For Future Physicians

Stand out. 

Poet T.S. Elliot glumly observed that "Our lives are mostly a constant evasion of ourselves." 

Henry David Thoreau gazed across the golden glaze of Walden Pond and in his solitude remarked, "The mass of men lead lives of quiet desperation."

Portia, in Shakespeare's Merchant of Venice, found a more excellent way: "The quality of mercy is not strain'd./
It droppeth as the gentle rain from heaven/ Upon the place beneath./ It is twice blest:/ It blesseth him that gives and him that takes."

Rubble and waste abound, but where mercy is found, you will 

stand out.  

Anil Pillay, MS I

Important PPD Testing

The CDC recommends 2 step PPD testing for persons in high risk situations (e.g. health care workers), due to the fact that TB is on the rise. This involves planting the serum, reading the results 48-72 hours later and then repeating the process 1-3 weeks later to validate the earlier results.

Unlike your tetanus booster, there is no guarantee that your PPD will "cover you" for any given period of time. While the majority of hospitals require a PPD within a year of your scheduled rotation, we have seen many that dictate testing within the last six months or even within the last three months. The CDC indicates that, except for pregnant women, frequent PPD testing is safe.

Our various Core training facilities, as well as preceptor sites, require us to provide documentation of each student's immunization status. In order to do this, we have scheduled the following dates and times to meet this requirement and the CDC recommendations for PPD:

Third Floor lobby, ACHS - COM classes of 2008 & 2009

(step 1)

First PPD Session: Monday, 4/3/06 5:00-7:00 p.m.

First PPD Read Session: Thursday 4/6/06 7:00-9:00 a.m.

(step 2)

Second PPD Session: Monday, 4/17/06 5:00-7:00 p.m.

Second PPD Read Session: Thursday 4/20/06 7:00-9:00 a.m.

Both testing and reading results will take just a few minutes and you may arrive at any time during the posted hours for each session.

The COM Clinical Affairs Office will pay for the above testing. If you fail to follow the above schedule, however, you will be required to pay for your own 2-step PPD testing.

Due to the importance of this message, you can expect to receive multiple reminders. Please remind your peers about this, especially those who may not read e-mail on a regular basis. Any questions, please contact LaRee Goulet in the COM Clinical Affairs Office, Ext 2309 or lgoulet@une.edu .

Thanks.

-Dean Kelley

Jeff Heckman, MS IV, is gung-ho about the sky above his head, the snow beneath his board, the trees behind his back, the.... etc. (In stark contrast, you will note, to Prabhakaran.)
Photo by Dan Sheps, MS I

The wave traveled at a rate of nearly 700 mph. In the open ocean it was difficult to see and was as small as 30 inches high, moving fast. Three hours later, on the east coast of India, in the capital city of Chennai, churches were letting out parishioners; Hindus and Muslims had finished their morning prayers; and many people were outside. The day was beautiful. 

The ocean stopped receding. Everything was still for a moment, and a diminutive wave appeared. As it approached, it grew and grew… 

A Sense of Impending Doom

I imagine people there must have had the same feeling that demon King Bali felt when Vamana, the dwarf and avatar of the god Vishnu, started to grow so much that he eclipsed the sun, the moon, and the stars. Bali granted Vamana anything he wanted. The dwarf requested whatever land could be covered by three of his paces. After granting such a paltry request, Bali must have been surprised and terrified to watch helplessly as the divine dwarf grew to eclipse the firmament. Already in the underworld, the dwarf stepped on Heaven and Earth. There was no place to put his third step. Bali offered himself. He had a lot to lose and he did lose a lot. Vamana placed his very large foot on Bali's head. A sense of impending doom, mixed with fear-evoking awe and beauty, would be what I imagine I would have felt. They say the wave was quiet as it grew to almost three stories, until it hit the beach.  

As the wave reaches the shore, a column of water molecules some distance from the shore is rising. As the column rises, other molecules rush to fill the space where the lowest molecule had been. The molecules that rush to fill this space come from the direction of the shore. The shoreline recedes and fish get trapped. Now, instead of imagining a column of water, imagine a two-dimensional plane of water, a sheet, that moves up and down, and is as long as the coastline that the entire Indian ocean touches - several thousands of miles. Imagine trying to lift that one-molecule thick sheet up and down once. Now imagine doing that for half an hour. Most of us couldn't lift a gallon of milk more than a couple of times. 

Everyone assumed that the Americans took warning and evacuated in time without notifying the Indians. Many days later, it would be discovered that the Americans did try to warn India by calling the office of former Prime Minister Vajpayee. The message did not get relayed. It was, after all, Sunday morning, and the day after Christmas. 

War and Pieces

Between the wave and India lies the island of Sri Lanka. Sri Lanka received the majority of the tsunami blast. The last I heard, 31,000 people were believed to have been killed there. One of those people might have been Prabhakaran, the leader of the Liberation Tigers of Tamil Eelam (LTTE). A little background is helpful. The Sri Lankan government, made up primarily of native Sinhalese, began talks with America in the 1970's. From India's geopolitical view, Americans in Sri Lanka could only lead to very bad things. One aim of the talks was to place an American military base there. 

The Vietnam War - waged on the farcical grounds of the Domino Theory - was concluding. The idea behind the Domino Theory was that if one nation fell to Communism, others would follow like dominoes: Korea, China, and next Vietnam. The US, through President Nixon, desired relations with China. Nixon and Secretary of State Henry Kissinger are both credited with the "opening of China." To open China, West Pakistan had to maintain the government that was in power. The US assisted West Pakistan (now Pakistan), by transporting West Pakistani soldiers in 1971 to overthrow the democratically elected government that happened to be in East Pakistan (Bangladesh). New data strongly suggests that the military leadership in Pakistan planned and executed a pogrom-like purge of Christians, Hindus, and educated Muslim elites. My Bangladeshi friend’s father, an economics professor, showed me the remnants of a bayonet scar in his side. He told me how he and his colleagues were marched into the rice paddy fields to be executed. A few were randomly chosen and forced to lie down on their backs. Soldiers cracked their sternums, spread their ribs, and poured salt into the wounds.

Nearly 3 million East Pakistanis died in order to maintain the General Zia al-Huq government in East Pakistan so that they could serve as a U.S.-mediator to open China. Bangladesh's national flag is a red circle surrounded by green. It represents the blood of those killed in the rice paddy fields.

India was forced to mobilize its military to blockade Bangladesh by sea and enter it by land to stabilize itself, Bangladesh, and to stop the influx of refugees from Bangladesh. The idea of a US base to the north of India, and now one coming to the south in Sri Lanka, must have been absolutely repulsive to India. The Indian state of Kerala had democratically elected to power a socialist government soon after Independence from the British. Would America think that India, too, was going to fall to the Domino Theory? Would America intervene in India? The Sri Lankans were in talks, and India was on edge.  

After many years of fighting, Indian Prime Minister Rajiv Gandhi was elected to office in 1984. He invited Prabhakaran to India. Immediately upon arriving, Prabhakaran was arrested by Indian Intelligence, but later escaped back to Sri Lanka. Reporters suggest that Prabhakaran was furious with his treatment by the Indians and ordered the assassination of Gandhi (watch a movie called The Terrorist.) 

A Brief History of Terror

When Americans hear of suicide bombers, we are reminded of Palestine. It is the Palestinians who first made Americans aware of suicide bombings, or so we think. When considering the phenomenon of suicide bombers, we may come to one of two conclusions: 1. Suicide-bombers are so crazy and categorically different from us that they don't deserve a place on earth anyway, and they must come from such different backgrounds that mothers breed children with the encouragement to blow themselves up; or 2. Alternatively, suicide bombers are people just like us who feel that their only option is to live in misery or die. It was not the Palestinians who first used suicide bombing as the guerrilla tactic of desperation. It was Prabhakaran.

One man I spoke to recalls talking to a weeping Indian infantry soldier who served in Sri Lanka as part of a UN peacekeeping mission. It was very hot and they had been patrolling in the jungle in the Tamil areas, which were thought to be friendly. The unit slung their weapons as they entered a village looking for water, but no one was around. Finally, at one house, there was a little girl of about six or so. She agreed to give the soldiers some water. She went in, brought out the water and poured it into cups for them. They drank. She put the pot of water down. They thanked her and as they turned to leave, they watched, frozen, as she drew a pistol from under her skirt and shot the closest soldier in the chest from three feet away. He died. The very first Indian casualty in the war was my uncle’s close friend.

Sr. Mary Virginia Orna ,
College of New Rochelle,
Speaks about:

"The Shroud of Turin and Other Mysteries: Uncovering Traces of the Past Through Science."

Thursday, April 6th, 2006
Multipurpose Rooms Campus Center, UC
12 Noon

Applications of the methods of archaeological chemistry can help scientists and non-scientist alike to appreciate our recent and ancient past. This talk will examine several laboratory techniques in the case of the Shroud of Turin, which is said by many to be the winding sheet of Christ. The present theories regarding the Shroud – their pros and cons – will be discussed.

Matt Pomykala, MS I, listens attentively to words of wisdom at Physicians' Day at the Legislature.
Photo by Dan Sheps, MS I

Alabi Awarded AFAR Grant

Oluwaseye (Sheye) Alabi, MS I has been awarded the American Federation for Aging Research (AFAR) Geriatric Medical Student Fellowship for 2006-07. This highly competitive and prestigious aging related research award is designed to encourage medical students to consider a career in academic geriatrics. AFAR has partnered with the NIA and several foundations to continue and strengthen the original Hartford/AFAR Medical Student Geriatric Scholars Program.

Sheye's 8-week summer research site will be the University of Pittsburgh School of Medicine. He is in the process of choosing his on-site mentor and research focus. Sheye's UNECOM Research Sponsor is Dr. Marilyn Gugliucci, who has sponsored 6 previous UNECOM students since 2002.

Congratulations, Sheye!

A woman touched his feet at a crowded out-door reception, and as she stood up she tripped the switch to detonate a belt-bomb around her waist. The woman had been drugged, probably with at least a partial tranquilizer. It can’t be that easy to kill yourself and blow up the Prime Minister of India, as well.

India has long since pulled out of Sri Lanka, but I am sure that its intelligence services are still quite active there. America never established a base in Sri Lanka, though I did hear of one unverified report that there is a small US air force base outside of Agra, in India. Today, India isn't officially supporting the LTTE, though in parts of Tamilnad and abroad they have support. Ironically, Israel sells arms to the LTTE, the organization that invented the suicide bomber. 

Strings Attached?

The tsunami smashed the LTTE areas and destroyed the LTTE navy. If the island of Sri Lanka had not shielded India from the brunt of the tsunami, India may have lost several thousand people. Prabhakaran was reported dead by the Sri Lankan government. Stories of an ornate coffin being smuggled into LTTE areas were in the press. The Indian government mobilized to give tsunami aid to Sri Lanka, as did America, Europe, and many religious organizations. A week later, Prabhakaran gave a statement to a news channel. He was alive and well and already re-building the LTTE. Many LTTE recruits come from families who are forced at gunpoint to contribute at least one child to the organization. These children are anywhere between 6 to 9 years old.  

India refused assistance from the US military and the rest of the world, as well. 300 US  organizations, many of them religious, went into tsunami-affected areas around the world. Indonesia quickly banned many of them because one of the evangelical groups had plans to adopt 300 Indonesian tsunami orphans and re-locate them to the USA. Indonesians were very offended by this. They had already lost around 80,000 people.

Indian weekly magazines also reported that conversion activities that bordered on the unethical started to occur. Some journalists tracked down a group of nuns in Tamilnad who denied clean water to people who refused to convert to Christianity. The nuns had no comment. Some of the aid now appeared to have some strings attached. 

Two Vivid Pictures

Soon after the tsunami hit, the fields flooded, as did the wells. The salt water in the fresh-water wells contaminated potable water. The fields were poisoned with salt and the crops died. In some places the waves came in several kilometers. Magazines and newspapers carried many stories of people suffering. They also reported a few miraculous escapes. One boy in Indonesia got pulled out to sea and found a mattress on which he survived for seven days. Entire villages in Tamilnad were washed away, with no survivors. 

Boulders the size of small houses were tossed around and smashed into buildings. The power of the tsunami was astounding. However, life in India among the Indians I know and met was hardly affected. Some people knew of friends or servants’ relatives who were lost. That was all. The impact on the urban Indian was minimal. There were no outbreaks of disease, and the infrastructure in India appeared to handle the crisis fairly well. The papers reported that many people were not receiving aid. Sometimes when they did get aid it was a paltry sum. The country continues on.

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Duck! Buckshot!

In December, more than a month before "buckshot" would be all over the news (from a misadventure at a Texas ranch), the New England Journal of Medicine reported the odd case of a 73-year-old Inuit woman hospitalized in Nome, Alaska, whose abdominal X-ray revealed an enlarged and photographically opaque appendix, which doctors concluded was an appendix filled with buckshot. 

The Inuits, doctors said, eat so many ducks and geese downed by buckshot that inevitably some buckshot remains in the cooked meat and is eaten and digested, with some migrating to the appendix, where it is trapped.

 The appendix was enlarged and opaque on the X-ray simply because it was overstuffed with buckshot. [New York Times-New England Journal of Medicine, 1-3-06]

-Jon Bausman, MS II

Art Gallery presents 'Studio Connections: Artists Supporting MPBN' April 2-30th

"Studio Connections: Artists Supporting MPBN" will be on view April 2-30, 2006 at the University of New England’s Art Gallery on the Westbrook College Campus.

An opening reception will be held on Sunday, April 2nd from 2:00-5:00 p.m.

The exhibition features select works of fine art and crafts chosen by a jury of art professionals from the hundreds donated to The MPBN Great TV Auction.

The State Capitol in Augusta.
Photo by Dan Sheps, MS I

"AMERICAN MEDICINE MEETS THE AMERICAN DREAM"

Professor Carl Elliott, M.D., Ph.D.

Center for Bioethics, University of Minnesota

Friday, April 28, at noon

Blewett 6, Westbrook College Campus

Dr. Elliott is a literate and elegant writer whose recent book, Better Than Well: American Medicine Meets the American Dream , provides as much insight into American life as it does into medical practice. Here's his description of his talk:

"There is nothing new about the American pursuit of happiness. But how are we to understand the steady incorporation of medicine into that pursuit? Over the past half-century American doctors have begun to use the tools of medical technology not merely to make sick people better, but to make well people better than well. From Botox, Viagra and Propecia to antidepressants, breast augmentation and sex-reassignment surgery, vast numbers of Americans now deploy the tools of medical technology to transform themselves, ward off shame and social stigma, and achieve self-fulfillment. Why do we feel so uneasy about these drugs and therapies even as we embrace them? What has drawn American medicine into the pursuit of the American dream?"

David Fish, MS II, compares notes with fellow students, including class president Ross Shauberger, MS II. Photo by Dan Sheps, MS I

UNECOM News and Events

  Photo by Steve Smith, RSAS

Geriatrics Class Featured on Television News Magazine

Charlotte Paolini, D.O. '89, believes her second-year students should not just learn about the sensory challenges many geriatric patients face, but experience them first-hand. As an assistant professor in the Experiences in Doctoring course, Dr. Paolini set up a number of activities that put the students in the shoes (literally and physically) of someone much, much older than them. Portland's NBC affiliate WCSH's daily news magazine "207" (Maine's only area code, if you remember) filmed students in some of the experiential exercises and featured the story on March 3.

All the activities were intended to let students experience the challenges many elders face on a daily basis. Some wore special glasses that intentionally blur and distort vision. Simple ear plugs were used to simulate severe hearing loss. Other students donned surgical gloves with pieces of cotton balls in the fingertips to simulate reduced touch sensation. Still others pulled on socks full of small beads or pebbles that disrupted walking and standing. Finally, some students had an arm or leg completely immobilized.

Donning the simple gloves or socks and putting on special glasses is only the first part of the exercise. Students then had to complete what are usually thought of as simple, everyday tasks. They ranged from making an edible peanut butter and jelly sandwich to putting on rubber boots and a heavy winter coat. Still others had to "shop" for basic food and household items and search through their wallets or purses for the correct change. Also included in the exercise was reading medicine bottles and prescription notes followed by counting out the correct number and variety of pills for different times of the day.

Dr. Paolini uses these and other sensory deprivation techniques to train second-year students to be more mindful and sympathetic of the physical limitations of their elderly patients.

-James Gaffney, RSAS  

Startling Increase in Admissions Applications

The number of primary (AACOMAS) applications (year-to-date) to UNECOM have increased by nearly one thousand in the past two years. For the class that began in August 2004, UNECOM had received 1,861 applications by March 1. For the class that will begin this August, more than 2,800 applications have been received so far, and that total could reach 2,900 before the cycle ends.  

Since January, interviews have been conducted on Tuesday mornings and Thursday afternoons nearly every week; interviews will continue through the end of March.   

-James Gaffney, RSAS

UNECOM Hosts Pre-health Advisors in April

UNECOM will welcome to campus in April a number of pre-health advisors as part of the Northeast Association of Advisors to the Health Professions (NEAAHP) regional conference. More than 100 pre-health advisors will be in Portland April 6-9 for four days of workshops, speakers, discussion sessions and networking. UNECOM is pleased to sponsor two events during this conference.

Thursday evening, UNECOM will welcome advisors to the Portland Museum of Art, a truly outstanding facility, for hors d' oeuvres, piano music, catching up with colleagues and browsing through the galleries. Patricia Kelley, UNECOM's associate dean for students and chair of the Admissions Committee will share a few words with those gathered.

Friday afternoon, UNECOM will welcome many of the same advisors to campus for tours and program presentations. They will have an opportunity to see first-hand the three components of the gross anatomy class: cadaver dissection; radiographic anatomy; and live (palpatory) anatomy.

Advisors will also have an opportunity to learn about osteopathic manipulative medicine as well as learn how osteopathy is developing around the world. Finally, advisors will experience first-hand some of the experiential elements of the second-year geriatric practicum.

Advisors will then have the opportunity to interact with many of our current first- and second-year students, and catch up a bit with those they have assisted through the application process a couple years back.

-James Gaffney, RSAS  

Student Doctors Participate in "Physicians' Day at the Legislature," March 2, 2006

Several UNECOM students spent a day at the Maine State Legislature in Augusta talking with legislators and attending sessions of the Maine State House and the Maine State Senate. 

Students Head to D.O. Day on Capitol Hill

The UNECOM Student Government Association (SGA) Legislative Committee has been working hard to generate excitement for the annual AOA advocacy event in Washington, D.C., known as "D.O. Day on the Hill." The program, organized by the American Osteopathic Association (AOA), provides D.O.s, students, and the osteopathic community the opportunity to become an osteopathic advocate.  Participants meet with their Members of Congress to discuss issues important to the profession. This year’s program is April 27.

David Fish, MSII, coordinator of UNECOM's delegation stated, "Already, 78 students have signed up to participate, more than double the 38 who attended last year, demonstrating concern for medical liability reform, student debt repayment and Medicare reimbursement. The large contingent is sure to make a big impression on Capitol Hill as it lobbies U.S. representatives and senators on these issues important to the AOA."

-James Gaffney, RSAS

CHP Annual Spring Symposium: Dealing With Disaster

The College of Health Professions will hold its 5th annual spring symposium titled “Dealing with Disaster: What is your responsibility as a Health Care Provider” on Thursday April 13, 2006 on the Westbrook College Campus.

Bilsky Articles Published

Dr. Glenn Stevenson and Dr. Ed Bilsky, along with their collaborator Steve Negus, Ph.D., at Harvard Medical School, have had an article recently accepted for publication in the Journal of Pain. The article which will appear in the April issue of the journal and is entitled “Targeting Pain-Suppressed Behaviors in Preclinical Assays of Pain and Analgesia: Effects of Morphine on Acetic Acid-Suppressed Feeding in C57BL/6J Mice”.

Dr. Bilsky is also a co-author on another recently published article in Anesthesia and Analgesia. The article, published in the December 2005 issue, is entitled  “Spinal L-type calcium channel blockade abolishes opioid-induced sensory hypersensitivity and antinociceptive tolerance. "

16th Annual Rural Geriatric Conference, June 1 and 2, 2006

"Aging in Rural Maine: Integration of Policy and Practice," is the theme for the 16th annual Rural Geriatric Conference this spring at the Holiday Inn in Bar Harbor, Maine. Besides a wide range of keynote speakers covering topics such as Hospice Care, Health Care Choices, and "Elders and Prescription Drug Abuse," there will be a number of workshops. 

Workshop topics include "Neurological Disorders in the Elderly," "Medicare Part D: Moving Forward," Using Research and Collaboration to Address Older Adult Alcohol Abuse," "Hearing Impairment: The Silent Disease," "Inner Eldering: Guidance from the Heart," and "Pain Management for Older Adults."

For more information, check out the on-line brochure at http://www.mcd.org/domestic/training.htm. 

Sixth Annual Primary Care Symposium, April 28, 2006

UNECOM is hosting the sixth annual Primary Care Symposium at the Eastland Park Hotel in Portland, Maine, from 8:00 a.m. to 5:30 p.m. on Friday, April 28, 2006.

This year’s theme is “Practice Dilemmas:Topics in Rheumatology.” Featured speakers include Jonathan S. Coblyn, M.D., Director of the Center for Arthritis and Joint Diseases, Brigham and Women’s Hospital Department of Rheumatology, Boston, MA; Brian J. Keroack, M.D., from Rheumatology Associates in Portland; Wayne D. Piers, D.O., an Orthopedic Surgeon at Maine Coast Orthopedics in Portland and clinical faculty member at UNECOM; Charles Radis, D.O., Program Chair, is in private practice at Rheumatology Associates in Portland, and has been a clinical professor at UNECOM and UVM since 1983; Edward Reardon, D.O., on staff at Kent County Memorial Hospital in Warwick, RI, and clinical faculty member at UNECOM; and Robert P. Smith, M.D., M.P.H., Director of the Infectious Disease Fellowship and an attending physician at Maine Medical Center in Portland.

Registration is free to students, but pre-registration is required. You may register by calling (207) 602-2589; or by emailing Marolyn Bissonnette at mbissonnette@une.edu

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Educational Enhancement Fund Information

The Educational Enhancement Fund (EEF) is designed by UNECOM as a way for the University to promote student leadership and extracurricular learning opportunities. The Fund reimburses students up to 50% of the costs associated with traveling to a conference.

This year, the University ear-marked $10,000 for the EEF during the 2005-2006 academic year. To apply, students must fill out an EEF form from the RSAS office in which they estimate conference expenses. Applications should then be returned to Joan Goulet in the RSAS office. 

While a number of students have taken advantage of this opportunity to help finance trips to conferences, there are still funds available. This is a great opportunity to participate in regional and national events with University assistance, so if you've been thinking about a specific opportunity, this may be a way to fund it.

Guerrieri Wins First for Original Research

The OPTI Northeast Osteopathic Medical Education Network has awarded Joy Guerrieri, MS II, first-place for medical student original research.

Guerrieri, co- president of the New England Research Club (NERC) at UNECOM, also helped to coordinate the research fair earlier in the year, besides doing research of her own.

Congratulations, Joy!

Jake Brooks, MS II, shares a laugh with Lifeflight crew members.
Photo by Dan Sheps, MS I

Civil War Brought End to “Medical Middle Ages”

Sometime after the butchery of closed-rank charges and frontal assaults; someplace between the piled corpses and dripping wagons of wounded; somewhere in the tents of screaming men and saws and piles of limbs; somehow amidst the breathtaking carnage wrought by blue and gray in the War Between the States, a miracle of growth took place that would ultimately save more lives than had been lost in conflict. Modern medicine grew from infancy to adolescence during the American Civil War.

The Civil War was fought, said the Union army surgeon general, “at the end of the medical Middle Ages.” Prior to the war, doctors usually gained experience through apprenticeships, in lieu of formal training. They generally received cursory clinical experience, no laboratory training, and precious little instruction about disease and infection. 

While European doctors often attended four year medical schools and spent months in laboratory training, Harvard University did not own a stethoscope or a microscope until after the war. That’s right – not a single one.

In agrarian areas, veterinarians were often more skilled than surgeons. In the spring of 1861, when the first shots were fired at Fort Sumter, the Confederacy had 24 military medical officers – total. The Union army boasted a whopping 100. 

By war’s end, over 13,000 Union and 4,000 Confederate doctors had served in the field, treating 10 million cases of injury and illness in just 48 months. Such a vast number of patients helped catapult medical officers from ineptitude to efficiency in a matter of months.

At the beginning of the war, a wounded man could expect to die. Period. Infection was so rampant, and surgeons so clumsy, that the majority of wounded men quickly succumbed to what could have been non-life-threatening injuries. As surgeons gained more experience, however, the fatality rates began to fall (For the wounded, at any rate. Healthy soldiers continued to kill each other with undiminished gusto.)

Approximately 600,000 men perished during the war. Of those, about a third died in actual battle. Military protocol of the day demanded massed charges of thousands of men across open fields, when terrain permitted. 

If the landscape was uncooperative in the business of spectacular slaughter, officers were ingenious at finding ways to kill their men by attempting river crossings that were too deep, fighting in trackless wilderness, or by assaulting mountaintops that were impregnable. Misguided honor has ever led to untimely death. 

To compound the ghastly cost of battle, the standard ammunition was a lead ball that seemed the size of a small grapefruit. Tragically misnamed the “Minnie” ball, it created an enormous wound, which if received on the abdomen or head was fatal, and which shattered even the heavy bones of an appendage. The Civil War Society claims that of approximately “175,000 wounds to the extremities received among Federal troops, about 30,000 led to amputation.” 

Surgeons tried to treat men within 48 hours (compared to the modern-day maximum of five to transport wounded soldiers from Afghanistan or Iraq to Landstuhl Regional Medical Center in Germany.) Contrary to myth, most soldiers did receive anesthetic before surgery, in the form of chloroform. Screams were generally from wounded soldiers who had been told that they were next in line for the surgeon’s saw.   

If a man could escape the wrath of the enemy, the hubris of his own commander, and the risk of infection from surgery, he had a very good chance of dying from illness. One in four Civil War soldiers did not survive the war. In camps where thousands of unwashed men ate, drank, and eliminated with abandon, diseases performed a macabre Mardi Gras as they paraded through the camp and into soldiers’ intestines.  Men died of interesting diseases such as cholera, typhoid, and dysentery due to the shocking filth of the camps.

The Union army reported “that more than 995 out of every 1,000 men eventually contracted chronic diarrhea or dysentery during the war,” while a quarter of Confederate deaths could be attributed to the drinking of water contaminated by salmonella bacteria. With latrines usually just a slit-trench down by the river, one winces at the thought of a fresh-faced 18-year old filling his canteen from the nearest stream.

In addition, the camps provided a grim sort of convention for regional diseases to advocate their particular brand of misery on a national platform. Young, old, or unfit soldiers were exposed for the first time to measles, mumps, chickenpox, and whooping cough as men came from across the country to join ranks and get their muskets in the fight. 

As recruiting standards tightened, troops generally fared better, but no man could escape the malarial swamps of southern latitudes or the pneumonia that stalked the camps in winter. The Union reported a million cases of malaria during the war.  

All of this was a doctor’s nightmare, but a student-doctor’s dream. Where better to learn about surgery and disease-prevention than in the world’s greatest incubator of injury and illness? Both North and South did their best to improve the level of care given to soldiers throughout the war. 

The Civil War Society reports that “More complete records on medical and surgical activities were kept during the war than ever before, doctors became more adept at surgery and at the use of anesthesia, and perhaps most importantly, a greater understanding of the relationship between cleanliness, diet, and disease was gained.”

The Civil War was horrible in so many ways, but it was the catalyst for much positive change in the health professions. Conflict brought an end to the medical “Middle Ages” and ushered in the dawn of modern medicine to a fully “United” States.

-Steve Smith, RSAS

Erica Root (left) and Lisa Billings-Linsey, both MS II's, at Physcians' Day at the Legislature.
Photo by Dan Sheps, MS I

Jeff Heckman, MS IV, is just
happy to be alive on this day.
Whether on the chair lift, on his seat, or on the slope, he is all there, giving 110%. Photo by Dan Sheps, MS I

Current Students

At the library, naturalists may find the elusive COM student in every stage of erudition. Photo Courtesy Kristy Frain, MS I

“Livin’ The VT Dream” 
by Zach Soucy, MS II

[Editor’s Note: Zach Soucy is President of the UNECOM Sports Medicine Club. He had the opportunity to attend the 2006 Winter Olympics in Torino, Italy, to cheer on his friend, Jim Cochran, who placed 12^th in the Slalom. Both young men grew up in Vermont. Zach also once re-aligned Jim’s face on a camping trip. We asked Zach to write about his Olympic trip.]

Ever since I can remember, my dream has been to be the best. When I was heavily involved in soccer throughout Jr. high and high school the dream went like this:  Final seconds of the world cup and I break through the defense right as the ball is lobbed over the left middies’ head. I take it off the chest and dribble through two defenders, fake the shot to jump the defender and calmly push the ball into the side of the net. Of course the crowd would go wild, and we all pig-pile on the field and carry the American flag around on our backs. When I was a cyclist, it was all about winning the key sprint to snatch the key points to take the green jersey in the Tour De France.  

Some say it is his genetics, and others say it is personality. I tend to say it is a combination of both. It is hard to deny that his family is athletically gifted. His grandfather was a semi-pro baseball player and coached the US ski team in the late 60’s and 70’s. His father has won the most US ski titles in the history of the country, and his family holds 19 Championships, the most of any family. They were called the “Flying Cochrans” on magazine covers and international newspapers. Bob and his three sisters all made it to the Olympics in the early to mid 1970’s, Marylyn earned a gold medal in 1972. The newer generation is just as impressive. Jim’s cousin Timmy is on the Jr. Development team, Roger and Jess are on the US ski team, and other relatives are still too young to make a team yet, but are up and coming. Jim’s sister Amy is a standout skier for UVM, and was one of two female athletes named ESPN all-American Student Scholars. Amy was also All-American in skiing and soccer, holding the UVM most-goals-scored-in-a-season record, and was one goal from the school’s most-goals-scored record. Jim’s mom was All-American in the decathlon at UVM in the 1970’s, and is in the UVM Track and Field hall of fame. Now for Jim: He finished 2^nd at NCAA’s in 2003, was All-American in skiing, won the US Championships in GS and slalom in 2004, and has been racing World Cup for the past two years, finishing 16^th at Worlds in 2005 and 12^th in the Olympics this past month. Do they have genes?? Yeah, I would probably give them that one.

However, it takes much more than genes to rise to the top of US athletics. Many athletes buckle under the pressure or expectations held aloft by overbearing parents or coaches. Though we had our fair share of pressure, Jim never seemed to be bothered by it. Times when I would get all worked up in the finals at states or playing the best team in a tournament, Jim would simply say, “It just doesn’t matter. Anything you do here today will not affect the history of the world. If it is meant to happen, it will happen. Just do your best and accept that fact.” If you are a forward thinker, you can see the prospect of winning that game and being scouted and going on to play in the World Cup. But that takes a lot of speculation and guesswork. If it ultimately did not work out the way that you hoped, then all that speculation was a wasted effort, and worse yet, reality would then be viewed as a failure to match the dream, even if reality worked out for the best.

Though Jim would use this rhetoric to seemingly make sense and drown out expectations, I knew he was human, and humans have dreams. I always knew his dream was to make it to the Olympics, though it was never stated. And he made it. Jim qualified for the US Olympic Alpine Ski Team just a few weeks before Torino, and I traveled to Europe to watch my friend compete against the world’s best skiers.

We entered Geneva, Switzerland, on a dismal day. It was overcast and there was hardly any snow on the countryside. I was hoping to get a couple of days of skiing in, so the prospect of nada snow made me feel sick. After shuffling through security and meeting up with Jim’s dad, Bob, I quickly learned that it had snowed in the mountains two days before and the skiing was pretty darn good. We stowed away the bags we didn’t need and slipped on our skis for a day in the French Alps. 

It’s hard to communicate when everyone speaks French and you only know a few words. However, we managed to gas up, avoid a landslide, find parking (by following really messed up signs), buy a ticket and get on with living. The snow was simply indescribable. If you have never skied packed powder, then I suggest you do.  I have never skied out West, but in my life of skiing here in the East I had never seen white gold like this. It was light but hard, soft but firm, and cold even when it was 40 degrees at 8500ft. As an East Coaster would say, “It was too easy/fun to ski.” Though I admit it was nicer…NE skiing takes a tougher breed. I was not interested in that mindset as I carved the cleanest turns at breakneck speed on the longest trails. It was nice to not be in New England…that day. 

Four days of gourmet skiing and glorious meals came and went. Travel to Italy was inevitable because Jim was racing on Sestriere, which was four hours away. After sitting in the compact car for hours it seemed as though the best part of the trip was over. I dreamed of skiing and more skiing and when I was not dreaming of skiing I was making believe I was in a breakaway on the back roads of Italy in the Giro D’Italia or scurrying up a steep climb to a petite village during the Tour D’ France. Some of the roads we drove on were the actual pave on which Lance won some of his many Tour victories.  

Better yet, we got to sit next to the Japanese guy dressed as Kermit the frog in a Kimono. He was crazy. I couldn’t understand one thing he said, but he was so entertaining - way more than the American version. As the night wore on, I wished I was Kermit for a couple of reasons: 1) One of his Japanese buddies kept bringing him beer and my six pack of PBQ (a cheap one-letter-shy version of good old Amercan PBR) had been confiscated at security. 2) He seemed to have a lot of friends. Everyone around him gave him hugs as he danced up and down the isle. 3) I was freezing my (rear) off and his Kermit suit looked like it was packed with tons of something warm. I made a deal with the Japanese that they would cheer for Jim, and in return I would cheer for their friend, though I must say I didn’t cheer as loud. 

It was time. Skiers started their Olympic runs. Most people would think that since you are at the Olympics you would watch the mountain. Ohhh, so wrong. They had the biggest TV ever. It was about 25 feet tall and zoomed right in on every turn and stumble the skiers made!! I was torn; watch the big TV, or watch it happen in real time. I guess they were both real time, so I tried to watch both. What was even greater was that the TV made funny squishing or zapping sounds when someone fell. Sort of like when you get eaten in Pac-man. On TV back here, things are so tense and serious, but over there it is a carnival with people on stilts dressed in long hair and blowing fire.  

We met up with him after the race, and little kids, teens, and parents approached him for an autograph and picture. It was weird to see him as a role model, almost like he was a parent, which is very scary. I guess better him than Jessica Simpson or Paris Hilton. We took some pictures and said good-bye. 

Connie Earl, MS IV: Two-Handed, Whole-Hearted Leadership

Connie Earl, MS IV, has a hard time sitting on her hands.

A natural dynamo, Connie has been actively involved in social projects and leadership opportunities for most of her academic life. A passionate, bubbly person, Connie combines exceptional inter-personal skills with a dynamic vision for the future of healthcare and a boots-on-the-ground approach to community service. As a direct result of her dynamic personality and academic capability, Connie was selected by UNECOM to serve as an OMM/Anatomy Fellow. The experience served to increase her comfort level in front of large groups, helped her plan curriculum, taught her to teach, helped her adapt to working on a team, prepared her to organize faculty, and gave her a better grasp of osteopathic medicine. 

Passionate and skilled, Connie has recently been named Student Director of the HEART Elective. The Humanistic Elective in alternative medicine, Activism and Reflective Transformation (HEART) will be held April 3 through April 28^th, 2006, at the Ben Lomond Quaker Center, near Santa Cruz, California. The rotation is a fourth year residential elective sponsored by the American Medical Student Association (AMSA) in partnership with the University of Florida School of Medicine. It is an entirely student-run elective.

Connie is one of five student planners chosen from a competitive national applicant pool. The planners coordinate the curriculum, housing and personal needs of the 25 HEART participants and 20 faculty members. According to Director Annastasia Kovscek, MD, the clerkship “is an introduction to the practice of holistic medicine through examination and teaching of complementary and alternative medicine, public health issues, relationship-centered care and communication, and community building.” Participating faculty include best-selling author Rachel Remen, MD, Karen Lawson, MD, and Wayne Jonas, MD. Topics include Ayurveda, Cross-cultural Clinical Nutrition, Evidence-Based Medicine in holistic care, and patient-centered communication.

The goal of the elective is to “give students an opportunity to critique Western medicine objectively and gain a better appreciation for the role of physician as healer, humanist, and element for social change.”

According to Connie, “HEART is the only fully student-run, fully accredited, residential, four-week rotation in existence.”  Currently in its third year on its own, HEART is an outgrowth of the Living Integral Global Healing and Transformation elective sponsored with the Global Medicine Education Foundation in 2002 and 2003.

Connie has put the OMM skills she learned at UNECOM to good use on the national level. She says, “In addition to my leadership role in planning, I have been invited by my peers to act as faculty, leading a 2 hour hands-on workshop on Osteopathic Manipulative Medicine.  This workshop is part of the mandatory HEART curriculum for students. This will be the fourth national conference at which I have presented a variation of this workshop, and the seventh time overall that I have presented this material to allopathic medical students and residents. Thanks to the OMM/Anatomy fellowship, I feel very comfortable in this role, and have received excellent evaluations from my peers at these meetings.”

The HEART elective is hardly Connie’s first leadership experience. Five years ago, she had the privilege of co-founding and running a nonprofit corporation, called “Doula Circle,” that provides holistic labor support and perinatal education to teenage mothers in Portland, OR. She says, “Doula Circle began as a group of five doulas sitting in a backyard discussing a shared desire to change the way young mothers are treated during childbirth. We believed that by changing the first act of parenthood into a more empowering, conscious experience, it would ultimately improve the relationship they share with their children.”

Another major leadership experience for the busy medical student was working as the Student Director of AMSA’s EDCAM (Educational Development in Complementary and Alternative Medicine) grant during her second year. According to Connie, AMSA was the final recipient of one of the NIH $1.2 million NCCAM grants. Connie’s responsibilities ranged from public relations work to pilot school evaluations to lecturing at conferences. “The best part of my job,” she says, “was planning the 2004 CAM Leadership Training Program. It was a week-long event, with didactic, experiential and group learning about Integrative Medicine; time for reflection; leadership and activist training; and daily work in planning a project for their school.” She is justifiably proud of the results, as the students developed a wonderful community and continue to amaze her with the projects they have created.

Connie doesn’t foresee giving up leadership just because she is about to graduate from UNECOM. Instead, she plans to take the various experiences she has had and the lessons she has learned with her on this journey of hands-on service and leadership:  “I have learned so much more about how to turn a vision into something tangible,” she says. “I have a vision for the future of medicine, and I have loved the opportunities I have had to shape that vision with others; to work toward a common goal together and see what we can create for the future.” 

With rising physicians like Connie Earl, patients may rest assured that the future of healthcare remains in good hands.

-Steve Smith, RSAS

Lowery awarded 2006 AMA Seed Grant

John Lowery has been awarded a 2006 Seed Grant through the American Medical Association. This prestigious grant encourages medical students and residents to enter the research field by providing funds to help them conduct small basic science, applied, or clinical research projects. John is the first D.O./Ph.D. student at the University of New England. He has completed his first two years of medical school training and is now working on his dissertation research in the laboratory of Edward Bilsky, Ph.D. The seed grant will be used to better understand the mechanisms of chronic pain in osteoarthritis and to test novel analgesics that have better therapeutic profiles than currently available drugs.

Two COM Students Chosen for Summer Institute in Geriatric Medicine

This message brings very good news - two of our MSII students, Joy Guerrieri and David Fish, have been chosen to attend the Summer Institute in Geriatric Medicine at Boston University Medical Center, which will be held June 26 - June 30, 2006. A total of 20 students have been selected from a national pool of applicants to participate in this program, so kudos to Joy and David! Marilyn Gugliucci, Ph.D is their sponsor.

This program is sponsored by the American Geriatrics Society and the Boston University School of Medicine, with full funding from the National Institute on Aging. The Summer Institute in Geriatric Medicine is a week-long conference designed for medical students who are interested in pursuing careers in academic geriatric medicine and geriatric research. Activities of the Summer Institute include lectures, seminars, and case discussions as well as site visits to research and clinical programs. Faculty members will include nationally recognized academic geriatricians and other individuals pursuing research in geriatrics and gerontology.

-Marilyn Gugliucci, Ph.D

Preparing for Residency (Part 2 of 2)
by Gerald "Wook" Beltran, MS IV

Timing of a Rotation

Once the list is narrowed down to a manageable level, deciding when to do a rotation in the specialties of interest can be of concern.  Most students start doing away rotations in their areas of interest in May-December of their fourth year.  It is usually a good idea to do the first rotation at a site which will not be your top choice for residency, as with anything new, there is a learning curve.  A second away rotation in the specialty of interest should ideally be done at a site of prime interest.

Interview Season

The interview season typically begins in November and ends the last week of January.  December and January tend to be the heaviest months for interviews.  As described previously, planning the away rotations may help to ease the time and money spent while interviewing.  It is also helpful to plan to do rotations with a set schedule during heavy interview periods (e.g. Emergency Medicine), as you the student may be able to plan his/her shifts around interviews.

ERAS

The Electronic Residency Application Service (ERAS) is utilized as part of the residency application process.  The web page for this can be found at http://www.aamc.org/audienceeras.htm.  ERAS acts as an electronic repository for candidate information (e.g. CV, Letters of Recommendation, COMLEX scores, personal statement, etc.).  Applicants pay a fee for the service and decide which programs they want their information to be available.  The residency programs then download the application information and decide whom they wish to interview.

For the 2006 cycle the following was the schedule:

  ERAS 2006 Applicant Timeline