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Letters


The letters we got in response to the last issue ranged from reminiscences to requests and from kudos to critiques. That's fine by us—we appreciate even critical feedback, because it means our readers are actually reading (as well as, it's obvious, scrutinizing the photos).

A hot topic
I read with great interest the article in your Summer issue about Dr. Harold Swartz's work in dosimetry.

It evoked memories of my own career beforemy retirement. Though my primary practice was in anatomic and clinical pathology, I was also certified in nuclear medicine. My associate and I covered three community hospitals—in Exeter, N.H., and Newburyport and Amesbury, Mass. The radiologists couldn't be bothered with measuring radiation exposure, so we filled the niche. Nuclear medicine was in its early stages then, and since we needed a license for some of our procedures, it was logical to get into measuring radioactive iodine uptakes, which led to doing thyroid scans and subsequently to treating hyperthyroidism with radioiodine.

The three hospitals were within a 10-mile radius of New Hampshire's Seabrook nuclear power plant, so we were also involved in setting up policies and procedures for managing potential accidents involving exposure to radiation and/or contamination with radionuclides. Since most physicians didn't (and still don't) know much about radiation or its various units of measure, we had to also develop a basic education program for the medical staffs, ER staffs, and EMTs in the area.

Most people's eyes would glaze over when I tried to explain the difference between curies, roentgens, and rads or rems. So I borrowed a page from Marshall Brucer's excellent books on nuclear medicine and adopted the analogy of the sun for quantities (curies and millicuries, etc.), sunshine for the intensity of radiation (roentgens and milliroentgens, etc.), and a sunburn for the absorbed dose (rads and rems). The model avoided medical jargon and provided a practical example.

Currently I live in Swanzey, N.H., part of which is within 10 miles of the Vermont Yankee nuclear plant. Swanzey's emergency planning program calls for having a written, regularly exercised plan to deal with any Vermont Yankee problems. Though I have been retired from practice for a long time, I volunteered to be the radiological defense officer for the town, which involves keeping track of survey meters, pocket dosimeters, and film badges for the police, firefighters, and public works personnel who may be exposed to radiation in the course of responding to an incident. This involves briefing individuals when dosimeters are distributed, so they know how to read them and what to do if the readings are above certain levels. The sun/sunshine/sunburn model has been quite useful in giving them some basic understanding of what the readings mean.

My experiences have been at the other end of the spectrum from Dr. Swartz's, but it's interesting how useful some expertise in this area has been throughout my career and beyond.

Dennis J. Carlson, M.D.
HS '60-64
Swanzey, N.H.

Symbolic gesture?
Rachael Labitt, the undergraduate pictured on your Summer cover [which is reproduced at right], says she wants to learn about science. But judging from her right hand—given the ancient superstition about fending off evil by placing the thumb between the index and middle fingers—it appears she doesn't want to take any chances.

However, she needn't worry. Magic is apparently still alive in the heart of her mentor, judging from the ancient charm that she is wearing around her neck. So much for scientific thinking. Did you do that on purpose, to lure readers into the inside pages? Anyway, nice job.

E. Wayne Martz, M.D., M.B.A.
DC '42, DMS '43
West Grove, Pa.

We do look very carefully at photos for unusual gestures or juxtapositions—both intended and inadvertent. But we must admit that this possible symbolism escaped us.

This must make us blow-hards
I found the Summer 2008 issue of Dartmouth Medicine to be another gem. However, I hope you receive enough negative feedback about the layout of page 29 to convince you to abandon the modern fad of locating the title of an article someplace other than at the beginning of the article. I am a retired engineer and therefore tend to think linearly. I expect each article to start immediately after its title and am slowed down by having to puzzle out such a non-linear situation. The title need not be at the top of a page, just at the top of the article.

Also, I believe there is a typo on page 54, in the ninth line from the bottom of the first column. I suspect the tiny balloons are made of silicone (silicone rubber), not silicon.

Roald Cann
Weathersfield, Vt.

Cann is absolutely right about those balloons. We'll do our best to . . . um . . . bounce back from the slipup. The title placement he didn't care for (on the layout that's reproduced at the top of the next page) is a more subjective matter, but we do always welcome getting such feedback from readers.

High praise The article "Help from on High" in your Summer issue offered an exciting look into "a day in the life" of the first responders at DHART [Dartmouth-Hitchcock Advanced Response Team]. I felt like I was right there with them!

Will there be a follow-up article? I want to know more!

Conrad L'Heureux
Meriden, N.H.

Chris Demarest, the author and illustrator of that article, plans to continue doing "ride-alongs" with DHART, so we may indeed run a sequel in some future issue.

A matter of some substance
I was recently researching the background of Dr. Robert Drake, a member of the Dartmouth faculty and a consulting member of a commission that I serve on—the Beeman Commission in Fairfax County, Virginia, whose purpose is to improve the delivery of public mental health services in the county.

My online search led to me to an article about his work in Dartmouth Medicine, and from there I noticed several other interesting articles. I spent more time than I had intended reading your magazine, but I consider it time well spent.

I thought you might like to know that, based on the information I found, I recommended that a reporter from the Washington Post speak with Dr. Drake about appropriate treatments for co-occurring disorders.

Carol Ulrich
Herndon, Va.

DMS's Drake is an international leader in the treatment of co-occurring disorders—a severe mental illness combined with a substance abuse problem. To learn about his work, click here. Ulrich is the immediate past president of the northern Virginia chapter of the National Alliance on Mental Illness and a member of the Commonwealth of Virginia Commission on Mental Health Law Reform.

Program's progress
I was very interested by the article on a tumor suppressor gene in the Summer 2008 issue of Dartmouth Medicine. Back in 1950, while I was on the surgical staff at the University of Wisconsin, I took part in a multiuniversity study on the effects of androgen and estrogen on breast cancer. I have been interested in the causes of cancer ever since. I hope the work on the tumor suppressor gene progresses well.

I was also interested in several recent articles on rural medicine. Many years ago, after I left Wisconsin to practice in Maine, I attended a surgical review session in Boston. The instructor asked where I was from, and I said Eastport, Maine, whereupon most of the other attendees laughed—I'm not sure whether out of ignorance or arrogance. My wife was much wiser. When I suggested we move, she asked me if city dwellers deserved better medical care than people in rural areas. In fact, rural areas badly need well-trained doctors and dentists.

In fact, the three doctors I admired most spent their careers in rural set t ings : Dr. Robert MacBride of Lubec, Maine; Dr. William Mosenthal, a surgeon at Mary Hitchcock Memorial Hospital in Hanover, N.H.; and Dr. William Putnam, a general practitioner in Lyme, N.H. Would that there were more like them!

Rowland French, M.D.
DC '41, DMS '42
Eastport, Maine

Southern living
I have been a Dartmouth Medicine subscriber for many years, but when I moved last October the magazine didn't get forwarded. I am just now getting my act together and would like to start receiving it again. I always read it cover to cover and consider it one of the best and most educational periodicals available. I was born at MHMH in 1953 and spent the majority of my life in the Upper Valley. I now live in Mexico (but have mail service in Texas).

I live an hour south of Guadalajara in a town of 18,000 people called Jocotepec. It is very high (5,200 feet) and dry. Gone are the gray skies of New Hampshire, the black flies, and the unbelievably high cost of health care! We have very good care locally and in the city. For instance, my husband just had a thorough workup, including an EKG, with an M.D. We called and were seen the same day. A cardiologist from Guadalajara saw him locally four days later. The cost? A total of $70 for the visit and the EKG, plus $55 for the specialist. Utterly amazing!

I'd appreciate being sent your Spring 2008 issue so I can read the article on poet Donald Hall. He lived two miles from me in New Hampshire, and I'm a great fan. Thank you.

Sarah F. Brownell
Jocotepec, Mexico

Human touch
My son was a patient at your illustrious medical center in March 2008. Perusing the issues of Dartmouth Medicine that I found in the visitors' lounges, I thoroughly enjoyed the human-interest stories, exciting news, and articles about ongoing research.

I happily accept your offer to send me this enjoyable magazine and eagerly await the issues to come.

Lauraine Lombara, R.N.
Beverly, Mass.


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