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

Text from Pages 1 - 144 of the 1964 volume:

45.111112 'Q-7' 50134 e s 5' 9 'QQN ,f-v 1 HH lv on-f1Y Q 6 5 Af, X Qf ffvwri w 1 'O' 'Q' 4 4 g -g ? fl 4 A QQ 09 .. . A M LE sji l ln. ' A QS . f 'T H1 I W NS! g 'YP ze' Km ' :sf W - , W Y 'I 'Z e 'AM' We 5 5 9? dfvar 0:20 Nineteen hundred SiXIy'fOU7' Duke University Medical Center Durham, North Carolina X DEDICATIO David Tillerson Smith, physician, teacher, scholar. we respectfully dedicate this Aesczzlapian to you. An indelible part of The Duke Experience, you have influenced each of us as you have every Duke medical student who has come before. Your sagacity, gentlemanliness, wit, and intellec- tual honesty give much for the student physician to emulate. Your accomplishments set an example to which we can aspire. - You were one of the group of outstanding men of American medicine which assembled at Duke University in IQ50 to found the School of Medicine, the philosophies and ideals of that original group became the principles which led the school to become, within a generation, a leading medical center of this country. ' David T. Smith was born October 1, 1898, in Anderson County, South. Carolina. He attended the public schools and then Furman University where in 1918 he received the A.B. degree. From there he went to The Iohns Hopkins University where he took his medical degree in 1922. He interned in pediatrics for one year at The Hopkins and then went to the Rockefeller Institute for Medical Research. A year later Dr. Smith accepted an appointment as Chief of Research Laboratories of the New York State Hospitals for Tuberculosis, a position which he held for six years as bacteri- ologist and pathologist. It was then that he was invited to join the new faculty at Duke. He came here in 1930 as Professor of Bacteriology and Associate Professor of Medicine. He was the youngest man on the staff. Dr. Smith's contributions to the body of medical knowledge are truly remarkable. He is author of more than one hundred fifty publications representing every type of professional communications medium including journals, texts, manuals, systems, books, articles. The Zinrser Textbook of Microbiology is a dehnitive reference work throughout the medical world, and this famous text has been carried with co-authors by Dr. Smith through four editions. He has contributed also to numerous lay pub- lications writing in a manner the public can understand, bringing to community level the principles of prevention, treatment, and rehabilitation. A His professional honors are legion: The Trudeau Medal for research in tubercu- losis, his capacity as consultant on tropical medicine to the Secretary of War during World War Il, his nomination by the President's Committee as Physician of the Year 1959 for his work in rehabilitation of the handicapped, his great efforts and successes in rehabilitation of chronic lung diseases, pellagra, and the mycoses, or his work in postgraduate education for the Negro physician, his leadership of numerous societies and associations . . . there are many many more. But really what is the essence of this man, of this doctor who is at home at the podium of the National Tuberculosis Association or the County Medical Society or guiding the presentation at a clinical pathological conference, streaking a petri plate in the student lab or spinning a yarn at a Medical Dames meeting? Dr. Smith, we can say simply, that you give-to your profession, your patients, your students, to science, to humanity. You are the good man. The good physician. three Foreword Mr. Iames B. Duke's interest in doing something for medicine may have started with an encounter with a small boy. The youngster saw Mr. Duke watching the power plant being built at Lake Iames fMarion, North Carolinaj and followed him around listening to his questions, his orders, his decisions. Finally, the boy asked his own question. Mister, he asked, can you cure lits?', The engineers thought it was an amusing joke. But Mr. Duke was interested in the child and questioned him. He learned that the boy's father was subject to Hts. There and then Mr. Duke gave orders that medical attention in New York be given to the child's father. Ionathan Daniels published the above story in the News and Observer on I4 Septem- ber 1947, and it was reproduced in papers all over the country. Duke Hospital was Hooded for the next month with the same question: uCan you cure fits? Mr. Duke's realization of the necessity of training doctors to meet the medical needs of the people of North and South Carolina may well have stemmed from this incident. On October 1, 1925, ten days before his death, he added ten million dollars to the Duke Endowment for a medical school, hospital and nurses home at Duke University. To quote Mr. Duke's Indenture: It is to these rural districts that we are to look in large measure for the bone and sinew of our country . . . and education when con- ducted along sane and practical, as opposed to dogmatic and theoretical, lines, is, next to religion, the greatest civilizing influence .... I have selected hospitals as another of the principal objects of this trust because I recognize that they have become indispensable institutions . . . and that if Duke University, in the judgment of the Trustees under this Indenture be not operated to achieve the results intended hereby, the Trustees may withhold support. W. C. DAVISON four CONTENTS Administration and Faculty .,... Classes . . A Seniors .... Iuniors ,... Sophomores . , . Freshmen .........,. ,..... Research Training Program Organizations .... ,,..,..... 4..,..,... I 0 1 Student Government Association SAMA Alpha Omega Alpha Medical Dames Features . . . Index and Advertising .... fizfe MEM ORIAM FRANK L. ENGEL, 1913-1963 The story of Dr. Engel's success clearly begins with the DNA of his mother and father. They produced three boys, and each has made his mark in the world. Lewis Engel is a distinguished biochemist at Harvard University. George Engel is Professor of Psychiatry and Professor of Medicine at University of Rochester, and Frank was Professor of Medicine and Associate Professor of Physiology at Duke. Frank was a scholar and a scientist and received international acclaim for his work on the mechanism of action of the hormones produced by ductless glands. He enjoyed the laboratory and was never willing to give up working at the bench with his own hands. He attracted to Emory and Duke many residents, fellows and graduate students. Ten of his disciples have already climbed to professorial rank. Frank was an unusually gifted teacher. He taught effectively at all levels. First- year medical students, third- and fourth-year medical students, interns, residents, fellows and faculty col- leagues all came under his spell. His work in physiology with the first-year students was one of the most effective recruiting devices ever developed by the Department of Medicine. Dr. Engel never ceased to be a physician. He was interested in both the patient and the disturbance caused .fix by the disease. The patients sensed the sincerity of his interest and responded to it. To have him see a patient with you was a most eiective form of graduate instruc- tion. As might be expected, there were many outside de- mands on his talents. Within the medical school, he was chairman of the committee which integrated the activi- ties of the departments of Medicine, Pediatrics and Gynecology into an effective endocrine division. He was chairman of the Policy Committee for the development of the Duke Clinical Center, and was responsible for the planning of the research ward which opened recently. He had a leading role in the development of a new medical school curriculum which is projected for 1965. He was an active member of the Library Committee and the Beaumont Committee. At the national level, he was a leader in the Endocrine Society, and played a large role in the development of its postgraduate assemblies. He served on the editorial board of seven scientific journals. We know that Frank devoted many hours to his work. He was unwilling to narrow his fields of interest. He wished to keep abreast of the fields of general medicine, of physiology, and of biochemistry. What is the significance of man's life? Surely not the number of years he has lived. The years are sig- nificant only as they are filled with worthy deeds-deeds which may have i unlimited beneficent consequences. When a great teacher is also a great physician, he effects eternity to a magnified degree, his influences are pro- jected through his disciples whom he has inspired and also through the useful lives he has prolongedf' By this means, Dr, Engel has attained immortality and will always live with us. Dr. Engel's inHuence on the Medical Center is a classic example of the concept that the effect of the whole may be far greater than the sum of the individual parts. It is this whole which we are going to find irreplaceable. The breadth of scholarship, the depth of his knowledge in many specialized fields, the interest in education at all levels, the ability to perform well in all parts of the Medical Center, the skill to tie together science and prac- tice, the ability to build without destroying, the ability to inspire and not limit the growth of young men: these are the marks of a master. MEMORIAM '15 EDWIN CROWELL HAMBLEN--1900-1963 Edwin Crowell Hamblen, gynecologist and pioneer clinical endocrinologist was born at Greenville, Missis- sippi, August 23, 19oo. He received the degrees of Bachelor of Science and Doctor of Medicine at the Uni- versity of Virginia. He interned at the University of Virginia Hospital from 1928 to 1929, was resident in Ob- stetrics and Gynecology from Iuly to December, 1929. He served as assistant in Surgery and Gynecology at the Gamble Brothers and Montgomery Clinic in Greenville, Mississippi from December, 1929 to April, 1930. He began his teaching career of thirty-three years as clinical instructor and assistant in Obstetrics and Gyne- cology at the University of Virginia School of Medicine in April, 1930. In Iune, IQ5I, he moved to Durham to become associated with the Duke University School of Medicine as Associate Professor of Obstetrics and Gyne- cology. In 1944, he was named as Clinical Professor U671 of Endocrinology and made Professor of Endocrinology in 1947. He founded the Division of Endocrinology Ianuary, 1937. He was the chief of this division until Iuly 1, 1955. Following this, he devoted his full time to teaching and research in the field of reproduction. He made important contributions to the physiology of repro- duction and to the pathology, diagnosis of treatment of disorders of gonadal function. He was the author of four books: g'Endocrine Gynecology, 1959, uFacts for Child- less Couples, 1942, Endocrinology of Woman, 1945, and 'KFacts About the Change of Life, 1949. Besides these he contributed more than 200 articles to various medical journals and chapters to many books. From 1950 until his sudden death on November 24, 1963 he was editor of the American Lectures in Gynecology and Obstetrics. Dr. Hamblen performed a large amount of post- graduate teaching in all sections of this cou11try, in seven countries of South America and in Canada. Partly due to his articles in Spanish and Portuguese, he was well known in Central and South America. He had many fellows from these countries study at Duke University with him, in addition to fellows from Scotland, Belgium, Canada, Israel, Lebanon, Iapan, Thailand, Iran and the Philippi11es. He was married ir. December, 1930 to Miss Agnes Morton Baptist of Albemarle County, Virginia. She survives him as well as two daughters and five grand- children. Dr. Hamblen had the most interesting hobby of gardening with special attentio11 to extensive rose grow- ing. He was instrumental in organizing the Durham Rose Society in 1948 and also served as a director-at- large of the American Rose Society for two 3-year terms. Edwin Crowell Hamblen will always be remembered for his teaching. His teaching material was always well organized and excellently presented. EDITORIAL STAFF E d itors-in -Chief Business Manager Faculty Editor Features Editor Senior Editors Iunior Editor Sophomore Editors Freshman Editors Artist Photography Stal? Business Stag Editorial Sta 17 Adviser Special Than lgs to David M. Hawkins Kirkwood T. Shultz Calvin C. Linneman, Ronald P. Krueger I. Battle Haslam Crawford F. Barnett, N. Bruce Chase Eugene I. Guazzo Wiley Bland Alvin M. Lewis Lee C. Underwood Robin T. Vollmer Frederick D. McFalls, M Kirkwood T. Shultz N. Bruce Chase I. Battle Haslam Lee C. Underwood Thomas C. Hoyle, III Robin T. Vollmer Paul Aaron Iohn Dunnin Lucy Krueger Helen Luly Mitz Martin Roberta McNeill Iane Shultz David Smith Sue Virgin Dr. Walter R. Guild Dr. Eugene A. Stead Dr. Walter L. Thomas Dr. William G. Anlyan Mrs. Iris Hildebran Mrs. Helen Thomas eight Ir Ir ADMINISTRATION and FACULTY OFFICE OF THE PRESIDE Medical education today is confronted with acceler- ating changes in its techniques and its means: hut it laces an equal need to maintain the human center of its purs poses-a need which must he protected from the conf stant temptation to forget what knowledge is lor, in the sheer excitement ol its discovery. lt seems to me that the great continuing task of our own Medical Center is the maintenance ol' ayhalance, and a constant interaction, among the three chief elements ol our work: teaching. clinical service, and hasic research. lt is perilously easy to encourage any one ol these at the expense of the others: to do so, however, would damage the rarest and hest quality of our own program. and one ol which we are iustly proud. YVhat we shall he concerned to do in the years ahead is to enhance and develop each part of this program hy means of the othersg this will ahove all he accomplished hy having the hest people liei'e-lrraft in the sense that they have the highest competence in their own special held. coupled with the greatest interest in the significance of the whole venture of medicine. In this way the Medical Center is a microcosm of the human attitude that makes the University itself elleetiveg 1871 the educated lilie. ln that way ol' life. you as doctors will , ----sr- i . v- .- N W . V-H V W X -:-. E mE::E::- PREslnigx'i' Do1'c1-.xs M. Kxicyifrr each of us at Duke has an et ual ohlisfation to his own l zs skill, his own discipline. and to the enduring values ol he privileged to play a leading part: and I hope that you will he proud to take our name with you as you do so OFFICE GF THE DEA When Dr. Davison retired as Dean, the half-life of the average medical school dean was 6.2 years. In the past four or five years, even this brief span of responsi- bility has been shortened, and, following this trend, Dr. William Anlyan will become Dean of the Duke Medical School on Iuly 1, 1964. He will then possess, among other tasks, the pleasant responsibility of writing this farewell note to the graduating classes of the future. The rapid turnover of deans on the national level is not a frivolous matter, it is a mark of the varied needs of modern edu- cation, and it is a response to the redistribution of people interested in the broad design and functions of a Medical University. I shall retain my post as Vice-Provost. This class showed considerable promise when it entered Duke, and it has proved this point with vigor and greater promise. Among its 71 members, 50 secured a first-choice internship, the best class record to date. I might add that the admission potential of the three other classes in residence shows even greater promise. This graduating class must continue its education with dedication, not because medicine is competitive, which it is, but because its major task is to take care of ill people in a wholly knowledgeable way. I would trust that this class would develop convic- tions about some or all of the major social issues that medicine as an art and science must consider today. The traditional doctor-patient relationship is still the most important component of our profession, and it can- not be compromised. There are, however, many other supporting components of this basic relationship, and you must support these as well. Let me quote one as an ex- DR. WOODHALL ample, 4'The survival of the community hospital, the accurate designation of the fiscal resources responsible for the care of indigent and medically indigent people, the economical development or programming of hospital beds, the total concept of good medical care at minimum cost, the professional goals and aspirations and training of White and Negro components of the health profes- sions are some of the proper ingredients of the so-called regional health design. Be aware of this issue and others, be a loyal alumnus, and good fortune to each and every one of you. BARNES WOODHALL, M.D. Dean of the School of Medicine Assistant Provost of the U nizfersity Professor of Neurosurgery 2 MRS. 'THOBIAS MRS. HILDEBRAN MRS. MAYE. OFFICE OF THE ASSISTA DEA To the Senior Class: Au revoir and not goodbye,' We are especially proud of the record of the Class of T64. You have reached this tier in your education suc- cessfully and with a sense of responsibility. The acquisition of the ancient and honored degree of Medicine Doctoris elicits a curious mixed emotional response from the recipient. lt is the climax of eight years of a hard. yet exciting, higher educational process. lt is also the passport to a lifetime dedicated to the im- provement of the multifaceted health problems of our fellow human beings. Most of you will be handling the sick individually, some of you will be looking at the collective ills of mankind, while still others will be seek- ing to improve man's lot through teaching and research. Unlike the days of Moliere in the 17th century when in his farcical play, Le Malade lmaginairef' he ribbed the physicians of his day for resorting to the only two methods of therapy available then-g'Seignare et Pur- garef, you will have at your disposition all of the modern tools of diagnosis and treatment. But forget not your ears, your eyes and your hands. Despite all the com- puters and elaborate laboratory tools, your own senses still provide you with eighty per cent of the tools necessary to cope with man's diseases. ln shedding your student coats fand the controversial name badgesj you are also acquiring a new set of re- sponsibilities. Perhaps the most important of these is the dedication to a life-time of continued self-educa- tion. Following varying lengths of internships and resi- dency training, you still have the obligation to keep up with the vast amount of new knowledge being created 1 . DR. ANLYAN by geometric progression in the biological sciences. Thus, it is hoped that you will never completely sever your umbilical cord with your medical school. The library, the faculty, and the administration stand ready to serve you hereafter. Though the names of the principal actors may change, there is a certain immortality in a first rate medical school such as ours. You have earned a life- time membership on its roster. One of my distinguished predecessors obviously dis- played great wisdom in placing QOZ5 of our medical students in the upper one-third of the class. There is more truth in this than meets the eye. Your record this year in obtaining first-rate internships with lifty out of seventy-one graduating seniors obtaining their hrst choice would lead me to say that 9o9Q, of you have obtained an fConzz'nz1c'4I' on page lgjj twelve ANATOMY The Anatomy Department has twin objectives: scholarly achievement and instruction in all phases of anatomy. Scholarly achievement is secured by investiga- tions by the staff, graduate students, and some special students. The teaching program is the primary respon- sibility of the department and this requires nearly 5,ooo hours time altogether by the members of the Anatomy staff. The teaching method used most extensively is indi- vidual contact with the student in various teaching lab- oratories, particularly gross anatomy, histology, and neuroanatomy. As an extension to this elbow teach- ing, use is made of varied audiovisual aids including brochures, lantern slides, overhead proiecturals, motion pictures, and television presentations. The latter two are used more extensively at Duke than at any other 'Qin-nga., 'Mun DR. EYERETT DR. MARKEE school's Anatomy Department. These aids are employed both to elucidate concepts and to illustrate these concepts by appropriate examples. Throughout the course in anatomy, special attention is paid to both basic anatomy and to its relationship with applied anatomy. For example, roentgenographs, dis- cussions of clinical applications, and patients themselves are presented at appropriate times during the course of study. This diversified approach to the teaching-learning en- vironment provided to the individual student by the Anatomy Department leads to a pleasurable reward for the staff. In this way, we strive to give students, with very different strengths, backgrounds, and problems, the maximum opportunity to achieve the high potential they bring to Duke University Medical Center. Iosiaifii MARKER, Pu.D. fjhtlllfliltlll of thc' 1JC'fJLlI'l!71C'l1l ftznzcu' H. Duke' l,l'0fC'550I' DR. PEELE DR. I-IETHER1txc:ToN DR. DUKE th irreen BIOCHEMISTRY In concert with all other departments in the Medical School, this department has been heavily involved in planning a new curriculum. Until the day that such a completely overhauled curriculum can be inaugurated, we shall continue to engage in serious self-study and to experiment with our present program. Two principles seem paramount in this endeavor. CID Biochemistry is no longer an isolated discipline nor an exercise in blood and urine analysis. It is the language of biology and the only available intellectual framework for understanding of all living forms-in- cluding man. It is our obligation to provide a grasp of this language and its conceptual framework. Once so equipped, the student is in position to grasp much which comes later in the curriculum-and which will be revealed by research during his lifetime. In this sense, it is almost a cultural course which is offered, a position which can be taken only in the full confidence that many of the preclinical and clinical faculty to be encountered later in the curriculum are fluent in this language. The biochemistry faculty has become inured to the recurrent, What has all this to do with medical practice? If it is irrelevant, then surely mankind is doomed ever to live under the threat of the same diseases which now take so heavy a toll, and medical practice must remain as frus- trating as ever. If it is relevant, as we fully believe and frequently demonstrate. one day medical practice will he far more rewarding than is presently the case. And it is our task to prepare for that day. Accordingly, our emphasis must remain on fundamentals: others who follow will reveal the utility of the clinical chemistry laboratory. Czj The experience of the student in the biochemistry laboratory must he designed to illustrate how biochemical MQW'-Ns-. My DR. BYRNE DR. THIERS DR. HANDLER information is gathered-not to illustrate or prove the notions discussed in lectures or conferences. If this hope is to be realized, the 'cookbook' must disappear, the Work must seem more like real investigation, and the tech- niques used must be as sophisticated as possible. To this end, as rapidly as possible the laboratory experience is being remolded. For next year, each student will engage in only four or five units of work, each requiring four consecutive days for its accomplishment. New ap- paratus will be introduced, several entirely new ap- proaches attempted. And, as this year, the ratio of students to staff in the laboratory, at almost all times, will be about ?i:r. This is an ambitious, and expensive program. Hopefully, a year hence, next year's class will think it has been worthwhile. llut they cannot really Ignozu this for many years. PHILIP H.XXDLEIi, Pii.D. Chairman of fflf' Dc'pr1rZmc'nl lame: B. Duke Professor DR. MCCARTY fourteen PH TSIOLOGT PH ARMACOLOGT The Department of Physiology and Pharmacology seeks to provide a focus for growth of ideas in these disciplines within Duke University. Physiology is that branch of science which seeks to understand how living things work. Pharmacology is the study of how drugs modify physiological processes. To understand is to relate, in the mind, things new and unknown to things l already known and familiar. ln science, he things most known and familiar are the concepts of physics and chemistry. ln large part, physiology is the attempt to relate living processes to and through these concepts. Indeed, in IQI3 L. Henderson wrote uThe biologist studies living organisms as inhabitants of this world and, by holding fast to physics and chemistry, he has created modern physiology, a science which unites many, indeed, nearly all of the departments of physics and chemistry in the task of describing the processes of life. The De- partment of Physiology and Pharmacology comprises a group of scholars who are descendants in spirit from Henderson and the other founders of modern physi- ology. Like them, we are moved by the conviction that the modern physiologist and pharmacologist must ahold fast to physics and chemistry, but also, like them, our primary concern is to understand living processes. It is this emphasis on the actual function of natural cells, organs and organisms which distinguishes finsofar as a distinction is meaningfulj the physiologist from the biochemist and the biophysicist. DR. TosTEsoN In recognition of the fact that a few investigators working on closely related problems seem to proceed more effectively and happily than either a single scientist working alone or a large group, both Divisions of the Department fPhysiology and Pharmacologyj are or- ganized into a loose confederation of relatively autono- mous Laboratories. There are, at present, 7 such Labora- tories in Physiology and bg in Pharmacology. Upon completion of the new Medical Sciences Building fcon- struction will begin in the Fall of IQ64D, there will be X Laboratories in Physiology and 5 in Pharmacology. Since it is obviously impossible to represent the entire fields of Physiology and Pharmacology within any one DR. SALZANO DR. Kosryo fifteen department, the selection of the areas covered by the Laboratories involved decisions regarding the most promising frontiers in the two disciplines. Research in the Department can be viewed as directed toward two such frontiers. First, the goal of much of the work is to increase our understanding of the molecular basis of the energy transformations which underlie fundamental physiological processes such as muscular contraction, nerve conduction, active transport, and cell division. The second frontier involves the analysis of complex inte- grated physiological functions such as the mechanics of respiration, the activity of the brain, etc., with the use of modern analogue and digital computer techniques. Within the Division of Physiology the following Labora- tories are in being: Laboratory of Cellular Neurophysi- ology fChief, I. W. Moorej, Laboratory of Integrative Neurophysiology fChief, G. Somjenj, Laboratory of Muscle Physiology CChief, P. Horowiczj, Laboratory of Molecular Physiology CChief, I. Blumj, Laboratory of Cellular Endocrinology fChief, I. Kostyoj, Laboratory of Cardiopulmonary Physiology fChief, I. Salzanoj, and the Laboratory of Cellular Transport Processes fChief, D. C. Tostesonj. The Division of Pharmacology QI-lead, E. M. Renkiny presently comprises the Laboratory of Biochemical Pharmacology QChief, E. A. Iohnsonj and the Laboratory of Circulatory Pharmacology QChief, E. M. Renkinj. The Department's view of the role of physiology and pharmacology in medicine is well expressed by the fol- lowing remarks of Claude Bernard in his brilliant treatise An Introduction to the Study of Experimental Medicine cI865,I mln the empirical period of medicine, which must doubtless still be greatly prolonged, physi- ology and therapeutics could advance separately, for as neither of them was well established, they were not DR. RENKIN vv if.. Q- I -21.3 1 :.QE5' 4' ff M, 1' ' ij!! ? , 'f ...- - -. starr H . . 4 . A f4?v v'I, -.:':55:f5'3?.2f:,.z..2: 5 , , f nf. , . -, :--.. M.: + -,144 ,--:,-r-,.:-:...:.:- -vm-. ..-z..--...aa s w DR. BERNHEHXI called upon mutually to support each other in medical practice. But this cannot be so when medicine becomes scientific: it must then be founded on physiology. Since science can be established only by the comparative method, knowledge of pathological or abnormal condi- tions cannot be gained Without previous knowledge of normal states, just as the therapeutic action of abnormal agents, or medicines, on the organism cannot be scien- tifically understood without first studying the physi- ological action of the normal agents which maintain the phenomena of life. But scientific medicine, like the other sciences, can be established only by experimental means, i.e., by direct and rigorous application of reasoning to the facts fur- nished us by observation and experiment. Considered in itself, the experimental method is nothing but reason- ing by whose help we methodically submit our ideas to experience,-the experience of facts. ln the introductory courses, we seek not only to inform first and second year students about the most im- portant principles and facts in physiology and phar- macology, but also to provide an opportunity to practice the experimental method in Bernard's sense of sub- mitting ideas to experience, e.g., the experience of others as reported in scientific journals. An effort is made to reveal the relevance of physiology and pharmacology to clinical medicine by conducting clinical-physiological conferences in the introductory courses and by participat- ing in certain special courses for residents. To this end, the faculty of clinical physiologists and pharmacologists who hold appointments in a clinical department as well as in this Department has been very valuable. DANIEL C. TOS'fESON, M.D. Chairman of the Department sixteen 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 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 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 MEDICIN The Department of Medicine traditionally has the responsibility of preparing the student for a lifetime of learning as he gives care to patients who ask him for help. The first step is to begin to think and act like a doctor. Two courses in the second year, Introduction to Clinical Practice and Clinical Microscopy, prepare the student so that he can take an active role in patient care. In the third and fourth years. the student assigned to Medicine acts in the role of a physician. His desire to give good care is the motive which drives him to ex- cellence. He learns to properly identify the problems of the patient. Having identified the problems, he mar- shalls the information which he can bring to bear on them by his past training, he recognizes the gaps in his knowledge as he attempts to focus the information learned from the basic sciences onto the specific clinical prob- lem. Using the patient as his means of integration, he re-reads his anatomy, physiology, microbiology, phar- macology and biochemistry. ln this clinical setting he has the opportunity to speak many words which he has previously only read, be discusses the problem with his fellow students, interns, resident and senior staffg he gains familiarity with ideas and concepts by actively manipulating them. The student crystallizes out his idea of the best diag- nostic and therapeutic approach to this particular pa- tient. He identifies the reasons for each of these de- cisions. He has real curiosity to see if his evaluation of the situation is correct or if he will have to admit that certain data which he interpreted as rock-like support for his house of cards have turned out to be shifting sand. He learns that the course of biology is unin- 251 Huenced by strong statements, by the rank of the faculty fl l . Q Ls t--' iiii fi 4? 4 A i ,f at 1 if ,., f ' ...,.,, it w Zts ':': ' 1 i: 1-- :- ',,,er: t' DR. STEAD member, or by the number of supporting references not quite applicable to the points in question. Under guidance from his fellow students and from faculty of all ranks, he slowly appreciates the difficulties of learning in this system of multiple variables operating on only partially defined substrates. Part of a doctor's learning is only experiential. He knows from living with his patients that certain things are possible, but he does not know the underlying sequence of events. In other instances, his learning is more precise because he understands and can control some of the important variables. He must learn both the liabilities and virtues of attempting to use logic in clinical practice. The goal of the Department of Medicine is for the student to have as many learning experiences as possible in which he plays an active role. We hope that he will -N., .-,.. N. ,. ,,., .. . X X,-5-cfs-P' DR. ORGAIN DR. HANSEN-IDRTTSS DR. RUFFIN twenty DR. CALLAWAY DR. WYNG.8.ARDEN DR, NICHOLSON enjoy these learning experiences so much that he will continue them as long as he sees patients. We are not interested in covering the entire field of medicine. If one of our graduates meets a new problem, correctly identifies it and has pleasure in solving it, we are satis- fied. We are 11Ot concerned that a new area of knowl- edge is being explored without our guidance. In caring for our patients with ill-defined genetic and acquired differences and with many variables of unknown strength at play, many erroneous conclusions are drawn. The student has to learn to examine statements both oral and written with care and to ask for all authorities the source of data which underlie their conclusions. One way for the student to learn the difhculties in drawing accurate conclusions about biological systems is to give him the opportunity to establish some fact on the basis of his own work. We call this research and find it a very effective method of teaching. The intellectual dis- cipline involved better prepares him for the role of a lifetime learner. ..., .,,. ..... . W --H:--:rv ..... ......, ' ., :. - afar-afls 1 si A ' V E i 'f The health Held is a broad one. Anyone with intelli- gence enough to gain entrance to the Medical School can find an area where he can be happy and productive. We are interested in producing manpower for the entire field. We are not interested in molding our students into any single career in the health field. The faculty accepts the fact that our intake is heterogeneous and that our output will be heterogeneous. Our role is to iden- tify the area where the individual will be most produc- tive and happy, and to help him reach this goal. We will continue to produce general practitioners, specialists, administrators, research workers, biologists, government workers and various combinations. There is no special honor attached to any of these roles. Our primary in- terest is that our graduates are productive, and receive emotional and intellectual satisfaction from their work. EUGENE. A. STEAD, IR., M.D. Cfzairmcm of the Department Florence Mcdlistcfr Professor of Mealicine DR. RUNDLES DR. I'IEYlX'IAN DR, ROBINSON twenty-one SURGERY Surgery applies the basic knowledge of the biologic sciences to the art of healing through an operative pro- cedure. The proper performance of the operation, with gentleness and dispatch and with strict attention to the principles of wound healing and to the altered physiology of the structures repaired, is essential. But the surgeon must first be a basic scientist and a physician. Ambrose Pare was one of the first to emphasize that knowledge other than of the technique of the operation was necessary for the surgeon, when, in closing his case reports, he frequently stated, 'Al dressed him but God healed him. Probably one of Iohn Hunter's greatest contributions to Surgery was his observation that the surgeon has no power to repair directly any injury and he must in all humility acknowledge that it is the pre- rogative of Nature to repair the waste of any structure. He must thus realize that it is his chief duty to under- stand and remove the impediments which thwart the efforts of Nature and thus, enable her to restore the parts to their normal condition. Advances in our understanding of the laws of Na- ture have been tremendous in recent years. It has been properly said that more has been added to the fund of human knowledge in the natural sciences in the past generation than had been amassed before in the whole history of mankind. This being the case, a surgeon must be constantly on the alert, as Lister was when he seized on Pasteur's discoveries, to apply this newer knowledge to his profession. Surgery is a very personal branch of the healing Art. The surgeon must establish a close relationship with the patient as he develops his diagnosis and prepares his V DR. GARDNER patient for the ordeal of surgery. He performs the opera- tion himself-and this consumes time and energy. After- wards, it is his responsibility to watch closely over the reparatory processes. This demands a continuing respon- sibility and a close association between doctor and patient which does not allow the surgeon to retire into his lab- oratory for long periods of uninterrupted study. If he does, he loses his operative dexterity or his zeal to leave a warm bed in the middle of the night to minister to an DR. BAKER DR. HUDSON DR. SEALY ZbUEHly'IWO DR. PICKRELL DR. GLExN DR. Onoxt emergency, and his powers of diagnosis and of decision may be blunted. These facts of life distinguish a surgeon from his medical colleagues. Indeed, in some localities, the lament is how to get the surgeon into the laboratory and how to get the internist back with the patient! The surgeon must keep one foot in the laboratory, for he alone can apply the discoveries in the biologic sciences in practical form to a surgical problem which the basic scientist has difhculty in understanding. It is this ability of the surgeon to seize upon the advances in the natural sciences and take them into his own labora- tory to test and apply to his own problems that has re- sulted in the phenomenal advances in surgery in recent years. Students must accept these facts. Learning to become a surgeon takes time. It requires thorough knowledge of the basic sciences, and understanding of the natural history of disease processes, and an ability to apply all of the newer knowledge in the natural sciences to surgical problems. It also requires knowledge of opera- tive procedures and manual dexterity and technical skill. The latter, though important, is subordinate to the former, and is learned during the period of postgraduate training. The former takes the longest to learn, indeed, its learning is a lifetime process. CLARENCE E. GARDNER, IR. Chairman of thc' Department DR, GREGG DR. STEPIIEN DR. AxnERsox tufenzy-zf11'fc' PEDIATRICS Pediatrics has been dehned as the study of the growth and development of the child from the moment of con- ception through adolescence, and the science and art of the prevention, diagnosis, and treatment of all diseases from the moment of birth through adolescence, whether these disturbances be on a physical, emotional, or mental basis. It is a profound concern with, and an abiding in- terest in everything that goes to make the final product -the healthy adult ready to assume his position in lifef' This definition indicates the broadened horizons of this specialty which, when it was founded about the turn of the century, was designed primarily to help children through the hazards of acute diseases such as dysentery which claimed so many young lives. Mere survival through infancy and childhood at that time was, in itself, a sufficient achievement. However, as these acute prob- lems were met and solved fat least in the developed countriesj the scope of pediatrics has expanded. New and fascinating areas of study have been explored and applied to our central focus,-the growing child. These trends have added to 'Lgeneral pediatrics, a number of pediatric subspecialties such as cardiology, hematology, endocrinology, allergy, infectious disease, and a host of others. Many of these are already represented within our own Department of Pediatrics and more of them will be added in the years to come with the natural growth and expansion of the Department. In addition, these broad- ening goals of Pediatrics have encouraged pediatricians into interdisciplinary cooperation with a number of other helds of human endeavor. Thus pediatrics, already in- volved in biochemistry and preventive medicine for ex- ample, must join forces with genetics, for this governs the directions and potentialities of development, with DR. H.ARRIS obstetrics, in a cooperative endeavor to understand the effect of prenatal events on the nature and later course of the infant, and with psychiatry, better to understand the psychological development of the child. The need to develop areas within pediatrics and with other dis- ciplines in order to achieve pediatric goals has led this past year to a new joint endeavor between the Depart- ments of Pediatrics and Psychiatry in a training program to enable pediatricians and medical students to function more effectively in recognizing, planning for, and deal- ing with the emotional aspects of childhood growth and development, the emotional impact of childhood illness on the family, and the emotional crises of children which have psychopathological significance. To this end, a team of pediatric psychiatrists Qqualified both in pedi- atrics and psychiatryj, a psychologist interested in mental and emotional development, and a social worker sim- fC0nzinued on page 1342 DR. SIDBURY DR. DEES DR. STEIXIPFEL twenty-four OBST TRICS GTNECOLOGT The opporttinity to think and to recall the experiences in the basic sciences and in the introductory physical diag- nosis gives the student scholar the opportunity in the disa eases of women for application and broadening the con- cepts for diagnosis and care based on the ability to continue to think and to apply the remembered knowledge. The problems of the female as a growing individual, who must develop and mature properly, who has to experi- ence adulthood, childbearing and the inevitable aging processes, are legion. ln each epoch of growth there are specific problems related to anatomy, physiology, bio- chemistry, hormonal chemistry, genetics, bacteriology. The growing and mature female may be subjected to all the various diseases which may be found in any popu- lation. In addition she is forced to face the problems which are related exclusively to her sex. The patient is an individual and is entitled to all specialized care which proper thinking by the physician deems best for her. Her work-up is not exclusively as an endocrine problem, a neoplastic problem, a childbearing problem, a psychiatric problem or a geriatric problem. She must be managed as an individual who is entitled to ordered and disciplined thinking by her medical attendant. The efforts to encourage orderly and disciplined think- ing find their expression in the care of the patients by an orderly, scholarly, scientific and thinking indi- vidual. Continuation education means the continued thinking by the student scholar of his defects in the pic- ture of the patient as a whole and not alone as a problem in a disease category or designation. Ability to see patients, to listen to them, to examine Q t t. ts is X DR. C.aR'rE.R them will recall the great fund of knowledge which lies in back of the present day mental attitudes toward any form of disease process. The student who brings to the fields of Obstetrics, Gynecology, and Gynecologic Endocrinology an in- ability to think and reason, will miss a great opportunity. The student who can think and reason, who has a sound concept of basic principles of human growth and de- velopment, can under supervision and enlightened criti- cism, gain much to prepare for continuation education which is simply the ability to think and reason and to know sources from which some help for the thinking and reasoning processes may be obtained. Withciut thinking and reasoning, experience is shackled: with thinking, reasoning, and supervision, experience is valuable, rational and rewarding. This is the type of experience we would hope for in the short time which may be used by the department in presenting the prob- lems of the diseases of women for due consideration and thought' F. l5.xY.ut1i fl.-XRTER, M.D. Chtl1il'7lIL1I7 of the Department DR. CHERNY DR. PARKER DR. PEETE twenty-fue RADIOLOGY Since the word Roentgenology was coined after Roentgen, less than 70 years ago, the curricula of medical schools over the world have included X-Ray, Roentgen- ology and finally the Term Radiology in the system of medicine and in the care of the patient. In the 1930's and in fact through World War II Radiology was devoted chiefly to the care and diagnosis of clinical conditions. With the rapid strides of research and with the better media and physical equipment, a greater interest was developed in the study of all the organs of the body. As a direct result of these achieve- ments, great interest was developed in the vascular system. During the past decade equipment has been de- veloped to an extent that Vascular Radiology has as- sumed particular importance and has led to increased medical knowledge that has enabled physicians to treat many cardiovascular conditions that were previously thought to be hopeless. The Diagnostic Division is now staffed by specialists in Cardiovascular, Neuroradiology, Pediatric, Gastro- intestinal and Thoracic Radiology. With the increase in research funds there has been a tremendous upswing in Radiological Research. Radiobi- ology has been a product of this research. We now have a division of Radiobiology, devoted almost altogether to research. Radiation Therapy has been able with the advent of supervoltage, Cobalt and Cesium to make considerable progress both in patient care and research. Radiation Therapy, as the clinical branch of Radiology, is devoted for the most part to treatment of patients with cancer. This division is an active one with 15000 patient visits annually. lt is staffed with two therapeutic radiologists, DR. REEVES a radiation physicist, residents and medical assistants. In this field, as in others, equipment and treatment methods have evolved in complexity, and our division employs a representative spectrum from superficial x-ray therapy to high energy Cobalt 60 and Cesium 137. A major problem of interest to workers in this Held is to Find ways to enhance the effectiveness of radiation, and the divisionis research program is oriented to that end. The Radioisotope Division operates a clinical Radio- isotope Laboratory which serves the medical staff of the hospital with routine diagnostic and therapeutic pro- cedures, and research facilities including a whole body scanner and counter. In addition, training in radioisotope techniques is provided for resident physicians, medical students and technician students. ROBERT I. REEvEs, M.D. Chairman of the Department DR. CAVANAUGH DR. BAYLIN DR. PIRCHER twenty-szx PREVE TIVE MEDICIN ln 1963 the Duke University School of Medicine established a formal Department of Preventive Medicine. The initial objective of the department will be to strengthen and broaden the teaching program. The lecture course will give careful attention to those funda- mental and applied contributions of scientists and educa- tors which provided the basis for the phenomenal health achievements of contemporary preventive medicine. The course will also blend the pertinent segmented knowl- edge of medical science specialties which in concert seek to attain the ultimate in Preventive Medicine-the main- tenance of the individual's health. A formal and applied community health experience in this and Central American countries, will be available for a limited numher of students. This program, in addition to broadening the students' medical and cultural perspectives, will enhance understanding of the phy- sicians' role in the community and emphasize the med- ical profession's vital responsibility in aiding development of emerging nations. Projected departmental plans will provide oppor- tunities for those students interested in fortifying their basic education for training as a specialist in family medicine. WM. J. DEMAMA, M.D. Professor of Prezfcntizfe Medzdne DR. SAUTH Cf2olIi7'77ZLlI'1 of the Department DR. DEM.ARI.4 DR. PERSONS lufenly-560611 MR. KNIGHT PH TSI CAL THERAPY Physical Therapy became available to patients soon after the opening of Duke Hospital. In 1943 due to the increased demand for such treatment and personnel, Duke Hospital and Medical School, in cooperation with the W0man's College established an accredited nine months' course in Physical Therapy for properly quali- fied men and women college graduates. Dr. Frank W. Clippinger is Chairman of the Physical Therapy Ad- visory Committee and Miss Helen Kaiser is the Director of Physical Therapy. To date, 225 students have suc- cessfully completed the course. Two programs are now available to our students. The Graduate Program is a two-year course leading to a Master of Arts Degree in Anatomy or Physiology and a Certihcate in Physical Therapy. The Certificate Program is a fifteen-month course following graduation from an accredited college and leads to a Certificate in Physical Therapy. The Department employs I9 physical therapists and one research associate from a foreign country. Patients are referred from all the major services and the ma- jority of minor ones. The Department treats over 100 patients daily, the greatest numbers come from the De- partments of Medicine and Obstetrics. These are fol- lowed in close succession by Pediatrics, Neuro-Surgery, Orthopaedics, and Psychiatry. Liaisons with each service keep the doctor, patient, and physical therapist in close contact. Miss KA1sER The most recent expansion of the Department's services has been to provide physical therapy in the home to patients in Durham County. Three physical therapists working through the Duke University Medical Center and the Durham County Health Department visit pa- tients referred by the Medical Center as well as local doctors. The Department occupies approximately 5,000 square feet in its new and adequate quarters in Room 045 and O42 on the ground floor of the Hospital and is well furnished with customary and recent equipment, in- cluding a therapeutic pool and an activities of daily liv- ing room, as well as a class or conference room. HELEN L. KA1sER, R.P.T. Director of Physzkal Therapy twenty-eight DIETETICS M1ss TATE The Dietetic Department at Duke University Med- ical Center is the second largest department in the hos- pital. Our objectives are to give outstanding service to patients and personnel, to teach, and to participate in research. It is our hope through the dietetic internship to help H11 the increasing need for dietitions and to offer leadership in preparing dietitians for the future. The approved Dietetic Internship program at Duke University Medical Center is one of 50 in the country and one of three in the Southeast. The candidates for admission must have a bachelor's degree from an ac- credited college or university with a major in Foods and Nutrition or Institution Administration. During the twelve months of post baccalaureate work, the interns have class instruction from the Dietetics, Medical and Para-Medical staff. They are given the opportunity to apply the principles of dietetics to administrative and normal and therapeutic dietetics. Their scientific and technical knowledge is practiced under the guidance and supervision of a selected, professionally qualified staff. Team effort and experience is gained in the areas of Out-patient Department and Patient Food Service, re- search areas, teaching, food production, management, and other learning experiences as conferences, patient contact and rounds. With the satisfactory completion of the dietetic in- ternship, the intern is eligible for membership in The American Dietetic Association. DOROTHY E. TATE, M.S. Director of Dietetics' twenty-nine . M 5 sim H T -5 l - . 4 .lm Q A f' aaaaa 4 rl MEDICAL ART- ILLUSTRATIO In the thirty-two years since its beginning, the medical art and photographic service has emerged from a staff composed of one medical artist and one part-time photographer to an organized department with, at present, personnel consisting of Eve artists, six photog- raphers and a secretary. Each is experienced and thoroughly trained for his particular position and as- sociated responsibilities. The department occupies a well equipped suite of eight rooms which was specifically planned to meet the thousands of requests for a wide variety of medical and non-medical illustrationsg each, of course, to be of the highest quality and made in the shortest possible time. The basic responsibility of this service is to produce illustrations for the Duke Medical Center staff, through the employment of various art and photographic tech- niques and methods. These illustrations are used to en- hance the medical records of patients, to illustrate scien- tific Writings and as visual aids in teaching. Services offered by this Division are: I. Medical Art: Illustrations made by using various media and artistic techniques, to depict anything per- ceptible to the eye, the existing but unseen, and even the theoretic, mechanical drawings, diagrams, charts, graphs, lettering, casts, models, exhibits, etc. 2. Medical Photography: Illustrations either in black and white or color of anything to which available photo- graphic equipment will respond. This section produces still and motion pictures, retinal pictures, photographic copies, Hlm strips, lantern slides, enlargements and con- tact prints. 3. Consultation and advice in the selection and use of illustrative material and visual aid equipment. ELON H. CLARK Services offered directly for the patient's benefit are: production of various types of facial prostheses made of a skin-like plastic material to be used to replace the natural part-for example, a missing nose or ear when surgery is not advisable, instruction in the use of opaque cos- metics for the purpose of making less conspicuous any skin discoloration fbirthmarks are an outstanding ex- amplej. At the present time no regular course of instruction is given in Medical Art, Medical Photography or any other service offered by this department. ELoN H. CLARK Chairman of Department Professor of Medical Art and Illustration ROBERT L. BLAKE HENRY F. PICKETT RAYNIOND L. HOWARD EMERITI HE FACL LTT 19631964 IAMES B. DUKE PROFESSORS Ioseph Willis Beard, M.D. Wilburt Cornell Davison, M.D., D.Sc., LL.D. lames B. Dulge Professor Emeritus of Pediatrics Dean Emeritus of the School of Medicine Surgery Norman Francis Conant, Ph.D. Microbiology George Sharpe Eadie, Ph.D. Professor Emeritus of Physiology ami Pharmacology Caroline Elizabeth Helmicl: Associate Emeritus of Preventive Medicine Leslie Benjamin Hohman, M.D. Professor Emeritus of Psychiatry Professors Alexander, I. E. Alyea, P. E. Amos, D. B. Anderson, W. B. Anlyan, W. G. Arena, I. M. Baker, L. D. Baylin, G. I. Bernheim, F. Bogdonoff, M. Boyarsky, S. Bressler, B. Brown, I. W., Ir. Bryson, E. C. Busse, E. W. Callaway, L. Carter, F. B. Clark, E. H. Creadick, R. N. Dai, B. Dees, I. E. Dees, Susan C. DeMaria, W. I. Dent, Sara I. Eagle, W. W. Estes, E. H., Ir. Everett, I. W. Forbus, W. D. Fowler, A. Gardner, C. E., Ir. Georgiade, N. G. Glenn, I. F. Goldner, L. Grimson, K. S. Hackel, D. B. Hall, F. G. Philip Handler, Ph.D. Biochemistry and Nutrition Ioseph Eldridge Markee, Ph.D. Anatomy David Tillerson Smith, M.D., Litt.D. Bacteriology FLORENCE MCALISTER PROFESSOR Eugene Anson Stead, Ir., M.D. Hansen-Pruss, O. C. E. Hardin, P., Ill Harris, S. Hart, I. D. Hetherington, D. C Heyman, A. Kaufman, N. Kempner, W. Kerby, Grace P. Kinney, T. D. Klavins, Larsh, E., Ir. Lowenbach, H. McBryde, A. M. Mclntosh, H. McKinney, I. C. Menefee, E. E., Ir. Nicholson, W. M. Odom, G. L. Orgain, E. S. Parker, R. T. Medicine Peele, T. L. Becker, R. F. Persons, E. L. Bernheim, Mary L. C Pickrell, K. L. Blum, I. I. Postlethwait, R. W. Bonar, R. A. Reeves, R. I. Bonk, I, Renkin, E. M. Borstelmann, L. I. Rhoads, M- Botwinick, Ruffin, I. M. Rundles, R. W. Sealy, W. C. Semans, I. H. Shingleton, W. W. Sieker, H. O. Silver, G. A., III Smith, 1. G. Stephen, C. R. Tanford, C. Thomas, W. L., Ir. Tosteson, D. C. Tyor, M. P. Vogel, F. S. Wilson, W. P. Woodhall, B. Wyngaarden, B. Young, W. G. Associate Professors Altrocchi, I. C. Barry, W., Ir. thirty-one Byrne, W. L. Cavanaugh, P. I. Cherney, W. B. Clippinger, F. W. Clower, Virginia L Cohen, S. I. Cuyler, W. K. Davidson, E. A. Day, E. D. DeTurk, W. E. Dillon, M., L. Dovenmuehle, R. H Duke, K. L. Fetter, B. F. Gehman, lla H. Goree, I. A. Green, R. L., Ir. Gregg, R. A. Gross, S. R. Guild, W. R. Hall, K. D. Harris, H. I. Hendrix, P. Hill, R. L. Hine, F. R. Horowicz, P. Hudson, W. R. Hull, VV. E. Iohnson, E. A. Kaiser, Helen L. Kamin, H. Kilburn, K. H. Kostyo, L. Kurtz, S. M. Lakin, M. Llewellyn, C. E., Ir. Long, E. C. Lynn, W. S., Ir. McCarty, K. S. McLachlan, Mary H. McPherson, H. T. Maddox, G. L. Moore, W. Moses, M. North, W. C. Obrist, W. D. Overman, R. Peete, C. H., Ir. Peete, W. P. I. Peschel, E. Pfeiffer, B., Ir. Preiss, Schmidt-Neilson, B. Shmavonian, B. M. Sidbury, I. B., Ir. Smith, A. G. Stempfel, R. S., Ir. Thiers, R. E. Vazquez, I. I. Viau, A. Wakil, S. I. Willett, Hilda P. Worde, B. T. Asszktunt Professors Anderson, W. B., Ir. Bassett, F. H., III Bressler, R. Capp, M. P. Carson, R. C. Chen, R. W. Cornwell, S. O. Crovitz, H. Dick, M. Eisdorfer, C. Elchlepp, Iane G. Ferguson, G. B. Flanagan, Eleanor Flanagan, F. Floyd, W. L. Fox, W. C. Fridovich, I. Friedberg, S. Greene, R. C. Greenfield, I. C. Hein, P. L. Hockstein, P. E. Huse, Mary M. Iohnson, H. W. Iones, D. Kirschner, N. Laszlo, I. Lebovitz, H. E. Lesage, M. London, A. H., Ir. McCollum, D. E. McCrea, Alice L. McFalls, F. D. McGough, W. E. McManus, T. Metzgar, R. S. Munson, D. Musser, A. W. Nashold, B. S., Ir. Nichols, C. R., Ir. Osterhout, Suydan Ostrolenk, D. G. Gttolenghi, A. Owen, E. V. Pircher, F. Robinson, R. R. Saltzman, H. A. Salzano, I. Sanders, A. P. Smith, R. E. Smith, W. W. Somner, I. R. Spach, M. Stedman, D. Stickel, D. L. Tate, Dorothy A. Taylor, W. E. C. Thompson, L. W. Tindall, G. T. Tomlinson, R. F. Turner, Violet H. Verwoerdt, A. Whalen, R. Wheat, R. W. Wittels, B. Wynn, I. O. Zmijewski, C. M. Associates Alexander, C. V., Ir. Anderson, W. R. Baldwin, Marie Beard, Dorothy W. Black, R. L. Blumenthal, Edna M. Buckley, C. E. Bugg, E. I., Ir. Burnett, Carolyn Christakos, A. Clapp, R. Coonrad, R. W. Craig, R. L. Cress, H. R. Cress, R. H. Easley, Eleanor B. Elder, T. D. Feather, B. W. Gale, G. Gerber, C. I. zhirzy-:wo Gillespie, R. A. Glasson, I. Gorten, R. I. Gunnells, I. C. Hernandez, R. R. Hollister, W. Iohnston, W. W. Iones, O. W., Ir. Iones, T. T. Keith, C. R. Klein, R. F. Knight, C. M. McPherson, S. D., Ir. Marler, E. G. Mengel, C. E. Miller, D. E. Morris, I. Naumann, Dorothy E Newborg, Barbara C. Patton, I. D. Pickett, H. F. Polt, Sarah S. Portwood, R. M. Reckless, I. B. Renkin, Barbara Z. Riebel, I. D. Rochlin, A. M. Rossett, R. Sallade, R. L. Sams, W. M. Schiebel, H. M. Silberman, H. R. Spock, A. Spradlin, W. W. Stuber, R. L. Styron, C. W. Thompson, H. K. Trotter, M. Vartanian, V. Vazquez, Martha D. von Roebel, Christa Wallace, A. G. Warner, I. S. Watson, G. A., Ir. I CLASSES PRESIDENT IAMEs W. TURNER, IR. CIIIXID Westjield, New jersey Duke University Class President, F oarth Year Charlotte Memorial Hospital llledieine in Piedmont North Carolina Evelyn M ealieine, Barnes H ospital, St. Louis SE IORS Most things with a beginning also have an end, as soon will happen with the formal education of our Class of ,64. Every class before us has undoubtedly in- dulged in the feeling of being different from the others. We are special to ourselves because each has become incorporated into the memory of the group. Eight of our original members have been lost from this processg twenty-two more have joined us from other classes or schools but five of them have dropped from our ranks. Wives and children, however, have increased much more in their numbers. From twelve and six, they have grown to over forty-five each, proving that the study of medicine is not an all-consuming pursuit. The immediate future brings that great change, the internship. Thirty-two of us will remain at Duke while the others will disperse across the country. Divided by type, we find twenty-six in Medicine, twenty-one Ro- tating, nineteen Surgery, eight Mixed, eight Pediatrics, and one in Pathology. The distant future will be of much interest as our careers develop through the years. But no matter where we establish ourselves, the stu- dents, staff, and faculty of DMC will remain a cherished portion of our storehouse of memories. thirty-four If you can't get your work done in 24 hours, maybe you should Work nights, too.',-E. Stead RAYIWOND H. ALEXANDER CRAY, Gastonia, North Carolina Princeton University Surgery in North Carolina Surgery, King County, Seattle BEN L. ALLEN, IR. Spartanburg, South Carolina Wofford College Spartanburg General Hospital Orthopedic Surgery in the Southeast Rita and Christina Louise Surgery, Duke M.ARVIN S. AMSTEY QMARVQ Steubenville, Ohio Cornell University Research Training Program Academic Obstetrics ana' Gynecology Freddie and Ross Mixezl, Strong Memorial, Rochester PAGE A. W. ANDERSON Oakland, California Duke University University of California at San Francisco Research and Teaching lllealicine, Duke '4Any man can make a mistake, but none but ll fool will continue in it. -Cicero th irty-fi ue A man prepared has half won the IRWIN ARLUK Richmond Hill, New York Queens College of the City of New York General Surgery in New York City Vivien Mixed, fewish Hoxpital, Brooklyn WAYNE S. BARBER Short Hills, New Iersey Amherst College Atithor of Medical School Shows Academic Pediatric Psychiatry in New England Patricia Pediatrics, Strong Mein orial, Rochester CRAXVFORD F. l5ARNE'r'r, IR. Atlanta, Georgia Yale University Cabot Society, Iota Society, Publica- tions Board, Trent Collection As- sociate, Trent llledical History So- ciety, Aescitlapian Editor, SAMA Oxford Uniaersityf Radcliffe In- firnzary Internal Nledicine in Atlanta Medicine, Dzflqe W1LL1.1.M W.ARD BAXLEY, IR. CBILLD Macon, Georgia Emory University Rotating, Pennsylvania Hospital, Philadelphia battle. -Cervzintes Quiet minds cannot he perplexed or frightened but go on . . . like the ticking of ll Clock storm. -Patrick Henry t hirty-six during 21 thunder- Trim your lamp so it will give more light and less smoke. -Unknown W1LL1s H. BELL, II CWILLD Indiana, Pennsylvania Harvard University Internal Medicine Minta Me1lic1'ne, Duke FREEBIAN A. BERNE CBILLD Columbia, South Carolina University of South Carolina Trent Mftll-Cdl H istory Society South Carolina Billie lean, Dabney, and David Rotatin g, Charlotte Memorial C. Ci1R1s'roPHER BREBIER QCi-nusj N ew Bern, North Carolina Davidson College Aesculapian Stag Family Practice in the South Barbara Medicine, Indiana University, Indianapolis IAIXIES WALTON CARRUTH, IR. Unx Red Springs, North Carolina Davidson College Obstetrics ana' Gynecology in North Carolina Rotating, Medical College of Virginia, Richmond' The education of u man is never completed till he dies. -Robert E. Lee thirty-rezfen gang NA nicke1's worth of history may prove better than a dollar's worth of examination. -W. Anlyan N. BRUCE CHASE Lewifbarg, West Virginia West Virginia University Aescalapian Stal? Anne and David Bruce Rotating, Army, Brooke General, San Antonio ANDREW I. COTTINGHAM, IR. CANDY, Laarinlvarg, Nortlz Carolina Duke University Charlene and Andrew III Rotating, Army, Tripler General, H onolala IOHN L. DOBSON Arlington, Virginia Wesleyan University Anne Medicine, Dalia ROBERT W. DRURY Qlioixj Palm Springs, Florirla Duke University Family Practice in western Virginia Rotating, Hartford Hospital, Conn. The sorrow which has no vent in tears may make other organs weep. --Maudsley thirty-eight In the hottle, distontent seeks comfort, cowardice seeks courage, and h ishfulness seeks confidencef'-Samuel DAVID B. DUBIN Lincoln, California Stanford University Sandra Rotating, Sacramento County Curr, Elsnonran Durham, North Carolina New York University Aescttlapian Staf7',' Metlifal Psychology Faculty Sandra, Erica, Mare, and Iason Rotating, Dzzlqe ROBERT O. FRIEDEL CBoBj Ramsey, New Ierxcy Duke University SAMA l'1'c.viflcnt,' Researclz Training l'rogram,' Alpha Omega Alpha 14CLllI,C'l77I-C l',fych1'atry Susanne and Christine M cvlicine, Dalia' Micximm. H. FIlIJNS'f1N KMIKED Stanford, Conncfticat Brooklyn College Research Tralnln g Program Acazlemic M ezlicfnc' in the Northeast Ellie and Melissa lvy M ezlicine, Duke Rire things .ire rire and common things are common. thirty-nine Give every man thine ear, but few thy voice.-Shakespeare KENNA S. GIVEN Clenrlenin, West Virginia West Virginia University Project N icara giia Sargery Surgery, Indiana University, Indianapolis HERBEIKT P. CQOLDAIAN CHERBJ Cetlarharst, New Yorlq Duke University Producer of Medical Scliool Show Creeclmor State Hospital, New Yorlq Psychiatry Rotating, Broolgzlale Hospital Center, New Yorlq City RONALD S. GOODING QRONQ Pampa, Texas U. S. Military Academy SGA,' Class President Military nezirosargery or ortlzopeclics Phebe, Carter, and Mary Alice Rotating, Army, Walter Reed General, Washington RICHARD GORENBERG CDICKD Miami Beaclz, Floricla Wesleyan University SAMA laclqson Memorial, Miami Obstetrics and Gynecology in Soatlzern Florida Caren Medicine, Dnlqe Few things are impossible to diligence and skill.-Johnson forty Duty means loving that which one makes imperative upon oneself. -Goethe IAAIES L. GREEN, IR. CIIAID Wake Forest, North Carolina Wake Forest College Obstetrics and Gynecology Betsy and Libby Mixed, Baptist Memorial, Memphis FREDERICK L. GROVER CFREDD Arlington, Virginia Duke University Cabot Society Dorothea Dix, Raleigh Sargery on the West Coast Carol Surgery, Duke JOHN HOWLAND HALL Fairfax, Virginia University of Oklahoma Dermatology in the South Iane, lack, and Kimberly Pea'iatrics, Dalqe FRANK T. HANNAH Atlanta, Georgia Georgia State College Aesculapian Stal? Cherry State H ospital, Goldsboro Practice in the South Metlieine, Dulqe Statistics: used by most people like a drunk uses a light pole-more for support than for illumination. forty-one To practice medicine is to understand people g one cannot hope to succeed with people whose interests and opinions are not understood.-Unknown LEE S. HARRIS QBUDQ Sarasota, Florida Duke University Internal Medicine in Florida Ianice and Kathy Medicine, Dulie DERYL HART Durham, North Carolina Washington and Lee University SAMA Queen's Square Hospital, London,' U .S. P.H.S., Mexico Medicine, Health Center Hospitals, University of Pittsburgh MrANFRED HERlNI.ANN HECHT QFREDQ New Yorlq City Columbia University Orthopedics Virginia, Karen, Monica, and Susan Rotating, Army, Broolge General, San Antonio HERBERT JAMES HERRING, IR. UIMD Durham, North Carolina Duke University SGA, Cabot Society, Aesculapian Stal? University of the Republic of Monte Video Hospital, Uruguay, Portuguese Hospital, Porto Alegre, Brazil Surgery, University of Virginia, Charlottesville You cannot push yourself forward by patting yourself on the hack.-Quale forty-two Motto of the researcher: Publish or perish. ARNED L. HINSHAW CARNIE, Burlington, North Carolina University of North Carolina Iohn Unistead State Hospital Virginia and Ned Surgery, Duke JAMES W. HOLSINGER, IR. UIMD Durham, North Carolina Duke University Surgery Barbara Surgery, Duke HOWARD HYDE Pierre, South Dakota Iowa State University University of Heidelberg Medicine in South Dakota Mixed, University of Wisconsin Madison LENARD E. IACOBSON KLENJ Woodbridge, New Iersey Duke University SAMA Exchange Program, Copenhagen, Denmark Internal Medicine Medicine, New England Center Hospital, Boston Procrastination is the thief of time.-Young forty-three Mind is the great lever of all things. Webster CHARLES A. Ionxsox Hiclqory, North Carolina Duke University Watts Hospital General and Thoracic Surgery in North Carolina Amanda, Charles, Ir., Tracy, and Ted Surgery, Barnes' Hoxpital, Sl. Louis' KENNETH LEE JONES CKENJ Branszuiclq, Marylanzl Adelphi College Iota Socictyj Research Training Program Academic Pediatrics Pc11'iazrics, lohn: H ophinf, Baltimore HERBERT E. KANN, IR. CHERBJ Fort Worth, Texas Duke University SGAQ Smith, Kline, Cf French Award for M czl ical Witziting lllczlicinc or hcmalology l'C'A'C'LlI'CfZ Carol Anne and Susan Mca'icz'nc, Dalia' IUIIN R. KARICKHOFF Spencer, Wcst Virginia Marshall University Ophthalmology Mczlicinc, Dalia' There is nothing so easy hut what lf hetomes lllfFlCLlll when you do it with great reluctance Cmero forty-four Wisdom is oftentimes nearer when we stoop than when we soar.-Bean V1cToR I. KERANEN CVICD Metaehen, New lersey University of Miami Iota Soeiety Dorothea Dix, Raleigh Neurosurgery or Psychiatry in North Carolina Elaine, Victor Iohn, Astarte Elain, Konrad Charles, Aline Valerie, Michele Renee, and Reina Maureen Surgery, Duke D.-XVID N. Kms QDAVEQ Frezlerieksharg, Virginia Washirigtcmii and Lee University SGAQ Dake Endowment Externship ana' Precepteeship Corn nzittee Sargery in Virginia Harriet Surgery, lllezlieal College of Virginia, R ich nz on rl GEORGE M. KORNREICII Harrison, New York University of Rochester Bellezfaej University of California at San Franeiscoj Cherry State Hospital Ohstetries and Gynecology in the Southwest Rotating, Ben Tauh Hospital, Hozzston IOSEPH R. LANNING Uoej M orristown, 'Tennessee Duke University Class President Private Practice in Psychiatry Rotating, Lenox Hill, New York City People are like little pins-of very little use when they lose their heads.-Unk nown forty-hae There is in the worst of fortune the best chance for a happy change.-Kingsley ALAN M. LARIMER Granville, Uhio Denison University Rotating, Philadelphia General IOHN I. LAROSA Pelham Manor, New York Columbia University Surgery, Iaekson Memorial, Miami STEPHEN M. LAZARUS QSTEVED Brooklyn, New York Trinity College SAMA,' SGA, Editor of Oppor- tunities For Medical Students University of Washington Surgery in New York Surgery, Bronx Municipal Center, New York KAY RIFFLE LEWIS Fort Discovery, Ohio Duke University Murdoch School, Butner Pediatrics Alvin Pediatrics, Duke No man is happy who does not think himself so.-Pehler forty-six No one knows what he can do until he tries.-Bassler WILLIAM G. LIAKOS CBILLD Bayard, N ehraslqa U. S. Military Academy Practice in the Southwest Kay, Keithley Anne, and William, Ir. Rotating, Army, William Beaumont General, El Paso DAVE M.ARTIN, IR. Palm Beach, Florida Massachusetts Institute of Technology Research Training Progranzj Alpha Omega Alpha Academic Medicine Medicine, Dzilqe ROBERT S. MATHEws QBOBQ Hertford, North Carolina University of North Carolina lohns I-Ioplqinsg University of North Carolina O rth op ed ics Barbara, Bobbie-Lyne, and Cindy Surgery, Medical College of Virginia, Richmond IAMES SPEARING MAYsoN CIIBID Dallas, Texas Sewanee College Dorothea Dix, Southwestern Medical School Caroline Rotating, Los Angeles County General The greatest of faults is to be conscious of none.-Seward forty-seven At, Kilt is not a divinity but the mystery of arteriosclerosis Qeerebralj that shapes the earthly endings of most lives. -NEIM, 246355, 1952 ARTHUR MCCUTCH.4N CART, Salisbury, North Carolina Davidson College Rotating, Norfolk General RALPH MCGRAW, IR. Follanshee, West Virginia Dulce University Vascular surgery Isabel Surgery, Dulqe I. D. MCL.4UGHLIN, IR. QDONQ Washington, D. C. George Washington University Cahot Society, Division of Physiology Staff St. Thomas's, Londonj George Washington Medical School Stag Mixed, D. C. General, Washington MARHN A. NASH Winston-Salem, North Carolina Duke University Dulqe Chapel Organist Bellevue, New Yorlgj Chila'ren's, San Franciscoj Manhatten State, N ew Yorlq Medicine or Pediatrics Medicine, Georgetown U nizfersity, Washington, D. C. Diogenes struck the father when the son swore.--Maeay forty-eight Lahour to keep alive in your hreast that little spark of celestial hre, conscience.fVVashington STEYEX L. Ntckst,-xx CSTEYE, Ventnor, New jersey Princeton University Research Tl'll!'HIiNg Program l'erliuZr1'e5 in Atlantic City Harhara Mixed, lllontefiore Hospital, lVew Yorlq City Roamzr C. NOBLE fliotsj Raleigh, North Carolina University of North Carolina Ae.vezzlup1'f,zn Stuff Research Training Program lntermzl Merlie1'ne Mezl1'c1'ne, Dzrlqe D.XYIlJ F. P,xt'Lsox fDixvEj Azzmzpolfx, lllarylamt' Duke University Alpha Omega Alphaf Roche Azutzrrl for fjllfiltllllfl-fig' Selzolurshipj Rexeureh T1't11'n1'1zg Progrtmz AC'LlIfL'l77lC Surgery Patricia and Robin Kyle lllzixezl, Ijlllil' I.-xmas liotsB1'r'1' PowE1.1. fl5oBB1T'1'D Elon College, North Carolina Virginia Military Institute Pathology Pathology, Duke '4What humanity needs is not the promise of scientific immortality, hut compassionate pity in this life and inhnite mercy on the clay of judgment. -Ioseph Conrad forty-nine 'vnu-Q., Neither the sun nor death can b eye.-Cadman THOBIAS B. PRICE. Cl-lfJBiMYJ Florence, South Carolina Davidson College Flora Szzrgery, Indiana Unizxerfity, Inzzlianapolzlv S. DUBosE R.XX'ENEL fliosiaj Greensboro, North Carolina Duke University Childrenk, Boston Medicine or Peo'z'aZries in N ortfz Carolina Meziicine, Duke Roxana C. REED Seattle, Washington University of Washington McGill U nizferxity STUART S. RoBERTs QSTUD N ew York City City College of New York Rotating, Bronx-Lebanon, New Yor Trust in nothing that man who has not Z1 conscience in everything.-Sterne iffy Death hath so many doors to let out life. Beware! -Plutarch CHARLES R. ROE QCHARLIEQ Ruxton, Maryland Duke University Research Training Program Pediatric Research Mary Ann, Charles, and Elizabeth Ann Pediatrics, Duke FREDERICK LEON RUBEN CFREDD Rocky Mount, North Carolina Duke University Bowman Gray Academic Internal Medicine Susan Medicine, Cleveland Metropolitan CARL I. RUBENSTEIN Perth Amboy, Neuf lersey Princeton University Cardio vascular M ed icin c Medicine, Duke B. WINFRED RUFFNER, IR. QB. Arlington, Virginia Duke University Research Training Program Academic Medicine and Research Rhoda Medicine, Duke To be conscious that you are ignorant is a great step toward knowledge.-Unknown hfly-one l.ove thyself and many will hate you Morten CiEORGE E. SCHMITZ Chicago, Illinois Georgetown University University of Illinois Psychiatry Eileen, Mary Eileen, Marion E., and Martha Ellen Surgery, Duke WILLI,-XXI R. Scorr fBlLL, Nazareth, Pennsylvania Duke University Research Training Program Southwestern U niifersity Neurology Medicine, New Yorlg Hospital. New Yorlq City Doi: SERAHN W1'ntei' Park, Florida Duke University University of Bristol, England Plastic Surgery in Winter Parlq Lenora Surgery, Grady Memorial, Atlanta R.ALI'l'I L. SHIELDS Bethlehem, Pennsylvania Moravian College Duke Chapel Choirg Aescalapian Staff' Research in Cytogenetics lohn Uinsteaa' State Hospital Internal Medicine in Bethlehem Rotating, St. Lalqe's, Bethlehem Fluttery is soft soapg and soft soap IS 90 lye Roe fifty-ZWO A man Wrapped up in himself makes a very small parcel -Lincoln PHILIP T. SHINER CPHILD Front Royal, Virginia Virginia Military lnstitute Warren Memorial, Front Royal Internal Medicine Medicine, Duke DONALD G. SLAUGI-ITER KGRAHAMD Baltimore, Maryland Princeton University St. loseplfs, Baltimore Neurosurgery on the East Coast Betsy, Donald, Ir., and lean Surgery, Duke LEONARD SPRINGER CLEND Roxelle, New lersey University of Chicago University of California, Los Angeles Internal Medicine in New Ierfey or California Arnette Rotating, Newark Beth Israel MICHAEL L. STEER fMIKEb Denver, Colorado Duke University University of Coloradof Hadassalz and Beilinson Hospitals, Israel Rotating, King County, Seattle Thinking is the hardest work there is, which is the probable reason Why so few engage in it.-Henry Ford X jifty-th ree Contentment abides with the truth.- NATHAN PHILIP STRAUSE, III QPHIL5 Henderson, North Carolina Duke University Urder of Hippoerates El Salvador Academic-Private Pediatrics Carol Sue Pediatrics, Dulqe ROBERT H. TANKEL QBOBQ Haledon, New Iersey Iohns Hopkins University Iota Society lohn U instead State Hospital General Practice in North Carolinit Mixed, Brookdale Center, New York City LARRY K. TOTTEN Charleston, West Virginia West Virginia University Baylor University, Houston Radiology Pediatrics, Dulge CHARLES R. VERNON CCHARLIED Columbia, South Carolina University of South Carolina Dorothea Dix, Raleigh Internal Medicine in the South Marjean Medicine, University of Florida, Gainesville Melville Self-conquest is the greatest of victories.-Unknown hfty-four Footprints On the sands Of time are not made by sitting dovvn.-Efner CHARLES E. VIRGIN CCHUCKD Miami, Florida Duke University SAMAQ SGA,' Class Presidentg Cabot Society University of Florida Orthopedics in Miami Susan Surgery, Dulge 'THOINIAS WILSON CTOMD Burlington, North Carolina Duke University Walqe County Memorial, Raleigh Obstetrics and Gyneeology in South or Midwest Ieanne Surgery, Indiana University, Indianapolis ROBERT H. WINTER CBOBQ LeRoy, Ohio Wabash College Radiology in Southeast or Midufest Medicine, Indiana' University, Indianapolis MICIiAEL L. WOLK KMIKEJ New Yorlq City Columbia College U nilfersity of California, Los Angeles Pediatrics, University of Minnesota, Minneapolis The fellow who pulls on the Oars doesnlt have time to rock the boat.-Iessup Jiffy-Jive Hmmm, a paradoxial idiopathic Rabhit-White- Martin murmursf' For some of us medicine has long been iz way of life ,... e Remember . . . those First few days at DMC . . . meetings . . . photos . . . introductions . . . a silent partner in the learning of Anatomy .... UI SUPPOSEQ, in M-110 . . . kangaroo ovaries . . . demonstrations-of what we didn? know . . . the Green Hornet . . . Uncle Dunc day . . . the primordial soup, or the Gospel according to St. Philip .... Murphyis Laws Qwhat will go wrong will go wrong, etcj .... Noooooooooo, it's not the foot pad of a puppy paw . . . slide rounds with Dr. Peele . . . the whispering whiz from Bell Bldg . . . the long and fruitless hours of Biochem lah . . . the Rayor, sur- rounded hy student Nightingales . . . the Hall and Hull team on respiration . . . a top-notch guy named Howard, without whom the P Sz P lahs would long since have perished .... N' lt's a long ladder to climh. . . . for others it began when we saw the Davison Building . . . parties, dances, open houses, ball games, bull sessions . . . the Kinney syndrome-high chair, cola, and weed holder . . . rat rounds . . . T. Wilso11's canine friend with etherogenic incompetency of the sphincter ani . . . D. T. Smith's jokes . . . Rudy in pursuit of Dorothy . . . Dapper Dewey, Mortician Marvelous . . . Hackel elephants . . . Vogel slide barrages, with pools . . . Cu uptake in Au-fish brain . . . duck emhryo liver mitochondria-or B12 deficiency of Chinook salmon, treated with hutterfly xanthopterin-or the effect of of antirabhit duck serum horse antigen on etiocholanolone levels in the three toed white eyed yellow breasted Bantu humming bird .... . . . the psychiatrist whose patients were much like his clocks-both out of adjustment . . . the Law of Mon Dieullt' K'Dr. Kempner suggested The Heatherington Poly- Anggomy puzzled U5 50 that I lose five pounds? chromatophilia Stain mllgh , , , . . . that we buried our heads We foiind Histology color- in the books. ful... fifty-six MSO than this guy wem to the fzirmcfs door . . . . . . and Plzysiology and Biochemistry time- consumlng . . . 'Az-Z-Z-z-Z . . .H It could be, bum may not be, MWCH, il believing doctor . . . until we begun plzysical but all I can say is . . . uses mathematical energy in fliagnoszk. We all remember momenzf the systemf, of grezzz zelzfhng . . . . . . and z'nrere.vtz'ng CPC5. and more Z-Z-Z-Z-Z-zw MSO than I . . .H We were lectzlrefl to . , . . . and lc'ctzzrc'zl. ffty-sezfefz was l in ' Gosh, it's cold. 'glt squeekslll' Examining pnzienzx wax always fun . . . . . even when we were examined by them. Wfhe idiopathic autoimmune hypersensitivity If a ten page paper gets a P, then a forty page WHAT!! syndrome? F F paper . . . We read, wrote. ' -1 -0- F' Tell me more . . f' 'Remember that ui fht at Pearl Laffoou when 5 an una' exchanger! UICIUJ. you and I . . . Y We learned 77Zl1C!7 : from nzfrses!!! ffty-eight viper Meanwhile hack at the oasis 'AHere,s how I feed onew residents, even lady rc.fizz'c'nt5. it UASL: some questionslw UYou sure gave But most of all we profteff from exposzzre 10 . . . of all zfiewx, .senior faculty . . . 3 X, it to im in that CPC? L'The finger honeas attached to the . . . Wrist Her, uh, a, no evidence of schizophrenia seen on bone . . .U this chest X-ray. the not-so-senfor-faczzlty, and the philosopfzcrs. ffty-nine 'AVVlien examining tlizit nulilviu you . . Did Nelson really stty that? It .fl'C'l7I4' lfltll wc were tflzmzyf going on rozfndx . . . 1'nlcf1'm1'm1blc mzzmfx. I clcnft cgirc wlitlt Terry says, l'm not going to quit. So l says tu lici' . . lflffzffl wc' zffcrv not lmttillg lflt' breeze Ill! the wc' were in Ilia' c't!fc'fc'r1l1 . . . .fflllffllf fozzngv. '-a--1.4-5 yy- M-m-m, it tastes genial. Huh, crit 45 and they still St1rg.,gct1nesurnc mercuro . . . or taking cure of fanzily want ti unit at 4 AMW? chrome. 111111151-5 , , , . . . 01' financial matters . . . . . or Ulzflc' Sfznfx nztztzwzf sixty Watch your hand, he's got a camera Occasionally we neglected medicine . . . I think I dropped it in here. . . eating . . . Ottolenghi, called the 'crease and 'crease effect . . . the K. Lewis-R. Bressler pepperoni . . . the rapid rise of antilazlo factor . . . memories of our first real exposure to patients, via PD .... . . . the big change to clinical quarters . . . getting the feel of patient responsibility . . . the awakening to what the Nightingales are really like . . . venipunctures . . . pelvics . . . rectals . . . scut . . . busy nights in the ER . . . EKGs . . . KUBs . . . consults . . . medicine et al a la taxpayer's SHS at VA . . . fleas . . . plumbers . . . spooks . . . skin Heas . . . doctors for your head- or kidneys-or female troubles-or nerves-or heart-or left little toe . . . hard Working fellow studs in BB and CC . . . curbstone consults . . . life is hard . . .' . . . LE preps times OO . . . nickels lost-or even a nickel won . . . dinner at the big man's house, or a party at his hideaway . . . morning report with Mort . . . the Health Team . . . resonance of the phosphate bond . . . the Iournal of Clinical Insignificance . . . or Tasmanian Iournal of Paleontology . . . fascinomas . . . according 1 Q A Y ,I kia, -1 f , H, Wm as-'ti Mull A'They'll squirt every timen . . . even with the faculty, . . . Roll your l . . . .. . or singing . .. to the literature . . . serum porcelain levels . . . . . did you watch him urinate? . . . uWhat this ward needs is some doctorsf' . . . . . . live better electrically . . . when in doubt, plug them in . . . psychosomatic . . . psychophysiological. . . . . . . precips in bed . . . telephone calls in the night -long hours with Gravidas I . . . Carter tutorials . . . Ed and Charlie shows .... . . . Gardner aphorisms . . . 7 AM rounds . . . That's all right, Son, you don't have to stand up for me . . . the Blitzkrieg thru SS subspecialties . . . The Study of Rocks Made Easy, by E. Alyea . . . 'ffeel with your left and draw with your right . . . watching the private men at Watt's . . . Scribner shunts . . . idiot sticks . . . C8:S to BB . . . good urine and bad urine. . . . . . . parties with the spooks-pedopods-and others . . . the med school shows . . . Baker House rounds. . . . . . . we remember-some favorites-Hetherington- Peele-Fetter-Carter-the Osterhouts-Nicholson-Pes- chel-Rufiin-Baylin-Sieker-Sealy-Peete-Shingleton ---Odom-DeMaria-Spach-We remember .... sixty-one JU IOR CLASS S ' I CLASS OFFICERS sixty-two M. T. Audriolu M. I. Andriola B. B. Baker I. Y. Burbee, Ir. W. R. Render D. Bigner C. Boone H. Hossen G. A. Butcher S. A. R. Butchc L. A. Cancclluro w A. Cf. Cavalluro T. P. Clancy F. V. Coville R. C. Crawford R. G. Crummie A. I. Dicrocc I. D. Dirk:-:rs W. M. Dunlap I. L. Emlct R. R. Fagin L. M. Flint, Ir. I. L. Frank F. H. Gerber H. K. Gold D. S. Goldman F. Q. Graybc-ral, Ir. R. H. Gross E. Guazzo S. C. Hall, III R. E. HHYDCF I. M. Harrelson, I. B. Haslam I. E. Hasson D. M. Hawkins T. C. Hoyle, IH R. 1. Katz D. E. Kay, Ir. R. P. Krueger S. M. Kulvin sixty-four W.. .ff ...1 '-V' . .-... .-:M +A., -fi- wt' mvnfig RK, A 41. . - Vg, -::-..:.,:-f-: - 1' f if Q.. M .. , fm- rrrrrrrrrr Q -if , V . .- , Q W ,AAA.,, ig lang fi? I . . 5 WR g ji f l 5, 1 .H ' v 'N. is sixty-five I VW E .aa We A ri li. S. Labauer C. C. Linnemuuu E. P. Lively B. A. Lucas I. E. Markee, Ir. D. R. Maynard R. E. McArtor I. D. McCracken F. H. McGregor, I. S. Minus I. T. Nuekolls G. L. Odom, Ir. M. M. Oken A. N. O'Quinu I. G. Powell A. R. Price K. P. Rumming I. P. Rein C. P. Riley L. A. Rogers ,I Ir I. B. Rouse E. I. Sanford L. M. Saputo P. C. Scheidt W. Scllwann G. S. Scott N. R. Scott I. H. Shore K. T. Shultz W. H. Spencer C. W. Sternber B. G. Stewart H. L. Stewart H. B. Stone T. A. Sullivan, I. I. Sulzycki I. B. Taylor K. W. Taylor B. D. Venetta G. S. Wagner gh, Ir Ir. wr .....M sixty-six , ,,,A. ., I. W. Weeks F H H up aa W e 1- D- Williams A lnzz , V Vnzl W. S. Yuncy A A, ef ':::'A Azzlb C. R. Wright K 4' f ea e , 4 A, ., , .' 4 'as-:' 1 . I. P. Zaepfel S. K. Zirkle A LA I E A , 5' There go those damned jaekhammers again! Today we shall discuss the more difczdt aspects 0 medicine. sixlv-seven i . A X 5 Iessic There are three days in medical school: the first day, the last day, and the first day on the wards. Each is with its own special significance, and can not be com- pared to the others. We can hardly believe that first day in anatomy was but two years ago or that it has been only that long since we donned our ties for Uncle Dune Day, later to find, sadly, that there were no uncles in biochemistry, or in physiology for that matter. But we pressed on, regardless. Year Two was a phantasmagoria of petri plates, para- Wc gained I0 lbs. on Psychiatry sites, post mortems, psychiatry, prescription writing, and physical diagnosis. All this was capped off by a down-to-the-wire smashing fcrashing?j finish with Board exams fthe last to confirm our suspicions that we hadn't learned anything during the first two yearsj. The first day on the wards was different, decidedly different from that First day in anatomy. Do we remember the name of our first patient? Not hardly . . . lost in a miasma of CBCS, LMP's, sensoria, lV's, intubations, murmurs, et cetera. And there have been many, many patients since ity! The ZZZK Club ...qi Why not? We could zlrinlq during RTP lectzzres . . . sixty-eight X Would you please co-sign my orders? I'm Nou! let's see . . . I3 3X4 drops just a student. that first oneg we often are pleasantly surprised to find that really we haven't forgotten any of those patients, as what We learned from each fills in still another niche in the understanding of this or that process or disease. On the medical quarter we found that compulsion was compassion and did enough LE preps to prove it. A differential diagnosis of less than ten items was viewed with some disdain, and for every heart there was a murmur fjust to he safej. On second thought, there may he something to the haelqufard theory. per minute X 47 minutes X IfI0 ee equals . . . 'The desire to take medicine is, perhaps the greatest feature that distinguishes man from animals. -Osler fActually, We had to take the coursej 'KThere's a sucker born ever minute. -Barnum Y QAnd at the damnedest hours.j With the help of a surgeon he might yet recover and prove an ass. -Shakespeare fOrgan transplantj Gently, Sir, it's Mother's Day! sixty-nin e 17' A breeeh through the selatie notch? Surgery was different. Here we learned to be de- cisive: to cut or not to cut Qthe conference, the patientj was our dilemma, and the V.A. was a revelati0n-sorne- body else did the lab work and filled out the lab re- quests. fWe had heard about this, but even seeing it were afraid to believe it true.j Siphonapteru of the elbow? CE'5 to BB, BSS out etc., etc. But for conferences, psychiatry set the pace. Here we listened most often to our teachers, occasionally to one another, rarely to our patients land even more rarely did our patients listen to usj. It was the non-directive approach all the way. il ms e o' s- uneasiness - ,.,. if Sienna? fr Wi' ,Q x , tg e if t 1 nasal i1Q.2 1 ,.s. if Now, our class will assemble here. :evenly Gnexr what? I found my IJLZZIAEIIZIS 'rayxl On obstetrics and gynecology we were waiting and for Watching the whole quarter it seemed. We all became paranoid at one time or another, convinced beyond doubt that everyone else was getting the multigravidas and the good hours for tox watch. We are still talking about those four hour lectures in the clinic C ,-Xsk me a ques- 1 - - 1 K: - -,.,. 4,--, A - filet, sy-f1'f :Q ggxtkxs , rw f' :ses W Je Q f e , W . 5, ,J . su:,.,,,, f M, .uf f f -Wu... .A Q ,,,,... . QP x 1 ., ., Flu! Form Flint tion, dammitlnj and after much probing, pushing, reach- ing and squeezing we were Hnally most relieved when told at the end of the quarter that you coulcln't feel the adnexa if they were normal, anyway. For some it was a first introduction to surgery, and after a radical Wertheim, the last. .Mus-s --0'-LM. Now if you giggle, 5lze'll never let you :lo itl Some recofnmenfled cz fedeml m arlcctom y. 5C'Z!C'71fy-0118 i a fi , M. -,- .s- QA - 6 A i J 'Q gf 'wifi' A,, ' I -Q ,get . Qi g, t figs-2 1' ,. ., ins:-s g A finger inserted in the Ncx lower end of the tl!f727t'l7Zcl7 V canal . l'ediatrics was a revelationfthe sequellae to the delivery room. Some aspects were Mold hat to the mar- ried ones, hut for those nursery newcomers, hahy-toting was like handling frangihle eggshell china on a merry-gay round, much to the merriment of all. In the clinic and on the ward we found that mama and the patient were the duo to he reckoned with, making examinations a matter ol sorting second-hand symptoms. There are three days in medical school, and two are 1? time l'll rernenzbw' to stand' up for Dr. Gtzrdnefs rounds. gone. It Winter comes, can Spring he liar hehind? Research Training Program CAhr Tee Peel was the choice lior that small but tenacious group who pursue Svedlierg units, hiostatistics, microhial genetics, electron microscopy, and the many other tools ol' the research lahoratory. lt was a nine month accelerated, concen- trated grind that left us macerated, hut unlvowed. lt was hioehemistry all over again, only more so. Cleanliness is next to Gozflinessf' The Beginning .t'C'l!C'fIfy'fll'0 In Memoriam MICHAEL E. ROBISON Mike Robison was a man of strong feelings and intense moods. He thought he could do just about any- thing he wanted-and I believe he was nearly right. He Hrst came to my notice in an interview for ad- mission to the RTP. His record was average, but the intense desire swayed us in his favor. In the early months of formal teaching, he said little and only occasionally spoke up with a penetrating question. Later, when he first came into my lab, I was concerned that he was seldom there, until I found that he had been spending all day in the library and all night in the lab. As time went on, it became clear that when he wanted specihc instruction, he asked for it and learned rapidly. Other- wise, he was a loner. In a few months, however, we got on to an experiment of considerable excitement which demanded close col- laboration. He loosened up a little, and stayed for a second year. As the work progressed, he put in longer and longer hours, and I can never forget the critical all night sessions, with three experiments running simul- taneously, heated arguments about the validity of this and that, and the excitement of finally believing we had truly significant results. They were signiicant, and Mike's drive had much to do with their accomplish- ment. I am proud of him and his work. After he returned to medical school for his last clinical year, Mike kept working in the lab, but with interruptions. He was full of ideas yet to be checked out, and we were looking forward to the spring vacation from classes. It was a shock to all his friends, and to us particularly, to see the morning paper that first day of Spring, 1964. He did all things intensely, had a large streak of brilliance, and went out too soon. seventy-th ree SOPHOMORE CLASS 5 CLASS OFFICERS .veffefzzy-four A do . , J 'W 5 L ff. ly A .f I I 'T fir , A gf l fj 1 I ' -I H ..... , .35 A A 4 seventy-five C. Adler I. A. Alexander B. T. Allen D. W. Allen I. K. Allen R. E. Appen H. Arndr R. M. Bullentine R. C. Bechtel, Ir. P. E. Berry W. R. Bland E. C. Borden I. W. Bradford E. W. Brian, Ir. R. G. Brown P. G. Burk W. A. Carr I. L. Clark E. B. Cooper I. N. Crook D. P. Currie W. E. Davis W. B. Dick W. S. Dillingham L. T. Donovan B. Ferris R. B. Fisher R. F. Ford W. W. Fox Doyle G. Graham I. A. Grant, Ir. I. E. Greene T. M. Grehl I. A. Halikas E. B. Hammett w G. M. Hayter C. B. Herron D. C. Hitch C. B. Hopkins T. M. Hudson 5' . ..,,,.. 5, 21 W ':2.. W. f. ,Ag AAA? 5 f , .. L 9 . A X ,.,......., A JM ! 51 X nr ...f x. ' f iii : 1 ...T ' T' .K DDDDD 'iii ..........., i:i:iT'TT .,.. G T :Ett'fti .:tt A .,,, -J -..,, ...-..- A ' 4 L is T ... .. .ii ' iiii T . ..- ,.,.,..,.,, , - '- M r Abbv A , Z Iizzizz i ...:, 1 2 , M A., ... ,,.... ...,, I ...,:.,,- ...... 13 llz: ::E: Q ..,, . .A-.vzvv 7 Q E- , ,,. . ii A IZZE E iiii: ,.,.. .,i,V. T 1 Q fezfenty-six M! at L ? L rg gf 1 l ,f xr s. ,was , hx M- I 4 X. I 4 sm I ,Q . I5 f I A :vv fc . ig, . 5 'M B M -I if I I I X .. J . . A ,,w? seventy-raven I. R. Iohnson S. M. Katz G. L. Kline S. E. Kohler P. Krokidas A. M. Lewis L. A. Lohrbauer I. G. Mcllully D. H. McGregor E. R. McNeill M. MCD. Martin R. Mignone C. T. Moorman F. H. Morriss, Ir. I. L. Nash C. I. Niemeyer C. B. Norton, Ir. W. H. Obenhour R. T. Osteen E. A. Palmer V. A. Perriello. W. C. Picrsou. . VV. D. Price ::1::.1,1 , K. A. Ray , Alllulull V lllubub Ir If .... A, .i1, :K 'W i 1 ' A M. S. Redding H A P 1. M. Rich ,PQ ..,.. I. U. Ruberisou ,. - ::1.- Iv. ...zv I M. P. Rozczlr I. P. Shock. Ir. C. T. Smith D. H. Smith I. A. Snead 1. C. Taylor R. H. Threliicl I. F. xil1iiCCIHi L. L. Vifzisscrman, jr. P Q ziiii? . . I. Weiue1', Ir. C. A. VVellingtou I. M. Withersiwooll I.. Ci. Zirkle. Ir. 'cucfzzfy-eiglil -x . ' 5 O . Q O .Q ,A-5-u x Ai .if,..,', iigr' MICRQBIOLOGT This is a theater. There is the play. It is a moclern play . . . a theater of the ahsurcl play. The characters are extreme. They heighten reality for us. They luring poignant meaning into our lives. lixperiencetl sages pass on their tales with laughs instead ol' cries. Bright young men wintl up their motors ancl screech through a clay while the autlience scratches its hrow. Other hright young men turn olT their motors while the audience pushes from hehind. Bright young women tall: zthout things men cannot .... F They are all screaming that we shoultl not memorize . . . that we should creatively think .... Aren't they liunny. . . l See the Heat. His name is Xenopsylla cheopis. He is very small, very small. He is dirty. 'very tlirty. He has two ctenitlia ahove his genal and two cteniclia hehintl his orhit. He has many cteniclia just in front of his pronotal. You can see him here in this microscope. Look. Look. See the Heal Descrihe now the relationship hetween such ohviously tlis- crete cteniclia clistrihution and the hacterial environment concentration on South Inclonesian rats with respect to this clistrihution even if the count is over ioo,ooo mm .... Here are your papers. See how pretty the recl is .... This is calletl l'impressionism. The red lines are only impressions. The artist will not talk ahout them .... This is the inalienahle sanctity ol? all impression- ISIS .... T. P.-XLLIDUN1 Home Gzmznm W1'lI Truzfe! xezfenly-n1'11c' YM.. REACT10 T0 IURT Upon gross examination of the Department of Path- ology the ohservant sophomore medical student recog- nizes the specimen to he a scrupulously cleaned. mottled, pink, tan, black, and very tightly organized mass of greater than normal size, hut of normal shape and varied consistency. On the surface it appears to he a normally functioning unit, with a thin exudate of puhlishahle. dull, researchoid papers and a few scattered hack issues of the Iournal of Lahoratory Investigation. The cut surface reveals an ectopic Hammond type organ laden with sheets of Liedermusila and surrounded hy an elongated, amorphous, horn-rimmed aide. a swaggering hass,ophilic mass with a German cast, and an extremely high-pitched neuron. The vascular supply is filled with copius green federal funds, so that one suspects congestion, with some parts receiving more than an adequate nourishment. Histologically, the lohules are variously constructed, three of them heing composed of hrilliant student cells attached to microscopes, among which are wandering macrophages. some with protuherant fat glohules and others ohviously vacuolated. Other lohules contain the easily recognized malignant professor cells. Several are congenital defects, and three or four are infiltrating foreign hodies. The Chief Cell is very hig and may he recognized hy the pahwees that issue from it. A lesser satellite cell lacks an acoustic organelle. Finally, one sees an idiopathic cell with crew cut cilia and a how tie con- striction. The hasement memhrane is lined with por- celainoid pots filled with dehris. Were the inquisitive student to speculate ahout the ante mortem function of this pathologic specimen. he might suspect spotty preparation with resultant epi- sodes of candle lighting. lt might he presumed that slowly migrating student cells had sensitized the Chief Cell to such an extent that a violent rejection reaction re- sulted when the Chief Cell was challenged hy other slowly migrating student cells. Finally, one might guess from the appearance of the student cells that they were overloaded hy the professor cells with more material than could he assimilated. decreasing the life span of the student cells and leading to their demise. The pathological features descrihed are consistent with the diagnosis of acute and chronic Pathologitis. The accompanying gross and microphcitographs are typical of this disease process. FRANK Nieciaosis. MTD. Prosector eighty l3,. ,nn 1 sbs, X is 'i PSTCHIATRT In order to get the inside story on the psychiatry course, we were fortunate in being able to corner an anonymous member of the staff at the proper moment during a recent cocktail party. Dr. X, adjusting his shoulder under the corner knick-knack shelf and mak- ing one last but futile effort to get the olive out of the bottom of his martini glass, licks his fingers wistfully and begins with a gravity befitting the occasion: mln the second year of psychiatry, the student gets his first taste . . f' fwith this word he pauses and looks sadly at the elusive olive, but this time he masters his impulse and continues . . Hof clinical psychiatry, i.e., personal contact with the disturbed patient. He begins to warm to his subject and his chin raises a bit with pride, 'This contact, however, is provided in such a way that it is not dependent upon the psychiatric service to supply material. A sly look is creeping into his eyes, 'KRather it is done in an elaborate and subtle fash- ion, beginning first year, when the student is reassured that all the shocking disparities in the various theories through which he is dragged will magically dissolve the following year when he enters the realm of practicality, treatment, and patient handling. The second step begins with Dr. Lowenbach's lectures sophomore year. His voice lowers and his eyes narrow shrewdly: A'Here our unsuspecting student is lulled into a confident, trusting attitude inspired by orderliness and rules. It's so simple. One doesnlt say KWhy?' he says, 'What is the reason that . . . P, One steps with beautiful simplicity through the categories of the mental status .... By this time, despite his rather dependent posture, Dr. X's voice and manner have assumed a certain swagger. After Christmas, he suddenly finds himself in a small group conference, shoved in 'front of a patient and variously instructed that the rules are all right ex- cept sometimes, when they aren't all right-that is to say, when you should actually use some other interview technique which can really only be determined accord- ing to the patient-although it is true that this is the initial interview and perhaps you don't actually know what the patient's like, but nevertheless .... Dr. X sighs. This, however, is enough to throw only ap- proximately two percent of the students into a state of acute confusion. 'Then he brightens: For the more resistant ones there is still the Saturday Morning Session where the student is plucked from the security of his familiar amphitheater niche and thrust before a patient while Dr. Lowenbach, Dr. Hohman and his classmates look on ominously. With swarms of admonishments swimming in his head, he makes one last desperate effort to remember if this is when he is supposed to start by saying what he ordinarily doesn't say according to Whose rule-or whether that was someone else's rule and his exception or .... Dr. X pauses dramatically and leans forward as far as possible under the circum- stances. Smiling wickedly he continues: L'At this point the student often mumbles something about how he wishes someone would be of help to him. His lips turn blue and he develops simultaneous horizontal and vertical nystagmus. Interesting and bizarre symptoms ensue. Often the patient helps carry the student out. Dr. X lingers for a moment on the exquisite memory, chuckling contentedly. He rebalances and continues professionally. 'This plan, when perfected, should provide enough interesting material, not only for our school, but perhaps enough for export. Which will, he points out enthusiastically, Not only produce extra income for the school, but also allow it to raise its number of admissions and hence increase total tuition. Dr. X pauses proudly and fin- ishes with a flourish of administrative pomp: Let no one say that our school isn't diligently and cleverly working to free itself from the traditional restrictions placed on medical education. With that, he smiles contentedly and disappears beneath the knick-knack shelf. ei gh ty-one E PHYSICAL DI AG OSIS I walked in and said hello to the patient. My voice cracked. This was my lirst patient. just look olhcial- that was key, I had heard. The zipper on hy hlaek card- hoard hag from Lilly was stuck, and the dye was ruhhing olI on my sweating palms. I'm a student-doctor and I would like very much to he of help to you hy examining you. It didn't sound sincere, hut, rather, memorized Qwhich it wasl. He smiled, and mumhletl something that sounded like no , fwhich I ignoredj. Uh, Sweet lesus, let me get out ol: here fast. I gave him a complete physical: every- thing that I rememhered my doctor doing to me when I needed health physicals for grammar school. I took his hlood pressure just like I had practiced on my kid hrother during Christmas vacation. 'lDoc, the ruhher tuhe isn't attached to your ear- plug. Hmmm. yes, yes. flust look oHieial.j First I couldn't get the pressure to stay up, then I couldn't get it to come down. I wondered what you listen for. I put the stethescope on his chest, and moved it around. I heard nothing with that funnel-thing. With the Hat side, I heard some crinkling and scratching, hut no lub-dub, luh-duh, like they told us in college. Hmmm , I rumhled as deeply as I could. I turned the man around and started tapping him on the hack, I discovered that, yes, his hack was, there. The edges of my lingers hurt. I put a stick in his mouth, told him to say i'Ahh , and was very pleased to see his uvula. I looked in his ear with the other funnel, but it was too dark to see anything. I tapped his knees with the ruhher hammer and he ohligingly kicked high. I felt secure, now, that I had done a comprehensive examination. l'Well, thank you, Sir, itls heen very productive. Doc, do you want to see why they're operating to- morrow. With that, he pushed his pants down, grunted, and this huhhle of skin popped out. Hmmm, what is it? It's a hernia, Doc, it's a hernia. MDL Hine, do you think 1'll ever hecome a doctorP'l eighty-1100 CLINICAL MICROSCQPT Teacher fcrashing list down on students deskj-Fair tastic! You wouldn't helieve it! Wliiit a tremendous pearl! Golly-gee! 'XVov.! Student A. what are a hundred and thirty-six things of interest that can go wrong with the reticulocyte count? Student A fasidejgll God. that's me! l can't think of anything of interest that can go right with it. Teacher Qsmiling faintlyj-Idiot! Student B-Dr., Sir, could I go down to the dope shop, Sir? You've crashed your list down on my hemo- cytometer, my pipettes, my cover slides, and my contact lenses. Teacher fsmiling hroadlyjmfll ignore that interruption this time. O. K., class, all together now, the numher one cause of iron deficiency is . . . ? Class fin unisonQfShistasomiasisF Teacher Chlowing a pontine arteryj4No. no, it's uh .... Mr. Smith-Blood loss, dammit Chuck. rememher? lt's hlood loss! Teacher Ccrashing list down on desk and showing vertical nystagmusj-lt's hlood loss, you dummies! O. K. now. does anyone have any question for ine on any- thing in the universe? Student C-Sir. is it true that yoti sleep in a Maxwell M. VVintrope sweatshirt? Teacher-I should hope so, student C, and now let me ask you one. You're sitting in your oflice, see. An Eskimo patient with paroxysinal cold hemoglohinuria comes in and wants to know il' she should marry a iaundiced farmer who raises anopheles mosqtiitoes. Now what are you going to do. for God sake? The patient is otit there waiting! Student C-Call in Mr. Smith for a consult? Teacher-No, no, let's try it again, class. All together now, never give hlood transfusions in cases of . . . F Class Qin unisonj-Blood loss, teacher! Teacher-Fantastic, they finally get the answer right, and I have to screw up the question! eighty three wx Uffzo the fzcll took tfzfxf' B111 llff been ,-'w'z1f1Iv1'ng for an IIOZIV, Cf1ur!1'c'.' 2 5 br 'ji , f 5 ,fwff sew You old fox, yon! lf! F Q V ' .,.,-- v is Y 'WM . . . and flll'Zf1C'I 7l1Ul'l', I find it bl mther Thank right, laugh if up! inlrigzzing uc-fourrenzenz to my bearing. eighty-fozzl' L! . . . There he fx. Qzziclql Belzinzz' the machine! Really! . . . Aim! . amz' when the all clazf' sounds, Imac the slieltcz' and go to xlalion 1, .... KNO Comnzentj . . . lvzrt, why arc' you all sleeping? eighty-j?L'f' all Zlzc' capzzzrcvl moments in zhe zlymmzlc putlzo gencxciv of the zlisemes for tozlayfr L'XC'l'C1'A'6 . . . F RESHMAN CLASS CLASS OFFICERS eighty-six eighty-sezferz P. Aaron D. G. Allen R. M. Auburn H. V. Austin N. M. Bath I. R. Beasbear W. W. Blackburn H. P. Bogess D. N. Broadbent G. L. Brown W. A. Brown I. H. Buehler I. T. Bunin W. H. Burwell S. A. Butler B. A. Campbell P. N. Chervin I. L. Clark F. A. Crawford C. Culver I. L. Danford A. Dean H. S. DeHart F. C. Delse W. E. Dodson M. 0. Farber I. T. Flaherty I. W. Futrcll R. W. Gaines H. A. Gallis I. A. Gzllotto G. M. Gianaras V. B. Giordano D. L. Grode E. Harper M. T. Himernhoff D. Wm. Hollister I. F. Huddleston 1. E. Jw... 14,15 W. Iurgelsky eighty-eight eighty-111716 Aizz. 1 ' ,,A,,,, :::::E:E:::E:l,.,, E 1,.,: 2 I M, M. E. Kendall R. W. Kesler R. M. Kurtz M. S. Levine C. T. Lynch B. D. McLees R. McMillan S. Maniscalco D. L. Marcus R. N. Marshall M. E. Matthews W. D. Meriwether R. F. Miller N. S. Otchin H. R. Parker C. V. Peery A. C. Raynor D. H. Riddick S. C. Robinson A. D. Rogol R. A. Rosati I. Saltz, Ir. I. D. Samuels W. H. Saunders W. Scurhorough I. L. Scherer H. C. Schneider H. E. Segal A. Speropoulos A. Stowell A. Stuhhs M. L. Thrush H. H. Trout T. W. Twc-lc L. C. Underwood R. T. Vollmcr N. W. Wetrerau R. F. Wilfong , if .... rrr: ,.'- . Q N X E I N5 5 K N L nincty D NVilliz1ms L. M. Willson . B. M. VVillwCrLh W. T. Woodard of lo -P W o W W ai qw sfE1:f: 5 W EEE f W o o W W W ' 58. fl ninety-one THE F0 UR HORSEMEN Anatomy . . . Biochemistry . . . Psychiatfry . . . Physiology 3 sfo? Ifnrvnrromv The room darkened. A bright light streaked toward the screen casting an image before the assembly of initiates. Out of the smokey mist a voice rose above the whirring projector, Today we will consider the mam- mary glandf' The entire medical class except two, maybe even more, were about to embark on a new experience. The lights reappeared. Eighty-one enlightened schol- ars quickly arose and raced to the elevator. Half an Baz :he boolg says if: male. .xl hour later, eighty-one disillusioned students dragged themselves and their equipment up four flights of stairs. Within weeks the situation began to change. Seventy- nine students slowly arose, and dragged their carcasses to the Dope Shop for CNS stimulation. Three weeks later, nervously meeting that fateful hour, the anatomists discovered that Dr. - was the one to watch out for. Anatomy conferences introduced all of the students to some new concepts: Dr. Markee: ulf you don't cure the patient's back- ache, he'll go to somebody else. It's our own fault that people go to Chiropractors. Dr. McFalls: Roman women picked their men by the size of their nosesf' Dr. Venetta: The Scaleni Brothers are innervated by the anterior rami of the lower four cervical muscles. Dr. Ferlic: Yes sir . . . No sir, the fascia here is not very tough . . . Oh, it is toughln 3 4 f . v :-, 'izfe' f ' 5Q?:Ax A .5'0uf9wK 1zi1zc'ty-three Q HISTOLOGT We can hardly forget those long, hot sessions in Uncle Dunes' class when it seemed that he could drone on forever in his well-tuned monootone. His first lecture about reticulocytes and erythroblasts set a re- ligiously followed pattern for his classes: black-out shades, lights out, stuffy room and barely audible lec- tures over his trusty projector. Those of us who were awake were entertained with his dry humor: The spleen, as you all knoow, is the seat of anger .... The liver does a tremendous job, expeditiously and With nio fussf, Once on one of his well-announced '4pop slide quizes we heard him comment, Noni Ncltfa, Heaven,s No! Those are not 1310195 of adipoze tissueg they are Blebs such as those comprizing an infant's lunch counterf' And then there was Uncle Dunc's Day when We quickly discovered he was not to be out-done by Clark,s monologue, Burwell's bourbon, or Blackburn's shirts. Somewhat crosspeyed and blood-shot we found our- selves completing our first hurdle only to leave our scopes and the lab collecting dust until Spring and neuro- anatomy. fzirzcty-four' I can also walk on water! BIOCHEMISTRY . . . And from the other side of the tracks came the priests from the Temple of Bell carrying the golden- leaved tome handlered down by the great high priest. The catechumens waited in deep meditation 'for the priests to instruct them in the profound secrets of life. The high priest spoke, i'The mysteries of the yEast are about to unfold before you. Mazeltovf' And he left. And it came to pass that on the second day the dis- ciples were taught the persistence and humility of their beloved Priest Kamin. And so it was. ln veneration of Priestess Bernheim they fasted three days and three nights. For Priest Hill they drew out their own blood, and they annointed it well with the oils of minerals and herbs, and they placed it in small vials within the cham- ber of light. Before the multitude Vicar McCarty per- formed the Sacrifice of the Gnawing Mammal to the great god D'na and the great goddess R'na. And they traversed many long roads. And the un- believers were numerous. When in the first quarter of the moon they were approached by the heathens, Line- weaver and Burke, who laid down a plot before them. While the plot might have overthrown the disciples, they assimilated it, and it was suppressed. And they were sore afraid, until on the high Holi-day they came to an Inn. There they met with the Bearded Prophet who spoke unto them as they imbibed in the nectar of the poor. And as the moon waxed and waned they gained in knowledge. When five moons came to pass they were bestowed with the Bell, Book and Handler, and they went out into the world. May the gods look down with favor upon them. ninety-five Qliaitimi It was assumed for many years that learning Physi- ology required logical thought processes. However, this was never proved empirically. Recent studies made on Duke University Medical Students have shown that learning Physiology is more a matter of luck. This pa- per will deal with studies made in this field by the Duke University Department of Physiology. Seventy-nine mammalian subjects were randomly di- vided into two groups, A and B. Observations were made on group A every Monday and on group B every Tuesday. During the work week the two groups were conditioned together in cage tio. The experiment was cleverly designed to produce a great enough pressure gradient so that absorption of knowledge would be ob- served. However, by the Monday and Tuesday of the following week it was revealed that some malabsorptive process was taking place. To correct this: rj shortly before the weekly observation, the pressure gradient was increased to within Loff, of the breaking point for a period of approximately ninety minutes: 2D more verbal Aiggiik S4 llllBl!, . Illlliif '!!!!!' N E and visual stimuli were presented during the work week period. In addition to the above experimental conditions, the subjects were also placed in electronically equipped cages where they were conditioned to push buttons, turn dials, and to write down meaningless numbers. After a period of eleven weeks the data was correlated and the following results were recorded: ij From 8:00 to 8:05 each morning, How was laminar. 2j 8:05-8:12, How suddenly became turbulent. gj 8:r5g the capacitance of the cage was reached, and in some cases, the critical number was exceeded and some subjects were seen groping for seats. 4D 8:55, subjects showed increasing resistance and tension. 55 9:00, there was a sudden outflow of subjects from the cage due to the change in conductance. Although the original premise has not yet been eluci- dated, work is still continuing in this field. nin tty-.fix 'Z lm Z1 LIBIDO UNCOVERED Late last night at Duke Hospital the morphological structure of the libido was uncovered by a Duke medical student as he was participating in an informal experi- ment in the anatomy laboratory. This discovery is held pertinent to all fcont'd on page 5Bj CLASSIFIED ADVERTISEMENTS Wanted Persons: Psychiatrist who likes everybodyg must not be aggressiveg to lecture to medical students. Contact Dr. I-Iine. Positions: Young male desires work-any work-previous experi- ence includes psychiatric training. Books: Desirous of obtaining old Sigmund Freud works. Frus- trated with present concepts. Contact Erich Fromm. We Bay 6? Sell old newspapers and blue covered paper works-Trent's Paper Collection. Lost ana' Found Lost-libido desires. Found-one aggression--fear complex. Advertisement Duke University Medical College Department of Psy- chiatry has made great strides into the area of Psychiatry. They are interested in young brains to work along side of the faculty. Men and women between the ages of trenty-five are being encouraged to join up. No previous education is necessary. Dr. Hine, a leading scientist in the field, has this to say about the opportunities avail- able: I feel that in comparison with other focal points of Psychiatric study, our department fcon't on page I6Dj Books Best Reading How to Faint and Malqe Something of It . . . Klein The Art of Self Defense . . . Hine Learn Conversion Reactions-A New Approach . . . Shmavonian Let's Swap Will swap Leary Circle for useful concept Four year old boy will swap thirty-eight year old father for any reasonable substitute. psyclzoszk is completely cared ninety-seven . . . informing you that your Now let'f ree, Three plus Three . . . RESEARCH TRAINING PROGRAM The Research Training Program was conceived to span the widening gap that modern technology has thrust between the physician and the research laboratory fand, conversely, between the scientist and his patientj. lt is dedicated to the proposition that it is not necessary for the practicing physician to be conversant with the nuances and intimacies of the calculus, of nucleic acid structure, of enzyme chemistry, but that it is indeed im- perative that the medical researcher be acquainted with the modus operandi of good experimental design and have at his command at least a familiarity with the tools and processes by which one may ask answerable ques- tions about natural phenomena. To this and sixteen RTPeers fa motley of medical students and post-doctoral fellows in various degrees of disarrayj assembled at the Bell Building in September to follow the bouncing ball of molecular biology-thereby being allowed to abandon that greasy clinical stuff for nine months. The RTP is popularly rumored to be the brainchild of Dr. Iames B. Wyngaarden who cleverly arranged his year's sabbatical studies in France to coincide with RTP season at Bell Building. While Dr. Wyngaarden was involved dam' le recherche, Dr. Montrose Moses was busy shepherding this year's Hock of RTPeers through a maize of genetics, chemistry, cytology, mathematics, sta- tistics, through seminars, lectures, discussions, demon- strations and labs. After four months of this Mosaic approach to knowledge, the students repair to one of numerous labs to pursue an intensive and prolonged study of a single problem. And, while Nobel awards may be a long while in coming to the RTP students, it is at least to be hoped that they will be conversant with the methods and aims of the scientific approach to medical problems and thus give the lie to Pogo's words fso aptly applied to medical researchj: K'We have met the enemy and they are us!', n in ery-eight 3 1 2 5 A 1,:::: .,, 1.. .::, E 5 . N I iP'f ! f:5:s:1w:2:f, - If ' , X A in ' sw ' f 2 TQ Y Zigi: Src the lfnzpfd droplets. A17 flnzizm Acid Aznllyzvr ' g-ag 'S'fvww X ff ,,,..,.,. , ,, M, .. ,, W, ,N M N j , .Q K X b v DQ U9 L. SW X fs., 5 an K , z ' ' P 'Z x W, I 9 ' l M W , fy M E X ,W W. muff' 'fff?7f2Eif::5'5f:fff'a 12 ,fm vM . 2 df is 6 e f I' Yay, zvcfll Cflffff your Enzyme purity. Drx. Kcmfrczzf umf Sfzzzgcr 111'11fty-171.216 Drs. fucob, Wolfman, and Bcnzer Q L Enzyrnologists at your xerzficef one hundred Piewcf ,f .-M E iii' A- '-1 ff' I , ', Q f'x '-.xx f' ff f- 1fE!g1 1fIwr1ze -2 'ix M , 1-km uv , , f fM2m1l. N aa Q f fi if W y LL Q Q .x A ifgjqgfgzf V, gig' ,,. Ttjiigg if Igifzif 1,5 QHH'?9-i,15Q3,E gmf J 1 594' X 31- 4 is ff fm lf mfif ff Xgffxmffsf fklaf J W' ,' :A:: 4 5 gm iffy ' fffif mm m.1mm ia Qybz Aix, AMN 1 A HQ Ni' 56,4 wfmfv I 94597451 'nf .,.,,,, i -x :lb Bakr Kufurrvw :::?' A Wim. LW, 4 GRGANIZATIG S STUDE GOVER ME T ASSOCIATIO SAM Yaxcv, CII-IARLES VIRGIN, Iola M.ARKEE The Student Government Association is composed of the elected representatives of the student body. This year, as iII the past, SGA has been involved in many aspects of the curricular and extra-curricular activities of the students. Also, the SGA functions as the Honor Council for the medical school and Court of Appeals for violations of the traffic code. l Y OFFICERS AND REPRESENTATIVES Every year projects and activities are those of past years, as well as some new ones. The student cur- riculum committee continues to work closely with its counterpart in the faculty, evaluating the current and proposed systems of medical education. Since the retire- ment of Dean Wilburt C. Davison, the Davison Scholar- ship for study abroad has been a sought-after award. This year funds for one of these scholarships was appropriated and granted to Iames G. Nuckolls. Departing from the more traditional Student-Faculty night, SGA and SAMA joined forces to sponsor an original musical comedy by Wayne Barber. A most enjoyable evening for all at- tending! Another departure from the usual, SGA held its annual dances at the lack Tar Hotel this year. The new environment seemed to increase the popularity of the dances, adding an atmosphere of conviviality to to the events. SGA OFFICERS Prc's1'dent.' Charles Virgin Secretary: Ioseph Markee Treasurer: Samuel Yancy SAMA Rcpresenmzivc.' Iames Nuckolls Senior Class President: Iames Turner Rcprcsentatz'vc's.' Lenard Iacobson, David Keys lzznior Class President: Iames Rouse Reprc'senZarizres.' William Dunlap, Kenneth Ramming Sophomore Class President: Leif Lohrbauer Representatives: George Hayter, Lewis Zirkle Frcslrman Class President: Eugene Kendall Represcntz1tz'zxes.' Benedict Maniscalco, Robert Marshall one hundred and two C. Barnett, V. Perriello, P. Strause, S. Yancy, I. Mar- kee, I. Greene, K. Shultz, I. Nuckolls, L. Flint STUDE T AMERICA MEDICAL ASSOCIATIO The Duke Chapter of the Student American Medical Association is the only national and international or- ganization representing Soy, of the student body's opinions and desires as future physicians of America. As a service organization SAMA maintains an interest in a wide spectrum of activities. As a member of SAMA and consequently a mem- ber of the International Federation of Student Medical Associations, Lenard Iacobson, a fourth year student, took his elective quarter at the Friedricksberg Hospital in Copenhagen, Denmark, last summer. In the fall SAMA sponsored two Danes, Mr. and Mrs. Iorge Ibsen from Copenhagen, to a quarter each at Duke. Mr. Ibsen took medicine and Mrs. lbsen took Pediatrics. All ar- rangements for their living in Durham during this time were made by the Duke chapter, as members of the International Federation of Student Medical Associa- tions. New and very popular events, begun by SAMA and the Cabot Society this year, were the Student Forums. A series of panel discussions, involving well-knowns of the University and the audience, their aim was to in- formally communicate on topics important to members of the health team. In all, five such forums were held with a great deal of success. ln addition to its routine responsibilities, SAMA ended the year by organizing a guide service at the Health Fair. SAMA OFFICERS Presia'ent.' Iames Nuckolls Vice-President: Kirkwood Shultz Secretary: Iohn Greene Treasurer: Lewis Flint SGA Representatizfe: Charles Virgin Senior Class Representative: Crawford Barnett Innior Class Representatives: Ioseph Markee, Eugene Guazzo Sophomore Class Representatives: Robert Fisher, Vito Perriello Freshman Class Representatz'zfes.' Charles Perry, Michael Levine one hundred ana' three Omega DR. ORG.AIN Alpha Omega Alpha is a national honorary medical society having as its purpose the promotion of the highest ideals of scholastic achievement and professional ethics. The Constitution perhaps best describes its basic tenets. The spirit of the Society is set forth in its motto and in a modern interpretation of the Hippocratic Oath. lt is the duty of its members to promote its ideals, to foster the scientific and plzilosopbical features of the medical profession, to look beyond self to the ufelfare of the profession and of the public, to cultivate social minded- ness as well as an individualistic attitude toufara' respon- sibilities, to sbouf respect for colleagues and especially for elders and teaclzers, to foster research, and in all urays enable tlze profession of medicine and advance it in public opinion. It is equally a duty to avoid ufbat is unufortby . . . and all practices injurious to the welfare of patients, tlze public or the profession. The Society was founded at the University of Illinois in 1902 by William W. Root, M.D. The number of chapters has gradually increased until at present there are 85 chapters in the leading medical centers in the United States and Canada with some 30,000 members. The Alpha Chapter of North Carolina was chartered in 1931 under the leadership of Dean Wilburt C. Davi- son, M.D. Dr. Edward S. Orgain is the ofhcial Coun- sellor for the Duke Chapter. CLASS or 1964 Robert O. Friedel David F. Paulson David W. Martin, Ir. Bob Friedel Dave Martin Dave Paulson one lzundred and four DUKE MEDICAL DAMES OFFICERS: Seated L. to R. Taylor, Ruben, Virgin, Wasser- man, Auburn. Standing L. to R. Price, Currie, Vernon, Strause, Clark, Dick. President: Sue Virgin First Vice-President: Marjean Vernon Second Vice-President: Flora Price Secretary: Ioanne Wasserman Treasurer: Margie Currie Publicity: Susan Ruben Duke Medical Dames, organized in the early forties by Mrs. Frank Swett, is an organization of the wives of medical students. Other sponsors have been Mrs. Iames Semans and Mrs. Deryl Hart. Mrs. Angus Mc- Bryde and Mrs. Madison Spach served as co-sponsors this year. Each month the Dames meet at the home of one of the medical school,s faculty members to conduct business and to enjoy a planned program and social hour. Each class also holds a separate monthly meeting. Objectives of the Duke Medical Dames are to provide an opportunity to gain insight into the role of the doctor's wife in community service, to grow intellectually along with their husbands, to obtain information about Projects: Carolyn Taylor Class Representatives: Senior: Sue Strause fanior: Ioan Venetta Sophomore: Elinor Clark, Ioy Dick Freshman: Diane Auburn interesting avocations, and to meet and get acquainted with one another socially. Annual social events include the Christmas Dance, the fashion show in the Spring, and the buffet supper for Dames and their husbands at the Graduation meet- ing in may. Speakers this year included Dr. Iames T. Cleland, Mrs. Rufus Powell, Mr. Ieremy North, and the home demonstrators at Duke Power Company. The life of the Dames is not all social. A contribu- tion to Edgemont Community Center was made from money raised at the annual bake sale. The Freshman Dames clothed dolls for the Salvation Army at Christ- mas, and many girls volunteered their services as baby- sitters for the 'faculty and staff of the hospital. one hundred and five SENIOR MEDICAL DAMES Seated L. to R. Flora Price, Isabel McGraw, Arnette Springer, Susan Ruben, Barbara Matthews, Ginny Hecht. Standing L. to R. Carol Grover, Anne Chase, Marjean Vernon, Sue Strause, Rita Allen, Sue Virgin. JU ion MEDICAL DAMES Seated L. to R. Marie Barbee, Nikki Maynard, Ze Gerber. Standing L. to R. Iuanita DiCroce, Sally Weeks, Sue Scheidt, Chotsy Spencer, Carolyn Taylor. one hundred and :tx SOPH OM GRE MEDICAL DAM ES Seated L. to R. Ioanne Wasserman, Elinor Clark, Margie Currie, Nancy Shock. Standing L. to R. Carolyn Palmer, Ioy Dick. L. to R. Iane Bath, Shirley Dean, Diane Rosati fhiddenj, Sarah Chervin, Laurie Buehler, Helen Samuels, Carolyn Scarborough, Diana Auburn. one hundred and seven F RESHM A MEDICAL DAM ES SA TA F ILOMENA ikkgqiiff V SANTA FILOMENA is the Senior honorary society of the Duke University School of Nursing. Its purpose is to recognize achievement and promote leadership within the school. The new memhers are puhlically tapped at the May meeting of the Student Government Association. They are selected from the memhers of the rising Senior class, and must fulfill the following three requirements: maintain a li or hettcr average throughout their First two years, demonstrate superior nursing ahility, and show some contrihution to the hetterment of the School of Nursing. SANTA FILOMENA strives to serve its school and profession. Because all proceedings and ceremonies ex- cept tapping are secret, it may serve in ways that other organizations cannot. SANTA FILOMENAS color is whiteg its flower, a white carnationg its pin, a small gold Florence Nightin- gale lamp. SAXTA FiLoxiExA: Lefl zo Right: A4ClI f!'VII Howe, janet Baker, Miss Elinor Cndzfefl fl-lonomry Menzberj, Barbara Bremer, fenffer Gzzrnmcy, Betsy Rowland. one hundred and fight 'UN I 1..L..5-CnrmC:' . . 1 z i 1 -' . -, I ,Ur I . In n 0 Y fg ,'5f2f1yfi5--- .I. , SH I II 'f YV I4 f. :ww fff'5 Y'ie5?9!lF' 43--- I ,.....K.-...-,.. H gin- - LL' L,.a4..fQinL3g,g,4,gQ5L.:,.'.1AEE 3 ' I' R I ? 1-5ugr,gifr M ,Q , 1.--1,-fj I mum: Pxaaggvluua - gg I ' 'fy i 5CR8.C7'f1 CI3'1Z'Ll y I ---.-.,4 .' ,---1-M--...........,....,...... I . ' gl -...- . ? , M' 1 I 16-45 H- .. ' 5 s' A 1c'+' 1 ' .: . ' A QQ, II- Qcowf E new c e q',?,, , -512' , I I I I I wfwcfm- I-. Is: fn X ..-..,.T. . .. ., 4. , .LPI Af5:rEn::1Lx:lE1au,Q'r1t randi.-.: .' : .. - 1 5-57 , A, V' W,- . VI ' ' ' 'I if- i ' ' .,'. 'lf 9' ' 'F -A-4, I 1131 I XI 11: -f' LIP? 4J' ' -' ,455 ' :fs . ---J:-I-1:-W-I--.-I 5 -J -,if 8-Q Jef I 1 I I 1 I I I X045 3! I 6 K ..,?-if v --1 ,ft f-,WV ,' + , ,I Q -2w1If'fI,,I fs-0 ' NIII Li is I '- I S' 'H ALJ, IA' 5 ' . M ,,' 3 lf,r:'c,Rxn:zsI.5-1-,muifi f .IK 5-0 -Im:-'ref f nm NO - . 1 V. X-W,- -313157. iffruc, U I :iii ..,,,-I I I i f I 'l05,rc.-ici! IL Jag? ' : -I nl-2' f J Q : .f'.134?xVI xl - . I T' x9i 1- M ,gfld .-T3 Q I , . -g .- ' .riff .-g'.g1igQ,:z,' 5 .I I , I kd aI I I I Q5 -Y .ga - 5?f,5Ll?g' ' I 'LOBBY' ' , ,Z-'f u-5.221 -7 Q lncxaxv 6-O C'3M UA Atauxvsr , , , I I - 'J751'!n.anu.q K , ' ' ' A 5 -'- 32lH-lNrS- I' .5 'IMI I' Clin:-xr1.tvzn ' 'X, CE 'SEL' SLEA - -vn:vC.w4xu5ca-r.- . - ,4-Q,-5'gmQ,, FL 'O 55fZF L I-Qc-Im-1 I I :O - ' A 'gb' 9 A 1-wigx D j fl A I , Lauvru . J. .iwx fiffnf-ilglgfnnan. REI 1' 3111-, QTILP, 'I . BBL ,. .gg , -J 1g,1 , ' lL.LL'I.!!zA1z4L-mn U K . V UTA- W-f--7 . .,r,,,,, . 'K- f4f7:Qf'-Q-Ska--1 '-fTTfif'!l'nfn't:nt 15 ' 7.3. 'T3T:'u'I':g 5'l i-'f'f: ' j v A.:-IJE-I-g ,X :5If 5 -sg, -JANIT-920 imp'-I, 5 - f' .pref . 555' Ifwff l,-,,-wh,-X IDF lgjgfjgz ' ! 'j .- zfg,L5,Y22iLi2'5'f n- 5 if Ma. 1 - - 5 3,132 'fn I 'LP Y . I... - '--- ---I . .NI V ' 372ME r.Arogg1gg' fi JL f,?', . I 31.5, . , gcgun N Q - K ., fl f 'LANL-,ISI 'ffm ' 3'0 A 40' I . ' ' Q , . I -. fm 0 fn! Q' I O'EL'E . -- 'TP U., . . . 'Yuvvc' . I' S5 I-5XIj!5 FI I T' N C3 LOON1 - 5 ' W '-'Cc'f'- ' ?f:5s..141-l-,1.:.'ffQ FEATURES I TRODUCTIO TO FEATURES SECTIG Duke Hospital is young. lt was hardly in existence a decade before most of us who are students were born. These have been thirty-four years of rapid growth and many alterations, and it is easy to lose one's sense of perspective in the labyrinth of our training. Defending against this, we will use these 'few pages to review some points of interest about the past and to preview the near future, while we are beset with the pounding and drilling of current remodeling. The Hospital was opened for patients on 21 Iuly 1930 in the midst of the Depression. At the end of that first day there were seventeen inpatients, and they were attended by the original Senior Staff plus a total of nine Interns, Residents and Fellows. The latter group was undoubtedly doing most of its own 24 hour sputums and stool guaiacs, for there were no medical students until eighteen intrepid Iuniors-one of them a girl-trans- fierred to Duke from other medical schools on 2 October 1930. These first medical students had their problems, too, for the first students of Nursing-thirty of them- did not arrive until 2 Ianuary 1931. And nobody met anybody at the Dope Shop back then, its precursor was a student book store established 21 Ianuary 1935. Dissatisfied with the stone then commercially available, Iames B. Duke had geologists search the Southeastern States for a vein of stone suitable for the new University. The result was this quarry near Hillsboro from which the facing stone for most of the University,s buildings, including the hospital, was ob- tained. A massive construction job demands massive transportation facilities. This vintage loco- motive is steaming down the tracks right where the main hall of the hospital now stands. one hundred and ten No ivy and no Baker House are seen in this view of what is now the Private Diag- nostic Clinic Entrance. Note the parking convenience, sans Campus Cops. Now named the Davison Building, the medical school and hospital structure was built between 1 September 1927 and 1 july logo at a cost of over 5.6 million dollars. one hundred and eleven In 1957 an extensive addition to the hospital was completed. This has provided space for the outpatient clinics, I4 new operating suites, recovery rooms, an Intensive Nursing unit and Hanes Ward. The main portion of this research building was completed in 1946 and named for William B. Bell, an ardent advocate of keeping research in ascendance at Duke. one hundred and twelve Completed in IQ62, the Gerontology building also houses the ENT Division, the Clinical Research Unit, and many other oFnces and laboratories. An addition to the Hpyerbaric research laboratories is scheduled for construction in 1964. EEE: Construction on the new Main lintrance Building is scheduled to begin in May 1964. It will provide new administrative space, a new Emergency Room, and additional area for the departments of Radiology, Psychiatry and Obstetrics and Gynecology. one hundred and Zhz'rlc'c'n Q . ' 5' 'F , ..: N W. ., ,. .' ' ' vlnap...,,.,,, , 1? H i 5 f 1 S 2 T an Dr. Woodhall and Dr. Anlyan contemplate the model of the proposed new Medical School Complex, with prominent structures planned for the area between the present heating plant and the Veteran's Administration Hospital. This might be called the Htwenty-Hve year plan. one hundrca' and fourteen ww, This diverse complex of hnildings and equipment is all designed for a common goal the understanding and treatment of human disease. In the Hnal analysis the respon sihility for gaining and using this knowledge rests with the studentsfof yesterday of today. and of tomorrow. one hundred and fifteen Aaro11, Paul Adler, Charles Alexander, lames A. Alexander, Raymond H. Allen, Barna T. Allen, Benjamin L., lr. Allen, David G. Allen, David W. Allen, James K. Amstey, Marvin S. A11de Andr Andr rson, Page A. W. iola, Mary T. iola, Michael I. Appen, Richard E. Arluli, lrwi11 Arndt, Hans Auburn, Robert M. Austin, Henry V. Baker, Bernie B. Ballentine, Rudolph M., lr. Barbee, Iohn Y., Ir. Barber, Wayne S. Barnett, Crawford F., lr. DIRECTORY 16 Hamlin Road, Highland Park, N. I. 226-49 Kingsbury Ave., Flushing 69, N. Y. 1201 Fairfield Dr., Gastonia, N. C. 1201 Fairheld Dr., Gastonia, N. C. 409 Hamilton St., Leaksville, N. C. 416 Forest Ave., Spartanburg, S. C. 624 East 20th St., New York 9, N. Y. 919 Lambeth Cir., Durham, N. C. S. C. Industrial School, Florence, S. C. 805 Louise Cir., Durham, N. C. 3715 Telegraph Ave., Oakland, Calif. 220 Monmouth Ave., Durham, N. C. 220 Monmouth Ave., Durham, N. C. 6201 Bresslyn Rd., Nashville, Tenn. IO3-I4 118th St., Richmo11d Hill 19, N. Y. 4Q Tannsstrasse 76, 1. Berlin, West Germany 110 lchabod Pl., Falls Church, Va. 410 Butler Dr., Clinton, N. C. Tyner, N. C. Ballantine, S. C. Scottsville Rd., Bowling Green, Ky. 955 Lambeth Cir., Durham, N. C. 2628 Rivers Rd., N. W., Atlanta 5, Ga. IIOREOLK GENERAL HOSPITAL JAMES WALKER A NEW MEDICAL CENTER Norfolk General Hospital serves as the main unit of a new medical center in Norfolk, Virginia. + Over 550 beds 1 Fully approved residencies in Medi- cine, Surgery, Obstetrics, Radiology, Pa- thology, General Practice and Pediatrics :Complete teaching program, medi- cal library and apartment house for mar- ried interns For further information: Director of Medical Education Norfolk General Hospital MEMORIAL HOSPITAL 275-bed general hospital serving southeastern North Carolina. Located in the pleasant city of Wilmington, ten miles from Wrightsville Beach. Approved by Council on Medical Education and Hospitals for 8 first year rotating internships and 3 second year rotating internships. These internships offer training and experience with the wide variety of illnesses seen in the com- munity hospital, close association with a well quali- fied senior staff, and regular conferences in all specialties. For further information: Director of Medical Education James Walker Memorial Hospital N0rf0lk 7. VlI'9il1if-'I Wilmington, North Carolina l If mfsytlr Memorial Hospital Dedicated to our Patients' Weyare and to the Advancement of Medicine The Forsyth Memorial Hospital, Winston-Salem, North Carolina offers a two-year Family Practice Training Program. The first year is medicine including psychiatry. The second year consists of pediatrics, obstetrics, surgery, and an elective rotation. The first year is acceptable as an intern- ship if the trainee develops interest in another field of residency training after entering the program. Inquiries and visits are welcome. Contact the Director of Medical Education, Forsyth Memorial Hospital, Winston-Salem, North Carolina. -,I QL' , .-ii, ,, ?6: N3v'5 f'w ' 41 iff'-'-''gii.:.:::.::',.5Qg4g4g-'3jLL?:?5?gi2sfi -' '1-6. h , , 12523: .4 ,5 .fh- +:.. v5,g5-fm-.,'4.faI' . W'f'A e L ' gr ,M '- SEEMAN PRINTERY INC. DURHAM-CHAPEL HILL BLVD. Y Serving I ndustry and Education in the Southeast for Over Seventy-nine Years Surveying village health needs, an SKGF Foreign Fellow examines a child in Kurali, near New Delhi, India. INDIA TAIIGAIIYIKA IRAN GUATEMALA At hospitals and medical outposts a long way from the classroom, medical students learn to cope with unfamiliar diseases, help to provide much-needed medical services to people in underdeveloped areas of the worldp and contribute to international under- standing and good will. This unusual opportunity to work and study in for- eign countries is offered to students through the Foreign Fellowships Program of Smith Kline 8: French Laboratories. Administered by the Association of American Medical Colleges, the program has enabled 123 students to work in 40 different countries during the past four years. Iunior and senior medical stu- dents are eligible to apply for Fellowships, which provide for an average of 12 weeks' work abroad to be completed before internship. Students who are interested in Fellowships should apply through the deans of their schools. SIIIIICII KIIIIB 8: FTBIIBII I.8Il0I'8tIlI'IB8 Bath, Nicholas M. Baxley, William W., Ir Bechtel, Richard C., Ir. Bell, Willis H., ll Bender, William R. Berne, Freeman A. Berry, Peter E. Beshear, Iames R. Blackhurn, William W., ll Bland, Wiley R. Boggess, Howard P. Boone, Stephen C. Borden, Ernest C. Bossen, Edward H. Bradford, Iohn W. Bremer, Charles C. Brian, Earl W., Ir. Broadbent, David N. Brown, Gerald L. Brown, Robert G. Brown, Walter A. Buehler, Iohn H. Bunin, Iohn T. Burk, Peter G. Burwell, William Butcher, Gene A. 4108 San Iuan, Tampa 9, Fla. 3140 Vista Cir., Macon, Ga. 210 Hillendale Dr., Doylestown, Penn. 464 S. Sixth St., Indiana, Penn. 526 S. Main St., Red Springs, N. C. 3207 Euhanks Cir., Durham, N. C. 2887 Howell Mill Rd., N. W., Atlanta 5, Ga. 205 N. Main St., Dawson Springs, Ky. Edward, N. C. 222 Locust Ave., Fairmont, W. Va. 3504 E. Oak Dr., Durham, N. C. 465 Assembly Rd., Fayetteville, Ark. G-3 Section, HDQ 2nd Army, Fort Meade, Md. 1255 Belvedere Ave., Iacksonville, Fla. 4800 Kanawha Ave., S. W., Charleston, W. Va. IGOS Tryon Rd., New Bern, N. C. 2111 White Cak Rd., Raleigh, N. C. 1606 W. Healey St., Champaign, III. Box 331, Hull Rd., Athens, Ga. 3900 Gosnold Ave., Norfolk, Va. 294 Read Ave., Tuckahoe 7, N. Y. 1210-G Morreene Rd., Durham, N. C. ESI Elm St., Kearny, N. I. 10541 Ahbott Ave., S., Minneapolis 20, Minn. Box III, Warrenton, N. C. 822 Onslow St., Durham, N. C. RE CO PRQDUCTS REABELA A. E. P. REAVITA EACH TABLET CONTAINS: EACH TABLET CONTAINS: EACH TABLET CONTAINS: PHENOBARBITAL ,,,,,,,,,,.. I6 mg. AMINOPHYLLIN ............ IM Grs. VITAMIN A ...... 5000 U.S.P. Units HYOSCYAMINE EPHEDRINE SULFATE ...,.,., 14 Gr. VITAMIN D ...... IO00 U.S.P. Units SULFATE ................ 0.1037 mg- PHENOBARBITAL .............. 14 Gr. THIAMINE HCL ,,,,,,..,,,, 10,00 mg ATROPINE SULFATE 0.0194 mg. RIBOFLAVIN -------.-,,,---. 5,00 mg HYOSCINE PYRIDOXINE HCL ........ 1.00 mg HYDROBROMIDE ,.., 0.0065 mg. ASCORBIC ACID .......... 75.00 mg CAL. PANTOTHENATE.. 5.00 mg NIACINAMIDE .,..,,...... 20,00 mg ALPHATO coPHERo1. .... 5.oo mg All above stocked by leading wholesalers and retail pharmacies in Southeastern area REACO PRODUCTS P. 0. Box 2747, West Durham, N. C. I. T. REAMER, Pres GOTHIC BOOKSHOP DUKE HOSPITAL STORE UKE NIVERSITY STORES WOMAN'S COLLEGE STORE DUKE UNIVERSITY BOOKSTORE Butcher, Suzanne A. R. Butler, Stephen A. Campbell, Barry B. Cancellaro, Louis A. Carr, William A. Carruth, Iames W., Ir. Cavallaro, Arthur G. Chase, Norman B. Chervin, Paul Niesen Clancy, Thomas P. Clark, Iames L. Clark, Ioe L. Cooper, Edwin B., Ir. Cottingham, Andrew I., Ir. Coville, Frederick V. Crawford, Fred A., Ir. Crawford, Robert C. Crook, Iohn N. Crummie, Robert G. Culver, Charles M. Currie, Donald P. Danford, Ierry L. Daniel, Eubert I. Davis, Walter E. Dean, Arthur I., Ir. Dehart, Henry S. 822 Onslow St., Durham, N. C. 1705 Richard St., Columbus, Ga. 401 E. Vine St., Millville, N. I. 120 W. Seeman St., Durham, N. C. 1715 Queens Rd., Charlotte 7, N. C. 225 E. Third Ave., Red Springs, N. C. 81-48 259 St. Floral Park, Queens, N. Y Box 43, Rt. 2, Lewisburg, W. Va. 4 Donna Rd., Worcester 9, Mass. 2832 Ridgewood Ave., Cincinnati, Ohio Box 885, Rt. 5, Charlotte 8, N. C. 1709 Forest Rd., Durham, N. C. 4508 39th St., N., Arlington 7, Va. Honolulu Hospital, Honolulu, Hawaii Box 34, Atkinso11, N. C. Rt. 1, Holly Hill, S. C. 202 E. Markham Ave., Durham, N. C. 401 S. Railroad Ave., Opelika, Ala. 3000 Chapel Hill Rd., Durham, N. C. No. 8-Atlas Apts., Durham, N. C. 2518 Inverness Rd., Charlotte, N. C. Apt. B, 3A University Apts, Durham, N QI Ellis St., New Britain, Conn. 35 Summit Dr., Easley, S. C. W. Vance St., Laurinburg, N. C. 907 Draper Rd., Blacksburg, Va. Delse, Frederick C. Dick, William B. Dicroce, Anthony I. Dillingham, William S. Dirkers, Ierome D. Dobson, Iohn L. Dodson, William E. Donovan, Lawrence T Drury, Robert W. Dunlap, William M. Eisdorfer, Carl Emlet, Iohn L. Fagin, Ronald R. Farber, Mark Ferris, Barry Fisher, Robert B. Flaherty, Iohn T. Flint, Lewis M., Ir. Ford, Raymond F. Fox, William W. Frank, Iames L. Friedel, Robert O. F ronstin, Michael H. Futrell, I. William Gabor, Andrew I. Gaines, Robert W. Gallis, Harry A. Galotto, Iohn A. Gerber, Frederic H. Gianaros, George M. Giordano, Vincent B. Given, Kenna S. Gold, Herman K. Goldman, David S. Goldman, Herbert P. Gooding, Ronald S. Gorenburg, Richard Graham, Doyle G. Grant, Iohn A., Ir. Graybeal, Frederick Q., Ir. Green, Iames L., Ir. Greene, Iohn E. Grehl, Todd M. Grode, David L. Gross, Richard H. Grover, Frederick L. Guazzo, Eugene I. Halikas, Iames A. Hall, Iohn H. Hall, Snowden C., III Hammett, Elliott B. Hannah, Frank T. Harner, Russell E. Harper, Eugene I. 24950 S. Woodland Rd., Cleveland 22, Ohio I605 C Sedgefield St., Durham, N. C. 1218 Broad St., Durham, N. C. 318 Elm St., Lancaster, S. C. 5932 Gakland Ave., S., Minneapolis, Minn. 825 Louise Cir., Durham, N. C. 907 A, Sedgefield St., Durham, N. C. 215 Purefoy Rd., Chapel Hill, N. C. 317 N. Davis Rd., Palm Springs, Fla. 605 Lake Boone Trail, Raleigh, N. C. 3423 Hope Valley Rd., Durham, N. C. Apt. II-C, 200 E. 71st St., New York 21, N. Y. I056 Fifth Ave., New York, N. Y. 1455 55th St., Brooklyn 19, N. Y. I5 Ofakim Lane, Haifa, Israel 498 Hawthorne St., N. E., Salem, Ore. 6 Rural Pl., Delmar, N. Y. I2 Normandy Rd., Fort Lee, Va. 42 Dellwood Ave., Chatham, N. I. 1202 Malvern Ave., Ruxton 4, Md. 631 Willow St., Mount Airy, N. C. 937 Lambeth Cir., Durham, N. C. 122 Hoyt St., Stamford, Conn. 1111 Rhode Island Ave., Lynchburg, Va. 858 Louise Ave., Durham, N. C. 315 E. 72nd St., New York 2I, N. Y. West Lake Dr., Athens, Ga. 326 Diamond Bridge Ave., Hawthorne, N. I. 1419 Clarendon St., Durham, N. C. 331 Pineapple St., Tarpon Springs, Fla. 919 Glendale Dr., Endicott, N. Y. 113 Koontz Ave., Clendenin, W. Va. 856 18th St., Newport News, Va. 98-40 64th Ave., Forest Hills 73, N. Y. 405 Oceanpoint Ave., Cedarhurst, N. Y. Box 579, Pampa, Tex. North Bay Rd., Miami, Fla. 311 Third St., Knox City, Tex. 532 Hart St., Tallahassee, Fla. 222 North St., Marion, Va. 3520 Courtland Dr., Durham, N. C. 2918 Woodside Dr., Tallahassee, Fla. 412 S. W. Seventh Ave., Fort Lauderdale, Fla. 110 E. Rockaway Rd., Hewlett, Long Island, N. Y 35 Greenwood St., Andover, N. Y. 2323 N. Utah St., Arlington 7, Va. 3812 Chapel Hill Rd., Durham, N. C. 1153 86th St., Brooklyn 28, N. Y. 304 Byrd Dr., Fairfax, Va. III Linden Dr., Danville, Va. 121 Andrews Rd., Durham, N. C. 1661 Iohnson Rd., N. E., Atlanta 6, Ga. 937 Longwood Ave., Los Angeles 19, Calif. Box 121, Knightdale, N. C. gyroemarint conjugated estrogens Qequiney Estrogen has long been employed as replacement therapy in the menopause and in such clinical disorders as postmenopausal osteoporosis and senile vaginitis. A fuller recogni- tion of estrogen as the metabolic strength of women-of its beneficial effect on practically every system, organ, and tissue of the body-provides a scientific basis for the wider ac- ceptance ofthe concept that estrogen administration should be continued beyond the limits of the actual menopause for its protective influence on vital processes, notably cardio- vascular, bone and protein, and cellular metabolismff This may be done rationally and safely, using the vaginal smear as a practical and reliable guide to managementf Wilsons concurs with earlier findings that there is no cancer risk with long term estrogen therapy. Effectiveness: Specific for estrogen replacement therapy in the menopause and postmenopause. Usual dosage: 1.25 mg. daily, Increase or decrease as required. Caution: In the female: To avoid con- tinuous stimulation of breast and uterus, cyclic therapy is recommended C3 week regimen with 1 week rest period-Withdrawal bleeding may occur during this 1 week rest periodj. In the male: Continuous therapy over prolonged periods of time may produce gynecomastla, loss of libido, and testicular atrophy. T AYERST LABORATORIES New York 17, N.Y. ' Montreal, Canada flfteferences available on reouestj 6357 Sherman Laboratories DETROIT, MICHIGAN In the service of medicine since 1907 PROTAMIDE65 ELIXOPHYLLINQ PERSISTINC9 BACTERIAL VACCINES 0 PHARMACEUTICALS Harrelson, john M., H1 Harris, Benjamin S. Harris, Lee S. H., III Hart, Iulian D., Ir. Haslam, Iohn B. Hasson, Iohn li. Hawkins, David M. Hayter, George M. Hecht, Manfred H. Herring, Herbert I., Ir. Herron, Charles B. Hinshaw, Arned L. Hinternholf, Mary T. Hitch, David C. Hollister, David W. Holsinger, james W., Ir. Hopkins, Christie B. Hoyle, Thomas C., III Huddleston, Iohn F. Hudson, Terry M. Hyde, Howard P. Iacobson, Lenard E. Iohnson, Charles A. Iohnson, james R. Iones, Ianice E. Iones, Kenneth L. 1124 Cedrow Ave., High Point, N. C. 1310-G Leon St., Durham, N. C. 868 Louise Cir., Durham, N. C. 2324 Duke University Rd., Durham, N. C. I3I4 Glendale Ave., Durham, N. C. 221 Fairfield Ave., Iohnstown, Penn. 2620 S. W. Fourth St., Miami 35, Fla. 636 Monrovia Ave., Long Beach 14, Calif. 142 Laurel Hill Terr. 5-I, New York 40, N 2010 Myrtle Dr., Durham, N. C. 229 West End Ave., McKenzie, Tenn. 1301 Cleveland Ave., Burlington, N. C. 1804 Bivins St., Durham, N. C. 918 Cowper Ave., Raleigh, N. C. 10110 Parkwood Terr., Bethesda, Md. 2306 Wilson St., Durham, N. C. 309 Southwood Dr., Columbia 5, S. C. 3605 Dogwood Dr., Greensboro, N. C. . Y 43 8 Water Oak Lane, Iacksonville 10, Fla. 5412 Staunton Ave., S. ll., Charleston, W. 517 Grand Ave., Pierre, S. D. 518 Tisdale Pl., Woodbridge, N. 960 N. Center St., Hickory, N. C. 627 S. Yorktown, Tulsa, Okla. 52 W. Munson Ave., Dover, N. I. 16 N. Virginia Ave., Brunswick, Md. Va Iurgelsky, William Kann, Herbert E., Ir. Karickholff, Iohn R. Katz, Richard I. Katz, Sheila M. Kay, Earl D., Ir. Kendall, Malcolm E Keranen, Victor Kesler, Richard W. Keys, David N. Kline, George L. Kohler, Stewart B. Kornreich, George M. Krokidas, Peter I. Krueger, Ronald P. Kulvin, Stephen M. Kurtz, Robert M. Lanning, Ioseph R. Larimer, Alan McC. LaRosa, Iohn Lazarus, Stephen M. Lebauer, Eugene S. Levine, Michael S. Lewis, Alvin M. Lewis, Kay L. R. Liakos, William G. 5011 Aurora Dr., Kensington, Md. 3818 Westcliff Rd., S., Fort Worth, Tex. Crescent Dr., Spencer, W. Va. 2557 Steele Rd., Baltimore, Md. 2260 Soth St., Brooklyn, N. Y. Rt. 2, Farrington Rd., Chapel Hill, N. C. 325Q Rose of Sharon Rd., Durham, N. C. 863-A Burch Ave., Durham, N. C. 17651 Henry St., Lansing, 111. 208 Brooke Dr., Fredericksburg, Va. Box 35, Robbins, Tenn. 112 Burruss Dr., Blacksburg, Va. 52 Stratford Rd., Harrison, N. Y. 34 Carew Terr., Springfield 4, Mass. llfl Bennett Ct., Durham, N. C. 1881 S. W. 36th Ct., Miami, Fla. 5 Reeve Rd., Rockville Centre, N. Y. 660 Carolina Springs Rd., North Augusta, S. C. 526 W. College St., Granville, Ohio 627 Francis St., Pelham Manor, N. Y. 6oo E. 18th St., Brooklyn, N. C. Q10 Cornwallis Rd., Greensboro, N. C. 543 Pio Nono Ave., Macon, Ga. 17o7 Forest Rd., Durham, N. C. 17o7 Forest Rd., Durham, N. C. R.F.D. 2, Bayard, Neb. MEN S GRADUATE CENTER Cafeteria Coffee Lounge DUKE UNIVERSITY mme HALLS WEST CAMPUS DINING HALLS 0 Blue and White Room ' University Room 0 Oak Room Linnemann, Calvin C., Ir. Lively, Edmund P. Lohrbauer, Leif A. Lucas, Bruce A. Lynch, Charles T., Ir. Maniscalco, Benedict S. Marcus, David L. Markee, Ioseph E., Ir. Marshall, Robert N. Martin, David W., Ir. Martin, Mitz MCD. Matthews, Robert S. Matthews, Minor E. Maynard, David R. Mayson, Iames S. McArtor, Robert E. McCracken, Joseph D. McCully, Iames G. McCutchan, Arthur D. McGraw, Ralph, Ir. McGregor, Douglas H. McGregor, Frank H., Ir. McLaughlin, Ioseph D. McLees, Byron D. McMillan, Michael R. McNeill, Emma R. Meriwether, Wilhelm D. Mignone, Robert I. Miller, Robert F. Minus, Ioseph S. Moorman, Claude T. Morriss, Frank H., Ir. Nash, Iames L. Nash, Martin A. Newmark, Emanuel Nickman, Steven L. Niemeyer, Charles I. Noble, Robert C. Norton, Charles B., Ir. Nuckolls, Iames G. Obenhour, William H., Ir. Odom, Guy L., Ir. Oken, Martin M. O'Quinn, Aglaia N. Osteen, Robert T. Otchin, Neil S. Painter, Simon M., Ir. Palmer, Earl A. Parker, Herman R., Ir. Paulson, David F. Peery, Charles V., II Perriello, Vito A., Ir. Pierson, Willard C., Ir. Powell, Iames B. 591 Parkview Dr., Burlington, N. C. 119 S. Main St., Reidsville, N. C. 1721 Estelle Dr., Clearwater, Fla. 1209 Washington St., Durham, N. C. Inlet Inn, Beaufort, N. C. 907 25th Ave., Tampa, Fla. 210 Linden Rd., Mineola, N. Y. 1015 Demerius St., Durham, N. C. Briar Creek Rd., Clemmons, N. C. 210 Osceola Way, Palm Beach, Fla. Box 203, Halifax, Va. Edenton Highway, Hertford, N. C. Box 419-A, Rt. 2, Durham, N. C. 341 Bellevue Ct., Los Altos, Calif. 6623 Brookshire Dr., Dallas 30, Tex. 769 E. Fifth St., Salem, Ohio 219 N. Brown St., Orlando, Fla. 1556 Parrish Pl., Iacksonville, Fla. 1616 Wittnberie Rd., Salisbury, N. C. 1223 Main St., Follansbee, W. Va. 1411 Green St., Durham, N. C. 2302 Pratt St., Apt. 7, Durham, N. C. Box 360, Mystic, Conn. Little Rock, Ark. 504 Lakeside Dr., Conway, S. C. 1056 Elm Ave., Columbia, S. C. 71 Ashe St., Charleston, S. C. 1477 Ridge Rd., North Haven, Conn. 2120 Spence Ave., Tallahassee, Fla. 869 Louise Cir., Durham, N. C. 1348 N. W. Seventh St., Miami, Fla. 2931 Avenue, S., Birmingham 8, Ala. 2327 Englewood Ave., Durham, N. C. 701 Roslyn Rd., Winston-Salem, N. C. 107 Goldsmith Ave., Newark 12, N. 2 S. Derby Ave., Ventnor, N. I. 9327 Ocala St., Silver Spring, Md. 2717 Fairview Rd., Raleigh, N. C. 4524 Country Club Rd., acksonville I ,F 502 W. Stuart Dr., Galax, Va. la 1201 W. Nokomis Cir., S. W., Knoxville I9 Tenn 121 Whitheld Rd., Durham, N. C. 37 Glen Ellyn Way, Rochester, N. Y. 1050 Cottonwood Rd., Dayton, Ohio 610 Anderson Ave., Savannah, Ga. 4430 Alton Rd., Miami Beach, Fla. 52 Orchard Rd., Staunton, Va. 557 Warren Ave., Washington Church, Ohio 7 Lakeview Mobile Ct., Chapel Hill, N. C 3 Lake Dr., Annapolis, Md. 1105 Pollock St., Kinston, N. C. 1228 Myers Ave., Dunbar, W. Va. S15 Lake Boone Trail, Raleigh, N. C. Box 395, Elon College, N. C. Welch Allyn Electrically Illuminated Diagnostic Instruments - W. A. LIGHTS THE WAY -- Otoscopes, Opthalmoscopes, Retinoscopes, Transilluminators, Headlights, Rechargable Battery Handles, Laryngoscopes, Proctoscopes, Sigmoidoscopes, Anoscopes, Oesophagoscopes, and many others. We are authorized agents for W. A. EXAMINING and TREATMENT ROOM FURNITURE, DIAGNOSTIC EQUIPMENT, THERAPY EQUIPMENT, INSTRUMENTS, LABORATORY SUPPLIES, ORTHOPEDIC APPLIANCES I WELCH AU-YN and other related items. Otoscope 8 Opthalmoscope Serving the Carolinas' since 1919 Distributors of KNOWN BRANDS of PROVEN QUALITY WIN HESTER HCAROLINAS' House or SERVICE N WINCHESTER SURGICAL SUPPLY CO. WINCHESTER- RITCH SURGICAL CO 1 1 I9 East 7th Street Charlotte, N. C. 421 West Smith St. Greensboro, N- C I IW , Y., ,, , , Y -YY W... me Beat ialzea to the Claaa of 1964 I I 0rtho Pharmaceutical Corporation 1 RARITAN, NEW JERSEY Powell, Iohn G. Price, Andrew R. Price, Thomas B. Price, William D. Ramming, Kenneth P. Ravenel, Samuel D. Ray, Karl A. Raynor, A. Clark Redding, Marshall S. Reed, Ronald C. Reitt, Iames P. Rich, Iohn M. Riddick, Daniel H. Riley, Charles P. Roberts, Stuart S. Robertson, Iames D. Robinson, Stephen C. Roe, Charles R. Rogers, Larry A. Rogol, Alan D. Rosati, Robert A. Rouse, Iames B. Rozear, Marvin P. 16th St., Silver Spring, Md. 4672 Malden Dr., Wilmington, Del. IOI9 Iackson Ave., Florence, S. C. 5215 Elsmere Ave., Bethesda 14, Md. 3812 Lillie St., Fort Wayne, Ind. IO6 Fisher Park Cir., Greensboro, N. C 1222 Pamlico Dr., Greensboro, N. C. 753 Riverside Dr., Osmond Beach, Fla 810 Dutch Ct., Greensboro, N. C. 16002 4ISt Ave., N. E., Seattle 55, Wash 224 W. Trinity Ave., Durham, N. C. 1064 Lawton Rd., Pk. Hill, Covington, Ky 2613 Legion Ave., Durham, N. C. 221 Roszel Rd., Winchester, Va. 3231 Rochaumbeau Ave., New York, N Y 103 Xanthia Way, Weirton, W. Va. 535 Kincaid Ave., Grifhn, Ga. 703 Louise Cir., Durham, N. C. 5009 Rembert Dr., Raleigh, N. C. 30 Garden St., Seymour, Conn. IZIO-F Morreene Rd., Durham, N. C. 3007 Fairview Rd., Raleigh, N. C. 28I2 Lydia St., Iacksonville 5, Fla. Serving Daily Noon 'til Nine aa4cceni on Uaaie U Durham-Chapel Hull Boulevard 2 AIR CONDITIONING HEATING SHEET METAL DURHAM, NORTH CAROLINA i i Compliments of WHITE LABQRATQRIES, INC. Pharmaceutical Manufacturers Kenilworth, N. J. i AM 55' GPR i Work-and-storage centers l tailored for your treatment rooms 1 American Modular is not just a new cabinet l -it is an entirely new idea! A complete selec- t tion of work-and-storage centers, arranged and l positioned exactly where you need them for more productive, less fatiguing office hours. American Modular centers Ht old or new, large or small areas - cost less - can be installed Gives treatment rooms modern, custom look. Smrirlly-styll-cl contemporary design creates a pleasant, more relaxing nt- mosphere for both doctor and patient. easily. AMERICAN CABINETS ,HAMILTON MANurAc1uRlNG coMPANY . rwo RIVERSoWIS F,tT,., t cease as at Ruben, Frederick L. Rubenstein, Carl I. Ruffner, B. Winfred, Ir. Saltz, Iames F.., Ir. Samuels, Iesse D. Sanford, Edgar I. Saputo, Leonard M. Saunders, Wade H., III Scarborough, Walter A., Ir. Scheidt, Peter C. Scherer, Iames L. Schmitz, George F. Schneider, Henry C., Ir. Schwam, Wallace Scott, George S. Scott, Neil R. Scott, William R. Segal, Herbert E. Serafin, Donald Shields, Ralph L. Shiner, Philip T. Shock, Iohn P., Ir. Shore, Iames H. Shultz, Kirkwood T. Slaughter, Donald G. Smith, Craig T. Smith, David H. Snead, Ioseph A. Spencer, William H. Speropoulos, Athan Springer, Leonard Steer, Michael L. Sternbergh, W. Charles, Ir. Stewart, Betty G. Stewart, Henry L. Stewart, Iohn I. Stone, Harry B., III Stowell, R. Ieremy A. Straub, Karl D. Strause, Nathan P., III Stubbs, Allston I., Ir. Sullivan, Thomas A., Ir. Sulzycki, Iames I. Tankel, Robert H. Taylor, Iack B. Taylor, Iane C. Taylor, Kenneth W. Thrash, Melvin L. Threlkel, Robert H. Totten, Larry K. Trout, Hugh H., III Turner, Iames W., Ir. Twcle, Thomas Underwood, Lee C., III 223 W. Thomas St., Rocky Mount, N. C. 138 Kearny Ave., Perth Amboy, N. I. 947 Lambeth Cir., Durham, N. C. 1001 28th Ave., N., St. Petersburg, Fla. 221 Elba St., Durham, N. C. 311 Haverling St., Bath, N. Y. III Sleepy Hollow Lane, Orinda, Calif. 540 Cassell Lane, S. W., Roanoke, Va. 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Venetta, Benjamin D. Vernon, Charles R. Virgin, Charles F.. Vollmer, Robin T. Wagner, Galen S. Wasserman, Louis L., Ir. Weber, Iaroy, Ir. Weeks, Iohn W. Wellington, Catherine A. Wetterau, Norman W. Wilfong, Robert F. Williams, Donald Williams, Iack D. Willson, Leroy M., Ir. Willwerth, Ben M. Wilson, Thomas Winter, Robert H. Witherspoon, Iohn M. Wolk, Michael L. Woodard, William T., Ir. Wright, Creighton B. Yancy, William S. Zaepfel, Ioseph P. Zirkle, Lewis G., Ir. Zirkle, Sara K. S. 1001 S. W. Fourth Terr., Hallandale, Fla. 2022 Pershing St., Durham, N. C. 601-A Maplewood Ave., Durham, N. C. 56155 St. Gaudens Rd., Miami 33, Fla. 2I9I Millvale Rd., Louisville, Ky. 410 E. Murphy Ave., Connellsville, Penn. 209 Carlisle Way, Norfolk, Va. 5520 Clinton, Beaumont, Tex. pg Sayle Rd., Charleston, S. C. Apartado 52 FO, Panama City, Panama 47 Casterton St., Akron, Ohio IIQ Dillard St., Carrboro, N. C. C-1513 Riverhouse, 1600 S. Ioyce St., Arling 215 Mercer St., Beckley, W. Va. 417 Emory St., Oxford, Ga. 105 Genesee St., Montour Falls, N. Y. 862 Louise Cir., Durham, N. C. Box 55, Leroy, Ohio Box 155D, Rt. 1, Brookeville, Md. 1470 Parkchester Rd., Bronx 62, N. Y. 511 Tihidaho Ave, Coral Gables, Fla. 3013-B VA Hospital, Durham, N. C. 6154 Wilson Blvd., 517 Mt. Holly Ave., SOI Kentwood Dr., Arlington 5, Va. Mount Holly, N. I. Blacksburg, Va. Ilfig W. Ridge Dr., Troy, Ohio ton 2, Va Compliments of COLONNA STUDIOS Incorporated On Location Photographers C 340 Westbury Avenue Carle Place, L.l., N.Y. Phone Edgewood 3-5606 , HOME l , l 1NsuRANcE AGENCY, INC. 1 l ' 318 Holland l l Our Business ls General Insurance 4 John A. Buchanan l W. Alfred Williams 4 Tom B. Cranford l l J, R, Coupland, III l 4 Hubert M. Brown i l l 1 . 1 James B. Bunting l Louis L. Sasser, Jr. OFFICE OF THE ASSISTANT DEAN fContinaed from page IZJ upper one-third internship. The nation recognizes your sterling label and your true quality. Finally, it has been customary for the author of this column to philosophize. Lacking the necessary chrono- logical mileage to speak from personal experience, I must seek a recognized authority. Last year, Dr. Wood- hall very adeptly wove into his column segments of the highly acclaimed F0under's Day address by President Knight. This year I have chosen to quote from one of President Knight's favorite literary figures-Shakespeare for Bacon, as some would have itj. The parting advice of Polonius to his son Laertes CI-Iamlet Act I, Scene IIIJ as the latter was about to be extruded into the outside world seems particularly appropriate to my colleagues in the class of '64. There, my blessing with thee! And these few precepts in thy memory See thou character. Give thy thoughts no tongue, Nor any unproportion'd thought his act. Be thou familiar, but by no means vulgar. Those friends thou hast, and their adoption tried, Grapple them to thy soul with hoops of steel, But do not dull thy palm with intertainment Of each new-hatch'd, unfledgld comrade. Beware Of entrance to a quarrel, but being in, Bear't, that the opposed may beware of thee. Give every man thine ear, but few thy voice: Take each man's censure, but reserve thy judgment. W. G. ANLYAN, M.D. Associate Dean and Professor of Surgery IMMUNOLOGY fffontinaed from page 18j is on immunogenetic research, the nature of antigens on the cells of leucocytes and various tissues and tumors of other animals or humans, and many of the investiga- tions are related to problems of transplantation, either at ways of reducing or modifying the immune response between donor and recipient as by antigenic matching or the establishment of immunological tolerance or of in- creasing the effectiveness of immunity in studies on tumor immunity. Investigations into the transfer of immuno- logical information from one cell exposed to antigen to a normal lymphoid cell, into the appearance of antigens in the fetus and in the placenta, of the development of immunological competence in the fetus and new born and of the activity of immune cells against a recipient animal or against a transplant are typical of other projects in progress. D. B. AM0s Professor of Immunology PSYCHIATRY fContinaea' from page l9f under the care and attention of his local physician and in the patient's own environment. Perhaps the major contribution that the Department can make in the future practice of medicine is the skill- ful and individual training of the medical student in the recognition of depression and anxiety and its role in everyday living and in the physical disease process. The aim is to equip the student to treat, within the limits of his skill, those emotional disorders that he can recognize and to refer to the specialist, those patients who require more intensive or practical management. By arrange- ment with other departments in the Medical Center, faculty members from the department are teaching ad- vanced courses in the management of emotional illness to residents in other specialties. But recognition and treatment are not enough with- out an understanding of etiology. Here there exists some confusion within psychiatry itself and a goal for the future is the intensive investigation of what makes a patient a schizophrenic, an alcoholic or a sex offender. Residents and students are encouraged to associate them- selves within the Department with those research teams probing etiological factors either biologically or psycho- dynamically. The student has the opportunity to witness the integration of psychiatry with medicine, psychology, sociology and anthropology by hearing these points of view propounded in the staff interaction within the De- partment. As biochemistry is to medicine, so perhaps the behavioral sciences are to psychiatry. The student who seeks a challenge in medicine can see such in the psychiatry of the future. It will be as different in the year 2000 as present day psychiatry is from that practiced in the year 1900. The psychiatrist of tomorrow will need broader skills and greater knowledge than in the past. We are en- deavoring within an eclectic framework of research, treatment and education to provide such a learning model. IUHN RECKLESS, M.B. CH.B. Assistant Professor of Psychiatry one hundred ana' thirty-three PEDIATRICS fContinaea' from page 242 ilarly motivated has been established to teach within the pediatric clinics and wards. Preparations are being made for studies into pregnancy, fetal life, and the perinatal period by both the Departments of Obstetrics and Pediatrics. In the projected main entrance building, new clinical facilities for the premature and newborn will be in close conjunction with the projected obstetric wards. In the vicinity of the delivery suites there will be facilities for both pediatricians and obstetricians to investigate problems of mutual interest relating to preg- nancy, prenatal life, the events attending birth, and the immediate postnatal state. As always, it is our intent that the undergraduate medical students, through exposure to the children dur- ing their Pediatric quarter, acquire an appreciation of the child in his family setting,-gaining an understand- ing of childhood disease states, normal growth and de- velopment, the child's interpersonal relationships, and the prevention of disease. This appreciation and under- standing will be needed by the medical school student in his role as a physician as long as he has to deal With patients be this as a pediatrician, internist, surgeon, psy- chiatrist, or subspecialist. IEROME S. HARRIS, M.D. Chairman of the Department AUTOGRAPHS one hzzndrezz' and thirty-four AUTOGRAPHS one lzzfnzlrezl and thirty-fue AUTOGRAPHS unc' f1z1nz2'1'czf um! lfzfrly-six 1 f Q' , .M 1 --. . , . -1'.',wgp .'.., -,-,-i, W. x .: , W.: 1-1 -gf. -n. , .uf My , Nw-r ,,, 5 --1 . . , 5 , . Q A QL,-E1-:g., ,,:54 ww 1. ,rwm ' -Q , , f, 4 7 w-41-'-Mq,'1,x L Q. ' .' ,, . .- . - af. v' , - - -154 - f 41 4 0,1 Y - X---. Q -,gx ' P , ky-f-iw.. ., 1, Q M M . , J ,, J, -- - - ,-,K ,f,1,.w-.wa .,,,,' W' . .-1 as V e.-' f-up ' 1- ' ' - ' :. .Jw A ., -.iwpfagf -If-' -, , ' H ,,,.,, ,. in Vx q'4'., '7'-in-,' X D, , w v,..1,., , - ,L,., -, . . 3371 'F' 4? , s , , 'gl I. 9 fn, , . Ls' Q3 L' - if 1 zi - 423 5' . E in V gi ii. f 1 15 54 5? v ,. . T. 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