NEWS OF THE TEXAS MEDICAL CENTER — VOL. 5 / NO. 2 — MARCH 2018
Bracing for the Future, p. 20
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President’s Perspective
This year the TMC will launch its bike- TMC | PULSE share program and install 14 bike stations Vol. 5 No. 2 throughout the campus, in addition to March 2018 financing three bike-share stations in the Museum District. When we shared our plans with our colleagues across the street at Rice President and Chief Executive Officer University, they doubled the number of William F. McKeon stations they planned for their campus. But what we’re most excited about is com- Vice President of Communications pletion of the initial design phase of TMC3, Christen Bagley our new city center which will be a true “live, work, and play” environment. It marks the Pulse Editor
Mark Mulligan/© Houston Chronicle. Used with permission. with Used Chronicle. Houston Mulligan/© Mark first time in our history of more than 70 years Maggie Galehouse that we’re developing one campus to support [email protected] WILLIAM F. McKEON multiple institutions. President and Chief Executive Officer, The TMC3 campus—dubbed the “double Staff Writers Texas Medical Center helix” for its design that evokes the shape of a Alexandra Becker DNA molecule—stretches nearly 30 acres and Christine Hall will serve as the nerve-center for collabora- Ryan Holeywell hen I look out my office window, I see tion and interaction. The base floor of the Shanley Pierce Wthe towering structures that make campus consists of three plazas filled with Britni N. Riley up the Texas Medical Center and take pride trees and vegetation, as well as restaurants, in the world-class research and clinical care retail, commercial and entertainment space Photojournalist that happen every day inside their walls. But to support the community throughout the Cody Duty I have to admit: I’ve been disappointed by day and evenings. what happens outside those walls. The second floor contains shared lab- Contributing Photographers Despite welcoming more than 100,000 oratories so that member institutions can Scott Dalton workers here every day, our campus is lacking work together with each other and alongside Nick de la Torre in vibrant, urban, outdoor activity. For too industry experts. Annie Mulligan long, we’ve lacked the green space, bicycling The top of the double helix will be a infrastructure, and retail and entertainment park that rises 60 feet from the ground and NEWSROOM offerings that are the hallmarks of any lively features regular programming. We’ll provide 713-791-8812 city space. That’s about to change. the community with amenities such as [email protected] But first, how’d we get here? In 1885, build- walking and running trails, bocce courts, ers constructed the world’s first skyscraper in yoga, tai chi, chef gardens, reading ham- ADVERTISING Chicago, and cities around the world followed mocks, children’s education gardens, and Felicia Zbranek-Zeitman suit, rapidly densifying major metropolitan more. The “helix” park will also bridge 713-791-8829 areas. It’s an efficient model, but it comes at a across to the bayou greenway system [email protected] cost: the concrete jungles gradually restricted which will provide access points to the light and air. Here in the medical center, entire Houston community. DISTRIBUTION we’ve become a victim of our own success. The campus and park will be beautiful, Daniel Martinez The collection of facilities we built to serve but that’s not the reason we’re building them. 713-791-6136 patients has crowded out much of our green These amenities are essential if we want to [email protected] space, an essential component of a healthy, attract and retain the millennials who will go vibrant, sustainable community. on to become the intellectual cornerstone of READ US ONLINE Today, cities across the globe have rec- our medical city. tmc.edu/news ognized this oversight and are taking bold We are just beginning our journey to steps to create accessible green spaces that transform the Texas Medical Center, and we FOLLOW US contribute to the health and well-being of will continue to work closely with our part- @TXMedCenter the public. Houston’s philanthropic commu- ners. I’m confident that before long, I’ll see @texasmedcenter nity and civic leaders are making strides to something totally different when I gaze out @thetexasmedicalcenter reclaim and energize our city with an increas- my window across our bustling medical city. ing number of parks and a connected bayou greenway system. We’re doing our part, by bringing more green space to our TMC cam- TMC Pulse is an award-winning pus and shifting our infrastructure emphasis monthly publication of the Texas from cars to people. Medical Center in Houston, Texas. Permission from the editor is required to reprint any material.
2 tmc» pulse | march 2018 Table of Contents
march 2018
10 Spotlight: Joel Cowley
13 Curated: BioRhythm
26 On the Side: Kristin “Avery” Acker
36 Solutions
38 Field Notes 4 40 Calendar
Say Hello to the SaberCats
14
#MeToo
27
Don’t Lose Sleep Over Daylight Saving Time
31
Hypnosis in the Operating Room
34
Lidia Lopez Gets a Bionic Eye
on the cover: A brace is crafted in the workshop at Shriners Hospitals for Children – Houston.
tmc» pulse | march 2018 3 oversee all aspects of player safety looked after before, during and after Say Hello to the SaberCats and health, including concussions, by our Baylor medical team.” Houston’s new rugby team is partnering with which have become a prominent In addition to concussions, concern in high-impact sports. other common rugby injuries Baylor College of Medicine “[Rugby’s] include shoulder track record is dislocations, By Shanley Pierce actually better clavicle frac- than in football tures and knee just because of the injuries. Neck way they tackle,” injuries can also ouston has long been a from the ground up, so I feel very said SaberCats occur during Hsports city, with devoted fans privileged, as we all do here at the lead team phy- the scrum, a cheering on the Astros, Texans, SaberCats, to be part of the launch- sician Jason formation used Rockets and Dynamo. This year, ing of Major League Rugby,” said Ahuero, M.D., to restart play
the city welcomes the SaberCats—a Houston SaberCats coach Justin assistant pro- Teasdale Judy Credit: in which both new rugby team—whose health will Fitzpatrick, who went from profes- fessor of ortho- SaberCats lead team physician Jason teams lock arms, be managed by a medical team at sional rugby star to coach after pedic surgery at Ahuero, M.D., assistant professor of pack tightly Baylor College of Medicine. three prolapsed discs in his neck Baylor College of orthopedic surgery at Baylor College together and of Medicine, left, with SaberCats coach One of the most popular sports ended his career in 2010. “It’s very Medicine. “They push against Justin Fitzpatrick. worldwide, rugby has gained a exciting times.” don’t hit with their each other with strong fan base in the United States. Those unfamiliar with rugby head. You can do that once and then heads down in an effort to gain Major League Rugby, a new entity, might be surprised by the high level you learn your lesson because you’ll possession of the ball. launched seven teams this year and of contact and collision involved get hurt pretty severely.” “There’s thousands of pounds will kick off its inaugural season in a sport with minimal protective According to Ahuero, who has of pressure on their necks,” Ahuero in April. gear. Rugby players do not wear worked with rugby teams for the said. “If that scrum collapses, the “In life, it’s very rare to have the pads or helmets like football players. past four years, many rugby concus- guy in the center, what they call the opportunity to formulate something Baylor College of Medicine will sions are due to accidental knee-to- ‘hooker,’ is particularly vulnerable to head or head-to-head contact. By a neck injury. That’s a unique rugby contrast, Ahuero said, football play- injury that can be catastrophic.” ers “use their helmets as a battering But Ahuero and his team ram and come in full speed will keep a watchful eye on the to hit somebody.” SaberCats players. Unlike football, Although rugby players come in which physicians and athletic into full contact with each other trainers stand along the sidelines, throughout the game, the rate of rugby physicians “stay on the ball,” concussions is generally consid- following the play up and down the ered to be lower than football due field and even running onto the field to strict reinforcement of proper to tend to an athlete while the match tackling techniques. A 2008 study is underway. published by the British Journal “It’s not like football where a of Sports Medicine found that whistle blows at the end of a play,” collegiate rugby game injury rates Ahuero said. “[Rugby] stops were lower than rates reported by occasionally if there’s a penalty, the National Collegiate Athletic but really, the play is much Association Injury Surveillance more continuous.” System for American football. The SaberCats, who play their “As with any collision sport, home games at the Sugar Land there’s an element of risk,” Skeeters’ Constellation Field, are Fitzpatrick said. “We feel that with currently playing pre-season our partners at Baylor, the screening exhibition games. work and the medical expertise that Fitzpatrick said the team is we’ve got, we limit as much of that determined to make Houston fall as possible. You can never protect in love with rugby. a player on the pitch completely “I think it’s going to be a really any more than you can anybody in exciting day out,” Fitzpatrick said. life. With a collision sport, pretty “Whether people are familiar with much any sort of injury can happen. rugby or not, once they’ve seen it up However, we pride ourselves on the close and seen some of the athletes way that we prepare our athletes, we’ve got, they’re going to have a
Credit: Photo by Leslie Plaza Johnson/Icon Sportswire; Icon Sportswire via AP Images AP via Sportswire Icon Sportswire; Johnson/Icon Plaza Leslie by Photo Credit: the way that they’re conditioned for good time.” Houston SaberCats lock Justin Allen wins the ball during a match against the Capital the game and the way that they’re Selects in February at Constellation Field in Sugar Land, Texas.
4 tmc» pulse | march 2018 You enjoyed a colorful 40-year career. Now you are working on your frst greatest hit. You never imagined moving to a community would be so inspiring, and now you couldn’t imagine living anywhere else. Be Inspired.
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tmc» pulse | march 2018 5 Correcting a Gene that Causes Blindness The FDA approves gene therapy to treat patients with inherited vision loss
By Alexandra Becker
ixteen-year-old Amanda Martin lay on the could finally treat disorders that we once thought Soperating table under full anesthesia, her body were untreatable.” covered in sterile cloths one shade shy of peacock The mechanics of vision are multifaceted. blue. Only her right eye was exposed, the word Light meets the cornea, travels through the pupil, “yes” scribbled in marker above it—visual verifica- the lens, and finally penetrates the gelatinous tion that it was, indeed, the correct eye. Numbing material in the center of the eye, called the vitre- drops pooled over her cornea and spider-like ous, to reach the retina—a membrane lining the surgical equipment held her lid wide open in back of the eye that converts light information preparation for surgery. into electrical signals for the brain to understand. Within minutes, Christina Y. Weng, M.D., “There is a lot of complexity in how the retina assistant professor of ophthalmology- does that—there are lots of moving pieces,” said vitreoretinal diseases and surgery at Baylor Christina Y. Weng, M.D., assistant professor of Timothy Stout, M.D., Ph.D., director of the Cullen College of Medicine’s Cullen Eye Institute, ophthalmology-vitreoretinal diseases and surgery Eye Institute. “Typically, these are proteins would begin a pars plana vitrectomy (PPV) to at Baylor College of Medicine’s Cullen Eye Institute, that are expressed in the retina that allow this scrubs in for Amanda Martin’s surgery. remove the vitreous gel from Martin’s eye. For conversion from light information to electrical Martin, the procedure would create space for an drug injected directly under the retina to correct a information to take place. There are hundreds artificial lens, but a PPV is also part of the ground- mutation on a gene called RPE65. One of the of thousands of moving parts that do that. It’s a breaking genetic therapy recently approved by most common conditions associated with the remarkably beautiful ballet.” the U.S. Food and Drug Administration to treat a mutation is Leber congenital amaurosis, or LCA, But as with everything in the human body, one rare form of blindness—the country’s first directly which is characterized by severe visual impair- small mutation in the genes that code these pro- administered gene therapy approved to target a ment at birth. Until now, no treatment options tein parts can wreak havoc on the whole system. disease caused by mutations in a specific gene. were available. How that translates to vision impairment depends “It’s a very exciting time for the retina world on the gene affected. ‘A remarkably beautiful ballet’ right now,” Weng said. “It’s taken giants in the “You can have some mutations that are in Pharmaceutical company Spark Therapeutics got research and clinical worlds to really consolidate certain moving parts that are so absolutely delete- the green light in December to market Luxturna, a their efforts toward developing something that rious that you can’t see light from day one of life,” Stout said. “Then, on the other end of the spec- trum, there are problems with proteins in your retina that may be so mild that maybe when you’re 70 or 80 you may have some issues, but other than that, you’re good.” What typically happens in Stout’s clinic is that parents notice a problem—their child fails a school screening or can’t see well when the lights go out or has trouble distinguishing colors. That information, he said, helps guide him toward which moving parts might be problematic, though some form of gene sequencing is required to make a conclusive diagnosis. “I might find out that the reason Johnny can’t see well is because he’s got a mutation in both copies of gene ‘X,’” Stout said. “So what we’ve started to say is, ‘If Johnny’s not seeing because he doesn’t have a normal copy of the gene ‘X’ and can’t make protein ‘X,’ what if we put a normal copy of that gene into a virus and then put the virus near the cells that are affected, infect those cells with the virus, and then have that normal protein be expressed?” And that’s exactly what they did for RPE65. Amanda Martin waits in pre-op with her mother, Patricia Martin. Facing page: Weng performs a pars plana vitrectomy on (continued) Amanda Martin’s eye to make room for an artificial lens.
6 tmc» pulse | march 2018 Pull Quote Here
tmc» pulse | march 2018 7 Fourth-grade graduation therapy can only be administered at eight U.S. Still, many of his patients were able to see for Leber congenital amaurosis is so rare it is thought sites; Baylor College of Medicine is one of those the first time in their lives, and the trial’s success to affect only a few thousand individuals in the sites and four surgeons there are trained to per- has paved the way for the development of genetic U.S. But it presented a perfect opportunity for form the surgery. therapy treatments for other inherited diseases. gene therapy trials because it is caused by a The first step is the pars plana vitrectomy. “One of the young girls I treated in Oregon relatively straightforward mutation. The disease Surgeons make micro-incisions through the wall did so well that she invited me to her fourth- typically manifests when both parents carry and of the eye and use a special hollow needle housing grade graduation,” Stout said. “She was in the pass on a copy of the mutation, an inheritance a blade whirring 2,500 times a minute to remove Washington State School for the Blind and she pattern known as autosomal recessive. the jelly-like vitreous, which is too viscous to invited me to graduation because they were kick- “What we’ve done is we’ve put a normal copy simply suction. Once the PPV has cleared a path ing her out. The school threw a big party—they’d of the human RPE65 gene into an adeno- to the retina, an even smaller needle—about the never been able to kick anybody out before.” associated virus, which infects the right cells circumference of four strands of brunette hair—is Baylor is currently working on additional trials inside the eye but doesn’t cause disease,” used to inject a small blister of Luxturna just involving other genetic mutations that cause explained Stout, who worked on the research underneath the retina. That injection is loaded ocular disease, but will continue the research and trials that led to the development of Luxturna. with the adeno-associated virus carrying the surgeries that are literally shedding new light on “Viruses have evolved over millions of years to corrected RPE65 gene. their patients’ lives. be gene delivery systems. They’re really, really Clinical trials showed extremely promising For Martin, who had the lenses in both eyes good at doing that. Adeno-associated viruses are results, although Stout and his fellow research- removed at age two due to complications from expressed for a long time—we believe that they ers did observe that the treatment worked best congenital cataracts, that means not wearing express forever—which is something we want for in younger patients, perhaps because their cells glasses for the first time ever. To celebrate, her an inherited disease. The virus goes into the cell, carrying the RPE65 gene had not yet reached a aunt took her to buy a pair of Ray-Ban aviators, infects the cell, then it’s over.” point of no return. but she’s most excited about going back to Disney That, in a nutshell, is gene therapy. Once the “You probably can’t treat dead cells, right? World. A roller coaster junkie, Martin can now corrective copy of the defective gene infects the Once you’re dead, it’s kind of game over,” Stout ditch the special goggles with lenses as thick as abnormal cells, genetic information should start said. “But what we don’t know is where in the magnifying glasses. processing correctly. In the case of RPE65, that disease process those cells become fated to never “I’m excited, because I’ll actually be able to see means making a once-missing protein. be repaired. So we’re expecting that there’s going the rides this time,” she said. The surgical procedure to inject the drug to be a spectrum of susceptibility for gene therapy requires special technical skill. Currently, the for different diseases and different genes.”
8 tmc» pulse | march 2018 Poison Control Local experts tout the importance of poison centers
By Britni N. Riley
ny chemical can be poisonous, emergency room—we can answer A depending upon how much is callers’ questions immediately, eaten, inhaled, injected or absorbed. give general first aid,” Cleary said. That means many items in our own “About 90 percent of cases just homes—including cleaning prod- require drinking fluid and monitor- ucts, pesticides and cosmetics— ing for symptoms.” have the potential to harm us. Greene helps the center with Poisoning is the leading particularly difficult cases, includ- cause of death by injury in the ing snake bites. United States, killing more than “You learn by doing this how 52,000 people per year—surpass- to ask the right questions so you ing motor vehicle-related deaths, can get an idea of what is going on according to the National Center without actually seeing the patient— for Health Statistics. Since 1962, the what they smell, feel and hear,” third week of March has been recog- Greene said. nized as National Poison Prevention The Southeast Texas Poison Center receives between 120 and 140 calls per day. The For patients who need to be seen Week to raise awareness of the dan- majority of calls are related to children consuming household cleaning products, in person, a variety of treatment gers of unintentional poisoning. according to Jean Cleary, PharmD, director of the center. options are available depending “It’s an opportunity to teach the on the toxin to which they have public what they really need to know Southeast Texas Poison Center from mislabeled or unlabeled been exposed. about keeping themselves and keep- (SETPC), housed at The University containers. “We generally do blood tests on ing their kids safe,” said Spencer of Texas Medical Branch at “Always, always, always keep patients unless we know what they Greene, M.D., director of medical Galveston, was the first poison things in the original packaging,” took and we know that it is not toxic. toxicology and assistant professor center in the state. Today, there Greene said. “About once a week I On rare occasions, we give patients of emergency medicine and pediat- are six poison centers across get a call about someone drinking charcoal,” Greene said. rics at Baylor College of Medicine. Texas, but calls from Houston a cleaning agent out of a Gatorade Activated charcoal, an emer- “We are in a time where there is a lot are directed to SETPC. bottle to make it more portable. Do gency decontaminant, helps absorb of misinformation out there.” “We get calls for overdoses, you know what happens when you toxins in the gastrointestinal tract. Greene is the only board- suicides, doubling-up on medi- put cleaning products in a Gatorade “We do not pump stomachs certified medical toxicologist in cations, drinking or ingesting an bottle? Someone will think it is okay anymore,” Greene added. “We have the city of Houston. He regularly unknown substance,” said Jean to drink.” known since the late ’80s that it serves Ben Taub Hospital and Texas Cleary, PharmD, director of the Cleary said that active listen- doesn’t work and that it is harmful.” Children’s Hospital, and responds center. “Most of the cases we see ing is key when taking a call at the Greene and Cleary urge to calls from many other hospitals in are accidental poisonings with kids. center. people who believe they have been the area. In addition, he is a consult- Our best customers are under the “I’ve been here for 30 years and exposed to toxins to call the poison ing toxicologist for the Southeast age of two. … The majority of our you never really get used to it,” she center. Texas Poison Center. calls are for kids eating household said. “You need to know what kind “People need to know to call “Poison centers exist to save cleaning products.” of questions to ask and how to ask the poison center when there is an lives and to save money,” Greene To avoid exposing children those questions and you need to be exposure that is not an immediate said. “God forbid, there is an expo- to dangerous substances, an extremely good listener. What life threat,” Greene said. “A lot of sure—if there are any life-threaten- Greene recommends thinking they are telling you and what they times the patient will be able to stay ing emergencies, call 911, but if it like a kid. are really saying may not be the home—the call center can do things is not, you should call the poison “Get on the floor,” Greene said. same thing.” to help the patient and we can center. The phones are answered by “What is accessible and attractive Once Cleary and her team of prevent them from doing things specialists in poison information— to a kid? If you open up the lower 12 at the call center have accurately that are more harmful.” typically nurses and pharmacists. cabinets … are there cleaning agents identified what a caller has ingested, They can field these phone calls to or pesticides that may be enticing they can offer help. Southeast Texas Poison Center tell you what is dangerous and what to a child?” “With the exception of severe The toll-free number for the call center, which is open 24 hours a day, seven is not.” Other common accidents overdoses and highly toxic days a week, is 800-222-1222. Established in 1959, the involve ingesting mystery fluids exposures—those are sent to the
tmc» pulse | march 2018 9 Spotlight
JOEL COWLEY is slightly allergic to livestock. Nonetheless, since he first showed two lambs at a Wyoming fair as a young boy, Cowley has built a professional life around livestock and rodeo. Since 2013, he has served as president and CEO of the Houston Livestock Show and Rodeo, a nonprofit with an annual commitment of more than $26 million to scholarships, research and other educational programs.
Q | You first visited the Houston they both qualified for the auction. undergraduate education was paid Livestock Show and Rodeo in 1985. I cried when I sold them, but when for through scholarship. What was it like back then and that check arrived a few months how has it changed? later, I thought, ‘I might want to Q | How did you make your way A | When you grow up showing do this again.’ Unfortunately, that back to Houston? livestock, you know about the December my mother passed away A | I graduated from Colorado Houston Livestock Show and Rodeo. of breast cancer. At that point, my State University with a bachelor’s In 1985, I was a junior college stu- paternal grandparents brought my in Animal Science, was on the dent and I came here as a member of two brothers and me to Fort Collins, collegiate livestock judging team the junior college livestock judging Colorado. My grandfather knew how there and then came to Texas A&M team. At that time, the contest was valuable and how powerful these 4H University to work on a master’s in still held in the Astrodome—which I programs were. He knew how much Animal Science. When I came to had only seen on TV and in The Bad I loved showing those first two Texas A&M and coached the live- News Bears. I can remember pulling lambs while I was still in Wyoming, stock judging team, I would bring up on the grounds that morning— so he leased property just outside of the judging team to the Houston it was me and my teammates and town in Fort Collins so that my two Livestock Show and Rodeo—starting coach in a station wagon. It was a brothers and I could raise sheep and in 1988 through 1995. When my old- really, really foggy morning and we show market lambs. est daughter was born and I thought drove up and, all of a sudden, the Believe it or not, I am slightly maybe I should get a job, Michigan Astrodome just appeared. It was allergic to livestock. I’m allergic to State University was hiring. I went to retired from the Houston rodeo huge. I went down on the floor and the dander of the animals. When I work full-time as an extension beef after 41 years, gave me a call. judged the contest, but I had never was in high school, I would shear cattle specialist, helping producers I flew down the day after Christmas seen a building like that. sheep and I would definitely notice evaluate their herds from a produc- in 2004 and agreed to come to work Since then, the Houston my allergies when I was doing that. tion and a financial standpoint. I as the executive director of agricul- Livestock Show and Rodeo has But through showing lambs, I got started working on a Ph.D., but I tural exhibits and competitions. grown and moved into the NRG enough courage to go out for wool completed an MBA at Michigan Center. This building is incredible. judging, which is where you actually State University. From there, I went Q | What’s it like to watch a It is 1.4 million square feet; the main evaluate which fleece is the best. to Certified Angus Beef in Ohio— younger generation compete at exhibit hall is 700,000 square feet. After that, I finally went out for the largest branded beef program in the rodeo, and what do you hope livestock judging—sheep, swine and the world. these young people will gain from Q | How did you get into livestock cattle. You apply logic and critical I still came back to every the experience? judging? thinking to rank the animals and Houston Livestock Show and Rodeo A | I feel a very close connec- A | I have agriculture on both then you have to stand in front of an when I was at Michigan State and tion with the show because of my sides of my family and rodeo on my expert and explain why you ranked Certified Angus Beef to help out background and seeing all of these father’s side. The summer after my the four steers or four pigs the way judging contests or judge junior young people who come here to father died, I was 8 years old. My you did, which for me was absolutely commercial steers. I have been to compete—and knowing that was me. grandfather bought me two market terrifying. But I actually ended up every Houston Livestock Show and I am a product of the very programs lambs to show—Fred and Barney, being pretty good at it, and eventu- Rodeo since 1988, either as a judg- and support that are offered by named after characters from The ally became a member of a national ing team coach, a judge, to help out the Houston Livestock Show and Flintstones. My mother helped me champion 4H livestock judging with the judging team contests, or as Rodeo. This year, we have over raise and show them at the fair. They team and then that led to a schol- an employee. In December of 2004, 19,000 4H and FFA [Future Farmers placed about fourth and fifth and arship to junior college. Half of my Mr. Leroy Shafer, who just recently of America] entries in a number
10 tmc» pulse | march 2018 of contests and competitions. I But we just take for granted that know the value that provided to food is going to be there and I think me growing up, by building confi- I am a product of the very programs the reason we take it for granted is dence, speaking skills and critical and support that are offered by the Houston that Americans spend less than
thinking skills. Livestock Show and Rodeo. 10 percent of their disposable income on food—that’s the low- Q | The rodeo is known for its est percentage of any nation in devoted volunteers. How did the world. And that’s because our that tradition start and how do 16,000 volunteers. Now we have over Q | Many people come to the agriculture production system is so volunteers support the mission 33,000. Those volunteers serve dif- Houston Livestock Show and efficient. But when you take a look at of the rodeo? ferent purposes. Each committee has Rodeo for fun and entertainment, the 7.6 billion people on the planet A | In 1936, the Houston Fat Stock its own mission that relates to the but the rodeo also educates today and projections having that at Show added the downtown parade, overall success of the show. Some visitors about agriculture. 9.8 billion by the year 2050, and you the souvenir program, the rodeo, the are working committees that assist Why is that so important? factor in that we are going to have horse show and formal volunteer the general public—directing traffic, A | We are passionate about that to produce food with the same committees. There were certainly scanning tickets, driving trams and because we cannot take agriculture amount of land, that’s going to volunteers before that, but they golf carts. We have outreach com- for granted. Unfortunately, we kind take technology. I know that scares were now formally added to sell mittees that make individuals aware of do. Hurricane Harvey was a great some people, but there is a way to tickets and exhibitor space and of all the great things the show does, example of that. When you went in sustainably and wholesomely feed that’s really where it took off. The but they also raise money for schol- a store two days before the storm or the planet using technology. volunteer base grew as additional arships. You have these committees four days after and you couldn’t find (continued) elements were added to the show. pulling together that support every a loaf of bread or a gallon of milk— When I came here in 2005, we had single area of the show. what if it were like that all the time?
tmc» pulse | march 2018 11 Spotlight
lives and go out and enjoy inter- Last fall, we acting within our communities. It purchased the is really a balance, I think. When it remainder of the gets right down to it, we are in the experience business. If we provide AstroWorld property, everyone who comes to our grounds so now we own 102 acres with a great experience, we will
across 610. be successful—whether they are a livestock exhibitor, a rodeo contes- tant, a star entertainer or the general Q | Has the Houston Livestock public. But you can’t have a great Show and Rodeo always been such experience unless you feel safe and a star-studded event? secure in the environment, so that is A | The first show that was held an absolute priority for us. in 1932, according to most records, sounded like it was a cattle show. Q | What will the Houston And there were impromptu rodeos. Livestock Show and Rodeo look I came across a newspaper clipping rodeo. That year we had Gene Autry, which was really struggling finan- like 20 or 30 years from now? for an ad featuring a vaudeville ‘The Singing Cowboy.’ He was the cially at that time, a really good deal A | Because of the tremendous performer—singing and dancing very first star entertainer to perform on the rodeo stock—the bulls and support both from the volunteer and what not. The organizers knew here. That was significant for two the horses that are used in the rodeo. standpoint and the community at early on what value entertainment reasons. One, he was an incredible I pulled the financials, and the gross large, the show just has tremendous had. It wasn’t until 1942 that we star at that time ... so he sold out his revenue between 1941 and 1942 grew potential. We tend to outgrow facil- really hit upon our current format of shows. But he was also a rodeo stock 40 percent because of Gene Autry. ities as soon as they are completed combining a star entertainer with a contractor, so he gave the show, From that point on, we have paired because of the demand for the rodeo with star entertainers to draw product and for the experience. people in and sell tickets. That’s our biggest challenge. We are constantly looking at ways to Q | In light of mass shootings add space and program space more around the world, how is the effectively for those who come to the rodeo preparing for a mass grounds. Last fall, we purchased the CHANGE trauma event and what would remainder of the AstroWorld prop- you say to those who may be erty, so now we own 102 acres across anxious to attend? 610. We did that because, looking YOUR A | We work very closely with the forward, we want to grow our impact police department and the Harris for those who come to our grounds County Sheriff’s Office and the to be entertained and to be exposed LIFE Houston FBI, as well. They are to agriculture. But we also want to constantly monitoring any threat grow our educational impact. There hccs.edu/coleman assessments for any direct threats, is additional need out there for edu- and then we consult with them on cational support. If we are able to our grounds security. We have made grow our event while still providing some enhancements this year com- a great experience, we will be able pared to last year, primarily in the to grow our support of education area of fencing around our carnival and agriculture. to make sure that it is more secure. We have added personnel, we have Joel Cowley was interviewed by Pulse added lighting. The sheriff’s office writer Britni N. Riley. This interview was edited for clarity and length. provides “eye in the sky,” where offi- cers are elevated to do surveillance. In the world that we live in today, The Houston Livestock Show and we all have to think about safety Rodeo runs through March 18 at before we attend. But on the other NRG Center, 2 NRG Park. Information: 832-667-1000 or rodeohouston.com. side of that, we still need to live our
12 tmc» pulse | march 2018
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worked with the museum on the circulation rates increase, and BioRhythm exhibit. when we are quiet or sleeping, “The primary rhythm in the they slow down,” Townsend said. The Intersection of ARTS and MEDICINE human body is that constant “This is an automatic response lub-dub of our hearts,” Townsend of our bodies.” By Britni N. Riley said. “The heartbeat is a sign of From the “Optofonica our circulatory system working. Capsule,” which converts The blood pumps through the sound into vibrations that pulse lungs where it is oxygenated and throughout the body, to a sonic usic has the power to Throughout the interactive the oxygenated blood travels to bed that wraps users in an Msoothe, invigorate and exhibit, BioRhythm encourages the brain, which controls the cen- intimate soundscape, the exhibit inspire us, no matter where we viewers to experience sound on tral nervous system and tells the allows visitors to see and feel come from or how we interpret many different levels. body how and when to move.” their emotional response the world. “We are trying to get people “Chains of Love,” one of the to music. Making and listening to to pause for a second and take a exhibit’s attractions, explores “We are basically jelly. We are music may seem second nature step back and think about why the relationship between sound full of liquid, so our bodies are to us, but is there something in they like the music they like and touch. When visitors grasp sensitive to vibration—you can our DNA that compels us to tap, or how music has happened,” two or more of the large chains feel it,” Courtney said. “We often hum and sing, or did this urge Courtney said. “Why does a suspended from the ceiling, the get preoccupied with our ears blossom over time as part of our minor chord sound sad? Why are chains release different sounds. being the most sensitive appa- cultural evolution? BioRhythm: major chords celebratory? Is that “The galvanic skin response ratus, whereas this is exploring Music and the Body, a traveling just cultural? Is there an objec- is associated with our emotional the idea that our bodies are also exhibit now on display at The tive physiological or biological state, and fluctuations in that sensitive in different ways.” Health Museum, explores reason for that?” response are associated with these questions. Just down the street from being stressed or having an emo- BioRhythm: Music and the Body, “I think music is something The Health Museum, Jennifer tional response to something,” a compilation of works by several that everybody plugs into, yet it Townsend, program manager Courtney said. artists, started in Dublin and has is kind of an abstraction,” said of music therapy at the Center Visitors of all ages are chal- traveled around the world. The Conor Courtney, project lead for for Performing Arts Medicine lenged to think about how they exhibit will be on display at The BioRhythm at Science Gallery at Houston Methodist Hospital, send and receive sounds—even Health Museum, 1515 Hermann Drive, through July 31. Dublin, where the exhibit was works on harnessing the body’s personal sounds that are subtle Information: 713-521-1515 or curated. “It’s a weird habit and natural inclination toward and involuntary. thehealthmuseum.org it’s kind of unique among ani- music to help heal her patients. “When we are excited or mals to have that appreciation.” Townsend and her team also nervous, our respiration and
Conor Courtney, project lead for BioRhythm at Science Gallery Dublin, uses listening devices that put the wearer into an altered sonic reality.
tmc» pulse | march 2018 13 #MeToo How Texas Medical Center institutions are responding to a cultural revolution
By Alexandra Becker
ince the rise of the #MeToo movement, Mikiba W. Morehead has conversations about it, that it’s not a one-time snippet that’s at our student Sseen an increase in the number of Baylor College of Medicine students orientation, but that it’s constant in our culture and our landscape from and employees sharing survivor stories about sexual abuse your first day as a new student or a new employee, all the way to the time and harassment. that you leave our community or retire.” “We have seen a small uptick in individuals who want to Similarly, Rice University has spent the past few share their stories and their experiences from multiple years years bulking up programs for survivors of sexual abuse ago, and they are attributing it directly to the #MeToo move- and harassment. ment,” said Morehead, the Title IX and student disability coor- “While we always are alert to ways to improve our dinator at Baylor’s Office of Institutional Diversity, Inclusion & programs on preventing sexual misconduct, we have Equity. “We know from research and as practitioners that the not made any policy changes in reaction more you talk about a topic, then the more it’s demystified, to the #MeToo movement,” B.J. Almond, the less taboo it seems, the more people become comfortable senior director of news and media rela- with speaking up.” tions at Rice, said in a statement. “Over Last October, when major figures in entertainment, news the past five years or so, Rice has imple- and politics started to be exposed as sexual predators who mented and enhanced programs intended used their positions of power to prevent sexual misconduct and provide to victimize women and men, support and services to survivors. We do plan #MeToo became a rallying cry to review our policy and procedures on sexual on social media—with survivors harassment this semester as part of our updates of posting personal and intimate university policies.” anecdotes alongside the hashtag. The Memorial Hermann offers a 24/7 hotline and a movement gave voice to topics usually centralized employee relations department that gives consigned to whispers. employees a way to anonymously and confidentially In the Texas Medical Center, many institu- report any concerns or policy violations. tions recognize the importance of this movement “We recognize that it takes constant vigilance and pro- for empowering employees, students and patients. active measures to prevent harassment, discrimination and Catherine Horn, Ph.D., executive director of the misconduct, which is why we consistently review our exist- Institute for Educational Policy Research and Evaluation ing policies and procedures while proactively discussing new at the University of Houston, said the #MeToo movement ideas for safeguards that allow us to continue fulfilling our is rekindling important conversations on campuses and promise to protect patients, employees and physicians,” Lori in workplaces. Knowles, senior vice president and chief human resources “It’s giving us permission to speak up and speak out and officer at Memorial Hermann, said in a statement. really engage in thoughtful dialogue and conversation,” said Horn, a Rola El-Serag, M.D., medical director of the Women professor and chair of the Educational Leadership and Policy Studies Veterans Health Program at the Michael E. DeBakey department. “One of the things that we’ve been talking a lot about Veterans Affairs Medical Center Houston, has been at the University of Houston is ... how a culture of diverse dialogue is working for years to cultivate a culture at the VA that incredibly important to us and to our mission, and this is a moment provides privacy, dignity and security to women vet- that both reminds us of that and essentially emboldens us to continue erans. The #MeToo movement is timely, she said. down that path.” “We have a very unique, very sensitive pop- It’s an important distinction—that this dialogue is not a result of ulation of women veterans here, so we have to the movement but rather fortified by it. Baylor and the University of ensure that they come and receive health care in Houston already have robust policies in place regarding sexual harass- a place that they feel secure and safe,” El-Serag ment and discrimination—be it sex-based, gender-based, identity-based said. “Our female veterans already have a high or orientation-based. rate of sexual trauma—23 percent is what’s “Are we making any changes in response to the #MeToo movement? reported, which is probably a gross under- The answer is ‘No,’” Morehead said. “We’ve got solid things in place estimate—and so it’s challenging because that we’ve been building and framing our conversation around for the we’re talking about a culture change. past three years … We are making sure that we continue to have open And culture change is extremely hard
14 tmc» pulse | march 2018 anywhere, especially in the military.” “You’ve got a social responsibility when it comes to speaking up or providing El-Serag stressed the importance of a safe environment, citing studies that resources, much like if someone had a heart attack on the sidewalk and you’re suggest harassment is associated with an increase in the number of no-shows CPR certified. We’d want you to act,” Morehead said. to medical appointments. Special training around sexual harassment helps propel an organization’s “One event—it could be the smallest of things that could happen to them— ethos forward, El-Serag said. could keep a woman veteran away from the VA for another year or two for critical “It’s not intuitive how to deal with these situations,” she said. “A lot of people care they really need,” she said. “We know will stay out of these situations just because that the implications of this harassment they really simply don’t know what to do.” are very significant in terms of their overall You’ve got a social responsibility El-Serag hopes her “End Harassment” wellness and their health care.” when it comes to speaking up or providing campaign will help female veterans feel The VA built a Women’s Health Center resources, much like if someone had a more comfortable reporting instances of on its Houston campus and El-Serag is also sexual harassment and abuse. heading up an “End Harassment” cam- heart attack on the sidewalk and you’re “What we hope is that as a result of
paign, which focuses on accountability and CPR certified. We’d want you to act. this campaign, we actually see an increase training for all individuals associated with in the number of complaints at first, not a the VA—veterans, law enforcement, employ- — MIKIBA W. MOREHEAD decrease. It may seem like, ‘Wow, why is this ees and staff. Title IX and student disability coordinator at happening more and more?’ But the truth “In the past, some of our complaints have Baylor’s Office of Institutional Diversity, Inclusion & Equity is that it’s always been happening, we just come from frustration from patients that need to create an atmosphere where women staff hasn’t acted on their behalf,” El-Serag said. “I think, ultimately, the most feel safe to come forward about it.” effective technique is accountability. If we follow through when that type of In the Texas Medical Center and beyond, giving survivors a voice and a safe behavior is witnessed, then we stand up and let our veterans or whoever is doing space to use it helps ensure lasting change. the harassing know that this is not going to be tolerated. I think that is going “Even as we’re reminded that the kinds of issues that underlie the #MeToo to be the best way to spread the word and make people aware that this is not movement are unfortunately ever-present, and are in many ways challenges acceptable. Women veterans need to feel like we understand that this is a threat of multiple generations,” Horn said, “we also understand that we have these to them and that we are doing something about it.” opportunities to change the narrative and change the direction.” Baylor’s training curriculum also addresses what to do as a bystander who witnesses harassment.
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tmc» pulse | march 2018 15 Fighting Epilepsy with Fat Today’s popular ketogenic diet is actually a century-old treatment plan for epileptic children
By Alexandra Becker
of carbohydrates—including all processed foods—and it’s no wonder the diet has recently been touted by celebrities and social media influ- encers as a tool for dramatic weight loss. But using it to trim down is not without controversy, and Schultz emphasized the importance of med- ical supervision due to potentially harmful side effects. “So many people come to me because they want off ‘those poisonous medicines,’ and to be on something they perceive as natural,” Schultz said, referring to patients who want to replace their epilepsy medication with the diet exclusively. “One of my responses to them is, ‘Wait a minute, think about this. What is natural about a high-fat diet? It can be harmful. You can die from this diet if it’s not properly administered, or if you happen to have some underlying metabolic Sarah Ybarra sits with her daughter, Kristin, during an appointment at Texas Children’s Hospital. problem. When I talk about being high in fat for the strict ketogenic diet, we’re talking 90 percent of the he plastic container held preferred form of energy, but in their Texas Children’s Hospital Epilepsy calories are coming from fat. Tcooked carrots and un-melted absence, ketone bodies will do. This Center. “In some way, we know It’s a huge change in the way butter chopped into pieces. The produces a state known as ketosis, that since it does have an effect on you’re eating.’” ratio of fat and carbohydrates had and for reasons not completely seizures, it alters the excitability of to be perfect. For more than seven understood, it leads to a reduction the nerve cells.” Pressing the reset button years, everything Kristin Ybarra in seizures. Some research suggests the According to the Centers for has put into her mouth has been “Although the diet has been ketogenic diet impacts potas- Disease Control and Prevention, measured and monitored to ensure around for at least nine decades, sium ion channels, which are cell nearly 470,000 children in the U.S. her body burned fat instead of and there has been a lot of research membrane pathways that generate have epilepsy. Approximately glucose for energy. Since starting done, we still don’t really know the electrical signals in cells. Ketosis 70 percent of those patients can the diet, her hours-long, noncon- exact mechanism for why the diet has also been shown to lower insulin be managed with medication, said vulsive seizures, which rendered works for treating epilepsy,” said levels and help train the body to Dave Clarke, M.D., who recently her blank and unresponsive, had Rebecca J. Schultz, Ph.D., RN, become exceedingly efficient at joined Texas Children’s Hospital completely disappeared. pediatric nurse practitioner at burning fat. Add to that the absence as director of clinical epilepsy and Originally developed in the early pediatric neurology and devel- 1900s as a treatment for epilepsy, The portions are smaller because this diet opmental neuroscience. But the the ketogenic diet is high in fat is high in fat, so it’s calorically dense. Fat has remaining 30 percent? and low in carbohydrates, which “We need everything in our forces the liver to convert fat into more calories per gram than carbohydrates, arsenal,” Clarke said. fatty acids and ketone bodies as so although the meal looks small, it’s the same One approach is the ketogenic
a replacement for glucose as its number of calories and you get full. diet. primary energy source. Typically, “It has multiple benefits, inde- carbohydrates are converted — REBECCA J. SCHULTZ, PH.D., RN pendent of just treating seizures,” into glucose, which is the body’s Pediatric nurse practitioner at Texas Children’s Hospital Epilepsy Center Clarke said. “It sometimes helps
16 tmc» pulse | march 2018 to improve mood, maybe because is a safe period of time to be it decreases seizures. It may help on it, but beyond that we can’t sleep, and in some people, it may answer some of the long-term risks. even help cognition a bit.” Having said that, I have patients For some types of epilepsy, the who have been on the diet for far ketogenic diet is so effective that more than two years because it’s it becomes the primary treatment. the most effective treatment for Disorders of brain metabolism, their seizures.” including a genetic abnormality Interestingly, for many patients, called GLUT1 deficiency syndrome just two years on the diet can have and a neurodegenerative disorder lasting effects. Clarke described it as called pyruvate dehydrogenase a “reset button” and explained that complex deficiency, respond the diet sometimes helps stabilize especially well to the diet, Schultz the brain in a way that persists long explained. after the reintroduction of glucose. “For those children, particularly Rebecca J. Schultz, Ph.D., RN, pediatric nurse practitioner at Texas Children’s Hospital But patients like Kristin are the children with GLUT1 disorder, Epilepsy Center, left, with the Ybarra family during a routine appointment. the exception. they can become seizure-free almost immediately once they’re placed on engage with parents or the outside necessarily the case for children No falling, no thrashing a ketogenic diet,” said Schultz, who world. But with that change in diet, with epilepsy caused by other bio- Kristin was just 4 years old the first recalled that one patient who was many of these kids can interact logical errors, in which the standard time her mother, Sarah Ybarra, suffering from hundreds of seizures appropriately and significantly of care is to follow the ketogenic diet noticed she was having a seizure. a day no longer experienced them alter their lives.” for just two years. More than likely, Sarah said, it after fewer than three days of the Individuals with these types of “One reason we say that is, even wasn’t the first, but Kristin’s seizures high-fat, low-carb regimen. epilepsies are encouraged to adhere though the diet has been around for were not apparent. There was no “The dramatic changes that you to the restrictive diet throughout 90 years or more, we still don’t have falling to the floor, no thrashing— can see in those patients are quite their lifetime; after all, they suf- any longitudinal data to tell us what nothing like you see in the movies. remarkable,” Clarke added. “They fer from a genetic disorder that the cardiovascular risks are,” Schultz (continued) may be severely impaired, unable to you can’t outgrow. But that’s not said. “The thought is that two years
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tmc» pulse | march 2018 17 characterized by confusion or lack come out of ketosis, and her phy- of responsiveness—as opposed to sicians agree that, in her case, the convulsions. According to the test, benefits outweigh the risks. Kristin was having episodes 10 to “I had a mom friend who had a 12 times a minute. Over time, the little boy who was on the ketogenic episodes grew longer, sometimes diet, and when he was in first grade, extending from six to eight hours. there was a party,” Sarah recalled. “We didn’t know what to do,” “He had a cookie and ended up in Sarah said. “We tried different med- the ICU.” ications and nothing was making them stop.” Peanut Butter Fat Bombs Kristin’s care was ultimately Foods allowed on a ketogenic diet transferred to Texas Children’s vary depending on the child and the Hospital in Houston, where doctors ratio of fat and carbohydrates that suggested she try a strict ketogenic works best for their condition, but diet. Sarah agreed, and Kristin some staples could include meat, hasn’t had a single nonconvulsive eggs, butter, cheese, heavy whipping episode since. cream, oils, nuts, avocados, low-carb Because of her congenital vegetables and small portions of condition, though, Kristin still some fruits. Kristin, who had to stop Dietitian Jillian Davis, left, with Schultz at Texas Children’s Hospital. experiences other types of seizures, eating meat because it was grow- and Schultz and Clarke utilize all ing increasingly difficult for her to Kristin was born with a congen- “She would just check out. Her the tools in their arsenal, including chew, gets a large percentage of her ital brain defect, so her mother was eyes would blink and blink, and then medications and surgeries, to try calories and nutrients from a special not unduly alarmed by her behavior. she’d come back,” Sarah recalled. to keep them at bay. Kristin is way formula through a feeding tube. But one day, Kristin’s occupational She took Kristin to get an EEG at past the two-year mark on the diet— She also eats two snacks a day that therapist suggested she might be their local hospital in Dallas, where come June, it will be eight—but include a form of fat, such as butter, experiencing something called she was diagnosed with nonconvul- her mother does not want to find mayonnaise or heavy cream, and a “absence seizures.” sive status epilepticus, a condition out what might happen should she small amount of carbohydrates like
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18 tmc» pulse | march 2018 peas, carrots or green beans. Her that’s keto-approved. You take that favorite snack is strawberries with extra step to make sure she doesn’t cream cheese. feel left out.” 12 ACADEMIC MEDICAL CENTERS “The portions are smaller Schultz and Clarke work with because this diet is high in fat, so it’s nutritionists to tailor each patient’s RECEIVED THIS PRESTIGIOUS QUALITY calorically dense,” Schultz said. “Fat diet as much as possible to mini- OF CARE AWARD. has more calories per gram than mize disruption to their lifestyles. carbohydrates, so although the meal “It’s important for kids to feel looks small, it’s the same number of like part of the group and to be able ONLY ONE IS IN TEXAS. calories and you get full.” to participate with their peers,” Maintaining ketosis is labor- Schultz said. “We tell parents, ‘If you intensive, and to be successful, know that the classroom is having everything consumed must be a party and they’re going to have 1. Mayo Clinic-Rochester weighed and measured. cupcakes, let us know, because we “You have to measure at a ratio have recipes for ketogenic cupcakes 2. NYU Langone Health to give her exactly what she needs, and cheesecakes.’” 3. Froedtert & the Medical College of including fluids,” Sarah explained. A popular favorite? Peanut Wisconsin – Froedtert Hospital “Kristin is currently at a 2.5 ratio, so Butter Fat Bombs. 4. Rush University Medical Center it’s 2.5 times as much fat as every- “It’s basically peanut butter 5. Penn State Health Milton S. Hershey thing else. If you don’t eat every- with a lot of butter,” Schultz said. Medical Center thing in the bowl, you’re not at that “According to what my patients tell 6. University of Utah Health ratio anymore.” me, they make a wonderful, deli- The diet’s highly restrictive cious treat.” 7. UC Health University of Colorado Hospital nature and lack of variety makes Despite the diet’s potential for 8. Lehigh Valley Health Network it difficult for patients and their treating epilepsy, families often 9. The University of Texas Medical Branch families. It limits social opportuni- find it too overwhelming, especially at Galveston ties, too. Kids on ketosis can’t have when kids are picky eaters. Sarah 10. The University of Kansas Hospital even one sip of soda, much less said that in some ways, it’s easier to Halloween candy or a celebratory maintain the diet because Kristin is 11. Nebraska Medicine ice cream cone. not a typical 14-year-old. 12. Oregon Health & Science University Hospital “When we treat epilepsy, we “She’s not a teenager that’s got to don’t just treat the child,” Schultz have it her way. If you’re fully devel- explained. “There are a number opmentally aware, that’s going to be The results are in. UTMB is ranked among the nation’s best academic of individuals that help to treat harder, because then you’re aware of medical centers in the 2017 Vizient Quality and Accountability Study. the child, and families have to what you’re not getting. Ultimately, Vizient is an impartial company that drives performance improvement in be invested.” families have to make the best deci- health care by measuring patient safety and care results among an elite “It’s our new normal,” Sarah sions for themselves, but the diet is group of 107 academic medical centers. UTMB is proud to be ranked said. “It’s our family, it’s our life, and definitely worth a try.” 9th in the nation—and the only one recognized in Texas—for its it’s all she’s known for so long. But As Sarah spoke, Kristin clutched superior quality and safety performance. initially, the biggest challenge was her Elsa doll while she listened to eating in front of her. You can’t just music on her iPad. Her nails were This is one of many accolades given to UTMB for superior patient care. come to dinner and sit there with painted a sparkly blue, another nod We have also received an A grade from the Leapfrog Group for our your family and pile your plate with to Frozen, her favorite Disney movie. accomplishments in reducing errors, infections and accidents. And, mashed potatoes and green beans. “She’s never going to be seizure- again, we have received Magnet® Recognition for meeting the highest You can’t just have pizza and you free; we know this,” Sarah said. standards in nursing. can’t have birthday cake. You can’t “Our goal is just to give her the best have all these things that are a part quality of life we can, and if that Before you decide where to be treated, take a moment to understand of a kid’s life growing up. And when means we implement five different the quality of care differences between hospitals. It could make all you have a twin sister and a brother treatments, then we do.” the difference. who’s 17 months older, that was a challenge.” Sarah said the diet was daunt- ing at first, but ultimately became Learn more at utmbhealth.com/quality. second nature. “You have to prepare and think ahead,” she said. “Figure out substi- tutions. You make some sugar-free Jell-O with heavy whipping cream
tmc» pulse | march 2018 19 Bracing for the Future
SHRINERS – HOUSTON CLINICS AROUND THE STATE BRING MEDICAL CARE TO PATIENTS
By Shanley Pierce
n Dec. 8, 2017, Jesus Badillo Garcia and On any other day, the Shriners Club houses his mother, Patty Garcia, curled up in local meetings, bingo nights and small concerts Oa 10-seat van parked outside a nonde- for the community. But four times a year, the script brick building off Interstate 2 in La Feria, club transforms into a fully operational two-day Texas, a small town eight miles north of the outreach clinic that serves between 160 and Texas-Mexico border. It was 4 a.m. and a frigid 240 underserved and underprivileged children 34 degrees. Jesus, along with other children who with limb deficiencies, club feet, hip dysplasia, are missing limbs, waited patiently for the doc- cerebral palsy and other conditions that inhibit tors from Houston to arrive. Though it was still their motor abilities. pitch-dark outside, a thin blanket of snow began More than 30 doctors, nurses, social to coat the flat, brown Valley. It was the first time workers, physical and occupational therapists, it had snowed in the area in nearly a decade. radiology technicians and orthotic-prosthetic Jesus and his mother had left their home in professionals from Shriners Hospitals for Mexico at 7 p.m. the evening before and headed Children – Houston travel to La Feria to to Monterrey, Nuevo León, where they caught provide care at no cost to the families. a bus to the Pharr-Reynosa Bridge, some four “Our goal is to take a child and help them hours away. After waiting three hours to get function to the best of their ability,” said Lindsay through immigration, they walked 15 minutes P. Stephenson, M.D., a pediatric orthopedic sur- across the bridge to the U.S. side of the Rio geon at Shriners – Houston. “If that means that Grande, carrying only their papers and some- we can help them walk further—maybe they still thing to drink. A white van, with “Shriners walk with their walker or braces, but walk Hospital Children Transportation” emblazoned twice the distance and not be as tired— on the side, waited to take them and other fami- that’s life-changing.” lies to the Rio Grande Valley Shriners Club of (continued) Al Amin in La Feria.
Top: Jesus Badillo Garcia and his mother, Patty Garcia, pose outside the Rio Grande Valley Shriners Club in La Feria, Texas. Bottom left: Children and families are shuttled to and from La Feria in vans operated by Shriners volunteers. Bottom middle: A Shrine clown entertains a child. Bottom right: Devin Garcia tests out his newly-fitted prosthetic leg.
20 tmc» pulse | march 2018 tmc» pulse | march 2018 21 22 tmc» pulse | march 2018 * * * La Feria is the oldest of the four sites across the state where Shriners – Houston holds In 1922, Shriners International, an offshoot outreach clinics. The other clinics are held in fraternity of Freemasonry, established a network Laredo, Amarillo and El Paso. Short of offering of hospitals across the country dedicated to treat- surgery, these clinics are equipped to take care ing children with orthopedic injuries, diseases of all the patients’ needs. and birth defects. The first hospital, located in The main hall of the 9,000-square-foot Shreveport, Louisiana, was initially named the building in La Feria is sectioned into five differ- Shriners Hospital for Crippled Children. Since ent zones of organized chaos during the clinic: then, Shriners has expanded its scope to treat administration, where patient files and charts are burns, spinal cord injury and cleft lip and palate. managed; the clinic area, which is outfitted with But its mission remains beautifully simple: examination tables; an imaging room for X-rays; to treat any child up to age 18, regardless of race, a physical and occupational therapy zone; and religion or a family’s ability to pay. No child an orthotic and prosthetic area for technicians is ever turned away. to create casting molds for custom prosthetic “It’s so refreshing that you can concentrate limbs. A built-in workshop occupies an adjacent on the patient and their needs, rather than room, where technicians can make adjustments insurance status or anything else,” said pediat- to orthotic and prosthetic devices right then ric orthopedic surgeon Douglas Barnes, M.D., and there. chief of staff at Shriners – Houston. “This is what Despite the snow outside, the La Feria clinic makes it great to work here.” emanated warmth inside. Cartoon animal cut- Each of the 22 Shriners Hospitals for outs and stickers adorned makeshift dividers set Children across North America serves a desig- up throughout the building. Children scooted nated area. Shriners – Houston treats patients around the hall in their walkers and wheelchairs, from Texas and three northeastern states of navigating rows of metal folding chairs. The Mexico: Tamaulipas, Coahuila and Nuevo León. Shriners volunteers, dressed as clowns or sport- Although patients south of the border are not ing their trademark red fezzes, traipsed around American citizens, Shriners – Houston does the hall with the children and their families, not distinguish or discriminate when it comes offering food, drinks and holiday toys. to treatment. Whether they’re from the U.S. or Many of the families had traveled six or eight Mexico, patients receive the same level of care. hours to get to the clinic. “We get to treat the patients the way they “Some of these children will come in with lit- deserve to be treated without having to worry erally every article of clothing that they own on about … all the governmental regulations and their body. They’ve traveled overnight. They’re so forth,” Barnes said. “If somebody needs tired. They’re hungry,” Stephenson said. “You something and it’s medically necessary, we’re just appreciate the struggle that it must be to going to get it. It doesn’t matter if it comes out have a child with special needs.” of our operational funds or whether it’s then (continued) sourced from third-party peers. … We’re going to get whatever they need.”
Top: Traci Phelps, an orthotist from the Hanger Clinic of Houston, makes adjustments to a prosthetic leg at the Shriners clinic in La Feria. Bottom left: Orthotist Dave Zaborowski cuts a cast off a child’s leg at the clinic. Bottom middle: Markings indicate what adjustments need to be made to a prosthetic leg. Bottom right: Douglas Barnes, M.D., chief of staff at Shriners – Houston, assesses a child’s arm in the clinic.
tmc» pulse | march 2018 23 * * * than me, I used to just shrug it off,” Jesus said. “But as I’ve gotten older, I came to realize and Jesus, 17, was born with a curved tibia, a appreciate that everything is okay. I’ve seen my cleft foot and only three fingers on each hand. disability from different angles.” In 2004, when he was 4 years old, his mother He befriended other amputees, one of whom took him to their local hospital to have his right encouraged him to play soccer on a league leg amputated and replaced with a splint and created by a group of patients. An avid sports shoe lift. fan and natural athlete, Jesus joined the team “It was a bit difficult to assimilate to the new and took up swimming and cycling shortly condition,” Patty said. “It was a little shocking for afterwards. He won competitions in both but him whenever he woke fell in love with an up and no longer saw altogether different his leg.” physical activity: para Patty, who was dance sport, formerly born without a tibia, known as wheelchair wears a prosthetic leg, dance sport. as well. She knew that Jesus is a member Jesus, like her, would of the adaptive sports eventually outgrow dance team at the his splint and require Álvaro de Obregón a series of prosthetic Technical High School legs as he got older. A of the Universidad prosthetic was neces- Autónoma de Nuevo sary for his quality of León. He and other life, but very expen- students with lower sive—a basic prosthetic typically costs between limb deficiencies perform in special wheelchairs $5,000 and $7,000 in the U.S. Patty works for a car and are often paired with standing partners. insurance company filing accident claims, but “I have a lot of fun dancing, more than as a single mother, she worried about how she anything, because I do it with a team,” would pay for prosthetics for both herself and Jesus said. “We’re more than a team. We’re her son. a family. All of us have a lot of confidence Later in 2004, a stranger on a bus told and have fun.” Patty about the Shriners – Houston outreach clinic in La Feria. She decided to take Jesus and * * * get him outfitted for a prosthetic leg. Of course, Jesus doesn’t remember any of In previous years, Mexican patients and this. Any memory of his amputation has evapo- their families who visited the Shriners clinic rated from his mind. As far he is concerned, there in La Feria were able to cross into the U.S. was no physical disability to surmount, no trag- with humanitarian visas. However, in 2015, edy over which to triumph. He never felt limited the Mexican border patrol suddenly put a by his missing limb. stop to this. “Just like me, he doesn’t really feel any Stephenson and Barnes couldn’t point to a different,” Patty said. “We feel normal. There is specific reason why, but violent events in the no handicap.” area may have triggered tighter restrictions. Over the years, as Jesus continued to receive That year, Reynosa erupted in violence care at the Shriners – Houston outreach clinic, he when gunfights broke out and vehicles were set met more and more children who were afflicted ablaze, leaving at least three dead. The mayhem, by congenital neuro- and musculo-skeletal dis- Mexican federal police said, was sparked by orders that curbed their mobility and movement. members of the Gulf Cartel who blocked the Some kids had legs of different lengths, some city roads and attacked federal forces. Over the had arms with no hands, some had club feet. past year, violence spiked in the city due to rival “When I was younger, coming here and drug gangs fighting to control border smuggling seeing other kids who were in worse situations routes and trafficking operations.
Above: Jesus Badillo Garcia sits in the waiting room of the Shriners outreach clinic in La Feria. Right: Orthotist Dave Zaborowski pulls vacuuming plastic over a foot and ankle orthotic to make a brace for a patient at the Shriners workshop in Houston.
24 tmc» pulse | march 2018 Patty recalled trying to cross the bridge in the midst of the shootings. She and Jesus decided to travel by day to Reynosa and stayed in a hotel until they could leave the following morning. “It was very dangerous,” she said. “We had to arrive during the day when it was calm so we didn’t expose ourselves to risk.” Violence along the border wasn’t the only thing patients and their families had to worry about. “When the cartel violence was really bad, people were leaving their houses and, when they’d come home, their house had been ran- sacked,” Stephenson said. “The cartels would watch them leave. While they were gone, [the cartel] destroyed their houses. They knew they were leaving the country because they were getting information from Mexican border patrol.” Now, in order to cross the border, patients and their family members must present both a Mexican passport and visa, which could cost approximately $400. As a result, some of Shriners’ neediest patients are unable to cross and receive the care they need. “As opposed to here, getting a passport in Mexico is very difficult. You have to have the father’s signature to get a passport for the child,” Stephenson said. “We still have an issue with families whose father is either in prison or has been likely murdered by the cartel, but there’s no death certificate because there’s no body. If you’re in prison in Mexico, it’s not like here where you know where they are.” Despite these challenges, Shriners – Houston continues to work diligently to help patients and their families get the financial support and nec- essary documents they need to get to the clinic. “It’s not what we physically do,” Barnes said. “It’s what we’re doing to enable them to develop on their own and do amazing things. That’s the rewarding aspect.” Jesus has traveled to New York and Canada to compete in para dance sport and is now one of the top medalists in Nuevo León. He hopes to one day compete in the World Cup of para dance sport, but for now is looking forward to going to college to study psychology. He has a bright future, Patty said, and it wouldn’t have been possible without Shriners. “Before we arrived at Shriners, my world was closed. I didn’t know what I was going to do with Jesus’ treatment. I was in the dark, but God always had an angel that helped me see the light when I felt that there was no way,” Patty said. “The people at Shriners are my angels.”
tmc» pulse | march 2018 25 HOW TMC EMPLOYEES SPEND THEIR SPARE TIME ierce P hanley S B y
gate, Acker chases the animal NAME: Kristin “Avery” Acker down the course to make sure
it doesn’t run the child into the OCCUPATION: Student at McGovern Medical School at The University fence. Once the ride is over, she picks up the child to wave of Texas Health Science Center at Houston (UTHealth) to the camera and the crowd,
and then runs the child back INTEREST: Volunteering as a rodeo clown for the Houston Livestock to his or her parents near the Show and Rodeo opening gate before the next sheep is released. “It’s a lot of running. It’s porting a cowboy hat, a and fresh air.” Mutton busting is a probably around six miles a Sred and blue rodeo clown The rodeo is very much competitive event in which day,” Acker said. “You have smock and a brightly painted in Acker’s blood. Growing up children between the ages of to chase the sheep down, get ON THE SIDE face, Kristin “Avery” Acker in Freer, Texas, a small town 5 and 6 latch onto a sheep and the kid, run back with them, can be found pumping up the 60 miles northeast of Laredo, ride bareback, as the animal and do that 20 times in crowd and chasing after sheep Acker spent her childhood on bucks and barrels down a dirt 30 minutes.” in the Mutton Bustin’ arena at a ranch and in the rodeo. Her course. Children’s scores are It’s a high-intensity the Houston Livestock Show mother, a cattle rancher, was based on how long they are cardio job that requires a and Rodeo. involved in rodeo throughout able to stay on the sheep. lot of energy, but “the kids “I feel like a real Texan high school. Her cousins “It amazes me every year get me pumped,” she said. when I’m involved in the and older brother are experi- how resilient kids are. They’re Acker’s commitment to rodeo. It’s a part of my culture. enced ropers. And her grand- so scared to do this, but then medicine and her love for It’s how I was raised,” said father, James Raymond “Bud” they hop on this sheep and rodeo clowning have one Acker, 24, a second-year Walker Jr., was a professional they have the best time ever. important thing in common: student at McGovern Medical rodeo bronc rider who will be They might cry a little bit, but people. School at UTHealth who is inducted into the Texas Rodeo they still love it,” Acker said. “In medicine, you aren’t volunteering as a rodeo clown Hall of Fame in April. He As a rodeo clown, Acker really practicing medicine, for the third year in a row. “You passed away in 2010, but his isn’t just responsible for per se, if you aren’t improving see so many smiles doing legacy lives on. entertaining the crowds and people’s lives,” Acker said. “I mutton busting and I really “When I’m at the rodeo cheering on the kids. She is believe the rodeo improves enjoy that. Life can get people and I see people who resemble there to ensure their safety people’s lives, even if it’s just so pessimistic, so it’s great to my grandpa,” Acker said, “I during the ride, as well. After through a smile.” have a breath of happiness feel close to him.” the sheep bursts from the
26 tmc» pulse | march 2018 HOW TMC EMPLOYEES SPEND THEIR SPARE TIME Don’t Lose Sleep Over Daylight Saving Time How to regain that hour lost on March 11
By Christine Hall
n the fall, when we set our clocks back, most of In addition, individuals who reported of U.S. high school students sleep fewer than eight Ius are happy to steal an extra hour of sleep. But getting fewer than seven hours of sleep a night hours a night, according to the CDC. on March 11, when daylight saving time begins were also more likely to report being obese and Losing that one hour during daylight saving and most Americans set their clocks forward, physically inactive. time is “a big deal,” Patel said. how do we recoup that lost hour? Sleeping well leads to a good metabolism and She hears from parents who are concerned Jerald Simmons, M.D., founding director of good learning abilities, which helps in making about how their child will adjust. No matter the Comprehensive Sleep Medicine Associates and good decisions, said Amee Patel, D.O., a sleep age, Patel said, some children adapt easily, while a neurologist specializing in sleep disorders medicine expert and pediatric pulmonary others do not. and epilepsy, does not recommend going to specialist at Texas Children’s Hospital. To help children when the clocks are set bed earlier. A good night’s sleep also helps with overall forward an hour, Patel suggests shifting bedtime “The only control on your circadian rhythm health: People who sleep fewer than six hours a earlier at a slow rate, in 15-minute intervals, until is when you wake up,” said Simmons, who was night tend to have elevated blood pressure— the one-hour mark is achieved. For infants, babies founding director of the Memorial Hermann even children, she said. and toddlers, she also recommends the 15-minute Sugar Land Hospital Sleep Disorders Center. “When we sleep, you might think it is a still shift for feedings and nap time. Instead of setting the alarm for the normal process, but actually we are very active,” Patel “Understand and expect that your baby may time on March 11, give yourself an extra half an said. “If you don’t go into REM (rapid eye move- not tolerate it, and they may need to have an addi- hour, he said. ment) sleep, you are going to miss out.” tional nap,” Patel said. And although it might be easy to reach for Memory is consolidated during the REM For school-age children, she suggests starting sleep aids, Simmons and other experts don’t rec- phase of sleep, she explained. When sleepers fail the Friday prior to daylight saving time and put- ommend them for coping with the one hour lost to enter that phase, it can be difficult for them to ting them to bed half an hour later than normal, to daylight saving time. There are other ways to remember what they learned during the day. allowing the child to recover during the day on ensure a good night’s sleep. Saturday. Then on Saturday night, add another For starters, stop looking at technology at Helping children adapt half hour to bedtime and give Sunday to adapt. least two hours before bedtime and while in bed. Infants need as much as 15 hours of sleep, adoles- Children who aren’t overly sensitive to the Simmons also recommends taking a bath cents need about nine and teenagers need eight change will be back on their regular schedule before bed to raise the core body temperature. hours of sleep per night. Unfortunately, two-thirds Monday morning. After the bath, the body begins cooling off, which enhances the feeling of relaxation. Don’t wait more than 45 minutes to hop into bed, he said, and slipping into a cool bed in a quiet environment will help even more. Toby Yaltho, M.D., a neurologist specializing in sleep medicine at Houston Methodist Sugar Land Neurology Associates, says bright light exposure affects melatonin levels. He recommends using light therapy to help overcome the hour lost by either getting outside in the morning or using an alarm clock with a wake-up light—often called a sunrise clock—that grows brighter over a period of 20 or 30 minutes.
Getting enough sleep Experts say most people aren’t getting enough sleep. According to the Centers for Disease Control and Prevention (CDC), adults should get seven hours of sleep a night, but a third of U.S. workers get fewer than six hours. Credit: Courtesy Texas Children’s Hospital Children’s Texas Courtesy Credit: Amee Patel, D.O., visits with a sleep patient at Texas Children’s Hospital.
tmc» pulse | march 2018 27 How High Will Drug Prices Climb? Experts explain how to reduce soaring costs
By Ryan Holeywell
agop Kantarjian, M.D. has Health policy experts agree on Hbeen practicing medicine for several key strategies. decades. But it was just five years ago that he began his crusade Let Medicare negotiate against the soaring cost of cancer drugs. In 2003, Congress passed a law Kantarjian, who chairs the leuke- that prevents Medicare from negoti- mia department at The University of ating drug prices with manufactur- Texas MD Anderson Cancer Center, ers. Removing this provision, noticed promising, new drugs to health policy experts say, could fight leukemia had price tags in help reduce drug prices, given the excess of $140,000 per patient. Even negotiating power such a vast older drugs, once considerably program would have. more affordable, were approaching Giving Medicare negotiating six-figures, as well. power could have reverberations Since then, Kantarjian has writ- across the health care sector, experts ten a petition, become a frequent say, since private insurers often media voice and authored more peg their reimbursement rates than 20 op-eds and journal articles to those of Medicare. And there’s decrying the high price of cancer precedent for such a move. The U.S. drugs and arguing for ways to push I look at these cancer drugs that add a Department of Veterans Affairs, costs down. His efforts are not which does have negotiating power, paying off. few weeks or months of life, that cost hundreds has brought down drug prices in “The progress,” Kantarjian said, of thousands of dollars, and I don’t think it’s its programs.
“has been zero.” worth it. He’s right. The average annual Allow the government to price of new cancer drugs per — OSAMA MIKHAIL, PH.D. consider cost-effectiveness patient increased from less than Professor of management, policy and community health at the $10,000 before 2000 to $145,000 in UTHealth School of Public Health When reviewing new drugs, the 2015, according to Rice University’s U.S. Food and Drug Administration Baker Institute for Public Policy, How did we get here? more than spending in Canada must determine whether they are although patients are not neces- Drugs represent a rapidly and Germany, according to the safe and effective. But many policy sarily responsible for covering the growing share of total health care Commonwealth Fund. experts prefer the United Kingdom’s full cost of these drugs. Kantarjian costs, with retail prescriptions President Donald Trump, along model. There, drugs must also estimates 40 percent of his leukemia (those obtained at a pharmacy) with Health and Human Services be deemed cost-effective to gain patients are getting less than opti- now exceeding 10 percent of the Secretary Alex Azar and Food and approval. The U.K.’s health agency mal care because they are unable to $3.3 trillion the U.S. spends annually Drug Administration Commissioner measures “value” by examining how afford the leukemia drugs they need. on health care. If you add in chemo- Scott Gottlieb, all say reducing drug much a drug costs and how well it “They just disappear, and therapy and other drugs adminis- costs is a major goal. Experts say works. Unless a new drug provides don’t take the drug, and they die,” tered by doctors, that rate a pair of plans the administration greater value than existing drugs, it Kantarjian said. “That’s the reality is even higher. released in February attack the issue doesn’t win approval. of my clinic—every day.” It hasn’t always been this way. at the periphery but don’t tackle the Kantarjian suggests drug prices The cost of drugs has emerged Until the mid-1990s, the U.S. “list price” of drugs head on. in the U.S. could be pegged to objec- as a leading political issue. In spent about the same amount Meanwhile, any serious effort to tive measures, like how many extra recent years, extreme price hikes on drugs, per capita, as the rest of reduce drug prices will almost cer- years of life they provide a patient, for drugs, including EpiPen and the developed world. Today, the tainly face opposition from a drug or to what extent they shrink a Daraprim, have become national, U.S. is an outlier. U.S. per capita manufacturing industry that spends tumor. Many drugs entering the U.S. high-profile scandals. More than spending on retail pharmaceuticals massive sums on lobbying—more today provide questionable benefits, 75 percent of Americans say the is about $1,000 annually. That’s than $170 million last year alone. given their cost, and drug compa- cost of prescription drugs today more than double United Kingdom So how can the country reduce nies simply charge what the market is unreasonable. spending and about 50 percent the soaring price of drugs? will bear.
28 tmc» pulse | march 2018 “I look at these cancer drugs advertisements are so controver- prescription drug marketing. A 2016 study published by a that add a few weeks or months of sial that the American Medical Tufts University research center life, that cost hundreds of thousands Association has called for them to Require greater price estimated that the average cost to of dollars, and I don’t think it’s worth be banned. transparency develop and get approval for a new it.” said Osama Mikhail, Ph.D., “Patients think because there’s drug is $2.6 billion. But that num- a professor of management, an ad, [the drug] must work for Drug costs in the U.S. are largely ber drew skepticism, with critics policy and community health at everyone who takes it,” said Vivian based on supply and demand. When questioning the methodology of the The University of Texas Health Ho, Ph.D., director of the Center lives are at stake, the sky’s often the study, the opaque nature of the data Science Center at Houston for Health and Biosciences at limit for prices. and the fact that the center itself is (UTHealth) School of Public Rice University’s Baker Institute “They’re like an unscrupulous industry-funded. Health and a former executive for Public Policy. “That’s why you grocery store in the middle of a A better number to focus on, with drug maker Eli Lilly. should get rid of the advertising. It’s hurricane that jacks up its prices to some say, is the drug industry’s not getting patients the information take advantage of people,” said Stan profit margins. Kaiser Health News, End direct-to-consumer doctors would want them to have.” Dorn, a senior fellow with the non- for example, found that 10 of the top advertising Doctors say consumers pressure profit advocacy group Families USA. publicly traded U.S. drugmakers them to prescribe the pricey drugs The drug industry has long earned $83.6 billion in profits on Since the mid-1990s, Americans they see on TV, and often, those doc- maintained that any efforts to curb revenue of $306 billion in 2016— have been treated to television tors are unwilling to say no for fear costs could threaten innovation, but a healthy 27 percent pretax advertisements of happy people of losing the patient. When doctors health policy experts are skeptical. profit margin. practicing yoga, riding bicycles and acquiesce, everyone pays for it, and “I think we should attack the A bipartisan bill by Sens. John relaxing in outdoor bathtubs, thanks costs go up. drug companies’ continued refrain McCain (R-Ariz.) and Tammy to the power of prescription drugs. Banning the ads would be a that whatever you do to them is Baldwin (D-Wisc.) would require Historically, pharmaceutical firms dramatic move that could raise the going to stop innovation,” said drugmakers to notify the federal only promoted their products to industry’s hackles, but it would actu- Arthur “Tim” Garson Jr., M.D., direc- government and submit a report if health care providers, but eventually ally put the U.S. on standing with tor of the Health Policy Institute at they raise certain drug prices by they realized aging baby boomers the rest of the world. Only one other the Texas Medical Center. “They 10 percent in one year, or 25 percent were an untapped market. developed country, New Zealand, [shouldn’t] say that anymore with- over three years. Now, direct-to-consumer allows similar direct-to-consumer out showing us actual data.” (continued)
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tmc» pulse | march 2018 29 Celebrating years If drugmakers hit those thresholds, keep generic manufacturers from 40 they’d be required to provide justifi- obtaining enough pills to manufac- of cation for the hikes, report their net ture a competing product. This was profits associated with the drugs, one of the tactics used by Turing Exceptional Service and list expenses associated with Pharmaceuticals to achieve a the drugs including manufacturing, 5,000 percent increase in the price research and development, market- of the decades-old Daraprim, used ing and advertising. to treat serious parasite infections. Today, there is wide, bipartisan Beth Wolf Ed Wolf Eliminate tactics that support for legislation that would Chairman CEO stifle generics prevent the practice.
New drug patents last for 20 years, What’s next? at which point generics can com- pete, but experts say it’s common If any reforms are to become reality, Transitional Style, for name brand drugmakers to try Kantarjian said, consumers need Incredible Detail to block generic competition. One to become better advocates. But practice that has gained a great deal he acknowledges that’s not easy, of attention is the “pay-for-delay” especially for patients with serious $1,995,000 arrangement, in which a branded conditions like cancer, who don’t Holley Madden drug maker will pay a generic com- have the time and resources to fight Hilshire Village petitor not to compete, preventing with Washington while simultane- lower-cost alternatives from enter- ously fighting for their lives. ing the market. The Federal Trade That’s where he thinks doctors Stunning Townhouse, Commission says the practice costs should step in. He points to the Spacious Backyard consumers and taxpayers $2.5 bil- Hippocratic oath, which states doc- lion in higher drug costs annually. tors will keep patients from harm Mikhail, the former Eli Lilly exec- and injustice. $749,000 utive, said another tactic branded “High prices are harm and Cathi Lamberth drugmakers use is to make a small injustice,” Kantarjian said. “[The Upper Kirby variation to an existing drug—say, oath] forces us to advocate for the changing the chemical composition patients, but you don’t see too many to allow it to be taken once a day doctors advocating.” Beautifully Updated, instead of several times daily—in Dorn, of Families USA, said he’s Hidden Retreat order to extend the patent. That pro- actually hopeful that reforms could cess is known as “evergreening.” be coming. He knows plenty of other “Rather than creating new advocates are skeptical, but he has medicines, pharmaceutical compa- seen other major reforms to the $1,150,000 nies are recycling and repurposing health care system enacted, such Linda Ricca Tanglewood Area old ones,” researchers from The as the Children’s Health Insurance University of California, Hastings Program and the Affordable Care College of the Law wrote in a paper Act, which were previously seen last year that found 78 percent of as unlikely. Classic Traditional, drugs associated with new patents “I think people tend to under- Guest Suite Down from 2005-2015 were actually exist- estimate the fluidity of the policy ing drugs. environment in Washington,” Dorn Other critics have pointed to said. “You can’t be Pollyannaish. $1,095,000 another challenge facing generic But I’ve seen all kinds of things Af on Oaks Nikki Simpson drugmakers. If pharmaceutical happen here that nobody thought companies have enough control was possible.” of their distribution, they can
Spacious with Pool on Cul-de-sac I think we should attack the drug companies’ continued refrain that whatever you do to them is
going to stop innovation. $489,900 Roya Arfa — ARTHUR “TIM” GARSON JR., M.D. Energy Corridor Director of the Health Policy Institute at the Texas Medical Center 713-622-9339 bethwolff.com Each offi ce is independently owned and operated. 30 tmc» pulse | march 2018 Hypnosis in the Operating Room Doctors and researchers at MD Anderson are exploring hypnosedation to manage pain and anxiety during certain breast cancer surgeries
By Shanley Pierce
My sole job is to sit at the head of the bed and focus on the patient. Any changes to breathing patterns [or] facial muscles is an alert to me that I need to check in. Periodically, I’ll ask the patient, ‘How’s your
comfort level?’
— ROSALINDA ENGLE Mind-body specialist at MD Anderson Cancer Center
patient experiences any discomfort. “Over the past couple of decades there is a very solid evidence base that incorporating hypnosis during invasive conscious sedation medical procedures reduces anxiety, helps to control pain, decreases recovery Rosalinda Engle, a mind-body specialist at MD Anderson Cancer Center, prepares a patient for surgery. As part of the clinical time, and helps lower medical costs,” hypnosedation trial, an electroencephalography (EEG) cap is placed on a patient’s head to record neurological activity before, during Cohen said. and after the surgery. General anesthesia is still the standard approach at MD Anderson, hen Beverly Levinson’s solution presented itself to stage 0/1 breast cancer who are even for smaller surgeries, such as Wdoctor noticed two unusual Levinson. Her surgeon approached undergoing lumpectomies with or lumpectomies. But the drugs used spots on her dense breasts, she was her about an ongoing clinical trial without sentinel lymph node dis- for general anesthesia can poten- sent to The University of Texas that would allow her to avoid gen- sections. The study, still in its pilot tially weaken the body’s immune MD Anderson Cancer Center for a eral anesthesia by using hypnosis. phase, will examine 50 patients who system and slow the recovery pro- lumpectomy—a surgical procedure Levinson, who had been hypnotized are randomly selected to receive cess, Cohen said. Cancer patients, to remove abnormal or cancerous for jaw pain years ago, immediately either general anesthesia or a in particular, cannot afford to have tissue along with a small portion of jumped at the opportunity. combination of local anesthesia their immune systems compro- the surrounding healthy tissue. “In my eyes, I had nothing to and hypnosedation before and mised. Cohen and his team want to Levinson, 64, wasn’t as con- lose,” Levinson said. “I could try during surgery. find out if hypnosedation would be cerned about the surgery as she something new or I could go the In both cases, a patient has an a viable replacement for general was about undergoing general anes- old-fashioned way. I’m the middle intravenous line placed in her arm anesthesia during smaller, less thesia. She had received general child. I always try new things. That’s and an anesthesiologist is present to invasive surgeries. anesthesia for previous surgeries, my personality.” administer a cocktail of drugs used but because of her temporoman- Led by Lorenzo Cohen, Ph.D., to put her under. For patients receiv- * * * dibular joint (TMJ) disorder, she director of the Integrative Medicine ing hypnosis, the anesthesiologist suffered severe jaw pain from open- Program at MD Anderson, the ongo- monitors their vitals, calculates the The practice of hypnosis, in ing her mouth wide enough for the ing clinical trial aims to determine appropriate dose of local anesthetic one form or another, has been breathing tube to be inserted down whether or not a method of deep medication, administers medication around for centuries. her throat. relaxation, called hypnosedation, is for pain and nausea and stands by to (continued) Luckily, an unconventional safe and effective for patients with convert to general anesthesia if the
tmc» pulse | march 2018 31 But it wasn’t until the mid-19th Engle guided Levinson through century that it came to be defined as what to expect on the day of the a kind of “nervous sleep” that could surgery. The room would be sterile, GET alleviate anxiety or pain during with five or six people at hand. The medical procedures. lights would be bright. Engle would In the 1840s, Scottish neuro- sit beside her throughout the proce- surgeon James Braid developed a dure to keep her calm and relaxed. technique of deep relaxation and “My sole job is to sit at the head visual fixation to guide patients of the bed and focus on the patient,” into a trance and help alleviate Engle said. “Any changes to breath- MORE their pain. He coined the term ing patterns [or] facial muscles “hypnosis” and defined it as “the will alert me that I need to check induction of a habit of abstraction in. Periodically, I’ll ask the patient, or mental concentration, in which … ‘How’s your comfort level?’” the powers of the mind are so much On the day of the surgery, doc- engrossed with a single idea or tors injected local anesthetics— train of thought, as … to render the lidocaine and bupivacaine—to numb individual unconscious of, or indif- Levinson’s right breast and made a ferently conscious to, all other ideas, 1-inch incision to remove some of impressions, or trains of thought.” the tissue. Although hypnosis is often asso- As promised, Engle sat next to ciated with parlor tricks and stage Levinson for the duration of the sur- magicians, the practice itself has gery, helping her maintain a state of been used clinically to address sev- deep relaxation. eral conditions, including smoking, “I didn’t feel anything,” Levinson anxiety and overeating. said. “You’re in a calm state. You’re For Levinson, it was a great in a safe state of mind. You’re being option. reassured. It was great.” A week before surgery, Levinson Throughout the surgery, met with Rosalinda Engle, a mind- Levinson recalled feeling pressure body specialist at MD Anderson on her breast as the surgeon SIENNA PLANTATION Cancer Center who would perform operated, but said it didn’t hurt the hypnosedation, in a small con- any worse than getting a filling Where Living Becomes Living It Up ference room in the hospital. at the dentist. Less than an hour “Do you have a place where you after her surgery was complete, • Fort Bend Parkway nonstop to Loop 610 feel really comfortable and at ease?” Levinson was out of bed, dressed • New builders 20+ new model homes Engle asked Levinson in her sooth- and walking around. • New and pre-owned homes ing, mellifluous voice. “It could be She skirted the unpleasant side • 7th on-site Fort Bend ISD School (COMING THIS FALL) your grandmother’s house. It could effects of general anesthesia, recov- • New entrance opening 2018 be a vacation you’ve enjoyed, a vaca- ered faster and didn’t require any tion spot. It could be anywhere, any post-operative painkillers. • Sawmill Lake Club - NOW OPEN! place in nature. Close your eyes and For hypnosedation to work, • On-site restaurants + retail call that up.” Engle said, the patient must be As Levinson focused on the task, receptive to it. Homes from the $250s to the Millions Engle continued to offer instruction. “All hypnosis is self-hypnosis,” “Breathe in deeply. Experience Engle said. “You’ll go as deep into your breath from the tip of your this trance state as you are willing to nose. Feel as your breath moves allow yourself to go.” through your body. Imagine breath- Engle points to shifts in atten- ing into the palm of your hands. tion and consciousness that people Now exhale. Breathe out through commonly experience throughout your fingers, the soles of your feet, the day. Ordinary moments—such your toes. Relax.” as zoning out while driving or Slowly but surely, Engle lulled becoming so engrossed in a conver- Levinson into a state of deep sation that you’re able to block out PLUS, DON’T CANINE CARNIVAL & relaxation. surrounding noise—are examples MISS OUR DOGGONE FUN RUN “I felt very, very safe,” Levinson of how the mind can tune Saturday, April 14 said, when it was over. “It was like out distractions. [going] into someone’s house where “Pointing out these everyday MASTER-PLANNED they’re baking a cake. It smells good, shifts and our capacity for absorp- COMMUNITYOF THE YEAR and they welcome you in. You just tion is important to let the patients SiennaPlantation.com have a warm feeling.” know they are in control and driving
32 tmc» pulse | march 2018 this experience,” Engle said. “They otherwise stressful experience. can train themselves to be as I felt very, very safe. It was like [going] into “It’s amazing how complex we relaxed and calm as possible. They someone’s house where they’re baking a cake. are as humans and how complex the
can guide themselves. They can It smells good, and they welcome you in. mind is. A lot of times, it’s mind over walk through this experience with matter,” Black said. “Hypnosedation surgery and take it throughout the — BEVERLY LEVINSON is a way we’ve applied mind over treatment process, the whole contin- Hypnosedation patient matter to a situation in the operat- uum of cancer care.” ing room for a specific population of While general anesthesia is very MD Anderson. “The patient doesn’t there are some people who the patients here. That mental forti- safe for most people, it can have require an extended period of time approach science from a belief per- tude and the strength that we have, unpleasant side effects. The most in the recovery room. They’re able to spective, as well, and they’re wrong.” that has to be carried through and common are temporary nausea and go on with the rest of their life.” Most surgeons were initially has better outcomes if we use that vomiting, dry mouth, a sore throat reluctant to participate in the clini- path throughout our cancer care.” and grogginess. Older patients who * * * cal trial, said Dalliah M. Black, M.D., No matter how effective the receive general anesthesia are more a breast surgical oncologist at MD clinical trial shows hypnosedation likely to experience longer-term According to Cohen, more than Anderson. Because the standard to be for surgeries, Rebello stressed cognitive and memory impairments, 34 clinical trials and numerous approach at MD Anderson is to use that hypnosedation will not become a condition called post-operative papers published in scientific jour- general anesthesia for surgeries a new standard approach for pain cognitive dysfunction (POCD) that nals have shown that hypnosedation large and small, most surgeons are management. can last anywhere from a few days to works. But he says there is still some accustomed to having their patient “I think there’s a concern that a few months. Those with a history doubt among his colleagues. sleep throughout every procedure. this is going to replace general of POCD have a higher risk of expe- “Although a physician may “Surgeon interest was very slow anesthesia. It is not going to replace riencing the condition again with think, ‘I don’t believe in hypnosis,’ up front, but I would offer them to general anesthesia,” Rebello said. repeated anesthetic. that is a scientifically unsound state- come in to watch my cases,” Black “But for a certain niche of patients, “[Hypnosedation] is a nice ment. Science is not about personal said. “Many colleagues have been there are certainly some benefits alternative,” said Elizabeth Rebello, belief. It’s about evidence,” Cohen so surprised.” that could exist and we need to find M.D., associate professor in the said. “Your religious practices are Using hypnosedation, patients out if that is, indeed, the case.” department of anesthesiology part of a belief system. Science is like Levinson can gain some and perioperative medicine at evidence-based. Unfortunately, semblance of control during an
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tmc» pulse | march 2018 33 Lydia Lopez Gets a Bionic Eye Patient will learn a new way of seeing with the Argus II retinal prosthetic
By Maggie Galehouse
Garvin Davis, M.D., MPH, and Amir Mohsenin, M.D., Ph.D., are the only physicians in the region authorized to implant the Argus II prosthetic. On the day Lopez’s eye was activated, they explained that the chip in her eye is outfitted with 60 elec- trodes. The camera signals stimulate this tiny array, which, in turn, helps Lopez see. “She has to move her head from side to side in order to scan images,” said Mohsenin, a University of Texas Health Science Center at Houston (UTHealth) ophthalmologist affiliated with Memorial Hermann and the Cizik Eye Clinic. “The image of what she sees is actually quite small.” Imagine watching black and white images on a cell phone placed directly in front of your field of vision. That’s essentially the size of the array that Lopez sees. Lopez sat straight up in her chair and smiled as the doctors and Second Sight employees turned on her vision. Davis, who was wearing a dark suit, and Mohsenin, wearing a white coat, Lidia Lopez is prepared for surgery at Memorial Hermann Hospital in January. encouraged her to try and see the difference in their jackets. She struggled a little, but could make out the contrast between light and dark. idia Lopez could not sleep the night before arrived at the Robert Cizik Eye Clinic to have her “She will slowly get better at this and learn Ldoctors activated her bionic eye. vision activated. In a conference room crowded what she is seeing,” said Davis, also a McGovern The 61-year-old had been losing her vision for with doctors, family, friends, media and a few Medical School at UTHealth ophthalmologist decades. Retinitis pigmentosa, a genetic disorder employees from Second Sight—the company affiliated with Memorial Hermann and the that causes a breakdown of cells in the retina, had that makes the Argus II—Lopez donned a pair Cizik Eye Clinic. “Some of the best patients shuttered her eyesight and independence. of special glasses outfitted with a miniature can sort laundry—light and dark. Some patients But Lopez, the first patient in Houston to video camera. can do archery.” receive a bionic eye, hoped that would change “Está bien!” said the El Salvadoran-born Lopez, In Spanish, Lopez told the crowd what she on Feb. 12. who spoke and answered questions in English hoped to gain with this new system of sight. One month after doctors implanted a tiny and Spanish. “I want independence,” she said. “To work. Argus II retinal prosthetic in her left eye, Lopez The camera in Lopez’s glasses sends images To walk in the park.” through transducers to the implant in her eye and The Argus II is the only retinal prosthesis ever simulates vision, essentially bypassing her degen- approved by the U.S. Food & Drug Administration. erated retina and using the functioning parts of It costs about $150,000, but Davis and Mohsenin her eye to connect to her brain. Going forward, said Lopez’s insurance would cover it. Lopez will carry a small video processing unit More than 280 patients worldwide have been with her—small enough to attach to a belt— outfitted with the Argus II, including more than that connects to the camera. 120 patients in the U.S. and Canada. Lopez is well aware that her bionic eye will not Mohsenin and Davis hope to implant four or offer 20/20 vision. She will not be able to read or five bionic eyes a year. The waiting list to receive drive, but she will be able to distinguish light from the Argus II, they said, is significant. Patients dark and make out the shapes and outlines of peo- have been calling Second Sight to find out where ple and objects. She will learn to see in a new way. they can get the surgery. The Texas Medical Center doctors who For Lopez, the real effort begins now that Amir Mohsenin, M.D., Ph.D., holds up the glasses outfitted implanted the chip in Lopez’s eye on Jan. 10, her eye has healed from the implant and her with a video camera that will help Lopez see in a new way.
34 tmc» pulse | march 2018 Some of the best patients can sort laundry—light and dark. Some patients can
do archery.
— GARVIN DAVIS, M.D., MPH McGovern Medical School at UTHealth ophthalmologist affiliated with Memorial Hermann and the Robert Cizik Eye Clinic
Carlos Lopez, 30, said his mother started to lose her vision before he was born. “I remember her from being able to distin- guish shapes and stuff and know who was there, to basically not knowing who was in the room,” he said. “She had it and then she lost it. So she knows what she’s been missing out on. Now that she’s regained some sort of vision, it’s nothing short of a miracle.” Garvin Davis, M.D., MPH, and Mohsenin help Lopez learn to use the Argus II in the Robert Cizik Eye Clinic on Feb. 12. He said his mother wants to be able to move around on her own, to spend time in nature. For vision has been turned on. She will work directly essential to the development of the device.” years, she has been confined to her home unless a with computer programmers and occupational “With time, we’d like her to be able to navigate, family member is with her. therapists to learn to interpret the visual stimuli to potentially make out a door,” Mohsenin added. In the conference room, Lidia Lopez looked that she is receiving. With software upgrades, her “Some patients say they can make out people in determined to make the most of this new way vision will improve, as well. their family. The range of results is large. Many of seeing. “We expect her to be able to tell high-contrast gain more benefit than what is promised in “I feel good,” she said. “I’m sure later on, I will shapes in the future,” Davis said. “Her feedback is the surgery.” see more.”
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A Pen that Detects Cancer in Real Time Handheld device identifies cancer in seconds during surgery
By Christine Hall
ne telephone call triggered “I responded with ‘Yes!’” The MasSpec Pen can The frozen section process, Oa new device that aims Mass spectrom- detect cancer in which has been around for to give surgeons more precise etry is a fairly human tissue. 100 years, involves the removal diagnostic information about new application of tissue or an organ so it can be what to cut and what to preserve within clinical Pen against the studied under a microscope. Frozen during cancer surgery. settings, patient’s tissue section is often slow and sometimes Livia Schiavinato Eberlin, Ph.D., Suliburk and uses a inaccurate, and each sample assistant professor of chemistry said. A mass foot pedal to can take a pathologist as much at The University of Texas (UT) at spectrome- trigger the as 45 minutes to prepare and inter- Austin, made that phone call, and ter measures automated pret, increasing the patient’s risk James Suliburk, M.D., associate characteristics analysis, waiting for infection. professor and head of endocrine sur- of individual mole- a few seconds In addition, frozen section gery at Baylor College of Medicine cules. Eberlin wanted for a result. The pen analysis is difficult to interpret for answered it. to test the MasSpec Pen, releases a drop of water some types of cancers. And once “She wanted to test a mass spec- a handheld device that can detect onto the tissue, and small mole- the tissue or organ is removed, it trometer to see if it would rule in or cancer by touch—in real time. cules from the tissue migrate into can’t be put back, said Suliburk, who rule out cancer,” Suliburk said. A surgeon holds the MasSpec the water. Then the device drives often operates on the thyroid. the water sample into the mass “We operate to remove a part spectrometer, which reads thou- of or all of the thyroid,” he said. sands of molecules as a molecular “What we find is that a majority of fingerprint. When the MasSpec Pen the patients will not have cancer, completes the tissue analysis, the but until now, our diagnostics were words “Normal” or “Cancer” appear not to the point, yet, where we could LIFE HAPPENS . automatically on a computer screen. improve that procedure.” CHIROPRACTIC CAN HELP. Surgeons then know which tissue to But with the MasSpec Pen, can- remove and which tissue to leave in cerous tissue is accu- the body. rately identified in Significantly, the pen allows about 10 seconds, surgeons to analyze tissue he said. while it’s still in the body, The MasSpec * unlike frozen section analysis, Pen was devel- $ the current method for diag- oped by a team nosing cancer during surgery of scientists, 29 and determining the boundary surgeons and Initial Visit NO APPOINTMENTS between cancerous tissue and healthy tissue. Includes consultation, NO INSURANCE NEEDED exam & adjustment OPEN EVENINGS & WEEKENDS
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36 tmc» pulse | march 2018 PROUDLY SERVICING THE TEXAS MEDICAL CENTER AND GREATER HOUSTON
281-883-5508 ICONHOSPITALONLINE.COM 19211 McKay Drive, Humble, Texas 77338
Buying a house can be a minefield. Credit: Wyatt McSpadden/University of Texas at Austin Facing Page Credit: Vivian Abagiu/University of Texas at Austin at Texas of Abagiu/University Vivian Credit: Page Facing Austin at Texas of McSpadden/University Wyatt Credit: Livia Schiavinato Eberlin, Ph.D., chemistry professor at The University of Texas at Austin, led a team of scientists and engineers in developing a tool for identifying cancer during surgery.
engineers from UT Austin, Baylor placed on microscope slides. and The University of Texas MD Suliburk expects to start testing Anderson Cancer Center. Led by the MasSpec Pen during oncologic Eberlin, the team has demonstrated surgeries this spring. The team that the pen diagnoses cancer in hopes the U.S. Food and Drug live, tumor-bearing mice during Administration will approve the surgery without causing any observ- pen as a medical diagnostic. able harm to the tissue or stress to “Dr. Eberlin and I both feel the animals. strongly that it will improve the “We anticipate certain lesions care of the patient and revolutionize will be 90 to 95 percent probable how we perform surgery,” Suliburk of a tissue diagnosis, but we want said. “Any time you can perform a to give a more precise diagnosis,” more precise, safer surgery, it’s a Suliburk said. “Our goal is to be win for the patients and results in more than 95 percent accurate.” better outcomes.” Don’t get blown up. The team is now refining the MasSpec Pen so it can read samples I’m on your side. You can count on it. Judy Thompson • Just Buyers Houston
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tmc» pulse | march 2018 37 Field Notes
[ 1 ] Houston Methodist Hospital’s ERIK SUAREZ, M.D., a thoracic surgery specialist, and THOMAS MacGILLIVRAY, M.D., chief of cardiac surgery and thoracic transplant, posed with Methodist’s 1,000th heart trans- plant recipient, TYLER WERTZ...... [ 2 ] AIMEE LIOU, M.D., a pediatric cardiolo- gist at TEXAS CHILDREN’S HOSPITAL, oversees a team of health professionals who knitted red hats for every baby with congeni- 1 tal heart disease at Texas Children’s Hospital. The team distributed the hats in February, in observance of Heart Month...... [ 3 ] MICHAEL C. LINN has been appointed chairman of the board at Texas Children’s Hospital...... [ 4 ] DIANA GRAIR, M.D., assistant professor in the department of family and community medicine at Baylor College of 3 4 2 Medicine, was named medical director of San José Clinic...... [ 5 ] Houston-area certified registered nurse anesthetists (CRNAs) celebrated NATIONAL CRNA WEEK in January at Cadillac Bar...... [ 6 ] MARGO MELCHOR, R.D.H., M.ED., ED.D., community outreach director for the School of Dentistry at UTHealth, has been appointed to the Texas State Board that regu- lates dentistry and dental hygiene...... [ 7 ] CARRIE L. BYINGTON, M.D., dean of the Texas A&M College of Medicine, senior vice president of the Texas A&M University Health Science Center and vice chancellor for health services at the Texas A&M University System, has been named a Fellow of the National Academy of Inventors...... 5 [ 8 ] DORIT DONOVIEL, PH.D., associate professor in the Center for Space Medicine at Baylor College of Medicine, has been named director of the Translational Research Institute for Space Health at Baylor...... [ 9 ] PEGGY SMITH, PH.D., professor of obstetrics and gynecology at Baylor College of Medicine, was honored with a Congressional Proclamation for her positive 6 7 8 9 impact on Houston teens and young adults as director of the Baylor Teen Health Clinic. Credit: Nos. 1, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 14 courtesy photos; No. 4, Allen S. Kramer, Texas Children’s Hospital; No. 13, Gary Fountain; No. 15, alexandersportraits.com
38 tmc» pulse | march 2018 [ 10 ] DANIEL MARTINEZ, who oversees the monthly distribution of TMC Pulse, stands beside the magazine’s new delivery van. Look for Martinez and the van in and around the medical center...... [ 11 ] PETER HOTEZ, M.D., PH.D., dean of the National School of Tropical Medicine at Baylor College of Medicine and Texas Children’s Hospital Endowed Chair in 10 11 12 Tropical Pediatrics, has been appointed as a representative of the U.S.-Israel Binational Science Foundation Board of Governors...... [ 12 ] DIMITRIOS P. KONTOYIANNIS, M.D., Texas 4000 Distinguished Endowed Professor in Infectious Diseases and deputy head research in the division of internal medicine at The University of Texas MD Anderson Cancer Center, is the 2018 recip- ient of the Award for Excellence in Clinical Microbiology and Infectious Diseases of the European Society of Clinical Microbiology and Infectious Diseases...... [ 13 ] Texas Medical Center President and CEO WILLIAM F. McKEON leads a keynote panel at the Healthcare Innovation Forum, featuring PETER PISTERS, M.D., president of The University of Texas MD Anderson Cancer Center; CHUCK STOKES, president and CEO of Memorial Hermann Health 13 System; and GIUSEPPE COLASURDO, M.D., president of The University of Texas Health Science Center at Houston...... [ 14 ] TOBY HAMILTON, M.D., exec- utive director of Healthcare Innovators Professional Society, will hold the nonprofit’s first event for members in the fall at the TMC INNOVATION INSTITUTE...... [ 15 ] ELIZABETH TRAVIS, PH.D., associate vice president of women and minority faculty inclusion at MD Anderson Cancer Center, presents GUILLERMINA “GIGI” LOZANO, PH.D., professor and chair in the department of genetics, division of basic science research at MD Anderson Cancer Center, with the Charles A. LeMaistre, M.D., Outstanding Achievement Award in Cancer.
14 15 DO YOU HAVE TMC PHOTOS YOU WOULD LIKE TO SHARE WITH PULSE? SUBMIT HIGH-RESOLUTION IMAGES TO: [email protected]
tmc» pulse | march 2018 39 Calendar FOR MORE EVENTS, VISIT TMC.edu/news/tmc-events
March 2018 “Head Space” is part of the BioRhythm: Music and the Body exhibit at The Health Museum, 1515 Hermann Dr., on display through July 31. 3/9 – 10 3/15 3/22 3/27 Houston Global Health Collabor- James T. Willerson, M.D., Third Annual O.H. “Bud” Frazier Friends of Nursing Luncheon ative GLOCAL Conference Cardiovascular Science Seminar: Transplant Roundup Conference and Fashion Show Friday, 12:30 – 7 p.m. “Dissecting Genomic and Thursday, 7 a.m. – 5 p.m. Tuesday, 11:30 a.m. Saturday, 8 a.m. – 6 p.m. Epigenetic Complexity in Houston Marriott River Oaks Country Club Rice University Heart Failure” Medical Center – Ballroom 1600 River Oaks Blvd. Jones Graduate School of Business Lecture by Yibin Wang, Ph.D. 6580 Fannin St. Register and purchase tickets at 1900 Rice Blvd. Thursday, 4 p.m. Free for students and SupportStLukes.org/Luncheon Tickets start at $20; register at Texas Heart Institute transplant physicians and staf. Tickets start at $500 eventbrite.com 6770 Bertner Ave. Tickets for external guests [email protected] [email protected] [email protected] start at $20; register at 832-355-5855 714-925-0257 832-355-9144 eventbrite.com [email protected] 713-882-0136 3/29 Ovarcome’s Seventh Annual REGISTER NOW Zeal for Teal Luncheon 3/24 Honoring women’s cancer survivors 5th Annual Texas Children’s Hospital Frontier Fiesta March for Marrow Thursday, 10:30 a.m. – 1:30 p.m. Advanced Practice Provider Conference 5k Run and Walk The Briar Club Saturday, 8 a.m. – noon 2603 Timmons Ln. University of Houston Free for cancer survivors. Lynn Eusan Park Tickets start at $25; register at 4450 University Dr. eventbrite.com Practicing Pediatric APRNs, Tickets start at $15; register at [email protected] PAs and graduate students aamdsif.salsalabs.org/m4mhouston2018 713-800-2976 are invited to join us for: [email protected] - Pharmacology: Variety of topics 512-589-3735 with practical applications in the community, includes Schedule II
- Skills Workshops: Suturing, Incision and Drainage, Line Placement and more
- Presentations: Autism, Asthma, Dermatology, Ethics, Food Allergies, Telemedicine and more
April 5-7, 2018 Texas Children’s Hospital Pavilion for Women Conference Center Houston, Texas
©2018 Texas Children’s Hospital. All rights reserved. Nurs109_012618
Agenda and additional information at texaschildrens.org/tchapp
40 tmc» pulse | march 2018
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