Columbia Medicine Columbia University College of Physicians & Surgeons Features:

4 10 16 Going Outside Blood Borne Getting Personal

the Four Walls As the new director of the Through the ambitious A community wellness center Columbia Stem Cell Initiative, NIH-funded All of Us program, led by two P&S faculty Emmanuelle Passegué P&S will help enroll members will strengthen is pursuing her vision to 1 million Americans in a initiatives in stroke prevention further the initiative, large-scale research effort and mental health support. established in 2008, to identify ways to prevent The center continues a longtime by integrating basic lab and treat disease based P&S tradition of expanding discoveries with their potential on individual differences access to health care for clinical application. in lifestyle, environment, throughout the city. and genetics.

http://ps.columbia.edu/ ColumbiaMedicine | 2017 nnual Report Issue

Departments:

2 Dean’s Message

26 2017 Year in Highlights

33 Philanthropy News

36 P&S News

39 About P&S · Trustees Committee on the Health Sciences · Columbia University Medical Center Board of Advisors · Other CUMC Advisory Groups · Senior Administration, CUMC · Senior Administration, College of Physicians & Surgeons · Executive Committee of the Faculty Council · Department Chairs · University Centers and Institutes and Directors · Affliated Hospitals · Facts and Statistics

On the Cover The cover is the second of three 2017 commemorative covers that celebrate the 250th anniversary of Columbia’s medical school. This cover recalls the design infuences from the middle part of the school’s 250 years, from the 22 mid-1800s to the early 1930s. Illustration by Ben Johnston. Then & Now 2017 Annual Report Offce of the Chief Executive Editor: Bonita Eaton Enochs and Dean of the Faculties of Health Sciences and Medicine Medical education at P&S Principal Writer: Sharon Tregaskis Columbia University Medical Center has passed through multiple Contributing Writers: Elizabeth Chute, 630 W. 168th St. eras of change during the Alla Katsnelson, Kelly Mays McDonald, New York, NY 10032 school’s 250 years, and a Carol Perloff new era has begun with a Art Director: Eson Chan Communications Offce campaign to help tomorrow’s College of Physicians & Surgeons Produced by the Communications students fnance medical 701 W. 168th St., Box 153 Offce at Columbia University school with scholarships New York, NY 10032 College of Physicians & Surgeons Phone: 212-305-3900 instead of loans. Christopher DiFrancesco, Fax: 212-305-4521 Chief Communications Offcer

Printed in September 2017 Offce of Development Columbia University Medical Center 630 W. 168th St., P&S 2-421 New York, NY 10032 Phone: 212-342-0088 • DEAN’S MESSAGE

P&S: 250 Years Strong

t this year’s alumni reunion gala in May, Ron Cohen’81 nies. His family’s connection to P&S includes 13 MD graduates regaled fellow alumni and guests with his portrayal of between the years of 1771 and 1867. Samuel Bard. Dressed in period attire, Dr. Cohen took The frst graduation ceremony, in 1769, was an impressive us back to the 1770s to remind us of the historic beginnings event. Held on May 22 in Trinity Church in lower Manhattan, of what is now the College of Physicians & Surgeons. Known guests included civilian and military dignitaries as well as Gov- then as the King’s College medical faculty, P&S has sur- ernor Sir Henry Moore. Samuel Bard’s speech that day was vived mergers, faculty insurrections, wars, and several moves later published and is remarkable for his call for the gradu- JÖRG MEYER around New York City. That the school—the second medical ates to raise the prevailing levels of medical ethics and to keep school established in the Colonies and the frst to grant the abreast of medical knowledge, two principles that remain part MD degree—is still here to celebrate its 250-year anniversary of the foundation of a P&S education today. is testament to the perseverance of the multiple generations of Those frst classes offered in November 1767 cost much less faculty and administrators who worked hard to raise the bar than today’s tuition, hence the need for a scholarship campaign on medical education, patient care, research, and service to to ensure that today’s graduates pursue the medical careers of our neighborhood, city, and nation. their dreams instead of careers that will enable them to pay back The latest achievements in those missions are described in the hefty loans. That campaign was jump-started by Diana and P. pages of this year’s annual report. Roy Vagelos’54, who have asked Roy’s fellow P&S graduates to help tomorrow’s alumni fund their education through schol- • Stem cell research that is expanding through the Columbia arships. They also have contributed to the education of our stu- Stem Cell Initiative dents by being the lead donors for the Roy and Diana Vagelos • Our many community programs, including a new commu- Education Center, which is now fully occupied and used by our nity wellness center in Manhattanville that not only offers students for classes or studying. The building, with its dazzling care to Harlem residents but also trains individuals to help views of the Hudson River and the George Washington Bridge, their neighbors at risk for stroke or mental illness has been popular beyond our wildest expectations and is a ft- • The latest developments in precision medicine and our role in a federal effort to enroll 1 million participants in the All of Us program • The 250th Anniversary Scholarship Challenge and our goal of making medical school at Columbia debt-free for students who otherwise would need to borrow money to become physicians

These articles and others not only document our success over the past year, but also celebrate the deep commitments to our missions throughout our history—a history we have been com- memorating all year as we near November 2, the 250-year anni- versary of the frst day of classes at Columbia’s medical school. At right is the announcement that ran in the New York Gazette in September of 1767. In 1769, a few years after those initial classes, two men were awarded bachelor’s degrees in medicine. Little is known about their careers. When one of those graduates, Robert Tucker, earned an MD degree a year later, he became the frst MD recip- ient in the Colonies. The other 1769 graduate, Samuel Kissam, received his MD in 1771—the second awarded in the Colo-

2 ColumbiaMedicine ting legacy to the generosity of Roy and Diana and the many Center, in honor of the commitment, loyalty, and generosity of other donors who made the building possible. Florence and Herbert Irving. Among the materials developed to celebrate the 250 years We are as proud of our medical school today as the founders of medical education at P&S is a graphic suggested by Don- must have been when they offered those £5 classes 250 years ago ald Landry’83, chair of medicine. It is impossible to view the to launch the frst generation of American-educated healers. Much graphic, above, without being awed by the context of our 250 has changed in education and patient care since then, but our core years in civilization. This hit home this year on the Fourth of values remain unchanged. Our students, classrooms, and clinical July, when we celebrated the 241st birthday of our nation. It is facilities may look different, but our commitment to educating humbling to recall that P&S is older than our country and that physicians and scientists, to caring for patients, to expanding med- our founding dean was personal physician to the nation’s frst ical knowledge, and to helping our neighbors has not diminished. president. We not only have made history with our medical We can only imagine how academic medicine may evolve over contributions, we also are an important part of history. the next 250 years, but we remain confdent that our ongoing As we continue to celebrate our history through special events commitment to excellence will ensure continued success—for our this year, we also are committed to shaping the future through medical school, our medical center, and our graduates. continuous retooling of our educational programs, growth of our research (our NIH funding increased by 17 percent With best wishes, last year), expansion of patient care programs, and increased engagement with our neighbors in our community and across the city. I invite you to peruse the pages of this report to learn more about the many ways we are making a difference. With our clinical partner, NewYork-Presbyterian, we also are celebrating the renaming of our shared campus in Wash- Lee Goldman, MD, Dean ington Heights as the Columbia University Irving Medical [email protected]

2017 Annual Report ColumbiaMedicine 3 Going the Partnerships Promote Health Literacy and Build Community Capacity

Four Walls By Sharon Tregaskis THINKSTOCK lajide Williams, MD, was a neurology resident at Colum- master’s degree in public health at Columbia’s Mailman School bia when an annual physical turned his world upside of Public Health, began giving speeches at local churches, and down. “I had just turned 30 years old and I was diag- authored “Stroke Diaries: A Guide for Patients and their Fami- nosed with high blood pressure,” says the Nigerian-born lies.” And with rapper Doug E. Fresh, he co-founded Hip Hop Oneurologist. “I was ft, healthy. My only risk factor was a family Public Health, a nonproft that uses music and media to pro- history and being black.” mote health literacy within economically disadvantaged under- Now a P&S associate professor of neurology, director of acute resourced communities and has developed programs such as stroke services at NewYork-Presbyterian, and co-director of the Hip-Hop Stroke, which is funded by the NIH and supported by Center for Stroke Disparities Solutions in New York, Dr. Williams the New York State Department of Health. was lucky. His diagnosis came early, he could afford the medical “I live in Harlem, I raised my children in Harlem, I have care he needed, and his professional training had given him the worked in Harlem my whole career as a neurologist, and I recog- health literacy he needed to keep his blood pressure in check: med- nized the painful disparities that plague communities of color,” ical compliance, diet changes, exercise, and stress management. says Dr. Williams, who performs for schoolchildren, calling him- Hypertension, which afficts nearly one-third of all Ameri- self the Hip Hop Doc and wearing scrubs and an outsized golden cans and is an underlying factor in more than 70 percent of chain yet speaking with the hint of a British accent acquired strokes, is a poster child of this country’s racial health dis- during his own youth at a boarding school in London. “I don’t parities. Americans of Hispanic and African descent are more think that we, as physicians, will be able to realize the type of likely to develop hypertension, less likely to be diagnosed early outcomes that our local communities desperately need if we do (when treatment is most effective), and less likely to respond not venture out of the four walls of our hospitals.” fully to the drugs that can manage the condition. Dr. Williams’ community-frst approach will be front and center While on rounds at Harlem Hospital Center to evaluate in Columbia’s new Community Wellness Center, slated to open later and treat patients who had suffered strokes, Dr. Williams bore this year in the Jerome L. Greene Science Center on the University’s daily witness to hypertension’s ravages and its disproportionate new Manhattanville campus. A partnership of the departments of insults in Harlem. Among people aged 35 to 45, the incidence of neurology and psychiatry and ColumbiaDoctors—with operating stroke is four times higher in blacks than in whites; of all races, support from the Mortimer B. Zuckerman Mind Brain Behavior African-Americans have the highest mortality rate from stroke. Institute—the self-contained center will house two new initiatives: And so even as the neurologist garnered millions of dollars in the Community Health Worker Stroke Prevention program, led research funding from the NIH to better understand how hyper- by Dr. Williams, and Mental Health First Aid, or MHFA, led by tension and racial disparities conspire to kill African-Ameri- Sidney Hankerson, MD, assistant professor of clinical psychiatry. cans, Dr. Williams resolved to make prevention—starting with “There is a huge stigma around mental health in the black basic health literacy—a cornerstone of his career. He earned a community,” says Dr. Hankerson. Dr. Hankerson’s passion for community-based interventions draws on personal experiences and NIH-funded studies focused on reducing race-based health disparities in the United States. The Baptist Church that Dr. Han-  HELP FROM OUR FRIENDS kerson regularly attended growing up—where his father served as a deacon and his mother played piano for the children’s choir— ELPING PEOPLE was a second family to him. “I was raised in Fredericksburg, Va., IN T E COMMUNITY where my church was a hub of educational, social, and civic engagement. We were a tight-knit community that helped people The Chapman Perelman Foundation has made gifts of more than $2.3 million to tackle familial challenges and supported one’s spiritual growth,” support programs in the Department of Psychiatry and new projects within the says Dr. Hankerson. Institute of Genomic Medicine that apply precision medicine technology to improve After completing undergraduate studies at the University of diagnosis and ultimately treat mental illness. The Chapman Perelman Foundation Virginia, Dr. Hankerson enrolled at Emory University School of is continuing support for a program it helped establish in 2014 to provide mental Medicine. He did most of his clinical training at Grady Memorial health services to victims of domestic violence in historically underserved Hospital, a large public hospital system which he calls “the Har- communities. Working in tandem with the New York City Mayor’s Offce to Combat lem Hospital of the South.” Fueled by his perception of substan- Domestic Violence, Columbia provides mental health services at the New York City dard mental health services at Grady, Dr. Hankerson obtained Family Justice Center in the Bronx. The new gift provides support to replicate this a dual MD/MBA at Emory to understand how to translate best program at Family Justice Centers in each of New York’s fve boroughs, allowing practices from business into research and clinical care. psychiatry faculty to continue providing comprehensive and integrated care for Dr. Hankerson came to Columbia in 2009 after receiving a families affected by domestic violence. competitive NIMH-funded research fellowship. He studied how community-based interventions could address factors such as

6 ColumbiaMedicine Olajide Williams MD

JÖRG MEYER lack of access to care, fnancial constraints, stigma, and distrust “It’s one thing to provide resources to of health care professionals that contribute to African-Ameri- cans’ low depression treatment rates. “When I frst arrived at a community and another thing to help Columbia, I attended several community meetings with Dr. Wil- communities build capacity.” liams, gave free mental health workshops, and talked to numer- ous community leaders,” says Dr. Hankerson. high rates of depression (20 percent) via a depression screening “I conducted several focus groups with pastors, who described study among congregants at three black churches in New York depression as a ‘silent killer’ in the black community.” Indeed, City. The study was the frst of its kind, and Dr. Hankerson was recent data from the Department of Health and Mental Hygiene invited to the White House last year to discuss the results and his show that clinical depression is the No. 1 cause of disability in community-based program. New York City, but many people refuse to seek depression care. Dr. Hankerson is delivering the eight-hour Mental Health First “The pastors’ insights caused me to pursue their role in mental Aid program, currently housed in Harlem’s First Corinthian Bap- health care more in-depth.” tist Church, in trusted community venues. His program draws on A landmark national study found that more people contact the strong social ties within communities of faith and the credibil- clergy frst for mental health problems compared with psychia- ity of clergy to combat the stigma of mental health troubles and trists, psychologists, or general medical doctors. “Our clergy are build connections among congregants and health care providers. trusted,” says Dr. Hankerson. And yet, faith communities are “The churches have spearheaded the emotional needs of their often ill-equipped to address the needs of members struggling congregations for years,” says Dr. Hankerson. with depression and other mental health illnesses. “The notion Mental Health First Aid, which is available in English and that people of faith don’t get depressed or struggle with other Spanish, trains faith leaders—pastors, imams, deacons, and mental health problems creates tremendous tension that we have other clergy—and Harlem community members to assess and to work through. It’s often counter-cultural for us to be talking support someone experiencing a mental health crisis. Partici- about mental health in the church, but it’s a great opportunity to pants learn to detect signs and symptoms of depression and reach people who need help.” For example, Dr. Hankerson found other mental illnesses, and the program provides a fve-step

2017 Annual Report ColumbiaMedicine 7 A 250-Year Commitment to Community

n May 16, 1769, the medical school now known as ies. Established by NewYork-Presbyterian Hospital nearly OColumbia University’s College of Physicians & Surgeons 30 years ago to provide health care to the underserved com- celebrated its frst commencement. “No less than Life, and its munities of northern Manhattan, the network is composed greatest Blessing Health, are to be the Objects of your Atten- of 14 primary care practices and more than 50 specialty tion,” the school’s dean, Samuel Bard, advised the graduates clinics that care for children and adults by combining the in his speech that day, “and would you acquit yourselves to resources of the hospital, the medical center’s schools, and your own Consciences, you must spend your Days in arduous the community to enable residents to have the fnest care Enquiries, after the Means of render- without leaving their neighborhood. ing those of others long and happy.” Demand for ACN appointments is high, and new patients Language—not to mention capi- sometimes had to wait six to eight weeks to get an appointment. talization—has changed signifcantly That prompted the ACN’s Broadway practice medical director since those early years of Columbia’s Rachana Gavara, MD, to make timely care a priority, boosting medical school, but the commitment the availability of same-day and walk-in appointments. to patients has only expanded with Dr. Gavara, assistant professor of obstetrics & gynecology, the times. Dr. Bard urged the two has a particular interest in patients who are pregnant and have graduates, who received bachelor of not received any prenatal care. “Initiating prenatal care early medicine degrees that day, to pursue on provides an opportunity for early detection of problems a life of inquiry, of integrity, and of during pregnancy and enables early intervention and preven- compassion. He also issued a call for tion of complications and poor outcomes,” says Dr. Gavara. a public hospital. Later the same day, To speed access for these patients, Dr. Gavara and her col- a subscription raised 1,000 pounds to leagues instituted a new policy to see any woman at more establish New York Hospital, dedi- than 20 weeks’ gestation within a week of her request for an cated not only to the care of the city’s appointment. “It has improved patient satisfaction, relieves poorest residents, but also to the the anxiety of the mother, and helps the staff, who are not study of disease in all its forms and seeing mothers for the frst time late in the pregnancy.” the training of aspiring physicians. In addition to emphasizing patient care, Dr. Bard early on Expansion of Dr. Bard’s vision envisioned the imperative for physicians to tailor their studies over the years has come in the form of disease to unique manifestations in different populations. of clinics and programs—including “Every Country has its particular Diseases,” he declared, many founded by students—that “the Varieties of Climate, Exposure, Soil, Situations, Trades,

JÖRG MEYER address the population’s changing Arts, Manufactures, and even the Character of a People, all

Rachana Gavara MD needs. Among the current student- Pave the Way to new Complaints and vary the Appearance run clinics are the Columbia-Harlem Homeless Medical of those, with which we are already acquainted.” Partnership, a 10-year-old program that provides free health The Irving Institute for Clinical and Translational Research services in West Harlem, and the Columbia Student Medi- has used part of its $58.4 million NIH grant to strengthen its cal Outreach, or CoSMO, which offers the uninsured in commitment to the neighborhood by creating new opportuni- Washington Heights primary health care and access to social ties to engage community leaders and residents in the design workers, health educators, Spanish-language interpreters, and and pursuit of medical research, including precision medicine. nurses while instilling in students a lifelong commitment to Led by José Luchsinger, MD, and co-directors Ana Abraido- the service of all who are in need. Lanza, PhD, and Rafael Lantigua, MD, and associate director The Community Wellness Center that will open in the new Elizabeth Cohn, RN, PhD, the Institute’s Community Engage- Jerome L. Greene Science Center on the Manhattanville cam- ment Core Resource provides education, training, and off-cam- pus will promote stroke and depression awareness, augmented pus space for health research and promotion activities and links by the efforts of specially trained health ambassadors. “Ours residents to health information and services. “Community- is not a unique endeavor,” says Olajide Williams, MD, co- based participation in research allows us to know more about founding director of the new center. “Community medicine how medical knowledge is generated,” says Dr. Luchsinger, has been a long and deliberate endeavor over many years.” who also directs the Center on Aging and Health Disparities The Ambulatory Care Network—ACN—is just one exam- in the Division of General Medicine. “It’s immensely important ple of providing care beyond the medical center’s boundar- for research and for the community we serve.”

88 ColumbiaColumbiaMedicineMedicine Sidney Hankerson MD

JÖRG MEYER action plan for connecting people to appropriate support. “It’s often counter-cultural for us to be Dr. Hankerson’s team has trained nearly 100 people and sched- uled monthly trainings for the remainder of 2017. talking about mental health in the Dr. Williams’ Community Health Worker Stroke Prevention church, but it’s a great opportunity to program has a similar commitment to honoring the ways in reach people who need help.” which relationships between congregants and their clergy can boost access to health care. Now in its third training block, the program recruits volunteers from local faith communities for a results plus information on ways to improve their health. Cen- free eight-week course during which they learn about stroke and ter staff will offer information—in English and Spanish—about cardiovascular disease risk factors, screening, and prevention and free and low-cost clinical resources in the neighborhood and at learn how to do CPR and motivational interviewing. “We train NewYork-Presbyterian/Columbia University Medical Center. community health workers as resources within the community, Perhaps most importantly, the programs housed within the to serve as health advocates, linkage to the health system, health center will address a key and long-standing obstacle preventing educators, and counselors,” says Dr. Williams, who plans to access to appropriate health care among African-Americans— extend the program to additional faith communities in Harlem that of mistrust of mainstream medical science and health care and to predominantly Latino churches in Harlem and Washing- in general. “We know that people of color—African-Americans ton Heights. “We provide them with myriad skills required for and Latinos—are disproportionately affected by chronic medi- them to act as the health foot soldiers in their churches.” To make cal conditions, such as high blood pressure, diabetes, depres- good on that promise, the program also helps participants earn sion, anxiety, and stroke,” says Dr. Hankerson. “This is going New York state certifcates that allow them to counsel and enroll to be an amazing opportunity for collaborations, for the devel- fellow New Yorkers into health insurance plans. “It’s one thing to opment of new partnerships with scientists, physicians, psy- provide resources to a community,” he says, “and another thing chologists, and, most importantly, among members of the West to help communities build capacity.” Harlem community to really identify how we can provide the In addition to offering stroke and mental health awareness pro- best care, delivered in a culturally sensitive way, and how we grams, the Community Wellness Center will provide free blood can positively impact the lives of people in West Harlem.” v pressure readings and cholesterol tests on weekdays and select weekends to all who walk in. Visitors will be given records of their Elizabeth Chute contributed reporting to this article.

2017 Annual Report ColumbiaMedicine 9 BLOOD BORNE From Bone Marrow Transplant Discoveries to Modern-Day Stem Cell Science, Columbia Investigators Propel Research to Enhance Patient Care

By Sharon Tregaskis Photographs by Jrg Meyer Emmanuelle Passegué PhD nown as the frst responders of the circulatory sys- harvested from older mice with those harvested from younger tem, hematopoietic stem cells, or HSCs, lie in wait knockout mice genetically engineered to not use autophagy. deep within our bone marrow and leap into action The work—a collaboration of Dr. Passegué and her former in response to injury or disease. Studying these cells colleagues at the University of California San Francisco’s Eli and may offer new treatment for cancer and immune Edythe Broad Center for Regenerative Medicine and Stem Cell Ksystem disorders and also help us understand the mechanisms Research and an independent team at the University of Michi- of aging in general. gan—showed that autophagy has a previously unknown role Emmanuelle Passegué, PhD, has devoted her career to as the gatekeeper for the process by which HSCs power down revealing the cellular and molecular processes controlling when they are not on duty. The team went on to demonstrate HSC activity during homeostasis and addressing the changes that loss of autophagy allows the accumulation of mitochon- that culminate in bone marrow malignancies and physiologi- dria running on overdrive, leading to changes in the epigenetic cal aging. Using a combination of mouse models and human landscape of the HSC DNA and contributing to many dysfunc- patient samples, she seeks to reveal the genes and biochemical tions associated with aging in this stem cell population. “This signals that regulate their optimal function—how they kick- is very much at the front edge of the science being developed in start cell production in the minutes and days after you give the stem cell feld,” says Dr. Passegué, “where we realize that blood, for example, and what breaks down as we age, increas- to understand stem cell biology, we have to bridge to the epi- ing our susceptibility to such conditions as chronic infamma- genetics with organelle biology and cell metabolism.” tion, anemia, and leukemia. Earlier this year, she celebrated Dr. Passegué’s second Nature article reported observations the publication of three groundbreaking discoveries in Nature on the mechanism behind leukemia development and drew on and also accepted an appointment as P&S Alumni Professor her long-standing interest in myeloid progenitor cells, which are of Genetics & Development (in Rehabilitation & Regenerative more committed cells produced by stem cells that give rise to Medicine) and director of the Columbia Stem Cell Initiative, a restricted type of white blood cells, granulocytes and macro- a collective of research groups whose work runs the gamut phages in this case. Using immunofuorescent staining of bone from basic and translational research to clinical applications sections, the team—comprised of investigators from UCSF, and ethics. Cambridge University, and the Dana-Farber Cancer Institute— Like any frst responder that leaps into action in a time of mapped the process of myeloid cell differentiation in situ in the crisis, HSCs spend a fair amount of time just waiting around. bone marrow cavity and identifed a series of chemical signals produced by the bone microenvironment that drive an emer- “Stem cells are deeply embedded in what we gency hematopoietic regeneration response and are transiently activated following an injury but are hijacked during leukemia do with both regeneration medicine and development. “Leukemia creates a perfect storm where muta- precision medicine to fnd novel therapies that tions in HSCs cooperate with changes in the bone marrow microenvironment to transform what is normally a very con- are tailored to the need of each patient.” trolled, emergency-stress response pathway into a never stop- ping mechanism for cancer cell production,” says Dr. Passegué. Professional frst responders use those lulls to recuperate and “This is a fundamental discovery, and we can now start think- prepare. So do HSCs—by going into a state of quiescence a ing about how to attack this process with drug agents.” lot like hibernation. And yet, over time, HSCs seem to accu- Dr. Passegué’s third Nature publication revealed that the mulate errors. “HSCs self-renew and maintain themselves for lung serves as a reservoir for hematopoietic stem cells and a life, which makes them one of the few blood cells that truly site for production of platelets, which are essential for blood age,” says Dr. Passegué. “While they effciently generate all clotting. “The contribution of the lungs to platelet biogenesis is mature blood cells in young individuals, they often fail with substantial, accounting for approximately 50 percent of total age, resulting in degraded blood production characterized by platelet production or 10 million platelets per hour,” wrote anemia, loss of immune response, and the development of the team, comprised of Dr. Passegué, her former colleagues at blood cancers.” UCSF, and collaborators at the University of California, Los Dr. Passegué and her team had a hunch that autophagy—the Angeles. The discovery—a coup in a feld so well tilled that cellular cleanup and recycling process that earned a Japanese basic discoveries rarely turn up anymore—has implications scientist the 2016 Nobel Prize in Physiology or Medicine— both for transplant medicine (think of the expansion of the plays a part in the signaling process by which HSCs transition feld since cord blood harvest was demonstrated in the 1980s) between quiescence and activation and maybe even holds the and basic investigation, as well as treatment of thrombocyto- clue to how those aging-related errors accumulate. To test their penia, a condition characterized by low platelet counts and hypothesis, they compared and analyzed features of HSCs inability to stop bleeding.

12 ColumbiaMedicine Throughout her career, Dr. Passegué has toggled between mortar, but she has made building the interpersonal connec- basic and translational investigations, and that emphasis on tions among initiative members her top priority. An ambitious Emmanuelle Passegué with integrating basic discoveries with their potential for clinical calendar of invited lectures, faculty seminars, work-in-prog- Stem Cell Initiative application infuses her vision for the Stem Cell Initiative. ress talks given by trainees, an annual off-site scientifc retreat, researcher “You need the basic laboratory fndings to push a treatment and informal happy hours can further spur the kinds of casual Evgenia V. Verovskaya in patients,” says Dr. Passegué. “And despite the best under- conversations and social connections that launch research col- standing you have, you’ll observe something you don’t expect laborations and partnerships. It also provides a fertile ground when clinical trials start and you’ll have to go back to the to recruit the best new talent in the stem cell feld to Columbia, lab to understand it and keep moving forward.” Established which is also one of the key goals of the initiative. Says Dr. in 2008 in the Department of Rehabilitation & Regenerative Passegué: “What really excited me about coming to Columbia Medicine, the Stem Cell Initiative is now a stand-alone pro- was the possibility to develop and shape the stem cell program gram with both a stem cell core research facility and a new of a premier medical institution with such a luminary faculty fow cytometry core facility. pool and, of course, an outstanding hospital network.” The Stem Cell Initiative is slated to move to a specially Despite the signifcant responsibilities associated with her designed space in the Black Building in mid-2018, giving Dr. own work and her duties to the Stem Cell Initiative, Dr. Passegué Passegué a busy slate of decisions to make about brick and also knows she may have an additional role as an ambassador

2017 Annual Report ColumbiaMedicine 13 A Long Road to Bone Marrow Transplants

When the eyes and lips of a 2-year-old Baltimore girl started swelling in none responded badly to their transplants and a few even showed signs that the grafted mar- June 1958, the girl’s mother took her to the children’s hospital. n anti- row was making healthy blood cells, none were histamine reduced the girl’s infammation and the pair returned home. cured. The longest-surviving participant gained Six weeks later, the child’s symptoms had grown far more worrisome: three months. “In an atomic age, with reactor accidents, not night sweats, vomiting, fatigue, and a persistent, low-grade fever. to mention stupidities with bombs, somebody is going to get more radiation than is good for This time, the doctors looked more closely, entists for treatments—had been building for more him,” Dr. Thomas wrote in a discussion of his drew blood, and took an X-ray. Acute leukemia, than a decade. Media reports on the Japanese sur- NEJM report. “If infusion of marrow can induce they said. A poor prognosis. A decade earlier, vivors of the atomic bombs dropped on Hiroshima recovery in a mouse or monkey after lethal radia- the diagnosis would have been a death sentence. and Nagasaki detailed the devastating effects of tion, one had best be prepared with this form But then a handful of children with acute leu- radiation on the human body. In 1949, the Soviet kemia—all being treated in Boston—briefy Union detonated its frst nuclear weapon, and in achieved remission in response to a novel drug 1952, the United States tested its frst hydrogen designed to block the action of folic acid in the bomb. Federally funded scientists raced to fnd production and maturation of blood cells, pre- tools for the prevention or treatment of aplastic cisely the process that goes haywire in leukemia. anemia and leukemia, the most likely diagnoses The Baltimore toddler was given a similar regi- to affict survivors of a large-scale nuclear event. men, but remission remained elusive. Each sub- Among inbred mice and guinea pigs, at least, bone sequent blood test was more ominous than the marrow transplant was the most promising option. last and fnally doctors proposed what amounted By the time he arrived at Bassett in 1955, Dr. to a Hail Mary pass: Transfer the youngster and Thomas was intent on unlocking the clinical her identical twin to an experimental program at mechanics of bone marrow transplant in human Columbia-affliated Imogene Bassett Hospital in beings, despite our far more complex and discor- Cooperstown, N.Y., to transplant bone marrow dant genetic profles than the lab animals in which from the healthy girl to her dying sister. the experimental technique had been developed. The hospital’s physician-in-chief, hematolo- With fellow Bassett physician Joseph Ferrebee, E. Donnall Thomas MD gist E. Donnall Thomas, MD, oversaw their MD, who was on a quest to refne the emerging feld care at Bassett. As a medical student in Boston, of kidney transplantation, Dr. Thomas acquired a Dr. Thomas had been witness to those frst che- research colony of outbred beagles and assembled of treatment in man. The leukemic patient who motherapy trials for pediatric leukemia. After a a team to investigate why inbred animals tolerated needs radiation and bone marrow and the uremic stint in Germany to fulfll his obligations to the skin, kidney, and bone marrow transplants while patient who needs a spare kidney are the people Army Specialized Training Program that had outbred animals encountered such complications who deserve immediate consideration. From fnanced his medical degree, he returned to Bos- as rejection and graft-vs.-host disease that made helping them one will be preparing for the atomic ton, a crucible for research in hematology, pedi- death a certainty. Confdent they would solve the disaster of tomorrow, and it is high time one did.” atric leukemia, and the emerging Cold War feld riddle, Dr. Thomas and his collaborators simulta- Following the frst clinical trial, the little girl of radiobiology. He had completed a postdoc- neously began refning their protocols for harvest, from Baltimore entered a specially designed toral fellowship investigating the cellular effects purifcation, and storage of human bone marrow, room in Bassett Hospital, where she received of radiation, established his own laboratory as practicing on cadavers, bones removed during sur- total body irradiation to kill every vestige of part of Sidney Farber’s nascent pediatric can- gical procedures, and even one another. diseased marrow, then received what doctors cer institute, and, as chief resident at Peter Bent In 1956, the team launched a study funded by hoped would be a life-saving infusion of new Brigham Hospital, managed postoperative care the U.S. Public Health Service and the Atomic marrow from her sister. The child celebrated her for the frst human kidney transplant patient, in Energy Commission. The results were published third birthday, underwent two cycles of irradia- which a man received whole body radiation to a year later in the New England Journal of Medi- tion and transplant, twice achieved remission suppress his immune system, then received an cine. The six trial participants—all with end-stage followed by a relapse, and survived 166 days organ from his identical twin. cancer—received varying doses of radiation, fol- before leukemia claimed her life. Public anxiety over the hazards of radiation poi- lowed by intravenous infusions of marrow from Immortalized in Dr. Thomas’ 1959 report in soning—and a concomitant quest by physician-sci- cadaverous, fetal, and living donors. And while the Journal of Clinical Investigation, the cases of

14 ColumbiaMedicine the girl from Baltimore and another from Florida demonstrated that bone marrow transplantation from a compatible donor was technically feasible and that the procedure could reverse the hemato- logical devastation wrought by high-dose, total body irradiation. A cure for leukemia, however, remained out of reach. So, too, did insights into the problems of transplantation for human bone marrow recipients without an identical twin. Over the next three decades, spanning his appointment at Columbia and posts in Seattle, Dr. Thomas continued circling from laboratory to clinic and back again. His team refned the protocols for irradiation preceding transplant and methodi- cally unraveled the role of antigens within the blood, establishing the imperative for tis- sue matching and laying the groundwork for effective histocompatibility analyses in human beings. They developed post-transplant immu- nosuppression protocols to combat rejection and graft-vs.-host disease and documented that for patients who lived long enough, an effect CHCHHE P REL known as donor-vs.-tumor disease could actu- ally keep errant malignant cells in check, thus to politicians to champion federal funding for basic and trans- maintaining remission. Other scientists would lational research that will help investigators achieve the clinical iPSC-derived dopaminergic discover that the stem cells that give rise to the promise of stem cell research. It is a role for which she seems neurons components of the circulatory system could be uniquely prepared after her years in California. harvested from fetal cord blood, as well as the Dr. Passegué was a postdoctoral research fellow at Stanford bone marrow, and the procedure pioneered by University when California voters pledged in 2004 to self-fund Dr. Thomas came to be known as hematopoi- stem cell research. Storm clouds had been brewing in Washing- etic stem cell transplants, a nod to the biological ton, D.C., for years, as Republicans took an increasingly hard actors who play the starring role in engraftment. line against the use of stem cell lines derived from embryonic By 1990, when Dr. Thomas was awarded the tissue. The California voters enabled Dr. Passegué and her fac- Nobel Prize in Physiology or Medicine for his ulty colleagues at UCSF to continue their work when President work, hematopoietic stem cell transplant was George W. Bush issued his frst veto in July 2006 to restrict an established clinical treatment for leukemia taxpayer-funded research to a short list of existing embryonic and aplastic anemia. Today, more than 1 million stem cells, overriding a 2005 bill to lift restrictions on federal people have undergone successful bone marrow funding for human embryo stem cell research. transplants to treat an ever-increasing array of Bush-era restrictions eased under President Barack Obama, diagnoses. “In the feld of bone marrow trans- but with federal funding for basic discovery ever more limited, plant, it took us 25 years to get from initial sci- Dr. Passegué feels a growing sense of responsibility to cham- entifc discovery to patients,” says Emmanuelle pion the promise of the work she has pursued since she arrived Passegué, PhD, director of the Columbia Stem in the United States in 2001. “Stem cells are deeply embedded Cell Initiative. “And for the frst 10 years, bone in what we do with both regeneration medicine and precision marrow transplants were risky as we worked out medicine to fnd novel therapies that are tailored to the need the best procedures. Now it’s so much safer—it’s of each patient,” she says. “I think my role now will involve the only curative approach for many blood can- way more advocacy and explaining why it’s so important that cers—but there was a long path to get there.” we continue to do this research.” v

2017 Annual Report ColumbiaMedicine 15

Colu bia Helps Lead A bitious New Precision Medicine Project

our genes are vital determinants of your health, but they almost never act alone. Variants or mutations of specifc genes might increase the risk of devel- Yoping Alzheimer’s disease, say, or heart disease, but they interact with myriad variables: other seemingly unrelated genes, clinical events such as infections, and environmental and lifestyle dimensions, including stress, diet, and sleep. The complexity of teasing out the interplay among all these factors is mind-boggling to understand and describe. In 2016, the National Institutes of Health launched an initiative known as All of Us to start untan- gling the cause and effect. Even in this era of big data, it is an ambitious undertaking: Track multiple contribu- tors to health in 1 million Americans from all walks of life over the course of a decade, then crunch the num- bers to pinpoint subtle interactions among them. “The results of this initiative will reveal more about our indi- vidual differences at all levels and will create the oppor- tunity for new and more effective treatments,” says Tom Maniatis, PhD, director of Columbia’s Precision Medicine Initiative, a collaboration of all of Columbia University and NewYork- Presbyterian Hospital. Last July, Columbia, in partnership with Weill Cor- Getting nell, NewYork-Presbyterian, and Harlem Hospital Cen- ter, received a major grant to enroll 150,000 people of Personal the 1 million planned nation- By Alla Katsnelson

Illustrations by Joey Guidone wide. The grant—for $4 million initially but expected to is completely consistent with the institute’s and Colum- total $46.5 million over fve years—is signifcant for the bia’s vision for bringing genomics as a starting point for University on many levels, says David Goldstein, PhD, precision medicine to the entirety of our patient popula- director of Columbia’s Institute for Genomic Medicine and tion—it’s as simple as that.” principal investigator for the grant. “Just having a leading Boiled down to its essence, Columbia’s mandate from role in the country’s signature precision medicine effort is All of Us boasts a deceptively elegant simplicity: Enroll the momentous. By participating in this national initiative we requisite number of subjects from the New York institu- can help optimize the way the underlying science of preci- tions’ ethnically and economically diverse patient popu- sion medicine develops.” lation, obtain their consent and basic information along The project also will have benefts for patients at with some biological samples, and send everything to the Columbia and in New York City in general, he says. “It program’s national biobank at the Mayo Clinic in Roch-

P&S at 250: James Wolff, Children’s Cancer Pioneer

ames Wolff was a newly minted MD when he started his residency in group set out to pool their Jthe nascent hematology/oncology program at Boston Children’s Hos- patients, develop consistent pital led by Sidney Farber, MD, and Louis Diamond, MD. It was 1946, methodologies for delivering and at that time, treatments for acute leukemia—which disproportion- therapies, and set criteria for ately affects children—were nonexistent. Doctors referred to the disease determining treatment. In the as “a cataclysmic disaster of childhood,” and most youngsters died in a mid-60s, Anneliese Sitarz’54, matter of weeks or months. a trainee of Dr. Wolff’s and Oncologists had just begun feeling out the possibility of treating cancer longtime professor at P&S, with chemotherapy, but most of their early forays were a bust. Then, in published one of the frst 1947, Dr. Farber and Dr. Diamond—Dr. Wolff’s mentor in the residency pro- reports showing that solid gram—began testing aminopterin, a folic acid antagonist, in children with tumors, too, responded to acute leukemia. The treatment worked, propelling a third of the children in chemotherapy. Soon after, the trial into remission, and in 1948, Dr. Wolff was among the co-authors of the study group expanded James Wolff MD a paper published in the New England Journal of Medicine, the frst paper its mission and simplifed its to show the effcacy of any cancer therapy in children. Shortly thereafter the name, becoming the Chil- group tested an even better, less toxic drug called methotrexate. dren’s Cancer Study Group, and over the years its members’ joint efforts That year, Dr. Wolff fnished his training and returned to his native yielded dramatic improvements in the prognosis for Wilms’ tumor, Hodg- New York City and joined Babies Hospital and P&S. He brought with kin’s lymphoma, and retinoblastoma. “It was the recognition of coming him the scientifc and clinical seeds of a hematological revolution, together and collaborating in a clinical trial group enterprise; that was really and they sprouted vigorously in his new professional home. Although how therapy improved,” says Michael Weiner, MD, professor of pediatrics large-scale collaborations were rare at the time, Dr. Wolff had a bent at P&S, who worked with Dr. Wolff in the 1970s. toward teamwork. In 1952, he and pediatric surgeon Thomas Santulli, The results of this coordinated approach have spread far beyond pediat- MD, longtime chief of surgery at Columbia, established their Combined ric cancers: Many of the drugs that eventually became mainstay treatments Tumor Clinic, one of the frst of what is now a patient-care standard for adult cancer were initially tested by the Children’s Cancer Study Group at academic medical centers nationwide: regularly scheduled conferences in pediatric patients. And the approach is still fourishing today. Now during which radiologists, pathologists, oncologists, surgeons, and other known as the Children’s Oncology Group, the study group launched by clinicians discuss the details of individual cases to integrate and optimize Dr. Wolff is an international network of more than 200 hospitals, universi- patient care. (The pair went on to establish a pediatric tumor registry, ties, and cancer centers; the network continues to be the main vehicle for also one of the frst in the world.) centralizing knowledge and clinical trial efforts in pediatric cancer. In the Within a few years, Dr. Wolff, who died in 2012, became one of the six decades since Dr. Wolff began his training, the fve-year survival of pedi- eight founding members of the Acute Leukemia Chemotherapy Coopera- atric cancer has gone from zero to some 80 percent, and half of all pediatric tive Study Group A. At the time, individual hospitals lacked the patient cancer patients are treated by Children’s Oncology Group-associated clini- volume to conduct statistically rigorous trials of new therapies. The study cians, suggesting that decades of collaboration have paid off.

1818 ColumbiaColumbiaMedicineMedicine ester, Minn. Scientists can then endlessly probe the result- Investigators also need to create a means for clinicians ing repository. The top-line idea, says Dr. Goldstein, is to to provide results to participants, says Wendy Chung, MD, combine these data with genomic sequencing to develop PhD, the Kennedy Family Professor of Pediatrics (in Medi- a method for state-of-the-art interpretation of everything cine), who directs the University’s clinical genetics pro- each individual’s genome can reveal. “We don’t actually gram and co-directs the molecular genetics diagnostics lab. know how to do that interpretation right now,” he says. “This is our frst foray into something on this scale, a big “I’m really excited about taking that on as a challenge as deal for Columbia because we’ve never done anything on we defne Columbia’s role in this project.” this scale,” she says. “We need to help every patient who walks through our doors understand that he or she has the opportunity to be a part of the cures of tomorrow.” Ultimately, the idea is not just for clinicians and research-  HELP FROM OUR FRIENDS ers to make discoveries and publish papers, but also to engage study participants with the research and help them ROY AND DIANA learn about their health in actionable ways. For example, says Dr. Chung, a password-protected dashboard might VAGELOS ADVANCE allow All of Us participants to log in to review their basic PRECISION MEDICINE health measures, like blood pressure or glucose levels, P. Roy Vagelos’54 and Diana Vagelos have given and assess other aspects of their health gleaned from their a lead gift of $34 million to support the Colum- genomic and environmental and lifestyle data. “We have bia University Precision Medicine Initiative. to realize that most of health is not happening at the doc- Their vision and generosity will enable Colum - tor’s offce. We want people to make daily decisions that bia to build its resources in basic biomedical are going to sustain their health.” research to improve our fundamental under - The NIH is still working out how data will be shared standing of diseases. Their gift will support with participants, but Dr. Chung says communication P&S faculty, programs, research, graduate must be done in a way that will beneft participants students, equipment, and infrastructure within regardless of their economic or educational status. “Some precision medicine. Faculty support will include of our underserved communities in New York don’t have start-up grants, bridge funding, and aid in fac - ulty recruitment and retention. 2017 Annual Report ColumbiaMedicine 19 Full Circle Data Repositories Yield Insights to Fuel Clinical Care

iGeorge syndrome may be one of the most common genomic dis- In January, Simone Sanna-Cherchi, MD, the Paul Marks Scholar Assis- Dorders you have never heard of. Affecting as many as one in 2,000 tant Professor of Medicine, and his colleagues identifed the glitch behind babies, the syndrome was frst described nearly 60 years ago and spans a DiGeorge-associated kidney malformations by conducting genomic analyses cluster of symptoms that can include heart defects, speech delay, intellec- of 2,666 children born with congenital kidney and urinary tract abnormali- tual disability, immunodefciency, and low serum calcium. The assortment ties. The study, co-authored by Ali G. Gharavi, MD, the Jay Meltzer, MD, of seemingly unrelated health issues that children face can be dizzying for Professor of Nephrology and Hypertension (in Medicine), chief of nephrol- families. About a third of all patients also have congenital renal system ogy, and a member of Columbia’s Institute for Genomic Medicine, led the malformations that can result in kidney failure. team to a nine-gene region within the DiGeorge stretch on chromosome 22. Over the past six decades, researchers have traced DiGeorge syndrome to To home in on the offending glitch, they tested all nine of the genes in both deletions within a segment of chromosome 22 that carries some 40 genes and zebrafsh and mice. Their results, published in the New England Journal of have tied certain hallmarks of the disease, such as cardiac malformations, Medicine, revealed that errors in the gene CRKL are the main driver of kid- to specifc genes within that stretch of DNA. But the deranged biochemical ney disease among children previously diagnosed with DiGeorge syndrome. codes that yield other DiGeorge symptoms have eluded investigators. Indeed, a full 1 percent of all kidney malformations—including those not pre- viously associated with DiGeorge syndrome—could be traced back to CRKL. Being able to trace kidney malfunction back to that particular stretch of chromosome 22 is life-changing, says Dr. Sanna-Cherchi, especially for chil- dren not previously diagnosed with DiGeorge syndrome, which is also asso- ciated with symptoms that emerge later in life, including schizophrenia and Parkinson’s disease. “So you can see how this knowledge would help patients understand their future diagnostic and disease management options.” Dr. Sanna-Cherchi’s study, which mined a global database of pediatric kidney patients, is just one example of the crucial role such repositories are likely to play as the feld of precision medicine develops. Investigators at Columbia expect such work will get a major boost as the NIH’s signa- ture precision medicine study, All of Us, goes online. The massive data- base will integrate genomic, environmental, and other individual factors to allow researchers to connect the dots among variations that protect our health and those that contribute to illness. For more than a decade, Columbia investigators have been proving the worth of smaller-scale and more defned databases like the one that led to Dr. Sanna-Cherchi’s DiGeorge discovery. Wendy Chung, MD, PhD, the Kennedy Family Professor of Pediatrics (in Medicine), has been a leader in SPARK, a project that aims to build a basic knowledge base about autism by collecting genomic, clinical, and environmental data on 50,000 individuals with the condition. Tom Maniatis, PhD, the Isidore S. Edelman Professor and Chair of Biochemistry & Molecular Biophysics at P&S and co-founder of the New York Genome Center, has worked extensively with the center’s ALS Consortium, which brings together multiple academic medical cen- ters, clinicians, scientists, and industry partners to combine clinical and functional genomics with bioinformatics in the study of the mechanisms behind Lou Gehrig’s disease. Consortium members have pledged to com- plete whole genome sequencing and analysis of 3,200 clinical samples in a quest to enhance early diagnosis and effective drug discovery. “Columbia has a leading role in establishing this framework that will apply state-of- the-art clinical and functional genomics together with bioinformatics to Simone Sanna-Cherchi MD study ALS disease mechanisms. This is our best hope for answering ques-

JÖRG MEYER tions about this devastating illness,” says Dr. Maniatis.

2020 ColumbiaColumbiaMedicineMedicine access to the technology of Silicon Valley, and they don’t dardize enormous reams of clinical data within OHDSI, think about things the same way,” she stresses. “We have and the NIH initiative will run on OMOP as well. to make sure we are getting everyone to the table.” At frst, says Dr. Hripcsak, the clinical and sociomedical Undoubtedly, the success of All of Us hinges on recruit- data that OMOP stores will be used to probe the demo- ing a diverse group of participants that represents the graphics of All of Us participants to confrm that they are genetic and environmental experiences of the country. statistically representative of the nation’s diversity. But But it also relies on creation of a data infrastructure that like Dr. Goldstein, Dr. Hripcsak stresses that the magic integrates all participating institutions across the coun- will really kick in when those data can be combined with try. Developing that infrastructure is a project in its own right, and last year Columbia received a grant of $13.7 million to play a central role in launching the NIH’s Data “Weneedtohelpeverypatientwhowalksthrough and Research Support Center, a collaboration being led ourdoors understand that he or she has the by Vanderbilt University. opportunity to be a part of the cures of tomorrow.” So far, clinical data for All of Us consist of a collection of electronic health records. Eventually, data will include extensive surveys flled out by participants and even data participants’ genome sequences. Imagine that 100 people from wearable technologies that track information such share the same genomic quirk, but only a small fraction of as sleep and exercise in real time, says George Hripcsak, them get the disease associated with it. “Then we can ask MD, the Data and Research Support Center grant’s prin- what factors seem to infuence whether people who have cipal investigator at Columbia. Dr. Hripcsak has a lot of that genomic characteristic get the disease or not,” Dr. practice with enormous databases of health information: Hripcsak says. “Is it your food, your environment, other He is the principal co-investigator of an international diseases you have, or drugs you are taking?” program called OHDSI (Observational Health Data Sci- Researchers acknowledge that learning more about ences and Informatics), a network of 60 patient databases “All of Us” may result in more questions than answers worldwide that contain hundreds of millions of patient at frst, but they are convinced that only by looking at records. His team developed a platform called OMOP the bigger picture will the precision needed for individ- (Observational Medical Outcomes Partnership) to stan- ual health come into focus. v

2017 Annual Report ColumbiaMedicine 21

A 250 -Y EAR LEGACY OF TRAINING DOCTORS FOR LIFELONG EDUCAT ION THEN & NOW By Sharon Tregaskis he opening of the Roy and Diana Vagelos Education Center at the beginning of the Fall 2016 semester marked the launch of a new T era. The 100,000-square-foot, 14-story glass tower at 171st Street and Haven Avenue incorporates technologically advanced classrooms, myr- iad naturally lit collaboration spaces, and a modern simulation center. “Our new education building will ensure that Columbia continues to train superior doctors and researchers, educated in the latest techniques, as medicine con- tinues to evolve rapidly throughout the 21st century,” said Dean Lee Gold- man, MD, when it opened. “The building also will allow us to centralize key activities in a state-of-the-art facility that refects our commitment to provid- ing world-class instruction and a superb learning environment for students.” The structure and the activities students now pursue within the Vagelos Education Center are a far cry from the earliest days of what is now the College of Physicians & Surgeons. But the facility exemplifes the vision that Opposite Page: P&S Class of 1894. bove: P&S Class of 2021. has been a cornerstone of medical education at P&S throughout its 250- year history—a commitment to improving teaching methods and creating the degrees required that students attend a full course of lectures—approxi- rigorous curricular standards intended to cultivate a commitment to lifelong mately nine months each—on anatomy, surgery, the theory and practice of discovery necessary in a profession where change is the only constant. “Do medicine, chemistry, materia medica (pharmacy), and midwifery, taught by not therefore imagine that from this time your studies are to cease,” said the six of the city’s most eminent physicians. To earn an MD, students were founder of the school, Samuel Bard, when he addressed graduates at the frst also required to demonstrate competence in Latin, attend a second year of commencement. “Far from it. You are to be considered as but just entering lectures, pass two rounds of oral examinations, complete a year of appren- upon them; and unless your whole lives are one continued series of applica- ticeship, and author an original research report on “some medical subject.” tion and improvement, you will fall short of your duty.” Course fees for the program—paid directly to the faculty in the form of The medical profession in the 1700s was in serious need of constant tickets for entry to their lectures—exceeded the median annual income at the improvement. Before Columbia began a medical faculty, New York’s lieuten- time and represented only a fraction of the total cost for training, which also ant governor, himself a physician-scientist, had signed the frst signifcant law included diploma fees, papers and books, and, for students whose families of the British province. “No person shall practice as a Physician or surgeon,” did not reside in the city, room and board. Not surprisingly, few registered the law read, “before he shall frst be approved in Physick or surgery and to pursue degrees. During the American Revolution, the fedgling school’s approved or admitted.” At the time, medical practice in New York City was facilities at King’s College were commandeered for military activities, so edu- something of a free-for-all with traveling quacks peddling dubious remedies, cational programs were suspended. a scant four dozen self-proclaimed physicians, no licensing body, and no The institution struggled for several decades to regain its footing after the common standard by which to judge the preparation of those who aspired to war, and when the College of Physicians & Surgeons was offcially incorpo- work in the feld. The new law was unenforceable—there being no mecha- rated as a separate, proprietary medical school in 1807, educational stan- nism to pursue complaints—but it laid the philosophical groundwork for dards for the MD were noticeably weakened. While two years of coursework the founding, in August 1767, of a program in medical education at King’s remained a requirement, the time allotted to lectures was cut in half to just College, later known as Columbia University. four months. Students were permitted to arrange with faculty to participate At the school’s inception, students could choose among multiple degrees, in anatomical dissection, though there was neither a laboratory nor a clinic from a relatively rudimentary bachelor’s in medicine to the MD. Modeled dedicated to the activity and body procurement was notoriously conducted on the medical courses of study offered at Edinburgh and Oxford, all of under cover of night. They were also permitted to observe clinical work at the New York Hospital, the Almshouse, or the Lying-In Hospital, but such sions standards. Lectures were expanded to seven months, prerequisites were pursuits were optional and not required as part of a student’s education. established, grades introduced, and written exams instituted. The subsequent decades were roiled with faculty infghting, but the college— Throughout the late 1800s and early 1900s, P&S continued to expand. The whose faculty and students had been merged into P&S in 1814—grew in step course of study increased to three years in 1888 and four years in 1894. A with the burgeoning city, acquiring new facilities and hopping ever northward series of gifts from William H. Vanderbilt and his family spurred construction up the island of Manhattan. In 1848, Bellevue Hospital was reorganized and of a new facility for the college on 10th Avenue and 59th Street, as well as became an additional site for student clinical experience. In 1851, the New multiple clinics and hospitals in the neighborhood where students were wel- York state legislature expanded access to cadavers for anatomy instruction by comed for demonstrations and hands-on training. Dedicated laboratory space lifting restrictions that had previously allowed dissection only of unclaimed increased and the basic sciences grew in prominence. Mandates for clinical bodies of criminals. In 1880, P&S President Alonzo Clark, an 1835 graduate training were instituted, with every student required to serve daily at either the of the school, oversaw signifcant improvements to the curriculum and admis- Sloane Hospital or the Vanderbilt Clinic. In 1911, the college embarked on its

A Campaign to Eliminate Student Loans

s part of its 250th anniversary celebration, The award of monetary prizes to medical stu- to be used to help other students pursue their P&S hopes to raise money to create a perma- dents for best thesis, best exam score, and best clin- medical education. nent endowment for scholarship support, allow- ical report began in the late 1850s. Chief among Federally sponsored student loans became ing all students with fnancial need to have that them was the Harsen Prize, a bequest of Jacob widely available after Congress passed the Higher need met by scholarships rather than by loans. Harsen Jr., an 1829 P&S graduate. Three decades Education Act in 1965, and by 1984, more than Known as the P&S 250th Anniversary Scholar- later, P&S began awarding annual grants and fel- 86 percent of students graduated in debt. As medi- ship Challenge for Endowed Financial Aid, the lowships. The frst—bestowed in 1887—was the cal education costs rose, fnancial aid expanded in fund was seeded with a $25 million gift from P. result of a bequest from Alonzo Clark, an 1835 the form of both scholarships and loans. Systems Roy Vagelos’54 and his wife, Diana. P&S graduate, longtime professor, and former have developed to support students receiving aid. The commitment to making a medical educa- president of P&S who directed his gift to “promot- P&S, for example, has a fnancial planning offce tion affordable stretches back to the 1807 found- ing the discovery of new facts in Medical Science.” that has created an 18-page fnancial aid hand- ing of the College of Physicians & Surgeons, In 1891, the Alumni Association created three book to help medical students navigate the pro- before it became part of Columbia. Founder research fellowships; recipients were required to cess for seeking loans, scholarships, grants, and Nicholas Romayne, MD, envisioned a plan to produce a thesis at the end of their terms. work study. The offce also has a robust program accept one student from each New York state In the early 1900s, P&S tuition spiked by for debt management and fnancial literacy to county who would receive free entry to all lec- 25 percent. Students petitioned Columbia’s trust- assist graduates with navigating the maze of rules tures. The presidents of the state’s myriad medi- ees to protest the hike, and fnancial relief fol- around the various loan programs and to assist cal societies were invited to designate recipients lowed in the form of several new scholarships. To with integrating student loan repayment in the who were “of good moral character, of promising choose recipients, the faculty formed a scholar- context of their overall fnancial planning during talents, and of diligent habits.” An 1808 report ship committee to draft regulations, review appli- postgraduate training. about the program noted that “a respectable cations, and recommend awards. Today, up to half of all P&S students need number of young gentlemen, from the interior of From the frst announcement of scholarship fnancial support—loans and scholarships—to the state, are now attending the lectures. These, applications published in the 1904-1905 cata- complete their medical education. The 2017 when they return to their respective homes, we logue of the medical school, the fnancial aid scholarship challenge hopes to enable students trust, will diffuse a taste for science in medicine, program grew with new gifts and support from with fnancial need to receive P&S scholarships and excite a laudable emulation in their brethren Columbia University. The Committee on Scholar- only rather than a combination of loans and of the profession; and thus contribute to rescue ships received 51 applications for 1907-1908 and scholarships. This debt reduction program would the practice of medicine generally from the hands awarded aid to 37 medical students. In the mid- make P&S more affordable and make it easier for of ignorance and imposture.” 1920s, the university also created a loan fund that graduates to pursue career options in felds such The program lasted just two years before schol- helped medical students bridge tuition increases. as primary care, research, and community service. arships were eliminated and student fees increased The preferred protocol for fnancial aid was That would ensure P&S’s leadership position in to boost faculty salaries. To make up for the loss, to award scholarships for frst- and second-year medical education for the next 250 years, while the college frequently offered free supplementary students and to save loans for third- and fourth- changing not only our institution but the land- courses open to all students, and alumni were year students who would be in a better position scape of medicine in perpetuity. allowed free admission to all courses. to pay back the loans sooner, allowing the funds — Sharon Tregaskis and Carol Perloff

2424 ColumbiaColumbiaMedicineMedicine partnership with Presbyterian Hospital to create what became the Columbia- Presbyterian Medical Center, the frst in the nation to embody the concept of a teaching hospital within a multifaceted health services center. Today, aspiring physicians at P&S complete a four-year curriculum that tog- gles constantly between theory and hands-on practice in preparation for resi- dency training. With its “study cascade,” a mix of ramps, elevators, stairwells, and open gathering spaces that link lecture halls and classrooms throughout the facility, the Vagelos Education Center is designed to promote that dynamic interplay. The facility also boasts 13,000 square feet of dedicated training rooms in which students practice everything from taking a patient’s medical history to performing a physical exam, all under the tutelage of faculty precep- tors. And unlike students in earlier centuries who gained their clinical educa-  HELP FROM OUR FRIENDS tion in amphitheaters where an impoverished patient exchanged privacy for the price of medical care in front of a large group, today’s students begin their clini- cal training with computerized, whole-body mannequins and specially trained A SC OLARS IP C ALLENGE actors who play the part of “standardized patients.” The specially equipped FOR T E 250T ANNIVERSARY rooms in which students work with these practice patients feature high-fdelity sound and video recording equipment to enable faculty and students to review P. Roy Vagelos’54 and Diana Vagelos pledged $25 million in matching a practice encounter in search of opportunities for improvement. funds to kick off the P&S 250th nniversary Scholarship Challenge. Donors who make gifts designated for endowed scholarships can Such features are all part of the latest curricular advance at P&S, an empha- double their impact by receiving a 1:1 match for gifts of $50,000 to sis on coaching, a persistent cycle of practice and feedback intent on cultivating $1 million and planned gifts of $100,000 to $1 million. With the goal students’ capacity not only to develop specifc skills, but also to accept and of raising an additional $25 million for endowed scholarships, this refect on input about their performance and seek out additional opportunities challenge launches an ambitious effort by P&S to eliminate student for enrichment. As one of 10 schools participating in a fve-year pilot study loans by providing needed fnancial support through scholarships funded by the Association of American Medical Colleges, P&S has the oppor- only, rather than a combination of scholarships plus loans. More tunity to test its coaching methods as the path to helping students master 13 than $10 million toward the goal has been raised to date through the core entrustable professional activities, tasks all trainees are expected to per- generosity of alumni, faculty, and friends of P&S. form independently on the frst day of residency. “You can’t learn how to do basic procedures overnight or in the last week of medical school; you have to learn what are the basic principles and then practice them over time with some kind of supervision, some kind of assessment, and opportunities for remedia- According to a review of existing research, conducted by Lauren Wasson, tion if you need them,” says Jonathan Amiel, MD, associate dean for curricu- MD, assistant professor of medicine at P&S, the high rates of burnout lar affairs at P&S and site principal investigator for the pilot study. and depressive symptoms among medical students compared with their peers in other graduate training programs and the general population “Medical school is a formative period for can be buffered by features of the medical school learning environment. “Medical school is a formative period for both the educational and the both the educational and the emotional emotional aspects of becoming a physician, and we aspire to immerse aspects of becoming a physician, and we students in optimal learning environments,” says Dr. Wasson. “We seek aspire to immerse students in optimal evidence-based ways to cultivate well-being among students during this time and in preparation for the rigorous careers ahead of them.” Among learning environments.” the supportive features Dr. Wasson and her collaborators identifed are pass/fail grading, accessible mental health programs, wellness programs The program pairs frst-year students with a coach responsible for that teach stress-reduction skills, group-based faculty advising and men- teaching their frst-year Foundations of Clinical Medicine seminar. Stu- toring programs, and a curriculum with increased clinical time. dents continue meeting with their coach throughout the remainder of With the move to the Vagelos Education Center, increased emphasis on their time at P&S. Says Dr. Amiel, “Our aim is to establish a trusting coaching and clinical skills preparation, and consolidation of student services relationship between the coach and the student so that the student can in the same facility where students spend the most time, P&S continues to come to the coach over the course of his or her medical school education seek ways to improve medical education while acknowledging that work with the feedback that they’ve gotten and try to interpret it so that they remains. Adds the JAMA review’s senior author, Karina W. Davidson, PhD, can create their own short-term and long-term learning plan.” vice dean for organizational effectiveness, “With so few published studies Such collaborative and supportive approaches to medical education prom- on the medical school learning environment, there is clearly a need for more ise a further beneft, according to research published this year in JAMA. rigorous research on an issue that could greatly impact future physicians.” v

2017 Annual Report ColumbiaMedicine 25 SCREENINGS AND TREATMENTS

Eye Care on the Go frst child in the world to receive motor neurons and also showed Columbia ophthalmologists are the drug, known as nusinersen, that increasing the activity of taking the fght against blind- was enrolled in a Columbia clini- these synapses can alleviate symp- ness to the streets with a mobile cal trial led by Claudia A. Chiri- toms of SMA. tele-ophthalmology unit. The boga, MD, professor of neurology unit, which hit the roads in June, and of pediatrics. A vital clue Tummy Trouble will provide free screenings for that led to the drug’s develop- Children with celiac and other at least 2,000 people every year ment came in 1999 when Umrao gastrointestinal problems now at locations in the Bronx, Wash- Monani, PhD, then a postdoc have greater access to treatment ington Heights, and Harlem. In at Ohio State and now associate with the opening of the Phyllis and Ivan Seidenberg Center for Chil- dren’s Digestive Health. The center features a multidisciplinary team of specialists who care for children with both simple and complex illnesses. The center, located in the Morgan Stanley Children’s Hospi- tal, was made possible by a $15 million donation from Phyl- lis and Ivan Seidenberg. “The expertise available in this center is unparalleled,” says team leader Joel Lavine, MD, PhD, professor

Eye care van and vice chair of pediatrics, “in terms of quality, access, and inter- addition to screening for glau- professor of pathology & cell disciplinary care.” coma, cataracts, macular degen- biology (in neurology), discovered eration, and diabetic retinopathy, that turning on a normally silent New Blood the mobile team, under the lead- gene had the potential to prevent Blood transfusions are one of ership of Lama Al-Aswad, MD, the disease. Dr. Monani also cre- the most common procedures in associate professor of ophthal- ated an SMA mouse model that U.S. hospitals, but new research mology, will assess patients for was crucial to enabling scientists reveals that older blood could common risk factors for eye dis- to test the drug in preclinical stud- ease, such as diabetes, hyperten- ies. With an effective treatment sion, and obesity. for SMA now available, Wendy Chung MD, PhD, the Kennedy SMA Progress Family Professor of Pediatrics The frst and only effective treat- (in Medicine), is directing a pilot ment for spinal muscular atrophy, screening project in seven New a neurodegenerative disease that York City hospitals to identify causes progressive muscle wast- SMA cases soon after birth. New ing, has been approved, thanks to work in mice, led by George Z. Highlights the leadership of several research Mentis, PhD, associate professor centers, including the SMA Clini- of pathology & cell biology and cal Research Center at Columbia, of neurology, was published in directed for many years by Dar- Nature Neuroscience and showed ryl C. De Vivo, MD, the Sidney that SMA may be partly due to Carter Professor of Neurology abnormalities in the synapses

and professor of pediatrics. The that connect sensory neurons and MELI P NICO 2017 Year in Year 2017

26 ColumbiaMedicine CANCER pose a threat to hospitalized pressure in these arteries. The Oncology Care Model patients. In a study led by Ste- lungs can be permanently dam- CUMC has joined nearly 200 ven Spitalnik, MD, professor of aged, and the heart must pump physician group practices and pathology & cell biology, and harder to push blood through the 17 health insurance companies Eldad Hod, MD, associate pro- lung, leading to life-threatening nationwide in the Center for Medi-

fessor of pathology & cell biol- CENTERS FOR DISE SE CONTROL ND PREVENTION heart failure in children and care & Medicaid Innovation’s ogy, the difference in outcomes adults. The Pulmonary Hyper- Oncology Care Model, a fve- between one-week-old and fve- if they did not receive antibiot- tension Comprehensive Care year pilot program developed by week-old blood was negligible, ics themselves. Antibiotics are Center at Columbia is one of the CMS Innovation Center and but six-week-old blood released a known risk factor for C. diff the frst—and among the larg- advanced by the Affordable Care large amounts of iron into recipi- infection, which leads to about est—in the world established to Act. The person-centered approach ent bloodstreams. The authors 27,000 deaths annually in the treat the disease. For the past 30 promotes coordination among recommend that the FDA lower United States. years, the center has been at the patient services and encourages the maximum blood storage lim- forefront of research, including practices to lower costs through its from six weeks to fve weeks, Breathe Easy major clinical trials, landmark episode- and performance-based due to concerns that excessive Most people with asthma are able genetic discoveries, and pioneer- payments that reward high-quality iron could exacerbate infection. to control their symptoms with ing treatments such as mechani- care. “This initiative is a necessary medications, but 5 percent to cal support for patients who fail approach to making cancer care as Crowdsourcing 10 percent have persistent symp- advanced medical therapy. Mat- accessible and affordable as possi- Some women with endometriosis toms and are more likely to have thew Bacchetta, MD, associate ble,” says chief of hematology and suffer a wide variety of symp- life-threatening asthma attacks. A professor of surgery and the cen- oncology Gary K. Schwartz, MD. toms, from debilitating menstrual new treatment offered by Colum- ter’s surgical director, is among cramps to painful sex, while oth- bia’s interventional bronchoscopy only a few surgeons in the world Improving Chemo ers experience no pain at all. The program is helping many dramati- who perform surgery for chronic More than 50 types of soft-tissue breadth of symptoms can lead to cally reduce their steroid use and, thromboembolic pulmonary sarcomas have been identifed. under-diagnosis and treatment in some cases, discontinue steroids hypertension, which happens These cancers arise in fat, muscle, differences. As part of a broader completely. Known as bronchial when thrombi build up in the nerves, joint linings, blood vessels, citizen science project known as thermoplasty, the treatment pulmonary arteries. and the other tissues that connect, Citizen Endo, Noémie Elhadad, works by applying mild heat to support, and surround various PhD, associate professor of bio- the smooth muscle in a patient’s Teen Talk body structures. A multicenter medical informatics, launched airways, which shrinks the tissue In New York City, young girls clinical trial by senior author “Phendo,” an iPhone app for and prevents it from swelling and with gynecological concerns have Gary K. Schwartz, MD, chief of women to share their day-to- constricting the airway. Faculty a unique program to turn to: the hematology and oncology, and day experiences. Data collected who perform the procedure at Pediatric and Adolescent Gyne- published in the Lancet has shown through the app will be examined CUMC are William Bulman, MD, cology Program at the Morgan that adding olaratumab, a novel for clusters that can develop a associate professor of medicine Stanley Children’s Hospital at monoclonal antibody therapy, to temporal picture of endometriosis. at CUMC; Keith Brenner, MD, NewYork-Presbyterian/Colum- traditional chemotherapy for met- assistant professor of medicine at bia. Many gynecologists are astatic sarcomas increases median Infection Control CUMC; and Roger Maxfeld, MD, not comfortable seeing younger survival by nearly a year. According to a study by Daniel professor of medicine at CUMC. patients and few specialize in the Freedberg, MD, assistant profes- feld, says program director Beth Mixed Signals sor of medicine, in JAMA Inter- W. Rackow, MD, associate pro- Cross talk among cells in the nal Medicine, hospital patients Respiratory Relief fessor of obstetrics & gynecol- stomach sets the stage for gastric who inhabit a bed previously Pulmonary arterial hypertension, ogy and of pediatrics. The NYP/ tumors, according to research by occupied by someone being considered a death sentence just Columbia program now sees a multinational team. Timothy C. treated with antibiotics may be at a generation ago, is a rare but more than 50 new patients each Wang, MD, the Dorothy L. and increased risk for infection with serious disease that occurs when month, providing medical and Daniel H. Silberberg Professor of Clostridium diffcile, the most the walls of the lung’s arteries surgical care for a wide variety of Medicine, was senior author of the common cause of diarrhea, even stiffen and narrow, raising blood gynecologic conditions. fndings published in Cancer Cell.

2017 Annual Report ColumbiaMedicine 27 2017 Year in Highlights

EARTFELT

The team’s mouse studies identi- of BRCA in uterine cancer; Bad Medicine an analysis of outcomes for fed the cascade of chemical signal- women with BRCA1 mutations A team of data scientists patients under age 18 who had ing that creates the conditions for may beneft from prophylactic has discovered eight distinct surgery from 2010 to 2013 carcinogenesis within the gastric hysterectomy along with risk- combinations of medications that to correct congenital heart epithelium. The team also dem- reducing salpingo-oophorectomy. can lead to a potentially fatal defects. Although Columbia onstrated that by interrupting the heart drug interaction. The team, had the highest number of signaling, which involves both ace- Web of Life led by Nicholas Tatonetti, PhD, cases (1,558), the hospital’s tylcholine and nerve growth factor, iCAGES, a computational tool assistant professor of biomedical adjusted mortality rate was tumor growth could be halted, with a user-friendly web interface, informatics, developed a novel just 2.26. Columbia has long providing a potential new target can rapidly predict which genes method for detecting drug paved the way for advancements for treatment and prevention. are implicated in an individual’s interactions and tested it by in pediatric cardiology care. cancer and recommend treat- mining two independent data The frst successful pediatric Sleeping Beauty ments. The development team, led sets: a government database of heart transplant was done by The molecule p53 is a potent can- by Kai Wang, PhD, associate pro- reported drug side effects and Columbia doctors in 1984. cer-fghting factor. But sometimes, fessor of biomedical informatics a university hospital archive Columbia is one of only a it goes to sleep, which allows and director of clinical informat- of patient records. Among few centers in the United tumors to grow unchecked. A ics at the Institute for Genomic the fndings, published in the States to offer hybrid research team at the Herbert Irving Medicine at CUMC, published its Journal of the American College cardiac surgery—combining Comprehensive Cancer Center has work in Genome Medicine. of Cardiology, the antibiotic conventional surgical methods implicated a protein called SET, ceftriaxone and heartburn with catheter-based techniques— which is often found in excess in Key to Resistance for infants and children. cancer cells, in p53 inactivation. Among people with aggressive By reducing SET levels, the team prostate cancer, treatment with Beyond the CABG Patch was able to revive p53 and halt anti-androgen therapy, the stan- Coronary artery bypass graft cancer growth. Nature published dard of care, may make things surgery, or CABG, has long been the full report by Wei Gu, PhD, worse in some patients. Research the preferred treatment for left the Abraham and Mildred Gold- in mice reveals that the problem is main coronary artery disease, in stein Professor of Pathology & SOX11, a genetic mutation that which the artery that supplies Cell Biology and in the Institute reprograms tumor cells to resist oxygen-rich blood to most of for Cancer Genetics, and Dong- treatment, according to a Cancer the heart muscle is clogged with lai Wang, PhD, a postdoctoral Discovery report co-authored atherosclerotic plaque. A major research scientist in Dr. Gu’s lab. by Cory Abate-Shen, PhD, the international study known as Michael and Stella Chernow EXCEL (Evaluation of XIENCE BRCA1 Professor of Urological Oncol- versus Coronary Artery Bypass Mutations in the BRCA1 and ogy, and Michael M. Shen, PhD, Surgery for Effectiveness of BRCA2 genes have been linked professor of medical sciences. Left Main Revascularization), to breast, ovarian, and fallopian Their work could help identify involving 126 medical centers tube cancers. According to a new which patients should avoid anti- in 17 countries, has found that report, BRCA1 mutations also androgen therapy and develop less-invasive drug-eluting stents may be associated with heightened new treatments for people with are safer and as effective for risk for an aggressive type of advanced prostate cancer. medication lansoprazole may many patients as bypass surgery. uterine cancer, called uterine trigger abnormal heart rhythms Gregg W. Stone, MD, professor serous carcinoma. Published and, in rare cases, sudden death. of medicine and director of in JAMA Oncology, the work, cardiovascular research and led by Catherine A. Shu, MD, Best in Class education at the Center for assistant professor of medicine, Pediatric cardiac patients at Interventional Vascular Therapy, with colleagues at nine academic NYP/Columbia have the lowest was frst author of the EXCEL medical centers, addressed an risk-adjusted mortality risk in report in the New England open question about the role New York state, according to Journal of Medicine.

28 ColumbiaMedicine PICTURE T IS BRAIN EALT

Good Image ecule known as TRPV6, which is responsible for transporting vita- Pregnancy and Stroke A condition known as transthyre- implicated in the disease process. min A into the cell interior. Vitamin Pregnancy-associated stroke tin-related cardiac amyloidosis, The work, published in Nature, A is essential to all mammals and occurs in an estimated 34 out of or ATTR-CA, can be detected reveals that the surface of TRPV6 is particularly important in making 100,000 women, and doctors through imaging—without a is lined with negative charges, a the light receptors in our eyes and have long believed that older biopsy—before it progresses to confguration that attracts posi- in the placenta and fetus where it is women were at greater risk for critical for normal development. the condition. A study published in JAMA Neurology by Joshua Z. Visual Appeal Willey, MD, and Eliza C. Several P&S investigators dedi- Miller, MD, assistant professors cated their efforts to revealing the of neurology, shows that while unseen, developing new techniques the incidence of stroke is rising for discovery in the process. A among all women, younger team led by Alexander Sobolevsky, women are at higher relative risk PhD, associate professor of bio- of pregnancy-associated stroke. chemistry & molecular biophysics, Among the causes of pregnancy- obtained the frst detailed images associated stroke, preeclampsia D M C ST NO MD of interactions between the AMPA develops in about 3 percent to 8 Tc 99m scan of patient without amyloidosis, left, and with amyloidosis, right receptor and molecules that regu- percent of all pregnant women. A advanced heart failure. The fnd- tively charged calcium ions. The late chemical signaling in the brain. second study by the same authors, ing in JAMA Cardiology emerged work could lead to novel therapies The fndings, published in Neuron, published in the journal Stroke, from a multicenter study led by and diagnostic tools for diseases revealed that stroke risk factors Mathew S. Maurer, MD, the that are caused by a malfunction among women with preeclampsia Arnold and Arlene Goldstein in calcium absorption. include urinary tract infections, Professor of Cardiology. “This is chronic high blood pressure, and a huge advance for patients with Big Picture clotting or bleeding disorders. ATTR-CA, which is under recog- Using a new lightning-fast camera nized and often misdiagnosed,” paired with an electron microscope Immune Response said co-frst author Adam Cas- scientists have captured images Parkinson’s disease may be caused tano, MD, a cardiology fellow at of one of the smallest proteins in part by autoimmunity, according P&S. “Many people with ATTR- in our cells to be “seen” with a to a study published in Nature by CA are frail and elderly, so being microscope. Science published the scientists at P&S and the La Jolla able to avoid a biopsy, even when images, produced by a team led by Institute for Allergy and Immunol- it can be done with a less-invasive structural biologist Filippo Man- may help elucidate the mechanisms ogy. The study, co-led by David catheter-based procedure, is a sig- cia, PhD, associate professor of of conditions such as Alzheimer’s Sulzer, PhD, professor of neuro- nifcant step forward.” physiology & cellular biophysics. and Parkinson’s diseases, epilepsy, biology, provides the frst direct The protein, called STRA6, sits in and schizophrenia. Using high- evidence linking a malfunctioning X-ray Vision the membrane of our cells and is resolution electron microscopy, immune system to Parkinson’s dis- Our bodies use dietary calcium other researchers uncovered new ease. The fndings could lead to a to regulate a variety of processes details of the structure and func- diagnostic test to identify individu- from muscle contractions to brain tion of an intracellular channel that signaling; dysregulation of that controls the contraction of skeletal process has been linked to cancer, muscle. Andrew R. Marks, MD, kidney disease, and Crohn’s dis- the Clyde’56 and Helen Wu Profes- ease. Alexander Sobolevsky, PhD, sor of Molecular Cardiology (in associate professor of biochemis- Medicine) and professor and chair try & molecular biophysics, has of physiology & cellular biophys- captured X-ray crystallography ics, led the team, which published

images of a calcium-shuttling mol- FILIPPO M NCI L B its results in Cell. JE N VONSTTEL

2017 Annual Report ColumbiaMedicine 29 2017 Year in Highlights

als at risk or in the early stages of of the COMT gene, which breaks the disease and prompt research down dopamine in the brain, will into immunotherapy approaches beneft from the elevated levels of to symptom management in more proline elicited by valproate. In a advanced stages of the disease. paper in Neuron, a team led by Jordan Hamm, PhD, a postdoc- ear, ear toral researcher with co-author A team that studies sensory pro- Joseph Gogos, MD, PhD, pro- cessing in the brains of electric fsh fessor of physiology & cellular has stepped from sea to land. A biophysics and of neuroscience, new study examines how the audi- B L N D B R describes how a breakdown in tory system cancels out sounds due Topological representation of four cellular populations during motor synchronized behavior of a small neuron differentiation to our own movements and behav- group of neurons could produce ior. By measuring the neural activity Chair of Biochemistry & Molecu- Behavior Institute have identi- the disordered thinking and of mice during licking behavior, lar Biophysics. fed a gene that allows neurons perceptions associated with the Nathaniel Sawtell, PhD, professor that release serotonin to evenly disease. The research was con- of neuroscience, revealed that mice Risk Management spread their branches through- ducted in two mouse models of use the dorsal cochlear nucleus, or Antidepressants are an important out the brain. Without this gene, the disease: a genetic model (mice DCN, to “tune out” sounds gener- treatment for depression, but these neuronal branches become carrying a mutation predisposing ated by their own behavior. His one with risks to be managed. entangled, leading to haphazard to schizophrenia in humans) and team’s report, published in Nature According to a report in JAMA distribution of serotonin and signs a pharmacological model (mice Neuroscience, sheds light on how Psychiatry, speech and language of depression in mice. These obser- the brain focuses attention on disorders were signifcantly higher vations shed light on how precise behaviorally relevant stimuli and among children whose mothers neuronal wiring is critical to over- may lead to insights into common purchased antidepressants at least all brain health while also reveal- hearing disorders such as tinnitus. twice during pregnancy. The study, ing a promising new area of focus by a team at P&S and the Mailman for studying psychiatric disorders Crystal Ball School, suggests that the incidence associated with serotonin imbal- Columbia computational biolo- of speech disorders was also higher ance, such as depression, bipolar gists have created a tool to recon- in offspring of mothers who were disorder, schizophrenia, and struct how a cell may differentiate. diagnosed with depression or autism. Tom Maniatis, PhD, the Rooted in the mathematical other psychiatric disorders but Isidore S. Edelman Professor and feld of topology, the algorithm, did not take an antidepressant. Chair of Biochemistry & Molecu- dubbed single-cell topological data P&S psychiatry faculty who lar Biophysics, led the team, which analysis (scTDA), provides a road co-authored the study: Alan published results in Science. map that offers detailed insight Brown, MD; Myrna M. Weissman, into how stem cells give rise to PhD; Jay A. Gingrich, MD, PhD; Network Theory given regular doses of ketamine, specialized cells. scTDA uses the and Andre Sourander, MD. A Two new studies offer insight an anesthetic that can produce RNA sequences of individual cells paper in Nature Medicine by into the genetic and neurologi- psychotic behavior in humans). to reconstruct their underlying Patricia Ducy, associate professor cal functions of schizophrenia. A The fndings support the idea that developmental trajectories and of pathology & cell biology, Translational Psychiatry paper by schizophrenia arises from disrup- capture the progression of differ- revealed the mechanism by which Catherine Clelland, PhD, assis- tions in small networks of neurons ent transcriptional programs in antidepressants lead to bone loss tant professor of pathology & acting on their own instead of as a time. Nature Biotechnology pub- and demonstrated that, in mice, cell biology, reveals that people coherent group. lished a report by the team, led by beta blockers can avert the damage. with a specifc genotype may be Raul Rabadan, PhD, professor of more receptive to the mood sta- Tangled Up biomedical informatics (in systems Balancing Act bilizer valproate than others. The Revelations in neurologi- biology), and Tom Maniatis, the Scientists with Columbia’s Mor- research suggests that people with cal functioning may lead to Isidore S. Edelman Professor and timer B. Zuckerman Mind Brain two copies of the “Val” variant improved treatment and diagno-

30 ColumbiaMedicine INSIDE INSIG TS sis of patients with Alzheimer’s. a donor lung for 36 to 56 hours. Research from the lab of Karen The study was led by Gordana Duff, PhD, professor of pathol- Vunjak-Novakovic, PhD, ogy & cell biology, describes University Professor, the how a toxic protein called tau Mikati Foundation Professor can spread through the brain, of Biomedical Engineering, and jumping among neurons via the professor of medical sciences, N G E L C H R I S T I N O L B O L N I T S I R H C L E G N extracellular space that surrounds Hair regrowth after ruxolitinib treatment of a patient with alopecia areata and Matthew Bacchetta, MD, them. The discovery, reported in associate professor of surgery. Nature Neuroscience, suggests Good air and the Lancet, the analysis of The lead authors of the study that studying the spread of tau Seventy-fve percent of people with patient records suggests that the were John O’Neill (bioengineer) may enable doctors to prevent moderate to severe alopecia areata, current method of assessing kidney and Brandon Guenthart (surgical Alzheimer’s from developing into an autoimmune disease that function may be misleading; fellow). In other research, a tool severe dementia. Another study, causes patchy and, less frequently, ongoing studies are underway to called a lung organoid, a tiny 3-D in Neuron, indicates that an accu- total hair loss, had signifcant identify more accurate biomarkers, structure made of living cells that mulation of tau causes the spatial hair regrowth after treatment including NGAL, which is being mimics the features of a real lung, disorientation in many Alzheim- with ruxolitinib in a clinical trial evaluated around the world. will help identify the pathogens of er’s patients. Dr. Duff suspects overseen by Julian Mackay- pulmonary diseases. As outlined that disorientation originates Wiggan, MD, associate professor Pulmonary Promise in a Nature Cell Biology paper, the in an area of the brain known of dermatology and director of Breakthroughs in respiratory team’s “organ in a dish” allows as the entorhinal cortex, which the department’s Clinical Trials technology may help tens of scientists to replicate models of controls memory and navigation. Unit, together with Angela M. thousands of Americans with human diseases, test drugs, and Although both studies were con- Christiano, PhD, the Richard and pulmonary illnesses breathe easier. regenerate damaged tissue. The ducted in mice, further research Mildred Rhodebeck Professor A new transplantation technique research was led by Hans-Willem may yield diagnostic methods of Dermatology and professor has for the frst time maintained Snoeck, PhD, professor of medicine using navigation-based cognitive of genetics & development. The a fully functional lung outside the (in microbiology & immunology). tests and the possibility to treat study was published in the Journal body for several days. Although disorientation with deep-brain of Clinical Investigation/Insight. transplantation is the only Scar Tissue stimulation or light-based therapy. By the end of treatment, average defnitive treatment for patients Thirty percent of U.S. adults have hair regrowth was 92 percent. with end-stage lung disease, a benign condition, known as Suicide Already approved by the FDA to transplant organs are highly nonalcoholic fatty liver disease, in Patients discharged from Ameri- treat bone marrow malignancies, perishable. In a study published in which excess fat flls the liver. In can psychiatric hospitals face a ruxolitinib is a JAK inhibitor; Nature Biomedical Engineering, one in fve people with the disease, high risk of suicide within 90 days it interrupts the dominant researchers detailed the cross- the liver becomes infamed and of discharge, according to a study infammatory signaling pathways circulation platform that maintains crisscrossed by fbrous scar tissue, by Mark Olfson, MD, professor responsible for hair follicle of psychiatry and epidemiology, dormancy in alopecia areata. in JAMA Psychiatry. Patients with depression had the highest rate Kidney Function of suicide within 90 days of dis- For many patients, an initial charge, followed by patients with diagnosis of “acute kidney bipolar disorder, schizophrenia, injury” may have been inaccurate, and other mental disorders. Dr. according to a study co-authored Olfson’s analysis indicates that by Jonathan Barasch, MD, PhD,

psychiatric patients remain ill at the Samuel W. Lambert Professor the time of discharge, highlight- of Medicine and professor

ing the need for continuity of care of pathology & cell biology. KOVIC -NOV K VUNJ N GORD and treatment even after patients Published in the Journal of the Photographic and thermographic images of injured lungs recovered with leave the hospital. American Society of Nephrology extracorporeal cross-circulation

2017 Annual Report ColumbiaMedicine 31 2017 Year in Highlights

IT’S IN T E GENES

Precision Genomics Lab contribute to common forms The Institute for Genomic of the disorder. In March, Cell Medicine and the Department of Systems published the identity Pathology & Cell Biology have of a common genetic variant launched a Precision Genomics that greatly affects normal brain Laboratory to enhance consti- aging, starting at around age tutional genomic diagnostics, 65, and may modify the risk for research, and education. The lab neurodegenerative diseases. The XI OBO W NG Mice were fed a diet rich in fat and sugar until they developed nonalcoholic is jointly led by David Goldstein, study was led by Asa Abeliovich, steatohepatitis-like features in their livers. On the left, staining reveals the most PhD, director of the Institute for PhD, professor of pathology & important feature of the condition—fbrosis—as dark linear structures (indicated with arrows). On the right, fbrosis reverted when T Z was silenced in the mice. Genomic Medicine, and Kevin cell biology and of neurology, Roth, MD, PhD, chair of pathol- and Herve Rhinn, PhD, assistant and liver cells start dying. The promotes long-term immunization ogy & cell biology. The lab will professor of pathology & cell condition, known as nonalcoholic against both common and novel combine emerging genomics biology; both are members of steatohepatitis, increases the risk strains of infuenza. The study, led research with clinically action- the Taub Institute for Research of liver failure and liver cancer, but by Donna Farber, PhD, professor able genomics testing to provide on Alzheimer’s Disease and the no drugs are available to slow or of surgical sciences in surgery and patients, families, and physicians Aging Brain. In April, Nature stop the disease. In a paper in Cell in microbiology & immunology, with information to help them Genetics published clues uncov- Metabolism, Xiaobo Wang, PhD, found that mice treated with one make health decisions. ered by an international team led associate research scientist, and Ira brand of intranasal vaccine pro- by Rando Allikmets, PhD, the Tabas, MD, PhD, the Richard J. duced T cells that protect against Getting Personal William and Donna Acquavella Stock Professor of Medicine and multiple strains, including those Wendy Chung, MD, PhD, the Professor of Ophthalmic Sci- professor of pathology & cell not present in the vaccines. Unlike Kennedy Family Professor of ences, to the genes behind Mac- biology, identifed TAZ, a factor traditional fu vaccines, which Pediatrics (in Medicine), launched Tel, a disease of the retina. And in liver cells that is responsible for produce antibodies that are often her program called DISCOVER initiating fbrosis; by inactivating outrun by rapid mutations of the (short for Diagnosis Initiative: TAZ in mice, they were able to initial virus, intranasal vaccines Seeking Care and Opportuni- reverse fbrosis. promote the production of “lung- ties with Vision for Exploration resident” T cells to protect against and Research) three years ago. Autoimmune Kidney Disease multiple viral strains. Through the Columbia-based DIS- In a PLOS Genetics report, Krzysz- COVER clinic, Dr. Chung and her tof Kiryluk, MD, the Herbert Boning Up team diagnose rare diseases using Irving Assistant Professor of Medi- A hormone secreted by bone cells whole exome and whole genome cine, and colleagues reported new can suppress appetite, according sequencing and provide personal- genetic clues to understanding IgA to mouse studies conducted by ized case management in partner- nephropathy, or Berger’s disease, Stavroula Kousteni, PhD, associ- ship with a team of specialists. an autoimmune kidney disease and ate professor of physiology & a common cause of kidney failure. cellular biophysics. The hormone, It’s Genetic In a genome-wide scan of 2,633 lipocalin 2, activates neurons in P&S scientists revealed genetic R NDO LLIKMETS clues to an array of human The center of the retina is damaged in individuals, the study described the brain that have been previ- MacTel disease. two genetic loci with large effects ously linked to appetite suppres- conditions in the past year. In on the abnormal glycosylation of sion. The fndings, published January, Lancet Neurology pub- in May, Circulation published a circulating IgA, an inherited risk in Nature, reveal a previously lished work by an international fnding that smoking counteracts factor for IgA nephropathy. unknown mechanism for regulat- team led by David B. Goldstein, the effect of a genetic element ing the body’s energy balance and PhD, director of the Institute that normally protects against The Nose as It could lead to new targeted thera- for Genomic Medicine, show- heart disease. Muredach P. Reilly, A study published in the Journal pies for the treatment of obesity, ing that several genes previously MBBCh, the Herbert and Flor- of Clinical Investigation/Insight type 2 diabetes, and other meta- implicated only in rare, severe ence Irving Professor of Medicine reveals that intranasal vaccination bolic disorders. forms of pediatric epilepsy also (in Cardiology), led the study.

32 ColumbiaMedicine  PHILANTHROPY NEWS HELP FROM OUR FRIENDS P&S enjoyed a milestone year for philanthropy in 2016-17. The year’s largest gifts refect the generosity of P. Roy Vagelos’54 and Diana Vagelos, who gave a $34 million lead gift in precision medicine and a $25 million gift for endowed scholarship support. This report features some of the programs that have been benefciaries of support from our many friends, and these pages describe other gifts that have made an impact on the research, education, patient care, and outreach missions that have made P&S one of the nation’s best medical schools for 250 years.

Cryo-EM Lynn Shostack and Terry Moore have given $9 million to enhance and expand a new imaging capability at Columbia known as cryoelectron microscopy. “Cryo-EM” uses electron beams to photograph frozen biologi- cal molecules to reveal their structures at the atomic level. A critical tool for precision medicine, Cryo-EM allows researchers to investigate the Lynn Shostack and Terry Moore cellular and molecular mechanisms associated with disease processes and the therapies used to treat them. Ms. Shostack, a member of the CUMC Board of Advisors, has provided major support to the David A. Gardner New Initiatives Fund to advance many cutting-edge technologies at P&S, including PET imaging and the small-animal MRI. Her gifts also have established permanent resources for P&S faculty and trainees through the David A. Gardner Professorship of Cardiology and the G. Lynn Shostack Cardiology Fellowship.

Jonas Children’s Vision Care

When Donald Jonas was diagnosed with a rare genetic condition that chief of pediatric ophthalmology, and Stephen Tsang, MD, PhD, the Laszlo T. would ultimately destroy the cells in his retina and lead to blindness, he and Bito Associate Professor of Ophthalmology and of Pathology & Cell Biology. his wife, Barbara, were determined that one day others would not have to “Barbara and Donald Jonas exemplify the philanthropic community,” face such a devastating loss. It was this experience, coupled with a deep says G.A. (Jack) Cioff, MD, the Jean and Richard Deems Professor, concern for the welfare of children, that led Mr. and Mrs. Jonas to provide a Edward S. Harkness Professor, and chair of the Department of Oph- gift to the Department of Ophthalmology to help establish a program aimed thalmology. “They realize that they can have a worldwide impact on at fghting vision problems in children. The initiative, known as Jonas Chil- diseases that have been a direct threat to their family, and they are very dren’s Vision Care, brings together the world-class technological and human smart about how they direct their funds.” expertise at Columbia to provide direct patient care, advocacy, scientifc The Jonas family joined Columbia faculty and other supporters in Jan- research, and education to fght childhood blindness. The program, which uary 2017 to launch the new, state-of-the-art program at the NewYork- also expands precision ophthalmology initiatives, will be directed by Steven Presbyterian/Morgan Stanley Children’s Hospital and in its home in the Brooks, MD, the Anne S. Cohen Professor of Pediatric Ophthalmology and Edward S. Harkness Eye Institute.

2017 Annual Report ColumbiaMedicine 33  PHILANTHROPY NEWS

Witten Outcomes Research Fund Chan Soon-Shiong Family Professorship

Richard and Lisa Witten have committed $2 million to the Herbert Irving Compre- Patrick Soon-Shiong MD committed $4 million to hensive Cancer Center to support the Center for Cancer Outcomes Research and establish the Chan Soon-Shiong Family Professorship Evaluation. The gift will strengthen cancer programs across the medical center and in Medicine and provide funds to support research and help Columbia lead the nation in developing evidence-based approaches to cancer clinical trials in myelodysplastic syndrome. treatment. Cancer outcomes research seeks to provide evidence on the comparative The Chan Soon-Shiong Family Foundation was estab- effectiveness, benefts, and harms of treatments in different populations of cancer lished by Dr. Soon-Shiong and his wife, Michele Chan. patients while developing strategies to optimize care for individual patients. The Chan Soon-Shiong Professorship and research gift cel- Research priorities of the center, which is directed by Dawn Hershman, MD, ebrate the mission of the foundation to fund research that address the challenges and opportunities in delivering high-quality care, with a strong accelerates the potential of immunotherapy as the next focus on racial, ethnic, and socioeconomic disparities. Center investigators also study generation standard in cancer patients. Azra Raza, MD, and learn from the successes and diffculties faced across different cancers, such as professor of medicine and director of the Myelodysplastic breast, ovarian, colon, brain, and, more recently, pediatric cancers and lymphoma. Syndrome Center at Columbia, is the inaugural incumbent Outcomes research helps ensure that every patient receives the right treatment, of the Chan Soon-Shiong Professorship. As a clinician- by the right physician, at the right place. scientist with an NIH-funded laboratory dedicated to cutting-edge MDS research, Dr. Raza explores the underly- ing pathology of MDS to seek new therapeutic targets and Challenge Grant for ALS non-toxic therapies. Research and Clinical Care The Tow Foundation awarded a Integrative Therapies for Children $2.05 million fve-year challenge and Adults with Cancer grant to beneft the Eleanor and Lou Gehrig ALS Center at P&S. Sidney and Helaine Lerner have pledged $2.5 million With this funding, P&S will support to establish the Sid and Helaine Lerner Professorship the expansion of clinical services for Global Integrative Medicine. The professorship will to provide care and access to vital support the leader of Columbia’s Integrative Therapies services for ALS patients in the New Program, which supplements conventional cancer care York metropolitan area. The funding with integrative approaches that have been demonstrated also will support research, including to improve health and healing, reduce stress, and minimize Leonard Tow founder and chairman of the research into the genomics of ALS pain in cancer patients. The gift pays tribute to several Tow Foundation and Emily Tow Jackson and opportunities for patients to individuals who helped found and establish the Integra- executive director and president participate in clinical trials. tive Therapies Program: the Lerners, who established the Carol Ann Resource Center/Integrative Therapies Program for Children with Cancer at Columbia in 1998; director Studying the Brain’s Relationship to Obesity Elena J. Ladas, PhD, who joined the program in 1999 and was recently appointed as the inaugural Lerner Professor; The Russell Berrie Foundation has pledged $8.25 million to launch the Obe- and Michael Weiner, MD, professor of pediatrics and vice sity Research Initiative at the Naomi Berrie Diabetes Center. The purpose of chair of development, who, as former chief of the Division this initiative is to study the relationships between neurobiology and metabolic of Hematology, Oncology, and Stem Cell Transplantation disorders, such as obesity and diabetes. The initiative will approach the science of in the Department of Pediatrics, supported the program body weight regulation by studying integrated elements of mind, brain, physiol- from its conception. Upon Dr. Weiner’s retirement from ogy, and metabolism. One goal of the program is to facilitate interactions among Columbia, the chair will be known as the Michael Weiner, Columbia’s strong research groups in neuroscience and metabolism. The Berrie MD, Professorship for Global Integrative Medicine. Foundation’s gift to support this research extends a longstanding philanthropic “We are all humbled by the Lerner family’s gener- commitment to Columbia University and the Berrie Center that dates back to the ous gift and thrilled by Elena’s appointment,” says Dr. center’s establishment at Columbia in 1998. Weiner. “Elena never ceases to amaze me, both in terms Rudolph Leibel, MD, the Christopher J. Murphy Memorial Professor of Diabetes of what she has accomplished and, most importantly, her Research and co-director of the Berrie Center, and Charles Zuker, PhD, professor of vision for the future. This is an incredible honor that will neuroscience and of biochemistry & molecular biophysics, will lead the initiative. allow Elena and the program to reach new heights.”

34 ColumbiaMedicine The Promise Project

The Promise Project under the leadership and better understand the origins and expressions of guidance of CUMC Board of Advisors member learning disorders. Dana Buchman, has continued its support for a Early diagnosis of and intervention for children

sixth year with grants totaling $1.416 million to with learning disorders are crucial, and the Promise Columbia’s Promise Program, a pioneering initia- Program helps to identify at-risk children and pro- MICH EL DIVITO DIVITO EL MICH tive for children with learning disabilities. As part vide them, their families, caregivers, and educators Dana Buchman a member of the CUMC Board of Advisors and Jeffrey A. of the Division of Child and Adolescent Psychiatry with appropriate and effective strategies for inter- Lieberman the Lawrence C. Kolb in Columbia’s Department of Psychiatry, the pro- vention. Faculty in psychiatry are working on scal- Professor of Psychiatry and chair gram focuses on the clinical needs of the learning able, exportable models for interventions to allow Department of Psychiatry disabilities population and engages in research to their work to help children elsewhere in the country.

Peter A. & Debby L. Weinberg Family Foundation Jay and Jeanie Schottenstein

In 2010 Debby and Peter Weinberg and East Coast, sets the standard for transi- A $1 million gift from Jay and Jeanie Schottenstein their families established the Weinberg tional, comprehensive, and holistic CP care. has established and endowed the Jay and Jeanie Family Cerebral Palsy Center to provide Debby and Peter have built on their com- Schottenstein Family Scholars Fund to support comprehensive, lifetime care to people mitment to the center by establishing the two junior investigators, one from the Division with cerebral palsy and other neuromus- Weinberg Family Assistant/Associate Profes- of Cardiology and one from the Division of cular conditions, conduct groundbreaking sorship for the center’s clinical director, a Cardiac Surgery, who will conduct research into research relating to CP, and educate the new position that will provide leadership for cardiac precision medicine. medical community, caregivers, and families the center alongside David P. Roye Jr., MD, about supporting and caring for this popu- executive medical director, and will be vital to lation. The center, the frst of its kind on the the center’s growth and continued success.

Gilbert Butler

A $1 million gift from Gilbert Butler has created a permanent endowment to support training of primary care physicians and innovations in medical education within Colum- bia’s Department of Medicine. It is a challenge grant, designed to inspire other donors to EVE V GG make similarly generous contributions, and future donations to the fund may carry nam- Shelby White a trustee of the Leon Levy Foundation ing rights. Mr. Butler asked that the fund be named to honor the memory of Henry S. Lodge, who died this year. The Henry S. Lodge, MD, Primary Care Endowment Fund is a tribute to Dr. Lodge and all he accomplished as a compassionate and intellectually curi- Leon Levy Foundation ous physician. At the request of Dr. Lodge’s family, his patients, friends, and loved ones The Leon Levy Foundation has given a $3 million have been donating to the fund in his memory. gift to renew and expand the scope of the Leon Levy Fellowship Program established in the Pincus Family Foundation Department of Psychiatry in 2010. The fellow- ship has become among the most competitive in Following the passing of David Pincus in evidence-backed interventions directly to the country, bringing some of the brightest and 2011, the Pincus Family Foundation contin- children, their families, and communities. most promising MD/PhDs in the feld to train ues to build upon David’s legacy of partner- With a recent gift of $1.3 million, the with Columbia faculty mentors. Alumni of the ship with the IFAP Global Health Program, Pincus Family Foundation has helped to program are among the nation’s leading investi- which encompasses comprehensive, family- expand IFAP’s network with other academic gators in psychiatry and neuroscience. centered primary and specialty care, training institutions engaged in immigrant and global Expansion of the program will allow support and education programs that prepare global health research and education, pursuing a for the work of young faculty members who are health leaders and improve health policy, mutual goal of improving health outcomes poised to take positions of leadership in their and innovative research designed to bring among vulnerable populations. respective disciplines.

2017 Annual Report ColumbiaMedicine 35 News from around the College of PhysiciansPS& news & Surgeons PS& news

Enrollment Begins for All of Us Research Program

olumbia has begun enrolling volunteers for All of Us, the federal socioeconomically diverse population we serve. It will also enable us to program to enroll 1 million Americans for the NIH-funded Pre- make sure that research fndings beneft our local population and beyond C cision Medicine Initiative. as quickly as possible.” The NIH awarded a fve-year grant expected to total $46.5 million to Adds Tom Maniatis, PhD, director of the Columbia/NewYork-Presbyte- Columbia, Weill Cornell, NewYork-Presbyterian, and Harlem Hospital rian Precision Medicine Initiative: “We are pleased and excited that the NIH to form a regional PMI Cohort Program Healthcare Provider Organiza- has chosen the Columbia/Weill Cornell/NewYork-Presbyterian, and Harlem tion (HPO) to enroll at least 150,000 volunteers by 2021. PMI is a large- Hospital collaboration as one of the partners in this ambitious and funda- scale research effort to improve the ability to prevent and treat disease mentally important program. This award is a validation of our commitment based on individual differences in lifestyle, environment, and genetics. to realize the vision of precision medicine, which identifes relationships The four centers will engage with community organizations through- between genetic, lifestyle, and environmental differences in individuals, and out New York City to ensure that the volunteers represent the geographic, the prevention, diagnosis, and treatment of human diseases.” ethnic, racial, and socioeconomic diversity of the country that the NIH “The mission of All of Us is simple: to speed up health research,” said program hopes to achieve through this “patient-powered” project. the invitation signed by the Columbia PIs, David Goldstein, PhD, director, “The PMI Cohort Program aligns perfectly with our own precision Institute for Genomic Medicine; Ali Gharavi, MD, the Jay Meltzer, MD, medicine effort, which we launched in 2015 in partnership with NewYork- Professor of Nephrology and Hypertension; and George Hripcsak, MD, Presbyterian and faculty from across Columbia University,” says Lee Gold- chair of biomedical informatics. “Together, we will build one of the largest man, MD, dean of the Faculties of Health Sciences and Medicine and chief health databases. Researchers will use it to conduct thousands of studies. executive of CUMC. “This award, in collaboration with NewYork-Presby- Their research may lead to the next big medical breakthrough.” terian, Weill Cornell, and our long-standing colleagues at New York City The program is developing features, tools, and resources for the offcial Health + Hospitals/Harlem, will extend our ongoing successes in taking an national launch in late 2017 or early 2018 and will use the early feedback individualized approach to treating some cancers and rare genetic diseases to help All of Us succeed. to a broader range of human illnesses across the ethnically, culturally, and To learn more and to sign up to participate, visit joinallofus.org.

New York First

P&S has joined other New York state medical schools in recent years to of dozens of additional laboratories throughout the state, each of which encourage New York lawmakers to fund the New York Fund for Inno- employs 10 or more skilled researchers and support staff and generates vation in Research and Scientifc Talents—NY FIRST—and the 2017-18 the intellectual property that leads to new cures, additional funding, and state budget includes $20 million for academic medical centers. The money new business opportunities. will be used to recruit and retain faculty members who have NIH grants. The program builds on the previous Faculty Development Program, The deans of the state’s 16 medical schools, through the Associated which yielded a greater than 7 to 1 direct return on the state investment Medical Schools of New York, called for an investment in what many and has helped academic medical centers keep top scientists in New York. other states have recognized is a central component of the innovation The Faculty Development Program has helped retain or attract 52 sci- economy: biomedical research. entists in the state since the program began a decade ago. More than 80 NY FIRST focuses investments on the economic development capaci- percent of the scientists are still doing research, still bringing in grant ties of research laboratories. The investment supports the development money, and still creating jobs in New York.

36 ColumbiaMedicine University Professor

Gordana Vunjak-Novakovic PhD the Mikati Foundation Professor of Biomedical Engineering, professor of medical sciences at P&S, and direc- tor of Columbia’s Laboratory for Stem Cells and Tissue Engineering at CUMC, has been appointed a University Professor, Columbia’s highest academic honor. The medical center now has fve faculty members who are University Professors. The professorships are granted to members of the faculty in recogni- tion of exceptional scholarly merit and distinguished service to Columbia. Dr. Vunjak-Novakovic has been a pioneer in the engineering of functional spirited biotechnology companies, the frst woman engineer to deliver the human tissue for use in regenerative medicine. With her research team, she Director’s Lecture at the National Institutes of Health, and the frst of has been able to engineer cardiac tissue by culturing stem cells and to grow Columbia’s female faculty members to be elected to the National Acad- bone grafts for facial reconstruction surgery. Her discoveries have led to emy of Engineering. new approaches for treating injuries and complex diseases and have sup- Other CUMC University Professors: Richard Axel, neuroscience, bio- ported the development and evaluation of therapeutic drugs. chemistry & molecular biophysics, and pathology & cell biology; Wayne Dr. Vunjak-Novakovic completed her PhD degree in chemical engi- Hendrickson, biochemistry & molecular biophysics and physiology & neering at the University of Belgrade and relocated to the United States cellular biophysics; Eric R. Kandel, neuroscience and physiology & cel- after receiving a Fulbright Fellowship. She is the founder of three public- lular biophysics; and Wafaa El-Sadr, epidemiology and medicine. M E L I P NI C O C NI P I L E M About the Class of 2017 Largest in P&S History

170 MD graduates 1 also received an MS degree in 16 percent matched to residencies narrative medicine at Columbia 51 percent of the graduates are women 30 students took an extra year for research 36 percent matched to residencies in 19 also received PhD degrees New York City 35 percent of the graduates took extra 3 were graduates of the three-year time for research or a dual degree 12 babies were born to students in PhD-to-MD program the class during medical school, and 12 graduates participated in the residency three students had two children during 2 also received MPH degrees match as couples medical school

3 also received MB degrees 19 percent went abroad for senior 26 students got married during medical electives or scholarly projects, mostly to school and 12 more got engaged 2 also have DDS degrees developing countries

2017 Annual Report ColumbiaMedicine 37 PS& news

Diversity Alliance Honors Students Residents Faculty

Students residents and faculty gathered in November 2016 for the Ken- neth A. Forde Diversity Alliance’s third annual symposium and reception to celebrate the achievements of the group. Four individuals received awards MELI P NICO in recognition of their contributions to promoting diversity at CUMC: Posing at the Diversity lliance event are, from left, Diversity and Multicultural ffairs Senior ssociate Dean Hilda Hutcherson, Christopher Travis, Naralys Batista, • Julia Iyasere, MD, assistant professor of medicine at CUMC, received Ken Forde, Julia Iyasere, Christopher Gonzalez, and P&S Dean Lee Goldman. the Faculty Diversity Award. • Christopher Gonzalez, MD, a resident in medicine at P&S, received sion of research conducted by students of BALSO—the Black and Latino the Resident Diversity Award. Student Organization at P&S—as well as musical performances by sev- • Two students in the Class of 2019, Naralys Batista and Christopher eral P&S students. Travis, received Medical Student Diversity Awards. The alliance was established in 2014 to recruit and retain a diverse community, provide networking events, foster and maintain a supportive The evening included a tribute to the alliance’s namesake, Kenneth A. environment, raise awareness about diversity, support pipeline programs, Forde, MD, the José M. Ferrer Professor Emeritus of Clinical Surgery. and provide career and leadership development through mentoring. P&S Alumni Association president Kathie-Ann Joseph, MD, led the trib- The newest pipeline program is the Gerald E. Thomson Undergraduate ute. Dean Lee Goldman, MD, announced a new scholarship established Pre-Medical Program, which will pair premed students at Columbia, Bar- in Dr. Forde’s honor. The Kenneth A. Forde Scholarship will be provided nard, and City University with mentors and provide career exposure and on the basis of need and merit and cover four years of tuition at P&S. development (through lectures, workshops, and networking opportuni- Dr. Forde has received numerous awards for his contributions to clini- ties) and practical experience (through clinical shadowing, medical school cal practice, research, teaching, and leadership, including the 2015 Dis- class visits, and volunteer opportunities). The program is named for Dr. tinguished Service Medal of the College of Physicians & Surgeons. He Thomson, the Samuel Lambert and Robert Sonneborn Professor Emeri- is a member of the CUMC Board of Advisors, a trustee of Columbia tus of Medicine, who received the inaugural Kenneth A. Forde Diversity University, and a trustee of NewYork-Presbyterian Hospital. Alliance Lifetime Achievement Award in 2015. Dr. Thomson joined the The evening’s program, sponsored by the Offce of Diversity and Mul- P&S faculty in 1970 and served in a variety of capacities, including senior ticultural Affairs and the P&S Alumni Association, included a poster ses- associate dean and head of the Offce of Minority Affairs.

Academy of Clinical Excellence Welcomes First Class

The new Academy of Clinical Excellence wel- we’re hoping the academy will do,” says James differences, and ways to help patients and their comed its frst members when 119 P&S clini- McKiernan, MD, chair of ACE and a mem- families cope with death and dying. cians were named to the academy’s frst class ber of the inaugural class. He also chairs the “Academies such as this have a bright future in May 2017. ACE was launched to laud the Department of Urology and is the John K. Lat- as long as the patient remains central to the achievements of faculty members who contrib- timer Professor of Urology. vision of academic medicine,” Dr. Forde said. ute to the P&S academic mission largely through At the induction ceremony, Kenneth A. Forde, In addition to recognizing clinical faculty, ACE high-quality, evidence-based, and humanistic the José M. Ferrer Professor Emeritus of Clini- launched a discussion series for clinical faculty. patient care. Inductees are full professors and cal Surgery, a Columbia University trustee, and Joseph Tenenbaum, MD, the Edgar M. Leifer Pro- have been at Columbia for fve or more years. a NewYork-Presbyterian trustee, said those who fessor of Medicine and a member of ACE’s inau- All devote more than 50 percent of their time most inspired him throughout his career were gural class, presented “What I’ve Learned: The to patient care and training the next generation “exemplary practitioners of the art of medicine.” Importance of Clinical Excellence” at the frst ses- of clinicians. He added that today’s clinicians face many sion in April. Dr. Tenenbaum talked about his expe- “The idea of recognizing and rewarding peo- challenges that can distract them from patient riences as a mentor and a mentee. He fondly recalled ple for outstanding performance helps shape care, but he noted a resurgence in clinical values all that he learned from his late mentor, Edgar M. other people’s behavior and helps them aspire evident in the medical school curriculum, which Leifer, PhD, MD, a physician he described as “the to that pinnacle of excellence and that’s what teaches lifelong learning, respect for cultural leading internal medicine clinician of his day.”

38 ColumbiaMedicine aboutPS& MEMBERSHIPS ND D T CURRENT S OF JULY 1, 2017, EXCEPT WHERE NOTED

Columbia University Trustees Dinakar Singh Taub Institute Advisory Board Operations Committee on the Health Sciences Andrew Solomon, PhD Richard Mayeux, MD, and Lindsay Graham, CPA Sarah Billinghurst Solomon Michael Shelanski, MD, PhD, Kenneth A. Forde, MD, Chair (effective Sept. 5, 2017) Ellen Stein Co-Chairs Rolando Acosta Senior Vice President/ Peter Tombros Noam Gottesman Chief Operating Offcer Leonard Tow, PhD Transplant Forum Andrew Barth Savio Tung Monica Segal, MPH, MS, Chair Abigail Elbaum Amador Centeno, MS Andy Unanue Michael Rothfeld Vice President, Facilities Management Joseph A. Walker Weinberg Family Cerebral Palsy and Campus Services Debby Weinberg Center Advisory Board CUMC Board of Advisors Peter A. Weinberg Debby Weinberg, Chair Ross Frommer, JD Torsten Wiesel, MD, P. Roy Vagelos, MD, Chair Vice President, Government Emeritus Member Women’s Health Care Council Philip L. Milstein, Vice Chair and Community Affairs George D. Yancopoulos, MD, PhD, Richard E. Witten Sarah Billinghurst Solomon, Chair Roger Wu, MD Vice Chair Christopher DiFrancesco, MA Keith T. Banks Senior Administration Chief Communications Offcer Michael Barry Other CUMC Advisory Groups Columbia University Stanley M. Bergman Medical Center 250th Anniversary William Innes, MS Gary B. Bettman Steering Committee Lee C. Bollinger, JD Chief Human Resources Offcer E. Garrett Bewkes III P. Roy Vagelos, MD, Chair President of the University Eugene Braunwald, MD Robert V. Sideli, MD Dana Buchman Babies Heart Fund Lee Goldman, MD Chief Information Offcer John A. Catsimatidis John Minio and Scott Roskind, Executive Vice President and Dean Anna Chapman, MD Co-Chairs of the Faculties of Health Sciences General Counsel Neil L. Cohen and Medicine and Chief Executive of Harris Diamond Patricia Sachs Catapano, JD Cancer Advisory Council Columbia University Medical Center F. Jonathan Dracos Associate General Counsel Richard Witten and Dina Dublon, John L. Eastman Co-Chairs Bobbie Berkowitz, PhD, RN Senior Administration Loren Eng Senior Vice President, CUMC Helene Feldman College of Physicians & Surgeons Center for Radiological Research Dean, School of Nursing Marjorie Harrison Fleming Advisory Council Lee Goldman, MD Kenneth A. Forde, MD Paul Locke, DrPH, Chair Linda P. Fried, MD, MPH Dean Carl Frischling Senior Vice President, CUMC Lee Goldman, MD Children’s Board at Columbia Dean, Mailman School Anne Taylor, MD Marc D. Grodman, MD Karen A. Kennedy, MD, Chair of Public Health Vice Dean, Academic Affairs Gerald L. Hassell Ara K. Hovnanian Columbia’s Cardiac Council Christian S. Stohler, DMD, Martha Hooven, MPA Ann F. Kaplan Peter J. Sacripanti, Chair DrMedDent Vice Dean, Administration Samuel L. Katz Senior Vice President, CUMC Ilan Kaufthal Diabetes Advisory Board Dean, College of Dental Medicine Steven Shea, MD Thomas L. Kempner Jr. John, Jodie, Jay, and Senior Vice Dean, Affliations Karen A. Kennedy, MD Katama Eastman, Chairs Development Jonathan S. Leff George A. Cioff, MD Ellen Levine Lynne Roth Health Sciences Advisory Council Vice Dean, Clinical Affairs, and A. Michael Lipper Senior Vice President Stuart Rabin, Chair President, ColumbiaDoctors Paul J. Maddon, MD, PhD Finance Phyllis Mailman Neurology Advisory Council Karina W. Davidson, PhD Robert F. Mancuso Joanne M.J. Quan, MA Richard Mayeux, MD, Chair Vice Dean for Organizational Paul A. Marks, MD, Emeritus Member Senior Vice President/ Effectiveness Joseph M. Murphy Chief Financial Offcer Ophthalmology Board of Advisors Lawrence Neubauer Sir Howard Stringer, Chair Education John W. Rowe, MD Wil McKoy, MBA Ronald E. Drusin, MD Kathe A. Sackler, MD Vice President, Budget and Planning Psychiatry Board of Advisors Peter J. Sacripanti Vice Dean Patricia and William Ramonas, Thomas P. Sculco, MD Francine Caracappa, MBA, CPA Co-Chairs Lisa Mellman, MD G. Lynn Shostack Controller Frank V. Sica Senior Associate Dean Precision Medicine Council Richard Silverman for Student Affairs P. Roy Vagelos, MD, Chair

2017 Annual Report ColumbiaMedicine 39 aboutPS& MEMBERSHIPS ND D T CURRENT S OF JULY 1, 2017, EXCEPT WHERE NOTED

Hilda Y. Hutcherson, MD Sankar Ghosh, PhD Medicine Surgery Senior Associate Dean for Diversity Silverstein and Hutt Family Professor Donald W. Landry, MD, PhD Craig R. Smith, MD and Multicultural Affairs of Microbiology & Immunology and Chair, Microbiology & Immunology Microbiology & Immunology Systems Biology Stephen Nicholas, MD Sankar Ghosh, PhD Andrea Califano, PhD Senior Associate Dean Ivaylo Ivanov, PhD for Admissions Assistant Professor of Neurological Surgery Urology Microbiology & Immunology Robert A. Solomon, MD James M. McKiernan, MD Maurice Wright, MD Senior Associate Dean, Robert Kass, PhD Neurology University Centers and Harlem Hospital Hosack Professor of Pharmacology, Richard Mayeux, MD Institutes and Directors Alumni Professor of Pharmacology Naomi Berrie Diabetes Center Jonathan Amiel, MD (in Neuroscience), and Chair, Neuroscience Robin S. Goland, MD Associate Dean for Pharmacology Steven A. Siegelbaum, PhD Rudolph L. Leibel, MD Curricular Affairs Donald Landry, MD, PhD Obstetrics & Gynecology Center for Family and Arthur G. Palmer III, PhD Samuel Bard Professor of Mary E. D’Alton, MD Community Medicine Associate Dean for Graduate Affairs Medicine and Chair, Medicine Richard Younge, MD Ophthalmology Elizabeth Shane, MD Charles Marboe, MD George A. Cioff, MD Center for Motor Neuron Associate Dean of Student Research Professor of Pathology & Biology and Disease Cell Biology at CUMC Orthopedic Surgery Darryl De Vivo, MD Noel Robin, MD William N. Levine, MD Serge Przedborski, MD, PhD Associate Dean, Arthur Palmer, PhD Hynek Wichterle, PhD Stamford Health System Robert Wood Johnson Jr. Professor of Otolaryngology/ Biochemistry & Molecular Biophysics Head & Neck Surgery Center for Radiological Research Henry Weil, MD and associate dean for graduate affairs Lawrence Lustig, MD David Brenner, PhD, DSc Associate Dean, Bassett Healthcare David Seres, MD Pathology & Cell Biology Center for the Study of Society Associate Professor of Medicine Kevin Roth, MD, PhD and Medicine and Center on Finance (in the Institute of Human Nutrition) Medicine as a Profession at CUMC Pediatrics Robin Honig, CPA David J. Rothman, PhD Associate Vice Dean and Lawrence R. Stanberry, MD, PhD Karen Soren, MD Chief Financial Offcer Columbia Stem Cell Initiative Associate Professor of Pediatrics and Pharmacology Emmanuelle Passegué, PhD Research Population and Family Health at CUMC Robert S. Kass, PhD Columbia Translational Michael L. Shelanski, MD, PhD Steven Stylianos, MD Physiology & Cellular Biophysics Neuroscience Initiative Senior Vice Dean for Research Rudolph N. Schullinger Professor Andrew R. Marks, MD Serge E. Przedborski, MD, PhD of Surgery at CUMC Jennifer Williamson Catania, MS, MPH Psychiatry Associate Vice Dean for Research Institute for Cancer Genetics Department Chairs Jeffrey A. Lieberman, MD Policy & Scientifc Strategy Riccardo Dalla-Favera, MD Anesthesiology Radiation Oncology Institute of Comparative Medicine lumni Relations and Development Ansgar Brambrink, MD, PhD Lawrence H. Schwartz, MD Brian Karolewski, VMD, PhD Anke Nolting, PhD Interim Chair Biochemistry & Molecular Biophysics Associate Dean and Tom Maniatis, PhD Institute for Genomic Medicine Executive Director Radiology David B. Goldstein, PhD Lawrence H. Schwartz, MD Biomedical Informatics Executive Committee of the Institute of Human Nutrition George Hripcsak, MD Rehabilitation & Faculty Council 2016-2017 Richard J. Deckelbaum, MD Regenerative Medicine Andrew Eisenberger, MD Dermatology Joel Stein, MD Assistant Professor of Medicine David R. Bickers, MD Herbert Irving Comprehensive at CUMC – Programs in Occupational Therapy Cancer Center Genetics & Development Janet Falk-Kessler, EdD Stephen G. Emerson, MD, PhD Mary Flood, MD, PhD Gerard Karsenty, MD, PhD Director Associate Professor of Medicine – Program in Physical Therapy Irving Institute for Clinical and at CUMC Debra Clayton-Krasinski, PhD Translational Research Director Muredach P. Reilly, MBBCh

40 ColumbiaMedicine Kavli Institute for Brain Science Clyde and Helen Wu Center Harlem Hospital Stamford Hospital Eric Kandel, MD for Molecular Cardiology New York, NY Stamford, CT Andrew Marks, MD Gertrude H. Sergievsky Center James A. Peters Veterans Helen Hayes Hospital Richard Mayeux, MD P&S Hospital Affliations Administration Hospital West Haverstraw, NY Bronx, NY Taub Institute for Research NewYork-Presbyterian Hospital Lawrence Hospital on Alzheimer’s Disease and New York, NY Mary Imogene Bassett Hospital Bronxville, NY the Aging Brain Cooperstown, NY Richard Mayeux, MD New York State Psychiatric Institute Michael L. Shelanski, MD, PhD New York, NY

F CTS & ST TISTICS, FY17

MEDICAL SC OOL ENROLLMENT, FALL 2016 DEGREES GRANTED, FY17 Total medical school enrollment ...... 660 MD ...... 170 Enrollment of international/nonresident students ...... 24 PhD ...... 66 Enrollment of in-state residents ...... 193 Doctor of physical therapy...... 63 Enrollment of men ...... 331 MS in nutrition...... 82 Enrollment of women ...... 329 MS in occupational therapy ...... 54 Certificate in psychoanalysis...... 4 ENROLLMENT BY YEAR M LE FEM LE APPLICATIONS (ENTERING CLASS 2016) First-Year Class 79 72 Number of applicants ...... 8,047 Second-Year Class 83 81 Number of applications considered...... 7,243 Third-Year Class 84 88 Number of applicants interviewed...... 1,009 Fourth-Year Class 85 88 Number of acceptance letters issued...... 327 Total Enrollment 331 329 Bassett Program applications ...... 864

MEDICAL SC OOL ET NICITIES FACULTY, 2016-2017 ACADEMIC YEAR Nonresident aliens ...... 24 FULL TIME P RT TIME Hispanic/Latino ...... 70 Clinical faculty 1,826 1,994 Black or frican- merican, non-Hispanic/Latino ...... 62 Basic sciences faculty 269 42 White, non-Hispanic/Latino ...... 307 sian, non-Hispanic/Latino ...... 121 FACULTY ONORS Native Hawaiian or other Pacific Islander, non-Hispanic/Latino .... 1 Nobel Prize in Medicine ...... 2 Two or more races, non-Hispanic/Latino ...... 9 National cademy of Sciences ...... 19 Race and/or ethnicity unknown ...... 66 National cademy of Medicine ...... 48 merican cademy of rts and Sciences ...... 25 OT ER STUDENTS Howard Hughes Medical Institute ...... 9 MD/PhD students ...... 118 PhD students ...... 394 FINANCIALS, FY17 (except where noted) Other students (PT, OT, Nutrition, Informatics) ...... 512 Budget ...... $1.9 billion Philanthropic support ...... $ 3 8 8 m i l l i o n Endowment ...... $1.8 billion Endowed chairs/professorships ...... 2 6 1 NIH research support (FY 2016) ...... $406.3 million 630 West 168th Street Non-Proft Org. New York, NY 10032 U.S. Postage Paid New York, NY PERMIT NO. 3593

A New Look on 168th Street

rojects in various stages of completion and planning will provide new looks for the Alumni Auditorium, its lobby, and the adjoining Black Building Plobby and frst foor. Renovation of the interior of the Alumni Auditorium was completed over the summer of 2017 and is now in use for classes and events. New auditorium seats with tablet arms and electrical outlets were installed, and the carpet was replaced. The renovation also included improved lighting and a new audiovisual system. Demolition of the auditorium’s lobby continued through the summer, and a new lobby and façade are expected to be completed by next summer. The ceiling of the lobby will be raised to create an open and larger lobby. Construction of the new glass façade will begin next spring. When complete, the auditorium will connect to the lobby of the P&S building. A design is being conceived for a project that would transform the lobby and frst foor of the Black Building into a new destination for students, faculty, and staff. Amenities planned include a lactation room, a large café, and additional electrical outlets for the community to use while lounging in the lobby and café spaces.

4 ColumbiaMedicine