WINTER/SPRING 2021

EINSTEINTHE MAGAZINE FOR ALUMNI AND FRIENDS OF ALBERT EINSTEIN COLLEGE OF MEDICINE

20 YEARS AFTER

In response to tragedy, a groundbreaking research program monitors the health of first responders WINTER/SPRING 2021

EINSTEIN A Message From the Dean Science at the Heart of Medicine Winter/Spring 2021 IN THIS ISSUE The magazine for alumni, faculty, or more than a year now, the students, friends, and supporters of COVID-19 pandemic has Albert Einstein College of Medicine COVER STORY and Montefiore upended our lives in unimag- 18 20 YEARS AFTER 9/11 inable ways. I offer my condo- Published by In the wake of tragedy, a groundbreaking research program Flences to everyone who suffered the loss The Philip and Rita Rosen Department monitors the health of World Trade Center first responders of Communications and Public Affairs of a loved one during a most difficult Gordon Earle, Associate Dean FEATURES year. Yet, even during these challeng- Office of Development and Alumni Relations ing times, we have been fully engaged Kathleen Kearns 12 THE POWER OF A PARTNERSHIP Senior Vice President of Development and Einstein’s longstanding global health program in Kisoro, in combating the coronavirus and the Chief Philanthropy Officer Uganda, benefits both patients and students disease it causes—and we have some Rachelle M. Sanders Vice President of Development 18 significant achievements to show for 32 THE DESIGN CHALLENGE our efforts. Director, Science and Research Content Students from Einstein team up with CUNY engineering Larry Katzenstein We have opened a new COVID- students to create better ways to protect people during Senior Director, Strategic Communications future pandemics 19 unit at Einstein and Montefiore to and External Relations test the effectiveness of vaccines. We Deirdre Branley 36 GUT REACTIONS have evaluated coronavirus treatments, Managing Editor Einstein and Montefiore researchers are finding that the Susan Byrne including convalescent plasma, corti- intestinal microbiome may hold the key to good health costeroids, and monoclonal antibodies. Reactions” (page 36), describes the Director, Creative Services Marie L. Kurtz And we have studied how COVID- promising microbiome research that 56 GUIDING ELDERLY HOLOCAUST SURVIVORS Senior Director of External Relations, With support from UJA-Federation of New York, 19 affects children and why it causes Einstein and Montefiore scientists are Development Montefiore is bringing vital mental health services to those psychiatric problems in adults. You conducting. Their studies suggest that Rachel Eddey who endured World War II concentration camps can learn more about our COVID-19 altering the makeup of the gut may Associate Director of External Relations, 12 research on pages 8 and 9. lead to treatments for intestinal prob- Development 60 NEW BLOOD CANCER INSTITUTE Sean McMahon A different tragedy, the collapse of lems as well as diseases such as sickle Einstein’s new research center will build on recent successes Art Director to create lifesaving treatments the Twin Towers, continues to dis- cell anemia and diabetes. Lorene Tapellini rupt the health and lives of many New I am heartened by what we’ve Associate Art Director DEPARTMENTS Yorkers. Our cover story, “20 Years After accomplished these past several Jeneffer Lee 9/11” (page 18), begins with David months. And as we begin to recover Illustrations 2 Campus News Prezant, M.D.—an Einstein graduate from the pandemic, I’m optimistic Tatyana Starikova Harris 4 Research Notes and chief medical officer for the Fire about what can be achieved as we Digital Imaging 6 Lab Chat: Britta Will, Ph.D. Donna Bruno Department of the City of New York— work together for a better future. 10 Mavens of Medicine: Mark Schoenberg, M.D. Photography 46 Passionate Pursuits: Steven Cohen, M.D. who arrived at Ground Zero shortly jtorresphoto.com before the towers fell. Dr. Prezant would 48 Einstein Editions: Age Later; High Risk Multimedia Communications 36 go on to establish a groundbreaking Sunita Reed, Director 50 Crossword: Albert’s Puzzler

program to monitor the health of first Address correspondence to: 51 Motivations: The Front Line of Philanthropy responders and obtain lifelong support Editor, Einstein Magazine 54 Continued Connection: John Braver, M.D. ’70 Jack and Pearl Resnick Campus for their care. A section titled “The 1300 Morris Park Avenue, Belfer 905 64 Class Notes Bronx, NY 10461 Ones Who Ran Toward Danger,” begin- GORDON F. TOMASELLI, M.D. 69 A Look Back Email: [email protected] magazine.einsteinmed.org ning on page 26, recounts the heroism The Marilyn and Stanley M. Katz Dean Visit Website: www.einsteinmed.org and health problems of three of those Albert Einstein College of Medicine ON THE COVER: David Prezant, M.D. ’81, pictured second from right, is a or scan code Copyright © 2021 professor of medicine and of epidemiology & population health at Einstein first responders. Executive Vice President, Chief Academic Officer Albert Einstein College of Medicine and a pulmonologist at Montefiore. He is the FDNY’s chief medical officer Our second feature article, “Gut Montefiore Medicine All rights reserved and helped create the World Trade Center Health Program.

MAGAZINE.EINSTEINMED.ORG 1 CAMPUS NEWS

Tenure for 10 Einstein Two Prominent Researchers Take Helm of PRIME Professors

Vilma Gabbay, M.D., M.S., and Dr. Radulovic, professor in the Jacqueline M. Achkar, M.D., M.S. Jelena Radulovic, M.D., Ph.D., Dominick P. Purpura Department of Professor of Medicine and of have been named co-directors of Neuroscience and of psychiatry and Microbiology & Immunology the Psychiatry Research Institute at behavioral sciences, uses animal mod- Montefiore Einstein (PRIME). els to study how memories of stressful Edward Chu, M.D. The new center will integrate research events cause fear, anxiety, and depres- Professor of Medicine and of in psychiatry and neuroscience to tackle sion. Her research has been funded by Molecular Pharmacology urgent problems such as trauma and Dr. Vilma Gabbay Dr. Jelena Radulovic the National Institute of Mental Health stress disorders, substance-use disorders, anxiety disorders in young adults. She since 2006. Tim Q. Duong, Ph.D. schizophrenia, depression, and anxiety, directs the Pediatric Mood and Anxiety She is leading a research project Professor of Radiology as well as multicultural health and men- Disorders Research Program at Einstein focusing on the molecular, cellular, and Einstein students, faculty, and staff members package produce for Montefiore’s Project BRAVO Food Pantry on Bainbridge Avenue in the Bronx. tal health disparities. PRIME is a joint and Montefiore, and recently received circuit mechanisms involved in the Louis Hodgson, Ph.D. initiative of the departments of psy- a $4 million grant from the National brain’s processing, storage, and recall of Professor of Anatomy chiatry and behavioral sciences and of Institutes of Health to study the neuro- negative memories and the roles they and Structural Biology neuroscience, and exemplifies Einstein biology of depression in teenagers. play in the development of depression. Honoring Martin Luther King Jr. and Montefiore’s commitment to basic, “PRIME is committed to pursuing “The challenges of researching U. Thomas Meier, Ph.D. translational, and clinical research. meaningful advances in understanding these questions connected to mental Professor of Anatomy Through Service Work Dr. Gabbay, associate professor of and treating mental illness,” Dr. Gabbay health disorders are big—but so is the and Structural Biology psychiatry and behavioral sciences and says. “Together, Dr. Radulovic and I will excitement and promise of our work at n Jan. 18, for the first time, continue to serve the community in the Dominick P. Purpura Department support and mentor teams of inves- PRIME,” Dr. Radulovic says. “If we can Einstein joined other organi- throughout the year, and we look Michal L. Melamed, M.D., M.H.S. of Neuroscience at Einstein, and a clin- tigators—from medical and graduate discover more about the mechanisms in zations nationwide in a day forward to making this an annual Professor of Medicine and of O ical psychiatrist at Montefiore, studies students and postdoctoral fellows to brain circuits that are affected, we can of service in memory of civil rights opportunity.” Epidemiology & Population Health the neurobiological basis of mood and early-career scientists.” work toward developing treatments.” leader Martin Luther King Jr. The As part of Einstein’s inaugural federal holiday honoring Dr. King’s MLK Service Challenge, dozens of Jelena Radulovic, M.D., Ph.D. legacy is unique in being observed as a students, faculty, and staff members Professor in the Dominick P. Purpura “day on, not a day off,” to encourage donated their time in person and vir- New Chief of Dermatology Appointed Department of Neuroscience and of Americans to volunteer to improve tually throughout the week. The office Psychiatry and Behavioral Sciences their communities. of diversity and inclusion partnered Beth McLellan, cancer. She has previously worked at the Bronx, and helped start a commit- “The difficulties of the past year with three local organizations, includ- M.D., has been New York University’s Grossman School tee for diversity, inclusion, and cultural Julie Secombe, Ph.D. have reinforced the importance of ing Montefiore’s Project BRAVO, named chief of the of Medicine and the NYU Langone competency in dermatology.” Professor of Genetics and in the community,” says Nerys Benfield, HERO High School, and the Bronx division of derma- Medical Center. A graduate of Wayne State University Dominick P. Purpura Department of M.D., M.P.H., senior associate dean Community Foundation, as well as tology at Einstein “Dr. McLellan is an exceptional School of Medicine in Detroit, Dr. Neuroscience for diversity and inclusion. “Dr. Einstein’s Food Justice and Medicine and Montefiore. An leader, outstanding educator, and role McLellan completed her internal med- Martin Luther King Jr. had a vision group, to offer volunteer events. associate professor model,” says Yaron Tomer, M.D., pro- icine internship at Loyola University in Duncan W. Wilson, Ph.D. of a ‘beloved community’ where all Those included packaging grocer- of medicine at Einstein and a clinical fessor and chair of the department of Maywood, Illinois, followed by a der- Professor of Developmental and people can live free from poverty and ies at a Bronx food pantry, helping dermatologist at Montefiore, she previ- medicine at Einstein and Montefiore matology residency at the Henry Ford Molecular Biology and in the racism,” says Dr. Benfield, who is also younger students online with health ously served as director of dermatology and the Anita and Jack Saltz Chair in Health System in Detroit, where she Dominick P. Purpura Department of an associate professor of obstetrics and science projects, delivering bags of at Jacobi Medical Center. Diabetes Research at Einstein. “She cre- was chief resident. She is currently col- Neuroscience & gynecology and women’s health at groceries by car to people’s homes, and Dr. McLellan specializes in onco- ated the oncodermatology program at laborating with Montefiore and Einstein Einstein and director of family plan- distributing food and personal protec- dermatology—diagnosing, treating, the Albert Einstein Cancer Center, leads researchers in infectious diseases, bio- Zhengdong Zhang, Ph.D. ning at Montefiore. “Our hope is that tive equipment to Bronx community and managing the complications of an annual free skin cancer screening in informatics, and radiation oncology. Professor of Genetics students, faculty, and staff members members from Einstein’s campus.

2 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 3 RESEARCH NOTES Sensory Nerves Mobilize Blood-Forming Stem Cells Bolstering the Health of Blood Stem Cells ematopoietic (blood-forming) marrow to the bloodstream. stem cells (HSCs) are stimu- Interestingly, the research team s we age, our hematopoietic H lated to leave their “homes” in found that feeding mice food contain- (blood-forming) stem cells the bone marrow and enter the blood- ing capsaicin (the “hot” component of A (HSCs) become less efficient stream, where they differentiate into all chili peppers) significantly enhanced and less able to make healthy new blood the body’s blood cells. The signals that HSC mobilization. These findings cells. In a study published in January activate this mobilization of HSCs have could help to increase the yield of 2021 in Nature, Einstein research- not been well defined. HSCs that are harvested from the ers found that this reduction in HSC In research published online in blood for use in bone-marrow trans- efficiency results in part from deteriora- December 2020 in Nature, Paul plants for treating blood cancers and tion of chaperone-mediated autophagy Frenette, M.D., and colleagues found other life-threatening diseases. (CMA), the housekeeping process that that nociceptive (pain-sensing) nerves Dr. Frenette is a professor of med- removes and recycles damaged proteins in the bone marrow play a key role in icine and of cell biology and the chair and other waste materials that interfere regulating HSCs. Those nerves secrete and director of the Ruth L. and David with our cells’ ability to function. peptides into the bone marrow, turn- S. Gottesman Institute for Stem Cell “While the aging of HSCs in our ing on a cascade of signals that instruct Biology and Regenerative Medicine A hematopoietic stem cell surrounded by bone marrow is inevitable, the good the stem cells to migrate from the bone at Einstein. red blood cells. news is that it may be reversible,” says study co-leader Ana Maria Cuervo, M.D., Ph.D., professor of developmen- tal and molecular biology, of anatomy Overcoming Melanoma Drug Resistance and structural biology, and of medicine, This illustration depicts autophagy. The large red area inside the cell is a lysosome— and the Robert and Renée Belfer Chair a membrane-bound, enzyme-filled structure that degrades a cell’s waste products. he so-called MAPK signaling reactivation of the MAPK pathway, for the Study of Neurodegenerative pathway regulates cell prolifer- which induces BRAF to form drug- Diseases at Einstein. Tation by transmitting chemical resistant dimers (two BRAF molecules In previous studies, Dr. Cuervo dis- blood-cell-forming state. drug developed by study co-author signals to cells’ nuclei from outside the linked together). covered that the decline in CMA allows The team found that blocking CMA Evripidis Gavathiotis, Ph.D., professor cells. Ten percent of all human cancers A study published in September waste to build up in cells, contributing in the HSCs of young mice duplicates of biochemistry and of medicine. The and half of all metastatic melanomas 2020 in Nature Communications by to Parkinson’s, Alzheimer’s, and aging in many of the features observed in the result: The HSCs recovered the ability result from mutations in BRAF, a gene Evripidis Gavathiotis, Ph.D., and general, and that revving up CMA can HSCs of aged mice. Conversely, young to make healthy blood cells. that codes for the protein BRAF in colleagues describes a drug that shows help prevent those processes. The cur- mice genetically engineered to prevent Dr. Cuervo notes that some blood the MAPK pathway. By far the most promise for inhibiting BRAF dimers. rent study investigates whether CMA’s CMA in their HSCs from declining with cancers, such as acute myeloid leuke- common melanoma BRAF mutation is The researchers designed a BRAF- age-related decline plays a role in the age were able to repopulate bone marrow mia and myelodysplastic syndromes, BRAFV600E—a single-nucleotide muta- dimer inhibitor based on the molecular falloff of HSC activity. with healthy blood cells even into old almost always affect older people and tion that causes glutamic acid to substi- structure of a drug called Ponatinib, Dr. Cuervo’s team first established age. “Even more interesting is that when evolve from mutations that accumulate tute for valine in the BRAF protein. approved by the FDA for treating that CMA in the HSCs of mice does we pharmacologically activated CMA in in HSCs; revving up CMA in HSCs, The U.S. Food and Drug chronic myelogenous leukemia. Since indeed become less efficient with age. old mice, we were able to restore their she says, could help prevent those blood Administration (FDA) has approved BRAF dimers encourage melanoma The researchers then showed that HSCs HSC activity,” Dr. Cuervo says. cancers from occurring. several BRAF-inhibiting drugs for treat- tumors to develop drug resistance, this depend on CMA for their vitality— These studies in mice may also be ing tumors possessing the BRAFV600E BRAF-dimer-inhibiting drug may help WATCH THE VIDEO both to maintain a healthy balance relevant to human health. The research- mutation. Unfortunately, nearly all extend the lives of melanoma patients. See Dr. Cuervo describe the of proteins and to switch from their ers took HSCs from people over 65 and cellular process of autophagy: Melanoma cancer cells as they appear in a tumors eventually develop resistance Dr. Gavathiotis is a professor of bio- normally quiescent state to their active, treated them with a CMA-activating magazine.einsteinmed.org/Cuervo21 cross section of the skin. to the drugs. A principal reason is chemistry and of medicine at Einstein.

4 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 5 RESEARCH NOTES

Lab Chat Detecting Neural Activity

ritta Will, Ph.D., studies hematopoietic (blood-forming) stem cells in Near-Infrared Light and their role in driving two age-related and largely incurable Bblood cancers: acute myeloid leukemia (AML) and myelodysplastic he ability of fluorescent proteins light, which penetrates deeply into syndromes (MDS). A native of Germany, Dr. Will earned her doctorate (FPs) to serve as building blocks biological tissues with minimal scatter; in biology at the Albert Ludwig University of Freiburg and came to the Tof biosensors allows scientists this allows scientists noninvasively to to observe normal and pathological observe activity in neurons deep within United States in 2005 for advanced training at Harvard. She has been Microbial Diversity biological processes in live cells in real living animals. a member of the Einstein faculty since 2013, where she is an assistant May Affect Lung Cancer time. FPs that emit visible light were The near-infrared calcium biosensor professor of medicine and of cell biology. In 2020, she was awarded Risk in Never-Smokers the prestigious Pershing Square Sohn Prize for Young Investigators in previously available, but only recently can be combined with biosensors func- Cancer Research. have FPs glowing in the near-infrared tioning in visible light, which allows Although tobacco products cause spectrum been developed, thanks to the for spectral “crosstalk-free” imaging of most lung cancer deaths, one-fourth work of Vladislav Verkhusha, Ph.D., several simultaneous biochemical intra- of lung cancers occur in people who What attracted you to biomedical things fall into place. That takes an open professor of anatomy and structural cellular processes. have never smoked. In a study pub- research? mind, courage, persistence, and time. biology at Einstein, and his lab. Dr. Verkhusha and his team con- lished in December 2020 in Thorax, I had a passion for nature at an early In a study published online in structed a hybrid microscope combining H. Dean Hosgood, Ph.D., associate age, which led me to study biology. But What led you to study blood October 2020 in Nature Biotechnology, fluorescence and photoacoustic imaging. professor of epidemiology & popula- for a long time, I didn’t know about cancers? Dr. Verkhusha and colleagues report The hybrid microscope can “see through” tion health at Einstein, and colleagues research as a career option. I didn’t have It was a natural trajectory, growing out the next advance in optical imaging. the skulls of living mice, simultaneously analyzed the diversity of microbiota any role models. My uncertainty made of my interest in stem cells and my Britta Will, Ph.D., likes exploring “completely Using two near-infrared FPs, they have using the near-infrared calcium biosen- that had been collected from the my parents quite nervous. While they desire to address diseases for which we uncharted territory” in her research. engineered a calcium biosensor that can sor to monitor neuronal activity as well respiratory tracts of men and women were supportive of me, they thought, have few treatments or cures. detect evoked and spontaneous calcium as photoacoustics to track blood oxygen in Shanghai, China, who had never “Aside from teaching, what can you do, the role of iron in creating and sustain- fluxes in the brain, which is an indica- levels in the brain. The new calcium bio- smoked. The researchers found that really, with a biology degree?” What brought you to the United ing the cancerous blood stem cells that tor of neural activity. The biosensor is sensor should prove useful in preclinical lower bacterial diversity was associ- States, and why did you stay? lead to AML and MDS. stimulated by and emits near-infrared studies involving animal models. ated with a greater risk for subsequent Did that experience influence how I wanted to see how research was done occurrence of lung cancer among you run your lab? in another country. I came to appreciate Have you read anything interest- never-smokers. I believe so. My first goal is to make an how the system here supports young sci- ing lately? In addition, the researchers found impact scientifically, of course. But in entists and is completely open to novel The Power, a dystopian science fiction that increased abundance of bacte- addition, I feel honored to be in a posi- ideas. I stayed because I had an oppor- novel by Naomi Alderman. It’s my very ria in the Firmicutes phylum, and tion where I can help young scientists tunity to do a postdoc with Einstein’s first novel of this genre, and a deeply Lactobacillales in particular, in the remain on their paths, especially when Ulrich Steidl [an expert in stem-cell moving—and in parts disturbing— respiratory tract may be associated they experience difficulties. research, AML, and MDS]. He instilled story about gender and power. with an increased risk of lung can- in me the confidence that you can cer in never-smokers. The findings How do you boost their spirits? discover something new by pushing Do you have any hobbies? provide further insight into the causes When they’re having a bad streak with boundaries. Currently I like doing anything that is of lung cancer in the absence of active their research, for example, I tell them, making our son, who is 2, happy. Also, tobacco smoking. “Whatever you do today, just make Is pushing boundaries what you my husband and I love to go on hikes. Dr. Hosgood is also the director sure to come back tomorrow.” If they’ve hope to do with the funding of global environmental health for made it this far, they can work through you’ve received from the Sohn This image shows the overlay of near-infrared fluorescence of a calcium biosensor the Global Health Center at Einstein WATCH THE VIDEO the ups and downs. It’s in the nature of Prize—$600,000 over three years? (purple pseudocolor) and blood oxygenation (rainbow pseudocolor) in the brain of a and the associate director for popula- Dr. Will talks about why she went living mouse. It was made using a hybrid fluorescence and photoacoustic microscope Yes, the Sohn Prize will allow me to research to be wrong. You continue ask- into stem-cell research: developed by Einstein’s Vladislav Verkhusha, Ph.D., and Junjie Yao, Ph.D., of Duke tion and clinical sciences in Einstein’s

ing questions and pushing forward until explore completely uncharted territory: magazine.einsteinmed.org/Will21 Photo by Jonathan Heisler University. Oxygenation levels range from low (blue) to high (red). Clinical Research Training Program.

6 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 7 RESEARCH NOTES

published in September 2020 in Science Neurological Surgery at Montefiore holds the Selma and Dr. Jacques Mitrani Einstein and Montefiore Scientists Translational Medicine, suggest that and Einstein. Chair in Biomedical Research at Einstein. children’s stronger innate immunity Continue to Tackle COVID-19 protects them against SARS-CoV-2, the CONVALESCENT PLASMA PSYCHIATRIC PROBLEMS novel coronavirus that causes COVID- A study published in In a letter published in 19. Betsy Herold, M.D., chief of pediat- January 2021 in JCI the Journal of Psychiatric ince our coverage of the COVID-19 crisis in the Summer/Fall 2020 issue ric infectious diseases and vice chair for Insight found that Research in August 2020, of Einstein magazine, physician-scientists at Einstein and Montefiore research in the department of pediatrics plasma donated by members of Einstein people who’ve recov- and Montefiore’s have made further progress in understanding the disease and developing at Einstein and Children’s Hospital S at Montefiore, was one of the senior ered from COVID-19 is effective in department of psychiatry and behavioral strategies for preventing and treating it. Here are some recent highlights. authors of the study. treating younger patients hospitalized sciences added to evidence indicating for the disease. that COVID-19 may cause psychiatric NEUROLOGICAL SYMPTOMS Einstein and Montefiore researchers problems. VACCINE UNIT MONOCLONAL ANTIBODIES people hospitalized with moderate to People hospitalized administered convalescent plasma to The authors described two adults In November, AND BLOOD THINNERS severe COVID-19 who are on oxygen with COVID-19 who 103 severely ill patients with COVID- with COVID-19 admitted to the emer- Einstein and Einstein and but are not intubated. have neurological 19 who were admitted to Montefiore gency department with severe psycho- Montefiore opened Montefiore have All participants receive the antiviral problems have a higher between April 13 and May 4, 2020. sis and mania. Neither patient had a a new COVID-19 become a testing site drug remdesivir, and are randomized to risk of dying than Seventy-three of those patients were prior psychiatric history or significant vaccine unit, enroll- for trials funded by receive one of two anti-inflammatory other COVID-19 patients, according matched with 73 COVID-19 patients medical or pulmonary symptoms; both ing people in a phase 3 clinical trial to the National Institutes drugs: baricitinib and dexamethasone. to a study that Einstein and Montefiore admitted during the same period who were discharged following treatment test the efficacy of the AstraZeneca- of Health (NIH) known as ACTIV-3 ACTT-4 seeks to compare the safety researchers published in December did not receive plasma. The authors with antipsychotic drugs. The authors University of Oxford vaccine. The unit and ACTIV-4. The ACTIV-3 trial is and effectiveness of the anti-inflam- 2020 in Neurology. found no difference in mortality speculated that the patients’ psychiat- is led by Barry Zingman, M.D., profes- evaluating the safety and effectiveness of matory drugs, both of which have The research is the first to show that between the people who received conva- ric problems may have resulted from sor of medicine at Einstein and clinical Eli Lilly’s monoclonal antibody (bam- shown promise in treating COVID- the presence of neurological symp- lescent plasma and those who had not at immune-system activation and its effect director of infectious diseases at the lanivimab) in patients hospitalized with 19. Each of the patients receiving toms, particularly stroke and confused 28 days following admission. on the central nervous system. Vilma Moses division of Montefiore. COVID-19. combination therapy is matched with or altered thinking, can predict a more However, when patients were strat- Gabbay, M.D., was the corresponding In recruiting people for the vac- ACTIV-4 is assessing several a patient receiving remdesivir alone. serious course of illness even when ified by age, those plasma recipients author. She is an associate professor of cine trial, Dr. Zingman and his team blood-thinner drugs for treating people The principal investigator is Robert problems with breathing aren’t severe. under age 65 had a fourfold lower mor- psychiatry and behavioral sciences and required that more than half the par- with COVID-19, particularly patients M. Grossberg, M.D., associate profes- The study looked at data from 4,711 tality after 28 days compared with sim- in the Dominick P. Purpura Department ticipants were adults most affected by with life-threatening blood clots. The sor of medicine (infectious diseases) at people admitted to Montefiore with ilarly aged control patients. Liise-anne of Neuroscience and a co-director of the COVID-19, with a focus on people of principal investigator for both trials is Einstein and medical director of the COVID-19 between March 1 and Pirofski, M.D., was the study’s senior Psychiatry Research Institute at Einstein, color and people older than 65. Michelle Ng Gong, M.D., M.S., chief Montefiore Center for Positive Living/ April 16, 2020. author. She is the chief of infectious and a clinical psychiatrist at Montefiore The randomized, placebo-controlled, of the divisions of critical care and of Infectious Diseases Clinic. The findings could potentially help diseases at Einstein and Montefiore and (see page 2). double-blind trial vaccinated two peo- pulmonary medicine at Montefiore and medical workers identify and focus their ple with the vaccine for each person Einstein and professor of medicine and COVID-19 AND CHILDREN treatment efforts on individuals most who received a placebo injection. Two of epidemiology & population health In the first-ever at risk, and could decrease COVID- injections were given to each partic- at Einstein. study comparing the 19 deaths. The study’s co-authors were ipant over 29 days. “To the health- immune responses of David Altschul, M.D., chief of the care providers and investigators who COMBINATION THERAPIES adults and children division of cerebrovascular neurosurgery enthusiastically joined the effort and Montefiore is also the with COVID-19, at Einstein and Montefiore, and Emad to the people who come in to partici- testing site for the researchers at Einstein and Montefiore Eskandar, M.D., M.B.A., the Jeffrey P. pate in these critically important trials, NIH-funded ACTT-4 and at Yale University detected key Bergstein Chair in Neurological Surgery we thank you for your role in helping clinical trial assessing differences that may explain why in the Leo M. Davidoff Department the world end this pandemic,” Dr. combination thera- children usually have a milder course of Neurological Surgery at Einstein Zingman says. pies for COVID-19. Those enrolled are of disease. The findings, which were and the David B. Keidan Chair of

8 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 9 MONTEFIORE AND EINSTEIN MAVENS OF MEDICINE Both your father and grandfather And cancer research? the national average. This has paid were physicians. Did they influence I always wanted to do clinical research, tremendous dividends. It has introduced your career choice? but the question was, what field? Cancer different points of view and pushed Not at first. In college, at Yale, I was seemed to be the most exciting choice. all of us, male and female, to rethink interested in Russian history and went to This was the early ’90s, when scientists work-life balance, which of course is a Russia to study and learn the language. were just starting to understand the particular challenge for female surgeons genetics of cancer, which had enormous in training who are considering having Was there family pressure to study implications for diagnosis and treatment. children. We don’t have all the answers, medicine? That led me to a fellowship looking at but at least we’re grappling with it. The only one who pressured me at all the genetics of prostate cancer at Johns was my paternal grandmother. She told Hopkins. Does having more women on staff me that studying Russian was a waste of affect patient care? time because I was going to be a doctor. I Why did you switch your focus to Women in general want to see female laughed and told her it wouldn’t happen. bladder cancer? doctors. Oncology was once the After my fellowship, I was offered a posi- fastest-growing subspecialty within What changed? tion at Hopkins to work on bladder can- urology, but today it’s female pelvic After I got back from Russia, I started cer. When I said I didn’t know anything medicine—problems such as female reexamining my professional options. about it, I was told, “You’ll learn.” And urinary incontinence, pelvic pain, I was curious about medicine and took I did. Hopkins, like Einstein, has a tre- and recurrent urinary tract infections. premed courses to figure out if that’s mendous bench of scientists with whom In collaboration with obstetrics and what I wanted to do. With no prior clinicians can do translational research. gynecology, we now have a Pelvic background in science, I really struggled. It turned out to be a very productive Floor Center at Montefiore, which is I applied to several medical schools but time. I promised my wife we’d stay just dedicated to these health issues. didn’t get in. a few years and then we’d return to Philadelphia, where both of us are from. How do you envision your role as How did you wind up going to But we stayed in Baltimore for 20 years. department chair? the University of Texas School of My goal is to support a culture of open- Medicine in Houston? What are the greatest challenges in ness and the habit of clear-eyed ques- On my father’s advice I moved to Texas, treating bladder cancer today? tioning. I want our faculty and trainees Supporting a ark Schoenberg, M.D., is the chair of which had a surplus of medical schools First of all, we need more therapeutic to ask, “Why are we doing what we’re urology at Einstein and Montefiore and a shortage of qualified applicants. I options to offer patients with bladder doing?” Don’t accept as gospel what took additional science courses, improved cancer. Checkpoint inhibitors have you’re told. We have a young faculty, Culture of Openness and an internationally recognized my grade-point average, and worked in transformed how we manage individual and it’s important to get this message M a couple of research labs, including one patients with metastatic bladder can- across early in their careers. I also tell in Urology authority on the treatment of bladder cancer. Dr. at MD Anderson Cancer Center. The cer, but we’re still not able to markedly my faculty, “I don’t care what you work Schoenberg came to Einstein and Montefiore combination of those extra experiences change the clinical course of disease for on, so long as you really dig into it.” Q&A with and Texas residency was enough to get me most of them. That’s the path to a fruitful career in in 2014, after 20 years at the James Buchanan into the med school there. academic medicine, to personal intellec- Dr. Mark Schoenberg Brady Urological Institute at the Johns Hopkins Your department has a high per- tual growth, and to innovation. How did you become interested in centage of female urologists. Was University, where he served as the director of urology? that a conscious decision? In retrospect, your grandmother urologic oncology. At first I was attracted to psychiatry, but They weren’t recruited because they are knew you best. ended up liking surgery and urology even women, but because they are excellent Maybe. But I do use my Russian now more—to the amazement of my father, clinicians and researchers. Our depart- and then, when treating patients here in who was a urologist. ment is about 40% female—five times the Bronx.

10 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 11 THE POWER ast spring, residents of Kisoro, a remote district of OF A PARTNERSHIP Uganda, heard that a new illness called COVID-19 was approaching. They feared it would be like the Einstein’s global health program in Kisoro, Uganda, L Ebola virus—a death sentence that would wipe out people in benefits both patients and students hundreds of villages.

BY TERESA CARR

Kisoro hospital workers braced for an a home drug-delivery initiative so that overwhelming flood of patients. They older patients with chronic diseases knew that the virus responsible for could continue to take their medica- COVID-19 was easy to transmit. And tions and would not have to go to the in a society where six people might sleep hospital-based clinic and risk exposing in one room and go to the market every themselves to COVID-19. day, suppressing COVID-19’s spread was going to require some work. A WINNING COMBINATION Fortunately, a program for han- Einstein and Montefiore’s connection dling this kind of challenge was already with the people of Uganda began two in place, developed over the years decades before the pandemic arrived, by Kisoro District Hospital leaders, with senior medical residents traveling Einstein faculty and students, and the to the western city of Mbarara to super- nongovernmental organization Doctors vise interns and medical students at one for Global Health. Ugandan village of the country’s two medical schools. health workers—people who knew their Gerald Paccione Jr., M.D., a profes- neighbors best and had their trust—had sor of medicine at Einstein, the direc- been trained to deliver medical care to tor of global health education for the people in their homes. primary care and social internal med- Now, they traveled throughout the icine residency program at Einstein region to give half-hour talks using flip and Montefiore, and an internist at charts to explain how COVID-19 could Montefiore, had been traveling around be transmitted and how to prevent the Uganda searching for another commu- illness. Working with four adults at a nity with which to partner on sustain- time, the workers reached more than able local healthcare programs. Kisoro, 14,000 village residents in three months. in Uganda’s southwest corner, fit the bill. “People told us the home talk was Though it is a breathtakingly beautiful the most valuable source for increasing region of mountains and dense forests, it their understanding of COVID-19, is also a place of stark poverty, with per more than what they were hearing on the radio,” says Shombit Chaudhuri, a fourth-year medical student at Einstein Nursing assistants Emilly Betty Niyonshuti, who spent a year in Kisoro as part of a standing at left, and Hadijah Kabaganda, seated at right, wear face masks as they global health initiative. prepare for patient visits at Kisoro

Photo by Aravind Addepalli The village health workers also began District Hospital last summer.

12 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 13 THE POWER OF A PARTNERSHIP

mattresses,” she says. “And families are clinicians pay close attention to their expected to help take care of their rela- patients. “Students learn to rely on their tives while they are in the hospital. On a clinical skills—talking to patients, doing nice day, you will see patients and their a thorough physical exam, using clinical families out on the lawn, sharing a meal reasoning,” Dr. Fung Chaw says. “That’s out of a common pot or doing laundry.” not the type of medicine that is deeply From a clinical standpoint, one of taught in the United States, where we the biggest differences from American emphasize technology—sometimes to the healthcare facilities is the lack of diag- detriment of both students and patients.” nostic tools, says Gloria Fung Chaw, Charles Moon, M.D. ’20, says he M.D. ’08, who spent years in Kisoro as found it valuable to reach a likely diag- a medical student, resident, and faculty nosis based on just the basic information member for the program. available. “Coming back and practicing “We have access to only four or five in U.S. hospitals now, I think I’m much basic lab tests,” says Dr. Fung Chaw, better at that,” says Dr. Moon, who an assistant professor of medicine at worked in Kisoro between his third and Einstein, an internist at Montefiore, and the associate director of the Global Clockwise from top right: Einstein fourth- years Aravind Addepalli and Shombit Health and Clinical Skills Fellowship pro- Chaudhuri take a coffee break; Gloria Fung capita income of less than $2 per day remote villages. (Like Mr. Chaudhuri gram. “The ultrasound is old and often Chaw, M.D., and senior translator Moses and the highest prevalence of chronic and fellow fourth-year medical student out of service. The X-ray machine func- Dushime talk to a group of village health workers; a microscope is used to analyze malnutrition in the country. Aravind Addepalli, some students will M.D. Photos by Aravind Addepalli and Jill Raufman courtesy of Gerald Paccione Jr., tions only if you have film and electric- cell cultures; and a socially distanced Dr. Paccione launched Einstein’s stay for a year.) ity—and we were often without either.” group of village health workers discusses global health partnership with Kisoro The program has grown tremen- The challenging setting demands that COVID-19. in 2005 with help from local hospital dously since its creation 16 years ago. leaders, and since then some 15 Einstein “We’ve invested in developing health medical students and 25 Montefiore resources in the hospital, clinic, and sur- residents have worked in the district rounding communities,” Dr. Paccione every year, closely supervised by Einstein says. “In turn, those communities wel- global health faculty members. come our students, helping ensure that Students and residents first spend a they receive top-notch medical training month at Kisoro District Hospital, the and have an excellent experience. It’s a only public (free) medical facility in the win-win.” (See page 17.) region, with more than 150 inpatient beds, and at the Chronic Care Clinic, LIVING, LEARNING IN KISORO which sees up to 200 patients a day. To prepare for their stays in Uganda, At the Chronic Care Clinic, students students and residents take an inten- and residents work alongside Ugandans sive monthlong global health elective. trained by the program to treat patients Still, says Alyssa Yeung, M.D. ’20, a with hypertension, diabetes, chronic Montefiore obstetrics and gynecology This page, from top left: Gerald Paccione lung diseases, heart disease, neurologic resident who spent much of 2019 in Jr., M.D., rides with Sam Musominali, disorders, and more. Kisoro, walking into the hospital for the Einstein’s site director and head of the Students then spend another month first time was an eye-opener. “Wards village health worker program; Vanice Ntambara, a village health worker, weighs a shadowing village health workers who are large, open rooms lined with basic baby; and a view of the large, open rooms deliver primary and preventive care to bed frames topped with camp-type of Kisoro District Hospital. Photos by Shombit Chaudhuri and Mark Scheflen 14 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 15 MEETING LOCAL HEALTH NEEDS THE POWER OF A PARTNERSHIP Einstein and Montefiore have worked with partners in Kisoro to create an ever-expanding fourth years of medical school and is and most are still on the job. They work, monitored by village health workers array of services: now a resident in pediatrics at Children’s on average, two days a week, educating maintained consistently lower readings Hospital at Montefiore. “I will be a bet- people about topics such as nutrition than patients treated only in the clinic, Community care programs, such as Chronic Disease in ter provider for my patients, no matter and family planning, and monitoring according to a 2016 study published in the Community and the Elders Program, involve village where they are.” discharged hospital patients, the elderly, Health Policy and Planning. health workers who visit senior citizens and those with Dr. Moon is careful not to sugarcoat and those with chronic diseases. Thanks to the low cost of living in chronic diseases at home, saving people the arduous trip the difficulties faced by the villagers “The village health worker program Kisoro, the village health worker program to the clinic. he cared for. “Life is hard there,” he is the foundation for a lot of community manages to operate on a modest budget. says. “People come to the hospital with programs that have been developed,” Dr. On average, village health workers are Women’s health initiatives reduce mortality and foster advanced cases of tuberculosis and rheu- Fung Chaw says. “One of the biggest paid $250 to $300 per year, and Einstein healthier lives for women and their families. The women’s matic heart disease—things you don’t accomplishments of our partnership has and Montefiore participants volunteer clinic and a community outreach program provide treat- see much here in the States. People die been training and supporting Ugandans their time. Einstein supports about ment, screenings for HIV infection and cervical cancer, because of a lack of access to medicines who can provide important health ser- 75% of the cost of student experiences counseling on family planning and domestic violence, and modern surgical care. Sometimes vices, particularly for chronic diseases. through global health fellowships, with postpartum care, and health education. Einstein students there’s little we can do.” They connect with their Ugandan clin- much of the money going to commu- team with midwives to host a popular call-in radio Asked what they liked best about ical supervisors when cases are com- nity projects the students participate in. program focused on women’s health. their time in Kisoro, Drs. Moon and plicated, and the supervisors, in turn, Other funding comes from Karen’s Tots Yeung both cited bumping along steep can take over on-site at Kisoro District Fund (money raised for disadvantaged Nutrition programs feed infants in the pediatric ward and dirt roads on the backs of motorbikes as Hospital or virtually. This is a unique children through friends and family of children in their homes. The programs help up to they accompanied village health workers infrastructure for delivering primary care Dr. Paccione in memory of his sister) and 800 children yearly, and the Ugandan parliament has on home visits. Since 2005, Einstein has and chronic-disease services in a rural Hofstra University, a recent partner in recognized them as one of the country’s most effective trained about 80 village health workers, district where resources are scarce.” the initiative. nutrition initiatives. Einstein and Montefiore’s long-term A MODEL FOR GLOBAL HEALTH collaboration of more than 15 years Treatment for psychiatric disorders, one of the leading The Kisoro village health worker pro- with the people of Kisoro is a model causes of disability in Africa, is made possible. gram could be a model for improv- for what global health can be, says Jill ing health in resource-poor countries, Raufman, M.P.H., M.S., director of A health census collects demographic, medical, and research has shown. It is also a model medical student global health programs behavioral information from people in the surrounding many think would work well in under- and associate director of the Global villages every two years to identify health risks. served areas of the United States, includ- Health Center at Einstein. ing rural communities and urban areas “It’s a key reason why we have been Patients with life-threatening heart conditions are referred such as the Bronx. able to develop successful programs to medical centers outside Kisoro equipped to care for For example, Kisoro-area patients and the infrastructure for healthcare them. Surgeries for up to four patients yearly are sup- with high blood pressure who were delivery. Our current faculty were ported, and the program has a growing waiting list. once Einstein students or Montefiore residents themselves,” she says. Ms. The Follow-Up Project, involving a team of four trained From top: Fourth-year Aravind Addepalli prepares to distribute a box of medication Raufman notes that Einstein will par- staff members, reaches out by motorcycle to reengage with senior translator Moses Dushime; pills ticipate only in global health programs with patients from remote villages who need continuous from the Kisoro Hospital pharmacy; and Jill that are ethical, collaborative, and sus- care but have stopped returning to the clinic—patients Raufman, M.P.H., M.S., director of Einstein’s with tuberculosis, HIV, high-risk chronic diseases, and medical student global health programs, is tainable. “Our Kisoro model fulfills all surrounded by, from left, Christopher Pina, of that,” she says. “Plus the people, who cervical cancer, and malnourished children. M.D. ‘18; fourth-year Sadia Ahmed; Galit open their communities to Einstein’s Benoni, M.D. ‘20; Michael Kornblit, M.D. young doctors in training, give as much Educational scholarships help high school–age orphans ‘20; and fourth-years Akarsh Vijayashanka, Shombit Chaudhuri, Aravind Addepalli, and as or more than they receive. It’s a real and former employees pursue careers in healthcare.

Shahaharyar Ilyas. Photos by Shombit Chaudhuri and courtesy of Jill Raufman partnership.”

16 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 17 The collapse of the Twin Towers forever transformed many lives—including that of an Einstein graduate who experienced a brush with death at Ground Zero. He would go on to look that I soon found out I deserved and replied, ‘Listen up—by federal statute all document the health effects of exposure to World rescue dogs must stop working after four Trade Center dust, help establish a groundbreaking hours unless a veterinarian is present. So you need to get me to the rescue dogs or healthcare program for first responders, and help I’m shutting them down.’” win lifelong federal support for their care. It was a humbling—and eye-opening— moment, he says. “Due to pure igno- rance, I almost wound up shutting the 20 YEARS AFTER BY GARY GOLDENBERG site down,” he says. “Later it occurred to me, ‘The dogs had to be monitored every four hours, but we let human n that impossibly clear the time we’d walked maybe 10 steps, beings work at the disaster site for God blue September morning everybody started running and, instinc- knows how many hours.’ Something to in 2001, David Prezant, tively, I did too. Before I knew it, [the remember.” M.D. ’81, was driving to tower collapsed and] I was blown across Ohis office at Montefiore and listening West Street and landed under a pedes- BRONX BEGINNINGS to the radio when he heard reports of trian bridge, partly covered in rubble.” Dr. Prezant, professor of medicine and a plane hitting one of the World Trade Battered and bruised, he dug himself of epidemiology & population health Center (WTC) towers. His other job, as out and returned to duty, directing a at Einstein and a pulmonologist at deputy chief medical officer for the Fire triage unit on Broadway just east of Montefiore, grew up two blocks away Department of the City of New York Ground Zero. from the Moses campus of Montefiore, (FDNY), required him to respond to He recounts a second story, about an the child of an elementary school major emergencies. He spun around and encounter later that terrible day, when a teacher (his mother) and a high school sped toward lower Manhattan. young woman in hospital scrubs came teacher and administrator (his father). “I arrived downtown shortly after rollerblading over to the triage unit and Science came naturally to their son, the second plane hit and started triaging asked for the physician in charge. and after college at Columbia University first responders and civilians coming “‘I’m Doctor So-and-So, a veterinar- he intended to pursue a Ph.D. in bio- out of the South Tower,” Dr. Prezant ian, and I’m here to help,’” Dr. Prezant chemistry, with designs on a career in recalls. “When debris—and, horrifi- recalls her saying. “I replied something bench research. Yet he couldn’t shake the cally, people jumping—started falling like, ‘We’ve been attacked and I don’t feeling that his talents were better suited near us, Charlie Wells, one of the EMS know how many thousands are dead to medicine. He enrolled at Einstein [emergency medical services] chiefs, told and injured. This is not a time to worry in 1977, less than confident about his In response to tragedy, a groundbreaking research program us to move away from the tower. By about cats and parakeets!’ She gave me a decision. monitors the health of first responders Neville Elder via Getty Images; Michael Foran; Wally Gobetz; Jörg Meyer; Millrock Productions, Inc. via Getty Images Productions, Meyer; Millrock Gobetz; Jörg Neville Elder via Getty Images; Michael Foran; Wally

18 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 19 “For the first two years, I wasn’t a newly opened pulmonologist position, “I have no hobbies. very motivated student—average at only to be told by the then-fire com- best,” he admits. But in his third-year missioner that physicians with military I like working. My clinical rounds, he found an affinity for experience were preferred. Walking out goal is to die at work. pulmonary medicine and intensive care. of the commissioner’s office, he tried one “The ICU [intensive care unit] is last gambit, mentioning that he’d been a Seriously.” very much like working in a lab, with Boy Scout. “And the commissioner goes, lots of data to process, plus the chal- ‘Well, that involves a uniform. Great— — DR. DAVID PREZANT lenge of caring for patients and inter- you’re hired!’” Dr. Prezant recalls. acting with their families—complete Over the years, Dr. Prezant became strangers with whom you form this more and more involved with the incredible bond and who are forever FDNY’s first responders, made up of scarred if the ICU experience doesn’t go EMS providers (paramedics and emer- well,” Dr. Prezant says. “The responsi- gency medical technicians) as well as bility is immense. It was then I began firefighters. That meant treating first to realize how engaging it could be to responders in the field and in the hos- care for patients, and how much of a pital, evaluating new firefighting gear privilege it is.” and personal protective equipment, After Einstein, he began a residency developing new health initiatives—and in internal medicine at Harlem Hospital, gradually winning the trust of the rank preferring to work with underserved and file. populations as he’d done in the Bronx. By 1996, Dr. Prezant had hit his Dr. Prezant returned to the Bronx for stride: He was appointed deputy chief fellowships in pulmonary care and medical officer at the FDNY, was pulmonary research in a joint program placed in charge of the pulmonary at Montefiore and Jacobi hospitals. All clinic at Montefiore and, at Einstein, the while he moonlighted at Harlem took over the second-year course called Hospital, regularly working six or seven Pulmonary, Critical Care, and Disaster days a week—a schedule he still keeps. Medicine, which is now in its 25th year. “I’m the most boring person on Earth,” His professional life was full and rela- he insists. “Other than going to the gym, tively uneventful. And then came 9/11. I have no hobbies. I like working. My goal is to die at work. Seriously.” EXAMINING HEALTH EFFECTS Dr. Prezant escaped Ground Zero with CONNECTING WITH THE FDNY cuts and bruises and a sore back, and In the mid-’80s, Dr. Prezant joined the quickly returned to work. His one lin- Einstein and Montefiore staffs in a role gering complaint was a case of “World that combined clinical research and Trade Center cough syndrome,” an patient care. With a new wife and two all-too-common legacy of the noxious stepchildren to help support, he also mix of asbestos, burning plastics, jet applied for a part-time position with fuel, and other toxins that fouled the the FDNY. He seemed a shoo-in for a air around lower Manhattan for weeks on end. He fully recovered after a few

At left, David Prezant, M.D., at his FDNY months, but many others didn’t, as he

Photos by Jörg Meyer; Andrea Booher/ FEMA; U.S. Navy Meyer; Andrea Photos by Jörg office in New York City. would eventually document.

20 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 21 Following the attacks, Dr. Prezant normal for their ages. work and at home, he reported in Public Treatment Program following passage increase in heart disease among the first and his team—including staffers at the Previous studies of firefighters had Health Reports. of the James Zadroga 9/11 Health responders. Those who arrived first at FDNY and at Einstein, Montefiore, found that the lung-function impair- A 2011 study in The Lancet reported and Compensation Act in 2011) was the site had a 44% higher risk of cardio- and other medical centers—launched ments caused by inhaled pollutants were that firefighters exposed to the WTC expanded in 2012 to include cancer vascular complications than those who the Fire Department’s WTC Medical mild and reversible. The serious lung site were at least 19% more likely than screening and prevention efforts. arrived later in the day. Similarly, those Monitoring and Treatment Program damage inflicted on 9/11 rescue work- their nonexposed colleagues to develop In 2016, the team reported in Mayo who worked at the WTC site for six under a multimillion-dollar grant from ers, the 2010 study concluded, most cancer in the seven years following the Clinic Proceedings that autoimmune dis- months or longer were 30% more likely the U.S. Centers for Disease Control likely stemmed from repeated daily disaster. “We expected we might see an eases had also increased. First responders to have experienced a primary or sec- and Prevention. (See “Teaming Up to exposure to high concentrations of air- increase in cancers after 20 years, but were 34% more likely to suffer from ondary cardiovascular event than those Study First Responders,” page 23.) borne particles and gaseous chemicals. not after just seven,” he says. diseases such as systemic lupus erythe- who worked less time at the site. “We expected an increase in upper The NEJM study was remarkable for The results, Dr. Prezant said at the matosus, Sjögren’s syndrome, and pso- “An important message is that new and lower pulmonary disease and other its findings and for its size and scope. It time, “support the need to continue riatic arthritis than a comparison group chest pain in this group should not health problems,” he says. “But to this remains the largest longitudinal study monitoring firefighters and others who of Midwestern men. automatically be attributed to well- day, I am amazed at the magnitude of of occupational influences on lung responded to the World Trade Center In 2018, Dr. Prezant and colleagues known WTC-related illnesses, such as those issues.” function ever reported. The research- disaster or participated in recovery and published a study in JAMA Oncology, acid reflux or obstructive airway disease. In a 2006 paper in the American ers performed 62,000 spirometry cleanup at the site. This monitoring reporting their findings that firefighters It might very well be associated with Journal of Respiratory and Critical Care (lung-function) tests on nearly 13,000 should include cancer screening and faced an increased risk for developing CVD [cardiovascular disease},” Dr. Medicine—one of the first of more than first responders, or 92% of those present efforts to prevent cancer from devel- myeloma precursor disease, which in Prezant said at the time. 100 attack-related papers in his curric- at the WTC site during the first two oping in exposed individuals.” As he some people leads to the blood cancer ulum vitae—he reported that 9/11 first weeks after the attacks—a testament had recommended, the federal WTC multiple myeloma. AN FDNY ADVOCATE responders lost substantial lung function to the trust that firefighters and EMS Health Program (the new name for A 2019 paper in JAMA Network Before 9/11 and especially afterward, As time went on, in the year following the attacks; they providers had placed in Dr. Prezant the WTC Medical Monitoring and Open linked WTC exposure to an Dr. Prezant saw that his role as an first responders suffered more than 12 times the decline and the WTC Medical Monitoring and expected with normal aging. Treatment Program at FDNY’s Bureau experienced an The largest lung-function decline of Health Services. increasing number of occurred in workers who arrived at “Many people affected by the attacks TEAMING UP TO STUDY FIRST RESPONDERS the WTC site the morning of 9/11, suspected that researchers were the serious WTC-related when the dust cloud was most intense. enemy—that we were just trying to Dr. Prezant has had many collaborators, including: & population health and in the Saul R. Korey health problems. Before 9/11, the FDNY had expanded prove that WTC dust had no lasting Department of Neurology at Einstein its annual medical exams to include health impacts,” Dr. Prezant says. “But The late Thomas Aldrich, M.D., professor of lung-function tests and other critical that wasn’t the case within the FDNY, medicine and director of the Pulmonary/Critical Care Simon D. Spivack, M.D., M.P.H., professor of health measures—a move championed where they realized we were partners, Training Program at Montefiore and Einstein and of medicine, of epidemiology & population health, by Dr. Prezant and one that provided that we would call it the way it is.” the Pulmonary Function Laboratory at Montefiore and of genetics at Einstein and a pulmonologist at crucial clinical baselines for the WTC Montefiore studies and gave them added weight. PTSD, CANCER, HEART David W. Appel, M.D., associate professor of Dr. Prezant and his team described DISEASE, AND MORE medicine and director of the Pulmonary Sleep Center Amit Verma, M.B.B.S., professor of medicine and of findings that were even more disturb- As time went on, first responders expe- at Montefiore developmental and molecular biology at Einstein and ing in a 2010 New England Journal of rienced an increasing number of serious director of hemato-oncology at Montefiore Medicine (NEJM) paper. A significant WTC-related health problems. Krystal Cleven, M.D., assistant professor of medicine portion of FDNY rescue workers who’d In 2010, Dr. Prezant found that and a pulmonologist at Montefiore Mayris Webber, Dr.P.H., professor of epidemiology & experienced acute lung damage still had first-responding firefighters had elevated population health at Einstein not recovered normal lung function a rates of post-traumatic stress disorder Hillel Cohen, Dr.P.H., M.P.H., professor of full seven years after 9/11. For 13% of (PTSD). More than 10% of them had epidemiology & population health at Einstein Rachel Zeig-Owens, Dr.P.H., research assistant the firefighters and 22% of the EMS signs of PTSD four years after the WTC professor of epidemiology & population health providers, lung function was below attack, creating significant difficulties at Charles Hall, Ph.D., professor of epidemiology at Einstein

22 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 23 Firefighter Terrence Jordan, circled, helps carry seriously injured colleague Alfredo Fuentes to safety. Lt. Jordan and Capt. Fuentes are both spot- extended through 2090—essentially (2011) and the American College of ”David’s lobbying lighted in this article, providing lifelong care for health- Chest Physicians’ Presidential Honor and their stories begin skills are legendary on page 26. impaired first responders. Mr. Stewart (2012). got much of the credit, but it could be and were seminal said that Dr. Prezant and other scientists THE GREATEST JOB softened up the hardened lawmakers for Apart from his 9/11 studies, Dr. Prezant in landing the the comedian’s final punch. has played major roles in the FDNY’s Zadroga Act.” “David’s lobbying skills are legend- responses to Hurricane Sandy, the Ebola ary and were seminal in landing the virus, and, most recently, COVID-19. — DR. SIMON D. SPIVACK Zadroga Act,” says Simon D. Spivack, “Dr. Prezant has been an essential M.D., M.P.H., professor of medicine, member of my team during the pan- of epidemiology & population health, demic,” Fire Commissioner Nigro and of genetics at Einstein and a pulm- says. “He has provided daily, and even FDNY physician stretched beyond legislators switched to saying, ‘We don’t matter, to what our patients are suffer- onologist at Montefiore. “He has been hourly, updates to ensure our members medical care into policy and politics—a know how we’re going to pay for this. ing on a daily basis,” he told the Senate a model of highly effective and caring were always armed with the latest infor- challenge he approached with a blend of We don’t know if it’s a priority.’” Committee on Health, Education, medicine, science, and advocacy—a mation and operating with the highest empathy and science. In 2008, Dr. Prezant testified before Labor & Pensions. He went on to very challenging juggling act. We are level of personal protective equipment.” “I’m especially proud of our transi- the U.S. House of Representatives’ describe one such sufferer: truly fortunate to have him as part of In his teaching role at Einstein, Dr. tion from compassion-driven advocacy Appropriations Committee on behalf “On 9/11, when the Twin Towers the Einstein community.” Prezant over the years has mentored to data-driven advocacy,” he says. “The of what is now called the WTC Health were burning, FDNY firefighters ran Dr. Prezant “has always been a almost three dozen epidemiologists, idea was that knowing what went on Program. After listing the many health into those buildings. By the time the tireless advocate for the health and biostatisticians, and pulmonary fellows down there on 9/11 would result in the issues plaguing the first responders, he second plane hit, most realized that safety of every FDNY member,” says in his lab. And for one month each right treatment for our responders and told the representatives that a com- this was not going to be just a fire; this Fire Commissioner Daniel A. Nigro. year, he supervises the training of young would enable us to advocate better for mitment to long-term funding was was an attack. And yet they continued “Through his work with the WTC doctors in pulmonary and critical care government support. Eventually all that needed “to ensure that we can continue to run in. I have a patient who told a Health Program, he has honored the medicine at Montefiore. came true, but not without a struggle. necessary treatment, monitoring, and younger firefighter, ‘You go left, I’ll go memory of all those innocent lives taken “When I joined Dr. Prezant’s And while we now have cancer covered, research into the future. As we know right.’ That younger firefighter died. on Sept. 11 and fought for the health of research team in 2008 as a newly we are still working on getting certain in environmental-occupational med- And that older firefighter, because of FDNY members—and really, every first minted epidemiologist, I knew I autoimmune diseases covered under the icine, there is often a significant lag that decision, feels he was responsible responder—who bravely served in the could make a difference under his federal WTC Health Program.” time between exposure and emerging for that firefighter’s death. He woke up rescue and recovery effort at the World leadership,” says Rachel Zeig-Owens, As early as 2002, Dr. Prezant began diseases. … The actual effect of the dust every night screaming for the first six Trade Center. His work has been key Dr.P.H., research assistant professor of lobbying members of Congress for and debris that rained down on our months. And now he wakes up scream- to ensuring early intervention for our epidemiology & population health at money to care for 9/11 first responders. workforce on 9/11 may not be evident ing less, but still so often that his wife members battling illness and in prov- Einstein, director of epidemiological “During those first trips to the Hill, for years to come.” sleeps in a separate room. That’s not the ing that funding is needed to care for research at the FDNY’s WTC Health naysayers in the hearing rooms would He testified again in 2010, this time way things should be.” the men and women who sacrificed so Program, and a co-author on many tell us, ‘Oh, they have symptoms and in support of the proposed Zadroga Act, Soon after, comedian Jon Stewart much to protect our city.” of Dr. Prezant’s papers. “But I didn’t our hearts go out to them, but most which would provide more funding for dedicated an entire episode of The Daily In 2010, Dr. Prezant was appointed know that 13 years later I’d still be at it people with symptoms will get over it,’” health monitoring and financial aid for Show to the Zadroga Act, more or less the FDNY’s chief medical officer and with a colleague who truly cares about Dr. Prezant says. “But starting in 2006, the first responders, volunteers, and sur- shaming Congress into passing the pro- special adviser to the fire commissioner his patients, his collaborators, and the after we had strong objective evidence, vivors of the attacks. posal, which President Barack Obama on health policy. He is responsible research as a whole.” no one doubted that the first respond- “These healthcare findings—they signed into law in January 2011. Four for the WTC Health Program at the Dr. Prezant still cares for patients ers were actually suffering. Then the really don’t speak to the heart of the years later, the act was reauthorized and FDNY, its Bureau of Health Services, (see firefighter profiles starting on next and its Office of Medical Affairs. His page). “That’s what I live for,” he says. 9/11 studies earned him the American “Being a physician is, without a doubt,

Millrock Productions, Inc. via Getty Images; U.S. Navy Productions, Millrock Thoracic Society’s Public Service Award the greatest job on the planet.”

24 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 25 avalanche of debris broke nine of his ribs, THE ONES WHO RAN collapsed his left lung, scorched his air- way, fractured his skull, and nearly tore TOWARD DANGER off his scalp. Somehow, he managed to radio for help. FDNY rescuers, including Studies assessing the health of 9/11 first responders Lt. Terrence Jordan (page 28), dug him out from the rubble and sent him to a conducted over the past 20 years are driven by data Jersey City, New Jersey, hospital, where and as a result are inherently dry and impersonal. Yet he was put into a medically induced such studies can have profound effects—on health coma for two weeks. Meanwhile, the FDNY’s then-deputy policy as well as on the health of the people studied. chief medical officer, David Prezant, M.D., Here are the stories of three World Trade Center first who was recovering from his own 9/11 wounds, arranged for Capt. Fuentes to be responders, whose health data was used to inform transported to Montefiore, where it was studies performed by David Prezant, M.D., and who thought he’d get better care. One of Capt. Fuentes’ first requests benefited from their findings. The three men ran on awakening was to see the FDNY toward Ground Zero while most others fled, but they chaplain, the Rev. Mychal Judge, a close paid heavily for their heroism. friend. “I said, ‘I need to talk to some- body, about the people jumping and everything.’” When his wife started cry- A DAY OF TWO Miraculously, Fuentes emerged ing, Capt. Fuentes knew that Rev. Judge unscathed, ready to resume his duties. hadn’t survived. ‘HAIL MARYS’ He then heard that people were trapped Then came news of the death of his inside the Marriott Hotel, and he joined friend and colleague FDNY Deputy n the span of 29 minutes on 9/11, the rescue efforts there. Standing in the Chief Ray Downey, who was near him Capt. Alfredo Fuentes, the acting middle of the street, he used hand sig- when the North Tower collapsed. It was Ichief of the marine division of the nals to let the other rescuers know when more than he could take. Fire Department of the City of New debris from the North Tower had tem- York (FDNY), escaped death not once porarily stopped falling and it was safe but twice. to evacuate people from the hotel. His first brush with mortality When one group struggled to make occurred at 9:59 a.m. While await- its way across the street, Fuentes started ing orders at a command post next to toward them—and then at 10:28 a.m. Ground Zero, the then-50-year-old came a second roar. “I looked up and Capt. Fuentes noticed that the South the North Tower was collapsing,” he “I bent down, put my Tower had begun to buckle. He warned says. “I couldn’t run because of all the his colleagues and then sprinted into rubble. I just bent over, covered my hands over my head, an underground parking lot. “There head, said the ‘Hail Mary’ again, and and said the ‘Hail Mary’ was a noise like an oncoming freight got ready for the hit.” train, and everything turned black,” because I thought it he remembers. “I bent down, put my RESCUED FROM THE RUBBLE was over.” hands over my head, and said the ‘Hail That was Capt. Fuentes’ last memory Capt. Alfredo Fuentes at Montefiore,

Mary’ because I thought it was over.” of 9/11—which is just as well. The where he was treated for his injuries. Meyer Photo at right by Jörg — CAPT. ALFREDO FUENTES

26 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 27 STILL STRUGGLING Lt. Jordan, then in his early 40s found Capt. Fuentes, pulled him from Sept. 11 would be Capt. Fuentes’ last and a member of the FDNY’s Marine the rubble, administered first aid, and day on the job. In the months that fol- Company 9, was on Randall’s Island for carried him to the docks for transport lowed, he underwent numerous surger- compulsory training when the planes across the Hudson River to a New Jersey ies and procedures—more than he can hit the towers. He made his way to the trauma center. remember. He spent the better part of Brooklyn Navy Yard, commandeered a Lt. Jordan returned to the debris piles a year confined to a recliner because of boat named (of all things) Smoke, loaded to search for more survivors. “We’d find inner-ear damage that had compromised it with medical supplies, and raced at an arm or a leg,” he says. “It was hor- his balance. He’s still recovering 20 full throttle to the North Cove Marina rible.” A few people were found alive, years later, struggling with lung disease, near Ground Zero, arriving shortly after and so he pressed on, staying on site for chronic sinusitis, and memory loss. the buildings collapsed. three straight days. “With help from the World Trade “The air was filled with an incredi- His own troubles started on day one, Center Health Program and Dr. Prezant, bly thick cloud of dust—you couldn’t with an asthma-like attack. Lt. Jordan we’re keeping everything at bay,” see two feet in front of you,” Lt. Jordan gulped a few mouthfuls of bottled says Capt. Fuentes, who was born in recalls. He had bypassed his firehouse oxygen, caught his breath, and rejoined Ecuador and lives in Woodside, Queens. and so hadn’t brought his mask and res- the rescue effort. More asthma attacks “Dr. Prezant sees me once or twice a pirator. That hardly mattered to him in followed, prompting him to contact Dr. year, goes over my case, and makes the heat and dust of the moment—espe- Prezant, who implored him to come for sure I get to the right doctors. I have to cially after overhearing radio calls from testing at the first opportunity. credit him for the quality of life that I a fellow FDNY mariner, Capt. Alfredo “I made him promise he wouldn’t put have now.” Fuentes, who was buried somewhere me on medical leave,” says Lt. Jordan. Capt. Fuentes has every right to be under the rubble (page 26). “There was so much work to be done.” bitter about the day that cost him so But when Lt. Jordan went for testing much, but he sees only the good that A SEARCH FOR SURVIVORS a few days later, the news was grim. His came of it. “What I witnessed that Moving through the eerie quiet, Lt. lungs were severely damaged, probably day was incredible, the way people Jordan and his team followed the peri- beyond repair. “Dr. Prezant told me, responded, and not just the firefighters odic beeps of fire safety equipment pro- ‘Terry, you won’t be going to another but also the civilians. I can’t say enough grammed to emit a distress signal when fire. You’ll have to retire.’” about the City of New York and the the wearer stops moving. The rescuers country,” he says. TETHERED TO A TANK “Who’s got it better than me?” he Twenty years of service in the FDNY asks. “I survived. I got to see my wife were followed by 20 years of pain and and family and my grandson.” suffering. Since 9/11, Lt. Jordan has struggled with chronic obstructive pulmonary disease, severe emphysema, bronchitis, and asthma. In 2010 he had ‘I’M LUCKIER THAN a stroke, which partially paralyzed his “The air was filled with right side. “I go to more doctors than SO MANY OTHER you could imagine,” says Lt. Jordan, an incredibly thick cloud PEOPLE’ who is tethered via a tracheal tube to an of dust—you couldn’t oxygen tank 24 hours a day. “It’s like I’m ike thousands of other first 140 years old.” see two feet in front responders, Lt. Terrence Jordan Yet he remains remarkably upbeat. of you.” of the FDNY would never be the Lt. Terrence Jordan on a visit to the 9/11 “I have my issues,” says Lt. Jordan, the

L Meyer photo at right by Jörg Jordan; Photo on this page by Theresa same after 9/11. Memorial in Manhattan. father of seven. “But I’m in reasonably — LT. TERRENCE JORDAN

28 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 29 good shape because of the World Trade “It was pure madness, like a scene me two years of therapy to come to Center Health Program and Dr. Prezant, out of the movie M*A*S*H,” he says. terms with it.” who stays on top of my health. Just this “We identified the first 20 bodies by As fall turned to winter, Mr. Tinney past November, I had another breath- sight, because we had worked with these came down with bronchitis, which ing episode, and he treated me over the guys before.” The remains kept arriving persisted for months. A scan adminis- phone for 10 weeks until it resolved. He at the morgue, body part after body tered the next spring picked up a small never gives up.” part. A total of 343 firefighters died nodule in his left lung. Dr. Prezant And neither does Lt. Jordan. Three that day. recommended that Mr. Tinney undergo years after his stroke, he participated Mr. Tinney stayed at the morgue for periodic scans to keep a close eye on in the annual Stephen Siller Tunnel-to- five days, until Charles Hirsch, M.D., the growth. Towers Run & Walk, pushing a walker the chief medical examiner, threatened with a battery-powered oxygen concen- to have him physically removed if he A BATTLE WITH LUNG CANCER trator. After last December’s nor’easter, didn’t go home. Seven years later, soon after he retired, he could be found clearing the driveway “I gave the neighbors a free show,” Mr. Tinney was told that the growth on of his Floral Park, Long Island, home he says. “I took off all my clothes on the his lungs looked suspicious and would with a snowblower, over the objections front steps, walked into the house, and have to be removed. “Let the dance of his wife and neighbors. And he still showered. After I started shaving my begin,” he said, the fight still left in the rides his motorcycle. beard, which had absorbed the smell firefighter. “I don’t want my life to be defined of death, I looked in the mirror and A biopsy confirmed that the growth by a terrorist incident,” he says. “I have broke down.” was cancerous, and a surgeon success- a pretty good life. I just had my ninth fully removed it from Mr. Tinney’s lung. grandchild. I never would have seen any WORKING ON THE ‘PILE’ But his ordeal was just beginning. of my grandchildren had I not survived Mr. Tinney soon returned to duty and After enduring several rounds of 9/11. I’m luckier than so many other spent the following weeks shuttling chemotherapy for the lung cancer, people.” back and forth between the morgue and Mr. Tinney went into renal failure. the “pile”—the term coined by rescue Then his immune system crashed, workers to describe the 1.8 million tons and he was prescribed an experimental ASSIGNED TO of smoldering debris left from the tow- immune-boosting therapy that saved his ers’ collapse. He didn’t wear a mask or life. Next came 36 rounds of radiation THE MORGUE respirator. “We were told [by the U.S. therapy aimed at eliminating any linger- Environmental Protection Agency] that ing cancer in his chest. ne thing was clear after the air was fine,” he says. All the while, Mr. Tinney strove to both World Trade Center It wasn’t, of course, and neither was live as fully as possible, indulging in towers collapsed on 9/11: Mr. Tinney. “Every morning, I’d walk his passions of photography and travel, The tragedy would claim over to my kitchen window, where I including journeys to Vietnam, Kenya, “It was pure madness, like Othe lives of many firefighters. Fire could see the smoke from the towers— and Namibia. That all came to a halt Marshal Conrad Tinney of the FDNY and I knew I had to go down there,” last year, and not just because of the a scene out of the movie was dispatched to the chief medical he says. pandemic. His “good” lung started examiner’s office in Manhattan later Three months in, disobeying direct filling with fluid, which doctors found M*A*S*H. We identified that day to expedite the handling of the orders, he reported to headquarters was the result of lymphoma. The dance the first 20 bodies by sight, remains. Mr. Tinney had seen his share instead of to the pile—no small decision continues. of death and destruction as a Navy sailor for a person in uniform. “I told them I “I’m still here,” Mr. Tinney says. because we had worked in Vietnam and then as a firefighter in just couldn’t take it anymore—that the “You have to look at the good part of it. with these guys before.” New York. Yet nothing he’d experienced human mind is not meant to handle People ask, ‘How’s your day?’ and I say,

had prepared him for the task at hand. such traumatic events,” he says. “It took ‘I got up this morning.’” Meyer Photo by Jörg — FIRE MARSHAL CONRAD TINNEY

30 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 31 THE

ueting “Hattie” Zhang, a second-year medical student at X Einstein, was intrigued but ner- vous. She was looking for a way to help out during the pandemic, and an email announcing a new summer educational offering had just popped up on her com- CHALLENGE puter screen. Called the “COVID-19 Design Challenge,” it asked students to Students from Einstein team up with CUNY engineering students devise innovative solutions for mak- ing healthcare workers and the public to create better ways to protect people during future pandemics safer in a future wave of COVID-19 or another infectious disease. And it gave BY TERESA CARR them just eight weeks to do it. “I wanted to register for it, but I was worried that if my design required engineering, I wouldn’t have the skill that was needed,” she says. Then she learned that participants would work in multidisciplinary groups that included engineering students from the City equipment (PPE) for healthcare workers “If motivated, interested, University of New York (CUNY). So hadn’t progressed much over the years. and excited students get she took a deep breath and signed up— “This moment seemed like an opportu- along with 16 others from Einstein, nity to reframe what’s really important together to work on a including medical students and Ph.D. during an outbreak—not just PPE, but challenge from different candidates, all eager to help fight a virus all the challenges we were facing—and that was ravaging the Bronx. get some really bright minds to think vantage points, good “If motivated, interested, and excited about it,” Dr. Cassese says. things will happen.” students get together to work on a While Einstein students had the challenge from different vantage points, medical know-how, Dr. Cassese realized — DR. TODD CASSESE good things will happen,” says Todd that engineering expertise would also Cassese, M.D., associate dean for med- be needed. Since Einstein already had a ical education, an associate professor of relationship with CUNY with existing medicine at Einstein, and a hospitalist at master’s of public health and Centers for Montefiore. “These types of experiences AIDS Research programs, it seemed like can be transformational.” a good place to start. Dr. Cassese pitched the idea of a OPPORTUNITY AMID CRISIS design challenge to the dean of the The idea to create a design challenge Grove School of Engineering at the City arose from conversations between Dr. College of New York/CUNY, where Cassese and Joshua Nosanchuk, M.D., Sabriya Stukes, Ph.D., caught wind of senior associate dean for medical educa- it. Dr. Stukes, who earned her doctoral Above, Einstein second-year medical tion at Einstein and an infectious- degree in microbiology and immunol- students Kevin Batti, left, and Hattie Zhang examine an N95 mask while diseases clinician at Montefiore, about ogy at Einstein in 2014, is the asso- collaborating on the COVID-19 Design how designs for personal protective ciate director of CUNY’s master’s in Challenge.

32 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 33 THE DESIGN CHALLENGE

translational medicine (MTM) program. it came to implementing our design, at Columbia University; and Lawrence Other winning ideas included two “MTM blends engineering, science, and we decided that simplicity was our best Levy, former chief financial officer of safer ways for healthcare workers to business concepts to teach scientists and friend,” Mr. Batti says. The team soon Pixar Animation Studios. deliver oxygen to patients and a method engineers how to design and commer- crafted a working prototype from inex- “I was so impressed by the creativ- for disinfecting taxis and car services to cialize medical technologies,” Dr. Stukes pensive parts ordered from Amazon. ity and the breadth of products—from reduce virus transmission. Members of explains. “So it felt like a very good fit.” “We were excited to arrive at some- things people could use in daily life to the winning teams are using the money Faculty members from Einstein and thing we felt could actually scale and go specific medical equipment to help pro- given to them to revise their prototypes CUNY then divided students into 10 to market,” Mr. Batti says. tect frontline workers,” Dr. Rhim says. and file patent applications. teams, with most containing a mix of “The high quality of the projects made it Ultimately, the first-ever design engineering and medical students. Each IDEAS WITH LASTING IMPACT difficult to decide on the finalists.” challenge also exceeded the expecta- team’s goal was to identify an unmet When the eight-week challenge was up, While proud of their design, Ms. tions of those who had created it. “The public health need and come up with each group presented its project to a Zhang and Mr. Batti didn’t expect to be degree of innovation really surprised a possible solution. There was also an panel of five experts. The judges from among the finalists. “I didn’t think we me,” Dr. Cassese says. But he says the incentive: Winning teams would be Einstein were Peter Bernacki, senior would win because everyone in the com- primary goal of the course was to enrich invited to submit a budget to develop director of business services, and Helen petition was really impressive—talented students’ educational experiences. “We

and refine their concepts and could be Photos by Jason Torres Rhim, M.D., M.P.H., director of educa- and smart,” Mr. Batti says. “We were think about how we can give learners awarded up to $5,000, paid from an Einstein medical student Hattie Zhang discusses design modifications with other tional innovations in the office of medi- going up against some amazing stuff like the tools and confidence to pursue ways Einstein educational fund for curricu- members of her team on a videoconference call. cal education and the fellowship director new types of ventilators.” Much to their to improve our healthcare system and to lum innovations. for pediatric hospital medicine at surprise, their face-mask device earned help their patient community, to really Initially, many medical students wor- FROM PAPER TO PROTOTYPE “Teamwork is so crucial Children’s Hospital at Montefiore. Other the top score among the four groups make a difference,” he says. “By that ried about their technical skills, while Ms. Zhang’s team included fellow to being a healthcare judges were Lola Brown, Ph.D., assis- chosen as finalists. measure, the design challenge was an the engineers felt they lacked medical second-year Einstein medical student tant dean for research at Weill Cornell “An important takeaway for the incredible success.” training. “The light-bulb moment was Kevin Batti and three CUNY engineer- provider. ... We can Medicine; Aaron Kyle, Ph.D., a senior students is that sometimes the simplest Dr. Rhim wholeheartedly agrees. when they realized that wasn’t a weak- ing students. The challenge they chose teach our students facts, lecturer in biomedical engineering design ideas are best,” Dr. Stukes says. “Teamwork is so crucial to being a ness,” Dr. Stukes says. “They found they was reducing healthcare workers’ risk of healthcare provider,” she says. “That could work across disciplines and admit, exposure to the coronavirus when put- but we need them to application phase is so important to ‘I don’t know about this, but here’s what ting on, taking off, or storing their PPE. be able to apply them what we are trying to achieve in the I do know, and I am willing to learn.’” The pandemic required the team medical school curriculum. We can CUNY engineering faculty created a members to discuss their concepts on at the bedside and in teach our students facts, but we need curriculum that taught students how to videoconference calls. “It was definitely innovative research.” them to be able to apply them at the sift through possible solutions, develop tricky, not being able to pass around bedside and in innovative research.” prototypes, make an initial proposal, tangible objects such as masks,” Mr. Ms. Zhang, who wants to special- — DR. HELEN RHIM build a business case, and craft a compel- Batti says. “We’d hold drawings up to ize in internal medicine, says that she’s ling narrative about their technology. the camera and point.” excited about tackling more problems. Einstein brought in experts with At the first meeting, Ms. Zhang came “This experience showed me that I don’t medical backgrounds, including pul- up with what she recalls as “a very rough have to be an engineer or a coder to be monologists, who explained how ven- idea”: a device for allowing people to an innovator. I can do it with everyday tilators work, and microbiologists and efficiently and safely put on and take off projects, and I can find a great group of infectious-disease experts, who covered face masks while minimizing the risk of people to help perfect my idea.” molecular virology. “There’s no way contamination. One of the engineering Mr. Batti, who hopes to become an this would have happened without the students then sketched a design on paper. orthopedic surgeon, agrees. “Realizing generous donation of time and energy The team kept returning to Ms. you can take an idea from a vision to a from a series of experts in engineering, Zhang’s concept for several weeks— tangible product is really cool,” he says. Members of the winning Design Challenge team convene via videoconference. They entrepreneurship, design, science, and only to abandon it in favor of devising are, clockwise from top left: Renato Vilca Valderrama of CUNY, Hattie Zhang of Einstein, “I feel like I can go on to improve opera- medicine,” Dr. Cassese says. something more impressive. “But when Oliver Brannigan of CUNY, Kevin Batti of Einstein, and Andrea Ozuna of CUNY. tions in the future.”

34 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 35 36 EINSTEIN :WINTER/SPRING 2021

Illustrations: ©Tatyana Starikova Harris O Gut Reactions BY GARY GOLDENBERG is resistant tomanyantibiotics,causes with cleared herlungsbutleftinfected with aboutofpneumonia.Antibiotics enterologist at Montefiore. atEinstein andagastro- and ofsurgery Brandt, M.D.,professor ofmedicine tion cametotheofficeofLawrence J. with adevastating intestinalinfec- patient happened in1991,whenanew moment onthespot. Yet that’s what a physiciantocomeupwitheureka ill patienttopleadforhelp, it’s rare for resort. Is there anythingyou coulddo?” me.I’mruining comingtoyou asalast account, it’s mysociallife,it’s ruining “Doctor, mybank thisdiseaseisruining range ofhealthproblems—some extremely serious. speciescontributetoawide disturbances inthelevels ofcertain us againstpathogens. While mostgutbacteriacausenoharm, those thatsynthesize folateandothervitaminsorthatprotect species. Some usefulfunctions,suchas ofthosespeciesperform mated 38trillionbacterialcellsbelongingto5001,000 sickle celldisease,diabetes,obesity, andmore to goodhealth—andthatalteringitmayhelptreat that theintestinalmicrobiome may holdthekey Einstein andMontefiore researchers are finding The elderlywoman’s problems started While it’s commonfor aseriously , a gut bug that Clostridioides difficile,agutbugthat in us.Our gutmicrobiome alonecontainsanesti- fungi,andothermicrobes livingonusand viruses, ur microbiome consistsofavast arrayofbacteria, seemed. Days later, Dr. Brandt tooka the therapy, oddthough itmayhave his stoolandputtingitinyour colon.” replace whatyou lostby takingsomeof in hisgutasyou had.Maybe we could years] wholikelyhasthesamebacteria right nexttoaguy[herhusbandof50 were protecting you. But you’re sitting thing tothebacteriainyour gutthat ment. “Ithinktheantibioticsdidsome- patient aftershe’d explainedherpredica- was halted. soon asthewoman’s antibiotictreatment panying diarrheawouldbothreturn as commonly referred to,andtheaccom- colon, andisoftenlethal.C.diff,asit severe diarrheaandinflammationofthe The coupleimmediatelyagreed to “I have anidea,”Dr. Brandt toldhis MAGAZINE.EINSTEINMED.ORG MAGAZINE.EINSTEINMED.ORG

37 37 stool sample from the woman’s hus- among nursing home residents. Roughly band, diluted it, and used a colonoscope a half million people in the United to inject the solution into her colon. States are affected annually, with a recur- “She called me at home that night and rence rate of about 20%, leading to an said, ‘I don’t know what you did, but estimated 29,000 deaths each year. I haven’t felt this good in months,’” The U.S. Food and Drug remembers Dr. Brandt. “She never had a Administration (FDA) still classifies recurrence.” FMT as an investigational procedure Only later did Dr. Brandt learn but allows its use for patients with that his “novel” therapy—now known C. diff who do not respond to conven- as fecal microbiota transplanta- tional treatment. (In November 2019, tion (FMT)—actually dates to the the FDA hosted a meeting to obtain fourth-century Chinese healer Ge public input on the state of the science Hong. He touted fecal material for food regarding FMT, which could lead the poisoning or severe diarrhea in Handy “She called me at home agency to reclassify the therapy.) Therapy for Emergencies, China's first that night and said, 'I The FDA’s limitations aside, the handbook of emergency medicine. major barrier to wider FMT use is the The Western experience with FMT don't know what you did, therapy’s “yuck” factor. can be traced to 1958, when Ben but I haven't felt this “In our society, stool is seen as Eiseman, M.D., a Colorado-based something dirty,” says Dr. Brandt. “We Lawrence Brandt, M.D., checks on the surgeon, used fecal enemas to cure four good in months.’” make light of it with scatological humor. C. diff under control,” he says. “It’s quite image clarity of an endoscope before beginning a procedure at Montefiore. patients with infectious colitis. Despite When I tell people I’m infusing stool as a another to treat younger patients with these and several other treatment suc- — DR. LAWRENCE BRANDT medical treatment, they laugh and think non-life-threatening conditions. We cesses, FMT garnered little attention I’m crazy.” He’s now encouraging the don’t know if FMT may set them up for until decades later, when Dr. Brandt field to rechristen the treatment as IMT, other problems later in life.” starting curing his Montefiore patients cured after two treatments, for an overall for intestinal microbiota transplant. FMT may work for other condi- who suffered from recurrent C. diff. cure rate of 94%, as reported in the “It is the microbiota that is trans- tions as well. Researchers are currently Journal of Clinical Gastroenterology. planted … not feces!” he wrote in a studying the technique in Crohn’s IN SEARCH OF A MECHANISM How does FMT work? “C. diff and recent issue of the American Journal of disease, ulcerative colitis, irritable bowel The first clinical trial of FMT occurred the antibiotics used to treat it reduce the Gastroenterology. “The term ‘fecal trans- syndrome, obesity, diabetes, Parkinson’s in 2013, when researchers in Amsterdam diversity of bacteria in the gut,” says Dr. plant’ is often puzzling to patients and disease, and autism. compared FMT with antibiotic therapy Brandt. “FMT immediately restores this awkward for providers.” in patients whose C. diff infections had diversity and prevents disease-causing In the meantime, Dr. Brandt THE MICROBIOME, relapsed after one round of antibiot- bacteria from infecting and colonizing cautions that physicians prescrib- METABOLISM, AND COVID-19 ics. FMT cured 15 out of 16 patients, the GI tract.” But how? ing FMT should obtain microbiota To a great extent, obesity and type 2 dia- while antibiotics cured just 7 out of 26, “We know that FMT works, but not from rigorously tested sources, such betes result from what we put into our according to a report in the New England the mechanism responsible,” Dr. Brandt as OpenBiome, a nonprofit stool stomachs. Our microbiome also has a Journal of Medicine. Every patient in the acknowledges. “We think the benefits bank, to reduce the risk of transmit- major influence—and is itself influenced antibiotics group who relapsed was sub- result from the presence of metabolic ting disease-causing microbes—a rare by a third variable: acculturation. Where sequently cured with FMT. products of bacteria found in healthy but potentially deadly complication. we were raised appears to influence our Dr. Brandt co-led a clinical trial stool that maintain and regulate our Another worry: No one knows the long- microbiome and hence our risk for met- in 2014, also involving patients with metabolism.” term consequences of using FMT to abolic disease. antibiotic-resistant C. diff. A single Better treatments for C. diff are manipulate the gut microbiome. Research at Einstein on the accultur- FMT treatment produced lasting cures certainly needed. C. diff infections are “It’s one thing to treat older patients ation connection can be traced to 2016, in 15 of 17 patients, and a 16th was growing at an alarming rate, particularly who might die if they don’t get their when the National Institutes of Health

38 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 39 GUT REACTIONS The

“The question is, awarded Einstein researchers a five-year, immunology, of pediatrics, of obstet- $3.9 million grant to investigate the role rics & gynecology and women’s health, Microbiome how do you make of the gut microbiome in type 2 diabe- and of epidemiology & public health favorable changes tes among Hispanics and Latinos—the at Einstein, and a pediatric geneticist at Facts & Figures fastest-growing segment of the U.S. pop- Montefiore. to the microbiome? ulation—enrolled in the long-running Robert Kaplan, Ph.D., the other With probiotics? With Hispanic Community Health Study of co-principal investigator of the HCHS/ Latinos (HCHS/SOL). The study has SOL gut microbiome study, notes that TYPES OF MICROBES IN THE regular foods? With been following 16,000 participants ages its findings also suggest that manipulat- MICROBIOME: BACTERIA, 18 to 74 since 2010, and Einstein is one ing the gut flora could help in treating medications?” VIRUSES, FUNGI, ARCHAEA, AND of four HCSH/SOL sites nationwide. or even preventing metabolic diseases EUKARYOTES — DR. ROBERT KAPLAN The Einstein researchers analyzed such as type 2 diabetes—which usually the microbiomes of more than 3,000 results from obesity and is especially adult HCHS/SOL participants who common among Hispanics, who have either were born here or came to the a 66% higher rate of diabetes than United States later in life. In a study non-Hispanic U.S. whites (11.8% ver- WEIGHT OF NUMBER OF BACTERIA IN THE HUMAN GUT: published in 2019 in Genome Biology, sus 7.1%). “The question,” he says, “is THE HUMAN they reported that the composition of how do you make favorable changes to MICROBIOME: people’s microbiomes was related to the microbiome? With probiotics? With 38 TRILLION their degree of acculturation. People regular foods? With medications? These who relocated to the United States at an are all things to be learned in the years NUMBER OF CELLS IN THE HUMAN BODY: early age had a lower diversity of intesti- ahead.” Dr. Kaplan is also a professor nal microbes compared with those who of epidemiology & population health, 0.44 relocated after age 45. the Dorothy Manealoff Foundation and 30 TRILLION

Acculturation’s influence on the Molly Rosen Chair in Social Medicine, POUND microbiome may have major health and the principal investigator for the implications. The study found that HCHS/SOL at Einstein. PROPORTION people with lower microbiome diversity Earlier this year, Carmen Isasi, M.D., OF THE MICROBIOME LOCATED IN were more likely to be obese (a major Ph.D., the co-principal investigator for “MICROBIOME” WAS COINED IN 2001 diabetes risk factor), which is consis- the Einstein HCHS/SOL site, took the THE G.I. TRACT: BY THE NOBEL tent with results from other studies. In lead in rapidly redesigning the entire JOSHUA LEDERBERG, addition, a reduced ratio of Prevotella HCHS/SOL project to encompass the PRIZE–WINNING MICROBIOLOGIST, “TO SIGNIFY THE to Bacteroides bacteria was significantly COVID-19 pandemic. ECOLOGICAL COMMUNITY THAT LITERALLY associated with obesity among the “We have already begun collecting SHARES OUR BODY SPACE AND HAS BEEN ALL BUT HCHS/SOL participants—a link not data on our study participants’ COVID- >99% IGNORED AS DETERMINANTS OF HEALTH AND DISEASE.” seen in other populations. 19-related diagnoses and hospitaliza- “These findings from our study are tions, including how the pandemic has important since they tie population- affected them personally from a health, specific microbiome associations to clin- emotional, and employment stand- NUMBER OF GENES IN HUMANS: ical outcomes,” says Robert Burk, M.D. point,” says Dr. Isasi, who is an associate He is the co-principal investigator of the professor of epidemiology & population HCHS/SOL gut microbiome study and health and of pediatrics at Einstein. 20,000–25,000 also vice chair for translational research That effort also includes analyzing stool in the department of pediatrics, pro- specimens to determine whether the gut NUMBER OF GENES IN HUMAN MICROBIOME: fessor of medicine, of microbiology & microbiome—which can profoundly >8 MILLION 40 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 41 GUT REACTIONS affect the immune system—influences hemoglobin become sickle-shaped and “What was most penicillin for at least six months) to com- pare the microbiomes of the children the body’s response to SARS-CoV-2, the less flexible, which causes them to clog surprising and exciting coronavirus that causes COVID-19. small blood vessels, triggering attacks while they were taking penicillin and “We could be dealing with the effects of severe pain called sickle cell crises, or was that the antibiotics after they stopped taking the antibiotic. Dr. Frenette is also trying to under- of COVID-19 long after this pan- vaso-occlusive episodes. These episodes greatly reduced chronic demic is over,” Dr. Kaplan says. “We’re cause major organ damage over time stand how the microbiome combines hopeful that our ongoing HCHS/SOL and contribute to the decreased life tissue damage in the with psychological stress to cause sickle cell crises. Using a mouse model of trial—and its recent redesign to study expectancy (now in the mid-40s) of spleen and liver.” the intersection of the gut microbiome, people with SCD. SCD, he has found that the path to COVID-19, and overall health—can In 2002, Dr. Frenette found that sickle cell crises begins in the brain. — DR. PAUL FRENETTE shed light on risk factors that can lead SCD vessel blockages occur when sick- Stress triggers the secretion of hor- to long-term complications and on what led red cells bind to neutrophils (a type mones in the brain that travel to the gut can be done to prevent them.” of white cell) that have adhered to the and increase its permeability. The greater In addition to his gut microbiome vessel walls. “This early work indicated permeability allows gut microbes known research involving HCHS/SOL par- that not all neutrophils are the same,” as segmented filamentous bacteria to ticipants, Dr. Burk is investigating the says Dr. Frenette. “Some appear to be interact with immune cells, which are role of microbiomes in health problems inert while others appear overly active stimulated to produce pro-inflammatory including human papillomavirus (HPV) in promoting inflammation—which is molecules that enter the bloodstream. infection, osteosarcoma (a pediatric useful for attacking microbes but causes These molecules promote the aging and bone cancer), kidney stones, HIV infec- neutrophils to capture sickled red cells accumulation of neutrophils that drive tion, and cognitive impairment. inside vessels, leading to blockages.” Deepa Manwani, M.D., director of the Sickle Cell Disease Program at Children's sickle cell crises. The findings were pub- A decade ago, he says, he was skepti- The hows and whys of neutrophil Hospital at Montefiore, listens to the heart of a young patient. lished in July 2020 in Immunity. cal about the importance of the micro- activation became clearer in 2015. “Importantly, we found we could biome in human health. “We’ve learned While studying a mouse model of SCD, markedly reduce sickle cell vaso-occlusive a lot since then,” he adds. “Now I think Dr. Frenette’s lab found that neutrophils “What was most surprising and mouse findings, children with SCD who episodes in mice through several differ- we have to take a step back and consider become more active and pro-inflammatory exciting was that the antibiotics greatly were not taking penicillin had many ent interventions: inhibiting glucocor- that there may be a role for the microbi- as they grow older in the blood, suggest- reduced chronic tissue damage in the more circulating aged neutrophils com- ticoid synthesis, depleting segmented ome in almost every disease.” ing they receive signals that tell them spleen and liver,” says Dr. Frenette, pared with healthy controls. filamentous bacteria, or blocking the to age—signals, it turns out, that come whose study appeared in Nature. “This is “Daily penicillin for patients with inflammatory molecules induced by PREVENTING SICKLE CELL from the gut microbiome. the first time that something was found SCD younger than 5 works really well in these bacteria,” Dr. Frenette says. “Each COMPLICATIONS “Since the body’s microbiota seem to have an impact on the organ damage preventing infections,” Dr. Frenette says. of those actions could potentially limit Paul Frenette, M.D., is the principal to ‘educate’ neutrophils to age,” Dr. that can be so devastating in SCD.” “Our study suggests that older people the impact of psychological stress on investigator on a study involving the Frenette says, “we realized that purging With help from the Sickle Cell with SCD could potentially benefit from people with SCD.” gut microbiome and sickle cell disease those microbes with antibiotics might Disease Program at Children’s Hospital preventive antibiotic therapy as well.” (SCD). Dr. Frenette is a professor of help against SCD.” at Montefiore (CHAM), Dr. Frenette His team is currently collaborat- MAKING CHEMOTHERAPY medicine and of cell biology and the In fact, when the researchers used and colleagues investigated whether ing with Deepa Manwani, M.D., who SAFER chair and director of Einstein’s Ruth L. antibiotics to deplete the microbiota their mouse findings might be relevant directs CHAM’s Sickle Cell Disease Patients who develop colorectal can- and David S. Gottesman Institute for of SCD mice, they observed a striking to people. They obtained blood samples Program, on a study evaluating peni- cer often are prescribed irinotecan—a Stem Cell Biology and Regenerative reduction in neutrophils but not in other from nine healthy children and from cillin’s effect on the gut microbiomes chemotherapy drug found on the World Medicine. white cells. Moreover, the antibiotics 34 patients with SCD. Of the 34 SCD of young SCD patients. Children are Health Organization’s List of Essential People with SCD have an inher- appeared to prevent sickle cell crises patients, 11 were taking penicillin daily enrolled and their microbiomes eval- Medicines. However, up to 40% of ited gene mutation that leads them to in SCD mice—markedly suppressing to ward off infections, as is recom- uated at age 4 to 5, while they are still patients who receive irinotecan experi- produce abnormal hemoglobin, the interactions between neutrophils and red mended for children 5 or younger with taking daily penicillin; their microbi- ence severe, potentially life-threatening oxygen-carrying protein in red blood cells, improving local blood flow, and SCD; 23 had been off penicillin for at omes are sampled again around age 5 diarrhea. cells. Red blood cells with abnormal increasing the rodents’ survival. least two months. Consistent with the to 7 (when they have stopped taking “As you can imagine, such patients

42 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 43 GUT REACTIONS

“Microbes are nature's processes leave behind) to group the In a project with even broader clin- fecal samples according to whether they ical implications, Dr. Kelly and two chemists, capable metabolically reactivated the drug. Four members of her lab (Leah Guthrie, of producing and of the 20 people were found to be “high Ph.D., and postdoctoral fellow metabolizers,” and the other 16 were Sarah Wolfson, Ph.D.) developed metabolizing a diverse “low metabolizers.” MicrobeFDT, a tool that groups 10,000 array of compounds.” The two groups of fecal samples were drugs, foods, and other compounds checked for differences in microbiome according to their chemical struc- — DR. LIBUSHA KELLY composition, with a focus on beta- ture and links them to gut microbial glucuronidase-producing bacteria. The enzymes that interact with them. The microbiomes of high metabolizers con- goal: predicting adverse health effects tained significantly higher levels of three from exposure to those compounds. Betsy C. Herold, M.D. previously unreported types of bacteria MicrobeFDT correctly predicted capable of producing beta-glucuronidases how gut microbes might alter the struc- THE MICROBIOME AND compared with low metabolizers. ture of altretamine, an ovarian cancer VAGINAL HEALTH The 2017 findings, published innpj drug that can cause diarrhea and kidney Biofilms and Microbiomes, a Nature jour- damage. “When we incubated altre- Studies show that PrEP, the nal, suggest that analyzing the compo- tamine in fecal samples from healthy two-drug-combination pill taken Libusha Kelly, Ph.D., at work in her Einstein lab. sition of patients’ microbiomes before volunteers, the drug was altered as the daily for preventing HIV infection, giving irinotecan might predict whether tool predicted,” says Dr. Kelly, whose can be highly effective—capable of intestinal side effects will occur. Thus findings were published in 2019 in the reducing the risk of sexual transmis- are already quite ill, so giving them a compound toxic to cancer cells. Other forewarned, physicians would know journal eLife. sion of HIV by more than 90%. In treatment that causes intestinal problems liver enzymes later convert the drug when to prescribe diarrheal treatment “We hope this research will ultimately 2019, the Eunice Kennedy Shriver can be dangerous,” says Libusha Kelly, back to its inactive form, which makes preventively and to monitor patients enable us to improve people’s health by National Institute of Child Health Ph.D., associate professor of systems & its way to the intestine for elimination. more closely for irinotecan side effects. monitoring and potentially altering their & Human Development awarded a computational biology and of microbiol- But some people possess gut bacteria Dr. Kelly is now testing her hypothesis microbiomes,” Dr. Kelly says. five-year, $2.6 million grant to Betsy ogy & immunology at Einstein. that use part of inactivated irinotecan as in a study involving colorectal cancer In an npj Biofilms and Microbiomes C. Herold, M.D., to study the Dr. Kelly wondered if the gut’s a food source by digesting the drug with patients who are receiving irinotecan, in paper published last October, Dr. Kelly vaginal microbiome’s influence on microbiome might be to blame for enzymes called beta-glucuronidases. collaboration with Montefiore oncolo- and her postdoctoral fellow William PrEP’s effectiveness. adverse reactions to irinotecan. “We’ve That’s good for the bacteria but terrible gist Sanjay Goel, M.B.B.S., M.S., Chang, Ph.D., devised an analytical The study will identify which of known for years that variations in for the intestines. This enzymatic action professor of medicine at Einstein. method that was able to distinguish several new PrEP formulas remain genetic makeup can affect how people reactivates irinotecan into its toxic form, The findings also suggest that the between gut microbe dynamics found in effective when used by women respond to a medication,” she explains. which damages the intestinal lining. use of drugs that inhibit specific beta- “healthy” and “sick” people, despite the with different microbiomes under “It stood to reason that microbi- To minimize irinotecan-related glucuronidases might prevent adverse continually changing microbiome com- real-world conditions. The find- ome variations might also play a role. toxicity, doctors have tried using oral irinotecan reactions—and that pre- positions in both conditions over time. ings could help in developing Microbes are nature’s chemists, capable antibiotics to kill the offending bacteria biotics (nondigestible fiber that gut “How does one’s microbiome better PrEP formulas for protect- of producing and metabolizing a diverse but found that the antibiotics killed off microbes feed on) might help, too. respond to a trip outside the country? ing women at high risk for HIV array of compounds. That’s benefi- protective gut bacteria as well. “Beta-glucuronidases have an appetite Does the state of your microbiome infection. cial in some cases—when gut bacteria In a search for an alternative treat- for the carbohydrates found in the today tell us anything about your health Dr. Herold is professor, chief of make vitamin B12, for example. But ment, Dr. Kelly and her colleagues inactive form of irinotecan,” Dr. Kelly tomorrow, or next week? We have so infectious diseases, and vice chair the microbiome can also turn otherwise collected fecal samples from 20 healthy says. “If we feed patients a compet- many questions,” says Dr. Kelly. “It’s for research in the department of helpful drugs into toxins.” individuals and treated the samples with ing source of carbohydrates when we early days for this field, but I’m excited pediatrics at Einstein and Children’s Irinotecan is administered intrave- inactive irinotecan. They then used administer irinotecan, perhaps we could about the potential to translate this basic Hospital at Montefiore, and the nously in an inactive form. Certain liver metabolomics (the study of the unique prevent those enzymes from metaboliz- research into the clinic and hopefully Harold and Muriel Block Chair enzymes metabolize the drug into a chemical fingerprints that cellular ing the drug.” help improve people’s lives.” of Pediatrics.

44 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 45 PASSIONATE

PURSUITS decades later when, at age 69, he talked to a rock climber The Thrill of at a party and was instantly intrigued. The the Climb climber invited Dr. Cohen BY WAYNE COFFEY Dr. Cohen to stop by his climbing gym in Brooklyn. t’s a Tuesday night in Long Island Climbing, like gymnastics, requires City, and a sinewy septuagenarian strength, balance, and the ability to han- Iis making a sure-footed ascent up dle technical challenges. It immediately a rock-studded wall, his muscles taut appealed to Dr. Cohen, along with the as a rope. Three times a week, Steven sport’s demand for “interdependence” Cohen, M.D., M.P.H., morphs into with climbing partners—a quality Dr. rock climber extraordinaire, scaling Cohen refers to as “part of the gestalt of walls for hours at The Cliffs, an indoor climbing.” facility where he evokes awe among his He also loved climbing’s adrenaline fellow climbers. rush. “I was climbing in the crib,” Dr. “He’s the most focused and driven Cohen says. “My parents couldn’t put person in the gym,” says Judy Aschner, enough bars on it to keep me in it. I M.D., a fellow climber and an Einstein climbed telephone poles, chimneys, professor of pediatrics and of obstetrics anything I could find. I think it was & gynecology and women’s health. built into my consciousness from birth. “He pushes himself every single Clockwise from top: Dr. Cohen balances on one arm before being named the NCAA After I went [to the Brooklyn gym] climb, every single time, to do more- all-around gymnastics champion while competing for Penn State University in 1966; at once, I never turned back.” challenging things and to do them Rattlesnake Mountain in Rumney, New Hampshire, he hugs the face of the rock during Dr. Cohen now enjoys introduc- an ascent in 2018; at The Cliffs in Long Island City, New York, an indoor rock-climbing perfectly. It’s astonishing to watch him. facility, he perfects his skills in 2020. ing the sport to friends and students. He’s the strongest person his age I’ve Several have become dedicated climb- ever seen.” and member of the 1968 U.S. Olympic Shawangunk Mountains in New York’s ers themselves. He says medicine will gymnastics team in Mexico City. Hudson Valley. His goal is to become always be at the core of who he is, OLYMPIAN GYMNAST More than a half-century later, he the oldest person to climb El Capitan, because “taking care of people is really At 5 feet 7 inches and 150 pounds, the works full time as a professor of derma- the 3,000-foot granite monolith in what I love doing.” But he’s grateful 75-year-old Dr. Cohen has a physique tology at Einstein and is chief emeri- California’s Yosemite National Park. to have found an outside pursuit that that would be envied by people half tus of the division of dermatology at “My energy level is high,” Dr. Cohen keeps him vigorous and sharp. his age. That’s no surprise, given his Einstein and Montefiore, specializing in says with a soft laugh. He may be the oldest man on the previous athletic life. Growing up in rare skin diseases. rock-climbing wall, but he’s fine with Philadelphia, Dr. Cohen was a two- Still, he makes time to climb. He typ- THE APPEAL OF CLIMBING that. “To me,” Dr. Cohen says, “climb- time city champion as an all-around Steven Cohen, M.D., M.P.H., adjusts ically travels twice a year to such iconic An avid runner, cyclist, and swimmer ing is part of the joy of living.” his footing as he scales a steep vertical gymnast before going on to become wall in the White Mountain National climbing destinations as Red Rock as a younger man, Dr. Cohen had to a Penn State University All-American Forest in Rumney, New Hampshire, Canyon National Conservation Area undergo a full hip replacement at age VIEW MORE in 2018. in Nevada’s Mojave Desert and Joshua 40, after doctors discovered a tumor. Find additional photos of Tree National Park in California. Closer Though he stayed active, he didn’t Dr. Cohen’s climbing adventures: to home, he enjoys climbing in the find an enduring athletic passion until magazine.einsteinmed.org/photos21

46 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 47 EINSTEIN EDITIONS Stories of Pregnancy, Birth, and the Unexpected Exploring the Science Chavi Eve Karkowsky, M.D. of Longevity Associate professor of obstetrics & gynecology and women’s health at Einstein and medical director and clinical liaison Nir Barzilai, M.D. of outpatient obstetrics at Montefiore Medical Center Founding director of the Institute for Aging Research at Einstein, the Ingeborg and Ira Leon Rennert Chair in Aging “ regnancy” is often used as Research, professor of medicine and of genetics at Einstein, shorthand for “happily ever and an endocrinologist at Montefiore Pafter.” But the experience is almost never that simple, as maternal- very year, trees signal their fetal medicine specialist Chavi Eve leaves to change color and die. Karkowsky, M.D., describes in her EAre people programmed to new book, High Risk. deteriorate in a similar way? Or is it Some women—those with possible to stave off mortality? Nir an autoimmune disease or a history of miscarriages, for Courtesy of St. Martin’s Press Courtesy of St. Martin’s Barzilai, M.D., who has spent the past example—already know they’ll need a maternal-fetal medi- Courtesy of Liveright few decades researching the mecha- cine specialist, also known as a high-risk-pregnancy doctor, nisms that drive aging, addresses that • Unusually low levels of the growth hormone IGF-1 (insulin- when they get pregnant. But plenty of others might be having From 2011 to 2014 in the United States, pregnancy-related question in his new book, Age Later. like growth factor 1), a protein produced in the liver; and a completely routine pregnancy—until they’re not. Maybe mortality rates for Black women were 3.2 times those for white Growing old, after all, not only transforms us but makes us • Unusually high levels of mitochondrial-derived peptides, their water breaks at 27 weeks. Maybe an ultrasound picks up women, a “shameful truth,” Dr. Karkowsky notes. The medical susceptible to one or more of the “big four” illnesses: Alzheimer’s, which provide resilience against the stresses of aging. something not quite right about the shape of the fetal heart. establishment is beginning to understand the scope of the prob- cancer, diabetes, and cardiovascular disease. Dr. Barzilai had long Many of the Super Agers also benefited from healthy life- High Risk offers insights into those complications, but also lem, she writes, but countering physicians’ implicit biases (sub- wondered whether the aging process could be targeted like a dis- styles and healthy environments. But their most significant covers a wide spectrum of reproductive health issues—genetic conscious prejudices) is going to take hard and constant work. ease, to slow it down and lengthen the human “health span.” common denominator was possessing gene mutations that testing, ultrasounds, miscarriages, preterm births, the dra- The book concludes with a night on the labor and delivery In 1998, to gain insight into the biology of aging, Dr. seem to confer long life spans. Dr. Barzilai and his colleagues matic rise in cesarean sections, and the diagnosis of stillbirth. floor, “routine and amazing, everyday and earth-shattering, Barzilai launched a study of “Super Agers”—people living have so far identified dozens of such “longevity genes.” Pregnancy, Dr. Karkowsky explains, often produces plenty all at once.” It begins at 5:05 p.m. after an already busy day independently at age 95 and beyond who had not experienced So how can the rest of us improve our chances of becom- of surprises, and almost nobody (not even some doctors) knows at the clinic, when Dr. Karkowsky and her colleagues divvy diseases that plagued their peers. Dr. Barzilai and his team ing centenarians, especially if we haven’t inherited the right what can happen before, during, and after. “I wish someone up the evening’s patients. One has chronic hypertension and focused on Ashkenazi Jews, who are more genetically uniform genes? Dr. Barzilai is working on that. He co-founded a had told me” is what she hears often from patients, she writes. three prior cesarean sections; another, eight days past her due than other groups, making it easier to spot gene differences biotech company that is targeting several hallmarks of aging, Dr. Karkowsky aims to do just that by telling compelling date, came in because her water broke; a third patient had just and similarities that might be present. The Longevity Genes and he serves as chief medical consultant for several other stories of some of the patients she has seen in her years of prac- fallen down stairs at 27 weeks; a fourth is already 5 centi- Project enrolled nearly 3,000 men and women, about 750 of companies with a shared goal: developing drugs to prevent tice, in well-written chapters organized like a pregnancy itself: meters dilated; and a fifth is recovering from a cesarean and whom were ages 95 to 109 and the rest either offspring of the Alzheimer’s, diabetes, and other diseases of aging. trimesters one, two, and three; full-term pregnancy; going into being monitored after a blood transfusion. Super Agers or older adults with no longevity in their back- In the meantime, he says, the best antidote for aging is exer- the hospital (or staying out); and postpartum and beyond. Dr. Karkowsky runs from patient room to operating room grounds. Participants were mainly from the New York metro- cising for at least 25 minutes three to five times a week. What else She also shares her own experiences, including the nau- and back all night, until the morning team arrives at 7:30. politan area and had similar education and income levels. helps? Don’t eat too much or too often, and focus on the positive sea and vomiting (which affects 70% to 90% of pregnant She exits the hospital exhausted but upbeat. After all, she Most of these exceptionally long-lived individuals possessed things in life—one of which, in the near future, he assures us, will women) that had her “hating every moment” at six weeks and notes, she has had “a front-row seat to the most interesting at least one of the following genetically influenced traits: be drugs that mimic what longevity genes can do. grabbing the sides of her bed “as if I were shipwrecked on an and compelling parts of human experience.” • High levels of good cholesterol—high-density lipoprotein— unstable raft.” which protects them from heart attacks and dementia; PUBLISHED BY: St. Martin’s Press, 2020 A chapter is devoted to maternal mortality and racial disparities. PUBLISHED BY: Liveright, an imprint of W.W. Norton, 2020

48 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 49 ALBERT’S 1 2 3 4 5 6 7 8 9 PUZZLER 10 11 12 MOTIVATIONS BY DEIRDRE BRANLEY 13 14 15 16 17 The Front Line of Philanthropy at Einstein and Montefiore

18 19 20 21 It Was 20 Years Ago Today* 22 23 Across 1 Gaping mouth 24 25 4 She wore a swan dress to the Oscars 26 27 28 29 7 This pioneering peer-to-peer music- sharing site was shut down 30 31 32 10 Pop singer Billie ____ was born 12 When Destiny’s Child broke up, 33 34 Beyoncé went ___ 13 Quiet 35 36 15 Shortened term to describe people whose gender identity corresponds to 37 38 39 their sex assigned at birth 16 Allison Janney took home an Emmy 40 41 for playing this character on The West Wing 42 43 18 Smallville began, which featured this reporter friend of Superman 44 45 19 This Russian space station was 46 decommissioned

20 Lithium on the periodic table 47 48 49 22 This infamous energy company went bankrupt 23 The ginger best friend of Harry, in the top movie of the year Down 24 This filmmaker released Ali, starring 1 This future special counsel for Russian 26 ____ Pitt starred in Ocean’s Eleven and Will Smith election interference was named FBI The Mexican 26 Not true director 28 Prescription abbreviation 27 This first transdermal birth control 2 These sisters met in a Grand Slam final 29 It merged with Time Warner patch was released 3 He was inaugurated as president in 30 Winner of Best Picture Oscar January 30 Pediatric surgery that redirects blood 31 Simpsons’ neighbor ___ Flanders was flow from upper body directly to the 4 Bromine’s atomic symbol on the cover of Christianity Today lungs 5 The Lasker Award honored this model 34 Short for user interface IN THIS ISSUE 32 This satellite radio service launched of human disease 36 This Lonely Hearts Club Band had 52 From the Chief Philanthropy Officer 33 ____ Rudd starred in Wet Hot 6 Limb where humerus is located the No. 1 album of the year American Summer 8 This leaning tower reopened after 37 Tools to get COVID-19 test sample 53 Remembering Roger W. Einiger 35 These Arizona snakes beat the Yankees 11 years 38 Apple’s digital music service was in the World Series 54 Continued Connection: 9 Habitual muscle spasm launched 39 Iron’s atomic symbol John Braver, M.D. ’70 11 First drafts were simultaneously 39 The car film franchise The ____ and the 40 This open-source encyclopedia was released by Craig Venter and Francis Furious began 56 Spotlight: launched Collins 41 Not night Holocaust Survivors 42 He and Nicole Kidman divorced 12 This cartoon ogre’s first movie was 43 She starred with 42 Across in released Image: Justin C. Wheat, M.D./Ph.D. candidate 44 She sang “I’m a Slave 4 U” at the MTV Vanilla Sky 60 Your Impact: Video Music Awards 14 Silicon, for short 45 Yadda, yadda, yadda New Blood Cancer Institute 46 NWA rapper Ice ____ released his 17 This Latina released an eponymous 46 A type of scan that uses X-rays greatest hits album 64 Class Notes 47 This future secretary of state became 21 Not out * Note: Many clues refer to 2001, a nod to 68 In Memoriam the first Black female national security 23 They won the Super Bowl, besting our cover story. advisor the New York Giants (as our dean will 48 A warm, shallow bath that cleanses the know) See how well you did at: To learn more, please visit perineum 25 This Barry broke the season home run magazine.einteinmed.org/ montefiore.org/giving and 49 Justin Timberlake’s band, ’N ____ record, which he still holds puzzler2021 einsteinmed.org/giving

50 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 51 MOTIVATIONS

A Message From the Senior Vice President of Development and REMEMBERING EINSTEIN BOARD CHAIR Chief Philanthropy Officer ROGER W. EINIGER KATHLEEN KEARNS he Einstein and Montefiore communities lost a devoted and loyal friend on Dec. 9, 2020. Roger W. Einiger, chair of the Einstein Board of Trustees and trustee of Montefiore Medicine and Montefiore Health System, died peacefully at his home in New York City What motivates philanthropists to give? Throughout my decades-long T career, those reasons—from the personal to the visionary and beyond— at age 73 after a courageous, two-and-a-half-year battle with pancreatic cancer. have always moved me. When I came to Albert Einstein College of Medicine and Montefiore Health System at the end of 2020 as the new STEADY LEADERSHIP of the COVID-19 pandemic,” notes Dr. senior vice president of development and chief philanthropy officer, “Few people have played a more Tomaselli. “For these and many other reasons, I was privileged to present him hearing from so many generous and passionate Einstein supporters important role in the recent history of Einstein and Montefiore,” says Philip with an honorary doctorate of humane confirmed what I had long known: Einstein is a special place, made O. Ozuah, M.D., Ph.D., president and letters during our 2020 virtual com- more so by the people who hold it so close to their hearts. chief executive officer of Montefiore. mencement ceremony.” This devotion is evident in the latest issue of Motivations. You will “Over his lifetime, Roger provided Kathleen Kearns read about John Braver, M.D., from Einstein’s Class of 1970, who joined important leadership and generous HIS LIFE AND CAREER forces with fellow alumnus Gordon F. Tomaselli, M.D. ’82, the Marilyn support for all aspects of Einstein’s Mr. Einiger spent more than 30 years at and Stanley M. Katz Dean at Einstein and executive vice president and chief academic officer mission, strengthening its position as Oppenheimer & Co. and its successor at Montefiore, to fund the renovation of the Education Center in the Forchheimer Building a research powerhouse, top-ranking companies, ultimately serving as execu- (page 54). You’ll learn how UJA-Federation of New York has partnered with Einstein to care academic destination, and force for tive vice president, chief administrative for Holocaust survivors coping with the COVID-19 pandemic (page 56). And you’ll take a look social good.” Mr. Einiger’s service officer, and vice chairman. He began a inside the emerging Blood Cancer Institute, where researchers are gaining crucial knowledge continued his family’s long relation- second career in 2001, devoting his time about the causes of blood cancers and more-effective treatments for them (page 60). ship with Einstein: His parents, Jack to serving on the boards of numerous In this issue we also pay tribute to one of the most inspiring humanitarians I’ve had the and Glory Einiger, were among the led the recruitment in 2018 of Gordon nonprofit organizations important to honor of knowing, however briefly: the late Roger W. Einiger (see facing page). A committed College of Medicine’s earliest support- F. Tomaselli, M.D., the Marilyn and him, helping to advance their missions ers and were members of the Society of Stanley M. Katz Dean at Einstein and and strengthen their finances. In addi- chair of the Board of Trustees and notable thought leader, Mr. Einiger created a legacy for Founders. executive vice president and chief aca- tion to Einstein and Montefiore, these Einstein that will forever fill chapters of Einstein’s history—and indeed, our future. Mr. Einiger joined the Einstein demic officer at Montefiore. included UJA-Federation of New York, The Einstein community is exceptional, composed of dynamic individuals motivated to Board in 2005 and served in numer- Among his many other contribu- Big Brothers Big Sisters of NYC, the make the world a better place. That mission binds us all through our vocations, volunteerism, ous roles, including treasurer, chair of tions, Mr. Einiger led the Campaign Anti-Defamation League, the University and philanthropy. the executive committee, and chair of to Transform Einstein, which raised of Pennsylvania School of Design, As our namesake said, “Only a life lived for others is a life worthwhile.” That philosophy the budget and finance committee, nearly $200 million for the College of and The Washington Institute, guided Albert Einstein in his brilliant work and still guides many of us here today. With that, tapping into three decades of experi- Medicine. In 2020, Mr. Einiger was among others. I’ll open up the conversation: What motivates you to give? ence in finance and investment bank- the trustee lead for the search com- Born in New York City in 1947, Mr. ing and providing Einstein’s leadership mittee that recruited Edward Chu, Einiger earned his bachelor’s degree in With gratitude, with invaluable strategic and finan- M.D., M.M.S., as the new head of the economics from the Wharton School cial advice. He joined the Montefiore Albert Einstein Cancer Center. Dr. of the University of Pennsylvania and Board in 2014 and was instrumental Chu holds the Carol and Roger Einiger his M.B.A. from New York University’s in finalizing the historic partnership Professorship of Cancer Medicine. Stern School of Business. He is survived Kathleen Kearns between Einstein and Montefiore “Roger was an unrelenting supporter by his wife of 51 years, Carol; their son, one year later. Mr. Einiger became of the medical school and a stalwart Joshua; their daughter-in-law, Julie; their Einstein’s board chair in 2015, succeed- friend and, most recently, he helped grandson, Jacob; and Mr. Einiger’s sister, ing Ruth L. Gottesman, Ed.D., and steer us through the turbulent challenges Ellen, and brother-in-law, Mitch.

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A New and Improved DR. JOHN BRAVER Technology Experience CLASS OF ’70 A lifelong physician and educator helps the Einstein Education Center meet the future

BY JOAN LIPPERT

ess than a decade ago, Einstein’s Brigham residents once or twice a week. Education Center was a state-of- In June 2019, Dr. Braver attended L the-art technology hub for learn- a brunch for Boston-area Einstein ing about everything from anatomy alumni hosted by Janina Galler, M.D. to zoonoses. But 10 years is a lifetime ’72, and Burton Rabinowitz, M.D. ’72. when it comes to today’s increasingly There he met fellow alumnus Gordon F. wireless teaching spaces. Tomaselli, M.D. ’82, Einstein’s Marilyn Low ceilings and cement columns and Stanley M. Katz Dean, who shared were causing audio and connectivity campus updates and answered questions challenges. Outdated equipment made about admissions, student life, residency it harder to project information from matching statistics, and other details. newer computers onto large screens. “We talked about supporting students, John Braver, M.D., standing next to a And smartphones, tablets, and laptops and I left impressed by the dean’s enthu- security robot in Silicon Valley, says he sees were straining the Wi-Fi system. The siasm and vision,” Dr. Braver says. great value in new technologies for use in education, medicine, and more. Education Center needed a reboot. That meetup inspired Dr. Braver to make a generous donation at the end of PAYING IT FORWARD 2019 to benefit medical students and to hospital, so we created a nine-week virtual Fortunately, Einstein alumnus John support education. “I trusted Einstein’s course with lessons from the clerkship,” Braver, M.D. ’70, had been thinking leaders to know how my contribution says Joshua Nosanchuk, M.D., senior for a while of making a gift to his alma could best be used to help students associate dean for medical education. and breakout sessions. New glass boards Dr. Braver has seen firsthand how with excellent teachers,” Dr. Braver says. mater, to express his gratitude to the learn and engage most effectively,” Dr. Also, all first- and second-year lectures and 12 large monitors allow students innovation has revolutionized medi- “Today’s Einstein students have that College of Medicine. “I got a terrific Braver says. were being delivered virtually. Dependable to study and collaborate actively while cine. “Surgeons operate with robots same caliber of educators and teaching education and a career for life,” he says. digital communication with Montefiore maintaining safe social distancing. now. Meetings and Grand Rounds— platforms, plus high-tech computer pro- Dr. Braver had retired in 2016 as IMPROVED INFRASTRUCTURE and beyond was more essential than ever. “We’ve made the infrastructure more and whole curriculums—are virtual,” grams and devices that Dean Tomaselli chief of gastrointestinal radiology and Dr. Braver’s gift came at a crucial Dr. Braver’s donation allowed work functional—more plug-and-play,” says Dr. Braver says. “Everything is heading and Dr. Nosanchuk have put in place. co-director of abdominal imaging at time. Costs for repairing and replacing on massive technology upgrades to begin Dr. Nosanchuk, who has led the renova- in that direction, and this pandemic I’m glad that my contribution has made Brigham and Women’s Hospital in Education Center equipment were run- quickly. The vastly improved Education tion effort with Shailesh Shenoy, assis- has tremendously accelerated that an impact on Einstein and its role in Boston. He had not, however, retired ning as high as $60,000 per year. Plus, Center now offers a new Wi-Fi system, tant dean for information technology at trajectory.” driving cutting-edge education.” from his longtime dedication to medical the surge in digital communication a refined broadcast frequency to pre- Einstein. “It’s a key move in innovating He points to one constant in the students. A beloved and skilled educa- caused by the COVID-19 pandemic vent outside interference, and improved medical education at Einstein.” midst of medicine’s dynamic changes TO DONATE tor, he was voted Brigham’s Teacher of was stressing the aging educational microphone audio that uses Bose tech- over the decades: the quality of an  einsteinmed.org/giving the Year in 1982 and again in 2010. facility. “The pandemic meant that our nology. Small tables have replaced large A DIGITAL FUTURE Einstein education. “I was at Einstein  [email protected] Even after retiring, he still teaches third-years couldn’t see patients in the ones to accommodate more test-takers Over the course of his medical career, before the digital age, and I was blessed  718.430.2411

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fter her husband’s death, 90-year-old Sarah L. of Washington Heights* moved to a new Aapartment to be closer to her children. Sadly, the combined loss of her spouse, home, and neighbors was too much to bear, leaving her depressed and confused. Worse yet, she struggled with nightmares about her childhood in Eastern Europe, where she was deported to Auschwitz, along with her four siblings, all of whom perished in Nazi concentration camps.

Sarah’s decline seemed unstoppable— remain safely and comfortably in their until she connected with an unusual homes, which is what most prefer.” GUIDING alliance of caregivers from Montefiore and Selfhelp Community Services, WHEN THE PAST IS PRESENT a local agency, bolstered by a phil- New York City’s 36,000 Holocaust sur- ELDERLY anthropic partnership with UJA- vivors are an incredibly resilient group. Federation of New York. They’ve endured the camps, built new SURVIVORS “It was heartbreaking,” says lives in a foreign land, and lived well Alessandra Scalmati, M.D., Ph.D., into old age. But their survival has associate director of geriatric psychiatry exacted an emotional toll. OF THE at Montefiore and associate professor “Most Holocaust survivors have been of psychiatry and behavioral sciences at able to cope with the lingering effects Einstein, who oversaw Sarah’s care. “But of their trauma,” says Gary Kennedy, HOLOCAUST with her family’s assistance, we got her M.D., director of geriatric psychiatry started on antidepressants and psycho- at Montefiore and professor of psychia- With support from UJA-Federation therapy, and arranged for in-home care. try and behavioral sciences at Einstein, After a while, her nightmares and other who has been involved with the alliance of New York, Montefiore is bringing symptoms began to ease.” since its inception. “But with aging, vital mental health services to those The caregiver alliance—dedicated they tend to lose their natural filters to to addressing the mental health of contain the horrors they experienced.” who endured the World War II Holocaust survivors and their families— Cognitive impairment affects about concentration camps has provided help to hundreds of people one in four individuals over age 85 and like Sarah. “This is our last opportunity tends to make matters worse. “With to ensure that the survivors can live out dementia, people can get trapped in BY GARY GOLDENBERG their years with dignity,” says Briana their early memories,” Dr. Scalmati Hilfer, L.M.S.W., a planning executive says. “They might not remember with UJA-Federation of New York, the what they had for breakfast, but they alliance’s founder and funder. “By pro-

viding this care, along with other critical * Some details have been changed to protect support services, we can help survivors the family’s privacy.

56 EINSTEIN : WINTER/SPRING 2021 MAGAZINE.EINSTEINMED.ORG 57 MOTIVATIONS | SPOTLIGHT 36,000 HOLOCAUST SURVIVORS can usually recall every detail of their poor Jewish immigrants. live in the New York area. were separated from family.” childhood. If they remember playing in Today, Montefiore’s geriatricians are Adds Ms. Hilfer: “As the pandemic the fields, fabulous. But if they remem- among a handful of specialists nation- SINCE COVID-19 STRUCK ... intensified, our partner agencies sprang ber being confined in the camps, that wide with expertise in aging and trauma. into action. Social workers were in touch can rekindle nightmares and flash- The third partner in the alliance is with their clients, some almost daily, backs and trigger other symptoms of Selfhelp, the organization operating the 36% OF HOLOCAUST when in the past clients would be in post-traumatic stress disorder, increas- oldest and largest support program for NEW YORKERS SURVIVORS touch with social workers only a few ing their vulnerability and risk of Holocaust survivors in North America. times per month. These efforts were institutionalization.” “UJA, Selfhelp, and Montefiore’s col- reported symptoms of are coping with resurfaced not only appreciated, but also crucial to Further complicating matters, many lective goal is to ensure that Holocaust depression and anxiety, with trauma from early lives boost mental health. These conversations “If they remember survivors are reluctant to seek support. survivors are treated with the utmost elderly and Holocaust survivors spent in hiding and years are an opportunity to adopt telehealth being confined “Some don’t want to be at the mercy dignity, compassion, and respect,” acutely affected. of food scarcity. techniques that will have lasting utility of strangers, while others fear being says Alisa Doctoroff, a member of after the pandemic has passed.” in the camps, stigmatized by psychiatric care or being the boards of trustees of Montefiore Source: UJA-Federation of New York that can rekindle forced into a nursing home or hospital,” Medicine, Montefiore Health System, A MODEL FOR Dr. Scalmati adds. and Einstein, as well as a past president TREATING OTHERS nightmares and of UJA-Federation of New York. While caring for local flashbacks.” AN ALLIANCE IS CREATED “Montefiore and Einstein’s caregivers Holocaust survivors is their In 2012, the United Jewish Appeal pay attention to all vulnerable people primary goal, Drs. Kennedy and — DR. ALESSANDRA SCALMATI (UJA)—long a sponsor of programs within their community, whether they Scalmati also want to conduct for Holocaust survivors—realized that are aging Holocaust survivors or mem- training programs for Selfhelp’s survivors were declining in number but bers of often-overlooked or disadvan- staffers and caregivers and to share that their needs, particularly their men- taged groups,” she says. “This mission findings with the geriatrics and psy- tal health concerns, were rising. To help makes Montefiore and Einstein the ideal chiatry community. address that problem, the UJA found an partners to lead this work.” Both Magda Goodman, above right, “In a decade or two, there will ideal partner in Montefiore, established The collaborative’s guiding philoso- and Bernard Igielski, pictured with his be no more Holocaust survivors,” daughter and grandson, are Holocaust more than a century ago to care for phy—person-centered, trauma- Dr. Scalmati says. “But sadly, there is no survivors and program participants. informed (PCTI) care—recognizes the “We can help them Mr. Igielski often gives talks about his shortage of people who need this special- impact of violence and trauma and experiences to students. ized care. Having generous and devoted promotes people’s dignity, strength, and understand what is partners to support communities who empowerment. While PCTI may sound triggering their fears understand what is triggering their fears need their help gives me hope for these dry in principle, it’s deeply humanistic and assure them they are safe.” people and for future generations.” in practice. and assure them they The program team also offers care Mrs. Doctoroff has a similar vision. “You need to have extra sensitiv- are safe.” to family members, who can feel the “My hope is that this program will not ity for people who have experienced effects of a parent’s trauma. “We call only improve the lives of Holocaust sur- trauma,” Dr. Kennedy says. “You can- — DR. GARY KENNEDY this ‘vicarious traumatization,’ in which vivors but also inspire others to reach out not force people to address their issues. trauma passes from one generation to to underserved and marginalized popu- The challenge is to convey the message the next through a parent’s behaviors,” lations—and inspire motivated donors ‘If you want to talk, I want to listen.’ Dr. Kennedy says. to support these efforts through their These patients are naturally cautious The COVID-19 pandemic has philanthropy.” about new relationships and can come heightened the challenge of caring for across as ‘difficult.’ Caregivers need to Holocaust survivors. “Social isolation is TO DONATE understand and respect this or they hard on older people,” Dr. Scalmati says.  einsteinmed.org/giving won’t be able to help. But once we earn “It can provoke memories of wartime,  [email protected] Montefiore Medicine trustee Alisa Doctoroff and her husband, Daniel. the patients’ trust, we can help them when survivors had to go into hiding or  718.430.2411

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MOTIVATIONS | YOUR IMPACT

n 2010, Amit Verma, M.B.B.S., and Ulrich Steidl, M.D., NEW Ph.D., were spending hours in their Einstein labs Istudying cellular mechanisms linked to a group of blood cancers called myelodysplastic syndromes (MDS). BLOOD CANCER This cancer of the bone marrow leaves people with too many defective blood cells and too few normal ones, INSTITUTE leading to life-threatening anemia. “Treatments at the time could reduce levels of defective blood cells for a while, but we needed therapies that could attack the TO LEAD THE SEARCH root cause of MDS,” Dr. Verma says.

FOR CURES A few years earlier, these researchers had hematologic malignancies at Montefiore. been among the first to show that MDS The researchers’ hunch proved cor- Einstein’s new research center will build on recent successes arises from abnormalities in hemato- rect. Scientists across the globe soon to create lifesaving treatments poietic stem cells (HSCs)—cells in the began testing potential therapies, first bone marrow that produce all of the in animals and then in human clini- body’s blood cells. Dr. Steidl’s lab went cal trials. The payoff came in January BY TERESA CARR on to identify novel targets against these 2020 when the New England Journal of disease-causing malignant stem cells in Medicine published a study they partic- Amit Verma, M.B.B.S. both MDS and a related disease, acute ipated in showing that the drug luspa- myeloid leukemia. tercept significantly reduced the need Dr. Verma and his team were homing for blood transfusions to treat anemia in in on a signaling pathway in HSCs that MDS patients. inhibits the cells from developing into Three months later, the U.S. Food mature red blood cells. They discovered and Drug Administration approved the that this pathway, known as SMAD2/3, drug (brand name Reblozyl)—the first was overactive in MDS patients. “We new therapy for MDS in 12 years. “It’s theorized that blocking the SMAD2/3 gratifying when you can see how the basic pathway with a drug would allow blood science eventually leads to life-changing cells to develop normally, preventing the treatments,” Dr. Verma says. “That’s the debilitating and even deadly anemia that driver for everything we do.” accompanies MDS,” says Dr. Verma, now associate director for translational FINDING TREATMENTS FASTER research at Albert Einstein Cancer “Nearly all therapeutic breakthroughs Center (AECC), professor of medi- have a similar story—arising from ideas cine and of developmental & molecu- born in labs and then worked on for 10 lar biology at Einstein, and director of to 15 years before their use in the clinic,” Ulrich Steidl, M.D., Ph.D.

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“We would like to says Dr. Steidl, who is associate direc- T-cells to attack cancer cells, has given tor for basic science at AECC, professor new hope to patients with certain forms bring innovative of cell biology and of medicine, and of leukemia and lymphoma. But further therapies to patients the Diane and Arthur B. Belfer Faculty progress is vital. Scholar in Cancer Research at Einstein, “Many types of blood cancer remain at a rapid pace ... and associate chair for translational hard to treat,” Dr. Shastri says. “And actual fundamental research in oncology at Montefiore. But older people—the people most likely to it can be challenging, he says, to obtain develop blood cancers—are often too frail advances.” research grants and government funding, to undergo aggressive blood-cancer thera- “especially for ideas that are outside of pies, such as stem cell transplants.” — DR. ULRICH STEIDL the mainstream.” Philanthropic giving will support the To speed the development of new AECC Director Edward Chu, M.D. people and projects needed to get the therapies, Drs. Verma and Steidl are state-of-the-art Blood Cancer Institute helping to launch the first-of-its-kind and also early-phase clinical trials with off the ground. Initial funds will endow Blood Cancer Institute within AECC, novel compounds, for instance,” he a directorship, provide seed funding of which they will be the co-directors. says. “Then we can take the next step for research projects, and support the Stanley M. and Marilyn Katz, longtime members of the Einstein Board of Trustees, at the “We would like to bring innovative ther- and bring the state-of-the-art science 65th Spirit of Achievement Luncheon in 2019, when the Women’s Division recognized recruitment of junior faculty to conduct apies to patients at a rapid pace,” Dr. into the clinic.” Mrs. Katz as an honoree. research and mentor the next generation Steidl says. “And by that, I don’t mean Achieving that vision will require a of scientists. variations on tried-and-true treatments $6 million-plus philanthropic invest- synergy between our research scientists For Marilyn Katz, who served as a but actual fundamental advances.” ment. Marilyn and Stanley M. Katz, and clinicians helps us translate lab find- trustee chairperson for the AECC from The institute will kick-start the early both longtime members of Einstein’s ings into clinically applied solutions for 1995 to 2020, the commitment to can- stages of both basic and translational Board of Trustees and staunch support- changing the course of cancer medicine cer research and the AECC’s expansive research, when outcomes are less certain, ers of AECC, believe in the vision of and to improve the lives of our cancer work is personal. She talks of people Below and pictured on the cover of Motivations (page 51): Mouse Dr. Verma says. “We will focus on areas these researchers and in the powerful patients.” in her life stricken by cancer—a close blood-forming stem cells. where we can make a unique contribu- role philanthropy plays in elevating friend who recently died from leukemia; Colored dots are single RNA tion to the field—basic bench research influential cancer research. “This is ON THE CUSP OF CURES her daughter-in-law, who had breast molecules corresponding to about hitting the home run, finding The discovery about 20 years ago that cancer; and her sister, who died of brain different cancer-relevant genes. the cure,” Mr. Katz says. “But to get genetic mutations in HSCs could lead cancer at age 52. “My hope for the new there, you need enough charitable gifts to cancer “changed everything when it institute is that it makes enough prog- to get the preliminary work done, so Aditi Shastri, M.D. comes to treating blood cancer,” says ress for more people to live healthy, full you can land funding for larger-scale Aditi Shastri, M.D., assistant profes- lives,” she says. investigations.” sor of medicine and of developmental Dr. Verma says that he is more & molecular biology at Einstein, an optimistic about realizing Mrs. Katz’s COLLABORATION IS KEY oncologist at Montefiore, and a member vision now than at any point in his The AECC is ideally suited to take of AECC. “We realized that we could career. “This new institute will provide the lead on blood-cancer research, says design treatments that target those resources and access to technologies, but Edward Chu, M.D., M.M.S., director of mutations and spare healthy cells.” most important, it will foster collabo- the AECC, professor of medicine and of One prime example is the targeted rations,” he says. “That’s how science molecular pharmacology, and the Carol therapy imatinib (Gleevec) that has advances.” and Roger Einiger Professor of Cancer transformed chronic myeloid leuke- Medicine at Einstein, and vice president mia—once nearly always fatal—into a TO DONATE for cancer medicine at Montefiore. “Our manageable disease for many patients.  einsteinmed.org/giving cancer center is at the forefront both in And CAR T-cell therapy, which involves  [email protected]

the lab and in the clinic,” he says. “The Image: Justin C. Wheat, M.D./Ph.D. candidate reprogramming the immune system’s  718.430.2411

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to optimize the patient-provider relation- Rosen Teaching Award, named for a beloved Secure Kids in the Age of Anxiety (Harmony ship. He just released a book he wrote former dean of education. He looks forward Books). Dr. Koplewicz is a child and ado- CLASS NOTES with a patient—Gut Feelings: Disorders to many more years of teaching at Einstein, lescent psychiatrist and founding presi- of Gut-Brain Interaction and the Doctor- and says it’s “great to be back!” dent and medical director of the nonprofit Patient Relationship (drossmancare.com/ Child Mind Institute. All book proceeds gut-feelings-book). Mitchell E. Geffner, M.D. ’75, pro- benefit the institute. 1960s at Tufts. He is engaged in teaching in the Daniel Nussbaum II, M.D. ’67, has fessor of pediatrics at the Keck School of Mervyn (Bud) Goldstein, M.D. ’60, graduate programs in immunology and practiced in Minnesota; Rochester, New Sterling Haidt, M.D. ’70, reports that Medicine of the University of Southern August Leinhart, M.D. ’78, retired in has had a varied career, from providing genetics, and he maintains a small research York; and Massachusetts. He did a fellow- he enjoys seeing his grandchildren and California, is the Ron Burkle Chair in July after 32 years at Bassett Medical Center material assistance to Israel during the footprint in genetic regulators of aging. He is ship in developmental pediatrics at the doing digital photography and art in a the Center for Endocrinology, Diabetes, in Cooperstown, New York. He served 1973 war to treating a man who was involved in antiracist workshops, training in University of Minnesota. Dr. Nussbaum studio in San Carlos, California. and Metabolism at Children’s Hospital for 25 years as the chief of the department gored by an African cape buffalo. He has implicit bias and passive racism, and increas- and his wife, Alice, have returned to Los Angeles (CHLA). He has been a of emergency and trauma services. Dr. received numerous honors, including the ing diversity among faculty and trainees. Rochester, and he’s enjoying retirement. John S. Graves, M.D. ’71, has pub- principal investigator on a trial studying Leinhart continues performing musical Montefiore Staff and Alumni Award of Alice is a Judaic needlework designer. His lished Lessons on the Road to Hope: A youths with type 2 diabetes and a national gigs—crooning jazz and composing on Appreciation, the Montefiore President’s Morton Schatzman, M.D. ’62, daughter, Yapha, directs a school library Psychiatrist’s Journey, now available on consultant on a study of endocrinological/ the guitar. His son, James, recently joined Award, the Einstein Lifetime Service trained as a psychiatrist at Mount Sinai in Los Angeles; his son, Joe, is an Emmy- Amazon. His memoir includes his expe- metabolic manifestations of HIV infec- Bassett in the emergency department, Award, and the Scarsdale-Edgemont and Montefiore hospitals in New York nominated producer/director in Hollywood. riences as a medical student at Einstein, tion. He co-directs the CHLA Congenital which brought James and his wife and two Community Service Award. and then moved to London. He lives in which he says were instrumental in Adrenal Hyperplasia Center of Medical children to Dr. Leinhart’s neighborhood as Highgate with his wife, Vivien. He has David H. Abramson, M.D. ’69, serves cementing his decision to become a psy- and Surgical Excellence. Dr. Geffner is well. He sends love and peace to all. Sidney Levitsky, M.D. ’60, lives in two sons: Daniel, who lives in Manhattan, as the chief of ophthalmic oncology at chiatrist. Dr. Graves retired in 2016 from a co-editor of UpToDate and Pediatric Boston and is a cardiac surgeon and the and Gideon, who lives next door to him in Memorial Sloan Kettering Cancer Center full-time practice after serving on the Practice: Endocrinology (McGraw-Hill). Stuart Orenstein, M.D. ’78, wonders senior vice chair of the department of London. Each son has three children. and received a U.S. patent in November volunteer clinical faculty at the University how many of his classmates have retired, surgery at Beth Israel Deaconess Medical 2020 for a bionic ocular prosthesis. of Colorado Health Sciences Center. Steven Mandel, M.D. ’75, received a are pursuing second careers, or are still Center and the David W. and David Steve Weissman, M.D. ’63, is, he Existing prostheses had poor movement Currently he volunteers with Mental Rothschild Award from the Metropolitan active in medicine. He left clinical medi- Cheever Professor of Surgery at Harvard reports, “in good health and happily and no pupillary response; Dr. Abramson’s Health Colorado, a nonprofit devoted to New York Region of United Synagogue cine 13 years ago to pursue the arts, taking Medical School. Dr. Levitsky has prac- married.” He is still practicing psychia- new one incorporates microelectronics education, advocacy, and legislation to Youth of the United Synagogue of classes at Santa Barbara City College. He ticed for more than 50 years. He and his try in Washington, D.C. He is writing with a screen that mimics ocular motility. improve access to treatment. Conservative Judaism for community has acted on stage, in film, on TV, and via wife, Lynne, formerly chief of pediatric a family history for his grandson, Sam. His 700th publication appeared this past service on poverty and hunger, LBGT and Zoom and streaming. Some of his work endocrinology at Massachusetts General Sam’s mother—Dr. Weissman’s daugh- year, and his work has been cited more Barbara McCormack, M.D. ’71, has gender equality, climate change, mental can be found through the Internet Movie Hospital, have three children and seven ter Annie—represents the third gen- than 13,000 times. retired from her OB/GYN practice, which health, and inclusiveness for people of Database and YouTube. He hopes every- grandchildren. He still remembers Bill eration of psychiatrists in their family. she had joined as the first woman on staff all ages with special needs. He has been one is staying safe and well. Metcalfe arranging a surgical elective at He was saddened to learn that his good Robert Hoffman, M.D. ’69, tested posi- at Englewood Hospital. She belongs to involved with the Foundation of Jewish Johns Hopkins Hospital for him. friend and Einstein classmate Arnold tive for COVID-19 last summer. He went several choral groups and a small opera Life, the Federation of Jewish Men’s Goldschlager, M.D. ‘63, passed away. to the emergency room at the University company, and she and her husband, who is Clubs, and Imagine Life: A Mental Health 1980s Melvin Scheinman, M.D. ’60, and of California, Los Angeles, 13 days later; a musician, play golf. They live in Spring Initiative Before It’s Too Late, promoting Dorothy Levine, M.D. ’80, and Dr. his wife, Margaret, live in San Francisco, David White, M.D. ’63, is living in an X-ray revealed COVID-19 pneumonia. Lake, New Jersey. programs to reduce the stigma associated Alvin Rosenfeld are enjoying their first where he heads the genetic arrhythmia Eugene, Oregon, with his wife of 56 years. Over the next four days he was treated with mental illness, suicide, and addiction. grandchild. Neither is fully retired yet, unit at the University of California. They are “happy to be together and enjoy- with oxygen until discharge. He received Sandra L. Blethen Chasalow, M.D. but they keep saying “Soon!” Dr. Levine He has received the American College ing each other,” he reports. convalescent plasma, monoclonal anti- ’75, reports that she, like many others, is William Clusin, M.D. ’76, continues is the chair of the board of directors’ of Cardiology Outstanding Scientist bodies, dexamethasone, and Lovinox. Dr. mostly staying “safer at home.” She thinks to work full time as an associate pro- quality improvement committee at the Award and the Distinguished Alumnus Stanford M. Goldman, M.D. ’65, Hoffman was back at work the next week that many colleagues must be revisit- fessor of medicine in cardiology at the Connecticut Children’s Medical Center. Award for his internationally recognized who received the Dominick P. Purpura and gradually recovered completely. He ing their notebooks and patient records Stanford University School of Medicine. She finds her role interesting and chal- expertise in cardiac arrhythmias. Dr. Distinguished Alumnus Award in 1996, has resumed daily exercise with interval because she has been asked to review a He conducts research on cardiac arrhyth- lenging, “especially as the coronavirus Scheinman also performs an annual mis- recently had his photo and biography pub- training, hikes, and resistance training. number of manuscripts for endocrine mias and the role of calcium channels and outbreak rears its head.” sion to Phnom Penh, Cambodia, to care lished in the Marquis Who’s Who magazine journals. This activity keeps Dr. Chasalow calcium-activated potassium channels in for the indigent and teach at a hospital millennium second edition. He is a pro- engaged, and she enjoys trying to make cardiac excitation. Dr. Clusin has three Ellen Weinberg Mausner, M.D. ’81, and medical school. He reports he is the fessor of radiology emeritus, a professor of 1970s each manuscript better. adult sons; his daughter, Audrey, is in the works as a psychiatrist for the Office of “proud grandpa of three talented chil- urology at the University of Texas School of Douglas Drossman, M.D. ’70, is eighth grade. Mental Health in New York City. She dren and nine wonderful grandchildren.” Medicine in Houston, a professor of radiol- a professor emeritus of medicine and Mark Erlich, M.D. ’75, has been teaching has written a biography of her grandfa- ogy at MD Anderson Medical Center, and psychiatry in the division of gastroen- clinical gross anatomy at Einstein for the past Harold Koplewicz, M.D. ’78, released ther, Jacob Weinberg, a prolific composer, Henry H. Wortis, M.D. ’60, is still an adjunct professor of radiology and urol- terology. He has been developing pro- five years, and says he is having a great time a book in February 2021, The Scaffold called Jacob Weinberg: Musical Pioneer; working in the department of immunology ogy at Baylor College of Medicine. grams that teach communication skills doing it. Last year he received the Samuel Effect: Raising Resilient, Self-Reliant, and it came out on Amazon in January

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the chief safety and quality officer at the New York, the Center for Musculoskeletal Camille A. Clare, M.D. ’97, was for the Basser Center for BRCA. Dr. April 2018, his daughter Elsie was born, STAY IN TOUCH Children’s Hospital of Philadelphia. After Disorders, has not closed during the pan- appointed the new chair of the depart- Greenberg’s laboratory investigates basic and a second child is due in April 2021. he spent 12 years working in Colorado demic, which is allowing for a smoother ment of obstetrics and gynecology and a mechanisms of genome integrity mainte- Dr. Nishinaga reports that he and his Keep your classmates up to and living apart from his wife, Martha J. recovery phase. If anyone with those spe- professor at the College of Medicine and nance and their impact on cancer etiology family have been healthy, happy, and safe date by submitting your news Sack, M.D. ‘86, they are happy to be in cialties is looking for a change of venue, the School of Public Health at SUNY and response to therapy. during COVID-19. “Be well, be safe,” he @ one home. Martha continues her work as drop Dr. Lewin a line at drjdlewin@gmail. Downstate Health Sciences University. says, “and thank you for all you are doing.” to Einstein magazine. We an attending cytopathologist at Abington com; his practice is expanding. He says Dean J. Straff, M.D., ’04, has been look forward to including you. Hospital in the Jefferson Health system. he’d love to reconnect with fellow alumni. Brian L. Gumbs, M.D. ’97, was selected named director of emergency medicine Sunju Park, M.D. ’11, has been the asso- Email us at einsteinalumni@ for the Northwest Permanente (NWP) at Montefiore’s White Plains Hospital in ciate residency program director for the Rafael Pelayo, M.D. ’88, has been Hugh Bases, M.D. ’94, completed his Care Experience Hall of Fame for 2020, White Plains, New York. Dr. Straff is also department of ophthalmology and visual einsteinmed.org. promoted to associate division chief for residency in pediatrics and then did a fel- recognizing his expertise in the care expe- an assistant professor of emergency medi- sciences at Montefiore since 2019, and the sleep medicine division at Stanford lowship in developmental-behavioral pedi- rience. With more than 1,500 physi- cine at Einstein. is enjoying working closely with her resi- University. He has published a new book, atrics. He is currently the program director cians and clinicians, NWP is the largest dents. Her husband, Kevin Hsu, M.D. How to Sleep. of the fellowship at the NYU Grossman self-governed, independent, multispecialty Rachel Fleishman, M.D. ’05, has ‘11, is also on the faculty at Montefiore, 2021. She continues to write jokes and School of Medicine. He also has a small medical group practicing in Oregon and combined her work as a neonatologist in the division of neuroradiology. Dr. Park do stand-up comedy, and enjoys acting private practice. His wife, Randi Asher, southwest Washington. with her undergraduate studies in creative says she and Dr. Hsu are settling into their and writing plays. Dr. Mausner played 1990s Psy.D., has a busy clinical psychology writing to explore the emerging discipline new home in Scarsdale and look forward a psychiatrist on The Sopranos (episode Barry Kraushaar, M.D. ’90, is busy in practice on the Upper West Side. Ari Mosenkis, M.D. ’98, moved to of narrative medicine. She teaches semi- to being able to host dinner parties. 48). Her play Prescriptions was published, Nanuet, New York, practicing orthopae- Israel in 2018 after nearly 15 years in pri- nars for her hospital system, including for and she appeared in a documentary called dic, sports, and joint medicine. He serves Justin Greisberg, M.D. ’95, is a pro- vate practice in the Midwest. His current pediatric trainees, and has been writing Rachel Aviv, M.D. ’15, and her hus- Vegucated, available on Amazon Prime. on the National Board of Councilors at fessor of orthopaedic surgery at Columbia clinic provides “high-quality healthcare and publishing essays about humanism in band, Sasha Semach, live in Forest Hills, the American Academy of Orthopaedic University. He is also the chief of foot at low cost” to Israelis of all religions. His neonatal care. In December 2020 she won New York. She is a pulmonary and critical Judith Lustig, M.D. ’82, has retired Surgeons and the board of the New York and ankle orthopaedics at NewYork- novel First Among Nations (published the Lancet’s Wakley Prize for best essay. care fellow at Northwell Health. from practicing neurology. She has been State Society of Orthopaedic Surgeons. Presbyterian and the chief of orthopaedic under the name Ira Mosen) involves an doing volunteer work, including teaching His twin boys are finishing college, trauma at NewYork-Presbyterian Lawrence Israeli soccer team competing in the World Dominique Aimee Jean, M.D. ’05, Marissa Lombardo, M.D. ’15, is in neurology to adults at Bergen Community focusing on engineering, and his eldest is Hospital. He misses his time at Einstein Cup; it explores the complexities of Israeli has taken a nontraditional path. Striving the second year of her fellowship at the College. Dr. Lustig has “been blessed with applying to dental schools. Dr. Kraushaar and his great friends from the Class of society and the dangers of anti-Semitism. for balance in her life, she launched a dual New York University Langone Medical three boys,” and now has three grandchil- and his wife, Helene, say they hope their 1995, and hopes to reconnect. The book has been a bestseller on Amazon. career as a pediatric anesthesiologist and Center. She specializes in noninvasive dren. Her passion is cycling. She would classmates are well, and they would like to com in several different categories. fashion stylist. She started a charity, the cardiology. love to hear from her classmates. hear from their Einstein friends. Kim Starer Landzberg, M.D. ’95, Haute Healing Foundation, whose mis- and her husband, Brian R. Landzberg, Karen Zur, M.D. ’98, was named the sion is to provide hope to chronically ill, Shira Wieder, M.D. ’15, started an David Tal, M.D. ’85, has continued Lisa Moreno, M.D. ’90, M.S., is a M.D. ‘95, have been happily married chief of the division of pediatric otolar- terminally ill, and disadvantaged young attending position at West Derm Skin and his geriatrics work at St. Joseph’s Health professor of emergency medicine at since 1992. They have three children: yngology at the Children’s Hospital of people (including LGBTQIA individuals) Laser Center in Riverdale, New York. Dr. Centre in Toronto, Ontario, Canada, and the Louisiana State University in New Zachary (24), Renée (22), and Eddie (18), Philadelphia; she started the job Dec. 1, through head-to-toe makeovers, gifts, and Wieder and her husband have a newborn, is enjoying his grandchildren. He offers Orleans. The American Academy of and an English shepherd named Dash. 2020, after having served as interim chief photo shoots. Ralphi, and a daughter, Orly. his warmest wishes to all. Emergency Medicine elected Dr. Moreno She has practiced in Riverdale, the Bronx, since March 2020. It was “quite a whirl- to be its president; she is the first woman since completing her glaucoma fellowship wind” to take over the division during the Carol Yuan-Duclair, M.D. ’05, after Lauren Roth, M.D. ’16, was recently Etta May Eskridge, M.D. ‘86, Ph.D. ever to hold that position. in 2000. She enjoys forging relationships COVID-19 pandemic, she reports, but eight years in hospital administration appointed co-chair of the Lesbian, Gay, ‘95, has been a palliative-care physician, with whole families of patients; one spans she is honored to be the first female surgi- and a brief stint in private practice, is Bisexual, Transgender, and Queer Health board-certified in internal medicine David Rauch, M.D. ‘91, just published four generations. She has found implant- cal division chief. She is leading a team of embarking on a new path. Passionate and Well-Being Special Interest Group of and palliative and hospice medicine, at his second book, Challenging Cases in ing trifocal intraocular lenses during cata- 16 surgeons. about empowering people to live healthier the Academic Pediatric Association. Rochester General Hospital since 2013. Pediatric Hospital Medicine, and has started ract surgery tremendously rewarding. lives, she has created B. Hai Sleep Health, She has been a board member for the work on the third edition of Caring for the a telehealth sleep service, to help women Cameron Kemal, M.D. ’17, and Global AIDS Interfaith Alliance, which Hospitalized Child. He is happy at Tufts Brian Blaufeux, M.D. ’96, was on the 2000s become good sleepers. She encourages Chiara Campana were married Feb. 22, organizes trips to Malawi to train medical Children’s Hospital in Boston with his panel of a NODE.Health webinar about Roger Greenberg, M.D., Ph.D. ’00, people to check out her website. 2020, at Our Lady of Pompeii Church in students and clinical officers in a resource- wife, Mindy Stimell-Rauch, M.D. ‘90. digital health, telehealth, and primary is the J. Samuel Staub, M.D., Professor New York. Dr. Kemal is a resident in inter- poor country. She says Einstein prepared care post-COVID-19. He was also in the department of cancer biology at nal medicine at NewYork-Presbyterian/ her well for her work as we face a rapid Jonathan Lewin, M.D. ’93, reports that interviewed by the Westchester Senior Voice the University of Pennsylvania Perelman 2010s Columbia University Irving Medical increase in the number of elderly patients. he “is weathering COVID-19” and that about telehealth, and conducted a virtual School of Medicine. He recently formed Brian Nishinaga, M.D. ’11, moved back Center in New York. Ms. Campana is pur- in some ways he has gotten stronger. His live session to take questions from its the Penn Center for Genome Integrity, home to the San Francisco Bay Area to suing a Ph.D. in biomedical sciences in the Daniel Hyman, M.D. ’86, returned private orthopaedic/pain/spinal surgery readers. Read more at: nodehealth.org/tag/ where he serves as the inaugural director. work for Kaiser Permanente at the hospital department of pharmacology at the Icahn to the Philadelphia area and is serving as practice in Englewood, New Jersey, and digital-health. He is also the director of basic science across the street from his high school. In School of Medicine at Mount Sinai.

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IN MEMORIAM BACK

Chair Emeritus of Medicine, Chief of Cardiology Philip Aisen, M.D., age 91, professor emeritus, physiology & Ullmann James Scheuer, executive vice president and chief of biophysics and medicine at Einstein, M.D., distin- academic affairs at Montefiore. April 10, 2020, New York City. and Einstein guished pro- In addition to being a highly respected Sixty years ago, on May 7, 1961, fessor emeritus clinician and mentor, Dr. Scheuer was a Peter Davies, Ph.D., age 72, Albert Einstein College of Medicine of medicine noted scientist who studied basic aspects clinical professor of pathology at welcomed a special guest: Hans (cardiology) of heart muscle function. “He was con- Einstein, director of the Litwin- Albert Einstein, Ph.D., a son of the tinuously funded by the NIH [National and university Zucker Center for the Study of school’s namesake. Dr. Einstein, a chair emeritus Institutes of Health] for 40 years, which Alzheimer’s Disease and Memory professor of hydraulic engineer- of medicine at Einstein, died Feb. 17, is unheard of in cardiology,” says Mark Disorders, and a leader in the field of ing at the University of California, 2021, at age 89, following a brief illness. Menegus, M.D., Einstein professor of Alzheimer’s disease research, Aug. 26, Since arriving in the Bronx in 1972 medicine (cardiology) and director of the 2020, Greenwich, Connecticut. Berkeley, had come to the Bronx to and even after retiring in 2011, Dr. cardiac catheterization lab at Montefiore. represent his father (who had died Scheuer served Einstein and Montefiore “He ran his lab and trained lots of cardiac Hiltrud Mueller, M.D., age 94, six years earlier) at the ground- in numerous roles, including vice chair, researchers, many of whom are leaders in retired professor of medicine at breaking for the Ullmann Research interim chair, and the Ted and Florence the field today.” Einstein, former associate chief of the Center for Health Sciences. Dr. Baumritter Professor and Chair in He and his wife established the Ruth division of cardiology at Montefiore, Einstein, center, joined Samuel D. Medicine; physician-in-chief; chief of car- and James Scheuer, MD, Endowment and a trailblazing physician-scientist, Belkin, Ph.D., president of Yeshiva diology; director of medical service and of in Cardiology to support special train- Dec. 23, 2020, New York City. the medical house staff program; professor ing in research for future cardiologists University, left, and Dean Marcus D. of physiology; and principal investigator. at Montefiore; the division of cardiol- L. Juden Reed, M.D., age 86, Kogel of Einstein to initiate con- “Dr. Scheuer was one of the giants of ogy on Montefiore’s Moses Campus associate professor of medicine struction of the 10-story, 12-sided cardiology and a consummate physi- bears his name. The couple also created (hematology) at Einstein and an biomedical research tower. cian, serving as a role model to genera- the James and Ruth Scheuer Fund at oncologist at Montefiore, Dec. 11, Siegfried Ullmann, a noted tions of physicians,” says Yaron Tomer, Einstein, which provides an annual 2020, Pelham, New York. industrialist and philanthropist, and M.D., chair of medicine at Einstein and award for a graduating M.D. or Ph.D. his wife, Irma, donated $2 million Montefiore, and a professor of medicine student whose disciplinary focus will be Bernard “Bern” Slosberg, M.D. to help build the facility, which and of microbiology & immunology internal medicine. ‘67, M.P.H., age 79, retired regional and the Anita and Jack Saltz Chair in A native New Yorker, he earned his medical director for Aetna Health was intended to attract top-notch Diabetes Research at Einstein. “He left bachelor’s degree at the University of Insurance, volunteer physician and molecular biologists, cell biolo- an incredible legacy.” Rochester and his medical degree at Yale medical school instructor, Dec. 12, gists, and geneticists. The National Adds Gordon F. Tomaselli, M.D., School of Medicine. He completed his 2020, Silver Spring, Maryland. Institutes of Health provided an ad- Einstein’s Marilyn and Stanley M. Katz medical internship at Bellevue Hospital in ditional $2 million toward construc- Dean, “Although I didn’t have the good New York and residency at Mount Sinai. Tyr O. Wilbanks, M.D., age 64, tion of the $8.5 million building. Its fortune to train under him directly, Dr. Dr. Scheuer is survived by his wife, assistant professor of surgery and circular design was meant to allow Scheuer was renowned in American Ruth Lucas Scheuer; their children, former medical student clerkship natural light to illuminate all labora- cardiology. His colleagues, trainees, Kim Scheuer, M.D. (Derek Olsen), Jeff director at Einstein and a surgeon and many other physicians would flock Scheuer, and Greg Scheuer; his grand- at Montefiore, Dec. 3, 2020, Old tories and to encourage collabora- to his presentations at national meet- son James; his brother Robert; and Greenwich, Connecticut. Albert Einstein College of Medicine Archives tion among scientists. ings.” Dr. Tomaselli is also a professor many nieces and nephews. His brother of medicine (cardiology) at Einstein and Thomas predeceased him.

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Science at the Heart of Medicine

Winter/Spring 2021

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EINSTEIN IMAGE

Hematopoietic stem cells (HSCs) are self-renewing cells that reside in the bone marrow and generate all of the body’s blood cells. Clinicians can stimulate HSCs to enter the bloodstream, where they can be harvested and used in bone marrow transplan- tation to treat cancers and other conditions. But scientists have long assumed that HSCs otherwise remain immobile within their bone marrow niches. In a study published last June in Cell Stem Cell, researchers led by David Fooksman, Ph.D., found that HSCs move constantly—probably to maintain their survival. The researchers used two-photon laser-scanning microscopy to observe HSCs in the bone marrow of living mice over several hours. This image shows the white tracks of an HSC (labeled bright red) as it wanders the bone marrow and interacts with differently colored stromal (niche) cells that nourish the HSC by expressing growth factors such as SCF-1. Dr. Fooksman is an associ- ate professor of pathology and of microbiology & immunology. Image credit: The Fooksman lab

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