Great Expectations - Newsroom

THE MAGAZINE OF WEILL CORNELL MEDICAL COLLEGE AND WEILL CORNELLGRADUATE SCHOOL OFMEDICAL SCIENCES

weillcornellmedicineSPRING 2012

GreatExpectations

Dean Laurie Glimcher aims to lead Weill Cornell to new heights

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weillcornellmedicineTHE MAGAZINE OF WEILL CORNELLMEDICAL COLLEGE AND WEILLCORNELL GRADUATE SCHOOL OFMEDICAL SCIENCES

SPRING 2012

22 MEET THE DEAN

BETH SAULNIER

Weill Cornell’s new dean, Laurie Glimcher,MD, is a highly respected physician-scientist—board-certified in internal medicine andrheumatology and the founder of a successfulimmunology lab at Harvard. In a conversationwith Weill Cornell Medicine, Glimcher talksabout her plans to expand WCMC’s researchenterprise, the importance of mentoring, thechallenges facing medical education, the valueof collaborating with industry, and more.“We’re on the brink of a huge opportunity,”Glimcher says. “It’s my dream job.”

26 COMPREHENSIVE CARE

ANDREA CRAWFORD

Located at the Iris Cantor Women’s HealthCenter at NYP/Weill Cornell, the multidiscipli-nary Weill Cornell Breast Center offers an inno-vative, patient-centered approach to clinicalcare and research. Home to one of the firstbreast cancer tumor boards in New York City,the Center has long been in the vanguard ofintegrating specialists to battle the disease—bringing together oncologists, surgeons, radiol-ogists, and others to craft personalized treatment plans.

32 ACID TEST

SHARON TREGASKIS

Since the Nineties, women of childbearing agehave been urged to take folic acid supple-ments to prevent their babies from being bornwith neural tube defects (NTDs). NeurologistM. Elizabeth Ross, MD ’79, PhD ’82, hasdevoted her career to studying these devastat-ing defects, which include spina bifida. But asRoss notes, the relationship between folateand NTDs still isn’t fully known—and folicacid may play a role, both preventive andcausal, in a host of other conditions.

FEATURES

•Twitter: @WeillCornell •Facebook.com/WeillCornellMedicalCollege •YouTube.com/WCMCnews

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Cover photograph by John Abbott

Weill Cornell Medicine (ISSN 1551-4455) is produced four times ayear by Cornell Alumni Magazine, 401 E. State St., Suite 301,Ithaca, NY 14850-4400 for Weill Cornell Medical College and WeillCornell Graduate School of Medical Sciences. Third-class postagepaid at New York, NY, and additional mailing offices. POSTMASTER:Send address changes to Public Affairs, 525 E. 68th St., Box 144,New York, NY 10065.

2 DEANS MESSAGESComments from Dean Glimcher & Dean Hajjar

4 CAPITAL CAMPAIGN UPDATE

6 SCOPETech campus across the river. Plus: Dean Glim cher’s inaugural address, Office of FacultyDev elop ment, heart disease expert dies, $25,000for Community Clinic, student research day, andre mem bering Joseph Artusio, MD ’43.

9 TALK OF THE GOWNBattling Chiari malformation. Plus: Doctors’ decision-making, a place in the Sun, hypertensionalgorithm, exploring metabolomics, Asian beautysecrets, radio MD, neonatal stroke, dancing withdolphins, the biostatistics work of the lateAndrew Leon, PhD, and a mysterious composer.

38 NOTEBOOKNews of Medical College alumni and GraduateSchool alumni

47 IN MEMORIAMAlumni remembered

48 POST DOCAcross disciplines

DEPARTMENTS

Weill Cornell Medicine is produced by the staff of Cornell Alumni Magazine.

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Beth Saulnier

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Published by the Office of Public AffairsWeill Cornell Medical College and Weill Cornell Graduate School of

Medical Sciences

WEILL CORNELL SENIOR ADMINISTRATORSLaurie H. Glimcher, MD

The Stephen and Suzanne Weiss Dean, Weill Cornell MedicalCollege; Provost for Medical Affairs,

Cornell University

David P. Hajjar, PhDDean, Weill Cornell Graduate School

of Medical Sciences

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WEILL CORNELL DIRECTOR OF COMMUNICATIONS

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2 W E I L L C O R N E L L M E D I C I N E

A Brave New World

Deans Messages

Laurie H. Glimcher, MD, Dean of the Medical College

care. Each part depends upon the other—and each is close to my heart, because thethree have long been the components ofmy own professional life.

Health care in this country is facing awatershed moment, and the challengesposed will require bold new ideas and acommitment to excellence. I intend forWeill Cornell to be in the vanguard offinding solutions. I take my inspiration forthis from stories of other great medicalgroundbreakers—from the clinicians whotransformed surgery with the discovery ofgeneral anesthesia to the researchers whoprolonged human life through the devel-opment of vaccines. These bold innova-tors show that it is possible for a handfulof passionate, talented individuals tomake a difference in the face of dauntingproblems.

For Weill Cornell to pioneer such solu-tions will require an interdisciplinaryapproach to biomedical research, wherethere are no barriers among our clinicians,our translational researchers, and our basicscientists. It will require a culture of coop-eration, collaboration, transparency, inclu-siveness, and collegiality. It will requirestrong partnerships—not only with the

academy, with NewYork-Presbyterian, and with other health-careorganizations, but with the private sector as well. It will require acommitment to confronting the issues facing the current health-care system. Above all, it will require intense effort from each of us:basic scientists and clinicians, faculty and administration, currentstudents and alumni alike.

Over the next ten years, as we populate the more than one mil-lion square feet of space newly built along York Avenue, this insti-tution will undergo an impressive transformation. We have anopportunity available to very few American medical colleges: tobend the curve in clinical care, graduate education, and biomedicalresearch. And when we combine that opportunity with the engi-neering and technical campus that Cornell is building on RooseveltIsland, it seems safe to say that in the next decade, CornellUniversity will become the premier educational presence in NewYork City.

Let us embark on this exciting new frontier together, as wecontinue to build one of the strongest academic medical centersin the world.

British-born Elizabeth Blackwell was the first woman toearn a medical degree in the United States. She trainednurses in the Civil War and founded the New YorkInfirmary for Women and Children, which was later

incorporated into New York Downtown Hospital. “It is not easy tobe a pioneer—but oh, it is fascinating!” Blackwell once said. “Iwould not trade one moment, even the worst moment, for all theriches in the world.”

My vision for Weill Cornell in the next ten years can be summa-rized simply: I want this institution to be a pioneer in everythingthat it does. A decade from now, I want to see Weill Cornell rankedamong the top ten medical schools in this country, with a doublingof its current NIH support. I want this institution to furtherenhance its status as a world-class biomedical research enterprise,renowned for its ability to translate science into meaningful thera-pies. Building on Dean Gotto’s legacy in expanding the scope ofWeill Cornell as an institution of both national and internationalstanding, I want us to be among the best in the world in each ele-ment of our tripartite mission: research, education, and clinical

JOHN ABBOTT

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Funding Outside the Box David P. Hajjar, PhD, Dean of the GraduateSchool of Medical Sciences

It is no secret among the biomedical commu-nity and lay public alike that federal fundingfor science has been flat over the last several

years, and that it will likely remain so for theforeseeable future. In 2011, for example, the NIHfunded, in general, only about 15 percent of theapplications it received for the R01 grant, its old-est funding mechanism for health-care relatedresearch and development.

At the same time, the costs of conducting bio-medical research have continued to increase. Toadapt to this new funding landscape, in 2010 wecreated within the Office of Research andSponsored Programs a Research Developmentand Outreach Office. Directed by Brian D.Lamon, PhD, assistant dean for research develop-ment and outreach, this office provides institu-tional and administrative support to studentresearchers and faculty, to help identify appropri-ate sources of nontraditional funding, so that ourfaculty can maintain their laboratories. Thesources we categorize as nontraditional on thiscampus include the Department of Defense, theNational Science Foundation, and the Depart -ment of Energy, as well as philanthropic founda-tions, voluntary health organizations, and othernongovernmental organizations. Two of the well-known non-federal foundations are the HowardHughes Medical Institute and the Bill andMelinda Gates Foundation.

The Research Development and OutreachOffice—like the Office for Industrial Support,headed by Caren Heller, MD—constantly seeksalternative funding for investigators doing bothbasic and clinical research. Such funding canhelp investigators support lab infrastructure, purchase equipment and supplies, travel to meet-ings, and pay laboratory personnel. These grantsare also important resources for seeding the pre-liminary work that can develop into large NIH-supported studies.

Built from scratch, the office began by sim-plifying grant databases and organizing, in oneplace, numerous other digital resources for grantwriting. It also oversees proposal development,helping faculty craft applications specific to themission and goals of the granting agency fromwhich they seek funding. The support that fac-

ulty members receive from the ResearchDevelop ment and Outreach Office is particular-ly im portant as investigations grow more inter-disciplinary and proposals more complex.Today’s funding agencies often reward collabo-rative efforts that bring researchers togetheracross different areas of an institution, andamong multiple institutions as well.

After just two years, the office has alreadybegun to see measurable results. Even thoughbiomedical research funding from nonprofitsdeclined 20 percent in the aftermath of thefinancial crisis, Weill Cornell increased its non-traditional funding during this difficult time byat least 10 percent.

Today’s biomedical researchers must be morecreative in seeking support for their work, yetthe hunt for alternative funding sources shouldnot encroach upon their search for scientificbreakthroughs. I am pleased that the ResearchDevelopment and Outreach Office is helping toensure that Weill Cornell’s researchers can suc-cessfully negotiate the vicissitudes of the morecompetitive funding landscape—without spend-ing even more time out of the laboratory.

PROVIDED

Brian D. Lamon, PhD

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ScopeNews Briefs

In Inaugural Address, Dean Laurie GlimcherOutlines Ten-Year Plan for WCMCIn her inaugural address to the Weill Cornell community in earlyJanuary, Dean Laurie Glimcher, MD, described her vision for theMedical College—as a global leader in clinical care, biomedicalresearch, and medical education. “We are facing watershedmoments in this country in clinical care, in medical education, andin biomedical research,” Glimcher told a standing-room-only crowdin Uris Auditorium. “The challenges these pose will require boldnew ideas and a commitment to excellence. I intend for WeillCornell to be a pioneer in finding solutions to these issues. We willlead the way.”

In her talk, Glimcher laid out a ten-year plan whose goals includemaking Weill Cornell one of the top ten medical schools in thenation—and to see its NIH funding double. To that end, she aims torecruit thirty top-tier faculty who will become the next generation ofclinical and research leaders. Other goals include raising more moneyfor student scholarships; building on the Medical College’s commit-ment to ethnic and gender diversity; and strengthening the relation-ship with its partner institutions, including NewYork-PresbyterianHospital, Methodist Hospital, and Cornell University. “We havemuch to do and it won’t be easy to do it,” she said, “but I know thattogether we can accomplish astonishing things.”

Cornell Wins NYC Tech Campus Competition

SKIDMORE, OWINGS & MERRILL

Across the river: A rendering of the planned tech campus on Roosevelt Island

Shortly before Christmas, Mayor Michael Bloombergannounced that Cornell University and the Technion-Israel Institute of Technology had won the competi-tion to build an applied sciences campus on RooseveltIsland. Located across the East River from the Medical

College, the campus will include a “hub” devoted to health-caretechnology, offering myriad opportunities for research collabora-tions with physician-scientists at Weill Cornell. At the announce-ment ceremony, held at Weill Cornell, Bloomberg called theCornell-Technion proposal “far and away the boldest and mostambitious.” The agreement calls for the city to provide eleven acresof land—some of which currently houses a hospital long slated fordemolition—and up to $100 million in infrastructure improve-ments. The University has also received a $350 million gift to sup-port the project from philanthropist Charles Feeney, a 1956alumnus; it’s the largest single donation in Cornell history and oneof the largest in the history of American higher education.

The school will open this fall in a temporary location; construc-tion will begin in 2015, with the first phase of the facility openingno later than 2017. When fully realized—by 2043—the project willcomprise more than two million square feet of space, with environ-mentally friendly buildings and public open spaces. The school isplanned to have 2,500 master’s and doctoral students and some280 faculty members, and create up to 8,000 permanent jobs.

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Office Established to Aid Developmentof Junior and Senior Faculty

With the aim of supporting profes-sors at all career levels, the MedicalCollege has established an Officeof Faculty Development. “Suc -cessful career development re -quires a clear understanding of thecriteria for promotion, mentorshipat all levels, provision of protectedtime for research and academicactivities, and formal training inwriting of grants, manuscripts,and clinical trials,” Dean Glimcher

said in an announcement. “This office will ensure theseopportunities permeate through the entire Weill CornellMedical College community. Moreover, as medical discov-ery and its translation to improved clinical care involvemultidisciplinary teams of investigators and clinicians, thisoffice will help faculty to promote collaborative team build-ing among clinical researchers and translational and basicscientists.” The office will be led by the new associate deanfor faculty development, Barbara Hempstead, MD, PhD.

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TIP OF THE CAP TO. . . JoAnn Difede, PhD, whose research teamwon an $11 million grant from theDepartment of Defense to study the useof virtual reality and other novel thera-pies to treat PTSD in veterans of the Iraqand Afghanistan wars.

Clinical professor of medicine MarkPasmantier, MD, winner of the Out -standing Service Award from the NewYorkWeill Cornell Medical Center AlumniCouncil, in recognition of his fourdecades of service to the hospital and theMedical College.

Manish Shah, MD, assistant professor ofmedicine and director of gastrointestinaloncology at NYP/Weill Cornell, who rangthe closing bell at the New York StockExchange on December 19 to highlightthe fight against stomach and esophageal

WCMC-Q researchers Sara Abdul-Majid,Joel Malek, Christopher Ogden, PhD,and Renee Richer, PhD, and Ithaca col-leagues Anthony Hay, PhD, and MichelLouge, PhD, whose work on the micro -biology of sand dunes was named BestEnvironment Research Program of theYear by the Qatar Foundation.

Pediatrics professor James Bussel, MD,co-winner of the $200,000 King FaisalInternational Prize for Medicine for hiswork on the treatment of fetuses withalloimmune thrombocytopenia, whichcauses intracranial hemorrhage.

Professor of psychology in psychiatry

cancer. He was accompanied by colleaguesNasser Altorki, MD, the David B. SkinnerProfessor of Thoracic Surgery, and AndrewDannenberg, MD, the Henry R. Erle, MD-Roberts Family Professor of Medicine.

Andrew Schafer, MD, the E. HughLuckey Distinguished Professor of Medi -cine and chair of the Department ofMedicine, winner of the Robert H.Williams, MD, Distinguished ProfessorAward, the highest honor given by theAssociation of Professors of Medicine.

NewYork-Presbyterian’s Westchester Div -is ion, the first behavioral health facilityin the nation to be named a PlanetreeDesignated Patient-Centered Hospital.Planetree is a nonprofit that promotespatient empowerment and positive heal-ing environments.

Community Clinic Benefit Raises $25KA January fundraiser garnered more than $25,000 to support thestudent-run Weill Cornell Community Clinic. The event, whichbrought a sellout crowd of 200 to the Astor Center in NoHo, fea-tured a silent auction of fifteen donated art works created on thetheme of “Without a Safety Net.” MD-PhD student Megan Riddle,co-director of the clinic—which is funded by donations and grantsand is staffed by volunteer students, physicians, and social work-ers—noted that the event raised far more than organizers hadhoped. “Right now, there is much more demand for our servicesthan we are able to offer,” she said. “This puts us much closer toour goal of being able to meet that demand.”

Event Showcases Student Research Thirty student scientists presented their work at the tenth annualMedical Student Research Day in February. The event featuredpresentations on such topics as the benefits of community-basedtesting for heart disease and the relationship between sepsis andblood clots. According to assistant dean for research developmentBrian Lamon, PhD, the day offers valuable lessons for young sci-entists. “You can be doing the best science project in the world,”he says, “but if you can’t sell that to other people and let othersknow what you are doing, it’s useless.”

Barbara Hempstead,MD, PhD

State of the art: A silent auction inNoHo supported the Community Clinic.

WEILL.CORNELL.EDU

JOHN ABBOTT



FROM THE BENCH

Diagnoses of AutismSpectrum Disorders Vary A study in the Archives ofGeneral Psychiatry findsthat diagnoses of autismspectrum disorders varywidely across clinics.“Clinicians at one centermay use a label likeAsperger syndrome todescribe a set of symp-toms, while those atanother center may usean entirely different labelfor the same symptoms,” says lead investigatorCatherine Lord, PhD, director of the Center forAutism and the Developing Brain on theWestchester campus. Lord and her team trackedsome 2,100 people aged four to eighteen whowere given a diagnosis of autism spectrum disorderat twelve university-based centers. They foundthat the diagnoses varied widely from site to site,rendering the various categorizations almostmeaningless. “Because clinicians may not be usinglabels appropriately or diagnosing accurately, theymay not be getting a sense of children’s strengthsand weaknesses and what therapy is best forthem,” Lord says. The take-home message, sheadds, is that “there really should be just a generalcategory of autism spectrum disorder, and thenclinicians should be able to describe a child’sseverity” based on a variety of factors.

Study Compares HipReplacement ImplantsAn FDA-funded data analysis has found no clearevidence that one type of hip implant is moreeffective than another. Art Sedrakyan, MD, PhD,director of the Patient-Centered ComparativeEffectiveness Program and associate professor ofpublic health, and colleagues examined out-comes for patients who received metal-on-metal,metal-on-polyethylene, and ceramic-on-ceramicdevices. The researchers, who examined datafrom more than 830,000 surgeries in nationalregistries as well as the records of more than3,100 patients enrolled in comparative studies,note that the potential risks of the variousimplants are still unclear, and that their studywas limited because of differences in method -ology and reporting. “Before any claims of bene-fit are made, there should be large,peer-reviewed clinical trials comparing thesetreatments,” Sedrakyan says.

Early HIV Intervention Is Cost-EffectiveEarly initiation of antiretroviral therapy (ART) forHIV-infected adults in Haiti not only saves lives,it’s cost-effective. After a three-year study,researchers at Weill Cornell and GHESKIO havefound that patients who received early ART inHaiti had lower overall medical costs than thosewho had the standard treatment. “This studysuggests that the new WHO guidelines for ARTinitiation can be cost-effective in resource-poorsettings,” says GHESKIO director and medicineprofessor Jean Pape, MD ’75. “Despite substan-tial budget and logistical constraints to imple-menting earlier treatment, policy makers shouldallocate resources to maximize their ability toimplement the new guidelines.”

Genetics of Cleft PalateIn the journal Development Cell, researchers ledby Licia Selleri, MD, PhD, associate professor ofcell and developmental biology, have describeda genetic method to repair cleft lip and palatein mice embryos. The team found that genesfor Pre-B Cell Leukemia Transcription Factorproteins contribute to the development of thedefect, and that altering one type of moleculein the Wnt signaling pathway (which plays arole in embryogenesis) can correct it. The workcould lead to a method for preventing or treat-ing the condition in humans.

Positivity Promotes Health Self-affirmationcan encouragehealthy decision-making, finds thefirst large, random-ized trial on thetopic. The work,funded by theNational Heart,Lung, and BloodInstitute, involved756 patients in three studies. Those in theexperimental group were told to think of smallthings in their lives that make them feel good,when they get up in the morning and through-out the day. They were also asked, when facedwith obstacles, to recall moments in their livesthat they’re proud of. Mary Charlson, MD, exec-utive director of Weill Cornell’s Center forIntegrative Medicine, and colleagues found thatthe affirmations made subjects more likely toincrease their physical activity and to takemedication to control high blood pressure.

Catherine Lord,PHD

Mary Charlson, MD

Remembering Heart DiseaseExpert Lawrence HinkleRetired medicine pro-fessor Lawrence HinkleJr., MD, a pioneer instudying the naturalhistory and mechanismof sudden death and ofcoronary heart diseaseamong middle-agedAmerican men, died on January 10. He wasninety-three. The for-mer head of the Div -ision of Human Ecol -ogy of the Departmentof Medicine, Hinkle practiced for morethan four decades and published morethan 135 papers. His many honors includethe Bernstein Award for Excellence inMedical Research from the New YorkMedical Society. Hinkle retired from WeillCornell in 1988.

Anesthesiology PioneerJoseph Artusio Dies at 94Joseph Artusio Jr., MD ’43, founding chair-man of the Department of Anesthesiologyand longtime anesthesiologist-in-chief atNYP/Weill Cornell, died on December 21.He was ninety-four. Artusio spent his entirecareer at Weill Cornell and was its highest-ranking anesthesiol-ogist for forty-twoyears, retiring withemeritus status in1993. He made maj orcontributions to thefield, including thedevelopment of anes-thetic techniques forearly heart surgeryand research intononflammable anes-thetic agents.

His numerouspub lications includethe textbooks Practical Anes thesiology andAnesthesiology: Problem-Oriented PatientManagement; the latter remains in wide useby residents and has been translated intonumerous languages. Among his WeillCornell honors are the Maurice GreenbergDisting uished Service Award and theAlumni Award of Distinction. A professor-ship was established in his name in 1989; itis currently held by his successor, JohnJoseph Savarese, MD.

Lawrence Hinkle Jr.,MD

Joseph Artusio Jr., MD ’43

UNIVER

SITY OF MICHIGAN

AMELIA PAN

ICO

WCMC

WCMC


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Talk of the GownInsights & Viewpoints

New Jersey high school sopho-more Connor Ventura was play-ing in a soccer showcase inPhoenix in December 2009when he experienced severe

dizziness, headache, and near-delirium. He decid-ed to play through it; after all, this was his shotat impressing the Division I college scouts.

At the end of the game, he collapsed. Thecoaches thought it was a concussion. ButVentura, then fifteen, didn’t recall getting hit.Nor did his mother, Patti, remember Connorhaving anything more than normal impact with

Goal oriented: Connor Venturais back on the soccer field.

Brainstorm

After successful neurosurgery to repair a

Chiari malformation, a teenager resolves to

raise awareness about the condition

another player. At a Phoenix hospital, they gotsome sobering news: Connor needed brain sur-gery, and soon. “I tried to keep it all in,” he says.“I could see my Mom was a wreck, so I wantedto be strong. But I can’t tell you the feelings thatwent through me. I was scared.”

Ten days and a battery of tests later, Venturawas diagnosed with a condition known as Chiarimalformation. He underwent a surgical decom-pression procedure at the Weill Cornell Brain andSpine Center, the region’s leading hospital fortreating patients with Chiari. The operation wasa success; today, Ventura says he is “healthier

VICTOR VENTURA

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than I’ve ever been.” Chiari malformations are structural abnor-

malities at the back of the head. Normally, alarge hole in the base of the skull accommodatesthe connection between the brain and spinalcord; the area is surrounded by fluid that canmove freely between head and spine. In a personwith Chiari, the back of the brain (the cerebel-lum), is pushed down through the opening, cre-ating pressure on the cord and restricting fluidmovement. That can cause a wide variety ofsymptoms; the most common are headache andneck pain, which typically get worse with exer-tion (exercise, coughing, sneezing, even laugh-ing). Another frequent complaint is temporarytingling or numbness in the hands and fingers.

There are no figures for Chiari in the generalpopulation, says Jeffrey Greenfield, PhD ’99, MD’02, an assistant professor of neurological surgery,the Victor and Tara Menezes Clinical Scholar in Neuroscience, and an assistant attendingneuro logical surgeon at NewYork-PresbyterianHospital/Weill Cornell Medical Center. He wasone of two neurosurgeons who operated onVentura; the other was Theodore Schwartz, MD, aprofessor of neurological surgery and an attend-

ing neurological surgeon at NYP/Weill Cornell.“A lot of people are walking around with

Chiari and don’t even know it,” says Greenfield.“People can have it and lead normal, relativelysymptom-free lives.” Connor Ventura hadn’tbeen one of them. He says that even before theArizona incident, he knew the inside of his pedi-atrician’s office as well as his locker room. He suf-fered from routine sinus infections, strep throat,and constant headaches, among other ailments,and was frequently on one antibiotic or another.“But since the operation two years ago I haven’tbeen in a doctor’s office except for follow-ups onmy Chiari,” says Ventura, whose only lasting evi-dence of the experience is a five-inch scar on theback of his head. “I haven’t gotten any sinusinfections or colds since the operation.”

Greenfield notes that when it comes toChiari, accurate diagnosis and appropriate evalu-ation are key. “With the advent of the MRI, morepeople are finding that they have Chiari,” hesays. But not all cases warrant surgery. “We tendto be conservative because it’s a major operation,”he says. “We will often take a wait-and-seeapproach if the symptoms are not severe. There isnothing worse than performing invasive surgeryon a patient who doesn’t really need it. Whenpatients are referred, we follow them conserva-tively more often than we operate on them.”

Currently, the Brain and Spine Center is rais-ing funds to hire a pediatric research fellow tooversee three Chiari studies, including work onthe association between the malformation andspine deformity, and on determining whichsymptom-free patients are at highest risk for pro-gression. The Center is also exploring howChiari—as well as other conditions such as braintumors and aneurysms—can be treated with lessinvasive techniques. Greenfield’s partner, MarkSouweidane, MD, director of pediatric neuro-surgery at the Komansky Center for Children’sHealth at NYP/Weill Cornell and director of theWeill Cornell Pediatric Brain and Spine Center, isoverseeing many of the Chiari research initia-tives. “I have nothing but the highest accoladesfor the Center, from the staff in the ICU to thenurses on the floor and, of course, the doctors,”says Patti Ventura. “They did an exceptional jobat every level and continue to do so.”

In fact, Connor Ventura and his family were sograteful to Greenfield and his staff that they raisedmore than $8,000 to create a section about Chiarion the Center’s website, cornellneurosurgery.org. “Isee my Chiari as a gift,” Ventura says. “It changedmy life. Most people don’t get to experience whatI’ve gone through until they are much older. Iwant to share that experience with younger kidswho come in here as scared as I was—and showthem that they’re going to be okay.”

— Franklin Crawford

Jeffrey Greenfield, PhD ’99,MD ’02

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A s an internal medicine res-ident, Tara Bishop, MD’02, MPH, was troubled by inconsistencies. Some -times physicians would

order tests to evaluate a patient’s complaint;other times, they would tell someone withthe same problem to wait and see. Duringher rotation in the intensive care unit, shesaw that some patients received every pos-sible lifesaving technique, but others gotfewer interventions. Later, when she wason the other side of the stethoscope, shewanted to know whether her own doctorssuggested tests or procedures purelybecause they were necessary or effective,or for other reasons. “I’ve never reallyquestioned my doctors’ decision-making,but it definitely crosses my mind to askwhy things are done,” says Bishop, anassistant professor of public health in Weill Cornell’s Division of Outcomes andEffectiveness Research.

As a researcher, Bishop is making acareer out of studying how and why doc-tors make certain day-to-day decisions. Fiveyears after completing her residency, she isquantifying variation in medical care anddetailing why it happens. A series of stud-ies she has published—on errors in outpa-tient settings, “defensive medicine” (inwhich physicians make decisions becauseof malpractice fears), and inconsistencies indoctors’ acceptance of insurance—are espe-cially relevant in an era of skyrocketinghealth-care costs and implementation ofthe 2009 reform legislation, which empha-sizes the need for evidence-based medicine.“Dr. Bishop is very good at asking impor-tant questions that get to the heart of thematter. That’s easy to say, but hard to do,”says Alvin Mushlin, MD, ScM, chair of theDepartment of Public Health. “Her inter-ests are central to helping us understandhow better to organize various aspects ofmedical practice to enhance quality andefficiency.”

Bishop’s focus on how health care isdelivered differs from most comparativeeffectiveness research, which traditionally

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Deciding Factor

Public health researcher Tara Bishop, MD ’02, MPH,

studies how physicians make choices—on issues from

accepting insurance to practicing ‘defensive medicine’

Tara Bishop, MD ’02, MPH

ABBOTT

tests whether one drug or procedure worksbetter than another, explains her divisionchief, Lawrence Casalino, MD, PhD. Hesays: “We don’t have information on ques-tions such as: Do large medical groups pro-vide better care than small ones? Doespublic reporting of physician or hospitalquality affect the quality of care doctorsand hospitals provide? What kinds ofprocesses can doctors use to improve care?Which groups are more likely to use effec-tive processes?” All those factors are impor-tant for physicians, medical societies, andhealth-plan administrators to understandas they strive to provide optimal care.

In a study published in the Archives ofInternal Medicine, Bishop found a slightdecline (2 percent) in the number of doctorsaccepting Medicare patients between 2005and 2008, challenging anecdotal reports ofmore widespread shutouts. But in the samestudy, she found a surprise: more than 10

percent of physicians don’t accept privateinsurance, requiring patients to pay out ofpocket and seek reimbursement them-selves—a 5 percent increase in the sametime frame. “As more people—30 millionmore—are insured under health-carereform, a question is whether they will havedoctors willing to see them, who have timeto see them, and will take their insurance,”says Bishop, the Nanette Laitman ClinicalScholar in Public Health and ClinicalEvaluation. “Doctors may have enoughpatients that they can pick and choose thetypes of insurance they want to take.”

Bishop was again surprised when sheexamined mistakes made in outpatient set-tings. Conventional wisdom holds thaterrors are more likely to happen in hospi-tals; patients there are sicker and morepeople are involved in their care.Consequently, error-reduction efforts havefocused on inpatient facilities. But Bishop

Talk of the Gown



found that the proportion of malpracticeclaims was about the same in ambulatorysettings as in hospitals: about 43 percentof the alleged errors happened in out -patient settings, while 47 percent wereinpatient. While errors in outpatient set-tings tended toward issues of diagnosisand treatment, surgical and obstetric errorswere the most common hospital mistakesaccording to her findings, which werepublished in the Journal of the AmericanMedical Association. Still, she says, “manyof the errors in both settings led to reallybad outcomes like death and majorinjuries. It brings up the need to find waysto make outpatient settings safe and toensure we are measuring quality in ameaningful way.”

Bishop was also able to test anotherhypothesis: that doctors order tests requir-ing the use of technology they own. Herhunch proved correct. Specialists are morelikely to order five common tests (completeblood count, electrolytes, glycoslyatedhemoglobin A1c, cholesterol, and prostate-specific antigen) if they have an on-site labto perform them, as Bishop reported in aJune 2010 study in the Journal of GeneralInternal Medicine. She has found that theyorder tests for another reason, too: in a

study published in the Archives of InternalMedicine, Bishop noted that doctors believethey order more tests and perform moreprocedures out of fear of malpracticeclaims.

Bishop’s work is striking a nerve amongher colleagues, especially those in privatepractice. But she says the feedback shereceives isn’t defensive so much as reflec-tive of the realities of medicine as a busi-ness. “I haven’t gotten a real negativeresponse to the research I’ve published,”she says. “Coming from an academic set-ting, it’s interesting to know the strugglesand hard work of doctors in private prac-tice, the pressures they’re feeling to keepup with reimbursement and paymentchanges and still run a business, and tokeep up with increasing regulation in themedical system overall.” Some of that regu-lation includes emerging benchmarks forquality, safety, and appropriateness ofordering tests, all of which will be linked tophysicians’ future payments and ratings ongovernment quality-comparison websites.

When she began her career, Bishopdidn’t anticipate becoming a health policyresearcher. As a Weill Cornell medical stu-dent who was equally happy on all herrotations, she decided to focus on general

Talk of the Gown

ColumnInches’What’s Up, Doc?’

aims to unite

students on

distant campuses

W hile earning an undergraduate degree in biology from Cornell, it occurred to AnkitPatel that students on the Ithaca campus didn’t know much about the MedicalCollege, located 200 miles away. After graduating in 2004 and matriculating intoWeill Cornell’s MD-PhD program, he realized that the door swung both ways. “Beingat the medical school,” he says, “I heard very little about the undergrad campus.” As

the years passed and Patel pursued his medical and doctoral studies, the two institutions grew closer; cardiologist-President David Skorton, MD, encouraged collaboration, and the University offered facultyseed grants for intercampus projects.

But how could students develop tighter ties? And more to the point: what could encourage closenessand require no funding?

The answer proved to be “What’s Up, Doc?”—a column written by Weill Cornell students that has runin the Ithaca student newspaper, the Cornell Daily Sun, since fall 2009. Every other week during the academ-ic year, MD and PhD students contribute essays on topics that have ranged from the duties of a first respon-der to the controversy over raw milk. During the cold and flu season, Eric Heintz ’12 discussed the dangersof overdosing on over-the-counter medications. After serving on the Weill Cornell admissions committee,Andre Shaffer, MD ’11, offered advice on medical school interviews. On Slope Day—the traditional spring-time bacchanal marking the end of classes—Scott Kramer, MD ’10, described alcohol’s effect on the body.

When Patel first recruited writers via a mass e-mail, he wasn’t sure if he’d have many takers—but theresponse was overwhelming. “I didn’t have to beg people to write columns,” says Patel, who has sincehanded over the reins to medical student David Roy ’12, also a double-red alumnus, “and we had a multi-tude of reserve people if someone wasn’t able to do it last minute.” The column has gotten positive feed-back from readers; Patel notes that a few pieces, like a quiz on exercise physiology by Matthew Goodwin’13, have prompted spirited debate. “It went back and forth with contradictory comments,” Patel says. “Iwas thrilled to see it, because people are actually reading the column.”

— Beth Saulnier

internal medicine with a subspecialty inpalli a tive care and geriatrics. But during afellowship in palliative medicine at MountSinai between the births of her first andsecond sons, she found herself workingunpredictable hours. “If a family wants ameeting, it’s very hard to put that off untilthe next day,” she recalls. “I’d have to callmy nanny at 6 p.m. and say I’d be a fewhours late. I really struggled with that.”When she took two years off after the fel-lowship to stay home with her boys, shebegan thinking more seriously about whather working life should look like.

During a second fellowship in generalinternal medicine, also at Mount Sinai,Bishop emphasized policy research, focus-ing on quality and use of services in ambu-latory care settings. The experiencereassured her that she could successfullybalance medicine and motherhood (herthird son was born in 2009). She joinedWeill Cornell’s Department of PublicHealth last year and works as a primarycare physician one day a week. “The inter-action I have with patients is a criticalaspect of my research,” she notes. “Thereisn’t a day I see patients that I don’t leavethinking of another issue in health care.”

— Jordan Lite

BANANA STOCK


S P R I N G 2 0 1 2 1 3

Overcoming ResistanceWith the ‘Mann algorithm,’ a Weill Cornell specialist offers a

formula for combating the toughest cases of hypertension

If you suffered from a treatable diseasebut the treatment didn’t work for you,you’d probably expect your doctor totry something different. But what if heor she didn’t know what to do next?

For approximately 15 percent of the 75million Americans who have hyperten-sion, this scenario is a reality: They do notrespond to typical treatment regimens,and their doctors have only vague guide-lines to follow in caring for them. Forcedto guess which drugs might work, thesedoctors often randomly prescribe medica-tions, tweaking dosages and combinationsand hoping for the best.

Samuel Mann, MD, a hypertensionspecialist at NYP/Weill Cornell, hopes tochange that. He has created an algorithmto help physicians decide which medica-tions to prescribe when faced with patientswho suffer from drug-resistant hyperten-sion. His approach, described in a recentissue of the Journal of Clinical Hypertension,narrows the strategies for treatment, formost patients, to just one or both of twooptions, depending on the kind of hyper-tension a patient has. “In 90 percent ofcases, this method will work to bringblood pressure under control,” says Mann,a professor of clinical medicine. “It canreduce the number of drugs patients takeand, in many cases, the side effects theyexperience.”

The algorithm addresses three mecha-nisms that, alone or in combination,underlie hypertension in most cases: reten-tion of sodium and fluid, the renin-angiotensin system (which regulates bloodpressure and fluid balance), and the sym-pathetic nervous system. Most anti hyper -tensive drugs target these mech anisms,and most patients with ordinary hyperten-sion respond to two-drug combinationsthat target the first of these two mecha-nisms, such as a diuretic and an ACEinhibitor. For patients who do not respondto such combinations, Mann’s algorithmidentifies three options that are likely towork: strengthening the diuretic regimen,usually through the use of spirono lactone,

Samuel Mann, MDABBOTT



patient. Until now there’s been no guid-ance.” Also, because the algorithm canreduce the number of drugs prescribed forhypertension patients and reduce theircardiovascular risk by bringing resistanthypertension under control, it could helpcut health-care costs.

So far, Mann says, the medical worldhas seemed responsive to his approach.

Talk of the Gown

Mighty Metabolomics

Upending the traditional scientific method,

WCMC-Q biophysicist Karsten Suhre, PhD,

is exploring the root causes of common diseases

F or a certain type of scientist, a subject under observation—whether aplanetary body or a human one—is treated much the same way.Karsten Suhre, PhD, a professor of physiology and biophysics at Weill

Cornell Medical College in Qatar, used to study ozone interactions with aircraft.But five years ago, he turned his attention to the human body and to a new fieldof biochemistry called metabolomics. Today the former atmospheric scientist ishelping illuminate the genetic basis of human metabolism—and offering impor-tant new insights into a number of complex diseases.

While the name is new, metabolomics is actually an old concept, says Suhre,director of the bioinformatics core at WCMC-Q, which he joined last spring. Itdates to about 150 years ago, when biochemistry sprang into life. Today it is oneof what scientists call the “omics” technologies, fields of study in which con-stituent parts—such as genes or proteins— are approached systemically, and ofwhich genomics is the most commonly known. Recent significant advance-ments in mass spectrometers and nuclear-magnetic resonance machines havemade metabolomics possible by increasing the visibility and measurability ofmetabolites, the molecules such as sugars, fats, and carbohydrates that are thesubjects of cellular metabolism.

As every chemical process in the body converts one compound into another,the involved compounds—or metabolites—provide a revealing footprint of theunderlying biochemical processes. So while genomics gives access to knowledgeabout what an organism can do, Suhre explains, metabolomics indicates whatactually occurs. “The more you go from genomics to transcriptomics to pro-teomics to metabolomics,” says the German native, “the closer you come towhat’s really happening in the body.” Since complex diseases are not caused bya single genetic variation alone, these precise metabolic readouts are importantresearch tools, offering new ways to identify multiple genetic and lifestyle-dependent contributions that underlie or contribute to disease.

As a self-described “biosystems analyst,” Suhre specializes in combining data,particularly heterogeneous types. In this way, his contribution has been to ana-lyze two systems—the genome and the metabolome—in tandem. In a recentstudy, which he says is “the most comprehensive evaluation of genetic variancein human metabolism so far,” Suhre and his colleagues were the first to combine

“When I lecture, audiences are uniformlyenthusiastic about the rationale and themuch more straightforward treatmentapproach,” he says. “When I talk withother doctors about it, I think there’s asense of relief. Here’s something thatsimplifies the approach—and best of all,it works.”

— Amy Rosenberg

which keeps potassium levels stable; usingcombinations of alpha- and beta-blockersto hinder the effects of the sympatheticnervous system on blood pressure; or both.

There are clinical clues that can helpguide the decision about which of the twooptions to select first, says Mann.Examples of clues that suggest strengthen-ing the diuretic regimen include largebody size, high sodium intake, and thepresence of fluid retention in the legs dur-ing diuretic therapy. Examples of clues thatsuggest treating with an alpha- and beta-blocker combination include failure torespond to the usual two-drug combina-tion, rapid heart rate, and alcoholism. Theapproach is innovative, Mann says,because it rethinks established notionsabout treating hypertension. “In the olddays, high doses of diuretics were widelyused—but the negative side effects led tonearly universal usage of low doses,” hesays. “Now the pendulum needs to swingback toward use of higher doses whenneeded, especially considering how muchsalt most people consume.”

In addition, Mann says, physiciansneed to reconsider the effectiveness ofalpha-blockers. They were largely dis-missed as a treatment for hypertensionwhen the ALLHAT trial, published in 2000,concluded that an alpha-blocker, whenused as a first-step therapy, was less effec-tive than a diuretic in lowering blood pres-sure and preventing cardiovascular events.Mann agrees with these findings, butemphasizes that alpha-blockers are safeand often extremely effective when givenas add-ons in combination with otherdrugs. “In hypertension circles alpha-blockers for treating resistant hypertensionare very much accepted, but not widelyused,” he says. “The approach needs moreattention.”

Mann has been lecturing about thealgorithm for the past two years. Lastspring, he presented data supporting itsuse at the annual American Society ofHypertension meeting, reporting a 90 per-cent success rate in controlling resistanthypertension. He hopes to obtain fundingfor a larger study in the next year or two.He believes the algorithm’s value lies in theclear steps it provides for treatment whenthe disease has resisted standard treatmentstrategies. “It narrows the choices and out-lines a logical decision-making process,”says Mann. “This allows for simplifiedtreatment options and for choices basedon the characteristics of the individual


S P R I N G 2 0 1 2 1 5

ulation of Qatar—one of the highest per capitarates in the world. “The genetic variants we dis-covered are most often in a gene that has some-thing to do with the metabolite, such as anenzyme that processes the metabolite or a carrierprotein for its transport,” Suhre observes. “I amsurprised how well it all falls together. And inplaces where it does not fit, it opens questions of,‘Is there something we haven’t understood yet?’ ”

One such question led the team to discoverthe function of a transporter gene—one of thegenes that essentially build the machinery formoving compounds across cell membranes.Suhre’s data showed that people with one spe-cific version of the gene SLC16A9, whose func-tion was unknown, had elevated levels of themetabolite carnitine in their blood; this indi-cated that SLC16A9 was likely responsible fortransporting carnitine, a compound withantioxidant properties involved in convertingfat to energy in the body. The team gave thefindings to a specialist, who experimentallyvalidated what their findings predicted—estab-lishing SLC16A9 as a carnitine efflux trans-porter, a gene responsible for moving carnitineout of cells.

From a broad, hypothesis-free method ofmeasuring the genome against the metabolome,Suhre says, “you then generate a hypothesis tocharacterize a very precise function of a gene.That is something I never would have thoughtpossible five years ago.”

— Andrea Crawford

measurements of metabolites with genome-wideassociation studies, in which geneticists scan thegenes of a large group of individuals to identifyvariants that might associate with a particular dis-ease. The findings, which appeared in theSeptember 2011 issue of Nature, revealed thirty-seven genetic locations where individuals withdifferent versions of a gene also had very differ-ent metabolic capacities. Many of these loci arealso known to associate with type 2 diabetes, car-diovascular and kidney disorders, cancer, gout,venous thromboembolism, and Crohn’s disease.Of those, twenty-three were new associations andfourteen were previously known.

With samples from 2,800 subjects taken fromtwo large European population-based studies, histeam analyzed 250 metabolites from sixty meta-bolic pathways. The researchers’ methodology ofworking without a hypothesis—and insteadmeasuring everything that can be measured—turns classical scientific inquiry on its head. SaysSuhre: “The approach was to say, ‘Let’s do itwithout any assumptions, let’s try to measurethe known genetic variants and all metabolitesaccessible to present technology, and let’s do thisin a very large population so as to get high statis-tical power.’”

Their discoveries included a highly significantassociation between a diabetes risk gene and thelevel of mannose, a simple sugar, in the blood.This reveals a potential new biomarker for therapyor diagnosis of a disease that now affects 8 percentof the U.S. population and 15 percent of the pop-

Karsten Suhre, PhD

In the DNA: A diagramthat appeared in Natureillustrates the geneticbasis of human meta-bolic individuality. ILLUSTRATION FROM NATURE

JOHN SAMPLES



Talk of the Gown

beauty treatment Jhin came across in herresearch. In her chapter on China, for example,she offers recipes for skin-rejuvenating soupsmade from swallows’ nests (which contain thebirds’ saliva) and from the fallopian tubes ofsnow frogs.

For the less culinarily adventurous, what areJhin’s top three Asian beauty secrets? She recom-mends eating foods rich in antioxidants, promot-ing inner peace through stress-reductiontechniques like meditation, and protecting your-self from the sun. “One thing I learned is howdiligent Asians are about avoiding the sun,” shesays. “A geisha never went out without herumbrella. In Korea, women wear hats all the time,and they even wear gloves when they drive.”

Jhin practices what she preaches. She drinksgreen tea daily and still makes monthly trips to aKorean bathhouse—where she soaks in the hottub, relaxes in the sauna or steam room, and getsa half-hour exfoliating scrub followed by an oilmassage and facial mask. “My skin is seriouslysmooth,” she says, “and I really believe that’s thereason why.”

— Beth Saulnier

K orean-born dermatologist Marie Jhin, MD ’94, has long enjoyed her cul-ture’s health and beauty practices. Growing up, her female relativeswould take her to the bathhouse, where they’d spend hours soaking in

hot tubs and having exfoliating scrubs. When she was a busy first-year medical stu-dent, her mother declared her “tired and pale” and made haste to an herbalist, whoprescribed a rejuvenating—and, Jhin recalls, rather foul-tasting—tonic. After Jhin gavebirth to each of her three children, her mom insisted that she follow the tradition ofstaying home and keeping warm for the first few weeks, and made her iron-rich sea-weed soup to promote breast milk production.

With those and other traditions in mind, Jhin was inspired to write a book aboutthe health and beauty habits that have been practiced in Asian societies for millennia.Asian Beauty Secrets: Ancient and Modern Tips from the Far East came out last year fromBush Street Press; it’s available on Amazon.com (in paperback or on Kindle) and canbe ordered through Jhin’s website, www.drmariejhin.com. “As a dermatologist, I wasso fascinated,” says Jhin, who’s in private practice in the San Francisco Bay Area. “Whydo people do this? Is there any science behind it? Is it good for you? What other Asiancultural traditions may be good for beauty and health?”

For example, Jhin noted, the scrubs of the traditional Korean bathhouse have thesame aim as Western dermatology treatments like microdermabrasion, chemical peels,

and Retin-A. “They make cells turn over more quick-ly and stimulate collagen, and I realized that’s whatthe Koreans were doing for centuries,” Jhin says. “Byscrubbing down their skin, they were getting rid ofthe dead cells faster.” Similarly, while health-conscious Americans aim to consume antioxidants,Asians have been doing so for centuries throughfoods like green tea and ginseng. “The main mes-sage,” she says, “is that beauty is not just aboutouter beauty, but inner health.”

In addition to reading scientific papers on thetopic, Jhin’s research process included interviewingpractitioners of Eastern medicine such as acupunc-turists and herbalists, as well as polling friends andcolleagues about their personal and family habits.She opted to focus on three countries: Korea, China,and Japan. “What I learned is that in each country,

nutrition is very important, and also the mind—being at peace with yourself is veryhealthy,” says Jhin, who left Asia at age five when her father, a manager for Korean AirLines, was assigned to the U.S. “They talk about the qi, the energy, and they encour-age movement and exercise.”

In her book—which Jhin stresses is geared toward people of all races and ethnici-ties—she chronicles traditional Asian practices and ingredients that have made theirway to the West, including products containing pearl powder and sheep placenta. Shedescribes a geisha-style facial made from rice bran and nightingale droppings—whichcontain the nucleobase guanine—available for $180 at a New York day spa. “[G]uanineis one of four integral parts making up the body’s DNA,” Jhin writes. “That’s why,although they may appear as lowly droppings on the surface, nightingale guaninespeeds up skin healing on an esteemed level.” And bird feces aren’t the most bizarre

Comfortable in Your Skin

In Asian Beauty Secrets, dermatologist Marie Jhin, MD ’94,

offers tips to enhance body and mind

Marie Jhin, MD ’94PROVIDED


S P R I N G 2 0 1 2 1 7

The caller, a long-haul trucker, was cruisingdown the highway in the early hours of aTuesday morning when he was stricken

with chest pains. Radio host Francis Adams, MD’71, and his guest, a cardiologist, had to take apatient history on the air—and fast. “We askedhim where the pain was, and he said in the cen-ter of his chest traveling down his left arm, clas-sic for a heart attack,” Adams recalls. “Thecardiologist and I both concluded that this fellowwas about to have a heart attack—and he wasdriving one of these huge rigs. We were able toconvince him to pull over and call 911.”

Most calls to Adams’s show, “Doctor Radio,”aren’t quite that dramatic. (Though some, likethe woman who sought advice on coping with adaughter who’d just attempted suicide, come

close.) For the past three years, Adams has field-ed questions on all manner of medical issues asone of Sirius XM Satellite Radio’s physicianexperts. Every Tuesday from 6 to 8 a.m., Adamsoccupies a glassed-in booth in the lobby ofNYU’s medical center, where he and his gueststake calls from around the country. “The showhas been a great outlet for me to express myself,and also to allow people access to experts,” hesays. “I often say it’s the callers who make theshow, because they have wonderful questionsthat stimulate us.”

On Sirius XM, “Dr. Radio” isn’t so much ashow as a channel—number eighty-one, to beexact. Some two dozen experts—in fields fromdermatology to psychiatry, emergency medicineto women’s health—host two-hour spots, broad-cast live and then rerun throughout the week.Given Adams’s specialty (a pulmonologist, he’son the NYU faculty and has been in private prac-tice for thirty-five years), he hosts the weeklyshow devoted to lung issues. But though he’sexpected to spend at least part of every programon pulmonology—a recent episode includedquestions about air filters, respiration duringexercise, and the potential risks of working on achicken farm—he’s free to explore other topics.Adams is an animal lover, and he devotes oneshow per month to discussing such issues as pettherapy, service animals for veterans with PTSD,and dogs’ ability to detect cancer. “That’s ourmost popular show,” says Adams, whose twoHavanese dogs, Tucker and Dolly, figure promi-nently in his bio on the Sirius website. “It’s notasthma or emphysema, it’s pets.”

Most of Adams’s guests are fellow physicians,but some are laypeople; recent invitees haveincluded a World Trade Center survivor and awoman who regained her voice after beingunable to speak for three decades. Experts andotherwise, they have to think on their feet;though a producer screens each caller and ascer-tains the general question, anything can happenin live radio. For example, until Adams’s produc-er got to know the voice of one regular caller—anight owl based in L.A.—the man repeatedlyfibbed so he could get on the air and rail againstWestern medicine. “It can be a little nerve wrack-ing,” says Adams, who also serves as an NYPDpolice surgeon, “but generally it’s a lot of fun.”

The show also gives Adams the chance topromote issues he sees as vital to pulmonaryhealth, such as appropriate control of asthma,imaging to screen for lung cancer, and smokingcessation. “My patients listen a lot, and they’llsay, ‘That’s what you told me ten years ago,’ ” hereports with a laugh. “I say, ‘I must sound like abroken record.’ But I do use the show toexpound on things I feel strongly about.”

— Beth Saulnier

Air Apparent

Pulmonologist Francis Adams, MD ’71, fields

health questions live on ‘Doctor Radio’

ABBOTT

Francis Adams, MD ’71



Susan J. Vannucci, PhD, had thejitters. Her daughter was preg-nant—but in addition to cele-

brating, the grandma-to-be was mullingover the ominous possibility of neonatalhypoxia-ischemia, an injury similar to astroke. One in 4,000 infants suffers astroke-like event during or shortly afterdelivery, exactly the sort of statistic bestnot pondered by anyone anticipating abirth in the family.

For Vannucci, a pediatric neuroscien-tist, it was impossible to completely ignorethe risk. She has spent her career studyingthese insults to the newborn brain andtheir associated aftermath: widespread celldeath leading to epilepsy, cerebral palsy,

and developmental disabilities in the oxy-gen and nutrient-deprived infant brain. “Ifmy daughter had wanted to do a homebirth, I think we would’ve had a very seri-ous talk with her and her husband,” saysVannucci. “Luckily, it didn’t come up.”

Vannucci well understands her ownanxious response. Fortunately, her grand-daughter—born via an emergency C-section—missed the sort of brain injuryVannucci feared. “There are so many thingsthat can go wrong at the last minute,” shesays. From umbilical cord strangulation tothe difficulty newborn lungs may have pro-cessing oxygen for the first time, a myriadof mishaps can compromise an infant’s airsupply and blood flow to the brain, leading

to the gloomily titled “toxic cascade”: anoften-fatal inflammation and cell-deathresponse. The full health fallout in babieswho suffer such an event may not beimmediately apparent, and the effects arepermanent. “It’s important to determinewhy it happens and when,” says JeffreyPerlman, MD, director of newborn medi-cine at Weill Cornell. “How can one poten-tially salvage some or all of the brain thathas been injured?”

Vannucci launched her career in 1971,with a fresh-out-of-college job as a researchtechnician for renowned Medical Collegeneurologist Fred Plum, MD ’47; she beganworking with a pediatric neurology fellow,Robert Vannucci, MD, who ultimatelybecame her husband. At the time, academiawas flush with funding to study stroke inadults, while the puzzle of neonatal strokelanguished unexamined. “They didn’t real-ly think that the baby brain was impor-tant,” Vannucci says, recalling the struggleto get neonatal stroke its due attention. “It’sbeen a long, hard, uphill climb.”

Apathy wasn’t the only problemVannucci encountered. A whopper of amis conception—that the adult brain andthe developing brain were essentially simi-lar—dogged her efforts as well. But, shenotes, “the developing brain is tremen-dously different—sometimes absolutelyopposite.” After Vannucci earned her PhDin physiology from Penn State in 1989,she and her colleagues began working toreplace such shaky inferences withgrounded scientific observation.

For example, she revealed that starkdiscrepancies appear even in glucose deliv-ery and energy failure, the first step of thetoxic cascade. As opposed to the brains ofadults—who have fully developed glucosedelivery systems—the newborn brain canrun out of this essential fuel. But due to itslower energy demand relative to that ofadults, the infant brain can survive longerbefore resuscitation. However, Vannuccinotes that the newborn brain is also morevulnerable because of the various activitiesof its immature cells, which impact its ulti-mate development. “We’ve made tremen-dously important progress towardunder standing how the developing brainis different from the adult brain in how itresponds to the same kind of injury,” shesays. “That for me has been gratifying, tosee all the pieces of the puzzle we’ve col-lectively been able to put into place.”

Last year, Vannucci and five collabora-tors received a five-year, $6 million grant

Talk of the Gown

Susan J. Vannucci, PhD

The Baby Brain

Pediatric neuroscientist Susan J. Vannucci, PhD,

has spent her career studying neonatal stroke

ABBOTT


In 2009, Chisa Hidaka, MD ’94, established the Dolphin Dance Project, whose membersplay with wild dolphins and capture the unique interspecies interactions on film. Thefollowing year, the nonprofit released Together: Dancing with Spinner Dolphins, which has

been screened at environmental and dance film festivals worldwide. By raising awareness ofthe animals’ cognitive abilities, Hidaka aims to inspire increased respect and protection fordolphins, their habitats, and all the creatures with whom they share the ocean. “You can seethe intelligence, the presence, and the curiosity in the eyes of the dolphin,” she says.“Humans are not the only sentient, moral creatures.”

In the three-and-a-half-minute movie, which was named best experimental film at the2010 Big Apple Film Festival and won the award for best short film on animal advocacy atthe Artivist Film Festival, the dolphins’ self-awareness and generosity becomes apparent asHidaka and a wild Pacific spinner dolphin engage in an underwater dance. The dolphinmakes eye contact, deliberately slowing its swimming so Hidaka can keep pace. “It’s a lot likebeing with human dancers,” she says. “They seem to understand synchrony and mirroring.It shows a lot of cognitive sophistication.”

Motivated by a lifelong interest in human movement, Hidaka trained as a dancer, earn-ing a BA from Barnard in 1986. Somatic dance, her preferred technique, emphasizes anatom-ical and physiological coordination rather than aesthetic perfection, so medicine seemed likethe logical next step in her career. “It was an outgrowth of my interest in the musculoskele-tal system,” she says. “When I got to med school, anatomy was my favorite thing.” After aresidency in orthopaedics, Hidaka ran a lab at Hospital for Special Surgery, exploring the useof gene transfer to improve cartilage repair and accelerate bone regeneration. In 2010, sheclosed her lab to focus on the Dolphin Dance Project.

Currently, Hidaka works in both fields, teaching anatomy in the Department of Dance atBarnard while serving as an assistant scientist at HSS as educational program manager andorthopaedic clinical expert in the Biostatistics and Epidemiology Core. On breaks, she’sworking on a feature-length film that further explores human-dolphin interaction. Hidakasees her dance and filmmaking work as something of an “other life,” and relishes opportu-nities to share it with her medical colleagues. She had that chance last summer, whenTogether was screened at HSS to a standing-room-only crowd. For more information, go to:www.dolphin-dance.org.

— Kristina Strain

S P R I N G 2 0 1 2 1 9

Diving InAn orthopaedist dances with dolphins

from the Paris-based Fondation Leducq tostudy the toxic cascade in the neonatalbrain. Her contribution stems from herrecent revelation about mast cells, immunesystem bodies that mediate the inflamma-tion response. “People don’t think of mastcells as being important in brain injury,”Vannucci says. “But we have evidence thatthey’re the first cells to respond.” As theresearchers are learning, however, thesefirst responders—long presumed detrimen-tal—are in fact the wily double agents ofneonatal stroke. “They can be good,”Vannucci says, “or they can add to thedamage depending on their environment.”Tricking them into controlling—not pro-moting—inflammation is the team’s goal.“The science of the grant is to understandwhat makes these cells good, and creategreater protection,” Vannucci adds.

Vannucci stresses that a Leducq grantsupports more than just scientific research;it also promotes a meeting of the mindsamong the co-recipients and their labs,helping to establish “international net-works of excellence.” She and the rest ofthe team—doctors and researchers fromBritain, France, Sweden, and the U.S.—have formed a positive feedback loop ofmutual expertise as they hold the toxiccascade in their collective crosshairs.“Among us,” she says, “we have differentand complementary models for looking atinflammation and neonatal stroke.”

Vannucci’s model, which she and herhusband developed in 1981 while workingat Penn State’s Hershey Medical School, hasprovided an important tool for understand-ing neonatal stroke. Unlike a chronic dis-ease that unfolds over the course ofmonths, newborn hypoxia-ischemia orasphyxia is “really more accidental; it can’tbe predicted,” providing little opportunityfor prevention. Turning this mishap into aprogrammable occurrence in lab rats,Vannucci’s model enables researchers toreplay and analyze it—and test differentcourses of treatment. Recently, hypother-mia—cooling an oxygen-deprived infant to34 degrees Celsius for up to seventy-twohours after birth—has become the standardof care worldwide. About 50 percent of full-term asphyxiated infants survive withoutbrain damage thanks to this treatment, butdoctors need to act within a six-hour win-dow to reap its benefits. “It’s immediateresuscitative treatment,” says Vannucci.“The closer to the injury you can initiatethe cooling, the better the outcome.”

— Kristina Strain

DOLPHIN DANCE PROJECT

Water dance: Chisa Hidaka, MD ’94,with a spinner dolphin



Andrew Leon, a beloved faculty member in theDepartment of Psychiatry, passed away on February18, shortly before this story was scheduled to go topress. He is survived by his wife, Yuki Okuma, andtheir daughter, Angelica. A member of the WeillCornell faculty for almost twenty-five years, he washighly respected by his colleagues worldwide andwas a wonderful collaborator and mentor. His pass-ing is a great loss for all who knew him.

Ms. Okuma, as well as the administrative lead-ership of the Department of Psychiatry, felt that thispiece highlighting his very important work should bepresented to the Weill Cornell community. It hasbeen adapted to reflect his passing.

Five decades ago, a wave of profoundbirth defects spread across Europe.Scientists suspected thalidomide, pre-

scribed to combat morning sickness among expec-tant mothers. If it hadn’t been for a single FDAregulator’s demand for evidence of the drug’s safe-ty, thalidomide might also have been released in

the U.S. As word of the narrowlyaverted public health disaster spread,Americans demanded protection. In1962, Congress passed legislationrequiring that drug manufacturersprovide the FDA with “substantial evi-dence of effectiveness from adequateand well-controlled studies.”

The randomized controlled trialhas been the gold standard for thefederal approval process ever since.The concept is elegantly simple:Randomly assign a pool of qualifiedparticipants to multiple experimen-tal conditions. Some receive a prom-ising new compound or therapy,while others might receive a sugarpill or the standard treatment.When the study ends, any differ-ences among the groups owe to the

protocol being tested—or so the thinking goes. The approach works beautifully with lab

rats. But when it comes to people, there’s aproblem: they drop out. Subjects die or moveaway; they forget an appointment; they get bet-ter and stop taking their pills—or feel worse and

The Attrition Dilemma

By understanding why subjects drop out, biostatistician Andrew Leon, PhD,

worked to design better clinical trials

stop taking them. And the longer a study lasts,the higher the attrition rate.

Biostatistician Andrew Leon, PhD—a DeWittWallace Senior Scholar and professor of biostatis-tics in psychiatry and of public health—devotedhis career to parsing the data hidden in theincomplete records of trial dropouts and devel-oping new analytical approaches to preserveresearch integrity, despite the foibles of humanparticipants. “Attrition rates in studies of majordepression in adults are typically 30 to 40 per-cent; in schizophrenia it’s 50 to 60 percent, andeating disorders can be even higher,” he said.“Self-selection becomes a problem. The peoplewho leave have characteristics somewhat differ-ent from those who stay in the study.”

In a test of new drugs for panic disorder, forexample, those with the most extreme symp-toms assigned to the placebo group might dropout because they’re too sick to keep regularappointments for assessment. Those mostresponsive to the experimental treatment mightalso drop out—because they feel great. The finalanalysis would then include only the least sickmembers of the control group and those whobenefited least from the intervention. The prob-lem, of course, is that once participants are gone,investigators have a tough time learning whythey left and distinguishing them from thosewho stayed.

Leon joined Weill Cornell’s Department ofPsychiatry as a consultant in 1987 and becamea full faculty member two years later. The tenstudies with which he was involved at the timeof his death included one on the effectivenessof home health intervention in the treatmentof geriatric depression and another delving intothe influence of genotype and stress on learningand brain development. This spring, PsychiatricServices published his study with collaboratorsat the Tuscaloosa Veterans Administration onthe efficacy of interventions to help unem-ployed veterans with PTSD get back to work.“Andy was a world-class biostatistician,” sayspsychiatry professor James Kocsis, MD ’68,director of the Affective Disorders ResearchProgram at Payne Whitney Psychiatric Clinic,who worked with Leon to understand howincomplete recovery from an early depressiveepisode affects a person’s risk of recurrence. “He

Andrew Leon, PhD

PROVIDED

Talk of the Gown


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Temperamental artists, particularly composers, havelong been indulged despite their bad behavior—solong as the quality of their work is commensurate to

their tantrums. But in the case of Bohuslav Martinuo , a bril-liant and successful composer in the mid-twentieth century,temperament may have had more to do with an autism spec-trum disorder than with the quirks of genius.

Retired plastic surgeon F. James Rybka, MD ’61, has writ-ten a biography of this prolific Czech composer. Published byScarecrow Press in 2011, Bohuslav Martinuo : The Compulsion toCompose asserts that Martinuo suffered from Asperger syndrome and that this conditionfacilitated his composing. It also helps explain Martinuo ’s peculiar asocial behaviors.“Ever since I graduated medical school, I wanted to write a biography of him,” saysRybka. “Then one day I happened to pick up a Newsweek with a cover article onAsperger—then newly defined—and it was an electrifying moment for me. Suddenly Iunderstood our old friend in a completely different way.”

Rybka was born in 1935 in New York City. His mother was a pianist and his Czech-born father an organist, choral director, and cellist. In 1941 when Martinuo came toNew York, he and his wife became close to the Rybka family. “My father used to playcello duets with Martinuo in the house,” says Rybka, who lives in California and isretired from the clinical faculty of the University of California, Davis, medical school.

Although Martinuo was brilliant and highly successful, he exhibited an array of eccen-tric features: extreme shyness, a lack of social reciprocity, excessive dependency uponothers, and a habit of becoming lost during solitary nighttime walks because he would“zone out” in deep thought about music and become oblivious of his surroundings.(This dangerous habit nearly killed him one night in 1946 when he ambled off a roof.)

Rybka describes an almost comical moment during a trip to his family’s vacationhome in the Adirondacks. The children were in awe of thepeculiar man and were told to behave and stay quiet when hewas visiting. One day, Martinuo came out of his room andfound the score to “Chattanooga Choo-Choo,” then a popu-lar boogie-woogie tune, sitting open on the piano. “Stone-faced and with such stolidity, he sat and played through thewhole song perfectly but without any expression whatsoever,”recalls Rybka, a founding member of the InternationalBohuslav Martinuo Society. “It was an astonishing thing. Not asign of emotion through that whole song. He played like anautomaton.” Done, Martinuo stood up, aloof and distant asever, and returned to his room.

Rybka, who visited Martinuo in Switzerland a month beforehis death in 1959, avers that composing brought him somesolace from his condition. He has participated in several inter-national conferences on Martinuo and co-authored a paper on

the composer’s disorder (with Sally Ozonoff, PhD, a psychologist at UC Davis’sMedical Investigation of Neuro devel op mental Disorders Institute, one of the country’slead ing centers for autism studies), which was published in the journal Czech Music in2009. But getting his book to print was more difficult. For one thing, it is a hybrid:part biography, part memoir, part autism treatise. After many rejections, he found aneditor at Scarecrow Press who was fascinated with the subject. Finally, Rybka has satis-fied his own obsession—to publish his book on the compulsive composer.

— Franklin Crawford

F. James Rybka, MD ’61

Artistic Temperament

A retired plastic surgeon remembers a

famed composer who, he argues,

had Asperger syndrome

PROVIDED

OSKARMORAWETZ.COM

Bohuslav Martinuo

was also a communicator and a ‘people per-son’ with an interest in clinical issues. Thosethings are somewhat unusual in the world ofbiostatisticians.”

Perhaps most important, Leon had a knackfor developing mathematical techniques toreveal the patterns and insights hidden by theincomplete records left behind by subjects whodrop out before a study ends. He even had hisown National Institute of Mental Health-fundedinvestigation into new analytical methods, ararity in the world of federally funded research.“Andy was one of the pioneers in mixed-model analyses,” says Kocsis. “Every availabletime-point of data was counted for everypatient, regardless of whether there’s missingdata or the patient drops out of the study. Bydoing that, he brought more power to thetable. You didn’t lose data from patients whomiss a rating or drop out.”

Making sense of such incomplete dataafter the fact is better than nothing. But a fewyears ago, Leon decided to start accounting forattrition before a study begins rather thanafter it’s over—just by asking participantsabout their intentions. “It’s a simple, two-itemscale,” he said. “We ask them at baseline,‘How likely are you to finish the study?’ andthen every week, ‘How likely are you to showup next week?’ ” Participants reply on a scalefrom zero to ten, and investigators follow upwith anyone who answers below a five,“somewhat likely” to show up. Leon, whoused the scale in more than twenty clinical tri-als of everything from schizophrenia to sub-stance abuse, had begun evaluating its valuefor predicting who will see a study throughand who will drop out.

But even more promising was the prospectthat investigators’ responsiveness to subjects’concerns could increase retention andenhance the validity of results. Often, Leonnoted, staff can address complaints by alteringappointment schedules to accommodate care-givers or providing carfare for those withtransportation difficulties. “Those are simplethings that are not easily ascertained,” Leonsaid, “unless you ask.”

— Sharon Tregaskis


2 2 WE I L L CORNEL L MED IC INE

WCM: You had a long and successful career at Harvard. Why didyou want to take on this challenge now? LG: I have been asked many times over the years to look at chair ofmedicine positions and other deanships, but it wasn’t right for methen. I was completely embedded in the laboratory, and it was toointense for me to consider leaving. When I was asked to considerthe Weill Cornell job, I immersed myself in studying Weill Cornell,and in the process of doing that, I realized that this place was poisedto be a first-rate biomedical research enterprise. The more I thoughtabout what my vision would be, the more excited I got—and themore I felt that this was much more important for me to do than tofocus solely on my own lab. Here, I can enable the science of othersand contribute to increasing the excellence of an academic medicalcenter, which is a threatened species nowadays. We’re on the brinkof a huge opportunity. It’s my dream job.

By Beth Saulnier

Laurie Glimcher, MD, became Cornell Universityprovost for medical affairs and the Stephen andSuzanne Weiss Dean of the Medical College onJanuary 1. The daughter of eminent Harvardorthopaedic surgeon and scientist Melvin Glimcher,MD, the new dean grew up steeped in the life ofthe physician-scientist. She graduated magna cumlaude from Harvard in 1972 and earned her MDcum laude from Harvard Medical School beforejoining its faculty and founding a leadingimmunology lab. Board certified in internal medi-cine and rheumatology, Glimcher has pursuedinterdisciplinary research topics including work oncancer, metabolic disease, neurodegenerative dis-ease, and skeletal biology. A past president of theAmerican Association of Immunologists, she hasauthored more than 350 scientific articles andchapters; one of her publications, a landmark paperin Cell on the T-bet transcription factor, has beencited more than 1,100 times. While celebrated as aresearcher, Glimcher says, “I consider myself aphysician first and foremost.”

Meet the Dean

A conversation with physician-scientist Laurie Glimcher, MD

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WCM: Why would you say that academic medical centers are anendangered species?LG: Our health-care system is in crisis, and the financial pressures aregoing to affect academic medical centers with decreasing reimburse-ments for patient care from the government. That’s going to compro-mise our clinical income—from which, in part, we derive support forour biomedical research. And with the NIH budget so constrained, it’sharder and harder to get grants. How are we going to support ourresearch? As costs get put under further pressure, there’s going to beless support from the government for teaching hospitals to supportour residents. We’re already facing a physician shortage now, and it’sgoing to get worse as costs continue to be constrained.

WCM: Is funding the major challenge facing medical educa-tion today? LG: We are responsible for making sure that the U.S. has the kinds

of physicians it needs. But if a student comes out of school with$150,000 in debt and wants to go into primary care, family practice,or pediatrics, he or she may say, “I’ve got to go into a more lucrativespecialty.” The debt of Weill Cornell’s medical students is significant-ly lower than the average; we’re at about $131,000 and the overallprivate medical school average is more than $176,000. Nevertheless,an important priority for me is to continue to raise funds for schol-arships. During this last campaign we did very well—the goal was$20 million, and we’re up to $22 million now—but we need more.

WCM: Given that Weill Cornell has raised some $1.5 billion inrecent years, and major gifts have helped support facilities likethe Belfer Research Building, why do we still need to fundraise? LG: Bricks and mortar cost a fortune. The Belfer Research Buildingwas an urgent campaign priority because it doubles our researchspace and puts us on par with our peer institutions in our ability to

JOHN ABBOTT

“A physician first and foremost”: Laurie Glimcher, MD, visitsthe lab of Barbara Hempstead, MD, PhD (second fromright), the associate dean for faculty development.



attract more top scientists and research dollars. And now we want tofill our buildings and populate them with outstanding faculty—andthe kind of top-notch, first-rate luminaries I want to recruit are notgoing to be cheap. That recruitment process starts with funds raisedin this campaign. In close partnership with Sandy Weill and theentire Board of Overseers and campaign leadership, our priority is tocomplete the campaign, which allows us to move into the nextphase—to attract the amazing biomedical researchers who will com-plement the already outstanding faculty here at Weill Cornell.

Each new scientist will require many millions of dollars in fund-ing to set up a vibrant operation—to create a laboratory, buy equip-ment, and to allow them to recruit junior faculty. I have thecredibility, I hope, to attract outstanding scientists to this wonderfulinstitution and show them what a great opportunity it is to comehere and how exciting it would be for them to build somethinghere. Lack of space had constrained Weill Cornell from recruiting acritical mass of scientists. Thanks to the wonderful commitmentand vision of our former dean, Dr. Gotto, and of our Board ofOverseers, our alumni, and so many generous donors, we will nowbe able to double our research space with the Belfer ResearchBuilding. I am committed to finding the resources to fill this build-ing with a vibrant collection of biomedical researchers passionateabout translating discoveries made at the bench into new therapiesfor our patients.

WCM: What do you see as the priority research areas forWeill Cornell going forward?LG: I think it’s important that we further strengthen areas wherewe’re already strong—because that can be done relatively quickly—and that we align ourselves with the clinical strengths of the hospi-tal. One area is cancer, because NYP takes care of many cancerpatients, and we have some wonderful cancer physicians and scien-tists already here. I believe that if we bring in some carefully chosenfaculty, we could become a world-class cancer research center.Another area where we are already strong is neurodegenerative dis-ease, and that is a health-care crisis. It’s going to cost the health-caresystem something like $1.2 trillion by 2050 just to take care ofAlzheimer’s patients. Another epidemic is metabolic syndrome—obesity, diabetes, cardiovascular disease, high cholesterol. We havesome strength in that, but we need more, because it’s such animportant medical need. But this is a work in progress; none of it isset in stone. I want feedback, thoughts, and ideas from everybodyhere, and we’re setting up a crowd-sourcing website to facilitate that.

WCM: How do you see the relationship between translationaland basic science research?LG: I would love to abolish those terms. I like to call it “research”—

because to me, it is a continuum. Let me tell you a story that illustratesthat. A microbiologist named Barnett Rosenberg, PhD, did an experi-ment to test what happens if you put E. coli bacteria in an electricalfield. And what he saw was surprising: the bacteria changed shape. Hewas thinking about why that might happen, and he remembered thatif you put bacteria under certain other conditions they can also changeshape. One of those conditions is exposing these bacteria to drugs thatare effective against tumors, so he wondered whether some anti-cancersubstance was being generated by the electrodes in these bacterial cul-

tures. So he set out to isolate this substance, and itturned out to be cisplatin, which is probably themost important cancer drug ever. Then he teamedup with some “translational” researchers who hadanimal models of cancer. They put it into rodentsand showed that the drug worked against tumorcells. And it would have ended there—but the clini-cians stepped in and started treating patients with itin clinical trials, and now we have cisplatin. Itwould never have happened if there hadn’t beenthis seamless transition among a microbiologist,biomedical researchers, and clinicians. This is myvision for Weill Cornell—that we’re one seamless

whole. Our overarching goal is to find better treatments for ourpatients, and that requires collaboration among all of us.

WCM: Why do you see it as vital for academia and industryto work together?LG: Because our mission and our responsibility is to use, in the bestway possible, the taxpayers’ money that supports biomedicalresearch. The ultimate goal is to provide novel therapeutics and bet-ter ways to fight human disease. So what’s the best way to do that?Partnering with the private sector is certainly one of them. We’regreat at generating new targets, new genes, new pathways that wehave shown in the laboratory and in animal models could be help-ful in a given disease. Taking it to the next step is the hard part forus. This is where we should be teaming up with the pharmaceuticalindustry to say, “We’ve got this new gene that would be good toscreen with your library of compounds,” or “We’ve got a handful ofcompounds that look good in animals; now what do we do?” A lotof medicinal chemistry needs to be done on those compounds, andwe would like, as an academic institution, to be able to bring thosecompounds into Phase I clinical trials in patients. But we’re not setup in most cases to carry out Phase II and Phase III trials—that iswhere the pharmaceutical industry is so strong. These types of academic-industry collaborations can be very successful as long aseverything is completely transparent. I always like to say, “Sunlightis the best disinfectant.”

WCM: What changes do you envision for Weill Cornell’sclinical care? LG: Our clinical care is fantastic, and plans are afoot to expand it.When somebody calls our offices, that individual deserves to have anappointment in a timely way—but it can be tough, because our waitlists can be long. We need more primary care physicians; we needmore physicians, period. We will soon be opening the Iris CantorMen’s Health Center, and we have plans to establish more primarycare and ob/gyn practices in other locations in New York City.

WCM: How do you see the relationship between WeillCornell and the Ithaca campus?

‘I have the credibility, I hope, to attract out -standing scientists to this wonderful institutionand show them what a great opportunity it is to come here and how exciting it would be for them to build something here.’


S P R I N G 2 0 1 2 2 5

LG: There’s a lot of complementary talent. Cornell University isobviously extremely strong in engineering and bioinformatics, andwe have the biomedical research strength here, so a lot of good col-laborations are already taking place. A number were fostered byintercampus seed grants, and that’s going to be done again and will,I hope, foster new collaborations. Those projects have brought in farmore funding than was spent on them.

WCM: What do you see as the benefits of the planned techcampus on Roosevelt Island?LG: It’s going to be transformative for New York City, and it’s goingto be wonderful for Weill Cornell. We very much want to be in onthe ground floor and work with the tech campus in the area ofhealthy living, which is one of the proposed hubs. I think CornellUniversity is going to be the major educational presence in NewYork City ten years from now.

WCM: Do you plan to continue your immunology research?LG: My lab is going to physically relocate. I hope to bring my labmanager, one other technician, several postdocs, and a graduate stu-dent. My lab was quite large at Harvard, and I’m working on reduc-ing its size. Between professionals and support staff, there were abouttwenty-five people. I can’t run a lab that size and do what I want todo here as dean. But it would be very tough for me to give up the sci-ence. We have a lot of exciting things going on in the lab, and I alsothink that continuing to be a scientist makes me a better facultymember and better dean. My goal would be to have maybe a total often people and to focus on areas that have been of particular interestto me, because we’ve been quite eclectic in the last few years.

WCM: One of your first acts as dean was to create an Officeof Faculty Development. Why?LG: Mentoring is really, really important. I’ve spent a lot of my timementoring, and I always say the prize that I’ve won that means themost to me is the Excellence in Mentoring Award from the AmericanAssociation of Immunologists. And when I got here, I felt that nurtur-ing our faculty was an area of opportunity. The new associate dean forfaculty development, Barbara Hempstead, MD, PhD, will focus on allfaculty, not just those at the junior level. Senior faculty may have hita rough patch; they’ve done well, but they kind of ran out of steamand need to reshape. Maybe they need a sabbatical—everybody needsadvice and support. There are lots of people who don’t realize how farthey can go until someone they respect tells them.

WCM: When you were starting out as a physician-scientist,could you have used some guidance yourself? As a woman, wasit hard to balance your career with raising a young family?LG: I was in my early thirties, and those were tough years because Iwas supposed to be doing clinical work in rheumatology full-time, butI was also setting up my lab. I had a six-month-old and a three-year-old and a husband who was a surgical resident. Luckily, my parentslived a few minutes away, and we could afford a live-in babysitter. Ihad my own lab by the time I was thirty-one—but those years weredifficult, and I really didn’t have a mentor. I got through it, but it mademe believe that I should try to make it easier for the people I trained.

WCM: How did you get through it?LG: I’m no smarter than a lot of other people, but I am a very effi-cient multitasker. I had to decide what mattered and what didn’t,and I learned to be a perfectionist in only the things that mattered.

The data have to be perfect, robust, repeatable, well controlled. Butif I’m writing a review or doing a mundane administrative task, 95percent good is good enough—because getting from 95 percent to98 percent takes twice as much time as getting from zero to 95. Andthe same thing went for my family life, because it was very impor-tant to me to spend time with my kids. I got home at a reasonablehour, and I wasn’t worried about whether the linens were folded orthe closets were tidy. You can’t be obsessive about things that don’tmatter, and I’m good at not doing that. We need to pay attention tothe kinds of childcare subsidies and support that we provide at WeillCornell. This is an important priority for me.

WCM: In addition to that kind of assistance, what other sup-port do you hope to offer to women scientists at Weill Cornell? LG: If you look at the numbers, it’s 50/50 male/female for medicalstudents and graduate students and close to 50/50 for assistant pro-fessors. But after they get their first grants from the NIH, then comethe tough times. A young scientist needs a second or a third grant,needs to hire more people and hit a home run. That’s where womenfall out, at the assistant to associate professor transition. If, at thatpoint, you take somebody who’s clearly talented and doing well—butthey have children or other family responsibilities—and you say, “Iknow you don’t have time to write a grant, and anyway funding isreally tough, so the institution is going to give you the equivalent ofan RO1 [NIH research project] grant.” I’d love to be able to do that.

WCM: Please tell us a little about your family.LG: I’m married to Greg Petsko, PhD, an eminent scientist who is astructural biologist and more recently a neurobiologist. He hasjoined the Weill Cornell faculty as a professor of neuroscience in theDepartment of Neurology and Neuroscience.

I have three terrific kids. My older son is in the fourth year of hissurgical residency at the Mass General; he wants to be a cardio thoracicsurgeon. My daughter is in Washington, D.C.; she’s a lawyer with theFDA interested in health-care policy and health-care law, and themother of my one-year-old grandson. My younger son is deploying toAfghanistan in the spring; he’s a second lieutenant in the MarineCorps, where he commands a platoon of light armored reconnaissancevehicles. I thought he was going to be a history professor, but he sur-prised us all by doing Marine officer training during his junior and sen-ior years at Harvard. I’m extremely proud of all three of them.

WCM: What do you do in your spare time?LG: I have no spare time at the moment, but I’m pretty religiousabout exercising; I feel my life is chaotic if I can’t exercise. Four timesa week, I either run five miles or do the elliptical, as well as someweightlifting. I love theater and opera. I used to love to play tennis,but I haven’t had the chance for a while.

WCM: What book is on your nightstand?LG: I just started Joan Didion’s latest book, Blue Nights, about thedeath of her daughter. As a mother, when I think that she lost herhusband and then her daughter within a short period of time, it’stotally devastating.

WCM: You’re assuming the deanship at a pivotal moment inWeill Cornell’s history. How do you feel about the challenge?LG: It’s an honor to be the dean. I am privileged to lead this insti-tution at this time. It’s a huge challenge, but it’s also incrediblyexhilarating and energizing. •


ComprehensiveCare

With a permanenthome at the IrisCantor Women’sHealth Center atNYP/Weill Cornell,the multidisciplinaryWeill Cornell BreastCenter offers aninnovative, patient-centered approach toclinical care andresearch

THE

LOU

VRE

MU

SEU

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S P R I N G 2 0 1 2 2 7

In 1972, the National Cancer Institute was eager to start atrial for treating early-stage breast cancer with “adjuvanttherapy,” a phrase coined a decade earlier by NCI

researcher Paul Carbone, MD, to describe treating patients withchemotherapy in addition to surgery. It was a radical proposalat a time when radical mastectomy was the prevailing treat-ment, and most surgeons disregarded the idea. To award thecontract, the NCI turned to two Italians at a cancer institute inMilan—“the only surgeon-chemotherapist pair seemingly ontalking terms with each other,” Siddhartha Mukherjee writes inlast year’s Pulitzer Prize-winning The Emperor of All Maladies: ABiography of Cancer. Three years later, when the Italian teamannounced study results at a conference, the room responded in“stunned silence.” Half of the women receiving no additionaltherapy relapsed; only a third of those receiving chemotherapysaw their cancer return.

By Andrea Crawford

Around the same time, two future pioneers in breast cancertreatment, both now at NYP/Weill Cornell—Anne Moore, MD, pro-fessor of clinical medicine, and Alexander Swistel, MD, associateprofessor of clinical surgery—were starting their careers, not realiz-ing how their fields would someday become one. Back then, saysSwistel, “there was no such thing as a multidisciplinary approach—mainly because there were so few options available to patients interms of treatment strategies.” Says Moore: “In the old days, youjust did a mastectomy, and that was the end of that.”

But in the following years, Moore, Swistel, and colleagues inother disciplines at NewYork-Presbyterian Hospital began workingtogether and meeting weekly to discuss their patients, two decadesago forming one of the first breast cancer tumor boards in New YorkCity. Today they collaborate under the aegis of the Weill CornellBreast Center, which offers an innovative, multidisciplinaryapproach to patient care and research, bringing together a widerange of specialists along with nurse practitioners, a genetic coun-selor, and a nutritionist. “We feel very strongly at this point thatone doctor can’t figure it all out,” says Moore, the medical director.

Even though they’ve “always worked as a unit,” Moore notes,the team hasn’t always physically been in the same building. But in2002, when the Iris Cantor Women’s Health Center opened on East61st Street, the Breast Center found its first dedicated home. Lastyear, Rache Simmons, MD, professor of breast surgery and chief ofbreast surgery at Weill Cornell, led the Center to become the first oftwo accredited breast centers in Manhattan, following the creationof a national accrediting body by the American College of Surgeons.

While the Center’s patient-centric focus makes care convenientfor those diagnosed with breast cancer, it also drastically improves

Anne Moore, MD

PROVIDED

the quality of treatment. “We discuss findings right away,” saysMichele Drotman, MD, chief radiologist of women’s imaging atNYP/Weill Cornell. “A lot of the time, patients will have theirappointments with their doctors either before or after their mam-mogram, so action can be taken and a plan can be developed.”

On a Friday afternoon this winter, that immediacy and close col-laboration was on display when Eleni Tousimis, MD, associate pro-fessor of clinical surgery, met with several medical oncologists, aradiation oncologist, a pharmacist, a nurse practitioner, and fellowsin the Center’s sun-filled conference room for a weekly informalboard. A pathologist joined the conversation by phone, as partici-pants shared cases, showed reports, asked questions, gave advice,grappled with extenuating circumstances, and together developedthe best treatment plan for each patient. “This place is very cre-ative,” says Linda Vahdat, MD, professor of medicine, director of theBreast Cancer Research Program, and chief of the Solid TumorService. “One thing we know is that people aren’t the same, situa-tions are not the same. You have to personalize your care as much



as you possibly can. When you profile tumors you see that althoughon the surface they may look the same, they certainly aren’t thesame on a molecular level.”

Forty thousand Americans died of breast cancer in 2011,but for the 230,000 patients newly diagnosed each yearthe odds of survival have drastically improved over thelast two decades—due to better treatments, earlier detec-

tion, and greater public awareness of screening and prevention. Asmall fraction of those diagnosed with the disease—only about 15percent—have any family history at all, and only about 5 percenttest positive for a mutation in the BRCA genes, known cancer sup-pressors identified in the early Nineties. As Ann Carlson, the BreastCenter’s genetic counselor, explains, everyone is supposed to havetwo copies of BRCA1 and BRCA2, but carrying a mutation in eithergene gives women up to an 85 percent lifetime risk for breast andovarian cancer. Medical oncologist Tessa Cigler, MD, often workswith those at high risk, as they undergo more rigorous screening,including mammograms in addition to ultrasound or MRI. Sometake chemoprevention drugs or opt for prophylactic mastectomies.

For women without a family history of breast cancer, the Centerrecommends an annual mammogram beginning at age forty. Thetechnology of using X-ray machines to find tumors in the breaststarted in the Sixties, and in 1971 the first large U.S. study (althoughlater found problematic) revealed initial findings indicating a signif-icant benefit from screening. With that, mammography skyrocketed—galvanized as well by First Lady Betty Ford’s public an nounce mentof her diagnosis and radical mastectomy. The resulting rise in diag-noses became known as the “Betty Ford blip.”

In the decades since, mammographic techniques have evolved,most notably in the last five to ten years with the advent of digital

technology. “What we can see has dramatically improved,” saysDrotman. “We’re picking up cancers earlier and earlier.”Approximately 90 percent of the Center’s patients are diagnosed instages 0, 1, and 2, which have excellent survival rates: the five-yearrates for women with stage 0—which is noninvasive, or in situ—is97 percent at NYP/Weill Cornell (whose rates in each category arehigher than national averages). Stage 1 and 2 survival rates are 94percent and 88 percent, respectively. The prognosis worsens formore advanced stages, with stage 3 survival rates at 75 percent andstage 4, or metastatic breast cancer, at 20 percent.

Such success in detection and treatment has prompted a newapproach to care. Currently, there are 2.6 million survivors in theUnited States; in 2005, the Institute of Medicine published FromCancer Patient to Cancer Survivor: Lost in Transition as a call from thegeneral medical community to pay closer attention to the issuesthey face. “We want to make available to our patients tools to movealong after they’ve had a diagnosis of breast cancer,” says Moore. InMarch 2012, the Center held its third annual patient symposium, adaylong event featuring panels and guest speakers. At the sympo-sium, Ellen Chuang, MD, associate professor of clinical medicine,addressed the important topic of bone health and the interface ofmedicines to prevent osteoporosis and decrease breast cancer risk.

Unsurprisingly, for the majority of patients the biggest concernis the chance of recurrence, which Cigler calls the most difficultlong-term issue they face. “Part of breast cancer is learning to livewith some uncertainty, but it’s learning to live with uncertainty, tocontinue to enjoy life,” she says. Some patients benefit from psy-chotherapy or medications for anxiety or depression, and theCenter incorporates relaxation therapies, meditation, and otheralternative practices into both the patient’s treatment course andsurvivorship plan.

That shift in philosophy—“It’s not a matter of just getting youto survive,” Swistel tells patients, “we’re going to get you to thrive”—has driven numerous advances in breast cancer surgery as well,including minimally invasive techniques and an approach knownas oncoplasty, which combines tumor removal with plastic surgeryto improve the cosmetic outcome and reduce complications. “We’realways asking the question, ‘Is there a better way to do some-thing?’” Swistel says. He was among the first to do sentinel lymph

Tessa Cigler, MD

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node biopsies, which identify the lymph nodes to whichcancer has spread—a departure from the traditional practiceof removing twenty to thirty lymph nodes in conjunctionwith mastectomy. Simmons initiated the use of a novel dyeto identify the sentinel lymph node, which has become astandard of care in the technique because it is safer thanpreviously used dyes.

Another innovation, called skin-sparing mastectomy,allowed better breast reconstruction by saving a generousskin envelope to cover either an implant or the patient’sown tissue. Such techniques have progressed to a pointwhere now both areola and nipple sparing is becomingmore popular; Swistel calls this “the last frontier of mastec-tomy.” Plastic and reconstructive surgeon Mia Talmor, MD’93, notes that the combination of oncoplasty techniquesresults in greater patient satisfaction. Says Simmons: “It issuch a great compliment to have my patients’ other doctorsask which breast had the mastectomy, because it looks sonatural and matches the healthy breast after nipple-sparingmastectomy and reconstruction.”

Surgeons are also working with radiation oncologists todevelop a way to offer partial breast irradiation over fivedays instead of the traditional six weeks, and early this yearthey acquired the capability to conduct interoperative radi-ation; as of this spring, patients will be able to have radiationdone at the same time as their lumpectomy. Mary Hayes,MD, associate professor of clinical radiation oncology, isspearheading the effort to establish Weill Cornell as a centerfor the latest innovations in radiation therapy. Simmons isleading research on techniques to destroy tumors withoutsurgery through an office procedure called cryoablation, inwhich she freezes the tumor. Currently, she removes themass to prove that all cancerous cells have been destroyed—but the next step will be cryoablation without excision. “Weare looking at ways to destroy breast cancer without sur-gery,” she says.

The Breast Center also runs a robust research effortled by Linda Vahdat that covers everything fromanalyzing the effects of chemotherapy on fertility toworking with bench scientists to understand why tumors

spread and how they can be stopped. Physicians there have beencritical partners in the development of the last two drugs formetastatic breast cancer: Eribulin, which was approved in November2010, and Ixabepilone, approved in 2007 to treat patients no longerresponding to chemo. The team is now testing a number of newdrugs that offer additional options for patients with advanced dis-ease. These include a pair, close to approval by the FDA, which tar-get HER2 positivity—a protein that promotes tumor growth,resulting in a more aggressive cancer.

But the ultimate goal is to prevent tumors from spreading in thefirst place. The most exciting research on this front involves deplet-ing the copper in cells to undermine the body’s own infrastructuralsupport for tumor growth. “Tumors don’t know how to spread,”says Vahdat, “so they sort of trick your body into telling themwhere to go.” Researchers are not entirely certain why copper deple-tion works, but they believe the metal is critical for enabling cell

movement. “If you don’t let them move, they’re in suspended ani-mation, which means the infrastructure never gets to where thetumors are,” says Vahdat. The original plan for the study was to fol-low women, all at very high risk of a recurrence, for two years. Buttheir results were so good that Vahdat continued the study and hasnow followed the cohort for six years.

The Center’s investigators are also looking closely at a number ofways to limit the side effects of existing cancer therapies, such asaromatase inhibitors, which stop the production of estrogen butcommonly cause joint pain in postmenopausal women. “The painranges from mild to bothersome enough that women have to betaken off lifesaving medicines,” says Cigler, who, along with Moore,is collaborating with rheumatologists at Hospital for Special Surgeryon the work.

A common side effect of chemotherapy is peripheral neuropa-thy, which causes numbness or tingling in the fingers and toesthat can be quite debilitating. Vahdat has partnered withresearchers at the Rockefeller University to study patient skin biop-

‘You have to personalize your care asmuch as you possibly can. When youprofile tumors you see that although on the surface they may look the same,they certainly aren’t the same on amolecular level.’

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sies under an electron microscope. “We can start to see what’sactually happening, correlate it with the physical exam,” she says,with the goal of determining a strategy either to treat the sideeffect or to identify people at risk for it who could benefit fromprevention. She has also started a study based on preliminary datathe Center generated several years ago suggesting that glutaminemight prevent some of the symptoms of neuropathy induced bythe chemotherapy drug Taxol.

Hair loss is another side effect of chemotherapy, and the Centeris conducting a study of cold caps, which patients wear for a halfhour before and during chemo, and for four hours after, keeping thescalp cold enough to protect hair follicles. “It’s safe and reasonablywell tolerated for patients who are highly motivated to maintaintheir hair during chemotherapy,” Moore says.

Some critics have worried that the caps prevent the drugs frombeing delivered to the scalp, but Moore says the safety has been welldemonstrated by European doctors, who have long used cold capsand now administer them almost routinely. According to Cigler, the

A ny woman receiving anew diagnosis ofbreast cancer mustmake immediate deci-sions about treatment.

But for women of childbearing age, whoaccount for about 12 percent of newdiagnoses, the best options can havepotentially devastating consequences ontheir ability to conceive children.Chemotherapy often triggers earlymenopause, and the typical course of hor-monal therapies, such as Tamoxifen, canlast five years—representing a delay that,as oncologist Tessa Cigler, MD, puts it,“can make the difference between beingfertile or not.”

Cigler discusses these issues with herpatients at the time of diagnosis. Some—assuming they do not have a high-riskcancer for which chemotherapy mustbegin immediately—can preserve fertilityby undergoing in vitro fertilization toretrieve eggs prior to treatment. “Time isof the essence,” Cigler says, both in treat-

Baby StepsNew techniques to help breast cancer patientspreserve their fertility

ing cancer and in scheduling IVF, since thestimulation of ovaries must begin at aspecific time in a woman’s natural men-strual cycle. “Waiting for two days couldmake someone delay for a month.” Toexpedite care, she has a special phonenumber to reach Weill Cornell’s Center forReproductive Medicine and Infertility(CRMI), where her colleagues will seepatients with newly diagnosed cancerimmediately—often that same day.

According to CRMI’s Glenn Schattman,MD, it is imperative to remove eggs fromthe body before chemotherapy exposure.In addition to the risk of menopauseonset, “chemotherapy affects the eggsthat are developing,” says the associateprofessor of clinical reproductive medicine.“There’s a significant concern in the risk ofmalformations.” A typical course of treat-ment involves lumpectomy first, followedabout twelve weeks later by chemotherapy.During that time, a woman can usually getthrough two IVF cycles (even while under-going radiation, if needed).

CRMI has been helping patients withcancer preserve their fertility since thelate Eighties—stimulating eggs, fertilizingthem immediately with sperm, and freez-ing the resulting embryos. Until 2001,however, Schattman says, “we didn’t real-ly have the means to adequately preservefertility in single women without a part-ner.” At that point, freezing eggs becamefeasible, although success rates remainedlower than for frozen embryos, andwomen without partners would still oftenuse donor sperm and freeze embryos.

In 2004 protocols for freezing eggsimproved dramatically, and today, withfurther refinements in freezing techniques,CRMI’s latest data show that for womenunder the age of thirty-two, “the chanceof pregnancy with a frozen egg is almostthe same as it is with a fresh egg,”Schattman says. Now, even women withpartners often choose to freeze eggsrather than embryos, to avoid potentialethical questions down the road.

But does an IVF cycle put at risk a suc-cessful outcome in treating cancer? “Thatis the million-dollar question,” says Cigler.“There is no evidence to date that doingone cycle of IVF before chemotherapy isassociated with worse outcomes. Wecan’t say with 100 percent certainty, andwe worry a little bit. But the outcomes todate have been reassuring.”

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about ten times higher than normal.“There’s always the concern for women—even if their cancer is estrogen-receptornegative—that stimulation of theirovaries is going to cause the cancer togrow or spread,” says Schattman. To limitthis risk, CRMI has developed specialprotocols for patients with cancer, stimu-lating the ovaries to produce multipleeggs while using aromatase inhibitors toblock production of estrogen. (The estro-gen, which is made by cells surroundingthe egg, would be necessary to preparethe uterus if the released egg were to befertilized naturally or if embryos were tobe transferred back into the uterus dur-ing regular IVF.) “We can stimulate fifteeneggs, and the estrogen levels are aboutthe same as you would find in naturallevels,” he says.

Success rates have been good. Thechance of pregnancy depends on the num-ber of eggs retrieved. For a patient underthirty-five, the chance of pregnancy per eggfrozen is 9 to 10 percent—which meansthat for a woman who produces andfreezes twenty eggs, there is a very goodchance of achieving pregnancy. As womenget older, the chance of success with frozeneggs diminishes, decreasing dramatically forwomen over thirty-five. At forty and above,it’s 1 percent or less per egg.

Oncologists typically ask patients towait two years after treatment beforeattempting to get pregnant. “There’s nodata to suggest a harmful effect of preg-

nancy after a diagnosis of breast cancer,but we typically ask women to wait,”Cigler says. “First, because if they’regoing to do hormonal treatment, we’dlike at least two years of treatment. Andalso, there’s some debate about this, butprobably the highest risk of recurrence isthe first two years.”

Cigler and colleagues at Memorial Sloan-Kettering Cancer Center are conducting astudy to determine ways to predict awoman’s chances for chemotherapy-induced menopause by looking at bloodmarkers that indicate the ovaries’ remain-ing egg levels. If a woman is likely tobecome menopausal, one potential treat-

ment is to remove ovarian tissue beforechemotherapy and replace it afterward,which causes ovulation to restart. So far,some twenty children have been bornworldwide from this procedure. In thefuture, Schattman says, doctors may beable to mature eggs from frozen ovariantissue directly in the laboratory. Thiswould help patients who have had ovariesremoved because, for example, they carryone of the known genetic mutations thatput them at very high risk for breast andovarian cancer. “We get the pictures, thee-mails, the cards every year,” Schattmansays of the news he receives from cancersurvivors. “It’s a good feeling.”

caps often provide a positive outlet for patients, giving them a focusfor their nervous energy as they play a role in administering theheadgear, which is replaced every thirty minutes to maintain propertemperature. “It’s a way they can take the chemotherapy into theirown hands and have some control,” she says. “It takes their mind offit in an empowering way. We’ve been surprised, as have our patients,at what a good experience such a difficult thing has turned into.”

From the nineteenth century until a generation ago, a womandiagnosed with breast cancer had only one option: a radical mastec-tomy, which often included the removal of muscle, bone, and eventhe rib cage and chest wall, leaving her permanently disfigured anddisabled—and still at risk for metastasis. Over the last three decades,treatment options have evolved dramatically. Today when a womanfaces a new diagnosis, a team of specialists at the Breast Centerdetermines an individualized plan based on numerous factors,including the genome of the tumor, which tells them how fast it

might grow, whether it will respond to hormone therapy, how like-ly it is to return, and even its potential response to chemotherapy.Drugs are then targeted to specific receptors or to blood vessels thatsupport the tumor. A woman has mastectomy options that preservethe entire skin of the breast, and ways to preserve her fertility aswell as her hair. And—even before diagnosis—a patient at high riskhas a range of medical and surgical preventative options.

Multidisciplinary research underlies all of these clinicaladvances. “We’re committed to our patients; we want to cure themall,” says Vahdat. “To do that, you really have to understand howtumors spread.” With a robust research program encompassing col-laborations with scientists across institutions, the Weill CornellBreast Center’s clinicians believe that the coming decades will bringeven greater improvements in the treatment and prevention ofbreast cancer, including an answer to the fundamental issue: how toprevent a cell from becoming cancerous. •

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Neurologist M. Elizabeth Ross,MD ’79, PhD ’82, and colleagueswork to prevent neural tubedefects—and understand the roleof folic acid in human disease

For decades, doctors have been urg-ing young women to eat a diet highin leafy greens, legumes, and other

folate-rich foods to protect against a class ofcongenital anomalies, including spina bifidaand anencephaly, known collectively as neuraltube defects (NTDs). They affect between300,000 and 400,000 newborns worldwideeach year. If a woman waits until a pregnancyhas been confirmed to start thinking about theB-complex vitamin, it’s often too late: the neural tube, precursor to the central nervoussystem, is closed by the fifth week after con-ception. By the time many women realizethey’re pregnant, the opportunity to preventNTDs—which range from a condition so subtleas to go undiagnosed for a lifetime to so pro-found that the fetus fails to survive gestation—has long since passed.

By Sharon Tregaskis

Scientists started documenting the role of vitamins in theembryological development of barnyard animals in the mid-Thirties. The effects of profound food shortages in Europe through-out World War II served as a natural experiment revealingadditional insights among humans. Then, in the Fifties, scientistsbegan testing the influence of specific micronutrients on individualorgan systems in lab animals. Between 1976 and 1991, a series ofstudies involving women in England, the U.S., and Cuba confirmedthat a folate-rich diet—or the use of supplements containing folicacid, a synthetic form of the molecule—in the months precedingconception and during the first few weeks of embryological devel-opment drastically reduced the incidence of NTDs.

No one knew how folic acid worked its magic on the nascentcentral nervous system. But in 1992, the U.S. Public Health Service

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M. Elizabeth Ross, MD ’79,PhD ’82



recommended that every woman of childbearingage—reproductive intentions notwithstanding,due to the high incidence of unplanned pregnan-cies—consume 400 micrograms of folic acid everyday. Despite a growing body of evidence, fewwomen changed their habits and the rate ofNTDs held steady. So, in 1996, the FDA and itsCanadian counterpart mandated that foodprocessors include folic acid in enriched grainproducts—pasta, rice, bread, and the like—effec-tively boosting the entire population’s consump-tion of the water-soluble vitamin. Forty othercountries have done the same, and in the lastfourteen years the rate of neural tube defects hasdropped by an estimated 30 percent (considerablyless dramatic than the 70 percent reduction antic-ipated from the early-Nineties U.K. and EasternEuropean studies).

Throughout the Nineties, as public healthadvocates launched outreach campaigns to pro-mote folic acid awareness, neurologist M.Elizabeth Ross, MD ’79, PhD ’82, was seeingpatients with NTDs and other complex congeni-tal brain anomalies at the University ofMinnesota Hospital. For more than a decadeshe’d been investigating the genetic basis forneuronal differentiation, a developmental phasethat spans the second trimester, during whichneurons migrate to what will become the frontal,

parietal, occipital, and temporal lobes and begintaking on the characteristics of those regions ofthe brain. In the process, she’d begun delvinginto lissencephaly, in which the cerebrum devel-ops with a smooth surface instead of the typicalconvolutions characteristic of human gray mat-ter. Scientists attributed the condition to glitchesin the chemical signals that guide or enable theneuron to move and migrate from its point oforigin to its position in the mature brain. To sortout the genes behind the biochemical confusion,Ross had assembled a small menagerie of engi-neered and naturally occurring mutant mousestrains, each exhibiting a unique symptomreflecting a mutation in one of the genes thatchoreograph development of the fetal brain.

When Ross mentioned that she’d found agene on mouse chromosome six with an inter-esting pattern of developmental expression, acolleague alerted her to a strain of mice—knownas Crooked tail—with an unknown mutation inthe same general neighborhood on chromosomesix. If they were lucky, the brain defect inCrooked tail might be due to a mutation in thatinteresting gene, and fine mapping would leadto its identity. “I thought I’d work with theCrooked tail mice maybe for a summer, to dosome mapping and see how close the defect wasto the gene I was working on. My gene and theone responsible for Crooked tail would be milesapart—and that would be the end of it,” saysRoss, now a professor of neurology and neuro-science at Weill Cornell and an attending neu-rologist at NewYork-Presbyterian. “Naiveté is agreat thing when you’re building a project.”

Her team spent the three months she’dexpected mapping the Crooked tail genome—and then, suddenly, the fatal NTD characteristicof the strain simply disappeared. “I thought thatwas pretty much impossible,” says Ross. “Thisline had been around since 1954; it seemedunlikely we would lose the mutation in our owncolony in just three months.” One day in a labmeeting during which the team again struggledto explain what had happened, Ross quipped,“Did someone slip them some folic acid?”

That was exactly what had happened. Tosave money, the university’s animal facility hadswapped the usual brand of mouse food for lessexpensive rat chow—and in the process nearlydoubled the amount of folic acid being ingestedby all of Ross’s animals. Her team hadn’t lost themutation characteristic of the Crooked tail geno-type: its phenotypical expression had been trans-formed by the doubled dose of vitamin B-9. Rosspromptly launched a diet study to investigatehow different amounts of folic acid affected thepercentage of mice born with an NTD. “Bythen,” she recalls, “we had markers sufficientlyclosely linked to the gene so you could look at

Microscopic view: Mouseembryos engineered to expressgreen fluorescent protein in allcell membranes to more easilyvisualize the steps of neuraltube closure

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the effect of diet on the phenotype.” Ross’spaper revealing the name of the first mousemodel shown to be protected from NTDs bydietary folic acid with close parallels to humanclinical data was published in Human MolecularGenetics in 1999. Ross’s lab then found the pointmutation responsible for Crooked tail thatchanged a single amino acid in Lrp6, a proteinin a Wnt signaling pathway that is criticallyimportant for brain development, reported inthe Proceedings of the National Academy of Science,USA, in 2005. Finally, with Crooked tail andabout a half dozen more mouse models thatwere shown by others to reduce their NTDoccurrence with folic acid, scientists could begindesigning experiments to elucidate the geneticand biochemical pathways through which folicacid influences neural tube development.

L ike origami, the ancient Japaneseart that can transform a sheet ofpaper into a crane, the first weeksof human embryological develop-ment follow a strict pattern: fold,

turn, divide, repeat. One layer of cells differenti-ates and becomes the respiratory system, anoth-er becomes the brain and spinal cord. Theprotean heart splits into four quadrants; fourlimb buds become arms and legs. Folic acidplays a starring role, as the supplier of vital carbon-hydrogen molecules to promote methy-lation, the process that activates one gene andsilences another—converting one pluripotentcell into an islet cell in the pancreas and anoth-er into a neuron, then promoting the neuron’sfurther migration and differentiation within thecentral nervous system. In essence, methylationof DNA and proteins provides a way to modu-late how the blueprint encoded in DNA is readby the cell. As in origami, any divergence fromthe norm echoes through each subsequent stepin shaping the nervous system. “When the braindevelops in utero, it’s a fascinating process,” saysRoss. “To get such complexity of cell types andpatterned organization from a single fertilizedegg is nothing short of miraculous. It seems asurprising thing that it ever goes normally.”

Most of the time, the transformation ofundifferentiated cells does indeed proceed with-out a hitch. Yet in as many as ten of every 1,000births (an estimated one in 2,000 births in theU.S.), something goes awry as the embryonicneural sheet folds, bends, stretches, andexpands—making NTDs second only to cardiacmalformations among the most common con-genital anomalies. At their most mundane,NTDs leave a slight gap where a few vertebraestop short in their embrace of the tail end of the

spinal cord. Rather than forming a protective“O” around the serpentine rope of nerves thatconducts signals to and from our limbs, thebones stop in the shape of a “U” or “C,” oftencausing paralysis below the level of the opening.At their most extreme, NTDs are fatal. In anen-cephaly, the embryonic brain is openly exposedto the amniotic fluid and the developing graymatter dies in utero. In exencephaly—the birthdefect that disappeared among Ross’s Crookedtail strain when their folic acid consumptionspiked—the process is the same as for humananencephaly, but the mouse’s shorter gestationof only twenty-one days means less time for theexposed brain tissue to die away, leaving thebrain to bubble out of shape. Both anencephalyand exencephaly kill within hours of birth, ifnot before.

Spina bifida—in which the spinal cord pro-trudes from within the partially formed scaffold-ing at the base of the vertebral column—is themost common NTD seen by clinicians in the U.S.Beyond the risk of infection at the lesion site,compression and pinching of the bundled nervesconstrains fetal development and permanentlylimits sensation, mobility, and self-control. Fetalsurgery—offered at only a few academic medicalcenters in the U.S. and unavailablein the developing countries wherespina bifida is most common—cansome times minimize the pinchingand preserve a greater range ofmotion. Postnatal treatmentsfocus on management of the con-dition, not its cure.

Recessive diseases like sicklecell anemia and Tay-Sachs diseaseowe to matching mutations of asingle gene transferred by the par-ents to the resulting zygote; thecondition’s signature code is repli-cated in every cell in the body. Bycontrast, NTDs are caused by acomplex process gone wrong. “Weknow of more than 250 genesthat can be mutated and lead toNTDs in the mouse,” says Ross.“In almost no cases are thosemutations 100 percent penetrant;even if you have two copies of themutated gene, there is only a 30to 80 percent chance that theresulting embryo would be affect-ed. The situation in humans, inclinical populations, is even morecomplicated.”

Preventing NTDs requires asystems-level analysis that inte-grates the effects of multiple slightgene changes in concert with a

Pre-surgical: An MRI of aninfant with spina bifida priorto repair; cerebral spinalfluid appears white.

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It was her voice he noticed first. As a postdoctoral fellow in the Weill Cornell laboratory of Donald Reis ’53, MD ’56, Costantino Iadecola, MD, was investigatinghow neural stimulation of the cerebellum influences blood flow in the brain. It was1981, and M. Elizabeth Ross was doing research for her PhD in the Division of

Neurobiology on the biochemistry of neurotransmitter production before beginning herinternship and residency in neurology at Massachusetts General Hospital. Each put in longhours. “One evening she was singing some kind of aria, just walking around in the lab,”says Iadecola, who was learning to play Renaissance music on his guitar. “She was spoton, in perfect tune, with beautiful tone and clarity.”

Many of the pieces Iadecola was learning had been composed as duets for lute andvoice, but so far he’d been playing solo. “I could tell that she had a good ear,” he says.“Most important, I did not know anyone who had such a great voice and could be con-vinced to play with me.” They had their first performance at a lab seminar in the Divisionof Neurobiology, says Iadecola, who has succeeded the late Dr. Reis as the George C.Cotzias Distinguished Professor of Neurology and Neuro science and Chief of the Divisionof Neurobiology at Weill Cornell.

The rest, he says, is history. The couple married in 1987, and after a decade on thefaculty at the University of Minnesota Medical School they returned to Weill Cornell in2002, their young son in tow, as tenured professors in the Division of Neurobiology. Theyfirst published together in 1995, and in the next eleven years produced another twodozen papers combining his expertise in neurobiology and acute brain injury with hercommand of biochemistry and molecular biology. While their last formal collaboration wasin 2006, each remains a valuable consultant on scientific projects and grant applications.“A lot of working couples don’t understand exactly what the other is doing, and that canbe a source of misunderstanding and friction,” he says. “Working on a grant applicationor on the hospital wards, we understand perfectly what it entails and stay off each other’sback. She gets a new grant or a paper in Science, and I know what it means. We canshare the successes and the sorrows.”

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deeper understanding of the role of folic acid inthe myriad metabolic processes that promoteneural tube development. “We’re trying tounderstand not just the genetic changes, but thegene-environment interaction,” says Ross. “Thegenes provide a predisposition, and the environ-ment determines whether a defect is expressed.”

In September 2011, the NIH awarded Rossand co-principal investigator ChristopherMason, PhD, a Weill Cornell assistant professorof computational genomics, a $5.5 million trans-formative research project grant to integrate datafrom mouse models of folate-sensitive NTDswith human data gathered collaboratively inRoss’s laboratory and that of Richard Finnell,PhD, a geneticist at the University of Texas,Austin, and the director of genomic research atDell Children’s Medical Center in Austin. Theirgoal is to identify the impact of folic acid supple-mentation in the methylation of the humangenome of NTD patients and compare it withhow DNA and protein methylation alters geneexpression in mice that are genetically predis-posed to NTDs. They hope to reveal principles ofhow the environment can tip the balancetoward health or disease in a particular individ-ual. “I can’t believe that we’ve evolved in such away that these nutrient-gene interactions andhow they influence metabolism are unique toNTDs,” says Finnell. “Neural tube closure hap-pens pretty early [in embryological develop-ment], and I think we’re going to learn aboutfundamental changes that apply to all of thestructural defects.”

Ross, Mason, and Finnell also expect theirwork to reveal why NTDs haven’t been entirelyeradicated among populations where a combi-nation of access to fresh vegetables, prenatalsupplements, and mandatory fortification hasvirtually eliminated folic acid deficiencies.Scientists have long speculated that genetic pre-disposition influences the critical dose requiredto avert an NTD. Says Mason: “Finding the bestmarkers for risk would allow two parents totake a test and determine how much folic acidto take.”

Growing insights into folic acid’s role in genetranscription and other cellular processesincreasingly suggests that the public healthimplications of fortifying processed foods are notuniformly positive. Finnell notes that in addi-tion to eating fortified grains, many Americansalso take a multivitamin containing folic acidand consume a diet that includes natural folatein the form of leafy greens and other wholefoods, leading to significant variations in theamount of the vitamin in an individual’s blood-stream. While the combination may benefitwomen of childbearing age, its influence onother populations could be more complicated.

“People intuitively understand that there can betoo much of a good thing,” he says. “We areunique entities, and it’s possible that there arepeople for whom having too much of this B-vitamin creates an idiosyncratic situation thatisn’t good.”

While folate deficiency increases the risk ofNTDs—as well as heart attacks, hardening of thearteries, and cancer—too much can be equallydangerous. In 1947, when pathologist SidneyFarber, MD, sought a treatment for childhoodleukemia, he discovered that folic acid madepatients sicker, while aminopterin—whichblocks folic acid’s action—slowed their diseaseprogression. More recently, studies have shownthat the B-vitamin also fuels the growth of pre-cursor lesions of colorectal cancer, increases therisk of breast cancer, and promotes cognitiveimpairment among some elderly people. Even inthe case of NTDs, Ross’s research in mouse mod-els published in Human Molecular Genetics in2010 indicates folic acid may sometimes reduceNTD occurrence by promoting the miscarriage offetuses with profound defects. Says Ross: “Thereare many effects of folic acid that we don’t yetunderstand well, and the levels of the vitaminneeded to ensure a healthy birth outcome mayvary according to the genetic makeup.”

Understanding how NTDs develop has impli-cations for the hundreds of thousands of familieswho every year grapple with the diagnosis andits implications. If Ross and Mason can untanglethe relationships among genes and folic acid,their findings promise to give families theinsight they need to fine-tune diet and supple-ments to promote fetal health. But for millionsmore, the research promises to enhance the pos-sibility of personalized medicine, in whichresearchers identify the combination of geneticpotential and environmental interventions—from exercise and diet to early screening andprophylactic treatments—that minimize or pre-vent an array of diseases that strike throughoutlife. “It’s a natural fit to be working on NTDs, butthis isn’t the only common disease that muta-tions, molecular changes can predispose us to,”says Mason, who holds assistant professorshipsin the Department of Physiology and Biophysicsand in the Institute for ComputationalBiomedicine. “My goal is to find the computa-tional techniques that will advance our under-standing of disease.” He points out that none ofthe work he and Ross have envisioned in theNIH grant would have been possible withoutrecent advances in technology. “Much of thehardware and methods of investigation that weneed in this project to let us look at the wholegenome at once didn’t exist five years ago,” hesays. “This is an astounding time to do work ingenetics.” •

‘We’re trying tounderstand notjust the geneticchanges, butthe gene-environmentinteraction. Thegenes provide apredisposition,and the environmentdetermineswhether adefect isexpressed.’


Dear fellow alumni:The fall and winter were very mild in the New York metropolitan area—which, after the previous

year’s record snowfall, was a most welcome change. I hope that the season has proven equally enjoyablefor all our alumni. Of course, for the skiers and snowboarders out there, it has been pretty dismal, espe-

cially here in the Northeast. On January 1, we saw a changing of the guard with the esteemed Antonio M. Gotto Jr., MD,

DPhil, stepping down after fifteen years of service as the Stephen and Suzanne Weiss Dean of WeillCornell Medical College and Provost for Medical Affairs at Cornell University. Dr. Gotto was suc-ceeded by Laurie Glimcher, MD—who, by all accounts, has hit the ground running. She has donean admirable job of meeting with staff and appears ready to build on the foundation set by Dr.Gotto. Dean Glimcher’s ambitious goals were outlined in her reports to the Board of Overseers andthe Cornell University Board of Trustees. In essence, she plans to elevate Weill Cornell further intothe highest rankings of medical schools in the country and worldwide, by expanding our researchcapabilities and improving our world-renowned clinical services.

At the center of the Weill Cornell universe are the students, of course. Dr. Glimcher hasengaged them most warmly, and they have responded in kind. She has also been pleasantly sur-prised by how engaged alumni are with the Medical College; Dean Glimcher recently remarkedthat she had never seen such an active group of alumni who are so supportive of their medicalschool and its students. She is looking forward to working with the Alumni Association and thealumni community at large to achieve our mutual goals. It appears that Dean Glimcher will con-tinue the tradition, set by Dr. Gotto, of keeping alumni engaged, both now and in the future.

The Association’s ASK (Alumni-to-Student Knowledge) sessions continue, the latest represent-ing internal medicine subspecialties. These events provide an informal venue for students to askalumni candid questions about life in their chosen specialties. The students find these sessionsinvaluable, so if you are interested in participating please contact the Alumni Association formore information.

The Association was well-represented at the recent Rogosin Institute Scholars Reception, with sixboard members in attendance as Dean Glimcher presented five deserving medical students with theirscholarships. Also in February, the Association hosted a reception in San Francisco for local alumni aswell as those in town for the annual meeting of the American Association of Orthopaedic Surgeons. Wehad a large showing of more than fifty alumni representing from the 5th through 50th reunion classes.

Planning for Reunion 2012 (save the dates: October 19–20) continues apace. Featuring reports from bothDean Glimcher and President Skorton, it promises to be a fun-filled reunion, and I hope to see you there!

Thanks again to all alumni for your continued support of the Alumni Association, the MedicalCollege, and our students.

Best and warmest wishes,Michael Alexiades, MD ’83President, WCMC Alumni [email protected]


NotebookNews of MedicalCollege and GraduateSchool Alumni

Michael Alexiades, MD ’83

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1940sCharlotte Rush Brown, MD ’45, and David

Brown, MD ’45, are enjoying their retirementafter 60-year practices in pediatrics, internal med-icine, and public health. They live in elder hous-ing in New Canaan, CT, the community wherethey worked.

Abraham Blumer, MD ’49, is retired in WestBloomfield, MI, where he enjoys country-westernand line dancing. He would like to hear from anymember of the Class of 1949.

1950sMartin J. Evans ’46, MD ’50: “I remain in

close contact with my older ‘kid brother,’ HowardE. Evans ’44, PhD ’50, the better Cornellian, whonever left Ithaca and the Veterinary College.Thanks to classmate Frank Perrone, MD ’50, fortaking such good care of my friend Bill Brief. Sadto see the passing of Leon Charash ’47, MD ’50, agreat friend and possibly the smartest kid in theClass of ’50.”

Francis A. Wood, MD ’50: “For a good manyyears, even prior to retiring from practice as aneurosurgeon, I’ve been a consultant to the NewJersey Motor Vehicle Commission. I review med-ical material on individuals who have neurologi-cal problems and advise them regarding driverlicenses and testing. I’ve been doing it for 47years, and last June the Motor Vehicle Com -mission held a luncheon at their headquarters inTrenton in my honor. Having something to do inretirement that allows me to feel slightly useful isa great plus. Also, it keeps the gray cells rubbingtogether and forces me to try to keep up withsome of the newer developments in neurologicalmedicine. As an example, since I retired therehave been a number of new anti-seizure drugs,and since seizures are one of the problems I dealwith I have to keep abreast of the treatmentoptions that I read about in the cases I review.Finally, you wouldn’t believe how interestingsome of the cases can be, and even, at times, howamusing.”

Stanley Birnbaum, MD ’51: “I am still practic-ing gynecology in NYC at NYP/Weill Cornell. Ilive in Manhattan with my wife, Michele, andenjoy my two grandchildren, Riley and Spencer,who live nearby.”

Russel Patterson, MD ’52: “I retired from thepractice of neurosurgery in 1995. Julie and I stilllive in midtown, and we still go to neurosurgicalmeetings, mostly to keep in touch with oldfriends. In addition, I serve as historian of one ofthe neurosurgical societies. All the usual accom-paniments of aging have arrived, like stiff joints,poor balance, and fuzzy memory. When I hit 80,we unloaded our small airplane, which has com-

plicated getting to our place near Burlington, VT.The children are all thriving. Daughter Ritchie ischair of the physics dept. at Cornell, son Hugo isa computer scientist/entrepreneur in Los Altos,CA, and son Xander is involved in educationand writing. I have no idea what the futureholds, but so far it has been a good ride.”

Earnest Curtis, MD ’53: “No exciting travel oraccolade this year, but still vivid in my memorywas my arrival in 1949 by Southern Railway atCornell University Medical College as a third-yeartransfer student from the University of AlabamaMedical School. Two suitcases, but no books, noradio, no place to live, no computer, and mostimportant, not a single acquaintance. From thatbeginning grew two years of wonderful experi-ences and a year’s internship. Many new friendscome quickly to mind: Ames Filippone ’50, MD’53, Jim Strickler, MD ’53, Allen Mead, MD ’53,Marvin Fox ’48, MD ’53, John Branche, MD ’53,and Dick Mattingly, MD ’53 (deceased). I followwith great pride the current progress of WeillCornell and wish you all well.”

J. Robert Buchanan, MD ’54 (former associ-ate dean and later dean of the Medical College1969–74): “I’m retired now from MGH for 16years and widowed for four years. For the pasttwo years I have been a resident of an attractivecottage on the 40-acre campus of a continuingcare retirement community in Evanston, IL,

SHERMEL B. SHERMAN



event of system failure. All went well. “Youknow you are getting old when what wasyour ‘state of the art’ medical monitoringstation is now part of a USAF museum. Theceremony was fine: Scott Carpenter, one ofthe original seven astronauts, and about 100of us who had supported Shepard’s flightwere there, plus high-paid help from NASA.A video of the flight was played at the timeof the original launch—an American eaglesoared overhead (the Cape is a bird sanctu-ary). Also had a tour of the last two shuttlesbefore their last flights.”

Paul Carter, MD ’56: “Since retiring fromthe practice of general surgery and teachingsurgery at the Ohio State College ofMedicine at Toledo, I’ve been involved inperforming surgery on short-term medicalmissions, mainly in rural Guatemala. I alsoprovided general medical care for uninsuredelders at the Senior Friendship Center inSarasota, FL, for ten years. When my wifeexperienced increasing vascular dementia, Iserved as her primary caregiver for two yearsuntil she died in November 2011. Morerecently I had resection of a chondrosarco-ma of a rib and am now recuperating fromthat. I enjoy church activities, reading, andvisiting with family and friends.”

Albert Z. Kapikian, MD ’56, chief of theepidemiology section at the NationalInstitute of Allergy and Infectious Diseases,received the 2011 Maurice Hilleman/MerckAward. In 1972, Dr. Kapikian and his col-leagues discovered the Norwalk virus, oneof the first viruses to be associated withacute epidemic gastroenteritis in humans.He and NIAID scientists Dr. StephenFeinstone and Dr. Robert Purcell first identi-fied the virus that causes hepatitis A. Dr.Kapikian’s research on the humanrotavirus—the leading cause of severe diar-rhea in infants and young children world-wide—led a 25-year effort to develop a

We want to hear from you!Keep in touch with your classmates.

Send your news to Chris Furst:[email protected] by mail:Weill Cornell Medicine401 East State Street, Suite 301Ithaca, NY 14850

close to my son and his family. This year ismy 30th as a trustee of the Aga KhanUniversity, the first private university char-tered in Pakistan, which now operates pro-grams in multiple locations globally,principally in South and Central Asia andin three countries of East Africa. My role asa trustee requires considerable traveling:two trips to Paris, and one each to Pakistanand East Africa in the past 12 months. ThisApril, to celebrate my 84th birthday, I amtaking a ten-day cruise of the Adriatic. Allthings considered, my health is good.Reading for a challenging book club, artclasses, care of my dog, and subscription tothe Chicago Symphony and Lyric Opera fillmy days. In sum, I am content, comfort-able, and fortunate.”

Seneca L. Erman, MD ’54: “I have hadan eventful year with cruises to the Baltic,the Caribbean, and the Norwegian fjords. Ihad a total colectomy and ileostomy; bleed-ing diverticulum (on Plavix and aspirin forheart problems), 24 units before and duringsurgery—exciting, to say the least. Bilateralcataract surgery, hearing aids—oh well, atleast I’m contributing to medical economics.Continuing to play the guitar, doing oilpainting, and lots of walking and dancingwith a new lady friend. Have maintained mylicense with 20-plus hours of CME a yearand attendance at local medical conferences.Life goes on and is enjoyable. Hope all iswell with my classmates and fellow alumni.”

William Augerson, MD ’55: BillAugerson and his wife, Ginny ’52, are inMillbrook, NY, fairly healthy and busy.Bill still works a little and is quite busy aspresident of the Dutchess County Boardof Health. In May, they were invited toparticipate in a ceremony at CapeCanaveral, FL, to commemorate the 50thanniversary of the first American mannedspace flight by Alan Shepard. Bill servedas an Army flight surgeon with SpaceTask Group NASA (Mercury, Gemini,Apollo) from its formation in 1958.Among his duties was serving as the med-ical officer in the blockhouse a few hun-dred feet from the launch pad—monitoring the condition of the astro-naut, prepared to remove him in the

By the book: Author Jonathan Franzen spoke with students during a February visit toWeill Cornell as part of the “Readers and Writers” series.

AMELIA PANICO


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rotavirus vaccine, which gained FDAapproval in 1998.

Bert Brown, MD ’56: “I had hoped tocome to the 50th Reunion, but I am notsure our class had one. Joy and I have beentogether for nearly 60 years. We have fourdaughters and four granddaughters. After abusy career in the US Public Health Service,a university presidency, and 15 years withthe Pentagon working on quality assur-ance, I’m retired in Key West, FL. I wouldlove to hear from any of my classmates.My work for the past 30 years has been onterrorism. E-mail: Bertramsbrown @ gmail.com.”

Sherburne M. MacFarlan, MD ’56: “I’malive and well and living in a retirementcommunity in Boulder, CO. My wife,Susan, BS Nurs ’55, passed away about ayear ago.”

Frank G. Moody, MD ’56: “I continueto work at the University of Texas MedicalSchool in Houston as a professor of sur-gery. Lest you worry about my advancedage and sanity, I retired from the chair ofsurgery here in 1994, stopped operating in2003, and closed my research laboratory in2008. Fortunately I have been given theprivilege of pursuing my role as a teacherof both medical students and residents,and in order to be relevant I attempt tokeep up with the rapid advances beingmade in surgery by attending conferencesboth in the States and abroad. My fiancée,Inger Ardern, is a Swede living in England,my family home is in Salt Lake, and oursummer home is in Klassbol, Sweden, so—you guessed it—we spend a lot of time onan airplane. I have enjoyed watching theWeill Cornell campus develop here at theTexas Medical Center and enjoy readingabout the remarkable progress being madeat the Medical College in New York. I amvery proud to be a part of such an out-standing institution and look forward toour next reunion.”

Don Hoskins, MD ’57: “Carol, BS Nurs’56 (professor emeritus, NYU), and I areboth retired. We moved in December 2010to Galloway Ridge, Pittsboro, NC. Gallo -way is a CCRC 15 minutes south of ChapelHill in the Fearrington Village communityand some 35 minutes from daughterLauren Lingley and family. Lauren is onthe medical faculty at the University ofNorth Carolina and a practicing familymedicine physician. Sons David and Bruce’83, DVM ’89, are in McLean, VA, andOssining, NY, and are, respectively, anenvironmental lawyer and a veterinarian.

We have eight grandchildren ranging inage from 6 to 26. Travel is high on theagenda and included southern Africa in2011, with St. Petersburg and Moscowscheduled for August 2012. Our best to all,Don (dhoskins8 @ nc.rr.com).”

Bernie Siegel, MD ’57: “In the fall of2011, A Book of Miracles came out withamazing stories and my comments. Youcan learn more at my website: www.BernieSiegelMD.com.”

Martin W. Korn ’55, MD ’58: “Phyllis’57 and I were in Laos for nine days andsouthwestern China for 21 days from mid-June to mid-July 2011. We spent five daysin a 60-family rural farm village in YunnanProvince for a nephew’s wedding celebra-tion. We lived in the bride’s home. Thenon to the World Heritage cities of Dali andLijiang, and a three-day trek up TigerLeaping Gorge. It was all wonderful andunique. Very beautiful. Contrasting cul-tures between Laos and China.”

Jules Schwaber, MD ’58: “I plan toretire this spring after completing almost47 years in the clinical practice of internalmedicine and pulmonary disease. Duringthat time I have served as a staff physicianand pulmonologist at Lahey Clinic (whenit was situated in Boston) and subsequentlywas appointed chief of medicine atBrookline Hospital. When the latter institu-tion closed its doors in 1980, my practicemoved to the New England DeaconessHospital, which merged to become BethIsrael Deaconess Medical Center. Over theyears I’ve enjoyed working with many col-leagues who represent multiple specialties,and especially with wonderful patients,among them three generations of the samefamily. It’s been a true ‘Norman Rockwell’type of practice based at a large universityteaching hospital. Along the way, I’ve hadthe privilege of tutoring decades of HarvardMedical School students, and it’s been atrue joy to have them participate in thecare of patients. The practice of medicineremains ever challenging, ever changing,and always stimulating. I remain grateful tothe Medical College for having admittedme to the Class of 1958 and for havingeducated me in the fundamentals of thisextraordinary profession. My dear wife,Evelyne, continues practice as a psychoan-alyst. She graduated in the first class of theAlbert Einstein College of Medicine in 1959and was recently selected for the Alumnaof the Year award to be presented at theircommencement exercises in June. Our foursons and ten grandchildren are well and

thriving; our son Mitchell is a physicianspecializing in infectious disease, practicingin Tel Aviv. He served in the Israeli Army’shospital mission to Haiti, which arrivedthere 72 hours after the earthquake.Currently he is spearheading that nation’seffort to curb the incidence of resistant bac-teria in their hospitals and nursinghomes.”

John Baldwin, MD ’59: “Jeannie and Ihave lived in the High Sierra Gold Countryfor 20 years, in Twain Harte, CA, after leav-ing our vascular practice on the MontereyPeninsula. A sweet, forested place at 5,000feet, surrounded by lakes and mountains,with good people and incredible sunnyweather. I have become a professionalguide, often to Alaska for halibut and kingsalmon, and here in the foothill lakes fortrout and bass. This eliminates lawyers andwaiting-room discussions, broadens thesoul, and calms the heart. We cherish thememories of the Medical College in thegolden days when medical school was stillfun, the East River Yacht Club was sailingyearly, and you could smoke outside thedissection room. All very best to everyone.”

Peter Burkholder, MD ’59: “We are stillliving in Arizona, and since our two daugh-ters are now in the US we get to visit themmore often. Daughter Lisanne returnedwith her Aussie husband this past year afterseven years in Australia and is now practic-ing general medicine in Truckee, CA. (Theylove winter sports, especially skiing.)Kristen is now the physician for the GrandCanyon clinic here in Arizona, where shepractices family medicine. For the past fouryears I’ve been the president of a home-owners association in Pine, AZ, where wehave a summer home. Barbara continues inher retirement years to serve the communi-ty for women’s health-care issues, asthmahealth care, clean air, public health, andother environmental issues. I’m walkingwith and caring for our 8-year-old blackLabrador retriever. I’d rather live at leasthalf of the year or more by the ocean in awarm climate with opportunities to swim,sail, hike, explore, and fish. I rememberstruggling academically in the third yearand then in the fourth year performingvery well in clinical training and findingmy eventual lifetime passion in pathology,research, and teaching.

“I welcome communication with anyclassmate, but in particular I would like tohear what has become of Peter Bing andRalph McFarlane. I always appreciate hear-ing from my Yale and Cornell classmate,



Mike Conroy. Barbara and I wish all class-mates good health and encourage everyoneto vote their professional and personal con-science in the upcoming elections.”

1960sKen Barasch, MD ’60, Mike Carey, MD

’60, Gideon Panter, MD ’60, and Ken Swan,MD ’60: “The 50th Reunion of the Class of1960 was a splendid success by all counts.Our class numbered 86 in 1956; currently66 are living and 30 (45 percent) attended,a new record for the 50th Reunion. Notsurprising, the most popular event ofReunion was the class dinner on the firstnight. Classmates had been asked to sub-mit a one-page description of “A MostMemorable Event In My 50 Years As APhysician” prior to Reunion, and wereceived 44. A bound volume was given toeach classmate. Lewis Glasser ’56, MD ’60,and Alvin Poussaint, MD ’60, were the twofeatured Reunion speakers. Dr. Glasser ismedical director of Cord Blood Registry,the world’s largest cord blood stem cellbank; his presentation, “Umbilical CordBlood Stem Cell Banks: Controversy,Reality, and Hope,” was brilliant, informa-tive, and enthusiastically received. Dr.Poussaint is professor of psychiatry atHarvard Medical School and an expert onrace relations in America; his presentation,“My Experience as a Physician on theSelma March During the Civil Rights Move -ment,” was another highlight of Reunion.Thank you, Alumni Association, for a great50th Reunion. Yes, we know it’s a lot ofwork, but it’s events like this that inspireloyalty to our alma mater, renew our com-mitment to its mission, and, most of all,remind us of our great good fortune tohave become Cornell doctors.”

Ken Haslam, MD ’60, retired from anes-thesiology in 1993. He was a ship’s physi-cian on three ocean voyages: the Arctic,Antarctica, and Europe. He spent severalyears in Hemlock Society work, finishing aspresident of the Washington, DC, chapter.He has been nationally active in thepolyamory community (ethical, responsi-ble, consensual multi-partnering) andfounded the Kenneth R. Haslam MDPolyamory Archive Collection at the KinseyInstitute, Indiana University, in 2005. He isactive in sex education for medical stu-dents through the American MedicalStudent Association, providing textbooks,and his current interest is aging and sexual-ity. He is partnered with a lovely hospice

president of the American College ofSurgeons.”

Joel Sherlock, MD ’63: “There must besome good causes to work on. Not fundrais-ing. Any ideas from the alumni?”

James P. Baden ’61, MD ’65: “I’mretired from private practice but working onHilton Head Island, SC, as a volunteer in afree clinic. Traveling extensively.”

Jack Meyer, MD ’65: “I’m celebratingmy 25th year at Brigham and Women’sHospital and 20th year as a professor ofradiology at Harvard Medical School. I’mworking full time in breast imaging andspend my time in clinical practice andteaching. Almost no administrative duties—quite a luxury. I was awarded the residentteaching award for the second time in aca-demic year 2011. I’ve been blessed and haveno idea what I will do if I retire.”

Al Einstein, MD ’67, has recently retiredas executive director of the Swedish CancerInstitute, Swedish Health Services, Seattle,WA, and is looking forward to sharing trav-el, sailboat cruising, and time with hisseven grandkids with his wife, Margie.

Yale Fisher ’64, MD ’67: “Just a noteconcerning a work in progress that has beena passion of mine for 40 years. I began afree website to teach the basics ofOphthalmic Contact B-Scan Ultrasound.The site has been live for two years andtraveled around the world much to my sur-prise. It began several years ago with a web-master and animator. It has been fun and, Ihope, helpful to those wishing to learn ocu-lar B-scan. The site is called Ophthalmicedge.org. I am about to increase the infor-mation to include other retinal imagingtechniques as well as ocular retinal surgery.There are lectures and real-time movies foreach subject. Continuous updates and addi-tions are planned. On a personal note, myyoungest child was admitted to Cornellundergrad in Arts and Sciences.”

William V. Hindle, MD ’67: “Last June Iretired from a satisfying practice of radiolo-gy in Alexandria, VA, and it’s a treat to befree of schedules. We’ll continue to live inWashington, DC, and will also be able tospend more time at our place in SteamboatSprings, CO. In addition, there’ll be moretime for our grandchildren: three inDayton, OH, and three in nearby Virginia.”

Ruth Dowling Bruun, MD ’68: “This wasa hard year because my husband, Dr. BertelBruun, died on September 21 after a longillness. On the positive side, I am beinggiven the Wendy Ann Ochsman Award forDistinguished Achievement and Advance -

nurse and planning on moving from theEastern Shore of Maryland to a retire-ment community in Durham, NC. Hegave up smoking—everything—but stillhas a Scotch every day. “At our age life isshort,” he says. “Eat dessert first. Hugsall around.”

Clay Alexander, MD ’61: “I’ve beenretired since 2000, and my right brainseems to have taken over my life. Myfirst novel was not published, but mysecond one is now in the hands of myNew York agent—fingers crossed. I’vehad a painting accepted into a juriedexhibition that was shown in February. Icontinue to volunteer in various areasand am on the board of a local art muse-um. Our three boys are all married, and Ihave four grandchildren so far. I play sixhours of tennis a week, and Paula and Itravel when we can—Machu Picchu inApril. Retirement is another life. I lookforward to seeing classmates again inOctober.”

Carl Becker, MD ’61: “On December30, 2011, I had my right hip replaced. Sofar, things are going very well and lastSunday we attended a performance ofThe Magic Flute at the Lyric Opera inChicago. I hope to be fully recuperatedfor hiking, bike riding, and sailing in thespring. My wife, Susan, is now com-modore of the Milwaukee Yacht Club, atwo-year term. It’s the oldest yacht clubon the Great Lakes, founded in 1871. Isuppose that makes me the com-modore’s consort. I e-mailed PrincePhilip for advice regarding duties anduniforms associated with this position,but I have yet to get a response. TheMedical College of Wisconsin is revisingits curriculum for medical students, andI shall most probably be a teaching vol-unteer.”

Nicholas L. Tilney, MD ’62: “My latestbook, Invasion of the Body: Revolutions inSurgery (Harvard University Press 2011),was named one of ‘The Year’s Five BestBooks’ in the Health and Welfare sectionof the Wall Street Journal.”

Francis Bohan, MD ’63: “I wouldappreciate hearing from fellow classmates.Three years with brain metastases.”

Edward M. Copeland, MD ’63: “Ihave recently received the LifetimeAchievement Award from the Universityof Florida College of Medicine and havebeen elected a Distinguished Professor inthe University of Florida system. Like -wise, I’ve recently finished my year as


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ment of Tourette Syndrome Medical Treat -ment and Science this coming April. Since Ihave devoted much of my career to researchand treatment of Tourette syndrome, thismeans a lot to me. I hope to see many class-mates next year at our 45th Reunion.”Robert P. Herwick ’64, MD ’68: “I’m still

practicing dermatology half time andspending the other half at our home on theBig Island of Hawaii. I just heard from LeeJohnson, MD ’68, that he has fully retiredfrom the faculty of the University of Utahsince he realized that his med student sonknew more in his first year than Lee does.There must have been a few advances in thepast 44 years. I hear from prostate researchmogul Skip Holden, MD ’68, in Los Angelesfrom time to time and also from eating-dis-order expert Arnie Andersen ’64, MD ’68,who is still on the psych faculty at least parttime at the University of Iowa.”Steve Pieczenik ’64, MD ’68, developed

NBI Pharmaceuticals, an ultra-virtual compa-ny located in Bozeman, MT, that focuses ondeveloping products for orphan diseases. Inits first year in business, NBI Pharmaceuticalswas granted 15 FDA Orphan Drug Desig -nations for rare cancers and neurological andmitochondrial diseases.Jeffrey S. Borer, MD ’69: “I am professor

and chairman of the Dept. of Medicine andchief, Division of Cardiovascular Medicine,at SUNY Downstate Medical Center. I’malso president of the Heart Valve Society ofAmerica, which will hold its seventh bien-nial meeting on heart valve disease (in con-junction with the European Society forHeart Valve Disease), “Valves in the Heart ofthe Big Apple VII,” at the Marriott MarquisHotel in Times Square on April 12–14. Asco-director of the meeting, with MauriceSarano and Hartzell Schaff of the MayoClinic, I’d like to invite anyone with aninterest in this area to attend. Details areavailable on the HVSA website (heartvalvesocietyofamerica.org).”N. Reed Dunnick, MD ’69: “On

December 2, 2011, I became chairman ofthe board of the Radiological Society ofNorth America. This is the largest radiologysociety in the world, with more than 48,000members and an annual meeting of 60,000attendees.”Leroy R. Sharer ’65, MD ’69: “I am profes-

sor of pathology at New Jersey MedicalSchool in Newark, where I have been on thefaculty for 31 years as a neuropathologist.Last June, at the annual meeting of ournational professional organization, theAmerican Association of Neuro pathologists

(AANP), I was awarded the MeritoriousService Award for Neuro pathology. One ofmy roles in the AANP was as manager (sec-retary-treasurer) of the Diagnostic SlideSession. I have also completed ten years aspresident of the New York Association ofNeuro pathologists, also known as theNeuro Plex, the largest regional neu-ropathology group in the US.”

1970sRichard A. Lynn, MD ’71: “With our

reunion coming up this October, I havebegun hounding our classmates to makethis a successful event for all of us. So farI have heard from ’71 classmates FrankBia, Paul Shank, Ivan Login, FredHelmkamp, Carl Sadowsky, and LouRambler. I hope all the class will makean effort to join together.”Fred Ferlic, MD ’72: “I’m still very

active in orthopaedic surgery, adding thenew dimension of robotic surgery fortotal hips/knees. I’m also entering poli-tics as a candidate for South Bend CityCouncil. Mary, whom many of youknew, passed away in 2011. Although wewere divorced, she is still missed.Thinking of all of you fondly, and hop-ing for a great class reunion.”Dave Folland, MD ’72: “I retired from

a stimulating and rewarding career in pri-mary care pediatrics in 2009. Since retiring,I have been volunteering for CitizensClimate Lobby, a nonprofit, nonpartisangroup that is working to get the politicalwill to make the urgently needed transitionto sustainable energy. I’m convinced thatfuture generations will pay a high price forour continued use of fossil fuels, and alter-natives can successfully be developed. If youhave interest in this endeavor, please e-mailme (dsfolland @ gmail.com) or visit ourwebsite (www.citizensclimatelobby.org).”Kenneth Kelleher, MD ’72: “I gave the

keynote address at the meeting of the RoyalCollege of Physicians and Surgeons ofGlasgow this past November. The talk wason the experience and results of the Role IIIField Hospital at Camp Bastion, HelmandProvince. This was a British hospital supple-mented by personnel from the US Navy.Consequently, I was elected a Fellow of theRoyal College of Surgeons (Glasgow).”Jeffrey D. Urman, MD ’72: “I was reap-

pointed as an adjunct clinical professor ofmedicine at Stanford University MedicalCenter and recently appointed as consult-ant for the Medical Board of California.Marian and I have loved living in Palo Alto,CA, for these past 35 years. We have twosons and three grandchildren.”Allan Gibofsky, MD ’73: “I recently fin-

Future facility: A rendering of lab space in the Belfer Research Building, now under construction on East 69th Street.

PROVIDED



ed from the University of Michigan LawSchool and is currently an associate atPaul Hastings Law Firm in San Francisco.Our younger daughter, Sara, is a PhDcandidate at Cornell in Ithaca, studyingimmunology. We all hold diplomas fromCornell, as both children graduated fromthe Ithaca campus: Aliza ’04 in engineer-ing and Sara ’07 in biology. We expect tohave five Cornell diplomas soon!”Warrick L. Barrett, MD ’75: “My

grandson, Darius, graduated from highschool this past Saturday. Prior to hiscommencement, he had already begunclasses at Old Dominion University. Hehas earned a football scholarship there,and his name already appears on the ros-ter. The Monarchs appear to have a chal-lenging schedule, including games withGeorgia State and James Madison univer-sities; both of those teams participated inthe national playoffs in their division ofcollegiate competition last year. In addi-tion to being a formidable football play-er, Darius is also an excellent student.Let’s wish him continued success.”Milagros Gonzalez, MD ’75: “I’ve

been working at Providence Pediatrics inPhoenix, AZ, since September 26, 2011. Itraveled to Albuquerque and Santa Fe onvacation during the month of June, andalso went to visit family and friends inPuerto Rico in September. Had a great

time. Hello to everyone.”Paul Miskovitz, MD ’75, a clinical profes-

sor of medicine at Weill Cornell, edited andcontributed to Colonoscopy (InTech), a bookthat conveys the history, state of the art,and future of the discipline. He recently gottogether with Stu Fox ’71, MD ’75, andMichele Winter, MD ’75, and their spousesfor an enjoyable evening.Wally Schlech, MD ’75: “I’m still work-

ing part time as professor of medicine in theDivision of Infectious Diseases at DalhousieUniversity, Nova Scotia, doing ID and GenMed rotations. Also working as a mentorwith Accordia Global Health Foundationand spending a few months a year inUganda and Nigeria as a professor-in-resi-dence teaching HIV and ID medicine toyoung African physicians and medical stu-dents. I was honored last year with aMastership in the American College ofPhysicians. Five kids (one MD, two pilots,one librarian, and one still in school) andthree grandbabies (in Little Rock, AR). Golf,fishing, duck hunting, and flying keep meentertained, as does wife Mary, BS Nurs ’73,with her Celtic fiddling.”Martin Leopold, MD ’78: “I am now

retired and living in the mountains ofColorado. My youngest son, Daniel, was afinalist with the Dartmouth Aires on NBC’s‘The Sing-Off.’ ”David Frank, MD ’79: “I continue to

practice gastroenterology in RockvilleCentre, NY. I’ve also been associate medicaldirector at MagnaCare Health Plans for thelast five years. I recently started teaching atthe Hofstra Medical School to round out myclinical activities. Rhonda and I are lookingforward to our daughter Naomi’s weddingin June 2012.”Tom O’Dowd, MD ’79: “Bill Schickler, MD

’79, Steve Werns ’75, MD ’79, SteveLuminais, MD ’79, and I got together thismonth at my house in Cherry Hill, NJ, for amini-Class of ’79 reunion. There were twoother Cornellians present: Betsey KindwallLuminais, MD ’80, and Nancy Feller O’Dowd,BS Nurs ’77. We are still recognizable, I think,but some have fared better than others, espe-cially in the hair department. We get togeth-er on a regular basis to discuss medicine,kids, life, and retirement. Our time togetherat the Medical College is still one of the mostsignificant common elements of our lives.George Gray and Lew Drusin, MD ’64, arestill among our favorites, and the MartyGardy, MD ’60, legend continues.”Harley A. Rotbart, MD ’79: “All three

kids ended up at Cornell as undergrads.

Wall of wonders: WCMC-Q’s second annual research retreat, held in January, included sixty-four posters presented by students and postdoctoral fellows.

AREND KUESTER

AREND KUESTER

ished my term as chair of the ArthritisAdvisory Committee of the US Food andDrug Administration. I continue to serve asa senior consultant.”Larry Koblenz, MD ’73: “My son, Adam,

offspring of Mom and Dad MDs, wasadmitted to the bar in New York State.”Benjamin Lipsky, MD ’73: “After 36 years

on the faculty of the University ofWashington and VA Puget Sound, I am tak-ing ‘retirement’ and moving to England for afew years. I now have a UK medical license,will be on the faculty of the University ofOxford Medical School, and have beenappointed to the UK Independent ScientificAdvisory Committee that oversees NationalInstitutes for Health Research grants. Mywife has also left her UW post and taken aposition as bursar (CFO/COO) of KelloggCollege (University of Oxford).”Steven N. Cohen, MD ’74: “I have been

in private practice of ophthalmology since1978 in San Francisco, still working fulltime. We love living in The City. My wife,Elly (née Ellyn Glazer), graduated from theGraduate School of Medical Sciences in1975 with a PhD in pathology and is cur-rently an assistant professor of surgery atUC San Francisco. She is also the programdirector of BreastCancerTrials.org, a non-profit, online service that matches breastcancer patients to clinical trials nationwide.Our older daughter, Aliza, recently graduat-


S P R I N G 2 0 1 2 4 5

Matt ’10 is now in law school at NYU,where his fiancée is in social work gradschool; Emily ’12 is applying to psychologydoctorate programs; and Sam ’14 is slum-ming in the frat house. Since there is still noCornell family tuition discount, my newbook, No Regrets Parenting (Andrews McMeelPublishing 2012; www.noregretsparenting.com), has to go viral fast. Sara fixes leaksand does minor electrical in her propertymanagement business; we will celebrate our25th anniversary this spring. I’m still in full-time academic medicine, but desperatelytrying to bridge the great generationaldivide—now blogging, tweeting, facebook-ing, podcasting, and totally LinkedIn. If youdon’t believe me, check out www.harleyrotbart.com, where you can also see picturesof how gracefully I’ve aged. Really.”

1980sJim Blankenship ’76, MD ’80: “One of

the highlights of my year is returning toWeill Cornell each spring to attend thereception where medical students report onthe adventures from their overseas rota-tions, which often include climbing Mt.Kiliman jaro, for example. The price ofadmission is supporting one of those stu-dents, and it doesn’t cost much. Comparedto other donations to nonprofit organiza-tions, the fun one gets from this is enor-mous. I encourage classmates to contact thealumni office to find out how to getinvolved, and I hope to see you there thisMay or the next.”Frank Brickfield, MD ’81, has left federal

service after 25 years and will be startinglaw school in August 2012 at George MasonUniversity School of Law (his spouse’s almamater). He retired as deputy director ofMedical Services at the CIA. He plans onworking in the fields of disability andhealth-care law.Michael Steiner ’77, MD ’81: “I practice

comprehensive and oculoplastic ophthal-mology in Burien, WA. I invested a greatdeal of time and energy to develop thephysician social networking website calledCommunity-of-Doctors.com. After twoyears of work, I discovered that theAmerican Hospital Association and the USmedia did not care to include physicians inthe discourse concerning health-care policyin the US. Our government’s decision-mak-ing in this regard has been dictated by thewealthy lobbies in Washington, leaving doc-tors to try to rediscover reasons to continuepracticing. I would rather be working

among a community of doctors who stillfind rewards in practicing their art. Iremember most the awe that we experi-enced in physical diagnosis. The art ofhistory taking and performing a physicalexam is seldom practiced in my commu-nity, making my practice exceptional. Ihad tremendous respect for the late Dr.Franklyn Walker. When he asked how Iwas doing, I believed that he reallymeant it.”Elizabeth A. Wuerslin, MD ’81: “I’m a

pediatrician, still working and happy withmy profession, in Colorado and theRocky Mountain area. I’ve worked locumsfor Colorado Children’s Hospital for thelast ten years and love the variety of loca-tions and diversity of patients. I continuemy volunteer work as a Copper MountainSki Ambassador, Larimer County MasterGardener, and world-traveling doc forcleft lip and palate mission trips, with mylast adventure to Wenzhou, China. Lookme up in Fort Collins, CO, a great placeto live and work.”Robert A. London, MD ’82: “Loren

and I send regards to all from Orlando,FL, where we have resided and I havebeen in practice since 1986. We havebeen together since the orientation wineand cheese party for new medical stu-dents and nurses at Lasdon House in thefall of 1978. Obviously it worked. Ourdaughter, Andra, who was born at NewYork Hospital, lives in Atlanta. She worksfor Coca-Cola as a global brand managerand is getting married this summer. Ourson, Brent, lives in New York; he worksfor Google, and if they had dormitorieswould probably live there as well.”Perry Kamel, MD ’84: “Both work

and home life is busy. Elena and I havetwo kids applying to college. All is well.”Judith Rovno Peterson, MD ’86: “I’m

working on a project to decrease ACLinjuries in athletes. Approximately 80percent of noncontact ACL injuries canbe prevented by neuromuscular retrain-ing programs. I believe every athleteshould be offered this type of program.The program began as a state initiativeunder Drexel University College ofMedicine’s Vision 2020.”Larry Robinson, MD ’84: “I graduated

from RPI with my MBA in May 2011.Since that time I’ve become the manag-ing director of the research group at mypractice, the Endocrine Group, and I’veincreased my Dept. of Surgery manage-ment role to include technology assess-

ments, optimizing OR time utilization, andorganization of the surgical services in ourfour-hospital merger. Oh yeah, I stillremember how to be a surgeon. EventuallyI hope to move to a senior executive posi-tion in the hospital merger team with afocus on acute care and surgical services.Brigit and I are enjoying our rescue Germanshorthaired pointer, Georgia, and summersailing up on Lake Champlain. If you get amoment, drop me a line at: lrobimd @gmail.com.”Brian Aboff, MD ’85: “Ingrid and I are

getting used to having an empty nest for thefirst time. Our two children, Michael andMark, are both now in college. Given thehigh price of tuition, we’ll never be retiring.I’m enjoying my role at Christiana Hospital(Newark, DE), where I am the InternalMedicine Residency Program director andassociate chair for education. It’s a blast tointerview Weill Cornell applicants for ourprogram. I’m also having fun doing somenational work, where I’m very involvedwith the Association of Program Directors ofInternal Medicine and the chair-elect of theACGME Transitional Year Review Com -mittee. I hope all is well for everyone.”Roger S. Blumenthal, MD ’85: “I was edi-

tor-in-chief of a new textbook, PreventiveCardiology: A Companion to Braunwald’s HeartDisease. The book was geared to a ‘JacksonFive, ABC, Simple as 1-2-3’ format. I haveenjoyed seeing Troy Elander, MD ’85, in LAand Dave Blaustein, MD ’85, in NYC. It’shard to believe that our class’s fastest notetaker and biggest Tab drinker, Nan Hayworth,MD ’85, is a high-powered Congress womanfrom New York.”Stephen Rosenfeld, MD ’86: “I have

recently taken the job of board chair atQuorum Review IRB, an independent IRB inSeattle. Before this I spent two and half yearsas president and CEO of the WesternInstitutional Review Board, in Olympia, WA.”Mark Albanese, MD ’87: Network

Health appointed Mark Albanese as medicaldirector of behavioral health. He currentlyserves as director of addiction treatmentservices at Cambridge Health Alliance andis also an assistant clinical professor of psy-chiatry at Harvard Medical School.Anne C. Beal, MD ’88, was appointed the

first chief operating officer of the Patient-Centered Outcomes Research Institute.Congress created PCORI as an independent,nonprofit research organization to helppatients and their caregivers make informedhealth decisions. Dr. Beal is a pediatrician andpublic health specialist. She is a recognized


Women’s Association (AMWA). I hope tosee you all at the annual meeting inMiami (www.amwa-doc.org). I am alsocurrently the AMWA delegate to the AMA-Women’s Physician Congress (WPC), soI’m keeping busy.”

Sarah Stackpole, MD ’89: “I am happyto give an update after a prolonged illness.Two years ago, I was able to address thereunion gathering on my area of specialinterest, taking care of professionalsingers. Later in 2010, however, I becameseverely ill with salmonella and asepticmeningitis, with vertigo and doublevision. I have been practicing only parttime, but I am pleased that I have

returned to otherimportant aspects ofmy life. I have re -sumed more serioussinging and am cur-rently enrolled in anevening course atJuill iard. This is a ter-rific enhancement ofmy focus within mypractice of otolaryn-gology, and I amhop ing to continueto pursue more grad-uate work in music. Ialso hope to return tofull-time practice and

surgery over the course of the upcomingyear. I’m enjoying a lot of teaching,including involvement in the curriculumrestructuring efforts at Weill Cornell.”

1990sR. Hal Baker ’86, MD ’90: “I’m in my

sixth year as chief information officer forWellSpan Health in York, PA. We are an8,500-employee integrated delivery net-work. To keep in touch with the realitiesof using the EHR, I continue to practiceprimary care internal medicine eighthours a week.”

Carolyn S. Eisen, MD ’91: “I am stillworking at NYP/Weill Cornell. I’m a radi-ologist specializing in breast imaging. Myhusband, Mark Schwartz, MD ’84, is aplastic surgeon also on staff at NYP/WeillCornell and in private practice. We havetwo daughters, Rebecca, 8, and Alexa, 6.”

Eric Pollack, MD ’92: “I’m a gastroen-terologist in private practice in Bethesda,MD. We have joined with several otherpractices around the D.C. area to form alarge single-specialty group, Capital


authority in health disparities, quality ofcare, and children’s health, and is the authorof The Black Parenting Book: Caring for OurChildren in the First Five Years. During herterm as president of the Aetna Foundation,she transformed the foundation from a localcorporate philanthropy to a national strate-gic grant-maker and targeted three areas ofhealth care: obesity, racial/ethnic equity incare, and the promotion of coordinated careand integrated health-care systems. Beforeher presidency of the Aetna Foundation, Dr.Beal was assistant vice president for the pro-gram on health-care disparities at theCommonwealth Fund and was a health-services researcher at the Center for Child andAdolescent Health Policy atMass General. She has taughtat Harvard Medical Schooland the Harvard School ofPublic Health.

Paul Kirchgraber, MD’88: “I was recently promot-ed to vice president, GlobalTesting Services andMedical Affairs, with addi-tional responsibilities asgeneral manager of theAmericas for Covance Cen -tral Laboratories. The labo-ratory is fully dedicated totesting samples frompatients involved in clinicaltrials. I’m responsible for laboratory opera-tions in Indianapolis, Geneva, Singapore,Shanghai, and Tokyo, and the physicianand PhD scientist teams, as well as generalmanager of the 1000 FTE Indianapolis site. My beautiful wife, Theresa Rohr-Kirchgraber, MD ’88, also recently took onnew responsibilities as executive director ofthe National Center of Excellence in Wo -men’s Health at Indiana University and isresponsible for working with public and pri-vate interests to improve women’s health inIndiana and nationally.”

Dinah Miller, MD ’88: “My only excitingnews is that I had a book come out in June2011. I am co-author, along with AnnetteHanson and Steven R. Daviss, of Shrink Rap:Three Psychiatrists Explain Their Work (JohnsHopkins University Press). It’s part of a largerventure we have called the AccessiblePsychiatry Project, and we will be speakingat the American Psychiatric Association’sannual meeting in Philadelphia in May.”

Theresa Rohr-Kirchgraber, MD ’88:“Thanks to all who voted for me! I wasrecently elected for a second term on theboard of directors of the American Medical

Digestive Care, with more than 50 doctors.This was an interesting cat-herding experi-ence, but the group is flourishing now. Ourfamily has also grown in size. Shannon and Iare constantly entertained by our delightfultwin girls, who turned 3 in March. I’m notsure if either of them will become doctors,but they enjoy using their toy stethoscopeand thermometer on our long-suffering dog,Mel. It has been fun getting together withBill Maisel, MD ’92, and Jen Schreiber, MD’92, and their two kids, who moved fromBoston to the D.C. area a couple of years ago.Hopefully, we’ll all be able to make it to ourupcoming (gasp) 20th Reunion.”

Jeff Kauffman, MD ’93: “I’m an ortho -paedic surgeon who specializes in sportsmedicine. I spent the last ten years inSacramento, CA, but moved back to NewYork 11 months ago. I now live in ColdSpring, NY, and have joined the OrthopedicAssociates of Dutchess County.”

Maria Shiau, MD ’93: “Currently, I amworking at the NYU Langone MedicalCenter. In order to further my interest inmedical education, I completed a master’sin adult learning and leadership at Teacher’sCollege at Columbia. Soon afterwards, I waspromoted to director of Medical StudentEducation in Radiology. I spend half of mytime teaching and the other half practicingclinical thoracic imaging. My husband,Howard, and I are the proud parents of our15-year-old daughter, Elissa, a sophomore atBronx High School of Science.”

Alicia Salzer, MD ’93, is a co-founder ofa new urgent care center in the NYC finan-cial district called Medhattan ImmediateMedical Care. Staffed 365 days a year by 15board-certified ER doctors, Medhattanopened in October 2011 and is a resourcefor the travelers, residents, and visitors ofthe downtown area. It has an X-ray, labs,and fluids on site and treats both childrenand adults. When not at Medhattan, Aliciais busy with her two kids: True, 18 months,and Piper, 6.

Jonathan Samuels, MD ’98, and his wife,Dr. Svetlana Krasnokutsky Samuels, wel-comed twin sons Leon and Samuel into theworld on June 13, 2011. They are alreadyangling to become members of the Class of2037. In the meantime, they are learning asmuch as they can from their parents, whoare both on the rheumatology faculty atNYU Langone Hospital for Joint Diseases.

Christopher E. Starr, MD ’98, is an assis-tant professor of ophthalmology, director ofthe ophthalmology residency program,director of the Refractive Surgery Service, and

‘I have resumedmore serioussinging andam currentlyenrolled in anevening courseat Juilliard.’

Sarah Stackpole, MD ’89


S P R I N G 2 0 1 2 4 7

director of the Cornea, Cataract, and Refrac -tive Surgery Fellowship at Weill Cornell.

2000sNonkulie Dladla, MD ’02: “I did my pri-

mary care residency at Methodist Hospital. Isubsequently went back to Weill Cornell tocomplete a master’s in clinical research inacculturation of black Caribbeans in the US.I am currently in medical management andwork as a medical director at Park SlopeFamily Health Center, affiliated withLutheran Medical Center. I’m engaged inquality research and research in health dis-

’34, ’38 MD—Arthur F. Valenstein ofCambridge, MA, January 17, 2012; psychia-trist; president and faculty member, BostonPsychoanalytic Institute; associate clinicalprofessor of psychiatry, Harvard MedicalSchool; contributed to a study of normalpregnancy at Beth Israel Hospital; participat-ed in long-term psycho-physiological obser-vations of healthy college-age twins; author;veteran; active in professional affairs.

’38, ’41 MD—Emanuel Wolinsky ofBeachwood, OH, January 13, 2012; chief ofthe Division of Infectious Diseases andinterim director of pathology, Metro HealthMedical Center; developed a drug treatmentfor tuberculosis; author, Textbook of PulmonaryDiseases; professor of pathology and medi-cine, Case Wes tern Reserve University; creat-ed the pa tient registry for the CuyahogaCounty Tuberculosis Clinic.

’43 MD—Joseph F. Artusio Jr. of Pelham,NY, December 21, 2011; founding chairmanof the Dept. of Anesthesi ology, Weill CornellMedical College, and anesthesiologist-in-chief, Weill Cornell Medical Center; devel-oped anesthetic techniques for heart surgery;researched nonflammable anesthetic agents;recipient, Maurice Greenberg DistinguishedService Award; chief anesthesiologist, 170thEvacuation Hospital, US Army; president,Pelham School Board. (See page 8.)

’44 MD—William A. Maddox of Birm -ing ham, AL, December 29, 2011; clinical

professor of surgery, University ofAlabama School of Medicine; surgicaloncologist and specialist in head andneck malignancies; led the AlabamaBreast Cancer Project; US Navy medicalofficer; active in professional affairs.

’44 MD—Gerald F. Whalen of Shrews -bury, NJ, February 4, 2012; neurosurgeon;practiced at Riverview Hospital, BayshoreCommunity Hospital, St. Vin cent’s Hos -pital, and Monmouth Medical Center;served in the US Army Medical Corps;painter; champion skeet shooter.

’45 MD—Malcolm K. Towers ofNorthwood, UK, November 11, 2011;cardiologist.

’45, ’47 MD—Robert D. Harwick ofWyncote, PA, October 14, 2011; profes-sor of surgery and chief of surgical oncol-ogy, Temple U. School of Medicine;retired lieutenant commander, US Navy;president, Society of Head and NeckSurgeons, the Medical Club of Phila -delphia, the Philadelphia chapter of theAmerican College of Surgeons, thePhiladelphia Academy of Surgery, andthe Philadelphia division of the Am -erican Cancer Society; captain, Cornellgolf team; tennis player; amateur ornith -ologist; active in alumni affairs.

’47 MD—Robert E. Wolf of Pittsford,NY, November 30, 2011; physician.

’47, BA ’46, ’49 MD—Robert J. Hermof Bluffton, SC, formerly of Keene, NH,December 10, 2011; ophthalmologist;former city councilman in Keene, NH;taught at Harvard Medical School; assis-tant professor of surgery, West VirginiaUniversity; inspector for the Joint

InMemoriam Commission on Hospital Accreditation;

owner, Paperback Trader bookstore; USNavy veteran; co-author of two medicaltextbooks on refraction and fundamentalsof ophthalmology.

’55 MD—Willard T. Weeks of Pelham,MA, December 26, 2011; family and pri-mary care physician; served in the IndianHealth Service; active in civic and commu-nity affairs.

’62 MD—Willard B. Fessenden Jr. ofChicago, IL, October 8, 2011; dermatolo-gist; opera aficionado.

’67 MD—Mark L. Teitelbaum of Balti -more, MD, July 14, 2011; psychiatrist;author. Wife, Sandra (Dorn) ’63.

’69 MD—Richard J. Haber of Lagunitas,CA, June 11, 2007; professor of internalmedicine, UCSF; vice chief of medical serv-ice and director of the primary care pro-gram, San Francisco General Hospital;active in civic, community, and profes -sional affairs.

’76 MD—Robert P. Huben Jr. of Buffalo,NY, October 25, 2011; leading expert inurology; retired chief of urologic oncology,Roswell Park Cancer Institute; associate pro-fessor, Dept. of Urology, U. at Buffalo; med-ical staff member, Buffalo General Hospital;wrote hundreds of publications and bookchapters; recognized by Castle ConnollyTop Doctors and Best Doctors in America;founded the Western New York chapter ofthe Us Too Prostate Cancer Support Group.

’80 MD—Janet Mary Werkmeister ofTenafly, NJ, November 22, 2011; allergistand immunologist; executive director,Institute for the Study of Aging. Husband,Howard Fillit ’70.

parities relating to chronic diseases inthis underserved community. My goalsare to continue to elevate in medicalmanagement and bring community fed-erally funded health centers on par withUDS health standards. I spend my freetime trying to develop health infrastruc-tures in underdeveloped countries suchas El Salvador.”

Asha Yancy Okorie, MD ’05: “UzoOkorie, MD ’05, and I will be moving tothe Midwest in July. We’ll both be workingat the Marshfield Clinic in centralWisconsin. I’ll be the new glaucoma spe-cialist, and Uzo will join the pediatric car-

diology team. We’re sad to be leaving NewYork, but we’ll come back to visit family andfriends frequently. We’ll be close to Chicago,so we’ll get to discover a new city.”

Meera Mani, MD ’09, and her husband,Nikhil, live in New York City and are theproud parents of Medha, who arrived inSept ember 2011. Meera is a consultant inMcKinsey and Company’s health-care practice.

2010sMichael Day, MD ’11: “I am getting

married on March 31, 2012, to Rachel A.Moquete, Class of 2013.”



Team Effort

An innovative program promotes collaboration

among students in medicine, nursing, public health,

and social work

Post Doc

by color, the candy represents seven corresponding medications.The handout details the woman’s dosing regimen: Prandin beforeeach meal, Zocor and a self-injection of insulin at bedtime, Actocelonce weekly (take on an empty stomach; remain erect for at leastthirty minutes afterward), and three other drugs. The students’assignment: using the candy as a proxy, maintain the regimen forthree weeks and report back at the next class session.

Medical student Rachel Feldman ’15 made a grid-like scheduleto keep herself on track. Some of her classmates used an app fortheir iPhones or iPads, complete with automated reminders. A weeklater, Feldman, who spent three years as a critical care nurse beforeenrolling at Weill Cornell, admits that popping the green“Synthroid” (which treats hypothyroidism) and the orange“hydrochlorothiazide” (high blood pressure and fluid retention) ontime has been harder than she expected. “I’ve been trying to becompliant,” she says, “but I’ve learned quickly that it isn’t easy.”

The exercise is part of ITEACH (Integrating TransdisciplinaryEducation at Cornell Hunter), a course on teamwork and patient-centered care that brings together first-year medical students atWeill Cornell with first-year trainees in Hunter’s nursing, socialwork, and public health programs. “Historically, medical schoolshave taught teamwork with other health professionals informally—you get thrown in, hope you have good mentors, and emulatethem,” says Joe Murray, an associate professor of clinical psychiatry,who collaborated with Joyce Griffin-Sobel, PhD, RN, professor atHunter College’s School of Nursing, and other colleagues from WeillCornell and Hunter College to design the ten-month course, fund-ed by the Josiah Macy Jr. Foundation. “It’s not enough just to say,‘It’s important to work in teams,’ then step back and watch it hap-pen. One of the ideas behind ITEACH is to actually talk about howyou work in teams.”

Modeled on training modules developed in the military and theairline industry, ITEACH integrates monthly small-group discussions,role-playing with standardized patients, and online assignments; stu-dents even take field trips to Lincoln Center and local museums toponder how culture and teamwork shape the behavior of patientsand health-care professionals. They’re also assigned to small interdis-ciplinary teams that follow a patient with a chronic condition fromhospitalization through discharge and outpatient care. “This is anexceptionally important initiative in our educational program totrain our students to work with the other health professions infuture medical care environments,” says Carol Storey-Johnson, MD’77, senior associate dean of education at Weill Cornell.

“There’s so much we all have to learn in our own silos,” saysCalifornia native Michelle Neely ’15, one of fifteen Weill Cornellstudents in the course. “I wanted concrete ideas of what those otherprofessions do before I go out and get my hands dirty.”

— Sharon Tregaskis

On a rainy afternoon in lateJanuary, Byron Demopoulos, MD ’91, an associate professor of clinical medicine, distributes

small bags of Skittles and M&Ms to thirty-ninestudents from the disciplines of medicine,nurs ing, public health, and social work assem-bled in Uris Auditorium. The sweets come withinstructions. “Assume the role of a sixty-five-year-old woman,” declares a handout that liststhe hypothetical patient’s diagnoses: acidreflux, osteoporosis, hypothyroidism, hyper-tension, diabetes, and high cholesterol. Sorted

JOHN ABBOTT

Daily dose: Associate professor Joe Murray, MD (right), leads an exer-cise in which students organize a regimen of candy “medications.”

48-48WCMspring12postdoc_WCM 3/19/12 2:39 PM Page 48


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