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REPORT CARD: In the National Research Council's ranking of 5,000 U.S. doctoral programs, pharmacology-toxicology and physiology at DMS were among the top 10 such programs nationally and molecular and cellular biology was in the top 20.

BRIGHT IDEAS: Healthspottr.com ("we believe in the future of health care" is its mantra) recently named the top 100 healthcare innovators in the United States. Three are from DMS: Drs. Jack Wennberg (#7), John Wasson (#14), and Elliott Fisher (#18).

Farm-acology Initiative

Say "migrant farmworker" and most people think of picking lettuce in California, not milking cows in New England. But many area dairy farms can't hire enough labor locally and so use migrant workers. Exact numbers are hard to come by, but there may be over 2,000 in Vermont and New Hampshire.

Something else that's hard to come by, for the workers themselves, is health care. But thanks to two Dartmouth medical students, Karl Dietrich and Holly Schroeder, that's changing. With funding from an Albert Schweitzer Fellowship, they're reaching out to workers on dairy farms throughout the Upper Valley. They've met with about 40 so far and expect to reach many more. They're conducting health screenings and making sure workers are aware of the resources at Little Rivers Health Care, a Bradford, Vt.-based federally qualified health center.

"Most of the migrant workers we've met don't know that 10 minutes away there is a federally qualified health center that will see them for free," Dietrich and Schroeder explained in an e-mail. And, they added, the workers "are reluctant to do anything that takes them away from making the money they need to send home." So they're now tackling those problems, as well as creating a DMS interest group to sustain the effort.


IT'S A BIRD, IT'S A PLANE: No, it's med student Mike Piccioli. The intellectual prowess he flexes in class is matched by his physical prowess. Piccioli pulled a 24-ton fire engine 75 feet in 29 seconds to become New Hampshire's Strongest Man.

Exceptions opportunities

Watch the talk by Collins on the future of biomedical research
View video

EXTRA! EXTRA!: On November 8, Dartmouth rated what may be the 2010 version of a banner headline: a Google home-page link. The browser's tribute to the x-ray linked to a Wikipedia entry citing Dartmouth as the site, in 1896, of the first medical x-ray in the U.S.

GIVE ME FIVE: Dr. Francis Collins, the director of the National Institutes of Health, gave the inaugural C. Everett Koop Lecture at DHMC in November. He called Koop an "icon" and listed five areas of biomedical research he thinks are ripe with opportunity.

Signature of the times

When Dr. Ira Byock asks a patient to sign an advance directive, sometimes the patient's eyes will widen in surprise. "I'm not dying," he often hears. But everyone should have an advance directive, Byock believes, not just those who are close to death. He has one, as do his wife and two adult daughters.

An advance directive is simply a document that takes effect if people are unable to make decisions about their own care as a result of injury or illness. It can state their individual preferences regarding the kinds of treatments they would want, such as whether they'd want CPR if they were terminally ill. Or the document can simply designate someone else to make those decisions.

Byock's persistence is part of an effort to get every DHMC patient who undergoes a procedure requiring informed consent, as well as every employee, to sign an advance directive. The effort puts DHMC in the vanguard of a national trend. "Asking about an advance directive isn't a hidden message that somebody is ill," Byock says. "It's a clear message that, at DHMC, we think this is part of giving the best care possible."


TAKEN FOR GRANITE: DMS and the University of New Hampshire are the lead institutions on a $15.5-million federal grant to bring research opportunities to students and faculty members at eight undergraduate schools throughout the Granite State.

DIE-CAST: The Dartmouth Atlas reported that between 2003 and 2007, nearly a third of patients with advanced cancer died in hospitals and ICUs. The rate of hospital deaths ranged from 47% in Manhattan to 7% in Mason City, Iowa.

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