PHAROS of ALPHA OMEGA ALPHA HONOR MEDICAL SOCIETY Winter 2009 the PHAROS of Alpha Omega Alpha Honor Medical Society Winter 2009

THE PHAROS OF ALPHA OMEGA ALPHA HONOR MEDICAL SOCIETY Winter 2009 THE PHAROS of Alpha Omega Alpha honor medical society Winter 2009

´"YJP7XKFMF ´ ˆJOUPV7` BMHP´ VOUB7ˆ Alpha Omega Alpha Honor Medical Society “Worthy to Serve the Suffering” Founded by William W. Root in 1902

Officers and Directors at Large Editor: Edward D. Harris, Jr., MD Rae-Ellen W. Kavey, MD Editor Emeritus: Robert J. Glaser, MD President Associate Editor and Managing Editor Bethesda, Maryland (in memoriam) Edward D. Harris, Jr., MD Helen H. Glaser, MD Executive Secretary Menlo Park, California Managing Editor Art Director and Illustrator Donald E. Wilson, MD Debra M. Lancaster Jim M’Guinness Vice President Baltimore, Maryland Administrator Designer Ann Hill Erica Aitken C. Bruce Alexander, MD Secretary-Treasurer Birmingham, Alabama Robert G. Atnip, MD Editorial Board Hersey, Pennsylvania N. Joseph Espat, MD Jeremiah A. Barondess, MD Lawrence L. Faltz, MD Eric Pfeiffer, MD Providence, Rhode Island New York, New York Sleepy Hollow, New York Tampa, Florida David A. Bennahum, MD Faith T. Fitzgerald, MD Richard C. Reynolds, MD Ruth-Marie Fincher, MD Albuquerque, New Mexico Sacramento, California Gainesville, Florida Augusta, Georgia John A. Benson, Jr., MD Daniel Foster, MD William M. Rogoway, MD Douglas S. Paauw, MD Omaha, Nebraska Stanford, California Dallas, Texas Seattle, Washington Gert H. Brieger, MD James G. Gamble, MD, PhD Shaun V. Ruddy, MD Baltimore, Maryland Stanford, California Richmond, Virginia Don W. Powell, MD Richard Bronson, MD Dean G. Gianakos, MD Bonnie Salomon, MD Galveston, Texas Stony Brook, New York Lynchburg, Virginia Deerfield, Illinois John C.M. Brust, MD Jean D. Gray, MD John S. Sergent, MD Joseph W. Stubbs, MD New York, New York Halifax, Nova Scotia Nashville, Tennessee Albany, Georgia Audrey Shafer, MD Charles S. Bryan, MD David B. Hellmann, MD Medical Organization Director Columbia, South Carolina Baltimore, MD Stanford, California Marjorie S. Sirridge, MD Robert A. Chase, MD Pascal James Imperato, MD John Tooker, MD, MBA Kansas City, Missouri Stanford, California, and Brooklyn, New York American College of Physicians Jaffrey, New Hampshire Clement B. Sledge, MD Elizabeth B. Lamont, MD Marblehead, Massachussetts Henry M. Claman, MD Chicago, Illinois Councilor Directors Denver, Colorado Jan van Eys, Ph.D., MD Kenneth M. Ludmerer, MD Nashville, Tennessee Eric P. Gall, MD, MACP, MACR Fredric L. Coe, MD St. Louis, Missouri Chicago, Illinois Abraham Verghese, MD, DSc Chicago Medical School at Rosalind James B.D. Mark, MD (Hon.) Franklin University of Medicine Jack Coulehan, MD Stanford, California Stanford, California and Science Stony Brook, New York J.Joseph Marr , MD Steven A. Wartman, MD, PhD Chicago, Illinois Ralph Crawshaw, MD Broomfield, Colorado Washington, DC Portland, Oregon Stephen J. McPhee, MD Gerald Weissmann, MD Amy Goldberg, MD Peter E. Dans, MD San Francisco, California New York, New York Temple University School of Medicine Baltimore, Maryland Robert H. Moser, MD David Watts, MD Philadelphia, Pennsylvania Scott K. Epstein, MD Madera Reserve, Arizona Mill Valley, California Boston, Massachussetts Edmund D. Pellegrino, MD Anne Mancino, MD Washington, DC University of Arkansas School of Medicine Little Rock, Arkansas

Student Directors Natalia Berry Dartmouth Medical School Manuscripts being prepared for The Pharos should be typed double-spaced, submitted in triplicate, and conform to the format outlined in the manuscript submission guidelines appearing on our website: www.alphaomegaalpha.org. They are also available Kara Maria Cavuoto from The Pharos office. Editorial material should be sent to Edward D. Harris, Jr., MD, Editor, The Pharos, 525 Middlefield Road, University of Miami Suite 130, Menlo Park, California 94025. Cason Pierce Requests for reprints of individual articles should be forwarded directly to the authors. University of Texas Southwestern Medical The Pharos of Alpha Omega Alpha Honor Medical Society (ISSN 0031-7179) is published quarterly by Alpha Omega Alpha Honor School Medical Society, 525 Middlefield Road, Suite 130, Menlo Park, California 94025, and printed 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 Administrative Office © 2009, by Alpha Omega Alpha Honor Medical Society. The contents of The Pharos can only be reproduced with the written 525 Middlefield Road, Suite 130 permission of the editor. (ISSN 0031-7179) Menlo Park, California 94025 Circulation information: The Pharos is sent to all dues-paying members of Alpha Omega Alpha at no additional cost. All correspondence Telephone: (650) 329-0291 relating to circulation should be directed to Ms. Mara Celebi, Webmaster, 525 Middlefield Road, Suite 130, Menlo Park, California 94025. E-mail: Fax: (650) 329-1618 [email protected] E-mail: [email protected] POSTMASTER: Change service requested: Alpha Omega Alpha Honor Medical Society, Post Office Box 2147, Menlo Park, CA 94026. www.alphaomegaalpha.org Editorial The dreaded burnout

David P. Hill Edward D. Harris, Jr., MD

Two words: poverty and depression. They are personal What causes the despair that can lead to full depression disasters. Poverty is easier to recognize and treat than is de- and suicidal ideation or suicide among medical students? One pression. Recall the agonizing account of George Hurstwood study published in the Annals of Internal Medicine in  in Theodore Dreiser’s novel, Sister Carrie, whose descent by Liselotte Dyrbe and her colleagues attempts to relate the from manager to tramp defines poverty with incisive detail. prevalence of suicidal ideation in medical students and its re- Alleviating poverty usually entails providing resources, such lationship to burnout, demographic characteristics, and qual- as money. Depression, in contrast, is a black hole separating ity of life.2 Using the evidence that suicidal ideation is a direct one from life. John le Carré, in A Most Wanted Man, describes precursor of a suicide attempt, they found a direct relationship the feelings of a man standing in the Ernst Barlach museum, between suicidality and burnout, and a strong dose-response viewing sculptures of mythic figures not easy to view: “each relationship between burnout and suicidal ideation during the figure was as alone as he was, and . . . each was communicat- subsequent year. ing something; but nobody was listening, each was searching But what is “burnout”? The investigators defined the do- for a solace that was not available.” That is depression. mains of burnout as: Do you remember your years as a medical student? Oh sure, t FNPUJPOBMFYIBVTUJPO there was stress—the oral exam in biochemistry, falling asleep t EFQFSTPOBMJ[BUJPO trying to really understand renal clearance, suffering the arro- t MPXTFOTFPGQFSTPOBMBDDPNQMJTINFOU gance of residents. But balancing and trumping those traumatic Within the group of  students meeting the criteria for times were the camaraderie of your classmates, the pizza and burnout, twenty-seven percent were no longer burned out at beer that appeared late Friday afternoons, and the glimmering one year follow-up. They had recovered! This group of “recov- crescendo of certainty that when these trials were behind you, ereds” were less likely than students with “chronic burnout” a career in the most respected of professions would be yours. to report suicidal ideation in the subsequent year (. versus There was idealism, too, although cynicism eroded away much .). Burnout among medical students, then, can be revers- of what you had brought to medical school. ible! The authors make logical recommendations: Is it not confounding and perplexing, then, to read that . Require medical schools to have systems in place to among medical students, depression occurs in fifteen to thirty identify currently suicidal students percent, three times higher than the rate of depression in ei- . Identify students with burnout—those at high risk for ther the general population or in age-matched peers? What is suicidal ideation medical education doing wrong? Or does this imply a link of a . Implement “student support and wellness programs [to] depressive trait to aptitude for science and a caring nature? optimize the learning environment, the organization of clini- Heather Finlay-Morreale was, as you were, in a bedeviled cal rotations, and the diversity of clinical experiences.” 2p340 but balanced and accepting state of mind before her classmate, Could AΩA chapters help with these interventions? On Mike, in the first year of medical school, committed suicide. one hand, our students are not equipped to help with therapy This was not an impulsive act on his part in the midst of a self- of students with suicidal ideation, nor can we expect AΩA to limited crisis. He chose to die by carbon monoxide inhalation, have a significant impact upon curricular reform. What AΩA a method that requires step-by-step planning. Ms. Finlay- can do is to organize mentoring programs for fellow students. Morreale wrote about the impact of his death upon her in Mentoring is contact of one to another that is not teaching, her essay, “And then there were eight,” for which she received not therapy, not role modeling. It is taking the hand of and second prize in the  AΩA Helen H. Glaser Student Essay guiding someone through the treacherous waters that the Competition. Her essay was published in the Winter  mentor has already navigated successfully. AΩA is the national issue (pp. –). Her review of the literature found that only honor medical society recognizing scholarly achievement, but forty-two percent of medical students with suicidal ideation providing service to others can be a greater reward than the asked for help. Reasons for not seeking help included fears of AΩA key and certificate. documentation on academic records, of unwanted interven- tion, and of lack of confidentiality. She found encouragement References in recent efforts, including a consensus statement published . Center C, Davis M, Detre T, et al. Contronting depression and in JAMA, to set up systems that recommend specific inter- suicide in physicians: A consensus statement. JAMA ; : . ventions to reduce physician suicide.1 These steps to cure, . Dyrbe LN, Thomas MR, Massie FS, et al. Burnout and sui- however, do not address causality. For Heather, the question cidal ideation among U.S. medical students. Ann Int Med ; remains: Why? Why? Why? : –.

The Pharos/Winter 2009 1 The Pharos • Volume 72 Number 1 • Winter 2009 In This Issue

ARTICLES

Judah Folkman, MD (1933–2008) DEPARTMENTS David G. Nathan, MD, and Michael A. Gimbrone, MD Editorial 1 The dreaded burnout Edward D. Harris, Jr., MD 4 The physician at the 42 movies Peter E. Dans, MD Stagecoach The Horse Soldiers Be still, my (irregularly) beating heart Reviews and reflections Mark D. Lo, MD 47 When the Air Hits Your Brain: Tales from Neurosurgery Reviewed by Michael Egnor, MD Patient Listening: A Doctor’s Guide 10 Reviewed by Frederic W. Platt, MD Henderson’s Equation Reviewed by Jay Baruch, MD Samuel Johnson and I 54 Letters Leon Morgenstern, MD, FACS 14 AΩA NEWS

2008 Alpha Omega 52 Alpha Robert J. Glaser Distinguished Teacher Page 14 Awards Page 10 National and chapter 60 news Winners of the 2008 Pharos Editor’s Prize Announcing the 2009 Pharos Editor’s Prize Instructions for Pharos authors Leaders in American Medicine

Alpha Omega Alpha 64 members elected in 2007/2008 On the cover Illustration of a removal of a breast tumor by Seishu Hanaoka from Geka Kihai In This Issue (1851) a treatrise by one of Hanaoka’s students, Keishu Kamata. Image courtesy of Wellcome Images, London. See page 35

Isabella James Reilly, MD

POETRY 18 Extracorporeal Membrane 9 Oxygenation (ECMO) Sarah Cross, MD

Maternal mortality and world history: Do Old Men Dream? The case of Princess Charlotte of Wales 13 Eric Pfeiffer, MD Roy Macbeth Pitkin, MD Nursing Home Villanelle 21 Bonnie Salomon, MD Bridge 21 41 Radhika Sreeraman What Kind of Guy? 58 Richard Bronson, MD Shut Up Seishu Hanaoka, surgery, and Melvyn H. Schreiber, MD anesthesia in feudal Japan 59 Don K. Nakayama, MD Welcome to AΩA 63Daniel V. Schidlow, MD Palliatives 35 72Virginia Aronson Inside Back My Eye Doctor 00Cover Jenna Le

Back Breaking Good News Cover0 Dean Gianakos, MD Page 35

Page 18 Photo courtesy of the authors. 4 The Pharos/Winter 2009 Judah Folkman, MD 1933–2008

David G. Nathan, MD, and Michael A. Gimbrone, MD

Dr. Nathan is President Emeritus of the Dana-Farber At Ohio State University, Folkman came to the attention Cancer Institute, Physician-in-Chief Emeritus of Children’s of Dr. Robert M. Zollinger, Sr., a pioneering surgeon who Hospital in Boston, and the Robert A. Stranahan became his early mentor. That relationship profoundly influ- Distinguished Professor of Pediatrics and Professor of enced Folkman’s career, further forging his nascent interest Medicine at Harvard Medical School. His recent book, The in surgery and inspiring him to take his medical education at Cancer Treatment Revolution, was reviewed in the Summer Harvard, Zollinger’s alma mater. That decision conferred a 2008 issue. huge benefit on Harvard Medical School, Boston Children’s Dr. Gimbrone is the Ramzi S. Cotran Professor of Hospital, and the entire field of cancer research. Pathology at Harvard Medical School and the Chairman of the Department of Pathology and Director of the Center for Excellence in Vascular Biology at Brigham and Women’s Hospital in Boston. He was the first postdoctoral fellow in From the dog lab to the Folkman laboratory at the Children’s Hospital, Boston, from 1971 to 1972, and remained a lifelong colleague and medical school friend of Judah Folkman.

he sudden catastrophe that stopped the heart of Folkman was a precocious medical student who im- Judah Folkman on January , , robbed his fam- mediately caught the eye of Dr. Robert Gross, the master ily of a loving husband, father, and grandfather, and pediatric surgeon at Children’s Hospital and a man armed prematurelyT terminated the career of one of the world’s most with a sure taste for talent. Gross invited him into his dog productive physician- scientists and leaders in modern aca- surgery laboratory where incredibly daring and creative new demic medicine. surgical procedures to correct congenital heart defects were Moses Judah Folkman was indeed a remarkable man. being devised. Folkman thrived in that environment, gradu- Gifted with a keen intellect, engaging personality, and ated magna cum laude from Harvard Medical School in genuine humanity, his creativity and energy were seemingly the class of  (and was elected to AΩA in the same year), boundless. Brought up in a highly religious Jewish family, he and went on to become an intern and resident in Surgery at was a source of intellectual ferment from early childhood. the Massachusetts General Hospital. The surgical service at Like the elephant child in Kipling’s Just So Stories, Judah MGH was then a fabled place. It was dominated by surgeons Folkman had “ ’satiable curiosity.” He combined his bound- of the quality of Richard and William Sweet, Oliver Cope, less determination to find answers to difficult questions with Edward Churchill, Robert Linton, Claude Welch, Arthur a devotion to the betterment of the human condition. The Allen, Marshall Bartlett, John Burke, and many others. In result was his early decision to become a physician and sur- that rarified environment, Folkman performed exceptionally geon. well, but in , after his senior residency, he was forced to

The Pharos/Winter 2009 5 Judah Folkman, MD

interrupt his training to answer the call to compulsory mili- diseases, and point the way to novel strategies for their treat- tary service. ment. Intrigued by the apparent abundance of blood vessels Before he took up his Navy commission, Folkman made he encountered during his attempts at surgical resection of the smartest decision of his entire life. He proposed to Paula tumors in the operating room, he became fascinated by the Prial, a Wellesley graduate with a beautiful character, vis- basic question of how tumor blood vessels grow, a problem age, and voice. Paula was accustomed to the medical life to which he productively devote his creative energies for the because she was the daughter of a physician in Fall River, rest of his life. Massachusetts. They were married for less than a month Though Folkman was content with his clinical and re- before they loaded a small trailer with their possessions and search activities at Boston City Hospital, a seismic event headed for basic training and then Folkman’s assignment at was about to occur across town at the Children’s Hospital. the National Naval Medical Center in Bethesda. Robert Gross, Folkman’s medical student mentor, decided The salutary role of the major military hospitals and the to retire, and an ad hoc committee to select a successor to National Institutes of Health intramural program in the that giant of pediatric surgery was established. To the aston- development of modern academic medicine cannot be over- ishment of many, the committee, vociferously urged on by stated. The Korean and Vietnam wars had many unintended cancer researcher Sidney Farber, selected Judah Folkman. consequences, most of them very negative, but the “doctor After a six-month special fellowship in pediatric surgery un- draft” that gave the opportunity for some of the very best der the watchful eye of Dr. C. Everett Koop at the Children’s young physicians and surgeons to be awarded Public Health Hospital of Philadelphia, Folkman returned to the Boston Service commissions and work in those excellent and well Children’s Hospital to assume his new leadership position as equipped institutions provided a level of scientific training its surgeon-in-chief in  at the remarkably young age of that for three decades fostered the careers of a new breed thirty-five. of physician- scientists. Many of the advances in academic Soon after the wunderkind arrived, those who were medicine in the United States are owed to that draft. amazed at the selection began to understand its wisdom. Indeed, Folkman’s posting to the National Naval Folkman was a competent and careful surgeon, but his clini- Medical Center at Bethesda laid the foundation of his fu- cal forte was differential diagnosis and, above all, teaching. ture career. There he joined a cadre of like-minded young Crowds of students and residents surrounded him on rounds physician- scientists and began initial studies of the behavior because he could combine modern biology with clinical of tumor cells outside of the body, in the novel context of practice in a fashion equaled by none. His choice of descrip- isolated perfused organs. Along the way, he investigated the tive words was unique. He invented the term “chronophage” semipermeable characteristics of silastic tubing, an inquiry on one of those rounds to describe administrators and rule that directly led to an efficient contraceptive device for use in makers who find countless ways to consume the time of the underdeveloped world. clinical investigators and rob them of the moments they need with their patients and in the lab. His devotion to patients and families was exemplary, and his respect for the opinions Constantly of colleagues palpable. Despite the considerable burden of his new leadership role, he remained devoted to his mission imagining, creating, as a physician- scientist and redoubled his research efforts in coalescing thoughts the laboratory focusing on the phenomenon of tumor blood vessel growth.

Upon completion of military service, Folkman returned to the Massachusetts General Hospital to serve as chief Tumor cells need resident in Surgery, an exalted post. Realizing that he would blood vessels have to leave the womb of the MGH to achieve indepen- dence, he then took his first faculty position as an assistant for growth professor of Surgery on the Harvard Surgical Service at the then Boston City Hospital. There, in , in a tiny laboratory in the basement of the Sears Surgical Building, he be- But the early going on the research front was challeng- gan in earnest his career-long study of tumor blood vessels ing. Folkman’s initial formulation of the tumor angiogenesis that would ultimately open up a new field in the biomedical hypothesis consisted of three basic components: sciences—angiogenesis—and, in the process, permanently . Tumor growth per se is critically dependent upon the transform our thinking about the biology of cancer and other ingrowth of newly formed blood vessels from surrounding

6 The Pharos/Winter 2009 host tissues. The Folkman laboratory then went on to establish a num- . This is an active, not a passive process, mediated by ber of very creative bioassays for observing and quantifying the production of tumor angiogenic factors (TAF’s) by the the angiogenic process: the corneal micropocket neovas- malignant cancer cells. cularization assay, the chick egg chorioallontoic membrane . The inhibition of tumor angiogenesis— assay (with Robert Auerbach), and ultimately the culture of antiangiogenesis—could arrest the progressive growth of tu- capillary endothelial cells in vitro (with Bruce Zetter and mors, representing a novel strategy for cancer therapy. Christian Haudenschild). Each of these advances brought This hypothesis, first published in the New England new insights into the biology of the angiogenic process, Journal of Medicine in , and now widely considered as well as the challenge of bioassaying putative pro- and “transformative,” “brilliant,” “visionary,” and “prescient,” was antiangiogenic factors. Moving from initial experiments initially met with considerable criticism and outright skepti- with crude tumor extracts to the isolation and purification cism by the cancer research establishment. Indeed, the ap- (collaboratively with Yuen Shing and Michael Klagsbrun in parent hypervascularity of tumors had long been attributed ) of the first tumor-cell-derived angiogenic stimulator, to a reactive process of inflammation in the surrounding basic fibroblast growth factor (bFGF), the Folkman group tissues, and the primary target of “curative” therapeutic ap- established the second tenet of the original tumor angio- proaches—toxic chemotherapies, ablation by radiation, and genesis hypothesis. In parallel fashion, his team described surgical excision—was the malignant cancer cell population, the existence of a variety of naturally occurring substances not the benign vasculature. Angiogenesis as a process was with antiangiogenic activities, such as the fungal antibiotic thought to be limited to the formation of new blood vessels fumagillin (with Donald Ingber), angiostatic steroids (with during the development of the organs and tissues of the em- Robert D’Amato), and endogenous proteins and protein frag- bryo, and was not believed to occur to any appreciable extent ments, such as angiostatin and endostatin (with Michael in the adult. Furthermore, no specific growth factors with O’Reilly and others). Each of these served to provide further activities directed towards the cellular components of blood insights into the complex biological balance that controls vessels had been identified. the angiogenic process in cancers and other nonmalignant, Trained as a surgeon, but a physician- scientist by in- angiogenic-dependent pathologies such as ocular neovascu- clination, Folkman actually lacked any formal expertise in larization, hemangiomas and other vascular malformations, biochemistry or cell biology. Nonetheless, he had an un- psoriasis, and atherosclerosis, as well as normal embryonic canny aptitude for asking penetrating questions and seeking development. Indeed, several of these putative angiogenesis their answers in unlikely places. He progressively attracted inhibitors have shown efficacy in animal models, and a num- Harvard Medical School students, postdoctoral fellows, and ber have found their way into human clinical trials in the visiting scientists to work in his lab, and systematically began United States and abroad. Perhaps the best studied example to build the case for the tumor angiogenesis hypothesis. A of a selective antiangiogenic therapeutic is the anti-VEGF key experiment was performed in the rabbit eye, demonstrat- antibody, bevacizumab (Avastin). Rationally designed to neu- ing that tiny tumor spheroids implanted in the avascular, tralize one of the first angiogenic factors, vascular endothe- fluid-filled anterior chamber would remain dormant for lial growth factor,* Avastin and related agents have found extended periods of time, but then could grow exponentially application in the therapy of certain cancers, and have been when allowed to contact the surface of the iris, from which shown to be highly effective in the treatment of wet macular they elicited the ingrowth of new capillaries. Published with degeneration, the most frequent cause of progressive vision his first postdoctoral research fellow Michael Gimbrone in loss and blindness in the Western world. The Journal of Experimental Medicine in , this work As these studies unfolded, Folkman established a group provided the proof-of- principle that the malignant growth of creative and committed young colleagues, including Bruce behavior of solid tumors was indeed dependent upon angio- Zetter, Robert Langer, Henry Brem, Michael Klagsbrun, genesis. Patricia D’Amore, Michael O’Reilly, Anthony Adamis, Robert D’Amato, and Marsha Moses, each of whom has gone on to define various dimensions of the field of angiogenesis research at the basic and translational levels. Some remain Folkman’s associated with the Children’s Hospital Boston, while others challenge: Stop have created a network of angiogenesis research laboratories

tumor angiogenesis * VEGF was originally discovered by the laboratory of Harold Dvorak as a “vascular permeability factor”—VPF—and subsequently cloned and characterized by Napoleone Ferrara at Genetech.

The Pharos/Winter 2009 7 Judah Folkman, MD

worldwide. Early in this process, Folkman enlisted the collaboration of his close friend and colleague, the late Ramzi Cotran, who was appointed chairman of the Department of Pathology at the adjacent Peter Bent Brigham (now the Brigham and Women’s) Hospital at approximately the same time Folkman came to the Boston Children’s Hospital. Not only did they collaborate scientifically (Folkman often referring to his Pathology colleague as “the conscience of the surgeon”), but together they established the Harvard Medical Area Vascular Biology Seminar Series, a weekly gathering that has for more than thirty years been an open forum drawing students, young researchers, and emeritus professors alike. Up to the very week before his untimely death, Folkman sat in the front row, notebook in hand, and was among the first to ask a thought- provoking question of the speaker. A much sought-after speaker himself at national

and international meetings, Folkman’s style was spell- courtesyPhoto of the authors binding. His enthusiasm was contagious and his self- deprecating humor a foil for the penetrating nature of his and, indeed, the godfather of a scientific generation that will subject matter. Always sharing his latest insights (and often continue to expand its boundaries and amplify its impact to unpublished data), he viewed fellow workers in the field not the benefit of humankind. as potential competitors but as potential collaborators in the quest for the correct answer. Open to the input of others, he Address correspondence to: often incorporated their criticisms into his working hypoth- David G. Nathan, MD esis. He had a remarkable influence on others. He was acces- President Emeritus Dana-Farber Cancer Institute sible to the most junior of students and senior peers alike, 44 Binney Street D1644 and even the briefest conversation—in an elevator, for exam- Boston, Massachusetts 02115 ple—left a positive impression. And, most importantly, his E-mail: [email protected] accessibility extended to patients and their families, to whom he remained a constant source of hope and encouragement. In , the terms “angiogenesis” and “endothelium” “Asking penetrating questions” did not exist in the lexicon of the Medlars medical index. It is true that Judah Folkman had “an uncanny aptitude In  alone there were more than ten thousand citations for asking penetrating questions and seeking their answers in related to angiogenesis, endothelium, and vascular biology unlikely places.” This aptitude was matched by his fascination in the world’s medical literature. It is estimated that more with diverse phenomena in biopathology about which one than a thousand laboratories worldwide are currently en- would have thought he had no interest. gaged in angiogenesis-related research. Folkman’s seminal In , Steven Krane and I, working at the MGH in contributions were recognized by over one hundred national Boston, hypothesized that rheumatoid synovium had char- and international scientific prizes and more than a dozen acteristics of a locally invasive malignancy. Judah Folkman honorary degrees. He was an elected member of the U.S. suggested that we implant pieces of this tissue (removed at National Academy of Sciences, the Institute of Medicine of synovectomy) into his unique culture system. Its design was the National Academy of Sciences, the American Academy that of inverting segments of sterile rat gut over glass rods, of Sciences, and the American Philosophical Society. In  and constantly nourishing them by slow-moving tissue cul- he received the Helen Keller Prize for Vision Research for his ture medium. Folkman could correlate the aggressiveness of contributions to the cure of blindness—a wonderful byprod- colon cancers by the extent of invasion of the gut segments uct of his lifelong quest to understanding and combat cancer. by explants. Sure enough, the synovial tissue invaded the gut Patients, colleagues, mentors, teachers, role mod- serosa at a rate equal to that of cancer. els, friends—all who had the privilege of knowing Judah Edward D. Harris, Jr., MD Folkman—have had their lives enriched in myriad ways. He Editor will always be remembered as the father of angiogenesis,

8 The Pharos/Winter 2009 Extracorporeal Membrane Oxygenation (ECMO) Student on Pediatric Surgery

Learning to be a surgeon, the senior resident, in his cowboy boots and sea-foam scrubs, tries to explain ECMO in 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 apex of 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, lash the diaphragm—would-be mighty muscle of respiration—shut, and invade artery & vein to stream oxygen into the blood ourselves to buy time. Her chest filled with blood, she is opened again. Then I am allowed to sew the wound closed, between two ribs as soft as green twigs in spring, perhaps because it was futile, or perhaps small things heal well. Sarah Cross, MD

Dr. Cross (AΩA, University of Chicago, !""#) is a resident in the Department of Obstetrics, Gyneology & Reproductive Sciences at Yale-New Haven Hospital. Her address is: $%& Willow Street '(, New Haven, Connecticut ")&$$. E-mail: [email protected]. Illustration by Erica Aitken

The Pharos/Autumn 2008 9 Be still, my (irregularly) beating heart

Mark D. Lo, MD The author (AΩA, University of sounds of an arrhythmia, probably atrial the right place, as it was the only ECG Vermont College of Medicine, 2005) is fibrillation. available. I explained the problem in the an instructor in pediatrics at the Duke- “Damn,” I said out loud. Afib isn’t an appropriate medical lingo. NUS Graduate School of Medicine in immediately fatal disease, but certainly “Palpitations? Shortness of breath Singapore. is serious, even for younger people. I without syncope? Fill out these forms had heard enough of these arrhythmias and we’ll see you right away!” she ex- t was barely the end of my clerkship in older patients to recognize that I claimed. Three minutes later I was year. I had just driven home to visit now needed a hospital visit. I knew having a nurse confirm my irregular Imy parents for the weekend during just enough to know that I needed to heartbeat and take my blood pres- a call-free elective month in medical start with an ECG, and the only place sure, which was dramatically elevated. school. They were already going to bed, open during the weekend was the lo- “White coat syndrome,” she murmured. so I said goodnight to them before cal hospital emergency department. I “Happens all the time.” I say that to my flipping open my laptop to check my wrote my folks a note to tell them I hypertensive patients, too, I thought. e-mail. would be in the ED, trying to use the And I’m usually the one wearing the Ka-chung. My heart suddenly ac- most benign language I could think of. white coat. celerated, like I had just finished a run. Stupidly, I then drove myself to the hos- Ten minutes later, I was wearing a It didn’t slow down in the next five pital, not realizing how risky that could flimsy hospital gown for the first time minutes, so I figured it was just some be. I was secretly hoping that I would be in my life. It kept slipping off my shoul- random adrenaline in my twenty-eight- wrong, that the ED would think I was a ders. I had the ECG leads on, and the year-old system, or maybe the coffee I paranoid medical student and send me printout confirmed atrial fibrillation. had just drained. It would be fine after away with a lecture on not adding to “Nice pickup,” said the nurse, but I was a good night’s sleep. But I couldn’t sleep the burgeoning costs of overcrowded already running through the treatment more than four hours that night, and EDs. And I was somehow fantasizing options in my head. I woke with the weird heartbeat still that I only needed an ECG, as my basic I knew I wouldn’t be leaving anytime there. coverage student health insurance plan soon, and the treatment might be more I puttered around the house, noticing + emergency room visit = much poorer invasive than I wanted. Coming to the that I didn’t feel my normal energy level. student. Maybe I could sneak off with ED meant the full workup automati- No lightheadedness, but my breaths just “the basics.” cally, and I couldn’t get away with my à were rushed, even at rest. I’m sure it will I had never been to the ED for any- la carte request. Labs were drawn, IVs go away in a little bit, I told myself as I thing more serious than a sprained were inserted, chest X-rays were taken. I threw myself into bed. I’m just tired, and ankle. Walking in, I felt slightly embar- was stunned at how painful the IV could I can sleep this off. After a short nap, rassed as I spoke with the desk clerk. be, jammed against a valve in my vein. there was no relief from my symptoms. “I don’t think this is emergent or I felt like a sham, as I squirmed in pain I finally took my quickened pulse, and it anything, but, uh, I was wondering when the nurse tried to flush it. I was felt “irregularly irregular,” an unwelcome where I could get an ECG this time of ashamed at my reaction to this ubiqui- indicator of what my problem might be. day. Is there an after-hours clinic (read: tous procedure that I myself had sub- Closing my eyes, I slipped on my stetho- cheaper)?” jected so many patients to. Suddenly I scope and heard the confirmatory heart She assured me that I had come to was cognizant of the fact that although

10 The Pharos/Winter 2009 The Pharos/Winter 2009 11 Be still, my (irregularly) beating heart

we medical students practiced insert- the hospital. blurred. The last sounds I heard were ing IVs on each other, we never stayed Cardioversion is the process of pass- the irregular beeping of the C-R moni- hooked up to them for very long, and no ing a couple hundred joules of energy tor fading away . . . medicine ever passed through the lines. through the heart, effectively obliter- Zap. A paper funnel was handed to me. ating any irregular rhythm. It is then “Urine sample!” chimed a different assumed that the natural pacemaking I awoke and immediately knew I nurse. I was getting confused between ability of the heart will take over and a was in sinus rhythm. I also immedi- the different people taking care of me, regular heartbeat will be re-established. ately wished I had just chosen hospital- each with the greeting “I’m [insert dif- In essence, cardioversion is just like on ization. Since cardioversion, I’ve been ferent name] and I’ll be your nurse.” TV when the medics break out the pad- cleared of any cardiovascular issues. It Why didn’t they ask me for the urine dles and yell “Clear!” before delivering is thought that caffeine or the stress of before I was hooked up to the IV?” I the electric shock to reboot the heart. medical school triggered an episode of grumbled. Giving the sample with IV Risks include the arrhythmia persist- lone atrial fibrillation. The experience lines and monitoring wires all tangled ing even after the shock, or the heart of being a patient in the emergency up, I suddenly appreciated the fact that stopping and not remembering to start room brought home the reality of what it’s hard to move—much less undo a beating again. The cardiologist wanted we do every day. I was struck again by zipper—without free hands. to sedate me and do this to me. In my our effect on our patients, and how very The patient in the bed next to me head, I knew that this was the normal quickly even our own health can change. began moaning in pain, and I wondered protocol and perfectly safe. In my heart My many years of youthful invincibility what was wrong with her. Her moans of hearts (pun intended!) I thought this were all taken away in a literal heart- turned into yelps of pain, and through was nuts. I was now on the wrong end beat, with no warning whatsoever. For the curtain I could hear her family try- of a code situation. the first time in my life I felt betrayed ing to comfort her. They could also hear It might have been the first time in by my body, and for months afterwards what my care providers were telling me my life that I truly had to trust doctors I wondered if every tiny chest pain or about my newly diagnosed arrhythmia. completely. In the end it came down to tachycardia or quickened breath meant Being roommates with somebody else my unwillingness to be hospitalized and that something more serious was about pretty much obliterates any kind of pri- wait longer, with the potential of weeks to occur. I can still live my life happily vacy, I discovered. of anticoagulation ahead. I made sure in the moment, but in the back of my Almost two hours went by as I waited that I talked to my loved ones before mind there is a shadow lurking. The for the cardiologist to come see me. I going under sedation, and even drafted shadow is the uncertainty of health, and thought about how I always ended up a quick living will. I wanted to clarify understanding the tremendous speed making patients wait on me as well. The my future medical wishes should I be with which illness may come. nurses started me on an IV medicine incapacitated, and from the corner of As physicians, we do our best to safe- in an attempt to convert me back to my eye I thought I saw the cardiologist guard our patients’ health, and to fight my normal heart rhythm. I lay back on roll his eyes. But if my brief foray into for them when the illness does come. my pillow, watching the monitor as the medicine taught me anything, it was Atul Gawande writes of the doctor’s medicine dripped in for an hour, pray- that you never knew how things were profession, “We are for the moment the ing to see P waves. It didn’t work—I still going to turn out. healthy few who live among the sick.” 1 was in arrhythmia and I could feel it. My eyes widened as they broke the My new insight to the experience of be- Argh. I knew what was coming next. plastic lock to the code cart. The oxy- ing both healthy and sick has convinced On cue, the cardiologist came bus- gen mask went on, and they tore open me once again that being a doctor is the tling in, looking every bit the profes- the silver bag containing the adhesive most meaningful profession I could hope sional one could hope for. I wondered if paddles. The sticky gel was cold, and I for. As long as we are still healthy few, I looked like this when I saw patients as felt a slight tingle as they pushed mor- ours is the privilege to help the sick. a student doctor—with me it was always phine and midazolam. The cardiologist partly competence and partly me con- switched on the defibrillator. Reference vincing myself I really was competent. “Hang on, hang on,” I choked out. . Gawande A. Nine Thousand Sur- We chatted for a few minutes about “I’m still here, I’m still totally awake.” geons. In: Gawande A. Complications: A my history and presentation, and how More midazolam. Surgeon’s Notes on an Imperfect Science. the medicine hadn’t worked. He then “Nope, still here, I think I need some, New York: Picador; : –. told me what I had been expecting, that uh, uh, m-more . . .” cardioversion was the next option if I My eyelids were closing of their The author’s e-mail address is: mark.lo@ wanted to avoid staying overnight in own accord and the edges of my vision duke-nus.edu.sg

12 The Pharos/Winter 2009 Do Old Men Dream?

he dreams of riding down a canopied highway on his monster Harley to the beach the beach a woman waits for him with food and drink the Florida sun exploding in his head pelicans diving and diving and skimmers skimming Eric Pfeiffer, MD

Dr. Pfeiffer (AΩA, Washington University in St. Louis, !"#$) is a member of the editorial board of The Pharos. His address is %!&$ W. Hawthorne Road, Tampa, Florida %%#!!. E-mail: epfe- [email protected]. Illustration by Jim M’Guinness

The Pharos/Winter 2009 13 Isabella James Reilly, MD

18 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 you so you don’t fall. This will feel cold and sticky.” The grounding pad slaps onto her bared thigh skin. Quickly now, she begins her transformation from person to inanimate object, as we gradually cease talking to her and begin talking about her. “This is Isabella Montez, medical record number . Date of birth is January , . We’re removing a pelvic tumor.” Electronic boxes with flashing lights and digital screens decorate the room, strange sculptures stacked on shelves. The room is harshly lit. Isabella seems deathly pale, such little mass rising beneath the sheets that define her supine form. The paper- swaddled nurse in the corner hovers over rows of sparkling stainless cutlery-like tools. She’ll have to fetch them quickly, and mistakes are not good. The patient gives up all control to the doctors

Isabella is senseless now, consciousness gone. The drugs do that, and now the anesthetist pries her mouth open and peers in. The foot-long breathing tube slides in. She’s now completely under our control, an almost inanimate object. Isabella has been losing weight for months. The selfish tumor takes her food for itself. I paint her abdominal skin with the antiseptic fluid. The tumor hump pushes up against the sponge stick. We arrange the green and blue paper layers carefully, hiding Isabella. Soon she’s gone. All that remains is the square of sickly orange-brown skin centered on her navel. I cut her quickly with a knife, then move to a hot electric cau- tery. A sparking tip ignites her fat in a flash. Too hot. “Turn the Bovie down to ,” I murmur. We go on. A cloud of vaporized fat and fascia rises from the wound. I’m in now, and my hand gropes deep, till I find what I want. The tumor is mobile, and I pull it up and out, into the light, an ugly face- less lump encasing and dimpling her colon, about softball size. “Let’s take this out,” I say. I sound like a coach. And so we begin. The author (AΩA, University of Pennsylvania, 1972) is di- A few days later, I stand outside her room with a crew of rector of Surgery at the Kings County Hospital Center in young earnest surgeon types. A medical student begins, “This Brooklyn, New York, and Professor of Clinical Surgery at the fifty-six-year-old woman underwent sigmoid colectomy three SUNY Downstate College of Medicine. days ago. She’s afebrile, her abdomen is soft, her wound is clean and dry. She had a BM last night.” pushed Isabella Montez’s gurney into the operating room “Good morning, Mrs. Montez,” I lead the group as we at first light. She shivered, “I’m cold.” crowd around her thin hidden form on the hospital bed. Her I “We’ll give you a warm sheet in a minute,” I replied. roommate seems asleep behind the curtain that separates She sees no reassuring smiles, no bright teeth here; we’re the two patients, but she could easily hear every word. The all face-covered with paper masks and drug company-logoed two women have talked about their kids, their spouses, their

Photo by Gonzalo Cisterna Sandoval The Pharos/Winter 2009 19 Isabella

disease, their fears. They talk about the nurses and, especially, it won’t come back, reassure her that she’ll live. Sometimes I about their doctors. meet these expectations, but too often I just bring more bad “May I see your incision?” I ask and begin stripping the news. The tumor has spread, chemotherapy and radiation are tape and gauze from her abdominal skin. “Looks good. Diet next. And no promises for a future. as tolerated, staples out on POD , please.” The young sur- Under these circumstances, Isabella and I can’t get too geons scribble notes. Then I notice. Isabella has put on a face, attached. So we focus on the task, on my craft, the opening, used some make-up, a bit of blush on her cheeks, and lipstick. probing, taking-out, rearranging, sewing up. But no commit- She’s back from her trip in Charon’s boat, her visit to Hades. ment to the future, just the here and now. “The lipstick sign,” I intone. “Usually seen on POD . Ms. Other doctors do commit. The pediatrician expects to Montez, you’re ahead of schedule. You’ll be just fine.” see a child from birth through adolescence, to be witness to growth spurts, runny noses and fevers, first day at school, Outcome: Back to normal, a lifelong maybe a broken bone or bad appendix. Internists watch their patients for years, to detect the blood pressure or glucose or scar . . . or worse cholesterol misbehavior, to counsel against those bad choices we all make and seek absolution for, and to witness and hold at bay the slow breakdown of form and function we all suffer Surgeons do terrible things to patients. In a cold harshly-lit as we age. Even an obstetrician gets nine months with his pa- operating theatre, we render them helpless, unconscious, tients, and a singular joyful new person as a reward. and mercifully unfeeling. We strip them naked, and cut them Not so for surgeons. Our patients don’t want to get to open, looking, grasping, moving things about, removing know us. Mostly our failures keep coming back, and they’re parts, replacing them, putting them back together. We give often angry or sad at the predicament that keeps us together. them immediate suffering in exchange for a better future, an My patients want nothing more than to hear me say, “You’re almost religious bargain. And we know there’s no going back. done with surgery for now. Let’s get you back to your doctor.” Once I start working, Isabella Montez will never be the same. Or to the next specialist in chemotherapy or radiation therapy She’ll most likely be better, I think, but different, for sure. or rehabilitation. Just not more surgery, or surgeons. She’ll wear my incision’s scar all her life and, if things don’t work out the way we both hope for, she’ll take it with her to Introducing a patient to the a perhaps premature grave. That realization of irreversibility haunts every surgeon’s decision. beginning of more living Surgeons need some protection from this awful real- . . . or death ity, and our defense mechanisms have to be robust, if not impenetrable. We erect some walls of separation. We some- Isabella and her daughter came to my clinic two weeks times depersonalize our patients, transform them from flesh after surgery. She admitted to being fatigued, but was eating and blood people, like us, with parents, loved ones, hopes, good familiar food, enjoying visits from attentive family mem- dreams, a future, into a body part, specifically, the one that’s bers, and described in singular detail her bowel habits. She acting up, misbehaving, the part that needs dealing with, to knew I’d want to know. I had some good news. come out and be done with. The nagging hernia, the stone- “I have your pathology report. We got the whole tumor, filled gallbladder, the ulcerated stomach, the inflamed or and the lymph nodes were all negative. No tumor in the cancer-burdened colon. nodes. That’s good news.” Surgeons experience surgery with shocking intensity. She began to weep, but then thought better of it, wiped During an operation, every sense, tactile, auditory, and espe- her eyes, and murmured, “Thank you, doctor.” Her daughter cially visual, is acutely energized, laser-focused on the task, hugged her. Isabella put on her coat, gathered her bag, and every tissue probed and cut, every bleeding surface, every left arm in arm with her daughter. They’d be back in a few structure we disturb, and those we leave be. For days to months for a check-up. months after an operation, I can recall the details of the pro- A few moments later, my resident introduced me to my cedure with singular clarity, a mental videotape that reruns next patient, a forty-three-year-old woman with a stone-hard when I encounter Isabella recovering, and even in my dreams. breast mass, and a lump in her armpit. “May I examine you?” This remembrance gives Isabella a new and singular dimen- I asked. Her eyes filled with tears; she knew I would break her sion that is our shared secret. No one has seen Isabella as I heart. I handed her a tissue, and we began to get acquainted. have, explored her in this frighteningly intimate way. And so, when I refer to her as “the colectomy,” I’m describing her in a The author’s address is: dimension uniquely known between patient and surgeon. 21 E. 87th Street #9A Isabella, while she’s stripped and vulnerable, lying abed in New York, New York 10128-0506 pain, nevertheless has high hopes for me. She prays I’ll bring E-mail: [email protected] her good news, tell her that the tumor is gone, promise her

20 The Pharos/Winter 2009 ursing ome illanelle H V !N Gravity shifts me to the ground. Mornings, I float down from dreams. Natural forces spark light and sound. Outside my head, again I’m bound By 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, MD

Dr. Salomon (AΩA, University of Illinois at Chicago, !"#$) is an emergency physician and a member of the editorial board of The Pharos. Her address is: !%" Riverside Drive, Deerfield, Illinois &''!(. E-mail: [email protected]. Illustration by Karen Brezsny

The Pharos/Winter 2009 21 Bridge

She wouldn’t hear the words, yet Rivers appeared on parched creeks, Traversing the hills and valleys of her face, Leaving behind a desert, more barren. She shivered now, in the silence Of 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 trees Beneath which they first faced each other, Memorizing details while sipping juice. Please consider, she vaguely heard The doctor say, stepping back. This compelled her thoughts back to the blank white room as She considered, questioned and contemplated. Does the essence of a tree Remain when it is fallen? If then, its leaves are shorn and branches severed? Her eyes moved past the hallway. Outside she saw the sidewalk Glistening in the onerous summer sun Beside 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 Sreeraman

Ms. Sreeraman is a member of the Class of !"## at the University of California, Davis, School of Medicine. This poem won third prize in the !""$ Pharos Poetry Competition. Ms. Sreeraman’s address is: %&"# V Street, Sacramento, California '($#). E-mail: [email protected]. Illustration by Laura Aitken

The Pharos/Winter 2009 41 The physician at the movies

Peter E. Dans, MD

Doctors in two John Ford films trated this in such films as Young Mr. Lincoln, in which Lincoln hen Orson Welles, whose Citizen Kane is considered (Henry Fonda) talks to Ann Rutledge at her grave and in She by many to be the best film of all time, was asked to Wore a Yellow Ribbon, in which the Colonel (John Wayne) pays nameW the three best movie directors, he replied “John Ford, visits to his wife’s gravesite to share the news of his retirement John Ford, and John Ford.” In Directed by John Ford, a master- from the army. ful documentary tribute to Ford first produced in  and Paradoxically, Ford, whose pictures are suffused with the updated in , director Peter Bogdanovich interviewed importance of family, had a disordered one. He was profane, Welles, Walter Hill, Martin Scorsese, Steven Spielberg, had affairs, drank heavily, and was far from a model Catholic, and Clint Eastwood. All acknowledged the debt yet his films respectfully portrayed Catholics and their imagery. they owed to Ford. Calling him a “Catholic poet,” Although his films radiated warmth, he was often very cold and Hill went on to say that “what set him apart off- putting in person. It sort of reminds me of my response to was his sense of spirituality, his sense that Amadeus, in which Mozart’s behavior is portrayed as hardly death is not the end.” Bogdanovich illus- matching the excellence and otherworldliness of his work. To the extent that the portrayal was true (and many dispute it), I say, “So what! Just enjoy the works and leave him to God’s mercy where his oeuvre should speak for him.” The same holds for Ford. Indeed, nothing says it better than the line in Ford’s classic The Man Who Shot Liberty Valance. Senator Ransom Stoddard (Jimmy Stewart), whose career was built on his being the hero who shot the evil Valance, admits to reporters that it wasn’t him but his friend Tom Doniphon (John Wayne), who wouldn’t take

Stagecoach, 1939, directed by John Ford (left), starring John Wayne and Claire Trevor. UA/Photofest ©United Artists the credit. When he expresses dismay that the reporters won’t (The Grapes of Wrath [], How Green Was My Valley [], print the truth, one replies, “This is the West. When the legend and The Quiet Man []), oddly enough was never honored becomes the fact, print the legend.” for his quintessential westerns. Nonetheless, his influence is indelible, no more so than in High Noon. Stagecoach (1939) This film is noteworthy for being the first Ford film shot on Starring John Wayne, Claire Trevor, Thomas Mitchell, and location in isolated Monument Valley, at the time  miles John Carradine. from Flagstaff over rough roads, and for making John Wayne, Directed by John Ford. Not rated. Black and white. Running in his eightieth film, a star. Born Marion Michael Morrison, time 96 minutes. Wayne was a pre-law student at USC on a football scholarship, but when he injured his knee he could not afford to continue. alled by some the first adult western, Stagecoach was one Starting in Ford’s silent films in  as an extra, stuntman, and of the many classic films that has led  to be labeled gofer, he worked his way up to a starring role in the  film CHollywood’s Golden Year. Other great films of that year in- The Big Trail, for which Ford had recommended him. When the clude Gone with the Wind, The Wizard of Oz, Mr. Smith Goes picture bombed, he became persona non grata with all the major to Washington, Ninotchka, The Women, Goodbye Mr. Chips, Gunga Din, Dark Victory, Young Mr. Lincoln, and Destry Rides Again. Director John Ford, who had already received an Oscar for The Informer (), and would go to on to win three more

The Pharos/Winter 2009 43 The physician at the movies

the victims of a foul disease called social prejudice, my child. These dear ladies of the Law and Order League are scouring out 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 the street before stopping at the saloon, where the bartender tells him that if talk were money he’d be his best customer, and gives him one for the road. Another passenger is Samuel Peacock (Donald Meek), a whiskey drummer (salesman) complete with a satchel full of samples that Doc commandeers to get him through the journey. Another is a former Confederate soldier and now “notori- ous gambler” Hatfield (John Carradine), whose courtliness will also belie his disrepute. There’s a southern belle, Lucy Mallory (Louise Platt), who is traveling to reach her husband who com- mands the local cavalry garrison, only to learn that he is on patrol chasing the Indians. Another passenger, a presumably UA/Photofest ©United Artists “upstanding” citizen, is the banker Henry Gatewood (Berton Churchill), who is given to statements that played to the dis- studios. Reportedly, Ford didn’t talk to him for four years. Finally content of ’s audiences: “What’s good for banks is good for after working in B pictures for years at Republic and Monogram the country.” The husband of the head of the Law and Order studios (known as “Poverty Row”), Ford gave him the starring League, he is absconding with , the latest shipment by role in Stagecoach, even though his presence led many produc- Wells Fargo. ers to turn Ford down. Finally, Walter Wanger agreed to finance The wagon driver Buck is played with comedic effect by the picture and the rest, as they say, is history. Andy Devine. Strangely enough given his girth, Devine was a Based on a Collier’s magazine article, “The Stage to real cowboy who could handle the difficult job of controlling Lordsburg,” with some amendments courtesy of the short the stagecoach’s six-rein team of horses. This became essential stories “Boule de Suif” by Guy de Maupassant and Bret Harte’s when Yakima Cannut (born Enos Edward Cuniff), the greatest “Outcasts of Poker Flat,” the film is more complex than the stuntman of all time, doubled as an Apache and jumped on shoot-em-ups of its day. The picture is really a social com- the horses, and after being “shot” had to make two transfers mentary on hypocrisy and a character study of redemption, through the rampaging team. He had only three feet to spare a recurring theme in ’s films. It’s also a low-key love story. between the horses, and he timed it assuming the driver main- Most of this is played out in the cramped quarters of the stage- tained the horses at a steady speed. See his Wikipedia bio to coach, and the station stops along the way. Although the trail- learn more about all the films for which he did or arranged the ers emphasized the “action,” the confrontation with Geronimo stunts. Despite his fearlessness, he died in his bed at ninety. His and his Apache warriors who had left the reservation, as well as son did the stunt doubling for Charlton Heston in the famous the showdown between the bad guys and the hero, don’t occur Ben-Hur chariot race. until late in the movie. The last member of the ensemble cast is Marshal Curly The film starts with the Lordsburg Stage arriving in Tonto, Wilcox (George Bancroft), who is anxious to get to Lordsburg and the driver learning from the Comanche scouts that their where The Ringo Kid (John Wayne), who has just broken out hated enemies the Apaches are on the warpath. The stagecoach of jail, is headed to kill Luke Plummer (Tom Tyler), who killed fills with an odd assortment of characters. Two are being given his father and brother. He wants to make sure Ringo isn’t killed, the heave-ho by the Law and Order League. One is Doctor not only because he likes him but also to claim the reward Boone (Thomas Mitchell), who had been honorably discharged money for capturing him. from the Union Army but whose skills had been undermined The Ringo Kid’s entry into the film, holding his saddle in by alcohol such that his landlady claimed that “he can’t doctor one hand and twirling his Winchester in the other as the stage- a horse” and that he hadn’t paid his rent (or his bar bill for that coach rounds the bend, is considered one the most dramatic matter). A literary soul, Boone looks at her and, paraphrasing entries of a newly-minted star. Ringo joins the group as a cap- Christopher Marlowe’s reference to Helen of Troy in Doctor tive and later, when the stagecoach is threatened, he becomes Faustus, asks, “Is this the face that wrecked a thousand ships an essential team member. At first, he and Dallas are shunned and burned the towerless tops of Ilium? Farewell, dear Helen.” as societal outcasts. He calls Dallas “a lady” and treats her as Then he turns to the other outcast, Dallas (Claire Trevor), the such. As their relationship deepens, Ringo’s rendezvous with proverbial prostitute with a heart of gold, and tells her, “We are Luke Plummer (Tom Tyler) and his brothers looms over it. The

44 The Pharos/Winter 2009 film illustrates three hallmarks of Ford’s films: () a pictorial style of filmmaking, () spare dialogue, and () the use of facial and body reaction rather than dialogue to advance the story. This is best shown by Ford focusing on Wayne, who sits in the middle of the interplay of the characters, silently registering responses and reactions. Thomas Mitchell won an Oscar for best supporting actor as Doc, who is hardly a great advertisement for the profession of medicine. He smokes cheroots and drinks during most of the trip and calls himself “not only a philosopher but a fatalist.” We do learn that he fixed Ringo’s brother’s arm. When Ringo adds, “You did a great job even if you were drunk,” Doc replies, “Thank you, son, professional compliments are always pleas- ing.” Doc is like a lot of the stock characters in Ford’s films, a compulsive drinker but a good man at heart who can pull himself together when needed. He does so on at least three occasions. The first is when he is reluctantly pressed into service after Mrs. Mallory faints. He calls for lots of hot water as well as lots of black coffee as he prepares to sober up for an emergency delivery, after which he says, “I brought hundreds of these fellas into the world and the new one was always the prettiest.” The second time, he saves the life of the whiskey drummer, who is shot with an arrow. The third takes place before the climactic shootout. He’s not your prototypical doctor as paragon, but he’s a good man nonetheless.

The Horse Soldiers (1959) UA/Photofest ©United Artists Starring John Wayne, William Holden, Constance Towers, and Althea Gibson. Directed by John Ford. Not rated. Running time 119 minutes. and Sherman lament that “the war is not going well, not in Washington, not in the newspapers, not in the field.” They nlike his protégé Wayne, John Ford was a liberal Democrat decide to send a patrol  miles deep into Confederate terri- until late in life, and although his movies tended to glorify tory to destroy the railroad junction at Newton Station supply- Uthe military he was very critical of the effects of war on these ing Vicksburg. Heading the mission is Colonel John Marlowe men. Ford spent much of World War II filming in the heat of (Wayne) of the Michigan militia, a railroad section hand in ci- battle at Midway, the Normandy invasion, and other hotspots. vilian life. He is assigned Colonel Phil Secord (Willis Bouchey), On his return, he made one of the strongest anti-war films, who is more interested in victories to help his political ambi- aptly titled They Were Expendable. Even in the trilogy in which tions, and Major Hank Kendall (William Holden), an insubor- he vividly portrayed the U.S. cavalry, he shows a disdain for dinate military surgeon who arrives out of uniform. Kendall those who impetuously and vindictively pursue war contrary is more concerned about casualties and how the men will be to the advice of veterans who counsel peace with the Indians. cared for as they try to maintain the thirty-five-miles-a-day This is best shown in Fort Apache, in which the wrongheaded plan. Marlowe responds that “we’ll move on. It gives your commander played by Henry Fonda refuses to listen to Wayne’s people a wider opportunity for experimentation.” However, character and brings havoc on himself and his troops, but is when they do suffer casualties, Kendall does agree to stop and remembered as a hero. In short, Ford conveyed a respect for send the wounded back, reducing his strength. They skirmish those who fought for their country out of a sense of duty, while over the duty roster and Kendall’s refusal to certify a malaria lamenting the waste of fine young men. patient for duty. The latter is replaced by Sgt. Major Kirby The film starts with a typically striking view of the cavalry- (Judson Pruitt), the familiar drunken sergeant. During a halt, men singing “I Left My Love” as they go out on patrol, remi- Kendall agrees to deliver a baby in a poor black homestead, niscent of the scene in She Wore a Yellow Ribbon. Although and afterwards says, “As many as I have delivered, it never fails the screenwriters drew on a novel by Harold Sinclair, the story to awe me.” He then adds, “One born, one dies,” referring to has a basis in fact in Grierson’s Raid in April  when the their first casualty. Marlowe tells him to confine his duties to Battle of Vicksburg was at an impasse (see addendum). Grant the troops.

The Pharos/Winter 2009 45 The physician at the movies

One needs to get past the hokey scene involving their coming school’s older reverend are pressed into service to delay the upon a mansion inhabited by a Southern belle named Hannah Union soldiers until Nathan Bedford Forrest’s cavalry can reach Hunter of Greenbriar (Constance Towers) and her black maid them. To Marlowe’s credit he refuses to fight them and turns Lukey, played by Althea Gibson, a tennis star between  tail and runs, leaving the cadets ecstatic. They recruit Deacon and  who was called the Jackie Robinson of tennis (again Clump (Hank Worden), who was part of the Underground check out her bio). Although the accents and the dialogue at Railroad, to help them escape from Forrest’s men. Kendall dinner are cringe- producing, stay with it because there is a nice stays behind to care for the wounded, knowing that he will be duplicitous twist at the end such that the two women are forced imprisoned. As he says, “Medicine is where you find it, even at to join the patrol on its march to prevent them from letting the Andersonville.” The latter is one of the film’s anachronisms, in Confederates know of their presence. Hunter adds some spice to that the prison had not been built in . Still, all in all, this the movie, as she reinforces the doctor’s dislike for the Colonel. is a picture worthy of putting on your rental list, if only to see You also have to overlook Hunter being generally all made- a favorable portrayal of a doctor in the era before we got to be up and well-coiffed except in the field hospital scenes, when “the bad guys.” Kendall operates without anesthetics and with little laudanum and copious whiskey. The benefits of a tree moss poultice that Addendum Kendall learned from a Cheyenne are extolled. According to Wikipedia and other sources, The Horse After the confrontation at Newton Station, the Colonel is Soldiers is based on the April  raid led by Colonel upset at all the casualties and starts drinking, and reveals to Benjamin Grierson, who, with  men, traveled several Hunter why he has been so harsh on doctors. He says they hundred miles from Northern Mississippi to disrupt the rail- say, “Medicine is the most noble profession. Banners held on road from Newton Station to Vicksburg. The successful raid, high—so high they won’t admit they’re groping.” He then tells which prevented troop reinforcements by General John C. how he trusted the doctors when they told him that his wife Pemberton, was said to have been “remarkably bloodless.” had a tumor. They operated and found nothing. “They said they were sorry; they made a mistake. They had something to Dr. Dans (AΩA, Columbia University College of Physicians and talk about before their next experiment.” Surgeons, 1960) is a member of The Pharos’s editorial board and Although the mission is accomplished, Marlowe refuses to has been its film critic since 1990. His address is: retreat and pushes on to Baton Rouge. Along the way they pass 11 Hickory Hill Road a black church where they are saluted. The cadets at Jefferson Cockeysville, Maryland 21030 Military Academy, none of whom are over sixteen, and the E-mail: [email protected]

John Ford and John Wayne on the set of The Horse Soldiers, 1959. UA/Photofest ©United Artists

46 The Pharos/Winter 2009 Reviews and reflections

David A. Bennahum, MD, and Jack Coulehan, MD, Book Review Editors

Neurosurgeon Dr. Frank Vertosick “Yeah . . . ah . . . fine, sir,” Carl has written a superb and honest book stuttered, “we just put a nick in about his training in neurosurgery. the cerebellum, I think . . . We’re When the Air Hits Your Brain, first fine.” p37 published in , has become a classic. It’s been translated into five languages The patient ultimately recovered and has appeared on the reading list of from the mishap, but the pain of Dr. several medical schools. It has been up- Vertosick’s initiation into the reality of dated and re- released, and is well worth neurosurgical practice—the thin line a second (or first) reading. between healing and catastrophe—is When the Air Hits Your Brain: Dr. Vertosick recounts his journey unavoidable. All neurosurgeons must Tales from Neurosurgery from medical student to his decision, come to grips with it. Frank Vertosick, Jr. based on happenstance as well as intent, Much of Dr. Vertosick’s story is a New York, W. W. Norton, 2008, 272 to become a neurosurgeon. wry account of residency training. He pages His account of the first neurosurgical recounts the “skull-o-gram” incident, operation he saw as a medical student in which a resident was left to close a Reviewed by Michael Egnor, MD recalls a scene painfully familiar to all craniotomy that had been performed by neurosurgeons: a resident, hurried by his an attending who had annoyed the resi- fear that he will displease the chairman dent by not allowing him to perform the t is an aphorism among neurosurgeons (who has not yet arrived in the operating main portion of the surgery. After the that the community of neurosurgeons room) by taking too long to drill through attending had left the operating room, canI be divided into thirds. A third are a patient’s skull, inadvertently plunges the resident engraved his opinion of technically inadequate as surgeons, a the drill deep into the patient’s brain. the attending on the bone flap— “FRED third are competent but unethical, and SUCKS”— before wiring it back into a third are competent and ethical. Of [The chief resident] grabbed the place. The wound became infected a few course, neurosurgeons who cite this drill away from [the resident] and weeks later, and the attending, on re- maxim always consider themselves to be yanked it out of the patient’s head. opening the incision, acknowledged the the competent- ethical cohort. The apho- A torrent of blood and some stuff “skull graffiti” with a string of invectives. rism is harsh, and not true, but there is that looked like runny strawberry The enraged (and embarrassed) surgeon certainly an enormous spectrum of per- milkshake poured from the small spent an hour drilling the message off sonalities and skills in my profession (I’m hole in the bone. . . . the bone before sending the specimen a pediatric neurosurgeon). There is such . . . . [The chief resident said], to the pathology lab. an enormous spectrum in part because “Hopefully, we just trashed the cer- Neurosurgical arrogance is some- of the technical challenges inherent to ebellar hemisphere. . . . If we went times sardonic. Dr. Vertosick recalls a performing surgery on the nervous down to the [brain]stem, we’re all dinner with his chief resident (Gary) system, and in part because of the screwed . . . Lordy, lordy, just so the early in his training: emotional stress—really the stem is OK, tell me the stem is OK.” spiritual stress—inherent to The door swung open. The I was a Buddhist pupil seated in the doing neurosurgery for a [chairman] again. “Is everything OK? presence of the Enlightened Master. living. . . . I SAID IS EVERYTHING OK?” “The next five years of your life,

The Pharos/Winter 2009 47 Frank, will be hard,” Gary contin- to her unborn son throughout her preg- mix of bravado, elation, and emotional ued, “but always remember this: If nancy, then dies of her tumor shortly incineration. But there is a connection, neurosurgery wasn’t hard, every- after he is born. I think, between neurosurgical bravado one would do it. Look at those fleas In a chapter titled “Nightmares, Past and the agonizing task of working the [non- surgical resident doctors] over and Future,” Dr. Vertosick expresses his fine line between healing and catastro- there. Do you think they really want agony over a surgical error that leads to phe. Neurosurgeons insulate themselves to write prescriptions for Inderal for a brush with “emotional incineration.” as best they can from the risks that the next forty years? Do you think He operated on a forty-year-old man they and their patients face each day. they wake up at night screaming with an aneurysm on his middle cere- Neurosurgery contains a remarkable ar- ‘Dialysis! I must dialyze one more bral artery. The man was neurologically ray of characters, most quite decent and patient!’ . . . most of them wanted to normal prior to the operation, but dur- talented men and women, but a few, not be surgeons but just couldn’t hack ing the dissection of the aneurysm, Dr. so. But all neurosurgeons inflict serious the work it takes to be one. If a genie Vertosick accidently ruptured the thin harm, at times, and all must come to popped out of their pizza right now dome of the aneurysm, causing massive some kind of accommodation with this and said he could make them into bleeding that could only be stopped by agony of our profession. Each of us lives any type of doctor they would want occluding arteries to critical parts of the with faces in our mind—faces of people to be, . . . which one of them do you man’s brain. The patient had a massive we’ve hurt, or even killed. Some of us think would say ‘Oh, genie please stroke, was left paralyzed and unable to accommodate with cynicism and hubris. make me a gastroenterologist so speak, and ultimately died. Dr. Vertosick Some accommodate with a passionate that I could look up someone’s ass explained the catastrophe to the patient’s effort to master surgical technique, even all day and my office can be filled wife immediately following the surgery: at the expense of other important but with spastic colon patients wanting less technical medical and interpersonal to show me Polaroids of their latest “We . . . we had some bleeding skills. Some accommodate by restrict- bowel movement.’ ” pp149–50 . . . we were forced to put a clip ing their practice to types of operations around the main blood vessels to that can be performed with minimal But there’s much more than cynicism his left brain . . . He . . . he has had a risk. Some burn out and quit practice. in Dr. Vertosick’s story. He shares stories very large stroke, I’m afraid . . .” Some devote themselves to money, sex, of tragedies; a young woman dying after “A stroke? Is he . . . alive?” Her alcohol, or drugs. Some take up causes. a car accident, talking to him while her hands began to shake and her eyes Some become atheists and make up ni- brain oozes out of her skull, and his filled with tears. hilistic stories about the lack of meaning dread of telling her hopeful family in a “Yes. Yes, he is alive. But he can’t in life. Some find faith in God. In one nearby waiting room that she is gone. speak or move his right arm or leg. way or another, all neurosurgeons ac- He recounts the story of a baby with a I’m afraid that’s . . . permanent.” commodate. malignant brain tumor and the child’s “Permanent! You mean he’s never Dr. Vertosick has written a superb teenaged parents who can’t compre- going to talk again?!” book, an honest account, of how he hend that their daughter is seriously My eyes looked down. “Yes. became a neurosurgeon and how it ill. The surgery does not go well, and Never. He may not even survive.” changed him. And one can see in his the child is devastated neurologically. She began to hyperventilate, then wry narrative and engaging stories how The doctors convince the parents to went to a wastebasket and vomited. he has learned to cope with the dilemma distance themselves emotionally from Collapsing in a heap on the sofa, she at the heart of neurosurgery. He copes, their daughter, so they stop visiting her. buried her ashen face in her hands at least in part, by telling the truth about But she survives longer than expected and began to weep softly. what it means—and what it costs—to and becomes the daughter, in a way, “Is there anyone I can call for take such enormous risks to heal. of the hospital staff, who care for her you? Friends? Family?” I knew that until she dies. In another case, a young Charles had no children from either Dr. Egnor is professor and vice chairman of mother in her late twenties was found to of his marriages. Neurosurgery at the State University of New have a malignant brain tumor when she “No, leave me alone. You’ve done York at Stony Brook, where he has been on was pregnant with her first child. To the enough.” the faculty since 1991. His address is: astonishment (and anger) of the treat- “It was a risk of the procedure . . . Department of Neurosurgery ing neurosurgeon, this mother refuses it was explained to both of you— “ 12080 Health Sciences Center abortion or chemotherapy, in order to “Go away.” pp217–18 Stony Brook University give her child life, even at the cost of her Stony Brook, New York 11794-8172 own. She faithfully videotapes messages The practice of neurosurgery is a E-mail: [email protected]

48 The Pharos/Winter 2009 has taken Sleigh’s prose comments and experience. rendered them, boiling down the fat, “You’ve never been pregnant, have into a lean and surely poetic form: you?” “You’ve never lost a child, have Nightmare you?” My mother arranged It is easy to back off and say that for me to see a doctor who had PNH. I have never experienced that so, of He wouldn’t transfuse me. course, I cannot understand. But the His experience with PNH was you don’t arm that reaches out to others for us transfuse. is our imagination, and we can always It was so stupid reply, “No I haven’t, but I can imagine Patient Listening: A Doctor’s and useless, that it is the worst loss a person can Guide and pointless have.” And having been in that person’s that I was denied transfusions shoes doesn’t mean that they crimp in Loreen Herwaldt because my exactly the same places. I recall a female University of Iowa Press, Iowa City, doctor oncologist who told her patient, “You Iowa, 2008, 174 pages had been through this experience. must be really angry to discover the Reviewed by Frederic W. Platt, MD He was a good man and a good doctor, breast cancer.” The patient denied any but it was frustrating and infuriating anger and the oncologist responded to deal with him because with “Well, I had breast cancer and I ow do you create a poem? Do you he didn’t have the detachment to step was plenty angry so you must be too.” sit at the keyboard (now a com- away What a nightmare! We need our doctors Hputer, no longer pencil and paper or from his case to understand us, not just understand manual typewriter) until beads of blood and look themselves. form on your brow? Do you stare at the at my case. Herwaldt approached numerous au- ceiling for inspiration? Loreen Herwaldt, thors, some of them eager to contribute Everyone thought he would be an infectious disease physician at the to her project and others reticent. In the so compassionate. University of Iowa has a different ap- end she narrowed down to twenty-four But I could not get him to listen. proach. She selected twenty-four well- interviewees; some, such as Richard He refused. He was adamant. known authors, some but not all of them Selzer, Oliver Sacks, and Arthur Frank, He knew it had to be done his way. physicians, and interviewed them at were well known to me; others less so. length about their experience of illness It would be a much smarter idea A few use aliases, noms de plume. I find and their interaction with the medical to have a hematologist many of the resultant poems wonderful care system. Then, from their lengthy who did not have and others ho-hum, but it is Herwaldt’s interviews she distilled short pieces that the same disease I was suffering from. process that seems most fascinating omit all the unnecessary words. Shades and relevant to readers of The Pharos. I talked to him two years ago. of Strunk and White! She calls them After all, the big question is, “Of what It was amazing, utterly amazing. “Found Poems.” use is poetry to doctors?” Here are four He said to me, Herwaldt doesn’t want to claim her of the many possible answers to that “Every time I have a hemolytic episode, work is poetry, but I have no idea what question. I think, man, this is it. else to call it. Consider this little trea- . Poetry can be fun. There are lots I’m convinced I’ll hemolyze down to  sure that deals with the common er- of physician- poets out there who create and die.” roneous assumption that you have to poetry that delights. You may be one of His guard came down. have worn the shoes of your patient to them. Give it a try. And it can also be It was touching and it delighted me. empathize with him or her. Well, some- fun to read. But on the other hand, times having been in that very situation . You may end up with a poet or boy, what a nightmare gives you a better understanding of the two in your practice, and they may be it was patient’s reaction, but sometimes your champing at the bit to show you their to have him treat me.pp125–26 own reaction gets in the way. Here’s work. Read it. The poems will help you Herwaldt’s “Nightmare,” distilled from Doesn’t that tell the story? Yes, I’ve had understand them better than the prose Tom Sleigh, who describes himself as a patients ask me how I could possibly they speak and will likely be more suc- poet with PNH, paroxysmal nocturnal understand how they were feeling when cinct. hemoglobinuria. In this piece Herwaldt I never had gone through the same . Great poems can evoke and

The Pharos/Winter 2009 49 Reviews and reflections

Henderson’s Equation re- imagine the terrible experiences all was kind of like using my high school humans face better than anything writ- French Jerome Lowenstein ten in any medical textbook. I would when I went to Paris. Gadd & Company Publishers, Great cite Auden’s “Musée des Beaux Artes” Let me put it this way. Barrington, Massachusetts, 2008, 304 and Hopkins’s “To a Young Child.” Some doctors would encourage me, pages Where can you find a better evocation help me along. Reviewed by Jay Baruch, MD of loss and grief than in these two short I felt they were open to my questions poems? because when they used words I didn’t . Most importantly for physicians, understand, must start with a confession: I dreaded we encounter powerful stories; hear I would say, “Well, what’s that?” acid-base balance in medical school. amazing things from our patients. We and they would explain. IComprehending the dissociation and carry those images and stories around Then there were other people movement of ions, the creation of buf- with us for days. Writing them down who could tell, of course, fers, the arrows darting into and out of in a journal, or perhaps in a poem, that I didn’t know much and they would blood, kidneys, and lungs led directly and helps us unburden ourselves, a form be like immediately, I believe, to my hair loss. of healing. I remember the time a almost insulted that I would even try. Late at night, nauseated from too much patient, who had once experienced It was as if they were saying, caffeine, jittery with self-doubt, I’d torture shock therapy for recurrent depression, “Leave that to me. myself even further by considering the told me, “It took away the memory Leave that kind of talk to me. truth of my predicament. I wasn’t intel- of my children’s childhood.” I carried You just had swollen ankles. ligent enough to grasp fully the intimate that statement around for days until I You didn’t have edema. details intuited and refined by Lawrence thought to write it down. Or the time Let me talk about edema.” J. Henderson. Unlike me, he didn’t need an eighty-five-year-old woman told That’s the way it was to check the answers at the back of the me, “I’ve been sinking.” And when I when I used medical language.p98 textbook. I’d get depressed, then I’d eat responded as if this were a metaphor, a pint of Ben & Jerry’s. Dr. Henderson she corrected me: “I swim half a mile Sekou Sundiata died in  and was known to us only as a surname, a three times a week, and last Friday Herwaldt dedicates her book to that tag attached to some seminal equations when I swam, I sank. I couldn’t float brave person who had the courage to that described how the body used buf- any more” Once we discovered the speak medicalese like someone attempt- fer systems to maintain neutrality with pleural effusion that had taken away ing high school French in Paris. It is a changing acid concentration in blood. her buoyancy, we were on the track to fitting tribute in a fine book. Now he appears in the flesh as a central effective understanding and treatment. character in Dr. Jerome Lowenstein’s I had to write that one down too. Dr. Platt is a general internist in private novel Henderson’s Equation. So I heartily recommend this book practice and clinical professor of Medicine I wish I’d had Dr. Lowenstein to to physicians, would-be- physicians, at the University of Colorado. A leading explain the beauty of Dr. Henderson’s physicians-in- training, and other clini- authority on communication skills in med- intricate and provocative thoughts. cians. (That’s a whole lot of us.) I rec- icine, Dr. Platt is the author of Conversa- The specific details by which the body ommend it because it offers a wealth of tion Failure, Conversation Repair and Field regulates itself and maintains dynamic unexpected poems to read and savor Guide to the Difficult Patient Interview. His equilibrium through elegant buffering and because it opens a door for all of address is: systems comes alive in this novel, partly us, a route into literary unburdening 396 Steele Street because the ideas of “fitness” and the that will be comforting and joyous. I Denver, Colorado 80206 relationship of the organism to his or her invite you all, do open that door. If you E-mail: [email protected] surroundings, and Henderson’s later ap- are lucky, you will end up with a piece plication of his physiological principles like Sekou Sundiata’s story, transmitted to sociological systems, takes on meta- through Loreen Herwaldt’s abridge- phorical resonance. ment to: I don’t know how best to categorize this work: novel, creative nonfiction, Speaking Their Language memoir? Maybe all three genres were I didn’t learn medical language recruited to construct a story that feels only to communicate with doctors. innately personal and intellectually am- It gave me a sense of power too. bitious. The story centers around Aaron Using medical language with doctors Weiss, a young Jewish medical student

50 The Pharos/Winter 2009 training. Interestingly, as Aaron ad- an understanding of interacting vari- vances in his career, he doesn’t establish ables in a complex system.p235–36 new mentors in medicine. He constantly craves his early mentor’s approval, and Towards the end of his career, seems envious of and bitter about the Henderson directed his energies to the succession of brilliant young protégés student/physician relationship. He said: taken under Dr. Henderson’s wing. As “How do we teach students to become Aaron grows older, he begins to view caring physicians when we do not un- his mentor differently, begins to tease derstand the basic system?” pp234–35 This apart the contradictory elements in the book could serve as a springboard for any with roots on the Lower East Side of man from his powerful influence. The number of larger discussions on health Manhattan. The book chronicles his de- mentor/student relationship is a myste- care systems, physician training, caring velopment and evolution as a physician, rious bond. I related to a young doctor for the poor and underserved popula- son, husband, father, and friend against connecting with a rare, inspiring, and tions, social determinants of health, and the backdrop of social and political un- perhaps flawed teacher or role model, the process of nurturing and negotiating rest in the early twentieth century. Much and holding him in his sights as he valuable relationships in medicine. of Lawrence Henderson’s character is advances in his career. The mentor sto- Medical training and the practice of biographically faithful to the real-life ryline also speaks to the profound im- clinical medicine is a personality stress chemist, physiologist, sociologist, and pact students and former students can test. If there are blemishes, opinions, philosopher. The novel draws a brilliant, have on their mentors. The inspiration biases, insecurities that had been safely complex man as seen through the ador- moves in both directions, establishes concealed, the intense experience of ing eyes of an equally brilliant student. a balance, a neutrality, and, if they’re medical school and medical practice Henderson is enigmatic, gracious, and lucky, true friendship. will eventually root most of those out. quirky, but also a self- centered, elitist, Aaron’s relationship with Henderson And this isn’t necessarily a bad thing. and removed man of ideas. is situated alongside his sweet connec- To study medicine, to be a careful and The breadth of Henderson’s ideas is tion with DePodesta, a poor but skilled caring clinician, to be appropriately sen- woven into the narrative. The reader Italian carpenter and wood craftsman he sitive and humane, you must first study feels ionized and nonionized characters meets one summer working in his Uncle yourself, and discover how and where dissociating and recombining, buffer- Max’s factory in Brooklyn. you fit. ing to achieve balance in their lives. To Dr. Lowenstein has written a book Dr. Lowenstein is an accomplished quote Henderson: “Effective planning that takes us back in time, but touches researcher, clinician, educator, and med- of one’s life was impossible and that the upon timeless topics in medicine. ical humanist. The breadth of his ex- art of living was in great part the art of Medicine is a complex system with mul- pertise is illustrated through work that adapting one’s self to the changing pat- tiple powerful forces at work. Social ranges from the book Acid and Basics tern of external circumstances.” p89 determinants of health, like poverty, to The Midnight Meal and Other Essays The notion of dynamic equilibrium working conditions, and access to health About Doctors, Patients and Medicine, resounds throughout this narrative care, are increasingly relevant today. to his role as publisher of the Bellevue work. How does a poor, working-class Now, more than ever, physicians must Literary Review. Henderson’s Equation Jew fit into the affluent Brahmin world think about patients as individuals with adds to his wide-ranging contribution to of Harvard Medical School in the early singular experiences, relationships, and medical writing. twentieth century? How does a phy- worlds, not simply as diseases in a text- sician square courageous and often book. Dr. Weiss told Dr. Henderson: Dr. Baruch is an emergency physician at unflattering commitment to poor and Warren Alpert Medical School of Brown vulnerable patients with the more de- Working with patients, I seek the University, where he also directs the ethics tached, intellectually progressive, and opposite. I seek the unique . . . each curriculum for medical students. His book reputation-building work in research? patient’s experience of disease is of short fiction, Fourteen Stories: Doctors, How does one measure his or her ideals unique. The most important part Patients, and Other Strangers (Kent State and values when they’re tested in origi- of the relationship with a patient University Press, 2007) received Honor- nal and unimaginable ways? is the physician’s ability to respond able Mention in ForeWord Magazine’s 2007 The tender, tenuous, and volatile re- to that uniqueness. This is what I Book of the Year Awards. His address is: lationship between Dr. Henderson and teach my students. And at the same 55 Claverick Street, 2nd Floor Aaron casts a penetrating light on the time, I teach them that the regula- Providence, Rhode Island 02903 mentor/student relationship in medical tion of acidity in the body requires E-mail: [email protected]

The Pharos/Winter 2009 51 2008 Alpha Omega Alpha Robert J. Glaser Distinguished Teacher Awards

ach year since , Alpha Omega Peter G. Anderson, DVM, PhD Washington State University, and his Alpha, in cooperation with the Professor of Pathology, University of PhD in Experimental Pathology at the AssociationE of American Medical Alabama School of Medicine University of Alabama at Birmingham. Colleges, presents four faculty members Dr. Anderson has a widespread na- in American medical schools with the tional and international reputation for Daniel W. Foster, MD, MACP AΩA Distinguished Teacher Award. In his design and production, with col- John Denis McGarry, PhD, , AΩA named the award to honor leagues, of the Pathology Educational Distinguished Chair in Diabetes and its retiring executive secretary Robert J. Instructional Resource (PEIR.net). Metabolic Research, University of Glaser, MD. Nominations for the award Matching the increased use of web- Texas Southwestern Medical School are submitted to the AAMC each spring based teaching materials, this is one Following his fifteen-year tenure as by the deans of medical schools. of the most popular electronic re- chair of Medicine at the University of Nominations were reviewed by a sources for pathology educational ma- Texas Southwestern Medical School, Dr. committee chosen by AΩA and the terials. At the University of Alabama, Foster became the John Denis McGarry, AAMC. This year’s committee mem- Dr. Anderson is a powerful and ef- PhD, Distinguished Chair in Diabetes bers were: Paul Aravich, PhD; Robert fective teacher, being nominated for and Metabolic Research. Three quali- B. Daroff, MD; Richard deShazo, MD; or receiving the awards each year for ties emphasize his teaching excellence: Steven L. Galetta, MD; Robert M. Klein, Best Teacher, Best Course Director or () Integrity, () a great intellect and PhD; Virginia M. Miller, PhD; John Best Course. In  he received the sense of compassion and justice, and Nolte, PhD; Louis N. Pangaro, MD; highest teaching honor at UASOM, () devotion to his patients and stu- Richard Schwartzstein, MD; James L. the President’s Award for Excellence dents. Dr. Foster continues to be one Sebastian, MD; Steven Spitalnik, MD; in Teaching. He has been Coordinator of the most popular attending physi- Michael Vergare, MD; Robert T. Watson, of the School of Medicine’s Medical cians on the medical wards. He has MD; Jeffrey G. Wiese, MD. Education (Curriculum) Committee received twenty-six awards as a dis- Winners of the award receive ,, since its inception. He is chair of the tinguished teacher from medical stu- their schools receive ,, and active USMLE Step  Pathology Examination dents at UT Southwestern, as well as AΩA chapters at those schools receive Committee, and will join the National the Upjohn Award for the outstand- ,. Schools nominating candidates Board of Medical Examiners in . ing Physician Educator in the field of for the award receive a plaque with the Within the University of Alabama, his Diabetes (), the Robert H. Williams name of the nominee. leadership skills have been recognized Distinguished Chair of Medicine Award Brief summaries of the accomplish- by his election as chair of the UAB (), a Great Teacher Award from the ments in medical education of the  faculty senate. He has been well funded National Institutes of Health (), award recipients follow. by the NIH and other sources for his and the Eric Neilson, MD, Distinguished research into the mechanisms of hyper- Professor Award from the Association Edward D. Harris, Jr., MD tension and cardiovascular diseases. of Subspecialty Professors (). Dr. Executive Secretary Dr. Anderson earned his DVM at 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 leadership following his undergraduate and medi- Distinguished teacher nominees and bioethics, civil rights, and religion, cal school experience at Harvard, where Murray Altose, MD, Case Western Reserve which culminated in his being named to he was elected to AΩA in , his University School of Medicine William Anderson, PhD, University of New the President’s Council on Bioethics in residency in medicine at the Beth Israel Mexico School of Medicine . He is the host on “Daniel Foster, Hospital, research training at UCSF, Ronald Arky, MD, Harvard Medical School MD,” a weekly television series on PBS and chief residency and early faculty David A. Asch, MD, University of and the BBC. appointments at Stanford University Pennsylvania School of Medicine Except for two years as a clinical School of Medicine. Chantal Brazeau, MD, UMDNJ-New Jersey Medical School associate at the NIH, Dr. Foster has , University of North Paul L. Rogers, MD Patrick Carr, MD spent his entire life in Texas. He earned Dakota School of Medicine and Health his MD at UT Southwestern, graduat- Professor, Critical Care Medicine, Sciences ing first in his class and being elected University of Pittsburgh School of Francis Counselman, MD, Eastern Virginia to AΩA in , and he stayed on for Medicine Medical School Craig Wilson Davis, PhD, University of his residency in Internal Medicine un- Dr. Rogers has seven Golden Apple South Carolina School of Medicine der the direction of Donald Seldin. He awards for Excellence in Clinical Thomas M. De Fer, MD, Washington serves on the editorial board of The Education sitting on his desk, and six University in St. Louis School of Medicine Pharos. awards as the Critical Care Medicine Donna Elliot MD, Keck School of Medicine Faculty member of the year. Rounding of the University of Southern California David W. Nierenberg, MD Glen Gabbard, MD, Baylor College of out these recognitions are the University Medicine Edward Tulloh Krumm Professor of Pittsburgh Chancellor’s Distinguished Bertha Garcia, MD, University of Western of Medicine and Pharmacology/ Teaching Award () and the Society Ontario Faculty of Medicine and Dentistry Toxicology and Senior Associate of Critical Care Medicine Presidential Erika Goldstein, MD, University of Dean for Medical Education, Citation Award (). His dean calls Washington School of Medicine Joel A. Gordon, MD, University of Iowa Roy Dartmouth Medical School him “the most highly regarded educator J. and Lucille A. Carver College of Medicine Since arriving at Dartmouth on the at our school, both by students and by Jesse B. Hall, MD, University of Chicago faculty in , Dr. Nierenberg has peers.” Dr. Rogers has been a pioneer Divison of the Biological Sciences Pritzker been known as an “educational star” in the use of human patient simulation School of Medicine at DMS. He founded what remains as a teaching modality for medical stu- Thomas S. King, PhD, University of Texas Medical School at San Antonio the best course at Dartmouth, Clinical dents. At the University of Pittsburgh, Arno Kumagai, MD, University of Michigan Pharmacology and Therapeutics, given his innovations set in motion an institu- Medical School to the entire senior class. In addition to tional decision to embrace high-fidelity Albert Kuperman, PhD, Albert Einstein a sound foundation in therapeutics, he simulation as an essential education College of Medicine of Yeshiva University has modeled for students how to be free modality. His excellent curricular devel- Linda Mottow Lippa, MD, University of California, Irvine, School of Medicine from influence from the pharmaceutical opments facilitated a decision to require Fred A. Lopez, MD, Louisiana State industry. Since  Dr. Nierenberg has critical care medicine as a component University School of Medicine in New directed the Scientific Basis of Medicine of the internal medicine clerkship. Dr. Orleans course correlating organ system physi- Rogers conducts daily teaching sessions Bennett Lorber, MD, Temple University ology, pathology, and clinical disease. with medical students before leading School of Medicine Susan Masters, PhD, University of Recently, he has worked on curricular bedside rounds in the ICU. He has re- California, San Francisco, School of renewal, the New Directions plan uti- ceived substantial research funding for Medicine lizing problem-based learning to de- his work in experimental therapeutics Gary D. Plotnick, MD, University of velop competency-based physicians. His in critical illness. Maryland School of Medicine longevity as a teacher is reflected by After receiving his BS at Century David A. Rogers, MD, Southern Illinois University School of Medicine his having received from the graduat- College and his MD degree at the Monica Shaw, MD, University of Louisville ing class in  the Clinical Sciences University of Arkansas, where he was School of Medicine Teaching Award, with repeated awards elected to AΩA in , Dr. Rogers Myles Sheehan, MD, Loyola University in  and . In  and  he was an Internal Medicine resident at Chicago Stritch School of Medicine was given the Best Educator prize in the the University of Virginia and Critical Jack T. Stern, Jr., MD, Stony Brook University Medical Center School of Department of Medicine. Second-year Care fellow at the NIH. He joined the Medicine students in  and  voted him University of Pittsburgh faculty in . John Tarpley, MD, Vanderbilt University their best lecturer, small group leader, School of Medicine and overall educator. Patricia Thomas, MD, Johns Hopkins Dr. Nierenberg arrived at Dartmouth University School of Medicine

The Pharos/Winter 2009 53 Letters to the editor

Re “Wrongful death” and they want to operate on her.” I told was coming to see her. “Okay”—shortly I read your recent editorial (Summer him I would check on things. When I the husband called our office and can- , p. ) with the greatest interest: it came back to see him, I told him I had celed the house call. I went anyway and recalled a score of patients throughout checked things out and she needed knocked on the door, was treated cour- my nearly fifty-year career as a hema- surgery. He said, “Yes, I want her oper- teously and shown to her bedside. tologist and oncologist. ated on but I can’t sign for it because I found a young woman lying on You struck a marvelous balance I’m a Christian Scientist, as you know.” I her side with a contracture of her hip without being stridently censorious . . . felt a chill go down my spine. Mr. Kyser due to a ruptured appendiceal abcess and it shined a light on homeopathy then said, “Georgia is not a Christian presenting in her groin. The husband which celebrates the dictum of “pri- Scientist. She could sign but she’s visit- would carry her to the bathroom. Her mum non nocere.” ing her mother in California.” Another temp was  and she was quite pale. Thanks for your successful efforts. spinal chill. After relaxing a few sec- She had been bedridden for three onds, I said, “Do you have her phone weeks. George H. Porter, MD number?” We had the hospital phone The husband agreed to hospitaliza- (AΩA, Duke University, ) operator call the number and got Mrs. tion, and there I got consultation from President Emeritus, Ochsner Clinic Kyser. I told her what was necessary, my wonderful surgeon friend, who was Foundation she said, “Yes,” as the phone operater a gentle, quiet guy, not threatening in New Orleans, Louisiana and another resident listened in. any way. Together we took her to the I just read your editorial in the Years later, the other daughter de- OR, drained the abcess, and started recent issue of The Pharos. Do you veloped ovarian cancer, said goodbye antibiotics. Later, she walked out of the remember the band leader Kay Kyser, to her friends, and went off somewhere hospital. who had radio shows on NBC in the to die. Some months later I got a letter s? I have never understood Christian from the patient, thanking me, and Some time in the mid s he Science. I wish when I was a student at saying that she was wrestling with her converted to Christian Science to help UNC School of Medicine they had Mr. belief in Christian Science and had not his “arthritis.” During his active days, Kyser come to a class or Grand Rounds come to a conclusion yet. he married late to a young singer in and discuss it. So thank you for teaching me what his band, Georgia Carroll. He moved I didn’t know about the background of Duncan S. Owen, Jr., MD, FACP to Chapel Hill in . They had two Mary Baker Eddy and Phineas Parker (AΩA, Virginia Commonwealth girls. As a freshman in , I remem- Quimby. University, ) ber the Kysers rolling the children in a Richmond, Virginia William W. Johnson, MD baby carriage. We became friends. My (AΩA, Northwestern University, ) late physician father had known Mr. My general practice was in Los Medford, Oregon Kyser when they were in undergraduate Gatos, California. I had an estimated school. , patient encounters in forty I was a medical resident at the hos- years. Medical illiteracy pital in . One night, when I was One day out of the blue came a The summer issue was superb. Every on call, I stopped by the ER to see phone call from San Francisco, the pro- article sparkled with elegant writing what was going on. Mr. Kyser was ducer of an excellent medical TV show. and pertinent new information (to standing against a wall. I said, I don’t know how he got my name. me). But several of the essays left me “Mr. Kyser, can I help you “I have a niece who is a Christian with a forlorn sense of angst. In my with anything? He said, Scientist, who is very ill in your simple-minded view, the historical and “Duncan, one of my area. Would you see her? She’s only contemporary popularity of alterna- daughters is sick twenty-eight and can’t get out of bed at tive medicine (CAM is an unfortunate with appendicitis home.” I phoned the home and said I euphemism) is primarily related to the

54 The Pharos/Winter 2009 dismal medical illiteracy of the public, 1955: Polio and the bomb are still being followed for their health a worldwide phenomenon. Far too Samantha Williamson’s excel- outcomes after the A-bombs. These many are uncritical and uninformed, lent winning student essay, “The included pregnant women and children regardless of sophistication or level of Congressional Polio Vaccine Hearings who were exposed. The systematic ob- education—thus vulnerable to myth and of ” (Spring , pp. –) de- servations, based on the template of the hype. What is printed or spoken in the scribed the role of Dr. Thomas Francis Francis Report of , have become the media seems to be accepted as inviolate and awoke memories of my first month major basis for current radiation protec- “truth”—despite tons of evidence to the of internship on the Tufts service at the tion recommendations. Major findings, contrary. The Internet has had an am- old Boston City Hospital (BCH) during particularly cancers and growth and bivalent influence; most people are in- July . Dr. Francis, at the University developmental effects in those heavily sufficiently curious or critical to identify of Michigan, was the influential epi- exposed, have been widely published. sources, even when such are available. demiologist for the Salk polio vaccine The next generation is not affected. One possible partial solution I once program at the Congressional Polio The two Francis Reports, about entertained was to educate our young Vaccine hearings in the Spring of . six months apart in , and the about the basic science and logical ra- He also was the major architect for a Congressional hearings that year af- tionality of the scientific method. Many project in which I participated fourteen fected the lives of many people world- years ago, when I first was retired from years later; the second Francis Report, wide, including me and my family. My medicine, I lived in a remote rural com- delivered later that year, established the marriage that year was sensational, but munity. Just for fun, I undertook to epidemiologic basis defining the closed had little global attention. teach “scientific method” to senior high populations that would be examined I joined ABCC in  as Chief of school students as part of their science every two years for health effects of the Medicine for the next three years and, class. Among other things, I tried, in atomic bombs dropped on Hiroshima with my wife, Jane, and four children one lecture, in simplest language (with and Nagasaki in . Benefits of the aged seven through thirteen, lived in metaphor and blackboard), to describe Salk vaccine and the biennial examina- Itsukaichi, a suburb of Hiroshima, in an the mechanism and critical importance tions of A-bomb survivors continue elegant Japanese house overlooking a of randomized controlled trials in med- today. fishing boat harbor on the Inland Sea. icine. I also expressed my professional The wards of the BCH infectious Joseph L. Belsky, MA, MD humility at the vast area of unknowns disease building were virtually empty (AΩA, Albany Medical College, ) in human physiology, the many uncer- when I arrived. Before the end of the Danbury, Connecticut tainties in medical knowledge, and the fourth of July holiday weekend, polio need for all of us to be observant and suspects began to arrive. My co-intern critical of many things we read and and I performed increasing numbers of More REAL doctors in the hear in the popular media—to insist on spinal taps, filled the empty ward beds movies reasonable scientific “proof” before ac- and learned quickly how to hand pump I was glancing through the lat- cepting things as “facts.” the respirator bellows when electricity est Pharos and, as always, your movie It was a disaster. Perhaps it was the failed. Before the end of July more help reviews. I noted the question of ac- clumsy technique of the pedagogue, but arrived. There was no specific treat- tual physicians in feature movies and the very few students who managed to ment, mostly isolation, hot packs (the wanted to reply. The Steve McQueen remain awake seemed to grasp the basic Sister Kenny method), and analgesics movie classic Bullitt was, as I’m sure idea that they should be critical of what for myalgia and headache. you know, shot in San Francisco in they heard and read. Maybe that should The building housed mementos of about . A fair amount of the movie have been enough. past epidemics. The spinal trays were was shot at the old San Francisco I suspect that reasonable medical porcelain with glass manometers. The General Hospital and a number of phy- literacy, especially a sense of skepti- iron lung was not far from the beds. A sicians, mostly house staff, were in the cism about what is loudly (or subtly) fireman’s pole sped the on-call house film. Two of them I knew well. They touted in the media, may be imparted officer from his bed on the second floor were Louis Gilula (now a radiologist at to students by those more skilled—but to expedite treatment of a choking child Washington University in St. Louis) and probably not. Sadly, I suspect it is a lost with a mahogany obdurator to break a Lorne Elthrington (an anesthesiologist cause. diphtheritic membrane. at Stanford and in practice in Redwood At the Atomic Bomb Casualty City, California). Both had speaking Robert H. Moser, MD Commission (ABCC) in Hiroshima and roles, which were highly prized as the (AΩA, Georgetown University, ) Nagasaki, Japan, post-World War II roles paid , which you will remem- Green Valley, Arizona Japanese numbering more than , ber was truly a windfall profit based

The Pharos/Winter 2009 55 Letters

on our house staff salaries in . Lou Kent Brooks, MD, a  graduate of Maladies des Poumons et du Coeur,” played an anesthesiologist in an OR the University of Kansas School of published in . Laennec found direct scene (note it was Lorne who ultimately Medicine, played the role of the inef- auscultation of the thorax to be less became the anesthesiologist) and fectual Dr. John Spivey in One Flew than ideal under many circumstances. Lorne, if my memory is correct, had Over the Cuckoo’s Nest. Dr. Brooks Stimulated by his observation of chil-  speaking scenes! Part of my vivid was Superintendent of Oregon State dren playing near the Louvre listening memory of these details comes from Hospital, where the film was shot, and to the end of a long piece of wood that envy. You see, both Lou and Loren were he gave co- producer Michael Douglas transmitted the sounds of a pin scratch- my interns then when I was a first-year access to a vacant ward and the hospital ing, the following day Laennec rolled a resident (now called an R) and  grounds in . Dr. Brooks came under piece of paper into a tube, tied it with a got the parts and I didn’t. Envy is espe- fire for allowing Cuckoo’s Nest to be string and listened to his patient’s chest. cially green when others get the green. filmed at Oregon State Hospital and for Being a carpenter, Laennec fashioned tacitly portraying psychiatric treatment his listening device from wood, con- Gerald Charles, MD in a harsh and technically incorrect structing a cylinder  centimeters long (AΩA, University of Colorado, ) light for the time period (for example, and . centimeters in diameter. Thus University of California, San Francisco anesthetics and muscle relaxants were the stethoscope was born. Laennec died The summer issue of The Pharos is in common use in  even though the of pulmonary tuberculosis. His nephew, splendid, from cover to your thought- film shows Jack Nicholson’s character Meriadec, listened to his uncle’s chest ful and informative film reviews. The receiving ECT without such benefit). and heard the fateful sounds of pulmo- question of doctors as film actors was In fact, in the wake of a long history of nary tuberculosis. He used his uncle’s intriguing. documented patient abuses, Oregon stethoscope to make the diagnosis. Do bit parts count? While I was in State Hospital is being torn down and Laennec returned to Brittany from my four years of training for Pathology rebuilt. Dr. Brooks, who retired from Paris following the diagnosis, which (–) at what was then the U.S. practice in , is now ninety-one was a harbinger of certain death at that Public Health Service Hospital on years old. time. While in Brittany, he wrote his Staten Island, New York, the head of will, in which he bequeathed his stetho- Arthur Lazarus, MD, MBA the OB/Gyn division was a Dr. Robert scope to his nephew. (AΩA, Temple University School of B. Dorsen, an excellent obstetrician in Recently I had a routine appoint- Medicine, ) the old style, who eventually delivered ment with my doctor. A few days later Chadds Ford, Pennsylvania three of our six children. Bob delivered I accompanied my wife to a follow-up our son Douglas () by the normal Regarding physicians who were appointment with her oncologist. route, despite a forecoming hand, with cast in feature films, I submit Bruce Thankfully both encounters resulted in no harm to mother or baby. He was Gewertz, who was a year or two behind good news. At each of the two visits the justifiably proud of avoiding a C- section me at Jefferson. Bruce, a surgical de- patient was examined first by a fellow by careful maneuvering during the birth partment chairman in Chicago, played and then by the attending physician. process. the department chairman at Richard On all four examinations of the thorax, Bob was also proud of having had Kimball’s (Harrison Ford) hospital in the physician listened through the pa- a bit part as a public health officer in the movie version of The Fugitive. You tient’s shirt or gown, never raising the Panic in the Streets. It has been so long will recall that movie also featured clothing to listen to the lung fields or, since I viewed that film that I cannot mountains and a very large dam in the for that matter, to percuss the thorax. I recall whether Bob had any spoken plains of Illinois. cannot say that I was shocked by these lines. At any rate, Bob will always have observations, rather I was surprised James E. Barone, MD a special place in our hearts. I doubt and disappointed. Having examined the (AΩA, Jefferson Medical College, ) that he is still alive, but wherever he is, chests of thousands of patients during Stamford, Connecticut he deserves respect as a fine doctor . . . the past fifty-five years in the specialty and actor! of Thoracic Surgery, I learned that, at Calling Dr. Laennec! least for my hearing process, applica- John L. Meyer II, MD René-Théophile-Hyacinthe Laennec tion of the stethoscope directly to the (AΩA, SUNY Downstate, ) was born on February , , and died skin yields the most dependable audi- Rockland, Maine on August , . He invented the tory transmission. I am aware of at least one “real doc- stethoscope in  and reported its use Like others of my vintage (MD ) tor” who had a somewhat memorable in a paper entitled “De l’Auscultation I decry the decline and misuse of the role in a very substantial movie. Dean Médiate ou Traité du Diagnostic des History and Physical Examination,

56 The Pharos/Winter 2009 which are the first and usually most References politically and in medicine has been important steps in the doctor- patient . Caroline NL, Schwartz H. Chicken unable to effect more than band-aid encounter. It is more than the infor- soup rebound and relapse of pneumonia: changes to the system, perhaps AΩA mation that one can glean from the Report of a case. Chest ; : –. can at least begin a working model for H&P that make them so important. . Kisch B. Salt-poor diet and Jewish desirable change. Essential, too, are the bonding and dietary laws. JAMA ; : . Henri R. Carter, MD, FACS relationship-building that the H&P Shimon Glick, MD (AΩA, University of Arizona, ) imparts between the patient and the (AΩA, SUNY Downstate, ) Yuma, Arizona physician. I do not minimize the im- Beer-Sheva, Israel portance of new and sophisticated diagnostic tests, such as the CT scan, MRI, and the PET scan. But they Health care reform should supplement, not replace, a I don’t know if it is even a consider- properly planned and carried out H&P, ation for Alpha Omega Alpha, through which includes listening to the chest The Pharos, to put forth a request for with the stethoscope diaphragm or bell proposals for health care reform. This applied directly to the skin. country is in desperate need of a com- prehensive Flexner-type report involv- James B. D. Mark, MD ing cradle-to-grave medicine rather (AΩA, Vanderbilt University, ) than just the educational aspect. This Stanford, California could be divided into various components such as, but not limited to, medi- Be careful of chicken soup cal school prerequisites and admission In your recent editorial (“Wrongful process, medical school curriculum, death,” Spring , p. ), you com- medical school indebtedness, post- Physician-statesmen pared homeopathy to chicken soup graduate training, regulation of medi- We enjoyed reading the excel- with respect to their harmlessness. I cal practice, liability issues/defensive lent Pharos article by Davidson and agree about homeopathy, but I must medicine, payment and funding issues, Dantas (Summer , pp. –) caution about chicken soup, par- competency, paraprofessional involve- on three-term U.S. Senator Royal ticularly the kosher type so famously ment, etc. The intellectual prowess and S. Copeland, MD (–), who extolled by the late Nancy Caroline in lifelong commitment of Alpha Omega served for a decade as dean of New her now classic article.1 Chicken soup Alpha members rendering opinion on York Homœopathic Medical College prepared from chickens according various aspects of our medical system (–). His work marks him to Jewish dietary laws (popular even that need to be addressed and rectified as one of the top three of fifty-one among non-Jews) can often be deadly may help to extract ourselves from the “ physician-statesmen” in U.S. Senate for patients with congestive heart morass in which our health care system history for spearheading the land- failure because of its extraordinarily is bogged. It might be that a compila- mark and enduring Food, Drug, and high salt content. Those who work tion of these essays could even serve Cosmetic Act of . We are in favor in hospitals serving an elderly Jewish as a basis for reform and perhaps even of the idea that being a medical school population have long been aware of the have some funding, given that CMS is academician might qualify one for high epidemics of pulmonary edema follow- willing to pay for “quality” advice from elective office and hope Copeland’s ing Passover and other Jewish holidays. outside consultants. biography will inspire American medi- Over fifty years ago the cardiologist A combination of legal threats, reg- cal school leaders to consider this op- Dr. Bruno Kisch published data show- ulatory obligations, payment schemes, tion, as the United States might be ing that the salt content of koshered and, paradoxically, technological in- enhanced by physicians joining lawyers meat can be reduced to its basic level novation, has led to “medical care” in running our country. However, we by three successive half-hour soaks beyond recognition of what had consti- note that this essay avers that NYHMC in warm water.2 This information has tuted reasonable and customary in the remained operational only until . been of great assistance to a number past. As a result, in the United States, In fact, its name was altered slightly in of my patients who had previously suf- health care has deteriorated to a point  by dropping “homœopathic,” but fered from recurrent attacks of pulmo- of general mediocrity while simultane- it continues vigorous and vibrant to nary edema induced by chicken soup. ously generating costs to a a point of this day as New York Medical College, bankruptcy. As current leadership both along with the other four surviving

The Pharos/Winter 2009 57 Letters

homeopathic-oriented medical schools: before this issue of The Pharos arrived Boston University, the University of my wife unearthed my old thesis. Its Michigan, the University of Iowa, and title was “Medical School Curricula: Hahnemann Medical College (since The Second Revolution, –.”  Drexel University College of The work was a description of a period Medicine) in Philadelphia, all commit- of flux in medical education. What was ted to allopathic medicine but proud of then Western Reserve University began their history when medicine was in a to rethink the basics of medical educa- different stage of development. tion, striving to turn med school into a “graduate school experience.” Here is Robert A. Schwartz, MD, MPH the first paragraph of the paper. (AΩA, New York Medical College, ) Councilor, UNDMJ-New Jersey Medical In  the Council of Medical School Education of the American Medical Newark, New Jersey Association surveyed the curricula of the medical schools then in op- Karl P. Adler, MD eration. They found the first year (AΩA, Georgetown University, ) predominantly filled with courses President and CEO, New York Medical in anatomy, biochemistry, and What Kind of Guy? College physiology taught by the respec- New York, New York tive departments. The second year “He’s a bow tie kind of guy,” was essentially an extension of the I heard her say, first, with pathology, pharmacology, while waiting in a crowd. bacteriology, physical diagnosis, “I am a bow tie kind of guy,” and clinical laboratory instruction I thought, then wondered taught in the same way. The sopho- what that meant. more year was intended to be tran- It was not the color of the tie sition between the basic sciences of that mattered, the first part of the curriculum and nor the pattern of the silk. the later clinical instruction; but at Was it the Windsor knot, almost every school, the first two that hangman’s noose around the years centered on long lecture ses- neck, sions, grading was on an A through the butterfly so much lighter? James Harvey Young and medical F basis with many schools rank The choice was not comfort— education ordering students to heighten com- then practicality? I read Donald Marcus’s article petition, and the rigid “lockstep” I was always needing “James Harvey Young, PhD (– schedule of courses did not allow to tuck the tie ): Historian of Medical Quackery” students to assume a hand in their inside my shirt, (Summer , pp. –) with delight. own education. for fear of dirtying it at work. The content was good but the memo- That’s why I had worn ries were priceless. Harvey Young was Re-reading this paragraph leaves paisleys in the past. faculty advisor for my college honors me with at least two questions. First, thesis. Visions of the then well-worn wouldn’t it have been great to have had One day, it just happened— Emory University Department of a word processor in college? Second, I discovered something History building complete with Dr. if I were a college student now writing about myself. Young’s dusty office stacked to the a similar thesis, would my word pro- I am a bow tie kind of guy. eaves with papers, books, and pat- cessor produce an opening paragraph ent medicine bottles—empty as I significantly different from what was Richard Bronson, MD recall—came back to me. I can see written in ? Dr. Bronson ( , New York University, !"##) is his generous mutton-chop sideburns AΩA Frederick E. Turton, MD, MBA, FACP director of Reproductive Endocrinology at Stony and remember the calm guidance so (AΩA, Emory University, ) Brook University Medical Center. He is a member needed by his charge. of the editorial board of The Pharos. His address Sarasota, Florida As luck would have it, about a week is: Department of Obstetrics, Gynecology and Reproductive Medicine, SBUMC, Stony Brook, New York !!$"%-&'"!. E-mail: richard.bronson@stony- brook.edu. 58 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 grandpa Had visited the world, And on the phone they talked each night, Youth and age unfurled. “You’re seventeen and don’t need me To see through manhood’s lens, And I will understand if you Would rather be with friends. We’ll still connect from time to time And find a way to chat.” “Shut up!” said teen-aged Will, and meant He’d heard enough of that. Melvyn H. Schreiber, MD

Dr. Schreiber (AΩA, University of Texas Medical Branch, Galveston, !"#$) is the Robert N. Cooley Distinguished Professor of Radiology at the University of Texas Medical Branch, Galveston. His address is: The University of Texas Medical Branch at Galveston, Department of Radiology, Galveston, Texas %%###-&%&". E-mail: [email protected]. Illustration by Jim M’Guinness Winners of the 2008 Pharos Editor’s Prize Library in San Marino, California. He suggested that I look The  Pharos Editor’s prize has been awarded to into London’s mysterious death from renal failure given my four authors: Andrew Bomback, MD (AΩA, Columbia dual interests in fiction and nephrology. London’s writing University, ) for his collaboration with Dr. Philip J. provided a fantastically detailed patient history, and Dr. Klemmer on “Jack London’s ‘chronic interstitial nephri- Klemmer’s expertise helped whittle down the differential tis,’ ” (Winter , pp. –); Andrew J. Schoenfeld, MD diagnosis to the suspected case of mercury nephrotoxicity. (AΩA, Northeastern Ohio Universities, ), for his his- Dr. Schoenfeld says of himself: Born and raised in New torical fiction piece, “The private remonstrance of Doctor York City, I have been writing creative fiction since I was Botkin, or Pharaoh’s Physician” (Summer , pp. –); seven. I am an Honors graduate of Kent State University, Mani Mokalla, MD (AΩA, University of Minnesota, ) where I studied both history and creative writing. My infor his personal essay, “Searching for God below the vo- terests include Eastern European history, military history, cal cords” (Winter , pp. –); and Madeline Leong, Jewish history, and ethno- religious cultural mythology. I MD/PhD candidate at Duke University, for her essay, “First have published widely in the fields of orthopaedics and month on the wards” (Spring , pp. –). Jewish history. Besides my involvement in academic re- Dr. Bomback writes: I am currently the Doc J. Thurston search, I combine my historical and literary interests into III Fellow at the University of North Carolina at Chapel Hill. works of fiction. My first novel, The Place of the Skull, I have been writing fiction for the last decade. My short which touches on many of the same topics addressed in stories have appeared in a number of literary magazines, “The Private Remonstrance of Doctor Botkin,” was released and my first novel, You’re Too Wonderful to Die, was pub- from Borders Publishing this fall. I am currently a fellow in lished in . My senior author, Philip J. Klemmer, became spine surgery at Harvard Medical School. interested in Jack London’s life after visiting the Huntington Dr. Mokalla says: I serve as a pediatric hospitalist at

Andrew Bomback, MD Andrew J. Schoenfeld, MD

60 The Pharos/Winter 2009 National and chapter news

Mani Mokalla, MD Madeline Leong, MD/PhD

Minneapolis Children’s Hospital. I am Iranian and mar- to the author(s) of original nonfiction manuscripts pub- ried to a lovely Irish-American woman. We have two lished in The Pharos. Authors need not be members of wonderful children. My life is rooted in a culture rich ΑΩΑ, but must be forty-five years old or younger as of with storytelling. My parents are well established au- December of the calendar year in which the paper is sub- thors, and reading and writing has been a cornerstone mitted. To be competitive for a prize, the paper submit- of my life. Living and studying in different cultures has ted must be in the standard format of The Pharos (see strengthened this foundation. Medicine provides unique Instructions for Pharos Authors immediately following), and ample opportunities for sharing stories. By sharing and not published previously in any form. Content should stories from my work I hope to convey the wide spec- be in the areas emphasized by The Pharos—medical trum of human behavior in times of stress, and the ideals history and biography, ethics, professional issues, and common to all. personal essays. Essays submitted to the ΑΩΑ Helen H. Ms. Leong tells us: I am half-Chinese, half-Jewish and Glaser Student Essay competition are not eligible for this grew up in New Mexico. When I was seven, my mother prize, nor are previous winners of the Editor’s Prize eli- made me keep a journal, and each entry had to be four sen- gible to compete. All manuscripts are subject to review of tences long. I complied as long as “Hi” and “Bye” counted Pharos editorial board members. Judging will be on the as sentences. Then I started writing. It took me a long time basis of style and composition, originality, scholarship, to find what stories matter, which ones bring you outside and interest and relevance to medicine. yourself. When I wrote “First Month,” I felt overwhelmed by my first experiences in the hospital. And yet, the kind- Instructions for Pharos authors ness I saw in patients and doctors alike comforted me. We welcome material that addresses scholarly and non- Looking back, I think how lucky I was. technical topics in medicine and public health such as history, biography, health services research, ethics, education, Announcing the 2009 Pharos Editor’s Prize and social issues. Poetry is welcome, as well as photograph/ For the twelfth year, Alpha Omega Alpha is pleased poetry combinations. Photography and art may also be to offer up to four prizes of , , , and  submitted. Scholarly fiction is accepted. All submissions

The Pharos/Winter 2009 61 National and chapter news

are subject to editorial board review. Contributors need be used to verify the accuracy of the quotations in the text not be members of Alpha Omega Alpha. Papers by medical and the references cited, and to correct any errors or omis- students and residents are particularly welcome. sions. The photocopies will not be returned. Submissions must meet the following criteria: References should be double-spaced, numbered con- . Submissions may not have been published elsewhere secutively in the text, and cited at the end in the following or be under review by another journal. standard form: . Essays should have a maximum of  pages (approximately  words), and be submitted in -point type, Journal double-spaced, with one-inch margins. They should be Zilm DH, Sellers EM, MacLeod SM, Degani N. accompanied by a covering letter, a -word abstract, and Propranolol effect on tremor in alcoholic withdrawal. Ann a title page with the word count (or page count), return ad- Intern Med ; : –. dress, and e-mail address. Papers exceeding the page count noted will be returned to the author. References should not Book exceed  unique items (see below). Harris ED Jr. Rheumatoid Arthritis. Philadelphia: WB . Poems or photograph/poetry combinations should be Saunders; . in -point type, with one-inch margins, with the author’s name, address, and e-mail address on the first page. Book Chapter . Send your submissions to Edward D. Harris, Jr. M.D., Pelligrini CA. Postoperative Complications. In: Way LW, Editor of The Pharos,  Middlefield Road, Suite , editor. Current Surgical Diagnosis and Treatment, Ninth Menlo Park, California . You may also e-mail them to: Edition. Norwalk (CT): Appleton & Lange; : pp –. [email protected]. . After peer review, comments on the manuscript will Each reference should be listed in the bibliography only be sent to the author along with an editorial decision. Every once, with multiple uses of a single reference citing the same attempt is made to complete preliminary reviews within bibliography reference number. Examples are available at six weeks. our web site: www.alphaomegaalpha.org. . The editors of The Pharos will edit all manuscripts Citation of web sites as references is discouraged unless a that are accepted for publication for style, usage, relevance, site is the single source of the information in question or has felicity, and grace of expression, and may provide appro- official or academic credentials. Examples of such sites are priate illustrative material. Authors should not purchase official government web pages such as that of the National illustrative material because the editors cannot guarantee Institutes of Health. Encyclopedia sites such as britannica. that it will be used. com are not primary references. . In accordance with revised copyright laws, each con- tributor will need to sign an Author’s Agreement, which will Leaders in American Medicine be sent with the edited galleys. Information on copyright In , as a result of a generous gift from Drs. David ownership and re- publication of articles is detailed in the E. and Beatrice C. Seegal, Alpha Omega Alpha initiated a Author’s Agreement. program of one-hour videotapes featuring interviews with distinguished American physicians and medical scientists. Reference information The collection has been donated to the National Authors are responsible for the accuracy of citations and Library of Medicine, which will maintain it for permanent quotations in their papers. Once a manuscript has been ac- use by scholars visiting the library. Videotapes continue to cepted for publication, therefore, the author will be required be available for loan from AΩA. A listing of available tapes to provide photocopies of all direct quotations from the can be found on our web site: www.alphaomegaalpha.org, primary source material, indicating page numbers. (Please or by contacting Ms. Debbie Lancaster at d.lancaster@ mark the quoted material on the photocopies with high- alphaomegaalpha.org or () -. Please also con- lighter.) In addition, the editors will require photocopies of tact Ms. Lancaster to borrow tapes. Those wishing to pur- all references: the title page and copyright pages of all books chase copies may do so by contacting Ms. Nancy Dosch, cited, the first and last pages of book chapters cited, and the manager, Historical Audiovisuals, History of Medicine, first and last pages of journal articles cited, as well as the Building , Room E-,  Rockville Pike, Bethesda, Table of Contents of the particular issue of the journal in Maryland . Telephone () -, e-mail nancy_ which the cited article appeared. The foregoing items will [email protected].

62 The Pharos/Winter 2009 Welcome to

To the tune of “La Donna e Mobile” from the opera Rigoletto by Giuseppe Verdi Verse I

Welcome to AΩA You’ve made it all the way You will not go astray Because you’re A-OK It was just yesterday That you entered the entryway To med school’s alleyway For your first study day

You are now AΩA To you a big hooray And let us all say Drink Chardonnay Aha, aha, drink Chardonnay Ah . . . to AΩA!

Verse II Soon you will graduate And likely relocate And start to activate A license to medicate Remember your identity With joy and humility Work with tenacity And keep your virtuosity

You are now AΩA To you a big hooray And let us all say… Drink Chardonnay Aha, aha, drink Chardonnay Ah . . . to AΩA!! Daniel V. Schidlow, MD

Dr. Schidlow (AΩA, Drexel University, !""#) is professor and chair of the Department of Pediatrics and Senior Associate Dean of Drexel University College of Medicine. He sang this song at the April $%, !""%, AΩA induction dinner there. His address is: St. Christopher’s Hospital for Children, Erie Avenue at Front Street, Philadelphia, Pennsylvania $&$'#-$"&(. E-mail: daniel.schidlow@ drexelmed.edu.

The Pharos/Winter 2009 63 Alpha Omega Alpha members elected in 2007/2008 Chapters are listed alphabetically by state, province, or country, then in order of charter

David Geffen School of Medicine at UCLA—Delta California This listing is current as of December ,  Students: John Anderson-Dam, Yagil Barazani, Jori Felice Bogetz, Michael Ryan ALABAMA Briseno, Jennifer Chang, Michael Carl Chen, Bryan Joseph Correa, Adam DeConde, University of Alabama School of Medicine, University of Alabama at Allison Marie Faucett, Kiran Gollapudi, Anna Leah Grossberg, Hannah Hope Birmingham—Alpha Alabama Holcombe, Jo Marie Janco, Sarah Sung Kim, Michael Aaron Lalezarian, Mathew Students: Laura Ellen Anderson, Donald Earl Baker, Wesley Michael Cleaves, Chad Douglass Longacre, William Charles Lorentz, Niraj Harendra Mehta, Allison Ann Matthew Corrigan, John Benjamin Crew, Phillip Jordan Dean, William Bruce Morgan, Rupa Narayan, Oreoluwa Ogunyemi, Amy Paris, Steven Rad, Monika Donnellan, Michelle Elizabeth Downing, Justin Michael Hall, Stephanie Weikard Saeedian, Supriya Saha, Victor Sai, Madeleine Joanna Saran, Justin Robert Wallace, Israel, Bethany Ann Jackson, Katrina Ann Julian, Charles Anthony Khoury, Michael Aviva E Weinberg, Jonathan A Wu, Celia Ka Wai Yau Jeffrey Lyerly, Kevin Tyler Nash, James Timothy O’Neil, Kristin Kelly Porter, Erin Lee Loma Linda University School of Medicine—Epsilon California Prince, Virginia Stinson Radcliff, Leah Kathleen Rankine, Megan Danielle Seibert, Students: Allison Danielle Bacon, Kelsie Janelle Bickley, Cassie Lee Booth, Jonathan William Richard Stetler, Cosby Allen Stone, Nicholas M Vetrano, Anup Amit Vora, Wilson Boyd, Ioana Flavia Brisc, Cody Allan Chastain, Carol Chiu, Sara Chiu, Charles Graham Wells, Shad Atkinson Williams, Shelton W Wright Andrew Lewis Cornelius, Annemieke Mattanja de Lange, Adam Fershko, Terry Alumni: David Winston Kimberlin, Nathan Bert Smith Robert Fleck, Gwen Ellen Gleason-Rohrer, Kelly Thomas Kieper, Victoria Valinluck Faculty: Jamy Darone Ard, Omar Hameed Lao, Rebecca Jean Larson, Samuel H Lee, Justin McLarty, Sharon Elaine McNeill, House staff: Brandon Wayne Harden, Victor Wai-Da Sung Brian Darryl Moseley, Amanda Munk, Tanya Sami Nino, Mary Elizabeth Ritter, University of South Alabama College of Medicine—Beta Alabama Gillian Seton, Matthew Charles Shillito, Timothy Snelson, Astrid Ruth von Walter Students: John David Adams, Eugene Willis Brabston, Kate Minor Brown, Thomas Alumni: Robert Thomas Smith E Foster, Paul Joseph Hannon, Anthony DeVan Hollman, Brett Agee Parker, Sarah Faculty: Francis Dick-Wai Chan, Darla Roye Shores Elizabeth Swyers Parker, Kathryn N Pettit, Ryan Christopher Pettit, Marat Yanavitski House staff: John Christian Gregorius, Brinda Thimmappa Alumni: Leslie Weyler Panus, Kevin Keith Varden University of California, Irvine, School of Medicine—Zeta California Faculty: Elizabeth Ann Manci, Richard Marc Zweifler Students: Kristopher Troy Chiles, Allyson Estess, David Floriolli, Shahrouz Ganjian, House staff: Samuel Bennett Slade Hooks, Suzanne H Martin Amandip Singh Gill, Marnie Granados, Allison Campbell Hill, Kristy Faye Hinchman, Shawn Keiji Kaku, Neil Kalra, Rupa Pugashetti, Lili Sheibani, Jesse Stondell, Erin ARIZONA Michelle Toole, Christopher Washington, Jeffrey Eric Wong, Tritia Reina Yamasaki University of Arizona College of Medicine—Alpha Arizona Faculty: Shahram Lotfipour Students: Matthew William Beal, Andrew Loren Blount, Munish K Chitkara, Kyle University of California, Davis, School of Medicine—Eta California Palmer Edmonds, Benjamin Harold Feldman, Elizabeth Gobble, Charity Lynn Students: Ashkan Ehdaie, Teresa Flores, Antonio M Germann, Robin Janet Gibbons, Jackson, Travis Jones, Shaylona Kirk, David Michael Medina, Andrea Wolfrey Patton, Amy Marie Harley, Emma Simpson Jacobs, Molly Bowen James, Dylan Christopher Jeremy Dwight Rowlett, Larisa Sotinsky Speetzen, Ryan Andrew Stevens, Lisa Anne Kann, Raj Kullar, Diana Lap Ying Lam, Dennis Jung-Min Lee, Michaela Ann Onstad, Tarris, Long Trinh, Corina Joy Veatch, Justin Carmine Wong Anabella Pascucci, Scott McIntosh Porter, Caleb Steven Siler, Raja Kameswaran Alumni: Noah M Tolby, Dale P Woolridge Sivamani, Agnieszka Ewa Witkowski Faculty: James E Maciuilla, Jeremy R Payne Faculty: John Lee Dalrymple, Donald M Hilty House staff: Rose Quy Do, Todd Jay Hofeling, Brian Madigan House staff: Martin Nicolas Lee ARKANSAS COLORADO University of Arkansas for Medical Sciences College of Medicine—Alpha University of Colorado School of Medicine—Alpha Colorado Arkansas Students: Dale Alan Burkett, George William Chaus, Brian Matthew Christenson, Students: Kaith Almefty, Lindsey Erin Bell, Jennifer Evins Bishop, Jacob O Sarah Jane Yost Clutter, Robert Jackson Courtney, Amy Carol Drumm, Anthony Boeckmann, Patrick A Brown, Cristyn Nicole Camet, William (Will) Royal Copeland, Foianini, Daniel Bruce Heppe, Shideh Majidi, Richard Jay McMurtrey, Kimberly Dinh Joshua Daily, Darren Scott Freeman, Ashley Frith, Angela Virginia Pope Frost, Ngo, Lauren Nicole Puls, Emmett David Ratigan, Jordan Forister Schaeffer, Shabnam Jennifer Hester, Kellie D Hughes, Ana Marie Liolios, Joshua Barton Morrison, Mark Omidi Showell, Jill Elizabeth Sindt, Kristina Steiniche Sowar, Joshua Bengtson Sykes, Allen Moseley, Brian D Norton, Ezekiel Elliott Shotts, Matthew Frank Spond, Amy Michal Lee Taylor, Julie Elizabeth Thompson, William Chia-ching Yao, Grant Ryan Catherine Taylor, Bradley Alan Thuro, Phillippe Andre Tirman, Rocky Tsang, Andre Young Wineland, Eric Jason Wright House staff: G Ryan Berger Alumni: Robert Leroy Archer, Ray K Parker DISTRICT OF COLUMBIA Faculty: Robert Hopkins, Eduardo R Ochoa House staff: Robert David Pesek, Surya Prasada Rao Rednam, Jill E Sanders The George Washington University School of Medicine and Health CALIFORNIA Sciences—Alpha District of Columbia Students: Stephanie Michelle Aleskow, Omer Abdulrehman Awan, Nasir Akhtar Aziz, University of California, San Francisco, School of Medicine—Alpha Noa Biran, Nicholle Daniel Bromley, Laurence William Busse, David Edward Conrad, California Laura Hagen Dean, Shaun C Desai, Rachel Eve Ershler, Rebecca Ann Fausel, Trusha Students: Nidhi Agrawal, Amy Robin deIpolyi, Meredith Rebecca Dunn, Ravinder Jayanti Govindji, Christine Marie Heske, Meghan Sri Karuturi, Benjamin William Singh Gogia, Dana Elizabeth Myers Henry, Duncan Marshall Henry, Allison Yuri McClintock, Andrea Marie Morris, Cimmie Lynne Shahan, Rachel Glickman Shnider, Iwaoka-Scott, Timmy Mathew Joseph, Hemal Kanti Kanzaria, Puja Kohli, Brett Swati Singh, Joann Marie Spinale, Benjamin Eric Stein, Lorraine Chava Stern, Kristin James Ley, Kirk Ko Fong Lin, Angela Kelliher Mancuso Lipshutz, Kalyani Amelia Loo Thanavaro, Frederick Ethan Weiss McCullough, Tracey Ann McLean, Janina Lord Morrison, Pradeep Natarajan, Lydia Alumni: Peter S Jensen Eleanor Wiedel Pace, Alexander Wojciech Pastuszak, Vikram Ramnath Rao, Jacob Faculty: Peter Hotez Owen Robson, Amit Jayant Sabnis, Zadok Jacob Sacks, Varun Saxena, Jennifer Grace Faculty: Samir Shashikant Patel Wilson House staff: Seth Michaels Pollack, Juan A Reyes, Neil Tanna Alumni: Anda K Kuo, Jody Ellen Steinauer Georgetown University School of Medicine—Beta District of Columbia Faculty: Nora Fox Goldschlager, Cindy J Lai Students: William Carl Anderson, Heather Marie Avedissian, Nicole Ann Chiota, House staff: Lawrence Adya Haber, Jennifer Ho, Michael Keith Pickens Caitlin Joyce Crowther, Brian Paul Cullingford, Lindsay Anne Curtis, Lindsey Keck School of Medicine of the University of Southern California—Gamma Elizabeth Daggle, Lisa Anne DelSignore, Stephanie Lynn Fisher, Arden E Fredeking, California Sean Matthew Gratton, Caroline Bennett Hobbs, Jonathan Eric Holtz, Keith Lynn Students: Tina Bhutani, Alexandra Bright, Steven Bennett Chinn, Katherine Fanny Jackson, Daniel Gene Kang, Patrick N Lenaghan, Ilona Sinead Lorincz, Jennifer L D’Harlingue, Karla Friedman, Sarah Noranne Gee, Andrew Christopher Ghatan, Lyons, Terah Jean Malette, Katherine Marie Mercy, Amy Lynn Nicholas, Alicia Eve Reyhaneh Hamidi, Sally Medhat Kamal, Vanessa Leigh Lauzon, Bethany Lehman, Ogram, Alicia Katherine Peterson, Constantine George Saites, Grant Courtenay Marlowe Majoewsky, Michael Anthony Marques, Jennifer Lynn Martindale, Erin Sorkin, Matthew Kirk Steehler, Brad Gregory Stevinson, Katherine Paisley Sullivan, Gregg Newman, Christopher James Ng, Sumit Hamendra Rana, Paola Giovanna Andrea Shirley Wang Rodriguez, Erik Quinn Roedel, Julie Schalhorn, Adam Seidl, Ketan Kiritkumar Shah, House staff: Christopher Joseph Abularrage, Kiran Kumar Dhanireddy, Christopher Allyson Akiko Spence, Ashley Brooke Sutton, Alicia Genice Turlington, Sean William C Wyckoff Wilson, John Justin Workman, Eric John Yavrouian Howard University College of Medicine—Gamma District of Columbia Faculty: John W House, David H Peng Students: Ifeanyichukwu Jude Ani, Adedoyin Olukemi Kalejaiye, Binyam Muluneh, House staff: Cynthia Hsiao-Yun Ho Deepti Muraleedharan, Alero T Nanna, Khara M Simpson, Carlos A Williams Alumni: Richard J Derman

64 The Pharos/Winter 2009 Faculty: William Bradford Lawson, Terry Lamar Thompson HAWAII House staff: Rabia Cherqaoui University of Hawaii at Manoa John A Burns School of Medicine—Alpha FLORIDA Hawaii Students: Mireille K Anawati, Jennifer Malia Akemi Kaya, Katy Rose Mahealani University of Miami Miller School of Medicine—Alpha Florida Linskey, Jon Yukio Narimasu, Jared Kiyoshi Oyama, Sebastian Sugay, Erica Jane Students: Sarah Akerman, Ibrahim Alava, Christian Michael Andrade, Danielle Alyse Walsh Becker, Pooya Isaac Bokhoor, Stacy Marie Chimento, Nicole Marie Christin, Jonathan Faculty: Patrick Murray, Karen Thompson Colasanti, Christine Thuyvan Dinh, Christopher John Dy, Lauren Elizabeth Frost, House staff: Chelsea Ching-Endow, David Shaeffer Dalia O Girgis, Scott Mattox Haake, Andrew Stuart Krasner, Marlen Leon, Ashleigh Levinson, Ashleigh Laurin Levison, Nicole Desiree Martin, Christina Adel Michael, ILLINOIS Nirmal Nathan, Matthew Rochefort, Leo Elliot Rosales, Reagan Lindsay Ross, Elissa University of Illinois at Chicago College of Medicine—Alpha Illinois M Schwartzfarb, Holly Katherine Marchiniak Thompson, Alexander Tuchman Students: Theodore Carl Bailey, Gabrielle Marie Baker, Bennett Barch, Lisa Faculty: Elizabeth Anne Ouellette, Richard Louis Riley Leilani Bayer, Henish Ashish Bhansali, Katherine Ann Binder, Frank Christopher House staff: Subha Sundaram Bohnenkamp, Ryan James Bolton, Tara Eileen Brennan, Wen Chen, Liz Dailey, University of Florida College of Medicine—Beta Florida Virag K Dandekar, Kaci Lyne Dinga, Matthew Elkins, Christopher Thomas Erb, Students: Richard Douglas Beegle, Jason N Crosson, Lori Anne Filichia, Daniel Pablo Eric K Fanaee, Tracy Lynn Flood Bramall, Katharyn Freund, Sumul Ashok Gandhi, Friedmann, Jonathan Graff-Radford, Elizabeth Russell Griffin, Leon Hatch, Tenessa Sean Michael Hill, Michael Anthony Holzman, Carrie Nicole Hood, Zi Yang Jiang, Morgan MacKenzie, Omayra Lizzie Marrero, Brett Miller, Ryan Wesley Nall, Mark Christopher Reavis Johnson, Christina Tara Khan, Jenna Kim, Marie Leger, Shihhon Wilson Newman, Alissa Orvis, Deidre Rachel Pachman, Brendan M Prendergast, Li, Elliot Daniel Lieberman, Charles Louis Lupo, Reid Woodside Masters, Sona Scott Keith Schultz, Neil Sengupta, Ankur Janak Shukla, Lindsy Nicole Williams Mehta, Rachel Rose Miller, Nicholas Patrick Morley, Nelson Moy, Andrew James Alumni: Jose Lezama Pastor, Craig Joseph Pastor, Mital Patel, Matthew Ryan Plunk, Neil David Saunders, Faculty: Matthew McKillop, Kerlan Peter Wolsey Adrienne Michele Schupbach, Nirav Shah, Shaival Shah, Jennifer Shroff, Christopher House staff: Anil Kumar Puri Michael Starr, Eric Taylor, Stacy A Trent, Stanley Wang, Jacqueline Marie Wegge, University of South Florida College of Medicine—Gamma Florida Adam Daniel Wolfe, Marika Inga Wrzosek Students: Melanie Stacey Altholtz, Jason Robert Buckley, Rahul Narayan Chavan, Faculty: Errol Christopher Baptist, Debra A Goldstein Clarence Henry Clay, Seth Ian Felder, Sudeep Gaudi, Gregory Randell Hartlage, House staff: Jose Gilberto Trevino Kristin Walsh Houseknecht, Jason Michael Jennings, Jessica Boynton Johnson, Lisa University of Chicago Pritzker School of Medicine—Beta Illinois Caroline Klepczyk, Andrew Bryson Lemmon, Lisa Carolyn Moody, Shana Rose Students: Katherine Bekeny, Amanda Britt, Jessica M Buck, Nicole Anne Cipriani, Coplowitz Okolica, Daniel Nathan Shippy, Kerry Lyn Thomas, Kathlyn Valleau Wilde, Daniel Clayburgh, Jill Huber, Matthew Mark Kalscheur, Rohan R Lall, Jun Matsui, Daniel Eugene Yoder Jennifer McDonnell, Itai Pashtan, Jennifer Pogoriler, Katie Sharff, Erik Stoltenberg, Alumni: Charles Morgan Edwards Elizabeth Sullivan, Alan Eih Chih Thong, Colin Walsh Faculty: Bryan A Bognar, Laurie J Woodard Alumni: Richard J Cote, Rex Charles Haydon Florida State University College of Medicine—Delta Florida Faculty: Nora T Jaskowiak, John Henning Schumann Students: Erkan Alci, Ashley Nicole Bassford, Peter Jeffrey Bechtel, Charles House staff: Laron N Johnson, Nathan Oliver Stitziel, Megan E Tarr LeRoy Clark, Paola Ballester Dees, Adam Joseph Huddleston, Jessica Suber, Cody Northwestern University, The Feinberg School of Medicine—Gamma Illinois VanLandingham, Johnny Washington, Jeremy Lee Williams Students: Christopher Burch Anderson, Jessica Casey, Anisha Desai, Erik B Eller, Faculty: Charles Christopher Ouimet Matthew Rodrigo Endara, Bradley Gross, Justin Shinyu Han, Peleg Moshe Horowitz, House staff: Michael Hernandez, Julia Mercer Niebauer Kenneth Kehl, Thomas O Kim, Vasantha Kolavennu, Anita Kumar, Leonardo Vicente GEORGIA Lopez, Amun Makani, Farzad Moazed, Bati Myles, Jyoti Pathria, Charles Pearce, Jori Pollack, Matthew Ryan Reynolds, David Ian Rosenthal, Jill Starzyk, Raeka Talati, Medical College of Georgia School of Medicine—Alpha Georgia Gunilla Carlsson Thorn, Neelam Vashi, Arjun Krishna Venkatesh, Elizabeth Kim Students: Amir A Ahmadian, Thomas Cary Alexander, Anthony Joseph Anfuso, Wolf, Lynn Meredith Yee Brian Joshua Boyce, Dustin Joseph Calhoun, James Parker Callaway, Jeremy Scott Alumni: Charles Stanley Modlin, Elliot Roth Cardinal, Ashley Snell Chaplin, Matthew Dale Chetta, Julie Lynn Colantoni, Kristin Faculty: Richard M Green, Jacob Iasha Sznajder Tott Collier, Kelly Vlass Culbertson, Justin Dunn, Tunisia Vershaun Finch, Devon House staff: Karl Bilimoria, David E Montgomery, Deepa Patil Ghodasra, Corey Harkins, Daniel Thomas Huttman, Paul McPherson Johnson, The Chicago Medical School at Rosalind Franklin University of Medicine Katherine Elizabeth Kasik, Katherine Elaine Kohler, Jimmy Kuo, Timothy Joseph and Science—Delta Illinois Moore, Mary Frances Pilcher, John William Schleifer, Clay Alexander Spitler, Steven Students: Brian Michael Ames, Ioanna Athanasiadis, William Whitney Beeman, Mark Spitz, James Mattingly Stevens, Ching Yen Tsao, Meredith Cross Udell Brian Thomas Caldwell, Richard Harriman Comstock, Timothy Michael D’Alfonso, Alumni: J Mark Gresham, Daryl C Wiley Ha Kirsten Do, Marina Gitman, Madina Holmuhamedova, Soo Yeun Hur, Samuel B Faculty: S Marcus Fulcher, Kathleen Tarrant McFarlane McKie Kieley, Joseph Younghan Kim, Payman Kosari, Lior A Levy, Theodore Lyu, Sidharth House staff: Bryce Nattier, Molly Szerlip, Jeremy Aaron Warren Mahapatra, Nur-Ain Nadir, Raja Ramaswamy, Dina Reiss, Jonathan Craig Rimler, Emory University School of Medicine—Beta Georgia Kerry A Rogers, Benjamin A Rubin, Sanjum Sethi, Michael Squire, Zachary C Students: Gabrielle Nicole Berger, James Ian Cameron, Michael Earl Egger, Jeremy Stender, Dawn Masano Taniguchi, Katherine Gross Tarlock, Meera N Tejura, Jordan Keith Jones, Jill McConaughy Klein, Timothy Van Johnson, Schuyler David Elizabeth Toman, Amy Ru-ci Wang, Christopher Yenter Livingston, Aki Morikawa, Margaret Frances Moscato, Claire Susan Nicholas, Leah Faculty: Marc Steven Abel, John Tomkowiak Ann Palifka, Ateet Bhupendra Patel, Gaurav Pravin Patel, Sofya Tokman, Sarah Anne House staff: Hari Raj Paudel Twichell, Jennifer Eliece Vaughn, Charlene Alexis Wong Loyola University Chicago Stritch School of Medicine—Epsilon Illinois Faculty: David Abraham Kooby Students: Katherine Nicole Aragon, Harold Henry Bach, Christopher Jude Cirone, House staff: Raul Roberto Blanco, John P Hackett, B Robinson Williams Jennifer Christine Colvin, Matthew Ryan Deluhery, Moira Eileen Dwyer, Jillian Morehouse School of Medicine—Gamma Georgia Roxanna Foley, Erica Jennifer Grimm, Christopher David Hughes, Julie Anne Jackson, Students: Brittany Jamille Bivines, Nicholas Alexander Borm, Damayea Isatu Hargett, Rachel M B Kacmar, Molly Ann Marker, Nathan Wesley Mesko, Margaret Guinn Aleeia LaMour Johnson, Nicole M King, Megan Nicole Manento, Kenneth Obinna Mueller, Kristen Michelle Pierce, Nadia Janine Razaq, Dominic Joseph Ricci, Michael Matthew, CharlRe Ev Anthoni Slaughter James Ross, Matthew Bernard Siegel, Melissa Rose Siegel, Michael WIlliam Sjoding, Faculty: Eve J Higginbotham, Folashade Stella Omole Elizabeth Ann Thompson, Robert Mercier Turner, Brian Patrick Walcott Mercer University School of Medicine—Delta Georgia Faculty: Eva Maria Bading Students: Neal W Burkhalter, Nicholas L Henson, Matthew D McLeod, Morgan M House staff: Carley M Davis, Troy Donovan Woodard Pinkston, Amy M Rodatus, Jonathan W Rutledge, Michael Neil Woodall Rush Medical College of Rush University Medical Center—Zeta Illinois Alumni: Edward H Young Students: Leah Bowser, Laura Carter, Michelle Cecchini, James Cho, Natasha Faculty: William F Bina, M Gage Ochsner Cunningham, Eric Gantwerker, Jordana Goldman, Henry Govekar, Mark Hamming, House staff: Andrew L Foret, Jill Q Purdie, William Clinton Streetman Michael Hehman, Stephanie Hensler, David Hulata, Lanea Keller, Kristen Labovsky, Azher Merchant, Rachel Neems, Anne Pizzi, Joshua Podjasek, Adam Schiff, Falak Shah Faculty: Steven Feinstein House staff: Prakash Balan, Jennifer Erickson Foster

The Pharos/Winter 2009 65 New members

Southern Illinois University School of Medicine—Eta Illinois LEBANON Students: Naurin Ehsan Ahmad, Meredith H Burge, Jennifer Lynn Creamer, Edward American University of Beirut School of Medicine—Alpha Lebanon Price O’Dell Harter, Hassan Ali Hassan, Katrina Sophia Pedersen, Sapa Thi Pham, Students: Georges Al-Helou, Melhim Bou Alwan, Chadi Makary, Fadi Makari, Ali Catherine Marie Rapp, Dustin J Stehling, Gregory Arthur Tester Mehdi, Tania Rebeiz, Karim Saab, Fadi Jaber Sawaya, Hamdi Sukkarieh, Samer Alumni: Michael A Pick Tohme, Abdallah Abou Zahr Faculty: Richard Rosher Faculty: Anwar Nassar House staff: Ibrahim Bulent Cetindag, Joji Jacob Varghese House staff: Randa Mustafa Al Barazi INDIANA LOUISIANA Indiana University School of Medicine—Alpha Indiana Tulane University School of Medicine—Alpha Louisiana Students: Jesse Allen Beery, Peter Carl Bergmann, Parin Bhayani, Jeffrey Melson Students: John Baber, Susan Brim, Chevelle S Brudey, Robert Lamont Carruthers, Clarke, Sara Elizabeth Cook, Elizabeth Ann Gates, Shawn Travis Greathouse, Marc Shannon Shung-Ling Chang, Mollie Nicole Dahlgren, Annelies L De Wulf, Melissa Scott Haro, Cara Freeland Hennings, Joseph L Hunt, Andrea L Jester, Jamie Lynn Claire DeVito, Clayton Clement Eiswirth, Meryle E Eklund, Alessandrina Marie Knuth, Nicholas Andrew Koontz, Margaret Darden Kramer, Hans Chulhee Lee, Pei- Freitas, Shane Andrew Gailushas, Jennifer Leigh Galjour, Andrew Cameron Harbin, Fen Lin, Andrea Elizabeth Losch, Rachel Dianne Manley, Anubhav N Mathur, Peter Elizabeth Ann Jensen, Daniel Jay Kravitz, Diego Arturo Lara, Joshua David Linnell, Joseph Mehta, Daniel Benjamin Moore, Adam Steven Morgan, Daniel James Musick, Kara Mari Loubser, Anjali Malik, Diana Nicole Moustoukas, Sepehr Oliaei, Brett Meagan Beth O’Neill, Samuel Luke Oyer, Kellie Adrienne Park, Chirag Ghanshyam Roberts, Matthew James Rose, Andrew Marc Schutzbank Patel, Neal Balvant Patel, Cara Ann Pecina, Jonathan Addison Peng, Brett C Pieper, Louisiana State University School of Medicine in New Orleans—Beta Matthew Allen Rider, Emily A Ruden, Lori Jacquemin Sanford, Laura Ann Sech, Louisiana Christopher Doyle Stephens, Allison Kasey Taraska, Nathan Eric Thompson, Emily Students: Carlo Joseph Alphonso, Beau Stephen Black, Benjamin Boudreaux, Lien Walkey, Patrick Collins Walz, Adam M Werne, Diana Margaret Winston, Yuriy O Kim Bui, Victoria Elizabeth Burke, Michael Cusick, Rebecca Delahoussaye, Jason Zhukov, Matthew M Zipse Robert Determann, Lindsey Dietrich, Corey Paul Falcon, Drew Flansbaum, Emily Alumni: Lisa Ellen Harris, Douglas J Schwartzentruber Grieshaber, Camille Catherine Gunderson, Russell Gerard Hendrick, Amanda Hestle, Faculty: Marilyn Jean Bull, Robert D Tarver Ross Hogan, David Shannon Howell, Joan Hunter, Leah Jacob, Keith LeBlanc, Kristen House staff: Daniel Hamp Fulkerson, Joshua Wesley Garrett, Ben M Tsai LeBleu, Jeffrey Melancon, Emily Miller, Lacey Ann Millet, Adrienne Musumeche, IOWA Charles Nunez, Stephen Anthony Quinet, Elizabeth Robert, Paul Rogers, Jordan Thaddeus Romero, Chelsey Tyler Sandlin, Justin Andrew Walker, Rebecca Lee University of Iowa Roy J and Lucille A Carver College of Medicine—Alpha Woodson Iowa Students: Michael Lee Adix, Mazen Saadi Albaghdadi, Amaris Anderson, Michael Alumni: Mario A Calonje, Ellis Ralph Lupin Lonnie Bullard, Chiraag Dharia, Henry Richard Diggelmann, John Edwards, Elizabeth Faculty: John Patrick Hunt, Giovanni Lorusso Mary Grace, Lindsay Anne Griffin, Leah Maxwell Habib, Jonathon Heath, Amanda House staff: Travis Dotson, Stacey L Holman, Daniel S Hsia Jean Hohmann, Brett William Hronek, Bridget Kamen, Lindsey Elizabeth Klocke, Louisiana State University School of Medicine in Shreveport—Gamma Stephanie Anne Leeson, Anne Meredith Lewis, Bethany Kirk Helms Lewis, Kathryn Louisiana Elise Miller, Jason Alan Patterson, Benjamin Andrew Paulson, Thomas Allen Pietras, Students: Tyler Sean Auschwitz, Amber Cooper Bazler, Christopher Joseph Beck, Larissa Marie Pisney, Anne Renze, Rachael Raelynn Rickertsen, Dan Mohsen Kyle Bailey Bruyninckx, Elena Mitkevicius Campbell, Amber N Cockburn, Britni Shivapour, Neil James Sink, Jamie Jane Vanourny, Derek Zhorne Fabacher Hebert, Stuart Craig Hebert, Lainie Joffrion Jorns, April Marie Landry, Alumni: Steven Schurtz Tanja Jordan Minova-Foster, Timothy Patrick Moran, Elizabeth JA Waller, Emily Jane Faculty: Richard Le Blond Zerwas, Shihao Zhang House staff: Jason Scott Mizell KANSAS MARYLAND University of Kansas School of Medicine—Alpha Kansas Students: Lindsay Elise Abbott, Emily Anne Blankenship, Josiah D Brinkley, Jason A Johns Hopkins University School of Medicine—Alpha Maryland Cheng, Julianne E Donnelly, Brian MacNeille Everist, Emily MW Haury, Bryce Adam Students: Hannah Haruko Alphs, Mark Magdi Awad, Christopher John Brady, John Hoffman, Kate S Jennings, Landon M Johnson, Megan Louise Krause, MyChi Han Le, Peter Campbell, Han-Ying Peggy Chang, Lia Ellen Clattenburg, Jennifer Warner Abby J Loch, Leonel Martinez, Katherine J Moore, Jill K Onesti, Lindsey Leigh Saint, Dharamsi, David Wesley Dowdy, Steven Jeffrey Eliades, Allison Ruth Larson, Corinna Andrew B Schlachter, Seth H Sheldon, Casey L Smith, Jennifer Ann Spiegel, Kevan C Josephine Moore, Afshan Amin Nanji, Shantanu Nundy, Romina Mariam Ma Wing Stanton, Ourania Thomai Stephanopoulos, Joella E Wilson Shan Wahab, Gina Louise Westhoff, Alice Shufeng Yao, Amir Mozaffar Zamani Alumni: Robert P Moser Alumni: Theresa Ann Barry Shapiro, Eileen PG Vining Faculty: J Brantley Thrasher Faculty: Thomas E Finucane, Gabor Kelen House staff: Abebe Mulugeta Abebe, Steven William Bormann House staff: Christopher James Barreiro, Oluwaseun Omotomilola Falade, Robert Eugene Hoesch KENTUCKY University of Maryland School of Medicine—Beta Maryland University of Louisville School of Medicine—Alpha Kentucky Students: Jennifer Jihyun Ahn, Brendan Timothy Bowman, Emile Nathaniel Brown, Students: Natalie Hill Beaven, Ryan E Bennett, Andrea Jo Brooks, Harmony Faith David Carlberg, Kathryn M Conniff, Jessica DeGrandis, Erin Einbinder, Ruth E Carter, Leslie Caudill, David Shi-wei Chang, Andrew Bryce Crush, Eileen Moira Gardner, Amie Gupta, Sarah P Hale, Jacqueline Karp, George C Kochman III, Duggan, Carter Smith Gerard, Theodore L Gerstle, Holly Elisabeth Hensley, Zachary Nathan Kon, Michelle M Levender, Priscilla Nelson, Elizabeth M Nichols, Nicholas Jon Larsen, Brannon David Mangus, Michael Lewis McClintock, Kathryn Yun Ja Park, Ann Parker, Ebrahim Paryavi, Mary K Porteous, Eric Shang, Eugene Michalczyk, Sean Matthew Miller, R Joseph Mittel, Natalie Banet Olberz, Daniel R Yuriditsky Pike, Jason Harold Reynolds, Karthik Suresh, Cassey Vessels, Joel Warren, Joshua Faculty: Majid E Cina, Andrea Wong Scott Wiglesworth House staff: Robert J Habicht, Michael T McCurdy, Mayur Narayan Alumni: Richard Dale Hurt, James Frederick Silliman Uniformed Services University of the Health Sciences F Edward Hébert Faculty: John Joseph Buchino, Vinay Puri School of Medicine—Gamma Maryland House staff: John M Draus, Ryan Thomas Hurt, Gena Napier Students: Daniel J Adams, William Boller, Robert O Brady, Steven H Craig, Michael University of Kentucky College of Medicine—Beta Kentucky EA Cunningham, Paul M Drayna, Cicely Anne Dye, Delnora L Erickson, Brent A Students: Arthur W Baker, Sandhya Bondada, Barrett W Brown, Leigh Anne Feldt, Brian M Fitzgerald, Philip M Flatau, Anthony A Giberman, Kelly L Groom, Hoskins, Alyssa Ashley Hunter, Pradeep Saigopal Mettu, Megan Murphree, Meghan Nicole M Hsu, Katherine M Ivey, Andrew J Kuschnerait, Katherine M Kuster, Gary L Hennessey Nadeau, Michael T Newcomb, Jennifer Rene Olges, Gary Travis Patterson, Legault, Caroline Ko Mans, Andrew D McLaughlin, Sandra S McLaughlin, Nicholas Amanda Elizabeth Smith, Robert Todd Sweeney, Sarah Collier Thornton, William Orr, Marit Connor Peterson, Lindsey R Rath, Jeanmarie B Rey, Kristina R Rustad, Alexander Wilson, Melissa May Yingling, Kristine Ziemba Kathleen M Sarber Faculty: Nirmala Desai, Chester Darell Jennings Alumni: John H Farley, Tandy Garth Olsen House staff: Nicolas Ajkay, Kara O’Brien Faculty: Richard M Conran, Patrick G O’Malley House staff: Daniel William Carlson, Jess D Edison, Alyssa C Perroy

66 The Pharos/Winter 2009 MASSACHUSETTS Jonathan Peter Williams, Katie Helen Willihnganz, Justin Michael Wudel, Andrea Tufts University School of Medicine—Beta Massachusetts Michelle Zins Students: Lisa Maria Battaglia, Evan R Berg, Emily Melissa Berger, Molly Chase MISSISSIPPI Broder, Margaret Naomi Chapman, Anna Lee DeSista, Kevin Russell Dougherty, Katherine McKinley Esselen, Edward Wilson Grandin, Margaret Mary Hayes, Lucian University of Mississippi School of Medicine—Alpha Mississippi Students: William Bacon Bell, Marcus Daniel Biggers, Kathryn Luise Brown, Garth Iancovici, Richard Samuel Kalman, Justin Meng Ko, Michael Kriss, Christie Jean Seamus Campbell, Jessica Larsen Gullung, Angela Devi Gupta, David Paxton Jones, Langenberg, Scott Bissell Loomis, Gunjan Malik, Lucas Marzec, Carissa Meyer, Jason Kyle Jones, Laura Marie Robinson, David Robert Sayers, James Byron Shipp, Richard Alexander Misiaszek, Sonali Paul, Sara Sanarin Prasertsit, Wilson Flynn Pyle, Robert Kyle Thompson Jason Pierce Rahal, Elena Leah Resnick, Jay Won Rhee, Benjamin Pratt Romney, Jason Saillant, Jocelyn Tara Scheinert, Aaron Nathaniel Stayman MISSOURI Boston University School of Medicine—Gamma Massachusetts Washington University in St Louis School of Medicine—Alpha Missouri Students: Jeremiah Kirk Alexander, Rama Somayajula Ayyala, Bridget Mary Canavan, Students: Jessica Duan, Jeremy Etzkorn, Margaret Garin, Cheryl Gray, James Allison M Carelli, Michelle Carey, Michael Ryan Cassidy, Brian Thomas Clark, Hudspeth, Julia Anne Kauffman, Andrew King, Kory Lavine, Kathleen McKeon, Armen Derboghossians, Ryan Christopher Goerig, Allison Elaine Hunt, Rebecca Eric Nordsieck, Ilana Rosman, Shada Rouhani, Sunitha Sequeira, Annemarie Sheets, Johnson, Steven Russell Kussman, Grace Jennifer Lee, Luke Macyszyn, Ravikanth Arsham Sheybani, Devon Cady Snow, Steven Sperry, Kristin VanderPloeg, Sunitha Maddipati, Deepa Ramakumar Magge, Jules Powers Manger, Melissa Ann Martchek, Vemula, Karolyn Wanat Daniel Stewart Roberts, Noelle Nugent Saillant, Sarah Elaine Wyhs, Christina Deck Alumni: Gary A Ratkin, Robert A Swarm Yarrington Faculty: Arnold Bullock, Arie Perry Alumni: Richard H Mattson, Kenneth B Simons House staff: Ryan Courtney Fields, Andrea Ruth Hagemann, Julie Kristina Schwarz Faculty: David B McAneny Saint Louis University School of Medicine—Beta Missouri House staff: Philip Alexander Cohen, Jens Thiele, Edwin Tigerenashe Zishiri Students: John Nathan Allan, Andrew Robert Barina, Cory Bethmann, Eric A University of Massachusetts Medical School—Delta Massachusetts Bloemer, Sofia Begum Chaudhry, Kristen Michelle Covert, Brian Wesley Cross, Students: Alexandra S Bailey, Rachael Blake, Stephanie Carter, Kelly Holland, Austin jay Crow, Angela Marie DiCarlo-Meacham, Matthew F Dilisio, Sara L Franzen, Andrea Klayman, Amanda Kolb, Noah Kolb, Candice McElroy, Mark McKeen, Vilas Olivia Kathryn Giddings, Dana Anne Hartnagel, Estebes Akira Hernandez, Lindsey Patwardhan, Jennifer Rosenberg, Magdalena Slosar, Michael Sylvia, Hilary Womble Allison Herrel, Sonya Jagwani, Gregory Patric McLennan, Anthony Alan Nuara, Alumni: Joseph DiFranza, Arnold Freedman William Simon Clarke Payne, Denise Renee Pounds, Jacob McCabe Pounds, Marsha Faculty: Richard Irwin, Phillip Zamore SK Reuther, Allison Lynn Sterner, Colin Michael Thompson, Joanna Elaine Thomson, House staff: Sanjeet Hegde, Darshana Patel, Heidi Smith Bradley Warlick, Anne-Marie Woelbel MICHIGAN University of Missouri—Columbia School of Medicine—Gamma Missouri Students: Brenon L Abernathie, Joel Robert Brockmeyer, Katharine Ann Connolly, University of Michigan Medical School—Alpha Michigan Sarah Elizabeth Driver, Anna Christine Harris, Benjamin Kinnear, Marina Litvin, Students: Kristen Elise Adams, Sudha Rani Amarnath, Andria Lynn Amendt, Alison Benjamin Mark Martin, Shannon Kathleen Martin, Scott A Norris, Jason Ryan Pettus, Marie Bates, Timothy Bodnar, Emily Kathleen Damuth, Kara D Gaetke, Steven Adam Dominic Emmanuel Sanford, Lindsay R Shotts, Blair David Westerly, LeAnna Renee Giuseffi, Jonathan Greene, Steven Christopher Gross, Tannaz Guivatchian, Daniel Witt Reed Jensen, Christopher Warren Jones, Joel Christopher Joyce, Jyoti S Kandlikar, Alumni: Girish Mishra, James R Sowers Michael Krug, Robbi Ann Kupfer, Milton Thomas Michael Little, Jeffrey Philip Mako, Faculty: Bert Bachrach, Ellis Andrew Ingram Kevin Brett Messacar, Elizabeth Rose Meza, Priya Vijay Mhatre, Daemeon Achilles House staff: Mark Nelson Beard, Atif Iqbal Michael Nicolaou, Michael William Rowley, Eric W Schneider, Derrick Ying Siao, Miller Hayden Smith, Kathryn Angela Volz, Deborah Jean Weener, Christina Y Weng University of Missouri—Kansas City School of Medicine—Delta Missouri Faculty: Valerie P Castle, James O Woolliscroft Students: Michael Haessam Amini, Jacob Daniel AuBuchon, Dawn Christine Charles, Steven Ross Cohen, Christopher M Fox, Neil Maheshchandra Gheewala, Jessica Wayne State University School of Medicine—Beta Michigan Nicole Gillespie, Rachel Marie Griggs, Lauren M Ludwig, Jessica Lyn McCammon, Students: Andrea Lynne Barbieri, Kurt David Bernacki, Matthew Bernbeck, Kathy Surya Narayana Mundluru, Jessica L Reddoch, Michael Gregory Rodriguez, Nicholas Borovicka, Steven Daniel Daveluy, David Steven Demos, Stephanie Diamond, Jason Ryan Wasson Domina, Michelle Figueroa, Gary William Gallagher, Adrian Gasperut, Bianca Alumni: Jeffrey James Peterson Gruber, Elizabeth Corey Gwinn, Erin Hendriks, Zachariah Hicks, Ronald Huang, Faculty: Jean R Hausheer Louis Joseph, Anastasia Kay Ketko, Paul Hyon-Uk Kim, Jonathan Edgar Kivela, House staff: Gretchen Marie Dickson, Angela Leigh Myers, Madhu Babu Narra Michael Kopec, Nicholas Gregg Kujala, Angela C Liang, Adam Michael Lubert, Ankur Mehta, Andrew Kent Moriarity, Brian Mott, Laura Ann Owczarek, Manish NEBRASKA Navnitlal Patel, Andrew James Powers, Isaac Peterson Reeve, Crystal M Ritsema, University of Nebraska College of Medicine—Alpha Nebraska John David Schwartz, Saloni Shah, Christopher Alan Smith, Kelly Ann Smith, Melissa Students: Jocelyn Kaye Bailey, Isaac Joseph Berg, Benjamin James Bixenmann, Natalie J Sundberg, Itishree Trivedi, Gwendolyn Rose Zirngibl Ann Black, Joseph T Cheatle, Andrew Michael Coughlin, Michael Alexander Donner, Alumni: Renee Dwaihy Brian Charles Gartrell, Jonathan R Henning, Andrea Lynn Mack, Daniel Dean Mosel, Faculty: Chokechai Rongkavilit Nathan William Murdoch, Evan C Pike, Sonya May Reynolds, Kelli Lynn Rudman, House staff: Gregory Norwood Allison Lee Stangel, Michelle Elizabeth Sudyka, Jason Phillip Weber, Thomas J Wilson Michigan State University College of Human Medicine—Gamma Michigan Alumni: Ray E Hershberger, Steven Phillip Wengel Students: Brian J Gavitt, Richard Michael Hall, Christina Lynn Harsant, Jennifer Em Faculty: Leslie C Hellbusch, Rubens J Pamies Kretschman, Amanda Marie McClure, Andrew K Nash, Rebecca Marie Palacios, House staff: Douglas Francis Niemann, Eric Thomas Rush, Michael David Sather David Pettersson, John Michael Pietila, Manish Tushar Raiji, Erin Chava Ruth, Creighton University School of Medicine—Beta Nebraska Rebecca L Creswick Saenz, EmmaLeigh Madeline Smith, Jasmine N Stannard, Alan Students: Elizabeth Durand Adams, Mary Anne Andrews, Scott Michael Atay, Erin David Van Opstal, Elizabeth R Van Opstal Marie Bruno, Heather Anne Dobbs, Gary Peter Graham, Travis Edward Grotz, Jason Alumni: Gregory Lewis Barkley, Glenn W Jelks Patrick Kelly, Laura Kristine Mirch, Ho V Nguyen, Quyen Trung Nguyen, Margarita Faculty: Adesuwa Benedicta Olomu, Vincent J WinklerPrins Roykhman, Marilee Michelle Simons, Joshua Spendlove, Andrew Christian Stevens, House staff: Ayodeji Johnson Ajibola, Jeffery L Chamberlain, Shalabh Chandra Morgan Leigh Swank, Sandra Swedean, Chad Thorson, Jacob Chris Walter, Casey MINNESOTA Woster Alumni: Alfred D Fleming, Gary S Francis University of Minnesota Medical School—Twin Cities—Alpha Minnesota Faculty: Robert Charles Allen, Martin Goldman Students: Brianne Claire Barnett, Ryan Patrick Brady, Joanna Mary Burns, Benjamin House staff: Nitin Garg, Jacob Sam Koruth, Saeed Kamran Shaffi Ray Coobs, Devon Rae Dannen, Ryan Michael Dunn, Tyler John-Miles Dunphy, Laura Corinne Evavold, Laura Ann Freeman, Adam John Gess, Jacob Richard Hodge, Daniel NEVADA Orlin Keys, Colleen Christina Kniffin, Meghan Michelle Lelonek, Joseph Corral University of Nevada School of Medicine—Alpha Nevada Mayerle, Heather Maureen Nelson, Joshua Harlen Olson, Justin Charles Peltola, Students: William Thomas Edwards, Aicha Maria Hull, Kyle Nathaniel Klingler, Scott Gerald Perkinson, Somnath Jagannath Prabhu, Jacob Frank Quail, Natalie Ruth Suzanne Larson, Chantal Reyna, Justin Bradley Smith, Whitney Waldroup, Ryanne Roeser, Joseph William Rohrer, Jessie Lee Kerns Roske, Laura Catherine Speltz, Elliot Walther, Nancy Wong James Price Stephenson, Matthew Aaron Taintor, Jake Ronald Theis, Jared Thomas Faculty: Samuel D Parks Verdoorn, Jay Justin Vlaminck, Jerome Richard Walker, Andrea Lynn Westby,

The Pharos/Winter 2009 67 New members

NEW HAMPSHIRE Faculty: Court B Cutting Dartmouth Medical School—Alpha New Hampshire University at Buffalo, School of Medicine and Biomedical Sciences, State Students: Narath Carlile, Elizabeth Lynn Fingar, Jennifer M Frese, Jessica H Hayward, University of New York—Epsilon New York Joan SL Hier, Heidi Ladd Keup, Tivon Isaac Sidorsky, Sharon Anne Silveira, JPedro Students: Megan K Barnhart, Kelly Devine Berchou, Adam R Brod, Margherita Bruni, Teixeira Jennifer Erica Emmett Costello, Jillian J Delmont, Sameer Madhav Deshmukh, Amy Alumni: Stephen Atwood, Mark Northfield Beth Devlin, Katherine Dunham, Matthew Michael Fernaays, Alan John Hsu, Mariam Faculty: Bruce Wayne Andrus, Lionel Lewis Imnadze, Victoria Ann Lilling, Andrew Marino, Benjamin P McGreevy, Joel R Moore, House staff: Diana L Fitzpatrick, John Maynard Levenick, D Joshua Mancini Francis James O’Connell, Jenna Lynn O’Neill, Jennifer Helen Paul, Coralynn Sack, NEW JERSEY Lisa A Steketee-Weaver, Alan F Vainrib, Justin Mark Zbrzezny Faculty: Alexander C Brownie, Michael E Duffey University of Medicine and Dentistry of New Jersey, Robert Wood Johnson University of Rochester School of Medicine and Dentistry—Zeta New York Medical School—Alpha New Jersey Students: Matthew Davis, Anne Bartlett Fender, Tracy Elizabeth Fuller, Marjorie Students: Yana Barbalat, Sonica Bhatia, Jaclyn Renee Brunner, Antonia Chen, Sophia Gloff, Koto Ishida, Matteo Charles LoPiccolo, Brooke Ellen Miller, Sydney Timothy Scott Fallon, Katherine Marie Fox, Eric Heckman, Dana Joy Herrigel, Butler Montesi, Brian Harrod Morray, Maryann Katherine Overland, Tracey Ann Thomas J Hopkins, Sangeeta Ramalingam Iyer, Kathryn Marie Kent, Christin Kim, Perazone, Pooja Rao, Deanne Robinson, Natthapol Songdej, Tara Wenger Sandra Anne Kopp, Christopher Steven Manfred, Jaclyn McKinstry, Michael Brian Alumni: Randy Nathan Rosier Murphy, Michael N Nakashian, George Patounakis, Gabriel Rama, Brian William Faculty: Cheryl Kodjo Roberts, Ehud Sarlin, Rehan Syed Shamim, Rachel Beth Sotsky, Adam Brett Strohl, House staff: Andrew James McGarry, Rona Lin Norelius Drew Steven Weber, Taylor Douglas White, Brian Seth Winters, Lauren Elizabeth Wong, Jennifer Caroline Yu State University of New York, Downstate Medical Center College of Alumni: Jeffrey Craig Brenner Medicine—Eta New York Faculty: Robert Joseph Risimini Students: Erika Brutsaert, Charles Chang, Karmina Karman Choi, Anne Elisa Cossu, House staff: Jillian Grace Corbett, Ralph Ibrahim Kanaan Alexander Filatov, Michael A Kadoch, David Scott Ketner, Yana Kleyner, Michelle Nicole Kornblum, Michelle Han Lee, Brian Liebler, Gregory Alex Maniatis, Edward UMDNJ—New Jersey Medical School—Beta New Jersey Robert Mathney, Megan Elizabeth Miller, Jong Ho Park, Mital Patel, Derek Daniel Students: Nrupen Yogesh Baxi, Sonia Belliappa, Toni Beninato, Eric Adam Breitbart, Prabharasuth, Matthew G Rein, Lisa Silver Richman, Lauren Ruth Schneider, Michael Sean Stephen Ciullo, Pascal Scemama de Gialluly, Neil Francis Fernandes, Serena John Seibert, Zohar Shamash, Brent Shepherd, Michael Shy, Inna Shyknevsky, Fernandes, Alex Seth Gaffan, Christian Sander Geannette, Samantha Paige Herman, Matthew Lawrence Smith, Sheeja Thomas, Gylynthia Elaine Trotman, Anthony James Gina Hong, Mahim Kapoor, Marissa Anne Kellogg, Emily Kott, Jeremy Eric Mangion, Visioni, Pramod Babu Voleti, Charles Wang, Michael J Winfeld, Kristina Wittig, Kapila V Paghdal, Alyssa Maria Parian, Heather Loryn Platt, Sarada Sakamuri, David Jeahad Zohny Jung Seto, Ryan Michael St Clair, Raja Taunk Alumni: Barbara Elaine Cammer Paris, Leslie Anthony Saint-Louis Alumni: Rini Susan Abraham, Frederick F Buechel, John Chae Faculty: Mary Ann Banerji, Edward F Smith Faculty: William E Halperin House staff: Nancy Blace, Pooja Malhotra, Michael Frederick Timoney House staff: Brian Eric Benson, Maueswani Senthil Albany Medical College—Theta New York NEW MEXICO Students: Eric Sooyong Ahn, Daniel B Aruch, Artur Chernoguz, Michael Aloysius University of New Mexico School of Medicine—Alpha New Mexico Freeman, Adam N Frisch, Elaine Marie Giannakos, Abbey Kathleen Iles Gore, Bridget Students: Eva Angeli, Katherine Sue Callahan, Leah Enright, Michaela Haney, Jonas Marie Grant, Kara-Lynne Kerr, Santosh Jacob Mathen, Mary Elizabeth Moore, Hines, Mary Helen Laughlin, Allison Anne Legler, Kristen Livingstone, Katrina Michael Lucius Pomerantz, Jaime Marie Puglisi, Gavin D Roach, Ann E Rutter, Kevin Peariso, Sally Anne Vender, Donald Wenner, Zachary Charles Wilson Michael Semelrath, Victoria Eva Varga-Huettner, Kathryn A Walsh, Harrison Franklin House staff: Christopher Charles Abbott, Spencer Paul Barney, Mohamed O Othman Wang, Joshua Weisbrot, Sara Jane Westergaard, Bharat B Yarlagadda NEW YORK Alumni: Gary L Gottlieb Faculty: Dennis P McKenna Columbia University College of Physicians and Surgeons—Alpha New York House staff: Scott L Lee, Leon Salem, Richard Vincent Schaller Students: Lisa Marie Bebell, Eric Michael Black, Leif-Erik Bohman, Jennifer Tenye New York Medical College—Iota New York Chang, Jason William Harper, Kim Jain, Christopher Paul Kellner, Kara Anne Students: Sinan Altiner, Craig Elliot Berzofsky, Lisa Bienia, Allison Marie Borowski, Kerscher, Daniela Justine Lamas, Susan Elizabeth Mackie, Moira Margaret McCarthy, Melissa Ann Burns, Melissa Ann Christino, Comana Monica Cioroiu, Samuel Mary Rebecca Mulcare, Elizabeth Christine Oelsner, Adedamola Ogunniyi, Tristram Coffin, Matthew Ryan Curley, Levi Ray Dansby, Jessica Baer Dekhayser, Adefolakemi Morenikeji Oni, Carlton Prickett, Jessica Anne Sims, Sarah Grace Sliva, Barry Diener, Sarah Elizabeth Eccles-Brown, Elizabeth Farrell, Julie I Goldman, Matthew Ian Tomey, Karoly Andras Viragh, Richard Lawrence Weinberg, Karen Kai- Tyson Jonathan Hawkins, Houman Khakpour, Abdrea Siobhan Kierans, Rebecca Lun Wong, Bob Yin McAteer, Orlando Micheli, Daniel Ari Newman, Marie Matina Ng, Gina Paek, Anup Cornell University Joan and Sanford I Weill Medical College and Graduate Panduranga, Haatem Mostafa Reda, John-Ross Rizzo, Courtney Beth Sherman, School of Medical Sciences—Beta New York Gagan Singh, Christopher Szlezak, Cai-Ling Wang, Yi-Chiun Wang, Carolyn Marie Students: Jessica Bauman, Adrienne L Davis, Avnish Arvind Deobhakta, Daniel Wassong, Kimberly Mei Winges, Vahe Zohrabian, Rachel Zubko Greninger, Tanya Lila Hamilton, Ariella Aliza Hochsztein, Jennifer Anne Inra, Elena Alumni: Eric J Feldman, Catherine Butkus Small Kamenkovich, Brett A Lenart, Erika Maria Moseson, Lindsay S Norris, Smrita Sinha, Faculty: Leanne Forman, Martha Shelley Grayson Alon Terry, Kelly C Vranas Albert Einstein College of Medicine of Yeshiva University—Kappa New York Alumni: Richard Daines Students: Netanel S Berko, Oren Elias Bernheim, Scott Adam Boruchow, Heidi Moss Faculty: Oheneba Boachie-Adjei Bours, Erin Reis Callahan, Lauren Crocco, Annette Czernik, Carey Anne Eberle, State University of New York, Upstate Medical University, College of Justin Ian Friedlander, Rebecca Mates Friedman, Balazs Galdi, Caryn A Gamss, Ari Medicine—Gamma New York Matthew Grinspan, Robert Francis Hanna, Michael Gerard Hannon, Jaime Berg Students: Steven Altmayer, Paul D Aridgides, Kimberly Rae Blasius, Catherine Grace Hyman, Meredith Ann Kelly, Charles Francis Lanzillo, Deborah Wonwah Leong, Chung, Stacy Cooper, Anthony Cucci, David A Drew, Rachel Lipson Garner, Melanie David Albert Liebelt, Eric David Manheimer, Jeremy Aryeh Mazurek, Jonathan Rose Hawver, Jennifer A Jarosz, Rebecca L Lenhard, Austin Liu, Matthew Mason, Nachman Mazurek, Crystal Suzanne Query, Ilana Saal-Forchheimer, Darryl Brett Lauren Morrison, Tina Ann Nguyen, Sarah M Nicolai, Jennifer Dawn O’Reilly, Sneag, Sasha Elizabeth Stanton, Diana Mai-Khanh Tu, Allen Benjamin Yeroushalmi Jonathan Oheb, Zoe A Orecki, Christopher M Palmer, Aleksandra Policha, David S Faculty: Chaim Putterman Shi, Adrienne Ruth Socci, Robert Swan, Melissa Urckfitz, Anne Elizabeth Villari Mount Sinai School of Medicine of New York University—Lamba New York Alumni: Ruth Helen Hart, Howard M Simon Students: Joshua Bauml, Adam Belanger, Parul R Chaudhari, Jessica Anna Cintolo, Faculty: Elinor Spring-Mills, Anne Rose Sveen Randy M Cohn, Serina Deen, Ankur M Doshi, Jonathan Philip Bragg Elmer, House staff: Nicholas John Bennett, Sean Edwin Button, Orson Dy Go Laurel Glaser, Jonathan S Hausmann, Casey Jo Humbyrd, Thomas J Klein, Levi G New York University School of Medicine—Delta New York Ledgerwood, Eli Miloslavsky, Sara Urana Schwanke, Risa Michelle Small, Gabriela Students: James T Bennett, Andrea C Chen, Selby G Chen, Lauren Beth Ende, Luis Soriano, Peter Joseph Vasquez, Kelly Leigh West, Dmitriy Zamarin Isaac Garcia, Alfred L Garfall, Ann Rebecca Garment, Leonard Glickman, Sandra Alumni: Michael L Marin, John A Martignetti Harriet Kamholz, Andrew J Kleinberger, Anna Podolanczuk, Irina Privorotskaya, Faculty: Eileen Scigliano Patrick Morris Sullivan, Rull James Toussaint, Levon Haig Utidjian, Amanda Moberg House staff: Anu Lala, Philippa Newell, Carlos Rios Wilson Alumni: Carolyn Barley Britton

68 The Pharos/Winter 2009 Stony Brook University Medical Center School of Medicine—Mu New York University of Cincinnati College of Medicine—Beta Ohio Students: Thomas Boes, Inderjit Chabra, Alisa Femia, Cecile Audrey Ferrando, Bella Students: Paul Timothy Bunch, Michael Dentler, Blake J Evans, William J Forton, Fradlis, Jonathan Gale, Lindsay Jubelt, Courtney Elizabeth Juliano, Yee Cheng Low, Sarah Elizabeth Fox, Brian Michael Grawe, Joseph Hall, Lauren Imwalle, Gregory Adam Miller, Joshua Russell Olsen, Sabera Pirmohamed, Julie Ann Stein, Elizabeth Kohls, Robert Brett Lloyd, Andrew D Lund, Lauren Rose Ostling, Brandi Reeves, Weiner Justin Stevens, Christopher Tangren, Philip To, Joseph S Turner, Emily Wiebracht Faculty: Stephen Anthony Vitkun Alumni: Barbara Bowman Tobias House staff: Fady Michael Kaldas Faculty: Diya F Mutasim NORTH CAROLINA House staff: Samir Rama Belagaje, Jared Travis Hagaman Ohio State University College of Medicine—Gamma Ohio Duke University School of Medicine—Alpha North Carolina Students: Sireesha Achanti, Mary Ellen Acree, Brian Becknell, Randall T Butler, Students: Aarti Asnani, Daniel Coke Barr, Ari Brettman, Stephen James Dolgner, Jeffery Chakedis, Shane Chamberlain Clark, Michael Edward Cody, Ryan Patrick Wen-Chi Foo, Sidney Maloch Gospe, Khaled M Hassan, Tiffany Renee Hodges, Ficco, Eric Freeman, Aharon Gideon Freud, Blake Paul Gillette, Daniel Gerard Michael Lee, Donald Jay Lucas, Robert Gil Micheletti, Kunal Mitra, Yvonne Marie Gorbett, Jon Clifford Henry, Erik Christopher Hustak, Seth Karol, Clare Johnson Mowery, Toma Omonuwa, Mrinali Patel, Ashley Wysong Kelleher, Hallie Sara Kendis, Vu H Le, Rushyuan Jay Lee, Eric Michael Liotta, Alumni: William D Bradford Sean Thomas McCarthy, James Ryan Meadows, Jessica Moennich, Trucian Adam Faculty: J Lloyd Michener, Christopher Wildrick Woods Ostheimer, Cedric Pritchett, David Carleton Reed, Wilford Lee Richardson, Elizabeth House staff: Thomas Pilkington Ann Schloss, Andrew Brian Shaw, Kameron Alexandra Teal, Jeffrey Joseph Wargo, Wake Forest University Health Sciences (School of Medicine)—Beta North Brent Thomas Warner, Wesley Joseph Whitson Carolina Alumni: Paul D Dusseau, Sayoko E Moroi Students: Gretchen Cort Banks, David Werth Barry, Stephen Joseph Blaha, Laura Kyle Faculty: Bruce Alan Biagi, Michael A Caligiuri Brett, John Joseph Brewington, Brandon Lee Craven, Jessica Eichinger, Morgan Taylor House staff: Carl Backes, Candace Huebert, Jason Wayne Smith Fordham, Jeffrey Michael Hick, Ryan Christopher Johnson, Christopher Marcus The University of Toledo, College of Medicine—Delta Ohio Lack, Emily Walters Langley, Jacob Albert Misenheimer, Jessica Lynn Pilchard, Karen Students: Daniel Zachary Adams, Tyler Brian Anderson, Adam John Bobbey, Jacinta Elizabeth Schmitt, Kathryn Marie Fesler Steele, Lindsay Chaney Strowd, Roy Strowd, Catherine Borgelt, Ann Bui, Bethany Calaway, Anne Kowatsch Clark, Suzanne Dietz- Jennifer Ann Vaughn Quinter, Nathan Egbert, Theresa Marie Frey, Shelley Patricia Godley, Jennifer Nicole Alumni: Daryl Rosenbaum Gueth, Mark Louis Lembach, Patty Liu, Lisa Anne McGee, Christopher John Owens, Faculty: David Edwin Manthey Victoria Louise Sheridan Owens, Aimee Marie Pollak, Benjamin Thomas Prince, House staff: Jimmy Ruiz, Samuel Turner Amanda Proctor, Katherine Jane Rodewald, Valijan Sevak, Peter Paul Stanich, Daniel University of North Carolina at Chapel Hill School of Medicine—Gamma George Straka, Arul Thirumoorthi, Seth A Waits, Brett Brunner Williams North Carolina House staff: Amy Riese, Sandeep Vetteth Students: Alisa Patricia Alker, Shruti Laxmikant Chudasama, Christy Johnson Wright State University Boonschoft School of Medicine—Epsilon Ohio Crockett, Reid W Draeger, James E Ferguson, Lauren H Gainor, Jennifer Bushman Students: Deborah Amann, Tyler M Angelos, Julia Denise Burrow, William Cornwell, Gilner, Lynn Jackson Howie, Michael Hromadka, Sarah Broom Hubbell, Margaret Beth Davis, Jason Richard Faber, Daniel Blake Flora, Richard N Greene, Bryan Steven E Jackson, Rebecca Irene Kalman, Alison Keenan, Gregory P Larsen, Chad Michael Jewell, Scott Thomas Leffler, Jacob McAfee, Sonal Kishore Moratschek, David Wayne McCall, Andrew McWilliams, Caleb Evans Pineo, Nell Brock Pollard, Adam J Froyum Morris, Dipika Mahendra Patel, Kyle Lee Randall, Sarah Von Lehmden Roise, Robert E Sapp, Lucy Marie Schenkman, Taylor James Stone, Gregory Tayrose, Faculty: Dean X Parmelee, Jerome J Schulte Catherine Elizabeth Varner, Tilley Jenkins Vogel, Katherine Davis Westreich, James House staff: David Jens Dalstrom, Jason Thomas Hedrick, Charles Brock Miller Robert Young, Lindsay Sallach Young Alumni: Anil Kumar Sood Northeastern Ohio Universities College of Medicine—Zeta Ohio Faculty: Julie Story Byerley, Laurence D Dahners Students: Emily Lee Albertson, Dominic MIchael Buzzacco, Nicholas Walter House staff: Alan Cheng, Jason Paul Glotzbach, Bhakti B Paul Detore, Rebecca Elizabeth Duncan, Andrew Robert Esterle, Gopi Ashwin Kesaria, Amanda Kristine Kinney, Casey Jean Maks, Jessica Nassar, Sandeep Magesh Patel, The Brody School of Medicine at East Carolina University—Delta North Dominic Joseph Peters, Scott Joseph Rapp, Patrick Michael Riley, Ashley Elizabeth Carolina Smith, Megan Christine Smith, Megan Kathleen Walsh, Halley Wasserman, Cynthia Students: Richard Alan Bloomfield, Brian Christopher Domby, Adam Dean Houser, Elizabeth Weber Shelby Ann Kaplan, Zachary Philip Kiker, Jeremy Michael Kilburn, Heang Muy Lim, Alumni: Rodney Jay Ellis, Christopher A Sheppard Nicholas Dean Mayes, Joshua Daniel McKinney, Roger Jacob McMurray, David Faculty: Joseph P Burick, William Francis Fallon Clinton McNabb, Laura Maha Nasrallah House staff: Andrea Kuntaraf Crane, Brian Christopher Lenczewski, John David NORTH DAKOTA Scrocco University of North Dakota School of Medicine and Health Sciences—Alpha OKLAHOMA North Dakota University of Oklahoma College of Medicine—Alpha Oklahoma Students: Allison Jean Clapp, Ryan Miles Clauson, Margaret Kay Cook-Shimanek, Students: Ore-ofeoluwatomi Adesina, David Aaron Behrmann, Sara Ann Collier, Khalin Dendy, Theresa Anne Hegge, Joshua J Knudson, Lindsay Anne Magura, Shannon Gregory Cox, Marc E Error, Timothy James Garlow, Shaun Gobind Singh Nicholas Milanovich, Jill Marie Steinle, Megan Bess Welsh Grewal, Terry Lynn Grigg, Shelbi Renee Hayes, C Lenny Henderson, John Mikel Alumni: L Michael Howell, Christopher H Tiongson Hubanks, Andre Paul Marshall, Dustin J McLemore, Lauren Alexandra McQueen- Faculty: Scott Eric Knutson, Mary Ann Sens Shadfar, Justin Michael Neff, Kathryn Marie Piercy, Scott Shadfar, Santosh N Shah, House staff: Jeffrey Ben Andersen, Laura Ann Berg, Daniel Raymond Padgett Adam Doyle Sharp, Tony William Spatz, Spencer Jay Stanbury, Nicole Lorraine NOVA SCOTIA Tintera, Cydni Nicole Williams, Margaret Zanger Dalhousie University Faculty of Medicine—Alpha Nova Scotia OREGON Students: Michael W Aucoin, John Haverstock, Mary Jamieson, Gavin Langille, Oregon Health & Science University School of Medicine—Alpha Oregon Morgan Alexander Langille, Lorine Pelly, Deborah Anne Pink, Derek J Roberts Students: Caryn Entine Avery, Daniel Ivan Avery, Erin Nicole Berry-Bibee, Patricia Alumni: Evelyn Deborah Sutton M Frew, Kristin J Herring, Erick Jacobson-Dunlop, Katie L Lemieux, Jesse Madden, House staff: Patrick JG Feltmate, Brian G Moses Marc Montanaro, Jarrad Scarlett, Kelly Ann Sweerus, Laura Marie Webb, Jessica OHIO Anne Yu Case Western Reserve University School of Medicine—Alpha Ohio Faculty: Robert L Potter, Charles Richard Thomas Students: Lindsay Catherine Burrage, Katarzyna Buzanowska, Sophia Wai-yun House staff: Michelle RoseAnn Shaw Chen, Bryan Randall Costin, Barry M Czeisler, Colleen Anne Foster, Jessica Randa PENNSYLVANIA Goldstein, Joanna Kriegler Grossman, Jennifer Elizabeth Hagen, Evelyn Morley Jefferson Medical College of Thomas Jefferson University—Alpha Hemmingsen, Michelle Miran Kim, Eugene Brent Kirkland, Ethan S Lea, Benjamin Pennsylvania Lee, Rachel Benelli Markey, Kelly Ann Morrissey, Haruko Okada, Tehnaz Nawzer Students: Eleanor Ruth Ainslie, Christopher Velasquez Almario, Laurence Justin Parakh, Matthew Allan Popa, Aleksandra V Rachitskaya, Jacob Gardinier Scott, Belin, Stephanie Beth Boswell, Justin Samuel Brandt, Leslie Bryden, Jeffrey Clough, Aaron Gilman Wightman, Lindsay Bashaw Wilson Jennifer Leigh Coats, Vincent Quang Dam, Ranvir Dhillon, Sarah Dickinson, Kevin Faculty: Robert L Haynie, Michael J McFarlane Michael Eanes, Aparna Goel, Craig Thomas Haytmanek, Patricia C Henwood, Kari House staff: Theodore Alexander Kung Horowitz, Sadaf Hashim Hussain, Lauren Smith Krill, Doriann Lee Lavery, Cynthia

The Pharos/Winter 2009 69 New members

Elizabeth Lee, Amanda Rachel Lerman, Katie Kupfer Lockwood, Theresa Madaline, Alumni: Joxel Garcia Rebecca Matro, Alexander Francis Mericli, Leslie Moroz, Jennifer Neuman, Laila Faculty: Jesus Cruz Correa, Juan B Fernandez-Perez Nurmohamed, Nicholas J Petruzzi, Joseph Portale, Karl Martin Schweitzer, Laura Universidad Central del Caribe School of Medicine—Gamma Puerto Rico Ann Snyder, Kristina Stransky, Marguerite Thomer, Scott Howard Troob, Sarah Mary Students: Michelle M Arrieta Gonzalez, Gustavo Bauza Almonte, Gabriel Mariano Wallett, Jason David Walls, Melissa Ann Wilson Covarrubias, Eduardo J Cruz-Colon, Teresa Garcia, Jordan Michael Glaser, Jeanne Faculty: Katherine Berg, Edward Jaeger Gissele Guevara, Jesus I Hernandez Rivera, Mireily Rivera-Rosado House staff: Alexander Arriaga, Geoffrey Bowers, Eric Hager Alumni: Carlos A Blanco Ramos, Francisco R de Torres University of Pennsylvania School of Medicine—Beta Pennsylvania Faculty: Ohel Soto-Raices Students: Cynthia Marie Adams, Kiona Yasmin Allen, Daria Babushok, Andrew House staff: Jose Antonio Rivera-Valles Richard Bond, Robert Scott Fenning, Boris Gershman, Laurie Beth Gray, James RHODE ISLAND Matthew Gregory, Amma Hewitt, Lillias Christine Holmes, Daniel Edward Houseman, Andre Michel Ilbawi, Deborah Jones, Autumn Michelle Kieber-Emmons, The Warren Alpert Medical School of Brown University—Alpha Rhode John Nicholas Lukens, Landi Marie Parish, Ross Hamilton Parker, Rebecca Frances Island Rabin-Bloomberg, Alexander Tuukka Ruutiainen, Patricia Marie Salmon, Ilana Students: David Lloyd Ain, Sophia Califano, Christina M Cinelli, Apara Dave, Juliann Michelle Sherer, Peter Bernard Veldman, Jonathan Wanderer Gaydos-Gabriel, Jonathan Greer, Silvia Hartmann, Elizabeth Naylor, Christina Ronai, Faculty: Gregg Y Lipschik Justin Routhier, Joshua Spaete, Gita Suneja Alumni: Griffin P Rodgers University of Pittsburgh School of Medicine—Gamma Pennsylvania Faculty: Brian Alverson, Anthony A Caldaone Students: Jonathan Bortinger, Shawna Teresa Bouwers, Patrick Joseph Brown, House staff: Brenda Ijeoma Anosike, Samielle Brancato, Elizabeth Dufort Amanda Banks Christini, Jessica Ellerman, Jesse Fisk, Paul Joseph Hoffman, Douglas Jason Hsu, John Robert Klune, Yinchong Erica Mak, Sami Paul Makaroun, Nidhi SOUTH CAROLINA Mehta, Christopher Andrew Rippel, Arun Sharma, Gennedy Shiferman, Eveline H Medical University of South Carolina School of Medicine—Alpha South Shue, Nicholas T Spina, Paul G Tarasi, Joyce Tawfik, Nicole Francesca Velez, Emily K Carolina Weber, Alik Widge, Richard Wiley Williamson Students: David Arrington, Joshua Stephen Black, Devon Eileen Bork, Jason B Coker, Faculty: Gregory Matthew Bump, Asher Arthur Tulsky Jason Andrew Curry, Virginia Culyer Daughtery, Matthew Garin, Bradley S Kalinsky, House staff: Niladri Das, Paulraj Samuel, Linwah Yip Ian D Kane, Amy Ketcham, Peter Jennings King, Carlotta Jenkins Lalich, Andrew Drexel University College of Medicine—Delta-Zeta Pennsylvania Roper Lewis, Meredith Cates Northam, Clarice Marie Seifert, Todd Nathanial Senn, Students: Mark Robert Anderson, Farah Awadalla, Katherine Rotondo Baker, Ryan Katherine Culp Silver, Barclay Thompson Stewart, Julie Miller Swick, Benjamin John Callahan, Maria Syl de la Cruz, Ryan Duffy, Elysia Marie Engelage, Abbey Fingeret, Thomas, Zeke Jonathan Walton, John Weathers, Caroline Felder Wooten, MaryShell Adam Benjamin Fleit, Rebecca Anne Fox, Sandi-Jo Galati, Lisa Kay Gibson, Israel Zaffino Green-Hopkins, Zachary Scott Hoffer, Adam Holleran, Rebecca Jackson Howell, Amy Faculty: Paul Ray Lambert, Stuart Marc Leon Hyun Kyung Hwang, Kiana Kashef, Linda Keele, Stephanie Keller, Steven Hyungmin House staff: John R Barbour, Thomas Slade Dozier, Corey Michael Hatfield Kim, Jessica Hope Klausmeier, Jodi Dara Langer, David Ansley Lawrence, Annette University of South Carolin School of Medicine—Beta South Carolina Meliza Lopez, Marcelo Malakooti, Abhijith Dev Mally, Ajay Mahesh Manchandia, Students: Sarah Bailey, Kevin Budman, Franklin Gettys, Bevin Elizabeth Hearn, Jacob Christian Miss, Nikhil Mull, Mona Patel, Steve Pugliese, James Eric Roth, Christopher James Huffman, Christopher James Huffman, Philip Ross Mason, Inderpreet Singh Saini, Pooja Sharma, Kimberly Ann Slininger, Dennis Michael Rebecca Suzanne Napier, Courtney Riley, Patrick Ware, Krystal Southerlin White, Sopka, Ksenia Stafeeva, Amaal Jilani Starling, Michael Charles Tressler, Byron Jesse Woodard Vaughn, Sarah Wood Alumni: Ralph N Riley Alumni: Mary Ann Adler Cohen, Christopher Todd Olivia Faculty: Donald J DiPette Faculty: Edward Gracely, Nancy Dollase Spector House staff: Jeremy Michael Byrd, Shanna Bradley Holcomb House staff: Jeffrey Morgan Denney, Jose N Nativi Nicolau, Amy Elizabeth Pattishall SOUTH DAKOTA Temple University School of Medicine—Epsilon Pennsylvania Students: Behrad Ben Aynehchi, Roya Azadarmaki, Brian Christopher Barrett, Sanford School of Medicine of the University of South Dakota—Alpha South Katharine Theresa Criner, Racher Elaine Davis, Jayanth R Doss, Jonathan B Ford, Dakota Michael Joseph Franco, Joshua S Gluck, Janelle Marie Hesse, Janice Elizabeth Hobbs, Students: Nathan Bradley, Sam Joseph Chelmo, Andrew John Gunn, Kassy Arnette Shraddha Devendra Jani, Sarah Ann Johnson, Robert James Katzer, Matthew T Hegge, Emily J Horner, Nathan James Miller, Tara Nikole Miller, Jenny Nelson, Kleiner, Aiham Chaher Korbage, Kevin John Krauland, Daniel Jeffrey Landsburg, Annette L Siewert Christine Agnes Martin, Katie Lynn Miro, Melissa Ann Mroz, Michael Joseph Alumni: Juliann Reiland-Smith O’Malley, Alexander Pantelyat, Utpal Patel, Jason Joseph Redon, Katherine Nicole Faculty: Joseph J Fanciullo Rinaldi, Jonathan C Roberts, Michael Thomas Schweizer, Scott Simonson Short, House staff: Deshandra M Raidoo Timothy P Smith, Stephanie Lynn Tessing TENNESSEE Faculty: Susan Gersh, Nikitas J Zervanos Vanderbilt University School of Medicine—Alpha Tennessee Pennsylvania State University College of Medicine—Eta Pennsylvania Students: Jeffrey Martin Albert, India Fox Bayley, Ryan Patrick Bayley, Mihaela Students: Justin B Bigger, Erik James Elwood, Christopher David Hanks, Jessica Lynn Hristova Bazalakova, Christopher Bunick, Kevin Meyer Elias, Kirsten Inglee Gibbs, Holzman, Leah Marie Kinlaw, Katherine Louise Maietta, Bradley William Moatz, Erin Roxanne Horn, Kathryn Lynn Jongeward, Jonathan Andrew Kropski, Diana Maribeth Ruth Morral, David Thomas O’Gurek, William Michael Peterson, Nicholas Catharine Lemly, Jason Richard Mann, Carrie Campbell McCoy Menser, Mary Alice Stephen Pierson, Nicole Marie Saddic, Sara Jane Heilig Wasong, Douglas Matthew Nading, William Michael Oldham, Rebecca Anne Snyder Wisner, Joselyn Lee Wozney Alumni: Kevin B Churchwell, Wonder P Drake PUERTO RICO Faculty: Derek A Riebau, Charlie B Rush House staff: Nicole S Carroll, Peter F Crossno, Michele R Henson University of Puerto Rico School of Medicine—Alpha Puerto Rico Students: Juan Carlos Almodovar Mercado, Ana M Montanez Concepcion, Omar University of Tennessee Health Science Center, College of Medicine—Beta Corujo Vazquez, Eneida Maria De La Torre Lugo, Lilliam Diaz Velez, Hermes Gabriel Tennessee Garcia, Arlene E Garcia Soto, Rafael S Garcia-Cortes, Maria C Gonzalez Mayda, Students: William David Algea, Kevin Todd Arnold, Reem S Awwad, Joshua Bryant Jahzel M Gonzalez Pagan, Tania Maria Gonzalez-Santiago, Luis J Haddock Morales, Byrd, Tyler Austin Cannon, Lauren Roberts Cooper, Evan James Dunn, Kristen Lynn Nicole Rassi Stella, Carlos Felipe Sanchez-Glanville, Sheila Garcia Santana, Rafael A Heins Fernandez, Daniel Peter Mazei Fowler, Allison Leigh Gratzer, Jessica Hammett, Vicens-Rodriguez Jonathan Paul Hayes, Rose Lee Hiner, Julia Amanda Jackson, Emily Hicks Jones, Alumni: Marcia Roxana Cruz-Correa, Maria Isabel Herran Jack William Lambert, Kerry Allison Lavigne, Michael Paul Lazarowicz, Van Karlyle Faculty: Fernando Luis Joglar, Nerian Ortiz Morris, Amir Paydar, Matthew Whitby Roberts, William Bradley Rogers, Bryan House staff: Jose Guillermo Cabanas Rivera, Hilton Franqui - Rivera, Carlos J Romero MIchael Sabbe, Bighnesh Satpathy, John Patrick Selph, Paul Albert Tennant, Mridula Marrero Bagrodia Watt, Jonathan Taylor Whaley Faculty: Jerome Walter Thompson Ponce School of Medicine—Beta Puerto Rico Students: Yamilka Abreu, Amelia Karen Adcock, Jesse R Aleman Ortiz, Tracy Catlin, House staff: Christopher James DiBlasio, Paxton Vandiver Dickson, Kathryn Azelia Alejandra Matilde del Toro, Cynthia Gonzalez Gonzalez, Tareq Ali Khedir Al-Tiae, Providence Peter Anthony Mennie, Neha Morparia, Cumara O’Carroll, Maria Cristina Rueda Meharry Medical College School of Medicine—Gamma Tennessee Rueda Gonzalez, Jennifer Rullan, Taina Aracelis Trevino Students: 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-nikqua Texas Tech University Health Sciences Center School of Medicine—Zeta Trenae Thomas, Prince John Thommen, Fonda Delores Webb Texas Alumni: Nelson L Adams Students: Steven E Burgess, Hua Chen, Sarah Elizabeth Cooper, Jonathan Daniel House staff: Olumuyiwa Abolade Esuruoso, Damaris Morenike Olagundoye, Kesha Crews, Cathryn Anne Doughtie, Jason James Ginos, Theodore E Hackl, Benjamin Shunte Robertson Aaron Hirsch, Allison Lea Hulme, Jennifer Leigh Johnson, Michal Klysik, Joseph East Tennessee State University James H Quillen College of Medicine—Delta Wilson Magley, Rene Alphonse Mai, Bonnie Marie McCann, James A Muns, Kristina Tennessee Nichole Orey, Malini Patel, Megan Nichole Rivers, Jeremy Matthew Saller, Gregg Students: John William Beddies, Kristin Orr Bresowar, Matthew Melton Cole, William Schmedes, Tyler Clayton Street, Angel Sun Christopher Lewis Cropsey, Jason Allen French, Jennifer Kathryn Jantz, James Alumni: Lorenz Lutherer, Kellie Flood-Shaffer Richard Layton, Samuel Douglas Richesin, Justin Ray Sigmon, Daniel Scott Smith Faculty: Ari Halldorsson TEXAS House staff: Eduardo Rosas Blum, Steven Brooks, Dustin Turner Texas A&M Health Sciences Center College of Medicine—Eta Texas University of Texas Medical Branch, University of Texas Medical School at Students: Grace Elizabeth Brown, Jessica Lynn Clark, Kristoffer Lee Crawford, David Galveston—Alpha Texas Jeffrey Crockett, Susan Leigh Greenhut, Darci Janell Hansen, Ronald Paul Hobbs, Students: Sabrina Akhtar, J’Cinda Bitters, Kristen Boyle, John Phillip Brach, Conner Slade Alan Hodges, Eric Andrew Lenehan, Brad Alan Onhaizer, David Dung Pham, Chan, Andy Leechuan Chen, Harold DelasAlas, Chad David Fairchild, Rachel Connie So, Jonathan Martin Williams Finehout, Lance Michael Freeman, Clarisa Ysela Garcia, Ashley Group, Barbara Alumni: Robert Emmett Myers Lawson Heil, Kristopher Gray Hooten, Jeffrey John Houlton, Qaali Hussein, Julie E Faculty: Andrejs Eriks Avots-Avotins, Mohsen Shabahang Jackson, Jared M Kasper, Katherine Kintner, Lauren Ashley Layer, Rachel Justine Le, House staff: Marc Elieson, Nicholas Paul Souder, Ethan Joseph Wright Di Lin, Rachel Elizabeth Lindenborn, J Andrew Livingston, Jason K Mann, Neema Nayeb-Hashemi, Donna Nguyen, Abhilasha Jayantilal Patel, Nisha Babu Patel, Brian UTAH Christopher Quigley, Adam Richter, Jennifer Schopp, Phillip Guy Wortley University of Utah School of Medicine—Alpha Utah Faculty: Frederick Szujuei Huang, Gottumukkala Subba Raju Students: Sidney Baucom, Jade Bringhurst, Cory Carlston, Stephanie W Chen, Ryan House staff: Lindsay Kay Hilbert, Stephen Paul Lester, Juan Diego Martinez C Craner, Ashley Ellsworth, Nathan David Faulkner, Mark S Hansen, Kyle Hobbs, Baylor College of Medicine—Beta Texas Matthew James Kolek, Evan Kulbacki, Paul Lambert, Jay Jeffrey Meyer, Jeffery Muir, Students: Robert McLain Beardsley, Michelle Renee Butler, Leon L Chen, Matthew Michelle Regruto, Nicole Wilde David Driscoll, Samuel Justin Hankins, Joanna Lee Harp, Ashley Margaret Holder, VERMONT Heidi Hullinger, Andrew Louis Juergens, Christopher Raymond Kauffman, Gregory Charles Lieser, Travis Douglas Lyons, Benjamin Allen McArthur, Ryan Arthur University of Vermont College of Medicine—Alpha Vermont Students: Whitney Noelle Casares, Derek Chase, Sara Elizabeth Delaporta, Kerrin McConnell, Elizabeth Burns McQuitty, Erica Maria Sehne Munch, Anisha Bipin DePeter, Jonathan Straffin Hall, Colby Halsey, Elizabeth Alden Kreiling Hunt, Carl Patel, Ehsan Rahimy, Lauren Allison Raimer-Goodman, Justin Michael Ream, Behram Kapadia, Caitlin Elizabeth Kennedy, Lee Jae Morse, Shannon Dawn O’Keefe, Timothy Kirk Ruttan, Beth Ann Zarnow Scholz, Michael Scott Stewart, Alex Daniel Gulnar Amin Pothiawala, Anne Pearce Rowland, Danielle Christina Williams, Sweeney, Livia Van, Sage Parrian Whitmore, Brian Jeremy Williams, Ina Wu, Carolyn Joo Hyun Yoo Stephanie Nicole Wuest Faculty: Christa M Zehle Faculty: Jennifer Elizabeth Pate House staff: Christopher Michael Sullivan House staff: Yuval Raizen, Wendy Lea Smitherman University of Texas Southwestern Medical Center at Dallas, Southwestern VIRGINIA Medical School—Gamma Texas University of Virginia School of Medicine—Alpha Virginia Students: Steven B Albright, Rebeccah Bradshaw Baucom, Bret D Beavers, Benjamin Students: Andrew Richard Batchelet, Justin Thomas Lloyd Baynham, Daniel Kittelle Jacob Brown, Benjamin E Cassell, Christopher P Chaney, Emily E Crozier, Lance Bennett, Jordan Andrew Brewster, David Benjamin Bumpass, Laura Elizabeth Edwin Davis, Jennifer L Duewall, Guy E Efune, Allison Ellzey, Abbie Martha Ewell, Burt, Eric Kent Cannon, Peter Nelson Dean, Keiko Iwahara Greenberg, Alexander Mary A Gajewski, Jason W Gillman, Taylor L Gist, Nakul Gupta, Robert U Hartzler, Tharrington Hawkins, Brian Daniel Hobbs, Mindy Ju, Thomas Christian Keller, Brian Joshua Aiden Hill, S Tyler Hollmig, Adam C Jenkins, Wislon Kwong, John Thomas Jeremy Kipe, Allison Layla Marie Kirk, Laura Ellen Koehn, William Randolph Mook, Lemm, Sara Stevens Lindsey, Nelson Eddie Liou, Huay-ying Lo, Jordon G Lubahn, Jonathan Boyd Parr, Matthew Wall Semler, Brandon John Webb Tessa L Manning, Kalpana Manthiram, Alexis Allyson Melton, Jonathan C Mills, Faculty: Charles McCLaskey Friel Joshua Delbert Mitchell, Proshad Nemati, Chan Nguyen, Nina Nuangchamnong, House staff: R Ramesh Singh Andrew Scott Paulson, Amy Alison Pierce, Cason Pierce, Autumn L Pruette, Rachna Virginia Commonwealth University School of Medicine—Beta Virginia Rai, Isaac See, Michael E Seymour, Lauren V Skaggs, Christina Stine, Tiffany B Sun, Students: Barbara J Adams, Cheryl Elizabeth Anderson, John David Au, Joshua Eric Tranvinh, Zachary D Vest, Kendall Walters, Alycia M Wanat, Jonathan Michael Stephen Butler, Katherine Middleton DePlatchett, Kyle Joseph Eliason, Georgia Watts, Marcus Weatherall, Matthew John Whinery Yowell Ferrell, Rebecca Leigh Gibbons, John Edward Greer, Marie Kate Gurka, Faculty: Robert S Munford, Fiemu E Nwariaku Katherine Lynn Harding, Tiffany Brock Kelly Helman, Jonathan R Helms, Sara Beth House staff: Hamed khalili, Allen P Lee, Min Chong Yoo Huberman, Heather Melee Katebini, Ashley Brittingham King, Nicholas David University of Texas Medical School at Houston—Delta Texas Lahar, David James Mooney, Susan Bich Nguyen, David Sunghan Paik, Michelle Students: John H Anderson, Allison D Bollinger, Anthony F Boyer, Vera Drecun Lynn Palumbo, Payal S Patel, Michael Fitzgerald Rolen, Brian Michael Showalter, Cooke, Jennifer B Cowart, Nathan A Davis, Hayley L Epstein, Paul D Evans, Olufenwa David Falace Smith, Sally Gowen Stander, Hasan Raza Syed, Clare Francisco Wallner, J Famakinwa, Brandice M Graves, Michael C Greaser, Jessica A Hersman, Lindsey Garrett Douglas Walters D Hicks, Robert E Honey, Andreas Kaden, Heather L Klein, Justin A Krajca, Chad Alumni: Ralph R Clark M Lonsford, Patrick C Marcin, Heidi L Matus, Leslie R McClanahan, Courtney Faculty: John D Roberts, Isaac K Wood J McCray, Eileen M Merkle, Michael H Moghimi, Emily M Moglovkin, Bryan T House staff: Claire VanEenwyk Chehrazi, Angela Horton, John Charles Kirkham Patterson, Martin T Paukert, Jason R Pearce, Lee G Phillips, Olivia B Romano, Eastern Virginia Medical School—Gamma Virginia Thomas M Shary, Justin G Smith, Austen W Worsham Students: Ariane M Abcarian, Daniel J Bebereia, David Michael Callender, Adam Paul Alumni: Lisa Y Armitige Childers, Justin Craig Cohen, Edwin Fulghum Crandley, James Joseph Daniero, Brett Faculty: Patricia M Butler, Giuseppe N Colasurdo M Hesse, Kevin Michael Hibbard, Nathan Andrew Kludt, Ashley N Lock, Matthew House staff: Yvette S Drake-McLin, Jean I Onwuchekwa, James William Suliburk JP LoDico, Michele Anne Nedelka, Caroline M Parker, Jessica Lynn Salzman, Kristin University of Texas Medical School at San Antonio–Epsilon Texas Anne Stubben, Robert Benjamin Swanson Students: Adam Bellinger, Annie Chan, Joshua Adam Delavan, Candice Nicole Alumni: Silvina M Bocca, Ralph S Northam Dubose, Natalie L DuMont, Rachel Aubrey Hassan, Fernando Alejandro Hernandez, Faculty: CW Gowen, Chee Keen Woo Cara Marie Horny, Melissa S Hu, Sara Ann Jackson, Tyler Scott Jorgensen, Stephanie House staff: Amy Page, Gregory Duncan Rushing, Nicole Watring Anne Lewis, Kristina Lozano, Tiffany Lee Milner, Aaron Moon, Brett C Norman, WASHINGTON Ifeoma Obiageli Onuorah, Elizabeth Anne Osborne, David Schmit, Andrew D Shedd, Seema Sheth, Weiwen Vivian Shih, Shaum Sunder Sridharan, Elizabeth Ventura, University of Washington School of Medicine—Alpha Washington Andrew Jon Wall, Stephanie Anne Watson, Brian Weatherford, Jennifer M Welch, Students: Natalia Bajenova, Amaya Marie Basta, Andrew Blackman, Nicole Teresa Dustin Blake Williams, Christopher Beau Willison, Clarence Joseph Wolinski, Bleakly, Jennifer Brady, Alson Burke, Rebecca E Curry, Judy McCarty Gayne, Bijan Rebekah Helen Wright, Shehnaz Aysha Zaman, Symeon Vasilios Zannikos Justin Ghassemich, Naomi Kim Gilman, Anna Golob, Gregory Haveman, Derek Dean Jackson, Luke Judge, Stacy Kessler, Erich E Koerner, Andrew Kyle Larsen, Jenny Lessner, Karen Livne, Jarod P McAteer, Kinsey McCormick, Crystal Marie

The Pharos/Winter 2009 71 New members

North, Andrew P Pace, Callie Nicole Riggin, David Shearer, Ian Slade, Dawn Stanek, DeLong, Zobeida Margarita Diaz, Milad Hakimbashi, Aric Cameron Hall, Kathryn Sundrayah N Stoller, Kathryn Treit, Mark P Van Tighem, Jason Van Winkle, Sadie Anne Hammes, Benjamin Joseph Heinzen, Jaime L Hook, Adam Owens Kadlec, West Marcie Ann Navratil, Emily Diana Kerins Ruedinger, Neil Sandhu, William Robert Faculty: Richard William Arnold, Roger Perry Tatum Schmitt, Shannon Marie Straszewski, Kim Mary Strupp, Kathryn Therese Sullivan House staff: Massimo Arcerito, Basak Coruh, Dinah Thyerlei Dillie, Kyle Ian Swanson, Ryan H Sydnor, Abigail Marie Tokheim WEST VIRGINIA Medical College of Wisconsin—Beta Wisconsin Students: Jill Marie Arganbright, Mark Richard Beahm, Lisa M Benz, Carmen Renee West Virginia University School of Medicine—Alpha West Virginia Bergom, Timothy John Berkseth, Kyle Matthew Blake, Michael Blair Bradshaw, Beret Students: Melissa Ann Alleman, Anthony Louis Cacco, Jonathan Michael Christy, Ann Casey, Jeff Chang, Maria Anna Delgado, Mary Patricia Eldridge, Colby Scott Grant Michael Clark, Anna K Donovan, Evan A Dougherty, Gregory Alan Hickey, Engar, Benjamin Lange Garvey, Gwen Marie Grimsby, Ethan Benjamin Handler, Natalie P Kreitzer, Lindsay A Kruska, Adam Joseph Lorenzetti, Thomas Christopher Genevieve A Henry, Andrew George Keenan, Jessica Layne Lambert, Joyce Ying Lin, Marshall, Barbara Jean Meade, Elliot Isaac Palmer, Elizabeth Gail Roberts, Sarah Gregory Leo McHugh, Anne Catherine Melzer, Donna Mae Bartyzal Miller, Donald Helen Sofka Alan Neff, Christine M Palmer, Payal S Potnis, Benjamin Carl Ringger, Stephanie Faculty: Hassan H Ramadan Leigh Siehr, Takashi Takahashi, Norman Earl Taylor, Matthew Raymond Vernon, House staff: Tanya Fancy, Nicholas Ryan Young Christopher Edward Weber Joan C Edwards School of Medicine at Marshall University—Beta West Faculty: Julian H Lombard, James J Nocton Virginia House staff: Jill M Bader, Prem Anand Kandiah Students: Paul David Fletcher Bailey, Janelle Marie King, Robert Martin Ore, Aaron R Parry, Susan K Saunders, Andrew Phillip Stack, Preeti Subhedar, William David Terrell Students  Faculty: Patricia Jean Kelly, Dilip Nair Alumni  House staff: Hany H Guirgis, Benjamin Lee Moosavi, Matthew Earl Simpson Faculty  WISCONSIN House staff  University of Wisconsin School of Medicine and Public Health—Alpha Wisconsin Total new members  Students: Bamidele Oyebamiji Adeyemo, Jonathan David Barlow, Laura Ann Bonneau, Sara Anne Buckman, Elizabeth Nicole Chapman, Bridget Stephanie Palliatives this is what you feel you must when the minutes open up like crackled skin, blank spaces to fill, the rows of doors down the long gray halls of hospital wings spread sheetlike across your days, your future and you resist reality with all you’ve got left, which is nothing perfect nothing is perfect, never was you’re leaning now in that direction when you stop nibbling off plastic trays turn off the IVs, spit pill after pill scowl at all in white, blue scrubs soft-sole shoes that squeak in the night the dimming drone of respirators and tvs Spanish soap operas, courtroom catfights the blare of emergency room melodramas with sutured endings, benign little plot twists where others’ stories unfold as scripts everyone swallows and enjoys but you refuse to abide by the popular soundtrack suckling your Saltines between gum sores aspirating your way down the road less taken, cluttered with the bones of your ancestors this is how you fade away your filament shivers, quivering out no longer do you wish to cast a shadow nor scratch any surface, nor leave any scars

Virginia Aronson Erica Aitken

72 Ms. Aronson lives in Florida. Her e-mail address is: [email protected]. My Eye Doctor

Today my ophthalmologist, who has been happily married to another woman for a decade, looked more deeply into my eyes than any of my lovers has ever looked. First, he oiled the keyhole of my eye until it grew so large that he could tumble right through it. He landed— plop!—in one of the trapdoored cellars of my face. Then, armed with candlestick and with monocle, he scrutinized that chamber’s contents until my retina burned more hotly than the proverbial virgin’s blushing face. Laid bare for him to see were the diaphanous garments worn by my sylphlike blood, the trailing translucent gowns whose trains lay all tangled together in a nexus of scarlet threads. And he saw the alabaster cup and saucer from which I sipped Perception, and he approved their shape and size.— Today, I said, my ophthalmologist looked 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 would separate two prisoners whom he suspected of being in cahoots so 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, or what expression was in them?” he’d have been unable. His motivations were nobler than love, and much more stable. Jenna Le

Ms. Le is a member of the Class of !"#" at Columbia University College of Physicians and Surgeons. This poem won first prize in the !""$ Pharos Poetry Competition. Ms. Le’s address is: %&" W. #%$th Street, P&S Mailbox '(#$, New York, New York #""&!. E-mail: jnl!#")@columbia.edu. Breaking Good News

I 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, MD

Dr. Gianakos is associate director of the Lynchburg Family Medicine Residency, and a member of the editorial board of The Pharos. His address is: Lynchburg Family Medicine Residency, !"#$ Langhorne Road, Lynchburg, Virginia !%&"'. E-mail: [email protected].