Friday, November 16, 2007

Not the first "first"



OHSU's Oregon National Primate Research Center is in the news today. No matter where you live, it seems, your local news outlet of choice is probably running a story about the cloning breakthrough announced yesterday at ONPRC. Your local news outlet might not have covered the story out of ONPRC earlier this week, when PETA again sent an undercover operative into Primate Center labs to uncover evidence of animal mistreatment at the Hillsboro site. Even the Oregonian remained unconvinced about the severity of PETA's claims, and the announcement of Mitalipov's success in creating primate embryonic stem cells provided further confirmation of the valuable work being done by OHSU's animal researchers.

Of course, this isn't the first breakthrough to by logged by researchers here, and although the enormity of the task of maintaining of a list of the University's "firsts" has bested the most diligent staffers here (including yours truly, and I've tried), ONPRC maintains its own small list of recent advances on its website. More basic facts about research at OHSU can be found on one of the "about" pages, including the impressive finding that OHSU researchers are producing "one new breakthrough, innovation or discovery every four days."

The Oregon National Primate Center, originally dedicated in May 1962 as the Oregon Regional Primate Research Center, was the first research center of its kind in North America. While the center is often shy about divulging specifics about its researchers (with good reason; having worked out at the West Campus for a time myself, I can testify to the routine presence of animal rights protesters and their often questionable tactics and actions), a short fact sheet and historical time line are both available online.

Since the inception of the Oregon Center, another seven primate centers have been established around the country. All are funded by the National Institutes of Health and all are dedicated to advancing scientific knowledge through the study of nonhuman primates. A short history of the national primate centers is available from the center at the University of Wisconsin, Madison.

Thursday, November 15, 2007

Women in dentistry

We've talked a bit lately about women in medicine, spurred by our participation in the 2008 Portland showing of the National Library of Medicine's exhibit, Changing the Face of Medicine: Celebrating America's Women Physicians, hosted by the Central Branch of the Multnomah County Library.

But what about women in dentistry? For some brief information on this topic, there's no better place to start than W. Claude Adams' History of Dentistry in Oregon, a companion volume of sorts to Olof Larsell's The Doctor in Oregon. Written in 1956 on the occasion of the "consummation ... of one hundred and ten years of progress in dentistry in Oregon," Adams' history covers the pioneer days of "primitive dentistry" through the 1950s, highlighting dental organizations, practice, education (merger mania!), research, and consumer health as well as "present-day problems" like payment plans, insurance, and legislation.

Adams devotes an entire chapter to women in Oregon dentistry. Writing from the vantage of a successful male dentist at the top of his game in postwar America, Adams writes:
Knowing of the prejudice against which women in dentistry had to battle, mere man can do no less than admire the courage of the women who braved the opposition and chose dentistry as a life work.
Most of the women dentists he chooses to include in his narrative are those who graduated from dental schools in the 1890s and early 1900s, such as Lizzie Stewart and Alice Magilton, two 1902 graduates of the North Pacific College (a predecessor of the OHSU School of Dentistry). Stewart went on to practice in Seattle, while Magilton chose Klamath Falls as her home base.

Several notable women dentists in turn-of-the-century Oregon practiced jointly with their husbands. One such, Dr. Mollie Bowman Hickey (1866-1951), came to Portland with her husband in 1894 after graduation from the University of Iowa dental school. After her husband's death, Hickey continued in solo practice until her retirement in 1944. Adams notes that "she was especially successful with artificial dentures."

Reading about Dr. Grace Keith Pulliam, I was struck by the similarities between the wartime activities of Pulliam and Esther Pohl Lovejoy, one of our most notable female medical graduates. A 1908 graduate of the University of Michigan School of Dentistry, Pulliam opened her practice in Portland in 1909 becoming the first dentist in Oregon to specialize in periodontia. She was also a charter member of the Academy of Periodontology in 1914 and was made an honorary life member upon her retirement from active practice. During World War I, Pulliam served with the American Red Cross in France as a dentist for refugee children; when that service was discontinued, Pulliam stayed on as "a canteen worker at Brest, the debarkation point." Her dedication to dental care for the war-torn nation no doubt earned her much respect among her colleagues. After her return to the United States, Pulliam went on to serve as president of the Association of Women Dentists (1931-32). At that time, Adams notes, there were approximately 1200 women dentists in the U.S. and Canada.

For more facts about the history of women in dentistry and about current activities of women dentists, check out the American Association of Women Dentists' website.

Wednesday, November 14, 2007

140 years of surgical history

On Monday, we heard some opinions about the influence of surgery in the 21st century; now, we can read more about the influence of surgery since the 19th century in a new work just published by the OHSU Department of Surgery. History of the Department of Surgery, 1867-2007 was written by Patricia Southard, R.N., J.D., and edited by many notable surgical faculty past and present including Drs. John Hunter, Don Trunkey, Cliff and Karen Deveney and several others.

The volume includes a short history of the University, a history of the Dept. of Surgery, and histories of the surgical divisions (general surgery, pediatric surgery, plastic and reconstructive surgery, trauma and surgical critical care, cardiothoracic surgery, vascular surgery, surgical oncology, urology and kidney transplantation, liver and pancreas transplantation, orthopedics, and neurosurgery). Based on source materials here in Historical Collections & Archives as well as departmental records, the Oregonian news archives, and the institutional memory held only in the brains of senior practitioners from the community, the story begins with the establishment of the Willamette University Medical Department in 1867 and extends right up through late 2007 (Dr. Albert Starr's reception of the 2007 Lasker Award and the performance of the first natural orifice transluminal endoscopic procedure by teams at OHSU and Ohio State University in September are both included). A six-page timeline of departmental highlights supplements the narrative.

Interestingly, a whole chapter of this institutional history is devoted to "The Downtown Surgeons." Conflicts between town and gown have long been a feature of the history of medicine in Portland, but it is equally true that the university as we know it today would not exist without the myriad valuable contributions of private practice physicians who did donate and continue to donate their time and effort to advancing the missions of teaching, healing, and research. The Dept. of Surgery history formally recognizes several of these contributors, including Drs. John B. Cleland, Lewis P. Gambee, William Garnjobst, and Roger Alberty, who is currently Director of Surgery at Providence St. Vincent Hospital.

Dr. Hunter's introduction nicely summarizes the history of the department over the last 140 years:
In researching the history of the department, the common theme that emerged was the presence of a pioneer spirit that allowed individuals with imagination to push the frontiers of surgery, but required that progress be forged by dint of determination and resourcefulness rather than privilege and entitlement.
To get your hands on this history, watch for this slim volume to appear in the catalog.

Tuesday, November 13, 2007

New Lovejoyana

Last week we received two more pieces of Esther Pohl Lovejoy-ana from Maxine Fraade, donor of a major portion of the Lovejoy materials currently held by our repository.

One, an issue of American Women's Club Magazine, London (v. 4, no. 3, March 1928), contains a short article on "American Women's Hospitals in Greece." Written by Julie Helen Heyneman, it focuses on the efforts of the AWH in Greece in the period 1922-1928. Cutting short the complete narrative of events, Heyneman writes:
However, Dr. Esther Lovejoy has told that whole astounding story--an epic if there ever was one--in her book Certain Samaritans, which is probably on the shelves of the library. If it is not, I urgently suggest that it should be, so that whenever we feel depressed about manifestations at home with which we are out of sympathy, we may have our righteous pride reinforced by the account of the activities of the women who enlisted under the banner of the American Women's Hospitals in the Balkans." (p. 142)
And who can't use a little reinforcement of righteous pride on occasion?

The other donated item, an issue of the American Women's Club of Paris Bulletin (v. I, no. 21, Sept. 1924), includes a piece on the ceremony at which Lovejoy received the Legion of Honor from France, "The Fete at the Residence Sociale in honour of Docteur Esther Lovejoy." The commendation itself had been awarded on Oct. 26, 1923; the citation read, in part (pardon the lack of proper punctuation):
"On peut sans crainte insister sur l'influence enorme exercee par le Docteur Esther Lovejoy, soit par la parole, soit par son livre: "The House of the Good Neighbor," edite chez Macmillan et preface par Herbert Hoover, lequel constitue une excellente propagande francophile..."
I wouldn't have thought of the book as French propaganda, but maybe we should add some subject headings for that... The article goes on to state:
On a radiant Sunday afternoon of this July, the "Residence" held fete at Levallois for Doctor Lovejoy, in affectionate gratitude for the gift to humanity of her beneficient life since 1917. What this gift of herself has been to France and to the near East is known to all the world! In the little portrait of Doctor Lovejoy accompanying this story we see looking from starlit eyes the deep enthusiasms, the fine intellectuality of a fervid spirit, in its first vivid living. On that Sunday afternoon a little while ago, the blue eyes flashed the same rare glance of eternal youth but the hair told of her self-gift to a world that suffers, and gleamed silvery white, exquisite, about the lovely face, at once portraying and framing her thorough-bred personality, strenuous and dainty in one. (p. 691)
All the photos in our collections confirm this description: Lovejoy does appear dainty and strenuous in each. These two newly donated pieces will be wonderful additions to our Lovejoy collections, and provide that much more support for the monumental legacy of her work as "Oregon's doctor to the world."

Monday, November 12, 2007

Fifth annual Donald D. Trunkey Lecture

I arrived back from my week away just in time to attend the fifth annual Donald D. Trunkey Lecture this morning, held as part of the OHSU Dept. of Surgery's Grand Rounds. The yearly Trunkey lecture is dedicated to the "history and humanities of surgery," and this morning's talk was a fine example of that strain of scholarship.

Dr. Haile Debas, currently executive director of Global Health Sciences at UCSF, presented his talk on "The influence of surgery in the 21st century." Department chair John Hunter, M.D., outlined some of the similarities between Trunkey and Debas in his introduction, which include not only year of birth (1937) but distinguished careers at UCSF and even time spent here at the Medical School. Debas confessed that he had spent the summer between his second and third years of medical school in Portland, partly at UOMS and partly at St. Vincent Hospital; from that experience, Debas told the audience, he "knew that God lives here."

Debas began by noting that while surgery is one of the oldest professions in the world, it -- like another of the "oldest professions" -- got very little respect for most of its history. It has only been in the last century that surgeons have gained prominence as skilled practitioners of the healing arts; Debas went on to share his thoughts on how surgery can build on its past success and maintain its influence in the coming century.

Key to maintaining surgery's prominent place in medicine is education of medical students, who, according to Debas, should be introduced to surgery in the preclinical years (years 1 and 2 of medical school), before they are told that surgery is difficult and uninteresting. Debas believes that the younger students would be more receptive to the notion that "the definitive treatment is surgical treatment," and that more would be recruited into the field. Surgery must also become more flexible, Debas noted, so that women, among others, would be more willing to commit to surgical careers.

While surgical leaders have, to date, generally been chosen according to the Peter Principle, Debas urged the audience to consider proactive and structured development of the surgical leaders of tomorrow. Those leaders should focus on maintaining surgery's strengths in robotics and digital imaging technologies; leverage the new developments in stem cell and regenerative medicine; and pioneer new advances in tissue engineering. These efforts will require interdisciplinary collaborations and team-based approaches, which surgeons should embrace and foster.

Debas' main interest, however, lies in surgery's role in global health initiatives. Emphasizing that surgery is a public health strategy, Debas outlined four areas in which surgery must contribute to global health: treatment of injuries (trauma), obstetrics, emergency medicine, and major types of elective surgeries (such as cataract surgery). The "unprecedented" groundswell of interest in global health is coming from students, residents, and established faculty alike, who see it as a major trend in healthcare. Medical education in developing countries, medical tourism, and impending global conflicts over the effects of global warming are all major components of the global health movements in American medicine.

Here at OHSU, the Global Health Alliance is a student group that focuses on global health equity. Much of the philosophy and ethic behind this current interest in global health recalls an earlier era of medicine, especially the international efforts of Dr. Esther Pohl Lovejoy and her colleagues in progressive Portland and across the world to establish institutions and organizations dedicated to universal health care and global health equity. Many of Lovejoy's writings continue to resonate today; let us hope that the renewed spirit of cooperation is as persistent as the written word.