Faculty Bibliography

It was by a narrow margin that Dr. [Barney B. Clark] ''was strong enough to move out a few days ago,'' Dr. [Chase N. Peterson] said. ''By a narrow margin on the down side,'' he added, ''he is now not strong enough to stay out.'' ''We haven't been successful in getting him to the stage of full respiratory self-sufficiency,'' Dr. Peterson said. He gets to the point where he can breathe without the mechanical respirator for a few days, ''but then he just doesn't quite hold on,'' Dr. Peterson said. Sleep a Mixed Blessing A hospital source reported Dr. Clark as ''discouraged'' about returning to the intensive care unit. He has seen several other patients, who have been much sicker, die. ''It bothers him,'' the source said. ''The fact that he's made a step ahead and then has to take a step back is really discouraging to him.''

''I don't know what it is,'' Dr. [Irving G. Kagan] said. ''They may have something very important, but if so it is not a parasite.'' However, he cautioned that there were cases in parasitology in which experts' first impressions proved wrong. Dr. [John I. Brewer] declined to name any of these parasitologists ''because I don't care to.'' Dr. [Marietta Voge] said ''Dr. Brewer should name the parasitologists'' who, in turn, should publicly provide the scientific reasons for the opinions they gave Dr. Brewer. Further, Dr. Voge contended, Dr. Brewer's team should submit its specimens to an expert committee for independent evaluation. Asked if that was not an unusual step, Dr. Brewer said that the unnamed parasitologists who had examined the specimens ''didn't know what it was'' but had said ''it was a real thing, not an artifact.''

Dr. [Barney B. Clark] ''has really started to turn the corner just in terms of the nonspecific things, mostly muscle strength,'' Dr. [Chase N. Peterson] said. But doctors have not upgraded Dr. Clark's condition, which remains ''serious but stable.'' The 62-year-old retired dentist has walked many steps with the help of a walker, although he has ''not been striding down the hall,'' Dr. Peterson said. At times, he said, Dr. Clark has been able to support his own weight by himself. Now Taking Showers Twice last week, Dr. Clark took showers, his first since the Jarvik-7 artificial heart was implanted Dec. 2. On Friday, Dr. Clark added handgrip exercises to his daily schedule. He has pedaled an exercise bicycle for up to 10 minutes ''and is getting a lot of pleasure out of that,'' Dr. Peterson said

A medical spokesman said yesterday that Dr. Barney B. Clark's continuous nosebleeds had brought him a serious setback but that doctors were encouraged by other aspects of the artificial heart case

It can be a tricky procedure. First a tube is passed through the bleeding nostril and into the throat. There, the doctor grabs it with a pair of tongs and pulls the tube out through the mouth. There are two strings attached to the gauze pads. After one string is tied to the end of the tube coming out of the mouth, the doctor pulls tight on the end of the tube protruding from the nose. In that way, the gauze pad is jammed in the back of the nose

It can be a tricky procedure. First a tube is passed through the bleeding nostril and into the throat. There, the doctor grabs it with a pair of tongs and pulls the tube out through the mouth. There are two strings attached to the gauze pads. After one string is tied to the end of the tube coming out of the mouth, the doctor pulls tight on the end of the tube protruding from the nose. In that way, the gauze pad is jammed in the back of the nose. Occasionally, lasers can stop the bleeding if its source can be closely enough identified. However, Dr. [Barney B. Clark] was bleeding from two points, one of which Dr. [James L. Parkin] said he could not find, despite the aid of thin fiber-optic devices, because his view was obstructed by Dr. Clark's badly deviated septum, the dividing wall between the two passages of the nose. Dr. Parkin made an incision under Dr. Clark's upper lip and bored through the maxillary sinus, an empty cavity above and behind the teeth, to reach the internal maxillary artery, which fed the bleeding area. He pinched it shut with metal clips. But because the bleeding continued, he made another incision at the side of the eye to stop the flow of blood from the anterior ethmoid artery, another conduit to the bleeding region

When Dr. [Barney B. Clark] ''is fully awake and active, he appears to be fully alert,'' Dr. [Chase N. Peterson] said. Dr. [Lyle Joyce] said that Dr. Clark had been ''totally lucid most of the time'' in the last three days. Still, Dr. Clark has his good and bad days, they said. ''His lungs do not function well,'' Dr. Peterson said. ''They are doing all right but they are not going to be as strong as normal lungs would be and probably never will be.'' But despite the serious lung impairment, Dr. Clark should be able to function well in the future, Dr. Peterson said, Dr. Peterson said that Dr. Clark had fewer filtering cells in his kidneys than he once had and therefore had less reserve. ''If the blood supply to his kidneys is not perfect, he will show some mild kidney impairment,'' Dr. Peterson said. ''If it is, he does better.''

Two skiers who saw Mrs. [Debra Anne Rollins] fall summoned the ski patrol. A friend called to her husband who was skiing behind. When Mr. Rollins arrived, he expressed surprise: ''Of all the places, I couldn't believe it would happen there because it was the smoothest spot of the run.'' In Dr. [John R. Merendino]'s experience, variations in the patterns of injuries occur each year as skiers change their equipment and style. For example, he said, over the last two years he has treated more dislocated hips than in earlier years at this resort. He has also seen an increase in shoulder injuries. Dr. Merendino said he suspected that these injuries were related to the higher ski boots now in fashion. ''If the energy in such an injury is not dissipated to the leg, it has to go somewhere, and it seems to be the shoulder,'' Dr. Merendino said. However, he said, one benefit of the higher boots seems to be fewer broken legs

Both Dr. [Barney B. Clark]'s wife, Una Loy, and daughter, Karen Shaffer, spoke about the problem at a news conference on Christmas Day. It was a time when Dr. Clark's mental status was improving, and Mrs. Clark said, ''He recognizes the fact that he is confused.'' Nevertheless, hospital officials are seeking several other sources to pay for parts of Dr. Clark's medical bill. One is the Federal Medicare program. Although Dr. Clark, at 61 years old, is younger than the entry age of 65 for such insurance, a disability clause allowed Medicare to pay for much of Dr. Clark's bills before he received the artificial heart, a hospital official said. He said Dr. Clark's wife and children had decided to hire an agent, adding, ''It only makes sense that they hire an agent or lawyer to represent their interests.''

The doctors said that ''Dr. [Barney B. Clark] suffers no medical condition that is not thought, at this time, to be fully reversible.'' They also said that there had been no significant change in Dr. Clark's condition in the preceding 24 hours