2008

Rules and regulations

By Erik Moore September 23, 2008
AHC documents, Hospitals

Rule #1: Keep your Friday lunch open.

That is rule number one in the nineteen point Rules and Regulations of the University of Minnesota Hospitals approved October 11, 1961.

The Rules, approved by Dean Robert Howard and Ray Amberg, Director of University Hospitals, represent a carefully worded outline of expectations and duties for faculty physicians on staff at the University Hospitals.

The Rules, however, were not formulated without some criticism and changes.

After reviewing a draft version in the spring of 1961, Dr. John McKelvey, Head of Obstetrics and Gynecology, objected to the provision in item number 2 that all patients seen at the University of Minnesota Medical Center be referred by a private physician. He noted that most staff and students’ wives are seen in Obstetrics without such a referral. His suggested substitution was accepted as added language to the rule allowing “Obstetrical patients without a referring physician.”

After the Rules were distributed, Dr. Richard DeWall submitted a complaint regarding item number 15 and the need for all staff to secure autopsies. Dr. DeWall responded by expressing his concern that the effort to secure autopsies would surpass their usefulness and that house staff, not the attending physician, could complete the task.

Also, note an early version of HIPAA in rule number eighteen.

Read the Rules and Regulations below and see you at noon on Friday.

Brutal

By Erik Moore August 27, 2008
Curiosities, Facilities

Erwin’s molar.

That is how some referred to the Health Science Unit A shortly after it was completed in 1971, now officially named the Malcolm Moos Health Sciences Tower. The reference was to the then dean of the School of Dentistry, Erwin Schaffer. The school and dental clinics are one of the primary occupants of the structure.

I have heard others refer to the building as ugly, dark, oppressive, and Orwellian. But the most apt derogatory term would be brutal.

Moos Tower, Weaver-Densford Hall and the Phillips-Wangensteen Building, which comprise the majority of the health sciences complex expansion during the 1970s, are all examples of Brutalism in architecture.

The designation of Brutalism is actually derived from the French term for the style “breton brut,” or literally raw concrete. The style, common from the post-WWII period until the 1970s, is usually marked by rough concrete or stone exteriors with protruding sections that underscore the functionality of the interior spaces over the aesthetics of the facade.

A 2008 story on NPR highlighted the love/hate people have for the brutal style and discussed the move toward designating many structures, to the dismay of the occupants, as historic landmarks.

Boston’s City Hall, which has a strong resemblance to the U of M’s health sciences complex, is one such building on its way to receive a landmark designation.

An institution of worldwide responsibility

By Erik Moore August 13, 2008
AHC documents, Medical school

As many of us spend our evenings watching the Olympic Games in China we have the opportunity to learn more about the country and people who are hosting this year’s games. Television, radio, newspaper and Internet news stories communicate the hardships and advances taking place in one of the world’s most fascinating places.

Twenty-nine years ago, a delegation from the University of Minnesota had the opportunity to learn more about China first hand. Sent by the University administration in support of the recently adopted mission statement of the Board of Regents that cast the U of M as “an institution of worldwide responsibility.” The delegation consisted of twelve members including representatives of the College of Liberal Arts, the Institute of Technology, U of M administration, and two from the Medical School: Dean Neal Gault and Professor Yang Wang. The delegation traveled to various locations during the three week trip in an effort to promote scholarly exchange.

In his own report chronicling the trip, Dean Gault recounted in vivid detail his impressions and thoughts on the hospitality of the officials who welcomed them as well as an account of the infrastructure and institutional challenges China faced as it emerged from the Cultural Revolution.

In one account in particular, Dean Gault captured both the enthusiasm of their hosts as well as the sentiment of friendship when visiting Jilin University.

Smiles, smile, smiles—a[n] ocean full of smiles. Never have I had such a surging within me to imbibe the exhilarating fellowship that was being extended to me; it was a powerful and moving experience that I trust I will never forget. Of course I know such a welcome is extended most visitors and although I think they were so pleased to have the University of Minnesota there I suspect others who come will get the same first class treatment. For the Chinese are very hospitable people who are very kind and gracious.

Dean Gault’s praise and excitement came from a man whose own experiences at Seoul National University and the Okinawa General Hospital made him quite qualified to make such an assessment.

Read the full text of Dean Gault’s Report of the University of Minnesota Delegation to the Peoples’ Republic of China, September 1-21, 1979 below. Page ten is missing from the report copy.

100 years of service

By Erik Moore August 4, 2008
AHC documents, Medical school

The AHC and its health science programs are commonly thought to focus on the health of the individual and larger populations. However, one program focuses on serving the individual and their families long after traditional forms of health care are no longer applicable. The Mortuary Science Program educates students in behavioral and applied sciences in order to provide a service to grieving families and individuals planning for end of life decisions.

Uniquely housed within the University’s Medical School the Mortuary Science Program traces its origins back to the School of Embalming in 1908 and is marking its 100th anniversary this year.

From 1908 until 1927 the School of Embalming provided vocational training. During the 1930s the program changed to require a high school diploma and at least one year of college to receive state licensing through an expanded 36 week course overseen by the General Extension Division. In the 1950s the University offered the first associate degree in mortuary science and by 1968 the University offered a Bachelor of Science degree and transferred the administrative authority from Extension to the College of Medical Sciences.

The commemorative pamphlet below is from the Program’s 50th anniversary in 1958.

Not so Cuil

By Erik Moore July 31, 2008
Curiosities

This month a new internet search engine was released – Cuil (pronounced “cool”). It is a new endeavor by former Google employees meant to change the way we think about search results. Some highlights include 2 or 3 column listings instead of a single column in an attempt to emulate online newspaper layouts. It attempts to attach an image to each result from the web site in order to provide a visual cue on what to expect and finally, it touts a privacy policy that does not collect personally identifiable information.

Organization, access and privacy – the triumvirate of the information professional.

But now, let’s see how it works.

The search for Academic Health Center University of Minnesota (without quotes) sometimes brings up the AHC home page as the first result (as it should) and at other times, it isn’t even listed. A common variation on this search uses quotes to ensure inclusion so let’s try “Academic Health Center University of Minnesota.” No results were found. That seems a bit drastic. A different variation using “Academic Health Center” “University of Minnesota” does produce results, including the AHC home page, but occassionally the first result presented is the AHC’s dreaded 404 file not found page.

For comparison, the above three searches on Google consistently provides the AHC home page as the first result each and every time.

Let’s give it one last try with the simple search AHC History Project (without quotes). No direct results on the first page. In Google, this blog is number one.

As for the images associated with the search results, some are obvious, others are not even found on the page that is returned, meaning Cuil is just grabbing anything out of an image folder on the server.

Consistency during Cuil’s first week seems to be its biggest deficit. Search engines do get better over time and I may eventually be won over, but for now, Cuil, is not so cool.

Ten rules for Med School (and 5 absolute truths for the rest of us)

By Erik Moore June 26, 2008
Medical school

A recent reference question asked if it was possible to track down the ten tips Dr. William Albert Sullivan, former Associate Dean of the Med School used to give incoming students. My original answer was a hesitant maybe.

Dr. “Sully” Sullivan was Associate Dean for Admissions and Student Affairs from 1968 until his death in 1990. Originally from Nashville, TN, Dr. Sullivan came to the U of M in 1947 as a resident under Dr. Owen Wangensteen. Dr. Sullivan is probably most well-known for his personal interviews with each Medical School applicant. Dr. Sullivan had the ability to separate the self-assured from the self-absorbed. He was a strong believer in a well-rounded education that gave physicians the ability to relate to their patients on a personal level.

I could find little archival material related to Dr. Sullivan, let alone his 10 rules. I paged through a clippings file with various articles on his service to the Medical School and a few obituaries. It became evident that Dr. Sullivan may have never recorded his advice for medical students.

And then I found it.

In the August 1990 issue of The Cutting Edge, the Department of Surgery’s newsletter, there was a reprint of Dr. Henry Blackburn’s eulogy for Dr. Sullivan. At the end of his prepared remarks, Dr. Blackburn noted that “in keeping with Sullivan’s own fabled love of language and zest for communication, it is fitting to allow him the last word.”

And, here they are for you. Dr. Albert Sullivan’s 10 rules for new med students (and 5 absolute truths for the rest of us):

1. If money is the only thing that leads you into medicine, you might as well give up now.

2. If you want to be in charge all the time, then start your own business where you can call the shots.

3. Medicine is fun, and in contrast to many other professions or skills, people rarely leave it.

4. Any physician who stops learning after medical school is doomed to mediocrity, to poor medicine.

5. The human component of your existence that says you are just as selfish and egocentric as all the rest of those persons who have gone into medicine will keep you going and lead you to that position where you do indeed heal the sick, comfort the afflicted, and have one hell of a magnificent time doing so.

6. You must continue to utilize [your] other interests while in medical school, whatever they may be – athletics, music, painting, etc. If you don’t you’ll be perfectly miserable, and you’ll make a lousy physician.

7. There will be many times when situations arise in which you will need assistance. You are equipped to handle these crises if you take advantage of the resources common to all Medical Students: your own good brains, the support of friends and family, and our Office of Student Affairs.

8. Medicine is not a science or an art. Things are not black or white, but rather shades of gray. The make of really mature medical students is that they can tolerate the ambiguities and uncertainties, as well as the discrepancies of different teachers, knowing that each represents the truth as he or she sees it.

9. As a group you have a high degree of social orientation and desire to be helpful to the patients you will treat. However, it does no good whatsoever to sympathize completely with patients if you don’t know what is happening at their cellular level or if you don’t know what organism is causing their infection.

10. Don’t ever get so over involved with the technical aspects that you forget about the humanness of the people you are treating. This sensitivity and feeling must be combined with your scientific competence in order for you to become a competent and thoughtful physician.

Five fundamental and absolute truths:

1. E=MC2
2. There is no cure for the common cold.
3. There are more horse’s asses in the world than there are horses.
4. Excrement always flows downward.
5. If you’re treed by a bear, enjoy the view.

An evening at the Veterinary Medical Center

By Erik Moore June 3, 2008
Veterinary medicine

Often times our work and personal lives overlap. Such was the case for me this past week as I spent some quality time with my beagle at the Veterinary Medical Center’s Small Animal Hospital Emergency Care.

While waiting in the examine room to learn about my dog’s test results, I began to wonder about the history of the VMC and the care it provides.

Clinical veterinary work first began at the University in 1888 with the appointment of the University’s first veterinarian, Michael Treacy. For the next 60 years, veterinary medicine was taught and practiced as part of the curriculum of the School of Agriculture. In 1947 the School of Veterinary Medicine was established and later reorganized into the College of Veterinary Medicine.

The Veterinary Medical Center grew out of the original veterinary clinics associated with the School of Veterinary Medicine. The clinic on the St Paul campus received state funding to construct new facilities, which opened in 1950. The Veterinary Clinic was to serve as “a hospital for animals just as the University Hospitals on the Minneapolis Campus are devoted to caring for humans. In the hospital, students will be able to observe treatment given by trained University veterinarians to ill animals.” You can read more about the 1950 dedication ceremony in the pamphlet below.

The Veterinary Clinic was reorganized as the Veterinary Hospital in 1969. It was renamed the Veterinary Medical Center in 2003 to better reflect the advanced care and outpatient services it provides.

The Lewis Hospital for Companion Animals is a component of the VMC and was dedicated in 1983. It was named after the MN State Senator Robert Lewis, an advocate for promoting health and welfare in various communities and who was also a trained DVM. There is a plaque honoring Senator Lewis behind the check-in desk above the floor scale.

As for my beagle, he was treated aggressively and released. All signs show him to be in good health. Thank you to all the staff that took great care of him!

From here to Timbuktu

By Erik Moore May 21, 2008
Digital, News

The New York Times recently ran a story on the digitization of historic Arabic language manuscript material from Timbuktu dating back to the 17th century. The digitized texts represent works of law, science, medicine and the humanities. When the digitization project is completed, scholars will have access to material that will shed light on the methods of health care and medical education practices of the sub-Saharan region (See aluka.org/).

The AHC History Project hopes to shed a similar light on the health care delivery and health science education practices of the latter half of the twentieth century in the United States in order for researchers to better understand the educational practices, the relationships between funding institutions and their academic counterparts, and the areas of research focus during this time in academic medicine.

Although the Twin Cities is a far away both in time and space from the Golden Age of Timbuktu, the process of promoting health care education and practice are still subjects we record in written format and will be the things we pass on to future generations both near and far. Browse a few of the most recently added digitized texts to the digital archives from the AHC archives.

Googling your health

By Erik Moore May 20, 2008
HIPAA, News, Perspectives

If the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was designed to give patients more control over their medical records in the electronic age, what does it say if twelve years later we decide we’d prefer Google to manage it for us?

In a recent article in the New York Times, it seems patients are eager to do just that:

The Google record … allows the user to send personal information, at the individual’s discretion, into the clinic record or to pull information from the clinic records into the Google personal file.

The move toward online control and access to personal health information changes the previously static, analog patient record into a dynamic set of data that serves multiple purposes. Our concepts of record management and documentation might have to change as well.

What did this place used to be?

By Erik Moore May 6, 2008
Curiosities, Facilities

Most people do not walk through Fairview’s Environmental Services in the “B” corridor on the first floor of the Mayo Memorial Building. Even if they do, they may not realize that this corridor was the former home to Station 12 of the old University Hospital. They also may not realize that this section of the “B” corridor was originally the Elliot Memorial Hospital which opened in 1911.

A passerby will also not know that at one time an artist, who was also a patient, painted a scene of this corridor and that it hung behind the desk at Station 12. The painting depicted the patient’s view of the hallway while suffering from a detached retina. The upper left portion of the picture is shadowed from the loss of vision. I ran across a copy of this painting in a former newsletter published by the University Hospitals; however, I do not know where the original is located. It no longer seems to be hanging on the wall at the former Station 12.

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2008

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