photo, judging by the plain white caps, would have been taken during our first year—so in the fall of 1970 or the winter or spring of 1971.

This happened to be my class. I recognized those in the front row right away and then found myself in the back row (wearing dark-framed glasses, looking up).

Sally Patton, M.S.,
MHMH SON '73
Lebanon, N.H.

Patton is nursing director of the inpatient surgical services at DHMC.

. . . and cuffs that chafed
I read with gratitude and nostalgia your article on the Hitchcock School of Nursing. Much to my surprise, the undated photo here is of my class. We graduated in 1964, so the photo would have been taken in the winter of 1961-62. We are wearing caps, so it is after our probation period—but we are still wearing the collars and cuffs that chafed and choked us, so we have not completed our first year (after which we received a triangular and much kinder kerchief). And each one of those white buttons had to be carefully inserted in its buttonhole—usually the night before the uniform was to be donned, because it took so long we would never have been on time for anything. And judging from the length of the skirts and aprons, we had not yet dared to introduce "fashion" by shortening them—then being subjected to the "bend-over test" to make sure the tops of our stockings were not visible should we lean over to select a treat from the ice cream bin in the dining hall (mustn't present an unchaste appearance to all the males in the cafeteria!).

I recognize most of the students but do not see myself. The teacher looks familiar, but I don't recall her name.

I was particularly interested in the comments about the nurse-physician relationship being more collaborative and collegial at DHMC than in many other institutions. It helps me to understand where my rather "uppity" assumption that that was the norm had its roots. That attitude/belief hasn't always set well here in the south, where "nurse as handmaiden to the doctor" has until recently been the expectation.

My spouse (Peter Wright, DMS '65) and I had a wonderful time at his class's 40th reunion this past September and are looking forward to moving back to the area in a few years' time.

Again, thank you for such a comprehensive and caring article on a very formative aspect of my life.

Penelope Frizzell Wright,
M.S.N., MHMH SON '64
Nashville, Tenn.

We checked with Peter Nolette, B.S.N., a 1977 graduate of the MHMH School of Nursing and the school's de facto historian, to see if he could settle the "which class was it" question. But the plot thickened—he was sure he recognized a member of the Class of '66, and he said another '66 was certain the class was hers. But there appears to be no doubt that the faculty member pictured is Olive Cummings (later Paine; she married after she retired), who taught nursing arts.

Cultivating relationships
The essay by Jonathan Ross—"Is this what we want?" in the Spring 2005 Dartmouth Medicine—raises a number of issues overlooked in our compartmentalized approach to medical care. One of my close friends, dependent for care on the internal medicine division at DHMC, has difficulty reaching her physician and often encounters an entirely new physician for followup care. This is quite in contrast to her previous physician, who almost always returned her calls and seemed to understand her needs prior to his untimely death a few years ago. She feels her care is now impersonal in contrast.

Her observations are echoed at Maine Medical Center in Portland, which is similar in size to Dartmouth-Hitchcock Medical Center. Both institutions are known for their superb achievements with hospitalized patients, due largely to

competent specialists—many of whom are outstanding in their skills.

But I believe that DMS needs to continue and expand its efforts to create an environment that encourages young doctors to take an interest in the patient as a person, to understand the patient's concerns and fears, and even to provide house calls for local patients. I agree with Dr. Ross that interpersonal relationships with patients and families are important to cultivate and should be encouraged throughout the training of students and residents, regardless of their fields of interest.

DMS has developed a fine program to foster these relationships, but such training is in danger of being eclipsed by clinical duties and long working hours.

John Radebaugh, M.D.
Falmouth, Maine

Radebaugh, a clinical associate professor emeritus of community and family medicine at Dartmouth, wrote a feature for our Spring 2005 issue about his career- long practice of making house calls—to which the next letter is a response.

Bringing down the house
The article in Dartmouth Medicine's Spring issue about Dr. John Radebaugh's total dedication to the care of his patients via the almost-passe house call was inspiring. What a pity that, for all the miracles of modern medicine, the warmth and satisfaction for both patient and physician provided by the house call now hardly exists. It is also of interest to note that many of the letters in the Summer issue lauding his dedication appeared to be from physicians of essentially the