Who's minding the bookstore?

Don Levy's career has taken him from reporting to academia and, now, to selling medical textbooks.

By Cathy Shufro

Yale Medical Bookstore manager Donald M. Levy was ringing up three hefty surgery texts when he suggested to the customer, a surgical resident, that he take a look at Zollinger’s Atlas of Surgical Operations.

Levy wasn’t expecting to make a sale: the Atlas costs $199, about what the resident had just spent. Nevertheless, the surgeon opened the book, checked the index and began reading. “This is the operation I had to do yesterday,” he said. “If I’d had this book, I would have been better off.” He bought the book.

Making that sale wasn’t Levy’s primary motive. “I don’t like being sold stuff, myself,” says Levy, a warm, talkative man who remembers customers by name. “There’s a subtle difference between offering and selling.”

Levy has managed the store at 320 Congress Avenue, which is owned by Barnes & Noble, since it opened in October 2001. He came to the medical school campus from the main Barnes & Noble store on Broadway. But before he got into the book business he spent 10 years as a television reporter in upstate New York, Vermont, Ohio and Kentucky.

A complex career path next led him into journalism education at Syracuse University; graduate studies in religion at Yale, where he received a master’s degree in 1992; and a brief tenure running his own company selling out-of-print volumes in philosophy, psychology and religion. When the advent of Internet shopping undermined his sales, he joined Barnes & Noble.

Running the store gives him a chance to draw on his interest in religion and healing. For example, to customers fresh from the doctor’s office he can recommend a mass market book on diabetes or heart disease “You’re kind of being pastoral.” he says. “You show them the section and maybe you ask a few questions.”

The bookstore offers shelf after shelf of review books and primers like Clinical Microbiology Made Ridiculously Simple and Laughing Your Way to Passing the Pediatrics Boards. Also for sale are medical accessories and necessities, including one big seller, a $16 dissection kit. It contains tweezers, pick, scalpel, scissors and replacement scalpel blades in a box—“all Larry Rizzolo-approved”—a reference to Lawrence J. Rizzolo, Ph.D., one of the directors of the first-year anatomy course. The store also carries tuning forks, Babinski hammers and stethoscopes.

“I really like selling ’scopes,” says Levy after watching a student equivocate between navy and burgundy models. “It’s an important purchase, and it’s a personal fashion statement.”

Levy welcomes ideas from customers. “My customers help me manage my bookstore if I’m careful to listen to them,” he says. He started carrying cotton lab coats when customers requested them and he listens to the medical students who compare notes on various texts. “I like it when students come in really informally and pick each other’s brains,” says Levy. He began the year with four student texts for hematology. Very quickly, students had reached a consensus that Hematology at a Glance was the best.

Even when students are looking for a particular title, Levy likes to suggest alternatives. “They will come in and say ‘Do you have that blue book for ICU?’ I tell them, ‘This is the book they told you to get. It’s a great old book, but it’s 1998. This is the standard, but I want you to look at this.’ ” Then he’ll show them another guide, published in 2001. “That way,” he says, “they feel like they made a much more informed purchase than if they came in like lemmings and bought the one they were told to buy.” YM

Bookshelf is a column in Yale Medicine focusing on matters related to books and authors at the School of Medicine. Send ideas to Cathy Shufro at cathy.shufro@yale.edu.

Book notes

Leave No Child Behind: Preparing Today’s Youth for Tomorrow’s World
by James P. Comer, M.D., M.P.H., HS ’66, associate dean of the School of Medicine and the Maurice Falk Professor of Child Psychiatry in the Child Study Center (Yale University Press) Comer offers proof that students from all backgrounds can learn at a high level, adopt positive attitudes and prepare for fulfilling adult lives if they learn in schools that provide adequate support for their complete development. Comer draws on his own experiences as the creator of the School Development Programs.

Metamorphoses: Memoirs of a Life in Medicine
by William G. Anlyan, M.D. ’49 (Duke University Press) Born in Alexandria, Egypt, in 1925, Anlyan attended Yale as both an undergraduate and a medical student before leaving for Duke University in 1949 for an internship in surgery. Among other things, he describes changes in the world of medicine, recalling an era when medicine focused on controlling infectious diseases like tuberculosis and polio.

What Every Senior Needs to Know About Health Care
by James J. Nora, M.D. ’54 (University Press of Colorado) This guide to the medical, financial and social issues of today’s American health care system is written for people 50 and older. The author discusses mental and social health, elder abuse, retirement, end-of-life issues and health maintenance strategies involving nutrition, fitness and the avoidance of risk factors.

The Packard Weight Health Plan: A Medically Based 5-Step Program for Permanent Weight Loss
by Andrew R. Packard, M.D. ’77 (Ballantine Books) Packard, who in his medical practice sees the chronic pain and illness that are directly related to excess weight, details his plan for “weight health” for life—one that is not a diet plan. The key to regulating weight, he feels, lies in understanding the triggers for releasing the neurohormones dopamine, serotonin, GABA and endorphins and other hormones like leptin, insulin and ghrelin.

Hyperbaric Medicine Practice, 2nd ed.
edited by Eric P. Kindwall, M.D. ’60, and Harry T. Whelan, M.D. (Best Publishing) An international group of more than 40 hyperbaricists provides practical information on the application of hyperbaric oxygen therapy in the treatment of patients.

The Doctors’ Plague: Germs, Childbed Fever, and the Strange Story of Ignac Semmelweis
by Sherwin B. Nuland, M.D. ’55, HS ’61, clinical professor of surgery (W.W. Norton & Co.) Before the discovery of bacteria and bacterial diseases and before Pasteur, Lister and Koch, the mid-19th century Viennese physician Ignac Semmelweis insisted that doctors should wash their hands before examining patients. Although his observations were largely ignored in his lifetime, Semmelweis is remembered for this now commonplace practice.

Clinical Management of Hypertension, 7th ed.
by Marvin Moser, M.D., clinical professor of medicine (Professional Communications) This book reviews the results of major clinical trials completed over the past 20 years, with special emphasis on newer trials completed within the last several years. The author discusses treatment of hypertension and reviews drug therapies.

Understanding Cosmetic Laser Surgery: A Description of the Processes and Procedures Available in Cosmetic Laser Surgery
by Robert C. Langdon, M.D., HS ’84, assistant clinical professor of dermatology (University Press of Mississippi) Laser treatment is an alternative to more invasive cosmetic procedures and can be used to reduce facial and body scars and remove lesions, tattoos and hair. In this book for the general reader Langdon describes the technology of the laser as well as the basics of laser surgery, its risks and postoperative recovery.

Discrete Distributions: Applications in the Health Sciences
by Daniel Zelterman, Ph.D. ’83, professor of public health (biostatistics) (Wiley) This book provides an overview of discrete distributions and their applications in the health sciences. Zelterman focuses on real examples, giving insight into the utility of the models, the properties of each distribution and the methods that led to their development. Examples come from the health sciences, including cancer and epidemiology, and from demography.

On the Take: How Medicine’s Complicity With Big Business Can Endanger Your Health
by Jerome P. Kassirer, M.D., adjunct professor of medicine (Oxford University Press) Compiled from interviews with hundreds of physicians, Kassirer’s book delves into the kind, extent and consequences of physicians’ collaborations with industry.

Pediatric Toxicology: Diagnosis & Management of the Poisoned Child
by Timothy B. Erickson, M.D., William R. Ahrens, M.D., Steven E. Aks, O.D., Louis Ling, M.D., and Carl R. Baum, M.D., assistant professor of pediatrics (McGraw-Hill Professional) Evidence-based and age-specific, this book guides the clinician through the diagnosis and management of the poisoned pediatric patient. Features include case presentations throughout; a self-assessment section with more than 200 questions; antidote dosage tables; color plates; and coverage of herbal products, vitamins, cosmetics, spider bites and snake bites.

Atlas of Foot and Ankle Sonography
by Ronald S. Adler, Ph.D., M.D., Carolyn M. Sofka, M.D., and Rock G. Positano, D.P.M., M.Sc., M.P.H. ’89 (Lippincott Williams & Wilkins) This atlas is a complete guide to using ultrasound to diagnose foot and ankle disorders. More than 160 illustrations display both normal ultrasound anatomy and a variety of pathologic states.

Clone Being: Exploring the Psychological and Social Dimensions
by Stephen E. Levick, M.D., HS ’78 (Rowman & Littlefield) Levick uses narratives of patients from his own practice along with studies of twins, namesakes, adoptees and offspring of famous parents to anticipate the challenges that human clones and their “families” will face and how to meet their psychological and social needs.

Against the Spirit of System: The French Impulse in Nineteenth-Century American Medicine (paperback)
by John Harley Warner, Ph.D., professor and chair of the history of medicine, American studies and history (Johns Hopkins University Press) Warner describes how, between the 1810s and the 1860s, when Paris emerged as the center of Western medicine, hundreds of Americans studied in Parisian hospitals and dissection rooms and then applied their new knowledge to advance their careers at home and to reform American medicine.

A Woman’s Guide to Sexual Health
by Mary Jane Minkin, M.D. ’75, HS ’79, clinical professor of obstetrics, gynecology and reproductive sciences, and Carol V. Wright, Ph.D. (Yale University Press) This guide includes explanations of how the female body works, problems that may arise and comprehensive solutions for women of all ages who are concerned with their reproductive health.

The Early History of Hospice Buffalo
edited by Abel K. Fink, Ed.D., and Donald P. Shedd, M.D. ’46, HS ’53 (The Center for Hospice & Palliative Care) This book traces the course of Hospice Buffalo from its inception in 1974, including the educational effort that was required to convey to the public and the professions the full meaning of the hospice concept.

The Whistlers’ Room: Stories and Essays
by Richard A. Selzer, M.D., HS ’61 (Shoemaker & Hoard) Selzer’s latest book contains 24 pieces from diaries, memoirs and essays. The title piece is the story of three World War I soldiers who were shot in the larynx and could only communicate by forcing air through tubes in their throats.

The descriptions are based on information from the publishers.

Send notices of new books by alumni and faculty to Cheryl Violante, Yale Medicine, P.O. Box 7612, New Haven, CT 06519-0612, or via e-mail to cheryl.violante@yale.edu.

In Circulation

Gift endows library post and pays tribute to “a nurturing treasure”

John Robinson Bumstead surely knew the story of how his father became the first physician to administer penicillin in the United States. He was 17 years old in March 1942 when his father, John Henry Bumstead, M.D., was caring for 33-year-old Anne Miller. Neither transfusions nor surgery nor sulfa drugs had cured Miller of a streptococcal infection. She was dying and Bumstead was desperate. His colleague, physiologist John F. Fulton, Ph.D., M.D., had befriended the Australian researcher Howard W. Florey, Ph.D., and helped him come to the United States to begin production of penicillin; Bumstead asked Fulton to obtain a sample of the still-experimental antibiotic. It worked, and Miller lived to be 90.

When he died in July 2003, the younger Bumstead remembered in his will the medical library, as well as Connecticut’s historic Mystic Seaport, where he was a librarian, and New Haven’s St. Thomas’ Episcopal Church, where he was a parishioner. Bumstead left $1.2 million to the Harvey Cushing/John Hay Whitney Medical Library. Director R. Kenny Marone, M.L.S., used the gift to endow a librarianship at what she calls “one of the premier medical historical libraries in the world.”

Built in 1940, the library was established by three men who donated their collections of tens of thousands of volumes of medical literature: neurosurgeon Harvey W. Cushing, M.D.; Swiss tuberculosis specialist Arnold C. Klebs, M.D.; and Fulton. Cushing, says librarian Toby Appel, Ph.D., M.L.S., saw the library as “the heart of the medical school,” a uniting force in an age of increasing specialization. Thanks to Bumstead’s gift, Appel is now the John Robinson Bumstead Librarian for Medical History.

The two-story room that holds much of the 125,000-volume historical collection has a vintage air, with a vaulted wooden ceiling, twin balconies and a fireplace. “There’s something special when you can walk in and see Volume One of The Lancet,” says Marone. “We just have marvelous resources.” Among those using the historical library now is medical historian Michael Bliss, Ph.D., at work on a biography of Cushing.

Surgeon, historian and writer Sherwin B. Nuland, M.D. ’55, HS ’61, is among those who have written about the room and its “treasured stacks.” In Doctors: The Biography of Medicine, he writes: “Of all the libraries in all the educational institutions of our world, there is none quite like this one. … a sanctum containing the lore and the collected reminiscences of the art of healing ... a nurturing spring for renewal and strengthening of purpose.”

—Cathy Shufro



Farmer		Rosenberg



Paoletti		Ruffin

On campus

A human rights view of health care

“What is the cost of not doing the right thing?” Paul Farmer, M.D., Ph.D., asked in March during a talk sponsored by the Diversity Action Committee at the School of Nursing. With that question he challenged the cost-benefit analysis that underpins most global health projects.

In Haiti, where he has spent most of his career, no patient, he said, has ever told him, “Thank you very much for offering me this therapy, but it’s really not cost-effective here.”

In 1987 Farmer co-founded Partners In Health (PIH), which is dedicated to improving health care in poor countries. PIH’s low-cost projects have achieved impressive outcomes in settings where resources were thought to be too scarce to make modern interventions practical. Their cure rate for multidrug-resistant TB—using innovative drug procurement strategies and locally trained community health workers—was 83.3 percent in the slums of Lima, Peru. The same model delivers antiretrovirals for aids patients in rural Haiti and in inner-city Boston.

He urged his listeners to have a “technically correct human rights perspective,” in which feasibility is a problem to be solved, rather than an excuse for inaction.

—Colleen Shaddox

Cautious excitement about a “living cancer reagent”

The patient was a 57-year-old radiologist with advanced melanoma. The treatment was experimental—it combined immune-sensitized T cells with chemotherapy, and it had worked for a 16-year-old boy at death’s door. After years of unsuccessful trials, the therapy had evolved to the point where it made a volleyball-sized tumor disappear from the boy’s pelvis and left him free of disease.

Did the new patient want to try it? “He said, ‘Absolutely, doc. I want to receive this new treatment while it’s still working!’ ” recalled Steven A. Rosenberg, M.D., Ph.D., head of the surgery branch at the National Cancer Institute.

The patient was joking, but years of effort with vaccine and cell transfer therapies for cancer are starting to pay off, Rosenberg said at Cancer Center grand rounds in May. Combining CD4 cells with sensitized CD8 cells in the right proportion made the difference. “We gave the [16-year-old] patient a cell packet of 23 grams, and it made over half a kilogram of tumor disappear,” he said. “The reason is that it’s a living cancer reagent. These cells continue to live and produce anticancer activity inside the patient.”

—Michael Fitzsousa

Art and plague in the Middle Ages

When the plague reached Europe in 1348 it was seen as a divine punishment. How else to explain a disease that killed entire families with no regard for their station in life and wiped out as many as two-thirds of a city’s inhabitants?

Along with the civic disruption came a spiritual catastrophe. The plague struck so swiftly that it denied its victims the chance to indulge the rituals that eased the passage to death, said John T. Paoletti, Ph.D. ’67, professor of art history at Wesleyan University.

As the plague spread, artists turned to images of Madonna of the Misericordia and St. Sebastian, protectors against the plague, Paoletti said. Cherubic angels flinging arrows at their victims symbolized the still-unexplained plague as victims sought protection from saints and the Virgin Mary, who offered her cloak as a shelter. Medicine of the time offered little hope against the plague.

“Your salvation is dependent upon a confession, on other sacraments, sometimes the Eucharist,” he told an audience at the Program for Humanities in Medicine in April. “The doctor is dead. The confessor is dead. And if they’re not, they’re not going to come to your house.”

—John Curtis

Striving not to narrow, but to eliminate, racial disparities

For years health statistics have revealed a grim dichotomy—members of racial and ethnic minority groups bear a greater burden of chronic and infectious disease. “The problem is here because we ignored the warning signs,” said John Ruffin, Ph.D., director of the National Center on Minority Health and Health Disparities.

Addressing an audience of health care providers at the annual meeting of the Division of Prevention and Community Research at the Department of Psychiatry in April, Ruffin said, “If health disparity is to be eliminated it is going to be eliminated by you, not by us in Washington.”

To that end Ruffin has worked to provide the tools to health care professionals. New programs to investigate health disparities, he said, will repay student loans of physicians, establish centers of excellence and endow underfunded institutions. The NIH has also adopted a strategic plan to address health disparities.

“I do believe we are not talking about narrowing health disparities,” Ruffin said. “I really believe we are talking about eliminating health disparities.”

—J.C.


			Originally published in Yale Medicine, Fall/Winter 2004. Copyright © 2004 Yale University School of Medicine. All rights reserved.