thoughts on the february issue

From Eileen Duncan

I was thrilled to arrive home and see the February issue in the mail today. I am the mother of Carolyn Duncan '02 and I have been involved with school gardening since 1987. My children, including Carolyn, grew up around and involved with these greening efforts. I am familiar with the Edible Schoolyard and although we have had different partnerships in Los Angeles with hundreds of school gardens, there is a program being developed that will be similar to the Edible Schoolyard with a chef in this area, Nancy Silverton (La Brea Bakery), Linda Slater, teacher at 24th Street School, and support of community and fellow master gardeners. I am going to refer the other master gardeners I have the pleasure of working with to your website for the February issue as well as about 60 schools I network with throughout Los Angeles. Keep up the wonderful work!

remembering carlton whitehead

From John (Klempner) Bear '59

Reading Carlton Whitehead's obituary reminds me, once again, that this man did more to change my life than anyone else. My parents bought into the housing cooperative he managed, and we ended up living a few doors away when I was in high school. While weeding his geraniums for 50¢ an hour, I told him of my plan to major in physics at CalTech. His relentless message to me, and my parents, was that if I lost interest in physics while at CalTech, there was no easy alternative, while if I majored in physics at his place (Reed), there were dozens of other interesting options. His argument won the day, and my, was he right. I was a physics major at Reed for about three days (in my heart; a bit longer on paper), discovered the social sciences, switched to psychology, and never looked back.

kudos on the calendar

From Robert Myers '61

Colin Diver must be the most eloquent writer and penetrating thinker of all college and university presidents. It may not have been his idea to make words the feature of your 2005 Reed calendar, but his own words, along with the poetry and the weathergrams of Lloyd Reynolds, have made this year's calendar unique and outstanding. An inspiration. Although I have read the articles and letters in Reed magazine about Lloyd, I have forgotten his vital statistics. Could you let me know what they are?

[Ed. Note: Lloyd Reynolds was a master calligrapher and professor of English and art at Reed; read more information, including the Lloyd Reynolds Collection given to the Reed library, on the library site.]

more memories of jerry barta

From Jim Borders '63

The news of Jerry Barta's passing reminded me of something that could have only happened at Reed. It was the fall of 1959, and after an afternoon in freshman physics lab (the lab was located in the northwest corner of the Eliot Hall basement in those days), I wandered down to the track where a friend of mine was running in a meet. I think it was against the Portland State PE majors. Jerry walked up to me as I watched, handed me a pair of track shoes, and calmly informed me that he needed another person to run the mile and since I was there, I was it. I did and to this day I don't understand how I managed to come in second (out of four).

cost of malpractice

From Michael Mahoney '62

Carl Stevens, from whom I took Economics 201 a few years ago, points out (Reed, November 2004) that the cost of malpractice coverage is a comparatively small part of the total cost of health care, and suggests that a patient would probably want to be able to seek compensation in the event that the physician botched the job.

These periodic malpractice crises, where doctors receive staggering premium increases or companies threaten en masse to leave the state, usually triggered not by a change in the litigation scene but by a drop in the stock market, sometimes lead to legislative attempts to curb patients' rights to compensation. And yet one has the feeling that the doctors do not object to the high premiums so much as to the uncertainty of being hit with a severe increase. We buy insurance to protect us from uncertainty; yet the one uncertainty we are not protected from is the uncertainty of next year's premium.

One hesitates to use the "R" word, but maybe a touch of regulation is indicated here. If insurers were told that they could charge any premium they liked to start, but could not increase it more than, say, 5% in each following year, they might become a bit more responsible in their underwriting projections, and the market for insurance could be left to take care of itself.

From Lance Montauk '71

I read Carl Stevens' "The Medical Malpractice System and Tort Reform" and the two follow-up letters. I fear both Professor Stevens and those who replied miss the main issue.

The professor points out that malpractice premiums total only 1% of personal health care expenditures; in reply, Mssrs. Daehler-Wilking and Schiesser fret that malpractice suits drive doctors from practice, and endanger future physician-supply. Professor Stevens states that health care consumers are "passive bystanders caught in the crossfire" between lawyers, whose suits "improve the quality of medical care by serving to deter provider negligence," and doctors, who work in a "litigation climate (which) promotes fear and secrecy." While I agree doctors work in fear, I'm not sure medical malpractice suits improve care.

A patient under the beam of an unneeded CAT scan or at the end of a needle drawing blood for an unnecessary exam is not a "passive bystander"; s/he is a victim of our tort system, on the receiving end of invasive tests—with their known negative consequences—due to litigation fears. A growing proportion of the total radiation exposure of the U.S. population is now from diagnostic CAT scans. In the ER where I practice, many tests are ordered due to fear of medical malpractice suits. All the societal pressures encourage doctors to do more tests—especially scans. The cancers caused decades hence by scans we do now will never be attributable to the physicians who ordered them, but a single lawsuit following a scan that wasn't done mars the doctor for life. Physicians wish—at all costs—to avoid litigation, since dismissal, winning at trial, or a capped award, are Pyrrhic victories. Radiating a patient seems a small price to pay for security, and this motivates doctors, consciously or otherwise.

I try to avoid ordering tests due to my anxieties regarding potential lawsuits. For many years now—compared to other physicians where I work—my patients' testing and care costs run about 1/3 less than average. These patients also leave the emergency department faster, and thus others wait less.

In essence, I suspect the cumulative effect of our tort system right now worsens the quality of care emergency patients receive. Is this worth 1% of our personal health care expenditures?