Untitled - Dartmouth Class of 1956

Wah, Who? Whisper!
Page 2
December 2013
“THE RAIN IN SPAIN STAYS MAINLY IN THE PLAIN”
When he wrote the above lyrics for “My
communications from the Soviet fleet in
Fair Lady,” Alan Jay Lerner must never
and around the Mediterranean. One of
have been to San Sebastian and Bilbao in
my duties was to assure that intercepted
November. Both of these cities nest in the
Russian dispatches were properly directed
north of Spain near the Pyrenees far from
to him, and that is how we met. The two
the country’s “plain,” but Fran and I can
of us were practically the only officers we
attest that it rains like hell there, too. We,
encountered who intended to vote for Adlai
nevertheless, had a marvelous week in
Stevenson in the coming election. That
spite of the almost constant downpour, one
Bob
made us fast friends.
day in Bilbao and the rest in San Sebastian
Grossman
At the time, cities in Morocco like
- or as the Basques call it, “Donostia” - which is as
Casablanca, Rabat, Tangier and Marrakech each
charming a city as I’ve ever seen, a miniature Paris.
had a small colony of Russians who had fled their
For those of you who have not been there, I’ll tell you
homeland in 1917, first escaping to Turkey, then
more below, but first let me dwell on Madrid where
moving on to Paris and ultimately settling in Morocco
we also spent a week, four days at the beginning of
which was then controlled by the French. On days
our trip and three at the end.
off, Matt would travel to Tangier to seek out members
The real purpose of our visit was to be with my
of the colony there with whom he could work on his
ailing friend, Matt Malison, who has lived in the
Russian. He found Tania’s parents to practice with
Spanish capital for over 40 years even though he
and they got to like him a great deal, so much so
grew up in New Jersey and went to Notre Dame.
that they wanted him to meet Tania who was then
He and his talented wife, Tania, settled in Madrid
studying at college in Madrid. Although I could
largely through Tania’s attachment to the city.
hardly speak a word of Russian, I went with Matt on
Soon after arriving there, they created an exquisite
many of the excursions to Tangier and watched him
Russian restaurant, El Cosaco (The Cossack),
enchant Tania’s parents. He finally got the chance to
which they ran for decades before retiring. It is
fly to our airbase near Madrid, made his way into the
located in Plaza De La Paja and is now owned and
city and sought out Tania. He found her and they’ve
run by their former head waiter. During those first
now been married for some 55 years.
four days we revisited Madrid’s great museum, the
As couples we have traveled together to places
Prado, and explored one we hadn’t been to before,
around the world, and Matt and I have taken our own
the Mapfre with it pre-Impressionist exhibit. We
journeys as well. One in particular was our search
ventured out at night whenever Matt was up
for our roots in Poland and Belarus, first to Posnan
to it, eating wonderful meals and spending one
in western Poland where Matt’s forebearers are from
terrific evening at Club Cardamomo watching the
and then to Belarus where my father was born. That
best flamenco dancing in Spain. We stayed at the
trip created the firmest bond of friendship between
Malison home which is located in a lovely area of
us, and prompted me to write about it in a piece
Madrid next to a spacious park where Matt and
entitled “The Catholic Owl and the Jewish Pussycat.”
I took long walks and reminisced about our past
While in Poland we also visited Warsaw, the lovely
together.
city of Krakow and the ugly site of Auschwitz.
The two of us first met in the fall of 1956 while
So you can see why a visit to my dear friend, who
serving as young naval officers at our air station
at just over 80 is more and more fragile, was essential.
in Port Lyautey (now Kenitra), Morocco. Before
After our time with the Malisons, we boarded a train
being sent there, Matt, who has an aptitude for
for the five hour ride to San Sebastian, supposedly
language, studied Russian at the Navy Language
leaving behind “the rain that stays mainly in the
School in Washington for nine months. As soon
plain.” We stayed at the Hotel Parma at the mouth of
as he arrived at the air station, he undertook the
the Urumea river where it runs into the Bay of Biscay.
critical role of translating and interpreting Russian
The staff at the hotel was as gracious and helpful as I
Wah, Who? Whisper!
Page 4
December 2013
“EMPATHY” by Joseph S. Gonnella*
About a decade ago, our research team at
Jefferson Medical College became interested
in studying empathy in the context of medical
education and patient care. We started the project
with a comprehensive review of the literature on
the meaning of empathy. The word was viewed
by many researchers as a mysterious and elusive
concept which was, according to them, difficult
to define in order to measure. Based on our work,
we came to define the word’s meaning as it relates
to patient care as predominantly a rational as
opposed to an emotional attribute, one that involves
an understanding as opposed to a feeling of an
intention to give help. This definition makes a
distinction between empathy, a rational attribute,
and sympathy, an emotional one.
Arising from our study of its general meaning,
we concluded that there was a need for a sound
instrument to measure empathy in the context
of medical education and patient care. We next
created the Jefferson Scale of Empathy (Scale)
and have developed evidence of its validity and
reliability. The Scale is presently available in three
forms: one for physicians and other practicing
health professionals, another for medical students,
and a third for students in such fields as nursing,
pharmacy, dentistry and clinical psychology. The
Scale is one of the most applied instruments in
medical education. It has received broad attention
in the United States and abroad, has been translated
into 42 languages and used in 63 countries so far.
This is the first in a series of works your editor,
with the help of Dick Abrams, has sought out
from classmates about whose achievements you
may not be aware. Subsequent such contributions
will consist of professional and literary works
from classmates who tend not to blow their own
horns but whose pieces will reflect their significant
talents. From time to time there will also appear
comparable pieces from classmates with whom
you are more familiar.
Through our empathy research over the past
decade, we found significant associations between
medical student Scale scores and faculty ratings
of student clinical competence. We also found
significant links between student scores, on the
one hand, and simulated patient evaluations
of student empathetic engagement in objective
structured clinical exams, peer nominations on
professional attributes, and scores of attitudes
toward interprofessional collaboration, on the other
hand. Women scored higher than men on the Scale,
and students with high empathy scores were more
likely to pursue “people-oriented” specialties, such
as primary care or psychiatry. In our longitudinal
studies, we found that empathy erodes in the
third year of medical school when the curriculum
shifts toward patient care activities – findings
that received broad media attention. Decline of
empathy was also observed among residents and
among nursing students who had more exposure
to patient care than others. Medical students
reported a lack of positive role models, excessive
workloads and exhaustion, disrespectful and overly
demanding patients, over-reliance on computerbased diagnostic and therapeutic technology, and
a market-driven health care system as factors
that contribute to the erosion of empathy and the
escalation of cynicism.
We have shown that physicians’ Scale scores
were predictive of outcomes in diabetic patients.
In another large Scale study in Italy, we found
that physicians with higher as against lower Scale
scores had a lower rate of hospitalization for
their diabetic patients. These findings on the link
between physician empathy and clinical outcomes
have also received broad media coverage.
In addition, we have shown that it would be
possible to prevent erosion of empathy in medical
students and residents, and even to enhance
empathy among them. For example, in one study,
we found that watching a short theatrical play
(depicting problems facing elderly patients) could
significantly increase the Scale scores of medical
and pharmacy students. In another study, empathy
in medical students increased after a workshop in
which selected video clips of patient encounters
from movies were shown to the students and the
positive and negative aspects of encounters were
discussed. However, the increase in empathy