharyn Freund, Sumul Ashok Gandhi,Sean Michael Hill, Michael Anthony Holzman, Carrie Nicole Hood, Zi Yang Jiang,Christopher Reavis Johnson, Christina Tara Khan, Jenna Kim, Marie Leger, ShihhonLi, Elliot Daniel Lieberman, Charles Louis Lupo, Reid Woodside Masters, SonaMehta, Rachel Rose Miller, Nicholas Patrick Morley, Nelson Moy, Andrew JamesPastor, Craig Joseph Pastor, Mital Patel, Matthew Ryan Plunk, Neil David Saunders,Adrienne Michele Schupbach, Nirav Shah, Shaival Shah, Jennifer Shroff, ChristopherMichael Starr, Eric Taylor, Stacy A Trent, Stanley Wang, Jacqueline Marie Wegge,Adam Daniel Wolfe, Marika Inga WrzosekFaculty: Errol Christopher Baptist, Debra A GoldsteinHouse staff: Jose Gilberto TrevinoUniversity of Chicago Pritzker School of Medicine—Beta IllinoisStudents: Katherine Bekeny, Amanda Britt, Jessica M Buck, Nicole Anne Cipriani,Daniel Clayburgh, Jill Huber, Matthew Mark Kalscheur, Rohan R Lall, Jun Matsui,Jennifer McDonnell, Itai Pashtan, Jennifer Pogoriler, Katie Sharff, Erik Stoltenberg,Elizabeth Sullivan, Alan Eih Chih Thong, Colin WalshAlumni: Richard J Cote, Rex Charles HaydonFaculty: Nora T Jaskowiak, John Henning SchumannHouse staff: Laron N Johnson, Nathan Oliver Stitziel, Megan E TarrNorthwestern University, The Feinberg School of Medicine—Gamma IllinoisStudents: Christopher Burch Anderson, Jessica Casey, Anisha Desai, Erik B Eller,Matthew Rodrigo Endara, Bradley Gross, Justin Shinyu Han, Peleg Moshe Horowitz,Kenneth Kehl, Thomas O Kim, Vasantha Kolavennu, Anita Kumar, Leonardo VicenteLopez, Amun Makani, Farzad Moazed, Bati Myles, Jyoti Pathria, Charles Pearce,Jori Pollack, Matthew Ryan Reynolds, David Ian Rosenthal, Jill Starzyk, Raeka Talati,Gunilla Carlsson Thorn, Neelam Vashi, Arjun Krishna Venkatesh, Elizabeth KimWolf, Lynn Meredith YeeAlumni: Charles Stanley Modlin, Elliot RothFaculty: Richard M Green, Jacob Iasha SznajderHouse staff: Karl Bilimoria, David E Montgomery, Deepa PatilThe Chicago Medical School at Rosalind Franklin University of Medicineand Science—Delta IllinoisStudents: Brian Michael Ames, Ioanna Athanasiadis, William Whitney Beeman,Brian Thomas Caldwell, Richard Harriman Comstock, Timothy Michael D’Alfonso,Ha Kirsten Do, Marina Gitman, Madina Holmuhamedova, Soo Yeun Hur, Samuel BKieley, Joseph Younghan Kim, Payman Kosari, Lior A Levy, Theodore Lyu, SidharthMahapatra, Nur-Ain Nadir, Raja Ramaswamy, Dina Reiss, Jonathan Craig Rimler,Kerry A Rogers, Benjamin A Rubin, Sanjum Sethi, Michael Squire, Zachary CStender, Dawn Masano Taniguchi, Katherine Gross Tarlock, Meera N Tejura, JordanElizabeth Toman, Amy Ru-ci Wang, Christopher YenterFaculty: Marc Steven Abel, John TomkowiakHouse staff: Hari Raj PaudelLoyola University Chicago Stritch School of Medicine—Epsilon IllinoisStudents: Katherine Nicole Aragon, Harold Henry Bach, Christopher Jude Cirone,Jennifer Christine Colvin, Matthew Ryan Deluhery, Moira Eileen Dwyer, JillianRoxanna Foley, Erica Jennifer Grimm, Christopher David Hughes, Julie Anne Jackson,Rachel M B Kacmar, Molly Ann Marker, Nathan Wesley Mesko, Margaret GuinnMueller, Kristen Michelle Pierce, Nadia Janine Razaq, Dominic Joseph Ricci, MichaelJames Ross, Matthew Bernard Siegel, Melissa Rose Siegel, Michael WIlliam Sjoding,Elizabeth Ann Thompson, Robert Mercier Turner, Brian Patrick WalcottFaculty: Eva Maria BadingHouse staff: Carley M Davis, Troy Donovan WoodardRush Medical College of Rush University Medical Center—Zeta IllinoisStudents: Leah Bowser, Laura Carter, Michelle Cecchini, James Cho, NatashaCunningham, Eric Gantwerker, Jordana Goldman, Henry Govekar, Mark Hamming,Michael Hehman, Stephanie Hensler, David Hulata, Lanea Keller, Kristen Labovsky,Azher Merchant, Rachel Neems, Anne Pizzi, Joshua Podjasek, Adam Schiff, FalakShahFaculty: Steven FeinsteinHouse staff: Prakash Balan, Jennifer Erickson FosterThe Pharos/Winter 2009 65
New membersSouthern Illinois University School of Medicine—Eta IllinoisStudents: Naurin Ehsan Ahmad, Meredith H Burge, Jennifer Lynn Creamer, EdwardPrice O’Dell Harter, Hassan Ali Hassan, Katrina Sophia Pedersen, Sapa Thi Pham,Catherine Marie Rapp, Dustin J Stehling, Gregory Arthur TesterAlumni: Michael A PickFaculty: Richard RosherHouse staff: Ibrahim Bulent Cetindag, Joji Jacob VargheseINDIANAIndiana University School of Medicine—<strong>Alpha</strong> IndianaStudents: Jesse Allen Beery, Peter Carl Bergmann, Parin Bhayani, Jeffrey MelsonClarke, Sara Elizabeth Cook, Elizabeth Ann Gates, Shawn Travis Greathouse, MarcScott Haro, Cara Freeland Hennings, Joseph L Hunt, Andrea L Jester, Jamie LynnKnuth, Nicholas Andrew Koontz, Margaret Darden Kramer, Hans Chulhee Lee, Pei-Fen Lin, Andrea Elizabeth Losch, Rachel Dianne Manley, Anubhav N Mathur, PeterJoseph Mehta, Daniel Benjamin Moore, Adam Steven Morgan, Daniel James Musick,Meagan Beth O’Neill, Samuel Luke Oyer, Kellie Adrienne Park, Chirag GhanshyamPatel, Neal Balvant Patel, Cara Ann Pecina, Jonathan Addison Peng, Brett C Pieper,Matthew Allen Rider, Emily A Ruden, Lori Jacquemin Sanford, Laura Ann Sech,Christopher Doyle Stephens, Allison Kasey Taraska, Nathan Eric Thompson, EmilyWalkey, Patrick Collins Walz, Adam M Werne, Diana Margaret Winston, Yuriy OZhukov, Matthew M ZipseAlumni: Lisa Ellen Harris, Douglas J SchwartzentruberFaculty: Marilyn Jean Bull, Robert D TarverHouse staff: Daniel Hamp Fulkerson, Joshua Wesley Garrett, Ben M TsaiIOWAUniversity of Iowa Roy J and Lucille A Carver College of Medicine—<strong>Alpha</strong>IowaStudents: Michael Lee Adix, Mazen Saadi Albaghdadi, Amaris Anderson, MichaelLonnie Bullard, Chiraag Dharia, Henry Richard Diggelmann, John Edwards, ElizabethMary Grace, Lindsay Anne Griffin, Leah Maxwell Habib, Jonathon Heath, AmandaJean Hohmann, Brett William Hronek, Bridget Kamen, Lindsey Elizabeth Klocke,Stephanie Anne Leeson, Anne Meredith Lewis, Bethany Kirk Helms Lewis, KathrynElise Miller, Jason Alan Patterson, Benjamin Andrew Paulson, Thomas Allen Pietras,Larissa Marie Pisney, Anne Renze, Rachael Raelynn Rickertsen, Dan MohsenShivapour, Neil James Sink, Jamie Jane Vanourny, Derek ZhorneAlumni: Steven SchurtzFaculty: Richard Le BlondKANSASUniversity of Kansas School of Medicine—<strong>Alpha</strong> KansasStudents: Lindsay Elise Abbott, Emily Anne Blankenship, Josiah D Brinkley, Jason ACheng, Julianne E Donnelly, Brian MacNeille Everist, Emily MW Haury, Bryce AdamHoffman, Kate S Jennings, Landon M Johnson, Megan Louise Krause, MyChi Han Le,Abby J Loch, Leonel Martinez, Katherine J Moore, Jill K Onesti, Lindsey Leigh Saint,Andrew B Schlachter, Seth H Sheldon, Casey L Smith, Jennifer Ann Spiegel, Kevan CStanton, Ourania Thomai Stephanopoulos, Joella E WilsonAlumni: Robert P MoserFaculty: J Brantley ThrasherHouse staff: Abebe Mulugeta Abebe, Steven William BormannKENTUCKYUniversity of Louisville School of Medicine—<strong>Alpha</strong> KentuckyStudents: Natalie Hill Beaven, Ryan E Bennett, Andrea Jo Brooks, Harmony FaithCarter, Leslie Caudill, David Shi-wei Chang, Andrew Bryce Crush, Eileen MoiraDuggan, Carter Smith Gerard, Theodore L Gerstle, Holly Elisabeth Hensley,Nicholas Jon Larsen, Brannon David Mangus, Michael Lewis McClintock, KathrynMichalczyk, Sean Matthew Miller, R Joseph Mittel, Natalie Banet Olberz, Daniel RPike, Jason Harold Reynolds, Karthik Suresh, Cassey Vessels, Joel Warren, JoshuaScott WiglesworthAlumni: Richard Dale Hurt, James Frederick SillimanFaculty: John Joseph Buchino, Vinay PuriHouse staff: John M Draus, Ryan Thomas Hurt, Gena NapierUniversity of Kentucky College of Medicine—Beta KentuckyStudents: Arthur W Baker, Sandhya Bondada, Barrett W Brown, Leigh AnneHoskins, Alyssa Ashley Hunter, Pradeep Saigopal Mettu, Megan Murphree, MeghanHennessey Nadeau, Michael T Newcomb, Jennifer Rene Olges, Gary Travis Patterson,Amanda Elizabeth Smith, Robert Todd Sweeney, Sarah Collier Thornton, WilliamAlexander Wilson, Melissa May Yingling, Kristine ZiembaFaculty: Nirmala Desai, Chester Darell JenningsHouse staff: Nicolas Ajkay, Kara O’BrienLEBANONAmerican University of Beirut School of Medicine—<strong>Alpha</strong> LebanonStudents: Georges Al-Helou, Melhim Bou Alwan, Chadi Makary, Fadi Makari, AliMehdi, Tania Rebeiz, Karim Saab, Fadi Jaber Sawaya, Hamdi Sukkarieh, SamerTohme, Abdallah Abou ZahrFaculty: Anwar NassarHouse staff: Randa Mustafa Al BaraziLOUISIANATulane University School of Medicine—<strong>Alpha</strong> LouisianaStudents: John Baber, Susan Brim, Chevelle S Brudey, Robert Lamont Carruthers,Shannon Shung-Ling Chang, Mollie Nicole Dahlgren, Annelies L De Wulf, MelissaClaire DeVito, Clayton Clement Eiswirth, Meryle E Eklund, Alessandrina MarieFreitas, Shane Andrew Gailushas, Jennifer Leigh Galjour, Andrew Cameron Harbin,Elizabeth Ann Jensen, Daniel Jay Kravitz, Diego Arturo Lara, Joshua David Linnell,Kara Mari Loubser, Anjali Malik, Diana Nicole Moustoukas, Sepehr Oliaei, BrettRoberts, Matthew James Rose, Andrew Marc SchutzbankLouisiana State University School of Medicine in New Orleans—BetaLouisianaStudents: Carlo Joseph Alphonso, Beau Stephen Black, Benjamin Boudreaux, LienKim Bui, Victoria Elizabeth Burke, Michael Cusick, Rebecca Delahoussaye, JasonRobert Determann, Lindsey Dietrich, Corey Paul Falcon, Drew Flansbaum, EmilyGrieshaber, Camille Catherine Gunderson, Russell Gerard Hendrick, Amanda Hestle,Ross Hogan, David Shannon Howell, Joan Hunter, Leah Jacob, Keith LeBlanc, KristenLeBleu, Jeffrey Melancon, Emily Miller, Lacey Ann Millet, Adrienne Musumeche,Charles Nunez, Stephen Anthony Quinet, Elizabeth Robert, Paul Rogers, JordanThaddeus Romero, Chelsey Tyler Sandlin, Justin Andrew Walker, Rebecca LeeWoodsonAlumni: Mario A Calonje, Ellis Ralph LupinFaculty: John Patrick Hunt, Giovanni LorussoHouse staff: Travis Dotson, Stacey L Holman, Daniel S HsiaLouisiana State University School of Medicine in Shreveport—GammaLouisianaStudents: Tyler Sean Auschwitz, Amber Cooper Bazler, Christopher Joseph Beck,Kyle Bailey Bruyninckx, Elena Mitkevicius Campbell, Amber N Cockburn, BritniFabacher Hebert, Stuart Craig Hebert, Lainie Joffrion Jorns, April Marie Landry,Tanja Jordan Minova-Foster, Timothy Patrick Moran, Elizabeth JA Waller, Emily JaneZerwas, Shihao ZhangHouse staff: Jason Scott MizellMARYLANDJohns Hopkins University School of Medicine—<strong>Alpha</strong> MarylandStudents: Hannah Haruko Alphs, Mark Magdi Awad, Christopher John Brady, JohnPeter Campbell, Han-Ying Peggy Chang, Lia Ellen Clattenburg, Jennifer WarnerDharamsi, David Wesley Dowdy, Steven Jeffrey Eliades, Allison Ruth Larson, CorinnaJosephine Moore, Afshan Amin Nanji, Shantanu Nundy, Romina Mariam Ma WingShan Wahab, Gina Louise Westhoff, Alice Shufeng Yao, Amir Mozaffar ZamaniAlumni: Theresa Ann Barry Shapiro, Eileen PG ViningFaculty: Thomas E Finucane, Gabor KelenHouse staff: Christopher James Barreiro, Oluwaseun Omotomilola Falade, RobertEugene HoeschUniversity of Maryland School of Medicine—Beta MarylandStudents: Jennifer Jihyun Ahn, Brendan Timothy Bowman, Emile Nathaniel Brown,David Carlberg, Kathryn M Conniff, Jessica DeGrandis, Erin Einbinder, Ruth EGardner, Amie Gupta, Sarah P Hale, Jacqueline Karp, George C Kochman III,Zachary Nathan Kon, Michelle M Levender, Priscilla Nelson, Elizabeth M Nichols,Yun Ja Park, Ann Parker, Ebrahim Paryavi, Mary K Porteous, Eric Shang, EugeneYuriditskyFaculty: Majid E Cina, Andrea WongHouse staff: Robert J Habicht, Michael T McCurdy, Mayur NarayanUniformed Services University of the Health Sciences F Edward HébertSchool of Medicine—Gamma MarylandStudents: Daniel J Adams, William Boller, Robert O Brady, Steven H Craig, MichaelEA Cunningham, Paul M Drayna, Cicely Anne Dye, Delnora L Erickson, Brent AFeldt, Brian M Fitzgerald, Philip M Flatau, Anthony A Giberman, Kelly L Groom,Nicole M Hsu, Katherine M Ivey, Andrew J Kuschnerait, Katherine M Kuster, Gary LLegault, Caroline Ko Mans, Andrew D McLaughlin, Sandra S McLaughlin, NicholasOrr, Marit Connor Peterson, Lindsey R Rath, Jeanmarie B Rey, Kristina R Rustad,Kathleen M SarberAlumni: John H Farley, Tandy Garth OlsenFaculty: Richard M Conran, Patrick G O’MalleyHouse staff: Daniel William Carlson, Jess D Edison, Alyssa C Perroy66 The Pharos/Winter 2009
MASSACHUSETTSTufts University School of Medicine—Beta MassachusettsStudents: Lisa Maria Battaglia, Evan R Berg, Emily Melissa Berger, Molly ChaseBroder, Margaret Naomi Chapman, Anna Lee DeSista, Kevin Russell Dougherty,Katherine McKinley Esselen, Edward Wilson Grandin, Margaret Mary Hayes, LucianIancovici, Richard Samuel Kalman, Justin Meng Ko, Michael Kriss, Christie JeanLangenberg, Scott Bissell Loomis, Gunjan Malik, Lucas Marzec, Carissa Meyer,Richard Alexander Misiaszek, Sonali Paul, Sara Sanarin Prasertsit, Wilson Flynn Pyle,Jason Pierce Rahal, Elena Leah Resnick, Jay Won Rhee, Benjamin Pratt Romney, JasonSaillant, Jocelyn Tara Scheinert, Aaron Nathaniel StaymanBoston University School of Medicine—Gamma MassachusettsStudents: Jeremiah Kirk Alexander, Rama Somayajula Ayyala, Bridget Mary Canavan,Allison M Carelli, Michelle Carey, Michael Ryan Cassidy, Brian Thomas Clark,Armen Derboghossians, Ryan Christopher Goerig, Allison Elaine Hunt, RebeccaJohnson, Steven Russell Kussman, Grace Jennifer Lee, Luke Macyszyn, RavikanthMaddipati, Deepa Ramakumar Magge, Jules Powers Manger, Melissa Ann Martchek,Daniel Stewart Roberts, Noelle Nugent Saillant, Sarah Elaine Wyhs, Christina DeckYarringtonAlumni: Richard H Mattson, Kenneth B SimonsFaculty: David B McAnenyHouse staff: Philip Alexander Cohen, Jens Thiele, Edwin Tigerenashe ZishiriUniversity of Massachusetts Medical School—Delta MassachusettsStudents: Alexandra S Bailey, Rachael Blake, Stephanie Carter, Kelly Holland,Andrea Klayman, Amanda Kolb, Noah Kolb, Candice McElroy, Mark McKeen, VilasPatwardhan, Jennifer Rosenberg, Magdalena Slosar, Michael Sylvia, Hilary WombleAlumni: Joseph DiFranza, Arnold FreedmanFaculty: Richard Irwin, Phillip ZamoreHouse staff: Sanjeet Hegde, Darshana Patel, Heidi SmithMICHIGANUniversity of Michigan Medical School—<strong>Alpha</strong> MichiganStudents: Kristen Elise Adams, Sudha Rani Amarnath, Andria Lynn Amendt, AlisonMarie Bates, Timothy Bodnar, Emily Kathleen Damuth, Kara D Gaetke, Steven AdamGiuseffi, Jonathan Greene, Steven Christopher Gross, Tannaz Guivatchian, DanielReed Jensen, Christopher Warren Jones, Joel Christopher Joyce, Jyoti S Kandlikar,Michael Krug, Robbi Ann Kupfer, Milton Thomas Michael Little, Jeffrey Philip Mako,Kevin Brett Messacar, Elizabeth Rose Meza, Priya Vijay Mhatre, Daemeon AchillesMichael Nicolaou, Michael William Rowley, Eric W Schneider, Derrick Ying Siao,Miller Hayden Smith, Kathryn Angela Volz, Deborah Jean Weener, Christina Y WengFaculty: Valerie P Castle, James O WoolliscroftWayne State University School of Medicine—Beta MichiganStudents: Andrea Lynne Barbieri, Kurt David Bernacki, Matthew Bernbeck, KathyBorovicka, Steven Daniel Daveluy, David Steven Demos, Stephanie Diamond, JasonDomina, Michelle Figueroa, Gary William Gallagher, Adrian Gasperut, BiancaGruber, Elizabeth Corey Gwinn, Erin Hendriks, Zachariah Hicks, Ronald Huang,Louis Joseph, Anastasia Kay Ketko, Paul Hyon-Uk Kim, Jonathan Edgar Kivela,Michael Kopec, Nicholas Gregg Kujala, Angela C Liang, Adam Michael Lubert,Ankur Mehta, Andrew Kent Moriarity, Brian Mott, Laura Ann Owczarek, ManishNavnitlal Patel, Andrew James Powers, Isaac Peterson Reeve, Crystal M Ritsema,John David Schwartz, Saloni Shah, Christopher Alan Smith, Kelly Ann Smith, MelissaJ Sundberg, Itishree Trivedi, Gwendolyn Rose ZirngiblAlumni: Renee DwaihyFaculty: Chokechai RongkavilitHouse staff: Gregory NorwoodMichigan State University College of Human Medicine—Gamma MichiganStudents: Brian J Gavitt, Richard Michael Hall, Christina Lynn Harsant, Jennifer EmKretschman, Amanda Marie McClure, Andrew K Nash, Rebecca Marie Palacios,David Pettersson, John Michael Pietila, Manish Tushar Raiji, Erin Chava Ruth,Rebecca L Creswick Saenz, EmmaLeigh Madeline Smith, Jasmine N Stannard, AlanDavid Van Opstal, Elizabeth R Van OpstalAlumni: Gregory Lewis Barkley, Glenn W JelksFaculty: Adesuwa Benedicta Olomu, Vincent J WinklerPrinsHouse staff: Ayodeji Johnson Ajibola, Jeffery L Chamberlain, Shalabh ChandraMINNESOTAUniversity of Minnesota Medical School—Twin Cities—<strong>Alpha</strong> MinnesotaStudents: Brianne Claire Barnett, Ryan Patrick Brady, Joanna Mary Burns, BenjaminRay Coobs, Devon Rae Dannen, Ryan Michael Dunn, Tyler John-Miles Dunphy, LauraCorinne Evavold, Laura Ann Freeman, Adam John Gess, Jacob Richard Hodge, DanielOrlin Keys, Colleen Christina Kniffin, Meghan Michelle Lelonek, Joseph CorralMayerle, Heather Maureen Nelson, Joshua Harlen Olson, Justin Charles Peltola,Scott Gerald Perkinson, Somnath Jagannath Prabhu, Jacob Frank Quail, Natalie RuthRoeser, Joseph William Rohrer, Jessie Lee Kerns Roske, Laura Catherine Speltz, ElliotJames Price Stephenson, Matthew Aaron Taintor, Jake Ronald Theis, Jared ThomasVerdoorn, Jay Justin Vlaminck, Jerome Richard Walker, Andrea Lynn Westby,Jonathan Peter Williams, Katie Helen Willihnganz, Justin Michael Wudel, AndreaMichelle ZinsMISSISSIPPIUniversity of Mississippi School of Medicine—<strong>Alpha</strong> MississippiStudents: William Bacon Bell, Marcus Daniel Biggers, Kathryn Luise Brown, GarthSeamus Campbell, Jessica Larsen Gullung, Angela Devi Gupta, David Paxton Jones,Jason Kyle Jones, Laura Marie Robinson, David Robert Sayers, James Byron Shipp,Robert Kyle ThompsonMISSOURIWashington University in St Louis School of Medicine—<strong>Alpha</strong> MissouriStudents: Jessica Duan, Jeremy Etzkorn, Margaret Garin, Cheryl Gray, JamesHudspeth, Julia Anne Kauffman, Andrew King, Kory Lavine, Kathleen McKeon,Eric Nordsieck, Ilana Rosman, Shada Rouhani, Sunitha Sequeira, Annemarie Sheets,Arsham Sheybani, Devon Cady Snow, Steven Sperry, Kristin VanderPloeg, SunithaVemula, Karolyn WanatAlumni: Gary A Ratkin, Robert A SwarmFaculty: Arnold Bullock, Arie PerryHouse staff: Ryan Courtney Fields, Andrea Ruth Hagemann, Julie Kristina SchwarzSaint Louis University School of Medicine—Beta MissouriStudents: John Nathan Allan, Andrew Robert Barina, Cory Bethmann, Eric ABloemer, Sofia Begum Chaudhry, Kristen Michelle Covert, Brian Wesley Cross,Austin jay Crow, Angela Marie DiCarlo-Meacham, Matthew F Dilisio, Sara L Franzen,Olivia Kathryn Giddings, Dana Anne Hartnagel, Estebes Akira Hernandez, LindseyAllison Herrel, Sonya Jagwani, Gregory Patric McLennan, Anthony Alan Nuara,William Simon Clarke Payne, Denise Renee Pounds, Jacob McCabe Pounds, MarshaSK Reuther, Allison Lynn Sterner, Colin Michael Thompson, Joanna Elaine Thomson,Bradley Warlick, Anne-Marie WoelbelUniversity of Missouri—Columbia School of Medicine—Gamma MissouriStudents: Brenon L Abernathie, Joel Robert Brockmeyer, Katharine Ann Connolly,Sarah Elizabeth Driver, Anna Christine Harris, Benjamin Kinnear, Marina Litvin,Benjamin Mark Martin, Shannon Kathleen Martin, Scott A Norris, Jason Ryan Pettus,Dominic Emmanuel Sanford, Lindsay R Shotts, Blair David Westerly, LeAnna ReneeWittAlumni: Girish Mishra, James R SowersFaculty: Bert Bachrach, Ellis Andrew IngramHouse staff: Mark Nelson Beard, Atif IqbalUniversity of Missouri—Kansas City School of Medicine—Delta MissouriStudents: Michael Haessam Amini, Jacob Daniel AuBuchon, Dawn Christine Charles,Steven Ross Cohen, Christopher M Fox, Neil Maheshchandra Gheewala, JessicaNicole Gillespie, Rachel Marie Griggs, Lauren M Ludwig, Jessica Lyn McCammon,Surya Narayana Mundluru, Jessica L Reddoch, Michael Gregory Rodriguez, NicholasRyan WassonAlumni: Jeffrey James PetersonFaculty: Jean R HausheerHouse staff: Gretchen Marie Dickson, Angela Leigh Myers, Madhu Babu NarraNEBRASKAUniversity of Nebraska College of Medicine—<strong>Alpha</strong> NebraskaStudents: Jocelyn Kaye Bailey, Isaac Joseph Berg, Benjamin James Bixenmann, NatalieAnn Black, Joseph T Cheatle, Andrew Michael Coughlin, Michael Alexander Donner,Brian Charles Gartrell, Jonathan R Henning, Andrea Lynn Mack, Daniel Dean Mosel,Nathan William Murdoch, Evan C Pike, Sonya May Reynolds, Kelli Lynn Rudman,Allison Lee Stangel, Michelle Elizabeth Sudyka, Jason Phillip Weber, Thomas J WilsonAlumni: Ray E Hershberger, Steven Phillip WengelFaculty: Leslie C Hellbusch, Rubens J PamiesHouse staff: Douglas Francis Niemann, Eric Thomas Rush, Michael David SatherCreighton University School of Medicine—Beta NebraskaStudents: Elizabeth Durand Adams, Mary Anne Andrews, Scott Michael Atay, ErinMarie Bruno, Heather Anne Dobbs, Gary Peter Graham, Travis Edward Grotz, JasonPatrick Kelly, Laura Kristine Mirch, Ho V Nguyen, Quyen Trung Nguyen, MargaritaRoykhman, Marilee Michelle Simons, Joshua Spendlove, Andrew Christian Stevens,Morgan Leigh Swank, Sandra Swedean, Chad Thorson, Jacob Chris Walter, CaseyWosterAlumni: Alfred D Fleming, Gary S FrancisFaculty: Robert Charles Allen, Martin GoldmanHouse staff: Nitin Garg, Jacob Sam Koruth, Saeed Kamran ShaffiNEVADAUniversity of Nevada School of Medicine—<strong>Alpha</strong> NevadaStudents: William Thomas Edwards, Aicha Maria Hull, Kyle Nathaniel Klingler,Suzanne Larson, Chantal Reyna, Justin Bradley Smith, Whitney Waldroup, RyanneWalther, Nancy WongFaculty: Samuel D ParksThe Pharos/Winter 2009 67
New membersNEW HAMPSHIREDartmouth Medical School—<strong>Alpha</strong> New HampshireStudents: Narath Carlile, Elizabeth Lynn Fingar, Jennifer M Frese, Jessica H Hayward,Joan SL Hier, Heidi Ladd Keup, Tivon Isaac Sidorsky, Sharon Anne Silveira, JPedroTeixeiraAlumni: Stephen Atwood, Mark NorthfieldFaculty: Bruce Wayne Andrus, Lionel LewisHouse staff: Diana L Fitzpatrick, John Maynard Levenick, D Joshua ManciniNEW JERSEYUniversity of Medicine and Dentistry of New Jersey, Robert Wood JohnsonMedical School—<strong>Alpha</strong> New JerseyStudents: Yana Barbalat, Sonica Bhatia, Jaclyn Renee Brunner, Antonia Chen,Timothy Scott Fallon, Katherine Marie Fox, Eric Heckman, Dana Joy Herrigel,Thomas J Hopkins, Sangeeta Ramalingam Iyer, Kathryn Marie Kent, Christin Kim,Sandra Anne Kopp, Christopher Steven Manfred, Jaclyn McKinstry, Michael BrianMurphy, Michael N Nakashian, George Patounakis, Gabriel Rama, Brian WilliamRoberts, Ehud Sarlin, Rehan Syed Shamim, Rachel Beth Sotsky, Adam Brett Strohl,Drew Steven Weber, Taylor Douglas White, Brian Seth Winters, Lauren ElizabethWong, Jennifer Caroline YuAlumni: Jeffrey Craig BrennerFaculty: Robert Joseph RisiminiHouse staff: Jillian Grace Corbett, Ralph Ibrahim KanaanUMDNJ—New Jersey Medical School—Beta New JerseyStudents: Nrupen Yogesh Baxi, Sonia Belliappa, Toni Beninato, Eric Adam Breitbart,Sean Stephen Ciullo, Pascal Scemama de Gialluly, Neil Francis Fernandes, SerenaFernandes, Alex Seth Gaffan, Christian Sander Geannette, Samantha Paige Herman,Gina Hong, Mahim Kapoor, Marissa Anne Kellogg, Emily Kott, Jeremy Eric Mangion,Kapila V Paghdal, Alyssa Maria Parian, Heather Loryn Platt, Sarada Sakamuri, DavidJung Seto, Ryan Michael St Clair, Raja TaunkAlumni: Rini Susan Abraham, Frederick F Buechel, John ChaeFaculty: William E HalperinHouse staff: Brian Eric Benson, Maueswani SenthilNEW MEXICOUniversity of New Mexico School of Medicine—<strong>Alpha</strong> New MexicoStudents: Eva Angeli, Katherine Sue Callahan, Leah Enright, Michaela Haney, JonasHines, Mary Helen Laughlin, Allison Anne Legler, Kristen Livingstone, KatrinaPeariso, Sally Anne Vender, Donald Wenner, Zachary Charles WilsonHouse staff: Christopher Charles Abbott, Spencer Paul Barney, Mohamed O OthmanNEW YORKColumbia University College of Physicians and Surgeons—<strong>Alpha</strong> New YorkStudents: Lisa Marie Bebell, Eric Michael Black, Leif-Erik Bohman, Jennifer TenyeChang, Jason William Harper, Kim Jain, Christopher Paul Kellner, Kara AnneKerscher, Daniela Justine Lamas, Susan Elizabeth Mackie, Moira Margaret McCarthy,Mary Rebecca Mulcare, Elizabeth Christine Oelsner, Adedamola Ogunniyi,Adefolakemi Morenikeji Oni, Carlton Prickett, Jessica Anne Sims, Sarah Grace Sliva,Matthew Ian Tomey, Karoly Andras Viragh, Richard Lawrence Weinberg, Karen Kai-Lun Wong, Bob YinCornell University Joan and Sanford I Weill Medical College and GraduateSchool of Medical Sciences—Beta New YorkStudents: Jessica Bauman, Adrienne L Davis, Avnish Arvind Deobhakta, DanielGreninger, Tanya Lila Hamilton, Ariella Aliza Hochsztein, Jennifer Anne Inra, ElenaKamenkovich, Brett A Lenart, Erika Maria Moseson, Lindsay S Norris, Smrita Sinha,Alon Terry, Kelly C VranasAlumni: Richard DainesFaculty: Oheneba Boachie-AdjeiState University of New York, Upstate Medical University, College ofMedicine—Gamma New YorkStudents: Steven Altmayer, Paul D Aridgides, Kimberly Rae Blasius, Catherine GraceChung, Stacy Cooper, Anthony Cucci, David A Drew, Rachel Lipson Garner, MelanieRose Hawver, Jennifer A Jarosz, Rebecca L Lenhard, Austin Liu, Matthew Mason,Lauren Morrison, Tina Ann Nguyen, Sarah M Nicolai, Jennifer Dawn O’Reilly,Jonathan Oheb, Zoe A Orecki, Christopher M Palmer, Aleksandra Policha, David SShi, Adrienne Ruth Socci, Robert Swan, Melissa Urckfitz, Anne Elizabeth VillariAlumni: Ruth Helen Hart, Howard M SimonFaculty: Elinor Spring-Mills, Anne Rose SveenHouse staff: Nicholas John Bennett, Sean Edwin Button, Orson Dy GoNew York University School of Medicine—Delta New YorkStudents: James T Bennett, Andrea C Chen, Selby G Chen, Lauren Beth Ende, LuisIsaac Garcia, Alfred L Garfall, Ann Rebecca Garment, Leonard Glickman, SandraHarriet Kamholz, Andrew J Kleinberger, Anna Podolanczuk, Irina Privorotskaya,Patrick Morris Sullivan, Rull James Toussaint, Levon Haig Utidjian, Amanda MobergWilsonAlumni: Carolyn Barley BrittonFaculty: Court B CuttingUniversity at Buffalo, School of Medicine and Biomedical Sciences, StateUniversity of New York—Epsilon New YorkStudents: Megan K Barnhart, Kelly Devine Berchou, Adam R Brod, Margherita Bruni,Jennifer Erica Emmett Costello, Jillian J Delmont, Sameer Madhav Deshmukh, AmyBeth Devlin, Katherine Dunham, Matthew Michael Fernaays, Alan John Hsu, MariamImnadze, Victoria Ann Lilling, Andrew Marino, Benjamin P McGreevy, Joel R Moore,Francis James O’Connell, Jenna Lynn O’Neill, Jennifer Helen Paul, Coralynn Sack,Lisa A Steketee-Weaver, Alan F Vainrib, Justin Mark ZbrzeznyFaculty: Alexander C Brownie, Michael E DuffeyUniversity of Rochester School of Medicine and Dentistry—Zeta New YorkStudents: Matthew Davis, Anne Bartlett Fender, Tracy Elizabeth Fuller, MarjorieSophia Gloff, Koto Ishida, Matteo Charles LoPiccolo, Brooke Ellen Miller, SydneyButler Montesi, Brian Harrod Morray, Maryann Katherine Overland, Tracey AnnPerazone, Pooja Rao, Deanne Robinson, Natthapol Songdej, Tara WengerAlumni: Randy Nathan RosierFaculty: Cheryl KodjoHouse staff: Andrew James McGarry, Rona Lin NoreliusState University of New York, Downstate Medical Center College ofMedicine—Eta New YorkStudents: Erika Brutsaert, Charles Chang, Karmina Karman Choi, Anne Elisa Cossu,Alexander Filatov, Michael A Kadoch, David Scott Ketner, Yana Kleyner, MichelleNicole Kornblum, Michelle Han Lee, Brian Liebler, Gregory Alex Maniatis, EdwardRobert Mathney, Megan Elizabeth Miller, Jong Ho Park, Mital Patel, Derek DanielPrabharasuth, Matthew G Rein, Lisa Silver Richman, Lauren Ruth Schneider, MichaelJohn Seibert, Zohar Shamash, Brent Shepherd, Michael Shy, Inna Shyknevsky,Matthew Lawrence Smith, Sheeja Thomas, Gylynthia Elaine Trotman, Anthony JamesVisioni, Pramod Babu Voleti, Charles Wang, Michael J Winfeld, Kristina Wittig,Jeahad ZohnyAlumni: Barbara Elaine Cammer Paris, Leslie Anthony Saint-LouisFaculty: Mary Ann Banerji, Edward F SmithHouse staff: Nancy Blace, Pooja Malhotra, Michael Frederick TimoneyAlbany Medical College—Theta New YorkStudents: Eric Sooyong Ahn, Daniel B Aruch, Artur Chernoguz, Michael AloysiusFreeman, Adam N Frisch, Elaine Marie Giannakos, Abbey Kathleen Iles Gore, BridgetMarie Grant, Kara-Lynne Kerr, Santosh Jacob Mathen, Mary Elizabeth Moore,Michael Lucius Pomerantz, Jaime Marie Puglisi, Gavin D Roach, Ann E Rutter, KevinMichael Semelrath, Victoria Eva Varga-Huettner, Kathryn A Walsh, Harrison FranklinWang, Joshua Weisbrot, Sara Jane Westergaard, Bharat B YarlagaddaAlumni: Gary L GottliebFaculty: Dennis P McKennaHouse staff: Scott L Lee, Leon Salem, Richard Vincent SchallerNew York Medical College—Iota New YorkStudents: Sinan Altiner, Craig Elliot Berzofsky, Lisa Bienia, Allison Marie Borowski,Melissa Ann Burns, Melissa Ann Christino, Comana Monica Cioroiu, SamuelTristram Coffin, Matthew Ryan Curley, Levi Ray Dansby, Jessica Baer Dekhayser,Barry Diener, Sarah Elizabeth Eccles-Brown, Elizabeth Farrell, Julie I Goldman,Tyson Jonathan Hawkins, Houman Khakpour, Abdrea Siobhan Kierans, RebeccaMcAteer, Orlando Micheli, Daniel Ari Newman, Marie Matina Ng, Gina Paek, AnupPanduranga, Haatem Mostafa Reda, John-Ross Rizzo, Courtney Beth Sherman,Gagan Singh, Christopher Szlezak, Cai-Ling Wang, Yi-Chiun Wang, Carolyn MarieWassong, Kimberly Mei Winges, Vahe Zohrabian, Rachel ZubkoAlumni: Eric J Feldman, Catherine Butkus SmallFaculty: Leanne Forman, Martha Shelley GraysonAlbert Einstein College of Medicine of Yeshiva University—Kappa New YorkStudents: Netanel S Berko, Oren Elias Bernheim, Scott Adam Boruchow, Heidi MossBours, Erin Reis Callahan, Lauren Crocco, Annette Czernik, Carey Anne Eberle,Justin Ian Friedlander, Rebecca Mates Friedman, Balazs Galdi, Caryn A Gamss, AriMatthew Grinspan, Robert Francis Hanna, Michael Gerard Hannon, Jaime BergHyman, Meredith Ann Kelly, Charles Francis Lanzillo, Deborah Wonwah Leong,David Albert Liebelt, Eric David Manheimer, Jeremy Aryeh Mazurek, JonathanNachman Mazurek, Crystal Suzanne Query, Ilana Saal-Forchheimer, Darryl BrettSneag, Sasha Elizabeth Stanton, Diana Mai-Khanh Tu, Allen Benjamin YeroushalmiFaculty: Chaim PuttermanMount Sinai School of Medicine of New York University—Lamba New YorkStudents: Joshua Bauml, Adam Belanger, Parul R Chaudhari, Jessica Anna Cintolo,Randy M Cohn, Serina Deen, Ankur M Doshi, Jonathan Philip Bragg Elmer,Laurel Glaser, Jonathan S Hausmann, Casey Jo Humbyrd, Thomas J Klein, Levi GLedgerwood, Eli Miloslavsky, Sara Urana Schwanke, Risa Michelle Small, GabrielaSoriano, Peter Joseph Vasquez, Kelly Leigh West, Dmitriy ZamarinAlumni: Michael L Marin, John A MartignettiFaculty: Eileen SciglianoHouse staff: Anu Lala, Philippa Newell, Carlos Rios68 The Pharos/Winter 2009
Stony Brook University Medical Center School of Medicine—Mu New YorkStudents: Thomas Boes, Inderjit Chabra, Alisa Femia, Cecile Audrey Ferrando, BellaFradlis, Jonathan Gale, Lindsay Jubelt, Courtney Elizabeth Juliano, Yee Cheng Low,Adam Miller, Joshua Russell Olsen, Sabera Pirmohamed, Julie Ann Stein, ElizabethWeinerFaculty: Stephen Anthony VitkunHouse staff: Fady Michael KaldasNORTH CAROLINADuke University School of Medicine—<strong>Alpha</strong> North CarolinaStudents: Aarti Asnani, Daniel Coke Barr, Ari Brettman, Stephen James Dolgner,Wen-Chi Foo, Sidney Maloch Gospe, Khaled M Hassan, Tiffany Renee Hodges,Michael Lee, Donald Jay Lucas, Robert Gil Micheletti, Kunal Mitra, Yvonne MarieMowery, Toma Omonuwa, Mrinali Patel, Ashley WysongAlumni: William D BradfordFaculty: J Lloyd Michener, Christopher Wildrick WoodsHouse staff: Thomas PilkingtonWake Forest University Health Sciences (School of Medicine)—Beta NorthCarolinaStudents: Gretchen Cort Banks, David Werth Barry, Stephen Joseph Blaha, Laura KyleBrett, John Joseph Brewington, Brandon Lee Craven, Jessica Eichinger, Morgan TaylorFordham, Jeffrey Michael Hick, Ryan Christopher Johnson, Christopher MarcusLack, Emily Walters Langley, Jacob Albert Misenheimer, Jessica Lynn Pilchard, KarenElizabeth Schmitt, Kathryn Marie Fesler Steele, Lindsay Chaney Strowd, Roy Strowd,Jennifer Ann VaughnAlumni: Daryl RosenbaumFaculty: David Edwin MantheyHouse staff: Jimmy Ruiz, Samuel TurnerUniversity of North Carolina at Chapel Hill School of Medicine—GammaNorth CarolinaStudents: Alisa Patricia Alker, Shruti Laxmikant Chudasama, Christy JohnsonCrockett, Reid W Draeger, James E Ferguson, Lauren H Gainor, Jennifer BushmanGilner, Lynn Jackson Howie, Michael Hromadka, Sarah Broom Hubbell, MargaretE Jackson, Rebecca Irene Kalman, Alison Keenan, Gregory P Larsen, Chad MichaelMcCall, Andrew McWilliams, Caleb Evans Pineo, Nell Brock Pollard, Adam J FroyumRoise, Robert E Sapp, Lucy Marie Schenkman, Taylor James Stone, Gregory Tayrose,Catherine Elizabeth Varner, Tilley Jenkins Vogel, Katherine Davis Westreich, JamesRobert Young, Lindsay Sallach YoungAlumni: Anil Kumar SoodFaculty: Julie Story Byerley, Laurence D DahnersHouse staff: Alan Cheng, Jason Paul Glotzbach, Bhakti B PaulThe Brody School of Medicine at East Carolina University—Delta NorthCarolinaStudents: Richard Alan Bloomfield, Brian Christopher Domby, Adam Dean Houser,Shelby Ann Kaplan, Zachary Philip Kiker, Jeremy Michael Kilburn, Heang Muy Lim,Nicholas Dean Mayes, Joshua Daniel McKinney, Roger Jacob McMurray, DavidClinton McNabb, Laura Maha NasrallahNORTH DAKOTAUniversity of North Dakota School of Medicine and Health Sciences—<strong>Alpha</strong>North DakotaStudents: Allison Jean Clapp, Ryan Miles Clauson, Margaret Kay Cook-Shimanek,Khalin Dendy, Theresa Anne Hegge, Joshua J Knudson, Lindsay Anne Magura,Nicholas Milanovich, Jill Marie Steinle, Megan Bess WelshAlumni: L Michael Howell, Christopher H TiongsonFaculty: Scott Eric Knutson, Mary Ann SensHouse staff: Jeffrey Ben Andersen, Laura Ann Berg, Daniel Raymond PadgettNOVA SCOTIADalhousie University Faculty of Medicine—<strong>Alpha</strong> Nova ScotiaStudents: Michael W Aucoin, John Haverstock, Mary Jamieson, Gavin Langille,Morgan Alexander Langille, Lorine Pelly, Deborah Anne Pink, Derek J RobertsAlumni: Evelyn Deborah SuttonHouse staff: Patrick JG Feltmate, Brian G MosesOHIOCase Western Reserve University School of Medicine—<strong>Alpha</strong> OhioStudents: Lindsay Catherine Burrage, Katarzyna Buzanowska, Sophia Wai-yunChen, Bryan Randall Costin, Barry M Czeisler, Colleen Anne Foster, Jessica RandaGoldstein, Joanna Kriegler Grossman, Jennifer Elizabeth Hagen, Evelyn MorleyHemmingsen, Michelle Miran Kim, Eugene Brent Kirkland, Ethan S Lea, BenjaminLee, Rachel Benelli Markey, Kelly Ann Morrissey, Haruko Okada, Tehnaz NawzerParakh, Matthew Allan Popa, Aleksandra V Rachitskaya, Jacob Gardinier Scott,Aaron Gilman Wightman, Lindsay Bashaw WilsonFaculty: Robert L Haynie, Michael J McFarlaneHouse staff: Theodore Alexander KungUniversity of Cincinnati College of Medicine—Beta OhioStudents: Paul Timothy Bunch, Michael Dentler, Blake J Evans, William J Forton,Sarah Elizabeth Fox, Brian Michael Grawe, Joseph Hall, Lauren Imwalle, GregoryKohls, Robert Brett Lloyd, Andrew D Lund, Lauren Rose Ostling, Brandi Reeves,Justin Stevens, Christopher Tangren, Philip To, Joseph S Turner, Emily WiebrachtAlumni: Barbara Bowman TobiasFaculty: Diya F MutasimHouse staff: Samir Rama Belagaje, Jared Travis HagamanOhio State University College of Medicine—Gamma OhioStudents: Sireesha Achanti, Mary Ellen Acree, Brian Becknell, Randall T Butler,Jeffery Chakedis, Shane Chamberlain Clark, Michael Edward Cody, Ryan PatrickFicco, Eric Freeman, Aharon Gideon Freud, Blake Paul Gillette, Daniel GerardGorbett, Jon Clifford Henry, Erik Christopher Hustak, Seth Karol, Clare JohnsonKelleher, Hallie Sara Kendis, Vu H Le, Rushyuan Jay Lee, Eric Michael Liotta,Sean Thomas McCarthy, James Ryan Meadows, Jessica Moennich, Trucian AdamOstheimer, Cedric Pritchett, David Carleton Reed, Wilford Lee Richardson, ElizabethAnn Schloss, Andrew Brian Shaw, Kameron Alexandra Teal, Jeffrey Joseph Wargo,Brent Thomas Warner, Wesley Joseph WhitsonAlumni: Paul D Dusseau, Sayoko E MoroiFaculty: Bruce Alan Biagi, Michael A CaligiuriHouse staff: Carl Backes, Candace Huebert, Jason Wayne SmithThe University of Toledo, College of Medicine—Delta OhioStudents: Daniel Zachary Adams, Tyler Brian Anderson, Adam John Bobbey, JacintaCatherine Borgelt, Ann Bui, Bethany Calaway, Anne Kowatsch Clark, Suzanne Dietz-Quinter, Nathan Egbert, Theresa Marie Frey, Shelley Patricia Godley, Jennifer NicoleGueth, Mark Louis Lembach, Patty Liu, Lisa Anne McGee, Christopher John Owens,Victoria Louise Sheridan Owens, Aimee Marie Pollak, Benjamin Thomas Prince,Amanda Proctor, Katherine Jane Rodewald, Valijan Sevak, Peter Paul Stanich, DanielGeorge Straka, Arul Thirumoorthi, Seth A Waits, Brett Brunner WilliamsHouse staff: Amy Riese, Sandeep VettethWright State University Boonschoft School of Medicine—Epsilon OhioStudents: Deborah Amann, Tyler M Angelos, Julia Denise Burrow, William Cornwell,Beth Davis, Jason Richard Faber, Daniel Blake Flora, Richard N Greene, Bryan StevenJewell, Scott Thomas Leffler, Jacob McAfee, Sonal Kishore Moratschek, David WayneMorris, Dipika Mahendra Patel, Kyle Lee Randall, Sarah Von LehmdenFaculty: Dean X Parmelee, Jerome J SchulteHouse staff: David Jens Dalstrom, Jason Thomas Hedrick, Charles Brock MillerNortheastern Ohio Universities College of Medicine—Zeta OhioStudents: Emily Lee Albertson, Dominic MIchael Buzzacco, Nicholas WalterDetore, Rebecca Elizabeth Duncan, Andrew Robert Esterle, Gopi Ashwin Kesaria,Amanda Kristine Kinney, Casey Jean Maks, Jessica Nassar, Sandeep Magesh Patel,Dominic Joseph Peters, Scott Joseph Rapp, Patrick Michael Riley, Ashley ElizabethSmith, Megan Christine Smith, Megan Kathleen Walsh, Halley Wasserman, CynthiaElizabeth WeberAlumni: Rodney Jay Ellis, Christopher A SheppardFaculty: Joseph P Burick, William Francis FallonHouse staff: Andrea Kuntaraf Crane, Brian Christopher Lenczewski, John DavidScroccoOKLAHOMAUniversity of Oklahoma College of Medicine—<strong>Alpha</strong> OklahomaStudents: Ore-ofeoluwatomi Adesina, David Aaron Behrmann, Sara Ann Collier,Shannon Gregory Cox, Marc E Error, Timothy James Garlow, Shaun Gobind SinghGrewal, Terry Lynn Grigg, Shelbi Renee Hayes, C Lenny Henderson, John MikelHubanks, Andre Paul Marshall, Dustin J McLemore, Lauren Alexandra McQueen-Shadfar, Justin Michael Neff, Kathryn Marie Piercy, Scott Shadfar, Santosh N Shah,Adam Doyle Sharp, Tony William Spatz, Spencer Jay Stanbury, Nicole LorraineTintera, Cydni Nicole Williams, Margaret ZangerOREGONOregon Health & Science University School of Medicine—<strong>Alpha</strong> OregonStudents: Caryn Entine Avery, Daniel Ivan Avery, Erin Nicole Berry-Bibee, PatriciaM Frew, Kristin J Herring, Erick Jacobson-Dunlop, Katie L Lemieux, Jesse Madden,Marc Montanaro, Jarrad Scarlett, Kelly Ann Sweerus, Laura Marie Webb, JessicaAnne YuFaculty: Robert L Potter, Charles Richard ThomasHouse staff: Michelle RoseAnn ShawPENNSYLVANIAJefferson Medical College of Thomas Jefferson University—<strong>Alpha</strong>PennsylvaniaStudents: Eleanor Ruth Ainslie, Christopher Velasquez Almario, Laurence JustinBelin, Stephanie Beth Boswell, Justin Samuel Brandt, Leslie Bryden, Jeffrey Clough,Jennifer Leigh Coats, Vincent Quang Dam, Ranvir Dhillon, Sarah Dickinson, KevinMichael Eanes, Aparna Goel, Craig Thomas Haytmanek, Patricia C Henwood, KariHorowitz, Sadaf Hashim Hussain, Lauren Smith Krill, Doriann Lee Lavery, CynthiaThe Pharos/Winter 2009 69
New membersElizabeth Lee, Amanda Rachel Lerman, Katie Kupfer Lockwood, Theresa Madaline,Rebecca Matro, Alexander Francis Mericli, Leslie Moroz, Jennifer Neuman, LailaNurmohamed, Nicholas J Petruzzi, Joseph Portale, Karl Martin Schweitzer, LauraAnn Snyder, Kristina Stransky, Marguerite Thomer, Scott Howard Troob, Sarah MaryWallett, Jason David Walls, Melissa Ann WilsonFaculty: Katherine Berg, Edward JaegerHouse staff: Alexander Arriaga, Geoffrey Bowers, Eric HagerUniversity of Pennsylvania School of Medicine—Beta PennsylvaniaStudents: Cynthia Marie Adams, Kiona Yasmin Allen, Daria Babushok, AndrewRichard Bond, Robert Scott Fenning, Boris Gershman, Laurie Beth Gray, JamesMatthew Gregory, Amma Hewitt, Lillias Christine Holmes, Daniel EdwardHouseman, Andre Michel Ilbawi, Deborah Jones, Autumn Michelle Kieber-Emmons,John Nicholas Lukens, Landi Marie Parish, Ross Hamilton Parker, Rebecca FrancesRabin-Bloomberg, Alexander Tuukka Ruutiainen, Patricia Marie Salmon, IlanaMichelle Sherer, Peter Bernard Veldman, Jonathan WandererFaculty: Gregg Y LipschikUniversity of Pittsburgh School of Medicine—Gamma PennsylvaniaStudents: Jonathan Bortinger, Shawna Teresa Bouwers, Patrick Joseph Brown,Amanda Banks Christini, Jessica Ellerman, Jesse Fisk, Paul Joseph Hoffman, DouglasJason Hsu, John Robert Klune, Yinchong Erica Mak, Sami Paul Makaroun, NidhiMehta, Christopher Andrew Rippel, Arun Sharma, Gennedy Shiferman, Eveline HShue, Nicholas T Spina, Paul G Tarasi, Joyce Tawfik, Nicole Francesca Velez, Emily KWeber, Alik Widge, Richard Wiley WilliamsonFaculty: Gregory Matthew Bump, Asher Arthur TulskyHouse staff: Niladri Das, Paulraj Samuel, Linwah YipDrexel University College of Medicine—Delta-Zeta PennsylvaniaStudents: Mark Robert Anderson, Farah Awadalla, Katherine Rotondo Baker, RyanCallahan, Maria Syl de la Cruz, Ryan Duffy, Elysia Marie Engelage, Abbey Fingeret,Adam Benjamin Fleit, Rebecca Anne Fox, Sandi-Jo Galati, Lisa Kay Gibson, IsraelGreen-Hopkins, Zachary Scott Hoffer, Adam Holleran, Rebecca Jackson Howell, AmyHyun Kyung Hwang, Kiana Kashef, Linda Keele, Stephanie Keller, Steven HyungminKim, Jessica Hope Klausmeier, Jodi Dara Langer, David Ansley Lawrence, AnnetteMeliza Lopez, Marcelo Malakooti, Abhijith Dev Mally, Ajay Mahesh Manchandia,Jacob Christian Miss, Nikhil Mull, Mona Patel, Steve Pugliese, James Eric Roth,Inderpreet Singh Saini, Pooja Sharma, Kimberly Ann Slininger, Dennis MichaelSopka, Ksenia Stafeeva, Amaal Jilani Starling, Michael Charles Tressler, ByronVaughn, Sarah WoodAlumni: Mary Ann Adler Cohen, Christopher Todd OliviaFaculty: Edward Gracely, Nancy Dollase SpectorHouse staff: Jeffrey Morgan Denney, Jose N Nativi Nicolau, Amy Elizabeth PattishallTemple University School of Medicine—Epsilon PennsylvaniaStudents: Behrad Ben Aynehchi, Roya Azadarmaki, Brian Christopher Barrett,Katharine Theresa Criner, Racher Elaine Davis, Jayanth R Doss, Jonathan B Ford,Michael Joseph Franco, Joshua S Gluck, Janelle Marie Hesse, Janice Elizabeth Hobbs,Shraddha Devendra Jani, Sarah Ann Johnson, Robert James Katzer, Matthew TKleiner, Aiham Chaher Korbage, Kevin John Krauland, Daniel Jeffrey Landsburg,Christine Agnes Martin, Katie Lynn Miro, Melissa Ann Mroz, Michael JosephO’Malley, Alexander Pantelyat, Utpal Patel, Jason Joseph Redon, Katherine NicoleRinaldi, Jonathan C Roberts, Michael Thomas Schweizer, Scott Simonson Short,Timothy P Smith, Stephanie Lynn TessingFaculty: Susan Gersh, Nikitas J ZervanosPennsylvania State University College of Medicine—Eta PennsylvaniaStudents: Justin B Bigger, Erik James Elwood, Christopher David Hanks, Jessica LynnHolzman, Leah Marie Kinlaw, Katherine Louise Maietta, Bradley William Moatz,Maribeth Ruth Morral, David Thomas O’Gurek, William Michael Peterson, NicholasStephen Pierson, Nicole Marie Saddic, Sara Jane Heilig Wasong, Douglas MatthewWisner, Joselyn Lee WozneyPUERTO RICOUniversity of Puerto Rico School of Medicine—<strong>Alpha</strong> Puerto RicoStudents: Juan Carlos Almodovar Mercado, Ana M Montanez Concepcion, OmarCorujo Vazquez, Eneida Maria De La Torre Lugo, Lilliam Diaz Velez, Hermes GabrielGarcia, Arlene E Garcia Soto, Rafael S Garcia-Cortes, Maria C Gonzalez Mayda,Jahzel M Gonzalez Pagan, Tania Maria Gonzalez-Santiago, Luis J Haddock Morales,Nicole Rassi Stella, Carlos Felipe Sanchez-Glanville, Sheila Garcia Santana, Rafael AVicens-RodriguezAlumni: Marcia Roxana Cruz-Correa, Maria Isabel HerranFaculty: Fernando Luis Joglar, Nerian OrtizHouse staff: Jose Guillermo Cabanas Rivera, Hilton Franqui - Rivera, Carlos J RomeroMarreroPonce School of Medicine—Beta Puerto RicoStudents: Yamilka Abreu, Amelia Karen Adcock, Jesse R Aleman Ortiz, Tracy Catlin,Alejandra Matilde del Toro, Cynthia Gonzalez Gonzalez, Tareq Ali Khedir Al-Tiae,Peter Anthony Mennie, Neha Morparia, Cumara O’Carroll, Maria Cristina RuedaRueda Gonzalez, Jennifer Rullan, Taina Aracelis TrevinoAlumni: Joxel GarciaFaculty: Jesus Cruz Correa, Juan B Fernandez-PerezUniversidad Central del Caribe School of Medicine—Gamma Puerto RicoStudents: Michelle M Arrieta Gonzalez, Gustavo Bauza Almonte, Gabriel MarianoCovarrubias, Eduardo J Cruz-Colon, Teresa Garcia, Jordan Michael Glaser, JeanneGissele Guevara, Jesus I Hernandez Rivera, Mireily Rivera-RosadoAlumni: Carlos A Blanco Ramos, Francisco R de TorresFaculty: Ohel Soto-RaicesHouse staff: Jose Antonio Rivera-VallesRHODE ISLANDThe Warren Alpert Medical School of Brown University—<strong>Alpha</strong> RhodeIslandStudents: David Lloyd Ain, Sophia Califano, Christina M Cinelli, Apara Dave, JuliannGaydos-Gabriel, Jonathan Greer, Silvia Hartmann, Elizabeth Naylor, Christina Ronai,Justin Routhier, Joshua Spaete, Gita SunejaAlumni: Griffin P RodgersFaculty: Brian Alverson, Anthony A CaldaoneHouse staff: Brenda Ijeoma Anosike, Samielle Brancato, Elizabeth DufortSOUTH CAROLINAMedical University of South Carolina School of Medicine—<strong>Alpha</strong> SouthCarolinaStudents: David Arrington, Joshua Stephen Black, Devon Eileen Bork, Jason B Coker,Jason Andrew Curry, Virginia Culyer Daughtery, Matthew Garin, Bradley S Kalinsky,Ian D Kane, Amy Ketcham, Peter Jennings King, Carlotta Jenkins Lalich, AndrewRoper Lewis, Meredith Cates Northam, Clarice Marie Seifert, Todd Nathanial Senn,Katherine Culp Silver, Barclay Thompson Stewart, Julie Miller Swick, Benjamin JohnThomas, Zeke Jonathan Walton, John Weathers, Caroline Felder Wooten, MaryShellZaffinoFaculty: Paul Ray Lambert, Stuart Marc LeonHouse staff: John R Barbour, Thomas Slade Dozier, Corey Michael HatfieldUniversity of South Carolin School of Medicine—Beta South CarolinaStudents: Sarah Bailey, Kevin Budman, Franklin Gettys, Bevin Elizabeth Hearn,Christopher James Huffman, Christopher James Huffman, Philip Ross Mason,Rebecca Suzanne Napier, Courtney Riley, Patrick Ware, Krystal Southerlin White,Jesse WoodardAlumni: Ralph N RileyFaculty: Donald J DiPetteHouse staff: Jeremy Michael Byrd, Shanna Bradley HolcombSOUTH DAKOTASanford School of Medicine of the University of South Dakota—<strong>Alpha</strong> SouthDakotaStudents: Nathan Bradley, Sam Joseph Chelmo, Andrew John Gunn, Kassy ArnetteHegge, Emily J Horner, Nathan James Miller, Tara Nikole Miller, Jenny Nelson,Annette L SiewertAlumni: Juliann Reiland-SmithFaculty: Joseph J FanciulloHouse staff: Deshandra M RaidooTENNESSEEVanderbilt University School of Medicine—<strong>Alpha</strong> TennesseeStudents: Jeffrey Martin Albert, India Fox Bayley, Ryan Patrick Bayley, MihaelaHristova Bazalakova, Christopher Bunick, Kevin Meyer Elias, Kirsten Inglee Gibbs,Erin Roxanne Horn, Kathryn Lynn Jongeward, Jonathan Andrew Kropski, DianaCatharine Lemly, Jason Richard Mann, Carrie Campbell McCoy Menser, Mary AliceNading, William Michael Oldham, Rebecca Anne SnyderAlumni: Kevin B Churchwell, Wonder P DrakeFaculty: Derek A Riebau, Charlie B RushHouse staff: Nicole S Carroll, Peter F Crossno, Michele R HensonUniversity of Tennessee Health Science Center, College of Medicine—BetaTennesseeStudents: William David Algea, Kevin Todd Arnold, Reem S Awwad, Joshua BryantByrd, Tyler Austin Cannon, Lauren Roberts Cooper, Evan James Dunn, Kristen LynnHeins Fernandez, Daniel Peter Mazei Fowler, Allison Leigh Gratzer, Jessica Hammett,Jonathan Paul Hayes, Rose Lee Hiner, Julia Amanda Jackson, Emily Hicks Jones,Jack William Lambert, Kerry Allison Lavigne, Michael Paul Lazarowicz, Van KarlyleMorris, Amir Paydar, Matthew Whitby Roberts, William Bradley Rogers, BryanMIchael Sabbe, Bighnesh Satpathy, John Patrick Selph, Paul Albert Tennant, MridulaBagrodia Watt, Jonathan Taylor WhaleyFaculty: Jerome Walter ThompsonHouse staff: Christopher James DiBlasio, Paxton Vandiver Dickson, Kathryn AzeliaProvidenceMeharry Medical College School of Medicine—Gamma TennesseeStudents: Ronald Clinton Atwater, Jeremy Michael Bennett, Irma Fleming, Nam Le,Katrina Andrea Mattingly, Jeremy McDuffie, Kenya Chantel Miles, Natu Mmbaga,70 The Pharos/Winter 2009
Sudha Mogali, Jeremy Nelson, Imelda Odibo, Kwame Okyere-Asante, La-nikquaTrenae Thomas, Prince John Thommen, Fonda Delores WebbAlumni: Nelson L AdamsHouse staff: Olumuyiwa Abolade Esuruoso, Damaris Morenike Olagundoye, KeshaShunte RobertsonEast Tennessee State University James H Quillen College of Medicine—DeltaTennesseeStudents: John William Beddies, Kristin Orr Bresowar, Matthew Melton Cole,Christopher Lewis Cropsey, Jason Allen French, Jennifer Kathryn Jantz, JamesRichard Layton, Samuel Douglas Richesin, Justin Ray Sigmon, Daniel Scott SmithTEXASUniversity of Texas Medical Branch, University of Texas Medical School atGalveston—<strong>Alpha</strong> TexasStudents: Sabrina Akhtar, J’Cinda Bitters, Kristen Boyle, John Phillip Brach, ConnerChan, Andy Leechuan Chen, Harold DelasAlas, Chad David Fairchild, RachelFinehout, Lance Michael Freeman, Clarisa Ysela Garcia, Ashley Group, BarbaraLawson Heil, Kristopher Gray Hooten, Jeffrey John Houlton, Qaali Hussein, Julie EJackson, Jared M Kasper, Katherine Kintner, Lauren Ashley Layer, Rachel Justine Le,Di Lin, Rachel Elizabeth Lindenborn, J Andrew Livingston, Jason K Mann, NeemaNayeb-Hashemi, Donna Nguyen, Abhilasha Jayantilal Patel, Nisha Babu Patel, BrianChristopher Quigley, Adam Richter, Jennifer Schopp, Phillip Guy WortleyFaculty: Frederick Szujuei Huang, Gottumukkala Subba RajuHouse staff: Lindsay Kay Hilbert, Stephen Paul Lester, Juan Diego MartinezBaylor College of Medicine—Beta TexasStudents: Robert McLain Beardsley, Michelle Renee Butler, Leon L Chen, MatthewDavid Driscoll, Samuel Justin Hankins, Joanna Lee Harp, Ashley Margaret Holder,Heidi Hullinger, Andrew Louis Juergens, Christopher Raymond Kauffman, GregoryCharles Lieser, Travis Douglas Lyons, Benjamin Allen McArthur, Ryan ArthurMcConnell, Elizabeth Burns McQuitty, Erica Maria Sehne Munch, Anisha BipinPatel, Ehsan Rahimy, Lauren Allison Raimer-Goodman, Justin Michael Ream,Timothy Kirk Ruttan, Beth Ann Zarnow Scholz, Michael Scott Stewart, Alex DanielSweeney, Livia Van, Sage Parrian Whitmore, Brian Jeremy Williams, Ina Wu,Stephanie Nicole WuestFaculty: Jennifer Elizabeth PateHouse staff: Yuval Raizen, Wendy Lea SmithermanUniversity of Texas Southwestern Medical Center at Dallas, SouthwesternMedical School—Gamma TexasStudents: Steven B Albright, Rebeccah Bradshaw Baucom, Bret D Beavers, BenjaminJacob Brown, Benjamin E Cassell, Christopher P Chaney, Emily E Crozier, LanceEdwin Davis, Jennifer L Duewall, Guy E Efune, Allison Ellzey, Abbie Martha Ewell,Mary A Gajewski, Jason W Gillman, Taylor L Gist, Nakul Gupta, Robert U Hartzler,Joshua Aiden Hill, S Tyler Hollmig, Adam C Jenkins, Wislon Kwong, John ThomasLemm, Sara Stevens Lindsey, Nelson Eddie Liou, Huay-ying Lo, Jordon G Lubahn,Tessa L Manning, Kalpana Manthiram, Alexis Allyson Melton, Jonathan C Mills,Joshua Delbert Mitchell, Proshad Nemati, Chan Nguyen, Nina Nuangchamnong,Andrew Scott Paulson, Amy Alison Pierce, Cason Pierce, Autumn L Pruette, RachnaRai, Isaac See, Michael E Seymour, Lauren V Skaggs, Christina Stine, Tiffany B Sun,Eric Tranvinh, Zachary D Vest, Kendall Walters, Alycia M Wanat, Jonathan MichaelWatts, Marcus Weatherall, Matthew John WhineryFaculty: Robert S Munford, Fiemu E NwariakuHouse staff: Hamed khalili, Allen P Lee, Min Chong YooUniversity of Texas Medical School at Houston—Delta TexasStudents: John H Anderson, Allison D Bollinger, Anthony F Boyer, Vera DrecunCooke, Jennifer B Cowart, Nathan A Davis, Hayley L Epstein, Paul D Evans, OlufenwaJ Famakinwa, Brandice M Graves, Michael C Greaser, Jessica A Hersman, LindseyD Hicks, Robert E Honey, Andreas Kaden, Heather L Klein, Justin A Krajca, ChadM Lonsford, Patrick C Marcin, Heidi L Matus, Leslie R McClanahan, CourtneyJ McCray, Eileen M Merkle, Michael H Moghimi, Emily M Moglovkin, Bryan TPatterson, Martin T Paukert, Jason R Pearce, Lee G Phillips, Olivia B Romano,Thomas M Shary, Justin G Smith, Austen W WorshamAlumni: Lisa Y ArmitigeFaculty: Patricia M Butler, Giuseppe N ColasurdoHouse staff: Yvette S Drake-McLin, Jean I Onwuchekwa, James William SuliburkUniversity of Texas Medical School at San Antonio–Epsilon TexasStudents: Adam Bellinger, Annie Chan, Joshua Adam Delavan, Candice NicoleDubose, Natalie L DuMont, Rachel Aubrey Hassan, Fernando Alejandro Hernandez,Cara Marie Horny, Melissa S Hu, Sara Ann Jackson, Tyler Scott Jorgensen, StephanieAnne Lewis, Kristina Lozano, Tiffany Lee Milner, Aaron Moon, Brett C Norman,Ifeoma Obiageli Onuorah, Elizabeth Anne Osborne, David Schmit, Andrew D Shedd,Seema Sheth, Weiwen Vivian Shih, Shaum Sunder Sridharan, Elizabeth Ventura,Andrew Jon Wall, Stephanie Anne Watson, Brian Weatherford, Jennifer M Welch,Dustin Blake Williams, Christopher Beau Willison, Clarence Joseph Wolinski,Rebekah Helen Wright, Shehnaz Aysha Zaman, Symeon Vasilios ZannikosTexas Tech University Health Sciences Center School of Medicine—ZetaTexasStudents: Steven E Burgess, Hua Chen, Sarah Elizabeth Cooper, Jonathan DanielCrews, Cathryn Anne Doughtie, Jason James Ginos, Theodore E Hackl, BenjaminAaron Hirsch, Allison Lea Hulme, Jennifer Leigh Johnson, Michal Klysik, JosephWilson Magley, Rene Alphonse Mai, Bonnie Marie McCann, James A Muns, KristinaNichole Orey, Malini Patel, Megan Nichole Rivers, Jeremy Matthew Saller, GreggWilliam Schmedes, Tyler Clayton Street, Angel SunAlumni: Lorenz Lutherer, Kellie Flood-ShafferFaculty: Ari HalldorssonHouse staff: Eduardo Rosas Blum, Steven Brooks, Dustin TurnerTexas A&M Health Sciences Center College of Medicine—Eta TexasStudents: Grace Elizabeth Brown, Jessica Lynn Clark, Kristoffer Lee Crawford, DavidJeffrey Crockett, Susan Leigh Greenhut, Darci Janell Hansen, Ronald Paul Hobbs,Slade Alan Hodges, Eric Andrew Lenehan, Brad Alan Onhaizer, David Dung Pham,Connie So, Jonathan Martin WilliamsAlumni: Robert Emmett MyersFaculty: Andrejs Eriks Avots-Avotins, Mohsen ShabahangHouse staff: Marc Elieson, Nicholas Paul Souder, Ethan Joseph WrightUTAHUniversity of Utah School of Medicine—<strong>Alpha</strong> UtahStudents: Sidney Baucom, Jade Bringhurst, Cory Carlston, Stephanie W Chen, RyanC Craner, Ashley Ellsworth, Nathan David Faulkner, Mark S Hansen, Kyle Hobbs,Matthew James Kolek, Evan Kulbacki, Paul Lambert, Jay Jeffrey Meyer, Jeffery Muir,Michelle Regruto, Nicole WildeVERMONTUniversity of Vermont College of Medicine—<strong>Alpha</strong> VermontStudents: Whitney Noelle Casares, Derek Chase, Sara Elizabeth Delaporta, KerrinDePeter, Jonathan Straffin Hall, Colby Halsey, Elizabeth Alden Kreiling Hunt, CarlBehram Kapadia, Caitlin Elizabeth Kennedy, Lee Jae Morse, Shannon Dawn O’Keefe,Gulnar Amin Pothiawala, Anne Pearce Rowland, Danielle Christina Williams,Carolyn Joo Hyun YooFaculty: Christa M ZehleHouse staff: Christopher Michael SullivanVIRGINIAUniversity of Virginia School of Medicine—<strong>Alpha</strong> VirginiaStudents: Andrew Richard Batchelet, Justin Thomas Lloyd Baynham, Daniel KittelleBennett, Jordan Andrew Brewster, David Benjamin Bumpass, Laura ElizabethBurt, Eric Kent Cannon, Peter Nelson Dean, Keiko Iwahara Greenberg, AlexanderTharrington Hawkins, Brian Daniel Hobbs, Mindy Ju, Thomas Christian Keller, BrianJeremy Kipe, Allison Layla Marie Kirk, Laura Ellen Koehn, William Randolph Mook,Jonathan Boyd Parr, Matthew Wall Semler, Brandon John WebbFaculty: Charles McCLaskey FrielHouse staff: R Ramesh SinghVirginia Commonwealth University School of Medicine—Beta VirginiaStudents: Barbara J Adams, Cheryl Elizabeth Anderson, John David Au, JoshuaStephen Butler, Katherine Middleton DePlatchett, Kyle Joseph Eliason, GeorgiaYowell Ferrell, Rebecca Leigh Gibbons, John Edward Greer, Marie Kate Gurka,Katherine Lynn Harding, Tiffany Brock Kelly Helman, Jonathan R Helms, Sara BethHuberman, Heather Melee Katebini, Ashley Brittingham King, Nicholas DavidLahar, David James Mooney, Susan Bich Nguyen, David Sunghan Paik, MichelleLynn Palumbo, Payal S Patel, Michael Fitzgerald Rolen, Brian Michael Showalter,David Falace Smith, Sally Gowen Stander, Hasan Raza Syed, Clare Francisco Wallner,Garrett Douglas WaltersAlumni: Ralph R ClarkFaculty: John D Roberts, Isaac K WoodHouse staff: Claire VanEenwyk Chehrazi, Angela Horton, John Charles KirkhamEastern Virginia Medical School—Gamma VirginiaStudents: Ariane M Abcarian, Daniel J Bebereia, David Michael Callender, Adam PaulChilders, Justin Craig Cohen, Edwin Fulghum Crandley, James Joseph Daniero, BrettM Hesse, Kevin Michael Hibbard, Nathan Andrew Kludt, Ashley N Lock, MatthewJP LoDico, Michele Anne Nedelka, Caroline M Parker, Jessica Lynn Salzman, KristinAnne Stubben, Robert Benjamin SwansonAlumni: Silvina M Bocca, Ralph S NorthamFaculty: CW Gowen, Chee Keen WooHouse staff: Amy Page, Gregory Duncan Rushing, Nicole WatringWASHINGTONUniversity of Washington School of Medicine—<strong>Alpha</strong> WashingtonStudents: Natalia Bajenova, Amaya Marie Basta, Andrew Blackman, Nicole TeresaBleakly, Jennifer Brady, Alson Burke, Rebecca E Curry, Judy McCarty Gayne, BijanJustin Ghassemich, Naomi Kim Gilman, Anna Golob, Gregory Haveman, DerekDean Jackson, Luke Judge, Stacy Kessler, Erich E Koerner, Andrew Kyle Larsen,Jenny Lessner, Karen Livne, Jarod P McAteer, Kinsey McCormick, Crystal MarieThe Pharos/Winter 2009 71
New membersNorth, Andrew P Pace, Callie Nicole Riggin, David Shearer, Ian Slade, Dawn Stanek,Sundrayah N Stoller, Kathryn Treit, Mark P Van Tighem, Jason Van Winkle, SadieWestFaculty: Richard William Arnold, Roger Perry TatumHouse staff: Massimo Arcerito, Basak Coruh, Dinah ThyerleiWEST VIRGINIAWest Virginia University School of Medicine—<strong>Alpha</strong> West VirginiaStudents: Melissa Ann Alleman, Anthony Louis Cacco, Jonathan Michael Christy,Grant Michael Clark, Anna K Donovan, Evan A Dougherty, Gregory Alan Hickey,Natalie P Kreitzer, Lindsay A Kruska, Adam Joseph Lorenzetti, Thomas ChristopherMarshall, Barbara Jean Meade, Elliot Isaac Palmer, Elizabeth Gail Roberts, SarahHelen SofkaFaculty: Hassan H RamadanHouse staff: Tanya Fancy, Nicholas Ryan YoungJoan C Edwards School of Medicine at Marshall University—Beta WestVirginiaStudents: Paul David Fletcher Bailey, Janelle Marie King, Robert Martin Ore, AaronR Parry, Susan K Saunders, Andrew Phillip Stack, Preeti Subhedar, William DavidTerrellFaculty: Patricia Jean Kelly, Dilip NairHouse staff: Hany H Guirgis, Benjamin Lee Moosavi, Matthew Earl SimpsonWISCONSINUniversity of Wisconsin School of Medicine and Public Health—<strong>Alpha</strong>WisconsinStudents: Bamidele Oyebamiji Adeyemo, Jonathan David Barlow, Laura AnnBonneau, Sara Anne Buckman, Elizabeth Nicole Chapman, Bridget StephanieDeLong, Zobeida Margarita Diaz, Milad Hakimbashi, Aric Cameron Hall, KathrynAnne Hammes, Benjamin Joseph Heinzen, Jaime L Hook, Adam Owens Kadlec,Marcie Ann Navratil, Emily Diana Kerins Ruedinger, Neil Sandhu, William RobertSchmitt, Shannon Marie Straszewski, Kim Mary Strupp, Kathryn Therese SullivanDillie, Kyle Ian Swanson, Ryan H Sydnor, Abigail Marie TokheimMedical College of Wisconsin—Beta WisconsinStudents: Jill Marie Arganbright, Mark Richard Beahm, Lisa M Benz, Carmen ReneeBergom, Timothy John Berkseth, Kyle Matthew Blake, Michael Blair Bradshaw, BeretAnn Casey, Jeff Chang, Maria Anna Delgado, Mary Patricia Eldridge, Colby ScottEngar, Benjamin Lange Garvey, Gwen Marie Grimsby, Ethan Benjamin Handler,Genevieve A Henry, Andrew George Keenan, Jessica Layne Lambert, Joyce Ying Lin,Gregory Leo McHugh, Anne Catherine Melzer, Donna Mae Bartyzal Miller, DonaldAlan Neff, Christine M Palmer, Payal S Potnis, Benjamin Carl Ringger, StephanieLeigh Siehr, Takashi Takahashi, Norman Earl Taylor, Matthew Raymond Vernon,Christopher Edward WeberFaculty: Julian H Lombard, James J NoctonHouse staff: Jill M Bader, Prem Anand KandiahStudents 2607Alumni 100Faculty 166House staff 219Total new members 3113this is what you feel you mustwhen the minutes open up like crackled skin,blank spaces to fill, the rows of doorsdown the long gray halls of hospital wingsspread sheetlike across your days, your futureand you resist reality with all you’ve gotleft, which is nothing perfectnothing is perfect, never wasyou’re leaning now in that directionPalliativeswhen you stop nibbling off plastic traysturn off the IVs, spit pill after pillscowl at all in white, blue scrubssoft-sole shoes that squeak in the nightthe dimming drone of respirators and tvsSpanish soap operas, courtroom catfightsthe blare of emergency room melodramaswith sutured endings, benign little plot twistswhere others’ stories unfold as scriptseveryone swallows and enjoys but yourefuse to abide by the popular soundtracksuckling your Saltines between gum soresaspirating your way down the road less taken,cluttered with the bones of your ancestorsthis is how you fade awayyour filament shivers, quivering outno longer do you wish to cast a shadownor scratch any surface, nor leave any scarsVirginia AronsonErica Aitken72Ms. Aronson lives in Florida. Her e-mail address is: VAcelstia@aol.com.
My Eye DoctorToday my ophthalmologist, who has been happily married toanotherwoman for a decade, looked more deeply into my eyesthan any of my lovers has ever looked.First, he oiled the keyhole of my eyeuntil it grew so largethat he could tumble right through it. He landed—plop!—in one of the trapdoored cellars of my face.Then, armed with candlestickand with monocle,he scrutinized that chamber’s contentsuntil my retina burnedmore hotly than the proverbial virgin’sblushing face. Laid bare for him to seewere the diaphanous garmentsworn by my sylphlike blood,the trailing translucent gownswhose trains lay all tangled togetherin a nexus of scarlet threads. And he saw the alabastercup and saucer from which I sippedPerception, and he approved their shape and size.—Today, I said, my ophthalmologistlooked in my eyes more deeply than any lover.But, unlike a lover, he looked in them one-by-one,just as a shrewd prison-guard wouldseparate two prisonerswhom he suspected of being in cahootsso that he could interrogate them more fruitfully.And if you’d asked him later that morning,after he’d stared into my eyes so long and hard,“Can you recall what color those eyes were, orwhat expression was in them?” he’d have been unable.His motivations were nobler than love, and much more stable.Jenna LeMs. Le is a member of the Class of 2010 at Columbia University College ofPhysicians and Surgeons. This poem won first prize in the 2008 Pharos PoetryCompetition. Ms. Le’s address is: 630 W. 168th Street, P&S Mailbox #418, New York,New York 10032. E-mail: jnl2105@columbia.edu.
Breaking Good NewsI have good news:The white spot is fading.I know what you have,And it’s not what I thought.It’s not a cancer,It’s not a clot.A spot of pneumonia,Is what you’ve got.You look surprised,Well, so am I.Ask some questions,Before we move on.More good news:You’ve lost five pounds,And your rash is gone.I checked your cholesterol,And it’s way down.There’s more:The smokes in your pocket,Haven’t burned you. Yet.Dean Gianakos, MDDr. Gianakos is associate director of theLynchburg Family Medicine Residency, and a memberof the editorial board of The Pharos. His addressis: Lynchburg Family Medicine Residency, 2097Langhorne Road, Lynchburg, Virginia 24501. E-mail:deangianakos@yahoo.com.
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