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Message from the MGH

Reflecting on Proto's first year, by Peter L. Slavin and David F. Torchiana.

Fall 2006
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Proto Fall 2006 cover

With this issue, Proto enters its second year of pondering and probing what’s new and intriguing in medicine. From the outset, our goal has been, as we promise in our mission statement, to report back from the frontiers of research and practice—exploring breakthroughs, dissecting controversies and opening a forum for informed debate. Though it’s too early to evaluate whether we’ve made good on those objectives, two stories epitomize what we have hoped to accomplish. In our first issue, our article on avian flu pointed to lessons of history and evolutionary biology to argue against the inevitability of a human pandemic. That ran counter to popular scientific opinion, and in the next issue, a public health researcher used our Second Opinion page to deliver a sharp critique of the science in our story. But so far, at least, the avian virus hasn’t made significant inroads into the human population.

The second story, in our spring 2006 issue, on the potentially game-changing approach known as natural orifice translumenal endoscopic surgery (NOTES), also took us into controversial territory. To many surgeons, the idea of threading a scope through the esophagus or colon and then intentionally puncturing the alimentary tract seems ludicrous and potentially deadly. Yet NOTES proponents argue that in the not-too-distant future this technique could become standard practice, making abdominal procedures safer and far less invasive. Once again, this is where Proto wants to be—facilitating and advancing medicine’s crucial debates.

The current issue continues in a similar vein. We detail medicine’s evolving understanding of the complex interaction of genes, neurons and hormones that triggers puberty and we consider new treatments for puberty disorders. Our story on addiction describes how images of drug-altered brains are explicating brain pathways and identifying chemicals that could lead to approaches for treatment.

We also explore the subject of slime—biofilms—and the threat these colonies of microbes pose to recipients of surgical implants. And we look into the controversial pay-for-performance trend, which has shown uncertain progress toward its goals of improving medical quality and controlling costs. Finally, in a change of genre, we focus the evocative lens of poetry on a sixteenth-century anatomy class.

Peter L. Slavin, M.D.
Massachusetts General Hospital
David F. Torchiana, M.D.
CEO and Chairman
Massachusetts General Physicians
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