From the editor: Lessons from Uganda

When I returned from Uganda in July, people who asked about my reporting trip to Mulago Hospital assumed that the Yale attendings and residents had gone there to teach. It would seem to make sense that professionals coming from one of the leading universities in the richest country in the world and with access to the latest medical technologies would have much to teach the doctors and medical students at a hospital in one of the world’s poorest countries. In fact, the reverse was often true. In the middle of one Yale doctor’s first day on the wards at Mulago, he lamented how ineffectual he felt. Said Sam Luboga, M.D., deputy dean of the Faculty of Medicine at Makerere University in Kampala, “When people come here they can really feel bewildered. They find a hospital full of patients, without drugs, without supplies.”

At Mulago the Yale doctors became the students, with a lot to learn from their Ugandan colleagues. Denied all the accoutrements of modern medicine that are part of their daily lives, the Yale physicians fell back on the most basic tool of medicine—the physical exam—at which the Ugandan doctors excel. This is not to say that the Yale doctors had nothing to offer. While at Kampala, the Yale attendings and residents taught evidence-based medicine and provided new models for interactions with patients. The collaboration has also brought to Uganda textbooks and access to electronic medical texts. Both Makerere University and Yale University stand to benefit from the collaboration, which is expected to improve clinical care in New Haven as well as in Uganda.

In this issue we also feature profiles of two doctors who specialize in the heart. John A. Elefteriades, M.D. ’76, HS ’83, chief of cardiothoracic surgery, learned the basics of cardiology from Lawrence S. Cohen, M.D., HS ’65. The two started as student and mentor, became colleagues and are now co-authors of a book about the heart, Your Heart: An Owner’s Guide.

On November 30 we learned of the passing of Nicholas P.R. Spinelli, M.D. ’44, a warm, kind and generous man and a good friend to all of us at Yale Medicine. When we were next door to the Office of Alumni Affairs, he often took the time to chat with us and ask us what stories we were working on or to suggest ideas for articles. And he always had something nice to say about our latest issue. We will miss him.