MCG

FALL/WINTER 2014 at Georgia Regents University Salt Wars Researchers Battle Sodium Retention FALL/WINTER 2014 MCG MCG Medicine is produced biannually by the Georgia Regents University Office of Communications and Marketing with financial M D support from the Medical College of Georgia at GRU. e icine at Georgia Regents University Medical College of Georgia 11 Salt Wars Researchers Battle Sodium Retention

springing into action...... 17 Skull Procedure Ensures Healthy Brain Growth

brush with death...... 21 Alumna’s Cancer Inspires Lifelong Commitment to Altruism

welcome!...... 25 J. Harold Harrison, M.D. Commons Opens Its Doors

a great legacy...... 27 Inaugural Harrison Scholars Begin MCG Education

a foundation of excellence...... 29 MCG Foundation Celebrates 60 Years of Success

a mountain to climb...... 33 An Essay by Dr. Alan Kaplan (’82)

DEPARTMENTS 4 News at a Glance 7 Newsmakers 9 Research Roundup 37 Faculty Spotlight: Dr. richard schwartz 43 Links in the Chain 45 Education Update 47 Class Notes 50 Alumni Affairs Update Dean: Peter F. Buckley, MD

Chief of Staff:Jeanette Balotin

Interim Vice President, Communications and Marketing: Jack Evans

Executive Editor: Toni Baker

Senior Editor: Christine Hurley Deriso

DESIGN & PRODUCTION P.J. Hayes Design

PHOTOGRAPHY Senior Photographer: Phil Jones

The Medical College of Georgia at Georgia Regents University does not discriminate on the basis of race, color, national origin, sex, disability, religion, age, veteran status, gender identity or expression, or sexual orientation in its programs and activities as required by Title IX of the Educational Amendments of 1972, the Americans with Disabilities Act of 1990, Section 504 of the Rehabilitation Act of 1973, Title VII of the Civil Rights Act of 1964, and other application statutes and university policies. gru.edu/mcg © 2014 GEORGIA REGENTS UNIVERSITY

WHITE COAT 2014

MCG’s first-year students marked the beginning of their medical careers at the 2014 White Coat Ceremony Oct. 11 at Augusta’s Bell Auditorium. The ceremony symbolized the 230 students’ transition into medical school. The MCG Foundation funded the coats. From the Dean

None of us haS to imagine stress; most of us finding solutions that will translate to a healthier live with it throughout our busy days and lives. life for many. Their work will clearly help the 30 But imagine, if you would, that after a stressful percent of blacks and 15 percent of whites who live encounter has passed, your body inexplicably held with impaired sodium excretion as it provides more onto the sodium you needed to drive your blood insight into the even more pervasive problem of pressure up just long enough to get through that hypertension. moment. Speaking of pioneers, Dr. Richard Schwartz In some very young adults, those moments can has roamed many ranges in his day, both as a drag into an hour or more, keeping their blood medical officer working with U.S. Army Special pressure elevated far longer than normal. Imagine Forces and, even as we speak, providing medical adding obesity to this risky scenario. support to Federal Bureau of Investigation field Armed with a $10.6 million Program Project operations, including hostage rescue. Our Chairman grant re-renewal from the National Institutes of of Emergency Medicine has definitely made Health, our Georgia Prevention Institute, under the some serious contributions to the safety of us all, leadership of Dr. Gregory Harshfield, is working including helping fine-tune disaster preparedness in with hundreds of young individuals to try to piece this country and beyond. together why this happens and how we can help In this edition of MCG Medicine, you also will keep these young people healthy. learn about the amazing strength and insight of Harshfield is an absolute leader in the field of Drs. Alan Kaplan (’82) and Jacqueline Fincher (’85), sodium retention and hypertension. A dozen years who had different battles to fight and win. ago, he presented the concept of impaired sodium You will read how Drs. Jack Yu and Ian Heger excretion to the 17th Annual Scientific Meeting of the were the first in the nation to use a commercially American Society of Hypertension. With the help of available spring to restore more natural growth to medical student Evan Mulloy, he more recently gave the skulls of babies with prematurely fused growth us an easy way sites. to identify these You will learn more about our MCG Foundation, individuals: which has for 60 years defined dedication and take a urine support of your medical school. You will see sample and pictures of the new J. Harold Harrison, M.D. blood pressure Education Commons, a beautiful and lasting measure before testament to what can be done when our and after a foundation and so many of you work together to doctor’s visit. support your medical school. One student, Lauren Harshfield Titus, recently said it so succinctly after her first and his team visit to the new building: “It feels like the Medical are making College of Georgia.” tremendous We hope you feel the same. With your continued strides in support, MCG will feel great. n understanding the problem and

PETER F. BUCKLEY, MD 706-721-2231 [email protected]

3 MCG medicine News at a Glance

Top Docs

Fourteen MCG physicians are included in the 13th edition of “America’s Top Doctors,®” a national patient reference guide published by Castle Connolly Medical Ltd. that identifies the top 1 percent of doctors in the nation by specialty. Georgia Regents Medical Center is the only hospital in the Augusta-Aiken area with physicians included in this list: GRU President Dr. Ricardo Azziz, reproductive endocrinology and surgery; Dr. Sharad A. Ghamande, gynecology/ denise kornegay oncology; Dr. David C. Hess, neurology; Dr. Sheldon E. Litwin, ahec leader rural incentive cardiovascular disease;

Denise Kornegay, Executive Director of the Georgia MCG is teaming with AHEC to offer Dr. Walter J. Moore, Statewide Area Health Education Network based The Georgia Preceptor Tax Incentive rheumatology; at Georgia Regents University, is the inaugural Program, which allows physicians Dr. Julian J. Nussbaum, Associate Dean for AHEC at MCG. statewide to be the first in the nation ophthalmology and vitreo- AHEC is a health workforce pipeline program to claim a state tax deduction for retinal disorders; that encourages student interest in the health their service as volunteer educators. A Dr. Gregory N. Postma, professions and helps secure and maintain $1,000 deduction applies to each core voice and swallowing education sites with physicians and other health rotation they provide for third- and disorders; professionals across the state. fourth-year medical students, as well as Dr. Satish S. C. Rao, “Our medical school and AHEC have overlapping students enrolled in nurse practitioner gastroenterology; interests and missions in ensuring that our state and physician assistant programs at Dr. Kapil D. Sethi, has adequate numbers of exceptional health care accredited state public or provide neurology; providers,” said MCG Dean Peter F. Buckley. “AHEC universities. Dr. Sandra G. B. Sexson, and Denise have been invaluable in identifying Core rotations provide 160 hours of child and adolescent students interested in the health professions and in training in internal medicine, pediatrics, psychiatry; helping us develop learning opportunities for our obstetrics/gynecology, psychiatry, family Dr. Robert A. Sorrentino, medical students with physicians across our state. medicine, emergency medicine, and cardiac electrophysiology; This strengthened role with our medical school general surgery. The deduction cannot Dr. David J. Terris, thyroid will enable and encourage the future success of exceed $10,000 annually. and parathyroid surgery; Dr. programs that are good for the well-being of our “This is available to community-based Martha K. Terris, urology; state and our medical school.” faculty who are not being compensated Dr. Jack C. Yu, pediatric Kornegay, who has directed the Georgia AHEC in another way,” explains Kornegay. “This plastic surgery. for nearly 20 years, received the National AHEC’s is a great way to incentivize community Ghamande, Dr. David 2014 Eugene S. Mayer Program of Excellence physicians across Georgia, particularly in Terris, and Dr. Martha Award. She is an Associate Professor in the MCG rural areas, to train the next generation of Terris were also named to Department of Family Medicine and Assistant health care providers.” n “America’s Top Doctors for Professor in the Mercer University Cancer®” in 2014, ranking in Department of Family Medicine and For more information, visit the top 1 percent of cancer n Community Medicine. n gru.edu/ahec/ptip or call 706-721-8331. doctors in the nation.

FALL/WINTER 2014 4 3 Chairmen Named

Department of Anesthesiology and Perioperative Medicine Department of Neuroscience and Regenerative Medicine Dr. Steffen E. Meiler is the new He is working to strengthen basic Chairman of the Department of and clinical research in the department, A Department of Neuroscience and Anesthesiology and Perioperative which now ranks in the top 20 nationally Regenerative Medicine that further Medicine. in federal funding. Other plans include strengthens research and educational Meiler, an anesthesiologist, internist, adding fellowships in pediatric and endeavors in neurological and psychiatric and critical care specialist, came to MCG cardiothoracic anesthesiology and disease has been established at MCG. in 2002 from Massachusetts General e-learning and simulation opportunities Dr. Lin Mei, a neuroscientist and expert Hospital and Harvard Medical School for residents and students. Clinical in brain cell communication who has as the department’s Vice Chairman for enhancements will include remote directed MCG’s Institute of Molecular monitoring of intensive care patients and an enhanced, evidence-based perioperative care plan for all patients receiving anesthesia. Meiler is Co-Director of the GRHealth Perioperative Executive Team, Chairman of the GRHealth OR Committee, and a member of the MCG Clinical Translational Science Advisory Committee and MD/ PhD Admissions Committee. He researches genetic and pharmacological therapies for sickle cell disease. Meiler is a member of the Executive Committee of the Medicine and Genetics for six years, is the National Institutes of Health-funded inaugural Chairman of the department Nanomedicine Center for Nucleoprotein that also is pursuing the restorative Machines at the Georgia Institute potential of stem cells. of Technology, which is pursuing “Neurological and psychiatric disease nanomedicine-based gene correction has significant, lasting, and frequently technologies for sickle cell disease. His devastating effects on our citizens,” collaborative, federally funded studies said Dean Peter F. Buckley. “Under at MCG are exploring ways to help sickle the leadership of Dr. Mei, this new cell patients avoid kidney and lung department will further strengthen our damage and pain. already significant contributions in this Research and Director of the Program Meiler is a graduate of the Johann field.” of Molecular Perioperative Medicine and Wolfgang Goethe University School Focus areas include innovative Genomics. Most recently, he was named of Medicine in Frankfurt, Germany translational research, medical and Interim Executive Vice Chairman. and spent 11 months at The Ohio State graduate student education, and “Dr. Meiler is an exceptional physician- University College of Medicine as a postdoctoral mentoring. Goals include scientist, educator, and collaborator who visiting medical student on scholarship. expanding teaching responsibilities leads by example with a steady and clear He returned to Ohio State for a to include undergraduates at GRU’s sense of purpose,” said Dean Peter F. research fellowship in heart failure. He Summerville Campus and pursuing Buckley. “We are very pleased that he also completed an internal medicine federal support for a graduate-level has assumed this new leadership role at and anesthesiology residency at neuroscience training program. About our medical school.” the University of Iowa Hospitals and 60 postdoctoral fellows and students are Meiler calls his specialty a team Clinics and a critical care fellowship at working with the department’s 26 faculty sport and anesthesiology a department Massachusetts General Hospital and members. without borders that will continue to Harvard Medical School. He completed Dr. Carlos M. Isales, who has served reach out to the talent of the university research fellowships in molecular as Chief of the institute’s Program in and beyond to ensure success in a time genetics and gene therapy at Harvard’s Regenerative Medicine, is Vice Chairman of unprecedented legislative, regulatory, Cardiovascular Research Center. n of Clinical Affairs of the new department. and payment changes. Drs. Darrell Brann, Associate Director of

5 MCG medicine News at a Glance

the Institute of Molecular Medicine and Department of Otolaryngology - Head and Neck Surgery Genetics, is Vice Chairman of Academic Affairs. Dr. Stilianos E. Kountakis is the “These terrific leaders will work new Chairman of the Department of closely and collaboratively with Drs. Otolaryngology-Head and Neck Surgery. David Hess and Cargill Alleyne in Kountakis has served as department our Departments of Neurology and Vice Chairman for more than a decade Neurosurgery as well as Dr. Joe Tsien and directed the MCG/GRU Rhinology in the Brain and Behavior Discovery Fellowship and Otolaryngology Residency Institute and many others across our Program as well as the Georgia Sinus campus and the world to advance our Center at GRHealth. He also has served understanding and treatment of the as Chief of the Department’s Section brain,” Buckley said. “Collectively, these of Rhinology-Sinus Surgery and led GR strategic realignments enhance our Medical Associates, the group practice for focus on neuroscience across clinical, MCG physicians, from 2010-12. basic science, and translational realms.” As Chairman, he is continuing to direct Said Mei, “We believe this is the right the Rhinology Fellowship and Georgia time to form a department with a focus Sinus Center. on research and educational initiatives “Dr. Kountakis is an exceptional in the brain as well as regenerative surgeon, educator, and leader at our medicine, which uses human cells institution and nationally,” said Dr. Peter and tissue to repair our bodies.” He F. Buckley, MCG Dean. “His commitment, cited President Barack Obama’s enthusiasm, and skill will enable first encyclopedia of otolaryngology, 2013 announcement of the National the continued targeted growth and the five-volume “Encyclopedia of Institutes of Health BRAIN Initiative strengthening of his department as well as Otolaryngology, Head and Neck Surgery,” to revolutionize the understanding our medical school.” published by scientific, technological, of the human brain by accelerating Kountakis is growing the pediatric and medical publisher Springer Science the development and application of otolaryngology program, including + Business Media. He is Co-Editor of the technologies that provide a more establishing a multidisciplinary Pediatric first comprehensive reference book on dynamic picture of the functioning Airway Center to further strengthen surgical techniques for the nose, sinuses, brain. critical care at Children’s Hospital of and sleep apnea, “Rhinologic and Sleep Mei, a Georgia Research Alliance Georgia. He also will grow the Section Apnea Surgical Techniques,” published Eminent Scholar in Neuroscience, of Otology-Neurotology, which focuses by Springer, and Senior Editor of the is Associate Editor of the Journal on disorders of hearing and balance, and first textbook on “The Frontal Sinus,” of Neuroscience, Section Editor of develop The Ear, Hearing, and Balance also published by Springer. Kountakis Molecular Brain, and a member of the Disorders Center. Other plans include is Associate Editor of the International Editorial Board of NeuroSignals and growing residency and fellowship training Forum of Allergy & Rhinology, a member Neuroscience Bulletin. He is a member as well as research funding and scope. of the Editorial Board of Ear, Nose & of the International Advisory Board He is Vice President of the American Throat Journal, and a member of the of the International Symposium on Laryngological, Rhinological, and Review Board of Otolaryngology-Head Cholinergic Mechanisms and chaired the Otological Society, Southern Section, and and Neck Surgery. 2012 Gordon Research Conference on a member of the Board of Directors and He is a graduate of the University Molecular and Cellular Neurobiology. Past President of the Georgia Society of of Texas-Houston Medical School. He He received the 2008 Mathilde Solowey Otolaryngology-Head and Neck Surgery. completed a general surgery residency Lecture Award in the Neurosciences He is Past President of the American at UT-Houston Medical School, Hermann from the NIH’s Foundation for Advanced Rhinologic Society and received the Hospital MD Anderson Cancer Center, and Education in Sciences and was a society’s 2011 Golden Mirror Teaching Memorial Hospital System of the Texas 2008 Distinguished Investigator of Award. He has served on the society’s Heart Institute; and an otolaryngology the National Alliance for Research on Program Committee since 2007 and is a residency at UT-Houston Medical School, Schizophrenia and Depression. He Program Committee member of the 2015 Hermann Hospital, Lyndon B. Johnson was elected a Fellow of the American American Laryngological, Rhinological, General Hospital, and MacGregor Medical Association for the Advancement of and Otological Society Sections Meeting. Associates. He completed a PhD at the Science in late 2013. n Kountakis is Editor-in-Chief of the University of Crete Medical School. n

FALL/WINTER 2014 6 Newsmakers

GRU President Ricardo Azziz has re- Brett Heimlich, a GRU MD/ ceived the Polycystic Ovarian Syndrome PhD student, has received a Ful- Challenge Inc.’s Leadership and Advo- bright-Fogarty Award to study cacy Award for his research, influence in sickle cell disease for a year in the field, and efforts to increase public Malawi, Africa. He is based with awareness about the syndrome, one of the University of North Carolina the chief causes of infertility. Project-Malawi, a collaboration between UNC at Chapel Hill and Dr. Jie Chen, Professor in the Depart- the Malawi Ministry ment of Biostatistics and Epidemiology, of Health. Heimlich has been elected a Fellow of the Ameri- is focusing on early can Statistical Society. Chen is one of 63 detection. Upon his new Fellows from 25 states, the District return to Augusta in of Columbia, and seven countries hon- 2015, he will complete ored for their professional contributions his last two years of and leadership in the field of statistical medical school. science.

Dr. J. Paul Ferguson, former Presi- brett heimlich dent and CEO of the Harbin Clinic in Rome, Ga., has received the 2014 MCG Community Advocate Award. He chairs the Advisory Committee of MCG’s North- west Campus. Ferguson has received the Dr. Achih H. Chen, MCG Director of Facial and Heart of Community Award for Rome and Plastic Reconstructive Surgery, discussed the age- Floyd County and is a former President of minimizing results of facial cosmetic surgery on the the Neurological Society of America and May 8 episode of the syndicated health and well- the Georgia Neurosurgical Society. ness show, “The Doctors”. Chen, also Director of The Georgia Center for Facial Plastic Surgery in Evans, shared his experience with a single operation ad- dressing the three major issues of the aging face and neck: a sagging chin and neck line, loss of volume in the middle of the face, and wrinkled, discolored skin.

7 MCG medicine Dr. Edmund A. Krekorian (’57), a Dr. Gregory N. Postma, Director of Dr. Edgar Shartilov (’14) has received retired otolaryngologist, has received the the Center for Voice, Airway, and Swal- GRU’s 2014 John F. Beard Award for 2014 MCG Distinguished Alumnus for Pro- lowing Disorders, has been named Vice Compassionate Care. Despite dealing with fessional Achievement Award. Chairman of the Department of Otolaryn- his own health challenges during medi- gology-Head and Neck Surgery. He treats cal school, Shartilov was cited for exten- Department of Psychiatry and Health voice disorders, swallowing disorders, sive volunteerism as well as empathic Behavior Chairman W. Vaughn McCall, airway surgery and reconstruction, and compassionate patient care during Vice Chairman Peter B. Rosenquist, spasmodic dysphonia, reflux, and chronic his training. The $25,000 annual Beard and Dr. Adrianna Foster, an MCG cough. He researches extraesophageal Award, endowed by William Porter “Billy” psychiatrist, discussed identifying suicide reflux and surgical and nonsurgical man- Payne and his wife, Martha, honors a risk as presenters of a workshop at the agement of swallowing disorders. graduating GRU student who exemplifies American Psychiatric Association Annual caring and compassionate health care. Meeting. MCG trains students to assess suicide risk through virtual patients, elec- tronic medical records, and consideration of factors such as sleeping habits.

Dr. Walter J. Moore, an MCG rheu- matologist, Senior Associate Dean for Graduate Medical Education and Veterans Affairs, and Associate Medical Director for Performance Improvement at Georgia Regents Medical Center, has been elected a Master of the American College of Physicians. Mastership recognizes internal Dr. David Terris, Professor of Otolaryngology and Surgical Director of the GRU medicine physicians who demonstrate Thyroid Center, has co-edited a textbook for endocrine surgeons detailing ad- character, compassion, mentorship, and vances including no-neck-scar thyroid surgery and advanced imaging. The book, advocacy. “Minimally Invasive and Robotic Thyroid and Parathyroid Surgery” (Spring Science + Business Media, 2014), was co-edited by Dr. Michael C. Singer, an otolaryngolo- gist specializing in endocrine surgery at Henry Ford Health System in Detroit.

From Left: Dr. J. Daniel Hanks Jr. (’69), a retired radiologist from Rome, Ga., has received the 2014 MCG Distinguished Alumnus for Loyalty and Presidential Alumnus awards.

Dr. William E. Mayher III (’64), a retired neurosurgeon from Albany, Ga., and the MCG Alumni Association’s 2011 Distinguished Alumnus for Loyalty, has received the 2014 MCG Professionalism Award. He has twice chaired the MCG Foundation Board of Directors, overseeing assets that increased nearly 60 percent during his tenure.

MCG Dean Peter F. Buckley has received the 2014 Kempf Fund Award for Research Development in Psy- chobiological Psychiatry from the American Psychiatric Association. The award recognizes a senior researcher and mentor who has made significant contributions to defining causes and better treatments for schizophrenia. Buckley’s research focuses on the neurobiology and treat- ment of schizophrenia.

FALL/WINTER 2014 8 Research Roundup

Autism Insight The same hormone that helps protect females from stroke may also reduce their risk of autism, scientists say. In the first look at a potential role of estrogen in autism, MCG researchers have found expression of estrogen receptor beta – the source of the hormone’s potent brain protection – is significantly decreased in autistic brains. The receptor also plays a role in locomotion and behavior. Estrogen is known to help protect premenopausal women from stroke and dementia. Exposure to high levels of testosterone during early development has been linked to autism, which is five times more common in males than females, according to Dr. Anilkumar Pillai, an MCG neuroscientist and corresponding author of the study in Molecular Autism. dr. ryan harris Comparing the autopsied brains of 26 deceased children, half with autism Cystic Fibrosis Studies spectrum disorder and half A little white pill may help scientists learn why cystic fibrosis saps exercise capacity, even if the lungs are relatively healthy. The researchers are studying the drug sildenafil – marketed as Revatio for pulmonary hypertension and Viagra for erectile dysfunction – in hopes of understanding the blood vessel dysfunction that makes exercise difficult for these patients. “We want to understand why these patients have blood vessel dysfunction and exercise intolerance even though there are all these new therapies improving their lung function,” said Dr. Ryan A. Harris, clinical exercise without, he and his colleagues physiologist at MCG’s Georgia Prevention Institute. His found a 35 percent decrease previous studies have shown that leg fatigue, not lung in estrogen receptor beta capacity, limits the exercise capacity of young patients. expression as well as a Evidence implicates insufficient blood and oxygen delivery 38 percent reduction in to the muscles. the amount of aromatase, Harris is Principal Investigator on three new grants the enzyme that converts that should help resolve the dilemma. Grantors include testosterone to estrogen. the National Institutes of Health, the Cystic Fibrosis Levels of estrogen receptor Foundation, and Vertex Pharmaceuticals Inc. beta proteins, the active Harris and Dr. Katie T. McKie, Director of GRU’s molecules that result from Pediatric Cystic Fibrosis Center, were the first to report dr. xingming shi (left) gene expression and enable blood vessel dysfunction and exercise intolerance in young with dr. nianlan yang, functions such as brain cystic fibrosis patients in 2012 in CHEST Journal. n mcg postdoctoral fellow protection, were also low. n

9 MCG medicine Disrupted Equilibrium Key Protein A bacterial infection can throw off the A protein that equilibrium between two key proteins in promotes cancer the lungs, posing a risk for a highly lethal appears to give acute lung injury, researchers report. blood vessels Bacteria can alter a single amino strength and acid in the protein RhoA, pushing its shape, researchers activity level well above that of Rac1 and report. prompting blood vessels to leak and When yes- flood thousands of tiny air sacs in the associated protein, lungs, said Dr. Stephen Black, an MCG or YAP, is removed cell and molecular physiologist. from vascular smooth His study, published in The Journal muscle cells during of Biological Chemistry, also proposes development, the protein a biological shield that appears to makes thin-walled blood vessels protect RhoA from the potentially lethal that over-dilate in response to reducing GPR 132 expression increases alteration. blood flow, saidD r. Jiliang Zhou, vascular smooth muscle cell Nitration – adding a nitro group to a an MCG vascular biologist and proliferation. protein to change its function – occurs corresponding author of the study Zhou suspects that alterations in at high rates in acute lung injury and featured on the cover of the American YAP may also produce aneurysms. He normalizes when the stimulus, such as a Heart Association journal, Circulation and his colleagues are working on a bacterium, is removed. Using human lung Research. method to selectively manipulate YAP cells and mass spectrometry, they found The researchers also found that YAP levels in smooth muscle cells to further the amino acid Y34 is altered in this appears to manage vascular smooth pursue their theory. condition, turning RhoA into a steady- muscle cells by controlling expression Dr. Yong Wang, a GRU postdoctoral firing protein. of the cell cycle arrest gene, GPR 132. fellow, was the study’s first author. The The research was funded by a When the scientists removed YAP in research was funded by the National National Institutes of Health Program mice, GPR 132 expression increased and Institutes of Health. n Project grant. n cell proliferation decreased. Conversely,

Constipation Relief Halting Bone Loss Georgia Regents Medical A protein called GILZ appears to protect Center is among about a dozen against the bone loss that often accompanies centers nationwide exploring arthritis and its treatment, MCG researchers the potential of a new drug to report. treat constipation in people Arthritis and aging prompt the body to make with Parkinson’s disease. more fat than bone, and the researchers have “Constipation in Parkinson’s previously shown GILZ can restore the balance is very prevalent,” said Dr. while decreasing inflammation, a major factor John C. Morgan, Director of in arthritis. Now, they have evidence that GILZ the GR Medical Center National might treat arthritis better than widely used Parkinson’s Foundation Center synthetic glucocorticoids, which actually increase of Excellence and a study bone loss, said Dr. Xingming Shi, an MCG bone Principal Investigator. biologist. Study participants will To study the impact on bone loss, the inject themselves daily for researchers crossed mice bred to systemically two weeks with RM-131, an overexpress tumor necrosis factor alpha with agonist for ghrelin. Ghrelin is a mice that overexpressed GILZ in only their peptide hormone that naturally mesenchymal stem cells. stimulates gut motility while the mice that overexpressed only tumor independent of dopamine, a necrosis factor alpha quickly developed arthritis chemical messenger in the and bone loss, those that also overexpressed brain and gut damaged in GILZ had significantly less bone loss, Shi said. n Parkinson’s. n

FALL/WINTER 2014 10 Salt WarsBY TONI BAKER

Researchers Battle Sodium Retention

11 MCG medicine Takeria Tolbert and Jamell Dunbar with their son, Preston, and Takeria’s parents Kenneth and Salt Wars Francine Walker

Over on the next block of ‘My Little Man’ Augusta’s downtown medical “That is my little man,” says Tolbert, sharing district, Takeria Tolbert’s a picture of her baby, whose absence of baby newborn, Preston, is alert, fat does give him the look of a very small growing, breathing on his grownup. While his conception and early arrival weren’t planned, his tiny presence has own. Born at 26 weeks and 2 given his driven 27-year-old mom even more pounds, 2 ounces, things no momentum. Preston immediately changed some of her short- and long-term priorities. doubt could have gone very “I am more focused on my health, my differently. eating habits, getting back to the gym. Where everything was good, now it has to be great,” says Tolbert. So on a September day, while her baby worked to get out of Neonatal Intensive Care, she was at the Georgia Prevention Institute, participating in pioneering studies to see if she can escape hypertension. CONTINUED>

FALL/WINTER 2014 12 Multiple times each day, about a “We know that holding onto third of blacks and about 15 percent sodium is bad for you – these of whites hold onto sodium – and patients have increased damage heightened blood pressure – for at to their hearts, their kidneys, and least an hour after the stress that their vasculature – so how do we raised their pressure has passed. optimally treat them?” says Dr. While her blood pressure is still Gregory Harshfield, Director of good at the moment, the beautiful the GPI at the Medical College of and outwardly calm Tolbert is among Georgia. that 30 percent. Nearly a third of American adults – about 67 million people - are Staying Healthy for Preston hypertensive, and 35.8 million have uncontrolled hypertension, including Now, she is helping scientists figure 16 million who are taking one or out more about how chronic mental more medications, according to the stress, obesity, and inflammation Centers for Disease Control and conspire to produce this unhealthy Prevention. response so she can stay healthy for Harshfield, who holds the Dorothy baby Preston. A. Hahn, MD Chair in Pediatrics, is

dr. gregory harshfield Principal Investigator on a $10.6 Teasing Out the Mechanism million Program Project grant re- renewal from the National Heart, Sodium retention, which is Lung and Blood Institute. The grant regulated by the kidneys, is a natural will fund enrollment of 1,200 people response to stress. It’s part of the in six studies that the researchers fight-or-flight survival mechanism hope will soon significantly whittle that gets the heart pounding and the the uncontrolled number by body moving quickly when needed, illuminating why some individuals Harshfield says. Water follows salt, hold onto sodium and how best to so the mechanism enables a quick, help them let go. temporary increased volume inside

13 MCG medicine blood vessels and higher-than- vessels. “If you have more fat cells, which increases the size of the left normal blood pressure. you are generating higher levels of ventricle, and damages the blood But he has shown that individuals hormones [such as] angiotensin vessels, the whole gamut,” Harshfield such as Tolbert hold onto about an II and aldosterone hormones says. additional 250 milligrams of salt that are being dumped into the Their bottom line is finding the – approximately the amount in a bloodstream,” Harshfield says. most direct and effective place medium order of fast-food fries – The scientists consider high to intervene and help this group each time they are stressed. angiotensin II levels a measure of of individuals control their blood Now, he and a team of scientists increased stress in those with this pressure. To better discern how the that also includes Dr. Ryan A. Harris, tendency to retain sodium. “Stress is multiple factors interact, parallel clinical exercise physiologist, and all over the place, and the problem animal studies are being conducted Dr. Yanbin Dong, geneticist and is we don’t know how to define it by Drs. David and Jennifer cardiologist, want to know exactly in a way that we can actually treat Pollock, Director and Co-Director, how that occurs. They suspect that it it. One way we define stress is as respectively, of the Section of can vary with the individual. “We are an increase in angiotensin II levels. Translational Cardio-Renal Research trying to tease out the mechanism When those levels go up, people at the University of Alabama at underlying sodium retention,” hold onto salt, which increases the Birmingham School of Medicine. Harshfield says. fluid volume, which increases blood It’s a complex, interwoven chain pressure, Stressed Out of events that appears to start with stress activating the Harshfield first presented sympathetic nervous the concept of impaired system in the kidneys, sodium excretion and increased increasing the amount of hypertension risk at the 2002 sodium the kidneys retain. 17th Annual Scientific Meeting One way stress does this of the American Society is by activating angiotensin of Hypertension and first II, a protein and powerful published the findings constrictor of blood vessels, that year in the journal which in turn activates Hypertension. aldosterone, a hormone that That study put 118 prompts the kidneys to hold black teens on a diet for onto sodium. Angiotensin II three days to approximately also activates the immune equalize their sodium levels. system, which is directly On test day, the youths activated by increased blood relaxed for two hours, were pressure and raises blood stressed for an hour by playing pressure. Harshfield has shown competitive video games, then that individuals such as relaxed for two more hours. The Fat Factor Blood pressure and sodium Tolbert hold onto about an excretion by the kidneys were Another way is that stress additional 250 milligrams checked throughout the five- – as well as a high-salt diet – hour protocol. Two-thirds appear to decrease activity of of salt – approximately the showed a normal response, the endothelin B receptor in the with blood pressure and sodium kidneys, also essential to sodium amount in a medium order conservation increasing during excretion, and increase activity of of fast-food fries – each stress and decreasing promptly the endothelin A receptor, which afterward. But one-third emerged prompts sodium retention. time they are stressed. with decreased sodium excretion Fat produces more of all of following stress, which kept their the above, as well as oxidative blood pressure up during the stress, which also damages blood recovery period. CONTINUED>

FALL/WINTER 2014 14 “This says to me that the stresses Filling In the Gaps of the day are affecting these individuals differently in that they “A lot of work in stress and are affecting their long-term blood- hypertension has been done by pressure control system,” Harshfield psychologists and hasn’t looked at said a dozen years ago. In fact, his hormonal factors underlying it. They previous work at Charles R. Drew have looked at the hemodynamics University of Medicine and Science of blood pressure and heart rate, so in Los Angeles showed that the we are trying to fill in those gaps of blood pressure of blacks doesn’t knowledge,” Harshfield says. drop even while sleeping as much One irony they will further explore as that of whites. Today, he reasons is that angiotensin receptor blockers, that impaired sodium excretion is a considered ineffective in blacks, primary reason why. may work like a charm in blacks with An NIH Program Project grant impaired sodium retention. awarded in 2002 to Dr. Frank Treiber, “From a population point of view, then Director of the GPI, included angiotensin receptor blockers are a look at the genes that might be not considered effective in blacks,” responsible. A subsequent Program says Harshfield. “But it’s not true Project, as well as other studies, from an individual point of view.” Of have focused more on how the body course, outside the research setting, regulates blood pressure in response sodium retention rates aren’t tested. to stress and how to intervene. And angiotensin receptor blockers typically aren’t recommended for blacks. In fact, this year’s Joint National Committee on Prevention, Detection, Evaluation, and Treatment Takeria tolbert in the GPI lab

15 MCG medicine of High Blood Pressure again it may help, it won’t be nearly as from a cocktail of over-the-counter recommended a calcium channel effective as the angiotensin receptor antioxidants such as vitamins E and blocker and diuretic for hypertensive blockers, which more directly block C and the cardio-protective alpha blacks – a great option, Harshfield the problem. lipoic acid. concurs, for most. To better tease out the effects Still, this work may also circle “Angiotensin receptor blockers of endothelin, they are putting back to sodium retention, because normalize sodium excretion and study subjects’ hands in ice water early life stress, which prompts some individuals to produce excess “If I can get ahead of any health problem, I want angiotensin II, may ultimately be one reason children grow into adults who to be ahead. I want to make sure I am going to hold onto sodium, Harshfield says. Pre- and post-therapeutic urine be there for the long run with him.”–TAKERIA TOLBERT and blood samples from all study participants collected by Dong will blood pressure,” Harshfield says of as a stressor to see whether a drug give scientists a ton of human data, his team’s experience with it in study that inhibits the action of both such as biomarkers that gauge participants, including Tolbert. So the endothelin A and B receptors immune system activity, which they they are using competitive video reduces study participants’ stress can compare with animal data over games again to stress sodium response. the next few years. The scientists retainers. They are then giving one A related study focus is early-life hope the information will eventually of the blockers, phentolamine, which stress and free radicals, a natural lead to pinpointing why a patient is dilates blood vessels and already is byproduct of biological activity retaining sodium and how best to widely used for hypertension, heart such as oxygen use that, at high treat him. failure, and kidney failure prevention, levels, can wreak havoc in the body, Harshfield notes that once they and comparing the response to including vascular dysfunction and find how best to treat sodium those who get a placebo. They are even DNA damage. While clinical retainers, identifying them – outside doing a similar study comparing the experience with antioxidants for of a research setting – could be as drug’s effect on obese versus leaner cancer, as an example, has not simple as getting a second urine sodium retainers, anticipating that it panned out, Harris thinks the right sample and blood pressure measure will be even more effective in obese combination of over-the-counter as patients head out of their individuals because of fat’s multiplier antioxidants in the right population doctor’s office. Work by Harshfield effect. may. and medical student Evan Mulloy indicates that the simple stress of a Emerging Data Childhood Clues doctor’s visit can help sort them out. Dr. Varghese George, Chairman of Emerging data is showing that Rather than focusing on sodium the MCG Department of Biostatistics when stress increases angiotensin retainers, he’s instead looking at a and a core leader on the grant, II, much like a bacterial invader, it cohort of individuals now in their helped design the Program Project also activates the immune system. 30s who were identified as high studies and will analyze collected In that scenario, sodium retention risk for hypertension as children data. clearly increases as a result of because of a strong family history. When Tolbert found out seven angiotensin II activation, but no Some have the additional risk factor years ago that she was a sodium clinical evidence to date suggests of early life stress, primarily due to retainer, she said she likely did not the immune system and resulting low socioeconomic status. Harris give the distinction the attention inflammation directly impact sodium is using cold as a stressor again to it deserved. But her 2-pound gift retention, Harshfield says. To further look at stress response, anticipating this summer has changed all that. tease out the role of the immune those with early life stress will “If I can get ahead of any health system, scientists are comparing the be the most responsive. He also problem, I want to be ahead. I want effect of the immunosuppressant anticipates that those individuals will to make sure I am going to be there mycophenolate, which transplant have the highest levels of oxidative for the long run with him.” n patients take, to placebo on sodium stress – made worse if they are excretion, anticipating that while now also obese – and will benefit

FALL/WINTER 2014 16 Springing Into Action BY TONI BAKER

Skull Procedure Ensures Healthy Brain Development

amanda king with james

When Brian King gazes at baby James, it’s a bit like looking at his past and his future. brian quickly agrees that his youngest got the easy smile from him. “My baby pictures and his look pretty similar,” he says. no doubt his youngest brings that HARRISONsmile AS A Y OUNGto his MAN face now.

17 MCG medicine Under Pressure Balancing Act Stuck in the On Position

When he and Amanda married in In what may be one of the earliest Unless it isn’t. In approximately 1 in 2013, a second marriage for both, and most important series of life 2,300 children, genetic mutations, they wanted just one more child to balances, the human skull has to chromosomal anbormalities, or complete their blended family of be strong enough to support the constraint of the head during five. brain, but pliant enough to compress development can lead to premature As the pregnancy progressed, the sufficiently to get through the fusion of one or more of these petite mom-to-be started having birth canal. It also has to grow fast sutures. “It’s a bone formation signal problems with her blood pressure. enough to keep up with the brain’s that gets stuck in the on position,” At-home bedrest seemed to do exponential growth. Rather than says Yu. Multiple pregnancies and the trick, but when the pressure having just one soft spot at the top advanced paternal age increase the returned a week later, Amanda was of the head, the young skull is more risk. hospitalized with preeclampsia. like a patchwork of plates and soft The most obvious indicator is an James was born about 10 weeks spots. oddly shaped head, often oblong, as early on Nov. 15, 2013 at 2 pounds, The plates are sewn loosely the skull grows insufficiently in some 12 ounces. While he struggled to together at about six different places and may overgrow in others breathe for a while, his sweet, smiling growth sites, called sutures, which to try to compensate. disposition was fully developed in have the consistency of a super- The brain, which is adding and the neonatal intensive care unit at tough, transparent rubber band. connecting neurons, is supposed to Augusta’s University Hospital. The growing brain puts pressure be exerting the pressure that signals Still, amid his steady progress, there was something a little unusual about the shape of his head. “When the brain wants to grow, Unflappable Amanda thought maybe it was positional plagiocephaly, a condition in which a portion of a you just add more bone. baby’s relatively pliant skull flattens, typically from lying on the back too It’s a beautiful thing.” Dr. Jack Yu long. Plagiocephaly has become increasingly common since the on either side of the 1990s, when mothers were first suture site, which in turn advised to lay babies on their backs lays down more bone so to prevent sudden infant death the skull can grow. It’s a syndrome. superfast process in the In James’ case, the pressure first two years of life that was coming from inside. Some decelerates but continues sites that enable a baby’s skull into the teens. to accommodate a rapidly “When the brain growing brain had fused too soon, wants to grow, you just misshaping his head and putting add more bone. It’s a pressure on his brain. His astute beautiful thing,” says parents and caregivers ensured that Dr. Jack Yu, craniofacial the problem, called craniosynostosis, surgeon, Director of the was caught and corrected early. At Craniofacial Center at age 3 months, James would become Children’s Hospital of the first patient in the United States Georgia, and Chief of the to have two tiny, commercially made Medical College of Georgia stainless-steel springs placed in his Section of Plastic and skull to help restore natural bone Reconstructive Surgery. growth and give James’ brain room dr. jack yu to breathe.

FALL/WINTER 2014 18 bone growth as well as the stretchy frozen lake,” Heger says. While the pioneered by Dr. Claes Lauritzen, suture material. In this case, the lack procedure is much quicker – about craniofacial surgeon and researcher of growth puts pressure back on the an hour – judging just the right at Sweden’s University of brain. amount of suture to remove is tough: Gothenburg, who fashioned the first “When we have brain swelling, the too little can mean the unnatural springs for use in the skull in 1996. pressure goes up in the head,” says propensity to lay bone down rapidly Orthopedic surgeons had already Dr. Ian M. Heger, Chief of the MCG will cause the problem to recur. “The provided plenty of proof that slowly Section of Pediatric Neurosurgery, bone has sort of a memory, and it spreading two edges of bone would referencing scenarios such as head tends to want to grow back in an prompt bone formation in between trauma or stroke. In an adult, the abnormal shape,” Heger says. with their success at correcting leg usually protective closed skull These patients wear helmets length discrepancies, Heger says. can increase brain damage as the continuously for up to a year to swelling brain pushes against it. encourage regrowth of a more Sealing the Deal In the child’s brain, the pressure naturally rounded head. can also deter brain development, The concept of adding springs Surgeons such as Dr. Lisa R. David, so connections are never made to spur normal bone growth was Program Director of the Wake Forest and brain cells can’t properly communicate, says Heger, who has begun a pilot study to better assess the neurodevelopment of these children. Carpentry Work

“Wiring enables higher functioning like thinking, remembering, reasoning,” Heger says. If repair is significantly delayed, the damage can be significant. More often, the loss is subtle, the difference between an eventual A plus or B minus. For decades, surgical teams, led by surgeons such as Yu at the Children’s Hospital of Georgia, have been intervening as soon as possible with multihour, superinvasive, but typically successful, surgeries during which the skull is disassembled into about a dozen pieces, then reshaped with significantly more room for the brain. “We essentially do carpentry. We literally stretch the bone out,” says Yu. More recently, Heger and others have brought along a minimally invasive approach in which fused sutures are removed through small holes in the skull, creating a new, larger suture site. “We are very selectively taking out pieces of the skull through small incisions, kind of like cutting pieces of ice from a

19 MCG medicine University Department of Plastic Yu didn’t make his own springs surgery in many patients in about Surgery, soon began fashioning their other than for experimental a half hour with typically no blood own springs. “It’s a lot less invasive, purposes, but was closely following loss – and the result of creating slow, a lot safer, and it takes advantage those who did. Last summer, the steady bone growth – sealed the of the natural body response,” says Food and Drug Administration deal for them. Yu. At the American Association of approved Texas-based medical/ The manufactured cranial Plastic Surgeons’ 91st Annual Meeting surgical device manufacturer expander, which resembles a big in 2012, David and her colleagues OsteoMed’s cranial expander. safety pin, has hooks on either reported their 10-year experience James’ surgery was Feb. 26, and end that, along with a few stitches, with the self-made cranial springs – the subsequent one to remove the secure the device to either side of 136 children at an average age of 4.4 springs was four months to the the suture after Heger has removed months – had shown them safe and day later. In fact, the need for that a small strip of the prematurely effective for many young patients. In second surgery was really the only fused area. fact, the outward force of the springs hesitancy Heger and Yu had about “We squeeze the spring, put it in, starts increasing skull size even before offering this approach to their then let it expand,” says Yu. Like the the child leaves the operating room. patients. But the ability to do the errant bone, metal has a memory. Birthday Boy

“When you bend it, it wants to open back up,” says Heger. It’s that tendency to spread that puts the pressure on the two new edges of bone that have been created by removing the sutures. Another great thing about having a standardized expander is that there are also a variety of newton strengths – a measurement of pressure – based on dr. ian m. heger the age of the child and size of his skull, the surgeons say. At the moment, Heger and Yu are limiting the springs’ use to the sagittal suture, the longest suture in the head, which runs from the front to back of the skull and is the most common site for premature fusion. “It’s sort of an evolution of the surgical approach,” says Heger, and an option for essentially any child who also qualifies for the endoscopic approach. When first approached about using the springs for James, Amanda, a writer and editor, consulted Dr. Google, along with Yu and Heger, before the parents decided it was his best option. With his first birthday on the horizon and a smile on his precious face, it drs. jack yu (left) and ian heger prepare for james king’s surgery appears they were correct. n

spring 2014 20 Brush with Death BY CHRISTINE HURLEY DERISO

Alumna’s Cancer Inspires Lifelong Commitment to Altruism

One of Laura Lemley’s first words was “flowers.” “Our house was always filled with them,” says her mother, Dr. Jacqueline Fincher, a 1985 graduate of the Medical College of Georgia. sadly, it wasn’t the family’s green thumb that kept their home abloom. It was Fincher’s breast cancer.

‘I Didn’t Want to Leave in Thomson, Ga. “Laura My Family’ remembered where she’d stayed, even though she was very young at the Laura was just an infant when her mother time.” was diagnosed with a Says Laura, “I don’t ever particularly aggressive remember feeling fearful form of the disease – or sad. All I knew was that the 10-year survival rate I was being taken care of was 10 percent – so her and that all my needs were early childhood was even met. But nothing was ever more of a crash course hidden from me.” in health care than might “We were very open be expected in a two- about it,” her father says. physician household. Not that they had much “For years when we choice. “I started chemo walked through the on Laura’s first birthday,” hospital, she could point Fincher says. “That first out her mother’s room,” year, I felt very fragile. I says Fincher’s husband was weak, pale, bald. . . of 27 years, Dr. James I remember thinking, ‘I Lemley (’85), who shares can’t wait for her second a practice with his wife birthday, when all of this

21 MCG medicine will be behind me.’ But then it’s scary because you’re not actively treating the cancer anymore. That’s where my holistic approach came in. I didn’t feel like I was just waiting helplessly. I wasn’t afraid of death, but I didn’t want to leave my family.” Community Support

And from day one of the diagnosis, Fincher’s family – indeed, her entire community – rallied to demonstrate that they would never leave her. “Everyone was extremely supportive – our church, family, patients, community. . . We’d drive down the street and see billboards: ‘Praying for you, Dr. Jacqueline,’” says Lemley. Adds his wife, “I remember one of my patients in particular said, ‘We believe you’re gonna be OK.’ I said, ‘Miss Eva, I’m gonna believe that with you.’ It was such a confirmation for me.” And the family’s support system extended far beyond the city limits. Fincher’s and Lemley’s alma mater marshalled every available resource to restore the good health of one of their own. “[Oncologist] Troy Guthrie, one of my most beloved mentors at MCG, was the first person I called,” Fincher says. “He referred me to Dr. Paul Bilodeau (a member of the MCG clinical faculty), and my surgeon was my classmate, Dr. Joe Wills (’85). Dr. Jerry Howington (’67) did my radiation. Talk about networking.” dr. jacqueline fincher CONTINUED>

FALL/WINTER 2014 22 Take Your Best Shot’ Says Laura, “I remember spending Full Circle a lot of time with my dad, taking walks outside and helping with Says her husband, “I told the Lemley may have felt shaky on the doctors, ‘Take your best shot the the garden. My grandparents were inside, but he was a veritable Rock first time around.’ It was very around a lot, too. But at the same of Gibraltar to his family. challenging not knowing what the time, my mom was always there for “He was truly my partner,” outcome would be.” Not only was me. My parents are a really good Fincher says. “He didn’t see it as he having to largely keep the home team.” my cancer; it was our problem, our running, his income was more vital But although Lemley was challenge. Whatever I needed to than ever. Fincher had to discontinue relentlessly optimistic around others, do – diet, exercise, whatever – we her practice for several months, and particularly his little girl, he couldn’t did it together. We switched to a the family’s health insurance was help fearing the worst. “When your macrobiotic diet for three years; canceled upon her diagnosis. loved one is sick, all you can think of it really made us mindful of the “It was difficult, but I had a lot is the tragic cases you’ve treated,” role diet plays in your health and of work to do, both at the office says Lemley, who practices family healing.” and at home,” Lemley says with medicine down the hall from his The couple drew on spiritual characteristic understatement. “And wife’s internal medicine practice. sustenance as well. “I got my it made us stronger; it brought me “You don’t think of the success undergraduate degree at Oral a lot closer to Laura. I wasn’t fishing stories.” Roberts University, so everything or on the golf course. I was at home His respite? “I’d listen to Jimmy kind of came full circle,” Fincher tending to my family.” Buffet music in the evenings,” he says. “We stayed focused on the says. “It really perked me up.” physical, the emotional, and the spiritual. We wanted healing going on in every area of our lives.” That’s just what they got. Fincher has been cancer-free since her treatment, and she’s never taken a moment of her good health for granted. “I remember going to Laura’s Christmas play when she was 3,” she says. “Tears were streaming down my face as I thought, ‘Now I know how special it is to be here.’” Reprioritizing

She also redoubled her already- considerable commitment to volunteerism. “When I was going through my treatment, I was invited to be President of the Georgia Heart Association in three years. I told [the association representative], ‘I might not be here in three years.’ He said, ‘We don’t believe it.’ So I did it. It

drs. james lemley and jacqueline fincher with daughter Laura

23 MCG medicine was a sign of other people affirming I would be healed.” She coordinated a Relay for Life fundraiser for the association and ran in it herself. Fincher also started her own breast cancer support group, running it personally for 12 years, and is Governor for Internists for the Georgia Chapter of the American College of Physicians. She performs sports physicals for local schools gratis as well and chaired a recent effort with the MCG Alumni Association to raise funds for one of her most beloved mentors, the recently retired Dr. Ruth-Marie Fincher.* “My brush with death has really driven School Days me and reprioritized things for me,” she says. “I remember thinking, ‘If my life will Drs. Jacqueline Fincher and James Lemley laugh that they didn’t be shortened, what’s my legacy to my child quite think things through when they declined full scholarships for and my community? Will the world be any medical school. Why? They would have to have agreed to practice for different because I was here?’ I wanted the a set amount of time in a rural community. answer to be yes. I feel very strongly about “Being a city girl [from Atlanta], I wasn’t quite sure I was cut out volunteer work, because I feel so blessed to for being a country doctor,” says Fincher. even be here. ” On the other hand, Lemley, who grew up in Thomson, Ga., could She and her husband feel their experience easily envision a career in a rural community. His dad practiced with cancer also enhanced their effectiveness medicine in Thomson, and he loved the thought of working alongside as physicians. “We now understand what our him. He just didn’t want to be locked into anything. patients are going through in a very personal The upshot, of course, is that both of them have practiced in rural way,” Fincher says. Thomson their entire careers. They love the long-term connections they That wasn’t the only miscue of their medical education. They met form with their patients, Lemley treating each other almost immediately upon arrival as first-year students, those of all ages and Fincher serving mostly but it took Lemley a while to catch on to what was clear to Fincher the elderly. Their specialties, they say, from the start: that they were destined to be together. “I always say I ensure strong relationships as continuity of chased him ’til he caught me,” she says with a laugh. care engenders deep trust. Their ability to But after a while, they were in sync both academically and celebrate milestones, share joys, and conquer personally. They began dating, enjoying MCG socials, Freshman Stunt challenges with their patients is a source of Night, Student Center happy hours, and occasional jaunts to Augusta abiding fulfillment, both doctors concur. hotspots such as Squeaky’s Tip Top. “I know what it’s like to be on the receiving As much as they relish their own MCG memories, Fincher and end of health care,” notes Fincher. Doctors Lemley are even more excited about the memories daughter Laura is are human; we’ll all at some point deal with creating as a second-year MCG student. disease ourselves. My experience gave “Mom and Dad were able to mentally prepare me for the me new insight. There’s no question my workload,” Laura says. “The best advice they gave me was, ‘Don’t experience helped me be a better doctor. worry. You’ll feel like an imposter at first. But you deserve this.” “And it made me appreciate my career She’s glad she got a heads-up about the imposter syndrome. “The more,” she adds. “The wonderful thing about further up in education you get, the smarter everyone else is,” Laura medicine is we really do get to help people says. “There are no slackers in med school.” every day.” n

*Dr. Ruth-Marie Fincher, who retired in 2012 as Vice Dean after nearly 30 years of service, has an administrative suite named in her honor in the J. Harold Harrison, M.D. Education Commons. To make a donation, visit mcgfoundation.org, “Make an Online Gift” and specify the 2014 Fincher Campaign. You can also make a credit card donation by phone at 706-821-5500.

FALL/WINTER 2014 24 Welcome! J. Harold Harrison, M.D. Education Commons Opens its Doors

Excitement and anticipation abounded at the Oct. 16 opening of the J. Harold Harrison, M.D. Education Commons, the new home of the Medical College of Georgia. Luminaries including Gov. Nathan Deal (facing page) were on hand. Highlights of the three-story, 175,000-square-foot facility include two 300-seat classrooms that enable class growth, 13 more intimate learning communities, and a 40,000-square-foot Clinical Skills and Simulation Center (facing page) to support interprofessional education. The building has spaces throughout for students to gather, relax, and collaborate. A $10 million leadership gift from the late Dr. J. Harold Harrison and his wife, Sue W. Harrison, resulted in the naming of the building.

25 MCG medicine FALL/WINTER 2014 26 A Great LegacyBY TONI BAKER

Inaugural Harrison Scholars Begin MCG Education

The inaugural recipients of had given his name and $10 million on the committee are Dr. Mason P. student scholarships funded by a toward construction of a new Thompson (’73), MCG Associate $66 million gift from the late Dr. J. academic home for the medical Professor Emeritus; Dr. Sandra Harold Harrison (’48) began their school. The J. Harold Harrison, M.D. N. Freeman (’68), MCG Professor medical education in August. Education Commons celebrated its Emeritus; and Dr. Charles Green The gift, bequeathed by the late grand opening Oct. 16. Last year, the (’74), Chief of Primary and vascular surgeon from Kite, Ga., MCG Foundation announced the $66 Emergency Care at the Charlie funds six MCG scholarships starting million gift for student scholarships Norwood Veteran Affairs Medical this academic year. Harrison Scholars and endowed chairs for faculty. Center and an MCG clinical faculty will be added in subsequent years to “This truly amazing gift has member. n each freshman class for a total of 48 enabled us to be even more scholars in five years. competitive for top students,” said “Dr. Harrison’s extraordinary gift Dr. Paul Wallach, MCG Vice Dean has already generated tremendous for Academic Affairs. “These are excitement at our medical school academically outstanding students and among our alumni across our who had many options for where state and nation,” said MCG Dean they went to medical school. The Peter F. Buckley. “To see the first commitment of Dr. Harrison and his impact in the form of scholarships family to MCG significantly impacted for these exceptional medical their decision to choose us.” students is remarkable as well.” In addition to the student Three of the Harrison Scholars scholarships, the Harrison gift will are the first MCG students ever to fund 10 University Distinguished receive a scholarship that covers the Chairs at $2 million each. The chairs entire $27,803 annual, in-state tuition will be established over the next five cost, said Dr. James B. Osborne, years. President and CEO of the MCG Said Osborne, “Knowing Dr. Foundation, which oversees MCG Harrison, he would have been very donations. Three Harrison Scholars proud of this moment. As a scholar, received partial scholarships of innovator, and physician, Dr. Harrison $15,000 annually. would have understood the real The merit-based scholarships, benefit of these students to society which emphasize intellect and for generations to come. He always leadership potential, are effective said that MCG gave a country boy for four years but will be reviewed the chance to be a physician; that annually to ensure the recipients’ always stuck with me. He left a great ongoing compliance with eligibility legacy here.” standards. The Harrison Scholars were Harrison died June 2, 2012. selected by the MCG Scholarship Shortly thereafter, GRU announced Committee, chaired by Wallach. that Harrison and his wife, Sue, MCG Foundation Board leaders

27 MCG medicine BY TONI BAKER

The inaugural scholarship recipients are (from left): Anna Willis, Powder Springs, Ga. n Studied biology and chemistry at the University of Alabama n Has family ties in the Georgia cities of Ellijay and Rome and hopes to practice medicine in rural Georgia n Uses her equestrian skills to help disabled children bond with animals

Robert MacDonell, Augusta n Studied biochemistry at the University of Georgia n Has family ties to MCG (both his father and brother are graduates) n Participated in GRU’s Summer Student Training and Research Program for undergraduates n Worked as a telemetry monitor technician at University Hospital and has Basic Cardiac Dysrhythmia certification

Travis Welsh, Tyrone, Ga. n Studied chemistry at UGA n Served the homeless through IMPACT Savannah n Hosted college radio shows for music, science, and medicine

Samuel Cochran, Atlanta n Studied biology and foreign language at Emory University n Is nationally certified as an Emergency Medical Technician Intermediate n Volunteered thousands of hours for Emory EMS and has worked for DeKalb Country EMS n Trained as a gymnast and coach n Speaks fluent Spanish

Matthew Winn, Peachtree City, Ga. n Conducted undergraduate research and majored in biochemistry, biology, and microbiology/bacteriology at UGA n Performed with the UGA Redcoat Marching Band and Derbies Pep Band n Volunteered at Athens Regional Medical Center n Founded Seeds of Knowledge to educate underprivileged children in Benin, Africa

Stanton Royer, Augusta n Studied chemistry and conducted research as a GRU undergraduate n Is a first-generation college graduate n Tutors the underprivileged and hopes to continue his volunteerism in rural Georgia

FALL/WINTER 2014 28 A Foundation of Excellence MCG Foundation Celebrates 60 Years of Success

29 MCG medicine Editor’s Note: This article by Christine Hurley Deriso is an updated reprint from the Worldwide Impact summer 2004 edition of MCG Today. The photos are from the foundation’s Sept. 6 60th anniversary gala. By this time, MCG already understood the impact its mission February 1954 state charter to establish a Medical could have worldwide. Dr. Virgil P. Academy of Georgia. Its first seven Sydenstricker had made huge strides students enrolled in a one-year course in the understanding of nutrition. Dr. Medical College of Georgia President leading to the bachelor of medicine Robert B. Greenblatt had conducted Edgar R. Pund has assembled four degree. The curriculum was expanded groundbreaking research that would MCG alumni for a meeting in Macon, to two years in 1829, culminating in lead to birth control and fertility pills. Ga. At the meeting, he articulates his a doctor of medicine degree. The Dr. Raymond P. Ahlquist had laid the mission to the others in attendance: school’s name was changed to the foundation for beta-blocking drugs. Drs. James Clayton Metts Sr. (’23), Medical College of Georgia in 1833. These are just a few examples of the William Lawrence Barton (’35), Fast-forward to the year 2014. The work that made it clear MCG had long Addison Wingfield Simpson Jr. (’39), school that began as a means to since outgrown an annual budget that and MCG President Emeritus George upgrade physician training in Augusta provided little room for growth. Lombard Kelly (’24). has evolved into a premier research If MCG was to truly optimize its The mission, Pund explains, is university with health sciences and potential, it needed the means to simple: MCG’s needs have greatly liberal arts campuses in Augusta, plus control its destiny with a heightened outgrown its annual budget provided MCG campuses in the Georgia cities of degree of financial security. by the state of Georgia. It is up to its Albany, Athens, Rome, and Savannah. “Any successful organization knows loyal supporters – chiefly, its alumni that future growth requires investment, – to provide a cushion of resources Leap of Faith and the foundation was created enabling the university to achieve its to make that possible,” said MCG full potential. The alumni agree. MCG’s It’s possible that Antony had the Foundation Chief Executive Officer supporters have risen to countless prescience to sense what he set in James B. Osborne. challenges since the school’s inception CONTINUED motion. More likely, a simple leap of > in 1828, and that support won’t falter faith inspired him to do his best work now. The men reach into their pockets, MCG Foundation in hopes that great things would and by the end of the meeting, the follow. 2014 Highlights MCG Foundation is born with assets That same spirit seemed to prevail totaling $450. n A University Distinguished at Pund’s meeting 126 years after the Endowed Chair is established with Symmetry in Motion school’s founding. By that point, the a $2 million faculty investment. necessity of a permanent endowment The chair evolved from its impetus in 1998 as the Georgia Academy was clear. There’s a certain symmetry to the of Family Physicians Joseph W. What exactly was at stake? Why humble origins of the Medical College Tollison, MD Chair. Dr. Joseph Hobbs, was an endowment so vital? MCG of Georgia Foundation. Chairman of the MCG Department of had a budget, after all, to meet its Family Medicine and a 1974 alumnus, The origins of the college itself (now needs. The state of Georgia had has held the chair since its inception a unit of Georgia Regents University) demonstrated its commitment to the in 1998. are nothing if not humble. When a school by providing ongoing funding small group of Augusta physicians led n Six inaugural scholarships (three and, most recently, by erecting a by Dr. Milton Antony established the full-tuition and three partial-tuition) teaching hospital, Eugene Talmadge Medical Society of Augusta in 1822, the are distributed from a $66 million gift Memorial Hospital (now Georgia from Dr. J. Harold Harrison and wife only goal was to enhance and upgrade Regents Medical Center), that would Sue for scholarships and endowed the training of local physicians. But open its doors in 1956. What more chairs. as the importance and far-reaching could the university possibly need? ramifications of that goal became n The J. Harold Harrison, M.D. Pund and the alumni were astute clear, the mission grew ever stronger. Education Commons, a building enough to know that the status quo Soon after the society was established, made possible by an additional $10 would never do for their beloved million leadership gift from Harrison Antony spearheaded establishment of institution. Year-to-year funding would and wife Sue, opens its doors in the the State Board of Medical Examiners keep the doors open, but it couldn’t fall. to regulate medical practice. possibly keep pace with MCG’s lofty In 1826, Antony began teaching n The endowment increases to more goals and ideals. apprentices. Two years later, he and than $230 million. Dr. Joseph Adams Eve received a

FALL/WINTER 2014 30 No Time to Waste Fund reflected its nascent personality. support and acknowledging gifts. A jingle sing-songed the message: As the endowment grew, Were it not for your degree the foundation’s functions and There was no time to waste. The From the M.C. of G., responsibilities grew. By April Macon meeting occurred amid We may not be able to say, 1966, the foundation’s endowment the backdrop of rapid growth and “Dear Doctor” – today. surpassed the six-figure mark, totaling unprecedented potential. In addition to $112,800. Around this time, the construction of the hospital, the Kelly fundraising aspect of the operation Administration Building was nearing Resounding Message was transferred to the MCG Division of completion. The Murphey and Dugas The jingle was simple, but the Institutional Relations. The endowment Buildings were being enlarged. Pund message resounds even today: hit the million-dollar mark in December was pushing for a full-time clinical an MCG degree translates into 1975, with assets of $1,138,341. Three faculty. The Georgia Legislature had profoundly fulfilling and respected years later, that figure was nearly mandated a 33 percent increase in the careers, and many of its alumni feel doubled. number of medical students, bringing obligated to help return the favor When Osborne came on board in the total of first-year MCG students to to future generations. One of the 1988 as Vice President for University 100. MCG was on the brink of nothing foundation’s earliest missions was to of Advancement of MCG (now less than total transformation. create scholarships and other means Georgia Regents University), he The alumni at Pund’s meeting didn’t of ensuring that the university could oversaw foundation operations and hesitate to demonstrate tangible attract and cultivate the best minds. It the university’s efforts in fundraising, support for this transformation – and is a worthy goal that many people are alumni affairs, public relations, and the means for MCG to continually proud to support. marketing. The scope of the operation transform itself in the future as new “MCG alumni have always reflected the university’s exponential opportunities for growth presented demonstrated remarkable altruism growth. The foundation was helping themselves. in every aspect of their lives,” said support every aspect of this growth, Soon after their meeting, five more Osborne. “They entered the health care including new buildings, equipment, supporters added $310 to foundation profession because of a compelling and other tangible signs of its mission. assets, bringing the total to $760. need to help other people, and they Probably most important was its An early appeal for contributions to very much care about helping the investment in brainpower. the foundation’s Alumni Endowment students following in their footsteps. MCG gave them an excellent and very affordable education, and they want to express their appreciation by reaching out to others.” When the foundation’s original charter was granted Oct. 19, 1954, its bylaws embodied this ideal by stipulating support of student scholarships. The bylaws also pledged support of a high standard of education, fellowships for advanced study of medicine, and facilities for A $50,000 endowment gift faculty and students. in 1954 would currently be Specifically, the foundation was charged to support MCG’s mission by valued at $141,590.81 and receiving, spending, investing, and would have generated re-investing donations and selling or $235,529.24 in support. exchanging property held in trust. A Personal Touch

A five-member Board of Trustees was formed and charged to meet each spring and fall. During its Feb. 17, 1955 james austin (with wife Madeline) meeting, Pund was named President, served as the MCG foundation’s personally writing letters seeking executive director from 1968-88.

31 MCG medicine Advancing MCG’s Mission return on that initial $450 investment. importance of its mission. Throughout “The foundation has grown because its 60-year history, the foundation has we’ve done something very simple: cultivated ties with alumni, community By the year 2000, foundation assets We’ve asked people to support us,” leaders, business executives, and exceeded the $100 million mark with Osborne said. “We explain what is others who help advance its goals. an $80 million endowment. needed to fulfill MCG’s goals, and our “There’s a synergy at work here,” said In 2001, Osborne retired from his supporters have committed resources Osborne. “The foundation’s successful university-wide role and became to help us.” Such commitment was stewardship of its resources has President and CEO of the foundation, epitomized in 2013 by a $66 million inspired MCG alumni and supporters which would now be managed bequest from Dr. J. Harold Harrison to give more. Most important, donors separately from the university to (’48), the largest single gift to a state believe in MCG’s mission and its accommodate its rapid growth. Its college in Georgia history. future.” alumni-led Board of Directors includes Since 1972, the foundation has Pund and his fellow supporters, graduates of MCG, the College of distributed over $142 million (over $18 Osborne feels sure, would be proud – Dental Medicine, and the College of million in 2013 alone) to support MCG and astonished – to know what they Nursing. Prominent business leaders sit and has 45 fully endowed chairs. set in motion 60 years ago. n on the board as well. A vital function of the foundation, The foundation’s holdings today? said Osborne, is articulating the Over $230 million, an exponential

‘I Consider It My Duty’

The first known MCG Foundation bequest came in 1955 from the late Dr. Earl Warren, a native of Swainsboro, Ga., who earned his MCG degree in 1925. (See Links in the Chain, page 43). In 1992, after the passing of Warren’s widow, his bequest funded the P.L., J. Luther, Ada Warren Professorship of Radiology and the Amy G. Warren and Lamar Warren Research Fellowship Fund. wrote Warren in 1959 to then- President Edgar R. Pund, “I am glad that you have the opportunity of keeping in touch with your former schoolmates and students, and I hope you will enroll every alumnus in the membership of the foundation. I am glad I am a member. I consider it my duty to continue to be a member in appreciation for the education which the medical school gave me.” In 2014, the P.L., J. Luther, Ada Warren Professorship of Radiology reached $1 million in funding and graduated into an Endowed Chair today held by Dr. James Rawson, MCG Chairman of the Department of Radiology. n

FALL/WINTER 2014 32 A Mountain to Climb By Dr. Alan Kaplan (’82)

I graduated from medical school in 1982. Everyone called me Dr. Kaplan. I loved hearing it. I was a doctor, and I had some good book knowledge, but I had had very little contact with patients. among other rotations, I spent a month on the oncology ward during my anesthesiology residency in Washington, D.C. I had taken oncology courses in medical school, but during the first few hours of that rotation, I realized I was completely lost. Book knowledge and patient care are totally different beasts. To this day, over 30 years later, I still remember my patients. At the time, then-President Richard Nixon was declaring that we would defeat cancer in 10 years. I believed it until I was on that ward.

Unfortunately, Losing Badly the infections started. Fungus began to take over his body. We treated him with broad-spectrum antibiotics One of my first patients was a and amphotericin, also known as young male with acute leukemia. I amphoterrible. Amphotericin can lead administered the chemotherapy and to seizures, chills, renal failure, a whole watched his disease progress. From host of complications. I am not sure book knowledge, I knew what the which was worse, the disease or the chemo was, but watching it in action is treatment. I was shocked, horrified, a whole different ballgame. The chemo traumatized. destroyed his bone marrow in hopes While undergoing treatment, the that the leukemia would be defeated patient decided to get married. He when new marrow regenerated. His believed he would beat the cancer. white and red counts fell to zero, then We all knew better. He died.

33 MCG medicine I had never seen people this to train on my treadmill, trudging daily 15 minutes in the waiting room, but this sick. We were not winning the war in those clunky hiking boots, is not how I wanted to spend my day on cancer. We were losing and off. A Mountain to Climb losing badly. An oncology fellow Not Getting Any Younger stated that oncology was an infant Hearty Stock By Dr. Alan Kaplan (’82) specialty, like genetics before Mendel. At close to 60, I felt that if I wanted I thought medicine was winning. I to make this trip, I needed to do it The machine appeared to be a was upset about this, but in a clinical now. I am not getting any younger, and typical CAT scan. I lay down on a and detached sort of way. I was hiking at altitude is a little frightening. hard X-ray table, and the scan lasted sympathetic and kind of empathetic, Having been a pretty good athlete about one minute. Holding my breath but I would never get any of these for much of my life, I felt confident as instructed, I watched my cardiac diseases. I had no family history of about making this commitment. I was monitor. In a couple of seconds, the cancer. All of my grandparents had a runner, averaging 10 to 15 miles a scan was concluded and I left. I did not cardiovascular diseases that they week. I competed in a couple of 5 and give it a second thought. I was sure developed late in life. I was bulletproof. 10Ks each year. I was on no medication it would be normal. I descend from a Cancer was not in my future. except for a statin. I had no cardiac long line of healthy people who never complaints or symptoms. went to doctors, took no medicines, Tackling Everest But in order to be safe and have and lived long and productive lives. peace of mind, I scheduled an But on the other hand, the idea to go I recently devoured a book called appointment with a local cardiologist. to Everest would have shocked my “Into the Silence” by Wade Davis, an All vital signs were normal. He ancestors. amazing account of Britain during recommended a treadmill test and The following day, I went to my World War I. The horrors of trench cardiac calcium scan, which checks synagogue to observe Yom Kippur, the warfare are shocking. The main for calcium buildup in plaques on the Day of Atonement. We fast and pray subject, however, is the attempt to walls of coronary arteries. High levels for another year in the Book of Life. find, explore, and climb Mount Everest. may indicate coronary artery disease. We try to amend our behavior and These intrepid men knew about I felt that both tests were somewhat seek forgiveness for our sins. Yeah, Mount Everest and many had seen of a waste of time, but I appreciated that is all true. Mostly we pray and we it. However, they had no idea how his thoroughness. I finally did schedule are bored and look forward to eating to approach the mountain or climb the treadmill test, which was more again. I remember the rabbi’s sermon: it. Satellites and GPS did not exist. strenuous than I realized. But my Typical Yom Kippur sermon, live each Many of these men had tremendous results were normal, as I knew all along. day like it is your last. Do good deeds. mountaineering experience in England I put off the calcium scan because Yadda, yadda, yadda. This is all fine and Switzerland, but Everest was an I thought it was pointless. I left the and good, but not really relevant to entirely different beast. At the center order in my car, which migrated to my me. I am not going anywhere. Another of the book is the story of George trunk and finally to my desk. Months year is in the cards. Life is good. Mallory. Did he or did he not reach the after the doctor’s visit, I called the Services finally end, and we go home. summit? What we do know is that he hospital and made the appointment. When services are over, you feel relief perished on the mountain. The day was Kol Nidre, one of the like a child leaving school for summer After reading this book, you want most important days on the Jewish vacation. to go to Nepal. You want to see the calendar. I needed to get in and out of We break the fast with a big meal. mountain – not necessarily climb it, but the hospital quickly so I could drive my My wife, mother, and daughter are see it and get close to it. Many travel mother to services that night. around the table eating and laughing. companies provide this opportunity. I checked into the hospital. I paid Life is good. We call our out-of-town Mallory and his expedition were the the fee. Insurance does not cover children. I realize I have a phone first Westerners to approach the this test. Grumble, grumble, will my message. It’s my cardiologist, asking mountain in the 1920s, but a huge insurance ever pay for anything? I me to call back for test results. tourist industry surrounds Everest waited. An elderly gentleman in a Without thinking, I return his call and today. When I mentioned this book to wheelchair sat near me, coughing leave a message. He calls me back my 26-year-old son, who was planning continually. Great, I thought. What am I immediately. I am in a jovial mood. to study in India, he asked me to go doing here? I don’t even want this test, After a nice holiday with my family, I on an Everest trek with him. Flattered and I am going to get TB. Finally after could use some more good news. beyond belief that my son wanted to what seemed an interminable wait, CONTINUED> spend so much time with his dad, I I was escorted to the machine. To a readily agreed. He even bought me doctor, a long wait is anything over one hiking shoes for my birthday. I began minute. I probably spent no more than

FALL/WINTER 2014 34 Every marriage has its own rhythm. My wife, who has worked throughout our marriage, runs the house and I run the finances. On the night before surgery, I show her where to find the life insurance, the disability insurance and our wills. I give her the log-in names and passwords for our online accounts. She watches, but I can tell she doesn’t hear one word. I wander around our house changing burned-out light bulbs, a combination of anxiety and worry that I won’t be able to do

The author (second from left) with his family, Danielle Kaplan (from left), that again. I pay all of our outstanding Barbara Kaplan, Adam Weinberg, Molly Kaplan Weinberg, and Jonathan Kaplan bills, trying to burn up nervous energy. Forever Linked The News: What?!? given radiologic contrast to drink and another dose intravenously. I lie under another CAT scan machine. The films On the morning of the surgery, I The cardiologist starts to talk. are taken and the tech offers to let me arrive at the hospital where I’ve worked I am kind of listening, and now I am review them. I am a doctor, so sure, let as an anesthesiologist for almost 28 really listening. He says that while my me see them. I glance at them and am years. No one knew I was coming heart appears to be fine, there is a solid struck with horror. I can’t look. There other than the two friends I’ve asked mass in my right kidney. Solid mass in is a large mass where my kidney used to administer the anesthesia. I know the right kidney. What? Mass on my to be. A giant mass. I ask the tech if he my colleagues are a little nervous. I am right kidney?!? I have no symptoms. I sees any spread. He demurs, saying a the old man of the department, and no need a CAT scan immediately. I begin radiologist should assess the results. one wants to make a mistake. On the to panic. CAT scan. Kidney. Mass. My first attempt, the IV is started. Versed family is in the other room. Should I tell The Wrong Guy and fentanyl work like magic. I do them? Should I tell my wife? Finally, my not remember going to the operating daughter and mother leave. I tell my , I drive to the surgeon’s room. I gently wake up in the post- wife. I try to think rationally. I call the In a fog office. He’s a good doctor, one I’ve anesthesia care unit. I have some hospital and speak to a radiologist on known for years, but I never thought pain, but nothing unmanageable. No call. He does not know me and doesn’t I would be his patient. He says he has nausea. No surgical complications. I really want to schedule the CAT scan. good news and bad news. The good love anesthesia, but I really appreciate What is plan B? I email a urologist news: He and the radiologists see no that my surgeon performed the friend. She responds immediately. Be in metastasis and no extension outside surgery with a laparoscope. No spread her office tomorrow at 8 a.m. She will of the kidney. I would like better good noted during the surgery. No cancer ultrasound my right side. She reassures news than that. That’s not what I call in the renal vessels or renal pelvis. The me that she sees this all the time – good news. You don’t understand. I urologists make a big deal out of that. mostly harmless cysts. I know that my was going to Nepal. I was having a No cancer in the adrenal gland. All mass is solid. cardiac scan. Nothing’s wrong with my appears to be encapsulated. As good I actually sleep. I wake up, and I kidney. You’ve got the wrong guy. a result as could be expected. At my go to her office. Negative review of He says I have a large kidney mass, first postoperative visit, my surgeon systems. No family history of solid probably cancer. Cancer! What? I don’t hands me my pathology report. Seeing tumors. No problem. There is going to get cancer. My family doesn’t get my name and cancer forever linked is be nothing here. There is blood in my cancer. We die of heart disease. Those difficult to comprehend. urine. I had never noticed it. I go for the patients during my internship had I am over one year out. Back at ultrasound. The urologist’s first words: cancer. work. The shock is still with me, but all “This is not a cyst.” The surgeon says my kidney needs reports are positive. No spread. Three “You need a CAT scan now,” she to be removed immediately. No Nepal. sets of scans down. All labs look good. tells me, “and we need to find you a Surgery is scheduled. My wife and I check my labs myself. I have become surgeon.” Now. She calls the surgeon I tell no one, not my mother, not my friends with the phlebotomists at the from her office. He wants to see me children, not our friends or relatives. local laboratory. The one kidney seems immediately after the scan. In shock, We need to get over the shock. From to be functioning well. I’ve gone from I am led to radiology. I am coming to total health to this in three hours. zero doctors to about 10: an internist, grips with what is going on here. I am

35 MCG medicine nephrologist, urologist, cardiologist, say, “Whatever, it happened. We are all or even just an acquaintance going and oncologists. Each physician sends human. Let’s move on. I need you. Your through a rough patch, reach out. One me to another one. Each physician children need you. Your colleagues second of your time means the world has been kinder than I ever expected. need you. Get better and we will go to someone else. You are not alone. I knew they were competent, but on.” Someone to help you through You are not forgotten. We miss you. I never expected the compassion the dark days, and there will be dark and caring. My nephrologist spends days. You go from being a bulletproof, The Internal Compass a whole hour with me. She is not average Joe to a survivor in the matter adequately compensated for that hour. of a few hours. As physicians, we become cynical Life with one kidney is our topic. She and jaded. I have participated in welcomes my wife. She writes down Kindness is Underrated many depressing conversations about her instructions. Even physicians need money, regulations, bureaucracy, and to be reminded of the basics. I review I am thankful for a nurse practitioner other onerous aspects of medicine. her instructions numerous times. She who checked on my pain pump Every so often, I would pipe in answers questions I didn’t know that the day after surgery. She asked sarcastically, “At least we get to help I had. Anesthesiologists don’t know if I needed anything. I asked her, people.” That line always got a laugh. a hell of a lot about kidney function, uncharacteristically, for biscuits from I am embarrassed I ever used that line other than the fact that clear urine in a the McDonald’s in our hospital. She cynically. We are under assault from so Foley is a good thing. returned in under five minutes with many different places and people that two Egg McMuffins. Nothing has ever we forget why we went into medicine Power of Love tasted better to me. I have learned in the first place. In the production that small favors are wonderful. pressure of modern medicine, we What have I learned? All the trite Five minutes of her time, and I am have lost our internal compasses. stuff you can find in any self-help still thinking about it months later. Production, production, production. book: Enjoy your life. Don’t put off until Kindness. As David Brooks of the New Money, money, money. tomorrow what you can do today. Look York Times wrote in a recent article, So, what else have I learned? We for the positive. Live for today. just be there. do a wonderful job. We don’t give What have I really learned? Find I am thankful for the many ourselves enough credit. Everyone in someone you can love . . . a spouse, colleagues and friends who visited the hospital treated me with respect a child, a friend, any significant other. my wife while I was in surgery. They and kindness, above and beyond the More importantly, find someone who comforted her, brought her drinks, call of duty. Caring and competent. I loves you. Someone who pushes you, made her laugh, made her cry. was alone and almost crying before who tells you when to buck up and Everyone shared secrets. Spend time my first scan, basically in shock. The grow up and move along. On my first with the family members. My wife is a radiology secretary attempted to put night of surgery, I was lying in the nursing instructor at a local university, me at ease. She did not know me. She hospital bed, IV in place, PCA running, but she was scared and alone. Five had no idea I was a “big shot” doctor. Foley catheter draining, fetal position, minutes of your time means the I was just another patient, but I really and as comfortable and content as world to frightened family members. needed a kind word, and I got it. I will someone could be in this position. My Kindness is the most under-rated of all be forever grateful for her kindness. wife announced I needed to get up and human emotions. Just be kind. She doesn’t even know the impact brush my teeth. What? At that point, I I am thankful for the friends and she made on me. We don’t know the didn’t care if they fell out. colleagues who contacted me during positive impact we all make every day. But she insisted. I dragged myself my recovery. I heard from nurses I We do good more than we know. out of bed and brushed my teeth. I had not worked with in years, long- We help people. Why do I even was also ordered to get up and walk retired colleagues, virtually everyone need to say that? My medical care was around the hospital corridors. She from my past. They sent food, books, superb. I want to thank my doctors, my pushed me, and I am grateful for that. cards, texts, and emails. All were vitally nurses, all who helped me recover. But Wallowing in self-pity is very easy important to my well-being. Texts most importantly, I want to thank and almost enjoyable. When you read raised my spirits more the cardiologist who ordered about people in bad situations, they than you can ever that waste-of-time calcium always say, “I never questioned why know. A simple scan. I think he saved my life. it happened to me.” Yeah, right. That text from a long Maybe I will get to is not real or human. You do question forgotten friend Nepal next year. why this happened. Why me? Who made my day. I still have the have I annoyed in the heavens? That When you have a shoes. n is normal. Well, you need someone to friend, colleague, LEONARD REEVES

FALL/WINTER 2014 36 Faculty Spotlight BY TONI BAKER Living on the Edge Lifelong Adventures Set Stage for Disaster Training

They lived in a small town baby would carry his name of little more than four square forward. miles in west central Wisconsin. “We did fine,” says Dr. Black River Falls, also home Richard B. Schwartz, who to the Ho-Chunk Nation, was remembers secondhand clothes built at the falls of the Black but never really lacked for River to harness the power of anything. Lois, now 93, never the 190-mile-long tributary of remarried, remaining instead the famed Mississippi River. focused on taking care of her Richard was a ranger who family. ran a national park and Lois a physical education major Taking the Plunge who ran her big, busy family. The baby of the Schwartz clan Schwartz would grow up was a late arrival to the scene. disciplined and physically The oldest of the six children, active. Water was a natural Nancy, predated him by 14 for him, whether he was years. Tragedy did as well. lifeguarding summers at the Son Michael, born a dozen pool his mother ran or learning years before their youngest, to scuba dive in the seventh had died at age 4 from a brain grade, when the family briefly tumor. Then, a week before the relocated to the Virgin Islands. youngest Schwartz was born, He worked in a local dive shop Richard was driving home from there, helping fill up dive tanks work when a car ran off the for tourists. Back home in road, overcorrected, and hit his Williamston, Mich., where his vehicle head on. The couple’s mom had moved the family to

37 MCG medicine Dr. richard b. schwartz Chairman, Emergency and Hospitalist Medicine

FACTS:

Military Honors Bronze Star Two Meritorious Service Medals Joint Services Commendation Medal Army Commendation Medal Two Army Achievement Medals Combat Medical Badge Two Southwest Asia Campaign Ribbons Kuwait Liberation Medal National Defense Service Ribbon Honor Graduate, U.S. Navy Diving Medical Officers Course

Memberships Editorial Board, American Journal of Disaster Medicine Boad Member, American Medical Association, National Disaster Life Support Education Consortium, Executive Committee Member and former Vice Chairman, National Association of Emergency Physicians, Development Committee Voting Committee Member, Committee for Tactical Emergency Casualty Care Board Member and former Board Chair, National Disaster Life Support Foundation Board of Directors, Georgia College of Emergency Physicians

FALL/WINTER 2014 38 be close to her parents, he would The Army’s Flight Surgeon’s doctor who had yet to complete take to the Red Cedar River to Course helped him learn to care his residency training. “Having that become a competitive kayaker, for special forces soldiers, who much responsibility for a substantial canoer, and swimmer. In 1979, he were often parachuting from very number of people, young people, placed seventh in the Junior World high altitudes to infiltrate a target giving themselves to their country, Championships, and the next year, location, a demanding charge on who were now hurt. . .” His voice Schwartz “just missed” making the the body and psyche. His last week trails off at the memory. Today, U.S. Olympic kayaking team. He also of school, Saddam Hussein moved the job is mostly done by boarded began to wonder what else he might into Kuwait. “We immediately went emergency medicine physicians, be missing. to our units. I remember we got our which he is today. But it was a He made starts as a paramedic household goods delivered, and a different time. and a chiropractor, and thought few hours later, I was on an airplane When the monthlong Operation about being a dentist, before joining going to Saudi Arabia.” Desert Storm began in earnest, the Army so he could afford medical That was the first time he left he embedded with an Egyptian school. While more a financial behind Polly, whom Schwartz had mechanized infantry unit near the necessity than part of some grand met in undergraduate school and center of the conflict. “I remember plan, medicine and the military married during medical school. lying in the foxhole all night, and the would become quite an intersection Before the days of Skype or even cell ground was just shaking from all the for Schwartz. After medical school phones, that meant they might not artillery coming from both sides.” at Wayne State University and a talk for months at a time. The war ended quickly and Schwartz transitional internship at William seems to have emerged a winner. Beaumont Army Medical Center, he In the Trenches Those perilous days on the front became a medical officer in several lines, strategizing about what care special operations units, including 5th Schwartz would also work with could be provided acutely and how Special Forces Group (Airborne), the the Air Force Special Operations 1st Special Warfare Training Group Units that provided search and (Airborne) and the Joint Special rescue for pilots who were shot Operations Command (Airborne). down, a pretty heavy load for a new

schwartz completed many jumps as an airborne medical officer and was a Seventh-place finisher in the 1979 Junior World Championships in kayaking. FACT:

Despite his packed schedule, Schwartz tries to make time each day for physical activity: running, kayaking, mountain- biking, and his newest love, paddle-board racing, help him stay physically prepared and, frankly, happier. There are benefits to at least one of his day jobs as well. Says he, “If you are going to be worldwide deployable to support an organization like the FBI, you need to be physically fit so you don’t become a liability to them.

39 MCG medicine best to evacuate the casualties, where he learned to parachute Optimizing Preparedness made Schwartz decide that, like the into the water and breathe without water, emergency medicine was also making telltale bubbles, Schwartz Schwartz and Dr. Phillip Coule the place for him. finished his emergency medicine (’96), then Director of Emergency One thing Schwartz really likes training at Madigan Army Medical Medical Services, established the about special operations is the Center. He found his way to Augusta Center of Operational Medicine. innovative thinking. One of his as Chief of Emergency Medicine They began collaborating with Dr. units was the first to bring donated at Dwight David Eisenhower Army Cham Dallas, now Director of the blood to the front line to better Medical Center at Fort Gordon. Institute for Health Management support resuscitation of bleeding He moonlighted in the Emergency and Mass Destruction Defense at soldiers. “If you look at how most Department at Georgia Regents the University of Georgia, along people die in combat,” he says, Medical Center, then came on with colleagues at the University of “it’s from hemorrhagic shock; they board at MCG in 1998 as Residency Texas Southwestern Medical Center are bleeding to death.” In the field, Program Director. at Dallas, and the University of where stopping bleeding isn’t The newfound stability was a Texas at Houston School of Public always an option, they could at least welcome change from the constant Health. They developed a series quickly restore the oxygen-carrying deployment that had kept him away of courses that today are used red blood cells and help soldiers from home for more than a year. And worldwide to optimize preparedness and their organs survive until they while his family had survived, and and help ensure that everyone, from reached definitive care. was probably stronger as a result, firefighters to paramedics to hospital While earlier wars had helped Schwartz wanted more time with his administrators, who would call the identify the golden hour after injury wife and two young children, Kyle shots or do the work in a natural or as the critical time, “there was no and Kenzie. manmade disaster, are working in golden hour for us. It was about But as one federal relationship concert. 10 to 12 hours before we could ended, another emerged. When the The lineup includes a Core actually get anyone to a medical USS Cole was bombed in 2000, a Disaster Life Support Course® facility,” Schwartz says. Even with contractor asked Schwartz to help teaching the essentials of natural today’s trauma and EMS networks, provide medical support to the and manmade disaster management circumstances can transform a Federal Bureau of Investigation. to hospital-based and frontline highway, a high school, or the Back in Augusta, Schwartz was medical providers. Basic and Boston Marathon into an equally talking with Dr. Larry Mellick, then advanced courses offer progressively isolated location. Chairman of the Department of more hands-on training and Emergency Medicine, about bringing knowledge. An overarching goal Special-Forces Mentality the best of the military along with is common knowledge and jargon him, a sort of all-hands-on-the- to eliminate ambiguity, says That special-forces mentality same-deck mentality with disaster Schwartz. became Schwartz’s mentality, or at planning and management training Even before 9/11, the more least reinforced his natural instinct. for the civilian and law enforcement synchronous approach was gaining After a few more stints, including community. momentum. Sept. 10, 2001, U.S. Sen. training as an Army combat diver, Max Cleland, a decorated war hero and veterans’ advocate, read into the Congressional Record: “In recent FACT: years, concerns have increased about the potential for terrorists or foreign Two years ago, Schwartz and Dr. John Croushorn, Chairman of the states to use biological, nuclear, or Department of Emergency Medicine at Trinity Medical Center in chemical weapons to inflict mass Birmingham, Ala., developed an abdominal aortic tourniquet that could casualties in the United States. As help keep soldiers injured below the body armor from bleeding to death. a nation, we are only just beginning The device is the first known to effectively and externally compress the to develop an adequate response body’s largest blood vessel. It is now used by the military and civilian EMS capability for such an attack.” alike. The invention is one of 13 U.S. patents Schwartz holds; another seven Sen. Cleland again offered the are pending. growing expertise at his home

FALL/WINTER 2014 40 state’s flagship university and public implement the recommendation interventions, such as a tourniquet or medical school to help make that nationally. opening their airway. The lifesaving happen. The guideline, the Model interventions are integrated directly Uniform Core Criteria, identifies into the triage protocol,” says Training the Trainers key features of a mass-casualty Schwartz, Principal Investigator triage system and standardizes the on the CDC grant that enabled Two years later, the four process to improve interoperability broad-scale assessment of existing universities, in partnership with between agencies responding to an military and civilian triage protocols. the American Medical Association, emergency with multiple casualties. “This guideline will ensure that established the National Disaster A key recommendation is to quickly all responders to a mass casualty Life Support Training Program identify those with survivable but incident are providing lifesaving with the help of a Congressional life-threatening injuries and provide interventions that only take seconds appropriation from the Centers for immediate lifesaving interventions, to do, then quickly moving to the Disease Control and Prevention. The such as placing a tourniquet to next victim.” next year, the National Disaster Life staunch bleeding at the scene. Amid the visible impact Schwartz Support Foundation – based at MCG and the MCG Department of but still very much a collaborative A National Standard Emergency Medicine have made in venture – formed to oversee making the world safer, there has increasing demand for the new all- “Having a national standard for been a covert one as well. For about hazards training approach. While mass-casualty triage means that a dozen years, the department has those early years were focused on all responders in these chaotic and provided medical support to the teaching classes, the current focus is rapidly changing situations will FBI’s field operations, including training trainers. be operating from the same sheet hostage rescue. Last year, Vighter Today, there are about 90 domestic training sites and a growing number of international FACT: sites, including a recent flurry in China and multiple war-torn The Center of Operational Medicine, founded by Schwartz in 2003 and now countries. The last course Schwartz directed by Dr. Andre M. Pennardt, provides consultation and support in ran was back in Kuwait; some of disaster, international, wilderness/survival, maritime, tactical, and military his collaborators at the training medicine. The center also has a Certified Hospital Emergency Coordinator center in Afghanistan were killed in Certification Program and an EMS Academy that trains EMTs, advanced a recent Taliban attack. One global consistency is enthusiasm about EMTs, and, most recently, paramedics. how to maximize survival in the face of the seemingly increasing of music. This will help to ensure Medical Group, a small Minnesota- number of mass-casualty situations that as many lives as possible are based medical direction and support domestically and beyond, Schwartz saved,” says Dr. E. Brooke Lerner, company, and the MCG department says. And each disaster reveals new Professor of Emergency Medicine teamed up to provide supplemental lessons that are incorporated into at the Medical College of Wisconsin medical support to the FBI’s field future courses. and Deputy Director of MCW’s operations. This is the first time in While not happy that it took 10 Injury Research Center. Lerner led its relationship with the FBI that years, Schwartz and his colleagues the 30-member multidisciplinary MCG has had a partner in ensuring this summer took what they consider working group representing federal that the federal agency always has a huge step toward ensuring that and academic institutions that physician or medic support on the care starts off on the right foot: the developed the MUCC guideline. ground or on the phone as needed Federal Interagency Committee “Based on the lessons learned to support field operations. The two on Emergency Medical Services from the battlefields of Iraq and also arrange transport of casualties recommended that state and local Afghanistan, the MUCC ensures to medical facilities, setting up field EMS agencies adopt a new mass- that critical patients with potential hospitals when needed and training casualty triage guideline. The for survival get immediate help FBI medics. committee also released a plan to by incorporating quick lifesaving

41 MCG medicine Growing Impact “You are their doctor on the It’s not really different than the life- scene,” says Schwartz, who and-death decisions that play out considers the mission a true in the emergency department, he It’s a good fit. Vighter oversees 60 privilege. “The primary mission is says, although, granted, there it’s not medics skilled in these on-the-scene to take care of the teams while usually his life at risk. maneuvers in high-risk areas such as they are there and to also have a “I look at things in a calculating Afghanistan. About a third of MCG’s plan if things go badly during the way and there are calculated risks, 35 emergency medicine physicians operation.” Not unlike during his but you do what you can to mitigate have Department of Justice security Special Forces days, there is a lot those,” he says matter-of-factly. clearance to work with the FBI. he can’t discuss, and what happens “There are certainly risks to getting Additionally, one medic is assigned can be dangerous. But the man in your car and driving to work every full time to the FBI in Quantico, Va., who has felt the ground shake with day.” n and works closely to regularly assist gunfire seems relatively unflappable. FBI operational medical providers. This includes bringing FBI medics to GRHealth for hands-on training in areas such as the operating room and emergency department. MCG also has developed a Special Tactics for Operational Rescue and Medicine course patterned after the military’s Tactical Combat Casualty Care course, which helps law enforcement personnel take better care of each other.

FACT:

Moving forward, Schwartz wants the department to push the envelope on resuscitation, a broad topic that gets down to the basics of maintaining airway, breathing, and circulation. He’s pushing for an adult extracorporeal membrane oxygenation program that will enable the heart and lungs to recover in the aftermath of, as examples, a spontaneous cardiac arrythmia, near- drowning, or drug overdose in an otherwise healthy adult.

FALL/WINTER 2014 42 Links in the Chain

Editor’s Note: This section of the magazine features an MCG supporter, faculty member, and student who share a link to their alma mater. This inaugural edition features Dr. Charles Hobby, a retired radiologist from Valdosta, Ga.; Dr. James Rawson, Chairman of the Department of Radiology; and Brent Bermingham, a student who plans to pursue a radiology career.

Dr. Charles Hobby (’67), one of the first members of the profession to become certified in interventional radiology, is a Fellow of the American College of Radiology and a longtime supporter of MCG, including as a past board member of the MCG Alumni Association. “MCG allowed me, a small-town boy from Fitzgerald, Ga., to attain my dream of becoming a physician,” he says. “It provided me with an excellent education, a respected profession, and an excellent income to support my family. The excellent education I received was not as expensive as other medical schools. A frequently used comment today when someone gives a gift is ‘Don’t say thank you, but pay it forward.’ I was blessed to have been an MCG graduate, and the donations I give to the Medical College of Georgia are my thanks for what I received, knowing it may enhance or finance the educations of future graduates.” One of Hobby’s sons is an internist in Valdosta and the other, a senior at the University of Georgia, hopes to become a physician as well.

For more information or to make a donation to serve as a link in the chain for future generations of physicians, contact: Christian M. Romero, MCG Foundation 706-823-5500 or 877-823-5501

43 MCG medicine Dr. James Rawson holds the P.L., J. Luther, and Ada Warren Endowed Chair of Radiology. The chair memorializes family members of Dr. Earl Warren (’52), who practiced medicine in New Jersey for over 50 years but never lost his connection with MCG, including donating $150,000 to his alma mater shortly before his death in 1979.

Brent Bermingham, a Newnan, Ga., native who earned his undergraduate degree at the Georgia Institute of Technology, plans to graduate from MCG in 2016. Says Bermingham, who is leaning toward a career in interventional radiology, “Studying at MCG has allowed me to focus on the latest in medical science applied directly to improving patient care with students and faculty who are as excited about that as I am.” n

FALL/WINTER 2014 44 Ultrasound? Ultracool!

“Ultrasound likely will ultimately be viewed as akin to a stethoscope, a routine part of the diagnostic tool set in an exam room. While the screening technology won’t replace or supplant diagnostic ultrasound in the practice of radiology, physicians who specialize in internal medicine, family medicine, pediatrics, rheumatology, critical care, and other disciplines will find it a helpful, handy, and safe adjunct to high-quality patient care.”

dr. paul m. wallach

45 MCG medicine Education Update BY dr. paul m. wallach Professor of Medicine and Vice Dean for Academic Affairs Ultrasound? Ultracool!

Before this decade is over, handheld portable n Identification of gallbladder stones ultrasound will be commonplace across most medical n Evaluation of the kidneys and bladder specialties and in the pockets of most physicians. n Uterine and ovarian screening MCG graduates will be ready! Ultrasound already n Presence of fluid in the pleural, pericardial, or is part of the practice of emergency medicine and peritoneal spaces obstetrics and gynecology. What is changing is n Identification of musculoskeletal injury and presence equipment that is super-portable—about the size of of joint effusion a cell phone – and more accessible because it links to n Facilitation of thoracentesis, paracentesis, tablet PCs that fit in a lab-coat pocket. In fact, the way arthrocentesis, and amniocentesis technology is surging, ultrasound may one day be yet More applications are likely to emerge as technology another app on our phones. Regardless, the advances improves. That functionality definitely also applies to promise a quick, affordable way to soon take an actual ultrasound’s educational offerings in the basic sciences, look, for example, at that aorta that just feels too large clinical skills, and patient care. In the first two years on physical exam. of our curriculum, after introducing the basics of Ultrasound likely will ultimately be viewed as akin to ultrasound technology, students are using ultrasound to a stethoscope, a routine part of the diagnostic tool set review structures emphasized in the anatomy course, in an exam room. While the screening technology won’t view physiological mechanisms in real time, reinforce replace or supplant diagnostic ultrasound in the practice components of the physical examination, and correlate of radiology, physicians who specialize in internal ultrasound findings with pathophysiologic findings. In medicine, family medicine, pediatrics, rheumatology, short, ultrasound is becoming a powerful teaching tool critical care, and other disciplines will find it a helpful, that provides context and enhances learning. handy, and safe adjunct to high-quality patient care. While we’ve wanted to introduce ultrasound into the To prepare our students, MCG this year joined roughly curriculum for several years, a number of opportunities 10 percent of U.S. medical schools in implementing coalesced to make this possible: a formal ultrasound curriculum. We use six bedside n We have recruited outstanding ultrasound educator ultrasound machines in our gross anatomy lab and six of Becky Etheridge. Royal Philips’ latest handheld versions, which are not yet n GRU has formed a long-term relationship with Royal generally available elsewhere in the country. The devices Philips, a Dutch health care and consumer goods not only help prepare our students for their careers but company, that optimizes our access to new serve as a terrific teaching tool. technology. Students are learning the physical exam while they are n We have the strong support and participation of learning the anatomy while they are learning to perform an outstanding educator who also happens to be the an ultrasound. Here are a few situations where handheld Chairman of Radiology, Dr. Jim Rawson. ultrasound might help with patient care: MCG provides outstanding learning opportunities and n Differentiation of solid and cystic masses prepares our graduates for not just the practice of today, n Evaluation of liver, spleen, and aortic size but the practice of the future. Ultrasound is one example. n Placement of central venous catheters Ultracool. n

FALL/WINTER 2014 46 Class notes

Dr. Lawrence L. Allen (’60) was David W. Retterbush (’77) chairs the Dr. F. Stuart Sanders (’82) has been honored with a proclamation designating Georgia Composite Medical Board. He named a U.S. figure skating physician and July 11 “Dr. L.L. Allen Day” in Thomaston, practices general surgery at South Georgia will continue as a U.S. Olympic sports Ga., upon his retirement from practicing Medical Center in Valdosta, Ga., where he medicine physician. He also chaired the medicine in the city for 50 years. has served as Chief of Staff and Chairman World Heart Games of the American College of the Department of Surgery. He is certified of Sports Medicine held at Agnes Scott Dr. Spencer B. King III (’63), Professor by the American Board of Surgery. College. of Medicine and Director of the Andreas Gruentzig Cardiovascular Center at Emory Dr. Darrell G. Lowrey (’78), an Dr. John D. Brophy (’83) has joined the University, is serving a five-year term on orthopedic surgeon and sports medicine Semmes-Murphey Clinic in Memphis, Tenn., Mercer University’s Board of Trustees, the physician, recently celebrated his 30-year as a neurosurgeon. institution’s governing body. anniversary at the Harbin Clinic in Rome, Ga. He is an orthopedic physician for the Dr. Michael Spencer (’84) is Chief of Dr. Charles F. Hobby (’67), a recently Rome Braves and the team physician for the Staff of the Charlie Norwood Veterans retired radiologist who practiced medicine Darlington School football team. Affairs Medical Center in Augusta. at South Georgia Medical Center in Valdosta, Ga., for over 40 years, has Dr. James Ross (’79) is Facility Medical Dr. Steven E. Kitchen (’85) has been been honored with the naming of the Director of First Choice Emergency Room’s appointed Chief Medical Officer at Phoebe interventional radiology suite at the center’s Spring-Gleannloch facility in Spring, Texas. Putney Health Systems in Albany, Ga., after main campus. The Hospital Authority of Ross is board certified in emergency 25 years of private practice in obstetrics and Valdosta and Lowndes County extended medicine with more than 30 years of gynecology. the honor in recognition of Hobby’s long experience. years of service. Hobby, who is certified in vascular and interventional radiology, has served as the medical center’s Medical Executive Committee Chairman, Chief of the Dr. Dean Paschal (’80), an emergency Radiology Service, and a longtime member room physician at the Southeast Louisiana of its foundation’s Board of Trustees. Read Veterans Health Care System in New more about Hobby in “Links in the Chain,” Orleans, has written a novel, “The Frog page 43. Surgeon” (Portals Press, 2013). His stories have appeared in Best American Short Dr. Harvey B. Stories, The Pushcart Press Anthology, Roddenberry (’67), Norton’s New Sudden Fiction, Portals Chief of Obstetrics Press’s Something in the Water anthology, and Gynecology and Press 53’s The Surreal South. and Chief of Staff at Coliseum Medical Centers in Macon, Ga., has been named Dr. Kurt Markgraf (’87) has received the Bibb County the Florida Society of Anesthesiologists’ Medical Society’s 2013 top honor, the Distinguished Service Physician of the Year. He regularly staffs the Award. Markgraf chairs the Department of OB/GYN clinic at the Macon Volunteer Clinic Anesthesiology at Lee Memorial Hospital and is recently retired from Obstetrics & and is a partner at Medical Anesthesia and Gynecology Specialists. Pain Management Associates in Fort Myers, Fla. Dr. Merle P. Stringer (’68), a neurosurgeon in Panama City, Fla., is Dr. Michael Mitchell (’82) has opened a Dr. Michael Hollifield (’88) is a serving a second term on Florida’s Board solo practice, Turkey Creek Internal Sergeant in Georgia’s Hall County Sheriff’s of Medicine. Stringer has served on the Medicine, in Knoxville, Tenn., as a division of Office reserve unit and an emergency board of trustees at two area hospitals and Summit Medical Group. medicine physician in the Northeast Georgia Northwest Florida Surgery Center and is a Medical Center in Gainesville, Ga. Hollifield, past President of the Florida Neurosurgical who served in the Rabun County Sheriff’s Society and Bays Medical Society. Office for 20 years before attending MCG, volunteers his law enforcement expertise to the community.

47 MCG medicine Dr. Scott Miller (’90) is among Atlanta Dr. William Hogan Jr. (’03) has joined Dr. Paul D. Lane Jr. (’08) has joined magazine’s 2014 list of Top Doctors, his The Bellevue Hospital in Bellevue, Ohio as a Valdosta Orthopedic Associates as an sixth year of inclusion. Miller specializes in pain management physician specialist and orthopedic surgeon and is affiliated with laparoscopic and robotic urologic surgery. is a part of the hospital’s Pain Management South Georgia Medical Center in Valdosta, Center. Ga. Dr. George Cleland (’91), who practices internal medicine in Athens, Ga., Dr. Joshua L. Garrett (’04) has been Dr. Hans Carlson (’09) has joined has received the Elbertonian Award for named Chief of Staff at Habersham Medical Carolina Ear, Nose and Throat with offices in Outstanding Community Service. Center in Demorest, Ga. Garrett owns Greenville, S.C., and Simpsonville, S.C. Garrett Family Medicine and practices Dr. M. Michelle Berrey (’93) has emergency medicine in Demorest. Dr. Elizabeth A. Yardley (’10) has been named to the Board of Directors of joined the faculty at the University of South biopharmaceutical company Chimerix, Inc. Dr. Bennett Grimm (’06) has joined Carolina School of Medicine in Columbia, Berrey is President, Chief Executive Officer, Resurgens Orthopaedics, Georgia’s S.C., after completing a family medicine and Chief Medical Officer of Chimerix. largest orthopedic practice, specializing residency at Palmetto Health Richland. in minimally invasive spine surgery. The Her interests include pediatrics, women’s Dr. Joseph T. Stubbs III (’93) is board practice has sites in the Georgia cities of health, obesity/weight loss, and spirituality certified in female pelvic medicine and Canton, Marietta, and Woodstock. in medicine. reconstruction. Dr. Richard Jung (’06) has joined Ferrell- Dr. Matthew Farmer (’11) is an internal Dr. Susan C. Lee (’94) has joined the Duncan Clinic (Neurology) in Springfield, medicine specialist at Athens Internal Floyd Primary Care Network in Rockmart, Mo. He is board certified in neurology and Medicine Associates in Athens, Ga. Ga. vascular neurology and is a member of the Society of Neurointerventional Surgery, Dr. Trish Hall (’11) is a family medicine Dr. Sanjeev Saxena (’96), Fort Payne, the American Stroke Association, and the physician at Upson Family Physicians in Ala., has been named to the BBVA Compass American Academy of Neurology. Thomaston, Ga. Advisory Board to help support the bank’s business and development efforts. Saxena is Dr. William Brooks (’07) has joined Dr. Erin H. Meeks (’11) has joined the certified by the American Board of Internal Forsyth Street Orthopaedics in Macon, Ga., medical staff of the Emory Clark-Holder Medicine, with subspecialty certification in as an orthopedic surgeon. Clinic in LaGrange, Ga. cardiovascular disease. He earned a master’s degree in business administration from Dr. Destin Hill (’07) is a partner Dr. Christopher Hathaway, who Auburn University. at Arizona Sports Medicine Center in completed his urology residency at MCG, Scottsdale, Ariz., and is a team physician for treats urologic conditions for adults and Dr. Richard Myers (’97) has been named the Arizona Cardinals and Phoenix Coyotes. children at Yankton Medical Clinic, P.C., in Chief of Staff of Methodist University He assists with the Colorado Rockies, San Yankton, S.D. Hospital in Memphis, the largest hospital Francisco Giants, and Chicago Cubs during system in Tennessee. He also chairs the spring training. Dr. Daniel M. Khuc, who completed Senior Leadership Committee. his family medicine residency at GRU, has Dr. Jeremy Cardinal (’08) has joined joined Maury Regional Medical Center in Dr. W. Gregory Asbury (’01) has TRA Medical Imaging in Tacoma, Wash., as Columbia, Tenn., and practices at the Lewis joined the Floyd Primary Care Network in a radiologist specializing in neuroimaging Health Center in Hohenwald, Tenn. Centre, Ala. He is a member of the Georgia including the brain, spine, head, and neck. Academy of Family Physicians and the Dr. Valerie O. Walker, who completed American Academy of Pain and Medicine, Dr. Corey Harkins (’08) has joined her family medicine residency at GRU, has and is certified as a medical review officer the Plastic Surgery Center of the South in joined the staff of Oconee Primary Care through the American Association of Marietta, Ga. Center in Milledgeville, Ga., treating patients Medical Review Officers. age 5 and older.

Dr. David A. Woodrum (’01) is a radiologist specializing in abdominal imaging at the Mayo Clinic in Rochester, Minn.

FALL/WINTER 2014 48 In Memoriam

Dr. Carol G. Pryor (’47), one of the first women in Georgia to be certified by the American Board of Obstetrics and Gynecology and the first woman member of the Georgia Chapter of the American College of Surgeons, died May 12. After graduating from MCG, she completed a pathology residency at the Baroness Erlanger Medical Center, becoming the center’s first female house staff member. She completed her obstetrics/gynecology residency at the University of Maryland, Johns Hopkins University, and Augusta’s University Hospital. She received Georgia College’s 1982 Achievement Award and 2001 Alumni Heritage Award. She served on the State Medical Education Board from 1965-69 and the Governor’s Council on Maternity and Infant Health from 1981-90.

Dr. Joseph A. Blissit (’56), a physician in Henry County, Ga., for 43 years, died July 12. He was in the first U.S. class in certified family practice medicine and was the first Chief of Staff of Piedmont Henry Hospital in Stockbridge, Ga. He was a past Chairman of the Henry County Board of Health, clinician for the Henry County Health Department, and Medical Examiner for Henry County. The Henry County health building was named in his honor (Joseph A. Blissit Health Complex) and he was named the 1998 Henry County Citizen of the Year. In 2000, he was commended with a privileged resolution on the floor of the Georgia State Senate for his contributions to health care, and he was named a Georgia Hospital Hero in 2008 by the Hospital Association of Georgia. Survivors include his wife, the Rev. Dr. Janice L. Blissit, and their children, grandchildren, and great-grandchildren.

Kathleen “Kath” Girdler Engler, an award-winning sculptor whose artwork is displayed on the Georgia Regents University campus, died June 11. Her artwork on campus includes “Nature of Healing” at the Children’s Hospital of Georgia entrance and “The Graduate” at the entrance of the Greenblatt Library. In addition to sculpting, Engler was a nurse, fitness trainer, and community volunteer, logging many hours at the Children’s Hospital of Georgia guiding patients through art projects and emotionally supporting Upcoming MCG Alumni Association Events their families. She also sponsored Run with Art camps for children several times a year. Survivors include her husband, Dr. Harold “Chubby” Engler (’50), a longtime Feb. 17: Reception, Atlanta, 6 p.m. MCG Foundation board member, son Eben Engler, and five stepchildren. Feb. 24: Board meeting, meetings of Planning and Nominating Committees, dinner, Idle Hour Country Club, Macon, Ga.

March 5: Reception, Northeast History Museum, Gainesville, Ga., 6 p.m.

April 17: Raft Debate, Lee Auditorium, 6 p.m.

49 MCG medicine From the MCG Alumni Association President

Dear MCG Alumni, I am pleased to report that the Medical College of Georgia is thriving! As part of a comprehensive research university, we are offering several joint degrees and enjoying collaborations that were impossible before consolidation. We are becoming a destination university. At the same time, we continue to be truly the Medical College of Georgia, with satellite campuses in Albany, Athens, Rome, and Savannah-Brunswick. Our Deans are working diligently with the faculty in these areas to ensure that the quality of education does not suffer and is enhanced in many ways. Many of our alums are now helping to teach and mentor our future doctors, and we are grateful. At the home base in Augusta, we are thrilled to celebrate the opening of the J. Harold Harrison, M.D. Education Commons, MCG’s official “home.” In addition to housing classrooms for our students’ first two years of medical school, the building will Board of Directors, 2014-15 accommodate Dr. Betty Wray (’60), President dental and allied Dr. Buffi Boyd (’99), President-Elect health sciences Dr. David Gose (’99), First Vice President students, (’73), Second Vice President providing Dr. Mason Thompson opportunities Dr. A. Lynne Brannen (’82), Secretary/Treasurer for teamwork. Since the class is General Directors so large (190 in Dr. Harvey L. Simpson III (’91) Augusta and 40 Dr. Joseph Burch (’85) in Athens), we Dr. J. Price Corr (’77) will have student Dr. Alan Smith (’95) “homes” to foster Dr. Hugh Smisson III (’86) close relationships Dr. T. Wayne Rentz (’72) with each other and several Class Representatives faculty. Dr. George Lazari (’12) Our students Dr. Ronnie Zeidan (’13) continue to make Dr. Joshua Bell (’14) us proud on their board scores, and Recent Graduates a large majority Dr. Betsy Richwin Bolton (’06) of sophomores Upcoming MCG Alumni Association Events Dr. Champ Baker (’02) participated in research projects April 23-26: Homecoming this summer. These experiences will make them more discriminating in evaluating future developments. Be sure to visit the campus at every opportunity. If you can’t find May 4: Graduation Dinner, 6:30 p.m. your way around, call the Alumni Office at 706-721-4001. Put this year’s Homecoming on your calendar now (April 23-26) even if you May 7: Hooding Deremony, are not having a reunion. There will be plenty of activities to enjoy. Bell Auditorium, 2 p.m. With gratitude and fond memories, May 8: Graduation, Civic Center, 2 p.m. Betty B. Wray, MD

FALL/WINTER 2014 50 Medical College of Georgia Non-Profit Office of the Dean Organization 1120 15th Street Augusta, Georgia 30912 U.S. Postage PAID Augusta, GA CHANGE SERVICE REQUESTED Permit No. 210

The 175,000-square-foot J. Harold Harrison, M.D. Education Commons opened its doors Oct. 16. In addition to classroom space, it offers an interprofessional state-of-the-art simulation center. (Additional photos, page 25)