Photo: Belinda Carter

Dear Alumni/ae and Friends: Welcome to the sixth issue of at ! It’s hard to believe that the sesquicentennial celebra- tion has ended. The events over the past year have become another important part of the legacy of our Medical School, and I want to thank each and every one of you who took advantage of all of the opportu- nities to help us celebrate our anniversary. When the left the field at half time during the October 14th homecoming game, the celebration of the Medical School’s sesquicentennial offi- cially ended. The high-energy program was a fitting con- Science II Building is a colorful 27-foot-long art in- clusion to the final week of campus events that began with stallation that pays tribute to John Jacob Abel, Minor a “birthday party” outdoor barbecue for nearly 5,000 stu- J. Coon, James V. Neel, Horace W. Davenport, Frederick dents, faculty, staff and hospital employees. C. Neidhardt, Elizabeth C. Crosby and Gerald D. Abrams. (See pages 42-45 for details.) Lastly, four Other major events during the week included the open- bronze markers are now located around campus to ing of Seeing Is Healing? at the mark important sites in the history of the Medical Museum of Art; the dedication of the MCAS Hall of School at the University. Honor in the Towsley Center; the Medical Center Alumni Society all-classes reunion activities including With a newfound appreciation for the greatness of the keynote addresses by noted alumni Donald S. Medical School’s proud history and of all the men and Fredrickson, M.D., former director of the National women who contributed to it over many years, we are Institutes of Health, and Marshall Nirenberg, Ph.D., more determined than ever to carry that illustrious Nobel-prize-winning medical researcher; and a sesqui- heritage forward. In this issue, as in the five that have centennial gala dinner. preceded it, you will learn more about the truly out- standing people and programs that make up this won- While the last anniversary toast has been offered and derful place. The Medical Scientist Training Program the final set of remarks delivered, many lovely remind- is one of our most prestigious and exciting programs, ers of the celebration are now in place in the Medical one in which, with the support of the National Insti- School. Patients, visitors, staff and students alike pass tutes of Health, we train some of the most creative and through a permanent anniversary project when they most ambitious of the next generation of physicians walk through the connector between the Medical and medical scientists. The efforts of Ron Koenig and School and the hospital. Graduation class composites all of the Medical School faculty who participate in now hanging there re-establish the tradition begun recruiting and training these outstanding students is when the composites first hung in the connector to crucial to the success of the Medical School’s mission. Old Main. The turn-of-the-century doctor’s office Also, you’ll read about how Betsy Lozoff’s conscien- exhibit in the hospital lobby offers a historic view of a tious and long-running work examining the role of typical Ann Arbor practice. Seven of our leading basic iron deficiency in the development of children’s brains science faculty members now have lecture halls named is having an impact on children’s well-being in coun- after them. Near the third-floor entrance to Medical tries throughout the world.

Allen S. Lichter, M.D. Dean Letters to the Editor

vided to me, my father and my grandfa- When “Giants ther by your great institution. Walked the Earth” Thomas F. Scott I thoroughly enjoyed your series of (M.D. 1958, 1963) articles on the history of the Medical Huntington, West Virginia L School. I, too, am a third generation graduate of this school, and was thor- oughly imbued with its rich heritage. My grandfather was a member of the Class “He, George W. Hicks, of 1899, and my father graduated in 1925. Was the Senior Shown” My first year there was one of much free- floating anxiety. I was one of three One day last week, when my husband’s “legacies” in my class. Unfortunately the copy of Medicine at Michigan arrived, he other two did not survive the first year. was amazed to see, on the inside of the back page, scenes from LIFE Magazine of I still recall the squeaking 50 years ago. He, George W. Hicks (M.D. wooden floors of the West 1950), was the senior shown. At that time Medical Building. Changing we had three small children, George was classes in mid-morning I would working nights, and his GI bill was either descend the stairs under the dis- a thing of the past or woefully inadequate. approving gaze of both father A $300 scholarship from a medical soci- and grandfather. Their unspo- 1 ety and a modest and unexpected legacy ken question: “Why aren’t you from my step-grandfather in England doing better?” enabled George to be graduated. He was In any event, with the combined efforts the first U-M Medical School student with of Patton, Woodburn, Crosby, Nungester, a child to be accepted. When he entered Weller and countless others, I was suffi- ciently burnished that I was permitted to enter the clinical years. This was the period of Epidemiologist Thomas Francis Jr. 1 announces from the stage of when “giants walked the earth.” Dr. Rackham Auditorium on April 12, Alexander had just died, but Miller, Sturgis, 1955 that the Salk vaccine is Conn, Kahn (Reuben) and Kahn (Edgar), “safe, effective and potent.” Coller, Badgley and Nesbitt were all in their heydays. Dean Furstenberg must have had some blackmail material on each of the de- George W. Hicks, 2 partment heads, because the junior clinical photographed by Alfred Eisenstadt lectures were given almost exclusively by the for LIFE Magazine in 1950 chiefs and full professors. One of my most memorable days in the Medical School was Dr. James G. Van Zwaluwenburg 3 the day of the announcement by Dr. Tommy Francis of the positive results of the polio vaccine study. It took an additional five years of the Ann 2 Arbor experience to qualify me as a rela- tively complete orthopedic surgeon. Although my son is a physician, he was medical school he had a chemical engi- not permitted the Michigan experience. neering degree from Michigan and had served four years in the Army, honorably I have enjoyed every day of practice dur- discharged with the rank of major. ing the past 40-odd years and owe a debt of gratitude to the firm foundation pro- As a family doctor, George practiced 22- and-a-half years in Pascagoula, Missis- 4 Winter 2001 to the sippi, six years in Grand Bay, Alabama, behavior that unfairly punishes or intimi- and seven-and-a-half years on St. Croix, dates students can be laughed off under the U.S. Virgin Islands. At Pascagoula he rubric of, “Oh, well, that’s the way it was!”? delivered about 3,000 babies, had a large As the recipient of similar behavior I can office practice, made house calls, had Lettersassure you I didn’t find it funny then adventures in the Gulf of Mexico with the (1950), and I certainly don’t think it’s Coast Guard, and went up a gantry crane funny now, 50 years later. “Long Ago and Before once at Ingalls Shipyard to pronounce a man dead. He also made hospital rounds Joel I. Hamburger Many Others, He twice a day. He practiced solo except at (M.D. 1954) Embraced Diversity…” St. Croix, when he was an emergency West Bloomfield, Michigan room doctor for the U.S. Virgin Islands I want to thank for his Department of Health. For some years he work (“An Example Worthy of Imitation,” raised Santa Gertrudis cattle on our farm Fall 2000). If we forget where we have in Grand Bay. While on St. Croix George “Isadore Lampe Did Not been, we cannot find our future. I also was ordained a permanent deacon in the Found the Department of want to express my joy at knowing that Catholic Church after studies at night for ” Horace C. Davenport is still four years. We are the parents of six chil- contributing, and to have “Dr. dren. There has seldom been a boring In the article “The ABC” know how important his time for we have had 17 homes since we Deans on Canvas” quote “you live your life on the married in 1940. (Fall 2000), Isadore intellectual reserve accumulated Lampe is listed as the during the first twenty-five We wanted to let you know that it was founder of the years” has been to me. Another, good to be reminded of a time when we “Michigan produces a high level felt we were reaching a goal in spite of Department of Radi- ology. Dr. Lampe was of mediocrity,” has kept me difficulties, confident of the future, and a superb physician, humble and cautious to this day. trusting in the next day. radiotherapist, and Dr. Davenport is one of a very Alice Brown Hicks true gentleman. It was few who remain powerful long McDonough, Georgia an honor for me to be after their lectures are lost. one of his residents. Another of Dr. Davenport’s However, he did not 3 great contributions to the “One Might Wonder Why found the Depart- Medical School was his distaste You Would Publish These ment of Radiology. for provincialism and his aware- Dr. William Martel’s The Distinguished His- ness that greatness could come from Experiences” tory of Radiology at the University of Michi- many sources. Long ago and before many others, he embraced diversity not only Dr. Harry J. Schmidt, in “Alumni Remi- gan correctly states that in 1917 Dr. James G. Van Zwaluwenburg because it was right and noble, but niscences” (Fall 2000), reminded us of the became the first chairman of what was then because, as he so clearly recognized, it was admonition he heard as a medical student healthy and productive as well. at Michigan, “Look to your right and to the Department of Roentgenology. your left, one of you three will not be here Dr. Willis S. Peck was the first director of On the same day that I read Dr. Markel’s to graduate.” He went on to tell of receiv- radiotherapy, serving from 1933 to 1939, wonderful piece I had just mailed my ing a D because of an addition error by when he came to Toledo, Ohio. It was my friend’s grandfather’s Homeopathy Col- the person who graded his final exam in privilege to be associated in practice with lege sheepskin signed by President Angell anatomy. The professor agreed that an Dr. Peck from 1964 until his retirement to my first cousin, Eric Bates, M.D., of error had been made, but refused to cor- in 1972. Dr. Lampe succeeded Dr. Peck in your cardiology faculty to forward to the rect it, and the dean refused to intervene. 1939, and served as director of radio- Historical Center for the Health Sciences! therapy for 35 years. One might wonder why you would publish Grateful for your effort in recording and these experiences. Did you find them amus- Charles M. Klein publishing our history, I am, ing? Do they enhance the reputation of the (Residency 1962) Randall R. Smith Medical School? I think you should be Jupiter, Florida (M.D. 1971) ashamed of such events. Or is your arro- Redding, California gance so vast that any kind of deviant [email protected] Editor Medicine at Michigan 5 Lecture Halls Named for Michigan Luminaries in Basic Sciences A Tribute to Seven Scientists Recognizing the fundamental role basic science plays in the progress of medical7 knowledge and its applications to human health, the U-M Medical School, as part of its year-long sesquicentennial celebration, dedicated seven lecture halls in the names of basic scientists who, through- out the School’s history, have significantly contributed to basic science advances and, through effective communica- tion of their work, have inspired those who have come to Michigan to learn medicine. The seven scientists — John Jacob Abel, Minor J. Coon, James V. Neel, Horace W. Davenport, Frederick C. Neidhardt, Elizabeth C. Crosby, and Gerald D. Abrams — were selected as a result of nominations from their departments and are commemorated in a 27-foot-long multi-media installation, created by Ann Arbor artist Bill Burgard and showcased in the lobby of Medical Sciences Building II. To the primary medium of oil painting on lami- nated plywood, Burgard added elements of steel, granite, Artist Bill Burgard completes portraits of Frederick aluminum, Plexiglas and slate to depict and characterize Neidhardt and Elizabeth Crosby, two of the basic the scientists and their work. Dedication of the installation scientists honored during the Medical School’s and named lecture halls took place on August 21, 2000. Sesquicentennial with the naming of lecture halls in Medical School buildings. Se

42 Winter 2001 Gloria and Gerald Abrams at the Seven Scientists installation

Frederick Neidhardt and wife, Germaine Chipault Tetsufumi Ueda (Ph.D. 1971) and Minor “Jud” Coon

Priscilla Neel, widow of the late James V. Neel, and Executive Vice President for Medical Affairs eveGil Omenn n

Medicine at Michigan 43 The Seven Scientists James V. Neel, M.D., Ph.D., Department of Human Genetics. Neel founded, in 1956 at Michigan, the nation’s first department of human genetics and served as its chair for 25 years. Widely regarded as the father of human genetics, Neel’s work increased our under- standing of the genetics of diseases such as mellitus, neurofi- bromatosis and sickle cell anemia, as well as our understanding of the effects of atomic radiation on humans and the genetic structure of Amerindian populations. The Neel Lecture Hall is located at 2901 Taubman Library.

John Jacob Abel, M.D., Department of Pharmacology. Considered the father of American pharmacology, Abel was appointed, in 1891, the first professor of pharmacology at Michi- gan (and in the U.S.). He founded the Department of Pharmacology, a change from Materia Medica that was quickly emulated by other medical schools across the country, and he was a founding member of the American Society for Biological Chem- ists and of the American Society for Pharmacology and Experimental Therapeutics. Abel was also founding editor of the Journal of Experi- mental Medicine, of the Journal of Biological Chemistry, and of the Journal of Pharmacology and Experimental Therapeutics. The lecture hall located at 5330 Medical Sciences I was named for Abel. Minor J. Coon, Ph.D., Department of Biological Chemistry. Chair of the Department from 1970 to 1990, Coon’s work in unraveling the chemical, physical, catalytic and mechanistic properties of cytochrome P450, and in establishing its biomedical significance in steroid biosyn- thesis, chemical carcinogenesis and drug metabolism, led to worldwide recognition. Based on his pioneering research, he was elected to the Na- tional Academy of Science, the American Academy of Arts and Sciences, and the Institute Horace W. Davenport, Ph.D., D.Sc., of Medicine, and Department of Physiology. For 22 he was awarded an years Davenport chaired the Department of Physiology, during which time honorary medical he became the world’s leading authority on gastric secretion and acid-base degree from the balance. Noted historian, distinguished scientist and a popular teacher, Karolinska Insti- Davenport was president of the American Physiological Society and tute in Stockholm. author of several major textbooks, including the classic, The ABC of Acid- The lecture hall Base Chemistry. His Not Just Any Medical School chronicles the history of located at 3330 the U-M Medical School from its 1850 founding to pre-World War II times. Medical Science I The lecture hall located at 3699 Medical Science II South was named for was named for Davenport. Coon.

Se44 Winter 2001 ve Frederick C. Neidhardt, Ph.D., Department of Microbiology and . Neidhardt joined the University of Michi- gan in 1970 as chair of the Department of Microbiology and went on to serve the Medi- cal School as associate dean for faculty and the University as vice president for research. His own research focused on gene regulation and the molecular physiology of bacterial growth, and he served as president of the American Society for Microbiology. The Neidhardt Lecture Hall can be found at 2903 Taubman Library. Elizabeth C. Crosby, Ph.D., Department of Cell and Developmental Biology (the Department of Anatomy in Crosby’s time). A neuroanatomist of international author- ity and one of the Medical School’s most beloved teachers, Crosby was the School’s first female professor, teaching 8,500 stu- dents between 1920 and 1958. She worked an additional 23 years in the Section of Neu- rosurgery and co-authored several volumes of Correlative , the standard neurosurgery textbook for nearly 20 years. In 1980, President Jimmy Carter awarded Crosby the National Medal of Science. The Elizabeth Crosby Lecture Hall is located at 3695 Medical Science II North. Gerald D. Abrams, M.D., Department of Pathology. A surgical pathologist with special expertise in gastrointestinal and cardiac pathology, Abrams is a 1955 gradu- ate of the Medical School and has been a faculty member for over four decades. Particularly committed to medical education, he has served in About the Artist a number of administrative roles including coordinator of pathology education, director of anatomic pathology, and member of the Dean’s Bill Burgard (B.F.A. 1979) is Committee on Curriculum Improvement. Repeatedly recognized by an illustrator and designer in students as an outstanding and inspirational teacher, Abrams has Ann Arbor. He teaches at the received every major teaching award in the Medical School. The lecture U-M School of Art and is per- hall located at 3697 Medical Science II West was named for Abrams. haps best known for the post- ers he has created annually for the Ann Arbor Summer Festi- val since the festival began in 1984.

ven Medicine at Michigan 45 16 Winter 2001 by John Barton For Betsy Lozoff and her Research Team, 25 Years of Work Yield Important New Understandings in Child Development

After more than two decades of studying the complex Dramatic new insights regarding iron’s critical role in relationships between nutrition and childhood develop- children’s development were recently revealed to Lozoff ment, a team of scientific investigators from the Univer- and her research team in a long-term study of 191 lower sity of Michigan may finally be on the verge of learning middle-class children in Costa Rica that began in 1981 in how iron deficiency affects the human brain. conjunction with colleagues there at National Children’s

“It’s exciting,” says Betsy Lozoff, M.D., direc- tor of the U-M Center for Human Growth and Development. “We have finally gotten to the Painstaking point where it is possible to ask brain-behav- ior questions more directly. It used to be that Research Reveals I could never say what’s happening with the brain. We just had to put that aside. Long-Term Impact “But now we can ask those questions, and it is very exciting to know we are getting closer to the answers. There is a handful of investi- of Infant Iron gators who are looking at the basic science side of iron and the developing brain. A num- Deficiency ber of them are now starting to work together.”

Iron is required for myelin (the fatty sheath surrounding Hospital in San jose. The researchers discovered that axons, which connects nerve cells and speeds nerve con- infants with an iron deficiency at the beginning of the duction). Iron is also required for normal functioning of project exhibited learning and behavior problems as teen- the neurotransmitter dopamine. The hippocampus (a struc- agers — even though their original iron-deficiency ture in the medial-temporal lobe of the brain), which is anemia was corrected to normal levels through treatment. involved in memory processes, also seems to be particu- Lozoff says the results of the study suggest there are larly vulnerable to early iron deficiency. “These new long-lasting developmental effects among children who understandings of iron’s role in the developing brain make are afflicted with iron deficiency as infants. it possible for the first time to design studies to test for these effects and to understand some of the findings in The Costa Rican project was recently given a prestigious iron-deficient infants,” Lozoff notes. boost when Lozoff won a National Institutes of Health

Betsy Lozoff, M.D., professor of pediatrics and MERIT (Method to Extend Research in Time) grant that communicable diseases and director of the Center for will allow researchers to continue studying the children Human Growth and Development, photographed in her after the current set of evaluations is completed. North Ingalls Building office. In the background is a life-size self-portrait, done as a kindergarten class project, of Lozoff’s daughter, Claudia Brittenham, now 23 and a museum curatorial assistant in Washington, D.C. Photo by D.C. Goings, BMC Media.

Medicine at Michigan 17 “It’s great to be able to continue the research,” Lozoff says. “When I first started the project, I really thought the children would improve with iron. The fact that they didn’t has led to new ways of trying to understand what’s going on.

“At 12 years of age more of them have repeated a grade and have trouble with arithmetic and writing. These are problems in doing basic fundamental things that are going to make life harder for them as they go along. And

then there is more anxiety and depression. When I started wasn’t immediately inspired to Lozoff’s research in Chile the work, I would never have predicted that.” attend medical school. included a home-based intervention program to In addition to the Costa Rica study, Lozoff and her colleagues attempt to counteract the Instead, she found herself effects of early iron defi- are involved with a similar study of more than 1,000 children involved with anthropology ciency anemia. Here, one in Chile that began in 1990. In a joint project with the Univer- of the home visitors works projects that included summer with a mother and her baby. sity of Maryland, Lozoff is working with colleagues who fieldwork with the Otavaleno recently launched a new study in India that Indians of Ecuador for Harvard involves both iron and zinc supplements. University, a study of the Indians of Martinique, and a stint in India for a project dealing with childhood diarrhea. “These new under- “And,” she continues, “we are seeking standings of iron’s role funding for a program project grant to work “By that time, I was particularly interested in children’s in the developing brain on iron deficiency in the developing human behavior and development, and I was interested in situations make it possible for infant, the monkey infant and the devel- that were common from a world-wide perspective, not just the first time to design oping rodent. That’s a new phase of the in the United States. I went into medical school thinking that studies to test for project for us. I wanted to be involved with developing-country issues in some way or another. I didn’t know about pediatrics or these effects and to “I have to say that this research area is behavior and development, but somehow I knew I was going understand some of more intriguing now than at any time in to have something to do with developing countries.” the findings in iron-de- the 25 years I’ve been working on it.There ficient infants.” is still only a handful of people involved, She graduated from Case Western Reserve University in 1971, — Betsy Lozoff but for a long stretch there was barely then spent three years at nearby Rainbow Babies and anybody. With the advancements in basic Childrens Hospital in Cleveland, Ohio, followed by nearly 20 and the ability to assess years on the faculty of Case Western. Lozoff came to the young children, I can’t help but be excited about the Department of Pediatrics in the U-M Medical School in 1993, direction our research is taking.” and was named, later that year, director of the U-M Center for Human Growth and Development, a multidisciplinary Lozoff was born in Milwaukee, grew up in Kansas and gradu- collaboration among biomedical, behavioral and social ated from high school after her parents moved to the San scientists to further the understanding of the complex Francisco Bay area. She earned degrees in social relations processes by which human beings develop and grow. The and computer applications at Radcliffe College in 1965, and

18 Winter 2001 long-range goal of the Center is to optimize children’s physical, cognitive and socioemotional development.

“It was in the 1970s,” she recalls, “that I had the chance to hear Frank Oski, who was a wonderful hema- Dramatic new insights were tologist, talk about his pilot study recently revealed to Lozoff on iron deficiency. I listened to him and her research team in a and told myself, ‘That’s it!’” long-term study of 191 lower middle-class children in Costa It has been estimated that 20 to Rica that began in 1981 in 25 percent of children throughout conjunction with colleagues the world have anemia — a there at National Children’s reduction in oxygen-carrying Hospital in San Jose. The hemoglobin in the blood — due researchers discovered that to severe iron deficiency. infants with an iron deficiency Although the problem is less at the beginning of the project Naptime in Santiago — In the Sleep and Functional Neurobiol- common in this country, recent exhibited learning and behav- ogy Laboratory at the Institute of Nutrition and Food Technol- estimates indicate about five ogy of the University of Chile, infant subjects 6-18 months of ior problems as teen-agers — age come into the lab, accompanied by their mothers, for their percent of poor African-American even though their original afternoon naps. While napping, the babies are measured for a and 18 percent of Mexican- variety of things such as auditory responses, sleep-wake pat- lack of iron was corrected to tern, motor activity, rate and respiration to determine their American infants and toddlers are normal levels through treat- neurophysiologic development as it relates to iron deficiency. iron deficient. Infant health is generally excellent in Chile, but dietary iron ment. deficiency is common. “In the U.S. we put iron in baby The accompanying example of auditory brainstem response in two infants six months of age illustrates what Lozoff and her formula and cereals,” Lozoff colleagues have discovered. When the response of nonanemic explains. “We’ve also put ascorbic acid in certain foods control infants (top wave) and infants with iron deficiency (bot- tom wave) are compared, the response time of anemic infants to help the body absorb iron, and we’ve encouraged breast is longer. While differences were slight at six months, they got feeding. All of those things have helped reduce iron bigger at 12 and 18 months — a clear indication of slower de- velopment in the auditory pathway of the nervous system in in- deficiency in the United States. fants with iron-deficiency anemia. “The central nervous system used to be mostly a big black box “But there isn’t a good way to prevent iron deficiency in most about the effects of early iron deficiency,” says Lozoff. Today parts of the world. You’ve got areas where there are no safe Lozoff and colleagues around the world, including Vietnam where she will be speaking at the International Nutritional Ane- water supplies and that means you’re feeding babies unsafe mia Consultative Group Symposium in Hanoi in February, know formula. You also see more iron deficiency in European that a variety of factors, ranging from poverty and family disad- vantages to the infant’s biochemistry and behavior, influence infants than we have in the United States because many the development of a child’s brain. European countries have not endorsed the same iron supple- mentation recommendations as we have in this country.”

Medicine at Michigan 19 The interdisciplinary research team participating in Betsy Lozoff’s iron deficiency studies includes the following U-M scientists and fac- ulty:

ROSARIO CEBALLO, PH.D.: Assistant Professor, College of Literature, Science and the Arts, Psychology Department and Women’s Studies Program

BARBARA FELT, M.D.: Assistant Professor, Department of Pediatrics and Communicable Diseases

JOHN HAGEN, PH.D.: Director of Academic Programs, Lozoff says that as she began to become Center for Human Growth and The Costa Rican interested in iron deficiency, she was Development government made a attracted to Central and South America as national recommenda- JOHN JONIDES, PH.D.: potential areas for research. tion to supplement Professor, Psychology Depart- children’s diets with “I was looking for places where there was ment iron as a result of the not generalized malnutrition,” she explains. Rosa Angulo-Kinzler, Ph.D.: findings of Lozoff and “I wanted places where there weren’t prob- Assistant Professor, Division of her research team. lems with abnormal hemoglobins on a Kinesiology genetic basis, where there wasn’t malaria EILEEN MOLLEN, PH.D.: and where there weren’t a lot of parasites. Clinical Psychologist and Assis- “I wanted a place where I would be able to focus on iron tant Professor, Department of deficiency. That’s what took me into Central and South Pediatrics and Communicable America. There are countries there where they have very Diseases good health and have wiped out generalized malnutrition. STEPHEN RAUDENBUSH, ED.D.: Lead and parasites are not major problems.” Senior Research Scientist, Survey The Costa Rican government made a national recommen- Research Center, and Professor, School of Education dation to supplement children’s diets with iron as a result of the findings of Lozoff and her research team. ARNOLD SAMEROFF, PH.D.: Professor, College of Literature, “My colleagues in Chile,” she says, “have also moved Science, and the Arts, Psychology toward a national fortification program. The initiatives to Department; Director of the Cen- try to reduce micronutrient deficiencies have taken off ter for Development and Mental around the world. At the World Bank and UNICEF, it’s not Health; and Senior Research Sci- only iron. It’s also zinc deficiency and vitamin A deficiency. entist, Center for Human Growth and Development “It’s gratifying to be able to look back and say there is certainly a very different level of attention being paid to these issues than when we started.” m

20 Winter 2001 After 30 Years of Caring for Animals Used in at the University, Dan Ringler Retires from Laboratory MedAnimal Medicine i Dan Ringler grew up on a dairy farm in New London, Ohio, the sort of operation where people were unsentimental about their animals, especially the non-working kind. So when he entered the veterinary medicine program at Ohio State in 1961, “I really wasn’t prepared to see the depth of feeling that urban people had for their pets, treating them just like members of the family,” says Ringler, who retired last May after 30 years on the laboratory animal medicine faculty, the last 15 of them as the director of the Unit for Laboratory Animal Medicine (ULAM).

“I say we’re in the business of reducing pain and suffering on the planet, and that medical research and laboratory animal medicine go hand in hand in doing that.” —Dan Ringler

By then, he had a pet of his own — a dog that his sixth-grade girlfriend, now wife, was forced to give away by her parents and the first animal ever allowed into his own parents’ home — and later had many more. “We’ve had a whole menagerie over the years,” he says, “dogs and cats and hamsters and guinea pigs and birds.” Since one of ULAM’s principal functions is to house and care for the thousands of animals used in medical research at the University, as well as by the Unit’s own faculty and postdoctoral fellows, this might

46 Winter 2001 by Jeffrey Mortimer

A Veterinarian who icalFound hisResearc Niche in Medical Researchh come as a surprise to animal rights activists sanitation from our veterinary who take issue with the very enterprise that training” — but “part of our Ringler has run. It also leads to some training was related to gallows humor. laboratory animals, because veterinarians are also respon- “I’ve had a lot of pets offered to me over the sible for all the laboratory years,” he chuckles, “usually at social events animals, and doing that training after Bowser has had a particularly bad day.” piqued my interest in laboratory But he doesn’t just like animals; he esteems animal medicine, which was a them. “I think humanity owes a lot to new specialty of veterinary laboratory animals,” he says. And he medicine at the time. believes their use in research eventually “I thought the field would assist benefits their own kind as well as human- in medical cures. That was the kind. “I say we’re in the business of attraction, that taking care of reducing pain and suffering on the planet, the laboratory animals and and that medical research and laboratory ensuring that they were healthy animal medicine go hand in hand in doing and well would help medical that,” Ringler says. “Millions and millions of researchers find cures for animals have been spared diseases and human diseases and diseases of disability because of progress in human other animals. It was a niche medicine, which eventually works its way that a veterinarian could fill in into veterinary medicine.” the larger medical research It was, in fact, the chance to contribute to enterprise that would be advances in human medical knowledge that satisfying. I found that to be first drew him to the field of laboratory true over these last 30 years.” animal medicine. He graduated from Ohio After his Army stint ended in State at the peak of the Vietnam War, still 1967, Ringler came to ULAM as intending eventually to practice large- a postdoctoral fellow, earning a animal veterinary medicine, joined the U.S. Photos on these and the following pages of Dan master’s in pathology from the Medical Army Veterinary Corps rather than be Ringler and his wife, Ariane, on a post-retirement School as part of his program. He joined the drafted, and was sent for training at Walter motor tour of the U.S., at their campsite near San faculty as soon as he completed his Reed Army Institute of Research in Diego, California, taken by Don Kohlbauer of the training. The specialty was still in its Washington. San Diego Union-Tribune. infancy when Ringler came to Ann Arbor, His job would be to direct a laboratory having originated in the 1950s in the analyzing food being sent to the troops Chicago area. ULAM itself wasn’t estab- overseas — “The food inspection corps in lished until 1962, when its founding the Army was mainly veterinarians, because director, the late Bennett Cohen, brought a of what we knew about public health and

Medicine at Michigan 47 National Institutes of Health training grant Ringler. “That’s because surgery was the here with him from UCLA. Ringler, who principal medical research specialty, and succeeded Cohen as director in 1985, surgeons used dogs, because of their size, believes it’s the longest-running NIH to perfect all the techniques of surgery that training grant at U-M. we take for granted now.” Cohen was one of the so-called “Chicago These days, however, the mouse has Five” who founded both the specialty and become “the designer animal for biomedical the American Association for Laboratory research,” he says. “The genetics of the Animal Science, which now has about 7,000 mouse are known, the genome is almost members. “The veterinarians at that time sequenced, and almost any disease can be were being hired by medical schools to induced in mice, any genetic disease certainly, and studied as a substitute for humans that have the same genetic defect.” The average daily census of mice has quintupled during Ringler’s tenure, from Medical 12,000Re to 60,000, or about 90% of the s animals housed at ULAM. At the same time, the number of dogs used every year has plummeted to 500. Maybe that’s why the activists have been so quiet lately. “Dogs, cats and monkeys are the emotional species in this country,” Ringler says. “Other cultures have different animals that they treasure more or elevate to higher status for either religious or cultural reasons. There have been almost no demonstrations in Ann Arbor regarding the use of animals in research, but there have been a few minor demonstrations else- where in the last few years about the use of monkeys, in particular.” He is very clear about his views on this improve the quality of care of laboratory subject, and he has very clearly had to animals and to deal with the animal explain them more than once or twice. “I activists who were picketing in Chicago in feel that the animals are treated very well, the 1950s,” says Ringler. “The training better than most pet animals,” he says. programs basically brought in graduate “They seem healthy and happy in their veterinarians who understood cows and existence here, and they are doing a great horses and dogs and cats but had had very service for humans and other animals. The little training in diseases of the laboratory whole industry of laboratory animal care animals: rats and mice, guinea pigs, has grown up in this country since the monkeys and rabbits.” 1950s to ensure that the animals are healthy and well treated and that the And dogs, lots of dogs. “When I came here, research is worthwhile. And I assure the we were using about 6,000 dogs a year in activists of all of this. We give tours of the medical research, probably the most animal facilities to any responsible person numerous animal in use at that time,” says or group. We’re proud of what we have and pleased to show other people, and I’m convinced that the citizens of Michigan would be proud of what we have also.”

48 Winter 2001 “Millions of animals have been spared diseases and disability because of progress in human medicine, which eventually works its way into veterinary medicine.”

And he gives the activists their due. After all, they helped spur the creation of his specialty. “The animal activists all through searchthe years have pushed medical administra- tors and national groups to improve the lives of the laboratory animals and the controls on, and scrutiny of, the research,” he says. U-M established its University Committee on Use and Care of Animals in 1965. In 1986, a new federal law required that committee to approve all use of vertebrate animals on campus. “The regulations require that the committee also include a member of the public who is not affiliated in any way with the institution, and that that person be allowed to review the projects and file minority reports if there’s disagree- ment about whether the project should go forward,” Ringler says. “We’ve always had two outside members [out of 16], and we’ve never carried out a project where the outside members disapproved.” He also points out what might, at the very least, be considered an irony. “Animals have access to veterinary medical care 24 hours a day, every day,” he says. “The federal animal welfare act requires that every animal be observed every day for distress or illness or injury, and that veterinary medical attention be available that day. There’s no such law pertaining to children that requires that standard of medical care.” m

Medicine at Michigan 49 THE

They’reranslators: Michigan’s Elite Medical Scientists in Training TTheir ability by Jeffrey Mortimer to bring the They are the shining stars in a constella- Michigan, they are students — “fellows,” language of the tion that many believe is shrinking just technically — in the Medical Scientist when it should be growing. They are the Training Program, one of 38 such programs ones whose charge, in a sense, is to turn nationally that are heavily funded by the physician to scientific headlines into medical ones. They National Institutes of Health. Launched in aspire to careers in that region where the 1979 with an original class of three, the bench and Michigan’s MSTP now has 78 alumni and admits about 10 new fellows each year, or about five percent of incoming Medical the language School students. They’re really smart, even by medical school of basic science standards. They’re so committed to their goals that they’ll spend up to twice as much time in training as they would for an M.D. or to medicine is Ph.D. alone (an average of seven or eight years in the MSTP, plus internship, resi- more important dency and post-doctoral fellowship). They’re also willing to accept the possibility that the financial rewards, and other forms of than ever gratification, that they’ll reap from research will be less than those offered by clinical practice alone. Of the 16,000 who earn medical degrees annually in the United States, only 500, or a little over three percent, also earn Ph.D.s. “The most important thing is that they are able to connect the worlds of medicine and basic science in a way that other people Photo: DC Goings, BMC Media can’t,” says Ronald Koenig, director of Michigan’s MSTP since 1995 and an M.D./ MSTP Director Ronald Koenig knowledge produced by basic science is Ph.D. himself. “Part of the trouble with and Assistant Director applied to the maintenance and restoration medicine in general is that everything is Penny Morris of human health. becoming very, very, very subspecialized, and that’s required because we’re getting so Toward that end, they earn both M.D.s and much more knowledge. But to really be able Ph.D.s, and most of them devote their lives, to diagnose and treat complex diseases, you in one proportion or another, to both clinical have to get into the basic biology of the cell practice and scientific investigation. Many and how it works. And to have the best of them also teach. At the University of training to do that really requires you to

30 Winter 2001 have a Ph.D., because that’s where you The training itself is well funded, too. The learn how to ask basic science questions NIH’s National Insitute of General Medical and how to answer those questions using Studies supports Michigan’s MSTP to the “These students span a modern tools.” tune of about $1.2 million a year, and the Medical School adds another $600,000. “The MSTP is one of the highlights of our gigantically broad array of Michigan’s commitment to MSTP from the Medical School,” says Dean Allen Lichter. beginning has made it one of the biggest in “This is a very select group of individuals, research interests... so we the country. highly motivated, and rare. As research has become more and more the province of MSTPs nationally “vary a lot in size,” says work hard to get people Ph.D. scientists, we can’t lose sight of the Koenig. Michigan’s currently has 70 partici- fact that individuals who are trained both on pants. “In terms of NIH-funded positions, we together and feeling the Ph.D. side of the aisle and who also are one of the biggest,” he says. have rigorous medical training look at things “The size of the program is an important cohesive. The advantage is in a unique way. They ask questions issue,” he adds. “If it’s very small, then it’s differently. They bring a really quite easy for the people to interact but it may they may find there are irreplaceable perspective to biomedical not be so easy to find people you want to research and its advancement.” interact with. You may not find people like commonalities between Ironically, at a time when almost daily you, with similar interests. Also, the exposure to scientific “breakthroughs” has programs have less diversity, and I think them. After all, the tools of made the public impatient to see them diversity in social and academic interests is translated into medical treatments, the important in terms of the cross-fertilization science are fairly common ranks of such versatile thinkers appear to be of ideas and educational and personal dwindling. According to a study by the growth. But if the program is too big, then among broad areas. If they Federation of American Societies for it’s really hard to interact as a group. You Experimental Biology, a professional group never get to know half the people in the get together and talk, they that represents biomedical scientists, the program and it’s just too impersonal. There’s number of physicians who view research as some size in the middle that represents a can start developing an their primary activity dropped six percent good compromise and I think we’re in that between 1980 and 1997. That may be in ideal range now.” exchange of ideas that part because those who choose the dual But how to balance what’s ideal education- path face a dilemma: industrial research ally with pressure to enlarge the pipeline? offers little opportunity to practice, and would never happen The question of optimal size is “a difficult clinical practice leaves little time for one to answer,” says Dean Lichter. “There research. otherwise.” are those who say we should grow this M.D./Ph.D.s can be successful in getting grant program as big as we can because of its funding, however. “Of the Ph.D.s who apply for obvious importance. On the other hand, our —MSTP Director grants, an M.D./Ph.D. is far better able to school is of a finite size and there are many compete for money,” says George DeMuth, competing and worthy demands on our Ronald Koenig the MSTP’s first director. “And,” Koenig adds, resources. I think the MSTP as it stands “we have Michigan MSTP graduates now is reasonably sized, but if proposals succeeding nationally in faculty appointments come forward to allow it to expand at academic medical centers all across the somewhat, they will be looked at with country, such as Harvard, the University of interest.” Pennsylvania, Washington University-St. Louis, the University of California-Irvine, and the University of Virginia.” Medicine at Michigan 31 The strongest demand for M.D./Ph.D.s is biomedical research is to make patients “probably in academia right now,” says better, either to prevent diseases or treat “Ph.D. training is so basic Koenig. “There’s been a tremendous growth them. Understanding the patient is a very in the number of basic scientists working in important part of that.” clinical departments; I’m an example of science-oriented that it can Pharmacology professor Benedict Lucchesi that. The advent of molecular biology has is an M.D./Ph.D. He earned both degrees at allowed really clinical problems to be be difficult for a Ph.D. to Michigan in the early 1960s, long before addressed in a very basic molecular way. An there was an MSTP, much less NIH funding M.D./Ph.D. is a natural person to fill that have a medical perspective, or structured programs, when students and niche because they can see patients as well interested faculty were obliged to cobble as do basic research.” to know how these basic together their own arrangements. Although Although he has no hard data, Koenig his first love was and is research, he has science things really estimates that MSTP graduates typically always valued the extra dimension of his devote about 75 percent of their time to medical training. research, which would make academia a most relate to a human being, to “I think the double degree is extremely attractive venue for them, given that few important,” he says. “I wish everybody had the others allow, much less support, such breadth. understand what the opportunity to go that route, particularly those But a few do choose to focus on being that remain in an academic setting. It taught practicing physicians, and the “M.D.” part of problems are that patients me the language of the physician, and it gave the mix is significant for all, from an affective me a deep appreciation for the problems that as well as an intellectual perspective. actually get,” says Koenig. the physician is confronted with every day, the “Part of the interview process [which fact that the answers aren’t always there. “It’s important to connect typically takes at least two days] is for the There’s a lot of trial and error, a lot of prayer Medical School to evaluate whether the that you’re doing it right.” candidates are indeed capable of succeed- those two.” Moreover, says Dean Lichter, “There is a ing in the M.D. part,” says Morris. “There’s continuing need to make sure that those a need to see evidence that these students two facets of medicine do not become have some sense of service and community completely compartmentalized and stop and working with people. There’s a speaking to one another. This is a cadre of stereotypical Ph.D. candidate who would individuals who serve as important rather be in the lab and not need to translators between these two groups.” communicate, but the medical schools are insistent that they choose applicants who The admissions process for the MSTP is, not only have good academic credentials like medicine itself, part art and part but also have provided evidence that they science. “We get about 140 applicants a can serve the community, that they have year,” says Assistant Director Morris. “We some hospital or service experience.” interview maybe 45 of them, and then we choose a class of approximately 10 new “Ph.D. training is so basic science-oriented fellows. People who want to get both that it can be difficult for a Ph.D. to have a degrees are unusual, a very special breed. medical perspective, to know how these Our task is to find out who among those basic science things really relate to a who apply really and truly know what human being, to understand what the they’re getting into. For example, all of our problems are that patients actually get,” applicants have to already have a substan- says Koenig. “It’s important to connect tial amount of research experience. They those two. After all, the ultimate goal of

32 Winter 2001 Photo: DC Goings, BMC Media

can’t just say, ‘This Most applicants are not that focused in their Morris. “You did your med school, you did sounds like a good interest, so it’s not an issue.” your Ph.D., you came out educated, but you idea.’” did it by yourself.” Another element might be called simply Morris points out that “chemistry,” when it seems as if the person There are “both educational and social almost all the and the institution just belong together. reasons” for this approach, says Koenig. directors and “Some applicants, when I talk to them “These students span a gigantically broad assistant directors of about their own research or about the array of research interests. It’s not like the NIH-funded University of Michigan, just have a certain graduate students in the Department of MSTPs know each sparkle in their voice and eyes that makes Biochemistry; they’re all interested in other, and not only me think this person would be great here,” biochemistry, so it’s natural for them to be compete for the says Koenig. “I must say that response isn’t together. For us, it’s not so natural, so we work Benedict Lucchesi brightest stars but unique to me. When I see that sparkle in an hard to get people together and feeling also cooperate with each other. “It’s not applicant, most of the other interviewers cohesive. The advantage to that is they may unusual to have people apply to multiple feel the same way. It’s a little bit hard to find there are commonalities between them. programs and get multiple acceptances,” she know exactly what it is.” After all, the tools of science are fairly says. “Then our task is to make a good match common among broad areas. If they get Recreational activities and even the size of for the student.” together and talk, they can start developing Ann Arbor can also tip the scales one way cross-fertilization and an exchange of ideas Research interests usually constitute the or the other. “The School of Music here is that would never happen otherwise. major component of such a match. “The top very strong and there are a lot of musicians 10 medical schools tend to be not terribly in our program,” he says. “Someone who is “And I think it’s important to have a social different from one another,” says Kirk Frey, musically oriented might want to come here aspect to this interaction because it’s a long an original MSTP fellow and one of two because they know they could find people program. People are typically in the program members of its first graduating class. “So to play music with or take lessons from. I eight years, seven if they’re lucky. Nobody’s most students are making their decisions of usually tell them, ‘Yeah, if you can find the life goes smoothly for eight years nonstop, and where to attend on the specifics of graduate time.’ Sometimes there are things that I think it’s really helpful to be able to talk to school offerings and the scientific interests make me feel a person would not be a good peers who have been through similar things, of the faculty.” Frey is now a U-M professor match here. I’ve met a lot of people that who have faced similar issues. Besides, when of radiology and , as well as a wouldn’t feel right if they lived in a city that most people hear you’re an M.D./Ph.D. or senior research scientist at the Mental had less than five million people in it, so you’re doing this combined training, they think Health Research Institute. Ann Arbor probably wouldn’t be the best you have to be some sort of mutant, and it’s place for them. It isn’t the best place for good for people to interact socially and realize “We’re lucky in that this is such a big medical everybody. There’s nowhere that’s the best that these are real people.” center that almost any research interest would place for everybody.” be well represented here on the faculty,” says Koenig, “but occasionally there is an applicant From its inception, one of the Michigan who has a very, very narrow research interest. MSTP’s defining qualities has been its For him or her, this may not be the best place. efforts to support its participants’ collegial- If there’s only one person here who’s an expert ity, including social events during the school in that area, suppose that faculty member year and a scientific retreat in northern leaves or the student comes and decides that Michigan each summer that features they don’t have a good personal chemistry homemade entertainment in addition to the with that mentor? I think it’s important that presentation of papers. whatever the person perceives their research “There have been programs elsewhere that interest to be, it’s likely there are going to be were cut back because students didn’t feel several outstanding mentors here for them. there was a sense of community,” says

Medicine at Michigan 33 Both Healers and Scientists: For MSTP Grads, the Lure of both Clinic and Lab Will Shape their Careers

Catherine Keegan Applying Developmental Biology to the World of Babies It makes perfect sense that Catherine ‘Katy’ Keegan, a 1996 graduate of Michigan’s MSTP, is now working on John Germiller adrenal gland development, even as she finishes her clini- “Michigan was an easy cal fellowship in pediatric genetics. She can do research, see patients, and help kids. choice.” “When you’re in the lab, you’re always relating your “It’s extremely hard to have a career where experience back to the clinical realm, to a patient that you’ve you’re a good scientist and also a good seen or some sort of clinical problem,” she says. “When you surgeon,” says this fourth-year surgical translate over into the clinical world, especially for me now resident in otolaryngology and 1997 MSTP doing genetics, I think about a lot of patients that I see in grad. “Being a good surgeon requires that terms of how studying that disease or that problem could be you operate a fair amount to keep your approached from a basic science standpoint.” skills up and get enough experience with your hands. Being a good researcher re- Her Ph.D. is in cellular and molecular biology, quires devoting a lot of time to being in and her role in the lab illustrates how research the laboratory. To be honest, there are only has become a “team sport,” so to speak. “I’m a few people that do both really well, and working on understanding how different I don’t fool myself that I’ll become the first genes function together to result in normal person who is a great surgeon and a great

adrenal development. If this process is scientist and has time for everything. Photo: DC Goings, BMC Media disrupted, it can result in life-threatening adrenal insufficiency,” she says. “I feel like “The surgical disciplines in general seem to be aching I’m following along the career path that I had for M.D./Ph.D. surgeon-scientists, so I knew there intended to follow, based on this training that would be opportunities, no matter what specialty I went I’ve received.” into.” Michigan’s was his first choice among the MSTPs that he applied to. “There are a lot of great MSTPs and Relating it to children completed the picture. great medical schools, but there were very few that “My Ph.D. research mentor, Sally Camper, did had strength in both medicine and in the type of developmental mouse genetics, so I sort of biomedical engineering that I was interested in,” says had an interest in development from working Germiller. “There were few that even had Ph.D. pro- in her lab,” she says. “And I found that chil- grams in bioengineering, and fewer still that had real dren were the patients I enjoyed working with strength in biomechanics. Michigan was an easy choice. most. The more I thought about it, the more I felt pediatrics would be a good basis for what “And my experience with the MSTP at Michigan was Photo: Cheryl McIntire, BMC Media I wanted to do. When development goes outstanding. It really allowed me to be exposed to a wrong, that often results in a baby with a birth variety of disciplines and researchers, and they were defect. Understanding that whole process very supportive of my desire to make my Ph.D. research from the scientific level all the way through a project interdisciplinary — my goal was to understand clinical level is very interesting to me.” how mechanical forces influence the development of bones in the fetus and the embryo — and they helped me out with the logistics of getting that done.”

34 Winter 2001 Charles Neal Asking Questions about the Development of the Newborn’s Brain Charles Neal (M.D., Ph.D. 1991) sought an MSTP because “it became really clear to me that answering the ques- tions I was really interested in, how the brain works and knowing the brain, could be helped much more by under- standing the human condition. Medicine seemed like the Kirk Frey way to go, but I didn’t want to do straight medical school.” Seeing Clinical Problems in a He became enamored of neuroanatomy en route to his Different Way doctorate in anatomy and cell biology, and he became The multiplicity of hats worn by Kirk Frey enamored of pediatrics during his rotation through it. “I (M.D., Ph.D. 1984), a member of the original fell in love with the kids,” he says, and did his residency, MSTP class, reflects the range of his including a year as chief resident, at the University of Cali- interests and training: he’s a professor of fornia at San Francisco. radiology and neurology, as well as a senior Neal was the only one of the M.D./Ph.D.s he knew during research scientist at the Mental Health his residency who went back to the lab. While that deci- Research Institute and co-director of the sion necessarily came at the expense of clini- Movement Disorders Clinic. “About 20-30 cal work, it did not come at the expense of

Photo: Lin Goings, BMC Media percent of my time is oriented towards compassion. His particular interest is in the clinical care or the use of clinical examples in long-term effects on the brain of drugs resident and medical school education,” he says. “About administered to premature newborns. half of my time is spent in basic neurochemical research, and the remainder is in clinical research, where I utilize “Newborn premature babies are undergoing my clinical contacts, particularly in the Movement Clinic, a tremendous number of stresses that they to recruit patients for clinical research protocols that are wouldn’t normally undergo, because their under way in my laboratory.” brains finish developing outside mom,” he says. “Not only light and sound and cold and Patients are the focus for academic physicians, too, not pain and being separated from their mother, only to be cared for, but also to be learned from. “There but we also give them a lot of drugs to help are situations where the clinical problems presented keep them alive, including opiates and gluco- by patients serve as a focus for a research direction,” corticoids, a steroid hormone. We give he says, “or you’ll be presented with a clinical situa- premature babies a fair amount of that, so my tion that offers a unique insight into a disease mecha- research is going towards learning how it nism or human biology, and if you weren’t tuned to look affects the development of the stress system for it or ask the right questions, it might go untapped.” in the brain and whether it has an impact that About his MSTP experience Frey says: “There were a may be permanent.” number of very successful role models, not only in the immediate area that I had chosen for my studies but in Photo: DC Goings, BMC Media clinical medical science in general. It was very enlight- ening, and the MSTP was key in exposing us to them.”

Medicine at Michigan 35 Photo: DC Goings, BMC Media

Heather Burrows Immediate Gratification in Pediatrics Even though she says “We didn’t come to any grand conclusions,” Heather Burrows’ (M.D., Ph.D. 2000) study of cell development in the anterior pituitary was named one of the Rackham Graduate School’s four most distin- guished dissertations in 1999. She followed that in 2000 with the George R. DeMuth Medi- cal Scientist Award for Excellence, given to a graduating senior in the MSTP “who has dem- onstrated outstanding accomplishments in research and who exhibits the personal and professional qualities desired in the complete physician.” Despite such honors, she’s one of the few MSTP graduates to choose clinical practice over research, at least for now. “Research is more about delayed gratification and medi- cine is more about immediate gratification,” says the pediatrics intern at University of

Photo: DC Goings, BMC Media Michigan Hospitals, “and it’s easier to get hooked on instant gratification. I’m definitely going to do clinical work. I’m still interested in research, but I’m not sure how to incorporate it right now.” Burrows describes the Michigan MSTP as “a great program. I’ve always been very happy that I picked U-M for my M.D./Ph.D.,” she says. “The two women whose labs I worked in — Sally Camper and Audrey Seasholtz — were wonderful mentors; they took that job seriously. One of U-M’s strengths is a youngish faculty that’s very involved in the lab and with graduate students. It’s impor- tant to get that kind of exposure. And the MSTP office is very supportive and nurturing; they look out for us. During the interview trail, I didn’t always get the feeling that some of the other programs would do that.”

36 Winter 2001 GeorgeDe uth THE MAN WHO MADE MSTP A REALITYM AT MICHIGAN More than 21 years ago, the University of Michigan applied to the program late in 1983, too late to Medical School became the first state-supported receive funding, but who sold himself anyway on medical school in the country to become part of the basis of his academic strengths and his own the national Medical Scientist Training Program Minority Access to Research Careers fellowship. network supported by the National Institutes of “George is wonderful; I really love the man,” says Health. Neal, now a researcher in U-M’s Mental Health The program’s inception at Michigan can be Research Institute and a lecturer in pediatrics. “I attributed to the efforts of George DeMuth, was a very outspoken person, and George was very professor emeritus of pediatrics and communi- patient with that. I’m sure a lot of it came from cable diseases, who, in 1979, wrote the proposal to insecurity and culture shock, and me not knowing the NIH, building the case for Michigan’s partici- if I fit in here. At 24 I probably just seemed angry. pation based on its strengths not only in medicine But I made sure I did well in classes. I didn’t want but in public health, pharmacy and biology as well. to let anyone down, particularly myself, and I He was also careful to demonstrate the excellence didn’t want George to second-guess his decision to of those medical students then working toward help me out here, and I don’t think he ever did.” their doctorates at Michigan. “There weren’t too The quality of DeMuth’s personal relationships many,” he recalls, “but they were very strong and with MSTP fellows was a key ingredient in the they made a very good impression. We asked them program’s success at Michigan, many of them say to talk basic science, not medicine, because the site today. “George raised us and then he booted us out visitors from NIH were all scientists. Our message of the house and told us we could make it,” Neal was, ‘If we can do this without NIH support, think says. “He was supportive, and he’d give advice if what we could do with it.’” you asked for it, but in general the message was, DeMuth, whose medical stops prior to joining the ‘You’ve got what it takes, now go out and do it!’” faculty at Michigan in 1959 had included the “I always felt as though he was looking out for my Cincinnati Medical School (his M.D. and resi- best interests,” says Catherine Keegan, M.D., Ph.D., dency), the University of Michigan (his intern- a 1996 MSTP alumna and now a house officer in ship), as well as post-doctoral fellowships at both pediatrics. “We got tremendous support from both Cincinnati and the University of California, San the Medical School and from the Rackham School Francisco, set his sights on attracting some of the of Graduate Studies, and that, I think, was a result best applicants from the pool of perhaps 100 of George’s early work to promote the program.” candidates available nationwide at that time, all of whom had at least a dozen schools to choose from. For Catherine Keegan and for many others, MSTP He also began recruiting some of the most at Michigan means George DeMuth. “Without outstanding minority scientists, largely thanks to George,” she says, “the MSTP at Michigan would prodding from Charles Neal, M.D., Ph.D., who not be what it is today.” m

Medicine at Michigan 37 ABOVE TH

Above the Huron

Scientists Find Molecular Switch that Inhibits Fat Cell Development

Tissue samples from Scientists knew that experimental control mice Wnt proteins were in the U-M study show how involved in early cell expression of Wnt blocks development, but the formation of adipocytes. U-M study is the first (Left) Fat cells develop in to identify the impor- tissue grown from pre- tance of Wnts in fat adipocyte cells. (Right) Cells cell formation. “We remain unchanged in tissue found that Wnt signal- grown from the same ing represses adipo- preadipocyte cells when genesis or fat cell Wnt is espressed. development,” says Sarah E. Ross, a U-M Photo: Ormond MacDougald graduate student and first author of the study published in Science on August 11, 2000. U-M Medical School scientists have discovered a molecular “This is just the first piece of the puzzle, but it is an important switch that controls the formation of fat cells in mice. If the one,” says Ormond A. MacDougald, Ph.D., who directed the switch is on, fat cells will not develop. Switch it off, and even study. MacDougald is an assistant professor of physiology in would-be muscle cells turn to fat. the Medical School and a member of the U-M Center for This powerful molecular switch is one of several related pro- Organogenesis. “Understanding this developmental pathway teins called Wnts (pronounced “wints”), which exist in all types could help scientists learn how and why obesity develops.” of animals. Wnts regulate the complex genetic and biochemi- MacDougald and his research team worked with two types of cal changes that take place during embryological development. mouse cells — precursor muscle cells called myoblasts and Development begins with a ball of generic stem cells capable precursor fat cells called preadipocytes. “In the absence of of becoming any type of cell. Stem cells become precursor Wnt, both cell types consistently differentiated into fat cells,” cells, which can change into a limited number of cell types. By Ross says. the end of the developmental stage, cells are committed to just one cellular future.

6 Winter 2001 E HURON

When Wnt protein binds to a cell membrane receptor, it sets off a chain of biochemical signals, according to Ross. Signals are passed from one messenger molecule to another until they reach the cell nucleus where they either turn on or turn off genes that regulate development. Ross demonstrated Wnt’s power to control cell differentiation by blocking proteins in this signaling pathway to interrupt the Wnt signal. After just a few days, myoblasts already on their U-M Project Documents History way to differentiating into muscle cells spontaneously switched gears and became fat cells instead. “This suggests that active of Health Care in Michigan’s Wnt signaling is required for continued commitment to the myocyte lineage,” says MacDougald. Black Community Other significant results documented in the Science article include: Photographs, old letters, certificates, medical artifacts and testimonials col- • Of 18 known proteins in the Wnt family, Wnt 10b is the one lected by University of Michigan researchers reveal the rich history of medical most likely responsible for regulating adipogenesis. care in southeast Michigan’s black community between 1940 and 1969. • Wnt appears to repress fat cell development by inhibiting Collected through the production of two transcription factor proteins, C/EBPalpha U-M’s Kellogg African- and PPARgamma. American Health Care Project and gathered • Preadipocytes were injected beneath the skin of laboratory from physicians, nurses mice and allowed to grow for seven weeks into a small pad and others who worked of tissue. Tissue in and were treated at grown from Wnt- black proprietary hospi- free cells con- tals and small doctors’ tained adipocytes, offices, the information while tissue from has been placed in pub- cells expressing lic locations around the Wnt remained region, including the undifferentiated. Bentley Historical Library and the Center for Afro- In future research, American and African MacDougald will Studies at U-M, the study whether Wnt Walter P. Reuther Library at Wayne State University, the Charles H. Wright 10b has the same Museum of African American History in , and the Detroit Public Library. fat cell-inhibiting “We’ve been able to document a very important era in health care in southeast effect in living mice Michigan and I think we were surprised by some of the findings,” says Norman L. as it does in mouse Foster, M.D., associate professor of neurology and senior research scientist at cell cultures. “We the Institute of Gerontology. plan to use genetic Research revealed that Detroit was among the cities with the highest number of Ormond MacDougald, engineering to direct expression of Wnt 10b to the developing black hospitals, most of which were black proprietary hospitals owned and oper- assistant professor of ated by African-Americans. “There was a tremendous investment that individu- physiology, and Sarah adipocyte,” says MacDougald. “Our goal is to create a fat-free mouse.” als made in trying to deliver the best health care to their own people who were Ross, graduate student, being denied access to care by others,” says Foster, who, with Harold W. Neigh- examine assay results to Other U-M collaborators in the study bors, Ph.D., associate professor in the U-M School of Public Health, led the determine which Wnt pro- included Nahid Hemati, research research team. teins are expressed during associate; Kenneth A. Longo, Ph.D., The Medical School maintains the project’s Web site where visitors are given a fat cell development. Ross postdoctoral fellow; Christina and MacDougald’s discov- preview of the information available at the public repositories. Foster hopes the Bennett and Robin Erickson, gradu- collection influences two audiences in particular. “I hope that we can encourage ery of how Wnts control ate students; and Peter C. Lucas, students who are considering careers in the health sciences to explore the infor- the formation of fat cells M.D., Ph.D., resident in pathology. mation,” he says. “It’s a record of achievement in African-American history that in mice was featured The study was funded by the can encourage people of all types to overcome their personal barriers to succeed in the Aug. 11 issue of National Institutes of Health, the in the health sciences.” He also hopes the information will influence those who Science. Natural Sciences and Engineering are trying to develop new health systems so that they may be more sensitive to

Photo: Bill Wood, UM Photo Research Council of Canada, and the the issues and attitudes of all patients. Services U-M. — Valerie Gliem MacDougald can be reached at macdouga@ umich.edu; Ross For more information, visit the Kellogg Project at: http://www.med.umich.edu/haahc/. can be reached at saraross@ umich.edu. — Sally Pobojewski

Medicine at Michigan 7 ABOVE TH

New Cardiovascular Cause of Manic Depression? Center Approved by New Research at Michigan Points to Neurochemical Explanation Regents People with bipolar disorder have an aver- The University of age of 30 percent more of a class of signal- Michigan regents sending brain cells, according to new evidence have approved a being published by U-M Medical School new Cardiovascular researchers. The finding, in the October 2000 Center that will issue of the American Journal of Psychiatry, bring together all strengthens the idea that the disorder has bio- of the University’s logical and genetic roots. resources in heart and vascular treat- The discovery is the first neurochemical dif- ment, research and ference to be found between asymptomatic education. bipolar and non-bipolar people. “To put it sim- ply, these patients’ brains are wired differently, “Fighting such a in a way that we might expect to predispose deadly group of them to bouts of mania and depression,” says interrelated and Jon-Kar Zubieta, M.D., Ph.D., assistant pro- Kim Eagle common diseases fessor of psychiatry and radiology. “Now, we requires the mus- must expand and apply this knowledge to give tering of our resources in a cohesive and them a treatment strategy based on solid sci- effective fashion,” says Gilbert S. Omenn, ence, not on the current method of trial and M.D., Ph.D., executive vice president for error. We should also work to find an exact medical affairs and U-M Health System genetic origin, and to relate those genetic ori- chief executive officer. “This center will gins to what is happening in the brain.” help our institution serve the people of Jon-Kar Zubieta this state and this nation better, as we com- Zubieta and his colleagues made the discov- bat both the causes and the effects of ery in 16 patients with type I bipolar disorder pants and 16 people without bipolar disorder. cardiovascular disease.” using positron emission tomography, or PET. The patients and control subjects had been The scans let them see the density of cells that carefully matched for age, gender and educa- The Center will bring together cardiovas- release brain chemicals such as dopamine, tional status. cular programs from the Health System serotonin and norepinephrine, which together and the rest of the University, including are known as monoamines. Monoamines are DTBZ binds only to a protein called VMAT2 adult and pediatric cardiology, adult and involved in mood regulation, stress responses, inside the synaptic connections of monoam- pediatric , vascular surgery, pleasure, reward, and cognitive functions like ine-releasing cells, making it a good tracking vascular medicine, hypertension, stroke, concentration, attention, and executive func- device for the density of those terminals. It is and many related disciplines and projects. tions. Scientists have hypothesized their role also often used in PET scanning to study “Cardiovascular disease kills one person in in bipolar disorder for decades, but have never Parkinson’s disease, which is characterized by this country every 33 seconds, and nearly proven it. a severe shortage of cells that produce 77 Michigan residents each day. We have no dopamine. On PET scans, DTBZ density — and time to lose,” says Kim Eagle, M.D., interim The new U-M result points to a clear differ- therefore monoamine cell terminal density — chief of the Division of Cardiology and co- ence in the density of monoamine-releasing can be quantified by the amount of director of the current Heart Care Program. cells in the brains of bipolar people even when radioactive signal present in different areas. they are not having symptoms. Using the PET Eagle can be reached at [email protected]. scanner to examine areas of the brain where By looking at the intensity of the DTBZ signal in all the subjects’ brains, the U-M team found that — Kara Gavin monoamine-releasing neuronal transmitters are concentrated, the team looked for the sig- bipolar patients averaged 31 percent more bind- nal of radiotracer DTBZ, which they had in- ing sites in the region known as the thalamus, jected into the bloodstream of the 16 partici- and 28 percent more in the ventral brain stem.

8 Winter 2001 E HURON Michigan Medical Journal: A New Publication, Student-Inspired and Student-Run, Showcases Students’ Work in the Medical School Third-year U-M medical student Binh An impending P. Phan was still an undergraduate doing death of a labo- research under the auspices of the U-M’s ratory rat (“The Zubieta and his colleagues hope their initial Student Biomedical Research Program and Existential Lab finding will lead to further research on brain Undergraduate Research Opportunity Rat”) to a piece chemistry and bipolar disorder. Specifically, Program when he began thinking about the by Genevieve more study is needed to examine which kinds idea of a student-run science journal to Stewart, a 1999 of monoamine cells are involved. Zubieta showcase research being done by U-M graduate of the especially suspects those that produce sero- students. Without such a journal, he felt, Medical School tonin and norepinephrine. the work of his fellow students might not and former be brought to the public’s attention. While Peace Corps vol- The study was funded by the U-M’s General students can submit their research to pro- unteer, who Clinical Research Center, by the National Alli- fessional journals, the highly competitive wrote on “Rites ance for Research on Schizophrenia and nature of such journals makes acceptance of Passage: The Depression, and by the Mental Illness of the work of such novice scientists Construction of Research Association’s Arthur Forrest Tull II unlikely. Female Adoles- Research Fund. cent Sexuality in “I thought there was a great need to have Sub-Saharan Africa.” Phan hopes the Zubieta can be reached at an effective medium to disseminate student experience of preparing work for the [email protected]. work at the graduate and undergraduate Michigan Medical Journal will help develop level,” Phan says. When he began his first — Kara Gavin in students the writing and analytical skills year in the U-M Medical School in 1998, he necessary for their future careers as physi- brought up the idea of a student-run sci- Find the complete version of this article at: cians and scientific researchers. ence journal again. According to Phan, “the http://www.med.umich.edu/opm/newspage/ time was right,” and soon the U-M Medical It was important to Phan that the journal bipolar.htm School Office of Student Programs and not just focus on original research being Office of Research and Graduate Studies done by students but also explore the inter- agreed to provide funding for the inaugu- play of medicine and society as seen through ral issue. What had begun as Phan’s good reviews, essays, poetry, and interviews. He idea soon became a wanted the humanity of medicine and the reality: the Michigan diverse interests of these young scientists to Medical Journal. also have a voice. “As authors, editors and readers of this journal, we Students at all levels Response to last year’s inaugural issue has hope to promote independent thinking and skillful of the U-M now been positive. Medical School students, investigation. To succinctly and clearly present ideas. have a forum for administrators and faculty, Phan says, have To critically review essays and research papers, and allowing the Uni- told him that the journal is needed and analyze and digest information crucial — or maybe versity community timely, and that they appreciate the oppor- not so crucial — to the field of work we have chosen. to see what they are tunity it provides for the dissemination of We also want the Michigan Medical Journal to doing to contribute important, first-rate student contributions elevate the learning process and give encouragement to science and to science and medicine. to our fellow students. We want to awaken, educate medicine. Accord- ing to Phan, the Distribution of the inaugural issue of and excite.” “Michigan Medical Michigan Medical Journal was limited, but the students who put together the journal — Journal is more for Editor-in-Chief Binh An P. Phan in his introduction also established a Web site to the first issue of Michigan Medical Journal students who don’t have the opportu- (www.umich.edu/~michmedj) to provide nity to publish their another medium for reading their journal. work anywhere else With new funding from the Office of — it is an experience you get, a process you Student Programs, Phan and the rest of his go through to pick up some knowledge editorial board and staff are working hard along the way.” The first issue included a on the second issue of Michigan Medical range of materials from original research on Journal to come out in early 2001. HIV (“HIV-Infected Macrophages Induce — Liz Nelson Apoptosis of Neutrophiles”) by Brian Lane and Sara Cheng to a poem in which the author, Christina Yee, contemplated the

Medicine at Michigan 9 ABOVE TH

Growing Bone: Tired But Not Sleepy: It can be an important distinction in A new technique holds diagnosing sleep apnea promise for children with Being low on energy during Chervin arrived at his finding facial defects the day might be caused by by reviewing patients’ descrip- trouble breathing while you tions of their symptoms as sleep, even if you don’t well as their sleep patterns. He Nine-year-old Ryan Dewald’s face actually feel sleepy, a recent reviewed survey answers and has been deformed since birth, caved University of Michigan study sleep test results from 190 in on one side and not only affecting suggests. In fact, doctors and people found to have sleep his appearance but also hindering his ability to chew, breathe and speak. patients may be missing the apnea during sleep studies at But thanks to a pioneering treatment real cause of some cases of the U-M Sleep Lab. In all, 73 he’s receiving at the University of daytime fatigue: a potentially percent of the study’s subjects Michigan, Ryan’s face is changing. serious but treatable condition said they suffered from sleepi- Plastic surgeon Steven Buchman, known as sleep apnea. ness, fatigue, tiredness or lack of energy often or almost all M.D., has led the effort to grow Ryan The study, described in an the time. But when the four almost an entire left jawbone, and a article in the August 2000 joint to connect the bone to his skull. descriptive terms were com- issue of Chest, notes that pared independently, less than The process, which has previously patients with undiagnosed Steven Buchman half the patients reported feel- been used only to heal fractures in sleep apnea don’t always ing sleepy often or always, large bones or lengthen or repair existing facial bones, has suc- describe their symptoms in while 62 percent said they cessfully created an entirely new structure for Ryan’s face. He’s ways that alert their physicians lacked energy often or always, the second young patient to undergo such an extensive treat- to the problem. “Sleep apnea 57 percent reported problems ment in the Craniofacial Anomalies Program, one of the largest is a common and under-diag- with fatigue, and 61 percent and oldest in the nation. nosed condition in which said they felt tired. Women breathing stops temporarily The technique is called distraction osteogenesis — literally, were more likely to describe dozens or even hundreds of growing bone by distracting, or pulling apart, the ends during such symptoms. the healing process. Buchman and a handful of other surgeons times a night. It can have an around the country are hopeful that with more research, the important impact on a Asked which of the symptoms technique can be used to help thousands of children born each person’s productivity, quality was most significant to them, year with facial defects, and others with facial bone problems. of life and health if not more patients chose “lack of “This is a process by which new bone is formed from the old treated,” says Ronald Chervin, energy” than any other bone that was there,” says Buchman, who heads the Craniofa- M.D., M.S., assistant professor problem. Chervin and his cial Program. “You cut the bone, and when you cut it, it wants of neurology and director of colleagues also asked subjects to heal. If you fool the body by moving those two cut surfaces the U-M’s Michael S. Aldrich which symptom most kept away from each other very slowly, almost like a clock moving Sleep Disorders Laboratory. them from accomplishing every day, you fool the body into making new bone.” “But the classic symptom doc- what they wanted to do dur- tors look for in a patient with ing the day. Forty-four percent Buchman is also studying the long-term effects of distraction apnea is sleepiness — and said lack of energy, while only osteogenesis on the psychosocial and communication status of people with apnea often don’t 16 percent said sleepiness. children who have the procedure done for facial deformities, talk about sleepiness, only that compared with those who do not. Since social and psychologi- — Kara Gavin cal factors are often cited as part of the reason to make such they’re tired much of the time dramatic and costly efforts to fix facial birth defects, he hopes or that they lack energy.” to show how the outcome and timing of each procedure affect patients in non-physical ways. You may read the full article on-line at: Buchman’s work is being supported in part by a three-year http://www.med.umich.edu/opm/newspage/sleepy.htm $447,000 gift from the Carls Foundation of Detroit. You can reach Buchman at [email protected]. — Kara Gavin You can find the full article on-line at: http://www.med.umich.edu/opm/newspage/distoste.htm

10 Winter 2001 E HURON

Life Sciences Institute Leading Breast Directors Named Cancer Expert University of Michigan President Named New Chair Lee C. Bollinger announced in October that he has selected two prominent scientists — a of Internal Medicine biochemist from the U-M and a Photo: Marcia L Ledford The University of Michigan Medical cell biologist from the University School has appointed noted breast can- of California, San Diego — to cer specialist Marc E. Lippman, M.D., serve as lead scientists and co- to chair its Department of Internal directors of the U-M’s new Life Medicine effective January 2001. Sciences Institute. Lippman heads one of the Medical Jack E. Dixon, currently the Minor School’s biggest departments, made up J. Coon Professor of Biological of 13 divisions and accounting for a Chemistry and chair of Biological sizable portion of the school’s faculty, Chemistry in the Medical School, clinical visits, medical curriculum and Jack E. Dixon will begin his new position on July research grants. As chair, he also holds 1, 2001, after completing his term the title of John G. Searle Professor of as department chair. Scott D. Emr, Medicine. professor of cellular and molecu- Lippman comes to the U-M from lar medicine in the School of Georgetown University Medical Center, Medicine at the University of where he directed the Vincent T. California, San Diego, and a

Photo: Marcia L Ledford Lombardi Cancer Research Center and Howard Hughes Medical Institute chaired its Department of Oncology. He investigator, will become co- was also a professor of medicine and director in July 2002. chief of the Division of Hematology- Marc Lippman “We are very fortunate, indeed, to Oncology at the Georgetown Medical have as directors two great scien- School. tists who possess the personal Lippman’s research specialty has been the basic qualities to attract and support other biology of breast tumors. He established the first cell great scientists at our University,” culture models for studying estrogen action; these said Bollinger. “They will be out- human breast cancer cell lines were used to better Scott Emr standing as scientific leaders and understand the molecular mechanisms by which co-directors of the Institute, estrogens alter gene transcription and result in maintaining their own excellent research efforts while jointly building the progression of breast cancer. new institute from the ground up.” — Kara Gavin Currently under construction and scheduled for completion in spring 2003, the Institute building will contain laboratories and offices for 30 science faculty - dually appointed to their academic departments-of- origin as well as to the Institute — plus postdoctoral fellows, graduate students and staff. — Sally Pobojewski Additional information on the Initiative and the Institute may be found at: http://www.lifesciences.umich.edu.

Medicine at Michigan 11 ABOVE TH

New HIV Model Shows Virus Radioactive Doesn’t Kill White Blood Cells, It Antibody Developed Just “Homes” Them to Death at U-M Proves Highly Effective as First-Line Treatment for Non-Hodgkins Lymphoma

A radioactive antibody compound, Bexxar, first developed at the U-M, produced tumor shrinkage in 97 percent of 76 previously untreated patients with advanced-stage, low-grade non-Hodgkins lymphoma. These promising results, from the first completed study of a first-line, stand-alone radioimmunotherapy for cancer, were presented last year at the meet- ing of the American Society of Clinical Oncology by Mark S. Kaminski, M.D., U-M professor of hematology/oncology and co-director of the U-M’s leukemia/lym- Medical School scientist Denise Kirschner, Many scientists believe HIV destroys the phoma and bone marrow transplant Ph.D., has developed a new mathematical model immune system by attacking white blood cells programs. that shows how HIV — the virus that causes AIDS called CD4 or helper T-cells in the bloodstream. Most notably, 76 percent of patients — slowly destroys its victim’s immune system But Kirschner and Cloyd maintain that HIV’s achieved a complete remission, with no by accelerating a normal process called homing, lethal action is much more subtle and indirect. sign of cancer. In addition, 84 percent of which diverts white blood cells from the blood- Their model shows that CD4 cells actually self- patients with evidence of molecular-level stream to the lymph system. Increased under- destruct in the lymph system. Death comes as lymphoma at the start of the trial achieved standing of the complex relationship between HIV a result of exposure to biochemical signals molecular remission for as long as three and the immune system is important to helping involved in the homing process, which trigger years with the treatment. Molecular scientists develop more effective treatments for apoptosis or cell suicide. remissions were determined by a rigor- AIDS and suggest new targets for therapeutic “Previous HIV models have focused on what ous use of polymerase chain reaction, or drugs. happens in the bloodstream, but the real PCR, technology, a method that is argu- “This model indicates that the key to extend- action is in the lymph system,” says Kirschner, ably the most sensitive cancer detection ing survival time for people with AIDS is to an assistant professor of microbiology and method available today. minimize the number of CD4 cells exposed to immunology in the U-M Medical School. “A The original studies in the therapeutic signals in the lymph system which lead to very small percentage of cells dies from development of Bexxar, or Iodine I 131 apoptosis or cell suicide,” says Miles W. Cloyd, apoptosis on a daily basis, but over a seven- tositumomab, were done at the U-M by Ph.D., professor of microbiology at the Univer- year period, it adds up to almost 100 percent.” Kaminski and his colleague Richard Wahl, sity of Texas Medical Branch at Galveston. — Sally Pobojewski M.D., professor of nuclear medicine and Developed in collaboration with G.F. Webb, radiology. The therapy is now being Ph.D., of Vanderbilt University, Kirschner’s For more information, read the complete jointly developed by Coulter Pharmaceu- model validates the homing theory of HIV pro- article online at: tical, Inc. and SmithKline Beecham. gression first proposed by Cloyd and his col- leagues. Results from the model were pub- http://www.med.umich.edu/opm/newspage/ lished in the August 1, 2000, issue of The Jour- AIDSmod.htm nal of AIDS.

12 Winter 2001 E HURON First Tobacco-Funded Grants Announced by State To Support “We are extremely excited by these find- ings, which showed remarkable response Life Sciences Research rates and molecular remissions lasting up to and beyond three years,” says Kaminski. Awards to U-M Total $47.8 Million “Molecular remissions are seldom seen The state of Michigan Life Sciences Corridor recently awarded the first grants from a with chemotherapy in low-grade $1 billion tobacco settlement to support life sciences research and economic development lymphoma, and appear to coincide with throughout the state. U-M scientists were lead investigators in 25 of 59 proposals approved for prolonged, durable responses. Further- funding by the Life Sciences Corridor steering committee. U-M awards totaled $ 47.8 million. more, these results demonstrate the Winning proposals included research by U-M scientists developing a new gene therapy for potential of this treatment as an effective cancer and tests by a U-M spin-off company of a substance to kill bacteria and viruses in food. and well-tolerated first-line, single-agent treatment for low-grade lymphoma, a “The announcement is the result of a unique disease without a known cure.” collaboration between Michigan’s state govern- ment, its research institutions and its growing The study was funded by Coulter biotechnology industry,” said Lee C. Bollinger, Pharmaceutical. U-M president. “It is a tangible sign of the signifi- cance of today’s life sciences revolution to our — Kara Gavin state’s economy, the educational mission of its Read the complete version of this article universities, and the profound impact the Corridor on-line at: will have on medicine and society.” The largest Life Sciences Corridor award of $58.7 http://www.med.umich.edu/opm/ million over five years will be used to develop a linked network of advanced technology labora- newspage/bexxar.htm tories in structural biology, proteomics, genomics, bioinformatics and animal models for researchers from universities, private research institutions, and biotechnology or pharmaceuti- cal firms throughout Michigan. These core facilities will be physically located at the University of Michigan, Michigan State University, Wayne State University or the Van Andel Institute, but they will be open to all scientists affiliated with the Life Sciences Corridor. The U-M will house two of these facilities: the Michigan Proteome Consortium ($12 million in funds), which will use technology to separate and identify proteins created by cells in response to genetic instruc- tions, and the Michigan Center for Biological Information ($9 million in funds), which will have advanced computing and bioinformatics resources for analyzing and interpreting massive amounts of complex data. — Sally Pobojewski

Tree-Planting Honors U-M Role in Interna-

Photo: Bill Wood, UM Photo Services Photo: Bill Wood, tional Training Two gingko trees the Geriatrics Center, the Japa- donated by the nese Ministry of Health and Japanese Planning Welfare, Univers Foundation Committee of the and the Tanabe Seiyaku Com- U.S.-Japan Training pany, has provided training in Institute were Ann Arbor to more than 200 planted late last Japanese health care profes- summer on the sionals, including physicians, grounds of the U-M nurses, social workers, psy- Geriatrics Center to chologists and home health commemorate 10 aides, in a team-based years of collabora- approach to geriatric care. In tion. The Institute, Japan, gingko trees symbolize in partnership with long life.

Medicine at Michigan 13 ABOVE TH

STUDENTS WILL LEARN HOW CULTURE, RACE AND GENDER PLAY ROLES IN PATIENTS’ HEALTH AND CARE

Michigan’s future doctors, nurses and other health care professionals will gain a better understanding of the roles that culture, race and gender play in their patients’ health problems and needs, thanks to a newly awarded federal grant.

The $208,000 award, from the U.S. Department of Education’s Fund for the Improvement of Postsecondary Education, will allow professors from the University of Michigan, Wayne State University and Michigan State University to develop and teach an interdisciplinary curriculum for pre-med students and other under- The aim of the graduates bound for health careers. It will also bring national experts to the project is to help classroom to discuss major issues and will provide for faculty workshops. students learn early The aim of the project is to help on how culture and students learn early on how culture and health intersect and interact, from health intersect and beliefs about diseases and treatments to the health impact of a subculture’s interact, from be- history or diet. Such understanding may help them serve patients better liefs about diseases in their future careers. Child Magazine Names C.S. and treatments to The program, housed in the U-M’s Mott Children’s Hospital Institute for Research on Women and the health impact Gender and the Department of One of Ten Best Children’s Psychiatry in the U-M Health System, of a subculture’s is called “Seeing the Body Elsewise: Hospitals in U.S. Connecting the Health Sciences and history or diet. the Humanities.” A national survey of children’s hospitals in the February issue of Child magazine lists the University of Michigan’s C.S. The series of courses and lectures will Mott Children’s Hospital among the top 10 children’s hospi- use literature and other aspects of the tals in the U.S. The top 10 children’s hospitals were selected humanities to teach students about the varying perceptions, from among the 178 hospitals that are members of the experiences and expectations of people from different back- National Association of Children’s Hospitals and Related grounds, ethnicities and genders. Institutions. Criteria included quality of physicians and nurses, survival rates of common childhood cancers and amount of “Patients and educators alike have told us that health government research funding the hospitals receive. Each of the professionals need more awareness of cultural diversity,” says 10 hospitals was asked to name a physician on their staff who principal investigator Jonathan Metzl, M.D., Ph.D., assistant is an outstanding representative of their facility. Mott named professor of psychiatry and women’s studies, and co-director Steven M. Donn, M.D., who led a series of clinical trials show- ing that a new ventilator allowed premature babies to breathe of the Rackham Interdisciplinary Institute. “Our project will on their own earlier than did older types of ventilators. Alexa offer a unique way for students to explore cultural differences Canady, M.D., a leading pediatric nuerosurgeon and a 1975 and understand how those differences may affect their inter- graduate of the University of Michigan Medical School, was action with patients in the future.” the choice of Children’s Hospital of Michigan in Detroit.

—Kara Gavin Visit the Child Magazine Web site at www.child.com.

For the full article, visit: http://www.med.umich.edu/opm/newspage/edgrant.htm

14 Winter 2001 E HURON

Over the Top!

New Drug Works Well as ETOTH Sole Therapy for Difficult- IV E to-Treat Epilepsy Patients R G D $ R

E

ew results of a multicenter, double-blind study Graphic: Steve Maggio N G

led by a Medical School neurologist demonstrate E

N that a drug called oxcarbazepine is safe and N

effective enough to be used alone in patients with O

! $ partial epilepsy who do not respond to other anti- L 2000 GOAL REACHED epileptic drugs. $3.2 Million

The study, published in the June 27, 2000, issue 1999 $2.6 Million of the journal Neurology, looked at the safety and efficacy of the compound in trials at the U-M and several other sites. It compared the results of 1998 $1.8 Million treatment with a dose of 300 milligrams per day with results from a dose of 2,400 mg/day. 1997 $1.1 Million

“Patients participating in this study were aver- 1996 $800,000 aging eight seizures a month despite treatment 1995 $600,000 with other anti-epileptic drugs,” says Ahmad 1994 $500,000

Beydoun, M.D., associate professor of neurology 1993 $200,000 and director of the Comprehensive Epilepsy Cen- ter at the Health System. “The results are par- Millie Schembechler Memorial ticularly encouraging as this difficult-to-treat population responded well to the drug, with 12 for Cancer Research percent of patients in the 2,400 mg/day group remaining seizure-free during the four-month trial.” The research was sponsored by Novartis Phar- Golf Classic Raises Funds for maceutical Corporation, which makes oxcarbazepine as Trileptal. The drug was approved in January 2000 by the Food and Drug Adrenal Cancer Research in Administration, partly on the basis of the find- ings of this trial. Millie Schembechler’s Name — Kara Gavin At the Millie Schembechler Memorial Golf Classic last July, former U-M head football coach presented Cancer Center Director Max Wicha, M.D., with $300,000, the final install- Read the full article online at: ment of the Millie Schembechler Adrenal Cancer Research Fund. http://www.med.umich.edu/opm/newspage/ Eight annual golf tournaments in Ann Arbor were hosted by Bo beydoun.htm Schembechler to raise money for the Fund, with a goal of $3.2 million. The Fund, with a current market value of more than $5 million, will endow a professorship and support adrenal cancer research. Millie Schembechler died from adrenal cancer in 1992.

Medicine at Michigan 15 On a sunny Sunday afternoon last August, the 171 members of the Class of 2004 were inducted into the University of Michigan Medical School during the fifth annual White Coat Ceremony held in Rackham auditorium. “Two ceremonies will mark your time The Class of 2004 White Coat Ceremony here,” Dean Allen Lichter (M.D. 1972) told them. “Graduation day in 2004 when you become doctors of medicine, and today A rite of passage into one when you receive the white clinicians’ coats “ you will wear during your time as medical students here.” By becoming Medical of the proudest professions School alumni, a group numbering ” approximately 16,000 living members, the incoming students will be joining a world- wide fraternity that supports the School spiritually as well as financially, the dean said. Coming from 61 different undergraduate schools and selected from among nearly 5,000 applicants, the entering Medical School class was welcomed by Tom Varbedian (M.D. 1956), speaking on behalf of the Medical Center Alumni Society, to this “rite of passage into one of the proudest professions.” MCAS co-sponsored the ceremony with the Medical School. Delivering the keynote address, Professor of Pathology Gerald D. Abrams (M.D. 1955) noted that the entering class comes from the top one percent of the population intellectually. Calling them “learn- ing machines that, by succeeding, make faculty look good,” Abrams complimented them on a “fabulous career choice” and quoted Studs Terkel, author of the seminal book on work, Working, who said, “Physicians work not for daily bread but for daily meaning and astonishment.” “Practicing medicine is an incomparable endeavor,” Abrams said. “Every day as a physician is a fascinating parade of human experience, and no other experience except war so alters the cognitive power of the mind.” But certain obligations come with the profession, Abrams pointed out. Since the public substantially funds education, a social contract exists that calls above: MCAS Board member Tom Varbedian upon physicians to give with equal measure, congratulates Lorin to turn unselfish attention to the welfare of Sanchez. Sanchez and his brother, Sean, come to the public, to nurture the faith and trust Michigan from Portland, patients place in doctors and to guarantee Oregon, one of two sets of identical twins in the that faith and trust are not misplaced. “Each Class of 2004. of you has the individual task to become right: Njeri Thande, the best physician you can be.” from Boston, Massachu- setts, dons her white Abrams, who was himself inducted into the coat for the first time. medical profession in Rackham Auditorium far right: Gerald Abrams, keynote nearly 50 years ago, thanked the parents of speaker: “Each of you has entering students for inspiring and enabling the individual task to become the best physician them to this point in their education. As did in his you can be.” commencement address to the Class of 2000 last spring, Abrams encouraged the students to not slight the needs of their personal lives and to nurture the close professional relationships with colleagues they will form. In light of the demands of medical education and the rigors of the careers that follow, Abrams said, such connections will prove to be “wonderfully supportive and sustaining.”

38 Winter 2001 The Class of 2004

The University of Michigan Medical School Class of 2004 represents, as always, a very selective group of George Blum (M.D. 1955) with Mark students from Michigan and across the Shaver, recipient of scholarship support from nation. Of 4,928 applicants, 606 were the Class of 1955. invited to personal interviews. From Shaver is from Reno, Nevada. those interviewed, 171 (about 3.4% of all applicants) were accepted into the class.

left: First-year students (front, left to right) Sean A little more than half of the students Sanchez, Corey (93) are from Michigan, 68 of them Bregman (from Skokie, Illinois), Lorin Sanchez graduates of the University of Michigan. and (rear, center) Rahwa Ghermay (from Seattle, The remaining 78 students come from Washington), recipients of Norman H. Mette 24 different states. More than half the Foundation scholarships, students majored in biology as under- with Foundation trustee and attorney Karl graduates; two students entered with Schettenhelm and his wife, Suzanne degrees in dentistry, one with a degree below: Hehshin Kwak in law and another with a doctorate in from Canton, Alica genetics. Arnold from Hudson, Ohio, and Gretchen Carter from Grosse The mean college grade point average Pointe have their picture taken on the steps of of this year’s entering students was 3.6 Rackham. (out of 4) and their mean score on the MCAT was 11 (out of 15). The gender and ethnic composition of the class closely mirrors that of classes across the nation: 42 percent of entering students were female (45.8 percent nationally), 19.9 percent were Asian or “Practicing medicine is an Pacific Islander (19 percent nationally), incomparable endeavor. Every day 12.3 percent were black (8 percent nationally), 8.2 percent were Mexican- as a physician is a fascinating American, Puerto Rican or other parade of human experience, and Hispanic (7 percent nationally) and .6 no other experience except war so percent were Native American (1 alters the cognitive power of the percent nationally). (National numbers mind.” are from an article in the September 6, —Gerald Abrams 2000, issue of the Journal of the American Medical Association by B. Barzansky et. al., “Educational Programs in U.S. Medical Schools.”)

Medicine at Michigan 39 1940s Keith Weller (M.D. 1943, Residency 1948) and Robert Tupper (Residency 1962) were inducted into the Grand 1950s endocrine Rapids Medical Hall of Fame for trainee and Victor Bloom (M.D. 1957) is in pri- 2000. They were among 39 U-M research vate practice in Grosse Pointe Park alumni/ae in medicine, medical fellow at the and writes a weekly column for the education, nursing and medical busi- . Grosse Pointe News, as well as ness who were nominees. Tupper, an articles for the Detroit Medical News internist with a specialty in gastro- Robert Bartlett (M.D. (Wayne County Medical Society) and enterology who retired in 1999, is 1963, Residency 1969), profes- the Academy Forum (a quarterly pub- sor of general and thoracic surgery who lication of the American Academy of headed the Medical School’s Sesqui- Psychoanalysis). He can be reached centennial Celebration Committee, has 1980s by phone at (313) 882-8640 or by designed a dinner plate in honor of the e-mail at [email protected]. School’s 150th anniversary. The plate Douglas S. Paauw (M.D. 1985), has as its centerpiece “Old Main,” associate professor of medicine in 1960s which served as the University’s main the Division of General Internal Robert Tupper (Residency 1962) hospital for almost 60 years. Other his- Medicine at the University of Wash- was inducted into the Grand Rapids toric hospital and Medical School build- ington School of Medicine, has been Medical Hall of Fame for 2000. See ings are featured on the rim of the plate. named the first holder of the 1940s entry on Keith Weller. The plates are available in the U-M Rathmann Family Foundation Endowed Chair in Patient-Centered William J. Hall (M.D. 1965), an Hospital Gift Shop for $70 or can be ordered from Classic Collegiate China Clinical Education. Paauw is an internist in Rochester, New York, has attending physician at the University served as president-elect of the Ameri- at (888) 866-9321 or by mail at 556 Galen Circle, Ann Arbor, MI 48103. of Washington Medical Center and can College of Physicians-American Harborview Medical Center. He has Society of Internal Medicine since last 1970s received distinguished teaching April and will become the organization’s awards from both the University of president in March 2001. Hall is pro- Steven L. Giannotta (M.D. 1972, Resi- Washington and from its School of fessor of medicine and pediatrics and dency 1978) (pic- Medicine. He also has received the chief of the general medicine/geriatrics tured) has been Clinician-Teacher Award of Excel- unit at the University of Rochester elected presi- lence from the Society of General School of Medicine and Dentistry. He dent of the Internal Medicine, the Paul M. is director of geriatric programs at American Board Beeson Teaching Award, and has Strong Partners Health Systems in of Neurological three times been named one of the Rochester. Surgeons. “Best Doctors in America.” Paauw is Giannotta, pro- Hossein Gharib (M.D. 1966) has the editor of the book, Guide to fessor of neuro- Internal Medicine and Continuing served as vice president of the Ameri- logical surgery at Keith Weller Robert Tupper can Association of Clinical Endocrinolo- Medical Education editor for the University of Southern California Scientific American Medicine. known for his work in instituting phy- gists since May 2000, when he was School of Medicine, has served as a di- sician-training programs. For 27 chosen for the post at the ninth annual rector of the Board for five years and as years he was vice president for meeting of the American Association secretary for one year. He will be joined graduate medical education with of Clinical Endocrinologists. He is by fellow alumnus William Chandler Blodgett Hospital and later Spectrum professor of medicine at the Mayo (M.D. 1971, Residency 1977) who this year Health, and earlier taught gastroen- Medical School in Rochester, begins a six-year term as a director. terology at the University of Michi- Minnesota, and a consultant in the gan. Keith Weller, who in his retire- Department of Internal Medicine, ment spent 11 years providing medi- Division of Endocrinology and Metabo- cal care to the homeless through lism at the Mayo Clinic in Rochester. Saint Mary’s Health Services, was He did his internship at Philadelphia chosen for his humanitarianism. General Hospital and was a resident,

http://www.med.umich.edu/medschool/mcado Want to locate classmates or other graduates of the University of Michigan Medical School? Want classmates and other graduates of the Medical School to be able to locate you? Try the popular feature, “Search Alumni Doctors,” on the Medical School’s Web site. It’s a listing of those who have chosen to provide information about themselves for the site. C

40 Winter 2001 U-M Psychiatrist Class Notes Raymond Waggoner Dies at 98 Delbert Pearson (Residency Raymond W. Waggoner, 1955), who established his medical Lives Lived (M.D. 1924), Sc.D., a noted Uni- practice in Ypsilanti in 1960, died at versity of Michigan psychiatrist, Arthur L. Lennox (M.D. 1934) died age 75 on May 28, 2000, from com- medical administrator and gov- March 21, 2000, in Naples, Florida, plications of diabetes. He completed ernment advisor who was one after more than four decades as an his residency in pediatrics and com- of the first to see mental illness obstetrician and gynecologist in the municable diseases at University as both an emotional and physi- greater Toledo, Ohio, area, including Hospital where he was chief resident cal problem, died of natural three years in practice with his son, from 1955 to 1960, at which time he causes at Heartland Health John Lennox, M.D. He was a fellow joined the staff of Beyer Hospital Care Center in Ann Arbor on of the American College of Surgeons where he remained until his death, June 27, 2000. He was 98. and the American College of Obste- serving as chair of the Department tricians and Gynecologists, and he of Pediatrics from 1981 to 1985. Throughout his career, served on the staff of Toledo Hospi- Especially interested in sports Waggoner worked to modern- tal and on the courtesy staffs of St. medicine, Pearson served as team ize treatment of the mentally ill, Luke’s and Flower hospitals in Toledo. physician for the Ann Arbor Public and to bridge the gap between Lennox, who was 90, left a bequest Schools from 1953 to 1965, for the the Freudian psychosocial to the University to establish the Ypsilanti Public Schools from 1965 to model and the discipline of neu- Jennie I. Lennox Endowed Medical 1986, and for Eastern Michigan roscience, which aims to find Student Loan Fund, honoring his University from 1986 to 1998. He was biological explanations for psy- mother who loaned him the money a supervisor/fellow in sports chiatric disorders. “That to attend the U-M Medical School. medicine in the U-M Department of biopsychosocial model, which William Kaufman (M.D. 1938) Family Practice from 1994 to1998. he helped pioneer, now forms the basis of our entire medical died on August 24, 2000, in Winston- Rex Goodnow Wilcox (M.D. specialty,” according to John Greden, M.D., Salem, North Carolina, at age 88. For 1960), died on June 20, 2000, at Ph.D., current chair of the U-M Department of many years he maintained a private age 64. practice in Bridgeport, Connecticut. Psychiatry. David Cheris, M.D. He did clinical research on niacina- Waggoner received his undergraduate and (Residency 1963), 66, mide, a form of vitamin B3, and its medical degrees from the U-M by the age of 22. died in Newton, Massa- ability to lessen or eliminate osteoar- After earning his doctorate in neuropsychiatry chusetts, on April 21, thritic pain, and was considered a in 1928 at the University of Pennsylvania, he 2000. Practicing in Syra- pioneer in vitamin therapy for rheu- returned to the University of Michigan in 1929 cuse, New York, for 34 matism and arthritis. A prolific writer, as a neurologist. Eight years into his 65-year years, Cheris was former he was the author of two books on U-M career, he switched to the Department of chairman and director of niacinamide as well as many articles Psychiatry and soon began a 33-year term as the Department of dealing with arthritis, nutrition, food department chair. In those years, 1937 to 1970, Radiology at Community allergies and psychosomatic medi- he built a nationally renowned clinical and General Hospital and cine. He was also a playwright and research faculty noted for its eclectic mix of associate professor at artist. He is survived by his wife, disciplines and for integrating psychotherapy Upstate Medical Center Charlotte, who, with him, established and neuroscience. Under Waggonner’s direc- of the State University of New York. the Dr. William and Charlotte S. tion, the Department grew from a small clinical Cheris was the author of several Kaufman Endowment Fund for Library and teaching unit in the 1930s to a major force publications, including Basic Physics: Technology at the University of in psychiatry research, care and education. Michigan. Principles of Diagnostic Radiology, co-authored with Barbara Cheris, his Waggoner also had a strong interest in ethics wife of 42 years. and values, which he saw as combining the human and the humane. Since 1995, the U-M has held an annual lecture on the topic in his name. Gifts may be made to the Raymond W. Waggoner Lectureship on Ethics and Values in Medicine, care of Philip Margolis, M.D., Waggoner Lec- tureship Committee Chair, U-M Department of C lass NoPsychiatry, 900 Wallte Street, Ann Arbor, MI, 48105. s

Medicine at Michigan 41 Sesqui-Finale! The Celebration of 150 Years of Great Medicine at Michigan Culminates in a Grand Party in Ann Arbor

The University of Michigan Medical School capped the year-long com- Following Markel’s address, George Morley (M.D. 1949, Residency memoration of its 150th anniversary with a special Sesquicentennial 1952), the Norman F. Miller Professor Emeritus of Gynecology, Celebration and All-Classes Reunion in Ann Arbor October 13-14, 2000. presided over the induction of 76 “true Michigan greats” into the new Alumni from 53 different classes and 31 different residency and gradu- Medical Center Alumni Society Hall of Honor which recognizes alumni/ ate programs comprised the largest and most diverse representation ae who have contributed significantly to medical science and educa- ever assembled for a Medical School reunion. tion over the past 150 years. Located in the lobby of Dow Auditorium in the Towsley Center for Continuing Medical Education, a collection Observing that it is “the mark of a great institution to keep its past of plaques bearing the image and brief biography of each honoree alive,” Dean Allen S. Lichter opened the two days of reflection and was unveiled and dedicated by Dean Lichter and Executive Vice celebration with a special Heritage Program and introduced Howard President for Medical Affairs Gil Omenn. A complete listing of the Markel, M.D., Ph.D. (M.D. 1986), director of the Historical Center for first members of the MCAS Hall of Honor appears on pages 26-28. the Health Sciences, as the first George Wantz Professor of the History of Medicine. Markel referred to the Wantz Professorship, Donald S. Fredrickson (M.D. 1949), former director of the National created by George E. Wantz (M.D. 1946) of New York, as a shining Institutes of Health and the Howard Hughes Medical Institute, example of alumni support, noting that receiving an endowed profes- concluded the Heritage Program with a reflective address recounting sorship from the institution at which he trained is “the highest honor.” his life journey from youthful origins in Colorado to college-town Ann Markel presented a history of the Medical School, highlighting its Arbor via troop trains during World War II. His rather casual choice of contributions to research and education as an “example worthy of medicine as a course of study turned out, he said, to be inspiration imitation,” a phrase derived from the Flexner Report of 1910 which borne of youthful ignorance. “Science is an unselfish, incurable identified the University of Michigan and a handful of its early peers addiction,” he said, describing the way in which his life had been as models of medical education. happily consumed by his love of medical science and the challenges it presented to him. Even greater challenges remain for those who choose to pursue them, he suggested, with tremendous opportunities for study and exploration ahead.

22 Winter 2001 That prediction was echoed by luncheon speaker Marshall W. Nirenberg (Ph.D. 1957), winner of the Nobel Prize in 1968 for his early work on the genetic code and its role in protein synthesis. “There has been no other time with such great opportunities in medical research,” Nirenberg said. Stating that the age of gene discovery is already over, Nirenberg predicted that the genome will accelerate research and that computers will make an enormous difference in processing the resulting information—information that used to reside in the minds of the men and women performing the research. “Fifty years ago, no one knew where we’d be today,” Nirenberg said, advising younger researchers who might be inclined to avoid high-risk projects with uncertain outcomes to embrace the unknown, that even though they might not realize it at the time, “those projects are the most important.”

A spectacular black-tie gala, with reception, dinner, entertainment and dancing, brought the day to a rousing end, followed the next afternoon by a sesqui-romp over the Indiana Hoosiers in , 58-0, with a special half-time salute to the Medical School by the U-M Marching Band.

Dancing the night away, clock- wise from top: Janet and Cyrus Farrehi, M.D., of Flint; Barbara and Darrel A. Campbell Jr., M.D. (Residency 1978) of Ann Arbor; Catherine and Donald Findlayson (M.D. 1941) of Brimley; and Barry Rosenberg and third-year stu- dent Emily Hu of West Bloomfield.

Medicine at Michigan 23 Howard Markel, the George E. Wantz Professor of the History of Medicine, begins the morning Heritage Program with a history of the University of Michigan Medical School.

Heritage Program speaker Donald S. Fredrickson, M.D.: “Science is an unself- ish, incurable addiction.”

George W. Morley, M.D., the Norman F. Miller Professor Emeritus of Gynecology and professor emeritus of obstetrics and gynecology, announces the 76 “Michigan greats” inducted into the MCAS Hall of Honor.

Guests view the newly unveiled Hall of Honor.

Gil Omenn with Cozette “Cozie” Grabb, wife of the late William C. Grabb (M.D. 1953, Residency 1956) who was named to the MCAS Hall of Honor

24 Winter 2001 Marshall W. Nirenberg delivers the reunion lun- cheon address: “There has been no other time with such great opportunities in medical research.”

Former Interim Dean A. Lorris Betz (below, left) and Robert Visscher (M.D. 1955) (below, right) of Holland Awards and listen to remarks during the luncheon program. Transitions During the luncheon program, which also saw the MCAS presidency pass from Jeffrey M. Dunn, M.D. (Residency 1977), to Richard L. Bucciarelli (M.D. 1972), the following Medical School alumni/ae received MCAS honors: Early Distinguished Achievement Award Kirk Frey (M.D., Ph.D. 1984) for distinguished achievements by an alumnus/alumna who graduated within the last 20 years Distinguished Achievement Award Bernard Agranoff, M.D. James Stanley (M.D. 1964, Residency 1970) for distinguished achievements in their fields Distinguished Service Award Saeed Farhat, M.D. (Residency 1964) Gerald S. Connor, M.D. (Residency 1958) for outstanding service to the U-M Health System, MCAS, or health services Student Award Christy Petroff for demonstrated service by a third-year Enjoying the evening gala are (front row, left to right) student to the Medical School, hospitals, former Dean Joseph E. Johnson III, M.D.; Elizabeth Bole; community or fellow students former Dean William N. Hubbard Jr., M.D.; (back row, In addition, three alumni joined the left to right) former Dean Giles G. Bole (M.D. 1953, Resi- : dency 1956); Ann Betz; Joyce Hubbard; and former In- MCAS Board terim Dean A. Lorris Betz, M.D. James E. Wasco (M.D. 1966) Boxford, Massachusetts Kenneth McClatchey (M.D. 1975) Chair of the Department of Dermatology Ann Arbor John Voorhees, M.D., with Sesquicenten- Keith L. Black, (M.D. 1981, Residency 1987) nial Committee Chair Robert Bartlett, Los Angeles, California M.D. Both Voorhees and Bartlett earned their M.D.s at Michigan in 1963 and com- Two alumni became MCAS Academy pleted their residencies in 1969. members (those who have completed Board terms): Timothy Laing (M.D. 1981, Residency 1984) Kirt Nichols (M.D. 1966)

Medicine at Michigan 25 Medical Center Alumni Society

John Jacob Abel Hugh Cabot Arthur Robertson Cushny Henry Fitzbutler 1857-1938 1872-1945 1866-1926 1842-1901, M.D. 1872 Widely regarded as the father of Ameri- Professor and chair of Surgery and Professor of pharmacology, he later The first African-American medical can pharmacology, he was appointed dean of the Medical School from established the pharmacology graduate of the University of Michigan, to the first chair of pharmacology in the 1921-1930, he expanded the resi- department at the University College he went on to found and serve as dean U.S., at U-M. dency program in the new University in London of the Louisville National Medical Col- Hospital of 1925. lege in Kentucky. John Alexander Russell N. DeJong 1891-1954 Roy Bishop Canfield 1907-1990, M.D. 1932 Corydon Ford Thoracic surgeon and professor of sur- 1874-1932, M.D. 1899 Professor and chair of Neurology and 1813-1894 gery at U-M, he advanced the treatment Professor and chair of Otolaryngol- founding editor of Neurology, he Surgeon and professor of anatomy, of tuberculosis and other chronic lung ogy, he pioneered the use of local performed meticulous research on his knowledge and reputation as a conditions. anesthesia, helped advance surgical migraine and other disorders and great lecturer drew large numbers of techniques, and established a resi- diseases and wrote a classic text- students; he was elected dean of the Mathew Alpern dency program for ear, nose and book on neurological examination. early medical faculty many times. 1920-1996 throat conditions. Professor of and Lydia Adams DeWitt F. Bruce Fralick physiology as well as psychology, Charles Gardner Child III 1859-1928, M.D. 1898 1903-1983, M.D. 1927 and an expert in color vision, he made 1908-1991 A pathologist and research scientist Professor and chair of Ophthalmology, significant contributions to our under- Professor and chair of Surgery, his known for her contributions to the an outstanding surgeon and teacher, he standing of the mechanisms of work focused on surgery of the anatomy of the pancreas and heart developed subspecialty areas in genet- human vision. abdominal organs, and for pioneering work ics, neuro-ophthalmology, and oph- especially the liver and in the chemotherapy of thalmic pathology. Edmund Andrews pancreas. tuberculosis, she 1824-1904, M.D. 1852 founded the Woman’s Thomas Francis Jr. Surgeon and professor of comparative Frederick Amasa Research Club at U-M. 1900-1969 anatomy at U-M and Rush Medical Col- Coller Professor of epidemiology best lege, he developed anesthetic agents 1887-1964 Reed O. Dingman known for his work with poliovirus and advanced surgical instrumentation Professor and chair of 1906-1985, M.D. 1936 and influenza vaccines and prospec- and technique. Surgery, he was recog- Plastic surgeon and pro- tive community studies, he directed nized as an authority in fessor of surgery, he es- the classic double-blind study that Carl E. Badgley the surgical treatment tablished and served as proved the Salk polio vaccine safe 1893-1973, M.D. 1919 of thyroid diseases and the first head of the and effective. Orthopedic surgeon and professor of developed a replace- Section of Plastic Sur- surgery, he is best known for his work ment for water and gery. Several surgical A. James French with crippled children, especially electrolyte loss in sur- devices bear his name. 1912-1985 congenital dislocation of the hip and gical patients that is Professor and chair of Pathology and non-union of infected fractures. used worldwide. George Dock an able administrator, he performed 1860-1951 research on the effects of sulfonamide Albert Moore Barrett Jerome W. Conn Professor of internal drugs on the heart, liver, kidney, and 1871-1936 1907-1994, M.D. 1932 medicine, he introduced tumors of the lungs and salivary glands. Psychiatrist and neuro- Endocrinologist and a program of clinical in- pathologist, professor professor of internal medicine, he struction at Michigan that became a and chair of Psychiatry, identified primary aldosteronism model for medical schools around he improved the care of (Conn’s syndrome) and was an inspir- the country. the mentally ill in Michi- ing teacher and noted clinician. gan. Hubert Arthur Eaton David Murray Cowie 1916-1991, M.D. 1942 William Lemuel 1872-1940, M.D. 1896 Medical and civil rights activist, physi- Benedict U-M’s first professor of pediatrics and cian and surgeon, he is best known for 1885-1969, M.D. 1912 infectious diseases, he was an ardent his work on behalf of racial integration Professor of ophthal- promoter of iodized salt to prevent goi- of hospitals. mology, University of ter. Minnesota, and head of Charles Wallis Edmunds ophthalmology at the Elizabeth Caroline Crosby 1873-1941, M.D. 1901 George Edward Frothingham Mayo Clinic, he contrib- 1888-1983 Professor of pharmacology and direc- 1836-1900, M.D. 1864 uted significantly to the Professor of anatomy, she was a noted tor of the Pharmacology Laboratory, he Professor of materia medica, oph- development of post- investigator and teacher of neu- is best known for his digitalis assays thalmic and aural surgery, and clinical graduate teaching roanatomy and taught its clinical and his leadership in the standardiza- ophthalmology, he was the first chair worldwide. application on patient rounds with tion of drugs. of Ophthalmology and developed the neurosurgeon Edgar Kahn. department’s course of lectures. Detlev W. Bronk 1897-1975, Ph.D. 1925 Physiologist and president of Johns Hopkins University, founding president of Rockefeller University, he also served as president of the National Academy of the Sciences.

2626 WinterFall 2000 2001 Hall of Honor

Albert Carl Furstenburg Fred Jenner “Ted” Hodges II Jack Lapides Louis Harry Newburgh 1890-1969, M.D. 1915 1895-1977 1914-1995, M.D. 1941 1883-1956 Professor and chair of Otolaryngol- Professor and chair of Radiology, his Urologist and professor of surgery, Professor of clinical investigation in ogy, he contributed to the under- early work focused on radiologic his classification of neurogenic Internal Medicine, he focused mainly standing of the fascial planes of the heart measurements in normal and bladders is in widespread use. His on nutrition and metabolism with neck and the neurology of the ears, diseased states, and he envisioned greatest contribution was the devel- specific reference to obesity, diabe- nose and larynx. As dean of the Medi- a treatment for cancer with radioac- opment of clean, intermittent self- tes mellitus, nephritis and body cal School, he promoted high stan- tive material produced by a cyclotron. catheterization. water and electrolytes. dards for education, research, and clinical service and oversaw expan- John Floyd Holt William J. Mayo Frederick G. Novy sion of the medical campus. 1915-1991 1861-1939, M.D. 1883 1864-1957, M.D. 1891 Professor of radiology and first direc- Surgeon; with his brother and father, Professor of bacteriology for over 40 William C. Grabb tor of Pediatric Radiology, he published he developed the Mayo Clinic in Roch- years, he studied the chemistry of 1929-1982, M.D. 1953 papers on physiologic bowing of the ester, Minnesota, into one of the bacteria, the cultivation of trypano- Plastic surgeon and professor of sur- legs in children, neurofibromatosis and, foremost centers for patient care, somes and spirochetes, immuniza- gery, he directed the Section of Plas- with Fred J. Hodges and Isadore Lampe, training and research. tion, and microbic respiration. A jar tic Surgery, performed research on a popular book on radiology for medi- for the culture of anaerobes bears his cleft lip and palate, and authored four cal students. Norman Fritz Miller name, as do several microorganisms. textbooks, including a concise guide 1894-1990, M.D. 1920 to clinical practice in . Gotthelf Carl Huber Professor and chair of Obstetrics and Alonzo B. Palmer 1865-1934 Gynecology and a superior surgeon, 1815-1887 Moses Gunn Professor and chair of Anatomy, direc- he advanced the surgical treatment Professor of internal medicine and 1822-1887 tor of the Anatomical Laboratories, and of benign and malignant diseases. dean of the Medical School, he lob- Professor of anatomy dean of the U-M Graduate School, he With Isadore Lampe, he established bied successfully for a nine-month, and surgery, dean, and a was primarily interested in embryology a gynecologic tumor registry and one three-year curriculum and adding highly skilled teacher and histology. of the first tumor conferences in the laboratory courses in physiology, and surgeon, he was country. hygiene and pathology. one of the first five pro- Charles Brenton Huggins fessors to be appointed 1901-1997 Charles B.G. deNancrede to the Medical School. Professor of surgery at the University 1847-1921 of Chicago, he completed his resi- Professor and chair of Surgery and Cameron Haight dency under Frederick Coller and director of the surgical clinics for nearly 1901-1970 trained in under Reed Nesbit, 30 years, he stressed the importance Professor of surgery and winning the 1966 Nobel Prize for dis- of antiseptic and aseptic surgery. head of the Section of coveries concerning the hormonal Thoracic Surgery, he treatment of prostate was widely recognized cancer. as the first American surgeon to remove an Edgar A. Kahn entire lung successfully. 1900-1985, M.D. 1925 Neurosurgeon and pro- Walter R. Parker fessor of surgery, he 1866-1955 1869-1970, M.D. 1893 developed, with Max Professor and chair of Ophthalmology, Pathologist, bacteriologist, industrial Peet, techniques to he established a three-year residency hygienist, assistant professor of indus- treat tumors, trauma program in ophthalmology and contrib- trial medicine at Harvard, and special and infection, and con- uted significantly as teacher, investigator for the U.S. Department of tributed much to standardizing cor- James Van Gundia Neel researcher and surgeon. Labor, she is recognized as the founder dotomy for intractable pain. 1915-2000 of the field of occupational medicine; Professor and chair of Human Genet- Bradley Merrill Patten her work led to the enactment of Reuben Leon Kahn ics, he did groundbreaking work that 1889-1971 worker’s compensation laws. 1887-1979 identified the genetic basis for sickle Professor and chair of Anatomy, he Professor of serology and chief of the cell anemia and studied atomic bomb promoted the growth of gross anatomy, Preston M. “Pop” Hickey Serology Laboratory, he developed the radiation effects. Many of the prin- microscopic anatomy, neuroanatomy 1865-1930 first practical and rapid precipitation ciples he introduced are basic to our and embryology, and is best known for Professor and chair of Roentgenol- test for syphilis; the Kahn test replaced understanding of genetics today. his classic textbook, The Early ogy, he promoted the importance of the Wasserman test in 1941. Embryology of the Chick. strong clinical diagnostic skills, tech- Reed M. Nesbit nical mastery and knowledge of Isadore Lampe 1898-1979 Max Minor Peet physics. He was the founding editor 1906-1982, Ph.D. 1938 Urologist and professor of surgery, he 1885-1949, M.D. 1910 of the American Quarterly of Roent- Professor of radiology and director of is best known for his work on pros- Professor of surgery, he is best genology. the Radiation Therapy Division, he tatic obstruction and for designing known for his research and extensive initiated a tumor coding system that the Nesbit resectoscope, a one- experience in treating malignant became a national model, and he handed endoscope for use in tran- hypertension with lumbar sympath- proved radiation therapy successful surethral prostatectomy. ectomy as it related to the adrenal in curing certain types of cancer. Prin- gland. ciples developed by him are still ba- sic to the field.

MedicineMedicine atat MichiganMichigan 2727 Reuben Peterson George Linius Streeter James G. Van Zwaluwenburg Udo Julius Wile 1862-1942 1873-1948 1874-1922, M.D. 1908 1882-1964 Bates Professor of Obstetrics and the Professor and chair of Anatomy, Professor and chair of Roentgenol- Professor and chair of Dermatology, Diseases of Women and Children and director of the Anatomical Labora- ogy, he advanced fluoroscopy and he developed its resident training chair of his department, he started the tory, and noted embryologist; under stereography and improved the inter- program and performed research on residency program that developed into him, a graduate program in research pretation of roentgenograms of the many aspects of syphilis and derma- a four-year program and improved was established. lungs, heart and abdominal organs. tology. facilities for maternity care and advanced gynecologic surgery. Cyrus Cressey Sturgis Victor Clarence J. Robert Willson 1891-1966 Vaughan 1912-1993, M.D. 1937 Professor and chair of Internal Medi- 1851-1929, Ph.D 1876, Professor and chair of 1797-1872 cine and director of the Simpson M.D. 1878 Obstetrics and Gynecol- Physician, surgeon, naturalist, public Memorial Institute for Medical Professor of hygiene and ogy at Temple Univer- official; as a U-M regent, he orches- Research, he encouraged scientific physiological chemistry sity and at U-M, he was trated the approval of a medical school research and strengthened teaching and dean of the Medical the primary author of a and helped frame its first policies and at all levels. School for 30 years, he popular textbook and name its first faculty. As mayor of built a scientific faculty promoted the idea of Detroit, he lobbied successfully for free Homer Stryker and implemented the primary care for public schools. 1894-1980, M.D. 1925 four-year curriculum in women. Orthopedic surgeon and inventor in addition to performing William D. Robinson Kalamazoo, he founded the Stryker research on bacterial Frank Norman 1911-1988, M.D. 1934 Corporation, a medical equipment toxins, tuberculosis and Wilson Professor of internal medicine and manufacturing firm, his best known typhoid fever. 1890-1952, M.D. 1913 director of the Rackham Arthritis invention being the Stryker Frame Cardiologist and Research Unit, he inspired the devel- which allowed staff to turn a patient Raymond W. professor of internal opment of rheumatology as a subspe- easily. Waggoner medicine, he trans- cialty and contributed to its growth 1901-2000, M.D. 1924 formed electrocardio- nationally. Robert B. Sweet Professor and chair of Psychiatry and graphy into a science and advanced 1917-1980 director of the Neuropsychiatric the diagnosis of myocardial infarc- Abram Sager Surgeon and professor and chair of Institute, he established residency tion. 1810-1877 Anesthesiology, he started the programs in adolescent and child Professor of obstetrics and diseases Department’s resident training pro- psychiatry and significantly improved James Leroy Wilson of women and children and first dean gram. Under his leader- mental health services in Michigan. 1898-1978 of the Medical School, ship, the Department Professor and chair of Pediatrics and he endorsed admission performed most of the Aldred Scott Warthin Communicable Diseases, he focused of women to the School research work on the 1866-1931, M.D. 1891, Ph.D. 1893 his research on children with poliomy- in 1870. A botanist and drug ketamine. Professor of pathology and director elitis and was an expert in respiratory zoologist, he gave his of the Pathological Laboratory, he problems. impressive collections Harry A. Towsley inaugurated the demonstration to the University. 1905-1993, M.D. 1931 course on physical diagnosis and the Professor of pediatrics course in microscopic pathology. Maurice Harrison and communicable dis- Seevers eases and of post- John Elmer Weeks 1901-1977 graduate medicine, he 1853-1949, M.D. 1881 Professor and chair of served as historian for Physician and ophthalmologist, he Pharmacology, he pro- the 298th General Hos- and Robert Koch discovered, sepa- moted growth of the fac- pital, the U-M World rately, the causative organism of ulty and programs in War II unit. The Center pinkeye and Egyptian ophthalmia, clinical pharmacology, for Continuing Medical now known as the Koch-Weeks performed research on Education and a visiting bacillus. narcotic analgesics and professorship are general anesthetic named after him. agents, and was long Carl Vernon Weller 1887-1956, M.D. 1913 associated with Japa- Bertha Van Hoosen nese pharmacologists. Professor and chair of Pathology, he 1863-1952, M.D. 1888 expanded research and consultation Associated with Cook County Hospi- services and established weekly Henry Sewall tal, Women and Children’s Hospital conferences in which all facets of a 1855-1936 in Chicago, and Loyola University, she case were discussed. Professor of physiology, he per- was known as the dean of women formed research on equilibrium, surgeons in America, founding and muscle contraction, respiration and serving as first president of the Walter M. Whitehouse color vision, and is best known for American Medical Women’s 1916-1985, M.D. 1941 immunizing animals against snake Association. Professor and chair of Radiology, he venom, demonstrating the principle promoted growth in the of antitoxin production. subspecialties and kept pace with advances in nuclear medicine and imaging techniques.

28 Winter 2001 Michigan’s Continuing Medical Education Calendar

Winter/Spring2001 2001 FEBRUARY 4-9 25th Annual Midwinter Family Practice Boyne Highlands Inn, Harbor Springs 14-17 Echocardiography The Registry, Naples, Florida 16-17 Advanced Trauma Life Support (Student Course) Towsley Center, Ann Arbor 16-18 GI/Liver Wrap-Up South Seas Resort, Captiva Island, Florida 19-21 Management of the Difficult Airway Last Call for MCAS South Seas Resort, Captiva Island, Florida 21-25 Radiology in the Desert Nominations! Marriott’s Camelback Inn, Scottsdale, Arizona MARCH The Medical Center Alumni Society seeks 1-3 Infectious Diseases nominations for the following: South Seas Resort, Captiva Island, Florida 2-3 Clinical Informatics MCAS BOARD (Location to be determined) 6-9 Spring Family Practice 2001 Appointment to the Society’s board, for (Location to be determined) a term of office lasting three years. The board meets twice a year, usually in Ann 24 Advanced Trauma Life Support (Refresher Course) Arbor. The board serves the Health Sys- Towsley Center, Ann Arbor tem in a variety of ways, through its outreach programs to students and by APRIL assisting faculty and Health System lead- ership in promoting and strengthening 2-4 Management of the Difficult Airway the worldwide network of graduates of DoubleTree La Posada Resort, Scottsdale, Arizona the University of Michigan Medical 4-7 Obstetrics and Gynecology-Perinatal course School. (Location to be determined) 21-22 Neuro-Ophthalmology THE MCAS AWARDS Kellogg Eye Center, Ann Arbor

• The Distinguished Service Award for 27-28 Advanced Trauma Life Support (Instructor Course) outstanding service to the University of Towsley Center, Ann Arbor Michigan MAY • The Distinguished Achievement Award 3-5 29th Annual Spring Update in Internal Medicine for professional accomplishments Towsley Center, Ann Arbor • The Early Distinguished Career 17-19 Practical Picture Archiving and Communication Systems (PACS) Achievement Award for professional (Location to be determined) accomplishments in the first 20 years 19 Vascular Disease following graduation Dearborn Inn, Dearborn In each case, please submit relevant 30-1 Automated Information Management in the Clinical Laboratory information, including biographical data Towsley Center, Ann Arbor and qualifications for service or for awards, to Michael DeBrincat in the Office of Medical Development and Alumni Relations, 301 E. Liberty, Suite 300, Ann Arbor, MI 48104-2251. Questions may be directed to DeBrincat at (734) 998-8107 or via e-mail at [email protected].

Medicine at Michigan 29 Five New Professorships Further Enhance the Medical School’s Ability to Reward Distinguished Achievement in Teaching, Research and Clinical Medicine

Executive Vice President for Medical Affairs Five new endowed professorships in the Medical Gilbert S. Omenn with Peg Child, wife of School were made possible last year with funds the late C. Gardner Child who served as totaling $6.5 million. chair of the Department of Surgery from 1959 to 1974, and Frederic Eckhauser, first A gift from Max Karl Newman (M.D. 1934) of Bloomfield holder of the Child Professorship of Surgery, Hills and the Newman Family Foundation established at the inauguration of the Child chair on the Newman Family Professorship in Radiation Oncol- May 30, 2000. ogy. The gift was made in recognition of the longstanding relationship of Max Karl Newman and his sons, Donald The first C. Gardner Child Professor of Surgery is helped establish the clinical teaching program in L. Newman (M.D. 1973) and Steven E. Newman (M.D. Frederic E. Eckhauser, M.D., who joined the dermatology at the University of Michigan. Taylor 1970) with the University of Michigan and to honor the faculty in 1976 and whose major areas of clinical retired from teaching in 1992, and died in 1997. many accomplishments of their medical careers. Max interest include pancreatobiliary cancer, chronic Newman was a pioneer in physical medicine and pancreatitis, and portal hypertension. His professor- The Taylor Professorship was established through rehabilitation and one of the founding members of his ship was inaugurated on May 30, 2000. gifts from friends of the Department of Dermatology, specialty. All three of the Newmans are practicing graduates of the dermatology residency training physicians in the Detroit area, Donald in family program, faculty members and grateful patients. medicine and Steven in neurology. The Newmans’ gift In the Department of Anesthesiology, Ralph Lydic, Ph.D., has been named the Bert N. La Du Professor of Anesthesiology Research. The professorship honors Bert N. La Du Jr. (M.D. 1945), Ph.D., a former chair of the Department of Pharma- cology and a biochemist-physician whose illustrious career included research into metabolic pathways, specifically those involved in drug Alfred Chang with sons, Stephen and Chris, and wife, Lana metabolism. La Du was among the first to describe the drug-metabo- The first Hugh Cabot Professor of Surgery is Alfred lizing enzyme system of liver E. Chang, M.D., who joined the Michigan faculty in Dean Allen Lichter with microsomes that later became Sophie and Max Newman is also to honor Dean 1988 and whose major research interests include known as cytochrome P-450, now at the inauguration of the Allen Lichter, M.D., who cancer immunotherapy and gene therapy. His profes- recognized as the major enzymatic Newman Family Professor- will be the first holder of sorship was inaugurated on September 28, 2000. pathway responsible for most of the Newman Professor- ship in Radiation Oncology, Timothy M. Johnson, M.O., associate professor of the metabolic detoxication of ship and whom Max on December 10, 2000. dermatology, therapeutic drugs, as well as the Dean Lichter is the first Newman first knew many otolaryngology and metabolism of hundreds of other holder of the Newman years ago as the young surgery, was inaugu- organic compounds in the environ- chair. son of his friend and class- rated January 13, ment. La Du has also made major mate, Max Lichter, M.D. A 2000 as the William contributions in clinical research on ceremony to inaugurate the Newman Family Professor- B. Taylor Collegiate several inborn errors of metabolism Ralph Lydic ship was held December 10, 2000, at the Michigan Professor of Derma- of amino acids and in pharmacoge- League in Ann Arbor. tology. Johnson is netics, the study of genetic traits that cause unusual Two professorships in surgery were made possible also the director of reactions in some people to therapeutic drugs. with an endowment established by bequest in 1958 Cutaneous Surgery The Bert N. La Du Professorship of Anesthesiology to benefit the Department of Surgery from the estate and Oncology in the Research was created with gifts from faculty, of Battle Creek resident Maud T. Lane. Distributions Department of residents and alumni/ae to acknowledge and from the Maud T. Lane Scientific Research Fund Timothy Johnson Dermatology, and commemorate La Du’s contributions to academia and provided $2.4 million toward the professorships, with serves as the clinical science. La Du recently celebrated his 80th birthday. the balance coming from the Department of Surgery. director of the Cutaneous Oncology Program in the An earlier 1996 distribution from the Lane bequest Comprehensive Cancer Center. His clinical research Lydic, whose own research focuses on the cellular and funded a professorship in her name in the concerns the systematic surgical management of molecular mechanisms that cause respiratory depres- Department of Surgery. malignant melonoma, basal cell carcinoma and sion during unconscious states, is the current president squamous cell carcinoma. of the North American Sleep Research Society. m Lane was a patient of the late C. Gardner Child, M.D., who served as chair of the Department of Surgery The Taylor Professorship honors William Brooks from 1959 to 1974. One of the new professorships is Taylor, a member of the Medical School faculty for named in honor of Child. The other new professor- 40 years, 25 of them as a professor. Taylor’s legend- ship is named in honor of Hugh Cabot, who was ary diagnostic skills and knowledge of his patients professor of surgery and director of the Department inspired many, including more than 250 residents who of Surgery from 1919 to 1930. He also served as dean trained with him. As a pioneering teacher, Taylor of the Medical School from 1921 to 1930. Medicine at Michigan 21 at MICHIGAN Winter 2001 A PUBLICATION OF THE UNIVERSITY OF MICHIGAN MEDICAL SCHOOL

ealing Hand D iscovering: Michigan’s Ambitious MSTP Grads Bridge the Clinic and the Laboratory The Road to a Successful HMO 1984 1986 1988 The University of Michigan, faced with a national trend toward managed M-CARE is created by the University and Warner-Lambert (now care in medical services delivery as well as rising benefit costs as an is licensed by the state of Michigan. With ) becomes one of the employer and the migration of U-M employees to health care delivery its entrance into the managed care mar- first major employer organizations other than the U-M, contemplates the establishment of its ket, M-CARE becomes one of the first Uni- groups to offer an own HMO. A group of researchers and planners led by John Forsyth and versity-owned HMOs in the country. M-CARE health plan to George Zuidema, M.D., begins exploring the feasibility of establishing a their employees. non-profit health maintenance organization at the U-M.

by John Barton

At a time when the nation’s health maintenance orga- nizations are among the favorite targets of physicians, politicians and even potential members, M-CARE — the University of Michigan’s HMO — is drawing praise instead of criticism. In recent months, M-CARE has garnered national rec- ognition and high rankings in such HMO-related cat- egories as customer satisfaction, quality of care and overall excellence. Enrollment, which includes about 51,000 members from U-M, has skyrocketed to more than 180,000 since the plan was conceived a little more than 16 years ago by a team of researchers and plan- ners led by John Forsyth (currently chairman and chief executive officer of Wellmark Blue Cross and Blue Shield for the states of Iowa and South Dakota) and George D. Zuidema, M.D. “We were at a point in 1984 when people were beginning to think HMOs would be the answer to saving the health care system,” recalls Zuidema, who lives in his hometown of Holland, Michigan. Zuidema, who was on the U-M Medical School faculty from 1960 to 1964, returned after 20 years as surgeon-in-chief and professor of surgery at Johns Hopkins to become professor of surgery and U-M vice provost for medical affairs. “There was a general sense that we should somehow get involved,” he continued, “but we first had to figure out how HMOs operated. Then we had to Under Executive Director Zelda Geyer-Sylvia’s lead- figure out what we would have to do to make such a ership, M-CARE has managed to reverse a frustrating plan acceptable to the medical staff and faculty series of annual financial losses. before presenting it to them and their families.” Two years later, M-CARE was launched from its drawing-board infancy and toddled into reality. Zuidema says he is not surprised at M-CARE’s steady growth in membership or prestige.

50 Winter 2001 1993 1995 1996 Recognizing the need to grow in order to meet market demand, M-CARE Consistent with the mission of M-CARE M-CARE reaches an begins expanding beyond the Ann Arbor service area and introduces two and the Health System, M-CARE begins enrollment milestone of additional service plans — M-CARE Point of Service and GradCare. participating in the federally-funded Med- 100,000 members. In the M-CARE Point of Service allows members access to providers outside of icaid program. M-CARE receives one-year next few years, member- the M-CARE network. GradCare offers a plan with enhanced affordability Accreditation from the National Commit- ship will increase to over and accessibility for graduate students at the U-M. tee for Quality Assurance (NCQA). 180,000.

“There continues to be a need for physicians and educators to U-M’s M-CARE Gets High Marks work together on the managed care evolution. Managed care is

Photo: Gregory Fox from both Patients and Doctors evolving but probably will not go away, and that’s why it is so “As a matter of fact,” he the HMO. Primary care physi- explains, “It appears that many cians in an HMO provide and important for us to partner with of the things that I had hoped coordinate a member’s health the health care delivery system. would happen actually did care, approving or requesting happen. I am pleased with the referrals to specialists in the It allows for all the different way things turned out in the plan’s network for consultation. pieces of the system — same way that you want to be HMOs have drawn the fire and able to say you gave birth to a including the physicians and the ire of critics because of strictly healthy child.” interpreted coverage limita- hospital — to really understand This particular health-care child tions, and allegations that what the financial issues are in may have started out small, but patients are frequently deprived it has grown to include a mem- of appropriate care because relation to health care.” bership base scattered over 16 non-medical personnel are Michigan counties. M-CARE making treatment decisions. —M-CARE Executive Director holds contracts with nearly “Everyone seems to be beating Zelda Geyer-Sylvia 2,000 employer groups and has George D. Zuidema, M.D. up on HMOs, although our access to a cadre of more than own M-CARE gets very high 5,500 physicians and affiliation marks from members and providers alike,” with more than 40 hospitals in southeastern Michigan, observed Gilbert S. Omenn, M.D., Ph.D., during a Flint, Jackson and Lansing. recent forum on health policy that was held at the M-CARE also supports Medicaid and Medicare University of Michigan. plans. Medicare is a federal health insurance program Omenn, the chief executive officer of the U-M Health for the elderly and disabled. Medicaid is a federal System and the University’s executive vice president for assistance program that pays medical bills for eligible medical affairs, went on to say during the forum: “There needy persons. is no doubt in my mind that a compromise patients’ By definition, an HMO is an association that provides bill of rights, more focused on assuring prompt resolu- a specified package of health care for a fixed sum that is tion of clinical care coverage disputes and less on paid in advance and furnishes coverage for a specified generating business for attorneys, would be widely period of time. Generally, a patient cannot seek care acceptable. Unfortunately, the advocates on each side outside the providers or hospitals under contract with have staked out extreme positions.”

Medicine at Michigan 51 1997 1998 Again affirming its mission of providing M-CARE works with the U-M Health System in its service across the community and distin- development of Partnership Health for Ford Motor Com- guishing itself from other managed care pany. M-CARE and the Health System go on to develop organizations, M-CARE establishes the a similar insurance product, Activecare, in partnership M-CARE Senior Plan to serve the Medi- with General Motors. M-CARE receives a four-star care-eligible population. national rating for its HMO in US News & World Report’s guide to managed care plans.

“M-CARE is different because the Medical School adds a lot of value in terms of the quality of our programming.” M-CARE’s niche lies somewhere short of It is also an extremely important source for scien- —Geyer-Sylvia those extremes, according to the tific research, with M-CARE members having the organization’s executive director, Zelda opportunity to voluntarily participate in a number Geyer-Sylvia. “What we are finding is that of wide-ranging studies involving everything from our M-CARE members are generally sat- diabetes to pediatrics and pharmacology. isfied,” she says. “People are aware of the negative “We also have an educational mission,” Geyer-Sylvia images that are out there, but they say, ‘that is an says. “We have a couple of grants — one from the HMO, but it is not my HMO.’ state Medicaid program and another sponsored by “That means our main focus is on our delivery sys- the Robert Wood Johnson Foundation to promote tem, which has as its heart the U-M Health System. interdisciplinary education in managed care for We have a lot of relationships with very good health physicians, nurses, social workers and pharmacists. systems throughout our service area, including Beau- “We have a real commitment to Medicaid and Medi- mont, Oakwood, St. John, Genesys and Providence, care and continue serving these populations because but our base is still the U-M Health System.” they are important to us as part of our mission to Those close ties to the U-M Health System give serve the community.” M-CARE an advantage over competing HMOs, she Geyer-Sylvia earned her master’s degree in public health continues. “For example, we use all of the Medical from Yale in 1976. She has spent nearly 15 years in the School-developed and faculty-developed clinical guide- health care plan industry, including a stint as a regional lines — the guidelines on how to practice. We adopt administrator for Vermont Community Health Plan them, don’t have to develop our own, and it turns out which developed the first HMO in that state. to be a very good partnership for both of us. She came to M-CARE in 1998, after Community “M-CARE is different because the Medical School Health Plan merged with Kaiser-Permanente, the adds a lot of value in terms of the quality of our pro- largest HMO in the country. Under Geyer-Sylvia’s gramming.” leadership, M-CARE has managed to reverse a frus- The opposite is also true, according to Omenn, who trating series of annual financial losses. points out M-CARE’s importance to the U-M Health “There continues to be a need for physicians and System. “M-CARE gives us a window on the insurance educators to work together on the managed care world at a time of unprecedented changes,” he says. “It evolution. Managed care is evolving but probably will also gives us an opportunity to experiment with man- not go away,” she says, “and that’s why it is so important aged care strategies and instruction. And it’s an excel- for us to partner with the health care delivery system. lent health plan option for our employees.”

52 Winter 2001 1999 2000 M-CARE receives a five-star rating from Health M-CARE receives an Excellent Accreditation — the highest possible — from NCQA for its Commer- Grades.com, making it the top-rated plan in Michigan. cial, Medicare, and Medicaid HMO health plans. In addition, the Health System and M-CARE receive In addition, M-CARE is selected as one of 38 managed a $150,000 one-year grant - one of only six such grants awarded — from Partnerships for Quality care organizations from across the country, and the only Education and the Robert Wood Johnson Foundation, administered by the U-M Geriatrics Center, to one from Michigan, to be included in the first edition of develop interdisciplinary teaching programs for health professionals who provide care to elderly Quality Profiles: In Pursuit of Excellence in Managed patients in a managed care system. M-CARE’s successful evolution continues as it rolls out a five- Care, produced by the National Committee for Quality year (2000-2005) strategic plan and continues its return to profitability. Assurance with support from Pfizer, Inc.

M-CARE has garnered national recognition and high rankings in such HMO-related categories as customer satisfaction, quality of care and overall excellence. Enrollment, which includes about

“It allows for all the its physicians, hospitals and other 51,000 members from U-M, has different pieces of providers well while offering employers skyrocketed to more than the system — and members highly cost-effective and

Photo: Gregory Fox including the phy- innovative benefit programs for clinical 180,000 since the plan was sicians and the care, home services, patient education and conceived a little more than hospital — to health promotion.” really understand 16 years ago. Geyer-Sylvia acknowledges the challenges what the financial that lie ahead. She says M-CARE will issues are in rela- fulfill its future mission through planned, tion to health care. careful and controlled growth. “What we have to do It helps them is make people understand that there are differences understand that between us and those big insurance companies who there isn’t an open have adopted managed care. We are not an checkbook out insurance company. M-CARE is a health mainte- Geyer-Sylvia: “Our main focus there. There are nance organization that believes in prevention and is on our delivery system, financial realities, quality services.” m which has as its heart the U-M and employers are Health System.” only going to pay just so much. We bring a consciousness of the need for cost efficiency. “In addition, a strong partnership with the health care delivery system allows us to focus on providing high quality care. We can demonstrate our quality — in a tangible and measurable fashion — to employer groups and others who want to take a look at our performance.” Omenn says the achievements of the recent past have been impressive, but they have also generated high expectations for the future. “I expect M-CARE to be an increasingly well recognized model of a top qual- ity, financially sound health care program which pays

Medicine at Michigan 53 In the Limelight

Five U-M Medical School faculty elected fellows of world’s largest scienceLi organization m Five University of Michigan Medical School Jack E. Dixon, Ph.D., Minor J. Coon Professor faculty members have been elected fellows of of Biological Chemistry and chair of the the American Association for the Advancement Department of Biological Chemistry. His of Science, the world’s largest organization of nomination cited his pioneering discoveries of scientists. They make up the majority of the peptide hormones, structure and catalytic U-M’s seven new AAAS fellows, the largest mechanism of phosphotyrosine phosphatases, group from any single U.S. institution this year. and the lipid second-messenger target of the tumor suppressor PTEN.

Stanley J. Watson, M.D., Ph.D., Raphael Collegiate Professor of in the Department of Psychiatry and co- director and research scientist at the U-M Mental Health Research Institute. He Huda Akil George Brewer Jack Dixon Stanley Watson Max Wicha was elected in recognition of his AAAS fellows are a select group chosen by their distinguished contributions to understanding peers for distinguished efforts in advancing the neurobiology of stress and depression. science or scientific applications. The 251 individuals elected this year will officially Max S. Wicha, M.D., professor of internal become fellows on February 17, 2001, at the medicine and director of the U-M Comprehen- national AAAS meeting in San Francisco. sive Cancer Center. He was elected for his contributions to the understanding of The five Medical School faculty members are: apoptosis in the biology and treatment of breast cancer, and for national leadership in the Huda Akil, Ph.D., Gardner C. Quarton Profes- fight against cancer. sor of Neurosciences, professor of psychiatry and co-director and senior research scientist The other two U-M faculty elected AAAS of the U-M Mental Health Research Institute. fellows were Vincent Pecoraro, Ph.D., profes- She was recognized for her outstanding con- sor of chemistry in the College of Literature, tributions to the neurobiology of depression Science and the Arts, and Nancy Reame, and stress, and for leadership in creating a M.S.N., Ph.D., professor, School of Nursing, modern scientific basis for psychiatry. and a research scientist in the Reproductive Sciences Program. George J. Brewer, M.D., professor of genetics and internal medicine. He was elected for his clinical research on copper metabolism and Wilson’s disease, and the development of zinc and tetrathiomolybdate treatments that have transformed care of patients with the disease.

54 Winter 2001 Robert M. Anderson, Steven R. Buchman, Kim Eagle, M.D., Ed.D., professor and M.D., associate profes- Albion Walter Hewlett senior research scien- sor of surgery in the Professor of Internal tist in the Depart- Section of Plastic and Medicine and chief of ment of Medical Edu- Reconstructive Sur- clinical cardiology, has cation, received the gery and director of been appointed editor Outstanding Educa- the Craniofacial of Current Journal tor in Diabetes Award Anomalies Program, Review by the Ameri- from the American has been selected as the can College of Cardi- Diabetes Association Robert H. Ivy Society ology. The College is a mon June 10, 2000, at elighAward Winner at the professional society of t their annual Scientific Sessions meeting in San 2000 national meeting over 25,000 cardiovascular physicians and Antonio. The award is presented each year to of the American Society of Plastic Surgeons. The scientists from around the world who support the distinguished health professional who has award is given annually for the paper showing the mission of fostering optimal cardiovascular made exceptional educational efforts in diabe- the greatest degree of excellence in preparation, care and disease prevention through professional tes. The honor recognized Anderson’s work in presentation and illustration of scientific mate- education, promotion of research, leadership in defining the essence of diabetes education as rial as well as the greatest degree of excellence in the development of standards and guidelines, and encouraging informed decision-making and scientific merit, originality and impact. the formulation of health care policy. personal responsibility, and in positioning the health care system to better respond to the Alphonse Burdi (Ph.D. , M.D., ongoing needs of people with diabetes. 1962), professor of cell professor of neurology and developmental and director of the Diane Baker, M.S., biology and research Juvenile Diabetes clinical associate pro- scientist in the Center Foundation Center for fessor of human for Human Growth Complications of genetics and director and Development, was Diabetes, was honored of the Genetic Coun- awarded an Honorary by the American seling Program, has Doctor of Science de- Diabetes Association been selected as a gree at the University for her commitment 2001 AAAS Congres- of Athens commence- and dedication to sional Fellow. ment exercise on May 26, 2000. This high honor, diabetes research. Approximately 80 recommended by medical and dental faculty at Feldman has been continuously funded by the fellows per year take the University, recognizes Burdi’s more than 200 American Diabetes Association since 1995, and part in this program, scientific and clinical contributions to the world her work was highlighted in their 2000 Progress which allows accomplished, socially aware sci- literature on developmental craniofacial biology Report. Feldman also received the 2000 Jane L. entists/health care professionals to participate and the causes of leading birth defects and Cobb Promise Award for excellence in scientific in and contribute to federal policy-making pro- syndromes such as clefts of the lip and palate. research from the Juvenile Diabetes Foundation. cesses. The program is supported by the Ameri- can Association for the Advancement of Sci- Horace Davenport, John Greden, M.D., ence, the American Society of Human Genet- Ph.D., D.Sc., the Wil- Rachel Upjohn Pro- ics, and the fellow’s home department. liam Beaumont Pro- fessor of Psychiatry fessor Emeritus of and Clinical Neuro- Physiology and sciences, chair of former chair of the psychiatry, senior Department of Physi- research scientist in ology, has been listed the Mental Health as one of the 50 most Research Institute influential gas- and director of the trointestinal profes- new Michigan sionals of the past century by the Depression Initiative, has been appointed chair vGastroenterology.com Web site. In consulta- of the American Psychiatric Association’s tion with leading professionals, Council on Research. The American Psychiat- vGastroenterology.com identified 50 scientists, ric Association is a medical specialty society clinicians and inventors who have had the big- recognized worldwide, with a membership of gest influence in the field of gastroenterology 40,500 U.S. and international physicians over the past 100 years. A brief description of specializing in the diagnosis and treatment of Davenport’s contribution to the field of mental illnesses and substance use disorders. gastroenterology and some biographical information are posted on the site. Medicine at Michigan 55 Medical School Professor Receives Top

Michael J. Imperiale, National Medical Teaching Award Ph.D., professor of microbiology and immunology, was selected to receive a University of Michi- gan 2000 Faculty Recognition Award. He was recognized for groundbreaking research in cancer biology and gene therapy, outstanding teaching, and exemplary leadership and admin- istrative service.

Mohamed K. Khan, M.D., Ph.D., lecturer in the Department of Radiation Oncology, has been elected to the American Medical Association’s Council on Scientific Affairs (CSA). There are 11 members who sit on the Council; each is elected by the AMA’s House of Delegates. CSA is an advisory council within the AMA regarding scien- tific medical issues. It also drafts reports that serve as a national source of information on science and research-based issues that affect the practice of medi- cine and the quality of patient care. The Council Cyril Grum in 1996 with students Tina Hahn and Kwabena Osei-Boateng (standing) and prepares policy positions and makes policy Wilmer Balaoing (seated) recommendations, most of which have been One of the Medical School’s leading educators of future physicians has now been named approved by the AMA House of Delegates and are now the official policy of the AMA. one of North America’s top teachers of medicine. Cyril Grum, M.D., professor of internal medicine and coordinator of many medical education activities at the U-M Medical School, The American Acad- received a major national award for medical student teaching last October at the meeting of emy of Physical the Association of American Medical Colleges in Chicago. Medicine and Reha- bilitation recently Grum and three co-recipients were honored with the Alpha Omega Alpha Robert honored James A J. Glaser Distinguished Teacher Award, recognizing outstanding contributions to Leonard Jr., M.D., medical education by gifted teachers. The four were chosen from a select group clinical professor and of faculty, one nominated by each medical school dean in the U.S. and Canada. chair of the Depart- The award carries with it a $10,000 prize for each recipient, $5,000 for each ment of Physical institution’s teaching activities, and $1,000 for each local chapter of the Alpha Medicine and Reha- Omega Alpha medical student society. bilitation, with a Distinguished Clinician Award. The Academy “It’s a tremendous honor to be recognized for my teaching efforts over the past 20 honors physical medicine and rehabilitation phy- years,” says Grum. “As a teacher, I work to excite, inspire and lead students — I do sicians who have achieved distinction on the ba- whatever it takes. My greatest duty is to send them out on a career journey where sis of their scholarly level of teaching and their outstanding performance in physiatric patient they’ll surpass what I have done. Every teacher should strive for that.” care activities. Leonard has devoted most of his clinical career to the care and treatment of pa- At the Medical School, Grum directs the curriculum for all third- and fourth- tients needing orthotic and prosthetic services. year students, as well as directing his department’s clerkship program, during He is a renowned teacher and clinician, has which third-year students practice the art and science of medicine in patient-care authored numerous publications and has pre- settings. He also teaches second-year students, counsels fourth-year students on sented more than 130 lectures to medical and pro- their career directions, and carries out research designed to improve the effec- fessional organizations on topics in the field of tiveness of medical education. medical rehabilitation.

56 Winter 2001 The Graduate Pro- Barbara Luke, Sc.D., James J. Mulé, Ph.D., gram in Cellular and M.P.H., professor of Maude T. Lane Profes- Molecular Biology obstetrics and gyne- sor of Surgery, was has named its annual cology, won the named by the director lectureship the American Society of of the National Cancer Myron Levine Lec- Journalists and Institute to serve on its tureship to honor Authors Outstanding Board of Scientific Professor Emeritus Book of the Year Counselors, beginning Myron Levine, Ph.D., (Service Category) for July 1, 2000. Mulé is founding director of her book, When You’re responsible for the the Cellular and Expecting Twins, Trip- review of the Institute’s Molecular Biology Program, now in its 27th lets or Quads: A Complete Resource. Founded in entire intramural clinical research program and year. The inaugural lecture, “Signal Transduc- 1948, the American Society of Journalists and will serve as an adviser to the director. Mulé also tion Mechanisms that Control Nervous System Authors is the nation’s leading organization of serves as the chairman of the Institute’s Experi- Development and Function,” was presented on independent nonfiction writers. mental Therapeutics study section. He is the September 5, 2000, by Michael Greenberg, director of the U-M’s Graduate Program in Ph.D., professor of neurology and neurobiol- Ralph Lydic, Bert Immunology and the Cancer Center’s Tumor ogy at Harvard University, at the Annual LaDu Professor of Immunology Program. Symposium and Poster Session of the Cellular Anesthesiology, and Molecular Biology Program. director for research Elizabeth Petty, M.D., in the Department of associate professor of Simon Levine, Ph.D., associate professor and Anesthesiology, and internal medicine director of the Rehabilitation Engineering Pro- professor of physiol- and of human genet- gram in the Departments of Physical Medicine ogy, has been named ics, received the 2000 and Rehabilitation and Biomedical Engineer- president of the Sleep University of Michi- ing, was awarded the esteemed Mentor Award Research Society. The gan Regents’ Award by the Rehabilitation Engineering Society of Sleep Research Soci- for Distinguished North America. The award is given for leader- ety exists to promote understanding of the Public Service. The ship in counseling and nurturing of others in processes of sleep and its disorders through Regents’ Award, the rehabilitation and assistive technology field. research, the training of practitioners of presented annually Levine was also elected as a fellow of the Soci- research and the dissemination of the fruits of since 1991, recognizes ety for his national and international contri- their efforts to the scientific and medical public service activities that relate closely to butions to rehabilitation technology. communities as well as to the general public. teaching and reflect professional and academic expertise. Petty was chosen for her Manuel O. Lopez- John Moran, Ph.D., contributions to the public’s and medical Figueroa, Ph.D., a assistant professor of profession’s understanding of genetics; her postdoctoral fellow in human genetics and service to the Medical School, University and Stanley Watson’s lab at internal medicine the state of Michigan; and the example she the Mental Health and one of the Medi- provides for students and young physicians. Research Institute, was cal School’s first Bio- recently presented logical Sciences with the 2000 Young Scholars, has received Investigator Award for one of five 2000 Keck Superior Research Distinguished Young Achievement in the Scholars awards. The Field of Nitric Oxide Keck award carries a Biology/Chemistry. The award was presented by grant of up to $1,000,000 over the next five the three Nobel Laureates in Medicine and Physi- years and was instituted by the W.M. Keck ology for 1998 at the First International Confer- Foundation to support the nation’s most prom- ence of the Biology, Chemistry and Therapeutic ising young scientists involved in biomedical Applications of Nitric Oxide. research addressing the fundamental mecha- nisms of human disease. Lopez-Figueroa was also one of four recipients of the Brain Research Interactive Young Inves- tigator Award from the Society for Neuro- science in 2000. He was selected for outstand- ing research demonstrated by articles published on the Brain Research Interactive Web site and in Brain Research during the past year.

Medicine at Michigan 57 Julia Richards, Sanjay Saint, M.D., Thomas L. Schwenk Ph.D., associate M.P.H., has won a (M.D. 1975), profes- professor of ophthal- 2000 Excellence in sor and chair of mology and visual Research Award for Family Medicine, has sciences, has been Physicians from the been elected to the selected to receive the Blue Cross Blue Shield National Depressive Lew R. Wasserman of Michigan Founda- and Manic Depres- Merit Award from the tion, for his work sive Association Board of Trustees of examining the effec- (DMDA) Board of the Research to tiveness of a clinical Directors. The Prevent Blindness practice guideline for National DMDA is (RPB) health organization, a world leader in the management of the largest patient- Limelirun, illness-specific organizationgh in the nation. support of eye research. uncomplicated urinary tract infection in women. For the work, published in the American Journal Richards was appointed last year to the Scientific of Medicine, Saint, assistant professor in the Schwenk was also elected to the Board of Direc- Advisory Board of the Glaucoma Foundation in General Medicine Division of the Department of tors of the American Board of Family Practice. New York. In September of 2000, she was the Internal Medicine, receives $10,000 in funding for The American Board of Family Practice is the sec- co-chair of the Seventh Annual Optic Nerve future research on clinical protocol and pathway ond largest medical specialty board in the U.S. Rescue and Regeneration Think Tank entitled evaluation. Schwenk was elected for a five-year term. “Immune Modulation and Gene Expression in Glaucoma: Toward a Unified Field Theory of Jochen Schacht, Audrey F. Seasholtz Glaucoma.” Richards is engaged in the search for Ph.D., professor of (Ph.D. 1983), associate genes which cause glaucoma, one of the leading biological chemistry professor of biological causes of blindness in the U.S. and professor of chemistry and senior otolaryngology, is part associate research Jean Robillard, M.D., of a small group of scientist in the Mental professor and chair of scientists and teachers Health Research Insti- Pediatrics and Com- working, with funding tute, received the Uni- municable Diseases, from the National versity of Michigan’s has been elected to a Institutes of Health, to 2000 Research six-year term on the develop curriculum Scientist Recognition Board of Directors of materials, including Award. The award the American Board of experiments and computer-based exercises, for recognizes exceptional scholarly promise in Pediatrics. Through- middle school students to help them learn about primary research faculty. out his career, the ear as a sound processor. The initial results of Robillard has been a their work, which began last summer, will be Kent J. Sheets, Ph.D., member of numerous boards and committees. posted on the Web for field-testing by students associate professor of For the American Board of Pediatrics, he has in selected schools in 2001. The project is family medicine, served on the Certifying Examination Planning supported by the Office of Science Education at received the Society Committee, the Task Force on Transplantation NIH. of Teachers of Family Medicine, and the Examination Committee for Medicine “Innovative the Sub-Board of Pediatric Nephrology. He also Program Award” at has served as the chairman of the Sub-Board of the Annual Spring Pediatric Nephrology. Conference in Orlando in May. The American Board of Pediatrics is one of 24 Sheets was honored certifying boards of the American Board of for his work in devel- Medical Specialties. Board certification represents oping and directing the Preceptor Education dedication to the highest level of professional- Project. These highly successful materials were ism in patient care. The Board of Directors designed to help busy community family consists of distinguished pediatricians in educa- physicians become more effective teachers of tion, research and clinical practice, as well as one medical students in their private practice or more non-physicians who have a professional settings. The materials teach basic skills in interest in the health and welfare of children and several core teaching areas — organization and adolescents. planning, observation, assessment, teaching, feedback, evaluation, tips on handling prob- lems, and collaborative teaching and learning.

58 Winter 2001 Photo: Joe McNally

Dara Spearman, a graduate student in the Program in Bio- medical Sciences, is serving a three-year term on the National Heart, Lung, and Blood Institutes Sleep Disorders Research Advisory Board. The Board, comprised of ght 12 physicians, scientists, and representatives of patient advocacy groups and 11 National Institutes of Health representatives, advises the director of the NIH on research activities of the National Center on Sleep Disorders Research. Spearman’s role on the Board will be to review research proposals and advise in long- range planning for sleep disorders research. Spearman is also pursuing an M.D. degree as a member of the Class of 2004.

Two Medical School faculty members have been selected to serve as members of the 2000-2001 Class of fellows in the Hedwig Gold Medalist Jason Wening Van Amerigen Execu- tive Leadership in Academic Medicine Jason Wening, a graduate student in biomedical engineering in the lab of Steve Program for Women. Goldstein, won the gold medal in the 400-meter freestyle at the 2000 Paralympics in Sydney, Australia, in October. Wening is a bilateral below-the- Denise G. Tate (top), knee amputee who was also born with a partially formed left arm and hand. Ph.D., associate profes- sor and director of Wening is the defending gold medalist from the 1996 and 1992 Paralympics. He research in the Depart- set a new world record during his gold medal swim at 4 minutes, 42.97 seconds, ment of Physical improving his previous world record by almost Medicine and three seconds. He had set that record earlier the Rehabilitation, and same day in a qualifying swim. Hope Haefner, M.D. (bottom), associate Breaking the record twice in one day was an professor of obstetrics and gynecology, join accident, Wening said, because he’d only tar- only 42 faculty nation- geted it for the final. “I thought breaking the ally who were selected to participate. Over the record in the morning might have sapped too year-long fellowship, fellows work together with much energy but I guess it worked out,” he said. eminent faculty and national leaders to find “I knew it would take a world record to win it innovative ways of implementing the positive because every time I’ve won at the Paralympics, changes in leadership that are necessary to recast the silver medalist has gone under the old and reconfigure academic health centers, and, record as well.” ultimately, health care for the 21st century.

Wening, who is the co-captain of the U.S. swim team, has not been beaten in his 400-meter freestyle class since 1991.

Medicine at Michigan 59 Michael Aldrich, Sleep Pioneer Noted for Narcolepsy Work,

Dies at 51 Jeremiah G. Turcotte (M.D. 1957, Resi- dency 1963), profes- Michael S. Aldrich, M.D., a Univer- sor of surgery, is serv- sity of Michigan Medical School ing as the elected neurology professor who was the vice-president of the founder of the U-M Sleep Disorders United Network for Laboratory and a prominent clini- Organ Sharing. He is cal and basic sleep researcher, died also a member of the July 18, 2000, at his home in Ann Network’s Board of Arbor after a long fight against Directors and was osteosarcoma. He was 51. recently nominated for the position of president. The Board, composed of medical Known internationally for his and other transplant professionals, transplant work on narcolepsy, Aldrich was recipients and donor families, advises the considered a pioneer neurologist Department of Health and Human Services in the relatively young field of and the Health Resources and Services Admin- sleep medicine. He established the istration on policies for allocation of transplant U-M Sleep Disorders section of donor organs throughout the U.S. The United the U-M Department of Neurol- Network for Organ Sharing also administers ogy in 1985, when sleep disorders were mainly the province of psychia- the Organ Procurement and Transplant trists. Over the next decade and a half, he developed the center into a Network which maintains a computerized burgeoning clinical service, a home to groundbreaking research on sleep waiting list for all patients awaiting a cadav- and its relationship to neurological disorders, and a training ground eric organ transplant and coordinates the for numerous young sleep specialists. The Sleep Disorders Laboratory distribution of donor organs within the U.S. has been renamed the Michael S. Aldrich Sleep Disorders Laboratory in his honor, with Ronald Chervin, M.D., serving as director. John Voorhees (M.D. 1963, Residency 1969), Aldrich’s narcolepsy research explored both the basic underpinnings of Duncan and Ella Poth the disorder in the neurotransmitters of the brain, and its clinical mani- Distinguished Profes- festations. Aldrich is credited with codifying the signs of narcolepsy and sor and chair of establishing the most effective diagnostic methods, allowing physicians Dermatology, was in- to distinguish it from other causes of excessive sleepiness. ducted into the Royal College of Physicians. In 1990, his seminal New England Journal of Medicine article on the Approximately 15 topic provided an eye-opening primer for general physicians and spe- non-United Kingdom cialists, giving them the means to detect cases of narcolepsy that might physicians are selected have otherwise gone undiagnosed. His recent book on the topic in the annually from all Oxford University Press Contemporary Neurology series is already con- specialties for induction into the College. Electees sidered a classic. are chosen based on accomplishments within their field, and Voorhees, who was cited for his Aldrich’s wife, Leslie Aldrich, M.D., is a clinical assistant professor of research in psoriasis and skin aging and for his gastroenterology at the Medical School. overall impact on modern dermatology, is believed to be the first American dermatologist given the honor. The Michael S. Aldrich Sleep Disorders Fund has been established to help the Sleep Disorders Laboratory continue to advance research on Voorhees has also been awarded honorary sleep disorders, to provide the best in clinical care to patients seeking membership in the Netherlands Society of Der- help with sleep disorders, and to ensure that many future physicians matology and Venereology. He was honored for wishing to specialize in sleep medicine may obtain the advanced train- his outstanding merits and leadership in re- ing they need to become contributors to this important and growing search during the past three decades in the field field of medicine. Gifts can be made to the Michael S. Aldrich Sleep of pathogenesis of psoriasis and the Disorders Fund, U-M Office of Medical Development, 301 E. Liberty aging process. Street, Suite 300, Ann Arbor, Michigan, 48104-2251.

60 Winter 2001 Brian Zink, M.D., associate professor of emergency medicine and assistant dean of Leaving Retirement medical student ca- Assets to the University reer development, has been elected presi- of Michigan Medical dent of the Society for Academic Emergency School: Medicine for 2000- A great way to help educate future 2001. The Society is a 5,000-member organization whose mission is generations of physicians to improve patient care by advancing research and education in emergency medicine. Retirement assets, which are often subject to income taxes and estate taxes at a combined marginal rate of 75% or more, are an excel- Jorge Iñiguez-Lluhí, Ph.D., and Ursula lent vehicle for making a gift to a charitable Jakob, Ph.D., have become the seventh institution such as the University of Michigan and eighth Biological Sciences Scholars at the University of Michigan. Medical School. By simply advising the plan administrator of your wishes and signing the Iñiguez-Lluhí, of the Department of appropriate beneficiary designation form, you Pharmacology, is a native of Mexico City and earned his doctorate at the can make the Medical School the beneficiary University of Texas Southwestern of the balance of your retirement plan Medical Center in Dallas before doing postdoctoral work at the accounts during your lifetime or after your University of California at San death. Because this area of estate planning Francisco. His research focuses primarily on cellular signal recogni- is relatively new and complex, guidance from tion, transduction and response. your attorney or other professional knowl- edgeable about tax law is advisable. If you Jakob, who earned her Ph.D. in biophysics and physical biochemistry would like more information about contribut- from the University of Regensburg in ing retirement assets to the University of Germany, completed postdoctoral work at the U-M where she has Michigan Medical School, please call the continued as a research scientist Office of Medical Development and Alumni focusing on the structural and func- Relations at (734) 998-7705 or write to direc- tional characterization of recently identified heat shock proteins. Jakob’s tor Jim Thomas by e-mail at Biological Sciences Scholar appoint- [email protected] or by U.S. mail at 301 E. ment, in the Department of Biology in the College of Literature, Science Liberty, Suite 300, Ann Arbor, MI 48104-2251. and the Arts, begins September 2001.

The U-M Biological Sciences Scholars program recruits top faculty to the emerging Life Sciences Initia- tive through appointments within the Medical School and in other life sciences-related departments throughout the University.

Medicine at Michigan 61 A Special Message from University of Michigan Provost Nancy Cantor Regarding

Late last year, W.W. Norton & Co. The University of Michigan takes allegations of CLAIM: Improper use of a vaccine initiated published the book Darkness in El impropriety in research very seriously. When we and exacerbated a measles epidemic that Dorado, by Patrick Tierney, which first learned of the claims made in the book killed “hundreds, perhaps thousands.” contained serious allegations Darkness in El Dorado, we immediately convened OUR FINDINGS: regarding the 1960s research of the a team of senior administrators, research staff The measles outbreak occurred in November 1967. Measles was introduced into late geneticist James V. Neel, M.D., and scholars to begin an internal inquiry. These Ph.D., and anthropologist Napo- individuals spent hundreds of hours over the the region by a party of Brazilian missionaries before the January 1968 arrival of the Neel leon Chagnon (Ph.D. 1966) among course of several weeks conducting a careful and the Yanomami, an indigenous thorough review. Their efforts included inter- expedition. There is substantial evidence of the outbreak existing long before Neel left for Ven- people of the Amazon River basin. views with individuals who had firsthand knowl- Following is a statement, edited edge of the work of James Neel and Napoleon ezuela, so Neel could not have been the cause. slightly for length, by University of Chagnon, as well as medical experts on measles Previous studies in 1966 had indicated a Michigan Provost Nancy Cantor vaccination; review of James Neel’s research logs substantial absence of measles antibody in the regarding the allegations and the and other published and unpublished writings; Yanomami. There were some individuals in findings of scholars who investi- and research into other relevant literature and Villages J and W with antibodies to measles, gated those allegations. Supporting published materials. indicating there had been sporadic prior research was conducted by the The evidence uncovered by our review sup- exposure but many individuals were not offices of the Executive Vice Presi- protected. Accordingly, in the fall of 1967, in dent for Medical Affairs, the Vice ports the conclusion that the claims are false. We are satisfied that James Neel and Napo- anticipation of the January 1968 expedition, President for Research, the General Neel initiated requests to pharmaceutical Counsel, and by faculty in the leon Chagnon, both among the most distin- guished scientists in their respective fields, companies and obtained 2,000 doses of Medical School and the Depart- Edmonston B vaccine plus gamma globulin. ment of Anthropology in the acted with integrity in conducting their research, and that their medical care of the He also consulted with a Centers for Disease College of Literature, Science and Control expert on measles on the best way to Yanomami and their attempts to halt the the Arts. Complete text of Provost administer the vaccine. Cantor’s statement can be found at: spread of a pre-existing measles epidemic through vaccination were humane, compas- Upon hearing of the outbreak, Neel acted quickly http://www.umich.edu/~urel/ sionate and medically appropriate. and responsibly to stop the spread of the darkness.html disease. The records show Neel spent at least two We believe that Tierney did not consult impor- tant original source material that was readily full weeks providing vaccine, antibiotics and medi- cal care as needed. Forty Indians and available for review. Analysis of that material and other material from persons familiar with the Brazilians in the immediate area of the noted cases received vaccine and then Neel initiated an exten- expeditions, the measles outbreak and the measles vaccine refutes the allegations. The sive program of immunization throughout the region. One thousand doses were administered by serious factual errors we have found call into question the accuracy of the entire book as well Neel; the rest were provided to and given by missionaries and medical auxiliaries of the Venezu- as the interpretations of its author. elan government to “get ahead” of the disease. All The allegations were circulated widely through- doses, except for the original 40, were given with out the academic community in September 2000 gamma globulin. At that time, administration of in an e-mail message from two reviewers, Terry vaccine, with or without concomitant gamma Turner of Cornell University and Leslie Sponsel globulin, was the accepted and recommended of the University of Hawaii. The e-mail message procedure. No death or serious untoward events implied that the two had just learned of these resulted from use of the vaccine with or without allegations, but in fact they were interviewed for gamma globulin. the book as early as 1995 and are credited in the ‘Acknowledgments’ section. Edmonston B vaccine, developed in 1958, was an internationally tested and safe vaccine. Below are listed some of the claims made in Samuel L. Katz, professor emeritus and chair- either the book or the e-mail message, and a man of Pediatrics at Duke University Medical description of our findings. School, was the co-developer of the vaccine (with John F. Enders) and he reports that its use was safe and appropriate in this population. It is claimed that a “fatal” epidemic was “caused” Nancy Cantor, Ph.D. or “greatly exacerbated” by the vaccine. Live attenuated vaccine has never been shown to be U-M Provost and Executive Vice President for Academic Affairs

62 Winter 2001 the Research of James V. Neel

transmissible from a recipient to a subsequent CLAIM: Neel held extreme eugenic theories. CLAIM: Chagnon’s characterization of the contact. Katz has studied the vaccine in devel- Yanomami as “fierce people” encouraged OUR FINDINGS: Neel’s published works show oped and developing nations and never saw any 40,000 invading gold miners to use violence that he was a critic of eugenics from his gradu- transmission of vaccine to susceptible contacts. against them between 1980-1987. ate student days in the late 1930s. Far from hold- Moreover, death as a result of the vaccine is ing “eugenics” positions, Neel strongly supported OUR FINDINGS: We have already established that exceedingly rare in any population. maintaining the rich diversity of the entire Chagnon was not the first author to describe the CLAIM: Refusal of medical care so that Neel human gene pool and urged “egalitarian Yanomami as violent. In fact, critics who have could observe an epidemic. control of population growth” to protect the accused him of this characterization forget that future of our species. He championed the view the Yanomami refer to themselves as waitiri, OUR FINDINGS: William Oliver, professor emeri- that each individual be able to maximize genetic ‘fierce and valiant.’ What Chagnon did was tus and chair of Pediatrics at the University of potential; this is a far cry from eugenic efforts to translate the term into English. Michigan Health System, was on several of the “improve” the species through reproductive expeditions and reports that on every expedi- theory and policy. His work with the Yanomami Given that the behavior of miners toward indigenous people during ‘gold rushes’ in the tion a large quantity of medical supplies was helped them survive the pre-existing measles brought in and used to treat the Yanomami. outbreak and was a humanitarian act by a 1850s and 1860s in places like California and Australia was similar to that seen in the 1980s Neel’s basic philosophy was to treat all illnesses compassionate physician. before any scientific observations. Each day he in the Amazon, the idea that Chagnon is would treat any new illnesses before starting the CLAIM: Chagnon himself is directly or indi- responsible for such behavior is not convinc- day’s planned studies. Any not used rectly responsible for endemic warfare ing. Published accounts of Yanomami violence would be left with resident missionaries with among the Yanomami. had preceded Chagnon’s arrival by a consider- detailed instructions for use. able length of time. Thus it seems much more OUR FINDINGS: This claim is among the easiest plausible that the miners were familiar with In the case of the measles outbreak, the facts to refute, especially since there is an extensive sensationalized newspaper articles on Yanomami are clear. The predicted death rate from history on the topic. Warfare among Indian warfare than that they had spent time reading untreated measles is 30 to 36 percent; the most groups in South America goes back a minimum the anthropological literature. common complication is bacterial pneumo- of 3,500 years. Abundant archaeological data nia. In this outbreak, the death rate was a very show raiding, including the saving of trophy CLAIM: Turner and Sponsel learned of this low 8.8 percent, showing clearly that proper heads, throughout the pre-Hispanic periods “impending scandal” from reading the medical care was provided. The records show called Chavin, Moche, Chimu, Wari and Inka. galley proofs of Tierney’s book. that the research team systematically and aggres- Warfare also was reported by the Spanish con- OUR FINDINGS: While the e-mail letter to the sively treated every patient with all available querors of the sixteenth century A.D. American Anthropological Association by medications. As indicated above, Neel stopped In the specific case of the Yanomami, our first Turner and Sponsel leaves the impression that his research work so that he could provide medi- report about these people is from the mid-1800s, they had just learned of the accusations cal care to the population. by Moritz Schomburgk (1847-1848). Then against Neel and Chagnon, there is published CLAIM: Secret radiation experiments were sometime between 1875 and 1910, we have evidence that they knew about them long conducted. reports that women had been acquired by before. The first piece of evidence, according Yanomami raiding (Peters 1998:167-168). In to sources who have seen uncorrected page OUR FINDINGS: Neel did not conduct any 1911 Theodor Koch-Grunberg (1923) described proofs of the book, is that both Turner and radiation studies with the Yanomami. In 1962 the Yanomami as ‘very warlike people who Sponsel are thanked in the ‘Acknowledgments’ and 1968 a physician named Marcel Roche succeeded in dominating several weaker tribes.’ section of Tierney’s book, which indicates that conducted a population study of thyroid The year 1931 is given as the year a war occurred they read it long before the galley stage. A uptake in the lowlands of Venezuela and high between two Yanomami subgroups, the Xilixana second piece of evidence is that Tierney’s book in the Andes showing that at very high and the Macu; 1935 as the year of the war cites a 1995 interview with Terence Turner. altitudes there was a uniformly higher thyroid between the Xilixana and the Yekwana; and 1946 radioiodine uptake. This study used proper as the year of a major epidemic (Peters 1998:167- Evidence leads us to believe that the accusations against Chagnon in Tierney’s doses of radioiodine (I-131). Radioiodine was 168). These and many other accounts make the then and remains today a commonly used claim that Yanomami violence began with forthcoming book were known to both Turner and Sponsel long before that book reached the diagnostic tool to measure pathological Chagnon’s arrival obviously false. conditions including thyroid function. galley proof stage. Some allegations had already been made in print by Turner as far Neel was well known for his extensive study back as 1994, and others in print by Sponsel on the aftereffects of atomic radiation on in 1998. The accusations are part of a long- survivors of Hiroshima and Nagasaki and standing academic feud that shows no sign of their children. A review of Neel’s field journal diminishing, rather than recent discoveries by and daily logs makes it clear that he never an investigative reporter. conducted any “secret radiation” studies.

Medicine at Michigan 63 Message from the Executive Vice President for Medical Affairs

This issue of Medicine at Michigan highlights our Church, D.O., M-CARE received maximal accredita- outstanding M.D./Ph.D. program for medical tion for its commercial, Medicaid and Medicare HMO students keen about careers in the science of medi- plans from the National Committee for Quality cine. We are expanding this program, and building a Assurance (NCQA). M-CARE was commended for base for clinical translation, as well as laboratory excellence in service, quality improvement programs work. The opportunities here at Michigan during the and consumer protection. M-CARE was one of only next decade will be tremendous, as the Life Sciences 38 health plans nationwide — and the only one in Institute and the Life Sciences Initiative on campus, Michigan — to have a quality initiative highlighted in plus the Life Sciences Research Corridor of the state the first edition of Quality Profiles: In Pursuit of of Michigan, enable us to greatly enhance our Excellence, published by NCQA with support from facilities, equipment, faculty, research and technology Pfizer, Inc. transfer programs. The Health Plan Employer Data and Information Set We are also making remarkable innovations in the (HEDIS) scores used by employers and the media to delivery of clinical services, including the role of compare health plans put M-CARE in the top 10 M-CARE (see page 50). M-CARE is an important percent nationally for mammography, prenatal care, element of the University of Michigan Health System. childhood immunizations and comprehensive Founded in 1986, M-CARE currently has 180,000 diabetes care. Regionally, M-CARE received a five-star subscriber-members, including more than 50,000 (highest) rating from the Greater Detroit Area Health faculty, staff, graduate students, retirees and their Council in the “Staying Healthy” category. dependents at the University of Michigan campuses. Moreover, General Motors rated M-CARE quality and We recruited M-CARE’s executive director, Zelda price an outstanding value. Thus, GM offered its Geyer-Sylvia, from Kaiser Northeast in October 1998; employees the lowest employee contribution for their she has more than 15 years’ experience in the HMO monthly health insurance premium if they chose world. Zelda has done a remarkable job of reshaping M-CARE — and 2,500 additional GM employees did her executive team, with colleagues who have local, so in 2000. Each year for several years an increasing regional and out-of-state experience. They have percentage of U-M employees have chosen M-CARE. markedly improved member satisfaction and physician satisfaction, enhanced relationships with Financially, the M-CARE team has turned around a key employer clients (including the U-M) and their series of annual losses and completed calendar year provider network, and worked with the U-M Health 2000 with a positive margin and a good contribution System’s Faculty Group Practice and the Hospitals to reserves. The marketing strategy now focuses and Health Centers to assure competitive payment for primarily on seven counties in southeast Michigan. our clinical services. M-CARE has been an essential We anticipate a moderate growth rate, which the component of our development of innovative current strategic plan shows reaching about 250,000 partnerships directly with Ford Motor Company members after five years. (Partnership Health) and with General Motors The leaders and staff of M-CARE are active partici- (Activecare). pants in many initiatives in the Health System and M-CARE has earned an enviable record of regional excellent University citizens. I am proud that my and national recognition for quality and leadership. family and I and so many U-M colleagues are With the guidance of Medical Director Robert members of M-CARE.

Gilbert S. Omenn, M.D., Ph.D. U-M Executive Vice President for Medical Affairs and CEO, U-M Health System

64 Winter 2001