A DOCTORATE IN ENVIRONMENTAL HEALTH AT STANFORD UNIVERSITY

A proposal for your consideration by Prof. Joshua Lederberg, Dept. Genetics

A recent report by R. W. Miller (Lancet 1189 11/29/69) remarks that U. S.
childhood mortality from leukemia has shown a definite improvement in the epoch
1960-66 compared to the previous decade. The reduction applies specifically to
the peak at 5 years of age or less, a part of the incidence that is plausibly
assigned to events that began during fetal life. Data of this kind are always
subject to conflicting interpretations. A very plausible one is that about
1000 pre-school children have escaped having leukemia in consequence of the
concern about prenatal exposure to x-rays that took hold during the last decade.

This report will receive minimal public attention compared to the headlines
that would attend an announcement of a “cure” for leukemia that had been verified
on 1000 cases.

This disparity is symptomatic of the distortion of attention away from
issues of environmental health and towards reparative medicine; put another way,
it illustrates the important gap between "health" and "medicine". Any student of
contemporary affairs could produce a dozen more cogent examples.

Meanwhile, the School of Medicine is doing very little either to meet this
challenge, or to advertise that others should. I would support the former alternative,
and suggest that the medical school give the most serious thought to the ways
that it can properly encompass 4 broader range of responsibilities in its teaching
and research programs, as well as in its ministrations to human needs.

One proposal (of many that might be implemented in several areas) is a
graduate program in environmental health. At this time, I suggest that this be
viewed as a Ph. D. to be administered by interdepartmental committee.
(Eventually, we may wish to consider the prierity of a degree more patently
parallel to the M. D., a professional "Doctorate of Environmental Health’

Unlike prevailing offerings in ‘public Health", the EH degree would be based on

the same depth of basic sciences as the M. D. We might then also seriously
consider enlarging the freshman class of the "medical school" to include a number
of potential candidates for the EH degree. These do not have to be identified
before about the middle of the 3rd year, i. e.; the time when the student begins

to make a major commitment to patient care in the M. D. program. We could also
consider to recruit graduates who have already achieved the M. D. or other advanced

degrees, as well as a joint E.H.-M.D. program.

- Besides the basic medical sciences now taught here, the E.H. student should
also have advanced courses in biometry, epidemiology, nutrition, the physics and
chemistry of the biosphere, and techniques of instrumental analytical chemistry
and environmental toxicology. He probably should also have some exposure to
processes of government and other media of social policy.

 

a | pee AUG 23 1974 |
Then he should do a dissertation on some highly focussed aspect of

E. H. research. This will be the responsibility of individual professors.
For example, I am thinking of seeking funds for a facility that could look
at urine and other specimens from large numbers of people in looking for

‘ special metabolites -~ these would te new evidence of genetic idiosyncrasy,
of disease, or of exposure to peculiar environmental factors. Such a facility
would be based on the work done by the Genetics-Instrumentation Research
Laboratory for many years with NASA support for the development of computer—
based instrumentation in gas-liquid chromatography and mass spectometry. Other
members of the genetics department are well equipped to examine interactions
of environmental additives with DNA, or to screen for dominant lethal mutations
or. teratogenesis in animals. The medical school generally has unusual resources
for research programs that could be related to this theme.

 

The next step would be simply to organize an interdepartmental committee
that would seek authority to define and grant the Ph. D. in Environmental
Health. While based primarily in the medical school, this will benefit a great
deal from cooperation with other faculties in the university.

OFFICE MEMORANDUM ¢ STANFORD UNIVERSITY © OFFICE MEMORANDUM

Date: DEC i 8 1869

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GUOdNVIS © WNMONVHOWIW 331430 © ALISHTAINN GYOINVIS

From

Joshua Lederberg

Susect: Ph.D. in Environmental Health.

1. Would you favor me with your general reactions to
this proposal?

2. Would you suggest any specific research areas that

your or any of your identifiable colleagues might
seriously consider for sponsoring dissertation work?

Can you think of any other role that you might
wish to play in such a program?
PLEASE DISTRIBUTE THIS Pee LY TO OTHbits OK SUGGEST
NAMES OF wORTHY PROSPECTS 10K SOLICITATION,

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