n e w s & v i e w s j u ly / a u g u s t 2 0 0 8

making patients the center of it allQ&a with Dr. Bernard Birnbaum, chief of hospital operations, and kevin hannifan, new senior Vice president, tisch hospital and rusk institute

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The arithmetic is inescapable. some 99,000 Ameri-cans are waiting for organ transplants. while the number of organ donors has risen steadily over the past 20 years, the growth of the waiting list has outpaced it, increasing by some 5,000 transplant candidates each year, according to the United network for Organ sharing. in new York City, 8,000 people are awaiting a life-saving organ. For nearly 6,000 Americans last year, time ran out.

“every day i see people die while waiting on the transplant list and i see people die of cardiac arrest who wanted to become

that others may liVea Bold plan to increase organ Donations in new york city takes shape

iT’s 8 A.m, And The dOCTOr is nOT OnlY in, bUT AbOUT TO gO live. As the last notes of “everybody is a star” fade away, legendary dJ bruce (“Cousin brucie”) morrow gives a shout-out to the host with “the 411 on the 911.”

Taking his cue, dr. billy goldberg tells listeners coast-to-coast: “You are in the er with us.” An-other edition of Tales from the ER, broadcast on sirius satellite radio (Channel 114), is on the air. For the next two hours, dr. goldberg, assistant director of the department of emergency medicine, deftly juggles callers with a rotating roster of medical experts.

Today’s coffee klatch kicks off with a truck driver complaining of acid reflux. immediately, Jack from Pennsylvania, a regular, dials in to recommend a natural remedy of blended collard greens and water. “i’m getting more and more into the mind-body connection,” says dr. goldberg, author of the bestsellers Why Do Men Have Nipples? and Why Do Men Fall Asleep After Sex? “i’m going to be a guru soon.”

Tales from the ER is fast becoming one of the most popular programs on doctor radio, powered by nYU lan-gone medical Center, a pioneering program that officially launched in June. broadcast 24/7, doctor radio will soon include 40 hours of live programming per week. hosted and co-hosted by nearly 40 prominent nYU physicians who were specially trained for this off-duty role, the programs originate from a gift shop turned state-of-the-art studio in the main lobby of the medical Center.

As the phone lines light up, dr. goldberg and his sidekick, Christopher mcstay, m.d., assistant professor of emergency medicine, banter with, educate, and comfort any number of sirius’s 8.5 million subscribers in north America. with dr. goldberg on call, the booth is as frenetic as any er. david from Texas wants to know why he tested positive for a pregnancy hormone. stephanie from Ontario asks for advice on reaching out to troubled teens. russ from minnesota describes his headache as akin to “someone taking a baseball bat and hitting me on the right side of my head.”

“it’s the worst headache of your life,” says goldberg. “we call it the thunderclap headache…. i’d take this very seriously.”

doctor radio’s medical director, marc siegel, m.d., clinical associate professor of medicine, emphasizes that the physicians don’t diagnose, but instead offer informal consultations, what he calls “curb siding.”

“doctors never take two hours out of their day to speak to a patient,” says dr. siegel. “Our hosts make that time. it’s a unique opportunity to talk to some of the top physicians in the country with no appointment, no referral, and no co-pay.”

Peering through the studio’s glass wall, curious passersby survey the scene. inside, the seconds tick off the big clock on the wall as producer melanie Kron and engineer emily Anton screen callers and cue up music. with gary belkin, m.d., bellevue’s deputy chief of psychiatry, the discussion swings to a woman brought into the er after jumping off the brooklyn bridge. “This is why people work at bellevue,” says dr. belkin. “it’s an adrenalin shot.” mcstay, who was on duty when paramedics rushed her in, marvels: “she didn’t have a scratch on her.”

his last guest gone, dr. goldberg winds down the show with a heartfelt discus-sion of his week. “i worked the monday overnight at bellevue and walked into chaos,” he recalls, describing regulars, prisoners from rikers island, and a man who sliced his hand with a saw.

leaning into the microphone, dr. goldberg offers anxious listeners what may be the most reassuring words of all: “The doctor is in.”

For more information, visit sirius.com/doctorradio.

you’ve been conducting “listening rounds” for nearly a year now. What have you heard? initially, we heard a good deal about the physical plant. There’s only so much we can do at this time. meanwhile, we’re focusing on keeping the facilities well-maintained and renovating whenever possible. we also heard a lot about how our iT system was impacting pharmacy operations. That led to various improvements, many of which have been implemented. Feedback like this is invaluable because it comes from those on the front lines. it also helps me get to know our employees. any surprises? i was aware of the loyalty factor at nYU because i had studied and trained here, and have been back on the faculty for years. but i was surprised to meet employees who have been here for 20, 25, 30 years who say they would

radio daysas a pioneering station makes its Debut, nyu finds its Voice

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volume 9 number 4

news&viewsjuly/AuGuST 2008 A N E W S l E T T E R F o R T H E N y u l A N g o N E M E D i c A l c E N T E R c o M M u N i T y

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At the official launch of Doctor Radio on June 17, Scott Greenstein, president, entertainment and sports, SIRIUS Satellite Radio (far left), joined (left to right) Kenneth Langone, chairman, Board of Trustees; Dean & CEO Robert I. Grossman, M.D.; and Marc Siegel, M.D., medical director and physician coordinator, for the ribbon-cutting ceremony.

Card-carrying members of the NYU staff who are self-designated organ donors proudly display their badges of honor.

As part of an ambitious series of capital improve-ment projects, nYU langone medical Center is in the midst of a multi-million-dollar makeover that will bring a host of renovations, expansions, and new facilities. The plan extends to such diverse areas as patient care settings, laboratories, classrooms, and libraries, with many projects now complete, others in the final stages, and some just breaking ground. The renovations will revitalize more than 100,000 square feet of space and

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j u ly / a u g u s t 2 0 0 8 n e w s & v i e w s

a Branch grows in Queenslike any business, a medical center relies on mergers and acquisitions to gain

a competitive edge. By acquiring satellite facilities in communities where people live and work, nyu is not only expanding its patient population, but reaffirming its commitment to underserved patients.

“We believe in developing and/or acquiring larger, physician-based practices of high quality,” explains andrew rubin, vice president for clinical affairs and affiliates. the newest example is the columbus medical practice at 97-85 Queens Boulevard in rego park, Queens, purchased in february. at 22,000 square feet and 115 non-physician employees, it’s one of our largest satellites. it’s also one of two ambulatory partner-facilities — trinity center in lower manhattan is the other.

“We’ve had a relationship with this practice for about two years, so some physicians in cardiology, orthopaedics, and radiology rotated through the facility,” says rubin. “now, all 26 doctors who practice there are on the nyu faculty.” their specialties include gastroenterology, internal medicine, and pulmonary services. patients also have access to a complete imaging suite.

Queens is a melting pot within a melting pot, and a growing number of physicians and staff members speak multiple languages, primarily russian, spanish, and english, but also less common ones that reflect the immigrant-rich community.

For more information, call (866) 382-3413.

modernize numerous patient services over the next two years.

major projects• inpatient Cardiology has moved to a newly reno-vated 31-bed unit on the 11th floor of schwartz health Care Center (hCC), freeing up space for an expanded iCU on Tisch 15.

• by summer 2009 the first half of the new intensive

Care Unit on Tisch 15 west will be completed, with 18 critical care beds. by summer 2010, the east side of the 35-bed iCU will open, doubling the size of the existing iCU.

• The ambulatory chemotherapy infusion program will move from hCC 14 to 317 east 34th street this summer.

• This fall 14 beds will be added to the Post Anesthe-sia Care Unit (PACU), expanding capacity by more than a third. This will ease logjams and increase the volume and efficiency of the Ors.

• Construction of the new Ambulatory surgery Center at 333 east 38th street begins this summer and will be completed by next. The focus has shifted from a general day-surgery facility to one that specializes in orthopaedic surgery, to complement the new nYU musculoskeletal institute, which will be located in the same building.

• This summer the Cardiac and vascular Center on hCC 14 will expand to include two new Cardiac Cath-eterization labs with associated prep, holding, and support facilities.

• The diabetes education Center and the Patient & Fam-ily resource Center have relocated from the 14th floor of hCC to the first, next door to the blood donor Center.

• A new rnAi research laboratory has been complet-ed on the third floor of Tisch. rnAi (for rnA interfer-ence) screening is a powerful tool that can rapidly survey whole genomes. next door are dermatology research laboratories, completed last year, where sci-entists are studying the effects of ultraviolet radiation and autoimmune disorders affecting the skin.

• The spacious new Founders Conference room, located on the first floor of the medical science build-ing, was completed in June, providing state-of-the-art audio-visual equipment.

• Coles classrooms are being renovated to accom-modate additional seats, reflecting an increase in the school’s class size.

• The inpatient pediatric unit at nYU hospital for Joint diseases (nYUhJd) will get a facelift, with more private rooms and a new playroom. Construction should begin this fall, and take one year to complete.

• in February nYUhJd’s herman robbins medical library opened — a complete renovation of the facility.

A makeover for the medical Centerrenovations, expansions, and new facilities

nyu child study center launchesnew jersey satellite

garden state residents will no longer have to trek to new york city to take advantage of the nyu child study center’s premier diagnostic and treatment services for chil-dren and teens with psychiatric, developmental, and learning disorders. in may, the center, which has treated patients from 41 states and 26 countries, opened its new clinical care and research facility in hackensack, n.j.

harold s. koplewicz, m.D., founder and director of the nyu child study center, launched the new location with an on-site, live broadcast of about our kids, a weekly Doctor radio program on sirius satellite channel 114. sharing the microphone with hackensack mayor jorge meneses, Dr. koplewicz described the need in new jersey. “there are 15 million children in the united states with a psychiatric or learning dis-order,” he explained, “and fewer than 10 child and adolescent psychiatrists for every 10,000 children living in new jersey. We’ve been providing the highest quality care at our sites in manhattan and long island for over a decade, and we’re thrilled to be able to extend our world-class services to the families in the garden state.”

the new jersey center, located at 411 hackensack avenue, is staffed by expert cli-nicians with access to groundbreaking research and specializations in psychophar-

macology, diagnostic evaluations, neuropsychological evaluations for learning disorders, and specialized non-medication treatments. lisa kotler, m.D., clinical assistant professor of child and adolescent psychia-try, is the new center’s medical director, and jerome Bubrick, ph.D., clinical instructor of child and adoles-cent psychiatry, is its clinical director.

For more information, call (201) 465-8111 or visit AboutOurKids.org.

irB Becomes first in nyc to gain accreditation

nyu school of medicine’s human research protections program, or institutional review Board (irB), has been awarded full accreditation by the association for the accreditation of human research protection programs inc. (aahrpp).

aahrpp is a nonprofit organization that works with organizations that conduct human research to raise the level of protection for research participants.

aahrpp accredits organizations that can demonstrate they

Dr. Ramanuj Dasgupta is director of the new RNAi Research Laboratory, one of several new facilities that are part of the Medical Center’s

ambitious capital improvement plan.

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joint Diseases announces joint Venturesif the patient can’t get to the hospital, then the hospital will get to the patient. that’s the thinking behind the recent debut of two satellite practices affiliated with nyu hospital for joint Disease. Zip code analysis convinced the hospital to extend its reach to clinical modelo at 4334 Broadway (185th street) in Washington heights, and Westchester orthopaedic specialists at 244 Westchester avenue in White plains.

an existing nyu presence at clinical modelo already offered the Washington heights community cardiology and gastroenterology services. nyuhjD has added three orthopaedists and a podiatrist, who offer sports medicine, hand surgery, joint replacement, spine surgery, and general orthopaedic services.

in Westchester, seven orthopaedists and a physiatrist provide adult reconstruction/joint replacement, spine surgery, sports medicine, minimally invasive/arthroscopic surgery, general orthopaedics, shoulder and elbow surgery, and rehabilitation medicine.

these initiatives make clincal modelo and Westchester orthopaedic specialists high profile among nyuhjD’s growing list of satellites in Brooklyn, Queens, and, now, manhattan and Westchester. “the big picture,” says joseph Zuckerman, m.D., chairman of orthopaedic surgery, “is that, as an outstanding academic center, nyu langone medical center recognizes that there are important benefits to be gained from going out into the community.”

For more information, call (212) 927-1717 for Clincal Modelo and (914) 227-9626 for Westchester Orthopaedic.

provide participant safeguards that surpass the threshold of state and federal requirements, and therefore heightens the level of public confidence in research safety and ethical conduct of research. By establishing a “gold seal,” accreditation signifies that organizations such as nyu are committed to the most comprehensive protections for research participants and the highest quality research. “after a lot of hard work by elan czeisler, irB’s director, thomas j. j. Blanck, m.D., ph.D., chairman of the Department of anesthesiology, and others, our irB has become the first academic

medical center in new york city to become accredited by aahrpp,” says Vivian lee, m.D., ph.D., m.B.a., vice dean for science and chief scientific officer. “this means that nyu

has received the highest mark of distinction for institutional review Boards, which are charged with the vital task of ensuring the protection of research subject welfare.”

n e w s & v i e w s 3

as a cardiologist, no one knows better than jennifer mieres, m.D., associate professor of medicine, that preventing cardiovascular disease is serious business. But as an african-american woman, it’s more than that. it’s personal. african-american and latina women, she notes, are at higher risk for heart disease, stroke, and other cardiovascular diseases, and they’re more likely to die from these conditions. “my family also has a history of risk factors,” she adds, “and both my grandfathers died of heart disease.”

Dr. mieres, director of nuclear cardiology, is determined to change the odds. a nationally recognized expert in cardiovascular disease in women, she believes that giving women user-friendly health information empowers them to make heart-smart choices. With that goal in mind, she recently published Heart Smart for Black Women and Latinas: A 5-Week Program for Living a Heart-Healthy Lifestyle (st. martin’s griffin, 2008), written with collaborators terri ann parnell and carol turkington. the book dovetails with Dr. mieres’ work at the leon h. charney Division of cardiology, where she is one of the principal investigators in a national study that is trying to determine the best diagnostic test for women suspected of having heart disease.

for african-american anD latina Women, aDVice they shoulD take to heart

A Keynote speaker with Perfect Pitchnew york’s governor addresses the graduating class of ’08

“i owe a lot to doctors,” governor david A. Paterson, the keynote speaker at this year’s commencement ceremony for the school of medicine, told those gathered at Avery Fisher hall on may 15. “Thanks to doctors, i became one of the first legally blind students to attend public school.” earlier this year, Paterson also became the first legally blind governor of the state of new York.

Presenting new York’s 55th governor with a Presidential Citation, nYU President John sexton praised Paterson for his personal and professional achievements, de-scribing him as a public servant of great vision. “Though legally blind,” said sexton, “you see in ways few politicians do.”

Paterson’s keynote address touched on several aspects of the state’s support for healthcare and the medical community. As lieutenant governor he championed the empire state stem Cell initiative, leading to legislation that will channel $600 mil-lion in state funds for stem cell research over the next decade. so far, $1.6 million has gone to nYU. Under a new Child health insurance Plan, every child in new York will receive health insurance starting next year. Another new program, doctors Across new York, will help young physicians to reduce their medical school debt by providing grants to those who practice primary care in underserved areas through-out the state. within the next year and a half, Paterson promised, new York state will have an electronic medical record for every patient profile.

“Though legally blind,” said sexton, “you see in ways few politicians do.”

with a dash of his trademark wit, Paterson drew a big laugh when he apologized for seeming ill-prepared, explaining that Class President Tom Kim, m.d., “tore up my speech right before i took the podium.” Turning serious, he told the Class of ’08 that “the role of a keynote speaker is to inspire, but i must tell you: You inspire me.”

The ceremony, which was presided over by dean & CeO robert i. grossman, m.d., conferred degrees on 154 students from 23 countries, 27 states, and the Commonwealth of Puerto rico. Almost the entire class participated in independent research, and 23 students completed a full year of research under the auspices of such prestigious programs as the doris duke Clinical research Fellowship and the luce Fellowship for language study, as well as the national institutes of health. Twelve members of the class attained an additional degree: five in m.P.h. programs and seven earning a combined m.d./Ph.d. eleven graduates earned their degrees with honors. Twenty-four graduates will remain at nYU for their residency, and nearly 84 percent received appointments at the top 50 medical schools.

Pediatrics: The Road Most TakenThis year’s residency match Program saw a surprising spike in the number of

aspiring pediatricians. For the past several years, the number has hovered between 15 and 17, but 25 members of the Class of 2008 chose the path to pediatrics.

As a primary care specialty, pediatrics is one of the fields that leaders in medi-cal education have been urging young physicians to pursue. “For too long, the pendulum had swung the other way,” says m. brownell “brownie” Anderson, senior associate vice president in the division of medical education at the Association of American medical Colleges (AAmC), which administers the match process. “we were turning out highly skilled doctors who could administer tests and procedures and do diagnoses with sophisticated instrumentation. but what we were losing was that connection to the person — the selflessness that puts the patient’s needs before your own.”

At a time when more lucrative specialties — anesthesiology, diagnostic radiology, and plastic surgery — are rising in popularity, does this point to a focus on altru-ism at nYU? it’s certainly possible, says lynn buckvar-Keltz, m.d., associate dean for student affairs. “in general, we’re seeing students who are interested in service to the underserved,” she says. “Part of the reason they come to nYU is to work at bellevue and to care for patients in need. And one-fourth of our students participate in the student-run nYC Free Clinic, which is open every saturday for uninsured new Yorkers.”

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NYU President John Sexton presents the University’s presidential citation to New York State Gov. David Paterson.

Dean Robert I. Grossman, M.D., with Erica Pollack, M.D. (’08) and her mother, Lynda Pollack, M.D. (’70).

Dr. Jennifer Mieres, director of nuclear cardiology, with a 3-D image of the beating heart of a patient complaining of chest pain who was found to have blockages. A nationally recognized expert in cardiovascular disease in women, Dr. Mieres was recently featured on the cover of Black Enterprise magazine for being “one of the best and brightest in medicine.” She is also the co-author of a book that alerts black and Latina women to their increased risk for cardiovascular disease.

“for african-american women, there’s an intrinsic genetic predisposition to hypertension,” explains Dr. mieres, “but a big component is lifestyle.” african-american and latina women are more likely to eat a high-fat diet and be overweight or obese, and less likely to be physically active. “this puts them at higher risk for hypertension, which is a potent risk factor for heart disease, and an even greater risk factor for stroke.”

to compound the problem, many of these women aren’t aware that cardiovascular disease is an “equal opportunity killer,” as Dr. mieres puts it, striking african-american and latina women even more often than it does men. “i think of these women as the forgotten ones in terms of getting the message about how vulnerable women are to heart disease.”

Dr. mieres’ book offers advice on nutrition, fitness, and stress management, all within the context of african-american and latina lifestyles and cultures. “i wanted to let african-american and latina women know that they can still use their traditional recipes, as long as they make heart-healthy choices for ingredients. if you can start by incorporating just 10 minutes of exercise a day into your schedule, with the goal of attaining 30 minutes most days of the week, you are definitely going to improve your heart health. all it takes is small, simple steps to get big rewards.”

n e w s & v i e w s

nyu extenDs its expertise in Bariatric surgery to BelleVue

Obesity and the life-threatening diseases it spawns are a full-fledged epidemic — the single greatest risk to the health of the American public. But of all dieters with a history of obesity, only one-fifth sustain a loss of 10 percent of their body weight for a year or more. For some, the best long-term solution is bariatric surgery, which brings about dramatic weight loss by reducing the amount of food the stomach can intake.

The NYU Program for Surgical Weight Loss, the largest of its kind in the country, is a nationally renowned center of excellence. Its team — George Fielding, M.D., associate professor of surgery, Christine Ren, M.D., associate professor of surgery, and Marina Ku-rian, M.D., assistant professor of surgery — has collectively performed more than 7,000 weight loss procedures.

Now, that level of expertise is also available at NYU’s primary affiliate, Bellevue Hospi-tal Center, which for the first time is offering Laparoscopic Bariatric Surgery for weight loss in morbidly obese patients. Spearheaded by Manish Parikh, M.D., assistant profes-sor of surgery, and assisted by John Saunders, M.D., assistant professor of surgery, the Bellevue program performs gastric banding, gastric bypass, and sleeve gastrectomy on patients with a body mass index (BMI) greater than 40, or greater than 35 if patients have other medical conditions, including diabetes, hypertension, sleep apnea, or osteoar-thritis. “Thanks to these procedures,” explains Dr. Fielding, “patients have an 80 percent chance of getting off all the medications they’re on for high cholesterol, high blood pres-sure, and diabetes.”

“The reason we’ve recruited these two outstanding surgeons,” says Leon Pachter, M.D., chairman of Surgery, “is to offer the indigent population of New York City who suffer from the dire consequences of morbid obesity the same medical options available to patients at private hospitals.”

Patients must be 18 or older and be free of active substance abuse. The surgery is covered by Medicaid and managed Medicaid plans. For uninsured patients, financial counselors will help them apply for HHC Options, a Health and Hospitals Corporation program that qualifies patients for government-sponsored insurance or substantially reduces the costs of medical and surgical treatments.

To make a referral to this clinic, physicians can contact the Bellevue Hospital Referral Center (212) 562-1011. For more information, contact Dr. Manish Parikh in the Department of Surgery at (212) 562-3917 or manish.parikh@nyumc.org.

… anD pt makes three

pregnancy is rarely comfortable, but for some women it can be downright debilitating, preventing them from working, sleeping, even walking. for these moms-to-be, the rusk institute offers welcome relief with individualized exercises designed to stretch back muscles pulled tight by growing babies, and realign bodies thrown off by bulging bellies.

adriana rendon, 33, was sent by her physician to the Women’s health program to find relief from abdominal pain so intense by her sixth month that she could barely leave the house. the graduate student lifts weights and loosens her hips by wiggling on a giant balance ball under the supervision of therapist ting-ting kuo, who develops a new routine for her each week, tailored to the shifting aches and pains of her rapidly changing body.

“i would get this pain that was so intense that i would have to stop walking,” says rendon, who will deliver at tisch hospital. “coming here has taught me what movements to avoid and what exercises to do to ease the pain.”

lower back pain is the most common reason women — about half a dozen at any given time — find their way to the program’s fourth floor treatment rooms. But abdominal aches and shoulder tightness caused by expanding breasts are also frequent complaints. typical therapies include flexibility and core strengthening, and soft-tissue massage may also be included. rendon’s routine includes pelvic pull-ups, lots of time on the balance ball, and sets of flyaways with one-pound weights to stretch her shoulder blades.

a thorough discussion of the week’s aches and pains is as much a part of the therapy as any exercise. realizing that rendon’s discomfort appeared worse after her weekly birthing class, for example, kuo identified an unsupportive chair as the culprit. she also helped rendon adjust her

for DiaBetes eDucation, it’s aBout location, location, location

sunhi shin, r.n., coordinator of the Diabetes education center, recently discovered that while all real estate in manhattan is valuable, some of it is prime. since relocating from the 14th floor of the schwartz health care Building to the ground floor in april, business is way up. “We have 20 to 30 percent more patients,” she beams.

patients with diabetes who are under the care of nyu physicians come via referrals, of course. But now even people at risk for the disease, as well as their concerned family members and friends, are visiting the center, which is located along the corridor where people donate blood and have their blood drawn.

“Diabetes is a silent disease,” she explains. type 2 diabetes, which accounts for 90 to 95 percent of cases, typically develops later in life, and is associated with obesity and inadequate exercise. according to the centers for Disease control and prevention (cDc), the number of diabetics in america has grown to about 24 million, or 8 percent of the population, including nearly 25 percent of those aged 60 and older. What’s more, some 57 million people have abnormal blood sugar levels that qualify as pre-diabetes. Diabetes results when the body lacks enough of the hormone insulin, needed to convert sugars and starches into energy for daily life. left untreated, it can lead to blindness, kidney failure, amputation of the toes, feet, or legs, and even death. “most people think of diabetes as just ‘high blood sugar,’ ” shin says. “i try to explain what happens as the disease progresses. they say, ‘Wow, i didn’t know.’ ”

With a nutritionist, shin assesses each new patient, offers educational resources, and makes referrals to classes about medications for diabetes management.

for more information, call (212) 263-8206.

neW DeVices may Bring a Breath of fresh air to those With emphysema

life with emphysema is a life spent gasping for air, straining like a marathoner to suck in oxygen after every stroll to the fridge or the mailbox. yet for all its severity and prevalence, the disease has few available treatments, and they are surprisingly low-tech. except for severe cases, surgery to remove diseased portions of the lungs is too risky. instead, the newly diagnosed emphysema patient is sent home with pills, inhalers, and a cumbersome oxygen tank.

But all that may soon change. David ost, m.D., director of interventional pulmonology, is part of a team that is testing two new devices, implanted directly into lung tissue, designed to relieve suffering by diverting air from sick lung areas to healthy tissues that need it. the fingernail-size devices — intra-Bronchial Valve (iBV) and exhale airway stents for emphysema (ease) — are for a particular type of emphysema.

one result of the progressive hardening and crumpling of the lungs’ microscopic air sacs is the buildup of stale air in the non-working parts of the lung. emphysematic tissue can’t process the air it receives, but it can’t get rid of the extra gas either. this leads to hyperinflation of the lungs, which often becomes so extreme that it’s visible — people with emphysema sometimes develop a barrel chest.

While the umbrella-shaped iBV valve is best for patients whose disease is limited to the upper lobes, the artery-style ease stent is suited to those whose damage is more dispersed. While both devices offer trapped air a path for escape, only the valve actually blocks off sections of lung. neither procedure requires invasive surgery — they’re done using a bronchoscope that travels deep into the lungs. Valve installation doesn’t involve cutting at all, while the stent insertion requires poking a needle through small sections of lung to create airways.

so how does that first breath feel after you wake up from the procedure? “it’s tough to say,” says Dr. ost. he’s witnessed scenes of foggy-eyed patients, breathing better in the recovery room than they have in many years. “But we don’t really know yet how patients will feel,” he adds. “that’s why we’re doing the study.”

for information on how to participate in this clinical trial, call (212) 263-4170.

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tennis anyone? Wii, Wii.When nintendo unveiled its fifth-generation home video game console — the Wii

(pronounced we) — in 2006, the company explained that its whimsical name was intended to underscore that the product is for everyone. that has certainly been the case at nyu’s rusk institute, which received its first Wii as a gift earlier this year. With its addictive array of sports games and technological wizardry that detects movement in three dimensions, it not only provides a welcome distraction for those consigned to therapy, often in a wheelchair, but a valuable rehab tool as well.

“With the Wii,” says senior recreation therapist lisa Delguidice, “we can persuade patients to do something that’s good for them much easier. With other therapies they are driven by performance, but here there’s no performance anxiety.” Delguidice and her colleagues have also found that little kids often play as well or better than older ones. “the self-esteem that gives to a child is huge,” she says. “it takes away the barriers.” the Wii’s motion-sensitive remote controller helps patients improve their balance, endurance, hand-eye coordination, range of motion, muscle strength, and cognitive skills. this makes it ideal for those grappling with the challenges of cerebral palsy, head trauma, strokes, ms, and seizure disorders. adhiambo mitchell, 32, who lost both legs after a car accident in april, says that the Wii kept him from getting depressed. “it totally took my mind off being in a wheelchair,” he explains. “i used to box, and here i am in a wheelchair, standing up, boxing. the Wii will throw you right off. it makes you think you’ve got your legs again.”

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research anD clinical serVices spotlight

abdominal binder, a thick stretch band she now wears constantly under her belly. With a simple tweak, rendon was able to walk faster, a sign that her pain had lessened. she left the hour-long session

braced for another week of maternal bliss.

a physician’s prescription is required for the Women’s health program. to make an appointment, call (212) 263-5601/6075.

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in melanomas, siZe matters

a DouBly Dangerous Disease, a singularly ingenious solution

concern, and lesions that are multiple colors are especially suspicious.” more than 20 years ago, nyu dermatologists developed a widely used guideline —

aBcD — for recognizing skin growths that could be early melanomas. they recently added the letter e to the list. the warning signs are: a for asymmetrical lesions; B for lesions with irregular borders; c for lesions with multiple colors unevenly distributed; D for lesions larger than 0.2 inches (6 millimeters) in diameter; and e for evolving lesions that change in size, color, shape, or symptoms, such as itching and oozing, over time.

the incidence of melanoma continues to rise. the american cancer society estimates that in 2008 in the u.s., there will be 62,480 new cases and more than 8,400 fatalities. excessive exposure to sunlight, a fair complexion, a family history of melanoma, and numerous moles, among other factors, place people at higher risk for the disease.

for orthopaeDic emergencies, neW yorkers make no Bones aBout their first choice: nyuhjD

But cardiologists had something that fit the bill: a contrast agent measuring 5 to 7 microns in diameter, the size of a red blood cell. the agent, delivered intravenously, would flow through the bloodstream. When an ultrasound transducer was held over the ovary, Dr. fishman reasoned, it would pick up the

micro-vessels indicative of early oec.Dr. fishman’s prediction has been borne out. in a recent

clinical trial of the technique, conducted with colleagues at Vanderbilt university, he reports that the ovary’s microvasculature “lights up like a christmas tree,” with changes in cancer-related blood vessels easy to identify. Because this clinical trial represents a first test of the technology, Dr. fishman and his team are only including women whose ovaries will be removed later for a host of reasons, such as a standard hysterectomy, so that they can double-check their results. first the ovary is examined through a transvaginal ultrasound (conducted with a transducer shaped to fit into the vagina.) then the ovary itself is removed and physically examined.

so far, Dr. fishman reports, his team has examined 120 ovaries and found every single cancer — 15 in all, including three located in the fallopian tubes. of the cancers found, he adds, three were missed by conventional diagnostic techniques and picked up at the earliest stage, 1a, when his new contrast sonography was employed.

“our goal now,” says Dr. fishman, “is to test 1,000 women with the technique. Were we lucky or is this real? if it’s real, this could become as easy and common as a colonoscopy, a new standard of preventive care.”

recommended that we come here for the ankle,” says mrs. rana. “We couldn’t believe how fast he was treated.” in a typical emergency room patients would be triaged, and those with non-traumatic orthopaedic injuries would be given lower priority than those with life-threatening conditions. But at orthopaedic immediate care — open seven days a week from 8 a.m. to 11 p.m — bruised, battered, and broken bones come first. about 70 percent of walk-ins are released within 2 1/2 hours. if a patient requires emergency surgery, the or is only minutes away.

“the level of expertise here is very high,” says alan Dayan, m.D., clinical assistant professor of orthopaedic surgery, the center’s medical director since 1998. “We have a

three months after he was treated for a broken ankle at the samuels orthopaedic immediate care center at nyu hospital for joint Diseases, 15-year-old sambhrant rana is back in new york city’s only walk-in orthopaedic urgent care center. on a friday afternoon in late may, he can’t bend a finger he’d banged up a few days earlier playing football on a class trip from the united nations international school.

x-rays reveal that there’s no fracture, so about two hours after arriving, sambhrant is heading home to roosevelt island with an appointment to follow up with a hand specialist. his mother, ananta, says that if her son has another orthopaedic issue, his first destination will be 301 e. 17th street.

“his pediatrician

number of orthopaedic surgeons who specialize in each area of expertise.

each year some 7,000 new yorkers visit the facility, mostly residents of manhattan and Brooklyn, but people come in from as far away as connecticut and new jersey. the most common injuries are wrist or ankle sprains or fractures and knee sprains or cartilage tears. the center also treats patients with acute rheumatoid arthritis, chronic back pain, and neurological complaints.

patients with knee or hip replacements who sustain an injury also come here to make sure their new joints haven’t been damaged. “the elderly can dislocate or fracture their prosthesis if they fall,” says linda mendez, r.n., who has worked at orthopaedic immediate care since it opened in

skin lesions that are about the size of a pencil eraser are more likely to be melanomas, a deadly form of skin cancer, than smaller moles, according to a new study led by nyu researchers. in a study published in the april issue of Archives of Dermatology, the investigators confirmed that an important warning sign of melanoma — moles that are larger than 6 millimeters, the size of a pencil eraser — is still valid. in recent years, some researchers have argued that strict adherence to this guideline may make clinicians miss smaller melanomas.

“Diameter is a reasonable guideline for paying attention to lesions and we did not see any reason to change this criterion,” says David polsky, m.D., ph.D., assistant professor of dermatology and pathology, and associate director of the pigmented lesion section in the ronald o. perelman Department of Dermatology, who led the study. “lesions smaller than 6 millimeters are unlikely to be melanoma. new and changing lesions are the most cause for

j u ly / a u g u s t 2 0 0 8

December, 1992. she says the busiest day is monday, when people seek treatment for painful injuries they suffered over the weekend. summers get pretty busy, too. “When you get all the kids out in the parks playing,” says mendez, “they can end up getting hurt.”

the center, which recently partnered with nyu’s Department of emergency medicine to increase coverage, is staffed by orthopaedic residents and attending physicians in emergency medicine and orthopaedics, with subspecialists on call. “this brings a level of expertise and supervision consistent with the care at tisch hospital,” says joseph D. Zuckerman, m.D., chairman of the Department of orthopaedic surgery. “it enhances our ability to care for our patients.”

a new ultrasound technique in clinical trial at nyu langone medical center could become the first reliable method for early diagnosis of ovarian cancer, the fourth leading cause of death among women in america. the technique is the brainchild of David fishman, m.D., director of gynecologic oncology, cancer prevention, and early detection at the nyu cancer institute.

ovarian epithelial cancer (oec) is a doubly dangerous disease. it often appears with vague symptoms, or none at all, making it hard to catch in the earliest stages, when 90 percent of cases are cured. instead, some 75 percent of women aren’t diagnosed until stage iii or iV, when the cancer becomes resistant to treatment, bringing the five-year survival rate down to 15 percent.

Dr. fishman says that as he lost late-diagnosed patients year after year, the pain of watching them die was agonizing to him. “i became passionate about finding tests to save their lives,” he says. after many a sleepless night spent pondering a solution, Dr. fishman had a brainstorm: if ordinary ultrasound could be modified, the vasculature that feeds cancers as they grow could be analyzed. the problem was that while ultrasound captures large blood vessels, by the time those vessels are found in ovarian cancer, it’s too late. What was needed was a method for sharpening resolution and capturing the “microvasculature” — the tiny blood vessels that develop before a mass needs large quantities of blood to fuel its growth.

in the field of oncology, no such technology existed.

n e w s & v i e w s

of Child health and human development, part of the national institutes of health.As a mother of three, now it’s her turn to pass on the family passion for reading. And

as a physician of many more children than that, she doesn’t pass up the opportunity to put books in their hearts. dr. Klass is the medical director of reach Out and read, a national literacy program aimed at at-risk kids. in this role, she oversees the training of physicians who are taught to integrate books and advice about reading into their pediat-ric practices. Through this highly acclaimed program, healthcare providers around the country give out more than 5.4 million books a year to disadvantaged children. starting at 6 months old, children receive free, age-appropriate books during each doctor’s visit, with at least 10 books in their fledgling library by the time they reach kindergarten.

“For children, physical, mental, and developmental health are tied, and are very closely related to what goes on between parent and child,” says dr. Klass. “A lot of parents are surprised by how much a two-year-old can care about being read to — and

benefit from it.” “Physicians tend to be very concrete-

minded people. we give a lot of advice, but there’s something very exciting about also giving the tool,” she adds. “sending a book out of the clinic in a three-year-old’s hands and knowing it will be in the child’s home, you start seeing the books as bright little spots on your mental map of the city.”

6

wound, heal Thyself.

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The sore under the patient’s big toe didn’t hurt, but it wasn’t getting better. The 64-year-old woman had been living with type 2 diabetes for many years. she did a good job of keeping her blood sugar under control, but because her nerves had been damaged by diabetic neuropathy, she often didn’t notice blisters or sores on the soles of her feet. This one was smaller than a dime and not inflamed, so the woman’s doctor reassured her that in time it would heal.

by the time she found harold brem, m.d., chief of nYU langone’s new division of wound healing and regenerative medicine, an antibiotic-resistant infec-tion had eaten its way down to the bone. Amputation of her toe was a real possibility. dr. brem surgically removed diseased tissue from the woman’s ulcerated toe and applied human cells, which rapidly began to close the wound. her toe was saved.

Chronic wounds are a full-fledged epidemic. wound infections account for some 4.5 million emergency room visits each year, and complications from dia-

betic ulcers result in more than 80,000 lower limb amputations, often because no one recognizes the severity of the wound. “when it comes to diabetic ulcers,” explains dr. brem, “looks don’t matter. A very complex set of molecular abnormalities results in the ulceration.”

dr. brem’s research, funded by six grants from the national institutes of health, has pioneered under-standing of the cellular and molecular biology of chronic wounds. Among his team’s discoveries is that keratinocytes, specialized skin cells that normally mul-tiply and migrate across an open wound as it heals, behave differently in chronic wounds. They multiply but do not migrate, due to overexpression of c-myc, a gene that inhibits healing. The result is an abnormally thick margin on the edges of an open wound.

with regard to the three most common types of chronic wounds, dr. brem explains that pressure ulcers, or bedsores, cost the most lives; diabetic ulcers claim the most limbs; and venous ulcers, which afflict mostly the elderly, cause the most suffering.

A firm believer that “every wound can and will heal with proper care,” dr. brem has merged research and clinical efforts in the new division, which is part of the department of surgery. “All of our research is trans-lational,” he says, “pursued only if the results will di-rectly and significantly benefit the patient.” The result is a set of protocols designed to prevent ulcers from developing and to ensure complete healing if they do. These include daily examination and swift treat-ment of any break in the skin. wounds are measured, photographed, and tracked using advanced informat-

ics via a wound electronic medical record. diseased tissue is removed surgically, leaving healthy tissue at the margins. Cellular and collagen therapy is applied to tap the patient’s natural ability to regenerate tissue.

The division’s multidisciplinary team of health-care professionals provides same-day coverage for inpa-tients with a break in the skin and same-week cover-age for outpatients. nurses are specially trained to assess wounds and, if appropriate, refer patients for treatment at Tisch hospital and nYU hospital for Joint diseases.

“nYU has created the best clinical surgical depart-ment on the east Coast,” says dr. brem, who was recruited from Columbia University’s department of surgery, where he directed the wound-healing pro-gram. “by putting all these resources under one roof, we can offer patients a unique set of services with seamless care.”

dr. brem’s research program is focused on the hypothesis that non-healing wounds are a localized biological phenomenon rather than a systemic pathol-ogy. An ongoing funded clinical trial is testing a way to deliver a gene that makes a protein that can reverse a non-healing wound. The next step is finding out which genes stop the wound from healing. “we hope to one day just reverse the genes,” says dr. brem. “mean-while, our goal is to return patients to their referring physician, nursing facility, or home in the same condi-tion they were in prior to the wound.”

For more information, call (212) 263-7187 or visit NyuWound.org.

a new Division of surgery tackles one of the most Daunting challenges in medicine

Books anD other Best frienDspediatrician perri klass empowers parents to read to their children — and colleagues to read Between the lines

dr. Perri Klass was raised in a house brimming with books. she remembers the sight of novels, biographies, short stories, and fables neatly shelved in every room — and also their sounds, mostly coming from her father, an anthropology professor who brought The lord of the Rings and the stories of P. g. wodehouse alive by reading to his children almost every night in different voices and accents.

she learned to love books and write 12 of her own (her mother, an english profes-sor, wrote 16, all novels). At harvard medical school she launched her writing career, contributing articles to Mademoiselle and The New york Times and authoring her first book. in 2006 she came to nYU as professor of pediatrics and journalism. Along the way, she has become one of America’s most distinguished and prolific physician-writers, garnering, among other prizes, five O. henry Awards for short fiction.

And the honors keep coming. in Febru-ary President george w. bush nominated dr. Klass to the Advisory board of the national institute for literacy. she was also recently appointed to the national Advisory Council of the national institute

In the playroom of the pediatric ambulatory clinic at Bellevue Hospital, where Dr. Perri Klass sees patients, she shares the wonder of words with a visitor.

What’s cooking in fooD serVice?plenty, says the new Director, Who has a hearty appetite for Quality

kosher sushi. organic coffee. greek yogurt. is there a new gourmet deli in the neighborhood? actually, these items can be found right here in our cafeterias. When it comes to savoriness, hospital food has traditionally been ranked somewhere in between the fare served by airlines and prisons. But there’s a new food czar in town, and her credo seems to be: food is love.

regina toomey Bueno, senior director of food and nutrition service, leads a team of 275 that is determined to make “world class” the motto of the food, not just the medicine, at nyu. since arriving last september, she has given the institution a food facelift. there are weekly themes, featuring the cuisine and decor of countries like greece and ethiopia, and the vending machines stock healthier selections like vitamin water and fruit-and-nut mixes. the tisch hospital cafeteria will be overhauled; central perk, the starbuck’s coffee stand, will be rebuilt and expanded; and patient food will be served fresh, not reheated.

“i’m aiming to have the best hospital food in the united states, but we have a long way to go,” says toomey Bueno, who holds degrees in nutrition chemistry and healthcare administration. so far, the plan seems to be working. in april, sales increased by 19 percent in both the main and student cafeterias compared to the same month last year.

“i’m aiming to have the best hospital food in the United states.”

Regina Toomey Bueno, senior director of food and nutrition service, and Executive Chef Orlando Ramos get an impromptu review from Marianne Hardart and Elliot Bardavid.

“i don’t feel like i’m in a hospital cafeteria,” says charles Bridgeman, director of mcit telecom services. “i feel like i’m in a high-end emporium. i never ate at the cafeteria. i just didn’t like it. now i eat there twice a day.”

patient meals will also be enhanced, starting in selected areas this summer and expanding to the rest of the medical center by the end of the year. trays will be equipped with induction heating pads to keep freshly cooked food at 185 degrees, replacing the current practice of chilling cooked food and then reheating it on the tray.

and breakfast will become a hot meal, one of 1,500 served each day. aides who bring patients their meals will work more closely with a smaller number of

patients — taking their orders, personally assembling their trays, and delivering their food. the goal is to reduce miscommunication and ensure that patients receive what they request.

“if people don’t eat, they can’t get nutrition,” she says. “When you’re sick, your taste is off to begin with. if the food is unappetizing, you’re less likely to eat it. improving the food is not only a consumer issue, but a patient care issue.”

n e w s & v i e w s

margo amgott

margo Amgott has been appointed the first executive director of the nYU Child study Center, the only new York state Center of excellence in mental health. she serves as the center’s chief operating officer, overseeing its management and strategic growth. Previously, Amgott served as assistant commissioner for early intervention, new York City’s program for children with developmental delays and disabilities, as part of the leadership team of the new York City department of health and mental hygiene. she also served as assistant vice president for health services at Columbia University, leading psychological, psychiatric, medical, health promotion, health insurance, and related support services. Amgott has held positions at the new York City department of Juvenile Justice, sUnY downstate medical Center, and woodhull medical and mental health Center. she received her master’s in health Policy from nYU’s wagner school of Public Administration and her b.A. from barnard College.

george foltin, m.D., anD jessica foltin, m.D.

george Foltin, m.d., director of pediatric emergency medicine at bellevue hospital, and Jessica Foltin, m.d., director of the pediatric emergency medicine and transport program at Tisch hospital, were honored by Kids of nYU at its recent springfling gala for their contributions to both institutions. support from Kids has been integral to the development of the pediatric emergency medicine and transport program at Tisch hospital. Founded in 1991 by a group of parents and physicians, Kids is unique among pediatric philanthropic efforts in that it provides funds — more than $17 million to date — to support inpatient and outpatient

programs that serve children throughout nYU langone medical Center. This year’s gala raised more than $1.7 million.

fritZ francois, m.D.Fritz Francois, m.d., has been appointed assistant dean for academic affairs and diversity. he received his m.d. from nYU, where he also completed his residency and gastroenterology fellowship. during his chief residency he created the department of internal medicine Organization for nurturing diversity (diAmOnd) to help with resident recruitment, mentoring, development, and retention.

keVin r. hannifan

Kevin r. hannifan has been appointed senior vice president, Tisch hospital and rusk institute of rehabilitation medicine. in this capacity, he oversees all day-to-day operations at both clinical facilities, including the departments of supply Chain management and Care management, which embraces social work, as well as patient care units. hannifan earned a master’s in health administration from duke University, and has held senior executive positions, including CeO, in institutions ranging from community hospitals to academic medical centers. most recently he was executive vice president and chief operating officer of hartford hospital in Connecticut. There he chaired the Quality and safety Committee, earning outstanding recognition for quality from a recent unannounced JCAhO survey; encouraged and supported the hospital’s successful magnet application in 2004; implemented a hospital-wide service excellence program; introduced and enhanced a broad array of new clinical services, including the first JCAhO-accredited stroke Center in Connecticut; and served as the vice chairman of the Physician/hospital Organization.

mary ann hopkins, m.D.mary Ann hopkins, m.d., has been appointed director of education in the clinical sciences. dr. hopkins, former director of the surgery clerkship, has made major contributions to education as one of the principal investigators in the creation and funding of the Advanced learning exchange (AleX), the web-based initiative in surgical education (wise-md), and the Cyber Classroom. she is chair of the technology committee for the Association for surgical education (Ase) and sits on its executive committee.

georgeann mcguin-ness, m.D.

georgeann mcguinness, m.d., professor of radiology and vice chair of education for the department, was one of 48 senior women faculty in the country selected for the 2008–2009 class of elAm fellows, sponsored by the hedwig van Ameringen executive leadership in Academic medicine (elAm) Program for women. elAm is the only national program dedicated to preparing senior women faculty for leadership at academic health centers. its mission is to increase the number of women in leadership positions and their success rate in attaining and remaining in these positions. some 20 percent of its 520 graduates currently serve in the highest-level leadership ranks. elAm is a core program of the institute for women’s health and leadership at drexel University College of medicine in Philadelphia, PA. The institute continues the legacy of advancing women in medicine that began in 1850 with the founding of the Female medical College of Pennsylvania, the nation’s first women’s medical school and a predecessor of today’s drexel College of medicine.

Victoria ort, ph.D.victoria Ort, Ph.d., has been appointed director for education in the basic sciences. she is currently co-director of the embryology unit of

the morphological and developmental basis of medicine course and a dean’s advisor.

michele pagano, m.D.

michele Pagano, m.d., the may ellen and gerald ritter Professor of Oncology in the department of Pathology, has been named a howard hughes medical institute (hhmi) investigator. he is one of 56 scientists in the country this year to receive this honor, one of the highest that can be bestowed on a biomedical researcher. scientists are selected for their creativity, innovative ideas, and productivity, and are granted the resources and freedom to follow their instincts rather

than relying on specific research grants for predefined projects. dr. Pagano received his m.d., with honors in molecular endocrinology, from the Federico ii University in naples, italy, in 1989. A post-doctoral fellow at the european molecular biology laboratory (embl) in heidelberg, germany, from 1990 to 1992, he was a principal investigator and scientific co-founder of mitotix inc. in Cambridge, mA, from 1992 to 1996. he joined the nYU faculty in 1996. dr. Pagano’s research explores the roles that the ubiquitin system plays in cell proliferation, differentiation, and death, and how the deregulation of the system can cause cancers. nYU’s other hhmi investigators are ruth lehmann, Ph.d, the laura and isaac Perlmutter Professor of Cell biology, danny reinberg, Ph.d, professor of biochemistry, and dan littman, m.d., Ph.d., the helen l.

and martin s. Kimmel Professor of molecular immunology and professor of pathology and microbiology.

melVin rosenfelD, ph.D. melvin rosenfeld, Ph.d., has been appointed associate dean for curriculum. dr. rosenfeld is currently the interim senior associate dean for medical education. he will be responsible for the Office of medical education, curricular oversight, and new curricular initiatives. Among his responsibilities, dr. rosenfeld will help lead the Curriculum for the 21st Century Task Force, which will shape the school of medicine’s curriculum for the next decade.

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7j u ly / a u g u s t 2 0 0 8

On 14 west, nursing at its best

“14 west walked away with the Academy Awards,” said susan bowar-Ferres, r.n., Ph.d., senior vice president and chief nursing officer. she was referring to the nurses on the inpatient unit of the mary lea Johnson richards Organ Transplantation Center, who were honored with 4 of the 10 awards conferred at the nursing recognition week program on may 6.

The unit’s entire nursing staff won the evidence-based nursing Practice Award for developing a discharge teaching program and demonstrating that it improved patient outcomes. being a transplant patient is a lifelong challenge, so educating patients before discharge is both complex and vitally important. All 48 full-time nurses on the unit were involved in designing, implementing, and evaluating a process for educating patients about medication, organ rejection, complications, lifestyle adaptation, and other issues. “what i’m so proud of is that the nurses led this interdisciplinary approach,” says ron Keller, r.n., m.P.A., director of nursing, surgical services. The nurses of 14 west shared another honor, the Quality improvement Award, with the surgical nursing service as a whole, under Keller’s leadership.

Karen beltran, r.n., m.s.n., won the Professional staff excellence Award for overall performance. beltran has spent her entire 15-year career on 14 west. having attained the highest level on the clinical ladder, she has chosen to remain at the bedside as senior nurse clinician.

The nursing leadership excellence Award went to margaret Frank-bader, r.n., m.A., nurse manager, a 19-year veteran of 14 west, who has been instrumental in strengthening the quality of the nursing staff. People waiting for a transplant go through a near-death experience, she explains, “and the nurses go through that with them. Then we see the miracle when an organ becomes available. we see miracles every day.”

Ron Keller, R.N., Karen Beltran, R.N., and Margaret Frank-Bader, R.N., who shared the Evidence-Based Nursing Practice Award with all 48 full-time nurses on their unit.

Kevin Hannifan

Dr. Fritz Francois

Dr. Mary Ann Hopkins

Dr. Georgeann McGuinness

Dr. Vicky OrtDr. Michele Pagano

Dr. Mel Rosenfeld

Margo Amgott

Drs. Jessica and George Foltin

for the recorD

n e w s & v i e w s

organ donors,” says lewis r. goldfrank, m.d., chairman of the department of emer-gency medicine at nYU and bellevue hospital Center, “but there’s no mechanism to allow their wishes to be fulfilled.”

The vast majority of donor organs come from hos-pital patients declared brain dead, whose organs are preserved while consent is sought from their next of kin. There are nearly 35 times as many cardiac deaths — some 350,000 a year — as there are neurological deaths, dr. goldfrank explains, but none of those who die of cardiac arrest in the field become donors because there is no system in place for preserving the function of their organs outside the controlled setting of a hospital.

A project spearheaded by dr. goldfrank could alter the equation. Under a plan devised by bellevue hospital, new York City’s emergency medical service (ems), and the new York Organ donor network, an Organ Preserva-tion vehicle (OPv) would transport deceased victims of cardiac arrest to bellevue if they were under the age of 65, met certain health criteria, and were within 20 min-utes of the hospital. while the victim’s next of kin were

(continued from page 1)that others may liVe

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never think of leaving. now that kevin hannifan is on board, how does your job shift? Once Kevin totally familiarizes himself with the hospitals, i’ll be free to focus on developing new strategies. right now we’re finalizing our 10-year stra-tegic roadmap. This will incorporate development and growth of our five strategic areas: cancer, cardiovascu-lar disease, children’s services, musculoskeletal care, and neuroscience. Our biggest needs are money and space, both related to our aging infrastructure. we’re striving to become more patient-centered, and more physician- and staff-friendly. What are kevin’s top priorities? Kevin is a very ex-perienced operational executive. my vision is that we transform ourselves into an extremely efficient hospitals Center that delivers excellent clinical out-comes and superb patient-centered care. To that end, workflow is critically important. One of Kevin’s chief responsibilities will be to implement key recommenda-tions made by Price waterhouse Coopers in their 2007 assessment of the medical Center. we know that our patient length of stay, particularly on our medicine service, exceeds national benchmarks. we hope to improve patient outcomes and decrease length of stay while we reduce expenses and increase bed capac-ity. i’ve also asked Kevin to study the best means of expanding the size of Tisch’s emergency department (ed), using a phased approach. To become more re-sponsive to patient needs and maximize our resources, we’re studying what it means to become a seven-day patient care institution.so far, kevin, what impresses you most? i’ve been most impressed by the welcome i’ve received from every-one. i had heard about nYU’s family spirit and i’ve been fortunate to experience it firsthand. i’m also very impressed with people’s understanding and support of dean grossman’s vision. everyone seems to be ener-gized and working toward making it a reality.

“All of us are here to take care of patients, directly or indirectly. we should never forget that.”you’ve spent the better part of your professional life here, Dr. Birnbaum. how does that help you in this job? i have a substantial advantage by having trained at nYU, left, and come back. i’m familiar with our capa-bilities, but at the same time i’ve worked at another excellent academic medical center, the University of Pennsylvania. That gives me a better understanding of what we can do to raise the bar. i think most people really appreciate having a leadership team that is set-ting a clear direction and moving in that direction.how does your background in radiology help you to see things differently? A radiologist is essentially a physi-cian’s physician. we touch care throughout the institu-tion. my background also helps me appreciate the role and importance of technology. As the medical Center becomes more iT-integrated, it’s enormously helpful to grasp the strengths and limitations of information technology.What can employees do to help? every employee has a particular role in the organization, and being supportive and respectful of one another, regardless of position, is the cornerstone. it not only shows to

(continued from page 1)making patients the center of it all News & Views is published for nYU langone medical Center by

the Office of Communications and Public Affairs. readers are invited to submit letters to the editor, comments, and story ideas to: thomas.ranieri@nyumc.org.

NYU laNgoNe Medical ceNter

rOberT i. grOssmAn, m.d. Dean & cEo, Nyu langone Medical center

hArOld s. KOPlewiCz, m.d. Senior Vice President & Vice Dean for External Affairs

mArilYn l. CAsTAldi interim Vice President, communications & Public Affairs

FrAnK w. lOPez, Director of Publications

News & Views

ThOmAs A. rAnieri, Editor

mArJOrie shAFFer, Science Editor

r.h. design, Art Direction

Copyright © 2008 new York University. All rights reserved.

contacted, his or her organs would be preserved, thereby giving the family time to consider organ donation.

The project, funded by a $1.5 million, three-year grant from the federal health resources and services Adminis-tration (hrsA), was inspired by data from spain, where a law allowing organ preservation in the field, known as un-controlled donation after cardiac death (UdCd), has con-tributed to the highest organ donation rate in the world. in this country, the impact would be enormous. each of the 22,000 potential UdCd donors could save multiple lives. in new York City, for example, the donor pool could increase by as much as 13 percent or more, according to Fred selck of the new York Organ donor network.

but first, the grant recipients must address some significant issues. Among them are social, cultural, and ethical concerns about whether the medical profession has the right to preserve the organs of a deceased person without immediate family permission, and public fears that the efforts to resuscitate a victim might be compro-mised by the presence of an organ preservation vehicle. A rigorous protocol has been established, explains nancy n. dubler, l.l.b., director of the division of bioethics at montefiore medical Center, who is a co-investigator and ethics consultant for the hrsA grant.

emergency medical technicians (emTs) and para-medics generally try to resuscitate a patient in cardiac arrest for at least 30 minutes. The patient’s electrocar-diogram is interpreted with assistance from the ems command center, where a physician makes the final determination of death, at which time resuscitation ef-forts cease. Only after determination of death has been made would the command center decide whether to dispatch the OPv, unbeknownst to the paramedics. even after arriving on the scene, the specially trained OPv team would wait five minutes before acting — to ensure a clear demarcation between efforts to save a life and efforts to preserve organs.

if a family member were present and gave consent, explains dubler, only then would the body be moved to the OPv, where blood thinners and other fluids would be administered and an automated chest compression device would be applied en route to bellevue. if no fam-ily member were present, an organ donation counselor would try to contact the next of kin. if consent for the donation could not be obtained within five hours, the body would be taken to a funeral home or the morgue, as would routinely be the case.

“we are conducting focus groups with community and religious groups, as well as with legal and health-care representatives,” dr. goldfrank emphasizes. “if we do not get the substantial public support essential to assure confidence in our healthcare commitment to all, we will not proceed with the project.”

Helping to Heal the WorldOne life lost, Four Futures Found

Will families, in shock from the sudden death of a loved one, understand the true intent of new york city’s proposed organ donation project? susan terman of tenafly, new jersey, who lost her husband in may 2006, thinks they will. Bruce terman, ph.D., 53, an internationally renowned cancer researcher at einstein college of medicine, had just left home for a jog when he was struck by a car. having sustained massive head injuries, he was pronounced dead and taken to hackensack university medical center, where he was placed on life support while his wife was contacted. after summoning Bruce’s brothers and consulting with her rabbi, susan decided to donate her husband’s heart, liver, and kidneys.

“We felt that donating Bruce’s organs was an extension of his life’s work — medical research to save lives,” says terman. “his organs saved four lives, and it gave some meaning to this tragedy. in the jewish religion, we believe that saving even one life helps to heal the world — what we call tikkun olam. once people understand what this project is all about, i think they will support it. Who would not want to help heal the world?”

Dr. Bernard Birnbaum, chief of hospital operations, tours HCC 13 with Kevin Hannifan, new senior vice president, Tisch Hospital and Rusk Institute

What’s the Bright iDea? now you can share it.

if two heads are better than one, imagine what two thousand or more could accomplish. recognizing that collaborative thinking often solves problems more effectively than individual expertise, Dean & ceo robert i. grossman, m.D., recently launched the idea forum, an internal online discussion board. By encouraging employees to express opinions, share ideas, and put in their two cents, he aims to help the medical center become a better place for patients and employees alike.

in the week after its launch, the site logged more than 5,500 visits, with questions and suggestions on some 45 topics — from ways to welcome new employees to improving recycling to refining the electronic medical records system. in many cases, suggested measures, such as replacing older stretchers with modern equipment and expanding the cafeteria menu, are already under way. other ideas, such as providing easier access to electronic payroll information, were implemented immediately. still others require further consideration and study.

the idea forum builds on the “listening rounds” introduced last year. through visits to various departments by leadership, employees — especially those providing clinical care — are given the opportunity to share their concerns and observations about issues with which they have intimate, firsthand knowledge.

“i’ve been impressed with not just the interest in sharing ideas,” says Dr. grossman, “but also the constructive spirit in which people have approached these new forms of dialogue.”

To access the idea Forum, visit http://forum.med.nyu.edu.

our patients, but translates into better patient care. There’s a lot of planning under way to improve the patient experience at nYU. essentially, all of us are here to take care of patients, directly or indirectly. we should never forget that.