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OOne of the letters below celebrates the kind of physicianpatient relationship that may have been more common in times past, while another letter celebrates the fact that—for women in medicine—conditions today are much better than in days of yore.

We're always glad to hear from readers about matters pertaining to medicine at Dartmouth or to the contents of past issues of Dartmouth Medicine. Letters to the editor may be sent to Letters may be edited for clarity, length, or the appropriateness of the subject matter.

Reflections on relativity
I really enjoyed the article titled "At Home," by Dr. William Toms. It told me a lot about the kind of doctor he is and the kind of medicine he practices. He reminded me of a pediatrics preceptor I had when I was a student at DMS, Dr. Kaplan, whom I accompanied on several home visits. Whenever I have cause to reflect on Dr. Kaplan, I am reminded of how much home visits help a doctor to understand patients in their own circumstances. It is simply impossible to get that same understanding by taking a history in your office.

The article also gave me an opportunity to reflect anew on the physician-patient relationship. It is a bond of such intimacy, but it can also be one of distance. As a pediatrician, I often see kids who are the same ages as my own boys. It has struck me many times that if I had met some patients' mothers on the playground, at a birthday party, or at a sporting event, we might have exchanged phone numbers to arrange a playdate for our kids. But my relationship with my patients' mothers generally stays within the confines of the office. It mostly works well that way, for visits then have structure, definition, and a level of objectivity that can be very valuable. But there are some such relationships that evolve to a deeper level, some mothers who truly become friends. I treasure those relationships beyond measure, for connecting with patients on a deeper level gives me satisfaction well beyond making a clever diagnosis.

That seems to be true of Dr. Toms as well. I enjoyed reading how he and this one patient truly, unapologetically became dear friends. I also loved how the mood of the poems that form the heart of the feature moved from sunny and chipper to slow and sorrowful—taking the reader along on the emotional journey that these two had together.

By the end, it was clear that these friends really didn't want to say good-bye to each other. The final poem is so poignant that every time I read it, it makes me tearful. Thank you for showing what the physician-patient relationship can aspire to.

Julia Nordgren, M.D.
DMS '99, HS '02-03
Guilford, Conn.

Hail, Columbia(n)?
I just finished reading the article about Dartmouth and the Civil War and found it wonderful. But I wish to make a correction to the caption of the photograph on page 42 (which is reproduced below). The hospital labeled as the Columbian Hospital is actually Columbia Hospital, which later became Columbia Hospital for Women and about 10 years ago was converted into a high-end condo. The building was deemed historical by the Historical Preservation Society, so it couldn't be torn down. I worked there for 22 years.

This feature by a retired Dartmouth-Hitchcock family physician drew praise for illuminating the intimacy that the physician-patient relationship can aspire to.

In addition, I had a great-great-grandfather who fought at the Battle of Fredericksburg, where another of the photos in the article was taken.

Again, it was a great article.

Carolin Ringwall, R.N.
Oakton, Va.

It appears that Columbian Hospital and Columbia Hospital bear a resemblance to each other architecturally as well as nomenclaturally. So although we're pretty confident the photo above is indeed Columbian Hospital, it's easy to see how Ringwall could have taken it for Columbia Hospital. Readers interested in comparing the two structures can see a more tightly cropped version of the photo included in our article, and a photo of Columbia Hospital for Women. We appreciate Ringwall bringing to light the fascinating similarity.

No nostalgia here
I was very interested in your article about women in medicine, especially at Dartmouth. I graduated from Columbia University College of Physicians and Surgeons in 1953 and served my rotating internship at the old Mary Hitchcock Hospital. The feeling was that it would be "okay," since I was married to an internist who was spending a year as a cardiologist at the White River Junction VA. (We lived for that year at 6 Rope Ferry Road.)

I was told there had been one other female intern, but "she had worn long earrings in the operating room." I recused myself from army-style physicals at Dick's House but did take the urology rotation, much to the apprehension of the staff.

One reader thought the photo above might be a case of mistaken identity.

My experiences mirror those of the women quoted in the article. When I was applying to medical school, I was often asked "How many times have you been in love?" and "Do you plan to get married?" and "Certainly you don't expect to have children!" It was only after I earned an M.S. in zoology and reapplied that my application was taken seriously.

Application for residency was somewhat more straightforward, since I was headed for a career in anesthesiology. I started at the Massachusetts General Hospital (MGH) and transferred to the Peter Bent Brigham Hospital (PBBH) after six months. At the MGH, the men had call rooms in the hospital, but the women's call rooms were in an old firehouse down the street. We literally ran between buildings, since it was a very questionable area near Scolley Square. I disconcerted the PBBH because anesthesia was a section within the Department of Surgery at that time. So I was the first woman in surgery at the PBBH, in spite of the fact that, so I was told, there were "no call rooms for women" except with the nurses.

Academic advancement was dependent on publishing, and I could not manage that and my household of three sons. In the beginning, I wasn't even allowed to take the specialty boards (because I'd "interrupted my training" with pregnancy—although interruption for service in the military was approved; this policy was later countermanded). Since there was no option for maternity leave, I had to change hospitals each time I gave birth.

Attitudes have changed since then, thank goodness. I practiced for 35 years and loved it, despite the roadblocks.

Julie S. Crocker, M.D.
Housestaff '53-54
Peterborough, N.H.

An Ears-plug
I just read the article about Dartmouth Ears and wanted to congratulate all the participants in the program.

I am a volunteer caregiver coach with a similar program at Montefiore Medical Center in the Bronx. Volunteers at our Caregiver Support Center aren't involved directly with patients, like Ears volunteers, but we are involved, as needed, with their caregivers. We can offer a lovely lounge area with phone and computer access and, most important, shoulders to lean on as we listen to their concerns.

A reader who was one of the early women on the Mary Hitchcock housestaff was inspired by this article to recall how much has changed for women in medicine.

Caregivers are most appreciative, and if they're pleased with our services then it must help patients as well. We currently have 16 volunteers who staff the center from 9:00 to 5:00, five days a week, plus one paid, very capable administrative assistant.

Once again, all the best with Dartmouth Ears.

Alan Epstein
Dartmouth College '47
Mamaroneck, N.Y.

Narrative hook
This letter has been in my head ever since I read Jennifer Durgin's article about NH-INBRE. I am now finally sending it.

She is a great writer—that much is certain. What I particularly loved about her article was her ability to so succinctly identify the key element of our program and to work it into a beautiful narrative—about scientific haves and have-nots and how we at DMS are addressing a statewide concern.

The story reinforced for me the central meaning of the program; this is why I accepted the job and why I enjoy the work we do. I was fascinated, even awed, to see it captured in print. Thank you—a million thanks, really. I'll be keeping this article with me for many years to come!

Charles Wise
Thetford, Vt.

Wise is the project manager at DMS for NH-INBRE—the New Hampshire IDeA (Institutional Development Award) Network of Biomedical Research Excellence. The program, funded by a $15-million federal grant, aims to improve scientific research and education at eight undergraduate institutions in the state.

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