Duke University Alumni Magazine


uke Medical Center was front and center with a thirty-six page cover story--"A Week in the Life of a Hospital"--in Time magazine's October 12 issue. In introducing the special report inside, the magazine described the nature of modern medicine: "The same urgency and intellect that America's teaching hospitals apply to saving lives is now also going into saving the institutions themselves. All across the country, academic medical centers are trying to figure out how to marry progress with profits. At the Duke University Medical Center, Time visits the front line in the war between money and medicine."

According to university public-affairs officials, Time chose Duke over other academic medical centers because of Duke's creative responses to the new health-care environment, and also because of the range of medical news with a Duke focus.

Journalist Nancy Gibbs, who worked with a team of eight reporters (most of them non-specialists in the medical sciences) and six photographers in September, received praise from medical center staff. "I am really pleased. It's a beautiful piece of work," Ralph Snyderman, chancellor for health affairs, told The Chronicle. Snyderman, who was described by Time as Duke Medical Center's "chief visionary," said the article "captured" the medical center: "They realized that this is a very special slice of life."

"I didn't find the cameras or reporters to be disruptive to me," said Pierre Clavien in The Chronicle. "We had a good relationship," said the associate professor of surgery, who performed the partial liver transplant that was featured in the story and on the magazine's cover.

Duke's "new approach" to health care was the story's underlying theme. "People will hopefully better appreciate us for the value we deliver in the community as providers of everything from great primary care to the most complex of high-tech care," said Peter Kussin, chief medical officer at Duke Hospital. "We are pushing the envelope trying to figure out how to be a health system and good, old-fashioned doctors at the same time. If any place can do it, Duke can."

For an online version of the special issue, check Time's archives at www.time.com.


Gates: supporting independent thinking for University Scholars
Photo: Les Todd

$20-million endowment gift from Duke trustee Melinda French Gates '86, M.B.A. '87 and her husband, Bill Gates, will launch a pioneering academic program expanding teaching and research across traditional disciplinary boundaries. President Nannerl O. Keohane announced the gift in September, saying that she expects the new University Scholars program, which also will strengthen financial aid to students, to become known "as one of Duke's most distinctive achievements" in exemplifying a "bold commitment to intellectual risk-takers and to crossing disciplinary boundaries."

A principal goal of the University Scholars program, which will begin in the fall of 1999, is to identify intellectually gifted undergraduate, graduate, and professional students and

provide them with the resources, curricular freedom, and extracurricular forums for cross-fertilizing each other's ideas in creative and novel intellectual collaborations. Students selected as University Scholars will be characterized by a rare level of "intellectual brilliance and intellectual fearlessness," said Cathy N. Davidson, recently appointed vice provost for interdisciplinary studies, who heads the planning for the new program and will lead its initial phase. "A University Scholar will have demonstrated early signs of brilliance combined with an edge of individuality, independent thinking, risk-taking, iconoclasm, and even intellectual fearlessness. He or she will value dialogue and thrive in combinations of an individualized curriculum and collective, interactive thinking, linking learning and research."

Davidson said the program is expected to begin with a set of at least eight undergraduate scholars annually and eight graduate and professional students. Other support will be sought from alumni and friends of the university so that the program can grow to a steady state of seventy-five to eighty students, with at least half being undergraduates. The program will include students who have financial need, as well as provide research grants for those who do not.

Melinda Gates, who lives in Medina, Washington, was elected to Duke's board of trustees in 1996 and serves on its Academic Affairs Committee. She earned two degrees from Duke--a bachelor's degree in computer science and economics, and an M.B.A. from the Fuqua School of Business. From Duke she joined Microsoft Corp., serving as both product manager and general manager with oversight responsibilities for the development of many of Microsoft's multimedia products. In 1994, she married Microsoft founder, chairman, and CEO Bill Gates. After the birth of a daughter in 1996, she resigned from Microsoft to devote more time to family as well as charitable interests, including her roles as co-founder of the William H. Gates Foundation and trustee of the Gates Library Foundation.

Created in 1994 by Bill and Melinda Gates, the William H. Gates Foundation supports initiatives in areas that are of particular concern to them. Grants from the foundation support education and institutions of higher learning, world health and population, and nonprofit civic and arts organizations in the Northwest. The Gateses have also established the Gates Library Foundation, chartered to provide computer and Internet access to patrons at public libraries in low-income communities across the U.S. and Canada.

The gift to Duke is one of the largest in the university's history, comparable to entrepreneur J. B. Fuqua's $20-million donation in April to the business school that bears his name, and that of trustee Peter Nicholas and his wife, Virginia, who in 1995 donated $20 million to the Nicholas School of the Environment.


eginning with a paraphrase from John UpdikeĐ"The fact that we live well doesn't mean we live nobly"ĐDavid Gergen led a two-part informal seminar in late September. The seminar focused, in timely fashion, on morality and the presidency. Gergen has been a counselor to several presidents, Bill Clinton among them. He is about to leave his position as a visiting professor at Duke's Terry Sanford Institute of Public Policy for a faculty appointment at Harvard.

Reaching back to Watergate, Gergen said the "redeeming feature" of the political scandal of the Seventies was the sense that "the system had worked well." That's not at all clear, he suggested, with the investigation growing out of the president's involvement with White House intern Monica Lewinsky. What is clear is that the latest scandal has produced an industry of political "spin" that has "made a mess out of our politics," he said. "Nobody believes anybody about anything."

Gergen took the seminar participants on a brief tour of history and political philosophy. Aristotle assumed that the purpose of the state is to encourage people to lead the good life, and so the leader should foster a spirit of civic virtue. For Machiavelli, writing at a time of political turmoil, the first concern of the leader was safety and security; the leader could be either virtuous or duplicitous, but the ends would justify the means. Jefferson, in framing the Declaration of Independence with its "self-evident" truths, projected an optimistic view of humanity. That view was revised with the Constitution, which put in place a checks-and-balances system that would confront ambition with ambition--reflecting Madison's view that people would not be guided by the better angels of their nature.

Citing the writings of recent cultural commentators, Gergen said American history has been moving away from the notion of virtue: Conservatives have come to worship capitalism, while the left has come to worship entitlements, and "no one is arguing for virtue as a public good."

Gergen's own scrutiny of American history uncovered examples of moral leadership--though the examples were invariably nuanced. Lincoln was accused by the Abolitionists of being too tentative; from Lincoln's perspective, though, the need to preserve the Union trumped the need to end slavery outright. So he put off issuing the Emancipation Proclamation so as not to fan the seccessionist flames. Most political observers would rank both Franklin D. Roosevelt and Martin Luther King Jr., along with Lincoln, high on the moral-leadership scale. Their private lives, as Gergen put it, were "anything but a model of decorum." Still, they projected a principled steadfastness. King "knew he wasn't perfect, and he was humble--certainly not self-righteous--in front of audiences. He may have been sufficiently troubled by his private life that he felt an extra urge to contribute in his public life."

Gergen suggested that the ability to inspire the people to great ends requires a consistency about principles. Both Margaret Thatcher and Ronald Reagan were "conviction politicians who believed in what they were saying," he said. The Iran-Contra affair, which emerged in 1986, was particularly damaging for Reagan, according to Gergen: "It was the first time in which Reagan was caught in a situation where he was espousing one thing in public and doing something else in private." Gergen contrasted Reagan's presumed steadiness with an episode early in Clinton's presidency, when Clinton leaned on Democratic members of the House of Representatives to back a controversial energy tax--only to back off the idea during tough bargaining with the Senate.

Clinton has been hurt also by the shifting media landscape, said Gergen. "In the late Sixties, when I first came to Washington, it was standard that the press didn't talk about private behavior unless it interfered with public activities. The press and the government were very cozy with one another."

That standard has "obviously changed," he said, in part owing to the growing presence of women in the press corps, in part to new standards of conduct in the workplace, and in part to the recognition that a focus on private morality "sells." A generational shift within the press corps has brought into positions of influence individuals who are "much more cynical and judgmental," Gergen said, adding that "there is much to be cynical about." And with the explosion in the number of media outlets, a once-reliable audience is being "sliced and diced," with a felt urgency to "titillate rather than educate and enlighten the audience. Clinton in some ways has replaced O.J., and the dress has replaced the glove."

The very first president was "an extraordinarly rare person in our public life," said Gergen. Washington apparently had "an unblemished character." We should not expect "saints in our public life," and we should not subject the private lives of political leaders to microscopic review, according to Gergen. But Clinton crossed a line when he denied his extramarital involvement in a public statement, and then sent out his cabinet to defend him. "If you put yourself in the tradition of public trust and draw on the well of public respect, even veneration, for high office, certain things are expected."


Media master: author, anchor, commentator, and Commencement speaker Roberts

BC News' chief congressional analyst Cokie Roberts will deliver Duke's 1999 commencement address Sunday, May 16. Roberts, who co-anchors the ABC News program This Week With Sam Donaldson and Cokie Roberts, covers politics, Congress, and public policy issues for the network. Roberts often serves as substitute anchor for ABC's Nightline and is a senior news analyst for National Public Radio (NPR), where she was the congressional correspondent for more than a decade.

Roberts first served as a panelist on This Week With David Brinkley in 1987, and was named a regular panelist to the program in 1988. Along with her husband, Steven V. Roberts, a George Washington University professor, she writes a weekly column syndicated by United Media that appears in newspapers around the country.

Before joining ABC News in 1988, Roberts was a contributor to PBS-TV's MacNeil/Lehrer Newshour. She also has worked as a reporter for CBS News in Athens, Greece; served as a co-host for The Lawmakers, a weekly public television program on Congress; and produced and served as a host for a public affairs program on WRC-TV in Washington. She is former president of the Radio and Television Correspondents Association.

Earlier this year, she published the book We Are Our Mothers' Daughters, which is part memoir and part social history and has been on The New York Times best-seller list for more than half a year. Roberts is the daughter of two members of Congress: Hale Boggs, the Louisiana congressman who died in a plane crash in Alaska, and Lindy Boggs, who is now ambassador to the Vatican.

A 1964 graduate in political science from Wellesley College, Roberts received a 1985 Distinguished Alumnae Achievement Award. She and her husband are the parents of two grown children, including a son who graduated from Duke in 1990.


homas A. Langford B.D. '54, Ph.D. '58, former dean of the Duke Divinity School and university provost, was honored in September with the University Medal for Distinguished Meritorious Service for decades of service to Duke. The medal, the university's highest service award, was presented by President Nannerl O. Keohane during the annual Founders' Day Convocation in Duke Chapel. The convocation address was delivered by Elizabeth Locke '64, Ph.D. '72, president of The Duke Endowment.

First awarded in 1986, the University Medal recognizes long-standing contributions to members and close friends of the Duke community. Keohane also presented Duke's Humanitarian Service Award to Richard Stubbing of the Sanford Institute of Public Policy, and the Distinguished Alumni Award to Robert Price Jr. '52 of Selina, Minnesota.

The University Scholar/Teacher Award went to Toril Moi of the literature program. The award was created by the Board of Higher Education and the Ministry of the United Methodist Church for the purpose of "recognizing an outstanding faculty member forÉ dedication and contribution to the learning arts and to the institution." The Richard K. Lublin Distinguished Award for Teaching Excellence, Trinity College's top award for teaching, went to Clay Taliaferro, professor

of the practice of dance, and Marie Lynn Miranda '85, assistant professor of the practice in the Nicholas School of the Environment. The honor was established by Lublin '61, a member of Trinity College's board of visitors. The Trinity College Distinguished Teaching Awards went to David Aers, professor of English; Ruth Grant, associate professor of political science; and Roxanne Springer, assistant professor of physics. The awards honor recipients for their efforts "to encourage intellectual excitement," their knowledge of the field, their skill in organizing courses and communicating with students, and their commitment to teaching.

The Howard Johnson Distinguished Teaching Award went to Daniel Graham, professor of economics. Established by the Howard Johnson Foundation, the honor recognizes distinguished teaching by professors in Trinity College.

Keohane said Langford has the qualities cited in the title of one of his scholarly articles, "Discipline and Devotion." "Here is a man whose intellectual depth and range have invigorated the field of philosophical theology, whose religious faith has expressed itself in service to the church and the community, whose caring disposition has made him a revered colleague and a valued mentor, whose steadfastness has impressed those who have observed his administrative adeptness, and whose loyalty over more than forty years has helped to shape this university," Keohane said.

Langford's tenure at Duke touches nearly every aspect of the university community. He joined the faculty in 1956, teaching in both the department of religion, where he served as chair, and in the divinity school. From 1971 to 1981, he was divinity school dean. In 1984, he became vice provost for academic affairs under Provost Phillip Griffiths. When Griffiths took a sabbatical leave for most of 1990, Langford stepped in as interim provost. He assumed the position full time when Griffiths became director of the Institute for Advanced Study in 1991. Langford's tenure as provost ended in 1994. He is now William Kellon Quick professor emeritus of theology and Methodist studies.

As an administrator, he led Duke through an important time of change. He guided the divinity school through a period of growth, and as provost, he helped the university respond to a series of tight budgets caused in part by declining government support, escalating capital and technology costs, and an increasing need for financial aid.


ew women in their forties benefit from mammography screenings to detect breast cancer while many may suffer emotionally and physically from the consequences of unclear results, says a Duke researcher in the October issue of the Journal of the National Cancer Institute. Donald Berry, of the Institute of Statistics and Decision Sciences, based that conclusion on a study of the findings of eight large clinical trials that compared women in their forties who received mammograms with women who didn't.

Mammography screening is difficult in younger, pre-menopausal women because their breast tissue is often dense, and fat deposits are often diagnosed as suspicious tumors in a first screening. Berry says that often means a second mammogram needs to be taken, sometimes followed by a surgical biopsy to remove and test tissue for cancer--a procedure that is often negative in women this age. "Screening is a lottery. Any winnings are shared by the minority of women, about one in sixty or seventy, who are diagnosed with breast cancer in their forties," Berry says. "The overwhelming proportion of women experience no benefit and they pay with the time involved and the risks associated with screening."

Berry conducted his analysis to help guide women in their individual decision making. In his study, he found that having regular mammography from age forty to fifty adds about five days to the life expectancy of each woman screened. The risk of not having a mammogram until after age fifty is about the same as "riding a bicycle for fifteen hours without a helmet, or of gaining two ounces of body weight, and keeping it on," he says.

He says that women should carefully weigh recommendations for screenings because "mammograms are pushed by physicians and some members of the radiology community. Politics played a crucial role in the federal recommendations. Few medical issues have generated as much controversy as the question of whether to recommend regular mammograms to women age forty to forty-nine."

Berry was a member of a National Institutes of Health advisory panel that in January 1997 neither endorsed nor recommended against mammograms for women this age, but concluded women should decide for themselves. But after an outcry from breast cancer advocates and Congressional members, the National Cancer Institute took a different view, recommending screenings every one or two years for forty-something women. The American Cancer Society recommends them every year.

Berry studied the eight large clinical trials following the advisory panel conclusions. The trials compared women in their forties who received mammograms with women who didn't. Altogether, these trials enrolled 200,000 women in the United States, Canada, Scotland, and Sweden. When considered together in a meta-analysis, the studies conclude that approximately fifteen years after the trials ended, women who were screened had 18 percent fewer breast cancer deaths compared to women of the same age who weren't screened.

While that number sounds impressive, it isn't when put in context, Berry said. In the women followed, 689 died of breast cancer. Of that group, 326 had a mammogram while in their forties and 363 didn't. After accounting for different numbers of total women in the two arms of the trials, the difference in mortality between the groups represents the 18 percent reduction in death.

"The relevant question here is whether finding and treating breast cancer at an earlier time point extends women's lives or improves the quality of their lives," Berry says. "Although some people feel passionately, no one knows for certain whether, or how much, getting mammograms before the age of fifty increases life expectancy. Some women die from breast cancer even if their cancers are small when detected by mammography."

The difficulty with mammography is that no one can say for sure what the cancer that is detected will do, says Berry. "There is no universal answer. All women can do is to think carefully about the question and decide what is appropriate for themselves."


Acting as Eleanor: Anne Kanengeiser

uke Drama's Theater Previews series launches its second project, Eleanor: An American Love Story, a musical based on Eleanor Roosevelt's life with FDR before he became president. After performances at Duke on February 9 though 28 in Reynolds Industries Theater in the Bryan Center, the play will run at Ford's Theater in Washington, D.C., for sixteen weeks.

Written by Thomas Tierney, Jonathan Bolt, and John Forster, Eleanor explores women's rights and federal social programs in the context of the personal story of the former First Lady's life. Duke drama students will serve as understudies for the actors in the production on campus; they will also intern on the technical side of the production.

Eleanor is a co-production between Theater Previews at Duke and Ford's Theater, similar to last year's performances of Kudzu, which premiered at Duke. Performances of Eleanor at Ford's Theater will coincide with the opening of the First Ladies Museum in Washington. Tickets are available at Page Auditorium box office, (919) 684-4444; for groups of ten or more, call 681-1837.


  • Robert S. Shepard, a principal planner of Duke's new $1.5-billion fund-raising campaign, and H. Clint Davidson, who has led the university's human resources programs for sixteen months, have been appointed university vice presidents. Before coming to Duke in 1995 as associate vice president and executive director of University Development, Shepard was associate director of the University of Pennsylvania's successful $1.4-billion campaign and vice dean for external affairs of the School of Arts and Sciences. As vice president for development, Shepard will continue to direct the operations of the university's central fund-raising staff and play a leading role in the five-year campaign. Davidson, who also came to Duke from Penn, became associate vice president for human resources in May 1997. He has more than twenty-five years' experience as a human resources executive at research universities and health-care facilities; he was vice president for human resources at Penn when he came to Duke. He is overseeing a major effort to reorganize human resources operations and improve service to university departments. In addition, Davidson is playing an important role in supporting the integration of Durham County Regional Hospital and Raleigh Community Hospital with the Duke University Health System.

  • Susan Cranford Ross has been appointed director of development for Duke athletics and associate athletics director. Ross has been associate dean of arts and sciences since 1992. She was director of annual giving for the university from 1985 to 1992, responsible for fund-raising programs for alumni, parents, and others for current operating support of the university. She was assistant director and then associate director from 1980 to 1985. Jane Dittmann will succeed her as associate dean for development in arts and sciences, leading the development effort for Trinity College of Arts and Sciences, the home of most of the university's undergraduates. She joined arts and sciences development in 1993 and has been director of development for Trinity since 1996.

  • Edward W. Holmes has been named Duke Medical Center's vice chancellor for academic affairs and dean of the School of Medicine. He was selected to fill the vice chancellor's position vacated by the coming retirement of Gordon Hammes. Holmes spent twenty-one years at Duke, leaving as the Wyngaarden Professor of Medicine and chief of the division of metabolism, endocrinology, and genetics to develop the department of medicine at the University of Pennsylvania. He was most recently at Stanford as senior associate dean for research, vice president for translational medicine and clinical research, and special counsel to the president.

  • Photographer, filmmaker, and folklorist Tom Rankin has been named executive director of Duke's Center for Documentary Studies. Iris Tillman Hill, who has been director of the center since its inception in 1989, has been named director of programs and publications. Rankin, who comes to Duke from the Center for the Study of Southern Culture at the University of Mississippi, will focus on three core areas of the center's work: teaching, creating original documentary projects and publications, and working on community-based programs. He has been associate professor of art and Southern studies and director of documentary projects at the University of Mississippi since 1992.

CORRECTION: Information about an alumni discount was incomplete in the September-October issue under the Benefits and Services portion of the Duke Alumni Association Annual Report. The line should read: 20 percent discount at Duke Stores on all merchandise identified with an alumni logo, bought on store premises only (DAA membership card required).

The magazine apologizes for any confusion this may have caused.

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