“Be Worthy to Serve the Suffering” Officers and Directors at Large Editorial Board Medical Organization Director Councilor Directors Coordinator, Residency Initiatives Student Directors Editorial Standing on the shoulders of giants Richard L. Byyny, MD, editor am proud and honored to be serving as the Executive The Pharos continues as an excellent exponent of the aims and Director of Alpha Omega Alpha Honor Medical Society and purposes of our society and showcases AΩA and the values of EditorI of The Pharos. the profession of medicine. Our society, AΩA, is the national honor medical society for AΩA’s motto is: “Be worthy to serve the suffering.” Our mis- medical students, physicians in postgraduate training, medi- sion statement says: “Alpha Omega Alpha—dedicated to the cal faculty, practicing clinicians, and scientists. Alpha Omega belief that in the profession of medicine we will improve care Alpha is to medicine what Phi Beta Kappa is to letters and the for all patients by: recognizing high educational achievement; humanities and Sigma Xi is to science and engineering. Our honoring gifted teaching; encouraging the development of aims are the promotion of scholarship and research in medical leaders in academia and the community; supporting the ideals schools, the encouragement of a high standard of character of humanism; and promoting service to others.” and conduct among medical students and graduates, and the Up to one-sixth of a medical school class may be nominated recognition of significant contributions in medical science, for membership. Scholarly achievement is the primary but not practice, and related fields. AΩA membership is the best- the sole basis for nomination of a student. Leadership capa- recognized medical school award for achievement in medicine. bilities, ethical standards, fairness in dealing with colleagues, Since most members are elected in medical school and before demonstrated professionalism, potential for achievement in medical specialization, the membership is interdisciplinary and medicine, and a record of service to the school and community represents all fields of medicine. AΩA recognizes and advo- are additional important criteria. cates for excellence in scholarship and the highest ideals in the There are now AΩA chapters in medical schools and profession of medicine. there have been more than , members since the found- Our society represents more than a hundred years of hard ing of AΩA. As one example of AΩA members continuing to work, perseverance, and high ideals. My predecessors in AΩA demonstrate leadership in our profession, nearly seventy-five were an outstanding group of dedicated physicians who suc- percent of deans of medical schools are members of AΩA. cessfully led and continuously improved AΩA and our lasting Fifty-one Nobel Prize winners in Physiology or Medicine, and mission. William Root and a small group of medical students in Chemistry are members of AΩA. Thirty were elected before started AΩA in at the College of Physicians and Surgeons they received the Nobel prize. Eleven U.S. Surgeons General of Chicago. At that time, the practice of medicine relied on have been AΩA members. unproven traditions and mostly empirical practices. Medical Chapters are led by councilors and supported by the deans, education was poorly structured and medical students were AΩA faculty, and student members. Councilors manage the poorly prepared academically. Most faculty were unqualified nomination and election process of new members. In addi- to teach a scientifically oriented medical curriculum. Many tion to the nomination of students, chapters also nominate physicians, faculty, and students questioned the value of re- faculty, residents, and alumni who fulfill AΩA qualifications. search in contributing positively to the practice of medicine. Honorary members, from among distinguished physicians and Root started AΩA because of students’ lack of interest in scientists ineligible for nomination by any other means, may scholarly attainment and their lack of high professional values. be nominated by any member. The Councilors also submit Membership in the society was based on scholarly achieve- programs and candidates for AΩA awards and honors. AΩA ment and appropriate professional demeanor and values. After provides more than half a million dollars per year to sup- AΩA’s charter was granted by the state of Illinois in , the port AΩA programs and awards. These include the Robert J. group then provided leadership regionally and nationally to es- Glaser Distinguished Teacher Awards; the Edward D. Harris tablish other new AΩA chapters. Root continued to lead AΩA Professionalism awards; the Carolyn L. Kuckein Student for thirty years. Subsequent leaders, referred to as Secretary- Research Fellowships; AΩA Visiting Professorships; the AΩA Treasurer, included Dr. Winfield Scott Hall, Dr. Russell Burton- Medical Student Service Awards; the Helen H. Glaser Student Opitz, Dr. John Heffron, Dr. Walter Bierring, and Dr. James Essay Awards; the Pharos Poetry Competition awards; and the Campbell. The title was later changed to Executive Secretary AΩA Volunteer Clinical Faculty Awards. and Dr. Robert J. Glaser, one of my mentors, served for thirty- I thank the Board of Directors and members of AΩA for the four years, followed by Dr. Edward (Ted) Harris, who served opportunity to serve as the new Executive Director of Alpha for fourteen years until his death last May. Many other Omega Alpha. I am committed to providing leadership, sup- distinguished AΩA members have provided important port, service, and advocacy for AΩA and I will work diligently leadership and service to AΩA over the last years. and thoughtfully in my service to you. I will strive to maintain The Pharos, AΩA’s journal, was founded by the excellence of The Pharos and hope excellent thinkers and Dr. Bierring in and is named for one of writers will submit their work for consideration. the seven wonders of the ancient world, the To use a metaphor, I am fortunate to be standing on the Pharos lighthouse of Alexandria, whose shoulders of giants. beacon symbolizes the search for truth. To reiterate: “Be worthy to serve the suffering.” The Pharos/Spring 2011 1 DEPARTMENTS ARTICLES Editorial In anticipation of the germ theory 1 Standing on the shoulders of giants of disease Richard L. Byyny, MD, editor Middleton Goldsmith and the history of bromine Health policy David E. McMahon, MD, and Gregory W. Rutecki, MD 40 Will the new generation of physicians promote health care reform? Arnold Relman, MD Oswald Avery and the pneumococcus The physician at the Irving Kushner, MD, and David Samols, PhD 42 movies Peter E. Dans, MD The Social Network Secretariat Community-acquired pneumonia The tyrany of a term Reviews and reflections Bennett Lorber, MD, and Thomas Fekete, MD 49 Hijacked: The Road to Single Payer in the Aftermath of Stolen Health Care Reform Reviewed by Jack Coulehan, MD La Clinica: A Doctor’s Journey Defeat, poised in stone Across Borders Anatomical dissection and the indignity of Reviewed by Robert H. Moser, MD Smugglerius Stabbed in the Back: Confronting Back Pain in an Overtreated Trahern Jones Society Reviewed by Paul Levin, MD 53 Letters On the cover Former AΩA leaders Drs. Root, “Be Worthy to Serve the Suffering” Hall, Burton-Opitz, Heffron, Bierring, Campbell, Glaser, and Harris. Cover illustration by Marvin Plummer AΩA NEWS The poison in the cup Alpha Omega Alpha elects Horton A. Johnson, MD 38 honorary members National and chapter news 55 Minutes of the 2010 meeting of A modern epidemic in a historic city the board of directors of Alpha Tackling diabetes in Old Dehli Omega Alpha Syed Saad Mahmood, MD, MPH POETRY That which we carry with us Dyspnea Ibiayi Dagogo-Jack 13 Jordan Grumet, MD Cheated 25 Aysha Malik Agha 37 Akas Siddiqui Pericarditis 48 Chris Marett, MD Umbilicus 54 Jennifer Stella I Became a Doctor 56 Michael R. Milano, MD INSIDE Nomenclature BACK 40COVER Jana Lichtenfeld BACK COVERXX Medical Excellence Without Question Ralph Crawshaw, MD Hemlock plant, Conium maculatum. Sheila Terry/Photo Researchers, Inc. In anticipation of the germ theory of disease 4 The Pharos/Spring 2011 In anticipation of the germ theory of disease Middleton Goldsmith and the history of bromine David E. McMahon, MD, and Gregory W. Rutecki, MD Dr. McMahon is clinical associate professor of Medicine While the clinical description—including rapid evolution, at the Boonschoft School of Medicine at Wright State fetid odor, and the dissolution of surrounding tissues—has University in Dayton, Ohio, and practices general internal remained consistent, the condition has been known under a medicine in Grove City, Ohio, for Pickaway Health Services. broad array of titles.3 One of them, “hospital gangrene,” was Dr. Rutecki (AΩA, University of Illinois, 1973) is professor coined by Joseph Jones and contemporary military physicians of Medicine in the Division of Nephrology and Hypertension at the time of the American Civil War.4 Even today, in spite of at the University of South Alabama in Mobile. He was AΩA the likelihood of early diagnosis, and with surgical interven- councilor at the Northeastern Ohio Universities chapter from tion and antibiotic therapy, necrotizing fasciitis can still be 1993 through 1996. a lethal disease. What is surprising is that at the time of