Friday, May 14, 2010

Stories from the Clippings

Do not Spare Them - They Can Take It

There seems to be a plethora of articles written about medical ethics and the principles of self-determination and disclosure. The subject of disclosure not only pertains to medical error but also to whether a physician is obligated to disclose the "truth" about (in the article referenced) the prognosis and treatment of cancer patients with advanced disease. It begs the question of whether to uphold informed consent and self determination processes, in which a patient has the right to make decisions concerning how they want to proceed from diagnosis, versus a physicians concern with preserving a patient's faith in treatment and the brutal impact disclosure might have on the patient's unrealistic expectation of therapy.

"Some cultures do not place a great emphasis on informing the patient of the diagnosis, especially when cancer is the diagnosis. Even American culture did not emphasize truth-telling in a cancer case, up until the 1970s."[i]

In this light, it seems that Dr. Bernard P. Harpole, clinical instructor in surgery at the University of Oregon Medical School, (and, at the time, president-elect of the Academy of General Practice) was either ahead of his time or was encouraging physicians to hark back to earlier times before paternalistic healthcare overshadowed autonomy. The article describes a study published in the April 1955 issue of Current Medical Digest, which revealed his findings concerning disclosure. He garnered information from questionnaires sent to 141 cancer patients with advanced disease. The survey asked whether they preferred full disclosure of their prognosis and the treatment of life threatening illnesses or if they would rather not know the entire truth.

According to Harpole, only 3% did not wish to be informed of their condition. 85% of patients replied that they would want to know when the date of death is predictable and 2% wanted to be notified when death was inevitable. And 96% wanted to know if their parent, spouse, or a child was suffering from an incurable disease. In a second questionnaire, he found that most respondents understood what cancer is and how to recognize some symptoms. He credited the efforts of the medical profession to educate the public but also emphasized the need for continued education.

Dr. Harpole exhorted physicians to reexamine the merit of withholding the truth from patients. Further he contended that withholding the truth is a sure-fire way for patients to lose confidence in the physician. More of the population, he said, understands disease and therapies and are more capable of making their own decisions concerning their future than one might think.

Articles referenced: f1-p56-a1, 3-4

[i] Wikipedia Medical Ethics

Thursday, May 13, 2010

Covering the territory

One of the stock phrases we use around here when talking about the early days of the OHSU School of Medicine is that it was for many years the only medical school north of San Francisco and west of Denver. But did you know that for some years, the OHSU School of Dentistry was the only one north of San Francisco and west of Minneapolis? This is one of many interesting bits of information included in a 1945 article recently received here at the archives.

Virgil Smith's article "Dental School Goal Finally Reached: Casual Committee Task Undertaken at Behest of University of Oregon Becomes Life Work for Dr. Miller" ran a full page in the Sunday Oregonian for June 17, 1945. The piece chronicles the story of the school from its inception in 1898 as the Oregon College of Dentistry, through its merger with the Tacoma College of Dental Surgery in 1899 and the changing of its name to North Pacific College of Oregon, to its inclusion in the state system of higher education as the University of Oregon Dental School on July 1, 1945.

We read that Horace Miller, M.D, D.M.D., was first approached by the University of Oregon about establishing a dental unit in the early 1890s, shortly after Miller had arrived in Portland from Nebraska. The author gingerly describes the environment of dental politics in turn-of-the-century Portland:
There were some practitioners of dentistry in Portland in those days who were rugged individualists, and the committee eventually reported to the university regents that the time was not propitious for a dental school. First, it would be advisable to get the practicing dentists together in an organization, which would support such an institution and provide a competent faculty.
Meanwhile, the Tacoma school had opened and quickly relocated to Portland. By the time the Oregon dentists were ready to embark upon educational endeavors, the accrediting body of the Association of Dental Faculties was reluctant to support two schools in such close proximity. When Miller's proposal to merge the two institutions met with resistance from the stockholders of the Tacoma College, he quietly bought up 51 percent of the shares. (Dentist, doctor, and savvy businessman, apparently!)

In 1908, the North Pacific College opened its school of pharmacy (which lasted until 1941). In 1924 the school changed from a private to a public trust, and while it continued to do well financially, Miller continued to seek affiliation with the UO (NPC was one of only two dental schools, of 39 in the country at that time, that were not affiliated with a larger university). And so, in 1945, the state legislature approved the creation of the University of Oregon Dental School. In 1974, the dental school, along with the medical and nursing schools, joined together to create the University of Oregon Health Sciences Center, which in 1981 changed its name to the Oregon Health Sciences University. And the rest, as they say, is history!

The complete article is included here (click on image for a larger version).

Wednesday, May 12, 2010

More opportunities to show what you know

The busy folks behind the Oregon Encyclopedia have set up more community meetings for Oregonians to come forward and share their knowledge about local history. Learn more about the project and about local history resources in your area at the following events:
Community Meetings at the North Bend, Holgate (Portland), Shaw (Klamath), Newberg, and Baker City Public libraries:

Learn about the valuable historical resources available at your regional library and contribute your knowledge of local history to the Oregon Encyclopedia at one of the upcoming community meetings (listed below). Each meeting includes an overview of the Oregon Encyclopedia, a discussion on how to write an Oregon Encyclopedia entry and information on library resources that support the research and writing of local history.

Saturday, May 8, 2010 (10:00 a.m. - 1:00 p.m.)
North Bend Public Library
1800 Sherman Avenue, North Bend, OR 97459

Tuesday, May 11, 2010 (5:30 p.m. - 7:30 p.m.)
Holgate Library
7905 SE Holgate Blvd., Portland, OR 97206

Wednesday, May 12, 2010 (5:30 p.m. - 7:30 p.m.)
Shaw Historical Library at OIT
3201 Campus Drive, Klamath Falls, OR 97601

Saturday, May 15, 2010 (10:00 a.m. to 12:00 p.m.)
Newberg Public Library
503 E. Hancock Street, Newberg, OR 97132

Saturday, May 22, 2010 (10:00 a.m. - 1:00 p.m.)
Baker City Public Library
2400 Resort Street, Baker City, OR 97814
Suggest a topic! Volunteer to write an entry (or two)! In the race for most entries, the "Science, Medicine & Technology" category is still losing badly to "Arts"--c'mon people, let's help rectify that!

Tuesday, May 11, 2010

Toothsome trove

Yesterday, we highlighted the dental hygiene history materials from Friday's trip to the OHSU School of Dentistry vault; today we'll turn our attention to the rest of the haul.

On an earlier trip, we had picked up the majority of the oversize photographs, including some of dental school classes from a range of years. Last week, we brought up the rest of the class photos in 8 x 10 format, from the 1899 Tacoma Dental College class to the OHSU SOD Class of 2004. We also gathered up a smattering of images in other formats, including 35mm slide, glass plate negative, and copper plate etching. Other audiovisual materials in this installment are the raw footage from the school's centennial in 1999 (VHS) and a 1954 silent film of gold foil technique, created by Kenneth R. Cantwell, DMD (16mm).

A small stack of miscellaneous publications and a few wall plaques--including one rather mysterious one that will bear some study (more to follow, since we'll most likely need to appeal to the readership for some clue as to its meaning) also came up to the archives. But the most entertaining items are, again, the objects.

In a small cardboard box marked "history of prosthodontics", we received a number of dentures. Ivory dentures from the late 18th or early 19th century. Dentures made with the Fonzi technique, using platinum studs to anchor porcelain teeth to the denture base, from the mid-19th century. Vulcanite dentures. Celluloid dentures. A small green velvet-lined case holds three sets of dentures, one quite lurid in its redness (shown here). We even got a miniature set of dentures, created by Dr. T.W. McKinnon "just for fun." One set of dentures was kept to show the remarkable accretion of dental plaque on the prothesis; "disgusting, even to dentists," according to Dr. Henry Clarke. (I'll spare you a photo of that.)

We took in a beautiful dental mallet made of antler (also shown here) and an elevator with an ivory handle, worn to a warm yellow. Two dental keys, anterior and posterior, and two metal tools for removing pins from dental roots (which just sounds painful, doesn't it?)

We have a wonderful set of mounted tooth sections, prepared by student R.F. Banks at the North Pacific College in 1917. A lovely set of loupes (also shown here), a box of assorted handpieces from various eras, and a small box of random items including a glass vial with a worn label whose only legible word is POISON (good thing that word is legible, at least!).

All that, one one cart. Compact, condensed, concentrated--a nice dense history, to sink your teeth into!

Monday, May 10, 2010

Fifty years of dental hygiene history comes to archives

Friday's trip down to the vault at the OHSU School of Dentistry packed so much history onto one library cart that we can't possibly cover it all in one post. So, today we'll concentrate on the materials that chronicle the history of dental hygiene education in Oregon.

In two slim folders, we picked up several articles on that history, including Margaret Ryan's timeline of the OHSU Dental Hygiene Program and Rachel Espey-Holmes' history of dental hygiene in Oregon. The two women witnessed the majority of that history firsthand; Espey-Holmes began as a faculty member at the University of Oregon Dental School in 1954 and served as chair of the dental hygiene program from 1966 to 1976; Ryan was chair of the program from 1977-1997.

The two documents tell us most everything we might want to know about dental hygiene education in the state. For example, records indicate that 48 dental hygiene students completed a certification course through North Pacific Dental College between 1927 and 1947, but there was no Oregon state law defining and licensing dental hygienists during those years. Graduates had to go on to Washington State or other areas where dental hygiene practice was legal. It was not until 1949 that the state passed a law regulating dental hygiene. The first to apply for licenses were some of the school's old alumni, including the first male hygienist, Milton Willoughby, who graduated from UODS in 1947.

In 1949, the University of Oregon Dental School inaugurated a formal, two-year dental hygiene curriculum. It grew for over fifty years with great success until its closure due to budget cuts in 2001. The SOD vault held a wealth of primary materials pertaining to the program, including class photos, commencement programs, administrative records, curricular materials, alumni association records, issues of the newsletter Prophy Pals, news clippings, and ephemera from the program's 1999 Jubilee celebration. These materials will be incorporated into the collections here and made available to researchers. Our great thanks go out to alumna Barbara Marquam, RDH, who did a wonderful job organizing and preserving the materials; her preliminary index is included at the bottom of this post.

More information on the OHSU Dental Hygiene Program can also be obtained from the oral history interview conducted with Peg Ryan in 1998; the tapes and transcript can be checked out from the Main Library.

Dental Hygiene Files Index 4/05
I. Dental Hygiene/Hygienists - news clippings
II. Dental Hygiene Alumni Association
- Administrative
- 50th Jubilee
- Newsletter (1956-1969)
- News clippings
- Photos: reunions, updates
- Reunions
- Updates
III. Dental Hygiene ADHA
IV. Dental Hygiene Dept.
- Adminstrative
- Clinic
- Capping
- Didactic
- Faculty
- Photos: capping ceremony, class photos, faculty, facilities, students
- Pins and faculty badges
- Promotional materials
V. Dental Hygiene Assns - ADHA, Sigma Phi Alpha (1990), Alpha Kappa Gamma (1960)
VI. Dental Hygiene University - commencement and other ceremonies
VII. Dental Hygiene displays and songs and poems