DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE

GivingFALL 2019 in ActionREPORT ON PHILANTHROPY

Rural Health...... pg. 6 Reaching Patients Where They Are

Telehealth Mental Health...... pg. 15 Changing the services bring Conversation specialty care Community as Classroom...... pg. 23 to children and adults On the Road to throughout the region. Becoming a Doctor LEADERSHIP LETTER RURAL HEALTH Addressing challenges, Joanne Conroy, MD, and Duane Compton, PhD, presenting solutions. RESEARCH joined more than 4,400 04 BRIEFS supporters of Norris Cotton 06 07  THE RIGHT CARE IN Cancer Center (NCCC) at THE RIGHT PLACE the 2019 Prouty. This year’s event drew participants 11  A LIFELINE FOR RURAL from across the Northeast, CANCER PATIENTS DONORS, who raised a record- breaking $3.3 million to 12  REDESIGNING ACUTE 27 FISCAL YEAR support cancer research CARE FOR SENIORS 2019 and patient support services at NCCC. 14  RESEARCH IN RURAL HEALTH CARE GIVING 28 HIGHLIGHTS

Caring for Community 15 Giving in Action Sasvari Kata MENTAL HEALTH Fall 2019 Combating the stigma, Director improving treatment access. Kate Villars Managing Editor Every day, our caregivers, students, and staff touch the lives and planning to ensure that we are positioned to meet 16  NO SHAME! Lauren Seidman of people across our region. They reach beyond the walls of community needs now and in the future. 20  INITIATIVES IN Editorial Assistants Dartmouth-Hitchcock Medical Center and Dartmouth’s BEHAVIORAL HEALTH Patti Green The Geisel School of Medicine is training physicians who Geisel School of Medicine to meet people where they are— 22  BEHAVIORAL HEALTH Abagayle McMahon will take with them into practice the lessons learned not just from southern New Hampshire’s growing towns and cities to IN YOUR POCKET in the classroom and the clinic, but in the community as well. Design Production the rural North Country, and on both sides of the Connecticut Farah R. Doyle We are working to understand the needs of underserved River. They reach people in schools and senior centers; in individuals and communities and exploring new ways Contributors homes and care facilities; and in our numerous clinical sites, to deliver care. This work, and much more, is fueled by Mike Barwell reducing barriers to accessing care. Kerry Benson Interaction: The Campaign for Dartmouth Medicine, part Timothy Dean In this issue of Giving in Action, we share and celebrate a of Dartmouth’s comprehensive campaign, The Call to Lead. Jennifer Durgin few of those stories. Susan Green As an academic health system, the work we do together Lisa Marsch, PhD At Dartmouth-Hitchcock, our continued evolution as a extends far past those who turn to us for care, because when Abagayle McMahon health system includes fostering a coordinated and resilient we ease the burden of disease and improve health, we are Cathy Shufro rural health network that helps providers to keep care local strengthening communities across our region and beyond. Cover Photograph whenever possible. It includes a growing number of clinical Mark Washburn Thousands of donors, volunteers, and friends—many of sites and partnerships across the region, underpinned by our whom are recognized in this publication—help to make this Photography belief that through collaboration we can best serve patients, work possible. To each of you, we offer our sincere thanks for Lars Blackmore families, and communities. It includes research, innovation, 23 Jon Gilbert Fox your generosity and commitment to caring for community. Caleb Kenna COMMUNITY AS Kata Sasvari CLASSROOM Rob Strong Mark Washburn Embracing service, developing leaders. Produced by Office of Development and Alumni Relations 24  MAKING CONNECTIONS Dartmouth-Hitchcock/Geisel School THROUGH STEM of Medicine at Dartmouth DUANE A. COMPTON, PHD JOANNE M. CONROY, MD 25  COOKING FOR LIFE/ One Medical Center Drive, HB 7070 Dean, Geisel School of Medicine CEO and President, Dartmouth-Hitchcock and LEARNING IN A Lebanon, NH 03756 Dartmouth-Hitchcock Health COMMUNITY CLINIC Websites 26  HOUSE CALLS MAKE dartmouth-hitchcock.org/donate A COMEBACK geiselmed.dartmouth.edu/campaign GIVING IN ACTION | FALL 2019 • 3 Jon Gilbert Fox

RESEARCH RESEARCH BRIEF BRIEF Strides in Global Access to Machine CANCER SCREENING Human papillomavirus (HPV) is linked to high incidence of LearningReveals New Insights cervical cancer, and women who live in nations that lack the resources to provide routine cancer screenings are hit Atypical ductal hyperplasia, a particular kind of breast lesion, is associated the hardest: 85% of all cervical cancer cases occur in low- with a four- to five-fold increase in the risk of breast cancer. Currently, to middle-income countries. surgical removal is recommended whenever these lesions are detected—but A group of researchers from Norris Cotton Cancer Center, led by Gregory Tsongalis is a professor and vice chair of only 20% to 30% of these cases progress to cancer. Tsongalis, PhD, has introduced an inexpensive DNA-based testing protocol for research in the Department of Pathology HPV that could help detect and prevent cervical cancer in women who don’t and Laboratory Medicine at the Geisel Saeed Hassanpour, PhD, is finding innovative and social media data. In their study, nearly 2,300 have access to Pap smears, the standard screening procedure for HPV. The School of Medicine; director of Clinical ways to apply machine learning—the use of adult participants completed a survey about their Genomics and Advanced Technology team’s study also discovered significant differences in the types of high-risk and a member of the Cancer Biology and algorithms and statistical models by computers substance use while allowing researchers to extract HPV detected, a finding that could lead to new therapeutic vaccine trials. Therapeutics Research Program at Norris to detect patterns and make inferences—to a numerous images, captions, and comments from Cotton Cancer Center; and director “The causes of cervical cancer, while viral in nature, are not always the same of Molecular Pathology at Dartmouth- variety of fields, including breast cancer treatment their Instagram posts. The model proved able to Hitchcock. and behavioral health care. Hassanpour and his detect risk for alcohol use with high accuracy. type of virus and that could impact aggressiveness of disease, vaccinations, and research team developed a machine learning Further efforts by Hassanpour’s team will target therapies,” says Tsongalis. method that can identify with 98% accuracy which tobacco, prescription drug, and illicit drug use, and cases of atypical ductal hyperplasia are malignant also incorporate social network platforms including prior to removal, thus sparing from surgery some Facebook and Twitter. women who would otherwise have undergone Other work in Hassanpour’s lab focuses on a costly and invasive operation for what would using radiology images to aid in lung, esophageal, ultimately prove to be a benign lesion. and colorectal cancer classification and in detection In the field of behavioral health, Hassanpour and of osteoporotic fractures. Additional behavioral RESEARCH Understanding Best Practices in a team of researchers are developing a promising health research aims to predict depression risk in BRIEF new approach for identifying substance use risk social media users based on community responses through the combined use of machine learning to their posts. ADVANCE CARE PLANNING Advance care planning (ACP) conversations between physicians and older adults are associated with care that Rob Strong Rob aligns patient goals with the treatment they receive. Yet Mark Washburn Mark only a small percentage of acute care providers in hospital settings are engaging in these discussions. The low rates underscore the need for quality-improvement interventions to increase physician participation in ACP.

In order to improve care for seriously ill, older adults in a hospital setting, Hassanpour is an associate researchers from The Dartmouth Institute for Health Policy and Clinical Practice, professor of biomedical data science and led by Amber Barnato, MD, MPH, have partnered with a national physician epidemiology at the Geisel management group to better understand best practices in ACP. The project School of Medicine and a member of the Cancer aims to: understand the decision-making process influencing the likelihood of Population Sciences Barnato is the Susan J. and Richard M. Levy hospital-based physicians having ACP discussions with the seriously ill; explore the Distinguished Professor in Health Care Research Program at Norris association between acute care ACP and patient care outcomes; and test the effect Cotton Cancer Center. Delivery at the Geisel School of Medicine and a palliative care doctor at Dartmouth- of interventions designed to promote ACP discussions using a randomized trial. Hitchcock Medical Center.

DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE • 4 GIVING IN ACTION | FALL 2019 • 5 Caleb Kenna

Rural Health The Right Care in the Right Place

By Lauren Seidman

irst she clapped her hands. Then she tapped her head. Recognizing herself on the telemedicine screen, 7-year-old Megan* jiggled in her wheelchair with delight. The nurse and nurse assistant with FMegan shared in her joy—as did Margaret “Lou” Guill, MD, a Children’s Hospital at Dartmouth-Hitchcock (CHaD) pulmonologist, who watched from 66 miles away. Megan lives at Cedarcrest Center for Children with Disabilities in Keene, New Hampshire, a specialized pediatric Rural medical facility and school providing comprehensive services to children from New Hampshire, Vermont, and Maine with complex medical and developmental needs. Kids at Cedarcrest range in age from infant to 21, and they may have pulmonary REACHING PATIENTS disorders, neurological disorders, cerebral palsy, traumatic HealthWHERE THEY ARE brain injury, and other related conditions. An average of 22 children receive long-term care there with others coming for shorter stays and still others attending the Cedarcrest school as day students. Unique to the region, Cedarcrest is New Hampshire’s only pediatric rehabilitation and long-term Across America, rural residents struggle to access the same care facility. quality of health care available in many urban and suburban As New Hampshire’s only children’s hospital, CHaD has areas. Workforce shortages, socioeconomic factors, an enjoyed a long partnership with Cedarcrest. Its children aging population, and geographic isolation all contribute to often receive treatment from Dartmouth-Hitchcock (D-H) this growing disparity. Since 2010, 89 rural hospitals in the specialists, at D-H locations throughout the state and at U.S. have closed. In Northern New England, nearly 200,000 Cedarcrest. And, since 2017, specialists like Guill have made people live more than 15 miles from the nearest hospital. routine care for kids at Cedarcrest more efficient, more comfortable, and more accessible—through telemedicine. Anchored in rural New Hampshire, Dartmouth-Hitchcock Telemedicine allows health care providers to evaluate patients (D-H) and the Geisel School of Medicine are leading the way from a distance using secure telecommunications technology. in improving rural health care. D-H specialists use telemedi- “Almost all of New Hampshire is rural, and to have a facility cine to provide their expertise to patients across Vermont and like Cedarcrest available in the state at all is truly special,” New Hampshire. Norris Cotton Cancer Center caregivers and says Guill, section chief of pediatric pulmonology at D-H and researchers bring treatment, education, and access to clinical trials to people throughout Northern New England. Geisel Continued on page 8 . . . faculty and students probe the causes of rural health care disparities and present sustainable solutions. *Name has been changed to protect patient’s privacy.

GIVING IN ACTION | FALL 2019 • 7 Rural Health

Continued from page 7 . . . TELEMEDICINE Reaches Across the Region professor at the Geisel School of Medicine. “It’s “We needed to find a better way. Telemedicine an associate professor at Geisel, introduced Telehealth—the use of digital communications to provide long-distance attendant upon us to support them in order to is a great option,” says Cathy Gray, president and telemedicine to Cedarcrest in 2016 through care and services—is a key strategy for delivering on Dartmouth- provide this outstanding level of care to children CEO of Cedarcrest. a grant from New Hampshire Family Hitchcock’s (D-H) commitment to improving health across a rural region with special needs.” Since 2012, Dartmouth-Hitchcock Connected Voices, an organization that advocates and fostering a more coordinated and resilient rural health network. By Care and its Center for Telehealth has been for children with special needs. The pilot connecting expertise to distant sites, D-H Connected Care and Center FINDING A BETTER WAY addressing the challenge of delivering specialty went so well that everyone wanted to see for Telehealth aids in early intervention, care coordination, and better Transporting children like Megan to Dartmouth- care to the region independent of patient loca- telemedicine at Cedarcrest expand. To outcomes; broadens patients’ access to care while allowing them to Hitchcock Medical Center (DHMC) in Lebanon tion. Working with rural hospitals, clinics, and make that happen, Gray collaborated with receive care close to home; and improves operating efficiency and reduces isn’t easy. Supplies and medications must be packed community health centers, the Connected Care D-H Connected Care. staffing costs by delivering care in the right place at the right time. for the trip. Wheelchairs, oxygen, and, in some team identifies health care gaps that telemedicine “We were the matchmaker, bringing cases, ventilators have to be loaded and secured can fill and brings additional resources to patients Cedarcrest and CHaD specialists together inside the vehicle. Every child is accompanied and providers. Connecting expertise to distant in this new way,” explains Vanessa TeleEmergency TeleICN by two staff members. Preparation, round-trip sites improves patient outcomes, lowers health Brown, the Connected Care TeleSpecialty travel, and the appointment itself make each office care costs, and keeps patients where they want provides an emergency allows community hospitals practice manager who worked closely medicine physician and an to meet the needs of infants visit at least a half-day event. The experience is to be—close to home. with the Cedarcrest team. “We provided experienced emergency nurse that require a higher level emotionally upsetting for many of the children, Dartmouth medical school alumnus Richard the infrastructure and training, leased to join a hospital’s bedside of care. The support of ICN and less beneficial than being evaluated in their P. Morse, MD, a pediatric neurologist at D-H and them the telemedicine cart, and created team. services helps keep patients and families closer to home by Cedarcrest home environment. the best practices and workflows. At the providing expert evaluations. same time, we expanded our pediatric telespecialty services to rural hospitals and clinics throughout New Hampshire. Now, for example, young patients in the North TeleICU TeleNeurology Country, over two hours away from DHMC,

Mark Washburn Mark provides intensive care provides neurologists for Telemedicine allows can go to Coos County Family Health physicians and critical care emergency department and the children at Services for a telemedicine appointment nurses to augment a hospital’s inpatient consultations. This with a CHaD specialist.” bedside team. The service includes assistance not only Cedarcrest to spend provides high-level monitoring with stroke but also with other less time being D-H has broadened its telehealth services for to identify concerning trends adult neurologic emergencies. adults and children as rural regions continue to prior to patient deterioration. patients and more be hardest hit by health care staffing shortages. time being kids. At Cedarcrest, routine telemedicine neurology appointments began in April 2017, followed by pulmonology, urology, and nephrology TelePharmacy TelePsychiatry later that year. Gastroenterology was added connects hospitals to enables prompt assessment in January 2018 and, in January 2019, pharmacists who can provide of patients in the emergency endocrinology. medication order review and department or inpatient processing as well as clinical setting for locations that do “Our pediatric specialists are thoroughly consultation. not have around-the-clock invested in doing whatever they can to make psychiatric coverage. delivery of care to their patients easier,” says Brown. “The success of this program has been very gratifying for everyone.” TeleSpecialty TeleUrgent Care connects patients and provides back-up, support, health care providers to D-H and consultation to urgent Continued on page 10 . . . specialists. TeleSpecialty care providers by emergency increases access to medicine physicians. specialty care services for A child at Cedarcrest Center for patients located in rural or Children with Disabilities enjoys underserved areas. time with a nurse assistant during a telemedicine session.

DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE • 8 GIVING IN ACTION | FALL 2019 • 9 Rural Health

Behind Nirav Kapadia, MD, Continued from page 9 . . . is a linear accelerator, a state-of-the-art machine that gives radiation oncologists in St. Johnsbury the ability all the child’s records, and Carrier gives updates on to treat patients with the IMPROVING LIVES IN most advanced techniques RURAL NEW ENGLAND changes to health status or medical needs. A Lifeline available. “The regularity, that children will be seen every Telemedicine clinics are held quarterly at Cedarcrest. quarter, no matter what, is really reassuring,” says The CHaD specialist at DHMC sits at a computer Kathleen Fisher, MD, a Dartmouth medical school FOR RURAL CANCER PATIENTS workstation specially equipped with a two-way camera alumna, medical director at Cedarcrest, medical and secure videoconferencing software. At Cedarcrest, By Kerry Benson director of CHaD’s Complex Care Program, and the patient, nurse assistant, clinical nurse manager clinical assistant professor at Geisel. “Everyone here Sheila Carrier, and other caregivers as needed gather in When Norris Cotton Cancer Center North (NCCCN) opened in St. knows the kids well and now the D-H providers front of a mobile cart that includes a monitor, camera, Johnsbury, Vermont, in 2005, the staff assumed it would take a while know them well too. That makes a huge difference and computer workstation. The CHaD specialist has for their schedules to fill up. But in just months, they began noticing in overall care.” something they hadn’t expected: Not only were they completely The accessibility of specialty care through D-H booked, but scores of new patients were arriving—patients whose Mark Washburn Connected Care is just one of the ways telemedicine cancers had previously gone untreated. has improved the lives of rural Northern New This treatment facility—a satellite of Norris Cotton Cancer Center, Englanders. Providers across the region note that the National Cancer Institute-designated Comprehensive Cancer since partnering with D-H, patient health concerns can Center at Dartmouth-Hitchcock Medical Center (DHMC) in be addressed and treated more quickly, fewer patients Lebanon, New Hampshire—provides chemotherapy and radiation for require transfer to DHMC where demand for inpatient rural patients, who often face a variety of barriers to accessing care. beds often exceeds capacity, and patients appreciate Transportation is one of the biggest challenges for this population, that they can see specialists without the burden of says NCCCN director Nirav Kapadia, MD. Long commutes are costly costly and inconvenient travel. In addition, the support for patients and their families—and when they prevent people that caregivers at clinical sites receive from D-H has from seeking care altogether, they can even cost lives. Before this reduced burnout and improved retention. facility was established, many patients had to drive up to four hours And for Megan and other children at Cedarcrest, roundtrip to DHMC. telemedicine has made a dramatic impact on their Historically, rural patients also have had difficulty accessing clinical quality of life. Instead of uncomfortable trips to the trials, which are usually offered only at academic medical centers. doctor they can go on more fun-filled field trips with NCCCN breaks that mold—and its trials not only benefit its patients, their friends; instead of restless hours on the road but also medicine as a whole. they enjoy fruitful hours in school. Telemedicine “If researchers only recruit clinical trial patients at academic allows the children at Cedarcrest to spend less time medical centers, the findings of those studies won’t necessarily being patients and more time being kids. • be generalizable to the majority of the population,” Kapadia says. “Clinical trial patients tend to have more favorable outcomes just from having the resources to get to an academic center—so having a robust clinical trial network in the community is extremely important. “Our pediatric specialists This allows for more meaningful interpretations of research.” are thoroughly invested in As a graduate of The Dartmouth Institute for Health Policy and Clinical Practice at Geisel, Kapadia is passionate about improving— doing whatever they can and saving—the lives of underserved patients. To be sure, there are to make delivery of care to still barriers to be addressed. For example, he’s currently exploring their patients easier. The ways to ease the financial hardships cancer patients often face. success of this program “The Cancer Center in St. Johnsbury has changed the dynamic for cancer patients in northern Vermont and northern New Hampshire,” has been very gratifying Kapadia says. “We get to cure cancer. That’s always fulfilling. But for everyone.” the most fulfilling part of our job is knowing we’re there for some patients who would otherwise never even be treated.” From a specially equipped workstation at DHMC, pediatric pulmonologist and Geisel In addition to St. Johnsbury and Lebanon, Norris Cotton Cancer professor Margaret "Lou" Guill, MD, talks with Cedarcrest clinical nurse manager Sheila Currier (on screen) during a telemedicine clinic. Center has locations in Manchester and Nashua, New Hampshire, and Bennington, Vermont—so more people throughout Northern New England can receive world-class cancer treatment closer to home. Kata Sasvari Kata

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Redesigning in EDs are often highly complex patients with various medical and social issues that are challenging for any ED, and can be “It’s another step especially challenging for rural hospitals with fewer resources. ACUTE CARE FOR SENIORS This partnership with West Health will enable D-H to work with forward in D-H’s vision our rural colleagues to provide specialized senior-specific care to to improve access to more patients throughout the region. It’s another step forward high-quality health in D-H’s vision to improve access to high-quality health care for West Health Awards $3M to Dartmouth-Hitchcock for Partnered Project all people, regardless of where they live.” care for all people, By Lauren Seidman “This is the perfect union,” says Shelley Lyford, president regardless of where and chief executive officer of West Health. “Combining West they live.” Health’s experience in geriatric care with Dartmouth-Hitchcock’s Emergency care sits at the crossroads of health care. As the U.S. population pioneering work in telehealth and geriatrics will enable D-H ages, more older adults are turning to emergency departments (EDs) for their to add geriatric emergency telecare to its already world-class telehealth portfolio. And seniors will be the beneficiaries of this health care needs. EDs must be equipped not only to deal with acute medical important work.” • emergencies but also to coordinate care, avoid admissions when possible, provide patients with support, and connect them to community partners—all

in an ED environment designed with the needs of seniors in mind. Designing Lars Blackmore a “Geriatric ED” (GED) with protocols, resources, and even specialized care areas has been recognized as an important strategy to optimize the acute care of older adults, yet many of the hospitals implementing GEDs have been urban academic medical centers.

By contrast, rural sites—and the largely rural will contribute expertise and $3 million in capital setting of Northern New England in particular—offer to establish Dartmouth-Hitchcock Medical Center unique challenges to implementing improved acute (DHMC) as a Center of Excellence in geriatric care for the growing geriatric population. Northern emergency care. After DHMC earns accreditation New England is one of the United States’ most rapidly as a top-tier, level 1 GED “hub,” its specialized aging regions, with Vermont and New Hampshire services will be offered to four “spoke” sites through being the second and third oldest states respectively telemedicine. D-H has committed an additional $1.5 by median age. Older adults who live in poverty million to the overall project cost. are significantly more likely to live in rural areas. Limited access to services, workforce shortages, GERIATRIC EMERGENCY social isolation, and transportation problems are TELECARE particularly severe in these remote regions. Caring Ultimately, this project will demonstrate the effec- for older adults in rural areas such as Northern New tiveness and sustainability of using telemedicine England requires innovations in the delivery of to extend the reach of a GED to rural hospitals, as geriatric emergency medicine. well as investigate the opportunities for scaling this West Health—a family of nonprofit and concept to other rural facilities across Northern New nonpartisan organizations dedicated to lowering England—and throughout the country. health care costs to enable seniors to successfully age Scott Rodi, MD, interim section chief and regional in place—has chosen to partner with Dartmouth- director of emergency medicine at DHMC, associate Hitchcock (D-H) to address this gap in rural geriatric professor at Geisel, and principal investigator for this emergency medicine. Over the course of a three-year collaboration, says, “Seniors who seek treatment research collaboration, the West Health Institute

In August 2019, guest speakers from West Health presented Medicine Grand Rounds at Dartmouth-Hitchcock Medical Center. From left to right: Tim Lash, chief strategy officer and executive vice president of West Health and president of West Health Policy Center; Shelley Lyford, president and chief executive officer of West Health, the Gary and Mary West Foundation, and the West Health Institute; and Kevin Biese, MD, co-director of the Division of Geriatrics Emergency Medicine at the University of North Carolina at Chapel Hill School of Medicine and West Health consultant.

DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE • 12 GIVING IN ACTION | FALL 2019 • 13 Rural Health mental health Research in Rural Health Care

Residents of rural regions need health care solutions that will benefit them today, and in the years to come. Forward-thinking investigators at the Geisel School of Medicine study the factors that contribute to disparity in rural health care so their findings can inform programs and policies that ensure better rural health in the future.

STUDYING THE IMPACT OF EXAMINING THE AGING RURAL MATERNITY WARD CLOSURES PHYSICIAN WORKFORCE Why are small New Hampshire hospitals closing their Geisel School of Medicine student Lucy Skinner ’22 plans maternity wards at an alarming rate? How are these closures to practice rural medicine and is co-leader of Geisel’s Rural Mental affecting pregnant women, babies, and hospital emergency Health Scholars program. She’s also the lead author on a departments? And what can be done to mitigate the impact paper published earlier this year in the New England Journal of of these closures on rural communities? Medicine that examines the aging of the physician workforce Addressing these questions is crucial because as rural in rural areas. CHANGING populations age, birthrates decline, and the medical costs of Working with Doug Staiger, PhD, adjunct professor at The HealthTHE CONVERSATION pregnancy and childbirth rise, it’s becoming more difficult for Dartmouth Institute for Health Policy and Clinical Practice, mothers and babies in rural New England to get the care they and Montana State University faculty Peter Buerhaus, PhD, need, putting their health—and their lives—at risk. and David Auerbach, PhD, Skinner found that while the Timothy J. Fisher, MD, director of the Obstetrics and number of rural physicians had been stable over the past 20 Gynecology Residency Program at Dartmouth-Hitchcock and years, the rural physician workforce is aging—and not being The mental health crisis in America replaced with younger doctors. assistant professor at the Geisel School of Medicine, along doesn’t discriminate. It affects young with two researchers from the Urban Institute in Washington, This demographic shift forecasts a troubling future for rural and old, wealthy and poor, urban and D.C., has been awarded a three-year, $350,000 grant from residents who’ll have increasingly limited access to physicians. rural. Nearly 44 million adults in the the Robert Wood Johnson Foundation to study this trend and “The supply of physicians in rural areas is going to decline U.S. are affected by treatable mental suggest practical, affordable solutions. The Northern New in the next 10 years by 23 percent as older physicians retire,” health conditions every year, but England Perinatal Quality Improvement Network will also be explains Skinner. “If nothing is done, the already large a partner in the study. disparity in access to physicians between rural and urban barriers to care prevent more than half “More than half of all U.S. counties do not have ob-gyn doctors populations is going to widen.” of them from getting help. to serve pregnant women,” Fisher says. “It’s important that we Skinner and her colleagues acknowledge that initiatives There is an urgent need to eliminate have the resources in every county that can support the care involving focused training for medical students likely to and education of women where they live.” practice in underserved rural communities have slowed the the stigma around mental health The study is one of 15 projects in the Foundation’s state- decline of rural physicians, but they’re unlikely to narrow the conditions and improve access to based Interdisciplinary Research Leaders program, which is care delivery gaps. To break this cycle, the researchers offer treatment—and the Geisel School of examining problematic rural health trends in 21st-century strategies such as expanding graduate medical education Medicine and Dartmouth-Hitchcock America and developing potential solutions. programs in rural hospitals, increasing access to care through are responding. Initiatives include a mobile health vans, and furthering the adoption of telehealth “As we gather results and make our findings, we plan to be in program to support the mental well- touch with the major stakeholders who control maternal care: services. They also suggest the rapidly growing nurse ness of medical students and prevent the insurance companies who pay for many of these services practitioner workforce could be part of a solution to narrow and the legislators and policy makers who regulate health gaps in health care delivery. physician burnout; the development systems,” Fisher says. “We need to be sure they understand of affordable and evidence-based the importance of what we must do in the future to guarantee technological interventions for behav- that mothers and babies in New Hampshire have the care ioral health care; the integration of needed to live long, safe, productive lives.” mental health care into primary care; and community outreach to teenagers.

DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE • 14 GIVING IN ACTION | FALL 2019 • 15 mental Health

henever John Broderick tells his AN ILLNESS, painful family story of mental NOT A WEAKNESS W illness at high school assemblies, the students line up afterward to talk to him When his son Christian was 13, he tells the about their own struggles. Some wait for more students, Christian became increasingly with- than an hour. “I’m the grandfather they’ve never drawn, spending hours drawing in his room. met,” says Broderick. “They come up to me with Broderick and his wife, Patti, simply thought wet eyes and cracking voices.” he was artistic. They knew that Christian began drinking during college, and by the time he had The former chief justice of the New finished graduate school, they realized he was Hampshire Supreme Court has found a calling: an alcoholic. Four stints at rehab failed. The “I’m on a mission to change the conversation possibility that he was ill never crossed their about mental illness.” minds. “All we saw was alcohol,” Broderick says. Broderick does this work as senior director Eventually, they were persuaded to adopt a of external affairs for Dartmouth-Hitchcock “tough love” approach, now largely discredited, Health (D-HH), serving as the public face of and kicked their son out of the house. Only its R.E.A.C.T. Mental Health Awareness Cam- after Christian went to prison for assaulting paign. The program is a collaboration with the his father did the couple learn from prison psy- Children’s Hospital at Dartmouth-Hitchcock chologists that he had “off the charts” depression (CHaD), the New Hampshire Department and anxiety. He’d been drinking to cope. In of Education, and the Vermont Agency of prison, he finally got treatment. “You wouldn’t Education. tell someone with diabetes to ‘snap out of it,’ ” In just three years Broderick has spoken to Broderick tells the students. “Mental illness is 93,000 people—most of them teenagers. He a health problem, not a weakness.” begins each presentation telling how he missed Broderick has given these talks at 248 schools the signs of mental illness in his own son. “I was (and counting) in New Hampshire, Vermont, ignorant, and I did harm without intending Maine, and northeastern Massachusetts. “You to,” he says. “Now I’m trying to pay it forward. have 750 people in a gym and you could have … If Dartmouth-Hitchcock wasn’t on board, I heard a pin drop for the entire 45 minute talk,” couldn’t be doing what I am doing.”

Continued on page 18 . . .

No Shame! COMBATING THE STIGMA OF MENTAL ILLNESS Mark Washburn

By Cathy Shufro mental Health

Continued from page 16 . . . Mark Washburn

says Acting Principal Brian Emery of Broderick’s interferes in the daily lives of one in 25 adults. Express concern and offer support;A ct now and visit to John Stark Regional High School in The rates are higher among veterans, people talk to someone you trust; Care enough to follow Weare, New Hampshire. in prison, and first responders. Teachers and through and follow up; and Text signs—that When the talk ends, the students usually guidance counselors have told Broderick that is, use numbers provided to connect to a crisis give him a standing ovation. “They’re not mental illness is common in their schools, center. The campaign has distributed 400,000 applauding me,” says Broderick. “They’re public and private. Sometimes, he says, a coun- of these cards. applauding because they agree.” selor will only discover someone is suffering by Broderick wanted to extend the conversations noticing the student’s distress while listening that began in the schools he visited, and in April Broderick can recount dozens of stories to Broderick’s talk. that students have told him. A seventh-grader 2019 R.E.A.C.T. sponsored a summit for students and an advisor from every high school in New began to cry as she described losing a friend to SPREADING AWARENESS suicide when the girls were 10. Had she failed Hampshire. The 425 students attending chose Along with visiting high schools, Broderick her friend? No, he told her; her friend had an nine topics to explore with the help of experts has spoken to adults ranging from land- illness. At another school, a varsity football from D-HH. After student-led meetings on day use planners to TSA employees. He always player asked for a hug, then told Broderick that one, the students made presentations to guidance mentions the five signs of mental illness he couldn’t bring himself to tell his parents how counselors, principals, and school psychologists. developed by psychologist Barbara Van Dahlen: depressed he felt. Broderick asked, “What if you “They talked, and we were listening,” says Karen personality changes, agitation, withdrawal, hurt your knee and couldn’t play in the game on Borgstrom, director of external affairs at D-HH. poor self-care, and hopelessness. He also hands Saturday? Would you tell them?” Last spring, after Broderick heard about an out cards created by the R.E.A.C.T. Mental art exhibit called “The 99 Faces Project: Portraits Nationally, half of the people who will suffer Health Awareness Campaign that list steps Without Labels,” he brought it to Dartmouth- from lifelong mental illness develop it by age 14. for helping a person affected by mental illness. Hitchcock Medical Center. The work of Boston- Mental illness affects one in five adults in the Developed by D-HH, the cards advise readers based photographer Lynda Michaud Cutrell, United States in a given year, and substantially to: ecognize signs of emotional suffering; R it comprises 99 photographs: some of them of people suffering from mental illness, others of their loved ones, all of them anonymous. Cutrell added a portrait of John and Patti Broderick with Christian, who is doing well. Lebanon High School junior Kata Sasvari Kata Broderick notes that shame about mental ill- Emily Galeva speaks with Broderick before serving ness persists at the same time that Americans have on the Youth Voices: come to accept previously stigmatized groups. Knowledge–Empowerment– Understanding panel at Still, he has hope that the young generation will Dartmouth-Hitchcock resist the taboo. Medical Center in September. Galeva was a youth facilitator “I love this generation,” he says. “They’re the at Dartmouth-Hitchcock least judgmental generation in the history of this Health’s Youth Summit in Concord, New Hampshire, country.” He says he’s become less judgmental in April. himself. “After seeing my own mistakes and un- derstanding my own family’s suffering, I realize this could happen to anyone. The world is more complex than I imagined it to be.” • “You wouldn’t tell someone At New Hampshire’s with diabetes to ‘snap Lebanon High School, Broderick talks to out of it.’ Mental illness is students about mental health and stigma. a health problem, not a weakness.”

Watch John Broderick tell his story at GO.D-H.ORG/BRODERICK

DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE • 18 GIVING IN ACTION | FALL 2019 • 19 mental Health

INITIATIVES IN Duncan. “That’s why the data and measurement piece is so important and complex. We don’t have the resources at this point to hire people to do this. It “If we can share was really a gift when Julia, on her own, decided that the information we this would be a good focus for her ethics fellowship.” gather in a sensitive Behavioral Health Berkowitz believes her work could ultimately help and confidential way, reduce the stigma medical students feel around their students will see that own mental health: “If we can share the information No one should have to wait weeks for help for a mental health issue, and no one they are not alone.” should be afraid to ask for the help they need. At the Geisel School of Medicine and in we gather in a sensitive and confidential way, stu- dents will see that they are not alone.” And that can Dartmouth-Hitchcock clinics, new initiatives are improving access to mental health care be the first step in asking for help.• for medical students and patients—quickly, confidentially, and without judgment. HEALTHY STUDENTS, HEALTHY PHYSICIANS BRINGING MENTAL HEALTH CARE INTO THE MAINSTREAM By Jennifer Durgin By Lauren Seidman

Attending medical school is notoriously stressful. New to the Upper Valley, a man with bipolar disorder Matthew Duncan, MD, a staff psychiatrist at D-H, Nationally, nearly a third of medical students report found himself in trouble. He’d been managing his assistant professor at the Geisel School of Medicine, and symptoms of depression and related mental illness, disease successfully for decades with lithium, but the a Dartmouth medical school alumnus, was one of the and one in ten have considered suicide, according to drug had begun to damage his kidneys. Shortly after clinicians who helped bring collaborative care to D-H. a 2016 study published in the Journal of the American his nephrologist took him off lithium, the patient He says, “These are common medical conditions and it’s Medical Association. The picture is equally grim for became suicidal. The first appointment he could get a really positive evolution that mental health has moved physicians, who have a suicide rate twice that of the with a psychiatrist was months away. In deep distress, into the mainstream of medicine.” general population. the man turned to his Dartmouth-Hitchcock primary Patients are screened for mental health issues “We have a professional responsibility to care for care provider (PCP) for help. through a pre-visit questionnaire, a tool that can help ourselves and our colleagues,” explains Matthew At Dartmouth-Hitchcock (D-H), most adult pa- start conversations about mental health needs and Duncan, MD, associate dean for student affairs at the tients who present a mental health issue during a visit initiate early interventions. Geisel School of Medicine and an assistant professor with their PCP have access to immediate counseling Jonathan Thyng, MD, medical director at D-H of psychiatry. Several studies have linked physician through Integrated Behavioral Health. Formally Nashua and clinical assistant professor at Geisel, says, depression and burnout with medical errors and lower- introduced at D-H Nashua in 2017 and now available “The screening has been the biggest eye-opener. By quality patient care. at D-H clinics in Lebanon, Manchester, Concord, asking people about depression, anxiety, and substance and Keene, this model of collaborative care embeds a

Duncan is leading a multi-faceted initiative at Washburn Mark use, you get answers you wouldn’t anticipate—and Geisel to address the mental health needs of its licensed clinical social worker or licensed clinical men- we can help prevent these issues from getting worse.” medical students. This includes improving confidential Associate Dean for Student Affairs Matthew Duncan, MD, a Dartmouth tal health counselor within a primary care practice. medical school alumnus, and Julia Berkowitz ’20 partner on a program These mental health providers can conduct same-day State funding and the commitment of D-H leadership screening for mental health; strengthening the school’s to address the mental health needs of medical students. have facilitated the expansion of Integrated Behavioral wellness and resiliency programming; providing assessments, establish treatment plans, serve as a liai- son between patients and community organizations, Health. But, notes Duncan, “Reimbursement models mental health clinical services that are tailored to is working with Duncan to develop measurement tools check in on patients after the initial visit, and offer are in the earliest stages of development, so sustaining medical students’ unique schedules; and promoting a to assess the program. Berkowitz learned how to create, short-term therapy. Cases are reviewed weekly by a the program requires the institution to invest at a loss culture that encourages seeking help for mental health test, validate, and implement program assessment tools supervising psychiatrist, and e-consults—an electronic to do the right thing clinically.” issues. Enhancing these efforts are recent changes when she was an S.M. Tenney Medical Student Fellow at communication system—allow PCPs to get guidance Even so, collaborative care has demonstrated to the MD curriculum and advising program that The Dartmouth Institute for Health Policy and Clinical from a psychiatrist usually within 10 hours, and always success in improving outcomes and lowering health will create a more efficient and supportive learning Practice at Geisel in 2017-18. Now, as the recipient of within 24 hours. care costs, and D-H is working on adapting its adult environment—while at the same time fulfilling the another Geisel fellowship, the Olive M. and Joesph F. model for pediatrics. “People are used to coming to ever expanding spectrum of knowledge, skills, and Swigart Ethics Fellowship, she is applying those skills Developed by a cross-disciplinary team of D-H their primary care doctors with all sorts of issues,” professional competencies that medical students to initiatives that will benefit her fellow students. Both caregivers, this collaborative care model was adapted says Thyng. “With demand for mental health care far today must master before graduating. fellowships were funded through the generosity of donors. from other models used throughout the country to meet the region’s needs. The program supports PCPs in exceeding the supply of specialists who can provide “I feel grateful that Geisel is tackling these issues “One of the big questions with any initiative is their ability to treat a wide range of mental health issues, it, this model helps patients receive expert care in the head on,” says medical student Julia Berkowitz ’20, who how do we know that it is working and effective,” says from depression and anxiety to substance use disorders. medical home they know and trust.” •

DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE • 20 GIVING IN ACTION | FALL 2019 • 21 mental Health community as classroom BEHAVIORAL HEALTH Mark Washburn Mark IN YOUR

PocketBY LISA MARSCH, PHD

Across the globe, one in four people While health care resources delivered APPLYING SCIENCE struggle with a mental health problem, and via mobile devices can surely complement AND ETHICS one in 10 people struggle with a substance traditional models of health care, digital use problem. Drug overdose is the leading health is not confined to the walls of Our priorities at the CTBH are multi- cause of death of Americans under age a health care institution. The phone faceted. We create flexible, adaptive, 50—killing more people than car crashes, takes health care to where there are no scientifically validated, and personalized Community as gun violence, and HIV. doctors and empowers people with tools digital health tools. We prepare future leaders in this space. And we partner with While the need for behavioral health care to support self-care. academia, industry, and governments is great, there simply are not enough trained They’re like a “virtual clinician” in your to ensure science informs digital health clinical professionals nor the financial pocket 24/7 to support the full spectrum of ON THE ROAD TO policy, business, and health care delivery. resources to meet this need—even in high- health—from changing unhealthy behavior, classroom We are also working to address the ethics BECOMING A DOCTOR resource countries like the U.S. to helping people effectively manage of digital health, asking questions such chronic conditions, to reducing premature At the Center for Technology and as: Who owns the data? When, where, deaths worldwide. For example, digital Behavioral Health (CTBH) at the Geisel and with whom are data shared? How therapeutics can teach people effective, For MD students at the Geisel School of Medicine, community School of Medicine, we develop and evaluate do consumers, clinicians, payers, and scientifically validated skills to recognize service is an integral part of their medical school experience. digital technologies, delivered via mobile governmental and industry stakeholders and change unhealthy thoughts and devices, to provide anytime, anywhere, develop best practices for digital health in Eighty percent of first- and second-year students partici- behavior and provide tools to help people science-based behavioral health care. At a the space of public health? And how do pate in a remarkable array of community service projects, apply these skills to their everyday lives. time when digital technology is exploding, we engineer digital health technology to including mentoring high school students, leading workshops the CTBH brings scientific methods and In fact, our research has shown that be secure, respect individual privacy, and with seniors at Dartmouth-Hitchcock’s Aging Resource ethics to the world of digital health. evidence-based, digital therapeutics can be usable by people without technology Center, and bringing health care to underserved populations. roughly double abstinence rates from expertise? A VIRTUAL CLINICIAN drugs, including opioids, when compared Through their interactions with community members in need, How our institutions, governments, to standard addiction treatment. We’ve students cultivate and practice the essential skills of caring, Digital health interventions (called and communities approach and answer also shown that digital therapeutics can communication, and empathy. These experiences also pre- “digital therapeutics”) are interactive these questions will determine the future greatly reduce depression, help people software tools that can overcome some of digital health and its potential to im- pare students to collaborate effectively with diverse teams in manage chronic pain, and reduce costly, of the striking disparities in treatment prove the lives of millions of people who varied social, political, and economic environments. unnecessary visits to emergency depart- access and treatment quality evident are in great need of accessible, affordable ments. And we are seeing that entire in health care settings across the globe. behavioral health care. Geisel graduates the complete physician—one who excels Given that there are more mobile phone health care systems can be transformed. in the basic sciences, delivers outstanding clinical care, dis- For example, our center is collaborating subscriptions in the world than there are covers and shares new knowledge, and works to improve people, treatments delivered via digital with Pontificia Universidad Javeriana Lisa Marsch, PhD, the Andrew G. Wallace systems of health care delivery. A medical education that platforms can be widely accessible at a in Colombia to test a low-cost mental Professor at the Geisel School of Medicine at embraces community service helps develop leaders who population level. health care system, delivered largely via Dartmouth, is the director of the Center for smartphones, for millions of people who Technology and Behavioral Health. are distinguished by their commitment to others and the Lars Blackmore currently have no access to such care. positive impact they have on the world.

DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE • 22 GIVING IN ACTION | FALL 2019 • 23 community as classroom Kata Sasvari Kata

Leslie Yuen ’22 prepares a treat for seniors at Kenny Williams ’21 (left) Dartmouth-Hitchcock's Aging Resource Center. and Shuaibu "Sha" Ali ’21 (right) mentor students at Cooking for Vermont's Hartford High School. By Kerry Benson Life Geisel School of Medicine students Britney Petrina ’22, Landis Walsh ’22, and Leslie Yuen ’22 are encouraging healthy habits one recipe at a time. They’re leading a monthly Cooking for Life class at Dartmouth-Hitchcock’s Aging Resource Center to educate seniors through interactive culinary demonstrations. “We recognize we’re not teaching these folks how to cook. They’re people who’ve supported themselves for years,” Walsh says. “But in nutrition, new studies come Kata Sasvari out all the time. We’re using our medical education to share dietary recommendations in fun, creative ways.”

A recent session was Italian-themed, featuring The trio draws inspiration from their professors, veggie-packed Tuscan bean soup, sweet potato gnocchi, who stress that exceptional physicians don’t just gather and low-fat Bolognese. knowledge—they share it. “There’s a misconception that eating healthy means “For us, cooking is a passion, and our passion con- eating boring dishes,” says Yuen. “But it’s fun to teach nects us with the people we’re teaching,” Walsh says. people new ways to eat healthy that are enjoyable, “We really want to help them achieve their best selves.” • sustainable, and easy to do.” ThroughMaking STEM Connections By Tim Dean and Lauren Seidman

Shuaibu “Sha” Ali ’21 and When Ali and Williams applied to of students of color at Lebanon High Learning in a Kenny Williams ’21 share a the Schweitzer Fellows Program—a School who were feeling like they didn’t By Lauren Seidman one-year mentored fellowship program have access to people of color who were Community Clinic When students arrive at Geisel, they dive right into Sasha Pashchenko ’22 is gaining her clinical passion for medicine and a focused on health-related community in leadership positions in the Upper their clinical training with a two-year On Doctoring experience at Little Rivers Health Care in Wells River, vision of a more equitable service and leadership development— Valley,” explains Ali. “We saw that as an course. Through hands-on experience—first in a simu- Vermont, with preceptor Stephen Genereaux, MD, a they seized the chance to lead the Upper opportunity to expand the project.” world. They also share a lated clinical setting and then at regional clinics—and Dartmouth medical school alumnus. Valley STEM (Science, Technology, En- In addition to visiting both schools close collaboration with faculty mentors, students deep appreciation for the gineering, and Mathematics) Scholars “Dr. Genereaux is a great teacher, he encourages me regularly, Ali and Williams brought all learn the fundamental skills required to develop into mentors who helped them and introduce local underserved youth to do new things all the time,” says Pashchenko. the students together for activities at highly competent and compassionate physicians. believe that they, two to a world of possibility. Geisel. The high-schoolers learned about Working at a community primary care clinic, Pash- men of color, could have “I know somebody sparked my interest organs, the musculoskeletal system, and chenko has been exposed to a wide variety of patients, the same opportunities as in STEM, so to be the flint that starts the disease processes in the anatomy lab, and from six-day old twins to people with diabetes, thyroid

fire in someone else is humbling,” says discussed the ways that societal issues, Strong Rob conditions, or substance use disorders. She’s learned everyone else—including Williams. such as poverty and racial status, impact how to conduct patient interviews, complete physical examinations, and perform ultrasounds. careers as physicians. The program at Hartford High School the health of communities. in Vermont was initiated by Luke Mayer “We’ve connected people who have Pashchenko and Genereaux also work together on ’20 and Chad Lewis ’20 when they were different forms of marginalization, Project Salud, a student-run initiative that Genereaux Schweitzer Fellows in 2017. When Ali whether that’s being under-resourced helps to coordinate, which brings health care to seasonal and Williams inherited the project, they or being under-represented, and used agricultural employees. continued to engage students in STEM STEM to help them see the things they “Access to health care can be daunting for many rural activities and discuss STEM career op- have in common—and that they have populations,” says Pashchenko. “One solution is to bring tions—but that’s not all they did. the power to bring change to their Watch a video about the the care to them.” • communities,” Ali says. Upper Valley STEM Scholars at “We learned that there was a group • dartgo.org/campaign-complete-physician Stephen Genereaux, MD, advises second-year Geisel student Sasha Pashchenko '22.

DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE • 24 GIVING IN ACTION | FALL 2019 • 25 community as classroom

By Susan Green and Abagayle McMahon House Calls Make a Thank You As former emergency medical technicians (EMTs) Donors in rural communities, Nick Valentini ’20 (D’13) and Karissa LeClair ’21 arrived at Geisel with insights into the challenges of meeting the health care needs of rural populations. They used their knowledge to develop Comeback and launch a community paramedicine project that During the 12 months ending June 30, 2019, 25,674 donors made gifts and commitments partners medical students with Upper Valley Ambu- to the Geisel School of Medicine and Dartmouth-Hitchcock (D-H) totaling $50 million. lance paramedics and EMTs to make house calls—the first partnership of its kind in New Hampshire. These gifts are expressions of gratitude, of hope, and of who made gifts or pledges totaling $1,000 or more during the confidence in Geisel and D-H. They fuel the education of future period July 1, 2018, through June 30, 2019. While space does not Community paramedicine is an emerging field physicians; advance innovation, collaboration, and discovery; allow us to list all donors here, every gift to Geisel and D-H Karissa LeClair ’21 at that allows emergency medical staff to provide Upper Valley Ambulance support a quality of patient care recognized as among the advances our work and touches lives. Every gift, large or small, is headquarters in Fairlee, routine primary care to underserved populations. best in New England; and help to fund unreimbursed care and a manifestation of the caring for community that runs so deeply Vermont. Some rural patients who lack easy access to primary services at the Children’s Hospital at Dartmouth-Hitchcock, in our region. care use 911 services for non-urgent health care, Norris Cotton Cancer Center, and throughout D-H. which can burden emergency services. Community For this extraordinary generosity, we thank you. In the pages that follow, we are pleased to recognize those paramedicine eases this burden by proactively mee- ting the needs of these rural residents. “Providing preventative care is a great bridge between primary care and emergency medicine,” LeClair says. “As medical students, we have no idea what patients experience in their homes and the Anonymous (84) American Foundation for Suicide The Arthritis Foundation, Inc. The Barrette Family Fund same is often true of physicians who send patients 92.5 The River Prevention Mr. and Mrs. Kevin L. Ash Raymond J. Barrette American Heart Association home with instructions to either take medications or Ashkenazy Acquisition Corporation Richard J. Barth, Jr. a American Occupational Therapy Astronics Luminescent Systems, David V. Bartlett and modify their behavior without understanding what Foundation Inc. Jennifer L. Moyer A to Z Cakes obstacles there may be to patients complying with American Society of Clinical AT&T Tom and Barbara Bascetta Dr. and Mrs. Thomas M. Oncology Aaberg, Sr. Atlas PyroVision Entertainment Bonnie E. Basom those instructions. Nick and I saw these obstacles American Society for Gastrointes- Group, Inc. Elizabeth A. Bassett and Gershen M. Abraham tinal Endoscopy as EMTs, so we wanted to bring that awareness to Aubin Woodworking, Inc. Dr. John A. Pane Menachem C. Abraham American Urological Association, medical students while also being a resource for Drs. Andrew Auerbach and Dr. Ellen Adams Bassett and Dr. Agron Abrashi Inc. Kristina Rosbe The Hon. James P. Bassett patients.” Access Sports Medicine & America’s Gardening Resource, AutoFair Group Nancy J. Bassett Orthopaedics Inc. Danielle Basta and Samuel Casella The project took shape while both Valentini and Mr. and Mrs. Wayne H. Adams Allan E. Ames Mr. and Mrs. H. James Baum LeClair were Rodis Fellows during their first year at Robert Adams Drs. James B. and Bethany L. Ames b David N. Baxter Geisel. The Pano Rodis Fellowship in Compassion- Adimab LLC Carl H. Amon III and Rae J. Bachelder Charles Baylor Aetna Foundation, Inc. Karen F. Kolodny, Esq. Mimi Baird Centered Medical Care encourages medical students Dr. Brian A. Beattie and Dr. Mohamed A. Ahmed Amoskeag Beverages Gregory L. Baker to design and implement an independent project. Brenda Stewart Mentor Ahmeti Amyotrophic Lateral Sclerosis Mr. and Mrs. William J. Baldasaro Heidi and Steve Beaulieu The community paramedicine program launched in Ndubuisi I. Ajukwu Association Dr. and Mrs. E. Bradford Baldridge Paul and Barbara Beaulieu the New Hampshire towns of Orford and Piermont Sarah Albert Anagnost Investments Dr. Perry A. Ball Dr. and Mrs. Thomas M. Beck Alessi Vascular Surgery, P.C. Dr. Holly S. Andersen and Banks Chevrolet in 2018 and is expected to expand into Vermont. Douglas A. Hirsch Mr. and Mrs. Timothy H. Beck Mary W. Allen Banwell Architects Mr. and Mrs. Errik B. Anderson Bill and Mary Ann Becker “Our mentors and the directors of the Rodis Dr. Jandel T. Allen-Davis and Bar Harbor Bank & Trust Dr. Kristofer E. Anderson Bedford AL Operator LLC Anthony T. Davis Betty H. Barba Fellowship provided a lot of support as we planned Dr. Mary Essemena Anderson Bedford Ambulatory Surgical The ALS Association Robert L. Barber the program. That and the support we received from Dr. Patricia Anderson Center Dr. Omar Alsamman Mr. and Mrs. Marco Barbier William P. Annable Bedford School District Dartmouth-Hitchcock and Upper Valley Ambulance American Association for Cancer Mrs. K. S. Barclay Mr. and Mrs. John W. Beer ultimately made this successful,” says Valentini. Research ANSYS Toby Barclay • John and Jessica Bell American Association of Retired Apple Therapy Services The Barley House LLC Persons Chapter #763 Ben & Jerry’s - Manchester, NH Appleseed Restaurant Dr. Erin R. Barnett and Dr. Elizabeth M. Bengtson American Cancer Society Dr. Diane L. Arsenault and Anthony R. Barnett Peter R. Pirnie Steve and Cinny Bensen

This list includes donors of $1,000 or more between 7/1/18 and 6/30/19.

DARTMOUTH-HITCHCOCK | GEISEL SCHOOL OF MEDICINE • 26 GIVING IN ACTION | FALL 2019 • 27 continued on page 28... Kata Sasvari Kata OUR DONORS 7/1/18-6/30/19 OUR DONORS 7/1/18-6/30/19

Benson Family Charitable Trust Buchika’s Ski & Bike Cincinnati Children’s Hospital Collision Works Drs. Eric D. and Marleen B. Mr. and Mrs. Tedd H. Benson John H. Buckner, MD City of Manchester, NH Dwight and Kathleen Comer Donnenfeld f Mr. and Mrs. Peter M. Fahey Dr. Henry Berger Barrett R. Bullock Claremont Speedway LLC The Commonwealth Fund Dover Police Association Mr. and Mrs. Gregg E. Fairbrothers K. Reed Berkey Kristina L. Burgard Drs. Jane R. Clark and Community Foundation of Kirstin Dow Michael and Sharon Fanger Mr. and Mrs. Arthur M. Berkowitz David W. Burlingame Jonathan P. Gertler New Jersey EXPANDING Dr. Barbara B. Dowd Isabelle M. Farmer Steven K. Bernier Burroughs Wellcome Fund Margaret B. Clark Community Foundation of the Mr. and Mrs. Robert N. Downey Chattahoochee Valley, Inc. Dr. Thomas J. Farrell Berstein-Magoon-Gay LLC Burrows Foundation CLD Consulting Engineers Neurocritical Care Downs Rachlin Martin PLLC Compass Retirement Consulting Charles and Charlotte Faulkner Burton M. Bickford Patricia M. Bushway Cleary, Shahi & Aicher, P.C. Patricia M. Doykos Group Violetta and Quentin Faulkner Marie A. Bigelow Dr. Ira Byock and Yvonne Corbeil Sandra L. Cleary and Dr. David Doyle Bruce C. Ganezer Comprehensive Pharmacy Services Merrill and Beth Fay Dr. and Mrs. William Bihrle III Ames Byrd Dr. Laurie F. Draughon Karen F. Clements Duane A. Compton, PhD Dartmouth-Hitchcock (D-H) opened a 10-bed Dr. and Mrs. John V. Federico Bio X Cell The Jack & Dorothy Byrne Mr. and Mrs. Alexander J. Dria Dr. and Mrs. Jeffrey A. Clingman Dr. David L. Conard Susan and Barry Feinberg Dr. Laurie E. Blach and Brad Kinder Foundation Neurocritical Care Unit in July 2019, becoming the Mr. and Mrs. Michael R. Drouin Dr. David Cloutier Mr. and Mrs. William J. Conaty Dr. and Mrs. John D. Feldmann Black Dog Foundation Mr. and Mrs. James R. Byrne first hospital in New Hampshire to deliver intensive Mr. and Mrs. Richard B. Drubel, Jr. Clovis Foundation Conifer Health Solutions Mr. and Mrs. Philip J. Ferneau Dr. Mark R. Blackwood Dr. Kathleen Ryman Dube Dr. Ruth I. Connor and neurologic care to patients with severe brain injury Club Alpine Michael D. Dude Ari S. Fingeroth Harry R. Bleiwise c Frederick V. Lee or neurological illness. Made possible in part by Mrs. Fred Cluthe Dulude Family Foundation Fireside Inn Ruth and Pete Bleyler C Squared Systems LLC Dr. Joanne M. Conroy Coalition To Transform Advanced generous gifts from Jake and Donna Carpenter Fisher Cats Foundation Mr. and Mrs. Jonathan F. Block C&M Machine Products DB Adfund Administrator LLC Care Consolidated Communications and other donors, the new unit fills a crucial need Drs. Keith R. and Katherine K. Drs. Timothy and Kathleen Fisher Boardman-Ellis VFW Post 6977 C&S Charities, Inc. Mr. and Mrs. Vincent S. Conti Coca-Cola Bottling Company of in our region, bringing together state-of-the- Dunleavy Mr. and Mrs. Andrew P. Fitzpatrick Amy B. Bodwell Caldwell Law Northern New England Continental Academic Mr. and Mrs. Henry B. duPont IV Ryan M. Fitzsimons Boloco Restaurant California Healthcare Foundation Estate of Dr. Edward M. Cohen Convent General Knights of art technology and specially trained clinicians to Dussault Property Management Gerald Flaxer Charitable Mr. and Mrs. James K. Bonney Andrew T. Campbell and Mr. and Mrs. Steven Cohen the York Cross of Honour provide expert care for patients with neurological The Duval Revocable Trust Foundation Dr. and Mrs. Daniel B. Bornstein Susan K. Zak (A Masonically-Affiliated Susan N. Cohen disorders. The unit makes D-H a destination for Dr. and Mrs. Timothy P. Flood Robert and Cynthia Campbell Organization) Duval’s Towing & Garage Dr. and Mrs. David Bornstein Coldwell Banker Lifestyles Alissa M. Cooley neurocritical care and offers training opportunities Drs. Diane Dwyer and Joseph Gall Flying Goose Brew Pub & Grille Dr. and Mrs. Joshua A. Bornstein Canaday Family Charitable Trust Nancy Cole Foley Distributing Cynthia A. Canaday Mr. and Mrs. Timothy M. Cooney for residents. Miriam Bornstein Thomas and Barbara Cole Co-op Food Stores Mr. and Mrs. Lionel P. Fortin Mrs. Murray Bornstein William W. Cantlin e Mr. and Mrs. Miles C. Collier Foundation for Healthy Cardigan Mountain School Mr. and Mrs. Herbert R. Cooper Eastern Bank Charitable Dr. Judith A. Boule Mr. and Mrs. Adam and Tracey Communities Bekki Carlin, MD Dr. Denis A. Cortese Foundation Drs. Philip and Suzanne Boulter Collins Foundation for Women’s Wellness Dr. Robert M. Carolan Estate of Eleanor and Eastern Propane Gas, Inc. Bow Police Association, Inc. Lindsey K. Collins, MD Dr. Diane Louise Fountas Lynne (deceased) and Norris Cotton Couch Family Foundation Prof. and Mrs. Paul P. Danos Katie Eaton Frank and Mardi Bowles Four Seasons Events Donald Carpenter Richard and Barbara Couch Mr. and Mrs. Craig D. Darling Mr. and Mrs. Robert J. Eckenrode Tawnya L. Bowles Four Seasons Sotheby’s Mr. and Mrs. John B. Carpenter Dr. and Mrs. Brian Crathern Kathleen Darrigo Dr. and Mrs. Mark T. Edney Helen M. Bowman Miller and International Realty Dr. and Mrs. Charles Carr Fred and Sophia Crawford Dartmouth Coach Edwards Lifesciences Glenn S. Miller Joan P. Fowler Rowan A. Carroll Dr. and Mrs. Mark A. Creager David Josef Fashions Jesse C. Edwards, Jr. Bill and Susan Boyle Michael J. Fox Foundation for Brain and Behavior Research Mr. and Mrs. Francis Casale Marilyn R. Crichlow David Middleton Photography Eichenauer USA Parkinson’s Research Foundation Dr. Kristin Pisacano Casale and Crohn’s & Colitis Foundation of Castle N. Day Mr. and Mrs. Eric Y. Eichler Patricia J. Frankenfield Francis Casale America Renee Brandon DCU for Kids Eisai Inc. Franklin Savings Bank Annual Mr. and Mrs. Barney L. Brannen III Casella Waste Systems TRANSFORMING Dr. Jack L. Cronenwett Dead River Company Eduardo Elejalde Charity Softball Tournament Braucher & Amann PLLC Dougal M. Casey Daniel H. Crook and Raymond A. DeFelice Eli Lilly and Company Fraternal Order of Carla R. Sandstrom Dr. and Mrs. Marc F. Brazie Drs. Leo and Joy Cass Gordon and Shirley DeFoe Midge and Tim Eliassen Eagles Club 1464 Care for Patients with E. J. Cross Foundation Thomas F. and Patricia A. Brennan Dr. and Mrs. John E. Castaldo Demers, Blaisdell & Prasol Estate of Carol A. Elliott Mr. and Mrs. Ronald D. Frauton Mrs. Courtland Cross Mr. and Mrs. Stanley J. Bright Catholic Medical Center James M. Demers Mr. and Mrs. Eric J. Ellis Mr. and Mrs. Thomas J. Frawley Dr. and Mrs. John F. Crowe Barbara K. Bristol Celebrations Distinctive Catering Serious Illnesses Bruce R. Denis Dr. and Mrs. Robert M. The Hon. and Mrs. Louis J. Freeh Judy and Tom Csatari Bristol-Myers Squibb Company Celgene Corporation Susan Dentzer, D’77, P’16, P’22 and Ellsworth KRFrench Family Foundation CSD Sealing Systems North Bristol-Myers Squibb Foundation Centene Management Company Charles Alston, P’16, P’22 Mr. and Mrs. Charles P. Mr. and Mrs. Calvin W. Frese, Jr. LLC America LLC Emerson, Jr. Jennifer M. and Since it opened its doors almost two years ago, the Derry Sports & Rehab Jane Friedensohn and Cumberland Farms Peter R. (deceased) Brock Dr. Mary Dickinson Chamberlin Devine, Millimet & Branch, P.A. Mr. and Mrs. Edward E. Richard Horsch Jack Byrne Center for Palliative & Hospice Care has Drew and Penny Cunningham Emerson, Jr. Peter Brock and Anna Kondolf Drs. Steven H. Chapman and Mr. and Mrs. Jesse F. Devitte Leopold Friedman & Catherine D. Shubkin provided personalized care in a homelike environment Dr. Sandra J. Cunningham Encompass Health Ruth Friedman Foundation Steven H. Brock William E. Dewhirst, MD and Drs. Dale B. and Mary E. Chappell John A. and Judith A. Currier Endowment for Health Roger B. Friend Jane Brock-Wilson to over 600 patients with serious illnesses and their Patricia G. Dewhirst Dr. Jocelyn D. Chertoff Phil and Jane Currier Energy Efficient Investments Mr. and Mrs. James J. Fronheiser Dr. Carlene H. Broderick families. Construction of the Jack Byrne Center was Dr. and Mrs. Robert M. Di Mauro Mr. and Mrs. John C. Chester, Jr. Mr. and Mrs. Robin C. Curtiss John S. Engelman Carolyn and Milton Frye Dr. Mark J. Brodkey made possible by philanthropy, and generous donations Dr. and Mrs. Samuel Dicapua Children’s Fund of the Upper Valley Christofer Curven and Anne Engen FUJIFILM Dimatix Marlene Brody Mr. and Mrs. Dickenson Children’s Prize Foundation continue to support the vital work of staff and Kristyn Wallace Epic Dr. Ann Furtado Drs. W. Blair Brooks (deceased) Cheryl Dickson Customink LLC and Nancy Philips Children’s Tumor Foundation volunteers who help every patient live well as life draws Digital Federal Credit Union Zeid Essaid Cystic Fibrosis Foundation Mrs. Arthur K. Brown Child’s Play Charity to a close. The Jack and Dorothy Byrne Foundation Dr. James A. DiNardo Evans Group g Cystic Fibrosis Foundation John Willoughby Brown Chill Cares has made an additional $2 million gift to establish an Mr. and Mrs. Jeffrey A. Dionne Doug and Betsy Evans Dr. Tisha Gallanter Therapeutics Dr. Mark W. Brown Drs. Homer L. S. Chin and Frank J. Dluzniewski Joyce and Robert Evans Peter Gamble Xubo Song operating endowment for the Center, helping to ensure Mr. and Mrs. Scott S. Brown Trey and Amy Dobson Mr. and Mrs. George H. Evarts Gap, Inc. Mr. and Mrs. David Chinn, Jr. that the special programs and services offered at the d Brown’s Furniture and James M. Dobson (deceased) EverGreen Capital Partners, Arthur Gardiner, Jr. and Dr. and Mrs. Yanek S. Y. Chiu Center remain available to patients and families. In D.E.W. Construction Corporation LLC America’s Mattress Cleveland H. Dodge Foundation Robin Nuse (deceased) CHMC Anesthesia Foundation Drs. Lawrence J. Dacey and Eversource Energy Foundation Richard W. Brunelle addition, more than 400 donors made gifts in honor Francis X. Dolan Mr. and Mrs. John M. Gargasz Dr. Kyung H. Chung Linda B. Dacey Executive Health & Sports Drs. Keith R. and Christine J. Bruno of 101 individuals in FY2019. Dr. and Mrs. Emil R. Dominguez, Jr. Mr. and Mrs. William Garrison Anthony C. Daigle and Center Charitable Foundation of the Mary Ann Church Dr. Theodore H. Gasteyer II Julie M. Stevenson Domus LLC Bryant Chucking Grinder Dr. and Reverend Charles M. Exeter Hospital The Patrick and Catherine The Bill and Melinda Gates Company Ciambra Mr. and Mrs. Robert W. D’Alelio ExpressMed Weldon Donaghue Medical Foundation Dr. and Mrs. Aristotle J. Damianos Buchanan Family Foundation Dr. Deus J. Cielo Research Foundation Extra Care Auto Repair Gateway Motors Elena and Jere Daniell

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Dr. Marc Gautier and Jonathan’s Jewelers Kendal at Hanover Drs. John M. and Mike and Nancy Loucks Sarah H. Davie h Robert K. and A. Joyce Jones Dr. and Mrs. Walter C. Kerschl Margaret J. Lagnese Mr. and Mrs. Douglas M. Loudon Matthew P. Haag and Bill Schaefer Dr. and Mrs. Alan B. Gazzaniga Foundation Mr. and Mrs. Robert J. Kerwin Michael J. Lally Philip and Elizabeth Loughlin Mr. and Mrs. Harold Haddock, Jr. GENC Realty LLC Alison Jones/Ken Jones Ski Mart Drs. Thomas J. and Carol A. Lambert Jan Lubbe Mr. and Mrs. Rudolf K. Haerle, Jr. Genentech R E A C H I N G Barbara H. Jones Rebecca L. Kesman Drs. David R. Lambert and Drs. Klaus and Patricia Lubbe James J. Hagan Andrea S. Hinkle General Electric Foundation Sara W. Jones Kettering Family Foundation Luckow Family Foundation Kevin Hagan Lamont, Hanley & Associates Lauren A. Gentile Jordan & Kyra Memorial Drs. William M. and Luebbert Family Charitable Fund at Genzyme-Sanofi Corporation Dr. Tenagne W. Haile-Mariam Children in Need Foundation Cynthia Nichols Kettyle Laura K. Landy and the New Hampshire Charitable Robert P. Corman Geokon, Inc. Jeffrey E. Hale Mr. and Mrs. Patrick F. Jordan III Eglantina Kica Foundation Dr. Carole Lannon Philip George and Mr. and Mrs. Roger W. Hamblin Joy in Childhood Foundation King Arthur Flour Pamela M. Lunny Valerie George (deceased) Mr. and Mrs. Richard C. Hambrick Bruce and Mary King Dr. and Mrs. Nicolas C. Lupus Research Alliance Nancy Morrell is a dedicated supporter of the Child Lansigan, Jr. The Gerber Foundation Mr. and Mrs. Gerard Hamel k Kinney Pike Insurance Nora Lusterio and Advocacy and Protection Program (CAPP) at the Edward Lappen Foundation Michael McFetridge Stacey T. Gerrish Hamill Family Foundation Mr. and Mrs. John P. Kacavas Dr. Kathryn B. Kirkland Children’s Hospital at Dartmouth-Hitchcock (CHaD). Lorena R. Laprade and Estate of Ruth S. and Mr. and Mrs. Donald A. Giffin Dr. and Mrs. Charles Hamlin Louis and Mary Kahn Kiva Foundation Gary A. Florucci Charles B. Lutz Gilberte Interiors Estate of Paul W. Hammond She’s established a planned gift to help fund the vital, Kaiser Permanente KJRASM LLC Laps 4 Backs Bud and Terri Lynch John D. Gillespie and Hanover Inn Dale A. Klemarczyk compassionate work of caregivers who evaluate and Estate of Charles F. Kane, MD Karen Laski Andrea V. Borden Dr. Joseph P. Lynch III Hanson Family Mr. and Mrs. Edwin M. Kania, Jr. Dr. Paul D. Kligfield treat suspected victims of child maltreatment—work Estate of Edward Connery Lathem Aaron W. Lynds Dr. and Mrs. D. David Glass Christopher R. Hanson Knights of Columbus State Kidney that health insurers cover at a rate of only about 10 Crissy Kantor Lavalle Brensinger Architects Global Forest Partners LP Janet T. Hanson Fund Dr. Jonathan E. Kapsten Lavoie Foundation Global Health Initiative Technology percent. Now, she and her son, Justin McLane, have Dr. and Mrs. Karl M. Koenig Mr. and Mrs. Jack R. Harkins Dr. Kristine A. Karlson and m Fund James S. Lawrence Mr. and Mrs. Roswell L. Harlow II teamed up with matching donations to establish a David L. Stiger Kohl’s Department Stores M2S Drs. Peter F. and Global Rescue Kohl’s National Giving Program Dr. and Mrs. Donald A. Dr. and Mrs. Allan C. Harrington CAPP Director’s Fund. Thanks to this fund, CAPP will Karpus Family Foundation Karen R. Lawrence The Goat - Burger Grill and Macdonald, Jr. Mr. and Mrs. Roby Harrington III Samuel L. Katz Susan G. Komen for the Cure Whiskey Bar be able to expand its reach and provide more care to Dr. and Mrs. D. James Lawrie Drs. Anne H. and Lawrence S. Mado R. Macdonald Drs. John and Joyce Harrison Kaufman Family Foundation Drs. William S. Laycock III and Arnold P. Gold Foundation the children who depend on its critical services. Koons Kimberly A. Maclauchlan Kate and Phil Harrison Dr. Vladas Kaupas Kathryn A. Zug Mr. and Mrs. Justin Gold Barbara and Eugene Kopf Mr. and Mrs. Vincent S. Maddi Harrow Sports Dr. and Mrs. Haig H. Kazazian, Jr. Carola B. Lea William Goldman Foundation Suzanne and Robert Kriscunas Mr. and Mrs. Gregory B. Maffei Dr. and Mrs. Orville A. Hartford Timothy and Blythe Keane Dr. Steven Douglas Leach Mr. and Mrs. Jeffrey P. Goodell Charitable Fund Hulda B. Magnadottir Lori R. Hartglass and Dr. William M. Keane Mr. and Mrs. David P. Leatherwood Paul D. Goodhue Thomas R. Kuhns, MD David and Ann Malenka Ralph J. Schwan Keene Uniform Company LeBaron Foundation Dr. and Mrs. David C. Goodman Hirshberg Foundation for Matt Hurley Kurtz Family Foundation Hartland Cooperative Nursery Mallory Portraits Pancreatic Cancer Research Bryan Hussey Mr. and Mrs. James R. Kehoe Dean Francis LeBaron Dr. and Mrs. Philip P. Goodney School Malloy Events Mr. and Mrs. Jeremy P. Hitchcock Charles and Elva Hutchinson Dr. Tibor P. Keler Mr. and Mrs. Stephen J. LeBlanc Dr. E. Ann Gormley and Harvard Pilgrim Health Care l Manchester Country Club Mr. and Mrs. John A. Hochreiter Dr. Colleen E. Kelley and Ledyard National Bank Richard A. Wallace Foundation Mr. and Mrs. Raymond J. Antonino L. Mendolia Laars Heating Systems Company Carla Manley-Russock and Goss-Logan Insurance Agency Dr. Eric K. Hoffer and Hutchinson Dr. Ting David Lee, Jr. Harvest Ace Hardware Marc Labelle (deceased) and Robert Russock Anne W. Gordon Hypertherm HOPE Foundation Dr. Elizabeth A. Kelley and Mr. and Mrs. Cooper Leland Mr. and Mrs. James G. Gottling Harvey Construction Corporation Helene Perrier Mann and Rodgers Funeral Home Dave and Melanie Hoffman Robert H. Dumanois Michael L. Gould Mr. and Mrs. Paul J. Lelievre & Cremation Services Jeffrey Hastings and Gail and James Kellogg Family Fund Laconia Middle School Joseph Hoffman Dr. Paul J. Lena (deceased) W.F. Grace Construction Kathy Emery-Hastings i of the Community Foundation of Paul LaFontaine Drs. Jonathan Mardirossian and Drs. Pamela M. and Marc A. Hofley Grafton County Medical Society Mr. and Mrs. Paul E. Haunfelner IAABO VT Board 105 New Jersey Robert and Barbara Levenson Kathryn McGoldrick Elizabeth Holland Granite State Children’s Alliance Mr. and Mrs. Glenn K. Hauser IBM Corporation Theodore L. Lewis II and Mr. and Mrs. Stephen R. Marion Estate of Helen H. Holland Susan M. Sabia Granite State Police Career Leslie M. Haynes Ignite Bar & Grille MarketReach Mr. and Mrs. Robert D. Holley David B. Lewis Counseling HD Supply White Cap iHeart Media Mr. and Mrs. Clifford J. Marotta Dr. Alison Holmes and Mr. and Mrs. Douglas M. Lewis The Granite YMCA Construction & Industrial Supply Image 4 Ryan Marotta Michael Holmes Brandon Libby, MD Mr. and Mrs. Wayne G. Granquist Bruce and Judy Healey ImmuNext Thomas Marshall Foundation Home Builders & Remodelers Liberty Energy Utilities Green Acres Parent Teacher Group Dr. Anne M. Hebert and Indian Motorcycle Riding Group Therese and Jeffrey Marshall Association of New Hampshire (New Hampshire) Corporation Dr. Alan I. Green and John P. Cooke Granite State Drs. Meredith A. Martin and Mr. and Mrs. John K. Honey Mr. and Mrs. Jason R. Lichtenstein Frances S. Cohen Heilind Electronics Ingram Construction Corporation SCIENTIFIC Thomas L. Treadwell Drs. P. Jack Hoopes and Brian Greenberg Drs. Karen Kramer Hein and George and Dominique Lightbody William and Judith Martin Vicki Scheidt Innogest SGR Robert A. Greene Ralph B. Dell INNOVATION Lightbox Technologies LLC Mascoma Savings Bank Dr. Harriet W. Hopf and Integra Biosciences Corporation Dorothy Behlen Heinrichs and Mr. and Mrs. Donald R. Lightman Estate of Robert J. Greene Leo M. Hopf IOOF Waverly Lodge 59 Mascoma Savings Bank Foundation Jay A. Heinrichs Lignetics of the Web, Inc. Jill and John Schiffman/ Dr. and Mrs. Edward S. Horton The Ironwood Foundation W.B. Mason The Greenspan Foundation Mr. and Mrs. Christian D. Henault Benefits Patients Julia J. and Carl W. Lindquist, MD Amos B. Hostetter III Irving Oil Millicent N. Mason Susan Rosie Greenstein and Dr. Bonnie Henderson and Mary C. Liston Barbara and Amos Hostetter Ivek Corporation Mass Bay Brewing Company Lewis Greenstein Edward Henderson with Cancer Litchfield Middle School Sandeep Mathrani Dr. Eric Henderson and Hotchkiss Law Office PLLC Marge and Ward Ives Dr. and Mrs. Jeffrey S. Greenwald Little Box of Sunshine Ms. Kylene Halloran Dr. John Houde and Gretchen and Roger Maynard Griffin Construction LLC Drs. George and Carol Little Hendricks/Felton Foundation Jennifer Rybeck Houde Gary and Cyndi Mayo Wayne J. Griffin j Dr. and Mrs. Brian H. Livingston Mr. and Mrs. Troy McBride Brett R. Hershey Mr. and Mrs. Christopher Houlihan Joanna R. Jackson The J. Brian and Allie J. Quinn Scholars Fund was Jazmyn M. Griffith Lock and Lube Derik Hertel Mr. and Mrs. Coleman W. Hoyt Tom and Victoria McCandless Hugh and Shana Griffiths Trish Jackson and Will J. Millard established by the Quinn family in 2018 to spur Long Term Care Partners LLC Drs. Seth McClennen and John H. and Thelma K. Hewitt Dr. Jiong-Ming Hu and Yi-Jun Chen Drs. Judith M. and Nicholas J. Mr. and Mrs. Alfred L. Griggs innovation in cancer research. This year, Quinn family Longchamps Electric Martha C. Wu HHP, Inc. Dr. and Mrs. Francis E. Hubbard Jacobs Louise and Walter Griggs Judith A. Longpre Drs. C. Robertson McClung and Robert C. Hickcox and J.M. Huber Corporation Mr. and Mrs. Daniel P. Jantzen friends Ed D’79 and Ann Kania added to the fund with Grimshaw-Gudewicz Charitable Mary Lou Guerinot Jacqueline D. Henry Fund Hudson Police Employee Drs. Garry Jennings and a generous gift in honor of Brian and Allie. The fund Loon Mountain Resort Foundation Cindy McCollum and Robert A. Hickin Association Tramar Murdock-Jennings Dr. and Mrs. Alfred Lopez Julia and Seymour Gross supports Norris Cotton Cancer Center investigators John Spellman Dr. Hoyoung Huh and Drs. Jennifer J. Loros and Foundation Mr. and Mrs. Joe Hill Jewett Construction Company Eleanor I. Park working to transition promising new drugs and devices Jay C. Dunlap James C. McCracken Marlyn E. Grossman Hilton Garden Inn JGS Construction Thomas and Julia Hull from the laboratory to clinical use. Jennifer Lorrain Dr. and Mrs. Jock N. McCullough Hilton Garden Inn Hanover/ JHL Restaurant Group Drs. Margaret F. and Drs. Martha Dawes McDaniel and Lebanon Human Frontier Science Program Los Ninos Children’s Medical Clinic Marshall A. Guill III JJN 2010 LLC Stephen K. Plume Kelly and Andre Hunter Steven R. Losa and GYK Antler Hinckley, Allen & Snyder LLP Dr. David G. Johnson Elizabeth Ashworth Peter and Lori McDermott Prof. Heidi M. Hurd Dr. and Mrs. Stephen J. Johnson

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James and Bridget McGreevy Mountain View Publishing Drs. Glenn Rennels and Mr. and Mrs. Mark F. Schellhorn Dr. O. Ross McIntyre and Mr. and Mrs. James F. Mrazek o p Margaret Forsyth Jill and John Schiffman Mr. and Mrs. James M. Oates Emanuel A. Pacheco Helen Whyte Dr. and Mrs. Gilbert F. Mueller, Jr. Residence Inn by Marriott Mr. and Mrs. Mark C. Schleicher Louise O’Brien Marilyn M. Paganucci McKelvie Intermediate School Dr. and Mrs. G. Arnold Mulder Mr. and Mrs. Eric C. Resnick James and Kellie Schneider Robert P. Odell, Jr. Estate of John S. Paine Abigail McKenna Dr. and Mrs. David L. Muller Resource Systems Group Mr. and Mrs. Jonathan M. Schofield Dr. and Mrs. Joseph F. Nancy Sandelin Paisley OPTIMIZING Mr. and Mrs. David M. McKenna Richard C. Munn and Carin G. Reynolds Mr. and Mrs. Merle W. Schotanus O’Donnell, Jr. Palace Theatre Martha McLafferty and Holley M. Eaton Grant and Jo Reynolds Drs. Scott and Lisa Schubach Jonathan Skinner Dr. Makio Ogawa James Palastra Muscular Dystrophy Association Hospitalization of Dr. and Mrs. Jason E. Reynolds Steven and Sandra Schubert McLane-Harper Family Charitable Andrea and John Ogden Christopher P. Parios and Miles and Patrice Mushlin Mary E. Reynolds Anne Schuchat Foundation, Inc. Mary A. O’Grady Susan L. Wyant My Brigadeiro Roedel Companies Drs. Gary and Lynn Schwartz Peter McLaughlin and Ohiyesa, Inc. Dr. and Mrs. Steven Paris Newborns Myrtlewood Foundation, Inc. Dr. Thomas C. Ribovich Mr. and Mrs. Michael R. Schwartz Jane Kitchel McLaughlin Dr. and Mrs. Ernst M. Oidtmann Mr. and Mrs. Ernest C. Parizeau Michael Rice Paul Schwartz and Daphne Petri Mr. and Mrs. Bruce C. McLaughry Oliver Mechanical Bradley Parker The Richards Group Mr. and Mrs. Robert L. Schwartz Mr. and Mrs. William McNabb n Mr. and Mrs. Peter Oliver Dr. and Mrs. George W. Parker Jennifer A. Nachbur and Neonatal intensive care units (NICU) have greatly Dr. and Mrs. John E. Richards, Jr. Joseph and Nannette Schwartzman Karina B. McNamara Dr. George D. Olsen and Pauline and Henry W. Parker Mark A. Farrell reduced newborn mortality and morbidity, but many Peter M. Richards The Berthold T. D. and Thyra The Sydney Meaghan Memorial Deborah M. Olsen Philip F. F. Parshley, Jr. Foundation Corporation Nashua Ambulatory Surgical Ricoh-USA Schwarz Foundation Omni Hotels & Resorts Patient-Centered Outcomes aspects of care quality, outcomes, and efficiency remain Center Ride and Ski New England Eric R. Schwarz Dr. and Mrs. Kenneth R. Meehan Mr. and Mrs. Cedric F. Onsruth Research Institute (PCORI) Nashua Police Patrolman’s poorly understood. Previous studies have found that The Melanson Company Margaret and Matt Rightmire The Albert Schweitzer Fellowship Association Mr. and Mrs. David B. Openshaw Dana Patterson 1991 Revocable differences in NICU length of stay are unexplained Kathleen S. Riley Scleroderma Foundation Mellam Family Foundation Oracle America, Inc. Trust #1 NASPGHAN Foundation by health status, but instead reflect differing practice New England Dr. Vincent A. Memoli Amber J. Patterson Fannie E. Rippel Foundation National Multiple Sclerosis Society Oracle Corporation styles. Supported by a generous award from the Rise Private Wealth Management Scleroderma Research Foundation Memorial School, Newton, NH Orchard Surgical Center LLC Mr. and Mrs. Andrew Paul William and Lisa Nelson Robert T. and Joan M. Scott Dirk B. Mendel and Jill E. Paul Kettering Family Foundation, researchers from The William and Sharon Risso Linda L. Nelson Melissa J. Ordway Dr. Nancy K. Mak River Valley Club Mr. and Mrs. Thomas A. Scully Dr. P. Pearl O’Rourke Melinda and Norman Payson Dartmouth Institute for Health Policy and Clinical Drs. William Nelson and Seabrook Professional Firefighters Merck Sharpe & Dohme Prof. Donald E. Pease and Gloria King Merritt Paula Schnurr Orthopaedic Research and Practice will study variation in NICU length of stay. Charity Corporation Patricia McKee The River-WXRV & Oldies-WKBR Scott A. Neslin Education Foundation Dr. Edward and Margaret Merrens The research team hopes their findings will identify Mr. and Mrs. John K. Seaver Orthopaedic Specialists of Dr. Vincent D. Pellegrini, Jr. The Rizio family New England Patriots Foundation Mr. and Mrs. Bruce P. Seely Carol M. Merrill Scottsdale Abbie E. and Donald W. Penfield opportunities to optimize, and perhaps reduce, length Dr. and Mrs. Andrew B. Roberts New Hampshire Comprehensive Carolyn and Peter Mertz Seipmann Foundation Cancer Collaboration Estate of Dr. Barbara M. Osborne S. Richard & Patricia R. Penni of newborn hospital care. Dr. and Mrs. David W. Roberts Metro Aviation Charitable Trust Charles L. Sentman New Hampshire Distributors LLC David and Mary Otto Mr. and Mrs. Dana R. Robes Metro Walls Dr. and Mrs. Joseph Pepe Mr. and Mrs. Brian J. Sevigny New Hampshire Fisher Cats John P. Otto and Dr. and Mrs. Paul D. Robinson, Jr. Mr. and Mrs. Robert S. Meyer Joanne C. Lorence Frances Pepper Dr. John L. Seymour, Jr. New Hampshire Industries Mr. and Mrs. Dorian L. Rodizza Michael and Deborah Meyers Mr. and Mrs. David E. Ovens Mr. and Mrs. Bernard J. Perry III Dean J. Shapiro New Hampshire Interlocal Trust Rick and Linda Roesch Mr. and Mrs. William C. Michels Mr. and Mrs. Jon Owyang Verna M. Perry-Beliveau John M. Shapiro Charitable Trust New Hampshire Musculoskeletal Dr. and Mrs. Scott W. Rogge Peterson Center on Healthcare Project Blackout Edward J. Shaughnessy Mr. and Mrs. David W. Middleton Institute/Safe Sports Network Pete and Gerry’s Organics LLC Peter D. Roos Promosis, Inc. Adalbert F. and Mavis Shaw Milford Lumber Company New Hampshire PBS Pfizer Foundation Dr. Joseph M. Rosen and Mr. and Mrs. Joseph Proulx Mr. and Mrs. Edward W. Sheehan The Mill Foundation New Hampshire Prostate Cancer Pfizer, Inc. Stina L. Kohnke Dr. and Mrs. Matthew T. Mr. and Mrs. Roger Shepard Millennium Running LLC Coalition Pharmalogic Holdings Corporation Provencher David A. Rosenblum Mr. and Mrs. E. Michael Shipulski Dr. and Mrs. Peter J. Millett New Hampshire Steel Fabricators Mr. and Mrs. Willis J. Phelps Mr. and Mrs. Robert Prunier Dr. Kari M. Rosenkranz Shmaltz Brewing Company Mr. and Mrs. Peter H. Milliken New Hampshire Troopers Dr. and Mrs. Ervin Philipps Mr. and Mrs. Dorjan S. Puka Marlene G. Rotering Association Steven S. Siegel Milne Travel Mr. and Mrs. Darrell J. Philpot Mr. and Mrs. John L. Putnam Mollie M. Roth New Hampshire Union Leader Dr. and Mrs. Bruce Sigsbee Mr. and Mrs. Jeffrey Milne ADVANCING The Phinehas Corporation Neil A. Roth and Cheryl Boghosian New Hampshire Women’s Golf Devin N. Silovich Mint Bistro PhRMA Lia and Rich Rothstein Association q Mr. and Mrs. Jeffrey A. Silvestro Mittersill Alpine Resort Dr. Bradley P. Pickett Dr. Erin E. Rowell and Brian K. Newcomb Health Equity QLLA Charities, Inc. Christopher W. Schmidt Dr. and Mrs. Nathan E. Simmons Dr. and Mrs. Gary S. Moak Liz and Bill Pierce Newport Firefighter’s Association Sarah Quade, Rachel Dow, Mr. and Mrs. Joel M. Rudell David S. Simon Dr. and Mrs. John F. Modlin Rose Knaus NFI North Anne Pignatiello Moe’s Southwest Grill Joan D. Rueckert Kathryn Simonds NH Grand Chapter Order of the Worldwide Pinard Waste Systems Moglia Family Foundation Elizabeth Ruml Todd B. Sisitsky and Eastern Star Pinnacle Mortgage Corporation r Holly R. Hagens Estate of Donald J. Molick Peter L. Rutledge NH Chapter of AAP Winthrop D. and Mundy W. Piper Drs. Scott C. Rackett and Sarah J. and C. Partridge Rutledge Skating Club at Dartmouth Monarchs Care Foundation Mylien S. Pham Nike Philanthropic gifts from four families totaling $7 million Planet Aid SkillSoft Corporation Gordon and Betty Moore Dr. Amanda G. Ryder and John A. Niles Charles Plimpton and Rajamani Ramani Foundation will accelerate the growth of Dartmouth’s Center for A. Evan Newell The Skinny Pancake Dr. Bruce C. Nisula Barbara Nyholm Mr. and Mrs. Christopher Ramsden William G. Moore SLC Group Holdings LLC Global Health Equity (CGHE) by bringing together thriving Dr. Titus Plomaritis Drs. William H. Ramsey and Dr. and Mrs. Patrick C. Noble Crystal L. Smart Dr. and Mrs. John M. Moran international and domestic health equity programs at Mr. and Mrs. Alan E. Plumb Carolyn Rochester Ramsey s Dr. Brian W. Nolan Dr. Barry D. Smith Morgan Stanley and Company, Inc. Phil Plummer Ramunto’s Brick & Brew Pizzeria Safco Management, Inc. Jeanne M. Norris the Geisel School of Medicine and Dartmouth’s Dickey Dan and Hannah Smith Morgan Stanley Global Impact Brian Pogue and Jane Henry Bennett E. Rathbun St. Denis Church-Hearts Funding Trust Northeast Credit Union Center for International Understanding. Since 2013, the Open to the World Dr. Jacqueline Y. Smith Lawrence H. Pohl Bruce Ratner Morgan Stanley Smith Barney LLC Northeast Delta Dental CGHE has prepared Geisel students to become leaders Mr. and Mrs. Biria D. St. John Paul W. Smith Mary C. and Joseph A. Poisson Mr. and Mrs. Arthur I. Rauch Mr. and Mrs. Eric J. Morgan Northern New England Clinical Orson L. St. John, Jr. Dr. Sae I. Smith and Evan A. Smith Oncology Society in health equity, built robust reciprocal relationships with Mr. and Mrs. Charles Poor Raymond Post 90 American Legion Nancy L. Morrell St. Johnsbury Academy Drs. Timothy Smith and Dr. Mark R. Northfield international partners, and drawn together faculty and Mr. and Mrs. Robert L. Pope Red Hat, Inc. Dr. Michael F. Morris The Salmon Foundation Barbara Vance Kelley Norton staff from across Dartmouth to advance health equity Positive Tracks Ann M. Redican Randall H. Morse David J. and Christina L. Saltman Wendell & Ginger Smith Family Norwalk Wilbert Vault Mr. and Mrs. F. Herbert Prem, Jr. Amy Redpath Foundation Mr. and Mrs. John M. Morton among diverse communities worldwide. These donations John and Karen Sanders Company LLC Mr. and Mrs. James K. Prevo Mr. and Mrs. Edward L. Redpath SMJ Financial Services LLC Michael S. Morton and will expand student opportunities to participate in global Rhonda A. Sargent Norwich Partners LLC Kimberly Price Dr. and Mrs. John B. Reed SNHU Arena Daniela E. C. Ligett health equity projects in locations such as Greenland, Mr. and Mrs. W. Bryan Satterlee Norwich Technologies, Inc. Prime Motor Group Drs. Lester A. and M. Estelle Reid P. Michael Snide Mosquito Shield of SNH Mr. and Mrs. Richard Sayles Marcy A. Nott Tanzania, and Kosovo. Dr. Roderick E. Prior Andrea Reimann-Ciardelli and The Society for Cardiovascular Mt. Roeschmore Foundation The SCAN Foundation Pro-Cut International Limited Dr. Thomas L. Ciardelli Angiography and Intervention Matthew Schecter

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Society of Family Planning Mr. and Mrs. Robert J. Weissman Research Fund t v Mr. and Mrs. Richard A. Mr. and Mrs. Kenneth S. Solinsky J. T. Tai & Company Foundation Mr. and Mrs. James D. Vail Weissmann Arthur P. Solomon and Drs. Mojdeh and Farhad Talebian Mrs. James D. Vail III WellPoint Foundation Sally E. Lapides Peter J. Tannini John F. Vail Wells Fargo Financial Advisors Kurt F. Somerville Drs. Susanne E. and Dr. James C. Vailas Wells Fargo Foundation William J. Tanski Sons of the American Legion, R. L. Vallee, Inc. dba Maplefields Wells River Savings Bank Squadron #7 Sheila Harvey Tanzer Valley Originals Wendy A. and Robert L. Wells, Jr. Mary B. Sorensen Marlene and Eric Taussig Mr. (deceased) and Beth West South County Pulmonary Medicine Bruce and Anne Taylor Mrs. Robert W. Valpey Estate of Franklin H. West John T. Souther Jack and Christine Taylor Drs. Teresa A. Van Buren and Dr. Loyd A. West and Henry T. Sachs III Dr. Julie Southmayd and Team Tony Cancer Foundation/ H. Sloane Mayor J. Peter Rizzo Coming Together Against Cancer Mr. and Mrs. Carroll T. VanHooser Dr. and Mrs. Craig R. Westling Southwest Airlines Mr. Gregory M. Telge Mr. and Mrs. Timothy W. van Leer Phil and Donna Wheeler Dr. Harold Sox, Jr. and Prof. Estate of George Teloian Dr. Dirk J. van Leeuwen Frederick E. Whitcher Carol H. Sox Dr. Paul A. Testa Mr. and Mrs. Davis Van Winkle White Mountains Insurance Group Speedway Children’s Charities Shawn Tewksbury Jim and Cindy Varnum White River Valley School Paula Ness Speers and Dr. and Mrs. Charles A. Thayer Karen M. Veinotte Mark S. Speers Dr. and Mrs. Jon C. White Mildred N. Thayer Ronald and Susan Verge Spirit of Children Fund Wicks Insurance Group Mr. and Mrs. Jason D. Thom The Vermont Country Store Alicia Willette, DDS ___ Dr. Peter Spiegel and Kevin R. Thornal Vermont Law Enforcement Peregrine Spiegel Dr. and Mrs. Benjamin B. Williams Drs. Robert L. and Shari L. Thurer Hockey Charities, Inc. and Lydia S. Spitzer Vermont Police Association Jennifer A. and Stanton N. Williams Timken Company Charitable Trust Mr. and Mrs. John P. Stabile II Vermont Law School Debra L. Williamson Stu Timken Terrance F. Stadheim Vermont Mutual Insurance Ben Willwerth and Betsy Blume Elizabeth H. Tine Mr. and Mrs. John M. Stadler Group Marie C. and Joseph C. Wilson Jay A. Tome Stanley Elevator Company, Inc. Anne-Lee Verville Foundation TooCap Foundation Stave Puzzles Mr. and Mrs. Matthew H. Viens Dr. and Mrs. Peter M. Witherell Topnotch Resort Drs. Stephen Stein and Emily Fine The Village Trestle JoAnne Withington TORCH (The Organization for Jeffrey Steinkamp VIP Tires & Service Mr. and Mrs. J. Alan Witmer Renal Care in Haiti) Dr. Margot D. Stephens and Dr. and Mrs. Frank R. Virnelli WMUR-TV ABC 9 Mr. and Mrs. Eben J. Tormey Thank John G. Stephens Dr. and Mrs. Robert M. Vogel Mr. and Mrs. Daniel H. Wolf Drs. Tor and Anna Tosteson Tom and Susan Stepp Nancy R. Vogt Mr. and Mrs. Marc B. Wolpow Town of Canaan, NH Drs. Michael and Maxine Stevens Mr. and Mrs. Peter F. Volanakis Dr. Sandra L. Wong Mr. and Mrs. Matthew T. Toy Robert and Elizabeth Stevens Dr. Matthew D. Wood and David H. Trask Mr. and Mrs. Bayne Stevenson w Allison R. Ellsworth TriPyramid Structures Mr. and Mrs. James Woodley Ryan L. Stewart Dr. and Mrs. Jon W. Wahrenberger Jeff Troxell Woodstock Farmers’ Market Mr. and Mrs. James M. Stoff Lucy R. Waletzky, MD Jennifer B. Truman Donna J. Wright Matthew E. Stoller and The Walking Company Melissa A. Powell Trumbull Hall Troupe President Emeritus James Wright Walmart Foundation Elizabeth T. Stragnell Turbocam Automated Production and Susan DeBevoise Wright You Systems Wal-Mart Stores Dr. and Mrs. James C. Strickler Mr. and Mrs. Joshua B. Wright Turner Construction Company Dr. and Mrs. Daniel B. Walsh Stephanie J. Stringos Mr. and Mrs. A. Bradford Wyman Mr. Andrew Twite Jonathan D. Walsh and Mr. and Mrs. William W. Wyman Stromgren Plumbing & Dulce Donovan Heating Co., Inc. Tyler, Simms & St. Sauveur, P.C. Gary G. Wyne ___ Mr. and Mrs. Liam Walsh Mr. and Mrs. Scott M. Stuart Mr. and Mrs. Patrick W. Walsh Mr. and Mrs. Emanuel R. Sturman u x Mr. and Mrs. Steven Y. Walsh Brady Sullivan Properties LLC Ulysses Holdings Jim Xhema Dr. Joseph Walters Summit Distributing LLC Mr. and Mrs. William R. Underhill John E. Xiggoros Dr. and Mrs. Thomas N. Ward Lois H. Surgenor Union Mutual Fire Insurance Dr. Feiyu Xue and Fang-Mei Chen Michael E. Warren Stephen and Gina Surgenor Company Arthur K. Watson Charitable Surgi-Care Sales LLC University System of New Hampshire Lead Trust y Dr. and Mrs. Arief A. Suriawinata University of Vermont Walter H. and Hannah H. Webb Dr. and Mrs. G. Neil Yates Dr. and Mrs. Jeffrey L. Susman Medical Center Family Foundation Dr. and Mrs. Philip A. Yazbak Jeff Sutton University of Vermont and Bernadina M. Webber Dr. and Mrs. Oglesby H. Young Dr. and Mrs. Rand S. Swenson State Agricultural College Kenneth E. and Carolyn L. Weg Laurie S. Swett Unum Group Mr. and Mrs. Keith Weigand z Buffy L. Swinehart USA Gymnastics Vermont Dr. and Mrs. James N. Weinstein Dr. Cathy J. Zack and John Holahan Ann H. Symington Foundation The Weir Family Robert Zwolak, MD Thank you, to all our donors, Richard D. Weis Dr. and Mrs. Frank M. Weiser for your caring and generosity.

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th

25anniversary

Since 1994, the Dartmouth-Hitchcock Advanced Response Team (DHART) has been providing both air and ground specialized emergency medical transport services throughout Northern New England, for adults, children, and neonatal patients. DHART is one of the most visible examples of Dartmouth-Hitchcock’s commitment to bringing the full power of its expertise to provide the best possible care to patients, people, and communities across the region. Mark Washburn Mark