yale medicine spring 2002 on t he cover Ro b e rt U d e l s m a n’s arrival at Yale last June as chair has foc u s e d major attention on the Depart- ment of Surgery. Recruited from Johns Hopkins, where he helped develop new techniques for thyroid and parathyroid surgery and made laparoscopic adrena- lectomy standard,Udelsman has sethis sights on making the department one of the world’s leaders. Page 16 Cover photograph by Sean Kernan s p r ing ya l e me d i c i n e 2 0 0CO 2 NTE NTS This season on the We b 2 L E T TE RS info.med.yale.edu/ymm 4 CHRO NI CL E Ex p l o re the fo l l owing topics in 8 RO UND S g re ater depth by visiting our 10 F IND IN G S website and selecting ext r as : 12 BOO KS –Surf the Janeway and 13 ON CAM P U S Medzhitov lab websites and 14 learn more aboutinnate CA PS UL E immunity. Pay a virtual visit to the Howard Hughes Medical Institute. 16 RE IN V E NTI NG SURG E RY – Visitthe ayam and learn Ro b e rt Udelsman left one of the busiest medical ce nters on the about Reunion 2002 (and view p l a n e t to lead Ya l e ’s Depart m e nt of Surge ry out of its doldrums and photos from 2001 reunions). i nto national pro m i n e n ce. H e ’s a man on a mission. See which of your classmates By Cat hy Shufro are coming to Alumni Reunion Weekend on June 6 to 8. 24 – View additional photos from P UT TI NG EVO LUTION TO USE the second-year show, From the landscape of an ancient “rna world”springs an idea O Doct o r, W h e re Art T h o u ? that could lead to the creation of ultrasensitive biosensors based on and recent alumni events. molecular switches. On the we b s i t e , readers can I nt e rview by Marc Wo rt m a n s u b m i t class notes or a c h a n ge of addre s s, check t h e alumni eve nts calendar, 28 THE TO L L ROA D a r ra n ge for a lifelong Yale In science,an idea can lie dormant for a century and then enjoy a e-mail alias t h rough the fantastic rebirth.That’s what happened when Charlie Janeway virtual Yale Station and search proposed a theory abouthuman immunity in 1989 that captured the our electronic arch i ve. imagination of Ruslan Medzhitov. By Tr i s h a G u ra 38 FAC ULT Y 42 STUD E N TS 44 A LUM NI 50 IN MEMO RI AM 52 A RC H I V E S 2 le t t e r s A N OTH ER LESSON A SLIGHT FOR G OOD NEWS, F ROM ANTHRA X S O R E EY E S ? BAD NEWS Yale Medicine’s roundtable on Apropos of the letter from John We found ourselves on the receiv- bioterrorism was an encouraging Mahoney, m.d. ’00, in the Winter ing end of a brief flood of opinions take on a very discouraging 2002 issue,I’m gratified that he, this spring from readers who found subject (“Lessons from Anthrax,” as a young person,pointed outthe our new typeface too small.“Your Winter 2002).It was particu- difficulty of reading the small format is great—it will win awards, larly heartening because so much print in the magazine. The maga- butnotfrom your senior readers. care has gone into thinking about zine itself is very attractive,but we One needs a magnifying glass how to deal with the possibility needed a magnifying glass to read to read it,”wrote George R.Barnes, of great tragedy. much of it. Also, in our age group m.d.’47,hs ’50, of Tucson,Ariz., The big issue that those inter- many of us have painful arthritis one of a half-dozen readers who viewed skirted,however, was in the hands, and the stiff cover as weighed in on the topic. the politics of coercion in public well as stiff binding and stiffer Dr. Barnes was right on both health policy. This is an old issue (than in old format) pages make it counts.In April, Yale Medicine within public health, certainly. hard to turn the pages.Miserere won the silver medal for best ma ga - Butitbecomes much more salient nobis.... zine and bronze medal for Visual as discussions proceed about Thanks. Design in Print from the 23,500- mass vaccination for diseases such laura neville,m.d. ’46 member Council on Advancement as smallpox and anthrax,either john neville,m.d. ’46 in Support of Education.The cate- before or during an epidemic. cotuit, mass. gory in which we were judged was Under what circumstances special-interestmagazines, which would itbe permissible for Amen,amen and amen to John includes entries from graduate and the federal or state governments Mahoney’s comments regarding professional schools nationally. to require vaccination for such the size of the print in Yale These honors follow the Award of diseases? Right now, mostpublic Medicine. On the other side,thank Excellence granted lastNovember health authorities are advocating you for using adequate contrast by the Association of American only “ring vaccination” in case of between the print and the colored Medical Colleges, the group’s high- an outbreak of smallpox. And background. estlevel of recognition.But regard- even Anthony Fauci has eloquently edna may klutas, m.p.h.’57 less of these glories, itis also true written in a recent issue of The newville,penn. that Yale Medicine is hard to New England Journal of Medicine read for many in our audience. To that the formulation of smallpox address this, we are tuning up vaccination policy mustproceed the type for better legibility in time through democratic dialogue. for the Summer issue. Buthow will we balance the often-competing values of democ- racy and authority, coercion and how to reach us informed consent,in the midst of Yale Medicine welcomes news a bioterror crisis? and commentary. Please send letters One thing is certain: we to the editor and news items to need to begin to re f l e ct on these Yale Medicine, P.O.Box 7612, New m atters now, n o t during such Haven, CT 06519-0612, or via an episode. The time to begin is electronic mail to [email protected], n ow, and our discussions must and include a daytime telephone include ord i n a ry citizens as we l l number. Submissions may be as public health elites. edited for length, style and content. robert johnston associate professor of history 3 F ROM THE EDITO R Feedback mechanism Two years ago, the spring issue of Yale Medicine included a feature story on an initiative by Dean David A. Kessler, m.d., to review the curriculum and examine the larger questions surrounding medical education at the start of the 21st century. The magazine also featured an interview with the school’s new education dean, Herbert S. Chase Jr., m.d., and a collec- ya l e me d i c i n e Alumni Bulletin of the tion of alumni essays titled “Eight Decades of the Yale System.” Several Yale University School of Medicine Spring 2002, Volume 36,No. 3 issues earlier we had invited alumni to reminisce about what the Yale Editor-in-Chief System meant to them and to their generation. The response we received Michael Kashgarian,M.D. Professor of Pathology and Biology was overwhelming, as was the obvious affection nearly every alumnus Publisher and alumna appears to have for the Yale System. Jane E. Reynolds Associate Dean This past February, a new generation of Yale scholars brought the Editor topic into focus once again with a statement and petition, mailed to Michael Fitzsousa Director of Publications alumni, seeking to prevent proposed changes to the second-year testing Associate Editor format. The nine medical students who circulated the petition felt that John Curtis requiring certain qualifying exams was incongruous with the Yale System, Contributing Editors Sharon McManus conceived in the 1920s by then-Dean Milton C. Winternitz, m.d. His Karen Peart Cathy Shufro vision was to give students freedom to pursue knowledge in a graduate- Jacqueline Weaver school-like environment by eschewing grades, class rankings and required Marc Wortman,Ph.D. exams in favor of close mentoring relationships between students and Contributors Rachel Engers faculty and the completion of a thesis based on original research. Trisha Gura The proposed second-year qualifiers have since been dropped, but Copy Editing Anne Sommer not before the issue elicited a huge response from alumni. From their Office Manager / Editorial Assistant mailing to more than 4,000 addresses, the students received well over Claire M.Bessinger m. d . Senior Administrative Assistant 400 replies, many echoing Stanford oncologist William M. Rogoway, Cheryl R. Violante ’61, who wrote: “The freedom to chart one’s own course with support Design and encouragement along the way (and few inhibiting rules) is a model Daphne Geismar Typesetting for a professional career.” Amy Storm As a course director at Columbia P&S in the mid-1990s, Chase Design Consultant Peter Johnson lobbied for the abolishment of grades for the first- and second-year Yale RIS Graphic Design courses, and he came to New Haven excited about Ya l e’s emphasis on Production Consultant Joe Maynard intellectual independence.