O U R R E A D E R S W R I T E
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An "unbearable" right-ness of
Dale Keiger's article "Political Science" [November] articulated the pit that has been growing in my stomach regarding the outcome of the 2004 presidential and congressional races.
My doctoral research encompasses the epidemiology of viral hepatitis/HIV co-infection — an obvious target for "faith-based" watchdog groups. I chose this field for two reasons: First, it's of critical importance to public health, and second, I love what I do. In February 2004, I attended a Young Investigator's career development workshop at the 11th Conference on Retroviruses and Opportunistic Infections. As Chris Beyrer warns, many of these top trainees are seriously considering leaving HIV for bioterrorism research because "that's where the funding and security are." Stemming HIV transmission is difficult enough even with a full, focused onslaught of funding and manpower. If there were to be an exodus of young researchers or the rescinding of funding, it may well prove impossible.
It is imperative that the President, Congress, and courts enforce the separation of church and state regardless of personal beliefs. Furthermore, they must affirm the mission of the National Institutes of Health — to provide leadership and direction to programs designed to improve the health of the nation, a mission made possible because of the expertise of its scientifically and medically trained staff.
Watching funding dwindle for our principal investigators is
bad. Censoring grant/article titles to avoid political
scrutiny is worse. Thinking that a faith-based,
non-scientific watchdog organization has the power to alter
grant funding and possibly future scientific direction in
the U.S.? Unbearable.
Dale Keiger's article on the political scrutiny of taxpayer-funded research was hilariously one-sided. Imagine, elected officials concerned about where tax dollars are spent! Government employees who are expected to advocate U.S. government policies!
I have some sympathy for the scientists' argument that peer review is a good way of allocating research funds to projects that seem most promising. But surely the preferences of those funding the research also matter. On the margin, perhaps I would prefer research dollars to move more toward a cure for breast cancer or heart disease than how prostitutes transmit HIV, even if the likelihood of success of the marginal breast cancer project is lower than for the marginal HIV project. Furthermore, scientists are not immune from promoting their interests over those of the public. (It was not encouraging to read that scientists were "uncomfortable" answering questions from the religious community. Was that because the scientists couldn't adequately explain their positions, or were merely contemptuous of the devout?) If elected officials and their appointees make bad decisions, voters have frequent opportunities to replace those officials. If we disagree with the way scientists at NIH spend our money, what recourse do we have?
Keiger's article read like a press release from researchers
who wanted the government to cut them a check then leave
them alone. Is it any wonder that academia is widely
perceived to have a strong liberal bias?
Why shouldn't such grants be scrutinized? I have values
that affect how I think my tax money should be used. I want
to know that my money is used for things that support
traditional family values. Bravo to the Traditional Values
HIPAA is a complex regulatory scheme that addresses a vast, regulated community. Any such scheme is expensive and difficult to implement. Whether HIPAA is worth the difficulties it has engendered is a policy question worthy of discussion.
Unfortunately, Maria Blackburn's article ["HIPAA, Heal Thyself," November] appears to be part of the current proliferation of unfounded alarms as to the evils of HIPAA. The very first example offered by Blackburn, "in which patient care suffers," appears to have no basis in law. A hospitalized patient does not need to sign a HIPAA release to permit the hospital to provide protected health information to a physician for the purpose of participating in direct patient care. The hospital and its staff can communicate that information as part of reasonable and appropriate clinical care. If a physician providing prior outpatient care remained unaware of the hospitalization, that was not a function of HIPAA requirements. If Blackburn and her source of information, Dr. Treisman, would review Title 45 of the Code of Federal Regulations, at Part 164, I believe that they might see the error in their analysis.
Misunderstanding caused by misinformation will not advance
the policy debate over HIPAA.
Dr. Bromberg and several others we heard from are indeed
correct that it was confusion about HIPAA, not HIPAA
itself, that caused the problem in the ER example in
"HIPAA, Heal Thyself."
Suddenly, in the spring of 2003, we residents of a lifecare retirement community, The Forest At Duke, in Durham, North Carolina, were faced with the impact of abiding by the rules and regulations of HIPAA. One day in March 2004, [my friends and I] were joined by a friend and resident of the retirement home whom we had "lost track" of for over two months. It turned out that she had been quite ill for several weeks and had subsequently been transferred in and out of the hospital and rehabilitation center before being discharged to The Forest at Duke. To our amazement, we were unaware of her difficulties. After a serious discussion, she admitted, "I felt so abandoned."
This struck us as completely inconsistent with the usual atmosphere of caring that is so prevalent at this retirement home. Therefore we set our course to find a way to minimize the impact of HIPAA on our way of life. The process that we have devised centers around a resident locator book that contains the name of each resident and a voluntary listing of a confidant for each resident. This confidant is allowed to be informed when the resident enters the health care system or is moved within the system to another location. No medical diagnoses or treatment are in the book — only location. If appropriate, the entry may include the suitability or desire for visits, telephone calls, or "notes only."
This system works within the guidelines of HIPAA and yet
helps preserve the wishes of the extended family. And, by
keeping the system voluntary, those who do not wish to
participate are not forced to identify a confidant.
For several years, I have been a volunteer coach for a variety of recreation-level youth sports. I am distressed by parents applying so much pressure on their children (some not even teenagers) to do well in sports so they can get a scholarship or gain admission. Now that my two boys are in school sports, I sit in the stands and hear conversations much like the one Bill Conley overheard at his daughter's lacrosse game [Editor's Note, November]. Fun has been removed from sport for these kids. I would bet that most will not want to play their "designated" sport in college. This is a shame, since sports can enhance the growth experience so positively.
My wife and I have emphasized the importance of being
well-rounded. With all the college admissions talk around
us, it was comforting to know that we are not
short-changing our lads' college chances.
"When the Angles Aren't Right" [Editor's Note, November] points out an interesting distinction between diversity and uniqueness. In college admissions, it is always said that both are important for any candidate. This issue needs to be clarified.
I question whether high school students are really not well-rounded. I graduated San Marino High School, one of the most prestigious public schools in Southern California, in 1999. In SMHS, there was strong emphasis on SAT I and II scores, GPA, community service, the MTAC music theory test, high school sports, and City of Hope research. Most students were overextended for much of their four years, trying to diversify.
SMHS traditionally had at least 15 to 20 graduates go on to a private [college or university]. This year, it only had three. Only about 15 to 30 students were able to attend a state school such as UCLA. Considering that a SMHS graduating class is about 320, this is a complete disaster for students who sacrificed so much to enter a prestigious school, only to find themselves in a crowded community college.
More frightening is that life in and after college does not get any easier. Law and medical schools are so difficult to get into because students' grades are often not based on how hard they work, but on how their grades compare to other students'. Not only that, the job market has been tight since 2000. The many Asian parents who think that a big name college would help need to realize that they do not live in Japan, where every year the bureaucracy recruits 400 of 600 students from Tokyo University alone. There are plenty of JHU graduates who cannot manage to find a definite career path in the form of graduate/professional school, or a career, for several years.
Imagine, after spending so much money on mathematics cram
school, SAT I prep classes, AP private tutor, private piano
lessons, and personal tennis coach for 15 years and paying
about $200,000 in college tuition and living costs, and
your child ends up no better than those who never bothered
to work themselves so hard. This is the reality in
education in the United States. College officials,
students, and parents need to take this dilemma seriously
if they want to create a brighter future for the next
As usual I absorbed the Johns Hopkins Magazine as soon as it arrived. I am especially interested in getting Larzer Ziff's new book, Mark Twain, after reading your article ["More on the Man Who Never Let His Schooling Interfere With His Education," November, p. 24].
In [reading about] some of Twain's "lesser known works," I
found the most important of all of his works was not
mentioned: The War Prayer. In this day and age, and
with this country's apparent endorsement of "pre-emptive"
war with the re-election of Bush, this thin volume should
be held out as what Twain thought on war. I find it is
little-known in even the more academic circles of this
country. I don't as yet know if Ziff covers it in his book,
but it should be read, and often.
Thank you for the timely article about the School of
Nursing and our efforts to combat the nursing shortage
["Building a Solution to the Nursing Crisis," November, p.
67]. Unfortunately, we provided inaccurate tuition
figures. The current tuition for the entire traditional
two-year baccalaureate program is $45,559.
A decidedly mixed memory was evoked by your piece on the late 1960s yearbooks ["Photographic Freedom, Sixties Style," September, p. 54]. Each year, I ponied up some hard-earned dollars for the yearbook. While the 1966 effort dutifully memorialized the events of the year, each succeeding year through 1969 became more esoteric and less related to those who were not members of the yearbook staff.
I thought then that we must have entered some post-literate age, since the yearbooks devolved into a series of bound photographs, even taking into consideration the separate paperback volume of someone's profound thoughts in the 1968 effort. Recently, my teenage sons have reviewed those efforts and found them equally puzzling. Who are these people? What happened back then? You can't tell.
When people complained about the lack of substance to the
yearbooks at the time, they were told, simply, If it's
important to you, you won't need a yearbook to remember it
with. The response was unsatisfying then. It is even less
After reading the letter of Ray Gordon '66 [November], I turned to the cover of the magazine to see if I was reading the John Birch Society Magazine and not Johns Hopkins Magazine. He questions why Vinny De Marco, A&S '79, '81 (MA) ["Grassroots Guru," September], does not contribute his own money when he lobbies on behalf of victims of handgun violence, teenage smokers, and those without health insurance.
I have known Vinny De Marco since our days together at Hopkins. After graduating from Homewood and Columbia Law School, Vinny had the opportunity and the offers to work at every major law firm in this country. Instead, he has made a great financial sacrifice to choose a career as a public advocate. Thirty years later, he still lives in one of Baltimore City's great urban neighborhoods, rather than in an exurban McMansion. There is no question that, contrary to Mr. Gordon's suggestion, Vinny has "put his money where his mouth is."
Now to the substance of Mr. Gordon's aspersions: Thanks to Vinny, when the federal assault weapons ban expired, Maryland still had a strong ban on the books. Of course, with Maryland in the crossroads of major thoroughfares, gun laws will never be completely effective until passed on a national basis.
Thanks to Vinny, when Maryland's cigarette tax went up, teenage tobacco use went down. It is a matter of record.
Finally, thanks to Vinny, the Maryland General Assembly is
focusing on the needs of those who lack basic health
insurance in Maryland. The cost need not be borne on the
regular taxpayer, but on those employers who refuse to
provide their employees with basic health coverage.
In the November issue, we incorrectly credited the photographs in "Political Science." The photographs were taken by Claudio Vasquez and Peter Howard. We apologize for the error.
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