RENAMESRECORD-SETTING MEDICALPERELMANS’ SCHOOL $225 MILLION GIFT

SPRING 2011

VACCINES IN THE VANGUARD

Dean Rubenstein Leaves His Mark: 10 Years of Success A Little Program That Flourished: “Bridging the Gaps” Gaps and Transformations sicians may be seeking out employ- firm was still Lewis & Engstrom. When ment arrangements that compensate I became editor of the magazine for the The cover article of our Winter them in other – nonfinancial – ways,” Spring 1998 issue, I was very happy 2010/2011 issue was about a study by such as greater flexibility and “family- to have so talented and experienced a Penn Medicine investigators to find friendly attributes.” designer to lean on. strategies to achieve greater equity for “The Pyramid Problem,” in The Al was a graduate of the Philadelphia women in academic medicine. The Chronicle of Higher Education (March 9, Museum School of Industrial Art (now study – “Transforming Academic Cul- 2011), looks not at women M.D.s but the University of the Arts) and a veteran ture” – is supported by a grant from the at women Ph.D.s working at American of the Korean War. During his career National Institutes of Health. Women universities. Unfortunately, the situa- as an artist and designer, he created are overrepresented in the lower ranks. A tion sounds familiar. According to Mary award-winning publications, logos, 1995 study found that only 5 percent of Ann Mason, the author, “We measure and communication materials for some women had achieved the rank of full gender equity in three important ways: of the most prominent foundations and professor while 23 percent of men had. representation on the faculty, pay, and educational institutions in Philadelphia, Ten years later, another study found that family formation. Put simply: There including The Annenberg Foundation, women held 11.5 percent of the full are far fewer women than men at the The Pew Charitable Trusts, and LaSalle professorships – at the same time that top of the academic hierarchy; those University. He also designed labels and women now made up half the students women are paid somewhat less than packaging for Dock Street, the Philadel- in medical school. men, and they are much less likely phia beer, which he mentioned one day As reported in the article, Penn in- than men to have had children.” Women when I happened to raise a bottle of vestigators are testing interventions to made up 23 percent of full professors. Dock Street Bohemian in his presence. correct this rather extreme imbalance. As Mason also points out, not all tenure- With much of the credit going to Al, I suspect other medical schools will be track jobs are of equal weight, and Penn Medicine received the Pepperpot, paying attention if the interventions are women are least well represented at the highest award, in the magazine successful. But as a few articles that doctoral-level institutions. The pyra- category for both 2009 and 2010 in have appeared elsewhere since the Penn mid, she argues, “is unlikely to change the annual competition run by PRSA Medicine piece suggest, fixing the pay its shape without serious structural Philadelphia, the local chapter of the gap and position gap in the medical transformation.” Public Relations Society of America. profession will not be easy. An article in Transformation is precisely what the In addition, the cover of the Spring Health Affairs (February 2011) exam- Penn Medicine investigators are trying 2010 issue of Penn Medicine, illustrating ined the starting salaries of physicians to achieve. an article on autism research, won finishing their training programs in New two awards: an American Graphic York State from 1999 to 2008. The It is my sad task to report that Albert Design Award from Graphic Design sample size was 8,233 physicians. Even Lewis, principal in the design agency of USA; and the Gold Medal in the Visual while avoiding “confounding variables,” Lewis & Nobel Design, died on April 13, Design and Print category, from the the investigators demonstrated that after a two-year battle with pancreatic 2010 CASE District II Accolades Award “the gap in starting salaries between cancer. Al was busy working on the Program. One of my favorite Penn male and female physicians existed design and layout of Penn Medicine up Medicine covers appeared in 2005. For throughout the ten-year survey period, to a week before his death. That was that issue, Al found a local artist, Wally despite the fact that proportionately not a surprise to those who knew him, Neibart, to bring to life our somewhat fewer women were entering the lower- because his dedication and attention crazy idea for illustrating an article on paying primary care fields.” In 2008, to detail were remarkable. Al began Penn’s Weight and Eating Disorders the male physicians newly trained in designing Penn Medicine with its very Program: it showed the familiar pair New York State earned on average first issue, back in Fall 1987, when the from Grant Wood’s American Gothic, $16,819 more than comparable female with substantially more poundage! physicians – a wider gap than there Al will certainly be missed. Graham was at the start of the study period. Perry, who worked very capably with The authors of the study do suggest Al on Penn Medicine for several years, one possible explanation: “female phy- designed this issue.

Cover photograph courtesy of Bruce L. Levine, Ph.D. Magnetic beads (false yellow color) are coupled to monoclonal antibodies against CD3 and CD28 on T lymphocytes (false color orange). CD3 and CD28 are molecules involved in activating T lymphocytes. SPRING 2011 / VOLUME XXII NUMBER 4

2A 'MOMENTOUS' GIFT -- 4A DECADE OF SUCCESS AND A NEW NAME By John Shea Raymond and Ruth Perelman have After 10 years as dean of the School of made a $225 million gift to rename Medicine and executive vice president of the School of Medicine. It is the largest the University of Pennsylvania for the single gift ever given to the University of Health System, Arthur H. Rubenstein steps Pennsylvania and creates a permanent down from what he once called a “job endowment for the school. made in heaven.” His faculty, colleagues, and professional organizations agree: he filled the role with distinction.

24VACCINES IN THE VANGUARD By Jessica Stein Diamond At Penn Medicine, physician-scientists are creating new DNA vaccines that hold great promise for fighting disease more effectively, with fewer side effects. Less like a drug in a bottle or a vaccine in a vial, they are “more like a next-generation blood transfusion.” But the new vaccines are expensive, and funding can be hard to find. 11A NOVEL IMMUNE THERAPY 1A QUIET2 LITTLE REVOLUTION FOR PANCREATIC CANCER By Jennifer Baldino Bonett By Holly Auer and Rabiya Tuma Bridging the Gaps, a unique community- Departments Penn researchers have discovered a health program with grass roots at Penn, novel way to treat pancreatic cancer – has reached 20 years. And it shows no signs by activating the immune system to of slowing down. The program connects Inside destroy the “scaffolding” of the cancer. students from academic health centers in Front EDITOR’S NOTE Cover The investigators believe their findings Pennsylvania and, more recently, in New Gaps and Transformations could lead to quicker, less expensive Jersey with community agencies to provide development of cancer drugs. health-related supports and education. 3 VITAL SIGNS From Students to Doctors New Chair of Path & Lab 30 DEVELOPMENT MATTERS Thank You, Dean Rubenstein 34 ALUMNI NEWS Progress Notes and Obituaries THE LAST WORD TRAILBLAZERS, INVENTORS, ISLET CELL TRANSPLANTATION: Inside 19 22 Back Forward Thinking AND TEACHERS A PATIENT’S PERSPECTIVE Cover By John Shea By Andy Gordon Britton Chance and Christian Lambertsen, Andy Gordon, living with diabetes, entered a both alumni of the medical school and long- clinical trial at the University of Pennsylvania. time members of its faculty, died in recent Islet cells taken from a donor pancreas months. They were among Penn’s most would be transplanted into his liver. If the honored and admired professors, and their procedure was successful, the new islets achievements had an impact on the world would begin to produce the insulin his own Staff outside academe. body did not produce.

JOHN R. SHEA, Ph.D. Editor GRAHAM PERRY, NCS Studios Design / Art Direction ADMINISTRATION SUSAN E. PHILLIPS Senior Vice President for Penn Medicine is published for the alumni and friends of Penn Medicine by the Office of Public Public Affairs Affairs. © 2011 by the Trustees of the University of Pennsylvania. All rights reserved. Address all correspondence to John Shea, Penn Medicine, 3535 Market Street, Suite 60 Mezzanine, University MARC S. KAPLAN of Pennsylvania Health System, Philadelphia, PA 19104-3309, or call (215) 662-4802, or e-mail Director of Communications [email protected]. Visit Penn Medicine’s web site: http://www.uphs.upenn.edu/news/publications/PENNMedicine/ The School of Medicine

Receives a ‘Momentous’ Raymond Perelman is president and chairman of the board of RGP Holdings Gift – and a New Name Inc., a privately held holding company The Perelmans’ $225 million gift is the largest that includes many manufacturing, min- single gift to the University of Pennsylvania. ing, and financial interests. He also serves as a Penn Medicine trustee. On the evening of May 10, an e-mail care.” At the same time, the gift will en- “Ruth and I believe the future of medi- message from President Amy Gutmann courage efforts to make Penn a global cine depends on the ability to produce reached Penn alumni with a message that model of a comprehensive academic med- world-class clinicians and researchers, could hardly be believed: Raymond and ical center that integrates innovative re- the hallmarks of Penn and a Penn educa- Ruth Perelman were contributing $225 Photograph by Daniel Burke million to Penn’s School of Medicine, the largest single gift ever given to the Uni- versity and the largest single gift to name a medical school in United States history. This “momentous gift,” as described by Gutmann and David L. Cohen, chair of the University trustees, would create a permanent endowment for the school. The school has been renamed the Raymond

According to President Amy Gutmann, the Perelman gift will enable the school “to increase financial aid for our exceptional students, recruit more of the most outstanding Raymond and Ruth Perelman, center, are flanked, left to right, by David Cohen, Amy Gutmann, and Arthur Rubenstein. medical faculty and clinician educators, and invest more search and education across specialties with tion,” said Perelman. “We are confident that precious resources in innovative the very highest quality of patient care. Penn’s outstanding faculty and students research programs that yield One immediate result is that the Perel- will continue to make significant contribu- life-saving and life-enhancing man School of Medicine will increase its tions to medicine in the years ahead.” breakthroughs in medicine and financial aid budget by at least 20 percent The Perelmans are two of Philadelphia’s for the medical-school class that will enter medical care.” most prominent philanthropists. In 2005, in 2012. they pledged $25 million to create the Ruth “Ray and Ruth Perelman’s incredible and Raymond Perelman Center for Ad- and Ruth Perelman School of Medicine at gift to the University of Pennsylvania vanced Medicine, which opened in 2008. the University of Pennsylvania. School of Medicine will enable us to They have also endowed a professorship in According to Gutmann, the Perelman become an even greater global force for internal medicine at the University. In ad- gift is “transformational”: it will enable the the improvement of human health in the dition to their support for health care, the school “to increase financial aid for our 21st century and beyond,” said Arthur H. Perelmans have made major gifts to the exceptional students, recruit more of the Rubenstein, M.B.,B.Ch., then the execu- Philadelphia Museum of Art, the Kimmel most outstanding medical faculty and clini- tive vice president of the University of Center, the Perelman Jewish Day School, cian educators, and invest more precious Pennsylvania for the health system and and many other Jewish cultural and wel- resources in innovative research programs dean of the Perelman School of Medi- fare organizations. that yield life-saving and life-enhancing cine. “They have placed their trust in us The Perelmans’ gift brings Penn’s “Making breakthroughs in medicine and medical to use the gift to do good in the world.” History” campaign total to $3.31 billion.

2 ■ PENN MEDICINE As Ralph Muller, CEO of

Penn’s Health System, looks Photograph by Daniel Burke on, Jennifer Rowland brings her three children to the dais. A Long-Awaited Culmination: From Students to Doctors On May 15, 147 students received their medical degrees in a ceremony at Philadelphia’s Kimmel Center. The event included a Graduation Address by Arthur H. Rubenstein, M.B.,B.Ch., appearing at the ceremony as dean for the last time. Stanley Dudrick, M.D. ’61, G.M.E. ’68, a prominent professor of surgery and recipient of the School of Medicine’s Distinguished path would be hard. I wanted to have 2011. Formerly the Irene Diamond Graduate Award, delivered remarks as children, and because of my own breast Professor of Immunology and chair of representative of the 50 Year Class. cancer risk, my doctors advised me to have the Department of Pathology at N.Y.U. Introducing Rubenstein was Amy Gut- children soon. And, because of my hus- Langone Medical Center, he served as the mann, Ph.D., president of the University of band’s career, I was already committed to director of its Medical Scientist Training Pennsylvania. She acknowledged his ten living in Wilmington, Del., so it would Program, as director of the Pathobiology years as dean and described him as “an mean commuting at least two hours every Graduate Program, and as co-director of incomparable academic leader.” After day just to get to and from school. . . the Cancer Immunology Program. Rubenstein delivered his remarks, Gutmann “I was already 23 years old, and it Roth’s research and clinical interests returned and surprised him with a spe- would mean starting over. I would have include DNA repair and the mechanisms cial citation from the new graduates. In to attend a Post-Bac program before I of programmed gene rearrangements part, it read: “We have admitted Arthur H. even started my 10 years of training. . . . during lympho- Rubenstein, M.B.,B.Ch., as a member of There were times I only slept a couple cyte differenti- The Class of 2011.” hours. There were nights I slept on a ation. His re- Among the other members of the class, friend’s couch in Philly and didn’t see my search has been 19 received both M.D. and Ph.D. degrees; family for two days. There were moments consistently five received M.D. and M.B.A. degrees; four I thought I was going to fail. There was a supported by received M.D. and M.S. degrees in bioethics; lot of pizza. And yet, as graduation nears, the National two received M.D. and M.S. degrees in I know the road has been worth it.” Institutes of translational research; and two received What lies ahead? For Rowland, the first Health. M.D. and M.P.H. degrees. In addition, 21 step is a transitional year at Christiana Roth is one percent will pursue additional training in Hospital in Delaware. Then she returns of the editors of Roth surgery, and just over 30 percent will be to HUP as a radiology resident. Immunology, 7th edition. Elected to the going into residency in primary care – a American Association of University Pathol- specialty facing a national shortage. NEW DEAN ARRIVES ogists (The Pluto Society), he is a member One of the new graduates – who de- of the American Association for the Ad- scribed herself as “not a typical Penn Med On July 1, J. Larry Jameson, M.D., Ph.D., vancement of Science. student” – is Jennifer Rowland. She grad- took office as executive vice president Roth earned his M.D. degree and his uated from Stanford University in 2002, of the University of Pennsylvania for Ph.D. degree in biochemistry at Baylor Phi Beta Kappa, with a dual B.S. degree in the Health System and dean of the College of Medicine. From 1988 to 1991, economics and Spanish. Her honors thesis, Perelman School of Medicine. More to he was a resident in anatomic pathology which investigated genetic testing for breast come in our next issue. at the National Cancer Institute. For five and ovarian cancer, earned her Stanford’s years, Roth was an assistant investigator of top undergraduate research award. the Howard Hughes Medical Institute. As she noted on a Penn Medicine blog: Path & Lab Chair Roth has won several teaching awards, “By the time I realized that I wanted to David B. Roth, M.D., Ph.D., was named including the Distinguished Teacher in become a doctor, there was an entire list chair of the Department of Pathology the Basic Sciences from Langone’s 2008 of reasons not to pursue medicine. The and Laboratory Medicine, effective July 1, graduating class.

2011/SPRING ■ 3 A Decade of Success By John Shea A Role Model for Both Professors and Students, Dean Rubenstein Steps Down from His “Job Made in Heaven”

Arthur Rubenstein acknowledges the applause at this spring’s Graduation ceremony. President Amy Gutmann is at left.

“I think you should become a physician.” advised Arthur to become a physician, solid, even enviable foundation, despite Those were words that Arthur Ruben- Arthur took him seriously. the economic crisis of these last few years? stein was delighted to hear, but ones he “I was actually quite an obedient child,” he How did he go from being a young medi- had not necessarily counted on hearing says with a smile, adding, more seriously, cal researcher at the University of Chica- from his father. The senior Rubenstein ran “he pushed me to make that decision.” It go, uncertain about his position in a new a small, independent pharmacy in South was a decision he would never regret – a country, to the recipient in 2009 of the Africa. “I used to work at the pharmacy decision, in fact, that he praised this year’s Abraham Flexner Award for Distinguished on weekends and nights,” says Arthur. graduating class for making as well. As he Service to Medical Education, one of the “Often I’d come there after school.” In put it in his Graduation address in May: most prestigious honors in academic fact, Arthur thought it was possible he, “Even in this changing and challenging medicine? Now that Rubenstein has too, would become a pharmacist. Be- world, I believe the opportunities are great, stepped down after 10 very successful cause he was also “good at maths,” at one and you have made the absolutely right years, it is time to look back. His is a sto- point he considered a career in account- decision in pursuing a medical profession.” ry of hard work, intelligence, determina- ing as well. According to Arthur, his father, How, from this early stage, did Arthur H. tion, long-held principles, family support, who had emigrated from Poland, had Rubenstein, M.B.,B.Ch., proceed to become and, yes, a certain amount of serendipity. dreamed of being a physician himself. the dean of Penn’s Perelman School of But his financial situation and family ob- Medicine, recently ranked Number 2 for the The family support came both from ligations did not permit him to do so. second year in a row among all research- parents and, later, from his wife, Denise. The senior Rubenstein delighted in talking oriented medical schools in the United Arthur and Denise had met in medical with his customers, offering guidance as States by U.S. News & World Report? How school at the University of the Witwa- he filled prescriptions, and Arthur recalls did he come to oversee a remarkable finan- tersrand in Johannesburg. She graduated “imbibing some of that warm human in- cial turnaround that brought the medical in 1959, he a year later. One reason the teraction.” His father, however, had side of the University of Pennsylvania Rubensteins decided to leave South Africa greater dreams for his son. So when he from the brink of financial disaster to a was that there was very little opportunity

Photos by Daniel Burke Photography 4 ■ PENN MEDICINE fellow in endocrinology at Hammersmith. reform, he added: “Nobody said such an “It was just the most exciting thing,” he approach will be easy.” recalls, but money was very tight. Still, the It’s hard not to see the influence of combination of Fraser’s fortuitous visit to growing up under a system of apartheid South Africa, Denise’s firm support, and in Rubenstein’s embrace of another cause the financial aid made it possible for them in academic medicine: advancing the role to embark on their adventure. of women as leaders. Apartheid, after all, There was another major reason why is one of the more obvious hallmarks of the Rubensteins chose to leave South Af- inequality. Even in our medical centers,

Dean Rubenstein added his signature to the beam rica. Apartheid was at its height in the early which pride themselves on being among signing for the Translational Research Center. 1960s. As Rubenstein recalls, “Growing the nation’s most enlightened institutions, up in South Africa, my wife and I were women still make up a very low percentage for research and almost no funding for it. pained by the unequal quality of health of tenured faculty, full professors, and On the other hand, Rubenstein has nothing care delivered to different people depend- chairs of departments. Rubenstein served but praise for what he did learn at Wit- ing on the color of their skin and of the on a committee of the Association of watersrand. The focus there was on provid- terrible discrimination that black families American Medical Colleges that examined ing the best patient care and nurturing the faced in everything they did. That experi- what progress had been made in improving physician-patient relationship. His teachers, ence was seared in my brain and made me matters. In 2002, the committee issued says Rubenstein, “were incredibly wonder- realize, every day of my life, how lucky we its report, and the statistics continued to ful role models. The model was very impor- all are.” Arthur and Denise knew they could be grim. As dean of Penn’s medical tant to me, because I came to love and not continue to live in that kind of society. school, Rubenstein has consistently and embrace taking care of patients and their Many years later, Rubenstein’s sense of publicly pushed for more women in senior families at the highest level. . . . I have lived justice compelled him to speak out on positions, all as part of a drive for greater with that for the next 50 years in a way that I feel very happy and proud about.” To pursue his research interests else- At the University of the Witwatersrand, the focus was on where, however, Rubenstein decided to providing the best patient care and nurturing the physician- apply for scholarships and fellowships. patient relationship. “The model was very important to me, He had little success. A turning point because I came to love and embrace taking care of patients came when Dr. T. Russell Fraser, a promi- and their families at the highest level.” nent professor and endocrinologist at Hammersmith Hospital in London, visited South Africa and delivered a series of lec- behalf of health-care reform in the United faculty diversity. His efforts – and the im- tures. Here Denise Rubenstein played an States. As he put it in one of his columns proved situation for women at Penn important role. After hearing one of Fraser’s in Penn Medicine, as a physician he be- Medicine – were recognized by Penn’s lectures, says Rubenstein, “I was too shy lieves that reforming health care “is, first FOCUS on Health & Leadership for to ask him for a job, but Denise gave me of all, a civic and ethical imperative: the Women, which presented him with its a push and said, ‘Dr. Fraser, Arthur is a primary goal should be to expand cover- inaugural Visionary Leadership Award very good endocrinologist. He would like to age for the millions of Americans who have last year. come and work with you.’ ” As it happened, either no health-insurance coverage or Fraser told him he was welcome to come very little. . . . Many of us in academic The Rubensteins arrived in London in to Hammersmith but would have to pro- medicine believe that reducing costs in 1964, in the middle of a snowy winter. vide his own money. This time around, with the way we do our work will allow us to London, says Rubenstein, “was incredible,” the Fraser name to help him, Rubenstein direct those savings toward the expansion and Hammersmith Hospital was intellec- was able to get a scholarship from a British of coverage. We must become more effi- tually exciting, as he had hoped. There medical supply company – and the family, cient, providing a higher quality of care was more science applied to medicine now with a one-year-old baby, set out for for less.” Acknowledging the difficult and than he had seen before, and scientists London. Rubenstein was to be a junior contentious environment for health-care and physicians worked together. For

2011/SPRING ■ 5 15 months, Rubenstein pursued his In August 1967, they landed at O’Hare the University of Chicago Hospitals and dream, but then, as he puts it, “we kind Airport, the first time either Arthur or Health System notes that Steiner and Ru- of ran out of money.” That meant looking Denise had been in the United States. benstein developed “the first accurate for more jobs, poring over such profes- Unlike their first taste of London, with method to measure insulin secretion” in sional journals as The Lancet and the Brit- cold and snow, Chicago seemed to sim- diabetic patients being treated with insulin ish Medical Journal. “I got rejected I can’t mer at about 105 degrees! derived from beef or pork pancreases (by remember how many times!” he says. At the University, the twist was that measuring C peptide, the piece that is re- Professor Fraser told him that many of the Rubenstein would be a postdoctoral fel- moved from proinsulin). “It was also key jobs in medicine were allotted years be- low in cardiology, the only slot that was to the commercial production of human insulin for diabetics.” They were also part of a team that discovered the first case of The financial situation of Penn’s Health System was precarious, diabetes caused by an abnormal insulin. and continued problems could seriously affect both the School After a year, Richard Landau, M.D., of Medicine and the University itself. Looking back, Arthur chief of the Endocrinology Section, asked Rubenstein says, “I thought it was daunting, but I just felt this Rubenstein if he was interested in an was an opportunity I couldn’t turn down – to be a dean in an opening for assistant professor. When integrated medical center in a university like this.” Rubenstein said he was, Landau asked, “What do you want for salary?” Tentatively, Rubenstein asked for $12,000. “You are a forehand and recommended that he try available. Still, he says, “I loved it – the dope,” responded Landau. “You’re supposed his luck first in Scotland and Wales. Arthur quality of the faculty, the integration, to negotiate with me. Ask me for more.” So and Denise even considered jobs in Aus- great students. I grew to love universi- Rubenstein asked for $15,000. “You really tralia. There was an offer, but at an ex- ties.” Much as he would discover years are dumb – ask me for a lot more!” Ruben- tremely low salary for a family with, by later at Penn, the University of Chicago stein suggested $18,000. “That’s too much – now, two children. had various schools on the same campus, I’ll give you $16,000.” So in July 1968, Then came another stroke of luck: Dr. “all talking about excellence all the time.” after this introduction to the delicate art of Godfrey Getz, a South African physician Although his heart was still set on endo- negotiation, Rubenstein became assistant who had emigrated to the United States crinology, Rubenstein realized the value of professor of endocrinology. and was a senior professor at the Univer- being trained in the scientific technology. From that point, his energy and deter- sity of Chicago, visited London and Then came another turning point: taking mination took over, and Rubenstein made looked Rubenstein up. As Rubenstein re- advantage of the library, he says, “I saw the most of the opportunity. As he puts members it, Getz said, “Why don’t you this beautiful article on how insulin is it, “I wrote a lot of papers, won teaching come as a postdoctoral fellow on an N.I.H. made,” by a certain Donald Steiner. He awards, and took care of a lot of diabetic grant – I have a slot.” Rubenstein filled was pleasantly surprised to learn that patients. I loved it all.” Outside organiza- out form after form and mailed them. But Steiner was on Chicago’s faculty and had tions were paying attention as well. Be- in the meantime, the money ran out. With made “seminal discoveries” in diabetes tween 1973 to 1983, he received three regret, the family returned to South Africa. studies. So Rubenstein asked his mentor if awards from the American Diabetes Associa- Rubenstein found a job there and was he could introduce them. tion and two from the Juvenile Diabetes trying to make the best of the situation. With permission, Rubenstein began to Foundation. In 1979, he was appointed Then one day good news came in the work in Steiner’s laboratory at night, while associate chairman of the Department of mail: he had been offered the postdoctoral continuing as a cardiology fellow. His very Medicine, overseeing teaching. Two years position. He and Denise consulted with full days soon paid off. Rubenstein, who later, when the chairmanship became va- their families. Denise’s father, he recalls, had published articles earlier in his ca- cant, he was asked if were interested in showed them Chicago on a map and reer in The Lancet, Nature, and the Archives that position. Although he told his dean warned them about a harsh climate. In of Internal Medicine, was particularly pro- that he was not particularly interested, he the end, their relatives were supportive lific from 1967 to 1970, sharing author- became acting chair. When six external but sad that Arthur and family would be ship of 43 papers (17 of them with Steiner). candidates turned the position down, the so far away. In its section on “firsts,” the Web site of dean approached Rubenstein again, this

6 ■ PENN MEDICINE time more pleadingly. “So I said, ‘OK, I’ll things I can’t do, she did!” And in this but Brown also asked, “are you interested?” be the chairman.’ ” It was a position he case, too, “it turned out to be an abso- Maybe, replied Rubenstein. held for 16 years while also serving as lutely perfect decision.” A week later, Judith Rodin, Ph.D., then the Lowell T. Coggeshall Distinguished Rubenstein enjoyed his stay at Mount the president of the University of Penn- Professor of Medical Sciences. Sinai School of Medicine, but, he adds, sylvania, called. The process began in In discussing this period of his career, he missed being at a university. As it earnest. Rubenstein met with John Fry, Rubenstein puts aside his characteristic turned out, opportunity came knocking then executive vice president of the Uni- modesty: “I built a great department with once more, this time in the person of versity; Dwight Evans, M.D, chair of the great people,” he says, and it eventually Michael S. Brown, M.D. ’66. Department of Psychiatry, who was leading became one of the leading departments in the country. Again, however, his em- phasis is on the people who worked for and with him, “fantastic” faculty, house staff, and students. The department bal- anced education, patient care, and re- search – “just like here” at Penn. By the end of his tenure as chair, he had become president of the Association of American Physicians and had received the Robert H. Williams Distinguished Chair of Medicine Award from the Association of Professors of Medicine. Rubenstein was elected to the Institute of Medicine of the National Academies in 1987 and was immediately put to work as chairman of its Committee on Responsible Conduct of Research. After that two-year term, he also served on the Institute’s Panel on Scientific Integrity for two years. The topic has long been close to his heart, and in Always an eager teacher, Dean Rubenstein speaks to a group of students involved in the Bridging the 2002-03, he was called upon by the I.O.M. Gaps program. again to serve as chairman of the National The Regental Professor and the Paul J. the faculty’s search committee; John Glick, Research Council Committee on Assessing Thomas Chair in Medicine at The Univer- M.D., then director of the Abramson Cancer Integrity in the Research Environment. sity of Texas Southwestern Medical Center, Center; other members of the search Brown shared the Nobel Prize in Physiol- committee; other deans and medical In 1997, Rubenstein was recruited to ogy or Medicine in 1985 with his longtime students. Coming to Penn was seeming Mount Sinai School of Medicine as dean collaborator, Joseph L. Goldstein, M.D., more and more attractive. and chief executive officer. In part, he was for describing the regulation of cholesterol Then, as Rubenstein puts it, “Some- motivated by the attraction of moving metabolism. When he came to Mount body said to me, ‘you know, the finances closer to his daughter-in-law and his Sinai to present a lecture, he also hap- are not in good shape.’ ” He learned older son, a rabbi and faculty member pened to be on the search committee for there was a cumulative deficit of more and professor of religion at New York a new dean at the University of Pennsyl- than $500 million. Because of several University. When the call came from vania School of Medicine. According to reasons – managed care, the competitive Mount Sinai’s president and CEO, John W. Rubenstein, it is another example of purchase of physician practices for a pri- Rowe, M.D., Denise Rubenstein was there “how my career’s involved chance.” After mary care network, a health and disease to answer it. “We’ll accept the job!” she delivering his lecture, Brown chatted management organization for which the told Rowe. As Arthur explains, Denise with Rubenstein. Rubenstein gave him a payoff was years in the future, the Federal “has always negotiated for me. All the few recommendations for the deanship, Government’s Balanced Budget Act of

2011/SPRING ■ 7 One important reason he took the challenge was the faculty. “The faculty was fantastic,” Rubenstein recalls. Despite the setbacks and profound uncertainty, “Nobody left. They all worked their tails off.” Even at his press conference, Ruben- stein noted how impressed he was by the faculty’s continued faith in the institu- tion. He paraphrased what they told him: the experience was hard to go through, “but we still believe that this place is great, and it’s going to be greater.” Together, Robert Martin and Rubenstein “cut hundreds of positions, froze salaries, sold off Phoenix- ville Hospital later, cut disease manage- ment programs. . . . We started to make money, and we paid off the debt.”

The next step was to develop a strategic plan that would involve all those who had a stake in the medical school and the Health

Dean Rubenstein congratulates Maria Horch Dugan at this year’s Graduation ceremony. Jon B. Morris, M.D., System – and that would build upon the associate dean, looks on. successes of the retrenchment. When Martin left, Rubenstein knew exactly who 1997, which Rubenstein described at an sell the hospitals to a for-profit group or he wanted in the crucial position of administrative meeting in 2001 as “a kind spin the Health System off into a separate Health System CEO: Ralph W. Muller, of body blow,” and other factors – Penn’s 501(c) (3) organization. The goal of such with whom he had worked in Chicago. Health System had lost $98 million in moves would be to protect the University Muller, who spent 15 years as president Fiscal Year 1998 and $198 million the and keep it from going bankrupt if the and CEO of the University of Chicago following fiscal year. Health System took another sharp turn for Hospitals and Health System, had also By the time Rubenstein was introduced the worse. Rubenstein had strong feelings held positions of leadership with the As- as the new dean and executive vice presi- about the matter. As he recalls, he told sociation of American Medical Colleges. dent of the University of Pennsylvania for the trustees, “If you can put it all together He took office at Penn in May 2003. the Health System at a campus press under me, I’ll give it a shot, but if you’re The strategic plan was one of Ruben- conference on July 30, 2001, the Health going to separate it off in separate corpo- stein’s greatest successes. Both faculty System under CEO Robert Martin had rations, I’m not coming.” Indeed, he won members and administrators had input, made great strides toward cutting the a concession: he would have a year or their views were seriously considered, losses. In FY 2001, it had an operating two “to try to get it straightened out with and the goals that were articulated were profit of $25 million. As Rubenstein put a single organization.” widely accepted. In addition to selecting it at the press conference, “The turnaround Looking back, Rubenstein says, “I which areas of research and clinical care has been amazing – truly amazing.” There thought it was daunting, but I just felt to support and prioritize, the plan specif- were still important steps to be taken, es- this was an opportunity I couldn’t turn ically described the goal to “become a more pecially if the School of Medicine and the down, because, you know, it’s what I collegial, intellectually exciting, and sup- Health System were to regain and surpass wanted all my life – to be a dean in an portive institution in which to work.” As their previous stature. integrated medical center in a university a result, the School of Medicine established And the future was not yet clear. Ru- like this.” At his first campus press con- such programs as the Association of Se- benstein was told by the University trustees ference, Rubenstein called his new position nior and Emeritus Faculty, which helped that there was still a chance that Penn would “a job made in heaven for me.” keep valuable faculty members engaged

8 ■ PENN MEDICINE in and connected with the Penn commu- opened in May, Francis Collins, M.D., of our organization to prosper both indi- nity of scholars. The Office of Faculty Af- Ph.D., the director of the N.I.H., was the vidually and collectively.” The new gover- fairs was substantially expanded to facili- featured speaker. After touring the facility, nance model reduced redundancy and al- tate the recruitment and appointment, he said, “I veritably drooled.” Without a lowed administrators to be more flexible promotion, and retention of distinguished doubt, he asserted, science “will be pur- and to move more swiftly in a volatile faculty and to assist in their professional sued with creativity and vision” in the new economic environment. development. center. For her part, Amy Gutmann, Ph.D., On the face of it, Rubenstein’s notion That this important goal of the strategic president of the University, said that the of the best approach to leading in such a plan has largely been met is suggested by Translational Research Center “represents difficult and uncertain situation is simple a recent survey of faculty satisfaction. Ninety our hope for the future of medicine.” Ac- and perhaps anathema in an age of the percent of the faculty who responded were knowledging Rubenstein, she added, “There imperial CEO. He embraced distributed satisfied with “collaboration, mentoring, is no better capstone for Penn Medicine’s leadership or distributed management. In and feedback.” Eighty-five percent felt their most passionate advocate.” short, distributed leadership, in the aca- work was appreciated, that the workplace The Translational Research Center is demic setting, means the department culture cultivates excellence, that there is not the only building to be constructed chairs have primacy in terms of running intellectual vitality, and that colleagues during Rubenstein’s 10 years. In fact, things. But with this crucial overarching respect a balance between home and the TRC sits atop the Roberts Proton principle: whatever they do must benefit work. Perhaps even more telling are the Therapy Center, the largest of its kind the institution as well as the depart- responses to two hypothetical questions: in the nation, and is adjacent to the Ruth ments. The institution, that is, is more “If I had it to do all over, I would again and Raymond Perelman Center for Ad- important than its parts. According to choose an academic career” (94%) and “If vanced Medicine, an innovative facility Rubenstein, that view is fundamentally I had it to do all over, I would again choose for inpatients. different from what is found in many to work at this medical school” (90%). corporations or academic health centers, Another way to meet the goal of greater To achieve these goals, whether in pro- where the titular head runs the place and collegiality was for the medical school to grams, personnel, or constructions, Ruben- exercises power. Rubenstein explains become more connected to the rest of the stein believed that another significant that he read “a lot of books on manage- University. As Rubenstein put it in one of change was necessary: a new leadership, ment” and learned as well from “The his early columns in Penn Medicine, “There is enormous potential for productive col- laboration” among the University’s many Rubenstein’s “distributed leadership” differs fundamentally from schools. Penn has long fostered centers what is found in many corporations or academic health centers, and institutes that involved several disci- where the titular head runs the place. As he puts it, “the dean and plines and schools, and under Rubenstein, the hospital CEO are here to serve the faculty and the chairs. . . . Our the medical school launched several im- greatness is because there’s shared responsibility.” portant ones, such as the Institute for Translational Medicine and Therapeutics, the Institute for Diabetes, Obesity, and operational, and financial model for run- Faculty – 2000 Project,” chaired by Metabolism, the Penn Cardiovascular ning the institution. Thus was born Penn James C. Saunders, Ph.D., professor of Center, and the Institute for Regenerative Medicine, an umbrella governance struc- otorhinolaryngology, which reported on Medicine. Such centers have enhanced ture that operates, oversees, and coordi- the results of a survey of Penn Medicine the quality of research across the institu- nates the educational, research, and clinical faculty in the late 1990s. As Rubenstein tion and fit very well with the renewed operations of the Health System, the medi- puts it, “the dean and the hospital CEO support of the National Institutes of cal school, and the faculty’s clinical prac- are here to serve the faculty and the Health for interdisciplinary research tices. As Rubenstein put it in a Penn Medicine chairs. I’m here to make the chairs func- and accelerated translation of basic column in 2002, the institution “cannot tion more successfully.” In addition, he discoveries to cures. function as an assembly of discrete smaller says, “I don’t tell them how to do their When Penn Medicine’s long-anticipated entities, each with its own set of goals.” At jobs – our greatness is because there’s Translational Research Center officially Penn Medicine, “the goal is for all parts shared responsibility.”

2011/SPRING ■ 9 Symbolically, Rubenstein underscored this approach by moving his office from the 21st floor of Penn Tower Hotel to the second floor of the John Morgan Building, a place that also exudes more tradition. It’s not that Rubenstein’s distributed leadership lacks teeth. Indeed, he estimates that, of the 28 department chairs, “I’d say about half are new since I came . . . and pretty much all the Health System leader- ship is new.” The leadership of Penn Med- Arthur Rubenstein with his wife, Denise Rubenstein, M.B., B.Ch., and their older son, Jeffrey L. Rubenstein, Ph.D. icine, in other words, has been recast – and the results speak for themselves. For much million. For FY2011, the projected margin tering, but he expressed confidence that of the time, it seemed Rubenstein could was $206 million, an impressive figure the younger generation of physicians would proceed as manager and leader with equa- given the difficult economic environment be able to find solutions to some of the nimity – or, as one of his idols, Dr. William of the last three years. As one financial areas of medicine and health care that Osler, once put it, aequanimitas – and act report noted, strong operating margins in most concern their older colleagues. He coolly even in a crisis. But one longtime the Health System have funded increased also touched on a more personal but no administrator suggests that, in certain rare support for Penn Medicine’s missions of less important matter: the physician-pa- circumstances, he could change tactics clinical care, research, and teaching. In tient relationship. Even with all the changes and become “the Velvet Hammer.” addition, the School of Medicine most and innovations in medicine, for Ruben- In 2009, Rubenstein received one of the recently had $690.6 million in research stein that relationship is crucial. To be highest honors in the profession, the Abra- funding in FY2011, nearly three-quarters successful, he argued, physicians must ham Flexner Award for Distinguished of that from the N.I.H. also be humble. It is a view much in keep- Service to Medical Education, presented Rubenstein leaves his administrative ing with those he has articulated during by the Association of American Medical positions in Penn Medicine while the in- his 10 years at Penn Medicine, when he Colleges. According to the Association, stitution is on solid financial ground. The has been able to teach. As he stated in Rubenstein’s career “has come to epito- outlook has been greatly enhanced by the his first press conference on campus, “I mize what Abraham Flexner envisioned recent record-setting $225 million gift wouldn’t come if I couldn’t teach.” And for the future of U.S. medical education, from Raymond and Ruth Perelman to en- teach and lecture he did, such courses with a greater emphasis on research as dow the School of Medicine, which will and topics as the History of Medicine/ part of the medical education experience; permit the renamed Perelman School of Professionalism; Bioethics and Professional- an integrated, institutional focus on learn- Medicine to increase financial aid for stu- ism; Community Service; and The Doctor- ing; and, above all, a joy for the university dents, recruit more outstanding medical Patient Relationship. Back in July 2001, environment and academic medicine as a faculty and clinician educators, and in- he also expressed hope that he could be profession.” Citing the comments of his vest in innovative research programs. But a role model for the students. colleagues, the Association described Rubenstein is not leaving the institution. Like the graduates before them, the Rubenstein as “the complete academic Instead, he will be professor of medicine members of the Class of 2011 appeared medicine physician leader.” in the Division of Endocrinology, Diabetes, to appreciate such efforts. In a surprise and Metabolism. It is a return to an earlier gesture, after Rubenstein concluded his The financial status of Penn Medicine and probably quieter life, and perhaps he Graduation address, President Gutmann has improved greatly since its lowest will subsequently sleep more than his presented him with a citation on behalf point in the late 1990s, an indication customary four or five hours a night, a of the new graduates. It announced that that Rubenstein hired the right people in fact he shared with The Daily Pennsylvanian they have admitted him as a member of important positions and made the right in 2002. the Class of 2011. Based on everything decisions. In Fiscal Year 2003, the Health In his Graduation address, Rubenstein people know about Arthur Rubenstein, System’s operating margin was $19 mil- acknowledged the complicated and chal- it’s likely this citation will have a special lion. By FY2007, it has risen to $259 lenging world the new graduates were en- place among his many honors.

10 ■ PENN MEDICINE A NOVEL IMMUNE THERAPY FOR PANCREATIC CANCER

By Holly Auer and Rabiya Tuma

Researchers at the University of Penn- tibody manufactured by Pfizer Corporation. gemcitabine in combination with CD40 sylvania’s Abramson Cancer Center have The antibody binds and stimulates a cell antibodies, the results looked like those of discovered a novel way to treat pancreatic surface receptor called CD40, which is a the human trial. Some mouse tumors cancer by activating the immune system crucial regulator in the activation of T cells. shrank and were found to be loaded with to destroy the “scaffolding” of the cancer. The investigators initially hypothesized that macrophages but contained few or no T The strategy was tested in a small cohort of the CD40 antibodies would activate the cells. Closer inspection showed that the patients with advanced pancreatic cancer, T cells and allow them to attack the tumor. macrophages were attacking what is known several of whose tumors shrank substan- The treatment appeared to work, as as the tumor stroma, the supporting tissue tially. The investigators believe their find- some patients’ tumors shrank substantially around the tumor. Pancreatic tumors se- ings – and the novel way in which they and the vast majority of tumors lost met- crete chemical signals that draw macro- uncovered them – could lead to quicker, abolic activity after therapy; however, all phages to the tumor site, but if left to their less expensive development of cancer drugs. of the responding patients eventually re- own devices, these macrophages would The authors call the results, published protect the tumor. On the other hand, in the March 25 issue of Science, a big “It is something of a treating the mice (or patients) with CD40 surprise. “Until this research, we thought Trojan horse approach. antibodies seemed to flip that system on the immune system needed to attack the The tumor is still calling its head. According to Vonderheide, “It is cancer directly in order to be effective,” in macrophages, but now something of a Trojan horse approach. The said senior author Robert H. Vonderheide, tumor is still calling in macrophages, but M.D., D.Phil., an associate professor of we’ve used the CD40 now we’ve used the CD40 receptor to re- medicine in the division of hematology/ receptor to re-educate educate those macrophages to attack – not oncology. “Now we know that isn’t neces- those macrophages to promote – the tumor.” sarily so. Attacking the dense tissues sur- attack – not promote – The researchers believe that the CD40 rounding the cancer is another approach, the tumor.” antibodies also activated T cells in the similar to attacking a brick wall by dissolv- mice, but the T cells couldn’t get into the ing the mortar in the wall. Ultimately, the lapsed. When the researchers looked at tumor or its surrounding tissue. “The immune system was able to eat away at post-treatment tumor samples, obtained area surrounding pancreatic cancers is this tissue surrounding the cancer, and via biopsy or surgical removal, they could very dense, fibrotic, and hostile,” says the tumors fell apart as a result of that find no T cells. Instead, they saw an Vonderheide. “This is one of the main assault. These results provide fresh insight abundance of another white blood cell reasons standard therapies for this dis- to build new immune therapies for cancer.” known as a macrophage. ease often work so poorly.” The current study is part of a unique To understand what was happening in “Beyond our specific findings, we think research model designed to move back the tissues of these patients, Vonderheide, these findings point to a new approach and forth between the bench and the Beatty, and their colleagues turned to a for drug development in cancer – one bedside: the investigative team consists of mouse model of pancreatic cancer devel- where we use state-of-the-art mouse models researchers based in both the laboratory oped several years ago at Penn. Unlike for preclinical trials to guide which trials we and in the clinic. In the clinical trial led at older mouse models that were simplistic should do next in patients,” Vonderheide Penn by Peter O’Dwyer, M.D., professor models of human disease, new genetically says. “It should be faster, cheaper, and give of hematology/ oncology, and Gregory L. engineered mice develop spontaneous us a head start in the clinical trials.” Beatty, M.D., Ph.D., instructor of hema- cancers that are very close reproductions tology/ oncology, patients with pancreatic of human tumors. For a related video: http://www.uphs.upenn.edu/ cancer received standard gemcitabine When the investigators treated mice news/News_Releases/2011/03/pancreatic-cancer- chemotherapy with an experimental an- that developed pancreatic cancer with immunotherapy

2011/SPRING ■ 11 At last fall’s 20th Anniversary Symposium, more than 80 posters were on display. Bridging the Gaps, a unique community-health program with grass roots at Penn, reaches 20 years. And keeps right on going.

By Jennifer Baldino Bonett Photographs by Addison Geary, except where noted. A Quiet Little Revolution In 1990, Cindy Weinbaum and Steve Med looking for ways to enrich the training now its executive director. “But I doubt Chapman were first-year students in the of physicians, and Mary Anne Johnston, any of us thought it was going to be this.” School of Medicine. Extremely interested Ph.D., then director of educational devel- This is the Bridging the Gaps Network, in community health, they were hungry opment. Since that summer, Bridging the which has programs at all five academic for experience and turned to their profes- Gaps has expanded into a unique multi- health centers in Philadelphia (Penn, sors for advice. disciplinary program that links academic Drexel University, Philadelphia College of Those professors were Jeane Ann Grisso, health centers in Pennsylvania and now in Osteopathic Medicine, Temple University, Anthony L. Rostain, and Donald F. Schwarz, New Jersey with community agencies to and Thomas Jefferson University) and af- all physicians with roots in community provide health-related supports and educa- filiated programs at other Philadelphia health and outreach. Inspired by the activ- tion within local communities. educational institutions. It also has grow- ist era of the 1960s and 1970s, these physi- When Bridging the Gaps formally ing programs elsewhere in Pennsylvania cians were eager to “cook something up,” launched in 1991, “we thought it was a (Erie, Pittsburgh, the Lehigh Valley) and recalls Rostain, now a professor of psychia- funky little program, that it was a nice in New Jersey. This is local, regional, and try. That “something” started with a half- idea, that it would fulfill a passion to be national recognition for Bridging the dozen committed people, including Lucy proactive contributors in collaboration Gaps. This is a program that, through the Wolf Tuton, Ph.D., who had come to Penn with the local community,” recalls Tuton, Bridging the Gaps Community Health In-

12 ■ PENN MEDICINE ternship Program, has served communi- I see students feeling empowered. It’s like nothing static about this program. We are ties at some 400 sites and offered hands- they realize this is why I wanted to be a constantly thinking about what skills and on community-health experience for more doctor. And for students new to the field, what understandings are important for our than 3,400 students. This includes a sem- it’s a real eye-opener. By the end of the students to have.” inar series and a clinical program in Phil- summer, it’s changed them, giving them In September 2010, Bridging the Gaps adelphia that extends the training for stu- respect for the resilience of the communi- held its 20th anniversary symposium at dents interested in community service. ties they serve and a better understanding Rodeph Shalom on North Broad Street in of the challenges and opportunities of Philadelphia (see sidebar). Bridging the Bridging the Gaps . . . community health.” Gaps students presented more than 80 in Medical Education To make this new model work, the re- posters about their community-health With their vision for a hands-on pro- lationships between the students and projects. There were also ten workshop gram in community health, Weinbaum, community agencies had to be strong – and sessions and a talk by Wendell Pierce, an Chapman, and their faculty advisors wrote real. The students would have academic actor and activist who founded the Pont- a proposal and sent it to The Pew Charita- ble Trusts. The proposal landed on the desk of Tom Vernon, M.D., then in Pew’s division of health and social services. Vernon, now a policy and public health consultant, was struck by the unique op- portunity the program would provide: giv- Daniel Burke by Photograph ing students – eager and with eyes wide open – direct, paid experience in com- munity health. The Pew staff made one suggestion: Make the program broader than Penn. As a result, an unusual part- nership developed among several aca- demic health centers and educational in- stitutions and made it possible to avoid duplication of effort. At the same time, collaborating allowed each institution to provide what it did best. Amanda Holloway, left, a BTG intern from Thomas Jefferson University, lends her support to Shareda Fitzgerald at Covenant House. “We were jumping up and down, screaming with pure joy,” recalls Grisso, now and community preceptors. The program chartrain Park Community Development a professor of medicine and nursing. “It would include an academic component Corporation to assist after Hurricane Ka- was one of the finest moments of my life.” for every student. Bridging the Gaps staff trina. About 200 Bridging the Gaps stu- “I genuinely believed then, and more would work closely with community dents from the Philadelphia, New Jersey, to this day, that this program is extremely agencies to explore their needs and assess and Lehigh Valley programs attended, important for students,” says Vernon. how students might enhance their work. along with representatives from the Erie “Bridging the Gaps is a very useful step Then the students would be matched with and Pittsburgh programs. in the direction that medicine needs to the community sites. “Never in a million years” did Cindy be going – putting the emphasis not on “We expect our students to contribute Weinbaum, M.D. ’93, one of the student medical care, but on health care.” something and not just feel good about founders, imagine how successful Bridg- It was a new way of thinking about themselves,” says Rostain. “Plus, there’s a ing the Gaps would become. Weinbaum, medical education. “For students who al- chance to get to know others and learn who now works at the Centers for Disease ready are oriented this way, Bridging the what it’s like to walk in another’s shoes.” Control and Prevention, calls the program Gaps is a soul-restoring experience,” says As the health-care landscape has essential to “supporting community health Rostain. “Year after year as a preceptor in changed, Bridging the Gaps has aimed to and to supporting students who want ca- the Community Health Internship Program, keep pace. As Tuton puts it, “There is reers in community health.”

2011/SPRING ■ 13 Bridging the Gaps . . . Between Sixteen years later, Thomas recalls the partners began to talk with one another Penn and the Community first nutrition class as if it were yesterday. and get things done together, and that be- Since its inception, Bridging the Gaps The Penn students asked where French gan to build trust in a place like Penn.” has focused on local communities. As a fries come from. Familiar with fast foods, Building that trust, says Abby S. Letcher, result, students and faculty learn a great the kids called out “McDonald’s!” and M.D. ’95, provided lessons on both sides. deal about the culture, resources, pro- “Burger King!” “Then the Bridging the Gaps Letcher, a student coordinator for the first grams, and lives of residents who may students held up a potato,” says Thomas. fully operational year of BTG’s Community become their future patients or clients. “The kids had never seen one before.” Health Internship Program, explains: BTG also brings community leaders and Such experiences, she says, “really left “Bridging the town-gown divide . . . taught people from academe together, which an impression on our Bridging the Gaps us a lot about perception, about who’s can lead to new collaborative initiatives. students about how much our children the expert and who isn’t, about what is “Bridging the Gaps is built on the primary didn’t know. In Bridging the Gaps, stu- healing and what isn’t, about what our values of collaboration,” says Tuton. Sup- dents learn things they don’t get in a roles are as medical professionals. The port for the program comes from public classroom setting.” Seeing patients on people in the community really deal with these issues day in and day out.” Today, Letcher is on the family medi- “Medical students come with big dreams and idealism, and cine faculty at the Lehigh Valley Health BTG gives them a way to connect with community early on Network and serves as medical director and make a difference. I can’t stress enough how important for Neighborhood Health Centers of the this is in the development of professional identity. It was for Lehigh Valley. Inspired by her Bridging me, and continues for today’s students.” the Gaps experiences, she is part of the team that established the first community – Steven H. Chapman, M.D. ’93 health center in the Lehigh Valley. “I take Director, Boyle Pediatrics Program, Dartmouth Medical School the lessons that I learned from Bridging the Medical Director, General Pediatrics Clinic, Dartmouth Hitchcock Medical Center Gaps and use them every day,” she says. “We ask our students to volunteer, we work to develop respectful partnerships and private grants and donors and from their own “turf,” says Thomas, gives the in the community, we have passion for participating academic institutions. In its medical students unprecedented insight. the well-being of our communities, and 20 years, BTG has exceeded the expecta- “They meet the same people in the ER or we are drawing on everybody’s strengths tions of both its founders and community in the doctor’s office up at Penn. But when to make it happen.” Recently Letcher col- leaders. In underserved communities, they see [their patients] in the community, laborated with others to bring Bridging where doctors are often viewed with sus- it’s totally different. They might get infor- the Gaps to the Lehigh Valley. Another picion and wellness is often neglected, mation they wouldn’t get otherwise because member of the team is Mary Ellen Miller, Bridging the Gaps has become synony- [the patients] are more comfortable.” Ph.D., R.N., assistant professor at De Sales mous with health-related service and edu- As part of the Community Health In- University, who had worked with BTG cation – and with partnership and trust. ternship Program, a group of BTG students when she was at LaSalle Univerity. At the Health Annex on Woodland Av- spends seven weeks every year at the Health One of BTG’s earliest partners was enue in Southwest Philadelphia, Lorraine Annex. According to Thomas, the stu- Frances Walker’s organization, Parents Thomas, its outreach director, had been dents are well known in the neighbor- Against Drugs. She recalls that the chil- looking for educational opportunities for hood. “The people at the newsstand say, dren there “learned how doctors and her summer-camp kids. In one of its ear- ‘Oh, those are Lorraine’s kids.’” nurses are all right, because usually they liest community partnerships, Bridging This kind of symbiosis with the commu- [the children] go to the hospital in a the Gaps sent medical students eager to nity was an original goal for Bridging the traumatic situation.” Walker also was a share information about nutrition, hand- Gaps. “People kept talking about building guest lecturer in a course Schwarz and washing, “stranger danger,” and poison relationships, not just doing things to peo- Rostain used to give. “Bridging the Gaps,” control, as part of the Community Health ple, but with people,” Rostain emphasizes. she says, “is teaching the students that Internship Program. “Over time, a number of our community their patients have underlying [social and

14 ■ PENN MEDICINE Bridging the Gaps health] issues.” Now a consultant for at Covenant House Temple’s medical school, Walker is in- volved in community activities all over Covenant House, in the Germantown the city. As she puts it, “What a wonder- section of Philadelphia, serves homeless ful experience this has been for me.” and runaway youth and youth in crisis. Affiliated with Bridging the Gaps since Bridging the Gaps . . . Between 2002, Covenant House is where it “gets

Medicine and Other Professions real,” says the executive director, Cordella Daniel Burke by Photograph Drawing on diverse strengths is a hall- Hill, M.S.W. Coming from loveless lives, mark of Bridging the Gaps. Built on a broken homes, and tough streets, the res- multi-disciplinary model, the program idents of Covenant House need healing brings together students who otherwise for their bodies and their minds. Ken- might not meet – from medicine, other neth Ginsburg, M.D., associate professor of health professions, and social services – pediatrics at the University of Pennsylva- to work together in community settings. nia and medical director at Covenant Donald Schwarz, M.D., considers this House, explains that Bridging the Gaps approach a “very quiet little revolution.” students learn to start their presentations It creates “a shared purpose that has been to him with “What this kid really has go- unique in this program,” says Schwarz, ing for him is . . .” or “What I really find Cordella Hill, M.S.W now Philadelphia’s deputy mayor for myself loving about her is . . .” That way, health and opportunity and the city’s they learn to see the strengths and resil- As a short-term crisis center, Covenant health commissioner. “I would challenge ience in each patient before they think House works to establish residents in inde- you to find other programs where this about how to handle their problems. pendent, stable living situations. But it also varied a set of schools really collaborates.” “The kids and the Bridging the Gaps expects residents to do their share. For ex- The approach resonates with students. students bond,” says Hill. “On so many ample, on a bright day in September, a Chris Renjilian, a fourth-year student, levels this partnership has worked.” Bridging the Gaps medical student helped says Bridging the Gaps drew him to Penn For the young people at Covenant lead a class on job skills. Hill tells her Med. “Making those connections and see- House, BTG exposes them to positive role charges: “We will work with you as hard as ing who our colleagues and our patients models “in a health system they don’t you are willing to work. If you break your are is very important in allowing us to necessarily trust,” explains Hill. The young leg and I put you on my back, you’re not follow the dreams we all have of working people start to see the Bridging the Gaps going to get very far. If you hop on one leg in the community.” students as part of the staff and even as and lean, we’ll get far. I will not carry you Renjilian, currently applying for pedi- examples of possible careers. The dental all the way.” atric residencies, also took part in the students often hear: “We don’t like den- Chris Renjilian, a fourth-year medical two other BTG program components that tists, but we like you.” student, participated in the BTG Com- have been developed in Philadelphia: the At the same time, Bridging the Gaps munity Health Internship at Covenant seminar series and the clinical program. students learn about “regular people in House during his first year at Penn Med As a result of completing all three com- bad situations” which can upend some and then returned to do a rotation there ponents, Renjilian will graduate as a stigmas of homelessness and abuse. “It’s as part of the BTG Clinical Program. He Bridging the Gaps Clinical Scholar. real life,” says Hill. “It’s messy sometimes, gained insight into adolescent medicine While participating in the BTG Com- but we as a staff try to come together – and says he appreciated seeing the atten- munity Health Internship Program, every faith and persuasion – and ask for tion to “the strengths and resiliency in Renjilian worked at Covenant House some kind of guidance because we are adolescents rather than what they do (see sidebar) with a team of three medical working with people’s lives. Bridging the wrong.” Bridging the Gaps, he continues, students and a student from the Drexel Gaps recognizes the seriousness we take “was an amazing opportunity that en- University Creative Arts Therapies De- with our kids. We need help and we’re abled me to spend even more time doing partment. The experience opened Renjilian’s not shy to say we need additional help something I had already wanted to do.” thinking to creative approaches to treat- and those additional perspectives.” – J. B. B.

2011/SPRING ■ 15 At the 20th Anniversary Symposium: Posters and Posterers ment. “The observations the therapist made about youth through her music therapy sessions were really important adjuncts to what we were able to do for some of the youths in the clinic,” he says. “We saw more of their personalities, health, and behavior through music than we were able to get through interviews in the clinic. It made me want to connect with and work with people who do all kinds of therapy.” At Penn, four schools are consistently part of Bridging the Gaps: Medicine, Dental Medicine, Nursing, and Social Policy and Practice. The Law School has recently rejoined the effort. BTG was ahead of its time in inviting Penn’s Dental

Medicine to be part of the program from From left to right: Barrie Nussbaum, Yona Silverman, and William Conor Darby. its earliest stages. Joan I. Gluch, Ph.D., points out that, twenty years ago, the “They left an impact,” said Shaina Simon, ing a multigrain brand with less fat and link between oral health care and general a community preceptor for Education- no cholesterol or trans fat. And teaching health care was little understood. Gluch, Works, Morton Project. dental care was made easier when the associate dean for academic policies and Simon was referring to three students Penn Dental bus came by to give free director of community health at the from the University of Pennsylvania, who exams. School of Dental Medicine, is joined by were summer interns from Bridging the Clearly, the BTG rotation was a mixture Maryfran Cummings, M.P.H., R.D.H., in Gaps. William Connor Darby (School of of work and play. As Darby summed it providing expertise in oral health to Medicine), Barrie Nussbaum (Social Policy up, “We had a great time.” Bridging the Gaps. and Practice), and Yona Silverman (Medi- On September 24, Bridging the Gaps According to Gluch, BTG stands apart cine) spent seven weeks with children at held its 20th Anniversary Symposium at from traditional community-service pro- Morton Summer Camp, as their subse- Philadelphia’s Congregation Rodeph grams because of its instructional compo- quent poster put it, “Exercising Bodies Shalom on North Broad Street. In addi- nent. During each week of their seven- and Minds.” Their goal was to urge the tion to workshop sessions and a talk by week rotation, students spend four days children toward healthier eating and Wendell Pierce, an actor and activist, the at their community sites and one day in physical, mental, and social health. event featured a poster session. In the classes. “Bridging the Gaps allows stu- One approach, said Darby, was helping synagogue’s large and airy auditorium, dents to apply theoretical concepts to their them to make “practical choices” and eat BTG students – like Darby, Nussbaum, community-based activities and reflect more modest portions. The interns did and Silverman – were eager to talk about on their experiences in the context of im- that in part by measuring out the amount the more than 80 posters assembled. proving health within the community.” of sugar in foods. “We sufficiently Each poster gave the gist of the commu- That opportunity is also important to grossed them out.” For snacks, the in- nity-service initiatives they had taken social workers and policymakers in train- terns suggested trail mixes, and they part in. Students from Penn’s schools ing, notes Jeffrey Draine, Ph.D., a professor made guacamole, which the children had mingled with students from Drexel in the School of Social Policy and Practice. never seen before. As Nussbaum put it, University, Thomas Jefferson University, In their Bridging the Gaps experiences, “One kid saw me eating air-popped pop- Temple University, Philadelphia College students “face some challenges,” he says. corn” and tried it: “Hey, that’s really of Osteopathic Medicine, LaSalle Univer- “Some of the things they want to do are good!” Simon recalled that one child sity, University of the Sciences, and Bryn met with resistance in the communities, with special needs would bring “regular” Mawr College, as well as from universities or students are challenged about how chips to camp – but he changed to bring- outside Philadelphia and in New Jersey. The

16 ■ PENN MEDICINE At the 20th Anniversary Symposium: Posters and Posterers

enthusiasm in the auditorium was palpa- “Educating and Empowering Youth at ble. Here are some additional snapshots. South Philadelphia High” was the title of Natalie Spaccarelli and Keirnan Willett, the poster by Jonathan Kole (Medicine) both in Penn’s School of Medicine, did and Deep Shah (Dental Medicine). Here, their rotation with Neighborhood Bike too, health and fitness played central Works. Their focus: nutrition and fitness. roles. Shah made use of his connections Spaccarelli noted that they worked with with labs and was able to bring in some 10 to 12 campers at a time, ranging from human specimens for the children to ex- 8 years old to 14. They taught the chil- amine. As he noted, a fast-food restaurant dren how to strip down and rebuild a bi- was “literally next door to the school,” so cycle. The interns took the children out they spent part of the time comparing on the bikes, including an all-day trip on prices, portions, and nutrition. Finding the Schuylkill River Trail and off road. “It that many of children had overbites, Shah tried to encourage consistent floss- ing. If the kids don’t floss, he said, “it’s like taking a shower without washing your whole body.” Kole pointed out other Anna Hunt emphases of their rotation: helping the high-schoolers to develop skills valuable Community mental health was the focus for their future professional lives (such as of two other Penn student interns: Anna making a presentation) and to develop Hunt (Social Policy and Practice) and additional technical skills. An engaging Dana Kozubal (Medicine). They worked way to connect with technology was us- with The Consortium at two sites that of- ing Flip cameras to make videos. fered day programs for adults. One Sarah Cermak (Social Policy and Prac- theme the interns pushed was helping to tice) and Tricia Smyth (Nursing) dealt get the adults back into the work force. with two disparate age groups: high- They assisted the faculty, teaching about school volunteers and senior citizens at healthy eating, smoking, and diabetes. They Living Independently for Elders (LIFE), a even “rallied” at City Hall to protest bud- program of Penn’s School of Nursing. get cuts that would affect similar programs.

Jonathan Kole There, they helped with “all-inclusive According to Kozubal, the students care” for four days a week over the seven worked to develop a “personalized quit weeks. They also helped the elders make plan” for smokers in their groups. Near was a blast!” said Spaccarelli. Among the jewelry, do art therapy, and dance. An- the end of the rotation, some people re- different things they did with the children other topic was the problems elders face. ported having gone without smoking for was to make healthy smoothies, with These include “elder abuse,” which in- two weeks. “It exceeded any expectations such unlikely ingredients as kale, lettuce, cludes financial abuse, and they distrib- that I had,” said Kozubal. The interns and broccoli. As Willett noted, they tried uted material that listed resources to con- also tried to get healthier snacks at one to motivate the kids and “give them some tact, as Cermak put it, “if you’re being of the sites. take-home skills,” such as paying attention taken advantage of.” Cermak and Smyth One of the things Hunt learned from to the sugar and vitamins in various foods ran a session on hypertension awareness organizing community activities and and drinks. There was also a contest to as well. They also tried to debunk the joining peer support groups underscores determine the best-tasting and most nu- misconceptions that high-schoolers often a central tenet of community health. As she tritious smoothies, and each kid gave his have about older people, that they’re all put it, “Community is critical to recovery.” or her smoothie a name. senile and “not there.” – John Shea

2011/SPRING ■ 17 every nursing student could have such lack of safe transportation, little access to an experience.” a pediatrician, multiple children to tote. Peter Cronholm, M.D., assistant pro- As Truchil puts it, “I began to appreciate fessor of family medicine and community more contextual factors that influence health, adds that the program “provides patients’ health decisions.” critical experiences for health-care profes- Over dinner conversations, Bernadette sionals in building connections between West, Ph.D., listened carefully to her systems of care and the communities daughter Rachael and saw her evolving they serve – a critical step in addressing into “this very well-rounded medical stu- health disparities.” dent who was paying attention to the en- Donald Schwarz emphasizes the big vironment and issues people were experi- picture. “Bridging the Gaps ultimately encing in their communities.” West recalls creates an incentive for a student to inte- thinking: “This is something we should grate community health into practice,” he all be doing.” As an associate dean at the says. “It creates a different awareness University of Medicine and Dentistry of among health-care professionals of what New Jersey’s School of Public Health in the impediments are to health, so health- Stratford/Camden, West was in a position care professionals are more into what’s to make it happen. going on with housing for a client’s family, West arranged a meeting with her dean Natalie Spaccarelli what plans they have for the summer and Lucy Tuton. In 2007 they founded a they understand social issues or problems for their kid, how they are managing Bridging the Gaps program in Camden. that they confront.” work and monitoring their blood pres- There, BTG students work with the BTG also opens the window on inter- sure. And that’s important for both the homeless population. That may involve disciplinary collaborations for social work professionals who work in underserved visiting a tent city under a highway by- students. “You have an idea what the communities and health professionals pass to distribute water, provide diabetic nursing profession is and what dental more generally.” foot care, and instruct on sun protection. medicine is,” Draine continues, “but see- They work with a needle exchange proj- ing that each of these professions has some Bridging the Gaps . . . ect and on a health-needs assessment for focus on interaction with community and in Health Care male reproductive health; they staff a building community capacity is a unique Bridging the Gaps has continued to children’s summer camp that likely would perspective.” expand to new communities in need. Ra- not exist without the BTG team. “Bridging For Ann O’Sullivan, Ph.D., professor chael Truchil, M.D. ’09, M.P.H., had the Gaps is a godsend to our community of nursing, the uniqueness of this experi- studied community health as an under- agencies,” says West. She hopes to expand ence stands out. “Without BTG, nursing graduate at Brown University. As a first- the program to other New Jersey sites. students at Penn would not have as in- year medical student steeped in the hard Of course, West is very proud of her tense an interdisciplinary experience as is sciences, she found herself looking for a daughter, who is on the primary-care currently offered through this program. community experience. When she learned track in Penn Med’s internal medicine Knowing how each profession sees itself about Bridging the Gaps, she says, “a light residency program. Says Truchil, “Not in the community and working side by bulb went off. I had found a group of peo- only am I going to be practicing medicine side with dental, medicine, and social- ple who came from a similar background.” as a physician taking care of patients policy students allows nursing students The BTG seminar series led her to an with disease, but I will be taking care of to demonstrate their approach as a team internship with Early Head Start in North patients who are living in a community member to a variety of community inter- Philadelphia, together with a nursing stu- and who have a unique set of character- actions. Experiencing how slow it is to dent and a dental student. Teaching and istics from their backgrounds. I will be accomplish objectives when on a team in supporting new mothers during home taking care of a community of patients.” a community is the most valuable part of visits energized Truchil and inspired her Truchil hopes to open her own clinic these activities. The Institute of Medicine’s to conduct a survey about obstacles parents someday, bridging the gaps one com- Future of Nursing report would wish that face in having their children immunized: munity at a time.

18 ■ PENN MEDICINE Trailblazers, Inventors, & Teachers: Britton Chance and Christian Lambertsen

Born in 1913 in Wilkes-Barre, Pa., Chance developed a passion for sailing and BRITTON CHANCE early on displayed an uncanny knack for PLAYED A PIVOTAL invention. These interests came together when, as a teenager, he invented and pat- ROLE IN DETERMINING ented a novel automatic ship-steering de- BIOENERGETIC ACTIVITIES vice. Later, he was contracted by the Brit- ish General Electric Company to test it in a IN CELLS. THESE freighter between England and Australia. DISCOVERIES CULMINATED His passion for sailing never waned. In 1935, Chance earned his bachelor’s IN THE 1980S IN HIS degree in chemistry from the University of Pennsylvania. As a Penn graduate stu- PIONEERING WORK IN dent, he developed a microflow version MAGNETIC RESONANCE of a stopped-flow apparatus to study en- zyme mechanisms, observing their SPECTROSCOPY IMAGING changing compositions in milliseconds. IN HUMANS. Back in England, Chance worked with the originators of the flow apparatus Portrait of Dr. Chance by Leslie Dutton, Ph.D.

BRITTON CHANCE, PH.D., D.SC., for Even in his early 90s, Chance, the more than 50 years one of the giants of Eldridge Reeves Johnson Emeritus Pro- biochemistry and biophysics and a leader fessor of Biophysics, Physical Chemistry, in transforming theoretical science into and Radiologic Physics, could be spotted useful biomedical and clinical applica- riding his bicycle to his Penn laboratory. tions, died on November 16, 2010, at In 2001, still in pursuit of new things, age 97. He had the distinction of receiv- Chance unveiled a detection technique, ing both a National Medal of Science developed with collaborators at Penn and (1974) and a Gold Medal in the Olympics Harvard, that uses fluorescent molecules (sailing, 1952). Chance was also rare in to track and illuminate malignant cells being elected not only to the U.S. Na- in the breast. Even more recently, he was tional Academy of Science but also to part of a team that proposed developing foreign academies such as The Royal a portable, real-time system for monitoring Society of London. and imaging brain function.

2011/SPRING ■ 19 technique at Cambridge University. With radar. Despite his relative youth, he Lambertsen was Distinguished Emeritus these unique instruments he made im- became a group leader and eventually Professor of Environmental Medicine. portant research contributions, funda- supervised 300 people. For this work, Even before enrolling at Penn, Lam- mental and applied. He demonstrated the Chance was awarded the President’s bertsen, an enthusiastic swimmer who long-predicted but never-seen enzyme- Certificate of Merit. had worked at resorts along Barnegat substrate complex. He discovered that From 1949 to 1983, Chance directed Bay, had been experimenting with an ap- biological electron transfer – vital to res- the Johnson Foundation, which became paratus to breathe underwater. His early piration, photosynthesis, and oxidative widely recognized as a stimulating re- device used parts from the rebreathing metabolism – was quantum-mechanical search environment. For part of that time, circuits of anesthesia machines. With the tunneling, an understanding that now he was also chair of the Department of help of Dr. Henry Bazett, his professor of underpins engineering of nanoscale elec- Biophysics and Physical Biochemistry. physiology, Lambertsen offered his im- tronic devices. Chance also played a pivotal Chance’s earlier work on enzymes was proved device to the United States Navy role in determining bioenergetic activities fundamental to the understanding of in cells. These discoveries culminated in how oxygen is used in the body to pro- the 1980s in his pioneering work in vide energy and to a broader knowledge of the diseases that result from a lack of CHRISTIAN LAMBERTSEN’S energy. He also invented the dual-wave- length spectrophotometer, and his other “COMPREHENSIVE discoveries formed the basis for the glu- BACKGROUND AND cosometers in use today. Mark Lemmon, Ph.D., Penn’s chair of Biophysics and EXPERIENCE AS A Biochemistry, notes that Chance was DOCTOR, INVENTOR, continuously funded for 70 years and had six papers that reached more than AND DIVER MADE HIM 1,000 citations. A UNIQUE ALL-IN-ONE In addition to honorary degrees from Penn and several other universities, ASSET.” HE WAS CALLED Chance’s honors included the Franklin Medal from the Franklin Institute and THE FATHER OF U.S. the Christopher Columbus Discovery COMBAT SWIMMING. magnetic resonance spectroscopy imag- Award in Biomedical Research, from the ing in humans, and in the 1990s in his National Institutes of Health. In 1995, initiating the application of near-infrared Penn Med named the Stellar-Chance optics for the clinical diagnosis of breast Laboratories partly in his honor. cancer, muscle dynamics, and cognition. in 1941. The Navy, however, seemed Back in the United States, Chance be- CHRISTIAN J. LAMBERTSEN, M.D. satisfied with its hose-to-helmet diving came a fellow in Penn’s Eldridge Reeves ’43, founder and former director of techniques. The Office of Strategic Serv- Johnson Foundation for Research in Penn’s Institute for Environmental Medi- ices, a branch of the Army, welcomed his Medical Physics, where he completed his cine and inventor of what became known device and ideas. Throughout World War first study on enzyme kinetics. He earned as SCUBA (self-contained underwater II – and through medical school and his his Ph.D. degree in physical chemistry in breathing apparatus), died on February 11, internship at Penn – Lambertsen worked 1940. Two years later, he received a second 2011, at the age of 93. One of Penn with the OSS and established its special doctorate – in biology and physiology – Medicine’s most honored professors, underwater demolition forces, which from Cambridge. When the United States he began his long association with the were deployed in Burma. entered World War II, Chance was re- School of Medicine as a first-year student After the war, Lambertsen joined cruited to M.I.T. to work in its Radia- in 1939. His research had an impact on Penn’s Department of Pharmacology. tion Laboratory, as part of a secret team the study of human physiology, environ- Soon, however, the Navy called him back focused on developing and enhancing mental medicine, and physical medicine. to train its surface frogmen to become

20 ■ PENN MEDICINE divers. During his service, Lambertsen made the first exit from and re-entry into a submerged submarine. His work marked the beginning of modern under- water demolition teams and Sea, Air, and Land teams. According to the Defense Media Network, Lambertsen’s “compre- hensive background and experience as a doctor, inventor, and diver made him a unique all-in-one asset.” His education and research in the new fields of diving and hyperbaric medicine “gave him vast empirical and practical knowledge of the physiological effects and dangers of such edly increasing oxygen tolerance. In happiness” of humans. Among the recipi- conditions as oxygen toxicity, hypoxia, 1985, Aron B. Fisher, M.D. ’60, succeeded ents have been Madame Curie, Thomas prolonged activity underwater at depth, Lambertsen as the institute’s director. Edison, and Jonas Salk. Lambertsen was and other dangers.” In 1965, Lambertsen was honored honored for inventing “the underwater Back at Penn, Lambertsen had an with the University of Pennsylvania breathing apparatus known as SCUBA.” abandoned altitude chamber converted Alumni Award of Merit. He also received Among Lambertsen’s many other hon- into a positive-pressure thermal labora- the 1989 Distinguished Graduate Award, ors are the Aerospace Medical Association tory. It soon became a mecca for those the highest honor bestowed on alumni Award (1970); the Distinguished Public interested in undersea and aerospace by our School of Medicine. In addition, Service Award from both the Department environmental physiology. In 1955, Lam- Lambertsen was the recipient of the of Defense (1972) and the United States bertsen organized the first Symposium on Lindback Award for Distinguished Coast Guard (1976), their highest civil- Undersea Physiology, sponsored by Penn, Teaching, the University’s highest teach- ian honors; the New York Academy of the Office of Naval Research, and the ing honor. Since 1986, the Department of Sciences Award for Research in Environ- National Research Council. The Institute Pharmacology has sponsored The Christian mental Science (1974); and the 2001 for Environmental Medicine was officially J. Lambertsen Honorary Lecture, which Pioneer Award from the Navy Historical established in 1968. It was the site for brings leading researchers to the Penn Society. In 2000, the Navy SEALS pro- a series of pioneering multidisciplinary campus. claimed him “the Father of U.S. Combat studies that probed the pathophysiology Last year, Lambertsen was presented Swimming.” A Fellow of the College of of oxygen toxicity, diving-related diseases, with the John Scott Award, given by Physicians of Philadelphia, Lambertsen and mechanisms of hypoxic response in Philadelphia’s Board of Directors of City was elected a member of the National humans. Among the findings of Lambertsen Trusts to those whose inventions have Academy of Engineering in 1977. and his associates was a means for mark- contributed to “the comfort, welfare, and – John Shea

2011/SPRING ■ 21 Islet Cell Transplantation: A Patient’s Perspective By Andy Gordon

I needed to pee really badly. It was the pancreas. When enough beta cells are I needed better control. Thus, early in spring of 1966. The Vietnam War was destroyed, little if any insulin is pro- the Reagan era, I entered a D.C. hospital going on, and I was in Lyndon Johnson’s duced and, as a result, sugars in the body and was connected to an insulin pump. White House shaking my legs while tak- are not properly converted to energy. In- The pump provides a continuous infu- ing the public tour. Back then, there was stead, the sugar levels become elevated in sion of insulin at a programmed “basal” no place in the White House for the pub- the blood stream. rate by placement of an infusion set in lic to conduct “business.” So my Dad and The disease can be controlled but not the abdomen or other body part. The in- I ran next door to the Treasury Building, cured by the use of insulin. During these fusion set is connected to a syringe filled quickly glanced at Alexander Hamilton’s initial years, my control of the disease with insulin that is infused into the body statue, and made it to the restroom just was probably poor, but there were no by a programmable pump. One can also in time. (Entering a federal building was glucose monitors to measure blood-sugar infuse a “bolus” of insulin prior to eating. once a simple matter.) levels. Nor did I make much of an at- I was hooked up to my new pancreas – Of course, the entire family trip to D.C. tempt to eat a controlled diabetic diet. I the insulin pump – for close to 30 years. involved many stops to relieve my blad- do remember being taken to the hospital With the use of the pump, blood-sugar der. My parents suspected that something in an ambulance twice when my parents monitoring, and a more careful diet, was amiss. Back home, they took me to were unable or too afraid to treat bad my control of the diabetes certainly im- our doctor, and a few days later he called incidents of hypoglycemia (low levels of proved. But over the years, I still had to tell us that I had juvenile diabetes blood sugar). Nevertheless, I managed incidents of hypoglycemia, including one (now called Type 1 diabetes). well enough to work my way through when the downstairs neighbors had the As we learned, Type 1 diabetes is an college and law school without any more D.C. police visit me because I was tumbling auto-immune disease in which the im- ambulance trips. around the furniture in my apartment mune system goes awry and destroys After giving myself a daily injection of and making a lot of noise. Luckily, I was the insulin-producing beta cells in the insulin for more than 15 years, I realized still conscious enough to convince the Public of Science. Library Illustration: Giovanni Maki

22 ■ PENN MEDICINE police that I had low blood sugar and that read, “I will one day eat this star that I didn’t need to be arrested. on the day my diabetes is cured.” I kept More recently, I lost my ability to recog- that star and note in my possession for nize when my blood sugar was low. I was well over 30 years, waiting for the cure, no longer having the typical symptoms as does every Type 1 diabetic. At some of hypoglycemia – sweating, shaking, point within the last 10 to 15 years, I tingling, etc. A number of times in the finally gave up and tossed the plastic middle of the night I would wake up, bag filled with the decomposed star and somehow walk down the stairs, test my raggedy note. The long-promised cure, blood sugar – and discover that my read- despite the efforts of many doctors, re- ings were well below the desired range. searchers, and dedicated volunteers, still Andy Gordon seemed far away. An Experimental Treatment At age 56, I realized that this imperfect At the suggestion of a friend, I inves- kidney function, hypertension, toxicity transplant may be the only chance I had tigated an experimental treatment for to the nervous system, an increased in- to “cure” the disease. What would it be Type 1 diabetes called an islet cell trans- cidence of both opportunistic infections like to live a life free of my constant com- plant. After reviewing the history of such and malignancies, and other side effects panions: the insulin pump, the glucose transplants, I applied to participate in a too numerous to mention. monitor, the finger pricker, and the hard clinical trial at the University of Penn- Weighing the risks and benefits of the candy that was always in my pockets? sylvania. The trial at Penn Medicine in- transplant was a complex decision. Al- It has been 14 months since the islet cell volves transplanting islet cells taken from though I had never achieved total control transplant, and I have lived free of my a donor pancreas into the liver of Type 1 of my disease, I was healthy, with fairly insulin pump for the last year. After being diabetics. These transplants are limited good blood-sugar levels. I was unscathed attached for 30 years, the pump became to Type 1 diabetics of a certain age who by kidney damage, nerve damage, dam- so much a part of me that even now I either have great difficulty controlling age to the retinas, uncontrollable infec- sometimes reach for it in my pocket. Do I the disease or fail to recognize when they tions, or heart disease — the so-called consider myself “cured”? Not necessarily, have hypoglycemia. If the procedure is “complications” of diabetes. but certainly the islet cells are functioning successful, the new islets will begin to So why proceed with the transplant? well, as shown by my blood sugar readings produce insulin. After filling out a ques- While the risks from the immunosup- and hemoglobin A1C levels (now within tionnaire and undergoing a battery of pressant drugs were daunting, my 44 the desired range of a non-diabetic). Would tests, I qualified for the trial in the sum- years of Type 1 diabetes bore their own I have made the same decision to have mer of 2007. scary risks. How many more years was the transplant if I had known about the Over the next 2 1/2 years, I made many I going to visit the eye doctor without canker sores, swollen hands and feet, acne, visits to the Hospital of the University of any finding of retinal damage? Would my and tremors almost certainly caused by the Pennsylvania, where the staff members cardiologist eventually discover heart dis- immunosuppressants? Probably. Am I a treated me with great kindness and were ease resulting from long-term diabetes? different person? Not necessarily, but I always willing to talk with me when I How long would my kidneys continue suppose my post-transplant life is a work in had concerns or questions. But as the to function as they should, even with my progress. Would I eat that blue Jewish star waiting period for the transplant length- fairly good control of the diabetes? now if I still had it? No, probably not. ened, I became increasingly troubled But more important – as odd as it may But it feels good that maybe I could. about actually going ahead with the pro- sound – I can trace my decision back to cedure. Most of my uncertainty stemmed the celebration that was held at the syna- from the need to take medications on gogue right after my bar mitzvah. On The Penn-JDRF Center for Islet Transplantation a regular basis to suppress my immune one table was a huge cake decorated with was established by Ali Naji, M.D., in 1999. Michael R. Rickels, M.D. ’99, M.S. ’07, is medical director of system so it would not attack and destroy a Jewish star made of sugar and blue Penn’s Pancreatic Islet Cell Transplantation Program. the transplanted islet cells. The immuno- food coloring. I could eat neither the If you are interested in participating in the islet transplantation trial, call (215) 662-4449. To learn suppressants can cause a wide variety of cake nor the star. But I grabbed the star more about diabetes research and care at Penn adverse effects, including impairment of and placed it in a plastic bag with a note Medicine, go to http://www.med.upenn.edu/idom/

2011/SPRING ■ 23 V CCINES in the Vanguard By Jessica Stein Diamond

At Penn Medicine, physician-scientists are creating new DNA vaccines that hold great promise for fighting disease more effectively, with fewer side effects. But the new vaccines are expensive, and funding can be hard to find.

After living with chronic lymphocytic cal protocols, the risks and the side ef- seeing the development of these vaccines. leukemia (CLL) for 14 years, James Smith fects. It was one of those things that should “This isn’t a drug in a bottle or a vaccine (not his real name) faced a pivotal deci- work based on the science, which looked in a vial,” says June, a professor of pa- sion. Chemotherapy no longer kept his solid.” Smith, a married father of four adult thology and laboratory medicine. “This is disease in remission; he had to choose children, adds, “That’s never a given when more like a next-generation blood trans- between two next-stage treatments. One you’re talking about a biological system.” fusion. The principles of this have been was a bone-marrow transplant. With such known for decades and are finally begin- a treatment, there was a 10-to-20-percent Personalized Vaccines ning to yield therapeutic benefits, thanks chance Smith would face life-threatening Show Promise to advances over the past 10 years in cell complications as well as a 50-percent Drawing upon decades of research and engineering and gene transfer.” chance of long-term remission that would new techniques for modifying DNA, Until recently, therapeutic immunization require him to take anti-rejection drugs Penn researchers are refining autologous was used for only one medical necessity: for the rest of his life. The other treatment cellular immunotherapy, a new form of after a patient was exposed to rabies. was to take part in the pilot phase of a personalized therapeutic vaccines. “What Newer vaccines, built upon the elusive clinical trial using autologous cellular im- we’re doing falls under the area of per- promise of gene therapy, now have the munotherapy, run by David L. Porter, M.D., sonalized medicine in the extreme sense – potential to transform therapeutics for a professor of medicine and director of using a person’s own white blood cells or wider range of conditions. The approach Penn Medicine’s blood and marrow trans- tumor cells to develop a personalized involves inserting genes to redirect and plantation program. vaccine,” says Carl H. June, M.D., direc- activate a host’s immune system to attack Smith chose the second option. As a tor of translational research at the cancer – while sparing healthy cells. Un- scientist, he says, “I understood the clini- Abramson Cancer Center, who is over- like traditional vaccines that protect

24 ■ PENN MEDICINE term remission, a low level of the disease, or a cure. Still, two of the three CLL patients who have participated so far in this clini- cal trial – and were resistant to all other therapies – appear to be in complete re- mission after this cell therapy. The third Photograph by Tommy Leonardi Tommy by Photograph patient has had an excellent, though partial, response. If the responses of the CLL patients are durable and can be reproduced, Porter ventures, “this kind of treatment might be developed for patients with all different sorts of cancers. It is really the beginning of the very new field of immune therapy. It’s very early in the trial, but our initial experience has been very exciting. You don’t see completely new therapies work so effectively very often.”

David L. Porter, M.D., makes use of autologous cellular immunotherapy. June is pleased by the progress as well: “We went into this trial not expecting to against future exposures to a pathogen, the infusion he woke up with what felt see home runs. But we’re seeing home personalized immunizations treat an ex- like the flu. “I said ‘Great, the war has runs in our first couple of swings. If results isting disease or infection. Phase 1 and 2 started,’” he recalls. “That was the indicator continue as they are, I’m quite optimistic clinical trials under way at Penn are us- we were all looking for – when my ge- this will become an FDA-approved therapy.” ing immunotherapy for blood cancers netically modified T cells started killing When Penn Medicine’s new Translational such as chronic lymphocytic leukemia, off the CLL cells.” After more than a week Research Center opens this spring, half of solid tumors such as ovarian and breast of feeling lousy at home, he experienced its eighth floor (comprising 20,000 square cancer, and viruses such as HIV. so strong a reaction against his CLL that feet of laboratory space) will house a re- As Smith reports, in his clinical trial he needed to be hospitalized so that the search team of more than 100 people, in- protocol, “blood came out of one arm side effects could be monitored and man- and went into a centrifuge. They separated aged. He was released after four days. out the white blood cells and returned Since then, he says, he has felt “terrific.” the rest into my other arm.” Next, his Smith’s hope was that the pilot phase T cells were genetically modified at of the clinical trial would help him defer Penn’s Clinical Cell and Vaccine Produc- bone-marrow transplantation as long as tion Facility (CVPF) so they would kill possible. To his surprise, however, the mature B lymphocytes, including his treatment appears to have completely cancer cells. The facility plays a crucial cleared his body of CLL. At six weeks after role in this research, providing both sci- his treatment, he reported, “Right now entific support and regulatory support to they can’t find any disease in my bone clinicians. Bruce L. Levine, Ph.D., the fa- marrow and blood.” cility’s director, worked with June to refine and advance the therapeutic vaccine used Hope for the Future in the CLL protocol. The field of personalized vaccines is at In September, over the course of three least a decade away from widespread closely monitored days, Smith was infused clinical use, but early signs are promising. with those modified cells and had no re- According to Porter, it is not clear whether action to the infusion. Two weeks after Smith’s pilot treatment will lead to long- Bruce L. Levine, Ph.D., director of the CVPF.

2011/SPRING ■ 25 How pressing is the need to develop a better vaccine against the flu? Approxi- Photograph by Sabina Louise Pierce by Photograph mately 30,000 Americans die of the ill- ness each year. There is always the risk of an influenza pandemic. And despite these concerns, no manufacturer based in the United States currently produces a flu vaccine. These facts underscore the importance of influenza prevention. David B. Weiner, Ph.D., professor of pathology and labora- tory medicine, is developing a breakthrough DNA vaccine that holds the potential for Carl H. June, M.D., likens the new personalized therapeutic vaccines to next-generation blood transfusions. preventing such a flu pandemic while improving the availability of the vaccine. cluding six senior faculty members of the Center and the Celso-Ramon Garcia Pro- Weiner is known as one of the found- School of Medicine. The goal: to advance fessor of Reproductive Biology, is the ers of the field of DNA vaccines. More autologous cellular immunotherapy. principal investigator, in collaboration with than a decade ago, his laboratory was the “We have the largest group in the world Chaitanya Divgi, M.D., chief of nuclear first group to move such vaccines for dedicated to cancer immunotherapy,” says medicine, and June. AIDS into human clinical trials and to June. “More patients are treated with Their approach involves inserting a prove that DNA injections were safe. His more novel trials here than at any other gene into a patient’s T lymphocytes that group then went back to the bench to cancer center in the country. What sets would attack the “stroma,” the vascular develop a new generation of DNA-based us apart from any other center is our bal- cells that support tumor growth with vaccines formulated to be more efficient ance of basic research and translational blood and oxygen. Although tumor cells in triggering an immune response. Work- therapy, the number and caliber of our mutate frequently, posing challenges for ing in collaboration with Inovio Pharma- clinical trials, and the teams behind them.” cancer treatment, stromal cells do not ceuticals, Inc., and the Public Health The Clinical Cell and Vaccine Production mutate and are consistent throughout the Service of Canada, Weiner is now using Facility, he continues, is an essential part- body. That means they present an easier those insights to create a new method for ner in the developmental science as well therapeutic target. “If successful, this per- producing flu vaccine and is refining the as in producing the treatments and safely sonalized targeted approach can become science for early-stage animal studies. testing new therapies for humans. a truly powerful universal cancer therapy,” Unlike traditional vaccines that use at- In October, a team of Penn physician- says Coukos. June underscores his point: tenuated or killed virus or recombinant scientists received a $3.2 million “Transfor- “The principle of engineering the im- proteins, Weiner and his collaborators mative Research” grant from the National mune system to attack tumor vasculature are creating a flu vaccine that would work Institutes of Health for innovative research could work in a lot of different cancers by delivering plasmids – synthetically that has the potential to make an extraor- beyond ovarian cancer, such as lung built pieces of genetically modified DNA. dinary impact. The grant is supporting cancer, colon cancer, breast cancer, and When taken up by cells, the plasmids Phase 1 trials of a personalized immuno- pancreatic cancer.” would drive expression of a foreign therapy aimed at attacking and destroying Another form of autologous vaccine protein, which then trigger the body’s blood vessels of targeted ovarian cancer immunotherapy – for breast cancer treat- production of antibodies. tumors. George Coukos, M.D., Ph.D., di- ment – is in Phase 1 trials led by Brian J. The DNA in the flu vaccine would not rector of the Ovarian Cancer Research Czerniecki, M.D., Ph.D., the Rhoads- become part of the host. Instead, explains

26 ■ PENN MEDICINE Harrington Associate Professor in Sur- gery. In this case, a gene is inserted into dendritic cells. As a result, the immune system attacks HER2/neu proteins (which are highly correlated with cancer recurrence) Illustration courtesy of David Illustration courtesy Weiner, Ph.D. as if the cancer cells were an infection. Universal Influenza Vaccine Preliminary results demonstrate that the treatment stimulates an immune response in early-stage breast cancer, Czerniecki

Seasonal Influenza says, but he also notes that more out- is diverse come research is needed. The proximity ] Identify common immune of the Clinical Cell and Vaccine Produc- features of varied Influenza tion Facility, he adds, has helped to re-

Convert to Synthetic fine the treatment: “Our dendritic cells Consensus DNA Vaccine Idealized viral an,gens were taken back to the lab and improved designed to broadly and are back in patients with better ac- s,mulate immunity against all strains tivity. The ability to circle back to the CVPF makes the difference clinically.” Autologous vaccines also hold promise to transform the treatment of HIV. Pablo Tebas, M.D., associate professor of medicine Protective Antibodies against and director of the Adult AIDS Clinical diverse influenza from a Formulate & deliver the single vaccine formulation Trials Unit, is leading Phase 1 clinical vaccine trials at Penn in collaboration with San- gamo BioSciences Inc., of Richmond, Ca- lif. The trial makes use of engineered Weiner, “when that foreign protein ap- non-infectious genetic material to gener- “zinc finger” proteins that bind to DNA pears in the body unexpectedly, the im- ate a customized immune response. to genetically modify a patient’s white mune system says, ‘I hate foreign things The N.I.H. took notice. In October, it blood cells, turning them into molecular in my body,’ and will destroy it. The made a $3.2 million grant for “Transforma- “scissors” that prevent the spread of HIV. vaccine, in effect, teaches the body to tive Research” to Weiner and his collabora- Earlier research has shown that one produce an immune response and to tors. The central goal is to stimulate immu- percent of Caucasians have a natural re- create antibodies against a viral target – nity against diverse strains of influenza in a sistance to HIV because they lack a co- in this case, traits of multiple strains of single vaccine formulation. N.I.H. funding receptor for a protein called CCR5. That influenza. The next time there is an ex- of this kind is reserved for innovative ap- lack makes it impossible for the virus to posure, the body is trained to fight back.” proaches that have the potential for an ex- enter a cell. The treatment developed by Current methodologies rely on select- traordinary impact on public health. Tebas in collaboration with Sangamo ed- ing from among several flu virus strains Weiner’s work with the flu vaccine – and its out CCR5 at the genetic level and six to nine months before flu season in in particular the promotion of an anti- generates a protected population of im- the United States. That strategy is not al- body response against multiple changing mune cells that are specifically designed ways successful. The new approach Weiner viral strains – promises to inform his lab’s to fight both the virus and opportunistic and his collaborators are developing of- well-established efforts to develop HIV infections. fers other advantages: the vaccine would vaccines as well. “Flu gives us insights At an AIDS conference in March, Carl be available before the new flu season; it into strategies to develop vaccine immu- June, who was involved in Sangamo’s trials, doesn’t need to be produced in an egg; it is nity to other rapidly changing pathogens presented preliminary results for nine pa- cheaper, more stable, and can be manu- such as HIV.” As he points out, “HIV is a tients with HIV. They received the new factured more rapidly and in greater major challenge because it is several-fold treatment in Philadelphia, New York, and quantities; and it uses non-replicating, more diverse than flu.” California. According to June, the engi-

2011/SPRING ■ 27 neered cells in all patients remained free There is still work to be done. As Tebas fact that personalized vaccines are radically of HIV infection – and in eight of them, the puts it, “Our holy grail is to develop an different from factory-produced vaccines engineered cells multiplied dramatically. immune system that’s resistant to HIV or pills. In addition, none of the patients reported infection, so people don’t have to take All such therapeutics must cross what serious side effects. anti-retroviral therapy. We’re a decade June and others call the “valley of death” – In a press release from Sangamo, June away from that at least.” obtaining funding for Phase 2 clinical trials stated that this new direction of therapy that typically cost $10 million (far be- provided a “proof of concept” while Across the Valley of Death yond typical N.I.H. funding levels). “A showing “the most promise of any yet The journey toward more widespread lot of promising therapies stop at Phase 1 tested.” The Associated Press ran a pho- use of personalized therapeutics is ardu- because that’s the most you can support tograph of Tebas with Jay Johnson, a pa- ous. It requires validating and advancing with N.I.H. funding,” says June. “Finding tient who had received the treatment in the science, obtaining approval from the the bridge across the valley of death is September. “My results are excellent,” Food and Drug Administration, and – not the challenge we continually face. Unless said Johnson, who works for Action the least of it – raising up to $50 million you can get industry investment or find AIDS in Philadelphia. “The overall goal to bring each new therapeutic to market. angel investors, philanthropic or founda- is not to have to take medication” while For personalized therapeutic vaccines, tion support, you’ll never get to Phase 2. hoping for an eventual cure. those challenges are compounded by the When a treatment is novel like this, it

Personalized immunotherapy vaccines Genes are transferred into the cells using Each culture bag eventually contains are now being generated for subjects who a “Trojan horse” vector such as a lentivi- several billion enhanced cells. Next, the enroll in clinical trials in the Clinical Cell rus to reprogram T cells permanently beads are removed using powerful mag- and Vaccine Production Facility (CVPF) with genes so that they have therapeutic nets. Cells are washed, concentrated, put at the Hospital of the University of Penn- anti-tumor or anti-viral properties. Al- through extensive F.D.A. tests, and then sylvania. though the production process is similar placed in infusion media or cryo-preserved Patients involved in cell-based clinical for all patients, the gene and vector vary (potentially for years). When the patient is trials begin with a standard blood-collec- depending on the patient’s ailment. ready for treatment, the cells are shipped tion process similar to that used for col- The genetically modified cells are in- to an infusion room and thawed in a warm lecting blood stem cells used in transplants cubated for a day. Next, they are grown water bath just before being infused. following high-dose chemotherapy. At in gas-permeable culture “bags” or per- At present, the process of preparing a HUP’s apheresis center (or at Children’s fused bioreactors for 10 days, during patient’s personalized therapeutic vaccine Hospital of Philadelphia), a two-to-three- which time they are nurtured by media takes nine to ten days from apheresis to hour collection yields an enriched popula- rich in nutrients and gently rocked. To infusion. For gene-modified cells, several tion of billions of the patient’s own white obtain enough cells for therapeutic pur- additional weeks are required for testing, blood cells in a volume of less than half a poses, the facility’s staff uses plastic beads which is why cells are cryo-preserved. cup. Patients receive back their own red coated with antibodies that improve on The manufacturing process is highly con- blood cells, platelets, and plasma. the natural way the body makes T-cells trolled to ensure that each patient receives Next door at the CVPF, the staff further grow. The process for using these beads, back his or her own modified white enriches the “killer” T cells or dendritic which contain an iron core, was invented blood cells. There are other precautions: cells and subsequent transformation of by Bruce L. Levine, Ph.D., director of the access to the culture bags is restricted to the blood cells into a therapeutic vaccine. facility, and Carl H. June, M.D., director sterile tubing and connecting devices, and The facility is accessible only by key card of translational research at Penn’s each culture room in the facility manufac- and is certified at Biologic Safety Level 3. Abramson Cancer Center. tures only one product at a time.

28 ■ PENN MEDICINE takes a lot longer until industry believes in it and is willing to invest in it.” In November, the National Cancer Institute awarded $2 million in funding for a Phase 2a multi-center trial for Porter’s treatment for acute leukemia patients – according to June, just enough money to get started but not enough for the number of patients treated in a typical Phase 2 trial. The Special Translational Research Acceleration Project grant, designed for projects “ripe” for translation, was award- ed to project director Renier J. Brentjens, M.D., Ph.D., of Memorial Sloan-Kettering Cancer Center, with subcontracts to Stephan A. Grupp, M.D., Ph.D. associate professor of pediatrics at Penn and a physician-scientist at the Children’s Hos- pital of Philadelphia, and June. Porter is the clinical principal investigator. The The Clinical Cell and Vaccine Production Facility plays a crucial role in developing new therapeutic vaccines. team is pursuing additional funding for the Phase 2 trial. tech company. Provenge has already been ling donors. June expects a slower rate of Lack of sufficient funding threatens approved for reimbursement by such health acceptance among oncologists and cancer to stall other promising leads on per- insurers as Aetna, Humana, and Kaiser. doctors who don’t typically give transfu- sonalized vaccines in the pipeline. As If the funding and science of personal- sions – and who will need to learn about Czerniecki puts it, “The science for this ized vaccines both fall into place, physician the immune system. field has outpaced the funding model. training and practices will also need to According to June, Dendreon’s prostate- Because grants from N.I.H. are small, cancer treatment involves a very similar most people have to stick with animal change of practice for physicians who models. Then, when people conduct perform it. “If that goes smoothly, it bodes clinical trials, they have to limit it to five well for the kind of technology we’re de- or six patients because they can’t get veloping at Penn.” more funding.” Tebas likens the quest to move promis- “National Cancer Institute funding for ing new personalized vaccines through research has been cut more than five years the research pipeline toward clinical use in a row,” June notes. “That’s a real strain to “running two or three marathons one on the system, compounded by the fact after another!” In his view, “There are so that the pharmaceutical industry has run many steps along the way that can go out of gas. They’ve invested a lot of mon- wrong. Only a fraction, probably less than ey but aren’t coming up with new drugs. one percent of products in development, Once things start to work with personal- change. June anticipates relatively swift reach the end of the line in that marathon. ized vaccines, then industry will jump in.” acceptance among doctors trained in We’re working against the odds, but that’s Precedents are emerging for commer- bone-marrow transplantation. Familiar the nature of it.” cializing cellular therapies that are specific with blood transfusion protocols, they to patients. Last April, the first autologous are well aware of the limitations of Information about eligibility and enrollment in all cellular immunotherapy was approved by bone-marrow transplants, which have clinical trials at the Abramson Cancer Center is available at http://www.penncancer.org/patients/centers- the F.D.A.: Provenge, for treating prostate high toxicity and are typically limited to programs-services/phase-i-and-ii-clinical-trials- cancer, by Dendreon, a publicly held bio- relatively young patients who have sib- developmental-therapeutics/

2011/SPRING ■ 29 Development Matters THANK YOU, DEAN RUBENSTEIN

In the past decade, more alumni, friends, advocates, and volunteers than ever have joined Dean Rubenstein and Penn Medicine to create a record of development success that is unprecedented. With their support and Dean Rubenstein’s guidance, Penn Medicine has become a true leader in academic medicine, attracting the best students and faculty, building revolutionary new research and care facilities, and exerting a strong influence on American and global medicine. The tangibles during the Rubenstein era are impressive: Arthur Rubenstein was just the right prescription for the record-setting dollar totals, the spectacular new skyline, the “University of Pennsylvania Health System when he arrived doubling of financial aid, and, finally – Penn’s largest gift ever, more than a decade ago. His leadership had just the right Raymond and Ruth Perelman’s $225 million naming gift to mix of scholarly wisdom and implied expectations.” the School. — Rosemary Mazanet, Ph.D. ’81, M.D. ’86, Chair of the At Commencement, Dean Rubenstein spoke with pride Campaign for Penn Medicine and Co-Chair of Making about Penn Medicine’s strengths. But he spent more time History: The Campaign for Penn. challenging the School’s graduates to restore the “beauty of the physician-patient relationship.” This characteristic concern for the work remaining to be done is no surprise to alumni and friends who know Dean Rubenstein. As his tenure ends, we invited some of those who know him best to share their thoughts.

Our family has always had the highest regard for Arthur. During “his tenure, the Abramson Cancer Center has made meaningful progress — both in research and in developing truly exceptional, comprehensive, and respectful programs for cancer patients and their families. We met Arthur shortly after he arrived 10 years ago and We believe we have influenced thousands of lives for “were impressed by his warmth and genuine interest in the better. Arthur has been an extraordinarily kind, intelligent, people. We have been encouraged by his strong support and forward-looking guide, and we are very glad to have had his of the scholarship program.” expertise on an enterprise that is so important to our family.” – Walter Gamble, M.D. ’57, and Anne Gamble, Penn Medicine’s – Leonard and Madlyn Abramson, whose generosity and guidance most loyal supporters of scholarships. More than 50 Gamble have made the Abramson Cancer Center a leader in cancer scholarships are awarded each year. research and care.

30 ■ PENN MEDICINE THANK YOU, DEAN RUBENSTEIN

We have witnessed firsthand how innovation can change – “and save – lives. Our entire family is proud to be associated with the brilliant minds at Penn, and we commend the many achievements of Dean Arthur H. Rubenstein. His compas- sionate and visionary leadership has set the standard for all of Penn Medicine. Over the years, we have been fortunate to have supported ” “ – Suzanne and Ralph and Aileen and Brian Roberts. Above, Ralph many causes and organizations that do good in our city and and Suzanne Roberts at the opening of the Roberts Proton throughout the world. None has made a bigger impact on our Therapy Center, the largest in the world. lives than the creation of the Ruth and Raymond Perelman Center for Advanced Medicine and now the naming of the Perelman School of Medicine. Arthur’s foresight led the way in helping us take part in building this magnificent legacy of hope and achievement for countless students, patients and their families.” — Raymond and Ruth Perelman Perelman School of Medicine at the University of Pennsylvania Perelman Center for Advanced Medicine

A Distinguished Decade: Statistics of Success Barrie McNeil Jordan and family at the 2010 White Coat Ceremony.

Dean Rubenstein and my late husband, Henry, worked closely More than $1.4 Billion: Total Support Raised “together from Arthur’s earliest days at Penn Medicine. They shared a vision: to make Penn Medicine one of the premier Research: Nearly $760 Million Raised medical institutions in the world while instilling a level of caring for patients and their families equal to the excellence Student Aid: $82.6 Million Raised in medical treatments. Arthur is an extraordinary leader. He possesses a keen Professorships: 38 new chairs endowed intelligence, builds consensus at many levels, shares his gentle sense of humor, and has a humbleness that is rare to find in Association of American Medical Colleges ranking someone so accomplished. I share Henry’s love for our friend, for alumni giving: first among our peers Arthur, and thank him for fulfilling this vision for Penn Medicine.” Number of Penn Medicine Leadership Volunteers: Nearly 350 – Barbara “Barrie” McNeil Jordan. The Jordans have been among the strongest supporters for medical students and generously endowed the Jordan Center for Gynecologic Cancer.

2011/SPRING ■ 31 Development Matters

The new skyline includes the Perelman Center for Advanced Medicine, the Roberts Proton Therapy Center, and the Translational Research Center. Everyone associated with Penn Medicine has always felt the “steady hand, outstanding leadership, quiet modesty, and superb “I have spent my entire professional career as an academic and perceptiveness of Dr. Rubenstein. All have loved working with have witnessed the contributions of many deans to their re- and for him, which is the greatest regard anyone can achieve. spective institutions. None have been more extraordinary than ” – Raymond Welsh, W ’53, and Joanne Welsh, CW ’52. Raymond is those of Arthur Rubenstein. His vision, foresight, and good an Emeritus Trustee of the University of Pennsylvania and a Penn sense have been centrally important in transforming Penn from Medicine Campaign Cabinet member. He sits on the Director’s what was simply an excellent medical school and hospital into Leadership Council of the Abramson Cancer Center. He was honored with the Alumni Award of Merit in 1986. Both Raymond a truly world class institution. As an alumnus, I deeply feel the and Joanne have dedicated decades of service to Penn through gratitude, joy, and pride of the rest of the University family in alumni participation and are devoted supporters of scholarship aid. having witnessed the outcome of Arthur’s tenure as Dean. ” Arthur Rubenstein’s integrative and collaborative approach to – Stanley Cohen, M.D. ’60, Hon ’95, former University of Pennsylvania “ Board member, is a pioneer of genetic engineering. He is the medical education, research, and care has led to his brilliant re- winner of both the Albert Lasker Award for Basic Medical configuration of medical practice through the centers and insti- Research and Penn Medicine’s Distinguished Graduate Award. tutes at Penn. His compelling vision of the future of medicine blends both humanistic understanding of medical practice and respect for the value of data and assessment. A kind and com- passionate physician, Dr. Rubenstein has led the way in creating a patient-focused model of care throughout Penn Medicine.” – Janet Haas, M.D., a physician and philanthropist, has served on many Penn Medicine boards over the past 20 years, including the Penn Medicine Campaign Cabinet, the University Board of Trustees, and the Bioethics External Advisory Board, which she has chaired since 2006.

Arthur is that rare person who does a myriad of things exceed- “ingly well. In addition, it is always a great pleasure to be in his company.” – Adele K. Schaeffer, C ’55, and Harold G. Schaeffer recently established the Adele and Harold Schaeffer Professorship in Medicine, held by Dr. Jack Ende. Adele is an emeritus trustee of the University of Pennsylvania, and the Schaeffers have been loyal donors for more than thirty years.

32 ■ PENN MEDICINE Dean Rubenstein at the beam signing for the Translational Research Center. I was privileged to be both a medical student at Penn and a “house officer at HUP, and I am even more proud of being a I have known Arthur for many years, and he is very special to Penn Medicine Board member. Quite simply, Arthur is an ex- “me. His kindness is genuine. He has done so much for me as traordinary leader. Because of him, Penn Medicine has provid- a trustee and an individual. I want him to know that he will be ed a clear-cut blueprint for a changing health landscape. His truly missed. ” historic innovations have redefined how American Medicine – – Mary L. Smith, Trustee of the W. W. Smith Charitable Trust. both clinical and research initiatives – will be structured for The Trust has been a generous supporter of Penn Medicine decades to come. initiatives for more than three decades, including the William Wikoff Smith Chair in Cardiovascular Research, currently held He took a struggling institution and masterfully wove by Dr. Jonathan Epstein. many disparate parts into an even greater institution that has assumed the pinnacle of medical and health institutions. He did this not with fanfare, but with honesty, integrity, and the ability to have all of us put our trust in him and his vision. To me, Arthur has accomplished the best in collaboration. To use a sports analogy, he has changed a team of champions into a championship team.” — Marc Garnick, M.D. ’72, G.M.E. ’73, is a member of the Penn Medicine Board, the Campaign Cabinet, and the Medical Alumni Advisory Council, and is a recipient of the Alumni Service Award. Dr. Garnick and his wife, Dr. Bobbi Garnick, are shown here with Dean Rubenstein and his wife, Denise, at a reception the Garnicks hosted in the dean’s honor. The Garnicks are great proponents and generous supporters of scholarship aid.

2011/SPRING ■ 33 Progress Notes Robert W. Block, M.D. ’69, prove training and to reach busi- serves as co-director of the Obesity G.M.E. ’73, professor at the Uni- ness objectives. Institute and a principal investi- Send your progress notes to: versity of Oklahoma School of gator in the Sheikh Zayed Institute Andrea Pesce Community Medicine, has been Ronald L. Kotler, M.D. ’82, for Pediatric Surgical Innovation, Assistant Development Officer elected president of the American G.M.E. ’87, clinical associate launched in 2009 through a gift PENN Medicine Development Academy of Pediatrics. For the professor of medicine at Penn, from the Government of Abu and Alumni Relations past 25 years, his priority has received the Edward D. Viner Dhabi. Nadler performs bariatric 3535 Market Street, Suite 750 been the prevention and treat- Teaching Award for the second surgery on adolescents who meet Philadelphia, PA 19104-3309 ment of child abuse and neglect. time. The award, given annually certain criteria. His basic research by the medical house staff of has focused on the liver fibrosis Pennsylvania Hospital, goes to a associated with biliary atresia. member of the hospital’s medical With Monica Hubal, Ph.D., he is ’70s staff who has contributed most working to unravel the origins of ’50s effectively to the professional de- metabolic disease so that eventu- Michael D. Schneider, M.D. ’76, Gerald M. Edelman, Ph.D., velopment of the house staff. ally these conditions can be was a recipient of the 2010 Dis- The award is named for Edward treated or prevented before they M.D. ’54, Hon ’73, San Diego, tinguished Alumnus Award from director of The Neurosciences Viner, M.D. ’60, G.M.E. ’64, reach a state where surgery is a the Duke Medical Alumni Asso- longtime chair of medicine at desired option. Their aim is to Institute and president of Neuro- ciation. He took his residency in sciences Research Foundation, Cooper University Hospital. develop a blood test to identify internal medicine at Duke which patients are most likely to received the Navigator Award for (1976-78) and later trained in 2010 from the Potomac Institute Guy Fredrick Glass, M.D. ’87, succeed with certain interven- research at the N.I.H. under No- a psychiatrist who practices in tions. Formerly at New York for Policy Studies The awards bel Laureate Marshall Nirenberg. are presented to members of Manhattan and New Jersey, had University, Nadler was a visiting Schneider is an eminent re- his first staged full-length play professor at the Royal College of Congress and to representatives searcher in the regeneration of of the executive branch, indus- last year: The Last Castrato, at Physicians and Surgeons of Canada heart muscle following heart at- the Connelly Theater in New in 2008. try, and academia in recognition tacks, having discovered the ex- of distinguished contributions in York City. He has had perfor- istence of latent heart stem cells mances and readings of his plays Bernard J. Costello, D.M.D., science and technology. Edel- in both mice and humans. Since man, who is also a professor at in New York City, New Jersey, M.D. ’97, G.M.E ’00, was recently 2007, he has been at Imperial Pennsylvania, Nebraska, Wash- promoted to professor at the The Scripps Research Institute, College London, where he now won the Nobel Prize in Physiol- ington, D.C., England, and Japan. University of Pittsburgh. He is serves as director of the British Healing and The Therapeutic Hour chief of pediatric oral and maxil- ogy or Medicine in 1972 for his Heart Foundation Centre of Re- work in antibodies. were published by Smith and lofacial surgery at the Children’s search Excellence and holds the Kraus in the Best Ten Minute Plays Hospital of Pittsburgh. He has British Heart Foundation Simon Peter J. Jannetta, M.D. ’57, of 2007. Glass is on the faculty of received a $4 million grant from Marks Chair in Regenerative the Albert Einstein College of the Department of Defense to G.M.E. ’64, was honored with Cardiology. the Neurosurgical Society of Medicine. study a new regenerative bone putty to treat craniofacial defor- America’s Medal for Outstanding Thomas A. Einhorn, M.D., Service at the 2011 annual meet- mities from trauma or other G.M.E. ’ 77, chairman of the causes. ing. In 2009, he also received Department of Orthopaedic Sur- the Medal of Honor from The gery at Boston University, was ’90s World Federation of Neurosurgi- appointed to the Medical Advisory David J. Brailer, M.D., G.M.E. cal Societies. The Oxford Uni- Board of NeoStem, an interna- ’91, Ph.D. ’92, chairman of versity Press issued his book, tional biopharmaceutical company Health Evolution Partners, an ’00s Trigeminal Neuralgia, last year. with operations in the United investment company, was elected Matthew F. McManus, M.D. ’05, Jannetta is professor and vice States and China. to the board of directors at Wal- Ph.D. ’03, has been appointed chairman of neurosurgery at Al- green Co. He was the first na- president and chief executive of- legheny General Hospital. Adrienne Bentman, M.D. ’78, tional coordinator of health-care ficer at PrimeraDx. The compa- received the 2010 Robert Cancro information. ny, based in Mansfield, Mass., is Academic Leadership Award of dedicated to the emerging field the American Academy of Child Charles L. Nelson, M.D. ’92, of molecular diagnostics. He had ’60s Adolescent Psychiatry. She is di- G.M.E. ’97, was appointed direc- been head of Cleveland Clinic Fredrick Keller, M.D. ’68, pro- rector of the Adult Psychiatry tor of orthopaedic reconstructive Laboratories and chief operating fessor and director of the Dotter Residency Program at the Insti- surgery at Geisinger Medical office of the Pathology and Lab- Interventional Institute at the tute of Living/Hartford Hospital. Center in Danville, Pa. oratory Medicine Institute. Oregon Health & Science Uni- versity, was recently awarded the James B. Jones, M.D. ’94, has Gold Medal of the Cardiovascu- joined Strativa Pharmaceuticals, OBITUARIES lar and Interventional Society of ’80s a wholly owned subsidiary of Europe. He is the second Ameri- Par Pharmaceutical Companies, C. Martin Harris, M.D. ’82, as chief medical officer. can physician to be honored chief information officer and with this award. The medal is ’30s chairman of the Information Evan P. Nadler, M.D. ’95, re- presented to individuals who Technology Division of Cleve- Paul Mecray Jr., M.D. ’34, demonstrate continuing distin- cently joined the Department of land Clinic Foundation, joined General and Thoracic Surgery at G.M.E. ’41, Medford, N.J., for- guished and extraordinary ser- the board of directors at Health- mer chief of surgery at Cooper vice to the discipline of interven- Children’s National Medical Stream, Inc., which works with Center in Washington, D.C. He University Hospital; September 1, tional radiology. health-care organizations to im-

34 ■ PENN MEDICINE 2010. He was 102 years old. As He was certified by the American George W. Thoma Jr., M.D. ’45, Harlan F. Fulmer, M.D. ’46, a member of the Penn Reserve Board of Family Practice. Galveston, Texas; August 8, Fresno, Calif.; September 2, 2010. Surgical Unit during World War II, 2009. A retired pathologist, he In 1948-49, he was a U.S. Air he and other Penn doctors formed S. Fulton Tompkins, M.D., joined the staff at the University Force Flight Surgeon in Nagoya, the 20th General Hospital in As- G.M.E. ’43, Oklahoma City; Oc- of Texas Dental Branch in Hous- Japan. He had been secretary- sam, India, which served combat tober 22, 2010. In July 1945 he ton in 1961. He went full-time treasurer of the Fresno County casualties and Japanese prisoners joined the Navy, in which he there in 1967, when the school Medical Society. After a long ca- in India and Burma for three years. served for 11 months. He re- adopted a self-paced curriculum reer as a pathologist at St. Agnes While working as attending sur- turned to the Mayo Clinic as an that allowed him to test his ideas Medical Center in Fresno, he geon at Cooper University Hos- orthopaedic resident. After fin- about reforming education. He became interested in the stock pital in the 1950s, Mecray was ishing his training, he joined an is credited with enlarging and market and became an accom- also on the visiting staff of Jeanes orthopaedic surgery practice in expanding the diagnostic biopsy plished investor. Hospital and Fox Chase Cancer Oklahoma City. Tompkins devel- service, expanding the clinical Center. He served on the execu- oped a subspecialty interest in diagnostic service, and establish- Robert D. Pearson, M.D. ’46, tive committee of the American treating curvature of the spine. ing the first approved residency Scarsdale, N.Y.; June 22, 2007. Cancer Society and started the In 1987 he was joined in practice training program in oral pathol- A retired internist, he was presi- first New Jersey chapter of the by his son John, and they prac- ogy in Texas. He was the first dent of the Westchester Academy American College of Surgeons. ticed together until 1998 when pathologist to chair the com- of Medicine and a fellow of the In the 1960s, he founded the the senior Tompkins retired. bined departments of general American College of Physicians. Surgical Group of South Jersey, and oral pathology. The author now Virtua Surgical Group. Robert Day, M.D. ’44, GM.E. ’53, of two dozen scientific papers, James M. Tanner, M.D. ’46, Vero Beach, Fla.; October 29, Thoma was thesis chairman of Wellington, U.K.; August 11, Morton I. Silverman, M.D. ’38, 2009. He was a veteran of World pathology for many graduate 2010. For much of his career he G.M. ’50, Allentown, Pa., a re- War II, serving in the U.S. Army dentists working on master’s de- was associated with two London tired physician and cardiologist; Medical Corps. An ophthalmolo- grees in dental specialties. After hospitals specializing in the care July 18, 2010. During World War gist, he was a longtime professor his retirement in 1983, he of children, the Institute for II he was a captain in the US and staff member at The Colum- moved to Galveston and taught Child Health and Great Ormond Army Medical Branch in Europe. bia Presbyterian Medical Center. weekly seminars in pathology at Street Hospital for Children. the University of Texas Medical Though his early research was Michael C. Luciano, M.D. ’44, Branch for residents in oral and focused on the children of 20th- Bridgeport, Conn.; October 11, maxillofacial surgery. century Britain, his data and his ’40s 2010. In 1944, he served an in- theories have been applied ternship at St. Vincent’s Hospital Herbert A. Ecker Sr., D.D.S., across the world. In 1948, he Eleanor M. Anthony, M.D. ’41, in Bridgeport. He was inducted M.D. ’46, G.M.E. ’53, William- took over a study of the child- Raritan, N.J., a physician who into the U.S. Army and served sport, Pa., a retired plastic sur- hood growth of residents of an retired from the U.S. Public in Europe until 1948, when he geon; December 18, 2009. He orphanage in Harpenden, north Health Service; May 11, 2010. opened a family medicine prac- earned his D.D.S. degree from of London. It was initially in- She had been a staff physician at tice in Bridgeport. From 1972 to Penn’s dental school. His mili- tended to observe the effects of the National Jewish Hospital. 1973, he served as president of tary service started while he at- malnutrition on growth, but it the medical staff at St. Vincent’s tended medical school as a 1st evolved into a longitudinal Lee Rogers, Jr., M.D. ’42, Co- Hospital. He retired from his lieutenant in the Army. During study. The Harpenden study coa, Fla.; September 1, 2010. He practice in 1991. the Korean War, he was an offi- gave rise to what came to be interned at the Touro Infirmary cer of the U.S. Navy, stationed at known as the Tanner stages, or in New Orleans, then did his John J. Laskas Sr., M.D. ’45, a hospital in Long Island, N.Y., the Tanner scale, a series of steps surgical training at the Lahey G.M. ’49, Upper Darby, Pa.; July where he was the chief of plastic that defines physical maturation Clinic and later at New York 6, 2010. Laskas enlisted in the surgery. A diplomat of the Amer- as a boy or girl passes through University Post-Graduate Hospi- Navy and completed his intern- ican Board of Plastic Surgery, puberty. Beginning in the late tal. The first surgeon in Brevard ship at the former U.S. Naval Ecker was also a fellow of the 1950s, Tanner was among the County, Fla., to be certified by the Hospital in Philadelphia. He American College of Surgeons first scientists to study how and American Board of Surgery, he served as chief medical officer and a former president of the when to use human growth hor- later served on the Wuesthoff on the troop transport ship American Society of Maxillofa- mone to treat children with Hospital Board as representative U.S.S. Henrico before completing cial Surgeons, of the American growth retardation and other de- of the medical staff. his residency in dermatology at Society of Plastic and Reconstruc- ficiencies. He was one of a hand- HUP. Laskas opened his first of- tive Surgeons, and of the Ameri- ful of scientists who first sug- Arlington A. Nagle Sr., M.D.’43, fice in Chester, staying in the can Association of Hand Sur- gested that growth data could be Robesonia, Pa.; April 12, 2010. city until his retirement in 1992. geons. He instituted and ran the applied in fields like sociology From 1945 through 1947, he was He was a clinical professor of Williamsport Cleft Palate Clinic. and economics. Tanner’s books a captain in the U.S. Army Medical dermatology at HUP for more At the Williamsport Hospital, he include A History of the Study of Corps, having served in World than 30 years and served as was chief of maxillofacial sur- Human Growth (Cambridge Uni- War II. In 1947, he started a pri- chief of the medical staff at the gery, plastic surgery, and oral versity Press, 1981); Fetus into vate medical practice, and even- former Sacred Heart Medical surgery, and had also served on Man: Physical Growth From Con- tually he became part of the Conrad Center in Chester and at Crozer- the hospital’s board. He also was ception to Maturity (Harvard Uni- Weiser Medical Group. Nagle was Chester Medical Center in Upland. a consultant for the United versity Press, 1990); and, with former president of the Berks He volunteered for many years States Public Health Service at Phyllis B. Eveleth, Worldwide County Medical Society and was at the free clinic at the old Phila- the U.S. Penitentiary in Lewisburg, Variation in Human Growth (Cam- regularly appointed a delegate to delphia General Hospital and at Pa. He was a former president of bridge University Press, 1976, the Pennsylvania Medical Society. Crozer-Chester Medical Center. the Lycoming County Medical 1991). Society.

2011/SPRING ■ 35 Leonard Casser, M.D. ’47, pital and Dunham Army Medical Harold H. Gist, M.D., G.M. ’48, tant surgeon. In 1960, he earned Lafayette, N.J.; June 14, 2008. Hospital until he retired in Smithsburg, Md.; June 24, 2007. a Ph.D. degree in history at Har- He retired as a general practi- 1983. He was instrumental in He practiced obstetrics and gy- vard University, and went on to tioner in 1986. creating the EMT training pro- necology in Hagerstown for 26 have a career as an educator and gram for the Carlisle Hospital. years. A Fellow of the American scholar. He published several Sidney O. Hughes, M.D. ’47, He was also the first doctor in College of Obstetricians and groundbreaking articles on med- Winona, Minn.; February 21, the area to perform gastroscopy Gynecologists and a Diplomat of ical ethics, death and dying, and 2009. A retired internist, he and colonoscopy procedures. the American Board of Obstetrics aging and the elderly. His book, served as medical director of St. and Gynecology, he had been The History of Ideas on the Prolon- Anne’s Hospice and of the stu- John H. Updegrove, M.D. ’47, president of the Washington gation of Life, was first published dent health service of Winona Easton, Pa.; August 21, 2010. County Hospital medical staff in 1966 and republished in 2003. State University. He was a captain in the Army and of the Washington County during the Korean War and Medical Society. During World William A. Pettit Jr., M.D. ’49, Harvey C. May, M.D., G.M. ’47, served as a surgeon. In 1968, he War II, he served with the U.S. G.M. ’54, a San Diego ophthal- Charlotte, N.C.; August 8, 2010. went to Vietnam as a volunteer Army Medical Corps in China, mologist; September 6, 2008. During World War II, he was a civilian physician. He started his Burma, and India. major in the U.S. Army Medical medical career with his father Charles H. P. Westfall, M.D. Corps, serving in the South Pa- and continued in private practice Whitney J. Haight, M.D., G.M. ’49, Lombard, Ill.; June 20, cific. He completed his residency as a surgeon in the Easton com- ’48, Salt Lake City, a retired oto- 2010. He interned at Walter and fellowship in obstetrics and munity until retiring in 1988. rhinolaryngologist; June 10, Reed Army Hospital and com- gynecology at Tulane University. Updegrove was a president of 2010. He served in the U.S. Army pleted his residency at Brook He practiced medicine in Char- the board of directors of ProJeCt during World War II and was Army Medical Center. Westfall lotte for more than 40 years and (The Center for Family Assis- stationed in Japan during the served in the Army and retired retired in 1992. He was an ac- tance and Literacy) of Easton, of occupation. from the Reserves in 1990 at the tive member of numerous na- the Lehigh Valley Health Foun- rank of colonel. He was a partner tional and state medical societies dation, and of the Northampton Oscar M. Powell Jr., M.D. ’48, in the Elmhurst Clinic, where he and was president of the Char- County Medical Society. A gov- G.M.E. ’52, San Diego; July 9, practiced obstetrics and gynecol- lotte Obstetrics and Gynecologic ernor in the American College of 2010. He joined the U.S. Navy ogy for more than 30 years. At Society, the North Carolina Ob- Surgeons, he chaired several while at the University and Elmhurst Memorial Hospital, stetrics and Gynecologic Society, campaigns for Easton Hospital. served during World War II as a he served as chairman of the and the Southern Obstetrics and member of the V-12 Training Department of Obstetrics and Gynecologic Society. Howard P. Wood, M.D. ’47, units in school and as a corps- Gynecology. He was a former Haverford, Pa.; June 20, 2010. man at the U.S. Naval Hospital president of the Illinois American Franklin C. Reyner, M.D. ’47, When the Korean War broke in Bainbridge, Md. During the Cancer Society and the Illinois Sunny Isles Beach, Fla.; August 1, out, he was in his second year of Korean War, he served at Naval Interagency Council for a Tobacco- 2010. He was former president psychiatric residency at the Col- Hospitals in Chelsea, Mass., and Free Society. He received the of the National Cancer Center in orado Psychopathic Hospital in Oakland, Calif., and then saw American Cancer Society Na- New York and was a Life Member Denver. After being discharged combat with the First Marine tional/Division award for out- of the Nassau (N.Y.) Obstetrical in 1953, he worked at Lankenau Division as a field doctor on the standing service. and Gynecologic Society. Hospital. He retired in 1989 as front lines. He entered the U.S. its chief of adult psychiatry. He Naval Reserve as a commander, Robert M. Ruch, M.D. ’47, also held sessions during those serving until retirement from the Memphis; February 26, 2008. A years at his home office. Wood military in 1983. As a physician, ’50s retired obstetrician-gynecologist, was coauthor of “Psychological he initially practiced internal he had been a member of the Factors in Alcoholic Women” medicine but became interested William K. Brendle, M.D., G.M. executive committee and director and “Perception in Residency in the early development and ’50, Havre de Grace, Md., a re- of the Tennessee Division of the Training: Methods and Problems,” practice of nuclear medicine. A tired surgeon; February 4, 2010. American Cancer Society. He was both published in the American research radiologist and clinical During World War II, he served the author of The Two Clubs of Journal of Psychiatry. professor at the University of as a flight surgeon in the Army Menasha: A History (1994). California at San Francisco, he Air Forces; he eventually retired Rocko M. Fasanella, M.D., G.M. had been director of Nuclear from the Maryland Air National William L. Shelley, M.D. ’47, ’48, Scituate, Mass., chief of Medicine Laboratories at Samuel Guard with the rank of lieutenant G.M.E. ’54, Carlisle, Pa.; Sep- ophthalmology at Yale University Merritt Hospital, Providence colonel. For 34 years, Brendle tember 29, 2010. He interned at from 1951 to 1961; February Hospital, Oakland Hospital, and operated surgical clinics in Havre the Reading Hospital and took 10, 2009. He established the Allegheny General Hospital. He de Grace and Fallston. He also his fellowship in surgical pathol- ophthalmology residency program was founding president of the served as chief of staff and chief ogy at HUP, where he was an as- at Yale and headed the section American College of Nuclear of surgery at Harford Memorial sistant instructor. From 1953 to there when it was still within the Physicians and served as vice Hospital. 1955, he served as a captain Department of Surgery. He is president of the Society of Nu- with the U.S. Army at Ft. Camp- known for a surgical technique clear Medicine. Alvin J. Cummins, M.D., G.M.E. bell, Ky., during the Korean War. that bears his name and is still ’50, Carmel, Ind.; September 27, A specialist in plastic surgery, he widely performed, the Fasanella- Gerald J. Gruman, M.D. ’49, 2010. After completing his med- had a fellowship in the Ameri- Servat procedure for drooping Somerville, Mass.; September 13, ical training in gastroenterology can College of Surgeons in 1949. eyelid, which was developed 2007. During the Korean War, at Cornell Medical Center in He opened a practice in Carlisle, with Javier Servat, M.D. He was he served in the Public Health New York City, Cummins moved where he was also a full-time editor of Management of Compli- Service/Coast Guard with the to Memphis to become assistant staff member of the Carlisle Hos- cations in Eye Surgery (W. B. rank of captain and senior assis- professor of medicine at the Uni- Saunders).

36 ■ PENN MEDICINE versity of Tennessee. He eventually Mary McNeal Wood, M.D. ’50, Robert J. Stubblefield, M.D., fellowship in pharmacology at rose to chairman of the Depart- G.M.E. ’53, Montclair, N.J.; July G.M.E. ’51, Memphis, Tenn.; Penn. He was then a professor of ment of Gastroenterology. He 10, 2010. As an intern at HUP, June 2, 2010. anesthesiology at Penn for eight then went into private practice she met her future husband, Dr. years. He spent two years as di- and retired in 1985. He pub- Francis Wood. Following her Arthur Brody, M.D. ’52, Santa rector of the Navajo Indian Hos- lished more than 50 articles in residency in anesthesiology at Barbara, Calif., a retired ortho- pital in Winslow, Ariz. After a professional journals. A member HUP, she joined the anesthesia paedic surgeon; January 19, 2010. period as chairman of the De- of Alpha Omega Alpha Honor staff. In 1959, Wood settled in He took his internship at Belle- partment of Anesthesiology at the Medical Society, he was also a Montclair. She was successively vue Hospital in New York City University of Connecticut, he Fellow in the American College on the anesthesia staffs of the and later completed his training at served as chair of anesthesiology of Physicians and a Fellow in the New Jersey Orthopedic Hospital Columbia Presbyterian Hospital. at the University of Wisconsin American Gastroenterological in Orange; of Orange Memorial Brody was one of 14 doctors who for 20 years. From 1991 until he Association. From 1964 until his Hospital, where for a time she started the Hawthorne Commu- retired in 1996, Alexander was retirement, Cummins served on headed the anesthesia department; nity Medical Group, which at one dean of affiliate affairs at Hahne- the editorial review board of the and eventually at the Mountain- point grew to include 120 doctors mann Medical College, now Drexel Southern Medical Journal. side Hospital in Glen Ridge/ and 700 employees, with branches University College of Medicine. Montclair, from which she re- throughout the Los Angeles area. Active with the American Society Stanley Edeiken, M.D. ’50, tired in 1989. She served as a The group formed an early health- of Anesthesiologists and the As- G.M. ’57, Philadelphia; Septem- trustee of Bloomfield College. management organization, Maxi- sociation of University Anesthe- ber 5, 2010. He served in the care Health Plans, Inc., which siologists, he helped establish U.S. Army, 1954-56, then en- John M. Keller, M.D., G.M. ’51, served more than 200,000 pa- the Foundation for Anesthesia tered private practice in Long Naples, Fla.; August 18, 2010. tients. Brody was also one of the Education and Research. Branch and Asbury Park, N.J. He was associate professor of first orthopaedists in the region to He was on the staffs of Mon- obstetrics and gynecology at the incorporate arthroscopic surgery William Bernard Haeussler, M.D. mouth Medical Center and Jersey University of Illinois and then into his practice. ’55, Chandler, Ariz.; October 12, Shore Medical Center (then professor of ob-gyn at the Uni- 2010. He served a term as presi- known as Fitkin Hospital). After versity of Health Sciences/Chicago Herbert W. Copelan, M.D. ’52, dent of the Arizona Psychiatric a sailing sabbatical in 1974, he Medical School. Keller pioneered Boca Raton, Fla.; September 29, Society. changed his practice and became research in placental perfusion 2010. He was a specialist in in- a specialist in diseases of the and diagnostic ultrasound in ternal medicine and cardiovas- Thomas C. Lloyd Jr., M.D. ’55, breast. Edeiken retired in 1997. obstetrics. From 1986 to his re- cular disease until his retirement former Professor of Medicine tirement in 1994, he practiced in 1989. He had been director of and Physiology at Indiana Uni- David T. Tayloe Sr., M.D. ’50, high-risk ob-gyn in Lincoln, Neb. the Department of Medicine at versity Medical Center, India- Washington, N.C.; June 25, Albert Einstein Southern Division napolis; July 8, 2010. 2010. After taking his internship Harry H. Kretzler Jr., M.D. ’51, and was an attending physician at the Medical College of Virgin- G.M.E. ’55, Seattle, a retired or- at Pennsylvania Hospital. Albert E. Marland Jr., M.D., ia, he entered military service at thopaedic surgeon; July 5, 2010. G.M. ’55, Bethesda, Md.; July Portsmouth Naval Hospital. He He practiced primarily at North- Wayne B. Lockwood, M.D. ’54, 26, 2010. He practiced medicine then took his pediatrics residen- west Hospital and Stevens Hos- Nichols Hills, Okla.; December, in Washington, D.C., with his cy at Duke, interrupted in part pital. He taught orthopaedics at 14, 2008. He had been a clinical father, Albert Sr., and his brother, by another year of military ser- the University of Washington professor of orthopaedics and Jackson T. Marland. He served vice at Camp Lejeune. In 1955, School of Medicine and served chief of orthopaedic clinical fac- as a medical officer in the Navy he began his pediatric practice as orthopaedic consultant to the ulty at Oklahoma University during World War II and was a in Washington. A Fellow of the Rainier State School for more School of Medicine. doctor at Bethesda Naval Hospital American Academy of Pediatrics, than twenty years. Kretzler had during his 14 years of Naval ser- he served as a district chairper- also been the team physician for William P. Rumsey, M.D., G.M. vice. Later, he was appointed to son for the academy. The N.C. a number of sports clubs, in- ’54, Wallingford, Pa., retired chief the White House Staff by President Pediatric Society/N.C. Chapter cluding the United States World of surgery at Sacred Heart Hos- Harry S. Truman and President of the American Academy of Cup Ski Team and the United pital in Chester; July 9, 2010. Dwight D. Eisenhower. Pediatrics presents the annual States Olympic Team, and David T. Tayloe Senior Award for served on physician panels for George T. Varga, M.D. ’54, Neville G. Achong, M.D., G.M.E. Community Pediatrics to its out- the National Football League as Bridgeton, N.J.; June 11, 2010. ’56, Tampa, Fla.; February 24, standing community pediatri- well. He was a founding member An obstetrician, he was a former 2004. cian. In 1985, Tayloe received of the American Academy of chief of staff at Bridgeton Hospi- the Distinguished Service Award Sports Medicine. tal. He then taught at Holy Cross Sushil C. Chakravarty, M.D., of the University of North Caro- Hospital in Salt Lake City. In G.M. ’56, New Delhi; January 1, lina School of Medicine. Carl M. Shetzley, M.D. ’51, 1979 he joined the medical staff 2010. He was on the staff of the Doylestown, Pa.; July 1, 2010. at Medical Center of Arlington, V. P. Chest Institute at the Uni- Joseph Winsten, M.D., G.M. He retired from family medicine where he also served as a board versity of Delhi. Earlier, he had ’50, Lexington, Mass., a retired practice in 1991, having served member and chief of staff. been in the Department of Chronic plastic and reconstructive sur- as president of Doylestown Hos- Diseases of the Chest at Phila- geon; April 14, 2010. His prac- pital’s medical staff and as president Samuel Craighead Alexander Jr., delphia General Hospital. tice began in Boston and Cam- of the Bucks County Medical So- M.D. ’55, G.M.E. ’62, Haverford, bridge. For more than 25 years ciety. He was a delegate to the Pa.; June 23, 2010. He completed Richard O. Rogers Jr., M.D., G.M. he practiced in Concord at Em- Pennsylvania Medical Society for an internship at Philadelphia ’56, Franklin,, Va.; November 18, erson Hospital. 20 years. General Hospital and both a res- 2008. idency in anesthesiology and a

2011/SPRING ■ 37 Chicago, he served in the U.S. tain in the U.S. Army Medical treat patients in private practice Charles T. Fitts, M.D. ’57, G.M.E. Army at Walter Reed Hospital Corps. He joined Lycoming Ob- until he suffered a stroke in ’64, Awendaw, S.C.; November 4, and with the 1st Cavalry Divi- stetrics and Gynecology in 1966 1995. 2008. During his tenure at the sion in combat duty in Korea. and retired from there in 1997. Medical University of South Car- Board-certified in family practice A Diplomat of American Board William W. Duke, M.D. ’61, olina (MUSC), he held several and pathology, he practiced in of Obstetrics and Gynecology, he Lancaster, S.C.; August 14, appointments, including profes- Maine, Pennsylvania, and Flori- served in numerous capacities 2010. After completing his med- sor of surgery, medical director da. He retired from the Naples with the Lycoming County Med- ical training at the University of of the South Carolina Organ Medical Center, in Fla., where ical Society and the American North Carolina and the Univer- Procurement Agency, and at- he founded the Walk-In Clinic College of Obstetricians and Gy- sity of Alabama, he practiced tending surgeon at Medical Uni- to provide affordable medical necologists. At the Williamsport medicine for almost 40 years. versity Hospital and at the Veter- care to all people. He was a for- Hospital, he had been chief of He was a Fellow of the American ans Administration Hospital. He mer president of the MacDuffee staff, chairman of the Depart- College of Physicians and a Fel- is credited with pioneering the Clan Society of America. ment of Obstetrics and Gynecol- low of the American College of organ transplant program at ogy, and president of the medi- Gastroenterology. MUSC, where he performed the James E. Brackbill Jr., M.D. cal staff. He had also served as first kidney transplant on De- ’59, West Newbury, Mass.; July chief of staff at Divine Provi- Gilbert A. Friday Jr., M.D., cember 3, 1968. Fitts also 28, 2010. He served as a captain dence Hospital. For more than G.M.E. ’62, Upper St. Clair, Pa., served as a trauma surgeon in in the U.S. Army in Korea. He 30 years, he was on the William- a retired pediatrician who had Vietnam as well as chief of the practiced family medicine with sport City Council and had been specialized in allergy and immu- Trauma Study Branch, at the his brother in Georgetown for its president. Hipple was hon- nology. He had taught pediatrics Brooke Army Medical Center in 10 years before taking a surgical ored for his strong commitment at the Children’s Hospital of Texas. Author of more than 100 residency at the Maine Medical to historic preservation in 2005 Pittsburgh and was a president medical articles, he was also a Center in Portland. He was the when the “Dr. Randall F. Hipple of the Allegheny County Medical sought-after specialist in snake physician for the Georgetown Historic District” was designated Society. and alligator bites in the South- High School football team and in recognition of his efforts. He east. After retiring from MUSC, conducted yearly physicals for received the Lycoming County Mary Luz Coady Baldwin, Fitts entered private practice the Boy Scouts during his medi- Medical Society Community Ser- M.D., G.M.E. ’63, former direc- with his son, Dr. Casey Fitts, at cal career. He returned to prac- vice Award in 1999. tor of pediatrics at Bryn Mawr Coastal Surgical Associates in tice surgery at the Hale Hospital Hospital; April 4, 2010. She Charleston. (now Merrimack Valley Medical John Clark May, M.D. ’60, Lan- earned her M.D. degree from Center) in Haverhill and the caster, Pa.; June 22, 2010. Fol- Women’s Medical College of Guenther H. Heidorn, M.D., Anna Jaques Hospital in New- lowing his service with the Pennsylvania. Senior attending G.M. ’57, Minot, S.D., a retired buryport from 1973 until the Army, May completed his medi- physician at Bryn Mawr Hospital cardiologist; February 2, 2009. late 1990s. cal training at the Mayo Clinic. from 1984 to 1991, she was In 1966, he began his career in named Distinguished Emeritus Charles E. Schlager, M.D. ’57, A. James Fessler, M.D., G.M . obstetrics and gynecology in Pediatrician by the hospital in York, Pa.; September 20, 2007. ’59, Trenton; November 6, 2010. Lancaster. With his partner, 1999. She was a Fellow of the After completing his residency at He entered his father’s practice Alistair Grant, he established American Academy of Pediatrics York Hospital, he founded Lyon/ and practiced there until his one of the largest ob/gyn practic- and had served as president of Schlager Medical Practice, where death at the age of 83. He had es in Pennsylvania. He was on The Philadelphia Club of Medi- he practiced for 49 years. (It is been associated with McKinley the staff at both the Lancaster cal Women. known today as Family Health Hospital and Helene Fuld Hos- General Hospital and St. Joseph’s Associates). Schlager was the pital. He was a fellow of the In- Regional Hospital; from 1990 to Yung-Ching Chu, M.D., G.M. program director for the Family ternational College of Surgeons. 1994, he served on the faculty ’63, Marlboro, N.J., a retired Practice Residency Program at of the Lancaster General Hospi- physician of internal medicine; York Hospital for nine years. A tal Family Practice Residency October 15, 2010. charter member of the American Program and received its award Board of Family Practice and of the ’60s for outstanding teacher. In 1999, Peter J. Cohen, M.D., G.M.E. American Association of Family the hospital awarded him the ’64, Washington, D.C., a former Practice, he had been president of Adolfo Fernandez-Carol, M.D., Henry S. Wentz Award for out- associate professor of anesthesia the York County Medical Society G.M. ’60, Miami; July 4, 2010. A standing contributions to the at Penn; August 14, 2010. Dur- and secretary of the Pennsylvania Diplomat of the American Board hospital, to graduate medical ed- ing the 1970s and 1980s, he Medical Association. of Internal Medicine and a Fel- ucation, and to the Lancaster chaired the anesthesiology de- low of the American College of community. He retired from partments at the University of Robert R. Lawrence, M.D. ’58, Gastroenterology, he practiced medical practice in 2005. Colorado and University of Lancaster, Calif.; September 1, medicine for more than 40 Michigan medical schools and 2010. An orthopaedic surgeon, years. Much of his career was William F. Wieland, M.D. ’60, became an outspoken supporter he was associated with the Ante- spent at Mercy Hospital, where G.M.E. ’65, Atlanta; October 4, of the legalization of medical lope Valley Hospital and Lan- he served as chief of staff of the 2010. In 1972, he was appoint- marijuana. He parlayed his med- caster Community Hospital. gastroenterology department and ed by Governor Jimmy Carter to ical career into advocating for president of the medical staff. direct the Department of Drugs the research and testing of medi- Robert C. MacDuffee, M.D., and Alcohol for the State of cal marijuana when he earned a G.M.E. ’58, Elizabethtown, N.C., Randall Fraser Hipple, M.D. Georgia. He went on to serve in law degree from Georgetown a retired physician; December 7, ’60, Williamsport, Pa.; August leadership positions at Rid- University in 1995. During the 2009. After earning his medical 22, 2010. From 1964 to 1966, geview Institute and CPC Park- mid-1990s, he worked as a policy degree from the University of he served in Vietnam as a cap- wood Hospital. He continued to

38 ■ PENN MEDICINE expert for the National Institute lished twenty original papers Alfred P. Fishman, M.D., the Lung, and Blood Institute; and on Drug Abuse. Since 1998, he and many abstracts, editorial re- William Maul Measey Emeritus chairman of the Health Sciences had been an adjunct law professor views, and chapters. Professor of Medicine; October Policy Board of the Institute of at Georgetown University, teach- 6, 2010. Born to Lithuanian im- Medicine. A former president of ing public health law and a Joseph K. Eshleman, D.O., migrants in Depression-era the College of Physicians of Phil- course that explored the legal, G.M.E. ’76, Pottsville, Pa.; July 21, Brooklyn, he received an M.D. adelphia, he edited nine books medical, and ethical issues sur- 2010. He was board-certified in degree from the University of and published more than 250 rounding alternative medicine. physical medicine and rehabili- Louisville in 1943. He worked scientific articles. From 1964 to 1966, he served tation in 1978 and later became in several laboratories, including in the Army Medical Corps, con- the director of physical medicine the Cournand, Richards, and Alan Gewirtz, M.D., the C. Wil- ducting medical research at Wal- at the VA Hospital in Philadel- Werner Forssmann Laboratory, lard Robinson Professor of He- ter Reed Army Institute of Re- phia. He had taught in Penn’s which won the Nobel Prize in matology-Oncology; November 17, search in Silver Spring and set- medical school and was a mem- Physiology or Medicine a year 2010. He earned his M.D. and ting up a hospital near Tokyo to ber of the clinical teaching facul- after he left. Fishman came to M.A. degrees in microbiology treat wounded soldiers from ty of the Philadelphia College of Penn in 1969 as an associate from State University of New Vietnam. He chaired the Society Osteopathic Medicine. He relo- professor of medicine and direc- York at Buffalo in 1976. After six of Academic Anesthesiology cated to Pittsburgh in 1990, tor of the Cardiovascular-Pulmo- years at Temple University, he Chairs. From 2000 until June 2010, where he was director of physi- nary Division, a position he held came to Penn in 1990. He ad- he was chairman of the Physi- cal medicine and rehabilitation until 1989. During his tenure as vanced to full professor in 1998. cian Health Program of the Med- at St. Francis Hospital. chief of the Division of Cardio- Gewirtz’s research focused on ical Society of the District of Co- Pulmonary Medicine, his group the cell biology of normal and lumbia. He wrote Drugs, Addic- Harold E. Wells, M.D. ’78, made many contributions in the malignant human hematopoie- tion, and the Law: Policy, Politics, Wallingford, Pa.; February 19, field, including discovering why sis, and his goal was to advance and Public Health (2004), as well 2010. He was a board-certified patients with severe deformations the development of more effec- as books and articles about the internist and pulmonologist at of the spine (kyphoscoliosis) suf- tive and less toxic therapies for effects of anesthesia on the brain. the Coatesville VAMC. He took fer lung disease and how to im- human leukemia. He was the re- his residency in internal medi- prove their care. For seven years cipient of the Doris Duke Distin- Harry C. Press, M.D., G.M.E. cine at the University of Cincin- he was also associate dean of the guished Clinical Scientist Award ’65, Washington, D.C.; July 4, nati Medical Center and his fel- School of Medicine and later as- and Philadelphia Magazine in- 2010. After taking a residency in lowship in pulmonary medicine sociate dean for research. A for- cluded him in its 2010 listing of radiology at Freedmen’s Hospital at Temple University. mer chair of the Department of “Top Docs.” Gewirtz served on a (now Howard University Hospi- Physical Medicine and Rehabili- number of editorial boards, in- tal), he trained at what is now Eric E. Holt, M.D. ’79, Jesup, tation and chair of the Health cluding Cancer Gene Therapy, Walter Reed Army Medical Cen- Ga.; May 19, 2010. He complet- Promotion and Disease Prevention and reviewed manuscripts for ter and the National Naval Medi- ed his residency at Tulane Uni- Council, he served most recently numerous scientific journals. A cal Center. In the mid-1960s, he versity. A nephrologist, he was as senior associate dean for pro- holder of nine patents, he was a joined Howard University’s fac- associated with Wayne Memorial gram development and director member of the Medical/Scientific ulty and led its radiology depart- Hospital. of the Office of Complementary Advisory Committee of the Leu- ment for several years. During and Alternative Therapies. kemia Society of America and his tenure, the department's resi- Among his many honors, was a national trustee of the or- dency program became nationally Fishman was elected a member ganization. He was elected to the accredited. ’80s of the Institute of Medicine of American Society of Clinical In- the National Academy of Arts vestigation in 1990. Wendell M. Kury, M.D. ’66, Saw Batunkyi, M.D., G.M.E. and Sciences and was an honor- Laramie, Wyo., a psychiatrist; ’87, Lafayette Hill, Pa.; May 6, ary fellow of the American Col- Thomas R. Kadesch, Ph.D., November 12, 2010. 2009. Board-certified in physical lege of Cardiology and of the professor of genetics and interim medicine and rehabilitation, he was American College of Chest Phy- chair of the department; January a member of the Burmese Medi- sician. He also received the Dis- 12, 2011, after pancreatic sur- cal Association of North America. tinguished Achievement Award gery. He was 58. Kadesch earned ’70s of the American Heart Association a doctorate in biochemistry at AHA, and the Distinguished the University of California at Michael B. Bongiovanni, M.D. Alumnus Award from the Uni- Berkeley, then completed a fel- ’76, G.M.E. ’80, Harrisburg, Pa.; FACULTY DEATHS versity of Louisville. In 2001, lowship in biochemistry at Stan- August 21, 2010. He served two Fishman was the recipient of the ford University. He joined Penn years as director of the hematol- Samuel Craighead Alexander. prestigious Edward Livingston in 1984 as an assistant professor ogy laboratory and associate di- See class of 1955. Trudeau Medal, the highest of human genetics and an assis- rector of the blood bank at HUP award offered by the American tant investigator for the Howard before joining the faculty at the Michael B. Bongiovanni. See Thoracic Society. In 2003, he Hughes Medical Institute. In 1996, Penn State Hershey Medical Class of 1976. was designated a Fellow of the he became a full professor in Center in 1982 as medical direc- American Heart Association. 1996. Kadesch’s research con- tor of its blood bank and aphere- Peter J. Cohen. See Class of Over the years, he had been a centrated on ways in which cells sis. In 1990, he became chief of 1964. consultant to NASA for the Mer- control the expression of their its Division of Clinical Pathology cury space program; a consul- genes, with a focus on a particu- and director of Clinical Labora- Joseph K. Eshleman. See Class tant to the executive office of the lar molecular process called the tories. He played an active role of 1976. President of the United States; a in supporting the Central Penn- member of the National Heart, sylvania Blood Bank. He pub-

2011/SPRING ■ 39 LEGACY GIVING

Notch signaling pathway that is developing and refining double- critical to cell differentiation. Ed- contrast studies for both the up- itor of the journal Molecular and per and lower gastrointestinal Cellular Biology from 1992 to 1996 tracts. His work generated a re- Helping Others Beat the Odds and a member of its editorial surgence of barium studies and a Patient Triumphs with Legacy Gift to the Transplant House board from 1991 to 1993, he new era of double G.I. radiology. was also a member of the Ameri- Author of Double Contrast Radiol- can Society for Microbiology and ogy of the Gastrointestinal Tract, the American Association for the he had been president of the So- Advancement of Science. ciety of the Gastrointestinal Ra- diologists and received its Walter Winifred A. Koelle, M.D., Bryn B. Cannon Medal, for outstand- Mawr, Pa., a retired internist and ing lifetime achievements in G.I. professor of pharmacology; July radiology. In 2005, he won the 30, 2010. Raised in the Dutch Outstanding Educator Award East Indies, now Indonesia, by from the Philadelphia Roentgen her father, a Dutch colonial offi- Ray Society. cial and her American mother, Koelle and her family were in- William Harker Rhodes, V.M.D. n 2003, Maureen Hillary donned a pair of boxing gloves terned by the Japanese during ’55, Douglassville, Pa., emeritus and ran up the steps of the Philadelphia Art Museum. World War II. She learned sci- professor of radiology at Penn’s The iconic fists-raised-in-triumph stance she took was ence and chemistry from educat- School of Veterinary Medicine ed women in the labor camps. and its School of Medicine; Sep- more than just a pose. When the war ended, she at- tember 29, 2010. From 1955 She completed her “Rocky Run” on the last day of re- tended Wellesley College and until his retirement in 1985, he hab four months after receiving a double lung transplant. then obtained a medical degree was a faculty member in the vet- I “After my surgery, I was reborn, and I had a new out- from Columbia University. Early erinary school with a joint ap- look on life. I knew it was now time for me to help other in her career, she was a fellow in pointment in the medical school. transplant patients,” she said. research medicine at Penn before He received a Lindback Award Mrs. Hillary decided to include a bequest in her will to going on to become the chief of for Distinguished Teaching in support the Clyde F. Barker Transplant House, which is the intensive care unit at Taylor 1965. Rhodes played a major due to open in mid-June. By adding this specific bequest, Hospital. From 1970 to 1975, role in the development of veter- Ms. Hillary has created a legacy gift, planned for the future Koelle was chief of outpatient inary radiology; he was a found- medicine at Philadelphia General ing member and president of the of the Transplant House, and helped preserve excellence Hospital. She taught at Penn in Educators in Veterinary Radio- in care for future transplant patients. the pharmacology department logic Science and president of The purpose of the transplant house is to provide af- until her retirement in 1982. the American Veterinary Radio- fordable housing to transplant patients and their families. logic Society. In addition, he was For many, traveling to and from the hospital is mentally John J. Laskas. See Class of 1945. a charter member and chair of and physically draining; and housing during their hospi- what is now the American Col- tal stay takes a great financial toll. Igor Laufer, M.D., Bala Cynwyd, lege of Veterinary Radiology, Mrs. Hillary recalls that during treatment, she had to Pa., professor of radiology; Sep- which honored him with its visit the hospital three times a week for three months. tember 14, 2010. Born in what award for distinguished service. Fortunately she and her husband, Geoff, could afford is now Slovakia, he earned his From 1963 to 1979, he was the M.D. degree from the University first editor of Veterinary Radiology. accommodations. Mrs. Hillary thought of others who of Toronto in 1967. He was a He had served as a radiology might not be as fortunate. clinical fellow at Harvard Medi- technician in the U.S. Navy, “I am passionate about helping others who are going cal School from 1969 to 1972, 1943-46. through the same type of adversity,” she said. “Illness af- then chief resident at Beth Israel fects everyone whether you are rich or poor. I needed to Hospital in Boston. He also served J. Edwin Wood III, M.D., Bryn ensure other patients would be taken care of during a as an assistant professor of radi- Mawr, Pa., emeritus professor of time of crisis.” ology at McMaster University in medicine at Penn and chair of Mrs. Hillary is on her third “bucket list,” travels every Toronto. In 1976, he joined medicine at Pennsylvania Hospi- chance she gets, and makes a point to never turn down Penn’s medical faculty and tal from 1969 to 1990; August 15, an invitation to a party. quickly rose to full professor after 2010. He had also been presi- only four years with the depart- dent of the professional staff at “When you are living on borrowed time, you enjoy every ment. He was the chief of gas- the hospital. Until retiring in moment. Penn gave me my life back, and I am just thrilled trointestinal radiology at HUP 1996, he worked for Correctional to share my gratitude!” from 1976 to 1997 and residency Healthcare Solutions in Chal- Mrs. Hillary chose one of a multitude of creative gift selection director for the depart- font. He was the author of The opportunities that benefit both the School of Medicine ment from 1999-2004. Laufer Veins: Normal and Abnormal and donors. As you plan your financial future, the Office was known for pioneering the Function (Little Brown, 1965). of Planned Giving is ready to assist in developing an ap- techniques for performing double- propriate strategy to incorporate your charitable objec- contrast G.I. radiology and for tives. Contact Christine S. Ewan, J.D., Senior Director of Planned Giving, at 215-898-9486; or you can e-mail her at [email protected]. For more information, please visit the web site at www.plannedgiving.med.upenn.edu.

40 ■ PENN MEDICINE Forward Thinking illusioned, the best and brightest students physician – the art of listening to the pa- are competing to become physicians. tient. Patients often experience physicians After my 10 years as dean of the Perelman The major challenge, I feel, is mainly a as being too busy to listen and too dis- School of Medicine and executive vice generational issue. What is difficult and tant to care.” president of the University of Pennsylvania stressful for older generations may be much The first solution I offer is to empha- for the Health System, I would like to less so to today’s young physicians. They size the quality of humility. Over the thank everyone who helped me and may value autonomy less than those of years, many writers have suggested the worked with me during this often chal- us who went into practice in the 20th attributes necessary for a successful pa- lenging but always enjoyable time. It has century. At Penn, recent classes have been tient-physician relationship, among them been a privilege to serve you as leader of organized into teams, which we believe will honesty, warmth, and patience. But more Penn Medicine, and I am profoundly position our students well to work in the and more, I am convinced that humility grateful to have had this opportunity. changing health-care system. Our recent is essential. Physicians must not hide be- In May, I addressed the Class of 2011 graduates often place a higher value on a hind their superior knowledge and their during our graduation ceremonies. As we balanced lifestyle, with more time for their brand-new instrumentation. We should send our new physicians out into the world, families. They are able to deal with the not patronize. We must realize that we I wanted to explain why, despite some profusion of new knowledge because they are not superior to our patients but just dissatisfaction being voiced about our are adept at evaluating it with the help of more fortunate. I am particularly con- profession, I believe our graduates have new information technologies. They are cerned for poor patients, who often get made the right choice. My last words to certainly more proficient at using newer lost in the system – but whose needs are our new physicians underscored my reasons electronic devices. To think that playing often greater than anyone else’s. for continued optimism. Here, I will use video games could help prepare a doctor As for my second solution? That one I my last “Last Word” to suggest why the to perform delicate robotic surgery! leave to my new colleagues. We older future for our profession is not bleak but physicians have not solved the problem, exciting and challenging. A Range of Opportunities but I am confident that the solution lies In a recent issue of Penn Medicine, In spite of the uneasiness expressed among our newest graduates or those physicians who practiced solo or in small by many older physicians, there are still in medical school. groups cited battles with insurers and wonderful opportunities for our new There are many precedents to support bureaucracies, lower reimbursements, graduates. Because of our interdisciplinary my confidence, among them, Bill Gates higher office expenses and malpractice in- programs, a majority of Penn Medicine and Paul Allen, barely in their twenties surance costs, and longer work hours. They students earn more than one degree or when they created Microsoft; or Larry also felt a significant loss of autonomy. Many certificate or take a year out to do re- Page and Sergey Brin, both Ph.D. candi- cannot or will not embrace electronic medi- search or to work in global health. Our dates at Stanford University when they cal records and other forms of technology. new M.D.s, many with broader training, founded Google. Penn’s faculty has given For these and other reasons, many older are well suited to contribute to public policy, our graduates the tools to transform our physicians feel a widening gulf between public health, health-care delivery, and clinical care system as the next decade themselves and their patients. scientific research. Some may work as a unfolds. They will be able to perform Yet despite these concerns, enthusiastic hospital administrator, an epidemiologist, translational research; work ethically young people continue to enter the profes- a developer of policy at the FDA, or bio- with industry to discover new drugs; and sion of medicine! At the top-ranking schools, tech entrepreneur. become great clinicians. They will be the the median grade-point average most re- But it is the other chief role of a physician ones to shape more workable health-care cently was an incredible 3.8 to 3.9. Sixty- that gives concern to the profession – the policies. And if they embrace humility, eight percent of Penn Medicine students physician as healer. they will also find innovative ways to re- entering in 2010 took at least one year off Recently, the Journal of the American store the beauty of the physician-patient between college and medical school. In Medical Association ran a commentary relationship. that time, some were Fulbright Scholars, called “Patient-Physician Communication” Even in this challenging world, I be- Gates Foundation Scholars, and Howard (May 4, 2011). The authors acknowledge lieve our students have made the right Hughes Fellows. Some did not-for-profit the incredible progress made over the last decision in pursuing a medical profes- work in such places as Botswana and decades in discovering the scientific un- sion. I am optimistic that, like me, they Haiti. Others performed research in aca- derpinnings of medicine. Their concern, will look back some day on a full and demic medical centers. however, is that technological advances satisfying career. Thus we have a paradox: while many “have taken precedence over one of the older members of the profession are dis- most important skills of the compassionate Arthur H. Rubenstein, M.B.,B.Ch. Non Profit UNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM Organization U.S. Postage 3535 Market Street, Suite 60 Mezzanine Philadelphia, PA 19104-3309 PAID Phila., PA Permit No. 2563

t Penn Medicine, physician-

scientists are creating new DNA

A vaccines that hold great promise for

fighting disease more effectively,

with fewer side effects. Less like a

drug in a bottle or a vaccine in a

vial, they are “more like a next-

generation blood transfusion.” But

the new vaccines are expensive, and

funding can be hard to find.