The Cancer Moonshot Mission Industry Partnerships Boost U Advances

UNIVERSITY OF MINNESOTA MEDICAL SCHOOL FALL 2016

PAGE 8 The Cancer Moonshot mission Industry partnerships boost U advances

12 Photos capture 20 How 40 years of Duluth 22 U experts tackle autism hospitalized kids’ reality campus alumni stack up on many fronts PAGE 12 A new perspective

/&ƛ&+%*"+',("0/,2+!4&1%%&0!!Ǿ 2/1Ǿ,+,+",#%&0$,,!!601+&3"/0&16 of Minnesota Masonic Children’s Hospital. PHOTO: JILL DAHMEN PHOTO:

The Medical Bulletin is published twice a year For more information or to update University of Minnesota Foundation by the University of Minnesota Foundation. your address, please contact: 200 Oak Street SE, Suite 500 Minneapolis, MN 55455 Editor Design and Production Meredith McNab, editor Meredith McNab Woychick Design give.umn.edu 612-625-0657 or 800-775-2187 Managing Editor Printing and Distribution [email protected] The University of Minnesota is an equal Nicole Endres Sexton Printing opportunity educator and employer.

8 The Cancer Moonshot mission Why the University needs partnerships with private industry — and vice versa

8 12 A new perspective +"*,1&,+ȒƜ))"!-%,1,-/,'" 1!"-& 10$,,!!60Ǿ hard days, and everything in between for hospitalized children and their families

20 The big 4-0 Medical School’s Duluth campus marks four decades of graduating small-town doctors and Native American physicians

22 A spectrum of expertise From large prevalence studies to brain imaging, the University is investigating the best ways to serve 20 children who have autism spectrum disorder

ALSO IN THIS ISSUE MORE ONLINE

2 Medical School News Visit medicalbulletin.umn.edu 1,Ɯ+!4" Ȓ,+)6 ,+1"+1+! 6 Global Outreach the online edition of the Reducing health Medical Bulletin. disparities for people on the move

28 Alumni Spotlight Set to retire, Steven Web extras produced by Nicole &)"0ǾǽǽǾ/"Ɲ" 10 Endres and Shawn Sullivan on his career Go green 30 Scholarship Winner Email us at [email protected] Sarah Roe applies rugby to receive the Medical Bulletin lessons to medicine by email instead of as a 32 Alumni Connections paper copy.

34 In Memoriam 22 36 A Look Back At 50, CUHCC meets more needs than ever

FIND THE MEDICAL BULLETIN ONLINE AT: medicalbulletin.umn.edu

Cover illustration by Dan Woychick Medical School News

Our path toward a true academic health system

Being part of an LAST FALL I ANNOUNCED in the advancing health care through academic health Medical Bulletin that the University groundbreaking research, and of Minnesota and University of delivering the highest quality system is critical Minnesota Physicians (UMP) were care to patients from Minnesota as we strive to negotiating with Fairview Health and beyond. deliver on our Services to form a new, fully Our overall goal has not integrated academic health changed. We know that a world- clinical care, system. This was a significant step class medical school requires a education, and toward an important goal. Being 4,/)!Ȓ )00%")1%0601"*Ǿ'201 research mission. part of an academic health system as a world-class health system is critical as we strive to deliver on our clinical care, requires a world-class medical school. We are committed education, and research mission. to finding a new path to get there. Unfortunately, after nine months of negotiations, we The Academic Health Center and UMP have started a were unable to reach an agreement with Fairview. In July, strategic planning process that will consider a range of the University and UMP terminated the letter of intent options going forward. We have heard from several health and began looking for other partners and paths that care organizations since the Fairview talks ended. We are could help us achieve our goals. lucky to live in a state with excellent health care options, We were disappointed that we could not reach an agree- providing many exciting possibilities for collaboration and ment. In the end, it became apparent that the University partnership. In the meantime, we continue to work with and Fairview don’t share a common vision for what a true Fairview through our existing University of Minnesota academic health system needs to be. The University could Health partnership. not enter into an agreement that did not protect the aca- We are confident that we will find new, innovative ways demic and research mission that is so critical for this state. to ensure a positive future for our health sciences schools, The University of Minnesota and UMP share a mission faculty, patients, and state. M|B rooted in academic medicine. We are dedicated to educat- Brooks Jackson, M.D., M.B.A., Medical School Dean ing the next generation of care providers for our state, and Vice President for Health Sciences

Medical School names Tolar executive vice dean

Renowned pediatric blood and marrow trans- scholarship activity, work with centers and Tolar — who also directs the University’s plant physician and researcher Jakub Tolar, institutes to maximize productivity and Stem Cell Institute, conducts research, and M.D., Ph.D., has been named to the new posi- impact, and partner with Medical School sees patients — is familiar with the challenges tion of executive vice dean for the Dean Brooks Jackson, M.D., M.B.A., to achieve faced by clinicians, physician-scientists, and Medical School. philanthropic and legislative goals. basic scientists alike. In this role, Tolar is “Jakub has ambition, experience, leader- “I believe this Medical School has the focusing on implement- ship skills, and a strong track record of people we need to make us one of the best ing the Medical School’s research, clinical, and administrative suc- in the nation,” he says. “I hope to work with strategic plan. He cess,” Jackson says. “He brings 24 years of faculty and staff to identify and remove will work closely commitment to our school, having served in obstacles to success in recruiting and retain- with departments roles as varied as student, resident, fellow, ing faculty, performing meaningful research, on recruiting and faculty, physician, administrator, and mentor. and excelling at scholarship at the highest, retaining faculty and It is this breadth of experience that will be most creative level.” M|B increasing research and critical as he focuses on implementing the strategic plans for scholarship and research.”

2 MEDICAL BULLETIN FALL 2016 UNIVERSITY OF MINNESOTA MEDICAL SCHOOL Vinogradov tapped to lead Brooks Jackson, M.D., M.B.A. Department of Psychiatry Dean Jakub Tolar, M.D., Ph.D. Internationally recognized schizophrenia which we focus on Executive Vice Dean physician-scientist Sophia Vinogradov, M.D., prevention, preemp- in August took over as the new head of the tion, and the rever- TWIN CITIES CAMPUS Medical School’s Department of Psychiatry. sal of a potentially John Andrews, M.D. Vinogradov comes to the University of deteriorating Associate Dean for Graduate Medical Education Minnesota from the University of California, course.” Felix Ankel, M.D. San Francisco School of Medicine, where she The hire is a high- Assistant Dean for Medical School was professor and vice chair of the Depart- stakes one, as the Dr. Vinogradov is the right Faculty at HealthPartners ment of Psychiatry and associate chief of University moves for- Bruce Blazar, M.D. staff for mental health at the San Francisco ward with important leader to implement the highest Vice Dean for Clinical Investigation VA Medical Center. reformations to its standards of ethical research; Kent Crossley, M.D. Vinogradov is studying the use of cognitive policies on protecting Assistant Dean for Medical School and to build a new culture of Faculty at Veterans Affairs Health Care training and other approaches to improve human research par- trust and cooperation. Bobbi Daniels, M.D. neural system function in the brains of people ticipants, especially Vice Dean for Clinical Affairs who have mental illnesses. She has pioneered those who have – Brooks Jackson, M.D., M.B.A. Robert Englander, M.D., M.P.H. the use of cognitive training exercises that diminished mental Associate Dean for Undergraduate specifically target deficient areas in the capacity, says Medical School Dean Brooks Medical Education brain to restore more normal neural system Jackson, M.D., M.B.A. Michael Kim, M.D. functioning. With early intervention in young “Dr. Vinogradov is the right leader to move Assistant Dean for Student Affairs people who are struggling with their first reforms forward; to implement the highest Tucker LeBien, Ph.D. symptoms of mental illness, she is hopeful standards of ethical research; and to build a Vice Dean for Research that information-processing abnormalities new culture of trust and cooperation as the Dimple Patel, M.S. can be slowed down or reversed with cogni- department works to develop innovative, Associate Dean of Admissions tive training, perhaps in many cases without state-of-the-art programs of care for patients, Anne Pereira, M.D., M.P.H. Assistant Dean for Curriculum the need for medication. and to conduct important scientific investiga- “This starts to open a revolutionary new tions that will lead to better outcomes for Mark Rosenberg, M.D. Vice Dean for Medical Education path in psychiatry,” says Vinogradov, “one in those with mental illness,” Jackson says. M|B ,'&%&*&72Ǿ%ǽǽ Assistant Dean for Graduate Education U RESEARCHERS IDENTIFY A NONINVASIVE EYE TEST TO DETECT ALZHEIMER’S DISEASE Clifford Steer, M.D. Associate Dean for Faculty Affairs For the first time, technology designed to detect retinal changes linked Meghan Walsh, M.D. Assistant Dean for Medical to early Alzheimer’s disease has been proven effective in live animals. School Faculty at Hennepin The study, conducted by researchers in the University of Minnesota County Medical Center "+1"/#,//2$"0&$++!-2 )&0%"!&+1%"',2/+)Investigative Ophthalmology & Visual Sciences in June, explored the use of a camera DULUTH CAMPUS to noninvasively study the retina and detect any signs of Alzheimer’s Paula Termuhlen, M.D. disease in mice. Regional Campus Dean Researchers were able to visualize clear patterns of changes Raymond Christensen, M.D. Associate Dean for Rural Health suggesting the eventual development of the disease. WEB EXTRA

“Using currently available detection methods, you have to wait until Alan Johns, M.D., M.Ed. Learn more about the clinical trial, Assistant Dean for Medical Education the plaque is formed to identify Alzheimer’s disease,” says Center for which is now recruiting healthy and Curriculum Drug Design director Robert Vince, Ph.D. “This technology is a non- volunteers with no family history Robin Michaels, Ph.D. invasive way to identify Alzheimer’s disease before plaque is formed.” of Alzheimer’s, as well as people who Associate Dean of Student Affairs Researchers hope the technology will be able to detect early signs have been diagnosed with Alzheimer’s, and Admissions of Alzheimer’s in humans as well. A Phase I clinical trial designed to or watch a video on how the test Kendall Wallace, Ph.D. Associate Dean for Faculty Affairs test the theory began in July. M|B works at z.umn.edu/eyetest.

3 Medical School News

A billion reasons to celebrate

THE UNIVERSITY OF MINNESOTA Founda- tion’s Vision 2017 Campaign concluded on June 30 after surpassing its $1 billion fund-

,*)0,+Ǿ %*-&,+ raising goal — 15 months earlier than antici- ,#1%"&0&,+ǗǕǖǜ*-&$+Ǿ pated. Launched in 2007, the campaign celebrates the milestone. raised private dollars to advance medicine and promote health at the University through the Medical School, School of Public Health, Masonic Cancer Center, and U of M hospitals and clinics. In total, 77,674 donors contributed $1,052,283,342 for scholarships, faculty, research, new facilities, patient care, and academic programs on the University’s Twin Cities and Duluth campuses. Eighty-nine of these donors gave $1 million or more. The dollars raised added $65.5 million in student support, created 248 new scholarships and fellowships, and endowed 36 new chairs and professorships. The Children’s Health Campaign, which was part of Vision 2017, ended in 2015 after raising $220 million for University of Minnesota Masonic Children’s Hospital and the Department of Pediatrics, far exceeding its $175 million goal. “Our work isn’t done,” says Medical School Dean Brooks Jackson, M.D., M.B.A. “Vision 2017 will serve as a springboard, launching us into even bigger, bolder initiatives, such as ensuring healthy aging, solving addiction, expanding access to clinical trials, and eliminating health disparities.” M|B PHOTOS: A.M. PHOTOGRAPHY PHOTOS:

U receives $6.9 million NIH grant to continue brain connectivity research

The mapping Researchers at the University of Minnesota’s world- Minnesota, Washington University in St. Louis, University techniques we renowned Center for Magnetic Resonance Research (CMRR) of California, Los Angeles, and Harvard University. The PH.D. YACOUB, OF ESSA COURTESY IMAGE: were awarded a $6.9 million grant from the National Insti- four institutions will use imaging techniques developed created are truly tutes of Health (NIH) to continue their efforts to map human at the University of Minnesota to collect similar data to transformative, brain connectivity as it relates to aging and development create a large, publicly available database. allowing us to 0-/1,#1%"&#"0-+ 2*+,++" 1,*"/,'" 1ǽ The CMRR also participated in the Human Connectome The grant includes $3.6 million to investigate the struc- /,'" 1ț ȜǾ)/$" /&+*--&+$/"0"/ %&+&1&1&3" better under- tural and functional changes that occur in the brain during funded by the NIH five years ago. stand how typical aging and $3.3 million to map the development of “The mapping techniques we created in the HCP are the brain is brain structure and function from early childhood into truly transformative, allowing us to better understand how organized and !2)1%,,!ǽ,1%-/,'" 104&))20"0,-%&01& 1"!Ǿ+,+Ȓ the brain is organized and connected,” says CMRR director invasive magnetic resonance imaging scanning. Kamil Ugurbil, Ph.D. “With these new techniques, we are connected. This funding is part of a larger grant awarded to a con- now in a position to ask about how the brain develops and – Kamil Ugurbil, Ph.D. sortium composed of four institutions: the University of changes over time, and how it is altered in diseases.” M|B

4 MEDICAL BULLETIN FALL 2016 Medical School U introduces hires health equity B.A./M.D. pipeline

Discovery Team leader Minnesota needs a physician workforce J. Neil Henderson, Ph.D., has been hired to that is as diverse as its population. lead the University of Minnesota Medical But it’s a complex process that School’s Medical Discovery Team focused on involves not only attracting and health equity, rural health access, and Ameri- admitting top candidates from broadly + +!&+%")1%ǽ "',&+"!1%"# 2)16,#1%" the impact of culture on health care dynamics diverse backgrounds, but also retaining Medical School’s Duluth campus in August. and institutional and informal long-term care them through residency and practice. The Medical Discovery Team initiative was strategies in rural and urban communities. He That’s why the University of Minne- funded by the state Legislature last year, after comes to the University from the University of sota Medical School is partnering with Gov. Mark Dayton appointed a blue ribbon Oklahoma College of Public Health and directs the Office of Undergraduate Admissions commission to develop recommendations to the National Institutes of Health–funded and the College of Liberal Arts (CLA) strengthen the Medical School. The funding is American Indian Diabetes Prevention Center. to launch a new B.A./M.D. pipeline being used to recruit thought leaders to focus “The Medical Discovery Team concept is program on the Twin Cities campus. on pressing health issues facing Minnesota. an excellent vehicle for achieving outstanding The first cohort of B.A./M.D. scholars In addition to health equity, other Medical results,” says Henderson, an enrolled member will apply this fall and matriculate in Discovery Teams will focus on addiction, the of the Choctaw Nation of Oklahoma. “The the fall of 2017. biology of aging, and optical imaging and ability to work within a variety of medical and Already offered at a few dozen brain science. social systems to find solutions and to collab- U.S. medical schools, such pipeline Henderson is a renowned researcher in the orate with Native communities and rural programs enable students to gain the area of health disparities. His research focuses populations through the process provides a competency and confidence they need on medical anthropology, public health, and unique opportunity to improve quality and to thrive during their medical training and careers. community-based interventions, including access to care.” M|B Students embarking on the Univer- sity’s B.A./M.D. path will receive close mentoring and support from both CLA A MARK OF EXCELLENCE IN PARKINSON’S DISEASE RESEARCH and Medical School faculty. B.A./M.D. scholars also will receive support from The University of Minnesota has been named The University will each other, as this program follows a WEB EXTRA a Udall Center of Excellence for Parkinson's use the grant to: cohort model with up to 10 students Disease Research. The honor, which comes Study changes Watch a video about what each fall. Students accepted into the with $9.07 million in National Institutes of in brain circuitry sets the University of Minne- program will need to meet rigorous Health grant funding over five years, charges a that affect people sota apart at udall.umn.edu. standards and achieve certain mile- U team with defining changes in brain circuitry who have Parkin- stones while maintaining good GPAs that cause Parkinson’s and using that informa- son’s disease using and earning competitive MCAT scores. tion to improve deep brain stimulation and brain imaging and intraoperative tech- Interested students should follow develop new treatments for the disease. niques that Vitek pioneered; the U’s freshman application deadlines. “At the University of Minnesota, we have Develop new approaches for stimulating Eligible premed students will be invited a world-class, multidisciplinary team to the pallidum, a region of the brain that’s to apply and interview with Medical | treat patients with Parkinson’s disease,” says important for controlling voluntary School admissions staff. M B Jerrold Vitek, M.D., Ph.D., head of the Medical movement; and School’s Department of Neurology, who will Obtaining philanthropic funding Explore the effects of stimulation on lead the effort. “And because of our signifi- for this program is a Medical School brain circuitry that mediates movement cant experience and expertise, we are able to priority. To learn how you can support problems associated with Parkinson’s. take on this complex and often debilitating this program, please contact Holly The University of Minnesota shares the elite movement disorder with a goal of improving Gulden at [email protected] or Udall Center status with Harvard University, patients’ lives.” 612-625-8758. Johns Hopkins University, and six other institutions. M|B

MEDICAL BULLETIN FALL 2016 5 Global Outreach | Patricia Walker, M.D. LOCATION: Myanmar (Burma), Southeast Asia MISSION: Reducing health disparities, specifically for globally mobile populations

Cultural immersion

BORN IN TAIWAN and raised in Thailand until she was 11 years old, Patricia Walker, M.D., has always been immersed in many cultures. Today she’s an internationally recognized advocate for better refugee and immigrant health care and a committed ambassador for cultural humility among care providers.

With a belief that “global is local” in health care, Walker has focused on training the next generation of physicians in tropical and travel medicine. She is a professor of medicine and associate program director for the University of Minnesota Medical School’s Global Health Pathway, a three-year residency track that recently celebrated its 100th graduate, and department director at HealthPartners Travel and Tropical Medicine Center in St. Paul. She also spends up to four weeks per year abroad, teaching tropical medicine in Thailand and Cambodia.

Reducing health disparities for refugees and immigrants requires knowledge in clinical tropical and travel medicine, she says, but it also requires an open mind. Walker reflects on her work across cultures in the introduction she wrote for the book My Heart It Is Delicious: Setting the Course for Cross-

SUBMIT YOUR WORK Cultural Health Care by Biloine Whiting Young: The Medical Bulletin is seeking com- pelling photos and stories featuring Over the years I have recognized personal core values U of M Medical School student, alumni, or faculty experiences abroad. Selected that have helped me be clear in my purpose and submissions will be published in future issues of the Medical Bulletin. passionate in my advocacy. Those core values include For more information or to submit your global health equity, respect, trustworthiness, cultural photo or story, email managing editor Nicole Endres at [email protected]. humility, and compassion. …

6 MEDICAL BULLETIN FALL 2016 Walker, a photographer by hobby, took this shot on a trip to initiate a collaborative agreement with colleagues in Myanmar.

Ultimately, however, it is through the stories of our WEB EXTRA

patients’ lives — lives that we are privileged to hold View more of Walker’s in our hands and hearts for a few moments, in an photos at z.umn.edu/ walkerphotos. examination room or across a makeshift wooden table at a refugee camp clinic — that we may come closest to reaching across the cultural chasm to heal those who are suffering.

MEDICAL BULLETIN FALL 2016 7 BY BARBARA KNOX

THE CANCER MOONSHOT MISSION

HERE’S WHY THE UNIVERSITY NEEDS PARTNERSHIPS WITH PRIVATE INDUSTRY — AND VICE VERSA

8 MEDICAL BULLETIN FALL 2016 ILLUSTRATION: DAN WOYCHICK DAN ILLUSTRATION: When President Barack Obama declared a new “Cancer Moonshot” initiative in his final State of the Union address, he put a refreshingly positive spin on former President Richard Nixon’s 1971 “War on Cancer.” Reframing the effort to cure cancer seems wise. The War on Cancer conjures up other “wars”— on drugs, on terrorism, on poverty — all decades-long battles that have seen questionable progress. But the hopeful optimism of a “moonshot”? Heck, fundamental discovery in the lab to delivering everybody knows the moonshot was a spec- something measurable to the clinic — usually tacular success, a giant leap for mankind. five to 10 years.” Vice President Joe Biden was tapped to lead Harris, a Howard Hughes Medical Institute this Cancer Moonshot and, in an address to Investigator and holder of the Margaret Harvey researchers around the country this past July, Schering Land Grant Chair for Cancer Research, said, “We’re on the cusp of great change.” It’s spends his days focused on “moonshot” possible, he continued, that we can indeed research. He recently identified a predominant forge ahead and make 10 years of progress cause of cancer-producing mutations within in the next five. the human body. Discovering this source of But how exactly will that happen? For mutations — enzymes known as APOBECs — University of Minnesota researchers, one was a leap forward for Harris, who together important part of the answer is continuing with Masonic Cancer Center colleague Daniel to make new and stronger partnerships with Harki, Ph.D., and entrepreneur John Santini, private biotechnology companies to deliver Ph.D., has started a private company called breakthrough cancer therapies to patients ApoGen Biotechnologies Inc. They envision faster. That, after all, is what drives the work developing a cancer therapy that will inhibit of the Masonic Cancer Center’s scientists. the mutations caused by APOBECs in tumors. Keep in mind that while scientists like Different roles Harris oversee sizable research labs, they’re “Many people assume that the kind of funda- also training the next generation of scientists mental research that happens in places like in the classroom, writing scientific papers, the University of Minnesota should translate presenting their findings at conferences around immediately into new cancer drugs,” says the world, writing grant requests, and doing Masonic Cancer Center member Reuben service work. That makes having an outside Harris, Ph.D., a professor in the Department company with dedicated nonacademic person- of Biochemistry, Molecular Biology, and nel necessary for translating a fundamental Biophysics. “But it’s a very long road from a discovery to a new therapy.

MEDICAL BULLETIN FALL 2016 9 PHOTO: JIM BOVIN PHOTO:

Basic discoveries made in labs like mine can identify pathways to therapies, which private companies then end up producing. Then, the company often gives the therapies they develop back to scientists to test in new ways and in new situations. It’s a

back-and-forth process that really works. – David Largaespada, Ph.D.

A shared commitment “Spinning out our discoveries from the lab “Public/private partnerships are absolutely into private companies is another way we can critical to developing cancer therapies,” agrees take what we’ve learned and get it into the David Largaespada, Ph.D., the Masonic Cancer marketplace where it can help people,” says Center’s associate director for basic sciences and Largaespada, who holds the Hedberg Family/ a professor in the departments of Pediatrics and Children’s Cancer Research Fund Chair for Genetics, Cell Biology, and Development, who Brain Tumor Research. works to identify cancer-causing genes. Commercializing discoveries

PHOTO: SCOTT STREBLE SCOTT PHOTO: “The relationship goes both ways: basic The National Cancer Institute has long pro- discoveries made in labs like mine can identify moted these public/private partnerships, and pathways to therapies, which private companies the University’s Office for Technology Commer- then end up producing,” he continues. “Then, cialization exists to help move innovative lab the company often gives the molecules — the discoveries into the public realm. therapies — they develop back to scientists like Jeffrey Miller, M.D., deputy director of the me to test in new ways and in new situations. Masonic Cancer Center and holder of the Roger It’s a back-and-forth process that really works.” L. and Lynn C. Headrick Family Chair in Cancer It works because developing compounds for Therapeutics, knows firsthand how the process use as treatments in humans is complex and works. He’s currently involved with two private expensive, something universities are rarely companies that are developing cancer treat- TOP David Largaespada, set up to do alone. ments based on his research. Ph.D., has cofounded three And once private industry has developed “These types of partnerships involve two private companies to help a drug that’s ready to test, it needs access to key components,” Miller explains. “First, the get his lab discoveries to the patients, and it needs physicians with the marketplace — and thereby company agrees to further research and develop expertise to set up and run clinical studies to patients. the technology they’re licensing into a product successfully. that can be commercialized. And, second, they BOTTOM A private company Largaespada has cofounded three private agree to fund human clinical trials, which can cofounded by Reuben Harris, companies: Discovery Genetics, which focused be enormously expensive.” Ph.D., aims to develop a novel on developing gene therapies and was recently cancer therapy based on his Miller’s large research lab focuses on the purchased by another company; NeoClone, lab discoveries. potential of natural killer (NK) cells, which which makes antibodies; and B-MoGen Bio- are important mediators of the body’s natural technologies, a gene-editing start-up. He is anticancer immune response. He and his team also a scientific adviser for Recombinetics, have discovered a specific type of NK cell, called a St. Paul company focused on gene editing an adaptive NK cell, that kills cancer more in food animals. effectively than conventional NK cells. Miller’s

10 MEDICAL BULLETIN FALL 2016 team has also learned how to arm those adap- FINDING A CURE tive NK cells, aim them at cancer cells, and keep

PHOTO: SCOTT STREBLE SCOTT PHOTO: TWICE AS FAST the NK cells alive long enough to destroy the cancer cells. MORE THAN 500 cancer Last year, Fate Therapeutics, a biopharmaceu- researchers, oncologists, care tical company focused on developing immuno- providers, philanthropists, data therapies for cancer, and the University entered and technology experts, advo- into an agreement to take Miller’s NK cell cates, patients, families, and discoveries to the next level. They hope to begin cancer survivors participated in clinical trials with a new cancer immuno- the Minnesota Cancer Moonshot Summit at the University of therapy in the first quarter of 2017, Miller says. Minnesota on June 29. This year, Miller and Masonic Cancer Center Together, they generated colleague Daniel Vallera, Ph.D., saw their ideas and commitments that research on so-called TriKE — Trispecific Killer will accelerate advances in Engager — technology licensed by Oxis Biotech, cancer research, prevention, a company that develops cancer drugs. The Oxis treatment, and survivorship — cancer therapy based on Miller and Vallera’s all part of the national effort work is also expected to start clinical trials for Jeffrey Miller, M.D., says licensing agreements to double the rate of progress with private companies are essential to making acute leukemia patients in the first quarter of toward a cure. 2017, Miller says. progress against cancer. “These licensing agreements are absolutely To get involved, visit: essential to progress,” says Miller, “because in We’re seeing companies developing immuno- cancer.umn.edu/ addition to funding the clinical trials, they therapy products that are now making their cancer-moonshot fund the drug invention and help fund further way into clinics. That’s what happens once research for product improvement. Basic these partnerships are forged.” research will only take us so far.” With the Cancer Moonshot embracing The urgency of now the urgency of now, scientists like Harris, President John F. Kennedy’s original moonshot — Largaespada, Miller, and their teams are land a man on the moon by the end of the 1960s — nothing but hopeful, and they’re ready to was arguably less complicated than the Cancer pick up the pace, just as fast as the system Moonshot; after all, scientists don’t have to cure will allow. just one cancer, they have to cure 200 known “Reuben and Jeff and many others here at WEB EXTRA types of cancer. Every one may require a the U have great experience bringing their different “cure.” discoveries from lab to clinic,” says Largaes- Discover more at: pada, “and we all play multiple roles. But a z.umn.edu/moonshot: University researchers say Cancer Moonshot buzz is already growing, and they’re eagerly shared vision, a desire to help find the ways See what happened at the waiting to hear more about what it will entail: to end cancer, really holds us together.” M|B Minnesota Cancer Moonshot Summit and watch Vice President More grant funding? Heightened awareness? Barbara Knox is a freelance writer and editor and Biden's very personal address to A streamlined drug approval process? a frequent contributor to the Medical Bulletin. the national audience. As Miller says, science is advancing rapidly; anything that helps break down barriers and Find out how a U scientist and accelerate the process will be welcomed by the company that licenses his scientists. technique are using gene editing “I’ve been doing this work for 25 years,” he to combat cancer and improve says, “but in the past five, I’ve seen the area of food crops. cancer immunotherapy absolutely explode.

MEDICAL BULLETIN FALL 2016 11 A new perspective

NAME 0%)"6 "11&+$"/

AGE 17

TREATMENT Total pancreatectomy with islet autotrans- plant for chronic pancreatitis

Ashley

12 MEDICAL BULLETIN FALL 2016 +"*,1&,+ȒƜ))"!-%,1,-/,'" 1!"-& 10$,,!!60Ǿ%/!!60Ǿ+! everything in between for hospitalized children and their families

What is it like to have a severely ill child? Or a chronically ill child? A terminally ill child? Through a project called “Perspectives: A Visual Journey of Patients and Families from University of Minnesota Masonic Children’s Hospital,” Twin Cities photographer Jim Bovin invited families to document their hospital stays through photography and show others what they experience. With a donation from the Margaret Hagen Smaby Fund for Innovation in Arts and Healing, Bovin provided cameras and photography training last year to six families with children expe- riencing a severe or chronic illness.

“I said to the parents, ‘There are going to be some days you don’t WEB EXTRA

feel like talking. Pick up the camera,’” Bovin recalls. View more photos from And they did. Together the families took 7,151 photos. They 1%"#*&)&"0Ǿ#/,*1%"',6#2) to the gut-wrenching, took photos in the operating room, during painful procedures, at give.umn.edu/stories/ and while simply passing time in a hospital room. They also took new-perspective. joyful selfies. Bovin and the families worked with the University of Minne- sota Center for Spirituality and Healing as well as University of Minnesota Masonic Children’s Hospital’s Child-Family Life Services and Integrative Health and Wellbeing Program to make the project happen. It was so well received that Bovin is paving the way for a second — and third — round of patients and families to take part in it. “We

want everybody to have a chance with this,” he says. M|B

By Nicole Endres, managing editor of the Medical Bulletin

MEDICAL BULLETIN FALL 2016 13 “There are going to be some days you don’t feel like talking. Pick up the camera.”

NAME Taytem Lynn White

AGE 2

TREATMENT Bone marrow transplant for Hurler syndrome

Tay tem

/&ƛ&+

NAME Griffin Dahmen

AGE 8

TREATMENT Chemotherapy and surgery for Ewing sarcoma

MEDICAL BULLETIN FALL 2016 15 The families took more than 7,000 photos — in the operating room, during painful procedures, and while simply passing time in a hospital room.

16 MEDICAL BULLETIN FALL 2016 Anton

NAME Anton Ezekiel Delgado

TREATMENT Stem cell transplant for epidermolysis bullosa

January 16, 2010 – December 15, 2015

Though Anton’s transplant was considered a success, he died during his recovery of intussusception, which is not a complication of epidermolysis bullosa or transplant.

“We are so thankful we got to "-/1,#1%&0-/,'" 1+!0, thankful for the priceless photos we now have,” says Anton’s mother, Vanessa Delgado.

MEDICAL BULLETIN FALL 2016 17 NAME Grace Abera

AGE 1

TREATMENT Chemotherapy for acute myeloid leukemia

Grace

18 MEDICAL BULLETIN FALL 2016 JIM BOVIN’S PERSPECTIVE Bovin, a Bloomington-based freelance photographer, does frequent work for University of Minnesota Masonic Children's Hospital. %/,2$%1%&03,)2+1""/-/,'" 1Ǿ%"4&1+"00"! some of these families' most vulnerable moments — and was continually impressed by their commitment to keep shooting through them. “It was really fulfilling,” he says.

MEDICAL BULLETIN FALL 2016 19 Medical School’s Duluth campus marksarks four decades of graduating small-townn doctors and Native American physiciansans

EVEN IN THE 1960s, Minnesotans foresaw a shortage of physicians in rural areas. So when the 1969 state Legislature made an appropriation to establish “a separate basic sciences program as part of an addi- tional medical curriculum,” the University of Minnesota Medical School, Duluth campus was founded and has since focused on fulfilling the needs of rural Minnesota and Native American communities. The Duluth campus welcomed its first class of 24 students — which included two Native Americans, a set of identical twins, and a nun — to school on September 20, 1972. Twenty-three of those students 23 graduated with the Medical School’s Class of 1976. Forty years later, the Duluth campus’ mission Students who began their medical trainingg remains the same, and it has put up some impres- in Duluth awarded M.D.s in 1976 sive numbers. M|B

Statistics provided by James Boulger, Ph.D., director of alumni relations for the University of Minnesota Medical School, Duluth campus, unless otherwise noted Students who began their medical training *Source: Association of American Medical Colleges, 1,947 in Duluth awarded “Diversity in Medical Education: Facts and Figures 2008” M.D.s in 2016 University of Minnesota Medical School graduates who began their training in Duluth 20 MEDICAL BULLETIN FALL 2016 Practicing family medicine physicians in Minnesota who trained in Duluth

67 508 Practicing Minnesota 465 physicians choosing Percent of Duluth graduates other specialties who selecting a primary care trained in Duluth 47 specialty (including family medicine, pediatrics, Percent of all Medical School, or internal medicine), Duluth campus graduates compared with less than entering family medicine 39 percent nationally since 1976, compared with 11.2 percent nationally in the same time frame 48.6

Percent of Medical School, Duluth campus trainees who serve communities with populations smaller than 25,000 62

Percent of Medical School, Duluth campus alumni who serve communities smaller than 50,000 PHOTO: UNIVERSITY ARCHIVES UNIVERSITY PHOTO: NATIONAL CAMPUS DULUTH SCHOOL, MEDICAL NATIONAL CAMPUS DULUTH SCHOOL, MEDICAL

110 8 2 American Indian National ranking physicians in the country by number of Native American physicians who before the Medical American Indian started in Duluth who have graduated School, Duluth campus graduates 56 from the University of Minnesota opened in 1972* Medical School

MEDICAL BULLETIN FALL 2016 21 A spectrum of expertise From large prevalence studies to brain imaging, the University is investigating the best ways to serve children who have autism spectrum disorder

BY GREG BREINING

PATRICIA PACHECO WAS SURPRISED that her physically and socially. After a year, he was infant son, Thomas, didn’t seem to notice her. speaking in four- to five-word phrases, and “All the books I had read said you should his daily “meltdowns” of frustration abated. be staring lovingly into your infant’s eyes and Says Pacheco of the treatment, “We wouldn’t he should look at you,” says Pacheco. “Well, he have the son we have today without it.” never looked at me. He was my first son, so I The Pachecos’ experience underscores the really didn’t have a concept of what was normal importance of early diagnosis of the conditions and what wasn’t. I would try to look at him and known as autism spectrum disorder. The engage him, and he just never looked at me.” average age of children diagnosed with autism And, unlike most other kids, Thomas was ranges from 4 to 5 years. That represents more content to sit by himself with a single toy. “I just than two years of missed opportunity — because thought I had a really good baby,” says Pacheco. early treatment can pay big dividends. By age l, Thomas wasn’t saying any words. “We know from intervention studies that the Friends assured Pacheco that boys develop earlier you intervene, the better the outcome,” slowly. Even her doctor suggested she wait for a says Jason Wolff, Ph.D., an assistant professor speech evaluation. When Pacheco did schedule in educational psychology at the University of a full evaluation at 22 months, Thomas was Minnesota. “If we can identify presymptomatic found to have global developmental delays markers of children who are at the highest risk, that fit on the autism spectrum. we could do more preventive interventions The diagnosis opened the gate to insurance so that these children, hopefully, never fall and intervention to help Thomas advance behind, or at least have the maximum chance to gain the skills they’ll need to be successful.”

22 MEDICAL BULLETIN FALL 2016 MEDICAL BULLETIN FALL 2016 23 ILLUSTRATION: STUART BRADFORD STUART ILLUSTRATION: We know that the earlier you intervene, the better the outcome. If we can identify presymptomatic markers of children who are at the highest risk, we could do more preventive interventions.

– Jason Wolff, Ph.D.

Wolff and other University of Minnesota focused. I think it can become a leading center researchers are trying to better understand in autism nationally. The research can make the causes of autism spectrum disorder — to differences in individuals’ lives.” diagnose it at earlier stages when treatment Igniting a broad search for answers is more effective and to anticipate needs for therapy and support in the larger community. Autism spectrum disorder includes a range Their work is contributing to a national of neurodevelopmental disorders that appear in effort to understand this complex array of early childhood, mostly among boys. Symptoms developmental disorders — and establishing and levels of disability vary widely. Repetitive the University as a trusted research resource. actions and limited interests are common. “We are relatively new in our ability to do Social interaction and communication can be this level of work,” says Suma Jacob, M.D., Ph.D., particularly difﬁcult. The Centers for Disease a physician-scientist in the Medical School’s Control and Prevention (CDC) estimates that departments of Psychiatry and Pediatrics, who l in 68 children has some form of autism. was recruited four years ago. “I chose to come Scientists understand that genetics play a to Minnesota … because I saw Minnesota had strong role. Studies of identical twins show that certain strengths. It has a good education if one twin has autism spectrum disorder, the system, good medical care, it’s very community other twin has a high probability of having it, too. Finding the responsible genes would help

24 MEDICAL BULLETIN FALL 2016 SPARK is a nationwide collaborative study that will include 50,000 individuals with autism spectrum disorder and their #*&)&"0ǽ 1&01%")/$"0121&0*-/,'" 1 PHOTOS: ERIN REXROTH, ERIN J. PHOTOGRAPHY ERIN J. ERIN REXROTH, PHOTOS: ever planned.

“We’ve learned that we need large The Pacheco family — numbers in order to tease out common ț#/,*)"#1Ȝ1/& &Ǿ %,*0Ǿ11%"4Ǿ causes within subgroups of autism. and Michael — happily You can’t do that as one institution. contributes to studies like +!1%" +#+1/&+ *$&+$ ,2/"))6+""!1,',&+#,/ "0ǽȋ 12!61,%")-!3+ "(+,4)"!$" – Suma Jacob, M.D., Ph.D. ,2121&0*0-" 1/2*!&0,/!"/Ǿ which affects 4-year-old Thomas.

scientists understand the cause. It would also “It is the largest autism project ever planned,” BELOW Suma Jacob, M.D., allow very early diagnosis. But identifying says Jacob. “We’ve learned that we need large Ph.D., believes the U can those genes has been tough. numbers in order to tease out common causes become a leading autism research hub because of “Because it’s very heterogeneous — it’s a within subgroups of autism. You can’t do that Minnesota’s good educational broad spectrum — there is no single gene as one institution. You really need to join forces. system, quality medical care, or single cause,” Jacob says. “There are over “We applied for the [SPARK] grant through and community focus. 100 genes probably, and that has led to the the University of Minnesota, but I really see it challenge in ﬁnding [answers].” as a collaborative force with a growing group To identify those genes and more fully of faculty interested in autism,” she adds. “We understand who will show signs of autism spectrum disorder and why, scientists will have to study tens of thousands of patients. And that’s where SPARK comes in. SPARK— which stands for Simons Founda- tion Powering Autism Research for Knowl-

edge — is a nationwide collaborative study that JIM BOVIN PHOTO: will include 50,000 individuals with autism spectrum disorder and their families. Funded by the Simons Foundation, the study will collect personal information and DNA from saliva and mouth cells for genetic analysis. Recruiting such a large cohort is expected to take three years. The University of Minnesota is one of more than 20 U.S. medical schools and research centers that launched the effort this spring. Jacob is the lead investigator for the University, which will be a regional hub for SPARK.

MEDICAL BULLETIN FALL 2016 25 PHOTO: SCOTT STREBLE SCOTT PHOTO:

The study employs magnetic resonance imaging (MRI) scans to detect physiological differences between typically developing brains and the brains of children who have autism spectrum disorder. Pacheco brought young Michael in for a developmental assessment, an eye-tracking test, and MRI scan of his brain while he was sleeping. First, Wolff and Elison use MRI to examine the structure of the brain itself. Second, they use a type of MRI that’s sensitive to water movement in tissues, called diffusion tensor imaging, to show connections linking various regions of the brain. Says Wolff, “We’re looking What’s the key to getting usable have colleagues and collaborators at Mayo at the structure of the brain’s wiring.” brain scans from wiggly babies Clinic, in Duluth, and in other states who are Finally, a third type of MRI, functional without sedation? “Outlasting excited about sharing resources and oppor- MRI, detects brain activity patterns related to them,” say researchers Jed Elison, tunities with families.” Ph.D. (left), and Jason Wolff, Ph.D. blood oxygen, being that cerebral blood flow The U group plans to reach out to families is tied to neuron activity. “We’re interested in in the Dakotas, Wisconsin, and Iowa as well. which regions of the brain fire together while “I think the SPARK initiative is a unique the child is resting,” says Wolff. “We can use WEB EXTRA opportunity for Minnesota to collaborate at a this to understand more about functional Watch an interview with national level,” Jacob says. “And that’s exciting.” development.” Infant Brain Imaging Study Detecting physiological differences The upshot is that Wolff and colleagues are investigator Jed Elison, Ph.D., detecting objective differences in the brains of Knowing that autism spectrum disorder was at z.umn.edu/ibis. children who have autism spectrum disorders more common among siblings, Patricia Pacheco as early as 6 months of age. was thrilled to see a recruitment flier for the “With our best behavioral tools, we can Infant Brain Imaging Study. Her second son, feasibly diagnose a child around 18 months Michael, was 3 months old at the time, just the or 2 years,” says Wolff. right age to begin the study. Earlier detection can make a big difference Wolff and Jed Elison, Ph.D., began studying for families, says Patricia Pacheco. “I think it’s young children and families affected by autism just a great program because we have been able spectrum disorder as part of the Infant Brain to track Michael’s progress from just 3 months Imaging Study when they worked together old to know that so far he seems to be neuro- at the University of North Carolina. Now both typical.” Michael got another scan at 6 months are part of the U’s interdisciplinary Center for and will go back at years l and 2. “They give us Neurobehavioral Development, and Minnesota information as we go,” she says. is part of the Infant Brain Imaging Study, a Elison, a McKnight Land Grant Professor, also National Institutes of Health Autism Center was named a coinvestigator for the new Baby of Excellence Network that includes eight Connectome Project, a $4 million NIH effort universities in the United States and Canada. focused on imaging developing brains from infancy through early childhood. He will lead the effort at the U with Kamil Ugurbil, Ph.D., director of the U’s world-renowned Center for Magnetic Resonance Research.

26 MEDICAL BULLETIN FALL 2016 Prevalence data lets us plan for services TUNING IN Could addiction research shed light on autism? Possibly so, in a much better way. – Amy Hewitt, Ph.D. says University of Minnesota neuroscientist Patrick Rothwell, Ph.D., because the same area “The honest answer is we don’t know why,” The need to dig deeper of the brain appears to be says lead author Amy Hewitt, Ph.D., director of Last year the University joined the CDC- problematic in both disorders. funded Autism and Developmental Disabilities the University’s Research and Training Center “Imagine the brain as an Monitoring (ADDM) network, a nationwide on Community Living. “It’s the big question orchestra, with all of the cells initiative to estimate how many children that came out of our Somali prevalence study. working together,” he says. with autism spectrum disorder live in various What it tells us is we just need to dig deeper.” “You might hear a problem in, U.S. communities. Cultural factors could certainly be at play, say, the strings section. But University researchers were tapped to con- Hewitt explains. Because autism is a spectrum then you have to break it down tribute to the ADDM network after a 2013 of disorders, it would make sense that Somali further, to the cellos, the violas, report done in conjunction with the Minnesota children would fall along the entire spectrum the violins, to find out which is Department of Health revealed that Somali and and not just on the severe end, she says. “So one out of tune.” white children ages 7 to 9 living in Minneapolis thought is that we are missing those kids whose Rothwell has pinpointed a were about equally likely to have autism spec- symptoms are not as signiﬁcant.” particular group of malfunc- trum disorder — but the Somali kids were more Hewitt’s group is also building on its earlier tioning synaptic connections — likely to also have an intellectual disability. study to determine the prevalence of autism in say, the violins — in the brain’s Somali and Hmong communities throughout striatum that he believes plays Hennepin and Ramsey counties. The CDC is a role in autism; now he wants funding the research as part of the ADDM to pluck each string to find the network, and the University’s ﬁndings will discordant notes. become part of the nationwide database. He’s doing this using optogenetics, a relatively new tech-

PHOTO: AMY METRY PHOTO: “What prevalence data does for us is let us plan for services in a much better way,” says nology that uses light to probe the inner workings of the brain Hewitt. “[In Minnesota], most kids aren’t to study — and even control — diagnosed until the age of 5. Well, we can pinpointed regions. Because accurately diagnose autism in kids at 2.” addiction research in general That gap, she says, spans critical years for is further along, Rothwell says getting intensive services to those children. he’s applying that knowledge, “The ADDM network is there not just to count where indicated, to his autism and report the number of kids,” says Hewitt. investigations. “It’s there to provide data and trends that help “My previous work got us to us to improve services and support to kids.” M|B the violins,” he explains. “Now, /"$/"&+&+$&0',2/+)&01+!21%,/ 0"!&+1ǽ2)ǽ using optogenetics, we’re looking closer in hopes of being able Learn more about participating in the SPARK to ‘tune’ those cells, to restore study at sparkforautism.org/uminnesota, or about healthy function.” participating in the Infant Brain Imaging Study at – Barbara Knox ibis-network.org. Amy Hewitt, Ph.D., is investigating why Somali kids diagnosed with autism spectrum disorder were more likely than white kids also to have been diagnosed with an intellectual disability.

MEDICAL BULLETIN FALL 2016 27 Alumni Spotlight | Steven Miles, M.D.

A career built on compassion

IN 1999, STEVEN MILES, M.D., decided to Committee and has written four books, RESPECTED MENTOR run for the U.S. Senate. His central concern? including one on the Hippocratic Oath and Miles’ commitment to changing the world Affordable health care. Too many people, as another about the role of doctors involved one issue at a time has inspired countless he saw it, were forgoing critical medical care with torture practices. At last count, Miles students. Arthurine Zakama, who met Miles because they couldn’t afford it. So the Univer- had visited 82 countries — and had worked when she was in high school, says she decided sity of Minnesota professor and physician with refugees in Asia, Africa, and Europe. to go into medicine because Miles encouraged entered the race as a Democrat and began “Steve’s work makes a genuine difference her to reach for her dreams. “He’s an amazing touring the state to solicit votes. in people’s lives,” says Debra DeBruin, Ph.D., mentor,” Zakama recalls. “He always took the Miles never made it to Washington, but he an associate professor with the U’s Center for time to talk to me, write letters of recommen- fondly recalls his time on the campaign trail. Bioethics. “He provides leadership on very dation, and offer advice.” “I was struck by the incredible intimacy of controversial issues that most bioethicists Allison Whelan, a graduate of the U’s campaigning,” he says. “You have extraordi- don’t address — for example, the complicity of M.A./J.D. program in bioethics, echoes such nary conversations with people. I learned so health professionals in torture, ending gun praise. “Dr. Miles is, without a doubt, one of much by listening.” violence, and testing untested rape kits. He’s the best professors and mentors that I have Friends and colleagues say that Miles, not at all deterred by the heat he takes as a had in my academic career,” says Whelan. who will retire from the U faculty at the end result of his positions or research. His work “His door was always open. He went beyond of the academic year, has always been a good displays a lot of courage.” the call of duty to help me academically, listener. He rarely interrupts. He asks incisive Sitting on the patio outside his Minneapolis professionally, and personally.” questions. And above all, he is empathetic. home on a recent morning, Miles spoke quietly Miles says he tries to treat his students with As a teacher, caregiver, researcher, and men- as he tallied the accomplishments that make respect. “I want them to mature to their full tor, Miles has always led with compassion, him most proud. He helped develop the Do Not potential, beyond any class where we happen his fans say. Resuscitate order and an internationally used to meet,” he says. He attempts to answer protocol for treating tuberculosis in refugee every student email, he says, and corresponds COURAGEOUS LEADER camps. He successfully pushed for getting rid with many former students. Miles earned his medical degree from the of restraints in nursing homes and sat on the His students find him to be open and real: University’s Medical School in 1976 and committee that helped design MinnesotaCare. Years ago, shortly after he was diagnosed as has worked at the U for 35 years. A longtime What accounts for his success? “The bipolar, he disclosed his struggle with mental professor in the Division of General Internal truth is, I’m a lousy networker and not very illness to one of his classes. “I said, ‘You can Medicine, he also holds the Maas Family sociable,” Miles says with a smile. “But I know get help and have a successful career in medi- Endowed Chair in Bioethics and serves as an how to collate critical bits of information and cine, as I have,’” he recalls. “‘But you will have affiliate faculty member for the Law School’s then distill a simple, clear policy design from to educate your classmates.’ You could’ve concentration in health law and bioethics. them. Simplicity is key to the solutions I’ve heard a pin drop.” He has served as medical director of helped develop.” the Minneapolis-based American Refugee HUMANIST Much has changed in medicine over the course of 35 years, notes Miles. “Technology Steve’s work makes a genuine difference in people’s lives. now makes it possible to do literature research at a level we’d never dreamed of He provides leadership on very controversial issues that most before,” he says. But he worries that technol- bioethicists don’t address. He’s not at all deterred by the heat ogy can become a barrier between physicians and patients. “The electronic chart has he takes as a result of his positions or research. His work improved information flow and given us displays a lot of courage. – Debra DeBruin, Ph.D. access to tremendous amounts of data. But it has also prompted young doctors to stand behind a screen rather than risk relating with their patients and their families.”

28 MEDICAL BULLETIN FALL 2016 1"3"+&)"0ǾǽǽǾ-)+01, 0-"+!*,/"1&*"&+%&0$/!"+ +!4&1%%&0#*&)6Ǿ&+ )2!&+$%&0 !,$ /""0&Ǿ&+%&0/"1&/"*"+1ǽ PHOTO: SCOTT STREBLE SCOTT PHOTO:

To nurture their empathetic sides, Miles The truth is, I’m a lousy networker ALUMNI encourages his students and colleagues to HOSTS NEEDED read novels and listen to music. Listening to and not very sociable. But I know how '77+!/"!&+$21%,/0)&(" +"201"+ to collate critical bits of information Interviewing for a residency have helped make him a better person, he and then distill a simple, clear policy placement can be a nerve- says, and thus a better physician. Not surpris- racking process. The Medical ingly, he plans to spend more time in retire- design from them. Simplicity is key to Alumni Society is seeking ment engaged in both activities, as well as the solutions I’ve helped develop. alumni who live outside of $/!"+&+$Ǿ ,,(&+$Ǿ+!"+',6&+$%&0$/+!- Minnesota to host medical children with his wife of 35 years, Joline Gitis. – Steven Miles, M.D. students as they travel for Leaving the U will be bittersweet for Miles, residency interviews. Besides who says he’ll miss the students and patients. offering a friendly face and But he hasn’t had second thoughts about camaraderie, hosts help ease WEB EXTRA moving on. “There’s no point in dying on the the financial burden of travel ', Ǿȋ%"',("0ǽȊ%14,2)! "401",# Hear Miles discuss health for students. perfectly good retirement.” M|B disparities and possible ways to address them at To sign up, visit z.umn.edu/ By Joel Hoekstra, a Minneapolis freelance writer z.umn.edu/miles. alumnihost, or contact Katrina and editor Roth at 612-625-0336 for more information.

MEDICAL BULLETIN FALL 2016 29 Scholarship Winner | Sarah Roe

Lessons from the scrum

IN HER MEDICAL SCHOOL APPLICATION, Moreover, she felt wanted. “They were so Andrew Skildum, Ph.D., who is studying Sarah Roe could have written about being friendly and happy to have me there,” she whether an enzyme known to play a role in the only girl on the football teams she played says. “They knew my name.” Roe had visited diabetes, PDK4, also plays a role in breast on in Antioch, California. She could have other schools where that wasn’t the case. cancer. Roe developed a protocol that the described her route from the public schools She realized the school in the northern state lab is still using. of that working-class town to Stanford Univer- so far from home was actually a good fit, Skildum was impressed with Roe’s interest sity. Or she might have discussed how her and she made it her No. 1 pick. in the work. “She probably won’t be doing Mexican/Native American heritage shaped Western blot for the rest of her life, but she ROLE MODEL her. Instead, she wrote about rugby. wanted to learn that technique so she could She played the sport as an undergraduate One of the first people Roe met when she convey to patients the importance of basic and found it not only made her strong, it arrived in Duluth in 2014 was Mary Owen, science research,” he says. And Roe made an taught her something important: “In rugby, M.D., director of the Center of American Indian impression on the younger women working you go into a play full force and get buried, and Minority Health (CAIMH). Owen was teach- beside her, one of whom is now applying to but the play is going on without you, and you ing a course designed to give students feeling medical school. have to catch up to help the team,” she says. shaky about their academic skills a kick start. Owen says Roe was a role model for Native At Stanford, the high school valedictorian Roe signed up. American teens as well. Roe, who worked with had struggled. “I was putting in over 100 per- Owen, who is from Alaska, was aware that Native teens through CAIMH’s Health Science cent effort and still not achieving the results,” students like Roe, who come from different Academy one summer, says she wanted to Roe says. Although she learned from the parts of the country or who are members of a communicate a message: “You can be Native experience, by the time she graduated, she minority group, have a lot to deal with when and be in medical school.” questioned her goal of becoming a physician. they arrive in medical school. “Just being from FORWARD MOMENTUM In rugby, you go into a play full force and get buried, but the play Roe’s hard work in Duluth was acknowledged last year when she was awarded Edwin Haller is going on without you, and you have to catch up to help the team. and Eva Victoria Olson, RN, Memorial scholar- You can’t think about your mistakes. You have to keep going. ships. “It’s nice to be recognized,” she says. And with mounting debt, she’s especially You have to be better for the next play. – Sarah Roe appreciative: “Every bit helps to lower the financial burden that all of us face.” “My confidence was rocked. I didn’t know if the West Coast, Minnesota seems foreign,” With the confidence she gained in Duluth, I had what it took.” she points out. “And Native students are from Roe says she’s excited to be in the Twin Cities To test the waters, she decided to complete a group of people who have been stereotyped doing her clinical rotations. And she’s still a master’s program in medical sciences at and misunderstood for forever.” Yet Roe applying the lessons she learned from rugby, the University of South Florida. She did well, !'201"!ǽȊ 1!&!+ȉ11("),+$ "#,/"0%"%! pushing herself to share her clinical opinions so with budding confidence, she started that confidence and was excelling in school,” and not fretting if she’s wrong. As she says, applying to medical schools. Her goal: “I Owen says. “You can’t think about your mistakes. You 4,2)!+ȉ1'201$,1%"/"Ǿ-",-)"4,2)!(+,4 Roe says she simply buckled down and have to keep going. You have to be better M|B who I was. I wouldn’t get lost in the crowd.” worked, and asked for help when she needed for the next play.” it. “There’s so much support and encourage- One application made its way to the Uni- By Carmen Peota, a freelance writer and editor ment from faculty, especially from the Native versity of Minnesota Medical School, Duluth who lives in Minneapolis campus, an unlikely prospect for the sun-lover. American program,” she says. And she loved what she was learning. It all had purpose. “Coming from California and Florida, I was To support Medical School scholarships or to “The two years in Duluth were way beyond really nervous about the weather.” learn more, visit give.umn.edu/p/scholarships what I expected, in a good way,” Roe says. When Roe visited, however, her fears or contact Dan Brasch at [email protected] She took advantage of opportunities such subsided. She was intrigued by the school’s or 612-624-6453. focus on Native American and minority health. as working in the lab of assistant professor

30 MEDICAL BULLETIN FALL 2016 Third-year medical student Sarah Roe’s rugby days taught her not to fixate on her mistakes but to make herself better for what’s next. PHOTO: MOONDOG PHOTOGRAPHY PHOTO: PHOTO: SIGNE SHORES PHOTOGRAPHY PHOTO:

Quite a celebration

Hundreds of University of Minnesota Medical School alumni and their guests came back to campus in September to reunite with their classmates at the annual Alumni Celebration, hosted by the Medical Alumni Society. While all alumni were welcome to attend, the classes of 2011, 2006, 1996, 1991, 1986, 1976, 1966, 1961, and 1956 marked the occa- sion with class receptions. Other highlights included tours of the U’s Visible Heart Lab and SimPORTAL, research presentations by some of the U’s most innovative faculty members, and a Gopher football win over the Colorado State Rams. M|B

WEB EXTRA

See more photos from Alumni Celebration events at give.umn.edu/p/alumni-celebration.

MEDICAL BULLETIN FALL 2016 31 PHOTO: BRADY WILLETTE BRADY PHOTO: Alumni Connections

Medical Alumni Society honors five distinguished graduates

FIVE UNIVERSITY of Minnesota Medical School alumni were honored for their contributions ǽǾǽǽ to the medical profession at the Medical School Alumni Awards Banquet on September 22 at Koop has dedicated his career to children and the McNamara Alumni Center on the University of Minnesota’s East Bank campus. families affected by pediatric musculoskeletal The University of Minnesota Medical Alumni Society has presented these alumni with the disabilities. A member of the Medical School following awards: Class of 1979, Koop founded Gillette Children’s Specialty The Harold S. Diehl Award is granted to The Distinguished Alumni Award recognizes Healthcare’s motion individuals who have made outstanding University of Minnesota Medical School and gait analysis lab, contributions to the University of Minnesota alumni who have made outstanding helping Gillette Medical School, the University as a whole, contributions to their communities — at the become a world and the community. It was established in local, regional, or national level — through leader in caring for honor of the Medical School’s fifth dean, medical practice, teaching, research, or children and young Harold Sheely Diehl, M.D. other humanitarian activities. adults with cerebral palsy and other childhood-onset disabilities. ǽ Ǿǽǽ ǽǾǽǽ He has shared his expertise with Ecuadoran With spirited intelligence and a relentless A member of the Medical School Class of care providers who treat children with com- pursuit of excellence, Miller has been an inno- 1986, Bowers is a renowned transgender plex medical conditions. Also a deacon in the vative leader in medical education at the surgeon and a humanitarian committed to Catholic Church, Koop is known as a conscien- University for four decades. A member of delivering care for marginalized and under- tious, intelligent, kind leader by example. the residency class served communities. of 1977, Miller has Bowers helped to Ǿǽǽ 0%/"!%&0',6,# establish Mount Often touting the fact that she is a “triple learning and expertise Sinai Health System’s Gopher” — having received her undergraduate in evidence-based Center for Transgen- and medical degrees and an executive pro- medicine with stu- der Medicine and gram certificate at the University — Wheeler dents and peers alike. Surgery, one of the has been a champion He has received 12 first of its kind in the for quality care distinguished teach- nation, and helped and patient safety ing awards and has to re-establish the throughout her made time to partake in daily educational transgender surgery program at Sheba Medi- career. Now, as opportunities, even during the seven years he cal Center at Tel Hashomer in Tel Aviv. She president and CEO served the Medical School as Department of also has provided reconstructive surgery to of Allina Health, she Medicine chair. Miller’s colleagues know him as hundreds of women who have experienced is passionate about a skillful, compassionate, hands-on teacher. genital mutilation throughout the world. With putting patients first warmth and skill, Bowers has brought profes- while using data to sionalism to the often stigmatized field of determine their best care. She envisioned and transgender health care. implemented service lines that knit together the continuum of care, decrease waste, and enhance quality. Wheeler, a 1984 graduate of the Medical School, is known for her disarm- ing yet relentless influence.

32 MEDICAL BULLETIN FALL 2016 The loss of a health care innovator

GLEN NELSON, M.D., a University of Minnesota Medical School alumnus who made substantial contributions in The Early Distinguished Career Alumni health care delivery and the medical Award is given to a physician for exceptional device industry throughout his career, accomplishments within 15 years of graduat- died May 14 at age 79. Nelson tirelessly ing from or completing his or her residency at sought to improve health care outcomes, the University of Minnesota Medical School. whether for one patient in his care or the hundreds of thousands who benefit from medical innovation. ǽǾǽǽ After earning his medical degree in 1963, Nelson completed his A member of the Medical School Class of general surgery training at Hennepin County General Hospital (now 2001, Oberstar is an unwavering advocate for Hennepin County Medical Center) in Minneapolis. He practiced children struggling with mental illness. He is surgery for 17 years, including 11 years as chairman, president, regarded as one of the most highly skilled and chief executive officer of the Park Nicollet child psychiatrists in Medical Center. He was also a clinical profes- As a surgeon, the community and is sor of surgery at the University of Minnesota. a scholar in the area you save one life In 1988, Nelson became vice chairman of of evidence-based Medtronic Inc., serving in that role until his at a time, but with child psychotherapy retirement in 2002. Asked to describe the services. In his medical devices, transition from doctor of medicine to business current role as CEO executive, he stated, “As a surgeon, you save you know you of PrairieCare and one life at a time, but with medical devices, are saving so PrairieCare Medical you know you are saving so many more.” Group, he helps to Nelson helped pioneer and lead Medtronic many more. create policies supporting and developing innovations in heart rhythm therapies, from – Glen Nelson, M.D. mental health services for youth, with an pacemakers to defibrillators, heart valves, and overarching goal of expanding these services stents. After retiring from Medtronic, he founded GDN Holdings, for children and adolescents in Minnesota. focusing his expertise on health care start-up ventures. His reputa- Colleagues say Oberstar is considerate, kind, tion as a health care innovator and forward thinker was evidenced and generous with his time. by his abundant board service, which included advising multiple community organizations, academic institutions, nonprofit organizations, and corporations over the years. Scott Ward, chief executive officer of Cardiovascular Systems Inc., called Nelson “an extraordinary world leader in health care. He had boundless enthusiasm to improve the human condition. Whether it was improving the quality of life or saving lives, he knew about cardiac, brain, and spinal cord stimulation; orthopaedics; and cardiology. His interests spanned nearly all of medicine.” Nelson, who received numerous awards for his achievements, was presented with the University of Minnesota Outstanding Achievement Award in 2008 and was named a 2013 Harold S. Diehl Award recipient by the Medical Alumni Society. Nelson is survived by his wife, Marilyn Carlson Nelson; 3 children; 6 grandchildren; and 3 step-grandchildren. M|B

MEDICAL BULLETIN FALL 2016 33 In Memoriam

ǽǾǽǽ, Class of 1959, the practice and teaching of medicine. He was ǽǾǽǽ, Class of 1954, Aptos, Overland Park, Kan., died June 27 at age 82. preceded in death by his first wife, Carol. He is Calif., died June 9 at age 91. Dr. Katkov was in Dr. Appelbaum worked as a federal advocate survived by his second wife, Lynn; 3 children; private practice for many years before becoming for maternal and child health for 37 years. and 2 grandchildren. a staff physician/surgeon at the California He is survived by his wife, Elizabeth; 2 children; Veterans Home in Yountville. He was preceded ǽ Ǿǽǽ, Class of 1945, Fort and 4 grandchildren. in death by his wife, Mary. He is survived by Gratiot, Mich., died July 12 at age 95. Dr. Gholz 4 children and 2 grandchildren. Ǿǽǽ, Class of 1955, Fort was a pediatrician in Port Huron, Mich., for more Collins, Colo., died July 17 at age 88. An ophthal- than 40 years. He was preceded in death by his ǽǾǽǽ, Class of 1946, Minne- mologist, Dr. Boehlke introduced intraocular wife, Heidi. He is survived by 3 sons, 9 grand- apolis, died April 24 at age 93. In 1951 Dr. Lund lens implantation to northern Colorado. He was children, and 8 great-grandchildren. was a founder of the St. Louis Park Medical Cen- preceded in death by 1 daughter. He is survived ter, which ultimately became the Park Nicollet ǽ Ǿǽǽ, Class of 1954, Park Rap- by his wife, Donna; 4 children; 18 grandchildren; Clinic. He was one of the first pediatric cardiolo- ids, Minn., died July 13 at age 89. Dr. Grimes prac- and 6 great-grandchildren. gists in Minnesota and practiced at Minneapolis ticed medicine in Park Rapids for 34 years and Children’s Hospital during its formative years. LOUIS A. BUIE JͬǽǾǽǽ, Class of 1952, Edina, served as the Hubbard County coroner for 4 years He was preceded in death by his wife, Jeanne. Minn., died May 11 at age 88. Dr. Buie served after retirement. He was preceded in death by his He is survived by 2 sons and 2 grandchildren. as chief of staff and chief of surgery at Fairview wife, Jean. He is survived by 5 children, 13 grand- Hospital Downtown and Fairview Southdale Hos- children, and 4 great-grandchildren. ǽ Ǿǽǽ, Class of 1957, pital. He is survived by his wife, Joann; 5 children; St. Paul, Minn., died Feb. 21 at age 83. Dr. Lynch ASHLEY T. HASTI, Class of 2017, Brooklyn Park, 7 grandchildren; and 1 great-grandchild. practiced pathology until his retirement in Minn., died June 2 at age 31. Ms. Hasti was plan- 1996. He is survived by his wife, Jean; 3 children; ǽ Ǿǽǽ, Class of ning to apply to residencies in psychiatry upon and 1 granddaughter. 1957, Laporte, Minn., died June 19 at age 85. her graduation from the Medical School. She is Dr. Christenson was a family practitioner, and survived by her father and sister. ǽǾǽǽ, Class of 1986, Golden later, an emergency physician and medical direc- Valley, Minn., died Sept. 3 at age 56. After work- ǽ Ǿǽǽ, Class of 1952, tor for a nursing home. He was preceded in death ing in Russia, Ukraine, and the Czech Republic, died Aug. 28 at age 89. Dr. Heegaard was a family by 1 daughter and 1 grandson. He is survived by Dr. Meade founded Tiny Tim and Friends, a non- practitioner in Alexandria, Minn., until his retire- his wife, Biddie; 2 children; 3 grandchildren; and profit providing lifesaving treatment for HIV- ment, when he and his wife, Josie, traveled the 1 great-granddaughter. positive children and pregnant women in Lusaka, world, providing health care to underserved Zambia. He is survived by one son, his parents, ǽǾǽǽ, Class of 2002, formerly communities. He was preceded in death by Josie. and 6 siblings. of La Crescent, Minn., died April 14 at age 45. He is survived by 4 children and 10 grandchildren. Ǿǽǽ (see page 33). ǽǾǽǽ, Class of 1954, LEONG Y. W. HOM, Class of 1948, North Bend, Redmond, Wash., died March 20 at age 86. Wash., died April 30 at age 93. Dr. Hom was a ǽǾǽǽ, Class of 1956, Dr. Donaldson was a renowned ear surgeon and family practitioner for 43 years and a founding Spokane, Wash., died June 12 at age 87. Dr. Paul- professor whose 1967 book is still the standard member of the Fergus Falls Medical Group, P.A. son was chief of radiology at Providence Hospital medical school text in its field. He is survived He was preceded in death by his wife, Syen. He in Seattle for 25 years and also served as chief of by his wife, Maylie; 5 children; 13 grandchildren; is survived by 4 sons and several grandchildren. staff. He was preceded in death by 1 daughter. and 5 great-grandchildren. He is survived by his wife, Denise; and 2 sons. ǽ Ǿǽǽ, Class of 1970, JAMES P. DUDLEY JͬǽǾǽǽ, Class of 1957, San Eugene, Ore., died April 9 at age 71. Dr. Jacobson ǽ Ǿǽǽ, Class of 1948, St. Mateo, Calif., died June 5 at age 83. Dr. Dudley practiced obstetrics and gynecology in Eugene Paul, Minn., died June 5 at age 90. Dr. Rholl was was an otolaryngologist in private practice until for 26 years. He is survived by his wife, Linda; a general medical officer in the U.S. Navy for 5 ǖǞǜǛǾ4%"+%"',&+"!1%"# 2)161+&3"/0&16 2 children; and 7 grandchildren. years before completing his radiology residency of California at Los Angeles School of Medicine, +!',&+&+$1%"01##14"!&0% ,0-&1)&+&+- ǽ Ǿǽǽ, Class of 1966, Lake and eventually retired from Kaiser Permanente. neapolis. He is survived by his wife, Lois; 4 chil- Carlos, Minn., died April 28 at age 75. Following He is survived by his wife, Ann; 3 children; and dren; 9 grandchildren; and 4 great-grandchildren. military service as chief of medicine and cardiol- 5 grandchildren. ogy at Irwin Army Hospital in Fort Riley, Kan., ǽǾǽǽ, Class of 1959, Green ǾhǽǽǾǽǽ, Class of 1973, Dr. Jewson was in private practice until 2000. Cove Springs, Fla., died May 28 at age 82. Dr. Russ Springfield, Ill., died Feb. 5 at age 73. Dr. Freitag He is survived by his wife, Diane; 5 children; spent the first part of his medical career as a gen- was an orthopaedic surgeon who loved both 10 grandchildren; and 2 great-grandchildren. eral practitioner in small Minnesota towns. In 1974 he completed a fellowship in therapeutic

34 MEDICAL BULLETIN FALL 2016 radiology and spent the remainder of his career ǽǾǽǽ, Class of 1943, working as a radiation oncologist. He is survived Moorhead, Minn., died June 28 at age 96. by his wife, Carolyn; 3 daughters; 7 grandchil- Dr. Covey began his medical practice in dren; and 4 great-grandchildren. Mahnomen, Minn., serving as the county’s only physician. After completing an orthopaedic ǽ Ǿǽǽ, Class of surgery fellowship at the Mayo Clinic, he prac- 1978, Edmond, Okla., died Feb. 19 at age 63. ticed in Crookston and Moorhead. Dr. Covey Dr. Schwendeman was a family practitioner established free clinics for Mexican-American who became board certified in aerospace and migrants, volunteered at free clinics for children, occupational medicine and worked for the Fed- and established health clinics for the homeless in eral Aviation Administration Civil Aerospace Med- Fargo and Moorhead. He received the Harold S. Diehl Award from the ical Institute. He is survived by his wife, Becky; Medical Alumni Society in 1985 and in 1992 shared a McKnight Human 1 son; and one grandchild. Service Award with his wife, Grace, who preceded him in death. He is ǽǾǽǽ, Class of 1982, survived by 5 children, 11 grandchildren, and 9 great-grandchildren. Dubuque, Iowa, died June 7 at age 59. In 1986 /ǽ,/"+0,+',&+"!2 2.2" +1"/+)"!& &+" RICHARD A. D͟Ǿǽǽ, Class of 1952, as its first female internist. She is survived by Appleton, Minn., died Aug. 15 at age 89. In 1955 her husband, Allen Meurer; and 2 children. Dr. DeWall cocreated the first workable, portable bubble oxygenator, which quickly became the JOHN M. STREITZ ͬǽǾǽǽ, Class of 1951, model used around the world for open-heart Duluth, Minn., died April 15 at age 90. Dr. Streitz surgery. Dr. DeWall served as chair of the surgery practiced urology at St. Mary’s and St. Luke’s department at Chicago’s Mount Sinai Hospital hospitals, serving as chief of staff at both. from 1962 to 1966, and then moved to Dayton, He also taught at the University of Minnesota Ohio, where he began the open-heart surgery Medical School, Duluth campus from 1972 until program at Kettering Hospital. Sensing a growing his retirement in 1992. He was preceded in death need for doctors in Dayton-area hospitals, he enlisted support for the by his wife, Patricia. He is survived by 5 children creation of the School of Medicine at Wright State University. He also estab- and 10 grandchildren. lished the general surgery residency training program at Kettering, serving ǽǾǽǽ, Class of 1958, as its director from 1970 to 1976. A prolific inventor who paved the way for Stanford, Calif., died Feb. 12 at age 82. Dr. Swenson many medical innovations, Dr. DeWall will be remembered as a true vision- was a nephrologist at Stanford Medical School ary. He is survived by his wife, Diane; 3 daughters; and 7 grandchildren. when he performed the first kidney transplant on the West Coast. In 1989 he was appointed chief of ǽ Ǿǽǽ, Class of 1955, Minneap- staff at the Livermore VA Hospital. He is survived olis, died July 8 at age 86. Dr. White spent more by his wife, Carol; 2 daughters; and 4 grandchildren. than 50 years working at the University of Minne- sota, specializing in hematology research until ǽǾǽǽ, Class of 1961, his retirement in 2014 as a Regents Professor. Palm Desert, Calif., died March 27 at age 79. Acknowledged widely as the top platelet doctor Dr. Welcome was a surgeon in the U.S. Air Force in the world, he pioneered the use of the electron "#,/"',&+&+$1%"/2**,+!"!& ) /,2-+! microscope to study platelets and was responsi- operating at Ridgecrest Community Hospital )"#,/*',/ /"(1%/,2$%0&+1%"1/"1*"+1 for 28 years. He was preceded in death by 1 son. of bleeding and clotting disorders. Dr. White He is survived by his wife, Mary; 2 sons; and received numerous awards throughout his life, including the Harold S. Diehl 3 grandchildren. Award from the Medical Alumni Society in 2005 and the Hemostasis and Thrombosis Research Society Lifetime Achievement Award in 2013. He was preceded in death by 2 sons. He is survived by his wife, Mary; 3 children; and 6 grandchildren.

MEDICAL BULLETIN FALL 2016 35 A Look Back

SERVING A GLOBAL COMMUNITY At 50, CUHCC CUHCC has evolved a lot since its 1966 inception, 4%"+&1 "$+0-&),1-/,'" 1&*"!1-/,3&!&+$ pediatric medical and dental care to the then- meets more needs predominantly American Indian community in the Phillips neighborhood. Today, CUHCC provides comprehensive team- than ever based care —+,1'201*"!& )+!!"+1)Ǿ 21)0, mental health services, pharmacy, victim advocacy, legal services, education, and now, care coordina- The south Minneapolis WHAT DOES SENSITIVE, patient-focused, culturally tion — to nearly 11,000 patients from numerous clinic provides competent health care look like? Roli Dwivedi, M.D., countries, cultures, and faith traditions. medical director of the Community University Health “Our patients have complex medical and psycho- comprehensive team- Care Center (CUHCC), tells a story: “The other day, a social needs,” says Dwivedi. “We are committed to based care for a richly medical student and I were seeing a Somali patient. being present in their lives, even when they leave diverse, primarily She came in for pelvic pain and headache,” Dwivedi the clinic.” says. Conferring with Dwivedi outside the exam low-income patient %"+0%"',&+"! &+ǗǕǕǞǾ1%"/"4"/"+, room, the student suggested certain tests to care coordinators on staff. Their addition has been population explain her symptoms. hugely important, Dwivedi says. “The psychosocial But Dwivedi had sensed anxiety in the patient. care coordinator, for example, can go and assess the “I went back into the room, and I started asking patient’s living situation. That helps a lot in figuring more questions. My sense was, she is trying to things out.” Patients feel more secure, she adds, conceive and she is not able to. So I asked, ‘Are knowing that they can reach out to an entire team. you trying to conceive?’ And she said, ‘Yes. I think CUHCC is one of the largest primary care teach- it may be my mind that is causing these symptoms, ing sites in Minnesota, providing work and educa- because I am unable to get pregnant.’ tional opportunities for nearly 300 students and “In Somali culture, being able to conceive is residents from medicine, dentistry, pharmacy, very important,” Dwivedi explains. And for Dwivedi, nursing, social work, and public health each year. really seeing the patient had revealed clues that Fourth-year medical student and aspiring didn’t emerge initially. It’s the kind of interaction psychiatrist Kelly Setterholm describes her recent that can transcend language — and many languages monthlong CUHCC rotation as transformative. are spoken at CUHCC. “I learned a lot of the usual primary care stuff, The south Minneapolis clinic, celebrating its like how to help patients manage chronic disease. 50th birthday this year, serves a richly diverse, But at CUHCC, you also learn so much more,” she primarily low-income patient population. Its multi- says. “What are the intricacies of providing good disciplinary team includes staff interpreters who patient care to a Somali patient versus a Hmong speak Hmong, Lao, Somali, Spanish, and Vietnam- patient? Culturally appropriate care, trauma care — ese. The staff is diverse, too, and largely bilingual. these are hard to grasp in the classroom. At CUHCC, it’s alive, it’s happening right in front of you.”

CUHCC’s first 1966 Early ’70s 1975 CUHCC, Minnesota’s first A comprehensive mental An adult medical program half century community health center, health program and a is added to serve pediatric is founded by the U of M growing focus on cultur- patients’ parents. 0-&),1-/,'" 1#,/ ally appropriate care pediatric health and mark the new decade. dental care for low-income, predominantly American Indian families in south Minneapolis. 36 MEDICAL BULLETIN FALL 2016 2)12/)0"+0&1&3&16 is paramount to 1/201&+$!, 1,/Ȓ patient relationships 1 Ǿ060 medical director ,)&4&3"!&Ǿǽǽ COORDINATED CARE FOR PEOPLE WITH DIABETES

A $50,000 grant from the Medtronic Foundation is boost- ing CUHCC’s use of coordinated care to help people who have diabetes improve their health. Strategies include: Assigning a care coordinator to each patient for up to a year. PHOTO: SCOTT STREBLE SCOTT PHOTO: Developing a diabetes action plan for each patient. What are the intricacies of providing good patient care to a Somali patient vs. a Connecting patients with Hmong patient? Culturally appropriate care, trauma care — these are hard to grasp pharmacy residents who will customize medication in the classroom. At CUHCC, it’s alive, it’s happening right in front of you. plans as needed. – Kelly Setterholm, fourth-year medical student Providing support such as transportation assistance, interpretation, smoking cessa- ‘ACCESSING PATIENTS’ LIVES’ Dwivedi believes “everything is in place” at tion, legal services, and mental CUHCC to deliver the best possible care to the com- Setterholm spoke of one patient, a man whose health case management. physical health challenges were compounded by munity, but she hopes to expand the facility so the Helping patients to complete homelessness, depression, and substance abuse. team can serve more patients, more efficiently. “We MNSure insurance applications In collaboration with his CUHCC psychiatrist, she could meet more patients’ needs if we had a bigger and renewals. and other medical staff were able to help him structure. Otherwise, all the ingredients are here.” improve his emotional state. And that makes Dwivedi excited to come to work “The people at CUHCC, they are positive, they every day. “I feel like I did another residency when are flexible, they are kind, they are willing to try ',&+"! ǽ 1%&+(&+1%"#212/"Ǿ*,/"-/,3&!"/0 new things. And they’re so good at accessing will be interested in primary care if we can show -1&"+10ȉ)&3"0Ǿȋ"11"/%,)*060ǽȊ,1'2011%" them how this model works. I tell my patients, docs, but also the nurses, the nurse practitioners, ‘I’m on your side, I want to walk with you so that the interpreters, the scheduling staff. It’s so impor- you feel supported.’” M|B tant to have caring providers from all of these By Susan Maas, a freelance writer who lives disciplines under one roof.” in Minneapolis

Early ’80s 1991 Mid ’90s 2012 Demographics evolve CUHCC moves into its East African and Latino The clinic adds medical with the arrival of South- current building at 2001 arrivals add to the neigh- and psychosocial care east Asian and other Bloomington Avenue. borhood’s diversity. coordination. immigrants. Nonprofit Org. U.S. Postage PAID McNamara Alumni Center Twin Cities, MN 200 Oak Street SE, Suite 500 Permit No. 90155 Minneapolis, MN 55455-2010 give.umn.edu

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