Motherhood and Menopause

The commentary by Abigail Trafford on the new technology that helps women past menopause bear a child {Second Opinion, Oct. 30} offered a well-balanced presentation of many of the psychological issues involved in the newer technological fertility treatments. As a clinical psychologist and a consultant to the Genetics & IVF Institute of Fairfax, I agree that the feelings and issues can be intense and complex. The need to discuss motivation for participation, potential changes in expectations and relationships and ways to communicate to the child and others about the method of conception is indeed crucial to the success of the method on an emotional level.

However, I strongly believe that given the availability of counseling and evaluation services prior to participation, potential problems can be dealt with, negative emotional outcomes minimized and those infertile couples who wish to utilize these options can continue to do so with confidence. Linda J. Cimarusti, PhD Fisher, Cimarusti & Associates Bethesda Vaccinations for Medical Students

I read with interest the news that medical students lack some of the required immunizations {The Cutting Edge, Oct. 23}. The medical school at the Uniformed Services University of the Health Sciences in Bethesda was not included in the study. All the recommended immunizations discussed in the article are provided to our incoming students, approximately 160 each year, if they do not have documentation for previous shots. Students also receive a three-shot series for protection against Hepatitis B, an infection that health care workers are particularly exposed to as they work with patients, in their first year. Thomas A. Miller, MD Assistant Professor of Family Practice F. Edward Hebert School of Medicine Uniformed Services University of the Health Sciences Bethesda Sidelining Dangerous Drivers

The column on how driving difficulties increase with age {Healthtalk, Oct. 30} brought to mind a potential horror story. After extensive testing two years ago, my father was diagnosed as suffering from multiple infarct dementia -- tiny strokes in the brain. Both doctors who cared for him said he should never drive again but refused to take action to ensure that he was stopped. I begged them to write a letter stating he was incapable of driving, but the doctors expected the family to take steps to remove his license. Sandy Rovner's statement that "nagging families are the least effective way" is very true; a 5-foot, 2-inch, 100-pound "baby" daughter does not tell a stubborn, independent man he must relinquish his freedom.

When I contacted the police, they said there was nothing they could do without a doctor's letter. No one seemed concerned that my father's growing incompetence as a driver might lead to tragedy. The last time my father drove with me in the car, he parked in the outer lane of a four-lane highway and later drove through a red light, nearly hitting a pedestrian. Fortunately, his deterioration was so fast we managed to keep him from getting behind the wheel again, but there were many heated arguments.

There should be some sanctioned mechanism whereby the police could be notified of potentially dangerous drivers, not necessarily to revoke their license but simply to call them in for some sort of driving competency test. I pray some approved process is established soon, if not for the protection of the driver, at least for the protection of everyone else on the road. Alicia Kopfstein-Penk Bethesda

Letters must be signed and include a home address and home and business telephone numbers. Send letters to Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071.