~ APR8 1974 40051 ~ Che Roosevelt Hospital Department of Medicine \ ws . 4 i 3 Henry M. Greenberg, M. D. ——— ent Director Coronary Care THE ROOSEVELT HOSPITAL April 3, 1974 Dr. Joshua Lederberg Department of Genetics Stanford University Stanford, California 94305 i < Dear Dr. Lederberg: I am very appreciative of your kind note in response to my Op-Ed article in the New York Times, Rx for Conciliation. I have read the reprint from Social Research and have examined the concept and curriculum of the Human Biology program at Stanford. I hope that my comments will be of some help to you. An NIH site visit has disrupted my schedule and hence the delay. There are several assumptions which serve as a basis for formulating goals for the course. Since an open society can define social infra- structures such as health care delivery, a logical prerequisite is a supply of baseline information in a usable form directed at the polit- ically concerned population. Available sources of medical information seem impotent, and educational institutions: are simply not doing the job. From medicine's point of view, if it has single, focus, a public enlightened about the art and science of medicine, about human physiology and pathology, offers the best if not the only defense of maintaining excellence and the supremacy of individual clinical judgment in what- ever form of national health service is coming. On this foundation rest my goals. -I would like to demonstrate that an educational approach such as mine is feasible and that it can attract a healthy, non-hostile student body which believes that such instruction is necessary to fill a gap in their prior education. I would like to be able to show that they absorb and not merely attend with interest. I think I have at least illustrated the first portion of this goal, but I am not sure how to provide evidence that I have satisfied the second. During the fall semester I shall pay more attention to questionnaire I believe there is a market for this information but I think that defining and reaching it will require active participation IGG8 . 413 Woy Cod Wy. AIS NY [o0r4 by many many physicians, presumably working with or thru their local or national organization. I have not yet formulated any specific proposal to present to such groups, but I am considering doing so. The fact that my course is unique or nearly so provides insight into a current paradox. When faced with a clinical dilemma or sit- uation for which no ready remedy exists, the physician, or medicine, tries what is least toxic and most likely to offer effacacy. Various committees to oppose various governmental incursions into medical practice show this function in the political sphere. However, in medical lay education, this tradition is violated. There are in- numerable local and I presume national organizations that have committees and discussions about the most likely avenues for worth- while expendature in this area. They do little but generate. the same old pap over and over again; a strange paralysis of innovation prevadés. Why no one has attempted a course similar to mine is beyond me. When I first contacted the NSSR, I half expected a form letter stating that they turned down 20 such requests per year from physicians because medicine was outside their ken. My class presentation is usually a didactic lecture punctuated by slides of little lists I made up or material from the collections of clinicians, pathologists, and radiologists. I permit questions at appropriate intervals and make it clear tnat I will answer any- thing they ask if related to the topic. My suggested reading list is small. Initially I recommended only ore book, Richard Asher, Speaking Out published by University Park Press. Asher's essays on the art of medicine are excellent and do not unduly tax an educated Lay reader. I added Loren Eisley's Firmament of Time after a free flowing discussion. of informed consent. To complement my talk on infectious disease I suggested Hans Zinnser's Rats, Lice, and History. I anticipate more insights as I progress with this course and I will probably write it up for omof the gtneral medical journals. If it reaches press, I shall send you a copy. ‘ Thank you for your interest, i Sincerely whe M. Greenberg, HMG: et gineering. The course concludes with discussions of how alterations in the processes can occur, what the consequences are, and how they can affect individuals and ultimately entire populations. The only prerequisite is an interest in biology. ". 2965-3 Biological Determinants of Abnormal Behavior we Tuesdays, 5:55-7:25 P.M., beginning February 5. $80. Jay M. WEIss The possibility that disorders of thought and behavior are caused by physio- logical, biochemical, or genetic abnormalities is a subject of much interest. This course examines recent developments in the attempt to relate basic biological processes to mental illness. Animal models of abnormal behavior, their usefulness in making discoveries; their relevance to human disorders. Biochemical theories of depression and‘ psychosis. Hormonal influences on mood, emotion and stress. Neurosurgery for the control of aggression. Recent advances in psychosomatic diseases and behavior therapy. Readings consist of research reports that can be understood by intelligent laymen. 2966-3 The Natural History of Man * Wednesdays, 7:45-9:15 P.M., beginning February 6. $80. r Morris GREEN Man's biological evolution, structure, and functioning are related to the nature of man, and to his changing view of himself and his environment. Like other creatures, man is made up of cells, tissues and fluids; how are these integrated to make man the scientist, the poet, and the-uniqne orgenism:-he is? .. ~B967- Oo “Medicine 1974 — A Physician’s View Thursdays, 5:55-7:25 P.M., beginning February 7. $80. HENRY GREENBERG : A clear, concise, and accurate description of the major diseases and current controversies in clinical medicine. The course explains in straightforward terms the cause, diagnosis, and therapy of coronary disease, stroke, cancer, ; asthma, ulcers, diabetes, obesity, “common cold”, anemia, and others. Where | x se te, knowledge is lacking, the major thrusts of research will be reviewed. The- \ controversies include the misuse of medicines, the question of excessive sur- gery, the myth of vitamins, malpractice, informed consent, and the role of cost benefit-analysis in medical care. tt natant LRA ANSE A e thecastet staan 2970-3 Marihuana: Chemistry, Pharmacology and Behavioral Effects Tuesdays, 7:45-9:15 P.M., beginning February 5. $80. * ADAM DREWNOWSKI > The course covers the botany and chemistry of.the cannabis plant; the his- torical background, distribution and manner of marihuana use; the pharmaco- logical and physiological effects of the active drug, A-9 Tetrahydrocannabinol (THC), as well as its psychological action on animals and man; the drug's effects on mood, memory, and time perception; questions of tolerance, physical dependence and psychic dependence; clinical studies and case reports of marihuana users. shee 2A at A NL sania totem Pe AE tne MENS 2973-3 Our Universe: A Cosmic Panorama Tuesdays, 5:55-7:25 P.M., beginning February 5. $80. ROBERT M. WILLIAMS The Eastern, Greek and Renaissance roots of our present world view are 90 Aber wan Me crise?