Medicine on the MidwayThe University of ChicagoThe Medical Alumni AssociationThe Pritzker School of Medicine1025 East 57th StreetChicago, Illinois 60637 NON-PROFIT ORG.U.S. POSTAGEPAIDPERMIT NO. 9666CHICAGO, ILL.•Address corrections requestedreturned postage guaranteedPerioiical Record RoomJoseph Regenstein Library1100 East 57th StreeteM.cago. UlinQh QOQ�7.7Medicine on the Midway Vol. 28 No.1Bulletin of the Medical Alumni Association The University of ChicagoDivision of the Biological Sciences and The Pritzker School of Medicine_I I1973Cover: The adult and pediatric emergency rooms of theUniversity's Hospitals and Clinics complex log morethan 10,000 patients per month. Procedures used in thesefacilities must be accurate and immediate. Personnelmust be competent and have available on a 24-hour basisthe correct goods and services.In this issue F. Regis Kenna, Director of the Univer­sity Hospitals and Clinics, discusses the state of the med­ical complex at The University of Chicago. He providesparticular insight into the costs of maintaining the Hospi­tals' and Clinics' reputation for quality health service.Medicine on the MidwayVolume 28, No.1, Spring 1973Bulletin of the Medical Alumni Association ofThe University of Chicago Division of the BiologicalSciences and The Pritzker School of Medicine.Copyright 1973 by the Medical Alumni AssociationThe University of ChicagoEditor: Howard S. BimsonContributing Editor: James S. SweetPhotographers: Rudy JanuSandi KronquistDiane KutaLloyd Eldon SaundersMedical Alumni AssociationPresident: Richard L. LandauPresident-Elect: Catherine L. Dobson (Rush '30)Vice-President: Otto H. Trippel ('46)Secretary: Frank W. Fitch (' 53)Executive Secretary: Katherine T. WolcottCouncil MembersLampis Anagnostopoulos ('61)Joseph Baron (,62)William Moses Jones ('31)Edward Paloyan (' 56)Robert L. Schmitz ('38)Francis H. Straus, II (,57)1 ContentsThe Brain Research InstituteJames StaceyIntellectual Ideals and Educational RealitiesHealth Services in the USSROdin W. AndersonA Very Good Service: PediatricsAround the World with the JensensEndless AccountabilityThe New American TraditionJames D. WatsonThe Seniors Get Theirs . . .New InternshipsNews BriefsIn MemoriamDepartmental NewsAlumni News 2710161922252831343540The Brain Research InstituteJames StaceyThe admonition to "know thyself' was inscribed at theDelphic Oracle by Grecian sages in the seventh centurybefore Christ, an early recognition of the importance ofthe mind. Consciousness has always been the peculiarglory and scourge of man, offering the advantage of mem­ory and fine discrimination while also forcing the aware­ness of death. Poets, philosophers, and scientists havegrappled with the puzzle of consciousness for centuries,but in recent years their probing instruments havebecome more exact.During the Renaissance, a choleric man was thoughtto be suffering from an excess of yellow bile, one ofthe four humors then thought to regulate the humanbody. During the early twentieth century, an angry manwas thought to be the product of familial or environmen­tal factors. Neuroscientists now know that electricalstimulation of the hypothalamus (the region in the for­ward end of the brain stem) can produce" instant anger, "complete with autonomic nervous response, includingquicker breathing, faster heart-beat, and higher bloodsugar. Thus, irascible people may not be the productsof an indulged childhood, but might instead be victimsof some disorder of the hypothalamus. Problems suchas this are among those under study at the BrainResearch Institute of The University of Chicago.The Institute is directed by Dr. John F. Mullan, theJohn Harper Seeley Professor, internationally noted forhis pioneering work in the neurosurgical control of pain,and is one of the few centers in the world devoted toa comprehensive and systematic examination of the brainand nervous system. An interdisciplinary group of emi­nent clinicians and basic scientists are seeking new treat­ment for brain disorders, probing the relationships amongthe mind, body, and behavior, and are searching for basicinformation on some of the still largely mysterious func­tions of the brain and nervous system.The disciplines involved in this research includeneurosurgery, neurology, psychiatry, anatomy,pathology, pharmacology, biochemistry, and biophysics.Among the disorders under study are mental illness andretardation, brain tumors, multiple sclerosis, head injury,stroke, epilepsy, and muscular dystrophy. Among the2 Dr. John F. Mullan.brain and nervous system phenomena under investigationare sight, hearing, memory, and speech.At the moment, the neuroscientists of the BrainResearch Institute are working at widely scattered loca­tions within the University. Relocation in the new Sur- .gery and Brain Research Pavilion will offer importantadvantages: researchers will be more familiar with thevarious projects in progress; they will be more readilyable to complement one another's work; and new con­cepts will more easily develop through the sharing ofideas and techniques possible within a single building.Brain researchers will occupy the first three floors ofthe six-story building. Their work will receive continuingsupport from the Brain Research Foundation, aphilanthropic organization and an affiliate of the U niver­sity.Dr. Mullan points out that the integration of clinicalpractice and basic research is the key concept of theInstitute and is the tie that binds its myriad activities.Aron A. Moscona and Beatrice Garber"Only by understanding how the brain works can wehope to solve problems when the brain becomes dis­eased," he says. "We want to understand how brain cellsmaintain their viability, for example, hoping that mighttell us how to control brain tumors."Effects and DefectsBehavior is a central concern of all brain researchers,both in the traditional sense of acceptable social behaviorand in the clinical sense of normal physiologicalbehavior. One of the great contributions of modern sci­ence was the establishment of the link between the two."There is no behavior without psychiatry, withoutinvolvement of the brain," says Dr. Daniel X. Freed­man, the Louis Block Professor and Chairman of theDepartment of Psychiatry. "We are working to under­stand how the brain relates to experience and behavior.The component may be disability or disordered behavior.The task is to understand the extent to which altered brain functions are primarry or contributing causes.Another task is to discover a therapeutic aid to the disor­der. "Recent team research led by Dr. Herbert Y. Meltzer,Associate Professor of Psychiatry, offers an example ofthis approach. The team discovered that acutely psycho­tic patients have marked increases in the activity of twoenzymes at the onset of psychotic episodes. Theenzymes, creatine phosphokinase (CPK) and aldolase,have their origin in the muscle and are leaked into theblood stream.The finding has several aspects of importance. First,it is important to have identified a specific organic reac­tion linked to psychosis. It is a beginning of the under­standing of the biology of psychosis and therefore hasa narrowing function; the finding could lead to furtherdiscoveries. It also suggests that a drug might be foundto correct the condition, preventing the increased activityof the enzymes. And since the muscles show pathologicaleffects, further knowledge may contribute to understand­ing of muscle disorders. Dr. Meltzer also is exploringthe possibility that a function of the central nervous sys­tem is linked to the increased activity of the enzymes.Dr. Meltzer, Philip S. Holzman, Professor ofPsychiatry, and others are engaged in a related studyof the psychology of perception. It has long been feltthat there is a relationship between schizophrenia andthe functioning of the bottom of the brain where balanceand equilibrium are controlled. The feeling has been thatthese nerve cells do not function properly inschizophrenia, that there is something wrong with theschizophrenic's response to motion.To test this, an eye-tracking system was devised whichrecorded the electrical response to the motion of a swing­ing pendulum. The researchers discovered thatschizophrenics have an identifiably erratic response tothis kind of motion, something that does not show undernormal observation. Furthermore, members of the samefamily often show the same erratic response, even thoughthey are not disabled. The finding suggests an organicfunction in schizophrenia and that predisposition can beestablished.Findings such as these dramatize the current positionof psychiatry. "We cannot exculpate moral failings,"says Dr. Freedman. "Nor can we attribute all problemsto organic malfunctions of the brain. Mental illness mayinvolve both. " The Department also has several analystsworking on the subjective approach to behavior. They3were involved in the highly effective crisis interventionsessions last fall for the survivors and relatives of victimsof the tragic Illinois Central commuter train crash.Examining the InteriorNeurologists at the University study the functionalbehavior of the brain and nervous system. Dr. SidneySchulman (,46), the Ellen C. Manning Professor and Headof Neurology, is investigating the behavioral effects oflesions in the thalamus of the rhesus monkey. He wantsto determine the extent to which certain areas (theassociation nuclei) of the thalamus function with parts(the granular cortex of the frontal and parietal-temporalregions) of the cerebral cortex as a unit in higher mentalprocesses.Dr. Schulman also is conducting a study of cerebralhemispheres collected from human subjects who havecome to autopsy some years after having suffered non­fatal strokes (superficial cortical infarctions). A systema­tic examination is being made to determine the validityof inferences, drawn from laboratory work on lowerprimates, about connections between the thalamus andcortex in man. The examination also hopes to discoverthe nature of the connections, if any, between thethalamus and areas of the cortex in man which do notexist in the lower primates.Dr. Robert W. P. Cutler, Associate Professor ofNeurology, is studying the transport across capillary'membranes of amino acids into and out of the brain. Thepurpose of the study is a greater understanding of someof the mechanisms which regulate the chemical environ­ment of the brain."These studies are important as fundamental intel­lectual discipline," Dr. Schulman points out. "But prac­tical application often grows. from basic research. " Dr. Cutler's study of the exchange of materials between theblood stream and the nervous system might have impor­tant significance for multiple sclerosis research. Perhapsa no.rmal substance in the blood is accepted by the nerv­ous system of multiple sclerosis patients, something thatis not accepted by the nervous system of healthyindividuals.Multiple sclerosis is one of the more baffling diseasesconfronting scientists today. Its incidence above the 35thparallel is 50 per 100,000 population, while below theparallel its incidence is only 2 or 3 per 100,000. No onecan account for this difference. Knowledge about the dis­ease is so limited, in fact, that virtually no theoreticalresearch on it can take place.The primary lesion of multiple sclerosis patients is' dis­seminated degeneration of the myelin sheath. Dr.Nicholas Lenn (,64), Assistant Professor of Medicine,and Dr. Glyn Dawson, Assistant Professor of Pediatrics,are studying the anatomy and biochemistry of the myelinsheath. A better understanding of its function might pro­vide groundwork for a major systematic research projecton this' crippling disease.Fixing Humpty DumptyPain typically is a useful phenomenon; it is the body'ssignal to the brain of harm or danger. For a child, itcould be the burning sensation that follows placing hishand on a stove he was warned against. For an adult,pain inside the left arm and chest could be a criticallyimportant signal of heart trouble. But the pain of terminalcancer serves absolutely no purpose.To control this type of pain, Dr. Mullan introducedthe percutaneous cordotomy in 1961, a method of surgi­cal intervention in the cranial nerves to control intract-Jack D. Cowan and an associate view videotape recordings of slime moldactivity. Cowan is particularly interested in how information processing4 takes place in the vertebrate nervous system. He is trying to accountfor nerve cell response variability.able pain in the head and neck. Since then Dr. Mullanhas been improving the operation and extending it to con­trol pain in other parts of the body.He also heads one of the few neurosurgicallaboratories in the nation where head injury, the leadingcourse of death to the age of 45, is the main subjectof study. "It's a very difficult problem, not likely to yieldresults on the basis of short-term research," Dr. Mullansays. "It's almost as difficult as putting Humpty Dumptytogether again."In his laboratory, the mechanics of head injury arestudied at the structural, ultrastructural, elec­trophysiological and biochemical levels. Methods ofreducing morbidity and mortality are being sought. Therelationships between ultrastructural (intracellular) swel­ling and cellular metabolism are examined, as are therelationships between the clinical manifestations of braininjury and changes in intracranial pressure. The cerebralcirculation has been found to be profoundly altered, andthe degree of alteration is directly related to the prog­nosis.An understanding of the mechanism of autoregulationof cerebral blood flow seems to be a key factor in thisstudy. A successful laboratory method developed forcombating the effects of severe head injury consists oflowering the viscosity of the blood by dilution, and com­pensating for the diminished oxygen-carrying capacity ofthe diluted blood by the application of oxygen under pres­sure. Recent work suggests that this method may be sur­passed or complemented by the use of a membranestabilizer, which also has potential in the field of spinalcord surgery as well as in the management of strokes.Control of strokes is another important investigationled by Dr. Mullan. His research group has been con- cerned mainly with those strokes which are caused bycerebral aneurysm, or malformation of the cerebral bloodvessels, since this is the type most amenableto medicaland surgical treatment. One concept of treatment understudy relates to the delay or prevention of subsequentcerebral hemorrhages after the initial hemorrhage hasspontaneously limited itself by clotting. The idea is touse drugs to prevent the dissolution of the sealing clot.Another way to prevent or delay subsequenthemorrhages is by lowering the blood pressure, whichis difficult to do by drugs, but which can be done bypartially occluding, or mechanically closing, the bloodvessel on a temporary basis.Modeled on ModelsThe neuron is an immensely complex and remarkablybeautiful cell. Magnified, it resembles a tree from awinter forest, the dendrites appearing as leaflessbranches supported by the thin, trunk-like axon and root­like axon tips. Each nerve cell can have thousands ofnerve fibers and can relate to other nerve cells in tensof thousands of ways. The mystery of perception andother phenomena of consciousness is contained withinthe interrelationship of nerve cells. Examination of thismystery provides one of the more fascinating areas ofresearch in the Institute.Jack D. Cowan, Professor and Chairman of theDepartment of Theoretical Biology, and his associatesare investigating and interpreting the electrical activityof neurons as seen in single-unit recordings and elec­trocorticograms and electroencephalograms. They havedeveloped a theory of the cerebral cortex viewed as ahighly redundant and locally randomly interconnectednet. This model has been used to investigate signal pro-An architect's rendering of the proposed new six-story Surgery-BrainResearch Building, The building will include two major research centers: one for the investigation of the brain and nervous system, the other forthe Department of Surgery.5cessing in the visual system, and a series of psychophysi­cal experiments has been successfully replicated. Furtherapplications to vision and other sensory modalities arebeing developed. A somewhat related switching-netmodel is being developed for the analysis of the wayin which neurons process ambiguous and noisy stimuli.Cowan also has developed a series of stochastic modelsto try to account for the role of neuron dendrites in signalprocessing.Dr. Cesar Fernandez, Professor of Surgery, and JayM. Goldberg, Professor of Physiology and TheoreticalBiology, are studying the physiology of the auditory andvestibular mechanism with the object of advancing pre­sent knowledge of the functions of these systems. Thevestibular, or labyrinthine, sense is concerned with bodymotion, position, and balance, and depends upon variousmechanisms in the inner ear. Their research involvesstudies of the response to natural stimulation ofindividual neurons in both auditory and vestibular sys­tems. Research findings may help in the interpretationof disturbances associated with peripheral sense organs.One of the major mysteries in biology is the natureof selective cell adhesion-the nature of the mechanismby which individual cells are linked to one another duringembryonic development so as to give rise to specific tis­sue and organs. Aron A. Moscona, the Louis BlockProfessor of Biology, and associates are probing thismystery.Their studies have led to the isolation from liveembryonic cells of macromolecular constituents whichpromote the binding of cells to each other and enablethem to become organized into tissue. These cell-bindingmaterials are specific for the kinds of cells from whichthey were obtained, and they seem to provide embryoniccells with a mechanism for mutual recognition and selec­tive adhesion. Impairments in the properties of these cell'binders, or ligands, might result in changes in the adhe­sive and cognitive properties of the cell of the kind thatoccur in invasive cancer, and in connection with certaindevelopment malformations. Moscona and associates areworking toward further biological and chemical charac­terization of these intercellular ligands, their mode ofaction, and their biosynthesis in normal and abnormalsituations.There is good reason to believe that most brain func­tions, including behavior, are dependent upon the pro­cess of chemical neurotransmission, and that many dis-6 eases arise from the malfunction of this process. For thisreason, Dr. Alfred Heller (,60), Professor and ActingChairman of Pharmacology, is studying the role of specificchemical transmitters in the nervous system. In orderto do this, it is necessay to know which cells in the nerv­ous system manufacture and use these compounds forthe purpose of transmission of impulses from one neuronto another.During the past decade, Dr. Heller's laboratory hasbeen able to identify a series of fiber tracts whose pre­sence in the brain is essential to the production of specifictransmitter substances. The destruction of these cellscauses a loss of these important substances throughoutthe brain, resulting in serious biochemical deficienciesthat may be involved in development of physiologicaland behavioral changes associated with neurological andpsychiatric disorders. This research opens the possibilityof reversing the effects of usually irreversible pathologi­cal events in the brain.Work of PromiseThe basic purpose of the Brain Research Institute is tointegrate more fully the scientific disciplines mentionedabove. This is best done by concentrating manyresearchers and clinicians on one problem. One of thebetter examples of this approach is the current workbeing done on brain tumors, a major interest in the Divi­sion. The work involves a virologist, Dr. Werner H. Kir-, sten; an immunological chemist, Dr. Ramon Lim; anelectronmicroscopist, Dr. Nicholas A. Vick (,65); anoncologist, Dr. Stan D. Vesselinovitch; a surgeon, Dr.Donald Pearson; and two radiologists, Dr. Melvin L.Griem and Dr. Paul B. Hoffer ('63). Their research in­volves the production of animal model tumors, theiranalysis, and their suppression by immunotherapy andfast neutron radiotherapy.This is the direction of brain research at the Institute.Its promise is substantial, for the nervous system,autonomic and central, is the central intelligence thatdirects virtually all bodily activity. Better understandingof its function promises aid not merely in treating disease,but aid in promoting better health. The process of gainingunderstanding will be long and difficult-the brain maywell be the most complex organization of matter andenergy in the universe-but the Brain Research Instituteinterdisciplinary approach promises to speed that pro­cess.Intellectual Ideals andEducational RealitiesAn Interview with Dr. Alfred HellerActing Chairman of the Department of PharmacologyOn April 2 the faculty of the Division of the BiologicalSciences and The Pritzker School of Medicine votedunanimously to consolidate a number of departments.One faculty group will consist of the present Depart­ments of Biophysics, Theoretical Biology, and part ofPhysiology. This new department will have faculty mem­bers who are concerned with cellular, physical, andtheoretical aspects of biology. The second faculty groupwill consist of the present Department of Pharmacologyand the part of the Department of Physiology concernedwith organ or system physiology. As the Acting Chair­man of the Department of Pharmacology, will thischange be welcomed by your Department. 'HELLER: Yes, we favor this consolidation. The facultyof the Department of Pharmacology voted unanimouslyin favor of it. This reorganization, we think, makes agood deal of sense with regard to our intellectual andeducational needs in the areas of pharmacology andphysiology. The major reason for moving in this directionis the realization by the Division that a substantial groupof faculty should be organized in the areas of phar­macology, mammalian physiology, clinical phar­macology, and neurobiology.What will happen to physiology in this arrangement? Iswhat is happening to this discipline unique to this Univer­sity, or has this been occurring in other medical schools?HELLER: With the development of modem biology, ithas become clear that to compartmentalize areas suchas physiology, or for that matter pharmacology, is intel­lectually and educationally impractical. To organize aDepartment of Physiology based simply on the needsof teaching in the areas of cardiovascular physiology,gastrointestinal, pulmonary, and endocrine physiologywould be an inappropriate way to organize ourselves. This is particularly true in this University in which theDivision of the Biological Sciences serves educationalneeds in the College, graduate schools, and The PritzkerSchool of Medicine, which is of course an integral partof this Division. As for developments in other medicalschools, I think our situation is somewhat distinct, butone gets the distinct impression that such consolidationsof basic biological sciences will become a widespreadphenomenon.Is not part of the difficulty in staffing physiology depart­ments because much physiologic research is done in clin­ical departments?HELLER: Our idea is to take advantage of this fact bybuilding in areas which bridge the basic and medical sci­ences. One area which particularly needs developmenthere and could provide a very important bridge is thefield of clinical pharmacology. This is a discipline whichcombines many aspects of mammalian physiology,human biology, and the modification of physiological pro­cesses by pharmacological agents. As such, it requiresstrong underpinnings in the basic science areas, whichwe believe the new, fused department will provide. Itrequires as well the kinds of strengths in the clinical sci­ences which this University possesses.We have no clinical pharmacology group now. Do youplan to add such a staff to the new department?HELLER: What we hope to do is start with a core group,which would be housed in Abbott Hall. They would haveappointments both in the clinical departments and in thenew department. Extensive discussions have alreadybegun on the recruitment of faculty in this area.What are your conceptions of the functions of this new7department with respect to medical teaching?HELLER: Part of the function of this department shouldbe to organize and to initiate educational programs inthe general areas of pharmacology, clinical phar­macology, mammalian physiology, and at least a portionof neurobiology, specifically neurophysiology andneuropharmacology. I would stress that there are press­ing educational needs at the graduate and undergraduatelevels.H ow many members will the new department have?HELLER: Depending on how you want to count, thenew department will immediately consist of six coreapointments and probably an equal number of active jointappointees.The potential for this department seems to be immense,considering the needs in this area. Do you look forwardto a department of: about 20 or so, not counting the jointappointees?HELLER: There is, of course, currently a serious prob­lem of University resources, but I would say that if thisdepartment is to take on the type of responsibilities thatwe are talking about, its faculty has got to number inthe neighborhood of at least 15 core appointments plussome very active joint appointees.Can you tell us something of immediate recruiting plans?HELLER: At the moment there is an active attempt torecruit in the areas of neurobiology and clinical phar­macology.Some people have the impression that too many joint8 appointees can be a hazard to the integrity of the depart­ment. Do you share in this concern?HELLER: The problem of joint appointments can pre­sent, under some circumstances, a real difficulty. Thatproblem is now being considered in a general way bythe Division. The Department of Pharmacology has had,during the years, a number of joint appointees who havebeen very helpful indeed. Joint appointments must bemade judiciously and in general cannot take the placeof core appointments in a department. The developmentof clinical pharmacology will certainly involve someappointments across departmental lines, and at presentit is clear that a number of individuals with appointmentsin clinical departments will have an immediate and impor­tant role in the new department.You spoke about a group of neurobiologists that theUniversity hopes to recruit. You are a neurobiologist.One gets the impression that there are a number ofphysiology departments in which the faculty core con­sists of neurophysiologists. Is this true, and if so, doyou have any explanation for it?HELLER: I would say that neurobiology is an areawhich undoubtedly will be receiving increasing emphasis.The reason is that there are many unsolved problems inneurobiology which can now be approached experimen­tally. There is a great deal of interest in this area.Then you would regard this new department as likelyhaving that emphasis because of the anticipation thatthis is becoming a promising area for scientific growthand development?HELLER: Yes. One point should be made, however.Research in neurobiology also involves problems relatedjto regulation by the nervous system of physiological pro­cesses such as those of the cardiovascular and endocrinesystems.Does a large department have any political advantagesin a University like The University of Chicago over asmall department like Pharmacology, which you havelived in most of your professional life ? If so, what advan­tages are there?HELLER: There are a number of obvious advantages.It is difficult for a department of five or six membersto conduct the variety of activities that a department inthis University has to carry out. The faculty of Phar­macology, for example, has been teaching in the under­graduate curriculum, the graduate curriculum, and themedical school. At the same time the faculty membershave been carrying on active research programs andadministrative functions in the University. This posesobvious problems with respect to time commitments.In addition a larger and more diverse department canmore easily develop new educational approaches. Forexample, one of the ideas we are considering in the newdepartment is the possibility of coordinating someaspects of the teaching of physiology and pharmacology. Dr. Harry A. Fozzard suggests that the originof cardiac electricity appears to be in differen­tial ion movements across the sarcolemma ofcardiac cells. These can be studied in termsof time- and voltage-dependent conductances,using a voltage clamp. Studies are made of therole of passive membrane properties in excita­tion and conduction, especially the role of thecomplex capacitance. The electrical events alsoappear to represent the trigger for contractionand to regulate tension. This relationship isstudied with a voltage clamp under conditionswhere tension production can be measured andthe voltage- and time-dependent properties ofthe excitation-contraction coupling processdetermined.This would be intellectually preferable and at the sametime would provide a savings in time and personnel.Why don't you organize a department of neurobiology?HELLER: Well, we figured it was no more reasonableto do that than to suggest a department of liver.Neurobiology is an integrative discipline, and we thinkit will develop best within a framework of the traditionaldisciplines. It certainly is not unreasonable to organizea neurobiology department, but it was our opinion thatthis would have too limited a scope.Why has this reorganization occurred now?HELLER: I think there is a general recognition in theDivision that at this time we need time to build strongacademic -units in biology and that the present depart­mental structures do not really recognize moderndevelopments. The steps being taken are not really veryrevolutionary. Indeed, a genuine effort is being made tomaintain strength in the classical biological disciplines.Dr. Alfred Heller ('60) is a Professor in and Acting Chairmanof the Department of Pharmacology.9Health Services in the USSRReview and ImpressionsOdin W. AndersonAt the time of the Russian revolution in 1917 and theninto the twenties, there was a combination of circum­stances in the USSR which differed considerably fromthe developed countries in Europe and North America.These circumstances shaped a Soviet health service sys­tem which is organizationally and philosophically quitedifferent from the health service systems in the West.In Europe and North America the centuries-oldscourges of the common water- and air-borne diseasesand the lice-borne diseases had disappeared or weredeclining rapidly by 1914. Communicable diseasetechnology, developed during the latter nineteenth andearly twentieth centuries, was generally applied throughpublic health measures well before the great develop­ments in curative medicine. Public health and curativemedicine were separated operationally from their verybeginnings, because creative medicine was developingwhen public health-primary prevention-was already sosuccessful that it had established its own personnel, pub­lic funding, and operating base. Public health thenreached a plateau, while curative medicine developedrapidly. This rapid pace of growth of curative medicinecontinues today.At the time of the revolution in Russia, both the indus­trial base and the health services base were grosslyundeveloped. The disease picture was that of Europein the early 1800s, if not earlier, in terms of the ratesof typhus, cholera, typhoid, smallpox, malaria, and dis­eases from malnutrition.Infant mortality was reported to be around the 275per 1,000 mark, when it was approximately 100 per 1,000in Europe and North America. The average length oflife was about 38 years when it was about 60 years inthe West. Although there was a cadre of physicians, aux­iliary personnel, and hospitals, it was hardly equal tothe enormous task facing the country. It can be assumedthat such personnel and facilities as there were mainlyserved the small social segment of the upper classes andthe urban areas. 1Lenin was sufficiently alarmed by the deplorablehealth status of the country in 1921 to remark: "Eitherthe lice will defeat socialism or socialism will defeatthe lice. H2Since health conditions in Russia at the time of therevolution were analogous to those of Europe 100 to 1501. A much more elaborate and well-organized background can be foundin Mark G. Field, Soviet Socialized Medicine: An Introduction (NewYork: Free Press, 1967).2. Quoted in USSR Ministry of Health, The System of Public HealthService in the USSR (Moscow: The Ministry, 1967) p. 23.10 years previously, it is easy to see why the new govern­ment set a very high priority to eliminating the scourgesfor which there were available means to do so. It wouldseem that curative medicine had a lower priority becausethe disease pattern dictated otherwise. This is hardly tosay that curative medicine was ignored. There was, how­ever, and continues to be a prevailing concept of preven­tion, or, as it is translated locally, "prophylaxis," whichis broader than prevention in the American sense of theterm. Prophylaxis not only entails primary preventionby means of immunization, but it demands constant sur­veillance and follow-up of population segments andpeople in certain disease categories.The USSR health system was, therefore, naturallyestablished as a unified system, combining the preventiveand curative systems under one administration. Althoughthere is now a division of labor-sanitary doctors and'primary doctors of ill persons seeking care-the systemappears to be so interlocked by preventive and curativeconcepts in the same personnel that it is difficult to dif­ferentiate between the two types of activities.An Instant SystemAll enterprises in the USSR are designed by their rele­vant experts: engineers, educators, physicians, and soon. There is seemingly great reliance on expert opinion.The USSR health service, accordingly, was designed bymedical professionals. It is reported that prominent medi­cal professionals were unable to influence the pre­revolution Czarist governments, not to mention otherexperts, unless possibly specialized kinds like railroadtransport engineers. After the revolution, the experts invarious fields came into their own.Professional judgment, in the absence of formalizedscientific criteria, normally results in recommendationsthat are relatively abundant for the use of resources.In view of the high priority given by the state to healthservices, professional medical experts were thenaccorded relatively great leeway. As early as the 1930s,a norm of 10 outpatient physician visits per person wasestablished for the first Five-Year Plan." This goal wasnot attained during the first five years, but now it hasbeen exceededWhat has been developed in the USSR is a publichealth expert's dream of a rational health service system.Consider these characteristics:A. The core of the health service system is the poly­clinic, where an individual has his first contact in an illnessepisode. Within the polyclinic's area of services, thereare further population subdivisions into "ustachoks" foreach first-contact physician; each polyclinic physicianserves a designed population. The polyclinics are staffedby primary doctors (analogous to internists).Each polyclinic has an exclusive catchment area insome standard ratio to population. The primary doctorsare backed up at the polyclinics by a range of specialists,according to a specialist-to-population ratio. They haveno hospital affiliation.There are several types of polyclinics: adult, pediatric(14 and under), and maternity. Each has a catchmentarea which overlaps geographically but not functionally.Each is staffed with its primary pediatric or maternityphysician plus supporting specialists.B. Hospitals are organized in some sort of graduationby size and complexity, with established populationcatchment areas so that the population base is knownand exclusive. Hospitals are staffed on a salary basis3. I. D. Bogatyrev, ed., Morbidity in Cities and Standards of Care(Moscow: Meditsina Publishing House, 1967). From a translated man­uscript to be published by the Fogarty International Center forAdvanced Study in the Health Sciences, Washington, D.C. by a range and quantity of specialists. There are hospitalsby age and disease: adult (15 plus), pediatric, maternity,and for special conditions such as mental disease.In addition, there are specialized dispensary agenciesfor specific conditions such as tuberculosis, venereal andskin diseases, and mental disease. Dispensaries for otherdiseases are being added. The dispensaries receive refer­rals from the polyclinics and the hospitals. The conceptis one of long-term survei1lance of patients with the par­ticular diseases. Again, the dispensaries have catchmentareas, determined by some measure of a population basewhich yields certain types of patients.An elaborate system of emergency services for the lar­ger cities has been developed. It is a subsystem of thelarger health system but autonomous in staffiing and oper­ation. Such a system was probably included in the earlyplanning of the national health services, because an emer­gency service was started in Leningrad as early as 1917.There is a central medical emergency service stationin each city with a switchboard and operators who handleall calls. (Rural areas are served by emergency servicesin hospitals.) There is a standard number which can bedialed from all telephones, home and pay phones, freeof charge. The reason for the call is screened by theoperator, a trained medical auxiliary, who determines thenature of the call and advises ambulance service or avisit by the patient to his polyclinic or possibly even ahome call by a polyclinic physician.There are substations scattered throughout the cities.The emergency system has fleets of ambulances staffedby a physician, two assistants of the feldsher grade(which is lower than that of a physician but higher thanthat of a nurse), and a driver. There are also a fewspecialized ambulances, such as those for heart attackvictims, with the appropriate equipment.In rural and remote areas of the country, there are11Current and Projected USSR Facilities and PersonnelCurrent ProjectedN umber of Polyclinics 39,000 morePolyclinic Populationfor Primary PhysicianAdult 1/2,000Child 2/1,000Maternity ?Psychiatric ?Polyclinic Populationper PolyclinicAdult 45-50,000 samePediatric 15-18,000 sameHospital Bedsll ,000Population 10.8 13.2N umber of Physicians/ I 0,000 28.3 34.6Middle MedicallIO,OOO 73(?) 104district doctor stations staffed by doctors, when possible,and by feldsher assistants. If doctors are not available,feldshers operate the stations and have contact with thenearest hospital and clinic and polyclinic for guidancesupervision.Psychiatric services are a separate service withseparate staffing and facilities. There are relatively fewpsychiatric beds,' an estimated 10 percent of all beds com­pared to 50 percent or so of all beds in the United States.The outpatient and day care services are well developed,however, and cater to a large ambulatory population.Finally, in terms of services, mention should be madeof the services provided at places of work by factories,trade unions, and collective farms. There are first aidstations, physical screening stations, and, to somedegree, apparently, treatment facilities and personnel.12 Annual Use of Health Services in Four CountriesUSA Sweden England USSRHospital Admissions/1,000 140 140 90 200Days per Admission 8 13 13 14Days/I ,000 1,120 1,820 1,170 2,800Physician Visits/Person 5 3 5 IIPercent of PopulationSeeing Physician 65 65 65 95(?)The places of work also finance rest homes, sanitoria,health clubs, and other amenities.Division and SupervisionThe Ministry of Health in Moscow is the sole nationaladministrative agency responsible for the entire healthservices enterprise: services, education, and research.It has its own national budget for the guaranteed basicservices. This is supplemented, as indicated previously,by contributions from industry, trade unions, and collec­tive farms for nationally approved projects. The budgetis distributed to 15 republics, presumably on some sortof population basis and according to some criterion ofneed.Republics are divided into "oblasts" for all govern­mental administrative purposes and into regions called"rayons" for health service purposes. The rayons havepopulation catchment areas of several hundred thousandpeople. Each republic has a central administrative agencyreporting to the National Ministry of Health. Each rayonreports to the administrative agency within the republic.Within the rayon each of the hospitals, polyclinics, andsanitary services report to the rayon administrativeJUSSR Health Facilities and Personnel Improvement***Per 1,000 Population1950 latter 1960sHospital Beds 5.6 10.0Physicians* 1.6 2.4Middle-Grade Staff* .4 7.3Hospital Admissions (Urban) 150 201Hospital Admissions (Rural) 77 189*Probably includes dentists, who are regarded as technicians. Theywould count for approximately nine percent of the physician total.**/ncludes feldshers, nurses, midwives, and lab technicians.***Data from The System of Public Health Service in the USSR (Moscow:The Ministry, 1967).agency. Urban and rural services are reportedseparately. Below the National Ministry of Health levelthe budgets are controlled by the Ministries of Healthof the ·republics. Budget control is further disbursedthrough the oblast level and down to the city level.Projections and planning for the future presumablytake place at all levels, but the overall planning startsat the rayon level and flows up to the oblasts, the repub­lics, and finally to the National Ministry of Health, whichcoordinates all the plans nationally through the republics.The ministry engages in five-year plans, whereas therepublics can engage in one-year planning within thenational Five-Year Plan.Fast Personnel ProductionThe Ministry of Health bears the responsibility of sup­plying the USSR health service system with both facilities and personnel (except rest homes, sanitariums,etc.). Various levels of personnel are trained alongspecialized tracks and basically are divided into: physi­cians, middle medical feldshers, nurses, midwives, andtechnicians. The lower tracks include orderlies, maids,and other supporting and maintenance personnel. 4 Allievels are admitted to their various training tracks after10 years of general education or at about the age of 17.From the start students accepted for physician trainingmust commit themselves to one of five specialties anda subspecialty within the selected specialty. Those whogo on for postgraduate training are selected later. Unlessa student commits himself or herself to a specialty thatis open by planning quotas, he or she is not accepted.There are 10 applicants for every post-so reported onthis trip-and an application can be made to only onemedical school. Shifts in specialization after commitmentare rare and presumably frowned upon. The tracks are:(1) medical faculty, which includes internal medicine,surgery, obstetrics, and gynecology; (2) pediatric faculty;(3) stomatological faculty; (4) sanitary medicine andsocial hygiene faculty (public health); (5) and the phar­macologic faculty (not to be confused with the trainingof pharmacists).Medical training is provided in free-standing instituteswhich are unrelated to universities. Not all medicalinstitutes have all training tracks, but the majority havethe first three listed above. Each of the tracks hasseparate facilities and curricula, even though during thefirst two years the content is similar. Currently, the train­ing period is six years plus one year more or less analog­ous to an American straight internship or a first-yearresidency. During their internship students potentiallycan be assigned anywhere in the country, depending onopenings and staff competition for desirable spots whichwill enhance future connections. The more specializedtraining takes place after the internship and usually aftera three-year period of work in an assigned post. Again,I understand that the posts are very competitive, andassignment to undesirable posts is more or less bydefault.Russian physicians are ready, in effect, to practicemedicine at the age of 24. This is not to say they aregeneral practitioners. There is no such classification inthe USSR. All are specialists, as the saying goes; someare more specialized than others. The more specializedphysicians are then ready at the age of 27 for regularposts for which they can complete vigorously. Russianphysicians are legal practitioners three to four yearsearlier than American physicians, an important conside­ration in investing in medical manpower.The training period for middle medical trainees variesfrom one year and ten months to two years and sixmonths. Pharmacists, nurses, and dentists (stomatolog­ists are physicians) receive the longer training. Middle4. More details are provided in Medical Care in the USSR, reportof the U.S. Delegation on Health Care Services and Planning, MayI6-June 30, 1970, by Patrick B. Storey, M.D., U.S. Department ofHealth, Education and Welfare Publication No. (NIH) 72-60.13medical personnel are ready by 18� years (nurse) or 19�years (general feldsher and midwife).There is no tuition for medical training and for themost part there are stipends for subsistence support.Stipends can vary by the grades achieved by the stu­dents.Future of the SystemThe standard of living in the West is the USSR's refer­ence point, and the country's planners expect the USSRstandard certainly will equal someday and possibly thenexceed the Western standard. Also, it is expected thatgoods and services will be distributed more equitablythan in the West. The USSR health service is naturallyan integral part of this view, and it is expected that itwill become "bigger and better."The USSR health service is already better distributedthan health services in the Western countries. Whetheror not it is better overall than those in other countries,unit for unit, deserves much more than an impressionisticjudgment. Western observers can easily see that theUSSR facilities and equipment are, unit for unit, gener­ally not up to Western standards. The Russian medicalauthorities who travel must certainly know this, and mostcertainly I would assume that in their long-range planningthey visualize improvements in facilities and equipment.So far, the future of the USSR health service is basedon the desire for more, giving an astonishing impressionto Western observers who are now thinking in terms ofrationalization, efficiency, cost versus benefit, andretrenchment.The Russian criteria of need and use translated intofacilities, personnel, and expenditures, as established byprofessional judgment, have resulted in abundantresources and high use relative to Western experience.(I have deliberately selected the word "experience"rather than "standards," because in the West there areno systematic standards of use or resources to accom­modate this use.)Facts Set the PlanThe USSR government is investing 17 million rubles($20,000,000) in a morbidity survey of a sample popula­tion in nine medium-sized cities in various economicareas. This elaborate and expensive survey will lay thefactual basis for the indefinite future. Dr. I. D.Bogatyrev, the director of the Semashko Institute, Mos­cow, is the apparent brain child and promoter of thisreally stupendous study.It epitomizes the USSR reliance on the faith in sys­tematic data and expert opinion. The population basein the nine cities is about six million, and a sample of50,000 patients has been drawn from this base.Since the USSR health service is exhaustively com­prehensive, and all service components serve a knowndenominator, and all services are recorded unit for unit,a household survey of use and diagnosis is not necessary.Further, record linkages for individuals can be madebetween various types of service components that theindividual patient may use. All pieces of informationimaginable that go on record in a health system of this14 comprehensiveness are available: age, sex, residence,diagnosis and treatment procedures, physician visits bysite and time of day, hospital admissions, length of stay,preventive services, and so on.In addition, 12,000 individuals from the sample popula­tion have been selected for physical examinations byteams of physicians. Thus, it will be learned what propor­tion of the population has not sought services during theselected year, and what proportion has undetected symp­toms and consequently untreated disease. On these datathe experts will make estimates as to need and optimumdemand were people to seek services for all conditionsfound.Observations and ConclusionsCurrently, employed people and children in the US'SRhave periodic physical examinations. Future plans areto give an annual physical examination to every citizenand to expand specialized facilities and personnel toenable follow-up treatment and practice prevention onthe entire population. This is called the "dispen­serization" movement, a nucleus of which already existsfor heart disease, diabetes, tuberculosis, and possiblyother diseases. There will be total health surveillancefor the entire population, leaving hardly anything to theinitiative and discretion of the individual.Russian socialism has not only conquered lice, but itintends to conquer disease or control and manage it thethe maximum extent. The intent is to make medicineand medical care so scientific that professional judgmentwill be drastically reduced. Precise accountability willthen be possible, and annoying subjective judgment, thebane of planners, will not be necessary. When all agreeon scientific criteria, all are free of each other.From a comparative standpoint what I find overwhel­ming in the Soviet system is the seemingly lavish useof personnel-particularly physicians-and the greatnumber of specialized hospitals, beds, and polyclinicsand programs. I am sure that even if we could makecomparable judgments on the types of services, unit forunit, the extent to which the Russians seek and are pro­vided services would be much higher than that in theUnited States, Sweden, or England ..There is an official philosophy of abundance. Thereis an official philosophy of looking after the populationby means of its easy system access and the deliberatefollow-up of patients. When I asked Dr. I. V. Pustovoy,professor of health services in the Central Institute ofPostgraduate Training, Moscow, whether or not therewas a feeling that health services in the USSR were"overused," and whether it was an issue at all, he repliedthat essentially it is not an issue. No scientific evidencehas been brought forward that Soviet health services are,indeed, overused. That ended discussion on this par­ticular problem.In the United States, Sweden, and England there isa concern with high cost, high use, and, in fact, overuseof hospital services, and there are actions forretrenchment; in the USSR there is an atmosphere ofprideful expansion. This is in the face of my Russianinformants' estimates that their country is spending 12percent of its national income for health services, sixpercent from the state budget and the other six percentfrom other sources.Comparisons of percentages of gross national incomesare very tricky. I find the 12 percent estimate exceedinglyhigh comparatively. I feel sure, however, that the USSRspends more than the Western countries, and I am, there­fore, less concerned with the precision of the estimates.It should also be observed that although most Russianphysicians have not been well paid relative to engineers,for example, they still have shaped the most elaborateand accessible health service in the world. It has beentheir handiwork, as experts consulted by the politicians.Certainly, there have been ample professional incentivesif not financial incentives.The USSR health services should be judged in the Rus­sian context currently and historically in an economiccontext. In these terms the health services come outrather well. It is a plausible assumption that Russianamenities in their health service compare favorably withthe general amenities of Russian households and hotels.I believe American observers are oversensitive to thelack of amenities in their hospitals. It seems that theRussians can make dazzling exceptions if they so desire,such as are observable in their concert halls, operas, bal­lets, and subways, airplanes, and express passengertrains. Russian communism is expressing its humanist objec­tives in its health services. It is not for Western liberals,such as myself, expressing humanist objectives in politi­cal values. This is another and tortuous politicalphilosophical problem which is virtually beyond debatein a rational sense. The Russian and Western liberalpremises are much too wide apart.The USSR and Western policies and philosophies areindeed fascinating. We would say that the USSR is creat­ing a dependent population through a relatively lavishhealth system, where hardly any initiative needs to betaken by the citizen. The USSR critics would say thatwe capitalists-welfare state notwithstanding-are with­holding services from the people in order to save taxes.The USSR health service will give us an opportunityto study the operation and possibly the impact of a nearsaturation type of health service. No Western modelaffords this opportunity.Odin W. Anderson is a Professor in the Graduate Schoolof Business and the Department of Sociology and Directorof the Center for Health Administration Studies. He visitedthe Soviet Union in December, 1972, under the auspicesof the new health exchange agreement arrived at in March,1972, by President Nixon.Odin w. Anderson.15A Very Good Service: PediatricsAn Interview with Dr. Samuel SpectorChairman of the Department of PediatricsDr. Samuel S. Spector.Dr. Spector, you were the Acting Chairman of theDepartment of Pediatrics for several months before yourrecent appointment as Chairman. All of this experienceplus the number of years you have been in academiaand medicine should have given you lots of ideas aboutthe role of a departmental chairman in a clinical areaat The University of Chicago. What do you think yourresponsibilities are here"SPECTOR: It is a question of priorities. I think thattoo often in the past academic rewards have been greaterfor those involved in "pure" science, compared to therewards for those in applied fields such as clinical activ­ity. This second area has frequently been relegated toa lower echelon of importance with the result being lackof excellence. The chairman's role in a clinical depart­ment should be to bring the relationship between basicscience, the laboratory, and the patient into focus andbalance. Although such departments must foster basicscience research, their involvement with patients is theirdistinguishing feature. Clinical investigation and makingbasic science meaningful to the student, as it is appliedto study and care of patients, must be encouraged.16 This is the Chairman's philosophy, but how will you doit?SPECTOR: I think that the Chairman can develop aDepartment which would be more nearly equal in clinical-emphasis by encouraging the recognition of clinical ser­vices. If an individual is doing clinical work well in termsof investigation, in applying new knowledge, and inteaching, he ought to get the same rewards as theindividual in the laboratory. Such staff members mustbe developed; they should not be those who could notmake it in the laboratory.For many years the Department of Pediatrics has hada distinguished record, which has favorably influencedstudents and impressed them with the intellectual excite­ment of clinical pediatrics. This year is a turning point,not just because you are a new Chairman, but becausetwo of the Department's senior scholars are approachingretirement: Dr. F. Howell Wright and Dr. Donald Cas­sels. Are there successors for these people?SPECTOR: Their retirement will indeed result in a lossthat can never be fully replaced. They provide a wisdombased on experience, which requires time to develop.It is interesting that when such people leave they areusually replaced by groups. I think in Cardiology Dr.Rene Arcilla will be able to provide excellent clinicaland scientific leadership. He, along with Dr. OttoThilenius, Dr. Anthony Cuttilletta, and Dr. Domingode la Fuente, should make the Section of Pediatric Car­diology outstanding.Is Dr. de la Fuente a surgeon?SPECTOR: No, he is involved in the study of elec­trophysiology of the heart. Dr. Robert Replogle is thepediatric cardiac surgeon. The unique contributions ofDr. F. Howell Wright can be replaced only by develop­ing greater clinical competence in areas of ambulatorypediatrics dealing with both the well and sick child andin neonatology.Do you think the Department of Pediatrics should bedivided into specialties, or should it be more generalized?SPECTOR: I think there is an advantage in developingvery strong special sections. Interest and research in par­ticular fields increase and progress results. However, Iwould like very much to see all patients admitted to ageneral service with the specialists acting as consultants.I feel this results in better teaching and in better com­prehensive care for the patient.This means that you will have some general pediatriciansand some specialist pediatricians?SPECTOR: Yes. Up to now many of the specialists havenot acted as generalists. Recently, all have been usedin that capacity in our emergency room. There, all ofour staff do a stint; most of them enjoy it and contribute.I would not insist that every specialist take on generalistduties; some can not. The general service must be asexcellent as any special section. It cannot be relegatedto a duty. Great generalists must be developed. Theycan exist only. in an environment where there is continu­ous exchange of information and ideas betweenresearchers, basic and clinical, and clinicians.If you could add 5 or 10 faculty members to your Depart­ment at this time, budget permitting, what areas wouldget help and strengthening?SPECTOR: Our greatest need is to strengthen our clini­cal operation. There are a number of Pediatric Sectionswhich are extremely thin and need more faculty. We haveno full-time neonatologist. Specialist areas of allergy andimmunology, endocrinology, and infectious disease areeach operated by a single member. Scientifically, in theirfields of interest, they do have adequate stimulation andhelp through collaboration with and being part of a largergroup which crosses departmental lines.Which area is particularly strong? SPECTOR: The clinical sections which are particularlystrong are those of Pediatric Cardiology and Neurology.Each has an adequate staff in number so that they canengage in productive research and at the same time pro­vide excellent teaching and patient care.This is the ideal?SPECTOR: Yes. In addition the Department is verystrong in basic biochemical research under the directionof Dr. Albert Dorfman ('44).Your Department has funding from the Kennedy Foun­dation for Mental retardation. Who do you have andwhat do you do in this area?SPECTOR: The Kennedy grant for study of mentalretardation has been directed by Dr. Dorfman. Thereare three major areas involved. One has been concernedwith the investigation of the storage diseases such as themucopolysaccharidoses and the gangliosidoses. Therehas been a successful identification of the separateentities within the group with their specific enzymedefects. Although replacement of the missing intracel­lular enzyme is still not possible, it is apparent that itwill not be long before this can be done. The studiesare abetted by culture of fibroblasts. At present, we canidentify in many situations the heterozygote as well ashomozygote. This can be performed in the patient. Also,in pregnancy by amniocentesis one can determine thestatus of the fetus. This technique provides the meansfor more meaningful genetic counseling.There is also active research in basic brain functionunder the direction of Dr. Robert Moore (,57), Chief ofthe Section of Pediatric Neurology, and Drs. NicholasLenn and Ruthmary Deuel. And, to make the programtruly comprehensive, there is the clinical operation of theMental Development Clinic. There, an attempt is made todetermine etiology, chromosomally by cytogenetics orgenetically by identification of defect, or organic or emo­tional brain dysfunction. In all cases total evaluation isperformed to assess the problem, be able to counsel par­ents, including through genetics, and guide the develop­ment of the child so that he can realize his potential.Will you attract new staff?SPECTOR: Yes, we are engaged in recruiting aneonatologist and someone with interest in mentaldevelopment and nutrition. We also are expanding bydevelopment of a pediatric staff at Michael Reese Hospi­tal under Dr. Samuel Gotoffand at La Rabida Children'sHospitaL Both of these operations should complementour own operation.What about the area of infectious diseases?SPECTOR: Dr. Marc O. Beem ('48) is doing an excellentjob in supervision of our clinical microbiologylaboratories, which are of inestimable help in the care17Dr. F. Howell Wright, one of the Department's senior scholars, is soonto retire after a long career as a researcher and clinician.of our patients. However, there is a real need for growthin this section.There are not too many pediatric beds in hospitals inthis country. Why is this?SPECTOR: We are increasingly able to handle the prob­lems in pediatrics on an ambulatory basis. In the pastyear, of the 52,000 children we saw in our emergencyroom and 20,000 in our outpatient department, less thanthree percent required admission to the hospital. Also,the stay of children with chronic disease has beenremarkably shortened.You do not hospitalize infectious diseases anymore?SPECTOR: Most, no. At one point in my career I waschief resident of a hospital for infectious disease in NewYork City. During my last year there, we admitted 2,700cases of scarlet fever and 3,500 cases of measles. It isnow ridiculous to think of admitting such patients unlessthere, are severe complications. .Do you really think Pediatrics, which I presume splitoff from Internal Medicine, should remain a separateDepartment, as it is now, or should Pediatrics becomeexclusively a specialty for the handling of the 'young?The subspecialty groups which you have mentioned18 could become part of the Department of Medicine.General pediatrics then would be at one end, generalmedicine at the other, and specialty medicine for all ageswould be in between.SPECTOR: I think the pediatric age group is uniquenot only in terms of size and age. Obviously, there arecertain special characteristics of an infant and a childthat sets them apart from the adult. In many ways theyare different organisms. I feel it takes someone with adegree of expertise within pediatrics, apart from his ownspecialty area, to appreciate the total problem. in addi­tion there is a need for geographic separation of pediat­rics if we are to lessen the emotional disturbance causedin a child by hospitalization. In any case the developmentof pediatric specialists need not mitigate formation' ofspecialist groups across departmental lines. In fact agreat advantage that Wyler Children's Hospital enjoysis that it is so close and intimately involved with theother Sections and Departments within the Division ofthe Biological Sciences.If you could visualize the Department of Pediatrics 5to 10 years from now, what would you like to see?SPECTOR: As I view the changes that are occurringin Pediatrics, it appears to me that we are becoming moreand more involved with the finer aspects of development.Pediatrics has always been in the forefront in preventivemedicine. It provided the impetus for control of infecti­ous disease. In the future, I see increasing involvementin delineating the genetic make-up of the individual sothat we can prevent congenital defects or recognize andpossibly correct abnormalities which might in later lifeproduce disease.Do you really think that 10 years from now, as pediatricresearch has led to genetic research, that you will actas a counselor and will, in fact, counsel parents not tohave children?SPECTOR: I feel that it is the role of the physician toacquaint the parents with the risks involved for themin having a child and to help them make the decision.The situation also has been aided by our ability in someof the inherited disorders to determine if the fetus isaffected. In this way there is still another opportunity fordecision. I trust that the final choice of having a childwill remain with the parents.The more we learn about genetics, the more we will learnthat almost everybody has the seeds to some disorderthat might appear.SPECTOR: That is true. The problems that will becreated by our abilities in genetic screening and engineer­ing are very complex and need very serious ethicaland moral study.Dr. Samuel S. Spector is Professor in and Chairman of theDepartment of Ped i atrics.Around the WorldWith the IensensThe Director of Ben May LaboratoriesCarried the Word Far in Just Five WeeksThe miles that he traveled in his more than around­the-world trip go far to the left of the decimal point. Thatis pretty strange for Elwood V. Jensen, Director of TheUniversity of Chicago's Ben May Laboratory. He isreally used to working to the far right of the dot in hisnow internationally known work on estrogen receptorproteins. Recently, he sat down for just a moment totalk about his travels last fall and his work, which maysoon serve as the parent research for clinical investiga­tions in Tokyo, Lisbon and perhaps several more loca­tions worldwide.It started out simply enough. The Roussel Phar­maceutical Company in France invited Jensen to serveon the organizing committee for a small symposium onestrogen action. So, first it was to Paris via Air Franceto participate in "Estrogens: Outlook and Mechanismsof Action."In Paris, Jensen discussed his successful diagnostictest, which he reported first in 1970 and again at theFourth International Congress of Endocrinology inJune, 1972. The test identifies those women with widelydiffused breast cancers who will respond favorably to theremoval of their adrenal or pituitary glands. It determineswhether the breast cancer cells contain steroid-bindingproteins known as hormone receptors. The receptorschemically bind female sex hormones to the cells thatmake up hormone-dependent tissues."So, since Mrs. Jensen and I were in Paris already,we took advantage of the situation to go to Lisbon,"Jensen said. There, he discussed his work with Dr.Manuel Castro of the Portugese Institute of Cancer.Together, they laid plans for a long-term study of breastcancer patients screened by the estrogen receptor test.Unlikely spot? The advantage of Portugal for this long­term study is the relative stability of the population. If a woman with primary breast cancer visits a clinic doctorin Portugal today, and the doctor does a .mastectorny,chances are that if the patient has a recurrence threeyears from today, she will return to the same clinic forcare. In this country, of course, today's Chicagoan isI tomorrow's Bostonian.Next for Jensen it was off to Munich on Lufthansato lecture at: the University of Munich School ofMedicine. He then traveled across the border to Jenain East Germany. There, he had had a long-standing invi­tation to lecture on the basic biochemistry of hormoneactions. The East Germany Academy of Sciences, hefound, was in a better scientific situation than he hadanticipated. It seemed to him that the facilities were goodat Jena and that the scientists were able to get Westernjournals without long delays. Though no one behind theiron curtain is now involved in work similar to Jensen's,he found that the researchers in those countries are "in­terested in thinking about it."From East Berlin the Jensen's flew on the RussianAeroflot line to Moscow and then to Bangkok. Alongthe way, they picked up the knowledge that the Russiansdo not really drink quantities of vodka, since, it turnsout, the liquor is rather expensive for them; instead, theysettle for champagne. Jenson had no comment on thepolitics of this phenomenon, he just mentioned his fondmemories of his brief Moscow visit.An Oriental MysteryJensen changed from Aeroflot to Air India for the finalleg of his journey to Hong Kong, which he visited inthe interest of the Breast Cancer Task Force of theUnited States National Cancer Institute. The task force,which supports Jensen's work, has long been interestedin the incidence of breast cancer in oriental women. Occi­dental women-not just caucasians, but all Westernraces-suffer approximately nine times the incidence ofbreast cancer of oriental women."One might suppose this phenomenon is explained byheredity, that it is a genetic factor at work, but it is notentirely that," Jensen said. "When Japanese womenmove to this country, the probability of their being strick­en with breast cancer increases. The incidence amongorientals in this country does not reach the level of occi­dentals, but it goes up by a factor of three or so. Thereis something going on; something is protecting them."One explanation for the low incidence of breast cancerin orientals, Jensen suggested, is that the whole hormonalpattern of these women might be different from occiden­tal women. Previous studies of hormonal excretion pat­terns have revealed that there are some overall differ­ences. Jensen's method of checking women for the recep­tor protein offers a new criterion, or parameter, for inves­tigating the lower oriental incidence of breast cancer.Such an investigation could reveal if the same propor­tions of hormonal dependent and hormonal non­dependent breast cancer patients exist in the Orient asin the West.Jensen explained: "It has become recognized thatbreast cancer is not a disease but a family of diseases.There are wide individual differences. So, we are trying19to get as many different criteria for characterizing andclassifying breast cancers as possible."In Hong Kong Jensen discussed the possibility of astudy on estrogen receptors with the chairmen of thedepartments of surgery, pathology, and obstetrics andgynecology at Queen Mary Hospital, University of HongKong. Dr. Ong, chairman of the hospital's departmentof surgery, was particularly enthusiastic about the possi­bility. Subsequently, he sent one of his associates to theBen May Laboratory at the University to learn thetechniques of estrogen receptor identification. Jensenreported to the United States National Cancer Instituteand urged that group's support for the Hong Kong pro­ject. He is now waiting for a report from the instituteon whether support can or will be provided.After Hong Kong came a brief visit to Taipei, wherethe Jensens' son is a student of Chinese languages andliterature. The stopover included a lecture at theNational Taiwan University School of Medicine.The Institute for Enzyme Research at Japan's U niver­sity of Tokushima was the next lecture stopover, reachedby Japan Air Lines, naturally. Then, it was on to Tokyofor negotiations toward setting up a study similar to thatproposed for Hong Kong. This one would be at theTokyo Medical and Dental University. Dr. Okomoto,a faculty member in obstetrics and gynecology at theuniversity is a specialist in breast cancer and a few yearsago worked for two years under Nobel Laureate Dr.Charles B. Huggins, the William B. Ogden DistinguishedService Professor in the Ben May Laboratory. Two otherstaff members from the university have also spent post­doctoral time at The University of Chicago, and a third,Dr. Hirotomo Kitada, is now at the University studyingJensen's techniques. There should be no problem staffingthe Tokyo project.The remaining problem in getting the Tokyo studiesunderway, Jensen said, is the funding for the work. ByJapanese governmental policy the Tokyo Medical andDental University cannot accept funds from the UnitedStates National Institutes of Health. It may be possible,however, to contribute funding to the project throughthe National Science Foundation in an exchange programor a cultural relations program. The study would be incollaboration with the Japanese National CancerInstitute."Even with the lower national incidence of breastcancer there," Jensen added, "a tremendous numberseek care and treatment. There will be a plentiful supplyof medical subjects and everything looks favorable fora study in Tokyo."It must have been at least a small source of pleasurefor the Jensens to board a Canadian Pacific plane-to thefinal lecture-stop of their tour. Reaching the MontrealClinical Research Institute took them well past theround-the-world mark but not too far from home for thelast leg of the journey. The Montreal lecture at least com­pleted the list of Jensen's long-made commitments to dis­cuss his work with interested peers.A Routinely Complex TestJensen's research is based on the fact that in about20 one in four breast cancer patients with advanced disease,the cancer cells appear to require the female sex hor­mone, estrogen, to grow. In these patients a receptorprotein is present in the cancer cells. In pre-menopausalwomen it has been known for some 75 years that certainbreast cancers will cease growing if the patient's ovariesare removed. Dr. Huggins reported in 1952 that removalof the adrenal glands, which in post-menopausal womenappear to produce sex hormones, will bring about remis­sion of the breast cancer in some, but not all, cases.The problem has been to predict in advance whichpatients might respond to this surgery.Working with Dr. George E. Block, Professor in theDepartment of Surgery, Jenson and his associates foundthat only one of 32 patients whose cancers lacked thereceptor protein benefited from endocrine surgery. Thiscontrasted to remissions seen in 15 of 19 patients withreceptor-containing tumors."If the test is negative," Jensen reported in 1972,"there is very little probability that adrenal or pituitarysurgery will bring about a remission. The patient canbe spared the trauma of useless surgery."Now, the test is done frequently in The Universityof Chicago's Hospitals and Clinics complex, and thelabor involved has, to some degree, been made routine.Doctors take a sample of a patient's breast cancer tissueand look for a characteristic "receptor" protein in theextranuclear part of the cell. In the living cell this proteincombines with estrogen and moves to the cell nucleus,where the hormone is localized and the effect on growthis initiated. This nuclear localization is the end, but thecharacteristic extranuclear protein is the simplest meansof identifying patients in whom the localization will takeplace.The first step of the test involves extracting from thetumor tissue sample the clear, soluble part of the cells,the cytosol. Radioactive estradiol-the hormone labeledwith tritium, or radioactive hydrogen-is added to thecytosol. The radioactivity of the hormone serves as amarker; the investigator must determine if the radioactivehormone has bound to receptor protein molecules in thesample.. The test mixture is put on a sucrose gradient, a solutionof sugar which varies in concentration from a low con­centration at the top of the container to a high concentra­tion at the bottom. The test gradient actually goes from10 percent to 30 percent sucrose from the top to the bot­tom of the tube. An ultracentrifuge is used to sedimentthe various proteins in the test mixture. The proteinssediment through the sucrose at different rates, depend­ing on their size. Samples spin for 12 hours at approx­imately 300,000 times gravity, 56,000 revolutions perminute in the ultracentrifuge.Jensen explained: "We choose the conditions so thatbecause of its size the receptor protein goes about half­way down the tube. If the receptor protein is there, theradioactive hormone will be bound to it. We haveradioactivity halfway down the tube. If there is no recep­tor protein in the sample, the radioactive steroid just staysat the top of the gradient, since it is a much smallermolecule. "In essence the investigators look for the radioactivityof the hormone bound to the receptor protein by atechnique that separates proteins according to their size.At The University of Chicago this technique has nowbeen automated to a considerable extent. Even thoughthe equipment needed is fairly complicated, the applica­tion of the test has been simplified by means of themachinery. Three patient samples can be run at a timein the ultracentrifuge, and it runs automatically over­night. Counting of the radioactivity proceeds automati­cally, and the results are computer processed... Future Research Directions"There are really two aspects to these studies,"Jensen said. "One is to benefit patients with advancedbreast cancer who are candidates for endocrine surgery,to determine whether they are the type who will behelped by the surgery. This is the immediate problem,and this is what we have been concentrating on hereat the University for the past few years."The other emphasis of these projects is to study theprimary breast cancer at the time of mastectomy to seewhether it is receptor containing. Of the patients whoundergo mastectomy and are sent home hopefully cured,approximately 50 percent return within five years witha recurrence. We want to see if there is any correlationbetween the nature of the primary tumor and the inci­dence of return. Do returning patients tend to be of thereceptor-containing type or the non-receptor-containingtype?" Also, we can use the test data collected from aprimary-tumor sample to predict a returning patient'sresponse to endocrine surgery. We can not always carryout our test on these returning patients, because somedo not have an accessible tumor from which to take atest sample. If the test has already been done on theprimary tumor, we will perhaps be able to use the infor­mation in later years to select the proper treatment forthat patient."I t may turn out that information from the primarytumor will not allow an accurate therapeutic predictionat a later date. In this event we will at least be ableto study the changes in the cancer. We know that astime goes on, breast cancer tends to change from hor­monally dependent to non-dependent. We also havesome evidence that a loss of estrogen receptors accom­panies this change."For aman who can say that he went around the world,and farther, in five weeks to the day, Jensen remainsobviously untouched by jet lag, or any other lag for thematter. For a man who lost his luggage on the way toHong Kong and did not get it back until he reachedTaipei, he remains clear-minded in his interests and pur­pose. So, it should not be too long a wait until Jensenis back on a jumbo jet. He will be on his way to checkresults at functioning breast cancer research projects.'IIElwood V. Jensen is a Professor in the Department ofPhysiology and Director of the Ben May Laboratory andthe Biomedical Center for Population Research. Elwood V, Jensen (foreground) and Eugene DeSombre place samples ina radioactivity counter to check for the presence of estrogen receptorprotein in the specimens.2722 Endless AccountabilityAn Interview with F. Regis KennaDirector of University HospitalsIn 1927 The University of Chicago established a hospitalon the campus of the University to provide a teachingand research laboratory for the full-time clinical faculty.Assuming this remains the operating principle of theBoard of Trustees, what special problems does this posefor the hospital director?KENNA: As a teaching hospital naturally our costs ofoperation are higher for similar or the same services pro­vided in a non-teaching setting. At the same time thepatients are getting a greater quantity of care and, weassume, a better quality of care.Does this raise any problems for you as an administratorof a teaching hospital compared to a community hospi­tal, where the faculty is not salaried and where they andthe director are not working for the same agency?KENNA: We have to justify our higher costs to the thirdparty payers and at the same time isolate research costsfrom teaching costs and from patient-care costs.Does the professional staff make demands on the hospi­tal that you believe would not be made in a communityhospital?KENNA: Well, I think there may be more demands forsupport of laboratories. We have 30 service laboratoriesright now, and that means there are 30 groups of demandscoming in. In a community hospital you may have oneor two laboratories with limited demands.There are demands made by a surgeon, for example,for special equipment to help him with his work thatwould not be made in a community hospital, aside froma laboratory?KENN A: There are more demands; we do more sophis­ticated procedures in the operating room. This opens thedoor to many more types and quantities of demands.You have mentioned the increased costs of care as aprimary problem in a hospital-teaching relationship.Could you explain what increases the cost, other thanlaboratory costs?KENNA: It is not just the internal operation that costs;the fact that we are a teaching hospital in itself is notthe only factor. The fact that we are a teaching hospitalbrings us sicker patients. I could show you bills forhemophiliac patients that run up to $50,000 during a six­to eight-week stay. I could show you open-heart surgerycases where we have used $5,000 of a single drug onthe first day after this sort of surgery.W hat you really are saying is that by comparison withthe average community hospital, the degree of the illnessof the patients in this hospital is considerably greater?KENNA: There is no question about it. We have aboutseven intensive care units; the ordinary community hos­pital might have one or two. We have some 20 cardiacmonitors floating around the hospital in patient roomsoutside the intensive care units. We have numerousrespirators, I am not sure even how many, floatingaround.Could you compare our per diem cost with a non­teaching hospital in the same area?KENN A: Our latest report showed our average staywas 9.5 days. A nearby 140-bed community hospital hadan average stay of 10.5 days. Their cost was $110 a dayand ours was $152. But our $152 is an average, includingall our intensive care units, patients that require sophis­ticated surgery, and the radiology and anesthesia profes­sional fees, which in most other hospitals are billedseparately.If you subtracted the professional services, would theper diem cost be about $130?KENNA: Well, not that low. I would have to calculate.l'l In addition we support a tremendous house staff cost, of $2.8 million on the hospital budget alone, which you, do not find in a community hospital.Do you think the patient is getting his money's worthwhen he pays for his house service?KENNA: There is no question about it, because he notonly has the service available to him, but he also hasthe specialty services available 24 hours a day. Thiswould not be provided in a small community hospitalor even a large community hospital.This is an awkward question, but do you think we arejust providing better care for our patients who are justas ill as most other hospitals' patients, or are yousatisfied that the average patient that comes to this hos­pital is really more ill?KENN A: I think there are some patients here who couldbe taken care of in other hospitals, and there are manypatients in community hospitals who should be here. Asa result there are some patients with the same illness F. Regis Kenna.23getting a different quality of patient care, depending onwhere they are admitted.Do you think there are more patients hospitalized in com­munity hospitals than in this hospital for diagnosticinvestigation only?KENNA: I believe there are. In fact one of our chairmentoured a sizable community hospital in Chicago andreported that of all the in-patients in that hospital whowere in his service, only one out of three qualified foradmission by our standards. At the same time the Stateof Illinois has instituted the HASP program. Public-aidpatient stays are certified for payment before the factbased upon the diagnosis. We have had a negligiblenumber of days disqualified for payment through thismechanism. Some community hospitals have had a sig­nificant number of days denied for reimbursement.Is the cost freeze on hospital care that has been imposedby the federal government a fair or appropriate thing?KENNA: It is not fair under Phase III, because we arelimited in what we are permitted to charge, unless wefile for exception and it is approved. The people sellingproducts and services to us, however, are not restrictedin what they can charge us.I s the government's concern for the rapidly rising costof hospital care an appropriate one, considering thatpeople in this country seem to want good medical care?Also, is there much waste implied by these public govern­mental statements?KENN A: I do not believe that there is much waste.I think we have squeezed almost all of the fat out ofthe system. The big problem, I think, is with the cong­ressmen, the lay public, and many physicians who donot understand hospital costs.One gets the impression jobs in hospitals are becomingmore specialized. If this impression is correct, does thisresult in increased operational costs because people cannot cross lines to fill in gaps?KENNA: You are right in terms of some of the jobs,because we deal with many different unions. We do incursome costs because of specialization, but there are moresignificant costs involved in laboratories where techni­cians are all specialized. We offer approximately 780 dif­ferent laboratory tests, and you cannot train a technicianor a group of technicians to do all of them. At mostperhaps a single technician can do 50 in a chemistrylaboratory.Third party payers-the government is probably the big­gest one-are insisting upon more cost accounting in hos­pitals to justify their payments to the hospital. Do youbelieve that the elaborate accounting procedures nowrequired are increasing the cost of medical care to thepatient?24 KENNA: While most accountants will not agree withme, I firmly believe it is costing us $10 to $20 per patientper day just to complete the elaborate cost accountingrequired by the -government for third party contracts. Iam a firm believer that one day we are going to get anall-inclusive rate. Each third party is going to reimburseus at the same rate, based simply upon the total approvedbudget and the number of patient days, so we will nothave to do the elaborate accounting for each patient.You were a pharmacist before you became a full-timehospital administrator. Has this been advantageous foryou in your position here as Director rather than follow­ing the more conventional method of working yourselfup in hospital administration?KENNA: As a pharmacist I have a little advantage inbeing used to talking with physicians about their prob­lems. Also, I was a pharmacist in a hospital and a depart­ment head, which has helped me in working with hospitaladministration. I served two years in an Army labora­tory, so I also understand something about laboratories.I s there a substantial need in hospital managementfor hospitals to purchase special services from specialtyorganizations rather than to provide these services forthemselves? These would include food services, intraven­ous services, blood provisions, personnel services, andperhaps even nursing services. After all, Cook CountyHospital purchases its nurses from Cook County Nurs­ing School. Is this a trend in hospitals and is there someeconomic wisdom in this?KENN A: Personally, I do not think there is anyeconomic wisdom in doing it, particularly in an institutionof this size. We have looked at it at various times, andeach time we have determined we could provide suchservices ourselves at a lower cost. However, we do buysome services, such as computer services and someenvironmental sanitation services. On the other hand,smaller hospitals do benefit some from group purchasing.Do you have anything you would like to add to whatwe have discussed?KENNA: I think the financial restraints that we areoperating under now are going to be with us for one hellof a long time. I have estimated that I am spending 80percent of my time with financial matters, 15 percentof my time with physicians and physician problems inthe hospital, and about 5 percent with the administrativestaff. I think that financial problems are going to be withus for ever and ever. Third party payers, the governmentin particular, are holding us and are going to hold usat the point of bankruptcy and are paying brinkmanshipin the process. But I do not believe they are ever going tolet us look over the brink.F. Regis Kenna is Director of the University Hospitals andClinics and an Assistant Professor in the Hospital Adminis­tration Program in the Graduate School of Business.The New American TraditionTestimony Before the Senate Health SubcommitteeOn the Quality of Medical CareJames D. WatsonI am here this morning with two major objectives: one,to give you a broad overview of where the field of gene­tics now stands in relation to medical research and clini­cal application, and two, to voice my strong apprehen­sions about basic changes being proposed by the execu­tive branches for the organization and support of biologi­cal and medical research within the United States.You must, of course, realize I am a biased advocatefor the central importance of genetics to the well-beingof the American nation. I could not have kept the subjectof heredity my primary concern for almost three decadesif I did not find it of key importance to both basic biologi­cal thought and to many key facets of our human lives.Ever since my student days at Indiana University, whenI listened to lectures from the great American biologist,Herman Joseph Muller, I have been very conscious ofthe fact that the specific information carried by our genesis what makes us different from all other forms of life,giving to us our unique attributes which we call human.It is thus our most valuable human commodity and mustbe treated as a very precious and fragile gem carefullyguarded from unintentional harm.I am, naturally, not saying that our genes completelydetermine all our vital attributes; the many ways ourenvironment governs what we become or do not becomeare too well known to bear repetition here. But no matterhow optimal the environment, a child born with Tay­Sachs syndrome will never have a chance to become anadult. Because he received from both his father andmother bad copies of a vital gene necessary for normalbrain development, he will never be able to become anadult. The existence of this disease and many otherequally dehabilitating affections, all caused by faultygenetic material, provides much of the interest that we now have in the furthering of our knowledge of howheredity operates. We want to know the differencebetween good and bad genes, hoping somehow to preventmore of them coming into existence and to find waysto nullify their destructive consequences.Remarkable Detailed KnowledgeVery fortunately we have come a very long way duringthe past several decades in elucidating the chemicalnature of genes and chromosomes. Now, to remarkabledetail, we understand how the chemical organization ofgenes allows them to play such a dominant role in thelife of cells. We have found that genes are deoxy­ribonucleic acid molecules (often abbreviated as DNA).A DNA molecule is built up from the linear arrangementof a very large number (often many thousands) of fourdifferent building blocks (the nucleotides). The unique­ness of each gene lies in the specific linear order withwhich these nucleotides are arranged. Each gene has adifferent nucleotide order, analogous to the way eachword in the English language is characterized by a uniquearrangement of some of the 26 letters of our alphabet.Such nucleotide arrangements control the preciseorder of amino acids in specific proteins like hemoglobin.This fact is often simplified by the phrase "onegene-one protein," that is, a 'one-to-one correspondenceexists between the number of genes and the numberof different proteins which an organism may pos­sess. Thus, if a gene is changed, so will be its proteinproduct. Given this viewpoint, we can understand howa disease like sickle cell anemia arises.In this disease normal hemoglobin molecules are notpresent. Instead, the red blood cells of persons with thiscondition have slightly altered hemoglobin moleculesJames D. Watson graduated from The University ofChicago in 1947, receiving a B.S. degree in zoology.He received his Ph.D. degree in zoology in 1950 fromIndiana University. In 1962 he shared the Nobel Prizein physiology and medicine with F. H. C. Crick andM. H. F. Wilkins for work on the three-dimensionalstructure of deoxyribonucleic acid (DNA). He hasbeen a member of the National Academy of Sciencessince 1962 and is also a member of the NationalCancer Board. Currently, he is a professor ofmolecular biology at Harvard University and directorof the Cold Spring Harbor Laboratory.25with one specific amino acid being replaced by another.Because of this change, these mutant hemoglobinmolecules are unable to bind oxygen well, giving riseto the resulting anemia. Correspondingly, the geneswhich carry the information to make the abnormalhemoglobin products differ from their normal counter­parts by one very specific change in their nucleotideorder with one of the "letters" of its nucleic acidalphabet being replaced by another.As far as we can tell, most chemical changes of genes,which we call mutations, have detrimental consequences.Thus, we must minimize our exposure to any agent whichwe think may chemically modify our genes. Here, weare greatly indebted to the geneticists of the past 50 yearswho have probed to greater and greater detail how muta­tions occur. While some seem to occur without externalcauses, the origin of many others are now seen due toexposure to various forms of radiation or to specificchemicals. Equally important, we are just beginning tounderstand at the molecular level how these agents act.For the first time we can predict whether compoundshave a good probability of harming our genes. For exam­ple, we now understand so well how nitrates can be con­verted at high temperatures to the very highly mutagenicnitrosoamines that as a geneticist I must becomeapprehensive every time I have a nitrate-loaded pastramior bacon sandwich.Defects May be RepairedWe can also begin now to look to the question ofwhether it may be possible to nullify the consequencesof specific bad genes, conceivably replacing them withexternally added new genetic material. Here, however,we are on much shakier ground, since many past claimsof genetically altering higher animal cells by addition ofpurified nucleic acid molecules have been justly regardedwith great skepticism. During the past year, however,several very clean experiments have shown that exter­nally added DNA molecules can, in fact, enter animalcells and become inserted into their chromosomes. Theefficiencies of such insertions, however, are very lowwith at best maybe one cell in a million acquiring adesired gene.Greater efficiency in repairing genetically defectivecells might come someday from the use of human viruseswhich have been so manipulated that their chromosomescarry small parts of human chromosomes with a desired26 gene, for example, one which specifies normal hemoglo­bin molecules. Infection of the individuals affected withsickle cell anemia with such modified virus might con­ceivably expose most of their blood-forming cells to thegood genes, leading to massive replacement of the badsickle cell genes with good ones. Unfortunately, whilethis method works well with bacteria, I suspect it willbe horrendously difficult to apply to humans. One mightdraw the analogy of sending a man to explore Pluto undercircumstances where he has a chance of returning to theearth.But you should remember that when scientists areasked to predict the future, they tend to magnify dif­ficulties. They cannot assume the emergence of chanceobservation that can suddenly make a difficult task mucheasier. None the less, it probably makes sound senseto assume that genetic therapy is not around the comerand that we have no rational choice but to see that ourhuman genetic material does not gradually decline inquality because of massive unforseen mutagenesiscaused by wide scale dispersion of the all-too-manypoisonous industrial products of our increasingly artificialworld.Magnifying the mutagenic problem is the fact that mostmutagens also have the capacity to induce cancer,strongly suggesting that the origins of most cancers arechanges in genetic material. Some of these changes occur"spontaneously" while others are due to the entry ofviral genes into host chromosomes. Very, very likely,a satisfactory understanding of the cancer problem willalso depend on further deep advances in our knowledgeabout the organization and functioning of the chromo­somes of human cells.Here, I must emphasize that despite our striking suc­cesses of the past 25 years in working out many funda­mental genetic principles, we still have deep and funda­mental gaps in our knowledge of the fundamentalbiochemistry and genetics of human cells. For example,several years ago the general suspicion was that mostof the DNA in a human chromosome carried informationfor ordering amino acid sequences. Each complete groupof human chromosomes would contain some six milliongenes, a number much too large for us to effectivelystudy in a comprehensible time period. Now, however,the suspicion exists that most of our DNA does not con­tain genes, and that the real number of human genes maybe as low as 25,000 to 50,000, or only some 5 to 10 timesmore than the average bacteria possesses. If this newhunch pans out, which work during the next few yearsshould tell us, then the problem of someday describingall the human genes can be seen to be an accomplishabletask, though it may require some 50 to 100 years moreof dedicated research. Most likely, however, we willnot require anything like this interval before we un­derstand the essential organizational principles whichdictate how and when our genes are to work. The next10 to 20 years will probably give us this information,that is, if this country, together with the other majornations, continues to place a high priority on fundamentalbiomedical research.Correct Methods, Correct ObjectivesI, until recently, together with most of my colleagues,have thought this course of affairs so obvious as not tobe doubted. The objective of the preservation of ourhealth, both in the immediate and in future generations,should be clearly at the top of our national priorities.The events of the past several years, however, leave mewith much less confidence. For the message increasinglycoming out of the executive branch is that science isfine as long as the payoff is fast and our nation's scientistsare skillfully channelled into work on major nationalproblems. With the dollar weak and American productsnot always wanted by other nations, the word is out thatwe are not rich enough to do science for science's sake,but only ifit generates a quick return for the buck. Unfor­tunately, this way of proceeding, which could at firstsound like common sense, represents a puerile under­standing of both how good science is done and how itsdiscoveries have been directed toward human applica­tion.We must never forget for the most part we have littleinsight about the truly unknown; the world we live inis immensely complicated and on the whole its naturalphenomena are remarkably unpredictable. All too often,only after a chemical reaction within a cell has beenobserved, do we find a reason for its existence. Thus,it is almost impossible to plan ahead what the future willbring. About the best we can do is to try to bring ourmost intelligent and sensible minds to bear on a givenproblem. Then, let them go at their own speed and direc­tion. This should be the way the hoped-for "Conquestof Cancer' � should be administered. This objective alltoo clearly depends upon the emergence of unexpected new discoveries and so demands the talents of the verybest brains this nation possesses. They will do the bestjob if essentially left to their own intuition, not to thatof NCI scientific bureaucracy which, despite the bestof intentions, has no special calling for the undevined.Yet, the forthcoming governmental prescription forcancer research, if not for most other forms of medicalresearch, ominously points in the direction of more con­tract money, for which the government calls the shots,and less free grant money for which the individual scien­tist decides where the future may lie. All too large aproportion of this contract money will go to senior, estab­lished people as opposed to younger scientists who haveyet to prove themselves. Yet, almost every importantnew discovery comes from someone under 35, who, atthe moment of his breakthrough, is essentially unknownto the outside world and, so, unlikely to be given a con­tract by a government that looks with distaste on theunpredictable.Even more disturbing for the long run will be theeffects of the current edict to shut down all NationalInstitutes of Health-sponsored pre-doctoral and postdoc­toral training and fellowship programs, as well as thecareer development awards which now support most ofthe better, younger scientists in medically orientedresearch. If this threat is carried out, not only will allthe money be tightly held by middle-aged entrepeneurs,but the science itself will have to be done for the mostpart by an age group not noted for working into the night,which in the past has only rarely been innovative, andso cannot now be expected to have a better track record.I can, thus, only describe as lunacy a governmentalpolicy that openly states the wisdom of choking off thesupply of younger people into medically orientedresearch. One gets the horrid impression that somehowour nation is mounting mammoth crash programs todevelop new Pampers, not to conquer a collection ofwell-dug-in diseases against which conventionalapproaches bounce off as if they were ping pong ballsthrown at concrete walls. Must the new American tradi­tion be to lose our wars and call them victory? Is it possi­ble that someday we will have our government say thatthe real problem is not cancer or strokes or coronariesbut the scandalous behavior of the research scientistswho lack the integrity to carry out its government's wishfor instant victory? For the sake of my children and theirchildren, I hope not.27The Seniors Get TheirsNew Internships • • •On April 17 Joseph J. Ceithaml, Dean of Students inthe Division and The Pritzker School of Medicine,announced that the graduating senior medical studentshad received "the best group of first-year post-doctoralappointments secured by a graduating class in the lastfive years."His tone was slightly different on April 13, when hestood before the senior students, who were waiting tobe handed the official notices of their internships andresidencies. He said to them forthrightly, "I think you,as a class, did yourselves proud."More than half of the 84 seniors graduated in June fromThe Pritzker School of Medicine will go on to intern­ships and residencies at their first or second choice teach­ing hospitals. Most of the appointments came from theNational Internship and Residency Matching Program(NIRMP) for positions which will begin about July 1.This year, a third of the graduating class of the medicalschool will directly enter first-year residencies. Only sixstudents in the graduating class of a year ago entereddirectly into residency programs. Twenty-eight of the1973 seniors will go into such programs.Medicine internships predominated in the selection ofpost-doctoral work; 31 of the 84 graduates will internin medicine. Surgery and pediatrics proved to be the mostpopular residencies, with 11 students in each of the fields.Other internship selections were: 8 students in pediatrics,7 in rotating, 6 in surgery, and 3 in pathology. Otherresidency selections were: 2 students in psychiatry, 2in family practice, and 1 each in radiology and ophthal­mology. One graduate will spend her coming year at theUniversity in a research program in pharmacology.Dean Ceithaml attributed at least a portion of the stu­dents' good fortune to the efforts of Dr. George Block,Chairman of the Internship Placement Committee, andto the 'other members of the committee. Dr. Block andhis committee members encouraged faculty members toDean Joseph J. Ceithaml and Dr. C. Robert Cooley (center).28 write supporting letters for individual students and dida good deal of follow-up work to see that the letters werewritten. The students' appreciation for Dr. Blocks' workwas well expressed at the April 13 meeting by the healthyround of applause which greeted his entrance.The IS-minute April 13 meeting was a fine exampleof emotions barely under the control of fast-frayingnerves. About half of the seniors were too preoccupiedwith their hopes to remain seated in the amphitheatersetting of Frank Billings Auditorium. Distracted mindsallowed some hands to carry champagne glasses at ratherprecarious tilts. Some students opted for the coffee andcookies available down in front of the blackboards; somejust stared at the blackboards, as if still anticipating animmediate necessity to take notes.Most of the seniors managed to lower themselves intothe seats by the time Dean Ceithaml called out RichardBerger's name and handed him the first envelope. Fromthen on conversations degenerated into a series ofsounds: joyous cries, relieved shouts, and a few resolutesighs. Envelopes were misdelivered and passed overheads; eventually, they found their owners or their own­ers found them. One student just stood and stared athis unopened envelope.It was mostly finished in a few minutes. The seniors,with their coming year firmly in hand, clustered at theauditorium exit to pat backs, shake hands, and lay plansfor future action."Where are you going?""That's fantastic; three of us in one place!""See you there.""You can come out to San Francisco and ... "Following is a list of the graduating seniors, includingtheir specialties and places of appointment. (I indicatesan internship; R indicates a residency.)Dr. James E. Schwanke (left) and Dr. Clifford D. Marbut.Dr. Arlen R. Holter (left) and Dr. Elizabeth A. Reid.Earl M. Armstrong, I, Johns Hopkins Hospital, Balti­more, Maryland, Medicine."Richard Eugene Berger, R, University of ColoradoAffiliated, Surgery.Stephen Jon Bittner, R, New Haven Medical Center,Yale University, Connecticut, Pediatrics.Diana Jean Breslich, I, State University of Iowa Hos­pitals, Medicine. •Helen Brown Britton, I, University of Chicago Hospi-vtals and Clinics, Pediatrics.Stephen Robert Burstein, R, University of California,San Francisco, Pediatrics.Charles Mylan Chuman, R, Northwestern University 0Medical Center, Chicago, Surgery.Andrew Marc Churg, I, University of Chicago Hospi­tals and Clinics, Pathology.Glen Robert Cooley, R, Albany Hospital, New York,Surgery.Catherine Margaret Covey, I, University of Chicago xHospitals and Clinics, Medicine ...William B. Cutcliff, R, Strong Memorial Hospital,New York, Radiology.Jan Pierre DeRoos, R, Mayo Graduate School ofMedicine, Surgery.Kenneth Robert Diddie, R. University of Chicago vHospitals and Clinics, Ophthalmology.Samuel H. Doppelt, I, State University of Iowa Hos­pitals, Surgery.Walter Gary Eades, I, Beth Israel, Boston, Medicine .•William Joseph Estrin, I, Berkshire Medical Center,Massachusetts, Rotating.Robert Alan Freilich, I, University Hospitals, Colum-bus, Medicine.« .Richard William Furlanetto, I, University of Chicago ..Hospitals and Clinics, Pediatrics.Richard Francis Gaeke, I, University of Chicago Hos- �pitals and Clinics, Medicine. •David Anthony Gilbert, I, University of WashingtonAffiliated, Medicine. ,.Armando Elario Giuliano, R, University of California, Dr. Earl M. Armstrong.San Francisco, Surgery.Michael Edward Glick, I, University Hospitals, Madi­son, Wisconsin, Medicine. •Stephen Stewart Gloyd, R, University of WashingtonAffiliated, Family Practice"David Jeremy Gordon, I, San Diego County Hospital,Medicine»Jeffery Ivan Gordon, I, Barnes Hospital, St. Louis,Medicine.«Robert Lawrence Gottesman, I, Los Angeles CountyHarbor General, Rotating.Joel Steven Hagedorn, I, Childrens Hospital, SanFrancisco, Medicine.'John M. Harlan, I, University of California, San Fran­cisco, Medicine."David Kelso Henderson, I, Los Angeles County Har­bor General, Medicine .•Arlen Rolf Holter, I, Massachusetts General Hospital,Boston, Surgery.Vernon Paul Henry Horn, I, Parkland Memorial, Dal­las, Medicine!'Charles Thomas Janovsky, R, University of MissouriMedical Center, Family Practice. �Cathie-Ann Lippman Kamin, R, Los Angeles County,University of Southern California, Pediatrics.Robert Alan Kanter, I, Kings County Hospital,Brooklyn, New York, Medicine.>Elizabeth Starna Kessler, I, Presbyterian-St. 0Lukes Hospital, Chicago, Medicine."Robert Gene Kirk, R, University of Chicago Hospitals )(and Clinics, Surgery.Joel Edward Kleinman, I, San Francisco General,Rotating.Daniel Marshall Knowles, I, Presbyterian Hospital,New York City, Pathology.Kenneth Krantz, I, University of Chicago Hospitals Xand Clinics, Pediatrics.Rudiger Kratz, I, University of Chicago Hospitals and l(Clinics, Medicine.' eDwight Robert Kulwin, R, University of Colorado29Affiliated, Surgery.Linda Landgrebe, R, Northwestern University Medi- 0cal Center, Chicago, Surgery.Dennis R. Lardent, R, Cincinnati General Hospital,Ohio, Psychiatry.Carol Egel Lamer, I, San Francisco General,Medicine. I}Lee Daniel Leserman, R, Duke Medical Center,Durham, North Carolina, Pediatrics.Alfred James Lewy, I, Mount Zion Hospital, SanFrancisco, Rotating.Richard Ray Lichte, I, Rhode Island Hospital,Medicine. •James Joseph Madden, I, Temple University Hospi­tals, Philadelphia, Medicine»Hywel Madoc-Jones, I, University of Chicago Hospi- )Ctals and Clinics, Rotating.Clifford D. Marbut, R, Bronx Municipal HospitalCenter, New York, Pediatrics.Kenneth Louis McClain, R, Johns Hopkins Hospital,Baltimore, Maryland, Pediatrics.Ernest Edward Mhoon, R, University of Chicago Hos- xpitals and Clinics, Surgery.Richard John Mier, R, Strong Memorial Hospital,New York, Pediatrics.Brooks A. Mirrer, I, Montefiore Hospital, New YorkDr. David K. Henderson.30 City, Pediatrics.Lois Anne Nelson, I, University of Chicago Hospitalsand Clinics, Pediatrics.Kenneth V. Olschansky, I, Chicago Wesley Memorial QHospital, Medicine.« ....David M. Ota, I, Johns Hopkins Hospital, Baltimore,Maryland, Surgery.Eugene Stanley Pearlman, I, Roosevelt Hospital,New York City, Medicine!Jean-Paul Pegeron, R, University of MichiganAffiliated, Psychiatry.Sean B. Peppard, I, University of Minnesota, Sur­gery.Lawrence Robert Peterson, I, University of Washing­ton Affiliated, Pathology.Edward J. Prendergast, I, University Hospitals,Madison, Wisconsin, Medicine,"Mary Margaret Pretzer, I, Stanford University, Stan­ford, California, Pediatrics.Bernard Beryl Pritzker, R, Bronx Municipal HospitalCenter, New York, Pediatrics.Theodore James Pysher, I, Cleveland MetropolitanHospital, Pediatrics.Elizabeth Anne Reid, I, Massachusetts General Hos­pital, Boston, Medicine.'James Bruce Reuler, I, University of Chicago Hospi-?"tals and Clinics, Medicine.'Peter Douglas Reuman, I, University of Chicago Hos- Xpitals and Clinics, Pediatrics.William Steven Rudd, R, University of Chicago Hos- )<pitals and Clinics, Surgery.Walter W. Schell, I, Johns Hopkins Hospital, Balti­more, Maryland, Surgery.James Edward Schwanke, I, San Francisco General,Rotating.Stanley Steven Schwartz, I, University of Pennsyl­vania Hospital, Medicine .•Jeffery David Semel, I, Presbyterian-St. Lukes Hospi- ®tal, Chicago, Medicine!Michael Harris Silverman, I, State University of IowaHospitals, Medicine,Stephen P. Spielberg, R, Childrens Medical, Boston,Pediatrics.- Mark Christopher Steinhoff, R, Strong Memorial Hos­pital, New York, Pediatrics.Drew Robert Tomczak, I, Michael Reese Hospital, 0Chicago, Medicine.!William Edward Truog, R, University of WashingtonAffiliated, Pediatrics.James Leighton Weese, I, University of MichiganAffiliated, Surgery.Harry Wilson, I, University of Chicago Hospitals and 'YClinics, Pediatrics.Barry Edward Wright, I, Lenox Hill Hospital, NewYork City, Medicine.'James Kirk Wright, R, University of Chicago Hospi- )ltals and Clinics, Surgery.Robert David Toon, I, University of Toronto Hospi­tal, Canada, Rotating.Kathryn Bonese, Post Doctoral Research, Universityof Chicago.News BriefsNew Michael Reese AppointmentsThe following appointments of full-timemembers of Michael Reese Hospital andMedical Center to The Pritzker Schoolof Medicine have been made recently.Department of AnesthesiologyThe rank of Professor, effective March1, 1973, for two years: Dr. Ronald FrankAlbrecht (chairman).To rank of Associate Professor, ef­fective March 1, 1973, for two years:Dr. Anthony D. Ivankovic; Dr. EdwardT. Toyooka; Dr. Behrooz Zahed.To rank of Assistant Professor, effec­tive March 1, 1973, for two years: Dr.Ronald K. Grossman; Dr. David J.Miletich; Dr. Harold J. Heyman; Dr.Roger F. Bonnet.Department of MedicineTo rank of Professor, effective July 1,1973, for two years: Dr. Lawrence Froh­man (division chief, endocrinology).To rank of Associate Professor, effec­tive April 1, 1973, for three years: Dr.Gerald Glick.To rank of Assistant Professor, effec­tive July 1, 1973, for three years: Dr.Steven Pinsky.To rank oflnstructor, effective July 1,1973, for one year: Dr. Richard Desser;Dr. Murray Favus.Department of PathologyTo rank of Professor, effective March15, 1973, for three years: Dr. Jan Steiner(chairman).Dr. Samuel P. Gotoff, Chairman of the Depart­ment of Pediatrics at Michael Reese Hospital. Department of PediatricsTo rank of Professor, effective July 1,1973, for two years: Dr. Samuel P.Gotoff (chairman).To rank of Assistant Professor, effec­tive July 1, 1973, for two years: Dr.David Fisher; Dr. John B. Paton; Dr.Pipit Chiemmongkoltip.Compact and Disposable KidneyUniversity of Chicago and ArgonneNational Laboratory researchers havedeveloped a new compact and dispos­able artificial kidney (dialyzer). It is 30percent more efficient than any otherartificial kidney now in use.More than 70 successful clinical testshave been conducted since October,1972, on the new artificial kidney. Testswere conducted in the University'sHemodialysis Unit under the directionof Dr. Edmund J. Lewis. He is anAssociate Professor and Chief of theSection of Nephrology in the Depart­ment of Medicine and Director of theHemodialysis Unit.The device, invented by Finley Mar­kley of Los Angeles, former AssociatePhysicist in the High Energy Facility atthe Argonne National Laboratory,removes more of the urea and creatininewaste products in a single run of bloodthrough the machine than existingdevices. It is also twice as effective asthe human kidney in removing urea.Ninety percent of the urea and 73 per­cent of the creatinine were removed inone run during 30 test hemodialyses onpatients in the Hemodialysis Unit, Dr.Lewis reports.The Argonne kidney removed ureafrom an average of 146 milliliters (ml.) of blood per minute, while the humankidney's capacity is 75 ml. per minute.It removed creatinine from 117 rnl. ofblood per minute. The average humankidney removes creatinine from 120 ml.per minute. It performed its life-savingfunction at a rate 30 percent faster thanother artificial kidneys now in use.The new kidney unit is a 60-layerparallel-flow disposable dialyzer thatmeasures only 2x2x 12 inches. It utilizesas its filter material Cuprophan (super­thin cellophane) membrane supported bynon-woven polypropylene mesh. TheCuprophan is held together by a newtype of adhesive developed by Markley.He succeeded in bonding cellophanetogether in a manner which would with­stand water-which was previouslyimpossible.Challenge Grant from Kresge FoundationThe University of Chicago has receiveda $3.5 million challenge grant from theKresge Foundation toward constructionof the Surgery and Brain Research Pavil­ion.In announcing the grant, PresidentEdward H. Levi said:"The Surgery and Brain ResearchPavilion, which the Kresge grant willhelp assure, is especially important tothe University in maintaining its standingas a leading national referral center foradvanced study and for treatment. Thenew facilities in the Pavilion will assurethat patients in our Hospitals and Clinicscontinue to receive the best medical careavailable anywhere, and will greatlyassist us in attracting leading surgeonsand scientists."The six-story Pavilion is the largestFinley Markley (left), Dr. Edmund J. Lewis (center), and Evalds Butners (right) display the new compactand disposable artificial kidney which has been successfully tested.37component of Project AIMS (Advance­ment in Medical Science), the Univer­sity's current $50 million medical funddrive. Philip D. Block, Jr., chairman ofAIMS, said that with the Kresge grantthe University now has $11 million ingifts and pledges toward the $21.5 mil­lion needed to build the Pavilion. Amongpledges are $3.5 million by the BrainResearch Foundation and $2.0 millionby Dr. Clarence C. Reed, an alumnus.Block said the Project AIMS Cam­paign Committee hopes to match fundsthrough a special appeal to leaders of theChicago community to become benefac­tors of the Pavilion. If this goal isachieved, he said, construction of thePavilion will start late this year. Thebenefactors program was announced onApril 23 at a luncheon hosted byGaylord Donnelley, Block, and otherTrustees of the University. Donnelley isChairman of the Board of Trustees.The Pavilion will provide research andteaching facilities for the Brain ResearchInstitute and for the Department of Sur­gery of The Pritzker School of Medicine.Also, there will be 14 operating rooms,together with their support facilities, anda 26-bed patient care facility.Argonne Hospital RenamedThe Argonne Cancer Research Hospi­tal, operated by The University ofChicago under a contract with theUnited States Atomic Energy Com­mission, has been renamed the FranklinMcLean Memorial Research Institute.The. new name, proposed by the Univer- sity, was adopted by mutual consent ofthe AEC and the University's Board ofTrustees.Dr. Alexander Gottschalk, Professorof Radiology and Professor and Directorof the Institute, said:''There will be no change in the finan­cial support or the direction of our prog­rams. The name will honor one of thegreat teachers, administrators, andinvestigators in The University ofChicago's medical heritage."Dr. Franklin McLean (1888-1968), aUniversity of Chicago graduate (B.Sc.,1907; M.D., Rush Medical College,1910; M.D., pharmacology, 1912;Ph.D., physiology, 1915), became thefirst Chairman of the newly createdDepartment of Medicine at the Univer­sity in 1923. During the following fiveyears, Dr. McLean worked on the reali­zation of the University administration'sconcept of a full-time medical faculty.Dr. McLean took an active role in thebuilding and shaping of the University'sHospitals and Clinics system. Hebecame the first Director of the Univer­sity Clinics when they opened in 1927.The Franklin McLean MemorialResearch Institute forms part of theUniversity's medical center, facingSouth Ellis A venue at 59th Street in theHyde Park area of Chicago. Its origin,as the Argonne Cancer Research Hospi­tal, was in the United States Office ofScientific Research and Development'sMetallurgical Laboratory (later theManhattan Project) at the University.Ground was broken for the ArgonneHospital on June 19, 1950. The buildingThe Pediatric Catheterization Laboratory (above) was recently completed in Wyler Children's Hospitai.Soon, a similar facility, the Adult Cardiovascular Laboratory, will be built.32 was officially opened in 1953. The 58 sci­entist scholars who comprise theacademic staff of the Institute holdfaculty appointments in various depart­ments of the Division and The PritzkerSchool of Medicine.Dr. McLean's widow, Dr. Helen Vin­cent McLean, lives near the Univer­sity. AEC officials will attend the re­dedication ceremonies later this year.New Adult Cardiovascular laboratoryUntil recently, pediatric and adult diag­nostic cardiac catheterization proce­dures were performed in the samelaboratory of the Albert Merritt BillingsHospital at the University. Now, theseprocedures will be performed in separatenew laboratories. Pediatrics cases willbe done in a recently completed laborat­ory in Silvain and Arma Wyler Chil­dren's Hospital. Adult cases will receivecare in a proposed laboratory in BillingsHospital. This latter will be known asthe Adult Cardiovascular Laboratory.Construction of the new laboratory hasbegun, and completion is anticipated byAugust.The Adult Cardiovascular Laboratorywill be an ultra-modern facility costingapproximately $800,000. It will havefacilities for the diagnosis of variousforms of congenital and acquired heartdisease in adults. In addition there willbe facilities for the treatment of certaincardiac rhythm disturbances, electrover­sion, and the insertion of temporarytransvenous and permanent cardiacpacemakers.Beside the conventional techniquesfor the measurement of blood flow, intra­cardiac pressures, and shunts due tocongenital defects between the cardiacchambers, the new laboratory will havefacilities for biplane fluoroscopy andangiocardiography (simultaneous X-rayimaging in two views at 90 degrees),radioisotope myocardial imaging forassessment of total and regional myocar­dial blood flow, and techniques forassessing resting and maximal perfor­mance of the heart. All data will beanalyzed by a dedicated mini-computerlocated in the facility.Much of the activity in the new labwill be devoted to diagnostic cardiaccatheterization procedures prior to open­heart surgery in patients at the Univer­sity Hospitals and Clinics complex.There will also be on-going evaluating ofseveral innovations in the area of diag­nostic catheterization:1. Myocardial radioisotope imaging.This involves measurement of totalcoronary flow and regional nutrientblood flow in the diseased heart. It willhave its most useful application inevaluating patients with coronary heartdisease. (measurement of regionalmyocardial blood flow has recentlybecome feasible with the development ofradionuclear scintillation cameras whichcan analyze, with a high degree ofresolution, radionuclides which selec­tively localize in heart muscle).2. Computerization of cardiaccatheterization data. The laboratory hasbeen awarded an educational grant bythe Digital Equipment Corporation todevelop programs for the analysis of car­diac data, using one of the corporation'slarge line of mini-computers.3. Assessment of cardiac contractility.Various indices of contractile perfor­mance of the heart are being assessedin an effort to detect defects earlier inpatients with various types of heart dis­ease.4. Dynamic stress of the heart by avariety of techniques to assess itsreserve capacity. These include exer­cise, electrical capture of the cardiacimpulse, with subsequent pacing athigher than normal rates, and placinggraded transient pressure and volumeloads on the heart using various phar­macologic agents.5.' Evaluation of certain cardiacarrhythmias by high-speed electrograms.These will be recorded from intra­cardiac electrodes during artificial elec­trical stimulation of the heart.Chanock Receives Ricketts AwardThe 1973 Howard Taylor RickettsAward was presented to Dr. Robert M.Chanock (,47), nationally known vir­ologist and immunologist, on May 14 atDr. Robert M. Chanock. the University. Dr. Chanock is chief ofthe Laboratory of Infectious Diseases atthe National Institute of Allergy and In­fectious Diseases, National Institutes ofHealth, Bethesda, Maryland. He is also aprofessor of child health and develop­ment at George Washington University,Washington, D.C.The Ricketts Award, given "in recog­nition of outstanding accomplishment inthe field of the medical sciences," waspresented to Dr. Chanock by Dr. LeonO. Jacobson, Dean of the Division andThe Pritzker School of Medicine. Fol­lowing the award presentation, Dr.Chanock delivered the Howard TaylorRicketts Lecture. His topic was"Genetic Manipulation of Viruses andMycoplasmas with the Aim of Prevent­ing Acute Respiratory Tract Disease."Dr. Chanock was the first investigatorto recover the four parainfluenza virusesand the respiratory syncytial (RS) virusfrom man. Subsequently, he showed thatthese viruses account for approximately40 percent of the serious lower respira­tory tract disease in infants. His morerecent findings established the first evi­dence that host immunological enhanc­ing factors can play an important defen­sive role in respiratory disease.The Ricketts A ward was establishedin memory of The University ofChicago's scientist who demonstratedthat Rocky Mountain spotted fever istransferred to man by ticks. Dr. Rickettswas also the first to observe and describethe small bipolar bodies that cause thedisease. Later he found-at the cost ofhis life-the related organism that causestyphus fever. He died of the fever in1910.The award was established in 1913 byDr. Rickett's widow and was givenannually by the University'S Depart­ment of Pathology and Bacteriology toa student who had done the year's bestresearch. In the mid-1940s it wasdecided that the memorial should honorothers who had contributed significantlyto the medical sciences.The Ricketts A ward has beenbestowed on some of the world's mostdistinguished scientists. Among theseare John Enders, who first cultivated thepolio virus, and Dr. Albert B. Sabin,who developed oral polio vaccine.Disadvantaged Need More CareAlthough high-income and low-income,advantaged and disadvantaged, Ameri­cans now receive approximately thesame amounts of physicians' services,the disadvantaged still need more care,according to a recent University of Chicago survey. The survey indicatesthat those with low incomes have moreillnesses and this finding parallels theirhigh hospital-care figures. This samestudy also reveals that while overall useof health services is increasing, the typeof care available depends on income,race, and other social factors. Thisdependence on these factors may bebecoming more marked.Health Service Use, National Trendsand Variations (DHEW PublicationsNo. (HSM) 73-3004) was publishedrecently by the United States Depart­ment of Health, Education and Welfare.The booklet contains the first results ofthe 1970 University survey. The studywas directed by the University's Centerfor Health Administration Studies andsupported by the National Center forHealth Services Research and Develop­ment.Ronald M. Andersen, researchassociate in CHAS, the GraduateSchool of Business, and the Departmentof Sociology, served as study directorfor the 1970 survey. Odin W. Anderson,Director of CHAS and Professor in theGraduate School of Business and theDepartment of Sociology, was principalinvestigator. Joanna Kravits, a researchassociate in CHAS, served as theassistant study director. .According to the data gathered, theproportion of the public using hospitalsand clinics rather than a personal physi­cian increased from 1963 to 1970. Thedata also show the number of peopleclaiming no regular source of medicalcare decreased during the 1963-1970period. Center researchers found thatthough the number of high-incomeindividuals reporting particular physi­cians remained almost constant, con­siderable decreases occurred in thenumber of low- and middle-incomepeople reporting such care.A final measure investigated byCenter investigators was disability days,days during which individuals eitherstayed in bed or did not carry out theirusual activities. They found that thewhite population is more likely to reportdisability than the non-white population,regardless of economic status or resi­dence. White children contribute heavilyto these figures.In the adult population non-whites aremore likely to report disability. Par­ticularly low-income non-whites, thesurvey shows. Also, low-income groupsare disabled longer, which parallels thefact that middle- and high-incomeindividuals reported to investigators thatthey had considerably more physiciancontacts per 100 days of disability thanthe low-income individuals.33In MemoriamEmmet Blackburn Bay, 1901-1973One of the FirstDr. Emmet B. Bay, Professor Emeritusof Medicine and former Chief of the Sec­tion of Cardiology died on April 7, 1973,after a long illness. He was one of thegroup of 12 men to make up the firstDepartment of Medicine at the U niver­sity, and he will be remembered by everygraduate of this medical school-stu­dents from the date the school openedits doors in 1927 until Dr. Bay's retire­ment in 1965.He graduated from Rush Medical Col­lege in 1923, at the age of 22, and wasan intern and resident at the Pres­byterian Hospital, where he came to theattention of the great Dr. Herrick. Dur­ing his training he learned electrocar­diography by using the only string gal­vanometer in the Midwest at the time.He assisted Dr. Herrick in his privatepractice for two years, while serving asan assistant in medicine at Rush. In 1927he joined the new medical school of TheUniversity of Chicago as an AssistantProfessor of Medicine and AssistantDirector of the Student Health Service.He was elevated to Associate Professorand then Professor before serving asdean of Rush Medical College from 1936to 1939. This was during the transitionperiod when The University of Chicagoclinical faculty moved from Rush to theMidway.Dr. Bay's major interest in cardiologywas acknowledged when he became thefirst leader of that Section of the Depart­ment of Medicine. For many years heserved as an officer of the Chicago HeartAssociation. His scientific investigationsincluded early clinical applications of theDr. Emmet B. Bay.34 electrocardiogram, the experimentalpericardial effusion, effects of calciumon the isolated heart, hemodynamicstudies leading to the development of theelectromagnetic flowmeter, and the long­term clinical use of anticoagulanttherapy after myocardial infarction. Histrainees were encouraged to pursue inde­pendently their own research.During World War II he served on theMedical Research Committee of theNational Defense Council. He was lateran editor of Modern Concepts of Car­diovascular Disease and ultimately med­ical advisor to The Encyclopedia Brit­tanica. For many years he served on theCommittee on Publications in Biologyand Medicine of The University ofChicago Press. He attained membershipin many professional societies, includingthe Association of American Physicians,and served on the medical advisoryboards of Herrick House, the Old Peo­ple's Home of Chicago, and similaragencies. He was also the 1963-1964president of the University's MedicalAlumni Association.During his lifetime career at TheUniversity of Chicago, he, as much asany other member of the faculty, wasinstrumental in developing the full-timefaculty system of the University. From1929 to 1930 he spent on sabbatical underthe auspices of the Rockefeller Founda­tion, visiting other university hospitals tostudy their medical administration. Thisled to a book, Medical Administrationof Teaching Hospitals. He subsequentlypublished a study on the quality of carerendered by The University of ChicagoClinics. These two experiences pro­foundly influenced his views on the bestadministrative arrangement to foster theteaching of clinical medicine. He becamestill further convinced of the benefits ofthe then novel idea that paying patientsshould serve as material for the trainingof medical students as well as houseofficers.I mportant as his administrati ve andeducational roles were, it was as a mas­ter clinician and dedicated physician thatDr. Bay will best be remembered. Allthose for whom he cared, from the chair­man of the board to the employeddomestic, could attest to that combina­tion of the physician's qualities demon­strated at the bedside: alert concern, abroad knowledge of medicine, sagaciousclinical judgment, and a tenaciousdedication to the patient's welfare. Hiscare was sought by many of the Univer­sity's faculty families as well as by itsprofessional family; in fact, he was oftencalled a doctor's doctor. His teachingwas by example; he demonstrated thatthere was no substitute for a careful his- tory and that there was no detail toosmall to ignore in the management of hispatients.In 1925 he married MargaretSeymour, who remained his devoted andsupportive partner until her death in1971. He is survived by his daughters,Martha Hosp and Nancy Dinning, andsix grandchildren. The Emmet BayMemorial Lectureship was establishedfive years ago at the time of his retire­ment. Memorial contributions may bemade to the lectureship at: Culver Hall,Room 400, 1025 East 57th Street,Chicago, Illinois 60637.Dr. Richard J. JonesAssociate ProfessorDepartment of MedicineRobert A. McCleary, 1923-1973Commitment to TeachingDr. Robert A. McCleary, Professor ofPhysiology and Psychology, died ofnatural causes on March 20. He was 50.Dr. McCleary's main professionalinterest was the analysis of brainmechanisms of behavior. He was a con­sultant in his field to both governmentaland private agencies.He received a B.A. degree from Har­vard University in 1941, an M.D. degreefrom Johns Hopkins University MedicalSchool in 1947, and a Ph.D. degree inphysiological psychology from JohnsHopkins in 1951. He came to TheUniversity of Chicago in 1961 as aProfessor.From 1957 to 1959 he served on theArmy Surgeon General's Subcommitteeon Environmental Extremes. He becamea consultant to the National Institute ofMental Health and a member of theInstitute's Study Section on Experimen­tal Psychology in 1961. At that time healso became a consultant to the Aeros­pace Medical Center at Brooks AirForce Base, Texas.In 1964 Dr. McCleary was one of sixnationally known psychologists whoserved as guest faculty members for aninstitute for college psychology teachers.The institute was supported by theNational Science Foundation.Dr. McCleary was an innovator inseveral areas of psychological research.He made fundamental contributions tothe study of subliminal perception,interocular transfer of information, andthe limbic system of the brain.Dr. McCleary is survived by hiswidow, the former Nan S. Brown, threechildren, and a grandchild. His son, Dr.Robert E. McCleary, is an intern at Mar­tin Luther King, Jr., Hospital in LosAngeles.Contributions in his memory may bemade to the Dr. Robert A. McClearyFund for Student Research through theDepartment of Psychology.Alumni Deaths'06. Thomas H. Boughton, Trenton,New Jersey, August 13, 1972, age 91.'08. Samuel W. Forney, Boise, Idaho,January 8, 1973, age 90.'08. C. H. R. Hovde, Normal, Illinois,October 12, 1971, age 87., 14. Milford E. Barnes, Iowa City,Iowa, March, 1973, age 90., 14. Russell M. Johnson, Chicago,Illinois, January 21, 1973, age 85., 16. Wilmer D. McGrath, GrandIsland, Nebraska, January 29, 1973, age84., 16. Stephen A. Schuster, EI Paso,Texas, April 16, 1972, age 78.'16. Charles R. Tompkins, Grafton,North Dakota, July 18, 1972, age 83.'17. George H. Anderson, Spokane,Washington, August 20, 1972, age 79.'17. Homer P. Cooper, Chicago,Illinois, August 9, 1972, age 83.'17. Clyde F. Watts, Marengo, Iowa,December 31, 1972, age 74.']9. Nicholas L. Campione, Chicago,Illinois, February 11,1971, age 77.']9. Philip W. Whitely, Denver,Colorado, November 1, 1972, age 77.'20. Roger C. Cantwell, Shawano,Wisconsin, January 18, ]973, age 77.'2]. Francis L. Lederer, Chicago,Illinois, April 3, ]973, age 74.'22. Emmet B. Bay, Oak Lawn,Illinois, April 7, 1973, age 72.'22. Morris W. Lev, Chicago, Illinois,January] ], ] 972, age 73.'22. Francis J. Morris, Los Angeles,California, December 8, ]972, age 77.'23. Seth E. Brown, Evanston,Illinois, February 29, 1973, age 78.'23. Earl S. Carey, Wisconsin Dells,Wisconsin, February 16, ]971, age 81.'23. Sara G. Geiger, Milwaukee, Wis­consin, December 27, ]971, age 79.'23. Mary N. Tiffany Haenggi, West­mister, California, September 2, 1972.'23. Harry J. Mayer, Los Angeles,California, October 17, 1972, age 75.'23. William J. Vynalek, Riverside,Illinois, March 25, ]973, age 72.'25. Marine R. Warden, Ojai, Califor­nia, August 14, 1970, age 78.'26. Harold F. Beglinger, Escondido,California, September 26, 1972, age 76.'26. James Ernest Davis, Chicago,Illinois, March19, 1973, age 95.'28. Clarence O. Edwards, Liber­tyville, Illinois, December 27, ]972, age74.'30. Fred R. Isaacs, Lawrence, Kan- sas, January 12, 1973, age 75.'30. Harry W. Newman, Seal Beach,California, September 17, 1972, age 73.'31. Harold C. Wagner, Chicago,Illinois, January 13, 1973, age 74.'32. Arvid T. Johnson, North PalmBeach, Florida, December 26, 1972, age66.'32. William E. Jones, Spokane,Washington, April 2, 1972, age 71.'32. Gerald J. Van Heuvelen, Pierre,South Dakota, December 25, 1972, age69.'33. Archie Chun-Ming , Honolulu,Hawaii, January 26, 1973, age 69.'33. Cecil R. Gilbertson, Janesville,Wisconsin, September 5, 1972, age 67.'34. Charles D. Bussey, Dallas,Texas, December 19, 1972, age 64.'34. John H. Glynn, Chicago, Illinois,February 14, 1972, age 70.'34. Samuel Leibenson, Oshkosh,Wisconsin, January 30, 1972, age 66.'34. Henry Staff, Bath, New York,August 11,1972, age 71.'35. Louis M. Berger, Pasadena,California, January, 1972, age 64.'37. William N. Freeman, Colfax,Washington, April 4, 1972, age 60.'37. Victor Tepper, Verona, NewJersey, January 24, 1972, age 61.'38. J. Paul Klein, Fremont,Michigan, February 16, 1973, age 61.'38. Donald M. McEndajJer, Denver,Colorado, March 20, 1973, age 62.'38. Francis L. O'Keefe, Delavan,Wisconsin, May 14, ]972, age 63.'39. Arthur G. Nugent, Vacaville,California, December 27, 1972, age 57.'40. Della Moussa, Chicago, Illinois,April 17, ]972, age 71.Former Residents and InternsChester S. Keefer (Resident, '26-'28,Medicine), Boston, Massachusetts,February 3, 1972, age 75.Robert W. King (Resident, '31-'33,Orthopedic Surgery), Beverly Hills,California, February 20, ]973, age 68.Lewis V. Kogut (Resident, '36-'37,Ophthalmology), Kent, Ohio, February2, 1972, age 64.Watt Winn (Intern, '31-'32, Obstetricsand Gynecology), Dallas, Texas,December 21, 1972, age 76.Former FacultyLouis Nelson Katz (Visiting AssistantProfessor, '67-'70, Physiology; Directorof the Cardiovascular Institute, '30-'67,Michael Reese Hospital), Chicago,Illinois, April 2, 1973, age 76.Lotte M. Lewinson (Student Health,'50-'55), Chicago, Illinois, December30, 1972. Departmental NewsAnatomyFifteen faculty members and studentsfrom the Department presented papersat the 86th annual session of the Ameri­can Association of Anatomists meetingin New York City in April. Theassociation's bulletin reported theUniversity ranked 4th in the nation of113 medical schools for the highestnumber of papers presented. Two of thefirst three departments have facultiestwice the size of that at The Universityof Chicago.John Wymer, research associate, wasawarded the Henry Stopes MemorialMedal by the British Geologist'sAssociation for work on the "Prehistoryof Man and His Geological Environ­ment." Mr. Wymer resides in Englandand, since 1965, has conductedarchaeological investigations at sites inAfrica and England with Dr. Ronald Sin­ger, Professor of Anatomy andAnthropology, Chairman of the Depart­ment of Anatomy, and in the Commit­tees on Evolutionary Biology and Gene­tics and in the College.Dr. Charles E. Oxnard was nominatedas one of two overseas members of theCouncil of the Anatomical Society ofGreat Britain and Ireland. He is aProfessor in Anatomy, Anthropology,and the College, and the Committee onEvolutionary Biology; Master of theBiological Sciences Collegiate Division;Associate Dean ofthe College, the Divi­sion of the Biological Sciences, and ThePritzker School of Medicine.Leonard Radinsky, Associate Profes­sor in Anatomy, the Committee onEvolutionary Biology, and the College,lectured on "Studies of MammalianBrain Evolution: The Use of Endo­casts," at Duke University on March 8.Ben May LaboratoryDwight J. Ingle, Professor of Physiologyand in the Ben May Laboratory, haswritten a new book, Who Should HaveChildren? An Environmental and Gene­tic Approach. The author asserts that itis a clear right of society to exerciseintelligent control over its future, but heinsists that any program of selectivepopulation control must be free fromgovernment direction and must preservefreedom of choice.Elwood V. Jensen, Director of theBen May Laboratory and the BiomedicalCenter for Population Research andProfessor of Physiology, received theinternational science prize, "La Madon-35nina," from the Fondazione Carlo Erbain Milan, Italy, in February. The awardhonored Jensen's research on themechanism of steroid hormone actions.BiochemistryDr. Donald F. Steiner (,56), the A. N.Pritzker Professor of Biochemistry,Professor of Medicine, and in the Col­lege, was named Chairman of theDepartment. He had served as the Act­ing Chairman.Richard C. Lewontin, the Louis BlockProfessor of Biological Sciences, is leav­ing the University to become the Agas­siz Professor of Zoology at HarvardUniversity. He is also Professor ofTheoretical Biology, in the Committeeon Conceptual Foundations of Scienceand the College, and Chairman of theCommittee on Evolutionary Biology.Charles E. Olmstead, Professor ofBiology, attained emeritus status inJune, after 39 years of service. He wasChairman of the Department of Botanyfrom 1953 to 1968, when it was mergedwith Zoology. He is a former editor oftwo major journals, Ecology and TheBotanical Gazette, and has servedextensively in public affairs.Emil T. Kaiser, Professor inBiochemistry, Chemistry, and the Col­lege, received a grant of $60,000 from theNational Science Foundation. He willwork on the "Chemical Modification ofEnzymes for Use in SyntheticProcesses. "Marguerite Volini, Assistant Profes­sor in Biochemistry and the College, lec­tured on "The Interdependence ofDr. Donald F. Steiner.36 Enzyme Conformational Changes andRhodanese Catalysis," at the Universityon April 4.BiologyThomas Park received an honoraryDoctor of Science degree from theUniversity of Illinois at June 9 com­mencement exercises on the Champaign­Urbana campus. He is a Professor inBiology, the College, and the Committeeon Evolutionary Biology.Ronald G. Alderfer, Assistant Profes­sor in Biology and the College, lecturedon "Photosynthesis and EnvironmentalChange in Developing Plant Canopes,"at the University on April 9.Aron A. Moscona, the Louis BlockProfessor of Biology and Chairman ofthe Committee on DevelopmentalBiology, spoke at the April 3 meeting ofthe Chicago Association of Immunolog­ists on "Specification of Cell Surfacesin Differentiation." He participated in anApril Symposium on Tissue Culture inMedical Research which was held inSouth Wales. He lectured on the"Characteristics of Embryonic Cell Sur­faces" at the 4th International Confer­ence "de la Physique Theorique a laBiologie" in Versailles, France, in May.He participated in a symposium onmolecular neurobiology at the Univer­sity of Colorado, Given Institute forPathology, Aspen, June 18-22, and lec­tured on "Embryonic Cell Surfaces."He is a member of the organizing com­mittee of the VIIth International Cong­ress of the Scientific Program to be heldat the University of Montreal, Canada,in August.MedicineDr. Morton Arnsdorf has beenappointed Assistant Professor of Car­diology for three years. Dr. Arnsdorfwas an intern and resident in the Depart­ment from 1966-1969, before going intothe military.Dr. Thomas William Lester; J r., (,41)has returned to the University as aProfessor in the Department ofMedicine. Dr. Lester held appointmentsat the University from 1946 until 1962,when he joined the NationalJewish Hos­pital in Denver.Three members of the BiomedicalCenter for Population Research wereamong 33 scientists from the UnitedStates and Great Britain who partici­pated in a recent symposium on "OralContraceptives and High Blood Pres­sure" in Gainesville, Florida. Theywere: Drs. Suzanne Oparil, AssistantProfessor of Medicine and Director ofthe Hypertension Clinic; Edward N.Ehrlich, Associate Professor of Medicine; and Marshall D. Lind-heimer, Associate Professor ofMedicine and Obstetrics andGynecology. The meeting was spon­sored by the National Institute of ChildHealth and Human Development.Dr. Nicholas J. Gross (,70), AssistantProfessor and Head of the RespiratoryMedicine Section, Lectured onbronchial asthma and immunologic dis­eases at Michael Reese Hospital, St.Bernard's Hospital, the Abraham Lin­coln School of Medicine, and to theIllinois Thoracic Society.The Gastroenterology Section was thesubject of a full-page, picture story in theFebruary 21 issue of Medical Tribune.Much of the February issue of theAmerican Journal of Cardiology wasdevoted to a major symposium on themyocardial cell and was dedicated to Dr.Hans H. Hecht, the Blum-Riese Profes­sor of Medicine and Physiology andHead of the Cardiology Section, whodied in 1971. The symposium, on basicphenomena that underlie the normal andabnormal functioning of heart muscle,was written by Dr. Hecht's former col­leagues and current members of the Car­diology Section.Of thyroid cancer patients seen at theUniversity's Hospitals and Clinics, 80percent had received x-ray treatmentsduring their childhoods for diseases suchas tonsilitis or acne. Irradiation treat­ment for these diseases was used duringthe 1930s and 1940s, according to Dr.Leslie J. DeGroot in an interview inNewsweek, April 30. Dr. DeGroot is aProfessor of Medicine.Dr. Thomas W. Lester, Jr.Dr. Richard L. Landau, Professor ofMedicine, the Franklin McLean Memor­ial Research Institute, and the College,and Director of the Clinical ResearchCenter, was named editor of Perspec­tives in Biology and Medicine. He suc­ceeds Dwight J. Ingle, Professor ofPhysiology and the Ben May Labora­tory, who is retiring.Dr. Samuel Refetoff, AssistantProfessor of Medicine, et. aI., con­tributed "Chiari-Frommel Syndromeand Primary Adrenocortical Insuffi­ciency" to the New England Journal ofMedicine, December 28, 1972.Dr. Alberto N. Goldbarg, AssistantProfessor of Medicine, lectured on ''TheUse and Abuse of Exercise Tests," atSt. Francis Hospital, Evanston, Illinois,on April 3.Dr. Sumner C. Kraft (,55), AssociateProfessor of Medicine, spoke on "Im­munology and the Gut," at LouisianaState University School of Medicine,New Orleans, on February 14. He lec­tured on "Regional Enteritis andGranulomatous Colitis-ImmunologicalAspects," at the University ofMichigan, Ann Arbor, on February 26.Dr. Elliott D. Kieff, Assistant Profes­sor of Medicine and on the Committeeon VIrology, received a two-year grantfrom the American Cancer Society for"Herpes Viruses of Burkitt Lymphomaand Infectious Mononucleosis and TheirRelationship to Hodgkin's Disease."Dr. John E. Ultmann and Dr. M.Edgar Moran published "ClinicalCourse and Complications in Hodgkin'sDisease" in the March Archives ofInternal Medicine. Dr. Ultmann is aProfessor of Medicine and Dr. Moranis an Associate Professor of Medicine.Dr. James J. Castles (,64), AssistantProfessor of Medicine, was one of nineUniversity faculty members awarded fel­lowships in the John Simon GuggenheimMemorial Foundation's 49th annualcompetition.Dr. Joseph B. Kirsner, Chief of Staffof the University's Hospitals andClinics, ,Deputy Dean for MedicalAffairs, and the Louis Block Professorof Medicine, was the author of a discus­sion of cancer of the colon in patientswith ulcerative colitis in the March 19Journal of the American MedicalAssociation.The University was host to the NinthAnnual Meeting of the Midwest GutClub on March 3. The club, composedof academic gastroenterologists fromMidwestern medical schools, met in theCenter for Continuing Education. Uni­versity gastroenterologists and surgeonspresented a series of scientific papers andconducted a tour of the University's gastroenterology laboratories in themorning. Researchers from other insti­tutions presented papers in the afternoon.Dr. Richard W. Reilly, Associate Pro­fessor in the Section of Gastroenterologyof the Department of Medicine, organ­ized the meeting.Dr. Harry A. Fozzard, Professor andJoint Director in the Cardiology Sectionof the Department, was the author of"Excitation-Contraction Coupling andDigitalis" in the January issue of Circu­lation.Dr. Leon Resnekov, Professor andJoint Director of the Section on Car­diology and Director of the MyocardialInfarction Research Unit in the Depart­ment of Medicine, was guest editor ofthe January issue of The Medical Clinicsof North America. The 261-page issueconsisted of a "Symposium on CoronaryHeart Disease."Dr. Chase Patterson Kimball, As­sociate Professor of Medicine andPsychiatry, was the author of "MedicalEducation as a Humanizing Process" inthe January Journal of Medical Educa­tion.Dr. John E. Ultmann returned froma six-week trip to Hawaii, New Zealand,Australia, and South Africa, duringwhich he delivered 40 lectures on cancerresearch and therapy. After speaking tovarious medical groups in Hawaii andNew Zealand in late February and earlyMarch, Dr. Ultmann served a month asthe Norman Paul Visiting Professor atSydney Hospital, Australia. In late Aprilhe spoke in Capetown, South Africa, atthe Karl Bremer and Groote SchuurHospitals and at the University ofCapetown. He is a Professor in the Sec­tion of Hematology in the Departmentof Medicine and Director of ClinicalOncology in the Franklin McLeanMemorial Research Institute.Faculty members gave papers at theannual meetings of several organizationsdevoted to clinical research in AtlanticCity, April 28-May 2:American Federation for ClinicalResearch: Dr. Suzanne Oparil,Assistant Professor of Medicine andDirector of the Hypertension Clinic; Dr.John E. Hopper, Assistant Professor ofMedicine; Dr. Warren K. Bolton,research associate in the Department ofMedicine; and Dr. Edmund J. Lewis,Associate Professor of Medicine.American Society for Clinical Inves­tigation: Dr. Janet Rowley ('48), Asso­ciate Professor of Medicine and theFranklin McLean Memorial ResearchInstitute, and Dr. James L. Bayer, As­sociate Professor of Medicine.American Society for Clinical N utri­tion: Dr. Robert M. Russel, fellow in the Department of Medicine.MicrobiologyScience of February 9 notes the researchon an experimental cholera vaccine doneby William Burrows, Professor of Mic­robiology, and his associates J. Kaur andM. A. Furlong. The article is entitled"Cholera: New Aids in Treatment andPrevention. "Robert M. Lewert, Professor of Mic­robiology and in the College, spentMarch and part of April on his continu­ing studies of immunity to schis­tosomiasis in Japan and the Philippines.His work is supported by the UnitedStates-Japan Cooperative Medical Sci­ence Program.Obstetrics and GynecologyDr. Albert Tsai ('68) has returned to theDepartment as an Assistant Professor,after serving as a postdoctoral fellow inreproductive biology at the Johns Hop­kins Hospital, Baltimore. Dr. Tsai tookhis internship and residency at ChicagoLying-in Hospital, and in 1972 hereceived the hospital's outstanding resi­dent award.Dr. Anthony P. Amarose, AssociateProfessor of Obstetrics andGynecology, was elected to the obstet­rics and gynecology section of the 'editor­ial board of Excerpta Medica,Amsterdam.Dr. Edith Louise Potter publishedNormal and Abnormal Development ofthe Kidney with Year Book MedicalPublishers. Dr. Potter is ProfessorEmeritus of Obstetrics and Gynecologyand former Pathology Chief of ChicagoLying-in Hospital.Dr. Gebhard F. B. Schumacher,Associate Professor of Obstetrics andGynecology, participated in a task forcesteering committee meeting for theHuman Reproduction Unit of the WorldHealth Organization, Geneva, Switzer­land, March 26-28. He lectured on April10 on "Modern Aspects of ReproductiveBiology" before the Academy ofMedicine of Muncie, Indiana. On April11, he gave a seminar on "Cervical andImmunological Factors in Infertility" tothe residents and interns of Ball Memor­ial Hospital, Muncie.Dr. Frederick P. Zuspan, the JosephBolivar DeLee Professor and Chairmanin the Department of Obstetrics andGynecology, was a guest facultymember at a March 8-9 seminar onobstetrics and gynecology at the Univer­sity of Nebraska Medical School,Omaha. He lectured on "Drug Addic­tion in Pregnancy" and "Eclampsia."Dr. Zuspan also presided at the annualmeeting of the Association of Professors37of Gynecology and Obstetrics, of whichhe is president, in New Orleans, March18-20. He gave a paper entitled:"Should Departmental Chairmen BeAppointed for Three-to-Five YearTenure with Reappointment Dependentupon a Departmental Review? AreDepartmental Reviews Necessary?Should They Be Internal or External?"At the May 2-5 meeting of the Ameri­can Gynecological Society in ColoradoSprings, Dr. Zuspan lectured on"Ovulatory Plasma Amine (Epinephrineand Norepinephrine) Surge in theHuman Female." Co-author of. thepaper was his daughter, Katherine J.Zuspan, a student at Duke University.At the Midwest Clinical Conference,held March 25-28 in Chicago, Dr. Zus­pan chaired a panel on "Medical Educa­tion in Obstetrics and Gynecology inMedical Schools Today and What toLook Forward to in the Future." At thesame meeting, Dr. Moon H. Kim,Assistant Professor of Obstetrics andGynecology, presented "What to Dowith the Hairy Female."OphthalmologyAlumni of the Department held theirannual meeting on March 7. Events ofthe day included a tour of University eyeresearch facilities, paper presentations,and an afternoon reception.Dr. Frank W. Newell, Professor ofOphthalmology and Chairman of theDepartment, delivered the 14th WalterWright Lecture at the University ofToronto in February and was a visitingprofessor of ophthalmology at the U ni­versity of Puerto Rico in March. He wasalso re-elected vice-president of theNational Society for the Prevention ofBlindness at its annual meeting, April 12.Dr. Frank W. Newell.38 Dr. Ward R. Richter.PathologyDr. Ward R. Richter, Associate Profes­sor of Pathology, was appointed Direc­torofthe A. J. Carlson Animal ResearchFacility. Dr. Richter joined the Univer­sity in 1968 and is a specialist in electronmicroscopy and laboratory animalpathology. Dr. John H. Rust, previouslyDirector of the Facility, returned to full­time teaching and research as a Profes­sor of Radiology and Pharmacology.Dr. Maurice Lev, Professorial Lec­turer of Pathology, received the GiftedTeacher Award for 1973 from the Ameri­can College of Cardiology.Dr. V. William Steward of TheUniversity of Chicago and A. M.Koehler of Harvard University were co­authors of" Proton Beam Radiography inTumor Detection" in Science, March 2.Dr. Steward is an Assistant Professor ofPathology. Koehler is associated withthe Cyclotron Laboratory at Harvard.Dr. James E. Bowman was appointeeto two advisory positions within thefederal Department of Health, Educa­tion and Welfare. He will serve as chair­man of the Sickle Cell VasoocclusiveClinical Trials and on the Food andDrug Administration DiagnosticProducts Advisory Committee. Dr.Bowman is a Professor of Pathology,Medicine, the Committee on Genetics,and the College. He is also MedicalDirector of the University Hospitals andClinics Blood Bank and Director of theUniversity Hospitals and ClinicsLaboratories.At the first annual testimonial andawards dinner of Black Cross, Inc., aChicago community service and healthorganization, Dr. Bowman was honoredfor his fight against mandatory sickle celltesting laws. He attended a conferenceon February 23 on the economic impactof sickle cell anemia at the Harlem Medi­cal Center, New York City, and he gavethe keynote address at a conference on 'The Dangers of Sickle Cell Legisla­tion" at United Hospitals MedicalCenter, Newark, New Jersey, on Feb­ruary 24.Dr. Bowman delivered the keynoteaddress at the April 26-28 Sickle CellAnemia Symposium at Southern Univer­sity, Baton Rouge, Louisiana. He wasalso the author of "Sickle Cell Issues"in The Black Collegian for March-April.PediatricsDr. Albert Dorfman (,44), the RichardT. Crane Distinguished Service Profes­sor of Pediatrics and Professor ofBiochemistry, was elected to member­ship in the National Academy of Sci­ences. Dr. Dorfman also is Director ofthe Joseph P. Kennedy Jr. Mental Retar­dation Research Center and Professor ofLa Rabida-University of ChicagoI nstitute and on the Committee onGenetics.Dr. Albert Dorfman, the Richard T.Crane Distinguished Service Professorof Pediatrics, participated in a workshopon. arterial mesenchyme and arterio­sclerosis and lectured on "Cellular Com­ponents Involved in Connective TissueSynthesis and Degradation" at theAmerican Heart Association meeting inNew Orleans, April 2-4. Also, he wasappointed in February to the newlyformed Committee on DevelopmentalBiology.Dr. Robert L. Rosenfield, AssistantProfessor of Pediatrics, was elected tothe Lawson Wilkins Pediatric Endoc­rinology Society and named to the medi­cal advisory board of the Barren Foun­dation, Inc., a non-profit organization topromote fertility research. He was hon­ored with the Barren Foundation lecture­ship and spoke on the" Relationship ofAndrogens to Female Hirsutism andInfertility. "Dr. Samuel Spector, Professor ofPediatrics, has been named Chairman ofthe Department. He had been actingChairman since October, 1972. Dr.Spector joined the faculty in 1970; in1971 the graduating class awarded himthe J. A. McClintock Award as the out­standing teacher in the medical school.Dr. Spector, a specialist in endocrineand metabolic disorders, has engaged inextensive studies of cystic fibrosis andassociated medical problems of the lungsand pancreas.Dr. Rene A. Arcilla, Professor ofPediatrics, participated in a symposiumon "Intrauterine Cardiac Overload" atthe annual meeting of the American Col­lege of Cardiology in San Francisco,February 16. He lectured on "NeonatalCongenital Heart Disease" at CookCounty Hospital, Chicago, on March 15.Dr. Glyn Dawson, Assistant Profes­sor of Pediatrics, Research Associate(Asst. Prof.) of Biochemistry, and theJoseph P. Kennedy, Jr., Scholar ofPediatrics, spoke on "Uptake andMetabolism of Glycosphingolipids byCultured Cell Strains of NeurologicalOrigin" at the American Society forNeurochemistry, Columbus, Ohio,March 12.PharmacologyDr. Alfred Heller ('60), Professor ofPharmacology, has been named ActingChairman of the Department. He suc­ceeds Dr. Lloyd J. Roth, Professor ofPharmacology and in the College, whohas returned to full-time teaching andresearch. Dr. Heller was awarded hisPh.D. in pharmacology from the Univer­sity in 1956 and his M.D. with honorsfrom the University in 1960. His mainresearch interest is neuropharmacology.Many of his studies have concentratedon the neurochemical consequences ofcentral nervous system lesions.John O. Hutchens has been appointedas the Director of the Toxicity Laborat­ory. He is a Professor of Pharmacologyand Physiology and in the College. Hehad. been Associate Director of theLaboratory. Hutchens joined theUniversity faculty in 1941. From 1946 to1948 he was the Director of the ToxicityLaboratory. Kenneth P. DuBois hadmost recently served as Director. Hedied on January 24.PsychiatryDr. Chase P. Kimball, Associate Profes­sor of Psychiatry and Medicine, gave thededication address at the opening of theCenter for Research and Patient Care inDiabetes at the University of Alabama,March 4. He has also been appointed tothe American Sociological Society'sCommittee on Psychosomatic Medicine.On April 6-8 he led the Second AnnualPsychiatric Liaison Workshop at theAnnual Meeting of the AmericanPsychosomatic Society in Denver. Hewas the. author of "Medical Educationas a Humanizing Process" in the Journalof Medical Education in January.Dr. Daniel X. Freedman, the LouisBlock Professor and Chairman of theDepartment, and Dr. Edward C. Senay,Associate Professor of Psychiatry andDirector of the Illinois Drug AbuseProgram (lDAP) were the authors of"Heroin Epidemics," an editorial in theJournal of the American MedicalAssociation, March 5. The editorialsummarizes research by Dr. Patrick H.Hughes, Assistant Professor ofPsychiatry and Director ofEpidemiology for IDAP, and others in the Department and IDAP on their suc­cess in combating a macroepidemic (50or more new cases of heroin addictionduring a five-year period) in a Chicagoneighborhood.Israel Goldiamond, Professor ofPsychiatry and Psychology, lectured on"Behavior Analysis in Psychiatric Set­tings" at the Psychiatric ResearchInstitute of the University of IndianaMedical School on March 23.Dr. E. H. Uhlenhuth, AssociateProfessor of Psychiatry, presented"Symptoms and Life Stress in the City"and "Intensive Design in EvaluatingAnxiolytic Agents" at the WashingtonUniversity School of Medicine, S1.Louis, on March 27-28.Dr. Lawrence Z. Freedman, Founda­tions Fund Research Professor ofPsychiatry, served during February asa visiting professor at Tel Aviv Univer­sity's Israeli Institute of Criminal Lawand Criminology.RadiologyDr. Gary G. Ghahremani, previously anAssistant Professor of Radiology, hasjoined the Department of Radiology atthe University of Virginia at Richmond.Dr. G hahremani took his residency atThe University of Chicago from 1968 to1971 and was a faculty member until lastJanuary.Dr. Stan D. Vesselinovitch, Professorof Radiology and the Franklin McLeanMemorial Research Institute, presented"Transplacental and Neonatal Car­cinogenesis" and was chairman of aworkshop on the "Testing of Environ­mental Carcinogens" at the 2nd Interna­tional Symposium on Cancer Detectionand Prevention, Bologna, Italy, April 4-12.Dr. Marc R. Tetalman ('68), Instructorof Radiology, et. aI., published "Perfu­sion Lung Scan in Normal Volunteers"in the March, 1973, Radiology.SurgeryDr. C. Frederick Kittle ('45), Professorof Surgery, was elected to a two-yearterm as chairman of the Council of Car­diovascular Surgery of the AmericanHeart Association and to a two-yearterm as chairman of the American Boardof Thoracic Surgery.Dr. Hernan M. Reyes, . AssistantProfessor of Surgery, has been namedpresident of the society of PhilippineSurgeons in America.Dr. Charles B. Huggins, the WilliamB. Ogden Distinguished Service Profes­sor of Surgery and the Ben MayLaboratory and Director Emeritus of theBen May Laboratory, has been namedan honorary fellow of the Royal College of Physicians and Surgeons of Canada.Dr. Huggins, the 1966 Nobel laureate inmedicine and physiology, received theaward in Edmonton, Canada, on January25. He also lectured on the "Transfor­mation of Normal Animal Cells" at theUniversity of Alberta during his trip.He participated in a symposium on "TheCell and Cancer" in London, February15-16. He lectured on "The Phenotypeof Normal and Cancer Cells" at thesymposium, which was organized by theRoyal College of Pathologists.Dr. Paul V. Harper, Jr., Professor ofSurgery, Radiology, and the FranklinMcLean Memorial Research Institute,was program chairman of a conferenceon "Cardiac Imaging in NuclearMedicine: Critical Appraisal of Needs,Agents, and Instruments" at Chicago'sO'Hare Regency Hyatt House hotel onJanuary 21. Two hundred specialists innuclear medicine and cardiologyattended the program. The sessions weresponsored by the Society for NuclearMedicine. Also participating were Dr.Alexander Gottschalk, Professor andDirector of the McLean Institute andProfessor of Radiology, and Dr. LeonResnekov, Co-director of the Section ofCardiology, Director of the University'SMyocardial Infarction Research Unit,and Professor of Medicine. .In "Care of the Injured-The Sur­geon's Responsibility," the FebruaryBulletin of the American College of Sur­geons lists Dr. Lester R. Dragstedt asboth a "pioneer in biological research insurgery and a contemporary in modernsurgery." Dr. Dragstedt ('21), theThomas D. Jones Professor Emeritus inSurgery, is presently a faculty member atthe University of Florida.Dr. Ralph F. Naunton, Professor ofSurgery and Chief of the Section ofOtolaryngology, and Dr. Cesar Fernan­dez, Professor of Surgery, were scien­tific directors of a symposium on "TheVestibular System" at the University onApril 26-28. The symposium broughttogether anatomists, physiologists,pathologists, diagnosticians, and sur­geons specializing in the vestibular sys­tem.Dr. Ralph F. Naunton, Professor ofSurgery and chief of the Section ofOtolaryngology, served as a consultanton otological research facilities inMysore and Varanasi, India, for theNational Institutes of Health.Dr. Ralph F. Naunton, Professor ofSurgery and Chief of the Section ofOtolaryngology, and Dr. Gregory J.Matz, Assistant Professor of Surgery,and Dr. Phillip A. Collins, AssistantProfessor of Radiology, presented "Ef­fects of Radiation on the Temporal39Bone," at the 30th Annual MidwestClinical Conference of the Chicago andIllinois State Medical Societies at theConrad Hilton Hotel in Chicago onMarch 28.Dr. C. Frederick Kittle, Professor ofSurgery, delivered the Harvey MemorialLecture at Yale University on March 5;"The Travels of Physicians" to theTrent Society at Duke University onMarch 6; and the Sam Dunn Lecture,"Arthur Conan Doyle, Doctor­Detective" at the University of TexasMedical School, Galveston, on May 8.Dr. Edwin Kaplan, Associate Profes­sor of Surgery, discussed "HumoralSimilarities of Carcinoid Tumors andMedullary Carcinomas of the Thyroid"on February 8 before the Society ofUniversity Surgeons in New Orleans.Co-authors were Dr. Glenn Sizemore,Mayo Clinic; Dr. Bernard Jaffe,Washington University; and Dr. GeraldPeskin, University of California, SanDiego.Dr. Donald J. Ferguson, et aI., pub­lished "Surgical Experience with Stag"ing Laparotomy in 125 Patients withLymphoma" in the March Archives ofI nternal Medicine.Theoretical BiologyMorrel H. Cohen received an honoraryDoctor of Science degree from Worces­ter Polytechnic Institute, Mas­sachusetts, on June 2. He is the LouisBlock Professor of Theoretical Biology,Physics, the James Franck Institute, andin the College.Anthony D. J. Robertson, AssistantProfessor of Theoretical Biology and inAnthony D. J. Robertson.40 the College, received a two-yearresearch fellowship from the Alfred P.Sloan Foundation. He is one of fourUniversity faculty members to receivethe honor. Robertson is featured in aMay 11 Medical World News article onthe reponse of slime mold amoebas tocyclic AMP.Zoller Dental ClinicDr. Frank C. Besic, Professor in theZoller Dental Clinic; Marion R.Wiemann, Jr., research technologist inthe Clinic; and M. Bayard, McCroneLaboratories, Chicago; presented "IonProbe Analyses of Acid Resistant andAcid Susceptible Enamel" at the 51 stgeneral session of the InternationalAssociation for Dental Research inWashington, D.C., on April 13.GeneralThe Chicago Hospital Council presenteda special commendation to The U niver­sity of Chicago Hospitals and Clinics forits aid to victims of the Illinois Centraltrain wreck. Eight other Chicago hospi­tals received similar commendations.In December, 1972, the Universityreceived commitments of $1,984,715from agencies of the federal government.The Divisions of the Biological Sci­ences, the Physical Sciences, and theSocial Sciences received a total of 32awards.F. Regis Kenna, Director of theUniversity Hospitals and Clinics andAssistant Professor of HospitalAdministration Program in the GraduateSchool of Business, has been re-electedto another three-year term on the boardof the Chicago Hospital Council.The University of Chicago was theleading Illinois recipient last year ofAmerican Cancer Society funds, with$921,126 in society grants as of August1. Total society grants to Illinois univer­sities, principally in the Chicago area,were $1,827,098. The University ofChicago held 15 national grants and 4divisional grants from the AmericanCancer Society.Odin W. Anderson, Director of theCenter for Health AdministrationStudies and Professor of the GraduateSchool of Business and Sociology, wasappointed a -fellow of the Institute forEuropean Health Services Research,Leuven University, Belgium. Andersonis featured in the first audio cassette tobe released by the American College ofHospital Administrators. Also, Ander­son was the recipient of a $61,000 grantfrom the Robert Wood Johnson Founda­tion, Princeton, New Jersey. Centerresearchers will begirr work on an accessindex to the health care system. Alumni News1904E. E. McKibben, Sr., of Seattle,Washington, was honored recently bythe Kirkland Rotary Club. The 94-year-old charter member and past presi­dent of the club, a past mayor, and anesteemed general practitioner for 50years was named a Paul Harris Fellow.The $1,000 scholarship fund is used byRotary International for collegegraduates to study overseas. Dr.McKibben was born in Swatow, China,where his parents were medical mission­naries.1932George O. Baumrucker is an associateclinical professor in the department ofurology at the University of Illinois. Hisbook on transurethral prostatectomy,entitled T.U.R. Technique, Hazardsand Pitfalls, is a reference book for resi­dents in urology.1937Paul C. Doehring of Glendale, Califor­nia, has brought us up to date on hisactivities. He is an associate clinical pro­fessor of surgery at the University ofSouthern California, a senior attendingstaff member at Los Angeles Coun­ty/University of Southern CaliforniaMedical Center, and has a private prac­tice in surgery in Glendale.1947Robert M. Chanock was elected to theNational Academy of Sciences. Dr.Chanock is chief of the Laboratory ofInfectious Diseases at the NationalInstitutes of Health and professor ofchild health and development at GeorgeWashington University' School ofMedicine. He is also a virologist at theChildren's Hospital of the District ofColumbia.1948Kenneth R. Magee of Ann Arbor,Michigan, is one of four physicianswhose comments on prevention andrelief of migraine appeared in the April16 issue of Modern Medicine. Dr. Mageeis a professor of neurology at the U niver­sity of Michigan Medical Center.1949H. William Bardenwerper of Waterford,Wisconsin was elected a charter fellowof the American Academy of FamilyPhysicians at a formal ceremony atMadison Square Garden in New YorkCity. Dr. Bardenwerper completed moref than 750 hours of prescribed post­graduate study (50 hours per yearminimum requirement) during the last 12years. The Bardenwerpers are a Univer­sity of Chicago family. Their oldest sonwas accepted for the fall, 1973, class ofthe University's law school. Dr. Barden­werper, Sr., graduated from Rush Medi­cal College in 1919.1951Robert E. Bloom of Muskegon,Michigan, writes that while he may nothave achieved wide acclaim in his spe­cialty of dermatology, he at least livesin a world-renowned house. Designed byarchitects George Fred Keck and Wil­liam Keck, his home has been describedin architectural journals in Italy, WestGermany, and the United States andnow is featured in the book RodinneDomky V. Zahranici (Family HouseAbroad).1954Dorothy B. Windhorst of Rockville,Maryland, is a co-ordinator of an Inter­national Tumor Immunotherapy Regis­try at the National Institutes of Health.The registry serves as a center for collec­tion, storage and exchange of informa­tion on immunological methods of treat­ing cancer and will be a service at theInternational Cancer Research DataBank.1958Norman Zinner of Los Angeles wasappointed professor of surgery in theDrew Postgraduate Medical School andchief of urology service in the MartinLuther King, Jr., General Hospital. Dr.Zinner assumed his duties in January,upon his return from Leiden, Holland,where he occupied the Boerhaave ChairDr. Norman Zinner. at the Academisch Ziekenhuis for oneyear. His new appointment carries ajoint appointment in the department ofsurgery at the University of Californiaat Los Angeles.1967Monte Bernstein and his wife, RobertaBerger Bernstein, visited Chicago for theAmerican College of Physicians meetingand the Medical Alumni Associationcocktail party. Dr. Bernstein is a majorin the U.S. Army Medical Corps and hasbeen stationed in Frankfurt, West Ger­many, for one and a half years; he hasone and a half more years to serve.1968Walter Jung is a pathology resident atMassachusetts General Hospital, Bos­ton.1969David Cook is entering private practicein internal medicine in Bay City,Michigan, after completing two years atthe National Institutes of Health.Steven Goldstein is remaining atNIH.John Grant is leaving NIH and return­ing to Duke University to complete hissurgical residency.Alan Jacobson finished his psychiatryresidency at Massachusetts GeneralHospital, Boston.George W. Kriebel completed hispsychiatric residency at The Universityof Chicago and is now at Butler Hospi­tal, Providence, Rhode Island.Frank Pien was a fellow at the MayoGraduate School of Medicine and hasjoined the department of internalmedicine in the division of infectious dis­eases at Stanford University School ofMedicine.Michael Popkin completed hispsychiatry residency at MassachusettsGeneral Hospital and is entering militaryservice.Robert Schaefer completed his milit­ary obligation and is now a resident ininternal medicine at Children's Hospitalin San Francisco.Harold Toy was appointed assistantprofessor of pediatrics in the ambulatorycare section of the department of pediat­rics at the University of Texas MedicalSchool, San Antonio. He had been aninstructor of pediatrics at The Univer­sity of Chicago.William Weese is a second-year fellowin the pulmonary unit at MassachusettsGeneral Hospital, Boston.1970Paul Rockey, after two years in theIndian Health Service as the only physi- cian for 2,100 Indians at Rocky BoyReservation, Montana, is starting amedicine residency at the University ofWashington Hospital in Seattle.Paul Schlesinger received a Ph.D. inbiochemistry at The University ofChicago winter convocation. He is nowat the U.S. Naval Hospital inPhiladelphia.1972The following are beginning residenciesat their places of internship:Robert Chevalier: University ofNorth Carolina-pediatrics; Lee Frank:University of Iowa-pediatrics; PaulGallagher: UCLA-family practice;Kenneth Gracz: Rush-Presbyterian-St.Luke's, Chicago-general surgery; Den­nis and Jessie Groothuis: The Univer­sity of Chicago-neurology and pediat­rics; Allan Horwitz: Moffitt Hos­pital-pediatrics; Sheldon Hersh: LornaLinda University-internal medicine;Milton Lakin: Wilmington MedicalCenter, Delaware-internal medicine;Elliot Landaw: UCLA-pediatrics;Stephen Lobowitz: UCLA-internalmedicine; Philip Lisagor: University ofNew Mexico-surgery; Teackle W.Martin, Jr.: Rush-Presbyterian-St.Luke's, Chicago-internal medicine;William W. McIntyre: Grady MemorialHospital, Atlanta-internal medicine;Stephen Schabel: Strong Memorial Hos­pital-diagnostic radiology; Jose Velaz­quez: University of Miami-anes­thesiology; Stephen and Mary Weinstein:University of Iowa-surgery and pedi­atrics. Jonathan Costa is continuinghis research at the National Institutes ofHealth, Bethesda, Maryland.Former StaffGordon A. Genoe (Radiology Resident'67-'69; Instructor '70) was appointeddirector of radiology and nuclearmedicine of Doctors Hospital, LakeWorth, Florida.Scott Kleiman (Intern '67; OrthopedicSurgery Resident '68-'72) has enteredprivate practice in orthopedic surgery inAustell, Georgia.Philip Margolis (Psychiatry Faculty'56-'66) is a professor of psychiatry anddirector of adult services at the Univer­sity of Michigan Medical School, AnnArbor. His book, Patient Power:Development of a Therapeutic Com­munity in a Psychiatric Unit of aGeneral Hospital, will be published thisfall.Gerhart Schwarz (Radiology Residentand Faculty '42-'46) brought us up todate on his activities: director of the41department of radiology at the CliftonSprings Sanitarium and Clinic in westernNew York State-four years; X-raydepartment of the Columbia­Presbyterian Medical Center-14 years;chief of the X-ray department of the BirdS. Coler Hospital in New York City andprofessor of radiology at New YorkMedical College-seven years; directorof radiology at New York Eye and EarI nfirmary since 1971 and clinical profes­sor of radiology at New York MedicalCollege. His sub-specialties are ENTand ophthalmological radiology.Joseph B. Teton (Chicago Lying-inHospital Resident '36) wrote that he isa full-time senior attending physician inobstetrics and gynecology at MartinLuther King, Jr., General Hospital inLos Angeles and clinical associate pro­fessor at Charles Drew PostgraduateMedical School. Dr. Teton was inprivate practice in Chicago and anassistant clinical professor at the Univer­sity of Illinois College of Medicine.Association ActivitiesNew York City psychiatrists and theirspouses were guests at a Medical Alumni Association dinner on March 22which honored Dr. Daniel X. Freed­man, the Louis Block Professor ofPsychiatry and Chairman of the Depart­ment. Dr. Freedman addressed theUniversity alumni prior to the dinner.Los Angeles-area medical alumni andtheir spouses were Association guests ata cocktail party honoring Dr. David B.Skinner, the Dallas B. Phemister Profes­sor of Surgery and Chairman of theDepartment, on May 16 at the Bel-AirHotel.The Medical Alumni Associationhosted a cocktail party on April 10 atthe Blackstone Hotel in Chicago foralumni and their spouses attending theAmerican College of Physicians meet­ing. Greeting the guests were DeanLeon O. Jacobson (,39); Dr. Joseph B.Kirsner, Deputy Dean for MedicalAffairs; Dr. Richard Landau, Associa­tion President; Dr. Alvin Tarlov (,56),Chairman of the Department ofMedicine; and several other Universitysection heads.Among the guests were Dr. and Mrs.Richard V. Ebert (,37) of St. Paul, Min­nesota. Both Richard and his brotherRobert (,42) were made masters of the42 American College of Physicians.Alumni elected fellows of the Ameri­can College of Physicians were:Joseph M. Baron (,62) of Chicago;Hillel M. Ben Asher (' 56) of Mor­ristown, New Jersey; Michael J. Kinney('63) of Staten Island, New York; Mar­vin J. Stone ('63) of Dallas; Charles S.Winans of Chicago; Steven A. Armentr­out (' 59) of Irvine, California; J. DonaldCoonrod of Brookfield, Wisconsin;Eugene A. Gelzayd of Southfield,Michigan; Irwin S. Kasser of Atherton,California; Herman E. Kattlove (,62) ofPalos Verdes, California; Arnold M.Katz of New York; Joel D. Levinsonof Mountainside, New Jersey; David A.Morowitz of Washington, D.C.; ArthurH. Rubenstein of Chicago; Robert E.Slayton (,48) of Chicago; Willaim Q.Sturner of Dallas; and Donald M. Switz(,62) of Richmond, Virginia.Calendar of EventsWednesday, October 17Reception during American College ofSurgeons meeting, Chicago, Illinois,Sheraton-Blackstone, 5:30-7:00 p.m.Spouses invited.Old acquaintances were remembered at the April cocktail partyin Chicago hosted by the Medical Alumni Association. (aboveleft) Left to right: Raymond Vander Meer ('38) of Grand Rapids,Michigan; Dr. and Mrs. Richard V. Ebert ('37) of St. Paul, Min­nesota. (above right) Left to right: W. Philip Corr (,24) of Riverside,California; Robert T. Porter ('31) of Greeley, Colorado; and JosephB. Kirsner. (left) Left to right: James Rabb, resident; Alvin Tarlov('56); John s. Thompson ('53) of Iowa City; and Henry P. Russe('57) of Chicago.We Give A,s for AnswersEach summer 20 percent of our alumni .change their addresses. Please let usknow if you are one of them. Also, letus know what is new and interesting inyour life.Name Graduation YearHome Address TelephoneCity, State, ZipBusiness Address TelephoneCity, State, ZipTitleA new address?A new position?A new medical practice?new military assignment?new civic or professional honor?new book?Please tear out, fold, staple, or tape, and drop in the mail box. Thanks!.. --------,I II II Place II Stamp II II Here II I: I.. 1Medical Alumni Association1025 East 57th StreetChicago, Illinois 60637Fold this flap in first