A MAGAZINE FOR ALUMNI AND FRIENDS OF THE UNIVERSITY OF SCHOOL OF MEDICINE VOL. 35, NO. 1 SPRING 2012

WWAMI: THE BIG PICTURE

ALSO IN THIS ISSUE The Heart of the Matter

Occupying Wall Street What does it take to deliver world-class YOUR BELIEFS. ? It takes you. YOUR VALUES. YOUR GIFT.

Letters to the editor. UW Medicine welcomes your letters. Please email [email protected] or send mail to: UW Medicine Magazine UW Medicine Alumni Relations Box 358045 , WA 98195-8045 Letters may be edited for length or style.

Going green. Rather read UW Medicine on the web? Want to save resources? Send your full name and email (and your spouse’s or partner’s name and email) to [email protected]. LABELLINGMention the GUIDE LANDSCAPE LABEL EDITABLE EPS ARTWORK MATRIX magazine. Next time, you’ll get an few years ago, John Olerud, M.D. ’71, email notification rather than a print Res. ’76, ’78, and his wife, Lynda, created a publication.FSC Label Thank Artworkyou! FSC_Labels_Landscape Aprofessorship to support training. And they recently decided to use part of their retirement account to augment it. FSC_Labels_LPC FSC_Labels_LPBW FSC_Labels_LNC FSC_Labels_LNBW Landscape / Positive / Colour (LPC) Landscape / Positive / Black & White (LPBW) Landscape / Negative / Colour (LNC) Landscape / Negative / Black & White (LNBW) “We both believe very deeply in higher education and training,” says Olerud, the head of UW Medicine’s Division of Dermatology. “When we’re not here anymore, we want a FSC_100_LPC.EPS FSC_100_LPBW.EPS FSC_100_LNC.EPS FSC_100_LNBW.EPS FSC_100_LPC.TIFF FSC_100_LPBW.TIFF FSC_100_LNC.TIFF FSC_100_LNBW.TIFF portion of what we’ve accumulated in our lifetimes to go to Cert no. XXX-XXX-XXXX FSC_100_LPC.JPG Cert no. XXX-XXX-XXXX FSC_100_LPBW.JPG Cert no. XXX-XXX-XXXX FSC_100_LNC.JPG Cert no. XXX-XXX-000 FSC_100_LNBW.JPG something we really value.”

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9 PRODUCT LABELING GUIDE FOREST STEWARDSHIP COUNCIL A magazine for alumni and friends of the School of Medicine

Contents VOL. 35, NO. 1 I SPRING 2012

FEATURES WWAMI: The Big Picture. What our five-state medical education program is doing for your town, your region and your world...... 7

The Heart of the Matter. Patients are pioneers in this stem cell medicine/transplant venture...... 20 7 MEDEX Northwest: Coming Home to Wenatchee ...... 23 DEPARTMENTS Message From the Dean ...... 3 Message From the President of the UW Medicine Alumni Association ...... 4 News From UW Medicine ...... 5 Alumni and Student News ...... 24 ClassNotes ...... 27 Student Voices: Occupying Wall Street ...... 34 Passages ...... 35

Visit UW Medicine magazine on the web for »

20 • UW Medicine Salutes Harborview: slideshow and videos • Original Instructions • Researching Better Care in Yakima • The Road to Browning, Montana, and other WWAMI stories • Bridging the Gap Between Science and Patients

• And more at uwmedmagazine.org.

34

SPRING 2012 1 UW MEDICINE

Dean’s Office UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE Paul G . Ramsey, M D. . CEO, UW Medicine Executive Vice President for Medical Affairs and Dean of the School of Medicine, University of Washington Lynn K . Hogan, Ph D. . Chief Advancement Officer, UW Medicine, and Associate Vice President for Medical Affairs, University of Washington lhogan@uw .edu

UW Medicine Alumni Association EXECUTIVE COMMITTEE President Trish A . Raymer, M .D . ’89, Res . ’92 Past President Raymond E . Vath, M .D . ’65, Res . ’69 Ex Officio Werner E . Samson, M .D . ’53, Res . ’58, Faculty Liaison Ramoncita R . (Raye) Maestas, M .D . ‘83, Res . ‘86, Dean’s Liaison

UW Medicine Alumni Relations Director Annie Pontrelli pontrell@uw edu . Coordinator Lee Hill leejhill@uw edu .

MEDEX Northwest Alumni Association medexalu@uw .edu Division Chief Ruth Ballweg, PA-C, MPA rballweg@uw .edu Program Director Terry Scott, PA-C tscott@uw .edu

UW Medicine Magazine uwmedmagazine .org Editor Delia Ward deliamw@uw .edu Feature Writers Brian Donohue, Elisa Murray, Deirdre Schwiesow Graphic Designer Ann Wolken Web Designer Michael Dommer Photographers Clare McLean, Deirdre Schwiesow Production Manager Anne Totoraitis Contributors Caroline Anderson, Steven Campbell, Carole Fisher, Jennifer Hazelbrook, Lee Hill, Lilith Lysistrata, Sally Mantz, Annie Pontrelli, Marsha Rule, Anne Totoraitis, Marjorie Wenrich and UW Medicine Strategic Marketing & Communications Printing Coordinated by University of Washington Creative + Communications

Phone: 206 685 1875. . Toll free: 1 .866 .MED .ALUM (1 .866 .633 .2586) Fax: 206 685 9889 . . Email: medalum@uw edu . Web: www uwmedalumni. org . www .supportuwmedicine .org Address: UW Medicine Advancement Box 358045 Seattle, WA 98195-8045 < Messages

MESSAGE FROM THE DEAN Photo: Clare McLean In this second special UW Medicine issue celebrating the 40th anniversary of WWAMI, some of the many ways in which WWAMI positively affects the UW School of Medicine, the region and the world are explored . When WWAMI began, research was not part of the program’s activities . Today, faculty at the UW School of Medicine and WWAMI faculty region-wide are engaged in remarkable collaborations, as described in “Taking Research to the Community .” Also, when WWAMI started, there were no indications that the program would become a model for training healthcare professionals in the developing world . “A New Vision for Kenya” describes how that is occurring in one African nation . The founders had a major goal for WWAMI: ensuring an adequate healthcare workforce for the region . Maintaining medical students and residents to practice in the region was pivotal to meeting this goal . The presence of second-generation WWAMI students and graduates, as described in “Sons and Daughters of WWAMI” speaks to the success of the program in achieving this original objective and marks a wonderful family “tradition .” Ten years from now, when we celebrate its 50th anniversary, WWAMI will have changed and evolved in countless additional ways to meet the needs of the region — and the world . WWAMI is truly a wonderful program with far-reaching impact . Please join us in celebrating 40 years of partnership and service to the region .

Paul G . Ramsey, M .D . CEO, UW MEDICINE EXECUTIVE VICE PRESIDENT FOR MEDICAL AFFAIRS AND DEAN OF THE SCHOOL OF MEDICINE, UNIVERSITY OF WASHINGTON

SPRING 2012 3 Messages >

MESSAGE FROM THE PRESIDENT OF THE

Photo: Team Photogenic Photo: Team UW MEDICINE ALUMNI ASSOCIATION

The Space Needle . Urban Enoteca . Woodland Park Zoo . And, of course, your terrific classmates . This is no ordinary reunion — this is an extraordinary reunion! And I expect and hope to see you here the weekend of June 1–3 . The fun begins on Friday with lunch for the members of the 50-Year Association at the Shilshole Bay Beach Club — or, if you haven’t yet celebrated your 50th reunion, meet us at Urban Enoteca for some wonderful wines and a chat on heart health . The next day, Saturday, is full of great events: a lunch THE UW MEDICINE lecture about genetics and personalized medicine, a trip to the zoo with the ALUMNI ASSOCIATION’S kids for our more recent classes, and some fabulous tours . MISSION STATEMENT The absolutely can’t-miss event? A reception at the Space Needle on Saturday night . And then a last hurrah at brunch on Sunday . Support the University Be part of the best reunion ever . To register or to learn more, visit of Washington School www .uwmedalumni .org/reunion, or contact the alumni relations office at 1 of Medicine in the 206 .685 .1875, 1 .866 .633 .2586 or medalum@uw .edu . See you in June! fulfillment of its mission, Regards, serving as diplomats and advocates in the com- munities where medical alumni live and work.

Provide support for Trish A . Raymer, M .D . ’89, Res . ’92 (family medicine) students, residents PRESIDENT, UW MEDICINE ALUMNI ASSOCIATION 2and fellows at the UW School of Medicine through programs, schol- arships, fellowships and financial contributions. P S. . Want to be more involved in your alumni association? Visit www uwmedalumni. org. to check out Trish’s video Establish and maintain message (and opportunities to volunteer), or contact a sense of unity among our alumni relations staff at 206 685. .1875, toll free 3alumni. 1 .866 .633 .2586 or medalum@uw .edu .

4 UW MEDICINE < News From UW Medicine

ties . The Level 1 designation was created by the new Washington State Emergency For more news from UW Medicine, please visit uwmedicine.org. Our Cardiac and Stroke System, which also website also provides a wealth of information regarding health services establishes Level 2 Primary Stroke Cen- and other resources — and, while you’re there, sign up for the ters and Level 3 Acute Stroke Capable Twitter feed. designations . These facilities include UW Medicine’s Valley Medical Center (Level 2) and UW Medical Center (Level 3) .

Robotic surgery helps defeat Research given the retroviral protease problem, it liver cancer took them only a few days to develop a UW study reports Generally speaking, the less invasive a solution of sufficient quality to support evidence of struc- surgery, the faster a patient’s recovery scientific work . David Baker, Ph .D ., tural brain changes time . At UW Medical Center, James Park, UW professor of biochemistry and in diet-induced M .D ., became the first surgeon in the adjunct professor of bioengineering, was obesity Pacific Northwest to use the da Vinci among the authors of the study . Results The tendency to surgical robot — a high-precision instru- were recently published in Nature Struc- regain weight lost ment that drastically reduces the area of tural & Molecular Biology . Read more at through dieting and incision — to remove part of a liver in a nature .com/nsmb/ (search for “foldit”) . exercise is the single patient with cancer . Learn about one of Or play Foldit at fold .it . largest obstacle to successful obesity Dr . Park’s recent cancer cases; visit treatment . Body weight is controlled by king5 .com, and search for “Colehour .” Insulin spray and complex interactions between hormones Alzheimer’s and neurons in the hypothalamus . American Academy of disease Michael W . Schwartz, M .D ., Res . ’86, Sleep Medicine honors In a small study UW professor of medicine, director of UW Medicine conducted by the UW Medicine Diabetes and Obesity Sleep Center UW researchers, Center of Excellence and the Robert H . The American Acad- insulin supplied Williams Endowed Chair in Medicine, emy of Sleep Medicine through a nasal spray and his colleagues studied the results of (AASM) has named the was found to help slow the progression a high-fat diet in the brains of mice and UW Medicine Sleep Center of Alzheimer’s disease . The study was rats . They found evidence of very early at Harborview Medical undertaken by Suzanne Craft, Ph .D ., and lasting injury to a specific part of the Center an Academic Program of UW professor in the Department of hypothalamus in these animals . Using Distinction — one of six in the country Psychiatry & Behavioral Sciences, and her brain imaging, they also found signs to be so designated . The center has the colleagues at the Veterans Affairs Puget of similar damage in the same area of only Accreditation Council for Graduate Sound Health Care System . The research- the brain in obese humans . Their paper, Medical Education-accredited sleep fel- ers tested people with Alzheimer’s before “Obesity Is Associated with Hypothalmic lowship program in a four-state region, and after the trial for memory, cognition Injury in Rodents and Humans,” was and it educates medical students, resi- and functional ability . Of those receiving published in the Jan . 3, 2012 issue of the dents and fellows about sleep medicine insulin rather than a placebo, two-thirds Journal of Clinical Investigation . diagnosis and treatment . Diagnostic and to three-quarters showed improvement . treatment services also are offered at A larger study is scheduled to begin in Gamers help unlock UW Medical Center and several summer 2012 . the structure of an UW Neighborhood . HIV protein Top Doctors Retroviral protease is Patient Care a protein that is key Many UW School to the reproduction Harborview and Northwest: of Medicine of HIV . Scientists have Level 1 Stroke Centers faculty members spent years trying to deci- The Department of Health and the state were selected for pher its crystal structure, a first of Washington have designated Harbor- Seattle Magazine’s step in developing therapies that might view Medical Center and Northwest Hos- “Top Doctors 2011 .” stop the protein’s growth . Now they have pital & Medical Center as Level 1 Stroke Visit seattlemag .com taken a giant step forward through the Centers . The hospitals are two of only to browse under the “Seattle’s development of Foldit . This video game, four facilities in King County to qualify as Best” section . designed by UW faculty, challenges spa- Level 1 Stroke Centers: comprehensive tially savvy players to design and predict centers that excel in treatment and in protein structure . When gamers were providing treatment-related and educa- tional resources for other regional facili-

SPRING 2012 5 News From UW Medicine >

Education Notable An invitation to the arts Local doctors, local legends The School’s student affairs office invites A number of Washington physicians you to experience Arts in Medicine, a (alumni, faculty or both) were nominated collaboration among medical students, by members of Congress and honored as faculty and staff interested in promoting local legends by the National Library of the arts within our community, including Medicine as part of a larger celebration visual arts, writing, music and other art of female physicians . Our congratulations forms . Visit the site at depts .washington . to Margaret D . Allen, M .D . (cardiotho- edu/artsmed . racic surgery/tissue engineering), Wylie G . Burke, M .D . ’78, Res . ’81, Fel . ’82 Students have research and ( and medical genetics), community impact through Ann C . Collier, M .D ., Res . ’81 (internal investigative projects medicine), Carla J . Greenbaum, M .D ., Before they graduate, all M D. . students Res . ’84 (family medicine), Gail P . Jarvik, must complete an independent investi- M .D ., Fel . ’91 (medical genetics), Ramon- gative inquiry (III), a research or service cita R . (Raye) Maestas, M .D . ’83, requirement that provides them with Res . ’86 (family medicine), Bonnie W . the opportunity to ask — and answer — Ramsey, M .D ., Res . ’79 (pediatrics), and Ravenna photo: Clare McLean questions related to practicing medicine . Christina M . Surawicz, M .D ., Res . ’76, New UW Medicine clinics open in Family, friends and faculty saw the fruits Fel . ’80 (internal medicine) . Ravenna and Northgate of the III at a poster session held Nov . UW Medicine recently opened its eighth 17 . Many students’ posters came out of Saluting Harborview and ninth community clinics: one in longitudinal learning experiences under- With the Western Ravenna, one in Northgate . The taken over the summer, either through Washington Toyota UW Neighborhood Clinics provide the Rural/Underserved Opportunities Dealers Association primary-care services in several locations Program or the Global Health Immersion as our presenting around the greater Seattle area: Bell- Program . These programs give students partner, the 20th town, Factoria, Federal Way, Issaquah, hands-on training in service projects anniversary of UW Kent-Des Moines, Shoreline and Wood- in rural, urban underserved or global Medicine Salutes Harbor- inville . The clinic system receives high communities . The posters reflected view was celebrated in style on February marks; it has earned four consecutive many timely issues in healthcare: from 25, 2012 . The sold-out room — includ- perfect accreditation scores for meet- educating communities about diabetes, ing co-chairs Jeffrey and Susan Brotman, ing nationally recognized standards of to preventing falls in the elderly, to ma- Steve and Connie Ballmer, Bill and Mimi healthcare from the Accreditation laria, to contraception and unintended Gates, and Erik and Julie Nordstrom — Association of Ambulatory Health Care . pregnancies, to head injury/head safety helped UW Medicine raise more than in teen sports . $1 .6 million for Harborview’s mission of caring, the commitment shared by all WWAMI UW Medicine physicians and staff to provide the best care to everyone, Celebrating 40 years WWAMI’s 40th anniversary: we celebrat- regardless of their ability to pay . See ed it in the last issue, and in this issue, photos and videos from this inspirational too, with stories about the students, event at uwmedmagazine org. . faculty and community members who make it innovative and successful . See our coverage, beginning on page 7 . Correction from the fall 2011 edition The infographic accompanying the WWAMI story on page 17 in the last issue, titled “do residents return to their state of origin to practice?,” was titled incorrectly . It should have read: “do residents return to the state where they completed their residency to practice?” The answer to the latter, correct question is “yes” — and usually at a rate higher than the national average!

6 UW MEDICINE < Feature

WWAMI: THE BIG PICTURE

n the fall issue, we set out to celebrate On the following pages, we continue to celebrate the the WWAMI program, which turned program’s 40th anniversary by looking at the big picture: I40 in 2011. WWAMI is an innovative, responsive what WWAMI is doing for our communities and our world. program, one whose core objective has held steady: to train Activities such as training and encouraging medical students. primary-care physicians and other healthcare personnel from Fostering community-based research. And changing health- and for a five-state region — Washington, Wyoming, Alaska, care here — and in Africa! We also interviewed several Montana and Idaho. Especially in areas with too community leaders in WWAMI to get their take on the few physicians. program. Enjoy!

SPRING 2012 7 WWAMI Turns 40 > Continuity,Community & TRUST by Elisa Murray

efore Vanessa Maycumber started program to Idaho and Alaska. Suzanne their “continuity community,” a rural her first year at the UW School Allen, M.D., MPH, co-director of health site to which they are assigned Bof Medicine, she spent two TRUST and vice dean for regional for the duration of medical school. weeks shadowing a family physician at affairs, explains that TRUST’s aim is A TRUST student’s continuity Blackfeet Community Hospital in to increase the number of primary-care community — along with receiving Browning, Mont. physicians working in rural or under- While her soon-to-be peers were served areas. packing and spending time with “The notion friends, Maycumber was acquiring was to create a clinical experience, meeting the family special track… physician who would be her preceptor, that would really and learning about a community she encourage students would repeatedly return to over the to go into rural course of her medical-school career. medicine,” says Allen. The TRUST program Maycumber is one of a select group Strength in of UW School of Medicine students continuity who are part of a four-year-old program The program called TRUST (the Targeted Rural seeks interested Underserved Track). TRUST offers a students, especially comprehensive curriculum, a support those from rural network and clinical experience for and underserved students interested in practicing communities. rural medicine. Once accepted, Maycumber Photo courtesy of Vanessa students spend up Started in Montana in 2008, the As a second-year TRUST student, Vanessa Maycumber track is now also available for rural-fo- to two weeks prior spends a great deal of time learning about medicine in her cused students in Western and Eastern to entering medical home state, Montana, where she will return to practice . In the background of this photo: St . Mary Lake, Glacier Washington, with plans to expand the school, as May- cumber did, in National Park, Mont .

WENDY P. NOTABLE CURRAN She’s the former executive director of the Wyoming Medical Society . Senior Director, QUOTABLE Planning and “Being a doctor and having to go it on your own in a rural community is difficult . Program Rural physicians put in a lot of time . And being on call and being so remote causes Development, even more stress and strain . When practicing physicians in rural areas become Blue Cross Blue involved in WWAMI’s educational process, they get inspired again . Training someone Shield of Wyoming reinvigorates them . It reminds them of why they chose to practice in a rural area .” Cheyenne, FINAL WORDS Wyoming “The WWAMI success story and success model sells itself .”

8 UW MEDICINE < WWAMI Turns 40

consistent mentoring at the site — are In the community cornerstones of the TRUST experi- Maycumber says that ence. “For students to be able to go working alongside fam- back to that same community for all ily medicine physicians four years of medical school is extreme- in Browning is helping ly important,” says Allen. her understand the daily It gives them a taste of the kinds decisions and chal- of relationships doctors can form with lenges of rural medicine. patients, given time. “The students see “One of many things patients when they are having a new I’ve learned is the im- child and they see that same family portance of networking when someone is diagnosed with with other physicians in cancer,” Allen says. neighboring towns,” she says. “Even if you don’t Students visit their community at have all the resources, least two other times during their first you have colleagues in Photo courtesy of Hans Hurt and the Department Family Medicine year and for their four-week R/UOP other towns that you experience. (R/UOP is the Rural/ can call.” Medical student and TRUST program participant Hans Underserved Opportunities Program, Hurt helped treat patient Sharon Mills after she slipped which takes place during the summer Part of the student and fell while holding a screw . between the first and second year.) experience is learning During third year, students return about a community. During Maycum- for their most in-depth experience: a ber’s R/UOP experience, for instance, experience with one community, have 20-week WRITE rotation (WWAMI she attended a Blackfeet sweat lodge, established relationships with patients, Rural Integrated Training Experience), a traditional cleansing ceremony. “It gotten more hands-on rural training which includes clinical experiences in helped me experience some aspects of than the average student, and had most elements of primary care, from their tradition,” she says. extra classes in rural medicine.” family medicine, to psychiatry, to KayCee Gardner, a fourth-year It’s clear the students value pediatrics. student and one of the first TRUST TRUST — and the program’s adminis- Other components of TRUST students to graduate, will start a family trators will be evaluating its progress. medicine residency in Billings next include required rural health elec- “We don’t have a lot of data points year. She says that the decision to tives, participation in the School’s yet,” says Allen. “But we’re very hope- apply to TRUST was one of the best Underserved Pathway program, career ful that it will accomplish what we choices she’s ever made. counseling and residency assistance. plan — the production of a larger rural “I’ve learned so much,” she says. healthcare workforce across our five- “I’ve been able to have this continual state region.” 

ALAN KAHN NOTABLE He’s a Montana businessman who believes in the power of community . Trustee, DII Asbestos QUOTABLE PI Trust “The education and return of Montana students — that’s an obvious benefit of WWAMI . Bozeman, What’s often overlooked is the specialty care available to Montana residents . For instance, Montana a friend had a terrible accident; his feet were badly cut by a pasture mower, and he was airlifted to Harborview . We didn’t know if he’d walk again, but they were able to provide expert care in multiple disciplines . He couldn’t have gotten that variety in expertise here . After several surgeries in Seattle, he’s fully recovered .”

FINAL WORDS “I’m grateful that we have WWAMI . I’m grateful Montana’s a part of it .”

SPRING 2012 9 WWAMI Turns 40 >

TEACHING FOR KEEPS by Delia Ward

e prepared.” It should be a Day one, minute one The bet, says McEchron, seems motto for teachers as well as Boy Wyoming was the fifth state to to be paying off; approximately 66 “BScouts. Especially if the teacher become part of the WWAMI program, percent of Wyoming’s students return thinks the student may faint during joining the multi-state medical educa- to Wyoming to practice. (The national instruction. tion program in 1996. Robertson is one mean for medical-student returns is Kenneth Robertson, M.D., FACP, of a number of teachers who’ve been 39 percent.) an internal medicine specialist/hospi- involved in the program from the start, teaching first-year medical students The pull of Wyoming talist, remembers showing a medical Wyoming attracts people like student how to insert a central line what they need to know before they head off to the University of Robertson. He loves the state for its in the intensive care unit at Ivinson small communities, its open spaces; Memorial Hospital in Laramie, Wyo. Washington’s Seattle campus for their second year. he’s a rancher and a hunter, as well as “You take this big, huge long needle a doctor and teacher. Other people are equally invested and go deep into the upper chest, Pamela J. Langer, Ph.D., an associ- under the clavicle, and put a catheter in the WWAMI program, says Matthew D. McEchron, Ph.D., assis- ate professor of molecular biology at into the subclavian vein. Then you the University of Wyoming, also felt float a catheter close to the heart. And tant dean of WWAMI medical educa- tion at the University of Wyoming. the pull of the outdoors. “I’ve always I looked around at the student and wanted to live somewhere close to said, ‘You’re OK with this, right?’” Namely, doctors, politicians, the Wyoming Medical Society and com- mountains, so I didn’t have to drive six She said she was fine, but Robert- munity members. “People were com- hours to get there,” says the Phila- son wasn’t surprised when she passed mitted to the idea from the beginning, delphia native. And, like Robertson, out moments later. Trainees don’t and a lot of people were involved in she likes the close-knit, supportive get enough sleep, or they forget to getting things started,” he says. community of Laramie, evident even eat — or the medical procedure is a to casual visitors. The state is betting that students little grisly. It happens. “We were kind Langer, who researches the proper- of ready for it,” he says. educated in Wyoming will return there to practice, and the stakes are high. ties of spider silk for potential medical Robertson is an instructor for the Wyoming has few big cities, and applications, is an adventurous teacher. WWAMI program at the University of population centers are scattered, so More than once, she’s used theatre Wyoming. Having spent several years it’s hard to draw in medical special- as a teaching aid. For instance, she as a preceptor, he now teaches an in- ists — the population has to be large recently had undergraduate students troductory clinical medicine course to enough to support a practice. And, act as enzymes and receptors in order first-year medical students. Robertson as in other rural communities in to come to a fuller understanding of relishes his association with teaching WWAMI, it can be hard to recruit a biochemical process implicated in and with the WWAMI program. and retain general practitioners. It’s cancer. “If you treat information in a “I’ve been involved since day one, difficult being the only doctor for different media, I think you understand minute one,” he says. miles around. it in a different way,” she says.

10 UW MEDICINE < WWAMI Turns 40

And, of course, each class brings and the former executive director something to the learning environ- of the Wyoming Medical Society, is ment. Last year, says Robertson, his delighted by the program’s progress. class was very lively. “I couldn’t go five An early advocate for the development minutes without getting 10 questions of the WWAMI-Wyoming program, about something,” he says. This year, she remembers the moment when she he says, the students were quieter, heard a student say he’d been inspired more laid-back. to pursue medicine by a WWAMI Regardless of class temperament, graduate in his hometown. “I’ve come there’s a real benefit to having a class full circle,” she said to herself, “where Ken Robertson, M .D ., FACP, wears of just 20 first-year students at each the people who started the program are many hats: rancher, doctor and first-year WWAMI university. The recruiting students.” teacher among them . He was one of the first people to sign up to teach small, integrated setting is what On a different note, she says that Wyoming students are used to, Rob- she sees a decided shift in what

Photos (including previous page) courtesy of Kenneth Robertson, M.D., FACP first-year medical students at the WWAMI-Wyoming program . ertson says; it’s a reassuring start to WWAMI doctors want. Students medical school, one that teachers hope educated in earlier years were rugged will help cement the students’ rela- individualists who wanted to run their If Langer is motivated to teach, it tionship with the community and pull own businesses. Today’s doctors, says is, in part, because her students — in- them back to Wyoming when they’ve Curran, are less likely to want to run cluding the first-year medical students completed their training. A payback a business and more likely to want to taking her biochemistry class — are plan provides another incentive to focus on medicine. Robertson, who be- motivated to learn. “I especially enjoy return. The state underwrites the lion’s came a hospitalist in 2007 after spend- the WWAMI classes, because they’re share of their tuition, and students ing years in private practice, embodies small, and we have discussions about a repay the loan by practicing in the something of both generations. lot of things…they can be interested in state for three years — or by paying Shifting demographics, lifestyle everything,” says Langer. back the money. expectations, the cost of medical From campus to campus Coming full circle education. Educating medical students One of the foundations of the The WWAMI program in so that they’ll return to WWAMI WWAMI program is that all first-year Wyoming is relatively young, but it’s is a challenging proposition, one students receive basically the same effective, says McEchron. So are the administrators continue to finesse. education — whether they’re in Lara- doctors trained by the program, says McEchron, like Curran, is sanguine. mie, Pullman, Spokane, Anchorage, Robertson. Because the tradition of teaching is now crossing generations. Bozeman, Moscow or Seattle. Courses “The [WWAMI-trained doctors] have common objectives, and students that I’ve run across over the years “Many of our graduates who have at all first-year sites take common final have been just excellent, all the way returned to the state to practice are exams to ensure the objectives have around,” he says. now also teaching within the pro- been met. gram,” he says. “It’s exciting to see Wendy Curran, a senior director at the circle becoming complete.”  “We are very aware of what’s going Blue Cross Blue Shield of Wyoming on at different sites,” says Langer. She and her colleagues determined last summer that there’s a 75- to 80-per- Pamela J . Langer, Ph .D ., is always pleased when her cent overlap in course topics among undergraduate students — like the sites. That said, teachers bring Lauren Johnson and Mark their own strengths to the classroom. Wefel, left — are accepted to Not everyone has Langer’s creative the UW School of Medicine . Johnson and Wefel, now first- approach, and not every teacher gives year medical students, were first-year students the exposure to teaching assistants in Langer’s clinical care espoused by Robertson. clinical biochemistry class at the University of Wyoming in 2011 . Photo courtesy of Pamela J. Langer, Ph.D. Photo courtesy of Pamela J. Langer,

SPRING 2012 11 WWAMI Turns 40 >

Sons and Daughters of WWAMI by Elisa Murray Photo courtesy of the Chisholm family

There’s a huge need for qualified, dedicated doctors in the WWAMI region — and the Chisholm family is helping meet it . Siblings Tyler Chisholm, M .D . ’09, Hillary Chisholm, fourth-year medical student, Alison Chisholm Granier, M .D . ’06, and Sarah Chisholm, M .D . ’11, were all members of WWAMI-Idaho classes . Their father, Donald Chisholm, M .D . ’79, also gradu- ated from the UW School of Medicine .

hen they were young, accompanied their dad on rounds and Although Don wasn’t part of the Donald R. Chisholm’s four frequently ate dinner in the hospital WWAMI-Idaho contingent, he’s Wchildren had a movie they cafeteria. pleased that his children have had liked to watch together. It wasn’t People often stopped them on the that experience. “Clinical rotations Disney, or a holiday special. It was a street to praise their dad. “We grew [through WWAMI] give you critical video of the C-section birth of the up believing that medicine would be exposure in the clinic, the operating two youngest siblings, twins Hillary a great thing to go into,” says Hillary. room and other areas of training,” and Sarah. “Our father was clearly making a he says. “It was our favorite movie — the difference in the lives of the people All in the family gory, bloody delivery of my sisters,” around us.” It’s likely that most, maybe all, of says Alison, the oldest, with a laugh. And one by one, they all decided the four Chisholm siblings will return “It was definitely a different kind of to become doctors. With their father to the WWAMI region to practice. family experience.” and grandfather as models and a Tyler is in his third year of family At the time, the four children — shared interest in working with medicine residency in San Francisco. the three girls, plus one son, underserved populations, the choice He plans to return to the region with Tyler — didn’t think much about it. of attending the UW School of his wife, Megan Mendoza, M.D. ’09, It was simply part of their family’s Medicine — through the WWAMI another WWAMI graduate. They’d culture. Their father, a 1979 graduate program in Idaho — wasn’t difficult. like to practice in a locale with a of the UW School of Medicine, is a “I knew I wanted to return to Idaho Spanish-speaking population, such respected family medicine physician in and work in a rural area, so WWAMI as Yakima. Coeur d’Alene, Idaho. Their mother, was ideal,” says Alison. She recently Sarah is completing an ob/gyn Robin, a former pre-med student started practicing ophthalmology in residency in Denver and plans to herself, grew up with a physician as a Coeur d’Alene. “WWAMI gives you return to the Northwest to practice. father, and taught high-school biology grounding in real-life medicine rather Hillary, in her fourth year of medical and chemistry. The kids occasionally than an ivory-tower experience.”

12 UW MEDICINE < WWAMI Turns 40

school, wants to focus at least part of Like his mother before him, Abe Abe has since married a WWAMI- her practice on underserved communi- spent his first year at the Alaska Alaska classmate, Katrin Tsigonis, ties. Alison, in addition to working WWAMI site. Attending classes in M.D. ’11, also a first-year resident. The in Coeur d’Alene, has done medical Anchorage in his first year, he says, couple fully intends to return to their mission trips to Central America. “it was small enough that they let me home state to practice. “It’s a place Don says, “Our hope is that all our bring my dog to the classroom.” where you really get to influence the kids will be in places where we can He also enjoyed the close relation- medical culture and can make a differ- see them on a more regular basis. And ships he developed with his teachers ence,” Abe says. “And there is a huge we’d like to see excellent medical care at clinical rotations in Alaska, where need for doctors.” in our community.” there were no residents and few other “I’m excited about Abe’s choice,” medical students. “On my surgery says Jean. “He’ll come back to Alaska, Returning to Alaska rotation it was just the doctor and me,” which is exactly what we need. It is Much further north in the Abe says. “On my Fairbanks ob/gyn critical for us to bring doctors WWAMI region, another family is rotation, I actually got to work with back here.”  starting a medical legacy of its own. my mom for a few deliveries.” Jean Tsigonis, M.D. ’78, is a family physician in Fairbanks, Alaska, and a mother of five. Abe sigonis,T M.D. ’11, her oldest, is in his first year of residency in Wiscon- sin. Another child, Elizabeth, is going to medical school in California. Like the Chisholm kids, Abe understood early on the special role his mother held in the community. “I saw my mom as a do-everything kind of person. Everyone knew her,” he says. The kids also experienced Jean’s clinical work firsthand by traveling with their parents on medical missions to the Philippines, Costa Rica and Nicaragua, among other places. They

often helped with simple tasks, such as family Photo courtesy of the Tsigonis bandaging and wound care. Abe M . Tsigonis, M .D . ’11, and his mother, Jean M . Tsigonis, M .D . ’78, work together on a delivery during one of his rotations in Alaska .

MARC NOTABLE LANGLAND He’s been a part of the banking community in Alaska since 1965 . President, CEO QUOTABLE and Chairman “My physician was one of the first WWAMI graduates; he grew up here, and he’s a of the Board, good example of how it works . Most of our doctors used to be ex-military, or they’d Northrim worked for the Bureau of Indian Affairs and moved into private practice . Now we BanCorp, Inc. have more people from Alaska — and the other WWAMI states — who decide to practice here . If it weren’t for WWAMI, we’d be struggling to recruit doctors ”. Anchorage, Alaska

FINAL WORDS “We couldn’t afford a medical school in Alaska by any stretch of the imagination .”

SPRING 2012 13 WWAMI Turns 40 >

TAKING RESEARCH TO THE COMMUNITY by Delia Ward Photo (Olympic Peninsula): Abigail Echo-Hawk

esearch takes place throughout Res. ’84, MPH, the director of the “We identified the question,” said the WWAMI region: at universi- ITHS’s WWAMI Region Practice and Rex Force, Pharm.D., a researcher at Rties, in community-based clinics, Research Network. Pocatello Family Medicine in Idaho. and on reservations. It’s all part of a Baldwin and colleagues in the “Then the collaborative process kicked practical, multi-state initiative for Department of Family Medicine, in. The team at ITHS supported our providing better medical care in our Al Berg, M.D., MPH, Res. ’79, and idea and scaled it up to involve the communities. Gina Keppel, MPH, had begun to col- network. It was a great experience.” Take this real-life example from laborate with the 18 resident training “[The project] wouldn’t have Pocatello Family Medicine at Idaho programs in UW Medicine’s WWAMI- been possible if we had only done it State University, where a woman of based Family Medicine Residency at a single site,” says Baldwin. “We child-bearing age had been prescribed Network. These sites were interested designed the project together, col- a medication for high blood pressure. in community-based research, and the lected and analyzed the data together, Although she wasn’t pregnant, the question about lisinopril (and other reviewed the results together, and then clinic could see a potential conflict: medications with similar potential presented the data to the [other] sites the drug, lisinopril, might be harmful effects) provided the trial balloon together,” she says. they needed. to a fetus. Staff wondered: how many Community data of our other patients are in a In all, seven clinic sites signed on The WWAMI Region Practice and similar position? to the project, and staff, residents and Research Network, led by Baldwin, fellows gathered information from is one arm in the ITHS’s Community The trial balloon more than 300 female patients. The Enter the Institute of Translational Outreach & Research Translation Core data showed that other women were (CORT). CORT utilizes the power Health Sciences (ITHS) — specifi- affected by prescription choices, and cally, Laura-Mae Baldwin, M.D., of community research to “translate” the clinics worked together to medical discoveries into therapies that improve treatment.

14 UW MEDICINE < WWAMI Turns 40

help patients. Dedra Buchwald, M.D., Eliminating the gap leads the second arm of CORT, the One of the next subjects that American Indian/Alaska Native Com- Baldwin and her colleagues plan to munity Outreach & Research Transla- tackle — with Beverly Green, M.D., tion Core. A third arm is MPH, of the Group Health Research located at Group Health in Seattle. Institute — is blood pressure. Using a “Without this kind of research, web-based model developed at Group you can’t effect change in the health Health, they’ve written a grant to test of communities,” says Leo S. Morales, whether community pharmacists can M.D., Ph.D., MPH. Morales is co-di- help patients with hard-to-control rector of CORT, an associate investi- blood pressure. The protocol worked gator at the Group Health Research well at Group Health. With modifica-

Institute, and an associate professor of tions, says Baldwin, it should work in Photo courtesy of Laura-Mae Baldwin, M.D. the WWAMI region. health services at the UW. Laura-Mae Baldwin, M .D ., and her collaborators conduct community- Although the three arms of CORT Research topics like this one, which address urgent problems in based research to improve care for collaborate with different clinics and patients in the five-state region of populations, they meet regularly to talk primary care, are of great interest to WWAMI . about pilot programs and learn from practitioners like Jeff Kaplan, M.D., one another. And they’re working with medical director of Memorial Physi- Baldwin agrees. “If we used the Kari Stephens, Ph.D., and Ching- cians Group in Yakima, Wash. He and strategies we already know work, and Ping Lin, Ph.D. ’10, from the ITHS his colleagues anticipate partnering implemented them in communities Biomedical Informatics Core to bring in the blood pressure study. “We’re to their full extent, we would have a program called LC Data QUEST to looking for ways to change the ways a much greater impact on health,” clinics in the region. we provide care,” he says, to make medicine more efficient and less costly. she says. LC Data QUEST pulls standardized (Read more about Kaplan’s search Health disparities data from electronic medical records, for accountable care at Dedra Buchwald, M.D., UW allowing the collection of HIPAA- uwmedmagazine.org.) compliant research data within and professor of medicine in the Division among clinics for approved studies. With the work of partners like of General Internal Medicine, remem- In addition to serving as a powerful Kaplan, Green and Morales, and with bers an early meeting of the ITHS, data collection tool, the program can support from the ITHS, research fund- where members discussed potential help doctors manage health screening ing is helping ensure that medical dis- partners for community-based re- and chronic disease — it issues auto- coveries reach everyone — eliminating search. There were many choices, she mated care reminders and instructions the gap between laboratory and clinic. says, given the enormous breadth of for patients who meet certain “The gap occurs when there isn’t a WWAMI — roughly one-quarter of medical criteria. good mechanism for disseminating re- the American landmass. search in communities,” Morales says.

ROBERT NOTABLE LUNDEEN He’s a member of UW Medicine’s Scholarship and Student Support Committee . Retired Chairman QUOTABLE of the Board, “Without WWAMI, medical education in the Northwest would be, I think, in very Dow Chemical tough shape . I’ve always been impressed with the high quality of the students at the Company UW School of Medicine . They’re a bright and talented group of young people .” Deer Harbor, FINAL WORDS Washington “WWAMI is a very good program .”

SPRING 2012 15 WWAMI Turns 40 >

Buchwald, who has worked with research with American Indian and Alaskan Native tribal commu- communities for more than 20 years, nities or other suggested that the ITHS focus on small popula- those groups. Given a broad range of tions prevalent challenges and special circumstances, in WWAMI: including poverty, poor health literacy, numbers. limited educational opportunities, How do you widely dispersed populations, and maintain the the need to respect tribal sovereignty, anonymity of American Indian and Alaskan Native a 90-year-old

communities suffer from major study partici- Photo: Deirdre Schwiesow health disparities. pant if, for Dedra Buchwald, M .D . (left), and Karina Walters, Ph .D ,. discuss instance, “If we can make a difference with future research collaborations with Native communities . there are only this population,” argued Buchwald, a handful of “we can make a change for the bet- 90-year-olds in a tribe? ter in almost any population.” Her Native health researchers, and a colleagues agreed, and the American One answer may be partnering with member of the Squaxin Island Indian/Alaska Native Community other tribes to increase the numbers of Tribe, explains. Outreach & Research Translation study participants. Another is con- In conducting “bench-to-bedside” Core was launched. ducting qualitative research instead of research — shorthand for taking in- quantitative. Buchwald hopes the year Buchwald mentions the success formation gained at the lab bench and ahead — with the help of grants from of one ITHS-funded project that translating it into medicine or thera- the ITHS and the National Cancer focuses on the use of graphic materials pies that help patients — a scientist Institute — will provide some answers. to increase health literacy in Native recruits patients and follows protocols. populations. She is developing other Broken promises, broken hopes Working with tribes, he says, adds projects as well; some are funded by If numbers provide a challenge in another layer for the researcher. the ITHS, while others are funded by working with Native populations, so “You have an overlay of a sovereign major grantors concerned with issues do other circumstances. Ron Whit- government,” he says, referring to such as cardiovascular disease, cancer ener, J.D., a UW senior lecturer in law, the U.S. government’s recognition of and hepatitis C in Native populations. executive director of the UW Native American Indian tribes as sovereign nations. This extra layer can lead to Buchwald notes, however, that American Law Center, a graduate of misunderstandings. there’s a challenge in conducting Buchwald’s two-year fellowship for First, researchers and tribes may not Doing research-related agree on the impor- outreach with Ameri- tance of the research- can Indian and Alaskan Native communities er’s topic — or the takes members of the tribe’s need to invest American Indian/ in it. Second, some Alaska Native Com- researchers may not munity Outreach & Research Translation want the tribes to have Core far and wide — a say in the research including the small or the manner of its Alaska Native village of publication, though Mentasta Lake, Alaska, where the Mentasta such requests are well Tribal Council Health within tribal rights.

Photo: Abigail Echo-Hawk Clinic, left, is located . Then there’s the prob- lem of history.

16 UW MEDICINE < WWAMI Turns 40

“Tribes have been researched to bench approach,” where research is A new twist on a good model death in the U.S.,” says Whitener, of- informed by tribal participants. Walters and her colleagues could ten with poor outcomes. For instance, Walters makes her point by recall- bring a wealth of knowledge, ideas and some researchers have overpromised ing one of her own cases. Elders from approaches to work with the ITHS. the benefits of their studies, haven’t a tribe in Washington, concerned And like Baldwin and Buchwald and followed up with a tribe, or have bro- about their children — some of whom their colleagues, Walters believes ken contracts. Even so, says Whitener, were contracting type 2 or adult-onset strongly in research collaboration in tribes remain interested in research. diabetes — contacted her for help. At the WWAMI region. “They want to be involved,” the same time, the elders made sure Collaboration is key to community- he says. “But it has to be done in a Walters knew that they viewed being based research. If researchers have respectful manner.” overweight as part of their culture. something to bring to the table, so First, Walters — an expert in the do the communities with whom they The people and the research social and historical determinants of work. It’s a new twist on a good model: Karina Walters, Ph.D., agrees that health — did some research. She found making sure new and workable ideas in a respectful approach is key to work- old tribal photos that showed a lean, medicine are translated out in the field. ing with Native populations. She’s fit people. Then she met the elders to “What we’re saying is, we’ve got the director of the UW Indigenous talk about their “original instructions,” some knowledge,” says Walters. “But Wellness Research Institute (IWRI), a or the rules set out by their ances- our communities also have some professor in the UW School of Social tors. Each person in the room said the knowledge — how do we have these Work, and a member of the Choctaw same thing: that the instructions had things work together?”  Nation of Oklahoma. And she may changed when the tribe was moved soon be the newest collaborator in the to a reservation. No longer allowed to ITHS’s American Indian/Alaska Na- hunt, fish or travel, they were struck by tive Community Outreach & Research famine. To keep their babies alive, the Translation Core. tribe overfed them when they could She and Buchwald have col- feed them at all. laborated on projects and have shared It was an “aha” moment for the resources and information — “Indian elders, says Walters, where they country is small, and we all do a lot of realized that a historical survival work together” — but another level strategy — made in response to Extra content at uwmedmagazine.org » of integration could raise the work in major, negative shifts in their way of WWAMI to a new level. • Original Instructions life — was no longer useful. (Learn • Researching Better Care in Yakima Instead of the bench-to-bedside more about Walters’ novel approach • The Road to Browning, Montana, approach, says Walters, “what we to the obesity epidemic in her tribe at and Other WWAMI Stories would bring is the community-to- uwmedmagazine.org.)

ARTHUR F. NOTABLE (SKIP) He was the first chair of the board at St . Luke’s Health System in Boise and was named the Idaho Hospital Association Trustee of the Year in 2009 . OPPENHEIMER Chairman and CEO, QUOTABLE Oppenheimer “For Idaho, having a relationship with one of the finest medical schools in the Companies, Inc. country is a really big plus . It creates opportunities for our students . We’re getting some very well-trained physicians who practice in the region, thanks to the quality of Boise, Idaho education they get through the UW School of Medicine .”

FINAL WORDS “Getting the best quality of care possible for our employees is important .”

SPRING 2012 17 WWAMI Turns 40 >

A NEW VISION IN KENYA by Brian Donohue

hirty Kenyan medical students that they’re not able to get at Kenyatta the University of Nairobi’s Dr. James left the University of Nairobi in National Hospital, the main tertiary- Kiarie (a UW affiliate associate profes- TOctober 2011. Though travel- care hospital,” says Carey Farquhar, sor in global health and epidemiology) ing by land, their purpose held all the M.D., Res. ’97, MPH, Fel. ’03. Farqu- are principal investigators of a $9.5 consequence of a maiden voyage. har is a UW associate professor in the million grant that supports that goal. The 30 students represented the departments of medicine, epidemiology Over two weeks in May 2011, school’s first investment in enriching and global health. Farquhar was on point when a del- medical education through clinical “I just found out they’re having egation of Nairobi medical-school experiences in less-populated areas. weekly, case-based discussions through leaders visited for an immersion in If this sounds familiar, it is because distance learning. They connect the the WWAMI program, the immensely Nairobi is tacking to a course begun four sites — in Garissa, Naivasha, fruitful partnership of UW Medicine 40 years ago at the University of Mbagathi and Mombasa — on a video and the states of Washington, Wyo- Washington: the WWAMI program, conference, and one of the sites pres- ming, Alaska, Montana and Idaho. a five-state partnership in ents a case, which is then discussed by A core WWAMI tenet is that medical medical education. the students and a faculty member at students need to learn medicine where Almost immediately, the Kenyan the University of Nairobi,” she says. it is practiced — in the community, students’ feedback was validating. Farquhar has been integral to the not just in academic hospital settings. “It’s fantastic. They say this is giv- university’s vision: expanding clinical The Kenyan contingent learned ing them real, hands-on experiences training beyond the capitol. She and how WWAMI nurtures stakeholder

18 UW MEDICINE < WWAMI Turns 40

The visiting delegation from Nairobi saw facilities in Boise, Idaho, and Spokane, Wash . During the Spokane tour, simulation lab director Kevin Stevens (left) explains the use of simulators in training health professionals . From the University of Nairobi are (left to right) Drs . Grace Thoithi, Charles Omwandho, Dalton Wamalwa and Photo: Lindsey Kay Photography Erastus Amayo .

relationships, how faculty receive The group — which included deans As the UW School of Medicine’s training at rural clinics, and which of medicine, nursing, dentistry, phar- vice dean for regional affairs, Allen nuts-and-bolts issues require routine macy and public health, among others oversees the WWAMI program. She attention. Along with attending from Nairobi — was impressed. Equally wasn’t surprised to hear Farquhar’s myriad presentations in Seattle, the important, they were empowered to set account of Kenyan students’ initial visitors met with residents and students desired changes in motion back home. feedback. It resembles the feedback she in Spokane, Wash., and Boise, Idaho, For instance, a telemedicine pre- hears from students in WWAMI. and visited rural clinic sites, simulation sentation they saw in Seattle informed “The amount of experience they labs and classrooms. the weekly videoconference in which get, whether it’s helping with a surgery “Students come to study in Nairobi remote students and Nairobi faculty or delivering a baby or being with a and then they don’t want to go back discuss patient cases. family through a difficult time — it’s to the rural areas. If we give them op- “Distance learning with webinars is more hands-on than they might get portunities to do rotations as interns a great way to keep students feeling an- here in Seattle,” says Allen. in those rural areas, they may actu- chored and connected when they’re in “Students really feel the impact ally feel like working there. That’s the rural sites by themselves. It gives them they can have on patients’ lives out in major takeaway for me,” says Dr. Isaac a chance to check in, ask ‘What’s going these smaller communities.”  O. Kibwage, principal of the College on at your site?’ and exchange lessons of Health Sciences at the University about patient cases,” says Suzanne of Nairobi, after the visit. Allen, M.D., MPH.

KEITH RUPERT NOTABLE He’s had a 40-plus-year career as an architect, and he’s been in Billings since 1974 . Architect, CTA Architects QUOTABLE Engineers “Billings is a medical hub, but as you travel to outlying areas, you see communities Billings, Montana struggling to maintain regular care . Specialties are out of the question . At the same time, doctors are getting older . In some towns in Montana, their retirement might mean that practices disappear completely . Maintaining a reasonable level of primary care is imperative . WWAMI addresses this issue head-on .”

FINAL WORDS “I’d like to see more seats for students in the Montana first-year medical class .”

SPRING 2012 19 Feature >

by Deirdre R . Schwiesow

ight now, someone in Seattle is awaiting a heart trans- of patients who are critically ill with coronary artery disease. plant, and they may help to dramatically change the These volunteers are awaiting heart transplants, and, like Rway heart failure is treated. former Vice President Dick Cheney, are using left ventricular By serving as an incubator for his or her own stem cells, assist devices (LVADs) to survive. this person is taking part in an experiment designed to figure Because the implanted LVADs pump blood to the body, out some of the mysteries of re-growing heart cells: heart stem cells can be injected into the heart without risk to the muscle regeneration. It’s a process that may lead to a new era patient’s health. After the patient receives a new heart, the in congestive heart failure therapy. damaged organ is examined to determine if the injected cells “What started out as a wild idea a long time ago — that helped to regenerate heart muscle tissue. you could use stem cells to repair the heart — has turned State of the heart into a much bigger thing,” says Charles E. (Chuck) Murry, The need for new therapies for damaged hearts is acute. M.D., Ph.D., Res. ’92, UW professor of pathology, director of the Center for Cardiovascular Biology, co-director of “There are about one million heart attacks in the U.S. a the Institute for Stem Cell and Regenerative Medicine year,” says W. Robb MacLellan, M.D., UW professor of medi- (ISCRM), and the Arra and Eva Woods Endowed Professor. cine, head of the Division of Cardiology, and the Robert A. Bruce Endowed Chair in Cardiovascular Research. “A real This is where heart failure/transplant cardiologist April concern — if you make it through a heart attack — is that Stempien-Otero, M.D., Fel. ’97, FACC (and the patients) you develop a syndrome called heart failure.” enters the picture. Heart failure, also known as congestive heart failure Stempien-Otero directs injection of stem cells — harvest- (CHF), means that the heart loses its ability to pump blood ed from each patient’s own bone marrow — into the hearts forward through the body. Major causes include coronary

20 UW MEDICINE The Heart

of the Matterby Deirdre Schwiesow

Photo: Deirdre Schwiesow

artery disease and cardiomyopathy (weakening of the heart “What April is doing is really trying to study this in a muscle) due to high blood pressure, toxins such as alcohol systematic way — what’s happening to these cells? Are they and chemotherapy, viral infections or genetic factors. grafting to the heart? Because if we knew how they worked, “Unlike the liver,” says MacLellan, “the adult heart, once we would be better able to pick patients who might benefit it is injured, has very little capacity to regenerate itself.” Due from the therapy,” MacLellan says. to the scarcity of healthy donor hearts, fewer than 2,500 The mystery of success heart transplants are performed each year in the U.S. Thus, Stem cells do help people with heart disease. Studies in many patients who need heart transplants can’t get them. Europe have shown increased blood flow in the hearts of At the same time, no new CHF therapies that dramatically patients with coronary artery disease-induced heart failure improve mortality have been developed in the last 10 years after the injection of bone marrow-derived stem cells. The (although the survival rate after transplant has improved). mechanisms of improvement, however, are unknown. “The major advancements have been in mechanical Stempien-Otero’s experiment, which builds on those devices, but they’re extremely expensive. That’s why there’s already undertaken, has two primary goals. The first is to so much interest in regenerative solutions,” explains determine how certain bone marrow and other stem cells MacLellan. Experimenting with stem cells to regenerate can improve blood vessel formation and decrease scar tissue heart cells has been going on for the past decade, but so far, formation in ischemic hearts — hearts receiving insufficient he says, “the results have been quite variable — we don’t blood. The second is to have her study serve as a proof-of- know how the stem cells work.” principle for the process of injecting cells into damaged heart tissue and then examining the cells after the heart is retrieved.

SPRING 2012 21 The Heart of the Matter >

The study offers “a way that we can very directly test different strategies Photo: Clare McLean for improving heart muscle structure,” Stempien-Otero explains. Her project is part of a suite of studies at UW Medicine — funded by a grant from the National Heart, Lung and Blood Institute (part of the National Institutes of Health) — ultimately aimed at developing cell- Patient Tony Arena (center), with Chuck based therapies to regenerate the Murry, M D. ,. Ph .D ,. and human heart. April Stempien-Otero, M .D ., is taking part No ordinary clinical trial in an exciting study Stempien-Otero, a UW associate designed to advance professor of medicine and the Craig stem cell therapies for heart failure . Tall Family Endowed Professor in Heart Failure Research, is conducting her study under the auspices of the Center for Cardiovascular Biology and In addition to addressing this major Thus far, Stempien-Otero has stud- the Institute for Stem Cell and Regen- public health issue, Stempien-Otero’s ied five patients out of the 12 needed erative Medicine. “[UW Medicine] is program is significant because it to complete this initial study. In the one of the few places in the country represents “first-in-human” work that’s hearts of the first two patients, she was where I could have done this,” being done here in Seattle. able to track the area where the cells she says. “April’s work is not just like a stan- were injected. UW Medicine is a leader in cardiac dard clinical trial; it’s a scientifically “Our ultimate goal is to be the first regeneration research. From bioengi- driven study to understand [the effect institution in the world to actually do neering myocardium (heart tissue), of the cells on the surrounding tissue],” pluripotent stem cell therapy,” says MacLellan. “This next century is about curing disease through regenerative medi- “This next century is about cine,” he adds. “We’ll never be able to prevent heart attacks entirely, but curing disease through for those patients who do have a heart regenerative medicine.” — Robb MacLellan attack, we hope to regenerate the heart back to the way it was.” 

to using pluripotent stem cells (plu- says Murry. “Once you start under- Extra content at uwmedmagazine.org » ripotent cells can differentiate into standing how something works, then different types of cells in the body) to you can rationally try to improve it.” • Bridging the Gap Between Science and Patients regenerate heart muscle, to converting “This study is actually faster than a fibroblast stem cells (located through- normal clinical trial,” says Stempien- out the body and easy to obtain) into Otero. “Each patient can test several heart cells, “there’s a very multidisci- different types of cells at the same plinary, multi-investigator approach at time, and you can address these ques- UW Medicine to solve what is a huge tions much more quickly.” public health issue,” MacLellan says.

22 UW MEDICINE < Feature

Coming Home to Wenatchee

Derek Whitehall grew up near Wenatchee, Wash .; now he’s practicing medicine there . Here, he and his wife, Julie, pose with their children: Nathaniel (5) and Rachel (4) . Behind the Whitehalls, you can see the Columbia River and East Wenatchee .

Photo courtesy of Derek Whitehall, PA-C

he staff is so dedicated at Whitehall is a dyed-in-the-wool wheat fields. These days, “La Clinica Columbia Valley Community Eastern Washington resident. He grew Chiquita” serves the Wenatchee area THealth (CVCH) in Wenatchee, up in the small farming community of with primary-care services. The “big Wash., that you need to get up early Waterville, about 25 miles northeast clinic,” Wenatchee Valley Medical simply to volunteer for an outreach of Wenatchee, and he was working in Center, Whitehall adds, is phenomenal day — one spent providing migrant pre-hospital care when he first heard in assisting with specialty care. workers with diabetes treatment, about the MEDEX Northwest program. The sense of community at prenatal care and other vital services. Whitehall studied in Spokane; after CVCH is strong — among the provid- “The sign-up sheets fill up right graduation, he worked for a few years ers, and between providers and pa- away,” says Derek Whitehall, PA-C as the only healthcare provider in the tients. Whitehall, who’s close to fluent (Spokane Class 6). That’s because Springdale Community Health Center in Spanish, had to bring in a colleague everyone, including the CEO, the before relocating to Wenatchee. to translate part of a conversation with medical director and the staff, are so Now at Columbia Valley Community a patient. It turns out that the patient committed to the mission. Health, Whitehall has no plans to had seen Whitehall out mowing his move — he and his wife want their lawn in the neighborhood — the kind Caring for the underserved is a children to grow up near their grand- mission that Whitehall enjoys, too, of story you only hear in a tight-knit parents. And CVCH is a great place place like Wenatchee. and it’s an ethic that MEDEX helps to work. instill in its students. “I bought into “Wenatchee is the best place in the Ruth’s vision,” says Whitehall of Ruth “The MEDEX model of ‘health- state of Washington,” says Whitehall. Ballweg, PA-C (Seattle Class 11), care for everyone’ is exemplified by A great place to enjoy the outdoors, MPA, chief of the MEDEX section, CVCH,” says Whitehall. A non- to raise a family, and, not least, to find Department of Family Medicine. He profit, CVCH was founded as the meaningful work. “MEDEX prepared also — like many people trained in the Migrant Farm Workers Clinic, and me well,” he says.  WWAMI region — decided to remain it served the migrant workers drawn there to practice. by the region’s many orchards and

SPRING 2012 23 Alumni and Student News >

2012 Featuring brand-new programming for all of our alumni. Whether you graduated five years ago or 50, you’ll have a great time at Reunion the reunion weekend! Don’t miss: • Special reunions for the classes of 1952, 1957, 1962, 1967, 1972, 1977, 1982, 1987, 1992, 1997, 2002, 2007 • An evening in the city at Urban Enoteca Weekend •A trip to the zoo for young alumni families •A celebration for members of the 50-Year Association Your friends. Your class. Your university. • The underground mysteries of the University of Washington (+ other tours), and •A night to remember at the Space Needle WELCOME BACK, ALUMNI! Register! Learn more and register today at www.uwmedalumni.org/reunion! Or contact JUNE 1–3, 2012 UW Medicine Alumni Relations at 206.685.1875, Seattle, Wash. toll free 1.866.633.2586 or [email protected].

Pride in PreMat PreMat — a prematriculation program for first-year medical students — is sponsored by the UW School of Medicine’s Office of Multicultural Affairs . The program gives students the academic and social support they need to facilitate a smooth transition into medical school . David Acosta, M .D ., Res . ’91, the dean of multicultural affairs, instructors Andy Farr, Ph .D ., and Charles H . (Chip) Muller, M .D ., Ph .D ., Res . ’82, and program coordinator Mary Walls, MPH, congratulate the students on completing their histology course .

Photo courtesy of the Office of Multicultural Affairs, UW Medicine

24 UW MEDICINE < Alumni< and Alumni Student and Student News News Our WWAMI Students Medical students at the University of Alaska in Anchorage pose, at right, in the Alaska Native Medical Center . Every year, 20 students begin their first year of medical school in Alaska — part of the WWAMI program’s work in creating educational opportunities in a five-state region .

The WWAMI students at left — all from Montana, either in their third or fourth year of medical school — take a break from work and study to relax at a gathering in Missoula . Missoula is one of more than 100 sites in WWAMI where medical students undertake training . Pictured in the green shirt: Douglas S . Paauw, M .D ., Res . ’98, ’99, internal medicine faculty .

Dinner With a Doctor Jane A . Lester, M .D . ’86, Res . ’90, (second from left), hosts students Jaqui Foss, Kelly Fong and Lacey Irwin at a Student-Alumni Informational Dinner (SAID) in February . Interested in participating in SAID? Or in other programs where alumni help students with advice or a place to stay (and more)? Contact us at medalum@uw .edu, 206 .685 .1875 or toll free 1 .866 .633 .2586 .

Photos courtesy of the WWAMI-Montana program and Jane Lester, M.D.

SPRING 2012 25 Alumni and Student News >

Lifetime Achievement Franklin Newman, M .A ., Ph .D ., above, a founder and former director of the Montana WWAMI program, was awarded the UW School of Medicine’s Lifetime Achievement Award for his work on behalf of the program . The award was presented on Oct . 7, 2011; Newman passed away shortly thereafter, on Nov . 11 . Pictured above, from left to right: Dr . Newman, Jay Erickson, M .D ., Res . ’90, assistant clinical dean for Montana, Martin Teintze, Ph .D ., interim director and assistant dean of Montana WWAMI’s first-year program, and Kris Juliar, director of the Montana Area Health Education Center .

The Road to Browning Last fall, first-year students from the Montana WWAMI site visited with schoolchildren in Browning, Mont ,. (part of the Blackfeet Res- ervation) . Raima Amin and Justin Shinn, at right, used a circulatory- system chart to interest the kids in anatomy . Read about their trip at uwmedmagazine .org .

Photos courtesy of the Office of Regional Affairs, UW Medicine (top), Martin Teintze, Ph.D. (bottom)

26 UW MEDICINE < ClassNotes

M.D. Alumni

1962 1968 New job, award, move or family The Class of 1962 celebrates its 50th Joel A. DeLisa, M.D., Res. ’75 (reha- addition? Send us a quick note; reunion at the 2012 Reunion Week- bilitation medicine), has been elected to simply visit uwmedmagazine.org, end, June 1–3, 2012. Please mark your the Institute of Medicine of the National click on the “ClassNotes” button, calendar . If you’d like to join the reunion Academies, one of the highest honors in and let us know how and what committee, please contact UW Medicine the fields of health and medicine . DeLisa you’re doing. And take a minute Alumni Relations at medalum@uw .edu . served as professor and chairman of the to improve our residency Department of Physical Medicine and George Lavenson, Jr., M.D., is still records — use the “ClassNotes” Rehabilitation at New Jersey Medical on call all over the world . Today’s Army function to confirm your is short of vascular surgeons, and the School for the past 25 years . His text- specialty, location and year. book, Physical Medicine and Rehabilita- Society for Vascular Surgery organizes tion: Principles and Practice, is now in its volunteers to help . A veteran of the The ClassNotes below were 5th edition and has been translated into Vietnam War and the first Gulf War, received through January 2012; multiple languages . any received afterward will Lavenson recently volunteered at the U .S . Army’s Landstuhl Regional Medical Roger M. Oakes, M.D., Res. ’74 appear in the next issue. (family medicine), turned in his scrubs in Center in Germany . He and his wife, September 2011 after 37 years of service Prefer mail to the web? We’d love to hear Judy, a medical technician, have vol- from you: UW Medicine Alumni Relations, unteered in northern Guatemala, and in Port Angeles, Wash . Oakes said he is Box 358045, Seattle, WA 98195-8045 . Lavenson spent three weeks working in most proud of his service as an infantry battalion surgeon in Vietnam and for American Samoa in summer 2011 . He raising, with his wife, Martha, two sons has done three tours to treat wounded GIs from Iraq and Afghanistan and is who became family physicians . 1952 gratified to see that some of the meth- ods he and his colleagues developed in 1970 The Class of 1952 celebrates its 60th Vietnam are still in use . Kaj Johansen, M.D. ’70, Ph.D., a reunion at the 2012 Reunion Week- clinical professor at the UW School of end, June 1–3, 2012. Please mark your Medicine, has been elected to a two- calendar . If you’d like to join the reunion 1966 year term as chief of vascular surgery at committee, please contact UW Medicine Donald H. Mott, M.D., was awarded Swedish Medical Center . A nationally Alumni Relations at medalum@uw .edu . the Greater Tacoma Peace Prize in 2011 for his work with the medically under- known vascular specialist and surgical educator, Johansen is widely recognized served in China . On a different note, he 1957 throughout the Pacific Northwest not and his wife attended the Nobel Peace only for his technical skills, but also for The Class of 1957 celebrates its 55th Prize ceremony in Oslo, Norway, on Dec . the consultative assistance he provides reunion at the 2012 Reunion Week- 10, 2011 — “a once-in-a-lifetime experi- surgical colleagues in remote and rural end, June 1–3, 2012. Please mark your ence,” writes Mott . calendar . If you’d like to join the reunion areas . After graduating from the UW, committee, please contact UW Medicine 1967 he completed his surgery training and Alumni Relations at medalum@uw .edu . a Ph .D . in physiology/pharmacology at The Class of 1967 celebrates its 45th the University of California San Diego in reunion at the 2012 Reunion Week- 1978 . Johansen joined The Polyclinic end, June 1–3, 2012. Please mark your in 2008 . calendar . If you’d like to join the reunion committee, please contact UW Medicine Alumni Relations at medalum@uw .edu .

SPRING 2012 27 ClassNotes i M.D. Alumni >

1977 A Bill of Rights for COPD: The Class of 1977 celebrates its 35th Lawrence D. (Larry) reunion at the 2012 Reunion Week- end, June 1–3, 2012. Please mark your Grouse, M.D. ’72, Res. ’73, Ph.D. calendar . If you’d like to join the reunion “Now that I’m spending more time committee, please contact UW Medicine as a patient than as a physician,” says Alumni Relations at medalum@uw .edu . Lawrence D. (Larry) Grouse, M.D. ’72, Glen A. Halvorson, M.D., Res. ’80 Res. ’73, Ph.D., “I realized that more (rehabilitation medicine), an active sup- attention needs to be paid to patient porter of orphan and widow ministries, has adopted five children . This year, preferences and outcomes.” Halvorson and his 15-year-old daughter Grouse is the executive director will travel to an orphanage in Addis of the International COPD Coalition Adaba, Ethiopia, to bring home Samuel, a 5-year-old who lost his parents to ma- (ICC), a global organization that sup- laria last year . As a rehabilitation resident Photo courtesy of Larry Grouse, M.D. ports access to care for people suffering at UW Medicine, Halvorson diagnosed from COPD. Although chronic obstruc- a patient with malaria and another with tive pulmonary disease is most often caused by smoking, it also can be borrelia recurrentis within one week of caused by pollution and biomass fuel use. each other while rotating through emer- gency services . The chief of medicine was In 2009, the ICC developed a bill of rights for COPD patients. Grouse surprised that a rehab intern made those and his colleagues are using the bill — which includes the right to safe diagnoses . Says Halvorson, “Guess he air and a safe environment — as a tool. For instance, the ICC is working forgot I was a UW student . . . I still mar- with Prof. Nanshan Zhong and the Chinese Health Ministry in a global vel at how incredibly great an education I received in Seattle .” See photo at right . initiative to diagnose the disease early, when there may be a better chance of stopping or reversing its course. The ministry is motivated, in part, by 1982 the rise of COPD cases and related deaths in China, one of the side effects The Class of 1982 celebrates its 30th of the country’s rapid industrialization. reunion at the 2012 Reunion Week- “We obtained the strong support of the Chinese Health Minister, end, June 1–3, 2012. Please mark your calendar . If you’d like to join the reunion Dr. Zhu Chen, for our program,” says Grouse. And on Nov. 6, 2011, committee, please contact UW Medicine the ICC presented an achievement award to Dr. Chen and the Chinese Alumni Relations at medalum@uw .edu . Health Ministry for their work in combating COPD. Read about the ICC’s recent conference at internationalcopd.org/conference.

1972 1975 The Class of 1972 celebrates its 40th William R. Phillips, M.D., Res. ’78 reunion at the 2012 Reunion Week- (family medicine), MPH, has been end, June 1–3, 2012. Please mark your named the 2011 American Academy calendar . If you’d like to join the reunion of Family Physicians Foundation Philan- committee, please contact UW Medicine thropist of the Year . Phillips (no relation) Alumni Relations at medalum@uw .edu . holds the Theodore J . Phillips Endowed Professorship in Family Medicine at the UW School of Medicine .

William R . Phillips, M .D ., Res . ’78

28 UW MEDICINE < ClassNotes i M.D. Alumni

Glen A . Halvorson, M .D ., Res . ’80, and his famiily .

1984 1987 Emily Y. Wong, M.D., has joined the Li Ka Shing faculty of medicine at the John S. Jarstad, M.D., a former The Class of 1987 celebrates its 25th University of Hong Kong . She will teach, faculty member in the Department of reunion at the 2012 Reunion Week- practice and participate in research Ophthalmology, was selected to serve end, June 1–3, 2012. Please mark your within the university’s Department of as the team leader of a humanitarian calendar . If you’d like to join the reunion Family Medicine and Primary Care . mission for the U .S . Naval Mercy Pacific committee, please contact UW Medicine Partnership in 2012 by Latter-day Saints Alumni Relations at medalum@uw .edu . (LDS) Charities . In May, Jarstad and his W. Conrad Liles, M.D., returned to wife, Patricia, will deploy to Indonesia, the Department of Medicine as associate the Philippines, Vietnam and Cambodia chair for research in January 2012 . to oversee 120 LDS volunteer physicians, nurses and paramedical personnel on 1990 ship and in clinics on shore . LeeAnna Muzquiz, M.D., a member Marshall S. Horwitz, Ph.D. ’88, of the Confederated Salish and Koote- M.D. ’90, Res. ’92 (internal nai Tribes of the Flathead Nation, has medicine), conducted the U S. . portion returned home . A family physician, her of a study that discovered a new genetic practice is based in the new, three-story defect, one that predisposes people to Tribal Health Clinic in Polson, Mont . acute myeloid leukemia and myelodys- plasia . The findings — the result of an international collaboration in Australia, Marshall S . Horwitz, Ph .D, M .D . Canada and the U .S .— were reported in the advanced online publication of Nature Genetics.

SPRING 2012 29 ClassNotes i M.D. Alumni >

1992 The Class of 1992 celebrates its 20th The Thrillionaire: reunion at the 2012 Reunion Week- Nassim P. Assefi, M.D. ’97 end, June 1–3, 2012. Please mark your What’s a thrillionaire? Someone who calendar . If you’d like to join the reunion committee, please contact UW Medicine enjoys giving simply for the thrill of it. Alumni Relations at medalum@uw .edu . The word was coined by philanthropist Ruth Ann Harnisch, but School of 1996 Medicine alumna Nassim P. Assefi, Frederica C. Overstreet, M.D., was M.D. ’97, has embraced it as her own. accepted into the Department of Medical “I came to realize early in adulthood Education and Biomedical Informatics that I had won the lottery of birth — in Teaching Scholars Program, which fosters academic leadership . North America, to educated and sup- portive parents…and this perspective

1997 has fueled my deep desire to give back,” Photo: Niku Kashef The Class of 1997 celebrates its 15th says Assefi, a second-generation Iranian- reunion at the 2012 Reunion Week- American. One of the ways she gives back is her medical practice; Assefi end, June 1–3, 2012. Please mark your works at Country Doctor Community Health Centers in Seattle, which calendar . If you’d like to join the reunion serves people whether or not they can pay for care. She also volunteers for committee, please contact UW Medicine human rights clinics through Health Rights International and Physicians Alumni Relations at medalum@uw .edu . for Human Rights, networks of volunteer physicians that evaluate and advocate for torture victims. 2002 The Class of 2002 celebrates its 10th Assefi is a novelist, too — Say I Am You, her second book, explores reunion at the 2012 Reunion Week- privilege, the promises and perils of humanitarianism, and what two end, June 1–3, 2012. Please mark your young Muslim women in post-Taliban Afghanistan do with their lucky lot calendar . If you’d like to join the reunion in life. And soon, she’ll be adding another accomplishment to a long list committee, please contact UW Medicine of accomplishments: the birth of her first child. Alumni Relations at medalum@uw .edu . “The practice of medicine is more of a hobby for me these days than 2003 my professional livelihood, and I’ve never been happier,” says Assefi. Read more about Assefi at www.nassimassefi.com or follow her on Twitter Research by Jared M. Baeten, M.D., Ph.D., is included in TIME magazine’s at @nassefi. new book, 100 New Scientific Discover- ies: Fascinating, Unbelievable and Mind- Expanding Stories. Baeten is medical director of the UW International Clinical Research Center, which coordinates 2007 2011 multi-center infectious disease preven- The Class of 2007 celebrates its 5th Blaise Bellows, M.D., is a member tion trials . reunion at the 2012 Reunion Week- of the inaugural class of a new, four- end, June 1–3, 2012. Please mark your year residency in UW Medicine’s Division calendar . If you’d like to join the reunion of Emergency Medicine . Residents will committee, please contact UW Medicine train at UW Medical Center, Harborview Alumni Relations at medalum@uw .edu . Medical Center, Seattle Children’s and Providence Regional Medical Center in Mark Uranga, M.D., and Becky Gannon Uranga, M.D., are back in Everett . Boise, Idaho . Mark works at St . Luke’s Boise and Becky works for OB/GYN As- sociates in Meridian, Idaho . They hope to attend the 2012 reunion depending on their call schedules and their new baby boy, Joseba Gannon Uranga .

30 UW MEDICINE < ClassNotes

Residents, Fellows and Ph.D. Alumni

Division of Hematology UW Medicine rehabilitation medicine faculty Stanley A. Herring, M.D., New job, award, move or family John M. Harlan, M.D., Res. ’77, Res. ’82, in conjunction with Richard addition? Send us a quick note; Fel. ’78, was recently appointed the G . Ellenbogen, M .D ., the chair of the simply visit uwmedmagazine.org, first Eloise Giblett Endowed Professor in Department of Neurological Surgery, has click on the “ClassNotes” button, Hematology in UW Medicine’s Division helped launch a new online course for and let us know how and what of Hematology . The professorship pays healthcare professionals . Heads Up to Cli- you’re doing. And take a minute tribute to the memory of scientific nicians: Addressing Concussion in Sports to improve our residency giant Eloise Giblett, M.D. ’51, Fel. ’55, Among Kids and Teens was supported records — use the “ClassNotes” a UW research professor and the former by the Centers for Disease Control (CDC) function to confirm your executive director of Puget Sound Blood and Prevention and the National Football specialty, location and year. Center . Harlan investigates endothelial League, and the course appears on their cell and leukocyte biology . The ClassNotes below were websites . received through January 2012; Mark Jensen, M.D., Res. ’90, has Division of Metabolism, published Hypnosis for Chronic Pain any received afterward will Endocrinology and Nutrition appear in the next issue. Management: Therapist Guide (Treat- Kristina M. Utzschneider, M.D., ments That Work) . The guide is written Prefer mail to the web? We’d love to hear Res. ’96, Fel. ’05, received a Presidential for clinicians who treat patients with from you: UW Medicine Alumni Relations, Early Career Award for Scientists and chronic pain or clinicians who want to Box 358045, Seattle, WA 98195-8045 . Engineers, the nation’s highest honor acquire the skills needed to apply hypno- for scientists at the beginning of their sis to pain management . independent research careers . Botulism Toxin Injection Guide, by Ib R. Odderson, M.D., Res. ’89, is now Department of Division of Nephrology available in four languages: Chinese, Family Medicine Korean, Russian and English . Published Rahgu Durvasula, M.D., Res. ’02, in 2008, Odderson’s book covers the use Tom E. Norris, M.D., Fel. ’89, has has been appointed dialysis director for of botulinum injections for neurologic been named chair of UW Medicine’s UW Medical Center (UWMC) . He also conditions . Department of Family Medicine . serves as associate medical director for Janet M. Powell, Ph.D. ’01, OTR/L, Norris also was recognized by the inpatient care at UWMC . was recently appointed head of the UW American Academy of Family Physicians Division of Occupational Therapy . Powell for outstanding patient care, philan- Department of Pathology joined the faculty in 2001 after 20 years thropy, education and leadership at its Kimberly H. Allison, M.D., Res. ’07, of clinical practice in pediatrics and adult annual scientific assembly . wrote Red Sunshine, a memoir about her physical disabilities . Glen R. Stream, M.D. ’82, Res. ’85, journey from physician to patient after a Jelena N. Svircev, Fel. ’06, was was recognized by the American Acad- diagnosis of stage III breast cancer . She appointed the director of the Spinal Cord emy of Family Physicians for outstanding continues to initiate women on the same Injury (SCI) Fellowship Program at the patient care, philanthropy, education journey in her capacity as director of VA Puget Sound Health Care System . and leadership at its annual scientific breast pathology at UW Medical Center . assembly . Department of Division of Gerontology and Rehabilitation Medicine Geriatric Medicine Kevin N. Hakimi, M.D., Res. ’00, James E. Branahl, M.D., Fel. ’85, has been named director of rehabilita- received the 2011 Marsha Goodwin-Beck tion care services (RCS) at Puget Sound Interdisciplinary Award for Excellence Health Care System . RCS provides medi- in Geriatric Clinical Care Delivery . The cal and therapeutic services throughout award, given by the U .S . Department of the hospital, nursing homes and within Veterans Affairs, recognizes outstanding the VA’s accredited programs . geriatric healthcare providers and As medical director of the Amica leaders in the interdisciplinary care of Seattle Marathon in 2011, Mark A. older veterans . Harrast, M.D., Res. ’00, was responsi- ble for organizing and coordinating care for participants .

SPRING 2012 31 ClassNotes >

MEDEX Northwest Alumni

cian assistant business, which covered married Elliott Snyder, M .D ., whom I had New job, award, move or family cardiac surgery programs from Everett to met on a trip to Israel . They we moved addition? Your classmates want Tacoma . After that, Lopez studied busi- to Texas . We are living in Poetry, a rural to hear from you! Send us a ness, spent seven years on the board of area east of Dallas . I must say, tending to quick note; simply go to directors for the National Commission on chickens and goats is a pretty good ‘job,’ uwmedmagazine.org, click on Certification of Physician Assistants, and and life is good .” the “ClassNotes” button, and let served as president of the Association Ian Jones, MPAS, PA-C (Seattle us know how you’re doing. The of Physician Assistants in Cardiovascu- Class 30), CCPA, and his family are ClassNotes below were received lar Surgery . Since January 2009, he has settled in Winnipeg, Canada . He’s the through January 2012; any worked as the facility medical director program director at Canada’s only received afterward will appear for an inpatient hospital medicine service graduate-level PA program, located at in the next issue. in the Franciscan Health System in the University of Manitoba . Jones served King County . three years as the president of the Cana- Prefer mail to the web? We’d love to hear Debby Floyd, PA-C (Seattle dian Association of Physician Assistants, from you: MEDEX Northwest, 4311 11th Class 18), is living in the Seattle area . and he was selected for the Academic Ave . NE, Seattle, WA 98105 . She has retired from Group Health and Health Leadership Program sponsored by is exploring many new creative outlets . the University of Manitoba and Manitoba Mindy Opper, PA-C (Seattle Health . He was given a Lifetime Achieve- Seattle Class 21), opened her own practice in ment Award by MEDEX Northwest and Ruth Ballweg, MPA, PA-C (Seattle 2011 in order to offer more integrative the Washington Association of Physician Class 11), is the section chief for MEDEX care . Believing that traditional medicine Assistants (WAPA) for his roles as leader, Northwest, which became a part of the complements allopathic medicine, Opper role model, clinician and mentor at the Department of Family Medicine in 2011 . became an ayurvedic wellness counselor . MEDEX/WAPA reception in Seattle in She was awarded a certificate of recogni- In addition, many people in Missoula, January 2012 . tion by the department for exemplifying Mont ., are interested in alternative care Martha Kjos, PA-C (Seattle UW School of Medicine standards for options, and she wanted to meet their Class 30), has worked in primary care service excellence . needs . Opper is one of two allopathically in Redmond, Wash ., for the last 13 years . Claudio Lima, PA-C (Seattle trained providers working in a compre- She finds as much time for sailing as Class 15), retired in November 2009 hensive healing center . She’s enjoying her she can . after 25 years at Kaiser Permanente . He work, which focuses on family medicine Christopher Carson, PA-C (Seattle re-married 11 months ago, and he re- and women’s care . Visit her site at Class 31), has practiced in primary care, turned to work at Kaiser Permanente last pranafamilypractice .org . orthopaedic neurosurgery and emer- October . Lima is also involved in his com- Marilyn Wyse Snyder, PA-C gency medicine . After retiring from the munity — after a three-year hiatus, he (Seattle Class 24), writes, “In 2004, I Army after 22 years, he uses his new was nominated again as a commissioner found-freedom to work with Boy Scout for the planning board in Woodburn, troops on their rock-climbing and snow- Ore . Lima reports that his son graduated camping programs . Carson and his family summa cum laude in psychology from also enjoy cruises and road trips across Western Oregon University; later, he was the U .S . and Canada . accepted for the nursing program at the Marlina Robinson, PA-C (Seattle University of Portland . Lima’s son is now Class 31), is practicing in Henderson, working full time as an R .N . in the oncol- Nev ,. with a growing group called ogy department at a hospital in Portland . HealthCare Partners . She also works with Ed Lopez, PA-C (Seattle Class 15), Volunteers in Medicine of Southern Ne- worked at the Walla Walla Community vada, a privately funded volunteer clinic . Health Clinic for two years to pay back Kelly Adsero, PA-C (Seattle a federal loan . Then he left for New Class 39), is working at Auburn Regional York City to do a surgical residency at Medical Center and at the emergency Montefiore . He was recruited to start department in Swedish . She and her the first trauma surgery program in Flint, husband recently had a baby girl, and Mich ., and he stayed there two years . Adsero is participating in running events Lopez was then recruited by a cardiac and triathlons . surgery group in Tacoma, Wash ., where Brian Knutson, PA-C (Seattle he stayed for nearly seven years . In 1995, Class 39), has been working with U .S . he started his own cardiac surgery physi- HealthWorks for three years . He is prac- Marilyn Wyse Snyder, PA-C (Seattle Class 24) ticing at the Federal Way clinic, which

32 UW MEDICINE < ClassNotes i MEDEX Northwest Alumni

gives him exposure to family medicine, and Somali . The clinic is well-staffed and located above the Arctic Circle . James occupational medicine and urgent care . quite well-equipped — a small pharmacy, writes that he was in short sleeves in Knutson feels that it is a privilege to care nurses, a midwife, several support staff, Chicago for a CME program after for patients of all ages . and two providers called clinical health enduring five straight days of 40-below Stacy Lasater, PA-C (Seattle officers, who represent a Ugandan ver- weather at home . “Alaska is the highest Class 39), writes, “Wow, it has been sion of a mid-level and do very good quality of living I have found to date,” a long time, but I think of you all at clinical work . They’re well-trained . Much says James . “I am doing exactly what I MEDEX quite often . I am still in Northern of the treatment is based on Ugandan set out to do, where I wanted to do it, California, working for a large hematol- Ministry of Health and World Health Or- and serving the people and culture ogy/oncology practice, Valley Medical ganization guidelines . It’s a walk-in clinic, I chose to serve . My gratitude to MEDEX Oncology Consultants . Working as a PA where the complaints run the full range remains .” is amazing, and I love what I do, and of issues and ages . Many infectious although working in oncology is a very diseases are prevalent, including HIV, TB, Spokane demanding and mentally exhausting brucellosis and malaria . The rainy season Letitia McCully, PA-C (Spokane field, I definitely find it very rewarding . I had just begun, so malaria was on the Class 5), is working at the Commu- am constantly promoting the PA profes- rise . They have falciparum malaria, and nity Health Association of Spokane, in sion, and have pushed a few people into it’s not hard to see why it kills so many Spokane, Wash ., which she joined after the field who were considering other people . Interestingly, the standard and graduation . She became part of their HIV medical professions . I definitely advocate very effective treatment is derived from team approximately two years ago and for MEDEX as a demanding but fantastic a Chinese herb called Artemesia . My finds it to be challenging and rewarding; program . I worked in orthopaedics for a previous career was in Chinese medicine, in fact, she recently passed the specialty couple of years, but I wanted more medi- so it was interesting to use a medicine in exam given by the American Academy of cal experience — to fine-tune the skills Uganda that I had used for years in the HIV Medicine . McCully continues to en- and knowledge obtained from MEDEX .” past as part of an herbal pharmacy .” joy camping, hunting, and other outdoor Preston Lehr, PA-C (Seattle Hope Salvador, PA-C (Seattle activities . She was granted a moose- Class 39), has been in family medicine Class 40), MPH, continues to work at hunting permit this year and managed to for five years at the Columbia Basin the Anchorage Neighborhood Health fill her tag with a good-sized bull moose . Center in Anchorage, Alaska, and she Health Association in Othello, Wash ,. Carrie Conley, PA-C (Spokane earned an MPH from the University of and loves it! Class 12), is still in the North Pole Andrew Cahn, PA-C (Seattle Washington . Her clinical interests tend “loving life ”. She has been there for Class 40), as part of Medical Teams toward adult medicine, and she is trying several months and continues to practice International’s disaster response group, to start a hepatitis C program at the cen- at Midnight Family Medicine in Fair- traveled to the Nakivale Refugee Camp ter . When not working, Salvador enjoys banks, Alaska, with Dr . Kaihoi . Conley in southwest Uganda to provide medi- the great outdoors and travel, including was promoted from an enlisted member cal care last October . He was joined by recent trips to London and Nepal . of the Air Force Reserves to a second a veteran ER nurse from Oregon . Cahn Mingying-Monique Ying lieutenant . writes, “The refugees in Nakivale are (Bonner), PA-C (Seattle Class 40), is a mix of Congolese (DRC), Rwandan, currently working in inpatient cardiology Yakima Sudanese, Ethiopian, Burundian, Eritrean at Oregon Health & Science University in Portland, Ore . Cora Cummins, PA-C (Yakima Matthew James, PA-C (Seattle Class 4), practiced as a gastroenterology- Class 42), has completed two locum focused hospitalist in Tacoma, Wash ., for tenens contracts with Pine Ridge Lakota 12 years, then as an internal medicine Hospital in Wounded Knee, S .D . While hospitalist . She is now a nocturnist for there, he worked in emergency care Catholic Health Initiatives . and in outpatient internal medicine . He Danielle Grate PA-C (Yakima then took a two-year contract with Chief Class 10), has been working in an Andrew Isaac Health Center in Fairbanks, urgent care facility in Reno, Nev ., for the Alaska, where he directs the weekend last year . Previously, she spent two-plus clinic and is the only provider available years repaying a service loan by work- on the weekends . James also works with ing at Health Access Washoe County in two other PAs and a family medicine Reno . She has two little boys, Tyce (who doctor from Seattle Indian Health to turned 5 in November) and Talen (who serve a portion of the villages within the turned 2 on Christmas Eve) . Photo courtesy of Andrew Cahn, PA-C Tanana Chiefs Conference, a consor- (Seattle Class 40), who traveled to work in tium of 42 tribal villages in the Alaskan a refugee camp in Uganda . interior . The majority of the villages are

SPRING 2012 33 Student Voices >

OCCUPYING WALL STREET

n early December 2011, about 200 students in the health professions — many in their lab coats or scrubs — rallied The Rev . Jesse Jackson spoke with UW School of Medicine student in downtown New York City and marched in support of Colin McCluney and AMSA National President Danielle Salovich at I a December 2011 rally — held in New York City — of students in the Occupy Wall Street movement, access to healthcare for the health professions . Photo: Sonia Lazreg all, and the elimination of the social disparities that affect health. Participants “shared some fascinating and power- ful stories,” says Colin McCluney, who helped organize the event. “It was really fun and empowering.” After the “grand tour” — i.e., his third-year WWAMI rotations — McCluney started his AMSA fellowship in McCluney, who is taking a year off from his course work July 2011, based at the organization’s national headquarters at the UW School of Medicine to serve as the 2011–2012 outside Washington, D.C. “A big part of [the draw] was the Education and Advocacy Fellow of the American Medical opportunity to combine the education and the advocacy Student Association (AMSA), is a natural fit for this kind pieces,” he explains. of activism, having long followed the road less travelled. In his role as fellow, he helps to coordinate national Born in Scotland, McCluney has lived in the U.S. since conferences and symposia for AMSA members, develops his 1987 and in Seattle for the last 10 years. He was taking pre- mentoring skills through an intern program, directs AMSA’s med classes at Reed College in Portland, Ore., until a music legislative efforts — such as contributing to a brief for the theory course changed his direction. “I came back around to Supreme Court — and supports members’ efforts through medicine eventually,” he says. “It’s one of those things that training programs and other projects. you should be sure about before you commit the time and expense.” A non-traditional student by virtue of his relative “The fellowship is expanding my personal belief that age and experience, McCluney also has been more active in physicians should be involved in advocacy,” McCluney says. advocacy than many of his peers. “That can be writing a letter, or talking to people in your community; it doesn’t have to mean writing a policy paper.” An internship at AMSA’s national office the summer before he started medical school confirmed McCluney’s in- Which brings us back to the December rally and terest in the student-governed organization, which represents the support of the Occupy physicians-in-training. “Since then I’ve been involved in Wall Street movement. various aspects of the organization, including the ‘Healthcare Noting that AMSA has long for All’ campaign — students working toward everyone pushed for access to health- having access to medically necessary health care,” he says. care, McCluney says, “There are all different kinds of McCluney’s dedication to access also informed his advocacy, and one of them is choice of medical school. “The emphasis on primary care at direct action expression.” UW and the clinical opportunities provided by the WWAMI program were really appealing to me,” says McCluney. Read more about AMSA at amsa.org.

34 UW MEDICINE < Passages

Ronald Dale Graves, PA-C PASSAGES: MEDICAL ALUMNI AND FACULTY REMEMBERED (Seattle Class 1, 1970) Below we pay tribute to recently deceased alumni and faculty members. Dec. 22, 2011 Because we are not always aware of deaths in the larger UW Medicine Mr. Graves was a physician assistant with community, especially those that take place outside of Seattle, we rely on the Texas Department of Corrections and a other alumni, faculty and friends to notify us and send us obituaries. Our decorated military corpsman. sincere condolences to those who have lost loved ones. FACULTY Franklin S. Newman, M.A., Ph.D. Nov. 11, 2011 ALUMNI Howard R. Bowman, M.D. ’56 Dr. Newman was a founder of the Nov. 2, 2011 Charles E. Simons, Jr., M.D. ’51 WWAMI-Montana program. Sept. 10, 2011 Dr. Bowman loved wildflowers and the out- Dr. Simons, a urologist and surgeon, served doors, and he practiced in Naches, Wash., William O. Robertson, M.D. in both World War II and the Korean War. for 42 years. Nov. 30, 2011 Please see Dr. Robertson’s obituary, below. Gilbert K. Schaller, M.D. ’52 James W. Tupper M.D., Res. ’59 Dec. 23, 2011 Dec. 27, 2011 Cyrus E. Rubin, M.D. Dr. Schaller practiced internal medicine in Dr. Tupper was a Navy physician during the Dec. 19, 2011 the Seattle area for 42 years. Korean War; he also was an orthopaedist Please see Dr. Rubin’s obituary on page 36. and an avid skier. Haruto Sekijima, M.D. ’53 COMMUNITY Sept. 12, 2011 Joseph C. McCarthy, Jr., M.D. ’68, Ethel Victoria Hackett Scribner Dr. Sekijima was a military intelligence of- Ret., USNR Feb. 9, 2012 ficer and one of the founding anesthesiolo- Aug. 20, 2011 Mrs. Scribner was a longtime advocate for gists at Overlake Hospital Medical Center Dr. McCarthy was an expert in family and students at the UW School of Medicine. in Bellevue, Wash. emergency medicine who spent 20 years in the military. Joseph W. Voegtlin, M.D. ’54 Nov. 5, 2011 Full obituaries at uwmedmagazine.org » Dr. Voegtlin was instrumental in the opening of Skagit Valley Hospital in Mt. Vernon, Wash.; he was also a pilot.

WILLIAM O. ROBERTSON, M.D.

Died Nov. 30, 2011, in Seattle, Wash.

William O. Robertson, M.D., Washington Poison Center. Over the known as “Dr. R.,” was one of Seattle’s next five decades, he served as direc- most influential physicians. An expert tor of medical education at Children’s, in pediatrics, toxicology, teaching and chair of pediatrics at UW Medicine, poison prevention, Robertson was and medical director for Washing- born in Brooklyn, raised in New York, ton Poison Center. Robertson was a and graduated from the University strong advocate of medical marijuana of Rochester School of Medicine in and supported an initiative to legal-

Rochester, N.Y. He taught pediatrics at ize marijuana for terminally ill and Poison Center Photo courtesy of the Washington Yale University before heading to Ohio chronically debilitated patients; he also If you would like to read more State University to chair its Depart- supported an initiative that advocated about Robertson, please visit The ment of Pediatrics. for patients having the right to die Seattle Times at seattletimes.com. The with dignity. He is survived by several Moving to the Northwest in 1963 paper paid tribute to his life and ac- children: Andy, Doug, Kerry Kuenzi, to work for UW Medicine and Seattle complishments — while capturing his Kathy and Lynn. Children’s, Robertson started the interests and his inimitable style — on Dec. 6, 2011.

SPRING 2012 35 Passages >

CYRUS E. RUBIN, M.D.

Born July 20, 1921, in Philadelphia, Penn. Died Dec. 19, 2011, on Mercer Island, Wash.

A member of the UW School of to diagnosis, treatment and research Medicine faculty for 57 years, Cyrus E. on gastrointestinal disorders, becom- Rubin, M.D., was a pioneer in ing an authority on celiac disease and gastroenterology. Officially retired receiving international recognition for since 1992, he remained an active his many accomplishments. teacher, investigator and clinician. He Always mindful of patients’ needs, received an M.D. at Harvard Medi-

Rubin encouraged the food industry Photography Photo: David Wentworth cal School, and, after an internship to produce gluten-free foods to help at Beth Israel in Boston, he served as patients adjust to their condition. Rubin was a generous philanthro- an officer in the U.S. Army Medical More recently, he produced an online pist, a dedicated oenophile who grew Corps. He then completed further lecture series for physicians on celiac his own grapes, an enthusiastic sup- training: a residency in medicine at the sprue and many of gastroenterology’s porter of the arts, education, culture, VA in Framingham, Mass., a residency classic texts. He was a sympathetic and good causes of all kinds, a bonsai in radiology at Beth Israel, and gastro- teacher and mentor who trained scores artist, an amateur archaeologist, a sing- enterology training at the University of of gastroenterologists, including many er in the Old GI Geezers Quartet (with Chicago. Rubin came to the Depart- leaders in the field. Dave Saunders, M.D., Don Ostrow, ment of Medicine at the University of M.D., and Charles E. (Chuck) Pope Washington in 1954; at the time, he Rubin received international II, M.D., Res. ’61), and an all-around and Wade Volwiler, M.D., made up the recognition for his accomplishments, humanist. He is survived by his wife entire gastroenterology faculty. including the major awards given by all three American gastroenterologi- of 64 years, Grace S. Rubin, his son In the late 1950s and 1960s, Rubin cal organizations: the Distinguished and daughter, William D. Rubin and made engineering advances in gastric Achievement Award and the Frie- Betsy Deutsch, and five grandchildren: and intestinal biopsies that led to the denwald Medal from the American Aaron Akiva, Anna and Yoni Rubin, accurate diagnosis of celiac disease. Gastroenterology Association, the and Rachel and Sarah Deutsch. Use of the Rubin Tube demonstrated Rudolph Schindler Award from the that celiac sprue in children and in American Society of Gastrointestinal (With thanks to Roberta Wilkes and adults were identical disorders, and Endoscopy, and the Clinical Research William J. Bremner, M.D., Ph.D., chair, his classic 1960 paper established the Award from the American College of Department of Medicine) diagnostic criteria for the disease. Over Gastroenterology. The Cyrus E. Rubin the years, he continued to refine endo- Endowed Chair in Medicine at the scopic technology and its application University of Washington was created in his honor in 1997.

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2012 REGISTER TODAY! JUNE 1–3, 2012 Seattle, Wash. Reunion Featuring brand-new programming for all of our alumni, plus not-to-be-missed events at the Space Needle, Urban Enoteca and the Woodland Park Zoo. Whether you graduated five years ago or 50, you’ll Weekend have a great time at the reunion weekend! See page 24 for more details, including this Your friends. Your class. Your university. year’s featured reunions. And register today at www.uwmedalumni.org/reunion!