Suicide Prevention I enjoyed the Fall 1999 issue of HealthState, particularly the article on Karen Dunne-Maxim and her work in suicide prevention. In the "small world" department, I interviewed Karen Dunne-Maxim for the Princeton Packet in 1983, while completing an internship at one of its papers, the Windsor-Heights Herald. The result was a series of five or six articles on teen suicide, and I remember how helpful and knowledgeable Karen was to a young reporter. She has shed light on a very dark issue. Sheila Noonan Califon, NJ I read with interest your End Page article featuring Karen Dunne-Maxim. I recently lost a very close family member to suicide and the article made me feel a little more at ease with the situation. I would like to find out some more information about this subject. Does Ms. Dunne-Maxim have a support group, or can she refer me to one in my area? Thank you. Michele Sanzo-Laski, DMD Newark, NJ Ms. Maxim will be happy to direct you to a support group in your area. She can be reached at 732-235-9260. She works in the field most of the time, but if you leave a message, she will return your call. Volunteering to S.H.A.R.E. As a member of the UMDNJ community, I am writing to let you know about The S.H.A.R.E. (Student Health Advocates for Resources and Education) Center, a group of highly motivated medical students dedicated to creating partnerships with community-based organizations in Newark. The S.H.A.R.E. Center is a student-initiated, student-run organization that creates service-learning opportunities for medical students at UMDNJ-New Jersey Medical School. Students work with community members to improve quality and access to health care and education. The S.H.A.R.E. Center is primarily focused on four student-run community service programs: (1) The Student Family Health Care Clinic provides primary care for medically underserved families in the Newark community. (2) Community 2000 focuses on health promotion and disease prevention among the youth of Newark by offering educational workshops and health fairs. (3) STATS visits area high schools to distribute health education materials about HIV/AIDS, sexually transmitted diseases, and disease prevention. Group sessions are directed by medical students. (4) The NJMS student chapter of Operation Smile coordinates health care for children and young adults with facial, congenital, or other deformities who do not have the means for reconstructive surgery. If you are interested in becoming involved with The S.H.A.R.E. Center or have any comments or suggestions, please call 973-972-5685, or visit the website: www.umdnj. edu/shareweb Annette Pham, Student Director The S.H.A.R.E. Center Malpractice Website I'd like to alert your students and doctors to a new website, www.drwitherspoon.com, that analyzes medical malpractice cases for educational purposes. Each week, a case, selected for its learning value, is analyzed in a format that simulates how a case presentation might proceed during an "M&M" (morbidity and mortality) conference. "Dr. Witherspoon" is our crusty "chief of staff." This fictional character delivers a no-nonsense analysis of what went wrong and why. It is straightforward, informative and quite an entertaining read. Emphasis is on how mishaps can be prevented. Comments about legal proceedings, lawyers, etc., are purposely kept to a minimum. I'm the author of the site. The inspiration came from the "Grampaw Pettibone" series in Naval Aviation News magazine, a safety-related feature that has run since WWII. We think the site is a great learning tool, and hope you agree. John Kona, MD Williamsburg, VA Teens and Plastic Surgery Your article on teenage rhinoplasty (Spring/Summer 1999) treats this procedure as a no-brainer, as simple as trimming a toenail or cutting one's hair. The only concern you mention in your article is that of emotional maturity and realistic expectations on the part of the patient. Did the surgeon (Dr. Paul LoVerme) include any other warnings? Did he describe secondary atrophic rhinitis to the patient? If a breathing problem resulted from the surgery, did he assure the patient that some modification of the turbinate tissue is all that is necessary to correct the problem? My daughter, who had this simple procedure, is now disabled, unable to work. From this experience we have since learned that hundreds of other people, all victims of the act of "improving on nature," are similarly disabled. Physicians at the Mayo Clinic have prepared a paper on secondary atrophic rhinitis, and some doctors are calling for a clinical study on resecting the turbinate tissue as part of any rhinoplasty procedure. Sidney Etkin Caldwell, NJ Dr. LoVerme responds: The article in HealthState dealt with teenage cosmetic surgery in general and used the example of a rhinoplasty patient who was interviewed pre-operatively and post-operatively. Any surgical procedure carries risks and should never be regarded as something simple. Cosmetic rhinoplasty, however, does not include functional nasal surgery to straighten the septum or improve breathing and therefore was not discussed in the article. This article also was not meant to be a detailed medical review of all issues concerning nasal surgery. While the routine or radical resection of chronically enlarged inferior turbinates should not be performed, the judicious partial resection of turbinates which interfere with the essential functions of nasal humidification (warming and filtering of inspired air) is an essential component of nasal surgery in selected cases. Board Game Promotes Good Health I thought you might be interested in Infection, a new board game I invented that provides an educational, humorous look at medicine. It's designed for all age groups. Players start the game with five ailments passed out randomly. Whoever becomes healthy first wins the game. Players learn the common and medical names of the diseases, as well as symptoms, causes, and treatments. They visit specialists, clinics, drugstores, and even a voodoo doctor. They also leave behind - and sometimes catch - contagious diseases at the public restroom and swimming pool! Infection is a fun way to learn about health. The children at my mother's day care center enjoy playing Infection and can now tell you what causes rickets. A second edition of the game, designed for high school students, is in the works. For information about Infection, visit our website (Earwig.net) or write to me. Dan Sullivan Earwig Enterprises 1806 Milmont Ave. PM Box 102 Milpitas, CA 95035 More on Standardized Patients I enjoyed reading your article on standardized patients and student clinical evaluations in the last issue of HealthState. It was interesting, well presented and gave a clear and accurate account of how the testing is carried out. I would like to bring to your attention a program that has been developed to test the clinical competency of residents in physical medicine and rehabilitation (PM&R) at NJMS. In place for five years, the Objective Structured Clinical Evaluation (OSCE) program is the only one for PM&R residents in the country, and has been the subject of three articles in national peer-reviewed journals. The program was developed jointly by the Kessler Medical Rehabilitation Research and Education Corporation and UMDNJ-New Jersey Medical School and is under the direction of Sudesh Sheela Jain, MD, associate professor of PM&R at the school. Like the medical school OSCEs described in your article, the program requires students to examine patients in a clinical setting, make diagnoses and develop a treatment plan within a set amount of time. It is an excellent method to evaluate communication skills and clinical reasoning. The "patients" are actually able-bodied actors who have memorized scripts of symptoms and clinical findings. The students' performances are evaluated by the patients and faculty. The testing takes place at the end of every academic year and runs for two days. We currently have 20 scripts, and are continually writing more. The OSCEs enable us to use controlled grading criteria and they provide valuable feedback for both trainees and faculty. We would eventually like to make them a requirement for the completion of the residency. Joel A. DeLisa, MD Professor and Chair, Department of Physical Medicine and Rehabilitation UMDNJ-New Jersey Medical School Correction: In the article, "Lights, Camera, Action: Students Take Center Stage for Exam" from the Fall 1999 issue of HealthState, all photographs were taken by Peter Byron. We are sorry for the error. Winter Table of Contents HealthState Home The magazine of the University of Medicine and Dentistry of New Jersey