Wednesday, July 23, 2008

RBMS: Remembering "AD"

All right. Way back when (a couple of weeks ago) I promised to post some reflections on the most recent RBMS pre-conference. But there was this strange block in the way that I couldn't quite figure out or get around. It took a couple of weeks, but I finally figured it out. It might sound a bit strange (and maybe I'm just engaged in a bit of self-analysis or reflection), but underneath all the really good times that I had at the conference (the Getty, the Huntington, my colleagues, etc.) it turned out that it was actually a bit hard to come back to LA and environs, especially the UCLA campus. I haven't actually been to LA a lot of times, but for me its more wrapped up in a person (who just so happened to be connected with the place). And it was all connected with my last visit to LA, nearly ten years ago. I'm still talking in riddles here, so let me get to the point.

The last time I traveled to LA was to visit my aunt. She, maybe more than anyone else in the world, had the greatest influence on what would be my chosen career as an academic librarian. She was not a librarian, although she was, in part, an academic. And she was much more. At the time of my visit she was in the last stages of suffering from Pick's disease. I wouldn't see her again. I knew this when I saw her, which made the visit that much more poignant, and difficult. After she died, on January 10, 2001, I wrote an obituary. It was never published in full and I'd like to share it here.

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NOTED PHYSICIAN LaVONNE B. BERGSTROM DIES AT AGE 72

LaVonne B. Bergstrom, professor emeritus of surgery at the UCLA School of Medicine and a 1957 graduate of the University of Minnesota Medical School, died January 10th in Los Angeles following a lengthy illness. Dr. Bergstrom began her academic career at the University, completing an undergraduate degree cum laude from the School of Journalism in 1950 and a second undergraduate degree in Medicine in 1953. As an undergraduate, she worked for the Minnesota Daily as a reporter before her career interests turned away from the media and towards medicine.


While attending medical school, she decided to spend a summer as a lab technician at Embudo Presbyterian Hospital in New Mexico. What attracted her to New Mexico was the varied experience a mission hospital offered, plus the opportunity to see a different part of the country. While working at Embudo, she was impressed with the high caliber of medicine practiced by the staff and the atmosphere of dedicated service. Following medical school, she served as an intern at Minneapolis General Hospital for one year and then was commissioned in September 1958 by the Presbyterian Church USA for continued work at Embudo.

After a three years' stint as associate physician at Embudo, Dr. Bergstrom became the medical director of the Sangre de Cristo Medical Unit at San Luis, Colorado in 1961. The medical unit, operated by the Presbyterian Board of National Missions and the Synod of Colorado, was the only medical facility in a wide swath of south-central Colorado and northern New Mexico. General practitioner Bergstrom brought up-to-date medical care to an isolated, predominantly Spanish American community located eight thousand feet above sea level in the San Luis valley. Over one quarter of the population served by the clinic was over the age of sixty and the infant mortality rate was nearly double the national average. The nearest hospitals were forty-one miles to the north in Alamosa, Colorado, and sixty-five miles south in Taos, New Mexico.

Dr. Bergstrom was the only physician in the 1,215-square miles of Costilla County and the waiting room at the clinic was frequently standing-room-only. The county, with no industrial or agricultural base, was designated as a distressed area by the Federal government. More than half the residents were receiving some kind of welfare aid. Isolated, impoverished, and with little education, the inhabitants had no sustained medical care. In addition to the typical cases encountered by a general practitioner, Bergstrom found a higher-than-usual proportion of illnesses related to malnutrition, complications of pregnancy, and old age. In many of these cases she arranged for patients' care in distant city hospitals. While at San Luis, she commented that "sometimes it seems as if we're merely putting a Band-Aid on a large wound." But at the same time the staff was achieving a breakthrough with a wide-ranging program of preventive medicine, well-baby care, home nursing, prenatal care, and immunization clinics. In one day the staff inoculated 1,300 children. In 1962 the Medical Unit reported 7,338 patient visits for a county with a population of around 4,300.

Her schedule was grueling and frequently interrupted by emergency calls. In between office hours, she drove more than a hundred miles a day to make her hospital and house visits. She learned to dictate letters as she traveled. And, as the only doctor in the county, she had three unforeseen duties: draft board examiner, deputy coroner, and ringside physician at local prize fights. Because of these omnipresent responsibilities she was able to take only one day a month for relaxation. Volunteer doctors came from Denver to relieve her at those times.

In July 1965, Bergstrom left the clinic for a residency in otolaryngology at the University of Colorado Medical Center. Following her residency, in 1969, she joined the medical faculty at the University of Colorado and served in that capacity until 1975. Deborah Hayes, chair of the Audiology department of The Children's Hospital in Denver, observed that "I enjoyed working with LaVonne, and admired her pioneering work in otolaryngology, especially her work in [the] genetics of hearing loss."

In 1975, Bergstrom joined the faculty at the UCLA School of Medicine. Cydney Fox, director of audiology services at the Tracy Family Hearing Center in Los Angeles, reflected on her association with Dr. Bergstrom. "I first met her when I did my graduate work in Audiology at the University of Denver. She spoke to one of my classes and I was terribly impressed by her. Two years later, when I was hired at the UCLA Audiology Clinic, I could not believe that both she and Garth Hemenway, from the U. of Colorado School of Medicine, had been recruited. Dr. Ward, the chief of UCLA Head and Neck, kiddingly spoke often that there was now an embargo on Colorado faculty and staff because we were close to having a majority vote." Elliot Abemayor, current vice-chief of the department at UCLA, said that he "trained at UCLA under Dr. Paul Ward and worked with Dr. B. for four years as a resident, then as a young faculty member. I remember her animation, warmth, and love of patients." In June 1979, Bergstrom was appointed full professor, Department of Surgery, Head and Neck Division, at UCLA. In a profile by a local Los Angeles television station, the reporter observed that only 1% of the full professors of surgery at the nation's medical schools were women, making Dr. Bergstrom "a rare bird, indeed."

Over the course of her career, Bergstrom was active in a number of professional organizations. She was a member of the executive board of the American Auditory Society and served as its president in 1987. Ellen Friedman of the Texas Children's Hospital and current president of the American Broncho-Esophagological Association commented that she "was greatly influenced by Dr. Bergstrom. She was a remarkable woman who made significant contributions to otolaryngology in many, many ways." Rick Chole of the American Otological Society said that he "was a resident at the University of Minnesota when I first learned of her work in temporal bone histology. She was a role model for me as I completed my residency and graduate training and was one of my Board Examiners in 1977." Some of her other organizational affiliations included the American Academy of Otolaryngology—Head and Neck Surgery, the American Academy of Pediatrics (where she was a Otolaryngology Special Fellow), the American Academy of Ophthalmology and Otolaryngology (Fellow), the American Neurotology Society (Fellow), and the American Otological Society.

Beyond her work at UCLA, Dr. Bergstrom became involved with the Hope for Hearing Foundation in Los Angeles. Christine Coleman, executive director of the foundation noted that Dr. Bergstrom "was, indeed, very much associated with the foundation. She volunteered to take care of the ears of many of the children [who] were brought up here from Mexico for hearing aids. She was a wonderful woman. My office was next door to her's and I would talk to her every day. She had a great sense of humor, and common sense….She wrote a booklet for parents of hearing impaired children and had it translated into Spanish. We truly missed her when she became ill."

Children were her great love. Cydney Fox remembers that "LaVonne put tubes into my older son's ears twice. The second time, he took his Mickey Mouse doll into surgery with him and she put tubes into Mickey's ears via lots of tape. I thought it was creative and darling. My three-year-old did not agree and was incensed that Mickey had been degraded. Kids!!"

"I belong to the craniofacial team which evaluates children with multiple syndromes, the same type of specialization that LaVonne was so interested in. There isn't a Monday that goes by, when I go to the team meeting, that I don't think of her and how grateful I am that she shared so much of her love and knowledge in this complex area."

"I worked with her until her disease made her leave her position. I thought she was one of the most brilliant doctors and women that I had met. I still, to this day, believe that. I learned so much about children and otology and hearing function from her."

Bergstrom's nephew, Tim Johnson, special collections and rare books curator for the University of Minnesota Libraries, has memories of his aunt going back to early childhood, including numerous camping trips and hikes through the western mountains. But it is his recollections while an undergraduate that are perhaps the most profound. "We would get together when she came to Chicago for some medical convention or meeting. She had an excitement about research and higher education, a natural curiosity combined with a sense of playful adventure, that was contagious. Later on, I discovered the service and devoted side of her life and realized how much she cared for people, for her patients and their families. She, more than any other person, is why I pursued a career in higher education. She was a favorite."

In 1989 Bergstrom retired from the UCLA medical faculty with the title of professor emeritus. At about the same time, she was diagnosed with Pick's Disease, a disorder involving deterioration in mental function caused by disease-related changes in brain tissue, including shrinking of the tissues of the brain and the presence of abnormal bodies (Pick's bodies) in the nerve cells of the affected areas of the brain. Pick's disease is a rare disorder similar to senile dementia/Alzheimer's type and affects about 1 out of 100,000 people. It affects both sexes, but it is more common in women than men with the onset of the disease generally occurring between the ages of 40 and 60. The onset is usually slow and insidious. The exact cause of the disease is unknown. The symptoms are similar to senile dementia/Alzheimer's type, with aphasia (loss of language abilities), agnosia (loss of ability to recognize objects or people), and apraxia (loss of skilled movement abilities).

Marion Downs, wife of Dr. Hemenway (Bergstrom's colleague in Colorado and California, who is himself suffering from Alzheimer's disease), spoke on behalf of colleagues in Colorado. "We all knew Dene as one of the most brilliant physicians and surgeons in the field, as well as a loyal and congenial friend, and we have mourned losing her to that terrible disease for all these years. Now we will mourn her final leaving [of] us."

LaVonne Bernadene Bergstrom was born in Erskine, Minnesota, on October 17, 1928, the eldest child of Clara and Harry Bergstrom. Her father managed a store in Winger, Minnesota, owned by clothier and miscellaneous wholesaler Edward Baehr of Wadena. In the summer of 1930 the family moved to Wadena and it was from there, in 1946, that she graduated from high school as class valedictorian. In the fall of that year she matriculated at the University of Minnesota. Her parents preceded her in death. She is survived by two sisters, Leticia Johnson of South Haven, Minnesota, and Sharon Freude of Richmond, Virginia; one brother, Fred Bergstrom of Plymouth, Minnesota; and numerous other relations. Memorial services in California, Colorado, and Minnesota are pending.

Early in her career, while at the clinic at San Luis, Dr. Bergstrom made an early morning visit in sub-zero temperatures to a young boy, critically ill with pneumonia. Later, the boy's mother said that the doctor "looked like an angel when [she] came through the doorway." Bergstrom, who combined a bent for precise description with a whimsical sense of humor, would not have been one to claim wings and halo. "Slipshod medicine," she said, "would weaken our mission."

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That's my aunt. We called her "Auntie Dene" or "AD" for short. She lent me a lot of books, some of which I still have. I also have her bound volumes of favorite pieces from "The New Yorker." When she graduated from Minnesota with a degree in journalism, she was inducted into Kappa Tau Alpha, the national honor society in journalism and mass communication. Two months ago my second son graduated from the U of M with a degree in journalism and was also inducted into KTA. I guess some things are just in the blood.

A couple of days ago I left a comment on Lynne Thomas's blog about librarianship as a contemplative profession. I'll share some thoughts on RBMS in a next post or two, but for the moment I needed to contemplate and remember someone who brought me into the profession. Requiescat in pace AD, and thanks.

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