News From Harvard Medical, Dental, & Public Health Schools-June 20, 1997
CONTENTS
Alumni Week
Torch Passing Adds Glow to Graduation Events
Two Harvard Medical School department chairs, Philip Leder of Genetics and Peter Howley of Pathology, paid tribute to Dean Daniel Tosteson at the June 6 program "Passing the Torch," which culminated the School's Alumni Week and began a transfer of the deanship from Tosteson to Joseph Martin.
Leder said that because of the New Pathway--the innovation in medical education that is central to Tosteson's achievements--"a spirit of learning and joy in learning" permeate the classroom. Howley directed himself to Tosteson, saying: "Your commitment to science has made Harvard the preeminent center for biomedical sciences."
Following these and other highlights of the dean's 20-year tenure, Tosteson raised the torch by reviewing the past year. His was not a farewell address, however, which was fitting. He will continue to be active in the area's medical, scientific, and intellectual community after he steps down on June 30. His continued presence has taken on another form, as well--one that is truly larger than life. In a further tribute to Tosteson that took place on June 12, the School's Medical Education Center was renamed the Daniel C. Tosteson Medical Education Center as a permanent testimony to Tosteson's leadership. Harvard University President Neil Rudenstine spoke at the dedication, describing Tosteson "as someone powerfully committed to the education of students, at all levels." Rudenstine said, "Dan has thrived in a way that is not likely to be rivaled and surely not surpassed. Harvard has helped transform medical education, thanks largely to Dan Tosteson." As part of the ceremony, a bust of Tosteson in the center was unveiled.
Alumni Week, June 4-8, began a transfer of the Medical School deanship from Daniel Tosteson (right) to Joseph Martin, who starts officially July 1.
In his June 6 talk, Tosteson recognized several of his colleagues whom he had worked with closely for many years, presenting a gift to Daniel Federman, dean for medical education, for his many contributions to educational programs. Tosteson expressed gratitude to this year's reunion classes, 1947 and '72, for their gifts to the School. The gift of the Class of '47--$526,336--is "the largest we've received from any class," Tosteson said. The $265,567 from the Class of '72 is believed to be a record for a 25th reunion class. (These totals were tallied as Focus went to press.)
The increasing number of women appointed to full professor was a distinction Tosteson singled out. During one month this spring, he said, five out of the six appointees were women.
Turning to academic programs, the heart of his legacy as dean (see pull-out section, pp. 58), Tosteson pointed to the growth of graduate studies, success of the Markey program, and appointment during the past year of HMS academic deans representing the academic mission at affiliated health-care institutions. He also recognized several important new programs created during the year, including the Simon & Schuster publishing initiative and the Institute for Chemistry and Cell Biology.
Joseph Martin symbolically received the torch, saying that it is "a great honor to be invited to the deanship." He, too, praised Tosteson, "whose 20-year tenure as dean is virtually unparalleled with respect to both duration and accomplishment." He said his aim is to build on this accomplishment. Martin called attention to the biological revolution of the second half of the 20th century and its power for good or evil. "We as physicians need to stand guard over these advances and be disciplined in our attention to the Hippocratic oath "to do no harm," he said.
Tosteson has left little time to savor the past. On May 14, he became the 41st president of the American Academy of Arts and Sciences--the first physician in 80 years to hold this position. The academy is an independent, learned society based in Cambridge that has existed for more than two centuries. He also is returning to his lab on the Quadrangle to continue research on cell-membrane physiology. He will play an active role in the Armenise Foundation and maintain relationships with major donors to the Medical School.
--Robert Neal
MEC Dedicated to Tosteson
At the dedication of the Daniel C. Tosteson Medical Education Center, Harvard President Neil Rudenstine (left) said, "Dan has thrived in a way that is not likely to be rivaled and surely not surpassed. Harvard has helped transform medical education, thanks largely to Dan Tosteson." After the bust was unveiled, Tosteson said, "To the extent that I live in this bronze, there is no place I would rather be than with the students of the Harvard Faculty of Medicine in this place."
Making No Bones About How To Make Bone
In four studies published in the May 30 Cell, Harvard researchers and others are reporting the discovery of a gene that is essential for forming a complete skeleton. The studies are an example of how separate lines of investigation can suddenly converge into a major scientific advance.
One group, led by Bjorn Olsen, Hersey Professor of Cell Biology at HMS and Forsyth Professor and Chair of Oral Biology at Harvard School of Dental Medicine, identifies a gene that when mutated, causes a bizarre bone defect. Two other teams, one led by Olsen and European scientists, the other from Japan, describe mice in which this gene has been disrupted. Finally, a Texas team reports molecular evidence bolstering the claim that this gene serves as a "switch" that triggers uncommitted cells in the early embryo to become bone-formers.
"This gene is essential for bone-forming cells to arise in the embryo. Without it, there is not a single bone-producing cell in the body," says Olsen.
The Allure of the Bone: The human skeleton holds sway
over
Bjorn Olsen's scientific
imagination. In recent years, he has
identified three genes that control different aspects of bone
formation. When mutated, one gene causes a
form of dwarfism,
one leads to
misshapen hands, and the one described in this
story stunts the growth of the collar bone, among other symptoms.
"This series of papers provides the first molecular insight into how differentiation into bone is regulated," comments Gideon Rodan, head of bone biology and osteoporosis research at Merck Research Laboratories in West Point, Penn., who reviewed the topic in the same issue of Cell.
The goal of this research is two-fold, Olsen says. First, he is trying to understand the organogenesis of bone in the embryo and child as part of his overall interest in learning how nature puts together a vertebrate body. Second, he hopes that basic knowledge about what controls the activity of bone-producing cells will pay off in better treatments for osteoporosis.
Olsen's team started the current studies by hunting for the gene causing cleidocranial dysplasia (CCD), a rare developmental disorder that stunts the growth of certain bones. Adults with CCD have a hole at the top of their skull, because their infant fontanels never harden. Their collar bones develop as tiny stumps or not at all, enabling them to perform a contortion known since ancient history: "His shoulders were bent and met over his chest," Homer writes about a man who came to Troy.
While zeroing in on the gene, Olsen's team found a family whose affected members were missing a piece of chromosome 6. Of two candidate genes residing in that region, the researchers first ignored the correct one because another group had implicated it in the immune system. Serendipity got them back on track when immunologists in London genetically engineered mice to lack this gene. These researchers, expecting problems in immune development, instead found that these mice had defective skeletons. Mice lacking one copy of the gene turned out to mirror the human disease; mice lacking both copies have a skeleton made entirely of cartilage, like little sharks.
The two research teams then showed that the gene, called Cbfa1, indeed, is the one causing CCD. The Texas group filled in another piece of the puzzle by showing that this protein can induce laboratory-grown, immature cells to start producing proteins specific to bone.
This 10-year-old boy with cleidocranial dysplasia has a hole at the top of his skull, because a gene defect prevented his soft infant fontanels from hardening. The sides of his skull consist of small pieces of boneheld in place by connective tissue (fine darklines); normal people have one continuousbony plate.
The Cbfa1 gene is expressed from the second week of embryonic development, says Olsen, suggesting that it acts in two ways. First, it plays a role in setting up the basic body pattern, as does a previously discovered cousin gene in flies, dubbed runt. Second, Cbfa1 leads to the production of actual bone material.
That second role is what leaves holes in the skulls of people with CCD, says Olsen. Missing one copy of the Cbfa1 gene, they rely on the remaining copy to build a skeleton. But certain parts of the skeleton require that there be more protein than one copy of the gene can supply. In affected people, the growth of the skull cannot keep up with the overall growth of the head. "CCD is really caused by insufficient amounts of bone-forming cells," says Olsen.
The sharklike mice missing both copies of Cbfa1 illuminate other aspects of bone formation. Born with a skeleton made of cartilage, they show that cartilage arises quite independently of bone, he adds. However, Cbfa1 is essential for replacing cartilage with bone, the cartilage serving as a casting mold for later bone formation.
Cbfa1 is expressed in adult mice, indicating its possible importance throughout life. Researchers are now asking whether the gene plays a role in osteoporosis, says Olsen, which results from an imbalance between bone production and bone degradation. This work might also prove useful to ongoing efforts at creating laboratory-grown human bone. "For orthopaedic surgeons, it would be great to be able to form pieces of bone for implantation into the patient," says Olsen.
--Gabrielle Strobel
Alumni Day and Class Day Symposia
Alumni Probe Malaria and Other Unclosed Cases
The world was a very different place when the HMS Class of 1972 donned their crimson regalia and graduated. Women were few and far between in the commencement parade. Virtually no one gave a thought to health maintenance organizations. Human retroviral diseases were essentially unknown.
"Who could have known then the enormous impact these changes would have," said Peter Weller, HMS '72 and professor of medicine. He was introducing the Class Day Symposium held on June 5 as part of Alumni Week, a celebration that includes commencement, symposia, seminars, receptions, and a variety of other programs. During the day-long Class Day Symposium, alumni from the Class of 1972 discussed the enormous changes in medicine that have occurred over the past 25 years. Their talks were divided into three sessions: Lives of Pathogens, Lives in Medicine, and Lives of Doctors.
Reviewing a Rogues' Gallery
The previous afternoon, alumni from the Division of Medical Sciences (DMS) gathered to review developments over the past fifteen years in the areas of immunology, circadian rhythms, and neuroscience. Although different in scope, the two alumni symposia converged on a similar message: While medicine is being confronted by new problems, such as the rise of HIV and other killer microbes, it has yet to resolve many long-standing issues. (See p. 3 for the Faculty Scientific Symposia.)
Peter Weller (left) and Onesmo Ole Moiyoi listen to an HMS '72 classmate's presentation at the ClassDay Symposium.
A long-standing problem addressed by the first Class Day speaker, Onesmo Ole Moiyoi, '72, was that of malaria. Moiyoi, who is provost of Kenyatta University and senior scientist and founder of the International Institute of Molecular and Cell Biology in Kenya, showed how his research on the molecular biology of theileriasis, a leukemialike disease that affects cattle, could shed light on the mechanisms of malaria.
Identifying disease mechanisms with the aim of thwarting them was the focus of the next speaker Matija Peterlin, '72. Peterlin, who is professor of medicine, microbiology and immunology at the University of California, San Francisco, and a Howard Hughes investigator, has recently discovered that one way HIV turns human immune cells into HIV-producing factories is by secreting a protein that converts the immune cells' RNA polymerase from a nonprocessive to a processive form. He and his colleagues are developing peptides that block the conversion of RNA polymerase by this protein.
Although less well-known than HIV, rotavirus currently accounts for one-third of the cases of diarrhea worldwide, and kills hundreds of thousands every year--mostly children in developing countries. Roger I. Glass, '72, recounted how he joined the Centers for Disease Control (CDC) in 1985 with the aim of drawing attention to rotavirus. "I wanted to make it into an American disease," said Glass, who is currently chief of the Viral Gastroenteritis Unit at the CDC in Atlanta. He found that 125 American deaths per year were caused by rotavirus at that time, though the number has dropped to 20. New vaccines for rotavirus are currently being developed. "Our hope is that hospitalization figures for the U.S. will go away completely with the use of this vaccine," said Glass.
Speakers at the DMS-sponsored Alumni Symposium presented research that is toppling long-standing assumptions. Rafi Ahmed, PhD '81, described how the immune cells that produce antibodies are much longer-lived than previously believed. Ahmed is professor and director of the Emory Vaccine Research Center at Emory University School of Medicine.
Margaret Moline, PhD '81, presented research showing that people suffering from depression, bipolar disorder, SAD, and PMS exhibit abnormal cycles of sleep, body temperature, alertness, hormones, and mood. Moline is director of the Sleep Disorder Center at Cornell Medical Center.
Perhaps most surprising was the research by Lorna Role, PhD '81, on nicotine. Role, who is professor of cell biology and anatomy at Columbia University, described how nicotine mimics a natural substance in the brain, acetylcholine, which in turn is involved in maintaining functions critical to life.
"It's important when we think about smoking and nicotine not to throw the babies out with the bath water. Nicotine can have potential benefits. On its own, it is not carcinogenic," said Role, adding that nicotine may be very promising in the treatment of Alzheimer's disease and Tourette's syndrome.
--Misia Landau
Leptin Found To Suppress Insulin Secretion
Leptin, a hormone linked to obesity, has been found to directly stimulate pancreatic beta cells, lowering secretions of insulin. The findings may help show how leptin is involved in human obesity and the development of non-insulin-dependent diabetes mellitus (NIDDM), or Type II diabetes. The study, led by Joel F. Habener, professor of medicine at Massachusetts General Hospital and Howard Hughes investigator, was published in the June issue of Diabetes.
The researchers created transgenic mice with mutations in the genes coding for the leptin hormone and its receptor. When normal mice do not eat, their insulin levels usually drop, but these mice develop hyperinsulinemia, extremely high levels of blood insulin. The scientists found that giving these mice leptin decreases insulin secretion. In humans, hyperinsulinemia from fasting is a risk factor for NIDDM and also for cardiovascular disease.
Leptin decreases insulin release by stimulating receptors on the beta cells of the pancreas. The team found that leptin interacts with an ATP-sensitive potassium channel, a key step in regulating insulin secretion.
Although obese people have elevated levels of leptin, no defects have been found in humans in either the leptin gene or its receptor. The researchers suspect that there may be a defect in the cell's intracellular signaling system, downstream of the receptor.
Other MGH authors of the paper are Timothy Kieffer, Scott Heller, Colin Leech, and George Holz.
Growth Hormone Contributes To Blindnes
Researchers have identified a method to control a hormone that may be responsible for the most common cause of blindness. This discovery could lead to new ways of preventing and treating certain eye diseases--including diabetic retinopathy, retinopathy of prematurity, and, perhaps, age-related macular degeneration.
Led by Lois E. H. Smith, assistant professor of ophthalmology at Children's Hospital, the scientists demonstrated that growth hormone (GH), caused retinal neovascularization, an abnormal growth of new blood vessels that can destroy sight. Furthermore, they found that blocking GH's actions decreased the amount of neovascularization. The findings are reported in the June 13 issue of Science.
The results suggest that new treatment approaches that inhibit GH's secretion or action could prevent neovascularization-related blindness. The current treatment for neovascularization consists of destroying the affected part of the retina with a laser or extreme cold. This treatment is only partially effective, and results in additional vision loss.
Retinal neovascularization occurs when the retina is deprived of oxygen. New blood vessels grow into the retina to increase the amount of oxygen. These blood vessels can cause scarring and bleeding, leading to a detached retina and blindness.
Other Harvard authors of the paper are Fumi Kinose, Douglas Daley, and Eliot Foley of Children's Hospital.
Faculty Scientific Symposia
Living Longer and Better Lives
Harvard Researchers Describe What Is in Store for Alumni--and for
Us
To dispassionate observers of human evolution, aging is merely an artifact of civilization: Not until this century did large numbers of people start living past middle age.
But no matter how long nature intended us to stay alive, aging is a real phenomenon, and it is quickly transforming contemporary society. Science therefore must address its many ramifications, Walter Frontera said last week, when he and other Harvard researchers presented to visiting alumni ongoing research into how today's elderly can live longer and better lives.
"The real issue is whether those who get to old age can improve the quality of their lives. That is where our concern lies," said Frontera in his opening remarks to the Faculty Scientific Symposium on rehabilitation and geriatrics. Frontera directs the Division of Rehabilitation Medicine at Harvard Medical School.
Booming Elders
When the Harvard Medical Alumni Association was founded in 1891, the average American could expect to live about 40 years. The population age structure was the shape of a triangle, with few people living into their 70s. By the year 2020, however, the number of Americans over 65 will equal the number of people under 20, effectively turning the triangle into a rectangle. Indeed, the fastest-growing segment of the population is the oldest old: nonagenarians and centenarians. The ranks of the latter will swell from today's 30,000 to at least 500,000 in the year 2020, said Thomas Perls, HMS instructor in medicine, who directs the New England Centenarian Study.
Societal implications of these demographics are already reverberating through public debates. Much of the talk about projected Medicare insolvency, the financing of social security, and health-care rationing is pitting the young against the old by invoking fears that the old will require ever-growing resources. But that tension may be unnecessary, said Perls, because the oldest old may never become a massive drain on society. His work with Boston-area centenarians shows that they are surprisingly vigorous and healthy. When they do enter the hospital, he reported last year, they cost less than do hospitalized patients in their 60s and 70s.
One explanation for this lies in a newly emerging paradigm for aging that defies conventional wisdom, said Perls. The general assumption that people get progressively weaker with age and inevitably end up bedridden and demented does not hold true for the oldest old. Rather, a third of the centenarians Perls studies are completely cognitively intact, physically healthy, and active. All of them were in excellent health into their mid-90s.
Perls explained this encouraging news as 'survival of the fittest,' saying that the 60s and 70s are a vulnerable period in a person's life, during which fatal diseases are most likely to strike. But "if you are in your 80s and healthy, you have demonstrated your survival prowess, and it becomes more and more likely that you will live the next ten or 20 years in good health. You have gotten over the hump," Perls said.
Coping with Stroke: Hilary Siebens,director of community rehabilitation services at Spaulding Rehabilitation Hospital, outlined research into improving the quality of life for the 3 million stroke survivors in the U.S. today. Here she demonstrates the Rollator, a sturdy walker designed with a seat, cane, and tray.
But how does one get over the hump? The scientific jury is still out on this question, and it will probably come back with multiple answers, including genes, nutrition, and exercise.
Frontera's research focuses on the latter. His group studies how muscles change with age, and what exercise can do to compensate. Aging people gradually lose muscle strength, mostly because the number of muscle fibers shrinks. That loss contributes to falls and to disability, he said. A recent study even showed that the rate of decline of muscle strength can predict mortality.
But research also indicates that at least part of the muscle's deterioration may be due to the sedentary lifestyle many old people lead, not just to aging per se. If that were true, then exercise should be able to reverse part of the loss, said Frontera, who came to Harvard last year to help build and chair the fledgling HMS Department of Physical Medicine and Rehabilitation, based at Spaulding Rehabilitation Hospital.
A study led by Frontera, in which elderly people exercised three days a week for 12 weeks, showed that their muscle strength doubled--a relative increase similar to what young people achieve in the same training period. Other studies have since shown that this finding holds up over time and that it applies to people in their 90s, as well. The gain in muscle strength helped the study participants to be more physically active and independent, said Frontera. He concluded that for some elders, carefully designed exercise training offers a way out of disability.
--Gabrielle Strobel
The Values of Medicine
Opening the graduation ceremony for Harvard Medical School and Harvard School of Dental Medicine, the Class of '97 student speakers set the tone, ringing the themes of leadership and ambition, of dedication to community and humanity. Their purpose was less to build on past achievements than to set their own direction against the pressures of change.
Their text sounded like notes for practicing the New Pathway.
Edward Hundert, the departing associate dean for student affairs who had been recognized by students for his impact on their education, gave a talk focusing on the class oath. Going line by line explicating the text, he pointed to honor as "the most important part of the oath," the overarching principle of the medical profession.
Graduates of HMS (l to r) Sherleen Huang, Virginia Hung, and Tina Denise Jackson, and of HSDM right (l to r) Shahrokh Bagheri, Brian Bast, and DinoBertini are set to launch honorable careers in medicine and dental medicine.
The keynote speaker, Dean Daniel Tosteson, said, "As you know, I will end my 20 years of service as dean of the Faculty of Medicine on June 30 of this year. It has been for me a labor of love ...." After introducing the incoming dean, Joseph Martin, as one who "will provide superb leadership for Harvard medicine," he gave his thoughts on a philosophy for learning in medicine.
He said one attitude essential for such a philosophy is "respect for each person who seeks our help." He suggested that doubt and skepticism are valuable attitudes since they promote a healthy questioning of the paradigms of clinical practice.
"Doctoring is a people business," Tosteson said. Any philosophy for learning in medicine has to draw on the sciences and on the arts. The first addresses the biological unity and diversity of life; the second, the dimensions of being.
HMS and HSDM Recognition
Student Commencement Speakers
Moderators: Steven N. Kalkanis and Elena M. MartinezAddresses: Douglas B. Haghighi, Thomas G. Roberts, and David E. Sloane
Prizes and Awards
Class of 1997
.Scott H. Podolsky, Richard C. Cabot Prize
Michael A. Steinman, Henry Asbury Christian Award
Colin M. Sox, The Community Service Award
Andrew T. Chan and Colin M. Sox, Robert H. Ebert Prize
Margaret C. Park, Harvard Dental Alumni Association Gold Medal
MaryEllen M. Heisler, Kurt Isselbacher Prize
Alexandra L. Haagensen, Bemy Jelin '91 Prize
Sitram M. Emani, Harold Lamport Biomedical Research Prize
Keith D. Amos, Laura H. Brown, Nneke R. Azikiwe, Garrick L. Motley, and Collin M. Stultz, The Multiculturalism Award
Dino Bertini, Dr. Norman B. Nesbett Award
Garth D. Meckler, The New England Pediatric Society Prize
Stelios M. Smirnakis, Leon Reznick Memorial Prize
Keith D. Amos, James H. Robinson, M.D. Memorial Prize
David H. Brendel, Dr. Sirgay Sanger Award
Colin M. Sox and Ashish K. Jha, Rose Seegal Prize
Collin M. Stultz, James Tolbert Shipley Prize
Ching-Ju J. Chang, Harvard Dental Alumni Association Silver Medal
FacultyJulian Seifter, Faculty Prize for Excellence in Teaching, First Year
Michael Lin, Faculty Prize for Excellence in Teaching, Second Year
Carolyn Compton, Faculty Prize for Excellence in Teaching, Second Year
Harley Haynes, Faculty Prize for Excellence in Teaching, Third Year
Charles McCabe, Faculty Prize for Excellence in Teaching, Third Year
Gary Setnick, Faculty Prize for Excellence in Teaching, Fourth Year
Vito Iacoviello, Leo A. Blacklow Teaching Award
Edward Hundert, associate dean for student affairs, was recognized by the students as "the faculty member who had the greatest impact on our medical training." Hundert, who is leaving to become the associate dean for medical education at the University of Rochester School of Medicine and Dentistry, bid farewell to the last graduating class of students he shepherded through medical school as well as the rest of the Harvard medical community.
Commencement
Healthy Public Investments
The Harvard School of Public Health held its graduation ceremonies June
5 in the Kresge courtyard. The School, celebrating its 75th anniversary
this year, graduated 341 students--the largest graduation class in the School's
history. Dean Harvey Fineberg led the ceremonies. He complimented the students
on their achievements and highlighted student public-health projects from
local food, toy, and clothing drives to health studies at the Mexico-Texas
border. He wished all the graduates, "a hope for achievement, satisfaction,
and success for personal work."
(Left) Kristijan Kahler. (Right - l to r) Sonia Hernandez,Deborah List, and H.-C. Alain Ma are prepared to address public health issues locally and internationally.
The commencement address was given by David Satcher, director of the U.S. Centers for Disease Control and Prevention. In his address, Satcher said: "Prevention is the best investment we can make in our people's health." He stressed the importance of partnerships between state and local governments and the community in promoting public health. He said that we must begin by fostering a sense of community, especially in communities that are so broken that people cannot safely walk the streets, much less care about public health. He also said there must be a continuity of responsibility in government, and that there is "no substitute for ethical values in public health."
During the student speeches, Wilfred Fon Mbacham, a PhD recipient and winner of the Albert Schweitzer Award, surprised Dean Fineberg and Cassandra Simmons, assistant dean for students, with a special award for their efforts in founding the Harvard Journal of Minority Public Health. Other awards were presented to students, professors, and teaching assistants for excellence in teaching, academics, writing, and research.
HSPH Recognition
Student Speakers:
Introduction: Sandra Jerez; Addresses: Sameera Al-Tuwaijri and Wilfred MbachamPrizes and Awards
Class of 1997
FacultyWilfred Mbacham, Albert Schweitzer Award
Stefan Horvath and Tianxi Cai, Robert B. Reed Prize
Sally Araki and Jennifer Hostettler, Charles F. Wilinsky Award
Guilherme Werneck, Uwe Brinkmann Memorial Travel Award
Nancy Isaac, Samdperil Health Law Essay Award
Irwan Julianto and Elisa Friedman (for HHR group), François-Xavier Bagnoud Health and Human Rights Essay Award
Yvette Roubideaux, Dr. Fan-Ching Sun Memorial Award
Charlene Brown, Student Recognition Award
William Hsiao, Roger L. Nichols Excellence in Teaching Award
Julia Hsu, Teaching Assistant Award
Robert Blendon, Deborah Prothrow-Stith, and Stephanie Shore, Faculty Teaching Citations
A Tribute to Daniel C. Tosteson
"Through his devotion to the medical profession-- and through his humane concern for both the people within the profession and the people they serve--Dan Tosteson has personified the highest aspirations of the University: to advance the search for knowledge, and in so doing, to help change lives for the better."
Neil L. Rudenstine, President, Harvard University
After twenty years of extraordinary leadership as dean of the Faculty of Medicine at Harvard, Daniel C. Tosteson will step down at the end of June 1997 and pass the torch to Joseph B. Martin. These past two decades at Harvard Medical School have been shaped by the remarkable accomplishments of an individual who helped transform medical education locally, nationally, and internationally; improved the HMS graduate program for biomedical scientists so it is one of the best in the nation; developed innovative ways to foster biomedical research; promoted the academic mission in the affiliated clinical institutions; and strengthened the financial base of the School.
As a result of Tosteson's unusually clear vision and his commitment to Harvard Medical School, the School has flourished during his tenure. It was his conviction that in order to remain a great medical school into the 21st century, Harvard Medical School must continually evolve as both medicine and society change, undertaking new initiatives to creatively improve teaching, research, and patient care. Twenty years later as he steps down as dean, his vision has been largely realized, and the School is poised to take on the challenges of the future.
To envision change is one thing. To make it happen is a much greater challenge, particularly in a medical-school environment which can be at the same time decentralized and bureaucratic, forward-looking and tradition-bound. As dean, he led with a style uniquely his own. He had a greater interest in doing the right thing, and a lesser interest in being popular. He used an analytical approach as he pursued his vision, not by rhetoric or a flamboyant personal style, but rather by using the power of persuasion. His courage, patience, and perseverance made it possible to experiment, take risks, and overcome barriers.
Tosteson also had the ability to select and inspire a skilled administrative team, many of whom worked with him through most, if not all, of his tenure, and to mobilize and focus their energies in creative ways. The contributions of his other deans, numerous department heads, basic- science and clinical faculty, staff, and students all played a critical part in enabling his visions to be realized.
A New Way to Learn
From his previous experiences as associate professor of physiology at Washington University School of Medicine, professor and chairman of the Department of Physiology and Pharmacology at Duke, and dean of the Pritzker School of Medicine at the University of Chicago, Tosteson came to Harvard with the strong conviction that medical education must change, in large part because the rapid explosion of medical knowledge was becoming so great that no one person could retain it. Consequently, medical education must focus more on the continuing act of learning, on deciding what and how to learn.
To explore the changing nature of general medical education and to develop an innovative curriculum to better prepare physicians to practice effectively in a future filled with rapid changes in medical knowledge, technology, and health-care delivery became central goals. The New Pathway to General Medical Education, a cluster of new and borrowed educational innovations that was first implemented as a pilot project in 1985, is now the basis for all four years of the curriculum and has become a national model for transforming medical education.
The New Pathway goals are to develop a broad and flexible knowledge base; skills in the lifelong acquisition and use of knowledge; and sensitivity to the world of the patient. To achieve these goals, this program focused around small-group, problem-based learning with particular emphasis on self-directed learning skills that are critical to physicians throughout their careers.
One of the goals of the New Pathway is to integrate basic sciences and clinical experiences. Students are exposed to clinical problems, patients, and practicing physicians from the start of medical school, and basic-science issues continue to be addressed during the clinical years. The curriculum is no longer departmentally based, but rather is integrated across disciplines and focused around major themes such as human systems. Problem-based learning teaches basic science through clinical cases. The scope of the curriculum also has been broadened to include important contributions from disciplines such as social medicine, the humanities, ethics, and health-care policy.
The importance of teaching and the need for the School to help faculty develop as teachers also have been emphasized by providing programs to train the faculty to teach more effectively and by establishing two new ladders for appointments and promotions, the Teacher Clinician and the Clinician Scholar.
A key part of the New Pathway is assignment of each student to one of five academic societies, which were created to involve groups of faculty in ongoing design and implementation of the curriculum, as well as to facilitate closer contact among faculty and students, and to strengthen the personal relationships that underlie the growth of commitment to learning. Each academic society is headed by a master--a distinguished senior faculty member--and has many other faculty associated with it.
Because Tosteson was committed to having Harvard Medical School be a leader in medical education worldwide, the Harvard Macy Institute was created to provide a multifaceted training program to prepare faculty, deans, and administrators from other medical schools to become better educators, and to develop a cadre of people prepared to bring about innovations in medical education in their own schools. The goal is not to create exact replicas of the New Pathway, but rather to help educators understand the issues they need to address in the process of change.
Tosteson has received national recognition for development of the New Pathway. The Association of American Medical Colleges, in bestowing its highest honor on him in 1991, said: "Daniel C. Tosteson, MD, a lifelong scholar, exemplary physician-scientist, and esteemed medical educator receives the Abraham Flexner Award for Distinguished Service for his notable contributions to medical education. Through his leadership, Harvard Medical School developed an innovative curriculum, creating a vibrant and dynamic environment in the classroom, the laboratory, the hospital, and the clinic--the many settings in which faculty and students learn medicine."
In 1993 Daniel Tosteson was awarded an honorary Doctor of Humane Letters degree by The Johns Hopkins University for his "excellence as a medical scientist, innovative leadership in medical education, and dedication and humanity."
This official portrait of Daniel C. Tosteson, dean of the Faculty of Medicine, was unveiled at the Committee of Professors meeting on June 11. The painting, by George Augusta, hangs in the Waterhouse Room of Building A, along with portraits of other HMS deans.Photo by Liza GreenOn the New Pathway: "A particular goal of this student-centered, problem-based approach is to develop physicians who practice "science in action" rather than attempting to apply learned formulas to clinical situations. The aim is to build an awareness that the methods and insights of the natural and social sciences and humanities basic to medicine are inseparable from the day-to-day practice of all kinds of medicine. To this end, from their first day students face clinical problems in the process of learning basic science, and they continue to confront scientific issues in clerkships toward the end of the sequence."
Growth Factors for Science
The training of future biomedical scientists is an integral part of all vibrant research communities. Not only do students add to the intellectual climate of the departments, but they also represent an important resource for faculty research. The strengthening and growth of the PhD programs has been an important element in the revitalization of research on the Quadrangle. The School's ability to ensure the availability of outstanding graduate students has been a key ingredient in the recruitment of the best faculty.
In 1988, Tosteson committed the Medical School to reorganizing the management, improving the curriculum, and enhancing the quality of the research training program, and to expanding its size from 280 to 500 students. The School committed resources necessary to support tuition and stipends for additional students, as well as the expanded leadership and infrastructure required to attract and sustain the best students for the PhD and the MD-PhD programs.
One of the most significant programmatic outcomes of the reorganization of graduate study was the establishment of the Biological and Biomedical Sciences Program (BBS). Proposed and nurtured by the leadership of the basic science departments, the BBS program offers a unified approach to the study of the biological sciences basic to medicine. Students admitted to the program are able to pursue doctoral work with faculty in one of five basic-science departments on the Quadrangle or in the affiliated hospitals. In addition to the BBS program, graduate students have the opportunity to apply to outstanding programs in neuroscience, immunology, virology, and biological sciences in public health.
Designed to take advantage of the unique Harvard Medical School environment for graduate education, in 1991 the Division of Medical Sciences established the Harvard-Markey Biomedical Scientist Program for students interested in gaining a more comprehensive understanding of human biology and disease. The underlying goal of the program is to provide nascent basic scientists with the knowledge required to identify research opportunities presented in human disease.
As a result of these far-reaching efforts to improve graduate education, the graduate programs in the Division of Medical Sciences now rank among the world's most highly respected, competing successfully with the best institutions nationally.
An active scientist throughout his career, Tosteson's research is directed toward a deeper understanding of the molecular mechanisms and cellular functions of the transport of ions across membranes, and has increased our understanding of such diseases as hypertension, manic depression, and sickle cell anemia. He is a forceful advocate for the vast potential that the explosion of biomedical discoveries holds for a medicine of the future, unprecedented in its power to heal, cure, and prevent diseases. He is convinced that cutting-edge research in the sciences basic to medicine will continue to illuminate our understanding of the human body during health and disease, and provide the basis for developing new ways to relieve suffering, to treat and prevent illness, and to improve the quality and delivery of health care.
Tosteson saw earlier than most the coming revolution in molecular biology and positioned the School to move forward creatively. In 1980 he established a new Department of Genetics, one of the first in the nation. Other biomedical-science departments were reorganized to better reflect directions of modern molecular biology, resulting in the formation of the Department of Biological Chemistry and Molecular Pharmacology and the Department of Cell Biology. Departments in the social sciences were also reorganized with the establishment of the Department of Health Care Policy and the Department of Social Medicine.
Premier scientists were recruited to head these and the other School departments, and Tosteson oversaw the selection and recruitment of more than 150 faculty on the Quadrangle, completely changing the face of research during his twenty years of leadership. Tosteson nurtured and enabled growth of the research departments by providing modernized facilities, resources for recruitment of senior and junior faculty, and new sources of funding for departmental initiatives, thus making it possible to attract the best scientists, graduate students, and postdoctoral fellows.
Tosteson has strongly encouraged interdisciplinary and interinstitutional research initiatives through creation of a number of divisions, institutes, centers, and other collaborative programs. The Harvard Institutes of Medicine were established to bring together scientists from the Quadrangle and from the affiliated hospitals to address problems at the interface between basic science and clinical medicine. The first institute program is the Harvard Institute of Human Genetics, which provides a collaborative research environment in which scientists from the Quadrangle and the affiliated hospitals will utilize the techniques and emerging technologies of molecular genetics to advance the understanding, diagnosis, and treatment of human disease.
Two recently established centers reflect collaborative efforts between the scientists at the Medical School and members of the Faculty of Arts and Sciences. The Harvard Center for Structural Biology determines the molecular structure of proteins and nucleic acids with the goal of understanding the relationship between structure and function. Understanding the structure of molecules gives insight for the rational design of drugs and therapeutic agents, which could be used to modulate the activity of that molecule, resulting in a treatment for the disease.
The Chemistry of Partnerships
The new Harvard Institute for Chemistry and Cell Biology will focus on integrating chemistry and chemical synthesis with the continually evolving fields of cell biology and biochemistry. Scientists in the institute will develop new ways to synthesize vast numbers of small molecules that will be used as molecular tools to modulate the activity of proteins found in complex biological systems. These efforts will yield the ability to evaluate novel gene products and systems and should result in dramatic advances in biology and medicine by providing a more direct link between them.
The newly established Giovanni Armenise-Harvard Foundation for Scientific Research, created by Tosteson in partnership with Count Giovanni Auletta Armenise, will support collaborative research in cell and molecular biology on the Quadrangle, and with first-rate scientists at five centers in Italy.
During the past 20 years, research at Harvard Medical School has grown dramatically in size and quality. National Institutes of Health (NIH) research grants to the Quadrangle-based faculty have more than doubled. Grants to faculty based at the affiliated hospitals have increased even more dramatically. Collectively, NIH research-grant support of the total Harvard Medical School faculty amounts to over $400 million annually, which is the highest in the nation.
As dean of Harvard Medical School, Tosteson has been a champion for the academic mission in the affiliated institutions. He has worked as a partner with the leadership of the affiliated institutions to recruit the best clinical scholars to head the academic clinical departments. A large number of new endowed clinical professorships, made possible by gifts to the School, have provided powerful recruitment tools to attract a superb community of clinical faculty members.
In response to changes in health-care delivery, and in an effort to shape new approaches to medical practice and provide more appropriate teaching opportunities, several new departments were established in connection with the affiliated teaching institutions. These include the Consolidated Department of Psychiatry and the Departments of Ambulatory Care and Prevention and of Physical Medicine and Rehabilitation.
Recognizing that the School's academic activities in preventive medicine should no longer be hospital-based, coupled with a desire to have stronger leadership in the training of medical students in ambulatory settings, the School created the Department of Ambulatory Care and Prevention as a joint venture with the Harvard Community Health Plan (which later merged with Pilgrim Healthcare to become Harvard Pilgrim Healthcare). The department's faculty has provided leadership in the restructuring of clinical training for medical students to increase training in ambulatory settings. Through the Division of Primary Care, the Department serves as an important anchor for faculty practicing in a variety of ambulatory settings, as well as a focus for health-services research.
Concerned about the impact of competitive pressures on the practice and organization of clinical medicine, specifically on the clinical department heads responsible for both the clinical and academic missions of their departments, Tosteson identified the need for differentiated leadership for the academic mission as a means of preserving the quality of these activities within the affiliated institutions. The Harvard Medical School Beth Israel Deaconess Mount Auburn Institute for Education and Research was established as a model for securing the leadership and financial commitments required to ensure innovative, high-quality programs in clinical education and research in an era of managed care. The cornerstone of this initiative was the appointment of a faculty dean for academic programs at CareGroup to provide leadership for teaching and research in close collaboration with the clinical chiefs throughout the system. Similar decanal appointments have now been made at all of the principal teaching affiliates to form the Council of Academic Deans. These individuals will work with the academic department heads in their respective institutions and with their counterparts across the affiliated institutions to propose and review academic appointments and to focus on issues and opportunities in research and clinical teaching.
New Spaces, New Faces
Although the Quadrangle buildings provide an architecturally rich setting for the Medical School, by the late 1970s these buildings, which had not been renovated since they were constructed in 1906, had begun to show their age. Tosteson recognized that modern physical facilities were needed that would make it possible to utilize the current research techniques and new teaching methods that are critically important to both research and education. Under his leadership, all of the physical facilities have been, or are about to be, renovated, and two new research facilities have been provided. One, a nearby former high school, now the Harvard Institutes of Medicine, was purchased and renovated to provide modern research space for scientists from several of the School's affiliated teaching hospitals, thus facilitating interaction among them and with the Quadrangle-based faculty.
As planning for the New Pathway progressed, it became apparent that Harvard Medical School's physical facilities would be unable to support this new educational venture. The existing teaching facilities were randomly dispersed throughout the Quadrangle. They were antiquated and lacked adequate computer and audiovisual capability. Teaching labs were dilapidated. Space assignment was haphazard, spaces were not dedicated to teaching, and rooms were not of appropriate size and design for the new style of teaching.
To address this need, one of the original Quadrangle buildings was totally renovated and connected with a new structure to create the Medical Education Center, designed to facilitate the New Pathway's emphasis on small groups and the use of interactive computer programs, and to provide space for the academic societies. The Medical Education Center makes a very visible statement about the importance of education.
As a permanent tribute to Tosteson's outstanding stewardship of Harvard Medical School, and in honor of his enduring commitment to medical education and extraordinary leadership in developing the innovative New Pathway, this building was named the Daniel C. Tosteson Medical Education Center on June 12, 1997, by the president and fellows of Harvard College in conjunction with Harvard Medical School.
Toeing the Bottom Line
When Tosteson arrived at Harvard Medical School, although the School appeared to be well endowed, in fact its endowment was increasing at less than half the rate of inflation and the income from the endowment supported too small a percentage of the School's expenditures. Over the past twenty years he has overseen the development of a comprehensive financial strategy that raised sufficient resources to support all of his priorities, while, at the same time, building an endowment to support the School's priorities for years into the future. In doing so, he institutionalized a fund-raising capability that incorporates resource development as an essential element of the School's administration. During his tenure, the endowment of the Medical School increased from $128 million to $1.1 billion.
"Dan has implemented a vision for science at Harvard Medical School that is without parallel in this century. Confronted with extraordinary developments in genetics, recombinant DNA technology, and cell biology, he determined that the Medical School would not be a spectator to these opportunities, but a front-line participant in creating new knowledge essential to medicine. He established the Department of Genetics and reorganized the departmental structure on the Quadrangle, strengthening departments and creating new Departments of Cell Biology, and Biological Chemistry and Molecular Pharmacology. It is a remarkable legacy for the 21st Century."
PHILIP LEDER, Chair of the Department of Genetics
Seeking to go beyond the limits of traditional fundraising for the support of science, Tosteson saw the need and the opportunity for pursuing new sources of support from corporations with strong biomedical research and development interests. Fueled by rapid advances in scientific technology and expertise, these corporations were interested in collaborating with academic scientists as a means of enhancing the quality and capability of their own research efforts and of generating new approaches and ideas for treatment and therapies. At a time when other academic institutions were unwilling to consider such opportunities in light of controversial issues around collaboration with industry, Tosteson guided the School in an approach that yielded mutually beneficial corporate agreements that protected the intellectual independence and discoveries of the faculty and the institution. He oversaw development of conflict-of-interest guidelines that serve as a national model. During his tenure he encouraged and shaped collaborative agreements with Monsanto, du Pont, Merck, Hoechst, Shiseido Hoffman-La Roche, Takeda, Sandoz, and others that continue to provide support for basic science and for graduate education, and serve as models for new opportunities.
Another key element of the School's financial strategy has been driven by Tosteson's ability to identify, shape, and champion new ventures that would provide challenging opportunities for faculty, as well as new sources of support for the School and its priorities. In each case, these ventures created new and expanded vehicles for extending the School's mission in education, research, and patient care. When few academic institutions would consider diversification of their core mission into business activities, the School undertook major initiatives in biotechnology, international medicine, and consumer publishing. The structures and understandings to launch these initiatives were established in such a way that the academic freedom of the University and its faculty was protected, as was the autonomy the new ventures needed to succeed in a competitive business climate. No other academic leader has had the vision and perseverance to succeed in this arena.
Boosting Business
Medical Science Partners was created in 1988 as a biotechnology venture fund focused almost exclusively on discoveries and technologies from Harvard and the affiliated institutions. The fund's purpose is to facilitate the commercial development of discoveries from the faculty to satisfy the objectives of capitalizing on scientific advances for public benefit and generating income for the School to support future research. Medical Science Partners is also a means for the School to hold equity at arms length, avoiding the conflicts of interest that would occur otherwise. To date, Medical Science Partners has been successful in raising two funds and in investing those funds in early seed-stage companies. Medical Science Partners currently holds investments in 24 companies, including seven public companies. Plans are under way to raise a third fund, in mid-1997, with a planned target of $80 to 120 million.
"There are several things that distinguish [Dan Tosteson's] tenure. One is his ability to establish priorities and really focus on them and to stick with those problems relentlessly until they are solved. The second is that he surrounded himself with a group of people who were not sort of yes men or pale imitations of the dean, but had varied talents, and kept them working with him throughout a very long period of time. It is really extraordinary that they should stick with the enterprise for that long."
DEREK BOK, President Emeritus of Harvard University
Academic and medical institutions throughout the world have long sought access to the expertise and insights represented in the Harvard Faculty of Medicine and its affiliated institutions. Harvard Medical International was created as a vehicle for responding to this demand in a way that allows the School and its faculty to contribute to the improvement of programs in teaching, research, and patient care internationally, while at the same time generating a new source of support for academic programs across the faculty. Harvard Medical International is successfully pursuing opportunities in educational-program design, research-program development, health-care facility design and management, and new health-related businesses. This agenda provides faculty physicians and scientists with the unique opportunity to pursue research interests of international relevance and to apply their expertise in teaching and clinical practice.
Seeking to add a new dimension to its programs in education, the Medical School has joined with Simon & Schuster to pursue public education in health and medicine. This venture provides the School and its faculty with a vehicle for providing the public with new, reliable information on discoveries in science and medicine related to health promotion, disease prevention, clinical effectiveness, and organization and use of medical services. The partnership provides faculty authors with the support and publishing expertise to produce and disseminate high-quality medical and health-care information for a lay audience through books, newsletters, and electronic products such as CD-ROMs and on-line services.
Tosteson arrived at Harvard Medical School twenty years ago with a vision for change and the resolve to see that change implemented. He may be most widely known for creation of the New Pathway, and its subsequent impact in helping to transform medical education across the nation. Yet his remarkable legacy will not be found in any one achievement alone, whether it be the New Pathway, an enriched research environment and improved graduate education, the expanded and improved physical plant, or a strengthened financial base. Today, Harvard Medical School is poised to continue as a premier medical school into the next century, a school that will remain in the forefront of advances in medical education, research, and patient care.
As Tosteson has noted, Harvard Medical School is a cultural family to which we all belong. The discoveries, knowledge, and gifts of those who have preceded us help us to understand that we are the present part of a community that extends from the past into the future. Much has been accomplished, but much more remains to be done as the torch now passes to a new generation of leadership. Tosteson's legacy will make it easier for the torch to burn brightly as it lights the way for future members of the Harvard Medical School family, who will train physicians and scientists in years to come, bring to bear the power of cellular and molecular medicine on preventing and treating disease, and help to relieve the sickness and suffering of the world.
--Adapted from the book by Susan K. Bender and Karla J. Pollick
Faculty Council
Tosteson Talks Frankly to Faculty
At the final meeting of the Faculty Council for 1996-97, members heard a report on the joint-degree and five-year programs at HMS. Daniel Federman, dean for medical education, said that approximately 50 percent of HMS students complete their medical degrees in four years, but that the remaining half take longer. Many of the students who take more time are pursuing numerous enriching avenues including Master of Public Health (through HSPH); Master in Public Policy (through the JFK School of Government); the MD-PhD program. Others travel both nationally and abroad where they teach and are involved in patient care. Many students are involved in research. In addition to allowing students to obtain new knowledge, these various avenues also allow students an opportunity for further focusing their posteducation careers. Audrey Bernfield, director of enrichment programs, said that efforts are being made to identify more interested sponsors to be involved in clinical research projects. Her office puts out a monthly newsletter in which she invited interested sponsors to advertise such opportunities for students.
Eleanor Shore, dean for faculty affairs, presented a summary of Faculty Council considerations and actions for the year. She noted some of the key issues considered by the council during the year, including the incorporation of computer technology into medical education; the use of the Harvard name; faculty proposals for new interdisciplinary or interinstitutional divisions, centers, or institutes; and the changing future of the VA hospitals.
Nancy Oriol, vice chair of the council, then presented a wooden desk box to Dean Tosteson, featuring a pen and ink sketch of HMS with the inscription: "To Dean Tosteson, sculptor of medical education and mentor of the students and faculty, thank you for joining with the Faculty Council to implement many proposals that have expanded the heart and mind of Harvard Medical School." Inside the box were notes of appreciation from individual council members.
For the remainder of the meeting, there was an open conversation between the council and the dean. Tosteson first thanked council members for their important work during the course of the year as representatives of the Faculty of Medicine. He then spoke of the current state of HMS, which he termed a "very complex, complicated organization." The dean said that since 1977 when he became dean of the Faculty of Medicine, the faculty has grown to over 13,000 members, including over 3,000 full-time faculty. The Office of the Dean oversees an annual budget of over $220 million, 60 percent of which is derived from grant monies, two-thirds of which come from the federal government. The dean said that only five percent of monies in the budget come from tuition. He also spoke of the Dean's Office's concern with respect to educational issues for residents and postdoctoral fellows; the natural, social, and clinical sciences; clinical research; outcomes research; institutional relationships; and high-quality patient care.
Tosteson said that new initiatives such as the Harvard Medical Center and the Council of Academic Deans have been formed to bring down institutional, departmental, and divisional barriers for the betterment of academic medicine, and that the societies of HMS were designed to address educational and other issues and bring together faculty. Tosteson deemed the societies successful, but said that the work of bringing together faculty is unfinished. He pointed out that the crucial questions of what to teach and how to teach will become more complicated in the future, as the rapid changes taking place in medicine currently continue.
In response to a question about the current state of institutions in competition for clinical monies, Tosteson endorsed academic cooperation. He encouraged faculty members to be proactive about cooperation and the academic mission in their own institutions and said that the clinical faculty underestimates its power and that this power is not currently well organized. Tosteson asserted that decisions regarding financing medical education and allocating grant money are, and will continue to be, difficult, but he was optimistic about the long-term future of the profession of medicine. He said that the 21st century could well be the century of biology and medicine and that we are all living through one of the greatest periods of scientific discovery in history. He also said that this fierce period of advancement will remold the whole field of health care. Tosteson concluded by saying that he is not discouraged by the short-term exigencies of the current health-care situation.
Research Alliance Formed With Hoechst Marion Roussel
On June 2, Harvard Medical School and Hoechst Marion Roussel, the pharmaceutical company of Hoechst AG, announced a five-year research alliance. The agreement stipulates that Hoechst will provide the Medical School with $15.9 million over five years to study common mechanisms of cell function that have potential applications to human disease.
The alliance will be effective July 1, 1997, and will initially focus on the areas of bioinformatics, apoptosis, cell-cycle regulation, and cell regeneration. Representatives from Hoechst Marion Roussel and HMS will cochair a steering committee that will review research proposals from the School's faculty and will manage the allocation of funds to support selected projects. As part of the agreement, Hoechst will have exclusive first rights to negotiate licenses for patents stemming from the alliance and can use nonpatented information at no additional cost. Harvard Medical School has the right to publish any and all information resulting from the alliance.
"Research is a key function of Harvard Medical School," said Stephen Carter, administrative dean for research. "The alliance with Hoechst Marion Roussel will help fund innovative, exploratory, and advanced research projects; support existing and new core research resources; and make substantial contributions to the MD-PhD fellowship program, a vital academic area with dwindling federal support."
Seven Researchers Awarded Funds For Discovery Grants
Seven Harvard Medical School researchers received Funds for Discovery (FFD) Exploratory Grants at a June 9 ceremony. John and Virginia Taplin (seated) established FFD in 1992 to support junior faculty research and to promote the development of their research into marketable technologies. This year's winners are (l to r) Elaine A. Elion, associate professor of biological chemistry; Rong Li, assistant professor of cell biology; Daniel Finley, associate professor of cell biology; Chao-ting Wu, assistant professor of genetics; Lori J. Lorenz, instructor of cell biology; John A. Assad, assistant professor of neurobiology; and John A.T. Young, (not pictured) assistant professor of microbiology and molecular genetics.
A Scientist's Coming of Age
They checked the box!" I made this triumphant announcement to my lab colleagues after a meeting with my Thesis Advisory Committee (TAC) last November. The TAC is composed of four to five faculty members, whose mission it is to guide us through our thesis work by meeting with us once a year, until they find us ready to graduate. The box I was referring to is the one that faces the sentence: "Student may begin to write thesis" on the TAC report form. There comes a time in every graduate student's life when all one (and one's entourage ...) can dream of is a tick mark in that box. I immediately called my parents in Lebanon and told them they should plan on being in Boston on June 5, Commencement Day 1997.
At the time, I was optimistic enough to believe that it would
all be a downhill ride from there. The hard part, I thought, was in the
five years I had already spent at the bench. All I had to do now was set
a date for my thesis defense, and give myself just enough time before this
date to be ready by then. Most people I asked said a thesis could easily
be written up in six weeks, once all the data had been collected and analyzed.
Needless to say, this assumes the person writing the thesis is immune to
all sources of distraction. In my case, at least two weeks out of the six
had elapsed before I could eliminate such sources. Having finally figuratively
chained myself to the computer, temptation still caught up with me in the
form of graphic-design software. So little time, so many Photoshop commands
to try! Fortunately, the mere thought of having to announce to my parents
that my graduation was being postponed was frightening enough to keep me
on track at all costs.
Six years in a PhD program have not taught me time-management skills. At midnight the night before my thesis defense, I was still rehearsing for my presentation. The thesis defense in the Division of Medical Sciences is preceded by a seminar open to the public in which the graduating student presents her thesis work. Part of the ritual is to be introduced to the audience by one's adviser. Each professor in the department has developed a personal trademark style for these introductions. For my luck, my own adviser likes to include incriminating photographs, secretly collected over the years, in the biographical sketch she gives of her students. Even with advance warning from charitable lab colleagues, I couldn't help but shrink in my seat when a most embarrassing giant image of me making a "fish face" filled the screen. Try impressing examiners with your scientific achievements after that!
Perhaps the single most significant event in the journey to graduation, the thesis defense, takes place behind closed doors in the presence of four examiners and one's thesis adviser. The process begins like an examination, but progressively gives way to acknowledgement of the candidate's mastery over a tiny but significant area of knowledge. The last question of my defense was addressed by one of the examiners to both my adviser and myself, as if to confirm that my opinion was now independent enough to complement hers.
However definitive the thesis defense is considered to be, it was not until I found myself on the stage of Sanders Theatre, one hand firmly gripping my diploma, the other shaking Dean Jeremy Knowles's hand, that I finally let myself think, I did it! At the risk of damaging my scientific credibility, I'll admit that until then, I had been afraid to jinx myself. Luckily, in the end, even the mistake that left me wearing the wrong color and style of cap and gown did not prevent me or my family from fully enjoying the festivities of Commencement Day.
Two weeks after commencement, the fact of having graduated is still an abstract notion for me. There was a time when obtaining a PhD, the highest academic degree available, was an achievement in and of itself, but not anymore. So the Star Trek fan that I am fantasizes that my diploma is rather like an injunction "to boldly go where no one has gone before."
--Diala Ezzeddine
Diala Ezzeddine received her PhD in the Biological and Biomedical Sciences program.
Focus
A Publication of HMS Office of Public Affairs
Editor
Robert Neal
Senior Science Writer
Misia Landau
Science Writer
Gabrielle Strobel
Production Manager
Suzanne Clifford
Editorial Assistant
Tiffany Doyle
Photography
Graham Ramsay
Harvard Medical School
Office of Public Affairs
25 Shattuck Street, Room 001
Boston, MA 02115
Tel: 617/432-1589
Fax: 617/432-0089
E-mail: Focus@hms.harvard.edu