Accolades for Volunteers

The beautiful and caring article about Melinda Lawrence {Cover, May 15}, her family and the volunteers who have added so much to their lives shows that there are many people helping others all the time, even though most of the stories covered by the media are of people hurting people. As a member of a wonderful all-volunteer hospice program in Montgomery County, Hospice Caring Inc., I am working with a woman with sickle cell anemia. Such a sensitive article and the pat on the back really helps keep us going. Beth Erickson Gaithersburg

The President on Health

Thank you for publishing the interview with President Bush on health care issues {Policy, May 15}. I consider myself a loyal Republican and supporter of the President's. However, on this issue, it is clear that Mr. Bush does not realize that our health care system is on the verge of a complete and total breakdown. Bruce Brown Alexandria

The First Lady's Choices

Many columns have been written about Mrs. Bush and her invitation to address the graduating class at Wellesley College, but the essay by Abigail Trafford {Commentary, May 8} was unjudgmental and presented a far wider viewpoint than others I've read. Also, it genuinely pertained to health. Women who work or stay home and are unhappy also tend to be sickly. Remember all those Victorian mothers who spent most of their time reclining on the couch with a headache! Helen Lillie Washington

After reading "Smart Women, Hard Choices," I was very upset. What is it that we really want for our daughters? I can't believe that the women of the class of 1990 know what it is they need to make them happy and fulfilled. Who knows that answer? Is being a "big chief" in the world or having all the material things in life going to make our daughters happier?

Yes, we want our daughters to have every opportunity and to strive to achieve their fullest potential, but the reason is to contribute to the world in some way, to make the world a better place.

Is it not true that to become the best we have to become the least? Being a wife and a mother and "living in the shadows of others" is tough, very tough. It is definitely a servant's role in many ways; you either sink or swim. Those who swim become strong like steel, and we need to be strong like steel to survive. Don't look down your nose at those who take the role of servanthood. Carol Ekman Fairfax

Circumcision Pros and Cons

I was truly dismayed by the article on a reversal of opinion on the practice of circumcision {Healthtalk, May 15}. This is still an operation in search of a reason, and the latest "findings" have changed nothing.

The study cited involved 400,000 babies, all Americans, of course. Since there is almost no information available on the care of uncircumcised babies in this country, it is no wonder that the infection rate is highest among them. A more accurate study would have to include all uncircumcised males in a variety of cultures, especially Europe and Scandinavia, where the practice is considered unnecessary and barbaric. Hygiene does not seem to be a problem for the 80 percent of the world's men who are uncircumcised. We are not only in the minority but, after a few generations of routine surgery, are pathetically ignorant about genital hygiene. Ellen Wilds Takoma Park

Prevention of Poison Ivy

From personal experience, I can attest that Roundup does kill poison ivy, but it may take several applications over the course of one season. To eradicate large areas of poison ivy, it is much safer than pulling and there is no disposal problem.R. Kettig Vienna

Another View on Medical Consensus

Concerning the article "The Contentious Process of Consensus" {Policy, May 15}, critics were cited who felt that the 1984 Consensus Conference on High Blood Cholesterol was somehow flawed by the composition of the panel. The overwhelming majority of cholesterol experts were, in fact, either pleased with the conference or concerned that its recommendations were too conservative.

The National Institutes of Health's consensus process, like all human endeavor, is not flawless. Some suggestions made to improve it, including recording votes taken and publishing minority opinions (if, indeed, they exist on the panel) seem quite reasonable. I am concerned, however, that the media not accept the notion that the process, which has provided the NIH enormous help and sound advice on "technology" transfer to the practicing community, is fundamentally flawed simply because a few disgruntled critics say it long enough and loudly enough.

One quote seemed to imply that, in the future, panel members will be chosen for a particular topic, based on their failure to have published anything on that topic. The solution to the problem is most assuredly not to have non-experts rendering medical policy advice to the practicing community. As a cholesterol investigator, I would not wish to be called upon to make decisions about the proper management of breast cancer. Nor would I call upon a breast surgeon to provide advice to the public about lowering cholesterol. John C. LaRosa, MD Dean for Clinical Affairs The George Washington University Medical Center

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