Just What The Dr. Ordered
Dr. Charles Brackett and his colleagues in DHMC's Section of General Internal Medicine have been using a novel way to get patients to exercise. Rather than offering them gentle reminders, or even insistent suggestions, about the benefits of exercise—advice that all too often falls on deaf ears—Brackett commits his counsel to paper and actually writes prescriptions for regular exercise.
The "take two miles and call me in the morning" approach appears to be working. Brackett observes that his exercise prescriptions are translating into fewer medication prescriptions for conditions such as high blood pressure and cholesterol. "I get excited when I see patients who have lost 20 or 30 pounds and they are able to come off medications," he says.
Cough Drops At DHMC
Dartmouth-Hitchcock Medical Center is breathing a collective sigh of relief after stanching an outbreak of pertussis, or whooping cough—a highly contagious bacterial infection of the respiratory tract.
The first cases, identified in March, were traced to a new employee in the clinical labs. DHMC's infection control team gave preventive antibiotics to all staff in the labs, but by mid April—when clusters emerged in other departments—the team stepped up the offensive. Any staff with possible symptoms were screened by Occupational Medicine and barred from pediatric units, since pertussis can be deadly for infants. And in early May, the team began vaccinating all employees. Most infants and children get vaccinated, but immunity usually wears off by late adolescence. In fact, until last fall, no adult vaccine was even available. Ultimately, 135 DHMC employees were diagnosed with pertussis and more than 4,500 were vaccinated. As for patients, the team is still tracking down those who may have been exposed, but the number infected appears to be very low.
The team also launched several studies during the outbreak, including one to assess how quickly the new adult vaccine takes effect. The studies, explains Dr. Kathryn Kirkland, associate director of infection control, are a great example of "how to turn an outbreak into a learning experience."
When You Care Enough . . .
James Varnum, the president of Mary Hitchcock Memorial Hospital for 28 years, never hesitated to personally thank employees who went the extra mile to serve patients and improve care. In the same spirit, the James W. Varnum Quality Health Care Endowment was established by the MHMH Trustees upon Varnum's retirement.
Each year, the endowment—which Trustees hope will reach $1 million—will recognize a national leader in health-care quality improvement, plus one or more DHMC employees or volunteers who exemplify quality health care. The awards will be presented at an annual or biennial conference at DHMC that will highlight best practices at medical centers across the country.
Although Varnum retired in April, the principles that he stood for will endure thanks to the endowment—and to the culture he left behind. For more on Varnum's tenure, see "Leading a Shared Endeavor" in the Spring 2006 issue of Dartmouth Medicine.
A Word About Awards
Four more awards will soon adorn the walls of the DMS Office of Publications. Judged one of the best academic medical center
magazines in the country, Dartmouth Medicine earned a 2006 Award of Excellence from the Association of American Medical Colleges. And Jennifer Durgin, the magazine's senior writer, won not just one but two Will Solimene Awards for Excellence from the American Medical Writers Association—for "Are We Hunting Too Hard?," the cover feature in the Summer 2005 issue (pictured at left), and a profile in Fall 2005 of Dr. Ann-Christine Duhaime, Dartmouth-Hitchcock's chief of pediatric neurosurgery.
In addition, a book project that the publications office oversaw— The Science We Have Loved and Taught: Dartmouth Medical School's First 200 Years, by Constance E. Putnam—also received a Solimene Award. The book, described in a recent review as "nuanced" and "imaginatively researched," is available at www.upne.com.
Gift From Close-Knit Clan
When Dale "Hoss" Lewis, a Pomfret, Vt., farmer and logger, died of an adenocarcinoma at age 41 last November, his family was heartbroken. But from heartbreak came inspiration. The family has since then begun to raise funds in his memory as a benefit for Dartmouth's Norris Cotton Cancer Center—by knitting and selling "Hoss Hats."
The hand-knit acrylic and wool hats have not only helped raise over $1,000 for the Cancer Center, but they've also given Lewis's family a positive and productive way to channel their grief. "It makes us feel we're helping out in some way," explains Lewis's aunt, Ann Bassett. "It's better than sitting around crying."
Fans Of Chinese Culture
Getting all the ingredients in a lab experiment just right is crucial to a successful outcome. Similarly, getting all the ingredients in the dumplings just right is key to a successful Chinese New Year celebration, says Dr. Song Lin, a biochemistry research associate at DMS. Jiaozi, as Chinese dumplings are known, call for pork, cabbage, bamboo shoots, and assorted spices, all wrapped in a thin dough.
"Dumplings are a very important food in Chinese New Year celebrations," says Lin. As the president of the Upper Valley Chinese Professional Club (UVCPC), Lin organized the group's 2006 Chinese New Year festivities—which were attended by nearly 300 people. Also on the menu were sour-sweet salmon (a symbol of abundance) and oyster-sauce-braised spare ribs with garlic sauce.
In addition to food, the gathering featured a Chinese history quiz and various presentations—from a demonstration of Chinese calligraphy to a performance by Dr. T.Y. Chang, chair of the DMS Department of Biochemistry, of the song "On the Jiang-Ling River."
The UVCPC has grown from 15 members in 1989 to over 200 today; its ranks include people who have emigrated from China, Americans of Chinese heritage, and individuals who have adopted Chinese children. The club even began a Chinese school in 1996, where about 150 students from age 5 to 40 have learned Chinese language, history, and traditions.
"People get together to see some Chinese" people, explains Lin, "to feel at home, to talk about life here [and] how life is changing back in China."
A Good Telling Of A Good Story: Vermont Public Radio reporter Susan Keese won an Edward R. Murrow Award for a report in 2005 on the memorial service that Dartmouth medical students hold for their anatomy-class cadavers.
Oh, Baby!: Dartmouth now offers one of the most generous parenting policies for graduate students of any institution. It provides up to 12 weeks at full stipend for a birth or adoption, and up to an extra year to finish a degree.
Better Babies: DMS just received its third grant in five years from the U.S. Agency for International Development—this one to
improve pregnancy outcomes in Kosova. Dartmouth physicians and nurses will work closely with their counterparts there.
Heart-Smarts: High school biology students from Hanover, N.H., and Hartford, Vt., got a chance in May to use a defibrillator in a cardiac simulation lab, to feel a real pig's heart, and to hear a presentation by Dr. Alan Kono, a DHMC heart-failure specialist.
Rank And File: DMS was again ranked among the top medical schools by U.S. News & World Report. Dartmouth was 32nd in the research category, 21st in the primary-care category, and 10th in the rural medicine category.
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