5/04/2007
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In an influenza epidemic, a certain number of people survive the illness and are immune to reinfection. 14, 1918 in high spirits three days after the armistice that ended the war, and with influenza cases declining the city reopened schools and businesses. Louis, carried out early interventions before the first peak, and then reinstituted them when transmission rates began to rise again. Demographic studies show that the population most at risk is single, urban, substance-abusing older white men with physical illness, few supports and low incomes. By these criteria, my patient could not be found on the map (though psychosis is also a high risk factor).
In our last meeting, before he stopped coming to appointments, he told me that he had joined the site to meet friends. There was a photo of him on one side of the screen, handsome and poised, with his astrological sign, educational background and a description of his ideal mate. They were not written to a haunted self, or someone who had failed trials of antipsychotic drugs, or someone who had been hospitalized again and again under duress. The last dozen messages on the screen were exactly the same.
I had gone on the site only a day after his death, but his cyberobituary must have traveled faster. Yet even though such acts can jeopardize patients, the inclination and ability of young doctors to speak up is hampered by the hierarchies in teaching hospitals. Although some senior physicians welcomed feedback from their juniors, others disdained it, either overtly or through intimidation. Wolfberg wrote in the same journal last month, for years medical students performed pelvic examinations on anesthetized women who had not given consent because senior obstetricians said it was the best way to learn internal anatomy. After the warning, suicides among American youth increased, and some mental health experts said reluctance to try antidepressants might be to blame.
The researchers analyzed data on 5,310 children and teenagers from 27 studies involving the antidepressants Prozac, Paxil, Zoloft, Celexa, Lexapro, Effexor, Serzone and Remeron. Thomas Laughren, director of the agency's division of psychiatry products. Adolescents responded better than children to treatment for depression and anxiety, the researchers found. They also found that only Prozac worked better than dummy pills in depressed children younger than 12. They found that for every 100 treated with antidepressants, about one additional child experienced worsening suicidal feelings above what would have occurred without drug treatment. The new analysis found that antidepressants worked best when used to treat anxiety. But he said the suicidal behavior risk, although lower than found by the F.D.A., demanded that doctors and families watch for warning signs. Louis persuaded the city to require that influenza cases be registered with the health department. And two days after the first civilian cases, police officers helped the department enforce a shutdown of schools, churches and other gathering places.
Louis were 347 per 100,000 people, less than half the rate in Philadelphia. Hatchett said, "is a function of a lot of modeling work that we did previously." As these numbers increase, the epidemic fades.
Louis, Milwaukee and Kansas City, Mo., had the most effective prevention programs, and time was of the essence. Ferguson said, "we would start a crash program to make a vaccine. He could, however, be found on MySpace.com. The messages had this in common: They were all written to a correspondent who led an unquestionably normal life. They were not written to a haunted self, or someone who had failed trials of antipsychotic drugs, or someone who had been hospitalized again and again under duress. Nor, apparently, was that unseen self writing back. Doctors in training sometimes confront situations in which they worry that their supervising physicians are making mistakes or bending the truth. This new division of labor established hierarchies. Although this practice made many students uncomfortable, most were afraid to speak up.
And, she added sheepishly, both the resident and the attending physician would be grading her. But when he told the resident, who had seen the patient earlier and more quickly, the resident refused to re-examine the patient. The student admitted that he was far from positive that something was seriously wrong.
Or the student might go directly to the patient or family, telling them that the physicians have a genuine disagreement and that they deserve to know about it. I don't know if he drank four to eight glasses of water a day. At a 1965 seminar on the future of higher education, the first vice-chancellor of Monash, J.A.L. Before the late 1940s, each state had just one university. But this latest reform remains unfinished business a private sector is allowed scope to compete, but public institutions remain bound and constrained. Close to the white mansion that John Wren built is Raheen, still occupied by Daniel Mannix, halfway through his immensely long archbishopric, and a vivid presence in the book, walking daily from Raheen to St Patrick's Cathedral in his frock coat and top hat. Did free education allow daughters to follow sons to university, or did this trend simply reflect school retention rates, with female rates of Year 12 completion exceeding male ones from the late 1970s? During 2006 Minister Bishop has allowed institutions to begin this process, while Labor has proposed a formal mechanism, a negotiated compact between Canberra and each university, acknowledging different roles, missions and circumstances. Elsewhere, we have Richard Holmes's seminal Footsteps: Adventures of a Romantic Biographer (1995) and Leon Edel's Bloomsbury: A House of Lions (1979), but Australian examples are few.
Eventually, she became his research assistant on a biography of Archbishop Mannix. Finally, Dawkins wanted consistent national standards. Flinders students could take Australia's first undergraduate course in Spanish, along with other subjects not offered at the University of Adelaide.
Forty-one years after those first students reached Flinders, we need a similar bold moment of experimentation. Goodbye, my dearest friend.
Almost three decades after her initial work on Martin Boyd, Niall's choice of subjects seems more unexpected and her sense of biography's possibilities more liberal than those of the young Monash academic. An expansion of provision improved opportunities for many young Australians, but equality of experience would be eroded if a clear hierarchy of institutions emerged. And yet this national consistency, created for a closed system in which student demand outstripped the supply of places, is now part of a global market for overseas students and faces private and international competitors at home. Another thing you once told me, while we were driving to an airport in the early 1990s: 'I would like,' you said, rather tentatively because I think you were horrified at the idea of appearing self-important 'to write something of significance one day'. As in 1966, there is now a university sector marked by uniformity, and a higher education industry outside, populated by numerous niche providers. As she considers Cassab's life story (migration to Australia in 1951, having lost her mother, grandmother, uncle and other family members in Auschwitz), and those of a generation of Holocaust refugees, Niall is acutely aware of the human cost of the Howard government's policy on detention centres and shocked by its 'scant respect for the rights of refugees'. His archive is vast and untouched; he knew Eamon de Valera and Michael Collins; he endured interminable summer holidays at Portsea as Archbishop Mannix's companion; he knew the Wrens and was astonished by Ellen Wren's calmness after the publication of Power Without Glory (1950).
His initiatives to assist the private sector have encouraged an expanding new sector of academies, colleges and institutes. I am in love with Nettie Palmer.' The idea has a certain appeal, but not for long. I was shocked at the time, for you had already published a dozen novels, including the wonderful trilogy My Father's Moon, Cabin Fever and The Georges' Wife, and it seemed to me, and to many, that the significance of your work was established beyond question.
If Australia is to develop a University of the Arts, or a Caltech equivalent, it will happen because an existing public university sees the opportunity and is allowed to evolve in that direction. In March 1966 the first students arrived at Flinders University.
