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

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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

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...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.

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...Boston Could Tell Us... One of mankind ' s greatest challenges is to make avail¬ able to world society its immense technological knowl¬ edge. Unless man has institutions and techniques through which scientific knowledge can be applied to society’s benefit, the knowledge itself is limited in its effect. The role of the Department of Public Health Practice is to add to our understanding of and to strengthen these in¬ stitutions and techniques and to train the policymakers and administrators who will serve the field of public health throughout the world. Public health administration is a multidisciplinary art and science.” — Catalogue, School of Public Health 1965-66 n he gap between the description and reality al- ■ - ways exists. How to teach a multi-disciplinary art with the limited budget and personnel of a single academic department is a very real problem. How should the time allotted for the teaching of public health best be put to use: with lectures? seminars? field experience? research?—or some¬ thing more adventurous and experimental? Does programmed instruction fit into future plans? Perhaps the teaching machine will teach the class of 75 about cost analysis. But the delivery of medi¬ cal services here and everywhere will depend on the mastery of political techniques—the hard sell, the ability to bargain, the sense of timing, the in¬ stinct for action. Should all this be taught at a school of public health? Can this all be taught? Smith, Kline, and French— Philadelphia Museum of Art How are private, public, and academic sectors to be coordinated? How much should they be co¬ ordinated? Roy Penchansky, Marjorie A. C. Young, Lenin A. Baler, Arthur Jacobs, Richard Daggy, Norman Scotch, Gerald Renthal, Sol Levine. 11