FALL 2016 Carilion Medicine
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AN EXHAUSTING BUT PRODUCTIVE THE HIDDEN DANGERS OF MILD LOW-DOSE SCANS SAVE LIVES DAY WITH A TRAUMA SURGEON TRAUMATIC BRAIN INJURIES OF THOSE AT RISK FOR CANCER FALL 2016 Carilion Medicine TIMING IS EVERYTHING From fertility assistance to teen pregnancy prevention, physicians are helping patients achieve their dreams contents CARILION MEDICINE FALL 2016 Departments 2 FROM THE CMO 3 IN BRIEF New Health Sciences and Technology Innovation District; other milestones 6 GRAND ROUNDS Education initiatives both classic and with a twist 36 THE ART OF MEDICINE The Burden Boat helps patients and families lighten their hearts. 38 CHEERS FOR PEERS Carilion physicians receive recognition for a range of achievements. 40 BACKSTORY: 16 THE QUALITY IMPERATIVE Physicians need to embrace transparency A SPOONFUL OF SUGAR: Carilion Children’s seeks to bring joy into in the quest for safe, high-quality care. kid’s lives as part of healing. BY RALPH WHATLEY, M.D. SPECIAL SECTION Timing Is Everything Features 8 12 16 18 22 26 30 IN DUE TIME ACROSS THE WONDER BRAIN FOUNTAIN SMOKE A DAY IN THE LIFE Carilion forged an STATE LINES YEARS STRAIN OF YOUTH SCREEN OF BRYAN COLLIER enduring partnership with local schools to help A fertility expert redraws Carilion Children’s care Experts cross disciplines Pediatricians help ensure A new lung-cancer Twenty-four exhausting reduce the state’s highest borders to give her extends beyond clinic walls to tease out the dangers clean water to improve screening holds out hope but productive hours with teen pregnancy rate and patients their best to capture imaginations of mild traumatic maternal and child health for long-time smokers who Carilion Clinic’s chief of keep futures bright. chance at pregnancy. and encourage healing. brain injuries. in Malawi. might otherwise have died. trauma surgery. BY JESSICA CERRETANI BY PAULA BYRON BY PAULA BYRON BY CHARLES SLACK BY VERONICA MEADEKELLY BY CHARLES SLACK BY DAVID HUNGATE PHOTOS: MARK HOOPER COVER; ERIC SOLLINGER TOP; SHUTTERSTOCK BOTTOM timing is everything. I was reminded of this simple yet powerful Carilion Medicine truth in June, when one of my role models President and Chief Executive Officer On the pulse of the Nancy Howell Agee passed away. Pat Summitt was an incredible Carilion Clinic community coach, leading the University of Tennessee Lady Chief Medical Officer and Executive Vice President Vols to 1,098 wins—the most of any coach in Patrice M. Weiss, M.D. women’s college basketball history. Pat was a Editorial Advisory Panel leader off the court as well. She raised the profile Nathaniel L. Bishop, D.Min.; Cesar Bravo, M.D.; of women’s basketball. She authored books. John Burton, M.D.; Hugh Craft, M.D.; Mahtab in brief Foroozesh, M.D.; Evelyn Garcia, M.D.; Mark Happy 200th Perhaps most important, she was a mentor who Greenawald, M.D.; Daniel Harrington, M.D.; Hal graduated 100 percent of her four-year athletes. Irvin, Ph.D.; Cynda Johnson, M.D.; Claudia Kroker- NEW INNOVATION HUB Bode, M.D., Ph.D.; Eduardo Lara-Torre, M.D.; Bruce Valve Replacement She also raised awareness about Alzheimer’s disease, which took her life Long, M.D.; William Rea, M.D.; David Sane, M.D.; Virginia Tech and Carilion Clinic have staked at the age of 64. Pat was one of my inspirations, and her death stopped me in Gary Simonds, M.D.; Jon Sweet, M.D. a new claim in the world of health sciences In March, a team of Carilion cardiologists, cardiothoracic surgeons, and radiologists hit a surgical Chief Administrative Officer through a strong public-private partnership my tracks. It was especially tough because for years my mother has struggled milestone when they treated their 200th patient Jeanne Armentrout and a major vote of confidence from the with the same disease. with transcatheter aortic valve replacement, or TAVR, Commonwealth of Virginia. That vote of Vice President making them the first in Southwest Virginia to do so. R. Wayne Gandee, M.D., a Carilion hero and leader, also died this year. He confidence—in the form of an estimated Mike Dame This surgery offers hope to patients considered too served as Carilion’s chair of radiology from 2006 to 2011 and then as chief $46.7-million allocation to be matched by high at risk for traditional treatment. Executive Editor $21 million from Virginia Tech and Carilion medical officer until illness led to his retirement in 2014. He was my boss during Linda Staley “We are leading the nation with our minimally Clinic—will result in the construction of invasive approach to TAVR, replacing heart valves that time, and I was proud to call him a friend as well. Wayne was never afraid to Editor a 105,000-square-foot facility to expand while patients are only lightly sedated to avoid the say what he felt and to tell the people around him that he loved them. Paula Byron health sciences and technology research perils of general anesthesia,” said Jason Foerst, M.D., an The strongest of the strong, the best of the best—we are all vulnerable. It can Art Director and training in Roanoke. interventional and structural cardiologist at Carilion. be hard to grasp that time is finite, even for those we regard as superheroes. Laura McFadden “We are building a foundation for “This strategy has allowed us to discharge many of Timing matters, in life and in medicine. Special Thanks biotechnology and medical research that our patients as soon as the next day. We’ve since been Catherine Doss, John Griessmayer, will establish Virginia as a hotbed for fortunate to present our approach and outcomes at For a trauma patient, five minutes at a Level 1 trauma center can mean the Laura Mitchell, Betsy Parkins, Anne Shaver, companies who want to be shoulder-to- three major national cardiology conferences.” difference between life and death. For a woman undergoing fertility treatments, Ashley WennersHerron shoulder with world-class collaborators five days can affect a potential pregnancy. For a baby born five months too early, CARILION CLINIC and a highly trained technical workforce,” access to a Level 1 neonatal intensive care unit is critical. For a teenage girl, 1906 Belleview Avenue said Virginia Governor Terry McAuliffe, Health Sciences and Technology Innovation Nancy Howell Agee, president and P.O. Box 13367 who signed a bond authorizing the District in Roanoke, with Michael Fried- chief executive officer of Carilion, delaying pregnancy by at least five years can improve her own life—and the lives Roanoke, VA 24033 building in May. “This is a cornerstone of lander, Ph.D., executive director of the remembers looking out from her office of her future children. CarilionClinic.org a new Virginia economy and will position Virginia Tech Carilion Research Institute, window at Carilion Roanoke Memorial 800-422-4842 Pat Summitt once said, “I won 1,098 games and eight national championships, the commonwealth as a national leader named the university’s inaugural Hospital less than a decade ago and and coached in four different decades. But what I see are not the numbers. I see in advanced research.” vice president for health sciences and seeing a deserted landscape. The initiative will enable the recruit- technology. “Now there’s a medical school, a their faces.” ment of an additional 25 research teams The innovation district will bring research institute, and a beautiful park As physicians, we spend only moments with our patients, but our impact Carilion Medicine is published twice a year at: to the Virginia Tech Carilion Research faculty members, students, and other where there once was only a brownfield,” transcends those moments. What we do affects our patients’ future selves and 213 McClanahan Street, Suite 200 Institute, raising the total number of trainees together with Carilion clinicians in she said. “This is a moment when we their families. The people—the faces—are why we are here. Roanoke, VA 24014 teams conducting scientific investigations biomedical and health sciences laboratories can take stock of all that has been Phone: 540-266-6586 Fax: 540-266-6608 in Roanoke to about 55. to do research in a real-world context, accomplished and build on it to create I invite you to read this second edition of Carilion Medicine, which focuses on Email: [email protected] Virginia Tech had earlier announced transcending disciplinary boundaries to an even more remarkable medical and time. In the end, it is our most precious commodity. a plan for the development of a far-reaching solve complex health problems. educational resource for our region.” Carilion Clinic is a nationally ranked integrated health care system headquartered in Roanoke, Virginia. Its flagship, Carilion Roanoke Memorial Hospital, is the clinical affiliate of the Virginia Tech Carilion School of Medicine and Jefferson College “ This is a cornerstone of a new Virginia economy and of Health Sciences. will position the commonwealth as a national leader in © Copyright 2016 by Carilion Clinic. No part of this Patrice M. Weiss, M.D. publication may be reproduced or transmitted Chief Medical Officer and Executive Vice President in any form or by any means without written advanced research.” Carilion Clinic permission from Carilion Clinic. All editorial rights — Terry McAuliffe, governor of Virginia, in signing a bill authorizing reserved. Opinions expressed herein may or may a significant expansion of the Virginia Tech Carilion Research Institute not reflect the views of Carilion Clinic. 2 CARILION MEDICINE | FALL 2016 PHOTO: DARRYLE ARNOLD PHOTOS: SHUTTERSTOCK TOP; DAVID HUNGATE/VIRGINIA TECH BOTTOM CARILION MEDICINE | FALL 2016 3 honors Research Institute Faculty Members briefings Honored with Endowed Professorships FORMER CHIEF MEDICAL OFFICER REMEMBERED Life-Guard Milestone R. Wayne Gandee, M.D., CMO at Carilion Upon his retirement, Dr.