contents 2 Letters 4 Chronicle 10 Rounds 14 Findings 17 On Campus 18 Capsule 20 A dramatic turn The doctor-patient relationship takes center stage in performer Anna Deavere Smith’s interpretation of medicine at Yale. Yale Medicine Alumni Bulletin of the By Cathy Shufro Yale University School of Medicine Spring 2001 Volume 35, No. 2 28 Learning for the long run Editor-in-Chief Michael Kashgarian, M.D. Professor of Pathology and Biology For a quarter-century the Wednesday Evening Clinic Publisher has offered steady care to patients and an Jane E. Reynolds unequalled lesson in medicine to Yale students. Associate Dean By John Curtis Editor Michael Fitzsousa Director of Publications Associate Editor 34 “Adrenaline and the ordinary, John Curtis in varying proportions” Contributing Editors Sandra J. Ackerman Rachel Engers A student’s exposure to medicine in this former Soviet Sharon McManus republic reveals a different rhythm in the OR and a vastly Pem McNerny Karen Peart different take on relations between doctor and patient. Cathy Shufro Letter from Armenia by Sharon Anoush Chekijian Jacqueline Weaver Marc Wortman, Ph.D. Copy Editing Anne Sommer 42 Faculty News Office Manager / Editorial Assistant Claire M. Bessinger 46 Student News Senior Administrative Assistant Cheryl R. Violante 50 Alumni News Design Peter Johnson and Daphne Geismar 54 Archives Yale RIS Graphic Design Printing 55 In Memoriam W.E. Andrews of Connecticut Inc. Yale Medicine is distributed to alumni, faculty, students and friends of the School of Medicine, as well as leaders in Yale University alumni activities. Address correspondence to: Editor, Yale Medicine P.O. Box 7612 New Haven, CT 06519-0612 Telephone: 203-785-5824 Facsimile: 203-785-4327 Electronic mail: [email protected] Web site: http://info.med.yale.edu/ymm Copyright © 2001 Yale University School of Medicine. All rights reserved. 1 letters from the editor No compliments for Building relationships 2000-2001 alternative care in the classroom and the clinic Association of Yale Alumni To the Editor: in Medicine I date way back from the class When we chose the lineup of feature stories of . In my class were Officers for this issue of Yale Medicine, we didn’t make Gilbert F. Hogan, .. ’ members Michael Puzak and a conscious decision to focus on the doctor- President James Bunce, noted on the “I had to fight,I had to advo- patient relationship. True, performer and play- . In Memoriam pages of the Frank R. Coughlin Jr., . ’ cate for myself to get doctors wright Anna Deavere Smith had made this Vice President Yale Medicine that recently to listen to me.” Page 22 topic the focus of her one-woman show, .. arrived in my mailbox. Francis M. Lobo, ’ Rounding It Out, for which she interviewed sev- Secretary In the same issue, I read eral dozen patients, physicians and staff (See Nicholas M. Passarelli, .. ’, ’ of the growing popularity “The whole idea of longitudi- Cathy Shufro’s story,“A Dramatic Turn,” page Past President of unregulated alternative or nal care struck me as being 20). Good communication—between doctor complementary treatments an awfully important one. I Keep up the good work and patient, mentor and medical student— Executive Committee (“Use of alternative medicine wanted to have a relationship is also an idea running through John Curtis’ Susan J. Baserga, .. ’, .. ’ To the Editor: widespread among mentally with people.” Page 31 portrait of the Wednesday Evening Clinic Arthur C. Crovatto, .. ’, ’ ill,” Et cetera, Fall | Yale Medicine has certainly (“Learning for the Long Run,” page 28). But the Mary V. Digangi, .. ’ gone upscale. It is quite a Winter ). I would prefer issue’s theme was completed when fourth- Robert J. Kerin, .. ’, ’ magazine—and also I suspect to call them unscientific “In outlying country hospitals, year medical student Sharon Chekijian filed Dwight F. Miller, .. ’, ’ a great marketing tool. Keep or unproven. the [surgeon’s] pay might be her letter from Armenia (“Adrenaline and Donald E. Moore, .. ’, ... ’ up the good work. My particular interest in a home-cooked meal followed the Ordinary, in Varying Proportions,” page 34), Romeo A. Vidone, .. ’, ’ retirement has been the expo- by toasts of vodka brought describing the state of health care in her Dwight F. Miller, M.D. ’, Christine A. Walsh, .. ’ sure of the alternative care to the hospital by the family HS ’ family’s ancestral homeland. Her observations, known as chiropractic. There to celebrate a successful gathered over the course of a decade and a Ex officio Waterbury, Conn. , are some practicing operation.” Page 38 half-dozen visits to Yerevan, reveal a different David A. Kessler, .. chiropractors, legally called rhythm for medicine in this ex-Soviet state, Dean , Visit Yale Medicine doctors, with new grad- where doctor and patient may toast the Sharon R. McManus on the Web uates every year, compared to success of the operation together and where Director, Alumni Affairs , medical graduates. In The content of Yale Medicine the surgeon’s fee may be paid in livestock Donald L. Kent, .. ’, ’ a survey of medical college is available on the Web in or potatoes. Chair, YSM Alumni Fund deans, termed the subluxa- john curtis html and pdf formats. Visit us Is the doctor-patient relationship alive Samuel D. Kushlan, .. ’ tion and adjustment theory at info.med.yale.edu/ymm and well where you practice medicine? What YSM Bequest and Endowment Officer to be false. I witnessed a stu- Snow falling on Cedar Street to view the current issue as do medical students and young physicians dent perform an adjustment A wet snow clings to the branches Representatives to the well as a searchable archive learn from the profession about listening and Association of Yale Alumni of the neck and back at one of a cedar tree outside Sterling Hall of dating to 1998. Alumni notes Medicine in late February. communicating well? Drop us a line at Daniel L. Arons, .. ’ chiropractic college, and was will appear on the Web [email protected] or the address below and Joseph F.J. Curi, .. ’ appalled. I have written a starting with this issue. Addi- tell us what you think. book to challenge this treat- Deborah Dyett Desir, . ’ , ’ tional online content includes . ment titled Chiropractic: The Michael Fitzsousa M. Felix Freshwater, . ’ , ’ video excerpts from Anna . Greatest Hoax of the Century? Editor Jocelyn S. Malkin, . ’ , ’ Deavere Smith’s performance . .. Yet the practice flourishes. [email protected] Valerie E. Stone, . ’ , . of Rounding It Out in Harkness Things were not so, way back Auditorium (See page 20). AYAM Representative, in my student days of ’. Medical School Council Perhaps the time is appro- Francis M. Lobo, .. ’ priate for Yale and other col- How to reach us leges of science to speak out on this subject. Yale Medicine welcomes news and commentary. Please send letters to the editor and news items to Yale Medicine, P.O. Box 7612, New Haven, Ludmil A. Chotkowski, M.D. ’ CT 06519-0612, or via electronic mail to [email protected], and include Kensington, Conn. a daytime telephone number. Submissions may be edited for length, style and content. 2 yale medicine spring 2001 3 chronicle et cetera GGG The cry for less-expensive AIDS drugs No time to lose first african-american grad- was heard in the streets of Pretoria, uate honored The first African- right,and in New Haven after Doctors A high-profile panel criticizes national efforts to fight AIDS/HIV. American to graduate from the Without Borders asked that d4T be made available in South Africa at low Last year, a committee of in place before the presi- School of Medicine has been hon- prices. Yale and Bristol-Myers Squibb, scientists and academics began dential election, Merson said. ored with a new scholarship, the drug’s licensee,reached an which once fully endowed will agreement for price and patent relief evaluating the nation’s efforts One of the national effort’s help recruit and support outstand- in late March. to prevent the spread of main failures, the report said, is ing students from underrepre- and . What it found was in the allocation of preven- sented groups entering public unsettling: a lack of coordina- tion resources. Money for pre- health. After his graduation in After an uproar,price of tion among federal agencies, vention follows reports of 1857,Cortlandt Van Rensselaer funding of interventions that cases, but because incu- Creed,M.D.,became a prominent showed no evidence of success, bates for years, this approach New Haven physician and a Civil AIDS drug falls in Africa press schwetz/associated christian reliance on political rather than yields old data. “It rewards peo- War surgeon. He was consulted in scientific criteria for funding ple for counting cases of the shooting of President Garfield A drug discovered in a Yale have and the . million was unwilling to distribute the patent relief in Africa. In and, perhaps most startling, instead of preventing in 1881,and his forensic work in laboratory made headlines this who are infected with . generic drug because of con- recent years the drug, known no clear goal for prevention. infections,” Kaplan said. the investigation of a New Haven woman’s murder played a part in spring in the ongoing debate said in mid-March, cerns over infringement of generically as stavudine and “Despite the fact that we The report proposed a six- michael marsland Virginia A. McConnell’s novel about the provision of after discussions with the Uni- patent rights in South Africa. marketed as Zerit, has brought know so much about how to pronged prevention strategy. about Victorian New Haven, medications in the Third versity, that it would make its The humanitarian group Yale about $ million a year prevent ,” said Michael H. Allocation of resources should Arsenic under the Elms.