What's in a Name? Everything.

"A rose by another name would smell as sweet." - Shakespeare

What is the purpose of a rose? Is there just to smell? Is it there to look at? Would a rose by a different name and a different look smell as sweet? Let's rename a rose to a "Rat's Armpit." I am not sure that Rat's Armpit Gardens would be springing up in gardens in places like Greenwich, CT, and Bellevue, Washington. There is a lot in a name.

I was fortunate to get into medical school in 1979. I was also fortunate to attend the Albert Einstein College of Medicine of Yeshiva University in New York. Besides all the academic reasons I felt fortunate to be there, Albert Einstein was also a personal hero of mine.

When we first got there we were shown a brief newsreel clip of a press conference with Albert Einstein where he proclaimed that he was proud to offer his name to a medical institution. Einstein was truly a great person. With Newton, he shares the podium as the greatest geniuses of the last two millennia. He wrote extensively on world issues related to peace and the human condition. Paraphrasing the famous science writer CP Snow, commenting on Einstein's General Theory of Relativity proclaimed that while many of Einstein's great discoveries world have eventually been found by others, this particular advance would never have been conceived by any human for eternity. Pretty good stuff. It gives you a good feeling to be educated in his house.

Let's fast forward to our current times. Alumni and students at two venerable institutions of higher learning - Cornell University Medical School and Brown University Medical School- essentially found that their institutions renamed their medical schools.

When I heard the medical schools were to be renamed I was excited. I thought of all the amazing people in the past half century that could have qualified for such a high honor from two Ivy League institutions. There was Martin Luther King, John Kennedy, Richard Feynman, The Dalai Lama, Mother Theresa, Jonas Salk, Eleanor and Franklin Delano Roosevelt, Harry Truman, and countless others of recent heroes not to mention historical figures like George Washington Carver, Robert Oppenheimer, Woodrow Wilson, Harriet Tubman, Sojourner Truth, Abraham Lincoln, and others.

It was not meant to be.

Cornell renamed its medical school for Sanford Weill, the CEO of Citibank, and Brown renamed its medical school for Warren Alpert, a billionaire who made most of his fortune developing selling fuel and groceries through Xtra Mart stores in gasoline stations across the country. Wow. Free checking and chili dogs for all incoming first year medical students.

Don't get me wrong. This is not about Mr. Weill or Mr. Alpert who by all accounts are deeply generous and good people. They gave a lot of money. A lot of money. I mean a real lot of money. For that something should be named for them - a building, a division of the school (The Weill Division of Cardiology at Cornell, for example) - but the entire medical school? What was Ezra Cornell, chopped liver? The naming of something as precious as one of our 80 medical schools in this country should be reserved to remind the public of the truly great figures in our country's history and not the fattest wallets.

In my living room there is a unique black and white photograph hanging over the fireplace. It is a photo of Albert Einstein taken at Princeton University (will that soon become Sam Walton College?) in 1948. The photograph was taken by the great jazz photographer Hermann Leonard who was an apprentice at the time with the great portrait photographer Yusef Karsch. Mr. Leonard was a young kid at the time and Mr. Karsch gave him permission to take shots of Einstein on the set that Karsch set up.

A few years ago I was in Herman's house in New Orleans and saw this photo in a stack of long-forgotten images in a career known for capturing the essence of Billie Holliday, Ella Fitzgerald, Louis Armstrong and others. I acquired this rare print from Herman who signed it: Albert Einstein, Princeton 1948 on the Karsch Set, Herman Leonard.

My hero, the namesake of my medical school is in a proud location in my living room. I wonder if graduates from the Weill school are so proud of their alma mater's namesake to have him (probably on the 9th hole at an exclusive golf club) smiling at them from their mantle? Don't even go there with Brown's Alpert School of Medicine. Do they distribute cardboard Warren Alpert-shaped scents to hang from their mirrors in their cars? Give me a freakin' break.

Now I know what a few of the yo-yo heads out there will say. These men are great philanthropists. Mr. Alpert started the Alpert Award in medicine 14 years ago recognizing and funding important medical research. Sanford Weill is also a supreme philanthropist.

Philanthropy is not a profession. You can't be a "great" philanthropist. You can be a generous one, but greatness? Hey, it is the giving of money. It is not discovering a cure, a planet, and solution for peace. There are many generous philanthropists. I have an aunt who gives a hundred dollars every year to her favorite charity. There are countless who give weekly to their church when they pass around the basket. I don't see any medical schools named after them.

Is it volume or frequency that makes a philanthropist generous? Well, I guess in the naming of medical schools size matters. That's all that seems to matter.

Giving to others should be the ordinary, not the extraordinary. Naming a medical school should be reserved for the extraordinary. There is nothing extraordinary about amassing money. These two schools passed over countless of extraordinary Americans and Internationals and moved their school names into the realm of the deeply ordinary.

I am waiting for Harvard to change its name to R. A. Pit School of Medicine. I am sure Mr. Rats Arm Pit gave a ton of dough. I am sure it will be the same prestigious school.

A rose by any other name...

Dr. K.

Related Topics:

• WebMD Video: Mini Medical School for Middle Schoolers
• WebMD Video: Human Side of Being a Doctor

Technorati Tags: medical school, medical education, Brown University, Cornell University, philanthropy

Walter Reed: Dot the "i"s, Cross the "t"s, and Dig the Graves

Unless you have been living in a foxhole off the coast of a small island in the Pacific for the past sixty years you must know what has been going on at Walter Reed Army Hospital. What is coming out is a story of neglect of patients and the physical plant. A crime of monstrous proportions committed by hospital bureaucrats- these happen to be in the Army. For excerpts on the atrocities perpetrated on our wounded citizens you can go to this article. After you read it, you will probably want to declare war on the United States Army Medical Corps.

Why are we surprised at the substandard care at Walter Reed? Who has been watching them? Unfortunately this issue has not been covered by the media yet but the answer is even more troubling. The answer unfortunately has consequences for the care we receive at our own local hospitals where many hospital administrators spend most of their days filling out paperwork and glossing over inefficiencies to pass inspections from an agency called the Joint Commission on Accreditation of Healthcare (now referred as the Joint Commission). Every "i" is dotted and every "t" is crossed. Unfortunately, at the same time, every grave is being dug.

It appears that the the Joint Commission which accredits hospitals signed off on Walter Reed. Follow this quote:

"We're fully accredited by the Joint Commission on Accreditation of Healthcare Organizations, which awarded us a final score of 97 out of 100 during their regular inspection..."

Walter Reed Army Medical Center Web Site

I wonder what a score of 90 out of 100 gets you - cyanide PEZ dispensers?

In interviewing many doctors around the hospital, it seems that their own hospital administrators tout their Joint Commission stature but at the same time here are a few horror stories:

• A patient requiring intravenous antibiotics for six weeks was sent home on antibiotics by mouth so the hospital can save the nearly $800/day antibiotic dose. The patient was soon readmitted to another hospital after the life-threatening infection came back.


• A hospital had the opportunity to obtain a special blood salvage unit called an OrthoPat that would save hundreds of transfusions a year but chose not to get this because the administrator refused to make available the hospital nurse practitioner to start the unit the first day after surgery. I assume that contracting hepatitis is OK with this hospital administrator.


• After repeated requests a hospital administrator refused to allow the stocking of premium antibiotic bone cement once the supply from a previous "cheaper" vendor was found to be defective and at risk to the patients. Now the surgeons do not put the same antibiotics in to prevent infections.

None of the above breaks any Joint Commission rules but clearly break rules of a higher moral code. A code that many hospital administrators do not abide by. Their code is saving money at acceptable harm rates to patients...and of course, pass Joint Commission surveys.

Apparently, just recently the Joint Commission pulled a surprise two-day inspection at Walter Reed. Wow, what a surprise. Where I come from it is called trying to cover your rear end after the fact. Where was this commission before the surprise inspection? Shame on them.

Years ago, hospitals were run by doctors and nurses that actually cared for the patients and made all decisions in the patients' best interests. Now many hospital administrators make bottom-line decisions without patient care and safety being their most optimal concern. They don't make decisions by moral reason but rather on the selective and arbitrary enforcement of hospital rules and by-laws. Anything to save money and pass those accreditation surveys. They will need all the help they can get because if Walter Reed scored 97 out of 100, your hospital will need to score 1000 out of 100 just to prevent killing a healthy patient. That ain't happening on this planet.

Now I know that when a hospital has a ground breaking ceremony they have a photo of the administrators and Board of the hospital digging the ceremonial first holes with a shovel. After the building is built they will need those shovels to dig the graves of those patients who died due to their bonehead decisions once the building started taking patients. At least they saved some money on extra shovels. I bet these shovels are accredited by the Joint Commission as well.

Dr. K.

Related Topics:

• Cost: A Deadly Barrier to Health Care
• U.S. Health Care: Pay More, Get Less?

Technorati Tags: Walter Reed, hospital, hospital safety, healthcare