Alpha Omega Alpha Honor Medical Society Autumn 2016
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Alpha Omega Alpha Honor Medical Society Autumn 2016 THE PHAROS of Alpha Omega Alpha honor medical society AUTUMN 2016 Alpha Omega Alpha Honor Medical Society “Be Worthy to Serve the Suffering” Founded by William W. Root in 1902 Editor Richard L. Byyny, MD Officers and Directors at Large Robert G. Atnip, MD President Managing Editor Dee Martinez Hershey, Pennsylvania Joseph W. Stubbs, MD Art Director and Illustrator Jim M’Guinness President-Elect Albany, Georgia Designer Erica Aitken Douglas S. Paauw, MD Immediate Past President Seattle, Washington Wiley Souba, Jr., MD, DSc, MBA Editorial Board Secretary-Treasurer Hanover, New Hampshire Jeremiah A. Barondess, MD James G. Gamble, MD, PhD Philip A. Mackowiak, MD Eve J. Higginbotham, SM, MD New York, New York Stanford, California Baltimore, Maryland Philadelphia, Pennsylvania David A. Bennahum, MD Dean G. Gianakos, MD Ashley Mann, MD Holly J. Humphrey, MD Albuquerque, New Mexico Lynchburg, Virginia Kansas City, Kansas Chicago, Illinois John A. Benson, Jr., MD Jean D. Gray, MD J. Joseph Marr, MD Richard B. Gunderman, MD, PhD Portland, Oregon Halifax, Nova Scotia Broomfield, Colorado Indianapolis, Indiana Richard Bronson, MD Lara Hazelton, MD Aaron McGuffin, MD Stony Brook, New York Halifax, Nova Scotia Huntington, West Virginia Sheryl Pfeil, MD Columbus, Ohio John C.M. Brust, MD David B. Hellmann, MD Stephen J. McPhee, MD New York, New York Baltimore, Maryland San Francisco, California Alan G. Robinson, MD Los Angeles, California Charles S. Bryan, MD Pascal James Imperato, MD Janice Townley Moore Columbia, South Carolina Brooklyn, New York Young Harris, Georgia John Tooker, MD, MBA Philadelphia, Pennsylvania Robert A. Chase, MD Therese Jones, PhD Francis A. Neelon, MD Peterborough, New Hampshire Aurora, Colorado Durham, North Carolina Steven A. Wartman, MD, PhD Washington, DC Lynn M. Cleary, MD John A. Kastor, MD John S. Sergent, MD Syacuse, New York Baltimore, Maryland Nashville, Tennessee Medical Organization Director Fredric L. Coe, MD Henry Langhorne, MD Clement B. Sledge, MD Griffin P. Rodgers, MD, MBA Chicago, Illinois Pensacola, Florida Marblehead, Massachussetts National Institute of Diabetes and Digestive and Jack Coulehan, MD Jenna Le, MD Jan van Eys, PhD, MD Kidney Diseases, National Institutes of Health Stony Brook, New York New York, New York Nashville, Tennessee Bethesda, Maryland Lawrence L. Faltz, MD Michael D. Lockshin, MD Abraham Verghese, MD, DSc (Hon.) Larchmont, New York New York, New York Stanford, California Councilor Directors Joseph J. Fins, MD Jerome Lowenstein, MD Steven A. Wartman, MD, PhD Regina Gandour-Edwards, MD New York, New York New York, New York Washington, DC University of California Davis School of Faith T. Fitzgerald, MD Kenneth M. Ludmerer, MD David Watts, MD Medicine Sacramento, California St. Louis, Missouri Mill Valley, California Charles Griffith III, MD, MSPH Daniel Foster, MD C. Ronald Mackenzie, MD Gerald Weissmann, MD University of Kentucky College of Medicine Dallas, Texas New York, New York New York, New York Mark J. Mendelsohn, MD Lester D. Friedman, PhD University of Virginia School of Medicine Geneva, New York Coordinator, Residency Initiatives Suzann Pershing, MD www.alphaomegaalpha.org Stanford University Student Directors Jeremy T. Bolin Manuscripts being prepared for The Pharos should be typed double-spaced and conform to the format outlined Uniformed Services University of the Health in the manuscript submission guidelines appearing on our website: www.alphaomegaalpha.org/contributors.html. Sciences F. Edward Hébert School of Medicine Editorial material should be sent to Richard L. Byyny, MD, Editor, The Pharos, 525 Middlefield Road, Suite 130, Richard Latuska, MD Menlo Park, California 94025. E-mail: [email protected]. Vanderbilt University School of Medicine Requests for reprints of individual articles should be forwarded directly to the authors. The Pharos of Alpha Omega Alpha Honor Medical Society (ISSN 0031-7179) is published quarterly by Alpha Laura Tisch, MD Omega Alpha Honor Medical Society, 525 Middlefield Road, Suite 130, Menlo Park, California 94025, and printed Medical College of Wisconsin by The Ovid Bell Press, Inc., Fulton, Missouri 65251. Periodicals postage paid at the post office at Menlo Park, California, and at additional mailing offices. Copyright © 2016, by Alpha Omega Alpha Honor Medical Society. Administrative Office The contents of The Pharos can only be reproduced with the written permission of the editor or managing editor. Richard L. Byyny, MD (ISSN 0031-7179). Executive Director Circulation information: The Pharos is sent to all dues-paying members of Alpha Omega Alpha at no additional Menlo Park, California cost. All correspondence relating to circulation should be directed to Ms. Dee Martinez, 525 Middlefield Road, Suite 130, Menlo Park, California 94025. E-mail: [email protected]. 525 Middlefield Road, Suite 130 Menlo Park, California 94025 POSTMASTER: Change service requested: Alpha Omega Alpha Honor Medical Society, 525 Middlefield Telephone: (650) 329-0291 Road, Suite 130, Fax: (650) 329-1618 Menlo Park, CA 94025. E-mail: [email protected] 2 Editorial I Information and cognitive overload: How much is too much? Richard L. Byyny, MD, FACP 8 Managing mission tensions in academic health centers Page S. Morahan, PhD; Sharon L. Newbill, PhD; Diane Magrane, MD; Sally Shumaker, PhD; Douglas Easterling, PhD; Aleya A. Lyn, MS; Deborah Helitzer, ScD; Gina Cardinali, MSW; Shine Chang, PhD 14 The 20th General Hospital: The reach of formalized medicine during World War II Christopher Magoon 22 History of present illness Liat Bird 26 The slavery hypertension hypothesis: A flawed explanation for its prevalence in African-Americans James Comotto 31 Radiation therapy, circa 1930 Lee Passarella, PhD 32 Speaking for a world at war: John McCrae, physician, soldier, poet Terrence Montague, CM, CD, MD 39 Floaters Clemens Schoenebeck 40 Shakespearean syphilis: An aggressive disease in evolution Autumn 2016 Autumn Gregory W. Rutecki, MD • 47 Medicine in the movies: Room Amy Haddad, PhD 49 Reviews and reflections 54 Letters to the editor 56 National and Chapter news Volume 79 4 Number Volume • Correction In “Excerpts from Dr. Atnip’s opening remarks,” Summer 2016, p. 59, the first sentence of the sixth paragraph should have read, “On a recent afternoon, his necrotic surgical The Pharos leg wound eroded into his bypass graft and he began to hemorrhage massively.” IN THIS ISSUE Information and cognitive overload How much is too much? Richard L. Byyny, MD e are in an age of information overload. The A 2012 survey found that average workers spend 28% Internet, e-mails, apps, spam, tweets, social of their time managing e-mail,1 and a British study found media, texting, Facebook, Instagram, memes, we check our phones on average 221 times a day, or Wnews feeds, online videos, updates, and myriad other about every 4.3 minutes.2 A Stanford University School of forms of information have significantly increased the Medicine team found that nearly one in eight Americans information directed at us, as well as those in which we exhibit problematic Internet use.3 request to participate. In 2009, 50 billion e-mails were sent each day. In 2010, We have come to regard this overload of information, that number rose to 294 billion e-mails per day. and brain drain, as the norm. We accept this inundation Social norms have introduced a presumed require- as communication, learning, practice, performance, social ment to participate, and collaborate, in every message we and professional interaction, and decision-making, without receive. In contrast to the continuous growth in technol- ever considering our well-being, productivity, and sanity. ogy and information, our human capabilities are limited. Illustrations (except for p. 4) by Jim M’Guinness. 2 The Pharos/Summer 2016 2 The Pharos/Autumn 2016 Our neurons don’t increase in numbers, nor do they and substantiated. Many so-called respond more quickly to this overdose of information. Our experts are more interested in serv- memory does not increase in capacity. We do not learn or ing their own egos, and enhanc- think faster, and this mismatch creates, contributes to, and ing their reputations than actually causes information, participation, and collaboration over- providing valuable information and load. The effort required to keep track of, and participate knowledge. Unfortunately, based on in, what is going on professionally, with family and friends, their biases, they presume that they and in the world requires an ever-increasing amount of know what we should know, and attention and time. think they know better than we know f o r We are continuously distracted from important priori- ourselves. ties—thinking, learning, reflecting, decision-making. The From a social perspective, this is compounded by a herd presentation of information has become an insidious influ- mentality that can characterize and influence the story and ence in the loss of our intellectual independence. We are information over time. As a society, we have come to let bombarded with jibber-jabber, rumor, and opinions that people we don’t know, and who are not always qualified, to are often biased with inaccurate or false information. decide what we need to know and when we need to know In the days of Walter Cronkite, there were only a few it. This creates an unintended consequence of impeding sources of information, and each had important filters — knowledge and learning. journalistic