Faculty Bibliography

At Babe Ruth Day at Yankee Stadium in 1947, the baseball hero of the generation stood before an admiring crowd, deep in pain and emaciated from advancing cancer, not yet aware of what ailed him. In the dugout moments before, clad in a topcoat and golf hat, he suffered a coughing spell, then, pulling himself together, walked to home plate, mentally recalling the day Lou Gehrig had made the same trip. In fact, he was among the first patients anywhere to receive experimental chemotherapy, and some researchers say he was the first ever to receive a combination treatment of chemotherapy and radiation for his type of cancer. For Ruth, the chemotherapy worked dramatically -- but only temporarily. Nevertheless, knowledge gained from his case helped shape the combination therapy that is now standard for his disease. But the images of a hoarse Ruth, perpetuated in audio and videotapes on the Internet, in movies and in sports broadcasts, in addition to his well-known smoking and drinking proclivities, have contributed to the myth that Ruth had throat cancer, which is generally taken to mean cancer of the larynx, or voice box

Dr. Paul M. Zoll, a Harvard cardiologist and pioneer in developing the heart monitors, pacemakers and defibrillators used by millions of people around the world, died on Tuesday at the Heathwood Rehabilitation and Nursing Center in Chestnut Hill, Mass. He was 87 and had lived at the nursing center for three years. The advances that Dr. Zoll and other researchers began making in the 1950's were applied widely and quickly and made possible the development of coronary-care units. All that was vastly different when Dr. Zoll returned from military service in World War II to work at Beth Israel Hospital in Boston. At that time the standard treatment for cardiac arrest was crude: a doctor would cut into the chest and squeeze the heart with his hand to pump blood through the body

In an action that reopens the question of how much responsibility nurses have to question doctors' orders, a Massachusetts licensing board said yesterday that it had started disciplinary proceedings against 18 nurses in the chemotherapy overdoses of two women in 1994 at the Dana-Farber Cancer Institute in Boston. The Board of Registration in Nursing said the patients, who died after the overdoses, were given a four-day dosage of intravenous chemotherapy on each of four days. One nurse hung the infusion bag and connected it to the patient. Nurses in following shifts monitored the flow. Dana-Farber's president, Dr. David G. Nathan, vigorously defended the nurses, saying they had been exonerated by three groups that investigated the incidents: the Massachusetts Department of Public Health, the Joint Commission on Accreditation of Healthcare Organizations and Dana-Farber

In an action that reopens the question of how much responsibility nurses have in carrying out doctors' orders, a Massachusetts licensing board said yesterday it had charged 16 nurses in the chemotherapy overdoses of two women in 1994 at the Dana-Farber Cancer Institute in Boston. The board said it had issued orders that, after hearings, could lead to disciplinary action against the nurses. The orders contend that the nurses failed to meet the standards of nursing practice, because in either administering or monitoring chemotherapy, they failed to recognize that the doses administered were in excess of those called for. Dana-Farber's president, Dr. David Nathan, vigorously defended the nurses, saying that they had been exonerated by three groups that investigated the incident - the Massachusetts Department of Public Health, the Joint Commission on Accreditation of Healthcare Organizations and Dana-Farber

This year, the 50th anniversary of Ruth's death, his sports legacy has been extolled again as baseball heroes of newer generations breezed past the home-run record the Babe [Ruth] held for 34 years, until 1961. But unknown to many, Ruth also left a legacy in the annals of medical history. In fact, he was among the first patients anywhere to receive experimental chemotherapy, and some researchers say he was the first ever to receive a combination treatment of chemotherapy and radiation for his type of cancer. For Ruth, the chemotherapy worked dramatically -- but only temporarily. Nevertheless, knowledge gained from his case helped shape the therapy that is now standard for his disease. But the images of a hoarse Ruth, perpetuated in audio and videotapes on the Internet and in sports broadcasts, in addition to his well-known smoking and drinking proclivities, have contributed to the myth that Ruth had throat cancer, which is generally taken to mean cancer of the larynx, or voice box

This study assessed the feasibility and potential effectiveness of using audiovisual presentations in the waiting rooms of busy South African primary health care clinics, to educate patients about STD prevention and treatment. A 24-minute episode of South Africa's popular soap opera. Soul City was played continuously during three consecutive days in the clinic waiting areas. The storyline of the episode chosen was intended to convey key health messages regarding the prevention and treatment of STDs. The research was conducted at four primary health care clinics serving large, poor peri-urban townships in South Africa. Observations of patient behaviour were made, and a random selection of patients were interviewed on exit. A focus-group discussion was held with all of the clinic staff at each clinic site, to assess staff attitudes towards the use of such audiovisual presentations as part of their future routine duties. The mean proportion of patients who were observed watching the video at any one time varied from 34 to 64 per cent at all four clinics. Based on exit interviews, the presentation was seen by 88.2 per cent of patients attending all four clinics, and its STD content was recognised by 91.5 per cent of those who had seen it. Over 90 per cent of patients found the presentation helpful and interesting. Clinic staff described the use of video-mediated education as a solution to the problem of inadequate health education, and there was unanimous support for it. In future, it will be important to evaluate whether such audiovisual presentations can be effective in improving patients' knowledge and attitudes, and changing their behaviour, without compromising important interactions between clinicians and patients.

The resurgence of tuberculosis (TB) in the early 1990s, including multidrug-resistant strains, led health officials to recommend the use of involuntary detention for persistently nonadherent patients. Using a series of recently published articles on the subject, this paper offers some opinions on how detention programs have balanced protection of the public's health with patients' civil liberties. Detained persons are more likely than other TB patients to come from socially disadvantaged groups. Health departments have generally used coercion appropriately, detaining patients as a last resort and providing them with due process. Yet health officials still retain great authority to bypass "least restrictive alternatives" in certain cases and to detain noninfectious patients for months or years. Misbehavior within institutions may inappropriately be used as a marker of future nonadherence with medications. As rates of TB and attention to the disease again decline, forcible confinement of sick patients should be reserved for those persons who truly threaten the public's health.