National
Hospital
Week
May 6-12
In 1921, leaders in the health care field established a National
Hospital Day to encourage public appreciation of the people
working in hospitals. The day chosen was May 12, the birthday of
hospital pioneer, Florence Nightingale. By 1953, the day was
expanded to National Hospital Week, recognizing the tremendous
growth in hospital services in this country.
The theme of National Hospital Week 1973, sponsored
nationally by the American Hospital Association and celebrated
by the nation's more than 7,000 hospitals in their local
communities, is "Your Hospital...A Caring Community—Your
Health...Our Common Concern."
With mounting public concern about the effectiveness of our
health care system and the rising costs of health care, hospitals
are being subjected to some sharp criticism and demands for
change.
Voicing sympathy with the demands of the American public
for improvements in the delivery and quality of health care, and .
for containment of health care costs, the Association also suggests
that National Hospital Week is an appropriate time to express
appreciation to the more than 3 million people working in the
nation's hospitals.
Not so long ago, the first hospitals were simple shelters where
people went to die. Today, they are complex healing, educational
and research institutions, where lives are saved, the causes and
cure of disease sought, and future health professionals educated
and trained.
Hospital employes represent an incredible diversity of skills
and talents, working in some 200 different types of jobs.
However, they have one goal in common: a working life
dedicated to caring for the ill and injured.
Modern technology and rapid scientific advances have made
possible saving of lives and prevention or curing of disease.
But the human hands and hearts are still essential to the
healing arts.
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VOLUME 20, NUMBER 18
MAY 4, 1973
DURHAM, NORTH CAROLINA
Hyperbaric Oxygen Effect
On Brain Damage Studied
Hopes that the use of high pressure
oxygen in hyperbaric chambers might
successfully treat brain damage in such
conditions as stroke and senility have
been jolted l?y Duke researchers.
The researchers reported in Boston last
week that elderly stroke victims and
presenile patients so treated showed no
more improvement in lucidity and
functioning than control patients who
were not treated.
Many studies of the effects of high
pressure oxygen on brain function have
been started around the country since
1969, when researchers in Buffalo
reported "dramatic" improvements in 13
senile patients given OHP.
The treatment is based on the idea
that the blood stream can be
supersaturated with oxygen when a
patient is under the high atmospheric
pressures that can be achieved in a
hyperbaric chamber.
It is generally believed that the
decrease in oxygen to brain tissue in
strokes and senility is the basis for the
loss of function seen in these conditions.
Since the Buffalo report, tentative
positive results have been reported from
half a dozen projects.
"But such research studies are costly
and difficult and time consuming and the
methods used by many of these
researchers have been subject to
criticism,” said Dr. Glen Davis,
coordinator of the Duke study.
"Each piece of our study and testing
was done by experts, and our testing was
much more extensive in all areas of
functioning than the other groups," he
said. "We feel these very strongly negative
results are important because the
government and institutions are spending
a lot of money on this."
Davis presented the findings at the
annual meeting of the American
Academy of Neurology in Boston. Davis,
who is now a medical intern at Duke, was
a fellow in the Center for the Study of
Aging and Human Development at the
time of the study.
The study format was the same as that
used in Buffalo by Dr. Eleanor Jacobs
and her associates at the State University
of New York and the local VA hospital.
Twenty patients received a series of
90-minute exposures to oxygen at 2Vz
atmospheres of pressure twice a day for
15 days. That is a simulated depth of 50
feet below sea level.
The control patients were taken to a
depth of 10 feet breathing room air to
simulate diving. Later in the study, each
of the control patients was also treated
with OHP after a control run so that
treatment was not withheld from anyone.
Before and after the treatments, both
groups were given an extensive six-hour
battery of psychological tests, including
memory, intelligence and motor
performance scales.
The patients were also given
electroencephalograms and cerebral blood
flow tests and were rated on their
functional ability before, during and after
by doctors, nurses and their families. The
nurses and the families were not told
which patients had received OHP during
the tests so that the evaluations were
double blind.
"We found no differences in
functioning between the groups of
treated patients and the controls," Davis
said. "None of the patients improved."
Unlike previous groups, the Duke
researchers chose the patients for the
experiment from specific disease
groups—those with Alzheimer's disease
or premature senility and those with
brain damage due to vascular
insufficiency. Other studies have used a
varied mixture of senile and
brain-damaged subjects.
Davis said the theoretical basis for
OHP treatment of these conditions is
tenuous indeed." Mental deterioration
as a result of vascular disease might
respond to an increased supply of oxygen
if there still remained, months after the
stroke, a significant amount of
oxygen-deficient but living tissue.
He said the only basis for believing
that a condition such as premature
senility might respond to higher oxygen
concentrations is the finding by some
authors of decreased oxygen utilization in
degenerative brain diseases.
"We don't really understand the
etiology of senility or presenility," he
said.
The principal investigators on the
(Continued on page 3}
BUILDING CASTLES IN THE S/C/—The season of spring is a time of rebirth and the
Division of Medical Psychology has been reminded of this fact by two roosting pigeons
who have built their castle of straw on a fourth floor terrace in CR II. According to
Mrs. Anita Hume, secretary to Dr. Doyle Gentry who is head of the division, the mama
pigeon recently layed two eggs and to ensure her complete privacy the division has put
up a sign on the terrace door cautioning passers-by against any disturbance to the
pigeons and their eggs. (Photo by Dale Moses)
Long-Term Employe Reflects
On Hospital’s Early Years
In 1928 a group of men converged on
a wooded area in West Durham to begin
making a reality out of the philanthropic
dreams the Duke family had to establish a
major private university and hospital in
the Piedmont of North Carolina. They
carried surveyor's equipment and within
weeks had marked out the boundaries of
West Campus.
In the course of the year, others
followed to clear the land, pour
foundations, haul in mountains of
Hillsboro stone and stack the gray blocks
into what was to become one of the
nation's foremost educational institutions.
One of the men who arrived that first
day and has worked ever since to build
Duke University and its medical center
was Earl W. Mangum. Mangum retired
early this year as head of the elevator
shop, but before he left, he shared with
"Intercom" some of his memories and
impressions of the early years.
"When I started working here it wasn't
Duke, it was the Southern Power
Company," he said. "We built a heating
plant over on the East Campus when they
were renovating it. I worked with the
engineers figuring out the elevations so
that people who came after us would
know how much dirt to cut out.
"Duke formed their own construction
company in those days, because no other
outfit in the area was large enough to
tackle building this university. One of rny
first jobs was working with the surveyors
cutting the stobbs that they wrote the
elevations on," he said.
Right where the Baker House is now
was an old school house called the Rocky
Knolls School," Mangum recalled. "We
used it for our office. The land used to
belong to the Rigsbees, and they sold it
to the Dukes so the university could be
built on it. Originally, it was going to be
over in back of the East Campus, but the
land was too expensive there because it
had buildings on it, and so they came
over here.
(Continued on page 3}