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Washington University School of Medicine Digital Commons@Becker Outlook Magazine Washington University Publications 1978 Outlook Magazine, June 1978 Follow this and additional works at: http://digitalcommons.wustl.edu/outlook Part of the Medicine and Health Sciences Commons Recommended Citation Outlook Magazine, June 1978. Central Administration, Medical Public Affairs. Bernard Becker Medical Library Archives. Washington University School of Medicine, Saint Louis, Missouri. http://digitalcommons.wustl.edu/outlook/48 This Article is brought to you for free and open access by the Washington University Publications at Digital Commons@Becker. It has been accepted for inclusion in Outlook Magazine by an authorized administrator of Digital Commons@Becker. For more information, please contact [email protected]. .r Construction of the West Pavilion, which is adjacent to the East Pavilion of Barnes Hospital, will be completed in 1980. @rnltil@@lli ih Washington University School of Medicine ...... Contents ,i,iri\. ... Computers assist in Virginia Minnich : John Knowles, Alumnus enjoys research, patient Overcoming the M. D. '51 : Advocate lifestyle on kibbutz care .......... 2 odds ..... .. 8 for individual .. 16 responsibility . .. 12 :'_. ~ ',-,?-:': •.­ ~ . " _~f d~ .·. :-;) ::r- .~ri ' ;,. -J.,.. f~. .:. , ~. ( ~ ~ ! rr ' / fl-' ~ ~" .... ,'4-- ~-:.. <~~ ' . ~ Graduation 1978 The Six Million Etc .. ... ... ... 27 . 18 Dollar Physician . .......... 23 ON THE COVER: Computers have become an '- June, 1978 important part of modern Volume XV, Number" medicine. Shown on the cover is Outlook (Publication No. 915840) an example of a long-standing is published quarterly by the computer system in use at the Washington University School of Medical Center. See story on Medicine at 1705 Dielman Rd ., page one. SI. Louis, Mo. , 63132. Second­ Photo Credits class postage paid at SI. Louis, Mo. Printed by Kohler & Sons, Cover picture and pages 3, 4, 6, Inc; Direct alumni news and 7, Alan Ritter, pages 3, 14, 18­ all other communications to the 22, Herb Weitman; pages 4, 5, editor, Outlook Magazine, 23 , Katherine S. Robbins; pages WUMS, 660 S. Euclid, SI. Louis, 9,11 , 17, Sharon Stephens ~ Mo., 63110. Murphy. Computers assist in research. patient care By Glenda King Rosenthal , During the past decade, investigator in one laboratory. "The LlNC computers have become an was the first real attempt at designing a integral part of medicine, As modern science has continued to general purpose computer for use in the advance, the volume of scientific data has laboratory. Previously the investigator had both in research and patient become overwhelming. In recent years a to take his problem to a large computer care. Physicians and tool to assist the scientist in research has located some distance from his labora­ biologists both depend on been the computer. In seconds a computer tory," Thomas says. can determine answers which would take "During the past 14 years the move computers to aid them with a researcher days, making analysis which has not only been toward the small com­ difficult biomedical otherwise would remain hidden. puters, but to the microprocessors which challenges. The Biomedical The Biomedical Computer laboratory are even smaller than the mini-computer," Computer laboratory (BCl) (BCl) was established at the School of he says. Medicine in 1964 for the advancement of These microprocessors can be lo­ at the School of Medicine, biomedical science through the application cated in a laboratory or at a patient's bed­ along with the Computer of computers to problems in medicine side. "One of the advantages of this type Systems laboratory and and biology. of computer," he says, "is that you don't Today computers are being used have to wait for the machine. If the re­ components in the Depart­ effectively, not only in research but also searcher has a problem that requires fast ments of Electrical Engineer­ in the delivery of patient care. More than processing, he can accomplish it with his ing and Computer SCience, 100 mini-computer systems are in opera­ own local computer. He can have the com­ tion at the School of Medicine in 15 depart­ puter accept information and operate on comprise the University's ments and divisions. it as the experiment is in progress." Resource for Biomedical When the BCl was organized the Thomas says this type of personal Computing which recently conventional approach was to bring the computer allows the researcher to have received a $5.77 million research project to a large computer, says immediate feedback. "The machine is lewis J. Thomas, Jr. , M. D. '57, associate essentially a research tool that receives grant from the Division of professor and director of the BCL. data and can interact with the environ­ Research Resources of the The feelings of Jerome R. Cox, Jr., ment and the researcher as well. He can NIH. Through this and other Sc. D., who founded the BCl was that the interact with the machine and make it do machine should be taken to the problem, what he wants when he wants," he ex­ support, the Resource has Thomas says. "This was the whole philos­ plains. contributed to the applica­ ophy behind the design of the LlNC (lab­ tion of computers in biology oratory Instrument Computer) which was introduced in 1963." and medicine. Wat makes the small computer According to Thomas, the LlNC approach feasible is the significantly lower formed the basis for the use of mini-com­ cost of these mini-computers compared to puters in biology and medicine. The tech­ the larger systems. It's no longer neces­ nological accomplishment of meshing the sary to have the machines doing some­ dynamics of a large computer into a small thing all of the time simply to justify their one provided the foundation for the use of existence. minicomputers in biology and medicine. "We are doing things with the micro­ "Before the LlNC the conventional processors we used to do with mini­ wisdom in the field of computers was that computers," Thomas says. "The capa­ it was the big machine which had the bilities, memory size and power of the power to solve significant problems," mini-computers are now up to what we Thomas says. "It was a maverick notion used to call midi-computers which are that these little computers could be useful. fairly large machines. A microprocessor is But the idea did payoff rather well, and not much larger than a small tape re­ the manufacturers of the large machines corder. are now making small ones." "However, some problems are still According to Thomas, it is important best handled by the larger machines. for a computer to be adaptable to indi­ Sensible use dictates matching the tech­ vidual research laboratories, serving one nology to the problem." 2 Some of the early work with the small enough to suit local needs. Eventually a computer systems was done in the Barnes national program was established where­ Hospital Cardiac Care Unit (CCU). In­ by a number of systems were replicated By studying these patients and estab­ stalled in a special room were two mini­ and tested at other institutions. After much lishing which ones have rhythm abnor­ computers which processed and moni­ feedback and many improvements, this malities, researchers can identify those tored the electrocardiograms of patients system and derivatives of it are in use all who are at high risk of having sudden in the CCU. "We can now do the same over the world." death and treat them more effectively. task with a microprocessor system that "We collect information from the pa­ can be picked up and carried to whatever tients who have entered the CCU at bedside we want," Thomas says. Barnes and Jewish Hospital," Thomas "The small size and low cost of micro­ Lomas says the study of sudden says, "and enter that information on one processors mean that instead of having death done at Jewish Hospital under the ~'" kind of computer system. We also have one computer doing the entire job, we can direction of G. Charles Oliver, M. D., pro­ those patients wear tape recorders that distribute separate subtasks among mul­ fessor of medicine, is a good example of a run for 24 hours and record the patient's tiple microprocessors. They can then be research project which has many different electrocardiogram. The recorded electro­ interconnected in interesting ways to make needs and uses computers in different cardiogram is brought to us and processed more flexible systems," he says. ways. The purpose of the project is to on another kind of computer system to get The minicomputers first used in the study the natural history of sudden death. the details of the kinds of abnormal rhy­ CCU and also in the radiation treatment "The evidence is overwhelming that thms the patient is having," Thomas ex­ clinic, were originally designed at the BCl. patients who are thought to be at high risk plains. "The mini-computer used in a radiation of sudden death have cardiac rhythm ab­ treatment planning project was designed normalities," Thomas says. "They have an The processing of the electrocardio­ here as a derivative of the LlNC compu­ abnormal rhythm which abruptly interrupts grams of the patients in the CCU led to a ter," Thomas says. "The computer was cardiac function and they die quite sud­ system called ARGUS, which stands for applied clinically and developed well denly." ARrhythmia GUard System. The name is PL:a ~' w,.• ~ Above: A computer terminal located in the Surgical Intensive Care Unit used for patient • monitoring. Right: Lewis J. Thomas, Jr., M. D., ~ director of the Biomedical Computer Labo­ ratory, with J. Alan Ritter, research assistant. " 3 l I: II Left: A wire wrap construction for a project; Below: A basic computer terminal used for the neonatology data base; Bottom: H. Dieter Ambos, research assistant. • • ....• • 4 m. '" .. ~.l Joe Flacke, electronic technician, working in the machine shop of the BCL.

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