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For the Record

The rewards of renewal
By Stephen P. Spielberg, M.D., Ph.D.

I recently had the pleasure of welcoming the Dartmouth Medical School M.D. Class of 2007 to campus. What a joy it was to meet these bright, enthusiastic students! They represent the future of medicine and, indeed, will become the doctors who will care for me and my fellow baby boomers in our advanced years. Some of them will be outstanding physician-scientists as well, while others will become leaders of medical organizations on the local and national scene, working to improve health-care delivery and access for all who are in need.

As I spoke with the members of the class during orientation week and reviewed their academic and personal accomplishments—reading the autobiographies that they had prepared to introduce themselves to their fellow students—I quickly concluded that the future of medicine is in good hands.

I was struck, as I looked recently at some old pictures of the Clinic and the Hospital, by the realization that renewal at an academic institution has a structural element as well.
Illustration: Suzanne DeJohn

Zeal: The same is true of the new students who have joined our ranks this fall in the graduate programs of DMS's biomedical science, evaluative clinical science, and public health programs. The zeal that these students evidence—whether it's for advancing the boundaries of our understanding about the mechanisms of disease, for devising more efficient and effective ways of structuring our health-care system, or for studying the best ways to deliver health information to the populace— serves as a constant inspiration to the faculty, administrators, and staff who have the pleasure of working with them.

One of the wonderful things about being associated with an academic institution is the sense of renewal that energizes the campus as each year's crop of new students arrives. They absorb the knowledge of the ages and yet ask probing questions about what's not yet known, impelling us to constantly reassess the world around us. They soak up the wisdom of their mentors and yet challenge the conventional wisdom, keeping us all on our toes.

Leaps: And this fall is not only a time of renewal for the institution, as it is every year, but it is a time of renewal for me personally, as I start my tenure as dean. I have begun to explore the history of Dartmouth Medical School, Mary Hitchcock Memorial Hospital, the Dartmouth- Hitchcock Clinic, and Dartmouth-Hitchcock Medical Center. It is humbling to review how these institutions came to be what they are today. It took incredible leadership to overcome what at times must have seemed like overwhelming odds. It is a history marked, in turn, by giant leaps forward, missteps, recoveries, and new beginnings. As at all institutions, some events were driven by external forces or sheer serendipity, while others were the products of individuals and groups working together towards a common goal.

We all owe an enormous debt of gratitude to those who steadfastly pursued the vision that has resulted in the institutions we have today. There are too many contributors to this process to acknowledge even the key players without leaving someone out. Nevertheless, there are two individuals who have recently played important roles and to whom we owe special thanks. Dr. Ethan Dmitrovsky, the Andrew G. Wallace Professor and chair of the Department of Pharmacology and Toxicology, served as acting dean for the 2002-03 academic year. Functioning in an acting capacity is a difficult task. However, not only did Dr. Dmitrovsky work tirelessly to assure that DMS maintained its strengths during his tenure, but he also accomplished a great deal to make it even better. His dedication and service to DMS are truly remarkable, and I am personally grateful to him for assuring a smooth and positive transition upon my arrival.

Similarly, Dr. Donald St. Germain, a professor of medicine and of physiology, has served with distinction and commitment as the acting chair of the Department of Medicine for the last two years. As he steps down from this role, I want to recognize and thank him for his outstanding leadership of the department and for all the support and counsel he has provided to me. The selflessness and dedication of these two leaders are what DMS and DHMC are all about.

Complexity: The complex interactions among Dartmouth College, Dartmouth Medical School, and Dartmouth-Hitchcock Medical Center are evident in the evolution of medicine here. I was struck, as I looked recently at some old pictures of the Clinic and the Hospital, by the realization that renewal has a structural element as well. To wit, the Medical School deans' offices are located in a building that once housed the Clinic and, furthermore, that sits on what is now part of the Dartmouth College campus.

There is valuable symbolism in this structural and historical synergy. Our past and current strengths, as well as our future potential, are all bound up in the "interdependent partnering" among the components of the medical enterprise at Dartmouth. The uniqueness of medicine at Dartmouth—what distinguishes us and gives us vitality in spite of all the problems facing medicine today—is our collaborative spirit, the commitment of each part to the whole.

I look forward to being a part of this great adventure. I am confi- dent that together we will accomplish our missions of excellence in health care, education, and research.

"For the Record" offers timely commentary from the dean of Dartmouth Medical School. This is Dr. Spielberg's first contribution to this section. Before taking office as DMS's dean on July 1, he had a long career in academic medicine—in pediatrics, clinical pharmacology, and human pharmacogenetics at Johns Hopkins and then as head of the Department of Clinical Pharmacology and Toxicology at the Hospital for Sick Children of the University of Toronto. Most recently, he was head of pediatric drug development at Johnson & Johnson. See the Summer 2003 issue for more about his background.

If you would like to offer any feedback about this article, we would welcome getting your comments at DartMed@Dartmouth.edu.

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