Kansas City University of Medicine and Biosciences - Stethoscope Yearbook (Kansas City, MO)

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Psychiatry mf -as Students and Psychiatric Staff at State Hospital No. 3, Nevada. Missouri l 1 t I . . f'lS'lf ffl r ' ' N ! . . l L 'vw---1 mi' The Clinic Patient Also ls Offered Psychiatric Therapy CHIZOPHRENIC reactions: catatonic, simple, para- noid types: obsessive compulsion: chronic brain syndromes: anti-social reactions-sterile phrases, objectively digested in an aseptic classroom environ- ment for three years suddenly become living realities to the senior student during his tenure of psychiatric service. During a brief four or five weeks, he loses himself in the problems of others and blends with a small dedicated staff, preoccupied with alleviating the anguish of some 2000 mentally ill. He becomes oblivi- ous to the outside world as he soon realizes that these hospitals and their grounds located at either Nevada or St. Ioseph are actually communities within them- selves, containing their own bakeries, laundries, thea- tres, clothing stores, and chapels. Becoming a member of this community, he is soon aware of the utter im- partiality of mental illness as it forcefully reveals itself causing distress to the very young and old, the very poor and wealthy. An average day of the student's psychiatric duty is full, varied, and extremely challenging. He is given the privilege of making rounds with a staff physician every morning, these rounds including geriatrics, male and female wards, and the admitting clinics. Here he gains a knowledge of correct communication between physician and patient, learning what to ask, and how to listen, each word having the potentiality of being a clue to the correct diagnosis of a particular patient. The student doctor is shown every possible considera- tion by the staff and made to feel free to question the physicians about various patients. He is also allowed the courtesy to interview any patient he so desires, and may have access to their mental, physical and social histories to complete his studies. Each day there are seminars presented by various members of the staff covering a multitude of subjects dealing with psychiatric problems and their therapies. Here again, he realizes the magnitude of just this one field of medicine. The most demanding and also the greatest challenge involves the individual patients assigned directly to the senior student for complete evaluation. The student performs a thorough psysical, as well as an exhausting mental examination. All of his findings are correlated, dictated, and presented to the staff at their bi-weekly meetings. With these find- ings, the student also offers his complete impression of each patient coupled with a tentative diagnosis. The patient is interviewed by the staff. and the student's diagnosis is either accepted or rejected, thereby proving to be another excellent training mechanism designed to help each senior student realize his short-comings, as well as his attributes in diagnosing the mentally ill. The training received at these hospitals should aid each forthcoming physician, whether he becomes a G.P. or specialist, to recognize symptoms-, to establish diagnosis, and to outline proper therapy. 'By living in these hospitals, he is certainly made aware of the tremendous improvements that have been made, but equally conscious of the vastness of the obstacles yet to be overcome. It has given the Osteopathic student doctor one more aid, one more insight, one more hand perhaps, to assist others, which should be and is his main goal in life.

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bstetrlcs VERY senior student at the Kansas City College of Osteopathy and Surgery looks with great antici- patlon toward the tour of duty at the on-campus Maternity Hospital. The Obstetrical phase of medicine incorporates an immense array of diagnostic problems and, thus, provides an enormous gamut of learning experience. The young physician who desires to pursue the field of general practice soon realizes the importance of acquiring the very best Obstetrical and Gynecologi- cal training possible . . . to that goal our staff physicians and field specialists are dedicated. Over fifteen hundred infants are born annually at Conley Hospital. Each student has the privilege of scrubbing or assisting on approximately 100 deliv- eries. Personal contact with the delivery room pro- cedures is, therefore, engrained many times over to facilitate confidence and proficiency. At the time of admission, the expectant mother is thoroughly evaluated both Obstetrically and medically by the Student Doctor on duty. It becomes his respon- sibility to attend her through the tense and anxious hours of labor and to lend support and compassion during this time of need. He will follow this case to the delivery room and assist or manage this miraculous event of bringing life into the world. Next to the medical phases of the post-partum recovery . . . the student will stay by the patient's side until her condi- tion is within satisfactory limits. It is then his respon- sibility to perform a complete physical examination on the brand new babe. After satisfying himself that all is well he proceeds to the next case with unaltered anticipation and vigor. This ritual may be repeated many times during the day or night, but somehow never loses its thrill . . . each case is unique and con- tinually offers a challenge to the ambitous young fetal doctor. As in all phases of medicine, the pathological problems embrace special interest to the knowledge- able mind. The student learns early through didactic material and practical experience, to recognize these abnormal clinical situations and to furnish a method of management intent upon the safety of both the mother and fetus. This employs a vast amount of responsibility and provides a learning situation unsur- passed by other forms of training. Not to be forgotten are the seminars presented three times a week under the direction of a certified Ob-Gyn specialist. A new and different topic is discus- sed at each meeting as are general diagnostic problems which extern has had an opportunity to witness or experience som-etime during the nine week service . . . such as, breech presentation, abruption placenta, pro- lapsed cord, etc. to mention only a few. Prior to graduation the student is limited only by his interest in the field of Obstetrics: however, he is required to deliver a minimum of three babies in order to meet the qualifications for graduation. This entails strict prenatal care of the patient up to the time of delivery, complete responsibility, under supervision, for the delivery room procedure, circumcision of the male infants and management of the post-partum course for both mother and infant. The routine day never occurs at a Maternity Hospital. Each 12 hour shift may provide for times of relaxation, reading and an occasional game of cards but the spirit and atmosphere of imminent maternal emergency is forever present in the minds of these physicians.

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Research Program WO hundred thousand dollars approximates the total grant monies channeled to the various depart- ments of our college for research purposes. For those students particularly interested in medical research the college offers a fellowship in a five year program to the doctorate degree which includes a full year of research programming. This year the departments of physical medicine and rehabilitation. mental diseases, heart, cancer, obstetrics, pharmacology and clinical medicine are participating in pilot research or specific research pro- grams. For example: the obstetrics department has a program studying The effects of tobacco tnicotinel on the pregnant mother: or unborn child and the new born child. What is being done specifically in the research department? The studies currently underway in the research department are designed to provide a strong basic control system for future work. The problem under consideration is a definitive exploration of the phe- nomenon of myoneural transmission. Enzymatic, bio- electrical, biochemical, and biomechanical activities at the motor end plate will be focal' points for study. However, before actual work on the problem can be undertaken, some steps must be taken to assure the investigator that the phenomena observed on his instruments or by his senses are actually due to the variables introduced by him and not due to some stimulus outside of the experimental format such as ambient temperature or barometric pressure. Therefore, the following broad control systems have been obtained and are now being introduced as standard procedures: l. Polygraph recorder providing simultaneous EKG, EEG, respiration, muscle response, and chemical concentration gradients. 2. Oscilloscope stimulator unit for nerve action potentials. 3. Complete autopsies of experimental animals with photomicrographs. 4. Multichannel temperature recorder. 5. Ultraviolet fluorescence microscopy with closed circuit television. 6. Warburg studies of muscle cell respiration. 7. Electron microscopy of control and test tissues with photomicrographs. In conjunction with the latter, a further study under consideration is electronautoradiography utilizing the electron microscope and radioactive gold isotopes. The problem outlined above is basic research as opposed to clinical research, the difference between the two being that the former does not have a specific application as a focal point. However, basic research forms the broad steps that medical research depends on for its tools and applications. For example, the work outlined above may provide some key facts for applica- tion to such diseases as myesthenia gravis.