Spring/Summer 2002

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Going National with Diabetes

By Anne Bennett Swingle

With 17 million Americans suffering from this once rare disease, Chris Saudek sounded a wake-up call during his year as president of the American Diabetes Association.

It's a side effect of prosperity," Christopher Saudek says, when he's asked about the rampant spread of diabetes. Saudek should know. As outgoing president of the American Diabetes Association, this endocrinologist has seen firsthand the sweeping grasp of this once rare condition. In the United States alone, diabetes affects more than 17 million people. Another 16 million Americans test with higher-than-normal blood glucose levels, putting them in a new category known as "pre-diabetic."

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The Rockefeller Chronicle

By Anne Bennett Swingle

For the first half of the 20th century, the research center founded by America's most powerful oil baron was all bound up with the School of Medicine.

In the summer of 1897 as Frederick Gates, a former Baptist minister who had become John D. Rockefeller's most trusted advisor, vacationed with his family on Lake Liberty in the Catskill Mountains, he began perusing William Osler's Principles and Practice of Medicine. Gates was fascinated with the scholarly approach to diagnosing and treating disease laid out by Johns Hopkins Hospital's first physician-in-chief. And yet, he hungered for more. "To a layman like me demanding cures, [Osler] had no word of comfort," Gates wrote later.

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Devices & Desires

By Anne Bennett Swingle
Photos Keith Weller

A diagnosis of heart failure once signaled imminent death. Today, specialists are abuzz with pacers, pumps and other implantable mechanisms that have changed the picture for patients with this lethal condition.

There is no cure for heart failure. Half the people diagnosed with it will be dead within five years. The heart gradually loses its ability to pump blood; the victim feels a deadening fatigue, struggles to breathe, and the lungs become congested with fluid. Luckily for most people with the disease, drug therapy is hugely helpful. But for those who don't respond to drugs or for some unknown reason stop responding there has been little aside from a transplant to make the damaged heart function effectively again.

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Better Send it to Epstein

By Janet Farrar Worthington

Prostate cancer cells may be the hardest of all to analyze. and they can spell big trouble. One pathologist has deciphered more of these splotchy microscopic patterns than anyone else in the world.

You are a man who may or may not have prostate cancer, and you are sweating bullets. You're still sore from the needle biopsy, and you're waiting for some guy you've never met-some faceless pathologist- to make the call. Is it cancer? Is it treatable? Now, switch roles: You are that pathologist, and a man's life may depend on what you can glean from a few tiny cores of prostate tissue. Did the urologist who sent you the biopsy nail the cancer, or miss it entirely? Consider that the prostate gland is roughly the size of a large strawberry and in it, a patch of cancer-the average cancerous prostate has about seven-is about the size of a strawberry seed. The cancer cells that are found generally tend to be hard to interpret; thus, biopsy is often a hit-and-miss affair. And now it's in your court. Your judgment will be a major part of the treatment decision-making. Is it cancer? Maybe yes, maybe no. The best you can determine is that it's "atypical." Better send it to Epstein.

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