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Petre tet) ee a ee monterey
oe Sean Gee
SPRING 1999
Small-town boy/
big-time surgeon
New understanding
of obesity, diabetes
edge
East Carolina University
Spring 1999
www.ecu.edu/research/edge
publisher
Dr. THOMAS L. FELDBUSH
Vice CHANCELLOR, RESEARCH AND GRADUATE STUDIES
executive editor
JOHN DURHAM
Director, NEWS AND COMMUNICATIONS SERVICES
yeliaelat-|meler-lae
TOM FORTNER
Director, MEDICAL CENTER NEWS AND INFORMATION
JOANNE KOLLAR
DirECTOR, UNIVERSITY PUBLICATIONS
Dr. ALAN A. SCHREIER
DirECTOR, OFFICE OF SPONSORED PROGRAMS
Dr. Emitie S. KANE
ASSOCIATE Director, OFFICE OF SPONSORED PROGRAMS
rveliaels
GARNET BASS
designer
DANA Ezzett Gay
UNIVERSITY PUBLICATIONS
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CuiFF HOLLIS
News AND COMMUNICATIONS SERVICES
TONY RUMPLE
News AND COMMUNICATIONS SERVICES
edge is published by the Division of Research
and Graduate Studies at East Carolina University.
Any written portion of this publication may be
reprinted with appropriate credit.
Comments or questions should be addressed to
olatam 2leisar-ias
East Carolina University
News and Communications Services
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© 1999 by East Carolina University
U.P. 99-044 & Printed on recycled paper
cw eet iv.e
the next big thing
Waa
THE LAST YEAR HAS BEEN AN IMPRESSIVE ONE FOR EAST CAROLINA.
WeTve received formal designation as a doctoral institution. WeTve
dedicated the greatly expanded and fabulously renovated Joyner
Library and its companion Sonic Plaza. WeTve completed design work
for the new Science and Technology Building, which now awaits
complete funding from the North Carolina General Assembly to
become a reality. And weTve become a member of UCAID"University
Corporation for Advanced Internet Development"the association of
universities working to build the next-generation Internet.
The future is equally exciting. This spring the university expects
to take over the 594-acre site that formerly housed the Voice of
America facilities just west of Greenville. It will immediately become
home to the North Carolina Institute for Health and Safety in
Agriculture, Forestry and Fisheries (see page 6).
But the site, now occupied chiefly by antenna towers, will be
much more than that. As a third campus for East Carolina"the
Millennium Campus, if you will"it will open up an unbelievable
array Of opportunities for us. Among the proposals are medical
clinics, an emeritus village� providing a learning and teaching
environment for retired professors, a wetlands preservation area and
a university golf course. The new campus will help us handle an
expected enrollment boom in the next decade as the high school
graduate pool adds an extra 50,000 students to the 16-campus
University of North Carolina.
At the same time that weTre planning a new bricks-and-mortar
campus, weTre hard at work on a Virtual University that will embrace
the digital revolution to make East Carolina faculty and instructional
prowess available worldwide. The challenge is to use the Internet and
other information technologies to deliver ECU courses to any student
at literally, any place on the globe.
The essence of these developments, both completed and planned,
is simply this"East Carolina is a different place, doing business in a
different way. We have always had confidence in the future, now we
are helping invent it. Some of our most exciting work is reported in
these pages. " Dr. Thomas L. Feldbush, Vice Chancellor for Research
and Graduate Studies
wet ivi Cy
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12
y
The geometry of sound
Will physics show the way to build
a better violin?
Walden pond and beyond
English professor Ronald Hoag explores
the many facets of the Thoreau legacy.
Obesity and diabetes
Research yields startling clues to the complex
connections between two deadly conditions.
The diabetes/obesity connection
Clinical trials advance treatment
of diabetes and its complications
It takes two
Part Odd Couple, part Dynamic Duo,
ECU social scientists make the most
of complementary talents.
One smooth operator
Randolph Chitwood never forgets his roots
as he builds an international reputation as
a cardiovascular surgeon.
A finger on the pulse of
farmersT stress
When a child testifies
Tracking the first North Carolinians
Nursing solutions
Topsoil gone with the wind, rain
At the top of their math class
An office for clinical trials
A parable for the ~90s
28
32
34
36
39
Space age
NASA technology proves a good fit for
interior design.
Quality care
Early studies show telemedicine compares
well with doctorTs visit.
Upbeat
For marimbist Mark Ford, making music
means having fun.
Seamless
Emotionally disturbed children benefit as
new approach to care takes hold.
Partnership to investigate issues
in welfare reform
Biomedical physics admits first
Ph.D. students
Technologies move closer to market
ECU implements state-of-the-art
research administration
Grant and contract activity increases
on the cover
Front: Dr. George Bissinger readies equipment to measure the
sound and vibration of a violin. (Photo by Cliff Hollis.)
Back: Walden Pond. (Photo courtesy of the Thoreau Society.)
Cover DESIGN By DANA EzzELL GAy
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violin, a fateful step for this amateur musician and
former nuclear physicist. ITve really spent all the
25 years since then trying to understand why, if
you build it all the right way with all the right
stuff, it still doesnTt turn out so good"the tradi-
tional problems with making a violin,� he said.
Today, Bissinger is poised to unite science and
art, employing the fundamental principles of vibra-
tion to help violin makers build good violins
consistently. He uses geometry"such things as
shape, stiffness and density"to predict vibration,
which in turn predicts sound. There is no way,
prior to the work ITm doing, anybody could pre-
dict the acoustic output of a violin from mechani-
cal measurements,� he said. The approach has
attracted the interest of violin makers and the sci-
entific community alike. One violin maker called
BissingerTs technology the tool violin makers dream
of.� And the National Science Foundation has award-
ed him and three colleagues"Drs. Robert Chin,
Hamid Khan and Biwu Yang of industrial technolo-
gy"a $370,000 grant to advance their research.
Bissinger, who directed ECUTs particle accelerator
lab from 1973 to 1992, learned to play the violin,
somewhat grudgingly, as a child and took up the
instrument again while finishing his doctoral
work at the University of Notre Dame. He built his
A
violin under the tutelage of musical acoustics
expert Carleen Hutchins while he was on a post-
doctoral appointment at Rutgers University. Years
later, he heard a talk about normal mode analysis
on the violin at a meeting of the Acoustical
Society of America. Being in physics, I realized
that if you had the normal modes of an instru-
ment, you literally knew everything possible there
was to know about that instrument and all you
had to do was figure out how all the individual
modes get put together,� he said.
Normal modes, in this case, amount to a collec-
tion of individually unique physical responses
gathered by tapping at discrete points on the body
of the violin while measuring the response at a
given point (or vice versa). Bissinger calls them the
building blocks of vibration. You hit it in a cer-
tain place and some modes will be excited strongly
and some will not,� he said. You hit it in a differ-
edge
ent place, and different modes will be excited
strongly. Any way that a violin can vibrate, no
matter how you hit it, bang it, tweak it, bounce
it, drop it on the ground, anything you do, you
can figure out how itTs going to respond to the
force that you apply if you have the normal modes.�
Sound flows from vibration. If it vibrates, itTs
pushing the air around so itTs going to radiate sound.
So if you know how it vibrates, you can figure out
how it radiates"even the direction in which it will
radiate, and once youTve got that, you have the
essence of really understanding a musical instrument.�
The difficulty comes in applying the concept. There
are an infinite number of normal modes, but less than
a thousand in the range of hearing, and every violin
will be different. Wood, shape, components, even glues
and worm holes can affect the normal modes. What
Bissinger must do is figure out which normal modes are
important to the sound quality of the violin.
PHYSICS SHOW THE way ®&
TO BUILD 2a
ae
A computer rendering of a violin takes music back
to its source: pinpoint responses to applied force.
His tools include an echo-less small room equipped with a
rotatable semi-circular arc of microphones and a laser scan-
ning system. A violin is suspended in the center of the arc,
SOUND Fiows
FROM VIBRATION.
ie iT VIBRATES,
ITTS PUSHING
and a carefully calibrated hammer taps on the bridge of
the instrument. The laser measures the resulting vibra-
tion at 270 different points on the violin, one point
at a time. As mechanical energy is converted to
acoustic energy, the microphones measure the
direction and volume of the sound. With the
cooperation of the Leo Jenkins Cancer Center
at Pitt County Memorial Hospital, each violin
THE AIR AROUND also will undergo a computerized tomo-
graphic, or CT, scan to reveal its structure,
from the shape of components to the
SO ITTS GOING TO
RADIATE sounb.
SO IF YOU KNOW
thickness of the wood. Start to finish,
measurements on a single violin take
about 12 hours.
These quantitative measurements,
however, cannot tell whether a violin
sounds good or bad. For a qualitative
assessment, Bissinger will draw on
PRA gy te
ret 4
ia ay ie
HOW IT VIBRATES,
the expertise of violinists at the
ECU School of Music. Then all of
YOU CAN FIGURE : " pe oi Be eee ec E 3 : 3 a the information will be entered
BS vere tae� * gitar me, : | : into an advanced statistical analy-
OUT HOW IT
SAND] PANE he
EVEN THE
DIRECTION
IN WHICH IT WILL
sis computer program that will
help sort out the correlations.
Before he can reach definitive
conclusions, Bissinger needs to
obtain measurements on hundreds
of violins, from the worst sounding
to the best. So far, a dozen violin
makers have promised to provide
instruments for him. He also hopes
to measure some classic violins, even
if it means transporting his equip-
RADIATE, INNipe) (a: ment to such places as the Smith-
sonian and Library of Congress or to
Europe to test museum instruments.
YOU VE GOT THAT,
The overall sound of the violin
relates to two independent factors, how
YOU HAVE THE effectively the vibrating string energy is
transferred to the normal modes of the
body and how well each normal mode of the
body radiates this energy in the form of
sound. As youTre bowing a string, youTve got
all these string harmonics and theyTre moving
back and forth frequency-wise across normal modes
of the body of the violin,� Bissinger said. The loud-
est sounds come when they cross the normal modes
that radiate well. One of the things that makes the violin
sO appealing is that it changes so much mode to mode.�
ESSENCE OF REALLY
UNDERSTANDING
A MUSICAL
INSTRUMENT.�
BissingerTs current anechoic, or echo-less chamber,
has evolved from this earlier model.
This relationship also means that a computer
will be able to simulate the sound of the violin
based on the measurements Bissinger has taken.
ItTs not that itTs going to make real good violin
sound,� he said. The important thing will be the
trend. If you make a modification and the sound
goes from a to b, you listen before and after and
decide if you want to go in the other direction.
With the computer, you can add just as well as
subtract. In the real world, unfortunately, once
youTve shaved the wood off, itTs difficult to get it
back on, so things donTt reverse so well.�
The prospect excites Joseph Curtin, a renowned
violin maker in Ann Arbor, Mich., who wrote a let-
ter in support of BissingerTs NSF grant. Here is a
way of both understanding what existing violins
actually do when they are played and predicting
how carefully specified changes in material and
design might affect the performance of a new instru-
ment,� Curtin wrote. This is a tool violin makers
dream of, and if it becomes a reality, I will be first
in line to use it! It should greatly reduce the time
needed to develop new instruments and contribute
enormously to our understanding of old ones.�
This will be a considerable change from the
centuries-old approach to making and improving
violins. ItTs a really tough job because itTs empiri-
cal,� Bissinger explained. You have to work with
someone who knows how to do it. They have to do
it and show you, and you have to hear it and feel
it yourself. Typically, by the time the really good
ones get really good, they die, and then some-
bodyTs got to learn from scratch again. ThatTs part
of the reason why weTre no better now than were
Antonio Stradavari and all the really great violin
makers who are gone.�
Bissinger is working closely with the violin
makers to assure that his work will translate into
useful knowledge. Peter Zaret, a violin maker from
Norfolk, Va., has patented a modification for the
bass bar and will supply violins before and after he
has modified them so Bissinger can measure the
resulting changes.
Zaret is confident of the outcome. ItTs scien-
tific confirmation of what I already know,� he said.
T feel itTs the best-sounding violin made.�
Of course, determining the best shape for a
violin is quite different from making music by
applying bow to strings. As Bissinger figures it, this
will be a perfect contribution to music for nerdy
people who would love to be able to play a *
musical instrument really well but canTt.�
S
PW ilive (sme am carom ole] iyo
of farmersT stress
Memory is a constructed, dynamic process,� says
Agricultural and medical professionals The four universities are organiz- 1998. The program may soon evolve
Dr. Robert Nida, a specialist in childrenTs ability
FS 8 fee wey a) ar ivercities j y = he re ive Tr? ol we 4 j 2 tee ti ae » e
wt ECU and three other universities ing a cooperative program to track eh com estes Oru beh iaiaticcmco)ms ale liesme tare bias eet
are cooperating to help farm families stress indicators and mobilize inter- Safety in Agriculture, Forestry and
cope with stresses related to depressed vention programs to head off wide- Fisheries. The UNC General Adminis-
pork prices, the statesT tobacco settle- spread problems. Three of the univer- tration is expected to approve the
ment and recent tobacco allotment sities"ECU, N.C. State University and establishment of the institute in 1999.
cutbacks. N.C. A&T State University"already are Under the universitiesT agreement,
During the farm crisis of the partners in the N.C. Agromedicine ECU will take the administrative lead
1980s, we saw an increase in the num- Program. The fourth, the University for the institute. If negotiations with
ber of suicides, incidents of family of Kentucky, serves the countryTs No. the U.S. Department of Education are
violence and highway accidents, espe- 2 tobacco-producing state. North successful, the core institute will be
cially in the Midwest, where the crisis Carolina is the leading tobacco-pro- housed at the former Voice of
hit particularly hard,� said Dr. Byron ducing state and the second major America site just west of Greenville.
Burlingham, chair of the N.C. Agro- hog-producing state. The 28,000-square-foot building sits
medicine Program steering committee The occupational stress project is on nearly 600 acres near the ECU
and professor of microbiology and one of the latest projects of the School of Medicine. Burlingham said
immunology at the ECU School of Agromedicine Program, which was the building could be renovated to
Medicine. WeTre in nervous anticipation established in 1989 as a cooperative house the instituteTs administrative
that tobacco and hog farmers may venture by ECU and NCSU. N.C. A&T offices, research facilities and clinics.
be in for the same stress responses.� signed on as a full partner in October
PHOTO BY GEORGE THREEWITTS
Dr. Byron Burlingham leads a
tour of the Voice of America
site, future home of the N.C.
Institute for Health and Safety
in Agriculture, Forestry and
Fisheries.
When a child testifies
Since 1992, Central PrisonTs death row has been home for a
Greenville man convicted of rape and murder. The key evidence link-
ing him to the crime was the testimony of a child who was 3 1/2
years old at the time of the killing. The manTs
attorneys are seeking a retrial.
For Dr. Robert Nida, associate professor in the
Department of Child Development and Family
Relations, this case and others involving childrenTs
testimony raise a red flag. We just donTt know
how accurate childrenTs long-term memory is,� he
said. We need more information on the accuracy
of memory, the individual differences involved in
the ability to recall and issues related to suscepti-
bility to suggestion. ItTs a very tricky issue.�
Nida has been studying the ability of children to
give accurate court testimony for more than 10
years, first during postdoctoral studies at the
University of North Carolina at Chapel Hill and
now with further research at ECU. His research
has focused on memory and suggestibility.
At Chapel Hill, Nida assisted in a series of stud-
ies looking into childrenTs memory of events they
personally experienced. Using the pediatric physical
examination as a point of reference, the researchers
interviewed children ages 3 to 7 immediately after
the exam and at intervals of up to 12 weeks to see
how well they could remember details of the exam
and whether they could correctly deny misleading questions.
The researchers found that even the youngest children could
remember the bulk of their physical exams, but they forgot more
over time and were more susceptible to suggestion than were older
children. The older children also were able to recall more specifics in
response to open-ended questions. The children came mostly from
middle- to upper-class white families.
Since coming to ECU, Nida has tried to replicate those studies
with African-American children from low-income households.
Although he found similarities in the ability to recall experiences,
children in this study were more susceptible to suggestion. More
research will be needed to explain the differences in suggestibility,
he said.
Meanwhile, he said, other research has shown that interviewer
bias can distort the reports of young children prone to susceptibility.
Intervening events also may have a profound effect. ThereTs a lot of
work that shows intervening experiences become integrated into
memory,� he said. Memory is a constructed, dynamic process.�
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bi ef s
Tracking the first North Carolinians
The trail is cold, but Dr. I. Randolph Daniel Jr.,
assistant professor of anthropology, hopes
ancient stone tools will point him toward sites
inhabited by the first North Carolinians.
People often think of history in North
Carolina as beginning with the Lost Colony,�
he said, but people lived here 10 millennia
before Virginia Dare was born. So much more
happened before European settlement thatTs
equally interesting and that has a lot to say
about life in North Carolina.�
Anthropologists call those earliest settlers
Paleoindians, for the Paleolithic era in which ~
they first ventured onto the North American .
continent. Eventually, Daniel wants to decipher
how North CarolinaTs Paleoindians lived. First,
heTs trying to find where they settled.
Dr. Randolph Daniel notes #�,� $ize, shape
and composition of tools that Paleoindians
Daniel has been combing public and private collections to create
a comprehensive record of fluted points"stones flaked into an elon-
gated point with a groove across the base"that have been found
here. He photographs each point that appears to date to the right
period (10,000 to 12,000 years ago), logs details about its shape and
composition, and plots where it was found.
left behind in North Carolina.
Stone type gives an important clue to mobility. Hunters and
gatherers have to move a lot according to where resources are avail-
able,� Daniel said, but stone for hunting may not be available where
the deer are. We have evidence they planned for these contingen-
cies.� Whenever they found a good source of stone, the Paleoindians
apparently packed tool kits, pieces of stone suitable for shaping into
Spear points and other tools, that they carried with them whenever
they moved on. Rhyolite from North CarolinaTs Morrow Mountain,
for example, has been found in South Carolina.
Already, Daniel is beginning to draw conclusions about dispersal
patterns. For example, based on the large number of points found in
the Piedmont, he theorizes that the high quality of stone in the
region may have determined the location of the first settlements. (In
a new book, Daniel argues that Uwharrie Mountain stone outcrops
were the main factor in the settlement of a previously discovered
site. See page 38.) Distribution patterns also will help Daniel narrow
his search for an undisturbed settlement site. If he finds it, he said,
he expects it will be at the fall line of a major river, buried under
several feet of deposits.
In the meantime, the current study will fill a gap in information
elololeian loo beret lemernienloleielesemlemestanvelliesle-CitospmOliccemic lic mn ill
studies have been completed in Virginia, South Carolina and Georgia.
Nursing solutions
Lying in one position without move-
ment for long periods can cause pres-
sure ulcers commonly known as bed
sores. A study led by nursing professor
Dr. Marie E. Pokorny is testing whether
a strict regimen of care will prevent
ulcer development in susceptible car-
diac surgery patients. The nursing staff
at Pitt County Memorial Hospital is
collaborating on the project.
The effort began in 1996 at the
request of critical-care nurses in the
cardiac surgery units of the hospital.
According to national studies, pres-
sure ulcers occur in about 15 percent
of intensive-care patients. PokornyTs
first task was to analyze which
patients were at risk of developing
ulcers. With bed sores, you think of
people who are immobilized, such as
elderly patients in nursing homes or
people who are paralyzed,� she said.
Among cardiac surgery patients who
developed ulcers, she found a range of
ailments that compromised circulation.
Blood flow nourishes the skin and
keeps it healthy. Most were over 65,�
she said. They had circulatory problems,
over 50 percent had diabetes, and a lot
had lung problems.� Because their sur-
geries required them to lie motionless
for long periods, their risks increased.
Dr. Marie Pokorny, center, and nurse Angela Merritt exam-
¥ 6
The next step involves testing
whether stringent use of a well-defined
regimen of care will prevent the devel-
opment of ulcers. Nurses in the car-
diac surgery unit perform a detailed
assessment of a new patientTs skin
condition and recheck the skin twice
a day, carefully documenting their find-
ings each time. At any sign of a prob-
lem, they immediately begin outlined
interventions, ranging from shifting
the patientsT weight to putting them
on specialty beds. Again, the steps are
carefully documented.
After she has collected data on 100
patients, Pokorny will evaluate the
results. If the procedures appear to
make a difference, she said, she will try
to get them instituted in other high-
risk settings, such as nursing homes.
Topsoil gone with the wind, rain
Challenging conventional wisdom, an ECU study has shown that
significant amounts of topsoil are being eroded every year from the
flat farm fields of eastern North Carolina.
Dr. Paul A. Gares, assistant professor of geography, said wind
alone carries off several tons of soil per acre. Rainfall washes tons
more into ponds, streams and field margins.
Erosion generally has not been considered a major threat in the
coastal plain, in part because of the flat topography. The sandy soil
also was thought to allow water to pass through the soil layers
instead of running off. ECU faculty questioned those assumptions in
the face of shallow, apparently truncated layers of soil and accumu-
lated sediment in eastern rivers.
Working with ECU colleagues, Gares obtained a $142,000 grant
from the U.S. Department of Agriculture to study erosion on coastal
plain agricultural lands. Gares has continued the project, now in the
fourth and final year. He presented his initial findings to the 1998
International Aeolian Conference in England.
Four tropical storms in the first year of the project left Gares
ine Donald Wayne Ross for signs of potential skin problems.
runoff,� he said. Most sediment is carried off then
awash in data on water erosion. The crucial part is initiation of
, before the
ground is saturated.� Most wind erosion occurs in February and
March, generally dry, windy months when fields lie bare.
Whether it is removed by water or wind, much of the eroded soil
appears to remain on site, but not all. On a windy day coarser sand
particles roll around close to ground and settle nearby, often forming
little sand dunes at the edges of fields,� Gares said. The rest is dust
and flies higher. ThereTs increasing evidence that the distribution of
dust is worldwide.� Dust settling on the East Coast of the United
States has been tracked back to Africa, he said, and North Carolina
top soil may be settling in England.
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ll er nk C
At the top of their math class
Three ECU mathematicians are building an international reputation
for work in the highly specialized field of operator algebra. Drs. John
P. Daughtry, Elias G. Katsoulis and Timothy D. Hudson work to dis-
cover results that other mathematicians and quantum physicists may
one day use.
In their specialty, they are a first-class group,� said David R.
Larson, professor of mathematics at Texas A&M University and associ-
ate editor of the proceedings of the American Mathematical Society.
With three in the same area, itTs one of the strongest groups in this
field in the country.�
Generally, their work involves determining properties for objects
that defy intuition. More specifically, it means investigating prob-
lems in HilbertTs space theory, which proposes that space has an
infinite number of dimensions. The field is so arcane that it can
be difficult even for other mathematicians to understand. For lay
people, it is harder still. Pressed to simplify, Katsoulis finally says,
ItTs like calculus, only more sophisticated.�
Because of their stature in the field, mathematicians from other uni-
versities"including Texas A&M, the University of Lancaster in England
and University of Waterloo in Canada"frequently visit the ECU cam-
pus. Every third year, Daughtry, Katsoulis and Hudson host the N.C.
Conference on Operator Theory, which draws researchers from through-
out the southeastern United States. Katsoulis and Hudson also organized
a special session of the 1996 national meeting of the American
Mathematics Society, one of only 12 special sessions held. Furthermore,
Katsoulis was one of a half-dozen plenary speakers at a 1998 interna-
tional conference sponsored by the North Atlantic Treaty Organization.
Each of the ECU mathematicians tackles a slightly different aspect
of operator theory. For Texas A&M's Larson, those differences consti-
tute part of their strength. This is a creative group that works well
together, as witnessed by their joint papers,� he said. They also have
the reputation of working well with researchers at other universities.�
worth $2.78 million.
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An office for clinical trials
The School of Medicine opened a clinical
trials office in 1998 to support researchers
working with pharmaceutical companies, the
federal government and other organizations
to test new drugs.
We could see we were doing an increasing
number of trials, and it was apparent that clin-
ical trials would be an increasing part of med-
icine,� said Sam N. Pennington, the School of
MedicineTs associate dean for research and
graduate studies. Our vision was to create a
support facility that aids investigators doing
trials or those who want to do trials.�
In the 1997-98 fiscal year, ECU investigators conducted 33 clinical trials
Clinical trials are complex, from the initial contract with the trial sponsor
through the process of enrolling patients, administering the drug(s) and track-
ing the resulting data. Usually, a team of three or four people will assist a
physician-investigator on a project. Pennington said the clinical trials office
will enable investigators to get their projects off the ground faster by recruit-
ing and training staff or supplying temporary assistance. During lulls in some
projects, staff can be shifted to work on others, which will help maintain the
integrity of the team. A team is fairly complex,� Pennington said. Once you
have one in place, you donTt want to let go.�
Dr. W. James Metzger, head of the schoolTs allergy and immunology sec-
tion, is the director of the clinical trials office.
See ee I iil il ccna ag it
oe = eae
You have to keep believing in your own stuff,� Dr.
Mark Taggart advises students in music composition.
A parable for the ~90s
Dr. Mark Taggart, composer and associate professor
of music, readily acknowledges that his music is not
intended as ear candy.� After all, art claims a high-
er calling than easy listening. Art gives you insight
you wouldnTt get elsewhere,� he said.
Parable, a 1997 composition, provides a case in
point. The 40-minute opera commemorates a col-
lege classmate who died of AIDS. At the time he
died, the 1994 political campaign was under way
and with it, there was a hate campaign directed at
gays and liberals,� Taggart said. A lot of them were
quoting scripture, to my mind, to suit their own
purposes. It came to me that what they were saying
was almost word for word what JobTs tormentors
said of him.�
So TaggartTs opera casts Job as a gay man dying of
AIDS and JobTs Old Testament critics as the likes of
Rush Limbaugh and U.S. Sen. Jesse Helms. For the
loving, encouraging voice of God, he used the poem To One About
to Die,� which Walt Whitman wrote for a Civil War soldier.
The piece was premiered with piano accompaniment at ECU in
February 1997. Taggart completed the orchestral score in the fall of
1998 and hopes to find more audiences. This needs to be heard in
�?
this region and in this culture,� he said. It lets them know that
words have an effect, and it may not be the effect you wanted.�
TaggartTs work defies neat categories. It includes a setting of the
Shaker hymn The Humble Heart for symphonic band; a tone poem for
band inspired by the legend of John Henry; Circination, for solo organ;
and Lament and Credo, written for a 12-piece saxophone orchestra.
The sax orchestra has proved to be a favorite vehicle for Taggart,
perhaps because he plays the saxophone himself. He has completed five
movements of an eight-movement symphony for sax orchestra called
only rhythm and.... The pieces have premiered individually, and orches-
tras in such places as Appleton, Wis., and Hattiesburg, Miss., have com-
mitted to playing the first four movements as a single work. Taggart also
will fly to Europe in the summer of 1999 to conduct the South German
Saxophone Orchestra in its performance of the four movements.
Taggart already has had an opportunity to hear the German band
perform the cycle he named Vigor. They are a very good, very seri-
ous group,� he said. But this one movement is supposed to be com-
ical. It has allusions to Mickey Mouse and other cartoon characters,
and they were so dedicated to performing the music accurately that
their seriousness added some unintended comedy.�
Taggart laments the difficulty in finding venues for modern compo-
sition but does not allow it to affect his work. ITve stopped writing for
other people,� he said. I say to students, youTre never going to become
popular like Madonna. You have to keep believing in your own stuff.�
Bee ne ne ee es
he
a
ra:
ab
RANDOLPH CHITWOOD NEVER FORGETS HIS
ROOTS AS HE BUILDS AN INTERNATIONAL
REPUTATION AS A CARDIOVASCULAR SURGEON
iad
SMOOTF
OPLRATIOR
room.
and adapts"
Dr. Randolph Chitwood adopts
new technologies for the operating
IN HIS YOUTH, RANNY CHITWOOD CAUSED HIS PARENTS FEW HEADACHES, EXCEPT WHEN
IT CAME TO HOMEWORK. HE PREFERRED HOBBIES~-PHOTOGRAPHY AND HAM RADIO-""TO STUDIES.
DEOPLE PROBABLY DIDNTT THINK |'D AMOUNT TO MUCH,� HE SAYS, FLASHING A QUICK GRIN.
By most standards, though, Dr. Randolph W. Chitwood Jr. has turned out pretty well. At 53, he chairs
the Department of Surgery of the ECU School of Medicine and Pitt County Memorial Hospital, where he
built the cardiovascular surgery program from scratch. He also is an international pioneer in both mini-
mally invasive heart surgery and the use of robotics in heart surgery, often flying to Europe or Japan as
well as around the United States to teach his surgical techniques.
With so many duties, perhaps it is no wonder that Chitwood fidgets when forced to sit and talk about
himself. He crosses his legs, flips his tie, recrosses the legs, checks his watch, flips the tie again. Later,
ChitwoodTs patients will describe an easygoing charmer who answers questions without the least
sign of hurry. At this moment, however, he is impatient, eager to move on to the patients and papers
that interest him more than the retelling of his lifeTs story. How long is this going to take?� he asks.
When my friends meet him, the first thing
they say is, ~HeTs intense.T He may be a
little intimidating when you first meet him.�
""ANNE CHITWOOD ON HER FATHER
Intense may be the word most often used
to describe Chitwood. The trait served him well
when, two years out of Hampden-Sydney College,
he decided to follow family tradition and go into
medicine. He quit his job as a DuPont chemist and
spent a year taking additional courses required by
the University of Virginia medical school. He grad-
uated from medical school in three years and
entered DukeTs rigorous 10-year residency pro-
gram for heart surgeons.
His arrival at Duke, he says, gave him his first
taste of big-time competition. He recalls looking
around in the first meeting of all new residents. I
leaned over to olT Erle Austin, who used to be my
associate here, and | said, ~WhereTd you go to
school?T and he said Dartmouth and Harvard. Next
guy, Berkeley and Harvard. Third guy, Harvard.
The guy behind me said West Virginia. I said,
~We're going to be friends.T�
He had almost a year to go in his residency
when he came to the attention of Dr. Walter J.
Pories, then-chair of ECUTs surgery department.
Pories was looking for someone to start a heart
surgery program in Greenville. ChitwoodTs mentor
at Duke, Dr. David Sabiston Jr., spoke highly of his
protege, and Pories invited the young doctor for
an interview.
Chitwood was impressed by the details Pories
had amassed to support plans for a heart program
eaeanetver
He will drop everything in a New York minute if his family
needs him,� Tamara Chitwood says of her husband, Ranny.
driving an old VW"one car had died,
the other was dying,� he says. So I
called my wife and she said, ~Oh,
thatTs good. You can look at that job.T�
For the next nine months, Chitwood
worked in Durham weekdays and drove
to Greenville on weekends, hiring
staff, buying equipment and laying the
foundation for a research program. On
July 10, 1984, within a week of arriv-
ing in Greenville full time, Chitwood
performed eastern North CarolinaTs first open-heart
surgery, a coronary bypass operation. He operated
300 more times that first year, spending the night in
the hospital to watch his patient after every opera-
tion. Only then did he begin to hire other surgeons.
The cardiovascular surgery team now performs more
than 1,200 operations annually.
After five years, a frustrated Chitwood left for
a job in Kentucky. I wanted a heart center here
�
and couldnTt get it,� he says. I see now it was
well in advance of the ability of the institution to
respond, but when youTre going at this speed, you
just expect the next level, and you canTt always
a
$$$ $$$ "_"""" a RR ART aT a ae oe a
convince people.� KentuckyTs bluegrass turned out
to be greener from a distance than close up. Two
years later, Chitwood was back in Greenville,
negotiating for"and getting"a multidisciplinary
heart center that pulls diagnostics, therapeutics,
surgery and rehabilitation under one roof.
He was a very strong-willed child. HeTs still
strong-willed. | think he likes to excel and
wants to be at the top of his field.�
"RUTH ANN CHITWOOD TALKING ABOUT HER SON
One goal accomplished, Chitwood needed anoth-
er. I had been piddling for a long time with the idea
of how to operate on a totally closed chest,� he says.
Then French surgeon Alain Carpentier announced
that he had performed the first endoscopic mitral
valve operation. (The mitral valve sits between the
upper and lower chambers on the left side of the
heart.) Instead of cutting the chest open and spread-
ing the ribs, Carpentier had worked through a rela-
tively small hole in the ribs. A tiny camera inserted
wwe ys te. :
ee
4 :
SP Make oor Fels Ju
~Ay
Gi KA
~ ay a a \ ANG
NX
. a \ ee
into the incision projected images on a video screen
to guide the surgeonTs hands. For the patient, the
result was less pain and faster recovery. Chitwood
met with Carpentier and set out to develop his own
endoscopic mitral valve operation.
Step one was to find a way to stop the beating
heart long enough for the surgery but without the
necessity of putting the patient on a heart-lung
machine. A U.S. surgical equipment company was
testing a balloon device that stopped the heart
by shutting off blood flow through the aorta.
Chitwood asked for one of the tools but was
turned down. Only the Stanford University med-
ical center could use the device, the company said.
So I sat in the cafeteria and sketched out a
design for a clamp that would occlude the aorta
and that would take their $5,000 balloon out of
action,� he says. ChitwoodTs $1,000 clamp, unlike
the balloon, is reusable.
Chitwood performed the first minimally invasive
mitral valve operation in North America on May 24,
1996. He then designed more instruments, giving
them long handles to make it easier to work through
a small incision. In 1998 he added a new twist. For
his first endoscopic sur-
gery, a human assistant
held the camera, moving it
at ChitwoodTs direction.
Today, a voice-activated
robot controls the camera.
The vision is to devel-
op a totally endoscopic
operation so the next gen-
eration of surgeons with
3D cameras and robotic
devices can do this with
facility,� he says.
HeTs not a workaholic. He just loves what he
does. ItTs hard. ItTs demanding, but itTs not
labor. And heTs great at it. ITve mentioned his
name here, and people recognize who he is.
He has an international reputation.�
""ROBERT M. JOHNSON, LECTURER IN ENTREPRE-
NEURSHIP AT THE LONDON BUSINESS SCHOOL
AND CHITWOODTS FRIEND SINCE CHILDHOOD
and even more impressed by what Pories offered" Hard work and medicine were bred into
Chitwood. His sister is a doctor. So were his father,
grandfather and uncle. His mother and grandmoth-
er were nurses. Saturdays usually took him to the
a decent salary, a full professorship and chief of
cardiac surgery, all straight out of training. I was
: "Chitwood and his staff prepare a patient for surgery one of 1,200
heart operations that will be performed this year at Pitt County
Memorial Hospital. Above right, surgical clamps are sterilized and
ready for use. |
edge 15
14 edge
with his cardiologist produced a verdict of perfect.�
Even before the check-up, the cardiologist had a
good idea of how his patient was doing. From the
moment I met [Chitwood], he started correspon-
ding with my cardiologist,� Ratchford says. He
keeps the other guys and girls totally informed.�
Good communication with referring doctors has
Chitwood Clinic in his hometown of Wytheville,
Va., where he folded gauze and blew up gloves to
test for holes. Often, he accompanied his father on
house calls, opening and closing farm gates along
Chitwood indulges his passion for antique medical instruments and
books and for all things related to fellow Virginian Thomas Jefferson.
the way.
Chitwood also had watched his father work late
into the night and on weekends. He knew long
hours came with the territory when he entered
medicine. For eight of the 10 years of his residency, with family. Regrets come with the territory, he
he spent every other night on call at the hospital. says. He wishes that he had called his parents more
At that time, I considered that if you werenTt on often, that he had spent more time with his wife,
call a lot, you were missing stuff,� he says. Tamara, and children, Anne, a University of Virginia
Harrizene Keyes, his administrative assistant, graduate working in the Washington, D.C., office
suggests that part of the drive comes from the of U.S. Senator Jesse Helms, and Randolph Ill, a
undivided attention he demands for his patients. A | geology major at the University of Montana. The
few years back, the surgeon himself underwent decision that family could not always come first
The greater cost of his schedule has been time Epen. 8 Sey (0 CORWEORS Senna Seer . One
behind excellence in quality. These guys are going
down to Rotary Club from their office to eat the
chicken and sing the song at lunch and then they
run into Uncle Louie down there and he says,
~HowTs Aunt Sally?T ItTs pretty impressive for him
to say, ~Oh yeah, Dr. Chitwood called me right
out of the operating room. SheTs in the recovery
room now.T It makes it look like heTs on top of
things. I learned that from my old man.�
|
|
|
|
|
quadruple coronary bypass surgery. Coming out of | was made when he entered medical school, he says.
the ICU, he was still worried about the operation
of the office,� Keyes says. When he went home,
he was working there. He even came by the office to
see what needed to be done and check on patients.�
Chitwood confirms that coronary disease, which
he attributes to genetics, has not slowed him
down. ITm working twice as hard as I was before
surgery,� he says. What gives you coronary dis-
ease, as far as stress is concerned, is not operating
on the human heart. ItTs what most managers deal
with"personnel, deadlines, people calling for
manuscript review, overcommitment, the anger
associated with that, the inability to get things
done. But the stress of operating on a high-risk
patient carries you like the guy coming down the
biggest ski slope. YouTre trained to do it. It carries
you to technical heights. My heart rate in the
operating room is lower than it is right now.�
His family is more generous. They say he made
time for the important events, trick-or-treating on
Halloween, Honor Society induction, the occa-
sional college football weekend. He will drop
everything in a New York minute if his family
needs him,� Tammy Chitwood says. In ~95, | was
diagnosed with HodgkinTs disease. He was right
there with me. When my father became ill, he
dropped everything and was there with him when
he drew his last breath.�
When | met him, | wanted him to do it. He
didnTt make us any great promises, but if
somebodyTs going to cut your chest open, itTs
important that you have a good gut feeling
about that person. ItTs not like somebody doing
your taxes or something that
can be fixed.�
"TERRY RATCHFORD, PATIENT
My heart rate is lower in the operating room than it
is right now,� Chitwood says in an interview.
Terry Ratchford, an insurance
agent from Gastonia, got bad news
from his cardiologist in the fall
of 1997. He needed surgery to
correct a defective mitral valve.
After conferring with surgeons in
Charlotte, Ratchford had resigned
himself to open-heart surgery and
valve replacement, but relatives
and friends had heard about a
doctor in Greenville who had
developed a procedure that didnTt
require opening up the chest. At his
motherTs insistence, he drove across
the state to meet Ranny Chitwood.
Looking back, Ratchford calls his a storybook
case. Chitwood was able to repair, rather than
replace, the defective valve using minimally inva-
sive techniques, and the surgeon made him feel
comfortable throughout.
He came in that first day and was totally pro-
fessional but very warm,� Ratchford says. He has
tremendous bedside manner. He was charming,
very accommodating and not at all in a hurry. He
makes sure you get all your questions answered.
When he looks you in the eye, you trust him.�
Ratchford was able to leave the hospital after
only three and a half days. Back home, a check-up
The old man� crops up frequently in his conver-
sation. A bust of Thomas Jefferson sits in ChitwoodTs
hospital office. In his new home, his wife is hav-
ing the parquet floor of Monticello reproduced in
the suite of rooms that will house ChitwoodTs
study, darkroom, ham radio equipment and a
library for a collection of antique medical books,
instruments and his grandfatherTs medical saddle
bags. It is obvious that Chitwood admires Jefferson
and the many inventors and surgeons he quotes
with ease. He stops short, however, of calling them
heroes. Instead, he recalls his father.
You have to be careful with heroes,� he says.
You pick out a hero and have to remember
theyTre just people. They have problems, too. But
sure, you have heroes. Your parents are heroes.
Your fatherTs a lot smarter 30 years hence. He's
dead now, and you canTt tell him. Some of those
little things, though"you pick up on the sub-
tleties later on, and you really wish he was around
so you could ask him what he meant.�
ChitwoodTs voice trails off. Memories of his true
hero, the one he wishes he had called more often,
fill the silence. Miles away, from an office in the
nationTs capital, another Chitwood has found a
hero, too.
Sometimes | think heTs a little hard on him-
self,� daughter Anne says. ITve met a lot of people.
They say, ~YouTre Ranny ChitwoodTs daughter. He
operated on my fatherT or ~He operated on my
uncle. What would eastern North Carolina
do without him?T I just swell with pride.�
=
ft
edge
17
NN
ee
a """"
English professor Ronald Hoag
explores the many v4
facets of the
Thoreau legacy
wre
oe
TY
ee TA
s §,
Fs G
he "~
a a
Today he is a leading scholar of the works of the pondTs most famous visitor, Henry David Thoreau.
Hoag serves as the treasurer of the Thoreau Society, an organization dedicated to studying Thoreau and
his work, and he edits The Concord Saunterer, the societyTs annual journal. He also is an adviser to the
Walden Woods Project, which seeks to preserve the land most closely associated with Thoreau, and was
a contributor to The Cambridge Companion to Henry David Thoreau. Although Thoreau lived from 1817
to 1861, his work continues to resonate worldwide. In spring 1998, President and Mrs. Clinton joined
the Thoreau Society and Walden Woods Project in dedicating the new Thoreau Institute for research and
education. Recently, edge talked with Hoag, a professor of English, about ThoreauTs legacy.
Dr. Ronald Hoag has made Henry David Thoreau
the focus of his career. He studies ThoreauTs
life and works"and sometimes retraces his steps.
edge: What accounts for ThoreauTs status as an
American icon?
Hoa: There are three areas of ThoreauTs life and
work that are particularly important. One is as a
transcendentalist. Another is as a political thinker,
and the third area, which is the subject of most of
the new books and articles today, has to do with
Thoreau as a founder of the science of ecology.
edge: LetTs explore those one at a time, starting with
transcendentalism. What was ThoreauTs major con-
tribution there?
Hoac: Ralph Waldo Emerson, his mentor, was the
principal formulator of the theory of transcenden-
talism as it gets translated into American culture
from various other sources. Basically, transcen-
dentalism assumes that there is a relationship
between the physical and the spiritual and that a
person can find spiritual significance by engaging
with physical nature in a conscious, receptive way.
Thoreau was a real pragmatist and put everything
to the test. He read EmersonTs statement of tran-
scendentalism, published in a pamphlet called
Nature, and wanted to see if these ideas would hold
up. ThatTs basically why he went out to Walden
Pond for a couple of years"to see if, away from
the distractions of the community"the transcen-
dental approach will work. ItTs his experiment in
transcendental living, and in the end, he pro-
nounces it a success. He says, yes, youTre never
going to get to the bottom of the universe, but
you'll get deeper and deeper into the meaning of
it until finally, (the fact) that itTs unfathomable
becomes a good� because it suggests just how
much meaning is there, an infinite amount. It
gives you a reason to get up the next day and go
look for some more. So his contribution is that of
a successful practitioner of transcendentalism.
edge: Those of us who came of age during the T60s
and T70s think of Thoreau in more political terms.
WhatTs the source of this influence?
Hoaa: One of his legacies is the rationale for civil
disobedience. He went to jail briefly rather than
pay his poll tax because he saw the poll tax as
supporting slavery. (In the essay On Civil Disobe-
dience�) Thoreau asks why, even in a democracy,
Walden Pond, where
/alelact-|0mumerlaal-te mumel ty
his experiment in tran
osiare (clad | Mihailo pm ele) 4
today much as it did
Tam dalce Bcadatma lalallava
The Concord Saunterer,
which
Hoag edits, carries articles by
established scholars and _ signifi-
cant newcomers.
a simple majority vote should determine what is
right. You could have a majority of people who
happen to be in the wrong. So, he says, con-
science should be the final arbiter when it comes
to making moral decisions, and any man more
right than his neighbors constitutes a majority of
one. And, he says that we should not just wait for
unjust laws to change or obey them while work-
ing to change them, but if they are truly unjust,
then they are immoral and we should go ahead
and break them. That plays out in the 20th centu-
ry in particular with Mohandes Gandhi in India
and also with Martin Luther King Jr. Thoreau is
one of the foundations they both built on, and
his ideas became very popular during the 1960s.
edge: We know Thoreau went off into the woods to do
his thinking, but youTve suggested that his contribu-
tions to science extend beyond that of nature lover.
HoaG: ThereTs been a whole spate of new scholar-
ship on this dimension of ThoreauTs work. It
began in 1993 when Bradley Dean, who used to
be a colleague here at ECU, edited and published
Faith in a Seed, a book that presented a previously
unpublished manuscript by Thoreau called The
Dispersion of Seeds.� This book shows Thoreau
was really ahead of the scientific establishment of
his time. The prevailing assumption of the day was
that some plants just spring up by spontaneous
generation or what was called special creation.�
This was the opinion even of Louis Agassiz of
Harvard, the top American naturalist. Thoreau,
who had been doing lots and lots of field work,
concluded no, it isnTt spontaneous generation.
Instead, you have this whole mechanism in
nature that disperses seed. ItTs done by wind, by
animals. He uses the example of a city person
who goes for an outing in the countryside and
takes a walk and comes back carrying sticky burrs
on his clothes, and those sticky burrs transplant
seeds to wherever that person happens to get off
the train at the end of the day.
ThoreauTs conclusion was that nature is not a
hodgepodge of isolated phenomena. ItTs a web, and
if you touch the web at one point, youTd better be
careful because itTs going to have an impact some-
where else. That, of,eourse, is the whole notion of
ecology and ecosystems, words that didnTt exist
in his day. Yet you.gan take page after page of his
writing, especially his later writing, and put them
appropriately» into an ecology textbook today.
ThatTs the reason heTs now considered a principal
founder of the science of ecology.
edge: These three areas of. contribution are very
different from each other. Is there a common denom-
inator to ThoreauTs work?
Hoaac: In Walden, he says one of the conclusions
he draws from his experience is that the universe
is wider than our views Of it. He tries to get beyond
our narrow views by consciously going beyond
boundaries, in everything. lf you look at the tran-
scendental area, he is going beyond the physical
to see the spiritual. If you look at the political
area, he is going beyond that narrow definition of
right that is inscribed into the laws and insisting
on a wider, more moral definition derived from
conscience and consciousness and God.
Thoreau was a big advocate of what he called
the wild.� In one of his essays, he states, In wild-
ness is the,preservation of the world,� which the
Sierra Club often quotes. | think for Thoreau, wild-
ness is just another word for that idea of going
beyond bounds. When he made a trip that he dis-
cusses in the first of three essays in The Maine
Woods, he talks about leaving civilization and
climbing a fence and then going into the woods.
When you read it, it sounds like a simple statement
of what he did. But itTs that act of going OVER the
fence, of going BEYOND bounds thatTs in his think-
ing, in his seeing, in his speech, in everything.
edge: YouTve made a particular study of those essays,
havenTt you?
Hoac: One of the two best things ITve done as a
scholar is an article I wrote on The Maine Woods
(The Mark on the Wilderness: ThoreauTs Contact
with Ktaadn,� published in Texas Studies in Literature
and Language, spring 1982.) For a lot of people, i
changed the thinking on some key passages. He said
at the beginning of the essay Ktaadn� that here in
the wilderness, one must confront the true source
_
THOREAU WAS A _ BIG ADVOCATE
OF WHAT HE CALLED ~THE WILD.T.
| THINK FOR THOREAU, WILDNESS
IS JUST ANOTHER WORD FOR THAT
IDEA OF GOING BEYOND BOUNDS.
rn
of evil. At the end of his account, heTs on the top of
this bald mountain, Katahdin (modern spelling).
ItTs windy and off-putting and heTs obviously trem-
bling and feeling overwhelmed. Other commenta-
tors had said well, putting two and two together,
he must now think that nature is evil instead of
being spiritual and something youTd want to tap
into. Someone refers to this key passage as a chink
in his transcendental armor.
The article I wrote said no, youTve got the lan-
guage right but youTre making the wrong inter-
pretation. What Thoreau was doing here in
Ktaadn� is describing his experience of the sub-
lime. The whole tradition of the sublime in
nature involves things like the Alps or Niagara
Falls or the Grand Canyon or the ocean in a
storm. These are natural phenomena that make
you feel bowled over, but what you're experienc-
ing is the power of nature. Thoreau says that
rather than making fear the controlling principle
of the sublime experience, he sees that principle
as reverence and wonder and awe. This is why
Katahdin becomes his holy mountain and why he
writes about it positively from then on. The evil
he writes of confronting is actually mankind,
including to some extent Thoreau himself,
because man insists on dominating the wilder-
ness, confining in one way or another what was
meant to be wild.
edge: You said this was one of your two most impor-
tant works. WhatTs the other?
Hoac: The other I did with Brad Dean. It was a book-
length examination of ThoreauTs career as a lectur-
er. Thoreau had an active, long career as a lecturer,
and itTs significant because he would write his
observations in his journal, then take things from
various journal entries and work them into lec-
tures. From the lectures they would become essays,
and then finally some of them would become
books. But no one had fully examined his career
as a lecturer. We put together the fullest account
thatTs been published. |
For each lecture, we give a narrative of the
event, a section that deals with advertisements
and reviews, and a description of the lecture itself.
In some cases, we found accounts in newspapers
where you would swear the newspaper reporter
had a tape recorder because heTs got seemingly
verbatim what the whole lecture would be. You
can take that and put it up against the published
essay Or whatever came as a result, and you can
see ThoreauTs thinking at work as he embellished
some things that got a good response or took out
others that went over like a lead balloon. You can
see him, the writer, at work. Our study was pub-
lished im the Studies in the American Renaissance
series from the University Press of Virginia divid-
ed into lectures before Walden and after Walden.
edge: The Concord Saunterer, which you edit, goes
to all 1,800 members of the Thoreau Society.and is
also sold to the public. These readers include untver-
sity scholars from many different fields and a major-
ity of members and others who aren't academicians
at all. How do you appeal to such a broad audience?
Hoac: I try to get as many articles of different
kinds in the journal as | can. Thoreau wore many
hats, and Thoreauvians collectively wear many
hats, too. There are lots of different areas of interest
in him. I canTt appeal to them all the time, but I can
be aware that theyTre out there and take advantage
of opportunities to present something that address-
es a constituency that doesnTt often get attention.
ITm also not much into recent trends in critical
theory that require a translator to understand. The
articles we publish are sophisticated"we publish
articles by some of the most established scholars as
well as by significant newcomers"but if a reader
comprehends English and puts in a little time and
thought, thereTs nothing that we publish
that canTt be understood.
RESEARCH YIELDS STARTLING CLUES TO THE COMPLEXCONNECTIONS BETWEEN TWO DEMDLY CONDITIONS
\
besity
Most patients are so surprised that someone will listen
and agree they have a bad disease,� says Dr. Walter Pories,
shown here with Glenda Williams.
A PAMLICO COUNTY WOMAN
sits quietly as she waits to see her
doctor. At age 32, she weighs 419
pounds and suffers from diabetes,
high blood pressure and a host of
other ailments.
She knows her health risks"
her father weighed 500 pounds
and died from complications of
diabetes"and she has decided to
move beyond the diets and med-
ications that have accomplished
so little: Her hopes now rest
in the staff of the ECU School
of Medicine.
Her choice is well-founded.
Over the past 15 years, a multidis-
ciplinary research team here has
been redefining medical under-
standing of obesity and diabetes.
[It is led by Dr. Walter Pories,
former chair of the Department
of Surgery, and biochemist Dr.
Lynis Dohm.
Writing in such prestigious
journals as the Annals of Surgery,
the ECU team has shown that
Ni: oe: oe ee oe
when morbidly obese, diabetic
patients undergo a special opera-
tion to bypass much of the stom-
ach, their diabetes lessens, often
disappearing spontaneously. This
finding has led the researchers to
suggest that non-insulin-depend-
ent diabetes stems from hormon-
al signals originating in the lower
stomach or upper small intestine.
They also have shown that as
these surgical patients lose weight
and as control of their diabetes
improves, other measures of oyert-
all health improve disproportion-
ately, and they live longer than
similar patients who do not
undergo surgery.
More discoveries may be on the
horizon. As the scientists continue
to refine their understanding of
the mechanism of diabetes, they
are opening new explorations into
how the body burns and stores
fat. And, in a new partnership
with the pharmaceutical giant Eli
Lilly, they are seeking out the
genes responsible for both dia-
betes and obesity.
The team is a rarity in medical
science. WhatTs unique here is
that we have basic scientists and
people who are surgeons working
together,� Dohm said. ItTs not
often you get this kind of collabo-
\
\
+
\
\
ration.� In addition to Pories and
Dohm, the core research group
includes seven lead investigators:
in surgery, Drs. Paul Gunningham
and Kenneth MacDgnald; in the
medical schoolTs basic science
division, Drs. Hisham Barakat and
Madhur Sinha; and in the Human
Performance Laboratory, Drs. Joe
Houmard, Robert Hickner and
Ronald Cortfight. The collabora-
tion has developed out of an equal-
ly unustial set of circumstances.
4n 1977, when we started (the
fnedical school) here at ECU, we
recognized that obesity was a
major problem in eastern North
Carolina and decided to make it a
focus of our work,� Pories said.
Obesity is closely associated with
numerous health problems, includ-
ing diabetes, heart disease, high
blood pressure, degenerative joint
disease and some cancers.
Morbid obesity"generally de-
fined as 100 pounds or more over
a personTs ideal weight"carries the
most serious risks, but also has
proved most difficult to treat.
Once the human body has reached
a set point, it vigorously defends
itself against weight reduction.
Cut back on calories, and metabo-
lism slows. Succeed in losing
weight, and the body puts it back
on at the earliest opportunity.
Since exercise revs up the metab-
olism, an average person may
shed excess pounds through a
combination of diet and exercise.
This approach may be less than
realistic for the morbidly obese,
however. To tell someone whose
weight is 400 pounds to walk four
miles a day is insane,� Pories said.
He sought another approach"
surgery. By reducing the size of
the stomach, he also would dras-
tically restrict the number of calo-
ries a patient could consume.
Weight loss should follow.
He tried several operations
described in medical literature.
When none proved optimal, he
began making his own revisions.
After 200 surgeries, he had devel-
oped what has become known
worldwide as the Greenville Gastric
Bypass. This operation divides the
stomach so that food can reach
only a small pouch at the top.
From there, it empties into a
shortened section of intestine.
This both limits the amount of
food someone can eat and speeds
its passage, reducing absorption.
Dr. Lynis DohmTs work with mice and exercise is
key to understanding cellular factors in diabetes.
From the start, results with the bypass were
remarkable. Most patients lost more than 100
pounds within two years, dropping from an aver-
age of 314 pounds to 206. Equally remarkable,
most of the weight stayed off.
Pories noticed something else. When he oper-
ated on his first diabetic patient, the diabetes dis-
appeared even before weight loss had occurred.
At first, | thought we hadnTt done a good job of
diagnosing the diabetes,� he said. Then I saw it
happen several more times.�
The National Institutes of Health estimates that 16 million Americans have dia-
betes mellitus, a serious disease that may lead to such complications as blind-
ness, kidney failure, coronary artery disease and nerve damage. It costs the
United States approximately $100 billion every year, about half of that in direct
medical expenses.
Although there are different forms of diabetes, in all cases it affects metabo-
hina pam dalam elele hae: pel Mmcelualiare mcolerem ial com ivi M Ralcmelele)vmelic-) cmanlesimeleremele\ iia)
into a simple sugar called glucose, its main source of fuel. To make use of that
fuel, it also needs insulin, a hormone produced by the pancreas.
The condition known as insulin-dependent diabetes occurs when the pancreas
cannot make insulin. As a result, the body is deprived of fuel, and unhealthy
CZs Kate) Me | Ureenvom olel ie mel em amealcme)(elerem jer r-lasmal Ralhe-(eq@ele(a QM (elm-lelele)l aoe ere cal
of all diabetes. Most often, insulin-dependent diabetes is diagnosed in children
role elelare melelelle em lect lepalcial@iiaraiece(onmacelllr-lmial(cedlelar me) Mmiarieliiam-laeme-liiUl maces
TiFelelelame)mcaicme liam
Non-insulin-dependent diabetes accounts for 90 to 95 percent of diabetes
mellitus in the United States. It occurs mostly in adults of middle-age or older
and in people who are overweight. In this condition, the pancreas produces
Takieliiapen ele) Gn dalciaclitwr-lecielar-|e)(cm com anl-] comcliici@ Gh Ucmhiome) ml Our ma@elalellelelam dale\i ami:
insulin resistance. A majority of people who are overweight have some degree of
insulin resistance, but only a portion develop diabetes. Diabetes is diagnosed
when blood glucose reaches an unhealthy level. Non-insulin-dependent diabetes
often may be treated with diet and exercise alone, but oral medication is some-
times needed.
Weight and diet affect diabetes in ways that are still being studied. Both body
fat and fat circulating in the bloodstream appear to interfere with the ability of
cells to use insulin. The pancreas compensates by producing additional insulin,
but as people put on more and more weight, the pancreas may be unable to
keep up with the added demand. Sometimes, the strain may be so great that the
pancreas wears out, and insulin-dependent diabetes results. A proper diet
more (U(@ ch Gal omr-lanleleial@elMmiarielipmalce(em em eslialale maalcme[palele lal mre) me lie(@e stom lale mre)
circulating in the bloodstream. Similarly, weight loss reduces the territory the
Takieliiamanieniaae) ice
Exercise has been shown to increase the cellsT ability to use insulin as much
as twofold. How this occurs is under investigation. Exercise also aids weight
gore (Ure dela par MiUiadalcim@ elclalcilim@lama@elslace)iiiavemelrleliccme
edge
Perplexed, he approached the scientists who
study the chemical and molecular workings of
the body. Together, they began the search for
explanations.
The gastric bypass patients provided a rare
opportunity. About one-third were diabetic, and
another third had insulin resistance, a precondi-
tion to diabetes. The scientists could study these
patients when they were obese and after they lost
weight and when they exhibited diabetes and
when they did not. They also could compare dia-
betic and non-diabetic patients. A key component
of the research has been-tissue obtained,
with the patientsT permission, at the time
of their bypass surgery. Small sections of
liver, muscle and adipose (fat) tissue go to
the labs where the scientists developed
specialized techniques for preserving and
growing the tissue for experiments.
These factors together amount to a
tremendous opportunity we have that
almost no one else does,� Dohm said.
Some of the most stunning results have
come from examining the long-term con-
sequences of surgery. For example:
¢« Gastric bypass patients and similarly
obese patients who did not undergo
surgery were followed for periods of
six to 10 years. During this time, the
surgery patients had a much lower
chance of dying in any given year.
This was attributed to a decrease in
deaths from cardiovascular disease.
¢ Among those same surgical and non-
surgical patients, the need for med-
ical treatment for diabetes differed
significantly. The percentage of surgi-
cal patients taking oral medication
for diabetes dropped while the_prfo-
portion of nonsurgical patients on
medication increased.
e In terms of metabolic fitness, the sur-
gical patients are significantly better
off than their weight predicts. After
surgery, they become more insulin
sensitive, even before they begin to
lose weight. When they are put on an
exercise program, they show greater
improvements in fitness than do
nonsurgical patients (matched for
such factors as size and sex) on the
same program.
Ce ee
_
A nagging question remains"how much the
improvements in the gastric bypass patients
can be attributed to the surgery and how much
to the dietary restrictions it imposes. (After full
recovery, most patients can eat no more than
half a hamburger at one time.) Early on, Pories
ran a study to rule out the effect of diet. To do
this, he compared patients who had gastric bypass
surgery with patients who tried to lose weight
through diet alone. They weighed the same, but
the difference in metabolism was enormous,�
Pories said. When/ diabetic patients diet alone,
insulin resistance lessens, but it doesnTt disappear.�
A current trial of a different surgical procedure
for morbid obesity may offer further evidence.
Gastric banding cinches the stomach to allow less
food to pass through, but unlike the gastric bypass,
it does not change the basic physiology of the
digestive system. Food continues to pass through the
entire stomach and intestine. As gastric banding
patients return for one-year checkups, their progress
will be compared with that of bypass patients.
If bypass patients\again show superior fitness, it
will give diabetes researchers more reason to focus
tightly on _hormonatsignals originating in the gut.
Progress also is coming on~the cellular front,
where advances in knowledge are measured in
increments. The researchers, for example, have
narrowed in on at least one factor contributing
to insulin resistance, the overabundance of\an
enzyme that appears to block cells from absorbing
glucose in response to insulin. To prove their the-
ory, they have developed a mouse in which they
can control the amount of the enzyme being pro-
duced. Next, to prove cause and effect, they will
chart the changes in insulin activity when the
enzyme is activated_at different levels.
Similarly, they are elose to identifying the
regions on a gene that regulate production of sub-
stances called glucose transporters. We have
found that we can cure diabetes in\mice by over-
expressing glucose transporters,� Dohm said. It
turns out that you can do the same\thing in
�
humans by exercising.� In fact, exercise \doubles
the number of glucose transporters in humans.
Production of glucose transporters appears \to be
controlled by several different promoter� regions
on the genes. The scientists have located one
region on the gene that directs the thyroid hor-
mone to produce transporters. Now they are seek-
ing the region that is activated by exercise.
The basic and applied aspects of this work
dovetail as tightly as the sides of a well-made
drawer. As DohmTs lab splices genes to locate pro-
moter regions, the team in the Human Perform-
ance Lab works with human volunteers to refine
knowledge about the effects of exercise on glucose
transporters. They have shown that the number of
transporters increases substantially with as little as
one week of regular exercise and that the effects
may be maintained when the-frequency of exer-
cise is reduced. The answers to all these questions
about glucose transporters may come together
one day in-anew treatment for diabetes.
Pories, shown reviewing x-rays, devel-
oped the Greenville Gastric Bypass to
help obese people lose weight. Above,
a genetically engineered mouse allows
researchers to control production of
an enzyme that blocks the absorption
of glucose.
The team also is
opening new areas
of exploration. Eli
Lilly has awarded
ECU a five-year, $2.5
million grant for a
cooperative study of
the genetics of obe-
sity and diabetes.
The ECU team _is
providing tilly with
tissue~and blood sam-
ples from, patients
and blood samples
of the patientsT sib-
lings. By comparing
the DNA in these
samples, the Lilly
researchers will try to
| pinpoint key genes.
Once they isolate
Suspect genes, the
ball comes back to the ECU court for experiments
We think there are
on the tissue to show how the genes work.
some changes in lipid
This isnot something any of us could do
metabolism that real-
by ourselves,� Dohm said. They have a large
ly predispose people
ly predis} ) peopie
capacity to analyze genes to see which ones
to become obese,�
a We xo ie are involved, which is something we couldnTt do.
At the same time, they donTt have the patients,
so itTs only through making this kind of connec-
tion that you could ever do this kind of research.
YouTve got to have\all the components, or it
won't work.�
The scientists also are opening an inquiry into
the causes of obesity. The National Institutes of
Health, which has funded most of-the research on
diabetes and obesity, is considering~a grant
request for three separate but related studies. In
particular, the team wants to examine the metab-
olism of blood lipids, a family of substances that
include fats, oils and cholesterols. Earlier research
has suggested that people become obese because
their muscles fail to burn fat and instead send it
to the adipose tissue for storage.
We think there are some changes in lipid
metabolism that really predispose people to
become obese,� Dohm said. They have to take in
more calories than they need, but when they do,
the fat is directly shunted off to the adipose tis-
sue.� The researchers will examine why that hap-
pens"what prevents the muscle from burning
the fat in the first place and why the adipose tis-
sue is so eager to absorb fat.
26 edge
One of those three projects, led by Dr. Hisham
Barakat, will study differences in white and
African-American women. African-American women
have been shown to gain more weight, to put on
weight at an earlier age and to have more diffi-
culty\in losing weight. They also deposit fat in
different patterns-than"do_white women. The
issue is made more complex because the pattern
of fat deposits in African-American women should
offer some protection from cardiovascular disease,
and they do indeed have lower cholesterol read-
ings:-Despite the lower cholesterol levels, African-
American womerdie from heart disease in higher
proportions than do white women. These factors
hold true even when economic and cultural fac-
tors are taken out of the equation. Barakat will
try to find out why.
In the end, there may be implications for
�?
different therapies for blacks and whites,� he
said. It may be we need different benchmarks
of health, such as lowering what we consider to
be safe cholesterol levels for blacks.�
As the research continues, so do the surgeries.
Since Pories developed the Greenville Gastric
Elance cole) ol-imar-lemelcelelelal@alhmel-lelics
Wiare(-1mmece)al ace) Mm 7itame-Mmeelanle)iar-lalelamme)|
oral medication and weight loss, but
the pain in his feet refused to go away.
The diabetes had caused nerve dam-
age, called diabetic neuropathy. | had
very little feeling to the touch,� he said.
oa eels] (olamam-\U-ammeihidialeleihiammae) (opm
they hurt like hell. | would walk like |
was 200 years old.�
Then came what Cooper now con-
siders the best move | ever made.�
Through the Diabetes and Obesity
Center at the ECU School of Medicine,
~atom cole) am ey- 1a Mam Mallialie-|Magt-| mem agl-mce) on
ical drug Clonidine. The trial was
designed to test the effective dose
range and safety for Clonidine cream in
the treatment of diabetic neuropathy.
For five months, Cooper rubbed the
Bypass, he and other ECU surgeons have per-
formed the operation more than 850 times.
In Pories, the patients find hope and com-
passion. Most patients are so surprised that
someone will listen and agree that they have a
bad disease,� Pories said. TheyTre used to being
told they eat too much or they're lazy because
they donTt exercise.�
Pories, too, sees cause for hope. For the first
time,� he said, weTre beginning to see hope that
we will be able to con-
trol diabetes better ca
than we do today.�
cream onto his feet three times a day. most up-to-date treatments for teach-
Gradually, the pain subsided, and nor-
mal feeling returned. Cooper's recovery
ing. ThatTs part of what universities are
supposed to do.�
was so successful that after his initial In the waning months of 1998, the
trial, he was allowed to stay on center was participating in nine trials
and had four more scheduled to start in
early 1999. Some address diabetes itself
while others offer potential help for
complications of the disease. They
included tests of several drugs for treat-
ment of mild to severe diabetic neuropa-
Clonidine as part of a compassionate-
use program while the pharmaceutical
company awaits federal approval to
market the drug.
| even went to a powwow and
danced awhile ago,� said the Native
American from Grimesland. I could tell
it the next day, too, but that had more
to do with age than with my feet.�
thy, one using commercially grown
human skin to treat foot ulcers, another
testing a drug to inhibit fat Flesvels olacelamce)
help patients lose weight, plus a trial of
an inhaled form of insulin. Next spring,
the center will participate in a trial of an
Cooper's story is one example of why
the Diabetes and Obesity Center pursues
a multi-million-dollar clinical trials pro-
automatic glucose testing device, which
Pfeifer called the missing link in being
able to develop an artificial pancreas.
Each trial must be approved by the
medical schoolTs human subjects review
gram. In these carefully controlled stud-
ies, the centerTs doctors, staff and patients
work with pharmaceutical companies
and other researchers to test promising
new therapies as part of the Food and
Drug AdministrationTs approval process.
ItTs important for us to keep at the
committee. WeTre careful about the
type of trial we do,� Pfeifer said. We're
not interested in just getting money to
run a trial. We want to know: Does it
make a difference? Will it change the
way we treat people? lf the answer is
yes, then it helps us bring things quick-
er to eastern North Carolina.�
Pfeifer came to ECU in 1997 with an
established reputation in clinical trials.
Doug Allin, clinical research manager
edge of what's going on,� said Dr.
Witear lo We aiclicmm tale ecalcmmelcracels
and section head of the endocrinology
and metabolism department of the
School of Medicine. We can bring to
our patients the state-of-the-art therapy
right away, often years before itTs gen-
erally available. It also allows us to be at
the edge and have experience with the
for Curatek Pharmaceuticals in Buffalo
Grove, Ill., had worked on a project with
Pfeifer 10 years ago at the University of
Kentucky and followed his work through
the years. When Curatek took on devel-
opment of Clonidine, he sought out
Pfeifer again, this time at ECU.
He didnTt let me down,� Allin said.
We did a pilot study first. When you
start a study, you figure the patients will
drift in slowly. Within a month, he had
all the patients enrolled. | was amazed
at how fast he got going. And his staff
people are always responsive. Every-
thing is very timely.� Pfeifer was quick
to add more praise for his research
staff"three nurses and two medical
assistants"who, he said, do most of
the work.
Tale eliecelam com talcm elel(caldt-lmeliarila
for the patients, Pfeifer said new thera-
pies may make significant inroads on
the costs associated with diabetes. Each
year Medicare alone spends $30 billion
to treat diabetes. Two-thirds of the total
goes to treating the complications of
the disease.
There are studies that show that if
patients followed currently recom-
mended practices, we could decrease
complications by as much as 85 per-
cent in the next five years"without
more research,� he said. The clinical
trials have the potential for helping
reduce complications even further.�
(For news about Michael PfeiferTs
new book on diabetes complication
and other related publications, see
page 37.) =
Dien Vilas wiciicmesse cman ae
tivity in James CooperTs feet. Cooper
suffers from diabetic neuropathy.
NASATs Marshall Space Flight Center gave Dr.
Pat Lindsey an opportunity to put virtual reality
to the test.
proves
design
AN ECU PROFESSOR HAS DRAWN ON
NASA technology to answer an impor-
tant question in interior design.
In interior design, weTre con-
cerned with planning living and work-
ing spaces to fit humans,� said Dr.
Patricia F. Lindsey, assistant professor
in the Department of Apparel, Mer-
chandising and Interior Design. The anthropomet-
ric qualities are especially important in medical and
technology elder care settings, but it really runs throughout
everything we do.�
The challenge is to be able to preview the archi-
tectural elements of a design in a way that allows
the designer and client to test the fit. Is the sink
~e| good placed at a comfortable height for an elderly
woman bent by osteoporosis? Will people bump
into cabinets as they turn corners? Computer-ren-
© . . . .
fit for dered three-dimensional drawings improve on the
traditional tools"perspective drawings and scale
models"but still fall short of the goal. A NASA fel-
interior lowship allowed Lindsey to test a newer method.
Since 1993, Lindsey has spent four summers at
the Marshall Space Flight Center in Huntsville,
Ala., testing the use of virtual reality as a design
tool. Created through sophisticated computer pro-
grams, virtual reality simulates a three-dimensional environment in
what appears to be actual size and gives the user or users the feeling
of being in and moving through the environment. The experience
comes courtesy of NASATs Summer Faculty Fellowship Program, which
brings about SO university faculty members to its Huntsville facility
each year to work alongside its own researchers.
The first year, NASA had Lindsey create a virtual reality version of
its payload operations control center. She then compared responses
of people using the real and virtual versions of the center. She pub-
lished an article expanding on her findings in the spring 1998 issue
of The Journal of Interior Design. In her later stints in Huntsville,
Lindsey created other virtual environments for NASATs use, including
a redesign of its own virtual reality laboratory.
The purpose was to see if virtual reality answers the same questions
as a real-size model and whether virtual reality can be used for proto-
typing interior environments,� she said. And indeed, you see the
same things. But there are several problems that havenTt been
solved. ItTs expensive, especially in time, to make virtual reality
look just like reality. Otherwise, you get a sort of cartoonish
look. We also havenTt found a good way to get tactile feedback,
but it is good for estimating visibility and spatial relationships.�
Lindsey has built on her contacts at NASA to present advanced
interior design students with a real-world problem. The stu-
dents, in a 3-D computer-aided design course, have tried to
solve problems in the design of the living quarters of the interna-
tional space station, such as creating space-efficient work surfaces
and indicating up from down in a micro-gravity environment.
Her next challenge may be the most difficult yet. She wants
ECU to become one of only a handful of universities with its
own Virtual reality equipment. A top-of-the-line setup car-
ries a $1 million price tag.
AS SURELY AS A NORTEASTER ERODES THE SHORELINE,
rapid development is changing the face of North
CarolinaTs coastal counties. Wealthy retirees
move in, placing new demands on local health
care systems. Sport fishermen compete for a
hiseeledeber-mmelecrbemmer-scelemmsiaemmr.berlUlla mm selemmer- hice
made their living on the water for generations.
Hotels scour the countryside in search of desk
clerks, maids and waiters to serve the bustling
tourist business.
In the Institute for Coastal and Marine Resources, two
social scientists noted for their contributions to fisheries
management have turned their minds to the problems
and pressures of coastal development. The coast is a lot
,
more complex than just fisheries and fishing,� said Dr.
David C. Griffith.
Griffith and his long-time collaborator, Dr. Jeffrey C.
Johnson, have begun a research initiative to examine
problems arising from the growth of ports and harbors,
AVOlecl Mm cOlebul yee Pmmcc@elcoleluljeime- baleen ial ielet)meucletucttilashameelie
munities. How, they ask, will these industries compete for
space, labor, resources and political influence? Already in
the Albemarle Sound area, ecotourism has run headlong
into established fishing and hunting clubs opposed to
sharing the waterways. And as hotels on the Outer Banks
bus in low-wage service workers from Elizabeth City,
Griffith sees problems in the making.
edge
PHOTO BY DANA EZZELL GAY
29
Look at Florida, where this process is already
advanced,� he said. You end up having ghettos
where people live who service the big luxury
hotels, and theyTre out there only during the day.
ItTs sort of like an apartheid situation. So along
with this coastal development, you have people
being marginalized and ghetto development going
on at the same time. That creates all kinds of prob-
lems for inland counties that are near the coast.�
Pressure also increases on traditional coastal
industries. Part of the story is whatTs happening to
commercial fishing,� Johnson said. In rural eastern
North Carolina, thatTs traditionally been one of the
primary sources of income for a lot of people. Our
purpose is to identify where there may be problems
and make people aware of where the problems lie.�
The coastal development project, still in the early
Stages, is the latest in a 15-year history of collab-
oration for Johnson and Griffith. At first they
seem an unlikely duo. Johnson is big, loud and pas-
sionate about numbers. Griffith is soft-spoken and
easygoing, more prone to literary references than
Statistics. Close up, the lines blur. Although he
is based in the sociology department, JohnsonTs
training includes anthropology, and he frequently
publishes articles in anthropology journals. Griffith
holds degrees in anthropology, but his books and
papers are widely read by rural sociologists.
We're social scientists, and we donTt see bound-
aries,� Johnson said. We see problems, and we
want to study those problems. Often interdiscipli-
nary work is the best way to approach them.�
Their peers see added strength in the collabora-
tion of two individually strong scientists. Jeff
Johnson is one of the few quantitative anthro-
pologists in the world,� said Dr. B.J. Copeland, a
professor of zoology at North Carolina State
University. But things arenTt always quantitative,
and David keeps you oriented to the social and
cultural aspects. ThatTs where David and Jeff work-
ing together are so important"in the interpre-
tation. Both have contributed considerably to our
understanding of social and economic structure of
coastal communities.�
Jim Murray, associate director for outreach of
the National Sea Grant Program, first worked with
Johnson and Griffith when he was director of
extension for North Carolina Sea Grant. TheyTve
always been on the cutting edge with regard to
creativity and risk-taking,� Murray said. Jeff was
way out in front with his ability to turn social
science research, specifically marine anthropol-
ogy, from what historically has been qualitative
work into quantitative research. This was 16 years
ago, at a time very few were doing
it. He set the precedent, and his
name is synonymous nationally
for quantitative techniques.
One of the things that makes
them such a good team working
together is that their skills are
complementary. Jeff is great at
conceptualizing, at developing the
methodology. DavidTs great at
operationalizing, doing the field
work, collecting the data to make
the methodology work. I truly
believe theyTre leaders in their
field. ECU is recognized as a, or
the, national leader in marine
anthropology, and a large part of
the reason is Jeff and David.�
The collaborations started in
1983 with a project designed to
interest recreational fishermen in
underutilized fish, such as shark,
amberjack and sheepshead. The
idea was to reduce pressure on the
stock of more popular fish. Drawing
on the precedent of market researchers, Johnson
and Griffith used linguistics and semantics, first, to
understand how people perceived fish and then
to create a more desirable image for underutilized
species. Throughout the project, they worked along-
YOU WANT TO HELP THE WORLD, BUT YOU ALSO
WANT TO BE ABLE TO PUT FORTH IDEAS,� JOHNSON
SAID. ALMOST EVERY ONE OF OUR PROJECTS HAS
BOTH AN ACADEMIC COMPONENT.AND AN APPLIED,
OR PRACTICAL, COMPONENT. | WOULDN T DO SOME-
THING THAT DIDNTT HAVE BOTH.�
side Sea Grant extension specialists, producing
both academic articles and 31 educational prod-
ucts"brochures, posters and cookbooks"targeted
at fishermen.
They succeeded so well that sharks and amber-
jack have been removed from the underutilized
list, and sharks are actually in danger of being
Drs. David Griffith, left, and Jeffrey Johnson liken
their collaborative process to tag-team wrestling.
overfished. What happened
was, when it went to being
recreational, it also became
commercial,� Johnson said.
Since that first successful
project, Johnson Apereme@suteenas
have kept at least one mutu-
Piece) U-loleye-heceyemm-beele)et-mmaete
four or five active projects
each is juggling at any one
time. Also among the lot will
pemere) UCloleye-teleyenmmnsieemeiesca
scientists, including biolo-
gists and economists, and
some solo work. Griffith,
for example, is directing a
mela coyervaiarcehme) mt leemntieca.
related to a special class of
work visas. Johnson has been
running a study of people in
isolation since 1991. His
research subjects"scientists
PYCoavatelcouter-mmtemmatelccvcaelece
On joint projects, they have
tackled such issues as public perceptions of
seafood safety, the effects of fishing policy on fam-
ilies and communities, conflicts among fishermen
and public perceptions of environmental risks.
People are pretty bad about judging risks to the
environment and to themselves from the environ-
ment,� Griffith said. E. coli is a classic example. E.
coli kills just a handful of people every year. Even if
9,000 people die from food-related exposure, thatTs
out of 750 million exposures and it says nothing
about whoTs dying or whether they had pre-existing
conditions or whether they were really riaesoycem-lerenens
food handling. Your risks of dying in a Car accident
are much higher than dying from eating stuff.�
Concern over the toxic dinoflagellate Pfiesteria
piscicida falls into the same category and shows the
harm in public misperception, he said. The prob-
lem is, when people misunderstand or exaggerate
certain environmental risks, they encourage politi-
cians and other people to essentially divert resources
and time to look at these issues when, in fact, we
know there are these real environmental risks, like
lead poisoning, rabies, PCB and problems in the
food supply,� he said. But if all this attention gets
focused away from them and onto some phantom
environmental risk like pfiesteria, well, then thatTs
just a total waste of public funds. In terms of
practical outcomes, thatTs how we would hope to
influence them.�
Their research sometimes tries to calm waters so
that opposing groups may eventually reach con-
sensus. Such was the case when they conducted in-
depth interviews about environmental problems
with recreational and commercial fishermen.
While the two sides pointed to different causes
(generally each other) for existing problems, both
held the same ideals. They wanted a clean envi-
ronment and plentiful resources. In the consensus
lies a starting point for public policy discussions.
Such practical applications can be found in
most projects Griffith and Johnson take on. You
want to help the world, but you also want to be
able to put forth ideas,� Johnson said. Almost
every one of our projects has both an academic com-
ponent and an applied, or practical, component. |
wouldnTt do something that didnTt have both.�
The two have worked together so long that
they often finish each otherTs sentences, some-
times pausing for the other to add a salient point.
They liken the collaborative process to tag-team
wrestling. One works awhile, then hands off to the
other. Back and forth they go until the project is
finished. Complementary strengths and trust that
each will carry his weight make the collaboration
work. So does mutual admiration.
JeffTs a lot better at analysis than I am,�
Griffith said.
DavidTs quite good at conceptualizing some
ideas, at thinking through how you collect data
PVavemm or bas C@estbubmr- lan eaneber-euam lelebenieyemy-lemmr-lelen bers
with a touch of awe, HeTs not only good at writ-
ing, but he likes to write. My thing is analysis.�
Even as both bemoaned a backlog of intended
publications, Johnson and Griffith also laid out
plans for a new study. This one, involving biolo-
gists and sea ice experts, will take them to the
Arctic to compare the environmental knowledge
of scientists and Native Alaskan whalers. They
hope to show scientists how to make use of the
accumulated knowledge of the fishermen.
The whaling captains have some knowledge
about how the ice works and other things, and
maybe their knowledge is useful for scientists so
they can figure out where to put their experimen-
tal stations, how best to use their resources to col-
lect data, things like that,� Johnson said. What
you have to be able to do is show that even though
{the fishermen] are not doing things in a scientif-
ic way, theyTre valid in some of the things theyTve
observed. Once you can model something, once
you can show scientists how people are thinking
and the logic behind it, it makes it easier to
be able to compare.� By:
30 -edge edge 31
BACKGROUND PHOTO BY DANA EZZELL GAY
ee ee " """ "" ss "
Allen Lawson.
Dr. Donald Shaw, wearing tie, explores whether telemedicine
can be used to deliver physical therapy. Helping him test an
electronic goniometer are Ashley Pace, David Gabriel and
Early studies show telemedicine
compares well with doctor's visit
IN SOME OF THE FIRST STUDIES OF THE EFFICACY OF TELEMEDICINE, SCHOOL
of Medicine faculty are asking whether telemedicine consultations give
patients the same quality of medical care that a visit to the doctorTs office pro-
vides. The early answer is a qualified yes.
This is one of the undone pieces of telemedi-
cine,� said dermatology assistant professor Dr.
Charles M. Phillips. ThereTs been a lot of enthu-
siasm for telemedicine, but nobody has any idea
if itTs good in all applications. As a clinician,
thatTs important.�
Telemedicine uses networks of computers,
video cameras and telephone lines to link patients
with physicians and other medical practitioners.
Electronic stethoscopes and other specialized tools
aid diagnosis. It has been hailed as an especially
promising way to provide cost-effective specialty
care to people living in remote regions. Because
patients and hometown physicians can confer
with distant specialists without leaving their
neighborhood, telemedicine saves time and travel.
The ECU School of Medicine, which serves 29
predominantly rural counties in eastern North
Carolina, is recognized as an international leader
in telemedicine. It has established a network for
providing clinical and educational programs to
12 remote sites"including six small hospitals,
Central Prison in Raleigh and five clinics. Since
the program was established in 1992, School of
Medicine specialists have provided more than
2,000 telemedicine consultations.
Everybody would like to have controlled
studies, but theyTre more important in some
applications than in others,� said Dr. Susan
Gustke, medical director of the ECU telemedicine
program. Some applications we know will work
because theyTre similar to others weTre using suc-
cessfully. But even if the specialist is very confi-
dent, controlled studies help us convince the
agencies paying for medical care that this is a valid
Goniometer Project
delivery system and should be used. Another pur-
pose of the studies is to make referring doctors feel
comfortable with the results.�
To test telemedicineTs applications in derma-
tology, where a good view of a suspect lesion
or mole might be critical, Phillips and some
colleagues set up a study in which 60 patients were
seen in person by one dermatologist and over
an interactive video network by another derma-
tologist. The two consultations took place on the
same day but independently of one another
so each physician was unaware of the
otherTs diagnosis. Later compar-
isons showed they agreed on a 4 |g
diagnosis 77 percent of the time.
Some studies since then of
~liveT dermatologist to ~liveT derma-
tologist show 80 to 90 percent
agreement, so weTre in the ball-
park,� Phillips said. The comfort
level (with the technology) gets
down to the individual patient. |
may see a patient and not be sure
whatTs going on. If itTs a telemedi-
cine consultation, thereTs a nag-
ging question: Is it because of the
technology? But in most cases,
when ITve seen that patient live, I
still wasnTt sure.�
The study was published in the
September 1997 issue of the Journal of the American
Academy of Dermatology. Since then, Phillips said,
better cameras have been installed on the telemed-
icine network. ThatTs one of the problems in this
area,� he said. As soon as you do a study, the tech-
nology advances.�
Dr. Michael E. McConnell, a pediatric cardiolo-
gist and associate professor, led a study similar to
PhillipsTs, to compare the results of cardiologistsT
examinations of 21 children sus-
pected of having heart mur-
murs. We found that telemedi-
cine was reasonably accurate,�
he said. In two cases, though,
the telemedicine consultant
symptoms within six months.
For the person looking at this,� McConnell
said, the question is: Is missing two small holes
acceptable?� When he presented his findings at
a meeting of the American College of Cardiology
in April 1998, reaction was generally favorable.
McConnell, however, remains cautious. When I
see a patient via telemedicine, I now realize itTs
not a sure thing,� he said. I have a higher index
of suspicion and might do an echocardiogram
when I otherwise wouldnTt, or I might ask them
to drive down to see me.�
Meanwhile, in fall 1998, physical therapy pro-
fessor Dr. Donald Shaw launched the first phase
of a trial that may lead to a new application for
telemedicine. If folks live in rural settings and
canTt get to a physical therapist, maybe we can
take the physical therapist to them,� he said.
As a first step, he needed to see whether he
could get accurate readings of joint angles over
the telemedicine network. Joint angles indicate
range of motion, which clues physical therapists
into a patientTs ability to carry out day-to-day tasks.
To do this, he strapped a knee brace equipped with
an electronic goniometer, which measures angles,
onto a leg of healthy student volunteers. Readings
from the goniometer were transmitted over phone
lines to a computer in the physical therapy depart-
ment. At the same time, a physical therapist also
took a direct measurement of the joint angle for
comparison. If the readings on healthy knees prove
accurate, Shaw said his next step will be to test the
electronic goniometer on people with problem joints.
More and larger studies will help health-care
professionals better assess the merits of telemed-
icine applications, but such research is likely to
be slow in coming. Finding funding is probably
the major limitation to this research,� Gustke
said. Most telemedicine funding has gone to get-
ting the networks up and running. We looked
long and hard to find the money for these
efficacy studies.� ay
Alan Branigan of the Center for Health Sciences Commu-
nication checks goniometer readings from ShawTs experiment.
FOR MARIMBIST MARK FORD,
MAKING MUSIC
MEANS HAVING FUN
MARK FORD, ASSOCIATE PROFESSOR OF MUSIC,
proved to be a musical innovator early on. When
I was 5 or 6 years old, I had long green Tinkertoys,
and ITd take the Tinkertoys out with my brotherTs
Beach Boys album and knock on all the Army hel-
mets,� he says. ITd have a whole string of rhythms
going on there.�
In succeeding years, Ford has progressed from
playing back-up helmets on Little Deuce Coupe to
solo marimbist, performing his own compositions
in concerts around the country and on his 1996
debut CD Polaris. He also directs the School of
MusicTs touring group, the East Carolina Percussion
Ensemble, which earned one of two performance
spots for student orchestras last fall at the annual
Percussive Arts Society International Conference.
During his off hours, he leads the popular Panama
Steel, a student-based professional steel drum
band he organized 10 years ago. HeTs an entre-
preneur to boot, a founder and vice president
of Innovative Percussion in Nashville, Tenn., one
of the leading companies making mallets for
marimba, vibraphone and xylophone.
Between his solo and ensemble work, Ford may
be onstage three or four nights a week for long
stretches at a time. He loves every minute. Wow,
they pay me to do this!� he says. Every week is
different. I get to work with wonderful people,
oXoldetebemaetomn ce slole) melaucm-belemeleslour-bushiag-belemrletic
cians around the state. And what I play is a part of
me. I have a love of life, and I want to share that
debueleraemmactomecteny emm
In a guest artist concert in Chapel Hill, he keeps
his audience entranced with a mixture mellow
edge
and mirthful. First comes the
er Lebehebet:@mmciaslcsuct- Mm etlcl (olehvame) mm gels
title track from Polaris, his own
composition. Later, he throws in a
steel-drum rendition of an Irish jig.
He concludes by having two stu-
dents join him on Stubernic, a piece
he composed for three marimbists
(o} etme) eCome beh ieuttieloel em Bela amet. bameele
keys, sides and a little bit of air as
they rotate around the marimba.
ItTs a bizarre situation,� he admits. I had
dreamed of people dancing behind the marimba.�
In its choreography, Stubernic has a touch of
FordTs first and most famous composition, Head
Talk, a piece several music publishers didnTt think
would ever fly. It calls for five drummers to sit on
the floor playing drum heads (not drums, just the
heads) and tossing them back and forth. Ford, a
pack rat, had been inspired by a closet full of used
heads. Since he wrote it in 1987, Head Talk has
been performed around the world, including per-
formances last year in Russia, Taiwan and Brazil.
In concerts and clinics, ITll hear someone say,
[loud whisper] ~ThatTs the Head Talk guy.T ItTs only
a five-minute piece, but itTs a crowd pleaser
Wow, they pay me to do this,� says
Mark Ford, associate professor of music,
composer and concert marimbist. At
far left, he is pictured with his band,
Panama Steel.
because itTs entertaining and very visual. And
drummers love it because they donTt have to cart
anything. They can put their drum heads under
their arms and go.�
Ford premiered his newest composition, Motion
Beyond, in the fall of 1998 and in spring 1999, will
premiere the Suite for Five-Octave Marimba by
another highly regarded composer, Richard
Maltz. Most of my repertoire lately has been a
good portion of my own composing, which is
good for me because ITm able to get my aeons comenens
to an audience,� he says, but I donTt want to
play just my own music in concerts. I enjoy a
variety of music in a recital.�
His ensemble work alternates. Panama Steel
will play 50 to 60 concerts between April and
October. The group performs throughout the
Carolinas and Virginia and has made three record-
ings. From October to April, Ford focuses on the
Percussion Ensemble, a laboratory group of
advanced students that is working on its second
CD. The first, with ECU tubist Jeff Jarvis, was
released in January 1999 on the Arizona
University Recordings label. This CD also features
several duets with Ford and Jarvis.
Since he founded Panama Steel in 1988, about
40 student musicians have played with the group
at various times. Each year he holds auditions to
replace those who have graduated. I try to
choose individuals who will connect with others
in the group, who have the talent and desire
to take something to a new level,� he says. But
it takes more than desire to keep them going
through rehearsals, performances and all the hours
spent traveling. I aVoyeMaandeteel ar-vehvare) mute wm velticemere
this for money if it werenTt fun,� he says.
For Ford, itTs all fun"marimba, steel drum,
vibes, performing, composing. If, for some reason,
the school thing went away, ITd still be playing
drums,� he says. I may be on the street play-
ing music with a hat in front of me, but ITd be
doing something in this vein. I don't think ov,
I could stop.� e
Mallets vibrate as Ford demonstrates the marimba. At lower right are mal-
let heads made by the company Ford co-founded, Innovative Percussion.
ECU IS PLAYING A MAJOR
role in a national movement
to improve services for chil-
dren with serious emotional
problems and their families.
Seven faculty members, plus
staff and graduate students,
have helped shape a demon-
Stration project that has
won national recognition.
The project, called Pitt
Edgecombe Nash-Public Academic Liaison (PEN-
PAL), originated in 1994 with a four-year, $5 mil-
lion federal grant to the Child and Family Services
Section of the North Carolina Division of Mental
Health. It was one of two dozen grants designated
for demonstration projects that would improve
community-based services for children with serious
emotional problems and reduce the need to place
the children in hospitals or other institutions.
PEN-PAL serves about 400 children who suffer
from such problems as attention deficit disorder,
oppositional and defiant disorder, anxiety and
depression. It works by pulling together multi-agency
teams of service providers, along with parents and
community organizations, to create a seamless sys-
tem of care for affected children. Previously, each
agency involved with the child"social services,
schools, mental health agencies and the juvenile
justice system"worked independently, sometimes
resulting in several intervention plans for a single
child. PEN-PAL also tries to build on the strengths
of the individual children, their families and com-
munities, for example, taking advantage of a childTs
interest in sports or a familyTs involvement in church.
ItTs gone remarkably well, but itTs also been
more of a challenge than any of us imagined,� said
Martha Kaufman, PEN-PAL project manager for
Child and Family Services. In a lot of ways, weTre
trying to change the world.�
The difficulties have been compounded by
reforms in welfare, education and health care, said
Dr. Susan L. McCammon, ECU associate professor
of psychology. Agencies have so many conflicting
demands that are simultaneous,� she said. In
todayTs climate, people in social services and men-
tal health need to produce and produce quickly.
ThatTs not compatible with restructuring.�
ECU faculty have provided training, resources
and technical assistance for services providers. The
university also has created an interdisciplinary
course that is based on the system of care concept
36 edge
EMOTIONALLY DISTURBED CHILDREN BENEFIT
AS NEW APPROACH TO CARE TAKES HOLD
and brings parents of emotionally disturbed children
into the classroom as faculty. The ECU team is as
diverse as the children the project serves. McCammon,
from psychology, and Dr. Betty Beacham in educa-
tion have coordinated ECUTs participation in PEN-
PAL. Other faculty involved include Dr. Dorothea S.
Handron in nursing, Dr. David A. Dosser Jr. in mar-
riage and family therapy, Dr. John Y. Powell in
social work, and Dr. John M. Diamond and Dr. Kaye
McGinty of the School of Medicine.
Stephanie Brown, director of student services for
Nash-Rocky Mount Schools and a member of the
PEN-PAL project management committee, praised
ECUTs contributions. TheyTre on the cutting edge of
where we need to be going,� she said. TheyTve done
a tremendous job of sensing our needs and design-
ing in-service training to suit those needs.�
Of all the funded projects, only PEN-PAL tied its
program to a university. Kaufman said ECUTs leader-
ship created a framework that allowed the project to
build logically. Otherwise, weTd just learn by doing,�
she said. Also, Dr. Lenore Behar [Child and Family
Services Section chief] felt from the beginning that
it was important to get a university involved so
rather than our spending years and years trying to
retrain professionals, weTre partnering with the uni-
versity to change the way they teach students who
will become professional service providers.�
Outside evaluators have noted improvements
in children participating in the PEN-PAL program.
In measurements taken six months and one year
after entering the program, the children on average
show higher academic performance and fewer
behavioral problems. Their parents report greater
Satisfaction, too.
Because of this success, PEN-PAL was selected
for presentation before a congressional panel in
May 1998. PEN-PAL and ECU also have been fea-
tured in four national professional publications.
In addition, McCammon and Powell were invited
to serve on the faculty of a national institute for
redesigning care programs for emotionally
disturbed children.
) ,
S Ea @ ""_1-prine
Book on Fred ChappellTs poetry nominated for two awards
elimi een ne Te hae. ee ee ee ee
cian iaae team es ih iat tea ate a ceca ne a eee ee ee ee
When one poet examines the work of
another, the results can be impressive.
PATRICK A. BIZZARO, poet and associate
professor of English, assembled the first
critical assessment of the poetry of
North CarolinaTs poet laureate in a book
titled DREAM GARDEN: THE POETIC VISION
OF FRED CHAPPELL (LSU Press, 1997). A
collection of essays, the book was
nominated for two awards in 1998"
the James Russell Lowell Award of the
Modern Language Association and the
Hugh Holman Award from the Society
for the Study of Southern Literature.
Contributors to DREAM GARDEN
included Pulitzer prize-winning poet
Henry Taylor, other internationally
known figures such as Dabney Stuart
and Robert Morgan and ECU faculty
Resa Crane, James Kirkland, Peter
Makuck and Alex Albright.
Other new books by ECU faculty
range from the erudite to whimsical.
Faculty also serve at the helm of several
respected journals.
Credit for one of the most complex
and unusual undertakings belongs to
DR. CHARLES FANTAZZI, Whichard pro-
fessor of classics. Fantazzi is deeply
involved in a long-range project by the
University of Toronto Press to publish
an 85-volume English translation of the
COLLECTED WORKS OF ERASMUS. The
16th-century Dutch humanist played
key roles in the development of the
Christian church and in education
through his writings, translations of
the New Testament and _ influential
friendships. Fantazzi has translated and
annotated five volumes, including the
1998 release of the second volume of
ON THE EDUCATION OF THE CHRISTIAN
WOMAN. He has completed a translation
of volume 13 of the CORRESPONDENCE
OF ERASMUS and begun work on volume
14. Erasmus wrote in Latin, the lan-
guage of scholars in his day.
On the lighter side, DR. WILLIAM
HALLBERG, golfing enthusiast and asso-
ciate professor of English, celebrated new
releases in 1998 of three previously
published books. THE SOUL OF GOLF, first
published in 1997 by Fawcett, has been
reissued in paperback by Ballentine. For
this book, Hallberg traveled the country
to try out an assortment of golf courses.
He writes about his travels, his golf game,
the people he met along the way and
life in general. In addition, Ballentine
brought out a paperback edition of Hall-
bergTs novel THE RUB OF THE GREEN, and
Simon and Schuster issued a paperback
version of his edited collection PERFECT
LIES: A CENTURY OF GREAT GOLF STORIES.
The Obesity and Diabetes Center of
the School of Medicine has become
headquarters for several important
publications. DR. MICHAEL A. PFEIFER,
director of the center, edited DEAR
DIABETES ADVISOR and co-edited THE
UNCOMPLICATED GUIDE TO DIABETES
COMPLICATIONS, both of which were
published by the American Diabetes
Association. DEAR DIABETES ADVISOR,
subtitled PLAIN AND SIMPLE ANSWERS TO
YOUR QUESTIONS ABOUT DIABETES, came
out in 1997. THE UNCOMPLICATED GUIDE
followed a year later. Acknowledging
that people with diabetes are living
longer lives, it gives diabetic people
and their families a thorough under-
standing of many complications that
may ensue and ways to prevent and
treat these complications. Topics range
from disorders of the feet to sexual
health and eye disease.
Pfeifer and his ECU colleague, DR.
ROBERT TANENBERG, also have taken
over as editors of the American Diabetes
AssociationTs two major lay periodicals.
Tanenberg edits the DIABETES ADVISOR,
a bimonthly newsletter in brief, read-
at-a-glance format. Pfeifer is editor of
DIABETES FORECAST, a monthly newslet-
ter with longer articles. (For articles on
diabetes-related research and clinical
trials, see pages 22-27.)
On the literary front, assistant pro-
fessor of English DR. MARGARET D. BAUER
assumed editorship of the NORTH CAR-
OLINA LITERARY REVIEW in 1998. She
follows in the steps the journalTs found-
ing editor and another ECU faculty
member, Alex Albright.
The annual journal is a publication
of the North Carolina Literary and
Historical Association.
37
edge
Among other recent publications
HARDAWAY REVISITED: EARLY
ARCHAIC SETTLEMENT IN THE
SOUTHEAST (UNIVERSITY OF
ALABAMA PRESS, 1998)
BY |. RANDOLPH DANIEL JR.
Daniel, associate professor of anthro-
pology, revisits one of the most famous
Early Archaic archaeological sites in
the southeastern United States, North
CarolinaTs own Hardaway site. Located
near Badin in Stanly County, the Hard-
away site provided early hunters and
gatherers with a base camp from which
to exploit the stone outcrops of the
nearby Uwharrie Mountains. Daniel pro-
poses that it was the availability of high-
quality stone that determined the loca-
tion of the settlement. Previously, schol-
ars have asserted that people in the
Early Archaic period (9,000 to 10,500
years ago) concentrated along the major
southeastern river valleys to take advan-
tage of food resources. (See page 8 for
an article on DanielTs current project.)
THE NORTH CAROLINA SHORE
AND ITS BARRIER ISLANDS: REST-
LESS RIBBONS OF SAND (DUKE
UNIVERSITY PRESS, 1998) BY
STANLEY R. RIGGS, ORRIN H.
PILKEY, WILLIAM J. NEAL, CRAIG
A. WEBB, DAVID M. BUSH, DEBO-
RAH F. PILKEY, JANE BULLOCK
AND BRIAN A. COWAN.
This volume follows up on the ground-
breaking 1978 book From Currituck to
Calabash. In the earlier book, Riggs,
ECU geology professor, and Duke
UniversityTs Pilkey outlined the hazards
of building on North Carolina beaches.
The North Carolina Shore provides a
detailed analysis of the two decades
of change since then, covering all that
nature and man have wrought, improve-
ments in mapping techniques and reg-
ulatory changes.
LEE MOVES NORTH: ROBERT E. LEE
ON THE OFFENSIVE (JOHN WILEY,
1998) BY MICHAEL A. PALMER.
This book analyzes Gen. LeeTs three
strategic offensives"the Maryland
campaign of September 1862, the
Gettysburg campaign of June-July 1863
and the Bistoe Station campaign of
October-November 1863. Lee lost all
three offensives, and Palmer, associate
professor of history, highlights the ele-
ments of LeeTs generalship that con-
tributed to his failure.
NONLINEAR TIME SERIES ANALYSIS
OF ECONOMIC AND FINANCIAL
DATA (KLUWER ACADEMIC PUB-
LISHER, 1998), EDITED BY
PHILIP ROTHMAN.
Rothman, assistant professor of eco-
nomics, pulled together 16 previously
unpublished papers by economic spe-
cialists in the field of nonlinear time
series analysis. Rothman is a contributor
as well as editor.
SERIOUS PLAY: THE CULTURAL
FORM OF THE NINETEENTH-CEN-
TURY REALIST NOVEL (UNIVERSITY
OF PENNSYLVANIA PRESS, 1999)
BY JEFFREY FRANKLIN.
Franklin, assistant professor of English,
takes a look at gambling, theatricality
and aesthetic theory as they are pre-
sented in Victorian society and novels.
He focuses on novels by Charlotte
Bronte, George Eliot, Charles Kingsley,
William Thackeray and Anthony Trol-
lope. Along the way, he develops a new
theory of the novel as a cultural form
and revises the definition of realism.
The book was published as part of the
New Cultural Studies Series.
STRUCTURALISMTS TRANSFORMA-
TIONS: ORDER AND REVISIONS
IN INDONESIA AND MALAYSIA
(ARIZONA STATE UNIVERSITY
CENTER FOR SOUTHEAST ASIA
STUDIES, 1999), EDITED BY
LORRAINE V. ARAGON AND
SUSAN RUSSELL.
In the bookTs introduction, Aragon, vis-
iting professor in the ECU anthropology
department, discusses the history of
structural and post-structural theo-
retical analyses of Indonesian and
Malaysian cultures. The volume then
presents 13 new ethnographic contri-
butions concerning Indonesian and
Malaysian cultures by U.S., Canadian,
British, Dutch, Australian, Japanese and
Indonesian authors. AragonTs co-editor,
Russell, is on the faculty of Northern
Illinois University.
YOUNG ADULT SCIENCE FICTION
(GREENWOOD PRESS, 1999),
EDITED BY C.W. SULLIVAN III.
This collection of essays by various
experts examines science fiction written
for the young adult market. It approach-
es the topic with overviews of young
adult science fiction from different
countries and with articles on specific
topics, such as women or war, in these
young adult books. The final section
is a massive annotated research bibli-
ography. Sullivan, professor of English,
also edited GreenwoodTs 1993 volume
Science Fiction for Young Readers, which
focuses on specific authors.
Partnership to investigate
issues in welfare reform
Responding to the growing complexity
of issues facing social workers, the
School of Social Work and Criminal
Justice Studies and the N.C. Association
of County Directors of Social Services
have established the Partnership for
Human Services. Its purpose is to link
the resources of the university with the
needs of human services agencies in
local communities.
The partnership officially kicked off
in May 1998 with a $700,000 contract
from the N.C. Division of Social Services
to conduct five research and curriculum
projects. The projects include examina-
tions of Work First welfare reform issues
and methods to reduce the backlog of
cases involving termination of parental
rights. New training programs are being
developed for workers in child protec-
tive services. Most of the projects are
scheduled for completion in 1999.
Executive director Myra Powell and a
five-person staff run the partnership under
the auspices of the School of Social Work
and Criminal Justice Studies and contract
with school faculty to carry out projects.
Oversight is provided by an executive
committee composed of six social services
directors and three social work faculty
not involved with individual projects. An
advisory board from outside the sponsor-
ing agencies also is being established.
Faculty leading the first set of proj-
ects are Dr. Reginald O. York, Dr. Vickie
D. Causby, Dr. Lessi L. Bass, Joyce G.
Reed, Dr. Paul E. Knepper and Dr. Mary
S. Jackson. Research assistance is pro-
vided by social work lecturer Shelia G.
Bunch and by Sara Davis and Beverly J.
Brooks of the partnership staff.
In addition to the state contract, the
partnership has signed four contracts to
provide technical assistance to individ-
ual county social services departments.
Biomedical physics admits first Ph.D. students
ECUTs newest doctoral programs are
getting off to a fast start. Biomedical
physics admitted four students in its
first class for fall 1998, and coastal
resources management is on track to
admit 10 to 12 students in fall 1999.
The UNC Board of Governors approved
both programs in early 1998.
Meanwhile, ECU awarded 307 grad-
uate-level degrees, including 17 doc-
torates, in 1998. Approximately 2,900
graduate students and 300 professional-
degree students are enrolled.
The biomedical physics program
trains scientists in the complex interac-
tions between the physical and biologi-
cal worlds, preparing them to under-
stand and develop advanced medical
technologies. These would include such
devices as laser beams, ultrasound, x-
ray and electromagnetic radiation
equipment. Students will study physics,
biology, chemistry and medicine.
Dr. Mumtaz Dinno, chair of the
physics department, directs the pro-
gram. Although based in the physics
department, the program is a collabo-
ration of the College of Arts and
Sciences and the School of Medicine, in
particular, the departments of radiation
oncology and physiology.
Dr. Lauriston R. King joined the ECU
faculty in spring 1999 to direct the
coastal resources management pro-
gram. He comes to ECU from the Uni-
versity of Southern Mississippi, where
he was director of research and spon-
sored programs. Before that, he had
worked at Texas A&M University as
deputy director of the Office of Univer-
sity Research and deputy director of the
Sea Grant Program and at the National
Science FoundationTs Office for the
International Decade for Ocean Explo-
ration. He is a past president of the
National Coastal Society and has served
on the executive committee of the
Marine Affairs and Policy Association.
The coastal resources management
program is designed to advance scien-
tific knowledge of the EarthTs oceans
and adjacent coastal environments,
with an emphasis on using scientific
knowledge in the management of
coastal and near-shore marine resources.
It will draw on the expertise of faculty
in seven academic disciplines"anthro-
pology, biology, economics, geogra-
phy, geology, political science and
sociology. It is based in the Institute
for Coastal and Marine Resources.
Within months of its approval, about
50 inquiries had been received from
eight states, Canada and India.
Another new program, the Ph.D. in
communication sciences and disorders,
will graduate its first student in 1999.
The university also anticipates receiving
approval from the Board of Governors
to admit students to the new doctoral
program in bioenergetics in the fall
of 1999.
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Technologies move closer to market
Medical technologies lead the list of ECU
innovations under review in the Office of
Technology Transfer.
The office reviews faculty inventions,
files patent applications and helps move
university technology into the market-
place through licensing agreements and
spin-off private enterprises. The office also
encourages multidisciplinary collabora-
tions within the university and collabo-
rations with private companies.
Innovations under review include:
« An anti-stuttering device. Three ECU
researchers in the Department of Com-
munication Sciences and Disorders have
identified a process that greatly reduces stut-
tering and frequently eliminates it. When a
stutterer speaks, the cells responsible for
communication receive too many signals
and basically short out, producing the stut-
ter. This new device uses headphones and a
sound board to redirect electric signals in the
brain. ECU researchers involved in the proj-
ect are Drs. Joseph Kalinowski, Michael
Rastatter and Andrew Stuart.
¢ Pediatric Heart Sounds CD-ROM.
This interactive computer application is
designed to help general medical practi-
tioners and medical students learn to dis-
tinguish between normal and abnormal
heart sounds in children. It allows users to
listen to heart sounds in four areas of the
chest, closely simulating a physical exam,
and to learn more about congenital heart
problems. Additional interactive text, illus-
trations and a self-test are included. The
program was developed by Dr. Michael
McConnell, a pediatric cardiologist at the
medical school, and Alan Branigan of the
Center for Health Sciences Communication.
« An alternative to mammography.
Although still in the early stages of devel-
opment, this technology holds the poten-
tial to improve on mammography as a
screening device for breast cancer at lower
cost than current alternatives. The device
uses a continuous-wave laser beam to
create high-resolution images. It is being
developed by Dr. Xin-Hua Hu of the
physics department.
¢ Telemedicine kiosk. This stand-alone
information booth could put health infor-
mation into shopping centers, hotel lob-
bies and airports. Based on interactive
computer programming, it allows users to
obtain medical information from self-con-
tained software packages or over the
Internet. Diagnostic tools such as blood
pressure cuffs and telecommunication links
can provide live consultations with medical
practitioners. The kiosk has been devel-
oped by the Center for Health Sciences
Communications under the direction of
David C. Balch.
ECU implements state-of-the-art research administration
The Office of Sponsored Programs cannot claim to be paperless, but the day may
come, thanks to a nationwide trend toward electronic research administration, or ERA.
ERA saves time and money by enabling ECU faculty members to submit grant pro-
posals to sponsoring agencies electronically, automating necessary accounting and
reporting functions, and transmitting information to sponsors on-line instead of by
mail. Traditionally, research management has depended on moving reams of paper.
As part of this movement, ECU is collaborating with major universities around the
nation in pilot projects testing electronic administration initiatives by federal agencies,
such as the National Institutes of Health. The Office of Sponsored Programs also has
taken the lead in promoting campuswide electronic sharing of financial information
and is assisting other UNC campuses in entering the electronic era of grant and con-
tract management.
Grant and contract
activity increases
Total grant and contract activity at ECU
continued its steady climb in 1997-98.
More than 400 faculty participated in
submitting 542 proposals requesting
almost $68 million in external funding.
Faculty received 441 grants and con-
tracts, totaling more than $28 million, a
9 percent increase over 1996-97. The
university was third among the 16-cam-
pus UNC system in external funding.
Just more than half of this funding
(S51 percent) supported projects in public
service, with 37 percent going for
research and 10 percent for instruction
and training. Clinical trials of new treat-
ments for disease maintained a steady
increase, going up by almost 15 percent
over last year. Government (federal, state
and local) accounted for 64 percent of
funding. Business and industry spon-
sored 20 percent, foundations and non-
profit agencies supplied 13 percent, and
other organizations sponsored 3 percent.
Grants and contracts generate
resources, over and above state appro-
priations, for projects that benefit eastern
North Carolina and the state. Some exam-
ples include improving math and science
learning in local schools, training health
practitioners for medically underserved
communities and rural areas, and moni-
toring water quality in the stateTs rivers
and estuaries. Faculty-initiated projects
help small businesses improve their oper-
ations and assist industry in solving funda-
mental manufacturing problems. On a
national and global scale, ECU research
advances the frontiers of basic science in
fields such as biochemistry, geology and
pure mathematics, and contributes to his-
torical and cultural scholarship.
SPILMAN BUILDING
five-year, $30 million project, was dedicated
in March as part of Founders Day activities.
Its front porch is a unique sound, water,
art, music, video and mist environment
,
created by renowned artist
Cristopher Janney and dubbed Sonic Plaza.
~
Sta i: 2 fet
CAROLINA
UNIVERSITY
edge
East Carolina University
Greenville, NC 27858-4353
