yCenterale to support Nanoparticle m aids edicineScholars and New spring 2012 teaching gene therapy Haven 4 6 18 Tissue from the lab mends a broken heart Last year a 3-year-old Bridgeport girl became the first patient in the United States to receive an implant made of bioengineered tissue. 12 on the cover Using a bioen- this page Angela Irizarry played gineered graft made with cells in her bedroom with her brother, from her own bone marrow, Yale Alexander. Last year she became spring surgeons rearranged blood flow in the first patient in the United the heart of a girl born with only States to receive a bioengineered one functioning ventricle. heart vessel. Illustration by Steven Hall Photo by John Curtis yale medicine spring 2012 CONTENTS 2 Letters 4 Chronicle 8 Books & Ideas 10 Capsule 12 Tissue from the lab mends a broken heart Last year a 3-year-old Bridgeport girl became the first patient in the United States to receive an implant made of bioengineered tissue. By John Curtis 18 Scholars work toward healthy communities Yale’s Robert Wood Johnson Clinical Scholars make a point of engaging the community in their research and making the world a healthier place. By Jennifer Kaylin 24 Faculty 26 Students 28 Alumni 32 In Memoriam 33 End Note On the Web yalemedicine.yale.edu On our website, readers can submit class notes or a change of address, check the alumni events calendar, arrange for a lifelong Yale e-mail alias through the virtual Yale Station, and search our electronic archive. 2 letters On physician-scientists physicians living in the com- In “Is the physician-scientist an Congratulations to Colleen munity would bring a practical endangered species?,” Colleen Shaddox for a very interesting and humanistic viewpoint to the Shaddox outlines the School and timely article in the Autumn medical wards that research sci- of Medicine’s noble efforts to 2011 edition [“Is the physician- entists who are focused on the encourage young people to scientist an endangered spe- purely scientific components of become the medical researchers cies?”]. I published an article in illness are incapable of. of the future. The major threat Yale Medicine: Alumni Bulletin But Abraham Flexner—who to the developing physician Non-Profit Org. U.S. Postage PAID Burlington, VT 05401 of the School of Medicine in the was an educator, not a physi- who undertakes basic science Permit No. 696 yMed alestudents The ethicsm of edicineDoctors winter 2012 get iPads seeding trials and writers spring of 1972, titled “Sicklemia: cian—held the contrary position. research is that this species is 4 6 12 The Doctor Bird Visits a Political He believed that physician- a financial liability in most aca- Arena.” As a student advocate scientists should be trained in demic departments. I helped to form the Sickle Cell the university and that full-time When faculty members are Committee of South Central professors of medicine should told by their chairs that they Connecticut between the com- train physicians. With the back- must “cover their salary,” they munity of New Haven and ing of the Carnegie Foundation encounter a conflict. On the one the School of Medicine. Then I and the Rockefeller Foundation, hand, a physician-scientist typi- graduated from the School of Flexner prevailed. The orienta- cally needs two nih r01 grants to Medicine in 1973 and have been tion of American medicine has pay a significant portion of salary A 21st-century ngo practicing internal medicine been research-based ever since. and cover the expenses of doing A handful of Yale medical students opened a clinic and hospital in a remote corner of Nepal. From 8,000 miles away, via the Internet, they provide support. Here’s how they do it. 18 ever since. I’m proud to have Some believe that the lack of research. And it is hard to see how YM_Winter2012_Front.indd 2 12/19/11 12:21 PM left a contribution to the com- primary care physicians is partly one could successfully run such munity. It’s important to be able due to the disproportionate a lab without at least 90 percent how to reach us to think outside the box if physi- attention to medical research effort. To cover the remainder of Yale Medicine welcomes news cians are to contribute to sci- compared to primary care. The his or her salary typically means and commentary. Please send ence or their local communities. effects of Flexner’s influence generating income through clini- letters (350 words or fewer) and Robert E. Galloway, m.d. ’73, on medical education are now cal work. When one considers news items to Yale Medicine, m.p.h., m.b.a. being questioned by some medi- the costs of seeing patients (mal- 1 Church Street, Suite 300, Houston, Texas cal educators. practice, room rental, administra- New Haven, CT 06510, or via The point is that medical tive support, etc.), however, the e-mail to [email protected], and Concern is expressed in the research is absolutely necessary break-even time point is typically include a telephone number. Autumn 2011 issue about the for medicine to advance. How about 40 percent effort. In the Submissions may be edited for future of the physician-scientist. much research and what kind, current academic department length, style, and content. Clearly the benefits that medi- however, are questions that business model, there simply is visit us on the web cal research has bestowed need to be addressed. Osler’s not enough time to be an effec- yalemedicine.yale.edu upon humanity are remarkable, idea of separating physician- tive basic science researcher and thanks to the efforts and perse- clinicians and physician-scientists, see enough patients to cover verance of research physicians’ as heretical as it may sound the remaining salary costs. The inquisitiveness and their relent- today, may have merit. Perhaps exception to this situation occurs less pursuit of answers. But do fewer m.d./ph.d.s will not have in wealthy departments—either medical researchers necessarily a generally negative effect on surgical departments or those have to be m.d./ph.d.s? medical progress. Maybe more with profit-generating procedures. Almost 100 years ago, Sir ph.d.s working in research insti- To the extent that departments William Osler, a respected clini- tutes and collaborating with must keep their financial house cian, author of a widely read physician-clinicians is a model in order, there is a major disin- medical textbook, and one that should be studied. centive to carry physicians who of the founders of the Johns It would lessen the focus undertake basic science research. Hopkins University School of on medical research and place Departments and medical schools Medicine, believed that medical more emphasis on the training must find intrinsic merit in researchers should confine their of primary care physicians. Is physician-scientist faculty mem- labors to research institutes that necessarily a bad thing? bers and support them accord- and that physicians should be Edward J. Volpintesta, m.d. ingly, or the physician-scientist will trained by community-based Bethel, Conn. go the way of the dodo bird. physicians in private practice. Robert G. Kalb, m.d., hs ’87, fw ’90 spring 2012 spring He thought that the separation Professor, Neurology would be beneficial because it Perelman School of Medicine edicine would lead to the training of University of Pennsylvania m more practical-minded physi- Philadelphia, Pa. ale y cians. Osler also believed that starting point 3 yale medicine Alumni Bulletin of the Yale University School of Medicine Spring 2012, Volume 46, No. 3 Editor in Chief Michael Kashgarian, m.d. ’58, hs ’63 Professor Emeritus of Pathology and Senior Research Scientist Editor John Curtis Yale Medicine goes viral Contributing Editors Peter Farley, Jennifer Kaylin, Karen Peart, As one who came of age professionally in the era of print and attended a high school that Cathy Shufro, Marc Wortman, ph.d. Contributors kept academic records on punch cards churned out by an off-site computer as big as a ware- Sonya Collins, Terry Dagradi, John Dillon, house, I’m still amazed by the possibilities of the digital age. Two e-mail messages that Jill Max, Kara Nyberg, ph.d., Stephanie arrived on the morning of January 30 reminded me of the increasing power of social media. Soucheray-Grell, Sarah P.C. Williams Design Debby Jagielow, director of alumni affairs for the medical school, wrote to say that our Jennifer Stockwell Winter 2012 cover story about Yale medical students who had launched Nyaya, a clinic in a Copy Editors remote corner of Nepal, was receiving many, many “likes” on Facebook. Rebecca Frey, ph.d., Anne Sommer Advisory Board The next message came from Pete Farley, managing editor of our sister publication, Sharon L. Bonney, m.d. ’76 Medicine@Yale. On January 29, a New York Times columnist, Nicholas Kristof, and Peter Irwin M. Braverman, m.d. ’55, hs ’56 Sharon A. Chekijian, m.d. ’01 Singer, the Ira W. DeCamp Professor of Bioethics at Princeton, had tweeted the article by John A. Elefteriades, m.d. ’76, hs ’81, fw ’83 freelancer Stephanie Soucheray-Grell. “Great piece on Yale med students who started a new Rupali Gandhi, j.d. ’00, m.d. ’04 Owen D. Garrick, m.d. ’96 style of ngo, saving lives in one of the poorest regions of Nepal,” Singer tweeted. Robert H. Gifford, m.d., hs ’67 That same day Facebook and Twitter drove 1,050 viewers to our site. Our website usu- Elliott Levy, m.d. ’87 Raymond J. Lynch, m.d. ’05 ally draws about 900 visitors per month.