Letters

AAmisspelling on the cover of our Summer issue—not in the cover text, but in a sign pictured on the cover—caught the eye of one reader. The misspelled word? The term for the medical specialty having to do with, wouldn't you know it, the eye. Our readers clearly have . . . well, an eye for the careful use of words, for another letter lauds an essay on that topic. We're always all eyes for your feedback, whatever the subject!

The eyes have it
Has anyone else written you about the misspelling on the cover of your Summer 2010 issue? In the photograph of Dr. Chidi Achebe, the word "ophthalmology" on the wall of his clinic is missing the first h. [The cover is reproduced below.]

I was six months into my residency in the field when the head of my department mortified me by telling me I should learn to spell the name of my chosen specialty correctly, with two h's. A short while later I had the pleasure of pointing out to him that his official stationery was similarly amiss.

Since then I've written to numerous publications to point out the misspelling, including Taber's Medical Dictionary (their reply was "It's a typo"!). I also called Dr. Achebe's clinic and left a message for him. It's remarkable how often one sees the error.

Hasan A. Benler, M.D.
Housestaff '67-68
Poway, Calif.

Our readers are a sharp-eyed lot, but Benler was the only one we heard from about the misspelling. Perhaps others noticed it but didn't write in. We spotted it as we were making the cover photo selection but decided to use the image anyway because it was the best one in all other respects.

How many other readers noticed the misspelling (barely visible here) in the righthand sign above the umbrella?

Match point
First, please let me thank you for sending me Dartmouth Medicine. As a graduate of Dartmouth College, though not of the Med School, I treasure reading about my fellow premeds of long ago and also about DMS's current activities.

I especially enjoyed the essay about Match Day by Sarah Dotters-Katz in the Summer issue. It brought back memories of my own Match Day in 1954. However, I was a bit surprised that no mention was made of the fact that one of DMS's own alums was a leader of a small group of medical students who established the current matching plan in 1951. W. Hardy Hendren III, DMS '50 and Harvard Medical School '52, while he was a third-year student at Harvard worked extremely effectively to establish the concept behind the matching program, beginning with his graduating class of 1952. This program has made a truly huge change in the process of matching applicants with hospitals for more than half a century.

Hardy became a world leader in his field, pediatric surgery, and is still very active today.

Thanks again, and keep up the good work on Dartmouth Medicine.

C. Peter Crowe, Jr., M.D.
Dartmouth College '51
Tucson, Ariz.

Crowe, who graduated from Harvard Medical School in 1954, two years after Hendren, is correct. Hendren, an alumnus of DMS in the days when the School offered only a two-year preclinical program and all graduates transferred to other schools to complete their M.D.'s, did indeed play a seminal role in creating the concept that underlies the National Resident Matching Program, through which all medical school graduates find a residency position. It's a tale we've told in Dartmouth Medicine, but not one we can go into every time we cover the Match. We're delighted, however, that Crowe's letter gives us a chance to reprise the quite dramatic story of Hendren's role.

DMS actually has a second tie to the history of the Match. When the transition was made in the mid-1990s to an electronic rather than a paper process, the Association of American Medical Colleges committee that oversaw the transition was chaired by DMS's then-dean, Dr. Andrew Wallace.

Kudos for essays
Bravo to Dr. Rassias for his essay on language in your Summer issue! I'm a guy who thinks for a few seconds after saying "to," to decide whether to use the subjective "whoever" or the objective "whomever." When I text, I put in commas and use "for" and not "4," unless I'm discussing the next integer larger than "3." As a former neurologist, I detested the term "blown pupil," rather than "fully dilated." Did somebody breathe on the eye? I also did not like "surgerize."

Now a volunteer math tutor, I have encountered three teachers who use "these ones," which my mother drilled out of me 50 years ago, as well as one teacher who posts on his door the schedule for "Intermidiate" Algebra. Incredibly, nobody but me has noticed, and when I pointed out the error the other math teachers asked me how to spell the word correctly!

Good communication is essential everywhere. However, where, oh, where, is a confidential, nondiscoverable error-reporting system, the way there is in aviation?

I also appreciated Dr. Guardiano's fine essay on the death of her mother. I especially appreciated her comment "I'll tell you what this doctor says. She's dying." I was fortunate with my parents; they made me promise not to let them linger the way so many of their friends had. Their own dying process was short and under their—and my—control. I didn't have to juggle training or practice to care for them. I was good at handling irreversible brain injury with families, and the ICU staff frequently sought me out. Helping people die when it was time was the best thing I did in practice—far better than the few I cured. I would have been absolutely superb in practice after dealing with the deaths of my own parents. Dr. Guardiano will have that chance, and I bet that she will be superb at doing it, for she will have lived firsthand through the pain, the guilt, and the family dynamics.

On a more trivial note, I was recently hacking at buffelgrass (an invasive species in Arizona) when I saw a bicyclist fall on the road. Luckily, he wasn't hurt badly. And as it happened, that was the one day in the past five years that I was wearing a Dartmouth hat—and his daughter was an alumna!

Michael S. Smith, M.D.
Dartmouth College '70
Tucson, Ariz.

A comment and a caution
I was a bit taken aback by the article announcing the formation of the Dartmouth Center for Health Care Delivery Science in the Summer 2010 issue. The stated purpose of the Center is "figuring out the best way to provide effective, appropriate care at a reasonable cost." I have no argument there. However, President Kim, the architect of this new interdisciplinary project, issued "a clarion call to colleges and universities throughout the country" to join Dartmouth in developing similar centers within five years.

I would like to respond to this call by suggesting that teaching the science of health-care delivery is ongoing at major colleges and universities across the U.S. at this very time. The schools of public health at UC Berkeley and UCLA, where I received graduate degrees in health-care management, as well as schools of business and departments of health-care policy, planning and development, and other fields across the country, are currently offering multidisciplinary courses and degrees, both master's and doctorates, in health-care delivery science.

While Dartmouth should be congratulated for establishing this Center with an anonymous gift of $35 million, and while its students will attain knowledge in medicine and health-care delivery through research and collaboration, I caution the Center's leaders lest they be under the misapprehension that academia can influence health-care policy in our statehouses and the nation's capitol. Politics is a force unto its own that is basically unfamiliar to most professors and academic administrators.

Daniel M. Anzel, Dr.P.H.
Dartmouth College '55
Los Angeles, Calif.

Anzel is a professor emeritus at the University of Southern California School of Medicine. For more on the new Center for Health Care Delivery Science, including the elements that distinguish it from attempts elsewhere to tackle the health-care delivery conundrum, see the article "Delivering the goods."

Thumbs up for going green
I enjoyed the Summer issue Editor's Note, "We're big on being green". As someone who considers himself green, I would like to stop receiving the paper copy of the magazine, since I am happy to read it online.

Can you help me do that? Thanks!

David Aman
Hanover, N.H.

We're delighted to accommodate requests like this from readers who want to help us minimize our output of paper. We've made a note to stop sending Aman our print edition and explained to him that currently, the way to read the magazine online is to check in early or mid July, October, January, and April at http://dartmed.dartmouth.edu. Our online edition is available there a few weeks after the paper edition comes out.

But we'll soon be making that process much easier. We plan to implement an e-subscription option, so people don't have to check our site but can sign up to get an e-mail, containing a list of key stories and a link to the online edition, whenever a new issue is posted. We'll be sure to announce this option both in the paper edition and online as soon as it's available.

But though we aim to be as green as possible, we are also committed to meeting our readers' preferences as to print versus pixels. One of the questions we asked in a reader survey in the last issue was whether people would rather get DM on paper, online, or both. Responses to the survey are still coming in so we haven't finished analyzing them yet, but a check of the answers to that question shows that 91% of respondents want to keep getting the paper edition, either by itself or in conjunction with the online edition.

However, partisans of neither print nor pixels need to worry—we plan to both preserve the former for the foreseeable future and to keep augmenting the latter.

So check out our online edition—including to watch, listen to, or read our web-extra content or to easily forward articles to friends or colleagues.