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Duke University Medical Center
VOLUME 24, NUMBER 11
DURHAM, NORTH CAROLINA
Outpatient Pediatric Surgery
Saves Time, Money, Anxiety
SNOOPY, THIS WON’T HL/Rr—Two-year-old David Schwartz learned about
stethoscopes and hospitals when he was the first patient in a new program here that
allows routine surgery for children without overnight hospitalization. The system
should cause less anxiety to the child and less disruption to the family, according to
Dr. Howard C. Filston, chief of the pediatric surgical service. David recovered so
quickly that he wanted to visit the people at the hospital again the day after surgery.
(Photo by Jim Wallace)
By Ina Fried
As many parents know, strange
faces and strange places are often
upsetting to young children, and
hospitals are no exception.
D^ke Hospital has developed a
new system designed to alleviate the
anxiety of many young patients by
allowing them to undergo routine
surgery without remaining
The service, called the Ambulatory
General Anesthesia Program
(AGAP), also is expected to save time
The system is organized to speed
up cdl the red tape associated with
hospitalization so that all of the
child's time in the hospital is used
constructively, says Dr. Howard C.
Filston, associate professor and chief
of the pediatric surgical service.
The first patient in the program,
2-year-old David Schwartz,
underwent surgery for hernia repair
earlier this month.
David, the son of Mr. and Mrs.
Michael Schwartz of Durham, visited
the hospital the day before surgery to
complete his lab work and meet the
pediatric nurses and recreation
therapists. He and his parents
completed pre-admission paper
work and consultation with Filston.
His parents received instructions on
preparing him for the surgery.
C)rdinarily the family wotdd go on
a tour of the hospital, but that was
not necessary since Schwartz is an
assistant administrative director and
Mrs. Schwartz works in the blood
bank at the hospital.
Home that Afternoon
David was admitted to the hospital
early the next morning. He
underwent surgery under a general
anesthetic, remained in the recovery
room about an hour, and then went
to a regular pediatrics room. His
parents were encouraged to remain
with him except during the actual
surgical procedure. David left for
New Diving Study To Focus on Bone Death
By David Williamson
As the search for the black gold
petroleum intensifies, commercial
deep sea divers can travel to exotic
lands, get plenty of sunshine and
ocean air and earn wages that run
upwards of $50,000 for six months
But before you kiss yotu" spouse
good-bye, slip on your swim fins
and promise to write at every
opportunity, consider that diving is
one of the most dangerous
professions there is outside a
municipal bomb squad.
Accidents, angry fish, cold
sickness ("the bends") and high
pressure nervous syndrome that can
cause vomiting, tremors and brain
wave irregularities are just a few of
the dangers to which underwater
explorers are exposed.
Combatting 'Bone Death'
In an effort to combat still another
of the health hazards associated with
deep saturation dives —
osteonecrosis or "bone death" — a
tecim of 24 professional divers from
Caiuida arrived here yesterday to
participate in three weeks of
experiments at the medical center's^
F.G. Hall Laboratory for
Environmental Research, more
commonly called the hyperbaric
A series of four simulated dives,
each involving six divers, will be
made to the equivalent of 60 feet
beneath the sea to test how well two
drugs can prevent the conditions
that lead to bone death, according to
Dr. Peter B. Bennett, professor of
anesthesiology at Duke.
Each dive last 48 hours in the
pressurized atmosphere of the
(Continued on page 2)
home in the early afternoon.
"We're not taking an)rthing away
that the patient needs," Filston
emphasized. "The patient receives
the same muring care, the same
anesthesia care, the same surgical
and recovery room care. All we're
doing is eliminating a lot of
"The less time the mother and
father have to miss work, the less
loss of income they have," he said.
"Most children don't come as
isolated entities. Parents have to find
a place to leave their other children
while they're at the hospital," the
From Simple Procedure
To Major Upset
"What starts as a simple surgical
procedure can turn into a major
upset in time; resources and
Before AGAP, a child might be
admitted to the hospital one day for
preliminary lab and paper work,
have surgery sometime the next day
(Continued on page 4)
He Talks about Us^
And Ifs Good!
(From an article written by Dale E.
Baker in the Feb. 14, 1977, issue of The
Centre Times in State College, Pa. The
headline was “On People Helping
Howard Smith, a State College
barber, has been telling me for years
about the great people at Durham,
N.C., and E>uke University Hospital.
My visit there last week reminded
me of the important goal of life in the
South — people helping others. For
example, I arrived at the
Durham-Raleigh Airport at 10 p.m. A
round trip limousine fare to Durham
(16 miles) was $6.
What help was available! The
driver made three phone calls to find
me a motel room; took me to the
motel; the motel used their coiutesy
car to take me to the hospital the next
The X-ray technician started work
within 5 minutes after receiving a
request from Dr. Boyce Cole, who
missed lunch to check the X-rays;
another doctor came in for
consultation during the lunch hour; I
was through the administrative
red-tape by 1:30; the secretary called
the limousine service and by 1:50 I
was on my way back to the airport
Maybe the attitude and happiness
exhibited by these people is
contagious. How might we start an
epidemic in State College?
As Arnold Glasgow said "there's
still time to be what you might have