Barnes Hospital, St. Louis, Mo. April, 1984, Vol. XXXVIII, No. 4

Auxiliary celebrates 25th anniversary Twenty-five years of dedicated service and finan- cial support will be celebrated by the Barnes Hos- pital Auxiliary at its annual spring luncheon and business meeting April 26. Elaine Viets, a feature columnist with the St. Louis Post-Dispatch, will be the guest speaker.

The Auxiliary's annual meeting begins at 11 a.m., with a cash bar and the silver anniversary lun- cheon following. The event is being held at the Radisson Hotel, Ninth Street and Convention Plaza.

One of the afternoon's highlights will be the pre- sentation of a check by Auxiliary president Mary M Ann Fritschle to Barnes board of directors chair- man Harold E. Thayer representing the Auxiliary's final installment of a $1 million pledge, made in 1981, to help finance the construction of new trau- ma center facilities at Barnes. The Auxiliary has already donated $685,000 to the project, which should be completed in early 1985. Before: A blockage in a coronary artery cuts off the sup- After: A new drug, t-PA, moves directlym to the clot and Since its inception in 1959, the Auxiliary, frequent- ply of oxygen-rich blood to the heart muscle. A heart dissolves the blockage, re-establishing blood flow to ly named as the top such organization in the state, attack results. the heart muscle. has given $3,260,723.72 to Barnes. The Auxiliary makes its yearly donations to the hospital through its sponsorship of the Wishing Well Gift and Flower Drug researched here least two ways: (1) by harvesting a human tissue Shops, Nearly New Shop, Tribute Fund and Baby culture system through a lengthy and expensive Photo Service. The 665-member Auxiliary also may prevent heart attack process of extraction and purification (to produce coordinates the hospital's highly successful volun- the amount of t-PA necessary to treat one heart A new drug, tissue plasminogen activator (t-PA), teer services program, whose 460 volunteers pro- attack victim, two technicians must work full-time vided 50,809 hours of service in 1983. researched by Barnes Hospital/Washington Uni- over three to four weeks); (2) by genetically en- versity School of Medicine staff members, may gineering it through a process developed last year. save as many as 100,000 to 200,000 lives each year in the United States alone by dissolving the T-PA dissolves a blood clot which is causing a 1983 Annual Report biood clots which cause heart attacks, according heart attack. Administered intravenously, during highlights mission to a published report in the March 8 issue of The the early stages (the first one to two hours) of an New England Journal of Medicine. attack, it circulates in the bloodstream but is, in Barnes' 1983 Annual Report, published this biological terms, relatively inactive until it comes month, highlights the sweeping changes in tech- Last September, Barnes/WU researchers received into contact with a clot. There it activates the nology and the delivery of health care that have FDA approval to conduct the world's first clinical body's natural clot-dissolving reaction in the imme- occurred during the past year and outlines the ad- trial of t-PA on human patients in the early stages diate vicinity of the clot, thus stopping the attack, vances that are enabling Barnes to continue ful- of heart attack. In six of seven patients studied, usually within seven to 30 minutes after injection. filling its mission as one of the world's pre-eminent t-PA stopped the attack within minutes by dissolv- Blood flow resumes to areas beyond the clot de- providers of health care. ing the blood clot that was causing it and restoring prived of blood during the attack. blood flow to the tissue beyond, without putting the The report also describes Barnes' role as a na- patient at risk of bleeding elsewhere in the body. T-PA may become an important form of early treat- tional resource for health care and education and ment for suspected or incipient heart attack pa- the institution's increasing responsibility as a major For several years, Barnes Hospital and Washing- tients. It dissolves the clot selectively, without pro- midwestern referral center. It is divided into seven ton University School of Medicine have played a ducing a tendency to bleeding elsewhere in the major sections, including technology, cancer ther- critical role in t-PA research. The center is the first body ("systemic lytic state"). Streptokinase and apy, VIP services, facilities, community outreach, in the world at which t-PA was used to dissolve urokinase, two other clot-dissolving drugs, both people/finances and future plans. clots causing heart attacks in animals. It is also the produce a systemic lytic state and therefore put Nuclear magnetic resonance, ophthalmology's first, in collaboration with a Belgian center, at the patient at risk of serious bleeding. And with its YAG laser, chemonucleolysis for dissolving herni- which the drug was used on human patients. It is low risk, emergency personnel, even heart disease ated discs in the lumbar spine, percutaneous the first to publish work which reported that genet- patients themselves, may ultimately inject t-PA nephrolithotripsy or the use of ultrasound to re- ically engineered t-PA had dissolved coronary ar- when a heart attack is suspected. tery clots in animals. The center is participating in move kidney stones, microsurgery and strepto- on-going clinical studies of t-PA, in combination It is possible, researchers say, that of the 400,000 kinase/t-PA infusion to reduce the amount of heart with other centers and with the National Institutes to 500,000 deaths from heart attack in the U.S. tissue muscle death during heart attack are just of Health. each year, some 100,000 to 200,000 lives might some of the technological advances, many of be saved through t-PA. For some patients, other which have been partially developed here, that are T-PA is an enzyme naturally occurring in the cells forms of treatment will still be required. But even a giving Barnes patients new hope for a normal life that line blood vessels. It can be produced in at cautious evaluation indicates that "in the relatively and are capsulized in the 1983 Annual Report. near future, t-PA will become part of general med- ical practice in the treatment of heart attack. It The report also features the multitude of advances Front cover: In the fight against cancer, new laboratory should definitely save the lives of many patients," that have taken place here in cancer therapy, in- techniques are enabling doctors to detect disease cluding the liver pump, which allows potent can- sooner and diagnose it more accurately, while medical says Dr. Burton E. Sobel, Barnes Hospital cardi- ologist-in-chief and director of the cardiovascular cer-fighting drugs to be infused directly into the and surgical advances in cancer treatment and man- liver, Moh's chemosurgery for facial cancers, agement are giving many victims hope for a cure. (See division at Washington University School of Medi- centerspread.) cine. (continued on page 2) emotional support and information during their Annual Report hospitalization for mastectomy, the surgical re- (continued from page 1) moval or partial removal of the diseased breast. nerve-sparing prostate surgery that preserves po- tency in men with bladder or prostate cancer, During this critical time, volunteers, all former mas- hyperthermia for superficial tumors of the head tectomy patients who have received special train- and neck, breast or chest wall and new tech- ing from the ACS, visit patients and share their re- **m niques in surgical pathology that are detecting lated experiences. Information is also given on v cancer sooner and more precisely than previously breast prosthesis, shopping for clothes, exercise nT * possible. and other tips. Patients are referred to RTR volun- teers by their doctors. ^^ Statistics in the Annual Report show that 37,276 S.H.A.R.E. (Support Has A Reinforcing Effect) is a patients were admitted resulting in an occupancy breast cancer support group that was started at rate of 82.35 percent for the hospital's 1,158 beds m Barnes in 1981 and provides ongoing support in use. (Barnes holds licensure for 1,208 beds.) through monthly meetings, newsletters, small in- Barnes also had 31,620 emergency department formal group sessions, a hotline and a lending - visits; 29,392 surgical procedures (up from 28,977 Ms i/JM library. Two S.H.A.R.E. publications, "Coping with in 1982) and 2,792 babies delivered. The total bud- ■ Breast Cancer—Strategies for Dealing with the get for 1983 was $188,667,660. Limitations, Problems and Discomforts of Breast Cancer" and "Breast Cancer Resources for Pa- Wages and benefits accounted for 49 cents of tients and Families" are also available, while car- every dollar, while 32 cents of each dollar was pool and mailing services provide transportation to spent on medicines and supplies. Other expenses and from meetings and keep those unable to at- IK include food, insurance, repairs, depreciation, tend meetings in touch. John Keppel retires after 30 years of service maintenance and utilities. S.H.A.R.E. members also sponsor an annual Since Barnes receives no government or tax sup- breast cancer educational conference that fea- port, the hospital's inpatients constitute its major Keppel, Telthorst, tures speakers from the medical profession and, source of income, contributing 83 cents of every along with RTR volunteers, they are actively in- Thurman retire dollar of revenue. Other sources of income in- volved in community health fairs. clude interest, gifts, clinic outpatient revenues, pri- Patient accounts director John Keppel, Jr., assis- vate outpatient revenues and sales to other insti- tant administrator Don Telthorst and safety and "S.H.A.R.E. helps women deal with many sensi- employee health director Edward J. Thurman re- tutions. tive and highly personal things such as relating to tired recently from Barnes with a combined total of children or dealing with their self-image and sex- Copies of the 1983 Annual Report are available more than 70 years of service. All three received uality after mastectomy," said Karen Greening, a certificates of appreciation for their years of dedi- from the public relations department, 362-5290. Barnes oncology social worker who serves as the cation and service. The complete audited financial statement may be group's advisor. "I've seen women come into the obtained from the controller's office, 362-5592. group crying because they couldn't cope and three Mr. Keppel, who retired February 25, first joined months later they are serving as one of its Barnes in 1946 as an accounting trainee. He left leaders." the hospital briefly in 1950, only to return in 1951 as chief cashier. In 1957, he was promoted to There are no dues for membership in S.H.A.R.E. credit manager. Later, the position title was It is supported through the voluntary donations of changed to director of patient accounts. its members and grants from various companies and societies. Many family members have also do- Mr. Keppel has always been an active member of nated to S.H.A.R.E. through Barnes' development numerous professional organizations, many of office. which he has served as president or in other lead- Seven other breast cancer support groups, in- ership roles. He has been a charter member of the cluding three in Illinois, have grown from Society of Certified Consumer Credit Executives S.H.A.R.E., whose stated purpose is "to improve since 1967 and served as the group's president the quality of life for persons with breast cancer from 1976-1977. He has also served as chairman through education and mutual support." of the International Consumer Credit Association and received its Distinguished Service Award in There are currently about 50 active members in 1971. He is currently serving on the ICCA's board Barnes' S.H.A.R.E. chapter, while more than 200 of directors. are in the group's mailing list, according to Mrs. Greening. The next S.H.A.R.E. meeting, marking Don Telthorst, assistant administrator-facilities, re- the group's third anniversary, begins at 7 p.m., tired January 27 after 20 years of service to April 26, in the fourth floor classroom of the Rand- Barnes. Mr. Telthorst had been in Barnes' employ Johnson building at Barnes. (Meetings are always since August of 1963, when he joined the hospital held the fourth Thursday of the month.) as an executive assistant.

S.H.A.R.E. coordinator Karen Greening For more information about S.H.A.R.E., contact Throughout the years, Mr. Telthorst held numer- Mrs. Greening at 362-5585. For more information ous administrative positions, many of which in- about Reach to Recovery, call 362-5326. cluded responsibilities for purchasing and long- Support groups offer range planning for future building needs. During hope to cancer victims his tenure with Barnes, he was involved in several construction projects, including the East and West Breast cancer. It is an insidious disease that often Barnes fact cards Pavilions, which were completed in 1974 and strikes women in the prime of their lives and is the 1980, respectively. leader in cancer-related deaths in women in the now available in PR United States. Although early diagnosis and treat- Barnes Hospital Facts, a wallet-size card printed Safety and employee health director Ed Thurman ment are assuring more of its victims a physical with 1983 statistics, is now available from the pub- retired March 16 after nearly 20 years of service to victory over the disease, the individual's emotion- lic relations department. The cards answer such Barnes. A safety engineer, Mr. Thurman first al, psychological and sociological recovery may commonly asked questions about Barnes as how joined the hospital in 1964 as director of safety and often lag far behind in terms of progress. many beds, admissions per year, patient days per security. His responsibilities at that time included year, occupancy rate, room rates, average length the writing, implementation and enforcement of At Barnes, many women who are struggling to of stay and the 1984 operating expense budget. fire, employee, visitor and patient safety and se- cope with breast cancer and the emotional devas- curity programs and policies. tation that can accompany it are finding renewed The card also includes annual statistics concern- hope through two breast cancer support groups: ing the number of operating rooms, deliveries, Mr. Thurman served in that capacity until 1974, Reach To Recovery and S.H.A.R.E. operating room procedures, emergency visits, and when he was named director of safety/employee number of doctors, residents and interns on staff. health, and security became a separate depart- Reach To Recovery (RTR), a joint project of the To obtain a fact card, stop by the public relations ment. His responsibilities have included the devel- American Cancer Society and the hospital's volun- department, ground floor Queeny Tower, or call opment of the hospital's Risk Management Pro- teer department, provides breast cancer patients 362-5290. gram, which has been in operation since 1976. Barnes sponsors surgical procedures were performed in Barnes op- erating rooms.) In addition, there will be two oper- Cardiology Update '84 ating areas specifically for oral surgery and 11 diagnostic/treatment rooms for the radiology ser- Barnes cardiologists, radiologists and cardio- thoracic surgeons, in cooperation with the hos- vice, which is run by the Mallinckrodt Institute of pital's department of education and training, are Radiology. Anesthesiology, pathology and ex- sponsoring "Cardiology Update '84"—a May 4-5 panded rehabilitation services will also be provided with the opening of the new facility. conference for practicing physicians that is focus- ing on the latest technological advances in car- diovascular disease care. Patient care areas are also being increased, in- cluding 22 intensive care beds (up from the current The conference's course of study has been divided 13) and 52 neonatal intensive care beds (which almost doubles the existing number). Additional into three major areas, including modification of provisions for patient and parent comfort include infarct size, advances in non-invasive imaging and electrophysiologic study and therapy. Application parent sleeping space in all patient rooms and in- room toilet facilities. in the clinical setting will be emphasized. Discus- sion times and informal luncheons are scheduled The emergency room and outpatient clinic areas to complement the presentations and to aid doc- have also been expanded, while access to the tors in managing their patients' individual prob- lems. hospital is being improved through the addition of a heliport that will serve the entire Washington University Medical Center. The new hospital has "Cardiology Update '84" speakers, all of whom an all-weather link to Barnes and the rest of the serve on the Barnes/WU medical staff, include medical center and has a structural capacity for Drs. Daniel R. Biello, radiologist (nuclear medi- future expansion to one million square feet. The cine); Michael E. Cain, cardiologist and director new hospital's annual budget is $46 million. of the Clinical Electrophysiology Laboratory; James L. Cox, cardiothoracic surgeon-in-chief and CCU director Dr. Allan Jaffe explains the advantages of head of the WUMS division of cardiothoracic sur- the external pacemaker. Swedish consultants gery; Edward M. Geltman, program chairman and medical director of the Cardiac Diagnostic Labora- observe QCCs here tory (CDL); Fernando R. Gutierrez, cardiac radi- CCU's external Consultants from a firm in Storfors, Sweden, spent ologist; Allan S. Jaffe, medical director of the Car- a day at Barnes last month, discussing and ob- diac Care Unit; Robert G. Levitt, radiologist; Julio pacemaker is area first serving the hospital's Quality Control Circle (QCC) E. Perez, assistant medical director of the CDL; Patients in Barnes Cardiac Care Unit (CCU) now program, which was started here in 1981 as a Kenneth E. Shafer, cardiology fellow and Barnes benefit from a new external pacemaker that can means of improving employee morale and produc- chief resident in medicine; Burton E. Sobel, car- stimulate cardiac activity through leads placed on tivity by encouraging problem solving at the "grass diologist-in-chief and director of cardiovascular the chest during the critical period just prior to roots" level. medicine for WUMS. invasive pacemaker placement or other kinds of therapies, according to Dr. Allan S. Jaffe, CCU di- The Swedish consultants, whose firm, EKAB, has In addition to the medical conference, "Cardiol- rector. installed approximately 800 QCCs in 40 com- ogy Update '84" also includes a program for the panies in Sweden, Finland, Norway, Belgium and doctors' spouses. Tours through the Missouri Bo- The pacemaker, the first of its kind in St. Louis, is Ireland, journeyed to Barnes to learn first-hand tanical Gardens (Shaw's Garden), St. Louis Art used short-term, anywhere from 30 minutes to how QCCs can function in the hospital setting. Museum and the St. Louis Mississippi Riverfront more than an hour, according to Dr. Jaffe, to sta- Barnes was one of the first health care institutions (including the Arch and Laclede's Landing), plus bilize the condition of a patient whose heart rate is to establish a QCC program. shopping at either Plaza Frontenac or Maryland life-threateningly slow. Plaza highlight the spouses' program, which also features a special fashion presentation. "We can use the external pacemaker on patients Burn patient group who are suffering from a slow heart rate and are Fees for the conference are $100 (physician only) acutely ill because of it," says Dr. Jaffe. "More sponsors Alarms for Life and $150 (physician and spouse) and include en- definitive types of therapies, such as pacemaker Members of Barnes burn patient support group, rollment, instructional materials, a hotel room re- placement, take time—less than half an hour here, Dealing With Feelings, have initiated a fundraising served at Queeny Tower (located within the hos- but much longer at institutions that do not have the campaign to purchase and donate 1,000 smoke pital complex) or the nearby Chase Park Plaza, same rapid access to cardiac support that Barnes detectors to the St. Louis City Fire Department for meals, Friday social hour, parking, transportation provides. Treatment during this interim period can eventual installation in the homes of the area's and entrance fees for spouses' activities, plus be critical to the patient's recovery." poor and elderly. tickets to the Fox Theatre's presentation of "42nd Street" on May 4. The external pacemaker is seldom used at Barnes The group, which is composed of recovered burn for more than an hour, according to Dr. Jaffe, as patients from Barnes Burn Center, hopes that the The registration deadline is April 16; registration the electric currents flowing through the chest program, called Alarms for Life, will have a signifi- will be confirmed within two weeks of receipt. All muscle wall to the heart cause uncomfortable cant impact on burn prevention. "We feel that conference fees are tax deductible and applica- muscle twitching and some pain. "It's not some- Alarms for Life will save lives," says Sara tion has been made for CME credit. For more in- thing you would want to use long-term," comments Schmeer, Burn Center social worker and the formation, call the department of education and Dr. Jaffe, "but it's very useful during that interim group's coordinator. "Our members are strongly training, (314) 362-5250. period." committed to the prevention of bum-related in- juries and deaths." An abnormally slow heart rate can be caused by Barnes dietitian honored any one of a number of factors, including heart at- The city's poor and elderly have been targeted to tack or conducting system disease. receive the alarms because recent studies have by state organization shown that they are the most susceptible to the Linda Gobberdiel, director of clinical dietetics for threat of accidental fire. "It is well established that the food and nutrition department at Barnes Hos- New Children's Hospital the poor and elderly have a high rate of fire deaths pital, will receive the Recognized Young Dietitian and are less likely to have smoke detectors than of the Year Award for 1984 during the Missouri opens this month are higher income families or younger people," Dietetic Association's annual meeting April 26-27 Patients will begin moving this month into the new says Ms. Schmeer. "It is also well established that in Kansas City, Missouri. $84 million Children's Hospital, which is located fire deaths in residences have declined as smoke adjacent to Barnes on a 2.5 acre site bounded by detector usage has increased." Ms. Gobberdiel was selected by the organization's Kingshighway, Audubon, Euclid and Parkview executive board in recognition of her contributions Avenues. The 500,000 square foot facility will Tax-deductible donations are now being accepted to the profession as well as to the state and dis- house 235-beds and will more than double the for the Alarms for Life program. (Make checks pay- trict dietetic associations. She has served on space of the existing structure. able to Barnes Hospital/Alarms for Life.) Donations Barnes staff since 1978 and holds a bachelor of should be sent c/o Sara Schmeer, Barnes Hos- science degree in medical dietetics from the Uni- The new facility will also feature eight operating pital, Barnes Hospital Plaza, St. Louis, Missouri, versity of Missouri—Columbia and a master of art rooms and support space that includes a 12-bed 63110. For more information call Ms. Schmeer at degree in management from Webster University. recovery area. (Previously, all Children's Hospital 362-1025. Cancer Care

Ask anyone about state-of-the-art care in cancer tians, social workers and chaplains and others this cooperative spirit is being carefully orches- and a few institutions leap instantly into mind. intricately involved in the care of cancer patients trated and facilitated through specially formed The Mayo Clinic, Memorial Sloan-Kettering and yields an interchange of knowledge and expertise committees and task forces within the hospital M.D. Anderson are a few commonly expressed ex- that is winning the fight against this dreaded dis- structure. amples. Yet, here in St. Louis, buried in the heart ease. of America, is perhaps one of the best kept "se- The Barnes Hospital Cancer Committee and Tu- crets" of the medical world when it comes to can- "A team approach to treating cancer patients is es- mor Registry, both initiated in 1980, are two such cer research, diagnosis, treatment and prevention: sential," says Dr. Jay Marion, Barnes/WU oncolo- forces that are fostering a coordinated, multi-dis- Barnes Hospital and the Washington University gist. "Most people who take care of cancer pa- ciplinary approach to cancer care at Barnes. The School of Medicine. tients are more than just technicians; there is sim- Cancer Committee, whose members include rep- ply too much to the disease to be that one-sided. resentatives from all medical/surgical specialties, "Barnes rivals the more famous cancer hospitals Even just saying the word 'cancer' has a strong nursing and ancillary services, is prompting in- as a complete, comprehensive cancer center, and psychological impact. Consequently, there has to terdepartmental communication and the sharing of Washington University's total biomedical research be a strong interaction between doctors, surgeons, information through quarterly symposiums on the activities are among the largest in the world," says social workers, nurses, psychiatrists, psycholo- latest advances in treating various forms of cancer. Dr. David M. Kipnis, Barnes physician-in-chief and gists, husbands, brothers, in-laws—anyone who Topics covered within the last year include cancer head of the department of medicine for WUMS. says, 'Yes, I have a key to this person's psyche, I of the breast, prostate, chest and, coming in May, understand, I can help.'" non-Hodgkins lymphoma. But what makes Barnes or any other hospital a true cancer center? A team approach to care At a large institution such as Barnes, with over The Tumor Registry, on the other hand, acts as where cooperation between researchers and clini- 1,000 doctors on the attending staff representing the statistical basis for the Cancer Committee and cians, physicians and surgeons, nurses and dieti- all medical/surgical specialties and subspecialties, aids clinicians and researchers by providing more

INLET SEPTUM NEEDLE STOP

OUTLET FLOW RESTRICTOR

NEEDLE STOP BELLOWS OUTLET CATHETER CHARGING FLUID CHAMBER

CROSS SECTION MODEL 400

The implantable liver pump injects cancer-fighting drugs directly into the liver and can dou- ble or triple the life expectancy of patients with this kind of cancer.

"You have to be more than just a technician," says Dr. Jay Marion, oncol- ogist. "You have to consider patients' psychological needs as well." accurate and detailed information on cancer pa- tients, whose immune systems have been weak- tients treated at Barnes and throughout the state. ened temporarily through the high dose chemo- The Tumor Registry is currently following 6,053 therapy and radiation treatments that are given as patients on an annual basis. As many as 8,402 pa- part of bone marrow transplant therapy. Special tients have been entered into the registry since its air filters trap 99.97 percent of the bacteria, molds inception nearly four years ago. and viruses normally circulating through the air, while window and door seals and positive air pres- "The primary advantage of the registry is going to sure act further to prevent contamination. This be the information it will yield through careful, long- added protection is particularly important as one term follow-up of individual patients concerning of the biggest risks for BMT patients is infection, the effectiveness of various treatments," says especially during the first few weeks following the Judy Herron, medical records assistant director procedure as the body begins rebuilding its de- and Tumor Registry coordinator. fenses with the healthy marrow.

In addition to the Cancer Committee and Tumor In addition to breakthroughs in treatment, the good Registry, several patient education subcommittees news in cancer care today is that the earlier it is for oncology nursing divisions meet regularly to detected and the more precisely it is diagnosed, plan methods to increase the patient's understand- the better are the patient's chances for a cure. ing of cancer and to improve each individual's Barnes' surgical pathology lab is utilizing new tech- ability to cope with a frightening and often debili- niques to help oncologists diagnose the exact type tating disease. The social work department, whose of tumor and determine its primary site, differenti- comprehensive discharge planning ensures that ate between malignant and benign inflammatory patients receive the best and least stressful fol- processes and categorize other aspects of hard- low-up care, also provides in-hospital counseling to-detect forms of cancer. The information gar- and referrals for patients and their families. Barnes nered through such sophisticated procedures is patients are also benefiting from the numerous enabling doctors to plan more effective treatment self-help groups in action here that provide emo- strategies and is improving the prognosis for many tional support and inspiration, as well as informa- patients. tion on the latest advances in diagnosis and treat- ment. Surgical pathology is also examining genetic de- fects that express themselves in endocrine abnor- Providing nursing care for cancer patients requires malities that predispose an individual to certain tu- special expertise not only in administering chemo- mors. With these new methods, doctors will be therapy and other technological aspects of render- able to detect the family member at risk before the ing care, but in dealing with the psychological im- tumor actually appears. plications of the disease as well. Barnes oncology Oncology nurse specialist Mary Dyer teaches cancer nurses, led by oncology nurse specialist Mary patient George E. Sobottka how to care for his catheter Through this vast commingling of pioneering re- Dyer, receive extensive in-hospital education and in preparation for his discharge from Barnes. search, innovative clinical trials and treatment, training in all aspects of cancer care and are widely educational committees and symposiums, and the respected as ranking among the best in this highly work of the various medical/surgical specialties specialized area of nursing. pump" to treat liver cancer, one of the most deadly and ancillary services and departments, world- forms of metastasis, for example. Preliminary find- class cancer care emerges that is at the forefront Barnes cancer patients also benefit from the hos- ings show that the implantable pump, which allows of medicine. Yet, it is the personal care and con- pital's affiliation with the Washington University potent cancer-fighting drugs to be infused directly cern received that blends this wealth of profession- School of Medicine, one of the nation's finest med- into the liver, can double or triple the life expectan- al expertise into a positive, as well as healthy, ex- ical schools. This close association helps bridge cy of these patients. perience for Barnes patients and their families. the gap that often exists between researchers and clinicians and reduces the lag time between the Other breakthroughs in cancer treatment available development of new therapies or procedures in the at Barnes, and in some cases, pioneered here, laboratory and actual patient use. include Mohs' chemosurgery, which has raised the cure rate for certain facial cancers from 50 percent Barnes was among a limited number of hospitals to 98 or 99 percent; nerve-sparing prostate sur- participating in the investigational use of the "liver gery, available at only one other hospital in the United States, that preserves potency in men with bladder or prostate cancer; immunotherapy with BCG, a weak form of a tuberculosis vaccine widely used in Europe, for superficial (surface) bladder cancer—a treatment offered in only three cities other than St. Louis; hyperthermia, or the use of extreme heat to kill cancer cells in tumors of the head, neck, breast or chest wall; new interdisciplin- ary surgical techniques for removing life-threaten- ing tumors involving both the brain and the neck or ear.

Barnes/WU is also breaking ground in the treat- ment of leukemia and certain lymphomas through autologous and allogeneic bone marrow trans- plants. Barnes is one of four or five centers in the United States performing autologous transplants, in which the patient's marrow is removed during a time of disease remission, treated with cancer- NMR can detect tumors and lesions without posing any fighting drugs, frozen, stored and then returned if risk or pain to the patient. Unlike CT, an intravenous in- the cancer recurs. The procedure, still considered jection of contrast material and exposure to x-rays are experimental, is improving the prognosis for pa- not necessary. In this NMR scan, a benign tumor com- tients with acute lymphocytic leukemia, acute non- posed of fat cells is clearly shown in the left thigh. (To lymphocytic leukemia, Hodgkin's disease and non- viewer's right.) Hodgkin's lymphoma—diseases against which more conventional therapies have proved largely ineffective.

Such patients' chances for remission or cure are also being enhanced through the hospital's 12-bed New lab procedures are helping doctors diagnose bone marrow transplant unit, which opened in hard-to-detect cancers and to plan more effective treat- 1983. The unit provides a protective environment ment. and highly specialized nursing care for these pa- died recently after spending nearly all of his life in a also been invited to be the co-chairman of the An- protective "bubble" for a February 23 segment on nual Ophthalmology Meeting of Hadassah Hos- KTVI with medical reporter Kathryn Pratt. pital June 14-15 in Jerusalem, Israel, and is re- sponsible for that meeting's American and Euro- Also on February 23, Dr. Lawrence Samuels, pean speakers. Barnes/WU dermatologist, was interviewed by KMOX reporter Debbie Faubian for a February 23 Dr. Eli Robins, Barnes/WU psychiatrist, has been segment on tanning beds. elected to honor membership of the St. Louis Metropolitan Medical Society. Radio Physicians Radio Network interviewed Dr. Alan Dr. Allan Kolker, Barnes/WU ophthalmologist, Tiefenbrunn, Barnes/WU cardiologist, about t-PA, was a guest speaker at the Royal Australian Con- a new drug studied here that may change heart gress of Ophthalmology in Adelaide, South Aus- attack treatment. tralia, where he addressed the scientific session of the Congress on Laser Surgery in Glaucoma and Sleep apnea was the subject of a KMOX radio seg- served as visiting professor at the Prince of Wales ment with announcer Jack Carney and KMOX-TV Hospital in Sydney. anchorman Julius Hunter. Dr. Donald G. Ses- sions, Barnes/WU otolaryngologist, was inter- Miriam Elizabeth Luetje, a first level student at viewed. Mr. Hunter was a recent patient at Barnes the Barnes Hospital School of Nursing, has been and was surgically treated for the syndrome, in nominated to serve on the National Advisory which the victim's breathing stops occasionally for Council on Nurse Training. A graduate of McCluer short periods of time when sleeping. North High School in Florissant, Missouri, she is currently serving as student government vice- Headaches, their causes, prevention and cure, president for Barnes School of Nursing and is a Dr. Burton Sobel announces the results of clinical re- were discussed by Dr. Stuart Weiss, Barnes/WU member of the Student Nurses' Association. search performed here proving that a new drug called neurologist, for a February 22 segment on KMOX. t-PA can halt the progress of a heart attack and may Dr. Willard B. Walker, Barnes/WU surgeon, has even prevent one. Dr. James L. Cox, Barnes cardiothoracic sur- been elected vice-president of the Gateway Vas- geon-in-chief and head of the division of cardio- cular Society of St. Louis. Dr. Gregorio A. Sicard, thoracic surgery for WUMS, was a guest on Barnes/WU surgeon, has been appointed to the Media spotlight KMOX's "Doctor to Doctor" program February 20. society's council. As a national leader in patient care and medical re- Dr. Cox's subject was open-heart surgery. search, Barnes also serves as an information re- Dr. Barry A. Siegel, Barnes/WU radiologist and source center. In 1983, more than 900 queries Vitamins and cancer was the subject of a February director of the division of nuclear medicine, has from broadcast and print media representatives 19 interview between Dr. Gary A. Ratkin, Barnes/ been appointed an American Medical Association were made to the hospital requesting that Barnes WU oncologist, and KMOX's Art Fleming. (AMA) representative on the Residency Review medical and professional staff elucidate current Committee for Nuclear Medicine. health care concerns and discoveries. Highlights Print of the media's coverage of Barnes during the last Dr. Paul M. Lacy, Barnes pathologist-in-chief and month include: head of the department of pathology for WUMS, Social work hosts was featured in an in-depth article in the Chicago Television Tribune's "Tempo" section titled "The cure for open-house April 24 Barnes' participation in the Girl Scout Council of diabetes: Is it within medicine's grasp?" The arti- About 75 administrators and directors from local Greater St. Louis' annual "recruiting" drive of area cle, last in a five-part series on diabetes, discussed skilled nursing and interim care facilities will tour newborns was featured on a KMOX segment Dr. Lacy's pioneering work in transplanting the Barnes and attend an open-house hosted by the March 11 with Robyn Smith. All baby girls born at Islets of Langerhans—pancreatic cells that pro- social work department from 2 to 4 p.m., April 24. Barnes between March 11-17 received free T- duce insulin. Dr. David W. Scharp, Barnes/WU The open-house is being sponsored by social work shirts, which read "Future Girl Scout," from the or- general surgeon, was also interviewed. to help expedite discharges to such facilities ganization. through better communication, according to Kim Orr, orthopedic social worker and program coor- Significant clinical research findings of a new drug, Non-Hodgkin's lymphoma dinator. tissue plasminogen activator (t-PA), that can stop a heart attack within minutes by dissolving the subject of symposium "With the implementation of DRGs (legislation that blood clot that was causing it, was the subject of a Non-Hodgkin's lymphoma and the latest advances reimburses hospitals according to a fixed rate, March 8 press conference held at Barnes which in its diagnosis and treatment will be discussed rather than according to costs incurred), discharge generated segments on KMOX, KSDK, KTVI and during a multidisciplinary symposium for the hos- planning for all patients becomes even more im- KPLR. Dr. Burton Sobel, Barnes cardiologist-in- pital's medical and professional staff beginning at portant," says Ms. Orr. "Through the open-house, chief and director of the cardiovascular division 5 p.m., May 16, in the East Pavilion auditorium. we're hoping to establish a contact person at each at WUMS, Dr. Alan Tiefenbrunn and Dr. Philip facility that will enable us to help patients plan their Ludbrook, Barnes/WU cardiologists, discussed Speakers from the Barnes-WU staff include Drs. follow-up care more efficiently and effectively." their findings, which may have a major impact on Rogers Griffith, surgical pathologist; Geoffrey P. heart attack treatment and, eventually, preven- Herzig, medical director of Barnes bone marrow tion. transplant unit; Todd H. Wasserman, radiation Speaking of health . . . oncologist, and Judy Herron, medical records as- Also on March 8, Dr. Gerald A. Wolff, Barnes/WU sistant director and coordinator of the hospital's ... get a personal physician while you're well. A cardiologist, discussed on KSDK the importance of Tumor Registry. Dr. Jay M. Marion, Barnes/WU personal physician takes care of your body. He or a cooling-off period following strenuous exercise. oncologist, will be the symposium's moderator. she may be a general family practitioner, internist, The cooling-off period is essential, according to Dr. pediatrician or an obstetrician/gynecologist. He Wolff, because the body needs time to gradually will understand your total health and refer you to reduce the build-up of certain chemicals associ- another specialist when necessary. ated with the fight or flight instinct that occurs dur- Hospital notes ing exercise. The following doctors are reported on staff: Theo- Having a personal physician can help you save dore M. Meiners, assistant obstetrician/gynecolo- money in many ways. He knows and understands Dr. Jerome M. Aronberg, Barnes/WU dermatolo- gist, effective January 1, 1984; Jeffrey D. Mil- your medical history and, through this relationship, gist and president of the St. Louis Dermatological brandt, assistant pathologist, effective October 1, he can often suggest ways to prevent illness or Society, discussed accutane—a relatively new, 1983; John Carl Morris, assistant neurologist, minimize its effects, financially as well as phys- highly successful treatment for severe acne, with effective February 1, 1984; Karen J. Pentella, as- ically. Dr. John Daniels, Barnes/WU internist and KSDK sistant neurologist, effective January 1, 1984. medical reporter, for a March 6 segment. You should think of your primary care physician as Dr. Jack Hartstein, Barnes/WU ophthalmologist, your health "manager." Plan ahead—it will save Dr. Jay M. Marion, Barnes/WU oncologist, dis- has been invited to be a guest speaker at the 24th you money, and maybe your life. For a physician cussed advances in bone marrow transplant ther- Annual Meeting of the Rudolph Ellender Contact referral or for help in getting a second opinion, call apy and the use of the procedure in treating rare Lens Meeting May 24-26 in New Orleans, Louisi- 362-2255 (St. Louis area). Toll-free numbers are disorders such as the complete immune deficiency ana, and the World's Fair of Ophthalmology Meet- also available for outstate Missouri (1-800-392- suffered by David, the 12-year-old Texas boy who ing June 28-July 1, also in New Orleans. He has 0936) and surrounding states (1-800-325-0737). IN HONOR OF: Eye clinic screens Barnes Hospital Recovery of Dr. Harry Malinee Srutanond Morgan nursing home residents Tillie & Frances Nornberg Who says doctors don't make house calls any- Sunny Poinsett and the more? On March 5, two doctors and a registered Barnes Hospital Physician Barnes Hospital Auxiliary Referral Service Sally Friedman nurse from Barnes eye clinic traveled 90 miles to M/M John Warmbrodt The Baptist Home in Ironton, Missouri, to perform complete eye exams on about 30 of the approxi- mately 200 elderly residents there. Barnes Annual Fund

Carl W. Adams Milton Hull The eye clinic staffers made the "house call" as Joseph Anselmo M/M Willie Jackson part of a new arrangement with the home, which Marguerite Bartok M/M Harry Kay previously transported its residents to Barnes as Thelma A. Basford Albert Kern many as five times a week in a six-passenger van. Eleanor L. Begley M/M H. W. Knapheide, Jr. Dixie Blanch Pete & Carol Mannisi The eye screenings, which cost the same as regu- Lucille C. Boykin Susie McKinney lar clinic visits, will continue on a monthly or bi- Vivian F. Bristol Raymond McCormick monthly basis, depending upon the home's needs, Ruth Burris Icie McNeal according to Carol Smith, eye clinic head nurse. Charlene V. Byrd Leota Newman Emil Carabelli Dorothy O. Reynolds Andrew Carosy Margaret H. Riley "Our staff members will be performing complete Clara Dworzynski Lawrence Rogaliner eye exams, including glaucoma and vision checks, Troy & Geneva Eye Emil A. Schwarz as well as writing prescriptions for eye glasses," Suzanne Lasky and Dr. Loeb shake hands after unveil- M/M Joseph Floret Lester Smissman says Mrs. Smith. A portable slit-lamp will be used ing a plaque commemorating Alvin N. Lasky. Hattie Franklin L. Bert Swartz for examining the anterior and posterior portions of Gretchen C. Ganschinietz George H. Wiehe, Jr. Opal Glandt the inner eye chambers. "It's a mutually beneficial Ceremonies celebrate M/M Peter A. Gross IN MEMORY OF: arrangement," says Mrs. Smith. "We'll be saving (for Cardiac Research) Francis Black them time and money, and we'll be able to screen Alvin Lasky's life, Cindy Gubin Helen Laura L. Black and treat more of their residents." Gordie & Cindy Gubin open new service Steve Hecinski Andrew F. Gazdik Carl R. Henry Margaret L. Gazdik In ceremonies March 9, a plaque was unveiled in John V. Holcombrink Patient expresses thanks the new outpatient transfusion facility on the third for care received floor of Barnes, commemorating the life of Alvin N. Lasky, a cancer patient who died here in 1982, and Patient Care Fund George A. Thompson, a recent patient on Barnes honoring his family and friends, whose generous Joyce Allen Quintin A. Siemer orthopedic surgery floors, wrote the following let- contributions made the facility possible. Edward F. Brandes M/M Kenneth G. Waller ter in appreciation of the care he received during Cecil C. Clausen Celia Wilson his long hospitalization. Mr. Lasky's widow, Suzanne, assisted by hospital M/M John Daniel, Sr. Lilly Woolsey president Robert E. Frank and Dr. Virgil Loeb, Jr., M/M Orren H. Freeman M/M Jack Gelso I was admitted to your hospital for three months in the Barnes/WU oncologist who treated Mr. Lasky, IN MEMORY OF: 1982, and for four months in 1983 after being in a Mary Grubisic Joseph L. Carter unveiled the plaque, which reads: "These ambula- M/M William E. Hill Barnes Hospital Medical motorcycle accident in Illinois. My stays were long tory care transfusion facilities are dedicated to the Cora M. Johnson Records Dept. and painful, but the staff went out of their way to loving memory of Alvin N. Lasky and have been Muriel H. Kiser make them more comfortable. equipped and furnished through generous contri- Philip Rider Ruth Glatz butions of his family and friends." Lucille J. Rogers Jim & Julie Wire I was on 7200 and 7300 (seventh floor Rand John- son, West Pavilion) where the nurses are very Speeches by Mrs. Lasky and Dr. Loeb praised Mr. Scott Jablonow Endowment Fund dedicated to their work. They not only took care of Lasky's love of life, sense of humor and fighting me, but helped me with the depression and per- spirit. "We have needed a facility such as this one IN HONOR OF: sonal trouble I went through. When they noticed Birthday of Scott Jablonow Birthday of Dr. Joseph where cancer patients could receive their transfu- Hope Komm Raider my mental condition declining they saw to it quick- sions in a pleasant, comfortable atmosphere for a Nettie Jablonow ly that I received professional help. long time," said Dr. Loeb. "I think it is a tribute to Birthday of Nettie Jablonow the kind of man that Al Lasky was that so many of Hope Komm One of my dislikes is to hear people that are on his family members and friends have contributed their jobs complain to other people about super- to this effort." Barnes Hospital Endowment Fund vision, shifts or other employees. During my stay I did not hear any nagging or complaining from your M/M William Tao people—from the nurses, food service, x-ray, housekeeping, maintenance, doctors or any re- Gifts to Barnes Hospital Sharon O'Berto Morad Fund lated employee. The rooms were as clean as pos- Listed below are the names of persons (honorees sible, and the food was very good (good variety). David M. Morad, Jr., M.D. in boldface) who have made contributions during I forgot to fill out the card before I left the hospital, the period February 10 to March 9 to the funds at so I decided to write this letter. I wish it could be Barnes Hospital. Because Barnes is a private hos- Louise Grove Library Fund posted so employees can know that someone pital and does not receive public funds, it relies on James Lane does care about the important jobs they perform. the gifts of individuals to continue providing quality patient care and to support research aimed at im- IN MEMORY OF: proving the lives of our patients. Cora Brooks Florence Hess Auxiliary Tribute Fund M/M Fred Hayden

IN MEMORY OF: Marge & Rick Harris Bulletin Nelle Connelly M/M Oscar H. Jekel Cordonnier Lecture Fund M. Richard Wyman Janet & Thomas Kavitski M/M John H. Livingston Blake S. Talbot, M.D. Published monthly for employees, doctors, volun- Mrs. M. J. Mathis Anna S. McCoron teers, Auxilians, donors, former and retired em- Mrs. Marvin Harris Evelyn B. McCown ployees, patients and other friends of Barnes Hos- M/M Albert W. Winter Barnes Cancer Fund pital. Available at no charge by contacting the pub- Philip Moss lic relations department, Barnes Hospital, Barnes M/M James H. Rowe Vera Smith IN MEMORY OF: Barbara & Richard Speer Mrs. George DuBois Ellanore Calhoun Hospital Plaza, St. Louis, Mo. 63110, (314) 362- M/M Percy Tucker Jim & Kathy Wire 5290. Circulation: 13,000 copies. M/M Paul L. Tucker James Walker Storment, Sr. James & Susie Storment Nora Carr, Editor Connor B. Shanley Barnes Heart Fund M/M George D'Arcy Mike Tripoli Daisy Shepard, Director Dan & Mary Ann Daues Jim & Cathy Hubbard IN MEMORY OF: Charlene Bancroft, Assistant Director M/M John L. Davidson, Jr. Norma Hoffman Mrs. Campbell Deane Garrett Daughter, Theta M/M Don Fortenberry Copyright 1984 by Barnes Hospital Marjorie & Robert Getty Mrs. Larry Tucker Brown Shoe Company April, 1984 Barnes Hospital, St. Louis, Mo.

A large contingent of Barnes staff members representing several departments screened 135 employees of The C. V. Mosby Company during a March 14 health fair. Tests and information for glaucoma, blood pressure, stress, fitness, oral cancer, vision, anemia, nutrition, chemical dependency, breast self-exam and a counseling and referral service were provided. For more information about scheduling a health fair, contact the department of education and training at 362-5252. Bulletin

Barnes Hospital Barnes Hospital Plaza St. Louis, Mo. 63110

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