|
|
|
A hub for health
care
Schools can provide access
to health care for children who might not otherwise see a doctor, former
U.S. Surgeon General Joycelyn Elders, M.D., said during a visit
to New Haven in early July. Speaking to teachers, principals, program
directors and policymakers at the 12th annual conference of the School
of the 21st Century (21C) initiative, Elders urged schools to establish
clinics focusing on prevention. “You can’t educate people who
are not healthy, and you certainly can’t keep people healthy if they’re
not educated,” said Elders. Established in 1988, the 21C initiative
was founded by Edward F. Zigler, Ph.D., one of the principal architects
of the federal Head Start Program, Sterling Professor of Psychology and
a faculty member in the Child Study Center. More than 1,300 schools in
20 states have adopted the program, which transforms schools into multiservice
centers providing a variety of resources for children, parents, teachers
and child-care providers.
|
|
|
|
Guarding
against germ warfare
When federal officials simulated
a bioterrorist attack on Denver, Colo., last year, “the city was
lost,” said Alan S. Rudolph, Ph.D., M.B.A., a program manager
at the Defense Advanced Research Projects Agency. “They had to close
the borders of the state of Colorado and they still couldn’t contain
the pathogen they were modeling, a strain of plague.”
In remarks that seem prescient
today after the terror attacks on the East Coast, Rudolph discussed the
Colorado simulation exercise during a talk at surgical grand rounds in
May. His topic? “Technological Challenges in Defending the U.S. against
Biological and Chemical Warfare.” The simulation, Rudolph said, “taught
us that we are ill-prepared to deal with this problem.” The military,
he continued, must rethink its traditional mission of defending against
a nuclear threat from a large adversary. “It is clear that a small
number of people can perpetrate a fairly large effect,” he said.
Protection efforts require the coordination of different agencies, he
said. On September 20, President Bush announced a new cabinet position
for homeland security to unify the government’s anti-terror efforts.
|
|
|
|
Racial
disparities and
community health
“The driving force behind
racial inequality in health,” said David R. Williams, Ph.D.,
“is the economic circumstances of social groups.” Williams,
a sociology professor at the University of Michigan and former Yale faculty
member, was a keynote speaker in May at a conference titled “The
Impact of Poverty on Individual and Community Health,” sponsored
by the Department of Psychiatry’s Division for Prevention and Community
Research. “Economic status is accounting for most of the racial difference
in health, but not all of it,” Williams said. “Poor white men
still live longer than poor black men. The racial differences in economic
status are not an act of God, but reflect the implementation of racial
policies in society that have predictable outcomes.”
|
|
|
|
Healing
outside the box
When Rachel Naomi Remen,
M.D., spoke at the Yale Cancer Center in May about the will to live, she
touched more than once on medicine’s preoccupation with control.
“We may be so deeply into the pursuit of mastery,” said the
author of the national bestseller Kitchen Table Wisdom, “that
we may not see mystery when it happens directly in front of us.”
Remen told of a patient she treated as an intern at Memorial Sloan-Kettering
whose bones and lungs were riddled with cancer. During a two-week hospitalization,
his lesions disappeared for no apparent reason. “Were we in awe?”
said Remen. “Certainly not. We were frustrated. It was obvious we
had misdiagnosed this man.” Pathologists consulted for a second opinion
concurred with the original diagnosis of osteogenic sarcoma. When the
patient was presented at grand rounds, the 250 physicians there concluded
that the chemotherapy that had been stopped 11 months before had suddenly
worked. “I sometimes wonder if too great a scientific objectivity
can actually make you blind,” said Remen. “It was 15 years before
I began to question this conclusion. When everyone is thinking inside
of the box, it is hard to think anything new, but outside the box is often
where life is.”
|
Originally published in Yale Medicine,
Autumn 2001.