Harvard School of Public Health - Yearbook (Cambridge, MA)

Page 13 text:

...If you see a pin... A I Te need for health professionals to know their ■ - community?—you’d better believe it. When I started out in practice, I learned first¬ hand of the conflicts between rationalistic medi¬ cine and the deeply-rooted mysticism of a small rual community in northwest Maine. I was in¬ troduced to the problems of the community health by experiences such as I am going to tell you about. . . One of my first good cases was a young man with a severe laceration of his hand. After I had sutured the wound, he looked up and said Gee, Doc, it’s a good thing I saw the healer. That was a bad cut.” Astonished, I questioned him further and found out that there were two healers in the town (seventh sons of seventh sons) who could sto p bleeding at will. They also treated nerv¬ ous conditions, abdominal cramps and chronic headaches. I didn’t pursue the matter further at that time but a little later I was called to see a young girl in coma from what turned out to be a subarachnoid hemorrhage. Her father advised me that she had been having headaches off and on for the previous week but that they had been relieved by the healer. After an ambulance trip of 120 miles and the tying off of her aneurysm, she recovered, luckily with no residual paralysis. Following this, I visited the healer for a personal talk but didn’t get anywhere. I was more than a little chagrined to find out he was a relative of mine. The point I want to make is that indigenous medicine isn’t confined to India and Africa. It is all around Boston and probably exists within less than a block of our school. . . . Medicine without an understanding of folk ways is an empty technical shell. And by the way, if you see a pin . . . pick it up and all the day you’ll have good luck. Niles Perkins TO DR. LEVINE October You say morale will take a dip, And be low in November, Then after that will rise again, Our trials we’ll not remember! November You now observe morale will drop, But that we should not fear, For spirits once again will soar Just after the New Year! January Again you tell us to cheer up. We really shouldn’t sigh, For ’though we feel down in the dumps In March we will feel high! It didn’t take me long to find out that the town not only had its indigenous healers but also had its indigenous standardized therapies for disease: the turpentine strips,” molasses enemas,” tarred ropes,” copper bracelets,” and nanny goat tea” were all a part of the kitchen closet. My pay was also often set by standards different from what I was accustomed to. The treatment for pneumonia would bring 5 lbs. of deer or moose meat. A gall bladder operation was worth 5 gallons of mountain dew which I couldn’t drink but which I found would keep the chemical toilet at my camp from freezing down to 30° below zero. The concept of spiritualism and the spirit world was way beyond my comprehension. The only problem was that all my relatives believed, and I would have to turn to my wife for consultation on complicated cases . . . March Again in March we may expect You’ll say we’ll smile quite soon, That even though things now look dark All will be bright in June! June And when June comes; the race is o’er; We hope we will feel bright. That on that day, in Cap and Gown We’ll say, Doctor Levine, You’re right!” Robert Gloor Seated —Roberta Idelson, Dorothy Bowden, Pamela Sis¬ son, Thelma Shapiro, Alberta Lipson. Standing —Sol Le¬ vine, Sydney Croog, Lenin A. Baler, Norman Scotch.

Page 12 text:

What I would like to see ne heartening manifestation of the growing acceptance of the behavioral sciences among public health professionals is that social scientists are called upon less and less to justify themselves. The social sciences are in public health to stay as long as work in this field involves understanding and influencing individual, group and community behavior. It is not an exaggeration to say that much of public health is, in fact, applied social science. The growing collaboration between the two broad disciplines of public health and social sci¬ ence is salutary. I would like to see the profession progress even more and foster the development of a substantial number of public health workers who have training in the behavioral sciences equivalent to that of Ph.D.’s in sociology, social psychology or anthropology. Obviously, the pres¬ ent curriculum of this School is not sufficient nor is it intended for that purpose. It is time to con¬ sider a combined degree in Social Science and Pub¬ lic Health for which both social scientists and pub¬ lic health professionals would be eligible. Our new Department of Behavioral Sciences would be in an excellent position to assume leadership in this area. Although there would be a number of merits in developing this new breed of public health specialist social scientist, there is one special con¬ tribution which I would hope this new profes¬ sional could make. As one who would possess social science acumen and understanding and still be a public health insider,” the new professional, hopefully, would be in a strategic position to in¬ fluence his professional colleagues and the organi¬ zations in which they serve. And this I deem to be especially important since I believe that the habits and culture of professionals and the needs and practices of organizations are often the major impediments to the realization of public health goals. As an activist” society, we tend to view with approval people who are active or are doing things. Even more we often tend to blur activity with doing good. But it is one thing for a pro¬ fession to be practicing its skills and another thing for the profession to be doing good” in helping to achieve larger public health goals. Profes¬ sionals often tend to approach or define prob¬ lems in terms of how they can best employ their own skills, and are less receptive to other skills and approaches which may be alien to them, but which in reality may be more relevant and effec¬ tive. How else, in view of the acknowledged shortage of qualified personnel, can we explain the failure of professionals to work aggressively for the massive deployment of auxiliaries and in¬ digenous workers in a whole range of public health programs? Why did such simple but innovational approaches to alcoholics and drug addicts—Alco¬ holics Anonymous and Synanon—develop outside and, in fact, remain outside of the public health profession? The literature is replete with examples of or¬ ganizations which deviate from their original goals and how major decisions are made in terms of professional convenience and organizational needs, instead of the needs and requirements of the original target population. The public health professional I would like to see developed is one who is steeped in the sociology of the professions and in organizational sociology, who is equipped to recognize and question some of the most fun¬ damental habits and modes of thinking of pro¬ fessionals and who has the skill and imagination to work towards achieving congruity between organizational needs and practices and those of the population requiring help. Sol Levine Sol Levine, A.B., A.M., Ph.D.

Page 14 text:

Richard Henry Daggy S.B, S.M, Ph.D, Dr.P.H. T wo decades hence public health will be con¬ cerned with the delivery of comprehensive health services to both individuals and communi¬ ties. New patterns of organizing and administering these services will be required, resulting in some communities in hospital-based preventive programs complementing the diagnostic, therapeutic and re¬ habilitative functions of the hospital. In other com¬ munities, multi-service centers will be developed in which welfare, mental health, rehabili tation, veterans, social service, and public health needs will be coordinated under one roof. Government—local, state, and federal—will be an active participant not only, as of now, in the funding of research and training programs, but also in the actual provision of all types of health and medical care services. Government controls will be exercised through the setting of minimal qualita¬ tive and quantitative standards for both personnel and facilities. The existing critical health manpower shortages will be relieved through the shortening of the re¬ quired training periods for physicians and dentists; through redefining the roles of all essential profes¬ sional personnel; and through the concomitant creation of a number of new health auxiliaries to carry out routine and technical skills formerly con¬ sidered to be professional responsibilities. As professional and technical specialization in¬ creases, care will become more scientific and more impersonal. This trend will be counter-balanced by an increased emphasis on personal health counsel¬ ing and education focused primarily on the preven¬ tion of major disabling conditions: chiefly heart disease, cancer, stroke, accidents, and arthritis. Research on the molecular level will be de-em- phasized in favor of more analytic studies of the psychosocial, cultural, and organizational factors affecting the delivery and utilization of health serv¬ ices. The lag between research discoveries and their incorporation into service programs will be reduced by such innovations as: • built-in continuing education of all profes¬ sional and auxiliary personnel as an integral function of agency program planning and eval¬ uation; and • use of computer techniques and operations research methods to assess continually the effi¬ ciency and effectiveness of the health agency: its goals, its structure, and its functions vis-a- vis the changing needs of its consumers. Richard H. Daggy Arthur R. Jacobs Marjorie A. C. Young 10