Outlook Newsletter Summer 06 - Upstate Medical University · Hodge, chair of neurosurgery; and Dr. Jeremy Shefner, chair of neurology. Lay people like myself marvel at these masters

OutlookOutlookUpstate

At brain-powered

SUNY Upstate,teams of

neurosurgeons,neurologists,

psychologists,scientists,

nurses and others

decipher,heal and harness

our mostintriguing

organ.

IT TAKESONE TO

KNOW ONE

OutlookNews on education, biomedical research & health care at SUNY Upstate Medical UniversityVolume 6, Number 2 Summer 2006

The Brain

The Brain

TheBrain

On His Watch

While maintaining Upstate’s unflinching focuson superior patient care, PresidentGregory Eastwood brought the

best principles of the business world tothe practice of medicine and kept theuniversity centered – and on sound financial footing – through times of unprecedented flux.

With his trademark grace, unflappablecalm and wry humor, Dr. Eastwood guidedthis university through its most challenging years, while steadilyexpanding its clinical,research and educationalenterprises. On hiswatch, the annualbudget has grownfrom $325 millionto more than$700 million.The endow-ment hasincreasedfrom $25 to$64 million,and externalresearch funding from $15 million to aprojected $40 million in 2007,with Upstate nowleading all SUNY campuses in researchgrowth.

Across the campus stand monuments to his leadership:the spectacular Institute for Human Performance,

the Health Sciences Library, the soon-to-becompleted Setnor Academic Building and

soon-to-be constructed East Wing expansion of University Hospital, topped

by the crown jewel of his presidency – the Golisano Children’s Hospital.

For Central New York at large, Dr. Eastwoodhas been a revered symbol of our community’sprowess in higher education. He has likewise

been a catalyst for expansion of our culturalresources. Across the nation, he’s been

highly visible, as president of theAssociation of Academic Medical

Centers and a measured, trusted voice in the politics

of medicine. But first and foremost,

Dr. Eastwood has beena committed physicianand scientist, a deeplyethical man, a teamplayer, and an inspir-ing role model forthose who study, trainand work at Upstate

Medical University. It has been an honor

to serve on his watch,and we wish Dr.

Eastwood, and his gracious family, Godspeed.

G R E G O R Y L . E A S T W O O D , M . D .

Presidential Perspective

He arrived at SUNY Upstate Medical University in 1993,

when the disparate cultures of medicine and commerce threatened to collide.

2 S U N Y U p s t a t e M e d i c a l U n i v e r s i t y O u t l o o k SUMMER 2006

Presidential Perspective

Taking the BatonD A V I D R . S M I T H , M . D .

The incoming president ofSUNY Upstate MedicalUniversity is a pediatrician

whose first assignment – at acommunity clinic on the Texas-Mexico border – taught him “the difference between healthand medicine.”

Working for the NationalHealth Service Corps inBrownsville, Tex., David R.Smith MD recognized that his patients most challengingproblems were more societal thanmedical, according to a profile in MedHunters magazine.

That distinction changed thedirection of Smith’s career, steer-ing him toward posts that influ-ence public health policy as wellas medical care delivery. “I knewthat I could do more by changingthe way things were done,” he explains.

National ProminenceSmith most recently served as chancellor of Texas

Tech University, a system with 31,000 students and abudget of almost $1 billion. Under his leadership, thesystem saw unprecedented growth in enrollment, studentquality and fundraising. Innovations included the devel-opment of the nation’s first four-year medical school onthe U.S./Mexico border and a geriatric program with a“teaching nursing home.”

En route to his position as chancellor, Smith served asmedical director of the Brownsville Community HealthCenter; a deputy director with the Department of Healthand Human Services in Washington DC; and senior vicepresident and CEO of Parkland Memorial Hospital in

Dallas. One of Smith’s initiativesthere – moving primary caredelivery out of the emergencydepartment and into the community – earned a chapter in Bill Moyer’s 1993 book,Healing and the Mind.

Smith also served as TexasCommissioner of Health, anagency with a $7 billion annualoperating budget. In addition tocampaigning for childhood vaccinations and folic acid forpregnant women, Smith was theplaintiff in the state’s landmarkcase against the tobacco industry.

Texas won a $17 billion settlement in that case.

He also served for five years as president of the Texas TechUniversity Health SciencesCenter and Dean of the Schoolof Medicine and Graduate

School of Biomedical Sciences. An Ohio native, Smith is said to “carry himself with

the air of a Texan. He has a warm handshake and awarmer heart.”

HomecomingSmith and his wife, Donna Bacchi MD, a New York

State native, pediatrician – and equally adamant publichealth advocate – met as undergraduates at CornellUniversity. “So in a way,” Smith said, “coming back toNew York is like coming home.”

Speaking briefly at Upstate when his appointment was announced, Smith said he prefers to be called Dave,and listening more than speaking. “I believe that’s why we have two ears and one mouth,” he said.

Smith will assume the Upstate presidency onSeptember 1.

SUMMER 2006 S U N Y U p s t a t e M e d i c a l U n i v e r s i t y O u t l o o k 3


Table of Contents

Our second issue on the brain features more of the enormous brainpower within the walls of thisacademic medical center.

Here at SUNY Upstate MedicalUniversity, we take great pride in the contributions made by our neuroscience teams and by physician/scientists such as Dr. Robert King,professor emeritus; Dr. CharlesHodge, chair of neurosurgery; and Dr. Jeremy Shefner, chair of neurology.

Lay people like myself marvel atthese masters of the brain and theirknowledge, skill and unyielding pursuit of excellence. When one considers the vital role of the brain,spinal cord and peripheral nerves, we soon realize the critical importanceof safeguarding what is collectivelycalled the nervous system.

This Outlook continues the journeyof exploring and understanding thisintriguing puzzle and sharing advance-ments in the treatments of braininjuries, diseases and disorders. It isno wonder that, when we describesomething relatively easy to compre-hend, we say ‘it’s not brain surgery.’

–Ronald R. YoungPublisher and Vice President for Public and Governmental Affairs

From the Publisher

Summer 2006

P U B L I S H E RRonald R. Young

Vice President, Public andGovernmental Affairs

E X E C U T I V E E D I T O R SDarryl Geddes

Director, Public and Media Relations

Melanie RichDirector, Marketing and

University Communications

E D I T O R - I N - C H I E FDenise Owen Harrigan

D E S I G NSusan Keeter

P H O T O G R A P H YSusan Kahn

pages 4, 14, 15, 25, 26Robert Mescavage

pages 10, 11, 13, 16-20, 22Deborah Rexine

page 2Upstate Outlook is published

by the Offices of Public Affairs and Communications.

SUNY Upstate Medical University inSyracuse, NY, is an academic

medical center with four colleges –Medicine, Nursing, Health Professionsand Graduate Studies – as well as anextensive clinical health care systemthat includes University Hospital andnumerous satellite sites. Affiliated

with the State University of New York,SUNY Upstate is Onondaga County’s

largest employer.

For more information, visit us online at

www.upstate.edu or phone us at 315-464-4836.

For corrections, suggestions and submissions, contact

Denise Owen Harrigan, 315-464-4822 or e-mail [email protected]

For additional copies, call 315-464-4836.

Upstate Outlook offices are located at 250 Harrison St.,

Syracuse, NY 13202

O N T H E C O V E RA N D A B O V Eimages.com/Corbis

What Lies Within?With new insights and revolutionary imaging, University Hospital’s brain experts tackle brain trauma and disease, while guarding the brain’s critical functions. Page 5

Striking BackPrestigious Stroke Center status awarded by the New York State Department of Health confirms that University Hospital treats stroke with the urgency of trauma. Page 9

Brain TrustIt takes teams of SUNY Upstate scientists – and decades of research – to stake out and investigate certain territories in the brain. Page 14

The Concussion CrusadeUniversity Hospital psychologist Brian Rieger PhD continues to gain ground on concussion, with coordinated clinical services and an ambitious awareness campaign. Page 17

Change of CourseAn immediate demand for ALS care helped steer Neurology Chair Jeremy Shefner MD/PhD from research lab to clinic. It also inspired him to create an ALS clinical trials research consortium of 60 centers in the Northeast. Page 20

OutlookOutlookUpstate

Academic Medicine


This is the riddle used by Louis Pellegrino MD,University Hospital neurodevelopmental pediatrician, topunctuate his presentations on brain plasticity. It breaksthe ice beautifully. It also foreshadows the remarkablecomplexity of the organ under discussion, for the humanbrain is the seat of medical problems such as insomnia;cognitive disorders such as dyslexia; and higher-level reasoning skills, such as an agnostic’s quest to provethere is no god.

The multitasking brain is also the organ often invadedby tumors, debilitated by strokes, rocked by seizures,flooded by hemorrhages and confused by concussion. Inother words: profoundly vulnerable to illness and injury.

At University Hospital, it is a daily challenge toaddress these medical problems without compromisingthe brain’s critical functions.

“Think of the brain as a Monopoly board, with high-and low-priced properties,” suggests Associate Professorof Neurosurgery Gregory Canute MD. “The areas thatcontrol speech and movement are examples of prime real estate. We constantly weigh the risks of losing thesefunctions against the benefits of treating brain disease.”

The Last FrontierIn the 1970s, Nobel Prize laureates predicted that

brain research would be the ultimate intellectual challenge in the last quarter of the 20th century.

But when Dr. Eric Kandel won the 2000 Nobel Prizefor his work on learning and memory, he said the brainwas far from understood. “The danger is that we’re atthe foot of a mountain range that people think we’vealready scaled,” he said. “It’s a huge mountain. It’s goingto take a century.”

“While central questions remain, our understanding ofthe brain has increased dramatically in the past severaldecades,” notes Charles Hodge MD, professor and chairof neurosurgery at SUNY Upstate. “When I was a resi-dent, neurosurgery was considered a pioneering field.You were lucky to leave the hospital alive after surgery

Q:

A:

What do you get when you cross an insomniac, an agnostic and a dyslexic?

Someone who’s up all night worrying if there’s a dog.

continued on page 6

The more we learn, the more questions we raise.

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for a major hemorrhage or braintumor.”

Hodge believes the most profoundadvance is awareness of the brain’splasticity. “The brain not only controls behavior, behavioral feed-back controls some aspects of brain structure,” he explains.

“The brain is a machine designedto learn. It’s softwired (plastic)rather than hard-wired,” accordingto a recent article in The New YorkTimes. “Whenever you learn something new, new neurologicalconnections are believed to form.”

WindowCredit for insights into brain

plasticity is due largely to advancesin brain imaging.

“For most of history, the idea ofwatching the mind at work was asfantastical as documenting a ghost,The New York Times article contin-ues. With X-rays, CT scans andmagnetic resonance imaging (MRI),“You could break into the hauntedhouse, but all you could find wouldbe the house itself, the brain’s architecture, not its occupant.”

But the latest neuroimaging toolssuch as functional MRI – fMRI –have finally captured this elusiveghost – the brain in action.

Imaging RevolutionProfessor Emeritus Robert King

MD, Upstate’s neurosurgery chairfrom 1957 through 1996, remembers when there was little

technology to light his path. “As neurosurgeons, we knew

much less about the areas we wereentering and the changes we wereinducing,” he explains. “You had tosurmise which elements of the brainwere not to be invaded. Today, neu-ronavigational tools help you knowwhen to stop and when to go. Thesetools keep extending what can beaccomplished.”

“Neuroimaging is exploding,”reports Kent Ogden PhD, a medicalphysicist in University Hospital’sDepartment of Radiology. “In thepast 35 years, the diagnosis – andtreatment – of brain disorders hasbeen revolutionized by the develop-ment of computed tomography

The Brain – continued from page 5


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(CT), magnetic resonance imaging(MRI), fMRI, PET, SPECT,angiograms and more.”

What Lies BeneathArmed with these images, neuro-

surgeons now approach procedures– such as tumor removal and hem-orrhage repair – with far greaterprecision. During the surgery itself,they can move a wand over thepatient’s head and ‘see’ on a com-puter screen what lies beneath theskull. They can also refer to fMRIscans, which identify the function,such as speech or movement, of specific brain tissue.

When these images are combined,the benefits are exponential.

“Today, the biggest trend is multi-

modal imaging – fusing the datafrom the various technologies into asingle set of images,” explainsOgden. Pointing to a vivid image onhis computer monitor, he zeroes inon an area that is the likely sourceof a patient’s epilepsy (above left,page 4). “In this image, we’ve com-bined the data from an MRI scan,which shows anatomical landmarks,and a series of SPECT scans, whichshow where the metabolism is high-er during seizures,” he says. “Theincrease in activity helps pinpointthe source of the seizures – andguides the neurosurgeon performingresection.

“The benefits to the patient aretremendous,” says Ogden.

Access PointIn addition to more accurate

diagnoses, the new imaging opensthe door to less-invasive treatmentoptions, such as Gamma Kniferadiosurgery, or surgery without ascalpel. Since the year 2000, 1,500University Hospital patients havehad computer-guided, ultra-preciseGamma Knife treatment for hard-to-access brain tumors and otherneurological conditions.

The Experience FactorNo matter how advanced the

technology, experience is the mostcritical factor when dealing withbrain disease and disorders.

At University Hospital, highlyexperienced health care profession-

“Think of the brain as aMonopoly board, with high- and low-priced property. Theareas that control speech andmovement are prime real estate.We weigh the risks of losingthese functions against the benefits of treating the disease.”

–Gregory Canute MDassociate professor of neurosurgery

continued on page 8


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als work in interdisciplinary teamsto tackle complex conditions, suchas brain tumors, Lou Gehrig’sDisease (ALS) and even concussion– a “mild brain injury” with potentially severe consequences.

To strike back against stroke – the nation’s second leading cause ofdeath – University Hospital hasdeveloped a stroke response teamthat’s alerted the minute the patientarrives in or is reported en route tothe emergency department. Its seam-less delivery of stroke interventionrecently earned University Hospitalthe prestigious designation “StrokeCenter” from the New York StateDepartment of Health. In CentralNew York, only University Hospitalholds this designation.

Uncharted TerritoryDespite major advances, those

who study the brain or treat brain-

related disorders agree: the more welearn, the more questions we have.

Thirty years ago, these endlessquestions prompted King to buildtwo years of bench research intoUpstate’s five-year neurosurgery residency. Most of the nation’s academic medical centers have since followed his lead.

“My own lab experience madesuch a difference in my understand-ing of the nervous system,” Kingexplains. “The research makes residents much more secure withuncertainty. In a laboratory, it’s allabout uncertainties. Your research is primarily a vehicle for learning to ask better questions.”

The Research FactorLong beyond their residencies,

Upstate’s neurosurgeons continuetheir research, in labs now locatedin the Institute for Human Perfor-

mance on Irving Avenue, adjacent tothe main SUNY Upstate campus.Hodge and his research team, forexample, continue their investiga-tion of cortical plasticity – thebrain’s remarkable ability to repairitself. Their studies focus on thebrain’s motor and sensory realms.But Hodge predicts even greaterplasticity in the executive and associative areas.

Hodge considers his laboratoryresearch – and the clinical trials itinspires – both a responsibility anda privilege. “As neurosurgeons,” he says, “we are the only group that is able to directly handle thehuman brain, to understand the disastrous consequences of manyneurological diseases and to bringmodern biological findings to theoperating room.” �

The Brain – continued from page 7

Functional magneticresonance imaging(fMRI) captures specific brain activity,whereas x-rays and CT scans reveal only brain architecture.

Sometimes bad news leads to good news.

In response to reports that Onondaga County has

the second highest stroke mortality rate in New York State,

University Hospital resolved to strike back at stroke with

all its resources.

Striking Back at Stroke

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Stroke – continued from page 9

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Now its efforts have earned theprestigious designation “StrokeCenter” from the New York StateDepartment of Health. UniversityHospital, the only Central NewYork Hospital with this stroke status, has also received the 2006Specialty Excellence Award forStroke Care from Health Grades,Inc., a leading healthcare ratingsorganization. The award ranksUniversity Hospital’s stroke carewith the top 10 percent of hospitalsnationwide.

But University Hospital is farfrom finished with its assault onstroke – the third leading cause ofdeath and the leading cause of dis-ability in the US. Stroke educationand prevention especially requiremajor attention.

Spread the WordMisinformation is the greatest

barrier to timely stroke intervention,according to neurologist Tarak

Ramachandran MD, stroke directorat University Hospital.

“There seems to be a nihilistic attitude that nothing can be done forstroke,” he says. In fact, organizedstroke care already results in a 21percent reduction in early mortality,18 percent reduction in 12-monthmortality and decreased stays in hospitals and rehabilitation centers.

Studies show that nurses are themost proactive about sending familymembers with stroke symptoms tothe hospital. The general public isprone to delay, misunderstandingstroke symptoms or believing that damage to brain tissue is irreversible.

Three-Hour Window“We need to treat stroke with the

urgency of trauma and spread theword that time is of the essence,”insists Ramachandran. “Certaininterventions must begin withinthree hours of symptom onset.”

“We need to treat stroke with the urgency of trauma.”–Tarak Ramachandran MD

Tarak RamachandranMD, stroke director at

University Hospital

Stroke Warning Signs


F a c eDoes the FACElook uneven? Ask the person to smile.

A r m sDoes one ARM driftdown? Ask the personto raise both arms.

S p e e c hDoes their SPEECHsound strange? Askthe person to repeat a simple phrase, like“The sky is blue.”

T i m eIf you observe ANY of these signs, it’sTIME TO CALL 911!Credit: MA Dept. of Health.

Act FAST! Call 911 at any sign of stroke:

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Often the public does not recognize stroke symptoms, saysRamachandran, citing a recentreport that fewer than five percentof patients who could benefit fromtimely stroke therapy receive thattreatment, simply because theyarrive at a hospital too late.

Clot BusterMore than 80 percent of strokes

are caused by blood clots which disrupt the flow of oxygen to thebrain. Many of these ischemicstrokes can be treated with tissueplasminogen activator (tPA), anenzyme which dissolves blood clots.But tPA must be administered with-in three hours of symptom onset.

A second type of stroke – hemor-rhagic strokes – cause bleeding inthe brain and are not appropriatefor tPA. But they may often be treat-ed by a neurosurgeon, with surgicalclipping or endovascular coiling.

Ready and WaitingDiagnosis of ischemic or hemor-

rhagic stroke requires a hospitalwith a CT scanner and a coordinat-ed stroke protocol. UniversityHospital’s multidisciplinary stroke

team follows a protocol developedby the National Institutes of Health.

Members of the stroke team evaluate patients within 10 minutesof arrival at the hospital and begin a CT scan with 25 minutes, todetermine if the stroke is ischemic or hemorrhagic. Within one hour ofarrival at the hospital, the appropri-ate patient is cleared for tPA.

FAST ResponseWith its clinical response aligned,

University Hospital is reaching outto educate the community aboutstroke symptoms and the need for a FAST response (see page 8).

“We want to inspire the samesense of urgency that people associate with chest pain,” explainsUniversity Hospital’s stroke coordinator Rochele Clark RN.

“Stroke symptoms, like facialdroop and slurred speech, tend to bevague,” she says. “People often laydown to see if the symptoms goaway. The average person waits 22 hours before seeking medicalattention for stroke.

“But a stroke is a medical emergency,” Clark insists. “You need to call 911 right away.”

Rochele Clark RN,stroke coordinator

Strokeepidemiology*Stroke is the third leading cause of death and the leading cause of adult disability in the US.

� 50 percent of stroke deaths occur before reaching the hospital.

� Stroke mortality is higher for women (61 percent) and African Americans (87 percent male, 78 percent female).

� Onondaga County has the second highest stroke mortality rate inNew York State (55.5 per 100,000 vs. the NYS average of 38.4)

*Epidemiology is the study of disease cause, control and distribution in specific populations.

Ready &

Waiting

University Hospital's immediateresponse stroke team includesan emergency department

physician and nurses, neurologist,neurosurgeon (as needed), radiologist,CT scanner technician and administra-tive supervisor, all prepared to respondwithin minutes of a patient’s arrival at University Hospital.

After patients have been diagnosedand admitted, the stroke team expandsto include certified neuroscience nurses(AANN), physical therapists, occupa-tional therapists, speech therapists and others.

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Once stroke patients receivethe necessary medical andsurgical care, the focus

turns to damage caused by oxygen-deprived brain tissue. The mostcommon deficits include speech,motor and memory problems –addressed at University Hospitalthrough intensive regimens of physical, cognitive, speech and other therapies.

Stroke rehabilitation accounts forabout 20 percent of patients treatedin University Hospital’s Acute BrainInjury Rehabilitation Program on 2 North.

Rehabilitation is very function-oriented, according to Cenk PekisMD, assistant professor of medicineand rehabilitation. “Our goal is tofind functional solutions for patientswho are impaired or disabled – andto get patients back home or back towork.” For example, a patient withweakness on one side of the bodymay learn to stand with special

devices and walk with assistance. Pekis says the role of the rehabili-

tation physician is to “orchestrate a large circle of professionals –physical, speech, cognitive andrecreational therapists; counselors;educators; nurses; and even therapydogs – whatever helps and motivatespatients to adapt to their limitationsand disabilities.

“Physical rehabilitation is a teamsport – it’s very democratic, inter-disciplinary, labor-intensive – andcostly,” Pekis adds. “We bring inwhatever medical professionals can help patients adapt to their limitations and disabilities.

“It used to be considered dogma, that brain tissue could notbe repaired or replaced,” he says.“But this is no longer valid. Cortical function is very complex.Recovery is not black and white, it’s measured by degrees. But intensive therapy can lead to functional improvement.”

A F T E R S T R O K E

ever

estA Better

Way?

Eagerly anticipated atUniversity Hospital isa clinical trial thatmay help strokepatients recover moremotor function afterstroke damage.

The EVEREST multicenter stroketreatment trial tests the use ofimplanted electrical brain stimula-tion with rehabilitation therapy,to see if patients develop bettercontrol of stroke-damaged upperextremities.

The trial, led at Upstate byNeurosurgery Chair CharlesHodge MD, involves implantationof an electrical pulse generator inthe cerebral cortex. According toHodge, “This is an important sitefor neuroplasticity – a process of reorganization in which newareas of the brain take over the function of brain-damagedareas.”

Previous studies have establishedthat cortical stimulation therapyis safe and more effective inincreasing motor function thanrehabilitation alone.

Patients who receive the implantwill also undergo six weeks ofphysical therapy. Control grouppatients will receive therapy only.

The Upstate trial exemplifies theinterdisciplinary nature of strokecare at University Hospital, with a research team that includesCharles Bradshaw PhD, neuro-psychologist; Margaret Turk MDof Physical Medicine andRehabilitation; Michael VertinoMD, neurologist; and LorrainePadden CNRN, ANP, study coordinator.


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Only a small fraction ofstrokes require interventionby a neurosurgeon, but that

hasn’t stopped University Hospitalneurosurgeon Satish KrishnamurthyMD from rallying the community tostrike back at stroke.

In 2003, Krishnamurthy agreed tochair the CNY Regional Stroke TaskForce, assembled by the AmericanHeart Association.

His motivation? “Better strokecare for our community. At thatpoint, Onondaga County had thesecond highest stroke mortality rate in New York State and no standardized stroke care.”

At 7 a.m. monthly meetings, the task force first identified deficitsin local stroke awareness and care.The group gathered strength asKrishnamurthy recruited his peers at other hospitals and stroke-relatedorganizations.

“Our first question,” he reports,“was why are so many people dyingfrom stroke?

“It turned out that close to 50percent of mortality was related tonot getting to the hospital in time,”he says. “People do not recognizethe severity of stroke symptoms or the importance of prompt intervention.”

But local hospitals also needed tofine-tune their stroke response.

University Hospital, the region’sLevel 1 trauma center, was first tomobilize its stroke response teamand earn certification by the NewYork State Department of Health.

Now it’s helping other local hos-pitals develop their stroke protocols.

“We need to approach this prob-lem not as competitors, but as onegiant hospital meeting this commu-nity’s serious need for stroke care,”Krishnamurthy says.

“Stroke is a problem that requireslots of resources, lots of attention,”he adds. “But there’s so much syner-gy and enthusiasm in this group. It’sthe most exciting thing I’ve done inthis community.”

Krishnamurthy believes that education is key to effective strokemanagement – and that physiciansmust be the most adamant educa-tors. “We have to warn our patientswho are at risk of stroke from obe-sity, diabetes, smoking, hypertension– and age. Age-related stroke is anepidemic just waiting to happen.”

Krishnamurthy is encouraged bythe medical community’s evolutionfrom reactive to proactive strokeresponse. “This generation is moving from treating stroke afterit’s happened to addressing theproblem before it happens, which is how it should be.”

“We need to approach this problem not as competitors, but as one giant hospital meeting

this community’s serious need for stroke care.”

SatishKrishnamurthyMD, Associate

Professor ofNeurosurgery

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E L U S I V E O R G A N

It takes one to know one. Never was this more true than in

the realm of brain research, where it takes decades of investi-

gation – and an almost unfathomable understanding of

medical science – to decipher the workings of this intricate organ.

That’s why SUNY Upstate assembles entire teams – of neurosurgeons,

research scientists, residents, doctoral and postdoctoral students,

lab technicians and lab assistants – to tackle the questions posed

in its brain research laboratories.

Brain TrustResearch Realm



Research Realm

In Upstate’s Brain TumorLaboratory, there is a sense of quiet urgency, inspired by

the glioblastoma multiforme braintumor (GBM).

“It’s the most lethal tumor knownto man,” according to the lab director and Associate Professor ofNeurosurgery Gregory Canute MD.Every year he surgically removes 50 to 60 GBM tumors, but the standard treatments – surgery plus radiation and chemotherapy –“don’t work very well,” Canutereports. “Almost all patientsdie within a year of diagnosis.”

In the U.S., about 9,000patients a year are diagnosedwith GBM. In patients age15 to 34, GBM is the thirdleading cause of cancer death.

Since 1993, Canute and hisresearch team have been

studying the molecular characteris-tics of GBM tumors and experi-menting with agents that mightthwart their growth. Several of theirstudies have led to clinical trials.

Recently the lab has been focusedon the monoclonal antibody cetux-imab, which has been approved foruse against colon cancer. It has alsoshown promise, in the Upstate lab’sstudies, in curbing GBM cell growth

and increasing cell death. The lab’s findings – published in 2002 and 2005 in the journalNeurosurgery – have inspired amultisite Phase I clinical trial ofpatients infused with the anti-

body prior to surgery fortumor recurrence.

Patients enrolled in thetrial have GBM tumorswith a genetic mutation –amplified epidermal growth factor receptor

(EGPR) – which seems to make thetumor cells more vulnerable tocetuximab. About 40 percent ofGBM patients – especially olderpatients, with poorer prognoses –have this amplified EGPR.

One of the questions the trial will answer is “Can the antibodypenetrate the tumor?”

“It has big, heavy molecules andis hard to spread outside vessels andpast the blood tumor barrier,”Canute explains. “But we’ve shownit can be done in the laboratory.”

If the drug can reach the tumor,be tolerated by patients and eventu-ally be added to the current GBMregimen, “This could represent ahuge jump forward,” says Canute.“Our standard chemotherapy –BCNU – is theoretically not even close to as effective as this antibody.”

In the Cortical Plasticity Lab, the questions concern the brain’s remarkable ability to

repair itself. For almost four decades,

Professor and Chair of Neuro-surgery Charles Hodge MD has ledstudies identifying the intricacies ofthis self-repair, known as plasticity.

“It is abundantly clear that thebrain and nervous system are notstatic,” Hodge explains. “The factthat we can adapt to new environ-ments and recover function afterbrain injury are indicators of that plasticity.

“As neurosurgeons, we have theopportunity to personally witnesshow the brain responds to diseaseor injury,” he says.

When stroke kills brain cells, forexample, the brain often reorganiz-es, with healthy cells assuming thedead cells’ functions.

In recent laboratory studies –funded by the National Institutesof Health – Hodge and his teamhave demonstrated that certainstimulants alter the brain’s self-repair mechanisms.

“In the lab,” Hodge explains,“we have pretty good evidence that these drugs improve

recovery. They ramp up the brainand stimulate more neurons to fire.Our hypothesis is that such stimulation, plus physical therapy,

will improve long-termoutcomes.”

The next step is a clinical trial to explorethis phenomenon inpatients. Hodge is alsothe principal investiga-

tor on a multisitestroke recovery trialthat employs animplanted electricalbrain stimulatorplus physical

therapy. (See page 12)


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Research Realm

With another NIHresearch grant,Upstate’s vision

research team is tracing thebrain’s ability to process visual input. It is painstakingwork – as demonstrated byNeurosurgery ResearchDirector Daniel Tso PhD,who has been on this research trailfor more than 25 years. His currentstudies build on the work of hisHarvard University mentors: NobelPrize winners David Hubel andTorsten Wiesel. “They made majorinroads into the working of thebrain and the visual cortex,” Tso explains. “As researchers, we all stand on the shoulders ofsuch giants.

“Visual information entering thebrain from the retina undergoes aseries of remarkable transforma-tions,” Tso continues, “includingseparation into channels thatprocess color, form, depth and

motion. Our research concerns the organization and processing of this information.”

Tso and his research teamuse optical imaging to identifyhow and where this process-ing occurs. “When a part ofthe brain is active, it blush-

es,” Tso explains. “Optical imagingcaptures that blushing by measuringchanges in blood oxygenation.”

Tso’s discoveries about the visualcortex have broad implications.“When you look at the neocortex, it all looks rather similar,” he says.“What largely defines the visual,auditory or sensory cortex is theinput it gets from the eyes, ears andskin. Our research should lead to abetter understanding of overall brainfunction and architecture,” he says.“Our insights into disorders of thevisual cortex apply to other diseasesinvolving neuronal connectivity,such as Alzheimer’s and epilepsy.”

Research – continued from page 15

Daniel Tso PhD

R E A D I N G T H E S I G N A L S

Optical imaging analysis of a section of the brain’s visual cortex. Above left: the same section, without optical imaging analysis.


Clinically Speaking

For psychologist Brian RiegerPhD, concussion has become acrusade, fueled by a huge gap

in community awareness and concussion care.

Rieger was enlisted by UniversityHospital to work with brain injurypatients almost 10 years ago, andhas seen – over and over – how aso-called ‘mild traumatic braininjury,’ also known as concussion,can have serious consequences.

“Many people have no idea of the symptoms or how disruptivethey can be,” explains Rieger. “The symptoms wax and wane. The cultural message is ‘You will be fine.’ On the other hand, peoplewho have suffered concussion oftensay, ‘I feel like garbage. I’m reallytired. I feel foggy all the time.Nobody understands.’”

High Alert Fortunately, Rieger understands,

and he’s alerting physicians, coaches,trainers, teachers and others to therealities and dangers of concussion –especially the fact that concussioncan sometimes cause lingering, andeven disabling, symptoms.

Several years ago, Rieger estab-

lished the Concussion ManagementProgram and CNY Sports Concus-sion Center at University Hospital.A team of physicians, psychologists,nurses and physical and occupation-al therapists provides coordinatedconcussion care.

The programs, which diagnoseand treat concussion patients, havedoubled in size in the past year, andremain unique in the region and thestate for focusing specifically onmild traumatic brain injury. The services continue to expand, and the team now includes Neuro-psychologist Dominic Carone PhD,who specializes in the effects ofbrain injury and illness.

Psychology Realm “When I’m out ‘preaching’ about

concussion,” notes Rieger, “audi-ences will ask, ‘What do psycholo-gists have to do with concussion?’

“Concussion causes a chemicalcrisis in the brain and alters its ability to function,” he explains.“Long-term symptoms are oftencognitive and emotional – thingslike anxiety and difficulty concen-trating. These are areas in whichpsychologists specialize.

“Patients arereferred with labelslike ‘lazy’ and ‘irritable.’ Some-times they thinkthey’re crazy,because concussionis such an invisibleinjury,” says Rieger.“They need a lot of reassurance and education.”

Front Lines Yet physicians play a key role in

diagnosing concussion, notes Rieger,who often collaborates with JamesCallahan MD of UniversityHospital’s dedicated PediatricEmergency Department.

“Concussion can be elusive todiagnose,” admits Callahan, anotherimpassioned concussion crusader.“There is no objective test. A CT scan looks normal,” he says.“Concussion is a clinical diagnosis,based on symptoms. Sometimesthose symptoms don’t appear until24-48 hours post-injury. So whenwe discharge patients from theemergency department, we oftenrefer them for follow up by theConcussion Program.”


Brain Rieger PhD

Gaining Groundon Concussion

Clinically Speaking

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Sports cause only a fractionof concussions, yet sportsconcussion gets plenty of

attention, in the media and atUniversity Hospital.

One driving force is secondimpact syndrome, which placesyounger athletes at greater risk,should they suffer a second concussion.

At all ages, repeat concussionsmay take longer to heal and canincrease the chances of lifelongsymptoms.

In recognition of this risk, theNational Federation of State HighSchool Associations passed a newmandate: players with suspectedconcussion must now have physi-cian clearance for return to play.

“It’s not law, but it makesschool districts liable," says Brian Rieger PhD, who has alsoaddressed the NYS AthleticTrainers Association about the perils of concussion.

1 5


Gathering Evidence Because pediatric concussion is

under-researched, Callahan andRieger are collaborating on a clini-cal research study tracking youngpatients’ symptoms for a year afterconcussion. “We know that themajority of adults will recover com-pletely from concussion within twoweeks, but up to 20 percent maystill have symptoms a year afterinjury,” says Callahan. “We don’tyet have statistics on children.”

Rieger is also collaborating withLawrence Lewandowski PhD fromSyracuse University on a studyexamining the academic effects ofconcussion in high school students.Students who still have symptoms ofa concussion are asked to keep trackof symptoms with a personal digitalassistant (PDA).

At What Cost? “When some students return

to school, they have trouble with memory and attention,” explainsRieger. “They get headaches and canget very tired from mental exertion.The PDA helps us to track theirsymptoms over the course of aschool day.

“We can’t just look at what thesestudents force themselves to do,” hesays. “We have to consider the pricethey pay to do it.”

Inside Look Rieger is also working with

Upstate research psychologistWendy Kates PhD and neuro-psychologist Carone to image concussion patients’ brains.The pro-posed study will utilize functionalmagnetic resonance imaging tech-nology in the Institute for HumanPerformance and will be “a huge step forward in our research,”according to Rieger.

TACKL ING SPORTSCONCUSS ION

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“The mandate underscores twokey messages: that it takes medicalexperience to diagnose concussionand that young athletes are moresusceptible – and take longer toheal – than professional athletes.We suspect it’s because their brainsare still developing.”

“In rare cases, the consequencesare fatal,” James Callahan MDwarns. “There is massive brainswelling and nothing we can do to stop it.”

Rieger and Callahan recentlyaddressed local Section III athleticdirectors about second impact syndrome and other potential consequences of concussion.

“Coaches, athletic trainers andstudent athletes were also invited,

to learn about recent findings in head injuries,” reports KarissaGraham (at right), assistant director of athletics with theMarcellus Central Schools. “Dr. Rieger and Dr. Callahan left a strong impression on this group.We’re still receiving compliments about their program.

“As an athletic trainer, I have also referred a patient to Dr. Rieger,” she continues. “The entire family – after months of trying to deal with a concussion on their own – found the program to be tremendously helpful.”


Propelled by a

fascination

with the

physiology

of the brain,

Jeremy Shefner

completed a PhD,

medical degree and

two post-doctoral

fellowships to prepare

for a research career.

But when he was finally

ready to settle into his

own lab, he discovered

a flaw in his plan.

“I missed the patient

contact and the

opportunity to be

immediately useful,”

explains Shefner.

ACUTE NEED FOR ALS CARE

STEERS NEUROLOGY CHAIR FROM

LAB TO CLINIC

Bench toClinically Speaking

Bedside


Jeremy ShefnerMD/PhD, chair,Department of

Neurology

Joining the faculty at HarvardMedical School, the young neurologist tried to tackle both patient care and research, but

he encountered another obstacle:Shefner was increasingly drawn topatients with Amyotrophic LateralSclerosis (ALS) – a challenging andtime-consuming disease to treat.

ALS, also known as Lou Gehrig’sdisease, attacks motor neurons,causing degeneration throughout thebrain and spinal cord – and leadingto paralysis and death.

Diverse Demands“A lot of these patients’ demands

are emotional and social. But I dis-covered I like giving that support,”says Shefner. “I get along well withthese patients. I find it rewarding tomake them more comfortable andfunctional, minimize their suffering,look for ways to extend their lives.”

After establishing an ALS clinicaland research program at Harvard,Shefner was recruited to SUNYUpstate in 1996.

“I came here to develop ALSresources for Central New York,”he says. “There were five major ALScenters in Boston. Creating an ALSprogram here was a real service.Otherwise patients had to go toVermont, Boston or NYC.”

Before leaving Boston, Shefner – aresearcher at heart – established theNortheast ALS (NEALS) Trials con-sortium, to rapidly identify and clin-ically test promising treatments forALS. He currently cochairs NEALS.

Hope Ahead“Patients with ALS are always

clamoring for new drugs and clinicaltrials. With clinical trials, there ishope ahead,” Shefner explains.

“There is no real disease modify-ing treatment for ALS,” he contin-ues. “Only one drug – Riluzole – is FDA approved. It’s not dramatic.It extends life 10 to 20 percent.”

The NEALS consortium nowincludes 60 U.S. academic healthcenters and has conducted four largemulticenter clinical trials. For threeof those trials, Shefner was principalinvestigator or co-investigator.

Shefner is currently involved infive ALS trials that have broughtmore than a million dollars inresearch funding to Upstate. Thesestudies are testing the safety andefficacy of drug compounds thatmay slow the progression of ALS, aswell as respiratory and nutritionaltreatments.

Genetic ConnectionRecent discoveries on the ALS

front include identification of amutation of the SOD1 gene,believed to make a defective proteinthat is toxic to motor nerve cells, aswell as genes that appear to serve asALS markers.

These findings have inspired inincrease in funded studies.

“Given the knowledge we cur-rently have, I believe ALS will some-day be considered a chronic diseasethat can be managed through drugtherapy,” Shefner says.

On the other hand, he notes thatALS is not a lucrative focus for drugdevelopment, since it affects about 5 out of every 100,000 people“More often, ALS appeals to small-er companies or companies lookingto expand use of existing drugs.”

Change in ApproachThe most positive change in ALS

treatment is a change in attitude.

“Physicians take a more active rolein management of the disease. Thepatient’s emotional needs are a bigpart of the practice,” Shefner says.

Under Shefner’s leadership, SUNYUpstate offers one of 33 ALSResearch and Treatment Centersdesignated by the MuscularDystrophy Association.

About 120 CNY patients receivetheir care at the SUNY Upstate center, receiving integrated treat-ment from a respiratory therapist,occupational therapist, social work-er, pulmonologist, neurologist, nutri-tionist, speech and language special-ist and physician’s assistant.

PrognosisShefner concedes that it requires

great patience and persistence totake on ALS. “We have to acceptthat progress toward new treatmentwill be slow and incremental. It’sfrustrating for patients and for me.”

As chair of the Department ofNeurology, Shefner continues hiscampaign to expand research. That’sa real challenge in a communitywhere demand for clinical neurolo-gists is high. “For now, our clinicalfocus is on the complicated diseases:epilepsy, active muscular dystrophy,muscular sclerosis. We also treatstroke, the most common neuro-logical disease.

“We have 12 full-time neuro-logists and four PhDs, as well as 15residents and three neurophysiologyfellows,” Shefner reports. “We needto double our faculty in a marketwhere the supply of academic neurologists is very limited. So we’recompeting with major markets. But we offer neurologists the opportunity I had: the freedom to build their own programs.”


Clinically Speaking

“(Someday) ALS will be...a chronic disease that can bemanaged through drug therapy.”

–Jeremy Shefner MD/PhD


Clinically Speaking

Aneela Darbar MD,sixth-year neurosurgery resident

While women now fill morethan half of Americanmedical schools, women

in neurosurgery remain a rarity. Ofthe nation’s 4,000 neurosurgeons,fewer than 5 percent are female. It’sa rigorous specialty, with a seven-year residency, grueling hours,daunting diseases and relentlessstress. An added deterrent, especiallyfor women, is neurosurgery’s

reputation as not family friendly.SUNY Upstate’s neurosurgery

residency program, however, has areputation as being women-friendly.Thirty years ago, it was the trainingground for one of the first womento enter the specialty: Elisabeth PostMD, now practicing in New Jersey.(SUNY Upstate also traces its rootsto Geneva Medical College, whichgraduated the first American female

physician, Elizabeth Blackwell MD,in 1849.)

Absence of BiasWhen Upstate’s Jennifer Jennings

MD, now a fourth-year resident,looked at Upstate’s neurosurgeryprogram in 2003, she found a“refreshing” absence of bias againstwomen. “I had the sense in myinterview that I would not be treat-ed any differently,” says Jennings.

Clinically Speaking


continued on page 24*motto of the national organization, Women in Neurosurgery (WINS)

Changing the Face of Neurosurgery

One of SUNY Upstate’s female neurosurgery residentshas been enthralled by the brain since she was

a small girl. The other fell under its spell unexpectedly,enroute to a career in primary care.

Both prove that “When women are in neurosurgery,neurosurgery wins.”*


Clinically Speaking

“That was not necessarily the casein other interviews.”

“Being a woman is not an issue in this program,” adds AneelaDarbar MD, a sixth-year resident.“The only issue is ‘Are you compe-tent enough to become a neuro-surgeon?’”

DetourStanford University graduate

Jennifer Jennings decided on acareer in medicine while working as an Americorps volunteer – in aSouth Dakota clinic providing freeprenatal care to homeless women.

“I assumed it would be primarycare,” says Jennings, “until my neu-rosurgery rotation in my third year.

“I loved the intricacy of the sur-gery and found the nervous systemfascinating,” she explains. “I knewit wouldn’t be an easy specialty. Out of 200 students in my medicalschool, at the University of Texas atSan Antonio, I was the only personto choose neurosurgery. My parents– my father is a computer program-mer and my mother, a preschoolteacher – are still trying to makesense of my decision. ”

Jennings describes her interviewsfor a neurosurgery residency as“daunting” – until she visitedUpstate and found its program bothwelcoming and highly ranked, with“a strong chair, a wide variety ofcases, the latest minimally invasivetechnology and a neuro-intensivecare unit.”

For Darbar, the path to neuro-surgery had other major obstacles.She is a graduate of a foreign med-ical school – Dow Medical Collegein Karachi, Pakistan – and from a

culture that is more restrictive for women.

“Everyone at home challenged my dream of becoming a neuro-surgeon,” says Darbar, who, as a young girl, amused herself bysculpting PlayDough® models of the brain.

Gray Area“I have always been fascinated by

the novelty and mystery of the brainand its diseases,” says Darbar.“There is so much gray area – so many things we have yet to figure out.”

As a medical student, Darbarcompleted a visiting clerkship atSUNY Upstate. Once she earned her medical degree, she returned to Upstate to fortify her credentialsfor a neurosurgery residency.

“Neurosurgery is the most competitive area of medicine,” sheexplains. “If you’re a graduate of a foreign medical school, you need a CV that’s better than the competition.”

As a postdoctoral research fellowat Upstate, Darbar worked withpain pioneer Vania Apkarian PhD,using fMRI to document how thebrain processes pain. With herresearch published in the Journal ofNeurophysiology, she then complet-ed an internship in surgery and pre-residency fellowship in neurosurgeryat University Hospital. In 2001,after six additional months of studyin Oxford, England, she secured aresidency in Upstate’s Department ofNeurosurgery.

Now heading into the homestretch of her training, Darbarassumes she will go onto a fellow-

ship in minimally invasive neuro-surgery. Her fascination with thebrain continues to grow.

She recently completed two moreyears of bench research – a depart-mental mandate – in the NIH-fund-ed laboratory of NeurosurgeryChair Charles Hodge MD. Thefocus here is on the brain’s plasticity– its remarkable ability to compen-sate for damaged cells.

In neurosurgery – where muchremains to be deciphered – researchis especially imperative, stressesDarbar, who presents research atnational and international neuro-surgery meetings. She earned firstplace for a poster presentation at the2006 American Association ofNeurosurgeons meeting in SanFrancisco. The abstract – on the effi-cacy of Gamma Knife radiosurgeryfor trigeminal neuralgia patientswith multiple sclerosis – will be published in the Journal ofNeurosurgery.

Research represents hope, in afield that can be very challenging forboth patient and practitioner.“Many of the diseases we treat arenot curable,” says Darbar.“Neurosurgery is very difficult,emotionally. In some ways, youlearn to detach. But sometimes, nomatter how hard you try, you aredeeply affected. You are human.”

Neurosurgery is also very physically demanding, according to Darbar. “Sometimes you get sotired – but that’s residency, not justneurosurgery. And the more you do,the more conditioned you become.”

Darbar uses exercise as an anti-dote for the legendary stress of

Residents – continued from page 23

“...if I can do something for 36 hours straight and still love it – I know I'm in the right place.”

–Jennifer Jennings MD, fourth-year neurosurgery resident

neurosurgery. “A lot of my col-leagues train for marathons andIron Man competitions,” she says.

Early in her residency, Darbarworked 120 hours a week. In 2004,the resident’s work week was cut to88 hours. “With the new limits, lifeis a little more sane. You can carveout time for a long run.”

InterludeNow in her fourth year of

residency, Jennings is in researchmode, investigating neuron signalingin the laboratory of Mary LouVallano. Their findings may provideimportant insights into neuro-degenerative disorders.

The orderly rhythm of researchoffers a welcome interlude beforeher two final clinical years. Jenningssuspects she will subspecialize inpediatric neurosurgery, and her eyeswiden with excitement when shedescribes the ever-expanding arrayof interventions, from Gamma Knifeto deep brain stimulation.

“Sometimes it seems surreal, thethings I’m seeing and learning,” says Jennings. “The hours are long,and it’s emotionally demanding. Butif I can do something for 36 hoursstraight and still love it – I know I’m in the right place.”

By HeartBoth Jennings and Darbar take

pride in the fact that two 2006graduates of Upstate’s College ofMedicine are studying neurosurgery– at Duke and Mount Sinai – afterrotating through their program.“I’m sure we’ll all stay in touch,”says Darbar. “The women in thisfield know each other by heart.”


Clinically Speaking

Jennifer Jennings MD,fourth-year

neurosurgery resident

Since it’s impossible to conveythe complexity of academicmedicine on a billboard – or in

a sound bite – University Hospitalhas launched a one-hour weeklyradio program that shares theexpertise of its own and other health care professionals.

HealthLink on Air airs 9 to 10a.m. Sundays on WSYR, 570 AM.Because guests work on the unpredictable front lines of medicalcare, the program is taped, not live.But listeners are encouraged to leave feedback, topic suggestions and questions at www.healthlinkonair.org or by calling 877-464-4545.

Defining theAcademic Difference

“For years, we’ve been using thephrase ‘the academic difference’ todistinguish University Hospital fromits hospital colleagues,” says PatriciaNumann MD, medical director ofHealthLink on Air. “Now we havean hour every week to talk with theremarkable people – doctors, nurses,scientists, therapists, patients, community activists and more –who help us deliver that academicdifference.”

SUNY Upstate’s educational mission inspired the creation ofHealthLink on Air. “We wanted to

make the community our classroom,because informed patients arehealthier patients,” explainsNumann. “They are alert to symptoms. They understand thepower of prevention. They shareresponsibility for their own health.”

The new radio program alsoevolved from the popular HealthLink seminars at UniversityHospital’s learning center (and alsohome to the OASIS senior program)in ShoppingTown Mall. Both venuesrecruit the hospital’s medical experts to help the public navigatean increasingly complex health care arena.


Clinically Speaking

HealthLink on Air U N I V E R S I T Y H O S P I T A L L A U N C H E S

Trisha Torrey, right, host of HealthLink on Air, interviews University Hospital internist Lisa Kaufmann MD, clinical professor of medicine, about her work with stress reduction and “mindful eating.”

9 A . M . S U N D A Y M O R N I N G S O N W S Y R / 5 7 0 A M

Easy to SwallowWhile HealthLink on Air address-

es serious medical issues, its tone isfar from somber. “It’s very upbeat,conversational and engaging,”reports Trisha Torrey, host of thenew program. “Medical news doesn’t have to be a bitter pill to swallow – it’s fascinating toexplore the different perspectivesand layers of expertise available at University Hospital.”

Torrey, a longtime Syracuse resident, is an authority on medicalconsumerism and patient advocacy –and author of the biweekly Post Standard column, Every Patient’s Advocate.

“Our guests are medical experts,but we talk about health and medi-cine in plain English,” says Torrey.“I’m not a medical professional or an insider. I’m ‘Every Patient’sAdvocate,’ with lots of questions.My goal is to help listeners becomemore informed, more discerning and more responsible for theirhealth and health care.”

Each episode of HealthLink onAir features an in-depth interviewwith a University Hospital expert,on topics such as stroke, trauma,depression, aging, concussion or the Golisano Children’s Hospital at University Hospital, which isapproaching its first phase of construction.

“Our guests bring a wealth ofinside information to the radioshow,” says Melanie Rich,University Hospital’s director of Marketing and UniversityCommunications and producer ofHealthLink On Air. “They are alsovery engaging. If you practice in anacademic medical center, you arevery comfortable teaching – medicalstudents, nursing students, residentsand patients.”

Empowerment“For most HealthLink on Air

guests, teaching is a critical part of their jobs,” says Rich. “This program turns Central New Yorkinto a huge classroom. Our listeners become students – and empowered patients.”

HealthLink on Air shows alsoinclude segments covering headlines,health tips, recipes, medical trivia,community conversations and a calendar of health-related events.

Torrey also offers a weekly segment on Patient Tools – strategiesfor becoming better health care consumers.

Beyond the HeadlinesThe Health Headlines segment

is designed to both update and stimulate listeners. “We are not justparroting what we’ve all read abouthealth this week,” says Torrey.“We’re training our listeners to bemore discerning about the dailyflood of health news. Headlinesoften oversimplify medical studies,which can be very detailed andapplicable to select patients only.

“Breaking news on hormonereplacement therapy (HRT) is agood example of the need to digdeeper and ask a lot of questions,”Torrey continues. “Several recentHRT studies seem to reach contra-dictory conclusions. In fact, thestudies apply to very specific groupsof patients – for instance, womenwho have been on HRT for 20 yearsor more. The findings are not uni-versally applicable. That’s why weneed to read beyond the headlines.”

Ultimately, says Torrey, patientsare advised to use health news as aspringboard for discussions withtheir own doctors. “We’ve all heardabout women who stopped HRTafter reading alarming headlines,”she says. “We checked with Dr.

Numann, the HealthLink medicaldirector, who said it can be danger-ous to discontinue a drug without a discussion with your doctor.”

“If there’s one overriding take-away message from this program,”Numann stresses, “it’s that everysignificant medical decision merits a discussion with your doctor.”

Guests of HonorAnother HealthLink on Air

segment features community conver-sations with Central New Yorkerssuch as Chris Arnold, whose daughter, Paige Arnold, was apatient at University Hospital’sCenter for Children’s Cancer and Blood Disorders.

Paige died in 1994, from complications of a bone marrowtransplant. But her brave spiritinspired Baldwinsville’s annualPaige’s Butterfly Run.

In the past 10 years, this popularevent has raised close to $450,000for pediatric cancer research andfamily support services at UniversityHospital as well as for scholarshipsin Baldwinsville.

“There are many inspiring storiesabout University Hospital patientsand families,” notes Rich. “This weekly radio hour gives us an opportunity to talk personallywith families like the Arnolds, who have rallied the community and turned a personal tragedy into positive energy.”

Encourage Interaction Audience interaction is an

important goal of HealthLink onAir, so there’s a dedicated phoneline, where listeners can chime in onthe weekly topics, make suggestions,or seek immediate advice fromUniversity Hospital’s HealthConnections service, which is staffed24 hours a day by registered nurses.


Clinically Speaking

FootNote

Non Profit Org.U.S. Postage

PAIDPermit No. 110Syracuse, NY

This portrait of Robert B. King MD by C. Schmidt hangs in University Hospital’s lobby.

As a pioneering neurosurgeon and chair of the Department ofNeurosurgery (1957 – 1996), Robert B. King MD has long been a catalyst for brain inquiry at SUNY Upstate Medical University.

He established the region’s first Neuroscience Intensive Care Unit (NICU)and the nation’s first neurosurgery residency program to require two years of laboratory research. He also established the Research Foundation of theAmerican Association of Neurological Surgeons. Dr. King set the bar veryhigh for the practice of neurosurgery, for the relentless pursuit of research and for the education of neurosurgeons nationwide. He continues to enlighten our campus with his compassion for patients and deep understanding of the human brain.

D E D I C A T E D T O R O B E R T B . K I N G , M . D .

750 East Adams Street � Syracuse, NY 13210-1834

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Outlook Newsletter Summer 06 - Upstate Medical University · Hodge, chair of neurosurgery; and Dr. Jeremy Shefner, chair of neurology. Lay people like myself marvel at these masters