U69873: 7/3/12 9:23 AM Page A ROCHESTER UNIVERSITY OF … › MediaLibraries › URMCMedia › ... · 2013-10-24 · UNIVERSITY OF ROCHESTER MEDICALMEDICINEMEDICINE CENTER † SCHOOL

ROCHESTERMEDICINEROCHESTERMEDICINE

UNIVERSITY OF ROCHESTER MEDICAL CENTER • SCHOOL OF MEDICINE AND DENTISTRY • VOL. 2 of 3 • 2012

Lessons LearnedAn innovative program assesses the clinical skills and styles of students through their second year.

The JourneyAlumnus Jeffrey Bazarian, M.D., M.P.H.,investigates the long-term effects of chronic repetitive blows to the head.

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On the coverThis image of the human brain uses colorsand shapes to show neurological differ-ences between two people. The blurredfront portion of the brain, associated withcomplex thought, varies most between theindividuals. The blue ovals mark areas ofbasic function. Credit: National Institutes of Health.

Find the School of Medicine and Dentistry on Facebook at:www.facebook.com/urmc.education

Rochester Medicine onlineRochester Medicine magazine’s online edition is available simultane-ously with the print edition, but with Web extras. The online RochesterMedicine is another way to keep in touch with the School of Medicineand Dentistry. Look online at: ww.rochester-medicine.urmc.edu

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espite the nail-biting drama of last month’s U.S. Supreme Courtdecision, the U.S. health care systemalready has begun to evolve in unmis-takably positive ways. Rising cost anduneven access will force the federalgovernment to demand increased value,to align financial incentives, andimprove transparency. Integrateddelivery systems hold the key to greatercoordination and cost-efficiency. Our investments in patient-centeredmedical homes, electronic medicalrecords, and quality/safety improve-ments will serve our organizations, and more importantly, our patients,well. Across the industry, there is now a self-perpetuating view of reform asnecessary, even exciting, opportunity to re-imagine medicine.

Here at the University of RochesterMedical Center (URMC), our facultyhas put together a portfolio of dozens of innovative approaches that serve as a wellspring for grant proposals andcommunity demonstration projects. We also are fortunate that one of ourDepartment of Psychiatry facultymembers, Yeates Conwell, M.D., has been selected for the Centers for Medicare and Medicaid Services’(CMS) Innovation Advisors Program.Yeates is one of 73 individuals from 27 States and the District of Columbiaparticipating in the InnovationAdvisors Program. These advisors willwork with the CMS Innovation Centerto test new models of care delivery in their own organizations and commu-

D

Bradford C. Berk, M.D., Ph.D. (MD ’81,PhD ’81), CEO, University of RochesterMedical Center; Senior Vice President for Health Sciences

nities. They also will create partnershipsto find new ideas that work and sharethem regionally and across the UnitedStates.

The selection of Yeates to thisnational role is no surprise to thoseaware of his incredible work on suicideprevention and mental health needs inolder adults. That’s why I’ve also askedYeates to head URMC’s new Office forAging Research and Health Services(OARHS), which will bring togetherhealth service and research experts fromacross the institution, coordinate theseefforts with community and regionalpartners, and act as test bed for caredelivery improvements.

Here in the Finger Lakes, one out ofevery five people will be age 65 andolder by 2025. Now is the time tomatch those emerging needs with freshideas that can make health care betterand more sustainable. And URMC islucky indeed to have leaders like Yeateswho can identify innovations with themost potential and help adapt thosenew ideas for our Medical Center andthe rest of the nation.

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ROCHESTER MEDICINE2 Vol. 2 – 20122

ob Joynt, who died on April 13,was a singular person with exceptionalskills in such numerous fields that his influence will be felt by many formany years.

Bob founded our Department ofNeurology and built it up to theproductive and influential departmentthat it remains today. His excellentsuccessor as chair of the department,Berch Griggs, calls Bob a role model as a chair. “He set high standards anddid his best to help you meet them. He always sought the very best for eachof us,” Berch has said. The current chairof the department, Steve Goldman, also calls Bob a role model and “theconsummate clinician and educator,and a dear and wise friend and guide.”

Bob’s leadership made possible theintegration of clinical care and academicmedicine of our Medical Center and ourSchool of Medicine and Dentistry.Without his leadership, his fairness andhis dedication to the accomplishment ofthis concept, we would not be thesuccessful institution we are today.

As you will read in this issue ofRochester Medicine, Brad Berk calls Boba “true renaissance man.” He was such asignificant figure in neurology that heheaded both leading societies inneurology, the American Academy ofNeurology and the American Neuro -logical Association. Bob loved scienceand teaching. He was involved inmedical school classes and researchuntil his last days. After a full workweek, he died on his way to neurology

grand rounds. Even after more than 45 years, he rarely missed grand rounds.

Bob came from a small town in Iowabut he had a large vision. His curiosityseemed endless. He enjoyed history andbecame an expert on health and theAmerican presidency. He was an excel-lent public speaker and a fabulous tellerof stories and jokes who also was wellknown for his parties.

In many ways, Bob was a model for a life well-lived.

I am certain there are graduates from many decades of our School ofMedicine and Dentistry who rememberclearly an encounter with Bob Joynt in a classroom, during grand rounds oron the hospital floor that bettered themas physicians. There also are facultymembers, researchers and hospitaladmin istrators who learned from BobJoynt. And, of course, there are manypatients helped by Bob’s diagnosticskills and treatment wisdom.

In this issue of Rochester Medicine,there also is an interview with Bobmade just weeks before he died. He wasthinking about students, the importanceof taking a good patient history andresearch.

Last year, an endowed professorshipwas established in Bob’s name. I am soglad he lived to see that honor awardedto another neurologist, Karl Kieburtz.

I met Bob late in his life, but he was anaid to me as dean and I knew he was thereand reliable if I ever needed him. BobJoynt remains with us and still helps us in many ways–and even makes us smile.

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Mark B. Taubman, M.D.Dean of the School of Medicine and Dentistry, Vice President for Health Sciences

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CONTENTS

FEATURES

DEPARTMENTS

ROCHESTER MEDICINE

Rochester Medicine is published by: The University of Rochester Medical Center,Department of Public Relations and Communications, in conjunction with the Department of Alumni Relations & Advancement for the School of Medicine & Dentistry.Associate Vice President for Public Relations andCommunications Teri D’Agostino Editor Michael WentzelContributing Writers Lori Barrette, Emily Boynton, Heather Hare,

Mark Michaud, Leslie Orr, Tom Rickey, and Leslie White

Art Director Mitchell Christensen Photographers Adam Fenster, Ken Huth and Vince Sullivan For questions or comments, contact: Department of Alumni Relations and Advancement for the School of Medicine and Dentistry300 East River Road, Rochester, NY 14627 800–333–4428 585–273–5954 Fax 585–461–2081Comments on this issue, e-mail: [email protected]

4 The Journey: In his search for a blood test for concussions, an alumnus also investigates the long-term consequences of chronic repetitive blows to the head.

14 Lessons Learned: An innovative program assesses the clinicalskills and styles of students throughout their second year.

20 An Immigrant’s Experience: Alok Kohrana thrives in hisadopted home as he challenges the mysteries and heartaches of cancer.

26 Robert J. Joynt: A Medical Center legend dies at 86.

30 Medical Center Rounds36 Philanthropy38 Match Day 2012 44 Alumni News47 Class Notes54 In Memoriam

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The Journey

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y In his search for a blood test

for concussions, an alumnus

also investigates the long-term

consequences of chronic repetitive

blows to the head.

An emergency medicine physician sees all

kinds of illnesses and injuries, but Jeffrey

Bazarian, M.D., M.P.H. (M ’87, R ’90, MPH ’02),

chose to investigate blows to the head

and concussions, now a more than 15-year

pursuit that has taken him from a search for

a blood test for concussions to suspicions of

an epidemic.

I saw many people coming into emergency with blows to thehead and I couldn’t be certain if they really had an injury,”he said. “If they didn’t seem to be obviously brain-injured, I sent them home. But I was never really sure they wouldbe OK. To me, this seemed odd as we had diagnostic aids formost other injuries and illness that came into the E.D., butnot for concussion.”

A head CT scan was used most often with injuredpatients, but the scans almost always were normal. In theearly 1990s, a number of investigators showed that concus-sions result in subtle, but measurable, injury to the brainand this injury almost never shows up on a CT scan,Bazarian said.

“From my standpoint, I was trying to evaluate an injuryto something as important as the brain and the only tool I had–a CT scan–was no good,” he said. “As the number ofhead-injured patients coming into the E.D. grew, I realizedwe were dealing with an unmet need. We needed an accu-rate and quick way to diagnose a brain injury after aconcussion–a blood test for concussion. That seemed like a reasonable goal.”

“

By Michael Wentzel

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The project was driven by

a patient, an 18-year-old girl

who was brought to the

emergency department.

She had been wearing a seat

belt. The car in which she

was riding sideswiped a tree.

She died in the E.D. from her

head injury. It was hard for

me to understand how

she died. And she was from

the town where I live.”

“

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Jeffrey Bazarian, M.D., M.P.H., with patientCourtney Porter.

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ROCHESTER MEDICINE 8 Vol. 2 – 2012

“I liked the way that Rochester was positioned to grow and afford junior faculty opportunities to pursue their goals,” said Yurcheshen.While many in academic medicine steer away from their alma mater,others– attracted by the School’s strengths and traditions that boostedthem as students – decide they can go home again.

But Bazarian, associate professor of emergency medicine atthe University of Rochester Medical Center, now sees a bloodtest as just a first step in unraveling a threat to the viability ofthe brain.

“I started out thinking concussion was bad, that it causesbrain injury that lasts forever and we need a blood test to diag-nose and treat it,” he said. “Now, it looks like not everyonewho has a concussion has an injury. If they do, the injury maybe transient and resolve with little intervention. It’s themultiple concussions or multiple sub-concussive blows thatmay represent the real threat to the long-term viability of thebrain, even leading to early-onset dementia. I’m talking aboutthe football lineman, for example, who thinks he is fine, buthis brain isn’t fine. The consequences of multiple hits are whatwe are trying to understand, prevent and/or treat. That is thereally silent epidemic.”

The path of Bazarian’s studies illustrates not only the natureof research but also his persistence.

“It might seem like my research stopped at times, but itnever did,” he said. “I’ve been working on this a long time. I’ve changed directions a few times but it was always in thedirection the data took me. It’s a journey. It really is.”

Inspiration and an injured teenage girlBazarian’s fascination with neurology goes back to his Schoolof Medicine and Dentistry student days when he was inspiredby the teaching of David Felten, M.D., Ph.D, then a professor ofneurobiology and anatomy at Rochester.

While in medical school, Bazarian also spent two summersworking in the lab of German neurologist Claus Meier, M.D., atthe University Hospital of Berne, or Inselspital, in Switzerland.But he eventually chose emergency medicine.

“I didn’t think then I was cut out for neurology,” Bazariansaid. “I did an internal medicine residency but discovered thatI really liked taking care of critically ill and injured patientsthe best. Emergency medicine was so new back then that youcould move right into it.”

He was further motivated to pursue his neurology interest in1993 when his father died of a head injury after falling down aflight of stairs. But Bazarian’s research started slowly as fundingfor his target was sometimes scarce. In 1997, a foundation grantsupported a small study of patients who visited the emergencydepartment and reported blows to the head.

“I did a study using pen-and-paper cognitive testing right in the E.D.,” he said. “If concussed patients said they were OK,how well were their brains working? Many patients were cogni-tively quite abnormal. This study started to tell us there wasmore than meets the eye with concussions.”

In 2002, with a $560,000 National Institutes of Health grant,Bazarian began the nation’s first emergency department-basedtraumatic brain injury registry. His project collected detailed

information–plus a blood sample–from every brain-injurypatient brought to Strong Memorial Hospital’s emergencydepartment for two years. Where and how did the injuryhappen? Was a sport involved? Was the patient intoxicated?Was the patient wearing a seatbelt or helmet? What tests wereperformed before treatment?

“These data, plus all the collected serum, are available,and we continue to go back and dip into that and look atserum samples,” Bazarian said. “But this study was even morevaluable because it forced me to realize that, in many E.D.patients, it was impossible to determine if they met the clin-ical definition of concussion. Many patients just couldn’t tellus if they lost consciousness, blacked out or were confused at the time of injury. I guess I shouldn’t have been surprised. In effect, we were asking a patient who may have had a braininjury that disrupts their ability to remember-to rememberthe details of their accident! When I came to this realization,I had to change the course of my research. It moved me awayfrom research focused on describing the epidemiology ofconcussion, and toward research attempting to improve thediagnosis of concussion through the use of objective aids,such as a blood test.”

At the same time, as a project for his master’s degree in

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public health, Bazarian and colleagues analyzed a sample ofcrashes reported to the National Highway Traffic SafetyAdministration in 2000 to determine the risk for brain injuries.

“The project was driven by a patient, an 18-year-old girlwho was brought to the emergency department,” said Bazarian,who lives in Honeoye Falls, south of Rochester. “She had beenwearing a seat belt. The car in which she was riding sideswipeda tree. She died in the E.D. from her head injury. It was hardfor me to understand how she died. And she was from thetown where I live.”

Bazarian’s analysis of the national accident reports showedthat occupants of automobiles involved in side-impact crasheswere three times more likely to suffer a traumatic brain injurythan people involved in head-on or other types of collisions.Females were found to be at a higher risk of brain injuries.

The researchers saw their analysis as the first population-based study to find that a side-impact crash is a risk factor fortraumatic brain injury.

“Cars were not well-protected then from side impacts,”Bazarian said. “With side protection, we thought many fataland non-fatal injuries could be prevented. Most cars now haveside-impact airbags.”

Even a mild or moderate head injury also might be a risk

factor for early-onset dementia or Alzheimer’s disease, Bazarianhad come to believe. A blood test would help doctors diagnoseaxonal injury, a type of brain injury that often occurs after a concussion but does not show up on a CT scan of the brain,and begin quick treatment.

But in order to develop a surrogate marker for brain injuryusing a blood test, Bazarian realized he needed to know whichconcussion patients had brain injury. In the mid 2000s, a newtest called diffusion tensor imaging (DTI) was found to be an accurate reflection of brain injury in animal models, but it had not been well studied in humans.

In a pilot study, Bazarian and his colleagues investigatedwhether DTI could detect axonal damage from a concussion.The DTI scans of six E.D. patients with mild concussions werecompared with scans of six non-injured brains. The DTIshowed subtle axon swelling, which is known to occur whenthe axons are over-stretched. The axonal swelling correlatedwith the patients who were having trouble processing informa-tion or remembering things as well as before the injury.

The data from the pilot study enabled Bazarian in 2007 toreceive a $1.5 million R01 award from the National Institutes of Health to use DTI to develop a blood test for concussions.

About 40 adults who sought emergency treatment for head injuries were enrolled in the NIH R01 study, along with a similar number of control patients who received treatmentfor orthopedic injuries. All patients received three sets of DTIscans, blood tests and cognitive tests.

“How does the brain injury we’re picking up on the DTIscan correlate to brain-related proteins in the test and howwell the brain functions, and how does that compare tosomeone who just hurt a wrist? Is the brain injury were seeingin the scan reflected by elevations of brain-related proteins in the in the blood?” Bazarian said. “The scans and blood testswere taken over a month. What happens over that month’stime? Does the brain injury go away? Does it get worse? We’re asking pretty fundamental questions about concussion.”

Bazarian and his colleagues are still analyzing the data.During the study, however, they discovered limits to theirproject.

“We were comparing E.D. patients with concussions andcontrols who were unrelated to them,” Bazarian said. However, there is so much variation in the brain structurefrom person to person that it was hard to know if the groupdifferences were due to injury or just natural variation. Thisvariation creates an obstacle to analyzing data using groupcomparisons. We wondered how we could get around thisobstacle. That’s when athletes came to mind. Athletes areunique in that they give us the opportunity to look at the brainbefore injury and compare that to its appearance after injury.This helps reduce much of the variation that clouds analysis ifbrain images using group comparisons.”

“

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Statistics behind a collision sportData from the 2011 football season

for 10 University of Rochester players

0

60,000

80,000

40,000

20,000

0

1,500

2,000

1000

500

C OT DL LB FB

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Vol. 2 – 2012 11

d t

Number of head hits during 2011 football season

Total linear acceleration (g) accrued

POSITIONS PLAYEDC CenterOT Offensive TackleDL Defensive LineLB LinebackerFB FullbackTE Tight EndRB Running Back

DL DL LB TE RB

Linear acceleration is a change in velocity of an object moving in a straight line. A 2g force, for example, would be equivalent to an object accelerating at twice the pull of gravity.

This chart shows the total linear acceleration experienced by the football players.

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An unsettling football findingNine Rochester area high school athletes and six students ascontrols volunteered to take part in the research funded by theMedical Center’s Center for Aging during the 2006–2007 sportsseason. Among the nine athletes, who recorded their estimateof hits in diaries, only one was diagnosed with a sports-relatedconcussion that season. Measurements showed many changesin the brain of the player with the diagnosed concussion.

“The control group had no damage, which was expectedbecause they were not engaged in sports of any kind,” Bazariansaid. “What was surprising to us was that the eight otherathletes also had damage. They never suffered a concussion but the DTI scans showed damage, and this damage correlatedto the number of times they say they got hit. The more theysaid they were hit, the more damage we saw on the scans.”

The finding unsettled Bazarian and his collaborators.“We thought about the hundreds of thousands of youths

playing football– from Pop Warner to high school and collegeteams–getting hit in every practice and in every game,” hesaid. “It’s one thing to assert that brain injury results fromfrank concussions. That’s a big problem, but relatively manage-able in scope. It’s quite another to assert that brain injury occurs

in every athlete undergoing repetitive head hits, whether theyhave a concussion or not. That would be a major public healthproblem. We felt we had to chase this as fast as we could.”

Bazarian and his collaborators successfully applied to theNational Football League for funding for research that wouldprovide more precise and more definitive information aboutchronic repetitive head hits and brain injury. Ten University of Rochester football players agreed to wear specially designedhelmets with sensors that detect the number of hits a playerreceives and the velocity and angle of the hits. Each playerreceived a DTI scan before the season began, after the seasonand then after six months. None of the 10 players suffered a concussion, but the hit statistics were significant. The playerwith the most in the season had 1,850 detected hits. The lowestnumber of hits was 500.

“All the players, including the one with the most the mosthits, are OK clinically, although we have not yet analyzed theDTI scans,” Bazarian said. “But the issue is not how they aredoing now. It is how they will be doing years from now. Does the low-level brain injury we expect to see on the scansbuild up with year after year of playing to form the substrate forcognitive problems down the line? Or does the injury go awaywith rest? These are fundamental questions we are asking,

Jeffrey Bazarian, M.D., M.P.H., with patientMichael Sweet.

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but they could give us insight into the development of chronictraumatic encephalopathy we’re been seeing in NFL players.”

The traumatic brain injury research group at the MedicalCenter includes Bazarian, Tong Zhu, Ph.D., research assistantprofessor of imaging sciences, Jianhui Zhong, Ph.D., professor ofimaging sciences, Brian J. Blyth, M.D., assistant professor ofemergency medicine, and Jason H. Huang, M.D., associateprofessor of neurosurgery.

The researchers now are following about 300 University ofRochester and Rochester Institute of Technology athletes,conducting detailed tests, taking blood samples and performingscans when they are injured. Bazarian believes he and hiscollaborators are very close to reporting a verifiable blood testfor concussions.

Bazarian also is part of the Medical Center’s sports concus-sion program, with Mark H. Mirabelli, M.D., and E. JamesSwenson, M.D., both assistant professors of orthopaedics andfamily medicine. He sees at least 10 patients a week and thenumber is growing.

“I use my research experience when I talk to families,”Bazarian said. “I tell them there may be a link between concus-sions and neurodegeneration. That can be scary to hear, but itis important to know. But we have to tighten and better define

that link to describe what happens to an athlete during acareer or a soldier who is subject to multiple bomb blasts andhow and whether they develop dementia. Then we can inves-tigate whether there is a point where you can stop playing andnot develop dementia and whether there is a point where wecan intervene.

“I believe chronic repetitive hits is the real public healthproblem, the real threat to the neurologic viability of thebrain. But the blood test is a first step. We can’t say what willhappen 10 years from now if we don’t know what has happenedto you now, if we don’t know if you have an injury to beginwith. This is so fundamental. We can’t really skip over it. We can’t talk about preventing a major public health problemuntil we know who is getting injured in the first place.”

The control group had no damage, which was expected

because they were not engaged in sports of any kind.

What was surprising to us was that the eight other athletes

also had damage.They never suffered a concussion

but the DTI scans showed damage, and this damage

correlated to the number of times they say they got hit.

The more they said they were hit, the more damage

we saw on the scans.”

“

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By Michael Wentzel

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When Meena Elanchenny watched the video of her examina-tion of a patient reporting persistent abdominal pain anddiarrhea, she liked most of what she saw.

“When I was talking to the patient, I was more at ease,” she said. “I asked the questions I was worried I would forget.I’ve also become more aware of certaingestures and things I say and I didbetter with those. For instance, insteadof replying ‘great’ to everything thepatient said, I said ‘I see.’ ”

But Elanchenny, a second-yearUniversity of Rochester School ofMedicine and Dentistry student, alsospotted some flaws she wants to address.

“I tend to talk very quickly,” theSwarthmore College graduate said.Sometimes, I am so interested in getting information from patients that I interject before they finish, asking thenext question while the patient is stillanswering the last. When you watch

the video, you’re not in the moment. You’re not nervous. I candetach myself and say: ‘I need to wait a little longer. I have tolet the patient finish and speak more slowly so they can under-stand me.’ ”

For the first time at the School of Medicine and Dentistry,second-year students have receivedmultiple clinical assessments during theacademic year and have been graded ontheir performance. The innovation inthe curriculum emphasizes the connec-tion between the basic science thestudents learn and the clinical world bypresenting the science in the context ofa patient. The assessments, given muchmore frequently than most, if not all,other medical schools, also give facultyand students a unique opportunity earlyin their medical education to see howthey communicate with patients.

“The assessments have really helpedwith patient relationships,” Elanchenny

An innovative program assesses the clinical skills and styles of studentsthroughout their second year.

tzel

Meena Elanchenny

“

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said. “You learn to organize your thoughts and approachpatients so that when you go into your clinic offices andencounter patients with different complaints, you are betterprepared. I’ve come a long way, particularly in interacting with patients, because of the assessments.”

The development Elanchenny has found through her clinical assessments highlights one of the goals of the program, said Anne Nofziger, M.D. (R ’00, FLW ’07), director of thePrimary Care Clerkship who oversees the assessments.

“Being able to ask the right questions in real time and to think diagnostically is really different from answering a multiple-choice question based on a clinical vignette,”Nofziger said. “This type of assessment requires that studentsdemonstrate skills and apply their knowledge in an active way,and then connect the basic science to the ‘patient’ they justsaw.”

The clinical assessments are conducted with standardizedpatients and sometimes with computerized mannequins. The well-trained standardized patients write evaluations foreach student who examines them. Videos of the exam enablestudents to match the evaluation with their performance.Students also are graded on a patient note on the case or

on an essay in response to a question linked to the case. This year, the students have encountered cases of back pain,chest pain, a urinary tract infection, gastrointestinal problemsand a shoulder injury. They also have conducted breast andprostate exams.

“We have a very robust early clinical experience. It is keythat we understand how a student approaches focused problemspresented by outpatients and assess this encounter,” said David R. Lambert, M.D., the School’s senior associate dean for medical student education who initiated the assessments. By creating standardized patient encounters with patient problems that mirror the course material taught in the concur-rent scientific foundations of medicine courses, we emphasizethe integration with clinical care. All of these assessmentsstrengthen the model of the Double Helix curriculum.”

Fidgeting, flipping and using a stethoscopeMost medical schools require some clinical assessments, usuallywhat is called an OSCE, or Objective Structured ClinicalExam. But few schools, if any, conduct as many clinical assess-ments as Rochester during the second year, or combine clinical

Written exams always will be part of medicaltraining, and provide an efficient way to assessknowledge.

They aren’t so good atpredicting what a personwill actually do in a realclinical encounter.

Our assessments get us a little bit closer to knowinghow a student will be with a patient.

Oluwateniola “Teni” Brown

“

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and basic science courses assessments in one format.In the past, clinical assessment of second-year students prima-

rily came from preceptors, the physicians in the community whowork with the students a few times a week for several months in their offices. But School officials viewed these assessments assubjective and variable, depending on how much the preceptorobserved a student.

“Written exams always will bepart of medical training, and providean efficient way to assess knowledge.They aren’t so good at predictingwhat a person will actually do in areal clinical encounter,” Nofzigersaid. “Our assessments get us a littlebit closer to knowing how a studentwill be with a patient. It is obviouslyartificial. The students know they arebeing tested and videotaped.

“But as clerkship director, I wantto know: Did the student gatherappropriate behavior to make a diagnosis? Did they conduct a

patient-centered interview? Did they do the appropriate phys-ical exam, and was it performed correctly? What does thisstudent need to work on in order to become a better clinician?Some students are good test-takers, but struggle on the groundwith patients, and some are the opposite. It is good for thestudents to identify their mistakes or flaws. As learners, they

benefit from a culture that recognizes thateveryone has something they have to workon, and that provides opportunities toimprove based on feedback as well as self-assessments.”

Although some students acknowl-edged the multiple clinical assessmentsincreased stress and caused anxiety, theyalso said they welcomed the experience as a chance to learn.

Oluwateniola “Teni” Brown calledthe clinical assessment days “safe opportu-nities to put what we learn in theclass room into practice.” For an assessmentinvolving a gastrointestinal case inFebruary, she found herself “really

Shadab Khan

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nervous,” an atypical state for the Duke University graduate.“I was not sure I did well in the assessment,” Brown said.

The tricky diagnosis of the case could have gone in a coupledirections, but Brown did not get the correct one. Still, herreview of the video encouraged her.

“I thought it was worse than it was,” Brown said. “I wentthrough the process with the patient. I asked the appropriatequestions. I did fine. I did develop a diagnosis properly. I told the patient that I wasn’t quite sure what her illness was. I share my differential and what I thought was most likely. I also talked about follow-up testing. Not being 100 percentsure and sharing this with the patient was uncomfortable but I realize that I need to be comfortable with uncertaintywhen working with patients.”

The video also highlighted some areas for Brown to address.“In watching the video, I realized the patient must have felt

bombarded with questions. It was like I was grilling her,” she said.I need to let the patient respond to one question at a time.”

Brown also noticed she was fidgeting at some points in theinterview.

“I kept flipping my papers constantly. That had to be sodistracting,” she said. “I had no idea I did that. I have learned,and am still learning how to effectively relay my assessment ofthe problem to patients, and actively and appropriately engagethem in the development of the plan.”

The standardized patient marked down Brown for hermethod of listening to the heart. She listened with her stetho-scope on the patient’s blouse, not on skin.

A more efficient learning styleFor Shadab Khan, the clinical assessments enable him to eval-uate whether he is making connections between the pathologyhe is learning in class to real life cases.

“I learned from all the assessments, especially the standard-ized patient encounters,” the graduate of the RochesterInstitute of Technology said. “When you work with a standard-ized patient and you spot a mistake or learn something, it sticks a lot more. You don’t forget.”

“We work with actual patients with our preceptors,” Khansaid. “I see the patient’s chart ahead of time. I generally knowwhat the patient wants to talk about. It is rare to go in with noidea of what we’re supposed to be looking for. But that is whathappens in a clinical assessment. It’s interesting to see whatyour mind goes through as you are getting the history, makinga differential and prioritizing a list of possibilities. Sometimes,you are thinking so much you forget to respond to the patient.My history-taking skills are getting better, but it’s definitelysomething I am still working on.”

In a review of a video of the February assessment, Khannoticed that he used many medical terms, technical words hemight not have known himself a few months before, he said.It’s important to explain your reasoning to the patient, discusswith them treatment options and share guidance about howthe illness may or may not proceed,” Khan said “It’s also

important to understand the information well enough that you can explain it to another individual who may not have a medical background.”

Katherine Herman did well in February’s clinical assess-ment. She received a “very positive evaluation” from thestandardized patient, who also gave her good advice on a morecorrect and thorough way to do an abdominal exam.

“It is very helpful to practice taking a patient history and toperform a focused physical exam with a patient who is trainedto give you feedback based on the questions you ask– or don’task,” the Eastman School of Music graduate said. “It is alsonice to receive comments from the patients as to how effectiveyou were in communicating your ideas, though I’ve found thatmost of the time you leave the encounter knowing what youneed to work on. There are always little gems you can take outof a patient encounter.”

Herman, an M.D./Ph.D. student, also did well on the patientnote, a requirement that caused problems for a number ofstudents.

“I’ve been lucky with my preceptors,” she said. “Theyexpect a lot from me. I’ve been doing notes for each patientI’ve examined so I’ve learned to do them. In the clinical assess-

Katherine Herman

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ments, I am working on timing, getting through the exam efficiently, using efficient language, painting a picture withoutbeing wordy. It is great to have the assessments through thesecond year, not just at the end when we can’t implementwhat we have learned in past assessments.”

To Anthony Carnicelli, the clinical assessments are “a greatway to get us to think more like clini-cians.”

“They change the experience of beinga medical student,” he said. “They turnthe traditional exams into something tolook forward to instead of something todread. Previously, you learn a bunch ofmaterial, memorize as much as you can,go and regurgitate it into an electronicdevice and come out feeling like you’vebeen battered. With the assessment days,it changes the way you approach learningbecause you know you have to apply itwith a patient.”

Carnicelli, a graduate of the BerkleeCollege of Music and a former music

teacher, praised his preceptors, who have encouraged him to dophysicals, get a full history and present in front of the patient.

“With the assessments, you can integrate skills you learnwith your preceptor in the community with information youlearn in lecture and combine them into one structured format,”he said. “The evaluations from the standardized patients, at the

very least, make you more aware ofwhat you’re doing in the clinic. Thevideo is the great equalizer. When thestandardized patients give you feedback,you can go back to the video and seewhere they are coming from.”

“This is the way medicine should betaught, applying the basic sciences in a clinical setting,” Carnicelli said. “It ismuch more practical than learning factsfor the first two years and then onlygetting to apply them in the third andfourth. That doesn’t translate properly.The clinical assessments encourage a more efficient style of learning.”

Anthony Carnicelli

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AN IMMIGRANT’S EXPEBy Michael WentzelBefore his first shift as a resident atMillard Fillmore Hospital in Buffalo in the summer of 1996, Alok Khorana,M.D. (FLW ’02), had not worked a singleday in a U.S. hospital.

He had never used a pager oranswered a page, never looked up labresults on a computer screen, dictated a note, or handled discharge planningor insurance issues. Having onlyrecently arrived from his native India,Khorana spent the day before his nightof work acquiring a stethoscope, scrubsand a lab coat.

“I made it through that night, andnone of my patients died or went to the intensive care unit, which is thedefinition of a successful intern,” he wrote more than a decade later in an essay in the journal Health Affairsdescribing his experiences.

Khorana has accomplished muchsince his pressure-packed night not all

that long ago. An associate professor ofhematology/oncology at the Universityof Rochester Medical Center, he is oneof the leaders of a multidisciplinarygastrointestinal cancer program at theJames P. Wilmot Cancer Center, wherehis patients praise his care and describehim as sensitive as well as direct.

His research has made him an inter-nationally known authority on venousthromboembolisms that develop as a complication of cancer treatment. And, with others at the MedicalCenter, Khorana is conducting researchand trials that could result in theprevention of cancer-related thrombosisand perhaps the progression of cancer.

“When I began my residency, myintention was to go back home to Indiaat some point after training,” Khoranasaid. “I don’t think in my wildestdreams that I thought I would be hereor be this successful, or have researchers

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Alok Khorana thrives in his adopted home as he chal lenges the mysteries andheartaches of cancer.ERIENCE

in Europe validating things I do here.”While that first night as a resident

at Millard Fillmore was a dramaticintroduction to a new culture, Khoranaalready knew well the world of thephysician, the hospital and research.

In his hometown of Baroda, a citynow called Vadodara that is about 270 miles north of Mumbai, his fatherwas chief of psychiatry and a professorat Maharaja Sayajirao UniversityMedical College. His mother was a clinical psychologist there. He grew upnext to the hospital in faculty quarters,where physicians were on call aroundthe clock.

His great uncle, Har GobindKhorana, shared a Nobel Prize in 1968for showing how genetic information is translated into proteins, which carryout the functions of a cell.

“I had a lot of stuff to live up towhen I was growing up,” he said.

Khorana earned his medical degreefrom Maharaja Sayajirao University, the school that he had known much of his life. But he chose to train in theUnited States.

“I had decided I wanted to go intooncology,” he explained. “I knew Iwouldn’t be good at surgery. For awhile,it was a toss-up between oncology andpsychiatry. I did not choose cardiology,where most of the big battles have beenwon. We know what causes heartdisease. We know how to treat heartattacks. In oncology, we are nowherenear the secret. I wanted to be therewhen the discoveries were made or help contribute to the research and the discoveries. It still is a developingscience. There is a lot of work to bedone.”

At that time, he said, there were notmany good cancer training programs inIndia.

I wanted a quality program, so I decidedon the United States.”

Before his journey to America,however, Khorana worked a year inIndia as an internal medicine intern ina public hospital that was a dilapidatedtwo-story building.

“Its windows were festooned withcolorful saris hung out to dry bypatients and their relatives. Inside,thirty to forty patients were housed intwo large rooms, their beds separatedonly by a distance of a few feet,”Khorana wrote in his Health Affairsessay.

“As a first-year resident, I was theperson on first call for these patients allday, every night, all 365 days of the year.(The U.S. term ‘night float’ was, for lackof a better term, a foreign concept.) I had exactly two nurses to help me. I would typically spend all day in theward as outpatients were sent in by my

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senior residents and attending physi-cian. My day would be occupied writingnotes, ordering tests, and performing avariety of procedures, including taps toremove fluid around the chest wall andabdomen, even liver biopsies. On occa-sion, I would also have to help thenurses with difficult intravenous line orurinary catheter placements. At night, I also doubled as a laboratory assistant,counting leukocytes and looking formalarial parasites in peripheral smears.Early in the morning, having had littleto no sleep, I would do rounds on eachpatient with my senior resident.”

The experience steeled him for hisAmerican adventure.

“I was better prepared than most U.S. medical students starting a resi-dency program,” he wrote. “I was usedto being independent. I had alreadyperformed more procedures than mosttrainees would conduct through thecourse of their entire residency. I hadconfidence in my physical examinationskills because we’d had to ‘make do’without access to expensive diagnostictests, and I had learnt to think quicklyon my feet.”

Clot risk scores and tissue factorIn 1999, Khorana joined the WilmotCancer Center as a Wilmot fellow inhematology and oncology. In 2002, he was named a senior instructor atWilmot and described as “a talentedphysician-scientist.” In 2003, hepublished his first paper as lead authorin the journal Cancer.

Macrophages that gather around a tumor and also carry a protein, calledVEGF, or vascular endothelial growthfactor, though originally thought toenhance cancer growth, may actuallyfight the progression of colon cancer,Khorana and his colleagues reported.The retrospective study of colon tumor

samples showed that patients who hadmacrophages with VEGF lived onaverage twice as long as patientswithout it – nine years compared to four-and-a-half years.

Khorana also began investigating asignificant threat to his cancer patients:blood clots.

“Cancer patients are much morelikely to get blood clots than non-cancer patients,” he explained. “It isnot clear the risk is spread evenly overall cancer patients. Breast cancerpatients are far less likely to get a clotthan a pancreatic cancer patient, braintumor patient or a lung cancer patient.Within those subgroups, about one outof five gets a clot. If you are looking atways to prevent a clot, you don’t wantto give a pill or an injection to millionsof patients. You just want to give it tothe patients who really are at risk.

“Why are patients getting bloodclots? How can we find these patients?What is it exactly that makes a cancerpatient clot?”

In 2005 in an article in Cancer,Khorana reported that an elevatedplatelet count put patients at a nearlythree-fold risk of developing bloodclots. Working with Charles W. Francis,M.D., professor of medicine, and GaryH. Lyman, M.D., M.P.H., a Rochesterfaculty member now at Duke Uni -versity, he followed patients for up tofour cycles of chemotherapy. The studyshowed blood clots occurred in nearly 2 percent of patients and incidenceswere significantly higher for people withlymphoma and stomach, pancreatic andlung cancers. Patients whose plateletcounts exceeded 350,000 per cubicmillimeter suffered three-times moreblood clots than others with plateletcounts of less than 200,000 per cubicmillimeter.

In 2008, Khorana and his colleagues

published an even more accurate way topredict clots.

“We developed a risk score thatcombines the type of cancer with fourother variables that are really simple:type of cancer, body mass index andplatelet, hemoglobin and white cellcount,” Khorana said. “You combinethose assigning points. If you have ascore of three or higher, the chance ofclots is very high. It was the first riskscore published at the time.”

Since then the risk score has beenvalidated by several programs and largepatient populations, including groups in Austria, Italy and New York City,attracting significant attention toKhorana and Wilmot.

“Alok has emerged as an interna-tional leader in studying cancer-relatedvenous thromboembolism, one of theleading causes of death in patients withcancer,” said Mark B. Taubman, M.D.,dean of the School of Medicine andDentistry. “In fact, his model forpredicting which cancer patients are athigh risk for venous thromboembolismhas quickly become an internationalgold standard.”

A conference on cancer-relatedthrombosis organized by Khoranabrought most of the leaders in the fieldto the Rochester area in 2010.

“The risk score has helped us withour patients,” Khorana said. “We arefinding a lot of blood clots. We arepreventing deaths.”

The success of the risk score also helped the Medical Center get a $3-million grant from the NationalHeart, Lung and Blood Institute toconduct a trial on the prevention of clots. The study, with Francis as principal investigator and Khorana and Taubman as co-investigators, is ongoing.

“The initial results look very

Maybe success isn’t curing every patient of cancer, because you can’t. Sometimes, success is being able

to provide some grace and dignity at the time of death, or provide comfort to the family or to make sure

the family understands. I always promise the patient and family that I will be honest with them.”

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Alok Khorana, M.D., with patient Anh Tran.

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promising,” Khorana said. “We see thatas a real way to have an impact onpatient lives.”

The researchers also are investigatingthe role of tissue factor, a key elementin coagulation but also a protein that isover-expressed in some cancer tumors.

“If you look at a normal pancreas, for example, there is no tissue factor.You would not expect it. There shouldnot be any,” Khorana said. “But as soonas the pancreas starts to turn to cancer–even before the cancer– the pancreasproduces tissue factor. We showed thatpart of the process of turning from a normal pancreas to pancreatic cancerwas generation of tissue factor on thesurface of tumor cells. That was a reallyimportant discovery.

“Blood clots are not just an epiphe-nomenon. They are there because thismolecule is really important for tumorcells to become cancerous. We discov-

ered that one of the functions of tissuefactor in this situation is to stimulateblood vessels to grow. The tumor cellsare producing tissue factor because it ispro-angiogentic. As a byproduct ofhaving so much tissue factor, people are getting blood clots when they havecancer.”

Khorana and Taubman have foundthat patients with high levels of tissuefactor had severe clots. In collaborationwith Roswell Park Cancer Institute,they examined samples from cancerpatients who also had blood clots. Theyfound that high levels of tissue factornot only predicted who would haveblood clots, they also predicted whohad a cancer that progressed faster andcaused death more quickly.

With tissue factor as a target, the researchers are now working withtwo private companies in clinical trialstesting novel therapeutics.

We not only want to see if they preventblood clots, we want to see if they canprevent cancer progression,” Khoranasaid. “It is very exciting work.”

Khorana also chairs a large world-wide study with industry support that isenrolling patients with colon and lungcancer and studying all the risk factorsbefore they start on chemotherapy andthen following them to see whatcomplications they get and how topredict who will get complications. The study will involve 4,000 patients inthe United States, Europe and Russia.

Heartache and a welcomeHardly any day at Wilmot CancerCenter passes without contact with apatient facing a difficult and frighteningchallenge.

“Half the job is delivering bad news,unfortunately,” Khorana said. “It is noteasy and it doesn’t get easier. You get

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better at doing it, but it still has a tollon you. I am not sure there is a wayaround it. We have a lot more survivorsthan we used to. People can have goodlives with cancer for years and years. It is not all doom and gloom.”

But the field of cancer treatmentchanges the view of success a little, he said.

“Maybe success isn’t curing everypatient of cancer, because you can’t,”Khorana said. “Sometimes, success isbeing able to provide some grace anddignity at the time of death, or providecomfort to the family or to make surethe family understands. I always promisethe patient and family that I will behonest with them. One success is keeping that promise and beinghonest.”

Khorana often turns to writing todeal with the “heartache” of cancertreatment. He and other oncologists,

Michelle Shayne, M.D. (BMus ’85, M ’98,R ’01) and David Korones (R ’86, FLW91), started a humanities group foroncology trainees. They discuss narra-tives about cancer care written byothers or the trainees.

“It is a great place to talk about what is bothering us,” Khorana said. We often spend about 10 minutes onnarrative and then branch off to patientcases, how they dealt with the case andhow the patient dealt with it. Writing iscathartic. Dealing with death is noteasy, but it’s part of the job description.Death is a part of life.”

Since his first night as an intern in a United States hospital, Khorana hasfound success and a home in America.He has an American wife and they areparents to four boys. He enjoys the fourseasons of upstate New York and thewelcome and respect he has received.

“When I have been assessed by the

faculty at my residency and fellowshipprograms, when I have been offeredfaculty positions or promotions, whenmy grant applications have been evalu-ated on their scientific merits anddemerits, I have never felt unfairlyjudged,” Khorana wrote in a HealthAffairs essay. “We don’t say this oftenenough as immigrants. We don’t say itprimarily because if you’re trying toassimilate, it is almost a requirementthat you adopt the cynical, ironicAmerican conversational tone. But the truth of the matter is that – unlikemost other nations – America alwayshas been and, almost as important,perceives itself to be, an immigrantnation. What this means is that, for usimmigrants, the United States is agenerous and welcoming country, and Americans are, for the most part, a generous and welcoming and forgivingpeople.”

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model, the Medical Center has flourished and has undergoneunprecedented growth.

“Bob Joynt was truly a great man. He made a fundamentaldifference in the way our Medical Center is led through his leadership in integrating academic medicine and clinical care,”said Joel Seligman, president of the University of Rochester. I met him late in his life, but his charm, his dedication to his

colleagues, the Medical Center andRochester, his capacity to inspire affec-tion in others were always evident. Hewill truly be missed. He was everyone’sfriend here.”

Dr. Joynt’s encyclopedic knowledge ofhealth and disease ultimately benefittedpeople around the globe who were treatedby the thousands of physicians influencedby him. That influence was a productboth of his intellect and his self-effacing,congenial personality, say colleagues.

“Bob was extraordinarily intelligentand able to make all kinds of challengingdiagnoses in his patients,” said Richard T.Moxley, M.D., a long-time friend andcolleague. “At the same time, he had aremarkably comfortable way dealing with

people, and they embraced him, and his knowledge and insights.”Dr. Joynt’s easy way with people, his rapier wit and readiness

with a good joke were legendary. He was a popular after-dinnerspeaker at gatherings that would have been sedate and stiff hadnot Dr. Joynt put the guests in stitches.

“Bob was a true renaissance man, with more knowledge

Robert J.Joynt

by Tom RickeyDr. Joynt was still working at the Medical Center, mentoringstudents and colleagues alike. After a full work week, he diedon his way to neurology grand rounds, a weekly event heenjoyed for more than 45 years.

A towering figure in international circles of neurology, Dr. Joynt headed both leading societies in neurology, theAmerican Academy of Neurology and theAmerican Neurological Assoc iation. Healso served as president of the AmericanBoard of Psychiatry and Neurology.

Beyond that, he was a belovedmember of the Medical Center’scommunity, which he had servedthrough several top-level posts,including dean of the School ofMedicine and Dentistry.

“The first word that comes to mindwhen thinking of Bob is integrity,” saidJules Cohen, M.D. (BA ’53, M ’57),professor of medicine and medicalhumanities, a good friend who enjoyedfrequent meals over a span of decadeswith Dr. Joynt. “He was honest andstraightforward, and did his job withoutfanfare. He was generous of spirit in his approach to everyone.He was just a totally decent human being.”

Dr. Joynt was the first individual to oversee both theacademic enterprise of the School of Medicine and Dentistryas well as the patient-focused clinical enterprise that includesStrong Memorial Hospital. Under this integrated leadership

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Robert J. Joynt in 1966

Robert J. Joynt, M.D., Ph.D., one of the most influential

neurologists of the last half century and the founder

of the Department of Neurology at the University of

Rochester Medical Center, died April 13, 2012, at Strong

Memorial Hospital. He was 86.

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on more topics than most people can imagine,” said BradfordBerk, M.D., Ph.D. (M ’81, PhD ’81), CEO of the Medical Center.Bob taught me neurology when I was a medical student, andpart of the reason he was such an extraordinary teacher isbecause he knew how to make you laugh. Later I had theopportunity to interact with him in a discussion group calledthe Pundit Club. He was the master of American history andshared with us his insights into our presidents and politicianswith his usual humor and whimsy.”

Balanced with that humor were remarkable insights, such asDr. Joynt’s conclusion that the Medical Center could benefit froma more integrated leadership structure. Thus was born a new posi-tion that brought the academic and clinical missions of theMedical Center together. He was the first to hold the position.

An Iowa native, Dr. Joynt grew up in the small town of Le Mars. After serving as a radio operator tracking troop move-ments in India during World War II, Dr. Joynt returned homeand attended Westmar College there. He went to medicalschool at the University of Iowa, interned at Royal VictoriaHospital in Montreal and then studied as a Fulbright scholar at Cambridge University. He returned to Iowa City and earnedhis doctoral degree in neuro-anatomy before joining the facultyof the University of Iowa.

In 1966, Dr. Joynt was tapped to create the University’sDepartment of Neurology, an effort that began with three full-time neurologists. Today, the department is home to more than25 times that number and is widely regarded as one of the topdepartments in the nation. Thanks in large part to Dr. Joynt’steaching prowess, Rochester quickly became a top choice foryoung neurologists in training.

In 1989, Dr. Joynt was elected to the national Institute ofMedicine. He was a fellow of the American Association for the Advancement of Science and a member of the Board ofRegents of the National Library of Medicine. He also served as editor of Archives of Neurology, founded Seminars inNeurology, and is the author of the field’s major textbook,Baker and Joynt’s Clinical Neurology.

At the Medical Center, he was director of the University’soriginal Alzheimer’s disease center. Dr. Joynt served as dean ofthe medical school from 1985 to 1989, as vice provost for healthaffairs from 1985 to 1994, and as vice president for health affairsfrom 1989 to 1994, before returning full time to faculty work. In 1997, the University conferred on him the title ofDistinguished University Professor.

In his later years Dr. Joynt became widely recognized as an expert on presidential health. In 2001, he co-editedPresidential Disability, a book devoted to the study of the 25thAmendment, which deals with succession in the nation’s lead-ership in the event that the president becomes incapacitated.

Dr. Joynt is survived by his wife, Margaret, and their sixchildren and nine grandchildren.

Contributions in Dr. Joynt’s memory can be made tomultiple sclerosis research at the University of Rochester, or juvenile diabetes research at Children’s Diabetes Center at Golisano Children’s Hospital.

Q&A Robert J. Joynt, M.D., Ph.D.

A top neurologist and former dean discusses

medicine, education and aging.

About two months before his death on April 13, 2012, Robert J. Joynt., M.D., Ph.D., Distinguished University Professorat the University of Rochester Medical Center and formerdean of the School of Medicine and Dentistry, sat down for an interview with Rochester Medicine for an article in the magazine’s spring issue. Here is what he had to say.

You have not retired. What keeps you busy these days?I work with first and third year medical students in Problem-based Learning sessions, presenting clinical problems to theclass. I do professor’s round with residents and medical studentsto see patients. I enjoy it very much. I used to work in theclinic and hope to start back again at least part time. I’m notready yet to stop. I enjoy the camaraderie with the youngpeople, the residents and the students and the staff. I’m stillvery interested in the new advances of neurology. Everydaythere is something new in the field and that is very encour-aging. If that is staying in the game, so far it has worked.

This year is the 60th anniversary of your graduation frommedical school at the University of Iowa. That’s quite a spanof medicine.I’ve seen a lot of medicine, good and bad. We have a lot ofnew treatments today in neurology. When I began, neurologywas a kind of no-man’s land. We didn’t have many goodmedications. We had antibiotics and the use of steroids hadjust been started. We had some drugs but they weren’t veryeffective. The major change came in the late 1960s and early1970s with new imaging technology like the CT scan and thenthe MRI. These diagnostics gave us a way to scan the brain andsee things we just could not see with radiographic techniques.You have to think these advances will continue.

The organization of medicine and the delivery of health careneed to be looked at closely. We have fallen down in that. Whenpoliticians put together health care plans, the last ones they talkto are the physicians. The Canadians have done a much betterjob with health care. People say there are delays. There may be,but, at the same time, you have a stable system and you are notgoing to become destitute over your health care plan. That willhappen more and more here unless we find a new way.

What about changes in medical education?The medical students here are wonderful. The amount oflearning has increased exponentially since I was a med student,particularly in genetics. Our med students come in pretty well-equipped. They take on these challenges very well … When I started medical school, there were few girls in my class.

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Now it’s about now 50–50 men and women. This change hassoftened health care in some ways. It’s been a very good influ-ence on medicine in general.

It used to be that when you started medical school, you gota basic science education and then a good clinical education.There was very little mixing in. With our Double Helixcurriculum, one is wrapped around the other. They are inter-twined. Med students start right out with clinical problems.We introduce a clinical problem that illustrates some of theeffects of damage or disease of the particular part of body theyare learning about. They get to interview patients. We have a lot of instructions in interviewing. It is very important thatstudents learn how to take a good history. To watch a goodhistory-taker take a history and see what they get out of it isamazing. It is a technique that is all important in medicine.Once you get a good history, you are on your way to helpingthat patient.

Reducing the importance of grades in the first two years is another good development. We are taking pressure off the students. They come to us out of a maelstrom of competi-tion for who has the best grades to get into medical school. It gives them a feeling of ease and camaraderie. They get toknow each other and work together and listen to other ideas.It’s a great collegial atmosphere.

You started the first Alzheimer’s center in Rochester. What do you think of the state of Alzheimer’s research?My early research was very basic, a neurophysiological projectthat investigated the way the brain releases vasopressin. But I also was interested in behavioral neurology, the waybrain lesions affect behavior, language disorders and dementia.I was director of the Alzheimer’s center here until I becamedean and could see I could not do justice to the research withthe job of being dean. A lot of the Medical Center’sAlzheimer’s research started from that center’s research.Alzheimer’s has remained very stubborn. We have some symp-tomatic treatments that help for a while, but they do not getdown to the core of the problem and what causes the disease.Hopefully, we will have more luck with stem cells, but we havenot demonstrated much with the current treatments.

I would like to see all the diseases solved, but Alzheimer’s,in many ways, is the most devastating. The humanity of theperson disappears before you. With other similar devastatingdiseases like stroke, which is more common than Alzheimer’s,we’ve made some progress. But Alzheimer’s continues to bevery elusive. If you think in terms of finances – and youshouldn’t always think in terms of finance –Alzheimer’s createssuch a huge health care cost to the country. Combine thatwith what it does to the emotional health of families, you seewhy we must figure out Alzheimer’s.

Are you concerned about tightening NIH research budgets?If you neglect medical research, you’ve neglected one of themost important facets of our government. People around theworld look to the United States for education, medical care

and scientific discoveries. We educate many internationalstudents here and they have enhanced our medical entouragegreatly by coming here.

How do you feel about getting older?I start a little slower than I used to. I think the University ofRochester is just a wonderful place. Even though it has gottenbigger and bigger, it still is a place you can get your handsaround. The students are friendly. There’s a good relationshipbetween the faculty and students. It’s a good place to work. I’ve been fortunate to be able to stay around. I’m probably a provost’s nightmare because I’ve stayed so long.

Robert J. Joynt in 1985

Marshall A. Lichtman, Lowell Goldsmith, and Robert J. Joynt—each a dean of the School.

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medical center rounds

atric facilities and programs.Even through the economic downturn, the

Medical Center has also maintained excellentfinancial results, providing vital resources fortransformation.

Despite the Medical Center’s impressiveperformance over the last five years, Berk facesformidable challenges as his leadership teamdevelops its new strategic plan. National healthcare reform will demand fresh approaches tohealth care delivery and financing and posesthreats to revenues that have supported theclinical and academic missions. As health caredelivery evolves, medical and nursing schoolsmust shift the way they educate and train futureclinicians. Federal funding for biomedicalresearch has tightened, making it more difficultfor investigators to maintain steady grantsupport.

Within the next few months, Berk and histeam will complete a new strategic plan thatwill serve as a roadmap for the next five years.Implementing this ambitious plan will requireintense focus, a fact that has caused Berk toreduce and continue reducing his role inresearch projects to concentrate more fully onleading as CEO.

“I am excited about the Medical Center’sfuture because we’ve assembled outstandingteams inspired with a shared vision. In ourstrategic plan, we will leverage our culture ofpatient-and-family-centered care along withcutting-edge research. Our goal is to becomenationally respected for innovation and excel-lence while providing superb care locally andregionally,” Berk said. “I can’t imagine a moreexciting time to be in health care.”

Bradford C. Berk, M.D., Ph.D. (M ’81, PhD ’81),will serve a second, five-year term as seniorvice president and CEO of the University ofRochester Medical Center, University PresidentJoel Seligman announced.

Berk’s reappointment was approved by theUniversity board of trustees in March.

“No area of the University faces quite therange of challenges that the Medical Centerdoes today in terms of its budget, structure,technology, response to new demands for alter-native forms of health care delivery, andchallenges to support of basic and clinicalresearch,” Seligman said.

Seligman praised the senior leadership teamassembled by Berk and their implementing ofthe Medical Center’s strategic plan, addressingongoing needs to expand and modernizemedical facilities, making difficult budget deci-sions for the hospitals and School of Medicineand Dentistry and School of Nursing, and nego-tiating more supportive relationships with thirdparty payers.

The reappointment demonstrates theUniversity’s confidence in Berk’s leadership at a critical juncture in the Medical Center’shistory.

As health care reform creates incentives forproviders to increase the value, rather than thevolume, of the care they provide, the MedicalCenter has substantially increased its qualityand patient safety initiatives. Inspired by hisown experiences following a serious spinal cordinjury in 2009, Berk also has driven the MedicalCenter to adopt a rigorous approach to patient-and-family-centered care, an effort that isboosting patient satisfaction scores across thehealth system.

In 2011, a record number of clinical programs– four adult and three pediatric specialties –

earned Top 50 rankings in U.S. News & WorldReport.

During Berk’s tenure, federal researchfunding to Medical Center scientists reached anall-time high, with stimulus funds compoundingthe rise. The Medical Center also opened a number of new facilities, including theSaunders Research Building and a freestandingambulatory surgery center.

A four-story addition atop the WilmotCancer Center also is opening, adding 42 newmuch-needed inpatient beds. Construction willbegin this year on a new 237,000-square-footGolisano Children’s Hospital, the centerpiece ofa $100 million fundraising campaign for pedi-

Bradford C. Berk appointed to second term as Medical Center CEO

I am excited about the … future because we’ve assembled outstanding teamsinspired with a shared vision. Our goal is to become nationally respected forinnovation and excellence while providing superb care locally and regionally.”

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As diabetesemerges,researcherstrack disease’sfirst steps By Tom RickeyScientists have taken a remarkably detailedlook at the initial steps that occur in the bodywhen type 1 diabetes mellitus first develops ina child or young adult.

The analysis comes from a team ofresearchers and physicians at the University ofRochester Medical Center who have expertiseboth in the laboratory and in treating patients.The team studied children from ages 8 to 18within 48 hours of their diagnosis with type 1diabetes.

The incidence of the disease is rising quicklyand has roughly doubled during the last 20 yearsor so. The trend is clear to Nicholas Jospe, M.D.,chief of pediatric endocrinology at GolisanoChildren’s Hospital of the University ofRochester Medical Center. His group now seesabout 90 new cases of type 1 diabetes per year,compared to approximately 25 annually 20 yearsago.

Every day, Jospe counsels families and chil-dren coping with the condition. At the sametime, immunologists like Deborah J. Fowell,Ph.D., use an array of high-tech equipment tointerrogate the likes of T-cells and macrophagesfor answers about the workings of the immunesystem.

For a study published in the journal Diabetesin February, Fowell and Jospe pooled theirstrengths to look at the disease in a way impos-sible to do alone. While scientists knowdiabetes is becoming more common, they don’tunderstand what factors trigger it, why somechildren are more prone to getting it, or evenwhy it’s becoming more common.

Important clues lie within the so-calledhoneymoon phase” in newly diagnosedpatients, a period when the disease is moreeasily controlled in patients than at any othertime.

While diabetes never fully goes away, it ismarked by a single, early remission phase thatstarts within weeks of diagnosis and lasts a

year or two. During this time, patients arehealthy and don’t need much insulin to controlthe disease.

“If we knew what was happening, perhapswe could replicate it or prolong it for the benefitof the patient.” Jospe said. “Most treatmentstoday attempt to do just that-prolong the honey-moon period. But there has not been muchsuccess thus far.”

In a hunt for answers, Jospe teamed withFowell, associate professor of microbiology andimmunology. Fowell’s group analyzed severalmeasures of the immune system during the yearafter diagnosis in 21 children with type 1diabetes, as well as in 22 healthy children and70 healthy adults.

The team focused on immune cells known asT-regulatory cells. Fowell is an expert on T-regs” and highlighted their role in a 2011 inthe Proceedings of the National Academy ofSciences. The team found a great deal of vari-ability among the children. In some, T-regulatorycells appeared to function normally throughoutthe remission period, while in others, activityappeared low throughout. In still other children,activity dipped during the honeymoon phase butthen bounced back.

At the same time, the team witnessed anincrease in activity of immune-boosting effector cells,” and increases in cytokines forinterleukin 17 and tumor necrosis factor. Such

chemical signaling molecules play a key roleprotecting us from pathogens, but in autoim-mune diseases they have a hand in causingtissue damage. In diabetes, for instance, theyhelp to incite the immune attack that destroysthe insulin-producing cells in the pancreas.

The mix of results can be interpreted inmany ways, said Jospe. One possibility is thatthe immune system is producing rogue immunecells that can’t be well controlled by the T-regu-latory cells. Another possibility is that thefunction of the T-regulatory cells is not up to par,giving wayward cells the opportunity to harmthe body.

Jospe and Fowell are hopeful that theresults, a series of molecular snapshots ofimmune activity in patients, will contribute to abetter understanding of the disease.

“One hope, of course, is to create bettertreatments for patients. Another possibility is tofind biomarkers to identify children who are atextra risk of developing type 1 diabetes,” saidJospe.

The study was supported in part by theUniversity’s Autoimmunity Center of Excellence,which is funded by the National Institute ofAllergy and Infectious Diseases.

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Researchers test drug,psychotherapycombo forfibromyalgia By Emily BoyntonFor the first time, researchers will test whethertwo treatments are better than one for patientswith fibromyalgia.

With a $5.5 million grant from the NationalInstitutes of Health, scientists from theUniversity of Rochester Medical Center and theUniversity of Washington School of Medicinewill evaluate the combination of a drug andbehavioral health treatments in easing thechronic, widespread pain characteristic of thecondition.

Calls for such a study – from experts andadvocates, to patients and families – stem fromthe very modest benefits available therapiesprovide for the estimated 3 to 6 millionAmericans, mostly women, with the often debil-itating disorder.

“Overall, current treatments for fibromyalgiaare only partially effective: No more than half ofpatients get relief, and the other half stoptherapy because they don’t get relief or theydon’t like the side effects,” said Robert H.Dworkin, Ph.D., professor in the Department ofAnesthesiology and the Center for HumanExperimental Therapeutics at the MedicalCenter. “Of those patients, who do get relief,their pain doesn’t decrease dramatically; it goesdown by a third, a half at most, so they are stillliving with considerable pain.”

Dworkin, a principal investigator who willconduct the study with lead researcher andlong-time collaborator Dennis C. Turk, Ph.D., the John and Emma Bonica Professor ofAnesthesiology and Pain Research at the

University of Washington, says no other studieshave looked at the combination of medicationand behavioral treatment in any chronic paincondition.

The team will study the effects of tramadol(brand name Ultram), a drug approved for thetreatment of acute and chronic pain, combinedwith either cognitive-behavioral therapy orhealth education treatment-both of which workto change the way people think about theircondition to ultimately improve the way they actand feel-to determine if a drug and one of thebehavioral health treatments together is betterthan either one alone. Researchers are not onlyinterested in the combo’s influence on pain, buton patients’ ability to carry out the activities ofdaily life, as well. Past research and Dworkinand Turks’ own experience studying fibro -myalgia suggest that increasing activity iscritical in helping patients get better.

“When you are more active and can do thethings you want to do-go to the movies withyour family, walk around the mall, do house-work-it takes your mind off the pain and makesyou feel better about your life overall,” saidDworkin. “I liken it to a virtuous circle or a posi-tive loop: When you are more physically activeyou sleep better, and when you sleep better youhave less pain, and when you have less pain youcan do more of the things you love to do.”

Robert H. Dworkin, M.D. Ellen Poleshuck, Ph.D.

Increasing physical activity and enhancingsleep quality are major goals of the behavioralhealth treatments that will be provided in thetrial. Ellen Poleshuck, Ph.D. (FLW ‘00), associateprofessor in the Department of Psychiatry at theMedical Center, who will also help run the trial,says the behavioral health treatments weredesigned specifically for patients withfibromyalgia. Participants will learn aboutfibromyalgia and various strategies forimproved coping, for example, pacing, or under-standing how much activity they can manageand monitoring themselves accordingly, andsleep hygiene, such as not doing anything inbed besides sleeping.

The study is funded by the National Instituteof Arthritis and Musculoskeletal and SkinDisease at the National Institutes of Health. Inaddition to Dworkin and Turk, James P.Robinson, M.D., Ph.D., associate professor ofrehabilitation medicine at the University ofWashington School of Medicine, will serve asprincipal investigator.

Increasing physical activity and enhancing sleep quality are major goals of the behavioral health treatments that will be provided in the trial.

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33

Rochester Medical Center.Strawderman replaces David Oakes, Ph.D.,

interim chair and professor of biostatistics, whohas been leading the department since thesudden death of Andrei Yakovlev, M.D., Ph.D., inFebruary 2008. Yakovlev pioneered a majorexpansion of the department beginning in 2002,to one of the best-funded in the country, andOakes has continued to drive that momentum.

The Department of Biostatistics andComputational Biology is at the core of allresearch and plays a pivotal role in planning forfuture research initiatives at the MedicalCenter, and Strawderman is an excellent choiceto build on the legacy of Yakovlev and Oakes,said Mark B. Taubman, M.D., dean of the Schoolof Medicine and Dentistry.

“Dr. Strawderman is an outstanding scien-tist and a delightful person,” Taubman said. I look forward to his galvanizing our efforts in allareas of biomathematics.”

Strawderman earned his master’s anddoctorate degrees in biostatistics from HarvardUniversity, where he also received theDistinguished Alumni Award in 2008. Heobtained a bachelor’s degree in mathematicsfrom Rutgers College. He was a faculty memberat the University of Michigan from 1992 to 2000,before moving to Cornell.

“Dr. Strawderman brings to Rochester the

Cornell scholarnamed chair ofbiostatisticsRobert L. Strawderman III, Sc.D., professor ofbiological statistics and computational biologyand statistical science at Cornell University, andprofessor in the Department of Public Health atWeill-Cornell Medical College, has been namedchair of the Department of Biostatistics andComputational Biology at the University of

The iPad links with theDouble HelixThe iPad officially is a part of the University ofRochester School of Medicine and Dentistrycurriculum.

All first-year medical students – 103 ofthem – received an iPad 2 in March. Beginningnext year, first-year students will receive iPadsduring orientation.

“The iPad will allow easier access to educa-tional material,” said David Lambert, M.D., theSchool of Medicine and Dentistry’s senior asso-ciate dean for medical student education. “TheiPad also will allow more interactive learningand more online learning that students can doon their own time.”

The School plans to eliminate the printing of

a syllabus and also purchase digital versions oftextbooks and chapters of textbooks that thenwould be available through the iPad. Materialfor the Problem-Based Learning classes willbecome electronic instead of paper handouts.

“We’ll save a lot of trees and students willhave less to carry in their backpacks,” Lambertsaid.

The iPad program began with only the first-year class to confirm the infrastructure and buildthe syllabus.

“We will get comfortable and learn from theprocess,” Lambert said.

First-year students used the iPad for theirHost Defense course. Miner Library librarians,IT staff and e-learning staff trained the first-yearstudents on use of the iPad. Miner also providesall support for iPad use by medical students.Miner won a Technology Improvement Awardfrom the National Network of Libraries ofMedicine to purchase iPads for the library andfor training of the staff.

vision of a great leader, the experience of agreat scholar, the patience of a great teacher,and the thoughtfulness of a true collaborator,”said Robert G. Holloway, M.D., M.P.H. (R ’93, FLW’96, MPH ’96), chair of the search committee,and professor of neurology and communitymedicine.

Strawderman’s major research area issurvival analysis, with a focus on problemsinvolving recurrent event data. More generally,he is interested in statistical inference for pointprocess data; outcome prediction in medicine,epidemiology and public health; evaluating thecost and quality of health care; demography andpopulation studies; asymptotics (theory andapproximation); and, various problems in statis-tical computing. At Cornell he served as directorof graduate studies for the fields of statisticsand biometry, and director of the Statistics Coreat Cornell Population Center.

Since 1997 Strawderman also has continu-ously served as an associate editor at theJournal of the American Statistical Association(JASA Theory & Methods) and is an associateeditor of The Electronic Journal of Statistics.

Strawderman said he recognizes theMedical Center’s strong reputation for both itsresearch and clinical enterprises and theinherent importance of maintaining a focusedand thriving biostatistics department. goals.

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Early surgerycontrolsseizures,improves qualityof lifeBy Mark MichaudThe majority of patients with previously uncon-trolled temporal lobe epilepsy who underwentsurgical intervention early in the course of theirdisease were not only seizure free, but experi-ence a significantly higher quality of lifecompared to those who only manage theircondition medically, University of RochesterMedical Center researchers reported.

“The results of this study are very clear:early surgical intervention works, it stopsseizures, and it improves quality of life,” saidMedical Center neurologist Karl Kieburtz, M.D.,M.P.H. (M ’85, MPH ’85), the senior author of thestudy published in March in the Journal of theAmerican Medical Association.

“Individuals with temporal lobe epilepsythat is not controlled with medicine should beevaluated for surgical intervention at a compre-

hensive epilepsy center not after decades ofpoor response to medicine but within two years.And if they are a surgical candidate they shouldgive strong consideration to that approach.”

While surgical treatment has been shown tobe effective in reducing seizures, a temporallobectomy is often only considered after allother medical options have failed. Con -sequently, patients referred for surgery havebeen living with the condition for an average of22 years and are often 10 years removed fromhaving been declared “refractory,” meaning thatthat at least two different antiepileptic drugshave failed to control their seizures. As a result,by the time patients opt for surgery they haveoften been living at high level of disability witha loss of independence and diminished qualityof life for an extended period of time.

The study, called the early randomizedsurgical epilepsy trial (ERSET), followed individ-uals with mesial temporal lobe epilepsy. Inorder to be eligible, patients had to be withintwo years of having been declared refractory.One group of participants underwent a temporallobectomy and the other group was assigned toa program of best medical care.

The study then tracked the frequency andseverity of the participant’s seizures, theircognitive function, quality of life, social interac-tions, and other outcomes such as employmentand education status, ability to work, and

number of hospitalizations over a 24 monthperiod.

After two years, 73 percent of the partici-pants who underwent surgery were seizure freein the second year after the procedure asopposed to none in the medical group. Thesurgical group also reported a significantlyhigher quality of life. Cognitive problems suchas memory loss were similar between bothgroups. The members of the surgical group alsoreported a significant increase in independenceand the willingness and ability to spend moretime with friends and family. For example, thenumber of individuals who reported being ableto drive a car rose from 7 to 80 percent in thesurgical group. At the end of two years, only 22percent of the medical group was driving.

The results were a surprise given that thestudy had been recommended for early termina-tion due to slow enrollment. The study wasoriginally intended to follow 200 patients, butonly 38 were ultimately recruited. Despite thelow number of participants, the results arestatistically significant enough, in the authors’opinion, to compel a new approach to the treat-ment of patients with uncontrolled temporallobe epilepsy.

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Brain fog’ ofmenopauseconfirmedBy Tom RickeyThe difficulties that many women describe asmemory problems when menopause approachesare real, according to a study published in March inthe journal Menopause by scientists at theUniversity of Rochester Medical Center and theUniversity of Illinois at Chicago.

“The most important thing to realize is thatthere really are some cognitive changes that occurduring this phase in a woman’s life,” said MiriamWeber, Ph.D. (FLW ’06), the Medical Centerneuropsychologist who led the study. “If a womanapproaching menopause feels she is havingmemory problems, no one should brush it off orattribute it to a jam-packed schedule. She can find

comfort in knowing that there are new researchfindings that support her experience. She canview her experience as normal.”

The study included 75 women, from age 40to 60, who were approaching or beginningmenopause. The women underwent a battery ofcognitive tests that looked at several skills,including their abilities to learn and retain newinformation, to mentally manipulate new infor-mation, and to sustain their attention over time.They were asked about menopause symptomsrelated to depression, anxiety, hot flashes, andsleep difficulties, and their blood levels of thehormones estradiol and follicle-stimulatinghormone were measured.

Weber’s team found that the women’scomplaints were linked to some types ofmemory deficits, but not others. Women whohad memory complaints were much more likelyto do poorly in tests designed to measure whatis called “working memory,” the ability to takein new information and manipulate it in their

Alumnus leads nationalpalliative careorganizationTimothy E. Quill, M.D. (M ’76, R ’79), director ofthe Center for Ethics, Humanities and PalliativeCare at the University of Rochester Center, isthe new president of the American Academy ofHospice and Palliative Care Medicine.

Quill takes the reins of the 4,100-membergroup at a time when hospitals are working tokeep up with increasing demand for palliativecare, which provides symptom-relieving meas-ures and added support during all stages ofserious illness. The focus is on alleviatingsuffering and relieving symptoms while at thesame time delivering the best possible medicaltreatments to patients.

“For too long, people have approached thequestions surrounding relieving suffering andenhancing patients’ well-being as an either/orproposition with regard to disease treatment,”said Quill, who also heads the Palliative CareDivision of the Department of Medicine. “Thequestion is no longer whether to treat medically

or to provide comfort-oriented care. Most oftenwe can do both side by side. This approach is atthe center of modern palliative care, providingthe best medical treatments while simultane-ously reducing pain, enhancing the patient’squality of life and opening lines of communica-tion within a family.

“Recent studies have shown that thisapproach enhances quality of care, savesmoney and may even prolong life. Our under-standing of palliative care has really evolved,”added Quill, who is professor of Medicine,Psychiatry, Medical Humanities, and Nursing.

Quill has helped train a generation of physi-

heads. Scientists also found that the women’sreports of memory difficulties were associatedwith a lessened ability to keep and focus atten-tion on a challenging task.

Such cognitive processes aren’t what typi-cally come to mind when people think ofmemory.” People usually consider memory to be the ability to tuck away a piece of infor-mation and to retrieve it later. The team foundlittle evidence that women have problems withthis ability.

Women who reported memory difficultieswere also more likely to report symptoms ofdepression, anxiety, and sleep difficulties. Theteam did not find any link between memoryproblems and hormone levels.

“Science is finally catching up to the realitythat women don’t suddenly go from their repro-ductive prime to becoming infertile,” said Weber,assistant professor of neurology. “There is thiswhole transition period that lasts years. It’s morecomplicated than people have realized.”

cians in medical schools across the countryabout how to work effectively with seriously illpatients. Increasing the pool of people trainedin palliative care is a top priority for Quill, whosays there are not enough young physicianstrained in the area to meet the growing nationalneed.

Quill heads one of the strongest palliativecare programs in the world. The team providesmore than 1,000 new inpatient consultationsand about 400 new outpatient and home consul-tations annually. The program also offers a12-bed inpatient unit, required palliative careeducational experiences for medical studentsand residents, a clinical fellowship program,and a clinical research team.

URMC and its community affiliates havemore than 25 board-certified physician special-ists in palliative care, one of the highestconcentrations of palliative-care physicianspecialists in the nation. Recently, theUniversity of Rochester Medical Center’sPalliative Care Program became the first in anacademic medical center nationwide to earnadvanced certification from the JointCommission.

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philanthropy

Richard and Margaret Burton DistinguishedProfessorship in Orthopaedics, with a goal ofraising a total of $2 million to fund the directorof the internationally recognized Center forMusculoskeletal Research. Their generouscommitment supports The Meliora Challenge:The Campaign for the University of Rochester.

During Burton’s tenure as chair of theDepartment of Orthopaedics, he developed thevision for a multidisciplinary research centerfocusing on orthopaedic conditions. With hissupport, the Center was among the first groupsnationally to have integrated teams of cliniciansand scientists working together to understandthe cellular and molecular aspects oforthopaedic disease and to extend this knowl-edge to improved patient care.

The inaugural Burton Professor will beEdward M. Schwarz, Ph.D., director of theCenter for Musculoskeletal Research. Schwarzis a national leader in the study of the interac-tion of the immune system with themusculoskeletal system. His pioneering work isleading to potential new treatments fordiseases such a rheumatoid arthritis, boneinfections, and tissue regeneration.

“The Department of Orthopaedics benefitedtremendously from Dick’s leadership, and I amthrilled that this professorship will carry on hislegacy and honor both Dick and Peggy for gener-ations to come,” said School of Medicine and

Richard and

Margaret Burton

Distinguished

Professorship

in Orthopaedics

establishedRichard Burton, M.D. (R ’64), has been a centralfigure in the University of Rochester MedicalCenter’s Department of Orthopaedics andRehabilitation, building it into a national leaderin musculoskeletal care, research and educa-tion. His 50 years of service to the departmentand Medical Center have been a catalyst for thetransformation of musculoskeletal care in theregion.

Adding to his extraordinary commitment andcontributions to the department and University,Burton and his wife, Margaret, have committed$1 million toward the establishment of the

Dentistry Dean Mark B. Taubman, M.D.Burton, currently senior associate dean for

academic affairs for the School of Medicine andDentistry, has high praise for the emphasis oncollaboration in orthopaedics and at theMedical Center: “We build bridges, not fences.Our outstanding research and clinical effortsreach across diverse disciplines, backgroundsand degrees, and focus on how to best treat andcare for our patients. Our goal is not achievingtoday’s excellence tomorrow, but alwaysstriving to make tomorrow’s excellence betterthan it is today.”

A partner every step along the way has beenPeggy Burton, a scientist in her own right,working as a research chemist, first at Polaroidand then for two years at the University. Overthe years she hosted countless dinners andevents in the Burton home, bringing faculty,residents, staff and administrators together andfostering a spirit of personal connection andcollaboration that continues today.

“I am so proud of everything that has beenaccomplished in the department over the years.Dick and I are so pleased to see the outstandingwork continue on improving the care oforthopaedic patients,” Peggy added.

Burton was a mentor throughout the careerof Regis O’Keefe, M.D., Ph.D (PhD ‘00), currentchair of Orthopaedics and Rehabilitation, the

Edward M. Schwarz, Ph.D.Margaret and Richard I. Burton, M.D.

Continued on page 55

U69873:_ 6/27/12 8:34 AM Page 36

$100 million campaign, which will support botha new children’s hospital and focus on programsto enhance care, research and education. The effort is part of the Medical Center’s $650 million campaign and the overall $1.2billion goal of The Meliora Challenge: TheCampaign for the University of Rochester.

The gift comes from two steadfastsupporters of the University for nearly fourdecades. McAnarney first met the Friedlandersthrough Carolyn’s work as a pediatric nursepractitioner at Elmwood Pediatric Group. Rogerwas the chair of the children’s hospitalfundraising board in 1993 when McAnarney wasnamed the sixth chair of the Department ofPediatrics and pediatrician-in-chief of what is now Golisano Children’s Hospital. TheFriedlanders have supported programs and proj-ects throughout the University, but chose toendow a professorship in McAnarney’s name tohonor her legacy of ongoing work and extraordi-nary contributions on behalf of children.

“We are so fascinated and intrigued by whatshe has done for children all over the world. Shewas the perfect person to recognize in thisway,” Roger said. “This is not just financialinvolvement; it’s heart to heart.”

The first recipient of the professorship willbe Richard E. Kreipe, M.D., professor of pedi-atrics and a protégé of McAnarney’s. Kreipe isthe founding director of the Child and

37

McAnarney

Professorship

in Pediatrics

funded by

FriedlandersPediatric research and education are movingforward at the University of Rochester MedicalCenter, with a major gift from a local couple thathas long supported the University.

A gift from Roger and Carolyn Friedlanderhas created a new endowed professorship inhonor of Elizabeth McAnarney, M.D., professorand chair emerita of pediatrics at the MedicalCenter. The Dr. Elizabeth R. McAnarneyProfessor ship in Pediatrics Funded by Roger andCarolyn Friedlander will be used to supportresearch activities in pediatrics, and to hire,train and mentor talented young scientists tofurther strengthen the future of its programs.

The Friedlanders’ generous commitment willcontribute to Golisano Children’s Hospital’s

Adolescent Eating Disorder Program at thehospital and is a board-certified pediatricianand adolescent medicine specialist, as well as aFellow of the Academy for Eating Disorders. TheChild and Adolescent Eating Disorders Programhas become a sign of hope for young peoplewho suffer from eating disorders as well astheir families, and is a very important compo-nent of the Golisano Children’s Hospital.

“This professorship is a fitting honor for Dr.McAnarney, who has always been responsive towhatever the University needs,” said Mark B.Taubman, M.D., dean of the School of Medicineand Dentistry. “The choice of Dr. Kreipe as thefirst faculty member to hold the professorshipdoubly honors her because he was one of herformer fellows.”

A genuine treasure among the Rochestercommunity, McAnarney’s many accomplish-ments include becoming the first woman tochair the Department of Pediatrics, earning theAlbert Kaiser Medal from the RochesterAcademy of Medicine (2003), and the CrystalHeart Award from the Ronald McDonald House.It is a singular honor to be acknowledged byone’s University and by cherished friends by thecreation of a professorship in one’s name. Thereis no other acknowledgement in academics thatresonates so deeply,” McAnarney said.

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Elizabeth R. McAnarney, M.D. Roger and Carolyn Friedlander

U69873:_ 6/27/12 8:34 AM Page 37

ROCHESTER MEDICINE38

Match Day 2012

Vol. 2 – 2012

ANESTHESIOLOGYChau Doan University of Washington Affiliate HospitalsThomas Fugate University of Rochester Medical CenterKim Hoang University of Rochester Medical CenterMark Jensen SUNY Downstate Medical Center, BrooklynJohn Kowalczyk Case Western/University HospitalsKeila Mayes Duke University Medical CenterPatrick Milford New York University School of MedicineCesar Padilla Cedar-Sinai Medical CenterDavid Sum Yale-New Haven Hospital

DERMATOLOGYAmanda Carpenter University of Rochester Medical CenterKathryn Somers University of Rochester Medical Center

EMERGENCY MEDICINEThomas Eckler St.Luke’s-Roosevelt Hospital CenterKatherine Fitzpatrick University of Pittsburgh Medical CenterHaleh Kadivar University of Wisconsin Hospital and ClinicsRyan McDermott Maricopa Medical CenterMark Pettit Christiana Care Health SystemDorcas Pinto Albany Medical CenterAaron Wiener University of Rochester Medical Center

FAMILY MEDICINECraig Betchart University of Rochester Medical CenterKaren Boston Kaiser Permanente, Los AngelesWilliam Bowen Tacoma Family Medical CenterMonique Castro Glendale Adventist Medical CenterReija Rawle O’Connor Hospital, San Jose, Calif.

MATCH DAY 2012The drama of Match Day took place in Whipple Auditorium at the University ofRochester Medical Center this year, where both tension and spirits were high.

Judging by the smiles and yells at 12:01 p.m. March 16, the Class of2012 was happy with the match results, said David R. Lambert, the School’ssenior associate dean for medical student education.

One hundred and four members of the Class of 2012 matched. In thatgroup, 25 will complete training at the University of Rochester MedicalCenter and 39 will complete training in New York State. Rochester studentsmatched to programs in 23 of the states and District of Columbia.

The top specialty choices in the class were: Internal Medicine (22),Pediatrics (13), Anesthesia (9), Obstetrics and Gynecology (8) and GeneralSurgery (7) and Emergency Medicine (7).

More than 95 percent of U.S. medical school seniors–the highest rate in30 years – matched to residency positions according to new data releasedtoday by the National Resident Matching Program.

Of the applicants from U.S. schools who matched, 81.6 percent matchedto one of their top three choices. More than 56 percent of U.S. studentsmatched to their first choice. Another 15.6 percent matched to their secondchoice and 9.5 percent their third.

David R. Lambert, M.D., addresses the gathering.

Andrew Pistner, William Bowen and friend.

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GENERAL SURGERYFrank Bauer Exempla St. Joseph Hospital, DenverChen He Case Western/University HospitalsBradley Hensley University of Rochester Medical CenterJing Li Huang University of Minnesota Medical CenterMelissa Mura University of Rochester Medical CenterMehr Qureshi University of Rochester Medical CenterTheophilus Ugheghe Banner Good Samaritan Medical CenterDaniel Young Virginia Mason Medical Center

INTERNAL MEDICINEMary Carpenter University of Rochester Medical CenterRobert Fulton Oregon Health and Science UniversitySarah Glantz Rhode Island Hospital/Brown UniversityHeather Hopkins Gil University of Rochester Medical CenterMichael Insel California Pacific Medical CenterJames Kim New York University School of MedicineDaniel Kroenig University of Rochester Medical CenterYi Lin University Hospital, CincinnatiKristy Mathes Oregon Health and Science UniversityAndrew Mathias University of Rochester Medical CenterAna Nunes Scripps Clinic/Green HospitalGregory Ouellet Yale-New Haven HospitalJennifer Ouellet Yale-New Haven HospitalLeslie Park New York University School of MedicineEllegant Pearson Lankenau HospitalAndrew Pistner University of Wisconsin Hospital and ClinicsMichael Raco Maine Medical CenterJames Shaw University of Rochester Medical CenterJennifer So Temple University HospitalZachary Suter University of Rochester Medical CenterMartha Trimbur Einstein/Montefiore Medical CenterRon Wexler Tufts Medical Center

MEDICINE-PEDIATRICSEmily Gaukler Christiana Care Health SystemBrian Stanistreet University of Rochester Medical Center

NEUROLOGYErin Casey St. Louis Children’s HospitalJennifer Cialone University of Rochester Medical CenterPeter Creigh University of Rochester Medical CenterLauren Loss University of Rochester Medical CenterMelissa Tsuboyama University of Rochester Medical Center

OBSTERICS-GYNECOLOGYAdebola Falae Tulane University School of MedicineJennifer Fichter University of Rochester Medical CenterAriel Lee Tulane University School of MedicineMeredith Pensak Pennsylvania HospitalRebecca Petersen University of Minnesota Medical SchoolArie Shaw University of Tennessee College of Medicine, MemphisJonas Wilson-Leedy Hershey Medical CenterRachel Zigler Barnes-Jewish Hospital

To view a Match Day video and slide show, visit RochesterMedicine online at www.rochester-medicine.urmc.edu

Keila Mayes and Melissa Mura

Mary Fraga

Trivia game before the Match.

U69873:_ 6/27/12 8:34 AM Page 39

Vol. 2 – 2012ROCHESTER MEDICINE40

Match Day 2012

OPHTHALMOLOGYMircea Coca University of Texas at GalvestonRobert Fargione Albert Einstein College of MedicineLeah Kammerdiener Medical University of South CarolinaKendra Klein Tufts-New England Eye CenterAmit Sangave University of Rochester Medical Center

ORTHOPAEDIC SURGERYDebbie Dang University of California at San FranciscoHavalee Henry Yale-New Haven HospitalSirish Kondabolu Stony Brook Teaching HospitalTyler Moore University of California at Irvine Medical CenterSandeep Soin University of Rochester Medical Center

PATHOLOGYXuan Wang Vanderbilt University Medical Center

PEDIATRICSLucy Amory Oregon Health and Science UniversityStanley Dunn Eastern Virgina Medical SchoolAdam Dziorny Children’s Hospital of PhiladelphiaMary Fraga Einstein/Montefiore Medical CenterCandace Gildner Children’s Hospital of PhiladelphiaKarla Haag University of Rochester Medical CenterBenjamin Marsh Einstein/Montefiore Medical CenterAlejandro Mones Baystate Medical CenterAndrea Petersen Baylor College of MedicineJoseph Point du Jour Einstein/Jacobi Medical CenterRachel Pokorney University of Washington Affiliate HospitalsTimothy Porter Northwestern McGaw Medical CenterDeborah Traub University of Colorado School of MedicineBrittany Walker Inova Fairfax Hospital

PHYSICAL MEDICINE & REHABILITATIONKurt Mildenstein Loma Linda University Medical Center

PLASTIC SURGERYEmily Von Kouwenberg Albany Medical Center

PRIMARY CARE MEDICINEIyerus Tariku University of Connecticut Medical Center

PSYCHIATRYDavid Benavidez University of Rochester Medical CenterKatherine Klingensmith Yale-New Haven HospitalMichele Nelson University of California at Irvine Medical CenterRobin Valpey University of Pittsburgh Medical Center

RADIATION ONCOLOGYPaul Youn University of Rochester Medical Center

UROLOGYIlana Jacobs University of Texas Southwestern Medical SchoolJeffrey Sparenborg Georgetown University Hospital

Jennifer Cialone

Ellegant Pearson (right)

Mehr Qureshi (holding letter) and friends.

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STUDENTS MATCHING HEREMatch Day is a two-way street. While many are leaving Rochester and the School of Medicine and Dentistry, more than 100 physicians will serveas residents and receive training in Rochester. They come from throughoutthe United States and many countries.

ANESTHESIOLOGYRyan Anderson Kansas City University of Medicine and Biosciences

College of Osteopathic MedicineSpencer Burk Virginia Commonwealth University School of MedicineJonathan Chow Albany Medical CollegeMadojutola Dawodu Duke University School of MedicineMehran Ebadi-Tehrani Michigan State University College of Human MedicineAlexander Hawson Columbia University College of Physicians and

SurgeonsScott Kagie Medical College of WisconsinSarah Kralovic St. George’s UniversityStephen Little New York College of Osteopathic Medicine of

The New York Institute of TechnologyJacqueline Lozano State University of New York at Buffalo School of

Medicine & Biomedical SciencesDerek Mitchell University of Washington School of MedicineKiritpaul Nandra Saba University School of MedicineYaser Rad Saba University School of MedicineMatthew Sabo UMDNJ–New Jersey Medical School

DERMATOLOGYAmy Strikwerda Medical College of Wisconsin

DIAGNOSTIC RADIOLOGYChung Cuiffo State University of New York at Buffalo School of

Medicine & Biomedical SciencesAmit Desai SUNY Upstate Medical UniversityChristopher Gange Drexel University College of MedicineAkshya Gupta Jefferson Medical College of Thomas Jefferson

UniversityOmar Hasan UMDNJ–Robert Wood Johnson Medical School at

PiscatawayAlexander Kessler SUNY at Buffalo School of Medicine & Biomedical

SciencesDara Omer SUNY at Buffalo School of Medicine & Biomedical

SciencesTejas Patel The Chicago Medical School at Rosalind Franklin

University of Medicine and ScienceBaxter Richardson University of Iowa Roy J. and Lucille A. Carver

College of Medicine

EMERGENCY MEDICINEBrian Barlow UMDNJ–Robert Wood Johnson Medical School at

CamdenPraneeta Bremjit University of Washington School of MedicineLisa Clark Lake Erie College of Osteopathic MedicineHolly Gunyan University of Vermont College of MedicineChristopher Harmon SUNY Upstate Medical University

Cole Klick University of Minnesota Medical SchoolValerie Lou University of California at San Diego, School of

MedicineJeffrey Moon UMDNJ–Robert Wood Johnson Medical School at

CamdenAntonio Rodriguez University of Texas Medical Branch at Galveston Henry Tran University of Utah School of Medicine

FAMILY MEDICINEChristine Cameron Medical University of South Carolina College of

MedicineJessica Ferger SUNY Upstate Medical UniversityJean Hamlin Dartmouth Medical SchoolMatthew Heckman Pennsylvania State University College of MedicineGerrit Heetderks Case Western Reserve UniversityYule Lee Drexel University College of MedicineKarolina Lis Jagiellonian University Medical CollegeRachel Long A.T. Still University of Health Sciences Kirksville

College of Osteopathic MedicineColleen Loo-Gross University of Kansas School of Medicine at Wichita

GENERAL SURGERYSharin Ayazi Shahid Beheshti University of Medical SciencesColin Powers University of Maryland School of MedicineNicole Toscano SUNY Upstate Medical UniversityJoshua Wong Jefferson Medical College of Thomas Jefferson

University

INTERNAL MEDICINEWilliam Amundson University of Minnesota Medical SchoolFerdous Barlaskar University of Michigan Medical SchoolJennifer Barnas SUNY at Buffalo School of Medicine & Biomedical

SciencesKatherine Dodd University of New England College of Osteopathic

MedicineEric Heintz Weill Cornell Medical CollegeMark Hodges SUNY Upstate Medical UniversityElise Janicke SUNY at Buffalo School of Medicine & Biomedical

SciencesSamata Kamireddy Jefferson Medical College of Thomas Jefferson

UniversityPoghni Peri-Okonny Rush Medical College of Rush University Medical

CenterBradley Petkovich University of Arkansas College of MedicineLeigh Sassaman Pennsylvania State University College of MedicineEmily Seif Michigan State University College of Human MedicineTyler Slyngstad University of Washington School of MedicineJennifer Stabel SUNY at Buffalo School of Medicine & Biomedical

SciencesWenjia Wang University of Kansas School of Medicine at Kansas

CityZiolkowski, Susan SUNY Upstate Medical UniversityZittel, Jason Pennsylvania State University College of Medicine

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Match Day 2012

PEDIATRICSUthayanee Balasubramaniam St. George’s UniversityHeather Comerci Temple University School of MedicineLynn Correll University of Utah School of MedicineRachel Diamond Sackler School of MedicineCarol Fries SUNY Upstate Medical UniversityKavithashree Gnanasekaran St. George’s UniversityJustin Goldstein Sackler School of MedicineEthan Helm University of Arkansas College of MedicineKarol Hyjek Jagiellonian University Medical CollegeNaazneen Iqbal The School of Medicine at Stony Brook University

Medical CenterDiana Miller UMDNJ–Robert Wood Johnson Medical School at

PiscatawayKatie Mowers Michigan State University College of Human MedicineSupriya Nair Loyola University Chicago Stritch School of Medicine

PHYSICAL MEDICINE & REHABILITATIONDaniel Amos Saba University School of MedicineDavid Essaff Western University of Health Sciences College of

Osteopathic Medicine of the PacificKatarzyna Iwan Jagiellonian University Medical College

PLASTIC SURGERYElaina Chen Indiana University School of MedicineDiana Meskill Drexel University College of Medicine

PSYCHIATRYRachel Borden SUNY at Buffalo School of Medicine & Biomedical

SciencesBrittany Klein University of South Carolina School of MedicineDana Mahmoud Lake Erie College of Osteopathic MedicineRachel Nadbrzuch SUNY at Buffalo School of Medicine & Biomedical

SciencesJoshua Nelson SUNY Upstate Medical University

RADIATION ONCOLOGYBergsma, Derek Michigan State University College of Human Medicine

SURGERY-PRELIMNathania Figueroa Guillani Ponce School of Medicine

THORACIC SURGERYAmber Melvin The Brody School of Medicine at East Carolina

University

UROLOGYBenjamin Nelson Sanford School of Medicine of the University of

South DakotaKevin Tsai Jefferson Medical College of Thomas Jefferson

University

VASCULAR SURGERYKhurram Rasheed Tufts University School of Medicine

MEDICINE-PEDIATRICSHeather Busick University of Massachusetts Medical SchoolCatherine Dailey Yale University School of MedicineMegan Ditty University of Michigan Medical SchoolPatrick Ellsworth Ohio State University College of MedicineJonathan Lin Indiana University School of MedicineJulia West University of North Carolina at Chapel Hill School

of MedicineMichael Winter Tufts University School of Medicine

NEUROLOGYJustin Chandler University of Utah School of MedicineJohanna Hamel Martin-Luther-Universitaet Halle-WittenbergPeter Morrison New York College of Osteopathic Medicine of

The New York Institute of TechnologyChristopher Tarolli SUNY Downstate Medical Center College of Medicine

NEUROSURGERYKatarzyna Czerniecka Jagiellonian University Medical CollegeKenneth Foxx New York University School of Medicine

OBSTERICS-GYNECOLOGYSnigdha Alur Jefferson Medical College of Thomas Jefferson

UniversityCorrie Anderson University of New England College of Osteopathic

MedicineMegan Locher Oregon Health & Science University School of

MedicineLaura Melcher University of Minnesota Medical SchoolAmy Nosek SUNY at Buffalo School of Medicine & Biomedical

SciencesChinedu Nwabuobi Albert Einstein College of Medicine of Yeshiva

UniversityRaksha Soora University of Arkansas College of Medicine

ORTHOPAEDIC SURGERYRami El-Shaar Northeast Ohio Medical UniversityRaymond Kenney Boston University School of MedicineBilal Mahmood Dartmouth Medical SchoolRobert Mason SUNY Upstate Medical UniversityLucas Nikkel Pennsylvania State University College of MedicineWenjing Zeng Washington University in St. Louis School of Medicine

OTOLARYNGOLOGYPriya Kesarwani Saint Louis University School of MedicineClara Rimmer Albany Medical CollegeJoseph Vella University of Pittsburgh School of Medicine

PATHOLOGYMeenal Sharma Lady Hardinge Medical CollegeBibiana Steinbaur American University of Antigua College of Medicine

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alumni news

How did your venture to Africa begin?Bruce Williams, my roommate in college atRutgers, and I were good friends but we had notbeen in contact in 40 years. When I retired, I made a resolution to find him. In 2008, I foundhim in Chicago. He’s a world-class educator. I went to see him. He invited me to go with himto Kenya to help with a training workshop forcommunity mobilization against HIV/AIDS withKenyan health care workers. I had never been to Africa. I agreed to go.

What happened during your first visit to Kenya?While I was there for the workshops, I wasinvited by a group of Maasai leaders to remotevillages in the Laikipia District in the northwithin sight of Mount Kenya. The farther northyou go, the more difficult it is to travel. Theroads are very poor. It was a rough ride.

I was taken to Lokusero, a village with just ashell of a clinic. The Kenyan government says avillage has to have funds to build the clinic. If itis built and the government certifies it, thegovernment provides personnel to man it. It wasan empty shell because the village had run outof money. This was at the beginning of a terribledrought, which has persisted the last threeyears, and they were totally impoverished. Thecost of completing the clinic was about $8,000.A day or two later, I was taken to anotherremote village, Chumvi, where there was aclinic supported by a small private hospital anda British nonprofit organization. It was in dangerof closing because it was running in the red. No one could fill in gap that turned out to be$250. I returned to the main town, where I metwith Maasai leaders and told them I would finda way to support both clinics.

Did you raise the money?I went home and met with Rotary Clubs, churchgroups, medical groups and people from Yale. I formed a small donor base that now is about100 people. I raised the needed money by mid-

2009. Wonderful things happened. By August2009, the Lokusero clinic was finished withnursing quarters. The government certified thefacility and it was ready to open. There was aproblem: there were no examining tables, desksor chairs. They needed money for capital equip-ment. I was able to raise the money and, by theend of 2009, the clinic was running with twonurses and a health care worker. In partnershipwith the community and the government, solarpanels were installed for lighting and a room foroutpatient maternity facility was added.Chumvi’s clinic was able to stay open with themoney raised and a two-bed maternity unit hasbeen added.

What other needs have you found?There is no reliable water in Lokusero. There isa traditional well about 100 feet from the clinicand a water tank on a hill. The pump is poweredby diesel fuel but the village is so poor theycan’t afford money for fuel. We have raised$22,000 for a solar-powered pump and up todozen solar panels that should provide reliablepower for the pump and for a refrigerator forvaccines and medications.

Another major health issue is the highneonatal mortality rate, which ranges from 56per thousand and 171 per thousand, which isextremely high. The goal of the government iscreation of an educational program so pregnantwomen in remote villages will understand theadvantages of delivering in a clinic or hospitalsetting. I’m now seeking grant money for aneducational program. There are insufficient fundsin the district. I’m working not in place of but intandem with the district health officers and thegovernment to bring the initiative to reality.

The Maasai have formed an effective lead-ership structure. There are committees toadvise on health care, schools, water and otherissues. I work with the Ilngwesi Afya Group.Afya is health care in Swahili. About 15 peoplewere given seed money in 2005 to form a

Q&A with Ralph F. Stroup, M.D.

Ralph F. Stroup, M.D., is a Class of 1965 grad-uate of the University of Rochester School ofMedicine and Dentistry. He spent two years inRochester as a surgical intern and then surgicalresident before joining the U.S. Air Force fortwo years. Stroup completed his urologytraining at Yale School of Medicine in 1973. He then joined a five-man urology practice inNew Haven, Conn. He retired from the practicein 2006, but he remains an assistant clinicprofessor at Yale, where he runs the residentsurology training clinic.

Retirement and Africa trigger a

dramatic change in an alumnus’ life.

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nonprofit in Kenya made up of Kenyans. Theyfirst did HIV awareness in the communities.They received funding from the Institute ofCultural Affairs, Canada and from the U.S.Agency for International Development. Theycreated a series of programs proven to beexceedingly effective in reducing HIV and AIDS.All the work I do is in direct conjunction withthis group. All the needs assessments and prior-ities come from them. They have receivedinternational recognition for effectiveness andhonesty. They are dynamic people andwonderful to work with.

I also work with the non-profit group,International Consultants and Associates,which has about 35 years of experience inAfrican initiatives. This group is our vehicle fortransferring money. We are IC&A’s largestproject.

What are you working on now?The main thing is to seek funds for an educa-tional grant for a neo-natal and maternityprogram to reduce mortality. I’m also interestedin a lens-less cell phone microscope that isbeing developed by an engineering group atUCLA. A device is attached to a cell phone toallow diagnosing of malaria or conducting anHIV test in the field, anywhere there is cellphone service. The remoteness of our clinicsmakes them an ideal test site. I’m exploring

insecticide impregnated mosquito nets. Malariastill is a very major problem in this part ofKenya. As many as 65 percent of children aretreated for malaria. The nets are about $10 apiece but that is more that the people canafford. I’m also looking at a water filter with nomoving parts and no chemicals. It’s a sand-and-gravel filtration system that is effective inmaking water potable. It eliminates almost 99 percent of disease causing elements. It costs$50 a unit and provides about 60 liters of cleanwater a day. It would mean a better standard ofliving.

How has this affected you?My trips to Kenya have been eye-opening. I always said that in retirement I wanted to stepout of my comfort zone. I found myself in aworld of poverty and need that has had aprofound effect on me. It really has changed mylife. It has changed my life’s priorities, mypersonal charitable donations, and my timepriorities. A lot of what I do is directly related tothese people and projects in Kenya. By concen-trating on building primary health careinfrastructure and clean water facilities, I canaffect the lives of thousands. I could go thereand do hands-on medicine for a week or two butthe number of people helped would be muchsmaller. I am pleased with that decision.

The Maasai and the people in the villages

are very positive and full of great gratitude. I’vebeen to Kenya three times and I plan to go againthis summer. As I’ve gone back and my credi-bility and trust levels have developed, I think I am in a position to bring about changes thatmight not happen otherwise.

To contact Ralph Stroup for informa-tion on his Africa projects, e-mailhim at [email protected]

My trips to Kenya havebeen eye-opening. I always said that inretirement I wanted tostep out of my comfortzone. I found myself ina world of poverty andneed that has had aprofound effect on me.It really has changedmy life. Ralph F. Stroup, M.D., with nurse and midwife Martha Maleson.

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alumni news

With the Major League Baseball season in fullswing, David Lintner, M.D. (M ’86, R ’91), stepsinto his most enjoyable, and perhaps hisbusiest, time of the year.

In addition to being chief of sports medicineat The Methodist Hospital in Houston, Lintneralso is the head team physician for the HoustonAstros, a position he has held since 2000. He isa past president of the Major League BaseballTeam Physicians Association and a member ofthe Baseball Commissioner’s Medical AdvisoryCommittee.

“This is my 18th year working with theAstros and it is the most enjoyable part of mypractice,” Lintner said. “I enjoy being in theathletic environment, the environment ofcompetition. I enjoy the challenge that it pres-ents. Players in the major leagues are thehighest performing guys in their field. Beingable to maintain that top level of performancecan be quite difficult for them. If a player getshurt, it becomes a challenge for team physi-cians.”

Lintner, who also is the team orthopaedistfor the Houston Texans of the National FootballLeague, is one of several University ofRochester School of Medicine and Dentistrygraduates who have landed positions withMajor League Baseball teams and other majorsports teams.

James Williams, M.D. (M ’89), director ofCleveland Clinic Orthopaedic Surgery at EuclidHospital, is an assistant team physician for the Cleveland Indians and a consultant for the Cleveland Cavaliers. Orr Limpisvasti, M.D.(M ’98), who is part of the nationally knownKerlan-Jobe Orthopaedic Clinic, is an ortho -paedic consultant with the Los Angeles Angelsand the head orthopaedic surgeon for theAnaheim Ducks Hockey, a National HockeyLeague team.

And there are most likely several othersbecause of Rochester’s strong program in sportsmedicine. Jan Fronek, M.D. (M ’78), of theScripps Clinic, for example, is head team physi-cian for the San Diego Padres. Elliott Hershman,M.D. (M ’79), is team physician for the New YorkIslanders hockey team. He also is chairman ofthe NFL injury and safety panel and teamorthopaedist for the New York Jets.

Lintner, Williams and Limpisvasti each citeKenneth E. DeHaven, M.D., now professor emer-itus at the School of Medicine and Dentistry, asa primary inspiration for their careers. DeHaven,a Rochester faculty member since 1975 mostrecognized for his work on the meniscus andmeniscus repair, was one of the first to utilizearthroscopy in an orthopaedic sports medicinepractice. He is a past president of the AmericanOrthopaedic Society for Sports Medicine and

the American Academy of Orthopaedic Surgeons.“He is regarded as one of the fathers of

sports medicine,” Lintner said. “Through theyears, the number of Rochester medicalstudents who worked with Dr. DeHaven and thenumber of physicians who did their orthopaedicresidency at Rochester and then went intosports medicine is quite large. I think thesubgroup who became team physicians at theprofessional sports level is unmatched for anyresidency in the country.”

In medical school, Lintner initially was inter-ested in internal medicine and pointed towardfamily medicine. He spent one summer inresearch with DeHaven, also following him inthe clinic and operating room.

“I loved the way he took care of his patients,his attention to detail in surgery and the natureof his patient population,” Lintner said. “Andyou got to spend part of a day on the sidelines,training room or at practice. That seemed morelike fun and not work. He was and is a superbrole model.”

Williams, who coached skiing and soccerand earned a master’s degree in sports manage-ment before going to medical school, first metDeHaven through a ski club near Rochester.

“The greatest thing I learned from Rochesterwas how to talk to patients,” Williams said.That’s a lost art these days. Patients wantdoctors to talk with them. From day one,Rochester is about listening to the patients. I remember when I was a student watching avideo of DeHaven doing a physical exam. I stilldo a physical that way today.”

As a medical student, Limpisvasti spentseveral weeks working with DeHaven.

“I loved what he did for patients and theyseemed to really appreciate his attention totheir athletic goals,” Limpisvasti said. “What I didn’t know at the time was how big a figurehe was in the field of orthopedic sports medi-cine. I just found him to be the kind of doctor I wanted to be one day.”

In Major League Baseball, a team’s headphysician is responsible for maintaining thehealth and well-being of the players throughoutthe entire organization and for providing gamecoverage for the team.

“You have to be available 24/7 for any issue,coordinating care whether a player needs adermatologist or an internist,” said Lintner. I am responsible for making sure it all gets doneregardless of where the team is.”

David Linter, M.D. James Williams, M.D.

Inspired by a legendary Rochesterfaculty member, team physicians care for the high-performance athlete.

Continued on page 55

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class notes

If you see any alumni whom you would like to contact, use the Online Directory atwww.alumniconnections.com/URMC to findaddress information.

Submit your class notes to your class agent or to [email protected].

Note: MD Alumni are listed alphabetically byclass, Resident and Fellow alumni follow inalphabetical order, and Graduate Alumni arelisted separately in alphabetical order.

MD AlumniClass of 1945James Dineen was inducted into the GreaterWilmington (N.C.) Sports Hall of Fame. Anorthopaedic surgeon and sports medicinepioneer, Dineen spent years researching sportsinjuries and promoting safety on the playingfield. He convinced coaches to hydrate theirplayers and instituted the wrapping of posts inend zones. He trained coaches how to wrapshoulders and ankles for strength and was

47

instrumental in instituting annual physicalexams for all high school athletes in the state.Dineen spearheaded the formation of theMedical Aspects of Sports Committee of theNorth Carolina Medical Society and organizedthe first of what has become an annual sympo-sium on sports medicine.

Class of 1948Marvin Epstein writes: “Grandkids aren’tmarrying or having children as early in life as mygeneration did. I married near the end of my firstyear at the School of Medicine and Dentistryand my daughter was at my commencement!However, lately, I have been blessed with a newgreat grandchild yearly! My first is 3 years old,and last December, her sister Noe BessEndelman arrived, and this January my grand-daughter, Flora Margolis, had Maya Shirleen!Exciting!”

Class of 1950Maurice Reizen reports: “It’s harder to write onmy son’s laptop while gazing outward at theGulf of Mexico with 78 degrees temperature inthe Florida Keys. To my surviving classmates:Class of 1950, I greet you and would dearly love

to hear from you. Leanor and I are surviving andenjoying much of what old age has to offer.Public health has always been my passion andhas continued to this date. I resigned my posi-tion as chair, Ingham County (Michigan) Boardof Health, but remain on the board. After all, Iget one free lunch a month. All the best!”

Class of 1954The National Institute of Social Scienceshonored D. A. Henderson (HNR ‘77) among its2011 Gold Medal awardees. The annual awardsrecognize “a small group of Americans whohave made the highest contribution to thewelfare and improvement of American-andoften world-society.” Honorees have come fromthe social sciences, law, government, educa-tion, philanthropy, the arts, medicine, science,and industry. Dr. Henderson is a DistinguishedScholar at the Center for Biosecurity of theUniversity of Pittsburgh Medical Center andformer chief medical officer of the World HealthOrganization Global Smallpox EradicationCampaign.

Class of 1961Richard Isay and Gordon Harrell, his partner of

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class notes

32 years, were married in New York City on Aug. 13, 2011. On Nov. 12, 2011, he was pre -sented with the Hans W. Loewald award by the International Forum for Psychoanalytic Edu -cation for his “original and outstandingcontributions to the development of psycho-analytic theory, practice and application.”

Class of 1962David Ross (R ’70) writes: “What a great fouryears we had together at this fantastic medicalschool. We got along well, and it was thegreatest day of my life when we all graduated in1962. I have had a rewarding career as a plasticsurgeon, getting my residency back at the U of Rwith Drs. McCormack and Hal Bales. I am nowretired in Twin Bridges, in the heart of threeMontana blue ribbon trout streams. The placeswhere trout live are beautiful and this one istoo. My wife is a retired county commissioner,the first woman to be elected in this ranchingtype county, Madison, with 8,000 people. Shestill volunteers on government commissions; Imess around with rafts, a boat, fly rods, and golfclubs. Bob McCormack always said ‘learn golfbecause you can play even when you are old!’

‘Mary Ann, oh Mary Ann, we have come tosee a patient up on C4 who says she cannotwee. Mary Ann, oh Mary Ann, this is whatbothers me: she’s another post op hysterec-tomy!’ Recall? Best to all.”

Class of 1964Joe VanderVeer is editor of the Oslerian,the newsletter of the American Osler Society, a group of about 150 mostly physicians dedi-cated to preserving the memory and teachingsof Sir William Osler.

Class of 1965Beverly Wood (R ’71) has received numeroushonors for her career achievements. In October,2011, she received the American Academy ofPediatrics Education Award. This award recog-nizes a member of the Academy whose careerreflects educational contributions that have hada broad and positive impact on the health andwell being of infants, children, adolescents, andyoung adults. She also received the President’sAward in January, 2012, from the Alliance forContinuing Education in the Health Professionand the Gold Medal of the Association ofUniversity Radiologists in March 2012. Wood iscurrently professor emerita at the University ofSouthern California, Keck School of Medicine

and still teaches a course in the Department ofEducation at the Medical School. She is also aprofessor of radiology at Loma Linda Universityin California and is a consultant of the AmericanAcademy of Pediatrics, where she is also chairof the Committee on Pediatric Education.

Class of 1966Arnold Melman recently published a booktitled: After Prostate Cancer: A What-Comes-Next Guide to a Safe and Informed Recovery. It addresses the physical, psychological andsocial implications of the disease in a straight-forward, informative manner that will hopefullyencourage men to seek help as they realizewhat they are experiencing is not unusual. Thebook provides tips on how to tell others aboutyour disease as well as suggestions as to howto stay connected in both heterosexual andhomosexual relationships. It also includes first-hand accounts of recovery from real patients.According to Dr. Melman, “Once a patientreceives a diagnosis of prostate cancer he andhis loved ones should start reading the book tohelp them through this medical journey.”Melman is chair of the Department of Urologyat the Albert Einstein College of Medicine inNew York.

Class of 1970Benjamin Liptzin received the Oliver WendellHolmes Stethoscope Award from the HampdenDistrict Medical Society and the DistinguishedFaculty Award from the Tufts University Schoolof Medicine. Liptzin is chair of the Departmentof Psychiatry at Baystate Medical Center andprofessor and deputy chair of psychiatry atTufts.Philip Pizzo, dean of the Stanford School ofMedicine, received the 2012 John HowlandAward, the top award given by the AmericanPediatric Society. He was recognized for hisresearch and advocacy for children afflictedwith cancer, HIV, and AIDS. Pizzo played animportant role in the passage of the BestPharmaceuticals for Children Act, whichpromotes clinical trials on drugs targetedtoward children. “He has changed the paradigmfor understanding and management of thesediseases and has been an advocate for thechanges that have translated pediatric researchto practice,” said David Stevenson, professor ofpediatrics, who nominated Dr. Pizzo for theaward. Pizzo also led an initiative to securefederal funding for resident training at children’s

hospitals in the late 1990s. He has more than500 published articles and 16 books about hisfindings in oncology and infectious disease.Pizzo joined the Stanford faculty in 2001. Hepreviously spent more than two decades at theNational Institutes of Health researching child-hood cancer, and has served as an advocate forpatients and families in need of pediatric care.

Class of 1971George L. Hicks (R ’77, FLW ’78) and chief ofcardiac surgery at the University of RochesterMedical Center, received the Socrates Awardfrom the Thoracic Surgery ResidentsAssociation, an arm of the Thoracic SurgeryDirectors Association. The award is given annu-ally to an outstanding faculty member whodemonstrates a remarkable interest in residenttraining, inside or outside of the operating room.Hicks has worked for years developingcurriculum and enhancing teaching methods tobroaden students’ skills and improve patientsafety. He served as chair of the committee oneducation for the American Board of ThoracicSurgery and is president of the Thoracic SurgeryDirectors Association.

Class of 1974Bernard T. Ferrari (BA ’70), a member of theUniversity of Rochester board of trustees, andhis wife, Linda Gaddis Ferrari, have made a $1 million gift to the University’s School of Arts,Sciences and Engineering to endow a yearlyhumanities symposium and related curricula. Its purpose is to explore collaborations betweenthe arts and sciences. This gift also is in supportof the $1.2 billion Meliora Challenge: TheCampaign for the University of Rochester. TheFerrari Humanities Symposia will feature apublic talk from a visiting scholar with expertisein humanistic thought from the 14th to 17thcenturies. The visiting scholar also will partici-pate in courses designed to complement thelecture. Ferrari’s interest in the arts stems froma course he took at Rochester as an undergrad-uate in medieval and Renaissance eraarchitecture and art. He recently publishedPower Listening: Mastering the Most CriticalBusiness Skill of All (Portfolio, 2012).

Class of 1975Charles Seelig (MS ’75) received a Palmer J.Parker Courage to Teach Award from theAccreditation Council for Graduate MedicalEducation. Seelig also was elected by the New

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York Medical College chapter of Alpha OmegaAlpha to be a faculty inductee to AOA.

Class of 1976Timothy E. Quill (R ’79) is one of the 19 individ-uals who received a Rochester BusinessJournal’s 2012 Health Care Achievement Award.He received the Physician Award. The awardhonors individuals and groups whose contribu-tion to health care has been deemedoutstanding by their colleagues, patients andsupervisors.

Class of 1977The Department of Surgery at the University ofCalifornia at San Francisco honored William Y.Hoffman, professor of surgery and chief of theDivision of Plastic and Reconstructive Surgery,with the Stephen J. Mathes, M.D., EndowedChair in Plastic and Reconstructive Surgery.

Class of 1979Robert T. Brodell (R ’82) and Linda P. Brodell (M’81) are leaving their private practice in Warren,Ohio, after 27 years. Bob has accepted the posi-tion of chief of the Division of Dermatology atthe University of Mississippi. Linda and Bob willbe moving to Jackson, Mississippi, this summer.

Class of 1981Bradford C. Berk (PhD ’81) chief executiveofficer of the University of Rochester MedicalCenter, has been appointed to the Board ofDirectors for Raland Therapeutics, Inc., a trans-formational medical device company withheadquarters in Fairport, N.Y.Linda P. Brodell and Robert T. Brodell, M.D.(M ’79) are leaving their private practice inWarren, Ohio after 27 years. Bob has acceptedthe position of chief of the Division ofDermatology at the University of Mississippi.Linda and Bob will be moving to Jackson,Mississippi, this summer.

Class of 1982Carl Krasniak is continuing in his practice inplastic and hand surgery in New Hartford, N.Y.Krasniak’s eldest son, Andrew, is a seniormajoring in history at Union College. Peter is asophomore at the University of Rochester,studying chemistry. Christopher is in the warm-up circle, a high school senior anxiouslyawaiting the thick envelopes, and Madeline is ahigh school freshwoman busy with figureskating and flute.Harold L. Paz (BA ’77), chief executive officer ofPenn State Hershey Medical Center, senior vicepresident for health affairs at Penn State, anddean of the Penn State College of Medicine, hasbeen named to a leadership position on theCouncil of Deans of the Association of AmericanMedical Colleges (AAMC). Paz will serve oneyear as chair-elect of the council followed by one year as its chair. The appointmentincludes a concurrent two-year term on the AAMC’s 17-member board of directors.

“The Rochester Genome” Come in the front door of the Saunders Research Building and see a 44-foot mural titled “The Rochester Genome.” The work,designed by architect Mark Chen, was inspired by the biopsychosocial model of medical education developed at the University of Rochester School ofMedicine and Dentistry in the 1970s and now emulated in medical schools across the nation. “The work is titled the Rochester Genome because it depicts theMedical Center’s fundamental approach to science and medicine,” said Thomas A. Pearson, M.D., M.P.H., Ph.D., director of the Clinical and TranslationalScience Institute. “It represents our dedication to basic science coupled with a focus on the patient and a commitment to the community.” The work was madepossible by a generous gift by David Guzick, M.D., Ph.D., and his wife, Donna Giles, Ph.D. Guzick, now senior vice president for health affairs at the Universityof Florida and president of the university’s health system, was dean of the School of Medicine and Dentistry.

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Paz, who was named to his current positions atPenn State in April 2006, has initiated theformation of the Penn State Hershey HealthSystem, which includes four hospitals, 58 ambu-latory care practices, and eight affiliatedhospitals. He has spearheaded the creation ofPenn State Hershey Rehabilitation Hospital,Pennsylvania Psychiatric Institute, and PennState Hershey Medical Group, and has overseena major 1.5 million-square-foot expansion of thePenn State Milton S. Hershey Medical Centercampus.

Class of 1989John L. Genier (R ’93) is one of the 19 individ-uals who received a Rochester BusinessJournal’s 2012 Health Care Achievement Award.He received the Physician Award. The awardhonors individuals and groups whose contribu-tion to health care has been deemedoutstanding by their colleagues, patients andsupervisors.

Class of 1990L. Gordon Moore (R ’93) is the president of IdealMedical Practices (www.IMPCenter.org) a non-profit supporting adoption of ideal practices inhealth care settings across America. He servesas advisor, expert, and faculty to numerousinitiatives working to achieve better healthoutcomes while bending the cost curve. Hiswork focuses on the intersection of operations,measurement, patient experience, staff satis-faction, outcomes and cost. He is the director ofclinical transformation for Treo Solutions wherehe helps plans and provider systems prepare fortotal cost of care contracting and effectivepopulation health management. Moore is arecent transplant to Seattle with his wife, JanaCarlisle, and their three children, Emma, Jared,and Isabel.

Class of 1995Daniel Ari Mendelson (MS ’93) was namedmedical director of Monroe CommunityHospital, a 566-bed skilled nursing facility and


class notes

community hospital affiliated with theUniversity of Rochester Medical Center.Mendelson was also named 2012 DistinguishedAlumnus from the College of Science at theRochester Institute of Technology, and was alsonamed Highland Hospital’s 2011 DistinguishedPhysician.

Class of 1996Joshua Goldstein has been named associatedean for medical education at NorthwesternUniversity Feinberg School of Medicine. He alsowill become vice president and AccreditationCouncil on Graduate Medical Education(ACGME) Designated Institutional Official for theMcGaw Medical Center. These roles constitutethe primary leadership position for graduatemedical education at Northwestern. Goldsteinhas served in an interim capacity for the pastyear. He joined the Feinberg faculty in 2002 asan assistant professor of pediatrics. His clinicaland scholarly interests are in pediatric neuro-critical care.

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Michael Trexler is the medical director ofpalliative care at Borgess Medical Center inKalamazoo, Mich. He and his wife, Renee, havefive children.

Class of 1998Marc Brower was named chair of theDepartment of Anesthesia Department at GrantMedical Center in Columbus, Ohio.

Class of 2006Aida Avdic joined the medical staff atBrattleboro Memorial Hospital in Brattleboro,Vt. For the past three years, she has been ahospitalist and instructor of clinical medicine atthe Hospital of the University of Pennsylvania.Lenny Lesser is a third year Robert WoodJohnson Foundation Clinical Scholar at UCLA.His most recent publication with Robert Brook(CSP Co-Director), “Assessment of FoodOfferings and Marketing Strategies in the Food-Service Venues at California Children’sHospitals,” was published in AcademicPediatrics. Researchers assessed 14 foodvenues at the state’s 12 major children’s hospi-tals and found much room for improvement intheir offerings and practices.

Class of 2008Aleksey (Alex) Tentler will graduate from theUMDNJ–Newark Med-Peds residency programin June 2012 and will stay on for a year as ChiefResident in Internal Medicine.

GRADUATE Alumni(Arranged alphabetically)

Kimberly J. Arcoleo (MPH ’96, PhD ’06) recentlywas named associate professor and director ofthe Center for Promoting Health In Infants,Children, Adolescents & Women in the Collegeof Nursing at Ohio State. The mission of thecenter is to foster excellence and to promotethe highest levels of health and wellnessthrough pioneering research, translational activ-ities, and transdisciplinary research educationalprograms. Arcoleo completed a two-yearfellowship in health disparities research at theSouthwest Interdisciplinary Research Center ofArizona State University. Her research focuseson health disparities in children with asthma.She currently is conducting a $2.5 millionNCCAM-funded study testing a multi-factorial

model for explaining disparities betweenMexican and Puerto Rican children with asthmain Phoenix and Bronx, N.Y.Bradford Berk (MD ’81, PhD ’81) – see MD Classof 1981.Richard Doolittle (PhD ’80, FLW ’82), has beennamed vice dean of Rochester Institute ofTechnology’s College of Health Sciences andTechnology. He served previously as the RITassistant provost for undergraduate education,head of the School of Life Sciences and head ofthe Medical Sciences Department.Ann Dozier (BS ’77, MS ’80, PhD ’96) was recog-nized for her exemplary work in reducing healthinequities and addressing priority communityhealth needs, particularly in the area ofmaternal and child health. Dozier waspresented with the award March 19, 2012,during a special grand rounds session featuringDavid Satcher, M.D. (R ’72, HNR ’95).Daniel Ari Mendelson (MS ’93, MD ’95) – seeMD Class of 1995.Carol Warren Nichols (BA ’72, MS ’75) wascertified as an Iyengar Yoga Teacher in 2011.The process takes several years of preparationin study, individual mentoring, private practice,and studio teaching experience. Certification isthrough the Iyengar Association of NorthAmerica, United States.Spencer Rosero (MS ’91) is one of the 19 indi-viduals who received a Rochester BusinessJournal’s 2012 Health Care Achievement Award.He received an Innovation Award. The awardspotlights individuals and groups whose contri-bution to health care has been deemedoutstanding by their colleagues, patients andsupervisors. Charles Seelig (MD ’75, MS ’75) – see MDClass of 1975.Marcia Scherer (MS ’86, MSE ’86, PhD ’87) will have two books published this year:Assistive Tech nologies and Other Supports forPeople With Brain Impairment and AssistiveTechnology Assessment Handbook. Carolyn M. Tyler (BS ’03, MS ’07, PhD ’09) andMark R. Bauter of Avoca, N.Y., were married atBelhurst Castle in Geneva, N.Y., on May 29,2011. Tyler is a postdoctoral fellow of the NewJersey Brain Injury Research Commission in themolecular biology department and the PrincetonNeuroscience Institute at Princeton University.Bauter is a study director at Eurofins ProductSafety Labs in Dayton, N.J.

RESIDENTS / FELLOWAlumni(Arranged alphabetically)

Robert T. Brodell (R ’81) – see MD Class of1979.Paul Cushman (R ’57) has published a secondprinting of his third book, Richard Varick, a biog-raphy of a distinguished Revolutionary Warofficer, aide to George Washington and mayorof New York City from 1789–1801.John L. Genier (R ’93) – see MD Class of 1989.George L. Hicks (R ’77, FLW ’78) – see MD Classof 1971.Jim Iannazzi (R ’98) writes: “Greetings fromMaine! Here is a somewhat belated update. I completed medical internship and neurologyresidency at Strong from July, 1994, throughJune 1998, since which time I have beenemployed at Acadia Hospital, a psychiatric and substance abuse facility in Bangor. FromSeptember, 2006, to September, 2008, I completed a part-time fellowship in behavioralneurology and neuropsychiatry at McLeanHospital in Belmont, Mass., which is affiliatedwith Massachusetts General Hospital, and is ateaching hospital for Harvard Medical School.My fellowship normally would have lasted oneyear, but since I pursued it half time, it took metwo years to complete. In November, 2010, I passed the exam given by the United Councilfor Neurologic Subspecialties, making me boardcertified in behavioral neurology and neuropsy-chiatry. I believe there are only about 300physicians who have such certification. I continue to practice at Acadia, and I live inHampden, just south of Bangor, with my wife,Corleen, my daughter, Angie (almost 17), andson, Max (almost 15). I adore the Maineoutdoors, and remain passionate about moun-tain biking, but also enjoy road biking, crosscountry and downhill skiing, hiking, snow-shoeing, etc.” Timothy E. Quill (R ’79) – see MD Class of 1976David Ross (R ’70) – see MD Class of 1962.Beverly Wood (R ’71) – see MD Class of 1965.

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Vol. 2 – 2012

poems, essays, and stories

55wordsA moment between doctor and patient can be captured in 55 wordsA collection of 55-word stories debuted in Rochester Medicine in the 2010 winterissue. Written by family medicine faculty and trainees, the stories encapsulatesome key moments in health care encounters. This collection features stories aboutthe developmental possessiveness of a plucky 3 year old, the selflessness of amiddle-aged woman facing major surgery, the struggle of managing a medicationmisunderstanding, and the yawning loss of a mother whose infant has died. Morethan the individual stories of the patients, however, is the impact that these storieshave had on their physician-authors. “The very act of writing and sharing thestories enriches us as clinicians and caregivers, and deepens our appreciation forour patients and our work,” says Colleen T. Fogarty, M.D., M.Sc., (R ’95), assistantprofessor of family medicine.

MineIn my laboring patient’s room, Comfortable with epidural,Esposo, abuela, hermana – all gathered for support.

When I arrived, her three-year old daughter greeted me: Doctora! Doctora! turned to her cousin saying, “she’s mine.”

Four hours later, viewing her new sister in their mother’s arms, With bright eyes,She again turned to her cousin, “she’s mine!”

Melanie Gnazzo, M.D., family medicine resident


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SIDSThe baby feels coldAs he firmly holds the chunky calfAnd grinds the needleThrough baby fat, and on into bone.

Fluids wide open.And he knows this is all futile.

Parents escorted outUnder the illusion of lifesaving care.

Mother’s screams heardWhen she sees us stop, eyes downcast.Her baby goneForever.

Stephen H. Schultz, M.D. (R ’96), associate professor of family medicine and residencyprogram director

LollipopsTuesday. She’s nervous, six days before mastectomy.I say I’ll visit. She lightens, reaches me for a hug. Next Monday, end of my long workday, I’m desperate to get home.As I pull back the curtain from 620-A, she smiles at me.

“I brought these for you…“I forgot them on Tuesday.”

Selfish meets selfless.

Bethany Calkins, M.D., (R ’10), palliative care fellow

Pill CountI’m taking the medicine Dr. Fogarty!”She proffers the antibiotic bottle, beaming.Her big toe still looks awful: swollen, red, draining.I read the label, dated ten days ago:

“Take 1 tablet every 12 hours.”Of twenty tablets, nine remain.How often are you taking it?” I probe.One a day, just like it says!”

Colleen T. Fogarty, M.D., M.Sc. (R ’95),family medicine fellowship director

“

““

53

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Vol. 2 – 2012

Paul L. LaCelle, M.D.

Paul L. LaCelle, M.D. (M ‘59), a Uni -versity of Rochester Medical Centerfaculty member for more than 40 years, a former department chair and formersenior dean, died March 9, 2012. He was82.

Dr. LaCelle joined the faculty in 1964as an instructor of what was then theDepartment of Radiation Biology andBiophysics. He was named a professor in1974 and chaired what is now theDepartment of Biochemistry andBiophysics from 1977 to 1996.

He was named acting senior associatedean for graduate studies in 1996 and wasappointed to the position in 2001,serving until 2008. After stepping downas dean, Dr. LaCelle became a professoremeritus of pharmacology and physi-ology. He continued to work in researchand in mentoring scientists until just afew months before his death.

“Paul LaCelle served our School ofMedicine and Dentistry and the MedicalCenter for many years by recruiting

LaCelle, died in 2008. He is survived byhis four children, two sisters, twobrothers and five grandchildren.Charitable donations can be made to theWilmot Cancer Center.

many excellent scientists and fosteringsolid research,” said Mark B. Taubman,M.D., dean of the School of Medicineand Dentistry. “We are proud of what heprovided us and we mourn his death.”Marshall A. Lichtman, M.D. (R ‘66),professor of medicine and a former deanof the School of Medicine andDentistry, called Dr. LaCelle “one of thegreat contributors to this MedicalCenter.”

“He was a fine physician and hema-tologist but chose to focus on blood cellresearch and in so doing he pioneeredthe field of blood cell biophysics at thisschool,” Lichtman said. “As chair, hedeveloped the department and recruitedoutstanding scientists to the school. He was a thoughtful and gentle personand had the great respect and affectionof those who worked with him.”

During Dr. LaCelle’s time as seniorassociate dean, three new graduateprograms were developed: a Ph.D intranslational biomedical sciences, aPh.D. in epidemiology, and a master’sdegree in marriage and family coun-seling. The number of graduate studentsalso increased, in parallel with theincrease in research faculty.

“Paul was one of the reasons I havespent my entire career in Rochester,”said Robert “Berch” Griggs, M.D. (R ‘71),a former chair of neurology. “He spentgreat effort on making sure excellencewas recognized and rewarded. Heworked, often behind the scenes andwith no interest in being recognized forhis own contributions, to make theUniversity of Rochester and Rochesterthe best we could be.”

Dr. LaCelle was the last chair of whatwas the Department of Biophysics. Histenure spanned the era when the depart-ment focused on the cold war mission ofunderstanding the effects of radiation onhumans to the current interest on detailsof molecular structure and how theyrelate to health problems.

Dr. LaCelle, who was born July 4,1929, earned his undergraduate degree atHoughton College. He served in theU.S. Navy during the Korean War. Dr. LaCelle’s wife, June Dukeshire

in memoriam


In memoriamJason O. Cook (MD ’47)Alan W. Cross (R ’75)John B. Flick Jr. (MD ’45)Alice Hopkins Foster (BA ’45, MD ’48)Peter B. Gram (MD ’52)Robert B. Jackson (MD ’52)Clare W. Johnson (BS ’43, MD ’46)Paul L. LaCelle (MD ’59)Gregory S. Liptak (R ’73)Marjorie McDonald (MD ’52)Clinton J. McGrew (MS ’57)Harold C. Miles (R ’56)Greg Nielsen (MD ’02, R ’05)Ruth Parker Oakley (BA ’37, MD ’41)Robert Rosen (MD ’52)Muriel King Schauble (BA ’50, MD ’54)Stanley B. Troup (R ’52)Kippen C. Wells (MD ’46)

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Marjorie Strong Wehle Professor in Ortho -paedics and the School’s associate dean forclinical affairs.

“It is extremely meaningful for me to assistDick and Peggy in the development of this chairand to celebrate their amazing contributions tothe department,” O’Keefe said. “I was able tosee firsthand the culture of excellence, caring,and commitment that he and Peggy promoted.Without Dick’s vision and support, the depart-ment would not have become a national leaderin research and patient care.”

In 1974, Burton was recruited back to theUniversity to help build the then newDepartment of Orthopaedics. In 1988, he wasnamed department chair and subsequently theMarjorie Strong Wehle Professor inOrthopaedics, a professorship endowed by oneof his grateful patients. During his 12-yeartenure as chair, he is credited with building thedepartment into one of the country’s top five

orthopaedics research programs in NationalInstitutes of Health funding. Also during thistime, Burton led the team that developed abreakthrough surgery for patients with acommon type of arthritis of the thumb. Theoperation, known internationally as the “Burtonprocedure,” is recognized as the gold standardtherapy for this condition.

For the Astros, Lintner spends “a fair amountof time” at spring training. He evaluates injuriesand treatments, helping the organization makedecisions on how long an athlete might be outof the game. He also goes over the medicalrecords of every player and prospect the team isconsidering to gauge risk of injury.

Williams also attends spring training forseveral weeks. He covers about a quarter ofthe Indians home games. And for severalyears, he evaluated all the organization’sminor league players and hundreds of players

Continued from page 36

Burton DistinguishedProfessorship

Team PhysiciansContinued from page 46

in the baseball draft.“It might seem a little glamorous,” Lintner

said. “But there is a lot more tedium than youwould expect. It helps to be good with people,to interact well with athletes and understandtheir fears and concerns.”

Returning patients to a very high level ofperformance is the attraction of sports medi-cine, Limpisvasti said.

“There is a lot of gratification in takingsomeone through surgery and rehabilitationwith the goal of a more active lifestyle or evenprofessional athletics, and in improving thequality of their lives,” Limpisvasti said.

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Write to us! Rochester Medicine welcomes letters fromreaders. The editor reserves the right to selectletters for publication and to edit for style andspace. Brief letters are encouraged. Please send to:[email protected] Medicine Magazine 601 Elmwood Avenue, Box 643,Rochester, NY 14642.

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Vol. 2 – 2012

University of RochesterSchool of Medicine and Dentistry601 Elmwood Avenue, Box 643Rochester, NY 14642

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