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VOLUME 20. NUMBER 12
March 23, 1973
DURHAM, NORTH CAROLINA
^Highland Hospital - A Special Part of Duke
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hospital
ENTRANCE TO A//GWZ.^/VD—Highland Hospital is a 131-bed psychiatry facility
located in Asheville. It was founded in 1904 and became fully integrated into Duke
as a Division of the Department of Psychiatry in 1967. Highland's campus consists
of 55 acres with eight patient-care buildings located on its premises. (Photo by
Dale Moses)
New Program Successful
In Curbing Fetal Deaths
The fetal death rate at Duke was cut
by 25 per cent • last year after the
creation of a new program for the
evaluation and management of high-risk
pregnancies.
The program is the Division of
Perinatal Medicine, started one year ago
under the Departments of Obstetrics and
Gynecology, Pediatrics and
Anesthesiology.
The division has just received a
$32,592 grant from the National
Foundation-March of Dimes to continue
its effort to improve the clinical
management of high-risk obstetrical
patients and further reduce intrauterine
and infant death rate.
The grant will include $25,000 from
the National Foundation-March of
Dimes and another $7,592 from the
Durham County Chapter of the
organization.
The Durham chapter plans to raise its
share of the grant during its second
annual Walkathon to be held April 7.
“Last year was the lowest death rate
it's ever been at Duke," said Dr. Carlyle
Crenshaw Jr. "We had 18 intrauterine
deaths per 1,000 live births. In the
previous four to five years it was
running 24 deaths per 1,000-live births.
"I would like to think this comes
from an improvement in the evaluation
of high-risk cases and in the handling of
labor and delivery," he said. Duke
handles more than 2,000 deliveries
annually.
Crenshaw and Dr. George W.
Brumley, director of Newborn Services
at Duke, are co-directors of the new
division. They have been working on
basic maternal and fetal research for
more than five years.
"Perinatal refers to the period of
intrauterine life when the baby is
considered viable to some time after
birth," Crenshaw said. "We plan to
follow them for five to 10 years after
birth.
"We're dealing with the babies of
high-risk mothers, those with such things
as diabetes mellitus, hypertensive
vascular disease, RH negative
sensitization, heart disease and the
obstetrically elderly—over 40."
Crenshaw said, "It's from this group
of patients that we have our greatest
perinatal mortality and maternal
mortality.
"There are relatively few perinatal
divisions in the country," he said. "We
hope that through centers such as this,
we can have an impact nationally as well
as locally in terms of the quality of care
for all obstetrical patients.
"North Carolina has one of the
highest perinatal death rates in the
country," he said, "and the United
States has one of the highest rates in the
civilized world."
Duke's Division of Perinatal Medicine
is an interdepartmental program, the
only effort of its kind in the state.
Besides Crenshaw and Brumley, the staff
includes Dr. David Cole, an obstetrical
anesthesiologist, and Dr. David
Schomberg, an endocrine physiologist.
(continued on page 3)
When people speak of the Duke
University Medical Center, they almost
always are referring to the medical
complex in Durham.
But one of the most important
divisions of the medical center is located
more than 200 miles to the west of
Durham in Asheville. Because of its
mountainous location, it is fittingly
called Highland Hospital.
Highland is situated in the highlands
of western North Carolina where skiiers
and outdoorsmen alike can find
relaxation and escape from the routine
stresses of everyday life.
For its size, Asheville is a unique city
in that it boasts almost a dozen medical
facilities in its surrounding areas. Amidst
this concentration of medical care stands
Highland Hospital, a 131-bed psychiatric
facility with some 250 staff and
employees. Oddly enough, a ski resort
located 27 miles from the hospital's
grounds advertises itself as a "great
escape" and this concept of refuge and
restoration is particularly underscored at
Highland.
According to public relations director
Stephanie Tindell, "the hospital serves as
a necessary refuge where patients can
restore themselves emotionally and
psychologically while discovering what
went wrong in their lives and how they
can better deal with future problems."
Highland Hospital was founded in
1904 by Dr. Robert S. Carroll who
donated the hospital to Duke in 1939
and served as its medical director until
1943. Dr. Carroll vvas a strong believer
in the importance of general, physical
and mental fitness as a basis for mental
health. His treatment programs stressed
a simple diet, work-centered activities,
vigorous outJoor recreation programs
and pleasant living quarters.
In July of 1967, Highland was fully
integrated into Duke as a Division of the
Department of Psychiatry. As a issult,
the governing body of Highland Hospital
is the Board of Trustees of Duke
University. Highland is under the
supervision of Dr. Ewald W. Busse, J. P.
Gibbons, professor and chairman of the
Department of Psychiatry at Duke.
Dr. Charles W. Neville Jr. has been
medical director of Highland since 1965.
He has been a member of the faculty at
Duke since 1964 and currently holds the
title of associate professor of psychiatry.
Highland's full-time staff, which
includes nine psychiatrists, three medical
psychologists and 10 social workers,
hold academic appointments in the
Department of Psychiatry and have
access to its resources. In addition to
the full-time faculty, there are 110
members of the nursing team.
Eight major patient-care buildings are
included on Highland's 85 acres of
beautiful woodlands. The hospital
handles all types of patients with
psychiatric disorders and each patient is
carefully evaluated and his treatment
program is tailored to meet his
particular therapeutic needs. His
treatment is arranged by his psychiatrist
and his residence hall team. This team
consists of a psychiatrist other than the
patient's doctor, a psychologist, social
worker, the nursing staff, and
representatives of the activities service.
In addition to the therapeutic milieu
maintained in each residence hall, more
(continued on page 3j
^ETAL heart /IfO/V/T’O/?—Mickey Fogleman (left), Durham County campaign
chairman of the March of Dimes, examines a fetal heart monitoring device with Dr.
Carlyle Crenshaw (right), co-director of the new Division of Perinatal Medicine, and
Dr. David Cole, an obstetrical anesthesiologist. The local March of Dimes chapter will
sponsor a Walkathon April 7 to raise money for the new program designed to improve
the management of high-risk pregnancies.