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Biohybrid Limbs a CME Issue Volume 90 No. 1 January 2007 Biohybrid Limbs A CME Issue UNDER THE JOINT VOLUME 90 NO. 1 January 2007 EDITORIAL SPONSORSHIP OF: Medicine Health Brown Medical School Eli Y. Adashi, MD, Dean of Medicine HODE SLAND & Biological Science R I Rhode Island Department of Health PUBLICATION OF THE RHODE ISLAND MEDICAL SOCIETY David R. Gifford, MD, MPH, Director Quality Partners of Rhode Island COMMENTARIES Richard W. Besdine, MD, Chief Medical Officer 2 Dress Codes for Doctors Rhode Island Medical Society Joseph H. Friedman, MD Barry W. Wall, MD, President 3 Perils of Life In the Left Lane EDITORIAL STAFF Stanley M. Aronson, MD Joseph H. Friedman, MD Editor-in-Chief Joan M. Retsinas, PhD CONTRIBUTIONS Managing Editor Stanley M. Aronson, MD, MPH Editor Emeritus BIOHYBRID LIMBS: A CONTINUING MEDICAL EDUCATION ISSUE Guest Editor: Roy K. Aaron, MD EDITORIAL BOARD Stanley M. Aronson, MD, MPH 4 Biohybrid Limbs: New Materials and New Properties Jay S. Buechner, PhD Roy K. Aaron, MD, and Jeffrey R. Morgan, PhD John J. Cronan, MD James P. Crowley, MD 6 Regenerative Medicine for Limb Trauma Edward R. Feller, MD Roy K. Aaron, MD, Deborah McK. Ciombor, PhD, Michael Lysaght, PhD, John P. Fulton, PhD Peter A. Hollmann, MD Edith Mathiowitz, PhD, and Michael G. Ehrlich, MD Sharon L. Marable, MD, MPH Anthony E. Mega, MD 10 Biomimetic Prostheses: The Next Generation Marguerite A. Neill, MD Hugh Herr, PhD, and Samuel Au, MS Frank J. Schaberg, Jr., MD Lawrence W. Vernaglia, JD, MPH 12 Neuromotor Prosthesis Development Newell E. Warde, PhD John P. Donoghue, PhD, Leigh R. Hochberg, MD, PhD, Arto V. Nurmikko, PhD, Michael J. Black, PhD, John D. Simeral, PhD, and Gerhard Friehs, MD OFFICERS Barry W. Wall, MD 15 Identifying Clinically Meaningful Improvement in Rehabilitation of President Lower-Limb Amputees K. Nicholas Tsiongas, MD, MPH Linda Resnik, PhD, PT, OCS President-Elect Diane R. Siedlecki, MD 21 Blast Injuries in Civilian Practice Vice President Margaret A. Sun, MD Christopher T. Born, MD, FAAOS, FACS, Ryan Calfee, MD, and Joann Mead, MA Secretary 25 CME Questions Mark S. Ridlen, MD Treasurer Kathleen Fitzgerald, MD Immediate Past President COLUMNS DISTRICT & COUNTY PRESIDENTS 27 GERIATRICS FOR THE P RACTICING PHYSICIAN – Using the Comprehensive Clinical Geoffrey R. Hamilton, MD Approach to Older Patients Bristol County Medical Society Ana C. Tuya, MD, and Richard W. Besdine, MD Herbert J. Brennan, DO Kent County Medical Society 29 HEALTH BY NUMBERS – Birth Defects in Rhode Island Rafael E. Padilla, MD Samara Viner-Brown, MS, and Meredith Bergey, MSc, MPH Pawtucket Medical Association Patrick J. Sweeney, MD, MPH, PhD 32 PHYSICIAN’S LEXICON – A Nervous Assortment of Words Providence Medical Association Stanley M. Aronson, MD Nitin S. Damle, MD Washington County Medical Society 32 Vital Statistics Jacques L. Bonnet-Eymard, MD Woonsocket District Medical Society 34 January Heritage Cover: “Envisioning Future Prosthetics,” 3D 35 2006 Index digital art, by Bryan Christie, an award-winning illustrator who has worked for Newsweek, The New York Times, Esquire, Wired, and National Geographic. He began as an assistant art director at Scientific American Magazine, where he de- Medicine and Health/Rhode Island (USPS 464-820), a monthly publication, is owned and published by the Rhode Island Medical Society, 235 signed and illustrated covers and editorial con- Promenade St., Suite 500, Providence, RI 02908, Phone: (401) 331-3207. Single copies $5.00, individual subscriptions $50.00 per year, and $100 per year for institutional subscriptions. Published articles represent opinions of the authors and do not necessarily reflect the official policy of the Rhode Island tent. While there, Bryan was impressed by the Medical Society, unless clearly specified. Advertisements do not imply sponsorship or endorsement by the Rhode Island Medical Society. Periodicals postage distinctive aesthetic of the magazine from the paid at Providence, Rhode Island. ISSN 1086-5462. POSTMASTER: Send address changes to Medicine and Health/Rhode Island, 235 Promenade St., 50s and 60s. His art strives to represent ideas, Suite 500, Providence, RI 02908. Classified Information: RI Medical Journal Marketing Department, P.O. Box 91055, Johnston, RI 02919, not just objects. Illustrating the unseeable is his phone: (401) 383-4711, fax: (401) 383-4477, e-mail: [email protected]. Production/Layout Design: John Teehan, e-mail: [email protected]. specialty. Web site: bryanchristiedesign.com 1 VOLUME 90 NO. 1 JANUARY 2007 Commentaries Dress Codes for Doctors THERE ARE TWO PARTS TO THIS COLUMN. tals, that these hospitals are for trainees The first is my reflection on dress codes, who aren’t good enough for the volun- and the second is my reflection on some- tary hospitals and they reflect their poor one else’s reflection on dress codes. quality with their insensitivity by “dress- My medical school training empha- ing down.” sized a strict dress and behavior code. Nei- This isn’t a problem in Rhode Island ther students nor doctors were allowed as it is in the big cities. But a more chal- to drink beverages or eat in front of pa- lenging problem that I have noticed, al- tients. All adult patients were called Mr., beit rarely, is the female student who Miss or Mrs. (before Ms was coined). dresses in a manner I deem thoughtless. Medical students and house-officers al- In fact, the only house-officer whose had been a medical student or house-of- ways wore white coats. Men wore ties. dress I’ve ever complained about was ficer, I wasn’t sure how’d I handle it. The Coats and ties were required regardless male. I found him making rounds on a problem gave me pause. I thought I’d of the temperature. At that time the hos- weekend wearing blue jeans and a t-shirt. probably ask some older female profes- pitals were not air-conditioned so that the I talked to his chair who threw up his sional to talk to the involved student, just wards in Manhattan during the summers hands and said he’d already talked to the as the N Y Times article described. were hot and uncomfortable. And the young man and there wasn’t anything he So, imagine my surprise at Thanks- end rooms on most wards were large, with could do. After all, it didn’t make sense giving, when my medical student daugh- 12 beds. It was not pleasant. Interestingly to threaten to remove him from the pro- ter announced her letter to the NY Times I didn’t rebel. I always wear a tie when I gram for determined minor social mal- decrying the bigotry of the very article see patients (except on weekends). I feel adjustment. A second dress problem I about dress codes that I had identified uncomfortable if a medical student or heard about, was a neurology attending with so closely (both the article and the resident working with me is not wearing many years ago who refused to wear a tie dress codes). Luckily for me she declaimed a tie and a white jacket. It has been im- or white coat, and kept his shirt unbut- before I did, so I knew where to stow my printed on me that this dress is a token of toned, exposing his hairy chest. The chair opinion. I marveled both at how differ- respect, not for the profession, but for the of another department told him he was ent the two ends of the gender and age patient. It’s true that I don’t always wear forbidden from entering his wards to see spectrum looked at things, and at how my white coat. I usually do, but in my patients there, even to recruit them for smart and independent a thinker my private office, with my bald head, gray his studies, unless he dressed better. The daughter had become. (She never reads temples and gray beard, I can compen- neurologist chose to not change. He what I write so my comments are safe sate somewhat by the “gravitas” of age. doesn’t work in RI any more. here). But my students can’t. The New York Times ran a column I am therefore stuck with a dilemma. During my training I rotated recently, written by a woman physician, My training, my hard wired inner core, through city hospitals. It was there that I describing the conflict she felt when a tells me that male medical students should believe the dress code should have been male colleague asked her to talk to a fe- wear clean white jackets and ties and be enforced the most, and was actually fol- male house-officer about her mini-skirt either clean shaven or bearded but not lowed the least. It is in these bastions of and low blouse. The male physician was in-between and women should dress rela- the poor and the oppressed where the astute enough to realize that he shouldn’t tively modestly. On the other hand, my patient needs to be treated with the re- be talking to the resident himself, but the demurely dressing daughter tells the spect they desire, not the dress down atti- female colleague was herself very uncom- world, “break out the defibrillators” be- tude that suggests social identification. fortable about confronting the resident, cause women doctors can’t be told how The casual attire that is meant to indi- and, in fact, chose not to do it. I was sym- to dress, and if they want to wear mini cate unity with the oppressed, that dress pathetic to them both. I had had the same skirts and bear their midriff, they won’t codes don’t matter, that we’re all in this problem with a student.
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