There is a question to which the answer is still not adequately explained. This question regards the potential for ultrasound to have any effect on the development of a maturing organism. This problem has a very real relevancy at this time because of the prevalence of this procedure. The average pregnant woman in this country, at this time, has at least one sonogram performed on her. Often, she has several performed during the course of her pregnancy. This raises the question, do these examinations have any potential dangers and do these examinations all have real medical significance? A sonogram entails bouncing sound waves off of an object and analyzing the reflection. Does the object off which the sound is bounce sustain any effects from the bombardment? The answer is that it most certainly does. Depending on the intensity of the waves the effect can be dramatic, even to fracturing stones. But this does not mean that less intensity has no effect. Even very low intensity has some effect though this may not be apparent grossly. The sonogram which is commonly performed on pregnant women has no noticeable effect on the patient or the fetus, but this does not prove that it does not have any effect. The word noticeable is vital in that sentence. In biological situations it is well known that many effects do not become apparent at once. Consider how long it was before the dangers of      X-Rays were understood. The fetus is a very active organism which is continually developing with cells actively dividing and connecting to each other. The mechanisms controlling these processes are not fully understood but we do know that they can be affected rather easily, either physically or chemically. It is not unreasonable to infer that a sound wave hitting a cell in active division or connection, at a crucial time, could disrupt the normal pattern of development. While this might have no apparent effect at that time, it might become manifest much later. This raises the possibility that the ultrasound bouncing off the fetus could affect various developing connections of neurons in the brain. If this is so, the effects of sonograms could have far reaching significance and deserve much more careful study. For instance; could this be associate with the incidence of autism and other neurological abnormalities, such as attention deficit disorders. There are two obvious ways to study the question. One is to correlate the number and timing of the sonograms performed on pregnant women with the future development of their offspring. A statistical analysis which would require a very large sampling and considerable effort to input the various significant data. The other method could be an animal experimental study whereby pregnant laboratory animals were subjected to sonograms at various stages and the effect on the offspring noted. Until the potential of ill effects of sonograms are more fully understood, it would be wise to limit the number of sonograms performed on pregnant women to those that have important medical significance. Too often they are performed to satisfy simple curiosity. If doctors and patients realized that there might be a potential danger associated with this simple and painless procedure, many less should be ordered.   EVOLUTION OF MEDICAL EDUCATION Called to be a Surgeon, Not for Bread Alone Author: Dr. Neville K. Connolly Ultrasound and the Fetus Read the full article

Dr. Neville Connolly’s desire to be a physician started early in his life when he decided he wanted to be able to spend his life helping people. When he started college at Kings College, Cambridge Univ. it was at the start of WW II in England. He felt that being a physician would allow him to be of help to many of the sick and wounded.  After graduating from Cambridge University, he was given a Rockefeller scholarship to go to Harvard Medical School in the USA. Neville went in a convoy of Merchant Marine ships, escorted by destroyers, to New York to attend Harvard. He arrived at Harvard just as the US was attacked at Pearl Harbor and entered the war. While attending Harvard he did training at Johns Hopkins Hospital in Baltimore, Maryland and was assigned to assist some of the great names of Hopkins surgeons. Among them were Blaylock, who developed the “blue baby” operation and was one of the pioneers of cardiac surgery, though he did not confine himself to this field. Firor, who was always a perfect gentleman and a superb, thoughtful surgeon, Reinhoff, nicknamed “Wild Bill”, was fearless but an excellent technician. All this activity was a sharp contrast to the leisurely discussions and seeming inactivity of the Medical Service that he was exposed to in Boston. The results of surgery were swift, and whether successful or not, determinate, it depended on technical skill as well as thoughtful planning. The whole atmosphere was intoxicating for a budding physician. It was here that he changed his mind and decided to become a surgeon. He still liked children and saw the possibilities of combining both his interests by becoming a pediatric surgeon. After graduating from Harvard. he returned to England to get his medical degree from Cambridge. To do this, he had to attend courses at an English Hospital. Since St. Thomas’s Hospital ln London had awarded Neville a scholarship before he accepted the scholarship from Rockefeller to go to Harvard, they allowed him to join their courses. Neville covers in great detail his learning experiences and the differences between the English and American system of training. At the end of his training he passed his exams at Cambridge and got his medical degree. Shortly after that the war ended in Europe, Neville started work at St. Thomas’s as a house officer This was his first year as a doctor, 1945-46. At the end of his six-month appointment he had to apply for another six months as a House surgeon before he could do his National Service in the ARF. He was anxious to get started in the field of his special interest, Pediatric Surgery. Neville’s father knew Sir Stanford Cade, who was the senior Surgical Consultant to the RAF and became Vice President of the Royal College of Surgeons. He was a very influential advocate for the RAF and was able to organize a special burn service at the RAF Hospital. He offered to introduce Neville to the staff of Great Ormond Street Hospital for Sick Children, the premier hospital for children in England. Though Neville was offered another six months at St. Thomas’s He applied at Great Ormond Street and was awarded a House Surgeon appointment to work with Denis Browne who later became Sir Denis Brown, the Queen’s surgeon. Great Ormond Street is a remarkable Hospital. It is the first Hospital in England to care for children exclusively. Neville goes into great detail about how much he learned and how many skills he mastered while working with Denis Brown. After his training at Great Ormand Street Neville started to study for his exams to become a Fellow of the Royal College of Surgeons. During this time, he went into the Royal Air Force to serve his military obligation and was assigned as a surgeon to Ely Hospital, which was one of the main RAF hospitals that had one of the main burn units set up to treat burned pilots, many of them casualties from the battle of Britain. After finishing his service in the RAF, Neville went to St. Thomas’s Hospital as a supernumerary registrar, which was a position provided for ex-service men to get extra training. During that time, he passed his exams and became a Fellow of the Royal College of Surgeons. England had just started the National Health Service and Neville got a position at Norwich Hospital as a middle grade surgical Registrar. He was assigned to two of the four consultant surgeons, Mr. Birt and Mr. Ridley Thomas. This was in the early days of the National Health Service. He found that they were inundated with patients. Once the patient chose the surgeon they wanted, they always saw the same surgeon unless they asked to have a different one. This allowed excellent continuity of care. On a busy day, and most were, they could see as man as 50 patients in a session. At the onset of the National Health Service no one had any concept of the enormity of the health problems lurking in the background. As soon as people realized they could get surgery for their problems without paying for it, they came forward with conditions like hernias, varicose veins and hemorrhoids that they had tolerated for years. The work load was stupendous. After two years at Norwich Hospital Neville returned to Great Ormond Street as a senior Registrar to continue his Pediatric surgical training. After he finished his training at Great Ormond Street he realized that there were few jobs for pediatric surgeon positions in the National Health Service. It was a specialty that was just beginning to be recognized. Neville realized it would be some time before he would possibly be able to get an appointment as a Pediatric surgeon. When he had visited his wife’s family in Washington, DC, he had been introduced to Dr. John Lyons, who was the Senior surgeon at one of the hospitals there. Dr. Lyons had taken care of Agnes, Neville’s wife, when she was very sick as a girl. Dr. Lyon’s told Neville if he ever decided to immigrate to Washington, he would welcome him as his associate. Dr. Lyon’s reputation was outstanding, both as a surgeon and as a man utterly devoted to his patients. Neville saw the move as a chance to make his own career on his own merits rather than chancing it on a selection committee of the Health Service. He decided to make the move to start his private practice in Washington. Read the full article