Herbert Benson with the Dalai Lama in 1991. Twelve years earlier, the Dalai Lama arranged for Benson to study the medditation powers of the Tibetan monks.
For centuries, Western physicians followed this approach, replacing negative thoughts and emotions-such as worry, doubt and fear-with a nourishing elixir of hope, faith and confidence. But the umbilical link between mind and body began to weaken with the advent of modern science.
In 1864, Louis Pasteur discovered that microscopic organisms-bacteria-caused a host of diseases. Then, in 1928, Alexander Fleming fortuitously discovered bread mold that killed bacteria. Within a short time, he had isolated penicillin.
"It was a miracle. Penicillin revolutionized medicine," says Herbert Benson, Harvard Medical School associate professor of medicine. "It didn't matter whether you were treated by a warm, sympathetic, charming practitioner. Belief had nothing to do with healing."
During the past 30 years, Benson has conducted research that has countered the prevailing scientific wisdom treating disease as a bodily affair alone. His studies of how mental processes affect physical well-being are providing scientific documentation of the healing powers of the mind.
In a new book to be published in April, "Timeless Healing: The Power and Biology of Belief," Benson argues that the "faith factor" is so powerful-and so pervasive in the healing practices of culture after culture-that it may be a part of our biological makeup.
"We seem to be hard-wired to believe in something 'beyond' as a species because it has survival value," says Benson, a cardiologist who was director of the division of behavioral medicine at Beth Israel Hospital for nine years, and now heads the Mind/Body Medical Institute at Deaconess Hospital.
Benson's three-decade quest to understand mind-body links may be taking him to the boundaries of theology and medicine, but it began squarely within the scientific tradition. As a cardiology fellow in the mid-1960s, Benson was steeped in teachings that relegated the mind and body to separate realms.
"The term mind-body medicine was beyond the pale," he says. Indeed, so strict was the perceived division between body and mind that stress, which was seen as a mental phenomenon, was disregarded as a cause of physical illness.
In the late 1960s, as a consequence of a curious clinical phenomenon, Benson began to question the separation. Patients would come to their physicians with high blood pressure and be put on anti-hypertensive drugs. But after awhile, they would start complaining of side effects associated with low blood pressure-suggesting their medication was too strong. It appeared that the patients' blood pressures had been raised to abnormally high levels during their exams, perhaps due to the stress of the visit.
"We now call it white-coat hypertension, but it wasn't known at the time," Benson says.
Fascinated by this effect, Benson began a series of animal experiments in the lab of A. Clifford Barger, Robert Henry Pfeiffer professor of physiology, emeritus. He trained squirrel monkeys to control their own blood pressure through feedback techniques. The monkeys that were "rewarded" for increases in blood pressure went on to develop severe hypertension with kidney changes-in other words, the monkeys suffered from cardiovascular disease brought on by their own behaviors.
But the meditators persisted in their desire to be studied. Benson began taking measurements on the meditators in the evening in his lab. He found that meditation led to decreases in heart rate, oxygen consumption, rate of breathing and blood flow.
In essence, meditation appeared to elicit the opposite of the well-known fight-or-flight response. In this response-which is triggered by a real or perceived danger-the sympathetic nervous system releases hormones that increase heart rate, oxygen consumption, and flow of blood to muscles.
As Benson continued his research, he found that this "relaxation response" was the consequence of two crucial steps practiced in meditation: repeating a sound, word, phrase or muscular activity and simply returning to the repetition when other thoughts intruded.
Sensing that the two steps were unleashing a basic physiological response, one that protected the body from too much stress, Benson began delving into the history of cultural and religious practices. He found that all cultures and religions-from Judaism and Christianity to Shintoism, Buddhism and Islam-incorporated the two steps into their practices.
Herbert Benson with the Dalai Lama in 1991. Twelve years earlier, the Dalai Lama arranged for Benson to study the medditation powers of the Tibetan monks.
"They built in ways to evoke the relaxation response.
Prayers, morning vespers, evening vespers, just staring at
the horizon," says Benson.
He then began instructing non-meditators in the two steps and found the same dramatic physiological response. "This then was a mind-body effect that met the properties of science. There were predictable, reproducible, measurable changes that occurred in the body when you thought a certain way-a mind-body effect," says Benson.
Still, Benson knew that the results were pushing the envelope of accepted medical beliefs. "Back in '68-'69 when I saw the data with transcendental meditation, I really became concerned. Because I knew what kind of struggle would be involved to continue working on this. This was so far beyond what was acceptable science at the time. But I couldn't walk away."
In fact, when Benson was offered a grant by a private foundation and was told by the HMS administration that he couldn't take it because it was unacceptable for an HMS scientist to be doing research on meditation, he almost left. The matter came to the attention of the late Robert H. Ebert, who was HMS dean at the time. "He said, 'If Harvard can't take an occasional chance on something new, who can? Let Benson take the money,'" says Benson.
With the support of the foundation and HMS, Benson embarked on a series of experiments to determine if the relaxation response could be used to treat hypertension and other conditions (an enterprise that continues to this day). Benson and his colleagues have shown that a mind-body approach-one that couples the relaxation response with nutrition, exercise and cognitive therapies-is a useful tool for helping to treat such conditions as chronic pain, infertility, premenstrual syndrome, and insomnia. They also have found that it can alleviate symptoms associated with cancer and AIDS.
But as this supporting data came in, so did doubts from other scientists. To answer the critics, Benson and his colleagues began looking for specific long-term physiological actions triggered by the relaxation response.
They found that subjects who regularly elicited the relaxation response had decreased sensitivity to plasma norepinephrine, one of the main hormones released by the sympathetic nervous system to trigger the fight-or-flight response. In addition, they found that the relaxation response brought about changes in the sympathetic nervous system regardless of whether a subject believed in its efficacy.
"It'll work whether you believe it or not. Just carry out the steps. Like penicillin," Benson says.
Benson had earlier witnessed the dramatic effects of coupling the relaxation response with spiritual beliefs while studying Tibetan monks who practice an advanced form of meditation called gTum-mo Yoga. During this meditation, monks are able to raise their skin temperatures 17 degrees while maintaining normal core body temperature.
"What they did was to go into the relaxation response and then visualize heat going up and down the center of the body. So they took the basic quiet state and added visualization to create heat," Benson says.
"The relaxation response is not a technique. It's a physiological state brought about by many techniques." -- Herbert Benson
"You are wired in your brain to know what it is to experience feeling well. You can reconstitute that image," says Benson, who has labeled this process "remembered wellness."
After years of struggling against prevailing scientific wisdom, Benson's research is finally being embraced by many in the medical establishment. In the fall, a National Institutes of Health Technology Assessment conference encouraged the acceptance of behavioral and relaxation therapies for treating chronic pain and insomnia.
In his most recent research, Benson has continued to explore the connection between the relaxation response, spiritual beliefs and health. He and his colleagues at the Deaconess Mind/Body Medical Institute have found that people who report feeling "spiritual" also report fewer medical problems.
Benson speculates that humans may be genetically predisposed to believe in something beyond because it provides a survival benefit.
"We are the most intelligent species that has evolved in terms of what our brain can do. And all the power that comes from that has brought us a knowledge that no other species has-that is, of our own death. That knowledge can be so fundamentally disturbing and depressing that it is counter to survival. A way around that is to believe," Benson says.
If history is any guide, a belief in something beyond has been an essential component of human experience, long before the ancient Greeks. He believes that this yearning for "God" is a reflection of a basic biological need. "Seemingly embedded within each of us is a hard-wiring to believe in something beyond. Therefore, one can argue we're wired for God."
Adds Benson: "It doesn't matter from a health point of view whether God exists or not. It's still win-win, because there are clear health benefits to believing. And if God does exist, all the better."
--Misia Landau
The planned merger was hailed by Harvard Medical School Dean Daniel Tosteson. "I am very pleased that the careful discussions that have been ongoing for many weeks have arrived at a decision that will dramatically strengthen the ability of the Harvard Faculty of Medicine to fulfill its triple mission of research, education, and patient care at a time when the health care market is threatening academic medical centers nationwide."
A merger would create a second major health care network in Boston, with each network anchored by affiliates of Harvard Medical School. In 1993, Partners HealthCare was formed when Massachusetts General Hospital and Brigham and Women's Hospital merged. Partners HealthCare, which includes McLean Hospital and Spaulding Rehabilitation Hospital, has annual revenues of $1.8 billion.
The merger of Beth Israel HealthCare and Pathway Health Network would produce a health network of more than 1,200 physicians, 7,660 employees and nearly $1 billion in annual revenue. Leaders of the two organizations said that consolidation of clinical departments, administrative functions, and governance would create "economies of intellectual and fiscal scale," while enhancing the quality of health care provided to patients.
Beth Israel Hospital, established in 1916, is the cornerstone of Beth Israel HealthCare, a regional health care system. The Beth Israel system is known, in particular, for its strong obstetrics and primary care services, and has emphasized a philosophy of "promoting lifelong well-being."
Pathway Health Network, which was established in 1994, is an integrated system of community-based physicians, hospitals and health centers serving communities in eastern Massachusetts. The hospitals in the network include Deaconess Hospital, New England Baptist Hospital in Boston, Deaconess-Glover Hospital in Needham, Deaconess-Nashoba Hospital in Ayer, and Deaconess-Waltham Hospital in Waltham.
"The mission of Pathway Health Network has always been to serve patients, communities, students and science. By bringing together academic and community-based colleagues and focusing on efficacy, quality and the cost of care, we can also add value to the health system. Collaboration will allow us best to fulfill our mission and to compete effectively in today's rapidly changing market," said J. Richard Gaintner, president of Pathway Health Network.
The leaders of the two organizations said they envision a merger leading to a "new concept of provision of care," one that would extend from neighborhood practices to the academic medical center. The network would be able to provide health care services ranging from primary care to hospital care for life-threatening injuries and illnesses.
A merger will "provide patients, their physicians, and their health plans with sophisticated medical care, a geographically diverse network of primary care providers, and the exceptional qualities of service and care for which Beth Israel and Deaconess are justifiably renowned," said John Hamill, Pathway's chairman of the board.
This is the second time that Deaconess Hospital has entered into merger discussions with another major hospital. Last year, it considered merging with New England Medical Center, a merger that would have joined an HMS teaching hospital with a Tufts Medical School teaching hospital. The two institutions subsequently decided not to join.
Beth Israel and Pathway Health Network expect to take several months to further discuss and negotiate the details of a merger. The proposed new group, yet to be formally named, "will build upon the strengths of both systems and will constitute a significant restructuring producing a vital new force in health care in Massachusetts," said Stephen Kay, chairman of Beth Israel's board of trustees.
The World Wide Web is often thought of as a vehicle for
linking people in disparate places. Web pages devoted to
resource materials are made available to web surfers from
around the world.
However, Orah Platt, Harvard Medical School associate professor of pediatrics at Children's Hospital, has found a way to use it for more localized purposes. She is using it as a teaching tool; her pathophysiology web page is designed to present material to her HMS students in an interactive way, and at any time of the day or night.
Platt heads up the four-week hematology module in the human systems course for second-year students. The web page she has created features computerized images of blood samples, along with case studies. Her students can call up the web page on their computers, and are then challenged to make diagnoses based on the clinical information provided in the case studies.
"The cases enable students to test themselves," Platt said. "The curriculum in human systems is very unstructured. Knowing whether they truly understand the material gives students self-confidence and a greater sense of satisfaction."
For her part, Platt can use the web page to determine how well the students are learning the course material. The students' answers to the case-study questions are anonymously e-mailed to her; the computer program also sends her a breakdown of overall class performance.
In addition, the web page lists the e-mail addresses of Platt and other faculty for the hematology module. Students are encouraged to raise questions that they might hesitate to voice in a room filled with their peers.
"Only some students feel comfortable asking questions during lecture. Those who do not can e-mail the professor in the privacy of their own rooms," Platt said.
Her students this year have been enthusiastic about the use of the web page, she said. However, initially many students were hesitant about the idea. "I was surprised to learn how many of my students were computer phobic," she said.
"I tried to emphasize to them that computer literacy is an essential tool for future physicians, especially for those who will practice in a hospital setting. In addition, most medical boards are computerized. We need to train students to feel comfortable around computers."
In the future, Platt would like to expand her use of the web to develop "the equivalent of a chat group, an on- line study group in which students could share information and ideas over the Internet."
She also believes that her web page will help her students appreciate the power of the Internet as a teaching and communications tool.
"The amazing thing about the web is that it provides you with immediate access to information, no matter where you are in the world," she said.
--Ann Kennon
"The association of Harvard Medical International with the Asan Medical Center is a tangible realization of Harvard Medical School's goal of sharing knowledge and experience on an international level," said Daniel Tosteson, dean of Harvard Medical School.
Harvard Medical International was formed by Harvard Medical School in 1993 to export the school's expertise and services to health care facilities and medical schools in other nations. Under the agreement with Asan Medical Center (AMC), HMS consultants will help design and implement professional development programs for the AMC staff, and help develop curricula for medical education at AMC. Collaborative research programs will be devised and undertaken by HMS and AMC postdoctoral staff.
AMC was founded in 1989 under the auspices of the Asan Foundation for Social Welfare. The medical center is the leading teaching hospital of the University of Ulsan College of Medicine, which was funded by the Hyundai Group.
"Through the agreement with Harvard Medical International, we hope to enhance medical education and research, and consolidate our position as the premier provider of high-quality patient services in Korea," said Pyung Chul Min, director of the center.
The statistics, no matter how often told, are damning,
stunning. In the Third World, an estimated 800 million
people are undernourished; nearly twice that number lack
access to medical care. An estimated 190 million children in
the Third World suffer from poor health because of chronic
undernourishment. And in Russia and many other former Soviet-
bloc countries, the political upheaval has led to a
dramatic increase in mortality and morbidity rates.
"Why?" asked Jim Yung Kim, instructor of social medicine at Harvard Medical School and director of Partners in Health, speaking at a Feb. 15 talk sponsored by the Health and Human Rights Group at Harvard School of Public Health. "How could it be that now, decades into a veritable scientific revolution, hundreds of millions of people are wasting from hunger and dying from preventable diseases?"
During his presentation, Kim read from a report on "The New World Order and the Health of the Poor" published in November by the Institute for Health and Social Justice, the research arm of Partners in Health. The 36-page report explores how international politics and banking policies have contributed to a growing inequality between the rich and the poor of the world, and details how this allocation of wealth is leading to a striking rise in the number of people living in extreme poverty.
Kim and the other authors of the report write:
"The numbers represent people who are struggling to survive against extraordinary odds. The numbers represent a Filipino woman, forced to temporarily abandon her two young children so she can find work in the city to pay for food; a Peruvian boy who is forced to leave school to help supplement the meager family income; a new mother in Senegal who walks for six hours, house to house, begging for the equivalent of 10 cents so her feverish baby may be seen by a nurse; a middle-aged man who struggles through a winter's day in a urban center of the United States searching in vain for access to drug treatment; and a small group of young Mexican girls who spend every day in the colossal garbage dumps of their urban squatter settlement looking for anything edible or saleable."
Partners in Health was founded by Kim and Paul Farmer in 1987. The organization supports community-based programs in the United States and in Haiti, Peru and Mexico that provide health care for poor people and "attack the root causes of poverty and poor health." Their goal is "to make a preferential option for the poor," said Kim.
Farmer was awarded a five-year, $220,000 MacArthur Award in 1993, which he turned over to Partners in Health to establish the Institute for Health and Social Justice. The research group has 15 members "with diverse training in history, political science, and public health policy," Kim said. "This interdisciplinary discourse creates a healthy and fresh dialogue that is important to our central mission of helping others."
The institute focuses on researching the relationship between poverty and health. It expects to publish a more exhaustive study of this relationship, with case studies from 10 countries, in the fall of 1996.
--Ann Kennon
Also at the meeting:
Garbage is not so easy to trash at Harvard Medical School.
In an effort to improve recycling at the academic buildings
and Vanderbilt Hall, administrators and students have forged
an innovative plan to expand recycling availability.
The new plan will affect primarily Vanderbilt Hall. Presently, recycling bins are located only in the courtyard and are emptied monthly. Students are responsible for bringing all recyclables to the central location. While the final details of the new plan will be announced on Feb. 29, recycling bins will definitely be available in all kitchens and on all floors of Vanderbilt Hall, said Jane Garfield, director of campus services.
Under the new plan, recycling will include commingled glass, bottles, jars, plastics, cans and metal in addition to bins for mixed paper. Housekeeping staff will be responsible for transporting the recyclables to a central location for removal.
The new plan follows a Harvard Medical School student initiative through the group EARTH (Environmental Awareness and Recycling To improve Harvard), which was formed several years ago. Second-year students Toshi Uchida and Thao Truong and first-year Matt Reeves are now leading the group's efforts to improve recycling at HMS. Particularly concerned about improving recycling at Vanderbilt Hall, Uchida, Truong and Reeves circulated a petition among HMS students, which they then sent to school administrators. Their two goals were to make recycling available on every floor of Vanderbilt Hall and to expand current recycling capacity to include glossy paper, glass, and plastic. Currently, students can recycle newspaper, white paper, mixed paper, and corrugated cardboard.
Curiously, building regulations have posed the greatest obstacle to providing recycling opportunities at Vanderbilt Hall, said Jim Horn, manager of the campus services' machine shop and manager of recycling at HMS. Because Vanderbilt Hall is part of Harvard University, it is designated by the city as an institution rather than a residence. Furthermore, since the university is tax exempt, it is not eligible to participate in municipal recycling programs, which are supported by tax dollars.
"We have been working for two years and finally we are getting something done. This plan includes all the recycling we need for Vandy." --Toshi Uchida
The housekeeping staff will also need to make arrangements to allow for extra bins that must be transferred each time trash is collected. "It may take up to twice as long to pick up and empty two containers as it does to empty one. It doesn't sound like a big difference, but when you multiply it by the number of sites, there are a significant number [of trash sites] that will require double handling," said Paul Blanchette, manager of custodial services. He cited a number of factors that would influence the time involved: the number of containers, the location, the method and the frequency of collection.
Indeed, the demands placed on housekeeping staff are a key factor in the scope of recycling that can be adopted, said Blanchette. The administration must balance the labor cost associated with increasing the number of trash receptacles with the desire to make recycling more accessible to students and staff.
The design of Vanderbilt Hall also poses challenges to recycling. Because of limited space in kitchens and garbage closets, there is not much room to accommodate additional bins, Horn said.
Uchida, Truong and Reeves are very excited about the new initiative. "We are so excited because we have been working for two years, and finally we are getting something done. This plan includes all the recycling we need for Vandy. I can't think of anything else we could need," Uchida said.
The new challenge for EARTH will be to improve student awareness of the new recycling opportunities. "That will take a lot more work than we have done to this point," Uchida said.
The new plan for Vanderbilt Hall builds on changes that have been made at academic buildings over the past year. Blue receptacles for white office paper have been available in central locations in each of the Quadrangle buildings. Recently, green bins for mixed papers have been added. Aluminum soda cans are collected by housekeeping staff, who return them for the deposit. In addition, HMS has the oldest program for recycling laboratory plastics of any New England institution, Horn said.
In conjunction with the Harvard School of Public Health, HMS has purchased a cardboard baler. Because of the volume of shipments the two institutions receive daily, they generate a lot of cardboard box waste. These empty boxes used to take up an enormous amount of space in the trash bins, but now the baler compresses all boxes into 1,700- pound bundles, which can then be recycled.
Encouraged by recent changes in the recycling policies at HMS, the students hope to continue to improve availability and accessibility. "Recycling should be as easy as throwing out your trash," Uchida said.
--Ellen Rothman
Countway Workshops
Wed., Mar. 6, 1 pm
Internet Intro
Thurs., Mar. 7, 10 am
Gopher
Mon., Mar. 11, Noon
Hollis/Hollis Plus
Tues., Mar. 12, 5:30 pm
Grateful Med
Wed., Mar. 13, Noon
Countway Plus
Thurs., Mar. 14, 10 am
World Wide Web
Mon., Mar. 18, 10 am
Internet Intro
Tues., Mar. 19, 2 pm
Countway Plus
For location and to register, call 617/432-2134.
BBRI-Boston Biomedical Rsrch. Inst.
BIH-Beth Israel Hosp.
BWH-Brigham & Women's Hosp.
B/WRVA-Brockton/W. Roxbury Veterans Administration
CBR-Center for Blood Research
CH-Cambridge Hosp.
CHMC-Children's Hosp.
DFCI-Dana Farber Cancer Inst.
DH-Deaconess Hosp.
FDC-Forsyth Dental Ctr.
HMS-Harvard Medical School
HSPH-Harvard School of Public Health
JBCC-Judge Baker Children's Ctr.
JDC-Joslin Diabetes Ctr.
MAH-Mt. Auburn Hosp.
MEEI-Mass. Eye & Ear Infirmary
MGH-Mass. General Hosp.
MH-McLean Hosp.
MMHC-Mass. Mental Health Ctr.
SERI-Schepens Eye Research Inst.
SRH-Spaulding Rehab. Hosp.
WEDNESDAY, MARCH 6
Paul Murray, Cleveland Clinic Fdn.
Anesthesia Grand Rounds:
Mechanisms of Pulmonary Vascular Regulation
7 am, Sherman Aud., BIH
David Soybel, BWH
OB/GYN Grand Rounds:
Benign Ano-Rectal Disorders
7:30-8:30 am, Duncan Reid Conf. Rm., BWH
Ivo Janecka, Longwood Skull Base Program
Longwood Head & Neck Cancer Ctr. Lecture:
Controversies in Skull Base Surgery
8-9 am, MEC 448, HMS
Deborah Cotton, MGH
Infectious Disease Unit Conference:
Clinical Investigations II
8-9 am, Bigelow 8 Conf. Rm., MGH
Selwyn Oskowitz, BIH
OB/GYN Grand Rounds:
The Lessons Learned From the Advent of IVF
8-9 am, Riesman Aud., BIH
Danny Jacobs, BWH
Surgical Grand Rounds:
Management of Patients With Short Bowel Syndrome
8:15 am, Joslin Aud., DH
Kenneth Minaker, MGH
Psychiatry Grand Rounds:
Medical Causes of Delirium
11 am-Noon, Blake 1 Aud., MGH
Linda Winston, Salk Inst.
Molecular Biology and Virology Seminar:
The Role of the JAK2 Protein-Tyrosine Kinase in Growth
Hormone Signaling
Noon, 2nd Fl. Conf. Rm., BBRI
Kenneth McIntosh, CHMC
Medical Grand Rounds:
AIDS in Children-A Thinking Person's Guide to Prevention and
Therapy
Noon, Enders Aud., CHMC
Iswar Hariharan, MGH
Pathology Seminar:
Regulation of Cell Proliferation and Differentiation in the
Developing Drosophila Eye
12:15 pm, Goldenson 122, HMS
Michael Simon, Stanford Univ.
Molecular Biology Seminar:
The Role of the Tyrosine Phosphatase Corkscrew and Its
Target During Drosophila R7 Photoreceptor Development
12:30 pm, Wellman 11 Conf. Rm., MGH
Richard Lewontin, HMS
Psychiatry Grand Rounds:
The Genetics of Disease and the Disease of Genetics
12:30-2 pm, Macht Aud., CH
Ronald Germain, NIH
Committee on Immunology Seminar: Generation and T Cell
Activation Properties of Peptide-MHC Class II Ligands
5 pm, Jimmy Fund Aud.,
DFCI
Membrane Biology Club
Roundtable Discussion
Caveoli-Multiple Views of an Emerging System
Dick Anderson, Univ. of Texas
Monty Krieger, MIT
Mike Lisanti, MIT
Jan Schnitzer, BIH
Wed., Mar. 6, 5:30 pm
Bldg. D Amp., HMS
For dinner/parking info.,
call 432-3267
THURSDAY, MARCH 7
Elizabeth Frost, NY Med. College
Anesthesia Lecture:
Effects of Anesthetic Agents on Intracranial Dynamics
8 am, Clinics 3, Upper Amp., MGH
Mike Makrigiorgos, HMS
Joint Program Nuclear Medicine Lecture: Molecular Dosimetry
of Chromatin-Associated Hydroxy Radicals
8 am, Bleibtrieu Rm., DFCI
J. Thomas LaMont, BIH
Medical Grand Rounds:
Pathogenesis, Diagnosis and Treatment of Clostridium
difficile Infection
8 am, Sherman Aud., BIH
Jerry Trier, BWH
Medical Grand Rounds:
Celiac Sprue-Current Status
8-9 am, Blake Bldg., Aud., MGH
Charles Hatem, MAH
Medical Grand Rounds:
Morbidity & Mortality/Dept. of Medicine Mtg.
8:15 am, Hurwitz Aud., MAH
James Levitt, BVA
Mental Health & Behavioral Sciences Case Conference:
A Case Presentation and Discussion of Schizoaffective
Schizophrenia
10:30 am-Noon, Bldg. 22, Rm. 1, BVA
David Burke, Jill Kaplan, Walter Panis & Joel Stein, SRH
New Beginnings in Rehabilitation Seminar:
Recovery After Stroke-An Exploration of Current Trends in
Treatment
11:30 am-4 pm, Conf. Rms. 8A&B, SRH
Ken Prostak, FDC
Dental Medicine Seminar:
Flouride Regulation by the Enamel Organ
Noon, Haigh Aud., FDC
Lisa Nachtigall, MGH
Reproductive Endocrinology Clinical Conference:
Delayed Puberty
Noon-1 pm, Bartlett Hall Ext., 5th Fl. Conf. Rm., MGH
Eric Hollander, Mt. Sinai Med. Ctr.
Psychopharmacology Grand Rounds:
OCD Spectrum Disorders
Noon-1 pm, deMarneffe 132, MH
Alvin Poussaint, JBCC
AMMP Discussion:
Perceptions & Reality
Noon-1:30 pm, White 4, Bigelow Amp., MGH
Mary Morrissey, HSPH
Statistical Methods in Epidemiology Working Seminar:
Comparing Standard Methods of Correcting Misclassified Data
to Calculate Odds Ratios
1:30-3 pm, Kresge 606, HSPH
Joseph Parrillo, Rush-Presbyterian-St. Luke's Med. Ctr.
Cardiovascular Grand Rounds:
Reversible Causes of Myocardial Dysfunction
3-4 pm, Duncan Reid Conf. Rm., BWH
Nora Sarvetnick, Scripps Research Inst.
Diabetes/Metabolism Research Seminar: Cytokines, IDDM and
Autoimmunity
4 pm, Level III Lecture Hall, JDC
Michael Popitz, BIH
Anesthesia Lecture:
Airway Management for Patients With Cervical Spine Disease
4 pm, Riesman Lecture Hall, BIH
Gary Johnson, Nat'l. Jewish Ctr. for Immunology &
Respiratory Med., Denver
Signal Transduction Seminar:
MEK Kinases and Their Regulation of Signal Transduction
Pathways
4:30 pm, Goldenson 122, HMS
Bjorn Olsen, HMS
Vascular Research Seminar:
Cell and Matrix Signaling in Vascular Development
4:30 pm, Enders Aud., CHMC
Daniel Little, Colgate Univ.
Center for Population Studies Seminar:
Development Ethics-Justice, Well-Being and Poverty in the
Developing World
4:30-6 pm, 9 Bow St., Cambridge
Linda Graham, Univ. Hosp. of Cleveland
George H. A. Clowes Visiting Lecture in Surgical Research:
Cell Function on Prosthetic Vascular Grafts
5:30 pm, Joslin Aud., DH
Law & Medicine Society/Castle Society Symposium
The Future of Medical Malpractice
Nancy Dickey, AMA
Pamela Liapakis, American Trial Lawyers Ass'n.
Troyen Brennan, HSPH
Randall Bovbjerg, The Urban Inst.
Thurs. Mar. 7, 6:00 pm
MEC Amp., HMS
FRIDAY,MARCH 8
In Sup Choi & Christopher Ogilvy, MGH
Cerebrovascular Conference:
Case Presentations
7-9 am, Gray 2 Reading Rm., MGH
Steven Reppert, MGH
Endocrine Grand Rounds:
Melatonin Madness
9-10 am, Riesman Lecture Hall, BIH
Scott Tucker, Esq.
Spaulding Grand Rounds:
Legal Issues in Rehabilitative Medicine
11 am, Conf. Rms. 8A&B,
SRH
David Jimerson, BIH
Psychopharmacology Lecture:
Update-Eating Disorders
11 am, Chapel, MMHC
Andrew Nierenberg,
MGH
Academic Conference: A Matter of Time and
Antidepressants-Short and Long-term Issues
11 am-Noon, Pierce Hall,
MH
Martin Hirsch, MGH
Medical Grand Rounds:
New Developments in HIV Therapy
Noon, Bornstein Amp., BWH
SATURDAY, MARCH 9
Martin Samuels, BWH
Surgical Grand Rounds:
Voodoo Death-The Modern Lessons of Neurocardiology
9 am, Bornstein Amp., BWH
Donald Glotzer, BIH
Surgical Grand Rounds:
Surgical Treatment of Crohn's Disease
9-10 am, Riesman Lecture Hall, BIH
MONDAY, MARCH 11
Ed Ryan, MGH
Infectious Disease Unit Conference:
Old & New World Trypanosomiasis
8-9 am, Bigelow 8 Conf. Rm., MGH
Martin Reinke, MEEI
Retina Service: Fellows' Conference
8-9 am, Sloane Teaching Rm., 3rd Fl., MEEI
John Herman, MGH
Medical Grand Rounds:
Depression in Primary Care Practice
Noon, Main Bldg. Lecture Hall, CH
George Bliley III &
Robert DeLorenzo,
Med. College of Virginia
Human Neurobiology Seminar:
Molecular Mechanisms in Epileptogenesis
Noon, Goldenson 122,
HMS
Lloyd Axelrod, MGH
Arthritis Grand Rounds:
Glucocorticoid Therapy
Noon, Ether Dome, Bulfinch 4, MGH
Roger Brent, MGH
Cardiovascular Research Lecture:
Charting and Manipulating Genetic Regulatory Networks
12:15 pm, CRC, Rm. 4501, MGH-East
Clifford Saper, BIH
Pathology Grand Rounds:
Neuronal Mechanisms of Fever
12:30-1:30 pm, Riesman Lecture Hall, BIH
Nan Stein, Wellesley College
Family Violence Seminar:
Sexual Harassment and the Repression of Sexual Expression in
Girls in Schools
12:30-2 pm, Seminar Rm. 1, DFCI, 57 Binney St.
Paul Sigler,
HHMI, Yale Univ.
Cell Biology Seminar:
The Structure and Function of GroEL and its Complexes
4 pm, Bldg. C, Cannon Rm.,
HMS
JoAnn Manson, HMS;
Frank Sacks, HSPH;
Ernst Schaefer, Tufts Univ.; & Walter Willett, HSPH
Public Health Rounds:
How Much Fat Is Healthy? The Broadening Debate About Weight
Loss, Nutrition and Longevity
4-5:30 pm, Snyder Aud., HSPH
TUESDAY, MARCH 12
David Acker, BWH
OB/GYN Lecture:
Induction for Macrosomia
8-9 am, Parsons Bldg., OB/GYN Conf. Rm., MAH
Brad Stringer, HSPH
Work-in-Progress Seminar:
Lung Epithelial Cell Interaction With Environmental
Particulates-Role of Priming and Oxidant Stress
9:30 am, Bldg. I, Rm. 1301, HSPH
Rogelio Bayog, BVA
Conference on Addictions:
Case Conference on Polysubstance Abuse Issues
9:30-11 am, Bldg. 2, Ward 2-1-C Day Rm., BVA
Carol Gregorio, Scripps Research Inst.
Cell Biology Seminar:
Capping Actin Filament Growth-The Role of Tropomodulin in
Cardiac Myocytes
11 am, 2nd Fl. Conf. Rm., BBRI
Jerry Trier, BWH
GI Grand Rounds:
Intestinal Mucosal Diseases Sans Celiac Sprue
11 am, Jackson 7, MGH
Peeyush Mittal, BVA
Psychopharmacology Conference:
Case Presentations
11 am-12:30 pm, Bldg. 2, LRC, BVA
Sally Radovick, CHMC
Molecular Endocrinology Seminar:
Cell-Type Specific Regulation of GnRH Expression
Noon, Enders Bldg., Byers A Conf. Rm., CHMC
Michael Gimbrone, BWH
Blood Research Seminar:
Vascular Endothelium, Biomechanical Forces and Atherogenesis
Noon, Library, CBR, 800 Huntington Ave.
Dennis Norman, MGH
Psychiatry Grand Rounds:
Expanding the Role of Mental Health Professionals in
Medicine in the 1990s
Noon-1:15 pm, Carrie Hall Conf. Rm., BWH
Mriganka Sur, MIT
Neurobiology Seminar:
Dynamic Regulation of Activity in Visual Cortex
12:15 pm, Goldenson 122, HMS
Ronald Arenson, UCSF
Sosman Lecture:
Surviving Managed Care
12:30 pm, Bornstein Amp., BWH
Joseph Lutkenhaus, Univ. of Kansas Med. Ctr.
Microbiology & Molecular Genetics Seminar:
FtsZ Ring-The Prokaryotic Division Apparatus
12:30 pm, Bldg. D Amp., HMS
Jiri Mestecky, Univ. of Alabama
AIDS Institute Research Seminar:
Mucosal Immunity in the Female Genital Tract
12:30-1:30 pm, Kresge 502, HSPH
Stephen Soumerai, HMS
Quality of Care Research Seminar:
Using Linked Claims Databases to Measure Adverse Outcomes of
Underuse of Beta Blockers Following MI in the Elderly
Medicare Population
12:30-1:30 pm, Kresge G-2, HSPH
Robert Baughman, HMS
Neuroscience Basics of Psychopharmacology Lecture:
Cholenergic (Metabolism, Anatomy, Receptors)
1-2 pm, Bldg. 2 LRC, BVA
Junichiro Hayano, Nagoya City Univ. Med. School
Division on Aging Seminar:
Respiratory Sinus Arrhythmia and Cardiopulmonary
Interactions
3:30-4:30 pm, Trustman Board Rm., BIH
Ken Huttner, CHMC
Research Seminar:
Antimicrobial Peptides-New Lessons From Sheep
4 pm, Jackson 7, MGH
Manuel Navia, Vertex Pharmaceutical
Oncology Seminar:
Two Case Studies on the Practical Relevance of Structure-
Based Drug Design to Therapeutics-HIV Protease and
Calcineurin Inhibition
4 pm, Smith Family Rm., Dana 1820, HMS
John Wasson, Dartmouth Med. School
Division on Aging Seminar:
A Replicable and Customizable Approach to Improve Geriatric
Care and Research
4:30-5:30 pm, Trustman Board Rm., BIH
Michael Welsh, Univ. of Iowa College of Med.
Medicine Seminar:
Understanding the Biology of Cystic Fibrosis
4:30-5:30 pm, Grossman Conf. Rm., BIH
WEDNESDAY, MARCH 13
Francis Agbonkpolo, BWH
Anesthesia Grand Rounds:
Carcinoid Tumor
7 am, CWN L1 Anesthesia Lecture Hall, BWH
Donald Baim, BIH
Anesthesia Grand Rounds:
Current Status of Coronary Intervention
7 am, Sherman Aud., BIH
Susan Arnold, BWH
OB/GYN Grand Rounds:
Development of the Vasopressin/Oxytocin System
7:30-8:30 am, Duncan Reid Conf. Rm., BWH
Philip Kantoff, DH
Surgical Grand Rounds:
Update on the Dx and Treatment of Prostate Cancer
8 am, Joslin Aud., DH
Louis Guzzi, Walter Reed Army Inst. of Research
Anesthesia Grand Rounds:
Colloid vs. Crystalloid-The Debate in Trauma Resuscitation
8 am, CWN L1 Anesthesia Lecture Hall, BWH
Marina Rabin, BIH
OB/GYN Grand Rounds:
HPV Infection and Its Relationship to Cervical Neoplasia
8-9 am, Riesman Aud., BIH
Daniel Singer, MGH
Infectious Disease Unit Conference:
Management of Community-Acquired Pneumonia-A Health Services
Perspective
8-9 am, Bigelow 8 Conf. Rm., MGH
Academic Teaching Conference Series
American Child Poverty in Cross-National Perspective: Policy and its Price
Wed., Mar. 6, 9-10 am
Speaking Out for Our Children: Developing an Agenda for Action
Wed., Mar. 13, 9-10 am
4th Fl. Aud., JBCC
Jonathan Benjamin & Michael Shannon, CHMC
Pediatric Practice Seminar:
Environmental Toxins (A Lead-Free Potpourri)
10 am, Enders Aud., CHMC
Ronald Bachman, Policy Consultant, Washington DC
Psychiatry Grand Rounds:
Political and Actuarial Influences in Health Policy
11-Noon, Blake 1 Aud., MGH
Jon Stahlman, CHMC
Grand Rounds:
Cases From the Wards
Noon, Enders Aud., CHMC
Geoffrey Cooper, DFCI
Pathology Seminar:
The PI 3-Kinase Signaling Pathway and Cell Survival
12:15 pm, Goldenson 122, HMS
Steven Tanksley, Cornell Univ.
Molecular Biology Seminar:
Identification and Map-Based Cloning of Agronomically
Important QTCs in Tomato
12:30 pm, Wellman 11 Conf. Rm., MGH
Elizabeth Anne Wilson, Bunting Inst.
Bunting Institute Colloquium:
Not in This House-Repressed Trauma, the White Middle-Class
Family and Contemporary Cultural Criticism
4 pm, Bunting Inst., 34 Concord St., Cambridge
Dialogues on the Brain
Schizophrenia: Mechanism and Management
Francine Benes, MH
Donald Goff, MGH
Paralysis and the Spinal Cord
Robert Brown, MGH
Alfred Sandrock, MGH
Wed., Mar. 13, 4 pm
MEC Amp., HMS
Reservations: 432-2397
Michael McClung, Oregon Health Sciences Univ.
Endocrine Grand Rounds:
New Therapies for Osteoporosis
4:15-5:30 pm, Enders Aud., CHMC
THURSDAY, MARCH 14
Lee Grodzins, MIT
Joint Program of Nuclear Medicine Lecture:
Noncommercial Analytic Tools at Micron-Level Resolution
8 am, Bleibtrieu A204,
DFCI
Marlene Rabinovitch, Hosp. for Sick Children, Toronto
Anesthesia Lecture:
EVE (Endogenous Vascular Elastase) and Beyond EVE in the
Progression and Regression of Pulmonary Hypertension
8 am, Clinics 3, Upper Amp., MGH
Melvin Burton & Homayoun Kazemi, MGH
Medical Grand Rounds:
Waiting to Exhale-How Long Can You Wait? Neurochemical Basis of Breathing
8-9 am, Blake Bldg. 1st Fl. Aud., MGH
Stephen Boswell, MGH
Medical Grand Rounds:
Update on Adult HIV Infection
8:15 am, Hurwitz Aud., MAH
Brian O'Donnell, BVA
Mental Health & Behavioral Sciences Case Conference:
Event-Related Potentials in Psychiatric Disorders
10:30-Noon, Bldg. 22, Rm. 1, BVA
Paul Boepple, MGH
Reproductive Endocrinology Clinical Conference:
Precocious Puberty
Noon-1 pm, Bartlett Hall Ext., 5th Fl. Conf. Rm., MGH
David Burke, SRH
New Beginnings in Rehab. Seminar:
Geriatric Sports Medicine-Fighting the Costs of Aging
Noon-1:30 pm, Conf. Rms. 8A&B, SRH
Consolidated Dept. of Psychiatry
Research Day: Poster Session
2-4 pm, Kennedy Bldg., G2, A&B, DH
Warren Manning, BIH
Cardiovascular Grand Rounds:
Magnetic Resonance Coronary Angiography
3-4 pm, Duncan Reid Conf. Rm., BWH
Charles Gilbert, Rockefeller Univ.
Neurobiology Seminar:
Spatial Integration and Cortical Dynamics
4 pm, Goldenson 122, HMS
Lynne Uhl, BIH
Anesthesia Lecture:
Transfusion Reactions
4 pm, Riesman Lecture Hall, BIH
Axel Ullrich, Max Planck Institute fur Biochemie, Germany
Ray A. & Robert L. Kroc Lecture:
Generation and Definition of Phosphotyrosine Mediated Signals
4 pm, Level III Lecture Hall, JDC
Ira Herman, Tufts Univ. School of Med.
Vascular Research Seminar:
Understanding the Molecular Mechanisms Mediating Endothelial
Motility Following Injury
4:30 pm, Enders Aud., CHMC
Judith Rapoport, NIMH
Mysell Lecture/Consolidated Dept. of Psychiatry:
Childhood Onset Schizophrenia-New Research
5-6 pm, Walter Amp., MEC, HMS
Michael Joseph & Norbert Liebsch, MGH
Skull Base Center Tumor Conferences:
Case Presentations
6-7 pm, Orr Conf. Rm., Cox 2, MGH
FRIDAY, MARCH 15
In Sup Choi & Christopher Ogilvy, MGH
Cerebrovascular Conference:
Case Presentations
7-9 am, Gray 2 Reading Rm., MGH
Richard Nesto, DH
Endocrine Grand Rounds:
The Impact of Diabetes Mellitus on Pathophysiology Diagnosis
and Management of Acute Coronary Syndromes
9-10 am, Riesman Lecture Hall, BIH
John Ratey, MMHC
Psychopharmacology Lecture:
Update-Adult Attention Deficit Disorder
11 am, Chapel, MMHC
Michael Holick, BU School of Med.
Spaulding Grand Rounds:
Vitamin D-Sunlight, Diet and Bone Health
11 am, Conf. Rms. 8A&B, SRH
Richard Lee, BWH
Medical Grand Rounds: New Insights on Cardiogenic Stroke
Noon, Bornstein Amp., BWH
SATURDAY, MARCH 16
Deborah St. James,
Miles, Inc.
Surgical Grand Rounds:
Writing for Excellence
9-10 am, Riesman Lecture Hall, BIH
MONDAY, MARCH 18
Ed Ryan, MGH
Infectious Disease Conference:
Intestinal Protozoa
8-9 am, Bigelow 8 Conf. Rm., MGH
Evangelos Gragoudas, MEEI
Retina Service Conference:
Management of Choroidal Melanoma
8-9 am, Sloane Teaching Rm. 3rd Fl., MEEI
Linda Langford, HSPH
Family Violence Seminar:
Patterns of Domestic Homicide in Massachusetts
12:30-2 pm, Seminar Rm. 1, DFCI, 57 Binney St.
Emilio Emini, Merck Research Labs
BCMP Seminar:
Maintenance of Long-term Virus Suppression in Patients
Treated With the HIV-1 Protease Inhibitor Crixivan (Indivavir)
4 pm, Bldg. C, Cannon Rm., HMS
Barry Nurcombe, Vanderbilt Univ.
New Eng. Council Child & Adolescent Psychiatry Program:
Developmental Psychopathology and Diagnostic Formulation
7-9 pm, Pierce Hall, MH
TUESDAY, MARCH 19
Charles Kawada, MAH
OB/GYN Grand Rounds:
Strategic Planning in OB/GYN
8-9 am, South 2 Cafeteria, MAH
1995-1996 Directions Forum:
New England Regional Primate Center
Ronald Desrosiers, Head of the NERPC AIDS Unit
Center for Minimally Invasive Surgery
Arthur Lage,Co-Director of the Center
9-11 am, Bldg. A, Benjamin Waterhouse Faculty Rm., HMS
Peggy Flynn Taylor, HSPH
Work-in-Progress Seminar:
In Vitro Efficacy of Antisense Oligos Targeted Toward TNFa
9:30 am, Bldg. I, Rm. 1301, HSPH
Marsha Vanicelli, BVA
Conference on Addictions:
Group Treatment for Substance Abusers
9:30-11 am, Bldg. 2, Ward 2-1-C Day Rm., BVA
David Carr-Locke, BWH
GI Grand Rounds:
Endoscopic Therapy of Pancreatitis
11 am, Jackson 7, MGH
Peeyush Mittal, BVA
Psychopharmacology Conference:
Literature Presentation
11 am-12:30 pm, Bldg. 2, LRC, BVA
Michael Briskin,
LeukoSite, Inc.
Blood Research Seminar:
In Vitro and In Vivo Analysis of MAdCAM-1a4§7 Adhesive
Interactions-Roles in Normal Lymphocyte Circulation and
Inflammation
Noon, Latham Library, CBR, 200 Longwood Ave.
Mary McCarthy, BWH
Psychiatry Grand Rounds:
Interpersonal Psychotherapy of Depression
Noon-1:15 pm, Carrie Hall Conf. Rm., BWH
Kathleen Dunlap, Tufts Univ.
Neurobiology Seminar:
Calcium Channel Modulation
12:15 pm, Goldenson 122, HMS
Dale Kaiser, Stanford Med. Ctr.
Microbiology & Molecular Genetics Seminar: Extracellular C-
Factor and Its Signal Transduction in M. xanthus
12:30 pm, Bldg. D Amp.,
HMS
Mahvash Rafii,
NY Med. Ctr.
Radiology Grand Rounds:
MR of Shoulder Instability
12:30 pm, Bornstein Amp., BWH
Shaul Margaliot, Maccabi Health Care Fund
Quality of Care Research Seminar:
Utilization Review-Determining the Level of Appropriate Care
in an HMO Environment-the Kupat Halim Maccabi Experience
12:30-1:30 pm, Kresge G-2, HSPH
Gino Segre, MGH
GI Research Seminar:
Characterization and Localization of PTH-PTH Related Protein
4 pm, Jackson 7, MGH
Helen Blau,
Stanford Univ.
Distinguished Lecture:
Genetic Approaches to Human Neuromuscular Development and
Disease-Knockouts and Regulatable Retroviral Vectors
4-5 pm, Kresge G-2 Aud.,
HSPH
Susan Leeman,
BU School of Med.
Neuroscience Seminar:
The Neuropeptides-Substance P and Neurotensin
4 pm, deMarneffe 132, MH
Marc Kirschner, HMS
Oncology Seminar:
Cyclin Degradation and the Cell Cycle
4 pm, Smith Family Rm., Dana 1820, DFCI
