Duke University School of Medicine - Aesculapian Yearbook (Durham, NC)

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MI CRGBIOLGGT Microbiology, like Pathology, is both a basic medical science and a clinical service. The department not only teaches basic knowledge and techniques of the discipline but in addition describes to the student the important clinical aspects of infections caused by viruses, bacteria, parasites and fungi and maintains several clinical diag- nostic laboratories which aid in the diagnosis and treat- ment of the various infectious diseases found in the Duke Medical Center. Besides medical students, Microbiology teaches nurses, technicians and graduate students, and most of the departmental staff are faculty members of both the Duke Medical School and the Duke Graduate School. Within the department are a number of research lab- oratories which are, for the most part, supported by grants from the United States Public Health Service. Dr. Gross,s genetics laboratory is concerned with problems related to gene structure and function. Dr. Willett's bacterial metabolism studies have been concerned with biochemical mechanisms of antituberculous drugs. Dr. Osterhout's virus research has studied the problem of latent herpes simplex infections. Dr. Overman,s virus laboratory has investigated by electron microscopy the mechanisms of virus particle entry into cells. Dr. D. T. Smith has studied the tuberculin skin reaction to various mycobacterial antigens. Dr. Conant's laboratory aids in the identification of fungi sent to it from all over the world. Dr. Eiring is concerned with the organization of the student laboratories as well as virus and rickettsial diagnostic studies for the clinical laboratories. Drs. Amos, Day, Metzgar, Zmijewski and Buckley comprise the Immunology group whose primary research interest is in organ transplantation. NORBIAN F. CONANT, PH.D. Chairman of the Department lame: B. Duke Professor IMM U OLQGT Immunology was, until relatively recently a rather stable and circumscribed subject dealing largely with the antibody response to various substances, mainly bacterial or serum protein. Within the last few years there have been a series of developments which have led to the de- velopment of immunology as a major science. To some extent immunological techniques are used by biochem- ists, microbiologists, geneticists and many others, in re- turn, the study of immunology now itself intrudes into DR. CONANT these subjects and uses their knowledge and techniques for a more thorough study of the basic facets of im- munity. To some extent this was due to the questioning of Burnet and others as to the actual mechanism of the initiation of immunity, but it also grew from studies of Medawar and his colleagues on the activities of the lymphoid cells and from realization that allergic and im- munologic processes were closely related and more com- plex than had been previously suspected. Duke University has recently established a division of Immunology with the expanded Department of Microbiology and Immunology. The division includes four full time faculty members: Drs. D. Bernard Amos, Eugene D. Day, Richard S. Metzgar and Chester Zmijewski, as well as a number of post doctoral fellows, visiting scientists and has provision for graduate and medical students. The major emphasis of the division fC0ntz'nzzed on page :ggi D. BERNARD AMOS eigh teen

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PATHOLOGT Pathology has been defined as the science which deals with the causes, mechanisms of development and effects of disease. It is the bridge between basic medical science and clinical practice, and the study of Pathology pro- vides the student with his first experiences in his life long study-disease. At a medical school such as Duke much of the departmental effort is devoted to the teach- ing of Pathology to medical students. In addition, be- cause of the large amount of surgical and autopsy ma- terial available at Duke, it is possible to maintain a very active graduate training program. Young physicians who choose to specialize in Pathology or who wish to receive further grounding in the basic fundaments of disease before entering a clinical speciality spend from one to four years in the department as a member of the house staff. At this stage the training is predominantly by the apprentice approach with close association between the resident and senior members of the department. Usually after a period of four years of such training, the resident is eligible for certification by the American Board of Pathology. During this period of training the residents in pathology gain teaching experience so that the majority of those who complete this training con- tinue to hold an academic position in pathology either at Duke or some other medical school. Those residents who go into a clinical specialty after a shorter period of graduate training in Pathology have the security of a fuller and more precise knowledge of disease. Harvey Cushing once wrote that 'iapprenticeship in the patho- logical laboratories always has been and always will be the only way to reach the very top either for the surgeon or physicianf' and William Osler claimed that suc- cessful knowledge of the infinite variations of disease can be obtained by a prolonged study of morbid anat- omy. The Practitioner of Pathology specializes in the prac- tice of laboratory medicine for the purpose of providing physicians and surgeons with the scientific information they must have in order to treat their patients most efficiently and successfully. The hospital pathologist is responsible for the identification of the disease process in the surgical specimen removed at operation and for the final diagnosis at the autopsy table. ln many hos- pitals he also may supervise the laboratories of clinical chemistry, hematology, and bacteriology as well as the blood bank. The pathologist works in close cooperation with the patientls physician in arriving at a diagnosis and assisting with the patient's treatment by furnishing lab- oratory tests which aid in determining effectiveness of the patient's therapy. No specialist is called upon for consul- DR. KINNEY tation by others as frequently as is the hospital patholo- gist. All universities have as one of their chief responsi- bilities the development, dissemination, and application of new knowledge in the various fields of learning. For this reason, the Department of Pathology at Duke Uni- versity maintains an extensive research program. Every effort is made to provide opportunities for students and residents to participate in basic research programs and to develop their own skills and interests in the field. This gives the imaginative young doctor a chance to ex- plore unknown areas of medicine. Research offers a major challenge to the physician who desires the excite- ment of discovery for experimental medicine is one of the truly genuine adventures. TI-Ioxras D, KINNEY, M.D. Clzrzirman of the Department DR. KLAVINS DR. KAUFBIAN .S'EZ!6'71ff3671

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PSTCHIATPCY The Department of Psychiatry has a three-fold pur- pose. lt is dithcult to assign priorities, but they may be stated as follows: the preparation and training of students of medicine to practice better the art and science of medicine through an understanding of normal and ab- normal behaviorg the training of the resident to practice his specialty. and through the demonstration of psychi- atric practice by the faculty coupled with a vigorous, broad and imaginative research program contribute to that body of information which will better equip society to deal with the physically and mentally ill. A century ago, the mentally sick were herded into large hospitals and segregated away from the main stream of life. Treatment in the main was custodial. With the advent of a liberal movement. the psychodynamically oriented psychiatrist focused upon the individual patient and his intrapsychic and interpersonal life. The one-to- one interaction with the emotionally disturbed patient brought hope and the focus turned away from the dis- turbed group and onto the disturbed individual. The second world war demonstrated dramatically that even the normal person under stress could develop a re- versible emotional illness and psychiatric care could lead to a speedier and more humane restoration of function. The concept of psychosomatic medicine popularized in the thirties received greater recognition and in medical education, attention was focused upon the role of emo- tions in the genesis of physical symptoms. It became more acceptable for a patient to consult a psychiatrist. The sixties will see more progress into the realm of preventative medicine by the understanding of those social patterns which lead to the dissemination of emo- DR. E. W. Bossa Chairman of the Department social and community psychiatry. An additional drive will be made at all levels of medicine to make available the skills of the psychiatrist in the therapeutic armamen- tarium of the non-psychiatric physician. Although this is the age of the gene, the biochemical equation, and the neurophysiological dysrhythmia, the psychological reaction to disturbed organic patterns cou- pled With a sound medical orientation still remains as the treatment cornerstone for the reversal of inappro- priate behavior and the maturing growth of individual personality. The physical therapies, such as psychotropic drugs, permit the disturbed patient to receive appropriate treat- ment designed to relieve his condition while remaining fContinued on page 1332 tional illness and the growth of what is now known as ::.,- Q. l a I gy I ff f gi DR. LLEVVELLYN DR. BRESSLER DR. LOVVENBACH nineteen