:: Are you at risk for :: Vanderbilt CARE team :: A course in malpractice? 24 evaluates child abuse cases 30 true love 36

Va nderbiltMedicineWINTER 2012

SHIFTING GEARS

The Vanderbilt Kennedy Center Prepares People with Disabilities for the Road Ahead

Medical student Jessi Solomon and Next Steps program graduate Jeanne Gavigan Web Sight Van derbiltMedicine VOLUME 29, NUMBER 1 John Worrell, M.D., MD ‘71, photographed these penguins (top) and the blue- footed boobie (below) about 30 meters off the coast of Isla Isabela, the largest Vanderbilt Medicine is published by Vanderbilt island in the Galapagos Islands. Worrell, a seasoned traveler, is a professor of University Medical Center in cooperation with the Radiology and Radiological Sciences at VUSM. VUMC Office of News and Communications. Copyright 2012 © Vanderbilt University

EDITOR Kathy Whitney

DESIGN AND ART DIRECTION Diana Duren

CONTRIBUTING WRITERS Carole Bartoo Craig Boerner Jessica Ennis Leslie Hill John Howser Nancy Humphrey Leigh MacMillan Ann Marie Owens Jessica Pasley Jan Read Dagny Stuart Jennifer Wetzel Kathy Whitney Sarah Wolf

PHOTOGRAPHY/ILLUSTRATION Dave Cutler Daniel Dubois Eric England Joe Howell Tommy Lawson Ethan Miller John Russell Leigh Wells Susan Urmy

DIRECTOR OF PUBLICATIONS Nancy Humphrey

EXECUTIVE DIRECTOR OF NEW MEDIA AND ELECTRONIC PUBLICATIONS Wayne Wood

COVER PHOTOGRAPH Daniel Dubois

EDITORIAL OFFICE Office of News and Communications T-5200 Medical Center North Vanderbilt University Nashville, Tenn., 37232-2390

VANDERBILT MEDICAL ALUMNI ASSOCIATION D-8200 Medical Center North Nashville, Tenn., 37232-2106 (615) 322-6146 (800) 288-0266 Picture Your Photo here! Fax: (615) 936-8475 Do you fancy yourself a photographer? If so, send us your best E-mail: [email protected] Visit us at: https://medschool.vanderbilt.edu/alumni shot and we will choose one to publish in this space in each issue. Photos must be a minimum of 300 dpi and 4” x 6”. Submit your digital photo to [email protected].

WEB LINK www.mc.vanderbilt.edu/vanderbiltmedicine Van derbiltMedicine WINTER 2012

:: on the cover Working in tandem with depart - ments across campus, the Vanderbilt Kennedy Center is improving the lives of those with disabilities.

A HARD DAY ’S NIGHT 18 HOW DID THIS HAPPEN ? 30 A COURSE IN TRUE LOVE 36 :: departments :: features

Making the Rounds 2 Shifting Gears 12 Around the Medical Center 3 Next Steps Program prepares young adults with disabilities for road ahead Personalized Medicine 7 17 Alumni Profile 8 Longer Lifespan Brings challenges Families plan for the future of children with disabilities Canby Robinson Society 38 Alumni Journal 42 A hard Day’s Night 18 Alumni News 43 The intriguing relationship between autism and sleep time out 23 Parents learn to manage their stress

Warning Signs 24 Program assesses physicians’ malpractice risk

how Did this happen? 30 CARE Committee evaluates suspected child abuse and neglect cases

A course in true Love 36 Medical students look to future after cancer-related detour

:: online highlights

Look for these stories and multimedia features online at www.mc.vanderbilt.edu/vanderbiltmedicine.

VIDEO: Next Steps at Vanderbilt program graduates its first class

ARTICLE: Q & A with Jonathan Metzl, M.D., Ph.D., the new director of Vanderbilt’s Center for Medicine, Health and Society

ARTICLE: International collaboration boosts autism genetics research RICHARD JOHNSTON JR ., M.D. 8

WINTER 2012 1 :: making the rounds

And it is a center of care to those with developmental disabilities and their families. the staff and faculty of the Vanderbilt Kennedy center are dedicated to offering knowledge and support broad in scope, creating a caring community for both children and adults. in this issue of Vanderbilt Medicine, we have several stories that bring to life J O human faces and extraordinary programs E

H

O at the center, including: W

E very time i visit the

L • the Next Steps Program, which L E Vanderbilt Kennedy center, provides a college experience to students i come away inspired. with disabilities, with a goal of employa - the center is truly a crown jewel of bility for every student within two years. the university. it is a special place, a • helping people with autism sleep microcosm where one can find everything better. our story profiles Beth Malow, that makes Vanderbilt great in a single M.D., who is both a Vanderbilt Kennedy place. center investigator and director of our the Kennedy center is a crossroads Sleep center, and who has two sons in of the university, one of the most inter - the autism spectrum. disciplinary places you’ll find at any uni - • A report on the family-centered versity, anywhere. there are educators, programs at the center, including those pediatricians, behavioral specialists, neuro - aimed at achieving stress reduction. scientists, geneticists and many other fields i hope this issue of Vanderbilt represented, all working together and Medicine captures your imagination – toward a common goal: understanding for me, the Kennedy center serves as a and solving the mysteries of human devel - poignant reminder of what a great univer - opment to help people with disabilities. sity can accomplish working as one. VM Not only does the Vanderbilt Kennedy center reach into nearly every BY JEFF BALSER, M.D., PH.D. school of the university, but the center Vice Chancellor for Health Affairs Dean of Vanderbilt University School of Medicine also reaches across the country. We are part of a national network of research centers on intellectual and developmental disabilities created by the Kennedy administration in 1963. it is a center of research; Vanderbilt Kennedy center investigators regularly publish groundbreaking research in the world’s leading journals. it is a center of education; students of disciplines from all over Vanderbilt converge to learn from the faculty, patients and families.

2 WINTER 2012 AROUND THE :: MEDICAL CENTER News and happenings at Vanderbilt University Medical Center L L

Vanderbilt endowed chair holders E W O H honored at event E O Eight Vanderbilt University School J of Medicine faculty members named to endowed chairs were praised for out - standing leadership in their academic fields and also on campus during cere - monies in September and November 2011, marking the fourth and fifth in a series to honor the contributions of Vanderbilt chair holders. The new chairs within the School of Medicine are: • Timothy S. Blackwell, M.D., Ralph and Lulu Owen Chair in Medicine • Richard M. Caprioli, Ph.D., Stanford Moore Chair in Biochemistry • Mark R. Denison, M.D., Craig- Adult Emergency Department personnel are taking part in a personal Weaver Chair in Pediatrics safety training program called Handle with Care. Here, instructor • Wael El-Rifai, M.D., Ph.D., Anthony Locklayer works with Katrina Peters, nurse resident, left, as H. William Scott Jr. Chair in Surgery she blocks a punch from McKeshia Crawford, care partner, during class. • Arthur Fleischer, M.D., Cornelius Vanderbilt Chair • Beth A. Malow, M.D., M.S., Burry Chair in Cognitive Childhood Program’s goal is to keep eD staff Development • Robert J. Matusik, Ph.D., William L. out of harm’s way Bray Chair in Urology With violence toward health care workers from patients and visitors on the • David Piston, Ph.D., Louise B. rise inside emergency departments, personnel with Vanderbilt’s Adult Emergency McGavock Chair Department are learning a new set of skills to keep them – and those they care Jeff Balser, M.D., Ph.D., vice chan - for – safe. cellor for Health Affairs and dean of In April 2011, Vanderbilt’s Adult Emergency Department launched Handle with Care, the School of Medicine, and Richard a crisis intervention and behavioral management program which teaches verbal and McCarty, provost and vice chancellor physical intervention methods. The course instructs staff on how to de-escalate an for Academic Affairs, thanked the gen - out-of-control patient and protect themselves if they feel threatened. erous donors for their support. Emergency departments across the country are faced with overcrowding, and “The chairs we celebrate today patients often use emergency services in lieu of primary care physicians, just a few of represent both new investments, the issues which can heighten frustration and lead to violent behavior, said Brent meaning donations in just the past few Lemonds, M.S., R.N., administrative director of Emergency Services for Vanderbilt. years, as well as gifts from many years He also noted a connection to violence with an increase in psychiatric patients, as well ago,” McCarty said . VM as a high percentage of patients under the influence of alcohol and drugs. - ANN MARIE OWENS Vanderbilt staff members Mike Malone, EMT, Anthony Locklayer, R.N., and Jacki Ashburn, R.N., volunteered to become certified Handle with Care instructors and have since led nearly 100 employees through the program. The majority of the four-hour course teaches verbal de-escalation techniques. Instructors stress that verbal de-escalation is powerful and the goal is to avoid physi - cal restraint when at all possible. All current emergency staff completed the course by September, although Handle with Care classes will continue for new employees and recertification purposes. VM - JENNIFER WETZEL

WINTER 2012 3 :: around the medical center

New genes linked to multiple sclerosis identified Grant bolsters Vu personalized

An international team of scientists medicine efforts has identified 29 new genetic variants Vanderbilt University’s efforts in personalized linked to multiple sclerosis (MS), pro - medicine – health care that is tailored to each viding key insights into the biology of individual’s genetic makeup – are getting a new the debilitating neurological disease. boost from the National Human Genome Vanderbilt University Medical Research Institute (NHGRI). Center’s Center for Human Genetic NHGRI is awarding $25 million over the next Research (CHGR) played an important four years to a network of institutions, including role in the research published in Vanderbilt, to discover links between genetic August 2011 in the journal Nature , information and disease characteristics/symp - which represents the largest MS toms in electronic medical records, and to use genetics study ever undertaken and the findings to improve patient care. effectively doubles the number of Dan Roden, M.D., assistant vice chancellor for genes known to be associated with Personalized Medicine, has led Vanderbilt’s par - the disease. ticipation in the eMERGE (electronic MEdical “We now know just how complex Records and GEnomics) network since its launch multiple sclerosis is,” said Jonathan in 2007. Jonathan Haines, Ph.D. Haines, Ph.D., director of the CHGR Vanderbilt also serves as the administrative and one of the principal researchers in coordinating center for the network, under the this effort. “These new genes give us leadership of Jonathan Haines, Ph.D., director of many new clues as to what is happen - the Center for Human Genetics Research. ing in MS and will guide our research “Vanderbilt’s commitment to the idea of per - efforts for years to come.” sonalized health care – including our DNA bank Researchers studied the DNA from BioVU, one of the largest of its kind in the world – 9,772 individuals with multiple sclerosis has put us into a leadership position in this area and 17,376 unrelated healthy controls. nationally,” Roden said. They were able to confirm 23 pre - “Our ability to contribute effectively to the viously known genetic associations first phase of eMERGE was due in no small part and identified another 29 new genetic to the collaboration of a very talented group of variants (and an additional five that are Vanderbilt investigators with a wide range of strongly suspected) conferring suscep - skills, including genomics, informatics, transla - tibility to the disease. tional medicine, statistics and ethics.” Many genes implicated in the study In its first phase, which wrapped up last year, Dan Roden, M.D. are relevant to the immune system, the eMERGE network identified genetic variants shedding light on the immunological associated with higher risk for dementia, pathways that underlie the develop - cataracts, cardiac conduction, peripheral arterial ment of multiple sclerosis. disease and type 2 diabetes. One-third of the genes identified in In the next phase, investigators will identify genetic variants associated with 40 the study have previously been implicat - more disease characteristics and symptoms, using genome-wide association methods ed in playing a role in other autoimmune to screen the entire genome for variations. About 32,000 participants will be included diseases such as Crohn’s disease and in each study, which will point to the genes that cause or contribute to diseases – type 1 diabetes, Haines said. information that can be used to guide clinical care. Previous studies have also Investigators in the eMERGE network have also developed privacy protection meth - suggested a link between vitamin D ods to prevent the risk of identifying patients in the studies, and they have explored deficiency and an increased risk of public concerns about genomic research and electronic medical records. VM multi ple scle rosis. VM - LEIGH MACMILLAN - CRAIG BOERNER

4 WINTER 2012 around the medical center :: S I O B U D

L E I N A D Lung disorder drug regimen found harmful

The standard treatment for idio - pathic pulmonary fibrosis (IPF) that has been widely used for the last 20 years is not only ineffective, but appears to be dangerous, according to the findings of a clinical trial. As a result, the National Heart, Lung, and Blood Institute (NHLBI), an arm of the National Institutes of Health, has stopped one arm of the clinical trial known as PANTHER-IPF that was studying treatments for the disease at Vanderbilt University Medical Center Folate may lower breast cancer risk and 2 dozen other sites around the country that are part of the IPF Clinical for some: study Research Network. The trial found that a currently A new study by investigators from Vanderbilt-Ingram Cancer Center and the used triple-drug therapy consisting of Shanghai Cancer Institute indicates that women who get adequate amounts of folate prednisone, azathioprine and N-acetyl - in their diet have a reduced risk of developing breast cancer, although the benefit cysteine (NAC) is a potentially harmful appears linked to a woman’s menopausal status. combination to people with IPF. The study found that women who had not yet reached menopause and who had the “This is a landmark change in highest average intake of folate had a 40 percent reduced risk of developing breast treatment because it shows that a cancer. treatment that has been used widely in Martha Shrubsole, Ph.D., assistant professor of Medicine in the Division of the U.S. and around the world does not Epidemiology at Vanderbilt, is the lead author of the paper, which was published in work,” said James Loyd, M.D., profes - the American Journal of Epidemiology in March 2011 . sor of Medicine and Vanderbilt’s princi - “In our study, it appears that folate is most protective of hormone negative, or what pal investigator for PANTHER-IPF. we call double negative, breast cancer,” said Shrubsole. The study data showed that com - “We don’t have evidence that an extremely high intake of folate protects against pared to placebo, those assigned to breast cancer, but it appears that low folate levels may increase a premenopausal triple therapy had greater mortality (11 woman’s risk of developing breast cancer.” percent vs. 1 percent), more hospitaliza - Using data from the Shanghai Women’s Health Study in China, the investigators tions (29 percent vs. 8 percent), and assessed the records of 72,861 women who enrolled in the study between 1997 and more serious adverse events (31 percent 2008. They identified 718 women who developed breast cancer during the course of vs. 9 percent) and also had no improve - the study. ment in lung function tests. In addition, After studying the data, the researchers found no link between vitamins B6 or B12 participants randomly assigned to the and breast cancer risk, but there was a clear protective effect with folate consumption triple therapy arm remained on their among premenopausal women. assigned treatment at a much lower For the first time, the researchers also found evidence that too much niacin in the rate (78 percent vs. 98 percent). diet may be linked to an increased risk of hormone positive breast cancer. No other “It’s very important that we learn studies have found this effect and the authors of the study recommend further from this and move forward,” Loyd research to validate these findings. said. The combination drug therapy has The principal investigator for the Shanghai Women’s Health Study is Wei Zheng, not been shown to be dangerous for M.D., Ph.D., chief of the Division of Epidemiology and director of the Vanderbilt treating other diseases or for preven - Epidemiology Center. VM tion of transplant rejection. VM - DAGNY STUART - KATHY WHITNEY

WINTER 2012 5 :: around the medical center M O

Music from the Heart C . O T

Since country singer Darius Rucker O red meat H P K

and 25 members of the ACM Lifting Lives C O T S Music Camp performed live at the cooked at I Academy of Country Music Awards Show last spring, more than 4,000 donations high heat have been made to Vanderbilt Kennedy Center, changing the lives of countless may boost people with developmental disabilities. The performance has been seen an risk of colon estimated 115 million times through a range of media. Rucker and the campers polyps traveled to Las Vegas to perform “Music From the Heart,” an original song written Cancer investigators from Vanderbilt-Ingram Cancer Center and the Veterans by the campers. The six-year-old music Affairs Medical Center (Tennessee Valley Health System in Nashville) have found that camp at Vanderbilt Kennedy Center eating a steady diet of red or processed meat, especially meat that has been cooked at brings together people with Williams high temperatures, may increase the risk of developing colon polyps. Syndrome, autism and other disabilities Polyps are small growths on the lining of the intestinal tract that may develop to celebrate music. into cancer. “People with disabilities often have The study, led by Wei Zheng, M.D., Ph.D., chief of the Division of Epidemiology and rare abilities, and in some cases those director of the Vanderbilt Epidemiology Center, was published in the journal Cancer abilities involve a special talent or affinity Prevention Research in July 2011. for music,” said Rucker. “I am honored to Patients who were evaluated are enrolled in the Tennessee Colorectal Polyp join ACM Lifting Lives and the Vanderbilt Study, a colonoscopy-based study group in Nashville. A total of 6,307 participants, ages Kennedy Center to highlight how music 40-75, were included in the research, making this the largest study of its kind to date. can better the lives of young people with Participants had colonoscopies performed at Vanderbilt University Medical Center developmental disabilities on country or the Veterans Affairs Medical Center between February 2003 and March 2010. music’s biggest night.” VM All of the patients were interviewed shortly after the colonoscopy and completed a - JAN READ food frequency questionnaire to determine their typical diets, including the amount of S

E red or processed meat they eat on a regular basis. Meats listed on the survey included G A M I fast food or home-cooked hamburgers or cheeseburgers, beef steaks, pork chops, Y T T E

G ham steaks, bacon, sausage, hot dogs, chicken, fish, gravy from meat drippings, short / R E

L ribs or spareribs. L I M

N Study participants also looked at color photographs depicting how the meat is A H T

E usually cooked – ranging from rare to extremely well done. “We found that a high intake of red meat, particularly meat cooked at high tem - peratures, was associated with an elevated risk of colorectal polyps,” said Zhenming (David) Fu, M.D., Ph.D., a postdoctoral fellow in the Division of Epidemiology and the Darius Rucker, center, sings with partici - first author of the study. pants of the ACM Lifting Lives music “We know that well-done meat contains mutagens, such as heterocyclic amines, camp at the Academy of Country Music Awards Show. that have been shown to induce tumors in experimental animals.” The investigators also evaluated other cancer risk factors among the participants, including tobacco use. “Overall, current smokers who also were exposed to a high level of red meat or meat-derived mutagens had the highest risk for colorectal polyps,” said Zheng. VM - DAGNY STUART

6 WINTER 2012 GETTING :: PERSONAL Update on Vanderbilt’s Personalized Medicine Initiative Y H P A

VICC LAUNCHES ONLINE R G O T O H

GENETIC RESEARCH TOOL P

Y O L L A

BY DAGNY STUART / R E E V

Vanderbilt-ingram cancer center (Vicc) has launched the nation’s first personalized cancer decision support tool, “My cancer Genome,” to help physicians and researchers track the lat - est developments in personalized cancer medicine and connect with clinical research trials for their patients. this Web-based information tool is designed to quickly edu - cate clinicians on the rapidly expanding list of genetic mutations that impact different cancers and, at the same time, enable them to more easily research various treatment options based on specific mutations. My cancer Genome is the latest addition to Vicc’s Personalized cancer Medicine initiative, which was unveiled last year. the physician scientists who created it have been named winners of a $20,000 health care technology award sponsored by the National cancer institute. “Next-generation, or genetically informed cancer medicine, holds the promise of tailoring anti-cancer treatment according to individual patient tumor characteristics,” said William Pao, M.D., Ph.D., associate professor of Medicine and director of Personalized cancer Medicine at Vicc. “Staying abreast of these fast-paced research changes may be difficult for time-pressed oncologists and medical caregivers. in particular, knowledge about rare variants found in cancers may be cancer clinical informatics officer for Vicc. hard to track down, especially in busy clinics. We launched this “this new online tool is already linked to Vanderbilt Web-based tool to enable a genetically informed approach to can - university Medical center’s StarPanel electronic medical record cer medicine that we believe can be more efficient and effective.” database to help our physicians make treatment decisions quickly, With just a few clicks, users can get up-to-date information based on the best science available. on the clinical significance of specific mutations. “once we test a patient’s tumor for specific mutations, the here’s how it works: A doctor receives tumor-profiling test results stay in a patient’s medical record, so as new treatment results from the lab that show a mutation in a specific gene. the options become available for each mutation, our physicians will doctor remembers a little about the gene, but hasn’t seen that have that information at their fingertips,” Levy said. result very often, as it is relatively uncommon. the first two forms of cancer featured on Vicc’s My instead of having to search through a great deal of literature, cancer Genome information tool are lung cancer and melanoma, the physician can log on to Vicc’s My cancer Genome tool and, with plans to add content on breast, colon and other cancers in a within a few minutes, find the latest information about the clinical few months. implications of the gene, either by reading the summary version or “We envision that Vicc’s My cancer Genome can become delving further into the primary literature through Web links. a global research and resource platform connecting the entire can - the physician can then recommend treatment that is cur - cer community, including doctors, researchers, students, patients rently available or refer the patient to a clinical trial that is testing and caregivers. a targeted therapy for that gene. “We will be reaching out in the future to encourage all stake - Finally, the patient also can go to the Vicc website and learn holders to contribute information so that we can improve infor - more about their cancer by using the My cancer Genome tool. mation flow and accelerate the development of better personalized “We designed this online tool to be comprehensive, scalable targeted therapy for all cancer patients ,” Pao said. VM and easy for clinicians to use,” said Mia Levy, M.D., Ph.D., assis - WEB LINK tant professor of Biomedical informatics and Medicine and www.MyCancerGenome.org

WINTER 2012 7 8 WINTER 2012 alumni profile ::

A SchoLAr AND A GeNtLeMAN

Richard Johnston Jr., M.D., MD ‘61, dedicates life’s work to improving the health of children

When women of childbearing age wake up in the morning and pour their favorite cereal into a bowl, they can thank the efforts of richard B. “Dick” Johnston Jr., M.D., for helping them have a better chance at delivering a healthy baby. research found that consuming folic acid prior to and during the early stages of pregnancy reduced the occurrence of neural tube defects. What better way to do so than by putting it into staple foods like bread and cereal? “it was during Dr. Johnston’s tenure as our medical director that the March of Dimes began its national folic acid awareness campaign. his leadership was crucial to bringing the nation’s obstetrician-gynecologists, pediatricians and women’s nurses together with the March of Dimes to urge all women of childbearing age to [take] folic acid every day beginning before pregnancy,” said Jennifer howse, M.D., president of the March of Dimes.

WRITTEN BY JESSICA ENNIS PHOTOGRAPH BY DANIEL DUBOIS

WINTER 2012 9 :: alumni profile

Johnston went directly to David enacted in 1998, since resulting in a one- Kessler, M.D., who served as u.S. Food third reduction of neural tube defects & Drug Administration (FDA) commis - such as spina bifida in the united States. sioner from 1990 to 1997, to urge that “We consider this a significant victory for folic acid be added to the nation’s grain America’s mothers and babies because it’s supply. Kessler, a pediatrician and lawyer, so rare to get the chance to prevent a was best known for taking on “big tobac - major birth defect with such a simple, co” in FDA v. Brown & Williamson low-tech solution as food fortification,” tobacco corp. howse said. Johnston first encountered “i remember going to Dr. Kessler’s the devastation of neural tube defects office with letters from the pediatric, during his residency at Vanderbilt. Richard Johnston, VU ‘57 obstetrical, and genetic academic and pro - “there was an entire ward occupied with fessional societies and the March of children suffering from spina bifida,” he Dimes to urge that folic acid be added to said. “the opportunity to try to prevent his desk was perfect. his books were in a fortified grains,” Johnston said. “When i these defects was spectacular.” small neat pile. it was the picture of neat rose to give Dr. Kessler the letters, two academic pursuit and that’s the way he’s lawyers jumped in front of me. he waved Driven from an early age continued.” As Johnston ramped up his them aside and said, ‘it’s oK, i know A deep desire to make the world studies, he also became more involved on these people.’ After consulting his nutri - better has been a driving force in campus, eventually being named Bachelor tion experts in the room, he turned back Johnston’s life since he was a child. of ugliness, which recognized the out - to me and said, ‘We’ll have this out by Born in Atlanta in 1935, he lived standing male undergraduate from his December.’ he’s a hero for me.” there with his three younger brothers, graduating class. “Somehow i accepted Despite much opposition outside the reared by “outstanding parents” in a leadership roles, and a part of me has medical community, the FDA ruling was household filled equally with a love for always wanted to be in those roles,” he athletics and literature. “our father was said. Johnston met his wife, Mary Anne an athlete. he had a personable, wonder - claiborne, Ph.D., at Vanderbilt in 1958, ful way about him,” Johnston said. “We and they married in 1960. thiNGS to Do were fed on athletics. We set out to be “My grades improved dramatically iN DeNVer the best, particularly in football and track. after marriage, a reflection of the irre - from Richard Johnston, M.D. our mother was extremely bright and placeable support Mary Anne has given had a particular sense for words. She me over the past 51 years,” he said. +++++++ raised us on robert Frost and encouraged Johnston, Mary Anne and his broth - our reading of poetry.” ers, Dillon and chuck, were all philosophy Summit County’s ski Johnston came to Vanderbilt majors at Vanderbilt. and hiking areas university in 1953 as a pre-med student, Johnston paid for college and med - summitcolorado.com/summit- but instead of immersing himself in his ical school by working summers at a county/hiking studies, he was drawn to participate in YMcA camp in Atlanta. extracurricular activities. “When i got to “When the camp ended at 3, i went Denver Center for Performing Arts Vanderbilt, i was not a committed stu - to the pool and taught private lessons to denvercenter.org dent nor was i an effective student,” he kids,” he recalled. “it taught me two said. he played halfback on the freshman things: i really loved interacting with Denver Art Museum’s art of football team until he had a career-ending kids – it was great fun for me – and it western U.S. and Asia anterior cruciate ligament tear midway taught me how rewarding teaching is.” 100 W. 14th Ave. Parkway through the season. Former teammate and longtime friend, Garrett Adams, “Where my soul is” Tattered Cover bookstore M.D., MPh, president of Physicians for a When it was time for Johnston to 2526 East Colfax Ave. National health Prog ram, remembers settle on a career, he chose pediatrics and that Johnston became focused on academ - immunology. “child health is where my Rioja Restaurant ics after he was unable to play football. soul is,” Johnston said. “My professional 1433 Larimer St. “i remember visiting him in his dorm goals are centered on doing something to room,” Adams recalled. “it was so neat. improve the lives and health of children.”

10 WINTER 2012 alumni profile ::

Medical school was a challenging but sat - system. these results were published in Society, and international Pediatric isfying time for Johnston. “i felt like i the New England Journal of Medicine in research Foundation and is a member of was tolerated and nurtured until i reached 1973. he has since published 285 schol - the institute of Medicine (ioM) of the a higher level,” he said. “i valued so much arly papers. Johnston first came to National Academies of Science. he has the sense of community that we had with colorado, where he and his wife live and chaired vaccine advisory committees for the faculty, and the way they were devote d work now, in 1977. he served as profes - the FDA and the centers for Disease to teaching us was remarkable.” Johnston sor of Pediatrics at National Jewish control and Prevention and has chaired appreciated the high expectations he felt hospital and university of colorado seven ioM committees. he received the throughout medical school and into his School of Medicine for nine years. he highest award in academic pediatrics, the two-year pediatric residency. was recruited in 1986 to join the howland Medal, in 2008, in the foot - “i was taught to never fall short of university of Pennsylvania as chair of the steps of his Vanderbilt teachers and earlier doing what was absolutely optimal for Department of Pediatrics and physician- howland awardees, Amos christie, every patient,” he said. “Whatever it took, in-chief at children’s hospital of M.D., and Mildred Stahlman, M.D. that is what we were taught; anything short Philadelphia. he later joined the Yale throughout his career, Johnston has of the best possible was unacceptable.” School of Medicine, then found his way remained a loyal supporter of Vanderbilt. During an immunology fellowship back to university of colorado School of in 2008, he was honored with the at children’s hospital, harvard Medical Medicine and National Jewish health, Distinguished Alumnus award, nominated School, Johnston did immunology where he has remained for the last 12 by Adams. Johnston recently joined the studies for the early development of the years. As the associate dean for research Medical center Advisory committee for haemophilus influenze type B vaccine. Development, Johnston created and over - the Vanderbilt university Board of trust. Later at the university of Alabama- sees four committees that the school uses For his many accomplishments, Adams Birmingham he investigated why sickle cell to support research and determine its says Johnston has remained the same patients were so susceptible to pneumococ - research priorities. warm, unassuming, genuine person he cal infection and found an abnormality in “he’s indispensable,” said e. chester met during their freshman year. the phagocytosis-promoting complement “chip” ridgway, M.D., executive vice “the gift he brings is the unusual chair of Medicine, Frederic hamilton depth of academic research experience at Professor of Medicine and senior associate the very highest levels,” he said. The Johnston family regularly gathers at Pawley’s Island, S.C. Top row: son Richard dean for Academic Affairs at university of Far more important than his career, (MD ‘89), son-in-law Jason, son Clay, Richard colorado School of Medicine. “he Johnston said, is being a father to three Johnston; Second row from top: daughter approaches everything with grace and and a grandfather to seven. his elder Kristin, daughter-in-law Clarissa and Johnston’s wife, Mary Anne; seven never comes to a problem with an agenda. son, richard, a 1989 graduate of VuSM, grandchildren complete the picture. Quite simply, he wants people to give is an orthopaedic surgeon and has been ideas an honest evaluation. his passion is a physician for the Atlanta Falcons. his to push process forward and he has done younger son, claiborne, is a professor that in spades on this campus.” of Neurology and research leader at Johnston has written and given university of california-San Francisco. talks on the subject of ethical decision- his daughter, Kristin, is a pediatric clinical making in medical policy and practice psychologist in Boulder, colo. Johnston and has urged other physicians to ques - may be inspiring a third generation to tion authority and focus on evidence. pursue medicine. When meeting Jeff “this belief is essential to the way i func - Balser, M.D., Ph.D., vice chancellor for tion,” Johnston said. “i really resist being health Affairs, during Vanderbilt’s 2010 told that ‘this is the truth.’” reunion, two of Johnston’s young grand - children told Balser they wanted to go to Accomplished yet humble medical school at Vanderbilt. it’s that principle that has made his “if i’ve contributed anything to the expertise and opinion a sought-after world, it’s being half of the parents of resource at many of the most respected three spectacular children and now grand - medical organizations in the nation. he father to their children,” Johnston said. has been president of the Society for “that’s the most fulfilling part of my Pediatric research, American Pediatric life.” VM

WINTER 2012 11 :: feature

12 WINTER 2012 vanderbilt kennedy center ::

WRITTEN BY JENNIFER WETZEL PHOTOGRAPH BY DANIEL DUBOIS

Next Steps at Vanderbilt program prepares young adults for the road ahead

eanne Gavigan embarked on her first bike ride at the age of 22. Like any beginner, she fell a few times before getting the hang of it, but unlike a novice, she already had the ambitious goal of a 20- mile race. A mere three weeks later, her mission was accom - plished as she and Vanderbilt J medical student Jessi Solomon crossed the finish line on a tandem bike at the 12th Annual Audi Best Buddies Challenge in Hyannis Port, Mass. “I won! I rode 20 miles!” Jeanne told Solomon at the completion of the race. As a young adult with Down syndrome, Jeanne has tackled many obstacles, including this bike ride, proving an intellectual disability doesn’t define a person.

WINTER 2012 13 :: vanderbilt kennedy center

er cycling disabilities, providing individualized pro - undergraduate-level class with other companion grams of study in the areas of education, Vanderbilt students. to date, 25 Solomon says social skills and vocational training. Vanderbilt faculty members have wel - her race with upon completion of the Next Steps comed Next Steps students into their Jeanne was program, the longtime goal has been for classrooms, with courses ranging from one of her every graduate to be in paid employment theatre to psychology, education to most memo - positions or volunteering their time in physics. H rable life expe - places they want to be. Jeanne’s goal is to A popular opportunity is the science riences. work at the tennessee Performing Arts lab, a partnership between the Department “We flew down the hills of cape center, and with the help of Next Steps, of Physics and Astronomy and Vanderbilt cod singing songs from “Aladdin” at the she is well on her way. Studen t Volunteers for Science (VSVS), a top of our lungs because [Jeanne] loves “With clear and high expectations, service organization comprised of under - Disney movies,” Solomon said. “We are we all rise,” said tammy Day, M.ed., graduate, graduate and medical students so much alike; Jeanne is so enthusiastic Next Steps program director. “our stu - who teach science lessons to middle and acts the way i want to act all the dents have very specific goals, and they’re school students. time.” rising to them.” “[expanding VSVS to] include people Solomon’s passion for individuals with disabilities reminds us that teaching with special needs ignited as an under - Experiencing College Life and learning take many different forms,” graduate student in the Department of recognizing a deficit in opportuni - sai d rich helms, Ph.D., lecturer in Special education at Vanderbilt’s ties for this population, coupled with the Physics and lab coordinator. “Working Peabody college, where she joined the desire many of these high school graduates with the Next Steps group has made me a Best Buddies chapter, an organization have for higher education, the Vanderbilt better teacher, even when working with that fosters friendships among Vanderbilt Kennedy center (VKc) created Next traditional students.” students and individuals with intellectual Steps at Vanderbilt, one of only two col - Sharon Shields, Ph.D., professor of disabilities. Now in her second year of lege programs in tennessee for adults the Practice of human and organizational medical school, Solomon plans to use her with disabilities. Development and Dean of Professional training to specialize in the care of adults “Most people don’t stop to think education, says participation with the with disabilities. about what happens to an individual with Next Steps program has been a highlight Jeanne is a student in the Next Steps a disability when they leave high school,” of her 35-year teaching career. at Vanderbilt program, a two-year certifica - Day said. “Parents really grapple with “i am just so taken with these stu - tion program for students with intellectual what’s going to happen next.” dents and what they add to our classes,” the goal of the program is to broaden Shields said. “they are eager to learn, career options and provide life skills train - their assignments are in on time, they Y

M ing. Students participate in internships, work diligently, they are attentive, they R U

N technical training, student-to-student attend each class and they understand the A S U

S mentorship and integrated classroom gift that is their education.” experiences while learning life skills that Shields teaches a course on health can lead to more independence. service delivery to diverse populations and twelve students enrolled in the four- says the Next Steps students contribute in semester program, attending classes, meaningful ways and offer perspectives spending time with their peer mentors, she and the traditional students otherwise eating in the cafeteria and simply experi - would not have in the class. encing college life. they complete four one of these experiences occurred classes each semester, including one when her class worked with Mending hearts, a Nashville-based transitional housing initiative for women who have been released from prison or are suffering Tammy Day, M.Ed., is program director from addiction and are homeless. A recov - for Next Steps at Vanderbilt, which pro - ering woman in the program shared her vides a higher education experience for story of addiction, a battle that ultimately people with intellectual disabilities. led to losing custody of her chil dren.

14 WINTER 2012 vanderbilt kennedy center :: L L E S S U R

N H O J A Look Back

TIMELINE OF THE JOHN F. KENNEDY CENTER, KNOWN NOW AS THE VANDERBILT KENNEDY CENTER

Jan. 31, 1964 - Peabody College submitted a proposal to the Joseph P. Kennedy Jr. Foundation for a matching gift to estab - lish the “Center for Research on Human Development.”

May 29, 1965 - A convocation was held marking the establishment of the John F. Kennedy Center for Research on Education and Human Development.

March 31, 1968 - A dedication was held celebrating the completion of the two Sharon Shields, Ph.D., right, says participa - “As more and more people find out Kennedy Center buildings. tion in Next Steps has been a highlight of her about the program, the movement will teaching career. grow bigger and stronger,” Brooks said. July 1979 - Peabody College merged “More people will want to join, and with Vanderbilt University, making Jeanne Gavigan was in this class and before you know it, there will be pro - possible expansion of the center’s interdisciplinary research, in particular spoke up to comfort the woman, telling grams all over the state. As Vanderbilt is neuroscience research. her about her own mother’s death a few successful, other colleges and universities years earlier. Jeanne told her she had will want to step on board and develop Oct. 20, 1994 - The inaugural meeting never forgotten her mother, and that her programs of their own.” was held of the Kennedy Center children had not forgotten her, either. Leadership Council led by Annette Career Aspirations Eskind, founding chair. The Nicholas “here is [Jeanne] who can share so Hobbs Donor Society was established. freely and be so direct and compassionate During Next Steps, students build and caring,” Shields said. “What if that their resume through a variety of intern - 1998 - Treatment and Research Next Steps student had not been sitting ships within area businesses and on Institute for Autism Spectrum in my class? that would have never hap - Vanderbilt’s campus in the libraries and Disorders (TRIAD) founded. pened on that day. bookstore. July 2001 - The Kennedy Center “the Next Steps students have Jeanne’s dad, William Gavigan, becomes a Vanderbilt University-wide changed the climate and culture of our M.D., a Nashville orthopaedic surgeon, research center, further enhancing the college. We are learning as much, if not says his daughter loves musical theatre center’s interdisciplinary resources. more, from them as they are from us.” and is currently in her “dream job” vol - 2005 - Vanderbilt Kennedy Center is Support for the creation of the pro - unteering in the administrative office at designated as a University Center for gram was provided by gifts from Linda the tennessee Performing Arts center Excellence in Developmental Brooks, her family, and her LDB (tPAc). in addition to her job at tPAc, Disabilities. Foundation. Key funding also came from she spent time working with the Kennedy the Louise Bullard Wallace Foundation center’s recent SeNSe theatre produc - 2008 - Vanderbilt Leadership Education in Neurodevelopmental Disabilities and a grant from the tennessee council tion, a theatrical intervention program for Training Program becomes a part of on Developmental Disabilities. children with autism spectrum disorders. the Vanderbilt Kennedy Center. Brooks, a member of the VKc “You put her on a stage and she does Leadership council, has worked for years great,” Gavigan said, noting she got this Fall 2011 - The “MRL Building” was for the creation of postsecondary oppor - interest and ability from her late mother. renamed One Magnolia Circle. tunities for young adults with disabilities Gavigan says the Next Steps program in tennessee. has made a huge impact on Jeanne, stat ing

WINTER 2012 15 :: vanderbilt kennedy center

that before this program, she was more to change their life course much earlier? Jessi Solomon has found by befriending inflexible and unable to deviate from rou - What supports need to be in place?” Jeanne and others with intellectual dis - tines. Next Steps has taught her how to one of the ways carter is tackling abilities. be more adaptive, he says. these questions is by launching a series of “everyone is different; there is no “She has transcended from a person community conversations, a gathering of ‘we’ and ‘they,’” Solomon said. “Some who could do hardly anything because business and community leaders, educa - people with disabilities can read, some can she was so stubborn,” he said laughingly, tors and parents whose goal is to seek do math, some can talk in front of a big “to becoming a young woman who can solutions and identify their role in help - audience, some can play the saxophone. do all kinds of things. ing individuals with disabilities gain “Get to know people’s individual “if there weren’t a Next Steps pro - employment. strengths and discover how you can sup - gram, most kids with disabilities would “if we tap into the resources we port them,” she encouraged. VM have nothing after high school. there’s already have, we can change outcomes in nothing really out there for them, and it’s radical ways,” carter said. “if we are Jessi Solomon received the Canby Robinson a universal problem.” going to change employment outcomes, Scholarship, a full-tuition scholarship to we have to engage more than the service Vanderbilt University School of Medicine. Community Involvement systems. Business leaders and employee Gavigan says his 22-year journey networks know more about what their with Jeanne has been full of closed doors, industry needs than anyone.” and he hopes communities will become more open to people with disabilities. The Road Ahead “Give them a chance,” he said. the first class of six Next Steps stu - “there is more under the surface, more dents graduated in December 2011, leaving there than you might think.” with tools to live more independent lives. employment outcomes for people one such tool is a one-page profile with disabilities are low, with the unem - developed with each student that, unlike VKC DIRECTORS ployment rate double that of people with - a traditional resume, details more human - 1965-1970 out disabilities, according to the united istic aspects about a person. Nicholas Hobbs, Ph.D. States Department of Labor. erik carter, the profile exemplifies person- Ph.D., associate professor of Special centered planning, the recommended 1970-1971 education and Kennedy center member, practice for life planning, says carol Donald Stedman, Ph.D. wants to determine what can be done to rabideau, Licensed clinical Social 1971-1983 set students with disabilities on a different Worker for the Kennedy center and cer - H. Carl Haywood, Ph.D. trajectory. tified person-centered thinking trainer for “We send young people to school for the state of tennessee. 1983-1990 years, and then we get a glimpse of what “the point [of person-centered plan - Alfred Baumeister, Ph.D. kinds of experiences they have at the end ning] is that we’re getting information 1990-1991 of that schooling when the bus doesn’t from the person instead of us trying to Steven Warren, Ph.D., acting director show up anymore, and it’s a pretty disap - decide what experiences they should pointing picture,” carter said. “Many have,” rabideau said. 1991-2000 adults with disabilities stay home after high “it’s impressive to see the things Travis Thompson, Ph.D. school and graduate to the couch, not important to [the Next Steps students] 2000-2002 because they have aspirations for that but about working,” noting examples such as Stephen Camarata, Ph.D., because they don’t have opportuni ties.” being on time, doing a good job, staying acting director carter’s research and teaching focuses busy and being in a social environment. on evidence-based strategies for promoting Additionally, the profile describes the 2002-2008 Pat Levitt, Ph.D. valued roles in school, work and commu - kind of support an employer can provide nity settings for children and adults with to help a person be successful in a job. 2008-present intellectual and developmental disabilities. however, it is not problem-focused, but Elisabeth Dykens, Ph.D. “We can’t start thinking about tran - rather demonstrates what a person with sitions to college or careers the day after disabilities can do, she said. high school,” he said. “how do we begin it’s these special talents and gifts that

16 WINTER 2012 vanderbilt kennedy center ::

Siblings Mary Landon, Rob and Sam Funk D N A L

LONGER LIFESPAN BRINGS G N E

C I R NEW SET OF CHALLENGES E

the life expectancy of examining these issues, using adults with Down syndrome both large-scale national sur - has nearly doubled in the last veys and the tennessee vital 40 years. What would be per - statistics databases. ceived as wonderful news for “We are finding that future families with a child with the caregiving is anticipated more most commonly occurring often by the family’s daughters chromosomal condition is (as opposed to sons), those with setting off alarms within the good relationships with the disability community. brother/sister with disabilities, And researchers at the and when parents themselves Vanderbilt Kennedy center are more (not less) able to care (VKc) are leading the charge. for the brother/sister. would more than likely outlive grader at Franklin road “We have been calling it a “our job is to develop her. She and her husband pre - Academy, he is enrolled in ‘demographic time bomb,’” policies and interventions that pared a special needs trust to heart to heart, a parallel edu - said robert hodapp, Ph.D., equip all family members with provide for him. But they also cational program for students professor of Special education the knowledge and skills neces - looked to their oldest child for with Down syndrome. it is one and director of research at sary to assume such lifelong support as well. a few of its kind in the country. the university center for commitments,” urbano said. “We have always tried to Although the Funks are excellence in Developmental instill in her a sense of respon - grateful for the innovative Disabilities (uceDD). “What One family’s experience sibility,” said Lori Funk of her program, they admit more we are seeing is that adult Lori and Glenn Funk of daughter, 19. “if i died today, attention needs to be directed service systems in most states, Nashville applaud the work she could completely and totally at people with disabilities. including ours, are limited. being done at VKc. the land - take care of rob. She knows “i have always felt that We, as a society, don’t spend scape has changed in the 17 his wants and needs and every - there is not enough attention a lot of money on caring for years since their middle child, thing about him.” or money spent on people adults with disabilities or rob, was born with Down When she turned 18, with special needs,” said Funk. providing appropriate services syndrome. Mary Landon did not hesitate “Whether it is education or the for them.” “At the time he was born, to accept her parents’ request. basics for day-to-day living, it VKc researchers are work - i did most of the research on “if something were to hap - takes a lot of money to give ing to inform policy makers at my own,” recalled Lori Funk. pen to my parents, i have been your child what he or she the local, state and national “My pediatrician was great. briefed on what to do,” said needs. More needs to be done.” level about the expanding rob was her first patient with Mary Landon, a freshman at hodapp and urbano agree needs for support and services. Down syndrome. there wasn’t Princeton university. “i’m that despite 150 years of docu - “one question that needs much else available in terms of ready for the responsibility and mentation of Down syndrome, particular attention, especially if support and information. i didn’t think twice about it. huge gaps exist in the field of most individuals with disabilities “i remember reading this “if rob was mine to look disability research. continue to live in their parents’ book “children with Down after, it would be just like look - “there are lots of ques - homes, is who is going to care Syndrome.” it devastated me to ing after anyone. i know it will tions and health issues that for this population when the read that i would outlive my be harder for various reasons, really haven’t been explored,” parents can no longer do so?” child. i remember crying and but it is not going to interfere said urbano. “With the work hodapp, along with col - crying,” Funk said. with my career path, my rela - we are doing, we are hoping to league richard urbano, Ph.D., rob joined big sister Mary tionships…” impact public policy and research professor of Pediatrics Landon. Six years later brother rob has the most common empower families, clinicians and director of evaluation at Sam, now 11, was born. over form of Down syndrome, and teachers.” uceDD, have spent years time, Funk learned that rob called trisomy 21. An eighth- - JESSICA PASLEY

WINTER 2012 17 :: music city medicine

18 WINTER 2012 vanderbilt kennedy center :: A Hard Day’s Night

Researcher aims to improve daytime behavior of children with autism, including her own, through better sleep

Beth Malow, M.D., M.S., is always on the go. Attending back-to-back meetings, she bursts into a room with an overloaded bag on her shoul - der, lunch in her hand and a caffeine-free Diet Coke. It’s 2:30 p.m., and she hasn’t eaten yet, so she eats while she talks. She is a busy woman who rarely has time to rest, yet sleep is her area of expertise.

She is specifically interested in the sleep habits of children with autism. As a Vanderbilt Kennedy Center investigator, she is a nationally recognized expert in this area, juggling multiple research studies on the subject, while running the Sleep Disorders clinic, and serving as the principal i nvestiga - tor for Vanderbilt’s Autism Treatment Network Site.

Her research area is not necessarily one she chose but one that chose her. Malow, who treats the sleep disorders of children with autism, edu - cates their tired and frustrated parents and runs clinical trials with the hope of improving their lives, is also the parent of two children, both of whom are on the autism spectrum.

WRITTEN BY KATHY WHITNEY PHOTOGRAPH BY DANIEL DUBOIS ILLUSTRATION BY KYLIE BECK

WINTER 2012 19 :: vanderbilt kennedy center

Able to Empathize autism within five minutes. Malow, who a wrapped gift the next day, a concept A professor of Neurology and was pregnant with her second child at the developed by child psychologist Patrick Pediatrics, Malow recalls that when her son time, was in shock. Friman. Austin was a toddler he did not respond to “i thought, ‘What in the world is “After three nights of doing this, he her calling his name. She attributed that to that?’ i thought kids with autism just sat in slept through the night. We didn’t have his delayed language development, which a corner in their own little world,” she said. to do it anymore,” she said. she attributed to his being a boy. Malow had graduated from Malow shares her personal experi - “he was my first son, and i hadn’t Northwestern university Medical School ences with her patients and their parents, been around younger kids because my in 1986, completed a Neurology residen - and for Joellyn Boggess of Paducah, Ky., brothers are both older than me. What i cy in Boston, and an epilepsy, eeG and it made all the difference. noticed was that Austin always liked to be sleep fellowship at the National institutes Boggess’ daughter, erin, was diag - in his car seat, and when i held him, he of health. She trained to practice adult nosed with Asperger’s syndrome a year was kind of rigid. i had trouble getting neurology. She and her husband, whom ago. her daughter was very active and him to respond to me, but i didn’t know Malow calls “one of the amazing supports had difficulty calming down enough to what normal was.” in my life,” quickly educated themselves fall asleep. Boggess and her husband also Malow, her husband, Stephen Pert, on autism. have 5-year-old twins and the whole fami - and Austin were living in Ann Arbor, “We did everything in our power to ly was exhausted from too little sleep. Mich., when they sought a professional interact with Austin. We got everyone to they enrolled in Malow’s sleep edu - evaluation. Austin was diagnosed with interact with him. he got better, like really cation study and during the course of that making nice strides. We got him into pre - trial, Malow called Boggess to talk school. the teachers made him look them through some concerns. in the eye and they taught him how to “it was so nice to talk with a physi - look at them. they taught me that you cian who understood. You rarely get one can’t just ask him to talk, you’ve got to who understands your life is different on make him talk.” a daily basis. When she said she has chil - ten years later, Malow still remembers dren with autism, i knew i didn’t have to clearly the day her son, now 13, spoke. explain anything to her. You don’t under - Tips for Getting Your “i was driving home from preschool stand unless you have this life and a child with him. i put on the Dixie chicks, and with special needs. You don’t know how Child to Sleep i knew he hated country music because stressful it is,” Boggess said. 1. Provide a comfortable sleep setting he would make grunting sounds. i said, (create a safe, quiet sleeping setting for ‘Austin, if you want me to turn off the Studying Sleep and Behavior your child). music, i will, but you’ve got to say stop.’ Malow runs two sleep clinics per More grunts. ‘Whenever you’re ready i week and treats a variety of sleep disorders 2. Establish a regular bedtime routine (bedtime habits that are short, pre - will turn off the music but you’ve got to in both adults and children. dictable and expected). say stop.’ he said ‘stop.’ that was the “i did more adult sleep than pedi - first time he ever said a word to convey atrics before i had kids. i like the idea of 3. Keep a regular schedule (choose a that he needed or wanted something.” whether you’re 2 or 92, whether you have bedtime and keep it). Fortunately, Austin was a good sleeper insomnia, sleep apnea or narcolepsy, your 4. Teach your child to fall asleep alone from the time of infancy. her second son, sleep disorder can be treated. i really like (if you regularly lie down with your child Daniel, now 10, also diagnosed with that,” she said. “What’s different is i now at bedtime, move to the chair beside the autism, experienced trouble falling asleep have a group of kids with autism who are bed and then move across the room and then out of the bedroom). and staying asleep. Malow and her hus - referred to my clinic. My research interest band put into practice some of the sleep has shifted from sleep and epilepsy to 5. Encourage daytime behaviors that hygiene protocols she gives to her sleep and autism.” promote sleep (increase exercise and patients, including the use of a bedtime two-thirds of children with autism decrease caffeine and other stimulants). pass which motivated Daniel to stay in are reported to have a sleep disorder, (source: the Autism Treatment Network) bed throughout the night in exchange for which is confirmed by objective measures

20 WINTER 2012 vanderbilt kennedy center :: S I O B U D

L E I N A D

Beth Malow, M.D., and her husband Stephen Pert with their sons Austin, S I O

left, and Daniel, both of whom are on B U D

the autism spectrum. L E I N A D

like actigraphy, which monitors sleep by given night they are much better the next sleep does not improve for the child, then tracking movements at night via a wrist - day, they are less volatile, calmer.” Malow begins to look at neurobiological watch-like device. it requires parents to Malow suspects that co-occurring factors such as melatonin deficiency. her keep accurate sleep diaries since actigra - medical conditions such as anxiety, research has documented, and is support - phy needs to be interpreted in the context depression or epileptic seizures, each com - ed by outside studies, that melatonin of when the child went to bed and arose mon in children with autism, contribute is low in some children with autism. from bed. to the problem, as well as poor sleep Neurotransmitters, serotonin and GABA the most prevalent sleep disorder hygiene such as too much stimulation receptors have been implicated in autism among children on the autism spectrum is before bedtime or lax bedtime rules due and also in sleep. insomnia, which can take the form of dif - to parents’ frustration. there may be “if someone has low or delayed mela - ficulty going to sleep, waking up at night underlying genetic factors as well. tonin, they may have more trouble falling or early morning waking. Short sleep “i am trying to clean up their sleep, asleep. By giving supplemental melatonin duration – three to four hours a night – is fix the things that are fixable. that makes you are replacing the melatonin they also common. great sense clinically. i want to know how don’t have or giving it to them at a time “When you take a child who is already many kids who are not sleeping well will when they need it to sleep,” she said. “We impaired and has issues with focusing, start if you do a few simple things with need to study if this theory actually is cor - behavior, social interaction and executive the parents, as opposed to those who will rect, however.” functions and throw on top of it their not still not sleep well if you do a few things it is important for parents to recog - sleeping, it’s going to take a toll,” she said. with the parents. i think they are differ - nize that melatonin is a drug, and needs “i’ve had parents who have participated ent genetically.” to be given under the care of a physician, in our observational studies commonly if a family changes its sleep behavior Malow said. say if their children get more sleep on any and addresses medical conditions and A recent Vanderbilt study indicates

WINTER 2012 21 :: vanderbilt kennedy center S I O

B unique viewpoint on working with and U D

L raising children with autism. E I N A

D “i think that there is a lot of talent and skills that people with autism possess. i think that the problem is they can’t suc - ceed in our society because they are held back in lots of different ways, particularly socially,” she said. “i think if people are sleeping better, they can be more focused and engaged.” the Autism Speaks’ Board of Directors recently renewed Vanderbilt university as an Autism treatment Network (AtN) site with a three-year, $420,000 grant to continue developing standards and guidelines for the evaluation and treatment of medical conditions asso - ciated with autism. Vanderbilt was first selected as a site in 2008 and is one of 17 Sleep research is one of the many initiatives know how many will respond to behav - centers in the united States and canada. made possible through Vanderbilt’s partici - ioral treatment and melatonin.” Malow said the grant would be used pation in the national Autism Treatment Network. to fund initiatives under way in the medical Receiving Recognition and behavioral aspects of autism research that melatonin shows promise in helping in September 2011, Malow was one and development of clinical guidelines. children with autism spectrum disorders of 10 Vanderbilt university faculty mem - “i really see, not just in my own kids, (ASD), and their families, sleep better. bers named to endowed chairs, recognized but interacting with other kids in the the study, published in the Journal of for outstanding leadership in their aca - autism community, how much potential Autism and Developmental Disorders in demic fields. She received the Burry chair there is for these kids and adults and how, January, contributes to the growing litera - in cognitive childhood Development in if we can just help them with their med - ture on supplemental melatonin for insom - the Department of Pediatrics. VuSM ical and psychological issues, we can help nia in ASD. alumnus Michael Burry, M.D., MD ’97, them lead fulfilled lives and contribute in Malow and colleagues recruited chil - was present for the ceremony. a positive way to society. dren ages 3-9 years with a clinical diagnosis Burry, profiled in author Michael “i think some of the brilliance, focus of an ASD whose parents reported sleep Lewis’ bestselling book “the Big Short,” and honesty that these individuals possess onset delay of 30 minutes or longer on is best known as the first financial analyst is actually very important for us all. if we three or more nights per week. to predict America’s financial crisis. Burry can free that up, it’s very exciting. that’s Supplemental melatonin, given 30 was diagnosed with Asperger’s syndrome my mission.” VM minutes before bedtime at 1 mg or 3 mg as an adult and has a son with the same dosages, improved the amount of time it diagnosis. takes to fall asleep in most children. it was an emotional event for Malow Malow is flanked by Jeff Balser, M.D., Ph.D., Melatonin was effective in the first and her family, including her parents who left, and Michael Burry, M.D. N O S

week of treatment, maintained effectiveness came in from South Florida for the cere - W A L

mony on Sept. 26, 2011, the day after Y

over several months, was well-tolerated and M M O safe, and showed improvement in sleep, Austin’s 13th birthday. T behavior and parenting stress. “it was a very intense time for me. “We really need to do this evidence- My husband and i never thought Austin based work. We just don’t know yet would talk or play sports. And now we enough about sleep and autism to make can’t get him to shut up. he’s very popu - solid recommendations. We don’t know lar in school. he is doing great,” she said. how many children will respond to Malow and Burry had a chance to behavioral treatment alone; we don’t talk over dinner and she shared her

22 WINTER 2012 vanderbilt kennedy center ::

Ana, Jemima and Juan Cardona L L E W O H

E O TIME OUT J Parents of children with disabilities learn to manage stress Juan Cardona thought he saw her getting the right feel - was “too much like a macho ings too.” man” to meditate, but as the Elisabeth Dykens, Ph.D., father of a daughter on the VKC director and principal autism spectrum, learning to investigator of PSIP, said breathe deeply and focus his despite the information and thoughts brought a tremen - interventions available for dous change in his stress level children with disabilities, par - and perspective on life. ent stress levels remain high. Juan and his wife, Ana, “What I really like about participated in the Vanderbilt this program is that it doesn’t Kennedy Center’s Parent heap on more information baseline stress associated began to withdraw and Stress Intervention Project about children’s disabilities. with raising a special needs become more introverted. In (PSIP), a research study fund - We don’t talk about more child, and then add moving college, she had constant ed by a National Institutes of therapy or less medication. every two to three years to a problems with roommates, Health Challenge Grant that We focus on adult growth and ne w community,” he said. and after graduating with a evaluated the best methods development, giving parents “Then you add the stress degree in graphic design was for managing stress in parents tools to stay engaged, find of deployment. We’re now fired from eight jobs all in the of children with disabilities. meaning, address their stress close to one of the longest first month. One group of parents was and take care of themselves. ongoing wars but the lowest “As her parents, it was randomly assigned to a con - Parents typically realized that percentage of people asked to hell. She has this frustration, ventional support group that if they could take better care serve. We place a significant which turns into anger, and taught positive parenting tech - of themselves, then they could burden on the same families every way she turns she feels niques while the other group, become a better parent,” over and over again. This has a boxed in. She could be very which included the Cardonas, Dykens said. significant impact on emotion - combative and we didn’t have learned a technique called PSIP enrollees totaled al factors, and special needs the tools to help her. We went Mindfulness-Based Stress 380 and served families families feel that even more.” through it blindly,” Geraci said. Reduction (MBSR). It uses impacted by a range of dis - Another facet of parent After a particularly bad breathing and movement to abilities, including autism, stress is that it can continue argument one night, he help people be deliberately attention deficit hyperactivity for a lifetime. searched for study groups at aware of the present moment. disorder, Down syndrome and “The reality is that about VKC and found PSIP. With their daughter Turner syndrome. 80-85 percent of adults with “One of the most impor - Jemima enrolled in pre- Results are still being intellectual or developmental tant things I learned is to take kindergarten and receiving compiled for publication, but disabilities live with their par - time for yourself and get away many interventions for her both interventions led to ents. So it’s a lifelong process, from it. You get so wrapped up disability, the Cardonas have improvements in parental and we’re here for them in it because it’s your child an impossibly full schedule functioning, with MBSR bring - throughout,” Dykens said. and you love them and want and stress is a constant. ing results faster and more Gene Geraci is one of what’s best for them. But you “I started taking 5-minute sustained. those older parents welcomed have to get away,” Geraci said. breaks to take a walk and PSIP also traveled to Fort into PSIP – he is father to a 30- “I owe Vanderbilt a lot notice my breath,” Ana said. Campbell, Ky., the U.S. Army year-old daughter who has a because I finally found what I “There are little things we just base, to evaluate stress in mil - genetic abnormality that brings was looking for after almost ignore because of the crazi - itary families, which Quentin developmental issues. He felt a 30 years.” VM ness of life. I started to notice Humberd, M.D., developmental bit out of place because many - LESLIE HILL the trees and the birds, and pediatrician at Blanchfield Army parents had young children, this helped me calm myself,” Community Hospital, said but he said what he learned Ana said. “If Jemima sees me come s in a unique combination. saved his family. frustrated, she gets frustrated. “Military families with dis - His daughter was a free- When I changed my attitude, I abled members have the spirited child, but in her teens

WINTER 2012 23 :: feature

24 WINTER 2012 feature ::

WRITTEN BY NANCY HUMPHREY ILLUSTRATION BY DAVE CUTLER WARNING

Program assesses malpractice risk and SIGNS advises physicians of possible danger ahead

A cloud of malpractice risk appears to hover over a very small subset of physicians. They may be well-trained and highly credentialed, even on a “best doctors” list somewhere, but for different reasons some physicians are at more risk to be sued for malpractice. The statistics are surprising. Only 2 percent to 8 percent of physicians per discipline are responsible for up to 30 percent of all malpractice claims in that discipline.

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Many malpractice claims can be prevented, say those involved in Vanderbilt’s Center for Patient and Professional Advocacy (CPPA),

which, through the Patient Advocacy marriage of those two areas of interest led community hospitals, as well as health reporting System (PArS) conducts yearly to the creation of cPPA. the center, systems and physician/medical groups. in risk assessments for physicians across the which has a staff of 36 and five faculty addition, the center has initiated work to country. the center, working with leader - members, has an additional area of focus – include other health care providers such as ship at 60 sites including Stanford, training professionals about professional - advance practice nurses (APNs) and physi - emory, university of Pennsylvania and ism, including the disclosure of adverse cian assistants (PAs). Loyola, collects data on the institution’s events and medical errors (see page 29). in their database, the cPPA has com - physicians and identifies those at risk. “early on i was stunned at the lack pilations from yearly risk assessments on “i like to think of it like one of those of any science, just war stories and anec - more than 35,000 physicians. Partnering traffic signs that flashes and tells you how dotes (about malpractice),” hickson said. hospitals and medical groups electronically fast you’re driving,” said Gerald B. “But over the years we’ve learned that transmit data about their physicians – how hickson, M.D., assistant vice chancellor families observe or experience things with - much they work, what families are saying for Medical Affairs, associate dean for in their health care setting that fail to about each of them – and the center’s data Faculty Affairs, and director of the center. meet or exceed their expectations. And team converts it into risk indexes with “our goal is to let some of our physician when they do, a small subset of them will local, regional and discipline comparisons. colleagues know ‘you’re driving 45 in a let us know – it may be that the physi - this compelling evidence-based informa - 30-mile-per-hour zone, and we thought cian’s office is disorganized or that the tion is then delivered to the leadership at you’d want to know.’” physician doesn’t seem to listen or that each partnering site. using cPPA-trained hickson has studied malpractice there is no follow-up.” peer messengers at each site, the informa - claims for more than 25 years. center the cPPA team has learned to use tion is delivered to the physicians in an co-director James Pichert, Ph.D., and what families say to help identify physi - intervention. “the goal is to encourage hickson combined their expertise 18 years cians who have more than their fair share the physicians to pause and reflect on why ago when hickson was conducting research of malpractice risk. Many of the groups they stand out. it’s a pretty powerful on why patients and their families sue their using PArS “partners” are academic med - process,” hickson said. doctors, and Pichert was researching ical centers like Vanderbilt, but the center only about 4 percent of physicians provider-patient communication. the is now working with more regional and need to be made aware that they stand

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“Our goal is to let some of our physician O B U colleagues know they are driving 45 in a D

L E 30-mile-per-hour zone,” says Gerald I N A Hickson, M.D., director of the Center for D Patient and Professional Advocacy.

out, he added. Since 1998 Vanderbilt’s PArS program has facilitated more than 3,000 interventions with physicians, APNs and PAs around the country. At Vanderbilt, about 100 high-risk physicians have been identified over the past 13 years. “Seventy have done well. Fourteen have departed, and the rest are getting additional assistance,” hickson said.

Delivering the Message once it’s determined that a physician might benefit from an intervention, cPPA professionals train physician-peers at each institution how to deliver the message to their colleagues during what hickson calls “awareness conversations.” the peer training identifies what types of behavior issues have been noted, what the barriers are for addressing the problems, and how to address theDmo uing a Sawyer wasn’t looking for a new treatment for heart failure constructive way. when he started his research fellowship 15 years ago. As a cardiolo - “the goal is not to be jguidsgt,m henet awl oars interested in helping patients with the condition, to be to play ‘gotcha,’ but respectfsuul,r neo, nb-ujut dag s- a scientist, he was more intrigued by the biology of heart mental sharing that ‘for somme ruesascolen , ycoeu lls. He wanted to understand how these cells maintain or your practice just stands out,’” hickson themselves for a lifetime. said. “Sometimes the busy professional doesn’t see what they’re doing. t“hHesoew m dayo constantly beating cardiac myocytes (muscle cells) with - be professionals with great tescthannidca lt hoer wear-and-tear of contraction? And how do they survive for cognitive skills, but sometimseos thme asnysyt emyes ars?” wonders Sawyer, M.D., Ph.D., Lisa M. Jacobson within which they practice aPrer opfoeosrsly or of Medicine and chief of the Division of Cardiovascular designed, and sometimes it mMaeyd bice itnhee at Vanderbilt University Medical Center. individual. regardless, no matter what Sawyer and other investigators have zeroed in on a survival factor – they think about the data, they need to pause and reflect why they staa npdr ootueti.n” called Glial Growth Factor 2 (GGF2) – that protects cardiac Many even become very effemctiyvoe cmyteessse n f-rom stressors in culture and enhances heart function and gers themselves, he said. survival in animal models of heart failure. Now, Sawyer and colleagues “ultimately it’s about healpt inAgc tohred a Therapeutics are poised to test GGF2 for the first time in individual understand their pherusmonaanl patients. accountability to the patients they serve. We can get so busy that we need help seeing a situation from the patient’s perspective.”

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Teamwork and Respect pected. “We had one individual who was a Bryan Bohman, M.D., associate chief surprising person to see on the list. he medical officer of Stanford hospitals and isn’t prickly or short-tempered. this indi - clinics, said that Stanford “leapt” at the vidual was ‘everybody’s favorite guy.’ chance in 2009 to implement Vanderbilt’s When we took a closer look at the com - PArS program. “We didn’t have a good plaints we found that many of his patients system for addressing disruptive behavior with chronic pain felt like he promised to and risk in a systematic way. it isn’t the make them better and couldn’t. he was old-style heroic doctor taking care of the giving them a false promise or sense of patient and everybody else is an after - hope.” thought. it’s a different world and to Armed with helpful information from function well you need an atmosphere of the PArS program the physician changed teamwork, trust and respect. the way he conducted introductory meet - “We had some professionals who ings with patients. Bohman said he were ‘toxic’ to the Stanford environment,” believes the PArS program has improved Bohman said. “We told them they needed physician behavior at Stanford. “i’m a Bryan Bohman, M.D., imple - to improve or depart, to be blunt.” scientist and i normally don’t put much mented Vanderbilt’s Patient the most beneficial part of the PArS stock in anecdotal reports, but we have Advocacy Reporting System anecdotal reports from our nursing staff at Stanford. program is its scientific basis and that it has been validated, he said. “When some - that they’re seeing a change. Mostly, one is identified as being at risk through there’s a lot more awareness that patient the PArS program, it’s a lot easier for us concerns need to be addressed.” to deal with them than by acting on one patient complaint at a time.” Impact of Tort Reform Bohman said that some of the data in May 2011, tennessee’s lawmakers provided by the PArS program was unex - passed the tennessee civil Justice Act of

PROGRAM HELPS SURGEON PRIORITIZE

A Vanderbilt surgeon, morale which was passed along determine the changes that physician,” he said. “In a large found to be at high-risk for to their care of the patients. “As needed to occur. system like Vanderbilt, we as being sued for malpractice, I got busier, my patients felt as “It helped me refocus on physicians will be pulled in said that a jam-packed sched - if they could not get a hold of my priority as a physician, many competing directions. ule made patients feel he anyone with a concern.” which is patient care, versus At the end of the day, we have wasn’t available to them. The bottom line was that trying to run an ‘efficient to step up and take responsi - “My patients were unhap - patient satisfaction was not assembly line’ of patients. I bility for the care of our py as they felt they had a hard the surgeon’s primary focus. learned to say ‘no’ and to work patients, and while we need to time with access to me, and I Clinical volume, and the hard to limit my patient load to remain professional, we can - was not spending enough time resulting revenue, was. something that I can manage not be passive in relegating communicating,” he said. “As An “awareness conversa - effectively,” the surgeon said. ‘responsibility’ of this to those a surgeon, our compensation tion” with a peer messenger An awareness conversa - around us. Vanderbilt is a and value is driven by volume, from Vanderbilt’s Center for tion should be taken for what great system with a fantastic and I was trying to see too Patient and Professional it is – a conversation to make infrastructure, but at the end many patients and schedule Advocacy left the surgeon a physician aware of concern - of the day, we are still the too many cases.” initially feeling frustrated and ing actions or behaviors. “It is physicians who our patients In addition, the surgeon’s confused about expectations. not a judgment of you as a place their trust in.” busy schedule affected clinic But then it allowed him to person, or that you are a ‘bad’ - NANCY HUMPHREY

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2011, a major tort reform package and a legislative priority of Gov. Bill haslam. it HOW TO DISCLOSE A MEDICAL ERROR caps “non-economic” and punitive dam - age awards in personal injury and health Admitting a mistake is Georgia, and University of outcomes occur. care malpractice lawsuits. Non-economic difficult. When the mis - Illinois at Chicago; and in Premature disclosure losses are difficult to quantify financially, take is a medical error, it other U.S. News and about medical errors like pain and suffering and loss of enjoy - becomes even harder. World Report Honor Roll without knowing all the ment of life. Awards will be capped at Over the past two years hospitals such as Mayo facts can be as disruptive $750,000, in most cases, and at $1 mil - Vanderbilt’s Center for Clinic and University of as no disclosure at all.” lion when victims suffer spinal-cord Patient and Professional Pennsylvania. Health care profession - injuries that lead to loss of use of two or Advocacy (CPPA) has “Professionals commit als are trained in four more limbs. economic damages, which overseen the training of to clear and effective aspects of disclosure – reimburse victims for actual costs like every medical student, communication, and that when there’s clearly an medical care and loss of income, are not resident, fellow, faculty also means when things error related to an avoid - capped. member and administra - go wrong,” said Gerald B. able outcome; when Allen Kaiser, M.D., Vanderbilt tive and nursing leader at Hickson, M.D., assistant there’s uncertainty involv - university hospital chief of Staff, said Vanderbilt University vice chancellor for ing a bad outcome; when that the cPPA has not only had an impact Medical Center on how to Medical Affairs, associate a health professional on Vanderbilt’s malpractice experience, disclose adverse events dean for Faculty Affairs, believes that a previously but on tort reform in general. “there’s a and medical errors. The and director of the center. treating colleague has huge debate on the national scene of the center also conducts pro - “We developed training made an error; and when lack of tort reform, and this center is hav - grams nationally, having programs to equip profes - a patient’s family is deter - ing the most meaningful impact that i “trained trainers” in sionals to understand the mined an error has been know of. our data shows that the severity insurance and risk man - how and when of disclo - made, but it hasn’t. of the outcome is not always the strongest agement societies and sure. We want to make “Ultimately, training has driver of a patient and family looking to hospital associations; sure that professionals to be sustained locally,” sue,” he said. “it’s absolutely tied to the physician practice groups; understand how to best Hickson said. “That is why ability of a physician to accurately and health systems such as share what they know and we are committed to compassionately communicate. Sisters of Mercy Spectrum what they don’t,” Hickson preparing others to share “Jerry hickson saw the problem, had Health and Catholic said. “Professionals are the ‘how to.’” an idea, and was able to implement a new Health Partners; medical committed to transparenc y - NANCY HUMPHREY vision into the day-to-day activities of centers such as Cedars- and to a thorough under - physicians and nurses in the real world of Sinai, Medical College of standing about why bad health care,” Kaiser said. “the center is having an enormous impact on MidTN VUMC Vanderbilt’s malpractice experience and Medical 16 our ability to 1) identify who’s at risk; 2) Malpractice 14 retrain physicians when possible on appro - Claims priate communication strategies; and 3) per 100 12 train all physicians in how to communi - Physicians cate about adverse outcomes and medical 10 errors. i don’t think Jerry will get a Nobel VUMC claims 8 Prize for his work, but it’s certainly genius have significantly in my opinion.” declined since 6 the inception of ultimately, the end goal of the center 4 is simple, hickson said. “We are commit - PARS in 1998 ted to making medicine kinder, safer and 2 more reliable, thinking about the health 0 and well-being of those we serve and those ‘92-93 ‘94-95 ‘96-97 ‘98-99 ‘00-01 ‘02 ‘03 ‘04 ‘05 ‘06 ‘07 ‘08 ‘09 ‘10 ‘11 who deliver their care.” VM

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34 WINTER 2012 feature :: How did this happen?

VANDERBILT’S CARE COMMITTEE OBJECTIVELY EVALUATES VICTIMS OF SUSPECTED CHILD ABUSE AND NEGLECT

hey arrive broken and battered with injuries so obvious there can be little question for the origin. At other times, however, victims of abuse and neglect treated at the Monroe carell Jr. T children’s hospital at Vanderbilt arrive with symptoms so subtle the hospital’s highly experienced team of clinical and legal experts must solve a forensic puzzle to clearly identify sophisticated efforts to conceal the damage done by abusers. in those instances the cAre committee, a team of physicians, nurse practitioners, social workers and lawyers come together to evaluate phys - ical evidence and statements from parents or caregivers about a child’s injuries when abuse or neglect is suspected. children’s hospital, along with other services such as Vanderbilt’s regional Burn center, treats more than 500 incidents of suspected child abuse and neglect each year. During the past five years Vanderbilt has examined 2,849 cases that were reported to tennessee’s Department of children’s Services (DcS) and local law enforcement agencies.

WRITTEN BY JOHN HOWSER ILLUSTRATION BY LEIGH WELLS

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ecause Vanderbilt is a tertiary refer - “i tell parents the reason i’m there is B that i am called upon to examine children ral center, suspected cases of child abuse and when they have unusual injuries. i will neglect are referred from throughout Middle perform a thorough physical evaluation of the child, frequently in the presence of Tennessee and Southern Kentucky. the parent or caregiver, where i am also asking them questions while performing child abuse is a medical diagnosis, medical appointments; and feeding or the examination,” Lowen said. with its own international Statistical nutritional neglect. exposure to illicit “then i’ll conduct a very in-depth, classification of Disease and related drugs during pregnancy is also a form of detailed evaluation of the child’s medical health Problems (icD-9) code; however, neglect and these cases are reported after records, looking through all the records it is also a legal finding to be determined the baby is born. with a fine-toothed comb. i’m looking at by DcS or the court system. Deborah Lowen, M.D., associate such factors as what the parents said to the cAre committee reviews cases professor of Pediatrics and director of the staff at another hospital if the child of children who present with questionable child Abuse Pediatrics, joined Vanderbilt was transferred here, what they said at the physical injuries such as atypical fractures, in 2010. A passionate advocate with sub - time the child presented, what was the concussion, cerebral hemorrhage, retinal specialty training to detect the signs and child’s condition at that point. i also look bleeding, burns, bruises and contusions. symptoms of abuse, she is more than up at all the imaging studies. if necessary, i the committee also evaluates instances of to the task. will again talk to the family to get a thor - medical neglect. “My primary role is to perform clinical ough history about the child, everything i At Vanderbilt there have also been evaluations of children when there are con - can find out.” highly deceptive cases of child abuse cerns about possible abuse or neglect. With through this very detailed process involving poisons or misuse of medica - this responsibility comes an obligation and a complete family, medical and social tions by parents and guardians. a necessity to liaison and interact with com - history takes shape that helps make a child neglect assumes many forms: munity responders such as the Department determination regarding the child’s cur - withholding essential medications, especially of children’s Services, law enforcement and rent circumstances. in chronic illnesses; missing necessary the prosecutor’s office,” she said. “these lengthy conversations with Along with direct clinical responsibil - the family so that i can obtain a history Social worker Mary Murray, left, and ities, Lowen is also responsible for educat - might take anywhere from 20 minutes to Deborah Lowen, M.D., partner to assess each ing faculty, colleagues, residents, medical an hour-and-a-half depending on how case of suspected abuse. students and other caregivers within many caregivers there are, how many L L

E children’s hospital, as well as members injuries a child may have and other cir - W O H of the law enforcement community, cumstances,” she said. E O J about the signs and symptoms of child abuse and neglect and how to respond appropriately. THE MOST RECENT NATIONAL “this is a big problem. You just can’t DATA INDICATES THAT ONE OR MORE put your head in the sand,” she said. PARENTS WERE RESPONSIBLE FOR

A Significant Public Health Problem When suspected child abuse presents, Lowen is contacted for consultation. 79% every case she sees is taken before the OF CHILD ABUSE OR NEGLECT FATALITIES. cAre committee for discussion.

32 WINTER 2012 feature :: L L Lowen conducts these evaluations in E W O H

close concert with social workers. if there E O is reason to suspect abuse she is bound by J tennessee law to report the findings to the DcS, and also to law enforcement. the state of tennessee mandates only one person suspect abuse before reporting is required. “only after we have gathered all the information and put the data together do we arrive at a conclusion. Sometimes the investigative authorities don’t like it when we don’t make a determination right away. i will push back if necessary and say that i am not going to give a determination i am uncomfortable with because i am well aware of the ramifications. i tend to be very conservative on calling abuse,” she said.

Children Most at Risk child abuse may involve repeated acts over time, called battered child syndrome, An indicator for intentionally inflicted Despite years of experience, Julia or may involve a single, impulsive incident. injury may be a parent or caregiver delay - Morris, J.D., deputy general counsel for the University, is still unnerved by With child neglect, injury or death can ing medical intervention. other indicator s the types of abuse injuries she sees. occur from a caregiver’s failure to act. may include a changing history from the According to the Department of health parent or caregiver for how an injury of child abuse as beating children, but it’s and human Services, children younger occurred; a stated history of the child’s still pretty common.” than 1 year died from child abuse and neg - injury not matching the injury’s pattern; As the only resource of its kind in lect at a rate of 17.89 per 100,000. Nearl y or a caregiver reporting a child did some - tennessee, the Burn center treats chil - 80 percent of child fatalities due to abuse thing to cause an injury they’re not able dren from throughout the region. Guy or neglect were caused by one or more to do from a developmental age. estimates as many as 20 percent of the parents. thirty percent of fatalities were Lowen says burns to the buttocks and children treated in the Burn center are perpetrated by the child’s mother acting genitals of toddlers are a frequent response victims of some form of abuse. alone and one-fifth of child fatali ties were to parental frustration over toileting acci - “there are patterns for burns we can caused by both parents. Perpetrators with - dents, while school-age children present look at and determine with significant THE MOST RECENT NATIONAL out a parental relationship to the child with injuries after being beaten with belts certainty the injuries were intentionally DATA INDICATES THAT ONE OR MORE accounted for 12.5 percent of fatalities. or electrical cords for poor grades. inflicted,” he said. “My obligation is to PARENTS WERE RESPONSIBLE FOR “Some people take out their frustra - the child and not to the parent. So some - tions on their kids,” Lowen said. “And Devastating Injuries Through times it can get contentious when we say occasionally there are caregivers who Intentional Burns we have some unanswered questions abuse children simply because they’re “there is an intentional form of child because the story they’re telling us doesn’t mean. those are the rare cases, but i’ve abuse that involves burning,” said Jeff fit the pattern of the injuries.” seen them. But in most cases what we see Guy, M.D., associate professor of Surgery Guy says each instance of a suspected OF CHILD ABUSE OR NEGLECT FATALITIES. is a caregiver taking out their frustrations and director of the Vanderbilt regional intentional burn must be objectively eval - on the child.” Burn center. “it’s not as com mon a form uated.

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“intentional scalding is the most lives,” Guy said. “it’s bad when you abuse still have authority to make medical common burn we see. it’s usually cen tered receive an injured child to treat. it really decisions,” she said. around toilet training with children who sets everyone on edge. however, when Morris has been involved in thou - are less than 3 years old,” he said. “A lot you have an abused child to treat it really sands of cases of child abuse but is still of these are immersion burns. Some of tears at you.” unnerved by some of the things she sees. these pattern injuries are easy to identify “Seeing photos of injuries, particularly based on the injuries themselves or where Reporting Child Abuse those which take real intent, i’m always they occur. it’s not uncommon for chil - tennessee’s aggressive statute, tenn. shocked,” she said. “this is the saddest dren to assume a defensive position when code § 37-1-403, was created to address part of my job, especially when a child being burned so the pattern of injury will the frequency of child abuse and to dies in one of these cases.” indicate their posture.” encourage reporting. the statute has two Work with intentionally burned chil - emphases. First, all citizens, including The Role of Social Workers dren is emotionally wrenching. health care workers, are required to report Mary Murray, director of Social Work “these children touch everyone’s suspected child abuse. Second, persons for children’s hospital, has been with who report in good faith are immune from Vanderbilt more than 30 years. her team civil and criminal liability for reporting. is always involved in cases of acute abuse, National “one thing we always have to keep in general abuse and neglect. Social workers mind is that while we collect a lot of perform their responsibilities in concert Statistics information that may support suspicions with other members of the health care of abuse or neglect, we’re not the investi - team, partnering to conduct a thorough n In the United States, 3.3 million cases of children being neglected or abused were gating arm. We want to leave this work assessment in each case of suspected abuse. reported in 2009. (source: 2010 report by for investigating agencies to perform,” said “once a determination has been the U.S. Department of Health and Julia Morris, J.D., deputy general counsel made, a report needs to be made to the Human Services (HHS) Administration for Children and Families) in the university’s office of General state. the social worker will be the one counsel. who fulfills this responsibility on behalf of n Of these, an estimated 772,000 children reporting suspected child abuse or the whole team,” Murray said. “We never were victims of maltreatment (physical neglect is a medical judgment, but within act alone.” abuse, sexual abuse, emotional abuse and neglect). a legal context. response from DcS is addressed by once reporting has occurred, myriad a codified system with the most serious n Across the nation there were 1,560 issues must be addressed such as who can cases receiving more immediate attention. deaths from abuse and neglect during visit, who can continue to receive infor - “DcS will take our report and deter - 2010, the most recent yearly total avail - able, reported by all U.S. child protective mation about the child and who will mine whether the situation is acute, services. interface with DcS and law enforcement. “After a child has been placed in Jeff Guy, M.D., estimates 20 percent of n Children under age 4 are at greatest risk DcS custody when severe abuse or neg - children treated in the Vanderbilt for severe injury or death from abuse. lect has been determined, we may be Regional Burn Center are victims of abuse. L L

Children younger than 1 year accounted dealing with end-of-life issues, which can E

n W O H for 47 percent of all child abuse fatali - become very difficult because DcS will E O ties. When combined with 1-3 year olds, not take a position on the removal of life J this accounted for 80 percent of all child abuse and neglect fatalities (2010). support,” Morris said. “there may be a court-appointed guardian who will per - n Although there isn’t a single profile for form a thorough evaluation and make the abusers, there are certain common determination to discontinue support.” characteristics: young adults in their 20s without a high school diploma with Multiple instances have occurred at few financial resources, and who may children’s hospital when an abuser sought be coping with significant stress or to block removal of life support because depression. Some abusers have been criminal charges would be elevated from victims of abuse themselves. Fathers and the boyfriends are most often the assault to manslaughter or murder. perpetrators in abuse deaths; while “unless parental rights have been ter - mothers are more often the cause in minated, it can be difficult for physicians fatalities from neglect. and staff when parents suspected of the

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where the situation is life-threatening, whether it can wait a few hours, a day or seven days,” she said. Murray says she and her team approach each situation objectively. “Due to our training we start with each person at the same place and are nonjudgmental on every approach we take,” she said. “We are able to continue to do this difficult work over time because we maintain this stance. it really is possi - ble to continue to do this work because you learn through the years that circum - stances vary so much from case to case.” Murray says when family members S I O

or caregivers are suspected of abusing B U D

their child and confronted, they can L E I N A

become confrontational or sad. D “Some family members who work in professions where children are involved, A Job Like No Other such as the school system, say they expect When Carrie Ann Donnell left the field of health policy, she decided nursing would questions about possible abuse or neglect. be a good fit that would allow her to address the impact of public health issues on however, those who are otherwise not children in a more personal manner. familiar can be very upset and react quite Fortunately, the perfect job awaited her with the CARE Team at the Monroe Carell negatively. typical reactions can be pre - Jr. Children’s Hospital at Vanderbilt. The team was in need of a pediatric nurse prac - dicted. ‘Should i get a lawyer? i can’t titioner, a position funded with support of the Andrew Allen Charitable Foundation. believe you would think this about me. i Donnell shares an office with Deborah Lowen, M.D., associate professor of didn’t do anything to hurt my child,’” Pediatrics and director of Child Abuse Pediatrics, and collaborates with her to evalu - Murray said. “or they may start propos - ate suspected cases of abuse and neglect that find their way to Vanderbilt. On the ing alternating versions of the events that job for less than a year, Donnell has faced a steep learning curve. led to the injuries.” “There was very little training in nursing school. There were a few lectures on Parents or caregivers are almost identifying abusive injuries and how to look at radiographic evidence. Nearly all of my training has been on the job with Dr. Lowen being my mentor. I’ve never learned always told when suspected abuse or neg - so much in such a short a time,” she said. lect is going to be reported to DcS. Donnell said that the hardest part of her job is the emotional toll that it can take. Murray has been involved with thou - “We’ve had a few cases where the injuries have been so severe the child has sands of child abuse cases, yet says her passed away. It’s hard to not take those cases home at the end of the day. What mentors have helped her and her team keeps me doing it is knowing there is so much to be done in this area, and in the end continue to maintain a high level of car - we’re getting the ball rolling to help these children have a better future.” ing and enthusiasm for what is perhaps Donnell recalls a case that received much media attention when a very young the hardest part of their work. child was in the Pediatric Intensive Care Unit with severe abusive injuries, and it was “it’s an important job to do, and to clear she was not going to survive. The child’s mother was not the perpetrator and make sure the families are handled correct - was not present when the abuse took place. ly. We don’t want the families to feel like “To see her go through that and hear what had been done to her child without her knowledge and watching her deal with that on such an acute level was very diffi - they are judged. We realize that every piece cult,” Donnell said. of this is about treating everybody with Donnell has made a career choice that brings her much fulfillment inside and out - dignity and as best as we can,” she said. side the hospital. When she is not consulting on a case, she teaches nurses, resi - “A big part of our assessment is to identify dents, DCS and others how to recognize and report abuse. risk to make sure the children are safe. So “It’s exactly the kind of difficult work I thought I’d be doing. I love the interdiscipli - you know that every day you are working nary nature of the work,” she said. “The reason I do this is I think this issue is too toward helping children be safe. that’s a important to ignore. So, I am glad there is a team like ours that is willing to address pretty good way to spend your day.” VM an uncomfortable issue that may be difficult for others to address.” - KATHY WHITNEY

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A course in true Love Medical students look to future after cancer-related detour

WRITTEN BY JESSICA PASLEY PHOTOGRAPH BY DANIEL DUBOIS

lthough clichés are passé, omnia vincit amor – love semester, while taking care of clark. conquers all – is highly appropriate in describing Always intent on becoming a doctor, Proffitt’s experience the longtime relationship between third-year with clark fueled her interest. A Vanderbilt medical student Sarah Proffitt and her “this really gave me a whole new perspective on being a boyfriend, Amos clark. doctor and working in health care,” said Proffitt. “i just kept Proffitt and clark grew up in the small town of Athens in charging ahead.” east tennessee where almost everyone knows everybody. these Proffitt attended school every summer to graduate on time. two were no exception. clark later transferred to Vanderbilt after his life-changing experi - Friends since middle school, the pair began dating their ence sparked his own interest in medicine. freshman year of high school. She attended their hometown high “i had absolutely no plans of going to medical school before school, while he ventured to Mccallie high School in nearby all of this happened,” said clark. “i probably would have gone chattanooga. the relationship continued when Proffitt came to into our family business, but things definitely changed for me. Vanderbilt university as an undergraduate, while clark attended “i came here because of Sarah. i would not be here without the university of the South (Sewanee). her. her hard work and dedication, her vision and outlook on everything was standard textbook romance until the fall of things really impacted me.” 2006 as the pair entered their sophomore year of college. on clark, now six years post-transplant, is a second-year medical Proffitt’s first day of classes she received gut-wrenching news – student at the university of tennessee college of Medicine in clark was diagnosed with Acute Myelogenous Leukemia (AML). Memphis, on schedule to graduate in 2014. he required immediate treatment. his future was uncertain. Proffitt, a recipient of the David hitt Williams, M.D., “i came back (home) the next day. he was already in Memorial Scholarship and the James Preston Miller Scholarship, Knoxville, starting chemo,” recalled Proffitt. “it was really a is slated to graduate from VuSM in 2013. whiplash kind of thing. here we were, both getting ready for a “i might not have considered staying on the medical school new school year and then the gears completely changed. route if this had not happened to Amos,” admitted Proffitt. “i “i didn’t have a lot of time to decide, but i knew the right might very well have found something different if i had not had thing for us was for me to take the semester off to help out with this extra drive and perspective from this experience. it really gave whatever he and his family needed,” she said. us a stronger sense of what we wanted to do with our lives.” Proffitt’s parents were hesitant, but supportive of their daugh - Although they do not get to see each other very often, the ter’s decision. it helped that Vanderbilt was also in her corner. couple is oK with knowing that, in the end, it will all be worth it. “Vanderbilt was very supportive,” said Proffitt. “the dean i “We are working towards something together,” said clark. worked with was a breast cancer survivor, as was her sister. She told “We are going to be together in residency. We are going to get me the road ahead was going to be tough and that Amos was going there. i feel like i have made a choice, in careers and in a partner.” to need a lot of support. She basically told me – do what you have For now Proffitt is considering whether to take a year off to to do. We will be here when you are ready to come back.” explore the world of research before heading into residency. With that reassurance, Proffitt stepped into her role as “if i take a year off, we can apply for residency programs as a caregiver. together the couple researched treatment options, couple and be guaranteed to go to the same place,” she said look - traveling to various cancer centers across the country, ultimately ing over at clark. “or, i can go ahead and apply to a city that settling on Vanderbilt university Medical center. has tons of residency programs and he can have options. clark’s best chance of long-term survival would be a bone “it’s tough enough getting our schedules lined up now. marrow transplant with his younger brother as the donor. either way it goes, the plan is to be in the same city. And we’ll go through it all, Proffitt stayed by his side. With a light aca - from there, together.” VM demic schedule, she was able to re-enter school the following

WINTER 2012 37 :: canby robinson society

PRESIDENT’S LETTER

arship support. Spending time with our initiative and the students who will bene - Dear canby crS Scholars provides me a firsthand fit from it. how often do we get a chance robinson Society, look at our generosity in action. i can to truly change someone’s life? assure you that each and every dollar one of the most gratifying aspects of invested toward School of Medicine schol - canby robinson Society board member - arships is money well spent. ship is participating in the Adopt-A- right now, we’re meeting less than Scholar program, which matches crS 25 percent of the financial need for med - Scholars with individual board members. ical student scholarships. that’s why the the goal of the program is for the board Scholarship initiative for the Vanderbilt members to develop relationships with the university School of Medicine is so students and provide them a “home away important. the initiative focuses our from home.” efforts on significantly growing the over the years, my wife, Gloria, and i endowment for student scholarship sup - have gotten to know several terrific young port, building on the longtime support of people. i even had one scholar who literal - so many community and faculty partners. ly became a member of our extended fam - With a larger scholarship endowment, we ily. We went to his wedding out of town will be able to provide more support for and were introduced as his “Nashville our students, reducing the graduation debt Paul Sternberg Jr., M.D. family.” that burdens so many of them. the class Board President i’ve helped my “adopted” students of 2011 left the medical school with an Canby Robinson Society with career advice and guidance, and average total educational debt of other board members have provided $135,800 – certainly a daunting figure for important support to these students with a anyone just starting out in their career. haven – a home-cooked meal and a place i hope that you will all join me in For more information about the Canby to relax away from the intensity of medical supporting this very worthwhile venture. Robinson Society, contact the Stewardship school. You can read more about it on the next office by mail at Vanderbilt University, Suite 850, 2100 West End Ave., Nashville, Tenn. As you know, most of these outstand - page. 37203, by phone at (615) 936-0439 or by email ing young men and women wouldn’t be i’d like to take this opportunity to at [email protected]. at the School of Medicine without schol - invite you to support our Scholarship Visit the website at www.mc.vanderbilt.edu/crs. ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

VANDERBILT UNIVERSITY More than 147,000 community partners came together to support the Medical MEDICAL CENTER Center and its missions of teaching, learning and patient care through Vanderbilt’s SHAPE THE FUTURE Shape the Future campaign. We are grateful, and we thank you. Your generous support CAMPAIGN FACTS makes it possible for Vanderbilt University Medical Center to fortify its leadership posi - AND FIGURES tion regionally, nationally and internationally and, most importantly, provide care and make discoveries that give us all hope for a better tomorrow.

$39 million $124 million $150 million $460 million for supporting student to endow faculty chairs for investing in facilities to fund programs and scholarships and technology research

38 WINTER 2012 L L

CHOOSING VANDERBILT E S S U R

Introducing the Scholarship N H O Initiative for Vanderbilt University J School of Medicine

two of the greatest telephone calls Van Nguyen has ever received read “call from tennessee” on his caller iD. John A. Zic, M.D., associate dean of Admissions, placed the first call to inform Nguyen of his acceptance to the School of Medicine. “i was thrilled – Vanderbilt was at the top of my list, but i had to wait to see if any schools would offer attractive aid packages,” Nguyen says. the next call, from Jeff Balser, M.D., Ph.D., dean of the School of Medicine and vice chancellor for health Affairs, made a Vanderbilt medical education a reality for Nguyen. he was offered a full scholarship. When Nguyen received the call from Balser, he was taking care of his nephews and working as a substitute teacher to “i owe much of my success to the generosity of others, cover the costs of medical school applica - tions and interviews. his family had and i want to contribute to society by maintaining the immigrated to california from Vietnam health of its people, so that they too can make their when he was 8, and Nguyen expected to follow in the footsteps of his hard-work - positive influence on the world.” – medical student Van Nguyen ing older siblings who had attended com - :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: munity colleges. “even when we struggled to pay rent, my mother’s work ethic and community partners, patients and faculty, giving when i was a student here. My her focus on the importance of education this initiative will allow students to choose scholarship made everything possible,” he never wavered,” says Nguyen, who credits Vanderbilt regardless of their financial cir - says. his mother for instilling the values of ded - cumstances. Vanderbilt students, on aver - Nguyen, now a third-year student, is ication and service. age, receive smaller scholarship awards working toward his goal of providing Nguyen’s path took an unexpected than students at peer institutions, whose oncologic care to underserved popula - turn when he received a scholarship to larger endowments allow larger scholar - tions. “Medicine is the greatest hope that attend the university of california, ships. the class of 2011 left campus with we have against all diseases, and i want to Berkeley, as an undergraduate, where he an average debt of $135,800. this initia - be a part of the generation that brings its was encouraged to pursue a career in tive will strengthen the scholarship potential to everyone in the world. i owe medicine that would marry his interest in endowment to help reduce that student much of my success to the generosity of science with his dedication to serving debt, freeing students like Nguyen to others, and i want to contribute to society those in need. build a career that’s meaningful to them by maintaining the health of its people, so the Scholarship initiative for and the communities they serve. that they too can make their positive Vanderbilt university School of Balser, a scholarship student himself, influence on the world,” says Nguyen. Medicine, launched in fall 2011, will knows the value of this initiative. As a result of the Scholarship extend this opportunity to other students “Scholarships change lives, for those who initiative, Balser says he looks forward to who seek to make a difference in medi - receive them and those who give them. i making many more of those life-changing cine. through the generosity of alumni, benefited from the tremendous legacy of telephone calls. - SARAH WOLF

WINTER 2012 39 ::

SHAIMPAPCT EALLOWST VUMHC TO CE HANGEF LIVEUS EVETRY DAUY R E the transformational $1.94 billion Shape the Future campaign is providing the momentum that allows Vanderbilt to change lives every day. Gifts from donors like you have transformed the campus skyline with the addition of the Monroe carell Jr. children’s hospital at Vanderbilt, expanded clinics and insti - tutes, but your true impact is best seen by looking inside those buildings where you can see how philanthropic support is transforming lives each day. over the course of the campaign, this community came together to pro - vide more than $833 million in gifts to the Medical center’s most pressing priorities, making it possible for Vanderbilt to deepen our commitment to educating tomorrow’s leaders, making discoveries that will shape health care and delivering outstanding patient care through personalized medicine and drug discovery.

As a nonprofit institution, philanthropic support plays a critical role in our ability to meet our mission as a center for scholarly research, informed and creative teaching, Impact and service to the community and society at large. ENDOWED FACULTY CHAIRS Recruit and retain faculty leaders, remarkable scholars

Michael S. Cookson, M.D. Michael DeBaun, M.D., M.P.H. Mary Zutter, M.D. Patricia and Rodes Hart Chair in Urologic J.C. Peterson, M.D., Chair in Pediatric Louise B. McGavock Chair in Pathology, Cancer Surgery Pulmonology Biology and Microbiology & Immunology

Michael cookson is a nationally recognized Michael DeBaun, an internationally known Mary Zutter, assistant vice chancellor for leader in the field of urologic oncology who sickle cell disease physician scientist, is direc - integrative Diagnostics, is one of Vanderbilt’s has served as the principal or sub investigator tor of the Vanderbilt-Meharry center for pioneers in personalized medicine. She guides on more than 50 grant-funded research stud - excellence. DeBaun leads the effort to create Vanderbilt’s efforts to integrate biomedical ies. in addition to his success as a researcher, a “medical home” model, where children and science and technology and emerging diag - cookson is a leader in teaching and education. adults with sickle cell disease can receive long- nostic tests and procedures. her research he directs the fellowship program in urologic term comprehensive care from a team led by helps clinicians make quick and accurate diag - oncology at Vanderbilt, designed to develop a primary care doctor. noses, determine the most appropriate thera - the next generation of academic leaders. the J.c. Peterson, M.D., chair was py and avoid unnecessary and costly tests. his chair was established in 2008 by established in 2010 thanks to growth in gifts Zutter’s chair was made possible by rodes hart and his wife, Patricia, Vanderbilt that James G. Stahlman gave to Vanderbilt in Louise B. McGavock. the Nashville philan - graduates and longtime generous benefactors the 1970s. the gifts from Mr. Stahlman, BA thropist and social leader never attended to Vanderbilt and Peabody college. the ‘19, former president and publisher of the Vanderbilt, but she left her trust to harts established the chair in thanks for the Nashville Banner, now support 13 endowed Vanderbilt, making it possible for the care hart received during his treatment for chairs. Mr. Stahlman’s focus on pediatric med - university to establish eight faculty chairs in prostate cancer. cookson, hart’s doctor, is icine was inspired by his daughter, Mildred the School of Medicine. the initial holder of the chair. Stahlman, M.D., BA’43, MD’46, a professor of Pediatrics and a pioneer in the field of neonatology.

40 WINTER 2012 canby robinson society ::

RESEARCH Advancing our understanding of disease, developing effective therapies

To lead in the area of research in the current economic environment, institutions must find creative ways to support researchers in ways that complement significant national awards, such as those from the National Institutes of Health. Thanks to generous gifts from donors, Vanderbilt is able to provide seed funding to researchers as they seek funding from national agencies and also provide researchers with a funding bridge between grant cycles. Funding is also necessary to support researchers who are already receiving grants. For every grant Vanderbilt receives, the University also makes an investment, currently about 30 cents for each grant dollar, and philanthropy has been instrumental in bridging that gap. The Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation has provided more than $18 million of support through the Shape the Future campaign to the Vanderbilt-Ingram Cancer Center, positioning the center as a leader in cancer discovery. The foundation’s long-term investment in basic and translational cancer science has enabled Vanderbilt to emerge as an international leader in the early detection of cancer and personalized cancer medicine – and has served as a catalyst for additional funding from extramural sources that extend the scope and impact of Vanderbilt’s work. The Ayers Institute for Pre-cancer Detection and Diagnosis was established in 2005 with a $10 million gift from West Tennessee businessman Jim Ayers. As a result of the Ayers gift, Vanderbilt has received $85 million in funding from the National Institutes of Health. The institute, which applies new technologies to identify protein biomarkers for cancer, brings together a research team spanning basic and clinical research disciplines to advance the science behind new diagnostics to save lives and pre- vent suffering due to cancer.

SCHOLARSHIPS COMMUNITY $ Supporting medical students An enduring partnership

Nicholas Giacalone is a third-year student at Vanderbilt Vanderbilt’s relationship with the community is one of University School of Medicine, where he has enjoyed the our greatest assets and deepest commitments. When it was support and encouragement of his faculty mentors. Recipient clear that a first-rate comprehensive children’s hospital was of the Class of 1978 Scholarship, the David Hitt Williams, needed for this region, Vanderbilt and leaders of the local M.D. Memorial Scholarship and the Sue and Nelson community worked together to secure the philanthropic Andrews Scholarship, Giacalone hopes to pursue a career at a resources needed to build the Monroe Carell Jr. Children’s leading academic medical center. “My support encourages Hospital at Vanderbilt. It is now recognized as one of the me to give back to scholarships in the future,” he says. “I nation’s top facilities. Similarly, as children and adults hope my class will establish one together some day.” most at risk and in need have sought out care, Vanderbilt has been there, delivering more uncompensated care than all of the other hospitals in our area combined. 10 nationally ranked pediatric specialties Vanderbilt15 University 186existing scholarships School of Medicine ranking in the School in U.S. News & World of Medicine Report’s 2012 edition 264,000 pediatric visits

WINTER 2012 41 :: alumni journal CONTACT Vanderbilt Medical Alumni Association ANN H. PRICE, M.D. Vanderbilt University Medical Center Associate Dean for Alumni Affairs, Phone: (615) 343-6337 School of Medicine Fax: (615) 936-8475 [email protected] https://medschool.vanderbilt.edu/alumni

Dear Vanderbilt university Medical Alumni, 2011 VMAA Board Meeting the annual VMAA board meeting convened in Nashville the VMAA is proud to welcome the class of 2015 as our Sept. 23-24, 2011. the board welcomed these new members: post - newest group of Vanderbilt university School of Medicine stu - doctoral representative tara Schwetz, M.D., (Molecular Physiology dents. the class of 2015 had an excellent White coat ceremony & Biophysics); house staff representatives Kevin Sexton, M.D., in August. Many thanks to all our medical alumni, faculty and (Surgery) and Aaron Shaver, M.D., (Pathology); and young alumni friends who sponsored white coats for all 104 of our new students. representative chloe rowe, M.D., (MD ‘03, New York city), Now the cycle of residency applications, interviewing, match - reappointed in August to a second term on the board. For a com - ing, graduating, and moving for residency training is in full swing plete list of our VMAA board members visit the VMAA website for the VuSM class of 2012. if you live in a city with a major and link to: https://medschool.vanderbilt.edu/alumni/vmaa-board. academic medical center with active residency programs, please consider joining the 300+ medical alumni who serve as VMAA Upcoming VMAA Events and Dinners hosts for residency interviews. Learn more about the VMAA host in February the VMAA will host regional medical alumni din - Program by visiting: www.medschool.vanderbilt.edu/alumni/host - ners in Pensacola, Fla., and Durham-chapel hill, N.c. on Feb. program. if you have questions about the VMAA host Program, 2, robert Snowden, M.D., (MD ‘69, VMAA board regional repre - please do not hesitate to contact me at: [email protected]. sentative, Pensacola, Fla.) will host our Pensacola regional Dinner with c. Wright Pinson, MBA, M.D., (MD ‘80) deputy vice chan - Vanderbilt Medical Alumni Reunion 2012 cellor for health Affairs, as the featured speaker. the Durham- We are pleased to announce that the 2012 Medical reunion chapel hill regional Dinner on Feb. 9 will be hosted by Joseph will take place oct. 25-27, in conjunction with the Vanderbilt cook, M.D., (MD ‘64) and will feature a presentation by Nancy university reunion and homecoming celebration. All medical Brown, M.D., (hS ‘86, Fe ‘91), chair of the Department of alumni are invited to participate in our VuSM reunion 2012 Medicine. invitations will be mailed to medical alumni in these festivities featuring a welcome reception on thursday evening, regions. For medical alumni residing in these areas, please save the oct. 25; cMe, Quinq inductions, the All Alumni Luncheon and date and look for your invitation. if you will be moving to either Grand Dinner on Friday, oct. 26; and more cMe, football festiv - of these areas, please be sure to update your contact information ities and class parties for all the special anniversary classes on via: [email protected]. if you have questions about either Saturday, oct 27. Learn more about VuSM reunion 2012 of these VMAA events, please do not hesitate to contact me at: at our VMAA website: https://medschool.vanderbilt.edu/alumni/. [email protected] or by calling 615-322-0310.

Worthy of Note News Reunion 2012 Special Anniversary Class Celebrants one of the most enjoyable aspects of my role with the VMAA is Quinq Plus 1961 and earlier hearing from you. Please take a moment to submit your “Worthy 50th 1962/1963 of Note news” for our next Vanderbilt Medical alumni news sec - 45th 1966/1967 tion. Send your news and digital photographs to medalum@van - 40th 1971/1972 derbilt.edu; or fax to (615) 936-8475; or mail to VuMc, 21st 35th 1976/1977 Ave. S., and Medical center Drive, McN D-8212, Nashville, tN 30th 1981/1982 37232-2106. 25th 1986/1987 20th 1991/1992 hope to hear from you soon. 15th 1996/1997 With very best wishes, 10th 2001/2002 5th 2006/2007

42 WINTER 2012 Read Vanderbilt Medicine online, and send in your alumni news :: alumni news at www.mc.vanderbilt.edu/vanderbiltmedicine. Digital photos (200-300 dpi and at least 4 by 6 inches) are always welcome and will be included as space permits.

KEY an experience he describes as three-year term on the governing MD - Medical School Graduate challenging and enlightening. board of the Intersocietal HS - House staff Accreditation Commission. He FE - Fellow Larry Parrott, M.D., HS ‘61, is in represents the American FAC - Faculty his 16th year of teaching at the Association of Oral and University of South Carolina Maxillofacial Surgeons. School of Medicine since retire - ment from MUSC in Charleston, H. Edward Garrett, M.D., MD ‘79, S.C., and USC, in Columbia, S.C. was elected a Distinguished 50 s He and Joy are blessed with six Fellow by the Society for Vascular Steve Burnham, M.D., MD ‘72, Robert Ray, M.D., MD ‘55, of grandchildren from their three Surgery during its Vascular HS ‘77, and his wife, Cathy, are Jaspen, Ala., reports that his lym - children. He and his son, Annual Meeting. This designation Peace Corps volunteers in Belize phoma is in remission and he Stephen, won the father-son golf is bestowed upon an active, inter - where he serves as the rural anticipates many happy years championship and he won the national or senior member of the health educator and works out ahead. Super Senior competition at Society for Vascular Surgery who of the Dangriga Polyclinic. Camden Country Club. has made substantial, sustained contributions in two of three cate - gories. Garrett is the chief and guide the clinical development of 60 s program director, Division of S1’s lead product, Lorexys, as it Leon Bullard, M.D., MD ‘68, Peripheral Vascular Surgery at prepares for clinical trials. S1 is recently completed a master’s 70 s the University of Tennessee an early-stage biopharmaceutical degree in bioethics and health Leland Albright, M.D., HS ‘70, Medical Center. He is also a pro - company developing therapeutic policy from Loyola, Chicago. He and his wife Susan, a pediatric fessor in the Department of solutions for disorders of had been on the bioethics com - neurosurgery nurse practitioner, Surgery at the University of women’s sexual health. mittee of the South Carolina moved to Kijabe a year ago. Tennessee in Memphis. Medical Association for many Albright teaches neurosurgery Richard Silver, M.D., MD ‘75, is years, serving as chairman for residents who rotate at the Kijabe William Huddleston, M.D., MD co-editor of a new book “Case about eight years. He currently Hospital and trains one PNS fel - ‘78, HS ‘97, and his wife, Peg, are Studies in Systemic Sclerosis.” serves as chair for his hospital’s low per year at what is among the living in New Zealand where he is He has been on the faculty of the clinical ethics committee. He largest spina bifida/hydrocephalus working for a county mental Medical University of South retired from the practice of practices in the world. You can health system south of Auckland Carolina in Charleston for the obstetrics in September and will view their blog at www.susanan - as the designated crisis psychia - past 30 years. He leads the devote most of his time to office dlelandinkijabe.blogspot.com. trist. Scleroderma Center and is cur - gynecology and the clinical ethics rently serving as director of the consultation service. Vic Baum, M.D., MD ‘74, has been Philip Lichtenstein, M.D., MD ‘76, Division of Rheumatology and named the first Frederic A. Berry has been named the first medical Immunology and interim chair - Arthur Freeman III, M.D., MD ‘67, M.D. Professor of Pediatric director of the Children’s Home of man of the Department of is serving as president of the Anesthesiology at the University Cincinnati. He assumed the posi - Medicine at MUSC. His daughter Southern Psychiatric Association. of Virginia where he is also exec - tion in July 2011, having been in Kate is a third-year resident at He and his wife, Linda, live in utive vice-chair of the depart - private practice in northern Birmingham, Ala., and enjoy ment, chief of cardiac anesthesia Kentucky, where he served as a spending time with their children and professor of pediatrics. pediatrician for nearly 30 years. and five grandchildren. For the past two summers he has studied Jeffrey Carter, M.D., MD ‘78, HS Jose Ortiz, M.D., HS ‘76, FE ‘77, is theology at the Oxford University, ‘80, was recently appointed to a a semi-retired orthopaedic sur - geon, doing evaluations regarding orthopaedic problems in workers’ compensation patients and no- book focus fault disability issues in Oviedo, Fla. His son Jose is an office Anderson Spickard Jr., M.D., MD ‘57, HS ‘63, manager with the House of emeritus professor of Medicine, has authored a Representatives; his daughter is a Stephen Jones, M.D., MD ‘78, book about his practice of internal medicine called nurse anesthetist in Orlando, Fla., was promoted to the rank of “Stay with Me – Stories of a Black Bag Doctor.” A and his granddaughter Kelsey is major general in the U.S. Army collection of 20 stories about his care of patients in the eighth grade. Medical Department. He is over a long and distinguished career, the book deputy commander of Joint Task emphasizes the importance of staying with the patient until the end Robert Segraves, M.D., MD ‘71, Force National Capital Region of his life. Through an entertaining combination of humor and professor of psychiatry at Case Medical, responsible for more emotion, Spickard gives an account unique to his specialty in infec - Western Reserve School of than 37 military medical treat - tious disease and addiction, and the manner in which he relates to Medicine, has been appointed to ment facilities in the National his patients. S1 Pharmaceuticals’ Scientific Capital area with 284,000 Advisory Board. He will help enrolled beneficiaries.

WINTER 2012 43 :: alumni news

worthy of note and husband, Bruce Burton, M.D., are Kentucky’s only husband/wife plastic surgeon/dermatologist. Brian Gibler, M.D., MD ‘81, right, and Kevin Joseph, M.D., MD ‘01, who graduated 20 years apart, were both recently named to new positions Carol Porch, M.D., FE ‘86, HS ‘88, at University of Cincinnati Health. Gibler is the president and CEO of closed her solo pediatric practice University Hospital of Cincinnati and senior vice president of UC Health. in 2002 and has been doing med - Joseph is president and CEO of West Chester Hospital and senior vice ical consulting for the Social president of UC Health. Security Administration, Department of Disability Services, in Birmingham, Ala., since 2006. She worked on the staff of Huntsville Hospital Pediatric ER in the intervening years. Jeffrey Prinsell, D.M.D., M.D., MD ‘86, HS ‘88, received the Dennis Wentz, M.D., FAC ‘88, has American Academy of Dental authored “Continuing Medical Sleep Medicine (AADSM) Education: Looking Back, Distinguished Service Award. He Planning Ahead,” (Dartmouth is past president of AADSM, College Press) the first compre - founding president of the hensive history of the field of con - American Board of Dental Sleep tinuing medical education in the Medicine and past chair of the United States and Canada. In American Association of Oral June 2011 he received the and Maxillofacial Surgeons Distinguished Service Award from (OMS) obstructive sleep apnea the University of Chicago’s clinical interest group. Medical and Biological Sciences the University of Alabama- semi-retired 12 years ago. He and Alumni Association. He and his Birmingham. his wife, Teresa, have two sons, wife, Anne Wentz, M.D., FAC ‘80- governors of the Daviess Robert, 17, and Jay, 14. Wilson ’89, reside in Bozeman, Mont. Community Hospital. He writes Norman Spencer, M.D., MD ‘76, plays baseball, runs, gardens, that he is grateful to Vanderbilt HS ‘80, is the medical director of travels and collects Renaissance each and every day for all of the Vanderbilt Integrated Providers Old Masters art. wonderful opportunities it has Midsouth and recently published made possible for him. He and his second novel “Flu.” 90 s Kara celebrated their 16th wed - George Hutton, M.D., MD ‘96, is ding anniversary in November Bedford Waters, M.D., MD ‘74, a an associate professor in the 2011, and they have five sons. urologist, was named to the U.S. 80 s Department of Neurology at News Media Group’s list of “Top Arthur Fleischer, M.D., HS ‘80, Baylor College of Medicine. He Henry Wilson, M.D., MD ‘96, and Doctors” in September 2011. He FE ‘81, FAC ‘80-present, professor was recently appointed as the Caroline Ford were married July was one of 10 Knoxville, Tenn., of radiology, has been named the medical director of the Maxine 23, 2011. She received a BA in Art doctors named to the list, created new Cornelius Vanderbilt Chair in Mesinger Multiple Sclerosis History from UNC Chapel Hill and from Castle Connelly’s database. Radiology. Comprehensive Care Center at an MA in Art History from the Baylor College of Medicine. University of South Carolina. She Robert Wilson, M.D., HS ‘74, a Melissa Knuckles, M.D., HS ‘82, is pursuing a doctorate in educa - plastic surgeon in Greenville, is board certified by the American Charles Mayes, M.D., MD ‘95, tional leadership from UNC S.C., for more than 30 years, Academy of Dermatology. She joined the staff of Wesley Medical Charlotte. He completed general Center as a cardiologist after and plastic surgery residencies completing a residency in internal and a fellowship at Georgetown medicine at the University of University Hospital and is in prac - tice at Plastic Surgery Associates book focus Texas at Southwestern and a fel - lowship in cardiology and inter - in Lynchburg, Va. ventional cardiology at Duke Francis Fesmire, M.D., MD ‘85, has published University Medical Center. Rick Wright, M.D., HS ‘94, has “Nashville Skyline,” an inspirational novel that deals been named the Dr. Asa C. and with the pain of loss, one’s search for self, and ques - Daniel McCarthy III, M.D., HS ‘95, Mrs. Dorothy W. Jones Professor tions God’s existence. Fesmire is a professor of has been in private practice for 16 in Orthopaedic Surgery at emergency medicine and research director for the years at the Daviess Community Washington University School of Department of Emergency Medicine at the Hospital in Washington, Ind. He is Medicine in St. Louis. Wright is a University of Tennessee College of Medicine. He resides in the director of anesthesia servic - nationally recognized contributor Chattanooga, Tenn., with his wife and two children. es and serves on the board of in the field of sports medicine.

44 WINTER 2012 alumni news ::

Darryl Zeldin, M.D., FE ‘93, has Baraboo Rural Training track for been named scientific director of the University of Wisconsin the National Institute of Department of Family Medicine, a Environmental Sciences (NIEHS). separately matched, accredited He will lead and manage a $114 rural training track that offers an million biomedical research pro - opportunity to explore a wide gram focused on discovering how range of practice areas in a rural the environment influences setting just 45 minutes north of human health and disease. Zeldin Madison, Wis. is trained in internal medicine with a subspecialty in pulmonary and Catherine Hawley, M.D., MD ‘12, critical medicine. He has spent and John Phillips, M.D., MD ‘10, Sandi Moutsios, M.D., HS ‘98, most of his career at NIEHS. are engaged to be married in Nathan Vanderford, Ph.D., FE is the Med-Peds Program spring 2012. Phillips is completing ‘09, has been appointed deputy director at Vanderbilt, a posi - a residency in radiation oncology director of research for the tion she assumed immediately at the Harvard Radiation University of Kentucky Markey after her residency. She Oncology program in Boston. Cancer Center. In this leader - serves as a preceptor for 2000 - ship position, he will be first-year medical students in Ellika Bartlett, M.D., MD ‘09, and Danielle Holt, M.D., MD ‘05, is responsible for the oversight, the Foundations of the Shawn McGuire were married now a staff general surgeon at planning, development and Profession, for second-year June 18, 2011. Bartlett is a psychi - Bassett Army Community evaluation of the Markey students in Physical Diagnosis atry resident at the University of Hospital in Fort Wainwright, Cancer Center’s research and for third- and fourth-year Washington in Seattle. McGuire is Alaska. She had a daughter, Lily, enterprise. students in clinic. She and her a mechanical engineer at in 2011, and deployed to husband, Michael, have three Program for Appropriate Afghanistan in October. sons - John, and twins Technology in Health (PATH), a Society. A longtime collector, William and Nicholas. nonprofit based in Seattle. Carrie Holloway, M.D., HS ‘09- writer and exhibitor, he was present, and Thomas Lind, M.D., among the first to apply sophisti - Parul Bhatt, M.D., MD ‘06, is a HS ‘09-present, were married on cated radiological techniques to pediatric hospitalist at Children’s Sept. 24, 2011, in Columbia, Tenn. the evaluation of antique decoys. Hospital Colorado and instructor at the University of Colorado Mary Margaret Huizinga, M.D., Brandon Litzner, M.D., MD ‘10, School of Medicine. MD ‘03, FE ‘07, has been appoint - started his dermatology residency ed vice president of quality at in July 2011 at the University of Robert Browning, M.D., MD ‘08, LifePoint Hospitals. She came to Texas Southwestern Medical and his wife, Krista, welcomed LifePoint from McKinsey and Co. Center. their first child, Madelyn Marie, on Sept. 12, 2011. Patricia Chu Klap, M.D., MD ‘00, Jason Mann, M.D., MD ‘08, has HS ‘01, and her husband, Guido, accepted an offer to serve as Jack Erter III, M.D., HS ‘07, and welcomed the birth of their first head of China pharma/health Noelle Daugherty were married child, Marco Willem, born on Aug. care within equity research at Oct. 22, 2011, in Columbus, Ohio. 4, 2011, at Scripps Memorial Barclays Capital. She is a pharmacist with CVS and Hospital in La Jolla, Calif. Jeff Sperring, M.D., MD ‘95, has he is a member of Tennessee Amy Morris Musiek, M.D., MD been named president and chief Oncology, both in Nashville. Caroline Knox, M.D., MD ‘09, and ‘04, HS ‘08, is an assistant pro - executive officer of Riley Michael Lindow, M.D., were mar - fessor of dermatology at Hospital for Children at Indiana Elise Fallucco, M.D., MD ‘04, ried on Aug. 13, 2011, at Gateway Washington University, and her University Health. Sperrin, 42, received the American Academy Canyons resort in Gateway, Colo. husband, Erik Musiek, M.D., joined IU Health in 2002 and has of Child and Adolescent They met during their fourth year MD ‘07, HS ‘08, started a fellow - served as chief medical officer Psychiatry 2011 Robinson in medical school while on an ship in the Alzheimer’s Disease of Riley at IU Health since 2009. Cunningham Award for the Best international rotation in India, Research Center at Washington Paper by a Resident. Fallucco setting up clinics in the University. presented her paper, “Adolescent Himalayas. They are completing Depression and Suicide Risk their third year of residency in J.P. Norvell, M.D., MD ‘04, and Assessment: Training family medicine at St. Mary’s Michael Hooper, M.D., MD ‘04, Pediatricians Using Standardized Hospital in Grand Junction, Colo. completed the Ironman triathlon Patients,” at AACAP’s 58th in Wales in September 2011. Norvell Annual Meeting, Oct. 21, 2011. A. Everette James, M.D. , FAC ‘00, is a transplant hepatology fellow former chairman of the and Northwestern. Hooper prac - Stuart Hannah, M.D., MD ‘00, is Department of Radiology, has tices internal medicine and pul - the program director for the been elected to the board of the monary medicine in Norfolk, Va. Family Medicine Residency North Carolina Decoy Collectors

WINTER 2012 45 :: alumni news

tant professor of surgery at Albany Medical College.

Bett Pitchford, M.D., MD ‘04, HS ‘07, and Clovis Pitchford, M.D., MD ‘04, HS ‘08, welcomed a daughter, Madeleine Jane, born on June 24, 2011. The fami - ly resides in Kensington, Md.

Meeta Prasad, M.D., MD ‘01, HS ‘01, and Michael Kerlin were married Oct. 1, 2011, in Princeton, N.J. Prasad is a pul - monary and critical care physi - Justin Gregg, VMS IV, and his girlfriend, Becky Blades, had the cian at the Hospital of the Vanderbilt football stadium to themselves when he proposed to her. Emily Shuman, M.D., MD ‘03, and University of Pennsylvania and She said ‘yes.’ The wedding is set for June 9. her husband, Andrew, welcomed an assistant professor at the their son, Jonah McCallister, on University of Pennsylvania Nov. 3, 2010. Shuman joined the School of Medicine. Kerlin is an May 23, 2011, at the Phipps Lisa White, M.D., MD ‘06, HS faculty of Weill Cornell Medical associate principal in the Conservatory in Pittsburgh, ‘06, joined the General Surgery College in August 2011. Philadelphia office of McKinsey Penn. department of Murfreesboro and Company. Medical Clinic in September Richard (Brick) Wall, M.D., 2011, after completing a resi - Mario Nieto, M.D., MD ‘08, and Megan Skorupa, M.D., HS ‘11- MPH, HS ‘01, is in private prac - dency at Vanderbilt. Kirsten Gibbs Nieto, M.D., MD present, and Patrick Stevens, tice near Seattle, where he spe - ‘08, are both chief residents at M.D., HS ‘11-present, were mar - cializes in pulmonary, critical Amy Whigham, M.D., HS ‘05, is Baylor, he in anesthesiology and ried May 27, 2011, in St. Louis. care and sleep disorders medi - an assistant professor of pedi - she in medicine-pediatrics. cine. He is director of his hospi - atric otolaryngology at Wake Kirsten will do an additional year Daniel Stover, M.D., MD ‘08, HS tal’s critical care unit and also Forest University School of as chief resident in internal med - ‘08-present, chief resident in has an appointment with the Medicine in Winston-Salem, N.C. icine next year. the Department of Medicine at Department of Medicine at the Vanderbilt, is the recipient of University of Washington. Ashit Patel, M.D., HS ‘11, a this year’s Holt Young Physician plastic and reconstructive sur - Leadership Award presented by geon, has joined Albany Medical the Southern Medical Center’s Department of Surgery Association. and has been appointed assis - Nicholas Tarola, M.D., HS ‘09, is a specialist in breast cancer reconstruction at Middle Tennessee Medical Center. Tarola completed his internship and residency in general sur - gery at Thomas Jefferson University Hospital in Philadelphia before coming to Nashville for fellowship training in plastic surgery at Vanderbilt.

Keli Turner, M.D., MD ‘08, and Antonio Haynes were married Sept. 3, 2011. Turner is a resi - dent in general surgery at the Matt Luther, M.D., MD ‘01, HS University of Maryland Medical ‘02, FE ‘07 and his wife, Anna, Center and Haynes is employed welcomed a daughter, Allis by Brasfield and Gorrie General Frederick Ochieng, M.D., MD ‘10, HS ‘10, left, is doing his Med-Peds McLean , on Aug. 17, 2011. She Contractors in Nashville. residency at Vanderbilt, and his brother, Milton Ochieng, M.D., MD joins big brothers Marshall, 8, ‘08, was interviewed by President Clinton at the Clinton Global and Andrew, 4. Matt is a Tomoharu Uchiyama, M.D., HS Initiative 2011 opening plenary session in September. Their nonprofit nephrologist at Vanderbilt. ‘07, married Shu Ying Kwan on agency, the Lwala community Alliance, is based in Nashville at the Vanderbilt Institute of Global Health.

46 WINTER 2012 in memoriam ::

professor and chair of the William Johnston, M.D., MD ‘67, Bruce Dan, M.D., MD ‘74, HS ‘78, FE ‘80, Department of Pathology and as died Nov. 9, 2011. He was 69. He died Sept. 6, 2011. He was 64. An adjunct interim dean and vice president served as captain in the U.S. Army associate professor of Preventive for Medical Affairs at the from 1969-1971 and was a recipient Medicine at Vanderbilt, he was a leading University of South Alabama of the Bronze Star. He was in pri - federal researcher who helped establish College of Medicine from 1997- vate practice as a cancer surgeon a link between toxic shock syndrome and 1999. Dr. Gardner is survived by in Nashville since 1980 and was an the use of tampons. He was a member of his wife of 51 years, Ann; children, associate clinical professor of the Toxic Shock Syndrome Task Force Elizabeth, Lee and William; and Surgery at VUMC. He is survived created by the Centers for Disease seven grandchildren. by his wife of 45 years, Pat; chil - Control and Prevention in 1980 after an dren, Emily, William and David; outbreak of the disease. He later Harry C. Helm, M.D., MD ‘40, died and three grandchildren. became editor of The Journal of the Nov. 12, 2011. He was 97. He was American Medical Association , and then commissioned as a medical officer Hossein Massoud, M.D., FAC ‘73- executive editor and anchor for the Medical News Network, which in the U.S. Naval Reserve and was ’89, died April 26, 2011. He was 81. provides daily newscasts directly to physician’s offices. He also con - a flight surgeon aboard the carrier After graduation from medical ducted media training for academic faculty members at Vanderbilt USS Yorktown when World War II school in Isphahan, Iran, he and other institutions. In 1981 he received the CDC’s highest award ended. In 1945-1946, he served as worked as a company physician for epidemic investigation, the Alexander D. Langmuir Prize, and the senior medical officer, U. S. Naval for Amiran Oil Co. in Abadan, Iran. United States Public Health Service Commendation Medal. Dr. Dan is Air Station, Memphis, Tenn., and He trained in pediatrics at T.C. survived by his wife, ABC News correspondent Lisa Stark; and chil - was discharged from active duty in Thompson Children’s Hospital dren, Rachel and Ethan. March 1946. After serving a surgi - (now Children’s Hospital at cal residency at Thayer Veterans Erlanger), and was named med - Hospital, he moved to Columbia, ical director in 1965 and remained Robert J. Capone, M.D., HS ‘66, Ingrid; children, J. David, Dorothy Tenn., and helped obtain funding in that position until his retirement died June 29, 2011. He was 72. He and Deborah; and 11 grandchildren. to establish the Maury County in 1996. He was associate profes - served as lieutenant commander Hospital. Dr. Helm retired from sor of Pediatrics at Vanderbilt. Dr. and practiced at the Oakland John W. Fristoe Jr., M.D., MD ‘45 active medical practice in January Massoud is survived by his former Naval Hospital from 1968-1970. He died Dec. 5, 2011. He was 92. He 1987 after serving the medical wife of 30 years, Carolyn; children, was a professor of medicine at served in the U.S. Army for two needs of Maury County for 36 Jamileh, Mary and Susan; and six Brown University and a cardiolo - years, attaining the rank of captain years. He is survived by his wife, grandchildren. gist at Rhode Island Hospital from and practiced medicine in the field Marie; children, Anne, Clay, John 1972-1991. He also held positions of obstetrics and gynecology in and Martha; four grandchildren; Stanley R. McCampbell, M.D., at Strong Memorial Hospital and Jackson, Miss., Atlanta and two step-children, and three MD ‘53, died Sept. 23, 2011. He was Albany Medical Center Hospital Decatur, Ala. He delivered the first great-grandchildren. 85. He served in the U.S. Navy until 2008. Dr. Capone is survived baby at DeKalb General Hospital. during World War II. He began the by his wife, Emilie; children, He also practiced at the VA Robert and Jeffrey; and four Hospital for 13 years as a member grandchildren. of the psychiatric staff treating Alan H. Fruin, M.D., MD ‘67, HS ‘73, died patients with substance abuse. Dr. Aug. 20, 2011. He was 69. He practiced Robert (Bob) Dorton, M.D ., MD Fristoe is survived by his wife of 67 neurosurgery in Omaha, Neb., where he ‘59, died Dec. 12, 2011. He was 78. years, Ruth; four children, was chief of the Division of Neurosurgery He started his career with an Katherine, John, Elizabeth and in the Department of Surgery at Creighton internal medicine practice in Thomas; eight grandchildren and University from 1975-2000. After retiring Richmond Heights, Mo., before five great grandchildren. from his practice, he and his wife, Carolyn, relocating to an office near St. returned to Nashville at which time he Mary’s Health Center in St. Louis, William A. Gardner Jr., M.D., offered his services to the Department of with Dr. J. Collins Corder. He FAC ‘76-’81, died Oct. 2, 2011. He Neurosurgery at Vanderbilt. He spent the taught at St. Louis University was 72. He served as director of last decade taking care of patients at the School of Medicine for more than laboratory services for Veterans Veteran’s Administration Hospital and invested a significant amount 40 years before retiring in 2000, Administration Medical Centers, of time in the education of neurosurgery residents. In 2008, he was and was honored by the Missouri Charleston, S.C., from 1969-1976 the recipient of the first Robert S. McCleery Master Teacher Award Medical Society and the American and as professor and vice chair of for Surgical Resident Education. He is preceded in death by his wife, College of Physicians for his serv - the Department of Pathology at Carolyn. Dr. Fruin is survived by children, Alex and Candy, and five ice to the university. He is sur - Vanderbilt University from 1976 grandchildren. vived by his wife of 51 years, until 1981. He served 21 years as

WINTER 2012 47 :: in memoriam

William G. Riley, M.D., MD ‘45, Robin and Karl; and five grand - Eugene W. Fowinkle, M.D., MPH, FAC HS ‘51, died June 10, 2011. He was children. ‘99, died Aug. 26, 2011. He was 76. Dr. 88. He served two years in the U.S. Fowinkle earned his medical degree at Army Air Force as a flight surgeon Andrew W. Walker, M.D., MD ‘60, the University of Tennessee College of then returned to Meridian, Miss., died Sept. 25, 2011. He was a sup - Medicine, interned with the City of in 1950 and began practicing gen - porter of Vanderbilt University and Memphis hospitals and was a resident eral pediatric medicine alongside its athletics teams, serving as in Neurosurgery at Baptist Hospital, his father until his retirement in president of the Vanderbilt alumni Memphis. He earned a Masters of 1984. He also served in an admin - association and chairman of the Public Health degree at the University istrative capacity at Riley university’s major gifts programs of Michigan in 1962. In 1983 he became Memorial Hospital and Riley in western North Carolina. In 1969, associate vice-chancellor for Health Development Systems and served he joined the practice of William Affairs and associate professor of as a founding member of the Riley Berkley, M.D., and Hal Chaplin, Preventive Medicine at Vanderbilt University, where he served until Foundation, which has made M.D., which later became his retirement in April 1999. Dr. Fowinkle was active in state, region - numerous grants for the better - Charlotte Plastic Surgery, where al and national health policy and a member of the President’s ment of Meridian. Dr. Riley is sur - he performed surgery until his Commission on Three Mile Island Task Force on Public Health and vived by his wife, Christine; chil - retirement in 1996, and served as Epidemiology in 1979. Among the honors he received were dren, Beth, Gail, Harriet, Kim and medical director of the Charlotte Distinguished Service Awards from the Tennessee Medical Amanda; and 11 grandchildren. Surgery Center. Dr. Walker is sur - Association, UT College of Medicine Alumni Association, Tennessee vived by children, Scott, Bruce and Public Health Association, and the Association of State and William (Bill) P. Riordan Jr., Heather; former wife and the Territorial Health Officials. He enjoyed spending time with his family M.D., HS ‘05, FAC ‘11, died Sept. 9, mother of his children, Kathleen and relished his role as grandfather. He is survived by his wife, 2011. He was 42. Dr. Riordan was Walker Hartley; and four grand - Ruby; children, Greta, Frieda and Brenda; and five grandchildren. chief of Emergency and General children. Surgery Services, assistant pro - fessor of Surgery for the Division Houston (Corky) W. White, M.D., private practice of cardiology in practice of obstetrics, general of Trauma and Surgical Critical HS ‘91, died Oct. 27, 2011. He was Oklahoma City, Okla., in 1957 and medicine and surgery in Morrilton, Care at VUMC. He held numerous 52. He was an anesthesiologist at in 1964 became the medical direc - Ark., until 1963. He then held a honors and awards in the medical Saint Thomas Hospital in tor of Globe Life Insurance Co. number of administrative positions and surgical fields, presented dur - Nashville, an avid outdoorsman, a Among his greatest joys was at the University of Arkansas, ing many conferences and has member of the Cedar Creek Yacht spending time at the family farm, Rush Medical College, South been published in several medical Club and attended St. Mary’s of raising horses and tending to a Dakota School of Medicine and journals and medical books. Dr. Seven Sorrows Church in down - world-class vegetable garden. He East Tennessee State University Riordan is survived by his sister, town Nashville. He served in the is survived by his wife, Joan; chil - before returning to Conway, Ark., Margaret; brother-in-law, James; Tennessee National Guard for 13 dren, Sody, Robert, Jim and Kelly; to retire. Dr. Mobely is survived by stepbrother, Lee; stepsister, Kelly; years and was honorably dis - and six grandchildren. his wife, Susanna; children, Jack, and many nephews, nieces, charged with the rank of major. T. Andrew, Susanna and Deborah; cousins, friends and Vanderbilt Dr. White is survived by his wife of Donald McIntosh, M.D., HS ‘81, and six grandchildren. colleagues. 23 years, Debbie; and daughters, died July 11, 2011. He was 60. He Kaitlin and Alexandria. began his medical practice in 1981, Robert E.L. Nesbitt Jr., M.D., MD Marvin E. Schmidt, M.D., MD ‘62, served on the staff of Upstate ‘47, died May 25, 2011. He was 86. HS ‘67, died Sept. 8, 2011. He was Carolina Medical Center for nearly He served in the U.S. Army during 75. He served in the U.S. Army as 30 years and was affiliated with World War II, and again during the a captain during the Vietnam con - the Spartanburg Regional Korean War, when he was a cap - flict as a preventive medical officer Healthcare System for the past 15 tain, U.S. Army Medical Corps, at Fort Riley in Kansas for two years. Dr. McIntosh is survived by chief of obstetrics and gynecology, years. He was director of Graham his wife, Debra; and children U.S. Army Hospital, Bad Hospital Laboratory for 30 years Elizabeth, Donald and Rachel. Kreuznach, Germany, 1952-1954. and director of Mason District He served as professor and chair - Hospital Laboratory for 35 years. A Jack. E. Mobley, M.D., MD ‘48, HS man of the Department of board-certified pathologist, he was ‘50, died July 17, 2011. He was 85. Obstetrics and Gynecology at the an avid world traveler, tennis play - He served in the U.S. Navy as a State University of New York er, a lifelong St. Louis Cardinals commissioned medical officer and Health Science Center at fan and a member of Delta Tau later as a flight surgeon during Syracuse, retiring as professor Delta fraternity. He is survived by the Korean War. He joined his emeritus. Dr. Nesbitt is survived his wife, Rachel; children, Laurie, father, H.E. Mobley, M.D., in the by his wife, Ellen.

48 WINTER 2012 photo gallery ::

1 2

1) W. Bedford Waters, M.D., MD ‘74, left, and Robert Mallard, M.D., MD’74, HS 3 ‘78, attend the VUMC board meeting.

2) From left to right: Michael Casner VMS III, Kristen Ploetze, VMS II, Ian McGuinness, VMS I, attend the first-year medical student welcome reception.

3) Anderson Spickard Jr., M.D., signs copies of his book “Stay with Me – Stories of a Black Bag Doctor” at the VMAA open house.

PHOTOS BY LISA GUSTY

Board of Directors Vanderbilt Medical Alumni Association Board of Directors

Officers Steven F. O’Sheal, M.D. (‘81) James W. Felch, M.D. (‘77, HS 77) Ex-Officio Members PictPurreeside hnet re: Birmingham, AL Savage Society rep--Nashville, TN Jeffrey R. Balser, M.D., Ph.D. (‘90) David W. Patterson, M.D. (‘85) Ming Robinson, M.D. (‘88, HS ‘92) Benjamin P. Folk, III, M.D. (HS 89, FE 87) Vice Chancellor for Health Affairs Washington, DC Irvine, CA Friesinger Society rep.-Leland, MS Dean, School of Medicine -Nashville, TN President-elect Alan S. Rosenthal, M.D. (‘64) (HS ‘64) Richard Goldstein, M.D. (HS ‘90, FE ‘86, Ann H. Price, M.D. (‘78, HS ‘79) Clifton R. Cleaveland, M.D. (HS ‘64) (FE ‘66) PhD ‘94, FAC ‘99-03) Associate Dean for Alumni Affairs, (FE ‘70) La Jolla, CA Scott Society rep. -Louisville, KY School of Medicine -Nashville, TN Chattanooga, TN Robert T. Snowden, M.D. (‘69) H. Newton Lovvorn Jr., M.D. (‘63, HS ‘64) Bonnie M. Miller, M.D. (HS ‘80) Pensacola, FL Burnett Society rep. – Nashville, TN Senior Associate Dean for Health Regional Directors Mitchell S. Steiner, M.D. (FE & FA ‘93-’95) Robert Mallard, M.D. (‘74, HS ‘78, FAC ‘83) Sciences Education – Nashville, TN William J. Anderson, M.D. (‘69) Memphis,TN Christie Society rep. - Nashville, TN Nashville, TN W. Bedford Waters, M.D. (‘74) Paul Sternberg, M.D. VUSM Representative John T. Cobb, M.D. (‘78) Knoxville, TN CRS Past President – Nashville, TN Scott Zuckerman (VMS 2012) Atlanta, GA Anderson Spickard III, M.D. (‘89, FAC Nashville, TN Carl A. Grote Jr., M.D. (‘54) Young Alumnus Representative ‘95-Pres) Huntsville, AL Chloe E. Rowe, M.D. (‘03) Brittingham Society rep. -Nashville, TN Post-Doctoral Organization President Jill Hutton, M.D. (‘96) New York, NY Richard F. Treadway, M.D. (‘64, HS ‘65) Tara Schwetz, Ph.D. Houston, TX Luton Society rep. – Nashville, TN Nashville, TN Kenneth Bruce Jones, M.D. (‘78) Graduate Student Representative Shih-Hsin Eddy Yang, M.D. (HS ‘06) Jonesboro, AR Laura Titus Burns Roentgen Society rep. – Staff Members (non-voting) W. Ben Kibler, M.D. (‘72, HS ‘73) Nashville, TN Birmingham, AL G. Roger Chalkley, D. Phil. Lexington, KY (FAC ‘86-Pres) Susan Niermeyer, M.D. (‘79) Specialty Society Representatives House Staff Representatives Sr. Assoc. Dean for Biomedical Denver, CO Oran Aaronson, M.D. (HS ‘99) Kevin Sexton, M.D. Research David Niver, M.D. (‘75) Meacham Society rep. – Nashville, TN Nashville, TN Donald Brady, M.D. (‘90) Alamo, CA Sam S. Chang, M.D. (‘92, HS 92) Aaron Shaver, M.D. Assoc. Dean GME Thomas W. Nygaard, M.D. (‘78) Urology Society - Nashville, TN Nashville, TN Scott M. Rodgers, M.D. (‘94) Lynchburg, VA Thomas T. Dovan, M.D. (HS ‘97) Dean for Students Orthopaedics Society rep.-Nashville, TN Non-profit org. Van derbiltMedicine U.S. Postage Vanderbilt University PAID D 8200 Vanderbilt University Medical Center North Nashville, TN Nashville, TN 37232-2106 Permit No. 1446

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