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Philadelphia Inquirer's magazine section and of its editorial page.

Another butterfly
Congratulations on another fine issue of Dartmouth Medicine and for 30 years of a magazine that continues to inform alumni and help us stay connected to the roots of our experience in medicine. It seems like only yesterday that I enjoyed the seminal issue in the Fall of 1976.

I am a firm believer in the "butterfly effect," the subject of the Editor's Note in the Winter 2006 issue, and deeply appreciate the ripples that Dean Strickler has generated in both medical education and international health. I'm certain that we can't even begin to measure the effect Jim has had on countless students, young doctors, and untold millions of people displaced by conflict in the past few decades. He truly has been a leader in international health since his "retirement" from DMS.

But no issue of Dartmouth Medicine celebrating 30 years would be complete without a mention of another important "butterfly"—Dr. George Margolis, an early guiding spirit of the magazine (then the Dartmouth Medical School Alumni Magazine) and its senior editor for seven years. And George was not only a professor of neuropathology but also, in his role as director of minority student affairs, for many years led the effort to make DMS a welcoming and culturally diverse community. He was truly a "humanitarian for all seasons" and is still very much missed.

George also helped to broaden the criteria of excellence in medicine. In the Spring 1977 issue of this magazine, he referred to Eleazar Wheelock's watchwords, Vox clamantis in deserto ("A voice crying out in the wilderness"), and wrote: "The eminence of a medical school is to be measured not merely on the narrow basis of the practical knowledge imparted to its students. The level of social consciousness instilled in them, and the quality of care delivered to the surrounding population, beset by the ills attending poverty, loom just as large as criteria of excellence."

George Margolis's ripples still reverberate as we strive to practice medicine in a fashion that is culturally sensitive and competent, or, as we would like to believe, just "good medicine."

Robert M. Rufsvold, M.D., DMS '79
Lyme, N.H.

An amazing joint
I usually read Dartmouth Medicine just before going to sleep. This item in the

This box of statistics on prosthetic joints set one reader's mind spinning.

"Facts & Figures" box in the Winter 2006 issue caught my imagination: How are ">8,000 . . . explanted joints" stored, and with what kind of categorizing, etc.? It certainly has been an interesting mental exercise thinking about this. What a valuable resource, and what a monumental job!

Dona Jackson
Lyndonville, Vt.

We invited Dr. Michael Mayor, who was instrumental in establishing Dartmouth's prosthetic joint laboratory, to respond to this question. He wrote: "The 8,000 items are all manner of metal and plastic joint replacement parts that have been through a highly varied life in service to patients whose joints needed replacing for any of many reasons. It has been my responsibility and privilege to evaluate each piece as it came in to assess the damage it may have suffered, assign a value to the modes of damage, photograph it from many angles, and then move it along through a myriad of special evaluations to further explore how its service life has impacted the materials of which it was made.

"All this information is gathered in a computer so sense can be made of how human activities alter these materials, especially in undesirable ways. Once enough information is available, ordered analyses can follow, so they can be shared with the world in some form or other. This may involve a visit by interested parties to the laboratory, posters and/or presentations at international meetings, or papers in peer-reviewed journals.

"We've been gratified to have made a difference in how joint replacement parts are produced. It's been an effort to create

a set of approaches that are durable and more benevolent in service to people whose joints have 'gone south' on them. Combining insights from clinical practice and engineering science has been especially gratifying.

"Many thanks for your inquiry. Here's hoping you sleep soundly."

Topical storm
The diversity in the Spring 2007 issue of Dartmouth Medicine was outstanding. It is not often a reader can identify with so many topics. Here's what I found:

Faculty Focus: I used to work for Dr. Rosen.

Point of View: My father was mentally ill.

"Treating trauma in women veterans": I have suffered from PTSD myself.

"Pancreatic cancer: Deadly and on the rise": I lost a dear friend to this disease recently.

"When 'once upon a time' comes true": I know Wafica Brooks (the nurse who took care of Dr. Shoemaker), as well as her parents, from my church.

Thank you for reaching out to so many readers and on such different levels. Somehow this enables us not to feel isolated on cold winter days.

Mimi Baird
Woodstock, Vt.

The family business
I just finished the latest issue of Dartmouth Medicine and would like to have my niece added to your subscription list. She's about to graduate as a nurse practitioner from Mass General, and we'd love to see her eventually move back to New Hampshire. Perhaps DM will help convince her that she belongs here. Her grandfather practiced medicine on Boston's North Shore, and she was very fond of my father, Dr. John Milne, a fixture at MHMH for many years.

Many thanks for your excellent magazine.

Jeff Milne, DC '67
New London, N.H.

Reading matter
I was in the Manchester, N.H., library on Saturday and happened to pick up your magazine. Two hours later I decided I needed to be on your mailing list!

Katy Kramer
Manchester, N.H.

We're happy to add to our mailing list anyone at a U.S. address who's interested in the subjects we cover.

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