2019 HIGHLIGHTS
CHAIR’S MESSAGE ...... 2 FACULTY AFFAIRS ...... 6 VETERANS AFFAIRS ...... 8 BASIC & TRANSLATIONAL RESEARCH PROGRAMS . . . . .10 CLINICAL & HEALTH SERVICES RESEARCH PROGRAMS . . .12 ADMINISTRATIVE PROGRAMS ...... 14. UNDERGRADUATE MEDICAL EDUCATION ...... 16 GRADUATE MEDICAL EDUCATION ...... 18 QUALITY & INNOVATION AND EXTERNAL RELATIONS . . 20. DIVERSITY, EQUITY & WELL-BEING ...... 25 AWARDS ...... 27. PROFESSORSHIPS ...... 28 HONORING OUR PAST ...... 34 CREATING A LEGACY ...... 48. FUELING INNOVATION ...... 64 DEVELOPING BETTER TREATMENTS & CURES . . . . . 84. ADVANCING CLINICAL CARE ...... 98. CHAIR’S MESSAGE
CHAIR’S REPORT
John Carethers, MD | Chair of Internal Medicine During 2019, the Department of Internal Medicine turned 171 years old, and the University of Michigan Hospital, where our faculty work, turned 150 years old. Throughout this history, our faculty and staff have done many wonderful things for our patients, our department, our institution and our state and country. We continued to be recognized and honored for our excellence in many ways during the past year. Now we are focused on using these strengths to step up like never before as we face the many unknowns of health care in the coming year.
THE ROOTS OF OUR SUCCESS NATIONAL HONORS I selected this year’s annual report theme, “The U.S. News & World Report Roots of Our Success — Philanthropy’s Role in 2019–2020 Rankings Advancing Our Mission,” because I wanted to highlight the many stories made possible by our Hospital No . 11 (Honor Roll) donors . Philanthropy allows our department to Specialty Areas go above and beyond in all areas . It emboldens Pulmonary No . 10 risk in research, allowing us to find better cures Endocrinology No . 11 and treatments . It allows us to innovate medical Rheumatology No . 12 education for future generations . It inspires us Cardiology & Heart Surgery No . 13 to push the limits of understanding of the best Geriatrics No . 15 ways to care for patients and to bring those ideas Gastroenterology & GI Surgery No . 20 to life in the clinic . I hold the John G . Searle Nephrology No . 32 Professorship in Internal Medicine — the very Diabetes & Cancer No . 34 first professorship developed for our department in 1968 . When I took on the role of chair in 2009, Medical Education there were 28 professorships . Now just 10 years The U-M Medical School was ranked No . later, we have more than 100! The tremendous 6 for training primary care physicians and impact of this growth of support is reflected for internal medicine . It is No . 16 nationally throughout the pages of this report . among research medical schools .
2 2019 INTERNAL MEDICINE ANNUAL REPORT CHAIR’S MESSAGE
HOSPITAL ADMISSIONS
NEW ROLES Scott Flanders, MD, was named 16,840 3,912 16,794 9,388 16,730 9,811 16,919 9,644 16,929 8,873 Michigan Medicine’s chief clinical Internal medicine faculty are strategic officer for the University providing valuable leadership of Michigan Health System . 2014-15 2015-16 2016-17 2017-18 2018-19 through our department, Michigan Total 20,752 Total 26,182 Total 26,541 Total 26,563 Total 25,802 Medicine and the university . Bethany Moore, PhD, became n Discharges n Observation Cases the acting department chair for Leslie Aldrich, MD; David the Department of Microbiology & OUTPATIENT OFFICE VISITS Smith, MD and Vallerie Immunology at U-M . McLaughlin, MD, became associate chief clinical officers in our new U-M Medical Group 2019 PATIENT CARE ambulatory care structure . Our volume of off-site primary
and specialty care and on-site 135,111 150,202 111,369 16,572 145,387 164,796 120,087 19,268 151,414 167,921 118,879 19,214 163,071 171,597 135,432 18,888 168,919 174,695 153,939 17,711 Eve Kerr, MD, MPH was named specialty care continued to the inaugural vice chair for equity, increase during 2019 . This is inclusion and well-being for the 2014-15 2015-16 2016-17 2017-18 2018-19 primarily due to the great success Total 413,254 Total 449,538 Total 457,428 Total 488,988 Total 515,264 Department of Internal Medicine, of our many new outpatient along with Assistant Vice Chairs n Off-Site Primary Care n On-Site Specialty Care n Off-Site Specialty Care n On-Site Primary Care facilities in Ann Arbor, Brighton, Sarah Gualano, MD, and Livonia and Northville helping GROSS PROFESSIONAL CHARGES (in thousands) Michael Lukela, MD (page 25) . us meet the growing demand Timothy Laing, MD, previously for patient care in southeast our vice chair for clinical Michigan .
operations, transitioned to director 137,030 57,329 45,809 146,705 59,678 52,576 143,812 74,007 55,202 166,311 62,967 57,850 175,580 67,468 60,470 of billing and compliance . He will be working with our new Clinical Experience & Quality Team that began in early 2020 (page 22) . 2014-15 2015-16 2016-17 2017-18 2018-19 Total 240,168 Total 258,959 Total 273,021 Total 287,128 Total 303,518
n Outpatient Specialty n Inpatient Specialty n General Medicine Inpatient + Outpatient
2019 INTERNAL MEDICINE ANNUAL REPORT 2019 INTERNAL MEDICINE ANNUAL REPORT 3 CHAIR’S MESSAGE
A NEW HOSPITAL neurosciences and cardiovascular Michigan Medicine focuses its or our department . On the next services . Each of the 264 rooms resources on meeting the needs page, we’ve added a brief In late October 2019, Michigan in the hospital will be private of the COVID-19 crisis . overview of the current Medicine broke ground on a new and will be capable of being COVID-19 response at 12-story adult inpatient hospital . converted to intensive care . STEPPING UP Michigan Medicine . The facility is needed to increase The 690,000-gross-square-foot patient access while also As we go to print with our hospital will allow more patients providing state-of-the-art care to report this year, our world has to access Michigan Medicine’s patients, with an emphasis on just been hit with a global high level of care . Currently, clinical pandemic . This is a time unlike hospital facilities often operate at anything any of us has seen more than 90 percent capacity . before . Every day I am humbled This project was slated by the incredible heart, courage, to be completed in determination and hope our 2024 but has faculty, staff, residents and been put on students are bringing to the temporary frontlines . Many of the same hold as people you see featured in this report are now taking every bit of their talent, energy, compassion and innovation and applying that to this unknown, new world . We are determined to help more patients survive and thrive, to protect frontline workers and to find new solutions to treating and preventing COVID-19 . I have never been prouder of our work
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COVID-19 RESPONSE
The state of Michigan capabilities are available within its doors to non-Veteran (i e. ,. producing and distributing hand providers to HCQ vs . placebo By analyzing the registry data, confirmed its first two the university’s hospitals . All “humanitarian” or “civilian”) sanitizer to the local homeless to identify whether HCQ can participants of the MI-COVID19 COVID-19 cases on March staff caring for these patients are admissions on April 5, 2020 . To population . reduce infections in health care initiative aim to identify factors 10, 2020 . In the three prepared, trained and have the date, VAAAHS has cared for more providers at high risk and reduce associated with higher levels weeks that followed, the right supplies . civilians during the COVID crisis OUTPATIENT CARE the overall severity of COVID-19 . of critical COVID-19 illness number of cases in the than any VA in the country outside and worse outcomes; identify Division of Hospital Medicine To help our patients receive state soared to more than of New York City . Many internal IMPROVING COVID-19 CARE patient characteristics and Chief Vineet Chopra, MD, MSc, appropriate care with minimal 10,000, making it one of the medicine faculty have been part treatment regimens associated led the creation of the all-COVID risk of spreading disease in their Michigan Medicine has also nation’s hot spots . Michigan of this effort including Sanjay with improved outcomes; unit, with a team of hospitalists, communities wherever possible, teamed up with 25 other Michigan Medicine has been getting Saint, MD, MPH, the chief of and understand long-term nurse practitioners, physician we are providing enhanced hospitals and Blue Cross Blue many direct and transferred medicine at VAAAHS . complications for hospitalized assistants, nurses, respiratory access to outpatient care Shield of Michigan to collect COVID-19 patients since mid- patients . therapists and other staff during the COVID-19 pandemic, comprehensive clinical data on March . MEDICAL SCHOOL volunteers . including a COVID-19 hotline, COVID-19 patients to be included On March 17, the U-M Medical curbside screening and enhanced in an extensive registry that will REGIONAL INFECTIOUS By the end of March, they had School suspended student clinical access to virtual care (e-visits or provide insight into best practices CONTAINMENT UNIT handed over the reins to a team rotations and moved all classes video visits) . in treating patients with the virus . of experienced intensive care Part of Michigan Medicine’s online, in accordance with professionals, so the unit could Titled MI-COVID19, the comprehensive COVID-19 guidance from the Association PROTECTING PROVIDERS focus on the sickest patients . comprehensive, multisite registry planning and response program of American Medical Colleges . The RICU team moved on to A study led by internal medicine will likely be one of the largest included opening an isolation unit Faculty members continued to transforming other areas of the faculty Marisa Miceli, MD, collections of COVID-19 patient called the Regional Infectious mentor students beyond the hospital, and training their staff, in and Peter Higgins, MD, data in the country . It was Containment Unit (RICU), a clinical setting, including helping the same way . PhD, MSc, is exploring how developed by a team from the negative-pressure unit specifically them channel their efforts to effective Hydroxychloroquine Michigan Hospital Medicine created for these kinds of crises . maximum collective benefit VA ANN ARBOR HEALTHCARE (HCQ) may be in protecting Safety Consortium, a Blue The unit provides 32 private through student-driven community SYSTEM health care providers . This Cross-funded CQI led by Scott isolation rooms, and follows projects, including blood donation provider prevention study, with Flanders, MD, chief clinical CDC guidelines . In addition, The VA Ann Arbor Healthcare drives, free babysitting services 15,000 participants nationwide, strategy officer at Michigan focused locations with similar System (VAAAHS) opened for frontline care providers and randomizes health care Medicine .
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FACULTY AFFAIRS
Richard Simon, MD | Vice Chair for Faculty Affairs The total number of Department of Internal Medicine faculty continued to grow in our clinical track during 2019. The chart at the right breaks down our faculty growth trends by year and faculty type.
FACULTY PROMOTIONS the Association of American for the Department of Internal DISTINGUISHED UNIVERSITY Physicians . Medicine, along with Assistant PROFESSORS Fifty-one faculty members Vice Chairs Sarah Gualano, from the Department of The American Gastroenterological Two Department of Internal MD, and Michael Lukela, MD . Internal Medicine were Association (AGA) presented Medicine faculty members This new leadership team will promoted effective its highest honor, the Julius received one of the University be evaluating our programs and September 1, 2019 . We Friedenwald Medal, to John of Michigan’s top honors focusing on issues of physician congratulate these faculty Allen, MD, MBA, AGAF, for his as Distinguished University burnout and wellness (page 25) . members on their new status incredible contributions to the Professors recognizing and achievements . field of gastroenterology and AGA their exceptional scholarly CLINICAL EXCELLENCE SOCIETY over several decades . The Julius achievements, national and HONORS Friedenwald Medal, presented The department inducted 11 international reputations for annually since 1941, recognizes a new members into the Clinical academic excellence and Department of Internal physician for lifelong contributions Excellence Society in 2019 (see superior records of teaching, Medicine faculty are to the field of gastroenterology . photo at right) in honor of their mentoring and service: John recognized for their expertise expertise and dedication to Ayanian, MD, MPP, is the and excellence . Sanjay Saint, MD, MPH and providing the best patient care Alice Hamilton Distinguished Eve Kerr, MD, MPH were Elif Oral, MD, MS, a professor possible and mentorship of other University Professor of Medicine elected as Masters of the in the Division of Metabolism, clinicians . The society is made and Healthcare Policy (page 39) American College of Physicians . Endocrinology & Diabetes was possible by funding from Chair and Anna Suk-Fong Lok, MD, inducted into the American John Carethers’, MD, Searle is the Dame Sheila Sherlock DIVERSITY, EQUITY & Society of Clinical Investigation . Professorship . Distinguished University INCLUSION AND WELLNESS Professor of Hepatology and Bill Herman, MD, MPH, a Eve Kerr, MD, MPH was named Internal Medicine (page 103) . professor from the Division of the inaugural vice chair for Metabolism, Endocrinology & equity, inclusion and well-being Diabetes was inducted into
6 2019 INTERNAL MEDICINE ANNUAL REPORT FACULTY AFFAIRS
PRIMARY FACULTY BY TRACK
ENDOWED PROFESSORSHIPS Alpheus W . Tucker, MD, Collegiate Professor of Internal Medicine – The new professorships inaugurated Theodore Iwashyna, MD in the Department of Internal 392 271 91 423 282 110 425 273 109 469 260 105 493 257 102 Medicine during 2019 included: Nancy Wigginton Oncology Research Professor of Thyroid Giles G . Bole, MD, and Dorothy 2015 2016 2017 2018 2019 Cancer – Total 754 Total 815 Total 807 Total 834 Total 852 Mulkey, MD, Research Professor Megan Haymart, MD of Rheumatology – Michelle n Clinical n Instructional n Research Kahlenberg, MD Nancy Wigginton Oncology Research Professor – William Henry Fitzbutler Collegiate Frank Worden, MD Professor – Vincent Young, MD ABOVE & BEYOND Stevo Julius Research Professor of Much of the Department of Cardiovascular Medicine – Robert Internal Medicine’s faculty D. Brook, MD success, innovation and impact Melvyn Rubenfire Professor of that I get to report on each year is Preventive Cardiology – supported and made possible by Venkatesh L. Murthy, MD professorships you will read about in this year’s report . This funding Richard D . Schwartz, MD, Collegiate not only helps us recruit and retain Professor of Nephrology – the best and brightest, it also gives Panduranga S. Rao, MD our faculty the time and resources Larry Soderquist Professor – they need to truly shine as leaders 2019 Clinical Excellence Society Inductees: (From left to right): Michael Mendez, MD; Peter Farrehi, MD; Asra Ahmed, MD; Rashmi Rodica Busui, MD and best in research, education and Chugh, MD; Leslie Aldrich, MD; Wendy Marder, MD; Audrey Fan, MD; Mark Ealovega, MD; Sara Saberi, MD, MS; and Paul Grant, patient care . MD (not pictured: Carol Chenowith, MD)
2019 INTERNAL MEDICINE ANNUAL REPORT 2019 INTERNAL MEDICINE ANNUAL REPORT 7 VETERANS AFFAIRS
VETERANS AFFAIRS
Sanjay Saint, MD, MPH | Chief of Medicine, VA Ann Arbor Healthcare System; Vice Chair for VA Programs; AOA Councilor, U-M Medical School The VA Ann Arbor Healthcare System (VAAAHS) continued to experience steady outpatient and inpatient activity in 2019. Our Ann Arbor campus handled 654,748 outpatient encounters and 93,423 inpatient encounters. Through numerous quality improvement and patient safety initiatives, we continue to address the needs of our Veterans through efforts that are serving as models to improve patient care across the country.
BREAKING GROUND It is expected to open in late Veterans . The clinic’s anticipated and recognized for their Award from the Association spring 2020 . completion date is late 2021 . expertise in Michigan and for Professionals in Infection In late April 2019, construction across the country . Control and Epidemiology . began on the first Fisher House EXPANDING OUR REACH FACULTY APPOINTMENTS in Michigan at VAAAHS . A Jeff Curtis, MD, received the Brahmajee Nallamothu, MD, groundbreaking ceremony was In September 2019, VAAAHS During 2019, the following 2019 John B . Barnwell Award, MPH, was appointed to serve held on June 14, 2019 and it announced the location of a new faculty took on new the VA Clinical Science Research on the Medicare Evidence was officially completed and Community Based Outpatient appointments: and Development’s highest Development & Coverage turned over to the VA on April Clinic (CBOC) on the border of honor, given for scientific Advisory Committee . Grace Su, MD, became interim 20, 2020 . Once open, up to 16 Canton and Westland . Once contributions that change chief of the Hematology and Vineet Chopra, MD, MSc, families will be able to stay built, the nearly 40,000-square- clinical practice for Veterans . A Oncology Section . chief of the Division of Hospital there free of charge on any foot clinic will serve Veterans in pulmonologist and critical care Medicine, was invited to be given night, allowing them to be western Wayne County, and will Ashwin Gupta, MD, was physician at the VAAAHS, he has a member of the Annals of close to their loved ones at the allow for the full implementation named chief of the Hospital dedicated his career to making Internal Medicine Editorial most stressful time — during of the Patient-Aligned Care Medicine Section . fundamental contributions to Board . hospitalization at the VA Ann Team model of care delivery, the understanding of chronic Caroline Vitale, MD, was Arbor Medical Center . Veterans improving operational obstructive pulmonary disease Akbar K. Waljee, MD, MSc, named the associate director for receiving outpatient care may efficiencies and the Veteran (COPD) and lung defense from AGAF, and Vineet Chopra, education and evaluation at the also access lodging at the Fisher experience . The new CBOC will bacterial pathogens . He has also MD, MSc, were each honored Ann Arbor VA Geriatric Research House as long as they bring a provide primary care, and mental mentored many early-career with 2019 Distinguished Clinical Education and Clinical Center . companion to stay with them . health, laboratory, pathology and scientists and fostered the next and Translational Research This 16-suite, 13,400-square- imaging services to Veterans in generation of VA investigators . Mentor Awards by the Michigan AWARDS & RECOGNITION foot “comfort home” will join 87 a right-sized, state-of-the-art, Institute for Clinical & Health Sarah Krein, PhD, RN, other Fisher Houses operating energy-efficient health care Our VAAAHS internal medicine Research . was honored with the 2019 in the United States and Europe . facility serving over 14,000 faculty are regularly honored Distinguished Scientist
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CONCLUSION of many from the Department of Internal Medicine ensuring The theme of this year’s report The theme of this year’s report that the very best standards and highlights the many ways highlights the many ways methods are translated to the philanthropy is advancing care of our nation’s Veterans . philanthropy is advancing our our department’s missions of research, education and patient department’s missions of care . I am honored and grateful research, education and patient that Veterans benefit from these innovations . There are care. I am honored and grateful so many dedicated faculty at that Veterans benefit from these VAAAHS developing programs and research that are improving innovations. There are so quality of life and saving lives . many dedicated faculty As the recipient of the George Dock professorship myself, I at VAAAHS developing have been able to focus my programs and career on improving patient safety by preventing hospital research that are infections and teaching the next improving quality generation about how they can improve hospital medicine and of life and become better, more effective saving lives. physicians . As chief of medicine of VAAAHS, I know I am just one
2019 INTERNAL MEDICINE ANNUAL REPORT 2019 INTERNAL MEDICINE ANNUAL REPORT 9 BASIC & TRANSLATIONAL RESEARCH PROGRAMS
BASIC & TRANSLATIONAL RESEARCH PROGRAMS
Ben Margolis, MD | Vice Chair of Basic and Translational Research A record high in annual research expenditures at the University of Michigan in 2019 led to innovative research and scholarship endeavors that are addressing emerging problems and developing new technologies. U-M, which has ranked No. 1 in research volume among the nation’s public universities for the past nine years, reported $1.62 billion in research expenditures during 2019. Among U-M units the Medical School ranked No. 1 in research expenditures, with $690 million. More than a third of that funding comes from the work of internal medicine faculty. The Department of Internal Medicine competed for and obtained $198 million in research support in 2019 and published more than 2,200 research publications. Some of the advancements, honors and notable awards from the past year are detailed below:
TRANSFORMING FOOD the program seeks to develop are scientifically or socially to investing in and honoring its ALLERGY RESEARCH innovative strategies to diagnose distinguished ”. faculty through professorships is and treat food allergies . Internal not only creating a better future The Mary H . Weiser Food Allergy J. Michelle Kahlenberg, MD, medicine faculty member James for medicine; it’s creating better Center (MHWFAC) announced a PhD, received the Presidential Baker, Jr., MD, leads the lives for our patients . major new initiative called the Early Career Award for MHWFAC (page 69) . Michigan Food Allergy Research Scientists and Engineers, the Accelerator (M-FARA), in 2019 . highest honor bestowed by the NATIONAL HONORS This program was made possible U S. . Government to outstanding by a five-year gift of $5 million Internal medicine faculty scientists and engineers . $198 million from an anonymous donor, which members Kenneth Langa, Total Research Funding is renewable for a second $5 MD, PhD; Suzanne Moenter, INVESTING IN OUR FACULTY Awarded for FY 2019 million after its initial period has PhD; Linda Samuelson, PhD; Recruiting and training the lapsed . and Shaomeng Wang, PhD next generation of scientists U-M Ranked were elected as fellows of This gift aims to establish a and retaining top leaders and No. 1 the American Association for program designed to transform mentors is essential to keeping Public University the Advancement of Science how individuals understand the U-M at the forefront of novel in Research in 2019 . Fellows are elected fundamental mechanisms that basic and translational research . Volume annually by the AAAS Council are driving an increase in food As you will see throughout this for “efforts on behalf of the allergy rates in both children year’s report, the Department of advancement of science and young adults . Additionally, Internal Medicine’s commitment or its applications which
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NOTABLE AWARDS Bethany Moore, PhD Theodore Standiford, MD David Pinsky, MD NIH R35 $5 .9M (6 years) NIH T32 $4 9M. (5 years) NIH T32 $3 .1M (5 years) National Heart, Lung, “Multidisciplinary Training “Multidisciplinary Blood Institute Outstanding Program in Lung Disease” Cardiovascular Research Research Investigator Award Competitive renewal of a Training” “Immunobiology of Lung Injury federally funded training Competitive renewal of a and Fibrosis” program that is now in its 26th federally funded training year of funding . program that is now in its 21st Marc Peters-Golden, MD 2,200 year of funding . NIH R35 $6 .5M (7 years) Subramaniam Pennathur, Research MD Anna Lok, MD; Grace Su, Publications National Heart, Lung, MD; and Thomas Wang, Blood Institute Outstanding NIH P30 $2 9M. (5 years) MD, PhD Research Investigator Award “University of Michigan O’Brien NIH U01 $3 .3M (5 years) “Novel Functions of Lung Kidney Translational Core Macrophages and Fibroblasts Center” “Novel Strategies to Improve in Pulmonary Inflammation Center established to assist Liver Cancer Surveillance and Fibrosis” investigators and clinicians Update and Early Detection” worldwide in kidney disease research .
2019 INTERNAL MEDICINE ANNUAL REPORT 2019 INTERNAL MEDICINE ANNUAL REPORT 11 CLINICAL & HEALTH SERVICES RESEARCH PROGRAMS
CLINICAL & HEALTH SERVICES RESEARCH PROGRAMS
Rodica Pop-Busui, MD, PHD | Vice Chair for Clinical and Health Services Research My role this year has expanded with substantial risks — such as and received seed funding . Hayek, MD, received the 2019 We are pleased to announce to include both clinical and bloodstream infection, deep- Thomas Enzler, MD, PhD, from Samuel A . Levine Early Career a new Steno North American health services research . This vein thrombosis and death . the Division of Hematology Clinical Investigator Award from Diabetes Fellowship . Funded by is an exciting opportunity to Despite this, no clinical studies & Oncology, was one of four the American Heart Association . the Novo Nordisk Foundation, capitalize on the inherent, have been conducted to assess participants to receive additional It recognizes his research it will support exchanges of bidirectional synergies in these alternatives . To address this, funding for his outstanding showing that suPAR is a early-career diabetes and arenas . As our clinical trialists Chopra enrolled in the 2019 trial design for the treatment promising prognostic biomarker obesity investigators from U-M, identify effective interventions, Clinical Trials Academy and of pancreatic cancer . Our first and potential therapeutic target the University of Toronto and our outcomes researchers has designed a study, which participant from a nonclinical for acute kidney injury following the Steno Diabetes Centers in can examine them in clinical he is submitting to the Agency department, Scott Lempka, PhD, cardiovascular procedures . Denmark . Fellows will work practice . And if an intervention for Healthcare Research and from biomedical engineering, in both clinical care and on In 2019, MDiabetes launched falls short in practice, Quality, to compare the safety has already received an NIH clinical or health outcomes a Clinical/Translational our trialists can compare and effectiveness of midline R01 for his trial on spinal research, exchanging ideas, Research Scholars Program to alternatives . catheters vs . PICCs for extended cord stimulation for pain . forming research collaborations support early-career diabetes antibiotic delivery . In addition, one of our 2018 and developing projects that A perfect example of this kind of researchers, providing up to 50 graduates, Scott Hummel, can be submitted to the Novo synergy is the work being done This is the perfect example of percent salary support for three MD, MS, from the Division Nordisk Foundation . The new by Vineet Chopra, MD, MSc, how health services and clinical years . Brian Schmidt, DPM, of Cardiovascular Medicine, partnership will be marked with chief of the Division of Hospital research can inform each other from the MEND Division, was learned that his clinical trial of a symposium in 2021 to honor Medicine . The lead author of to improve clinical care . one of two inaugural awardees . home-delivered, heart-healthy the 100-year anniversary of the the Michigan Appropriateness meals after discharge for heart Our 2019 Clinical Research discovery of insulin . Guide for Intravenous Catheters CLINICAL RESEARCH UPDATES failure has been approved for Spotlight recognized Anna (MAGIC), he has found through Our early-career investigators multisite trials by the Veterans Mathew, MD, from the Division HEALTH SERVICES RESEARCH his health services research continue to flourish . We Administration Cooperative of Nephrology . She is using that peripherally inserted Internal Medicine has a sizable hosted 12 participants in the Study Program . metabolomics and proteomics central catheters, or PICCs, and accomplished history 2019 Clinical Trials Academy, to study the mechanisms behind are the most common means Another rising clinical research in health services research . five from Internal Medicine . kidney patients’ increased for delivering intravenous star from the Division of Indeed, researchers from our All successfully completed cardiovascular risk with the goal antibiotics, yet are associated Cardiovascular Medicine, Salim department make up the largest their clinical trial protocols of identifying targeted therapies .
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group within U-M’s Institute for MD, MSc, who explores equity, Healthcare Policy and Innovation access and evidence-based care 2019 JI PROJECTS (IHPI) . In response to the recent for individuals with chronic pain The Michigan Medicine/Peking University Health expansion of my role, I have been and substance use disorders . Science Center Joint Institute for Translational and scheduling meetings with several The opportunities to synergize Clinical Research funded 12 projects for 2019 . Those of these researchers to learn how are endless; I look forward co-led by internal medicine researchers include: we can add value to the robust to collaborating with my infrastructure of the IHPI, such as clinical and health services GASTROENTEROLOGY & HEPATOLOGY helping to connect clinical and research colleagues to take full Elizabeth Speliotes, MD, PhD, MPH outcomes researchers to achieve advantage of them . Genetic and microbiome effects on non-alcoholic the kind of synergistic insights fatty liver disease and its complications in a Chinese Vineet Chopra is aiming for . population Because our health services Andrea Tosisco, MD & John Kao, MD research footprint is so vast, we Molecular signatures of the progression of intestinal have the perfect opportunity to metaplasia: a multi-omics approach stimulate the development of clinical research projects that RHEUMATOLOGY address pressing topics already being investigated by our IHPI Jason Knight, MD, PhD colleagues, from healthy aging LILRA3 as a novel regulator of thrombo- to the opioid epidemic . Examples inflammation in antiphospholipid syndrome include research by Division of CARDIOVASCULAR MEDICINE General Medicine investigators such as Deborah Levine, Bertram Pitt, MD & Porama Thanaporn, MD MD, MPH, who examines risk Evaluation of mineralocorticoid antagonists in factors and outcomes for stroke, aldehyde dehydrogenase type 2 deficiency cognitive impairment and dementia, and Pooja Lagisetty,
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ADMINISTRATIVE PROGRAMS
Masada (Musty) Habhab | Chief Administrative Officer To advance medicine, effective teamwork is needed. In our clinics, you see physicians and in our research labs, you see scientists. However, tucked away in our offices sit the administrative staff — our unsung medical heroes. Overseeing finances, personnel decisions, process improvement and compliance — the decisions made by our administrative staff directly impact the care of our patients. This past year, we have welcomed new administrative team members, rewarded hard work and found ways to decrease costs while ensuring our continued success.
LEADERSHIP RETREAT establish a consistent process to 2019 Staff Award for • Charmaine Prichard, be followed across all divisions . Excellence Recipients Business Manager, General Identifying the best ways to Medicine continue advancing science • Mark Cichocki, SERVICE AND EXCELLENCE while decreasing the financial Registered Nurse, Infectious • Dawne Vowler, Graduate CELEBRATION burden of unfunded research Diseases Medical Education Program was the topic of the 2019 In October 2019, the fifth Administrator, Metabolism, • Kaley German, leadership retreat . The event annual Service and Excellence Endocrinology & Diabetes Administrative Specialist, brought together department Celebration took place, Hospital Medicine 2019 Administrator of the vice chairs, division chiefs which recognizes the many Year Award and administrators to share contributions, dedication • Rosanne Hadlock, ideas and help identify and and meritorious service staff Administrative Assistant, Marisa Rodriguez, Division implement next steps to this have made to the Department Gastroenterology and Administrator, Hospital Medicine complex problem . Attendees of Internal Medicine . The Hepatology were engaged early on in the celebration also featured • Tracy Hunt, Physician process through preliminary individuals who have achieved Assistant Lead, Hospital discussions, as well as a milestone anniversary with Medicine opportunities to review and Michigan Medicine within the comment on a proposed plan . past year . Attendees enjoyed • Matthew Magers, The team came together and lunch, a fun trivia quiz and prizes . Administrative Assistant, endorsed the final plan, which Nephrology allowed the department to
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NEW TEAM MEMBERS and decision support for a variety of Internal Medicine and Office of The impact on the Operation of projects in administrative, Clinical Affairs, Wayne-Westland Opportunity students is significant Swati Bajpayee, MS, joined educational, clinical operations/ Community Schools (WWCS) and as it gives them exposure to, our team as the new interim quality improvement and DEI Eastern Michigan University Bright and information on, careers in administrator for the Division of spaces . Prior to joining our team, Futures . the medical field they might not Allergy and Clinical Immunology . she was a project manager in the otherwise have known about; it She previously served as the In 2019, approximately 20 U-M Department of Obstetrics opens the door and changes their interim clinic manager for students from WWCS were & Gynecology for nearly six perspectives on what is possible . 2019 STAFF SERVICE AND EXCELLENCE AWARDS the Center for Reproductive selected to spend 10 days at years and was responsible John Carethers, MD, Marisa Rodriguez, Kaley German, Julianne Grant, Dawne Vowler, Medicine . Bajpayee has Michigan Medicine facilities . for their DEI initiatives and Matthew Magers, Charmaine Prichard, Mark Cichocki, Rosanne Hadlock and Musty also acted as the director of Activities in internal medicine Habhab implementation . Additionally, operations for a student-run free included meeting with faculty Price teaches diversity and clinic, held a role as a graduate and staff from the Divisions cultural communication courses researcher and worked closely of Hospital Medicine and as adjunct faculty at the University with the Medical School Faculty Genetic Medicine, participating of Toledo College of Business and Affairs Office as they enhanced in simulation activities and Innovation . the reporting associated with having the opportunity to talk faculty satisfaction survey data . with Department Chair John OPERATION OPPORTUNITY Carethers, MD . Erin Price, MPH, joined our team Founded in 2015, Operation as the new program manager The benefits are felt both by the Opportunity is a two-week youth for the Office of Diversity, Equity Michigan Medicine participants mentorship program designed and Well-Being . She partners and the Operation Opportunity to help highly motivated Wayne- closely with Drs . Eve Kerr, Sarah students . For the Michigan Westland high school students Gualano and Michael Lukela Medicine mentors, the program learn more about the many career in their work to evaluate, monitor increases their understanding paths in medicine . The program and refine diversity, equity and of vulnerable and underserved has evolved over the years to inclusion (DEI) and well-being populations and gives them become a partnership between initiatives . Price has a wealth of insight into the students’ life Michigan Medicine’s Department experience providing leadership challenges, fears and goals .
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UNDERGRADUATE MEDICAL EDUCATION
Cyril Grum, MD | Vice Chair for Undergraduate Medical Education The Department of Internal Medicine has a long history of providing leadership and innovation within the U-M Medical School. Our faculty oversee 25 percent of the school’s four-year curriculum, and during 2019 we continued to expand and refine our role in providing education, mentorship and clinical experiences to medical students to cultivate the future of patient care.
MATCH DAY 2019 GRADUATION for future medical students, setting . They are also building education and is the AAMC’s video series and submissions their skills as critical thinkers most prestigious honor . An impressive 97 percent of We had 164 future health care for journal publications and and collaborative future leaders the Medical School’s 2019 leaders and physicians in the conferences . working with other students SENIOR AWARD graduating class matched to one Medical School class of 2019 . enrolled in U-M’s various health of the residency programs they Overall, 66 percent of this The Senior Award is given by 2019 WHITE COAT CEREMONY professional schools . put on their lists, far exceeding graduating class completed the graduating class to a clinical the national average . That a Path of Excellence to gain In July 2019, 177 aspiring faculty member below the rank of 2019 FLEXNER AWARD success rate comes despite specialized experience and physicians were given a white associate professor who, in the intense and growing national training in subject areas like coat, a stethoscope and a Internal medicine faculty opinion of the graduating class, competition for a limited number medical humanities, health reflex hammer to officially mark member and Senior Associate has best upheld the ideals of of training spots . Twenty-eight policy, scientific discovery and the beginning of their lives Dean for Education and Global medical education . The graduating students matched into an internal patient safety . as medical students . Sarah Initiatives Joseph Kolars, class of 2019 recognized Dan medicine program and an Hartley, MD, who is a prominent MD, was the recipient of the Cronin, MD, with this award . Seventy-five students completed additional nine students matched educator in the medical prestigious 2019 Abraham Capstone for IMPACT projects, into a Med/Peds residency education program and an Flexner Award for Distinguished RICHARD D. JUDGE AWARD FOR designed to provide students program . Many of the students associate director for the internal Service to Medical Education EXCELLENCE IN MEDICAL with innovative opportunities chose these programs due to the medicine residency program, was from the Association of STUDENT TEACHING to take on society’s biggest role models they encountered the keynote speaker . American Medical Colleges . challenges in health, health This award is the department’s throughout their studies . The The Flexner Award honors care and health system delivery These incoming first-year highest award given for medical students often express gratitude individuals whose contributions while in medical school . students were immediately student teaching . It is based on for the strong and nurturing have had a demonstrable These important projects immersed in the mature student evaluations . Our 2019 support they receive from the impact on advancing medical included health-related new curriculum, working to recipient was Dale Bixby, internal medicine faculty and education . It recognizes the podcasts, student-led national understand the science of human MD, PhD . The students were house officers . highest standards in medical conferences, new electives health and illness in the clinical lavish in their praise of him
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as a teacher and mentor . They MD, with the Kaiser Permanente SUPPORTING OUR FUTURE noted his ability to clearly break Award for Excellence in Clinical 2019 STUDENT AWARDS As we reflect on the “roots down complex concepts in an Teaching . Dr . Lukela is one of of success” throughout this Henry Fitzbutler Award organized and structured way our legendary teachers and also year’s report, you can see the for Excellence in and communicate them clearly serves as the director of our many ways that philanthropy Hospital Medicine to learners at all levels . Medicine-Pediatrics Residency has contributed to new ideas Owen A . Thompson Program . and different approaches William Dodd Robinson SPECIAL RECOGNITION FOR to educating the doctors Award CONTRIBUTIONS TO THE LIFETIME ACHIEVEMENT of tomorrow through the Jennifer Sun MEDICAL STUDENT TEACHING AWARD IN MEDICAL groundbreaking work of our PROGRAM EDUCATION. faculty, including James Eli G. Rochelson Students recognized our 2019 At the 2019 Dean’s Award Woolliscroft, MD (page 75); Memorial Award awardee, Alli Ruff, MD, for Ceremony, Ronald J. Koenig, Joseph Kolars, MD (page Genevieve Allen teaching medical students in MD, PhD, received the Lifetime 80); and Rajesh Mangrulkar, Department of Internal the outpatient clinics . They Achievement Award in Medical MD (page 77) . It also allows Medicine Senior appreciated her ability to serve Education . For 25 years, our department to provide Scholarships as a great role model providing Koenig has provided incredible supplemental programming like Genevieve Allen an absolute and positive leadership and service as the Medical Arts Program (page Jacob Cedarbaum experience in the ambulatory director of our Medical Scientist 43), as well as scholarships, Nicole Cremer clinics . Training Program . Hundreds lectures and global experiences Vinay Guduguntla of physician-scientists have that enable our students to grow Hillary Iskin KAISER PERMANENTE AWARD thrived under Koenig’s individual and flourish . Daniel Kim FOR TEACHING EXCELLENCE approach to their development, Lauren Merz resulting in the phenomenal The Kaiser Award is the most Daniel Nelson academic success of the prestigious teaching award Jennifer Sun program’s graduates . given by the Medical School . Brian Weiland The 2019 Dean’s Awards recognized Michael Lukela,
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GRADUATE MEDICAL EDUCATION
John Del Valle, MD | Vice Chair for Graduate Medical Education The Internal Medicine Residency Program welcomed its incoming intern class of 68 individuals in June, including six graduates of the U-M Medical School along with individuals from other top-tier medical schools. Of this group, 41 percent were newly elected members of the Alpha Omega Alpha Honor Medical Society, and three individuals started our Physician Scientist Training Program track. This select group came honors and acknowledges predictable time off to promote from a pool of more than physicians who have offered resident wellness . We have 2,500 applications, of which their time, wisdom and support also enhanced our existing approximately 609 medicine throughout the professional wellness program by creating and medicine-pediatric careers of fellow physicians, a social event committee candidates were interviewed residents and students . This with departmental funding . by our faculty and program description definitely describes On our inpatient services we leadership from October 2019 Lukela — especially her have adjusted the number of through January 2020 . extensive efforts to build admissions per team in an community and provide effort to account for the high INSPIRATION AWARD opportunities and programming level of patient complexity . for women trainees in the The program also continues Congratulations to Associate Department of Internal to grow our primary track, to Program Director Jennifer Medicine . develop enhanced opportunities Lukela, MD, for being selected for research and to expand Doximity Ranks the as an American Medical PROGRAM UPDATES our commitment to community Internal Medicine Association Women Physicians service by partnering with clinics Residency Program Section Inspiration Award This year the program adjusted in Washtenaw County that No. 10 Nationally. honoree in 2019 . the resident annual schedule provide care for underserved from 12 months to 13 four- The AMA Women Physicians communities . week blocks to provide more Section Inspiration Award protected weekends and create
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RESIDENCY PROGRAM LEADERSHIP Kristin Collier, MD 2019 RESIDENT AWARDS Associate Program Director Bruce A . Jones Award for John Del Valle, MD Outstanding House Staff Spirit Director, Internal Medicine Residency James Brehany, IV, MD Program Dr . Jacob P . Deerhake Kevin Flaherty, MD, MS, FCCP Community Service Award Associate Program Director Emily Jacobson, MD Sarah Hartley, MD Galens Medical Society Bronze Associate Program Director Beepers Award Julie Barrett, MD, MPH Nathan Houchens, MD Paul Christine, MD, PhD Assistant Program Director Kenneth R . Stark Internal Jennifer Lukela, MD Medicine House Officer Associate Program Director Research Michael Lukela, MD Nicole Hadeed, MD Director, Med-Peds Residency Program H. Catherine Miller, MD (Oral) Rachel Perlman, MD Internal Medicine Award for the Associate Program Director Most Outstanding House Officer Julie Barrett, MD, MPH Thomas Sisson, MD Jacob Mack, MD Associate Program Director Director, Physician Scientist Training Laurie Edmunds Award for the Program Most Outstanding House Officer I Scott Ketcham, MD Adam Tremblay, MD Sarah Uttal, MD Assistant Program Director 2019–2020 CHIEF MEDICAL RESIDENTS Molly Tokaz, MD; Marcus Geer, MD; Alexandria Miller, MD and Raymond Yeow, MD
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QUALITY & INNOVATION AND EXTERNAL RELATIONS
Scott Flanders, MD | Vice Chair for External Relations & Quality EARLY-CAREER ENDOWMENTS HONOR QI The year 2019 was marked by change, with an exciting reorganization of the department’s Quality & Innovation (Q&I) LEADERS leadership structure, as well as a new role for me as chief clinical strategy officer for the University of Michigan Health Two of the three recipients of the department’s System (UMHS). I will share the department’s progress on the quality and external relations fronts while discussing the new 2019 Early-Career Endowment Awards are structure and roles that will impact each area. leaders in Michigan Medicine’s patient safety/ quality improvement (PS/QI) work (page 62) . QUALITY & INNOVATION resident education, scholarship which was implemented by topic, as well as a MiChart BPA and dashboards . They also the health system’s cirrhosis advising providers to include Elliot Tapper, MD (GI), received the Margaret Our Q&I program owes a debt of developed new activities that readmissions committee, has Bactrim prophylaxis when R . Gyetko, MD, Department of Internal Medicine gratitude to James Froehlich, further raised the profile of already resulted in more HE prescribing more than four Early-Career Endowment Award . He leads the MD, MPH, our assistant chair, the department’s PS/QI work, patients being discharged on weeks of steroids . Members of health system committee charged with reducing who served as interim vice engaging additional providers the optimal medication regimen . the resident team worked with cirrhosis readmissions and supported the resident chair for Q&I after I took on and patient perspectives . The resident team included the antimicrobial stewardship team invited to present their project on hepatic my new health systemwide James Brehany, MD, Paul committee to implement encephalopathy at Grand Rounds . role in February . He has been The first of these was selecting Christine, MD, Blake Haller, their recommendations . The instrumental in developing two second-year resident teams Geoff Barnes, MD, MSc (CVM), received MD, Elizabeth Lin, MD and resident team included Amy our Q&I program and has to present their month long PS/ the James O . Woolliscroft, MD, Department Johnny Ting-Zheng, MD, with Wang, MD, Jay Krishnan, led several quality initiatives QI projects during Grand Rounds of Internal Medicine Early-Career Endowment faculty advisor Kate Levy, MD, MD, Taylor Broome, MD and within cardiovascular medicine in October . Award . He was part of the PS/QI team that in from the Division of Hospital Chris Hoeger, MD, with faculty addressing atrial fibrillation, 2018 incorporated a new chest pain algorithm, The first team focused on Medicine . advisor Sandro Cinti, MD, chest pain and anticoagulation high-sensitivity troponin T test and MiChart reducing readmissions for from the Division of Infectious care at Michigan Medicine and The second team examined HEART Pathway to better risk stratify and assess hepatic encephalopathy (HE) . Diseases . statewide . ways to better prevent the needs of patients presenting to the emergency Through patient and provider pneumocystis pneumonia among Having resident groups with department (ED) with chest pain . Analysis of a Froehlich and our quality team, interviews, the residents patients on long-term, high-dose projects impactful enough to year’s worth of data showed that the new test and including Tammy Ellies, Linda identified key drivers of HE steroid therapy . Using chart be presented at Grand Rounds guidance increased the percentage of patients Bashaw, Katie Grzyb and readmission and suggested reviews and provider surveys, represents the culmination of discharged by 13 percent, led to a 2 8-hour. Elizabeth Spranger continued interventions including the residents identified a need our work over the last three reduction in ED length of stay for these patients to support the program’s patient patient education materials for the development of Michigan years to implement a new PS/ and freed up 25 hours of ED bed space per day . safety/quality improvement (PS/ and a best practice alert Medicine guidelines on this QI curriculum and to infuse QI) portfolio, including projects, (BPA) in MiChart . The BPA,
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our culture with a mindset of improve a U-M Medical Group Based on his work, in 2019 perspective into our work . For continuous quality improvement . (UMMG) focus measure for hospital funding was approved example, the residents on the 2019 — geriatric pneumococcal for a Beta-Lactam Allergy hepatic encephalopathy project After reimagining the PS/QI vaccinations . Evaluation Service, which will conducted in-depth interviews curriculum for first- and second- expand this work to also include with patients and their year residents, in 2019 we We’ve reported extensively cephalosporins . His team plans caregivers before developing piloted a new format for internal on our portfolio of faculty to implement this service materials to clarify the medicine residents in their PS/QI projects in previous hospitalwide in 2020 . steps patients should take continuity clinics . Developed by reports, including the work of in response to specific Amanda Cox, MD, from the our inaugural Faculty Quality We are seeing increased clusters of symptoms . A Division of General Medicine Improvement Award recipient, adoption of our efforts to faculty-led project convened with support from the quality Rajan Ravikumar, MD, from encourage patient participation focus groups to learn team, the curriculum addressed the Division of Allergy and in PS/QI projects and the use how patients on biologics quality improvement in the Clinical Immunology . His award of dashboards for continuous and immunosuppressives ambulatory setting with a supported the evaluation of an quality improvement . We’ve had could best be supported in focus on panel management . It inpatient penicillin skin-testing patient advisors on our Quality complying with the lab- featured an instructional video protocol designed to identify Council since its inception, and testing regimen required that aimed to provide consistent patients who were labeled as we routinely work with the to ensure their safety . content across six ambulatory but not truly allergic to penicillin Office of Patient Experience The team explored sites, engaging residents in so that more could be safely to explore high-value ways patients’ implementing interventions to treated with first-line antibiotics . to incorporate the patient
THIRD FACULTY QUALITY IMPROVEMENT AWARD WINNER Assistant Professor Jordan Schaefer, MD, from the Division of Hematology and Oncology, wants to ensure that patients’ use of daily, low-dose aspirin therapy matches today’s more conservative guidelines . His QI project aims to better capture patient aspirin use in MiChart and to evaluate a BPA encouraging primary care providers to discontinue aspirin in patients for whom the risk of bleeding outweighs the potential benefit in preventing heart attack or stroke .
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understanding of their disease patients with COPD . In addition vice chair spanning both — is CLINICAL EXPERIENCE & QUALITY TEAM and the need for medication to helping improve care, our the ideal next phase in Q&I’s monitoring and identified divisional dashboards provide evolution . The Department of Internal Medicine’s new Clinical Experience & Quality team knowledge gaps, and probed infrastructure that is easy This structure, and the team was announced in December 2019 and officially began their new roles in January their communication and support to expand with new patient members who fill it, are 2020 . The structure of this unit has been enhanced to ensure that the department’s preferences . populations, conditions and perfectly positioned to take complex clinical operations and all modalities are fully supported, from ambulatory measures . care operations to procedural and inpatient services . This team is partnering with In terms of dashboards, we our progress to the next level . now have a foundation that My Q&I successor, Roma all divisions and units to support the clinical operations of the department . CLINICAL EXPERIENCE & providers can use to readily Gianchandani, MBBS, has QUALITY Kevin Chan, MD Tim Laing, MD monitor target metrics and a deep passion for quality (PCCM) (Rheum) populations, easily spotting I am delighted that the improvement . In 2004, she Vice Chair for Billing & Compliance trends and generating lists of department’s new Clinical established U-M’s innovative Clinical Experience Officer patients who have gaps in care Experience & Quality Team Hospital Intensive Insulin & Quality to devise interventions . Eight (see box) will be able to build Program, which significantly divisions selected quality focus on this momentum . When I improved glycemic control in measures for 2019, and all made took on Quality & Innovation our hospitalized patients . She Roma Kendra Brown significant progress in achieving within the department five years brings expertise not only in Gianchandani, Director of Clinical them, with many clinics ago, the role was brand new . implementing and evaluating Affairs MBBS (MEND) reaching their 90th-percentile We were able to develop a PS/QI programs, but in scaling Associate Vice goals . Measures included program — creating initiatives them — which will be the next Chair for Quality & Innovation pneumococcal vaccination, and structures to engage our opportunity for many of our QI monitoring for diabetic faculty and trainees in PS/QI projects . nephropathy, prescribing so that it is now integral to our Vikas Parekh, statins for patients with culture and practice . This is why MD (Hospital Med) Associate Vice diabetes and vascular disease, the new structure — where Chair for Inpatient screening for geriatric fall risk, quality is viewed less as a & Hospital colorectal cancer screening for discrete portfolio and more as Operations patients with HIV and tobacco an intrinsic part of the broader cessation counseling for clinical experience under a
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EXTERNAL RELATIONS Center in Lansing . The second including Lacks Cancer Center will include clinician recruitment is with Munson Healthcare, at Mercy Health Saint Mary’s, and development as well as New Affiliations northern Michigan’s largest health Johnson Family Cancer Center strategizing how to best connect In addition to my external relations care system . It will lead with at Mercy Health Muskegon the institutions’ cancer programs Michigan Medicine’s role within the department, I now a neurosciences collaboration and Metro Health . Services will and extend U-M’s cancer-based serve as the chief clinical strategy that aims to enhance delivery of be supported by clinicians at clinical research to our west strategic vision is to be officer for UMHS . In this role, complex care for stroke patients . each of these facilities who will Michigan partners . I work with the chief strategy have a direct tie to advanced a source of high-quality, While these new affiliations do Metro & MidMichigan officer to represent the medical clinical trials, emerging protocols not yet involve internal medicine, Updates high-value care for 4 group and health system as we and internationally renowned it’s important to note that many implement our statewide clinical researchers in our Division of At Metro Health-University million people across of our partnerships begin with network strategy . Hematology and Oncology and of Michigan Health, we’ve specific service lines that allow the state by 2025. This Rogel Cancer Center . The aim is reported previously on the I’ve been working this year us to demonstrate our value and for patients to increasingly be able work of Michelle Anderson, includes providing to leverage my departmental explore how we can best work to access such expertise through MD, MSc, and four of her experience to develop new together, creating additional comprehensive care to their local physicians at Mercy colleagues in the Division clinical affiliations and to opportunities to collaborate as the and Metro Health . of Gastroenterology and 400,000 patients locally deepen relationships with relationship evolves . Hepatology to bring care existing partners, building key The search for an executive as well as remote or The third new relationship is a for advanced liver disease, clinical programs and supporting director of the Cancer Network joint venture between Mercy inflammatory bowel disease referral care for another continuous quality improvement of West Michigan is being Health and Metro Health- (IBD) and advanced endoscopic across the network . chaired by UMMG’s Associate 3.5 million through University of Michigan Health . procedures to patients at Metro Chief Clinical Officer for Cancer, At the health-system level, we’ve Called the Cancer Network of Health . While the U-M team collaborations with David Smith, MD, professor developed three new inter- West Michigan, it aims to foster initially commuted one day a in the Division of Hematology strategic affiliates institutional relationships . The first collaboration on advanced cancer week to provide these services and Oncology . The role will is a master affiliation agreement treatment for families in west directly, Metro has begun hiring across Michigan. involve building multidisciplinary with the Sparrow Health System . Michigan . clinicians to take over and cancer programs for lung, breast, One of the affiliation’s initial further develop these programs . Services will be offered across gastrointestinal, gynecologic and endeavors is a pediatrics joint three facilities in west Michigan, dermatologic malignancies . It venture with Sparrow Children’s
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In 2019, it hired U-M-trained gastrointestinal malignancies to schedule patients on one to discuss current and potential We also hope to extend this PS/ gastroenterologist Michelle be addressed within the Cancer day a month and commute to PS/QI collaborations . Our QI work within our partnership Muza-Moons, MD, PhD, to Network of West Michigan . Midland, Colvin can open up initial partnerships in critical with Metro Health . build Metro’s IBD program . more regularly occurring virtual care and electrophysiology Our work with MidMichigan We have been pleased with our The maturation of appointments that offer patients have developed target metrics, Health continues to mature, as progress in forging important Metro’s GI program more flexible scheduling . This dashboards and quality well, in areas from telehealth to clinical partnerships across the was foundational model is becoming increasingly improvement processes . Our quality improvement . Monica state . I am deeply gratified to in allowing feasible thanks to the health focus for the year ahead will Colvin, MD, MS, professor be able to share what is best system’s implementation of be hospital medicine, where and director of Heart Failure about Michigan Medicine while telehealth services and payers’ we aim to leverage Michigan Network Strategy in the Division learning how we can work greater reimbursement for them . Medicine’s experience with Blue of Cardiovascular Medicine, with our partners to elevate Cross Blue Shield Collaborative aims to use telemedicine to We also continue our joint work each other in ways that are not Quality Initiatives to jumpstart improve MidMichigan patients’ in quality and safety . In 2019 possible alone . I continue to be the development of dashboards access to the Advanced Heart we hosted a retreat with 50 excited about the opportunities and projects . Failure Clinic she created . participants from MidMichigan these relationships create . Rather than having to block- Health and Michigan Medicine
Monica Colvin, MD, MS, is using telemedicine to improve MidMichigan patients’ access to the Advanced Heart Failure Clinic . MidMichigan Medical Center
24 2019 INTERNAL MEDICINE ANNUAL REPORT DIVERSITY, EQUITY & WELL-BEING
DIVERSITY, EQUITY & WELL-BEING During 2019, Eve Kerr, MD, MPH, professor, Division of General Medicine, Eve Kerr, MD, MPH | Vice Chair for Diversity, Equity and Well-Being and the Louis Newburgh Research Professor of Internal Medicine, I am excited to be appointed vice chair of Diversity, Equity and Well-Being for the became the inaugural vice chair of Department of Internal Medicine. It is important that our department, which is the Diversity, Equity and Well-Being for the largest in the Medical School with nearly 900 faculty members and 300 residents and Department of Internal Medicine . fellows, has made a significant investment in addressing these critical issues. This commitment reflects our desire to become a more diverse and inclusive community Kerr brings to this post a passion that provides faculty, learners and staff with the tools, resources and support they for improving equity and wellness, need to reach their potential and really thrive. We want to provide the kind of leadership and mentorship experience, cultural environment in which each person’s voice is heard, and each person is and a deep understanding of healthcare given the chance to make a difference. improvement science and evaluation . She is charged with directing the COLLECTING DATA AND learning . We want to spend time The team is department’s diversity, equity and well- CREATING NEW INITIATIVES finding out what the gaps and currently working being initiatives across all 13 divisions . opportunities are . Of course, on a series of To start, I plan on meeting with we could launch right into new pilot programs In addition to her faculty appointment all of the division chiefs and initiatives, but in some ways that made up of in the department, Kerr is the director administrators to learn about might be premature because we representatives of the Michigan Program on Value their unique challenges . Many need to know what our faculty from each Enhancement (MPrOVE), and senior of the divisions have already and staff are thinking about, and division . There are investigator at the VA Ann Arbor created very innovative programs that’s most important . We have instances when Healthcare System’s Center for Clinical to promote issues of diversity, some ideas about the issues you have to act very Management Research . She is also equity and well-being . Our plan is that need to be tackled, such as quickly and do large a member of the Medical School’s to position representatives from gender equity, which are certainly scale change . But in ADVANCE Committee that helped to each division on a new council so not unique to our department, many cases, if you’re develop the Rudi Ansbacher Advancing we can begin to tackle specific Michigan Medicine or academic going to try something Women in Academic Medicine issues and challenges, and get medicine nationwide, so we will new, it makes sense to Leadership Scholars Program and the feedback about what’s going on focus on equal opportunities try it first in one or two annual Leadership Summit for Women in each area . in Academic Medicine and Healthcare . in advancement for women, divisions, or even in one The focus of our inaugural year recruitment and issues of or two clinics, to see how will be about listening and unconscious bias . it works . We plan to work
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very closely with divisions that have the TRACKING OUTCOMES most challenges in a particular area, or BUILDING A LEADERSHIP TEAM We also plan to evaluate everything we just in places where someone wants to do and track outcomes . We’re going Kerr will collaborate with practices hospital medicine well-being as we collaborate to the University of Michigan, try something new . From there, we can to bring a model and a framework of two associate vice chairs: at the University Hospital with trainees, faculty and she was appointed medical bring our concepts and ideas to more implementation science to the work Michael Lukela, MD, and primary care at the HOPE staff within and outside of director of the cardiac cath divisions . that we do to understand what the associate professor of Clinic for the uninsured in the department to continue lab at the VA Ann Arbor The team will also focus on issues of barriers are to implementation . If we’re internal medicine and Ypsilanti, Michigan . He is also cultivating an environment in Healthcare System . clinician well-being and burnout, and not measuring what we’re doing, pediatrics, and director of the director for the William which everyone is thriving,” “I am honored to be a part of how best to address these areas . Data we can’t possibly know if it works . the combined Medicine- Henry Fitzbutler House in the he says . this talented team dedicated suggests that more than 20 percent of This taps into my background as a Pediatrics Residency Program; medical student M-Home Sarah Gualano, MD to improving the work lives our clinicians experience some aspect researcher, and we can elevate the and Sarah Gualano, Learning Community . Lukela of the members of the of burnout . And that’s huge . There are work by rigorously reviewing it . The MD, associate professor brings a deep understanding Dr . Gualano trained at the department,” says Gualano . many reasons for this and we are not team will be working with a range of of internal medicine, and of undergraduate and University of Michigan, “We are eager to leverage our unique . As part of our focus groups existing data . For example, we’ll be interventional cardiologist at graduate medical education then joined the faculty at combined backgrounds and we want to understand what drives looking at the results of our faculty the VA Ann Arbor Healthcare coupled with his passion the University of Texas strengths in order to promote physician burnout; especially which of satisfaction and engagement surveys, System and Michigan to improve diversity, equity, Southwestern Medical a diverse and inclusive these things are potentially under our and current information around the Medicine in leading the inclusion and well-being for Center and served as the community that provides each control . This is a critical problem for all demographics of our department to diversity, equity and well- faculty, staff and learners . director of the cardiac cath person with the opportunities of Michigan Medicine; and not just the see which tracks being efforts . lab at Clements University “I’m delighted to have the and support they Department of Internal Medicine . If we faculty are Hospital in Dallas . She Michael Lukela, MD opportunity to learn from and need to don’t have healthy clinicians, we can’t on, and what graduated from the executive to work with Drs . Kerr and thrive ”. deliver the kind of patient care that disparities and Lukela serves as chair MBA program at Southern Gualano . I believe that the Michigan Medicine needs to deliver . issues they of the Wellness Methodist University creation of this office will There are great programs that are are faced with . Committee for the with a special interest in enable the Department of already championed by the Michigan This will help us department’s Clinical organizational behavior . At Internal Medicine to become Medicine Wellness Office . We will understand the Excellence Society, UTSW, she served on the a leader in addressing have a team approach to moving this issues in a much of which he’s Dean’s Wellness Committee . important issues related to needle and, for that, we need many deeper way . a member . He After her recruitment back diversity, equity, inclusion and perspectives .
26 2019 INTERNAL MEDICINE ANNUAL REPORT AWARDS
2019 INTERNAL MEDICINE AWARDS 2019 DEAN’S AWARDS
THE PAUL DE KRUIF LIFETIME H . MARVIN POLLARD AWARD FOR Nine faculty were honored with 2019 Dean’s Awards . The program recognizes Medical ACHIEVEMENT AWARD OUTSTANDING TEACHING OF RESIDENTS School faculty and staff who demonstrate exceptional accomplishment in the areas of Laurence McMahon, Jr, MD, MPH Ivan Co, MD teaching, research, clinical care, community service, innovation and administration .
CHAIRS’ AWARD FOR OUTSTANDING SPECIAL RECOGNITION FOR BASIC SCIENCE RESEARCH AWARD SERVICE TO THE DEPARTMENT OF CONTRIBUTIONS TO THE HOUSE OFFICER Kathleen R . Cho, MD INTERNAL MEDICINE TEACHING PROGRAM Kathleen L . Collins, MD, PhD Raymond Yung, MB, ChB Namita Sachdev, MD CLINICAL AND HEALTH SERVICES RESEARCH AWARD DEPARTMENT OF INTERNAL MEDICINE SPECIAL RECOGNITION FOR MeiLan K . Han, MD, MS IMPACT AWARD CONTRIBUTIONS TO THE MEDICAL Rodica Pop-Busui, MD, PhD STUDENT TEACHING PROGRAM DISTINGUISHED FACULTY LECTURESHIP AWARD IN BIOMEDICAL Allison Ruff, MD RESEARCH JEROME A . CONN AWARD FOR John V . Moran, PhD EXCELLENCE IN RESEARCH RICHARD D . JUDGE AWARD - MEDICAL Jason Knight, MD, PhD STUDENT TEACHING INNOVATION AND COMMERCIALIZATION AWARD Dale Bixby, MD, PhD William D . Chey, MD JOHN G . FROHNA OUTSTANDING TEACHING IN MEDICINE-PEDIATRICS STEVEN E . GRADWOHL EXCELLENCE KAISER PERMANENTE AWARDS FOR EXCELLENCE IN TEACHING AWARD IN CONTINUITY GENERAL INTERNAL Michael P . Lukela, MD Thuy LeDesai, MD MEDICINE TEACHING AWARD LIFETIME ACHIEVEMENT AWARD IN MEDICAL EDUCATION Linda Terrell, MD Ronald J . Koenig, MD, PhD
OUTSTANDING CLINICIAN AWARD John C . Magee, MD Elisa A . Ostafin, MD
2019 INTERNAL MEDICINE ANNUAL REPORT 2019 INTERNAL MEDICINE ANNUAL REPORT 27 28 2019 INTERNAL MEDICINE ANNUAL REPORT PROFESSORSHIPS Professorships have been ensuring the Department of Internal Medicine’s continued excellence and stature for more than 50 years while honoring the donors, faculty members, family members, friends, teachers and mentors for which they are named.
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PROFESSORSHIPS
THE ROOTS OF OUR SUCCESS The highest honor that a department can bestow TYPES OF PROFESSORSHIPS INCLUDE: upon a faculty member is a named professorship . Within the Department of Internal Medicine, the COLLEGIATE PROFESSORSHIPS tradition of this honor began almost 50 years $500,000 level ago with a gift from a Michigan alumnus, John Gideon Searle, in 1968 . Since then, more than 100 EARLY CAREER PROFESSORSHIPS professorships have been established . $1,000,000 level Professorships are made possible by the generosity of our donors and bring many practical benefits to RESEARCH PROFESSORSHIPS our faculty . These include advancing innovation and research, providing time to pursue novel or early $1,000,000 level areas of inquiry and more opportunities to develop younger colleagues and students . Examples of the FULLY ENDOWED PROFESSORSHIPS dramatic impact this support is having on the future $2,500,000 level of medicine are featured throughout this report .
Department of Internal Medicine Professorships 1968–2019
30 2019 INTERNAL MEDICINE ANNUAL REPORT PROFESSORSHIPS PROFESSORSHIPS
DEPARTMENT OF INTERNAL MEDICINE PROFESSORSHIPS This listing features current faculty members by division.
Department of Internal Cardiovascular Medicine Yuqing Eugene Chen, MD, Daniel A. Lawrence, PhD David J. Pinsky, MD Anna Suk-Fong Lok, MD, Medicine PhD Frederick G. L. Huetwell J. Griswold Ruth, MD and FRCP Keith D. Aaronson, MD Frederick G.L. Huetwell Collegiate Professorship of Basic Margery Hopkins Ruth Dame Sheila Sherlock John M. Carethers, MD Bertram Pitt, MD, Collegiate Professorship in Cardiovascular Research in Cardiovascular Professorship in Internal Distinguished University John G. Searle Professorship in Professorship in Cardiovascular Medicine Medicine Medicine Professorship of Hepatology Internal Medicine Medicine Stanley J. Chetcuti, MD Vallerie V. McLaughlin, MD Gastroenterology and Alice Lohrman Andrews Allergy and Clinical William F. Armstrong III, MD Eric J. Topol Collegiate Kim A. Eagle, MD, Endowed Hepatology Research Professorship of Immunology Franklin Davis Johnston Professorship in Cardiovascular Professorship in Cardiovascular Hepatology Collegiate Professorship in William D. Chey, MD James R. Baker, Jr., MD Medicine Medicine Cardiovascular Medicine Timothy T. Nostrant, MD, Chung Owyang, MD Ruth Dow Doan Professorship in Kim A. Eagle, MD Fred Morady, MD Collegiate Professorship in H. Marvin Pollard Professorship Biologic Nanotechnology David S. Bach, MD Albion Walter Hewlett McKay Professorship in Gastroenterology in Internal Medicine Park W. Willis III Collegiate Professorship in Internal Cardiovascular Disease Professorship in Cardiovascular Joseph C. Kolars, MD Thomas D. Wang, MD, PhD Medicine Medicine Venkatesh Murthy, MD Josiah Macy, Jr. Professorship H. Marvin Pollard Collegiate Daniel R. Goldstein, MD Melvyn Rubenfire, MD, in Health Professions Education Professorship in Endoscopy Robert D. Brook, MD Eliza Maria Mosher Collegiate Professorship in Preventive Research Stevo Julius Research Professorship in Internal Cardiology Professorship in Cardiovascular Medicine Medicine Hakan Oral, MD Kenneth A. Jamerson, MD Frederick G.L. Huetwell Faculty Frederick G.L. Huetwell Research Professorship in Collegiate Professorship in Cardiovascular Medicine Cardiovascular Medicine
1968
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DEPARTMENT OF INTERNAL MEDICINE PROFESSORSHIPS
General Medicine James O. Woolliscroft, MD Geriatric and Palliative Dean E. Brenner, MD Moshe Talpaz, MD Infectious Diseases Lyle C. Roll Professorship in Medicine Moshe Talpaz, MD, Alexander J. Trotman John Z. Ayanian, MD, MPP Kathleen L. Collins, MD, PhD Medicine Professorship in Translational Professorship in Leukemia Alice Hamilton Distinguished Neil Alexander, MD, MS Department of Internal Medicine Oncology Research University Professorship of Genetic Medicine Ivan Duff, MD, Collegiate Collegiate Professorship in HIV Medicine and Healthcare Policy Professorship in Geriatric and Ronald J. Buckanovich, MD, Muneesh Tewari, MD, PhD Research Eric R. Fearon, MD, PhD Palliative Medicine PhD Ray and Ruth Anderson- Alice Hamilton Collegiate Emanuel N. Maisel Vincent B. Young, MD, PhD Thomas H. Simpson Collegiate Laurence M. Sprague Memorial Professorship of Medicine Professorship in Oncology Julie Bynum, M, MPH William Henry Fitzbutler Professorship, Medical School Research Professorship Margaret Terpenning, MD, Collegiate Professorship in Joel D. Howell, MD, PhD David Ginsburg, MD Collegiate Professorship in Shirish M. Gadgeel, MBBS Shaomeng Wang, PhD Internal Medicine Elizabeth Farrand Collegiate Warner Lambert/Parke-Davis Geriatric and Palliative Medicine Marylou Kennedy Research Warner-Lambert/Parke-Davis Professorship in Medical History Professorship in Medicine Metabolism, Endocrinology Professorship in Thoracic Professorship in Medicine Lona Mody, MD, MSc & Diabetes Eve A. Kerr, MD, MPH Cheng-yu Lee, PhD Oncology Amanda Sanford Hickey Max S. Wicha, MD Louis Newburgh Research Robert H. Bartlett Collegiate Peter Arvan, MD, PhD Collegiate Professorship in Daniel F. Hayes, MD Madeline and Sidney Forbes Professorship in Internal Professorship in the Life William K. and Delores S. Brehm Internal Medicine Stuart B. Padnos Professorship Professorship of Oncology Medicine Sciences Professorship in Type 1 Diabetes in Breast Cancer Raymond L. Yung, MB, ChB Francis Worden, MD Research Sarah L. Krein, PhD, RN Stephen J. Weiss, MD Jeffrey B. Halter, MD, James M. Rae, PhD Nancy Wigginton Oncology Rensis Likert Collegiate E. Giford and Love Barnett Richard Auchus, MD, PhD Professorship in Geriatrics Thomas H. Simpson Collegiate Research Professorship in Research Professorship Upjohn Professorship in Internal James A. Shayman and Andrea Medicine Professorship in Cancer Thyroid Cancer Medicine and Oncology S. Kevrick Professorship in Kenneth M. Langa, MD, PhD Research Cyrus Sturgis Research Hematology and Oncology Hospital Medicine Translational Medicine Pavan R. Reddy, MD Professorship in Internal Laurence H. Baker, DO Sanjay K. Saint, MD, MPH Frances and Victor Ginsberg Medicine Collegiate Professorship George Dock Collegiate Professorship in Hematology/ in Cancer Developmental Professorship in Internal Rajesh S. Mangrulkar, MD Oncology Marguerite S. Roll Professorship Therapeutics Medicine in Medical Education
1990 1994 1995 1997 1999 2000 2001 2002 2003
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Charles F. Burant, MD, PhD William E. Rainey, PhD Pulmonary & Critical Care Rheumatology W. Joseph McCune, MD Pei-Suen (Eliza) Tsou, PhD Dr. Robert C. and Veronica Jerome W. Conn Collegiate Medicine Michael H. and Marcia S. Klein Edward T. and Ellen K. Dryer David A. Fox, MD Atkins Professorship in Professorship Professorship in Rheumatic Early Career Professorship In Gary B. Huffnagle, PhD Frederick G.L. Huetwell and Metabolism Diseases Rheumatology Nephrology Nina and Jerry D. Luptak William D. Robinson, MD, Megan Haymart, MD Research Professorship Professorship in Rheumatology Amr H. Sawalha, MD Matthias Kretzler, MD Nancy Wigginton Endocrinology Marvin and Betty Danto Warner-Lambert/Parke-Davis Theodore Iwashyna, MD Michelle Kahlenberg, MD, Research Professorship of Research Professorship in Professorship in Medicine Alpheus W. Tucker, MD, PhD Thyroid Cancer Connective Tissue Research Collegiate Professorship in Giles G. Bole, MD, and Dorothy Subramaniam Pennathur, MD Gary D. Hammer, MD, PhD Internal Medicine Mulkey, MD, Research Norman Radin Professorship in Millie Schembechler Professorship in Rheumatology Nephrology Vibha N. Lama, MD, MS Professorship in Adrenal Cancer Henry Sewall Research Dinesh Khanna, MD, MSc Panduranga Rao, MD William H. Herman, MD, MPH Professorship in Pulmonary and Frederick G L. . Huetwell Richard D. Swartz, MD, Examples of the Stefan S. Fajans, MD/ Critical Care Medicine Professorship in Rheumatology Collegiate Professorship in GlaxoSmithKline Professorship dramatic impact this Nephrology Bethany B. Moore, PhD in Diabetes Galen B. Toews, MD, Collegiate support is having on Rajiv Saran, MBBS, MD, Martin G. Myers, Jr., MD, Professorship in Pulmonary & DTCD, MRCP, MS the future of PhD Critical Care Medicine Florence E. Bingham Research Marilyn H. Vincent Professorship medicine are Professorship in Nephrology Theodore J. Standiford, MD in Diabetes Research Henry Sewall Professorship in featured throughout James A. Shayman, MD Rodica Pop-Busui, MD, PhD Medicine Agnes C. and Frank D. McKay this report. Larry D Soderquist Professorship Professorship
2005 2006 2007 2008 2009 2011 2012 2013 2014 2015 2016 2017 2019
2019 INTERNAL MEDICINE ANNUAL REPORT 2019 INTERNAL MEDICINE ANNUAL REPORT 33 34 2019 INTERNAL MEDICINE ANNUAL REPORT HONORING OUR PAST Many professorships are named in honor of inspiring historical figures who have led the way for others in internal medicine.
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William Rainey | Jerome W. Conn Collegiate Professor
CONTINUING CONN’S LEGACY
WORKING TO BETTER DIAGNOSE AND TREAT THE ADRENAL DISEASE FIRST DESCRIBED AT U-M It was in the mid-1950s when his study volunteers and his DIGGING DEEPER INTO PA like the luckiest researcher U-M endocrinologist Jerome new patient suggested that in the world to have a “Conn is a historical icon in this W . Conn, MD, treated a young the same secretion — by this professorship field; before his work, I don’t woman who’d reached him time identified as aldosterone named for the think it was on the table that Jerome Conn spent in desperation . She’d been — might be to blame for her person who the adrenal would have these struggling since her late 20s with puzzling symptoms . first described his entire career at masses that weren’t malignant debilitating symptoms — high the disease I Eight months of detailed but produced a steroid in an the University of blood pressure virtually unheard study ”. workups convinced Conn of the uncontrolled manner and of for her age and electrolyte Michigan. He received veracity of his theory, and he caused disease,” says William Rainey’s imbalances that caused spasms proposed surgical exploration Rainey, PhD, professor in the lab centers his medical degree in her hands and periodic of the patient’s adrenals . As Department of Molecular and entirely on paralysis in her legs . For seven from U-M in 1932, Conn looked on, the surgeon Integrative Physiology and the adrenals years she’d gone undiagnosed, discovered a 4-centimeter tumor the Division of Metabolism, and spans joined the faculty and but Conn thought he could help on one of the young woman’s Endocrinology & Diabetes . the bench- — thanks unexpectedly to some directed the Division glands, which Conn immediately An expert in the molecular to-bedside research he’d done during World recognized as the cause of her mechanisms of adrenal function, continuum, of Endocrinology War II to benefit allied troops in illness . and. medical history Rainey was recruited to U-M with his PA the South Pacific . and Metabolism for was made . This would be the in 2012 as the first recipient of work the Conn spent a good deal of first description of primary the Jerome W . Conn Collegiate most clinically 30 years. time and effort during the aldosteronism (PA), also called Professorship, to build on Conn’s focused . On war examining how the body Conn’s disease, in which an legacy by revealing why primary the more basic end, he explores acclimates to tropical heat, adrenal tumor secrets excess aldosteronism occurs and how the mechanisms that control with a special focus on the aldosterone, and which can be to improve its diagnosis and zonation of the adrenals (see conservation of sodium . He fully resolved by removing the treatment . box) as well as those that suspected the process was affected gland . instigate premature adrenarche, “Two-thirds of our lab’s research regulated by a then-unidentified in which an early rise in DHEA focuses directly on Conn’s secretion from the adrenal gland . accompanies the appearance disease,” says Rainey . “I feel A number of parallels between
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of pubic or underarm hair in This is important because, change this through a better it . In fact, part of his goal in children under the age of 8 or 9 . despite being the most common understanding of the disease coming to U-M was to identify disease of the adrenals — and better biomarkers for the disease’s remaining genetic But it is Rainey’s PA work that estimates suggest it causes screening . contributors — work that’s been is the most sweeping . He one in 10 cases of high blood accelerated by U-M’s resident and his extensive network of pressure and one in five cases of GENETIC INSIGHTS FOR expertise and resources . collaborators are elucidating treatment-resistant hypertension TREATMENT & DIAGNOSIS the molecular underpinnings Although there are various — only about 1 to 2 percent of of the disease, with One of Rainey’s most important subtypes of PA, they are patients who have PA are ever implications for improving its contributions to understanding all caused by adrenal cells screened for it . Rainey hopes diagnosis and treatment . PA is his work characterizing the producing aldosterone that working with the U-M team somatic mutations that cause independently — that is, of adrenal researchers will
Capsule THE BASICS OF ADRENAL PHYSIOLOGY Zona Glomerulosa The adrenal glands have distinct zones, each producing specific hormones . The outer Zona Glomerulosa produces aldosterone, which regulates salt and water balance in the body and is the key player in primary aldosteronism . The Zona Fasciculata produces cortisol, which is Zona Fasciculata involved in carbohydrate balance and the body’s response to physical and psychological stress . The Zona Reticularis produces DHEA, a hormone that rises then falls as we age and serves as a precursor to the sex hormones testosterone and estrogen . Zona Reticularis A unique feature of the adrenals is that the cells from the outer zones continually migrate inward, taking on the form and function of each layer in turn . Rainey’s lab studies how this occurs and how disruptions Medulla to this process cause disease .
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without prompting by the This insight has important The tumors characteristic PA for more personalized The team’s shared interests exceptional access to both kidney enzyme renin as part implications for treatment . of unilateral disease harbor treatment . were a major draw . “The healthy adrenals — obtained of the body’s normal, tightly While unilateral disease can additional mutations, with synergy of our expertise with permission via autopsy and controlled feedback loop . This be treated with removal of surprising features . “These THE PROFESSORSHIP’S IMPACT makes our research and grant kidneys donated through the excess aldosterone causes the the affected adrenal, bilateral tumor cells appear to be almost applications so much stronger,” U-M Transplant Center — and Rainey says that his research body to retain too much sodium disease requires medication a hybrid,” says Rainey, “sort he says . And the prestige and archived samples of diseased advances could only have and increases blood pressure . for life . The current standard of a cross between the zona resources of the professorship tissue . The latter became useful happened at Michigan, thanks The two most common types of care, says Rainey, employs glomerulosa and fasciculata . sealed the deal, providing an to him thanks to methods to the institution’s cutting-edge of the disease are primary mineralocorticoid receptor In seeing this, we developed edge in attracting and helping to developed in collaboration research tools, a professorship aldosteronism — the one Conn blockers, which work by blocking a hypothesis about a series of support top students, postdocs with U-M’s prostate cancer that marks his as the lab for described, where a benign the receptor for aldosterone . steroids that would be produced and collaborators in his lab . researchers to conduct whole studying Conn’s disease and an tumor on one gland pumps out But another class of drugs, if these cells were truly hybrids . exome sequencing on tiny adrenal team that is a fitting During his time here, Rainey aldosterone — and bilateral calcium-channel blockers, Working with collaborators in amounts of degraded, paraffin- tribute to Conn’s legacy . has made exceptional progress, hyperaldosteronism, where more shows promise in actually Japan, we started measuring embedded DNA, which has tapping expertise in the adrenal diffuse clusters of cells in both preventing production of the these steroids, and it turns out “When I was recruited to U-M, helped the group identify PA’s group and across the Medical adrenals release it . excess hormone . Rainey is now that patients with tumors did I wasn’t looking for a job,” says remaining mutations . School . Hammer’s mastery partnering with researchers at indeed produce these unusual Rainey . “But I saw the team By sequencing cells from patients of mouse models has helped The other progress Rainey Harvard University on a clinical steroids, whereas patients with Gary Hammer was assembling with tumors, bilateral disease Rainey’s lab employ a designer most prizes is teeing up the trial to test this hypothesis . bilateral disease did not .” — with his expertise in adrenal and normal adrenals, Rainey’s receptor exclusively activated next generation of adrenal development and cancer, Tom team has helped identify the Another insight from this work is Rainey hopes these steroids by designer drugs (DREADD) breakthroughs . “We send our Giordano’s in adrenal pathology cellular origins and key mutations that the mutations that cause PA may be useful as diagnostic to create the first inducible/ trainees all over the world,” he and Rich Auchus’ in the involved in both types of disease . appear to be extremely common biomarkers to identify whether reversible mouse model of says . “But we’ve also got a group biochemistry of steroid synthesis One of the most important, it and accumulate with age, so that patients are suffering from primary aldosteronism . The of young faculty here — people — they’re all internationally appears, is a mutation affecting even those without frank disease unilateral or bilateral disease . lab is using this model in its like Tobias Else, Adina Turcu, known leaders in the field . We cells’ calcium channels . It causes may have subclinical aldosterone zonation work, and other groups Brian Byrd and Juilee Rege And because the prevalence all shared a dream of being the an increase in intracellular excess . The emerging picture plan to use it to study PA- — who are creating their own of various PA mutations tends best adrenal research team in calcium, which in turn prompts is that as these mutated cells induced cardiovascular and renal NIH-funded destination labs and to vary by sex and ethnicity, the world — and developing aldosterone release . cluster and reach a critical mass, injury . Rainey’s genetic work will lead us into the future ”. Rainey believes there may be world-class junior investigators bilateral disease occurs . has taken advantage of U-M’s opportunities to further subtype to someday replace us .”
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HISTORICAL HIGHLIGHTS
GEORGE DOCK COLLEGIATE PROFESSORSHIP IN INTERNAL MEDICINE A physician once described as “a man who knows more about clinical procedures than anyone in the United States,” George Dock, MD, led the Department of Internal Medicine from 1891 to 1908 . As the first full-time professor of medicine in the U S. ,. he structured an inspiring academic environment for teaching and the clinical practice of medicine, which led to the clinical clerkship in 1899 and changed medical education across the country . He was widely known as a master clinician and diagnostician . His desire to structure an inspiring academic environment for teaching and the clinical practice of medicine established the groundwork for the U-M Medical School . The first Dock Professor isSanjay K. Saint, MD, MPH, a professor in the Division of Hospital Medicine . Saint’s research focuses on enhancing patient safety by preventing healthcare-associated complications, with a special focus on catheter-related infection, translating research findings into practice, and medical decision-making . He is the chief of medicine at the VA Ann Arbor Healthcare System and the director of the Ann Arbor VA Medical Center/University of Michigan Patient Safety Enhancement Program .
THE ALICE HAMILTON DISTINGUISHED UNIVERSITY PROFESSORSHIP IN MEDICINE AND HEALTHCARE POLICY Alice Hamilton, MD, a member of the U-M Medical School Class of 1893, was the first U S. . physician to devote herself to research in industrial and occupational health . After graduation from medical school, she traveled to Europe to study bacteriology and pathology before returning to Johns Hopkins for additional post-graduate training . In 1919, Hamilton was hired as an assistant professor in a new Department of Industrial Medicine at Harvard Medical School, making her the first woman appointed to their faculty in any field . She published the first American textbook on industrial hygiene and another on industrial toxicology . The Alice Hamilton Distinguished University Professor in Medicine and Healthcare Policy is John Z. Ayanian, MD, MPP, the inaugural director of the Institute for Healthcare Policy and Innovation — one of the world’s largest groups of health care and health policy researchers . He also serves as a professor of health management and policy in the School of Public Health and professor of public policy in the Gerald R . Ford School of Public Policy . Ayanian’s research is focused on analyzing health care data to assess the impact of policy, payment and practice changes on patients’ health .
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Vincent Young | William Henry Fitzbutler Collegiate Professor in Internal Medicine
AGENTS OF CHANGE
FIRST AFRICAN AMERICAN GRADUATE OF U-M MEDICAL SCHOOL INSPIRES PIONEERING RESEARCH When Vincent Young, MD, PhD, 66) . The drug, eliglustat, was to receive a medical degree in TANGIBLE SUPPORT AND was named the William Henry the first novel chemical entity to Kentucky . She later helped to lead INSPIRING LESSONS Fitzbutler Collegiate Professor in emerge from U-M, beginning as the institution . Its quality was When Young reflects on the Internal Medicine, it was an honor a concept and ending with FDA such that it was cited by Abraham careers of Shayman and along every dimension . First, it approval . It was also the first oral Flexner’s historic 1909 inspection Fitzbutler, he is struck by served as gratifying recognition of alternative to intravenous enzyme tour of medical schools as having a number of themes that the work he’s done to help build replacement therapy for Gaucher one of the best-run hospitals in resonate deeply for him . a cadre of expertise at U-M in disease type 1, and has been used the country . “The first,” he says, “is that studying the microbiome’s role in the treatment of some 1,500 Vincent Young himself represents your background doesn’t in health and disease . Just as adults worldwide . another first: the first to bring to define you ”. Fitzbutler was importantly, Young has drawn The award’s namesake, William U-M the tools of microbial ecology the son of a slave who fled substantial inspiration from both Henry Fitzbutler, MD, was the for medical research . Recruited to with his family to Canada via the physician-scientist whose first African American to graduate the Division of Infectious Diseases the Underground Railroad . work made the professorship from the U-M Medical School, in in 2007, in part for his carefully Yet, with few advantages possible and the pioneering 1872 . He established a practice amassed expertise in areas from beyond hard work and passion, physician for whom it is named . in Louisville, Kentucky, where high-throughput sequencing Fitzbutler was able to shatter he served as the only African- to systems biology, he also expectations, not only becoming A SERIES OF FIRSTS American physician for the city’s co-led U-M’s Host Microbiome a physician but creating the Each man represents a series 18,000 black residents . He went Initiative . And among his enduring infrastructure for others to do so . of exceptional firsts for the U-M on to found Louisville National accomplishments, teaching In many ways, this message Medical School . Funding for the Medical College, the first and fellow investigators how to probe is one that has made Young professorship was made possible only medical school owned and the microbiome — exploring an unparalleled catalyst for through proceeds from a drug operated by African Americans to its structure and function, the microbiome research at U-M . co-created at U-M by James train black students . Fitzbutler’s factors that perturb it and their The PI on five NIH U grants, he Shayman, MD, the Agnes C . wife, Sarah, eventually graduated consequences for human health . has an exceptional record of and Frank D . McKay Professor in from the college, becoming the drawing researchers from varied the Division of Nephrology (page first African American woman
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disciplines into large team-science Shayman is working to bring and resources to mentor others . with IBD are at greater risk of projects . And as the lead for the treatment for rare diseases to He is currently using it to help a C. difficile infection and have Microbiome Explorer Program, underserved parts of the world . postdoc pursue an extension of his worse outcomes after infection,” Young has helped more than 50 In his career, Young has worked signature research . he says . “My postdoc was eager U-M investigators learn how to to change how physicians think to explore this link, and the Young’s work at U-M has focused incorporate about the role of microbes, not professorship funds are allowing extensively on Clostridiodes microbiome- only as causative agents of her to do aspects of the work that “The science is difficile, a major cause of life- oriented disease but also as beneficial are outside of our NIH grant ”. threatening diarrhea sparked so important, but analysis partners in maintaining health . when broad-spectrum antibiotics into their mentorship is my Finally, says Young, his kill the beneficial bacteria that research . He professorship reminds him daily normally keep this pathogen proudest has done this of the importance of mentorship . at bay . He has shown how by welcoming achievement. “Any kind of success in biomedical a decrease in the diversity interested fields — in research, as a of the microbiome increases That’s why this investigators clinician, as an educator — stems susceptibility to C. difficile, from every award means so from the mentorship you get demonstrated the therapeutic discipline, during all stages of your training mechanisms of fecal transplant, much to me.” affirming and career,” he says . “It’s true for and helped develop models that that varied — Vincent Young, MD me, it was true for Jim Shayman use big data and machine learning perspectives and I imagine it was a driving to predict which hospitalized are an asset force in the Fitzbutlers establishing patients are most at risk for and that one’s background is a Fitzbutler’s legacy also a medical college . Interestingly, infection . launching pad, not a limitation . Jim has helped mentor me ever lives on at the U-M With professorship funds, The next theme for Young is that since I came to U-M, explaining he’s now supporting one of Medical School through physicians are well-positioned how Michigan Medicine works his postdocs in developing to serve as change agents in a and how to do research here that the Dr. William Fitzbutler mouse models to examine the variety of ways . Fitzbutler founded can transform patients’ lives ”. link between C. difficile and House M-Home a newspaper that advocated Young is particularly grateful that inflammatory bowel disease (IBD) . for equality and human rights . Learning Community. his professorship affords him time “We see clinically that patients
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Lona Mody | Amanda Sanford Hickey Collegiate Professor of Internal Medicine
ADVANCING WOMEN IN MEDICINE
AMANDA SANFORD HICKEY, MD, CREATED A PATHWAY THAT ENDURES TODAY When Amanda Sanford School and the sole female paved the way for many other academic medicine . Women Hickey, MD, walked up to the member in a class of 90 . After women to be absolutely fearless have made great advancements podium to accept her diploma graduation, she returned to her in their pursuits ”. in medicine, but when you look at commencement on March home in New York to set up a at their trajectories in leadership 29, 1871, she was pelted with practice in Auburn, which was INITIATIVES UNDER THE and career advancement, wads of paper launched by male subsequently expanded and PROFESSORSHIP they are falling students who disapproved of a named the Auburn City Hospital . behind,” says Overall, the professorship has Hickey’s woman graduating from the U-M She went on to become a pioneer Mody . “We have given Mody the flexibility to Medical School . This unfortunate in obstetrics, gynecology, surgery to take a deeper achievements are advance different causes and turn of events lingered in Hickey’s and general medicine . Her dive and a look ideas that may not necessarily also commemorated memory for years to come, and led dedication to the advancement of at why that is be funded through federal grants . her to advocate for women’s rights women’s health and advocacy for happening and today by the “The professorship has given me and health throughout her life . gender equality were profound what we can do to some recognition, and helped designation of the and endure to this day . Mody make it better . I’m Little would she know that nearly me advance some causes that I hopes to carry on her spirit so proud that our Dr. Amanda Sanford 150 years later, Lona Mody, MD, deeply care about,” she says . throughout her work . community comes MSc, associate chief, Division House, one of the together for these of Geriatric & Palliative Care “I am very humbled to receive this GRAND ROUND SERIES: events ”. Medical School’s Medicine, and associate director professorship . I hope to do justice WOMEN IN ACADEMIC of translational research for the to all the women in medicine that MEDICINE One of the group’s M-Home Learning U-M Geriatrics Center, would be came before me,” says Mody . “Dr . first speakers was Mody will use a portion of the Communities. awarded the Amanda Sanford Hickey embodied what women Rita Redberg, funding from the professorship Hickey Collegiate Professorship in in medicine are all about . All of MD, MSc, to host a grand round series on Internal Medicine . her classmates were male . It FACC, professor, University of faculty career development with was certainly a different time, California, San Francisco School The professorship was created a focus on advancing women and she endured no shortage of of Medicine, who gave a grand to honor Hickey as the very first in medicine . “Our vision is to discrimination and challenge, round on disparities between woman to graduate from the invite speakers who champion yet forged ahead despite the men and women in salaries, University of Michigan Medical the advancement of women in limitations she faced . Dr . Hickey career advancement, leadership,
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authorship and grant funding . physicians in dual career and then display their work at the The professorship has allowed Mody and her team will hold situations .” Medical School,” explains Mody . Mody to work in the same similar grand rounds in the methods . “Recently, we conducted Mody has also written on this coming year to focus on women MENTORING JUNIOR FACULTY a community survey of about 650 subject, including a 2019 paper in leadership and overall career patients and asked them what published in JAMA, titled Training the next generation is development issues . kind of values they appreciated “Dual Physician Households — critical to advancing science in their physicians,” she says . The team will also invite Strategies for the 21st Century,” and improving health . “Since my “We were really surprised to see speakers who are which she co-authored with early days as a fellow, I have that we got a response from 85 part of dual career Lauren Ferrante, MD, MHS, from held a deep interest in career percent of our patients . They care “I am very humbled couples . “I am part the Yale School of Medicine . development and mentoring,” about providers who practice in of a dual physician This paper has now been viewed she says . In this regard, she has to receive this this health care system and they household, so I over 46,000 times . helped several junior faculty, have an opinion about how things professorship. I hope understand what a fellows, postdoctoral students should be done so that it is more joy and a challenge MEDICAL ARTS PROGRAM and residents in developing their to do justice to all patient-centric as opposed to this is,” she says . research vision and conducting Another beneficiary of the institution-centric . We are now the women in “There’s a give and clinical, epidemiologic and professorship is The Medical Arts writing up the results ”. take between both laboratory-based research medicine that came Program, which aims to enhance members of a family projects . As a woman in academic the ability of medical students before me.” when they are in medicine, Mody cannot help and house officers to provide high- the same career PATIENT ENGAGEMENT thinking about Hickey from time to — Lona Mody, MD, quality, humanistic clinical care and are physicians, time as she faces the challenges through experiences and analysis Hickey was very interested MSc with issues ranging ahead . “If Dr . Hickey were alive of the musical, theatrical, literary in patient engagement and from where to today, I think she would marvel at and visual arts . “This program is did a considerable amount of train to where to the many ways in which women very near and dear to me, as I am community outreach . “She match, as well as child care have progressed in medicine,” an artist myself . I love to paint lectured and educated patients responsibilities . This is an says Mody . “It gives me chills just in oils and acrylics . So, over the outside of the health care emerging area for us, and we thinking about it . But we still have past two years, we have started setting so that they could have applied for a small grant a long way to go ”. a studio class for our medical understand the implications of to do surveys and interview students and residents to paint medical illnesses,” says Mody .
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Kim Eagle | Albion Walter Hewlett Professor of Internal Medicine
PASSING THE TORCH
THE LEGACY OF ALBION WALTER HEWLETT, MD, LIVES ON WITH THE WORK OF KIM EAGLE, MD Albion Walter Hewlett, improvement initiatives across effects of hypertension and published papers on cardiac MD, the founding father of the state of Michigan in pulmonary edema . He is also arrhythmias and disorders of cardiology, served as the chief acute myocardial infarction, credited with bringing the first cardiac conduction, among of medicine at the U-M Medical heart failure and coronary electrocardiogram machine other related topics . I was School from 1908 to 1916 . angioplasty . to the U-M campus in 1913 . fortunate to be asked to During his tenure, he earned Hewlett left the University of carry this mantle for the last the reputation as one of the ALBION WALTER HEWLETT Michigan in 1916 to continue 20 years . It has been a true finest teachers and researchers his clinical, research and joy and a privilege . I’d like The professorship was on the medical faculty . teaching work at Stanford to believe that the work established by his son William University, where he remained we are doing today would When Kim Eagle, MD, R . Hewlett with the support until passing away from a brain honor Dr . Hewlett and what director of the U-M Frankel of his son, Walter Hewlett, tumor shortly before his 51st he accomplished 100 years Cardiovascular Center, was daughter Eleanor H . Glimon birthday . ago .” awarded the inaugural Albion and Walter’s wife Esther . Walter Hewlett Professor of During his tenure, Albion In 1997, at the inaugural CARDIOVASCULAR PIONEER Internal Medicine in 1997, he Walter Hewlett earned a celebration for the was determined to carry the reputation as one of the finest Eagle credits much of the professorship, Eagle became torch forward . Since joining teachers and researchers work done today at the Frankel acquainted with several the faculty in 1994, Eagle has on the medical faculty . His Cardiovascular Center to the members of the Hewlett overseen a vigorous outcomes advocacy for laboratory tests to early efforts of Hewlett and his family, who had traveled from research program focused on supplement clinical evaluation colleagues . “This professorship Palo Alto, California, to attend . quality, cost-effectiveness, was an important contribution honors one of the great men “We became friends,” he says . use of practice guidelines in to American medicine . in our historical journey as “And not long after, I started cardiovascular care, evaluation Beginning in 1912, Hewlett a medical school: one of the to provide medical care for a and management of acute created an elective course earliest cardiovascular pioneers few of the family members . coronary syndromes and the in circulation that included in education and research at It has been nice to be able to evaluation and management disturbances of cardiac rhythm, U-M,” says Eagle . “Dr . Hewlett give back from a health care of aortic diseases . His team the consequences of valvular was a cardiologist well before perspective .” has led innovative quality lesions and the causes and the specialty existed . He
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Hewlett’s son, William R . immediately lead to national Michigan Cardiovascular Hewlett, made the family level funding, yet may have Outcomes Research and name famous around the world an impact . I think sometimes Reporting Program when the company he co- unique opportunities happen . Twenty-five years ago, Eagle founded, the Hewlett-Packard And having the ability, creativity started a laboratory, called Company, became one of the and support to explore them is the Michigan Cardiovascular most recognizable names in really important . Many things Outcomes Research and “Dr. Hewlett was a the computer and electronics I’ve been able to do would Reporting Program, to study industries . never have been possible cardiologist well before the common cardiovascular without it .” specialty existed. He conditions and procedures FREEDOM TO EXPLORE Further affirming the important among large populations; published papers on cardiac Eagle says that what has been role professorships occupy in develop modern mathematical arrhythmias and disorders of most beneficial throughout the the recruitment and retention of tools to assess risk and years is that the professorship faculty, Eagle confesses that he outcomes; and promote cardiac conduction, among has protected his time, and was being courted by another evidence-based care models other related topics. I was allowed him to take on things institution at the time of the that incorporate best science that are academically useful for inauguration of the Hewlett into care itself by targeting fortunate to be asked to the department, the Medical award . “I must say that this physicians, nurses and patients . carry this mantle for the last School and the university . “This professorship was significant in “Through that laboratory, we award has been instrumental in the decision I made to stay at were able to begin a 12-week 20 years.” the development of a number the University of Michigan,” he summer internship program — Kim Eagle, MD of innovations and initiatives . explains . for undergraduates and some It has also allowed me to graduate students in medicine, continue, in a more traditional DEVELOPING NEW INITIATIVES nursing and public health . investigative sense, with Students participate in clinical The professorship has provided the work that I do in aortic research using a registry Eagle with time to develop diseases,” says Eagle . “It has science that we have around innovative ideas and make a given me the opportunity to a variety of conditions,” says difference . take on projects that might not Eagle . “They also get wonderful
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exposure to medicine through since we initiated it,” he research study on implanting Currently, the Frankel Center is how the professorship allows and fellows . “There’s no joy shadowing of physicians, explains . “I’m really proud of used pacemakers in countries conducting a series of research me unfunded time to invest that’s greater than to see them nurses, surgeons and scientists . this . It’s had a large impact on in the world where patients projects aiming to establish in an idea that could have a grow up in their profession and I think it’s been a real positive students’ health, in terms of can’t afford to purchase one . pacemaker and defibrillator profound influence,” says Eagle . be successful and happy,” he experience . More than 250 what they eat, how much they Project My Heart Your Heart reuse as a feasible, safe and “The notion of pacemaker says . “That’s just one of the students from around the move and the things that really has implanted used devices in ethical means of delivering recycling has been there for wonderful things about being country have gone through it in matter like lowering blood a number of African countries . a long time, but somebody at U-M: the chance to interact the past 10 years .” pressure and cholesterol .” “We started the first pacemaker had to take it on . We believe with really talented young laboratory last year in Sierra that through studying this people and play some role in Project Healthy Schools Project My Heart Your Heart Leone, and the second in carefully, and doing this in the shaping of their careers . Seventeen years ago, Eagle In 2012, Eagle started a Kenya,” he says . And our a very methodologically That’s a reward that’s just founded a program called program called Project team, led by Thomas rigorous way, we can unbelievable for me .” Project Healthy Schools, an My Heart Your Heart . “A Christopher Crawford, make pacemaker educational intervention at few years ago, one of our MD, associate professor, recycling a reality . This middle schools in Michigan electrophysiology fellows Division of Cardiovascular is another example of with the mission of fighting had taken care of a patient Medicine, is visiting what I consider to be childhood obesity and its who needed a pacemaker . Nigeria next month . There is transformational thinking: long-term health risks . The And we put the pacemaker a great disparity between the the ability to imagine program focuses on sixth-grade in . Unfortunately, the patient high- and low-income countries pacemaker recycling from a students, and aims to stem died a few months later,” in terms of pacemaker and global health point of view .” the tide of the epidemic by says Eagle . “The patient’s defibrillator availability . Each teaching youth healthy habits, husband brought the brand- year 1 to 2 million individuals SHAPING CAREERS developing healthy school new pacemaker back to our worldwide die due to a lack this life-saving therapy to Among the many awards and environments and creating an clinic and asked us to ‘give it of access to pacemakers and patients with no resources . accolades that make up a infrastructure that supports to someone in the world who defibrillators . Meanwhile, Throughout this process they distinguished career, Eagle program sustainability and could not afford a pacemaker .’” almost 90 percent of individuals have been engaged with the says that he is most proud of replication . “The program is with pacemakers would donate Food and Drug Administration Over the past eight years, Eagle the opportunity he has had now in 100 middle schools in their device to others in need if in order to obtain approval and his team have developed to help shape the careers of the state, and we’ve reached given the chance ”. and begin a clinical trial . “This protocols and are now doing a medical students, residents more than 70,000 students is just another example of
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HISTORICAL HIGHLIGHTS
LOUIS NEWBURGH RESEARCH PROFESSORSHIP IN INTERNAL MEDICINE The professorship was developed to honor Louis Newburgh, MD’s multiple accomplishments in medicine, among them a dedication to advancing research protocol . The studies that he has skillfully conducted as an active member of the Department of Internal Medicine faculty from 1917 to 1922 made him an authority on the subject of nutrition, obesity and diseases involving metabolism . His many publications in this field brought him widespread recognition . Eve Kerr, MD, serves as the first Newburgh Professor . She has dedicated her research career to understanding how to more effectively translate advancements from clinical and translational research to routine practice in order to improve patients’ health and health care . In particular, she is internationally recognized for developing innovative, clinically meaningful methods to assess and improve quality of care and decrease low value care . Kerr is the inaugural vice chair of diversity, equity and well-being for the Department of Internal Medicine, the director of the Michigan Program on Value Enhancement and a senior investigator at the VA Ann Arbor Center for Clinical Management Research .
ELIZABETH FARRAND COLLEGIATE PROFESSORSHIP IN MEDICAL HISTORY Elizabeth Martha Farrand, MD, was an author, librarian and physician . She wrote the second book-length history of the University of Michigan and the one that was most frequently cited thereafter, “History of The University of Michigan,” in 1885 . She served as assistant librarian at U-M from 1878 until 1884 . In a surprising career change, she left the library after being accepted to the Medical School from which she received an MD degree in 1887 . After a year’s residency training at the Woman’s Hospital in Detroit she spent the rest of her life in private medical practice in Port Huron, Michigan . The Elizabeth Farrand Collegiate Professorship in Medical History is held by Joel D. Howell, MD, PhD, a professor of internal medicine at the Medical School, professor of history in the College of Literature, Science and the Arts and a professor of health management and policy in the School of Public Health at U-M . Howell also serves as director of the Medical Arts Program . His special interest lies in the history of medical technology and the medical humanities .
2019 INTERNAL MEDICINE ANNUAL REPORT 2019 INTERNAL MEDICINE ANNUAL REPORT 47 48 2019 INTERNAL MEDICINE ANNUAL REPORT CREATING A LEGACY Over the past decade the Department of Internal Medicine has started naming professorships honoring the careers and impact of senior and recently retired faculty.
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Raymond Yung | Jeffrey B. Halter, MD, Collegiate Professor of Geriatric Medicine
HONORING U-M’S GERIATRICS HERITAGE
PROFESSORSHIP SUPPORTS DIVISION’S LEGACY OF LEADERSHIP When Raymond Yung, MB, ChB, Halter, MD, Collegiate Professor of Geriatric and Palliative researchers, and featured a strong The first was the NIA Geriatrics was inaugurated as the of Geriatric Medicine in 2017, he Medicine . community orientation . Center Grant, designed to support Jeffrey B. was keenly aware of the honor research and training at U-M’s “Dr . Halter brought the division “The center featured an innovative bestowed upon him . After all, Geriatrics Center . and research program to where social work component that he had trained under Halter as it is today, with an incredible created community programs “There was a national a geriatrics fellow in the mid national and international to engage older adults around competition, and the ’90s, had worked with reputation,” says Yung . “Having health, disease prevention and NIA initially could him for two decades his name attached to mine as a social support,” says Halter . “It only fund one and in 2011 had credential is a mark of excellence helped find people in need and center — and stepped into that is recognized around the bring them into the health system . we were the his shoes as world ”. People from all over the world one,” says chief of the have come to learn how we did Halter . “That Division BUILDING U-M’S GERIATRICS that ”. was a huge INFRASTRUCTURE milestone: we As a Medical School center of emerged as Halter came to U-M in 1984 to excellence, the Geriatrics Center the national lead the new Division of Geriatric complemented existing expertise leader in “In clinical departments, there’s Medicine . Within five years, he’d in the universitywide Institute geriatrics and secured major external funding of Gerontology, which focused really no good funding stream aging research ”. to help launch a multidisciplinary on aging in society and the to support the level of training U-M Geriatrics Center modeled basic science of aging . The two The grant supported on the newly formed Cancer would eventually merge, but at a robust research and mentoring most faculty Center . With initial funding from this point, they set the stage for program on how want to do, so professorships the John A . Hartford Foundation two high-profile awards in 1989 inflammation and and a National Institute on Aging that, for Halter, were the perfect metabolism change provide time and resources to (NIA) Geriatrics Leadership Award, counterparts to U-M’s national with age and affect do that.” U-M’s Geriatrics Center brought basketball championship that health outcomes . These together key specialists and same year . were perfect fits for — Jeffrey B. Halter, MD
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both Halter’s research focus on awarded the region’s first PROFESSORSHIPS: University Hospital to coordinate professorships are vital to places have mountains and metabolism in aging and Yung’s on Veterans Affairs Geriatric MAINTAINING THE LEGACY adult outpatient palliative care our research and education saltwater,” says Yung . “I want the origins and effects of chronic Research, Education and Clinical through the Geriatrics Center and missions,” says Halter . “In clinical professorships for junior faculty to These programs formed the inflammation in age-related Center . As the name implies, community care in affiliation with departments, there’s really no set Michigan apart ”. backbone of the division’s work disease . it has research, education and Arbor Hospice and Elara Caring . good funding stream to support in clinical care, research and Halter says he is proud of what clinical components, and has been the level of training and mentoring The NIA would later rename education . Over time, palliative But one of Yung’s signature efforts Yung has achieved for the a leader in clinical demonstration most faculty want to do, so this grant, referring to funded care became a more prominent has been ensuring that all full- division in the professorship projects and research designed to professorships provide time and centers as Claude D . Pepper Older aspect of the division’s work . tenured professors in his division realm . He is also gratified to improve gait and balance in older resources to do that . In terms American Independence Centers . Thus, when Yung took the reins have named professorships . have a professorship named after Veterans, infection prevention of research, they do more than U-M’s center has maintained in 2011, he became chief of a “Professorships are critical to him . “It’s a wonderful feeling in medical facilities and the simply fund pilot work and provide continuous funding since 1989, renamed Division of Geriatric recruiting and retaining top to see Ray’s signature block in understanding of age-related protected time to write grants — solidifying its national leadership and Palliative Medicine . He later talent,” says Yung . “They provide an email with my name on it,” neurodegenerative diseases . even though that is invaluable . in aging-related health research . succeeded Halter as director of recognition and flexible funding says Halter . “I am thrilled that he Halter served as director of this They also make us more the Geriatrics Center and Institute to undertake work you are holds this professorship . It’s also The second coup for U-M center until 1998 . competitive for grants . When of Gerontology in 2016 . passionate about ”. a huge honor to have my family geriatrics in 1989 was being reviewers see that applicants name connected to such a great According to Halter, Yung has In Yung’s case, his Halter have salary support from an institution . I’ve been on the faculty been a “spectacular leader ”. Collegiate Professorship supports endowment, it’s almost like at U-M for more than 35 years, so The U-M Geriatrics Center now includes 300 He has overseen a number of his local and national mentorship matching funds — it shows that to know that association will live care innovations, such as the effort, funds research activities we can provide an impact that’s physicians and scientists from 14 U-M schools and on is a dream come true ”. development of Acute Care for and allows him to be present greater than could be achieved institutes, including 29 departments in the Medical Elders (ACE) units, featuring at important national meetings with the grant funding alone ”. Yung feels the same . “I think Jeff interdisciplinary team-based so that he can connect with would say that his most important School. It conducts almost $80 million in nationally Yung’s goal going forward is to care, watchfulness for geriatric colleagues and mentor former contribution to geriatric medicine build on these efforts and create sponsored research each year, and is ranked among syndromes, early transition trainees . throughout the decades has been professorships for early-career planning and senior-friendly his ability to bring up the next the top programs for both academic geriatrics and Halter believes the professorships physician-investigators to facilities . He also led the creation generation,” he says . “He did it for Yung has developed will be attract them to the division and hospital care for older adults by U.S News & World of U-M’s Palliative Care Service, me, and with this professorship I foundational to the division’s support them as they become a collaboration among Internal hope to continue that legacy ”. Report. future success . “Endowed independently funded . “Some Medicine, Family Medicine and
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William Chey | Timothy T. Nostrant, MD, Collegiate Professor of Gastroenterology
FUELING GI INNOVATION
PROFESSORSHIP INSPIRES AND FUNDS PATIENT-CENTERED GI INNOVATION It was 1990 when U-M Among the most important things Chey, “which is why being centers treating patients gastroenterology (GI) fellow Chey learned from Nostrant was named the Timothy T . Nostrant, with chronic constipation William Chey, MD, first met the the joy of being a physician . MD, Collegiate Professor of and fecal incontinence . He professor who would serve as his Another was the value of looking Gastroenterology means so much introduced the low-FODMAP clinical mentor for the next three forward, of embracing change . to me . Every time I see my title, diet to Michigan Medicine, years — and a beloved friend “The first flexible fiber optic I think of him and hope I’m living conducting the nation’s first and professional touchstone for endoscope was developed at up to his expectations . So often randomized clinical trial on it the ensuing two decades — U-M, and Tim was one of the when I face a big decision, I find and using it to transform the Timothy Nostrant, MD . What earliest physicians to adopt the myself wondering: ‘What would way gastroenterologists struck Chey most at the time was technology,” says Chey . “He Tim do?’ His example figures into manage patients with Nostrant’s breadth of expertise saw its potential and drove my calculus on a regular basis ”. irritable bowel syndrome and commitment to his patients . the creation of our Medical (IBS) . He created the Procedures Unit . He was pivotal FUNDING INNOVATION Digestive Disorders “Nowadays, you’re either a in helping endoscopy flourish Nutrition & luminal gastroenterologist, a Nostrant retired in 2011 and here ”. Behavioral Health hepatologist or an interventional passed away in 2015, but he Program, one endoscopist,” says Chey . “Tim Most of all, says Chey, Nostrant lived to see his protégé installed of the few was all those things . He was also was a force of nature — in the professorship bearing his programs in known for putting his patients passionate, demanding and name . Like his mentor, Chey is the country to first — always fitting in an generous to a fault . Chey also an accomplished clinician, incorporate extra consult or procedure to put recalls him routinely pulling out educator and researcher, but he nutritional them at ease . His tremendous his checkbook — even once is perhaps even better known as counseling knowledge made him the go-to spontaneously gifting his car — an innovator . and a GI William Chey, MD, with person in the division, and the when he noticed someone was Timothy Nostrant, MD Chey has developed new clinical psychologist relationships he formed with his struggling . programs, like the Michigan to help patients made him one of the “Tim was instrumental in my Bowel Control Program, a patients most popular gastroenterologists development, both personally multidisciplinary model for manage GI in Michigan ”. and professionally,” says other academic medical conditions . He
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generate a detailed medical “The professorship has been of the low-FODMAP diet that is SID results from an enzyme Considered by many “the history for their physician and critical,” he says . “It helped get easier for patients to utilize . missing from the lining of the offer educational materials our nutrition and behavioral small intestine, which can lead In related work, Chey and face of gastroenterology at tailored to their symptoms . He’s medicine programs off the to abdominal pain, gas, bloating members of the division, now leveraging the platform ground . It provides seed money and diarrhea . Chey is working U-M,” Timothy Nostrant including Clinical Lecturer to recruit patients for clinical for our research projects . It to understand the prevalence Kimberly Harer, MD, have completed his residency and trials . He is also developing allows members of my team of SID and whether an enzyme begun investigating a subgroup My Nutrition Health to help to present at key scientific supplement can resolve patients’ GI fellowship in the division, of patients for whom the patients with IBS identify the meetings . But most importantly, symptoms . low-FODMAP diet may be joined the faculty in 1979 and relationship between their diet it allows me to take risks — it’s contraindicated . “There is Chey’s group is also launching and GI symptoms . In partnership literally the fuel that allows me served U-M in a variety of evidence that those with an a precision-medicine trial to with biomedical engineers, Chey to innovate ”. eating disorder called Avoidant/ explore whether breath testing leadership roles for 36 years. has co-invented two disposable, Among the ways he’s used Restrictive Food Intake Disorder, can identify the subset of IBS point-of-care devices — a digital During his career, he trained this support is to help fund if put on an exclusionary diet, patients whose symptoms are manometry and rectal expulsion My GI Health study coordinators for novel can end up over-restricting likely to improve with the non- more than 300 fellows, built device — to help doctors easily research projects — many of their diets to the point of absorbable antibiotic Rifaximin . also helps lead the Food for identify a type of constipation key clinical infrastructure and which are aimed at developing being unhealthy,” says Chey . Life Kitchen, which provides that is best treated with Not surprisingly, there are more personalized treatments “This is a new condition to systems and was an architect cooking classes for patients biofeedback and physical therapy numerous other projects in the for conditions like IBS . One of gastroenterologists . We are rather than laxatives . hopper, each driven by a vision of of the clinician-scholar track. and novel “culinary medicine” these aims to drill down into working to better identify and . improving the lives of those with programming It is for these and other efforts which poorly digested sugars, understand these patients so Nostrant and Chey were both GI conditions . “Tim was always that Chey was recognized by or FODMAPs, are the biggest that we can learn how to best Chey is also a creator of new focused on what was best for his awarded the American technologies; he currently the Medical School with the drivers of IBS symptoms . In the care for them ”. patients, and that’s what drives holds two patents . He has 2019 Dean’s Innovation and short term, Chey hopes this Gastroenterological Another study aims to us, too,” says Chey . “That is why co-developed mobile and Commercialization Award . Much information will identify the understand the proportion receiving a professorship in his Association’s Distinguished web-based apps, including of this work, says Chey, has been best-tolerated sequence for of patients with IBS whose name is so validating to me; it My GI Health, which uses an fueled by the resources available reintroducing foods to the diet . Clinician Awards in 2012 and symptoms are driven by sucrase has truly been one of the most adaptive interview process through his professorship . Longer term, he would like to isomaltase deficiency or SID . meaningful points in my career ”. 2015 respectively. develop a less-restrictive version to probe patients’ symptoms, Similar to lactose intolerance,
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Bethany Moore | Galen B. Toews, MD, Collegiate Professor of Pulmonary and Critical Care Medicine
UNRAVELING THE MECHANISMS OF LUNG DISEASE
PROFESSORSHIP HONORS THE POWER OF CLINICAL-BASIC SCIENCE COLLABORATIONS It was 11:30 p m. . on a fall evening collaborator and division chief, CELEBRATING A MENTOR position out of state . “At U-M at receptor (CCR2) knockout mouse, in 1998 when Bethany Moore, Galen Toews, MD, telling her he the time, PhD faculty in clinical which the pair used to show that For Moore, the memory of that PhD, an immunologist had time to work on a grant they’d departments had to be affiliated these mice were protected from evening speaks volumes about recently recruited to discussed . “I was already in my with a clinician’s lab,” says drug-induced lung fibrosis . Their her dear friend and mentor . U-M’s Division of pajamas, but I got dressed, drove Moore . “So, when my original work revealed how activation First, he was passionate about Pulmonary and to his house and his wife met me mentor left, I found myself in the of this chemokine signaling research and mentoring, always Critical Care in the kitchen with a cup of tea,” strange position of sitting in the pathway recruited myeloid cells managing to find time in his Medicine, says Moore . The timing may have pulmonary division with a grant to the lung, causing them to demanding schedule for both . got a call been unconventional, but the pair studying chemokines in prostate produce factors that injured the Second, he was a champion of from her put together a grant that resulted cancer . Galen said, ‘You can do lung epithelium and signaled collaboration between clinicians new in one of Moore’s most highly anything you want in my lab — fibroblasts to produce excess and basic scientists, believing cited papers ever . but it’s got to relate to the lung ’”. extracellular matrix . deeply that sharing their skills It was also the start of the made everyone’s work stronger . The pair decided to merge Not only did they show that there most meaningful professional “Galen was a trailblazer in this Moore’s exploration of was an immune component to collaboration of Moore’s career regard,” says Moore . “There chemokine signaling with Toews’ pulmonary fibrosis, but that it — one that were very few PhDs in clinical focus on interstitial lung disease . was the innate immune system would last departments, yet Galen hired five “Most pulmonologists at the — monocytes and macrophages “There are a number of therapies targeting T and until Toews’ of us . He and the whole division time thought fibrosis didn’t have — rather than the adaptive passing in 2011 supported and valued us, sharing an immune component because immune system — T and B B cells but none really targeting macrophages or and would be their clinical insights so we they’d tried anti-inflammatories cells — that was promoting a monocytes. That’s because we need a better memorialized in could make our mouse models and steroids with little effect,” profibrotic cytokine cascade . This a professorship best fit the diseases we studied she says . “Yet here was Galen was a major breakthrough for a understanding of how those cells contribute to bearing his together ”. bringing in an immunologist to poorly understood disease with name, which work on it ”. limited treatment options . disease pathology. Our lab is trying to provide In fact, Toews was so committed she would to helping his PhDs succeed The combination was kismet . This was just the first of a that.” receive in 2017 . that he “adopted” Moore after Moore had a graduate school series of insights to emerge — Bethany Moore, PhD her original collaborator took a friend who’d made a chemokine from a collaboration that
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frame the story,” she says . “He same players and molecules are medical freezer that housed really taught me how to tie a big important ”. patient samples of lung disease, clinical problem to the specific which are critical to corroborating MOORE’S RECENT FINDINGS mechanistic questions we were THE PROFESSORSHIP’S IMPACT findings between humans and With support from her Toews trying to answer ”. animal studies . Moore says she is using her Collegiate Professorship, Moore’s Finally, says Moore, Toews professorship to advance her But perhaps the most significant group published research in 2019 always encouraged her to branch research (see box), particularly impact of her professorship has on the role of the microbiome in out — particularly in the early where it involves collaborators been on Moore herself . “If I think lung fibrosis . They showed that the 2000s when PhD faculty became within her division . “I’ve used about the most meaningful days amount and composition of bacteria eligible for the tenure track in it to fund research projects on in my life, there’s the birth of my in the lungs were different for clinical departments, giving her apoptosis in fibrosis with Jeff children, my marriage and my patients with progressive vs . far more independence . She Horowitz, microbiome studies professorship ceremony,” she stable fibrosis . They also identified continued to work with him on with David O’Dwyer, and a says . “Galen meant so much to cytokine profiles associated with fibrosis, but began to explore the number of others,” she says . “I me, so having a professorship various types of bacteria, which may role of viruses, the microbiome, feel a great responsibility to use with his name on it is incredibly help explain the difference in disease even bone-marrow transplant in this professorship wisely and in special . Then, as a scientist, the progression . Her lab also published pulmonary complications . a way that Galen would approve most important thing you have a study showing that patients of . This means supporting young is your body of work — and who developed certain herpes “These were natural extensions virus infections after a stem cell Galen Toews and Bethany Moore at the International Colloquium for Lung and Airway researchers in the division ”. you’re being told it’s worthy of of our work,” says Moore . “When Fibrosis conference in Switzerland, October 2002 a professorship . And, of course, transplant had a greatly increased people have these complications, To this end, Moore has funded there is this wonderful ceremony . risk of developing an inflammatory, Moore says was uniquely University of Texas Southwestern they have remodeling in their travel for pulmonary graduate My division, my trainees, my sometimes fibrotic, lung complication productive and nurturing . She Medical Center . lung, regardless of whether it’s students and fellows to present family and Galen’s family were known as idiopathic pneumonia and Toews truly enjoyed working due to idiopathic pulmonary their research at national Toews was also an excellent all there . It was a celebration of syndrome . Mouse models she together, thanks not only to fibrosis, drug-induced toxicity or meetings and conferences . coach . “When we’d discuss a Galen’s life and the biggest honor I developed confirm these findings and complementary expertise, but infection after a bone marrow grant, he’d get on the whiteboard She’s also funded essential could imagine ”. are allowing her lab to probe this to the natural simpatico that transplant . They all involve and draw out the aims, move research equipment, which is process . comes from growing up in Texas macrophage activation and arrows around, scratch things out beyond the scope of NIH funding . and Oklahoma, respectively, polarization toward a fibrosis- and talk out the very best way to One example is replacing a failing and having both trained at the inducing phenotype . A lot of the
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Kim A. Eagle, MD, Endowed Professorship in Cardiovascular Medicine EAGLE IS RECOGNIZED FOR CAREER SPANNING 25 YEARS
THE NAMING OF THE KIM EAGLE, MD, ENDOWED PROFESSOR OF CARDIOVASCULAR MEDICINE In 2014, Kim Eagle, MD, program focused on quality, cost- From there, David Pinsky, and they have a dedication to EAGLE RECRUIT IS RECIPIENT director of the U-M Frankel effectiveness, use of practice MD, chief of the Division of one or more providers who have OF NAMED PROFESSORSHIP Cardiovascular Center, was guidelines in cardiovascular care, Cardiovascular Medicine, and made a pretty big difference in Eagle was particularly delighted honored with the naming of the evaluation and management of John Carethers, MD, chair their medical journey . And they’re in 2014, when the Department Kim A . Eagle, MD, Endowed acute coronary syndromes, and of the Department of Internal looking for a way of honoring selected Vallerie McLaughlin, Professor of Cardiovascular the evaluation and management Medicine, worked with a number that by giving back, whether it’s MD, associate chief of the Medicine . Since joining of aortic diseases . His team of Eagle’s other patients, and the to a research fund, endowed Division of Cardiovascular the faculty in has led innovative quality U-M Office of Development, to professorship, fellowship or Medicine, to be the inaugural 1994, Eagle has improvement initiatives across try to bring the funding to a full student scholarship,” says Kim A . Eagle, MD, Endowed overseen a the state of Michigan in acute professorship, which they did . Eagle . “Obviously, it’s great for Professor of Cardiovascular vigorous myocardial infarction, heart “It’s very humbling to have your the department when we can Medicine . “I recruited Vallerie to outcomes failure and coronary angioplasty . bosses and your patients come raise professorships from our the U-M in 2003 from Chicago to research together and do something like grateful patients . If you look The impetus for the named run the Pulmonary Hypertension this . Obviously I was thrilled that across the Medical School, the professorship began with Program at the U-M Frankel it happened . It has been very department and the division, several grateful patients who Cardiovascular Center,” he says . powerful for me,” he says . there are many faculty members initiated discussions with division “This professorship sends a who have amazingly impactful leadership about establishing strong message to Vallerie, the PROFESSORSHIPS AWARDED careers who could have a some kind of legacy to honor first woman in our division to TO ACTIVE FACULTY MEMBERS professorship named after them . Eagle’s 25-year career at U-M, be awarded a professorship, I was just fortunate that some of and the impact he has made It is important to note that that the institution is deeply the patients I cared for wanted on preventive cardiology at the Eagle’s status as an active faculty committed to her programs in to do this, had the means and university and beyond . “One member has given considerable research, education and patient exercised that option . To be patient in particular was very weight to the support of this care . And, in her administrative awarded this professorship interested in trying to make that endowment . “This professorship growth . That she was selected is while I am still working is very happen, so he made a major calls to mind the fact that especially meaningful for me ”. gratifying ”. financial commitment to set this sometimes we care for patients A fellow of the American in motion,” says Eagle . who want to give back to the College of Cardiology, American institution . They have the means,
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College of Chest Physicians, and American Heart Association, “This professorship calls McLaughlin has been the principal investigator on several to mind the fact that major clinical trials of drug sometimes we care for therapies for pulmonary arterial hypertension and has published patients who want to numerous papers in this field . give back to the Eagle maintains that these institution. They have the types of endowments in the department, and in the Medical means, and they have a School, are invaluable . “They dedication to one or allow us to recruit and retain individuals who are really more providers who important to our mission,” have made a pretty big says Eagle, who is also the Albion Walter difference in their Hewlett Professor of medical journey. And Internal Medicine . This appointment honors they’re looking for a way Albion Walter Hewlett of honoring that by giving (1874–1925), a founding father of cardiology, A fellow of the American College of Cardiology, American back, whether it’s to a who served as chief of College of Chest Physicians, and American Heart Association, research fund, endowed medicine at the U-M Medical School from McLaughlin has been the principal investigator on several professorship, fellowship 1908–1916 . major clinical trials of drug therapies for pulmonary arterial or student scholarship.” hypertension and has published numerous papers in this field. — Kim Eagle, MD
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Melvyn Rubenfire, MD, Professorship in Preventive Cardiology
PUTTING PREVENTIVE CARDIOLOGY ON THE MAP
PROFESSORSHIP HONORS MELVYN RUBENFIRE, MD, A PIONEER IN CORONARY DISEASE PREVENTION In 2012, David Pinsky, MD, Department of Internal Medicine, and teaching in the areas of program development . Also, the rehabilitation has been available chief of the Division called Melvyn Rubenfire, MD, prevention, early detection and endowment would continue in for over three decades, and proven of Cardiovascular professor of internal medicine, and treatment of atherosclerotic perpetuity . to be very effective, it wasn’t Medicine, U-M director of preventive cardiology, cardiovascular disease . Over the until the past few years that the This award is especially important into his office to talk about an last 20 years at U-M, he helped to insurers actually encouraged, and to Rubenfire, given that just 10 “interesting opportunity ”. develop internationally recognized most recently mandated, referral years prior to the naming, the programs in cardiac rehabilitation, to cardiac rehabilitation because That’s when Rubenfire, an practice of preventive cardiology lipid management, pulmonary it reduced costs of cardiovascular esteemed clinician and researcher, had not yet garnered serious hypertension and metabolic care ”. learned that the division wanted attention in medicine . “Back fitness programs . to honor him with a named then, nobody really cared about In May 2019, Venkatesh professorship: The Melvyn Within months, the Melvyn prevention in academic medical Murthy, MD, associate Rubenfire, MD, Professorship Rubenfire, MD, Professorship centers and teaching programs . professor of radiology, and in Preventive Cardiology . “I in Preventive Cardiology was The only people that cared about associate professor, Division of remember saying something established to provide ongoing it were patients that suffered from Cardiovascular Medicine, was to the effect of ‘wow,’ as financial support to allow a cardiovascular disease,” explains inaugurated as the first holder of it was overwhelming to faculty member to continue to Rubenfire, who joined the U-M the professorship . hear this news, especially use multidisciplinary teams of faculty in 1991 . “Early detection As the decades have because professorships like health care providers, innovative and risk assessment, diet and demonstrated, Rubenfire was a this don’t usually happen technology and novel strategies exercise, the value of statins and true pioneer in coronary disease “I remember saying something to the effect of until a faculty member has for detecting, limiting, treating cardiac rehabilitation were not prevention . “I was always doing passed away . To receive and, in some cases, reversing considered important, but that ‘wow,’ as it was overwhelming to hear this news, prevention in my previous work,” this while I was still working atherosclerosis — the core changed . And in 2017, suddenly he says . Before joining the U-M especially because professorships like this don’t was very exciting . And of Rubenfire’s work . The the word ‘personalized medicine’ faculty, he was chair of the it was something that I professorship would represent came to the forefront . We were usually happen until a faculty member has passed Department of Internal Medicine couldn’t possibly say no to,” an endowment of $2 million, actually already doing this in and chief of cardiovascular away.” says Rubenfire, a general giving the recipient the latitude those days, not realizing that medicine at Sinai Hospital in cardiologist, who has focused his to spend a percentage of that there would be a name assigned — Melvyn Rubenfire, MD Detroit, and professor of medicine career in patient care, research sum annually for research and to it . For example, while cardiac
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at Wayne State University School had great personal relationships that I do, likely at a 50 percent patient care,” he says . “I decided 5-10 year project, because we’re of Medicine . with my patients . Also, it appointment,” he says . to try to create a relationship going to use this relationship to was easy to stay because my between the major cardiac rehab improve and refine both systems, Rubenfire remains grateful to PROFESSORSHIPS BUILD VALUE colleagues were among the best programs in Ontario and Michigan and to find the best parts of each Pinsky and John Carethers, in the country ”. with the goal of comparing two in Canada and the United States . Rubenfire, now 80 years MD, chair, Department of Internal health care systems with very From there, we want to distribute old, recalls that prior to the As it turned out, this was one Medicine, who were both very similar patients and only a bridge what we’ve learned through establishment of the professorship of the best things that could supportive in instituting this apart . A friend and colleague the academic community . And in 2012, there was an attempt have happened . Rubenfire has professorship . “I’m also very worked at the University of then perhaps we will be able to to recruit a new director of remained on the faculty, in part, appreciative of the major donors, Windsor in kinesiology, teaching change cardiac rehab, making it preventive cardiology at U-M to recruit and train the people most of whom were my patients, students exercise physiology a very cost-effective program who would eventually get the who will eventually carry on the family and members of the Detroit and cardiac rehabilitation . We for both countries . This Rubenfire Professorship . “The program . “We have 80 people Jewish community with whom recruited four large programs in will be my last piece of department did a national search, working with us and several I had a personal relationship,” Ontario and at the Henry Ford work . And it wouldn’t but was not successful in filling different programs . Now the says Rubenfire . “If it was years Hospital in Detroit and formed the have happened had the position,” says Rubenfire . legacy we created will continue after my death and they wanted Great Lakes Cardiac Rehabilitation I not received this “That turn of events influenced the because Michigan Medicine will to honor me, I can’t imagine this Consortium . Our mission is to professorship, trajectory of my career . With the recruit faculty whose interest is in happening . I came to realize that improve both short- and long-term because I job still open, I decided to extend prevention,” he explains . helping the process was important quality of life, and prevention of wouldn’t have my tenure at U-M years beyond but it was very difficult to ask for Rubenfire also had disability and death from coronary stayed on this what I had planned . Whether funds for a professorship in my responsibilities to an disease, by increasing utilization, long . The fact the professorship was created name ”. international program that he developing novel programs that there will or not, my work was ongoing had developed, and wasn’t (women-only, home-based, be a legacy to and very interesting to me . I LEAVING A LEGACY ready to leave . “These things telehealth) at a lower cost ”. what I have was active in the education of have kept me here . And now Three years ago, Rubenfire took spent 50 students and advanced trainees in Rubenfire has devoted the last I’m enjoying it such that, even a sabbatical . “I knew that I was years creating cardiovascular research . I enjoyed two years to working in this area . when I am replaced as director going to be replaced over the next is very a range of research opportunities “We’re right in the middle of of the academic program, I’ll still several years, but I wanted to be meaningful to with colleagues . My clinical load collecting data for the first time,” stay on to enjoy the research, involved in something that would me ”. was particularly satisfying, and I he explains . “This could be a teaching and clinical work have an important impact on Venkatesh Murthy, MD
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Panduranga Rao | The Richard D. Swartz, MD, Collegiate Professor of Nephrology A PLACE CALLED MICHIGAN
PANDURANGA RAO’S CAREER TRAJECTORY IS MARKED BY A FIRST INTERVIEW WITH RICHARD SWARTZ, MD Panduranga Rao, MD, Medical College in Chennai, At the time, Richard Swartz, advice on how to handle In 2010, Swartz retired from professor, Division of India, in the early 1980s MD, widely renowned for his the situation . He has no active faculty status . He Nephrology, was when he first heard about “a expertise in the area of chronic pretensions, and he’s very direct currently holds the title of a medical place called the University kidney disease and end-stage and refreshingly frank in his professor emeritus of internal student at of Michigan” just across the renal disease, was a professor communication .” medicine . His contributions Stanley globe in Ann Arbor, Michigan . of internal medicine — and, as to the Division of Nephrology Swartz is also highly regarded “I happened to read about the luck would have it, conducted have been invaluable at U-M for end-of-life care for patients university and it left a lasting the initial interview with Rao . where he has served as medical with debilitating diseases . impression on me,” he says . “It was like a dream come true director of acute dialysis, chief “Stories abound about Dr . for me,” says Rao . “In talking of clinic, director of the inpatient Rao spent the next 14 years Swartz’s compassion, and how with Dr . Swartz, I quickly sensed service and chief of staff . finishing his postdoctoral he has driven to a patient’s the enormous dedication he had training, including an internship, house to find out how he or she to patient care and education .” COMING FULL CIRCLE two residencies in internal is doing,” says Rao . “He has In 2003, Rao joined the U-M medicine and two fellowships a keen ability to communicate In 2019, after serving six years faculty as assistant professor . in internal medicine with his patients . Many on the U-M faculty, Rao’s nephrology . In 2000, he Swartz has served as a role physicians struggle with how dream about “a place called accepted a position as model and an inspiration for to talk with patients whose the University of Michigan” assistant professor at the Rao throughout his career at prognosis is poor, and how to came full circle when he Medical College of Ohio, in U-M . “I’ve tried to continuously talk about various treatment was awarded the Richard “To this day, when I come across patient issues Toledo, Ohio . improve myself based upon options, including the option of D . Swartz, MD, Collegiate how he works with patients, not pursuing active treatment in Professorship in Nephrology . that are not readily solvable, Dr. Swartz is the first It wasn’t long before that colleagues and students,” he the face of a terminal disease . “It is an extraordinary privilege spark of intrigue from person I turn to. He always comes up with really says . “When I come across Dr . Swartz, by virtue of his and honor for me to hold this his early days in India patient issues that are not expertise in end-of-life and professorship . Dr . Swartz sensible and very practical advice on how to led Rao to the University readily solvable, Dr . Swartz is palliative care issues, continues is an iconic person in the of Michigan; in 2003, he handle the situation.” the first person I turn to . He to serve as a role model for division, and he has a long applied for a faculty position always comes up with really how to improve such difficult reputation as an outstanding — Panduranga Rao, MD with the Division of Nephrology . sensible and very practical conversations .” clinician and educator,”
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says Rao, whose research what they see in Michigan, and Nephrology, with many of the focuses on outcome studies in even the United States, and gain division’s patients in attendance . kidney transplantation . “This a wider perspective . That makes “After the talk, three people award gives me a sense of them better nephrologists — from the audience approached In 2010, Swartz retired responsibility to become a which, in turn, impacts patient me to say how delighted they better doctor, a better teacher care .” were that I was the Swartz from active faculty and a better human being every professor . They were Dr . Toward that goal, Rao plans status. He currently single day .” Swartz’s patients, as well as to establish a nephrology donors for this professorship,” holds the title of training exchange program at LOOKING FORWARD says Rao . “It was very St . Paul’s Hospital Millennium professor emeritus of heartwarming, and gave me a A year after receiving the Medical College in Addis Ababa, renewed sense of purpose in internal medicine. His professorship, Rao will tell Ethiopia . “I think it would be terms of what is expected of you that he’s really just getting extraordinary for our fellows contributions to the me, and all I want to accomplish started . “I have not had the to actually get exposure to the with this professorship .” Division of Nephrology opportunity to fully leverage physicians in Ethiopia and train this professorship, since it’s under them because there’s a lot have been invaluable at relatively new . But I would like to learn even from a resource- U-M where he has to accomplish a few things, poor environment about how especially in the areas of physicians in other situations served as medical training and education,” says handle their patients, and how director of acute Rao, who also serves as the they approach things when the director of the U-M Nephrology sources are limited,” he says . dialysis, chief of clinic, Fellowship Training Program . director of the inpatient “I want to improve global THE CIRCLE CONTINUES nephrology exposure for my service and chief of Four months ago, Rao gave a trainees, using the resources presentation for the general staff. available . This would give public at the A . Alfred Taubman my fellows the opportunity to Health Sciences Library to experience nephrology beyond highlight the Division of
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EARLY CAREER ENDOWMENT AWARDS
Beginning in FY19, the department initiated the 2019 RECIPIENTS creation of three Early Career Endowment awards Geoffrey Barnes, Elliot Tapper, MD, Adina Turcu, MD, annually ($250,000 each) for five years for an MD, MSc, from the from the Division of from the Division of ultimate total of 15 awards by the close of FY23 . Division of Cardiovascular Gastroenterology Metabolism, Endocrinology These awards are competitively assigned to Medicine received the James O . and Hepatology received the & Diabetes received the Susan junior faculty at the assistant professor level (any Woolliscroft, MD, Department of Margaret R . Gyetko, MD, G . Urba, MD, Department track) who are within five years of their terminal Internal Medicine Early Career Department of Internal Medicine of Internal Medicine Early The Department of Internal Medicine residency/fellowship/post-doctoral training . These Endowment Award . His research Early Career Endowment Award, Career Endowment Award . Her junior faculty endowments are named after a continues to attract, recruit and retain interests include anticoagulation, His clinical activity and research research focuses on adrenal current or former faculty member, and will be held venous thromboembolism, quality efforts focus on the outcomes disorders, including congenital the most promising faculty to fulfill by the incumbent for one five-year cycle as long as improvement and shared decision of patients with cirrhosis, adrenal hyperplasia, Cushing’s they do not hold another endowment . and excel at its missions of research, making . He currently co-directs particularly those with hepatic syndrome, primary aldosteronism The 2019 awards were named in honor of esteemed the Michigan Anticoagulation encephalopathy . Prior to joining and pheochromocytoma/ education and patient care. Recruiting senior faculty members: Quality Improvement Initiative, a the faculty, he was resident, paraganglioma . and training the next generation of six-centered BCBSM-sponsored chief resident, and a fellow in Margaret R. Gyetko, MD; Susan G. Urba, MD; anticoagulation quality gastroenterology and transplant leaders to keep the University of and James O. Woolliscroft, MD . improvement collaborative and hepatology, all at Beth Israel Michigan strong and at the forefront of registry . He is leading an NIH- Deaconess Medical Center in sponsored study to improve the Boston, MA, where he served as novel basic, translational, clinical and coordination and care of patients director of quality improvement health services research is essential. on chronic anticoagulants around for the Liver Center . the time of surgical procedures .
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2019 Early Career Endowment Honorees and Recipients (from l to r): Susan G . Urba, MD; Adina Turcu, MD; Margaret R . Gyetko, MD; John Carethers, MD; Elliot Tapper, MD; Geoffrey Barnes, MD, MSc; and James O . Woolliscroft, MD
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Philanthropy allows our faculty to explore new ideas in research and education that are transforming the field and supporting further innovation.
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James Shayman | Agnes C. and Frank D. McKay Professor
MULTIPLIER EFFECTS
A UM-INVENTED DRUG SUPPORTS THE NEXT GENERATION OF PHYSICIAN-INVESTIGATORS Few might have expected Frank D . McKay Professor in The prevailing treatment strategy biochemistry, cell biology and that a casual chat on the Division of Nephrology and was to break down this waste lysosomal pathology . a bus ride to a U-M a professor of pharmacology, by giving patients more of the The duo collaborated for years, research retreat in was then a faculty recruit and missing enzymes, an expensive Eliglustat is the first synthesizing and testing variants 1988 would spawn rising star contemplating a approach requiring IV infusion . of Radin’s initial drug lead, with novel chemical entity to a collaboration change in research direction . Radin felt it made more sense Shayman becoming increasingly that would, His conversation partner was to block the enzymes that were emerge from U-M convinced of the soundness of decades later, Norman Radin, PhD, a professor producing the waste in the first their approach . When Radin beginning as a concept yield the first of neurochemistry decades his place . As early as 1971, he’d retired, Shayman continued his small-molecule senior and an expert in lipid been pioneering what is now and ending with FDA research until he had created a drug invented biochemistry, who was puzzling called “substrate reduction more specific approval. It is now a at U-M to out a new way to treat lysosomal therapy ”. When he met Shayman, and potent reach the storage diseases . Radin had already identified a first-line oral compound that marketplace . A compound that could bind to and Shayman’s These diseases include 50 or so possessed the treatment for drug that would inhibit the enzyme that created genetic disorders in which the characteristics of drug-development also become a new treatment glucosylceramide, the problem adults with enzymes that normally break a drug candidate . paradigm for lysosomal storage substrate in Gaucher . success has down wastes in our lysosomes Gaucher disease disease and a windfall to the are missing or defective . When Shayman first learned of THE PATH TO supported seven university poised to support type 1. Shayman This allows the wastes, or the approach, he was skeptical . COMMERCIALIZATION medical research for generations endowed “substrates,” to accumulate He assumed it would create other received the 2016 to come . While this should be the story’s in various organs, leading to problems for patients, causing professorships in the peak, it was in some ways just Distinguished University an array of symptoms, organ molecules further upstream to A NEW TREATMENT APPROACH the beginning . As a pioneer department and a damage, even death . Radin’s accumulate or preventing the Innovator Award for this in drug development at U-M, Perhaps most surprised by the focus was Gaucher disease formation of other important more robust climate Shayman discovered there were work. ripple effects of that chance type 1, in which fatty molecules lipids . But, he figured, even if the multiple hurdles to clear before for drug development conversation were the ones accumulate chiefly in the liver pair never devised an effective patients could benefit from his engaged in it . James Shayman, and spleen . drug, they’d still generate at the university. and Radin’s work . MD, now the Agnes C . and valuable insights in sphingolipid
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The first step was securing a SUPPORTING TOMORROW’S U-M’s tradition of cutting-edge University, Auchus a graduate make sex hormones and unusual patent . Although this process is BREAKTHROUGHS research ”. student and Shayman a fellow steroid intermediates instead of now robustly supported by U-M’s (in fact, Shayman served as cortisol . By mapping this process, Professorships Six of the professorships made Office of Technology Transfer, lead author on Auchus’ very first he hopes to develop better possible by his work are named at the time it was the chair of Though Shayman’s greatest paper as a graduate student) . In biomarkers for diagnosis and “I’ve received a fair bit of for individuals of historical internal medicine, Tachi Yamada, gratification has been the drug’s addition, both men study diseases treatment monitoring . importance to the Medical School recognition for the MD, and Shayman’s division benefit for patients, he is also driven by defective enzymes . One and department (see sidebar) . “It’s difficult to describe what chief, Roger Wiggins, MD, who pleased that the U-M/Genzyme of Auchus’ signature projects development of our This includes one honoring Radin, an honor it is for me to hold a chipped in to cover the costs of license and its royalty stream are focuses on 21-hydroxylase which has been earmarked for professorship named for Jim drug, but such attention the initial application . helping to fund medical advances deficiency, in which defective Shayman’s home division of Shayman,” says Auchus . “It of the future . The Medical enzymes cause the adrenals to is usually ephemeral. The The next step was finding a nephrology . signifies that we’re working to School has used resources from partner . Shayman pitched his idea that there is going Shayman’s work to invest in its Another was created in Shayman’s candidate compound to several Clinical Trials Support Units, own name and that of his late to be a professorship biotech and pharmaceutical and the Department of Internal wife, a UM-educated landscape companies — including that will be around long Medicine has funded the creation architect who designed beautiful, Genzyme, the primary player in of seven endowed professorships . functional spaces on the U-M after I am gone and that Gaucher disease — yet none campus and throughout Ann initially showed interest . “I am tremendously satisfied will support the kind of Arbor . The James A . Shayman and by this,” says Shayman . However, in 2000, Genzyme Andrea S . Kevrick Professorship research I believe is “The historical legacy of the licensed Shayman’s candidate in Translational Medicine was Department of Internal Medicine important is compound and worked with awarded in 2019 to Richard has been in recruiting and him to further refine it, leading Auchus, MD, PhD, an expert tremendously nurturing the careers of physician- to the discovery of eliglustat, in steroid biochemistry in scientists . Professorships satisfying.” which they ushered through the Division of Metabolism, provide us with protected time clinical trials and FDA approval . Endocrinology & Diabetes . — James Shayman, MD to concentrate on the lab as Eliglustat is now sold under the well as resources to take risks . It’s a meaningful award for both brand name Cerdelga and has This is critical for maintaining men . They began their careers been used to treat more than in adjacent labs at Washington The inauguration of Richard Auchus, MD, PhD, as the James A . Shayman and Andrea 1,500 adults worldwide . S . Kevrick Professor of Translational Medicine
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continue his legacy of using science affecting the central nervous U-M’s other drug-development “All the things Jim had to do so to change the way we understand system, such as Tay-Sachs and catalysts — such as the Office of laboriously, researchers can now HISTORICAL PROFESSORSHIPS disease and deliver care that helps other forms of Gaucher . In addition, Technology Transfer, Fast Forward outsource to other experts at In addition to a professorship in his name, proceeds patients live as productively as Shayman is taking on other passion Medical Innovation, the Michigan U-M,” says Groppi . “It shortens from Shayman’s work have endowed six professorships possible ”. projects, such as exploring ways to Institute for Clinical & Health development time tremendously ”. named for figures of historical importance to the bring treatments for rare diseases Research (MICHR) and the Rogel Medical School and department . Fittingly, Shayman’s own lab Things have come a long way to underserved parts of the world . Cancer Center — to accelerate the Daniel Goldstein, MD has also been the beneficiary since Shayman and Radin first translation of promising research of endowment funding, both Lessons in Drug Discovery launched their partnership . Their Eliza Maria Mosher Collegiate Professor of Internal into new medicines . Medicine from the McKay Professorship legacy includes not only the There are other, less tangible and eliglustat’s proceeds . With Shayman serves on Michigan Drug patients they’ve helped with their Eve Kerr, MD, MPH ways in which Shayman’s journey this support, he is continuing his Discovery’s executive committee, pioneering therapy, but also the Louis Newburgh Research Professor of Internal has had ripple effects on drug drug-development work with where he is a strong advocate for advances yet to emerge from the Medicine (page 47) development at U-M . “Jim’s longstanding members of his the types of support researchers physician-investigators their work Kenneth Langa, MD, PhD work was pioneering in so many research group and division, need at every step . This support will support for generations to Cyrus Sturgis Research Professor of Internal Medicine ways,” says Vincent Groppi, including Research Assistant is now light years beyond where come . PhD, immediate past director of Lona Mody, MD, MSc Professors Vania Hinkovska- it was for Shayman — and, Michigan Drug Discovery . “With Amanda Sanford Hickey Collegiate Professor of Galcheva, PhD, and Jonathan according to current director his own moxie and little structured Internal Medicine (page 42) Shillingford, PhD, and Associate Peter Toogood, PhD, is among support, Jim took a lead compound Subramaniam Pennathur, MD Research Scientist Liming Shu, the most robust, coordinated and to the point of licensing by a drug Norman Radin Professor of Nephrology PhD . One project focuses on sophisticated in the academic company . The goal at Michigan analogs of eliglustat that could medical community . Researchers Vincent Young, MD, PhD Drug Discovery is to take what Jim cross the blood-brain barrier . engaged in drug development William Henry Fitzbutler Collegiate Professor of did over 20 years and shorten it With collaborators, including now have access to a coordinated Internal Medicine (page 40) by half — making the path from Scott Larsen, PhD, the Joseph suite of funding opportunities and bench to bedside accessible to Burckhalter Collegiate Research core laboratory services, including researchers who might not have Professor of Medicinal Chemistry assay development and screening, the time or passion he did ”. in the College of Pharmacy, his lab compound libraries, structure- hopes to develop a compound to To do that, Michigan Drug based design, medicinal chemistry treat lysosomal storage diseases Discovery works closely with and pharmacokinetics .
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James Baker, Jr. | Ruth Dow Doan Professor of Biologic Nanotechnology
U-M’S NANOMEDICINE PIONEER
PROFESSORSHIP SUPPORTS NANOMEDICINE INNOVATION INCLUDING MULTI-PATHOGEN VACCINE PLATFORM When James Baker, Jr., president of the company . unique in their ability to enter water and detergent to form By 2001, Doan institutionalized MD, then chief of the The two men, it turns out, had cells because of their small spheres 200 to 600 nanometers his support by establishing the Division of Allergy and much in common . Both were size, and the human immune across, resulting in tiny droplets Ruth Dow Doan Professorship Clinical Immunology, innovative, visionary spirits . system evolved to clear viruses with extremely high surface of Biologic Nanotechnology, an was called to consult Both dealt in chemistry — Doan, in part because of this size . He tension . Their composition endowment named for Doan’s on a patient, he through his leadership at Dow, came to believe that efforts to was such that they wouldn’t mother and earmarked for Baker . never imagined and Baker, as the founder and deliver drugs and genes with merge with each other but The professorship was made the encounter director of what is now the most viruses would fail because would readily merge with the possible through Doan’s gift and would result in Michigan Nanotechnology of this immune response, but membrane of any pathogen they support from the Herbert and a professorship, Institute for Medicine and that synthetic materials of the encountered, blowing it apart . Junia Doan Foundation, and the never mind more Biological Sciences, where he same size, which did not elicit Fortuitously, most human cells Herbert H . and Grace A . Dow than a decade of was developing ultra-small an immune response, might be have sufficient structure to resist Foundation . “Thanks to the mentorship from synthetic materials that could more successful . this effect — with the exception “Thanks to the professorship, professorship, I was Michigan’s “father of perform medically important of sperm and red blood cells . Believing that engineered I was able to take a lot of venture capital” — tasks . Both men also served in able to take a lot of nanoparticles would be chances in my research,” says both of which would the military — Doan, in the Air A COMMERCIALIZATION essential to realizing progress in Baker . “It gave me protected chances in my research. help him develop a Force during World War II, and MENTOR areas from vaccine development time to go out and do the talks revolutionary vaccine platform Baker, in the Army during the It gave me protected to targeted cancer treatment, As the men chatted about this and make the contacts and seek and launch three biotech Gulf War . Baker fixed his attention on research, Doan immediately the grant funding we needed to time to go out and do companies to commercialize his It was, in fact, in the Army that nanomedicine when he returned saw its potential . He connected be successful .” work . the talks and make the Baker first became interested to U-M after the war . By the Baker with a chemist at Dow And successful he was — in nanomedicine . Having been time he met Doan, Baker and his to collaborate on dendrimers contacts and seek the COMMON GROUND particularly in a niche that was involved in the development collaborators had made some — branched nanomolecules so ahead of its time that many grant funding we The serendipitous consult of vaccines to combat acute promising discoveries . One used for targeted drug and gene funding agencies were still introduced Baker to Herbert respiratory illnesses among of these was a nanoemulsion delivery . As their relationship needed to be warming up to it . Through the D . “Ted” Doan . Doan was the the troops, Baker gleaned a capable of “exploding” microbes developed, Doan began to years, Baker’s lab has been successful.” grandson of Dow Chemical number of insights . First, he on contact . It was created by mentor Baker, setting him on the funded by organizations from Company’s founder and a retired observed that viruses were emulsifying soybean oil with path to entrepreneurship . — James Baker, Jr., MD
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the National Institutes of Health Capital Association — an As Baker reflects on his mentor, to the Department of Defense organization started in the ’80s he credits Doan not only for to the Bill and Melinda Gates to help university investigators his vision in creating the Foundation, averaging some $6 license their inventions — Doan professorship, but also with million a year in grant support . offered invaluable insight into a change in perspective that Herbert D. “Ted” “These professorships business development and was pivotal to Baker’s success . Among the most high-profile fundraising . “With Ted’s input, I started Doan was the are transforming the results of his work has thinking about the university as been creating an intranasal The support paid off . Crains grandson of Dow entire university. We are a platform to create things that vaccine platform based on has called NanoBio “perhaps could be developed beyond its Chemical Company’s creating a critical mass the nanoemulsion technology . the most successful fundraiser walls, rather than thinking about Preclinical testing shows the in the history of state tech founder. Doan of expertise that is how to secure my next grant to vaccines are effective against a startups,” and has featured keep myself employed,” he says . institutionalized his making Michigan ‘first broad range of viruses, bacteria the company more than 100 “As a result, we’ve developed and fungi, and Baker’s group times since its founding . Baker support by in class’ in addressing therapeutic platforms and has studied its use in respiratory received U-M’s Distinguished vaccines that are making their establishing the food allergies from syncytial virus (RSV), pertussis, University Innovator Award in way to the clinic, and we built influenza, anthrax, herpes 2008 in recognition of both his Ruth Dow Doan every angle. Our goal is a nanotech center that inspired simplex virus 1 and 2, chlamydia research and entrepreneurship . the nanomedicine program at Professorship of nothing short of and HIV . Since the vaccines are NanoBio, which recently the NIH . Ted changed the way applied to the body’s mucosal Biologic Nano- universal therapies that changed its name to BlueWillow I think, and ultimately that surfaces, where most pathogens Biologics, received FDA changed my life .” technology, an will eventually end this are introduced, they have the clearance in 2019 to begin advantage of inducing both endowment named disease.” phase I clinical trials of its mucosal and systemic immunity . intranasal anthrax vaccine . for his mother and — James Baker, Jr., MD With Doan’s encouragement, in Vaccines for several other earmarked for Baker. 2000 Baker launched NanoBio diseases are in the commercial Corporation to commercialize development pipeline . the technology . As the original head of the Michigan Venture
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THE ALLERGY ANGLE
As a platform technology, Baker’s getting independently funded,” which integrates the food ensuing five years, the center has The center’s research team THE MARY H. WEISER FOOD nanoemulsion vaccine has also he says . “In today’s climate, even allergen and nanoemulsion . She’s raised more than $28 million, and now includes 11 diverse faculty ALLERGY CENTER’S shown promise in treating food terrific researchers, particularly demonstrated in peanut-allergic in 2019, it announced a renewable focused on preventing, treating ENDOWED PROFESSORSHIPS allergies . In fact, his spinoff PhDs, are getting their first NIH mice that just a few doses of the $5 million gift to further escalate and studying the development Nina and Jerry D . Luptak Research company BlueWillow has grants in their 40s . They need vaccine can turn off their allergy research through the Michigan of food allergy . Basic research Professorship intranasal vaccines for peanut additional support and protected for an extended period and is now Food Allergy Research Accelerator . encompasses the physiological, Gary Huffnagle, PhD and milk allergy in the pipeline . In time if they’re going to be working out the mechanisms by immunological, biological, The center has also amassed Askwith Research Professorship in 2019, the company was awarded successful ”. which this occurs . gastrointestinal and environmental five endowed professorships Food Allergy a Small Business Research influences on food allergy . Simon Hogan, PhD One of the junior faculty he’s This work is just one example of designed to attract world-class Innovation contract from the NIH Translational research aims for helped support is Jessica the ways in which endowments expertise . Current professorship Kenneth and Judy Betz Family to complete the necessary steps improved diagnostics, prevention Research Professorship for Food O’Konek, PhD, a research are helping to revolutionize U-M’s holders are exploring topics from to prepare the peanut-allergy and treatment . And clinical Allergy Research assistant professor at the approach to food allergy . This how the microbiome mediates Chang Kim, PhD vaccine for human trials . researchers at the center helped Mary H Weiser Food Allergy work got a substantial boost in food allergy to the immunology pave the way for the recent William Chandler Swink Research Baker’s Ruth Dow Doan Center and MNIMBS (Michigan 2015, when the family of U-M of food-induced anaphylaxis to Professorship in Food Allergy FDA approval of desensitization Professorship helped paved the Nanotechnology Institute of Regent and retired Ambassador how vitamins, metabolites and Research therapy by conducting clinical way for this . “One of the ways Medicine and Biological Sciences) . Ronald N . Weiser directed $10 other factors alter the immune TBA trials at U-M . Ashken Family Professorship I’ve used the professorship is to She has been instrumental in million to U-M’s Food Allergy response . TBA support junior faculty while they’re creating and testing the vaccine, Center, which was renamed the “These professorships are “Our goal has been to build a Mary H . Weiser Food Allergy transforming the entire university,” multidisciplinary scientific team to Center, in honor of his daughter- says Baker . “We are creating a examine the fundamentals of food in-law’s food allergy advocacy . critical mass of expertise that is allergy,” says Baker, who directs The gift aimed to help the center making Michigan ‘first in class’ the Mary H . Weiser Food Allergy double down on its mission, in addressing food allergies from Center . “Sometimes the scientists conducting cutting-edge research every angle . Our goal is nothing with the expertise we needed to understand and treat food short of universal therapies that weren’t even working in this area, allergies, creating a national will eventually end this disease ”. so the professorships provided a destination center for treatment, carrot for coming here and getting and advancing information and involved in food allergy ”. The Mary Weiser Food Allergy Group public policy on the issue . In the
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Peter Arvan | William K. and Delores S. Brehm Professor of Type 1 Diabetes Research
DIABETES AS A PROTEIN-FOLDING DISEASE
BREHMS’ GIFT CATALYZES U-M DIABETES LEADERSHIP, NEW UNDERSTANDING OF DISEASE It was in 1949 when Delores years, Dee has defied the odds, new leads toward prevention, freedom to fulfill a vision of my “Dee” Soderquist was diagnosed proving Conn wrong on the first treatment and ultimately a cure . own ”. with type 1 diabetes by U-M’s three counts . And thanks to a To help build the program, Jerome Conn, MD (page 36) . $44 million gift from Dee and her THE EVOLUTION OF A GIFT the Brehms had designated a The prognosis, even under devoted husband, the Brehms are The Brehms’ starting point was portion of their gift to fund what one of the world’s leading driving the field closer to a cure . endowing the William K . and would become known as Brehm endocrinologists, was grim . The Brehms’ plan started with Delores S . Brehm Professorship Investigators . “This was funding Conn met with Dee and an endowed professorship — in Type 1 Diabetes Research . It that allowed me to partner with her fiance, William but it quickly evolved to include was used to recruit Peter Arvan, the heads of various departments “Bill” Brehm, to help a second professorship, five MD, PhD, as chief of the Division and centers to help recruit leading the young couple supported investigators, a national of Metabolism, Endocrinology & diabetes scientists,” says Arvan . anticipate their coalition and a center for diabetes Diabetes (MEND) and overseer “This is how we were able to future . He told research within a building that of the U-M diabetes programs . build diabetes expertise across them that Dee also bears their name . Arvan, who arrived in 2003, internal medicine, physiology, would probably was an accomplished diabetes pharmacology and pediatrics, not have children; The ripple effects of this support researcher whose focus was such as Malcolm Low, Santiago could expect have been extraordinary . understanding the synthesis and Schnell, Les Satin, Joyce Lee, serious, perhaps The Brehms’ generosity has secretion of insulin and how Scott Soleimanpour and a debilitating helped catalyze a movement of “Professorships provide flexibility pancreatic beta cells function in number of others ”. complications; philanthropy-driven, collaborative healthy people and those with that no grant or clinical activity can would have a diabetes research . It has The Brehms also endowed a diabetes . ever do; they allow faculty time to shortened life also yielded an entirely new second professorship, which they expectancy; understanding of diabetes as “I met with Mr . Brehm during my named in honor of Dee’s brother, think the great thoughts that are and would a disease marked by complex recruitment,” says Arvan, “and Larry D . Soderquist, who died in needed to advance the field.” battle diabetes metabolic derangement and it was clear that he wanted to 2005 . That professorship is now her entire life . protein-folding errors — an help me build a first-rate diabetes held by Rodica Pop-Busui, — Peter Arvan, MD, PhD In the ensuing 70 understanding that offers program, while also giving me MD, PhD, one of the world
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leaders in the study of diabetes people and position them for — with patient-centered care to that patients do have insulin- complications (page 100) . success . It’s like gardening: You prevent, treat and cure diabetes, making cells; they’re just highly plant seeds, fertilize, provide its complications and related dysregulated . The fact that they’re Of course, researchers need water and light, and then you metabolic disorders . there is important because it space, and the Brehms’ vision wait . In the end, people develop means there’s a possibility they was to leverage U-M’s culture their own collaborations, COLLABORATION BEYOND U-M could be rescued ”. of collaboration in support of a synergies and partnerships . cure . In 2004, they announced The Brehms’ gift has also been Discoveries like this happened Many of us have written grants, their support for the Brehm used to catalyze collaborations in part, says Arvan, because the review articles and book chapters Tower, a new building that would beyond U-M . The most high- Brehms’ gift inspired other donors William and Dee Brehm together — and since I’ve been THE GIFT OF A CURE house both the Brehm Center profile example is the Brehm with an interest in diabetes to here, U-M has become the for Diabetes Research and the Coalition, an inter-institutional make high-impact gifts of their Dee Brehm is one of only about 500 people in the nation known to number one funded institution Kellogg Eye Center . Opened collaborative of 12 leading type 1 own . Such gifts, along with have lived with type 1 diabetes for as long as she has . She is also from the NIDDK, the NIH’s in 2010, the tower houses a diabetes researchers from across the coalition’s model of inter- in the fortunate half of that group who have managed to avoid the diabetes institute ”. disease’s typical complications . Yet she and all those with type 1 critical mass of researchers North America . Initiated with institutional cooperation, helped diabetes remain reliant on insulin and live with the constant fear of in a collaboration-friendly To further coordinate the rich Brehm funding, the coalition lives catalyze a national tissue bank low blood sugar that can develop without warning . space . Together these Brehm diabetes-related work on campus, on, pursuing a common research called the Network for Pancreatic Center researchers use mouse the Elizabeth Weiser Caswell agenda and sharing expertise Organ Donors with Diabetes . So it was in 2000, after giving herself more than 100,000 insulin models, cell lines, human tissue Diabetes Institute was created . among the more than 100 Funded by the Juvenile Diabetes injections, that Dee asked her husband to help find a cure . samples, clinical research Directed by Martin Myers, Jr ,. scientists in members’ labs . Research Foundation, it is leading and bioinformatics to look at MD, PhD, the Marilyn H . Vincent to significant advances in diabetes As chairman emeritus of SRA International, a pioneering “The Brehm Coalition helped set everything from how the brain Professor of Diabetes Research in research . information technology consulting and systems integration firm, in motion a number of things,” drives obesity to how beta cells the MEND Division, the Elizabeth and a Defense Department appointee under three U S. . presidents, says Arvan . “From a scientific While the Brehm Coalition fail to how metabolic disturbances Weiser Caswell Diabetes Institute Bill was not one to shrink from a challenge . His career had given perspective, it challenged can’t take full credit for these initiate complications . coordinates the research of more him faith in the power of systems analysis and informatics to solve key assumptions about type outcomes, says Arvan, it did start than 250 scientists working on even the most challenging problems . “You can’t engineer synergies,” 1 diabetes . For example, it a movement — a movement of diabetes from various disciplines says Arvan, “but you can provide was originally believed that “philanthropy-based, collaborative After considering how to best catalyze a cure, the Brehms made a and programs . It aims to help an environment where good autoimmunity wiped out science tackling diabetes’ big record-setting gift to U-M . The gift recognizes not only Bill’s alma integrate rigorous science — such things can happen . The Brehms’ insulin-making cells in type 1 biological problems ”. mater, but the excellent care Dee received and the university’s as that produced by the Brehm gift allowed us to recruit excellent diabetes . We’ve come to realize reputation for stellar endocrine research . Center for Diabetes Research
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THE PROFESSORSHIP’S IMPACT not be converted to insulin, but production increases, so too do to blocking their contact with “Professorships provide flexibility that no grant or the misfolded product actually protein-folding errors . normal proinsulin so they can’t In Arvan’s own lab, the Brehms’ clinical activity can ever do; they allow faculty time to associates with the ‘normal’ form dysfunctional aggregates . endowment has contributed “It’s like that old “I Love Lucy” proinsulin from the ‘good’ gene, He is partnering in this work with think the great thoughts that are needed to advance to a new understanding of sketch, where Lucy’s wrapping creating large protein aggregates . U-M colleagues Ling Qi, PhD, diabetes — as a protein-folding candy on a conveyer belt,” says the field.” The result is that patients can’t professor in the Department disease . Since coming to U-M, Arvan . “It starts going faster and produce insulin even from the of Molecular & Integrative — Peter Arvan, MD, PhD Arvan’s lab has shown that the faster until she can’t keep up, so good gene, and as a result they Physiology and in the MEND misfolding of proinsulin is one of she starts pushing them aside and get severe insulin-deficient Division, and Billy Tsai, PhD, the the forces underlying beta cell eating them ”. diabetes, often within the first Corydon Ford Collegiate Professor failure . Proinsulin is a protein year of life ”. As this process continues, the in the Department of Cell & “prohormone” that, in healthy creation of misfolded proteins Developmental Biology, who study pancreatic beta cells, is converted He named the disorder MIDY, outpaces the cell’s ability to disposal pathways for misfolded to insulin — the hormone that for Mutant Ins-gene Induced break them down, stressing proteins in the endoplasmic acts throughout the body to help Diabetes of Youth . The name is the endoplasmic reticulum and reticulum . lower blood glucose . Proinsulin an homage to MODY, or Maturity- toppling the beta cell . begins inside an organelle called Onset Diabetes of the Young, Though his lab has several NIH the endoplasmic reticulum . a genetically driven subtype of Arvan’s team has found that the grants supporting this and related Without successfully making and type 2 diabetes in young people rise of misfolded proinsulin occurs work, Arvan says his progress folding proinsulin, there is no first described in 1964 by U-M even before blood sugar becomes wouldn’t have been possible insulin . endocrinologist Stefan Fajans, noticeably elevated . They also without his Brehm Professorship . MD . found in animal models that when “NIH grants are invaluable, By studying a genetic form of misfolded molecules reach 30 but there are many things that diabetes, Arvan’s team found that Since that time, Arvan’s lab has percent of total proinsulin, the these grants will not support,” a mutation which changes just shown that proinsulin misfolding animals start to develop diabetes he says . “My professorship a single amino acid in proinsulin is also at work in type 2 diabetes, from pancreatic beta cell failure . gives me funded time to do causes the protein to misfold . where it occurs without any creative thinking, which is the “When you’re born, you get two mutations . As the body’s cells He is now working to address most precious part of what I do . copies of the gene encoding become less sensitive to insulin, the problem, pursuing strategies Because of that, this professorship proinsulin, one from each parent,” beta cells have to make more from enhancing the degradation has a claim on every invention and says Arvan . “With this mutation, of it to control blood sugar . As rate of the misfolded molecules every discovery I’ve ever made ”. not only can the mutant proinsulin
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James Woolliscroft | The Lyle C. Roll Professor of Medicine
TRANSFORMING MEDICINE THROUGH EDUCATION
HOW A GIFT FROM GRATEFUL PATIENTS IS IMPACTING THE NEXT GENERATION OF PHYSICIANS In 2001, a generous gift from honoring his work in enhancing in Beijing, China, to form the Joint application of educational theory the estate of Marguerite S . the practice of medicine through Institute for Translational and to physician education, and he Roll, in memory of her husband, education . Clinical Research, which sponsors has accomplished much in this Lyle C . Roll, former CEO of the collaborative research between area via this professorship . “Most An internationally recognized Kellogg Company in Battle scientists based in China and the importantly, the professorship has medical educator and former Creek, Michigan, led to the United States to advance global given me the chance to get things dean of the U-M Medical School establishment of the U-M health . Researchers are currently done without having to wait on from 2006 to 2015, Woolliscroft Medical School’s Lyle collaborating in the areas of renal, funding,” he says . “Even before has played a major role in the C . Roll Program for pulmonary and cardiac medicine . it was established, the Rolls education of medical students, Humane Medical were incredibly generous, with residents and fellows . He has also “It was a great honor to receive Practice in support of an annual donation of $100,000, helped to establish standards for the Roll Professorship . I served as numerous medical which went to activities that I was education and accreditation at a a physician for both Lyle C . Roll, education and able to direct . This was something national level for medical schools who died in 1984, and his wife, research efforts . that really benefited the work I and graduate medical education . Marguerite S . Roll, who died in The endowment was trying to do ”. 1996 . For years, I have kept a also established Woolliscroft’s influence on photo of Mr . and Mrs . Roll in my The professorship has also funded the Lyle C . Roll medicine extends well beyond office . These are patients that I educational research studies “I served as a physician for both Lyle C. Roll, who Professor of the state of Michigan, including had the great privilege of caring that, Woolliscroft admits, he Medicine, which his work with the Medical died in 1984, and his wife, Marguerite S. Roll, who for and getting to know,” says wouldn’t otherwise have been was awarded School’s international academic Woolliscroft, who joined the U-M able to pursue . “In many ways, died in 1996. For years, I have kept a photo of Mr. that same program known as Global REACH . faculty in 1980 . it laid the groundwork for the year to James During the past two decades, and Mrs. Roll in my office. These are patients that I large educational transformation Woolliscroft, he has worked extensively with ACCELERATING PROGRESS that we did when I was dean had the great privilege of caring for and getting to MD, professor, educators at Chinese medical because it allowed me to expand Division schools . In 2010, the Medical Throughout his academic know.” my thinking about education,” of General School partnered with the Peking career, Woolliscroft has been says Woolliscroft . “A very early — James Woolliscroft, MD Medicine, University Health Science Center an institutional leader in the example of this was looking
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at the evaluation of residents’ A visionary, Woolliscroft resources professorships provide all sorts of different activities, as I see that as being ever more humane care; comparing patient, foresaw that clinical care are fundamental to Michigan’s other sources of funds become important going forward . This faculty, chief resident and nurse would increasingly be provided ability to attract and retain more constrained . Back when will be as important to the legacy assessments thereof ”. in ambulatory settings, and the brightest, most talented I was working with the Rolls, of all of these professorships as was among the first to require faculty possible — a strength there was just one person in the anything because, hopefully, in Funding has also facilitated the that medical students spend that translates into top medical development area . And now, 20 or 40 years, we will continue development of the Objective time learning and training in education for our students, a there’s a whole cadre of folks who to have good financial stewards Structured Clinical Examination, community clinics, rather than robust program of biomedical have that as their primary focus . who will enable work that we a practical exam initiated at just hospitals — a perspective research and the latest advances So I think it’s really a juxtaposition can’t even imagine at this point U-M many years ago, and that informs today’s curriculum in clinical care for our patients,” of all of these different factors in time ”. which continues to this day . “It changes . He was instrumental in he says . “We are grateful to those that has led to that . And predated the National Board creating the nation’s first medical who, through their gifts and spirit honestly, it’s a time when a lot of Medical Examiners Clinical student clinical skills course of giving back, have expressed of wealth is being transferred Over the last 10 years the number Skills examination, and really using community facilities for the enormous confidence in Michigan intergenerationally . So it’s a very demonstrated that, first of of professorships in the Department elderly as educational sites . “This and our mission of excellence in propitious time to be looking at all, there was a need for an facilitated the medical students’ medical education, research and professorships ”. of Internal Medicine has nearly integrative exam like that and it clinical skills education and their patient care ”. could be done in a reliable and That growth has also impacted quadrupled from 28 to 106. understanding of the challenges valid fashion,” he says . “We also Over the last 10 years, the Michigan Medicine and the faced by the elderly,” says created the Pattern Recognition number of professorships in the Medical School . “I would expect Woolliscroft . Exam, currently called the Chief Department of Internal Medicine this growth will only be positive . Complaint Exam, that continues to has nearly quadrupled, from 28 And, just as importantly, this is THE VALUE OF ENDOWED this day . The exam was developed to 106 . “This is largely due to a part of an enduring legacy . The PROFESSORSHIPS in collaboration with National renewed focus on professorships Roll Professorship was funded for Board of Medical Examiners Woolliscroft is quick to from leadership,” says $2 million, which was considered experts in psychometrics and acknowledge that endowed Woolliscroft . “It has also resulted a large professorship in that era,” test construction, wherein we professorships, and the scholars from an understanding of how he says . “It is growing, and we’ve developed a whole new way who hold them, are the foundation important it is to have funds such been able to split it and do all of assessing the progression of of an academic research as this available for recruitment, sorts of different things . That’s the expertise of medical students ”. institution . “The prestige and research, faculty development and magic of years and compounding .
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Rajesh Mangrulkar | Marguerite S. Roll Professor of Medical Education
THE LEGACY OF MARGUERITE S. ROLL
DEVELOPING A MORE HUMANE MEDICAL COMMUNITY When you walk into the office of root decades ago, when James Program for the Humane Practice a point that it could now result Rajesh Mangrulkar, MD, on Woolliscroft, MD, former dean of Medicine . Marguerite Roll was in two professorships . “That’s Catherine Street in Ann Arbor, of the U-M Medical School, passionate about advancing the when the Marguerite S . Roll Michigan, it’s impossible not assumed the inaugural mantle humaneness and compassion Professor of Medical Education to notice the sizable portrait of the Lyle C . Roll Professor of that incorporate an understanding was established,” he says . Jim hanging by the door . “People Medical Education (page 75) . of the whole patient . Throughout Woolliscroft asked me to assume usually walk in and say, ‘Who is It was during the long illness her husband’s frequent the first endowed position this? Is this your grandmother? of Lyle C . Roll, then head of hospitalizations, she did all she in 2015, which honors the And why do you have this the Kellogg Company in Battle could to humanize the experience extraordinary philanthropic large portrait in your office?’ Creek, Michigan, that his wife, for him . She would make sure spirit of the couple, and It’s a wonderful conversation Marguerite S . Roll, came to that The Wall Street Journal was their deep trust and starter,” admits Mangrulkar, know Michigan Medicine (then on his bedside table every day, belief in the Medical associate dean for medical known as the U-M Health along with a flower . She would School . At the time, student education . “That’s System) and to appreciate the also bring favorite paintings the focus of this when I am able to tell the story care of its physicians, especially from home so he had something new professorship that surrounds this photograph Woolliscroft, who served as familiar to look at . Her interest had not been of Marguerite S . Roll, which physician to both Lyle and in improving the experience of clearly defined . has hung at the entrance of Marguerite Roll . hospitalized patients led to the There were no my office since 2015 . And I’m establishment of the Art Cart family survivors, In 1984, many years after Lyle both proud and humbled to — a U-M program that brings so we had to Roll died, his estate honored “I see this professorship as really be able to carry on the legacy framed art to patient bedsides infer its focus the Medical School in the form of this extraordinary woman and endures to this day . based on Mrs . building the foundation for more of generous annual gifts to who cared so much about the Roll’s values and support education and research innovation in medical education in humane medical treatment of ESTABLISHING A SECOND what someone focused on the doctor-patient individuals ”. PROFESSORSHIP who holds this ways that are often constrained by relationship . After Marguerite professorship The intricate history of how Roll’s death in 1996, a gift from By 2012, the endowment for the the reality on the ground.” should represent ”. that portrait came to hang in the couple’s estate led to the Lyle C . Roll Professor of Medical — Rajesh Mangrulkar, MD Mangrulkar’s office actually took establishment of the Lyle C . Roll Education had grown to such
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In the absence of clear direction, Medical educators in my role experience, so that I can be a constrained by the reality on Mangrulkar and his mentors don’t traditionally hold endowed true partner with them on their the ground,” says Mangrulkar . shaped a vision where the professorships ”. health, rather than telling them “A lot of the investments made resources of the professorship what to do, which we know through this professorship have Mangrulkar recalls that, early would be shepherded by a faculty doesn’t work ”. been in innovative projects, led on, Woolliscroft actually used member with a deep passion by students, and initiatives that some of the funds from the Lyle for medical education and who MARKING NEW INITIATIVES are more outside the box that C . Roll Professor of Medical would care especially about wouldn’t normally get traditional Education endowment to allow As associate dean, Mangrulkar training physicians to be more grant funding ”. him to pursue advanced training provides oversight of the humane . Also important was that in the scholarship of higher curriculum, student affairs and Several different initiatives have the holder would be dedicated education . “Long story short, my admissions units for the Medical resulted from this professorship to the relationship that students career in educational leadership School . He has also led the that center around the humane created with their patients, really grew from that seminal Medical Schoolwide initiative practice of medicine and the and also to giving students a experience over the ensuing two to transform the curriculum into relationship and culture of chance to express themselves in decades,” says Mangrulkar, who a program that will graduate medical education . different ways, growing a culture joined the U-M faculty in 2001 . physician leaders who help drive and a community that is humane Capstone for Impact change in patient care, health and relationship-centered . As a primary care physician at the care delivery and research . Over the last 10 years, VA Ann Arbor Healthcare System, “Being named the inaugural Mangrulkar has led the Mangrulkar carries his strong Much of Mangrulkar’s work Marguerite S . Roll Professor of transformation of the medical focus on humane treatment into through this professorship has Medical Education reflects the student curriculum . “As part of his outpatient practice every been about supporting students glow of the amazing teams and this new program, all students, day . “My relationship with the who may not otherwise get mentors I have been so fortunate upon graduation, are required Veterans who have served their funding to do scholarly work or to work with during my career to complete a Medical School country is so important to me,” take risks in education, research here,” says Mangrulkar . “I have Capstone for Impact project, he says . “And I want to do that and patient care projects . “I nothing but gratitude for having a culmination of the Impact in a way where I really listen to see this professorship as really received this professorship, and curriculum where students The portrait of Marguerite S . Roll that hangs in Mangrulkar’s office the person . I want to understand building the foundation for I’m grateful to Dr . Woolliscroft demonstrate how they can move where these individuals are more innovation in medical for opening this door for me . medicine forward,” he says . coming from and their lived education in ways that are often
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Through the professorship, they in entrepreneurship . U-M was Wolverine Street Medicine, Student Education, and an universe because it’s in parallel sciences at the U-M Medical have tried to fund initiatives that the third school in the country founded in 2017 by medical external company, the Marteney with the universe that students School . allow students the opportunity to create a competitive startup students interested in the Group . “This leadership learning experience in the hospital and Mangrulkar will tell you that the to work on highly creative unit like Sling Health . The lab is health disparities of those community coaching experience in the classroom, which can professorship has served him and scalable projects that will inherently interdisciplinary and facing homelessness or housing has allowed us as leaders in be stressful and focused on well, but he hopes it has also influence medical education for uses creative problem-solving instability . Their mission is medical education to really achievement,” he says . contributed to the educational years to come . and teamwork to come up with to improve the health of the understand each other’s paths, RISE community . In moving ahead, he solutions to complex medical homeless community, incorporate role model how we work on Sling Health remains as committed as ever to problems . education about the care of and ourselves and in interpersonal Finally, Mangrulkar has carry on Marguerite Roll’s vision Funding from the professorship service to this population into spaces and then translate that most recently used some Wolverine Street Medicine for a more humane community . has been used to support the medical student curriculum culture to our students,” says of these resources to help “Although there are many the creation of Sling Health, The professorship has also and educate the members of the Mangrulkar . launch Research, Innovation, different endowed professorships an innovation lab run by helped fund the startup of community about health issues Scholarship, Education (RISE), an M-Home Parallel Universe with various purposes, the students who are interested related to homelessness . innovation initiative for health Seminar Series Marguerite S . Roll Professorship sciences education for which he Leadership felt like the one that fit me the With this professorship, is executive director . The work of Coaching best,” says Mangrulkar . “I’ve Mangrulkar and his colleagues RISE aligns with the education been nothing but honored to carry Mangrulkar have also invested in the Parallel pillar of the Medical School this title ”. has also used Universe Seminar Series, a series Strategic Plan and is beginning some of the of workshops and seminars to cultivate a learning community funds to support where students learn from of practice that engages in bold the growth of faculty and staff about authentic and innovative education for a community of struggles in medicine, drawn the advancement of science, educators who are from mistakes and failure, and health and health care delivery . coached in more humane also about the circuitous route Currently in its pilot phase, RISE practices through the U-M that most physicians take in their is being built to transform the Office of Medical careers . “We call it a parallel culture of education in the health
Wolverine Street Medicine in Detroit
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Joseph Kolars | Josiah Macy, Jr., Professor of Health Professions Education
CREATING A NEW ACADEMY OF MEDICAL EDUCATORS
TRANSFORMING MEDICAL EDUCATION ON A GLOBAL LEVEL
THE JOSIAH MACY, JR., Rockefeller’s Standard Oil in medical education,” says a beneficiary of the foundation’s FOUNDATION Company . Joseph Kolars, MD, professor, education programs dating back Division of Gastroenterology to the 1980s,” he says . “This was A principal in New York’s first oil Just four years later, in 1876, and Hepatology; professor, long before I became aware of refinery near Long Island City, Macy Jr . died of typhoid fever Department of Learning Health the type of opportunities that Jim Josiah Macy, Jr ,. was born at the young age of 39 . In the Sciences; and senior associate Woolliscroft was subsequently in 1837 to a philanthropic decades to follow, his daughter, dean for education and global afforded through this award in family in New York . His Kate (Macy) Ladd, worked to initiatives at the U-M Medical transforming medical education ”. father, Josiah Macy, extend the family’s philanthropic School . established a shipping focus . In 1930, to honor her late THE MACY PROFESSORSHIP and commission father, she created the Josiah In 1996, the foundation selected firm in New York Macy, Jr ,. Foundation, with the University of Michigan from In 2013, Kolars was awarded City, after leaving its initial commitment to the among 52 competing applicants the Josiah Macy, Jr ,. Professor the family home promotion of health and the for the grant that funded the of Health Professions Education . in Nantucket, ministry of healing . At the time establishment of the Josiah He has held a number of Massachusetts, of Ladd’s death in 1945, the Macy, Jr ,. Professor of Health leadership roles in education where they had foundation was valued at $19 Professions Education . James programs for medical students, settled during million . Woolliscroft, MD, professor, residents and fellows, including “Many times, people in education the early 17th Division of General Medicine, program director of one of Today, the foundation is the century . Macy and then-dean of the U-M the largest internal medicine spend much of their time on only national agency dedicated Jr ’s. wealth Medical School, was named residencies in the United solely to supporting projects compliance and regulation rather came in 1872 the inaugural holder of the States . Kolars’ scholarship that improve the education of when the professorship . has emphasized educational than the more creative health professionals . “The Macy refinery he outcomes, measurements of Foundation has been a real Kolars recalls his early opportunities to make better and his family competency, faculty development trailblazer in terms of education experience with the foundation operated was and effective learning venues . learning happen.” scholarship, and is the flagpole when thinking about his own purchased He has also worked closely that educators turn to both for development as a medical — Joseph Kolars, MD by John D . with the Accreditation Council creativity and novel thinking educator . “I was a student and
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on Graduate Medical Education people in education spend much students for a very different Education, to highlight how on their educational initiatives of their time on compliance and health system; preparing them to continuing medical education can to reform graduate medical regulation rather than the more take on the challenges we face in ultimately lead to better patient education . creative opportunities to make society such as prevention, cost, care . “Similarly, with graduate better learning happen,” he quality and access ”. medical education, we’ve had “I was so touched and explains . “The funding from this opportunities to try to incentivize extraordinarily humbled to be Following that approach, his professorship has allowed me the our faculty and residents who selected,” says Kolars . “These team has focused on shifting time to work in that space, and to want to work on education targeted professorships are more of the medical students’ support others doing the same ”. programs to inform how all few and far between . People course requirements to the first programs can translate better often assume that if you’re Impacting Society half of their school years, so education into better care,” says a good researcher or a good as to create more opportunity For more than 20 years, Kolars Kolars . clinician, you must be a good for flexibility and impact in the has been working to create a educator . To shine the light on second half . “We are committed Recently, these efforts have movement at the U-M Medical what it means to be an educator to preparing students to be come together under a dean’s School around more accountable is really terrific . Many of the change agents, with a focus on initiative called Research, education, designing educational funding agencies are looking how they can embark on careers Innovation, Scholarship, and programs and initiatives that for scientific breakthroughs or where they themselves are going Education (RISE) (page 79) . “With have an impact on society . In clinical trials . Yet those of us in to be transformative in terms this initiative, we are trying to 2003, his initiatives resulted Kate (Macy) Ladd academia are often wishful that of the health systems in which create a community of practice in a significant change in there was more recognition for they work,” he explains . “My around creativity and educational the curriculum that gained In 1930, to honor her late father, she individuals focused on education ability to work with our teams on projects that will impact patient recognition from the American scholarship ”. transforming the curriculum was, care and help society,” he created the Josiah Macy, Jr., Medical Association through in part, enabled by this award ”. explains . “We have a number of a transformative medical Foundation, with its initial commitment NEW PROGRAMS AND ongoing projects and education education grant . “This was one Improving Patient Care INITIATIVES programming in that area ”. to the promotion of health and the of the biggest changes to the Kolars has also worked to Perhaps the most valuable aspect Medical School’s curriculum to Making A Global Impact ministry of healing. At the time of develop the Innovation Grants of the professorship has been be launched in decades,” says Initiative, through the U-M As the first senior associate Ladd’s death in 1945, the foundation the latitude it has allowed Kolars Kolars . “The main orientation Office of Continuing Medical dean for education and global was valued at $19 million. over the years . “Many times, was in trying to prepare medical
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initiatives, Kolars leads efforts create new initiatives . The fact between the schools and their wave of change that is going on to adapt and enhance the full that I’m coming from a strong affiliated hospitals . in China spectrum of medical training — institution in the United States He has played a leadership from undergraduate to continuing with an esteemed professorship role in China in shaping their ABRAHAM FLEXNER AWARD FOR education to biomedical research lends credibility in the global competency-based medical DISTINGUISHED SERVICE TO MEDICAL education — and to bring it environment, and this has been an education movement . “We have EDUCATION together with global impact . asset in my career ”. collaborations with the China He serves as director of U-M Joseph Kolars, MD, was the In 2010, Kolars was appointed Medical Board and Global Reach, created to help inaugural co-director of the Joint the Ministry of recipient of the 2019 Abraham facilitate and promote the Medical Institute for Translational and Health,” School’s international initiatives Flexner Award for Distinguished Clinical Research between the he says . in research, education and University of Michigan Medical “There’s Service to Medical Education from collaborations in health . School and Peking University been the Association of American A large part of his work centers Health Science Center, a virtual this Medical Colleges (AAMC). The around strengthening health institute that consists of four systems in low-resource and thematic programs and three Flexner Award honors individuals underserved countries . “We cores to facilitate joint whose contributions have had a are focused on human capital, research projects and and how we can prepare training initiatives demonstrable impact on advancing better doctors, better nurses medical education. It recognizes the and better health care professionals highest standards in medical who are relevant education and is the AAMC’s most for a country’s or a community’s prestigious honor. needs,” says Kolars . “I’ve spent a lot of time in Africa, Asia and South America working to
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where they’re not just looking at U-M CENTER FOR GLOBAL “The Yamada’s recent gift provides been able to help shape that have how smart a person is, or what HEALTH EQUITY us with an opportunity to show gone on to have an impact in their knowledge base is as a how the University of Michigan, medical education,” During 2019, former Department doctor, but what their performance a great public institution, can says Kolars . of Internal Medicine Chair is about . Also, how performance be relevant to problem-solving “At the Tadataka Yamada, MD, and his can be measured, keeping that at the societal level,” Kolars end of wife Leslie, made a $10 million at the center point of medical explains . “And how we can start gift to inspire faculty to make a education . It’s a big change that’s to assemble a great diversity of greater positive impact on the going through the largest country talent across our institution to health and health care of people in the world, and I was able to address problems in health with the greatest need worldwide . play a part in that ”. care, as well as turn our focus A new U-M Center for Global to social determinants of Kolars has also been instrumental Health Equity is being developed health, and relationship in a sizable movement in Africa to accelerate work addressing “The Yamada’s of policy, economics, with the Medical Education inequities in health in the poorest education and recent gift provides Partnership Initiative, whereby nations and in disadvantaged climate ”. medical schools in Africa are populations in middle-income us with an partnered with medical schools in countries . SHAPING THE Kolars during one of his opportunity to show the United States to enhance the Building on the Yamadas’ FUTURE trips to Beijing, China quality of their education and the how the University vision, the new center’s initial number of health care providers . “I As a revered leader in medical concept was developed by a the day, I think my best work of Michigan, a great felt very fortunate to be a part of education at U-M for three team led by Kolars and John Z. has been the one-on-one with that movement at the leadership decades, Kolars reflects on what public institution, can Ayanian, MD, MPP, who leads students, trainees and faculty who level, but also in playing a has been most important to him . the U-M Institute for Healthcare are trying to shape their careers . be relevant to consulting role with different “The most memorable part has Policy and Innovation and holds If my success or impact was to be governments, civil society and the been the team building I’ve been problem-solving at professorships in the Medical measured, it would be the chance institutions themselves in terms able to participate in, and the School, School of Public Health, to touch these different lives, and the societal level.” of transforming their schools for extraordinary group of people I’ve and Gerald R . Ford School of to be touched by them, in terms better education and better care in learned from, not only in terms of — Joseph Kolars, MD Public Policy . of creating new solutions and Africa,” says Kolars . mentors, but also the careers I’ve opportunities in education ”.
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Funding for cancer research is allowing internal medicine faculty to make a world of difference.
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Gary Hammer | Millie Schembechler Professor of Adrenal Cancer
TACKLING ADRENAL CANCER
PROFESSORSHIP GALVANIZES GLOBAL BLITZ ON RARE CANCER WITH U-M OUT IN FRONT It was 1999, and Gary D. program at U-M . After a torrent said, ‘Dr . Hammer, I have just Hammer had become the Millie to share samples and data, Hammer, MD, PhD, was fresh of interviews, his last meeting one question for you: When Schembechler Professor of unveiled pathways driving the from his postdoc and being was a group dinner with you negotiated with these Adrenal Cancer in the Division development and virulence of vetted to launch an legendary football coach Bo gentlemen, did you negotiate of Metabolism, Endocrinology this deadly disease, identified international Schembechler . Schembechler football tickets? Because, if you & Diabetes (MEND) as well as and tested some of the first adrenal had lost his beloved wife Millie didn’t, you’re a damn fool ’. The the inaugural director of the new therapies in 60 years, even cancer to adrenocortical carcinoma and place roared with laughter as Endocrine Oncology Program in helped draft national rare- was raising millions toward an Bo sat down, eyes transfixed, the Rogel Cancer Center . “When disease legislation . endowment he hoped would without even the hint of a smile . I started, we had just a handful When asked how they did it, spare others the same fate . So I stood up, took his hand and of doctors working on adrenal Hammer answers with a single Sitting in the Gandy Dancer as replied, ‘Bo, I think that’s why cancer, two rooms in the cancer word — “leverage.” Schembechler strolled in, you’re here tonight .’” center and no nurse,” says Hammer thought a train Hammer . “We’ve now grown Hammer reflects fondly on that THE TEAM was passing . “The whole to more than 25 physicians and meeting, as he knew it was a test . place, 300 people or so, scientists, 20 rooms and the Hammer is the first to admit he “He wanted to be sure I wasn’t a stood up and started largest, most recognized adrenal stands on the shoulders of giants . shrinking violet,” he says . clapping,” he says . cancer program in the world ”. U-M has a nearly 70-year history “As Bo reached the Instead, the coach found the of pioneering work in the adrenals, But more than that, U-M’s table, the room young doctor very much his from identifying Conn’s syndrome adrenal team has led along fell silent . He equal in grit and passion . The (page 36) to birthing the field of every dimension — it’s looked me dead men became fast friends and endocrine surgery to developing catalyzed two global networks in the eye and fellow crusaders . By 2005,
“Through his endowment, Bo Schembechler not only launched my professional life, he resurrected U-M’s adrenal preeminence and ignited the adrenal cancer community around the world.” — Gary Hammer, MD, PhD
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the first nuclear imaging agents began hosting golf tournaments, “To flesh out the team, we So, with Schembechler funds, In one Bo and Millie for adrenal disease . drawing NFL players, celebrities needed specific expertise — he and his U-M colleagues of the Schembechler and U-M alumni, ultimately and we wanted the best ”. hosted a meeting in 2003, first big But despite this expertise, raising several million dollars inviting the handful of adrenal payoffs adrenal cancer is so rare — To make this happen, Hammer’s to fund a professorship and cancer researchers around the of this fewer than 1,000 cases are strategy was to let the research fund in his wife’s name . world . What began as a series cooperation, diagnosed in the U .S . each endowment grow . “That way, of tentative conversations the National year — and often shows As the steward of both when we found someone we evolved into two cooperating Cancer no symptoms until it has endowments, Hammer knew wanted to recruit, we had global networks: ENS@T, the Institute metastasized, that Millie’s he would have to use them resources for their startup European Network for the Study agreed to deep U-M doctors had little to offer strategically to make a packages . That made it easier of Adrenal Tumors, and the A5, sequence adrenal when she was diagnosed . “The dent in a disease that was for departments to hire them, the American Australian Asian cancer through the only drug they had — and still poorly understood and wildly and that’s how we got the Adrenal Alliance . Cancer Genome Atlas . It the only drug approved for underfunded . His goal was country’s leading adrenal was a coup to get a rare adrenal cancer — is mitotane, a leverage — making each experts, like Rich Auchus and Although he credits Schembechler cancer included in derivative of the pesticide DDT,” investment yield proliferating Bill Rainey, as well as the next for this outcome, Hammer’s the project, and it says Hammer . “It’s used because returns . generation of leaders like Tobias influence is difficult to write off . “If was possible it’s fatally toxic to adrenal cells, Else and Adina Turcu .” Gary sets his mind to something, He started with Schembechler’s only because but it only works in about 20 God help you if you’re in the way most famous mantra: the team, But Hammer had even more Michigan’s percent of patients . Bo became or you’re the target,” says MEND the team, the team . His vision sweeping visions of teamwork . global frustrated because even with a colleague William Rainey, PhD, was to expand U-M’s existing He knew he’d have to connect team that was one of the best in the Jerome W . Conn Collegiate expertise into the best, most researchers and resources around the world, they couldn’t do much Professor, whom Hammer comprehensive adrenal team in the world if the field had any for Millie other than operate, recruited to U-M when he was the country . “We started with hope of gathering the data, tissue not for a cure but to combat decidedly not looking for a job . leaders like endocrine pathologist samples and patient participation tumor growth and control the “His enthusiasm is unlimited, and Tom Giordano; Ed Schteingart, it would take to understand excess steroids her tumor was his ability to bring people together who was Millie’s endocrinologist; such a rare disease, forge producing .” around a common vision is like and Michigan’s top endocrine new treatments and conduct nothing I’ve ever seen ”. When Millie passed away, Bo surgery, medical and radiation meaningful clinical trials . turned his grief into action . He oncology teams,” says Hammer .
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partners were able to deliver 100 that drive adrenal cancer, ZNRF3 gene, which accounts for designed for atherosclerosis cells with the most mutations samples within months . improving prognostics and 20 percent of adrenal cancers into one for adrenal cancer . also have the highest levels of suggesting potential treatments . and is likely to be targetable The drug, ATR-101, changes cortisol . Cortisol inhibits the In a more recent example of by drugs currently under the way cholesterol is handled immune system . So we think leverage, the worldwide tissue In a 2019 paper in Clinical development . in the body, making it fatally adrenal cancer is essentially bank and genomic database U-M Cancer Research, Hammer’s toxic to adrenal cells, which use using cortisol to hide .” launched on behalf of the A5 drew group reported on a technology The third stratification pathway cholesterol as a steroid precursor . On the invitation of substantial support from donors they’ve patented that uses the is driven by cell cycle activation His lab has just received two Kerppola used her background Hirair and Anna Hovnanian . The molecular features of a patient’s and DNA methylation, and results large Department of Defense Senator Ted Kennedy, in the pharmaceutical industry database and repository, which is disease to stratify them by risk in the most aggressive cancer, grants to study this process to study ATR-101, co-launch Hammer helped draft now named in their honor, allows of recurrence and identify key says Hammer . Members of his and determine if inhibiting Millendo and shepherd the drug for a collaborative global effort, treatment targets . lab are working to understand the cortisol production will make health care legislation into phase I clinical trials before which is pivotal for rare diseases, underlying biology in the hopes of immunotherapy more effective . Interestingly, two of the her passing . directed at rare cancers. as researchers across the world identifying therapies that might pathways central to this Hammer says he believes can access the information, improve outcomes for patients . A final treatment insight While overshadowed by stratification, IGF and WNT the field is approaching a identify biomarkers and genetic concerns immunotherapy, which signaling, were among the first To further the development of new watershed moment when a healthcare reform, the markers, study genetic syndromes has traditionally been ineffective Hammer studied with the help therapies, Hammer has helped single treatment, approved of tumors, and accelerate in adrenal cancer . “We knew bill began a dialogue, of Schembechler funds . His launch two U-M spinoffs . The in the 1950s and based on a discovery by enabling large-scale, that adrenal tumors contained lab’s work on the IGF pathway first, Vasaragen, aims to develop pesticide, will finally yield to a advocating for research long term longitudinal studies of very few immune cells, but we helped set the stage for phase precision treatments matched to future of personalized medicine . patients . didn’t know why,” says Hammer . funding and insurance I, II and III clinical trials of the patients’ key mutations, leading “This is all because of Bo,” he “In most cancers, the number IGF-inhibitor linsitinib, which led with the IGF pathway . says . “Bo taught me to be bold, coverage for patients to PATHWAYS, PROGNOSTICS & of immune cells correlates to to progression-free survival in to have the courage to hire and DRUG DEVELOPMENT The second, Millendo how many mutations there are receive care at national patients for whom IGF was the work with people smarter and Therapeutics (a portmanteau of — the more alien the cancer Thanks to the Cancer Genome dominant mutation . better than me and to empower centers of excellence. “Millie” and “endocrinology”), cells look, the more immune Atlas sequencing, as well as that team to make a difference . In terms of the WNT signaling resulted from the efforts cells show up . But with adrenal work in Hammer’s lab and those That’s how we’re tackling pathway, Hammer’s group of patient-turned-research- cancer, it was the opposite . We of his collaborators at U-M and this disease and honoring the identified a previously unknown collaborator Raili Kerppola, finally got a clue by focusing around the world, researchers are Schembechler legacy .” loss-of-function mutation in the PhD, MBA, to repurpose a drug on the endocrinology . Adrenal identifying the genetic mutations
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Max Wicha | Madeline and Sidney Forbes Professor of Oncology
MOBILIZING THE VILLAGE
FORBES ENDOWMENT HARNESSES EXPERTISE ACROSS DISCIPLINES TO STRIKE AT THE HEART OF CANCER When Madeline and Sidney to embrace . After all, cancer hopes will end cancer during his “high-risk/high-reward” grants . Wicha has seen Forbes gave the University has proven to be a uniquely students’ careers . Wicha’s team is submitting the value of of Michigan $17 .5 million evasive foe . Yet that is the very the immunology results as endowments to fund multidisciplinary reason for Wicha’s optimism: FREEDOM TO INNOVATE part of a large National Cancer from translational cancer research his research strikes at the heart Institute SPORE grant that aims other Professorships have played a through the Forbes Institute of cancer’s evasiveness — to engage researchers from pivotal role in Wicha’s research for Cancer Discovery, there targeting stem cells, the cells bench to bedside in finding new breakthroughs, first through the was no one better to lead the most responsible for metastasis, approaches to battling cancer . Distinguished Professorship in effort than Max Wicha, MD . invasion and recurrence . He previously used his track Oncology that he held as head An internationally recognized record of innovation to secure Thanks to his sprawling vision, of the cancer center, and now breast cancer researcher, Wicha an R35 grant, the NCI’s his “village” of collaborators as the Madeline and Sidney served as chief of the Division Outstanding Investigator and the funding that has given Forbes Professor of Oncology . of Hematology and Oncology for Award, designed him the freedom to pursue “Endowment funding led to a decade and as the founding to allow cancer’s out-of-the-box ideas, Wicha our discovery of breast cancer director of what is now the most accomplished is unmasking the role of stem stem cells,” says Wicha, “and Rogel Cancer Center for 30 researchers to be cells in cancer and developing more recently has allowed us to years . Perhaps most importantly, adventurous in cunning ways to disarm them . partner with immunologists to Wicha epitomizes the Forbeses’ breaking new Known internationally for being get the immune system to target vision for cancer research: ground, rather the first to identify cancer these cells .” He collaborates vigorously than spelling out stem cells in a solid tumor, with partners in six university The big granting agencies exactly what they he’s identified the molecular departments, around the world increasingly want projects that propose to do . markers that characterize these and in the pharmaceutical already have evidence that cells, helped build tools to industry, harnessing wide- they’re going to work, he says, isolate and interrogate them, ranging expertise for a single and endowment funds can help “The Forbes Institute has fulfilled a dream of mine — to have philanthropic and conceptualized treatments goal — to cure cancer . provide that . — from vaccines to cellular money that can be used to stimulate new collaborations and ideas.” Cure . It’s not a word many in reprogramming — that he But they can also be leveraged — Max Wicha, MD the cancer community dare into larger, more flexible
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angles as well . He helped endowment — one that provides GROUNDBREAKING FORBES INSTITUTE SUPPORTS develop several professorships seed funding for interdisciplinary DISCOVERIES PROFESSORSHIP & TEAM RESEARCH that were instrumental in cancer research . “We give out There is no better case study recruiting and retaining talent grants of up to $250,000 to help for the results of well-leveraged that has helped make the Rogel move basic science into clinical flexible endowment funding than By creating the Forbes Institute for Cancer Discovery at U-M’s Rogel Cancer Center, Cancer Center one of the best applications,” he says . “It’s about Wicha’s own team’s science in the country . “With the help being creative and original, and Madeline and Sidney Forbes’ gift supports not only the endowed professorship held portfolio . of the Emanuel N . Maisel it’s also about building teams by Max Wicha, but also multidisciplinary team research grants designed to Professorship of Oncology, that capitalize on U-M’s expertise In 2019, Wicha was named for example, we were able to across the 10 different schools U-M’s Henry Russel Lecturer, the accelerate the translation of new technology and therapies to the clinic. recruit Eric Fearon and hold that are involved in the cancer university’s highest honor for onto him as he developed not center — each of which is top 10 senior faculty members . He used only as a terrific scientist but in the country ”. his lecture, “Attacking Cancer In 2019, awards were given to teams working in a variety of areas. One project into an outstanding leader at Its Roots: It Takes a Village,” The money is flexible and aims to use a U-M-developed ultrasound tumor ablation technology called of the cancer center,” says to demonstrate the value of designed to be leveraged for Wicha . “The same is true for cross-disciplinary cooperation histotripsy to sensitize resistant cancers to immunotherapy. greater impact . “We can buy Dan Hayes, one of the world’s in turning the tide on cancer equipment for people,” says top breast cancer researchers, metastasis and recurrence . Wicha . “One of the grants helped who holds the Stuart B . Padnos Another is using lab and computational approaches to determine how abnormal fund pilot costs in single-cell While great strides have been Professorship of Breast Cancer spatial analysis that went on made in areas such as early metabolism causes treatment resistance in brain tumors in the hopes of Research .” These and other to receive a large grant from detection, immunotherapy and professorships — including one developing better treatments. President Mark Schlissel’s drugs targeting the mutations named in Wicha’s honor — are Biosciences Initiative . In addition, specific to a patient’s cancer, big crucial to keeping U-M at the the SPORE proposal we’re challenges remain . Most notable cutting edge of cancer research, A third is studying a molecularly modified sugar-binding protein from bananas that submitting involves about 30 are relapse — where a patient’s education and care . people in 10 labs working on cancer becomes resistant to can target sugar-coated molecules on cancer cells. Led by David Markovitz, MD As director of the Forbes cancer stem cells, and each of treatment — and metastatic (Infectious Diseases), the team plans to use the protein to help immune cells seek Institute for Cancer Discovery, the projects has done preliminary disease, for which targeted and Wicha stewards another type of research with Forbes funding ”. and destroy lung cancer.
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immune-based therapies have purpose . One is an unlimited differentiate them from other as a cancer stem cell marker,” various transcription factors to SINGLE CELL RNA ANALYSIS not been as effective . capacity for self-renewal . cancer cells and finding drugs to says Wicha . “It’s delivered by cells can cause them to change A major challenge to targeting Another is plasticity . Wicha’s target the pathways that regulate a nanoparticle, developed by types — even going from a fully This is because stem cells, which cancer stem cells has group and others have found that them . He has co-founded James Moon from the College of differentiated cell to an induced may comprise only 1 to 5 percent been determining whether stem cells can rewire themselves OncoMed Pharmaceuticals Pharmacy, right to dendritic cells pluripotent stem cell . of a patient’s cancer cells, have therapies are effective . Are to avoid relying on a pathway to develop stem cell-directed of the immune system . We found unique properties that make “We launched a collaboration they actually killing the stem being targeted by a drug . They therapies, and the cancer center that by combining the vaccine them resistant to therapy and with Indika Rajapakse, a brilliant cells, reprogramming them or can change states — from a has run seven breast cancer with an immune checkpoint almost diabolically mathematician who was affecting a targeted pathway? mesenchymal type suited to clinical trials for them . blocker, we can almost suited to looking at how the structure Learning this required a way metastasis to an epithelial one completely knock out cancer stem their of chromatin regulates gene to identify and capture these programmed for proliferation . CANCER STEM CELL VACCINE cells . We’re looking at adding expression,” says Wicha . “He rare cells and sequence their They can lie dormant for years, other antigens so the cancer is One of Wicha’s latest developed an algorithm that RNA to determine which only to be reawakened without less likely to develop resistance . collaborative projects is a allowed us to predict, based on genetic pathways were active . notice . They can even travel Dr . Moon has formed a company vaccine against cancer stem the three-dimensional chromatin With funding from the Forbes through the bloodstream, in Ann Arbor to commercialize cells . It was an outgrowth of structure, which transcription endowment, Wicha collaborated not only as a single cell, the vaccines, and we hope to be the finding that immunotherapy factors needed to be added with U-M engineers Euisik Yoon, but as a cluster of running clinical trials here in the is enhanced by chemotherapy in what order to reprogram a PhD, and Sunitha Nagrath, PhD, cells with a portable next year or two ”. — not so much because of the particular cell into any other to develop a microfluidic device microenvironment latter’s effectiveness in killing type of cell . that can capture and barcode ideally suited STEM CELL REPROGRAMMING cancer cells but because doing each cancer stem cell circulating for growth at a “What we want to do now is so exposes the immune system Another of Wicha’s collaborative in the blood, sequence them, distant site . look at the structure of cancer to antigens from the tumor . projects aims to reprogram and then determine which cells stem cells’ chromatin and gene Wicha’s career cancer stem cells into more each sequence came from . Wicha used this insight to expression, and predict how we has focused on differentiated cells that are Wicha believes the technology, launch a collaboration aimed can use epigenetic-like therapies understanding easier to kill . This builds on a called Hydro-Seq, will at developing a vaccine against to reprogram these cells into a these cells, number of previous findings, transform researchers’ ability antigens specific to cancer stem type of cell that is amenable to identifying including those discovered by a to understand and target cancer cells . “Our proof of concept used being killed by therapeutics or to the markers team that won a Nobel Prize in stem cells — and ultimately a peptide against one of the directly induce cell death .” that 2012, which showed that adding lead to a true cure for cancer . molecules we first discovered
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Laurence Baker | Collegiate Professor of Cancer Developmental Therapeutics
PATIENT-CENTERED & MULTIDISCIPLINARY
PROFESSORSHIP RECOGNIZES SARCOMA EXPERT’S BROAD IMPACT ON U-M’S APPROACH TO CANCER After 50 years in medical revolutionizing the treatment of Starting with serendipity Baker a bone sarcoma was amputation . ifosfamide, oral mesna and IGFR-1 oncology, Laurence H. Baker, these cancers, devoted decades spent the first half of his career “You can imagine that one of kinase inhibitors . He also took the DO, has left his mark . One of to testing new diagnostics and at Wayne State University, the last things a teenager wants lead of Wayne State’s oncology the world authorities on therapies and is now closing the deeply engaged in first-in-human is to lose a limb,” he says . “The division, cancer center and the sarcomas, Baker loop with a focus on survivorship . clinical trials . It was through this surgeons asked if we could start sarcoma committee of SWOG launched his work that he came to focus on patients with chemotherapy in (formerly the Southwest Oncology But this impact only scratches career sarcomas — cancers that arise order to build in time to make Group), one of the largest federally the surface . Baker also helped in bone and soft connective better prostheses . This ultimately funded cancer clinical trials U-M usher in the modern era tissue . It’s also how he would led to a partnership with a cooperatives in the world . of cancer care, education and find himself at the center of a pediatrician at MD Anderson with research, and advanced clinical treatment revolution . whom we tested the idea of giving SHARING EXPERTISE research on the national stage . patients chemotherapy followed “One of the very first drugs I It was in 1994 when a He’s received a by surgical resection . The cure worked with in the early ’70s conversation with U-M’s cancer professorship that not rate went from 20 to 30 percent was doxorubicin,” he says . “We center director Max Wicha, only honors his work, up to 70 to 80 percent with this discovered that it worked in a MD (page 89), convinced Baker but will inspire the approach — and patients were number of cancers, including, to bring his expertise in sarcoma development of able to keep their limbs ”. remarkably, sarcoma . Few and clinical research to U-M . cancer therapeutics oncologists at the time were That serendipitous discovery At the time, says Baker, U-M at U-M for years to treating sarcomas, so I took it on ”. cemented Baker’s interest in was best known in cancer for come . sarcomas . He went on to study its basic research . But there At the time the standard other treatments — including was enthusiasm among Internal treatment for young people with
“My success had been in developing a strong training program and recruiting outstanding clinicians, engaging them in clinical research and getting them to partner with lab scientists.” — Laurence H. Baker, DO
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Medicine’s leadership to enrich sarcoma . He’s served as its chair artery disease at a very early and for you to accurately assess other aspects of the mission . and as a principal investigator age,” he says . “It turns out that their needs .” on a SARC SPORE grant testing doxorubicin causes inflammation “My success had been in In 2019, Baker transitioned new therapeutic strategies and of the coronary arteries, which developing a strong training establishing to emeritus status . But he biomarkers . leads to atherosclerosis . program and recruiting is still hard at work, both on this model Survivors can have strokes as outstanding clinicians, engaging for sarcomas and his survivorship program and A FOCUS ON SURVIVORSHIP early as their 20s or 30s .” them in clinical research and helping to make tumor a multi-institutional SPORE getting them to partner with lab boards standard throughout the anchored In recognition of his impact, Facing such complications proposal that will allow him to scientists,” says Baker . cancer center . Baker also helped with strong clinical researchers, in 2012 Baker was named and the specter of recurrence, investigate whether combining the Collegiate Professor survivors often grapple with doxorubicin with a new molecule Asked to do the same at catalyze clinical research — such as Professor Scott of Cancer Developmental anxiety, depression and suicidal that inhibits DNA repair will not U-M, Baker agreed, and was advocating for team science, Schuetze, MD, PhD, and Therapeutics . He’s used thoughts . So, in addition to only make sarcoma treatment appointed deputy director of especially projects designed to Associate Professor Rashmi the protected time afforded working with cardiologists, the more effective, but reduce its what is now the Rogel Cancer move promising lab discoveries Chugh, MD . him by the professorship program has partnered with cardiovascular effects . Center, director of its clinical into clinical trials and trial Baker increasingly took his to create the country’s first the School of Social Work to research and professor in the results back to the lab for While he pursues these passion to the national stage . Sarcoma Survivorship Program . address patients’ psychosocial Division of Hematology and deeper insight . He’s proud that efforts, Baker will retain his From 2005 to 2013, he served Developed with Monika Leja, needs . Oncology . the first team science award professorship . Afterward, it as chair of the SWOG Research MD, assistant professor in from the American Association Baker says the most important will become the Laurence H . The Veteran oncologist got Network . Under his leadership, the Division of Cardiovascular for Cancer Research went to resource his professorship has Baker Collegiate Professorship straight to work . In education, he the group expanded its patient Medicine, the program helps U-M jointly with the Dana- given him in this effort is time . of Cancer Developmental helped revamp resident rounding advocate and cancer prevention patients deal with sarcoma’s Farber Cancer Institute . “I don’t see patients in a typical Therapeutics, and it will support and the Hem/Onc fellowship, programs, partnered with major adverse outcomes: 15-minute slot,” he says . “I another torch bearer while putting the patient experience at In his own lab, Baker continued basic science centers and recurrence, heart disease and see them for an hour or more . memorializing Baker’s prodigious their core — and making U-M his work on sarcomas, testing established a biospecimen psychosocial distress . This is a young population of legacy . a coveted Hem/Onc training advances from diagnostic blood bank, which is now a global “What we’ve learned since cancer survivors who struggle destination in the process . He tests for circulating tumor DNA resource for cancer research . our early success in treating mightily, and you have to spend did the same for patient care, to new chemotherapy regimens Baker also helped launch SARC, young patients is that, while time together for them to be serving as an early champion designed to prevent recurrence an organization that fosters we cured the vast majority, comfortable talking with you of multidisciplinary care — and limit side effects . He also collaborative research among built U-M’s sarcoma team, national centers of excellence in many developed coronary
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Francis Worden | Nancy Wigginton Oncology Research Professor of Thyroid Cancer Megan Haymart | Nancy Wigginton Endocrinology Research Professor of Thyroid Cancer ADVANCING THE TREATMENT OF THYROID CANCER
IMPROVING PATIENT CARE IN MEMORY OF NANCY WIGGINTON In 2007, Nancy Wigginton, of aggressive and had spread passed away in 2013 at the age the same drugs that are now benefit, yet had not been proven West Bloomfield, Michigan, was to her brain, which required of 65 . FDA-approved for thyroid cancer ”. by clinical standards ”. diagnosed with an advanced radiation treatment that she “Once Nancy’s disease became Worden reflects with great Wigginton was part of the papillary thyroid received at Henry Ford Hospital,” refractory to radioactive iodine, fondness on the period of landmark trial with Sorafenib, a cancer . “The says Francis Worden, MD, i e. ,. when iodine was not taken time he provided medical care drug that inhibits the effect of cancer was professor, Division of Hematology up by her tumor and radiation for Wigginton . “We shared proteins (tyrosine kinases) that rather and Oncology . was no longer effective, she was meaningful time together . Nancy are overactive in many of the Together with Megan Haymart, referred to me by Dr . Haymart . asked some pretty difficult pathways that cause cells to be MD, associate professor, who Nancy’s disease had spread questions about her prognosis cancerous . “She really believed has a primary appointment in beyond her head and neck at and about her own mortality . in the benefits that she was the Division of Metabolism, that point, involving her lungs We learned from each other, and getting from the clinical trials, Endocrinology & Diabetes, and perhaps her bones,” says she was very special to me,” he and was able to have somewhat and a secondary Worden, whose clinical research says . “Nancy was a courageous of an improved quality of life appointment in the focuses on the treatment of and thoughtful woman who and to live longer than she Division of Hematology patients with head, neck and was always looking for a new probably would have otherwise . and Oncology, the thyroid cancers . “At the time, opportunity to treat her cancer . In Today’s treatment options, which team cared for drugs were just beginning to be this regard, she was very brave to are fairly effective, were just Wigginton until she launched from clinical trials for participate in clinical trials with not available then, and Nancy’s the treatment of iodine-refractory drugs that were showing some participation really helped to differentiated thyroid cancers;
“Nancy was a courageous and thoughtful woman who was always looking for a new opportunity to treat her cancer. In this regard, she was very brave to participate in clinical trials with drugs that were showing some benefit, yet had not been proven by clinical standards.” — Francis Worden, MD
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produce new therapies,” says will focus on clinical research of gifts from very generous that you might observe in other Worden . for thyroid cancer, including individuals like Jim and cancers, such as breast or lung the Nancy Wigginton Oncology Nancy,” says Worden, who in cancer, where if a particular Nearing the end of her life, Research Professorship in Thyroid collaboration with the U-M agent doesn’t work, there may be Wigginton approached Cancer awarded to Worden; Endocrine Oncology Program a second line agent,” he explains . Worden and said, “I want to and the Nancy Wigginton has been the leading medical “I am presently enrolling patients do something for you,” and Endocrinology Research oncologist for the treatment of with medullary thyroid cancers asked for suggestions . Worden Professorship in Thyroid Cancer metastatic thyroid cancers in the in a clinical protocol with a told her that supporting an awarded to Haymart . state of Michigan . “I am very novel agent that targets the endowed professorship would grateful to have been awarded RET oncogene . The results be invaluable because it could At Worden’s request, the this particular professorship from this clinical trial are due provide funding toward clinical funding was distributed between Nancy and as it focuses on treatments of to be published in 2020, and trials research . After she himself and Haymart . “I believe Jim Wigginton thyroid cancers that are so very will undoubtedly lead to an passed away, her husband, it is extremely important for rare . This honor is meaningful approval by the FDA . We will Jim Wigginton, expressed an these professorships to be to me in so many ways, namely next test to see if this agent interest in supporting thyroid shared across disciplines in it will allow me to collaborate performs better than standard cancer research at U-M . He the Department of Internal further with colleagues in tyrosine kinase inhibitors that was especially interested in Medicine, bridging oncology developing and treating patients are approved and commercially supporting Worden, as well as with endocrinology,” he under clinical trials that will available for this particular Haymart, who was involved explains . “I also think it’s hopefully continue to change the cancer ”. in health outcomes research important in this era to support therapeutic landscape of these related to thyroid cancers, a women in medicine . Megan is a The professorship is also malignancies ”. strong interest of his . world leader, and, with support allowing Worden time to from this professorship, she can establish smaller pilot projects . TESTING NEW TREATMENTS TWO PROFESSORSHIPS ARE continue to advance the field of “For example, one of the nuclear ESTABLISHED thyroid .” With this funding, Worden and medicine physicians approached his team have identified novel me about an agent we’ve In December 2019, a generous In general, professorships are agents that are active in thyroid actually used in adrenal cancer gift from Jim Wigginton in honor not commonplace for every cancers . “We don’t really have a that may have some activity in of his late wife Nancy created academic physician . “And hierarchy of treatment regimens thyroid cancer,” says Worden . two new professorships which oftentimes they are the result
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“So we’re talking around the hypothesis with a prospective understudied, and she saw collaborate with individuals at exceptionally devoted to her and idea of developing a pilot clinical study,” he says . “This an opportunity to make a other institutions to make sure to the idea of improving the care study, which means treating a is an investigator-initiated difference through research . that we have greater reach with of patients with thyroid cancer . small group of patients after study, and such an opportunity “The lack of high-quality the work that we’re doing,” she I’m deeply honored to receive they’ve failed their conventional would not be possible if we research influenced the quality says . “Without Mr . Wigginton’s this professorship .” Jim Wigginton created treatments to see if there is did not have additional funding of patient care,” says Haymart, support we wouldn’t be able to a signal suggesting clinical to pay for data management, who in the past decade built and build the team that we currently two professorships to activity ”. a research nurse and the now leads an internationally have . And we wouldn’t have honor his late wife additional non-standard of care recognized research team nearly the level of productive Another idea from the endocrine PET scans that will be required ”. focused on outcomes and health data we’ve collected with Nancy, which will focus oncology team is to evaluate services research in thyroid our research . We’re very the responses to tyrosine Worden is grateful for the on clinical research for cancer diagnosis, prognosis, appreciative of his interest in kinase inhibitors before and exceptional support he and management and survivorship . our work . We are inspired by thyroid cancer, including after undergoing PET imaging . Haymart have received from Her investigations focus on our patients, especially Worden and Anca Avram, the department . “The backing the Nancy Wigginton variation in the management of by the Wiggintons . MD, professor, Radiology; from John Carethers, MD, thyroid cancer, with an emphasis Jim is someone Oncology Research director, Nuclear Medicine chair, Department of Internal on the role of patients, providers who loved his Medical Student Education; Medicine, has been very Professorship in Thyroid and health systems in thyroid wife dearly,” and medical director, Nuclear important to us,” says Worden . cancer diagnosis and treatment . says Cancer awarded to Medicine Therapy Clinic, “John very much values Haymart . conducted a retrospective endowed professorships, and he Haymart has set up Worden; and the Nancy “He was analysis that suggested the has been exceptionally helpful in collaborations with other Wigginton Endocrinology degree of response on PET bringing these gifts to fruition ”. researchers at U-M with imaging correlated with duration complementary skills, including Research Professorship of treatment response and IMPROVING MANAGEMENT OF survey methodology, health in Thyroid Cancer. progression-free survival in THYROID CANCER economics and decision patients receiving tyrosine psychology, and with clinical For years, Haymart has kinase inhibitors for their iodine- colleagues who have expertise recognized that thyroid cancer refractory thyroid cancers . in surgery and radiology . “More research was underfunded, “The idea now is to test this recently we’ve started to leaving thyroid cancer Megan Haymart, MD
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Reddy Family Genetic Medicine Cancer Fund
THE REDDY FAMILY GENETIC MEDICINE CANCER FUND
GOUTHAM NARLA, MD, PHD, SUPPORTS FUNDING FOR A PROFESSORSHIP FOCUSED ON ADVANCING CANCER RESEARCH “If my grandparents were alive Family Genetic Medicine Cancer Department of Obstetrics & that my division and others health care and today to see our efforts in Fund within the U-M Division of Gynecology, and other members are doing from a sequencing research funding, establishing this professorship, Genetic Medicine in memory of of his family, and is expected to perspective . And then pairing oftentimes our they would be very happy,” says and to honor his grandparents be fully endowed within the next that with our oncologists to biggest and boldest Associate Professor Goutham R S. N. Murthy and Bhaskaramma four years . allow patients with metastatic ideas can be difficult Narla, MD, PhD, chief, Division Reddy for their unwavering cancer to get the newest and best to support from more From a long-term perspective, of Genetic Medicine . Narla’s commitment and passion for therapies ”. traditional mechanisms, such Narla believes that the impact grandfather had prostate cancer medicine and education . “This as the National Institutes of of the professorship will be in Looking forward, Narla and his and passed away a few years is actually a currently endowed Health or other funding agencies,” the development of new ways to family would like to support a ago, and his grandmother was an cancer fund, and the idea is that says Narla . “I really think that my treat cancer, coupling knowledge faculty member who believes ovarian cancer survivor who then it would eventually be converted philanthropy paves the way parents, as well of the genetics and genomics in and has a track record of developed mesothelioma years to a professorship in the family’s for some of our most bold and as the University of Michigan, for of cancer with novel targeted mentorship of the next generation after that . She passed away in name after monies are in place,” audacious ideas, and gives them doing such an exceptional job in therapies . “In the near term, it of physician-scientists and genetic 2019 . “Both were born in India says Narla . The mission of the a chance to really see the light of raising money to support those would result in better access to counselors . “The idea is to support and believed so much in the fund is to support highly innovative day . I am so incredibly grateful to bold ideas and concepts ”. patients, especially those who the research efforts, the laboratory education of their children and basic and clinical research, and are underserved,” says Narla . and an individual who really grandchildren . This professorship educational activities in the field “And I mean that broadly — from epitomizes that commitment,” he would mean so very much to them of cancer with a goal toward minority populations to those explains . “Of course, we want that The Reddy Family in that an institution of this caliber further developing new therapies who are socioeconomically person to be doing cutting-edge — the University of Michigan for cancer patients . Genetic Medicine disadvantaged to those in rural science in medicine . But we also — is partnering to eradicate The fund has already grown, areas of Michigan — to really want that person to be someone Cancer Fund was cancer and further the mission of with gifts and pledges from have access to state-of-the-art who truly believes in mentorship education ”. created to honor additional donors, including genetics testing and precision and is focused on education ”. A gift from Narla’s mother, Narla and his wife, Analisa medicine . For example, expanding R.S.N Murthy and Narla is optimistic that this Jyothsna Narla, MD, a pathologist DiFeo, PhD, associate professor, patient populations that have dream will come to fruition . “In Bhaskaramma Reddy. in San Jose, California in the fall U-M Department of Pathology, access to state-of-the-art the ever-changing landscape of of 2019, established the Reddy and associate professor, U-M sequencing at U-M, and things
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Professorship support is inspiring faculty to boldly explore new ideas, bring them into the clinic and dramatically improve patient outcomes.
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Rodica Busui | Larry D. Soderquist Professor
TARGETING DIABETES COMPLICATIONS
PROFESSORSHIP HONORS CAREER ADVANCING DIABETES CLINICAL RESEARCH AND CARE When Rodica or even insulin syringes,” she to nerve damage at a molecular She arrived in what is now events in adults with type 2 Busui, MD, PhD, says . “I remember rushing to level . So, after her residency, the Division of Metabolism, diabetes . was introduced the hospital every morning to she pursued a PhD in molecular Endocrinology & Diabetes under Not only would this experience to diabetes in boil urine before the wards biology, using her dissertation Division (MEND) Chief Douglas provide the foundation for a the 1980s as a opened and dosing insulin with to examine the role of oxidative Greene, MD . An expert in the number of insights Busui would medical student archaic, heavy instruments with stress in this process . pathogenesis and prevention of generate during her career in Timisoara, blunted needles ”. But what diabetic neuropathy, he became This preparation put her in the about the relationship between Romania, she she remembers most were the Busui’s mentor . At the bench, ideal position to exploit an event blood sugar fluctuations, cardiac had no way of complications . That’s when they explored new mechanisms that opened up opportunities she autonomic neuropathy and knowing she’d she became determined to do behind peripheral nerve damage could never have imagined . “The cardiovascular risk, it also gave one day be at everything in her power to help in diabetes, which they hoped resources for diabetes research in her experience in the very type of the leading edge patients with diabetes have a would lead to disease-modifying Romania were nonexistent,” says research the MEND Division was of the field . “As better life . therapies . Then, with Martin Busui, “but the [1989] revolution eager to develop . medical students, Stevens, MD, Busui engaged opened doors for me ”. In 1995, we didn’t have BUILDING EXPERTISE in clinical studies of autonomic So it was in 2005 that Busui was she was able to take advantage of glucose meters nervous system dysfunction in the recruited back to U-M to develop Preventing complications became her newfound freedom to pursue diabetic heart . a diabetes clinical research Busui’s mission — particularly postdoctoral research in the U S. . program . Division Chief Peter the peripheral neuropathy that on a Fulbright Scholarship . A faculty position in Ohio “The resources for diabetes Arvan, MD, PhD, (page 72) took led so many of her patients to introduced Busui to clinical “They asked me where I wanted the bold step of encouraging research in Romania were amputations and the cardiac research . She became a principal to go, and I immediately said, her to shutter the basic research autonomic neuropathy that investigator in the Action to nonexistent, but the [1989] ‘Michigan!’” says Busui . “There portion of her lab and focus on predisposed them to sudden Control Cardiovascular Risk in was a pause, and they replied, ‘Do becoming a leader in translational revolution opened doors for cardiac death . As a medical Diabetes (ACCORD) trial, which you know how cold it is there?’ and clinical research . Though it trainee, she became involved tested the efficacy of tight me.” But I began rattling off all of U-M’s rankled her a bit at the time, she in the first diabetic foot salvage glycemic control, tight blood expertise in endocrinology and says, it was some of the best — Rodica Busui, MD, PhD efforts in Romania . But she also pressure control and the treatment diabetes, and they could see I had advice she ever received . wanted to better understand why of multiple blood lipids in lowering made my decision ”. diabetes predisposed patients the risk of major cardiovascular
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INSIGHTS & LEADERSHIP glucose control — as well as Busui has offered expertise other complications in type 1 As robust as her body of the efficacy of various prevention and leadership to many of the diabetes; the inability to reverse research is, Busui is also In the ensuing decade and a and treatment strategies . She landmark diabetes trials funded established complications with a compassionate clinician, half, Busui has dug deeply into PREVENTING collaborates on much of this by the National Institutes of later glucose control; and the dedicated educator and how complications develop from AMPUTATIONS work with her U-M colleague and Health, including ACCORD, superiority of insulin-sensitizing dynamic university leader . She a mechanistic standpoint — mentor, Eva Feldman, MD, PhD, the Diabetes Control and over insulin-providing treatments is co-director of the Michigan In 2018, Busui built on her especially why some patients the Russell N . DeJong Professor Complications Trial/Epidemiology in reducing peripheral neuropathy Peripheral Neuropathy Center earliest work in diabetic develop them while others are of Neurology . of Diabetes Interventions in type 2 diabetes; and the role and vice chair for clinical neuropathy by helping protected, regardless of their and Complications (DCCT/ of cardiovascular autonomic research in the Department of to launch a diabetic EDIC), a multicenter clinical neuropathy as an independent Internal Medicine . In her latter foot research center at trial of allopurinol to Prevent risk factor for cardiovascular role, she has supported the U-M within the NIDDK’s GFR Loss in Type 1 Diabetes events and death in type 1 and Medical School’s ambitious Diabetic Foot Consortium. (PERL), Glycemia Reduction type 2 diabetes . overhaul of its clinical trial The center is helping to Approaches for Diabetes: A enterprise and worked to validate biomarkers that More recent team science with Comparative Effectiveness connect researchers across predict healing outcomes U-M colleagues has provided Study (GRADE), Bypass disciplines and along the and suggest appropriate insight into the heterogeneity in Angioplasty Revascularization research continuum . “My goal treatments. patients’ risk for complications, Diabetes 2 (BARI-2D), Targeting is to create mechanisms that including differences in amino The center builds on the Inflammation with Salsalate for foster communication along acid and TCA metabolism success of a MEND- Type 2 Diabetes (TINSAL T2D), as the entire pathway from our between those who do and podiatry partnership well as many other foundation- talented bench colleagues do not develop complications, that led to a 50 percent and industry-funded and who are identifying critical as well as a genetic locus on reduction in the rate investigator-initiated studies . disease pathways to our clinical chromosome 2 associated with of major, nontraumatic researchers who can design Through this work she has significant protection against lower limb amputations trials for proposed interventions contributed foundational insights, diabetic neuropathy . They for Michigan Medicine to our outcomes researchers including the importance of are now working to identify patients. who can study the intervention early, tight glucose control therapeutic targets relevant to in clinical practice,” she says . for the prevention of cardiac these findings . Department Chair John Carethers, MD; Executive Vice Dean Carole Bradford, MD, MS; autonomic neuropathy and Busui and Division Chief Peter Arvan, MD, MS
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One of her signature resources, irrespective of their is funding another mentee so contributions has been The Larry D. Soderquist sex,” she says . that he is not in clinic every day developing infrastructure to train and has some protected time Professorship, which Of course, the resources that the next generation of clinical for research . come with the professorship research leaders . In partnership aims to accelerate are highly prized as well . This kind of informal support with Assistant Dean for Clinical medical research “Professorship support gives for young investigators is a Research Anna Lok, MD, MSc you the freedom to be bold, critical complement to the early- (page 103), Busui co-created related to type 1 to explore something out career professorships recently the Clinical Trials Academy . diabetes, was created of the box that is not ready established by the department Designed to be the clinical- for traditional funding, but (page 62) . “Dr . Carethers trial counterpart of MICHR’s by William K. and may lead to a much bigger awarded three of these highly successful R01 Boot Delores “Dee” Brehm discovery,” she says . Busui professorships last year and Camp, it brings together U-M’s is using her professorship three this year,” she says . “They leading trialists, statisticians to conduct experiments on provide support for talented and regulatory experts to the heterogeneity in the young investigators, giving teach junior faculty how to risk of developing diabetes them a boost of confidence and design robust clinical trials . Its related to type 1 diabetes, Busui also feels a kinship to the fact that you are seen — complications . the freedom to pursue their graduates have already secured was created by William K . and Larry Soderquist . Like Busui, he these are so valuable ”. ideas and acquire data for a government, philanthropic and Delores “Dee” Brehm (page 73) was a Fulbright Scholar, a holder Busui is also using her Being the first woman in her successful grant submission . The industry funding and launched in memory of Dee’s brother . The of dual doctorates and a leading professorship resources to division to receive an endowed professorships also recognize investigator-initiated trials . award is resonant for Busui on a expert in his field, which was support her mentees as they professorship is especially the senior, very accomplished number of levels . securities law . seek sustainable funding of significant to Busui . “It’s faculty in the department for THE REWARDS OF A their own . She funded one of “First, it is an inspiration to have She is also deeply appreciative of important that Dr . Carethers whom they are named . This is PROFESSORSHIP them to present her research a professorship created by Dee the recognition the professorship has put so much effort into another professorship initiative at an important international It is for this body of work that in Brehm,” she says . “Dee has provides . “It is enormously acknowledging the excellent that has had a huge impact meeting, where she won best 2019, Busui was installed as the been fighting type 1 diabetes meaningful that the work I do quality research and work on our faculty, and it has been oral presentation, met and Larry D . Soderquist Professor . for 70 years . She and others is as recognized here at U-M as that is done by women in our rewarding to participate in it .” learned from other researchers, The professorship, which aims like her are the reason I am so it is externally,” she says . “The department, and is working and began to establish her to accelerate medical research passionate about what I do .” positive feedback, the prestige, to give faculty equal access to this type of recognition and international reputation . Busui
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Anna Lok | Alice Lohrman Andrews Research Professor of Hepatology, Dame Sheila Sherlock Distinguished University Professor of Hepatology and Internal Medicine
TRANSFORMING HEPATITIS TREATMENT
USING COMPLEMENTARY ENDOWMENTS TO BUILD HEPATOLOGY’S FUTURE Anna Suk-Fong Lok, MD, training, landed the field’s most three times a week was as focus on the natural history of and director of a clinical program, DSc, has defied doubters at coveted fellowship at the Royal effective as daily injections but hepatitis B . After quickly becoming had I not trained with the best several points in her career to Free Medical School in London . with fewer side effects became the equivalent of a full professor, in the world,” she says . “Dame become an international leader the worldwide standard of care for she decided to again defy the Sheila inspired me and many This fellowship introduced in hepatology with a legacy of the next decade . advice of those around her and others that it’s possible for women Lok to the woman who would turning robust clinical research leave her comfortable position to reach the top in science and become her mentor as well as the Under Sherlock’s influence, Lok into better care for patients with for what many thought would be medicine ”. namesake for the Distinguished developed her deep commitment hepatitis B and C . In the process, “professional suicide” in the U S. . University Professorship she to mentoring, her forthright style she’s been awarded most of “My colleagues felt that hepatitis LOK’S RESEARCH IMPACT would receive from U-M in 2019 of teaching and her personal the honors the field and the B would soon be eradicated in — Dame Sheila Sherlock, MD . approach to her patients . “I At U-M, Lok built the hepatology university can bestow, including the U S. . as an effective vaccine “Dame Sheila was one of the remember Dame Sheila would program into one of the largest in two professorships, and has had become available, and that I founders of modern hepatology,” ask her patients a lot about their the U S. ,. expanding from five to 16 created endowed research funds would never find a patient base or says Lok . “She was a pioneer, a lives — about their families, even faculty with expertise across the to support the next generation of grant funding,” says Lok . master clinician, an outstanding their pets,” she says . “And she spectrum of liver disease . researchers and the breakthroughs scientist and a mentor to more would put this information into But, eager to take her work to the they’ll incite . She also continued her clinical than 300 trainees from all over the medical record . As a trainee, next level, Lok took the plunge . research program, which would the world, including the only I thought this was strange: Why She accepted a position with PASSION FINDS A MENTOR go on to change how hepatitis B two directors of the Michigan would you document a patient’s Tulane University in 1992 and and C were treated, dramatically Flouting her father’s hepatology program — the late German Shepherd? But I realized then moved on to the University of improving patient outcomes and pronouncement that “science is Keith Henley and myself ”. that the next time she saw the Michigan in 1995 . not for girls,” Lok followed her patient, she would ask after the It was during this fellowship Lok credits “the Sherlock brand” passion into an all-boys school dog, and the patient immediately that Lok first engaged in clinical for her ability to make this leap . for science in the 12th and 13th felt at ease ”. “Dame Sheila inspired me and many others that research . One of her highest- “As a foreign medical graduate grades, proceeding directly into impact studies compared dosing After her fellowship, Lok joined with no clinical training in the it’s possible for women to reach the top in science medical school at the University regimens for interferon in the the medical faculty at the U S. ,. I would not have landed a of Hong Kong . There, she found a and medicine.” treatment of chronic hepatitis B . University of Hong Kong, where faculty position at U-M, let alone passion for hepatology and, after Her finding that dosing patients she began a career-long research an appointment as a full professor — Anna Suk-Fong Lok, MD, DSc completing her gastroenterology
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preventing the progression to methods to assess the severity can cure the disease . Her proof- her battle with liver disease eight cirrhosis and liver cancer . of liver disease, including the of-concept trial paved the way for years earlier . Both Charles and Lok Index and the aspartate the development of combinations Alice were U-M graduates, and In hepatitis B, Lok has helped aminotransferase-to-platelet ratio of direct-acting antivirals that can he asked Lok how the family could identify the influence of viral index . These scores — which cure hepatitis C without the use of support U-M’s search for more variants on disease progression indicate a patient’s risk for liver interferon in more than 95 percent effective treatments . and response to treatment . She fibrosis and cirrhosis — allow of patients . has also been involved in clinical Lok says she was deeply moved, clinicians to prioritize patients for trials for all the approved antiviral Lok has also written international but also surprised that Andrews treatment and have been adopted drugs, which have made chronic guidelines for AASLD and WHO would think of her after so much by the World Health Organization hepatitis B a controllable disease, on hepatitis diagnosis, prevention time, particularly when she hadn’t (WHO) and Centers for Disease despite not fully eliminating the and treatment . been able to save Alice . Andrews Control and Prevention (CDC) . virus from patients . told her that what motivated him In hepatitis C, Lok was the first to SUPPORTING PATIENTS, was Lok’s kindness: he recalled Lok has also developed demonstrate that a short course of TRAINEES the caring way she’d explained some of the first noninvasive orally administered antiviral drugs the disease’s progression and how Yet for all the impact it has had, they would approach it — making Lok’s research is only part of something terribly difficult a little her mission . “I take pride in my easier to bear . research, but I went into medicine to be a doctor,” she says . “There Andrews began by supporting is nothing more meaningful than Lok’s research through the to be recognized by patients and TUKTAWA Foundation, a family families for your medical skills and foundation of which he is a Dame Sheila Sherlock, MD, was one of the compassion ”. trustee . In 2007, the foundation established the Alice Lohrman founders of modern hepatology. She was a This is precisely what happened Andrews Research Professorship in 2004 when Lok got a call from pioneer, a master clinician, an outstanding scientist in Hepatology, which Lok now Charles Andrews, the husband holds . and a mentor to more than 300 trainees from all of Lok’s former patient Alice Lok with Gastroenterology and Hepatology Division Chief Chung Owyang, MD (left) Lohrman Andrews, who had lost over the world. and Charles Andrews (right)
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Lok is honoring this gift by investing in U-M . The latter is an endowed fund to explore liquid biopsies for liver Lok is among an elite group the next generation of hepatologists designed to support pilot studies cancer . “In liver cancer, it’s often hard PAYING IT FORWARD of clinical researchers to and the advances they will generate . by early-career U-M investigators to get a biopsy, and even when you She supports U-M fellows, residents with the potential to dramatically do, the sample is not necessarily have been funded With numerous awards and two and students, funding aspects of improve liver disease diagnosis and representative of the entire tumor,” continuously by the NIH for their research and sending them to treatment . Through appeals to her says Lok . “There’s a lot of interest in professorships to her name, Lok is meetings to present their results . For patients, medical school classmates, testing the blood to see if it contains more than two decades. paying it forward — using her international trainees, she often helps former trainees, fellow faculty, circulating cells that better represent She was also ranked in the cover their health insurance or other foundations and others, as well as different parts of the tumor . This professorship funds and also launching essentials not met by their stipend . her own contributions and matching technique is advanced in breast top 1 percent of most-cited two endowed research funds to She helps U-M undergraduates funds from the department, she was cancer, but not in liver cancer ”. researchers from 2002 to conduct research to strengthen able to secure a level of commitment support the next generation of Chen’s team seeks to identify the their applications to medical school . that will fund novel studies each year 2012 by Thomson Reuters. genetic characteristics of circulating hepatology investigators. The first — This includes several who traveled in perpetuity . tumor cells that might predict which In 2017, she served as to China as part of the Michigan the Anna S.F. Lok, MD, Hepatology “I’ve trained a lot of young people, patients are likely to respond to Medicine/Peking University Health president of the American and I know how difficult it is to get particular treatments . Breakthrough Research Fund — is Science Center Joint Institute for started,” says Lok . “Particularly when Association for the Study of Translational and Clinical Research . Lok says she is deeply appreciative housed at U-M and supports high- you have a wild idea that you think Lok’s mentees have investigated of the support that is allowing her to Liver Diseases (AASLD) and may lead to a breakthrough, but you potential pilot studies by junior faculty topics from how hepatitis B leads to bring up the next generation in the haven’t yet proven yourself and don’t is now assistant dean for liver cancer to why certain antivirals same way that her mentor, Dame and fellows. The second — The Anna have the pilot data you’ll need to cause drug resistance to patient Sheila Sherlock, did for her . Like clinical research at the U-M apply for grant funding ”. Her fund S. Lok Fund for Excellence in Research knowledge about fatty liver disease . Sherlock, Lok stays connected to her aims to support these early swing-for- Medical School, leading the international “family” of trainees, and Training — is housed at the AASLD To further this work, Lok recently the-fences studies by junior faculty gathering each year at the AASLD transformation of U-M’s established an endowed research and fellows . Foundation and supports mentored meeting and supporting them as they and training fund through the AASLD clinical trials enterprise. The first grant was awarded in carry on her legacy of transforming research by early-career academic Foundation (see box) as well as 2019 to Vincent Chen, MD, the treatment of liver disease . the Anna S F. . Lok, MD, Hepatology hepatologists. clinical lecturer in the Division of Breakthrough Research Fund at Gastroenterology and Hepatology,
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Michelle Kahlenberg | Giles G. Bole, MD, and Dorothy Mulkey, MD, Research Professor of Rheumatology
LUPUS WITHOUT ILLNESS
PROFESSORSHIP SUPPORTS QUEST TO FIND LUPUS TRIGGERS, PREVENT FLARES Michelle Kahlenberg, MD, portfolio and a bevy of accolades, interrupted when they got sick . with increasingly personalized PhD, is motivated by a clear including a 2019 PECASE award, It was easy to have empathy for treatments . vision — to create a world in the highest honor the U S. . them and want to help . There One of Kahlenberg’s earliest which patients with autoimmunity government bestows on scientists were also so many unanswered findings was that irritating the don’t get sick . She has spent the and engineers launching their questions that I had the skill set to skin of mice with lupus induced near-decade since completing her independent research careers . Her try and answer ”. inflammation in their kidneys . This rheumatology fellowship at U-M success was capped last summer This is because Kahlenberg’s led her to investigate whether the on a quest to identify the switches with her installation as the Giles MD/PhD training engaged disease switch she was seeking that trigger disease flares and G . Bole, MD, and Dorothy Mulkey, her in probing the molecular might be found in the skin . complications in lupus, so she MD, Research Professor of mechanisms of inflammatory can devise therapies to turn them Rheumatology . One of her most promising leads disease . Using mouse models, off . And she’s made astounding is the inflammatory cytokine human tissue samples, clinical progress, thanks to the RESEARCH MOTIVATION & interferon kappa (IFN-κ), a switch trials, bioinformatics, systems breadth of her expertise IMPACT that her lab has shown can be biology and cutting-edge and her lab, which spans turned on in photosensitive lupus It was during her fellowship that techniques from CRISPR-Cas9 the basic-to-clinical patients by exposure to sunlight . Kahlenberg found her passion to single-cell RNA sequencing, research continuum . They’ve revealed that compared to for lupus . “My patients were so she now works to reveal the Kahlenberg has healthy controls, IFN-κ is elevated much like me,” she says . “They mechanisms driving lupus — already amassed in the skin of lupus patients and were often working moms my aiming to interrupt the disease a sizable grant that it can induce the death of age, whose lives got severely
“Receiving the Giles G. Bole, MD, and Dorothy Mulkey, MD, Research Professorship of Rheumatology lets me be creative in my science. With a grant, you have to spell out every step in your plan, but an endowed professorship allows you to take a new direction to push your science to the next level.” — Michelle Kahlenberg, MD, PhD
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which in turn produces toxins that As her team explores the drivers of disease progression, can drive both local and systemic mechanisms driving various then examine how they respond to inflammation . Promisingly, they manifestations of lupus, various treatments . This was the found that exposure to the IFN- Kahlenberg hopes to make first study funded as a Taubman blocking drug, baricitinib, could treatment increasingly Institute Innovation Project . interrupt this process . personalized . “Lupus is a different disease for every patient,” she A RESONANT PROFESSORSHIP Kahlenberg is now undertaking says, “but today’s treatments don’t three clinical studies in the hopes When Kahlenberg was awarded reflect that . For example, our lupus of translating her findings into the Giles G. Bole, MD, and nephritis treatments have around treatments . The first, funded by Dorothy Mulkey, MD, Research 50 percent efficacy, so everybody a new 2019 NIH Autoimmunity Professorship of Rheumatology, gets that because half will Center of Excellence grant, will she found it gratifying along many respond . The problem is we don’t test whether the IFN-blocking dimensions . know ahead of time which half — drug, tofacitinib, can protect so there’s a lot of trial and error ”. First, she is deeply appreciative photosensitive lupus patients of the security and flexibility it from the harmful effects of UV To address this, she has launched provides . “Having a source of light . The second is studying a personalized medicine project funds to help protect your time whether topical antibiotics can with a U-M colleague from and pay for expenses if you change the inflammatory profile dermatology, Johann Gudjonsson, have a temporary pause in grant of lupus rashes . The third, funded MD, PhD, the Arthur C . Curtis funding is very reassuring,” she by a 2019 Lupus Research Professor of Skin Molecular says . “But just as valuable is that Alliance Novel Research Grant, is Immunology . In it, they will Kahlenberg at the professorship inauguration with Elizabeth Bole . it lets you be creative with your comparing the effects of UV light analyze biosamples and medical science . With a grant, you have to skin cells after exposure to UV Kahlenberg’s lab has also patients’ skin can interrupt its on the skin of photosensitive and histories from participants spell out every step in your plan, light . These dead cells, which implicated IFN-κ in what may be barrier function, allowing bacteria non-photosensitive lupus patients with lupus, psoriasis and no but an endowed professorship aren’t cleared efficiently in lupus a vicious cycle of inflammation like Staphylococcus aureus to as well as healthy controls to autoimmune disease . Among allows you to take a new direction patients, appear to help drive the and disruption to the skin’s adhere more strongly to it . They identify the molecular changes Kahlenberg’s goals for the study to push your science to the next autoimmune response . microbiome in lupus . They discovered that lupus rashes are, that occur in each . are to identify subgroups of level ”. found that the elevated IFN-κ in in fact, highly colonized by staph, patients who share common
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To that end, Kahlenberg is disease behaves differently,” manifestations of lupus in women . female rheumatology fellows, that using her professorship to study she says . Kahlenberg herself is a leader inspired her to honor Bole with an diseases that are related to in animal modeling, serving as estate gift that helped establish Kahlenberg also deeply values the but different from lupus, such associate director of the animal the professorship that now bears professorship’s gravitas . “It carries as dermatomyositis . “We don’t modeling core of U-M’s new their names . Mulkey would go on weight and shows that you are have a grant for this yet, so NIH-funded Skin Biology and to establish a flourishing private respected within your institution,” the professorship is allowing Diseases Resource-based Center . practice and serve as assistant she says . us to do skin biopsies, and She has also been involved in dean of Michigan State’s College compare and contrast But perhaps most rewarding identifying a molecular switch in of Human Medicine . the inflammatory are the personal connections the skin, called VGLL3, that drives Mentoring has become a pathways to learn she has found with her award’s inflammation in lupus and helps cornerstone of Kahlenberg’s career why each namesakes . Giles Bole, MD, is explain why the disease is more as well . She is profoundly grateful well known for serving as dean prevalent in women . for the examples and inspiration of the Medical School from 1990 Even less well known is the fact provided by the careers of Giles to 1996, overseeing diversity that Bole and Kahlenberg both Bole and Dorothy Mulkey . initiatives, a redesign of the raised sheep — Bole, extensively medical student curriculum, a in his retirement, and Kahlenberg, modernization of facilities and a on the farm she works with her leap in the Medical School’s U S. . For Kahlenberg, mentoring is family today . “The wildest twist, News & World Report ranking which we didn’t learn until my among the most satisfying aspects from 16th to 9th . induction ceremony,” she says, of her job. Not only does she enjoy Perhaps less widely known “is that the person who was is that his research focus mentoring my daughter in our 4-H supporting the scientists in her lab, was lupus . Early in his career, club for showing sheep is actually but she helped establish a national Bole and his collaborators Giles Bole’s granddaughter!” Bole’s explored immunosuppression mentorship program for academic Mentoring was an essential part granddaughter, in animal models of lupus and Emma Ford (left) and of Bole’s career as well . In fact, rheumatologists through the the connection between oral Kahlenberg’s daughter, it was his mentorship of Dorothy Emerson Skowronski, at the contraceptives and clinical American College of Rheumatology. 2019 Washtenaw County Fair . Mulkey, MD, one of U-M’s first
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Stanley Chetcuti | Eric J. Topol Collegiate Professor of Cardiovascular Medicine
PATHWAYS IN MEDICINE
CHETCUTI IS AWARDED PROFESSORSHIP NAMED AFTER REVERED MENTOR ERIC TOPOL, MD In 1989, Stanley Chetcuti, MD, also serves as director of the Cardiovascular Medicine, created to be able to soar slightly above was a student at the University of Cardiac Catheterization Laboratory to honor Topol’s many clinical the clouds and to think on a Malta Medical School in Msida, and co-director of the Structural and research contributions to the much grander scale than just Malta, completing a rotation Heart Program . subspecialty of interventional the day-to-day grind,” he says . in the cardiac unit when one of cardiology, both at the U-M and in “Dr . Topol has always been one A faculty member at U-M his professors said, “You know, the medical field at large . of the preeminent leaders in the from 1985 to 1991, Topol was we’ve been looking at a lecture field, so having this award comes instrumental in defining the role “This professorship is truly the that cardiologist Eric Topol gave with considerable weight and of coronary thrombolysis as a highlight of my academic career in the United States . He’s one of responsibility . Not only do you lifesaving treatment for acute and nothing will come close to it . the superstars in cardiology, an need to deliver patient care myocardial infarction . He also I was recognized by my institution outstanding speaker, and someone in the best possible way; made seminal contributions to and, just as important if not more you should really meet if you ever you also need to remain the understanding of the role of important, the award was handed get a chance ”. open to new frontiers and platelets, percutaneous coronary to me at the ceremony in the territories ”. As fate would have it, in 1995, interventions and genetics in presence of Dr . Topol, a world- Chetcuti matched for a fellowship acute coronary syndromes . renowned cardiologist . With Since joining the in internal medicine cardiology at During his tenure, Topol served it, I’ve been able to think more faculty in 2000, the Cleveland Clinic in Cleveland, as director of both the cardiac conceptually about programmatic Chetcuti has focused Ohio, and went on to spend three catheterization laboratory and the development of different aspects his research on years training under Eric Topol, interventional cardiology program . of interventional cardiology . And intravascular MD, then chair of the Department to have some breathing space ultrasound, novel of Cardiology . “It was a program CHETCUTI AWARDED TOPOL that was very vibrant, and I got PROFESSORSHIP to know Eric very well . He’s a “This professorship is truly the highlight of my academic career and nothing will come close to it. I was In 2011, Chetcuti found himself at dynamic force, and all of us who yet another fateful moment in his recognized by my institution and, just as important if not more important, the award was handed to me at the trained under him have nothing career, when he was named the but the utmost admiration,” says ceremony in the presence of Dr. Topol.” inaugural recipient of the Eric J . Chetcuti, professor, Division of Topol Collegiate Professorship in — Stanley Chetcuti, MD Cardiovascular Medicine, who
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treatment for acute coronary to a completely new way of the program, but we’ve made Funding from the professorship “Dr. Topol has always been syndromes and percutaneous managing patients with aortic it a powerhouse both clinically has also given Chetcuti management of patients with stenosis . There is currently a and academically . Just to put the latitude to develop and one of the preeminent structural heart disease . “The new focus in the mitral and the things in perspective, when we conceive of several new leaders in the field, so last nine years were very tricuspid valve space with many started doing structural heart programs and initiatives, such productive with the program’s trials planned for the coming procedures, we were doing 75 as the Chronic Total Occlusions having this award comes involvement in many landmark four years ”. per year . Now, we’re doing over (CTO) program, led by Daniel with considerable weight clinical trials in the field of 300,” he says . “When TAVR Stephen Menees, MD, The award has given Chetcuti percutaneous treatment of aortic was first introduced, we were assistant professor, Division and responsibility. the time and resources to focus stenosis,” says Chetcuti . “The only working with patients who of Cardiovascular Medicine, to on the growth of the U-M — Stanley Chetcuti, MD results of these trials has led were too sick to have surgery . treat nearly complete blockage Frankel Cardiovascular Center’s Now the procedure is approved of one or more coronary arteries . Structural Heart Program, for all over the age of 65, and “We have also initiated a recognized as one of the top TAVR has surpassed open heart MATRIx (Mitral and Tricuspid centers in the country with surgery as the most common Interventions) Multidisciplinary regard to transcatheter aortic way to replace an aortic valve Team which is committed valve replacement (TAVR), a in the United States, and in to providing catheter-based minimally invasive, catheter- the state of Michigan . That’s therapies for mitral and tricuspid based procedure to replace the dramatic . Today, we’re thinking valve disease,” says Chetcuti . diseased aortic valve in patients about TAVR in the lifetime “And we’ve recruited a faculty with severe aortic stenosis management of a patient with member who is helping us who are unable to withstand an aortic valve disease .” treat patients with chronic open-heart procedure . thromboembolic pulmonary Chetcuti adds that Paul TAVR has evolved at record pace hypertension, a form of Michael Grossman, since the first procedure was pulmonary hypertension caused MD, professor, Division of performed at the Frankel Center by blood clots affecting the Cardiovascular Medicine, has in 2011 . “The program was lungs .” built an active TAVR program in its infancy when I received at the VA Ann Arbor Healthcare this award . Through this System . professorship, we not only grew
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CLINICAL TRIALS placement during TAVR by be a primary implanter of new Interventional Cardiology Fellows with Chetcuti: Fredy El Sakr, MD; Saifullah Siddiqui, MD; Stanley Chetcuti, MD; and Devraj Sukul, MD providing physicians the valve devices,” says Chetcuti . In the last decade, Chetcuti and option to recapture the valve “Typically, when a new device is his team have been involved in and reposition it during the created, companies go to South a number of multi-center clinical procedure as necessary . U-M America or Europe to get them trials with TAVR . “We are one was one of the first heart implanted or tested . We would of the highest enrollers in the centers in the country, and the like to make U-M an ideal site country of all clinical studies first in Michigan, to use the for companies to come to for done with self-expanding valves device . testing first devices in humans . for this procedure,” he says . There are a plethora of new Chetcuti reports that there are In 2016, the Frankel Center devices we have to learn, test currently several new clinical enrolled its first patients in a and integrate into our practice . studies on the horizon, including newly expanded indication trial It’s a whole new horizon .” new edge-to-edge repair in for the CoreValve® Evolut® R the mitral and tricuspid space, The space of interventional System, a TAVR system that’s annular synching procedures cardiology has undergone a only been approved in the and percutaneous mitral and dramatic shift over the past United States for high- and tricuspid valve replacement . 10 years . “Looking ahead, not extreme-risk patients . The trial only do we have to change our was designed to assess the U-M has become very training programs, but we need safety and performance of a progressive in the aortic space the bandwidth to lobby national new approach to aortic valve with newer technologies and institutions, like the American replacement . The CoreValve® other innovations, offering College of Cardiology, to change Evolut® R System is the only patients five different valves, the format of our training “Looking ahead, not only do we have to change our training programs, but we next-generation recapturable, including: the SAPIEN 3, programs to incorporate newer self-expanding transcatheter CoreValve®, Lotus Edge, need the bandwidth to lobby national institutions, like the American College of technologies and techniques ”. aortic valve replacement system Accurate Neo and Jena Cardiology, to change the format of our training programs to incorporate newer commercially available in the valves as part of their clinical United States . The system practice multi-center trial . technologies and techniques.” was designed to increase the “Many companies and venture — Stanley Chetcuti, MD potential for optimal device capitalists consider U-M to
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W. Joseph McCune | Michael H. and Marcia S. Klein Professor of Rheumatic Diseases
ADVANCING TREATMENT FOR RHEUMATIC DISEASES
A GIFT FROM MARCIA AND MICHAEL KLEIN BRINGS NEW THERAPIES TO LIGHT In 2001, Marcia Klein, of her husband, Michael Klein, to autoimmune disorder that affects decided to make a new gift at $100,000/year for more than Bloomfield Hills, Michigan, was seek the help of W. Joseph the joints, skin, kidneys, heart, from their family foundation to 10 years . diagnosed with both lupus and McCune, MD, professor, Division blood vessels, lungs and brain . transform the Klein Research The Lupus Program has grown rheumatoid arthritis . of Rheumatology, and director His investigations study how to Fund into a professorship bearing significantly as a result of the The unsettling of the U-M Lupus Program . A predict disease progression and their name . In September 2014, Kleins’ generosity, and has news led her, relationship was forged as the activity, prevent permanent organ the Michael H . and Marcia S . supported the creation of the most along Kleins delved into learning about damage and reduce flares . Klein Professorship in Rheumatic important multidisciplinary clinical with the two autoimmune diseases Diseases was inaugurated and As the Kleins learned about centers for treating lupus in the that so deeply affected their lives, was subsequently awarded to McCune’s research — and about state . The collaboration includes the treatment options currently McCune . the 3 6. million Americans affected the expertise of rheumatologists, available, and the research being by the pain, inflammation and “I am honored to receive this nephrologists, pulmonologists, done at the U-M . debilitation of rheumatoid arthritis professorship,” says McCune . “It hematologists, dermatologists Since joining the U-M and lupus — they decided to would be difficult to overstate and high-risk obstetricians and faculty in the early establish a research fund to the impact of the support that the gynecologists, all with a special 80s, McCune had advance the work being done Kleins have provided to the U-M interest in lupus, who provide concentrated his at U-M . The fund also supports Lupus Program . For more than comprehensive care for all lupus clinical research on a long-term study to determine 20 years, the couple has been patients . rheumatic diseases, the causes and treatment of the most important contributor McCune points to the value of with particular premature cardiovascular disease to the program, as well as to philanthropic support that allows focus on lupus, an in women with lupus . my work . This commitment is a faculty to start projects before testament to their resolve to make they’re funded, or to finish projects ESTABLISHING A a strong impact on the diagnosis, that are not completely funded . “It would be difficult to overstate the impact of the support that Michael and Marcia PROFESSORSHIP IN treatment and eventual cures “If someone has enough grant RHEUMATIC DISEASES for rheumatic diseases such as Klein have provided to the U-M Lupus Program. For more than 20 years, they’ve money, for example, from the lupus ”. It is important to note The Kleins saw an even greater NIH, oftentimes, the actual funds been the most important contributors to the program, as well as to my work.” that, prior to the establishment of need for research in lupus and aren’t sufficient to complete the the professorship, the couple had — W. Joseph McCune, MD other rheumatic diseases, and project, or to pursue an idea,” he already supported MCune’s work
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says . “So that little bit extra lets SUPPORTING NEW RESEARCH to study the manifestations of professorship has gone to support side effects and became the first research has revealed that things happen in a larger way, systemic lupus and systemic a team of three coordinators who FDA-approved therapy for lupus in interferons are very important in The professorship has given rather than just the income itself vasculitis, and to characterize work in the clinical trials group . 40 years . skin disease (page 106) . Based on McCune the opportunity to being the entire source of support these diseases more accurately To actually be able to prove that such discoveries new therapies participate in many research In another avenue of research, for projects . The old saying that by analyzing them in an organized a new lupus drug works is much are being evaluated in clinical studies that would not have McCune and former colleague one philanthropic dollar generates way in large groups of patients . It more difficult than, for example, a trials . been possible otherwise, such Mariana Kaplan, MD, who 10 research dollars has certainly has also helped to support young new rheumatoid arthritis drug ”. as observational trials designed has since moved to a leadership “One of the recent drugs that we been true for us ”. researchers who are just starting Understanding the Genetics role at the National Institutes have looked at actually keeps out . “I’ve had several younger of Lupus of Health, showed that one of interferons from reaching the researchers, for example, who had the major causes of disability receptor,” says Kahlenberg . HISTORY OF THE PROFESSORSHIP part of their time protected so they In addition, McCune and his and death in lupus patients — “So work related to the role could do research or start research team have been able to do more It is important to note that, prior to the cardiovascular disease — is of interferons in causing lupus projects, and that’s been helped by translational research focused significantly worsened by the activity in various means, and establishment of the professorship, the couple had the professorship,” says McCune . on the genetics of lupus, such direct action of interferons on identifying compounds that as why people of different ages already supported MCune’s work at $100,000/year Lupus Clinical Trials blood vessels . Vascular damage suppress interferon activity, has and genetic backgrounds get Consortium is thus one of the many ways in been the thrust in terms of what for more than 10 years. the disease, the mechanisms by which interferons cause disease in kinds of therapies are likely to be He has used a large portion of the which lupus flares and the way in lupus, triggering lupus flares and recognized and supported in the funds to support the Lupus Clinical which therapeutic drugs work . inflammation in multiple organs, next few years ”. Trials Consortium, a multicenter The Role of Interferons in including skin, joints and kidneys . consortium designed to provide “This professorship has been Lupus infrastructure for performing lupus Michelle Kahlenberg, MD, an invaluable resource fostering clinical trials . “Lupus is a very The Lupus Clinical Trials Unit PhD, associate professor, collaborative research focused complex disease . Clinical trials, has helped to perform multiple Division of Rheumatology, who on rheumatic diseases, both which typically operate at a loss, trials of new therapeutic agents, trained in Kaplan’s laboratory, within the university and with have been very difficult to perform, notably belimumab, or “Benlysta,” has broadened these earlier other investigators nationally and and are almost impossible to do a drug designed to inhibit specific investigations into the importance internationally . It’s getting us much without philanthropic support . processes that induce lupus of interferons in the pathogenesis closer to better treatments,” says “For example, a large portion flares . Belimumab proved to be an of lupus to further characterize McCune . Joseph McCune, MD and his wife, Georgiana Sanders, MD with Marcia and Michael Klein at the professorship inauguration . of the actual income from the effective drug with relatively few injury in various tissues . Her
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2019 INTERNAL MEDICINE ANNUAL REPORT 2019 INTERNAL MEDICINE ANNUAL REPORT 115 ACKNOWLEDGMENTS
EXECUTIVE OFFICERS — UNIVERSITY OF MICHIGAN HEALTH SYSTEM ACKNOWLEDGMENTS Marschall S . Runge, MD, PhD, executive vice president for medical affairs, dean, University of Michigan We gratefully acknowledge Medical School, CEO, Michigan Medicine; David A . Spahlinger, MD, president, UMHS, and executive vice the role of many members of dean for clinical affairs, University of Michigan Medical School; Patricia D . Hurn, PhD, dean, School of the Department of Internal Nursing . Medicine and colleagues in UNIVERSITY OF MICHIGAN BOARD OF REGENTS the Medical School and across U-M for their contributions to Jordan B . Acker, Michael J . Behm, Mark J . Bernstein, Paul W . Brown, Shauna Ryder Diggs, Denise Ilitch, this report . Please note that Ron Weiser, Katherine E . White, Mark S . Schlissel, ex officio. due to space constraints, our NONDISCRIMINATION POLICY STATEMENT emphasis is on the internal medicine leadership involved The University of Michigan, as an equal opportunity/affirmative action employer, complies with all in various projects . However, applicable federal and state laws regarding nondiscrimination and affirmative action . The University of one of U-M’s key strengths Michigan is committed to a policy of equal opportunity for all persons and does not discriminate on the is its collaborative spirit; we basis of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender recognize and appreciate expression, disability, religion, height, weight, or Veteran status in employment, educational programs and the role of innumerable activities, and admissions . Inquiries or complaints may be addressed to the Senior Director for Institutional collaborators in making possible Equity, and Title IX/Section 504/ADA Coordinator, Office for Institutional Equity, 2072 Administrative the progress highlighted in these Services Building, Ann Arbor, Michigan 48109-1432, 734-763-0235, TTY 734-647-1388, institutional equity@. stories . Finally, it is important to umich edu. . For other University of Michigan information call 734-764-1817 . note that many members of the © 2020 Regents of the University of Michigan Department of Internal Medicine have important affiliations with Produced by Michigan Creative, a unit of the Office of the iceV President for Communications other U-M centers, institutes, MC 200110 departments, divisions and schools, as well as with the VA Ann Arbor Healthcare System that immeasurably enrich their educational, clinical and research roles .
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