!"Iedicine on the Midw3,-y Vol. 33 No.2I elf -', ' '-' \.I �-Bulletin of the Medical Alumni Association of The University of ChicagoDivision of the Biological Sciences and-The Pritzker School of Medicine. ® .�i .�i .� �;: :�. VI'?i "".� ,,:? '; f.� :�.� � rt f! '1" �� .�I �/ � ·� 7, 'CalendarWednesday, March 7Department of OphthalmologyAnnual Alumni Day. (See De­partment News for details.)Monday, March 26 (LosAngeles)Tuesday, March 27 (San Fran­cisco)Dinner for medical alumni.Special guests include DeanRobert B. Uretz and DeanJoseph Ceithaml.Tuesday, March 27Reception for alumni andspouses during American Col­lege of Physicians Meeting,San Francisco, 5:30-7:00 p.m.Check at convention registra­tion area for location.Tuesday, April 3Reception for alumni andspouses of Chicago Lying-inHospital during American Col­lege of Obstetricians andGynecologists Meeting, NewYork City, 5:30-7:00 p.m.,Americana or Hilton Hotels.(Check at convention registra­tion desk.)Thursday, June 14Frontiers of Medicine program(6 hours); Medical AlumniBanquet, Drake Hotel, 6:30p.m. (Details through MedicalAlumni Office.)Friday, June 15Medical Alumni Day: Dean'sbreakfast honoring CenturyClub members and classchairmen, scientific program,awards luncheon, and reunionclass parties. Cover:Four second-year residents in internal medicine pose with propssuggesting four courses of internal medicine training. Dr. LawrenceSamuelson (front) shelters a black bag representing general internalmedicine; Dr. Richard Larson (left) supports a mobile IV stand,representing the subspecialty of hematology; Dr. Sherwin Waldman (,77)(center) sits beind a model of the heart and a pacemaker, representing thesubspecialty of cardiology; and Dr. Russell Hall (' 77) (right) holds aproctoscope, representing the subspecialty of gastroenterology. TheGraduate Medical Education National Advisory Committee (GMENAC),headed by Dr. Alvin R. Tarlov ('56) at The University of Chicago, hasbeen tasked by the federal government with providing answers toquestions about national health manpower and training of physicians tomeet the anticipated health needs of the American population in 1990,2000 and 2010. A consensus of public opinion has developed over the pastfew years which asserts that what America needs is more generalphysicians and fewer specialists; more general internists and fewerinternal medicine subspecialists. GMENAC will try to advise thePresident on these and other concerns. See story on page 4.Photo by David JoelMedicine on the MidwayVolume 33, No.2 Winter 1978Bulletin of the Medical Alumni Association of TheUniversity of Chicago Division of the BiologicalSciences and The Pritzker School of Medicine.Copyright 1978 by the Medical Alumni AssociationThe University of ChicagoEditor: Christina West WellsContributing Editor: James S. SweetPhotographers: Mike Shields, David Joel, PatriciaEvans, Dick Katschke, Joe PeldunChairman Editorial Committee: Robert W. Wissler('48)Medical Alumni AssociationPresident: Joseph H. Skom ('52)President-Elect: Frank W. Fitch ('53)Vice President: Louis Cohen ('53)Secretary: Sumner C. Kraft ('55)Director: Katherine Wolcott WalkerCouncil MembersRichard H. Evans (' 59)Herbert B. Greenlee (' 55)Abbie R. Lukens ('50)Charles P. McCartney (' 43)Julian J. Rimpila ('66)Benjamin H. Spargo ('52)Francis H. Straus, 11('57) ContentsNational Health Manpower:Status and ChallengesHow the Graduate Medical Education National Advi­sory Committee works and what they are trying to doabout physician manpower planning.Dr. Alvin R. Tarlov ('56)Focus on NeurologyAn interview with Dr. Barry G. W. Amason,chairman of the Medical Center's youngestdepartment.Dr. Richard LandauPancreatic Cancer: SheddingLight on a Little-Known DiseaseA team of University surgeons, endocrinologists andradiologists pool efforts to find new methods for ear­lier diagnosis and treatment.Richard KatschkeNew Residents Today 12and Ten Years AgoUniversity of Chicago residents chose general inter­nal medicine in greater numbers in 1978 than in 1968,surgery remains stable, pathology up.James S. SweetComing Back to the 14Midway for CreditVisiting Clinician Programs offer one or two weeks atthe Medical Center under the guidance of a singlefaculty member in a specific area.Spotlight on Alumni 16One of Dr. Eloise Parsons' (Rush '24) former patientsreminisces about old-fashioned medical care. Dr.Parsons, now retired, is far from retiring, however,and still .. cares".Dorothy AldrichOn the Light Side 18An alumnus and class chairman describes preparingfor and participating in the Boston Marathon in "Re-ality Testing and Long Distance Running."Dr. Randolph W. Seed ('60)News BriefsDepartmental NewsAlumni News 4892024263National Health Manpower:Status and ChallengesDr. Alvin R. Tarlov ('56)Dr. Alvin R. Tarlov ('56)4 The following is an edited transcript of a talk Dr. AlvinR. Tarlov Professor and Chairman of the Department ofMedicine made to the members of the Council of theBiological Sciences on October 13, 1978.In 1974, when a lot of rhetoric about medical practice wasdeveloping, the professional societies in internalmedicine got together to discuss the questions of whetherthere were too many physicians or not enough physi­cians, whether they were in the right places or in thewrong places, and what was meant by "primary care" or"family practice" physicians?When we decided to examine these questions ration­ally, however, we found there was virtually no data onthe production of internists which would allow us to dis­cover whether we were producing too many or too few,and there was no data at all on the productivity of physi­cians. We did not know once we had trained these physi­cians how many people they could take care of or whatkinds of services they could provide. In 1975 we decidedthat until we could generate more data, perhaps we oughtto hold the line on the number of subs pecialists inmedicine; that maybe we had enough cardiologists, kid­ney specialists and diabetes specialists, etc., and maybewe ought to produce more general internists. Yet, wewere not sure. What we did know, however, was that weneeded more data.In response, a National Study of Internal MedicineManpower (N aSIMM) was commissioned under the aus­pices of the Federated Council for Internal Medicine(FCIM), comprised of the American Board of InternalMedicine, the American College of Physicians, the Amer­ican Society of Internal Medicine and the Association ofProfessors of Medicine. The study is directed by me hereat The University of Chicago. We use the National Opin­ion Research Center at the University to conduct ourwork which consists largely of four questionnairesnationwide. Three of the four questionnaires have nowbeen completed.SurveysIn the summer of 1976 we surveyed all 418 programdirectors of internal medicine in the United States. Wehad a 98 percent response rate to the questionnaire whichtook a chairman of medicine ten hours to complete.Early in 1977 we surveyed the 1447 subspecialty programdirectors, the people who train cardiologists, ne p­hrologists, endocrinologists, infectious diseases spe­cialists, etc. There are ten of these subspecialties and wehad an 85 percent response rate to that questionnairewhich took about six hours to complete.The information from these two questionnaires in­dicated that there were 15,000 young men and women intraining for the practice of internal medicine in America,and we decided to query them to see if we could findsome key common thread in their backgrounds, theirtraining or their training institutions which might leadthem to select a subspecialty versus general medicineor to select an urban versus a rural or suburban prac­tice. We surveyed a sample group of 2000 residents andhad an 85 percent response rate to that questionnaire.Finally, the fourth questionnaire will go out shortly towhat we call the 1973 exitors, people who completed theirtraining in 1973 and entered practice that year. Again, weare looking for common factors in their family, cultural,social, economic and geographic backgrounds which mayhave influenced the kind and location of medical practicethey chose to pursue. In addition, we wanted to find outwhat impact the training institution has on the careerchoices its medical graduates make.Physician NumbersThere are 350,000 active physicians in the United Statesnow. Of those 350,000 about 20 percent are internists andthese are the physicians, by and large, who take care ofadults. Their practices focus on older patients, chronic ill­ness and multi-system illness in the same patient.In our study year, 1976-77, medical schools in thiscountry took in 15,000 students, approximately doublethe number of students in the late 1960s.The event of the 1960s that led to this spectacular risewas the Medicare/Medicaid program adopted in 1965--66which led the American public to expect greater healthservices. In the late 1960s it became apparent that themedical manpower available to deliver these services wasinadequate. Federal, state and local initiatives wereundertaken to increase the number of medical students intraining and as a consequence, what had been a fairlystable curve of student numbers in medical educationtook a dramatic upswing. A disproportionate number ofthese new physicians, in addition, went on to sub­specialize."We know from our research, that two­thirds of the direct cost of graduate medi­cal education is borne by the federal gov­ernment ... $1.3 billion per year."Residency training in internal medicine is a three-yearprogram immediately following medical school. If a resi­dent wishes to subspecialize, he enters a fellowship pro­gram after these three years. The problem, according tothe argument which stems from Washington, is that afellowship takes two additional years of training largely atgovernment expense. (We know from our research thattwo-thirds of the direct cost of graduate medical educa­tion is borne by the federal government. The direct costof all United States residencies and fellowships is about$2 billion and $1.3 billion of that can be regulated federal­ly.) In addition to requiring two extra years of training,so the argument goes, once these fellows go into prac­tice, they do not want to do what is needed. What isneeded are doctors who will provide general care for theAmerican population rather than highly-trained, tech­nologically-oriented subspecialists. Furthermore, thesesubspecialists earn two to three times what a generalistdoes, and since the government is paying 46 percent ofthat bill as well, the whole thing costs too much. Fewer specialists and more general physicians to take care of theAmerican people will save a lot of money and people willbe more satisfied with their care. That, simply stated, isthe government's argument."While the 1976-77 ratio of generalists tosubspecialists was 2-1, we reasoned thatby 1992, given the current course, thatratio would reverse."What we found in our 1976-77 study was that a con­stant 35 percent of U.S. medical graduates entered inter­nal medicine training from 1971-79, a compounded in­crease of 7.4 percent per year. The number of fellowselecting subspecialty medicine, however, was increasingat a compounded rate of 10.6 percent per year. So that,while the 1976-77 ratio of generalists to s ubspecialists was2-1 (50,000 generalists versus 25,000 subspecialists), wereasoned that by 1992, given the current course, thatratio would reverse.There would be more subspecialists than generalists bya factor of two in 1992, and that would represent a prob­lem.The course away from general medicine seemed fairlystraightforward and it was flying in the face of publicopinion at the time which said, "There are too manysubspecialists and they are too expensive." That was theproblem from the internal medicine point of view, but itcan be extended to all other areas of medicine since it isequally applicable to them all.Reading the FutureWe used rather sophisticated actuarial data and tech­niques to calculate death, disability, retirement, migra­tion out of the practice field into others as well as an agingU.S. population to calculate our projection for 1992 andthere seemed every reason to accept it.In an effort to address this problem, President Fordcreated a special advisory committee in January 1977, a21-person Graduate Medical Education National Advi­sory Committee (GMENAC). It was reorganized underPresident Carter and Health, Education and Welfare Sec­retary Joseph Califano. The impetus for reorganizationderived from President Carter's commitment to nationalhealth insurance.The President's advisors' message was, "Do not repeatthe mistake of the 1960s, do not promise and not be ableto deliver on health care. Generate the manpower firstand then we'll implement our national health program."GMENAC's job is to determine those manpowerneeds. I became chairman in late June 1968 and our cur­rent goals are to advise Secretary Califano on:-the total number of physicians needed to care for theUnited States' population in the future, specifically theyears 1990,2000 and 2010,-the desired specialty and subspecialty distribution ofthese physicians,-the geographic distribution of physicians, whether5Number of Subspecialty FellowsAverage Annual Growth Rate1972 -197625%20%15%10%5% I I I 15,000. -- :3,000IS, 000a.,OOO 11,0009, ODD q,ooo, O/J{)" 0003,000 • F 1s'1/ '77The percentage of young physicianschasing internal medicine residenciesremained relatively constant from1972 -76 (R-Is in upper box). Yetthe percentage offellows in trainingwas increasing apace (Fs in upperbox, broken down by specialty atleft).CARD, GAST PUL. NEPH ENDO. HEM I. D. RHEU ONCOl HEM- ALL-ONe, IMM.there are regional differences throughout the U.S. in theutilization of medical services and how to address theproblem of maldistribution (inadequate numbers ofphysicians, particularly in rural and poor, inner cityareas, and an overabundance of physicians in otherareas),-the possible impact a college, medical school orteaching hospital has on the type and location of a.graduate's medical practice, and-what specific strategy should be adopted by the fed­eral government to finance graduate medical education.GMENACAll 21 members of our committee were appointed bySecretary Califano. Thirteen are physicians and none aremanpower experts. They are instead people who repre­sent the public.Among the members of the committee, there is aninternist who is the chief of medicine at a small commu­nity hospital and an orthopedic surgeon who also teachesat a medical school but is largely a private practitioner.There is a young, woman resident in emergency medicinewho is active in the National Housestaff Unionizationmovement; a director of a large, inner city black hospitaland an ophthalmologist. There is a university chancellor;the dean of an osteopathic school; the chairman of apediatrics department; the president of the AmericanMedical Association, who is a urologist; the president ofa large privately-operated medical center on the WestCoast; a young, black woman psychiatrist; and a manwho runs a family practice residency program.The five non-physician members include a minority6 ALLwoman from New York City, who represents consumerinterests; a vice president of an insurance company; thedirector of a university teaching hospital; a labor unioneconomist and an economist who is the chairman ofcommunity medicine at a medical center.There are, in addition, three ex-officio federal members:an official from the Veterans Administration who directstheir academic affairs, a military officer from the U.S.Naval Medical Center, and an administrator from theHealth Resources Administration where GMENAC isheadquartered and where our staff is located.We have a full-time staff of thirty individuals who workon this program. The committee itself meets bimonthlyin Washington; as chairman, I am there alternately one ortwo days every week."Since GMENAC [Graduate MedicalEducation National Advisory Committee]began its work, one of its largest under­takings has been to work out a method forplanning health manpower needs ... wehave created a model for determininghealth service requirements based onneed rather than demand."Since the committee began its work one of its largestundertakings has been to work out a method for planninghealth manpower needs. To avoid repeating the mistakeof the late 1960s, when the number of physicians wasincreased to meet an expected demand for health ser­vices, GMENAC has created a model for determininghealth service requirements based on need rather thandemand.It is an enormous task since this model has to beapplied to all 33 specialties in medicine and to every med­ical condition treated in each of these specialties. Forinstance, in internal medicine, each of the 800 conditionswhich comprise 98 percent of what an internist treats, hasto be analyzed separately. Using high blood pressure as asample condition, we begin by taking the true biologicalincidence of the condition in the U.S. population. Thenan adjusted incidence is calculated by factoring in howmuch of that high blood pressure needs to be seen by aphysician and under the best of circumstances given thatneed, how many of those suffering from high blood pres­sure will see a doctor. Fortunately, good data exists onboth the true biological incidence of most conditions andtheir adjusted incidence.The next step is to determine a norm of care. If thereare a million hypertensives, what kind of services dothey need? How many times a year should they be seenand what is the average time a physician spends caringfor a patient with this illness?Finally, we arrive at an adjusted need for services bydividing our previous calculations by physician produc­tivity (what a physician can do in a day, a week and ayear). The result is the health manpower requirement tocare for this condition. Care provided by non-physicians(nurse assistants, nurse associates, other health prac­titioners) is deducted from the total leaving the full-timephysician manpower requirement to care for hyperten­sion. We must go through this exercise for all thethousands and thousands of conditions which are caredfor by physicians in the 33 medical specialties.Preliminary ReportThough the final GMENAC report is not due until April1980, a preliminary report is due this winter. It will in­clude:-profile data on the present number of physicians andtheir specialties and a projection of what we expect in1990,-a discussion of non-physician health care providers,who are growing in numbers and importance,-an investigation of specialty fees, addressing thepublic sentiment that if, for example, they are paying highfees for cardiac catheterization there are going to be morepeople who want to become cardiologists,-suggested alternatives for funding the $2 billionmedical education costs,-an argument for considering academic medicine andmedical research separate from private practice and thedelivery of health care services, and-a recommendation for monitoring health care man­power in the future, and alternatives for influencing man­power.The crucial question is, how does one, once the data isavailable, impose a regulatory mechanism on teachinginstitutions and the medical schools to achieve a desired result with respect to physician manpower? On one ex­treme it can be legislated at the federal level. Since mostof the money for graduate medical education comes fromhospital income, a limit could be placed on the amount ofmoney from Medicare and Medicaid income to be used intraining new physicians. Penalties could then be imposedfor exceeding that amount.On the other hand, regulation could be left up to theprofession. Data suggesting a lack of public accountabil­ity in the production of physicians could be given greatervisibility in the hope it would engender a national con­sensus among medical educators about public account­ability and they would design their programs accordingly."The question is, simply by providingdata, giving it broad visibility, allowing itto become the focus of discussion anddebate in medical education com­munities, can you achieve a new balancein the public good?"An alternative plan would be to create a regulatorymechanism which places the federal government and theprofession in some kind of collaborative position so thatthe government can do what it does best (the collection ofdata and provision of incentives), and the profession cando what it does best (medical education and the training ofphysicians for the future). A regulation which does that, Ithink, can bring about a medical education and a trainingsystem that will meet the public needs.A New Balance?This summer we did some additional research. Webrought our original 1976-77 study up to date with in­formation on the distribution of residencies in 1977-78and 1978--79. In the three-year interim our data has re­ceived wide visibility and a public consensus has beencreated and accepted by nearly everyone in internalmedicine: "There are too many subspecialists inmedicine, let's reverse the trend. How do we do it?"We wanted to see if anything had changed since 1976-77-it has. The number of residents in America has con­tinued to rise, with a stable 35 percent in internal medi­cine, but the climb in subspecialty training has leveledoff in the past two years. For one reason or another, morepeople are being trained for general internal medicine,which is considered in the national good, and fewer arebeing trained in subspecialty medicine.The question is, simply by providing data, giving itbroad visibility, allowing it to became the focus of discus­sion and debate in medical ed ucation communities, canyou achieve a new balance in the public good? Our datasays something like that is happening. Is it enough? Willit be sustained? What are the incentives required to sus­tain it? Can the government afford to gamble on self­correction? These are some of the policy issues withwhich GMENAC will have to deal.7Focus on NeurologyAn Interview with Dr. Barry G.W. ArnasonDr. Barry G.W. Amason is Professor and Chairman ofthe Department of Neurology. He has headed the de­partment since 1976, one year after it was established andhas brought to it expertise particularly in immunologicneurological disease. Dr. Richard Landau, Professor inthe Department of Medicine, conducted this interview forMedicine on the Midway.LANDA U: Dr. Arnason, you've now been here for abouttwo years. There must have been some administrativeproblems in organizing a new department, in gettingstaff, in getting space, but also some things that make allthe problems worthwhile for you.ARNASON: Yes. We've been very pleased overall. TheUniversity of Chicago made a firm commitment toneurology and made available to us the facilities that I feltwould permit us to do the kind of investigative work weare interested in, under the most favorable conditions andwith the best equipment and space that I could find any­where in the country. Since you've broached the issue offrustrations, however, we are somewhat disappointed bythe fact that we have been unable thus far to get ourselvesestablished in the new Surgery Brain Research Buildingbecause of a delay in getting the necessary alterationsdone.LANDA U: You're still located in your old space, thebasement of the Clarissa A. Peck Pavilion [formerly theChronic Diseases Hospital], but are scheduled to moveinto the Surgery Brain Research Pavilion?ARNASON: Yes, that's right.LANDA U: Two years ago you started here with Dr.Douglas Buchanan as the only working holdover fromthe previous neurology section. What is the size of yourdepartment now?ARNASON: It is not quite correct to say that Dr. Bucha­nan was the only remaining section member, because Dr.Peter Huttenlocher, who is the head of Pediatric Neurol­ogy, was here, and Dr. Lawrence Bernstein, who wasfinishing up a fellowship here,joined the faculty this year.However, we did do some recruiting, and I brought inwith me from the Massachusetts General Hospital in Bos­ton Drs. David Richman, Jack Antel and Ew aChelmicka-Schorr, who formed our core team. Dr.Raymond Roos, who is a virologist and neurologist,joined us from Johns Hopkins; Dr. Jean-Paul Spire,whose interest is in electrophysiology, joined us from theUniversity of California at San Francisco; and Dr. SaraSzuchet, who is a biophysicist, joined us from the StateUniversity of New York at Buffalo. This year, Dr. RileyYu from Baylor University joined us and his interest is intissue culture of the nervous system. Altogether we haveeight neurologists, plus two pediatric neurologists whoseprimary appointment is in the Department of Pediatrics,8 Dr. Barry G. W. Amasonbut who are part of the Neurology team. They are Drs.Huttenlocher and Marvin Zelkowitz. We have in additiontwo scientists who are part of our research team, but donot do clinical work.LANDAU: Would you say that with the possible excep­tion of Dr. Spire, who is a clinical electrophysiologist,the department has a reseach focus?ARNASON: Yes. My own interests are in immunologyand virology. I decided that what I would like to do whenI came here was to build a center of excellence in thosedisciplines as they apply to the nervous system. I thinkthat the nature of science being what it is now, and thebreadth of neurology being what it is, that it is not possi­ble within the confines of any single institution to haveexpertise in all of the various areas of neurology and thatindividual institutions should perhaps concentrate on oneor two or a few areas where they can make a contri­bution. I also believe that in terms of the research en­deavor that it is helpful to have a critical mass of peoplewho will interact with one another and who are able tocomplement one another to solve problems collectively.This is not to say that I believe necessarily in the "teamapproach" to any problem, but there are advantages inhaving colleagues to discuss your research with who mayhave methods that can be brought to bear on your prob­lem.LANDA U: Although you have interlocking interests,each of the faculty members generally has his own prob­lem more or less, and some of these problems, thoughbased immunologically, for example, are directed to­wards some neurologic disease?ARNASON: Yes, and that is very straightforward. Dr.Richman is particularly interested in the problem ofmyasthenia gravis; Dr. Antel is interested in problems oflymphocyte function in neurologic disease with an em­phasis on multiple sclerosis. Dr. Roos is interested inslow viral diseases and also in dominantly inherited dis­ease, notable Huntington's disease. Dr. Schorr is inter­ested in tumors and the relationship between the nervoussystem and tumor growth. Dr. Yu is interested in organculture of the nervous system which can then be appliedto all of the diseases I just mentioned. I have an inter- est in amyotropic lateral sclerosis which I share with Dr.Antel. I'm also interested in multiple sclerosis (MS) andDr. Szuchet is interested in purification of nerve cells,notably oligodendrocytes, the cells primarily attacked inMS. Dr. Huttenlocher is interested in Reyes syndromeand in subacute sclerosing encephalitis which is a slowviral disease, which interfaces with Dr. Roos' work inslow viral diseases. Dr. Zelkowitz is interested in, from achemical standpoint, the dominantly inherited diseasesand Dr. Roos and I share an interest in these problems.So, each person has his own problem, but these problemsoverlap and intersect so that there is a continual ex­change and interplay between the members of the de­partment.LANDA U: We have a growing group of neurologists,psychologists, and neuropharmacologists on the cam­pus. Do youfind that your group isfinding it is profitableto interact with these people in terms of your research 'oryour teaching or both?ARNASON: Certainly one of the strengths of the Uni­versity is that there is a large group of people with inter­ests in various aspects of neuroscience, broadly stated.We have rather close contact with the neurosurgeons incertain aspects of our work, but they also have their ownpursuits which do not involve us. We are engaged in onecollaborative project with the Department of Psychiatry.I also draw on the expertise of the people in the Depart­ment of Physiology and Pharmacology on occasion.There is a neurobiology committee now being formed,but their interests are separate from ours.Pancreatic Cancer: Shedding Light on a Little-KnownDiseaseRichard KatschkeIt would help if there were early warning signs of pan­creatic cancer.But there aren't.It would be a breakthrough if scientists had an inklingof how pancreatic cancer could be prevented.But they don't.So instead of receiving the national attention that can­cers of the lung, breast, colon and other organs do, thepublic generally remains uninformed and unconcernedabout the dangers of pancreatic cancer.Yet, pancreatic cancer is the third leading cause ofcancer deaths for men between the ages of thirty-five andfifty-five. In 1979, approximately 22,000 new cases will bediagnosed in the U.S. Almost as many will die. It is con­sidered one of the most fatal forms of cancer. The na­tional five-year survival rate is only one per cent.At The University of Chicago, a multidisciplinary teamof basic and clinical scientists and physicians in one of the world's foremost centers for pancreatic cancer re­search are dedicated to finding new methods for earlierdiagnosis and treatment of the disease. They are trying todetermine which people are at greater risk for pancreaticcancer and new surgical methods for its treatment andcure. More patients are referred to the University forspecialized surgery and treatment than to any otherAmerican center.About the PancreasHidden deep in the body's abdomen behind thestomach and in front of the spine, the pancreas shares acrowded space with the liver, kidneys and large in­testines. It is basically two digestive glands housed in oneorgan.It produces enzymes which break down food in theintestine so that it can be absorbed. Pancreatic enzymesconvert food into chemical forms that provide the body's9Dr. James D. Bowie (above) and Dr. Arthur Rubenstein(right)nutrition. Juices produced in the pancreas neutralize theacid nature of gastric juice as it leaves the stomach on itsway to the digestive tract.Cancers stemming from these portions of the pancreasare called pancreatic exocrine cancers.The second function of the pancreas is the production ofinsulin which keeps the blood sugar at proper levels. Can­cers that develop in the insulin-producing islet cells of thepancreas are called endocrine cancers.Investigations are underway at the University into bothpancreatic endocrine and exocrine cancers.Some of the information learned about the disease re­sulted serendipitously from diabetes research. Diabetes isthe body's major disorder stemming from the pancreas.Who is at Risk?"There are no distinct, early signs or symptoms in­dicating pancreatic cancer," says Dr. A. R. Moossa, Pro­fessor of Surgery. "Routine tests are often negative, thusmaking early diagnosis difficul t. Because of its location, atumor in the pancreas cannot be detected by standard"x-ray.But sophisticated diagnostic procedures that can detectthese cancers in their early, curable, stages do exist. Ul­trasound scans and blood serum tests provide physicianswith early clues to the disease. The problem is that thesetests are costly and often require hospitalization."In the present 'state of the art', a large number ofpatients with relatively trivial diseases would have to besubjected to numerous tests to see if the cancer existed.We would have to screen almost 11,000 asymptomaticpeople to find one case of early pancreatic cancer," ex-10 plains Dr. Moossa. "It just wouldn't be practical."If scientists could zero-in on a population group atgreater risk for the disease, doctors would know whichpatients should undergo the detection tests. Unlike manyother cancers, however, there is no indication of heredi--tary predisposition. Though the cancer is usually moreprevalent in men between forty and seventy, Chicagophysicians are seeing an increasing number of womenand younger men with the disease.Dr. Moossa reports, however, that recent studies hereand at the Mayo Clinic point to cigarette smokers asprime candidates for pancreatic cancer.Mayo investigators screened 11,000 heavy cigarettesmokers for lung cancer. They found a sizeable numberof these people also had pancreatic cancer. The Mayoteam determined it is the second most common form ofcancer for cigarette smokers."In a research study at the University," Dr. Moossanotes, "we found a significant number of pancreaticcancer patients who, after surviving three years, now haveeither lung cancer or cerebral vascular disease. Both ofthese disorders are associated with cigarette smoking."He also notes that in a test done at the University onblood serum markers, patients with pancreatic cancerwere found to have elevated readings. Similar highreadings were noted for heavy cigarette smokers and lungcancer patients.Seek Quicker, Simpler Tests"Our goal is to develop quicker, simpler tests for earlydiagnosis of pancreatic cancers," says Dr. ArthurRubenstein, Professor and Associate Chairman of theDr. A.R. Moossa (right) and Dr. Edwin L. Kaplan (below).Department of Medicine and Director of the University'sDiabetes Research and Training Center. Dr. Rubenstein,Dr. Edwin L. Kaplan and Howard S. Tager are creditedwith developing several of the blood serum marker testsnow used throughout the world for diagnosing pancreaticendocrine cancers. Dr. Kaplan is Professor of Surgeryand Tager is Assistant Professor of Biochemistry."Some tumors of the pancreas secrete ins ulin into theblood stream and thus cause the patient to suffer fromhypoglycemia (low blood sugar)," Dr. Kaplan explains."There are many other causes of hypoglycemia, however.Sometimes it is difficult to differentiate which patients ofthis group have insulinomas (endocrine cancers)."With Dr. Rubenstein, we have devised a new test thatappears to pick out with great accuracy those patients whohave benign or malignant insulin secreting tumors," hesays. "This is called the calcium infusion test."Dr. Kaplan and Tager recently isolated a new peptidesubstance from the pancreas that has never been pre­viously known. They call this factor the calcium elevatingpeptide (CEP). "Since this is a new peptide, it deservesstudy as a potential tumor marker for pancreatic cancers,"Dr. Kaplan says. "Our goal is to create a test that willmeasure levels of CEP in the blood. It is our hope andconjecture that some pancreatic tumors will be associatedwith an elevation of CEP in their serum."If so, by means of a serum test, some pancreaticcancers could be diagnosed early when cure would bemore likely. This is the goal of everyone who works in thisfield. "In other studies, Dr. Rubenstein and Dr. David L. Hor­witz (,67), Assistant Professor of Medicine, measure in- sulin, proinsulin and C-peptide levels in the blood of pa­tients suspected of having pancreatic endocrine tumors.Proinsulin, the precursor of insulin, was discovered at theUniversity by Dr. Donald F. Steiner (,56), the A.N. Pritz­ker Professor and Chairman of the Department ofBiochemistry and Professor of Medicine.Dr. Rubenstein is also performing glucose tolerancetests on patients suspected of having exocrine pancreaticcancer. The results indicate that a patient with the cancerhas a higher degree of intolerance to the blood sugar thandoes the general population.Viewing the Pancreas"Our goal is to produce some sort of technique thatenables us to see cancers of the pancreas in a painless,non-invasive way," asserts Dr. James D. Bowie, Assis­tant Professor of Radiology. Two relatively new scanningtechniques, ultrasound and computed tomography, mayhasten this end.Because of the pancreas' location, standard x-rays areineffective for detecting possible tumors. Arteriogramscould pinpoint exactly where a tumor is located withinthe pancreas, but the procedure is risky, painful and ex­pensive.Dr. Bowie places great hope in ultrasound:"A transducer attached to our equipment sends sound­waves into the body," he explains. "This signal is re­flected from the internal structures and comes back.The transducer translates the sounds into images on ascreen."We look for any alterations from the norm to de­termine if there is a tumor," he says. Unlike x-rays, the11examination does not affect the body at the cellular level.There are no adverse effects.But there are problems.Ultrasound does not work in everybody. For some un­known reason, the imaging technique eludes twenty per­cent of the population.And the image produced only indicates abnormal swel­ling. It does not necessarily indicate cancer. "That imagecan represent a variety of diseases," Dr. Bowie notes,"and even when the image appears as normal, there maystill be a cancer present."The primary thrust of Dr. Bowie's work is to increasethe number of patients that can be imaged by ultrasound.He also hopes to work on contrast enhancements thatwill aid in the detection of pancreatic endocrine cancers.At the present time, the technique does not work as wellfo r ins ulin- sec reting t umo rs.Computed tomography scans, commonly known as"body scans," are an alternative to ultrasound. The pro­cedure, diagnostically effective in ninety percent of thepopulation, evaluates how much radiation is absorbed invarious tissues. Intravenous contrast fluids highlight pos­sible tumors."A computed tomography prod uction firm has devel­oped a technique for imaging the spinal cord," remarks Dr. Bowie. "We hope to apply these new advancementsto our studies of the pancreas.""We believe that patients with pancreatic cancershould be treated in specialty centers where there is aninterest and expertise in the problems," Dr. Moossastresses.He continues, "Early diagnosis and adequate surgicaltreatment remain tile only known methods of curing thisdisease. "The average hospitalization, according to the surgeon,is five to six weeks. During this time, the hospital staffhelps the patient adjust to a new lifestyle.After a major portion of the pancreas is surgically re­moved, the patient may become diabetic. The patient'sability to control glucose or blood sugar levels is far lessthan in an average person, and they will need to takepancreatic enzyme replacements orally to aid in food di­gestion.Even then, eating will present some difficulties. Pa­tients will eat smaller, more frequent meals to accommo­date the smaller size of their stomach. Their diet will besimpler with fewer fats or hard-to-digest foods.By maintaining a diet and therapy regimen with strictenzyme replacements, and by keeping a close watch forother body function changes, however, pancreatic cancerpatients can return to productive lives.New Residents Today and Ten Years AgoJames S. SweetDr. Patricia McElroy's day at The University of ChicagoMedical Center begins at 7 a.m. and ends about 8:30 p.m.Every third day, she is "on call," and keeps workingthrough the night until 8:30 p.m. the next day.Except for feeling tired, she admits that she enjoys it.Dr. McElroy is one of 17,000 brand new M.D.s whobegan their first-year residency training at hospitalsthroughout the United States on July 1.She is a resident in Internal Medicine, the mostsought-after specialty in the U.S. in recent years.Thirty-five percent of U.S. medical graduates chooseresidencies in Internal Medicine in 1978 according to theNational Resident Matching Program (NRMP), whichmatches the preferences of new M.D.s and hospitals inmaking residency assignments. Psychiatry and supportspecialties, such as Anesthesiology, Pathology, andRadiology, were relatively less popular with new U.S.12 medical graduates than were Internal Medicine, Surgery,Pediatrics, and Obstetrics-Gynecology.In line with the trend, 61 percent of this year's graduat­ing class at The University of Chicago Pritzker School ofMedicine (55 of 107 new M.D.s) chose Internal Medicineresidencies. Several of the Pritzker graduates, like Dr.McElroy, are serving their residencies at The Universityof Chicago, but most are stationed at 34 other hospitalsacross the nation.Residency TrendsStudent residency choices have changed over the pastdecade. Comparing the Pritzker residency assignmentsfor 1968 and 1978, what trends are discernible?In 1968, 23 of the 67 graduates entered InternalMedicine; that 35 percent rate was appreciably below thisyear's 51 percent. However, in 1968, 9 graduates enteredInstructing a medicalstudent is part of Dr.McElroy's job as a res­ident.XlDr. Patricia McElroy ('78) relaxes with a fellow resident on the GeneralMedicine floor (above) and checks charts after a night on call (right).old-style" rotating" internships, which no longer exist.Indeed, internships in general no longer are available,and medical students upon graduation now enter directlyinto first-year residency programs.-Twenty 1978 Pritzker graduates are now serving in asurgical residency, the same proportion as enteredSurgery in the 1968 graduating class (14 out of 67). TheU.S. General Surgical Residency lasts five years, afterwhich the apprentice specialist may take up to four moreyears of sub-specialty training.-Proportionately fewer new Pritzker graduates en­tered Pediatrics in 1978. The numbers, 13 in 1978, 12 in1968, were essentially the same, but there were fewergraduates in 1968.-Eight 1978 graduates entered Pathology residencies,versus none in 1968.-There was also increased interest in Psychiatry,which five Pritzker graduates selected versus only one in1968.-Two new M.D.s selected Radiology, against none in1968.-Family practice, a new residency program in U.S.hospitals, attracted one graduate in 1978. Obstetrics­Gynecology, Ophthalmology, and Anesthesiology at- tracted one each. In 1968, students had to take a year ofrotating internship before going into a specialty such asOphthalmology.Women in MedicineThere were many more women graduates this year-26versus only 6 in 1968.Like men, women favored Internal Medicine; fourmade such a choice compared to one in 1968. Fivewomen selected Pediatrics th is year against two in 1968;four women in 1978 chose Pathology compared to none in1968. Two are in Surgery this year vers us one in 1968,one chose Psychiatry versus none in 1968.The Pritzker figures do not reflect the greater nationalinterest among current U.S. medical graduates in suchprograms as flexible residencies, Family Practice, andObstetrics-Gynecology, according to an NRMP summaryof 1978 matchings which appeared in the June issue of theJournal of Medical Education. The University ofChicago Medical Center is a research-oriented institutionand many of its graduates aspire to careers in academicmedicine in which they can combine their interests inclinical practice, research, and teaching. Their choice ofresidencies reflects these interests.13Dr. Arnold Tanis ('50) attends pediatric grand rounds conducted by Dr. UdochukwuAsonye (second from left) in the Perinatal ICU.Dr. Tanis stops in to see faculty classmate Dr. Clifford Gurney ('50).14 Dr. Tanis goes over neonatal care literature in the FrankBillings Medical Library.ComingBack to theMidwayfor CreditWhat does The University of Chicago Medical Centerhave to offer its alumni who are now in private practice,on the staffs of small community hospitals, or otherwiseremoved from academic medicine? The answer is, what italways did-education.With many physicians facing recertification, continuingmedical education is becoming more and more important.The University's Visiting Clinician Program offers bothalumni and interested physicians a one-on-one studyperiod with a faculty member in a desired section orspecialty area of medicine for educational credit.Dr. Arnold Tanis ('51) is a pediatrician who heads thepediatric department of a private, county hospital in Hol­lywood, Florida. His hospital plans to extend its care ofnewborns to include a neonatal intensive care unit (ICU)in the near future. "I wanted to learn something aboutinfant ICUs first," says Dr. Tanis, "and what betterplace to come to for that information than here?"He requested a one-week visiting clinicianship underDr. John Madden, who heads the University's PerinatalCenter. He left his private practice in the care of his sixfellow pediatricians in Hollywood and returned to theMidway in November."I did not come to be trained, but to familiarize myselfwith as many facets of operating a neonatal ICU as possi­ble," he explains, "to anticipate the problems we mighthave and to prevent them from becoming problems."Dr. Tanis, who is the 1951 class chairman, took advan­tage of the Visiting Clinician Program, sometimes re­ferred to as a "mini-residency", twice previously. "Eachtime it has offered a potpourri of experiences," com­ments the pediatrician. He spent a week in the Depart­ment of Pediatrics attending special seminars with Dr.John Burrington in pediatric surgery one year, and withDr. Peter Huttenlocher in pediatric neurology another."From 8 a.m. to 5 p.m. five days a week I was in thehospital: on the ward, in the clinic, in the library, sittingin on grand rounds, and attending special seminars,"says Dr. Tanis. He also found time to visit classmate Dr. Clifford Gur­ney (,51) who is on the Department of Medicine facultyand Associate Director of the Franklin McLean Institute ... Seeing old friends adds a personal touch to the experi­ence," he notes. "In fact, though the program may sounda little hurried or structured, it is very personal."The programs, under the guidance of a facultymember, are designed to be flexible. They may be one ortwo weeks in length or broken up into one day each weekover several months. They may focus, as desired, onin-hospital or clinic care. Scheduling depends on the re­questing physician's and faculty member's convenience.The office of Postgraduate Medical Education suggeststhat applicants indicate the specific areas of learning, re­view or improvement desired, to facilitate processing.Appropriate credit hours and fees are assessed for eachindividual program. Applications are available from Mrs.Norma Morrow, The University of Chicago, Office ofPostgraduate Medical Education, 950 East 59th Street,Box 139, Chicago, Illinois 60637."I want to get as much as possible of what the Univer­sity has to offer," declares Dr. Tanis, "and this is one ofthe ways to do it."15spotlight on alumniModern Medicine and a MemoryThis discussion concerns doctors,.and begins the day I left a medicalbuilding and headed for the parkinglot, muttering to myself and shakingmy head.First, I'd had two visits to Dr. Awho saw "something questionable."This was followed by two visits toDr. B for "another opinion" [Dr.A's suggestion]. In Dr. B's office, Ihad spent a total of three hours, andhad fifteen minutes with him. Notonce did he call me by name. He did,however, suggest a trip to the hospi­tal for this nonperson "to have somecutting done." No explanation forthis decision was offered me.I tried to contact Dr. A for someenlightenment and also for the re­sults of a test taken in that office. Ihad paid for it, and it actually con­cerned me, but while Dr. B had re­ceived the information I still had not.The young-sounding voice that an­swered my call evidently wasn't im­pressed with my reasons for wantingto talk to Dr. A. She would "talk toSomeone Else," and that personwould call me back.In the meantime, I wondered howI could get through this palace guardand talk directly to Dr. A. I com­posed a speech, and wrote it downso I could deliver it when the Some­one Else called back. Feeling veryfoolish, I read my prepared petitionto her.I must have said the right thingsbecause I finally got to speak withDr. A. However, the vague explana­tions still left me confused. Fortu­nately, my condition was more puz­zling than critical. The figures in mycheckbook added up to a lot of16 Dorothy Aldrichmoney spent for such little satisfac­tion, and I was irritated.I called my daughter, who is a reg­istered nurse, and I poured out mytale of concern, confusion, and frus­tration. She was calm and reassur­ing, and said, . 'I'll make an ap­pointment for you with mygynecologist. He's good, and I'msure you'll like him." And then sheadded, "But you know what you'redoing, Mother-you're looking foranother Dr. Parsons. You might aswell face up to it-you can't expectto find another doctor like her."As I left the phone, I found myselfgetting misty-eyed. Memories of Dr.Eloise Parsons came flooding back.During the twenty-two years I washer patient, I found myself actuallylooking forward to my annualcheckups and visits to her office. Shetook time, she talked to me aboutmyself, and she was a human andwarm person, while remaining pro­fessional.I remembered the sadness andsense of loss I experienced at myfinal visit when I knew Dr. Parsonswas giving up her practice. She was74 years old then, and was tired, shesaid. I recalled thinking how un­fortunate it was that someone as car­ing and needed should have to getold and to reach the point where fad­ing energies would take away thewill and the ability to continue work­ing and serving. I tried to rememberwhere she had retired-a farmsomewhere in Illinois, I thought. Ipictured her sitting passively on afarmhouse porch and puttering in aflower garden.A few nights after this resurgence of memories, I had my answer. Theannouncer on the evening TV newswas saying, "Today, 82-year-old Dr.Baker who lives on a farm in the areaof Sh effield, Ill., whe re the atomicwastes are being dumped, testifiedbefore the Senate committee in­vestigating complaints about thissite. "There was Dr. Parsons [Baker isher husband's name], bristling withanger, and asking the members ofthe committee how they would liketo raise their children near this po­tentially hazardous site.I found myself cheering her imageon my TV set. Gone now, were myvisions of her vegetating among thevegetables. She was still a caringperson, and at 82, still using her abil­ities to work for other people. Sometime after her TV appearance, I sawher picture in The Chicago Tribune,and read the article relating her de­bate with a 33-year-old proponent ofthe site. She was coming out aheadon the issues. The article referred toher as the "fiesty Dr. Baker." Whata lift I got!As my daughter had said, thechances are that doctors like Dr.Eloise Parsons Baker are not to befound on today's medical scene. Itmay be that my expectations of ex­cellence which can also include acaring, personal touch are unrealistictoday, and I [like Dr. Parsons] be­long to a vanishing era.This article is reprinted with permis­sion from the author and TheChicago Tribune, where it appearedJuly 31. 1978.Dr. Eloise Parsons Baker (Ph.D. '23, Rush '24)If ... a physician does nothing more than feelmy pulse and put me on the list of those whom hevisits on his rounds, instructing me what to doand what to avoid without any personal feeling, Iowe him nothing more than his fee, because hedoes not see me as a friend, but as a client ... .4physician who gave me more attention than wasnecessary, because he was afraid for me ...who sat by my bedside among my anxiousfriends, and hurried to me at times of crisis ...who was not indifferent to my moans ... Such aman [is] not so much a physician but a friend.Seneca (4 B.C.-65 A.D.)I n Sheffield They Call Her a \\ Protestor"Dr. Eloise Parsons Baker (Ph.D. '23, Rush '24) practicedobstetrics and gynecology for fifty years in Chicago be­fore retiring to a farm. Whether she belongs to a vanish­ing era or not, she is, according to the accounts of herpatients, a physician who is both healer and friend. AsHippocrates instructed, she passed her interest inmedicine on to her son, William H. Baker (,62), who isnow on the department of surgery faculty at Loyola Uni­versity Stritch School of Medicine. Though she is nolonger in practice, her own life is far from retiring.The Sheffield Nuclear Disposal site lies one mile fromDr. Eloise Baker's farm in Neponset, Illinois. It startedas a small burial dump for hospital and laboratory wastebut now conceals 2.3 million cubic feet of low-levelradioactive waste gathered from nuclear plants through­out the U.S.By the time the hearings were under way to decidechanging the zoning of neighboring land from farming towaste disposal, Dr. Baker had already been labeled a"protestor" by the local radio station.She had successfully spoken against a new road in herarea. At a public hearing she decried plans to have theroad cut across farm fields, covering fertile soil with con­crete. The direction of the road was changed.At another public hearing, she challenged a CommerceCommission proposal to close down certain roads acrosslocal railroad tracks. Closing them "would have isolateda number of farms, including my own, and interfered with[transportation routes for] the school bus, and the fireprotection and rescue unit," writes Dr. Baker. "Since weare 12 miles from a physician or a hospital" it was aserious problem, she adds. In the end, the roads wereequipped with safety warnings and left open.When the Associated Citizens for the Protection of theEnvironment was organized to fight the planned expan- sion of the Sheffield nuclear waste site, Dr. Baker was anatural candidate for spokesman. As a result of nationalmedia coverage and rising American concern about nu­clear waste disposal and safety, the Sheffield site, man­aged by a Louisville firm, has been temporarily shutdown. "However, there is a great possibility that a newlicense will be granted," declares the 82-year-old Dr.Baker. "If nuclear waste was not enough, the same man­agement has an adjacent burial site for toxic chemicals,which is a more immediate polluting hazard."FarmingHer "protests", therefore, go on, but she still has timefor the farm. She gardens faithfully, manages her 1851farm house, and fills the cellar with potatoes, onions,carrots and apples "to last through the winter."To learn about modem farming she enrolled in a localcollege and took agronomy and farm managementcourses. "A farming operation which is not profitable isnot a success," she explains, and made the 16-mile trip toBlackhawk College to assure her success."Farming is the ideal retirement activity for aphysician-all that you have learned in scientificmedicine, all that you know about nutrition and fertilitycan be applied to the plant and animal life on the farm,"she declares.The key, apparently, to Dr. Baker's retirement is "ac­tivity." She admits there is never enough time for all theprojects she envisions, one of which is a wild life preser­vation filled with 5,000 trees."Come to see me," she writes, meaning it, and one istempted to set off immediately for her farm 145 milessouthwest of Chicago where she has translated fifty yearsof caring for people into caring for all living things.17on the light sideReal ity T esti ng and Long 0 i stance Ru n n i ngRandolph W. Seed ('60)Runners in the Boston Marathon are something like lem­mings racing to the sea. Fortunately when I ran it, Inoticed that those in my condition and speed were alldying before they got to the water. Why, I asked myselfin the last third of the race, was I even there? No social,medical or economic pressures had ever brought me suchmisery. It took us four million years to go from knucklewalking to lounging in a hedonistic milieu of excess food,fat and flatulence. Wherefore, then, did this atavistic de­sire for long distance running emerge?For me, the Boston Marathon started in January-areasonable time to begin training for an April race. Theusual rule of thumb is to run at least 520 miles in the eightweeks before a marathon, which meant by mid-FebruaryI should be running a comfortable 40-60 miles a week."Comfortable" is difficult to manage in -40 degreewind chill factors and more than 80 inches of wintersnowfall. In fact, any rational man would avoid it. So, Idid. February, the critical month, arrived and I increasedmy reading knowledge of running. I decided the rate­limiting factor in marathons was energy production.Therefore, while others trained their heart and legs, Itrained my liver, making prodigious efforts to eat all thecandy at all the nursing stations in the hospital-with theproviso it did not come from a jaundiced patient. (Thefirst piece of candy I ate at Billings Hospital was given tome when I was a junior student. The lady offered, I ate,she died of hepatitis seven days later, and I looked at myeyeballs for six months.)By March even my running friends were concernedabout my health. Instead of plodding hundreds of milesthrough the snow with them, becoming cachectic andweary, I was getting fatter, felt rested and suffered onlymild chondromalacia of the patellas. Then, in a panic, Istarted running.Easter weekend I planned to run twenty miles onSaturday and another twenty miles on Sunday. We hadan ice storm. One inch of ice covered everything. OnSaturday a senile friend and I ran with the freezing rainfor ten miles along Lake Michigan and saw no bikes, nodogs, no muggers, no joggers. Easter morning it startedto melt. We went seven miles on the ice cubes depositedby tree limbs. My Sisyphean labors were only beginning.After Easter came the Midwest Masters Meet-onehour around the track to see how far you can go. I wenttwo miles in fourteen minutes in another freezing rain,climbed into my car, turned on the heater, and watchedall the crazies continue. It is very depressing to besane when everyone around you is not only clearly18 131Dr. Randolph Seed ('60) nears the finish line of the Boston Marathon.psychotic, but enjoying it. I have never suffered fromrunner's euphoria. When I run I nearly always get tired. Ido not get any sense of running through the lilies, whichall the great running gurus seem to enjoy.The weather changed. I ran twice a day one week, putin 100 miles, took butazolidin the next four days, andwent to Boston. The one rational thing I did was join theAmerican Medical Joggers Association. This not onlymade the trip tax deductible, it gave me eight hours ofContinuing Medical Education (CME) credit. What Ilearned, however, was that we will probably never knowif coronary heart disease patients are benefited by con­trolled jogging programs. It seems the participants cannotbe randomized prospectively. About one-third of those inthe exercise program will quit, and one-third of the con­trol group will sneak exercise. In addition, the pro­fessional community is divided on the merits of running;a geographic immortality versus mortality factor. Theevangelists (those from California) think if you run youcannot drop dead from coronary heart disease, while thestaid purists (N ew Englanders) think such statements aredangerous and the public is likely to start dropping deadof cardiac arrests just before the finish line.Looking around at my Boston competition I noticedthe significant genetic and environmental factors-no onesmoked, no one was overweight and most were evensubaverage in weight. In marathon running I am fairlycertain the egg came first-it is the rare endomorph whoarrives at twenty-six miles non-stop.The Boston race starts in Hopkinton, a nondescriptlittle village twenty-six miles west of Copely Plaza. OnApril 17, some 5000 runners and their supporters (human)were jammed into its main street. My favored positionwas so far back that I did not even hear the gun go off. Itwas four minutes before I crossed the starting line andanother mile before I could run without elbowing some­one.The initial ten miles were exciting. The course wasdownhill, the crowds cheered, and the epinephrine wasflowing.At thirteen miles we ran through a corridor of chantingWellesley girls. Their enthusiastic greeting was bothneeded and appreciated since my cerebral cortex had bythat time begun to degenerate from anoxia.At fifteen miles I began to switch from glycogen to fatfuels. (This assumption was based on how lousy I sud­denly felt.) Clearly I had not trained my liver wellenough. Either that or my messenger RNAs forglucogenesis were too short-lived. The road became uncooperative. It developed an up­ward drift. Some miscreant placed a hill between theeighteenth and twentieth miles, dubbed "HeartbreakHill." This is just about at the collapse point or "wall"for most inadequately trained marathoners (me).I began to get irritated with the crowd. They lined thecourse from the 18-mile point to the finish line, leaving usan eight-foot-wide alley for running.First, they prevented me finding a space to sneak awayto and quit unobserved.Second, they kept venturing, "You're looking good,"when, in fact, I was a jogging rigor mortis on that hill.Third, they continually shouted warm greetings andencouragement to all the people passing me-little chil­dren, young women, old ladies, and Medicare men.Fourth, they fed me conflicting information-only 6miles to go, only 7Y2 to go, only 5 to go, ad nauseum.I resolved my feelings in a mature fashion. I becamehostile. Every time I passed limping, exhausted de­stroyed runners, I felt better. One and a half blocks fromthe finish line a runner in front of me clutched his righthamstrings and could not go on. Not a quantum of sym­pathy did I feel.When I crossed the finish, mother nature was waiting.It was 45 degrees and damp. In two minutes I was so coldI figured hypothermia would be on my death certificate.The warmth of the Prudential Building was just aheadbut to get there I had to negotiate a four-inch curb. Afterconsidering the state of lactic acidosis in my quadriceps, Iwalked 100 feet out of my way to a driveway and avoidedthe climb.Once inside the warm corridors I joined the group I hadtrained with, so to speak. One vowed he would never doit again (though he has), another was prone on the mar­ble floor retching into a paper cup, and a third could notstand up without fainting. It was more than an hour be­fore we were recovered enough to knuckle-walk out thedoor.After four million years we have finally learned how toget back on all fours-run a marathon.Dr. Randolph Seed is a surgeon at Grant Hospital inChicago. He has been running for several years and untilrecently held the record for the fastest time up a tallbuilding-the John Hancock Building in Chicago'sLoop. He used the stairs. Dr. Seed is also a class chair­man.19News BriefsTarlov Chairs National Advisory GroupDr. Alvin R. Tarlov (,56), Chairman andProfessor in the Department ofMedicine, has been named Chairman ofthe Graduate Medical Education Na­tional Advisory Committee (GMENAC)of the Department of Health, Education,and Welfare.The Graduate Medical Education Na­tional Advisory Committee wasestablished in 1976. The Committee'stwenty-one members are doctors, hospi­tal and health administrators, interns andconsumers. Its responsibilities includeassessing the number of physiciansneeded in the United States, and coor­dinating the geographical distribution ofmedical specialties and financial needsfor medical education. The role of theFederal Government is how to influenceall of these factors. (See "National Man­power: Status and Challenges" article inthis issue.)Dr. Tarlov is also Chairman of the As­sociation of Professors of Medicine TaskForce on Manpower Needs, Chairman ofthe Federated Council for InternalMedicine and President-Elect of the As­sociation of Professors of Medicine.Benson Heads Executive CommitteeDr. Donald Benson, Professor andChairman in the Department of Anes­thesiology, was appointed by DeanRobert Uretz as Chairman of the Execu­tive Committee of the Medical Staff. Hisnomination was supported by his fellowchairmen within the division.Dr. Benson has served as Professorand Chairman of the Department ofAnesthesiology since 1975. He expectsto accomplish more effective interplaybetween the clinical staff and hospitaladm inistration.David Bray, Associate Vice Presidentand Executive Director of the MedicalCenter, will be working closely with Dr.Benson and the Executive Committee onimproving the clinical operations of theMedical Center.Kovler Chosen lab of the YearThe Marjorie B. Kovler Viral OncologyLaboratories at The University ofChicago were chosen the 1978 Lab of theYear by the news magazine IndustrialRe search/ Developme nt. Architects forthe structure were Metz, Train, Olsonand Youngren, Inc., Chicago.The unique three-story building wasconstructed to meet strict biohazardsafety regulations. The design providessafety for personnel between hazardous20 and nonbiohazardous laboratories andworking areas. University scientists, ex­perts at the National Cancer Instituteand the architects coordinated the proj­ect. The laboratories are accessible onlythrough pressurized airlocks and eachlab has individualized regulated andfiltered air supply and exhaust systems.A major concern in the design was toprevent cross-contamination of cells andviruses for work with cancer-related vi­ruses.Located at the northeast comer of 58thStreet and Drexel A venue, directly northof the University Hospitals complex anddirectly adjacent to the Cummings LifeScience Center, it is ideally situated toserve as a bridge between the Univer­sity's clinical and basic science ac­tivities.The four major laboratories within theKovler building serve research teams di­rected by Bernard Roizman, Professor inthe Departments of Microbiology andBiophysics and Theoretical Biology, El­liott Kieff (,71 Ph.D., Associate profes­sor in the Departments of Medicine andMicrobiology, Sandra Panem (,70Ph.D.), Assistant Professor in the De- Harper's Bazaar, entitled "Best HealthCare in America."The list included Dr. Allan Lorincz(,47), Professor in the Department ofMedicine and Director of the Der­matology Clinic; Dr. Allen Recht­schaffen, Professor in the Department ofPsychiatry and Behavioral Sciences andDirector of the Sleep Laboratory; Dr.Robert Segraves, Assistant Professor inthe Department of Psychiatry and Direc­tor of the Sex and Marital TherapyClinic; Dr. Donald Tredway, AssociateProfessor in the Department of Obstet­rics and Gynecology and Chief of theSection of Reproductive Endocrinology;Dr. John Madden, Professor in the De­partment of Obstetrics and Gynecologyand Director of the Perinatal Center; Dr.Atef Moawad, Professor in the De­partments of Obstetrics and Gynecologyand Pediatrics and Co-director of thePerinatal Center; Dr. John Ultmann, As­sociate Dean for Research Programs, Di­rector of the Cancer Research Centerand Professor in the Department ofMedicine; and Dr. Arthur Herbst, theJoseph Bolivar De Lee Professor andChairman of the Department of Obstet­rics and Gynecology.Medical Center CitedThe University of Chicago Medical Cen-Dr. Donald Benson ('50, Ph.D.'57)partment of Pathology, and PatriciaSpear ('69 Ph.D.), Assistant Professorin the Department of Microbiology.The University's Viral Oncology Lab­oratories memorialize Marjorie BlumKovler, fo under and president ofChicago's Kovler Gallery.Eight Among Bazaar' 5 BestEight specialists at the Medical Centerwere featured in a recent article in ter was cited in the August issue ofGood Housekeeping magazine for pro­viding information to the public on re­search studies in arteriosclerosis,sickle-cell disease, head injury andmental retardation. The selected list wasprovided by the National Institute ofHealth.These are the programs and doctorslisted by Good Housekeeping:Dr. Robert Wissler (,48), the DonaldN. Pritzker Distinguished Service Pro­fesso r of Pathology, who directs theU nivers ity' s arteriosclerosis researchstudies; Dr. James E. Bowman, Pro­fessor in the Departments of Pathologyand Medicine, who directs the Com­prehensive Sickle-Cell Center; Dr. JohnF. Mullan, the John Harper Seeley Pro­fessor and Head of the Section ofNeurosurgery, who directs the newlyopened Margaret Hoover Fay and Wil­liam E. Fay, Jr. Brain Research In­stitute; Dr. Albert Dorfman ('44),the Richard T. Crane DistinguishedService Professor in the Department ofPediatrics, who directs the Joseph P.Kennedy, Jr., Mental Retardation Re­search Center in Wyler Children's Hos­pital; and Dr. Peter R. Huttenlocher,Professor in the Departments of Pedi­atrics and Neurology, who directs theUniversity's clinical investigations intomental retardation.Hans Hecht LectureThe 1978 Hans Hecht Lecture was pre­sented on October 10 by ProfessorHarold Reuter, professor and chairmanof the department of pharmacology at theUniversity of Bern, Switzerland. Hespoke on "The Regulation of theHeartbeat by Neurotransmitters."The lecture was established in honorof the late Dr. Hans Hecht, Chairman ofthe Department of Medicine, 1965-68,and chief of the Section of Cardiologyuntil his death in 1971.Bray Appointed Exec DirectorDavid M. Bray, Associate Vice­President for Business and Finance, wasappointed Executive Director for theHospitals and Clinics and AssociateVice-President of the Medical Center(Administration) .Mr. Bray came to the University in1976 from Washington, D.C. where hewas Deputy Associate Director of Eco­nomics and Government in the Pres­ident's Office of Management andBudget (OMB).In a recent interview he explained thata main priority is to follow up on the rec­ommendations of the University's TaskForce on Physical and Financial Feasibil­ity which are concerned with the im­provement of patient care and the de­livery of services to the patient.Another priority is to improve thequality of the environment for patientsand staff, how to handle large numbers ofoutpatients, and how to help the patientsee the physician sooner.He would also like to establish accoun­tability for effective and efficient man­agement.Hospital Finances and the Medical Center Information Systems (data pro­cessing) already have been reorganized.A new computer system will be installed,which will improve billing and collec­tions and an account manager will be re­sponsible for solving the patient's billingproblems.A plan for improving the Pharmacy isunder way and a unit drug system will beestablished within the year.The Medical Records department hasbeen reorganized and a new MedicalRecords Technician program will becompleted soon.Mr. Bray said: "Unless we developspecific strategies for eliminating certainproblems it will be difficult to achievelasting improvements here."Mr. David M. BraySurgery Cures Extreme PainVictims of trigeminal neuralgia must livewith sharp, stabbing facial pain, similarto undergoing a severe electrical shock.The malady, also known as ticdouloureux, involves the trigeminalnerve, the chief sensory nerve of theface.Supersensitive "trigger" areas onparts of the face served by the three­forked nerve can, if touched, set off theexcruciating pain, termed by victims asone of the most intense known to man.Victims of trigeminal neuralgia oftencannot wash or shave over the "trigger"areas, which may be near the nose butcan also be on the forehead, near theeyes or on the cheek.Now, a new surgical procedure cancure the extreme pain in many cases.The operation, unlike other procedures,which sever or injure the nerve, leavesthe nerve intact, says Dr. GeorgeDohrmann HI, of The University of Chicago's Brain Research Institute. Thesurgery was originated by a neurosur­geon now at the University ofPittsburgh.While the searing pain is felt in theface, it is caused by a kinky,atherosclerotic artery at the base of thebrain, which, with each heartbeat, ham­mers on the nerve. There is a trigeminalnerve for each side of the face. Theyconnect to the brain behind each ear."There are a number of these smallarteries near the back of the brain. Theyare free and close to the brain stem,"explains Dr. Dohrmann, Assistant Pro­fessor in the Department of Surgery(Neurosurgery), the University's Divi­sion of the Biological Sciences and ThePritzker School of Medicine."Some of these, when they becometortuous, can form an anatomical scis­sors, one beating on the top and onebeating on the bottom of the trigeminalnerve. Sometimes a 'knuckle' of the ar­tery is seen to be beating on the nerve."The repeated pressure of the artery onthe nerve may wear away its sheath ofmyelin, a type of protective tissue. In pe­ripheral nerves such as the trigeminalnerve, the myelin sheath will regenerateif friction or pressure against it is re­lieved.To perform the operation, the surgeonremoves a half-dollar-sized part of theskull from behind the ear, exposing theartery and nerve. He gently repositionsthe small artery that is pressing on thenerve.This must be done carefully under anoperating microscope because, if the ar­tery is excised, the patient would de­velop a stroke."We make a sort of micro-bridge ofteflon felt that fits over the nerve at thatpoint," says Doh rmann. "After re­positioning, if the artery later works itsway back near the fifth nerve, it willcome down on this teflon bridge and thebridge will hold the pulsations off thenerve."Trigeminal neuralgia is peculiar,"says Dohrmann. "You don't see motoror sensory loss, but you have pain." Inmost cases of pressure or traction on anerve, there is some loss of nerve func­tion and the patient describes a weaknessor numbness as well as pain."We can in many cases cure trigemi­nal neuralgia without motor or sensoryloss in the face," comments Dohrmann.The usual operation for the conditioninvolves alcohol injections at the nerveor radio frequency waves that kill a por­tion of the nerve. Another approach is tosever the nerve. If the nerve is cut, about10 to 15 percent of patients will developanother painful condition known as anes-21thesia dolorosa. This is described as"painful numbness" and is much worsethan trigeminal neuralgia since it is pre­sent constantly.The new operation can be used totreat hemi-facial spasm, which also re­s ults from arterial press ure on anothernerve, the seventh cranial nerve. Hemi­facial spasm is the involuntary twitchingof one side of the face.Prof. R. W. GuilleryAlbinos' Eye-Brain Nerves FaultyAboutone in 20,000 humans is an albino,lacking pigmentation in the eyes, hair,and skin.Most albinos are also cross-eyed andmyopic with about 20/200 vision.Having examined the brains of humanand animal albinos, R. W. Guillery, aUniversity of Chicago neuro­physiologist, thinks the reason for theircrossed eyes and for some accompany­ing visual problems is that all albinos thathe has studied had abnormal eye to brainnerve connections.A postmortem study by Guillery andhis colleagues of a human albino re­vealed abnormal fusion of adjacent nervecell layers in the thalamus, or sensoryrelay center of the brain. He is continu­ing his studies on two other autopsiedhuman brains.22 Normally, about 55 percent of thefibers from each eye cross over to theopposite side of the brain. The remaining45 percent go to the same side of thebrain, where the fibers from each sideend in layers that lie parallel to eachother in matching pairs.In a series of experiments, Guillerydemonstrated that a large proportion ofthe nerve fibers in albino animals do notcross over, but are connected to thesame side of the brain. He demonstratedin albino animals that the abnormallyrouted fibers may go to layers in thethalamus that tend to fuse with adjacentlayers.Guillery has studied abnormal nervefibers and fused layers in the brains ofalbino cats (Siamese), rats, rabbits, andferrets; he has found abnormally fusedoptic nerve layers in the autopsied brainof a white tiger.In normal animals and humans, nerveimpulses from the two eyes are matchedin adjacent layers of nerve cells in thethalamus before it relays the nerve sig­nals to the visual cortex of the brain.In albinos, Guillery has demonstratedthat some of the fibers not only fail tocross properly to the opposite side of thebrain, but that they do not match prop­erly in the thalamus.Guillery showed that most animalssimply suppress the non-matching sig­nals. Others rescramble the relayednerve signals from the thalamus andmatch them correctly in the vis ual cor­tex.He believes that his animal findingsapply to all albinos, human and animal.Guillery's research opened up a newfield of investigation in nerve and brainphysiology. Through it, scientists arenow learning about normal as well as ab­normal sensory function.Clinic Addresses PsychologicalNeeds of Elderly PatientsPsychological problems among the el­derly are often misdiagnosed as senility,and there are limited resources availableto those who seek help, report doctors atThe University of Chicago Medical Cen­ter."In addition to the lack of specializedresources that are responsive to theiremotional and behavioral needs, the el­derly are generally 'underusers ' of psy­chiatric services," said Dr. AllenKodish, who is Assistant Professor in theDepartment of Psychiatry."These persons are most likely to seekadvice from their personal physician,who may be serving the patient's emo­tional as well as physical needs. A physi- cians recommendation to see a psychia­trist is often met with resistance from thepatient since the referral could representtheir first contact with psychiatric ser­vices," he said."Another reason for underutilizationis that many persons who are sixty-fiveyears of age or older do not view them­selves as 'elderly' and therefore do notfeel they should have to attend a clinicwhich specializes in gerontology," Dr.Kodish added.The Gerontology Clinic at The Uni­versity of Chicago Medical Center wasrecently expanded to better serve theneeds of the elde rly. As an outpatientservice, the clinic has been organized bythe University's Department of Psychia­try, and includes psychiatrists, psychol­ogists and psychiatric social workers, allspecially skilled in the treatment of psy­chological problems of older persons."The emotional reactions that personsover sixty-five manifest are notessentially different from those ofyounger persons, however, the stressesthat cause their problems may be directlyor indirectly age related," explained Dr.Kodish.Reactions to life stress situations arethe most common cause of emotionalproblems for older persons, according toDr. Kodish. "This can result from dis­ruptions in long standing relationshipsand environmental supports due to lossor incapacity of family members, retire­ment, or loss of financial means," headded.-John PontarelliCongenital Hormone Disorder TreatableCongenital adrenal hyperplasia is an in­herited condition that can lead, in severecases, to sudden infant death. Infemales, it can res ult in an intersex babywhose true sex at birth is not im­mediately apparent.The disease can be treated if identifiedearly, say Dr. Robert L. Rosenfield, Pro­fessor of Pediatrics, and Dr. Anne W.Lucky, Assistant Professor. Rosenfieldand Lucky are seeking to develop sim­plified tests to identify the carriers andthe inherited defect of this genetic condi­tion. They also are working on a test toidentify affected children while they arestill in the womb.In some mild, undetected cases, thecondition can lead in later years to pre­mature growth. " A yo ung child will growexcessively tall but growth potential willbe exhausted very early and the childwill become a very short adult, often lessthan 5 feet tall," says Dr. Rosenfield.Dr. Robert L. RosenfieldThe condition involves faulty hormonesynthesis by the adrenal glands.If there is a family history of the dis­ease, parents should be tested to de­termine if they are carriers of the trait.About one in a hundred persons is a car­rier, says Dr. Rosenfield, of the Univer­sity's Wyler Children's Hospital. If bothparents are carriers, i.e., one in 10,000couples, there is a one in four chance ateach pregnancy that the child will havethe condition.Unfortunately, say Rosenfield andLucky, most physicians see only one ortwo cases of congenital adrenalhyperplasia in their professional lives,and may not immediately recognize it.In cases in which a girl offspring hasanomalous sexual organs, parents andphysicians will be impelled to determinethe cause. (Congenital adrenalhyperplasia causes 80 percent of allintersex babies.)In mild, undiagnosed cases, prematurepubic hair in a young girl may representa danger signal. Abnormal menstruation,acne, and excessive hair growth in girlsshould arouse suspicion, says Ro­senfield.The condition results from the infant'sgenetically impaired or lost ability toproduce an enzyme, 21-hydroxylase,essential to the production of cortisoland aldosterone, two essential steroidhormones.At the same time, the adrenals mayoverproduce male sex hormones. Cortisol is essential to the body's de­fense against stress. An infant who hasins ufficient or no cortisol can go intoshock and die following an illness,surgery, or accident-perhaps before theendocrine deficiency is diagnosed.If diagnosed, cortisone treatment forthe defect can be started in infancy. (Thebody converts cortisone to the naturalsteroid hormone, cortisol.) In severecases, extra salt is necessary to compen­sate for the lack of aldosterone, whichcontrols salt retention.The test for the genetic trait de­termines how the subject responds to aninjection of ACTH (adrenocorticotrophichormone), the pituitary hormone thattriggers the complicated multi-step pro­cess of steroid synthesis in the adrenals,two glands located near the kidneys.If the test subject overproduces cor­tisol precursor steroids, he or she may bea carrier of the genetic trait. If the sub­ject produces huge quantities, he or shehas congenital adrenal hyperplasia.In the developing fetus, excessive fetalmale hormone causes the intersex babygirls, says Dr. Rosenfield. "Both maleand female sex organs develop from thesame fetal tissues. They differentiate inthe embryo in response to specific sexhormones. Excessive male sex hormonein the fetus can cause a baby girl'sclitoris to develop to the size of a penis.The infant in severe cases may be mis­takenly identified as a boy, although shehas female sex organs internally," saysRosenfield.Excessive male sex hormones in lateryears also stimulate early growth andpubertal development in both males andfemales. However, since affected chil­dren stop growing early, they remainvery short later in life.An intersex girl's true sex in suchcases can usually be surgically restoredand the infant may develop into a normalwoman, with continued endocrine treat­ment, and bear children, says Dr. Lucky."Cold" Flies Adapt FasterFlies. Where did those pesky insectscome from? And what useful purpose dothey serve?Fruit flies, which are much studied bybiologists, probably originated in Asiaabout 50 million years ago, says LynnThrockmorton, a University of Chicagogeneticist. Like many geneticists,Th rock morton finds flies useful in study­ing genetic change. They cost very little,mutate relatively quickly, and are easilystudied under the microscope.Like all species, including humans,flies reproduce by DNA that codes for body proteins, so what is true about fliesis most likely to be true about otherspecies.Th rockmorton has called into questiona popular theory among scientists: theso-called molecular clock theory thatbiological molecules, especially DNAs,of all organis ms develop at a steady rate.He suggests that either the molecularclock does not exist, or, if it does, that itmoves erratically by jumps and starts, sothat only very long-term averages areconstant.Throckmorton is studying protein var­iations in ten related species of flies fromthe virilis group of DrosophiLa. These areall species that closely resembleDrosophila virilis, a cosmopolitanspecies found all over the world.Throckmorton believes that flies of thevirilis group originated in subtropicalforests in Asia about 20 million yearsago.The ten species of the virilis group, hebelieves, can be divided into two generalgroups: those that evolved slowly in an­cestral habitats similar to those found inthe southeastern United States today andthose that evolved more rapidly inhabitats further north, in climates similarto those of the Canadian North Woods.By studying variation in ten similarbody proteins in the ten varieties of vir­ilis fly groups, Throckmorton infers thatthe gene sites that code for those pro­teins changed over two and a half timesas fast over a 15 to 20 million year span inthe migrating "cold" group as in the orig­inal "warm" group.He believes that the changes reflect agreate r opportunity in the" cold" groupto adapt to the new habitats.Th rockmo rton uses a process calledacrylamide gel electrophoresis to studythe individual fly proteins. Elec­trophoresis is a process by which pro­teins can be distinguished from eachother by the rate at which they move in agel placed in an electric field.In the 1960s, Throckmorton, John L.Hubby, and Richard Lewontin of TheUniversity of Chicago first applied elec­trophoresis to the study of fly genetics.Michael ReesePritzker AppointmentsBeginning with this issue ofMedicine on the Midway, Univer­sity of Chicago staff promotionsand Michael Reese Hospital staffappointments will not be listed.23In MemoriamAlumni Deaths'13. Hugh E. Cooper, East Peoria, Il­linois, March 15, 1978, age 89., 15. Karl Lewis, Beverly Hills,California, May 31, 1978, age 87.'17. Nicholas C. St a m . Sanford,F1orida, April 23, 1978, age 84.'18. Wilson B. Moody, Hagerstown,Maryland, November 25, 1977, age 85.'21. Aaron S. Speier, Portland, Ore­gon, October 8, 1978, age SO.'21. Leslie H. Winans, Ashland, Ken­tucky, January 22, 1978, age 84.'22. Earl A. Zaus, Chicago, Illinois,April 21, 1978, age 82.'23. Henry E. Cope, Fayetteville,New York, date unknown.'24. Fred C. Heidner , Milwaukee,Wisconsin, December 17, 1977, age 77.'24. Kathleen B. Muir, Chicago, Il­linois, March 7, 1978, age 79.'24. John F, Pick, Chicago, Illinois,October 12, 1978, age 78.'25, William S. Snyder, Frankfort,Kentucky, August 20, 1978, age 77.'26. Joseph E. Jensen, Laguna Hills,California, August 26, 1978, age 82.'26. William R. Miner, Fort Mitchell,Kentucky, date unknown.'27. Gaylord P. Coon, Coronado,California, August 4, 1978, age 77. '27. Joseph Major Greene, Chicago,lllinois, January 4, 1978, age 77.'29. Le Roy H. Berard, Oak Park, Il­linois, September 6, 1978, age 80.'30. Maurice E. Cooper, Columbia,Missouri, June 29, 1978, age 76.'30. Ralph H. Fouser, Miami, Florida,June 23, 1978, age unknown.'30. Elmer T. No all, Santa Rosa,California, May 23, 1978, age 85.'30. James G. Smith, Jr., Henderson­ville, North Carolina, July 25, 1978, age79.'31. William V. Kelly, Chicago, Il­linois, December, 1977, age 78.'31. A. Ross Me Intyre, Omaha, Ne­braska, September 1, 1978, age 79.'31. Peter H. Ro zendal, Corvallis,Oregon, December 16, 1977, age 75.'32. Mildred W. Mc Kie , Storden,Minnesota, May 12, 1978, age SO.'32. Emory R. Strauser, Dixon, Il­linois, May 16, 1978, age 82.'33. Virginia J. Reuterskiold, RollingPrairie, Indiana, July 6, 1978, age 75.'34. Alfred J. Benesh, Seattle, Wash­ington, May 25, 1978, age 76.'34. Nathan F. Fradkin, Loudonville,New York, September 2, 1978, age 69.'34, Kent H. Thayer, Seal Beach, ,California, May 11, 1978, age 69.Departmental NewsAnatomyAppointment:Michael Labarbera, Ph.D.-AssistantProfessor.AnesthesiologyAppointment:Dr. Terence M. O'Connor ('75)­Assistant Professor.BiologyAppointment:Susan L. McKenzie, Ph.D.-AssistantProfessor.Biophysics and Theoretical BiologyAppointment:Russell Lande, Ph.D.-Assistant Pro­fessor.MedicineAppointments:Dr. Bennett Blitzer-Instructor.Dr. Douglas T. Domoto-AssistantProfessor.24 Dr. David Mehlman-Instructor.Dr. Michael D. Sitrin-InstructorlTrainee.Dr. Harvey Golomb discussed recenttrends in cancer incidence, the subject ofan October 19 National Cancer InstituteReport, on WLS-TV in Chicago.Dr. Leon Jacobson was honored by aspecial symposium at the InternationalSociety for Experimental Hematologymeeting at the Drake Hotel in Chicago,August 27-31. Papers in fields pioneeredby Dr. Jacobson-spleen studies andbone marrow implants-were presented.Dr. Janet Rowley delivered the annualguest lecture of the Leukemia ResearchFund of Great Britain at the Royal Soci­ety, London, November 14. Her topicwas "The Significance of ChromosomeChanges in Leukemia." Dr. Rowley andDr. Charles Huggins, the William B.Ogden Distinguished Service Professorin the Ben May Laboratory, were guestlecturers at the Christmas Lecture de­voted to the topic of cancer held by the '35. Felix S. Alfenito , Grand Rapids,Michigan, April 14, 1978, age 78.'35. Arthur C. Burt, Fargo, NorthDakota, February 1978, age 70.'37. Lloyd E. Harris, Rochester, Min­nesota, December 30, 1977, age 66.'39, Byrum E. Johnson, Wilmington,California, June 9, 1978, age 71.'40. John F. Stotler, Youngstown,Ohio, May 20, 1978, age 63.'41. Eugene G. Whitaker, Salt LakeCity, Utah, October 11, 1976, age 64.'44. Rudolph W. Janda, Jr., Hinsdale,Illinois, September 3, 1978, age 58., 45. James J. Ahern, Seattle, Washing­ton, February 24, 1978, age 62.'47. Robert D. Story, Fargo, NorthDakota, May 16, 1978, age 54., 50. John B. Cleveland, East Lansing,Michigan, July 17, 1978, age 65.'50. Marcus S. Handler, Northridge,California, January 6, 1978, age 63.'56. Lawrence E. Savage, Yankton,South Dakota, May 3, 1978, age 49.Former StaffKathryn E. Hoffman, (Obstetrics andGynecology, Resident, '43-'46), Milan,Ohio, April 22, 1978.Thomas C. Hurst, (Pediatrics, Intern!Resident, ' 39-' 41), Wichita, Kansas,July 22, 1978, age 64.Sheila Thomas, (Pediatrics, Resident,'71-'75), Kodambabkam, Madras 24, In­dia, December 22, 1977, age 36.Illinois Science Lecture Association,December 1 and 2 in Chicago. Dr. Row­ley spoke on the topic of chromosomalchanges in human cancer and Dr. Hug­gins on "The Induction and Extinction ofHuman Cancer" .Obstetrics and GynecologyAppointment:Dr. Richard J. Lowensohn-AssistantProfessor.Dr. Donald R. Tredway, Associate Pro­fessor in the Department of Obstetricsand Gynecology, accepted a position aschairman of the department of obstetricsand gynecology at the Oral Roberts Uni­versity School of Medicine, Tulsa,Oklahoma.OphthalmologyThe Department of Ophthalmology willhold its Annual Alumni Day Wednesday,March 7, 1979. The guest speaker will beProfessor Albert M. Potts ('38 Ph.D.),chairman of the department of ophthal­mology at the University of Louisville.Dr. Potts was a member of the depart­ment here from 1959-1975.The program includes a full-day scien­tific session, a buffet luncheon, and re­ception. Registration and scientific ses­sions will begin at 9:00 a.m. in P-117,Albert Merritt Billings Hospital. Sixhours of Category 1 credit is offered.There is no charge.The program is open to all alumni,physicians, and staff, and residents ofdepartments of ophthalmology. Forfurther information, contact Mrs. KarinCassel, Department of Ophthalmology,950 East 59th Street, Chicago, Illinois60637, or call (312) 947-6063.PathologyAppointment:Dr. Julius C. Ringus-Instructor.PediatricsAppointments:Dr. David G. Ruschhaupt ('66)­Assistant Professor.Dr. Mark S. Schiffer ('71)-AssistantProfessor.Dr. Robert R. Chilcote and Dr. JohnW. Moohr, Assistant Professors in theDepartment of Pediatrics, were ap­pointed Co-directors of the new Pediatricand Adolescent MUltidisciplinary Oncol­ogy Clinic established at Wyler.Dr. Robert R. ChilcoteDr. John W. Moohr The Pediatric Oncology Clinic is oneof the Midwest's most comprehensivecenters for the diagnosis and treatmentof childhood cancers. The clinic is one ofthe nation's twenty-five university-basedfacilities participating in the Children'sCancer-Study Group. These institutionsshare information on research and pa­tient care advances. Four times eachyear the cancer treatment and patientcare program are reviewed.Dr. Martin B. Mathews ('49 Ph.D.),Professor Emeritus in the Departmentsof Pediatrics and Biochemistry, pre­sented a lecture entitled "Coevolution ofCollagen." He also chaired a session onwound healing at a conference on thebiology of collagen held recently at theUniversity at Aarhus, Denmark. Theconference was part of a program cele­brating the fiftieth anniversary of thefounding of that university.Alumni of Wyler Children's Hospitaland Bobs Roberts Hospital held a reun­ion dinner in Chicago on October 25 dur­ing the American Academy of PediatricsMeeting. Dr. Marc O. Beem ('48) chairedthe party, assisted by Dr. BurtonGrossman (' 49).Pharmacological and PhysiologicalSciencesAppointment:Mitchel L. Villereal, Ph.D.-AssistantProfessor.PsychiatryAppointment:Dr. Morton M. Silverman-AssistantProfessor.Dr. Edward Senay discussed multi­modality methods in the treatment ofdrug abuse at a World Health Organiza­tion meeting in Tehran, October 12-22.Dr. Senay is the Executive Director ofSubstance Abuse Services, Inc.,Chicago.RadiologyAppointments:Dr. Chih-Chiang Hsu-Instructor.Dr. Mark H. Jaffe-Instructor.Dr. Jonathan Rubin ('74, '77Ph.D.),-Instructor.Dr. John J. Fennessy, Chairman and Pro­fessor in the Department of Radiologywas named an Honorary Fellow of theFaculty of Radiologists in October at theRoyal College of Surgeons, Dublin, Ire­land. He presented a paper entitled"Radiologic Findings in Nonspecific In­flammatory Diseases of the Colon."Dr. Lawrence H. Lanzi was awardedthe William D. Coolidge A ward of theAmerican Association of Physicists inMedicine, August 2. The award is given"to recognize physicists who have established distinguished careers in med­ical physics and to recognize their con­tinued contributions to the field."SurgeryAppointmentsDr. George Dohrman-Assistant Pro-fessor. .Dr. Wolfgang Schraut-Assistant Pro­fessor.Dr. David Skinner and more than a dozenmembers of the Department of Surgeryparticipated in the Sixty-Fourth AnnualClinical Congress of the American Col­lege of Surgeons in San Francisco, Octo­ber 16-20.Dr. John R. LindsaySection of OtolaryngologyDr. John R. Lindsay, the Thomas D.Jones Professor in the Department ofSurgery, was honored at a scientificsymposium and dinner on November 10at the University's Center for ContinuingEducation, marking "Fifty GloriousYears in Otolaryngology." A mong theformer residents and staff participating inthe program were Dr. Harold F. Schuk­necht (Rush '40), professor of otologyand laryngology, Harvard MedicalSchool, and chief of otolaryngology,Massachusetts Eye & Ear Infirmary,chairman of the first session; Dr. HenryB. Perlman (Rush '25), ProfessorEmeritus of Otolaryngology at the Uni­versity of Chicago; Dr. Meyer S. Fox, inprivate practice in Milwaukee; Dr. RaulHinojosa, Research Associate inOtolaryngology at the University ofChicago; Dr. W. Garth Hemenway, pro­fessor of surgery, UCLA School ofMedicine, and chairman of the secondsession; Dr. Cecil W. Hart, associateprofessor of clinical otolaryngology andmaxillofacial surgery, NorthwesternUniversity Medical School; Dr. John M.25Fredrickson, professor, department ofotolaryngology, University of Toronto;and Dr. Joan T. Zajtchuk, Lt. Col. ('66),assistant chief, ENT, department ofsurgery, Walter Reed Army MedicalCenter. Dr. Myron M. Hipskind, formerchairman, department of otolaryngology,Loyola University, was master of cere­monies at the dinner. Dr. Ralph Naunton has been elected amember of the Collegium Oto-Rhino­Laryngologicum Amicitiae Sacrum, aninternational professional society cul­tivating friendship and promoting basicresearch in the field.Zoller Dental ClinicAlumni News1929LeRoy H. Berard died September 6 at age80 in Oak Park, Illinois. He earned hismaster's and doctorate degrees from TheUniversity of Chicago and taught Englishat the University of Arkansas for severalyears before entering Rush Medical Col­lege. He was a member of the CookCounty Hospital staff from 1936 to 1962and of the former Chicago TuberculosisSanitarium staff from 1932 to 1974, ser­ving as its chief of medicine for 25 years.He also was associated with the North­western University allergy clinic.1931A. Ross McIntyre ('30 Ph.D., pharmacol­ogy) died of cancer on September 1 atage 76. Dr. McIntyre was chairman ofthe department of physiology and phar­macology at the University of NebraskaCollege of Medicine from 1935 to 1967.His research included work on musculardystrophy and polio. He helped showhow curare, used as a poison on tips ofarrows by South American Indians,could be used to relax muscles duringsurgery. In 1952 he was presented theUniversity of Chicago Medical AlumniAssociation's Distinguished ServiceA ward. The Academia N azionali DeiLincei in 1954 presented its first inter­national award to Dr. McIntyre and Dr.H. R. Griffith of Toronto, Canada, fortheir independent investigations of cu­rare. In 1974 the University of NebraskaMedical Center established the A. RossMcIntyre Award, consisting of a $1,000check and gold medal, for original con­tributions to medicine or medical educa­tion.1932Nathaniel E. Reich is a clinical professorof medicine and professor emeritus ofthe State University, New York. He wasthe first American physician to lecture inthe U.S.S.R. in 1956. He also lecturedduring August in both Chinas: at theShanghai College of Medicine and at the26 Taiwan National University in Taipei.1934LeMon Clark, Fayetteville, Arkansasgynecologist and author of numerousbooks and magazine articles on sexualadjustment, has addressed his latestbook to the teenager. It is entitled,Where Do Babies Come From? AndHow To Keep Them There' Dr. Clark isa member of the Royal Society ofMedicine (London) and the Society forthe Scientific Study of Sex.Nathan F. Fradkin, Albany, New Yorkgastroenterologist, died September 2 atage 69. Dr. Fradkin had a private prac­tice for many years and was professoremeritus of medicine at the Albany Med­ical College. He was a fellow of theAmerican College of Gastroenter­ologists.1935Eva Tysse McGilvray retired on October1 to High Lorton, Cumbria, UnitedKingdom after many years at the Ger­man Institute for Medical Missions inTubingen, West Germany.1938Willard B. Weary, neuros urgeon in Dal­las, Texas, has volunteered to serve asclass chairman.1942J. Blair Pace is residency director at theSanta Ana Tustin Community Hospital,Santa Ana, California. He is author of abook entitled Pain: a Personal Experi­ence, published by Nelson Hall,Chicago.1944J. Alfred Rider, San Francisco gastroen­terologist, is serving as chairman for hisclass as well as assisting with the Nor­thern California Medical Alumni LoanFund.1947Robert Story, a Fargo, North Dakota Dr. Thomas M. Graber, Professor in theDepartment of Pediatrics and the ZollerDental Clinic and Research Associate(Professor) in the Anthropology Depart­ment, recently returned from a trip toChina, where he studied facial-dentalconfigurations of 6,000-year-old skele­tons at the Shenei Province archeologicalexcavation site.cardiologist, died May 16 of a braintumor. Dr. Story was instrumental in theestablishment of intensive care units insmall hospitals throughout the region.He piloted his own plane and beganflying to rural hospitals eight years ago toset up intensive care units and to adviselocal doctors on diagnosis and treatmentof heart disease. Dr. Story had served aspresident of the North Dakota Heart As­sociation, as a governor for NorthDakota for the American College of Car­diology, and as professor of medicine atthe University of North Dakota MedicalSchool, as well as head of the 75-personFargo Clinic.1950John B. Cleveland, of East Lansing,Michigan, died July 17 of heart disease.Dr. Cleveland served in private practice. from 1951 to 1964 in Michigan City and in1964 joined the Olin Health Center atMichigan State University which heserved for 14 years. In addition to hismedical degree he had a B.S. in chemicalengineering from Purdue University anda B. A. in music theory and compositionfrom the Eastman School of Music inRochester.Marc S. Handler, medical director ofthe Los Angeles Department of Water &Power, died January 6 of heart failure, atthe age of 62. Dr. Handler received hisM.S. in Pathology from the University ofChicago. Following graduation he movedto Los Angeles where he was in privatepractice in Van Nuys for 15 years. In1966 he became a physician with the De­partment of Water & Power.1953David S. Greer recently assumed thechairmanship of the department of com­munity health at Brown University,while remaining associate dean ofmedicine. Mrs. Greer (Marion) is doinghealth education for the MassachusettsHospital Association and for the localFall River school systems; daughterLinda is in the school of public health atthe University of North Carolina, half­way through a course in environmentalscience and engineering leading to a mas-ter's degree; and son Jeff is working forthe Governor of Rhode Island in his en­ergy conservation office before going onto law school.Jack W. Japenga is president of Glen­dora Radiological Association, Inc.,Glendora, California. He was electedpresident of the American Federation ofPhysicians and Dentists, CaliforniaCouncil (a physicians labor union) andchairman of the Los Angeles CountyPublic Health Commission.1956Lawrence E. Savage, Yankton, SouthDakota surgeon, died May 3 at age 49.Dr. Savage collapsed while working atSacred Heart Hospital, Yankton, wherehe was attending surgeon. He had alsobeen a staff surgeon at the YanktonClinic since 1965 and clinical professor ofsurgery at the University of SouthDakota. Included among his many ad­ministrative appointments were: pres­ident, South Dakota Chapter, AmericanCollege of Surgeons, 1973-74; president,District VIII Medical Society, 1968-69;and president, Sacred Heart Hospitalstaff, 1973-74.Alan H. Schragger has been elected tothe board of trustees at Cedar Crest Col­lege in Allentown, Pennsylvania. Dr.Sch ragger is chief of dermatology atAllentown General Hos pital and assis­tant professor of dermatology atHahnemann Hospital.1958Gerald S. Gotterer was appointed as­sociate dean of medical student pro­grams at the Rush Medical College,Chicago.1963Larry Hefter is board certified in pathol­ogy and in nuclear medicine, practicingat Fairfax Hospital in Northern Virginia.He is also assistant clinical professor ofpathology at the George WashingtonUniversity. He lives with his wife Susanand two children, Jonathan and Rachel,in Bethesda, Maryland.1964Richard T. Rada is associate professorand vice chairman of the department ofpsychiatry at the University of NewMexico, School of Medicine. He is cur­rently serving as president (1977-1979) ofthe New Mexico Psychiatric Associa­tion.1965David S. Harrer has been appointed lab­oratory director at Commonwealth Doc­tor's Hospital in Fairfax, Virginia and laboratory director of the Bionetics Med­ical Laboratory at the hospital.1967Glenn R. Hodges has been promoted toassociate professor of medicine (infecti­ous diseases) at the University of KansasCollege of Health Sciences, Kansas City.He is also chief of the section of infecti­ous diseases at the Veterans Administra­tion Medical Center, Kansas City.Last year he was elected to membershipin the Infectious Diseases Society ofAmerica.1970Ken A. Colinsworth was appointed assis­tant professor of medicine in the divisionof cardiology at the University ofCalifornia at Davis.Reed C. Rasmussen has the rank oflieutenant colonel in the U.S. Air Forceat Scott Air Force Base, Illinois, wherehe is chairman of the department of fam­ily practice and director of family prac­tice residency.William L. Wolfson is assistant pro­fessor in the department of pathology(division of surgical pathology) at theUniversity of California, Los Angeles.He is also co-director at Astra-Med Lab­oratories, Inc.1971David Humphrey is working as a residentin clinical pathology at the University ofTexas Health Science Center in San An­tonio.John A. Schafer completed three yearsof residency training in neurology at theUniversity of California, San Franciscoand two years in the U.S. Navy as a staffneurologist at Oakland Naval Hospital,Oakland, California. He has entered pri­vate practice in neurology in Sac­ramento, California.1972Michael Kaufman recently joined thestaff of Evanston Hospital (Illinois) as anassistant pathologist. The Kaufmans arethe parents of Elizabeth Courtney, bornFebruary 22.1973Michael H. Silverman has moved to Port­land, Oregon and entered the clinicalpractice of rheumatology. Besides prac­ticing, he is participating in the teachingprograms at two private hospitals and isa clinical instructor at the University ofOregon Health Sciences Center.1974Kenneth Gass writes he is enjoying a pri­vate general pediatrics practice in Bel­lingham, Washington (on the north end of the Puget Sound) after completing apediatric residency at the University ofWashington in 1977.1975David Ostrow is in his last year of a psy­chiatry residency training at MichaelReese HospitalI Chicago) where he hasbeen appointed adult psychiatry researchfellow. He is the senior author of "AHeritable Disorder of Red Cell LithiumTransport in a Subpopulation of Manic­Depressive Patients" which appeared inthe September, 1978 American Journalof Psychiatry. Co-authors are John M.Davis, M.D., G. N. Pandey and StephenHurt, Ph.D., all of the University ofChicago, and Daniel C. Tosteson, M.D.In addition, he chaired a symposium onLithium Ion Transport in Affective Ill­ness, held at the Second World Congressof Biological Psychiatry, Barcelona,Spain on September 4, where he pre­sented a paper on "Abnormalities ofLithium Transport in Affective Dis­orders," co-authored by Drs. Davis andPandey.Michael Todd is the chief resident inthe department of anesthesia at Mas­sach usetts General Hospital and a fellowin anesthesia at Harvard Medical School.1976Judith and Robert Alpern will be going tofellowships in Northern California nextJuly-Bob in nephrology at Moffitt Hos­pital at the University of California atSan Francisco and Judy in gastroen­terology at Stanford.James Goldstein is working at the Uni­versity of California, Cardiovascular Re­search Institute, San Francisco, Califor­nia.1977Jeremy Hollerman announced the birthof daughter Laura Ann on May 29, 1978.The Hollermans are living in Winston­Salem, North Carolina.Burton Vander Laan is the representa­tive for his class. Dr. Vander Laan is aresident at Michael Reese Hospital,Chicago.1978James W. Fasules, a first year resident atthe University of Colorado Medical Cen­ter, is serving as class representative.Former StaffArnold R. Axelrod (Medicine, intern, '44)writes that he has been a professor in thedepartment of medicine at Wayne StateUniversity School of Medicine in Detroitsince 1969 and chairman of the depart­ment of medicine at Sinai Hospital (De­troit) since 1974. He also is a consultant27in hematology and serves as a councilmember of District II of the AmericanCollege of Physicians.Robert D. Moseley, Jr. (Radiology, res­ident, , 51-' 54, professor and chairman,, 54--71) has been elected an honorarymember of the Swedish Society of Medi­cal Rad iology. He is one of sevenradiologists outside of Sweden to haveever received this honor and is the onlyAmerican diagnostic radiologist to beelected. Dr. Moseley has been invited togive a lecture in Uppsala, Sweden inconnection with the honor. He also willbe visiting professor in Lund, at the Uni- versity of U mea and at the KarolinskaInstitute in Stockholm.Manual Porth (General Surgery,intemlresident, '68--'72) is an orthopedicsurgeon at the University Hospital,Tamaral, Florida. He retired as alieutenant colonel from the U. S. Armyafter eight years of military service. Hespent six years at Walter Reed ArmyMedical Center where he received his or­thopedic residency training. Last year hewas board certified.Mark Ravitch (Pediatric Surgery, pro­fessor, '65-'69) received honorary mem­bership in the Royal Australasian Col­lege of Surgeons at a meeting in Kuala Lumpur, Malaysia. Dr. Ravitch is firstvice president of the American Collegeof Surgeons.Divisional Alumni NewsEdmund Becker (Biophysics, Ph.D., '63)is living in Lexington, Massachusetts.He is product group manager at theAnalogic Corporation, Wakefield, Mas­sach usetts.Donald C. Mikulecky (Physiology,Ph.D., '63), associate professor in thedepartment of physiology at the MedicalCollege of Virginia writes that he com­pleted his first Marathon in 4:33:32 inRichmond on October 8.nota beneNew Class Chairmen1938Dr. Willard B. Weary712 N . WashingtonDallas, Texas 752461944Dr. J. Alfred Rider10 Charles-Dean RoadMill Valley, California 949411977Dr. Burton F. Vander Laan2951 S. King DriveApt. 1902Chicago, Illinois 606161978Dr. James W. Fasules573 RaceDenver, Colorado 80206.28 Frontiers ofMedicine ProgramsDecember 6 (3 hours)Organ TransplantationJanuary 10 (3 hours)Ethical Issues in Critical CareFebruary 14 (3 hours)Common Ear, Nose & ThroatProblemsMarch 28 (3 hours)New Developments in In­flammatory Bowel Disease* A continuing medical educa­tion program granting hour­for-hour credit in Category 1 ofthe Physician's RecognitionAward of the American Medi­cal Association. 50th AnniversaryA special issue containing many ofthe invited lectures delivered at the50th Anniversary of The Univer­sity of Chicago Medical Center hasbeen published in Perspectives inBiology and Medicine, Vol. 22,No.2, Part 2, Winter 1978--79.It is available from Journals, Uni­versity of Chicago Press, 5801South Ellis Avenue, Chicago, Il­linois 60637. The price is $3.60 percopy prepaid.Mutatis mutandisName Graduation YearHome Address TelephoneCity, State, ZipBusiness Address TelephoneCity, State, ZipTitleNew address?New position?New medical practice?military assignment?civic or professional honor?book?Please tear out; fold, staple, or tape; and drop in the mailbox. Thanks!Medical Alumni Association1025 East 57th StreetChicago, Illinois 60637Fold this flap in first , ---- .. -----1I II II Place II II Stamp II II Here II I� JBecome a part of your alma mater's future'""REMEMBER T E 1978MEDICAL CENTER ALUMNI FUNDA top-rated medical/biological sciences institution like TheUniversity of Chicago Pritzker School of Medicine and theDivision of Biological Sciences is as much about the futureas it is about the present. Medical students in training nowwi II care for patients not yet born, and the research ad­vancements of todays basic scientists will affect the courseof medicine in years to come. In the same way, a gift now isan investment in the future.The Medical Center Alumni Fund is the major source ofunrestricted gifts to the medical school and the division.There is still time to participate in the 1978 Medical CenterAlumni Fund (deadline for gifts is December 31). All gifts,restricted or unrestricted, are needed and wi II be greatlyappreciated. Please consider joining one of the followinggroups:Donors contributing $1,000 or more are recog­nized as Medical Alumni Patrons and Dean'sAssociates.Donors contributing $500 are recognized asMedical Alumni Sponsors.Donors contributing $100 are recognized asCentury Club Members.You may wish to earmark your 1978 gift to one of thefollowing funds established by medical alumni and friends. Student AidWilliam E. Adams Loan FundEric Afterman FundWill iam Bloom Loan FundHenry Boettcher Scholarship FundPaul R. Cannon Loan FundYing Tak Chan Loan FundColorado Alumni Loan FundGeorge F. Dick Loan FundMarc Dudmikov Loan FundCharles L. Dunham Loan FundJ. Nick Esau Loan FundJoel Murray Ferguson Loan FundLloyd A. Ferguson Scholarship FundAbraham Freiler Scholarship FundRoger N. Harmon Scholarship FundBasil Harvey Loan FundVictor Horsley Loan FundEleanor Humphreys Loan FundHilger P. Jenkins Loan FundAllan T. Kenyon Memorial FundDeane Lazar Loan FundFrancis L. Lederer MD,/Ph.D. ProgramFrank Lienhardt Loan FundFranklin Mclean Scholarship FundMedical Alumni Loan FundGeorge W. Merck Loan FundNorthern California Alumni Loan FundJohn F. Perkins Loan FundPlzak Family Loan FundFrederick R. Roberg Loan FundCassius Clay Rogers Scholarship FundA. Lewis Rosi Scholarship FundBernard and Rhoda Samar Loan FundMary Roberts Scott Scholarship FundSmith-Regan Loan FundNels M. Strandjord Loan FundGrant Merrill Trippel Loan FundFrank W. Woods Loan FundSam Zapler Loan FundEugene and Esther Somerfeld-Ziskind Loan FundOther Restricted FundsEmmet Bay Lectureship FundBatten's Disease Research FundJosephine Victoria Black Research FundClass of 1949 Gift FundClass of 1956 Gift FundDavis-Freedman Psychiatry Research FundCatherine L. Dobson Fund in Ob/GynLloyd A. Ferguson Library FundFisher Endocrinology Research FundBetty Frankel Housestaff FundDallas and Marjorie Schutz Glick FundGoldiamond Psychiatry Research FundJohn W. Green Sr. FundJ. P. Greenhill Foundation Fund in Ob/GynHoward Hatcher Research FundHans Hecht Lectureship FundVictor Horsley Research FundCharles B. Huggins Professorship Fund.1' Leon O. Jacobson Fund.�- Alex B. Krill FundClayton Loosli Memorial FundJames A. McClintock AwardWalter Palmer Visiting Professorship FundJohn Van Prohaska Library FundKlaus Ranniger FundRichard W. Reilly Memorial FundKurt Rossmann Education FundCornelius A. Vander Laan FundMedicine 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 guaranteed