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Full text of "Harvard medical alumni bulletin"

AUTUMN 2009 




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Science, Seance, 
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ALUMNI BULLETIN 




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For decades the owners of this daguerreotype 
hod assumed that it showed a whaler posing with 
his harpoon. Earlier this year, though, the owners 

contacted the Warren Anatomical Museum to 

help prove its true subject: Phineas Gage holding 

the tamping iron that had so famously rocketed 

through his skull in 1848. This photograph is one 

of the few extant images of the medical celebrity. 




AUTUMN 2009 • VOLUME 82, NUMBER 3 



v^lA^LLjUJ- Vj I 1 JL C^ 



DEPARTMENTS 



Letters 3 

Pulse 5 

HMS graduates head to Washington while 
faculty members receive top honors 

I Editorial 10 

I How worried should we be about health 

g care reform efforts? hy Timothy G. Ferris 

o 

I President's Report 12 

< by Steven E. Weinberger 

I Bookshelf 13 

o 

i Thinking Zebra 14 

§ Organ failures leave a young man perplexed 

1 and in pain, by Ann Marie Menting 

I Benchmarks 16 

5 Ancient proteins, a role for leptin in 

S diabetes, human heart stem cells, and 

5 clinical and molecular discoveries 

z 

§ Class Notes 52 

o 

^ In Memoriam 57 

§ Daniel C. Tosteson 

I Obituaries 58 

I Endnotes ...64 

g Athletes and the journalists who cover 

2 their stories make valuable assists to 
- doctors, by Sachin H.Jain 













SPECIAL REPORT: SKELETONS IN THE CLOSET 



20 



22 



28 



Skeleton in the Closet The schools first dean demonstrated both 
a dying and undying devotion to the education of medical students. 

IVlldniQrlt rlUnder To acquire the human cadavers needed for their 
dissections, early doctors hoped for the executed but depended on 
the resurrected. 



ANN MARIE MENTING 




I he Illusionist Harvard, Houdini, and high society tangled with a 
surgeon's wife, who nearly fooled them all. fc^jEssicA cerretani 

o4 MeOd Loses Phlneas Gage wasn't the only nineteenth- century 
worker with a blast to the brain — and a connection to Harvard 
Medical School. Jj^william ira bennett 

36 jCtlOOl tor jCOndOl corpses plucked from graves, murder conducted 
by mail, chivalry gone awry — ^what 227'year'old institution doesn't have 
a few skeletons clattering in its closets? Test your wits on these shocking 
stories from Harvard Medical School's history, hy paula byron 



FEATURES 



■'^ 



The Flirtatious Feline and Other Medical Mysteries what caused 

a boy's eye to dilate suddenly? A kindergartner to start bumping into 
furniture? And a banker's lung cancer to disappear? An emergency 
physician turns to the case files to depict doctors as detectives. 

b}' JONATHAN A. EDLOW 

46 Catalyst tor Change a game-changing Harvard program sparks 

collaborations among disparate researchers. Ij^jessica cerretani 




Co\er ^h.oto'Shxitratxon of]ohn Collins Warren: Marc Yankus 



Harv^^rrl Medirni 



A L U M N 



U L L E T I N 




In This Issue 

UKDER, MAYHEM, AND MORTUARY — EACH HGURED LARGE IN THE NINETEENTH- 

century edition of Harvard Medical School. The murder of physician 
George Parkman on School premises in 1849 filled the newspapers of 
the time, as did the mayhem of medical students collecting anatomical speci- 
mens from freshly dug graves. Yet a more positive focus on mortuary balanced 
these morbid facts: the tradition of the dead teaching the living through the 
Warren Anatomical Museum. 

Most of medicine — and much of this institution — has been transformed since 
those early days. Today's students, for example, can learn anatomy without 
having to pilfer corpses from cemeteries. And today's patients need not endure 
the bloodletting practices and questionable tonics of their physicians; instead 
they can benefit from a dizzying array of medical advances, many the legacy of 
knowledge gained by generations of avid anatomists. 

Some HMS traditions do endure, certainly; one of those has been the Harvard 
Medical Alumni Bulletin, with its rich, 82-year history. That history is taking on a 
new chapter, and this issue marks the beginning of several transitions for the 
magazine. As Steven Weinberger '73 mentions in his President's Report, the 
next issue will bear noticeable alterations, including a redesign, color through- 
out, and even a new title. Harvard Medicine. Those changes are exciting. One 
change we regret to report, though, is the stepping down in June of William 
Bennett '68 after five three-year terms as editor-in-chief. 

When Daniel Federman '53, then director of alunmi relations, asked him to 
take on the role fifteen years ago. Bill, like other HMS graduates who cannot bear 
to deny a request from Dan, accepted. BiU was perfect for the role. He had inter- 
rupted his residency to launch a medical writing and editing career. In addition 
to coauthoring a book on the physiological factors controlling weight, he wrote 
numerous articles on health, taught science writing, and served as editor for sci- 
ence and medicine at Harvard University Press and as editor of the Harvard Health 
Letter. By the time he returned to clinical medicine — undertaking a residency in 
psychiatry in the 1990s — he possessed a wealth of hfe experiences to inform his 
work as a doctor. He remains a sought-after psychiatrist. 

Bill has an extraordinary gift for leavening science with Uterature to bring 
fresh meaning to medicine. His introductory columns and his occasional arti- 
cles in this magazine — including one in this issue — provide evidence of his 
lyrically deft touch. And his intelligent stewardship of the Bulletin helped make 
it a magazine that truly celebrates the School and its graduates; as our ambas- 
sador, he served with distinction. We are indeed in his debt. 



/>Lc<n,cl- C - f:^riuJ>0uuJ^ 



ACTING EDITOR-IN-CHIEF 

George E. Thibault '69 

EDITOR 

Paula Brewer Byron 

ASSOCIATE EDITOR 

Ann Marie Mencing 

ASSISTANT EDITOR 

Jessica Cerretani 

EDITORIAL INTERNS 

Sarah Daniels 

Elizabech Purest 

Ariana Hakim 

BOOK REVIEW EDITOR 



Elissa Ely '88 



EDITORIAL BOARD 

Judy Ann Bigby '78 

Rafael Campo '92 

Elissa Ely '88 

Daniel D. Federman '53 

Timothy G. Ferris '92 

Ahce Flaherty '94 

Atul Gawande '94 

Robert M. Goldwyn '56 

Sachin H. Jain '06 

Perri Klass '86 

Victoria McEvoy '75 

James J. O'Connell '82 

Nancy E. Oriol '79 

Anthony S. Patton '58 

Mitchell T. Rabkin '55 

Jason Sanders '08 

Eleanor Shore '55 



DESIGN DIRECTOR 

Laura McFadden 



ASSOCIATION OFFICERS 

Steven E. Weinberger '73, president 

Gilbert S. Omerm '65, president-elect 1 

Phyllis I. Gardner '76, president-elect 2 

Kenneth Offit '81, vice president 

Neil R. Powe '80, secretary 
Deborah C. German '76, treasurer 



COUNCILLORS 

H. Thomas Aretz '76 

Judy Ann Bigby '78 

Rosa M. Crum '85 

Laurie Ghmcher '76 

Elizabeth Petri Henske '85 

Katherine Janeway '00 

Jim Yong Kim '86 
Triste N. Lieteau '98 
EQeen Reynolds '90 
Michael Rosenblatt '73 
David H. Sachs '68 
Rahul Sakhuja '03 

CHAIR OF ALUMNI RELATIONS 

A. W. Karchmer '64 



^H^r 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



REPRESENTATIVE TO THE 
HARVARD ALUMNI ASSOCIATION 

Joseph K. Hurd, Jr. '64 

The Harvard Medical Alumni Bulletin is 

published three times a year 

at 25 Shattuck Street, Boston, MA 02115 

c Harvard Medical Alumni Association 

Phone: 617-432-7878 • Fax: 617-432-0089 

Email: bulletin@hms.harvard.edu 

Third class postage paid at Boston, 

Massachusetts. Postmaster, send form 3579 

to 25 Shattuck Street, Boston, MA 02115 

ISSN 0191-7757 • Printed in the U.S.A. 



SECOND OPINIONS FROM OUR READERS | 



T.ETTEKS^ 



films, these HaiA'ard doccors al\va)'s have an audience. H ^|^| H^l H ^H H^P^K ^^^ 




A short man standing a few feet away fixed me in his gaze. 
I nodded. He nodded. Then he stepped up to me and barked, 
"You a producer?" When I rephed that I wasn't, he abrupt- 
ly turned and raced away, in search of the real thing. 



Walk of Fame 

Your Hollywood issue recalls my own 
experience with "the industry." No, I'm 
not an actor, nor am I a consultant to the 
dream factory. From 1976 to 1991 1 was 
chief of radiology at Hollywood Presby- 
terian Medical Center, one of the first 
hospitals in Los Angeles and for a time 
the hospital to the stars. Many old-time 
actors and movie people maintained a 
connection to the center. I'll resist the 
temptation to drop names, but very nice 
people, all of them. 

One of my patients, an actor who had 
played a key role in ThcManchurian Candi- 
date, gave my wife, Morelle, and me a 
membership into The Academy of Sci- 
ence Fiction, Fantasy & Horror Films — 
a lovely gesture. And so we attended the 
Saturn Awards, held at the Screen 
Actors Guild, then on Sunset Boulevard. 
It was a grand, star-studded event — 
heady company for a mere physician. 

At one point I was standing in the 
lobby among faces familiar from 
movies and television. A short man 



NORMAN D. LEVINE '56 



Standing a few feet away fixed me in 
his gaze. I nodded. He nodded. Then he 
Stepped up to me and barked, "You a 
producer?" When I rephed that I wasn't, 
he abruptly turned and raced away, in 
search of the real thing. Any illusions I 
may have had of status in that crowd 
thudded to the floor. I thought about 
calling after him, "But I'm a doctor!" to 
recover some sense of importance. But 
that would have only compounded 
the deflation. 

Then another Hollywood moment 
changed my view You may remember a 
TV series called Trapper John, MD, a spin- 
off of M*A*S*H. For several years our 
parking lot and office building served as 
the shooting location for the series one 
day a week. The crew would arrive very 
early and often shoot for hours. The activ- 
ity provided us onlookers with much 
entertainment, especially the sight of 
the many attractive young women carry- 
ing chpboards and trying to look busy. 
Most of the action, in fact, consisted of 
people running around doing tasks that 
no one seemed able to explain. 



One evening I watched a scene being 
shot that consisted of Trapper John 
emerging from our generic -looking 
office building and walking about 20 
feet to his funky, graffiti- covered van. 
The director had the poor guy repeat 
what looked to me like the identical 
walk at least a dozen times. 

The lesson I learned from Trapper 
John, MD is this: Pretending to be a 
doctor is boring. Actually being one is 
anything but. 

NORMAN D. LEVINE '56 
BRENTWOOD, CALIFORNIA 

Quality Time 

Congratulations on the Spring 2009 
issue, a classy and interesting edition of 
the Bulletin. 

I was intrigued by the comments of 
some of your readers in the Letters to 
the Editor section on the new realities 
in the practice of medicine. While I 
agree with the need for more general 
practitioners, we are not likely to see 
a significant change in the numbers 
until reimbursements from government 
agencies and insurance companies rec- 
ognize the value of these doctors' time 
as equally as they recognize the value 
of procedures. 

The new reality that comes under the 
heading of "quality of care" will affect 
all doctors, particularly surgeons. We 
have already seen a parade of health- 
care-quality agencies, quality improve- 
ment organizations, and, most recently, 
the P4P, or pay for performance, move- 
ment. While they all sound good and 
may prove beneficial, they're merely 
additional layers of reporting and con- 
straint on doctors' judgment and deci- 
sion-making. They also offer further 
mechanisms for reducing doctors' 
incomes, which are already threatened. 
Before my retirement, I always worked 
long and hard to give the best care and 
obtain the best results, but sometimes 
failure is inevitable. 

ARMAND LEFEMINE '52 
CENTERVILLE, MASSACHUSETTS 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



TETTERS 



I SECOND OPINIONS FROM OUR READERS 




THE BEAUTY OF THE BEAST 

The article "Design For Life" in your Spring 2009 issue cited the promise 
some endangered species carry in offering potential clues to curing human 
diseases. By inference many other "helpers" may one day benefit people. 
The author, Eric Chivian '68, makes the case for preventing these animals' 
extinction by appealing to our narcissism: How can humans benefit from 
these creatures? 

To accept his appeal means turning our attention to the future. Alas, 
there's the rub: "Me, now" is more than a slogan. It describes a mindset, one 
that must be changed. The language of "later" is neither widely understood 
nor widely valued. Nor, to my knowledge, is it taught. 

Which leads me to inquire about medical ethics, present and future. 
Is this subject discussed in the context of a population that's going on 
7 billion? Is there any obligation to keep humans alive to senility 
and beyond? 

How do assisted reproductive technologies that lead to multiple births 
factor in? Where does ethical thought take us when illnesses drain family 
finances and society's resources? 

Do, please, consider shining light on these issues by presenting an arti- 
cle on the status and reach of medical ethics. 

LENORE C. FRAZIER (WIDOW OF HOWARD S. FRAZIER '53) 
WINCHESTER, MASSACHUSETTS 



Affair to Remember 

The letters in recent issues from Massad 
Joseph '77 and Mark Klausner 11, two 
school chums from HMS, jogged my 
memory of the Great Grade Boycott of 
1973. Despite Mark's having little rec- 
ollection of the events, there very much 
was a grade boycott. I confess I was 
one of the former radicals who orga- 
nized it. (Don't forget that many of us 
were products of the sixties and the 
anti-war movement.) 

My recollections of the events jibe 
with Massad's memories. I also recall 
the class meeting in which Dean Robert 
Ebert informed us that we could be 
replaced. One classmate stood up and 
retorted that we were a "national 
resource" and not easily replaced. 

My proof of the boycott is the old 
three-ring binder labeled "Boycott" that 
I saved from my medical school days; 
the code number 137 is written on the 
inside cover. Those of us who took part 
in the boycott pledged to sign our tests 
using only our code numbers, and the 
keeper of the codes would divulge only 
the identities of those who had failed 
the test. All others agreed to accept a 
"pass" grade, regardless of how they 
had performed. 

Although it seemed Kke most of us 
talked about joining in, or at least that's 
what we said to each other in pubhc, 
our class was politically diverse and 
perhaps not everyone participated. That 
might explain why some people earned 
a real grade rather than pass or fail — if 
the School knew their identities. 

I dorit think the impetus for the boy- 
cott lasted long, and I think the honors/ 
pass/fail system was implemented for us 
the following year. But I have less recol- 
lection of the second-year experience, 
aside from our Second Year Show, "The 
Effects of a Six-Day Week on Ebert 
Coli." (I did keep a script and playbills 
from our Fourth Year Show — "Ship of 
Tools" — which was a sequel to the sec- 
ond-year production.) 

JAY H. HERMAN '77 
GLENSIDE, PENNSYLVANIA 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



MAKING THE ROUNDS AT HMS 



t 




Dr. Smith Goes to Washington 



ITH HEALTH CARE REFORM 

L%^nfl topping the must-do agenda 
k^^H of the nation's leader, the 
Obama administration has 
enhsted several HMS alumni to help 
transform the way this country dehvers 
medical care. Here's a roster of some of 
those graduates. 

David Blumenthal 74 

National Coordinator for Health Infor- 
mation Technology, U.S. Department of 
Health and Human Services. Blumenthal, 
who has taken a sabbatical from his 
HMS position as the Samuel O. Thier 
Professor of Medicine in the Institute for 
Health Care Policy at Massachusetts 
General Hospital, was the senior health 
advisor to the Obama for America cam- 
paign in 2008. 

Ezekiel Emanuel '85 

Special Advisor for Health Policy to the 
Director of the White House Office of 
Management and Budget. To serve in 
this new position, Emanuel has taken 
an extended leave from his role as head 
of the Department of Bioethics at the 
Clinical Center of the National Insti- 
tutes of Health. A widely respected 
researcher and scholar on bioethics, 
Emanuel has served on the National 
Bioethics Advisory Commission. He 
was a member of President Clinton's 
Health Care Task Force. 

Margaret Hamburg '83 

Commissioner of the U.S. Food and 
Drug Administration. Hamburg assumed 
her new position after nearly nine years 
of service at the Nuclear Threat Initia- 
tive, a foundation dedicated to reducing 
the threat that nuclear, chemical, and 
biological weapons pose to public safe- 
ty. Her previous positions include assis- 
tant secretary for policy and evaluation 
in the U.S. Department of Health and 
Human Services and New York City's 
health commissioner. 




Sachinjain '06 

Special Assistant to the National Coor- 
dinator for Health Information Technol- 
ogy, U.S. Department of Health and 
Human Services. A medical resident at 
Brigham and Women's Hospital, Jain is 
a member of the faculty of the Institute 
for Strategy and Competitiveness of 
Harvard Business School. As a medical 
student, Jain helped found Improve- 
HealthCare, an international organiza- 
tion that aims to educate physicians 
about health care systems. 

Joshua Sharfstein '96 

Principal Deputy Commissioner of the 
U.S. Food and Drug Administration. 
Sharfstein had most recently served as 
health commissioner for the City of Bal- 
timore in Maryland. While there, he 
won recognition for innovative pro- 



grams that sought to expand literacy 
efforts in pediatric primary care, 
increase influenza vaccination of health 
care workers, and enhance access to 
treatments for opioid addiction. 

Yvette Roubideaux '89 

Director of the Indian Health Service in 
the U.S. Department of Health and 
Human Services. Roubideaux, a former 
assistant professor of family and com- 
munity medicine at the University of 
Arizona College of Medicine, has con- 
ducted extensive research on American 
Indian health policy and health issues, 
especially diabetes. While in Arizona, 
she also co-directed the Special Dia- 
betes Program for Indians Demonstra- 
tion Projects, an effort that involved 
dozens of American Indian and Alaska 
Native communities. ■ 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



i^.r 



PTIT.SK 



I MAKING THE ROUNDS AT HMS 



Second Sight 



B 



LOYD M. AIELLO REMEMBERS A 

time in the 1960s when half 
his patients went bhnd every 
year. Mostly young adults, 
they suffered from a complication of 
diabetes in which weak, leaky blood 
vessels proliferate in the retina, leading 
to hemorrhage and vision loss. 

Today the vast majority of patients 
with this disease — diabetic retinopa- 
thy — retain their vision, thanks to a treat- 
ment Aiello, an ophthalmologist, pio- 
neered with his father-in-law, the late 
William Beetham, in 1967. AieUo received 
the Warren Alpert Foundation Prize for 
that work during a ceremony at the Joslin 
Diabetes Center in September. 

Retinopathy develops when blood 
flow slows in the retina, compromising 
vessel walls. As a result, blood leaks and 



pools in the tissue instead of reaching its 
destination. Deprived of blood flow and 
nutrients, other regions of the retina 
release factors that stimulate the growth 
of new vessels, which also are weak and 
leaky, perpetuating the problem. 

By studying thousands of retinas, 
Aiello and Beetham observed something 
curious; Patients with extensive retinal 
scarring from other diseases did not 
go blind as quickly as their peers. This 
finding provided the first major clue 
about how to stop this vicious cycle. 

"We decided to mimic the scarring 
observed in these patients to halt the 
proliferation of blood vessels in other 
persons with diabetes without signifi- 
cantly compromising the visual field," 
says Aiello, now a clinical professor of 
ophthalmology at Joshn. 




In 1967, the team took advantage of 
new laser technology to create scars in 
the retinas of young women and men 
without destroying the entire eye. Work- 
ing in a small room at Joslin that doubled 
as a broom closet, the researchers devel- 
oped a way to focus a parallel beam of 
light on each patient's retina, creating 
several hundred lesions on tiny regions 
of tissue. The patients remained awake 
for this laser surgery. 

After presenting preliminary results at 
a major diabetes conference, Aiello helped 
organize the Diabetic Retinopathy Study, a 
multicenter chnical trial for the National 
Eye Institute, in the late 1960s and 1970s, to 
rigorously test his technique, knov.Ti as 
scatter or panretinal photocoagulation. 
The success of the project spawned addi- 
tional clinical trials, which allowed Aiello 
and others to refine the method — and set a 
new standard for diabetes care. 

According to the World Health Orga- 
nization, diabetes is projected to affect 
366 miUion people by 2030. As incidence 
rises across the globe, Aiello is working 
to ensure that patients everywhere have 
access to the latest diagnostic tools and 
treatments in the future. He collaborated 
with Beetham Eye Institute colleague 
Sven-Erik Bursell to start the Joslin 
Vision Network, which brings advanced 
medical care to people with diabetes — 
including those in remote regions — 
through digital imaging. The images are 
sent to Joslin or Joslin- certified reading 
centers for analysis and, based on the 
resulting report, health care providers at 
the remote sites dispense advice and 
treatment to their patients. 

"Our only hope for handling the 
impending diabetes pandemic is telemed- 
icine — remote-site imaging and dehvery 
of treatment to patients wherever they 
happen to Uve," says AieUo. "We're devel- 
oping and automating this model." ■ 

Alyssa Kndler is a senior multimedia specialist 
at Harvard Medical School. 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



Eyes on the Prize 




STRING OF FINDINGS ABOUT 

some of nature's tiniest struc- 
tures has resulted in what 
many consider the scientific 
community's biggest honor. In October, 
Jack Szostak, HMS professor of genetics 
at Massachusetts General Hospital, won 
the 2009 Nobel Prize in Physiology or 
Medicine. Szostak, who shares the prize 
with Elizabeth Blackburn of the Univer- 
sity of California, San Francisco and 
Carol Greider of Johns Hopkins Univer- 
sity School of Medicine, was recognized 
for the discovery of how chromosomes 
are protected by telomeres and the 
enzyme telomerase. 

Some 70 years ago, scientists hypothe- 
sized that the ends of chromosomes had 
protective caps that prevented them from 
fusing together inappropriately, yet the 
theory had never been tested. By 1980 
Blackburn had discovered that these 
caps, called telomeres, were made up of 
DNA sequences in a single-cell proto- 
zoan but didn't know whether this fea- 
ture occurred in other organisms. After 
meeting at a research conference that 
year, she and Szostak teamed up to deter- 
mine whether the same sequence was 
present in yeast cells. It was. 

Further research by the investigators 
and Greider, then a graduate student, 
showed that cells must be able to replen- 
ish telomeres to function properly. 
Although they didn't know it then, such 




END ZONES: Jack Szostak, >vho >von the Nobel Prize for the discovery of ho^f/ telomeres 
and the enzyme telomerase protect chromosomes, has since turned his research 
attention to the molecular origins of life. 



findings have since played an important 
role in helping researchers understand 
the processes behind cancer and aging. 
Szostak, who is also an investigator at the 
Howard Hughes Medical Institute, has 
since turned his research focus to the mol- 
ecular origins of life. 



Szostak's award brings the number 
of Nobel prizes won by HMS faculty 
members to 13. His work, says HMS 
Dean Jeffrey Flier, "showcases the fun- 
damental importance of basic science 
and how it can open up an entire field 
of investigation." ■ 




Leading Lights 



Paul Farmer '90 (near left), the Maude and Lillian Presley Professor 
of Social Medicine at HMS, v^as recently named the new chair of the 
Department of Global Health and Social Medicine. He succeeds Jim 
Yong Kim '86, >vho became president of Dartmouth College in July. 
"As an international leader in global health and social medicine and 
an outstanding researcher, teacher, and clinician," says HMS Dean 
Jeffrey Flier, "Paul is uniquely suited to lead this department." 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 






ptit.se 



MAKING THE ROUNDS AT HMS 



Story Core 




writing. 



OME AUTHORS HAVE BEEN 

composing stories since they 
could hold a pencil, so natural 
and insistent is their gift for 
Others — the literary late 
bloomers — may take decades to uncover 
their talent. For Jerome Groopman, that 
moment came in his early 40s v/hen he 
found himself, inexphcably, on the brink 
of a midlife crisis. 

"I was desperately in love with my 
wife. And I had no interest in sports cars," 
said Groopman, the Dtna and Raphael 
Recanati Professor of Medicine at HMS 
and Beth Israel Deaconess Medical Cen- 
ter, speaking in June at the Alumni Day 
Symposium, "Doctors as Writers." 
Rejecting the usual alternatives, Groop- 



There is a special thrill in hearing the 
story behind a writer's stories. The 
nearly 200 attendees at the symposium, 
held beneath an enormous tent on the 
Quad lawn, were thoroughly engaged as 
they heard Groopman and three other 
well-known physician-authors — Perri 
Klass '86, Elissa Ely '88, and Stephen 
Bergman '73 (also known as Samuel 
Shem) — recount how they got their 
start as writers. What was striking, as 
George Thibault '69, symposium orga- 
nizer and president and CEO of the 
Josiah Macy, Jr. Foundation, noted in 
his introduction, was their variety. 

"I got my start as a writer growing 
up in a household with a mother who 
thought everyone should be a writer," said 




man decided to write. Sitting at his 
kitchen table in the dusky hours before 
dawn, he banged out three stories that, 
after much reworking, would appear in 
his first book. The Measure of Our Days. One 
of them, a tale about a wealthy cancer- 
ridden patient, would so impress the 
then editor of The New Yorker that she 
offered him a regular gig as staff writer. 
"Tina Brown said my story was hot," 
Groopman said. 



Klass, who has two siblings, both writers. 
In fact, aU three would turn their mother's 
love of stories to their advantage. "You 
could always get out of waUdng the dog," 
Klass explained, "by saying, 'Mom, I just 
had an idea I need to write down.' " 

Ely was also deeply influenced by her 
family and in particular her father, who 
died when he was 35 and she was 5. "He 
disappeared into Memorial Sloan-Ketter- 
ing and never came out," Ely said, adding 



that this loss, and her quest to understand 
it, haunted her early stories and still drives 
her writing. "After 46 years, I'm still 
writing about my father," said Ely, a psy- 
chiatrist and a regular contributor to The 
Boston Globe and National Pubhc Radio. 

It was later in life, during a Rhodes 
scholarship at Oxford that had him 
working in a laboratory studying cock- 
roaches, that Bergman decided he wanted 
to be a writer. When he told the labora- 
tory director of his decision, the man, 
with characteristic British aplomb, 
responded, "Well then, have a sherry." 

Despite the writers' diverse begin- 
nings, common themes ran through the 
tales. Several of the speakers described in 
agonizing and amusing detail their early 
disappointments. Klass, now a professor 
of journahsm and medicine at New York 
University, received multiple rejection 
notes before pubHshing her first article. 

Groopman described making the 
rounds of New York editors to sell his 
first book. One — an older woman with 
a bouffant and red nails who looked, 
according to Groopman, as if she had 
just flown in from a canasta game in 
West Palm Beach — said, "Doctor? I'm 
sure you're a very good doctor." She then 
went on to teU hun what was wrong with 
his stories, namely that their characters 
did not demonstrate the proper number 
of epiphanies. Ironically, the story that so 
impressed The 'New Yorker editor was a tale 
about an arrogant cancer patient who has 
a remission only to realize how empty 
his life is. "It really was an epiphany that 
didn't end happily," Groopman said. 

Doctors hear and hve out stories like 
that every day, which is why Klass said 
she prefers writing fiction to nonfiction. 
"When you write fiction you can choose 
the ending," she said. "The hardest thing 
about medicine is that you cannot 
always choose the ending." ■ 

Misia Landau was a science writer for Focus 

from 1994 to 2009. 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 




On the Road 




HEN UNINSURED AND UNDERINSURED PATIENTS CAN'T MAKE IT TO A 

k M vM physician's office for basic preventive counseling and screening 

k^^^l tests, a group of health care pro\dders hits the road — and brings those 
services to them. That's the premise of Family Van, a mobile health 
clinic that has been providing health care to medically disenfranchised Bostonians 
since 1992. Now a study by Nancy Oriol '79 and other HMS researchers shows that 
the Family Van doesn't just have the potential to save hves — it saves money, too. 

"People talk about the value of preventive measures all the time, but no one has 
ever really captured the important contribution of nontraditional prevention- 
based programs like the Family Van," says Oriol, who is the program's cofounder, 
the HMS dean for students, and an HMS associate professor of anesthesia at Beth 
Israel Deaconess Medical Center. "This value is underscored by the unique role 
that mobile health plays in reducing disparities in health outcomes, increasing 
access to care, and enhancing our ability to reach out to particularly vulnerable, 
at-risk communities." 

The Family Van provides screening, testing, and education for nutrition, weight 
management, diabetes, heart disease, pregnancy, sexually transmitted diseases, and 
other health concerns. To better quantify its cost- effectiveness, Oriol and her team 
used published data from the National Commission on Prevention Priorities, which 
assigns values to a broad array of preventive practices, as well as published data on 
the cost savings of preventing avoidable emergency department visits, to develop an 
algorithm that calculates a return-on-investment ratio. 

The results, published in the June 2 issue o[ BMC Medicine, were impressive: For 
2008, the Family Van had an estimated return-on-investment of $36 for every dol- 
lar spent. These numbers reveal not only the cost- effectiveness of the Family Van, 
but also provide a model for other preventive-services programs. Researchers 
hope to have the calculator used in the study available online within a year. ■ 



Web Resources 



Alumni Association. The Harvard 
Medical Alumni Association has 
revamped its website to include addi- 
tional alumni news, information about 
events, links to alumni benefits, and 
opportunities for social networking. 
Visit alumni.hms.harvard.edu; for links 
to class pages and social networking 
groups, click on "Community." 

Conflict of Interest. HMS Dean 
Jeffrey Flier has written a white paper 
exploring conflicts of interest in acade- 
mic medicine. The report is one part 
of the School's Integrity in Academic 
Medicine Web, a collection of policies, 
information, committee statements, 
and news. To access the website, visit 
hms.harvard.edu/public/coi; to read 
the report, visit hms.harvard.edu/ 
public/coi/dean. 

Match Day. In March, nearly half of 
the members of the HMS Class of 
2009 learned they would be staying in 
Massachusetts for at least part of their 
training. The largest percentage of the 
class — 24 percent — matched in internal 
medicine, followed by dermatology, 
general surgery, pediatrics, and radiol- 
ogy. To learn where recent graduates 
are undertaking their residencies, visit 
alumnibulletin.med.harvard.edu/ 
connect/matchday/2009.php. 

Obituaries. The Bulletin's reduced 
production schedule has swelled its list 
of alumni obituaries awaiting publica- 
tion. To view recent obituaries as 
well as longer versions of previously 
printed notices, visit alumnibulletin.med. 
harvard.edu/obituaries.php. ■ 



Jl>C 3. IjrUlCliriff OL3.r The Bulletin will be undergoing notable changes to its format beginning with the next issue, and 
we hope you will participate in the magazine's continued evolution by joining our new Readers' Panel. As a member, you 
will be asked to engage in periodic online surveys about the magazine, to offer feedback, and to suggest content. To learn more 
and to sign up for the panel, visit alumnibulletin.med.harvard.edu/readerspanel.php or contact the Bulletin's editor, Paula Byron, 
at 617-432-7762 or paula_byron@hms.harvard.edu. ■ 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 




KDTTORTAT. 



I PRESCRIPTIONS FOR A NEW MEDICINE 



Clean Bill of Health 



Dear Dad, 

It was great seeing you and Mom last week at her birthday 
party. The kids loved playing with you. I know the pain from 
your hernia slowed you down a bit, but I'm confident the 
operation next week will go well. 

I'm writing to foUow up on your questions about Obama's 
health care reform. Sorry I couldn't give better answers at the 
time. What good is having a doctor and a health pohcy wonk for 
a son if he can't help you understand 
health care reform? 

Looking back on that moment, I 
think I was tripped up by the diffi- 
culty of laying out what I see as the 
core issues without boring you with 
the details. And of course you've read 
so much already. What could I add? 
But I failed to appreciate at the time 
that you weren't expecting me to 
recount the facts on insurance cover- 
age or the causes of the impending 
bankruptcy of Medicare. You wanted 
to know whether you should be wor- 
ried about the coming changes if the 
reform legislation passes. 

So I thought I'd try again. And a 
good place to start might be: What 
should we be most afraid of? What's 
the worst that could happen? 

The worst that could happen is 
that we could lose the services that 
repaired Mom's pinched spinal 
nerves, stopped your bleeding ulcer, 
cured your cancer, saved your pre- 
mature grandchild, removed your 

cataracts, and slowed the progression of your sister's Parkin- 
son's disease. Actually, when you think back on how much 
our family has benefited from health care, we have much to be 
thankful for. So when Obama proposes to reform health care, 
we have plenty to be concerned about. 

Even though our family's experiences with the most impor- 
tant parts of health care — saving life and hmb — have been ter- 
rific, many people say that, overall, health care in this country 
is mediocre. Of course you've seen those report cards ranking 
U.S. health care lowest in the developed world. Having worked 
on some of those report cards myself — and having seen the care 
in other developed countries — I think those report cards exem 




statistics." I know all too well how those grades can be manip- 
ulated to produce the rankings that their creators preordained. 
This country's health care could certainly be better, but our 
family has direct benefited from truly remarkable health care. 
So, should we be worried? Perhaps vigilant would be a better 
word. I'U tell you why I beheve we can take heart. 

Health reform wiU increase the number of Americans who 
have health insurance. With two of your sons potentially bene- 
fiting, you obviously agree this is a good thing. Jeff now chooses 
to be uninsured rather than devote 
A half his income to pay for individual 

f health insurance, and Peter doesn't 

' know what he'U do if he can't find a 

new job before his COBRA runs out. 
The uninsured have no insur- 
ance because they cannot afford it. 
So regardless of whether the plan 
is a pubhc one, taxpayers must 
fund the new insurance. Spending 
more public funds means adding 
to the national debt or increasing 
taxes. You made sure I understood 
before the age of ten that neither 
option was good. And even though 
I now recognize why we don't want 
either one, I'm also convinced that 
our country must increase health 
insurance coverage in order to stay 
competitive and support social 
stability. We'll need to do the hard 
work to find ways to pay for this, 
but .in the long run, our country 
will be stronger. 

But of course the term "pubhc 
plan" has become code for an insur- 
ance plan operated by the government. Our Reagan-era dinner 
conversations introduced me to your disdain for the American 
tendency to oversimplify government as good or evil. Nothing 
I've learned since has changed my view that government agen- 
cies can be incredibly inefficient and yet, at the same time, 
they're the only organizations that can be entrusted with truly 
pubhc responsibihties. It's not about government as good or bad 
but about haxong government that works. 

So whether the new insurance plan is actually adminis- 
tered by the government isn't important to me; I can see 
advantages and disadvantages either way. On this point most 
doctors disagree with me. They're afraid that a government- 



phfy what Mark Twain referred to as "hes, damned hes, and run plan will pay too little. This may be true, but on balance 



10 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



I'd rather see my tax dollars spent on health care services 
than go into the coffers of private insurance companies. 
And pressure from patients and doctors will ensure that 
payment rates remain adequate. 

If this were aU that Obama's reform had in store for us — 
higher national debt and petty arguments over who adminis- 
ters the benefit — then, as a current Medicare recipient, you 
would have nothing to worry about when it comes to health 
care reform. But there's more. 

The other part of health care reform is cost containment. 
Health care costs are chmbing at an astounding rate, and the 
reform includes provisions that try to contain those costs. On 
this score you should be more worried about what is not in the 
legislation than what is in the legislation. The legislation has 
no sweeping changes in how Medicare is structured. Instead 
the legislation gives Medicare permission to try some cost- 



on 10 percent of the population, so improving care coordi- 
nation for the high-risk, high-cost patients must be part of 
the answer. Chances are that we will all be in that high- cost 
10 percent at some point in our hves, and more than likely it 
v^l be near the end of our lives. 

But deciding what is necessary isn't straightforward. 
And simply cutting the fees paid to physicians and hospi- 
tals doesn't help; it uses a sledgehammer to remove the 
tumor of overuse. The health care you've come to expect 
depends not only on payments to hospitals and doctors but 
also on investments in training programs, innovation at 
academic medical centers, and a biotechnology industry 
that pushes the envelope of what is possible. The proposed 
experiments would compel doctors and hospitals to work 
together to try to address the cost problem, and that's cer- 
tainly good for your care. 



Deciding what is necessary isn't straightforward. And simply 
cutting the fees paid to physicians and hospitals doesn't help; 
it uses a sledgehammer to remove the tumor of overuse. 



Mil 



containment experiments. Ln other words, the legislators have 
proceeded cautiously. No dramatic changes to your Medicare. 

Why is this experimentation worth worrying about? Well, 
in the near term, of course, it's fine. The people who wrote the 
legislation understood correctly that we don't know exactly 
how to contain costs without disrupting people's health care. 
So they moved slowly in some promising directions. 

The problem is that if costs keep rising then something 
much more dramatic will need to happen. And any dramatic 
action will certainly affect your health care. What if 
Medicare cuts its rates? Most health care costs are spent on 
the salaries of people working in the field. Rate cuts to hos- 
pitals would mean higher unemployment and fewer nurses 
on the floor when you get admitted; fewer nurses would 
mean compromised care. Rate cuts to doctors would mean 
less access to services. Given the magnitude of the cost crisis, 
such dramatic cuts may be necessary. Precipitous rate cuts 
are what you should be worried about. 

The key to cutting costs without reducing access to the 
services you need is to cut payments for unnecessary ser- 
vices. Few people realize that 70 percent of costs are spent 



From a high-level perspective, the health-reform effort has 
been a remarkable example of democracy at work; a motivat- 
ed president, an engaged electorate, and a legislature hound- 
ed by special interests. Given the complexities of the issues 
and the pohtics, the sausage they have made looks pretty 
darned good. So, to answer your question, you can relax; Your 
benefits won't change, and your health care won't change. 

I support Obama's health care plan because it gives more 
Americans health insurance but doesn't threaten what you 
and Mom have for health care. Managing the debt will be 
important, but investing in the health of the population is 
worth that effort. 

Love to you and Mom, 

Tim 

Timothy G. Ferris '92 is an HMS associate professor of medicine and 
pediatrics, medical director of the Massachusetts General Physicians 
Organization, and a senior scientist at the Institute for Health Policy at 
Massachusetts General Hospital. His brothers names have been changed. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



PRESTDENT^S REPORT 



Trading Places 



D 



N THIS ISSUE, I'D LIKE TO HIGHLIGHT SEVERAL CHANGES TO 

both the Harvard Medical Alumni Association and the 
HarvardMedical Alumni Bulletin. Such transitions provide 
us with an opportunity to celebrate past accomplish- 
ments and the people responsible for them while also intro- 
ducing new people and looking forward to new plans. 

In the Spring 2009 issue of the Bulletin, we announced that 
George Thibault '69 would be stepping down as chair of alum- 
ni relations. It is impossible to capture in a few words the scope 
of George's contributions to the School and its affiliated hospi- 
tals. Before moving to New York City to take his current posi- 
tion as president of the Josiah Macy, Jr. Foundation, George 
spent several decades serving HMS through major chnical and 
educational leadership roles at Massachusetts General Hospi- 
tal, the Brockton/West Roxbury VA Medical Center, Brigham 
and Women's Hospital, and Partners HealthCare. 



coness Hospital and eventually at Beth Israel Deaconess Med- 
ical Center. A. W. is deeply committed not just to HMS but to 
its alumni as well, having served on the HMS Alumni Council 
from 2004 to 2008 and as president of the Harvard Medical 
Alumni Association for the 2006-07 term. We are indeed 
dehghted that A. W has accepted the position of chair of alum- 
ni relations, continuing a legacy of truly outstanding individu- 
als who have served HMS in that role. 

This is also an important transition time for this award-win- 
ning publication, as the current issue will be the last to carry 
the title Harvard Medical Alumni Bulletin. Future issues vdll be 
pubhshed under the name Harvard Medicine, providing recogni- 
tion of the quahty and impact of this pubhcation that extends 
beyond the community of HMS alumni, faculty, and students. 
As the pubhcation unfolds with its new title and appearance, 
we look forward to recei\'ing feedback from our readers — both 



I We are delighted that A. W. Karchmer has accepted 

the position of chair of alumni relations, continuing 

i: a legacy of truly outstanding individuals in that role. 




At the School itself, George has left his fingerprints every- 
where — on countless committees and initiatives that he has 
led; on the Academy at Harvard Medical School, of which he 
was the founding director; and, of course, on alumni activities, 
as president of the Harvard Medical Alumni Association from 
1998 to 1999 and as director and then chair of alumni relations 
from 2005 until this October. 

On behalf of all HMS alumni, I want to thank George for his 
significant contributions and the impact he has had on the 
School, its students, and its alumni. On a personal level, I con- 
sider it a privilege to have worked with George during my tenure 
as Alumni Association president and during the many years we 
worked closely together as colleagues on the HMS faculty. 

Following a search process coordinated by a committee 
composed of several Alumni Council members and a Dean's 
Office representative, we were pleased to select an outstanding 
alumnus and career-long HMS faculty member as the new 
chair of alumni relations — ^A. W Karchmer '64. An internation- 
ally renowned speciahst in Infectious diseases and an HMS 
professor of medicine, A. W also served for many years as chief 
of the Infectious Diseases Division at the New England Dea- 



individually and through a new Readers' Panel — about how we 
can make the magazine as engaging as possible. 

Finally, I wish to recognize the enormous contributions of 
Wilham Bennett '68, who stepped down in June after 15 years 
as editor-in-chief of the Bulletin. I want to express my personal 
gratitude for all Bill has done to make the pubhcation such an 
outstanding one. His wonderful writing skills and his ablhty to 
weave together the world of medicine with the worlds of hter- 
ature, the arts, and history have allowed him to jom with the 
editor, Paula Byron, in shaping the Bulletin mto the exceptional 
pubhcation it has become. ■ 

Steven E. Weinberger 73 is senior vice president for medical education 
at the American College of Physicians in Philadelphia. He can he reached 
at sM'einhcrger@acponline.org. 

HMS alumni, faculty, students, and friends are encouraged to join 
the Bulletin's new Readers' Panel, an informal advisory group to the 
magazine. To learn more, visit alumnihulletin.med.harvard.edu/ 
readerspanel.php or contact the Bulletin's editor, Paula Byron, at 
617 '432-7762 or paula_hyron@hms.harvard.cdu. 



12 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



BOOKS BY OUR ALUMNI [ 



ROOKSHETF 



_E 





Hdi/ie^ tat 2)edd" 





ODD 



BHIVtBD HEOICIL SCHOOL ^ 

MAN OUT Testosterone 
for Life r 






Turning Blood Red 

The Fight for Life in Cookys Anemia, by 
Arthur Bank '60 (World Scientific, 2009) 

Written by a world-recognized expert 
on Cooley's anemia, a potentially fatal 
blood disease, this book provides new 
insights into the condition, which may 
lead to new therapies. A multidiscipli- 
nary guide that covers several fields, 
including hematology and pediatrics, it 
also details how Cooley's anemia serves 
as a model for understanding other 
human diseases. Bank further describes 
the emotional and medical impact of the 
disease on patients and their famihes. 

Dancing at the River's Edge 

A Patient and Her Doctor Negotiate Life with 
Chronic Illness, by Ahda Brill and Michael D. 
Lockshin '63 (Schaffner Press, 2009) 



This collaboration between a doctor and 
his longtime patient chronicles their 
experiences as they negotiate treatment 
for her chronic autoimmune disease. The 
dual memoir presents both a dialogue 
and a personal journey toward a new 
understanding of the chronically ill and 
those who treat and are touched by them, 
including family, friends, and colleagues. 

Retired, Not Dead 

Thoughts Plastic Surgical and Otherwise, by 
Robert M. Goldwyn '56 (Artnik Books, 



reflections on his career in medicine and 
life in general. With wit and wisdom, he 
offers his thoughts on topics as diverse 
as hospital politics, the Registry of 
Motor Vehicles, and shoe shopping. The 
author also holds forth on the plastic 
surgery field and his retirement from it. 

Unstucl< 

Your Guide to the Seven-Stage Journey Out 
of Depression, by James S. Gordon '66 
(Penguin, 2008) 



This practical, easy-to-use guide is 
designed to help patients overcome 
depression without the use of antide- 
pressants. The author, a psychiatrist, 
focuses on the benefits of food, nutri- 
tional supplements, meditation, exer- 
cise, Chinese medicine, and other inte- 
grative approaches, concluding each 
chapter with a carefully designed "Pre- 
scription for Self-Care." He also 
includes dramatic and inspiring exam- 
ples from his own patients. 

Odd Man Out 

A Year on the Mound with a Minor League 
Misfit, by Matt McCarthy '08 (Viking 
Adult, 2009) 



In this wide-ranging collection of brief 
essays, Goldwyn shares his engaging 



A former college baseball player, the 
author was drafted by the Anaheim 
Angels in 2002. Here, he recounts his 
grueling year as a pitcher with that 
team's minor league affiliate, the Provo 
Angels, and shares the often bizarre — 
and sometimes controversial — details of 
what goes on behind the scenes of our 



national pastime, from the dugout to the 
locker room. 



Testosterone for Life 

Recharge Your Vitality, Sex Drive, Muscle 
Mass & Overall Health, by Abraham 
Morgentaler '82 (McGraw-Hill, 2009) 

This authoritative, up-to-date guide helps 
male readers determine whether they have 
low testosterone, a common but frequent- 
ly underdiagnosed problem in middle- 
aged men. Morgentaler, a urologist and 
expert in sexual and reproductive medi- 
cine, also details the potential benefits of 
testosterone therapy for men, including 
increased vitality and virility, improved 
muscle mass, and better general health. 

Try to Remember 

Psychiatry's Clash Over Meaning, Memory, 
and Mind, by Paul R. McHugh '56 
(Dana Press, 2008) 



Written in response to the loss of public 
confidence in psychotherapy resulting 
from the trend in what the author con- 
siders false "recovered memories," this 
book examines what went wrong and 
what must be done to restore psy- 
chotherapy as an honored therapeutic 
approach. McHugh presents patients, 
families, and mental health providers 
with insight and guidance on how to 
work together. He outlines the best 
practices in psychiatry, shows readers 
how coherent therapy functions, and 
provides a clear approach to accurate 
diagnosis and effective treatment. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



Si. 



THTNKTNO ZERRA 



DIAGNOSIS OF A DIFFERENT HOOFBEAT 



Internal Conflict 




E KNEW HIS ORGANS MIGHT ONE DAY FAIL. HE JUST 

didn't expect them to begin failing during his 
mid-twenties — especially after simply carrying a 
basket of laundry to the car. Yet on a late winter 
day in 2001, this young man, whom we will call Craig Hud- 
son, was performing just such a task when he was stricken. 
"I got this sudden pain in my throat," says Hudson, "then in 
my chest. Then I found it hard to breathe." He bolted up the 
dozen stairs to his apartment and for three days tried to catch 
his breath. But it wasn't just breathlessness; curious sloshing 
sounds were audible in his chest whenever he moved. Could 
it be pneumonia? A trip to the doctor brought puzzled looks 
from the examining physician. 

"He kept asking me if I felt okay" says Hudson. "Then he 
ordered a chest x-ray." The image showed that Hudson's right 



"He talked with me frankly," says Hudson. "He told me my 
symptoms and history put me beyond the scope of his hospi- 
tal. But there was someone in Philadelphia he thought I 
should see." There, a physician at the Hospital of the Univer- 
sity of Pennsylvania considered Hudson's history and quick- 
ly referred him to Reed Pyeritz '75. 

Throughout the years and the confusion of symptoms, 
Hudson had researched each physiological calamity that had 
befallen him. He had investigated the treatments and diag- 
noses he had received, and he had studied the specialties of the 
doctors who had cared for him. Now he was scheduled to see 
Pyeritz. His research found that Pyeritz was the chief of the 
Division of Medical Genetics in the hospital's Perehnan Center 
for Advanced Medicine and that he was an expert in diagnos- 
ing and treating heritable diseases of coimective tissue. This, 



The litany of medical problems grew, as did the number of perplexed 
physicians. Rounds of hospitalizations ensued, bringing a lung biopsy, 
more tests, and more uncertainty. Finally his surgeon could do no more. 



lung was 80 percent collapsed, seemingly without any direct 
cause. Re-inflation proved difficult and recovery long. 

An unexplained shoulder dislocation and a bout with Bell's 
palsy joined the hst of mysteries. The palsy had been particular- 
ly unsettling — "I thought I was having a stroke," Hudson 
says — but a short course of steroids set him back on track. 
Then, two years later, another organ began to fail. 

"I was mowing the lawn," Hudson says, "when I felt what 
seemed hke a stomach cramp. Soon I was blinded by pain." This 
time doctors found that a spontaneous dissection of the artery 
to his left kidney had caused some tissue death. 

The litany of medical problems grew, as did the number of 
perplexed physicians. A month-long tussle with a bad cough 
that produced blood-tinged sputum led Hudson to the emer- 
gency department of his local hospital. Imaging revealed 
more lung problems, this time in the left lung; decreased air 
capacity, a fluid-filled cavity in the lower region of the lung, 
and another, smaller collapse. In addition, nodules and some 
areas of opacity were visible on images of Hudson's lungs. 
Surgery removed the nodules, and tests showed them to be 
cancer free. A few months later, though, Hudson was again 
gripped by intensive coughing with more blood-laced spu- 
tum. And new nodules. Rounds of hospitalizations ensued, 
bringing a lung biopsy, more tests, and more uncertainty. 
Finally his surgeon could do no more. 



Hudson thought, may be where I get my answer; this may be 
where I find out why my body parts keep gi^'tng out. 

Tissue of Cries 



Barbara Bernhardt, a member of Pyeritz's close-knit team, 
remembers her impressions of Hudson on his first visit to the 
clinic. "He seemed frightened," she says, "but determined. We 
began to talk." 

Bernhardt, a genetic counselor, helps guide Pyeritz's patients 
through questions of fanuly and future. And she helps them 
develop strategies for incorporating a genetic disorder into 
their Hves, including ways they can present their medical story 
to others to help normalize their daily routines. 

"He was quiet," Bernhardt recalls, "but clearly knowledge- 
able, relating all that had led to his referral to our office. Then 
he said what I beUeve had been on his mind since learning he 
was to see Dr. Pyeritz: He was concerned he may have Ehlers- 
Danlos. And he was worried it might be the nasty kind.' " 

Ehlers-Danlos syndrome is a constellation of gene-based 
disorders that ravage connective tissue, the biological scaffold- 
ing that helps give the body's skin, organs, and vessels their 
integrity and shape. For centuries before it gained its dual 
eponym, the syndrome was described only as a curious collec- 
tion of symptoms. Around 1900, though, patient cases separate- 



14 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



ly presented by physicians Edvard Ehlers and Henri-Alexandre 
Danlos to members of the Paris Society of Syphilology and Der- 
matology served to estabhsh the syndrome in the Hterature and 
to usher in efforts to fully characterize it. 

The disease was first described by physical manifestations; 
velvety, hyperelastic skin; hypermobile joints; and poor 
wound healing. But physicians soon were able to list other 
symptoms, including the development of calcified cysts under 
the skin and of "cigarette-paper scars," areas of mild trauma 
that imperfectly heal to resemble thin paper. 

The syndrome's prevalence among populations with 
European ancestry and occurrences in families helped estab- 
lish it as a heritable one that can take at least six distinctive 
forms. Each form brings hurdles to those with the syndrome, 
such as weak muscle tone, chronic joint dislocations, severe 
spinal curvatures, and, in the vascular form — the type that 
Hudson's research had him worried about — heightened risk 
of organ rupture and internal bleeding. Each form appears 
with differing frequencies. The most common one occurs in 1 
in 10,000 to 15,000 people. The vascular form, however, sur- 
faces a tenth as often. 

Diagnosing the syndrome — and pinpointing its form — 
involves genetic testing of a sample of a patient's tissue. Pyeritz 
would need to carry out such a procedure for Hudson. But first, 
he would need to talk with him and examine him. 

"When the patient was referred, I reviewed his medical 
history," Pyeritz says. "His extracellular matrix seemed to have 
a fundamental defect. Much of the evidence pointed to 
Ehlers-Danlos and, from my reading, the rare vascular form. So 
I began the exam realizing I had a bias, but I soon saw many of 
the signs I was expecting." Pyeritz performed a skin biopsy. 

The results confirmed his suspicion: Hudson had the vascu- 
lar form of Ehlers-Danlos. 

Ballooning Problem 

Pyeritz remembers well the first patient he saw with the vas- 
cular form of Ehlers-Danlos. It was in the late 1970s, while 
Pyeritz was a senior resident at the Johns Hopkins School of 
Medicine. He was working in the medical genetics clinic of 
Victor McKusick, a cardiologist whose interest in gene-based 
diseases led him to help found the field of medical genetics. 
To Pyeritz, he also was the godfather of heritable disorders of 
connective tissue. 

It was, in fact, while Pyeritz was at Hopkins that McKusick's 
group found the genetic trigger to the vascular form of the syn- 
drome. Later, mutations to the gene COL3AI, which directs 
the production of a collagen precursor, were identified as the 
fundamental cause. This genetic misdirection causes skin 




hyperelasticity but also leads to severe compromises to the 
strength of internal organs and blood vessels. 

"The boy was 12 or 13 years old," says Pyeritz of the 
patient he greeted that day at Hopkins. "I was examining 
some unusual scarring on his skin, when he said, 'Look, doc, 
what I can do.' The boy then held his breath and bore down. 
Out popped this mass above his clavicle. At first, I thought it 
was his lung." 

But tests showed it was a pseudoaneurysm. With a touch of 
amazement still in his voice these many years later, Pyeritz 
recalls, "The boy had actually ruptured his subclavian artery 
and survived." 

Life Redone 



With a firm diagnosis in hand, Pyeritz and his team are work- 
ing with Hudson to help him deal with his disease. And 
Hudson, with an answer to his years of questions, now hves with 
a diagnosis that is sobering but oddly Hberating. "Most people 
don't have to hve with their own mortality," he says. "I now try 
to live a bit more, to make every moment of hfe worth it." 

Pyeritz believes his ability to diagnosis Hudson's condi- 
tion rests in large part on a dictum that he and his colleagues 
follow. "We assume that uncommon events have a common 
linkage," he says, "and that patients don't tend to suffer an 
array of rare, unrelated conditions." ■ 

Ann Marie Mcnting is associate editor of the Harvard Medical 
Alumni Bulletin. "Thinking Zebra" refers to advice many medical 
students receive when learning the art of diagnosis: "When you hear 
hoofhcats, think horse, not zebra." 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



RENCHMARKS 



DISCOVERY AT HMS 



Relative Perspectives 




IGHTY MILLION OR SO YEARS AGO, 

during an ordinary day in the 
Cretaceous period, the genes 
of a Brachyhphosaurus produced 
some collagen proteins inside the 
dinosaur's bones. When the plant- 
munching giant died, its corpse was 
entombed in the sediment of a river that 
ran through today's Montana. Now, 
researchers have identified eight frag- 
ments of the proteins clinging to one of 
those aged bones — millions of years after 
the proteins were expressed from the 
dinosaur's DNA. 

The proteins, found on a three-foot- 
long femur of a Brachyhphosaurus canaden- 
sis, are the oldest to be extracted from a 
fossil, say the HMS and North Carolina 
State University researchers who report- 
ed the study in the May 1 issue of Science. 
The fragments show that the 30-foot- 
long Brachyhphosaurus, which means 
short-crested lizard, is more closely 
related to a chicken than to a lizard on 
the evolutionary tree. 

The findings build upon an earlier 
study, in which the team found similar 
results in a 68-milhon-year-old Tyran- 
nosaurus rex. "This helps verify that our 
first discovery was not a one-hit won- 
der," says John Asara, who coauthored 
the studies on the T. rex and B. canadensis. 
Asara is an instructor in medicine at 
HMS and director of the Mass Spec- 
trometry Core at Beth Israel Deaconess 
Medical Center. 

Location, Location, Location 

Many in the paleontology community 
consider the study's findings unsettling 
not for their reconfiguration of evolu- 
tionary relationships but because of the 
material relied upon for that reconfigura- 
tion. Current models say that soft tissue, 
DNA, proteins, and other biological 
material are replaced by minerals during 
fossilization, especially in fossils dating 
back more than a milhon years. 



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FOR THE BIRDS: Fragments of collagen proteins found on Brachylophosaurus 
bones suggest the creature is more closely related to a chicken than to a lizard. 



Although the study team cannot 
explain how the proteins they found 
on the ancient bone remained intact 
through the ages, they are relatively cer- 
tain the protein fragments did not come 
from other, nondinosaur sources; all their 
contamination controls were clean. 

An explanation for the proteins' 
presence could lie where the femur was 
found; the bone was buried 20 feet deep 
in sandstone along the side of a washed- 
out ridge at Montana's Judith River For- 
mation, one of the largest fossil sites in 
the United States. The scientists beheve 
the sandstone may have softened any 
wearing on the bone during the millions 
of years of aging. 

Feathered Friends 



Once the fossUs were extracted and 
cleaned of minerals, the North Carolina 
researchers analyzed them microscopi- 
cally and found what appeared to be ves- 
tiges of bone cells, blood cells, and blood 
vessels within a fibrous structure that 
resembled collagen, a protein that makes 
up to 90 percent of the bone in many 
mammals. Further analyses with anti- 
bodies confirmed the presence of colla- 
gen as well as other proteins within the 
fibrous structures. 

The samples were then sent to Asara, 
who usually uses mass spectrometry to 



ferret out low levels of signaling proteins 
in cancer cells. He scanned the material 
and isolated the eight collagen fragments. 
The protein sequences were only 149 
amino acids long — less than 10 percent 
that of a full-length collagen sequence — 
but were sufficient to allow the team to 
compare the fragments to collagen from 
21 hving species and to collagen found in 
the fossils of the T rex and those of a 
300,000-year-old mastodon. 

The sequences from the B. canadensis fell 
within the group of archosaurs, an 
ancient group of land vertebrates whose 
members were more genetically akin to 
today's chickens and ostriches than to 
alligators and lizards. The B. canadensis 
and T rex data pro\ide the first molecular 
proof of the well-estabhshed theory that 
birds evolved from dinosaurs, says Asara. 

Asara hopes the data alter paleonto- 
logical thought on the resilience of pro- 
teinaceous material: "This should help 
convince the skeptics," he says. He 
hopes that as sequencing techniques 
become more precise, more details on 
dinosaurs and other extinct species 
will be extracted from larger pieces of 
collagen and other proteins. Such stud- 
ies could usher in a new discipline 
that Asara and colleagues have dubbed 
fossilomics. ■ 

Nuno Dominguczwas an intern at Focus. 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



Course Change 



Receptive Audience 



m 



ORMONAL THERAPY FOR MEN 

with prostate cancer may 
increase their risk of 
death if they have coro- 
nary artery disease and have had 
congestive heart failure or a heart 
attack. This unsetthng finding is 
reported by researchers at Brigham 
and Women's Hospital and the 
Dana-Farber Cancer Institute in 
the August 26 issue of The Journal of 
the American Medical Association. 

Previous research shows that hor- 
monal therapy, when used with radi- 
ation therapy to treat localized, unfa- 
vorable-risk prostate cancer, increas- 
es survival rates in men with no or 
minimal comorbidity but not in men 
with moderate to severe comorbidity. 

"Until now, we were unsure 
which additional health risks might 
limit this well-established survival 
benefit," says lead author Akash 
Nanda, an HMS clinical fellow in 
radiation oncology at Brigham and 
Women's. So the scientists conduct- 
ed a retrospective study of more 
than 5,000 men who had received 
either hormonal and radiation thera- 
py or radiation therapy alone. They 
found the addition of hormonal 
therapy increased the mortality risk 
only in men with coronary artery 
disease-induced congestive heart 
failure or heart attack. But it did not 
appear to increase mortahty risk in 
men who had only one risk factor for 
the disease, such as diabetes, high 
blood pressure, or high cholesterol. 

"This study highlights the need," 
says senior author Anthony D'Amico, 
an HMS professor of radiation 
oncology at Brigham and Women's 
and Dana-Farber, "for a careful 
discussion of the potential risks 
and benefits of hormonal therapy 
with men whose coronary heart 
disease has caused a heart attack or 
heart failure." ■ 



CAN A SINGLE HORMONE, ACTING ON 

a tiny region of the brain, normalize 
blood glucose levels and increase 
physical activity in diabetic and 
obese patients? It can in mice, says a 
team of researchers at HMS and Beth 
Israel Deaconess Medical Center. 

Writing in the June 3 issue of Cell 
Metabolism, the team, led by Lihong 
Huo, a research fellov/ at the medical 
center, found that restoring leptin 
receptors to a particular group of neu- 
rons in the hypothalamuses of mice 
cured the animals' severe diabetes 
and doubled their activity levels. 

"This discovery suggests a new 
therapeutic pathway for drugs to 
treat insulin-resistant diabetes in 
humans with severe obesity and pos- 
sibly even to stimulate their urge to 
exercise," says senior author Christ- 
ian Bj0rbaek, an associate professor 
of medicine at HMS. 

First identified in 1 994 as an 
appetite- and weight-regulation hor- 
mone, leptin plays a role in energy 
homeostasis. Research has pinpointed 
the arcuate nucleus in the brain's hypo- 
thalamus as one key area in which 
leptin exerts an influence. Within this 
nucleus, scientists have identified two 
types of neurons that are respon- 
sive to leptin: the Agouti-related 
peptide neurons, which stimulate 
appetite, and the pro-opiome- 
lanocortin, or POMC, neurons, 
which curb appetite. 

Other studies have indicated 
that leptin's action on the arcu- 
ate nucleus helps control 
blood-sugar levels as well as 
activity levels. In designing 
their study, Bj0rbaek says, "We 
hypothesized that, in both 
cases, the POMC neurons 
were involved." 

The scientists began their 
inquiry by measuring the 
appetite and body weight of 
mice whose neurons were genet- 



ically deficient in receptors for leptin. 
These mice presented the characteris- 
tics associated with such a deficiency: 
extreme obesity, hypoactivity, and 
severe diabetes. The researchers used 
a technique that allowed them to 
genetically and selectively re-express 
leptin receptors in the POMC neurons. 
When leptin activity was restored only 
to those neurons, the mice became 
slightly less obese. More importantly, 
they became twice as physically 
active, and their blood glucose levels 
decreased to normal. So although 
replenishing leptin activity in the 
POMC neurons did not cure obesity, 
it did spur the mice to exercise more 
and it effectively halted the diabetes. 

"The fact that normal glucose levels 
were restored independent of food or 
weight changes suggests that it is pos- 
sible to normalize blood glucose even 
without weight loss," says Bj0rbaek. 
These findings may offer potential tar- 
gets for future drugs that alleviate dia- 
betes or increase the will to exercise 
in obese and diabetic patients. ■ 

]ue Wang, a former intern for Focus, 
contributed to this article. 



APPETITE FOR LIFE: 

In mice, the hormone 

leptin appears to 

promote exercise 

and v^eight loss — and 

to prevent diabetes. 



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AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



17 



RKNCHMARKS 



I DISCOVERY AT HMS 



Matters of the Heart 




HE HEARTS OF THOSE WITHIN THE 

community of cardiovascular 
scientists and clinicians may 
have skipped a beat when news 
of the discovery came their way. HMS 
researchers announced they had found the 
mother of all heart cells known as the 
master human heart stem cell, a cell that 
can differentiate to form all parts of the 
heart, including contracting and smooth 
muscles and blood vessels. And this dis- 
covery was coupled with another; Har- 
vard Stem Cell Institute researchers at 
Massachusetts General Hospital also 
found these \Ttal progenitor cells resided 



in regions of the heart known to be hot 
spots for congenital heart disease. 

The research team was led by Kenneth 
Chien, director of the institute's cardio- 
vascular disease program and the hospi- 
tal's cardiovascular research center. Its 
discoveries, pubhshed in the July 2 issue 
of feature, provide scientists with a vital 
cell standard for use in their investiga- 
tions of human heart development and 
the genetic diseases of the cardiovascu- 
lar system, particularly those known to 
cause heart disease in children. Identify- 
ing and manipulating the pathways 
along which these progenitor cells 




grow and differentiate could allow 
researchers to significantly influence 
congenital heart disease by converting 
severe forms of the disease to those with 
a better prognosis or even by preventing 
the disease in fetal and newborn hearts. 
The researchers do not, however, see 
these cells as playing a role in the regen- 
eration of the fully developed adult heart. 
For one thing, such cells are extremely 
rare in the adult heart. And the cause of 
morbidity in adults with heart disease 
differs from that for children; adults most 
often suffer from impaired function 
rather than structural abnormahties. 

A Growing Notion 

For their study the team focused on deter- 
mining how the human heart develops. At 
birth, the human heart is more than a thou- 
sand times larger than the adult mouse 
heart, yet embryonic human hearts differ 
Htde in size from those of mouse embryos. 
How, the researchers wondered, does the 
human heart achieve that level of growth? 

The team found two possible answers 
to that question. The first was straight- 
forward; Structural change drives the 
growth — that is, valves, muscles, and all 
other parts of the heart develop from 
their \'arious independent ceU lineages. 
Then the cells in those structures reph- 
cate and the heart's size increases. 

But the researchers speculated that 
the reason might rest elsewhere, in what 
Chien describes as a stem-ceU paradigm. 
In this line of thought, a single form of 
progenitor cell replicates, massively 
expands the pool of heart-cell precur- 
sors, and then differentiates into the var- 
ious cardiac structures. 

The researchers chose to investigate 
this paradigm by genetically tagging 
progenitor cells derived from a human 
embryonic stem-cell line and then 
tracking their dispersal in heart tissue. 
When they analyzed the developing tis- 
sue, they were astonished to discover that 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



large numbers of the progenitor cells per- 
sisted and were dispersed throughout the 
heart tissue. The highest concentration of 
the cells was in the aortic outflow track, a 
spot associated with congenital heart dis- 
ease. The team also observed a large num- 
ber of the distinctive intermediate cell 
types that give rise to all parts of the heart. 
These findings indicate the stem cells 
were capable of replicating and expanding 
their numbers before they diEerentiated 
in any specialized cell type in the heart. 

Since the findings show that heart 
expansion rehes on a stem-cell-mediated 
process, particularly in regions affected by 
congenital heart disease, the researchers 
consider the progenitor cells to be impli- 
cated in the underdevelopment or incor- 
rect development of heart structures. 

Core Group 

The team is currently studying three types 
of disease that affect children: Duchenne 
muscular dystrophy; specific chromoso- 
mal disorders, such as DiGeorge and 
Down syndromes; and rare, genetically 
based congenital heart diseases. For each 
disease type, Chien says, mouse models 
are not enough; "They are not likely to 
fully recapitulate the human disease." 

For Chien and his colleagues, this study 
also underscores the importance of human 
embryonic stem cells to the research 
enterprise, rather than relying on induced 
pluripotent stem cell lines that are created 
in the lab by forced gene expression. 

"Induced pluripotent stem cells are 
going to be good for research into certain 
diseases, but I'm not sure they wUl be 
good for research on heart diseases," says 
Chien. "The degree of variation in the 
induced lines is significant, so how do 
you even compare this cell to itself? But 
by targeting specific genes and manipu- 
lating them in human embryonic stem 
cells, you can create human models of 
human disease directly in a simplified 
format: human embryonic stem cells." ■ 



Research Digest 




llll^ WAYFINDER ALERT 

When determining the risk for heart attack in 
patients who have had coronary-artery bypass 
grafting, it may be wise to look beyond present 
standards, say researchers at Massachusetts 
General Hospital. Physicians often check levels of 
the biomarker cardiac troponin to determine the 
likelihood of an attack in such patients. But scien- 
tists led by James Januzzi, director of MGH's 
Cardiac Intensive Care Unit, report that consen- 
sus cut-points for troponin use in post-CABG 
patients are too low for routine application, resulting in over-diagnosis of post- 
CAGB heart attack. In their paper in the September 8 issue of Circulation, the 
researchers note that troponin remains an excellent predictor of death when 
its levels measure ten times higher than those currently acceptable. 

llli^ IN THE ZONE 

Travel that chases the sun across time zones is exciting, even invigorating — until 
jet lag hits. But an anti-lag aid may be on the way. In the June 1 9 issue of PLoS 
Computational Biology, researchers at Brigham and Women's Hospital and the 
University of Michigan report the development of software that uses various 
measures such as light levels and sleep schedules to calculate the countermea- 
sures needed to reset the body's inner clock. Team leaders Elizabeth Klerman '86, 
an HMS associate professor of medicine at Brigham and Women's Hospital, 
and Dennis Dean, a computational research associate in the hospital's Division 
of Sleep Medicine, believe their math-enhanced intervention could halve the 
numbers of days a traveler would need to adjust to a new time zone. 

111^ PROVISIONAL RESOURCES 

Nascent cancer cells seem to need community to thrive. If isolated during the 
early stages of tumor formation, such cells kill themselves, an action called 
apoptosis. Scientists had thought apoptosis was the sole way these homeless 
cells perished. But researchers working with Joan Brugge, the Louise Foote 
Pfeiffer Professor of Cell Biology at HMS, discovered another cause: starva- 
tion. In the September 3 issue of Nature, the scientists report discovering that 
cells that had been genetically altered to become precancerous lost their abil- 
ity to transport glucose, their primary energy source. When treated with 
antioxidants, however, the cells survived, opting to use fatty acids for their 
energy needs. By better defining the metabolism of precancerous cells, the 
research provides a fresh approach to new tumor-killing drugs. 

llll^ TRAIL MARKER 

Diagnosing acute appendicitis in children can be a bit like finding a particular 
tree in a forest: its symptoms resemble those of other conditions, and few diag- 
nostic markers are specific to the disease. A study by researchers at Children's 
Hospital Boston, reported in the June 25 online issue of the Annals of Emer- 
gency Medicine, has identified one such biomarker: leucine-rich alpha-2-gly- 
coprotein. The team was led by Richard Bachur, chief of emergency medi- 
cine at the hospital. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 




The cadaver lying before them came with its own 

set of instructions. "Let the body be injected with arsenic after 
death, soon," John Collins Warren, the first dean of Harvard 
Medical School, had written. The body, Warren continued, 
should be examined or dissected as appropriate, with the 
"morbid parts" carefully preserved and particular attention 
paid "to the heart, spleen, and prostate gland." 



Over the course of his long surgical 
career, Warren took the same detailed 
care in assembling an extraordinary col- 
lection of anatomical and pathological 
specimens, which he presented to Har- 
vard in 1847, along with a gift of $5,000 



to create the Warren Anatomical Muse- 
um. But no donation was more remark- 
able than the one he bequeathed nine 
years later; his own body as specimen. 

His bones, Warren had written in 
the same set of instructions, should be 



"carefully preserved, whitened, articu- 
lated, and placed in the lecture-room of 
the Medical College, near my bust; 
affording, as I hope, a lesson useful, at the 
same time, to morahty and science." 

Four days after Warren's death, J. B. S. 
Jackson — the School's first professor of 
pathological anatomy, the Warren Muse- 
um's first curator, and a member of the 
Class of 1829 — followed those instructions 
for preparing Warren's corporeal bequest. 
When the family later restricted the view- 
ing of Warren's remains to his descen- 
dants, his bones were placed in storage. 

And so John Collins Warren became 
a literal skeleton in a Harvard Medical 
School closet, thwarted in his intention of 
embodying the anatomists' motto of mor- 
tui vivos docait: the dead teach the hving. ■ 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 




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SNOOZE CONTROL: His 

devotion to anatomical 

study afforded John Collins 

Warren speed and surety 

in the surgical theater. 

Such expertise was critical 

for patients of the time, 

who had to remain dwake 

during their operations. So 

,4, when the chance arose to 

V limit surgical pain, Warren 

ieized it and, at Massachu-' 

f^ setts General Hospital in 

I 1846, performed the first 

* surgery to successfully 

|: incorporate anesthesia. 

5 Afterward, he famously 

concluded, "Gentlemen, 

fkic ic nn|iumbug!" 



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To acquire the human 

cadavers needed for 

their dissections, early 

doctors hoped for the 

executed but depended 
on the resurrectec. 

BY ANN MARIE MENTING 





The group operated clandestinely. Even its name remained unwritten. 
Correspondence from one member to another would merely contain discreet 

references to the Sp rs Club. Nothing else needed to be stated. But the 

group of young men undoubtedly had a home, a safe haven for the imple- 
ments so necessary to its gatherings. Perhaps it was simply a room that 
boasted a table, long but Kkely lean, as its furnishing. Around this fixture, the 
club members would gather, intent as one of their number separated skin 
from fascia, muscle from bone, and organ from cavity Small animals, even the 
occasional larger creature, were sacrificed, opened, and studied by the group. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 23 



students of medicine often took it upon 

themselves to procure a candidate for dissection 
either by hijacking a body between deathbed and grave 
or by extracting one from its earthy resting place. 



Had the club members restricted 
their explorations to four-legged 
species these activities would not, in 
themselves, have necessitated such dis- 
cretion. But it was their other endeav- 
or — the anatomical study of the human 
body — that demanded their secrecy. 
During this nation's formative years, the 
practice of human dissection struck 
equal measures of fear, loathing, and 
curiosity in the hearts of nearly every 
man and woman. And these attitudes 
were compounded by the knowledge 
that the fathers, daughters, grandmoth- 
ers, and uncles whose bodies graced 
those cutting boards were most likely 
resurrected during midnight raids on 
local graveyards. This fact made the 
actions of these young men — these 
young Harvard medical men — daring, 
dangerous, and possibly, even demonic. 



Like Father, Like Son 

The group of young anatomists, known 
without ehsion as the Spunkers Club, is 
one such story. Founded in the late 1760s 
by a group of Harvard students, the club 
featured several future luminaries, 
including John Warren, who would be a 
founder of today's Harvard Medical 
School, and William Eustis, a future gov- 
ernor of Massachusetts, U.S. Congres- 
sional representative, and secretary of 
war for President James Madison. They 
and their comrades studied general med- 
icine, surgery, and anatomy in the home 
of John's brother, Joseph, a noted physi- 
cian, teacher, and Revolutionary War 
hero. It is speculated that Joseph, abetted 
by John, was the club's instigator. 

The club was a response to the times; 
In the late eighteenth and early nineteenth 




SNATCHIN' STIFFS: Eighteenth-century caricaturists ^vere not coy about mocking the 
doctors who participated in grave robbing, as in this etching of a fleeing William Hunter, 
the physician >vho introduced the use of cadavers to medical education in Great Britain. 



centuries, a knowledge of human anato- 
my and skills in the surgical dissection 
of the human body were increasiagly 
considered critical to the education of 
young men who wished to practice 
medicine. Coupled with this demand 
was the burgeoning number of medical 
colleges in the colonies. 

Yet crucial components to such 
an education — human cadavers — were 
nearly nonexistent. Reasonable legal 
mechanisms for procuring a steady sup- 
ply of bodies wouldn't appear until the 
late 1800s. So any physician, teacher, or 
student who sought to learn the internal 
byways of the human body was forced to 
be inventive. The more daring of stu- 
dents often took it upon themselves to 
procure a candidate for dissection either 
by hijacking a body between deathbed 
and grave or by extracting one from its 
earthy resting place. This exercise was not 
unknown to young John Collins Warren, 
a future founder of Massachusetts Gener- 
al Hospital. He reported that in 1796, 
while a student at Harvard College, he 
"began the business of getting subjects" 
for anatomical study. And quite the busi- 
ness it was, to read one of his accounts. 

"We reached the spot at ten o'clock at 
night . . . [and] proceeded rapidly, uncov- 
ering the .coffin by breaking it open. We 
took out the body of a stout young man, 
put it in a bag, and carried it to the bury- 
ing-group wall." The theft was not to be 
that simple, though, for at the wall, the 
troop found a man walking along, smok- 
ing. The lads were forced to improvise. 

"One of the company . . . affected to 
be intoxicated, while he contrived to get 
into a quarrel with the stranger," War- 
ren recalled. "After he succeeded in 
doing this, another of the party, 
approaching, pretended to side with the 
stranger, and ordered the other to go 
about his business. Taking the stranger 
by the arm, he led him off in a different 
direction " The body was whisked off 



24 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



ope 



Ttl^S 




The opposition that colonial America held for the practice 
of dissection made it fertile ground for the body trade and 
the skills of the grave robber. Yet even in nations where 
dissection was accepted, the notion of cutting into a 
human body has rarely been taken lightly. For ages, in 
fact, it carried the possibility of divine disapproval. 

Early Egyptians believed the gods were displeased if a corpse 
was cut, even if the cutting was in preparation for embalming, burial, 
and the next life. To sidestep godly wrath, the ancient undertakers 
would press an elderly man into service. Armed with a sharp stone, 
the scapegoat would quickly slash into the abdomen of the corpse, 
then flee. The undertakers would further emphasize their noncompli- 
ance — and ensure the gods had the right man should they wish to 
exact revenge — by pelting the scurrying fellow with rocks. Greeks, 
too, avoided opening their venerated dead, but felt no compunction 
over peering into the bodies of those they conquered. 

Comparative anatomy provided many learned populations with the 
opportunity to gain knowledge of the mechanisms that sustained life 
and movement. The Romans were active as comparative anatomists; 
Galen, the second-century Roman physician and philosopher, appar- 
ently used apes as dissection models. Medieval Arabs, abiding by 
a doctrine that held human dissection as unclean, also investigated 
anatomy through the dissection of pigs and other animals. 

Although early Christians may have inherited the Romans' repul- 
sion toward dissection, indications are that attitudes changed; the 




death in 1410 of Pope Alexander V was followed by an autopsy. 
And despite a papal bull denouncing a gruesome practice of the Cru- 
saders — who dismembered, boiled, and macerated the flesh of fallen 
comrades so as to more efficiently package their remains for ship- 
ment home — there are few prohibitions on autopsy and dissection in 
Catholic or Protestant writings. In fact, in regions in which the 
Catholic Church traditionally held sway, dissection was legalized dur- 
ing the Middle Ages: From the end of the thirteenth century through 
the middle of the fourteenth, the countries now known as Spain, 
Germany, and Italy each had laws that legalized the science. 

This wave of legalization helped lift much of the stigma associated 
with the dissection of humans while also boosting the sources for bod- 
ies and body parts that could be used by those seeking to advance 
medical knowledge. Ultimately, this international change of opinion 
altered U.S. laws governing anatomy, leading to an expansion of 
academic instruction and research in the discipline and a shuttering 
of the activities of those who specialized in resurrecting the dead. ■ 



to Cambridge while the young Warren 
stayed behind, working until dawn to 
refill the grave and gather the tools. At 
the day's first class, he faced his teacher, 
John Warren, the School's first profes- 
sor of anatomy and surgery, former 
Spunker — and his father. 

"When my father came in the morn- 
ing to lecture," the younger Warren 
wrote, "and found that I had been 
engaged in this scrape, he was very 
much alarmed; but when the body was 
uncovered, and he saw what a fine, 
healthy subject it was, he seemed to be 



as much pleased as I ever saw him." The 
acorn, it seems, had not fallen far from 
the oak. 

The Company One Keeps 

While it was often the responsibility of 
the students to provide the specimens 
they would dissect in class, it was more 
usual for the professor to shoulder the 
duty of ensuring an adequate supply of 
cadavers. For centuries in England and its 
North American colonies, the sole sanc- 
tioned source of bodies was criminals. 



especially those whose crimes were so 
heinous that the judge added further 
insult to the death sentence by ordering 
the body "anatomized." 

In 1784, Massachusetts added 
duelists convicted of killing an oppo- 
nent to the list of candidates for the 
dissection table, and by 1824 the Com- 
monwealth had augmented that supply 
with the bodies of convicts who died 
while in prison. 

The numbers remained woefuUy inad- 
equate, however. Estimations of supply 
and demand in Vermont, for instance. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 25 



THE THRILL OF THE GRILL: 

To foil body snatchers, families 

sometimes erected iron grills around 

the grove of a loved one, as shown 

at right. And while resurrectionists 

avoided being seen with the bodies 

they snatched, later generations of 

medical students were proud of their 

anatomy work and often took group 

photos v/ith their cadavers, such as 

the one Harvard medical students 

had taken in 1905 at far right. 



indicated that betvs^een 1820 and 1840, 
nearly 1,600 students attended medical 
schools in that state, and each student 
was expected to perform a dissection 
alone, with a preceptor, or as a member of 
a small group. Conser\'ative talhes placed 
the number of bodies needed to serve 
Vermont's medical students at about 
400. Yet records indicate a mere 40 
corpses would have been available legally. 
If one extrapolated Vermont's situa- 
tion to the nation at that time, supply 
estimates grew to about 5,000 bodies, 
again far exceeding the number legally 
obtainable. Preceptors and physicians 
were forced to think along lines that usu- 
ally placed them in league with grisly ven- 
dors known variously as resurrectionists, 
sack 'em up men, exhumators, body 
snatchers, or grave robbers. 

Stock in Trade 

Although this form of commerce was not 
an above-board sort of business, there is a 
rich record of diaries, epistles, and news- 
paper accounts of grave robbers' exploits. 
These documents reveal the risky and 
lucrative nature of the business. An 1820 
bill to the London surgeon and anatomist 
Sir Astley Cooper, who kept more than a 
few resurrectionists busy, parsed one 
dehvery into such costs as transport and 
the hiring of carriage and coachmen for a 
total of 13 pounds, 12 shillings. In 2008, in 
the United States, that sum would have 
translated to roughly $1,300. Such pricing 
was not exclusive to England's com- 
merce; one early-nineteenth-century 
Ohio-based exhumator charged medical 
schools $30 per corpse, or approximately 
$409 in 2008 dollars. His business was 
said to have been brisk. 

The trade was also seasonal. Medical 
colleges held sessions from early Septem- 
ber through May. This calendar had olfac- 
tory benefits as it avoided the steamy 
months of June, July, and August when 




bodies, in this time before embalming, 
could become quite ripe quite quickly. 

Methods for raising and transporting 
the corpses were as varied as the person- 
ahties and talents of the robbers who 
employed them. For the standard grave 
robbery, however, a party of three was 
considered effective — two to dig the 
body out and one to drive the getaway 
wagon. Since resurrections were best 
undertaken at night, daytime reconnais- 
sance was ^dtal, not only to triangulate 
the grave against easy-to-locate land- 
marks but also to observe and map any 
traps the family may have set to thwart 
the very act the robbers were planning. 
Some deterrents were simple telltales — 
cleverly strewn flowers, perhaps, or a 
patterning of stones or shells — others, 
such as tripwires attached to loaded, 
cocked guns, were dangerous and direct. 

For the task, the minimum equipment 
was a shaded lantern, tarpaulins, an auger 
for preparing the coffin hd to be pried 
open, and one or two wooden spades — 
wood did not ring out as metal would 
when it hit a rock or other hard surface. 

In addition to these tools, the digging 
duo often had one of two items specially 
crafted for puUing the body from its 
crypt. One, a simple harness, could be 
shpped under the arms of the deceased; 
an attached rope allowed the robbers to 
tug the body free. Another device — the 
hook — may indeed have had its genesis 
among butchers. This tool, forged from a 
long iron bar, had one end curled to form 
a short, blunt hook. By snagging the hook 
under the corpse's chin, the diggers could 
puU the body up and out. 



Time from start to finish? Most sack 
'em uppers bragged one hour flat. 

Amateur Hour 



Sometimes anatomists and physicians 
of the do-it-yourself stripe would 
attempt to resurrect bodies for their 
ovvTi use. Such endeavors could be per- 
ilous, as Thomas Sewall, Class of 1812, 
learned. Sewall lived in Chebacco, a sec- 
tion of Ipswich, Massachusetts. There 
he married and set up practice. And it 
was there, in the fall of 1819, that Sewall 
was found guUty of possession of disin- 
terred bodies. 

The events that led to this outcome 
began on a wintry night a year earlier 
when residents near the town's grave- 
yard noticed glimmers of hght coming 
from its grounds. Worries were kindled 
and within days townspeople were in 
the graveyard with picks and sho\'els. 
One family found a distinctive hair chp 
next to the recent grave of their daugh- 
ter — ^yet her body, and the hair once 
moored by the chp, no longer lay in the 
grave. Others excavated the graves of 
their departed. A total of eight graves, 
some dating back to 1811, were found to 
be unoccupied. Suspicion quickly cen- 
tered on Sewall — he was known to 
teach dissection to students in his 
home — and when identifiable parts of 
three different bodies were found on his 
premises, he was indicted for what 
newspapers of the time called a "most 
daring and sacrilegious robbery." 

In No\'ember, Sewall, and his attor- 
ney, Daniel Webster, were handed the 



26 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



Some deterrents were simple telltales— 
cleverly strewn flowers or a patterning of stones- 
others, such as tripwires attached to loaded, 
cocked guns, were dangerous and direct. 




guilty verdict. Sewall was fined $800, 
possibly the largest fee assessed for pos- 
session of an unsanctioned corpse — a 
body other than that of a criminal's — in 
the country. No longer comfortable as a 
member of the Chebacco community, 
Sewall accepted Webster's invitation to 
move to Washington, DC. There, Sewall 
was professionally reborn, helping to 
found and lead the Medical Department 
of The Columbian College, which is 
today the medical school for George 
Washington University. 

By the Book 

The SewaU affair higUights some of the 
confounding legal aspects of grave rob- 
bing. By and large, the taking of bodies 
from graves was not illegal — a dead body 
was not considered property in EngHsh, 
and therefore in early colonial, law. Yet the 
clothing and ornaments buried vidth the 
dead were protected; their theft was 
actionable. To honor this fine hne, most 



grave robbers stripped the bodies they 
appropriated of all physical goods; their 
only worry then became the ire of towns- 
folk who might catch them at their labors. 

Physicians and medical schools were 
not exempt from the public's anger, for 
the anatomists' patronage of the body 
snatchers fueled an industry that preyed 
upon their departed neighbors, friends, 
and famihes. 

In Massachusetts, an effort to clear 
the legal ambiguity over the procure- 
ment of bodies began in earnest in 1815 
when the Commonwealth passed a 
law — the one that led to Sewall's dis- 
grace and fine — making it a felony to 
disturb a grave or to receive a body 
obtained in such a fashion. Punish- 
ments included a one-year imprison- 
ment or a fine of up to $1,000. Within 
two decades, the issue driving the 
trade — the meager supply of bodies for 
study — was taken up by Abel Lawrence 
Peirson, Class of 1816, a member of the 
Massachusetts Medical Society. 



Like many of his colleagues, Peirson, 
a Salem surgeon, was mortified by 
surgery's association with the grave- 
robbing industry. In February 1829, he 
formed a committee to petition the legis- 
lature to "modify the existing laws 
which operate to forbid the procuring of 
subjects for anatomical dissection." By 
January 1830, a bill had been introduced, 
but it went nowhere. So Peirsoris com- 
mittee began the nineteenth- century 
version of a media campaign — complete 
with pamphlets, op-ed pieces, and pub- 
hc debates — that aimed to educate the 
pubhc on the proposal's merits. 

Their tactics worked. In early Febru- 
ary 1831, the legislature requested that a 
member of the society address the pro- 
posal at a joint session; John CoUins War- 
ren, who since his grave-robbing days had 
become a widely respected surgeon — and 
the first dean of Harvard Medical 
School — was tapped to tackle the task. 
By the end of that month, an act protect- 
ing the "sepulchres of the dead" and legal- 
izing the study of anatomy, the first to do 
so in the United States, had been passed. 
The rule permitted ci\Tl officials to sur- 
render any corpse that would have other- 
wise been slated for burial at public 
expense, thereby increasing the supply of 
bodies for study and undermining the 
resurrectionist trade. 

The law also helped sever the hnk 
between dissection and crime that exist- 
ed in the pubhc mind. Gone was the cen- 
turies-old judicial fiat for treating dissec- 
tion and anatomical study as insults to 
be added to the execution sentences of 
those guilty of such major crimes as mur- 
der. And for famihes that for generations 
had associated the actions of anatomists 
with the theft and desecration of their 
loved ones, gone was their need to pat- 
tern the ground above their departed. ■ 

Ann Mark Mcnting is associate editor of the 
Harvard Medical Alumni Bulletin. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 27 



Harvard, Houdini, and 

ligh society tangled with 
a surgeoris wife, who 

nearly fooled them all. 



BY JESSICA CERRETANI 



It began, for Mina, as a lark. She sat with her husband and their 
guests in the dark spring night, holding hands around the table. The air 
was thick with quiet anticipation, and she giggled nervously. Then, sud- 
denly, the table began to tilt. ~ The seance had been the brainchild of 
Mina's husband, Le Roi Goddard Crandon, Class of 1898. Earlier that 
week, in May 1923, the surgeon had read an account of a paranormal 
occurrence called table tipping, and he wanted to see whether he could 
replicate it. He built a table exactly to the specifications in the book and 
invited friends to a party at the couple's Beacon Hill townhouse. ~ Now, 
against all logic, the table was rocking back and forth. In an 



GIVING UP THE GHOST: 

Mina and Le Roi Crandon 

conjure the face of a 

spirit above their heads 

in this publicity photo. 



1^ 



% 



/ 



# 




SOUL SEARCHERS: Mina 
Crandon poses with members 
of the Scientific American 
committee, from left: O. D. 
Munn, J. Malcolm Bird, and a 
highly skeptical Harry Houdini. 



n 



.JLJ- 



effort to determine who might be the medium through which 
the spirits were working, each person left the table; finally, 
only Mina remained. The table continued to move until she 
left. The doctor's wife, it seemed, had hidden talents. 

Until that evening, Crandon had been the more renowned 
of the couple, having earned the moniker Button Hole Cran- 
don for his iimovation of an appendectomy technique per- 
formed through a patient's navel. It may have been this proce- 
dure, in fact, that brought Crandon and Mina together: The 
HMS surgery instructor had allegedly met his new trophy 
vvdfe — number three, for those keeping count — at a Boston 
hospital when he treated her for appendicitis. 

Not long after that encounter, Mina divorced her first 
husband, a grocer, and promptly married the good doctor. 
She had, no doubt, traded up: A Boston Brahmin who could 
trace his lineage to one of the original Mayflower passen- 
gers, Crandon was educated and wealthy. But he was also 
nearly twenty years her senior, described as arrogant and 
antisocial. An unfortunate scandal, which stemmed from his 
misdiagnosis of appendicitis in a patient, had reportedly 
almost cost him his job. His resulting midlife crisis — during 
which he married Mina and bought a yacht — combined 
with his obsession with death, had spurred his new interest 
in Spiritualism. 

The movement, based on the belief that mediums can com- 
municate with the dead, had flourished during the nineteenth 
century but was still attracting followers in the 1920s. Sir 



30 HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 




Arthur Conan Doyle was the most visible proponent of Spiri- 
tualism at the time. "I consider the psychic question," the cre- 
ator of Sherlock Holmes declared, "to be infinitely the most 
important in the world." 

With this in mind, Crandon began a correspondence with 
Doyle, detaihng Mina's apparent powers. Since that first 
evening, the couple had held regular seances at their home at 
10 Lime Street in Boston, and with each one, Mina's abihties 
seemed to grow stronger: Whatever new phenomena Cran- 
don happened to read about — abrupt flashes of hght, ghostly 
music, the appearance of a hve pigeon — his wife was now 
able to conjure. Her mystical prowess reached new heights 
one evening, when she charmeled the spirit of Walter, her 
long-dead brother. 

Intrigued, Doyle invited the pair to his London home, 
where Mina so impressed the writer that he deemed her "a 
very powerful medium" whose psychic gifts were "beyond all 
question." Before long, Mina had caught the attention of the 
editor of: Scientific American, J. Malcolm Bird, who extolled her 
powers in a series of articles for the magazine, concealing her 
identity with the pseudonym Margery. A year earher. Scientific 
American had offered a $2,500 prize to any medium who was 
proved legitimate. Mina seemed a perfect candidate. It didn't 
hurt that her husband was a prominent Harvard surgeon. 
Surely a man of science and medicine — presumably interests 
that tend toward a natural skepticism — would only seek and 
promote the truth. 



Siiilu OF'I'i^lf CONDirCTCD her seances dad 
only in a negligee and silk stockings, but not before her husbanc. 
had proudly displayed photographs of her communicating — 
in varying stages of undress — ^with the Great Beyond. 



Tempting Fate 

At first glance, Mina Crandon hardly seemed to fit the stereo- 
type of a medium. The daughter of a Canadian farmer, she had 
moved to Boston to live with her older brother, Walter, until 
he was killed in a locomotive accident. Described as "too 
attractive for her own good," Mina had worked as a secretary, 
an actress, and even an ambulance driver before marrying 
Crandon. She often conducted her seances clad only in a neg- 
ligee and silk stockings, but not before her husband had 
piqued the interest of their guests by 
displaying photographs of her com- 
municating — in varying stages of 
undress — ^with the Great Beyond. 

Perhaps it was this very atmos- 
phere that initially convinced Sckn- 
tific American's prize committee of 
her talents. In fact, the group — 
which included Bird; William 
McDougall of Harvard University; 
Daniel Comstock of MIT; Walter 
Franklin Prince of the Society for 
Psychical Research; and Hereward 
Carrington, a psychic researcher — 
found the Crandons so welcoming 
that several members took up resi- 
dence at 10 Lime Street, living and 
dining with the couple even as they 
investigated Mina's veracity. 

This relationship was particular- 
ly dubious in light of the fact that 
Carrington had borrowed money 
from the couple. The editor's objec- 
tivity may also have been blurred: 
"Mr. Bird, if he wishes to achieve 
the authority in psychical research 
which I invoke for him," advised 
Prince, "must hereafter avoid faUing 
in love with the medium." 

The committee was poised to present Mina with the prize 
when Harry Houdini heard the news. The magician — who had 
begun debunking mediums as a side project — ^was a member of 
the committee but was unaware of the group's investigation. 
Peeved, he fired off a letter to Bird, demanding to be included. 
Houdini, aheady skeptical of Mina's abilities, called Bird's arti- 
cles about her "the worst piffle I ever read." When pushed by 
Houdini to judge the medium's authenticity. Bird responded, 
"Why, yes, she is genuine. She does resort to trickery at times, 
but I beheve she is fifty or sixty percent genuine." A month 



later, in July 1924, Houdini, accompanied by O. D. Munn, the 
magazine's owner, arrived in Boston to decide for himself. 

The Burden of Proof 




TRICK OR TREAT: Mina Crandon claimed to be 
able to communicate >vith the dead. 



That night, Houdini and Munn gathered at Lime Street with 
other members of the committee to witness Mina's abihties. The 
hghts were dimmed and the sitters clasped hands and touched 
their feet together, a method of control that presumably kept the 
medium from manipulating the table or other objects herself. 
Soon, the show began. As had 
occurred at prior seances, the spirit, 
"Walter," rang a beU attached to a box 
on the floor. Then he knocked over 
Mina's cabinet, the three-sided wood- 
en screen that surrounded her. Finally, 
he announced he was holding a mega- 
phone that had been sitting at Mina's 
feet. At Houdini's request, Walter 
threw it to him. The other sitters were 
impressed. Not so Houdini. Mina's 
performance was, he wrote, "the 
slickest ruse I have ever detected." 

He explained the trickery to his 
colleagues and, later, to the pubhc in 
a pamphlet entitled 'Margery" the 
Medium Exposed. The day of the 
seance, he had worn a rubber ban- 
dage around his calf, which allegedly 
rendered his leg painfully tender, 
allowing him more sensitivity in the 
limb. This, he claimed, made it easier 
for him to detect the movements of 
Mina's own foot when it was pressed 
against his during control: "I could 
distinctly feel her ankle slowly and 
spasmodically sliding as it pressed 
against mine while she gained space 
to raise her foot off the floor and 
touch the top of the box" to ring the bell, he said. Houdini also 
had explanations for the crashing cabinet and megaphone. 
Bird had briefly broken control with Mina and left the room, 
during which time she was able to topple the cabinet with her 
foot and pick up the megaphone with her free hand. She 
placed the megaphone on her head like a dunce cap, then 
jerked forward, tossing it at Houdini's feet. 

Despite Houdini's claims, the committee continued to 
investigate the Crandons. The result was aU-out war: Houdini 
strived to expose Mina as a fraud, while the medium sought 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 31 



'■YOU WANT TO KNl# w WH^i it feds like to 

be a witch? That's what they would have called me in Boston 
^50 years ago . . . now they send committees of professors from 
Harvard to study me. That represents progress, doesn't it?" 



to make him look foolish. In his quest to prove the hoax, 
Houdini buUt a large wooden box to constrain Mina, with 
holes for only her head and hands to remain free. The over- 
the-top "Margery Box" didn't help either party's case. Mina 
entered it, but complained that the wood blocked her com- 
munication with the spirits. Then Walter piped up, accusing 
the magician of planting a ruler in the box to make it look 
like Mina had secreted it there to help her move objects. 
(Houdini had previously accused Mina of holding a stick in 
her mouth to manipulate objects while her hands and feet 
were controlled.) Houdini denied planting the ruler — in fact, 
he charged the Crandons with placing it in the box to make 
him look bad — but the damage was done. As for Walter, the 
irritable spirit was incensed by the suspicions of his sister. 
"Houdini, you goddamned son of a bitch!" he bellowed. 
"Get the hell out of here and never come back." 

Houdini did return for one last seance that August. Com- 
pared to earher sittings, it was uneventful, save for one 
exchange between the magician and the medium. Houdini had 
shared with the Crandons his plans to denounce Mina as a 
hoax at a Boston theater; he had recently added reenactments 
of tricks used by various defrauded mediums to his traveling 
stage show. If he misrepresented her, she warned, her friends 
would give him a good beating. 

Blithe Spirit 

All threats aside, what happened next was rather anticlimac- 
tic — at least at first. Scientific American refused to grant Mina 
the prize, a disappointment that likely hurt her ego more than 
her purse; the Crandons had planned to donate the money 
to Spiritualist causes. Bird resigned from the magazine and 
began promoting the Crandons. Houdini continued with his 
stage shows. In January 1925, Doyle published an article in the 
Boston Herald criticizing Houdini and defending Mina, whom 
he termed "a most charming and cultivated lady." 

For her part, Mina went on with her seances, adding new 
elements — including ectoplasm, a phosphorescent material 
that seemed to pour from her orifices during spirit commu- 
nication — to the mix. It was this ectoplasm that attracted 
the attention of other psychic experts. The English 
researcher Eric Dingwall attended a seance with Mina dur- 
ing which the ectoplasm appeared. At first an excited believ- 
er, Dingwall soon turned skeptic: The Crandons never 
allowed the ectoplasm to be viewed in full light, it didrit 
move unless Mina threw it, and, upon further study, it 
"strongly resembled the cartilaginous rings found in the 
mammalian trachea" — a substance that Crandon could easi- 
ly obtain in his work as a surgeon. 



Later that spring, a group of faculty members from 
Harvard — including HMS pathology professor S. Burt 
Wolbach, Class of 1903 — visited Lime Street to observe the 
medium in action. The group took part in six seances and at 
the time mentioned no apparent trickery. Yet they revealed 
their true findings in an article pubhshed in the November 
1925 issue of The Atlantic, including the observation that Mina 
had at one point freed both her hands from control and 
removed objects from "the region of her lap." StiLl, they noted, 
an "internal search of the medium has never been permitted." 

The faculty members' final conclusion was that "trickery 
accounted for all the phenomena" they had witnessed. That 
finding, though, was of httle concern to Mina. "You want to 
know what it feels Kke to be a witch?" she asked. "You know 
that's what they would have called me in Boston 150 years 
ago . . . now they send committees of professors from Harvard 
to study me. That represents progress, doesn't it?" 

Dead Reckoning 

In the midst of these investigations, a curious thing hap- 
pened; Houdini died. The athletic magician had been 
punched repeatedly in the stomach by a college student 
whom he had dared to test his abdominal muscles. A few 
days later, on Halloween 1926, Houdini died at the age of 52. 
The cause of death was a ruptured appendix. 

The death came as a shock — to almost everyone. Two years 
earher, Houdini's friend-turned-nemesis Doyle had predicted 
that he would "get his just desserts very exactly meted out," 
while Walter himself had announced at a recent seance that 
the magician would be dead within the year. Houdini, Cran- 
don later concluded, "had been dealt with by the spirits for 
activities against the movement." 

Threats are one thing, forensic proof is quite another, par- 
ticularly when a maris death certificate notes the location of 
his appendix as his left, not right, side. In 2007, an effort — 
since aborted — began to exhume Houdini, sparked by theories 
that he had been poisoned. The chief suspects? The Crandons. 

The Myth of Fingerprints 

He may have died, but Houdini's suspicions about the Cran- 
dons li^'ed on. Subsequent im'estigations came to similar con- 
clusions as those of the Scientific American and Harvard groups, 
including a report by Joseph Banks Rhine, who would later 
found Duke University's Parapsychology Lab. Rhine was 
convinced Mina was a fraud, suggesting that "it is e\'idently 
of very great advantage to a medium, especially if fraudulent, 
to be personally attractive; it aids in the 'fly- catching busi- 



32 HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 




GHOST IN THE MACHINE: 
Houdini's "Margery Box," 
meant to prevent the medium 
from moving during seances, 
only served to fuel the 
controversy surrounding 
the Crandons. 



"tifM 



ness.' " Doyle, still a staunch supporter of the Crandons, fired 
back by purchasing advertising space in the Boston papers, 
in which he simply stated, "J. B. Rhine is an Ass." 

Mina paid no heed. By 1928, she had a new psychic talent to 
promote; Walter now claimed he could leave a fingerprint in 
wax to prove his presence. Indeed, following a seance, two 
prints appeared in a basin of dental wax in the room. Refusing 
to take the prints at face value, Crandon called on John Fife, 
an acquaintance he identified as the chief of police at the 
Charlestown Navy Yard and an expert on fingerprints. Fife 
confirmed that thumbprints found on the dead maris razor 
matched perfectly the prints in the wax. 

Emboldened by the findings, Crandon enlisted another 
friend, E. E. Dudley, to catalog all prints left by Walter in future 
seances. Dudley obhged, but took it upon himself to collect 
prints from all the sitters at Mtna's seances as well, to disprove 
critics' claims that the prints had been left by a living person. 

There was just one problem: They had been. To his surprise, 
Dudley realized that "Walter's" prints were identical to those 
of one Frederick Caldwell — Mina's dentist and friend. The 
apparently unwitting man had given the medium an imprint of 
his thumb as an example when he showed her how to use the 
dental wax he provided. Mina, it appeared, had then made a 



mold of the print and used it to create 
her dead brother's supposed prints. 
Later investigation of Fife revealed that 
no one in the poHce department had 
ever heard of him. This time, the evi- 
dence of fraud was clear. 

Unhappy Medium 

Mina's downfall was as sudden as her 
meteoric rise had been. Although she 
continued her seances for some time 
after the fingerprint fiasco, when her 
husband died in 1939 she became 
depressed and alcoholic. She even 
attempted to jump off the roof of her 
house. Her distress, perhaps, was root- 
ed in the fact that she'd lost her best 
audience: Crandon himself. " 'Margery' 
might take a chance and confess if 
Crandon did not firmly believe," W S. 
Griscom, a Boston Herald reporter and 
mutual acquaintance of the Crandons 
, _. and Houdini, once wrote to the magi- 

cian. "She knows it would end all their 
relations and she doesn't dare do it." 
While Crandoris interactions with Fife suggest he was com- 
phcit in the scheme, Griscom wasn't the only one who was con- 
vinced the surgeon wanted to beUeve in his wife; the Harvard 
investigators and other researchers posed similar theories. The 
couple, they suspected, had engaged in a sort oi folic ci deux that 
benefited them both in very different ways: The seances dis- 
tracted Crandon from his preoccupation with his own death, 
played to his sense of discovery, and bolstered his ego. And they 
made Mina a star, transporting her from mere hausfrau to 
Spiritualist celebrity — and likely kept her husband's eye from 
wandering to potential trophy wife number four. 

That star had faded by her final days: one visitor 
described her as a "dumpy little woman," hardly the neg- 
ligee-clad beauty of decades earlier. Yet Mina's air of mys- 
tique remained intact. On her deathbed in 1941, the medium 
was encouraged by yet another psychic researcher to finally 
confess and divulge the tricks she had used during the 
seances. After first suggesting that the questioner go to hell, 
she blithely added, "Why don't you guess? You'll all be 
guessing — for the rest of your lives." ■ 

Jessica Ccrretani is assistant editor of the Harvard Medical 
Alumni Bulletin. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



33 




4<Ste«, 



X 



■**«;«;#■ 



..::JW 




^ 



Phincas Gage wiisn t the only nineteenth eentury 
worker with a blast to the brain — and a connection 

to HarMirc xMec leal School. - by william ira bennett 



34 HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 








Every Harvard medical graduate knows the story: 

In 1848 Phineas Gage was tamping explosive powder into a rock 
in Vermont. The powder exploded prematurely and blasted an 
iron tamping rod out of Gage's hands and through his forehead. 
The railroad construction foreman famously survived this 
primitive lobotomy, with some possible deterioration of his per- 
sonality to become one of the great medical curiosities of his day. 



Harvard Medical School's Warren 
Anatomical Museum, which was only a 
year old when the accident occurred, soon 
acquired a plaster cast of Gage's head. In 
1867, seven years after his death. Gage's 
mother was prevailed upon to give her son's 
skull and the tamping rod to the physician 
who had treated him. The doctor donated 
the skull and the rod to the museum as 
teaching tools for medical students, creat- 
ing the museum's most famous exhibit. 

Yet for several days in 1868, M. Jewett, an 
Ohio physician, attempted to upstage the 
Phineas Gage exhibit. That year, some- 
where near Akron, a coal miner named Noel 
Lenn suffered a similar accident. A gas pipe 
was driven through two thicknesses of his 
cap in front, his right forehead, the front 
part of his brain, then back out of his skull 
a bit forward of his left ear, and finally 
through a third thickness of cap. With 
great presence of mind, and considerable 
strength, Lenris mate extracted the bent 
pipe and got the injured man home. In the 
ensuing days the doctors caring for Lenn 
removed a good deal of "coagulated blood 
and broken up brain" from the site of the 
wound — and incidentally purged him of a 
I7-foot-long tapeworm. 

The miner, who had studied for the 
priesthood in his native France, survived, 
but his faculties were slow to recover. "He 
holds no conversation either in French or 



Enghsh," Jewett wrote to Henry Jacob 
Bigelow, Class of 1841, a prominent surgeon 
and HMS professor who had studied Gage 
and other cases of brain trauma. "To my 
request that he go home with me and work 
in my garden he rephed, 'No sir-ee,' the 
largest number of words I have heard him 
connect since the injury." Jewett facetious- 
ly added that Lenn "could not realize any- 
thing from the sale of any books." 

Leim was by then "physically as well as 
ever but very averse to labor." He was, 
therefore, something of a burden to the 
community where he was hving. And this 
was what prompted Jewett to contact 
Bigelow. What is remarkable about the 
correspondence between the two is its 
very matter-of-factness. 

"What think you," Jewett asked 
Bigelow, "of the idea of taking him to 
Boston for a permanent residence in a 
museum? Have you any Barnum?" Jewett 
proceeded to offer Lenn to Bigelow for 
study, proposing that the man be installed 
in the museum as a living exhibit, his mea- 
ger needs to be supphed by revenue from the 
curious public and, perhaps, from physi- 
cians with a commitment to learning. The 
animate component of the exhibit would 
be accompanied by cap, gas pipe, and, as 
an added attraction, the preserved tape- 
worm. If the Harvard people weren't 
interested, Jewett cagUy suggested, "per- 



haps the faculty in Paris would be glad to 
take him in charge." 

Bigelow hastened to reply that the eco- 
nomics of displaying Lenn in a museum 
were utterly unfavorable. If anyone could 
have made a hving at it, Bigelow wrote, it 
would have been Gage, "a shrewd and intel- 
hgent man and quite disposed to do any- 
thing of that sort to turn an honest permy," 
who had "tried it for a short time at New 
York at Barnum's" but failed to support 
himself. "As for the Paris faculty collective- 
ly or singly," he added, "money appears to 
be the one thing in least abundance and in 
most demand among them." 

Bigelow then made a counterproposal: If 
Jewett would bring Lenn to Boston, Bigelow 
would arrange for the man to be kept at an 
appropriate institution. Bigelow would 
attend to any financial obhgations that 
might arise, in return for which he would 
have the exclusive right to study Lenn at his 
leisure. This arrangement was, of course, to 
be kept confidential. Jewett quickly assent- 
ed, though he noted that Ohio had a law 
against bringing paupers into the state or 
taking them out. But in this case he thought 
there should be no diEiculty. 

In due course Jewett arrived with Lerm 
for a meeting of the medical society. The 
Warren Museum eventually acquired 
exhibits 952 (a cast of Lenris head) and 3107 
(the gas pipe). Lerm himself was deposited 
in the Taunton Lunatic Hospital for several 
years, then transferred to the Tewksbury 
State Almshouse, from which he absconded 
in 1874 with his skull still inside his head. 
He was not heard from again. ■ 

William Ira Bennett '68, a psychiatrist in private 
practice in Cambridge, Massachusetts, served as 
editor-in-chief of the Harvard Medical Alumni 
Bulletin from 1995 until earlier this year This 
account was excerpted, adapted, and reprinted with 
permission from an article Bennett published in the 
July-August 1987 issue o/ Harvard Magazine. 



sdmsRh 

Corpses plucked from graves, murder conducted by 

mail, chivalry gone aw^ry — ^w^hat 227-year-old 

institution doesrit have a fev/ skeletons clattering 

in its closets? Test your w^its on these shocking stories 

from Harvard Medical School's history 



BY PAULA BYRON 





Webster 



Murder Most Foul 

George Parkman's prominent chin had always given 

him an air of determination. But as the gaunt, nearly 

skeletal physician climbed the steps of Harvard's medical college on 

the morning of November 23, 1849, the thrust of his jaw was more 

pronounced than usual: He was hellbent on collecting a long-standing 

debt from Professor John White Webster. Sadly, Parkman failed in his 

mission. He also failed to leave the building alive. 

For weeks Boston's citizens scoured the neighborhood for signs of the 
missing doctor. Finally, at the prompting of a suspicious janitor, authorities 
recovered Parkman's remains from Webster's chemistry laboratory. Upon 
his arrest, Webster, a member of the Class of 1815, swallowed a strychnine 
pill. He went on to survive his suicide attempt only to endure, in March 
1850, one of the more sensational murder trials of the nineteenth century. 
His feUow professors provided the forensic evidence needed to convict him. 

In the weeks before his death by hanging, Webster confessed, at the 
urging of a local minister, to having fatally struck Parkman during a heat- 
ed quarrel over the debt. ^ ^ 

After that, Webster stat- 
ed, "All I could see was 
the need to conceal 
Dr. Parkman's body 
in order to avoid the 
blackest disgrace." 



1. Where in the laboratory was 
Parkman's body found? 



A. The hole beneath Webster's privy 

B. A large wooden tea chest 

C. The furnace 

D. All of the above 



36 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



Nursed to Death 

Apart from her penchant for poisoning patients, Jane 
Toppan was, by most accounts, an excellent nurse. 
Her tender ministrations, astonishing efficiency, and 
ebullient personality kept "Jolly Jane" in constant 
demand as a private nurse in Cambridge, Massachu- 
setts, during the late nineteenth century. These wel- 
come traits, however, masked a dark, considerably less 
convivial one — ingenuity in administering morphine 
and atropine in varying lethal doses. This sinister 
twist on caregiving enabled Toppan to murder dozens 
of people and yet remain undetected for 16 years. 

Despite her outward joviality, Toppan nursed 
grudges. She resented her foster mother, who 
had abused her, and her foster sister, whose life 
seemed charmed. No doubt irked that the mother 
died of natural causes, Toppan dispatched the sister 
by slipping her a morphine-spiked tonic. 

But hostihty was not Topparis only motive. She mur- 
dered one friend because she coveted the friend's job, a 
landlord because he had grown "feeble and fussy," and 
countless patients because she wanted to see how 
their nervous systems would respond to different 
poisons. Others she murdered for the sexual thrill — 
or "voluptuous delight" — she felt in the presence of 
the dying. Dispensing poison, she would later confess, 
had simply become a habit. 

With each murder, Toppan grew bolder and more 
reckless. In 1901, she killed a dear friend, then the 
friend's grown daughter. "I went to the funeral and 
felt as jolly as could be," she exulted, after the second 
death. "And nobody suspected me in the least." But 
when Toppan went on to murder the friend's husband 
and other daughter just weeks later, suspicious family 
members requested toxicology tests. That's when Top- 
pan attracted the attention of Harvard Medical School. 

Harvard was not a new presence in Toppan's life; 
she had received her advanced training at an affiliated 
hospital. Yet supervisors at Massachusetts General 
Hospital had discharged her from the nursing school — 
amid rumors of falsified charts, petty thefts, and out- 
landish lies — and had refused to issue her a Ucense. 
Now, more than ten years later, an HMS professor, 




0- 



Edward Wood, found the evidence needed to indict 
her, and four HMS graduates helped ensure her incar- 
ceration, first in jail, then in a mental institution. 

"Something comes over me," she once told one 
of those graduates, Henry Rust Stedman, the psychia- 
trist who diagnosed her "moral insanity." "I don't 
know what it is. I have an uncontrollable desire to 
give poison wdthout regard to the consequences." 

After confessing, in gleeful detail, to 31 murders and 
vaunting her ambition to have "killed more people — 
helpless people — than any other man or woman who 
ever lived," Toppan was committed to the Taunton 
Lunatic Hospital for life. There she died, decades 
later, snow^ haired, docile, and unrepentant. In the 
early years, though, Toppan had proved a difficult 
patient: At mealtimes her attendants had needed 
to resort to placing her in a straitjacket and force- 
feeding her. 



2. Why did Nurse Toppan refuse to eat? 



A. She was convinced someone was trying to 
poison her 

B. A strict dietician with her own patients, she 
refused to eat the unwholesome hospital fare 

C. She wanted to lose the 50 pounds she had 
gained in jail 

D. She was staging a hunger strike in hopes that 
the hospital warden would agree to let her 
join the nursing staff 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 37 




A Fine Delicacy 

when Elizabeth Blackwell, the first woman to earn a medical degree in the United States, enrolled in New 
York's Geneva Medical College in 1 847, she was, according to a Boston Medical and Surgical Journal 
editorial, "a pretty little specimen of the feminine gender." She would arrive in the classroom with great 
composure, remove her bonnet ("exposing a fine phrenology"), and take assiduous notes. "The effect on 
the class has been good," the editorial concluded, "and great decorum is preserved while she is present." 

Emboldened by Blackwell's example, hlorriot Kezio hlunt applied to hiarvard Medical School that 
same year, including with her application a copy of the editorial. But Harvard found the idea of a 
woman settling into medical studies too unsettling. Sixty-five years after the School's founding, the 
fHarvard Corporation concluded that it would be imprudent to begin enrolling women. 

Three years later, encouraged by Blackwell's graduation, hlunt again applied to the School. The faculty 
voted to admit her, and the Corporation affirmed that vote. But this time the medical students protested, 
citing possible "feminine interference" with their studies. No woman of true delicacy would be willing 
to attend medical lectures with men, they declared, adding that they were loath to mix with any woman 
who had so "unsexed" herself and "sac- „. ^ 



rificed her modesty." Threats against 
hlunt ended only after faculty leaders 
convinced her not to attend. 

During the ensuing decades, appli- 
cations from other women met with rejection. Donations as 
high OS $50,000 were offered as sweeteners; those too were 
rebuffed. It was only when a world calamity caused grave 
staff shortages in Harvard's teaching hospitals that women 
were at lost allowed to attend the School. 



What world calamity finally prompted 
Harvard Medical School to begin 
admitting women to its student ranks? 



A. World War I 

B. The 1918 flu pandemic 

C. The Great Depression 

D. World War II 



11 






Evasion of the Body Snatchers 

Harvard medical students of the early nineteenth century were expected to further their education by 
taking lecture notes, undergoing an apprenticeship, and — in the predawn hours — unearthing corpses from 
freshly dug graves. 

John CoUins Warren, the first dean of the medical college, encouraged his students to supplement the insti- 
tution's meager supply of cadavers — and emulate his own youthful example — by staging night raids on ceme- 
teries. In one escapade, two students watched the burial of an almshouse 
resident, then marked the grave. Soon after midnight, they returned to the 
cemetery to disinter the body. But just as they were about to load their plun- 
der onto a wagon, several 
guards sprang upon them. 
In another grim caper, a 
student celebrated for his 
talent in procuring bodies 
returned to the grave 
he'd marked earlier only 
to find himself in the 
hostile clutches of ceme- 
tery watchmen. 




4. What did these three medical 
students do to escape prosecution? 



A. Drove about until morning, then returned 
to town with an air of innocence 

B. Fled, then hid under a pile of wood shavings 

C. Met the charges with great indignation 
and insisted that the watchmen were 
conspiring to extort money 

D. All of the above 



38 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



Message in a Bottle 



Josephine Barnaby agreed that the whiskey was vile, peeled the flypaper from his cell ceiling, soaked the 
yet she sipped it anyway. Within minutes, she was strips, and ingested the arsenic -tainted residue. 



gasping in agony. Within days, she was dead 

Barnaby had received the arsenic-laced 
whiskey while on vacation in Denver in 
April 1891. The package carried a 
Boston postmark; the bottle's label 
bore an unsigned greeting. "Wish 
you a Happy New Year," it read. 
"Please accept this fine old whiskey 
from your friend in the woods." 

As she lay dying Barnaby tried to 
imagine who would want to kill her. 
Finally, she voiced the unthinkable. 
"Can it be possible," she whispered to 
the friends gathered around her, "that 
Dr. Graves could do such a thing?" 

Thomas Thatcher Graves, Class of 
1871, had a talent for ehxirs — and a 
predilection for wealthy dowagers 
with nervous conditions. In Barnaby 
he had found his ideal patient, and he 
soon made himself indispensable. When 
her husband died leaving her a pittance, 
Graves helped her challenge the will and gain a 
handsome settlement. She named him a beneficiary in 
her new will, and he promptly took over her financial 
affairs. His ever-tightening control made her balk, 
though, so he threatened to place her in an asylum. 
She in turn made plans to change her will. And then 
the mysterious package arrived. 

Colorado authorities didn't take long to name 
Graves their chief suspect in the widow's murder. 
After a sting involving a Pinkerton detective, he was 
imprisoned, tried, and comdcted. But before he could 
be hanged, the state supreme court set aside the ver- 
dict on technicahties and ordered a new trial. 

Graves had found the first trial harrowing, and he 
could not bear the thought of a second one. So, on 
September 2, 1893, his jailers later reported, he 




Near his lifeless body was a suicide note dated, 
oddly, months earlier. "Please don't hold 
any autopsy upon my remains," Graves 
had written to the coroner. "The 
cause of death may be rendered as 
follows: 'Died from persecution — 
worn out — exhausted.'" A second 
letter to the public protested 
his innocence. 
Indeed, not everyone was persuad- 
ed of the doctor's guilt. Other sus- 
pects abounded — Barnaby's vengeful 
and violent son-in-law, her quarrel- 
some friend, her conniving secretary, 
even the doctor's mentally unstable 
wife. And not everyone remained 
convinced of Graves's death. The 
following year several newspapers 
printed the rumor that he had 
absconded to Brazil, leaving a wax 
double of himself on his cell cot and 
bribes in the pockets of his jailers. Other 
clues fueled that speculation: his widow's 
refusal to allow his remains to be embalmed, her 
later disappearance, and witnesses' claims that his 
casket, when opened at the gravesite against his 
widow's protests, did not contain his corpse. 



5. What, according to this rumor, did 
Graves's coffin hold instead? 



A. The body of a fellow inmate wfio'd had the 
misfortune to resemble him 

B. Three hefty sandbags 

C. A pine log 

D. A wax replica of the doctor, complete with 
mustache and beard 



D S- QV QZ V 2 a L :Xs>| JSMsuy 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 39 



the flirtatious 





- and other medical mysteries ~ 



BY JONATHAN A. EDLOW 



What caused a boy's eye to dilate suddenly? 

A kindergartner to start bumping into 

furniture? And a banker's lung cancer 

to disappear? An emergency physician turns to 

the case files to depict doctors as detectives. 



40 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 







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ny mediiMillP9Sf§(ries are easily solved: A man shovels 
iieavy vv^et snow, develops chest pams, and rushes to an emer- 
gency department, w^here an electrocardiogram shows a heart 
attack. Sometimes, though, doctors face far trickier dilemmas. 
Clues lead to dead ends. A failed treatment proves a presumptive 
diagnosis false. Or the diagnosis is definitive, but the cause remains 
elusive. In the following stories. Harvard doctors reveal how they 
cracked challenging cases. 



UNDER PRESSURE 



Five-year-old tuisa Alvarez 
Ruiz arrived at the emergency depart- 
ment of Children's Hospital Boston with 
a persistent headache. She had some 
nausea and sensitivity to light, but no 
vomiting. Her parents couldn't identify 
any triggers for the headache, and they 
insisted that she wasn't taking any med- 
ications. The pain, they said, seemed to 
wax and wane over the course of the 
day. Their daughter had no history of 
head trauma, no recent illnesses, and no 
family history of headaches. But lately 
her parents had noticed that Luisa, who 
lived with her grandmother every other 
month, had grown clumsy and was 
bumping into things. 



The standard tests revealed nothing 
worrisome, and Luisa's physical exami- 
nation was normal. But her headache 
had persisted for several months, so the 
emergency pediatricians ordered a neu- 
rological consult. 

"That was the point where I became 
involved," says David Urion, a pediatric 
neurologist at Childreris Hospital Boston 
and an HMS associate professor of neurol- 
ogy. His examination of Luisa uncovered 
only one unexpected finding: He couldn't 
detect the normal pulsations of her reti- 
nal veins. Yet without papilledema — a 
swelling of the optic nerves caused 
by increased intracranial pressure — he 
couldn't teU whether the absence of those 



pulsations indicated a problem. It did sug- 
gest, however, that Luisa's pain was not 
a minor, primary headache disorder. And 
her history of bumping into things made 
Urion worry about the possibihty of an 
infiltrating tumor. So he ordered an MRI. 

"The initial report showed 'something 
funny,' " Urion says. "The neuroradiolo- 
gists huddled around her scans as if in 
Tahnudic discussion." That "something 
funny" turned out to be a strange bright- 
ening of both optic nerves. 

After requesting an ophthalmology 
consult, Urion received a stunning find- 
ing: Luisa was almost blind. Her \dsual 
acuity was 20/400 in her left eye; in her 
right eye, she had barely any vision. 



42 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



It didn't take the mage nurse 
long to make notations in Shawn 
Matthews's chart: The ten-year-old had 
been playing in his room when he was 
seized by a sudden headache and blurred 
vision. His vital signs were normal, but 
his left pupil was markedly dilated. 

"Before I even stepped away from the 
chart rack," recalls Gary Setnik, chair- 
man of the Department of Emergency 
Medicine at Mount Auburn Hospital, "I 
was considering all the possible causes of 
headache and dilated pupH. Most of them 
were bad." 

Shawn was sitting on the examination 
table with his parents and a younger sis- 
ter clustered around him. Like the triage 
nurse, Setnik instantly noticed that the 
boy's left pupil filled the iris. 

Yet Shawn's parents reported that 
their son had always been in excellent 
health. He had never had an eye injury, he 
took no medications, and he hadn't used 
eye drops. So Setnik turned his attention 
to the boy's nervous system, concerned 
that a cerebral artery aneurysm could be 
to blame. He checked Shawn's sensation, 
strength, and balance. He placed his 
stethoscope on the child's head to check 
for bruits — whooshing sounds that 
would indicate a tangle of abnormal cere- 
bral blood vessels. He peered into 



Shawn's retinas to look for signs of brain 
swelling or bleeding. He checked 
Shawn's neck for stiffness, an indicator of 
inflammation in the subarachnoid space, 
where the cerebrospinal fluid resides. All 
the tests were normal. 

"I was struck by how well he looked," 
Setnik says. "It was just my gut feeling 
that he wasn't sick." 

Then Setnik realized that Shawn's lop- 
sided gaze looked familiar. Five years ear- 
her, a graduate student had come into the 
hospital with one dilated pupil. While 
working in a chemistry laboratory, he 
had accidentally spiUed atropine on his 
finger, then absentmindedly rubbed 
his eye. "Somehow," Setnik says, "the two 
cases linked up in my mind." 

Atropine is an alkaloid extracted from 
the Solanaceae family of flowering plants, 
whose most infamous member, Atropa 
belladonna, or deadly nightshade, has a 
long history of use as a medicine, a poi- 
son, and a cosmetic. Itahan for "beautiful 
lady," the species name, belladonna, derives 
from a popular practice during the 
Renaissance, when women would dab the 
juice of the berry into their eyes, knowing 
the chemical would dilate their pupHs — 
and hoping it would increase their allure. 

"In medicine, we feel about 80 per- 
cent of diagnoses can usually be made 



by the history alone," says Setnik. "So I 
started over." Was there any possible 
way, he asked Shawn's parents, that the 
boy could have gotten something into 
his eye? Was anyone else in the family 
using eye drops? Were there any old 
medications in the house? Suddenly 
Shawn's mother looked up and said, 
"Oh, my God! What are we putting in 
Fluffy's eyes?" 

"It turns out," Setnik says, "that Fluffy 
was the cat, and she had some type of eye 
problem that the veterinarian was treat- 
ing with an ointment." Then Shawn 
remembered: Right before developing his 
headache. Fluffy had rubbed up against 
him and demanded to be petted. 

"I hterally said, 'That's it!' " Setnik says. 
He asked Shawn's mother to retrieve the 
cat's medication. A half hour later, she 
returned with an aluminum tube whose 
label read "1 percent atropine." Like the 
absentminded graduate student, Shawn 
had touched his eye, transferring traces 
of the ointment from the cat's fur. 

"I told the family that Shawn's pupil 
would likely stay dilated for seven to ten 
days but that his eye would ultimately 
be completely normal," Setnik says. 
What had seemed like a medical crisis 
was nothing more than a brush with an 
affectionate pet. ■ 



wmi^'k:^^c>i>::i 





Now Urion ordered a lumbar punc- 
ture, and the results gave him the clue he 
needed. Luisa's cerebrospinal fluid was 
clear. The protein and glucose levels were 
normal, and there were no abnormal cells 
or bacteria. But the pressure in her skuU 
was two and a half times the normal level. 

"Now we had a diagnosis — pseudo- 
tumor cerebri, which occurs when 
intracranial pressure increases for no 
obvious reason," says Urion. "But it was a 
diagnosis that only raised another series 
of questions. To have that diagnosis in a 
skinny five-year-old was pretty unusual 
in itself." Also known as idiopathic 
intracranial hypertension, pseudotumor 



cerebri, a rare condition, is most often 
seen in overweight adult women. 

Urion quizzed Luisa's parents again. 
Were they sure she took no medications? 
Did she have access to the medicine of 
other household members? 

"The family took a Uttle umbrage at our 
repeated questions," Urion says. Finally 
the family asked what could cause the con- 
dition, and Urion gave them a hst. They 
stopped at the word vitamins and asked, 
"Could fish oil have these vitamins?" 

The next day, Luisa's grandmother 
brought in a bottle of Smith's Fish Emul- 
sion. Every other month, for more than a 
year, the grandmother had poured Luisa 



a tablespoon of the fish oil, giving her the 
recommended daily dose — for an adult — 
of vitamin A, supplementing what Luisa 
already received in her normal diet. The 
child had acute vitamin A toxicity. 

Luisa underwent multiple lumbar 
punctures and took diuretics to reduce 
the pressure. Not only was further loss of 
vision halted, but Luisa also recovered 
some of her eyesight. She stiU has occa- 
sional headaches. 

What the case taught him, Urion says, 
is the importance of teasing out medical 
histories. "Four of us, all good doctors, 
had asked about medication ingestion," 
he says. "But none of us had asked the 
question the right way. The family finally 
helped us out by asking us directly, 'what 
are you worried about?' That helped us to 
be more direct with our questions and 
to get the right answer." ■ 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 






THE CASE OF THE 
DISAPPEARING CANCER 



The doctor pulled Phillip Bradford's wife into the hospital corridor to 
dehver the news: The odd nodules on her husband's chest x-ray suggested lung 
cancer. He needed a thoracotomy — the surgeons would open his chest up like a 
clamshell — so the suspicious tissue could be biopsied. 

But when he learned the diagnosis, the SS-year-old patient wasn't frightened. 
"I simply didn't believe that's what I had," he says. "I was healthy and a non- 
smoker. I wanted a second opinion." 

Earle Wilkins, Jr. '44, then a senior thoracic surgeon at Massachusetts Gener- 
al Hospital, remembers the case clearly, despite the passage of three decades. "I 
was struck by two things," he says. "First, if this was metastatic cancer to the 
lung, I could detect no primary site. And second, one of the nodules on the latest 



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44 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



x-ray seemed slightly smaller than it 
had been on the previous film. If that 
was true, a cancer would be unlikely." 
The thoracotomy was cancelled. 

Bradford improved and remained well 
for almost a year. But then he started 
coughing and ruiming a fever, displaying 
all the symptoms that had first brought 
him to the doctors' attention. Once again, 
his chest x-ray blossomed with ominous 
nodules; several weeks later, as with the 
previous episode, his symptoms mysteri- 
ously vanished. 

This time, Wilkins sent Bradford to 
Robert Rubin '66, then an infectious dis- 
ease speciahst at Massachusetts General 
Hospital and now associate director of 
the Division of Infectious Disease at 
Brigham and Women's Hospital. Rubin 
reasoned that if the nodules that 
appeared on the x-rays were always in 
the same location, a chronic structural 
or anatomical lesion within the lungs 
would be the likeliest cause. Each x-ray 
showed, however, that different episodes 
affected different parts of the lungs, sug- 
gesting an environmental trigger. "And 
because none of the multiple tests had 
revealed the presence of a microbe that 
might have been the culprit," Rubin says, 
"the question of hypersensitivity pneu- 
monia immediately arose." 

Hypersensitivity pneumonia occurs 
when a lung becomes inflamed after 
breathing air that contains organic 
dusts laden with such biologic stow- 
aways as mold, fungi, bacteria, or spores. 
Although these substances are not nec- 
essarily as toxic or invasive as the virus- 
es and bacteria that cause typical infec- 
tious pneumonia, the immune system 
still perceives them as foreign invaders. 
Within hours of being exposed to these 
dusts, people with hypersensitivity 
pneumonia often develop symptoms — 
including fever, chills, headaches, cough, 
and shortness of breath — that can be 
easily misdiagnosed as flu, bronchitis, 
another kind of pneumonia, or, in rare 
cases, lung cancer. 

Among the more important agents of 
biological decay are thermophihc actino- 
mycetes, the primary decomposers of 
such tough plant materials as bark, 
leaves, and stems. Exposure to spores 
from these bacteria place farmers, 
pigeon breeders, and parakeet fanciers at 



H 



lis chest x-ray blossomed with 

ominous nodules; several weeks later, 

his symptoms mysteriously vanished. 



elevated risk for hypersensitivity pneu- 
monia. People who harvest sugarcane 
and coffee beans, cure tobacco, or work 
with wood dust, cheese, maple bark, 
mushrooms, soybean feed, or barley can 
develop the syndrome as well. 

Bradford, though, did not farm, breed 
pigeons, or harvest sugarcane. He worked 
as an executive in a banking firm. 

"I questioned Bradford at length 
about humidifiers, his home heating sys- 
tem, and hobbies," Rubin says. "But I 
couldn't come up with any exposures 
that would account for his symptoms." 
Finally, Rubin's extensive questioning 
uncovered a clue: The symptoms had 
begun shortly after Bradford's firm had 
moved into new office space. 

The theory, though, had at least two 
glaring problems. Bradford went into the 
office every day during the workweek. 
Why would the symptoms be intermit- 
tent? And why weren't his colleagues get- 
ting sick? 

'When Rubin checked the mainte- 
nance records of the office building's 
HVAC system, he found that the air 
ducts had been blown clean twice. And 
the schedule jibed perfectly with the 
appearance of Bradford's symptoms. 

Rubin's next step was to send a sample 
of Bradford's blood for analysis. He 
ordered a precipitin test to determine 
whether any antibodies in the blood 
would clump — or precipitate — ^with an 
antigen from the bacteria. The blood test 
was negative. 

But Rubin persisted. "I didn't have 
much faith in the test," he says. "If it's 
positive, great, but if it's negative, that 
doesn't necessarily mean anything." So he 
checked the ducts himself. "I put on 
work clothes and climbed up a ladder," 
he says. "I took samples and swabs from 
many areas, especially wet ones." 

Next, Rubin smeared the material 
onto culture plates. Within days, ther- 



mophihc actinomycetes were thriving in 
the culture. Every sample, from every site 
tested, produced them. 

During this phase of the investiga- 
tion, Bradford inadvertently inhaled 
another dose of air from the ducts and 
promptly developed mild symptoms 
again. Another set of x-rays showed a 
reappearance of the same ominous nod- 
ules, clinching the diagnosis. 

But Rubin had one last mystery. Why 
hadn't Bradford's fellow office workers 
also become sick? The full answer to 
this question remains elusive, but other 
building-related clusters of hypersensi- 
tivity pneumonia have shown the same 
phenomenon, suggesting that an indi- 
vidual's degree of exposure and genetic 
predisposition both play roles in deter- 
mining who gets sick. 

After Rubin's investigation, the build- 
ing's ducts were thoroughly cleaned. And 
Bradford, who worked in the buHding 
for four more years, never had another 
bout of the pneumonia. 

"If I get any credit as the patient's 
first physician," said Wilkins during 
a clinical case conference later held 
at Massachusetts General Hospital, "it 
is for picking a detective as well as 
a physician to take over this diagnostic 
problem." ■ 

Jonathan A. Edlow, UD, FACP, is vice chair- 
man of emergency medicine at Beth Israel Dea- 
coness Medical Center and an associate profes- 
sor of medicine at Harvard Medical School. 
These stories were adapted with permission 
from his most recent hook. The Deadly Dinner 
Party & Other Medical Detective Stories 
(Yale University Press, 2009). Edlow is also 
the author of Bull's Eye: Unraveling the 
Medical Mystery of Lyme Disease (Yale 
University Press, 2003). 

The names of the patients in these stories 
are pseudonyms. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



45 



A game- changing Harvard 
program sparks collaborations 
among disparate researchers. 




BY Jessica Cerretani 




^Hw!" 



Despite their ties, Harvard-affiliated hospitals have 

historically competed with one another — for faculty, patients, 
and fiaancial support. This sense of rivalry has meant that the 
thousands of researchers throughout the School and its hos- 
pitals felt not just a physical separation but a symboUc one, 
and they had little motivation to interact with one another. 



That culture has been changing, 
however, and in the past two years, a 
compeUing new force has helped unite 
investigators around one crucial com- 
mon goal: to cure human illness by 
translating basic laboratory research 
into patient care. The Harvard Clinical 
and Translational Science Center, 
better known as Harvard Catalyst, 



46 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 






now sparks innovative collaborations 
among researchers — not just among 
scientists at HMS and its seventeen 
affiliated hospitals and institutions, 
but also throughout Harvard Universi- 
ty's eleven schools. It's a stunning 
achievement, but one that HMS Dean 
Jeffrey Flier believes comes naturally to 
investigators. "We operate on the 



belief," Flier says, "that the people here 
want to come together because they 
really want to make those discoveries 
that save lives." 

In a test of that conviction, Flier 
approached Harvard's affiliates in 2007 
to persuade them to collaborate with 
the shared purpose of advancing clinical 
research. In truth, the affiliates didn't 



have a choice; The National Institutes 
of Health (NIH) had announced that it 
would be phasing out the individual 
clinical research grants historically 
awarded to Harvard's teaching hospi- 
tals. Instead, Harvard would have to 
apply for a five-year, $117.5-million 
award to be shared by HMS and its 
affiliates. Faced with the prospect of 



The team coined an inspired name for the clinical 
and translational science center: Harvard Catalyst. 
The new title evokes images of laboratories, energy, 
and innovation — and that's no accident. 



losing tens of millions of research dol- 
lars, this competitive community had 
to come together. The University and 
its affiliates would need to cede con- 
trol of the grant money — and therefore 
of publicly funded clinical research — 
to HMS. "We needed unprecedented 
support from the University and the 
hospitals," says Flier. "And we got it." 

HMS also got the grant — no small 
feat, considering that the team, spear- 
headed by Lee Nadler 73, dean for clin- 
ical and translational research at HMS, 
had just a hundred days to craft the 
proposal. But getting the grant meant 
the real challenges had just begun. 
"The grant was approved on a Thurs- 
day," Nadler says. "That Sunday morn- 



ing I got a call from the NIH telling me, 
'Okay, you're funded. Start spending.'" 

Bright Ideas 

It was a massive undertaking, but one 
that HMS was eager to tackle. This spir- 
it of collaboration and discovery drove 
the School's approach to the new Har- 
vard Clinical and Translational Science 
Center — admittedly not the catchiest of 
titles. "During our first few weeks of 
funding, it was hard to explain to people 
what the center actually was," says 
Nadler. So the team coined an inspired 
name for it: Harvard Catalyst. The new 
title evokes images of laboratories, ener- 
gy, and innovation — and that's no acci- 



dent. "All the components necessary to 
make an impact on human iUness already 
exist at Harvard," Nadler explains, refer- 
ring to the more than 17,000 investigators 
at the University and its partnering 
institutions. "Unfortunately, few of 
those components have been in the same 
'reaction vessel,' leaving our potential 
wtually untapped." 

The solution was clear: encourage 
researchers to forge novel alliances by 
eliminating obstacles to such collabo- 
rations — in short, unite those 
researchers in one large reaction vessel. 
Key to this process has been the cre- 
ation of Harvard Catalyst's website, 
which connects researchers and facili- 
tates teamwork by detailing investiga- 



written in th 




l»TARS 

Most people approach the prospect of an MRI exam with o 
sense of dread. The coffin-sized quarters and timpani-like racket of 
the machine conspire to create an environment that can make even 
the least claustrophobic patient uncomfortable. 

Now, an innovation by Ronald Walsworth and his group at the 
Harvard-Smithsonian Center for Astrophysics in Cambridge, Mass- 
achusetts, has the potential to make the process more tolerable — 
and accessible. Their open-access, walk-in, low-magnetic field MRI 
system lets patients be scanned while sitting, standing, or lying 
down, a modification that not only promises to ease nerves but 
also allows for more precise imaging of blood flow and airflow, 
which depend on posture. 

The idea for the scanner came to Walsworth, a senior lecturer 
on physics at Harvard and senior physicist at the Smithsonian Insti- 
tution, some 15 years ago when he was developing atomic clocks, 
which use noble gases like helium and xenon to provide precise 
measurements of time and frequency. For Walsworth — whose other 



48 HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



^n&„. 



MAN WITH A PLAN: J 
Lee Nadler leads the | 

Harvard Catalyst teqlini^! 









'^ 



research interests include Einstein's theory of relativity and the 
detection of new planets — the link to medical imaging made per- 
fect sense. "You can easily detect helium and xenon in the body if 
they're magnetized with a laser beforehand and then inhaled or 
injected," he explains. (Standard MRI scanners produce images by 
detecting the body's water and fat within a magnetic field.) 
"Because the gas magnetization is long-lived and done ahead of 
time, it doesn't require the large magnetic fields of conventional 
scanners. You can create an open, walk-in imaging system that 
doesn't affect pacemakers and medical implants, and allows imag- 
ing for all body postures. It's a great spin-off from physics to med- 
ical imaging." 

For several years, Walsworth built and refined the scanner as a 
side project. His available funding, however, could only take him 
so for. "It's hard to get money for things that are transitioning 
between physics and biomedical imaging," he says. "Not many 
programs fund them." Then he learned about Harvard Catalyst. 



If other Catalyst grants have helped connect disparate researchers 
with common goals, Walsworth's award has helped him take his 
invention to the next level by putting it in the hands of physicians. 
The Catalyst grant has paid for the scanner's move from Walsworth's 
lab to Massachusetts General Hospital's Martinos Center in 
Chorlestown, installation of tile flooring in its new home, and 
tweaks to the machine to make it technically optimal. "These are 
grungy, non-sexy things," Walsworth says, but they are changes 
that lay the groundwork — literally — for future clinical research. In 
fact, he recently learned that he will receive funding from the 
National Institutes of Health for pilot lung imaging studies with the 
scanner, thanks in part to the scanner's relocation. 

While frustrating, gaps in funding like those that have stalled 
his progress also present opportunities, soys Walsworth. "We've 
got these well-financed lobs, but it's difficult to bridge to other 
researchers. That's what Catalyst is doing, and I'm very grateful 
for it." ■ 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



49 



WALK 

thi 




IS way 



With obesity at epidemic 
proportions, it's clear that 
physical activity is crucial 
for good health. But what will spur 
confirmed couch potatoes to put down 
the remote and get moving? Massa- 
chusetts General Hospital internist and 
pediatrician Nicolas Oreskovic has 
an inspired suggestion: Create envi- 
ronments that encourage people to 
walk more. 

Oreskovic, also an HMS instructor in 
pediatrics, has previously researched 
the effects of the built environment — the 
layout and location of buildings, walk- 
ways, and roadways — on childhood 
obesity. His findings have been intrigu- 
ing, if not surprising. In a study pub- 
lished in the July 2009 issue of Clinical 
Pediatrics, for example, he and his 
team found an association between 
children's body-mass indexes and the 
distances from their homes to schools 
and subway stations, as well as the 
amount of nearby open space. 



STARTING OFF ON THE RIGHT FOOT: 
Researchers hope to identify 
architectural and design elements 
that inspire physical activity. 



Now Oreskovic is taking his 
research one step further. Working in 
collaboration with colleagues at MGH 
and at the Harvard University Gradu- 
ate School of Design — and funded by a 
pilot grant from Harvard Catalyst — he 
is using functional MRI neuroimaging 
technology to pinpoint just how the 
human brain responds to particular 
architectural and design elements. 
"We're trying to crack the nut of the 
human subconscious by determining 
what promotes the desire to walk," 
says Oreskovic. "If our theory is cor- 
rect, the areas of the brain associated 
with motor function and emotion should 
react positively when a person views 
certain architectural environments." 

The idea of reaching out to 
researchers in seemingly unrelated fields 
isn't new to Oreskovic, who met some of 
his co-investigators when he took courses 
at the design school while pursuing his 
master's degree in public health. Still, he 
acknowledges that such connections 
aren't forged so easily for many of his 
peers. "In medical research we tend to 
work in our own little silos," he explains. 
"Yet there's such a wealth of knowledge 
out there that we could draw from." 

Oreskovic hopes that harnessing this 
knowledge will help guide the develop- 
ment of novel ways to address the obesi- 
ty epidemic, with the ultimate goal of 
using architecture and design to improve 
human health. In the meantime, he's 
thankful for Harvard Catalyst's support 
of this study. "The infrastructure of Har- 
vard Catalyst is what's made this work 
possible — it's been easy and painless for 
me to connect with other researchers," 
he says. "That's unimaginable at many 
other institutions." ■ 



tors' expertise and latest discoveries. 
An updated search engine scours the 
site's pages, applications, and databas- 
es to help visitors locate people, publi- 
cations, clinical trials, and core facili- 
ties affiliated with Harvard. 

This September, a new apphcation 
was added that helps investigators find 
and secure funding by giving them col- 
laborative. Web-based tools for identify- 
ing opportunities, building project 
teams, and developing proposals. The 
apphcation, called Grant Central, con- 
tinues Harvard Catalyst's mission of 
removing barriers to research by stream- 
lining the grant process. Even more func- 
tions for the site are being planned. 

Such cutting- edge technology is 
impressive, but the real test of Harvard 
Catalyst will be its abihty to dehver clin- 
ical and translational science. Judging by 
its performance so far, that goal is in 
sight. In the first round of one-year pilot 
grants this past spring, 218 investigators 
from 23 Harvard schools and hospitals 
received a total of 62 grants of $50,000 
each; a second round of pilot grants 
announced this fall will underwrite an 
additional 65 projects. 

These diverse research teams include 
neonatologists and microbiologists, 
informatics experts and endocrinolo- 
gists, and cancer vaccine speciahsts and 
polymer engineers. Together, these and 
other speciahsts are making bench-to- 
bedside advances: One basic scientist 
who discovered an anticoagulant protein 
in the E coli bacterium, for example, has 
joined v\dth clinicians to explore devel- 
oping that protein into a new class of 
blood-thinning drugs. 

When it comes to Harvard Catalyst, 
however, game-changing collaborations 
Mice these are just the start. Plans to 
teach and assist researchers are also in 
the works. "We're revolutionizing our 
education program by integrating the 
School's master's programs and oEering 
more courses to help investigators apply 
laboratory research to human subjects," 
say Elliott Antman, director of the Har- 
vard Catalyst Postgraduate Education 
Program. "We want young researchers 
to come in with a baseline of knowledge 
and leave with the comprehensive 
knowledge needed to succeed as a clini- 
cal investigator." 

Harvard Catalyst wlU also support 
researchers by pro\'iding access to what 



50 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



Nadler calls a "dream team" of biostatis- 
ticians and other experts who will help 
design, execute, and analyze studies; 
to shared laboratory space; and to pro- 
fessional staff, such as nurses. "This 
approach," says Nadler, "is how you help 
clinical investigators succeed." 

Through Harvard Catalyst, HMS is 
also part of a group of nine institutions 
that recently received a two-year, $15- 
million stimulus grant. The grant will 



fund a new national research resource 
discovery program called the eagle-i 
Consortium, which aims to help inves- 
tigators across the country share scien- 
tific resources critical to advancing 
clinical and translational research. 
"This project is about linking scientists 
nationally to resources, technologies, 
and opportunities," says Nadler, "and 
about making invisible resources visible 
to the researchers who need them." 



For Flier, though, such achievements 
are just the beginning. "These are the 
next generations of researchers we're 
helping train and connect," he says. "This 
work will be transformative." ■ 

Jessica Cerretani is assistant editor of the 
Harvard Medical Alumni Bulletin. 

For more information about Harvard Catalyst, 
visit http://catalyst.harvard.edu. 



•mtlQtlhi rum 



Laws are meant to protect a community, but when it comes to 
immigrants, fears about enforcement policies may be haz- 
ardous to their health. That's the theory posed by Karen 
Hacker, executive director of the Institute for Community Health 
and an HMS assistant professor of medicine. In her work as a 
physician at the Cambridge Health Alliance, Hacker has 
observed firsthand the effects of those fears on her patients: 
missed appointments, unfilled prescriptions, and other forms of 
health care under-utilization that she suspects stem from patients' 
concerns that their immigrant status — whether documented or 
undocumented — might be exposed. 

"What's so amazing about this project in particular," Hacker 
says, "is that members of the community we're studying — Everett, 
Massachusetts — had similar concerns and approached me to work 
with them on this issue. Everett has undergone a huge demographic 
shift in a short period of time." Hacker cites the city's influx of for- 
eign-born residents, including Brazilians, Haitians, and Moroccans. 

Harvard Catalyst provided Hacker with the perfect opportunity 
to reach out to community partners, local representatives of immi- 
grant communities, and other researchers interested in the study. 
"The academic environment doesn't always provide the resources 
for collaboration," she explains. "And this particular area of study 
doesn't fit within mainstream research." 

Armed with a Harvard Catalyst pilot grant, Hacker has been 
able to build those connections and conduct a community-based 
participatory research project. Working with community co-investi- 
gators and investigators at the Harvard School of Public Health, 
the Harvard Kennedy School, and Tufts University, she has assem- 
bled a team of community and academic investigators to explore 
this issue. Their first step was to conduct focus groups of Everett 
residents to discuss the challenges faced by the community. She is 
also planning an electronic survey of some 300 local physicians to 
evaluate their experiences and to seek solutions. 




FEAR FACTOR: Concerns about immigration policies may keep 
patients away from health care providers. 



"We hope to determine what else we can do to assuage 
unfounded fears among immigrants so they take care of their 
health," Hacker says. "We also need to figure out how to help the 
community adjust to demographic changes and heal." 

Although Hacker's ultimate objective is to establish enough pre- 
liminary data to attract funding for larger studies of other commu- 
nities, she's quick to recognize the promise of her current work 
with Harvard Catalyst. "If it turns out that we don't get more fund- 
ing, but Everett has a healthier community," she muses, "have we 
not achieved our goal?" ■ 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



51 



CT.ASS NOTES 



NEWS ABOUT ALUMNI 



F.dmund Meadows 

1 944 "rm living with the after- 
effects of bladder cancer, but 
longevity — for more than 88 
years — has been my strong 
suit. My grandson Jeffrey is 
currently a pediatric interven- 
tional cardiologist." 

Martin Tuhin 



1 945 "In collaboration with my son 
Adam, I have published a new 
strategy for treating many 
tumors, such as lung and pan- 
creatic cancer, glioblastoma, 
melanoma, mesothehoma, 
osteosarcoma, soft-tissue sar- 
coma, and T-cell acute lym- 
phoblastic leukemia. Our 
paper on the topic appeared 
online in FLoS ONE on May 29. 
An abstract of our recent 
mouse studies was presented 
this past April at the annual 
meeting of the American Asso- 
ciation for Cancer Research. 
We now hope to find major 
funding to support extensive 
animal testing, and we wel- 
come suggestions for obtain- 
ing funding quickly." 

William Owen 



1 949 "Margaret and I continue to be 
in good health, although I have 
a touch of chronic obstructive 
pulmonary disease, which 
slows down my ability to play 
tennis and golf. Sorry to have 
missed the 60th reunion. I plan 
to catch the 65th, God willing." 

Herbert Ausubel 



dren. Ian and his fiancee are 
plarming their wedding. 

"My greatest joys have been 
seeing our children become 
productive members of society 
and h\'ing to see the next gen- 
eration. The love of medicine 
keeps me in active practice, 
and having my son working 
with me is something special. 
The Almighty has blessed 
Stephanie and me with health 
sufficient to maintain an 
active lifestyle — to travel 
through the Andes mountains, 
to talk to students at a univer- 
sity in an Islamic country on 
Israel and the Arab world, to 
visit Vietnam and observe the 
changes that have taken place 
in that country. By nature, I 
am an optimist and so I wall 
not dwell on the negatives. 
Instead, I will focus on my 
prayer for true peace in the 
Middle East. 

"And now my second task 
the completion — and pubUca- 
tion — of the six -book series on 
the ancestors of our children, 
which will serve as a micro- 
cosm of the history of the Jew- 
ish people over three mOlennia." 

Ralph Heising 



1955 "My beloved wife of 54 years, 
Nancy, died on December 11, 



1954 "I remain in active practice 

with my son. Dr. Ian Ausubel, 
and two other associates. My 
daughter. Dr. Lara Ausubel, 
has moved from the Brigham 
in Boston to the City of Hope 
in Duarte to continue her 
research, necessitating trips to 
California to see our grandclul- 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 




2008, of respiratory failure. 
She is sorely missed." 

John Laszlo 

"I'm happy to say that all goes 
well with our family. I'm still 
playing tennis, despite my 
artificial knees, and am glad 
to be active. Pat and I had a 
wonderful trip through II 
national parks in Utah and 
Arizona. I am currently 
engaged in interesting con- 
sulting work on DNA vac- 
cines and electroporation." 

Ernest Picard 

"I continue to serve in a vol- 
unteer job with the Serving 
the Health Information Needs 
of Elders (SHINE) program 
and am staying out of trouble. 
Joyce and I had our 55th 
anniversary this year!" 

Mitchell Rabkin 

recently coauthored an opin- 
ion piece on health care 
reform, which was pubhshed 
on the website of the Ameri- 
can Academy of Arts and Sci- 
ences, where he is a fellow. 

John Grnver 



1 956' "Plullipa and I are well (fin- 
gers crossed at the moment) 
and are awaiting results of 
dehberations by President 
Obama and Congress on 
health care. We should worry 
less about government's role 
in health care and more 
about the power of health 



Arnold Katz 

"I am now an HMS visiting 
professor of medicine, as I 
gave three lectures on cardiac 
physiology and heart failure 
as part of the second-year 
core curriculum. Looking up 




^^ 



iiii 

i i I i 

Pill 




at where I sat 55 years ago 
was spooky." 

John Ross 

"I recently headed up a group 
of professors at the Universi- 
ty of Florida to create a com- 
munity-based, free educa- 
tional seminar called 'What 
Parents and Adolescents 
Need to Know About Health 
and Competitive Sports,' 
which attracted more than 
500 attendees." 

Mark Perlroth 



1 960 "I am acclimating to retire- 
ment. I am busier than I 
thought I would be and con- 
tinue to attend the same 
weekly conferences at Stan- 
ford as before. I see Rex 
Jamison '60 regularly at 
Grand Rounds and I try to 
communicate — mostly by 
email — ^with some of our 
classmates. My health is 
good and Karen and the kids 
are well and busy." 

Herbert Eenson 



1 96 1 was named the 2009 recipient 
of the Mani Bhaumik Award 
by the Cousins Center for 
Psychoneuroimmunology at 
the University of California, 
Los Angeles. The award is 
presented each year to an 
individual who advances 
understanding of the mind's 
role in health and healing. 

Norman Cohen 
"This spring, our daughter 
Celine gave birth to a baby 
boy, William Heath Stum- 
bles, in Sydney, Australia. In 
addition, I was chosen to 
receive the Kaiser Award for 
Excellence in Teaching by 
the volunteer clinical faculty 
at the University of Califor- 



nia, San Francisco Medical 
School. I teach at the San 
Francisco VA Medical Center 
in the hematology-oncology 
clinic once a week." 

Yeu-Tsu Lee 

"Aloha to my classmates! 
Since my retirement in 1999, 
I have kept busy by traveling 
to Taiwan three times a year 
to teach medical students 
and train surgical residents. 
I have also made medical 
missions to Honduras, Laos, 
and the Philippines. See you 
at our 50th reunion in 2011!" 

James Reck 



John Mills 



1 963 "My wife, Susan S. Beck, JD, 
HLS '68, died March 7 after a 
long illness. We have posted 
photos of Susan and a record- 
ing of the funeral service to 
the Web. If you would like the 
Web address, please write me 
at jbeckl@partners.org." 

David Sachar 

dehvered both the keynote 
and concluding addresses at 
the Third International Sym- 
posium on Biomolecular Tech- 
nology at Shahid Beheshti 
University of Medical Sciences 
in Tehran, Iran, in May. 

Frank WiHiams 



1 964 "I continue to practice med- 
ical and surgical ophthalmol- 
ogy in Clearwater, Florida, 
and do volunteer medical 
teaching and eye surgery in 
Bhutan twice yearly. A high 
point of my visit there in 
November 2008 was attend- 
ing the coronation of the 
fifth king of Bhutan as a 
guest of the royal family. 
Jackie and I also visited 
Zambia and Botswana 
that summer." 



1965 "I'm enjoying my work in 
many different environ- 
ments — medical practice, 
virology research, diagnostic 
lab services, and biotechnolo- 
gy. My wife and I traveled to 
Laos in July where we partic- 
ipated in an HIV training 
course with our daughter, 
Christina, who has worked in 
a pediatric hospital there for 
a few months." 

James Nelson 

"My retirement is spiced up 
by my work as a partner in a 
small biomedical venture 
capital firm. I developed a 
new catheter design and have 
a new MRI contrast media 
grant in progress. Working 
on the NIH Challenge Grants 
provided a little Ught reading 
this summer!" 

Harold Sox 

is retiring as editor of the 
Annals of Internal Medicine after 
eight years in the position. 
He is considered a leader in 
the field of health policy. 

David Bergman 

1 966 "I recently started a new 
position as medical director 
of Casa Pahnera, a residential 
treatment center in Del Mar, 
California, that specializes 
in the care of people with 
addiction, eating, mood, 
and chronic pain disorders. 
Although I am retired from 
office practice, I continue to 
teach at the University of San 
Diego Medical School, where 
I'm an associate chnical pro- 
fessor of psychiatry." 

Wilham Shipley 

is a co-recipient of the 2009 
ASTRO (American Society for 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 




CLASS NOTES 



NEWS ABOUT ALUMNI 



Radiation Oncology) Gold 
Medal Award, presented annu- 
ally to two individuals for 
achievement in the field of 
therapeutic radiology and 
oncology. Shipley is chair of 
the genitourinary oncology 
unit at Massachusetts General 
Hospital and is the Andres 
Soriano Professor of Radiation 
Oncology at HMS. 

Thomas GutheH 



1 967 "After two years as president 
of the International Academy 
of Law and Mental Health 
(the international forensic 
psychiatric organization), I 
turned over the job to my suc- 
cessor at the organization's 
annual congress in New York 
in June. I was then honored by 
the estabhshment of the Prix 
Thomas Gutheil, to be award- 
ed every two years for high 
achievement in the area of 
chnical forensic practice and 
given this year to Jacques Tal- 
bot, a forensic psychiatrist at 
the Institut Philippe-Pinel de 
Montreal in Quebec, Canada." 

Eric Chivian 



Library journal. Chivian directs 
the HMS Center for Health 
and the Global Environment. 

Stephanie Pincus 

was recently named to the 
Board of Directors for the 
Center for Exploratory and 
Perceptual Art in Buffalo, 
New York. She is also the 
founding director of the 
RAISE Project, which aims 
to ensure that notable 
women are nominated for 
national awards in science, 
medicine, and engineering. 

Ralph Steinman 

was one of three doctors to 
be awarded the 2009 Albany 
Medical Center Prize in 
Medicine and Biomedical 
Research, the largest national 
award in medicine. Steinman, 
who received the award for 
his groundbreaking work in 
immunology, is the Henry G. 
Kunkel Professor of Cellular 
Physiology and Immunology 
at Rockefeller University in 
New York City. 

Martin Crane 



authority in the field of med- 
ical regulation. Crane is the 
former chair of the Massachu- 
setts Board of Registration 
in Medicine. 

Harvey V. Fineberg 



1971 was honored in June with the 
Harvard Medal, which recog- 
nizes extraordinary service to 
the University. Fineberg is a 
former dean of the Harvard 
School of Pubhc Health and 
the current president of the 
Institute of Medicine. 

Joel Greenberger 

"Our first-born, Rachel, is 
now in medical school. Emily 
begins her second year at 
Dartmouth, Josh is at the 
University of Pittsburgh 
School of Pharmacy, and Ben 
is a junior in pre-med at Har- 
vard. I continue to research 
new anti-radiation drugs and 
stem- cell transplantation for 
irradiation injury. I am begin- 
ning year 17 of my chairman- 
ship in radiation oncology at 
the University of Pittsburgh 
School of Medicine." 



1 968 had his book, Smtaming Life. 
How Human Health Depends on 
Biodiversity, named one of the 
best biology books of 2008 by 



1 969 has assumed chairmanship of 
the Federation of State Med- 
ical Boards, a nonprofit orga- 
nization that is the national 



Peter Rowley 



1972 was recently awarded a grant 
from the Angehnan Syndrome 
Foundation. His research will 




HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



focus on identifying the sub- 
strates and pathways for the 
neuronal pathogenesis under- 
lying Angelman Syndrome, a 
neurogenetic disorder. 

James Kirklin 



1 973 was elected president of the 
International Society for 
Heart and Lung Transplanta- 
tion, a multidisciplinary pro- 
fessional organization dedi- 
cated to improving the care of 
patients with advanced heart 
or lung disease through 
research, education, and 
advocacy for transplantation, 
mechanical support, and 
innovative therapies. Kirklin 
is currently director of the 
University of Alabama at 
Birmingham's Division of 
Cardiothoracic Surgery. 

David Mauritson 



1 974 "I graduated from the J. D. 

Birmingham School of Law in 
May 2008 and am currently a 
partner in the law firm of 
Grammer and Mauritson in 
Northport, Alabama. Lve kept 
my day job in cardiology 
because my daughter decid- 
ed — at age 30 — to go to med- 
ical school. I also remain an 
active flight instructor in air- 
planes, helicopters, gliders, 
and gyroplanes." 

Christopher Rose 

"Randi and I are sorry we 
missed the reunion. I am still 
trying to demonstrate the 
utility of electronic medical 
records to analyze the 
processes and outcomes of a 
large radiation oncology prac- 
tice. I hope this will help 
identify best practices and 
improve cancer care incre- 
mentally. We welcome visits 
from classmates who are in 
Southern California." 



Frank Valone 

was named chief medical oEi- 
cer of FibroGen, Inc., a San 
Francisco, CaMornia-based 
company that researches 
treatments for such conditions 
as tissue-fiber disorders and 
diabetic complications. 

JudyAnn Bigby 



1 978 received the 2009 Ruth M. 
Batson Social Justice Award 
from the HMS Office for Diver- 
sity and Community Partner- 
ship. Bigby is the Massachu- 
setts secretary of health 
and human services. Before 
accepting that position, she 
was director of community 
health programs at Brigham 
and Women's Hospital. 

William Frist 

has joined Aegis Sciences 
Corp., a Nashville, Teimessee- 
based forensic chemical and 
drug-testing laboratory, as a 
health care advisor. 

Daniel Podolsky 

is the recipient of the Ameri- 
can Gastroenterological Asso- 
ciation's 2009 Juhus Frieden- 
wald Medal for Distinguished 
Service in the field of gastro- 
enterology. He is currently the 
president of the University of 
Texas Southwestern Medical 
Center in Dallas. 

John Kelly 



1 979 has been named chief medical 
officer of lifechnic Internation- 
al, where he develops strategies 
to improve the health and well- 
ness of those who use the com- 
pany's blood pressure moni- 
tors, health stations, and health 
management systems. 

Samuel Stanley, J r. 

1 980 is the new president of Stony 
Brook University in New 




York. He was previously the 
vice chancellor of research at 
Washington University in 
St. Louis, Missouri. 

Jame.s O'ConneH 



1 982 was named the J. H. Kanter 

Prize Laureate in August, hon- 
oring his work in health care 
dehvery for low- income and 
homeless people around 
Boston. The prize provides 
$100,000 to allow O'Connell 
to continue his work. 

Robin Avery 



1985 "The transplant programs at 
the Cleveland Clinic are rapid- 
ly expanding, which keeps me 
busy. My husband, Mike Lauer, 
is now a division director at the 
National Heart, Lung and Blood 
Institute and commutes from 
Cleveland, Ohio, to Washing- 
ton, DC. Our sons, Nathan 
and Danny, are 17 and 15." 

Jim Yong Kim 



1986 became president of Dartmouth 
College in July. Kim was pre- 
viously the chair of the HMS 
Department of Global Health 
and Social Medicine, HMS 
professor of global health 
and social medicine, and the 
Frangois-Xavier Bagnoud 
Professor of Health and 
Human Rights at the Harvard 
School of Pubhc Health. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



CT.ASS NOTES 



I NEWS ABOUT ALUMNI 



Malcolm Reid 



1987 "I was recently appointed to 
serve on the New York State 
Hospital Re\iew and Planning 
Council. I am the chairman of 
the Department of Rehabihta- 
tion Medicine and an associate 
medical director at St. Luke's 
Roosevelt Hospital Center in 
New York City." 

Laurence Ronan 

received the 2008 Lifetime 
Achievement Award from the 
HMS Office for Diversity and 
Community Partnership for his 
work as director of the Thomas 
S. Durant, MD, Fellowship for 
Refugee Medicine program. 
Ronan is an HMS instructor in 
medicine at Massachusetts 
General Hospital. 

Richard Waldmann 

"I am enjoying family life in 
Milton, Massachusetts, with 
my wife, Janet, and our two 
children, Jonathan (age 5) 
and Clarissa (age 7). I work 
in a neonatal intensive care 
unit with a sideline in equi- 
ties trading." 

Paul Farmer 



1 990 was awarded the Lois Pope 
LIFE International Achieve- 
ment Award in February. The 
award honors his work in 
treating infectious diseases in 
impoverished nations. Farmer 
also succeeds Jim Yong Kim 
'86 as chair of the HMS 
Department of Global Health 
and Social Medicine. 

John Nash 

"Susan and I are enjoying rais- 
ing our six children, ranging 
from a toddler to teenagers. 
My work is very rewarding 
despite being very busy. I 
work in medical administra- 
tion in my 'spare' time." 



Robert Friedlander 

1991 was named HMS professor of 
neurosurgery in 2008. He is 
vice chairman of the Depart- 
ment of Neurosurgery at 
Brigham and Women's Hospi- 
tal and was recently appoint- 
ed to the National Advisory 
Council of the National Insti- 
tute of Neurological Disor- 
ders and Stroke. 

Andrew Sussman 

was recently appointed the 
president/chief operating offi- 
cer of CVS MtnuteClinic and 
senior vice president/associate 
chief medical officer of CVS 
Caremark. 

Rafael Campo 



1 992 received the 2009 Nicholas E. 
Davies Memorial Scholar 
Award for humanism in med- 
icine from the American Col- 
lege of Physicians. In July, he 
was also appointed director 
of the Office of Multicultural 
Affairs at Beth Israel Deaconess 
Medical Center, where he is 
an HMS associate professor 
of medicine. 

Pratik Multani 

has become vice president of 
chnical development at Fate 
Therapeutics, Inc., where he is 
leading upcoming chnical tri- 
als of stem cell modulators, 
small molecules, and biologies 
that guide cell fate for thera- 
peutic purposes. 

Lisa Clark Pickett 

1 994 was recently appointed chief 
medical officer of Durham 
Regional Hospital in Durham, 
North Carolina. She is also co- 
director of the Critical Care 
Unit, chief of the Division of 
General Surgery, and graduate 
education medical director for 
surgery at that hospital. 



B. Price Kerfoot 

1 996 developed a new learning 

technology platform, "Spaced 
Education," or SpaceEd, 
which Harvard recently 
adopted. Kerfoot is an HMS 
associate professor of surgery. 

Deborah Hung 



1997 received the 2009 American 
Society for Microbiology 
Merck Irving S. Sigal Memor- 
ial Award for her work in the 
microbiology of common 
infectious diseases. 

Howard Chang 



1 999 was named an Early Career 
Scientist by the Howard 
Hughes Medical Institute. 
Chang, a dermatologist at the 
Stanford University School of 
Medicine, v^dll receive a six- 
year appointment to the insti- 
tute as well as a $1.5-million 
research budget. 

Glenda Callender 

2000 "I finished my general surgery 
residency at the University of 
Chicago Hospital in 2007 and 
am currently completing fel- 
lowships in surgical oncology 
and endocrine surgery at the 
M. D. Anderson Cancer Cen- 
ter in Houston, Texas." 

M artin Burke 



2002 was named an Early Career 
Scientist by the Howard 
Hughes Medical Institute. 
He is a chemical biologist 
at the University of Illinois at 
Urbana-Champaign. 

Oni Blackstock 



2004 was one of two physicians 
awarded the 2009 Minority 
Clinical Fellowship Award by 
the HIV Medicine Associa- 
tion. She is a resident at 
Montefiore Medical Center 
in Bronx, New York. ■ 




HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



DANIEL C. TOSTESON, 1925-2009 | 



TN MEMORTA 




S DEAN OF HARVARD MEDICAL SCHOOL, DANIEL 

Tosteson '48 had an overarching ambition: to 
smooth the paths its students and facuky 
walked. Dan succeeded in paving estabhshed 
routes for the HMS community during his tM'o decades 
in the post, from 1977 to 1997 He also created some nev^ 
paths on his own. 

Dan died at the age of 84 on May 27, 2009 at his home in 
Boston after a brave struggle with Parkinson's disease. He is 
best known for bringing about 
radical changes to the School's 
approach to medical education — 
which carried the cognomen 
New Pathways. Its purpose was 
to create a hfelong love for learn- 
ing medicine and to prepare the 
School's students for the changes 
in medical practice they would 
surely encounter. Dan built the 
medical education center that 
now bears his name to house this 
curricular reform. It included 
student societies that became 
centers for student-faculty 
exchange; rooms for student-dri- 
ven case- analysis sessions that 
were intrinsic to the educational 
process; and new and updated 
classrooms and lecture haUs. 

A passionate supporter of the 
sciences basic to medicine, Dan 
strengthened the HMS Quad- 
rangle departments by recruit- 
ing eminent scholars as depart- 
ment heads, increasing the 
scope and size of the faculty, and providing faculty 
researchers with new laboratory spaces. He promoted an 
organization of departments that reflected the thrust of 
contemporary biomedical research as opposed to a reca- 
pitulation of a list of obsolete course titles. He also pro- 
vided for an increasing number of graduate students in 
the Division of Medical Sciences and a more coherent 
framework for their courses of study. 

Dan estabhshed two departments that helped acknowl- 
edge the importance of the social sciences to medicine: the 
Department of Social Medicine, since renamed Global 
Health and Social Medicine, and the Department of Health 
Care Pohcy And he founded the Department of Ambulato- 
ry Care and Prevention (now Population Medicine), which 
underscored how important it was for medical education 
to include experience with non-hospitalized patients. 

Dan beheved in sharing the lessons learned at HMS with 
the broader medical and scientific community. This attitude 




led to several national and international initiatives, includ- 
ing the Harvard Macy Institute for medical educators and 
the Giovanni Armenise-Harvard Foundation for promoting 
collaboration v/ith scientists at leading institutions in Italy. 
Despite his many accomphshments, Dan had his share of 
frustrations and unfulfilled wishes. He had hoped that the 
student societies would serve as a source for curricular inno- 
vation, yet, except for contributions by the Harvard-MIT 
Division of Health Sciences and Technology (now the London 
Society), this did not happen. Fear- 
ing an unhealthy competition for 
patients, Dan also sought to build a 
plan for cooperative activity among 
the School's affiliated hospitals. 
This initiative too was blunted. 

His interest in the natural and 
life sciences was early and intense. 
During college and medical 
school, Dan was intrigued by salt 
and water homeostasis and took a 
year off from his medical school 
studies to work with the cardio- 
vascular physiologist Eugene 
Landis. During his residency at 
The Presbyterian Hospital in New 
York City, Dan became curious 
about red-blood-ceU transport, a 
focus that led to an enduring 
interest in general physiology and, 
in particular, membrane biology. 
He continued to work with arti- 
ficial and red-blood- cell mem- 
branes during his fellowships in 
Brookhaven and Cambridge and 
at the National Institutes of 
Health and, subsequently, during faculty stays at Wash- 
ington and Duke universities. He brought that interest, 
one he shared with his wife, Magdalena, to HMS when he 
returned as its dean. 

Dan loved to talk about biomedical science, and his 
enthusiasm for discovery was infectious. He was a great 
advocate for HMS; he took its causes seriously and wanted 
his hsteners to feel them also. This sincerity is what made 
him such an effective spokesperson and fundraiser; under 
his stewardship the School's endowment burgeoned. 

Dan is survived by his wife; a brother, Thomas; his sons. 
Tor and Joshua; his daughters, Ingrid, Zoe, Heather, and 
Carrie; and five grandchildren. They are joined by many 
others in mourning the loss of his company. ■ 

S. James Adchtdn '53, the Paul C. Cabot Distinguished Professor of 
Medical Biophysics at Harvard Medical School, served as executive 
dean for academic programs under Daniel Tosteson. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



57 



^ 



OBTTTJARTES 



I COMMEMORATING DISTINGUISHED LIVES 



Emerson Day 



1938 Died October 21, 2008, at the 
age of 95, in WiLmette, Illi' 
nois. Day served as a flight 
surgeon for the U.S. Army Air 
Forces' Air Transport Com- 
mand during World War II. 
He was director of the Strang 
Cancer Prevention Clinic 
from 1950 to 1963 and chief of 
the preventive medicine divi- 
sion at the Sloan-Kettertng 
Institute from 1954 to 1964, 
both in New York City. Day 
was also a professor of medi- 
cine at Northwestern Univer- 
sity and an attending and vis- 
iting physician at Northwest- 
ern Memorial Hospital in 
Chicago. Day was predeceased 
by his first vvdfe, Ruth. He is 
survived by his second wife, 
Gerry; five children. Tad, Bob, 
Nancy, Bonnie, and Shery; 
thirteen grandchildren; and 
four great-grandchildren. 

Laurence G. Wesson 

1 942 Died September 2, 2008, at 

the age of 90, in Scarborough, 
Maine. A leading authority on 
kidney physiology. Wesson 
was also an expert in ento- 
mology. During World War II, 
he was an artillery battalion 
surgeon v^dth the rank of cap- 
tain in the U.S. Army. He was 
among the first Americans to 
hberate the Dachau concen- 
tration camp. After leaving the 
Army Wesson held various 
teaching positions at New 
York University College of 
Medicine. In 1962 he accepted 
an appointment as a professor 
of medicine to create the Divi- 
sion of Nephrology at Jeffer- 
son Medical College in 
Philadelphia. He pubhshed 
the standard textbook Physiol- 
ogy of the Human Kidney in 1969, 
and he retired in 1987. Wesson 
is survived by his wife of 60 



years, Eleanor; four children, 
Laurence, Anne, Robert, and 
John; and eight grandchildren. 

Douglas R. Morton 



1 944 Died September 9, 2008, at 
the age of 88, in Elgin, Illinois. 
Board certified in general, 
thoracic, and cardiovascular 
surgeries, Morton ran a pri- 
vate general surgical practice 
in Elgin. He served in the 
U.S. Army and was chief 

of surgery at Eort George 
Wright in Spokane, Washing- 
ton. He is survived by his v/ife 
of nearly 65 years, Mary; their 
children, Douglas, Jr., Carol 
Eletcher, Sarah Semich, and 
Bruce; nine grandchildren; 
and four great-grandchildren. 

H. Stanley Bennett 

1945 Died October 4, 2008, at the 
age of 87, in Lake Oswego, 
Oregon, of a ruptured abdomi- 
nal aortic aneurysm. Bennett 
served two years with the U.S. 
Army Medical Corps in post- 
World War II Germany. In 
1953 he helped form Associat- 
ed Physicians, a multispecialty 
clinic. After retiring in 1986, 
Bennett and his wife moved to 
Togo, where, as a Peace Corps 
doctor, he oversaw health care 
for volunteers in Togo, Benin, 
and Ghana. After moving to 
Lake Oswego in 1988, he con- 
tinued his volunteer service at 
the Old Town Chnic in Port- 
land, Oregon. Bennett was 
predeceased by a son, James. 
He is survived by his wife 

of 65 years, Mildred; a son, 
David; a daughter, Barbara 
Berger; five grandchildren; and 
one great-grandchild. 

D. Carleton Gajdusek 

1 946 Died December 12, 2008, at 

the age of 85, in Tromso, Nor- 
way. Gajdusek won the 1976 



Nobel Prize in medicine for 
his work on what are now 
known as prion diseases. In 
1951, Gajdusek was drafted 
into the U.S. Army and was 
sent to the Walter Reed Army 
Medical Service Graduate 
School as a research virolo- 
gist, spending time at the 
Institut Pasteur in Tehran. He 
later traveled to Austraha, 
where he performed postdoc- 
toral work at the Walter and 
Eliza Hall Institute of Med- 
ical Research. It was on his 
way home from that trip that 
Gajdusek learned of the Fore 
tribe of New Guinea, which 
was slowly being wiped out 
by kuru, a degenerative brain 
disease. In 1957, he identified 
the tribe's custom of eating 
the infected bodies and brains 
of deceased members as the 
cause of kuru, a discovery 
that won him the Nobel Prize 
19 years later. Gajdusek led 
the brain studies laboratory 
at the National Institute of 
Neurological Disorders and 
Stroke from 1970 untiil 1997 
He is survived by many 
adopted sons and daughters 
and two nephews. 

John M. R. Rruner 



1 949 Died May 28, 2008, at the age 
of 82, in Groton, Massachu- 
setts, of pancreatic cancer. 
Bruner served as a medical 
officer in the U.S. Navy during 
the Korean War before set- 
tling in Groton, where he 
practiced medicine for ten 
years. He specialized in anes- 
thesiology at what was then 
Peter Bent Brigham Hospital. 
He was later on the Massa- 
chusetts General Hospital 
staff and taught at HMS. 
Bruner is survived by his wife 
of 58 years, Barbara; three 
children. Temple Bruner 



58 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



Staples, John, and Bradford; 
and six grandchildren. 

Robert Byron Giles, Jr . 



1 949 Died December 16, 2008, at the 
age of 87, in Dallas, Texas. Giles 
was the former chief of staff at 
Presbyterian Hospital in Dallas 
and a former assistant professor 
of medicine at the University of 
Texas Southwestern Medical 
School. During World War II, 
he did research in the nuclear 
physics department at the 
Massachusetts Institute of 
Technology for the War Man- 
power Commission. He served 
as a first lieutenant in the 
8228th MASH unit during the 
Korean War; he received a com- 
mendation for his work in the 
unit's hemorrhagic fever center. 
Giles later had a private internal 
medicine practice in Dallas for 
40 years. Giles was predeceased 
by his first wife, Patricia, in 
1992. He is survived by his sec- 
ond wife, Ann; four children, 
Caroline Banks, Ben, Richard, 
and Phoebe; five grandchildren; 
and three great-grandchildren. 

Albert R Hendler 

1 949 Died November 17, 2008, at 
the age of 82, in Dallas, Texas. 
Hendler's internship and resi- 
dency were interrupted by his 
two years of service in the U.S. 
Army Medical Corps. He later 
spent one year at the Dallas Vet- 
erans Administration Medical 
Center before opening a private 
internal medicine practice in 
Casa linda. Hendler was the pri- 
mary medical support for the 
first open heart surgery per- 
formed at Baylor Hospital in Dal- 
las. He was a clinical professor of 
medicine at the University of 
Texas Southwestern Medical 
School from 1970 until his 
retirement in 1999. Hendler 
was predeceased by his son 



Charles in 2006. He is survived 
by his wife of 60 years, Pauhne; 
seven children, Robert, 
Richard, Katherine Huske, 
Gloria, Thomas, Sarah Feagin, 
and Pauhne Pagel; and 19 
grandchildren. 

T-ewis Rloomingdale 



1950 Died December 8, 2008, at the 
age of 89, in Norwood, Massa- 
chusetts, of an intestinal 
obstruction. Bloomingdale 
was a psychiatrist whose 
grandfather founded the 
Bloomingdale's department 
store chain. He served as a 
chemical engineer with the 
U.S. Army in the Pacific the- 
ater during World War II. 
Bloomingdale had a private 
practice in Scarsdale, New 
York, with his wife, Eileen, a 
clinical psychologist. He 
retired in 1998. Bloomingdale 
was also president of the Psy- 
chiatric Society of Westchester 
and taught on the faculty of 
New York Medical College 
for many years. His major 
research interest was atten- 
tion deficit hyperactivity dis- 
order, which he traveled to 
four other continents to study. 
Bloomingdale was prede- 
ceased by his wife in 2000. He 
is survived by a son, Kerry '77; 
three grandchildren; and a 
great- granddaughter. 

Thomas B. Hayes 

1950 Died August 24, 2008, at the age 
of 86, in North Andover, Massa- 
chusetts. Hayes served as a 
pharmacist mate and neuropsy- 
chology technician in the U.S. 
Navy during World War II and 
as a post surgeon in the U.S. 
Army in Japan during the Kore- 
an War. Hayes was chief of 
surgery at Lawrence General 
Hospital from 1965 to 1968 and 
president of Bon Secours Hospi- 



tal in Methuen, Massachusetts, 
from 1971 to 1973. He also served 
as that hospital's director of 
emergency medical services. 
Hayes is survived by his wife, 
Loretta Spires; his daughters, 
Judi Mancini, Mary Beth Hayes 
Rentschler, and Cathy Hayes 
Lee; his sons, Thomas, Jr., 
Michael, Kevin, John, Daniel, 
Brian, and Patrick; fourteen 
grandchildren; and six great- 
grandchildren. 

Federico Mora 



1950 Died October 9, 2008, at the age 
of 82, in Albuquerque, New 
Mexico. Mora received training 
in general surgery and neurolo- 
gy at Massachusetts General 
Hospital before serving two 
years in the U.S. Air Force as a 
neurosurgeon. He ran a private 
neurosurgery practice in Albu- 
querque from 1959 until 1995. 
Mora held staff appointments at 
BernahHo County Indian Hos- 
pital, BernahUo County Medical 
Center, and the Albuquerque 
Veterans Administration Med- 
ical Center. After closing his 
practice. Mora participated in 
neurosurgical missions to 
Guatemala, his birthplace, 
sponsored by Healing the Chil- 
dren. He also dedicated many 
hours to preparing paleontolog- 
ical specimens for the New 
Mexico Museum of Natural 
History and Science. Mora is 
survived by his vwfe of 57 years, 
Virginia; his children, Federico 
III, Clara Luz Nixon, Ana Maria 
Waller, Claudia Riciputi, and 
Juan; nine grandchildren; and 
one great-grandchild. 

Fvelyn Waitzkin 



1 950 Died October 21, 2008, at the 
age of 90. A psychiatrist, 
Waitzkin was a member of the 
second class of female stu- 
dents at HMS. She was prede- 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



59 



ORTTTIARTES 



I COMMEMORATING DISTINGUISHED LIVES 



ceased by her husband, Leo. 
Waitzkin is sur\ived by three 
daughters, Ellen, Carol, and 
Susan; and five grandchildren. 

Christopher C Fordham TIT 

1951 Died August 14, 2008, at the 
age of 81, in Chapel Hill, 
North Carolina. Fordham was 
a former chancellor of the 
University of North Caroli- 
na-Chapel Hill. He joined 
that university's medical 
school in 1958 and became its 
dean in 1971. As chancellor 
from 1980 to 1988, he helped 
create the Area Health Educa- 
tion Centers program, a col- 
lection of rural medical cen- 
ters across North Carolina. He 
also oversaw a major under- 
graduate curriculum revision 
and a renewed focus on pri- 
vate giving. Fordham is sur- 
\Tived by his wife, Barbara; 
three daughters, Pam Ford- 
ham Richey, Susan Fordham 
CroweU, and Betsy Fordham 
Templeton; six grandchildren; 
and seven great-grandchildren. 

H. Douglas Collins 

1952 Died October 14, 2008, at the 
age of 80, in Hanover, New 
Hampshire, of Alzheimer's 
disease. After a public health 
service stint in Anchorage, 
Alaska, he established a pri- 
vate practice in Caribou, 
Maine. From 1975 to 1980, he 
directed the Central 
Maine-Dartmouth Family 
Practice Residency in Augus- 
ta. Collins was predeceased 
by his first wife, Helen. He is 
survived by his second wife, 
Mary; his children, Herschel, 
Gordon, and Linda; his 
stepchildren, Thomas Dress- 
er, Peter Dresser, and Jane 
Howe; eight grandchildren; 
six step-grandchildren; and 
one great-grandchild. 



Thomas F. Dolan, J r. 

1953 Died September 28, 2008, at 
the age of 80, in Madison, 
Connecticut, after a prolonged 
iUness. Dolan completed his 
medical training at Children's 
Hospital Boston and at the 
National Institutes of Health 
in Bethesda, Maryland. He 
spent 40 years on the active 
faculty of the Yale School of 
Medicine and as an attending 
physician at Yale-New Haven 
Hospital in Connecticut. He 
was also director of Yale's cys- 
tic fibrosis clinic for 25 years. 
He was a past president of the 
American Academy of Pedi- 
atrics. Dolan was prede- 
ceased by his wife, Margaret, 
and a son, Christopher. He is 
survived by three daughters, 
Karen Garner, Maureen, and 
Evelyn; a son, Kevin; and four 
grandchildren. 

Jay Katz 



Sally and Amy Goldminz; two 
stepdaughters, Mary Whit- 
field and Emily Whitfield; 
and four grandchildren. 

Robert Katzman 



1953 Died November 17 2008, at 
the age of 86, in New Haven, 
Connecticut, of heart failure. 
A physician who focused on 
medical ethics, Katz taught 
psychiatry at Yale School of 
Medicine and was assistant 
professor of psychiatry and 
law at Yale Law School untH 
his retirement in 1993; he con- 
tinued to teach as an emeritus 
professor. In 1972, Katz was 
named to a federal panel to 
investigate the 1932 Tuskegee 
Syphihs Study. The panel 
described the study as "ethi- 
cally unjustified," yet Katz 
beheved the report didn't go 
far enough, stating that study 
participants had been 
"exploited, manipulated, and 
deceived." Katz was prede- 
ceased by his first wife, Esta, 
in 1987 He is surw'ed by his 
second wife, Marilyn Arthur; 
his son, Dan; two daughters, 



1953 Died September 16, 2008, at 
the age of 82, at his home in La 
JoUa, California, after a long 
iUness. An internationally 
known leader in Alzheimer's 
disease research, Katzman 
served as the chair of neurolo- 
gy at the Albert Einstein Col- 
lege of Medicine in the Bronx 
from 1964 to 1984, when he 
helped estabhsh the Shiley- 
Marcos Alzheimer's Disease 
Research Center at the Uni- 
versity of California, San 
Diego. Katzman held the Flo- 
rence Riford Chair for 
Research in Alzheimer's Dis- 
ease there from 1984 until his 
retirement in 1995. He co-edit- 
ed Basic 'Neurochemistr}' in 1972. 
Four years later, his landmark 
editorial in Archives ofNcuwlogy 
was the first to state the 
prevalence and severity of 
Alzheimer's disease. He was 
also a founder of the national 
Alzheimer's Association and 
served as president of the 
American Neurological Asso- 
ciation in 1985. Katzman is 
survived by his wife, Nancy; 
two sons, David and Daniel; 
and one grandson. 

Donald P. Zangwill 

1 953 Died October 7 2008, at the 

age of 80, in Mt. Lebanon, 
Pennsylvania, of mesothelioma. 
Zangwill worked in private 
practice in internal medicine 
for 35 years before retiring in 
2000. He was a frequent seek- 
er of adventures around the 
world. Zangwill was prede- 
ceased by his first wife, Estelle. 
He is survived by his lo\'ing 
companion and best friend. 



60 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



Carol Boll; his former wife, 
Grace; his children, Andrew, 
Rhonda, Kenneth, and Leonard; 
and three grandchildren. 

James A. GlKson 



1 954 Died September 15, 2008, at 
the age of 83, at his home in 
Hinsdale, Illinois. Gibson was a 
co-founder of the Institute of 
Family Therapy in Chicago and 
had a private practice in Hins- 
dale. Gibson was predeceased 
by two daughters, Mary Ellen 
and Lisa Erin. He is survived 
by his wife of 49 years, Bar- 
bara; three daughters, Suzanne, 
Gina Eielder, and Julie; and 
three granddaughters. 

Edward D. Holyoke 

1954 Died September 30, 2008, at the 
age of 79, at his home in Sandy 
Pond, New York. Holyoke 
served in the U.S. Army from 
1956 to 1958 in Kyoto, Japan, 
retiring as a colonel in the Army 
Medical Reserves. Holyoke was 
chief of surgical oncology at 
Roswell Park Memorial Insti- 
tute in Buffalo, New York, 
where he studied the use of 
interferon as a cancer treat- 
ment. In I99I, he joined the Vet- 
erans Administration in Togus, 
Maine, where he served as chief 
of staff. He was later chief of 
staff for the Veterans Adminis- 
tration Hospital in Syracuse, 
New York, and continued to 
work there as a research grant 
consultant until several months 
before his death. Holyoke is 
survived by his wife, Judith; 
four daughters, Amanda Neal, 
Rebecca Sumner, Melissa 
Gartz, and Cassandra Bluff; 
two sons, John and Edward; 
and nine grandchildren. 

Eugene Nobles, Jr 

1954 Died December 22, 2008, at the 
age of 79, in Memphis, Ten- 



nessee. Nobles served as a cap- 
tain in the U.S. Army during the 
Korean War and as chief of 
surgery for the 44th MASH 
unit. He joined the Department 
of Surgery at Baptist Memorial 
Hospital in Memphis, where 
he worked for 38 years. Nobles 
was the chairman of that hospi- 
tal's Department of Surgery and 
Accreditation Committee, as 
well as president of its medical 
staff. He also served as presi- 
dent of the Memphis Surgical 
Society and of the Southern 
Surgeons Club. He was an avid 
inventor and held three patents. 
He is survived by his wife of 47 
years, Gloria; two daughters, 
Helen Bird and Lil Rudd; and 
five grandchildren. 

Parvin S. Farmanfarmaian 

1 956 Died April 22, 2009, at the age 
of n, at her home in Princeton, 
New Jersey, of pancreatic can- 
cer. Earmanfarmaian was among 
the first cadre of faculty to join 
Rutgers Medical School, now 
called the Robert Wood John- 
son Medical School, in Prince- 
ton in 1968. As fellowship 
director for the hematology 
and oncology program at that 
school, Farmanfarmaian trained 
scores of hematology and oncol- 
ogy speciahsts during the past 
four decades. She developed the 
New Jersey Regional Hemophil- 
ia Program and served as its 
director starting in 1976. Ear- 
manfarmaian is survived by her 
husband of 50 years, Allahverdi 
Farmanfarmaian; two daugh- 
ters, Lara Terry and Kimya Har- 
ris; and four grandchildren. 

Malcolm H. Moss 

1 956 Died October 17, 2008, at the 

age of 11, at his home in Tampa, 
Florida. Moss served as a cap- 
tain in the U.S. Air Force, sta- 
tioned in Japan. He practiced 



pediatrics in Englewood, New 
Jersey, for 30 years and was 
chief of pediatrics at Engle- 
wood Hospital from 1979 to 
1989. After closing his practice, 
he became a medical director 
at Cigna Healthcare in New 
Jersey. He transferred to Flori- 
da in 1994. Moss is survived 
by his wffe of 45 years, Sylvia; 
sons Andrew and Jonathan; 
and four grandchildren. 

Geoffrey R. Paul 



1956 Died October 28, 2008, at the 
age of 79, in San Francisco, Cali- 
fornia. Born in Sydney, Aus- 
traha, Paul founded the Anzac 
Peace Prize and the Anzac of 
the Year national awards, annu- 
al prizes given to ordinary Aus- 
trahans for efforts toward glob- 
al peace, in 1976. Paul was also a 
physician at Kaiser Permanente 
in San Francisco for 25 years. He 
is survived by his wife, Sharon. 

Charles W. Fairfax II 

1957 Died December 9, 2008, at the 
age of 11, in South Dartmouth, 
Massachusetts. Fairfax worked 
as a radiologist at St. Luke's 
Hospital in New Bedford, 
Massachusetts, for 31 years, 
including many years as chief of 
radiology, until his retirement in 
1995. He helped establish that 
hospital's School of X-Ray 
Technology and was a member 
of several professional organiza- 
tions, including the American 
College of Radiology, which 
named him as a feUow in 1978. 
Fairfax is survived by his wife of 
50 years, Eleanor ("Sue"); five 
children, Diana Fairfax Miller, 
Laura Fairfax McDonough, 
Christopher, Peter, and Josh; 
and twelve grandchildren. 

Robert W. Shavelson 

1958 Diedjune8, 2009,attheageof 
75, at his home in New Jersey. 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



61 






ORTTTJARTES 



I COMMEMORATING DISTINGUISHED LIVES 



Shavelson practiced internal 
medicine and served in Viet- 
nam. He was predeceased by 
his wife of 43 years, Sonia, in 
1998. Shavelson is survived 
by his three children, Pamela, 
Patti, and Robert, Jr.; and two 
grandchildren. 

David V. Heisterkamp 



1 964 Died January 26, 2009, at the 
age of 69, in Denver, Colorado, 
in his sleep. Heisterkamp 
trained in anesthesia at the 
University of Pennsylvania 
before serving as a heutenant 
commander in the U.S. Navy 
from 1968 to 1970. He moved 
to Denver in 1970 and prac- 
ticed anesthesia, first at the 
University of Colorado Med- 
ical Center, then with the 
Metz Group and with Col- 
orado Anesthesia Consultants. 
He retired in 2005 to spend 
more time with his family. 
Heisterkamp is survived by 
his wife, Roberta; his five 
children, David, Wendy 
Wiehardt, Rebecca, Christo- 
pher, and Charles; and four 
grandchildren. 

Gerald r.nlman 

1 966 Died December 26, 2008, at 
the age of 68, at his home in 
Albany, New York. Coknan 
had been a lieutenant com- 
mander in the U.S. Navy and 
the officer in charge at the 
South Vietnamese Provincial 
Hospital in Quang Tri from 
1969 to 1971. His service 
earned him the Vietnamese 
Service Medal, the Repubhc 
of Vietnam Medal of Honor, 
the Cross of Gallantry, and 
the Pubhc Health Medal. In 
later years, he made several 
trips back to Vietnam — as 
well as to China, Russia, and 
the Philippines — as part of 
Operation Smile, performing 



surgery on children with cleft 
palates and cleft lips. Colman 
was chief of plastic surgery at 
the former Child's Hospital 
and St. Peter's Hospital, both 
in Albany, and taught as an 
associate professor at Albany 
Medical Center. He practiced 
with the Plastic Surgery 
Group in Albany for more 
than 30 years. He also served 
on the Board of Trustees of 
the Albany Jewish Commu- 
nity Center, which recently 
honored him with a Pillars 
Award. Colman is survived 
by his wife, Ruth; five chil- 
dren, David, Jonathan, Adam, 
Benjamin, and Rachel; and 
one grandson. 

James F.dw^ard Mclennan 

1 967 Died September 30, 2008, at 
the age of 68, in Providence, 
Rhode Island. McLennan 
completed his residency in 
neurosurgery at Brigham and 
Women's Hospital and Chil- 
dren's Hospital Boston. He had 
been a physician at Miriam 
Hospital and Roger Wilhams 
Hospital in Providence since 
1981. He also served as a clini- 
cal associate professor at the 
Warren Alpert Medical School 
of Brown University. McLen- 
nan is survived by his wife, 
Karen Jacobsen, and two 
daughters, JiU and Jenny. 

Richard Alan Kaiser 

1 969 Died November F, 2008, at the 
age of 63, in West Orange, 
New Jersey. Beginning in 1971, 
Kaiser served several years in 
the U.S. Navy and rose to the 
rank of heutenant comman- 
der aboard the nuclear sub- 
marine the U.S.S. Will Rogers. 
He maintained a private prac- 
tice in general and pediatric 
surgery in Montclair, New 
Jersey, retiring in 2004. Kaiser 



is survived by his wife of 40 
years, Debra; a daughter, 
Hilary Grove; a son, David; 
and two grandchildren. 

Barbara Ma llinrWrnd t Osborne 

1 969 Died March 29, 2009, at the 
age of 65, at her home in Hous- 
ton, Texas, after living with 
Alzheimer's disease for many 
years. Osborne completed her 
training at Massachusetts 
General Hospital and Beth 
Israel Deaconess Medical Cen- 
ter in Boston, and chose a 
career in pathology, specializ- 
ing in lymphomas. In 1975, she 
moved to Houston, where 
she practiced pathology and 
hematopathology for nearly 20 
years. She is survived by her 
children, Jonathan and Bizet 
Siegel, and four grandchildren. 

Donald Michael Vickery 

1 969 Died November 22, 2008, at 
the age of 64, in Evergreen, 
Colorado, of lung cancer. A 
pioneer in the self- care and 
wellness movement, Vickery, 
a nonsmoker, was also a life- 
long crusader against tobac- 
co. He founded the nonprofit 
Center for Consumer Health 
Education, now known as 
the Self-Care Institute, in 
Evergreen. In 1984, he started 
the Center for Corporate 
Health in Reston, Virginia. 
Vickery wrote and co-wrote 
numerous books about well- 
ness, and he founded Health 
Decisions International, a 
self-diagnosing software tool 
for doctors and patients. In 
2003 he received the Ameri- 
can College of Preventive 
Medicine Lifetime Achieve- 
ment Award. Vickery is sur- 
vived by his wife, Carol; a 
daughter, Meredith; two 
sons, Andrew and Michael; 
and two grandsons. 



62 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



John Richardson 

1 970 Died November 13, 2008, at 
the age of 64, in Little Rock, 
Arkansas, after an extended 
battle with cancer. Following 
his medical training, Richard- 
son joined the U.S. Public 
Health Service and was sta- 
tioned in Galveston, Texas. He 
later joined the National Insti- 
tutes of Health, where he con- 
ducted research on cholesterol. 
He eventually returned to 
Texas, where he taught at the 
University of Texas Health Sci- 
ence Center in San Antonio 
and practiced medicine at Cen- 
tral Texas Nephrology Associ- 
ates in Waco. Richardson is 
survived by his wife, Martha. 

■SiiyannpRigg.s 



1 972 Died April 28, 2009, at the age of 
62, in Providence, Rhode Island, 
after a battle with cancer com- 
plicated by kidney disease. Riggs 
spent six months studying in 
Colombia before completing her 
residency in pediatrics and a fel- 
lowship in adolescent medicine 
at Childreris Hospital Boston. 
She was a physician at Harvard 
University Health Services and 
at Childreris, where she founded 
the Young Parents Program. She 
later moved to the Brown Uni- 
versity School of Medicine in 
Providence to start its Division 
of Adolescent Medicine. She 
became professor of pediatrics 
at that school and served as 
medical director of clinical ser- 
vices at the Rhode Island Train- 
ing School for more than 20 
years. Riggs was known nation- 
ally for her work in the eating 
disorders field. Riggs is survived 
by her children. Amy Hennessy, 
Rob Lewis, and Jane Lewis. 

Mirrhpll R May 



Pittsburgh, Pennsylvania. His 
death was ruled a suicide. A 
neurologist and authority on 
the genetic basis of pain. Max 
was a senior investigator with 
the Center for Pain Research at 
the University of Pittsburgh 
Medical Center. He had previ- 
ously been a researcher at the 
National Institutes of Health, 
where he directed the Pain 
Research Clinic, and a captain 
in the U.S. Pubhc Health Ser- 
vice. Max is survived by his 
wife of 23 years, Lisa, and two 
daughters, Rachel and Laura. 

Andrpw Hanna.s 



1 976 Died September 24, 2009, at 
the age of 58, in his home 
in Lafayette, Indiana, from 
injuries suffered in a fall. 
Hannas worked for the 
Kansas State Department of 
Health and taught Enghsh, 
Latin, and Greek at Purdue 
University. Hannas was prede- 
ceased by a sister, Margaret. 
He is survived by brothers 
Mike and Jacob and sisters 
Molly and Polly Silverman. 

Peter Finstein 



1 974 Died October 22, 2008, at the 
age of 59, at his second home in 



1 978 Died suddenly September 22, 
2008, at the age of 59, in 
St. Louis, Missouri. A pediatric 
cardiac surgeon and unmunolo- 
gist, Einstein founded the Trans- 
position Study Group, where he 
pioneered an innovative training 
model for pediatric cardiac 
surgery. He also founded the 
Childreris Heart Project Interna- 
tional, which made resources 
available for childreris heart svirg- 
eries in the developing world. 
Einstein is survived by his wife, 
Kim Rosenfield, and his chil- 
dren, Jesse, Eric, Tracy, and Lisa. 

Rrure Van Bnerkel 

1 978 Died February 6, 2009, at the 
age of 56, in Greenfield, Massa- 



chusetts, following a four- 
month bout with cancer. Van 
Boeckel did a residency in 
internal medicine at George 
Washington University Hos- 
pital before moving to West- 
ern Massachusetts, where he 
was employed by the Sisters of 
Providence at Farren Memorial 
Hospital, hi 1990, Van Boeckel 
and his partners formed Con- 
necticut River Internists in 
Turners Falls, Massachusetts. 
He worked there until his 
retirement in 2001. In 2004, he 
helped found the Hospice of 
Franklin County and served as 
its medical director until his 
death. He was a strong believer 
in paUiative care, and during his 
illness he became a beneficiary 
of the hospice he had helped 
create. Van Boeckel is sur\'ived 
by his wife of 25 years, Terry. 

FHward R. Rrnrnfielrl 



1983 Died May 10, 2009, at the age of 
58, in Newton, Massachusetts. 
A recognized expert in the field 
of epilepsy, Bromfield was an 
HMS associate professor of 
neurology and chief of the Divi- 
sion of EEG, Epilepsy, and Sleep 
Neurology at Brigham and 
Women's Hospital. He joined 
the HMS faculty in 1993 after 
undertaking a two-year fellow- 
ship in epilepsy and EEG at the 
National Institute of Neurolog- 
ical Disorders and Stroke in 
Bethesda, Maryland. The Ameri- 
can Epilepsy Society honored 
him with the 2007 J. Kiffin Penry 
Award for Excellence in Epilepsy 
Care. In 1999, Bromfield helped 
found Camp Wee-Kan-Tu, the 
first overnight summer camp 
program in New England solely 
for children with epilepsy; he 
served as the camp's medical 
director. Bromfield is survived 
by his wife, Terry, and his 
sons, Daniel and Benjamin. ■ 



AUTUMN 2009 • HARVARD MEDICAL ALUMNI BULLETIN 



63 



ENDNOTES 



SOME FINAL THOUGHTS 



Game Plan 




Y THE TIME THE PATIENT WAS ADMITTED TO THE 

hospital, his creatinine level was ten times higher 
than normal. He was now paying the costly price 
of a long history of uncontrolled hypertension. His 
kidneys were shot, and he faced a certain future on dialysis. 

The wrinkle in the story was that the patient — I'll call 
him Fred — ^was refusing surgery to 
create an arteriovenous fistula that 
would allow us to filter his blood. 
Psychiatrists had ruled Fred com- 
petent to make his own decisions, 
and he was now testing our team's 
negotiation skills. A daily parade of 
doctors at every level of training — 
kidney speciahsts, general medicine 
doctors, fellows, residents, and, me, 
the medical student — ^would visit 
with him and repeat variations on a 
theme: He might feel fine now, but 
kidney failure would Idll him unless 
he went on dialysis. He would 
respond to us all in the same way: 
"I feel fine. I don't need dialysis, and 
I don't need surgery." 

Fred was at once frustrating and 
perplexing. Each day we debated 
hypotheses about the reasons for his 
refusal. Was he suspicious of our 
motives? Our competence? Our judg- 
ment? Was he afraid of surgery? Tired 
of hving? Our debate continued until 
one morning, when our team of doc- 
tors approached him during rounds. 
"I want dialysis," Fred said, "and I'll 
meet with the surgeons." 

Why the sudden change? 

"I was thinking about a picture I saw in Sports Illustrated of 
Hank Gathers," Fred told us. "He just collapsed and died on 
the court. I don't want that to be me. His death was so awful 
for people to watch. I don't want to be another Hank Gathers 
or Reggie Lewis." None of the other members of my team 
knew who these basketball giants were — and they didn't 
care. They couldn't afford to let the patient change his mind 
again, so they scheduled an immediate surgical consult. 

As an avid sports fan, I knew that Gathers was a college- 
basketball phenom who had died suddenly during a champi- 
onship playoff game, and that Lewis was the young Boston 




FINAL SHOT: Hank Gathers, a basketball star 
for Loyola Marymount University, collapsed 
and died during a tournament game. An 
autopsy revealed that he suffered from hyper- 
trophic cardiomyopathy, a heart-muscle disorder. 



Celtics star who had coUapsed and died one day during prac- 
tice. From the grave. Gathers and Lewis were accomplishing 
what doctors alone could not: saving Fred's Me. 

Fred's sudden change in thinking underscored for me the 
incredible influence that athletes have in shaping the way we 
think about our health. As icons of extreme physical well- 
being, professional athletes remind 
us of the pinnacles of human perfor- 
mance, but also of our own frailty. 
While they express the virtues of 
human perseverance and intense 
training, they can also bring to hght 
the egahtarian quahty of disease — 
striking anyone, even optimally 
conditioned professional athletes, 
at any tune. In doing so, they help 
patients like Fred understand dis- 
ease, feel less alone with their diag- 
noses, and persist in treatment 
when they feel like giving up. 

While athletes Kke Gathers and 
Lewis remind us of our mortahty, 
others call attention to our body's 
innate capacity to cope with disease 
and to heal. When Magic Johnson 
returned to the basketball court 
after announcing he had HIV, he 
helped destigmatize the disease, 
eased our fears of infectivity, and 
made us realize that those testing 
positive for the virus could stiU lead 
vigorous lives. When Red Sox 
pitcher Jon Lester pubhcly faced a 
Iffe-threatening cancer diagnosis 
and fought back to return to top 
form, he allowed us the reahstic 
hope that we, too, might recover and hve normally. 

Sports journalists, by chronicling the stories of the ill- 
nesses of athletes, and professional athletes, by sharing 
those stories with us, perform an invaluable pubhc health 
service. They help us understand and cope with disease in 
ways that caution, reassure, and inspire us. ■ 

Sachin H. ]ain '06, a resident in internal medicine at Brigham and 
Women's Hospital, was recently named special assistant to David 
Blumcnthal 74, national coordinator for health information technolo- 
gy at the U.S. Department of Health and Human Services. 



64 



HARVARD MEDICAL ALUMNI BULLETIN • AUTUMN 2009 



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11,758 STUDENTS, FACULTY, RESEARCHERS, AND STAFF DEDICATED TO ALLEVJtf 

HUMAN SUFFERING CAUSED BY DISEASE. At Harvard Medical School, the world's largest 

group of world-class researchers working on human genetics is on the brinl< of a revolution: 

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treatment is the future. It will be possible because of the breakthroughs in human genetics 

happening here. 

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HOLMES, SWEET HOLMES: Oliver Wendell Holmes, Class 
of 1 836, was far from the retiring, measured stereotype so 
commonly conjured for the Victorian era. His lively, inquir- 
ing mind led him to provide engaging discourses on such 
topics as the contagiousness of puerperal fever, the impor- 
tance of the U.S.S. Constitution ("Old Ironsides"), and the 
provincial view of those in his hometown — his belief that 
Bostonians considered their State House the hub of the 
solar system led to the city's nickname, _"the Hub." 

Holmes was a man of science, a man of letters, and, 
according to a recent symposium at the Francis A. Counlway 
Library of Medicine, a man of questions. Organized 
to commemorate the two-hundredth anniversary of the birth 
of the former Harvard Medical School dean, "Oliver 
Wendell Holmes and the Spirit of Skepticism" celebrated 
his life, his accomplishments, and the continuing relevance 
of his literary and scientific contributions. 

To view videos of the symposium, visit alumnibulletin. 
med.harvard.edu/history/people/holmes.php.