JUN 1) 1986

Ley S
STANFORD UNIVERSITY {ee oF ne wes8 Z

DIVISION OF HEALTH SERVICES RESEARCH

Department of Family, Community and Preventive Medicine Health Research & Policy Building, Room 7
SCHOOL OF MEDICINE STANFORD, CALIFORNIA 94305
(415) 497-6426

June 13, 1986

Dr. Joshua Lederberg

The Rockefeller University
123@ York Avenue

New York, NY 19021

Dear Josh:

I was pleased to get your note in reference to halothane hepititis and @
possible genetic basis. We took a modest stab at this a few years ago. An
anesthesiologist in Stockton named Harvey Goodman had called up to report
the observation of halothane hepititis in three pairs of closely related *
Mexican American women. With Goodman's, Peter Gregory's and my assistance,
one of our medical students, Rick Hoft, tracked down several generations of
blood relatives, but found no additional cases. We published the results
in the New England Journal, a copy of which I enclose. The original manu~
script had a chart of all family exposures to halothane, but in accepting
the artical for publication, the Journal asked to have it shortened con-
siderably. The November 1985 article in the New England Journal, the
accompanying editorial for which you sent a copy with your note, attempts
to present a metabolic basis for such a genetic mechanism. The issue does
continue to be of interest, for halothane is still very much a part of the
anesthesiologist's armamentarium, although I, myself, having left the
operating room some eleven or twelve years ago now, obviously no longer
use it.

I do continue to see patients in the Pain Clinic one or two days a
week, but most of my activities are in the Health Policy area. And, of
course, the seminars, to which you used to contribute by your regurlar
attendance, continue on and I think continue to make a contribution and
have some impact on activities within the University

It was good to hear from you. With best wishes,

Sincerely,
iY

John P. Bunker, M.D.
Professor of Anesthesia
and Family, Community
and Preventive Medicine

JPB: pmd

Enclosure