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Still a Formidable Foe in Treating Mental Health

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Still a Formidable Foe in Treating Mental Health SPRING 2011 STILL A FORMIDABLE FOE IN TREATING MENTAL HEALTH PLUS • WHEN DISEASES ARE RARE • THE TAUBMAN TRANSFORMATION p. 14 The first woman to serve on the faculty of Harvard University and widely considered the founder of occupational and industrial medicine, Alice Hamilton (M.D. 1893) was no stranger to blazing trails. CONTENTS SPRING ’11, VOLUME 13, NUMBER 1 Features 16 In the Wake of War As the U.S. engages in ground combat on two distant fronts, our soldiers often return with mental health needs as well as physical, and an inherent reluctance to seek help. BY JEFF MORTIMER 22 Desperately Seeking Answers When the disease that afflicts you is rare, the search for diagnosis and treatment can be long, uncertain and fraught with frustration. BY SALLY POBOJEWSKI 30 Secrets and Truths A U-M Medical School study reveals that physician depression can begin in the student years, and stigma frequently impedes treatment. BY WHITLEY HILL 36 A. Alfred Taubman: The Vision, The Legacy A. Alfred Taubman’s remarkable $100 million commitment supports the Taubman Medical Research Institute at the U-M and brings his overall giving to the University to a record high for an individual donor. BY JANE MYERS Departments 2 From the Dean Exclusively on the Web 3 @umich.edu 4 Inside Scope Match Day 2011 • 11 On Call The Galens Smoker • 14 Looking Back Sculpture enriches the • 36 The Michigan Difference medical campus 44 Limelight 48 Rotations 50 Lives Lived COVER: JOECOVER: ZEFF DESIGN LIBRARY HISTORICAL BENTLEY U-M THE OF COURTESY OPPOSITE: 52 Moments 1 WWW.MEDICINEATMICHIGAN.ORG/MAGAZINE FROM THE DEAN Published three times a year by the U-M Medical School and the Office of Medical Development and Alumni Rela- tions, 1000 Oakbrook Dr., Suite 100, Ann Arbor, MI, 48104, (734) 998-7705, DEPRESSION RESPECTS NO [email protected]. intellectual, economic or cultural boundaries. It strikes our students and www.medicineatmichigan.org/magazine accomplished physicians. Too often those affected wage a private battle with depression — in silence, out of James O. Woolliscroft, M.D. fear of what those around them might DEAN, U-M MEDICAL SCHOOL think. Anne Cooper The power of stigma is not absolute, INTERIM DIRECTOR OF MEDICAL DEVELOPMENT & ALUMNI RELATIONS but it can be a tremendous barrier to getting individuals the mental health Raymond L. Aldrich DIRECTOR OF DEVELOPMENT treatment they need. When those peo- COMMUNICATIONS AND MARKETING ple are themselves physicians or future physicians, the fears are not only for the present, but also the future: What would my attending think? Would my EDITOR Richard F. Krupinski peers consider me less of a physician? Will my career be derailed if someone finds out? While most physicians treat SCIENCE EDITOR Sally Pobojewski depressed patients effectively and with compassion, our medical culture — just like the larger American culture of which it is part — fosters a complicit silence ASSOCIATE EDITOR/PHOTO EDITOR about their own mental health, a silence born of stigma. Marie L. Frost The Berlin Wall of mental health, stigma will be broken down only as the EDITORIAL ASSISTANT culture that nurtures it changes. As we know with so many physical disorders, Robin M. Johnson treatments can allow patients to lead normal, productive lives. We must continue to extend this realization to mental health as well, and further to recognize that CONTRIBUTING WRITERS: physicians, for all their healing abilities and medical expertise, are in the end Kevin Bergquist, Whitley Hill, Jeff every bit as human, vulnerable — and treatable — as the patients they care for Mortimer, Jane Myers, Claire Northway, Nancy Ross-Flanigan, James Tobin, every day. Cailin M. Wilke CONTRIBUTING REPORTERS: Sincerely, Ian Demsky, Heather Guenther, Mary Masson, Jessica Soulliere, Bruce Spiher and Margarita Wagerson of the U-M Health System Office of Public Rela- tions and Marketing Communications ART DIRECTION AND DESIGN JAMES O. WOOLLISCROFT, M.D. (Residency 1980) B&G Design Studios Dean, U-M Medical School PHOTOGRAPHERS Lyle C. Roll Professor of Medicine Eric Bronson, Scott Galvin, Scott Soderberg and Martin Vloet of U-M Photo Services; J. Adrian Wylie FOUNDING EDITOR Jane Myers 2 U-M SERVICES PHOTO MARTINVLOET, MEDICINE AT MICHIGAN @UMICH.EDU Fall 2010 difference in her chance to survive. rounds sessions. These experiences When I hear the “chopper” go over my proved to be far less nerve-racking and house, I always send a mental “thank you more rewarding than I had anticipated. for all you do” to ride along with them. About 6-8 years ago, I spotted a famil- Critical Care Charlotte J. Wyche iar face among physicians at a pediatric in the Air Chelsea, Michigan grand rounds lecture at Santa Clara Also Valley Medical Center in San Jose, Cali- • Proteins, Good and Bad • CMe and Coi at the U-M fornia. (I’ve been a pediatrician in the I work with the Survival Flight team South Bay/San Jose area since 1982.) when they provide transport for us The familiar face was that of Dr. Oliver. SURVIVAL FLIGHT — MORE TO SAY during organ recovery cases. The pilots, After many years, he still maintained the There is much more that could be nurses and dispatch personnel in Sur- energy and interest to assist SCVMC said about the history and evolution of vival Flight all do a great job! peds residents as a visiting scholar. My Survival Flight (“Saving Lives in the Sky,” Larry Slate condolences go out to his family. fall 2010). I write to call attention to one Transplant Donation Specialist In this same issue, I read the brief more unique and important aspect of U-M Transplant Center story about Dr. Josip Matovinovic. As Survival Flight operations, and that is medical students, each of us was asked the weekly Tuesday morning confer- to select a faculty member to be our ence (“grand rounds”) at which flights REASON TO CELEBRATE personal advisor. Having heard Dr. M in are discussed, issues raised, problems We are celebrating our 29th year of clinical medicine lectures, I asked him if solved, and all participants learn from cancer survivorship courtesy of the he would be my advisor. He readily as- one another. This set the tone for Sur- University of Michigan! Gene now sented. Some weeks later, I and several vival Flight to be a learning organization. volunteers as part of colon cancer of his other “advisees” were invited to Credit for this goes to the late James R. prevention research (nutrition) at the dinner at his home. This was a won- Mackenzie, M.D., who was the surgeon University of California, Irvine, and we derful surprise and change from our and first director of the Emergency also volunteer with medical students. daily routines. We enjoyed a delicious Service (now Department of Emergency We, too, prefer the print edition of home-cooked meal, and Mrs. (Natalie) Medicine) who was instrumental in get- Medicine at Michigan — an A+ publica- Matovinovic was a warm and welcom- ting the program off the ground in 1983. tion! Keep up the good work! ing host. Some 33-and-a-half years Richard E. Burney, M.D. Gene and Bea Anderson belatedly, I’d like to thank Mrs. M for Professor of Surgery, U-M Medical School Anaheim, California her graciousness, and for welcoming us into her home. Hanley J. Yoffee (M.D. 1978) My beloved niece was one of the H1N1 CONDOLENCES AND GRATITUDE San Jose, California cases mentioned in the article. She died I read with sadness in the fall 2010 two weeks later, but I know that the team issue about the passing of Dr. William did everything they could to try to make a Oliver, chair of pediatrics during my To opt-out of a print subscription to regular pediatric rotation as an M3 in Medicine at Michigan and instead 1977, and during my chosen pediatrics receive e-mail notification when a Letters to the editor may be sent to sub-internship as an M4. During my M3 new issue appears online, send an [email protected] or 1000 Oakbrook rotation, I was put on the hot seat twice e-mail with your name and address to Dr., Suite 100, Ann Arbor, MI, 48104, as “difficult case presenter” for Dr. Oliver [email protected] with and may be edited for clarity or length. — I led Saturday morning peds grand “opt-out of print” in the subject line. 3 WWW.MEDICINEATMICHIGAN.ORG/MAGAZINE INSIDE MICHIGAN MEDICINE HEALTH SYSTEM-WIDE SCOPE In the Lab Skinny Worms stimulates overall protein production. shifts, the cell may respond in other This similarity suggests that whatever lifespan-extending ways. Live Longer scientists learn about how drr-2 works Hsu and his colleagues found that in roundworms may apply to the hu- drr-2 plays a key role in protein synthe- man version of the gene as well. sis, and that reducing the gene’s activity EAT LESS, LIVE LONGER! THAT’S NOT A Both genes function in a signaling slowed down protein production. What’s rallying cry for the latest fad diet; it’s the pathway called the TOR pathway that more, simply silencing the gene was conclusion from decades of solid sci- senses nutrient levels in cells and is be- enough to increase lifespan in round- entific research. Study after study has lieved to mediate the anti-aging effect worms. Taken together, these results demonstrated that drastically reducing of dietary restriction. suggest that drr-2 plays an essential role food intake lengthens the lifespan of “In the mammalian system, TOR in the TOR pathway, controlling both laboratory animals from roundworms senses the level of amino acids in a cell, protein synthesis and longevity.
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