Sometimes we get lots of letters about a single article—as was the case in the last issue, when nearly a dozen people wrote in about a feature describing writer Nancy Price Graff's decades-long struggle with chronic depression. But sometimes the feedback we get is all over the map—as is the case in this issue. So herewith is a "spring medley" of readers' opinions, questions, and reactions. Plus, sad to say, one correction.
Watch for speed bumps!
As a retired engineer, I could not help noticing the statement in the Winter issue "Editor's Note" that "velocity is a function of both time and speed." Actually, it is a function of both time and acceleration, the acceleration being that of gravity as modified by the angle of the incline. Velocity and speed are numerically identical, the difference being only that velocity also has direction in addition to magnitude.
Editor Dana Grossman responds: "Oh, dear. Ironically, speed (at the proofreading stage) was to blame for the error. I kept tweaking that passage till the last minute. Unfortunately the sentence got garbled in the process, and none of us caught it. I appreciate the correction of the record, of course. It's reassuring to know that Dartmouth Medicine has readers who care enough to write in about points like this."
Unusual research finding
Research can, indeed, yield unexpected results. As I read the "Discoveries" section in Dartmouth Medicine's Winter issue, I was intrigued by a photo here and thought I recognized the name of the researcher—Dr. Brenda Sirovich. I wondered if she might be a gifted dark-haired fourth-grader I taught 33 years ago in New York City.
Through the kindly assistance of Dartmouth Medicine, I received a most delightful response revealing that my suspicions were correct. Dr. Sirovich's research brought together two women with a sincere affection for each other and culminated in a joyous reunion.
My husband and I are retired. We live in the Upper Valley and use the Dartmouth medical system as our health-care provider. I know that medicine comes in many forms, and reconnecting with this talented researcher is one of them. Thank you, Dartmouth Medicine.
Joanne E. Sobel
A musical interlude
Thank you for the article "Dancing the Night Away" in your Winter issue. I write on behalf of myself and my seven sons, as well as my late wife, Christine, in whose memory our family donated the Steinway grand piano mentioned in the article.
Your story offers reassurance that the intent of the gift, which was made in 1993, is still being realized more than 10
years later, giving DHMC the capacity to provide for the total care of patients and their families.
The volunteers who play the piano are to be commended for their efforts; truly, as your story noted, "music hath charms." May the piano long continue to allow "dancing the night away" for patients, families, and staff hoping for recovery. Christine would have approved of this aspiration; she continues to live in our memory through DHMC.
Harking back, looking forward
Dr. Paul Lena's essay "A life in medicine" in the Winter issue of Dartmouth Medicine brought back recollections of medicine as it "used to be" when he and I were both residents in medicine at Hitchcock. As Archie Bunker and "the Dingbat" used to sing, "Those were the days."
When I was a boy, the policeman was referred to as Public Servant Number One. But when I practiced general medicine in a small Vermont town before going into pathology—and it was general indeed—I found out that it was really the country doctor who was Public Servant Number One, available 24 hours a day, every day of the week.
Making house calls to deliver babies at 2:00 a.m. deep in the countryside, sewing up lacerations on a Sunday afternoon, setting bones, making rounds in a cottage hospital with only rudimentary laboratory and radiology services (you read your own films) before seeing patients in the office
for three hours in the morning, making house calls in the afternoon after lunch, and never being far from the telephone: all of that was the way of life for the family doctor.
Also part of the picture were $4 fees for office visits ($8 for a house call) and care for everyone who called on the phone or walked in the office door, regardless of their ability to pay. That's the way it was before Medicare and Medicaid. You took care of the sick, whoever they were.
There is no doubt that over the years the quality of care has improved almost exponentially, and I don't buy the "good old days" mythology. But I do marvel, for instance, at emergency physicians who work 40 or 48 hours consecutively in a well-equipped and -staffed hospital, with guaranteed relief when the tour of duty is over for the week, plus all sorts of benefits and six- or near-six-figure salaries. Plus no follow-up responsibilities in patient care—just call the attending and move on to the next patient. That was not the image I had of what the doctor's life and the doctor-patient relationship would be or, indeed, what it was when I started my career.
With doctors like Paul Lena, the doctor- patient relationship wasn't just a meaningless buzzword but a real part of the healing process.
Paul is right in describing his point of view realistically, and I'm pleased that he has helped to put present-day medical care in perspective. The fact that he has continued to serve society in retirement is in the highest tradition of medicine. Caring for the sick, helping out, teaching the young—all these are, or should be, the doctor's calling throughout his or her life.
But we physicians still have a long way to go in defeating the enemy. Even in this prosperous and generous country, there is a need to care for those who have limited access to quality medicine, to help prepare for devastating epidemics, to push back further the perimeters of medical knowledge.
For the enemy is not government regulations, or insurance companies, or patient-advocate lawyers, or politicians who "just don't get it." The enemy is disease, pain, misery, suffering, ignorance, and irresponsibility. That was the doctor's challenge in the past, and it is still and will be forevermore.
Robert W. Christie, M.D.
Housestaff '51-53 and '55-56