+++++++++++++ +++++++++++++ +++++++++++++ +++++++++++++ [ ] +++++++++++++ ISSUE 2, 2014 +++++++++++++ A PHYSICIAN PUBLICATION FROM +++++++++++++ +++++++++++++ THE NORTH SHORE-LIJ HEALTH SYSTEM +++++++++++++ +++++++++++++ +++++++++++++ +++++++++++++ +++++++++++++ +++++++++++++ +++++++++++++ +++++++++++++ REBUILDING RESIDENT CONNECTIONS PAGE 7 A PHOTOGRAPHIC PHYSICIAN PAGE 29 Q&A: OPINIONS ABOUT ICD-10 PAGE 33 in Health Management SPECIAL SECTION: OBESITY PAGE 12 THIS ISSUE IN A WORD down, and whatever you say will be clouded by his weighty: embarrassment. You will not be an effective doctor. heavy; of great Your job is to be sophisticated and importance or introspective enough to understand and consequence neutralize your prejudices. Mind you, the aforementioned attitude is pervasive in all walks of medicine, health care and our society. It is up to you to stop the stares, the jokes and the insensitivity that too often emerge during treatment of the overweight. Understand appetite and energy metabolism. Bring something smart to the table. Do not assume obese patients are simply out-of- DEAR COLLEAGUES, control eaters. And if they are (which you need to ask about sensitively), assume that it is the A doctor enters the examination room underlying biology — or a mix of things — and the patient, terribly uncomfortable driving them to that next plate. in every way, struggles to close his cotton We must treat obesity without stigma. Our robe. He is obese. He can’t climb onto the minds must be set on helping overweight exam table without help. Thoughts swirl patients understand how weight contributes to around unstopped in the doctor’s head, and disease. We must work with them — or refer although nothing is said aloud, the patient them out — to help with weight loss gets the message: “You are fat. You have and exercise. no self-control. You are killing yourself, and The stigma will end one doctor at a time. now you’ve come to me with your long list of For three years now, I have met with the medical problems.” students and faculty of the Hofstra North Physician, heal thyself. Stop blaming Shore-LIJ School of Medicine for a lecture patients for their girth. There is now enough and discussion about obesity-related diseases. data to show that obesity is a complex You will see from several articles in this issue and multifactorial problem. It is a disease, that the North Shore-LIJ Health System takes according the American Medical Association. obesity seriously and has designed many ways If you are ever going to help your overweight to address the problem among our patients and obese patients, you must stop blaming and in our communities. We are also teaching them (even silently) and do your own work medical students and residents healthy cooking to educate them. methods so that they can better understand It is clear that fighting obesity is infinitely the messages they deliver to their patients. more complex than simply reining in eating habits. The minute you become judgmental Lawrence Smith, MD LEADERSHIP MESSAGE LEADERSHIP toward your patient, trust is gone. He may PHYSICIAN-IN-CHIEF, NORTH SHORE-LIJ HEALTH SYSTEM not be out the door, but his mind will shut DEAN, HOFSTRA NORTH SHORE-LIJ SCHOOL OF MEDICINE NORTH SHORE-LIJ EDITORIAL BOARD TRUE NORTH CUSTOM TERENCE LYNAM CHARLIE MILBURN ase Re le c P y Vice President, Public Relations Senior Account Manager . c e l e l Doctoring is published . c P y BRIAN MULLIGAN ASHLEA ROARK l c e e a as a service of the R s Art Director e Assistant Vice President, Public Relations North Shore-LIJ Health System. MARIA CONFORTI ED LAMMON Director of Editorial Services Managing Editor JAMIE TALAN CANDICE ST. JACQUES Science Writer Senior Managing Editor TO SUBSCRIBE OR UNSUBSCRIBE, call 800-624-7496. DOCTORING : ISSUE 2, 2014 3 DOCTORING DR. CONTENTS ISSUE 2, 2014 GADGETS & GEAR 10 ... Complex Care, Simplified 22 ... Cooking Up Health 04 ... Misconception Solutions ....... Scoping the Body ART & SCIENCE ....... Tiny Tech SPECIAL SECTION: OBESITY 26 ... The Stage Doc 14 ... Tipping the Scales CULTURE RESIDENT PROFILE Against Obesity 29 ... A Developing Passion 05 ... Inspired by Illness 17 ... Leading by Example OUTREACH 20 ... A Battle of the Bulge FIRST PERSON 07 ... Calling All Alumni Veteran Offers a Plan 33 ... Q&A: ICD-10 of Attack ON THE COVER: FAT CELLS, SEEN AT A MICROSCOPIC LEVEL IN THIS ILLUSTRATION, CAN EXPAND TO AS LARGE AS 1,000 TIMES THEIR ORIGINAL SIZE. HEY DOC, DO YOU HAVE AN iPAD? Special Section LOOK INSIDE FOR TABLET EDITION EXCLUSIVES. LOCATE THESE ICONS THROUGHOUT DOCTORING MAGAZINE TO LEARN WHERE YOU CAN ENJOY SUPPLEMENTAL 12 CONTENT IN THE TABLET EDITION: TABLET-EXCLUSIVE PHOTOGRAPHY OBESITY TABLET-EXCLUSIVE VIDEO GET YOUR FREE TABLET SUBSCRIPTION TO 10 22 DOCTORING FROM THE APP STORE TODAY. FOLLOW THESE STEPS: NEWSSTAND 1) DOWNLOAD OUR APP FROM THE APP STORE. 2) OPEN YOUR NEWSSTAND APP. 3) SUBSCRIBE TO DOCTORING. 29 4) DOWNLOAD ISSUES AND ENJOY! ISSUE 2, 2014: DOCTORING G gadgets & gear > A ROUNDUP OF PRODUCTS AND DEVELOPMENTS OF INTEREST TO PHYSICIANS by Jamie Talan 1 2 Scoping the Body [GI IMAGING] Swallow this camera and call me in the morning. Early this year, the US Food and Drug Administration approved PillCam COLON, a pill- sized video camera that can be swallowed, allowing it to travel through the gastrointestinal tract to the Misconception colon. There, the PillCam captures images that are READ MORE [FICTION-WRITING PHYSICIAN] transmitted to a data recorder worn on the patient’s belt. The device typically remains in the body for about 10 hours before it is eliminated as waste. Avner Hershlag, MD, has spent his career Doctors retrieve images from the data recorder bringing babies into the world who might not to inspect inconclusive yet suspicious polyps or otherwise have been born. Chief of the North adenomas following a standard colonoscopy — Shore-LIJ Center for Human Reproduction, offering an effective option for completing the Dr. Hershlag is also the author of an intricate approximately 750,000 incomplete colonoscopies novel based on the modern state of affairs in that require further testing in the US each year. reproductive medicine and genetics. The medical thriller Misconception delivers the right amount of fear and joy that comes with the prospect of conception. But what Tiny Tech [NANOMOTORS] happens when the new technology is 3 threatened and scientists have the tools to “poach” an embryo and alter the mix of genes? Scientists in the Mallouk Lab at Eberly What happens when a child is born grossly College of Science, Pennsylvania State deformed after in vitro fertilization? How did a University in University Park recently young woman (a senator’s daughter) who has introduced nanomotors — a technology being been in a coma for years become pregnant? developed to damage or kill abnormal cells Are embryos made in a laboratory safe from — into human systems. They were able to evil forces that want to alter humankind? steer these miniature “rocket-shaped metal As a fertility specialist, Dr. Hershlag has particles” through the anatomy to deliver been grappling with such questions for ultrasonic waves that can target and destroy decades. Now, he struts his writing stuff in specific malignant cells. a great read. Misconception can be ordered In the Penn State study, scientists targeted from amazon.com. human cervical cancer HeLa cells, which have READ MORE been widely used in scientific research due to their durability and propensity to proliferate. READ MORE The hope is that nanomotors could travel OR ORDER inside the body and perform various kinds of YOUR COPY diagnostics and therapy. DOCTORING : ISSUE 2, 2014 5 RESIDENT PROFILE RESIDENT Inspired by Illnessby Jamie Talan FOR ONE LENOX HILL HOSPITAL RESIDENT, THE JOURNEY INTO MEDICINE HAS LONG BEEN GUIDED BY PERSONAL MEDICAL EXPERIENCES. ISSUE 2, 2014: DOCTORING 6 RESIDENT PROFILE RESIDENT ichard Adamski was about five years old when might have another autoimmune disease. Tests revealed he began to understand that his mother he had rheumatoid arthritis. The unrelenting exhaustion couldn’t walk on her own because she was sick. scared him, but tenacity fueled him. His driving goal was R He was used to seeing other moms out and to become a doctor. He was only a few years away, and about — but the woman he loved was always home, and nothing was going to get in his way. most of the time she was lying in bed. Well, almost nothing. In college, he became interested Multiple sclerosis was the in toxicology, worked in a lab ghost that kept his mother and decided to pursue a doctor- down. He hadn’t even entered ate. But he was more interested elementary school when he found in the clinical experience and his calling. He told his father and later opted to turn back to medi- grandmother: “I want to make my cine. After medical school at St. mommy better.” George’s University in Grenada An only child, Richard spent — to which he was led by a cous- much of his youth surrounded by in — he applied for a fellowship doctors. He was as comfortable in rheumatology. At this point, around white coats as he was he was a second-year resident at around toy soldiers. Lenox Hill Hospital. Before his mother became ill, “I have never felt sorry for she, too, had dreams. She wanted myself, and I understand what it’s to become a nurse. But the first like to be a patient,” Dr. Adamski troubling signs appeared when said. “I don’t view this aspect she was 22. of my life as a hardship, but as She also wanted love, marriage something that strengthens me and a child — all of which became and contributes to a stronger Richard Adamski, MD, right, pictured with his father, hers, but not without challenges.