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/o\. XII



OCTOBER, 1964



No. 1



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mwW^m'ftW JfTAlTR APFAJF;^ t.IF.I^.ARY



THE BULLETIN



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School of Medidne
University of North Carolina



THE

MEDICAL SOCIETY OF THE STATE OF NORTH CAROLINA

ESTABLISHED THIS PLAN OF GROUP ACCIDENT AND

HEALTH PROTECTION FOR ITS MEMBERS IN 1940



NEW AND MORE EXTENSIVE
BENEFITS

We are proud to announce the most exten-
sive and far reaching benefits we have
ever offered your Society,




Plan
(A) NOW or

Seven

years

for

Sickness



Plan

(AA)

From inception

of sickness to

age 65



Lifetime on both Plan
for "A" & "AA"

Accident



We are as close as your phone . . . Call us Collect — Phone 682-5497 — Durham



PLAN A (Basic)
Lifetime Accident

and
7 years Sickness



SEMI-ANNUAL PREMIUMS



Weekly
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$250.00
$200.00
$150.00
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Dismemberment
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Up to $50,000.00
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Up to $30,000.00
Up to $20,000.00



Accidental

Death
$5,000.00
$5,000.00
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Premium

Over
Age 40
$244.50
$196.50
$148.50
$100.50



Reduced
Premium
To Age 40
$183.50
$147.50
$111.50
$ 75.50



PLAN AA (Long Term)

Lifetime Accident $250.00

$200.00

and $150.00

From Inception 5^°° °°
of Sickness to
Age 65



SEMI-ANNUAL PREMIUMS



Up to $50,000.00 $5,000.00 $292.00 $219.25

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Up to $30,000.00 $5,000.00 $177.00 $133.00

Up to $20,000.00 $5,000.00 $119.50 $ 89.75

The premiums for Plan AA will be reduced to the same premium as for

Plan A at age 58.



For Application or Further Information Write or Call

J. L. Crumpf-on, State Mgr.

Professional Group Disability Division

BOX 147, DURHAM, N. C.

J. Slade Crumpton, Field Representative

REPRESENTING COMMERCIAL INSURANCE COMPANY OF NEWARK. N. J.



-^^ "^







1407 East Franklin Street ■ Telephone 968-4472



Collier Cobb

& Associates, Inc.

Insurance and Surety Bonds / Chapel Hill, North Carolina



54808



GLEN LENNOX

Truly a Good Place to Live

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WENTWORTH & SLOAN

JEWELERS
Chapel Hill, North Carolina



V







A Pleasant Inn

Of A Great University

In A Good Town

A good place to stay, to dine, to entertain or just to visit and
enjoy the congenial homelike atmosphere. For your convenience
and pleasure we offer clean and comfortable guest rooms, appe-
tizing and wholesome food in our main dining room — The Hill
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for parties, banquets, meetings and dances.

You Are Invited To Hospitable ...

Carolina Inn

Owned and Operated by the University of North Carolina




This new model Elec-
trocardiograph is just
one of the many fine
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display in our show-
rooms.

We invite you to
pay us a visit and see
this equipment.



Burdick EK-111 Electrocardiograph



Carolina Surgical Supply Company



706 Tucker St.
RALEIGH. N. C.



Phone TE 3-8631











%1


Complete
Trust Services


Our Trust Officers will be glad to
work with you and your attorney
in planning the future security of
your family.






BANK&TRUST
COMPANY


TRUST DEPARTMENT

Frank D. Bozarth

Richard J. Potter

Norwood A, Thomas, Jr.

Milton E. Loomis









Please note these
dates:

Medical Alumni Day
April 2. 1965



Parents' Day
April 24, 1965

PLAN NOW TO
ATTEND



DONT BE
FOOLED!

Be sure your
Kodachrome film is
processed by
Eastman Kodak Co.

SEE US

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STORE

Chapel Hill, North Carolina



i^ Paying FOUR Per Cent Per Year
Dividends on Savings


i^ All Accounts Insured


^


Free Parking at Merchants Parking Lot
Across Columbia Street when
Transacting Business




HOME


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SAVINGS


In


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SMITH BUILDING 1
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COLUMBIA STREOT 1











Serving North Carolina
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CAPITAL FUNDS: Over $52,000,000

WORTH CAROLIIVA
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IVIEMBER:
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n S

liffet^




Directors:
J. S. Bennett
H. D. Bennett
D. D. Carroll
Miles M. Fitch



CHAPEL HILL, NORTH CAROLINA



Crowell Little

A Thrift Institution ^^^ o. Sparrow

R. H. Wettach

Ira A. Ward Paul \V. Wager



Current Dividends



LIFE INSURANCE ESTATE PLANNERS




W. H. Branch




Frank G. Umstead



Special Services
To the Medical Profession

Representing

JEFFERSON STANDARD LIFE INSURANCE COMPANY
OF GREENSBORO, NORTH CAROLINA

Local Offices: 136 E. Franklin St., Chapel Hill, Telephone 942-4263



OUR CHARLOTTE STORE HAS MOVED

After 40 years in the first block of East Seventh Street, we
have moved to 200 South Torrence Street at Corner of East
Third — just about two blocks from Charlottetown Mall and
one block off Independence Boulevard.

Our new building has 26,000 square feet of floor space and was
planned for more efficient service to our Customers.
We have plenty of parking area and cordially invite you to
visit us.

Our new telephone number in Charlotte is 372-2240.



Distributors of Known Brands of Proven Quality

WINCHESTER

"CAROLINAS' HOUSE OF SERVICE"



Winchester Surgical Supply Co.

2C0 S. Torrence St., Charlotte, N. C.



Winchester-Ritch Surgical Co.
421 W. Smith St., Greensboro, N. C.




Wilson & Owens Insurance Agency

Insurance & Bonds
Orange Savings & Loan Building



Adger Wilson, CPCU
E. J. Owens



Telephone 929-2566
P. O. Box 266



The Bulletin

OF THE SCHOOL OF MEDICINE
OF THE UNIVERSITY OF NORTH CAROLINA

Published in cooperation with the Whitehead Medical Society
and the Medical Foundation of North CaroHna, Inc.



/ol. XII October, 1964 No. 1

IN THIS ISSUE

3ur New Dean ^^

V Decade of Ob-Gyn at UNC 12

^ittie E. Pickard Loan Fund * ^

\ Conflict 1 ^

rhe Department of Medical Illustration 19

First Year Students

-no

Presenting the Faculty

Alumni News Items



Editorial Committee

Christopher Fordham, M.D. C. W. McMillan, M.D.

(UNC Med. '49) Chairman ^^^^^ ^ ^^^^^

Verne H. Blackwelder, M.D. (UNC Med. '44)

(UNC Med. '27) . r„ ^/r r^

^ rr, T. T^u T^ Isaac M. Taylor, M.D.

C. T. Kaylor, Ph.D. (AB UNC '42)

^- FjJ^cVed\^)-''- LLEWELLYN PHILLIPS, II

(UNC Med. 4z; ^gg ^^^ ,g2)

W W. McLendon, M.D.

(UNC Med. '56) Emory S. Hunt



Address all inquiries and communications to Emory S. Hunt, 117 Medical
Science Building— Box 1020, Chapel Hill, N. C.

Puhlished jour times a year — October, December, FebriLury and April —
Entered as third-class matter at the Post Ojjice at Chapel HiU, N. C.



*)



Our New Dean

Our new Dean is Dr. Isaac M. Taylor. The vital facts of his
personal and academic life are impressive credentials indeed. More
impressive, however, is the fact that Dr. Taylor has proven him-
self to be an able and sympathetic physician, an excellent teacher
of medicine, and a competent investigator. Moreover, in his ef-
forts during the past two years in the difficult area of planning
for expansion of the medical center facilities, he has exhibited the
administrative capacities which stamp him as a genuinely versatile
individual. The Dean of the Medical School, after all, is many
things to many men, and Dr. Taylor follows in the footsteps of
one who has fulfilled that role with courage, energy and per-
spicacity.

We of the faculty know Dr. Taylor well as one of our own.
We believe that his appointment as Dean assures the university
and the state of continued wise and progressive leadership in the
School of Medicine.



10




Dean Isaac M. Taylor



11



A Decade of Ob-Gyn at UNC

by Robert A. Ross, M.D.''"

The first staff appointments resulted from a fortuitous circumstance that
brought Doctor Deborah Gushing Leary to Chapel Hill with her husband Doctor
Lou Welt, the distinguished career professor in the Department of Medicine.
A scholarly background, solid training, academic experience at Yale, Columbia
and the National Foundation assured her competence; innate courtesy, rigid
integrity and ineffable love for human beings were manifest in her daily con-
tact with students and patients. Her death in 1957 saddened the academic
community and left the Deborah Leary Award a tangible memorial. Doctor
Leonard Palumbo was on the staff at Duke. In some fashion by some odd dis-
parities, he had acquired seven athletic letters in track, including undergraduate,
medical school and residency years, plus a year as a First Lieutenant in the Army
Medical Corps! More to the point, he was a member of Phi Beta Kappa and
A.O.A., possessed a mathematician's mind and was greatly interested in student
and resident teaching and patient care. All of these latter talents have con-
tributed greatly to our programme. Doctor Charlie Flowers, a native of Zebulon,
graduated from the Citadel, attended this institution and graduated from
Hopkins. At Citadel he was one of the top ranking cadets, graduating with
academic and highest miUtary honors, but the much lamented fact is that this
was much later than the rendezvous on Johnson Island when the corp of cadets
fired on the "Star of the West" and when the fanatical Virginian, Edmund
Ruffin, pulled the lanyard on Fort Sumter. Graduation from Hopkins was fol-
lowed by residency training there and later a faculty position at the Downstate
Branch of the State University of New York.

The return of this native was welcomed. His prodigious effort in inde-
pendent investigations and participation in state, regional and national matters
of scientific import have brought personal recognition and enhancement of our
school. His interest in teaching and care of patients complements other qualities
and fulfills a total obligation implicit in a doctor teacher. Doctor Hugh Hill of
Greensboro, a Davidson College and Hopkins graduate, was with us for several
years before going to Florida where he is now Assistant Dean of Student Affairs
and Associate Professor. He made a definite and happy contribution to our
growth. Doctor Luther Talbsrt, Hampden Sydney and University of Virginia
graduate, joined the Department in 195 8. In addition to duty in the Navy, he
had a year each in medicine and physiology before completing his residency at
Charlottesville. Doctor Talbert is carrying out fundamental investigation con-
cerning blood clotting factors in pregnancy, female sex endocrinology and
clinical research in cancer in the female pelvis. He enjoys reciprocal aid from
the Departments of Pediatrics and Medicine as well as the basic science facul-



The Editorial


Committee


was kindly


obliged


by


Dr. Ross


in


the


preparation of this


Departmental Review


article.


It


s one of


a series 1


concerned with the past


and


current activities


and


personnel


of '


the


various departments


in the


Medical School.













■•■ Dr. Ross is Chairman of the Department of Obstetrics and Gynecology,
U.N.C. School of Medicine.

12



ties. Doctor Stark Wolkoff joined our staff in 19 59. A long service in the tank
corps delayed his entry into Hahneman Medical College. Interneship at Blockley
and residency at Louisville were followed by an appointment to the staff of
Downstate, New York. A national fellowship with Barron at Yale furthered
his interest and gave foundation to his fundamental research in placental func-
tion and gas exchange and transportation through the placenta. This comple-
ments nicely our endeavor to learn more concerning the biology of human
reproduction.

It is heartening, and a point, that all see patients two days a week and
rotate night call duty in addition to research, teaching and staff patient super-
vision. All eagerly await the return of Doctor Bill Easterling, one of our own,
who completed his fellowship in female endocrinology and steroid chemistry at
U.C.L.A. and joined our full time faculty on July 1, 1964. Doctor Hugh
Shingleton, who served as Cancer Fellow and Chief Resident, has been to Oak
Ridge and now gives help in the needful division of "cancer." These additions
to our staff will allow the functioning of special clinics in female endocrinology,
complications of pregnancy, and fertility in addition to cancer. All should be
resoundingly welcomed.

The part time clinical staff and their local institutions have made a real
contribution to our total effort. Since 1954, we have enjoyed a mutually
profitable resident exchange with the Jersey City Margaret Hague Maternity
Hospital where for six months one of our house staff is in residence. This large,
well run center, being in a metropolitan area under the excellent supervision
of Doctor Joseph Donnelly's staff, gives added competence and perhaps
urbanity! Their exchange residents are superbly trained obstetricians and
profit especially by experience in the large tumor clinic here, some going to
Lenoir County Hospital with Doctors Fleming Fuller and Sam Parker and some
to Lumberton with Doctors Hugh McAllister and Jack Mohr for still another
helpful experience. Lumberton also has aided in our student teaching, the stu-
dents being sent for brief periods to see and participate in deliveries.
Doctors Easley, Pearse and Graham in Durham have offered every possible
help, and we have accepted "Watts Hospital residents and have sent residents to
Doctor Gunter in pathology. One noteworthy difference in Doctor Gunter's
service is that our residents are on his budget! Recently, we have sponsored the
Wake County Memorial Hospital in a successful effort to obtain approval for
a three year residency programme. We have furnished residents and have
accepted their residents for training here. This hospital should be a real addition
to North Carolina's resident training program. Doctor John Robert Kernodle,
his associates and Doctor Edward C. Sutton from Burlington; Art Summerlin,
Courtney Egerton, Tom Greer, Annie Louise and Lou Wilkerson and the staff
at Wake County; Jack Kirkland of Wilson; Bill Allen of Pinehurst; Harvey
Adams of Asheboro; Dick Boyd of Statesville; Ben Gold of Rocky Mount;
Leonard Woodall of Smithfield; "Pete" Powell, Bill Weinel and Sig Bear of
Wilmington; Bob Brame of Winston-Salem; Jim Burrus of Shelby, Joe Baggett
of Fayetteville; Talbot Parker of Goldsboro; Bennett LaPrade of Kinston;
Ernest Brown of Lumberton, and Joe Swanton of Garner attend at regular
intervals our weekly grand rounds on Wednesday afternoon. Certainly this is
one of our most informative exercises. Doctor James Donnelly, in the State
Board of Health, conducts perinatal mortality discussions once a week. He also
gives valuable aid in our joint maternal and perinatal mortality statistical
study.

13



The matter of patients and teaching opportunities has not been one of our
problems. Indeed, there were sixty prenatal patients in our complex while we
still had offices in Miller Hall. With the kind indulgence of Doctor Hedgpeth
and Doctor Fred Patterson, these patients were followed, and our friends at Duke
gave us every privilege and aid at delivery. With the activation of Memorial
Hospital in September 1952, our problems were not met. Doctor Tom Barnett,
while writing in a recent Bulletin, mentioned that the first patient to enter
the outpatient clinic was a pregnant female at term. Simply registering her did
not alter the course of labor and she was taken to Duke for delivery. Another
early emergency situation was only partially met but was financially rewarding!
to the hospital. This patient made it only to the grass plot back of the emer-|
gency entrance where a precipitous labor was attended beneath the shade of
the tree. The patient returned to Chatham after the business officer suggested
that the family at least pay "green fee." The first delivery in the hospital
(NCMH 04-26) occurred at 8:10 P.M., September 20, 1952 in one of the
operating rooms. The mother and infant were placed on 3 West effecting a
combined rooming in and camping out arrangement. The delivery rooms wereJ
activated January 13th, 195 3, 4-M February 22nd and 5-M October 19, 195 3. |
There must have been many frustrations, irritations and stupid acts, but some-
how if these did occur, they cannot be recalled. Spontaneous sympathetic
thought and action by hospital administrators, staff nurses, anesthesia and
operating room people certainly outweighed any patient or staff inconvenience.

Whether or not we have in some measure fulfilled our teaching obligation
can be answered, certainly in part, by comparing National Board Examination
performance: fewer failures, more honors than the national average. Adequate
house staff training is evidenced by number and calibre of applicants and their
later uniform success with the specialty board. Research endeavor, grants re-
ceived, publications, et cetera are documented in the annual reports which are
read by at least one person in our department.

The patient population, out and in, private and staff, does have some
geographic, ethnic and socio-economic fascination beyond that of being sick,
needing and receiving care, and does reflect opportunities for aid and purposeful
endeavor. Last year (1963) there were 15,094 outpatient visits, 7,684 staff and
7,410 private. The weekly tumor cHnic averages thirty-five patients. There
were 1,229 deUveries, 348 private and 881 staff. Of the staff patients there
were approximately one hundred student wives; of the remaining 781 staff
patients, 594 were non- white. A real opportunity for service was present in
the group of 222 registered unmarried pregnant females, of whom 195 were
non- white, and in the 63 patients who had abortions, 3 5 of whom were non-
white. Our social service worker has performed in magnificent fashion. There
were 777 gynecologic operations performed, 5 1 8 being staff patients. The
problem of management of our patients with cancer is an exacting one. Ap-
proximately 50 per cent of the total yearly tumor clinic represents cancer in
the female pelvis. Of the total hospital admissions, cancer accounts for 10.5
per cent; of this total 24 per cent were on our service. Stated another way, 42
per cent of all gynecologic admissions were for some form of pre-invasive or
invasive malignancy. This figure is not too remarkable when you consider that
at the present time there are only two facilities in our state that can offer com-
plete therapy for all people.

No one complains or should complain of the exacting opportunity to treat
(Continued on page 36)

14




Miss Mittie Pickard, now
winding up her 50 th year with
the U.N.C. School of Medicine
was honored recently by a re-
ception at the Medical School.
The first woman to be hired by
the School and it's first tech-
nician, she has, since her re-
tirement in 1959, from the
pathology laboratory, been in
charge of the eye pathology and
surgical research laboratory.



Mittie E. Pickard Loan Fund
in Medical Technology

A loan fund for medical technology students at the School of
Medicine is being established by the initial gift of an anonymous donor
in honor of "Miss Mittie". Contributions may be directed to the Medical
Foundation of N. C, Inc., 3 02 South Building, Chapel Hill, N. C.
Contributors should specify that their gifts are for the Pickard Loan Fund.



IS



A Conflict

by Robert Zeppa, M.D.



This article represents a major portion of the remarks made by
Dr. Robert Zeppa, Associate Professor of Surgery at U.N.C., to the
graduating class of 1964.

In medicine, we often hear of a schizoid conflict said to rage endlessly
between the science of medicine and the art of medicine. In this context, the
art of medicine frequently implies the practice of medicine with particular
reference to diagnosis and therapy. An intelligent layman might ask with real
perplexity, "Is this possible?" The answer seems to be "Yes, this conflict is said
to exist." Think back a few short weeks to the parody on postgraduate educa-
tion so skillfully performed by your classmates. Rose and Wooten, in their
delightful analog of "The Music Man." I refer, of course, to the refrain, "don't
know the territory." The implication seems clear, medical educators are not
aware of the needs of the practicing physicians. In the vernacular of "The
Music Man" a particular generalist might peruse the curricular notice describ-
ing a two- or three-day postgraduate course and comment, "Man, I don't' dig
that DNA jazz. What's with those ivory-tower eggheads?" "When the first-
and second-year students at Rush Medical College were transferred to the
University campus (Chicago) in 1901," reported Professor C. J. Herrick
recently, "many of them were unhappy about it and uncooperative. They were
not interested in science but in practice and they resented any exercise that had
no obvious practical application. When they were taking Professor Lillie's course
in embryology, they made noisy protests when required to study developing
hens' eggs. We are not going to practice obstetrics on hens, they wailed." Do
you detect any familiar refrains here? And are there any of you who will deny
the contributions of embryology to our understanding and, in some cases, the
control of congenital defects?

During my student days, many of us uttered similar asininities when
presented with information concerning, for example, chromosome counts in
drosophilia. Today's chromosome counts are on people in addition to fruit flies
and are important diagnostic tools for the evaluation of certain conditions.
Illustrations of this sort can be presented ad nauseam; they are so numerous.
What do they mean? Well, within the framework of our previous definition, it
seems clear that we have at least two major direction vectors associated with
the corpus of knowledge which constitutes medicine. In addition, it has been
interpreted by many that these vectors are opposed, in effect then there is a
conflict within the body of knowledge we call medicine. As you well know,
this conflict is most frequently referred to as the opposition of the practical
versus the theoretical aspects of medicine or again, the art versus the science of
medicine.

Let us examine these opponents individually in the hope that we may bring
some peace to this quarrel or indeed, even to find if there exists instead merely
a large smoke screen with a remarkable capacity to hide a skeleton or two.

First, the vector we call the art of medicine. This art of healing was
described some years ago by Dana Atchley as "the skillful and creative dispens-

16



ing of any type of relief to the sick of body or heart. Like all the arts, it can
be measured only in terms of the inspiration which it evokes." The lay press
has indicated recently, and with increasing vigor, that some decades ago the
pubhc had great warmth for the physician who sat up all night with httle
sister as she died from pneumonia. But today when he comes, gives her an injec-
tion of an antibiotic, and she recovers, he may be subject to criticism. I think
we all recognize this problem; the physician of generations past had so little
that he was able to do that he put major emphasis on those interpersonal rela-
tionships which are so vital in patient care. They are no less vital today. Even
though there may be less time to devote to the humanistic aspects of medical
practice, yet if the physician feels compassion its depth and integrity will
establish a mood that calms and re-assures almost wordlessly but with full
conviction. Further, to disregard the emotional aspects of little sister's illness
is just as unscientific as to disregard the antibiotics. As Francis Peabody pointed
out in his classic monograph "The Care of the Patient," "the practice of medi-
cine is an intensely personal matter. While the treatment of disease may be
entirely impersonal, the care of the patient m.ust be entirely personal." From
this brief unilateral consideration of the first vector, there are certainly no


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