Sharing Some THOUGHTS by Dr. William G. Aniyan Vice President for ^ Health Affairs Face-to-face meetings have some real advantages over the written w/ord. For one thing, they give people a better opportunity to size up one another. For another, more important, reason they allow people to ask questions and get answers right on the spot. But because of the size of the medical center, the thousands of people who work here and the different responsibilities each of us has, it's impossible for all of us to get together for person-to-person talks. For that reason. I plan to take the opportunity from time-to-time to discuss with you. in an INTERCOM column, some of the things that come across my desk. I plan to pass on some of the good and some of the bad — both the compliments and the complaints — because it’s through compliments that we can take greater pride in what we do and it's through complaints that we can see what we re doing wrong and attempt to do it better. One of the comments many of us hear about Duke occasionally is how large it has become, the idea being that the larger an institution gets, the more impersonal and cold it becomes. That may be true in principle, but it doesn't have to be in practice. Whether the atmosphere of a place is warm or cold, personal or impersonal, helpful or indifferent depends on one thing and one thing only — us. the people who work here. If we re friendly and courteous to one another and to our patients; if we go out of our way to try to be helpful to people who come here; if our faces and our voices and our attitudes are congenial, then that’s the atmosphere we II have throughout the medical center. In the letters we receive from patients, there is evidence that very often we do reflect that kind of an atmosphere. For example, onepatienttold us: “It s unbelievable that a place so large could show so much kindness.' Anotherwrote: "From the bottom of my heart, appreciate so .. jch everything. I will never forget ail of you for everything you did. And another, who had been on Reed Ward, expressed her thanks for the care she received, and then offered us this advice: "Keep your sense of humor. Nothing is worse thangloominthehospital." This last comment brings to mind a less complimentary expression from another patient. He observed what he called a “carnival atmosphere' in the hospital. The lesson here for all of us is that there s a place for good humor, backslapping and laughter, but they are out of place in the corridors of the medical center and the wards of the hospital. It s one thing to be good-humored with our patients, but it s quite another thing to laugh and cut up and be loud with our friends at a nursing station or while accompanying a patient on a stretcher down the corridor. Courtesy and consideration for our (Continued on page 4) ntetjcom 6ukc univcRsity mc6icM ccntcn VOLUME 22. NUMBER 13 MARCH 28,1975 DURHAM. NORTH CAROLINA WHAT A VIRUS SEES AT DUKE—This is a “virus-eye view ' from the inside of a containment line device, designed to protect scientists while they study viruses at the recently opened Animal Laboratory and Isolation Facility (ALIF). Dr. Darell Signer, associate professor of pathology and chairman of the ALIF committee, demonstrates how the accordion-like protective rubber gloves work. (Photo by Jim Wallace) Emphasis Placed on Safety in Design ALIF Opens for Cancer Studies By William Erwin Researchers have suspected for years that viruses — the pesky organisms that give us colds and warts— may also give us some forms of cancer. Virus-like particles have t>een found in the cells of patients with leukemia, breast and stomach cancer, Hodgkin's disease and cancer of the cervix. But unmistakable proof is lacking that viruses trigger these or any other human cancers. That proof may be found at last deep within a new one-story building here. It's the $1.7 million Animal Laboratory and Isolation Facility (ALIF) which is beginning operation this month as part of the Comprehefnsive Cancer Center. From its non-porous floor on up, the structure was designed as a place where investigators could work safely with “every known microorganism — virus, fungus, bacteria, rickettsia, protozoa — of any degree of risk to man,' according to Dr. Darell Signer, chairman of the ALIF committee. - It is the first facility of its kind in the southeast to be devoted to cancer research, Signer said. The laboratory resembles, in principle, a warehouse containing four submarines. Walk inside and you'll see that its windowless exterior walls surround four off-white fiber glass modules, or suites, each 44 feet long and 36 feet wide. The modules are self-contained and bristle with air conditioning and heating ducts. Inside each, you'll find airtight animal cages and an airtight containment line that could be mistaken for an elongated delivery room incubator. This is where Duke researchers will be cultivating their viruses. Protected by accordion-like rubber gloves protruding into the lines, they can handle infected animals and tissue cultures without worrying about catching the organisms they’re studying. The danger is not confined to possible human cancer viruses. Signer said. “Many animal tumor viruses have some degree of hazard,' he explained. Some scientists think cats may t>e able to transmit the feline leukemia virus to man, for instance. Because of the risks involved, “some experiments simply could not be done at Duke before, " the specialist added. “Now Duke investigators may work with many viruses that previously could not be handled here. We can greatly expand, as well, our attempts at discovering candidate human tumor viruses without endangering ourselves or contaminating the environment," One safeguard against contamination is ALIF's absolute air filters. These are fiber filters that can trap the tiniest of viruses. Air from the modules passes through them twice before being expelled outside the building. Liquid wastes passing out of the modules are treated in a concentrated chlorine solution for two hours before being released into sewer lines. Solid wastes from the cages and the carcasses of sacrificed animals are sterilized in massive ovens called autoclaves before they leave the modules to be incinerated. The laboratory's 25 autoclaves — worth $700,000 — were donated by the Federal government when its biological warfare centers in Arkansas and Maryland were were converted into medical research units. Yet another fail-safe device has l>een built into the facility. Air pressure inside the cages and containment lines is kept lower than the pressure outside them. The modules, in turn, have a lower air pressure than the rest of the building. (Continued on page 4) Engel To Discuss Recent Research One of the nation's leading clinicians in the field of psychosomatic medicine. Dr. George Engel, will be at Duke April 1-4 to discuss research and developments in his specialty. According to a spokesman for the university's Council on Aging and Human Development, Engel has significantly influenced contemporary attitudes and treatment of illnesses through his classic book, “Psychological Development in Health and Disease” and his more than 250 research papers. He is the twin brother of the late Dr, Frank Engel, professor of medicine and associate professor of physiology here, who died July 10. 1963. The Duke physician and scientist, before his premature death at the age of 49. was ranked among the leading experimental endocrinologists of this generation. George Engel is currently professor of psychiatry and medicine at the University of Rochester School of Medicine, His first address^ entitled (Continued on page 2)