UNIVERSITY OF PENNSYLVANIA MEDICAL CENTER■ SUMMER 2001

The Science of Addiction SURGEON TURNS SCULPTOR THE BIOLOGY OF BELIEF SALUTING THE CLASS OF ’51 Editor’s Note

Saluting Bill Kelley Holmes introduced Gail Morri- involving multiple health profession- son, M.D. ’71, Penn’s vice dean for als. Because a variety of disciplines his spring, the School of education, as “the chief architect of and competencies come into play, he Medicine held a symposium the new curriculum.” Morrison list- suggested that the various health T in honor of William N. Kelley, ed several challenges the curriculum professionals be educated together. M.D., who served for more than 10 must face. The explosion of new In fact, he feels it would be beneficial years as dean of the school and CEO knowledge forces medical schools to to have them problem-solve as teams of Penn’s Health System. “Predic- reassess what needs to be taught while in training. Like Morrison, he tions for the Next Millennium” was and learned. The curriculum must emphasized that people must be moderated by Edward W. Holmes allow different ways of “keeping educated not just for life-long learn- Jr., M.D. ’67, vice chancellor for up” and encourage students to be ing but for change as well. health sciences and dean of the self-directed learners, often by using Francis S. Collins, M.D., Ph.D., School of Medicine at the University the newest technologies. Morrison director of the National Human of California at San Diego. (Holmes recalled that Kelley had charged her Genome Research Institute, was chaired Penn’s Department of Medi- with “a fundamental restructuring” recruited to the University of Michi- cine from 1991-97, recruited by Kel- of medical education. One part of gan by Kelley when Kelley was ley.) Describing the guest of honor as that vision, she said, remains elu- chair of its Department of Internal “one of the dominant figures in sive: making it more affordable. Medicine. Collins spoke about the American medicine,” Holmes assert- P. Roy Vagelos, M.D., former impact of the human genome pro- ed that Kelley had “transformed the chairman and CEO of Merck and ject and predicted how the future School of Medicine.” Kelley, he said, former chairman of the University was “all going to play out.” By 2010, worked to make it possible to trans- trustees, sketched out the great he envisioned predictive genetic late fundamental discoveries more advantages when the universities do tests for perhaps a dozen risks; quickly into patient care; mandated the basic research, the government preimplantation diagnosis will be an innovative curriculum; encour- bears part of the cost, and industry widely available (although the lim- aged one of the premier M.D./Ph.D. does the rest of the “discovery” its of the process will be “fiercely programs in the country; and work. He cited three areas in which debated”); and the federal govern- increased Penn’s NIH research fund- such productive partnerships had ment will pass effective legislation ing until it was second among all benefited patients tremendously: against genetic discrimination. By medical schools. As dean, Kelley coronary heart disease, hepatitis B, 2020, there will be gene-based recruited 20 department chairs – and and benign prostate enlargement. designer drugs on the market for made it possible to attract the very Among the issues raised by Ken- diabetes, hypertension, and several best medical students. At the sympo- neth I. Shine, M.D., president of the other conditions. Cancer therapies sium, several prominent friends and Institute of Medicine of the National will improve significantly. colleagues spoke on topics central to Academy of Sciences, was quality of By 2030, comprehensive Kelley’s vision of an integrated acad- care. Medical institutions, he assert- genomics-based health care will be emic health system. Following are ed, had lost leadership and credibili- the norm. Individualized preventive some brief highlights. ty in the eyes of the policy makers, medicine will be available. For Samuel O. Thier, M.D., president nor had they done a good job in many diseases, the interaction of and CEO of Partners HealthCare providing access to care. Quality, he environmental factors with the System in Boston, spoke about acad- said, “represents the last remaining human genotype will be pinpoint- emic health centers as “ground zero area” where medicine can take the ed. A full computer model of the for change in health policy.” He lead and convince the public that it human cell will replace many labo- noted that in the 1990s, funding from is doing so for the public’s benefit. ratory experiments. The average life the NIH rose to unprecedented levels For that, however, medical institu- span will reach 90 years; even so, – while reimbursements from insur- tions will need accurate measure- major anti-technology movements ance companies and Medicare went ments, which they have not had. will arise. Finally, there will be seri- down. Simultaneously, the burden of Shine also praised interdiscipli- ous debate about humans possibly uncompensated care for AHCs grew nary research. Yet, he said, “from a “taking charge” of their evolution. heavier. It is clear, said Thier, that the policy point of view, we keep subdi- Following the symposium, the old way of organizing a medical cen- viding and subdividing and subdi- visionary gave way to the pictorial. ter “is no longer viable.” viding,” and the way research is cur- After several speakers gave In general, Thier argued, acad- rently funded does not help interdis- remarks, a portrait of the guest of eme has the important role of con- ciplinary study. He ended his honor was unveiled. The portrait tributing ideas and models for pub- remarks by raising a related “central now hangs in Biomedical Research lic discourse. Academic health cen- issue”: the growth of systems of care Building II/III, constructed during ters should “ask the questions prop- Kelley’s tenure – and one of the erly and toughly” and “make sure most visible signs of his ambitious the debates are better informed” plans for Penn’s medical school and than they often are. Health System.

Cover: Charles P. O’Brien, M.D., Ph.D. Photograph by Addison Geary UNIVERSITY OF PENNSYLVANIA MEDICAL CENTER / SUMMER 2001 VOLUME XIV, NUMBER 3

CONTENTS

THE SCIENCE OF In his 30 years as director of Penn’s Treatment ADDICTION Research Center, Charles P. O’Brien, M.D., 6 By Lisa J. Bain G.M.E. ’69 Ph.D., has witnessed changes in the way scientists understand addiction, thanks to advances in neurochemistry, neurophysiology, and genetics. Despite resistance among many who deliver treatment, the trend in research today is to focus on using medication to treat addiction.

IN THE STYLE OF When John A. Lanzalotti, M.D. ’75, found it HOUDON increasingly difficult to make a living as a sur- 15 By John Shea geon and physician, he was able to use his artistic talents and his skills at visualizing three dimensions to develop a business as a sculptor. His chief inspiration is Jean-Antoine Houdon, known for his busts of Franklin and other Founding Fathers.

A PHOTOGRAPH OF In a new book, Andrew B. Newberg, M.D. ’93, GOD? and the late Eugene D’Aquili, M.D. ’66, Ph.D., 18 By Andrew B. Newberg, M.D. reported on their quest to study spiritual experience through the latest techniques of modern medicine. Using a SPECT camera, they found that the human brain alters during intense contemplation such as Buddhist medi- tation and the prayer of Roman Catholic nuns.

CELEBRATING THE The questionnaires returned this spring by CLASS OF ’51 members of the Class of 1951 suggest that 21 many of them took the words of their old dean to heart: “If the demand for your services is great, your obligation to the community is correspondingly increased.” Fifty years later, these alumni have a record of achievement in many different areas.

DEPARTMENTS EDITOR’S NOTE Inside Front LETTERS 4 Saluting Bill Kelley ALUMNI NEWS 28 VITAL SIGNS 2 It Happened One Weekend Mount Sinai’s Rubenstein is named Progress Notes new EVP, dean Gene therapy reverses blindness in dogs THE LAST WORD Inside Back A new tool for the era of proteomics ACampaign Concludes

STAFF JOHN R. SHEA, Ph.D. Editor

LEWIS & NOBEL DESIGN Design / Art Direction

ADMINISTRATORS REBECCA HARMON Chief Public Affairs Officer MARCIA L. ROBERTS Director of Medical Alumni Relations and Institutional Events

Penn Medicine is published for the alumni and friends of the University of Pennsylvania Medical Center by the Office of Public Affairs. © 2001 by the Trustees of the University of Pennsylvania. All rights reserved. Address all correspondence to John Shea, Penn Medicine, 2018 Penn Tower, University of Pennsylvania Medical Center, Philadelphia, PA 19104-4385, or call (215) 662-4802, or e-mail john .shea @uphs.upenn.edu. Visit Penn Medicine’s web site: http://www.med.upenn.edu/prnews/publications/Penn_Medicine.shtml

2001/SUMMER ■ 1 VitalSigns

Robert Clink tion of American Physicians and of the Association of Professors of Medicine, he has also been chair- man of the American Board of Internal Medicine. Born in South Africa, Ruben- stein received his medical degree from the University of the Witwa- tersrand in Johannesburg in 1960. After affiliations with Witwater- srand, Johannesburg General Hos- pital, and the Hammersmith Hos- pital in London, he joined the Uni- Arthur H. Rubenstein, M.B., B. Ch., will lead Penn Med. versity of Chicago in 1967. As he made clear at his campus press conference, Rubenstein has Mount Sinai’s Rubenstein As executive vice president, devoted himself to all three compo- is named new EVP, dean Rubenstein will report to Judith nents of academic medicine: educa- Rodin, Ph.D., president of the Uni- tion, research, and patient care. rthur H. Rubenstein, M.B., versity of Pennsylvania; as dean, When asked whether he expected to B.Ch., an accomplished he will report to Robert Barchi, be able to teach at Penn, he replied, physician, internationally M.D., Ph.D., the provost (the Uni- “I wouldn’t come if I couldn’t teach. A versity’s chief academic officer). known endocrinologist, and leader . . . It’s in my bones and blood, and in academic medicine, has been Robert D. Martin, Ph.D., CEO of that’s why I love universities.” As he named executive vice president of the Health System, will report to put it, “What keeps the faculty ener- the University of Pennsylvania for Rubenstein. gized and on their toes and interest- the Health System and dean of the Barchi praised Rubenstein’s ed are outstanding students.” He School of Medicine. Rubenstein, “years of experience and a keen has taught values in medicine and 63, has served for the past four appreciation for the challenges fac- noted that he is a “devotee” of years as dean and Gustave L. Levy ing today's academic health sys- William Osler. He feels it is extreme- Distinguished Professor at Mount tems.” The ultimate structure of ly important to talk about values in Sinai School of Medicine in New the Health System and its relation- medicine “at a time when we’re real- York. As dean, he is credited with ship with the School of Medicine ly buffeted by all these difficult recruiting and retaining outstand- have not been decided, but Ruben- financial and HMO pressures and ing faculty, developing and imple- stein suggested that the compo- restricted time slots for patients.” menting a comprehensive strategic nents would be closely aligned. Equally important is the responsibil- planning process, and leading a “I’m going to work with my col- ity to “set the tone for young physi- successful effort to increase the leagues in the Medical Center, cians to do what’s right.” school’s federal funding for with Dr. Rodin, with the board, to Rubenstein explained that he research. Before going to Mount try to find exactly the right struc- gave up research when he felt he Sinai, Rubenstein was on the med- ture over the next several was no longer “competitive” ical faculty of the University of months,” he said. At the same because of his administrative Chicago for 30 years and served as time, Rubenstein emphasized the responsibilities. Even as chairman chairman of its Department of need to make sure that “the of medicine at the University of Medicine from 1981 on. Health System and the medical Chicago, however, he took care of Speaking at a campus press school conglomerations don’t neg- patients, and he said he was “think- conference, Rubenstein called the atively impact a great university” ing seriously about starting again.” Penn position “a job made in because of the volatility of the While noting Penn’s various heaven for me.” As he put it, “I health-care marketplace. and often well-publicized love universities, I love academic Author of more than 350 publi- strengths, Rubenstein mentioned medicine.” He underscored the cations, Rubenstein is recognized what he called “an incredibly key importance of close ties between a for his expertise and groundbreak- issue.” That was the faith the fac- university and its hospitals. While ing research in diabetes. He is a ulty showed in the institution, he plans to make sure that Penn is member of the Institute of Medi- despite “this tremendously trau- strong in all the major clinical cine of the National Academy of matic time” of financial constraints areas that attract patients, Ruben- Sciences and a fellow of the Amer- and uncertainty. “Almost to a per- stein also emphasized that treat- ican Association for the Advance- son,” he said, the faculty members ments at Penn will be at the cut- ment of Science and of the Ameri- he spoke with told him “we all ting edge, “where research inter- can Academy of Arts & Sciences. believe so much in the place.” sects patient care.” Former president of the Associa- John Shea

2 ■ PENN MEDICINE Health System continues its appeared in the May issue of the first successful outcome using financial recovery Nature Genetics. larger animals. “This study takes a Under optimum conditions, great stride forward in demon- lthough the final audited normal protein transports a Vita- strating that gene therapy does not figures for Fiscal Year 2001 min A-like compound to the just slow down a retinal degenera- are not yet available, the retina, which is necessary for tive disease, but can actually pro- A sight. In some cases of animal and vide recovery of vision to an ani- University of Pennsylvania Health System continues to make human LCA, wild-type RPE65 – mal that was previously blind,” progress in its financial recovery. the protein that transports the nec- said Bennett, a researcher at the F. Through the third quarter, ending essary Vitamin A-like compound – M. Kirby Center for Molecular March 31, 2001, UPHS had an is missing from the gene, which Ophthalmology at the Scheie Eye operating profit of $24.0 million. results in blindness. Institute. That is a $34.8 million improve- According to Jean Bennett, In the Penn study, researchers ment over the corresponding peri- M.D., Ph.D., associate professor of injected a recombinant adeno- od of the previous fiscal year. ophthalmology and a senior co- associated virus (AAV) carrying Given the Health System’s recent author of the study, previous stud- wild-type RPE65 into the area history – when it had close to $300 ies to reverse blindness in rodents between the photoreceptors and million in operating losses in have been successful, but this is the retinal pigment epithelium of FY1998 and 1999 – its showing for three dogs. After 90 days, an elec- this current fiscal year appears all troretinogram showed that the the more impressive. Nor has it waveforms of the treated eye were gone unnoticed by Penn’s peer similar in scope to those of a sight- institutions, the bond-rating agen- ed dog's eyes. Behavioral testing cies, and the media. For example, four months later was consistent in the February 5 cover story of with the electrophysiological Modern Healthcare, the perfor- results. The treated dogs all avoid- mance by UPHS was characterized ed collision with objects in front as a “dramatic success” story. and to the right (the side injected), Arthur Rubenstein, M.B., B.Ch., yet they consistently collided with the newly named executive vice objects to the left. In contrast, the president for the Health System untreated dog did not avoid objects and dean of the School of Medi- in any direction. cine, praised the “outstanding job” Albert M. Maguire, M.D., asso- done by Robert D. Martin, Ph.D., ciate professor of ophthalmology the CEO of the Health System. and one of the co-authors of the Said Rubenstein, “The turnaround study, told The Philadelphia Inquirer has been amazing – truly amaz- that a few early experiments had ing.” attempted to inject the protein Jean Bennett, M.D., Ph. D. directly into the eye. These met with marginal success, however, Gene therapy reverses and a better strategy seemed to be blindness in dogs Honoring Excellence to administer the gene that would allow the dogs to make the protein esearchers at Penn’s Scheie egun in the spring of themselves – which is the essence Eye Institute have devel- 1997, the Awards of of gene therapy. R oped a gene therapy proto- Excellence program is a Since the publication of the study col that successfully restored sight B and its resulting publicity, Bennett way for the School of Medicine in dogs afflicted with a variation to recognize its most outstand- has received hundreds of calls and of Leber congenital amaurosis ing faculty members for their e-mails. She cautions that “we are (LCA), a severe form of retinal research and clinical achieve- nowhere near the introduction of degeneration that, in humans, ren- ments. This year’s Awards of the missing protein in humans to ders infants permanently blind. Excellence dinner is scheduled restore sight,” yet she is very opti- The work was done in collabora- for Thursday, November 15, at mistic about future developments. tion with researchers from Cornell 6:00 p.m., in the lobby of Bio- The other researchers in the University (who discovered the medical Research Building study are Samuel Jacobson, M.D., mutated gene in dogs) and the II/III. Tickets are $90.00. For Ph.D. (Penn), Gregory Acland, University of Florida (who helped more information or to attend, V.M.D., and Gustavo Aguirre, establish the adeno-associated call Medical Alumni Relations V.M.D., Ph.D. (Cornell), and William virus that served to deliver the at 215-898-5298. Hauswirth, Ph.D. (Florida). necessary protein). The study Rosann G. Thompson

2001/SUMMER ■ 3 VitalSigns

According to Mark I. Greene, LETTERS M.D., Ph.D., professor of patholo- gy and laboratory medicine, another of the study’s authors, THE EARLY YEARS "IDAT has the potential to do for I was a member of the inaugural proteomics what PCR [polymerase “Bridging the Gaps” summer pro- chain reaction] did for genomics in gram for Penn Med students inter- the last two decades." ested in community health in 1991. Not only can IDAT quantify the During that summer, I was able to amount of protein – it is sensitive establish the UCHC medical clinic enough to pick out even a few that was featured in your Spring copies of a protein out of a highly 2001 issue [“Clinical Care,” by Greene Eberwine diluted sample. Moreover, IDAT Marie Gehret]. My heart was filled does not rely on radioactive label- with pride to see the clinic featured ing and is far less time consuming Anew tool for the era of so prominently and to learn that it and cumbersome than existing had met and exceeded our expecta- proteomics techniques. tions since its inception. I moved to Eberwine and Greene worked Seattle for residency and fellowship ow that scientists have with colleagues Hong-Tao Zhang, training but have run into enough identified the genes in the Ph.D., Janet Estee Kacharmina, Penn Med students through the Nhuman genome, the grow- and Kevin Miyashiro to develop years to know that the clinic was ing field of proteomics will pro- the IDAT technique and further still in operation. However, the clin- vide descriptions of how the pro- refine it for broader applications. ic’s growth over ten years is remark- teins encoded in those genes work. They have also found a way to able and reflects greatly on the com- Researchers at Penn’s School of create universal detection mole- mitment of Penn Med students to Medicine have created the first cules, so that IDAT could detect an serve and contribute positively to new technology for the proteomic unlimited variety of proteins as their community. The support of era, a technique sensitive enough well as lipids, sugars, and other faculty, UCHC, and St. Agatha-St. to detect individual proteins and cellular molecules. The research James are essential to the clinic, but robust enough to screen hundreds that developed IDAT has been the students’ commitment and sacri- or thousands of molecules in mass funded by the National Institutes fice for the clinic is the life force that automation. of Health and the Leonard and has kept the clinic alive. The technique is called IDAT Madlyn Abramson Family Cancer I wanted to add some details (Immuno-Detection Amplified by Research Institute at the Universi- about the early years that highlight T7 RNA polymerase). It has a vari- ty of Pennsylvania Cancer Center. the tiny events that, when pieced ety of potential uses, from detect- Greg Lester together over ten years, lead to the ing cancer earlier to sifting clinic as it exists today. First, without through samples of molecules to the initiative of students and faculty find new candidates for drug in the year before 1991, I would research. In the 23 April 2001 edi- never have had the opportunity to tion of Proceedings of the National commit a summer to establishing the Academy of Science, the researchers Atribute to Penn’s women Scheduled for November 1-2, clinic. Dr. Jerry Johnson [G.M.E. ’79] described how they used IDAT to was my faculty advisor in the sum- identify a protein marker for “125 Years of Women at Penn” will include a ceremony honor- mer of 1991. He gave me tremen- breast cancer at a resolution up to dous insight into the support needed nine orders of magnitude more ing women “firsts” at the Uni- versity, as well as book sign- to provide medical care and estab- powerful than conventional tech- lished a precedent that care was to be niques and explained how the ings, talks, and panel discus- sions. One discussion is the of the highest quality, regardless of technique can be further refined. the limitations of time, space, and "IDAT can detect proteins earli- medically oriented “Our Bod- ies, Ourselves: What You Know money. We started with BP screening er, faster, and with more sensitivi- but were quickly confronted with the ty than other methods," said James May Make the Difference.” The registration fee for the two-day need for resources for drug treat- H. Eberwine, M.D., professor of ment, STDs, simple medications, and pharmacology and of psychiatry package of events is $125. For more information, go to the occasional emergency care. Without and one of the authors of the Dr. Johnson's mentorship, the clinic study. "Tumors, for example, often event’s website, www.alumni. upenn.edu/celebratewomen, or would never have received approval shed particular proteins at an early to operate. In addition, Father Antho- stage and the sooner you can call the University’s Office of Alumni Affairs at 215-898-7811. ny Gonzales was a remarkable man detect the proteins, the sooner you who risked much of himself and his can treat the cancer." church to allow a group of naive

4 ■ PENN MEDICINE first-year medical students to come nating item at Pennsylvania Hospital. colonies’ first hospital” – no ques- under his roof during a soup kitchen Protected by a wooden cover is the tion. But since Louisiana became to provide medical care. Father Gon- original cornerstone which speaks of part of the Union in 1812, the facts zales died in 1992 and I hoped the the beneficence of George III in sup- have been different for 189 years! clinic would bear his name. As the porting the new hospital. I do not Let truth top tradition! students, faculty, UCHC volunteers, recall the exact text but it would cer- Isidore Cohn Jr., M.D. ’45 and clergy have changed with time, tainly be worth publication all these Chairman Emeritus, his name appears to have been lost. years later. Department of Surgery Finally, there were community health Bernadine Z. Paulshock, M.D. ’51 Louisiana State University workers, undergraduate volunteers, Wilmington, Del. and many of my classmates and The editor replies: Dr. Cohn’s letter friends who played vitals roles in the The editor replies: The timeline for raises again the question of primacy, clinic’s early days. Without their con- Pennsylvania Hospital that is found which we visited briefly in our Sum- tributions, the clinic would never on the hospital’s website notes that mer 2000 issue when trying to deter- have lasted past the summer of 1991. the original cornerstone can still be mine which was the oldest hospital When we started the clinic, we had viewed at the southeast corner of constructed by a medical school for visions of it becoming both a commu- the East wing of the Pine Building. teaching purposes (Editor’s Note: nity resource and an educational Instead of a wooden cover, it is now “Who Was First?”). Sources at Penn- experience for students, perhaps inte- protected by a more contemporary sylvania Hospital remain comfortable grated with the medical school cur- Plexiglas cover. The text, drafted by characterizing it as “the nation’s riculum. I agree wholeheartedly with Benjamin Franklin, acknowledges first.” The phrasing that troubled Dr. the sentiments in Marie Gehret’s arti- George II, who reigned until 1760. Cohn – “the oldest hospital in the cle that introducing students to this The text reads: “IN THE YEAR OF United States” – is ambiguous, and population in this setting early in CHRIST MDCCLV. GEORGE THE was written perhaps too carelessly by medical school has very positive SECOND HAPPILY REIGNING me, not by writers at Pennsylvania influences on their attitudes, clinical (FOR HE SOUGHT THE HAPPI- Hospital. Yet “United States” is syn- skills, and interpersonal skills. The NESS OF HIS PEOPLE) PHILADEL- onymous with “the nation,” a politi- clinic influenced the person and doc- PHIA FLOURISHING (FOR ITS cal entity, rather than with “Ameri- tor I have become and provided the INHABITANTS WERE PUBLICK ca,” a geographic entity. One could kind of care and education that my SPIRITED) THIS BUILDING BY argue, then, that Pennsylvania Hospi- classmates and I sought when enter- THE BOUNTY OF THE GOVERN- tal has been a United States hospital ing medical school. MENT, AND OF MANY PRIVATE for 225 years and that Charity Hospi- In the first year we knew there PERSONS, WAS PIOUSLY FOUND- tal has been one for 189 years. wasn't time to accomplish all that ED FOR THE RELIEF OF THE SICK But whether Dr. Cohn is persuad- we hoped but were elated to know AND MISERABLE; MAY THE GOD ed by this argument, the picture that other students would follow, OF MERCIES BLESS THIS seems even more complicated than adding their own initiative to the UNDERTAKING.” that. While conducting a search on clinic. It is extremely gratifying to the Internet, I discovered other see that the clinic has matured to be TRUTH VS. TRADITION? claimants to the title of oldest hospi- everything we dreamed and more, tal. In the San Francisco area, there and that there is consistent faculty Re: “The First Turns 250” (Spring is the Hospital San Juan of God, pre- support to keep the clinic running. I 2001): As a Penn graduate (x 3) and viously known as Saint John the want to applaud the hundreds of as one who spent ten years in Baptist Hospital. Its claim: founded students and faculty volunteers who Philadelphia, I am well aware of the in 1550. (As the web page oddly have individually and collectively importance of The Pennsylvania puts it, “Being also the oldest hospi- contributed to something very Hospital and of colonial dates and tal in America that works in the unique for a community in desper- events in the background of the city. same building of their foundation.”) ate need of support. Well done. I am As a native of Louisiana, and as The site for Bellevue Hospital in very proud of my Penn Med her- one who has spent his entire post- New York calls it “America’s oldest itage and the legacy you have left residency career in Louisiana, I have public hospital, which opened in for others to follow. some pride in this state, also, and a 1736.” (Compare the ushistory.org wish that historical accuracy be David A. Kregenow, M.D. ’95 description of Pennsylvania Hospi- acknowledged. tal as “America’s oldest hospital.”) Fellow, Pulmonary and Critical Care Charity Hospital of Louisiana at University of Washington If we define America as North New Orleans was founded in 1736 America, there is also a claimant in and celebrated its 250th anniversary ^ BACK IN 1755 Quebec: the Hotel-Dieu du Précieux with great fanfare in 1986. Thus I Sang, founded in 1637, “the oldest Neither your article or another one take exception to part of the open- hospital in North America.” I read recently, perhaps in a Jefferson ing sentence which credits Pennsyl- Taking the easy way out, the edi- publication, mentioned the most fasci- vania Hospital as “the oldest hospi- tor reserves judgment. tal in the United States.” As “the

2001/SUMMER ■ 5 THE SCIENCE OF

By Lisa J. Bain Addison Geary

6 ■ PENN MEDICINE Charles P. O’Brien, M.D., Ph. D., has served as director of Penn’s Treatment Research Center since its founding in 1971. INVESTIGATORS IN PENN’S DEPARTMENT OF PSYCHIATRY ARE TACKLING THE COMPLEX AND OBSTINATE PROBLEM OF ADDICTION FROM A VARIETY OF ANGLES. THEIR APPROACHES INCLUDE FINDING THE MOST EFFECTIVE DRUG TO DEADEN THE CRAVING, SEEKING TO UNDERSTAND THE NEUROANATOMY OF MEMORY AND DESIRE, AND STUDYING THE GENETIC LIKELIHOOD THAT AN INDIVIDUAL WILL BECOME ADDICTED.

he history of treatment for O’Brien. “That put a lot of pres- National Institutes of Health, and drug addiction has been a sure on us to develop treatment most of these trials are for the Tstory of change and resis- programs very rapidly.” At that treatment of addiction to cocaine, tance to change. So says Charles P. time, the focus was on heroin alcohol, and nicotine. O’Brien, M.D., G.M.E. ’69, Ph.D., addiction; cocaine was then very professor of psychiatry at Penn. As expensive and not widely avail- Animal models reveal clues director of Penn’s Treatment able. But in the 1980s, the cost of One of the factors that has Research Center (TRC) since its cocaine dropped and crack cocaine fueled the study of the science of founding in 1971, O’Brien has became available, which allowed addiction is the availability of ani- been a primary agent of that more efficient delivery of the drug mal models. In the late ’70s, change. During his two years of to the brain. As the demographics Joseph R. Volpicelli, then an service in the U.S. Navy during of drug use changed, so did the M.D./Ph.D. student at Penn, was the Vietnam War, he treated sol- TRC, not only in terms of what interested in using animal models diers returning to the States for a was treated, but how it was treat- of psychopathology to study the variety of illnesses, including ed. relationship between stress and many cases of heroin addiction. Throughout the decade of the medical problems, particularly But he found no effective treat- ’70s, psychotherapy was the only addiction. One question he pur- ment to offer these veterans. Given available therapy and the results sued: Might stress somehow cause his training in both neurology and were not encouraging. In the mid people to become addicted? Using psychiatry, O’Brien became partic- ’70s, O’Brien and colleagues foot shock to induce stress in rats, ularly interested in the effect of demonstrated for the first time Volpicelli observed the effect of drugs on the brain. that drug effects were conditioned, stress on the animals’ drinking “While I was in the Navy, I and studies began to focus increas- behavior. “I was really surprised at used my own money and my ingly on using medication to treat the findings,” he recalls. “What I Navy uniform and went around addiction. This trend in research found was that rats drink alcohol the country looking at the various continues today, despite continued not when they are really stressed, programs that were in operation resistance among many of those but after the stress is over. It was at the time,” he says, noting that delivering treatment. Meanwhile, that finding that led me to reexam- the uniform allowed him to travel research into the neurochemistry, ine the whole relationship between at reduced fares around the coun- neurophysiology, and genetics of stress and drinking and why some try. The results of his quest were drug addiction has changed the people become alcoholics.” discouraging. There was little way scientists understand addic- In response to trauma, the body research being done and little tion and has led to a new genera- releases endogenous opiates called knowledge among clinicians that tion of drug treatments. endorphins, naturally occurring any research was under way. “So Today, O’Brien oversees addic- brain chemicals that bind to opiate we designed a program that tion research and treatment receptors in the brain. Binding of would have treatment and involving about 40 investigators at the receptors, whether by endor- research together, so that we could three main clinical sites – the TRC phins or by opiate-containing study the treatment in an orga- at Penn, Presbyterian Medical drugs such as heroin, stimulates nized way and try to find out Center, and the Veterans Affairs the brain’s “pleasure centers.” whether treatment A was better Medical Center – as well as a net- Volpicelli theorized that when the than treatment B.” work of affiliates throughout the stress is over the opiate level falls, Federal funding was available Delaware Valley where clinical tri- resulting in an experience of let- because of the Vietnam War. als are conducted. Everyone treat- down or withdrawal, and that “There was a tremendous hysteria ed at the TRC participates in a alcohol stimulates the opiate about heroin addicts coming back grant-funded clinical trial. Most of receptors and compensates for the to the United States,” says the funding comes from the rebound withdrawal.

2001/SUMMER ■ 7 At about that time, Charles finally began to take notice. where you want to redose. So nal- O’Brien was investigating the Today, Volpicelli points out, the trexone really gets at the core of effectiveness of an opiate-receptor idea that opioids play a role in what makes alcohol addictive – blocker called naltrexone for the alcohol consumption is accepted in the tendency for one drink to set treatment of heroin addiction. the research community, but trans- the occasion for the next drink.” Volpicelli gave some of the nal- lation into clinical practice contin- Although the results of the first trexone to his rats. “What I found ues to meet with resistance. Many naltrexone study were impressive, was that you could block alcohol people are against using a drug to over time Volpicelli and others drinking in rats by blocking the treat addiction. They also view observed that people stopped tak- opiate receptors,” he says. In 1981, naltrexone as a insufficient ing the medication because they he completed the study, his disser- approach to the problem of alcohol missed the high. “An important tation, and earned his degrees, but addiction: although it removes the limitation of this whole endeavor,” the scientific community was slow “high” from drinking, it does he says, “is that you need to have to accept the idea that opiate nothing about what many people the person motivated enough to receptors were involved in alcohol see as the root cause of alcoholism take the medicine and want to get preference. “At that point when I – a “character defect.” better for the medicine to work.” was submitting papers, the But Volpicelli, today associate For their second naltrexone study, reviewers would say things like, professor of psychiatry at Penn, he and his colleagues designed a ‘This person knows nothing about believes naltrexone does get at the more personal psychosocial treat- alcoholism, obviously he’s really root of the problem. “Some people, ment, which he calls the “BREN- naive, and this theory is full of for reasons that are not their fault, DA” approach, to be used in con- holes,’” recalls Volpicelli. “I saw when they drink alcohol their junction with naltrexone. “It’s a some of the reviews and I was just brain releases a lot of these more expensive approach but we getting killed, it was such a radical endogenous opiates. So it pro- think that since the results are so idea. But there’s a part of me that duces a nice high, which is fine, much better, it’s ultimately cheap- sort of prays to the saint of lost except when you stop drinking er in the long run for society and causes, and that’s part of why I you go through a rebound phase even for insurance companies.” As got involved with alcohol research. Because people told me that you can’t really treat alcoholics or you Training Doctors to Treat Substance Abuse can’t develop animal models of alcohol drinking – and when peo- ple would say I can’t do some- esistance to the idea that Penn to take the course, spend time thing, that would get me motivat- addiction is a chronic dis- at the TRC, and learn more about ed to show that you could.” R ease runs strong in Ameri- addiction. In the mid ’80s, Volpicelli began can society. Nowhere is this more The course evolved gradually to conduct research in humans true than among medical profes- over the past 30 years. In the early who were addicted to alcohol. In a sionals, according to Charles 1970s, O’Brien recalls, a group of double-blind study, he randomly O’Brien, M.D., Ph.D. “People in medical students approached him sorted chronic alcoholics into two practice practice the way they and said they would like to learn groups. After both groups went were trained,” he says. And what more about addiction. At that through detoxification, both also medical professionals in training time, drug reactions were common received psychotherapy. The dif- are learning, he adds, is “very, on college campuses such as Penn, ference was that one group very little.” and a volunteer group of medical received naltrexone and the other According to a survey conducted students made themselves avail- a placebo. “What we found was by the American Association of able to talk to troubled undergrad- that people on naltrexone had Medical Colleges (AAMC) in 1999- uates about their drug problems. much lower relapse rates than 2000, only 5 of the 125 responding But the “student doctors” did not people who got the placebo,” says medical schools require a course in know very much, so they asked Volpicelli. substance abuse. Most medical O’Brien to teach them. The elective Again his finding met with schools offer an elective or fold sub- course O’Brien set up was very resistance. According to O’Brien, stance abuse studies into another popular with students — “stand- people did not believe the data. “It required or elective course. At ing room only,” as he puts it. was too good to be true, but it was Penn, medical students are required Then, in the late ‘80s, the School true,” he says. Despite the opposi- to take a full course in addiction: 25 of Medicine held a retreat to tion, “Joe wouldn’t take no for an hours in the “brain and behavior” review the curriculum and invited answer.” When an independent block of integrated neuroscience. several recent graduates of the research group from Yale repeated One of the few such offerings across school to talk to the faculty about the study and got similar results, the country, it attracts students from what they felt they had missed in however, the scientific community other medical schools who come to their training. Says O’Brien, “One

8 ■ PENN MEDICINE oreyo naRs hlrs,P.D. of Anna Rose Childress, Ph. Courtesy

the people get better, the treatment “keeps them out of hospitals, out of emergency rooms, out of need- ing liver transplants.” In a third study, the team showed that the treatment could be delivered by nurse practition- ers. More importantly, they showed that treatment over nine months rather than three months yielded better results. “It’s like the treatment of hypertension, dia- betes, or asthma,” says Volpicelli. “You stop the medication and peo- ple’s symptoms come back. So it looks like alcoholism is like other chronic medical diseases in which you need long-term care as opposed to just going away for 30 days and expecting that people are going to get better.”

The neuroanatomy of desire The pleasure centers of the brain that are tickled by alcohol and sex to cocaine and heroin. The oped early in human evolution are, of course, also activated by a centers are located in the limbic and have functions related to host of other stimuli, from food regions of the brain, which devel- activities important to survival – eating, reproducing, and avoiding danger. Animal studies have iden- tified certain areas in the brain that are especially important in this cir- cuit. One of these is a small of the things they kept mentioning that when the students go to the almond-shaped structure called was that they all were seeing wards, they are influenced by their the amygdala, found in the middle drug-abuse problems in their prac- senior residents and the attending part of the temporal lobe of the tices, and they didn’t learn enough physicians, many of whom pre- brain. This is a “way station” that about it in medical school because sumably have not taken the addic- is critical for learning about the elective was too brief” or the tion course in medical school. reward or danger. Another struc- students failed to grasp the con- “I remember one medical stu- ture involved in the circuit is tents. As a result of that retreat, a dent who came back to me after called the anterior cingulate, full required course on substance taking the course,” says O’Brien. which appears to be important in abuse and addiction was squeezed “He was doing this medicine rota- riveted attention and emotional into the curriculum. tion and he said, ‘Dr. O’Brien, I reactivity. The amygdala, the ante- Getting the course into the cur- had this patient who is an alcoholic rior cingulate, and a third struc- riculum has not completely broken with really severe liver disease and ture called the nucleus accumbens down the resistance among med- esophageal varices, and he was are part of a circuit that, says Anna ical professionals to accepting coughing up blood and every- Rose Childress, Ph.D., “enables the addiction as a chronic disease. thing. And so we treated all these organism not just to experience the Kyle Kampman, M.D., reports that problems, and I asked the chief reward, the pleasure, or the dan- he is occasionally surprised, when resident if I could refer this patient ger, but to learn about it, so that giving a lecture on addiction, to to the alcohol treatment program. they can get back to what they hear the responses of some med- And [the resident] said, ‘I don’t perceive to be the good things ical students – “that addiction isn’t believe in that.’ So, essentially, again or avoid the bad things.” really a disease.” That attitude, he what could the student do? This is Childress, a clinical associate says, is “part of the struggle.” like saying, ‘I’m going to give peo- professor of psychology in psychi- Yet according to O’Brien, the ple with pneumonia an aspirin to atry, has been using neuroimaging course on substance abuse has keep their fever down, but I’m not techniques in an effort to map out been effective in changing atti- going to treat the bacteria that’s the neuroanatomy of desire. Her tudes among many medical stu- causing the pneumonia.’” work began years ago as she tried dents. The problem, he notes, is to understand craving, a cardinal – Lisa J. Bain

2001/SUMMER ■ 9 Addison Geary

feature of addiction and one of the primary reasons for relapse. “One of the things we often heard from patients was that encountering things that were strongly reminis- cent of their drug abuse – whether it was the sight of someone they had used drugs with, or the loca- tion where they had purchased it, or paraphernalia lying in the gut- ter, or even internal states that had sometimes preceded use of the drug – many of those things could set off a state of arousal and drug desire.” That experience, she adds, often preceded a relapse. Originally, Childress heard these stories from patients addict- ed to opiates, but later she heard similar stories from those addicted to cocaine. “They could often taste a little bit of cocaine back in their throat even though it was nowhere around, smell it even though it was not in the room. Their ears would be buzzing, head light, With positron emission tomography, Anna Rose Childress, Ph.D., has shown which regions of the heart pounding. They’d feel a little brain experience craving. whiff of euphoria. And of course, importantly, they would feel a very strong pull toward the drug.” As she puts it, it is “the simplest anticipation of drugs, these struc- leagues have recently begun kind of association learning.” tures could be differentially acti- searching for the answer, again Childress and a multidiscipli- vated.” Among cocaine users, the using PET scanning. nary group of investigators at limbic regions of the brain, partic- Neurons communicate with one Penn induced craving in detoxi- ularly the amygdala and anterior another via neurotransmitters such fied cocaine users by showing cingulate, showed an increase in as dopamine. When a neuron is them a video that simulates drug- activity, while another brain region stimulated, it releases chemicals taking behavior or shows para- called the basal ganglia showed a called neurotransmitters, which phernalia or settings associated decrease in activity. This latter cross the gap (called the synapse) with drug taking. Next they used observation may help provide a between two neurons. The second a brain-imaging technique called neurological explanation for neuron has receptors on its surface positron emission tomography another phenomenon of drug that bind the neurotransmitter. (PET) to visualize activity in the addiction – that users seem to The binding of neurotransmitter to subjects’ brains. PET uses a radioac- ignore or forget the negative con- receptor may either activate or tivelylabeled compound to detect sequences of their drug taking inhibit the post-synaptic neuron, regional changes in blood flow. while they compulsively seek to depending on the specific receptor The results of Childress’s study, satisfy their craving. subtype and the neurotransmitter published in The American Journal involved. Many neurotransmitters of Psychiatry in 1999, made head- Next steps are involved in the brain’s reward lines across the country. “What we Mapping the anatomical basis pathway as well as in brain cir- saw, and what we had predicted, of craving, Childress asserts, is cuits that process emotions, learn- was basically that old brain only the first step. “Basically all of ing, and memory. Different drugs regions are involved not only in these brain regions perform multi- affect these neurotransmitter path- the experience of pleasure but in ple functions and have multiple ways in different ways. the anticipation and learning chemical messengers that are Much of the attention in the about it,” says Childress. Previous involved at each site. So the next addiction research community has research with animal models had level of question becomes not just focused on dopamine. Animal shown that these regions of the where the action is in the brain – data suggest that when an animal brain play these roles. “But it had which areas light up or are work- is staring at a sex partner across a never been demonstrated until we ing harder – but what’s the neuro- screen, or at a preferred food (rats, began this work in humans that in chemistry?” Childress and col- Childress notes, are particularly

10 ■ PENN MEDICINE Addison Geary

the spasms returned, along with both the cocaine craving and the high he got from taking cocaine. In effect, the patient had done his own baclofen experiment, with dose response, titration of dose, omission of dose – as Childress puts it, “all the things that if I had a long time to do I would like to do.” The patient’s experience provid- ed more than information about the effectiveness of baclofen. The medication was clearly helpful to this patient in bringing his craving into a manageable range. “He did not feel literally pulled out of his wheelchair to go look for cocaine, as he did when he omitted baclofen or before he was on it.” Before the patient decided to stop using drugs – which he did decide during his stay at Presbyterian – he was still “planning his life around essentially a couple of hours of cocaine pleasure at the Gary Aston-Jones, Ph.D., has studied the experience of withdrawal in addicted rats. end of the month. So he wasn’t driven by craving, but made a conscious intellectual plan to forego his baclofen knowing he fond of Cocoa Puffs), or at the sig- might be effective in blunting could have a few hours of plea- nal for cocaine, dopamine is craving. Baclofen works on the sure.” The lesson, asserts Chil- released in what Childress brain’s GABA (gamma-aminobu- dress, is that reducing the craving describes as “little gushes.” Her tyric acid) system. GABA is one of for drugs alone is not likely to be plan is to use tracers in the brain the most prevalent neurotransmit- enough for most people with an that have an affinity for dopamine ters in the brain. Animal studies addiction. Even if a drug reduces receptors. As before, she will show have shown that medications of cocaine craving quite a lot, it usu- subjects the video with cocaine this type affect many cocaine-relat- ally will not perform what Chil- associations before doing a PET ed behaviors: for example, they dress calls “a selective memoryec- scan. If the subject’s brain releases reduce the animals’ enthusiasm for tomy,” so that the person no dopamine while viewing the taking cocaine and block their longer even remembers cocaine or video, the dopamine will compete preference for a location in which the high it brought. “The person with the tracer for the receptors. they previously received cocaine. will still be in the role of making The image will thus be a mirror Childress had begun studies to an active decision of whether or image; if more tracer is imaged, it assess the effectiveness of using not to continue.” means there was less dopamine baclofen to treat addiction in Investigators are also looking competing for the receptor. humans when a colleague at Pres- at other neurotransmitters that Another way to ask the neuro- byterian Medical Center called to may play a role in addiction. “I chemical question, says Childress, say he had a patient that Childress doubt very much that in some- is to pretreat patients with a med- would be interested in meeting. thing as robust as addiction that ication that modulates brain The patient was a paraplegic who one neurotransmitter and one sys- dopamine and then observe had been taking baclofen for his tem is the whole story,” says Gary whether this pretreatment blunts spasms and who was also a Aston-Jones, Ph.D., professor of cue-induced craving and the acti- cocaine user. To keep his spasms psychology in psychiatry and of vation of the critical brain areas. under control, he doubled his dose pharmacology. In recent years, Such medications may act either of baclofen. According to Chil- several studies, including those directly or indirectly on brain dress, “He noticed when he took conducted by Aston-Jones and col- dopamine. For example, Childress that dose, it seemed like the leagues, have focused on the role has been interested in using this cocaine on the street was really not of serotonin, a neurotransmitter approach to investigate whether a as good as it was before. He began that interacts with many neuro- muscle relaxant called baclofen eliminating doses and noticed that transmitter systems, including

2001/SUMMER ■ 11 dopamine. Through animal stud- According to Aston-Jones, this utable to genetics. According to ies, the investigators have shown study indicates that something in Wade H. Berrettini, M.D., Ph.D., that administering the opiate mor- the brain of the chronically treated professor of psychiatry and of phine leads to an increase in sero- rats has changed and that the genetics, a first-degree relative of a tonin transmission in the nucleus SSRIs may be rectifying a deficit person dependent on heroin faces accumbens; furthermore, when induced by chronic exposure to a tenfold increased risk of becom- morphine is withdrawn, the sero- opiates. He recently completed a ing addicted himself or herself. tonin levels fall. Low serotonin second set of similar experiments Explaining this observation in levels have been linked with using cocaine rather than opiates genetic terms is likely to be quite depression and compulsive behav- and had similar results. “I’m quite challenging. As with other com- iors. Clinical reports have suggest- encouraged,” he says, “because it plex diseases, multiple genes are ed that drugs that inhibit the reup- suggests we might be looking at likely to interact with environmen- take of serotonin, thus increasing some common denominator.” tal factors as well as with psycho- the availability of the neurotrans- logical and social factors. Nonethe- mitter, may decrease drug craving. Probing at the molecular level less, the human genome is already These drugs, known as selective Questions remain in the effort revealing clues about drug addic- serotonin reuptake inhibitors or to understand drug addiction and tion. In fact, Charles O’Brien pre- SSRIs, include Prozac (fluoxetine) develop effective treatments. Why dicts that the genome project will and Zoloft (sertraline), drugs that does one person become addicted affect psychiatry more than any are widely used to treat depression and another does not? How is the other area of medicine. in humans. Aston-Jones has been brain of a person addicted to Scientists interested in addiction using an animal model of cocaine drugs different from the brain of are using a variety of approaches and opiate dependence to try to someone who is not? The answers to uncover secrets locked in the understand the physiologic mech- lie in understanding the changes genome. One approach is to give anisms whereby SSRIs might affect in the brain at a molecular and cel- drugs to animals and then look for craving. lular level and in learning how changes in gene expression in cer- He focused on the experience of genetic differences influence an tain areas of the brain. According withdrawal. Rats that have been individual’s tendency to travel the to one literature review published chronically treated with opiates road from drug use to drug addic- this year, the expression of more experience physical symptoms of tion. than 100 genes is altered after withdrawal such as anxiety, Studies of families and twins exposure to various drugs of depression, and drug craving suggest that 40-60 percent of the abuse. These genes are associated when the drugs are withheld. risk of becoming addicted is attrib- with a wide array of cellular func- Aston-Jones compared a group of chronically morphine-treated rats Wade Berrettini, M.D., Ph.D., has investigated the role of genetics in heroin dependence. (dependent) with a second group Addison Geary of rats that were given opiates acutely rather than chronically (non-dependent). When the drugs were withdrawn, both groups of rats expressed a preference for the environment where they received the opiate, although the dependent group showed a stronger prefer- ence. When the researchers treated the chronically treated rats with SSRIs, however, they found that two crucial indicators of with- drawal were alleviated: anxiety and the conditioned preference for the environment where they received the drug. In contrast, the acutely treated rats gained no ben- efit from the SSRI treatment. Aston-Jones was also able to show that even without subsequent administration of morphine, the chronically treated rats show decreased levels of serotonin transmission relative to acutely treated rats.

12 ■ PENN MEDICINE tions, such as up- or down-regula- and transporter genes for neuro- – methadone and LAAM (l-alpha- tion of receptors and production of transmitters that are involved in acetyl-methadol) – are available enzymes and other neurochemi- drug addiction. and a third one (buprenorphine) is cals. Another approach is to select nearing approval by the Food and candidate genes that seem likely to The payoff: better treatments Drug Administration. All of these be involved, and then look for The effort to understand the work by replacing opiates, but sequence differences among differ- neurobiology of addiction has led unlike heroin these agents are long ent individuals. to more effective treatments in acting. This property, said Charles Berrettini has been investigating several areas, although there is O’Brien, allows people to live a the role of genetics for a variety of still much more to be done. normal life even if they are unable psychiatric disorders, including According to Kyle M. Kampman, to eliminate the opiate completely. heroin dependence. He has M.D., assistant professor of psychi- “When you take a long-acting opi- focused on the idea that sequence atry, naltrexone is the best example ate, such as methadone, it kinds of variations in a gene that codes for of this progress. While most drugs goes up and stays sort of steady,” an opioid receptor might help used in psychiatry were discov- he explains. “There are some peo- explain differential susceptibility ered serendipitously, naltrexone is ple who seem to have a built-in to becoming addicted. “We started one of the few drugs that was need to be on something, some our interest in this gene because developed as the result of a scien- kind of external opiate. They func- we had done genetic studies in the tific theory about the neurochem- tion very well on the opiate, but if mouse that had pointed to the mu istry of addiction. Naltrexone was you take it away they do poorly.” opioid receptor as being impor- originally developed to treat Unfortunately, as Kampman tant,” he says. “Sequence variation addiction to heroin. Interestingly, notes, there are no drugs available in this gene seemed to explain a however, although naltrexone yet to treat cocaine addiction, fair amount of the variance in how blocks the craving for alcohol, it although several, including much morphine a mouse would does not block the craving for opi- baclofen, are under investigation. self-administer.” Since then, he has ates. And as Kampman bluntly “One of the reasons, in my opin- moved into human studies of the puts it, “If you find a medicine ion, is that we’ve asked the med- gene for this particular receptor, that doesn’t do much for craving, ications to do too much. In the examining sequence variations in it tends not to work too well.” A past we’ve basically tried to find a certain regions of the gene. Other second drug to treat alcoholism, medication that could do every- genes are also likely to be scruti- acamprosate, is also available out- thing for everybody.” By trying to nized in a similar manner – for side of the United States. treat everyone with cocaine addic- instance, genes for other receptors For heroin addiction, two drugs tion in the same fashion, Kamp- man believes, researchers have Kyle M. Kampman, M.D., found that patients who took regular doses of propanolol reduced their use of cocaine. overlooked the effectiveness of Addison Geary various drugs for certain sub- groups of people. Cocaine withdrawal, which can result in anxiety, sleep difficulties, appetite problems, irritability and depression, is usually less physi- cally dramatic than withdrawal from heroin or alcohol, which can involve shaking, sweating, and seizures. Still, Kampman has found that people with significant cocaine-withdrawal symptoms tend to drop out more easily and not get clean. “We looked at that and came to the conclusion that these people are really different.” Kampman has been studying the effectiveness of two drugs commonly used for other condi- tions that appear to lessen with- drawal symptoms: propanolol, which is used to treat high blood pressure, and amantidine, a drug used to treat Parkinson’s disease. Early studies produced mixed results; at times the drugs seemed

2001/SUMMER ■ 13 effective in relieving withdrawal chameleon-like medications that treat addiction. According to while at other times they appeared change their activity depending on Volpicelli, these programs are ineffective. “When you get results the level of the endogenous trans- often run by recovering addicts like that,” says Kampman, “you mitter around them,” explains who kicked their habits without start to think there’s a subgroup Childress. These drugs address a medical treatment; they often embedded in there that it may be dilemma in the effort to combat believe that other addicts can do effective for.” craving – that is, that cocaine crav- so as well, as long as they have the For Kampman, the mechanisms ing can result from either too motivation. of action of the two drugs suggest- much or too little dopamine. In a The view that addiction is a ed they might be useful for treat- chronic user of cocaine, halting the social rather than medical problem ing cocaine withdrawal. Amanti- use of cocaine can lead to a is further reflected in the medical dine stimulates the release of dopamine-depleted state; yet community. Most medical school dopamine; propanolol blocks the exposure to cues can stimulate curricula offer little training in the effects of adrenaline. People who enhanced dopamine activity. In treatment of addiction, although use cocaine get a strong adrenaline response to these varying states, since the late 1980s, a course on rush in response to cues that partial agonists stimulate drug addiction is required at remind them of cocaine; they also dopamine receptors when Penn’s medical school (see box on are very sensitive to the effects of dopamine levels are low and block pp. 8-9). Furthermore, there is adrenaline during withdrawal. the receptors when dopamine lev- resistance among physicians to Kampman and his colleagues els are high. Says Childress, “It’s treat drug addiction as a chronic, thought that propanolol might really fascinating to think that we rather than acute, illness. A. block some of the physical symp- might have medications that could Thomas McLellan, Ph.D., an toms of craving. In addition, the be able to essentially offer a adjunct professor of psychiatry at drug has been shown to affect moment-to-moment regulation of the Treatment Research Center, is memory. Kampman refers to a dopamine, depending on where the lead author of a paper in study in Science showing that the patient is.” JAMA (October 4, 2000) that lays propanolol reduced emotional out the case for regarding addic- arousal and, as a result, the memo- Resistance to change tion as a chronic disease. McLellan ry of events or things that were Despite increasing medical and compares addiction to three other emotionally arousing. According scientific evidence that demon- common chronic diseases — dia- to Kampman, O’Brien suggested strates the biological basis of betes, hypertension, and asthma. that he try the drug with cocaine addiction and the necessity of He demonstrates that these illness- patients. “Dr. O’Brien sees this and long-term treatment, much of the es share several features, including says, ‘well, what is cocaine craving general public and many profes- similar heritability estimates, fre- but an emotionally arousing mem- sionals involved in treatment con- quent problems with treatment ory of prior cocaine use? So let’s tinue to view addiction as a social compliance, and the influence of see if we can have that effect on problem rather than a health prob- personal behaviors on progression cocaine.’” lem. Since the beginning of the 20th of disease. The results of their eight-week century, the tendency in the Unit- According to O’Brien, the JAMA study indicated that those patients ed States has been to criminalize paper precipitated some strong with severe withdrawal symptoms addiction. “Most of the rest of the reactions. Physicians who wrote to stayed in treatment longer and world thinks of it as a medical the journal were indignant that used less cocaine when they took problem,” said O’Brien. “The ‘war addiction would be compared to regular doses of propanolol. An on drugs’ uses the metaphor of these other diseases, which do not earlier study led by Kampman had war and spends two-thirds of the carry a comparable stigma. In shown that amantidine reduced money on interdiction, which O’Brien’s view, “Doctors are just craving in cocaine patients with means burning poppy fields and like all other citizens and tend to significant withdrawal symptoms. shooting down planes in Peru. We blame the addict. They say, ‘They The next step will be to see have many more people in our brought it on themselves; they vol- whether giving propanolol and prisons than any other country in untarily took this drug.’” In reality, amantidine together will yield bet- the world, and it’s largely because he adds, “many, many people are ter results than either drug alone, of the drug war.” exposed to drugs but not every- or than a placebo. As a result, while research is body gets hooked, so there’s a lot New drugs are in the pipeline, well funded, there are too few that you’re not responsible for. But as well as familiar drugs for new treatment slots available for the once you get hooked, it’s really an uses. One class of drugs that has people in need of treatment. Much involuntary process.” ■ generated much interest for treat- of the treatment that is available is ment of cocaine craving is the delivered outside the health care Lisa Bain last wrote for Penn Medicine about Dr. dopamine receptor partial ago- system in 12-step programs that Katherine High’s gene therapy for dogs with hemo- nists. “Partial agonists are often reject the use of drugs to philia (Fall-Winter 2000).

14 ■ PENN MEDICINE ean-Antoine Houdon (1741-1828) Although very much a man of his seemed magically adept at neoclassical own time, a Penn Med alumnus has sculpture, with its traditional themes Jand idealized beauty. Yet he could also fashioned a second career outside bring naturalistic touches to his busts of th famous people, evoking their individuality. medicine, inspired by the 18 century’s Today, he is known for his statues and busts of people like Voltaire, Catherine the Great, most celebrated portrait sculptor. and Benjamin Franklin. Indeed, John A. Lan- zalotti, M.D. ’75, asserts that Houdon’s bust of Franklin “has become a part of the iconography of the United States.” As Lan- zalotti puts it, “all our concepts of the Founding Fathers come from Houdon.” One of the young nation’s leading citi- zens whom Houdon did not sculpt was James Wilson. Wilson signed the Declara- tion of Independence, served as a delegate to the Constitutional Convention, and was appointed one of the first Justices of the United States Supreme Court. The first lec- turer in law at any American institution of higher education, Wilson is recognized as the founder of Penn’s Law School. To commemorate Wilson’s legacy, the Law School’s Class of 2001 looked around for someone to create a marble bust of the School’s founder. Houdon, unfortunately, was nearly two centuries dead. But the rep- resentatives of the graduating class found someone to step in, chisel in hand: Lanzalot- ti, who has developed a commercially suc- cessful business creating busts of historical figures. During this May’s Alumni Week- end, Lanzalotti’s bust of Wilson was unveiled and presented to the school. How did Lanzalotti, who had been prac- ticing as a plastic surgeon, general surgeon, and generalist physician, come to be one of Houdon’s heirs? The short answer is man- aged care, but the story is somewhat more complicated than that. At any rate, the immediate impetus was his admiration for four Houdon busts of the Founding Fathers that Jefferson kept in his “gallery of wor- thies” at Monticello. During a visit, Lanza- lotti became interested in buying copies of Houdon’s work but was told there weren’t any to sell. Undaunted, Lanzalotti decided to try making his own copies. He was so

In the Style of HOUDON By John Shea

John Lanzalotti’s marble bust of James Wilson, founder of Penn’s Law School. 2001/SUMMER ■ 15 successful that today Lanzalotti’s in hand with his work as a med- copies of the four Houdon sculp- ical-legal consultant, he has made tures are on sale in the gift shop at detailed medical illustrations. As Colonial Williamsburg. he puts it, “I’ve got a whole “I’m totally self-taught,” he library of body parts.” says. He consulted texts on the art Still, creating sculptures was a and the materials, then set to new challenge. “It’s like a surgical work, apparently marshalling the operation,” he says. “I’m very effi- same determination that helped cient.” Doing the clay models usu- him get through Penn’s medical ally requires from six to eight school in three years. (He came to hours. Lanzalotti emphasizes that Penn after serving as an engineer- there is a technical component and ing officer in the Navy, already an artistic component. He also possessing what a friend calls “a notes that, much as in the days of rich life experience.”) Lanzalotti Michelangelo, the process of mak- turned to portrait sculpture in ing a sculpture begins with a earnest in 1996 – and he believes stonecutter knocking out some he’s getting better. “I’m amazed at stone for the artist. From that some of the stuff I turn out,” he point, Lanzalotti may spend any- says. No false modesty here. where from two to five weeks Indeed, a brief visit to his website “working every day and all day (www.williamsburgsculpture.com) long.” A large part of that time is reveals an impressive range of art, devoted to capturing the facial from what he calls the Houdon expressions and “projecting a cer- Reproduction Collection to recre- tain personality” as well as ations of Egyptian sculpture to smoothing the texture of the stone. copies of historic paintings that Stanley Taub, M.D., is in the have medical or scientific themes rare position of being able to eval- to detailed medical illustrations uate and appreciate Lanzalotti’s (for example, one shows the path work both as a plastic surgeon and of the facial nerve that innervates a sculptor – he, too, is both. “He the muscles of facial expression). does nice work as a sculptor,” says Henry R. Bleier, M.D., G.M.E. Taub, who adds that Lanzalotti’s ’77, M.B.A., a clinical professor of embrace of the neoclassical style psychiatry at Penn who is based at “is a natural for him.” Like plastic the Veterans Affairs Medical Cen- surgery, asserts Taub, sculpture “is ter, met Lanzalotti nearly 30 years all in the hands – the hands are in ago when Lanzalotti was doing a touch with a part of the brain.” clerkship in medicine and Bleier Both activities “have a sense of was his supervising intern. He purpose and design, there’s no calls Lanzalotti a “polymath” who guesswork.” Yet at the same time, “excelled at virtually everything Taub recognizes “a very Zen-like he did.” According to Bleier, the feeling” to plastic surgery and average person might be able to sculpture. He believes that visual- pick up an instruction manual and ization – seeing with “the mind’s build a model of some sort; in con- eye” – is very important in both. trast, Lanzalotti “produces an item of artistic excellence.” or all his talents, it is doubt- Although Williamsburg Sculp- ful that Lanzalotti would be ture is a relatively new venture, F following in Houdon’s path Lanzalotti had shown artistic incli- if his circumstances as a plastic nations as far back as high school. surgeon and general physician The summer before he took gross had not changed. After taking his anatomy at Penn, he points out, he residency in plastic surgery, Lan- was doing anatomical illustrations. zalotti settled in Williamsburg in Not surprisingly, his career as a 1982. He also enjoyed doing gener- plastic surgeon also fostered his alist medicine and felt he had suc- artistic talents. More recently, hand cess as a diagnostician. “I picked

Top: Lanzalotti’s copy of the Colonial Williamsburg unicorn (marble, 1999). Bottom: A commissioned portrait bust of Jacqueline Kennedy Onassis. 16 ■ PENN MEDICINE up a lot of early cancer patients,” describes Houdon’s portrait of he says, directing them to subspe- Franklin, which Lanzalotti copied cialists for confirmation and treat- in marble three years ago. Instead ment. On the whole, the 1980s of an idealized portrait, there are were a lucrative time for his prac- touches of naturalism, artistic tice. Then came the era of man- choices that show how Houdon aged care: “It’s been devastating.” went about evoking a complicated For one thing, he says, all the sense of character: “The expression other independent medical prac- on Franklin’s face seems to sug- tices in the region were bought gest his benevolence, wisdom, out. Lanzalotti lost his primary- humor, and his forthright quali- care patients because he had not ties. . . . His hair, thin on top, flows taken his residency in a compara- down over his ears and shoulders. ble field and the managed-care Houdon emphasized the wrinkles organizations would no longer at the corners of his eye, giving his refer patients to his practice. appearance from certain angles a Given his strong feelings on the look of weariness and even appre- matter, it is not surprising that hension.” Lanzalotti has published about Lanzalotti brings the same close health-care reform – for example, attention and awareness of context in the Journal of the Medical Associa- when he speaks about one of his tion of Georgia. The essence of his own works in progress, a statue of views is that “medicine is like a Justice commissioned for the sacred trust.” “You’re doing Williamsburg-James City County what’s in the best interests of the Courthouse. Eschewing naturalis- patient,” he says, or you shouldn’t tic touches, Lanzalotti says he was be doing it at all. Bleier points out striving for a neoclassical ideal. that Lanzalotti serves as a consul- Unlike the solid, somewhat mas- tant to the state legislature of Vir- culine Statue of Liberty, Lanzalot- ginia on health matters. ti’s embodiment of Justice is Besides sculpture, Lanzalotti “light, very graceful, very flow- has found other ways to compen- ing.” The statue, more than six feet sate for a reduced medical prac- high, will be carved in white mar- tice. He has been an adjunct facul- ble. Justice holds a sword in her ty member at the College of right hand and scales in her left; William and Mary. There he teach- both iconic accouterments are cast es some of the medical humanities. in bronze with a gold patina. The He especially enjoys dealing with lightness of the female figure con- the students, pointing out that trasts with the heaviness of sword some of them even have asked and scales – an attempt, says Lan- him to hood them at their gradua- zalotti, “to counterbalance the tion ceremonies. Another interest gravity of the legal system.” of his that burgeoned since the rise Although Lanzalotti can choose of managed care is consulting in among several career paths, sculp- medical-legal matters. In fact, he ture seems paramount at the says that one law firm has asked moment. “Sculpture frees him,” him to go to law school. “I’m toy- says Taub. That may be. What’s ing with that idea right now,” he undeniable is that Lanzalotti grew says. This range of passions and more animated when talking accomplishments has led both about the many other historical Bleier and Taub to describe Lanza- figures associated with the Univer- lotti as someone who approaches sity of Pennsylvania that could “the Renaissance man.” well deserve commemorative busts of their own. ■ t’s clear that Lanzalotti takes his sculpture very seriously, Iboth as practitioner and as stu- dent of the art. On his website, he

Top: Lanzalotti’s model for Justice, commis- sioned for the Williamsburg Ð James City County Courthouse. Bottom: Lanzalotti’s painted plaster bust of Nefertiti. 2001/SUMMER ■ 17 PC mgscuts fAde .Newberg, M.D. of Andrew B. SPECT images courtesy Scala /Art Resource, NY /Art Scala Frontal Lobes Frontal Lobes

BASELINE MEDITATION

A PHOTOGRAPH OF GOD?

Parietal Lobe Parietal Lobe BASELINE MEDITATION

Two Penn alumni explore the human biology brain activity. Their finding is that the human brain alters of belief, bringing with them the latest scien- during intense contemplation – and that these changes can tific tools. For several years, Andrew B. Newberg, M.D. be objectively observed and recorded. Newberg and D’Aquili ’93, has been fascinated by spiritual experience and by the published their research in The Mystical Mind: Probing the possibility of studying it through the high-tech techniques of Biology of Religious Experience (1999). Earlier this year, modern medicine. In 1991, while still in medical school, he Ballantine Books issued Newberg and D’Aquili’s Why God began a fruitful collaboration with Eugene D’Aquili, M.D. Won’t Go Away: Brain Science and the Biology of Belief, writ- ’66, Ph.D., a psychiatrist who also had a master’s degree in ten with Vince Rause. The new book presents their findings anthropology. Eventually, they began to study the brains of for a more general reading public. D’Aquili died in August, meditating practitioners of Buddhism and of Roman Catholic 1998. Newberg is now assistant professor of radiology at nuns at prayer. To do so, they used one of the tools of New- Penn. What follows is an excerpt from the first chapter. berg’s radiologic trade, a SPECT camera, which measures (The “large university hospital” cited in the text is HUP.)

18 ■ PENN MEDICINE n a small, dark room at the lab have led Gene and me to believe tion of the brain. The proper name of a large university hospital, a that experiences like Robert’s are for this highly specialized bundle Iyoung man named Robert lights real, and can be measured and veri- of neurons is the posterior superior candles and a stick of jasmine fied by solid science. That’s exactly parietal lobe, but Gene and I have incense; he then settles to the floor why I’m huddling, beside Gene, in dubbed it the orientation associa- and folds his legs easily into the this cramped examination room, tion area, or OAA. lotus position. A devout Buddhist holding kite string between my fin- The primary job of the OAA is to and accomplished practitioner of gers: I’m waiting for Robert’s orient the individual in physical Tibetan meditation, Robert is about moment of mystical transcendence space – it keeps track of which end to begin another meditative voyage to arrive, because I intend to take is up, helps us judge angles and inward. As always, his goal is to its picture. distances, and allows us to negoti- quiet the constant chatter of the We wait one hour, while Robert ate safely the dangerous physical conscious mind and lose himself in meditates. Then I feel a gentle jerk landscape around us. To perform the deeper, simpler reality within. on the twine. This is my cue to this crucial function, it must first It’s a journey he’s made a thousand inject a radioactive material into a generate a clear, consistent cogni- times before, but this time, as he long intravenous line that also runs tion of the physical limits of the drifts off into that inner spiritual into Robert’s room, and into a vein self. In simple terms, it must draw reality – as the material world in his left arm. We wait a few a sharp distinction between the around him recedes like a fading moments more for Robert to end individual and everything else, to dream – he remains tethered to the his meditation, then we whisk him sort out the you from the infinite physical here and now by a length off to a room in the hospital’s not-you that makes up the rest of of common cotton twine. Nuclear Medicine Department, the universe. One end of that twine lies in a where a massive, state-of-the-art To do its job so well, the orienta- loose coil at Robert’s side. The SPECT camera awaits. In moments, tion area depends on a constant other end runs beneath a closed Robert is reclining on a metal table, stream of nerve impulses from each laboratory door and into an adjoin- the camera’s three large crystal of the body’s senses. The OAA ing room, where I sit, beside my heads orbiting his skull with a pre- sorts and processes these impulses friend and longtime research part- cise, robotic whir. virtually instantaneously during ner Dr. Eugene d’Aquili, with the The SPECT camera (the acronym every moment of our lives. It man- twine wrapped around my finger. stands for single photon emission ages a staggering workload at Gene and I are waiting for Robert computed tomography) is a high- capacities and speeds that would to tug on the twine, which will be tech imaging tool that detects stress the circuits of a dozen super our signal that his meditative state radioactive emissions. The SPECT computers. is approaching its transcendent camera scans inside Robert’s head So, not surprisingly, the baseline peak. It is this peak moment of by detecting the location of the SPECT scans of Robert’s brain spiritual intensity that interests us. radioactive tracer we injected when taken before his meditation, while For years, Gene and I have been Robert tugged on the string. Because he was in a normal state of mind, studying the relationship between the tracer is carried by blood flow, show many areas of Robert’s brain, religious experience and brain and because this particular tracer including the orientation area, to be function, and we hope that by locks almost immediately into brain centers of furious neurological monitoring Robert’s brain activity cells and remains there for hours, the activity. This activity appears on at the most intense and mystical SPECT scans of Robert’s head will the scans in vibrant bursts of bril- moments of his meditation, we give us an accurate freeze-frame of liant reds and yellows. The scans might shed some light on the mys- blood flow patterns in Robert’s brain taken at the peak of Robert’s medi- terious connection between human just moments after injection – at the tative state, however, show the ori- consciousness and the persistent high point of his meditative climax. entation area to be bathed in dark and peculiarly human longing to Increased blood flow to a given blotches of cool greens and blues – connect with something larger than part of the brain correlates with colors that indicate a sharp reduc- ourselves. heightened activity in that particu- tion in activity levels. Whatever Robert calls this deep- lar area, and vice versa. Since we This finding intrigued us. We er consciousness, he claims that have a good idea of the specific know that the orientation area when it emerges during those functions that are performed by never rests, so what could account moments of meditation when he is various brain regions, we expect for this unusual drop in activity lev- most completely absorbed in look- the SPECT images to tell us a lot els in this small section of the brain? ing inward, he suddenly under- about what Robert’s brain was As we pondered the question, a stands that his inner self is not an doing during the peak moments of fascinating possibility emerged: isolated entity, but that he is inex- his meditation. What if the orientation area was plicably connected to all of cre- We aren’t disappointed. The fin- working as hard as ever, but the ation. To the traditional scientific ished scan images show unusual incoming flow of sensory informa- mind, of course, this description is activity in a small lump of gray tion had somehow been blocked? useless. Years of research, however, matter nestled in the top rear sec- That would explain the drop in

2001/SUMMER ■ 19 brain activity in the region. More mal brain function. In other words, to behave as our theory predicts compellingly, it would also mean mystical experience is biologically, that it would. These encouraging that the OAA had been temporarily observably, and scientifically real. results deepened our enthusiasm “blinded,” deprived of the informa- This result did not surprise us. for our work, and sharpened our tion it needed to do its job properly. In fact, it was exactly what all our interest in the fascinating questions What would happen if the OAA previous research had predicted. provoked by our years of research. had no information upon which to For years, we had scoured the sci- Questions like: Are human beings work? we wondered. Would it con- entific literature for studies examin- biologically compelled to make tinue to search for the limits of the ing the relationship between reli- myths? What is the neurological self? With no information flowing in gious practices and the brain, secret behind the power of ritual? from the senses, the OAA wouldn’t searching for insights into the biol- Are the transcendent visions and be able to find any boundaries. ogy of belief. Our approach had insights of the great religious mys- What would the brain make of that? been broad and inclusive. We tics based on mental or emotional Would the orientation area interpret found some studies that examined delusions, or are they the result of its failure to find the borderline simple physiology – for example, coherent sensory perceptions between the self and the outside they measured changes in blood shaped by the proper neurological world to mean that such a distinc- pressure of people as they meditat- functioning of sound, healthy tion doesn’t exist? In that case, the ed. Other studies aimed at loftier minds? Could evolutionary factors brain would have no choice but to stuff such as measuring the healing such as sexuality and mating have perceive that the self is endless and powers of prayer. We read the influenced the biological develop- intimately interwoven with every- research on near-death experiences, ment of religious ecstasy? one and everything the mind sens- studied mystical states induced by As we labored to better under- es. And this perception would feel epilepsy and schizophrenia, looked stand the implications of our theo- utterly and unquestionably real. at the data on hallucinations trig- ry, we found ourselves confronted This is exactly how Robert and gered by drugs as well as electrical again and again by one question generations of Eastern mystics stimulation of the brain. that resonated more deeply than before him have described their Besides our scientific readings, any other: Had we found the com- peak meditative, spiritual, and we also looked for descriptions of mon biological root of all religious mystical moments. Robert was one the mystical components of world experiences? And if so, what did of eight Tibetan meditators who religions and mythologies. Gene, in such an understanding say about participated in our imaging study. particular, researched the ritual the nature of the spiritual urge? Each was subjected to the same practices of ancient cultures and Askeptic might suggest that a routine, and in virtually every case, looked for a relationship between biological origin to all spiritual the SPECT scans showed a similar the emergence of ritual behavior longings and experiences, includ- slowing of activity in the orienta- and the evolution of the human ing the universal human yearning tion area, occurring during the brain. An abundance of informa- to connect with something divine, peak moments of meditation. tion exists that is relevant to the could be explained as a delusion Later, we broadened the experi- relationship between religious ritu- caused by the chemical misfirings ment and used the same techniques al and the brain, but little of it had of a bundle of nerve cells. to study several Franciscan nuns at been sorted or synthesized into a But the SPECT scans suggested prayer. Again, the SPECT scans coherent framework. another possibility. The orientation revealed similar changes that Yet as Gene and I sifted through area was working unusually but not occurred during the sisters’ most mountains of data on religious improperly, and we believe that we intensely religious moments. Unlike experience, ritual, and brain science, were seeing colorful evidence on the the Buddhists, however, the sisters important pieces of the puzzle came SPECT’s computer screen of the tended to describe this moment as a together and meaningful patterns brain’s capacity to make spiritual tangible sense of the closeness of emerged. Gradually, we shaped a experience real. After years of scien- God and a mingling with Him. hypothesis that suggests that spiri- tific study, and careful consideration As our study continued, and the tual experience, at its very root, is of our results, Gene and I further data flowed in, Gene and I suspect- intimately interwoven with human believe that we saw evidence of a ed that we’d uncovered solid evi- biology. That biology, in some way, neurological process that has evolved dence that the mystical experiences compels the spiritual urge. to allow us humans to transcend of our subjects – the altered states of The SPECT scans allowed us to material existence and acknowledge mind they described as the absorp- begin testing this hypothesis by and connect with a deeper, more tion of the self into something larg- observing the actual brain activity spiritual part of ourselves perceived er – were not the result of emotional of people engaged in spiritual prac- of as an absolute, universal reality mistakes or simple wishful think- tices. The images do not prove our that connects us to all that is. ■ ing, but were associated instead hypothesis beyond doubt but they with a series of observable neuro- strongly support it by showing From Why God Won’t Go Away, by Andrew Newberg, M.D. Copyright (c) 2001 by Andrew logical events, which, while unusu- that, in moments of spiritual Newberg, M.D. Reprinted by arrangement with al, are not outside the range of nor- behavior, the human brain appears Ballantine Books, a division of Random House, Inc.

20 ■ PENN MEDICINE he cover of the Class of 1951’s Scope reveals some urgent need for trained workers in every field, the demand of the typical levity of such books: the drawing for your services as physicians is almost without parallel. . . . Tshows a diapered tot approaching a rather imposing If the demand for your services is great, your obligation to set of doors, which could very well be leading into the John the community is correspondingly increased. While no one Morgan Building. The tot bears a satchel labeled “Frosh.” To will deny your right to consider your personal advantage, the right of the drawing, heading out – but presumably at a immediate expediency should never be permitted to cloud much slower pace – is a severely stooped old-timer with long your view of the more distant horizons. . . . We have confi- white beard and cane. He grasps a rolled-up diploma: in dence that you will make your choices wisely and, having short, the new graduate, shuffling off into the future. chosen, will acquit yourself well.” Much of the rest of the yearbook, especially the photo Now, 50 years later, some of those distant horizons are captions and cartoons, carried on this tone. One notable indeed here, and the time seems right to take a look at some exception is the message from the dean, John McK. Mitchell, of the paths taken, the choices made, by the members of the M.D., which was sober and high-minded: “In this time of Class of 1951 who answered their reunion questionnaires.

Celebrating the Class of ’51 ila Golden/SIS 2001/SUMMER ■ 21 ©She 1 Leeon F. Aller, M.D., and 5F. D. Beyer, M.D., Greens- his wife of 55 years, Vir- burg, Pa., retired from ginia, reside in Snohomish, pathology in 1998. He Wash. Emeritus professor of spends time playing golf family practice at the Uni- and the stock market. A versity of Washington, he former assistant professor at remains active in the med- the University of Pitts- ical mission work he began burgh, he received the many years ago. In 1991, Excellence in Education 1 he and his wife founded Award from Frick Hospital. the Hands for Peacemaking He also serves as a labora- Foundation, a non-profit tory inspector. He and his organization that “teaches wife Pat have two sons. and engages in actions and programs developing 6Henry P. Brown III, M.D., human services in Central Enfield, N.H., a retired America and throughout physician, is described by the world.” A former presi- his wife, Patricia, as “a gen- 2 dent of the Washington uine country doctor who Academy of Family Physi- delivered half the people in cians, Dr. Aller was named old Enfield.” Formerly on America’s Family Physician the staff of the Alice Peck of the Year by the American Day Hospital, he has also Academy of Family Physi- been chairman of the hos- cians in 1987. He has also pital’s board. He has served been honored by the U.S. on the planning committee 3 Military and the Boy Scouts of local schools, volun- of America. He and Vir- teered for Planned Parent- ginia had three children, hood, the Girl Scouts, and adopted seven more, and 4-H, and served as a direc- had 80 foster children. tor of the Grafton County Senior Citizens Council. 2Irvin C. Arno, M.D., Boyn- The people of Le Raysville, ton Beach, Fla., retired in Pa., named a new clinic 1986. A specialist in after him. 4 obstetrics and gynecology, he taught at Penn’s Gradu- 7 Laurence T. Browne, M.D., ate School of Medicine and Philadelphia, writes that he at the Temple University plans to retire from internal School of Medicine. He medicine in the year 2010. remembers Dr. Albert Klig- He is currently a clinical man as the most dynamic associate professor of med- lecturer during his years as icine at the Medical Col- a medical student. Dr. Arno lege of Pennsylvania, 5 enjoys fishing, golfing, trav- senior attending physician eling, and sculpting. He at Lankenau Hospital, and and his wife Maxine had director of the Presidential three children and have six Medical Center in Philadel- grandchildren. phia. Dr. Browne is also the executive and founder 3Eleanor M. Aurand, M.D., of the Philadelphia Ad-Hoc Lewiston, Pa., specialized Committee to Defend in pediatrics until her Health Care. In his free 6 retirement in 1987. She is a time, he enjoys photogra- life member on the Salva- phy, classical music, and tion Army Advisory Board. studying the history of medicine. He has three 4 Ross O. Bell Jr., M.D., lives children, all of whom work in Wheeling, W.Va., with in the field of medicine. his wife of 52 years, Wile- ta. Together they have five 8William Keegan Buchanan, children and 14 grandchil- M.D., lives in Hudson, 7 dren. Dr. Bell served as Ohio, with his wife of 54 chairman for the Depart- years, Celeste. They have ment of Pathology at the one daughter and one Ohio Valley Medical Cen- granddaughter. Dr. ter in Wheeling until his Buchanan was a fellow of retirement in 1990, special- the American College of izing in anatomic and clin- Anesthesiologists and ical pathology. served on the staff at St. 8

22 ■ PENN MEDICINE Francis Hospital in Pitts- erator in 1994 on “Alterna- burgh until his retirement tives to Silicone Breast in 1980. He is currently Implants.” In 1993, she researching his family his- received the Vitality Award tory and building his col- from the National Osteo- lection of American Indian porosis Foundation. She and Civil War artifacts. has six children and five grandchildren. 9 9 J. Lincoln Cain, M.D., and his wife, Rosemary, live in 13 Nancy Boucot Cummings, Wakefield, R.I. Dr. Cain M.D., has lived and was chief of radiology at worked in Washington, Waltham Hospital in Mass- D.C., for the past 42 years. achusetts for 34 years. Currently she is senior bio- Later, he worked as a radi- medical advisor for the ologist at Rhode Island National Institute of Dia- Hospital and as a clinical betes and Digestive and 10 assistant professor at Brown Kidney Diseases, clinical University until retiring in professor of medicine at 1995. He was a fellow of Georgetown University the American College of School of Medicine, associ- Radiology. Dr. Cain and his ate professor of community wife have five children and and family medicine at thirteen grandchildren. Howard University College of Medicine, and a fellow 11 10 William R. Campbell, at the Kennedy Institute of M.D., Salisbury, Md., Ethics. She is the recipient retired as an orthopaedic of numerous fellowships to surgeon in 1985. He now study infantile paralysis, enjoys playing bridge, golf- nephrology, and, more ing, and boating. He and recently, bioethics. In her his wife Marilyn have four free time, Dr. Cummings children. enjoys attending the opera, ballet, and symphony; she 12 11 Theodore B. Cohen, M.D., also sits on the Circles still works full time in the Board of the Kennedy Cen- field of adult and child psy- ter for Performing Arts. Her chiatry. In addition to three children and seven teaching, he has been the grandchildren live on three chairman of the Vulnerable different continents. Child Subcommittee and Discussion Group of the 14 Drs. Ruth Abrams and E. American Psychoanalytical Archer Dillard Jr. met in 13 Association. He has pub- medical school and will lished three volumes on the celebrate their 50th wed- “vulnerable child” and has ding anniversary on June received the B’nai B’rith 13. Both retired in 1990 Award for services to chil- after many years teaching dren. He has one son and at the University of Texas two grandchildren. In his Medical Branch in Galve- spare time, Dr. Cohen ston. Dr. Abrams special- plays tennis, gardens, and ized in pediatrics and Dr. 14 maintains a bird and ani- Dillard in obstetrics and mal sanctuary. gynecology. They now live in College Station, Texas, 12 Elizabeth B. Connell, M.D., and Boone, N.C. Dr. Dil- lives in Atlanta with her lard sits on the board of husband, Howard Tatum, directors at Hebron County 14 M.D., Ph.D. She retired in Ministries, a Christian 1997 but continues to con- home for alcoholics and sult, write, and lecture on drug addicts, while Dr. obstetrics and gynecology. Abrams spends time gar- Dr. Connell has taught at dening at Hebron and Emory University, North- singing in the church choir. western University, and They look forward to con- Columbia University. She tinuing their charity work worked with Planned Par- and have traveled to Belize enthood and the United five times on medical mis- States Food and Drug sions. They have three chil- Administration, including dren and six grandchildren. serving as workshop mod-

2001/SUMMER ■ 23 15 Victor H. Frankel, M.D., of the Award for Outstand- World Cup Ski Team and New York City, retired from ing Research in Hip the United States Olympic orthopaedic surgery in Surgery from The Hip Soci- Team, and has served on 2000. He is president emeri- ety and a two-time recipi- physician panels for the tus of the Hospital for Joint ent of the Kappa Delta National Football League Diseases in New York, pro- Award for Outstanding as well. fessor of orthopaedic Research in Orthopaedic surgery at New York Univer- Surgery. Dr. Harris has also 22 John B. Kucharczuk, M.D., sity School of Medicine, and been honored with the Allentown, Pa., still prac- 15 a docent in orthopaedic Maurice Muller Award for tices obstetrics and gyne- surgery for the University of Lifetime Achievement in cology. He and his wife of Uppsala in Sweden. Dr. Orthopaedic Surgery. He 40 years, Helen, have two Frankel has received various and his wife Nan have four children and three grand- awards for his research in children and five grandchil- children. In his leisure biomechanics, including the dren. time, Dr. Kucharczuk United States Ski Associa- enjoys photography and tion Award of Merit for 19 Walter L. Henley, M.D., working with computers, Research. He was made a lives in New York City with watches, and clocks. 16 Knight Commander of the his wife Edith. They have Royal Order of the Polar Star two daughters. Dr. Henley 23 Jerome M. Levine, M.D., by King Carl Gustaf XVI of retired in 1998 after teach- and his wife Bernice, New Sweden, in recognition of ing pediatrics for over forty Rochelle, N.Y., have been his promotion of Swedish- years and ophthalmology married for 53 years and American research programs for over twenty years at have three children. Dr. and educational studies. Mount Sinai School of Levine continues to prac- Medicine in the City Uni- tice psychiatry and psycho- 17 16 William F. Gebhart, M.D., versity of New York and the analysis in New York City; recently moved to Scotts- Albert Einstein College of he also teaches at the New dale, Ariz., after practicing Medicine of Yeshiva Uni- York University School of internal medicine and versity. He also worked in Medicine. In his free time nephrology in Santa Bar- pediatrics at Mount Sinai he enjoys music, lan- bara, Calif., for 42 years. Hospital, Beth Israel Med- guages, and gardening. His During that time he also ical Center, and the Hospi- fondest and most vivid served on the board of tal for Joint Diseases. medical school experience directors of the Southern was holding a retractor for 19 California Medical Council 20 John E. Keith, M.D., retired Dr. Henry Royster during and as co-medical director from orthopaedic surgery an eight-hour neck dissec- of the Santa Barbara Com- in 1992. A former associate tion. munity Dialysis Center. Dr. professor at the Medical Gebhart and his wife Rose- College of South Carolina, 24 O. Victor Lindelow, M.D., marie have been married he served as president of retired from internal medi- nine years. the South Carolina cine in January, 2001, after Orthopaedic Association. practicing for 46 years in 17 James W. Grifone, M.D., Dr. Keith has also been a Bismarck, N.D. He became 20 lives in Seal Beach, Calif., fellow of the American a fellow of the American with his wife of 43 years, College of Surgeons. He College of Physicians in Louise. He retired from now lives in Spartanburg, 1976. Dr. Lindelow has internal medicine in 1992 S.C., with his wife Kitty; served as governor of the but remains very active in they have four children and American College of Physi- Lions Club International eleven grandchildren. He cians for North Dakota and and still serves as medical hopes to organize a free as president of the North advisor for a Diabetes dental clinic in Spartanburg Dakota Medical Associa- Awareness Program. He to aid the working poor. He tion. Former chief of med- 21 recalls that shortly after spends his free time golfing ical service at St. Alexius graduation, he and class- and fishing. Hospital, he is clinical asso- mate Ross Bell found them- ciate professor of medicine selves working together in 21 Harry H. Kretzler, M.D., at the University of North the Far East, serving as and his wife Jean live in Dakota School of Medicine. medical officers in the Seattle. Retired from He has served as chairman United States Army Med- orthopaedic surgery last of the board of Blue Shield. ical Corps. year, he taught He and his wife Betty have orthopaedics at the Univer- been married since 1950 22 18 William H. Harris, M.D., sity of Washington School and have two sons and two Belmont, Mass., is the Alan of Medicine and served as daughters. Gerry Clinical Professor of orthopaedic consultant to Orthopaedic Surgery at the Rainier State School for 25 Albert A. Lucine Jr., M.D., Harvard Medical School more than twenty years. West Chester, Pa., was and chief of adult recon- Dr. Kretzler has also been chairman of the Depart- structive surgery at Massa- the team physician for a ment of Obstetrics and chusetts General Hospital. number of sports clubs, Gynecology at Chester He is a ten-time recipient including the United States County Hospital for about 24

24 ■ PENN MEDICINE fifteen years before retiring nia at Los Angeles and last year. He and his wife maintained a private prac- Mary Jane have two daugh- tice in Ventura, Calif., for ters, and the entire family nearly fifty years. Since has raised and showed a 1982 he has been active in few Morgan horses. Dr. Aeromédicos, providing Lucine is a past president medical care to outlying and director of the Nation- clinics in Baja California 25 al Morgan Association. and Mainland Mexico; he has also traveled to Kenya 26 William G. Mays, M.D., and East Africa providing lives in Tulsa, Okla., with his surgical services. He his wife, Ruth. In 1999 he enjoys flying and sailing retired from his occupa- and maintains an antique tional medicine practice airplane and car. and as instructor at Okla- homa University in Tulsa. 30 Bernadine Ziegler 26 He once managed a 25- Paulshock, M.D., retired bed hospital in rural Okla- from internal medicine in homa. For many years, Dr. 1960. She worked as senior Mays was a part owner of a attending and associate minor-league baseball team program director in the affiliated with the St. Louis Department of Family Med- Cardinals, and he was a icine at the Medical Center team physician for the of Delaware and as associ- 18 27 Tulsa Oilers baseball team ate clinical professor at and local high-school Thomas Jefferson Universi- teams. ty. After her retirement, she became editor of the 27 Charles F. Melchor Jr., Delaware Medical Journal M.D., retired from radiolo- and became a fellow of the gy in 1982 when he suf- American College of Physi- fered a massive stroke. He cians. She enjoys medical had spent the previous 25 journalism and history and 28 years in general diagnostic spends a great deal of time radiology at Decatur reading and writing. Of Memorial Hospital and medical school, she partic- Bloomington Radiology in ularly recalls “anatomy Illinois. Dr. Melchor and with Dr. Williams . . . phar- his wife Pauline live in macology with Dr. Myrtle Beach, S.C. Schmidt.” Dr. Paulshock lives with her husband 28 Edwin W. Monroe, M.D., Marvin in Wilmington, Del; 29 lives in Greenville, N.C., they have three children where he sits on the board and three grandchildren. of trustees of Pitt County Memorial Hospital and 31 Edward J. Pavsek, M.D., enjoys reading, walking, lives in Ponce Inlet, Fla., and playing golf. Before his with his wife of 50 years, retirement in 1993, he was Adelina. Of their seven executive dean at East Car- children, three hold olina University School of degrees from the University 30 Medicine, where he is now of Pennsylvania. Dr. Pavsek emeritus professor of medi- retired from radiology and cine. Dr. Monroe was for- nuclear medicine in 1989. merly executive director of He has been a member of the Kate B. Reynolds Chari- the faculty at the University table Trust. He is a fellow of Pittsburgh, Duquesne of the American College of University, the University of Physicians. Pennsylvania, and Penn State. He is the former 23 31 29 Charles F. Montague, M.D., chair of the Department of and his wife Marilyn met Radiology at Mercy Pitts- while they were students at burgh and a fellow of the Penn; they have been mar- American College of Radi- ried 55 years and have four ology. Dr. Pavsek is enjoy- daughters. Dr. Montague ing his retirement wood- was associate clinical pro- working, fly-fishing, gar- fessor in the Department of dening, and baking. Obstetrics and Gynecology at the University of Califor- 32 Gerald W. Peskin, M.D.,

2001/SUMMER ■ 25 and his high school sweet- Ariz., with his wife Marilyn. heart Pearl live in Emeryville, He plans to start work on his Calif., where he is clinical memoirs of the Depression professor of surgery at Uni- and war years, his education versity of California at and training, and his early Davis. He serves as associ- practice. ate editor of the Archives of Surgery. He hopes to retire 36 Douglas W. Sanders, M.D., within the next year and lives in Akron, Ohio, with 32 spend time with his family; his wife Jane. They have he has three children and been married for 51 years five grandchildren. He also and have three children. enjoys art and golf. Dr. He specializes in internal Peskin’s most memorable medicine and was a mem- experience at Penn was his ber of the Council of Sum- first clinical clerkship on the mit City Medical Society surgical service, with Drs. from 1988 to 2000. He has Koop, Ravdin, and Rhoads. no plans to retire yet. 33

33 Rose Pully, M.D., lives in Kin- 37 Robert T. Schorr, M.D., San ston, N.C. After retiring from Diego, closed his general her private practice in family surgery office in 1998, but medicine in 1976, she went continues to work as a surgi- on to become a clinical pro- cal assistant and hopes soon fessor of family medicine at to publish a piece in a East Carolina School of Medi- national publication for the 34 cine in Greenville, N.C. Her fifth consecutive decade. He pediatric experience at Chil- was inducted into Phi Beta dren’s Hospital during her Kappa and Alpha Omega third year of school still stands Alpha and received a out, and she writes, “I am for- Bronze Star and a Combat ever grateful and appreciative Medical Badge during the of my experience at the Uni- Korean War. He recalls his versity of Pennsylvania School proudest moment at Penn, of Medicine.” receiving a letter from Dr. 35 Francis C. Wood in February 34 David G. Rimer, M.D., of 1950 that congratulated lives in Santa Monica, him on “one of the best his- Calif., with his wife of 15 tories it has ever been my years, Anne Joy. Until his privilege to read.” He and retirement in 1994, he his wife, Georgene, have alternated between his full- been married 23 years. time private practice and various academic and 38 Bernard Shapiro, M.D., Nar- 36 directorial positions, berth, Pa., specialized in including clinical professor nuclear medicine before of medicine and acting retiring in 1998. He worked chief of gastroenterology at his way up at the Albert Ein- UCLA Center for Health stein Medical Center, even- Sciences and director of tually becoming director of the GI lab and chief of gas- the Radiation Research Lab- troenterology at St. John’s oratory – a position he held Hospital in Santa Monica. for nearly thirty years. He is 37 Still active in medicine, he now a trustee and chairman builds cabinets and furni- emeritus in the Department ture in his spare time. of Radiology there. Dr. Shapiro was a fellow of the 35 James W. Russell, M.D., American College of retired from internal medicine Nuclear Physicians. He in 1999. He maintained a pri- plans to study digital photog- vate practice in St. Johnsbury, raphy and enjoy retirement Vt., from 1958 to 1992 (he with his wife of 51 years, 38 expanded it to a group prac- Norma, and their three chil- tice in 1977). Dr. Russell also dren and six grandchildren. participated in establishing Founders Hall, a detoxifica- 39 Carl M. Shetzley, M.D., tion and primary rehabilitative Doylestown, Pa., and his care program for alcoholics wife of 53 years, Marion and drug addicts at Northeast- Elizabeth, have four chil- ern Vermont Regional Hospi- dren and five grandchil- tal. He now lives in Tucson, dren. He retired from fami- 39

26 ■ PENN MEDICINE ly practice in 1991, having ical staff, as president of served as president of the Union County Medical Doylestown Hospital med- Society, and as chairman of ical staff and of the Bucks the Committee on Family County Medical Society. Life and Sex Education. He Dr. Shetzley was a delegate is active in the local school to the Pennsylvania Med- board and Rotary Club. He ical Society for 20 years. has many memories of 40 He now enjoys gardening, Penn – including meeting playing bridge, and work- his wife on campus – and ing on his genealogy. is grateful that he and his classmates were privileged 40 Scott Dorsey Skillern, M.D., to practice during the South Bend, Ind., special- “Golden Age of Medicine.” izes in dermatology but plans to retire soon. He and 45 Edward Colmery Sutton, his wife have four children M.D., lives in Burlington, 41 and two grandchildren. He N.C., with his wife Jeanie. In is an active member of St. 1989 he retired from obstet- James Episcopal Church and rics and gynecology but still plays golf in his free time. volunteers at the Open Door Clinic in Burlington. He has 41 James E. Smith II, M.D., been chief of the medical Baltimore, practices psychi- staff at Memorial Hospital of atry in Towson, Md. He Alamance, president of the 42 and his wife Patricia have North Carolina Ob-Gyn six children. Society, and chairman of the ob-gyn section of the North 42 Irvin H. Sokolic, M.D., lives Carolina Medical Society. In in Princeton, N.J., with his his free time Dr. Sutton plays wife of 37 years, Joyce golf and gardens. Rochelle. They have six sons and six grandchildren. Dr. 46 Edgar H. Ward, M.D., Erie, Sokolic practiced general Pa., retired from internal 43 surgery for twenty years and medicine in 1994 but still maintained a general prac- contributes time to a med- tice for another twenty. He ical clinic. He enjoys playing has received 21 grants and golf and gardening. About published 16 original papers, his medical-school days, he has served as director of the recalls “a great education surgical residency program at and clinical experience – Albert Einstein Medical Cen- superb teachers.” Dr. Ward ter, and was named a fellow and his wife Jeanne met at 44 of the American College of Penn and have been married Surgeons. Now that he is for fifty years. They have two retired, Dr. Sokolic plans to children. pursue a Ph.D. degree in botany. 47 Allen M. Yeakel, M.D., lives in Mount Joy, Pa., 43 Robert Spier, M.D., splits his with his wife of 49 years, time between Punta Gorda, Theresa. They have four Fla., and East Aurora, N.Y. children and six grandchil- 45 He and his wife Mina have dren. Dr. Yeakel retired four children and three from anesthesiology in grandchildren. Dr. Spier 1990 and plans to spend practiced thoracic surgery time studying neurophysiol- until his retirement in 1987; ogy, growing vegetables, among the positions he held and enjoying music. While are instructor of surgery at practicing, he also taught at Cornell University and clini- West Virginia University cal associate professor of and was the founding 46 surgery at the State Universi- chairman of the Depart- ty of New York at Buffalo. ment of Anesthesiology at He plays tennis and golf, Pennsylvania State Univer- goes boating, and travels. sity College of Medicine. His favorite experience at 44 John J. Sprowls, M.D., Penn was participating in retired from obstetrics and summer work with John gynecology in 1995. He Lilly and Britton Chance at has served as president of the Johnson Foundation. 47 the Rahway Hospital med-

2001/SUMMER ■ 27 Daniel M. Albert, M.D. ’62, left, one of this year’s recipients of the Distinguished Graduate Edward W. Holmes, M.D. ’67, former chair of Penn’s Depart- Award, is flanked by Stuart Fine, chair of Penn’s Department of Ophthalmology. ment of Medicine, returned to campus to receive the medical school’s highest honor, the Distinguished Graduate Award. It Happened One Weekend

mid the pleasant meals, catch-up conversations, and high-spirited parades down Locust Walk that take place on Alumni Weekend, many returning alumni of the School of Medi- A cine also found time to attend the annual meeting of the Medical Alumni Society. They listened to Arthur K. Asbury, M.D., interim dean, speak about the state of the school, and they saw Joseph Gordon, M.D. ’57, introduced as the next president of the society. An internist from Drexel Hill, Pa., Gordon received the Alumni Service Award last year, at which time he was described as “the quintessential Penn citizen.” Gordon succeeds Henry A. Jordan, M.D. ’62, who completed his two-year term. Alumni also witnessed the presentation of the school’s highest honor, the Distinguished Graduate Award. This year, the two recipients were Daniel M. Albert, M.D. ’62, G.M.E. ’66, and Edward W. Holmes Jr., M.D. ’67.

At the Academy of Music, members of the Class of 2001 President Joseph Gordon, left, and Dean Arthur Asbury lead the parade of acknowledge family and friends for their support. School of Medicine alumni down Locust Walk.

28 ■ PENN MEDICINE Albert is internationally re- lism, Endocrinology, and Genetics. in his career, and has transmitted to nowned as a pioneering researcher, In 1991 he was recruited to Penn countless students, a set of values educator, author, and historian in as chair of the Department of that emphasizes treating the whole the field of ophthalmology. His six- Medicine. In his six years as chair, person. And he continues to com- volume Principles and Practice of the department increased its clini- mit his talents and energies to Ophthalmology is considered the cal revenue by 136 percent and improving the practice of medicine, authoritative contemporary com- raised its ranking in grant funding addressing the problems of risk pendium of the field. from the NIH from 22nd to 6th. management and medical malprac- After earning his M.D. degree Holmes was also a strong propo- tice.” Eisman is now Distinguished from Penn, Albert completed his nent of multidisciplinary centers Emeritus Professor of Clinical Med- internship and residency in oph- and institutes; four such new pro- icine at Penn. He has served the thalmology at HUP. In 1969 he grams, with faculty based primari- School of Medicine in countless vol- went toYale University School of ly in medicine, were begun under unteer roles and has contributed Medicine as assistant professor his chairmanship. many ideas that have shaped alum- and soon rose to full professor. He In 1997 he joined Stanford Uni- ni events for the better. joined Harvard Medical School in versity School of Medicine as the Gamble, described by Asbury as 1976 and was named the David G. senior associate dean for research a “quiet crusader” who has built Cogan Professor of Ophthalmolo- and vice president for translational support for student financial aid, gy in 1983. Since 1992 he has been medicine and clinical research. He established the Twenty-First Centu- chair of the Department of Oph- returned to Duke in 1999 to become ry Endowed Scholars Program with thalmology at the University of vice chancellor for academic affairs his wife Anne. As Asbury put it, Wisconsin-Madison and the Fred- of the Medical Center and dean of “His humble and generous nature erick A. Davis Professor of Oph- the School of Medicine. Last fall, has endeared him most to the peo- thalmology. Albert has received an Holmes was appointed vice chan- ple who are the focus of his atten- honorary degree from L’Université cellor for health sciences and dean tion: Penn medical students. He Louis Pasteur in Strasbourg. of the School of Medicine at the Uni- and Anne have forged strong rela- Editor-in-chief of Ophthalmic versity of California at San Diego. tionships with the students touched Surgery: Principles and Techniques Holmes has held continuous by their generosity.” (1998), Albert has served on the NIH funding since 1975, including The Graduation ceremony was editorial boards of nine scientific a M.E.R.I.T. Award. His laboratory held in Philadelphia’s Academy of medical journals. He is currently has made significant contributions Music, lending some additional editor of Archives of Ophthalmology. to our understanding of the con- glamour and color to the proceed- His research focuses on ocular trol of purine biosynthesis. He is ings. One of the speakers was tumors, specifically melanoma and currently focusing on a genetic Leeon Aller, M.D. ’51, representa- retinoblastoma. He is now investi- defect linked to congestive heart tive of the 50 Year Class, an emeri- gating the molecular biology of failure. Holmes is active on the tus professor of family practice at retinoblastoma and whether vita- NIH Scientific Boundaries Panel, the University of Washington, who min D analogs produce tumor the scientific advisory board of has devoted much of his profes- regression. SmithKline/Beecham, and the sional life to medical mission Holmes is widely known as an National Diabetes and Digestive work. But Aller took the opportu- advocate for the vital role of med- and Kidney Diseases Advisory nity to liven things up by playing ical schools in translational medi- Council of the NIH. He has been his harmonica, too. Delivering the cine – the application of scientific elected to the American Society for Graduation Address was Michael discoveries to the development of Clinical Investigation, the Associa- S. Brown, M.D. ’66, the Nobel better diagnostic methods and tion of American Physicians, and Prize recipient who serves as the treatments. He is also a nationally the Institute of Medicine of the Paul J. Thomas Professor of Molec- recognized clinical investigator and National Academy of Sciences. ular Genetics and Internal Medi- molecular biologist specializing in As in previous years, the School cine and director of the Jonsson genetics and metabolic disease. of Medicine also presented its Center for Molecular Genetics at After taking his internship at Alumni Service Awards. This year’s the University of Texas Southwest- HUP, Holmes went on to complete recipients, honored at the Dean’s ern Medical School in Dallas. As his research and clinical training at Dinner, were Sylvan H. Eisman, part of his message to the new Duke University Medical Center. M.D. ’41, and Walter J. Gamble, graduates, Brown emphasized He began a steady climb in Duke’s M.D. ’57. Eisman was described by some important characteristics of a academic ranks, eventually becom- Dean Asbury as “a sensitive and good physician that never change, ing chief of the Section of Metabol- knowledgeable physician as well as which can be summed up as ic and Genetic Diseases and then a committed teacher, . . . a healer in CLASS: Compassion, Learning, chief of the Division of Metabo- the classic sense. He has embodied Astuteness, Skills, and Science. ■

2001/SUMMER ■ 29 AlumniNews

Progress Notes years as professor of radiolo- Michael A. Grippi, M.D. ’76, chairman of the young physi- gy and chief of the division of G.M.E. ’82, was named chief cians section of the American compiled by Erin Hennessy neuroradiology. Earlier, he of medicine at the Philadel- Orthopaedic Foot & Ankle Send your progress notes to: had been associate professor phia VA Medical Center and Society. Abidi serves as Office of Medical Alumni Relations of radiology at Yale Universi- vice chair of Penn’s Depart- attending physician at University of Pennsylvania ty and chair of radiology at ment of Medicine. A member Dominican Hospital in Santz Medical Center the University of Pittsburgh. of the pulmonary/critical- Cruz, Calif., and is the team Suite 750 While at Yale, he developed care division, he recently physician for the University 3535 Market Street the C1-2 spinal puncture for completed a term as medical of California at Santa Cruz, Philadelphia, PA 19104 neuroradiology, now used director of Penn Medicine at Bethany College, and several throughout the world. He Radnor. He is also chair of local high schools. was the editor of the volume HUP’s Medical Board. ’s on neuroradiology in the Eric Britton, M.D. ’96, recent- five-volume series Clinical Theresa Vogel Crouch, M.D. ly completed his training for 30 Neurosciences. He received a ’79, after living in England general practice in the British Theodore Livingston Hart- “Best Teacher Award” from with her British husband for National Health System and ridge, M.D. ’34, is a retired Duke in 1988. Dr. Heinz con- almost 10 years, recently has been offered a partner- otolaryngologist in Madison, tinues to practice in the accepted a position as a diag- ship in the James Wigg Part- Wis. He and his wife are department part time. nostic radiologist at John nership, a large teaching members of the American Peter Smith Hospital in Fort practice in North Central Forestry Association; along Norman B. Ackerman, M.D. Worth, Texas. She had London. As part of his duties, with their interests in nature ’56, Ph.D., has published two worked as a radiologist at Britton will be responsible for conservancy, they have been books since his retirement RAF Lakenheath, Suffolk, educating students from Uni- actively involved in state and from surgery. Fat No More, England. She became a mem- versity College London Med- national history research. chronicling his experience ber of the Royal College of ical School. He can be During the Second World with morbid obesity, was Radiologists and of the reached by e-mail at eric.brit- War, Dr. Hartridge served in issued by Prometheus Books. Anglo-American Medical [email protected] or the Army Medical Corps and Morbid/Mortality, originally Society and a fellow of the [email protected]. received the Bronze Star. He published on the web by Royal Society of Medicine, all was one of the first American iUniverse, is a mystery set in based in London. medical officers to examine a teaching hospital, featuring prisoners in concentration a third-year medical student camps at Buchenwald, Cham, as protagonist. Ackerman is ’s OBITUARIES and Mauthausen. At Wash- currently at work on a sequel. 80 ington University, he was a H. Corwin Hinshaw Jr., M.D. fellow in otolaryngology Charles L. Greenblatt, M.D. David S. Block, M.D. ’86, was ’33, Belvedere Tiburon, Calif.; while also serving as profes- ’56, is preparing the second named executive vice presi- December 28, 2000. He served sor of military science and edition of his book Digging dent of international opera- as head of the Section of Med- tactics. Colonel Hartridge for Pathogens. The book, first tions for DuPont Pharmaceuti- icine at the Mayo Clinic Foun- served in the Office of the published (in English) by Bal- cals. Most recently senior vice dation, University of Min- Surgeon General at the Penta- aban Publishers of Israel in president of business develop- nesota, from 1947 to 1949, gon until 1950, and he also 1998, puts ancient diseases ment and strategic planning, then moved to California to served as chief EENT Sur- into context. He is also he joined the company in 1990 practice internal medicine. In geon at Brooke Army Hospi- presently involved in DNA and was a major contributor to 1952, he and collaborator tal in San Antonio. Named a analyses of thousands of the successful launching of the William Feldman were nomi- fellow of the American Col- shards from the Dead Sea anti-HIV medication Sustiva. nated for the Nobel Prize in lege of Surgeons in 1958, he is Scrolls. According to Green- An assistant professor of med- Medicine for their successful a former president of the blatt, reassembling individual icine at Johns Hopkins Hospi- treatment of tuberculosis Society of Otolaryngologists. scrolls from this complex tal, he also is a member of the patients with streptomycin. He was a professor of medi- puzzle would be much easier attending staff of the Moore He went on to become an cine at Baylor Medical School if the pieces can be linked to Clinic for HIV patients. Dr. emeritus professor at the Uni- before joining the Jackson specific (sheep) parchments. Block has an M.B.A. degree versity of California School of Clinic in Madison; there, he from Penn. Medicine at San Francisco. became staff surgeon and a member of the board and ’s James H. Farrior, M.D., G.M. president of the Methodist 70 ’s ’36, Iowa City, Iowa; April 11, Hospital medical staff. 90 1996. Mark T. Groudine, M.D. ’75, professor of radiation oncolo- Nicholas Abidi, M.D. ’90, John H. Prewitt, M.D. ’36, ’s gy at the University of Wash- was recently appointed an Lexington, Ky.; December 1, ington School of Medicine, associate editor for Foot and 2000. 50 was elected to the National Ankle International, and he co- Ralph Heinz, M.D. ’55, was Academy of Sciences. He edited the spring issue of Louis Udell, M.D. ’36, Phila- recently honored with a din- serves as director of the divi- Orthopaedic Clinics of North delphia, retired rheumatolo- ner by the Department of sion of basic sciences at the America. He has been a fellow gist and instructor; February Radiology of Duke Universi- Fred Hutchinson Cancer of the American Academy of 4, 2001. He was an instructor ty, commemorating his 22 Research Center. Orthopaedic Surgeons and at Penn from 1950 to 1974; he

30 ■ PENN MEDICINE also had a private practice in served his internship at Lan- Corps. From 1948 to 1966, in the Army Medical Corps, Northeast Philadelphia and caster General Hospital. Wiest practiced family medi- which included service in the was a staff physician at Starting his family practice cine in his hometown of East Korean War. He retired as a Nazareth and Lower Bucks less than two miles from the Petersburg, Pa. At Hershey major, and his decorations hospitals. He collaborated on farm where he was born, he Medical College of Penn State included the Legion of Merit an early study using cortisone practiced until 1986. A med- University, Wiest helped and the Bronze Star. Since the injections to treat arthritis. Dr. ical officer during World War establish a curriculum in 1960s, Segal had worked on Udell was a fellow of the Amer- II, he was a major in the U.S. family medicine and helped and off at the Washington ican College of Rheumatology. Army and served at an evac- found the Department of School of Psychiatry, where uation hospital in Europe. Family and Community he taught classes in advanced Calvin P. Wallis, M.D. ’36, Landis, who played clarinet Medicine. He was a former psychotherapy training and Duarte, Calif.; June 28, 2000. and saxophone, was a charter president of the Pennsylvania professional identity issues. member of the New Holland Academy of General Practice. He had also been affiliated Charles Fletcher Owen, M.D. Boys Band. In 1990, the Lan- He retired from Hershey in with the Georgetown Univer- ’37, Asheboro, N.C., retired caster City and County Med- 1981. Active in community sity School of Medicine, radiologist; January 6, 2001. ical Society honored him on education, he served as where he taught a course in the 50th anniversary of his president of the Hempfield communication skills for John Lockwood Morrison, graduation from medical Union and Lancaster County medical students. M.D. ’38, Waltham, Mass., school. school boards. obstetrician and gynecologist; Louis Magilner, M.D., G.M. February 9, 2001. During Edwin W. Cauffield, M.D., Robert Buch, M.D. ’46, ’47, Delray Beach, Fla.; June World War II, he served in G.M. ’42, Akron, Ohio; June Mountville, Pa.; February 7, 20, 2000. the Medical Corps, 55th Gen- 3, 2000. 2001. He had a family practice eral Hospital, stationed in in Mountville for 30 years and Richard P. Ornsteen, M.D. Europe. In 1998, the Massa- Victor J. Montilla, M.D., also served as deputy coroner ’47, Gladwyne, Pa; December chusetts Medical Society hon- G.M. ’42, Fayetteville, N.C.; of Mountville and West 28, 1999. ored him for his 50 years of June 4, 1994. Hempfield Township. During membership. World War II, he served as a John R. Higgins, M.D., G.M. Joseph S. Burkle, M.D. ’43, captain in the Army Air ’48, Floyds Knobs, Ind.; Feb- Oliver William Suehs, M.D., G.M. ’50, York, Pa.; December Forces Medical Services. ruary 2001. G.M.E. ’38, Austin, Texas, a 2000. retired otolaryngologist who Alfred H. Dobrak, M.D., G.M. David R. Patrick, M.D., G.M. had maintained a practice William F. McGuire, M.D. ’46, Pompano Beach, Fla.; Janu- ’48, Beaver, Pa.; November there for 35 years; January 2, ’43A, Wichita, Kan.; May 27, ary 26, 2001. He was an Army 29, 1992. 2001. During World War II, he 1999. captain in World War II, serv- was chief of the otolaryngolo- ing in the European Theater. In Blair W. Saylor, M.D., G.M. gy department at the 127th John J. Angelo, M.D. ’44, 1948, he became certified by ’49, Tucson, Ariz.; May 12, 2000. General Hospital unit in York, Pa.; January 23, 2001. the American Board of Radiol- Europe. A former chief of staff ogy. He practiced at Sisters Robert Greenleaf Umstattd, at St. David’s Hospital, he had Carl W. Filsinger, M.D. ’44, Hospital and the former Emer- M.D. ’49, Beckley, W.Va., served as president of the Stone Harbor, N.J., retired gency Hospital in Buffalo, N.Y., retired anesthesiologist; June Travis County Medical Society, physician; February 1999. before moving to Florida. 14, 2000. He served as a Unit- as vice president of the oto- ed States Navy Lieutenant in laryngology section of the Herbert S. Greenspan, M.D., Charles Herrick Knicker- the Korean Conflict, practic- Texas Medical Association, and G.M. ’45, Jenkintown, Pa., bocker, M.D. ’46, Bar Harbor, ing family medicine and as vice president of the Ameri- retired pediatrician and child Maine; January 9, 2001. Since surgery for two years before can Laryngology Association. psychiatrist; December 24, 1947, he served the Mount returning to the United States 2000. He had a private practice Desert Island community as a for an anesthesiology resi- Birna Nystrom Sullivan, and later served as head of the family physician specializing dency at Mary Hitchcock M.D., G.M.’38, Green Valley, children’s psychiatric clinic at in internal medicine and car- Hospital at Dartmouth, N.H. Ariz; Autumn 2000. Abington Memorial Hospital. diology. A chief of staff and He then returned to Austin, He also volunteered at the medical review officer for the Texas, where he grew up; in Eugene S. Bereston, M.D., Philadelphia School for the Mount Desert Island Hospi- 1957, he joined the Austin G.M. ’40, G.M.E. ’55, Deaf & Dyslexic and at Martin tal, he had been president of Anethesiology Group. Dr. Pikesville, Md., clinical pro- Luther King High School. the Hancock County Medical Umstattd was instrumental in fessor of dermatology at the Society. He also wrote several advancing outpatient surgical University of Maryland and Hiram L. Wiest, M.D. ’45, novels, including The centers, notably Bailey Square chief of dermatology at Hershey, Pa., a retired profes- Dynasty, Summer Doctor, and Surgical Center. Mercy Hospital in Baltimore; sor of family and community The Hospital War. December 16, 2000. He was medicine at Milton S. Her- Paul E. Maust, M.D. ’50, But- team dermatologist to the shey Medical College; Janu- Henry Albert Segal, M.D. ler, Pa.; January 21, 2001. Baltimore Orioles and the ary 11, 2001. After earning his ’46, Chevy Chase, Md., psy- After maintaining a family old Baltimore Colts. medical degree, he trained as chiatrist and psychoanalyst; practice in Petrolia for seven a general-practice intern at January 12, 2001. He did his years, he entered a four-year Floyd M. Landis, M.D. ’40, Lancaster General Hospital, psychiatric residency at Wal- residency in general surgery Leola, Pa., a retired physi- then served as an officer in ter Reed Army Medical Cen- at the Philadelphia Veterans cian; February 5, 2001. He the U.S. Army Medical ter. From 1946 to 1955, he was Hospital; during this time he

2001/SUMMER ■ 31 Gottlieb’s Gift also pursued graduate work full professor in both depart- in pediatrics at The Children’s ments in 1971; was director of Hospital of Philadelpia. He the endocrinology section in then practiced surgery for 30 the Department of Medicine years in Butler, serving as from 1966 through 1969; and chief of staff at Butler Memor- served as chairman of bio- ial Hospital and president of chemistry from 1971 to 1975, at the Butler Medical Society. which point the biochemistry department was merged with Robert H. Thomas, M.D. ’51, biophysics. He was appointed Yakima, Wash.; September 5, associate dean for special pro- 2000. grams in 1975, a position he held until 1986, and he served Ralph M. Brugger, M.D. ’52, on many advisory committees hilip M. Gottlieb, M.D.’35, believes in giving Ames, Iowa; August 9, 2000. both here and at the NIH. Fer- credit where credit is due. In private practice He practiced at the McFar- guson’s research centered on in internal medicine and allergy for more than land Clinic for 33 years. the molecular basis of hormon- 40 years, he played a major role in persuading the al action; an important contri- P American Medical Association to move allergy to its Hadley L. Conn Jr., M.D., bution was demonstrating the G.M.E. ’53, Piscataway, N.J., value of photoaffinity labeling own section (he served as founding chair) and to emeritus professor and chair in such studies. He was also a include it as an independent field in the American of the Cardiovascular Insti- flutist with the Philadelphia Board of Medical Specialties. tute of the University of Med- Doctors’ Orchestra, which he Today, Gottlieb takes pride in the fact that allergy icine and Dentistry of New served as president. After leav- “gets its due.” But he’s still pushing for recognition of Jersey-Robert Wood Johnson ing Penn, Ferguson spent people and institutions that make important contribu- Medical School; Dec. 3, 2000. seven years at the National tions. This time around, his focus is his alma mater. He was a former professor of Library of Medicine in Bethes- “In all those years of practice, I kept thinking back to medicine at Penn. da, Md., where he was the fine training I had in medical school and my profes- involved with the design of a sors,” he says, citing Truman Schnabel Sr., I. S. Ravdin, Ben P. Estes, M.D., G.M. ’53, biotechnology database. Philadelphia; October 14, and Charles C. Wolferth. “I just felt I ought to give back 1998. R. Claude Rogers, M.D., Bala some token of what they did for me.” In January, he did Cynwyd, Pa., emeritus assis- – honoring the School of Medicine by establishing a David Kasner, M.D., G.M. tant professor of physical charitable gift annuity. ’56, Coral Gables, Fla.; Janu- medicine and rehabilitation; Inspired by his three physician uncles, Gottlieb ary 6, 2001. December 15, 2000. Educated planned a career in medicine from the start, enrolling in in Bucharest, he came to the Penn’s special seven-year undergraduate/medical degree Willard F. Conger, M.D. ’74, U.S. in 1964. He joined Penn program. “I did it just to save a year and get to work,” he San Francisco; October 1995. in 1971 as an instructor and says. A Simon Muhr scholarship paid his $400-per- became an assistant professor semester tuition. Gottlieb graduated Phi Beta Kappa and in 1978. He retired in 1988. An artist himself, Rogers served as editor of the Class of ’35 Record. believed that art could play a His professional highlights include induction into FACULTY DEATHS role in healing mind and Alpha Omega Alpha and teaching appointments at HUP body, and he published a and Philadelphia General Hospital. He served on two Hadley L. Conn Jr. , M.D. See book on the subject. His own NIH consensus development committees and chaired Class of 1953. art was displayed in local one of them. He was a director of the American Board galleries, including Penn’s of Allergy and Immunology as well as president of the James Joseph Ferguson Jr., Faculty Club. M.D., Chevy Chase, Md., for- American College of Allergists and Immunologists. Fol- lowing a heart attack in 1981, he sold his practice. mer chair of biochemistry and Robert Stanek, M.D., G.M.E. A frequent visitor to Penn, Gottlieb approves of the former associate dean; Febru- ’77, Huntingdon Valley, Pa.; ary 17, 2001. After earning his December 31, 2000. After many changes he’s seen. His gift, he says, is also a form medical degree from the Uni- receiving his medical degree of thanks for the special status he enjoyed: “When you versity of Rochester, he took an from Temple University in circulate around doctors in the country, you discover internship and a residency in 1972, he went on to serve his that the title ‘Penn graduate’ is very highly regarded.” endocrinology at Massachu- residency at Rhode Island In addition to obtaining a generous income tax setts General Hospital. He Hospital at Brown University. deduction, Gottlieb will receive a lifetime income stream came to Penn in 1959 with a He served on the staff at from the charitable gift annuity. His planned gift is just dual appointment in biochem- Frankford Hospital, Holy istry and medicine (endocrinol- one of the creative gift opportunities that would benefit Redeemer Hospital, and HUP. both the School of Medicine and its alumni. As you chart ogy). A Markle Foundation He was a fellow of the Ameri- your financial future, the Planned Giving Office is ready scholar, he received a research can College of Surgeons. career development award to assist in developing an appropriate strategy. Contact from the NIH. He became a Louis Udell. See Class of Marcie Merz, J.D., director of planned giving, Univer- 1936. sity of Pennsylvania Medical Center, 3535 Market Street, Suite 750, Philadelphia, PA 19104-3309. Phone: 215-898-9486. E-mail: [email protected].

32 ■ PENN MEDICINE The Last Word

A Campaign Concludes Still, while we celebrate the tremendous success of the Creating ne of the most satisfying the Future of Medicine campaign duties during my year as and all it will continue to make pos- interim dean was observing sible, many challenges remain. Our O development efforts continue the wonderful progress made by the School of Medicine’s capital cam- because there are always fund-rais- paign. The Creating the Future of ing needs in an institution as large, Medicine campaign was launched in complex, and forward-looking as the fall of 1995, and it was my plea- ours. Our new executive vice presi- sure to preside at an event this past dent and dean, Dr. Arthur Ruben- stein (see “Vital Signs”), will be set- April that celebrated its official close. secure gifts from more than 250 fac- ting the priorities in conjunction There was indeed much to celebrate. ulty members in support of student with Krista Mattox and her expert The total raised in those five years is financial aid. Including matching staff in the development office, but a tribute to all our donors and vol- funds put up by the Welshes and by some needs stand out. A plan is unteers: $648 million for education, Walter J. Gamble, M.D. ’57, and under way to upgrade the school’s research, and patient care. We had Anne Gamble, close to $4 million educational facilities and cluster an amazing 42,000 donors, and the was generated by faculty giving. It them in the John Morgan Building average gift was about $14,000. was an honor for me to serve as and adjacent parts of the Anatomy- Among alumni, the average gift was chair of that committee. Chemistry Building. This is a major $8,469. I am happy to point out that No overview of the capital cam- project, and there are others. We Penn medical alumni have always paign would be complete without a need better connections and access answered the call for support during salute to the Gambles. They created between the parts of the Health Sys- capital campaigns. We can trace this the visionary Twenty-First Century tem on the old site of Philadelphia support back some 130 years, when Endowed Scholars program to General Hospital and the rest of the a young clinical lecturer named relieve the increasing debt burden medical campus. William Pepper Jr. led alumni in a shouldered by most medical stu- In the area of health services, the three-year campaign to raise dents. After their initial gift of $10 operating rooms and the periopera- $700,000 to establish the Hospital of million to create full-tuition scholar- tive acute-care units have to be the University of Pennsylvania. ships, they have continued over the upgraded and expanded, particular- Recruiting and retaining the finest years to support financial aid ly at HUP. Capital intensive faculty has long been a priority at through gifts of an additional $17 upgrades are also necessary at Penn- Penn. As the Ruth Wagner Van million. For example, they estab- sylvania Hospital, Presbyterian Meter and J. Ray Van Meter Profes- lished the Gamble Challenge to Medical Center, and Phoenixville sor Emeritus of Neurology, I know alumni donors at the $25,000 level, Hospital. Further, we have a desper- at first hand how valuable the sup- and 58 alumni responded. ate need for an ambulatory care cen- port provided by endowed chairs is Albert M. Kligman, M.D., Ph.D., ter on campus. Another opportunity to our faculty members. In the is both an alumnus of the School of is to develop more comprehensive course of the campaign, 45 endowed Medicine (Class of 1947) and an capabilities in the University of chairs were created in the school. emeritus faculty member in our Pennsylvania Cancer Center; a par- The endowment for financial aid Department of Dermatology. He and ticularly attractive possibility is a showed an astonishing growth: from his wife Lorraine H. Kligman, Ph.D., state-of-the-art proton-beam facility. $37 million in 1989 to $127 million in pledged $1 million in support of the It is still too early to measure the 2000. One reason for the increase is Twenty-First Century Endowed full impact of the Creating the that student financial aid was one of Scholars program. There are many Future of Medicine campaign – by the campaign’s priorities – but in other supporters, too numerous to definition, the future lies ahead. But addition, the School of Medicine had name here, but all of them have our we are confident that the impact will several alumni and friends who profound thanks. be measured in new advances made served as champions of financial aid. I would also like to thank the Cam- in research, in the world-class physi- Two couples deserve special men- paign Steering Committee, including cians trained in our tradition of tion, the Gambles and the Welshes. members from our Health System’s excellence, and in the number of Raymond H. Welsh, a trustee of our Board of Trustees, for providing lives saved and restored through our Health System and a 1953 alumnus essential oversight of the campaign, patient care. On behalf of this great of the Wharton School, chaired the for keeping us on track, and for pro- institution, I extend my sincerest entire campaign. In addition, he and viding stewardship on special pro- thanks to all who have contributed his wife, Joanne, launched the Welsh jects. Among our alumni, the National to our campaign to create the future Faculty Challenge, by which they Alumni Council made great contribu- of medicine. matched every gift of $1,000 or more tions to the capital campaign in terms from a member of the faculty, up to of gifts, loyalty, and wise counsel. I a total of $1 million. In all, the Facul- want to acknowledge its tireless chair- Arthur K. Asbury, M.D. ty Campaign Committee helped to man, Stanley J. Dudrick, M.D.’61. Interim Dean, School of Medicine Charles P. O’Brien, M.D., Ph.D., professor of psychiatry at Penn, has been director of the Treatment Research Cen- ter since its founding in 1971. The center has always sought to combine treatment for addiction with scientific research – among other rea- sons, as he puts it “to try and find out whether treatment A was better than treatment B.” During those 30 years, research into the neurochem- istry, neuropsychology, and genetics of drug addiction has changed the way scien- tists understand addiction and has led to a new genera- tion of drug treatments.

Non Profit UNIVERSITY OF PENNSYLVANIA MEDICAL CENTER Organization U.S. Postage 2018 Penn Tower 3400 Spruce Street PAID Philadelphia, PA 19104-4385 Phila., PA Permit No. 4097

Address Correction Requested