In 1994, after my back surgery and the prolonged recovery, I had to decide what to do with the rest of my life. The young man who I had taken in as a partner before my surgery, did not want me to continue in the surgery practice as a non-operating member. I had offered to see patients in the office and to help keep the referring doctors sending patients. I still had a fair sized breast practice which includes quite a bit of office work. He was not interested. That was a bad decision on his part but I had sold him the practice before my surgery and he was free to do as he chose.
I had been interested in the area of peer review in Medicine for some years and had served on the Board of Directors of California Medical Review, Inc. This was an outgrowth of a new federal policy called “Professional Standards Review Organizations. or PSRO. It was supposed to be about quality but it was always about cost. CMRI was founded in about 1986 and is now defunct. It was useful in trying to figure out how to measure quality but go into trouble later for exaggerating their case load.
Anyway, I was interested and knew that Dartmouth Medical School had a program called “Evaluative Clinical Sciences. The Director was a well known epidemiologist named Jack Wennberg who had become famous for his study of variation in medical treatment. His original study had been of tonsillectomy in Vermont where he was state health officer. He found that the incidence of tonsillectomy varied by town but not by medical indications. IT was a function of local medical “culture.” Eventually, his work resulted in The Dartmouth Atlas of Health Care.
I talked to him and then applied for the Fall Semester. In September, I leased my house and moved to New Hampshire for a year. I leased a house in the Hanover area and moved in.
The house was pretty and situated on 5 acres of land. It had a barn that served as a garage and I had my car winterized as New Hampshire is cold in Winter. It was 26 below zero Thanksgiving morning.
The house was about 6 miles north of the medical school, up this highway.
I had my dog and a cat that some neighbor children had brought over the first day I was moving in.
The cat and the dog got on very well and even ate from the same dish, although Sunny, the dog, ate faster and I eventually had to put Bill’s food in the basement to keep Sunny from eating it all.
Winter came quickly and the first snow was less than a month after I moved in.The house was comfortable although expensive to heat.
The land had a small stream running through it and there was a pond in front of the house.
That its a small bridge over the stream and the stream itself was frozen a good part of the winter.
The interior was nice. Here is the living room with Christmas decorations for the kids as they came to spend the holiday with me.
Being California kids, they had fun playing in the snow.
That was across the road from the junction of Grant Road and Lyme Road from the medical school.
Spring eventually came after “mud season,” which is the fifth season of New England. Graduation was fun as the older kids were there and Bill Clinton handed me my diploma.
My research project was on dialysis access surgery and I had thoughts of further study but we never got the grant I applied for. I returned to California and spent several years trying to use the same methods to analyze care of the elderly and of care of the poor, but I got no cooperation from the necessary authorities and eventually gave up on research on medical quality.
Here is the house I leased in 1994-95.
Obviously the photo was taken in summer.
My next door neighbor was a guy named Baxter Prescott and he had at least as large a property with lots of maple trees. Next to Baxter’s was his son, Tom’s, who had a home business making musical instruments, specifically recorders. He had an Apple computer connected top a milling machine and built the instruments, many using precious woods. I got to know Tom and his family while I was there. Baxter was a very interesting guy. He and his wife, Emily I think, had a nice home which was heated by a wood stove at the lowest level. The wood stove also heated their hot water, which circulated in copper tubing behind it. They had a Nigerian exchange student, enrolled at Dartmouth, living with them. He was a nice kid and worked nights in the 24 hour Dining Hall for extra money and at night so he could study.
In the Spring I helped (mostly watched) Baxter make maple syrup from his trees. He also had a pond, which in summer was a swimming hole and in winter a skating pond. He had a little gazebo for summer, which had removable walls to enclose it as a warming hut in winter. My kids were there in winter and got quite a bit of use with it. Baxter had a sort of Zamboni machine which would smooth out the ice.
They were very pleasant neighbors and I enjoyed knowing them.
Hi, Mike: I read your latest comments over at Chicagoboyz.net and figured you must have had some connection with Dartmouth. I’m a Dartmouth alum. Dartmouth’s descent into progressive liberal purgatory has been a case study in what is wrong with higher education, especially at America’s elite universities.
The interplay of federal politics, grant-making policy, federally guaranteed student loan programs, and the highest levels of academia (faculty and administration) is at the root of academia’s problems. Add-in decades-long personal and professional relationships between fellow travelers within the Ivy League-Beltway-Wall Street-Corporate Corridor, and you’ve got yourself a real mess.
By the way, I am familiar with Dartmouth Medical School’s involvement over the years with evidence-based medicine.
Thanks. The leftist stuff was gathering then. I bought a copy of Murray’s
“The Bell Curve’ and had several people at Dartmouth ask if they could borrow it when I finished. They did not want to be seen buying it in the Dartmouth Bookstore.
It’s far worse now.