CHILDREN’S HANDPRINTS A PUBLICATION OF CHILDREN’S HOSPITAL & RESEARCH CENTER OAKLAND

PEDIATRIC CANCER A baby born with cancer inspires other cancer patients

TRAINING FUTURE PEDIATRICIANS Children’s residency program is one of the largest in the state also inside Winter 2010 WINTER 2012 childrenshospitaloakland.org Fox Theater, Oakland • Saturday, April 28, 2012

www.notesandwords.org

CALLING ALL WRITERS! Notes & Words Essay Contest

As part of our annual event celebrating FIRST PRIZE: literary and musical talent, Notes & Words is The winner will have one-on-one consultations with: announcing an essay contest. Senior Editor, Random House/Ballantine We want your short personal essay (800 words Top Literary Agent, ICM or less) about the challenges of caring for a child Executive Editor, O, The Oprah Magazine (age 18 or younger), including medical issues (e.g., an accident, illness or diagnosis), emotional and will be introduced to: crises (e.g., a death, Michael Chabon, Pulitzer Prize winner divorce, breakdown) Anne Lamott, New York Times bestselling author or one of any one of John Hodgman, The Daily Show, HBO’s Bored to Death the more common Essay Contest Kelly Corrigan, New York Times bestselling author parenting dramas (e.g., academic, social, athletic, Finalists will receive two tickets to Notes & Words on epicurean). We welcome April 28, 2012 at The Fox Theater in Oakland. both humorous and serious essays. Submissions are due March 21, 2012. See notesandwords.org for rules and deadlines. Table of Contents

18 Training Tomorrow’s Pediatricians Children’s Pediatric Residency Program has trained dedicated physicians since 1926.

5 LETTER FROM THE 15 CANCER CENTER 25 GIVING BACK PRESIDENT & CEO Awesome Dawson Radiotón Para Nuestros Niños A baby born with cancer inspires prospers again. 6 WHAT’S NEW and gives hope to other cancer A former patient, Viviana Espinoza, Palliative Care Program opens at patients. Written by Joe Quirk. gives back by volunteering at the Children’s. hospital. 21 TEACHING HOSPITAL 7 FOOD CORNER Children’s Summer Research BlackRock’s Connectivity and This winter minestrone makes for a Program Trains Future Scientists Giving Program raises funds for nourishing, nutrient-rich supper. Since 1981 Children’s. Save the date for the 2012 St. Baldrick’s event. 8 ASK AN EXPERT 22 ADVOCACY Rachel Kuperman, MD, addresses Preserve Healthcare Funding Score Fore Kids golf classic raised one reader’s question about This funding provides organizations over $1.4 million since 2000 for seizures. like Children’s Hospital Oakland the Children’s. opportunity to ensure that all our Costco, a longstanding partner, children, regardless of income or raised over $780,000 for Children’s. 8 KIDS CORNER insurance status, have access to the Last issue’s puzzle solution. highest possible level of healthcare. Spirit Halloween donates Halloween Try your hand at logic puzzle #3. costumes to Children’s patients. AB25 Establishes California as a 10 RESEARCH UPDATE Leading State for Protecting the 30 SPORTS MEDICINE CENTER Ronald Krauss, MD, launches The Safety of Student Athletes New Program Announcement Family Heart and Nutrition Center, Bill addressing concussions is Athlete Development Program opening cardiovascular disease signed by Governor Brown. off ers a training program studies to the public. BONUS: Concussion Guide designed to achieve measurable improvement. 12 FUNDRAISER SPOTLIGHT 24 GOOD NEWS A Children’s staff member shares How to fi nd trustworthy health 31 100 AMAZING YEARS: 1973 her experience swimming in the information on the Internet We start to look back as Children’s San Francisco Bay to raise money reaches its centennial year. for cancer research. Written by Susan Martinez. Swim Across America’s Olympic swimmers visit Children’s. 28

14 100% KID-FOCUSED ADHD: A Common Getting to Zero Children’s recognizes 30 years Struggle for Children at ground zero of the HIV/AIDS pandemic. When left untreated, children with ADHD often feel they don’t do as well as they could in school and may develop poor self-esteem.

CHILDREN’S HOSPITAL & RESEARCH CENTER OAKLAND BOARD OF DIRECTORS

James Keefe, Chair Michael LeNoir, MD, Jeff rey Cheung James Levine Edward Penhoet, PhD Melba Muscarolas, Secretary Matthew Cox Leslie Littleton Sharon Pilmer, MD Vice Chair Jamie Bertasi Zerber Harold Davis Bertram Lubin, MD Ori Sasson Arthur D’Harlingue, MD, Rena Brantley Watson Laetsch, PhD Alexander Lucas, PhD Harold C. Warner, PhD Treasurer Tom Bret, Esq. Lou Lavigne Betty Jo Olson Richard Whitley, MD CHILDREN’S HANDPRINTS Did you know adult Children’s HandPrints is a publication of Children’s Hospital & Research Center Oakland, 747 52nd Street, Oakland, CA 94609; hospitals can use up to 510-428-3000.

Bertram Lubin, MD President and Chief Executive Offi cer 2X to 4X Marketing Communications Department Cynthia Chiarappa Vice President, Marketing and more Corporate Communications Tina Amey x-ray Administrative Assistant Debbie Dare Graphic Design Services Manager radiation Erin Goldsmith Media Relations Manager

Kevin Kimbrough dosage Marketing Manager

Michele Repine than a children’s Web Content Manager

Erika Sandstrom hospital? Senior Graphic Designer

Contributing Writers Bernardette Arellano Whether it’s a broken fi nger or a CT scan, Casey Capachi Susie Caragol Children’s Hospital Oakland knows the Jerome Gentes Paula Lykins radiation dosage level appropriate for your child. Rachel Kuperman, MD Susan Martinez Joe Quirk Petra Steinbuchel, MD

DIAGNOSTIC IMAGING SERVICES ARE AVAILABLE AT Contributing Photographer Alain McLaughlin TWO CONVENIENT LOCATIONS: The medical information contained in this newsletter should not be substituted for CHILDREN’S HOSPITAL OAKLAND advice from your child’s pediatrician.

747 52nd St. If you do not wish to receive future Oakland, CA issues of this publication, please email to 1 [email protected] your name and address 510-428-3000 BENICIA as they appear on the mailing panel.

If you’d like to write to the editor of WALNUT CREEK CENTER Children’s HandPrints, please send an 2401 Shadelands Dr. email to [email protected]. Walnut Creek, CA 925-979-3400

7 OAKLAND Walnut Creek

PLEASANTON 5 www.childrenshospitaloakland.org www.childrenshospitaloakland.org

4 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org A WORD FROM DR. LUBIN PRESIDENT & CEO

Dear Friend and Neighbor, Did you know over 75% of the pediatricians on the East Bay’s Best Doctors list work at Children’s? The Best Doctors in America® list represents the top 5% of doctors in the U.S. These are the doctors that other doctors recognize as the best in their fi elds. Doctors cannot pay a fee and are not paid to be listed, and they cannot nominate or vote for themselves.

Children’s pediatrician Pamela Simms-Mackey, MD, was featured on the cover of the Oakland Magazine December 2011 issue which carried the list. Dr. Simms- Mackey performed her pediatric residency and was Chief Resident at Children’s. She now serves as the residency program’s Associate Director (read more about the Children’s residency program on page 18).

The Graduate Medical Education leadership (Drs. James Wright, Pamela Simms- Mackey and Michael Lang), with help from members of our teaching faculty, actively help residents fi nd positions in a variety of professional settings, including some of the most competitive subspecialty fellowships and most highly regarded primary care medical groups and community clinics in the Bay Area and across the U.S.

CHILDREN’S HOSPITAL RESIDENTS’ CAREER CHOICES, 2000-2010 Field Overall Percent Working in the Bay Area Primary Care 43% 60% Dr. Simms-Mackey’s profi le can be found at www.oaklandmagazine.com/media/Oakland- Subspecialty 37% 52% Magazine/December-2011/Modern-Medicine. Hospitalist 20% 86%

Maybe your child’s pediatrician trained with us. Here, pediatric residents work across a spectrum of clinical rotations and have dedicated themselves to improving the health of children in communities all over the U.S. and throughout the world.

Cheers to the program’s 86th year, and cheers to your family’s health!

Bertram Lubin, MD Children’s Hospital & Research Center Oakland President & Chief Executive Offi cer

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 5 WHAT’S NEW

Palliative Care Program Opens at Children’s Portions of this article were adapted and used with permission from the OaklandNorth.net, November 21, 2011 post by Casey Capachi.

“Here’s our Jeff rey,” said Tarassa House staff worked for years Humphrey, proudly pointing to a photo to start the Palliative Care of her only son. In the photo, Jeff rey is Program. Vivienne Newman, MD, fl oating happily in a swimming pool, held Palliative Care Medical Director up by a therapist, a huge smile spread and critical care physician, across his face. The photo, carefully explains, “Many services laminated by strips of clear tape to provided through palliative care preserve its shape, is worn from being are not reimbursable through carried in Tarassa’s purse for so long after most insurance companies. Jeff rey’s passing in 2009. He was only We were fortunate to have the 6 years old. generous philanthropic support The Humphreys and several other of individuals, corporations, families who had lost a child gathered and foundations to launch the with staff and donors at Children’s for program at Children’s Hospital, the recent launch of the hospital’s new and we’ll continue to rely on our Pediatric Palliative Care Program. Jeff rey Sr. and Tarassa Humphrey describe the new community for sustaining and Refl ection Room as “an answer to our prayers.” The program works with healthcare expanding the program.” providers and a patient’s family to The opening of a Bay Area focus on enhancing quality of life and that was painted by the mother of a hospital-based facility was relieving suff ering for the child at any terminally ill child. There are fl at screen “the answer to our prayers,” Tarassa stage in their illness. The team also televisions, cozy couches, kid-sized Humphrey said. assists families with healthcare decisions, chairs, and beds that don’t look much “To have Jeff rey free of all machines, pain and symptom management, like hospital beds at all, with yellow free of being poked, just free to die emotional support and healthcare embroidered quilts draped over them. peacefully—that’s all we ever wanted for navigation guidance. The palliative care The Refl ection Room serves as a him,” Tarassa Humphrey said. Palliative team includes a nurse and educator, a transition room for families headed care, she added, is “what we would like pediatrician, and a nurse practitioner. home after a hospital stay with a child for other parents in that situation—just In conjunction with the program who requires a high level of attention to have that time alone with their child launch, Children’s opened a suite of or end-of-life care in a home setting. before, during, and after their end-of-life rooms called the Refl ection Room, Claire Vesely, RN, Palliative Care Program process.” designed for the particular needs of Coordinator, says family members “It’s all about the little things,” said families who may be spending their are often thankful to be able to have Vesely. “You don’t even have to say last days with their children. There is prolonged private contact with their anything. Just being there as a resource a refrigerator, stocked with food. The young loved ones. for a family. They’re happy that they can bedroom features a mural of a mountain A group of about a dozen Children’s focus on being the parents—that’s the range with butterfl ies fl ying overhead Hospital and George Mark Children’s biggest thing.”

In October 2011, the Wells Fargo A heartfelt “thank you” to Children’s Foundation generously donated Palliative Care Program donors: $100,000 to the Palliative Care Program. Individual donors have also given to the The Ackerman Family program, including the Ackerman family, Lorraine Gotelli who supported the program in honor of The Joseph & Vera Long Foundation their son, Christopher, who made a full Thomas J. Long Foundation recovery at Children’s after a terrible Mr. and Mrs. Richard Migliore fall in 2010 left him critically injured. (l-r) Vivienne Newman, MD, Palliative The MOCA Foundation Care Medical Director; Bertram Lubin, The Twanda Foundation MD, Children’s President and CEO; Paul Wells Fargo Foundation Rettig, Executive VP, Wells Fargo; Juli Rettig; Paul Ackerman, Executive VP To give to the Palliative Care Program, and Treasurer, Wells Fargo; Laura and go to www.chofoundation.org. Christopher Ackerman.

6 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org FOOD CORNER

We b our soups This winter minestrone makes for a nourishing, nutrient-dense supper during the darkest days of the year HEARTY MINESTRONE COOK 1/2 cup olive oil AUTHENTIC 1 cup thinly sliced onion ITALIAN 1 cup diced carrots VEGETABLE 1 cup diced celery SOUP 2 cups diced potatoes EVERYONE IN 1 cup canned cannellini beans THE FAMILY WILL 2 cups diced zucchini (about 2 medium) SLURP UP 1 cup diced fresh green beans 3 cups shredded cabbage, preferably Savoy cabbage 6 cups chicken stock The rind of a 2- to 4-inch long piece of Parmesan cheese scraped clean (optional, but well worth it!) 2/3 cup canned tomatoes 1/3 cup freshly grated Parmesan cheese (optional) Handful of chopped fresh chopped basil leaves for garnish

CHILDREN’S DIRECTIONS FARMERS 1. Choose a stockpot large enough for all ingredients. Put in the oil, butter and sliced onion, and cook over medium-low heat until the onion wilts and is MARKET pale gold in color, but not browned. Add the diced carrots and cook for 2 to 3 minutes, stirring once or twice. Repeat this procedure in sequence with the TUESDAYS celery, potatoes, zucchini, and green beans, cooking each one a few minutes 2–7 P.M. and stirring. Then add the shredded cabbage and cook for about 6 minutes, Across the street from giving the pot an occasional stir. the hospital, on 52nd St. 2. Add the broth, the cheese rind, and the tomatoes. Cover and cook at a very slow boil for at least 3 hours. If necessary, you can stop the cooking at any time and resume later. Minestrone must never be thin and watery, so cook until it is soupy thick.

3. Fifteen minutes before the soup is done, add the canned beans. Just before turning off the heat, remove the cheese rind, and swirl in the grated Buy the cheese. Taste and correct for salt. Serve with chopped basil. ingredients at Children’s Farmers Market! This is waaay better   than canned soup!

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 7 ASK AN LOGIC PUZ EXPERT PUZZLE #2 Rearrange the red and If you have a question you’d like to ask, blue circles in the grid email [email protected]. in such a way that no two circles of same color “I’ve seen my fall in the same row niece have a horizontally, vertically convulsion when or diagonally. she has a high fever. What is that?”

Commonly, Congratulations to everyone who there is a family history of febrile seizures. Febrile seizures typically start at about 1 year of age, peak between 2 to 3 years of age, and stop between ages 5 and 6.

Febrile, or fever, seizures are benign convulsions associated with a rapid rise in body temperature and usually occur at the beginning of an illness. The illness may be due to a viral or bacterial infection. Typical febrile seizures last 1 to 2 minutes, and are characterized by: • A sudden loss of consciousness • Becoming limp with eyes rolled up • Rhythmic jerking movements of the arms or legs, or the whole body stiff ens • Rapid return to consciousness • A period of drowsiness or confusion after the seizure.

Febrile convulsions are not considered to be a form of epilepsy. In general, benign febrile seizures are not treated with seizure medications.

Management consists of aggressive treatment of fever using acetaminophen (Tylenol or Tempra) and/or ibuprofen (Advil or Motrin), and sponging or bathing with tepid water.

Sometimes febrile seizures are atypical. If a child has one of the following, they have an atypical febrile seizure and may be showing early signs of epilepsy: • Prolonged seizure activity (longer than 15 minutes) • Only one side of the body is involved in the seizure • More than one seizure during the same febrile illness.

Rachel Kuperman, MD, is a pediatric neurologist specializing in epilepsy at Children’s Neurology Department.

8 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org KIDS CORNER ZZLE LOGIC PUZZLE #3 POSSIBLE ANSWERS: PROBLEM: Place the digits 1 to 8, in the circles in the figure. The numbers you can see are the totals for the surrounding numbers.

14

16 25 14 submitted an answer to the last quiz! 17

PUZZLE ANSWER:

14

16 25 14

17 LOOK!

It's Children's Submit your answer, and if it’s correct, you’ll win a prize. If you send in a photo of you holding the Hospital's solution, you might be in the next issue! Send your answer by March 31 to: CHILDREN’S HOSPITAL OAKLAND, COMMUNICATIONS DEPT., 747 52ND ST., Whiz Kids! OAKLAND, CA 94609

Anthony from Alameda; Maylin from Berkeley; Jay from Concord; Alvin, Kathan, and Aneri from Fremont; Margaret from Lafayette; Jimmy from Napa; Nathan from Oakland; Tim from NAME______AGE______Orinda; Adrian, Noah, and Rayne from Pleasanton; Aneesh, Avani, Jonathan, Kyle, and Puja from San Ramon; Michael and ADDRESS______Zakariya from Union City; Jonathan from Walnut Creek. CITY______ZIP______Special recognition goes to Norma Yaglijian, age 89, and Joginder Singh, age 75, for their correct answers. Thank you all for your entries!

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 9 RESEARCH UPDATE

Children’s Opens Cardiovascular Disease Studies to the Public

espite recent advances in • Current diagnostic testing does not of CVD. New technology has led the way treatment, cardiovascular disease identify many who are at risk toward redefi ning and individualizing D(CVD) remains the leading cause • Dietary and lifestyle guidance has dietary approaches for reducing metabolic of death in the U.S. and will soon achieve failed to substantially impact risk risk of CVD. this status globally. From 1996 to 2006, factors, particularly those related to Bringing the benefi ts of this research to the number of inpatient cardiovascular obesity the local community, however, remains a procedures in the U.S. increased from • Obese youth are more likely than challenge. 5,400,000 to 7,235,000 annually. Costs children of normal weight to become Dr. Krauss’s Family Heart and Nutrition of CVD in the U.S.—both direct and overweight or obese adults. Center is a comprehensive, innovative, indirect—are estimated to be $503 billion Today, Ronald Krauss, MD, and his community-based clinical approach this year. research team are at the forefront of new that will combine multiple avenues of While improved CVD prevention has research and technology that will provide community outreach and individual health the potential for reducing the incidence us with an even deeper understanding of guidance. In order to be truly effective, we of CVD and its corresponding costs to CVD risk. Current research efforts focus on recognize the importance of a family-based society by as much as 80%, there are major identifying dietary and genetic factors that approach in order to understand and help barriers: may affect the prevention and treatment modify risk factors for all family members.

Studies have shown that a family history of early coronary heart disease can help identify children at risk for accelerated atherosclerosis and for an abnormal risk profi le. In conjunction with Children’s cardiologists and the Healthy Hearts Program, this study will position the FHNC to become a nationally and internationally recognized center of excellence in the acquisition, implementation, and dissemination of knowledge for reducing the burden of cardiovascular disease across all ages and among diverse populations.

The Family Heart and Nutrition Center A Krauss Laboratory & Clinical Research Program at Children’s Hospital Oakland Research Institute Ronald Krauss, MD, Director

Children’s Hospital Oakland Research Institute (CHORI) is the internationally renowned biomedical research institute of Children’s Hospital & Research Center Oakland.

A collaborative nexus for innovative research and learning that stretches beyond local boundaries, CHORI is at the forefront of basic and clinical research that strives to change the world—one patient at a time.

To learn more about CHORI, go to www.chori.org.

10 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org RESEARCH UPDATE

Do you have slightly high blood pressure? Join our dietary research study.

Dr. Krauss and associates at Children’s Hospital Oakland Research Institute (CHORI) are looking for men and women for a 14-week research study on 70% of obese youth have dietary patterns and risk factors for heart disease. at least one risk factor for CVD; To be eligible, participants must be: • Male or female, 22 years or older • Have a systolic blood pressure <160 and diastolic blood pressure between 80 and 95 • Not on certain medications, including lipid- or blood pressure-lowering medications, diabetes medication, or hormones 39% • Able to travel to our clinic in Berkeley. have at least two risk factors for CVD. If you participate and complete our study, you will receive: • Free meals for 10 weeks of the study (you eat your own food for 4 weeks) 68% • Lab work results of all adults are • A home blood pressure monitor overweight—half of whom • $1000 for completing the study, are considered obese. which includes reimbursement for study foods purchased and payment for time and eff ort. Excess body fat can increase the risk for heart disease, as well as diabetes, high blood pressure, and some cancers. To see if you are eligible, go to: www.moddash.studysites.net

Be a part of a diet study

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 11 FUNDRAISER SPOTLIGHT Swim Across America A Children’s staff member shares her experience swimming in the frigid San Francisco Bay to raise money for Children’s cancer research

e gathered in the dark at Crissy the cold caps being -35°C on my head I had one frightening moment at the WField at 6 a.m. blanketed in thick for 10 hours each infusion day, one of 3/4-mile mark, when I was overcome by fog and biting winds, fog horns blaring. the Olympians said, “Then this water a horrendous leg cramp, a side effect of After a bit of hot coffee, a trolley took is no problem for you, woman!” I said my anti-cancer medication. I held to a us wet-suited swimmers to Pier 1 to he was right. I wasn’t afraid of cold, kayak while I kicked it out. I was afraid board our boat, the “Spirit.” Porpoises I wasn’t afraid of the distance, and they’d make me leave the water, but I escorted the boat as we headed I’m not afraid of cancer. Still, there’s continued. towards the Golden Gate Bridge where nothing like an Olympic medal winner Soon I could see the buoy that we’d be dropped off; porpoises are telling you you’re inspiring. was my next landmark. A kayaker said, good luck and I knew I’d finish well. The I needed that boost moments later! “You’re almost there.” Then I could see boat ride was inspiring, with cancer As we lined up on the edge of the the balloon arch on the beach and hear survivors, families, caregivers, and eight boat, we took flowers from a bucket the cheering on shore. Then the water Olympians. We received instructions to honor those in whose memory we was warmer, and finally, I felt sand in and safety tips, then folks spoke about swam. I picked three flowers: one for my hands and stood up, victorious! why they were swimming. One mom my late best friend Paula, who died I completed the 1.5-mile swim began swimming four years ago when of cancer eight years ago; one for my in exactly one hour, better than I her son was diagnosed with leukemia; late stepfather, and one for my favorite expected. The greatest satisfaction the following year he swam also. This uncle, Stan, the most adventurous guy is that I raised thousands of dollars year, they had a team of 17 swimmers who ever explored the planet. I lost to support our kids and continued including several of his school friends. them both to lung cancer. research. I never thought of myself as Then my teammate Dr. Howard I stood on the ledge and looked at a fundraiser, but I exceeded my goal. Rosenfeld tapped me on the shoulder the churning water below. I thought If you’re thinking about fundraising and said, “Get up there and tell your of a video I’d just watched and the for Children’s and aren’t sure you can story, Sue!” So I was the last speaker. motivational words in it: do it—whether swimming, walking, I said I’d wanted to attempt this “It’s you versus them. running, or anything else—my advice is: swim last year, but I was going through It’s you versus No. Jump In! I’m glad I did. my own cancer treatment. As an avid It’s you versus Can’t. swimmer, I’d swum every day through You versus Next Year. treatment without missing a day. This Last Year. year, treatment completed, I signed up Statistics. for the swim, not afraid of the distance Excuses. or the cold but apprehensive about my It’s you versus History. ability to raise the $1000 required to You versus The Odds. enter. But, as I fundraised, I received It’s you versus Second Place. such powerful support, validation of The clock is ticking, my own experience as a cancer patient. Let’s see what you got.” It reminded me that I’d benefitted I threw my flowers and jumped into from new research at every step of my the sea of petals. journey—from the surgical techniques, As soon as I hit the water, this swim diagnostics, even the chemo cocktail was about survival! The water was cold and radiation method. And I’d helped and choppy, but unlike a marathon, you pioneer a new technique (Penguin can’t stop: I couldn’t sit on a bench, Susan Martinez is Children’s Director of Cold Caps) to prevent hair loss during tie my shoes, and try again next year. Advocacy and Volunteers. She raised more than $6500 for Swim Across chemo, and kept a full head of hair When you jump in the water, you HAVE America 2011. throughout chemo. When I described to swim, to live!

12 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org FUNDRAISER Swim Across America is the inspired sequel to a SPOTLIGHT triumphant Run Across America completed by the two founders of SAA in 1985. This eight-month journey, which spanned the country from Boston to Los Angeles, raised over $1 million for cancer research. What makes this trek all the more remarkable is that one of the determined runners, a 22-year-old from Fairfield, Conn., had lost his right leg to cancer a decade before. Following college graduation, these two childhood buddies embarked on their mission, making history in the process. Together, they instilled hope in all who fight this disease and heightened consciousness about overcoming this frightening diagnosis.

It was in 1987 that Jeff Keith and Matt Vossler decided to bring their cause back home and transitioned from running to swimming for a cure. With a focus on raising money and awareness for cancer research, prevention and treatment, Swim Across America was chartered as a 501(c)(3) nonprofit organization.

Swim Across America, Inc., is dedicated to raising money and awareness for cancer research, prevention and treatment through swimming- related events. With the help of hundreds of volunteers nationwide and past and current Olympians, SAA is helping to find a cure for cancer through athleticism, community outreach and direct service. www.swimacrossamerica.org

SWIM ACROSS AMERICA 2011 OLYMPIANS VISIT CHILDREN’S (t-b, l-r) Prior to the San Francisco Bay Swim event, SAA Olympians, volunteers, and staff visited hospitalized patients and family members at Children’s. Olympians brought their medals and posed for pictures, signing t-shirts and swim caps for souvenirs. “I never thought I would ever hold an Olympic medal,” said patient CT Neely, “This is awesome. They are amazing for taking the time to be here and do this. Thank you.” Baby Christian with his mother and Daniel Watters. Teen Christian gets to wear a gold medal with Olympians Daniel Watters, Kirk Stackle, and Mark Henderson, and Janel Jorgensen McArdle. Patient Emily high fives Janel Jorgensen McArdle. Kay Foley, Swim Across America Program Director; Daniel Watters, Olympian; Dan Truesdale, longtime SAA volunteer & swimmer; Craig Beardsley, Olympian & Director of SAA’s National Pool Swim; Katherine Starr, Olympian; Mark Henderson, Olympian; Kirk Stackle, Olympian; Susan Helmrich, SAA SF Bay Area Co-Event Director; Janel Jorgensen McArdle, SAA President. All photos were taken by Alain McLaughlin.

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 13 100% KID FOCUSED Getting to Zero Children’s Hospital Oakland, 30 Years at Ground Zero of the HIV/AIDS/ Pandemic

ecember 1, 2011, marked World trials. Petru encouraged her HIV-infected DAIDS Day. The United Nations patients to enter studies—including ones chose “Getting to Zero” as its theme. Zero looking at new drugs for HIV and at infection, zero discrimination. Here at childhood vaccine—with more than half of Children’s Hospital & Research Center her patients eventually participating. Oakland, getting to zero is more than a As a result of major groundbreaking theme. It’s a mission, and has been for three studies, Children’s patients received drugs decades. like AZT and protease inhibitors, which “We were pioneers,” Program Director drastically changed AIDS and its course in of the Pediatric HIV/AIDS Program Ann the population, including children infected Petru, MD, frankly admits when asked with HIV/AIDS. about the early years of AIDS treatment “In 1994, pregnant women who carried here. When AIDS fi rst appeared in full-term babies had a 1-in-4 chance of California three decades ago, Dr. Petru had passing the virus on to the child, while been at Children’s four years, working in premature infants had a 1-in-2 chance Ann PetruPetru, MD, MD in 1991, 1991 sharing a hug and a laugh with a young patient having a blood transfusion. pediatric infectious diseases for only a year. of getting HIV,” explains Dr. Petru. By the time she saw her fi rst case of AIDS “However, when women were given AZT at Children’s in 1983, an epidemic was fully in the last six weeks of pregnancy and underway. Back then, treatment amounted during labor, and their newborns given medicative adherence—is the name of the to little more than diagnosis and death. AZT for their fi rst six weeks of life, the rate game.” “There was no HIV test,” she recalls. of infection decreased from 25 percent to The work of Dr. Petru and her team “No way to get critical information about 8 percent in full-term infants.” has established a solid foundation for an individual’s T-cell numbers or viral “When protease inhibitors came along preventing new infections through birth. loads. We were still fi guring out that the in the mid ’90s, transmission fell and Today, their work continues to positively disease could be transmitted to children remains now as low as 1 to 2 percent,” says improve the lives of children living with and newborns.” In one early case, Arthur Dr. Petru. This means that, with a good the disease. Heading into its fourth Ammann, MD, traced pediatric infection drug regimen, up to 98 percent of children decade of the AIDS epidemic, Children’s to a local blood bank. His work helped delivered by mothers with HIV are born Hospital, through the Pediatric Hospital prevent future transmissions, but it couldn’t without HIV. “In our clinic alone, where Aids Program, continues to provide care help dozens of already affected babies and we meet with HIV-infected mothers to for about 60 HIV/AIDS-infected children children. help them give birth to healthy babies, 300 and teens, along with 20 to 30 pregnant, to 350 consecutive infected women annually, encouraging “Because of the work we’ve done at Children’s women have not them to care for themselves and their Hospital Oakland,” says Dr. Petru, “between passed the virus to unborn children. their babies,” states “HIV/AIDS awareness has helped limit 300 and 350 HIV-infected mothers have given Dr. Petru. “That’s a new infection rates,” explains Dr. Petru. birth to healthy, uninfected babies. That’s a real achievement.” “However, to date there is still no vaccine real achievement.” If Children’s and none on the horizon. We cannot fi rst decade of become complacent. Further research needs In 1986, Children’s established a HIV/AIDS was about facing disease and to be done to develop new drugs, study Pediatric HIV/AIDS Program with Dr. death, the second was about transmission new drug combinations, simplify the drug Petru as director. prevention, and the third was about regimes—and thereby improve the lives of Dr. Petru’s team also sought treatments maintenance. Children and youth with those living with disease.” for mothers. In 1989, Children’s Hospital HIV and AIDS learned to live with their We haven’t gotten to zero yet, but Dr. Oakland received federal funding as part condition, and Dr. Petru’s program has Petru and her team are working towards of the national Pediatric AIDS Clinical been at their side. “This is no longer a fatal that goal, one mother and one child at a Trials Group. Many parents allowed their disease in children,” she says. “But getting time. children to participate in these vital clinical kids to follow their treatment regimen—

14 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org CANCER CENTER

Awesome Dawson A baby born with cancer inspires and gives hope to other cancer patients

half hour after birth, Dawson Dawson began throwing up his breast immediately.’” couldn’t breathe. This is common milk. “They said he had a milk allergy. The Lobao family found themselves A among severely premature infants, That didn’t make sense to me.” in the back of an ambulance being rushed but Dawson was born barely a month Finally, barely 6 weeks old, Dawson to Children’s Hospital & Research Center early, and he was a healthy 6 pounds, 3 was screaming inconsolably, as if he was in Oakland. ounces. Why was such a well-developed pain. When they arrived, Dawson received infant having trouble expanding his lungs? “Something told me to take his his second spinal tap within a matter of The staff at that adult hospital could temperature. I called the advice nurse. hours. He underwent more IVs, sedation, not have known that rare leukemia cells She said, ‘Get to the emergency room were already accumulating in Dawson’s right now.’” liver and spleen, causing them to swell When the Lobaos arrived at their so much that they were pushing against local hospital, they stood by helplessly Dawson’s lungs, preventing him from as physicians ordered an immediate inhaling properly. Dawson had developed spinal tap, blood tests, and X-rays. cancer before he was born. A normal white blood cell count is Once Dawson was breathing normally, between 4000 and 15,000. Dawson’s Mandy and David Lobao brought their was 70,000. baby home, but unusual symptoms Baffled doctors knew something accumulated. highly unusual was happening to “He started getting this weird rash all Dawson, and they knew they needed over his body,” says his mother Mandy. “It the best specialists in the world. would last for 10 or 15 minutes; then it “The doctor told us, ‘We’re Dawson’s rash was one of the indicators for would be gone. We said, ‘What is this?’” sending you to Children’s Hospital Children’s medical staff that he had cancer.

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 15 CANCER CENTER

and even a bone marrow aspiration, which is collecting bone marrow fluid through a needle injected into bone. His shocked and confused parents were quarantined, scrubbed, and taken to 5 South Ward, an air-filtered unit for patients whose immune systems are compromised. Mandy and David Lobao were informed that Dawson had both acute lymphocytic leukemia (ALL) and acute myelogenous leukemia (AML), two different types of a very aggressive cancer. The infant would be undergoing chemotherapy immediately. Mandy collapsed on the floor crying. She wouldn’t leave the hospital again for seven months. Ricky, another 5 South patient, greets Dawson in the hallway. Dawson’s mother did what mothers do. She blamed herself: She worked as a dental hygienist for children. Was it the X-rays? Though it was incredibly unlucky that life with a tough road ahead. Infants born She used cleaning products in her kitchen. Dawson inherited such a rare biphenotypic with biphenotypic cancer (two types of Maybe they were they toxic? cancer, it was incredibly lucky that he was cancer) begin their lives with a 30- to Jennifer Michlitsch, MD, Associate born within driving distance of one of the 50-percent chance of survival, and only Hematologist/Oncologist at Children’s, children’s hospitals in the world equipped if they undergo a difficult regimen of told them to banish such thoughts. with the personnel and technology to chemotherapy. Mandy and David estimate Dawson’s diagnosis is very rare. Acute rapidly diagnose and treat the rarest that their infant underwent general leukemias in infants occur in one per 5 cancers in children. anesthesia 25 times, and chemotherapy million births. Even so, Dawson was beginning his seven times. “They knocked him out six or seven times in the first month,” says David. BEADS OF COURAGE Dawson was David and Mandy’s first Kids with cancer endure countless child. This was not what they had planned probes, injections and tests. It for their lives. How could they find takes courage and resilience to get meaning in this? through the treatment. They should The answer came as all such answers get medals. At Children’s Hospital do: through a community. Oakland, they do get medals—in the Dawson was the only baby in the form of Beads of Courage. Patients chemotherapy ward. Older kids began to are awarded a bead for each procedure or treatment milestone comment on Dawson’s uncanny ability they endure. By the end of their to emerge from his harrowing treatments treatments, kids have a strand with a smile. of colorful beads, a map of their “Kids with cancer would come by journey to good health. Children’s our room in the early morning before was one of the first hospitals in the their treatments and say, ‘Can we see country to adopt the supportive care Dawson?’” Mandy remembers. “The program. teenagers especially would say, ‘Wow, your baby has cancer? I was ready to give up, By the time Dawson left Children’s, because treatment is painful, but if he can he had 397 beads—all before his first go through his treatment, so can I.’ My birthday. husband and I started thinking, Dawson

16 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org CANCER CENTER

Dawson’s diagnosis is very rare: Acute leukemias in infants occur in one per 5 million births. Luckily, he was born close to Children’s Hospital Oakland, one of the leading hospitals in the world equipped with the personnel and technology to rapidly diagnose and treat all forms of cancer in children.

might be going through this, but he is helping other kids to go through this, too.” With his “showstopper” smile, Dawson became a mini-celebrity MANDY’S TIPS FOR PARENTS OF among the kids battling cancer—who named him Awesome CHILDREN WITH CANCER Dawson. Soon “the beacon of light and positivity” was in demand for photo shoots with celebrities volunteering to draw attention to 1. Stay off Internet cancer sites: “It will drive you childhood cancers. crazy. Anybody can post anything.” All cancers are unique. This is about managing your anxiety, not Dawson’s cancer is in remission, and he’s kept pace with all provoking it. his developmental milestones, in fact, he may be a step ahead. He 2. Learn to surrender: imitates facial expressions and is motivated to learn to walk. You “Little is in your control. Allow yourself to trust the doctors and nurses. They are would never know he’s spent more than half his life undergoing an the best of the best, and they are there for love of ordeal even adults find difficult to bear. the children.” “Having a kid with cancer opened our eyes up to a whole new 3. Take breaks: “Parents should take one hour for world we never knew,” says Mandy. “Now that we know, we can’t themselves every single day. Children’s Hospital has ever turn our back on it. I’m going to do some volunteer work to a beautiful courtyard. Even if you’re not religious, give back. We still bring Dawson back to the kids on the cancer quiet time in the chapel is restoring. The chaplain is ward. We tell them, ‘Dawson hasn’t forgotten you.’” extremely helpful. Marriages need time, too.” 4. Get out of your head: Dave says, “Get to know the other families going through the same thing you are.” Mandy agrees. “If I had stayed in our room, I would have been lost in my negative thoughts.” 5. Laugh: Kids are funny. Mishaps will occur. You will make many mistakes. Learn to laugh even amid tears and rage. Life isn’t fair, but it sure is funny. 6. Participate in the “Beads of Courage” Program: Children receive a bead for each procedure they endure, over time earning a necklace of colorful beads. Mandy says, “It’s important to mark every milestone. Every round of chemo is scary. Every procedure is scary. Your beads show that you are making progress. I’ve seen kids wear their necklaces proudly. They know each bead represents an act of bravery.” 7. Be the match: Each year, 10,000 patients require a marrow transplant from an unrelated donor, but only half receive one. They depend on people like Dawson’s physician and pediatric cancer specialist, Jennifer Michlitsch, MD, you. Mandy recommends registering at marrow.org. says goodbye to Dawson on his last day at Children’s.

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 17 TEACHING HOSPITAL

Training Tomorrow’s Pediatricians with Values that Endure Children’s Pediatric Residency Program has trained dedicated physicians for 85 years

he world of medicine has changed California and nearby states, remains The number of fi rst-year residents a lot since the Pediatric Residency steadfast. (interns) admitted to the three-year TProgram at Children’s Hospital & “Historically, Children’s has been one program did increase this year, from 26 Research Center Oakland opened in 1926: of the largest trainers of pediatricians in to 30, thanks to a $3.84 million Primary the creation of vaccines to prevent deadly the country, and our efforts have become Care Residency Expansion Grant awarded viral illnesses; the discovery of antibiotics increasingly important as the nation faces a in 2010 by the Health Resources Service to treat bacterial infections; the invention serious shortage of primary care physicians, Administration (part of the Department of new medical devices, medications and including pediatricians,” says Vice of Health and Human Services). For the surgical techniques to treat heart disease, President of Medical Affairs James Hanson, next four years, the grant will fund the cancer, bone marrow transplants, surgery, MD. “With the passage of healthcare education of four new residents each year. and other conditions. reform, people are being encouraged to “We were one of only fi ve children’s Throughout the decades, the Pediatric seek more preventive care, which means hospitals in the country to receive Residency Program has led the way in the we need to train more residents to meet this grant,” says Director of Graduate education of pediatricians—becoming one the demand. Also, the Accreditation Medical Education and the Pediatric of the leading pediatric training programs Council for Graduate Medical Education Residency Program James Wright, MD. in the United States. Today, the program’s has decreased the number of hours that “The increased number of residents is dual commitment, to providing top-notch residents can work, so we need more tremendously important for providing training for residents and to caring for residents to keep up with our patient quality healthcare to children in our culturally diverse children from all over caseload.” community. But we are concerned about

18 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org TEACHING HOSPITAL

“One of the core principles of our program leadership is striving to recruit the most diverse group of pediatric residents to Children’s Hospital every year, ” says Director of Graduate Medical Education and the Pediatric Residency Program James Wright, MD. “This has a long lasting benefi t, leading to diversity on our medical staff and in the pediatricians who practice in the Bay Area.”

our overall funding, which is largely we are a hospital on the front lines where myocardial infarction (heart attack). We federal, for residency education and kids come for specialized care when they’re also deal with issues such as growth and pediatric care. With the budget impasse in really sick.” development and immunizations—which Washington, we are very concerned about Dr. Simms-Mackey adds, “Everything also differs from adult medicine.” how potential budget cuts could affect our we do, from diagnostic X-rays to advanced A 1997 Children’s residency graduate, hospital.” surgery, is modulated specifi cally for Dr. Simms-Mackey notes that today’s children. Pediatricians sometimes treat a residents share many attributes with A Competitive Edge very different set of diseases than adult former residents, including intellectual The Pediatric Residency Program physicians do. For example, a pediatric curiosity, a collaborative esprit de corps, competes with programs throughout the cardiologist would likely see more patients and a dedication to providing culturally U.S., successfully attracting top-ranked with congenital heart disease versus a sensitive care to Children’s diverse patient students from prestigious medical schools across the country and around the globe. The current 30-member class of interns was selected from 637 applicants. They Residents Speak came from 24 different medical schools Current residents and alumni share their experiences and their representing every region in the U.S., views of the Pediatric Residency Program at Children’s and they joined residents from 49 U.S. medical schools as well as one each from Kit Meddles, MD, Third-Year Resident France, New Zealand and Ireland. Part of my inspiration for becoming a doctor came from my experience “Our program is attracting more as a Spanish language medical interpreter at a free clinic in Arlington, and better applicants every year,” says Virginia. I admired the doctors who donated their time out of their busy Associate Director of Graduate Medical work schedules to care for low-income patients. I wanted to emulate that Education and the Pediatric Residency dedication. I like the people at Children’s—they are all down-to-earth Program Pamela Simms-Mackey, MD. and committed to the patient population. I have excellent teachers who “We are training the pediatricians of support me in providing the best possible care for patients and their tomorrow as doctors who can treat families. I learn something from every single one of them, and I like to think patients from all walks of life. Our that there is a little piece of each of them in the doctor I am becoming. program prepares residents for whatever pediatric career path they want to follow. They are well-equipped to pursue options from primary care in a rural area to pediatric subspecialties in an academic setting and anything in between.” A major advantage of the Children’s program is that the hospital is focused exclusively on pediatrics. “Pediatrics represents only 11 percent of the healthcare dollars in this country, so the care of children can become less of a priority in a large university teaching hospital where they treat many more adults than children,” says Dr. Wright. “Children can get lost in that environment. Our residents learn to diagnose and treat a wider variety of children’s diseases and conditions because

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 19 TEACHING HOSPITAL

population. But there are differences, to serve as instructors—including Dr. the health of children in this community too. “One big difference is that today’s Hanson, who teaches in the Pediatric and wherever our graduates go,” adds Dr. students have technology readily available Intensive Care Unit. “I enjoy teaching Wright. “There are so many graduates such as cell phones, laptop computers, our residents,” he says. “All of them are who make all of us who work in medical iPads and the like,” she explains. “Today’s advocates for children. They are hard- education at Children’s so very proud.”

students are very tech-savvy, and they make working and altruistic. Many have done Photo on page 18: Children’s pediatrician and the most of Internet access to medical medical mission work. There may be some mentor, Kelley Meade, MD, observes third-year information.” generational differences between residents resident, Jolene Collins, MD, during a patient visit at Children’s Primary Care Center. The Dr. Wright concurs: “Technology and instructors, but overall, physicians who “ABCD” bag represents Assuring Better Child should help residents spend more time become pediatricians do so because they Health and Development, a program sponsored with their patients. Once we have access want to help.” by First 5 Alameda County that aids in implementing universal developmental screening to a fully electronic medical record system, “The more diverse and talented a as recommended by the American Academy that will improve things even more.” group of residents we can recruit to of Pediatrics. Children’s performs universal Many program graduates go on Children’s, the more we contribute to developmental screening at 18 months.

Meg Renik, MD, Intern, First-Year Resident Carson Welty, MD, Second-Year Resident I worked as a criminal defense investigator in murder cases, traveling all over I wanted to be a pediatrician since high the country to interview clients and their family members. Many of my clients school. Now at Children’s, I’m getting very were former gang members, and I saw fi rsthand the eff ects of childhood good training with great support from the violence carrying over into adulthood. I also saw how inadequate the criminal attending physicians. We also get great justice system was in its capacity to address these eff ects. I decided that, as a training in specialty services. The second year primary care physician, I might be able to make a diff erence in people’s lives of residency defi nitely carries a higher level before the criminal justice system took hold. Children’s was my fi rst choice of responsibility, and you have to take more for residency. The practice of medicine here is idealistic: People actually care ownership of your patients and their outcomes. about their patients—not just as individuals, but also in the context of their communities. Also, Children’s focuses exclusively on pediatrics. The issues in Sarah Postma, MD, Residency Class of 2011, primary care are the nuts and bolts of what life is about. Current Chief Resident It defi nitely was an honor to be chosen as one of four chief residents this year at Children’s. I decided to go into medicine after an experience I had while volunteering in Botswana during college. I was assigned to assist a doctor who came to our small village once a month. It impressed on me what a diff erence a doctor could make in children’s lives. I still have the desire to work in international medicine, but the Oakland area has such a diverse international population that I feel as if I am doing international medicine here at home. I’m very grateful for the education Children’s has provided me and feel very well prepared for a career in pediatrics.

Jorge Ganem, MD, Residency Class of 2010, Chief Resident 2010-2011 I grew up in Juarez, Mexico, and attended high school and college in Texas. I chose Children’s for my residency because I wanted to be at a stand-alone children’s hospital where everything is pediatrics and where there is a mission to care for all children, regardless of

20 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org TEACHING HOSPITAL

KLAN L OA D R TA ES PI EA S R O C H 2011 H S COMMEMORATION ’ IN N S E T R I T D U L

I T

H E C \HDUV

S

H T C U R D Children’s Summer Research Program A E 6XPPHU5HVHDUFK N E S T 3URJUDP E S R D I F SC (VW O O ER VE W Has Trained Future Scientists Since 1981 RING THE PO ased on a structured curriculum, The CHORI Summer Research are underrepresented in biomedical and Bincluding participation in weekly Program is one of the largest in the behavioral research (e.g., work with seminars, research discussions, and a one- state. Now in its 30th year, the program individuals with disabilities). By partnering day Research Symposium, the CHORI pairs students with one or two CHORI with the NIH program, CHORI aims Summer Research Program is designed to principal investigators who serve as to signifi cantly help in contributing provide an unsurpassed opportunity for mentors, guiding the students through the to increased diversity in the research students to immerse themselves fully in the design and testing of their own hypotheses workforce of tomorrow. world of basic and/or clinical research for and methodology development. At the This past summer, program three months during the summer. end of nine weeks, students present participants hailed from various high their research to their peers just as any schools, colleges, and universities, professional researcher would. including University of California, A proud recipient of the National Berkeley, Columbia University, Brown background. Children’s also has a busy Institutes of Health (NIH) funding to University, Albany High School, and San clinical center, which gave me a broad increase diversity, CHORI is also pleased Francisco’s Jewish Community training across a wide array of cases. As to be able to help reach out to individuals High School. a resident, I learned a lot from attending from disadvantaged backgrounds—racial For more information, go to physicians and senior residents who and ethnic minorities and others who www.chori.org. shared their knowledge. Now I plan to continue the tradition of teaching and sharing my own knowledge. It’s our job and our duty to continue to train future physicians.

Bill Rhea, MD, Residency Class of 1964, Chief Resident The residency program was much smaller in those days. We had only 12 members in our fi rst-year class. I’ve witnessed many improvements in medicine and in the residency program over the years, including the development of various pediatric specialties. For example, Children’s sponsored me to attend a program at Cornell University for training in high- risk nursery care. When I returned, I brought back the enthusiasm and In 2011, Lauren Meiss, a senior Biomedical Engineering student at Arizona State University, spent knowledge I needed to help start our her second summer at CHORI in the lab with Beate Illek, PhD, and Horst Fischer, PhD. Lauren, who Neonatal Intensive Care Unit. was diagnosed with cystic fi brosis at 3 months old, was awarded a grant from the Elizabeth Nash Foundation to participate in CHORI’s Summer Research Program. Lauren says she now understands Through the years, I’ve maintained my her medical issues on a cellular level and plans to spend a year studying cystic fi brosis patients in relationship with Children’s, making Sweden before earning an MD/PhD dual degree. rounds with residents. I can honestly say that today’s residents have the same Earlier this year, Children’s Hospital was one of nine organizations nationwide to receive a three- year grant from the New York-based Doris Duke Charitable Foundation as part of its new Clinical enthusiasm, work ethic, and sense of Research Experiences for High School Students initiative. The grant funds of $194,400 will enable altruism that we did. I have nothing but CHORI to offer six internships each year to under-represented Bay Area high school students as high praise for them. part of the Summer Research Program. The Doris Duke Charitable Foundation hopes that these grants will enable hospitals, universities, and research institutions to play a leadership role in increasing the diversity of the biomedical workforce by providing training and mentorship for young people who might not otherwise have opportunities to explore careers in clinical research or related fields.

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 21 ADVOCACY children’s healthcare law watch PRESERVE HEALTHCARE FUNDING Contact your Congressperson to support funding for discretionary funding programs like the National Institutes of Health, Centers for Disease Control, and the Health Care Services Administration. This funding provides organizations like Children’s Hospital Oakland the opportunity to ensure that all our children, regardless of income or insurance status, have access to the highest possible level of healthcare.

he federal budget process Net Interest 1.5% of GDP Tbegins in February of each $227 billion year with the submission of the President’s budget for the next fi scal year to Congress. This chart shows Social Security 4.8% of GDP how funding for federal programs $725 billion is broken down among broad Defense categories of spending. This graphic 4.7% of GDP $700 billion is useful to understand how some of the programs at Children’s Hospital Mandatory Medicaid 1.8% of GDP SPENDING & Research Center Oakland are Spending Discretionary 13.5% of GDP $275 billion In 2011, the U.S. government Spending funded. For example, our research $2.0 trillion spent $3.6 trillion on a range of 9.0% of GDP $1.3 trillion institute, CHORI, is funded activities and programs primarily through grants from Medicare Non-defense the National Institutes of Health; 3.2% of GDP 4.3% of GDP $480 billion funding for our Graduate Medical $646 billion Education Program that trains the Other next generation of physicians is 3.6% of GDP $545 billion through the Health Care Services SPENDING: Programs related Administration (see story on page to health, income security, 18); and funding for our primary education, veterans’ benefi ts, SPENDING: Unemployment transportation, other activities care services and other community compensation, federal civilian benefi t services fl ow from other and military retirement, veterans’ benefi ts, food stamps, other discretionary funding programs. programs Throughout the upcoming year you will likely hear a considerable Chart adapted from www.cbo.gov/ftpdocs/125xx/doc12577/budgetinfographic.htm amount of discussion about appropriate levels of “government Please contact your legislator primarily during February and March of 2012. The budget spending.” This chart is a relatively and appropriations process is most active during these months. Below is a suggestion simple way to envision the scope for what you could say. You can fi nd your House of Representative member’s contact of services and programs that fall information by entering your zip code here: http://house.gov/ under that umbrella term. Although automatic cuts in discretionary My name is ______and I am calling as a supporter of Children’s Hospital defense and non-defense spending & Research Center Oakland. Oakland Children’s Hospital provides a wide range of in 2013 may take place, it is important services to the children in Northern California and serves a disproportionately important to urge legislators to do government-insured patient population. In addition, they train the next generation of what they can to protect important “ pediatricians and conduct world-class research. healthcare and social programs for In order to help them continue in their mission to serve all children regardless of children from further reductions. insurance status or income, I urge you to protect funding for the Health Resources & For more information about Services Administration, Children’s Graduate Medical Education program, the National the federal budget, go to Institutes of Health, and the Administration for Children and Families. www.cbo.gov. I recognize that some cuts may be automatically implemented per the provisions of the Defi cit Reduction Act, and I urge you to fi ght those cuts in order to prevent deeper reductions in critically needed services. Thank you.

22 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org ” children’s ADVOCACY healthcare law watch

AB25 Establishes California as a Leading State for Protecting the Safety of Student Athletes On Thursday, October 6, 2011, California’s or she is suspected of sustaining a concussion school players return to play too early after Governor Jerry Brown signed Bill AB25, or head injury. experiencing a head injury. In addition, 16 which establishes critically needed return-to- The bill would prohibit the return of percent of high school football players who play rules in school-sponsored sports. The the student until he or she is evaluated lost consciousness returned to play the very bill places California among the states with by, and receives written clearance from, a same day. The Centers for Disease Control the strongest laws to protect the health and licensed healthcare provider. In addition, the and Prevention state that high school athletes safety of student athletes. bill requires a concussion and head injury who sustain a concussion are three times Co-sponsored by Assemblymember Mary information sheet to be signed and returned more likely to sustain a second concussion. Hayashi (D-Hayward) and the National by the athlete and his or her parent/guardian Such cumulative head trauma can be Football League, AB 25 requires a school before the fi rst practice or competition. devastating, resulting in a number of health district to immediately remove an athlete The Center for Injury Research and problems, including sleep disorders, memory from a school-sponsored athletic activity if he Policy reports that over 40 percent of high loss, and depression.

CONCUSSION GUIDE Provided by Children’s Sports Medicine Center for Young Athletes

The brain accelerates and strikes the skull wall. WHAT TO DO Go to the Emergency Room for further evaluation if you are concerned The nerve endings and blood vessels are stretched and/or if the child is exhibiting worsening symptoms, including lethargy, and torn as the brain rotates “worst headache of his/her life,” excessive vomiting, decreased and rebounds. sensation—or if you think the child’s neck was injured. Full recovery from a concussion is different for each child; it may take 1 to 2 weeks, or several weeks or months. WHATATAT IISS A CONCUSSION?USSSISIO Sometimes kids may not experience symptoms until hours or days A concussion is a brbrain injury causedd after the injury. Keep the child from participating in activities (e.g., when the force from a blow to the attending public events/the movies), athletics and excessive cognitive head or other impact to the body activity until he/she has recovered. travels to the head. When the force of Recovery from concussion requires mental and physical rest to give the impact causes the brain to move the brain time to heal. This means no text messaging, no video games around inside the skull, a concussion and no homework, and possibly limiting school attendance and activities. may occur. Do not use ibuprofen for the first 48 hours if the child has a concussion headache. Ibuprofen can act as a blood thinner, so if the SIGNS AND SYMPTOMS: child has a head bleed from the concussion, this could make things UÊi>`>V iʜÀʺ«ÀiÃÃÕÀi»Êˆ˜ÊÌ iÊ i>`Ê worse. You may use acetaminophen to help decrease head pain. After the UÊ >>˜ViÊ«ÀœLi“ÃʜÀÊ`ˆâ∘iÃà first 48 hours, ibuprofen or acetaminophen may be used to help with UÊ-ˆ}˜ÃʜvÊVœ˜vÕȜ˜Ê concussion headaches. UÊ/ÀœÕLiÊVœ˜Vi˜ÌÀ>̈˜} The child may be tired and need more sleep. Allow him/her to take UÊ-ˆ}˜Ãʜvʓi“œÀÞʏœÃÃÊ­ˆŽiÊvœÀ}iÌ̈˜}ÊëœÀÌÃÊ«>ÞÃ®Ê naps. UÊiiˆ˜}Ê>˜ÝˆœÕÃ]ʈÀÀˆÌ>Li]ʜÀÊÃ>` vœÀʘœÊ>««>Ài˜ÌÊÀi>Ü˜Ê Make sure the child stays hydrated and eats a snack (combining UÊ >ÕÃi>ʜÀÊۜ“ˆÌˆ˜} carbohydrates and protein) every 3 to 4 hours while recovering from a UÊ6ˆÃˆœ˜ÊV >˜}ià concussion. Dehydration and low blood sugar may worsen concussion UÊ-i˜ÃˆÌˆÛˆÌÞÊ̜ʏˆ} ÌʜÀÊÜ՘` headaches. UÊ>̈}ÕiÉÏii«Ê«ÀœLi“à UÊ>ˆ˜Ìˆ˜}ʜÀʏœÃÃʜvÊVœ˜ÃVˆœÕØiÃà The child should not return to sports or play until given permission by a healthcare professional with experience evaluating concussions.

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 23 GOOD NEWS

How to Find Trustworthy Health Information on the Internet

When you need health information, websites can be a wonderful resource. But not all the information you fi nd is reliable or accurate. Below are a few guides to fi nding trustworthy health information. GOOD PLACES TO START

Talk with your doctor about health information you www.medlineplus.gov fi nd on your own. Consider bringing the information Run by the National Library of Medicine with you to a medical visit. You may want to ask • Medical encyclopedia with detailed information on medical questions about it, especially if it disagrees with conditions, prescription drugs, herbal remedies and other supplements. something you’ve been told. • Access to Medline, which has publications and summaries of articles in medical journals. Look for these features: • The website tells who is responsible for the site and how you www.cdc.gov can contact those in charge of the site. Run by the Centers for Disease Control and Prevention • The website’s only purpose is to give you information (it’s • Information on hundreds of health conditions. not selling anything). • Health-related information and advice for those traveling to other countries. • If the website collects personal information from you, it tells • Information about public health issues and concerns, such as you what it will (and will not) do with your information. outbreaks of disease. • The health information on the website is based on results from medical research and backed up with references to the www.healthfi nder.gov research. Run by the Department of Health & Human Services • Tips for staying healthy. • The website gives the source of the health information. • Details on hundreds of diseases and health conditions. • The information has been approved by medical experts. • Links to help you fi nd a doctor and other health providers. • The health information seems unbiased, objective, and balanced. The information seems reasonable and believable www.ahrq.gov (no promises of “miracle cures”). Run by the Agency for Healthcare Research and Quality • Information is reviewed regularly, and the date of the last • Consumer guides and other information to help you understand and choose “quality” healthcare. update is given. • Tips for getting the most from your visits for medical care. • Visit more than one website, and compare what you fi nd. In • Information on patient safety. general, information is more trustworthy when you fi nd the same type of information on more than one website.

24 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org GIVING BACKBACK Radiotón Para Nuestros Niños Prospers Again Children’s third annual Latin Ratiothon with Spanish-language station KRZZ 93.3 La Raza was another success, bringing in $533,000 during the three-day event that took place Oct. 21 though 23. La Raza DJs began broadcasting live from Children’s Outpatient Center at 5 a.m. on Oct. 21. Community members came by Clockwise: Children’s the Outpatient Center to make in- patient, Felix, 21, with person donations. friends and volunteers; Several Children’s patients and family members attended a visitor help KRZZ DJ Ernesto de Santiago “El the Radiothon to pledge their support—including Rocio Barzón” broadcast live Rodriguez and Ana Barajas, parents of oncology patients. from the Outpatient “In oncology, a large percentage of our population is Center; $533,000 check Latino and monolingual Spanish-speaking,” said Pamela from Radiothon Orren, PhD, Psychology Oncology Program (POP) clinical psychologist. Dr. Orren expressed gratitude at Children’s for La Raza and their continued support.

Former Patient Viviana Espinoza Gives Back by Volunteering at Children’s Viviana Espinoza works behind the counter at the Children’s children and their families. “I like to talk and play with the Hospital gift shop. With a warm and welcoming smile, this kids whenever I visit. It makes me feel like a kid, too.” From 21-year-old greets patient family members, employees and her own experience, she says, “a smile is the best medicine, and visitors. When she’s not in the gift shop, Viviana is delivering when a child smiles, it makes their parents smile, too.” presents and balloons to patient rooms, carrying the well Becoming an in-hospital volunteer at Children’s requires wishes of loved ones. “There could not a commitment. All hospital volunteers be a better person delivering gifts from go through extensive background checks, our shop,” says Gail Rubin, Children’s training and health screening. To become Gift Shop Manager. “She’s such a lovely an in-hospital volunteer, participants are person and has a good understanding of asked for a minimum of one shift a week, what our patients and their families are which equals about 100 hours per year. going through.” That’s because, at the Many of Children’s Hospital volunteers age of 10, Viviana was diagnosed with easily exceed their required hours, and most hydrocephalus caused by a tumor. have over 200 hours of service. After multiple surgeries over the “We try to leverage the talents of course of a few years, Viviana says, our volunteers in an appropriate and “Children’s Hospital is my home away meaningful way,” says Susan Martinez, from home.” While Viviana will always be Children’s Director of Advocacy and a beloved patient, she’s also a valued part Volunteers. “We want our volunteers to of the Children’s Hospital team. feel fulfi lled in the services they provide. Viviana is a hospital volunteer. She is Volunteers play a vital role in delivering one of as many as 1,045 people annually amazing care.” who give the gift of their time and To learn more about how to become a passion to Children’s Hospital. Through Children’s in-hospital volunteer, go to her volunteer work, Viviana has shared Volunteer Viviana Espinoza delivers well www.childrenshospitaloakland.org/join/ her own story of hope with hospitalized wishes to hospitalized patients. join_volunteer.asp.

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 25 GIVING BACK For the different ways you can give to Children’s, go to www.chofoundation.org and click on the “Giving to Children’s” tab at the top of the page.

BLACKROCK Connectivity and Giving Program Raises Funds for Children’s Over 600 participants from BlackRock, a multinational investment management corporation, and partner fi rms raised $830,000 for what marked the largest fundraising program to date for BlackRock’s San Francisco offi ce. The amount was split between Children’s Hospital Oakland and College Summit. “We’re proud to support the life-saving mission of Children’s Hospital & Research Center Oakland. We believe that gathering BlackRock’s employees together with our partner fi rms is more meaningful and impactful than doing it alone, and also creates a stronger, more unifi ed community,” said Michael Latham, co-head of BlackRock’s San Francisco BlackRockBl kR k and d ththe 49ers 49 Foundation F d ti present t a check h k for f offi ce. $830,000 to Children’s Hospital Oakland Foundation and College “The community spirit BlackRock employees and their Summit. (l-r): David Pope, BlackRock; Geoffrey Flynn, BlackRock; Kara Helander, BlackRock; John York, San Francisco 49ers; Dr. partners exemplify is inspiring, and the money raised will help Keith Frome, co-founder of College Summit; Bertram Lubin, MD, Children’s continue to offer Bay Area kids the most innovative, Children’s president and CEO; Jed York, San Francisco 49ers; up-to-date healthcare available,” says Bertram Lubin, MD, Robert Fischbach, BlackRock; Mike Latham, BlackRock. Children’s President & CEO.

MARK YOUR CALENDAR SCORE FORE KIDS MARCH 17, 2012 Golf Classic has raised over $1.4 million since 2000 for Children’s Hospital ST. BALDRICK’S For more than 11 years, volunteers and corporate sponsors HEAD-SHAVING have raised money to support vital services at Children’s Hospital. Each year Score Fore Kids holds what has become CELEBRATION the East Bay’s fi nest golf tournament at the Claremont Make a statement and Country Club in Oakland. We’re so thankful to all that go bald in support sponsor, donate, and participate. Look for details about the event at www.chofoundation.org. of pediatric cancer research

Join us in honoring brave children battling cancer while raising funds to advance research and treatment. Make a profound fashion statement with a bald head— alongside local celebrities, community members and the Oakland Fire Department. If you are not ready to join the ranks of baldies for pediatric cancer research, then lend your financial support to a Children’s Hospital Oakland team and learn more about the event by going to www.stbaldricks.org/events, or call Ana Morales at 510-428-3885, ext. 5227.

26 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org GIVING BACK

COSTCO WHOLESALE WAREHOUSE A longstanding partner in serving families in our communities During the month of May 2011, 26 Bay Area Costco locations enthusiastically participated in the 18th year of Children’s Miracle Network Hospitals’ iconic balloon sales for Children’s Hospital Oakland, raising $781,957 from member donations. Over the 18 years of this partnership, Costco has raised over $9.7 million to support Children’s Hospital. The Santa Rosa Costco warehouse raised the most money and visited the hospital for a tour and check presentation ceremony in October. “It was such an honor to give them a tour of the hospital so they could see for themselves the impact their work has on the children and families we serve,” said Bertram MembersMembersoftheCostcoSanRafael of the Costco San Rafael warehouse arehosetakeaphoto take a photo with ithBertramL Bertram Lubin, binMD MD, Lubin, MD, Children’s President and CEO. Children’s President and CEO, (center), after getting a tour of Children’s Hospital “We’re so grateful to Costco and to all the Oakland. team members who participated.”

SPIRIT HALLOWEEN Delivering a spooktakular celebration at Children’s Most children are thrilled by the excitement of Halloween. Spirit Halloween wanted to be sure that hospitalized kids got the chance to create, share and celebrate Halloween as well. Volunteers from local Spirit Halloween stores decorated, led arts and crafts projects in playrooms throughout the hospital, and passed out costumes to children at their bedsides. As part of Spirit Halloween’s support of hospitalized children, local stores took a portion of proceeds from sales to benefi t the Children’s Hospital’s Child Life Program, raising $57,835. Children’s Child Life Program provides highly trained specialists that bridge the gaps between home, hospital and school. The program delivers age-appropriate activities designed to help young patients understand and adapt to the hospital by providing pre- operative preparation, therapeutic play and Gabriel in his Halloween duds with Theresa Root, RN. education.

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 27 MENTAL HEALTH ADHD: A common struggle for children

by PETRA STEINBUCHEL, MD

Although both children and adults suffer oes your daughter quietly sit in the classroom and from the disorder, ADHD at age 5 can look D“space out”? Or, is your boisterous son throwing pencils, blurting very different from ADHD at age 15 or 45. out answers, and running around like the Energizer Bunny? Although the behaviors of these two children sound different, both combined type of ADHD includes both Like many other psychiatric disorders, exhibit symptoms of Attention Defi cit inattentive and hyperactive symptoms. having a diagnosis of ADHD does not Hyperactivity Disorder, or ADHD. There is no specifi c blood test or brain mean that the child is crazy; but it does ADHD is a common childhood scan that is used to diagnose ADHD. require adequate treatment, much like disorder that affects 5 to 10 percent of all Rather, it is a clinical diagnosis based on asthma, diabetes or other medical illnesses. children. Boys are three times more likely careful evaluation by a primary care or It often runs in families. than girls to suffer from the disorder, which mental health provider. Symptoms must Many disorders can look a lot like is characterized by inattentive, hyperactive be present in more than one setting—e.g., ADHD—including depression, anxiety, and impulsive behavior. There are actually both at home and at school—so it is visual or hearing diffi culties, learning three main types of ADHD. important that the evaluation involve disorders and even sleep apnea (a condition The inattentive type of ADHD was gathering information from parents or that involves disordered breathing). These formerly known as Attention Defi cit guardians and from other adults involved other disorders sometimes exist along with Disorder, or ADD. Symptoms include in the child’s life, like teachers or coaches. ADHD and also need to be treated. making careless mistakes, failing to Children with ADHD have a hard Treatment usually involves education follow through with tasks, diffi culty with time focusing or controlling their behavior with a mental health provider about the organization, losing things easily and because they lack the right balance of disorder, as well as therapy to help parents being readily distracted and forgetful. The neurotransmitters, or chemicals, in their and children learn how to cope with the hyperactive and impulsive type includes brains that help them focus and inhibit symptoms and problem-solve regarding symptoms like fi dgeting, squirming, impulses. Because kids with ADHD are school, sports, and family functioning. running around, climbing on things, often unaware of their behavior, they may School systems should accommodate talking too much, interrupting, or moving become defi ant and may even lie and claim, symptoms according to the child’s needs. quickly from one activity to another. The “I didn’t do it!” Parents may ask for a 504 or Individualized

28 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org MENTAL HEALTH

Educational Plan (IEP) evaluation from using other illegal drugs in adolescence, of kids with ADHD that are treated the principal after a diagnosis of ADHD presumably because they do better in develop at the same rate as the brains of is made if the child’s symptoms are severe school and generally feel better about kids without ADHD, while untreated kids’ enough to interfere with adequate school themselves. brains mature more slowly. functioning. When left untreated, a child with Up to a third or more of people Medication is often very helpful in ADHD often feels that he or she doesn’t with ADHD outgrow the symptoms— reducing the symptoms and helping the do as well as they could in school and may particularly the hyperactive and impulsive child learn and succeed academically to develop poor self-esteem because they symptoms—but sometimes the disorder their full potential. The most commonly are “in trouble all the time.” They may persists into adulthood and may require used and most effective medications are even appear depressed. Other kids may indefi nite treatment. Although both stimulants, but there are non-stimulant perceive them as the class clown, or they children and adults suffer from the options as well. Common concerns about may not want to play with a playmate who disorder, ADHD at age 5 can look very medication are “I don’t want my kid to is constantly jumping from one activity different from ADHD at age 15 or 45. turn into a zombie” and “I don’t want my to another. As people with untreated ADHD is a common disorder that child to become addicted to a drug.” In ADHD get older, they are at greater risk many children live and thrive with, but it is reality, a “zombie” effect only occurs if the for driving accidents, unwanted pregnancy important as a parent to remain supportive: dose is too high. Kids with ADHD who and substance use, as well as higher rates Remember that children with ADHD are treated do not become addicted to the of divorce and job change. Recent studies aren’t “trying to be bad”; they just really medication and are actually at less risk of have shown that certain parts of the brains have a hard time controlling their behavior.

SCREENING TOOL Children’s Psychiatry department’s preferred screening tool is the VANDERBILT ASSESSMENT SCALE FOR ADHD. This initial assessment tool, for use with children ages 6 to 12, contains rating systems for symptoms and for impairment in academic and behavioral performance. Although this tool is not intended for diagnosis, it is widely used to provide information about symptom presence and severity, along with performance in classroom, home, and social settings. The Vanderbilt Scale takes 10 minutes to complete (parent form has 55 items, and teacher form has 43 items).

ADHD SYMPTOMS Diagnostic and Statistical Manual of Mental Disorders (DSM-IV®) Criteria Before age 7: Six or more of the following symptoms have been present for at least 6 months, to a point that is disruptive and inappropriate for developmental level, both at home and at school

INATTENTION HYPERACTIVITY/IMPULSIVITY

1. Often does not give close attention to details or makes Hyperactivity: careless mistakes in schoolwork, work, or other activities. 1. Often fi dgets with hands or feet or squirms in seat. 2. Often has trouble keeping attention on tasks or play 2. Often gets up from seat when remaining in seat is expected. activities. 3. Often runs about or climbs when and where it is not appropriate 3. Often does not seem to listen when spoken to directly. (adolescents or adults may feel very restless). 4. Often does not follow instructions and fails to fi nish 4. Often has trouble playing or enjoying leisure activities quietly. schoolwork, chores, or duties in school (not due to 5. Often “on the go” or often acts as if “driven by a motor.” oppositional behavior or failure to understand instructions). 6. Often talks excessively. 5. Often has trouble organizing activities. 6. Often avoids, dislikes, or doesn’t want to do things that Impulsivity: take a lot of mental eff ort for a long period of time (such as schoolwork or homework). 1. Often blurts out answers before questions have been fi nished. 7. Often loses things needed for tasks and activities (e.g., toys, 2. Often has trouble waiting one’s turn. school assignments, pencils, books, or tools). 3. Often interrupts or intrudes on others (e.g., butts into 8. Often easily distracted. conversations or games). 9. Often forgetful in daily activities.

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 29 SPORTS MEDICINE PROGRAM ANNOUNCEMENT NEW! ATHLETE DEVELOPMENT PROGRAM

Through extensive clinic- and fi eld- FEES: based evaluation, Children’s experts Initial evaluations: $150/hour design a training program to achieve Sport team evaluations: $150/hour measurable improvement. Training sessions: $95/hour Optimal training program is 12 sessions over 3 months.

The Athlete Development Program provides: INITIAL EVALUATION EVALUATION AFTER TRAINING • Analysis of games and training sessions for coaches to enhance their practice First contact in front of the center First contact at the same level of • Team profi les to help coaching staff create of gravity the center of gravity playing strategies • Information for the coach, physical therapist and/or doctor to be used in the athlete’s development process

Outcomes: • Enhanced safety for young athletes • Enhanced technique and athletic effi ciency • Enhanced sports training design and implementation • Provide coaches with objective tools to design training and game strategies

This program benefi ts: • Athletes • Individual and team coaches Evaluations: • Conditioning coaches • Technical and movement video analysis • League managers and sports directors • Training design analysis • Physical therapists • Body composition relative to movement • Physicians • Conditioning tests: strength, speed, fl exibility, endurance and agility

CHILDREN’S HOSPITAL OAKLAND SPORTS MEDICINE CENTER Walnut Creek location: 100 N. Wiget Lane, Suite 200 • 925-988-0100 Oakland location: 744 52nd St. • 510-428-3558

www.childrenshospitaloakland.org

30 CHILDREN’S HANDPRINTS WINTER 2012 • www.childrenshospitaloakland.org 100 YEAR CELEBRATION

1962

Your story is our history.

Children’s is celebrating 100 years in 2012. If you have memories of Children’s you would like to share, write to [email protected].

CHILDREN’S HANDPRINTS WINTER 2012 • Donate at www.childrenshospitaloakland.org 31 Children’s Hospital & Research Center Oakland 747 52nd St. Oakland, CA 94609-1809

You choose food just for kids. Shouldn’t you choose a hospital just for kids? Ask your pediatrician to help you connect with a subspecialist at Children’s Hospital.

The hospital dedicated exclusively to caring for kids. www.childrenshospitaloakland.org