FALL 2011

GROSS ANATOMY: A TRADITION CONTINUES

A New Home for Penn’s Thriving Translational Research When Einstein’s Brain Was at Penn Doctoring 101: Learning About Dying Aspirations and Opportunities speaks volumes about the deep loyalty and commitment to our institution by its graduates, Philadelphia is rightly proud of its remarkable friends, and admirers. Perhaps I should not place in American history. This includes the field have been surprised, because even before I took of medicine, with the founding nearly 250 years office I received literally hundreds of messages ago of the nation’s first medical school at the of encouragement (and no small number of University of Pennsylvania. Nonetheless, some suggestions!) from our own alumni. feel that we have a predisposition to underplay Dr. Rubenstein made a characteristically wise our rich legacy and long record of accomplish- move when he initiated his strategic plan in ment – perhaps as a reflection of the Quaker in- 2003. The ensuing effort was comprehensive in fluence of William Penn and the early colonists. its sweep and laid an excellent foundation for: This may or may not be true, but that same heri- • impressive clinical growth with a renewed tage of reticence gave birth to a culture that val- focus on quality ued humility, deep reflection, and tolerance. By • the creation of new centers and institutes to comparison, other cities are not as hesitant in promote translational research, and declaring their own greatness. As a newcomer to • the recruitment of exceptionally talented Penn, recently arrived from Chicago, I am keenly faculty and staff members, students, aware of these differences. For example, the poet residents, and fellows. Carl Sandburg described Chicago as “Stormy, port, particularly from the National Institutes of A lot has happened since then and, as a re- husky, brawling, / City of the Big Shoulders.” Many Health, is consistently strong. The Health System sult, we’ve begun the process of developing a decades later, few in that city would disagree. is pushing ahead with important initiatives, new strategic plan for Penn Medicine. We’re for- But times have been changing in Philadelphia such as unit-based clinical leadership, which is tunate that we can approach our future from and at Penn Medicine. There is broad recogni- making major contributions toward reducing positions of strength in each of our central mis- tion on campus that we have much to be proud mortality, and knowledge-based charting, which sion areas of research, education, and patient of – and that by proclaiming our accomplish- offers caregivers immediate access to patient in- care. The new plan will build on these assets ments, we provide added reassurance to our pa- formation right at the bedside. In short, I be- and make full use of our strong connections to tients, draw in the best faculty members and stu- lieve the record confirms that Dr. Rubenstein the university at large. We’re confident that it dents, and help disseminate our research ad- was right: we at Penn Medicine are indeed a will help prepare the way for more great vances nationally and globally. For example, in guiding force in academic medicine. achievements in the years to come. 1995 Penn Medicine launched a fund-raising And there’s more. This spring, our medical I’ve asked two of our talented leaders, Deborah campaign boldly called “Creating the Future of school received an extraordinarily generous Driscoll and Jon Epstein, to co-chair the planning Medicine.” And the strategic plan initiated by my $225 million gift from Raymond and Ruth process, and they’ve graciously agreed. They’re outstanding predecessor and friend Dr. Arthur Perelman. President Gutmann called this nam- already hard at work, beginning with a recent Rubenstein laid out such goals as developing ing gift “transformational,” affirming that it will retreat of department chairs, center and institute “world-leading programs” in select areas of re- keep us at the pinnacle of global medical care, directors, senior faculty members, and adminis- search and building “superb clinical programs.” investigation, and instruction. trators. At the session we identified six thematic And today Penn Medicine is a crucial part of the The opening of our Translational Research areas that will anchor the plan, and we have es- University’s campaign, “Making History.” Can we Center in May also helps us stand tall in a tablished working groups for each. back up these claims and aspirations? crowded field. Translational medicine represents Our commitment is to an inclusive planning I believe that we can. For the second straight one of the most promising directions in medi- process as well as one that makes its workings year, the Perelman School of Medicine was cine, and our leadership in the field will be im- visible to all. Therefore we’ll be using web sites, ranked #2 among the nation’s research-oriented measurably fortified by this amazing new facil- blogs, e-mails, newsletters, and in-person meet- medical schools by U.S. News & World Report. ity. New knowledge and treatments from our ings to elicit ideas and keep everyone informed. For 14 straight years we have been ranked translational investigators and clinicians, cre- I’ll be keeping you up to date about our prog- among the top five in the same category. And ative collaborations across disciplines and de- ress as well. I also urge you to weigh in by we continue to receive large numbers of applica- partments, and an ethos of high expectations sending me your own hopes and aspirations for tions from some of the most accomplished and among those who enter the facility – all embody our future. Our obligation to excellence will be dedicated students in the nation (many of whom the future of medicine at the highest level. best achieved through the active contributions I had the pleasure of meeting at this year’s White When I came to Penn, I quickly learned the of the many talented people who make up the Coat Ceremony). priority placed on the “Making History” cam- Penn Medicine family – including you! In addition, for the fourth consecutive year paign. This emphasis is certainly paying off. Both the Hospital of the University of Pennsylvania the larger goal and the goal for Penn Medicine J. Larry Jameson, M.D., Ph.D. was ranked among the country’s top ten hospi- have already been reached a full year before the Executive Vice President of the University tals by U.S. News and included in its Honor Roll campaign closes (and as the nation remains in of Pennsylvania for the Health System for exceptional performance. Our research sup- an economic standstill). This inspiring generosity Dean, Perelman School of Medicine

Cover photograph by Candace diCarlo. Anna Jesus, center, and other medical students in the gross anatomy course. FALL 2011 / VOLUME XXIII NUMBER 1

A RITE OF PASSAGE – AND MUCH MORE By Mark Attiah A second-year medical student looks back at his anatomy lab, when doctors-in-training experience having an actual dead body in front of them for the first time. Students at Penn and other local schools can also join in a ceremony to honor the donors 15 who gave their bodies.

18“OUR HOPE FOR THE FUTURE 22WHAT EVER HAPPENED OF MEDICINE AT PENN” TO EINSTEIN’S BRAIN? 12THE ANATOMY LESSON By John Shea By Marshall A. Ledger By Marshall A. Ledger The Translational Research Center, dedicated The 20th century’s most famous brain had an The University has a distinguished tradition in gross in May, will enhance interactions and collabo- unusual post-mortem journey. One stop along anatomy. In fact, the course was on the medical program’s rations among scientists, clinicians, trainees, the way was Penn’s pathology lab, where first roster, in 1765. Even with today’s technical and and students of different departments and Einstein’s brain was brought for sectioning educational advances, medical students continue to disciplines. The overarching goal is to bring and slicing, in preparation for research. learn essential lessons in such classes. the fruits of research to the patient as swiftly and safely as possible.

Departments

Inside Front THE FIRST WORD Cover Aspirations and Opportunities 2 VITAL SIGNS 26LEARNING ABOUT DYING 28A NEW CENTER WILL TACKLE Speeding Discovery to Patient Care By Jennifer Baldino Bonett “ORPHAN” DISEASES By John Shea The IOM Selects Three Doctoring 101 is unlike the other classes medical students take. In some sessions, it Thanks to a $10 million gift from an Honors & Awards brings patients and family members to speak anonymous donor, the Perelman School New Chairs and Director to them about complex topics beyond the basic of Medicine has launched the first center Letters and physical sciences. One such topic: hospice. of its kind. The interdisciplinary center will bring together approaches to attacking and 36 DEVELOPMENT MATTERS treating rare diseases that otherwise might be overlooked. Many Thanks to Our Alumni Partners in Giving 40 ALUMNI NEWS Progress Notes and Obituaries Inside Back EDITOR’S NOTE Cover What Lies Ahead in Health Care 30A VIEW FROM BOTH 33PROVIDING A VOICE FOR SIDES OF THE BED VICTIMS OF DISASTER Staff By Marcelle J. Shapiro, M.D. By Gregory Richter At this year’s White Coat Ceremony, Dr. Shapiro, In a new book, a Penn medical student an alumna, shared the story of her medical and his writing partner tell the story of a JOHN R. SHEA, Ph.D. crisis – and some lessons it helped underscore flood that ravaged a city in India. To do Editor for health-care professionals in their dealings the necessary research, Utpal Sandesara with patients. returned to his family’s old home. GRAHAM PERRY, NCS Studios Design / Art Direction ADMINISTRATION SUSAN E. PHILLIPS Penn Medicine is published for the alumni and friends of Penn Medicine by the Office of Public Senior Vice President for Affairs. © 2011 by the Trustees of the University of Pennsylvania. All rights reserved. Address all Public Affairs correspondence to John Shea, Penn Medicine, 3535 Market Street, Suite 60 Mezzanine, Philadelphia, PA 19104-3309, or call (215) 662-4802, or e-mail [email protected]. MARC S. KAPLAN Director of Communications Visit Penn Medicine’s web site: http://www.uphs.upenn.edu/news/publications/PENNMedicine/ Photograph by Daniel Burke A Medal for Distinguished Achievement These awards are granted under three innovative research programs supported by the NIH Common Fund: the NIH Di- rector’s Pioneer, New Innovator, and Trans- formative Research Projects Awards. The Common Fund, enacted into law by Con- gress through the 2006 NIH Reform Act, supports NIH programs with a particular emphasis on innovation and risk taking. Penn has recipients in each of the three categories. The key investigators on the Pioneer Award are Jean Bennett, M.D., Ph.D., principal investigator of the study; Luk Vandenberghe, Ph.D.; and Albert M. Ma- guire, M.D., all at the F. M. Kirby Center for Molecular Ophthalmology and Scheie Eye Institute. They have been awarded $4 million over the next five years to use gene therapy to treat inherited forms of Wearing his medal and an honorary white coat, Raymond Perelman is flanked by J. Larry Jameson, left, blindness, which can be caused by muta- and Arthur H. Rubenstein. tions in any of hundreds of different genes. The researchers plan to develop a At a reception to celebrate the naming of the University’s history – to benefit the small number of therapeutics that could the Raymond and Ruth Perelman School School of Medicine. restore vision to millions of patients who of Medicine, Amy Gutmann, Ph.D., pres- A prominent Philadelphia philanthropist, are blind because of a diverse set of retinal ident of the University, presented Raymond Perelman has been a member of the Penn disorders. They propose re-sensitizing Perelman with the University of Pennsyl- Medicine Board of Trustees and has cham- the blind eye by delivering light-sensitive vania Medal for Distinguished Achieve- pioned the importance of advances in molecules to the remaining retinal cells. ment. The medal, created in 1993, is health-care education and innovation. This “optogenetic therapy” approach awarded periodically “to those individuals Mr. Perelman’s wife, Ruth, passed away takes advantage of circuitry between the whose performance is in keeping with the on July 31. In a statement, Gutmann retina and the brain that remains intact highest goals of the University and who noted that the University of Pennsylvania in many individuals long after they have have contributed to the world through “benefitted invaluably from her tireless become blind. Preclinical studies in blind innovative acts of scholarship, scientific generosity and that of Raymond and their animals have demonstrated that this discovery, artistic creativity, or societal family. Ruth’s generous spirit and strong strategy is effective. leadership.” In May, Perelman and his commitment to education, medicine, and Arjun Raj, Ph.D., assistant professor of late wife, Ruth Perelman, donated $225 culture in Philadelphia will be remem- bioengineering in the School of Engineering million to Penn – the largest single gift in bered for countless generations to come.” and Applied Science, received the New Innovator Award, for $1.5 million over five years. His research involves developing (NIH) as part of its $143.8 million na- and applying new microscopic imaging Speeding Discovery to tional grant program. Its goal is to chal- tools to reveal how the physical organiza- Patient Care lenge the scientific status quo with innova- tion of the genetic code determines the Three laboratories at the University of tive ideas that have the potential to speed manner in which the cell reads the code Pennsylvania have received $12.5 million the translation of medical research into itself. The development of these methods from the National Institutes of Health improved health for the American public. will establish a “nuclear GPS,” which would

2 ■ PENN MEDICINE allow researchers to directly visualize ge- one of five academic medical centers cases of health-care-acquired infections netic organization in single cells. Under- across the nation that received the fund- may be preventable by making use of standing this organization will be important ing. Ebbing Lautenbach, M.D., M.P.H., current evidence-based strategies. Craig for elucidating how defects in translating M.S.C.E., associate professor of medicine A. Umscheid, M.D., M.S.C.E., assistant the genetic code contribute to such dis- and of epidemiology, will head Penn professor of medicine and of epidemiol- eases as cancer. Medicine’s program. Its focus is on the ogy, and five Penn colleagues used esti- A team of researchers from the Perelman use of biomarkers, such as C-reactive mates from national reports and pub- School of Medicine, Emory University, protein, to improve the use of antibiotics lished studies related to health-care-ac- and Georgia Tech received a $7 million, in intensive-care settings. The Centers for quired infections. Their study proposes five-year Transformative Research Project Disease Control and Prevention estimates that if best practices in infection control Award. The team includes Sunil Singhal, that 1 out of 20 hospitalized patients will were applied at all U.S. hospitals, reduc- M.D., director of Penn’s Thoracic Surgery become infected while receiving hospital ing the number of cases of bloodstream Research Laboratory. If a tumor is more care for other health conditions. infections associated with the use of visible and easier to distinguish from sur- On the same topic, a study in Infection catheters could save as many as 5,520 to rounding tissues, surgeons will be more Control and Hospital Epidemiology suggests 20,239 lives per year. In the same man- likely to be able to remove it completely. that as many as 70 percent of certain ner, for ventilator-associated pneumonia, To that end, the team has developed flu- orescent nanoparticle probes that home Photograph by Daniel Burke in on cancer cells. The researchers’ main goals are to help surgeons distinguish tu- mor edges, identify diseased lymph nodes, and determine if the tumor has been completely removed. Having these capa- bilities can be expected to have a major impact in reducing recurrence rates of lung cancer after surgery. The proposed technologies could be broadly applicable to many types of solid tumors. According to James M. Anderson, M.D., Ph.D., who guides the Common Fund’s High-Risk Research program, “The awards are intended to catalyze giant leaps for- ward for any area of biomedical research, allowing investigators to go in entirely new directions.” – Karen Kreeger

The Problem of Health-care- Chairs Times Four Acquired Infections John Tomaszewski, M.D. ’77, G.M.E. rently serving as president of the American Penn’s Center for Clinical Epidemiology ’83, a longtime member of the Department Society for Clinical Pathology. Among and Biostatistics (CEEB) has received a of Pathology and Laboratory Medicine and those attending his farewell reception at $2 million grant from the Centers for most recently its interim chair, has joined Penn Medicine were three of the previous Disease Control and Prevention. The the School of Medicine and Biomedical department chairs. Shown from left to grant, which covers five years, will fund Sciences at the University at Buffalo. He is right: Tomaszewski; Leonard Jarett, M.D.; research to find new ways to reduce in- chair of its Department of Pathology and David B. Roth, M.D., Ph.D., the current fections in health-care settings. CCEB is Anatomical Sciences. Tomaszewski is cur- chair; and Mark L. Tykocinski, M.D.

2011/FALL ■ 3 13,667 to 19,782 lives per year; for uri- examined, preventable cases of blood- gies to reduce health-care-acquired infec- nary tract infections associated with cath- stream infections associated with cathe- tions, as well as the incremental costs of eters, 2,225-9,031 lives per year; and for ters are likely to have the highest associ- these infections.” surgical site infections, 2,133 to 4,431 ated costs, ranging anywhere from $960 lives per year. million to $18.2 billion per year. Similarly, Examples of current prevention strate- the hospital costs of preventable ventilator- Schizophrenia and How the gies include educating clinicians, washing associated pneumonia are estimated to be Brain Processes Sound hands, taking the maximum precautions $2.19 billion to $3.17 billion per year. Recent studies have identified many with sterile barrier during catheter inser- According to Umscheid, who serves as genes that may put people with schizo- tion, using chlorhexidine to disinfect director of the Center for Evidence-based phrenia at risk for the disease. But what catheters and surgical sites, removing un- Practice, “Given the limitations of the links genetic differences to changes in al- necessary catheters promptly, and using data used in this study and the resulting tered brain activity in schizophrenia is antibiotics appropriately. uncertainty in our estimates, it is our not clear. Now, three laboratories at the Reducing hospital-acquired infections hope that this study guides future research Perelman School of Medicine have come also saves money. Based on the studies to accurately measure the impact of strate- together using electrophysiological, ana-

The IOM Selects Three

Three members of the Perelman School Paul Offit, M.D., professor of pediat- of Medicine faculty have been elected to rics. He is director of the Vaccine Educa- the Institute of Medicine, one of the na- tion Center and chief of infectious dis- tion’s highest honors in biomedicine. The eases at The Children’s Hospital of Phila- new members bring Penn’s total to 75, delphia. In addition, Offit holds the out of a total active membership of 1,688. Maurice R. Hilleman Endowed Chair in Established in 1970 by the National Vaccinology. During his tenure as a pedi- Academy of Sciences, the Institute honors atrician specializing in infectious dis- professional achievement in the health eases, Offit developed RotaTeq, one of sciences and serves as a national resource the main vaccines currently used to fight for independent analysis and recommen- rotavirus, the leading cause of severe, de- dations on issues related to medicine, hydrating diarrhea in infants and young biomedical sciences, and health. The new Penn IOM members are: Vivian G. Cheung, M.D., professor of Vivian G. Cheung, M.D. genetics and of pediatrics and an investi- questions the fundamental step of how gator of the Howard Hughes Medical In- DNA is copied into RNA and proteins. In stitute. A pediatric neurologist, Cheung 2010, Cheung received the Curt Stern studies human genetics and genomics. In Award from the American Society of Hu- particular, her laboratory combines com- man Genetics, honored for her outstand- putational and experimental methods to ing contributions to genetic research. She study normal variation in human traits is a councilor of the American Society for and genetics of complex diseases. She Clinical Investigation and serves on the and her colleagues demonstrated that board of directors of the American Soci- like other quantitative traits, expression ety of Human Genetics. Cheung also levels of genes are variable and geneti- serves as the William Wikoff Smith Chair cally regulated. More recently, this work of Pediatric Genomics at the Children’s

has led them to a surprising finding that Hospital of Philadelphia. Paul Offit, M.D.

4 ■ PENN MEDICINE tomical, and immunohistochemical ap- signed to make other cells in the brain psychiatry and director of the Penn proaches – along with a unique high- work together at a very fast pace,” explains Memory Center, used a mouse with a speed imaging technique – to understand the lead author, Gregory Carlson, Ph.D., mutated dysbindin gene to understand how schizophrenia works at the cellular assistant professor of neuroscience in how reduced dysbindin protein may level. In particular, they are identifying psychiatry. “We know that in schizophrenia cause symptoms of schizophrenia. how changes in the interaction between this ability is reduced, and now, knowing The team demonstrated a number of different types of nerve cells lead to more about why this happens may help sound-processing deficits in the brains of symptoms of the disease. The findings explain how loss of a protein called dys- mice with the mutated gene. They dis- were reported in the Proceedings of the bindin leads to some symptoms of covered how a specific set of nerve cells National Academy of Sciences in October. schizophrenia.” that control fast brain activity lose their “Our work provides a model linking For the current PNAS study, Carlson, effectiveness when dysbindin protein levels genetic risk factors for schizophrenia to a Steven J. Siegel, M.D., Ph.D., associate are reduced. These specific nerve cells in- functional disruption in how the brain professor of psychiatry and director of hibit activity, but do so in an extremely responds to sound, by identifying reduced the Translational Neuroscience Program, fast pace, essentially turning large numbers activity in special nerve cells that are de- and Steven E. Arnold, M.D., professor of of cells on and off very quickly in a way that is necessary for normally process the large amount of information travelling into and around the brain. Other previous work at Penn in the lab of Michael Kahana, Ph.D., has shown children. He is also one of the most pub- logic regulation of lipoprotein metabolism that, in humans, the fast brain activity lic faces of the scientific consensus that and atherosclerosis, and he directs a that is disrupted in mice with the dysbin- vaccines have no association with autism. translational research program focusing din mutation is also important for short- Through his advocacy, Dr. Offit has suc- on human genetics of lipid disorders and term memory. This type of brain activity cessfully cut through misinformation and is reduced in people with schizophrenia helped to educate parents on the health and is resistant to current therapy. Taken benefits of vaccinating their children. Of- as a whole, says Carlson, this work may fit has also received the 2011 David E. suggest new avenues of treatment for Rogers Award, from the Association of currently untreatable symptoms of American Medical Colleges, in recogni- schizophrenia. tion of both his work with RotaTeq and – Karen Kreeger his public advocacy. According to the A.A.M.C., since the inclusion of RotaTeq in the recommended U.S. vaccination Honors & Awards schedule by the Centers for Disease Con- Joel S. Bennett, M.D., professor of trol and Prevention, the number of hos- medicine in Penn’s Division of Hematology/ pitalizations for rotavirus diarrhea has Oncology, and Barry S. Coller, M.D., vice decreased by 90 percent. president for medical affairs and physi- Daniel J. Rader, M.D., the Cooper- cian-in-chief at the Rockefeller Univer- Daniel J. Rader, M.D. McClure Professor of Medicine and chief sity, received the Ernest T. Beutler Lec- of the Division of Translational Medicine atherosclerosis and novel approaches to ture and Prize. The highest honor given and Human Genetics in the Department the treatment of dyslipidemia and athero- annually by the American Society of He- of Medicine. He is also associate director sclerosis. He is a recipient of several matology, the Beutler Prize is given to a of Penn’s Institute for Translational Medi- awards, including the Burroughs Wellcome basic scientist and a clinical investigator cine and Therapeutics and director of the Fund Clinical Scientist Award in Transla- whose work fundamentally changed the preventive cardiology program at Penn tional Research. Rader is a member of the field of medicine. Bennett was recognized Medicine. Rader’s basic research labora- Board of External Experts of the National for his pioneering laboratory research on tory focuses on genetic and pharmaco- Heart, Lung, and Blood Institute. the integrin receptor, GPIIb-IIIa. Coller

2011/FALL ■ 5 was recognized for advancing Bennett’s tor, has served for eight years as a mem- nolly Medical Ltd. The award, from the discoveries into a widely used drug. ber of society’s council. creators of America’s Top Doctors® guide, is designed to recognize physicians who Clifford S. Deutschman, M.D., pro- Susan Ellenberg, Ph.D., professor of exemplify excellence in clinical medical fessor of anesthesiology and critical care biostatistics in the Department of Biosta- practice and is part of their National Phy- and an attending physician on the Surgical tistics and Epidemiology and the School sician of the Year Award honors. Ken- Critical Care Service at HUP, was elected of Medicine’s associate dean for clinical nedy is widely noted for bringing endo- president-elect of the Society of Critical research, was appointed chair of the scopic sinus surgery to the United States Care Medicine, the leading international board of trustees of the National Insti- and fundamentally changing how these organization dedicated to ensuring excel- tute of Statistical Sciences. Her research procedures are performed. Kennedy has lence and consistency in the care of criti- has focused on practical problems and also helped advance image-guided sur- cally ill and injured patients. Deutschman, ethical issues in designing, conducting, gery, minimally invasive endoscopic skull an internationally known sepsis investiga- and analyzing data from clinical trials, base surgery, and trans-nasal endoscopic including surrogate endpoints, data orbital surgery. monitoring committees, clinical trial de- Fellows Three signs, adverse event monitoring, vaccine Jack Ludmir, M.D., G.M.E. ’87, profes- Three University professors were safety and special issues in cancer and sor and chair of obstetrics and gynecology named Fellows of the American Associa- AIDS trials. In addition to her teaching at Pennsylvania Hospital, was appointed tion for the Advancement of Science, two and administrative duties, Ellenberg the 2011 chair of the Section for Maternal of whom are professors in the Perelman serves as senior statistician for three and Child Health of the American Hospital School of Medicine. multicenter clinical trials and directs the Association. Ludmir also serves as vice James C. Alwine, M.D., professor of Biostatistics Core of the Penn Center for chair of obstetrics and gynecology at HUP. cancer biology, is also associate director AIDS Research. He has spearheaded several quality and pa- for core facilities at the Abramson Cancer tient-safety initiatives in obstetrics, includ- Center. His laboratory has been at the Judd Hollander, M.D., professor of ing the successful introduction of Philadel- forefront of studying how DNA viruses emergency medicine and clinical research phia’s first laborist practice – a model that alter cellular signaling in order to manip- director for the Department of Emergency focuses on providing in-hospital labor and ulate stress responses for the advantage Medicine, had received the Leadership delivery care – at Pennsylvania Hospital. of the infection. Award from the Society for Academic An advocate for making high-quality Gideon Dreyfuss, Ph.D., the Issac Emergency Medicine. It is considered obstetrical care available to the most vul- Norris Professor of Biochemistry and Bio- one of the most prestigious awards in the nerable populations, Ludmir has worked physics, is a Howard Hughes Medical In- field of emergency medicine. Hollander’s with Women and Children’s Health Services stitute investigator. He studies RNA- primary area of research pertains to in Philadelphia and is coordinator for the binding proteins and their complexes emergency care for patients with acute Dominican Republic Section of the Ameri- with RNAs (RNPs), the key mediators of cardiac problems; he has conducted ex- can Congress of Obstetricians and Gyne- post-transcriptional gene regulation, and tensive research about the use of CT an- cologists. For these efforts, he was recently their role in disease. His current research giography in patients with chest pain. A awarded the organization’s Award for focuses spinal muscular atrophy, the mo- former president of the Society, is cred- Outstanding District Service. tor neuron degenerative disease; splicing ited with establishing the Academic Asso- regulation; and high-throughput technol- ciate Emergency Medicine Research Pro- Teresa M. Reyes, Ph.D., research as- ogies for research and drug discovery. gram, which forms the backbone of one sistant professor of pharmacology, has been John C. Trueswell, Ph.D., is a pro- of field’s most successful and most repli- appointed to the NIH Study Section on fessor of psychology in the School of Arts cated clinical research programs. Neuroendocrinology, Neuroimmunology, and Sciences. His areas of research are Rhythms, and Sleep Study Section. Her developmental psychology; language and David W. Kennedy, M.D., professor in research interests include the central communication; memory and learning; the Department of Otorhinolaryngology nervous system circuitry that controls and sensation and perception. – Head and Neck Surgery, received the food intake and metabolism; anorexia Clinical Excellence Award of Castle Con- and cachexia associated with illness and

6 ■ PENN MEDICINE infection; development of obesity and scholars in clinical and academic bioeth- one of the annual Awards of Excellence metabolic syndrome in response to ma- ics and the medical humanities. presented by the School of Medicine to ternal and fetal undernutrition, stress, the medical faculty. or infection. Thomas Sollecito, D.D.M., chair of the Department of Oral Medicine in Kelly C. Wade, M.D., Ph.D., G.M.E. Judy A. Shea, Ph.D., associate dean of Penn’s School of Dental Medicine and ’03, a neonatologist at Pennsylvania Hospital medical education research and professor chief of the oral medicine service at HUP, and the Children’s Hospital of Philadelphia, of medicine in the internal medicine di- was named president of the board of was named Physician of the Year by PRO- trustees of the American Academy of LC, a local organization that promotes, Oral Medicine. He has been active in supports, and protects breastfeeding. Wade, leadership roles on the board over the an academic clinical assistant professor, past several years. worked with nurses and lactation consul- tants to create an education module that Scott O. Trerotola, M.D. ’86, the supports NICU babies and their parents in Stanley Baum Professor of Radiology and establishing breastfeeding. She also ensures professor of surgery, received the 2011 that medical students learn about breast- Leaders in Innovation Award from the feeding during their training. As a neona- Society of Interventional Radiology. The tologist, Wade advocates for breast milk as honor recognizes an individual who has the gold standard for premature babies. conceptualized and implemented an idea that has had an impact on the practice of Alan J. Wein, M.D., received the interventional radiology. Trerotola, who is Ferdinand C. Valentine Award in Urology also associate chair and chief of vascular from the Section on Urology of the New Judy A. Shea, Ph.D. and interventional radiology, holds eight York Academy of Medicine. Chief of the patents on devices for interventional pro- division of urology, Wein serves as director vision, was the recipient of the 2011 Ca- cedures. His extensive contributions to of HUP’s Urology Residency Program. reer Achievement in Medical Education the field of hemodialysis access interven- The award selection committee noted Award of the Society of General Internal tions have helped shape the role of inter- Wein’s “uncanny ability to sift through Medicine. In particular, the Society noted ventional radiology in this field. Trerotola huge volumes of data and extract those Shea’s work in evaluating medical programs also received the 2010 Louis Duhring which drive clinical practice. He is one of and developing instruments to measure Outstanding Clinical Specialist Award, the world’s great technical urological sur- efficacy. Shea also received this year’s John P. geons.” Wein is a former vice president Hubbard Award from the National Board of the American Board of Urology and is of Medical Examiners for her sustained editor in chief of Campbell-Walsh Urology, contributions to advancing the methodol- considered the gold standard in the field. ogy of evaluation in medicine. According to the award committee, her work has had Zhaolan (Joe) Zhou, Ph.D., assistant “substantial impact on medical education professor of genetics, was one of 12 in- processes and in multiple organizations.” vestigators across the nation who re- ceived 2010 Biobehavioral Research Jason L. Schwartz, associate fellow at Awards for Innovative New Scientists the Center for Bioethics and doctoral (BRAINS) from the National Institute of candidate in the Department of History Mental Health. Individual awards are and Sociology of Science in the School of made in the vicinity of $2.5 million over Arts & Sciences, was elected to the board five years. Zhou will use mouse models of directors of the American Society for to examine the molecular underpinnings Bioethics and Humanities. The society is that link early life stress and subsequent the national professional organization for Scott O. Trerotola, M.D. mental illness.

2011/FALL ■ 7 as associate editor of the journal Aca- administration and administrator of Fein- Transitions demic Emergency Medicine. Baren has been berg’s Department of Medicine, during Jill M. Baren, M.D., M.S.E. ’06, has consistently recognized for her teaching which time she helped double the de- been named chair of the Department of and mentoring. partment’s clinical revenue in five years Emergency Medicine. A member of After earning her medical degree at the by developing faculty incentives and in- Penn’s medical faculty since 1997, she is University of Pittsburgh (magna cum creasing efficiency of staff and space. professor of emergency medicine and laude) in 1989, Baren completed an in- At the Wharton School, Cooke was ternship and a residency in emergency awarded the Hospital Association of medicine and a fellowship in pediatric Pennsylvania’s Student Award. emergency medicine at Harbor-UCLA Medical Center in Los Angeles. Chi Van Dang, M.D., Ph.D., has been appointed director of the Abramson Cancer Rebecca Cooke, M.B.A., has been ap- Center of the University of Pennsylvania. pointed vice dean for administration and finance for the Perelman School of Medi- cine. She has executive experience in re- search administration, higher education administration, and the management of physician practices and hospital clinical programs. Most recently, she served as chief operating officer of Northwestern University’s Feinberg School of Medicine. Cooke received her M.B.A. degree in Jill M. Baren, M.D., M.S.E. health-care management from the Whar- ton School and earlier worked for The holds a secondary appointment as pro- Children’s Hospital of Philadelphia and fessor of pediatrics. Baren is an attending Thomas Jefferson University.

physician at both HUP and The Chil- As COO at the Feinberg School, Chi Van Dang, M.D., Ph.D. dren’s Hospital of Philadelphia. She suc- Cooke was responsible for strategic, op- ceeds William G. Baxt, M.D., who served erational, and financial leadership. Previ- He comes to Penn Medicine from The with distinction as chair since 1994, ously, she was senior associate dean for Johns Hopkins University School of when the Department of Emergency Medicine, where he was a professor in Medicine was established. the departments of Medicine, Cell Biol- Baren is recognized as an expert in pe- ogy, Oncology, Pathology, and Molecular diatric emergency medicine. A fellow of Biology & Genetics. He also served as vice both the American College of Emergency dean for research and executive director Medicine and the American Academy of of the Institute for Cell Engineering. Pediatrics, she has held major leadership Dang’s laboratory has contributed to positions in professional organizations of the understanding of the function of the both specialties. She has lectured and MYC cancer gene, which has emerged as written on informed consent issues in a central transcription factor or gene emergency medicine research, bioethical switch in many different human cancers. issues in resuscitation, and end-of-life is- Most recently, Dang was the principal in- sues in the emergency department. vestigator for Johns Hopkins in a Stand Widely published, Baren is senior editor Up to Cancer grant awarded to Penn of Pediatric Emergency Medicine. She was Medicine from the American Association associate editor of Journal Watch Emer- for Cancer Research to investigate how to gency Medicine for 10 years and continues Rebecca Cooke, M.B.A. “cut off the fuel” for pancreatic cancer.

8 ■ PENN MEDICINE With more than 200 scientific publica- tions, Dang is the editor of a special issue Welcome to the Academy chair of the Department of Cell and De- of Genes & Cancer, “MYC: A Far-Reach- Amita Sehgal, Ph.D., Jonathan A. velopmental Biology. He is known for his ing Cancer Gene,” published last year. Epstein, M.D., and Katherine High, studies of the molecular mechanisms of He has been senior editor and associate M.D., were elected members of the cardiovascular development and their editor of Cancer Research, associate editor American Academy of Arts and Sciences. role in understanding human disease. of the Journal of Molecular Medicine, and Sehgal, the John Herr Musser Professor High, the William H. Bennett Professor scientific editor of Cancer Discovery. and vice chair of the Department of Neu- of Pediatrics, is widely recognized as a Born in Saigon, Viet Nam, Dang roscience, serves as co-director of the hematologist and researcher. She is a earned his Ph.D. degree in chemistry at Comprehensive Neuroscience Center. Howard Hughes Medical Institute inves- Georgetown University, with distinction. She studies the molecular and genetic tigator and serves as director of the Center Four years later, he received his M.D. de- components of sleep and circadian for Cellular and Molecular Therapeutics gree from Johns Hopkins University, rhythms using a fruit fly model. Sehgal is at the Children’s Hospital of Philadelphia. where he was inducted into the Alpha also a Howard Hughes Medical Institute Founded in 1780, the Academy selects Omega Alpha Honor Medical Society. investigator. top experts in areas such as academia, the Following his internship and residency Epstein, the William Wikoff Smith arts, business, and the sciences to support in medicine at Johns Hopkins Hospital, Professor of Cardiovascular Research, is the independent policy center’s research. Dang took a fellowship in hematology- oncology at the Cancer Research Institute of the University of California at San Francisco. In 1987, he was appointed as- cine. He is a fellow of the American sistant professor of medicine at Johns Academy of Physical Medicine and Re- Hopkins, where he remained until join- habilitation and has been honored for ing Penn Medicine. his teaching. The inaugural recipient of the Johns Dillingham earned his medical degree Hopkins Family Professorship in Oncology from the University of Washington and Research, Dang is also an elected mem- took his internship and residency there ber of the Association of American Physi- while also earning his M.S. degree in re- cians and of the Institute of Medicine, habilitation medicine. From 1990 to and he is a fellow of the American Acad- 1994, he was a clinical instructor and emy of Arts & Sciences. He has served as then assistant professor in the Department president of the American Society for of Neurology at the Uniformed Services Clinical Investigation. University of Health Sciences in Bethesda, Md. He then joined the Johns Hopkins Timothy R. Dillingham, M.D., M.S., University as an assistant professor of Timothy R. Dillingham, M.D., M.S. has joined Penn Medicine as chair of the physical medicine and rehabilitation. Department of Physical Medicine and Dillingham joined the Medical College Rehabilitation. He had been chairman served as associate editor of the Ameri- of Wisconsin in 2003. and professor of physical medicine and can Journal of Physical Medicine and Reha- Commissioned as a second lieutenant rehabilitation at the Medical College of bilitation as well as a referee for several in the United States Army in 1982, Dill- Wisconsin. His research interests include other journals. He was an editor of two ingham eventually rose to major. In the rehabilitation and long-term out- volumes of Rehabilitation of the Injured 1994, he received the Meritorious Serv- comes for amputees, especially when the Combatant, published by the Office of ice Medal for exemplary performance of amputations are caused by a limb’s poor the Surgeon General. duties at Walter Reed Army Medical vascular status. He is also recognized as Among Dillingham’s many honors is Center, where he had served as staff an expert in the electrodiagnosis of pa- the Distinguished Researcher Award physiatrist and director of research for tients with limb symptoms and muscu- from the American Association of Neuro- PM&R; he was honorably discharged loskeletal disorders. Dillingham has muscular and Electrodiagnostic Medi- that same year.

2011/FALL ■ 9 Ezekiel J. Emanuel, M.D., Ph.D., has Emanuel was founding chair of the joined the University’s faculty as the 13th Department of Bioethics at The Clinical Penn Integrates Knowledge University Center of the National Institutes of Professor. As the Diane v.S. Levy and Health and served for two years as spe- Robert M. Levy University Professor, he cial advisor for health policy to the direc- has appointments in the newly reconsti- tor of the White House Office of Manage- tuted Department of Medical Ethics & ment and Budget. He is the author or ed- Health Policy in the Perelman School of itor of nine books, including The Ends of Medicine, where he is chairman, and the Human Life (Harvard University Press, Department of Health Care Management 1991), and hundreds of articles and es- in the Wharton School. In addition, he says, across such topics as health-care re- serves as vice provost for global initia- form, the ethics of clinical research, end- tives for the University. Ezekiel J. Emanuel, M.D., Ph.D. of-life care, and the physician-patient re-

Letters The editor replies: Medal of Freedom from President Lyndon A letter in the Texas Heart Institute Johnson for her work on thalidomide. An Accurate Count Journal notes that, “In 1921, Helen In the obituary section of the Winter Taussig was denied admission to Harvard A Question of Placebos 2010/2011 issue of Penn Medicine, we re- Medical School because she was a I am somewhat taken aback by a state- ported that Grace I. (Chen) Yuan, M.D. woman, yet she wrote the first textbook ment that appears in the article by Lynn ’52, “was the only female graduate of her on pediatric cardiology that incorporated Selhat in the recent issue of Penn Medicine. medical school class.” Our information hemodynamic principles. We must also [“The Goal Is Transformation,” Winter came from an item in a Newton, Mass., remember that Helen Taussig almost sin- 2010/2011] publication. Louis M. Palles Jr., M.D. ’52, glehandedly averted the thalidomide di- 1) On page 15 she supplies the reader has informed us that there were two saster in the United States” (Heinrich with what I consider to be “relative” mis- other female graduates in the Class of Taegtmeyer, M.D., D.Phil.). information. In randomized trials, be- 1952: Elizabeth Eliason Whereat and In Transactions of the American Clinical sides the treatment group there is a control Shirley Levin Jacobs. We regret the error. and Climatological Association (2005; 116: group, as she states. However, the control 1–12), Mary Allen Engle, M.D., wrote of group does not receive “no intervention.” An Instance of Unfairness her experiences with Dr. Taussig as a pe- This group usually receives a “placebo,” John A. Fust, M.D. ’45, responded to diatric intern in pediatric surgery and as which is not the same thing as no treat- “The Goal Is Transformation” (Winter a fellow at Johns Hopkins. She noted Dr. ment. This is critical in clinical trials be- 2010/2011) by raising the case of Dr. Taussig’s challenges: “Despite her father’s cause there can be a beneficial effect from Helen Taussig. He recalled reading about prominence on the faculty, Harvard was just taking a sugar pill with presumably her treatment within the medical estab- adamant against women in medical no efficacy in the disorder under study . . lishment: “How she had been the prime school and even against awarding her a . which brings me to the second and mover in the diagnosis and ultimate degree should she study in the School of more critical question. treatment of what became known as Public Health. She was, however, allowed 2) In the study by Drs. Grisso and Ab- Blalock-Taussig’s disease. How other resi- to study Histology while seated in a re- buhl, multi-level interventions are to be dents and others whom she trained were mote corner of the lecture hall, ‘so that undertaken in the “treatment group,” promoted over her. . . . I think, in these she would not contaminate the students,’ such as writing and leadership seminars, days when there is momentum toward she said. . . . Despite being an excellent etc. It is unclear what is the approach to giving women their due, the recall of Dr. student [at Hopkins], elected to Alpha the control group. If this group is not be- Taussig’s lifetime of mean treatment, all Omega Alpha, she did not upon gradua- ing brought together in some meaningful within the respect and admiration which tion obtain the internship in Internal (albeit non-leadership-related) ways, the she did receive, would be worthwhile. Medicine that she sought.” Later in her results from the experiment could well ‘Those who forget the past . . .’ ” career, however, Dr. Taussig received the be fatally flawed and uninterpretable. I

10 ■ PENN MEDICINE lationship. He has published in such in biochemistry from Oxford University. who received an M.B.A. degree from the leading medical journals as The New Eng- Before joining the N.I.H. in 1997, he was Wharton School in 1973, is a senior di- land Journal of Medicine, The Lancet, and associate professor of social medicine at rector of Goldman, Sachs & Co. A mem- JAMA, as well as in The New York Times the Harvard Medical School, where he ber of the University trustees since 2002, and The Wall Street Journal. taught since 1992. he serves on the board’s executive com- Emanuel has been elected to the Insti- mittee and is chair of the Budget and Fi- tute of Medicine and served on the Na- Mark O. Winkelman, M.B.A., a mem- nance Committee. tional Bioethics Advisory Commission. ber of the University of Pennsylvania’s Winkelman replaces James S. Riepe, His awards include the AMA-Burroughs board of trustees, has been named chair former chair of Penn’s trustees and re- Wellcome Leadership Award. of the board of Penn Medicine, effective tired vice chairman of the board of direc- Emanuel earned an M.D. degree and a November 1. He currently serves as a tors of T. Rowe Price Group Inc. Riepe Ph.D. degree in political philosophy from member of the Penn Medicine board and will continue to serve on the Penn Medi- Harvard University and an M.Sci. degree its executive committee. Winkelman, cine executive committee.

may have missed some details in my read partments and divisions in the control of Helsinki states that the benefits, risks, but asking the “controls” to just complete group carry on with their usual activities, burdens, and effectiveness of a new questionnaires will not be adequate as including faculty development and men- method must be tested against those that the placebo. torship, writing grants and manuscripts, are the best currently available.3 Unfor- As written, it is unclear to this reader and contributing to the academic, teach- tunately, there is no intervention proven that, indeed, (as stressed in the article) ing, and clinical missions of their depart- to help women advance in academic “our best scientific rigor” is being applied ments or divisions. This kind of active medicine. However, for the past 20 to this effort. control is essential to address whether years, the University of Pennsylvania Marie J. Stuart, M.D., G.M.E. ’72 the intervention is superior to the usual School of Medicine has had active pro- academic environment. grams in place to support women fac- Jeane Anne Grisso, M.D., M.Sc., replies: Including an additional active control ulty. Thus, we believe that this environ- We appreciate the questions raised by activity that ensures comparable contact ment serves as the best available com- Dr. Marie Stuart. with research staff is controversial. Be- parison treatment. We are conducting a cluster-randomized cause such an “attention” condition trial to evaluate whether a multi-level in- would need to match our multi-level in- 1 David H. Au, Mario Castro, and Jerry stitutional change strategy can help tervention, implementation at the level A. Krishnan, “Selection of Controls in women faculty succeed compared with of faculty members, departments, and Clinical Trials” (Introduction and Confer- the usual academic environment. We administration would be complicated ence Summary), Proceedings of the American randomly assigned eligible departments and likely infeasible. More importantly, Thoracic Society, 4: 567-569 (2007). and divisions (along with the faculty in Silverman, et al. argue that there are “po- 2 Ruth Lindquist, Jean F. Wyman, Kristine those units) to either intervention or tential ethical pitfalls when protocolized M. C. Talley, Mary J. Findorff, Cynthia R. “usual care” groups. The intervention is care in a control group deviates substan- Gross, “Design of Control-Group Condi- complex. Organizational change theory tially from the care typically provided.”1 tions in Clinical Trials of Behavioral In- has documented that institutional change The Hawthorne effect is another poten- terventions,” Journal of Nursing Scholarship, is more likely to occur if interventions tial problem that can occur when the 39: 3, 214–221 (2007). Proceedings of the target multiple levels. Thus, we have de- control intervention is so involved that it American Thoracic Society, 4:567-569 signed interventions that engage junior significantly changes participant behav- 3 http://www.fhi.org/training/en/RETC2/ women faculty, mid-level to senior fac- ior.2 Finally, commitment of participants’ RETCTraditional/p96.html. World Medical ulty and administrators, and department time and efforts should be considered Association Declaration of Helsinki, “Eth- chairs and division chiefs. carefully; burdening participants with ical Principles for Medical Research Involv- You are correct in saying that the con- time-consuming activities (just to pro- ing Human Subjects,” in Research Ethics trol status does not represent “no activ- vide an active control condition) is ethi- Training Curriculum, Second Edition. Family ity.” At each level, the faculty from de- cally difficult to justify.2 The Declaration Health International.

2011/FALL ■ 11

TheBy Marshall A. Ledger Anat my Lesson The Anat my Lesson Photographs by Candace diCarlo

“We want them to DISCOVER – to LOOK, to EXAMINE the structures, to THINK about what they’re doing.”

P oems, thank-you notes, messages to self about living up to expectations – these and other personal expressions are occasionally tucked under the cadavers in the medical school’s gross anatomy lab, placed by grateful first-year students at the end of the course and found by the diener as he is about to take the body for cremation. Gross anatomy inspires that kind of soul-searching – and other forms as well. Some students, after the last session, gather around their cadaver to discuss their expe- riences and reflect. And some write essays, as did first-year Penn Med student Mark Attiah in The Daily Pennsylvanian (see pp. 15-16) and second-year student Kristin Schwab in the Yale Journal for Humanities in Medicine (“Lessons Beyond the Body”). Clearly, most students find the course special. They begin it in their first Penn Med semester, after a month-long run through genetics, embryology, physiology, and biochemistry. “They know how to handle traditional courses,” says Neal Ru- binstein, M.D. ’73, Ph.D., who directs the gross anatomy course. But gross anatomy “is not just a medical course,” he continues. “Yes, you can stay out of the lab. You can study books, pictures, models, and you would learn a lot of gross anatomy. But that’s not all that we want them to learn. We want them to discover – to look, to examine

2011/FALL ■ 13 closed last year, isolated the first human myosin locus.) When Rubinstein joined the faculty in 1978, he was hired to do research and “teach something specific.” That happened to be gross anatomy, and he has proven to be the perfect heir to the Penn tradition. The proof: In each of the past seven years – almost covering the span of his leader- ship – the course has been voted the top-rated in the medical school. The ad- ministration has noticed his fine touch, making him overall head of Module I, which essentially teaches “core principles” during the first semester of medical school. He also runs the cell and tissue biology course. For gross anatomy’s high standing, Ru- Conferring, from left to right, are Emily Privette, Hayley Goldbach, and Colleen Bennett. binstein credits his faculty, all of them hired solely to teach gross anatomy (he is the the structures, to think about what part of the “practical” medical education only one on the standing faculty): Bob Boyd, they’re doing.” He tells the students this that would lead to his recognition as “the Joe Curci, Robin Fisher, John Ladman, right away, partly to calm their nerves. father of modern medicine.” Mike Speirs, and Jim White. The creden- “And we want them to think about the A century after Osler, the standard tials of this collection of professional people involved,” he adds. “They come to bearer is Neal Rubinstein. In some re- anatomists include teaching awards, sur- appreciate that someone has done some- spects, he is an unlikely descendant. In gical practice, neuroanatomy research, thing pretty spectacular for their educa- his student days, he avoided the class as and anatomy department chairmanships. tion – donated their body.” (The school does not use unclaimed bodies.) Dealing with cadavers introduces The University has a distinguished tra- dition in gross anatomy. The course was students to the privileged society of doctors, on the school’s first roster, in 1765. In fact, because one of the school’s founders, to medical uncertainty, and to the William Shippen, M.D., had already been teaching it for three years, Casper Wistar, M.D., Shippen’s successor as chair of limited state of medical KNOWLEDGE. anatomy in 1808, reasoned that the school originated in that course. often as he could (“I’m actually embar- Rubinstein summarizes their contribu- Wistar went on to revolutionize the rassed to tell you this,” he says, “but I tion: “Most people think of anatomy class subject. He wrote the first anatomy text didn’t like anatomy at all”). And he is as the stern professor asking the students in America, created sustainable anatomical based not in a clinical department, where question after question, grilling them until models by injecting wax into human re- he might apply the information gained from they get to the point where they don’t mains to keep them preserved, and gave gross anatomy, but in basic research – cell know the answers. To me, that’s negative compelling lectures. Decades later, William and developmental biology, where he fo- reinforcement, and it doesn’t work. Osler, M.D., chair of clinical medicine at cused on muscle development using “I’m a positive-reinforcement guy, and Penn from 1884 to 1889, brought stu- techniques from biochemistry and, later, they are, too. You go to the table, the stu- dents into his post-mortem laboratory, molecular biology. (His lab, which he dent doesn’t know the answer, you help

14 ■ PENN MEDICINE the student find the answer. You always class. About half, or some 80 students, ical information that I don’t have. They are give them the idea that, boy, they really participate. “When we first started getting role models. They’re comfortable, self-as- know a lot of material – well, let’s just them, I thought they’d be extra hands to sured, they know what they’re doing. find out some more material.” say yes, you can cut that or yes, that’s the “And I say to the first-years, ‘You know, Rubinstein also credits the teaching as- aortic artery, but they’ve turned out to be three years ago, these guys were you – and sistants he recruits from the fourth-year more than that by giving out all this clin- this is what you’re going to be like.’ I think A RITE OF PASSAGE – AND MUCH MORE BY MARK ATTIAH A PENN MEDICAL STUDENT EXAMINES WHAT HE HAS LEARNED FROM THE DEAD. The first day of anatomy of emotions. “I think it’s go- lab for most medical stu- ing to be really fun,” said dents is the turning point Ofole Mgbako. Jerome in their education when Molleston looked ahead they realize that they are, in with some enthusiasm, sug- fact, in medical school. Be- gesting that “the learning fore taking the course, stu- will be more relevant, more dents understand that they active.” On the other hand, will have to learn about the when asked what she was human body, and they may concerned about, Alexandra have toured cadaver labs. Charrow responded, “I But the experience of having don’t want to cut the face.” an actual dead body in Charrow’s comment ar- front of them is something ticulates a concern that that no syllabus or course many students have about description can really convey. the experience. It is not Close inspection: from left to right, Andrew Taylor, Chen Yan, Mark Attiah, and Ray Hu. Like any occasion of such only disgust at the sight gravity, it can make many first-year medi- tionally harrowing for some. “A few stu- of human entrails: the anatomy class cal students uneasy. “They are worried dents each year have had a recent experi- amounts to a crash course in how to that they will have nightmares,” wrote ence with death: grandparent, parent, tread the fine line between embracing your Neal A. Rubinstein, M.D. ’73, Ph.D., the sibling, close friend,” added Rubinstein, a own feelings of shared humanity – and anatomy course director, in an e-mail. professor of Cell and Developmental Bi- restraining them. “They see it as a rite of passage, but have ology, “and seeing a dead body brings My own greatest concern was that I heard that it is a terribly difficult rite of back all the emotions of those traumas.” might become numb – that someone passage and that scares them.” The course, Before the first dissection, last fall’s first- else’s eyes would no longer be the win- he concedes, has the potential to be emo- year students were feeling a wide range dow to his soul, but simply the corneas,

2011/FALL ■ 15 MY OWN GREATEST CONCERN zonular fibers, and optic nerves. As WAS THAT I MIGHT BECOME and he wanted to make sure that the Molleston put it, these cadavers “had “NUMB – THAT SOMEONE ELSE’S next generation of doctors would be as their own hopes and dreams, and we’re amazing if not better than the ones who EYES WOULD NO LONGER BE dissecting an endpoint.” The muslin cloth took care of him.” that covers a cadaver’s face is not so much THE WINDOW TO HIS SOUL, BUT In the auditorium’s mezzanine, many a mask to protect the donor’s dignity as it SIMPLY THE CORNEAS, ZONULAR students from Philadelphia’ medical is to protect our still-fragile sensibilities. FIBERS, AND OPTIC NERVES. schools looked on attentively. The dense But it is not only the students’ feelings sea of short white coats at the event un- that are considered. The organizers of the there was something very earnest about derscored the fact that even the most course take the dignity of the donors very hearing a eulogy from a person who” never “type A” students among us know that seriously. For instance, Penn does not use spoke a word to the deceased, yet knew no learning is ever really independent. unclaimed bodies for dissection, a gesture him, in some ways, better than he even There are many people involved, often in of respect for the autonomy of a potential knew himself. “It felt very human,” wrote unpublicized ways, so that doctors can donor. After dissection, bodies are cre- Karthikeyan Muthuswamy, a first-year do what they do – and someone had to mated and preserved for the families af- Penn medical student and one of those give for us to get. terward. This procedure is a far cry from who gave the eulogies. As he put it in an Anatomy is by far the highest-rated the practice of “resurrectionists,” the pro- e-mail message: “It was obvious that the course among first-year students at Penn, fessional body snatchers who supplied name readers had great respect for each according to Rubinstein. Given that you anatomy labs in olden times. person on the list.” Regardless of their can smell the unmistakable aroma of a This spring, Penn hosted the Celebration occupation in life, each of the donors had first-year taking anatomy from 400 feet of Remembrance, a ceremony to honor become an educator for the sake of a away, thanks to the hours spent in a the donors who gave their bodies. In a healthier future, and the families appeared formaldehyde sauna, this is not a trifling concerted gesture not unlike a 21-gun to be touched by this acknowledgment. “It feat. My classmates and I know full well salute for fallen soldiers, a multitude of was hard to look out into the audience that dead men do indeed tell tales, and brothers, sisters, wives, husbands, chil- and see some people starting to cry while we’re fortunate enough to learn how to dren, grandchildren, and other loved ones making my speech,” wrote Muthuswamy. listen to them. of the donors filed into Irvine Auditorium “But they also had a smile on their face. to hear words, verses, and musical notes One of them said that he always wanted Mark Attiah is a second-year medical student of gratitude from medical students. It to donate his body to science. He’d always from Dallas. An earlier version of his article was not an impersonal occasion; instead, had great doctors take care of him in life, appeared in The Daily Pennsylvanian.

that’s helpful. And it’s helpful for them to medical uncertainty, and to the limited see that there must be some importance state of medical knowledge. Fox suggests here if, after all their medical-school ex- that the course is a rite of passage: Though perience, the fourth-years think it’s better far from being a physician, the student to do some anatomy than anything else.” becomes more like one by the end of the course. “Some call the cadaver their first As Renée C. Fox, Ph.D., the Penn soci- patient – which it is,” says Rubinstein. ologist known for her studies of medical To help foster a good climate for learn- education and medical ethics, has noted, ing as well as a good attitude, students work gross anatomy is difficult partly because in teams of four of their own choosing. it makes visceral, emotional, and intellec- They take practical exams – on tagged tual demands on the students. In addition, body structures – together as a team. “No it begins to define them as physicians: matter how hard we make the questions, Dealing with cadavers introduces students you put the team together on it, they ace to the privileged society of doctors, to this exam,” Rubinstein reports. It’s rare

Going by the book are Ibardo Zambrano, left, and Ivor Asztalos. 16 ■ PENN MEDICINE that anyone slacks off: “No one wants to let the team down.” And because they’re studying harder for the team, the scores on their written exams, which they take individually, have been rising. Lectures play a smaller role than they did in the past–but likely a more exciting one because, when possible, they are based on real-life examples. When ortho- paedist Brian J. Sennett, M.D. ’88, dis- cusses sports medicine, he begins with a video of Tom Brady, the New England Patriots quarterback, smashing his knee at the start of the 2008 season. Sennett asks what could be injured, explains the structure of a healthy knee, and then shows what happened to Brady (he tore both his anterior cruciate ligament and his medial collateral ligament). “We’re not teaching them to be sports medicine people,” says Rubinstein, add- ing, “but if that grabs their interest, that’s Jerome Molleston, Lucie Guo, and Ryan Jamiolkowski observe as Ankona Ghosh, then a teaching assistant, shares information. Ghosh is now an intern in otolaryngology at HUP. great.” Instead, he emphasizes, “We’re showing them that there’s a reason that and the speaker could address the vari- is used sparingly, as when the radiology we’re teaching anatomy.” ous answers. residents give the lectures. Currently, stu- Technology is making the lectures in- Technology is also making cadavers dents view structures in cross-sections teractive. Speakers may use “smart more life-like. The Department of Ortho- and various planes, “but they tend not to boards,” slides on which they write and paedic Surgery is constructing a human reconstruct them into 3-D images,” he draw, which the students see developing fresh-tissue laboratory where cadavers says. “I’d really like to see us doing that. It would be a great advance on how we teach gross anatomy, and students could Penn students take practical exams – put it on their own computers and work on it themselves.” on tagged body structures – as a team. Rubinstein considers what technology has done to gross anatomy: “When I was “No matter how hard we make the a medical student, they said that anatomy was going away, that soon it would all be biochemistry. Then molecular biology QUESTIONS, they ace this exam.” came, and they said it would all be mo- lecular biology. But it’s not. Because of all the imaging, you don’t need to do surgical in real time. The slides are then posted on will be “lightly fixed” so that residents interventions to see what’s going on in- the “virtual curriculum,” where students can be trained on more normal-appear- side someone. It has actually ended up can download the images and make notes ing bodies. Rubinstein looks forward to being more anatomy.” on their own copies. One innovation last having the first-year students rotate fall was the use of remote-control clickers, through the lab. Marshall A. Ledger, Ph.D., is former editor which enabled students to answer ques- He also foresees expanded use of of Penn Medicine and Trust, the magazine tions; the results were tabulated instantly, three-dimensional imaging. At present, it of The Pew Charitable Trusts.

2011/FALL ■ 17 “OUR HOPE FOR THE FUTURE OF

By John Shea MEDICINE AT PENN”

Photographs by Scott Spitzer except where noted

18 ■ PENN MEDICINE “OUR HOPE FOR THE FUTURE OF The Translational Research Center Will Enhance Collaboration MEDICINE AT PENN” and Accelerate Discoveries

What could make Francis Collins, M.D., Ph.D., one of the nation’s most re- spected and powerful physician-scientists, “a little jealous”? What could lead Collins, director of the National Institutes of Health and former director of the international Human Genome Project, to confess that, at the end of a site tour, “I veritably drooled”? What could inspire Collins, while showing a slide of that same facility, to describe it poetically as “looking • 531,000 total net square feet somewhat like a ship, ready to move out across the coming horizon”? • More than 700 laboratory The answer: Penn Medicine’s Translational Research Center, which officially opened in May – although some work stations happy researchers had moved into the building earlier. Collins was on the Penn Medicine campus as the • 180 research bays keynote speaker, helping to dedicate the $370 million facility. The title of his presentation was “An Accelera- tion of Translation,” and it was clear that, in his view, the TRC is well prepared to provide a good deal of that necessary acceleration. Col- lins was certainly not alone in expressing enthusiasm for what he called “this re- markable research center.” The reasons are not hard to find. The numbers in them- selves are impressive: 531,000 total net square feet of research space; more than 700 laboratory work stations; and 180 research bays. Filling the space will be 100 lead

researchers and 900 staff members from a wide range of departments, centers, and Daniel Burke by Photograph institutes, including the three that were established in 2005: the Penn Cardiovascular Institute, the Institute for Diabetes, Obesity, and Metabolism, and the Institute for Translational Medicine and Therapeutics. As was stated at that time, these three institutes represent high priorities for Penn Medicine. Back in 2005, Arthur H. Rubenstein, M.B.,B.Ch., then dean of the medical school, stated that, “although only one of the three new institutes has the word translational in its name, all three share a general impulse to bring the fruits of research to the patient as swiftly and safely as possible. All three will be doing what centers and institutes can do more effectively than loose confederacies of in- Francis Collins: “A little jealous.” Photograph by Daniel Burke

2011/FALL ■ 19 vestigators – that is, encourage the inter- actions among researchers, physicians, trainees, and students more systemati- cally.” And now the three institutes have a home especially designed to encourage those very efforts. J. Larry Jameson, M.D., Ph.D., now the executive vice president of the University of Pennsylvania for the Health System and dean of the Perelman School of Med- icine, made sure not to miss the TRC’s opening. Even before taking office at Penn Medicine, he was a champion of translational research at Northwestern University’s Feinberg School of Medicine, which had its own version of the Institute for Translational Medicine and Therapeu- tics. Jameson has called the newly opened TRC “a remarkable example of Penn’s commitment to accelerate clinical ad- of Health in recognition of its success M.D., chair of Cell and Developmental vances through research.” In addition, he during the first five years of the Clinical Biology, one of the faculty panelists who noted that Penn Medicine’s particular ex- and Translational Science Awards pro- spoke about the research they conducted pertise in translational research and col- gram. Penn’s institute ranked first in the and how the new facility would support laborative science are “topics of clear focus review of the renewal applications. In them. In his words, it is “courageous and for funding agencies.” In a recent letter to this connection, Jameson noted the role visionary” to house certain of the basic of Garret A. FitzGerald, M.D., director of sciences in the TRC, and doing so under- ITMAT, who was recently named associate scores the effort to “reach out and dean for translational research. bridge” the various scientific areas in Penn Medicine. Glen Gaulton, Ph.D., ex- INTERACTION AND COLLABORATION ecutive vice dean and chief scientific offi- At the TRC’s dedication, Francis Collins cer, also emphasized that the center specifically discussed the idea of interac- would serve “different kinds of ap- tion. In fact, his brief touch of jealousy proaches and different kinds of people” was triggered, he said, “when I got a look from different schools across the Univer- at the lab space, the offices, the conference sity of Pennsylvania. He gave a quick list: rooms, the flexibilities provided by the wet scientists, computational researchers, way in which the architect put together clinical trial coordinators, a blend of ju- the space, the way in which it’s going to nior and senior faculty members, gradu- encourage conversations between stu- ate students, and medical students. The dents and postdocs and faculty – and Translational Research Center, he as- that’s often what drives the next set of serted, “will have no walls” but be “truly alumni, Jameson placed translational ideas.” (The architect in question is Rafael open” and platform-based. As a result, he medicine at the top of a list of highlights Viñoly, who also designed the adjacent predicted “a lot of smiling people” would “of great importance to the future of Perelman Center for Advanced Medicine be working and studying there. Penn Medicine.” in collaboration with the firm of Perkins Those people will find an open, flexible He also mentioned another recent Eastman.) design that includes DNA-like spiral stairs achievement: ITMAT received a $55 mil- It was a theme echoed by other speak- allowing for quick connections between lion renewal from the National Institutes ers. Among them was Jonathan Epstein, floors, as well as a direct connection with

20 ■ PENN MEDICINE the state-of-the-art outpatient facility, the cases. Building resistance to HIV in this way lational Research Center can indeed be Perelman Center for Advanced Medicine. appears to be a very promising direction. seen as a capstone to his tenure. This As Collins put it, “it’s just one example passage appeared on the very first page INCUBATE, ADVANCE, ACCELERATE of the kinds of things that are now be- when the draft for the Plan for Penn Medicine Collins, in his presentation, described coming possible with this combination of appeared, more than nine years ago: “To some of the areas of innovation in which technologies being applied from basic to benefit from the opportunities that lie the NIH is investing. At an event cele- clinical and which I think will be a wonder- ahead, greater collaboration amongst re- brating the Translational Research Center, ful incubator, right here, at this Translational searchers, clinicians, and educators is re- it was especially appropriate that Collins Research Center.” quired. . . . This collaboration is facili- also noted that the NIH has established a tated by establishing an intellectual envi- National Center for Advancing Transla- LOOKING BACK AND AHEAD ronment in which highly talented individ- tional Sciences; its mission is to catalyze In her opening remarks, Amy Gutmann, uals are working together in teams to inte- the development and testing of novel di- Ph.D., president of the University of Penn- grate a full continuum – from basic science agnostics and therapeutics across a wide sylvania, thanked Collins for the $13 mil- to clinical practice to population health range of human diseases and conditions. lion Penn received last year from the Na- observations and back to basic, transla- He made clear that it was not a matter of tional Institutes of Health as part of the tional, and clinical research – to achieve making discoveries but of helping move American Recovery and Reinvestment remarkable results in research, patient the discoveries along – building a bridge Act, specifically to construct additional care, and education.” across what is often a daunting gap. In research space in the TRC. (All told, Penn The Translational Research Center is this category, one of the interesting plans Medicine received more than $185 million intended to be a place where Penn inves- is to examine the oversight process for in ARRA funds.) The new center, she said, tigators can fulfill such aspirations. new drugs, which Collins described as “represents our hope for the future of “failure-prone and very expensive.” An- medicine at Penn.” other plan is to explore new uses for In addition to celebrating the opening abandoned and approved therapeutics – “to of the new center, the event was also the liberate these compounds,” as he put it, occasion for celebrating Arthur Ruben- that have already been shown to be safe stein. He was praised for his role in mak- for humans. ing the TRC a reality as well as for his very Collins also cited some recent Penn successful decade as leader of Penn Medi- successes. One is the work of Jean Bennett, cine. President Gutmann said there was “no M.D., Ph.D., and Albert Maguire, M.D., better capstone for . . . Penn Medicine’s in restoring some sight to patients with most passionate advocate.”According to Leber’s Congenital Amaurosis, a rare dis- Collins, he came to Penn to celebrate not ease. (“Isn’t that amazing!” exclaimed only the new center but Rubenstein as Collins.) Another example is the success well, who had made “legendary contribu- of Carl June, M.D., who happened to be tions” to academic medicine. And at the one of the event’s faculty panelists. June cake-cutting after the main program, and his team, working with Sangamo Ralph Muller, CEO of the Health System, BioSciences, have used engineered zinc said that he and all those involved in the finger proteins to modify the T cells of a TRC’s construction did their very best to patient with HIV/AIDS. The procedure make sure it was ready before Rubenstein knocks out the CCR5 gene necessary for stepped down as dean and executive vice HIV infection. Then the modified cells president of the University of Pennsylvania are put back in the patient, and there is for the Health System. no need for immunosuppression. In nine A glance back at the strategic plan that patients so far, the engineered cells re- Rubenstein initiated early in his tenure – mained free of infection, and they multi- and which drew substantial input from plied dramatically in eight of the nine faculty and staff – suggests that the Trans-

2011/FALL ■ 21 What Ever By Marshall A. Ledger Happened to Einstein’s

The 20th century’s most famous brain had an unusual post-mortem journey. At Penn, Brain? at least, it was treated right. ?

22 ■ PENN MEDICINE arly in 1933, the trustees of the University of EPennsylvania invited Albert Einstein to attend graduation ceremonies that year and receive an honorary degree. The world-famous physicist could not come, the invitation was never extended again, and there seems to be no public re- cord that he ever did make it to Penn’s campus. After his death in Princeton, N.J., in 1955, however, his brain was brought to Penn Medicine labs for sectioning and

slicing, in preparation for research. At the time, the tissue pro- The histology laboratory in Penn’s Graduate School of Medicine, circa 1954. cessing was a hush-hush procedure, but now it is generally ac- knowledged. But until now, few details had come forth. ate School of Medicine, then part of Penn’s School of Medi- cine. Edna Rogers Hughes was secretary to William E. Ehrich, M.D., the chair of pathology (a department that included his- Inherent interest – and speculation tology and neuroanatomy), and Monica Carr Fox was a lab There is likely to be great curiosity, especially among the technician there. The women knew Harvey and had small public, in the study of a genius’s brain, yet Einstein’s brain roles to play in the care of the brain, and what they read about shouldn’t have survived him. He explicitly directed that his the pathologist did not ring true to them. body be cremated, and so it was, with the exception of his Hughes and Fox were especially offended by the 2000 book brain and his eyes. Driving Mr. Albert: A Trip Across America with Einstein’s Brain, Thomas S. Harvey, M.D., the Princeton Hospital pathologist by the journalist Michael Paterniti. He had befriended Harvey who conducted the autopsy, removed those organs, certainly and indulged his impulsive desire to take the brain to the without prior approval to do so. Whether he received permis- West Coast. The former pathologist seemed to have a vague idea sion during the operation (from the executor of Einstein’s es- of discussing research possibilities with neuroscientists and tate, who was present) or after the fact has been a matter of showing the brain, perhaps even leaving part of it as a gift, to longstanding debate. Evelyn Einstein, the scientist’s granddaughter, who lived near The eyes went to his ophthalmologist, Henry Abrams, M.D., San Francisco. (She died this past April.) G.M. ’41, and reportedly are still locked away. (Abrams, who The trip took place in 1997. In Paterniti’s narrative, Harvey, taught at Penn Medicine for 15 years, died in 2009.) then 84, came across as a genial, shambling eccentric; the The brain stayed with Harvey for nearly 45 years. He took writer, as an eager, wonderstruck but clueless, 30-something it home with him, even though not returning it to Princeton partner on a “buddy” adventure; and the pieces of brain, as Hospital cost him his job there. He carried it to the Midwest, the ludicrous link between them. where for two decades the world seemed to forget about him. Hughes and Fox discussed their disagreements with Patern- And he took it with him when he moved back to New Jersey iti’s portrayal of Harvey and the implication in the book’s title in the 1990s. that the brain was whole rather than much diminished after In 1997, Harvey traveled to the West Coast by auto, and being dissected and distributed to researchers over the years. the sectioned organ made the trip in Tupperware containers (In the book, Paterniti clearly explains that the brain was “in inside a duffel bag in the trunk. Harvey seemed to be an im- parts,” but the mere phrase Einstein’s brain arouses particular proper caretaker, to say the least, and the brain took on the awe as the physical home of his genius.) mystique of an urban legend. After another former colleague, Barbara Johansen Smith, a technician in the department, corroborated their recollections, Not a caper Hughes this spring took an unusual step: She e-mailed Penn This past spring, two former Penn employees decided that Medicine’s administration, offering their first-hand account – they had had enough. In the 1950s, they worked in the Gradu- the first full disclosure of the brain’s stay at Penn.

2011/FALL ■ 23 Photograph by Frederick E. Lepore Copyright © 2000

exactly what she did, I later contacted Frederick E. Lepore, M.D., a neurologist at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. He reviewed the research on Einstein’s brain and interviewed Harvey for Cerebrum, the Dana Foundation pub- lication, in 2001. “The slides were labeled to indicate their block of origin,” he pointed out. “Harvey sketched a master map showing the anatomical place of origin of the numbered blocks.”) Most of the accounts that mention Penn’s Einstein’s sectioned brain in a glass specimen jar. At the upper left, the letters “GSMUP” (Graduate School of the University of Pennsylvania) are visible. work on the brain credit Keller’s efforts. Paterniti noted that “she must have been I met with Fox and Hughes in Hughes’s for the noted neuropathologist Harry a highly competent technician, for some home in suburban Philadelphia. As it turned Zimmerman, M.D.; in the 1930s, he had of those experts who’ve ultimately come out, Hughes knew Harvey even before he taught at Yale University’s School of Medi- by slides of Einstein’s brain still praise arrived with the brain in 1955. They had cine, where he was a mentor for Harvey. her work.” both arrived at the pathology department Hughes, Fox, and Smith all recalled Hughes and Fox described the schedule: in 1949, she as Ehrich’s secretary and he as Keller as exceptionally able. Smith, whom I After Harvey got Keller started, he traveled an instructor. Harvey went on to the Hos- reached by phone, reported to Keller, who from Princeton on Fridays once or twice pital of the University of Pennsylvania as also trained her in the lab. “She was a won- a month and, under a microscope, exam- a medical associate in clinical pathology derful, patient teacher,” said Smith. “I didn’t ined the slides that Keller had prepared. from 1950 through 1956; in 1952, he realize how unusual she was until later When he finished, he took the whole brain became director of the pathology lab at years, but she was one of only 11 techni- out of the jar and told Keller the part he Princeton Hospital, while apparently re- cians in the United States who could use a would like to study next. Over the follow- taining his HUP affiliation four more years. Sartorius microtome,” the state-of-the-art ing week or two, she did the slicing, stain- The women recalled Harvey’s profession- brain slicer of the mid-1950s. ing, and mounting, and the slides would alism and the proper care that Einstein’s The machine was huge, the size of a be ready for Harvey on his next visit. This brain received. “Dr. Harvey was a man kitchen table, with a 12-inch blade. Us- routine lasted about eight months. worthy of respect, and Paterniti introduces ing it “required great skill,” Fox said. “The Fox worked alongside Keller as she put him other than that,” said Fox. “And that brain was mounted in the center in a celloi- litmus paper between the sections (“be- makes me unhappy.” din block. It had to be properly embedded, cause they were so thin,” Fox pointed “Dr. Ehrich was a proper German and then the tech needed great skill to out). Hughes recalled looking at the samples gentleman,” Hughes added. “Nothing obtain a full brain section without shatter- under a microscope to make sure that the questionable would have ever happened ing the specimen.” staining was correct, so that it would high- in a lab that he was in charge of.” Keller produced 240 blocks and, from light the cells that Harvey wanted to see. each, cut microscope slides. (To understand The work took place in the basement of Sectioning the brain at Penn the Anatomy-Chemistry Building, where Hughes and Fox described the vital At press time, Penn Medicine has the pathology lab was located. Go down role played by Marta Keller, a histology learned that Lucy Rorke-Adams, M.D., the hallway, turn left and you’d find a has donated 46 slides containing technician who probably was the reason slices of Einstein’s brain to the Mutter vestibule, and at the back of that small that Harvey brought Einstein’s brain to Museum of the College of Physicians space was a closet. There the famous or- of Philadelphia. Rorke-Adams, a neu- Penn for sectioning. Hughes must have ropathologist at The Children’s Hospital gan was stored, along with brains used to known her from the pathology lab, and of Philadelphia and a clinical professor teach the Graduate School of Medicine they had another link: She formerly at the Perelman School of Medicine, students. “Einstein’s brain never got to received the slides in the mid-1970s. worked at Montefiore Hospital in New York, students,” Hughes said. “It was kept there

24 ■ PENN MEDICINE because that was the only place we had.” reason for Einstein’s genius?” “None as yet produce interesting links between the As she added: “It was locked.” far as I know,” Keller wrote. organ and intellectual creativity. Hughes saw the brain regularly. Ehrich, These findings concur with most re- If that happens, he suggested, Einstein’s the department chair, lectured on Satur- search on Einstein’s brain from the start. brain may yet make a contribution. Harvey days, and she prepared his teaching ma- For instance, its weight was normal (the died in 2007, but nine years earlier he gave terials: “I’d go in on a Saturday, get a cart, relationship of brain weight or size and the remaining parts of the organ – some go to the closet, put six brains on it, put mental powers is an continuing ques- 170 of the original 240 celloidin blocks – to rubber gloves on, wash the brains off, put tion). In addition to preparing work for the Princeton Medical Center. Parts also them on a metal plate, a pie plate, and give Harvey, Keller prepared slides for several are held at a brain bank assembled by the them out. The doctor-students would dis- clinical scientists around the country to neuroscientist Sandra F. Witelson, Ph.D., sect them while Dr. Ehrich was speaking.” whom Harvey sent them. Harry Zimmer- at McMaster University; and, according But information about the brain’s pres- man, his former mentor, received a set and to Lepore, at an institution that has re- ence was restricted to those who needed noted that he did not expect to “find the quested anonymity. to know. According to Hughes, “We were cells that made him a genius.” Based on what he has seen, Lepore told not to mention to anybody that we According to Lepore, the other slide re- credited Harvey for the “meticulous and had the brain in our lab, because they were cipients apparently had nothing to report. systematic preservation of Einstein’s brain.” actually afraid that it would be stolen.” Harvey’s own examination found “plaques Which is exactly the conclusion that Fox told her husband. “I told my mother, and neurofibrillary tangles” associated with Penn’s former employees reached. “Dr. and she didn’t care,” said Hughes. Alzheimer’s disease but “within normal limits Harvey might have really managed to pro- Eventually, the whole brain was sectioned, for a man his age”; he apparently did not tect that tissue so that farther down the “as far as we know,” Lepore told me in publish this result. road, further studies could be made,” said our later e-mail exchange. So it did leave Later studies, done with specimens Fox. “He may end up being the hero.” Penn “in parts.” That phrase has its own from Einstein’s brain that Harvey provided visceral impact, but Harvey in fact had to select scientists over the years, have accurate dissections, responsibly done in shown that a “neural basis of intellect” still a scientific and confidential manner by eludes us, Lepore concluded. But, he added, one of the best technicians of the day. neuroscience is a young field and may After Harvey left Penn with his blocks and slides, Hughes said, “Dr. Ehrich wanted to have a plaque put up, stating the location at Penn where this work was performed.” Whether he never got around to making an official request or whether his request was turned down is not known.

Research results so far Marta Keller wrote down her observa- tions of the brain only after Edna Hughes posed some questions to her in a letter in 2000. Keller, who died at 96 two years later, remembered Einstein’s organ as “a perfectly healthy, normal adult brain.” Asked about its convolutions – as if the fissures might have patterns relating to intelligence or creativity – Keller said they were typical.

Hughes also asked her about “any un- Top: Edna Hughes, second from right, and Monica Fox, right, with usual conclusions reached, giving the Graduate School of Medicine students. Bottom: In the foreground is the wheel of the histology lab’s Sartorius microtome, used for slicing brains for slides. From left to right, Edna Hughes, Marta Keller, Donna Liormanas, and Barbara J. Smith.

2011/FALL ■ 25 Learning About Dying

In some sessions, Doctoring 101 brings patients and family members to speak to medical students about complex topics beyond the basic and physical sciences. One such topic: hospice.

By Jennifer Baldino Bonett

Married for 27 years, Robert G. Rossheim unlike any others the students would be to heal and cure and save lives, learning and his wife Diane lived “a great romance.” It taking during their education. Required about death and dying is an important was the second marriage for both. When the over three years, Doctoring 101 covers part of their education.” country boy wed the city girl, the couple complex topics beyond the basic and Hearing the Rossheims’ story is a partic- enjoyed each other’s avocations – sailing physical sciences, such as giving difficult ular privilege and teaching moment, said for him and opera for her – and an active news, handling an angry patient, and preceptor Leslie S. Kersun, M.D., M.S.C.E. social life with friends. Mr. Rossheim was diagnosed with thyroid cancer in 2006 at age 81, and the couple remained active long into his illness. They Hospice isn’t a death sentence. It’s about getting had led a good life together and, when it “most out of life. But in many cases, people don’t was clear that Mr. Rossheim’s condition was terminal, the couple wanted a “good understand what hospice is. Hospice should be death” for him as well. Working with their one of the options offered to patients and families. physician, they sought out Penn Home Care and Hospice Services. ” “I think he died in peace,” said Diane F. Rossheim, a 1952 Penn graduate. “The working with patients and families dur- ’04, an assistant professor of pediatrics time that he had was good time and he ing terminal illness. and inpatient medical director in the on- knew that.” “This course gives our students a unique cology division at the Children’s Hospital Speaking clearly and quietly to a class experience and exposure to areas of patient of Philadelphia. of first-year medical students, Rossheim care and practice that aren’t encountered “Medical students haven’t really had unfolded the story of her husband’s pass- elsewhere in medical school,” said Paul N. much patient interaction at this point, so ing in 2010 and their hospice experience, Lanken, M.D., G.M.E. ’77, a critical care they are grateful to have these in-class in- which was, she said, “a blessing.” The specialist, professor of medicine, and as- teractions before doing it on their own,” students sat in rapt attention, listening sociate dean for professionalism and hu- explained Kersun. “The students develop carefully and respectfully as their guest manism. “They are dealing with difficult an appreciation not just for the medical speaker expressed both grief and joy. topics in a comfortable setting among aspects of the disease, but for what the They had come together to talk about faculty preceptors and student col- parent or mother or spouse has to do or hospice care in Doctoring 101, a class leagues. For medical students preparing might encounter in the medical system.”

26 ■ PENN MEDICINE Real patients and family members like called social worker Mary DeVito. DeVito There is also comfort for the caregiver Learning About Dying Diane Rossheim speak to small groups of set up the Rossheims’ bathroom with and the family, including respite services students in Doctoring 101. Although safety bars, arranged the hospital bed during care and bereavement services for up Rossheim remained stoic throughout the with an inviting quilt, and arranged for a to 13 months following a patient’s death. two-hour class, her voice conveyed ten- special foam mattress as Mr. Rossheim Joining Rossheim in Doctoring 101 was derness and urgency as she talked about her lost weight and needed more comfort. As Jeffrey Barg, M.S.S., L.S.W., bereavement husband’s illness and death. Mr. Rossheim he moved into his final days, the Hospice coordinator for Penn Hospice. “Hospice went from using a cane to using a walker, team left a morphine kit in the refrigera- isn’t a death sentence. It’s about getting and he continued to sail as long as some- tor and a special phone line for immedi- the most out of life,” he said. “But in one was able to lift him into the boat. He ate care. many cases, people don’t understand what would walk “as far as he could” through Rossheim read aloud to the medical stu- hospice is. Hospice should be one of the Washington Square, near their Philadelphia dents from “Letting Go,” a 2010 New Yorker options offered to patients and families.” home. In October 2009, after Mr. Rossheim article by Boston surgeon Atul Gawande: Barg encouraged the students to “push told his wife he did not want any more “In ordinary medicine, the goal is to yourselves to talk to patients about hos- medical treatment, David Mintzer, M.D., a extend life. We’ll sacrifice the quality of pice. Being realistic about it in a sensitive physician at Pennsylvania Hospital, “imme- your existence now – by performing sur- way is the greatest service to patients. It is diately wrote a prescription for hospice.” gery, providing chemotherapy, putting you a difficult subject to broach and it is easy Hospice focuses on palliative care – the in intensive care – for the chance of gaining to fall into a do-everything-at-all-costs lessening of symptoms and pain rather time later. Hospice deploys nurses, doc- mentality. Give patients the information they than cure – for terminally ill patients, who typically have a prognosis of six months or less to live. The hospice team – physicians, nurses, social workers, chaplains, home An academic medical center is the ideal home for health aides, therapists, dietitians, and “a hospice program, since this partnership ensures bereavement counselors – provides care that is physical, emotional, spiritual and that patients have access to both the most advanced social to the patient and the family. treatment and the most compassionate care. Penn Hospice is one of only a few hos- pice services in the country to be affili- ” ated with an academic medical center. “An academic medical center is the ideal tors, and social workers to help people need and want to make good decisions.” home for a hospice program, since this with a fatal illness have the fullest possi- As the two-hour class wound down partnership ensures that patients have ac- ble lives right now. That means focusing in Stemmler Hall, students asked how cess to both the most advanced treatment on objectives like freedom from pain and Mr. Rossheim transitioned from seeking a and the most compassionate care,” said discomfort, or maintaining mental aware- cure to realizing the disease would take David Casarett, M.D., G.M.E. ’99, the ness for as long as possible, or getting his life and seeking hospice care. “Bob chief medical officer of Penn-Wissa- out with family once in a while. Hospice was very aware of hospice and knew he hickon Hospice. Patients and their fami- and palliative-care specialists aren’t much had an incurable disease,” said his wife lies can receive care at home or as inpa- concerned about whether that makes candidly. “He really knew his end was tients at Penn Hospice at Rittenhouse. people’s lives longer or shorter.” coming and he accepted it. He had a quiet, For the Rossheims, Penn Hospice pro- Rossheim also showed a photograph of contemplative demeanor and wanted to vided at-home services including pain and her husband, from healthier times, stand- have as much pleasure at the end of his symptom management, spiritual support, ing aboard a sailboat. She told the stu- life as possible. There comes a time when 24-hour on-call support, and home health dents that at the end of his life, hospice the medicine has to stop. Bob under- aides to help with bathing. “There was enabled her beloved Bob to take pleasure stood that.” always someone available to help us with in his days. “Each department at the hospice To learn more about Penn Home Care and Hospice, a situation,” says Rossheim. “There were was so helpful to us,” she recalled. “Every- visit http://www.pennmedicine.org/homecare/ or call always solutions.” For example, she re- thing is for the comfort of the patient.” 1-866-888-8598.

2011/FALL ■ 27 A New Center Will Tackle “Orphan” Diseases $10 Million Gift Will Help Fill a Significant Gap in Research and Treatment

Earlier this year, Rachel Gill, who has one of the recipients of an award from gery, discovered the gene that causes fi- Friedreich’s ataxia, decided to donate Penn’s Institute for Translational Medicine brodysplasia ossificans progressiva. FOP funds she had received from the Make a and Therapeutics two years ago. The goal is a genetic condition that causes the Wish Foundation to the Friedreich’s was to optimize certain compounds for body’s skeletal muscles and soft connec- Ataxia Research Alliance (FARA). Com- potential use in treating FA. But in gen- tive tissue to turn into bone, rendering it bined with a matching gift from her fa- eral orphan diseases receive little funding, impossible for the patient to move. Penn’s ther’s employer, DST Systems, the total which means fewer advances in research Center for Research in FOP and Related amounted to $10,000. The check presen- and treatments. That situation makes the Diseases is the only center in the world tation was made at Penn Medicine – where support from Rachel Gill and ITMAT all dedicated to the disease. Robert B. Wilson, M.D. ’89, Ph.D., and the more important. But the situation for orphan diseases David R. Lynch, M.D., Ph.D., G.M.E. ’95, Other researchers at Penn Medicine on the whole is grim. According to a re- program director of the Friedreich Ataxia have not shied away from the challenge port by the Institute of Medicine, Rare Program at The Children’s Hospital of Diseases and Orphan Products: Accelerating Philadelphia, gratefully received it on be- Research and Development (2010): “Most half of the nonprofit advocacy organization. According to Glen Gaulton, of these conditions are serious and life- Friedreich’s ataxia is a debilitating, life- altering. Many are life-threatening or fa- the new center will build shortening degenerative neuromuscular tal. . . . Because the number of people af- disorder that leads to loss of coordination strong collaborative fected with any particular rare disease is in the arms and legs, fatigue and muscle relatively small and the number of rare loss, aggressive curvature of the spine, relationships at Penn and diseases is so large, a host of challenges diabetes mellitus, and a dangerous en- complicates the development of safe and largement of the heart. According to elsewhere, “all designed to effective drugs, biologics, and medical FARA, it affects about one in 50,000 peo- devices to prevent, diagnose, treat, or ple in the United States. In other words, translate innovative research cure these conditions.” Among the main it is what is commonly known as an “or- into the clinic. There’s simply challenges the report cites are difficulties phan disease,” defined as one that affects in attracting public and private funding fewer than 200,000 people. At the FARA nothing else like it.” for research and development and re- site, under “Treatments,” there is no cruiting sufficient numbers of research equivocation: “There are currently no participants for clinical studies. treatments for FA.” of orphan diseases, and sometimes they That’s why a new center at Penn Medi- Wilson, professor of pathology and lab- have achieved noteworthy advances. For cine can make a substantial impact in the oratory medicine at the Perelman School example, in 2008, Jean Bennett, M.D., field. Thanks to a $10 million gift from a of Medicine, is a founding member of Ph.D., and Albert M. Maguire, in the De- donor who prefers to remain anonymous, FARA’s board of directors and the organi- partment of Ophthalmology, announced the Perelman School of Medicine has zation’s founding scientific director. In a that their team had been able to return launched a first-of-its kind Penn Center description of one of his scientific proj- partial sight to children with Leber’s con- for Orphan Disease Research and Ther- ects, he is equally blunt: there are “no ap- genital amaurosis. A rare disease, LCA apy. The interdisciplinary center will bring proved treatments” for Friedreich’s ataxia. leads to total blindness because of retinal together approaches to attacking and Along with colleagues from Penn’s De- degeneration. A few years earlier, Frederick treating orphan diseases by establishing partment of Chemistry, Amos Smith, Ph.D., Kaplan, M.D., and Eileen M. Shore, Ph.D., facilities dedicated to research, translating and Donna Huryn, Ph.D., Wilson was of the Department of Orthopaedic Sur- scientific findings into therapies, foster-

28 ■ PENN MEDICINE A New Center Will Tackle “Orphan” Diseases

ing targeted grant awards, and educating physicians and researchers interested in the field. The center’s goal is to lead an international, coordinated effort to eradi- cate orphan diseases. One of the most important features of the new center will be a state-of-the-art drug-screening labora- tory, robotically controlled, that will allow researchers from around the world to rapidly probe libraries of compounds that already exist for possible use as ef- fective treatments. As Glen N. Gaulton, Ph.D., executive vice dean and chief scientific officer, put it, the center “will build not only strong collaborative relationships throughout Penn but also with other leading aca- demic medical centers, as well as public and private institutions – all designed to translate innovative research into the clinic. There’s simply nothing else like it.” In the continuing research into the rare disease fibrodysplasia ossificans progressiva (FOP), a team led by Frederick S. Kaplan, M.D., pinpointed the source of immature cells that spur misplaced bone growth. By investing in the necessary research The image, courtesy of the Journal of Bone and Joint Surgery, shows the stages of metamorphosis of muscle tissue into bone tissue in a mouse model. A: Inflammation in muscle tissue (M = muscle cells). that large pharmaceutical companies B: Destruction of muscle cells (FP = fibroproliferation). C: Formation of cartilage scaffold before bone avoid, the center aims to spur progress in formation (C = cartilage). D: Formation of mature bone (B = bone). finding cures. A crucial first step is help- ing to increase awareness of orphan dis- eases, their causes and potential treat- “This is a wonderful example of phi- reported on the “long, complex, and ments. The IOM report offers some hope: lanthropy in action,” said J. Larry Jameson, very expensive process to take a drug “Because many rare conditions stem from M.D., Ph.D., executive vice president of from the laboratory all the way to ap- defects in a single gene, they offer oppor- the University of Pennsylvania for the proval in the clinics.” One of the last tunities for faster progress, especially Health System and dean of the Perelman steps, he wrote, is to establish efficacy, given scientific and technological ad- School of Medicine. “I am proud that which typically involves hundreds of vances that identify the genetic basis of Penn Medicine is taking a clear leader- thousands of patients. But that is a diffi- rare diseases and find molecular targets ship position in transforming the health cult hurdle for any particular orphan dis- for the development of new treatments of millions.” ease and “puts up even further hurdles for these diseases.” The report also notes Jameson’s predecessor, Arthur H. Ruben- for drug companies who are willing to that, as previous research has shown, stein, M.B.,B.Ch. will serve as special ad- develop drugs for rare diseases.” Those “some of these advances will undoubt- visor to the center and oversee a search are some of the very challenges the Penn edly illuminate disease mechanisms and for a director. Center for Orphan Disease Research and treatment avenues for more common In a publication of the National Ataxia Therapy expects to solve. conditions.” Foundation four years ago, Robert Wilson – John Shea

2011/FALL ■ 29 A View from Both Sides of the Bed By Marcelle J. Shapiro, M.D. ’80, G.M.E. ’87 Photographs by Daniel Burke

A speaker at this year’s White Coat Ceremony, Dr. Marcelle Shapiro shared the story of her medical crisis – and some of the lessons it helped underscore for health-care professionals in their dealings with patients.

Jon B. Morris, M.D., associate dean, far left, and J. Larry Jameson, M.D., Ph.D., dean, listened as Dr. Shapiro addressed the incoming Class of 2015.

In 1987, I began my career bone-marrow or stem-cell transplantation office and angio suite remained the same in interventional radiology to survive. The first stop in the transplanta- but I, too, had to become a Temple Univer- in a full-time academic setting, training tion process is the Interventional Radiology sity physician in order to maintain my residents and fellows, doing research, (IR) suite, since we are the physicians practice at Jeanes. By late February, I was and writing. I loved it no matter what who place the intravenous catheters and feeling extraordinarily stressed – jittery, hours were spent at work. However, be- ports required for chemotherapy and ul- anxious, tachycardic (a racing heart) every ing married to a busy surgeon and having timately the bone-marrow or stem-cell day. There was a great deal of pressure at two growing daughters, I chose to work transfusion. work so I passed off these symptoms to part time. In 2002, I began working at To me, our job was not simply to place the changes at the helm. My heart rate was Jeanes Hospital, a Temple University af- a catheter for the impending marathon of running 100 on a daily basis. I became filiate in Northeast Philadelphia, not far treatment but to help allay some of the so run down that I developed a strep from our home. A large part of my practice patient’s fears and make catheter place- throat. Antibiotics cleared my sore throat was centered around patients in the Fox ment a positive experience. By being but the tachycardia persisted. Within a Chase Cancer Center-Temple bone-mar- available, providing timely care and service few days, I became short of breath after row transplant (BMT) unit, which is lo- to the patients of our clinical colleagues, only a little activity and just didn’t feel cated at Jeanes Hospital. I developed a we also gained their trust and became a right. My doctor referred me to the ER at wonderful and fulfilling work relation- faithful, reliable part of the clinical team. his hospital (different from Jeanes) for this ship with my transplant colleagues. These were our rewards. acute-care evaluation. In the process, I learned so much about The beginning of 2010 was a particularly It was a busy ER, a pleasant nurse some of the sickest patients one can care hectic and challenging time because ra- drew my blood, and I was efficiently for in medicine; patients with leukemia, diologic services were shifted from my transported for all of my x-ray studies. lymphoma, and myeloma who require private group to Temple University. My When I returned from radiology, a now-

30 ■ PENN MEDICINE very-concerned nurse returned to repeat respectfully who I was and how I func- the one who told me that I had survived my blood tests. She said the first set had tioned before all of this happened. It was the ICU storm against all odds, that I had to be wrong because she had never seen difficult for both sides, especially when miraculously gone into a complete remis- labs like these. Being the curious physi- very challenging clinical decisions had to sion with one round of chemotherapy, cian/patient, I politely asked what they be made. but that in order to have any chance of were before allowing any additional Obviously the right ones were made: I long-term survival, I needed a bone-marrow blood draw, at which point she stated: survived this horrendous chapter and or stem-cell transplant. Hbg 5 (nml: 10-15); WBC 200K (nml: awoke seven and a half weeks later in a I remember that day in late April so 5-10); platelets 60K (nml: 150-300K), complete remission from the acute leuke- vividly. Images of so many of the criti- and I promptly stated: “Oh my God, I mia, having had a tracheostomy and cally ill transplant patients in whose care I have acute leukemia.” The nurse said the been on dialysis – without knowing a bit of participated were now swirling in my labs may not be correct, but I knew they what happened. head. Here I was faced with another hur- were, given all of my symptoms. I remember waking up on a clinical dle: at Jeanes Hospital, my clinical colleagues From that moment on, my entire world floor outside of the ICU as smiling people would now be my personal doctors! As changed. Doctors and nurses were flying told me how great I looked and how well Dr. Mangan, chair of the BMT unit, a col- in and out of my ER room, and all I I was doing, considering how sick I was. league, a friend, and now my transplant could think was, How will I ever survive? Well, I didn’t look or feel great but at the doctor, half-seriously put it: “I not only My very troubled husband reassured me same time I couldn’t believe how “really have to care for you and answer to you that we would get through this together; sick” I had been, either. It was only after and your medical family, I have to answer he was and is my rock. many conversations with my family of to the transplant team and entire medical Before too long, I found myself in a physicians, my closest medical-school staff who have great respect and profound surreal world, being sedated in IR so I friends and colleagues, and a very special fondness for you.” could be fitted with a catheter similar to a dialysis catheter. Here I was – now the patient on the angio table! There is very From that moment on, my entire world changed. Doctors little I can recall from that day and a half and nurses were flying in and out of my ER room, and all I of treatment before I was transferred to Fox Chase Cancer Center (FCCC). My could think was, How will I ever survive? Before too long, I condition rapidly deteriorated; I was placed on a ventilator and on dialysis for found myself in a surreal world, being sedated in IR so I the next seven weeks in the intensive- could be fitted with a catheter similar to a dialysis catheter. care unit at FCCC. I have no memory of this period; I was placed in a drug-in- Here I was – now the patient on the angio table! duced coma so I would not fight the ven- tilator, which was breathing for me, or my other treatments. The critical-care conversation with a brilliant young 3rd- Imagine informed consent with a phy- physicians were left to deal with my family, year medical oncology fellow that I be- sician/patient and her family! Questions all of whom are physicians. gan to understand. I had worked with were tough on both sides but the answers How difficult the circumstances on this fellow when he rotated through the and statistics were tougher. I had a very both sides: my husband, a surgeon, and Temple BMT unit at Jeanes. He under- skewed view of this process because I my brother, a critical-care anesthesiolo- stood that for me as a radiologist, a pic- had seen only the sickest patients with gist, knew exactly what was going on as ture is worth a thousand words. So he al- significant complications after their trans- they monitored their loved one who was lowed me to review my healthy chest CT plants. My anxiety was high; I needed to critically ill. The only way my family scan and compare it to the worst one speak with long-term, healthy survivors. could help me was to make sure their from my ICU days; it was then that I ap- My doctors understood how important voices were heard by the ICU physicians preciated the magnitude of my illness. this was for me and complied with my and nurses taking care of me. They had My conversations with him were always request. Speaking with others who had to let my doctors know passionately and open, honest, and direct. In fact, he was been through this experience certainly

2011/FALL ■ 31 in my care; my doctors were very mindful and respectful of this situation. At the same time, I understood that I was their patient, not a colleague when it came to treat- ment, and had to respect their judgment. But imagine the lay patient who has to endure everything I described without an extensive medical background! As a base- line, patients do not feel well; that is why they are hospitalized. Remember, the un- known breeds anxiety, anger, fear, sad- ness in all of us. Any one of us may man- ifest these emotions with rage or scream- ing or complete withdrawal or silence. Even a smiling, seemingly happy face may conceal anxiety and fear inside. As a patient, I was able to articulate questions. Many patients don’t even know where to begin or what to ask. It is imperative to listen to what your patient Members of the Class of 2015 were an attentive audience in the Annenberg Center's auditorium. is saying and what he or she is not say- ing. The words silent and listen share the helped to temper my anxiety and allowed mile!), remained vigilant with mouth same letters for a reason: to truly listen to me to move forward. care despite severe painful ulcerations, a patient, one must take time, be ap- And I can report that miracles do hap- kept myself well-hydrated, and avoided proachable, and be silent. Standing above pen! My older brother, also a physician intravenous feeding (for fear of infection a patient, waxing poetically about how and chief of pediatrics with a specialty in and/or liver problems). It required great fascinating her problem is, does not build hematology-oncology, was a perfect match. I was admitted for the stem-cell transplant on June 30th and discharged I am an “educated consumer.” I could ask medical questions five weeks later on August 3rd. It was a very difficult hospitalization. Each day and be an active participant in my care; my doctors were brought new challenges. With the rigors very mindful and respectful of this situation. But imagine of transplantation, I often had to take it one moment at a time, not just one day the lay patient who has to endure everything I described at a time, because of the side effects of without an extensive medical background! treatment. The main risks were related to severe GI inflammation with mouth sores, overwhelming infection/sepsis, and bleeding until my new stem cells found focus and tenacity. However, I also knew a relationship. Being open, honest, mind- their way to the bone marrow cavities that this rocky road after my transplant ful, and understanding of their concerns and successfully “set up shop.” was the only road to a future life of builds trust, understanding, respect, and So much was out of my control, but health. With deep gratitude, I am here greater confidence in you and your treat- whatever part of the process I could con- today to relay my story to you one year ment – all essential for a rewarding medi- trol, I did. I was thankful that my doc- post transplant. cal career. This has always been my man- tors and nurses allowed me that privi- Critical lessons to be learned. I am an tra in medicine. It’s now been made even lege. I dressed daily, walked the halls “educated consumer.” I could ask medi- more compelling since I’ve had a view when I could (26 laps around the unit is a cal questions and be an active participant from both sides of the bed.

32 ■ PENN MEDICINE Providing a Voice for Victims of Disaster

A Penn medical student By Gregory Richter and his writing partner tell the story of a flood that ravaged a city in India.

On August 11, 1979, a two-mile-long mayor lent enthusiastic support to the dam in India’s Machhu River Valley could no longer project, in part because he lost his son hold back the pressure of an eleven-day on- in the flood and then spent years attempt- slaught of monsoon rain. The result: a flash ing to hold the government accountable for its flood that engulfed thousands in Morbi, a mu- mistakes that led to the tragic event. nicipality located in the state of Gujarat. In their book No One Had a Tongue to Speak: The Untold Forcing Government Transparency Story of One of History’s Deadliest Floods, Utpal Sand- According to No One Had a Tongue to Speak, the Guja- esara, a medical student in the Perelman School of rat state government engaged in an extensive cover-up of Medicine, and Tom Wooten share insight from 148 in- the poor preparation that led to the bursting of the dam. terviews and thousands of pages of never-before-released The Machhu Dam-II Inquiry Commission, which was government documents to tell the story of the flood and what charged with investigating causes of the dam’s failures, faced it shows about human resilience in time of overwhelming crisis. many obstacles from the state government; as a result, the “We tried to tell the story of the Machhu dam disaster group dissolved 18 months later, before it could effectively through the voices of those who lived it – government officials, complete its study. relief workers, and survivors,” said Sandesara. The text weaves By 2006, when the authors visited India, few government rep- accounts from people in vastly different walks of life to show resentatives knew about the Machhu dam disaster and none their experience in the tragedy. Among those anecdotes are would disclose any documents regarding the event or the ones about a paraplegic woman who rode a washbasin to commission. Sandesara then contacted the chief minister of safety and a priestess who was the only survivor among more Gujarat and managed to obtain two minutes with him to dis- than one hundred people who cuss what Sandesara framed as “an sought refuge inside a temple. important matter.” The chief minis- In addition to the stories of trials ter discussed his own work as a re- and triumph, despair and distress, lief volunteer in the wake of the the authors bolster their reporting flood and gave Sandesara and Woo- with masses of government docu- ten full access to the state’s archives. ments to substantiate and comple- For residents who lost loved ones ment the survivors’ first-hand stories. in the flood, this book provides a While researching in India for the partial answer from a government book, Sandesara met with the man that did not provide one for more who served as mayor of Morbi when than 30 years. For those not directly the disaster struck. The former affected by the tragedy, the book

2011/FALL ■ 33 and implementing large infrastructure maintaining objectivity – are precisely projects,” as in the case of the builders of those of a good medical history-taker.” the Machhu dam. “The destruction of the city of Morbi . . . was not a freak accident A Family Affair so much as an accident waiting to happen.” Sandesara and Wooten met as fresh- men at Harvard and soon, they report, Bridging Medicine they had “hatched the plan” for the book. and Anthropology Sandesara’s family had emigrated from At Penn, Sandesara is currently combin- the Morbi area to the United States. “I ing his passion for research and medicine grew up hearing about the Machhu dam by also pursuing a Ph.D. degree in an- disaster from my mother and grandpar- thropology in the School of Arts and ents,” says Sandesara, “and it was my Sciences. He concedes that writing a mother’s emotional reaction to the Indian book while working toward two degrees Ocean tsunami of 2004 that prompted was a challenge, but he was well moti- me to begin looking for more informa- vated for the task. “The people we met tion.” His first interview for the book was were entrusting us with something very with his grandparents, who provided important to them,” said Sandesara. “The many of the photos used in No One Had illustrates how disastrous poor planning completion of this project was a moral a Tongue to Speak. In fact, his grandfather, can be and how important a govern- imperative. They would say to us, ‘You go T. R. Shukla, appears in the book as the ment’s response is. Sandesara and Woo- back to America and write this, and then principal of Morbi’s arts college. ten do not cite a specific figure, but esti- maybe someone will listen.’ It was a story During the research in India, Sande- mates are that up to 25,000 people died that simply had to be told.” sara’s mother and sister served as inter- in the flood. For Sandesara, there is a similarity be- preters when Wooten spoke to local resi- No One Had a Tongue to Speak arrives tween pursuing a medical career and writ- dents, translating between English and from Prometheus Books with a foreword ing a book filled with people’s stories. As Gujarati. In addition, Wooten’s father used by one of medicine’s most admired prac- he explains, “The skills of a qualitative his experience as a geotechnical engineer titioners, Paul Farmer, M.D., Ph.D., chair researcher – listening carefully, processing to outline the technicalities of dam fail- of the Department of Global Health and facts on the fly, and empathizing while ures, and his mother drew maps and dia- Social Medicine at Harvard University and cofounder of Partners in Health. The non-profit health-care organization strives to provide an alternative to con- ventional treatment of the poor and sick and tries to prevent diseases before they occur. Farmer writes that “I was lucky enough to teach Sandesara during his first year at Harvard and to serve as a mentor to him in the years since.” For Farmer, one of the important points un- derscored throughout the book is that “The obvious distinction between ‘natu- ral’ and ‘unnatural’ disasters, between events like the 2004 tsunami, say, and Chernobyl, is not so obvious at all upon closer inspection.” Human agency often plays an important part. He cites “the ar- rogance of some in charge of designing An aerial photograph of the Machhu Dam-II after the disaster.

34 ■ PENN MEDICINE complexities more boldly than in many other compa- rable books. The range of real-life characters and the vividness with which they

Photograph by Tom Wooten Photograph Tom by are portrayed support Farmer’s view. Recent tragedies in Haiti, Japan, New Orleans, and elsewhere throw light on the crucial need for strong infrastruc- tures in case of environmental disasters and for an equally strong response to aid those afflicted by such disasters. Sande- sara and Wooten’s account reminds read- ers of what can go wrong – but also of what communities in crisis can some- times accomplish. The authors: Tom Wooten, left, and Utpal Sandesara Leaving the Unlivable grams for the book. Sandesara’s parents At the other end of the social spectrum Everyone was leaving Morbi. By early are currently developing a Gujarati transla- are the stories of those like Kanubhai evening, the roads leading out of the city, tion to bring the text to many of those Kubavat, a Brahmin who taught at a cleared of debris by the army, had grown who were directly affected by the flood. teachers’ college during the day but also thick with knots of people, cars, trucks, officiated at a small temple near his house and buses. Patriarchs and matriarchs Human Courage in in the Tiger Quarter of Morbi. After the herded children along, driving them gen- Time of Crisis flood, all that was left of his house was a tly forward and leading some by the Throughout the numerous stories as- pile of debris, despite its location in one of hand. Young men and women guided sembled in No One, many show the the areas of higher elevation and a raised wizened elders, pausing every few hun- will to survive and the impulse to help foundation. Later, after sending his family dred feet to rest. Haggard men with un- others. One involves Gangaram Tapu, off to other parts, Kubavat spent his days shaven, dirty faces and torn pants carried who at the time of the flood was a clearing away debris from his plot: “At soggy white bundles – repositories of all 24-year-old father of five, serving a life night, he slept in the lobby of a local cin- their remaining possessions – on their sentence for murder in the subdistrict ema. He did not obtain a clean set of stooped backs as their sandals shuffled prison. Tapu, a Hindu, had killed a Mus- clothes until four or five days after the through the grime. Dozens of survivors lim in what Tapu characterized as an act flood, when he visited a friend in Rajkot.” hung off the backs of trucks that of vigilante justice. As the flood bore down At one point after the flood, Sandesara’s chugged slowly through the mud. Peri- on the prison, Tapu helped other inmates relatives, the Shukla family, delivered food odic bursts of discordant honking punc- move to the roof to avoid the rising level and drink to faculty and staff families of tuated the funerary silence of the exodus. of water. A wave knocked Tapu over, and a local engineering college whose riverside Much of Morbi’s population exited the city he struggled to stay afloat as it carried him homes had sustained severe damage. by the night of August 12. With foodstuffs out of the prison. Even while attempting In his foreword, Farmer emphasizes ruined, homes destroyed, utilities obliter- to save his own life, he managed to save the importance of investigating disasters – ated, and bodies decaying at every street dozens of others from drowning before especially an “unnatural disaster,” such as corner, the city had become, as many sur- he collapsed. He turned himself in to the the Indian flood and Chernobyl – and vivors would recall, “unlivable.” police a few days later. His heroic behavior discovering their causes. But he also notes No One Had a Tongue to Speak, p. 171 weighed heavily in his favor, and many that No One “is also a social history” in weeks later, he was pardoned. which the authors confront the social For more information, go to www.thefloodbook.com.

2011/FALL ■ 35 Development Matters Development Matters MANY THANKS TO OUR ALUMNI PARTNERS IN GIVING

Spencer Foreman, M.D. ’61 Walter J. Gamble, M.D. ’57 Marc B. Garnick, M.D. ’72, G.M.E. ’73 Barry J. Gertz, M.D. ’79, G.M.E. ’82 Joseph S. Gordon, M.D. ’57, G.M. ’64 T Frank S. Harrison Jr., M.D. ’61, G.M.E. ’65 Howard E. Hudson Jr., M.D. ’67, G.M.E. ’81 * Henry A. Jordan, M.D. ’62, G.M.E. ’67 Martin S. Kanovsky, M.D. ’78, G.M.E. ’79 James J. Leyden, M.D. ’66, G.M.E. ’70 Ray N. Miller, M.D. ’61 T Joel Porter, M.D. ’66 Thomas J. Rohner Jr., M.D. ’61, G.M.E. ’62 T Robert G. Sharrar, M.D. ’66 William G. Sharrar, M.D. ’66 The spotlight has shone brightly on the Perelman Victor B. H. Siew, M.D. ’75 School of Medicine this year. The School is once Carol Herman Szarko, M.D. ’66, G.M.E. ’69 again ranked second in the nation and the Hospital of the Judith E. Wolf, M.D., G.M.E. ’84 University of Pennsylvania remains in the top 10. The Perelman gift of $225 million created a whole new standard for philan- Founder (Gifts of $10,000 - $24,999) thropic giving, not only for the entire University but also for Kenneth Lewis Brayman, M.D. ’81 medical schools nationwide. Wellington Chen, M.D. ’76 Clearly expectations are running high for Penn Medicine, Edward Michael Connor Jr., M.D. ’78 and we thank our alumni for their commitment to putting the T Melisa Cooper, M.D. ’82 School at the forefront. Your giving, your guidance, and your T Mark J. Cornfeld, M.D. ’82 good will are critical to our continued success. John S. Curran, M.D. ’66, G.M.E. ’70 More than 2,300 alumni from 52 different classes gave to T Robert Aaron Greene, M.D. ’86 the Perelman School of Medicine this year, a remarkably broad Rosemary Mazanet, M.D. ’86 base of support. We appreciate your generosity and invite you T Steven H. Ominsky, M.D. ’66 to visit the alumni web site where all donors are acknowledged: http://alumni.med.upenn.edu/PartnersInGivingHome.php Fellow (Gifts of $5,000 - $9,999) Here we recognize the alumni members of the Benjamin T Anonymous (3) Franklin Society, the University’s prestigious leadership annual Judi Ashbes Aronchick, M.D. ’78, G.M.E. ’78 giving society, including our loyal Thistle Society members. We Dennis A. Ausiello, M.D. ’71 also welcome our first contingent of Young Benjamin Franklin T Ronald B. Barg, M.D. ’80 Society members to this leadership group. T Joseph E. Bavaria, M.D., G.M.E. ’90 T Douglas A. Becker, M.D. ’82 Ambassador (Gifts of $25,000 or more) T H. Franklin Bunn, M.D. ’61 Marjeanne Collins Blasco, M.D. ’61, G.M.E. ’66 Emily Fox Conant, M.D. ’84, G.M.E. ’89 Robert B. Daroff, M.D. ’61 T David Y. Cooper, M.D. ’48, G.M.E. ’49 Stanley J. Dudrick, M.D. ’61, G.M.E. ’67 Raymond M. Dorsch Jr., M.D. ’56, G.M.E. ’60 Howard J. Eisen, M.D. ’81, G.M.E. ’84 T Sidney N. Franklin, M.D. ’42, G.M.E. ’46

T = Thistle Society Member, recognizing 3 or more years of consecutive giving Italics indicates Young BFS members, * = deceased View a full list of alumni donors at http://alumni.med.upenn.edu/PartnersInGivingHome.php

36 ■ PENN MEDICINE TO OUR ALUMNI PARTNERS IN GIVING

Class of 1961 Takes Jordan Challenge for Reunion Gift – And Doubles Its Contribution to Raise $500,000 for Financial Aid

“The stimulus of having your donation double was a really big The late Henry A. Jordan, M.D. ’62, G.M.E. ’67, and his factor,” said Ted Appel, M.D. ’61, who played a major role in his wife, Barrie, established the Challenge to inspire others to class’s fundraising as an active member of the reunion committee. give. The Challenge supports gifts to the John Morgan Schol- The Jordan Challenge adds speed as well as size to ars program and will continue through 2012. scholarship gifts, making funds available to students as quickly Dr. Appel says he and many of his fellow alumni could as possible. So it was an easy decision for the committee to not help but compare the cost of a medical education today – direct its reunion gift to the Challenge, instead of to the class $71,000 in tuition and expenses annually – to their costs in scholarship fund the members had previously supported. As a 1957, no more than $1,600 in tuition and $75 a month for a result, the Class of 1961 commemorated its 50th reunion with “really nice” apartment. Today, students in the Perelman School a gift of far greater impact than the members could otherwise of Medicine graduate with an average debt of $121,000. have achieved. Dr. Appel points out that several members of the Class of Along with the benefits of the Challenge, Dr. Appel credits 1961 know better than many the value of a Penn education. His the organizational skill and charisma of the reunion committee’s grandfather graduated with a medical degree from Penn; so did chair, Stanley Dudrick, M.D. ’61, with a cousin and his uncle James Z. Appel, president of the A.M.A. in the fundraising success as well as the mid-1960s. Lawrence Wood, M.D. ’61, another member of with great attendance at the festivities the reunion committee, is the son of Frances C. Wood, M.D. ’26, in May. “Stan assembled a committee INT ’30, Hon ’71, a former chair (1947-1965) of the Department that was looking forward to our 50th of Medicine. reunion and willing to call our class- “We all know that we aren’t going to have good doctors if mates to encourage them not only to we aren’t going to help students now,” Dr. Appel says. attend the reunion but to make signifi- cant donations.” Class of 1961 50th Reunion Committee Dr. Appel practiced obstetrics and gynecology in Boulder, Theodore B. Appel III, M.D. Ray N. Miller, M.D. Colo., until retiring in 1996 and moving to Aspen, where he works H. Douglas Barnshaw, M.D. Wylie L. Overly, M.D. part time as a ski instructor. Serving on the reunion committee was Marjeanne Collins Blasco, M.D. Sidney Pestka, M.D. a first for him, and he calls it an “experience not to be missed.” Edwin L. Bryan, M.D. Bruce M. Rodenberger, M.D. “It allowed me to visit with and talk with good friends from 50 H. Franklin Bunn, M.D. Thomas J. Rohner, M.D. years ago,” he says. “In addition, it was rewarding to be part of an Robert B. Daroff, M.D. William Schwartz, M.D. outstanding group of dedicated alumni with great leadership.” All of Stanley J. Dudrick, M.D. Amos R. Townsend, M.D. them, he notes, worked hard to meet the class’s goals to help pro- Norig Ellison, M.D. Lawrence C. Wood, M.D. vide funding for future physicians, many facing “staggering debt.” Myron Genel, M.D.

2011/FALL ■ 37 Development Matters Development Matters

George M. Gill, M.D. ’58, G.M.E. ’64 Architect Chosen for Medical Education Center T Michael J. Gitlin, M.D. ’75, G.M.E. ’79 T Julie A. Gubernick, M.D. ’90 T G. David K. Hopper, M.D. ’67 CO Architects has been selected to design the Perelman T Richard Janeway, M.D. ’58, G.M.E. ’62 School of Medicine’s new Medical Education Center. Based T Lawrence A. Kerson, M.D. ’68 in Los Angeles, CO is a nationally known campus architec- Louis Kozloff, M.D. ’69 ture firm with an extensive background in medical education T Robert J. Laskowski, M.D. ’78 and health-care facilities. Of the eight firms considered, CO T John Meyerhoff, M.D. ’75 was by far the most collaborative and the most concerned T James J. Patton, M.D. ’63 with meeting the School’s particular needs as a leader in the Richard A. Perlmutter, M.D. ’75 rapidly evolving field of medical education. Ernest F. Rosato, M.D. ’62, G.M.E. ’66 “With CO’s thoughtful approach to medical school architec- T Augustus John Rush Jr., M.D., G.M.E. ’75 ture, we will be able to create a focal point for innovative new T George M. Sonneborn, M.D. ’69 connections — not only between the medical school and the T Nicholas J. Vincent, M.D. ’61 Health System, but also with our colleagues across Penn’s T Robert E. Weibel, M.D. ’55 campus,” said Dean T Thomas F. Whayne Jr., M.D. ’63 Larry Jameson. This fall, Associate (Gifts of $2,500 - $4,999) CO and Penn Martin P. Altman, M.D. ’66 Medicine em- Anne-Marie Anagnostopoulos, M.D. ’04, G.M.E. ’07 barked on Rahul S. Anand, M.D., G.M.E. ’05 the master T William L. Annable, M.D. ’71 planning Anonymous (2) stage of the project, working closely with user groups that T Katia M. Apollon, M.D. ’96 will provide important feedback on design needs. T David F. Apple, M.D. ’62 To learn more, please contact Bill Bole, senior director, T H. Douglas Barnshaw, M.D. ’61, G.M.E. ’65 Development & Alumni Relations, at [email protected] or T Andrew N. Bausch, M.D. ’82 215-898-9175. T Peter E. Bertozzi Jr., M.D. ’71 Carter D. Brooks, M.D. ’59, G.M.E. ’63 Steven M. Brunelli, M.D. ’00, G.M.E. ’06 T Edwin L. Bryan, M.D. ’61 T John T. Carpenter Jr., M.D. ’52, G.M.E. ’58 T Dean Rice Dennis, M.D., G.M.E. ’98 T Gordon Yw Chang, M.D. ’88 T Walter John Dex, M.D. ’56 Norman P. Chapel, M.D. ’77 T Ira Dosovitz, M.D. ’74 T Melvin J. Chisum, M.D. ’52 Daniel Feinberg, M.D. ’62 T Brian G. Choi, M.D. ’02 T Stanton P. Fischer, M.D. ’56 Elisabeth J. Cohen, M.D., G.M.E. ’76 T Jerry D. Gardner, M.D. ’66 Neil L. Coplan, M.D. ’80, G.M.E. ’81 T Myron Genel, M.D. ’61, G.M.E. ’65 Raymond L. Cox Jr., M.D. ’74 Clarence M. Gilbert, M.D. ’57, G.M.E. ’63 T David E. Craig, M.D. ’65 T W. Darby Glenn III, M.D. ’56 T Mary E. Cunnane, M.D. ’97, G.M.E. ’02 T Judah L. Goldberg, M.D. ’07 T Gordon K. Danielson, M.D. ’56, G.M.E. ’63 Heidi Van Elkan Gordon, M.D. ’91 T Robert Michael Day, M.D. ’76 Jeffrey A. Gordon, M.D. ’91

T = Thistle Society Member, recognizing 3 or more years of consecutive giving Italics indicates Young BFS members, * = deceased View a full list of alumni donors at http://alumni.med.upenn.edu/PartnersInGivingHome.php

38 ■ PENN MEDICINE Robert I. Grossman, M.D. ’73 T Michelle Anne Smith-Levitin, M.D. ’90 T Robert L. Hall, M.D. ’53 Laura A. Sproat, M.D. ’05 T Douglas C. Heiner, M.D. ’50, G.M.E. ’54 T Alan D. Stewart, M.D. ’73 T Douglas G. Jacobs, M.D. ’71, G.M.E. ’72 T Eric A. Strom, M.D. ’72 T Peter J. Jannetta, M.D. ’57, G.M.E. ’64 Henry Su, M.D. ’04 T Ralph A. Jessar, M.D. ’46, G.M. ’50 Mark M. Tomsho, M.D. ’82 T Franklyn N. Judson, M.D. ’68 Daniel William Ulrich, M.D. ’00 T Michael M. Kaback, M.D. ’63 T Satish R. C. Velagapudi, M.D. ’85, G.M.E. ’92 Charles Paul Kimmelman, M.D., G.M.E. ’79 T Jay R. Venkatesan, M.D. ’02 T Catherine C. Kramer, M.D., G.M.E. ’92 Kristen S. Vierregger, M.D. ’08 T Christopher M. Kramer, M.D., G.M.E. ’89 Robert M. Wachter, M.D. ’83 T John B. Kucharczuk, M.D. ’51, G.M.E. ’58 Robert J. Westlake, M.D. ’61, G.M.E. ’65 T Larry C. Kuo, M.D. ’78 Sharese M. White, M.D.’01 T Donald W. LaVan, M.D. ’59, G.M. ’60 Kathleen M. Young, M.D.’01 T Gerald Michael Lemole Jr., M.D. ’95 Robert H. P. Yuan, M.D., G.M. ’51 T Richard L. London, M.D. ’76, G.M.E. ’80 T Joan Berkowitz Zamoiski Rogers, M.D. ’79 T Samuel Louie, M.D. ’75 T Donna Marie Louizides, M.D. ’02 Frank P. Maguire, M.D. ’81 Recent Major Gifts T Francis Marchlinski, M.D. ’76, G.M.E. ’80 T Robert T. McKinlay, M.D. ’64 Mrs. Sara Long Buck generously contributed $1.0 million Elliot Menschik, M.D. ’00 in securities to the Department of Neurology’s Comprehensive T Barry Miller, M.D. ’57 Stroke Center, led by Dr. Scott Kasner, in honor of her late hus- T Elaine Hall Mischler, M.D. ’70 band, Mr. Alexander Knapp Buck. T Nicholas E. Mischler, M.D. ’70 Mr. Richard Schiffrin and Mrs. Barbara Schiffrin con- T George A. Moo-Young, M.D. ’74, G.M.E. ’75 tinue their generous philanthropy to Penn Medicine with a $1.0 Joel G. Moranz, M.D. ’72, G.M.E. ’78 million pledge to establish the “Barbara and Richard Schiffrin In- T Philip K. Nelson, M.D. ’52, G.M.E. ’58 novative Cancer Research Fund.” This leadership gift will support Herbert J. Nevyas, M.D. ’59, G.M.E. ’64 basic and translational cancer research within the Abramson Can- T David Norman, M.D. ’67, G.M.E. ’71 cer Center and the Abramson Family Cancer Research Institute. John C. Nulsen III, M.D., G.M.E. ’87 The Schwab Charitable Fund recently contributed T Thomas E. Penn, M.D. ’72 $600,000 to the “Ovarian Cancer Vaccine Fund,” making its total T Frederick L. Porkolab, M.D. ’72, G.M.E. ’78 giving to this project $1.3 million. This initiative has provided criti- T Jules B. Puschett, M.D. ’59 cal funding to the groundbreaking work of Dr. George Coukos T Stephen A. Rafelson, M.D. ’72 on ovarian cancer, including immune therapy research and the T Andrew Rhim, M.D. ’04, G.M.E. ’10 development of the ovarian cancer vaccine. Robert L. Roschel, M.D. ’58 Wyncote Foundation has pledged $1.58 million to create Rhoda Rosen, M.D. ’58 the “John C. and Chara C. Haas Fund for Frontotemporal Lobar T James A. Roth, M.D. ’82 Degeneration (FTLD) Research and Treatment.” This gift will Stephen C. Rubin, M.D. ’76, G.M.E. ’82 provide investigators involved in frontotemporal lobar degenera- John M. Rusk, M.D. ’61 tion and related diseases with financial support for innovative re- T George W. Schnetzer III, M.D. ’64 search, treatment, and clinical care in the Penn Comprehensive T Eric J. Seifter, M.D. ’80 Frontotemporal Lobar Degeneration Center. T Lee S. Shearer, M.D. ’07 T Roberta J. Smith, M.D. ’68

2011/FALL ■ 39 Progress Notes tional levels, including the office Marc Wallack, M.D., G.M.E. issues surrounding a cardiac re- of the Denver mayor, the Institute ’75, and his wife, Jamie Colby, covery. The book also includes a Send your progress notes to: of Medicine, and the Sullivan have written Back to Life After a gripping first-person narrative, as Andrea Pesce Commission.” In addition, Gabow Heart Crisis: A Doctor and His in this scene: Penn Medicine Development is a nationally recognized expert Wife Share Their 8-Step Cardiac Now I wasn’t the person wear- and Alumni Relations on autosomal dominant polycys- Comeback Plan (Avery/Penguin ing the blue gown and mask and 3535 Market Street, Suite 750 tic kidney disease and has taught Group, 2011). He is chief of sur- holding a scalpel. I was the guy Philadelphia, PA 19104-3309 about renal disorders at the Uni- gery at Metropolitan Hospital who would have the iodine prep- versity of Colorado Health Sci- and vice chair of the Department aration on his chest and legs. I ences Center for nearly 40 years. of Surgery at New York Medical would be stained a deep burnt College; she is a longtime net- orange. I’d have a breathing tube ’60s work news anchor and journal- down my throat. John R. Durocher, M.D. ’67, ist. A marathon runner, Wallack My chief of cardiac surgery, G.M.E. ’71, Rock Hall, Md., med- ’70s experienced some chest pain someone I’d recruited to work at while running his typical morn- the hospital a few years before, ical director for Hospice of Queen Joseph M. Lane, M.D., G.M.E. Anne’s for nearly 12 years, re- ing trek through Central Park. was going to crack open my ’72, an orthopaedic surgeon, re- Two days later, after discovering breastbone, spread apart my ribs, ceived the Lifetime Achievement ceived the Lifetime Achievement Award from the Hospice and that more than 95 percent of his and take my aorta (the main ar- Award at the Annual Tribute Din- arteries were blocked, he under- tery that carries blood from the Palliative Care Network of Mary- ner of the Hospital for Special land. The network’s highest award went quadruple bypass surgery. heart to smaller arteries through- Surgery. He was recognized for Back to Life was written as a step- out the body) and another large recognizes his outstanding dedi- his innovative research on bone cation to promoting quality and by-step guide to tackling the vein and attach both to a ma- disease and the use of bisphos- physical, emotional, and career chine that would pump oxygen- compassionate hospice care. Du- phonates in treating osteoporosis. rocher retired as head of the he- In particular, his research helped matology/oncology section of identify the possible link between Pennsylvania Hospital and relo- long-term use of osteoporosis cated to Rock Hall, where he es- medications and increased risk Jerald Winakur, M.D. ’73, has Forest Park. He hears voices but tablished the Townsend Memorial for certain types of bone frac- practiced internal and geriatric can’t decode what is being said Medical Clinic, a free health-care tures. Lane is currently the hos- medicine in San Antonio for and his mind assumes the clinic serving uninsured and in- pital’s chief of the Metabolic Bone more than 30 years. He is also a worst: My mother is insulting digent adult residents. Disease Service and medical di- clinical professor of medicine at him, planning to run off; his rector of the Osteoporosis Pre- the University of Texas Health sons are belittling him, his Patricia A. Gabow, M.D. ’69, vention Center. Science Center, where he is an mother is scolding him, his G.M.E. ’73, chief executive officer After receiving a medical de- associate faculty member at the older brothers and sisters are of Denver Health, received the gree from Harvard Medical School Center for Medical Humanities. teasing him. He is lost, with no 2010 David E. Rogers Award in 1965, Lane went on to HUP, His memoir, Memory Lessons: A father to turn to. I see that he from the Association of American where he completed his intern- Doctor’s Story, was published by has wet himself; a dark ring Medical Colleges. According to ship, fellowship, and residency. Hyperion in 2009. The genesis marks his place on the couch. the A.A.M.C., “Dr. Gabow over- He is a professor of orthopaedic of the book was an article he My anger melts away. I have sees a high-performance health surgery at Weill Cornell Medical wrote about his father’s initial been through this before – not system that cares for one-fourth College and an assistant dean diagnosis of Alzheimer’s disease only with my father but with of all adults and 40 percent of all there and at the Hospital for and the issues that arose around many of my patients over the children in the Denver metropoli- Special Surgery. With expertise in caring for him. “What Are We years. I have been cursed, spit on, tan area, nearly half of whom are bone tumors, metabolic bone Going to Do with Dad?” was bitten, pinched, and punched uninsured. On a daily basis, she disease, geriatric vertebral com- originally published in Health by demented old folks over the performs the health-care equiva- pression fractures and geriatric Affairs and was then excerpted decades. A poor woman threw a lent of a high-wire balancing act: hip fractures, Lane has served as by The Washington Post and syn- shoe at me when I stepped in- expanding access to care for chairman of the Oversight Panel dicated in newspapers across the side the door of her hospital Colorado’s most vulnerable pop- on Women’s Health for the Amer- nation. Memory Lessons shows room. The day before, she ulations, while at the same time ican Academy of Orthopaedic Winakur in two over-lapping thought I was the devil. meeting Denver Health’s goal of Surgeons and as a member of its roles – skilled professional and I assume my doctor role with ‘level one care for all.’” Among her Council on Research. loving son. Here is a vivid excerpt, my father; I retreat once again other achievements, the Associa- an account of when the reality of into the armor of my starched tion highlighted her overseeing of Frederick Goldberg, M.D. ’75, his father’s illness hits home: white coat. As a doctor I know the implementation of “a sophisti- a pediatrician and executive what to do; as a son I am uncer- cated health IT infrastructure, physician at hospitals in Syra- There is no walking away tain. “Talk therapy” will not which links a patient’s electronic cuse and Utica, has been named now. My father is demented. work here; the time for psycho- health record to providers no vice president of medical affairs His agitation and paranoia arise analysis, for delving deep into matter where he or she enters the and chief medical officer at from distorted memories, night- his life has long since passed. It system. Such forward thinking Nathan Littauer Hospital. He mares he can no longer separate is time to acknowledge his fears has made Dr. Gabow an authority completed his residency at Up- from reality. He is an abandoned at the moment, to let him know on integrated health systems, and state Medical Center in Syracuse child. He searches for his boy- I will do whatever I can to ease her expertise has been solicited and earned an M.S. degree in hood home on Boarman Avenue, his agitation. by numerous boards and com- health-care management from or perhaps our first house in — Memory Lessons, p. 205 missions at both the local and na- Harvard University.

40 ■ PENN MEDICINE ated blood throughout my body. on Pediatric, Developmental, and see. Blalock was a Diplomat of This machine would temporarily Genetic Ophthalmology, is one of the American Board of Surgery function as my heart. the winners of the Carl Camras ’00s and the American Board of He was going to stop my heart. Translational Research Awards. Matthew Oster, M.D. ’04, M.P.H., Thoracic Surgery. (pp. 14-15) The award is presented after an a pediatric cardiologist, has joined international competition by the Children’s Healthcare of Atlanta at Gaines L. Cooke, M.D. ’43, Gre- Association for Research in Vision the Children’s Sibley Heart Cen- nada, Miss., an internist and for- and Ophthalmology. Nominees ter. He completed his residency in mer chief of staff at the Grenada ’80s for the awards must be research- pediatrics at the University of Cal- Lake Medical Center; December ers early in their careers who ex- ifornia in San Francisco and took 12, 2010. During World War II, Jeremy Nobel, M.D. ’81, M.P.H., hibit excellence in research and a fellowship in pediatric cardiology he served as a U.S. Navy physi- has been appointed medical di- whose discoveries or observations and an advanced fellowship in cian. He was a founder of the rector of Northeast Business must have led to, or have the health-outcomes research at Chil- Mississippi Heart Association. Group on Health, a network of promise of leading to, clinical ap- dren’s Healthcare of Atlanta. Oster employers, providers, insurers, plications. A Fellow of the Ameri- is also a senior associate of pediat- Morgan L. Zarfos, M.D. ’43, and other organizations seeking can Board of Ophthalmology and rics at Emory University School of York, Pa., a retired physician who to improve the quality and reduce of the American Board of Medical Medicine, where he received the specialized in internal medicine the cost of health care. Nobel, Genetics, Brooks received a Pediatrics Teaching Award. His and arthritis; November 6, 2010. who had served as a senior medi- 2009 Presidential Early Career areas of interest include outcomes During World War II, he was a cal advisor to the group, is board- Award for Scientists and Engi- research, quality improvement, captain with the U.S. Army Medi- certified in internal and preven- neers, the Federal Government’s prevention of congenital heart cal Corps. In York he spent more tive medicine and earned a mas- highest honor for early-career sci- disease, and public health. than 50 years in private practice. ter’s degree in epidemiology and entists and engineers. During this time he was ap- health policy from the Harvard pointed medical director for York School of Public Health. Quan D. Nguyen, M.D. ’93, M. OBITUARIES County and also operated his Sc., associate professor of oph- own arthritis clinic. He also Jonathan Leff, M.D. ’84, was ap- thalmology at the Wilmer Eye worked in the pathology lab of pointed chief medical officer of Institute of Johns Hopkins Uni- York Hospital, where he was on KaloBios Pharmaceuticals, Inc., versity School of Medicine, is one ’30s staff for 30 years. based in San Francisco. Previ- of the winners of the Carl Camras Kenneth A. Seifert, M.D., G.M. ously, he had been vice president Translational Research Awards. Howard Brooks Cotton, M.D ’39, Hot Springs, Ark., a retired and chief medical officer of Halo- The award is presented after an ’45, Birmingham, Ala., a retired physician who had maintained a zyme Therapeutics, Inc. He has international competition by the physician and longtime medical surgical and family practice in also been vice president and Association for Research in Vision director of the Protective Life In- Wauwatosa, Wis.; January 28, global head of inflammation clini- and Ophthalmology. Nguyen is surance Co.; February 15, 2011. 2011. He was 100 years old. As a cal development at Roche and one of the editors of Retinal Phar- He had served in the U.S. Army captain in the U.S. Army Medical vice president of North American macotherapy, 1st Edition (Elsevier, Medical Corps, attaining the rank Corps during World War II, he medical affairs at Amgen. 2010) and serves on the editorial of captain. A fellow of the Ameri- participated in the liberation of board of Journal of Ocular Inflam- can College of Physicians, he had the Ebensee concentration camp Paul J. DiMuzio, M.D. ’89, the mation and Infection. In 2009, he been a clinical assistant professor in Austria. William M. Measey Professor of received the Research to Prevent of medicine at the University of Surgery at Thomas Jefferson Uni- Blindness Foundation Physician Alabama School of Medicine. versity, was elected a Distin- Scientist Award. guished Fellow by the Society for Adolph W. Vogel, M.D. ’45, Vascular Surgery. He currently Jennifer L. Hunt, M.D. ’97, ’40s Glenolden, Pa., a retired ophthal- serves as director of the Division G.M.E. ’01, has been named chair Howard U. Kremer, M.D. ’42, mologist; December 4, 2010. He of Vascular and Endovascular of the Department of Pathology Farmington, Conn., an emeritus had served in the U.S. Army Surgery, program director of its and Laboratory Services in the associate professor of clinical Medical Corps, reaching the rank Fellowship in Vascular Surgery, College of Medicine at the Uni- medicine at Penn; December 16, of captain. He interned in Lan- and co-director of the Jefferson versity of Arkansas for Medical 2010. During World War II he caster and served a residency at Vascular Center. He is board certi- Sciences. She had been associate served with the U.S. Army Medi- Duke University Medical Center. fied in both vascular and general professor of pathology at Harvard cal Corps in Europe. He main- During his early years as a doc- surgery. Listed as a “Top Doctor” Medical School and associate tained a private practice in Phila- tor, he worked in the research in vascular surgery by Philadelphia chief of pathology and chief of delphia for many years and was departments of Lederle Laborato- Magazine, DiMuzio reviews for anatomic and molecular pathol- president of the Philadelphia ries and Merck & Co., and later 13 professional journals. His re- ogy at Massachusetts General County Medical Society, 1984-85. at Wills Eye Hospital. In 1974, search involves the creation of Hospital in Boston. Recognized he spent a year in north-central tissue-engineering bypass grafts for her expertise in head and John B. Blalock, M.D. ’43, Bir- Pakistan, where he performed made from adult stem cells. neck, endocrine, and molecular mingham, Ala., a retired thoracic cataract surgery as part of a anatomic pathology, she is the au- surgeon at Tulane University British volunteer mission. On an- thor of more than 110 publica- hospital; January 30, 2011. He other mission, he went to Alaska tions in the field and in quality did his internship at Jefferson to treat indigenous Indians. ’90s assurance and laboratory opera- Hillman Hospital in Birmingham. Brian P. Brooks, M.D. ’93, Ph.D., tions. Hunt recently was elected During World War II, he was a William J. Weller, M.D. ’46, San an investigator at the National president-elect of the Association ship physician in the Pacific, Jose, Calif., a retired anesthesiolo- Eye Institute and chief of its Unit for Molecular Pathology. and in the Korean War he served gist and family practitioner; April at a naval air station in Tennes- 16, 2010. He had served in the

2011/FALL ■ 41 U.S. Navy. He had worked in the Center in Rome, Ga., where he 2011. She initially trained in in- of the Pennsylvania Orthopedic Department of Obstetrics and Gy- started a residency program and ternal medicine and practiced Society. necology at San Jose Hospital and stayed for 13 years. Smith served geriatric medicine. One of the Health Center. 12 years on the Medina City first female psychiatrists in Mi- Clarence L. M. Samson, M.D., School Board and helped found ami Dade County, she served in G.M. ’53, New Orleans, a former Theodore E. Keats, M.D. ’47, the Medina County Joint Voca- various positions with the South clinical professor of ophthalmol- G.M.E. ’51, Charlottesville, Va., tional School. He was a charter Florida Psychiatric Society. She ogy at Tulane University; January former Alumni Professor of Radi- member of the American Board was married to Hugh R. Gilmore 14, 2011. He earned his M.D. de- ology at the University of Virginia; of Family Practice. III, M.D. ’50, G.M. ’54, and her gree from Louisiana State Univer- December 10, 2010. He was the brother is John R. Pellett, M.D. ’54, sity School of Medicine in 1943. author of nine textbooks. During Zachary B. Friedenberg, M.D., G.M. ’61. After serving in the Pacific The- the Korean War he was a captain G.M.E. ’49, Ardmore, Pa., a pro- ater during World War II, Samson with the U.S. Army Medical fessor of medicine at Penn and Harry C. Sammons, M.D., entered private practice in 1955 Corps in Japan. former chief of orthopaedic sur- G.M.’50, Fenton, Mo., January and practiced ophthalmology un- gery at the old Presbyterian Medi- 20, 2011. til his retirement in 2000. He had Adrian M. Sabety, M.D., G.M. cal Center and Chester County served as president of the New ’47, Sanibel, Fla., a retired profes- Hospital; January 27, 2011. He Homer F. Schroeder, M.D., G.M. Orleans Academy of Ophthalmol- sor of surgery at the New Jersey earned his medical degree from ’50, Greensboro, N.C., a former ogy. He also served as president of College of Medicine; February 18, the College of Physicians and Sur- clinical professor of obstetrics and the staff at the Eye, Ear, Nose, 2011. Founder of the Vascular geons of Columbia University. gynecology at the Medical College and Throat Hospital and as its Society of New Jersey and the While at Penn he was an early re- of Toledo in Ohio; December 19, chief of ophthalmology. American Venous Forum, he searcher in the electrical healing 2010. He had served in the U.S. was a former president of the of bone fractures by direct current Naval Reserve. James E. C. Walker, M.D. ’53, New Jersey Society of Thoracic stimulation. He set up the Clini- Avon, Conn.; January 6, 2011. Surgeons. cian Scientist Award of the Ortho- Ross O. Bell Jr., M.D. ’51, Wheel- He retired from medicine and pedic Research and Education ing, W.Va., long-time director of public health in 1992 but re- Stephen B. Burdon, M.D., G.M. Foundation, to help surgeons de- the Clinical and Anatomic Labo- mained active through 2002. He ’48, Peoria, Ill., a former profes- vote time to research. His books ratories of Ohio Valley Medical had served in several administra- sor of urology at the Peoria on medical history include The Center; July 5, 2010. He served tive positions at Peter Bent School of Medicine; February 2, Doctor in Colonial America; Medi- in the U.S. Army 1954-1957 Brigham Hospital-Harvard Medi- 2011. During World War II, he cine Under Sail; and Magic, Mira- and was honorably discharged cal School and at the University served with an Army mobile sur- cles, and Medicine, which was as captain. of Connecticut School of Medi- gical hospital in Asia; he was published last year. During World cine. A former president of the awarded a Bronze Star for his War II, he was an Army surgeon Sheldon B. Goldstone, M.D., board of the American Heart As- service in central Burma. in the 95th Evacuation Hospital G.M.E.’51, Naples, Fla., a derma- sociation of Hartford, he had also in North Africa and Europe; he tologist who had maintained a served for several years as presi- John F. Lynch Jr., M.D., G.M.E. took part in the D-Day landings practice in Scranton, Pa., for dent of the Canadian/American ’48, Wrightsville, Beach, N.C., a and won several honors. In 2002 many years; December 6, 2010. Health Council. former clinical associate professor he worked on a film for the He earned his M.D. degree from of pediatrics at the University of American Academy of Orthopedic Jefferson Medical College. He John H. Wilkinson, M.D., G.M. North Carolina; November 16, Surgeons, Wounded in Action, doc- served as an officer in the Army ’53, Dublin, Ohio, a retired physi- 2010. He had served as secretary- umenting the role of orthopaedic during World War II, with the cian; February 2, 2011. He treasurer of the North Carolina surgeons in World War II, and on rank of captain. For 25 years, he founded Home Health Care Serv- Pediatric Society. a subsequent exhibit, “A Legacy taught graduate-level medical stu- ices at Homestead Hospital in of Heroes.” His wife is Kathleen dents at Penn’s medical school. 1964. Thomas L. Shields, M.D., G.M. M. Friedenberg, M.D., G.M.E. ’48, Fort Worth, a retired chief of ’67, a sculptor. Silas J. Ginsburg, M.D. ’52, Harry H. Haddon Jr., M.D., dermatology at Harris Hospital G.M.E. ’55, Jenkintown, Pa., G.M. ’54, Chambersburg, Pa., a and John Peter Smith Hospital; November 19, 2010. An obstetri- former chief of staff at Chambers- January 11, 2011. During World cian-gynecologist, he retired in burg Hospital; December 24, War II, he served as a doctor in ’50s 1995 from Abington Hospital. 2010. He graduated from Temple the Army’s 97th Infantry Division; University School of Medicine in he was awarded a Bronze Star. George W. Deitz III, M.D., G.M. Frederick R. Hood Jr., M.D. ’52, 1948. He was a lieutenant junior ’50, Palm City, Fla., a retired car- G.M.E. ’59, Bellingham, Wash., a grade in the Navy, serving two Robert E. Smith, M.D. ’48, a re- diologist and former instructor at retired thoracic surgeon; February years at the Philadelphia Naval tired family practitioner; Mount Penn’s medical school; January 3, 27, 2011. He had specialized in Yard and as the medical officer Vernon, Ohio; December 17, 2011. A pilot, he was senior avia- burns and reconstructive work at on the U.S.S. Corregidor during 2010. After practicing in Parsons, tion medical examiner for the his practice in Anchorage, Alaska. the Korean War. W.Va., Oak Hill, Ohio, and Me- F.A.A. During World War II he From 1983 to 2001, he was di- dina, Ohio, he became involved served in the U.S. Navy. Dietz rector of thermal services at Provi- David E. Hallstrand, M.D., G.M. in family practice residencies. He also was director of cardiac care at dence Hospital in Anchorage. ’54, Pinecrest, Fla., a former clini- served at the Northeastern Ohio Jeanes Hospital in Philadelphia. cal professor of surgery at the Universities Colleges of Medicine Walter J. Helsing, M.D., G.M. University of Miami; December and Pharmacy, the University of Elizabeth Pellett Gilmore, M.D. ’53, Beaver, Pa., a retired ortho- 1, 2010. He served in the Navy Mississippi, and Ohio State Univer- ’50, Miami, a retired clinical as- paedic surgeon; February 9, and Public Health Service and sity Medical School. In 1983, he sociate professor of psychiatry at 2011. He had been president was discharged in November joined Floyd County Medical the University of Miami; April 4, 1946. After graduating from Em-

42 ■ PENN MEDICINE ory Medical School in 1945, he Harvey L. Glass, Ph.D., G.M. in 1955 and served his residency the Medical Society of the State of practiced general medicine in ’57, Hartford; August 24, 2010. in internal medicine at Thomas New York and founding member Tallahassee, then returned for He began his career interning at Jefferson University Hospital, then and chairman of the Jefferson more training at Penn’s Graduate the VA Hospital in Coatesville, completed a nephrology fellow- County Physicians Organization. School of Medicine. A Diplomat Pa., and later opened his private ship at HUP. From 1958 to 1960, of the American Board of Surgery, practice in Hartford. He was a he served as a medical officer in Harry G. Light, M.D., G.M.E. he was also a Fellow of the clinical psychologist with the the U.S. Army’s Operation Boot- ’72, Bethlehem, Pa., a retired sur- American Board of Surgeons and Children’s Service of Connecticut strap in Puerto Rico and was dis- geon; February 13, 2011. Former of the International College of and served on the staff of the charged at the rank of captain. He president of the Lehigh Valley Surgeons. Hallstrand had served Hartford Rehabilitation Center. was known for developing Lanke- Medical Society, he had been a as chairman of the founding He was also a highly regarded di- nau’s kidney-transplant program governor of the Eastern Pennsyl- bond committee for the creation agnostic child psychologist work- in 1994, the first of its kind in the vania Chapter of the American of South Miami Hospital. After ing with school systems across Philadelphia suburbs. He also College of Surgeons. closing his private practice, he Connecticut. helped introduce a technique worked for JCAHO for five years called slow continuous hemodial- as a chief inspector. In 1991 he M. Edwin Green Jr., M.D., ysis, in which postoperative pa- served as interim CEO of South G.M.’57, Mechanicsburg, Pa., a tients have their blood cleaned ’80s Miami Hospital. retired physician; July 25, 2010. around the clock. S. David Scott Jr., M.D., Ph.D., Phanor L. Perot Jr., M.D., Ph.D., Otillia Lerner Beaubier, M.D., Sherwood Appleton, M.D., G.M.E. ’81, Erdenheim, Pa., a G.M.E. ’54, Charleston, S.C., re- G.M. ’58, Saskatoon, Sask., Feb- G.M.E. ’63, Thornhill, Ontario, a pulmonologist; Feb. 2, 2011. He tired chair of neurological surgery ruary 23, 2010. She earned her psychiatrist who had specialized earned his medical degree at Jef- at the Medical University of South medical degree from the Univer- in sleep disorders; June 21, 2009. ferson Medical College and had a Carolina; February 2, 2011. A sity of Toronto in 1954. After doctorate in physiology. graduate of the Tulane University her son was born in 1960, she William H. Shapiro, M.D., G.M. School of Medicine, he earned a left medicine and became a full- ’65, Rutherfordton, N.C., a retired Naomi R. Uri, M.D. ’89, Minne- Ph.D. degree in neurosurgery and time homemaker. cardiologist at Rutherford Hospi- apolis, a physician who practiced neurophysiology from McGill tal; May 20, 2010. internal medicine for HealthPart- University. In addition to leading Richard W. Hazen, M.D. ’58, ners, an H.M.O.; February 19, the Medical University’s neurolog- New London, Minn., November 2008. ical surgery program, he served as 18, 2010. A radiologist, he had president of many neurosurgical worked in the Division of Radio- ’70s organizations, including the logical Health of the United States American Academy of Neurologi- Public Health Service at one time. Enos Trent Andrews, M.D., FACULTY DEATHS cal Surgeons, and as first vice G.M.E. ’71, San Francisco, a president of the World Federation Charles H. Wingert Jr., M.D. retired orthopaedic surgeon; Baruch Blumberg, M.D., Ph.D., of Neurological Societies. ’58, G.M. ’62, Bellefont, Pa., a re- October 12, 2010. He earned professor of medicine and anthro- tired dermatologist; January 23, his medical degree from Hahne- pology and a Nobel laureate; Charles J. Rife, M.D., G.M.E. 2011. He served in the U.S. Air mann Medical College. From April 5, 2011. He was best known ’55, Mechanicsburg, Pa., a retired Force, 1958-60. 1963 to 1967, Trent served in for identifying the hepatitis B vi- ophthalmologist; September 25, the U.S. Navy as a battalion sur- rus, a discovery that led to the 2010. Louis G. McAfoos Jr., M.D., geon with the Marines. A former first vaccine against hepatitis B, G.M.E. ’59, Downingtown, Pa., associate clinical professor at the the first vaccine capable of pre- Roger G. Boylan, M.D. ’56, a retired physician who later University of California at San venting a human cancer. He Tempe, Ariz., a retired physician served as an Episcopal priest at Francisco, he invented the An- shared the 1976 Nobel Prize, for who had helped the planning Grace Church in Haddonfield, drews Spinal Surgery Table and “discoveries concerning new and building of Desert Samaritan N.J.; December 6, 2010. He was the Andrews Frame. mechanisms for the origin and Hospital; January 31, 2011. a flight surgeon in the U.S. Army dissemination of infectious dis- Air Forces during World War II. Lewis D. Yecies, M.D. ’71, Wa- eases.” His book Hepatitis B: The Joseph A. Gian-Grasso, M.D., In addition to operating a private tertown, N.Y., a professor of Hunt for a Killer Virus detailed the G.M.E. ’57, Trenton, N.J., a re- practice in South Jersey for four rheumatology and clinical immu- discovery. During World War II, tired surgeon; January 11, 2011. decades, McAfoos served in vari- nology at S.U.N.Y. Stony Brook; Blumberg served as a deck officer During World War II and the Ko- ous positions at West Jersey Hos- January 23, 2011. He had served and then a commanding officer in rean War he served in the U.S. pital, including chief of the med- in the United States Public Health the U.S. Navy, while simultane- Navy, including time aboard the ical staff. Service at the National Institutes ously pursuing a physics degree aircraft carrier U.S.S. Bunker Hill; of Health, the Bethesda Naval at Union College. He earned his he attained the rank of lieutenant Hospital, and the Walter Reed M.D. degree from Columbia Uni- commander. He attended the Army Medical Hospital. From versity and his Ph.D. in biochem- State University of New York- ’60s 1993 to 1999, he was chairman istry from Oxford University, and Downstate Medical Center and of the Department of Medicine he conducted field work in Suri- was an attending physician and Miles H. Sigler, M.D., G.M.E. at Samaritan Medical Center in nam, Nigeria, Australia, and sev- surgeon at Saint Francis Hospital ’62, Haverford, Pa., who founded Watertown and served on its eral other locations. From 1957 for more than 50 years. He was the nephrology division at Lanke- medical executive committee for to 1964, Blumberg worked at the the recipient of the Golden Merit nau Hospital and directed it for 16 years. A former president of National Institutes of Health. He Award from the Medical Society more than 40 years; November the Medical Society of Jefferson began at Penn as an associate pro- of New Jersey. 29, 2010. He graduated from County, N.Y., he had also been fessor of medicine in 1964, while Cornell University Medical School president of the Fifth District of being affiliated with the Fox Chase

2011/FALL ■ 43 LEGACY GIVING

Cancer Center. Two years later, he Zachary B. Friedenberg. See received a secondary Penn ap- Class of 1949. pointment as an associate profes- sor in genetics; he was made full Sheldon B. Goldstone. See Trust in HUP Inspires a Trust professor in 1970 and held an- Class of 1951. other secondary appointment as a professor of anthropology. In 1977, Andrew M. Nemeth, Wynne- Blumberg was named a University wood, Pa., emeritus professor of Professor – a rare distinction at anatomy and a former lecturer in Penn – of both medicine and an- psychiatry; February 7, 2011. He thropology. In 1989 he returned earned his medical degree from to Oxford as master of Balliol Col- Johns Hopkins University. In 1956, lege. He also taught at Stanford he joined Penn’s anatomy depart- University. He was founding di- ment (now cell and developmen- rector of the NASA Astrobiology tal biology). While pursuing re- Institute, where he held the title search on enzyme formation in “distinguished scientist.” He re- the late fetal and newborn peri- ceived an honorary degree from ods, he taught histology and Penn in 1990. In 2005, he was gross anatomy to first-year medi- elected president of the American cal students. He also maintained eter Gartman is a consummate planner, and when it Philosophical Society, founded by a private practice in psychiatry came time to retire as president of Independent Produc- Benjamin Franklin, and held that for many years, and in 1985, tion Services, he wanted to make sure his health was in Pthe right hands. The Hospital at the University of Penn- position at his death. briefly joined the clinical-practice group of Penn’s psychiatry de- sylvania’s highly ranked reputation with world-class phy- F. William Bora Jr., M.D., Glad- partment. He retired in 1996. sicians played a key role in his decision to relocate from wyne, Pa., emeritus professor of Shelburne, Vermont, to the Philadelphia area. orthopaedic surgery; February 23, Patrick B. Storey, M.D., Haver- “I have had long-term chronic health issues, and I knew 2011. He began teaching at Penn ford, Pa., emeritus professor of I would be availing myself of the best and brightest,” he as an instructor in 1962 and re- medicine and former associate said. “I knew being close to HUP was a wise choice.” mained on the faculty until retir- dean for international medical ing in 1997. He also served as programs; February 17, 2011. He In memory of his father, Edward, a University of Penn- chief of hand surgery at the Phila- earned his medical degree from sylvania alumnus and respected physician, Mr. Gartman delphia Veterans Affairs Medical Georgetown University in 1947. decided to establish a charitable remainder unitrust Center and maintained an ortho- He came to Penn as professor of (CRUT) with Vanguard for the hospital. The trust would paedic practice in Yeadon. He is community medicine at the provide income to Mr. Gartman and his wife, Brenda, credited with performing the sec- School of Medicine and as medi- and ultimately benefit HUP. ond hand-reattachment surgery in cal director of Graduate Hospital. Mr. Gartman informed Penn’s planned giving office of U.S. history in 1965. Author of He became professor of medicine his arrangements: “I wanted my gift to be known, and I The Pediatric Upper Extremity: Di- in 1977 when his primary depart- have always been willing to talk and encourage others to agnosis and Management, he was ment changed. In 1989, he be- give back. Quality medicine and health care are important editor of the Journal of Hand Sur- came emeritus, and that same gery in the early 1990s. He served year he was appointed a member to me, and were to my father. This is my way of honoring as a flight surgeon with the U.S. of the Provost’s Council on Inter- him and giving back to the community in a way that can Air Force in Korea and Japan, national Programs. In 2000, Sto- have a tremendous positive impact on people’s lives.” 1955-57. rey was honored with the Com- The inspiration for his philanthropy also arose from his munity Leadership Award by thoughts on how he wanted to be remembered. “You John Lott Brown, Ph.D., Tampa, Philadelphia Health Services for can’t take it with you,” Mr. Gartman said. “Material pos- Fla., a former associate professor his pioneering efforts in making sessions are all well and good, but what legacy do you of physiology; January 16, 2011. community health care accessible want to leave? It is always mystifying to me when I talk He joined Penn as an assistant for thousands of families. He to the very wealthy people who are hesitant to make a professor in 1955 and served as learned Russian as an adult and gift. What are they waiting for? Why not use your re- an associate professor, 1961-65. intensively studied the Soviet He left Penn to hold administra- Union’s health-care system. Fol- sources in a way that helps others? What you receive in tive positions at Kansas State Uni- lowing the collapse of the Soviet return is wonderful.” versity and the University of Union, Storey was also involved Mrs. Gartman encouraged his decision to support HUP. Rochester. From 1978 to 1988 he in establishing academic ties with “High-quality health care is important not only to us, was president of the University of the Pavlov Medical Institute, and but to the others as well,” she said. “I feel people should South Florida, a period in which he was instrumental in bringing give what they can, whether it is money, talent, or time.” the university established a medi- Russian medical students to the Peter and Brenda Gartman chose one of a multitude cal school and a cancer center. United States. of creative gift opportunities that benefit both Penn Medicine and donors. As you plan your financial future, George W. Deitz III. See Class the Office of Planned Giving is ready to assist in devel- of 1950. oping an appropriate strategy to incorporate your chari- table objectives. Contact Christine S. Ewan, J.D., senior director of Planned Giving, at 215-898-9486 or e-mail her at [email protected]. For more information, please visit the web site at www.plannedgiving.med.upenn.edu.

44 ■ PENN MEDICINE What Lies Ahead in as he took Hanson and other residents get left by the wayside, which is a Health Care on rounds: problem for their patients and a missed “His examination was thorough but opportunity for themselves.” Less than three years after The Edge respectfully attentive to any feelings of Later, in Chapter 14, “Survival of of Medicine appeared, William Hanson, modesty she might have felt in a room the Fit,” Hanson amplifies his argu- M.D. ’83, G.M.E. ’89, has now given us full of strangers. . . . When it came ment: “Species in an ecosystem either Smart Medicine: How the Changing Role time to leave, unlike many of my other find hospitable niches or become food of Doctors Will Revolutionize Health Care professors, Schnabel carefully retied for other species and die off.” He pos- (Macmillan). A longtime professor of her gown and drew the bedcovers up its “a cutthroat era of medical evolu- anesthesia and critical care at Penn in the way he had found them. He tion.” For part of his argument, he Medicine, Hanson was recently named then wheeled the table with her food uses “Dr. Bryan Scherr (not his real its first chief medical information offi- and phone back next to the bed. He name),” who was a very successful car- cer. Perhaps he can offer some tips on said a few reassuring words to summa- diac surgeon, a “predator at the apex time management to the rest of us. rize, and we left. Once in the hallway, of the medical system.” But as the Hanson’s new book examines many Dr. Schnabel reviewed what he’d found number of coronary arterial bypass of the trends now shaping health care, on exam and headed off for the next procedures (CABGs) began to decline, such as the rapid adoption of smart patient, but then stopped with an after- so did Dr. Scherr’s position in the sys- phones and iPads by clinicians who thought: ‘You should always leave the tem, until he was forced to become a can use them as stethoscopes and ref- patient just the way you found her,’ be- wandering cardiac surgeon working erence sources, and enhanced medical cause, he said, ‘it is respectful.’ ” nighttime shifts. At the same time, dummies for training. Penn Medicine some revolutionary new tools – the has covered some of these topics in re- The Need to Adapt and Evolve balloon coronary angioplasty and cor- cent years: increased computerization; Hanson concedes it’s harder for onary vascular stents, for example – the emphasis on teams and leadership; practitioners today to spend the same increasingly allowed cardiologists who the growth of hospitalists; revised amount of time with their patients as used to diagnose the patients and send standards for medical residents’ hours; in the 1950s, 1960s, and 1970s. Back them on to surgeons like Dr. Scherr training in humanism and profession- then, a practitioner’s day might include now to reopen blocked heart vessels alism. But Smart Medicine brings the visits from eight to ten office patients, non-invasively, “thereby eliminating themes together with a broader con- followed by rounds in the hospital; to- the need for cardiac surgery in all but text – and a simpatico narrator. day, a practitioner might see about 25. the most complicated cases.” One feature of Smart Medicine is But Hanson also underscores why some Another important trend Hanson how Hanson mixes the old and the of these major changes are clearly for the writes about is the growth of Minute- new, often with examples from his better. His father’s handwriting was al- Clinics and other customer-friendly Penn experiences. As in The Edge of most illegible – but electronic medical re- sites. In an amusing chapter, he learns Medicine, his father, who also taught cords remove that problem, and they are to his chagrin that his own wife, a and practiced at Penn, plays an im- swiftly available in diverse locations. nurse practitioner, has taken their portant role. Amid the changes that Some observers have likened the ac- children to such a place for their flu have profoundly affected how medi- ademic health system to an ecosystem: shots – and he must investigate incog- cine is delivered today, Hanson does It is complex, its parts are interrelated, nito, wearing dark glasses! But his ac- not overlook lessons he learned from and it must be able to adapt to changes count again underscores the constant his father and his father’s contempo- in the environment. Hanson employs evolution of medicine and the need raries. One need not look far to find the metaphor as well, but his version is for health-care organizations to adapt contemporary complaints of patients somewhat more worrisome. Medicine, and find new and more efficient ways who felt ignored by those ostensibly he writes, “is a giant ecosystem that’s in to deliver care. treating them. Despite the pace of to- constant ferment. Physicians who fail As a bonus, I now have an unfamiliar day’s health care, Hanson offers the to stay current, to read, and to evolve word to try to work into my conversa- example of one of Penn’s beloved tion, one that Hanson uses to describe teachers and clinicians, the late Tru- the “skin” of the health-care system: man Schnabel, M.D. ’43, G.M.E. ’47, pachydermatous. Non Profit UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM Organization U.S. Postage 3535 Market Street, Suite 60 Mezzanine Philadelphia, PA 19104-3309 PAID Phila., PA Permit No. 2563

hen the University’s first medical program

opened in 1765, gross anatomy was a part of Wit. Even with today’s “virtual curriculum” and other technical and educational advances,

medical students continue to learn essential

lessons in such courses. Taking gross anato-

my is a rite of passage – and more.