Ralph Snyderman – författare

During his fifteen years as chancellor, Dr. Ralph Snyderman helped create new paradigms for academic medicine while guiding the Duke University Medical Center through periods of great challenge and transformation. Under his leadership, the medical center became internationally known for its innovations in medicine, including the creation of the Duke University Health System—which became a model for integrated health care delivery—and the development of personalized health care based on a rational and compassionate model of care. In A Chancellor''s Tale Snyderman reflects on his role in developing and instituting these changes. Beginning his faculty career at Duke in 1972, Snyderman made major contributions to inflammation research while leading the Division of Rheumatology and Immunology. When he became chancellor in 1989, he learned that Duke’s medical center required bold new capabilities to survive the advent of managed care and HMOs. The need to change spurred creativity, but it also generated strong resistance.  Among his many achievements, Snyderman led ambitious institutional growth in research and clinical care, broadened clinical research and collaborations between academics and industry, and spurred the fields of integrative and personalized medicine. Snyderman describes how he immersed himself in all aspects of Duke’s medical enterprise as evidenced by his exercise in "following the sheet" from the patient''s room to the laundry facilities and back, which allowed him to meet staff throughout the hospital. Upon discovering that temperatures in the laundry facilities were over 110 degrees he had air conditioning installed. He also implemented programs to help employees gain needed skills to advance. Snyderman discusses the necessity for strategic planning, fund-raising, and media relations and the relationship between the medical center and Duke University. He concludes with advice for current and future academic medical center administrators. The fascinating story of Snyderman''s career shines a bright light on the importance of leadership, organization, planning, and innovation in a medical and academic environment while highlighting the systemic changes in academic medicine and American health care over the last half century. A Chancellor''s Tale will be required reading for those interested in academic medicine, health care, administrative and leadership positions, and the history of Duke University.

There was a time, not all that long ago, when scientific study of the cell was called cytology, and the workers in the field named themselves cytologists. When I was a medical student, lectures in cytology were a special, segregated part of the curriculum in the histology course, given along with general anatomy, and they were, as I recall, the surest of cures for insomnia. I still possess Cowdry''s three-volume set entitled Special Cytology, published in 1934, and leafing through these books today is rather like examining a medieval manuscript. You could never have guessed what was going to happen to the field. At that time it was all structure, and all guesswork about the structure. When cells were packed together in various tissues, how did the geometry of packing work? How many sides did a liver cell have, in real life? What on earth were all those granules in­ side, and what were the best stains for looking at them? One thing about those granules, they never moved. Indeed, nothing moved. Cytology turned into cell biology much later on, and suddenly came alive. As has been the case in so many diSciplines in biology, it was brought to life by techniques. New instruments and cytochemical methods were devised for look­ ing at cells, manipulating cells, more or less in vivo.