Putting an end to pain
Economics training vital to foreign service
In search of alumni veterans
Dig out those dusty scrapbooks
Stopping the decline of songbirds
A sour note
Keeping Kelso Morrill's memory alive
The "devastating" threat of bioweapons
Setting the record straight

Putting an end to pain

I was extremely interested in Melissa Hendricks's article "Just Give Me Something for the Pain" in the June issue.

My son was diagnosed with non-Hodgkins histiocytic lymphoma in 1978 and died four years later at age 24. During the last months of his life he had a cough that at times was so severe he broke a rib when coughing. The only thing that relieved the cough was codeine. However, his primary physician, a hematologist-oncologist, was extremely reluctant to prescribe this medication. Less than a month before my son's death he told me, "We can beat the cancer, but we can't beat the drugs." It was his psychiatrist, a doctor who had been an internist before training in psychiatry, who told me at about the same time that my son did not have long to live, and to "give him all the codeine he wants."

That his oncologist could refuse palliative medication to a patient he knew to be near death was at best unthinking, and at worst cruel. At that point, the possibility of addiction should have had no bearing on the decision of whether or not to prescribe a medication that would have alleviated the suffering of his last weeks.

I sincerely hope that the work of physicians like Dr. James Campbell will educate those in the medical profession so that others do not have to suffer as my son did.
Olga Hughes
New York, NY

Senior science writer Melissa Hendricks responds: The recent discovery of a genetic basis for pain sensitivity may one day help physicians make wiser decisions about pain treatment. As we were going to press we learned that Hopkins neuroscientists have found that mice and people with greater numbers of mu receptors appear to be less sensitive to pain. Mu receptors occur along pain nerves and are the binding site of the body's natural opiates, as well as morphine. The difference in receptor number stems from differences in the gene that codes for the mu receptor. PET scans at Hopkins have shown that the number of mu receptors in humans can differ dramatically: some people have twice the number of receptors in certain parts of the brain than do others.

The researchers, led by Hopkins neuroscientist George Uhl, reported these findings in the July 20 Proceedings of the National Academy of Sciences.

The implications are that one day pain specialists might be able to use a genetic test for the mu receptor to calculate precisely how much pain medication a patient requires and can tolerate--or even to test a person's susceptibility to drug addiction. Pain control may become less arbitrary and more of a science.

Economics training vital to foreign service

In an effort to draw sharp distinctions in "Is SAIS's Soul at Stake?" (June) Joanne Cavanaugh unfortunately mischaracterizes the skills needed in the modern foreign service. Her assumptions that a career in the foreign service and a firm grounding in economics are mutually exclusive may have been true in the 1970s, when the State Department's lackadaisical attitude toward commerical promotion in particular gave rise to the Foreign Commercial Service under the Commerce Department. But they are certainly not true in the 1990s, when economic issues have come to the fore of U.S. diplomatic efforts, and ambassadors are charged with being the "lead commercial officer" in a given country.

In fact, Cavanaugh's whole thesis can and should be flipped on its head: SAIS's emphasis on economics sets it above and apart from other "international schools" in preparing its students to be successful foreign service officers. SAIS continues to maintain its status within the foreign service as probably the best master's-level preparation available. That's as true for our new ambassador to Thailand, Richard Hecklinger (SAIS '67), as it is for the new State Department desk officer for Thailand (me, SAIS '92). While our relationship with Thailand, one of five treaty allies in Asia, traditionally has focused around security issues, counternarcotics, and refugees, since 1997 economic issues have predominated. Addressing the effects of the Asian financial crisis, which started in Thailand, means understanding the underlying dynamics, engaging the Thai on monetary policy (SAIS grad and Treasury Undersecretary Tim Geithner plays a key role here) and international financial architecture, and helping craft a targeted assistance program emphasizing increased transparency and social safety net coverage.

Without the benefit of a firm grounding in trade and monetary issues, a foreign service officer simply can't do his/her job well these days--or represent U.S. interests overseas. While I handle the whole range of issues in U.S.-Thai relations, probably 75 percent of my work of the last year has been economic. Of course, that could change dramatically in the next year, or in my next assignment in the foreign service. But that's the beauty of a SAIS education--it is well-rounded, and prepares its students (those in the foreign service in particular) for the varied challenges in the international arena. SAIS should be commended for retaining the curriculum's relevance.

What SAIS grads choose to do with their degrees is, of course, entirely up to them!
George Kent (Bologna '91, SAIS '92)
KentGP@state.gov

In search of alumni veterans...

During a recent alumni reunion, a number of us discussed the fact that we knew of no memorial in Gilman Hall in remembrance of the Hopkins men who lost their lives in Vietnam or Korea. We have begun planning for an appropriate memorial plaque and have begun gathering the names of the Hopkins graduates and students who lost their lives in these conflicts.

If any readers know of any former Hopkins students who died in the Korean or Vietnam wars, I ask that they forward the names to me at 204 West Queens Drive, Williamsburg, Virginia 23185-4919. Call me at (757)229-7370, or send e-mail to me at mhaas504@sprynet.com. Copies of printed obituaries are especially helpful.
Michael Allan Haas '67
Lt. Col. (Retired), Judge Advocate
Generals Corp, U.S. Army
Williamsburg, VA

Dig out those dusty scrapbooks

Have you been wondering what to do with those pictures and mementos from your time at Johns Hopkins? Dig them out--right now--and submit them for possible publication in the book being prepared as part of the celebration of the university's 125th anniversary. Images and artifacts in all formats will be considered, so don't be shy about sending anything, from professional color slides to snapshots.

The book will feature all aspects of the university, so scenes from Homewood to East Baltimore, from APL to all SAIS locations, are needed urgently. It makes no difference whether your material is black and white or color--I want to see it all. Original material will be returned after the book is published in October 2000.

If you have images--or if you can point me to friends who kept scrapbooks or took lots of pictures--please contact me at 4545 North Charles Street, Baltimore, Maryland, 21210 or mew@jhu.edu, or call me at (410) 435-5314.
Mame Warren, editor
125th Anniversary Book

Stopping the decline of songbirds

I enjoyed your April issue, and especially the article "The ABC's of Birdsong." I hope this well-timed article about the songs of birds enhances your readers' appreciation for birds and their habitats because we are losing both at alarming rates. Our long-term prospects for enjoying birds depend in large measure on how well conservationists can engage the public in working to stop their decline.

To that end, I suggest an amended ABC's for birds: A is for advocacy of policies that protect birds and their habitats, or at least do not damage them. B is for building bridges to Latin America and the Caribbean, where many of our migratory species spend more than half their lives. C is for conserving habitat for birds and all biodiversity before it is too late.

American Bird Conservancy (ABC) is dedicated to just those principles. ABC builds broad coalitions of groups, agencies, and individuals to address poor policy, habitat conservation, and the need to assist budding conservationists throughout the Americas. Interested Magazine readers can learn more about the issues and what can be done to solve them by contacting ABC at P.O. Box 249, The Plains, VA 20198, (540) 253-5780, or fax (540) 253-5782.
George H. Fenwick (PhD '84)
The Plains, VA

A sour note

Your beautifully done article, "The ABC's of Birdsong," contains one very sour note. Several of the experiments behind the story involved deafening songbirds. I am appalled that a human being who knows how essential song is to a bird would deafen birds just to find out what would happen. It isn't worth ruining the life of a single bird just to see how it sings or hears. I wouldn't contribute a penny to such an enterprise.
Max Heppner
Baltimore, MD

Keeping Kelso Morrill's memory alive

In a fall 1994 article in Johns Hopkins Magazine, I announced plans to establish an award in honor of my father Kelso Morrill, and requested stories about his work in the classroom. I received some wonderful stories, many of which I've shared each spring during the presentation of the William Kelso Morrill Award for Excellence in the Teaching of Mathematics, which goes to the math graduate student who most displays the traits of Kelso Morrill--love of teaching, love of mathematics, and concern for students. The letters are kept in a scrapbook in the math department on the fourth floor of Krieger Hall.

I feel there are many more stories to be told. If you have one to share, please send it to me:

Jeanne Morrill Owings
Hopkins Dept. of Mathematics
3400 N. Charles Street
Baltimore, MD 21218

The "devastating" threat of bioweapons

"Rx Against Terror" [February] was a necessary firebell. With the threat of bioterrorism, the unthinkable has become plausible. Former Dean Donald Henderson and the Hopkins Center for Civilian Biodefense Studies are to be commended for their foresight in spearheading public education and proposing biodefense strategies in a think tank environment.

In the long term, it is apparent that the strategic application of bioweapons is both more likely and devastating than bioterrorism alone. This concern extends far beyond Iraq's upstart bioarsenal and its shell-game strategy to confound U.N. inspectors. I refer readers to Ken Alibek's account in Biohazard (Random House, 1999). Dr. Alibek, a witness before the Biodefense Center, is the 1992 defector and ex-director of the Soviet Biological Weapons Program who identified offensive bioweapons research, production, and testing facilities within what is present-day Russia and other former Soviet republics. Preparations included genetically engineered (bacterial and viral) pathogens and protocols for weaponizing these deadly agents into warhead components. Soviet scientists found that viral pathogens make excellent bioweapons: They store well in the inert state, require few viral particles to infect, are not susceptible to antibiotics, and can be readily packaged in a warhead and delivered as an aerosol. Ironically, Soviet reconnaissance in the late 1980s found evidence of hemorrhagic fever outbreaks in northeastern China, ominously near a large "fermenting plant" (ibid). Suspect pathogens included the highly infectious viral agents of Ebola, Marburg, and Lassa fevers.

Given: (1) dissolution of the Soviet Union and its scientific infrastructure; (2) aggressive foreign acquisition, by espionage or purchase, of U.S. ballistic missile technology, should we not infer that bioweapons technology constitutes a potential warhead for would-be superpowers as well as rogue states? Bioweapons could be deployed as a "poor nation's neutron bomb": Civilian populations or troop concentrations would be decimated by extensive morbidity/mortality while physical infrastructure remained intact.

Development of strategic biodefensive public health responses and clinical countermeasures is not in our long-term national research budgets. As future geopolitical events catch up with the facts, however, we will be compelled to implement the most feasible of these proposals. I can empathize with Dr. Henderson's lament: "I never thought smallpox would return. Ever. I resent it." His successful smallpox eradication program (1966-1980) assumed prima facie that it was everyone's desire to eliminate clinical manifestation of the most virulent pathogens. We can no longer afford to make that assumption.
Garry M. Marley, PhD (MSc '78)
gmarley@gateway.net

Setting the record straight

In the Letters section of our June issue, the letter titled "A look back at Hopkins postdocs" was contributed by Kenneth Zeiler, MD, professor emeritus of medicine and of physiology--not Kenneth Jeiler, as we mistakenly printed. And in "more insight on millennial matters," contributed by Franklin M. Wright '59, the founding of Rome should have read 753 B.C. We apologize to both letter writers for our mistakes. Wright took the typo in stride and actually wrote to correct one small error in his original letter: The Anglo-Saxon king who presided over the Council of Whitby was Oswy of Northumbria. --SD

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