Medicine on the Midway - Fall 2013
Medicine on the Midway is published for friends, alumni and faculty of the University of Chicago Medicine, the University of Chicago Division of Biological Sciences and the Pritzker School of Medicine.
MEDICINE MIDWAY UNIVERSITY OF CHICAGO on the Biological Sciences Division FALL 2013 Big Data The new age of biomedicine Dean’s Letter Dear Colleagues, T This issue features an in-depth look at the researchers whose efforts are transforming the Midway into a biomedical big-data hub, laying the foundation for discoveries that will advance patient care. Kenneth S. Polonsky, MD The Richard T. Crane Distinguished Service Professor Dean of the Biological Sciences Division and the Pritzker School of Medicine Executive Vice President for Medical Aﬀairs The University of Chicago he combination of a world-class faculty and massive computing power places the University of Chicago in an ideal position to play a leadership role in this age of big data-driven biomedicine. University of Chicago geneticists, mathematicians, computational scientists and clinicians are making great progress in defining disease at genetic and molecular levels, laying the foundation for discoveries that will advance patient care and improve patient outcomes. Our cover story, which begins on page 14, is an in-depth look at this new age and the enormous potential it holds. What may be most remarkable is the breadth of this effort, which spans many fields and facilities, from the medical center to Argonne National Laboratory to the Bionimbus Protected Data Cloud, the only cloud-based computing system approved by the National Institutes of Health to handle data from The Cancer Genome Atlas. Making much of this possible are generous philanthropic grants like those from Karen and Jim Frank, whose backing has helped establish a new Institute for Computational Biology and Medicine, and Carole and Gordon Segal, who are putting their support behind the Pancreatic Cancer Genomic Medicine Initiative to improve assessment, decision-making and treatment for pancreatic cancer patients. Combined, these efforts have the potential to advance patient care, and to coalesce into a biomedical big-data hub that could one day be a hallmark of the University of Chicago and an economic engine for the Chicago region. I’d like to welcome John Maunsell, PhD, as the inaugural director of the Grossman Institute for Neuroscience, Quantitative Biology and Human Behavior. An internationally known neuroscientist, Dr. Maunsell has made fundamental contributions to our understanding of the neuroscience behind vision, perception and attention. As director, he will oversee the development of a highly collaborative, world-class neuroscience institute built upon the University’s diverse strengths in evolutionary and quantitative biology and economic and social behaviors. Big data isn’t the only fertile ground for the University of Chicago’s crossdisciplinary approach. On page 22 of this edition, we go deep into the heart of the Gordon Center for Integrative Science, where researchers in biology, physics, chemistry and computational modeling are working together to unlock the governing principles of cell division and movement, and study the abnormalities in these processes that occur in cancer. And on page 28, we pay a visit to the Pritzker School of Medicine’s Clinical Performance Center, where “standardized patients” not only put medical students through their clinical paces but double as educators. Amid the excitement of welcoming a new class to Pritzker, we also note with sadness the passing of much loved former dean of students Joseph J. Ceithaml, SB ’37, PhD ’41. Dean Ceithaml was instrumental in building Pritzker’s national reputation for rigorous medical education and its staunch support of a diverse student body. As Holly J. Humphrey, MD’83, our current dean for medical education, notes on page 37: “He was a kind and generous man who placed student well-being at the top of his priority list.” With an equally heavy heart, we note the passing of Peter Richard Huttenlocher, MD, a former section chief of pediatric neurology known internationally for his groundbreaking studies on neural plasticity in children, and of Joel Schwab, MD, a “pediatrician’s pediatrician” and mentor to students and residents, whose example inspired more than a few physicians to dedicate their careers to the care of children. TA B L E O F C O N T E N T S Cover Story 14 The University of Chicago is ideally positioned to become a national hub for biomedical big data, paving the way for a future when diagnosis, treatment and prevention are intimately tied to a patient’s DNA. Meet the scientists, clinicians and philanthropists who are joining forces to advance data-driven discovery and transform the practice of medicine. COVER ILLUSTRATION BY STACY SWEAT Features 02 The University of Chicago and Marine Biological Laboratory aﬃliation oﬀers expanded opportunities for student and faculty, including a new collaborative research award. 08 M. Kelly Nicholas, MD’90, PhD’88, left art school when he became a physician, but never stopped thinking about making art. 10 Our new hospital: A tour of the Stem Cell Transplant Unit in the Center for Care and Discovery. 22 Working at the intersection of biology, physics, chemistry and computational modeling to understand metastasis. 28 Inside Pritzker’s Clinical Performance Center, where students learn clinical skills from highly trained “standardized patients.” Departments Letter from the Dean 12 Family’s gift supports neonatal care Midway News 12 BSD students recognized for research 34 Class Notes Hear from your classmates, near and far 3 New Medicine on the Midway mobile app 35 In Memoriam Joel Schwab, MD, 1945-2013 4 The earliest mammals, unearthed Pritzker News 6 BSD faculty member honored for teaching, mentoring 9 Appointments for Carole Ober, PhD, and Geoﬀrey L. Greene, PhD 27 Class of 2017 White Coat Ceremony 32 Alumni honored at Reunion 2013 Fall 2013 Volume 66, No. 2 A publication of the University of Chicago Medicine and Biological Sciences Division. Medicine on the Midway is published for friends, alumni and faculty of the University of Chicago Medicine, Biological Sciences Division and the Pritzker School of Medicine. University of Chicago Pritzker School of Medicine and Biological Sciences Executive Leadership Kenneth S. Polonsky, MD, the Richard T. Crane Distinguished Service Professor, Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago T. Conrad Gilliam, PhD, the Marjorie I. and Bernard A. Mitchell Distinguished Service Professor, dean for research and graduate education, Biological Sciences Division Sharon O’Keefe, president of the University of Chicago Medical Center Holly J. Humphrey, MD’83, the Ralph W. Gerard Professor in Medicine, dean for medical education, Pritzker School of Medicine uchospitals.edu/midway Joseph J. Ceithaml, SB’37, PhD’41, 1916-2013 26 Two Pritzker students named AMA Physicians of Tomorrow Editorial Committee Chair Chris Albanis, AB’96, MD’00 Lampis Anagnostopoulos, SB’57, MD’61 Arnold Calica, SM’61, MD’75 Melina Hale, PhD’98 Noah Schwartz, MS2 Jerrold Seckler, MD’68 Coleman Seskind, AB’55, SB’56, SM/MD’59 Madeleine Shapiro, MS4 Jack Stockert, AB’05, MBA’10, MD’10 Editor Anna Madrzyk Assistant Editor Gretchen Rubin Email us at email@example.com Write us at Editor, Medicine on the Midway The University of Chicago Medicine 950 E. 61st St., WSSC 320, Chicago, IL 60637 Editorial Contributors Laura Ramos Kevin Barrett Hegwer Elizabeth Brandon Kevin Jiang Thea Grendahl Catherine Julitz Christou Caroline Kraft John Easton Ellen McGrew Photo Contributors James Ballard David Christopher Megan E. Doherty Nabiha Khan Robert Kozloff Jean Lachat Bruce Powell Anne Ryan Jason Smith Ron Vesely/Chicago White Sox Argonne National Laboratory Gradimages Michael McHugh Eileen Norris Brooke O’Neill Stephen Phillips Matt Wood Molly Woulfe Marine Biological Laboratory Medical & Biological Sciences Alumni Association Pritzker School of Medicine Design Stacy Sweat Designs MEDICINE ON THE MIDWAY FALL 2013 1 M A R I N E B I O L O G I C A L L A B O R AT O R Y A F F I L I AT I O N Midway News Collaborative award to support groundbreaking T The MBL’s renowned summer program attracts scientists and advanced students from around the world. Q&A WITH NEIL SHUBIN first formal new research opportunity since the affiliation between the two institutions was announced in June 2013 — is open to collaborators from the worldwide MBL research community. This includes year-round MBL scientists and scientists from other institutions who currently participate or propose to participate as visiting researchers, or as course faculty in MBL’s renowned summer program. “The Lillie Awards signify one of the first steps our institutions are taking to- Affiliation means new opportunities for students and faculty The University of Chicago’s new affiliation with the Marine Biological Laboratory (MBL) provides expanded opportunities for scientific research, innovation and internships. UChicago’s point man in the alliance is Neil Shubin, PhD, the Robert R. Bensley Distinguished Service Professor of Organismal Biology and Anatomy and senior adviser to University of Chicago President Robert J. Zimmer and to the vice president for Research and for 2 he University of Chicago and Marine Biological Laboratory’s new MBL research award program will fund collaborative projects based at MBL that will lead to transformative biological discoveries. The Frank R. Lillie Innovation Research Awards are named in honor of the early 20th-century embryologist who served as the MBL’s second director and as chair of UChicago’s Department of Zoology. Funding through the awards — the National Laboratories. Shubin answered a few questions about the University’s new link to the Atlantic. Here are excerpts. What opportunities does this oﬀer UChicago students and faculty? The complementary aspects of the two places will enable greater research and educational opportunities. MBL is known for intense, hands-on learning in biological sciences, whether it’s embryol- THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Neil Shubin, PhD PHOTO BY ROBERT KOZLOFF ogy, neuroscience or diversity in marine science. We can develop similar courses here and interact with existing programs at MBL at the collegiate, graduate and M E D I C I N E O N T H E M I D W AY biological research gether to realize the highest aspirations of our new affiliation — to encourage innovative, groundbreaking biological research that benefits science at the MBL and beyond,” said University of Chicago President Robert J. Zimmer. In honor of the MBL’s 125th anniversary, the awards will provide for two years of pilot research for a total of $125,000 per award. They are intended to bring together interdisciplinary teams, which have not collaborated before, for a project that represents a new area of inquiry for the investigators.“By providing the time and place for new collaborations, these awards will help our scientists take unexpected directions and address new problems, including ‘high-risk, high-payoff ’ projects that are increasingly difficult to fund at the national level,” said Joshua Hamilton, chief academic and scientific officer at the MBL. For more information, visit the MBL/ University of Chicago affiliation website at mbl.edu/uc-affiliation. Download the free Medicine on the Midway mobile app The Marine Biological Laboratory in Woods Hole, Massachusetts, has been a driving force in biological discovery and research training for scientists since 1888. Take your alumni publication with you wherever you go. The new Medicine on the Midway app is available for download in the App Store and on iTunes. PHOTOS COURTESY OF THE MARINE BIOLOGICAL LABORATORY postgraduate levels. Their research strengths include ecosystem science, conservation and regenerative biology. Our faculty and student researchers will have access to unparalleled resources for the study of marine organisms at MBL. What does UChicago offer in this aﬃliation? We offer an important linkage of basic biological sciences to translational research and our medical center. Our connection with Argonne National Laboratory is very important, as is our computational and informatics infrastructure. It gives them technologies, tools, resources and people that are important to MBL’s research. uchospitals.edu/midway What are you looking forward to from this collaboration? We’ve done all these genome projects, and now we want to understand how they develop, how they regenerate and how they evolve. Oftentimes the best systems for asking these fundamental questions are marine systems, like fish or invertebrates. The access to that kind of system is really exciting. The educational environment there, especially in summer, is really electric; it’s intellectually exciting to be there. We’re really looking forward to being part of that mix. • Compatible with iPhone, iPad and iPod Touch • Instant access to Medicine on the Midway, including recent back issues • Allows you to watch embedded videos and link to web pages, podcasts and social media • Zoom and search capabilities • Developed by GradMags, a University of Chicago Booth School of Business startup To download from the iTunes store, follow this easy link: http://bit.ly/16rRYk8 or Use this QR code to download instantly on your iPhone or iPad. To read the full interview on the Science Life blog, visit bit.ly/ShubinQA. MEDICINE ON THE MIDWAY FALL 2013 3 O R G A N I S M A L B I O L O G Y A N D A N AT O M Y Midway News Small, furry and 160 million years old The discovery of two new fossils helps ﬁll in the blanks on how modern mammals evolved BY KEVIN JIANG O f all the ancient life, dinosaurs seem to always get the glory. Gigantic and fearsome, with sharp teeth and claws, the terrible lizards are subjects of perpetual public fascination. But the story of ridged teeth, flexible ankles and tufts of hair holds far more relevance to the modern world. After all, these are the features that allowed the earliest mammals not only to thrive for more than 100 million years alongside the dinosaurs but also to outlive them all. Zhe-Xi Luo, PhD, professor of organismal biology and anatomy, has spent his career uncovering this story. Among his numerous discoveries is the earliest known placental mammal, which is most certainly our very distant ancestor; the earliest known fossil with fur, proof that hair evolved well before mammals did; and a 195-million-year-old creature, the size of a paper clip, that already had a modern mammal-like, large brain. With the recent discovery of two new fossils, described in August 2013 in the journals Nature and Science, Luo adds to his impressive body of work and our collective knowledge of how our ancestors came to be. About 165 million years ago, a furry animal about the size of a squirrel spent its life scurrying across the Jurassic ground. Discovered by Luo and his team in Inner Mongolia of China and detailed in Nature, the nearly complete skeleton of Megaconus mammaliaformis reveals the ancestral conditions that would give rise to features of today’s mammals. An extinct relative to mammals, its lineage was, until now, known from only scattered teeth and bone fragments. 4 Life reconstruction of Megaconus mammaliaformis, top, by scientiﬁc illustrator April Isch of the University of Chicago. Rugosodon fossil photographed by Zhe-Xi Luo of the University of Chicago and Chongxi Yuan of the Chinese Academy of Geological Sciences. With a halo of guard hairs and underfur residue, the Megaconus fossil is only the second-known premammalian fossil with fur. Its heel spur, which was a half inch long and possibly poisonous, was similar to the spur of a living platypus. Its teeth were mammal-like, with elaborate rows of cusps that allowed it to eat both plants and insects. However, Megaconus was not a mammal. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Its primitive middle ear was still attached to its jaw — a reptilian feature. Its anklebones and vertebral column were similar to mammal-like reptiles. “We cannot say that Megaconus is our direct ancestor, but it certainly looks like a great-great-grand uncle 165 million years removed,” Luo said. “It allows us to piece together some enigmatic details of the critical transition of modern mammals from premammalian ancestors.” Of much closer relation to modern mammals were the rodent-like multituberculates. Named for the numerous bumps and cusps on their teeth, multituberculates were by far the most successful mammals of the dinosaur age, appearing continuously in the fossil record from around 170 million years ago until their extinction 35 million years ago. Despite this success, early fossils were fragmentary — a gap filled by Luo and his team when they found the earliest-known complete multituberculate skeleton, described in Science. Similar in size and diet to a modern African dormouse, Rugosodon roamed lakeshores around Asia 160 million years ago. Its surprisingly mobile anklebones suggested that it was an agile, fast runner. Luo points to this adaptation as the basis for all versatile locomotor adaptations, ranging from tree climbing to tunnel digging, that allowed later multituberculates to be so successful. Rugosodon’s teeth were ornamented by numerous ridges and wrinkles, indicating a diet of seeds and insects. Interestingly, the later rise of numerous herbivorous multituberculates seems to have originated from this omnivorous ancestral state. “Multituberculates were able to exploit parts of the ecosystem that were not accessible to many other vertebrates. With Rugosodon, we can finally paint a coherent picture of the evolutionary origin of these prolific and ancient mammals,” Luo said. Luo’s most recent discoveries further illuminate what our ancient mammalian relatives looked like and how they lived. They also serve as evidence that many “mammalian” feeding and locomotor adaptations, as well as such features as hair, arose long ago. However, Luo’s work also reminds us that although these adaptations were widespread, they were certainly no guarantee of evolutionary success. “In a sense, the three big modern mammal branches — monotremes, marsupials and placentals — are all accidental survivors among many other lineages that perished in extinction, like Megaconus or Rugosodon,” Luo said. To hear a podcast featuring Zhe-Xi Luo, PhD, visit http://bit.ly/ScienceLifePodcast. uchospitals.edu/midway B E H AV I O R A L N E U R O S C I E N C E A matter of trust How do we decide to trust another person? N ew research by Margaret Wardle, PhD, research associate (assistant professor), in the Department of Psychiatry and Behavioral Neuroscience, showed that a part of the brain called the caudate may help guide decision-making based on reputation. Wardle worked with K. Luan Phan, MD, professor of psychiatry at the University of Illinois at Chicago, who collected data on a group of adults who underwent fMRI scanning while playing a trust game with different partners. The images showed that the caudate — a small area involved in other kinds of decision-making located near the center of the brain — activated strongly when the subject was dealing with unfair or indifferent partners, but not with partners who “played fair.” “It’s important to be able to understand what goes on in a normal brain when you are deciding to trust someone, or when you are realizing that this is a bad bet,” Wardle said. The findings may help shed light on how these processes go awry in some conditions such as autism or social phobia, which are characterized by difficulties building interpersonal relationships and trust. This could lead to better understanding of how treatments impact these processes by modulating activity in that part of the brain. The study was published in PLOS ONE. Read more at sciencelife.uchospitals. edu. N S F G R A D U AT E E D U C AT I O N C H A L L E N G E BSD team thinks outside the TA box A team of graduate students in the Department of Ecology and Evolution and the Committee on Evolutionary Biology took third place in the National Science Foundation Graduate Education Challenge. Team members were Sebastian Heilpern, Courtney Stepien, Benjamin Krinsky, Robert Arthur and Colin Kyle. Their project, “Beyond the Academy: Enhancing STEM Education through External Graduate Assistantships,” developed a graduate assistant program that will create opportunities for graduates to serve society in a variety of nonacademic settings while expanding the range of career choices for STEM graduates. MEDICINE ON THE MIDWAY FALL 2013 5 G R A D U AT E T E A C H I N G A N D M E N T O R I N G Midway News Ruvinsky receives Faculty Award for Teaching Ilya Ruvinsky, PhD, associate professor of ecology and evolution, and organismal biology and anatomy, received the 2013 Faculty Award for Excellence in Graduate Teaching and Mentoring. The awards have been given since 1985 to honor full-time faculty members in the four divisions and the Divinity School for exemplary teaching. The awards are presented at Spring Convocation. Ruvinsky integrates developmental, genomic and computational approaches to study the evolution of gene functions. The award cited the following: “Enthusiastic, rigorous, critical, witty, and intellectually fearless, Ilya Ruvinsky challenges students to think about the scientific method and provides a superb example for students to follow in interdisciplinary biological and medical research.” Read more at uchicago.edu/features/ teaching_awards_ilya_ruvinsky/. “Life in science has to be a pursuit of passion...” PHOTO BY ROBERT KOZLOFF Ilya Ruvinsky, PhD, associate professor of ecology and evolution, and organismal biology and anatomy. Ilya Ruvinsky, PhD, on what he most hopes students take away from his courses: “That life in science has to be a pursuit of passion—the road is too tough and tedious, unless you feel that you simply must know the answers. That sometimes the answers remain elusive, no matter how hard we try. That many problems beneﬁt from being considered from a variety of perspectives.” T R A N S L AT I O N A L R E S E A R C H Breaking the truce between tumors and the immune system T he rare spontaneous remission in cancer raises the question: If an immune response can occasionally do this on its own, how can we nudge it to do so more often? In the August 2013 issue of Science Translational Medicine, a team led by Thomas F. Gajewski, MD’91, PhD’89, professor of pathology and medicine, shows how tumors manage to evade an immune response. Some tumors hide from the immune system or they prevent T cells from invading. Others allow some mingling, an initial dialogue with the immune system, then suppress it. Gajewski’s team focused on the minglers, tumors that were infiltrated by cytotoxic T cells, warriors that repel invaders. Was the tumor switching off the immune response, the researchers asked, or was the immune system learning to tolerate the tumor? 6 It turns out the immune system, rather than the cancer cells, is behind the peace-making process, research in laboratory models showed. Aggressive T cells, having infiltrated the tumors, then sent out signals to calm their fury. Tumors that had been infiltrated were soon bathed in IDO, an enzyme that contributes to immunologic tolerance; PD-L1, a T-cell inhibitor; and regulatory T cells, known as Tregs, that suppress the immune response. These molecules are already are becoming the next targets for therapy, Gajewski said. “Individual tumors have multiple immune suppressive mechanisms, so a combined blockade of two or more might be necessary for optimal therapeutic effects,” he said. “Knowing that these mechanisms may be intrinsic to the host immune system and the tumor refines our ability to develop these novel therapies.” THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION UChicago Cancer Conversations is a new blog featuring posts from cancer researchers, physicians and clinicians. Join the conversation at CancerConversations. uchospitals.edu. MACLEAN CENTER FOR CLINICAL MEDICAL ETHICS NEUROSCIENCES Seminar focuses on ethical issues in health care reform T he 32nd Annual Interdisciplinary Faculty Seminar Series features more than 25 speakers discussing the Patient Protection and Affordable Care Act. This three-quarter series, organized by the MacLean Center for Clinical Medical Ethics, opened in early October with a talk on the politics of health reform by David Axelrod, director of the University of Chicago’s Institute of Politics. Additional experts in the fields of medicine, law, public policy and economics will address questions such as: How will academic medical centers, organized medicine, and large employers respond? Will the ACA save money? What impact will the law have on the doctor-patient relationship? What changes can patients and physicians expect? This year’s series was organized by Mark Siegler, MD’67, director of the MacLean Center, and Marshall Chin, MD, MPH, associate director of the MacLean Center. Some sessions will be co-sponsored by the Institute of Politics and the Bucksbaum Institute for Clinical Excellence. Sessions are held from noon to 1:30 p.m. Wednesdays in P-117. Box lunches are provided. For a schedule of speakers, please visit uchospitals.edu/macleanseminars. To RSVP, visit MacleanCenter.eventbrite.com. M O L E C U L A R M E TA B O L I S M A N D N U T R I T I O N BSD student honored for best dissertation Suzanne Devkota, PhD ’12 , Committee on Molecular Metabolism and Nutrition, was awarded the BSD Best Dissertation Award in June 2013 for her dissertation, “Western Diet-Induced Changes in Host-Microbe Interactions: The Emergence of Pathobionts and Development of Colitis in Genetically Susceptible Hosts.” Devkota, now a postdoctoral fellow in the Joslin Diabetes Center of Harvard Medical School, also was honored with the award for outstanding performance in the general field of molecular metabolism and nutrition. uchospitals.edu/midway NIH COMMON FUND Researchers study novel therapy for multiple sclerosis R ichard Kraig, MD, PhD, the William D. Mabie Professor in the Neurosciences, has been awarded a five-year, $1.5 million grant from the National Institutes of Health (NIH) to develop stimulated dendritic cell-derived exosomes that show remarkable promise as a treatment for multiple sclerosis and other neurological diseases involving loss of myelin, the insulation around nerve fibers. The Kraig project focuses on exosomes — small lipid vesicles that carry protein, RNA and, importantly, non-coding, extracellular microRNA, which are thought to enable cell-tocell communication throughout the body. Exosomes produced in the blood appear to play a causal role in the protective effects of regular exercise and learning, collectively known as “environmental enrichment,” on the brain. These exosomes contain specific microRNAs that promote myelination of aging brain, as well as brain damaged by multiple sclerosis modeled in animal brain tissues. Kraig and his team, which includes Aya Pusic, a PhD candidate in neurobiology, and postdoctoral scholar Kae Pusic, PhD, discovered that dendritic cells — professional antigen presenting cells of the immune system — can be stimulated by factors released during environmental enrichment to produce exosomes containing microRNAs that improve brain health. When applied to cultured brain tissue or administered nasally to live animals, these dendritic, cellderived exosomes significantly increased baseline levels of myelin — the protective sheath around neurons, which is damaged in multiple sclerosis. Importantly, exosome administration also improved the recovery of demyelinated nerve cells, which serve as a model for multiple sclerosis. “We believe that we have identified a naturally occurring mechanism by which increased exercise and learning improves brain health through myelination. Importantly, we have also discovered a way to mimic this nutritive effect through the use of cultured, dendritic, cell-derived exosomes containing specific microRNAs,” Kraig said. “All evidence suggests that these exosomes can be crafted into a novel therapy to treat multiple sclerosis.” MEDICINE ON THE MIDWAY – Kevin Jiang FALL 2013 7 ALUMNI PROFILE Midway News Medicine and the Muse M. Kelly Nicholas left art school behind when he decided to become a physician, but he never stopped thinking about art-making BY ANNA MADRZYK AND MOLLY WOULFE M . Kelly Nicholas, MD’90, PhD’88, wanted to be an artist almost from the time he learned to draw. He was well on his way to a BFA in painting and printmaking at the University of Texas when he began to feel “somehow limited by art; that I needed to do something more.” His dean encouraged him to stick with art. With Nicholas’ grades, the dean said, he could “do anything” after art school. “To the long and short of it, he was right,” Nicholas said. “I became a doctor with my art degree.” He never stopped thinking about art, not while he was in premed PHOTO BY DAVID CHRISTOPHER Neuro-oncologist M. Kelly Nicholas with an abstract ink painting inspired by atomic bomb survivors. courses at the University of Illinois at Chicago, the MD/PhD program at the Pritzker School of Medicine or his residency at the University of Chicago Medicine. But for years, he didn’t have time for more than an occasional sketch in one of the small notebooks he keeps. Not that he has more time now. But at this point in his life and career, “it’s become more that I have to do this, so time has to be set aside,” Nicholas said. “I can’t keep it bottled.” Nicholas, associate professor of neurology, radiation and cellular oncology, and surgery, directs the O R I E N TA L I N S T I T U T E Photography exhibit offers fresh look at ancient origins of work N PHOTO BY MEGAN E. DOHERTY Photographer Jason Reblando, left, trains his camera on M. Kelly Nicholas, MD’90, PhD’88, representing the face of modern medicine in the Oriental Institute Museum exhibit “Our Work: Modern Jobs — Ancient Origins.” 8 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION euro-oncologist M. Kelly Nicholas, MD’90, PhD’88, is featured in “Our Work: Modern Jobs — Ancient Origins,” a photography exhibit at the Oriental Institute Museum. The exhibit pairs Chicagoans with artifacts used by their occupational counterparts in the ancient Middle East. Photographer Jason Reblando hand-developed the images as tintypes, a time-bending twist that reinforces the links between working men and women throughout the ages. Nicholas, who was recruited as LEADERSHIP NEWS neuro-oncology program at the University of Chicago Medicine. Emotions evoked by his abstract works of ink on paper are informed by the impact his patients have had on him. “I work with people who have very serious medical conditions, and it really shakes them to the core of their being,” Nicholas said. “They undergo a number of personal transformations in the course of living with brain cancer, and I am witness to that.” As a first-year medical student, Nicholas had a faculty member assigned to meet with him. It was Leon Jacobson, MD, physician-scientist and pioneer of chemotherapy and bone marrow transplantation. “He came by my apartment in the morning, and we walked over to campus a few times and we talked about the University of Chicago. I didn’t even know who he was at the time,” Nicholas said. Later, their topics expanded to include Jacobson’s role in World War II as health officer for the atomic energy program at the University and his later efforts to use radiation in a healing mode. As a resident, Nicholas cared for the eminent physician during his final illness. Transformation is a recurring theme in his art. In a work inspired by the Hibakusha, survivors of the atomic bombs dropped on Hiroshima and Nagasaki, a simple shape emerges from thousands of marks of ink on paper — red, orange, green, white, black. “Some people view the image as one of fire; others see trees,” Nicholas said. “The viewer completes the picture.” Nicholas won top honors for a set of abstract ink paintings in a University of Chicago Medicine staff art show, and he is co-organizing a 2014 exhibition at the University. “Imaging/Imagining” will showcase studies of the human body as perceived by scientists, scholars and artists. “One of the aspects of art making and art viewing is its healing power. It works at a very different level than traditional medicine, but it has the potential to transform, to widen experience and to brighten one’s life.” The exhibit pairs Chicagoans with artifacts used by their occupational counterparts in ancient times. the face of medicine by co-curators Jack Green, PhD, and Emily Teeter, PhD, posed with a Mesopotamian clay tablet that outlines the symptoms and treatments of neurological conditions around 2,500 years ago. The size of a slice of bread, the fragment bears enough advice — in ant-sized cuneiform script — for an ancient Merck Manual. According to a translation, when a patient’s mouth is “seized” so that he cannot talk, it’s likely due to a stroke or seizure. As for an alcoholic patient, he “drones” in the throes of withdrawal. University of Chicago President uchospitals.edu/midway Robert J. Zimmer, PhD, is paired with a clay cylinder with mathematical tables from ancient Iraq. Other photos in the show depict a Chicago police officer with the 3,000-year-old statue of an Egyptian lawman, a real estate broker with an ancient land contract and a baker with a bread pan from about 2500 B.C. “Our Work: Modern Jobs — Ancient Origins” continues through February 23 at the Oriental Institute Museum, 1155 E. 58th Street, Chicago. For details, visit oi.uchicago.edu. Ober, Greene receive appointments Distinguished scientist Carole Ober, PhD , has been named chair of the Department of Human Genetics at the University of Chicago. She is the Blum-Riese Professor in the Departments of Human Genetics and Obstetrics Carole Ober, PhD and Gynecology. Ober, who joined the University of Chicago in 1988, is a national and international leader in research on the genetic architecture of susceptibility to asthma and of fertility traits. She is an active teacher of undergraduate and graduate students and serves as a research mentor to numerous postdoctoral fellows and students. “I am confident that under Carole’s leadership the prominence of an already distinguished Department of Human Genetics will increase to even greater scientific standing,” said Kenneth S. Polonsky, the Richard T. Crane Distinguished Service Professor and Dean of the Biological Sciences Division and the Pritzker School of Medicine. Geoffrey L. Greene, PhD , the Virginia and D.K. Ludwig Professor for Cancer Research at the University of Chicago, has been appointed chair of the Ben May Department for Cancer Research. Greene, an internationally Geoﬀrey L. Greene, recognized cancer researcher, PhD has had a profound impact on understanding the genesis, treatment and prevention of hormonedependent breast cancer. “Geoffrey Greene is a direct scientific descendant of the founders of the Ben May Laboratory — Charles Huggins, Elwood Jensen and colleagues,” said Kenneth S. Polonsky, the Richard T. Crane Distinguished Service Professor and Dean of the Biological Sciences Division and the Pritzker School of Medicine. Greene has served as vice chair for the department since 2000. He is co-director of the Ludwig Center for Metastasis Research and associate director for basic sciences at the University of Chicago Medicine Comprehensive Cancer Center. He maintains an active role in teaching. – Molly Woulfe MEDICINE ON THE MIDWAY FALL 2013 9 CENTER FOR CARE AND DISCOVERY Midway News Inside the Blood and Bone Marrow Stem Cell Transplantation Program The 10th ﬂoor of the Center for Care and Discovery is devoted to cancer care, including a 28-bed unit for patients receiving blood and bone marrow DESIGNED TO HELP PATIENTS HEAL stem cell transplants. All patient rooms in the new hospital are private and spacious enough to accommodate families for extended stays. Rooms are equipped with comfortable furniture and other amenities. HEPA ﬁltration throughout the unit and a state-of-the-art airﬂow system protect recovering patients from infection. 10 EAST: PATIENT CARE, RESEARCH AND EDUCATION Michael Bishop, MD, professor of medicine, directs the Hematopoietic Stem Cell Transplantation program. Conditioning treatment, infusion of stem cells, and engraftment and recovery are completed on the unit. Bishop's research focuses on the prevention and treatment of relapse after stem cell transplantation. Pritzker School of Medicine students rotate on the transplant service and frequently participate in transplant research. Patient Robert Svendsen of Hinsdale, Ill., talks with nurse Anne Richter, RN, BSN, OCN, the day after his stem cell transplant in October 2013. PROGRAM HIGHLIGHTS Haplo-Cord Transplants combine donated cord blood stem cells and half-matched (haploidentical) cells from a related donor. Using cord blood helps new cells enter the bone marrow and improves blood count recovery. This procedure makes transplantation available for a wider group of patients. 10 Older Adult Stem Cell Transplant Program Research to Reduce Recurrence provides tailored care for patients age 60 and older. The transplant team collaborates with the Specialized Oncology Care and Research in the Elderly (SOCARE) program, the only dedicated program in Chicago for older patients facing a cancer diagnosis. focuses on new ways to identify patients at high risk for relapse after transplant. Physicians are also studying speciﬁc sets of cells that may result in graft-versus-host disease (GVHD) or that actually protect against relapse. Other research projects focus on familial predisposition to blood cancers. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION BY THE NUMBERS 28 private patient rooms TRANSPLANT AND RECOVERY 18 physicians on the blood and bone marrow stem cell transplantation team 165 adult and pediatric transplants yearly A technician prepares stem cells in the laboratory. Cells are frozen in liquid nitrogen until the patient is ready for infusion. A simple system gives physicians and nurses a quick view of which direction the air pressure is ﬂowing in isolation rooms. When the room’s sliding glass doors are closed, the ball pops out to indicate positive air pressure. A well-equipped exercise room helps patients regain strength during their recovery. WRITTEN BY LAURA RAMOS HEGWER I INFOGRAPHIC BY STACY SWEAT I PHOTOS BY ROBERT KOZLOFF AND BRUCE POWELL Specialized Care for Young Adults Disease-speciﬁc care is available through the University of Chicago Medicine Adolescent and Young Adult (AYA) Oncology Program, where pediatric and adult physicians work together to address the unique needs of patients ages 18 to 30 who are undergoing transplant. is at the heart of the transplantation program. Patients receive care from a physician who has expertise in their speciﬁc disease, such as leukemia, lymphoma or multiple myeloma, as well as in transplantation. uchospitals.edu/midway MEDICINE ON THE MIDWAY FALL 2013 11 BSD HONORS Midway News Students recognized for excellence ‘Your Inner Fish’ on PBS A three-par t tele vision s eries based on a best-selling book by University of Chicago Professor Neil Shubin is scheduled to air April 9, 16 and 23, 2014, on PBS stations (check local listings). Shubin, the Robert R. Bensley Distinguished Service Professor of Organismal Biology and Anatomy, is the author of “Your Inner Fish: A Journey into the 3.5-BillionYear History of the Human Body.” With Shubin’s book as the guide, the first episode traces common human traits to a prehistoric fish with primitive limbs. In the second hour, Shubin journeys from Nova Scotia to South Africa to reveal humanity’s “inner reptile.” In part three, Shubin travels back in time 50 million years to investigate the origins of the human brain and “inner monkey.” “PBS viewers love shows that highlight science and history in novel and intriguing ways, but “Your Inner Fish” takes this idea to a whole new level, by tracing the mind-boggling connections that can be made between the human form we know today and any number of now-extinct but biologically important species,” said Beth Hoppe, chief programming executive and general manager of general audience programming for PBS. “Your Inner Fish” is produced by Tangled Bank Studios in collaboration with award-winning producer David Dugan, founder of the U.K.-based production company Windfall Films. MARGARET M. AND GEORGE A. STEPHEN N E O N ATA L I N T E N S I V E C A R E U N I T Generous gift for the smallest patients A dozen members of the Stephen family, founders of Weber-Stephen Products Co., donated $10 million to support neonatal care at the University of Chicago Medicine Comer Children’s Hospital. The donation will support research toward advancements in treatment for critically ill and premature newborns, along with genetic studies to uncover links to early childhood diseases. The donation also enables the recruitment of an accomplished neonatologist who will become the new Stephen Family Professor of Pediatrics. 12 Matthew Nelsen, a graduate student in evolutionary biology, is the recipient of the William Rainey Harper Fellowship for 2013-2014. The highest honor that the University of Chicago offers to any graduate student, the fellowship is awarded in the final year of graduate study. Committee on Evolutionary Biology students Benjamin Winger and Benjamin Rubin received Field Museum of Natural History fellowships awarded to outstanding graduate students who are engaged in research at the museum. NSF fellowships Four Committee on Evolutionary Biology Students received the prestigious Doctoral Dissertation Improvement Grants from the National Science Foundation: Johnathan Mitchell, Benjamin Rubin, Courtney Stepien and Benjamin Winger. Field research grant Tom Stewart, a graduate student in organismal biology and anatomy, is the recipient of the 2013 Tinker Field Research Grant through the University’s Center for Latin American Studies. Stewart used the funds to develop a project on adaptive evolution in the Pimelodidae, a group of South American catfishes. Stewart also received the 2013 Raney Award for Ichthyology from the American Society of Ichthyologists and Herpetologists. Travel awards Jim Stephen, executive chairman of Weber-Stephen Products Co., greets a former Comer NICU baby. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION The 2013-2014 Steiner Travel Awards were awarded to microbiology student Matthew Perisin to attend a Marine Biological Laboratory summer course on “Strategies and Techniques for Analyzing Microbial Population Structures,” and evolutionary biology student Max Winston for travel to the Amazonian basin for research on phylogeny of the army ant genus Eciton. I N T E R D I S C I P L I N A R Y I N Q U I R Y A N D I N N O V AT I O N Ci3 awarded two prestigious grants L ess than a year after sexual and reproductive health expert Melissa Gilliam, MD, MPH, launched the Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), she was awarded $500,000 from both the Ford Foundation and the John D. and Catherine T. MacArthur Foundation. “Games have the power to reshape reality.” Leveraging expertise from scholars throughout the University, Ci3 addresses reproductive health along the trajectory from birth to adulthood. The center focuses on issues such as pregnancy, sex education, sexually transmitted infections and HIV, and reproductive cancers. Among its first initiatives was the use of gaming concepts, critical inquiry and storytelling to engage youth in matters of sexual, social and emotional health. The Ford Foundation grant funds Ci3 research on sexuality and health issues of urban African American youth. In PHOTO BY NABIHA KHAN Melissa Gilliam, MD, MPH, professor of obstetrics/gynecology and pediatrics, and Patrick Jagoda, PhD, assistant professor of English, with high school students who played The Source, an innovative game-based learning initiative of Ci3’s Game Changer Chicago. The University of Chicago summer program engaged more than 140 students in collaborative learning about health and social justice issues aﬀecting youth in Chicago. partnership with Global Girls, the Chicago Black Gay Men’s Caucus and the YMCA of Metropolitan Chicago, Gilliam and co-Investigator Alida Bouris, assistant professor in the University of Chicago School of Social Service Administration, and their team will work with youth to create digital narratives about living in racially segregated communities. “These stories will help bring new lenses to issues typically not heard by the broader community,” Gilliam said. The MacArthur Foundation award is supporting the creation of a design lab, The Game Changer Chicago Design Lab, to develop game-based interventions for youth. “Games have the power to reshape reality,” said Gilliam, “and now we’re creating an incubator for innovation around that notion.” CCHE A vision for HIV elimination The new Chicago Center for HIV Elimination (CCHE) at the University of Chicago is named for its ambitious goal. “Our vision includes a 30-year strategy for HIV elimination that works through existing social networks,” said John Schneider, MD, MPH, assistant professor of medicine and director of Global Health Programs. “We plan to borrow from previously successful infectious disease elimination campaigns and employ transdisciplinary collaborations to develop the most evidence-based strategies for achieving this significant goal.” Examples include expanded HIV screening in the health care setting and the community; linkage to comprehensive care and treatment of all individuals diagnosed with HIV infection; and preventive interventions, behavioral and chemoprophylaxis, for at-risk individuals. Prevention efforts will focus initially on the South Side of Chicago. uchospitals.edu/midway Schneider, who did his residency and internship at the University of Chicago Medicine, and David Pitrak, MD, professor of medicine and section chief of infectious diseases and global health, are codirectors. Fifteen staff members will work in renovated dry-lab space on projects awarded by the NIH and CDC. The CCHE is housed within the Biological Sciences Division, but it also will include faculty from the Department of Sociology, School of Social Service Administration, University of Chicago Booth School of Business and Harris School of Public Policy. The University of Chicago’s historic leadership in HIV treatment and prevention includes early treatment successes by current faculty at the first HIV clinic in Chicago in the 1980s, and endeavors that virtually eliminated HIV transmission from infected mothers to newborns. For more information on the CCHE, visit hivelimination.uchicago.edu. MEDICINE ON THE MIDWAY FALL 2013 13 Building a New Age of Biomedicine 14 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION with BY BROOKE E. O’NEILL ome patients are referred by their cardiologists. Others simply do a Google search. Yet perhaps the most heartbreaking cases seen at the University of Chicago Medicine Cardiovascular Genetics Clinic are the families who come seeking answers after losing a young loved one, often in his or her 20s, to sudden cardiac failure. “They give us a call saying, ‘We’ve heard this can be genetic. Can you help us?’” said Elizabeth McNally, MD, PhD, the clinic’s director and A.J. Carlson Professor of Medicine and Human Genetics. “Our job in that case is to not let it happen to anyone else in the family.” As one of only half a dozen centers in the country specializing in inherited cardiovascular disease, the Cardiovascular Genetics Clinic pinpoints genetic mutations that underlie potentially devastating heart conditions and treats patients and at-risk family members based on their DNA makeup. Take a patient with cardiomyopathy, a heart muscle weakness that can lead to shortness of breath, irregular heart rhythms and congestive heart failure. “Right now, we know there are more than 50 different genes that can mutate and cause that disease,” McNally explained. Typically, only one such mutation runs in a family. To identify the culprit, her team draws a blood sample and then analyzes the patient’s genes for variations from the norm. Welcome to the era of biomedical big data. Less than a decade ago, when genomic sequencing was still in its infancy, researchers could test only one gene at a time. Gene panels came on the scene a few years later, boosting that number to five. Then in 2007, McNally explained, next-generation sequencing “changed the equation.” Suddenly, researchers could sequence not a handful of genes but an individual’s entire genome — upwards of 21,000 protein-coding genes — at a fraction of the former cost. When the very first human genome was sequenced in 2000, the price tag was roughly $3 billion. Today, McNally’s team can obtain the sequence of a patient’s genome for approximately $2,000. Genetic testing is changing so rapidly that now it’s just as easy — and less expensive — to generate data that covers the whole genome as it is to target 50 genes up front. Paradoxically, S How University of Chicago researchers are harnessing genomics, supercomputers and high-powered infrastructure to transform patient care Continued on page 16 uchospitals.edu/midway MEDICINE ON THE MIDWAY FALL 2013 15 PHOTO COURTESY OF ARGONNE NATIONAL LABORATORY A ﬁsh-eye lens view of the Beagle supercomputer, housed at Argonne National Laboratory. To date, Beagle has hosted more than 80 independent projects throughout the Biological Sciences Division and led to more than 40 scientiﬁc publications. The combination of a world-class faculty and access to massive computing power positions the University of Chicago to lead the way in the new era of big data-driven biomedicine. analyzing that subset of 50 genes can end up costing more than double what some commercial laboratories charge to sequence a person’s entire DNA profile. Patients who agree to participate in the clinic’s research give a blood sample. Within 90 days, the sequencing company returns results to McNally as a terabyte drive of data. That’s about 1,000 gigabytes, roughly the equivalent of 4.5 million 200-page books. It’s then up to her team to home in on genomic variations linked to protein functions critical to the heart. “We’re going to look at differences in those 50 genes first,” McNally explained. “They’re all marked by signposts, so we can instruct the computer to read the data and give us just that information back.” The process isn’t as straightforward as it sounds, however. The first time McNally tried to upload a terabyte of raw sequencing data in 2011, she crashed the computer system. “We got this ‘whatever you people are doing, you need to stop it,’ message,” McNally recalled. The Biological Sciences Division (BSD) at that time had a large and well-functioning cluster of nearly 1,000 core computing units to support the faculty’s computationally intensive research. However, “whole genome sequences operate on a larger scale than what had been done up until that point,” McNally said. Meet the Supercomputer Enter Beagle, one of the world’s fastest supercomputers. In what turned out to be a game-changing collaboration, the BSD reached out several years ago to its world-class computing colleagues at the Computation Institute (CI) 16 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION and Argonne National Laboratory. By leveraging the long-standing collaboration between pioneering neuroscientists at Argonne and supercomputer leader Cray Inc., assembling a crack team of CI computer scientists, and pulling together state-of-the-art, computer-intensive biological problems from BSD scientists, the teams won NIH funding to support Beagle, one of the world’s largest supercomputers for biomedical research. The Cray XE6 system with its 18,000 tightly coupled core computing units was exactly the type of tool McNally needed to analyze the deluge of genomic data pouring into her laboratory. “People hadn’t necessarily been working with the sheer amount of data we had,” recalled McNally, who reached out to Ian Foster, PhD, the Arthur Holly Compton DistinPHOTO BY BRUCE POWELL guished Service Professor Elizabeth McNally, MD, PhD of Computer Science, director of the Computation Institute and Argonne distinguished fellow. “They liked our data set and we liked their computing power, so it was a match made in heaven.” Together, their teams began configuring the open source software needed to leverage Beagle for the genomic analysis. After a year of painstaking work, McNally can now use the system to analyze up to 240 genomes in only What Exactly is Big Data? A s much as the term gets thrown around, deﬁning “big data” is no simple task. For one thing, “big” is somewhat relative. “If you’re comfortable using an Excel spreadsheet, but not comfortable handling data 10 times larger than that, that data is big for you,” said Robert Grossman, PhD, professor of medicine and informatics director at the Institute for Genomics and Systems Biology. For biomedical researchers, big data is entering an era where the amount of genomic information available could occupy multiple Costco-like warehouses, stretching tens of thousands of square feet. “From that viewpoint,” Grossman explained, “big data is learning how to manage, analyze and operationalize information at that scale.” A single human genome ﬁts onto a single computer disk, but as more and more genomes are sequenced, soaring into the millions, the amount of data storage quickly reaches the scale of warehouses. two days. “That would take about two years to do on a typical biological sciences computer cluster. Beagle can process the genomes simultaneously in parallel rather than one at a time,” she said. Once they identify a mutation in a patient, the researchers confirm it via a certified laboratory and then use the findings to guide an individual’s treatment. For example, a 60-year-old man who carries a mutation associated with cardiomyopathy might encourage his children and grandchildren to get regular preventative screenings and educate themselves about symptoms. Meanwhile, a patient at risk of sudden cardiac death might opt to have a defibrillator implanted to shock her heart back into its regular rhythm if it stopped. “We’re using this incredibly high-tech supercomputer to treat the patients I see in my clinic,” McNally said. “We make lifesaving decisions based on this information.” Explore the Cloud Like any marriage, this union of genomic big data and patient care is not without its challenges. While sequencing is becoming more affordable and offers the promise of more targeted treatment for cardiovascular disease, cancer and other disorders, securely managing and organizing mountains of information remains no simple matter. uchospitals.edu/midway PHOTO BY JASON SMITH Robert Grossman, PhD, informatics director at the University’s Institute for Genomics and Systems Biology and senior fellow in the Computation Institute, led the University’s launch of the Bionimbus Protected Data Cloud. In many ways, McNally’s dilemma with her first terabyte of data captures the conundrum facing today’s life scientists: Technology makes it possible to generate massive quantities of DNA sequence, but the computational horsepower and data-storage capacity, as well as the high-speed computational pipelines and large-scale data analytics required to process and understand the biomedical information encoded in these massive troves, trail far behind. That’s why University of Chicago geneticists, mathematicians, computational scientists, clinicians and philanthropists have joined forces to create infrastructure and software powerful enough to translate genomic big data into precision medicine. They are tackling the challenge from different angles, but they share a common goal of using more efficient data-driven discovery to revolutionize patient care. For Robert Grossman, PhD, professor of medicine, informatics director at the University’s Institute for Genomics and Systems Biology (IGSB), and senior fellow in the Computation Institute, that means bringing more sophisticated data management and analytics to biomedical researchers. “Big data has changed other disciplines,” he said, citing behemoths like Amazon, Google and Facebook, which run massive computing warehouses to mine user data. “The hope,” he said, “is that if we apply those ideas to very large amounts of cancer data, we will gain insights that aren’t possible with the current instruments we’re using.” His vision gained traction in May when he led the University’s launch of the Bionimbus Protected Data Cloud, the only cloud-based computing system approved by the National Institutes of Health (NIH) to handle data from The Cancer Genome Atlas (TCGA). TCGA, the “We’re using this incredibly hightech computer to treat the patients I see in my clinic,” said Elizabeth McNally, MD, PhD, director of the Cardiovascular Genetics Clinic at the University of Chicago Medicine. “We make lifesaving decisions based on this information.” Continued on page 18 MEDICINE ON THE MIDWAY FALL 2013 17 team used Bionimbus to identify a gene pivotal to a type of treatment-triggered acute myeloid leukemia. Their findings, published in Blood, shed new light on how clinicians might tailor cancer therapy based on an individual’s genetic profile. Fuel the Eﬀorts PHOTO BY JASON SMITH Rick Stevens, PhD, co-founder and senior fellow of the Computation Institute The new Institute for Computational Biology and Medicine brings together pioneering computer scientists and biomedical researchers to transform massive troves of data into, ﬁrst, “knowledge” and then “wisdom,” with the potential to predict complex biomedical outcomes and to design lifesaving interventions. 18 NIH’s compilation of genomic sequencing data, covers more than 6,000 patients and tumors from more than 20 different cancer types. (Along with the University of California, Santa Cruz, the University of Chicago is one of only two “trusted partners” designated by the NIH to handle its genomic data for the entire national research community.) In the past, researchers could analyze the TCGA dataset only after building their own secure compliant computing system, a daunting task that could stretch for months. Now, thanks to Bionimbus, housed at the University’s Kenwood data center, NIH-approved scientists can access TCGA’s raw data and run analyses in mere seconds from anywhere in the world. TCGA soon will contain more than 10,000 genomes, making Bionimbus the largest genomics cloud available to the research community. “We’re trying to design these instruments, these warehouse-scale computers, that you can use to bring together data that’s never been looked at and examine it on an unprecedented scale,” Grossman said. “Our goal is to be able to analyze a million genomes.” Such infrastructure — Grossman calls it a “datascope” — is already becoming a cornerstone of more targeted medical care. Earlier this year, pathology instructor Megan McNerney, MD’07, PhD’05, and her THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION As many scientists struggle to harness its power, big data has found a natural home at the University of Chicago. “The main thing we have here that’s hard to replicate elsewhere is this collection of people who have all worked on high-performance computing environments and are now connected to this biomedical space,” said Computation Institute co-founder and senior fellow Rick Stevens, PhD, professor of computer science, senior fellow in the Institute for Genomics and Systems Biology and an Argonne associate laboratory director. “That’s the unique vector.” Further fueling biomedical discovery are the donors who understand big data’s potential. In April, Jim Frank, a longtime University of Chicago Medical Center trustee, and his wife, Karen, pledged $9 million to help establish a new Institute for Computational Biology and Medicine. The institute will bring together researchers at the leading edge of computer and information science with a new breed of biologists and clinicians to develop novel data-mining algorithms, simulate biological systems and — together with systems biology scientists and engineers — transform big data into actionable knowledge that will advance genomics-driven medicine. Meanwhile, a substantial gift from medical center trustee Gordon Segal and his wife, Carole, will ramp up genomic research to treat pancreatic cancer, predicted to become the nation’s second-most deadly cancer in the coming decade. The Pancreatic Cancer Genomic Medicine Initiative will sequence tumors from upwards of 200 patients and use the Bionimbus cloud to compare findings against nearly a petabyte — that’s 1,000 terabytes — of genomic data collected by the National Cancer Institute. Their target: identifying genetic variations that can predict treatment outcomes. “Our hope is that, in a couple of years from now, we’ll have a way to pinpoint some new biomarkers that help predict which patients will do better or worse under different therapeutic regimens,” said Kevin White, PhD, director of the Institute for Genomics and Systems Biology, the James and Karen Frank Family Professor in the Departments of Human Genetics and Ecology and Evolution, and senior fellow in the Computation Institute. White’s team also is collaborating with the Pancreatic Cancer Action Network to gather even more genomic data and bring quality care to a wider patient community. “The majority of pancreatic cancer patients are not getting the kind of cutting-edge genetic research and clinical trials they would get at a place like the University of Chicago,” said White. The nationwide initiative will reach out to more than 800 patients monthly, enabling them to securely share data with Chicago researchers, have their tumor material analyzed and gain access to clinical trials. Units of Data Storage the amount of data needed to store 1 character of text in a computer Byte 1,024 bytes; enough to store a short story Kilobyte Mine the Data When it comes to big data, one thing is clear: the bigger, the better. “By having enough data, you can use certain statistical or algorithmic procedures to try to signal what’s really going on,” White said. “If you had smaller amounts of data, you wouldn’t see significance.” Medical physicist Maryellen Giger, PhD’85, the A.N. Pritzker Professor in the Department of Radiology, director of the Imaging Research Institute and senior fellow in the Computation Institute, has seen this played out as she develops quantitative image analysis methods capable of more accurately predicting breast malignancies. A pioneer in computer-aided detection, she’s spent the past two decades training computers to distinguish between malignant tumors, benign lesions and normal tissues in mammograms, ultrasounds and MRI images, often with greater precision than the human eye. Over the years, she’s found that certain observable characteristics, or image-based phenotypes, are associated with a particular risk profile. Women at high risk for breast cancer, for example, tend to have dense breasts with a coarse texture pattern that’s low in contrast. “Now we’ve moved to decoding cancer with imaging and big data,” said Giger, whose lab has used the Beagle supercomputer to analyze more than 1,000 patient cases — nearly 3,000 ultrasounds of breast lesions — extracting 81 image characteristics, such as tumor shape, margin and texture. Her team already knew which lesions were benign masses, cysts or cancerous tumors. What they wanted to test was whether an unsupervised computer could predict the status by combing through reams of data and drawing relationships between hundreds of lesions, based only on the image characteristics. Turns out, the computer did quite well. The system grouped benign masses, cysts and malignancies with remarkable accuracy. Spotting connections among the image features, “the computer did all the association without knowing the truth,” Giger said. Such developments pave the way for even more precise diagnostic tools with which to guide treatment decisions, as Giger’s lab is investigating the association of these image-based phenotypes with genomics across different types of breast cancers. uchospitals.edu/midway Megabyte 1 million bytes; enough to store a small novel 1 billion bytes; enough to store a TV movie Terabyte 1 trillion bytes; enough to store all 200,000 MP3 songs 1 quadrillion bytes; enough to store 13.3 years of HDTV video Exabyte Petabyte 1 quintillion bytes; enough to store 67 million IPhones worth of data 1 sextillion bytes; enough to store 2 billion years of music Yottabyte Gigabyte Zettabyte 1 septillion bytes; enough to store 250 trillion DVDs Leave No Stone Unturned In many ways, big data is changing the paradigm of biomedical research itself, enabling scientists to discover unexpected connections that might otherwise be missed. White describes the process of transforming data to knowledge: “By bunching a heterogeneous mixture of data together that may have been collected for very different purposes, you can draw lines between things you didn’t necessarily expect to be related,” he said. “Big data can be used to look under lots of different rocks that people may not have thought to look under.” Computational biologist Andrey Rzhetsky, PhD, director of the University’s multi-institutional Silvio O. Conte Center for Computational Neuropsychiatric Genomics, senior fellow in the Computation Institute, and professor of medicine and human genetics, is doing just that. Inventor of an automated text-mining technology designed to scour decades of biomedical literature for connections, Rzhetsky has spent his career improving our biological understanding of how genes Continued on page 21 The University of Chicago is one of only two “trusted partners” designated by the National Institutes of Health to handle its genomic data for the entire national research community. The University’s Bionimbus Protected Data Cloud is the only cloud-based computing system approved by the NIH to handle data from the The Cancer Genome Atlas (TCGA). MEDICINE ON THE MIDWAY FALL 2013 19 Transforming the Midway into a Big Data Hub University of Chicago researchers are tackling biomedical big data from every angle: building powerful infrastructure to house it, designing sophisticated algorithms to mine it, developing computer intensive programs to model and test it, and working with scientists and engineers at the Institute for Genomics and Systems Biology and the new Institute for Molecular Engineering to develop high-throughput platforms to empirically test computational predications. Here are some of the initiatives that are making the Midway a national hub for biomedical big data. Bionimbus Protected Data Cloud Launched in May, Bionimbus is the only cloud-computing infrastructure approved by the NIH that allows researchers anywhere in the world to securely access reams of genomic data from The Cancer Genome Atlas. Center for Personalized Therapeutics The center’s ﬂagship initiative, the 1200 Patient Project, is collecting DNA samples from 1,200 patients to test for drug interactions and then design personalized proﬁles accessible to physicians through a secure database. It is the largest-scale clinical study of its type to date. 20 Cardiovascular Genetics Clinic Computation Institute Led by Elizabeth McNally, MD, PhD, the clinic specializes in treating patients and families grappling with inherited heart and vascular diseases. Researchers can analyze a patient’s entire genome using the Beagle supercomputer, identify which gene mutation may be causing the disease and then determine the best treatment. An interdisciplinary collaboration between the University and Argonne National Laboratory, the Computation Institute has spent more than a decade applying novel computational approaches and largescale infrastructure to grand questions in the life sciences, social sciences, astronomy, physics and humanities. Institute for Computational Biology and Medicine Institute for Genomics and Systems Biology Seeded with a $9 million gift, the newly created institute will bring together leadingedge researchers in ﬁelds including systems biology, computer science, and engineering to transform big data into knowledge that will advance genomicsdriven medicine. Initial eﬀorts will focus on cancer. The institute brings together University and Argonne researchers to improve basic biological understanding via advanced techniques in genome analysis and biological computation. Subjects include identifying signaling networks in human cells and decoding cancer’s genetic underpinnings. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Pancreatic Cancer Genomic Medicine Initiative This initiative, funded by a recent gift, will lead targeted genomic research to investigate one of the most lethal forms of cancer. First steps include sequencing 200 patients and comparing the results against National Cancer Institute data to identify whether certain genetic variations can predict treatment outcomes. Silvio O. Conte Center for Computational Neuropsychiatric Genomics The center is heading the nation’s ﬁrst large-scale eﬀort to use genomic big data and informatics in pinpointing genetic and environmental factors underlying neuropsychiatric disorders. Researchers are currently mining 100 million patient medical records. Systems Biology Knowledgebase (KBase) Imaging Research Institute Co-led by the University’s Rick Stevens, PhD, this Department of Energy initiative is an open-source data infrastructure that gives users access to a wide range of genomics, biological and environmental data, enabling researchers to collaboratively generate, test, and share hypotheses about interactions among microbes, plants and their communities. The multi-departmental BSD eﬀort has provided more than 100,000 imaging studies/scans through its Human Imaging Research Oﬃce (HIRO) for clinical research and through its integrated Small Animal Imaging Research Resource (iSAIRR) for advancing multimodality preclinical imaging in biological discovery. PHOTO BY JASON SMITH Kevin White, PhD, director of the Institute for Genomics and Systems Biology, talks about data-driven discovery before an audience that includes philanthropists Karen and Jim Frank, foreground, left, and Carole and Gordon Segal. and molecules interact to produce health or disease. “It’s not so much about individual findings as it is about creating a system from disconnected statements,” he said of the research. “Everything links in a bigger picture.” Rzhetsky and his team have created one of the most expansive analyses to date of the genetic factors at play in complex diseases — a category that incudes autism, diabetes and heart disease — by using disorders with known genetic causes to guide them. Analyzing more than 120 million patient records and identifying trends of co-occurrence among hundreds of diseases, they created a unique genetic map that has the potential to guide researchers and clinicians in diagnosing, identifying and someday developing therapies for complex diseases. The work was published in September in Cell. “He’s found some surprising co-morbidities,” noted White, a collaborator in the initiative. For example, Marfan syndrome, a connective tissue disorder, was found to have significant co-morbidities with such neuropsychiatric disorders as autism, bipolar disorder and depression. “It’s enormously rich data,” Rzhetsky agreed. Like their cancer-focused colleagues, Conte Center researchers are using the secure Bionimbus cloud-computing infrastructure to access electronic medical records, public and proprietary databases, and other genomic data resources in a way that ensures patient privacy. Going forward, Grossman’s Bionimbus team plans to integrate additional medical records into the system, adding even more stones for University of Chicago scientists to overturn. “We’ve only scratched the surface,” Rzhetsky said. Scale New Heights While big data is still the new frontier of biomedicine, there will likely come a day when having your genome seuchospitals.edu/midway MEGAN E. DOHERTY Andrey Rzhetsky, PhD, director of the Silvio O. Conte Center for Computational Neuropsychiatric Genomics quenced and compared against thousands, even millions, of other patient cases will be standard clinical practice. At the University of Chicago, that revolution is well underway. Across multiple disciplines, departments and centers, researchers are laying the foundation of a robust architecture: computing clouds, warehouse-scale facilities, statistical models and novel algorithms designed to mine an unprecedented amount of genomic data. “When we first used microscopes to look at small things — that was only one to two orders of magnitude of resolution, but it created a lot of new sciences,” Grossman said. “We used it to look at bacteria and microbes. When you had telescopes, you used them to look at far things. We saw features of the moon and stars we had never seen before.” Now, he explained, the infrastructure they’re building will empower scientists to “look at data at a scale that’s really never been done before.” It’s a transformation Grossman and his colleagues have fully embraced as they pave the way for more precision medicine. After all, he said, “you don’t get that many chances in your life to try to do something new like this.” Computational biologist Andrey Rzhetsky, PhD, left, and his team have created one of the most expansive analyses to date of the genetic factors at play in complex diseases, analyzing more than 120 million patient records and identifying trends of co-occurrence among hundreds of diseases. “We’ve only scratched the surface,” Rzhetsky said. MEDICINE ON THE MIDWAY FALL 2013 21 Immobilizing Cancer’s Working at the intersection of biology, physics, chemistry and computational modeling to unlock the secret of metastasis A close-up of a computational model of actin ﬁlaments devised by Ed Munro, PhD, assistant professor of molecular genetics and cell biology at the University of Chicago, and Ryan Gile, research assistant at the University of Washington’s Center for Cell Dynamics. The embedded spheres are “tracer balls” that oﬀer a way to compare simulations to real-life measurements of cellular forces taken in the lab. 22 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION BY STEPHEN PHILLIPS series of pulses moves erratically across a black backdrop on Ronald Rock’s computer screen. Each tadpole-like shape projects a writhing stem that seems to guide its rakish progress. One of the pulses shears in two. Others follow. As they multiply, the screen becomes a seething mass of activity. The spectacle could be considered beautiful. But this is not some beguiling computer animation designed for our entertainment. On the screen is a speeded-up time-lapse video made by Cleveland Clinic neurooncologist Steven S. Rosenfeld, PhD’85, of glioblastoma multiforme, the lethal brain cancer that each year claims roughly 13,000 American lives. The pulses are tumor cells stained with fluorescent dye; the black backdrop they’re colonizing is brain tissue (taken in slices from a mouse). “You’re watching metastasis,” says Rock, PhD, BS’92, associate professor of biochemistry and molecular biophysics at the University of Chicago. “There’s a cell that divided right before your eyes, and you can see each cell sensing out ahead as it worms its way through the densely packed tissue.” Deadly Engine Cell division and movement are essential for healthy development and wound repair. But in cancer, these processes spiral out of control. Rock draws attention to the counter at the foot of the screen. “These cells are crawling about one millimeter a day,” he points out — warp speed compared to non-cancer cells. Small wonder that average survival following diagnosis of glioblastoma is little more than a year. Rock is part of a group of young University of Chicago scientists working at the intersection of biology, physics, chemistry and computational modeling to unlock the operating principles governing cell division and movement, and how these processes go rogue to produce metastasis. The result could be a new flank in the war on cancer. To go big, these researchers are starting small. Downstairs from his light-filled laboratory, in the sub-basement of the Gordon Center for Integrative Science, Rock and his team train penetrating microscopes on the miniscule mobile packets of protein that ply back and forth in our cells. These so-called myosin motors transport proteins to different regions of the cell to enable movement, adhesion (as in tissue or organ formation) and other basic functions. Consider them cellular foot soldiers, and the analogy even uchospitals.edu/midway An image from a computational model by Ed Munro, PhD, and Jon Alberts (University of Washington) of the network of actin ﬁlaments and myosin motors that lies just beneath the cell surface. extends to the way they move. “They walk like we walk, swinging their legs,” Rock said. “We want to see that swinging of the leg.” It’s exacting work that demands pinpoint precision. “These motor proteins are covering a couple thousand atoms with each step,” explained Rock, who uses purpose-built low-vibration space and rigs up his own specially calibrated microscopes. “We need to be able to measure that very precisely.” The painstaking effort is yielding dividends. An estimated 40 myosin motors trundle around within each of our trillions of cells. Rock and his team are steadily revealing the order behind this frantic hive of activity. The cytoskeleton, the membranous sheathing encasing each cell, is crisscrossed by a constant turnover of tracks, or filaments, which are often braided together in bundles, along which a fleet of myosin motors shuttles protein payloads to different points in the cell. Rock and his cohort have found that myosin-10, present in elevated quantities in cancer cells, is optimized to travel on certain filaments that it can sense and navigate to. They suspect other myosin motors are similarly primed to use particular filaments. But what governs when, where and how the filaments are laid down? Here, Rock hands off to David Kovar, PhD, associate professor of molecular genetics and cell biology. “Ron’s lab has discovered that certain myosin motors appear to be molecularly tuned to crawl along particular filaments; my lab is trying to understand how these filaments are assembled in the first place,” said Kovar, who uses powerful microscopes to Continued on page 24 MEDICINE ON THE MIDWAY FALL 2013 23 Continued from page 21 eavesdrop on this process in a simple, single cell organism called fission yeast, which has much in common with human cells. Filaments are polymers made up of hundreds to thousands of protein subunits called actin. But cells have systems in place to ensure that this actin does not assemble into filaments until the time and place are right. The catalysts for this “polymerization” are so-called nucleation factors, binding proteins that coax actin to form filaments. These nucleation factors — Arp2/3 complex and formins — produce filaments that are either short and branched or long and straight, respectively. Form is function, said Kovar: the short, branched filaments propel cell movement, while the long, straight ones foster cell division. “Arp2/3 complex and formins are inert until the cell signals that the moment is right for them to spring into action,” he added. “Meanwhile, another protein, profilin, binds to actin subunits to prevent rogue filament formation without the aid of Arp2/3 complex and formins.” These machinations form part of an exquisitely orchestrated perpetual motion “machine,” in which proteins constantly generate forces that enable the cell to divide and move, and, when at rest, to exist in dynamic equilibrium, adapting to an ever-changing environment in the body. On the computer in his office not far from Kovar’s in the Cummings Life Science Center, Ed Munro, PhD, assistant professor of molecular genetics and cell biology, runs short movies he has made of some of these processes in action in the cells of the translucent worm C. elegans, another easy-to-study analog to human cells. One shows the pulsating contractions of myosin motors and actin filaments as they drive a rapid redistribution of proteins to one end of a newly fertilized cell; another shows the same cell organizing these motors and filaments into a contractile ring, through which it pinches itself apart into two daughter cells in cell division. Munro and Margaret Gardel, PhD, associate professor of physics, are working to comprehend how these intricate dances are choreographed. It is a partnership that brings disparate perspectives to bear. Trained in soft condensed matter physics, 24 PHOTO BY BRUCE POWELL Ed Munro, PhD, left, assistant professor of molecular genetics and cell biology; David Kovar, PhD, associate professor of molecular genetics and cell biology; Margaret Gardel, PhD, associate professor of physics; and Ronald Rock, PhD, BS’92, associate professor of biochemistry and molecular biophysics. Gardel is asking some decidedly unbiological questions to shed light on the forces wracking our cells. “We want to understand how the protein-based materials that form inside cells regulate how cells move and change shape, and how these forces are transmitted within the body,” she said. To this end, Gardel and her team calculate the force exerted by cells by placing cells on a squishy gel surface and measuring the impression their movement leaves. Befitting someone whose work straddles biology and physics, Gardel’s laboratory is nestled among the biologists in the west end of the Gordon Center, while her office is located alongside those of her colleagues in the physical sciences in the building’s east wing. “Physicists say, ‘let’s see if we can identify a simpler, more abstract version of a biological process that captures its essential physical features,’” Munro said. “As a cell biologist, I’m interested in how nature, through evolution, has found ways to exploit this physics — how evolution has tuned the physical properties of these biological systems to do useful stuff, and how they get de-tuned in disease.” Gardel and Munro use the data they glean from their laboratories to formulate mathematical models that can explain how these forces conspire en masse to produce different cellular behavior. “We’re trying to THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Snapshots of three time points in the life of an embryonic cell showing how actin ﬁlaments (left) and myosin motors (right) organize a sequence of diﬀerent contractile structures during cell polarization and division. build a bridge between what we know about individual molecules and how they interact, and what happens at the level of the whole cell and beyond,” Munro said. Models represent a powerful tool for discovery, he added. “They can encapsulate some simple idea about how something might work, allowing us to make a predictive bridge between what we know at one scale and what we know at another.” They can also help fill in the blanks. In some instances, Munro said, model-making is a case of, “let’s take all the details we know and put them together to see what they add up to, without necessarily, a priori, being smart enough to understand exactly how you go from the low-level details up.” “Ultimately you’d like to understand things conceptually, but very often you can build models that simply tell you if these facts add up to an explanation of the observed behavior or not.” In other instances, modeling can streamline the scientific process itself, removing a little of the trial and error involved in experimentation by allowing hypotheses to be prescreened. “We use mathematical models to ask, ‘is this hypothesis sensible?’” Munro said. “Very often a model will tell you an idea you discussed around the water cooler is a nonstarter because it cannot possibly work. Before you even get to the point of doing an experiment, it can tell you whether or not you have a good idea.” Gardel and Munro unspool simulations of cellular behavior, based on their models, on computers. “There isn’t a single interesting thing that goes on in a cell … that doesn’t involve so many moving parts that its complexity outstrips the ability of our brain to predict what’s going to happen,” Munro explained. But the computers they use are far removed from the humble deskstop on which Munro displays his videos of worm cells. For one recent study, their teams used the Beagle supercomputer at Argonne National Laboratory, one of the world’s most powerful supercomputers for biological investigation. To keep their models honest, Gardel and Munro subject them to constant reality checks, toggling between their computer screens and microscopes to verify that the computer-generated projections of cell behavior their models produce comport with their empirical observations of real-life cell behavior. “This tells us if we’re capturing the key properties of the myosin motors and their interactions with the actin filaments,” Munro said. The impact of this work could be farreaching. By unraveling the system behind cell behavior, Gardel and Munro are recasting the variables in that system as levers that uchospitals.edu/midway may be manipulated to produce certain effects. “The machinery that controls cellular behavior can be thought of as having all these knobs and dials — for instance, how much myosin you express, and how rapidly actin is turned over — that can be tuned to produce different physiological consequences,” Munro said. Such an approach would have immediate application in materials science. The cytoskeleton is “a material that generates stress within itself, and this is quite unique,” Gardel said. “Structures are forming and disassembling very quickly, and yet they are still able to give the cell shape or drive something coherent like cellular motion.” These properties offer of the scope of the problem,” Munro said. “But it is a way of thinking about disease that has to be taken into account in designing medical interventions.” Munro, Gardel, Kovar and Rock hope one day to generate the information needed to bring this vision to reality and open up cancer’s deadliest characteristic to new therapeutic assault. “What kills you in cancer is metastasis — cancer cells crawling around — and it is the cytoskeleton that is pushing them around,” Kovar said. “Once we understand how all the pieces fit together, we can start to attack that,” Rock added. “We can start to inhibit the formins or the bundle formers “We’re doing it as a team because there’s no way one lab could be doing all this by itself.” David Kovar, PhD, associate professor of molecular genetics and cell biology pointers for new smart “bio-inspired” material, mimicking the self-assembling, self-healing attributes of cells, which might, for example, be used as drug delivery vehicles — conveying therapies to hard-to-reach regions of the body — or in accelerating wound regeneration. Munro compares the possibilities to the nascent field of synthetic biology where scientists applying principles from engineering stitch genes together to fabricate new organic systems with useful properties. “This is the same kind of thing. Let’s take all the things we’re beginning to understand about how the material properties of a cell emerge from molecular properties and interactions, and see if we can tune these molecular properties to give us different material properties.” The same molecules are involved, of course, when the remarkable properties of cells go awry, resulting in disease states like metastasis. And this opens up the possibility that they might similarly be tweaked to “nudge” cells back into a healthy state. “At this stage, this is more a statement or the myosin motors that walk out on them.” Teamwork will be critical. “There’s this wonderful emerging interface between cellular biology and physics, chemistry and mathematics because of the ability we have now to peer into cells to see what they’re doing and to measure the forces at work and look at their dynamics,” Munro said. “The more we see at every scale, the more we see the hand of physics and chemistry at work. And biology, through evolution, is tuning these properties in all sorts of ways.” “The cell is a very complicated system where you have all these different types of actin filaments that self-assemble and coexist within the same crowded space,” Kovar added. “Collectively, our labs are trying to understand how this can happen. We’re using biochemistry, cell biology, single molecule imaging, mathematical modeling and whole cell studies, and we’re doing it as a team because there’s no way one lab could be doing all this by itself.” MEDICINE ON THE MIDWAY FALL 2013 25 F A C U LT Y A N D S T U D E N T R E S E A R C H Pritzker News A window into the nervous system Jacqueline Bernard, MD, assistant professor of neurology, is studying how optical coherence tomography (OCT) can be used to evaluate the extent of neurodegenerative disease and response to treatment. Working on research projects using OCT are, from left, Ashley Finch, third-year student at the Illinois College of Optometry; Michael Coppes, MS4; Christina Sprayberry, MA, LSW, multiple sclerosis study coordinator; and second-year Pritzker students Martin Greenwald, Gabrielle Liu and Garrick Talmage, participants in the Summer Research Program. PHOTO BY JEAN LACHAT PHYSICIANS OF TOMORROW 2013 SENIOR SCIENTIFIC SESSION Two Pritzker students named AMA 2013 Physicians of Tomorrow Seniors recognized for research Jessica Portillo, MPH, MS4 Kunmi Sobowale, MS4 Pritzker fourth-year students Jessica Portillo, MPH, and Kunmi Sobowale have been named recipients of the American Medical Association Foundation’s 2013 Physicians of Tomorrow Scholarship. The scholarship, established to help offset the cost of medical school, acknowledges a very select group of students who have displayed academic excellence. 26 T he 67th Senior Scientific Session on May 16, 2013, highlighted outstanding scholarship by Pritzker School of Medicine’s Class of 2013. Nearly half the class participated in the 2013 session, chaired by Vineet Arora, MD, MA’03, associate professor of medicine and assistant dean for scholarship and discovery. Eight students received awards for noteworthy scholarship. They are, from left: William Zeiger, MD’13, PhD’11; Yelena Koldobskaya, MD’13, PhD’09; Rachel Stork, MD’13; Nikita Alexiades, MD’13; Jordan Yoder, MD’13; Elizabeth Greenstein, MD’13; Tarak Trivedi, MD’13; and Marcia Faustin, MD’13. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION W H I T E C O AT C E R E M O N Y Pritzker welcomes Class of 2017 T he Pritzker School of Medicine’s 88 new students recited the Hippocratic Oath before their families, friends and new colleagues at the annual White Coat Ceremony on August 11 in Rockefeller Memorial Chapel. Mark Siegler, MD’67, was the keynote speaker. Siegler is director of the MacLean Center for Clinical Medical Ethics and executive director of the Bucksbaum Institute for Clinical Excellence. He has practiced internal medicine at the University of Chicago Medicine for 45 years. Proud families capture the moment. Medical students take part in the White Coat Ceremony. Ayushi Chandramani, MS1, right, wears a big smile with her new white coat. PHOTOS COURTESY OF GRADIMAGES Siegler’s talk focused on three points: Medicine remains a great profession for students to enter; now is an ideal time to enter medicine because of both scientific advances and increasing access to care; and Pritizker is an ideal place to study because it combines the science of medicine with the art of personal care. The White Coat Ceremony marks students’ formal induction into the medical profession and lifetime commitment to blending knowledge, excellence, and compassion as physicians. CLINICAL EXCELLENCE Bucksbaum Institute names Student Scholars The Bucksbaum Institute for Clinical Excellence has announced the selection of the 2013 Student Scholars. The Bucksbaum Institute is an initiative aimed at improving the doctor-patient relationship and communication in medicine. The scholarship supports Pritzker School of Medicine students with tuition and fees for the second through fourth years of medical schools. The four second-year students are involved in reuchospitals.edu/midway search with faculty mentors that examines aspects of the doctor-patient relationship. Dara Adams is studying the relationship between overall patient satisfaction and the patient’s perception of the communication between the hospital team and the primary care physician. Steven Bhutra is working on a pilot clinical trial investigating the application of personalized molecular profiling in patients with chronic myeloid leukemia. Brenna Hughes is conduct- Dara Adams, MS2 Steven Bhutra, MS2 ing research on the cost of improving diabetes care and outcomes on the South Side of Chicago. Ashley Tsang studies social networks of injection drug users in an HIV outbreak in Athens, Greece. They join 2012 Student Brenna Hughes, MS2 Ashley Tsang, MS2 Scholars Annie Lauer, MS3, Elizabeth Rhinesmith, MS3, and Robert Sanchez, MS3, and the inaugural Student Scholars selected in 2011, Jasmine Taylor, MS4, Liese Pruitt, MS4, and Alexander Ruby, MS4. MEDICINE ON THE MIDWAY FALL 2013 27 Pritzker News More than role playing Most medical schools use standardized patients to help students learn clinical skills. Pritzker takes it to another level with SPs who educate as well as act. BY EILEEN NORRIS K PHOTO BY ROBERT KOZLOFF Andrew Golden, MS2, examines standardized patient Vera LaVender in the Pritzker School of Medicine Clinical Performance Center. “The vast majority of our SPs are former educators, and we train them extensively in their scenarios and feedback skills.” Jeanne M. Farnan, MD’02, MHPE, medical director of the Clinical Performance Center 28 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION ate Ibara is seeing the doctor because she’s been experiencing abdominal pain. Actually, Ibara feels fine and is only pretending to be ill for the benefit of medical students. The 31-year-old has gone through rigorous training and rehearsals with staff from the Pritzker School of Medicine Clinical Performance Center (CPC). After carefully studying her case description and memorizing a dozen or so details related to her complaint, the standardized patient (SP) is ready to step into her role. By the end of the day, eight medical students will have examined her. Ibara doesn’t mind the poking and prodding; she winces and groans at the appropriate times. Neither she nor any of the students breaks out of character. At the end of each scenario, Ibara gives verbal feedback and enters her evaluation into a computer program. Later, the students can view a video of the encounter. “It gives the students a chance to practice in a low-stakes environment,” she said. “It’s interesting to see how they grow over the four years.” Ibara, who also has worked as a Spanish medical interpreter, has been an SP for five years. “I’ve played a patient with MS, a patient with depression and anxiety, and even someone with an obsessive-compulsive disorder.” While most medical schools hire standardized patients for clinical skills instruc- Meet an SP R PHOTO BY DAVID CHRISTOPHER Jeanne M. Farnan, MD’02, MHPE, and Jason Poston, MD’02, teach Pritzker’s clinical skills curriculum. tion, Pritzker takes a distinctive approach. “The vast majority of our SPs are former educators, and we train them extensively in their scenarios and feedback skills,” explained Jeanne M. Farnan, MD’02, MHPE, assistant professor of medicine, director of clinical skills education and medical director of the CPC. Pritzker employs a pool of “patients” representing various ages, genders and backgrounds. They earn about $18 an hour. “We expect a high level of professionalism,” said Kris Slawinski, associate director of the CPC. “A lot goes into this, and we take it quite seriously. The SPs go through tons of training to learn how to portray a patient in one of dozens of scenarios. We teach them about the disease they are representing, and they practice and study. The program is only as good as the SPs.” Initial encounters with SPs can be a little stressful for the medical students, but also revealing. “In our first year, we did historytaking and practiced physical exams,” Andrew Golden, MS2, said. “The SPs did a great job of making it real.” When Golden watched the playback of himself taking a medical history, he was shocked. “I thought, Why did I say that? Why was I sitting in the chair that way? I say ‘like’ too much, and I talk with my hands,” he said. “It was an eye opener and helped me a lot, even down to how I should enter the exam room.” The teaching moments paid off for Golden, especially now that he’s in clinic uchospitals.edu/midway seeing real patients. “I feel so much more confident,” he said. “The experience taught me how to be a better doctor.” Third-year medical student Kiara Tulla said the first time a student enters the center feels awkward. “Most of the SPs are fabulous and can really put on a show, so the encounter seems very real,” she said. “It’s nice to be in a protective environment where you really can’t do anything wrong.” With practice, the students’ clinical skills improve and so does their comfort level. Tulla recalls doing a complete physical in less than 45 minutes during her second year. Farnan says this head-to-toe exam serves as the final opportunity for standardized, mentored practice before preclinical students head off to the hospital units. Tulla worried that she had left out some of the 150 items on the checklist. The SP suggested a few things she could consider doing differently, but gave Tulla high marks. The CPC consists of nine fully equipped mock examination rooms located on the lower level of the Biological Sciences Learning Center. Students train there throughout medical school. The first year focuses on medical history and the physical examination; the second year on advanced communications; the third year on clinical examinations for different specialties; and the fourth year on high-level communications, such as end-oflife, death pronouncements and withdrawing care. The CPC is also used by trainees in fellowship programs and for advanced medical education for faculty. etired computer programmer Vera LaVender, 71, doesn’t like needles or blood, but she loves her job as a standardized patient (SP) and studies hard to be good at it. She often is cast as the geriatric patient, perhaps with shortness of breath that might indicate chronic obstructive pulmonary disease or trembling that could signal Parkinson’s disease. LaVender and her fellow SPs play an important role in helping Pritzker School of Medicine students learn how to examine and com- Vera LaVender municate with patients. LaVender has had some pretty tough assignments, she said, “especially in the death and dying series” for fourth-year medical students. In one of the scenarios, she is in the room with her “husband” (a cardiac patient simulator), as well as a nurse who summons the physician. The husband has passed, but LaVender’s character thinks he’s sleeping. “The student has to come in, tell me my husband has died, and pronounce him dead,” LaVender explained. “Of course, I’m grieving. There’s a lot of crying and emotions going on. We’ve been married a long time, how do I tell the children, and what will I do without him. It’s emotional and it drains me, but I get through it.” Once she “lost” her husband three times in one day. “I never feel like I’m acting, and it doesn’t get old,” she said. “I feel like the patient for whichever part I’m playing. I learn so much, and if I see four students they may find four different ways to get to the same conclusion. Really, I’m concentrating on my role and what each student is doing so that I can give him or her accurate feedback when we’re done. We work hard at this. It’s really teamwork.” – Eileen Norris MEDICINE ON THE MIDWAY FALL 2013 29 COMMUNITY Pritzker News Pritzker alum leads a team approach to ﬁghting childhood obesity PHOTO BY RON VESELY, CHICAGO WHITE SOX TEAM PHOTOGRAPHER Deborah Burnet, MD’89, throws out the ceremonial ﬁrst pitch at a White Sox-Texas Rangers game in August. C ountless campaigns have been launched to steer schoolchildren toward healthy habits. Yet with childhood obesity rates tripling in the last 30 years and type 2 diabetes showing up earlier in life, more effective ideas to promote nutrition and exercise are needed. One strategy is to create programs that are locally focused and tailored to the culture of the children they are trying to help. That approach inspired a research team led by Deborah Burnet, MD’89, to design Power-Up, an after-school program now in its fourth year at Woodlawn Community School on the Chicago’s South Side. Burnet, professor of medicine and pediatrics and section chief of general internal medicine at the University of Chicago Medicine, brings a well-rounded perspective to the project, says Marshall Chin, MD, MPH, the Richard Parrillo Family Professor in Healthcare Ethics in 30 the Department of Medicine and director of the Chicago Center for Diabetes Translation Research. “She has a great appreciation for the medical factors that impact obesity as well as the social, cultural, and family factors that are important to health in general and obesity in particular,” he said. Before launching Power-Up, Burnet’s team organized focus groups with overweight children and their parents to learn about the obstacles they face and the types of physical activity and classes that appeal to them. Those conversations laid the groundwork for programs tailored to the unique circumstances of participating families. Since its introduction at Woodlawn, Power-Up has served more than 70 students. Study findings have been encouraging — preliminary results found a significant drop in body mass index among overweight participants. Burnet’s THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION group may expand the program to other area schools. Meanwhile, University of Chicago Medicine initiatives to combat obesity through community partnerships continue to evolve, most notably through a new partnership with the Chicago White Sox. By sponsoring Sunday afternoon home games, Comer Children’s Hospital reaches consumers in a very public way, using its repertoire of research-based programs to teach families how to make healthy lifestyle choices. “The White Sox Family Sundays give us the chance to reach more kids and families through Power-Up All Stars activity booths at the ballpark, and through online Power-Up activities with the White Sox Kids Club,” Burnet said. “It’s an approach that appeals to kids and their families.” – Elizabeth Brandon 2013 SHUBITZ CANCER PRIZE Alum honored for cancer research Todd Golub, MD’89, received the 2013 Simon M. Shubitz Cancer Prize and Lectureship in October. Michelle Le Beau, PhD, the Arthur and Marian Edelstein Professor of Medicine and director of the University of Chicago Medicine Comprehensive Cancer Center, presented the honor. Golub is founding core member, chief scientiﬁc oﬃcer and director of the cancer program at the Broad Institute of MIT and Harvard, professor of pediatrics at Harvard Medicial School and a Howard Hughes Medical Institute investigator. Todd Golub, MD’89, and Michelle Le Beau, PhD MENTORSHIP AND DISCOVERY Pritzker students awarded research fellowships Several Pritzker students have been chosen for national and institutional fellowships. Students will work with faculty mentors throughout the 201314 academic year. Kirk C a hill, MS3, and Ramin Morshed, MS3, were selected to participate in t h e pre s t i g i ou s How ard Hughes Medical Institute Medical Research Fellows Program. Morshed is working with Maciej S. Lesniak, MD, to develop a system to deliver chemotherapeutic agents while allowing for MR tracking of neural stem cell carriers. Cahill is working with Bakhtiar Yamini, MD, on a project involving targeting Bcl-3 in glioblastoma. Kimberly Clinite, MS4 was awarded the Pritzker Fellowship. She is working with faculty mentor Shalini Reddy, MD, to study how medical education impacts students’ p e rc e pt i on of phy s i c i an lifestyle. Liese Pr uitt, MS4, was named as an award winner uchospitals.edu/midway by the Doris Duke Charitable Foundation (DDCF) with support for a Clinical Research Mentorship. These competitive grants are intended to support the development of a mentoring relationship between a DDCF clinical scientist and a medical student with an interest in becoming a future clinician investigator. Pruitt’s faculty mentor is Olufunmilayo I. O l op a d e for h e r proj e c t “Understanding Social and System Delays That Lead to Late Diagnosis of Breast Cancer in Southwestern Nigeria.” Kunmi Sobowale, MS4, is receiving support from the Fogarty Fellowship and from the Pritzker Fellowship for his project “Barriers to Care and Their Role on Effectiveness of Task-Shifting Mental Health Care in Vietnam.” Sobowale is working with Bahr Weiss, PhD, of Vanderbilt University to study barriers to care with the broader goals of ensuring proper delivery of depression treatment. 2 0 1 3 S U M M E R R E S E A R C H AWA R D S Medical students honored for excellence in research T he 19th Annual Pritzker Summer Research Program provided rising second-year students with the opportunity to delve into a scholarly area of interest over the course of 11 weeks. Students worked with faculty mentors throughout the summer to conduct the research on a well-defined project and then presented their work to a panel of faculty judges at the Summer Research Forum in August. Awards of excellence were granted to Kevin Wymer, Caitlin Chicoine, Robin Wagner, Carrie Kuhn, Amrita Mukhopadhyay, Megan Silas, Jennifer Houpy, James Lloyd, and David Xu. Honorable mentions for excellence were awarded to Camille Cross, Allison Louis, Omar Malas, Leslie Mataya, Michael Ramirez, Bryan Scott, Kathryn Sullivan, Adam Weiner and Nathaniel Wilson. The program is indebted to the counsel of faculty advisers Vineet Arora, MD, MA’03, associate professor of medicine and assistant dean for scholarship and discovery; Eugene Chang, MD, the Martin Boyer Professor of Medicine; V. Leo Towle, PhD, professor of neurology; David Meltzer, MD’93, PhD’92, associate professor of medicine; and William McDade, MD’90, PhD’88, associate professor of anesthesia and critical care, and deputy provost for research and minority affairs. MEDICINE ON THE MIDWAY FALL 2013 31 Pritzker News REUNION WEEKEND 2013 G R A D U AT I O N 2 0 1 3 Alumni return to campus to reconnect, recognize achievements The late Joel Schwab, MD, gave the keynote address at the 2013 hooding ceremony. Parting words for graduates: ‘Be kind’ PHOTOS BY ANNE RYAN Distinguished Service Award recipients Armando E. Giuliano, MD’73, left, and Sharon M. Swartz, SM’85, PhD’88, second from right, celebrate with family members. F our alumni were honored at a ceremony at the University Club during this year’s Reunion Weekend events. Richard L. Schilsky, MD’75, received the Gold Key Award, which recognizes faculty members for outstanding service. He is Professor Emeritus, former director of the University of Chicago Medicine Comprehensive Cancer Center and former section chief of hematology/ oncology. Schilsky is Chief Medical Officer of the American Society of Clinical Oncology in Washington, D.C. Distinguished Service Awards honor alumni for outstanding leadership in, and significant contributions to, the biological sciences or medicine. Honored this year were Armando E. Giuliano, MD’73, executive vice chair of surgery and chief of surgical oncology at Cedars-Sinai Medical Center in Los Angeles; Michael L. Shelanski, MD’66, PhD’67, chair of pathology and Richard L. Schilsky, MD’75, left, receives the Gold Key Award for faculty service from Dean Kenneth S. Polonsky, MD, the Richard T. Crane Distinguished Service Professor and Dean of the Biological Sciences Division and the Pritzker School of Medicine. Before they left campus to continue their education in 20 states by taking up medical residencies in 21 specialties, the Pritzker School of Medicine’s Class of 2013 was given a celebratory send-off. The 82 fourth-year students selected pediatrician Joel Schwab, MD, their teacher and mentor, to deliver the keynote address at the hooding ceremony on May 31, 2013, held in Rockefeller Memorial Chapel. “Pay attention to cost; value mentorship; educate others; continue to educate yourself; be kind,” was the counsel he gave based on his 42 years as a pediatrician and professor. “I love being a physician and I have enjoyed working with the graduating students,” he told the graduates and their guests. Dr. Schwab died of cancer three weeks later. cell biology at Columbia University and director of the Alzheimer’s Disease Research Center and Medical Scientist Training Program at Columbia; and Sharon M. Swartz, SM’85, PhD’88, professor of biology and engineering at Brown University. PHOTOS COURTESY OF GRADIMAGES 32 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION NEWS Class Notes Alumni, get the latest news and stay connected with your classmates through the Medical & Biological Sciences Alumni Association (MBSAA) website at medbsd.uchicago.edu/alumni. REUNION IS COMING UP JUNE 6-7, 2014 Attention alumni emeriti and those from the Classes of 1964, 1969, 1974, 1979, 1984, 1989, 1994, 1999, 2004 and 2009. Reunion is coming up in June 2014. So that you stay up to date, be sure to submit your current contact information at medbsd.uchicago.edu/alumni/get-involved/update-your-info. 1960s Robert Perlman, AB’57, SB’58, MD’61, PhD’63, is the author of “Evolution and Medicine,” an accessible introduction to the new field of evolutionary medicine. Evolutionary concepts help explain why we remain vulnerable to disease, how pathogens and cancer cells evolve, and how the diseases that affected our evolutionary ancestors have shaped our biology. The book examines the theory of evolution by natural selection, the genetic basis of evolutionary change, evolutionary life history theory and hostpathogen coevolution. It uses these concepts to provide new insights into such diseases as cystic fibrosis, cancer, sexually transmitted diseases and malaria. “Evolution and Medicine” empha- 2013-14 ALUMNI COUNCIL Rene Mora, PhD’88, MD’89, President Robert Doroghazi, MD’77, Immediate Past President Michael H. Silverman, MD’73, Vice President and Chicago Partners Chair Paul R. Rockey, MD’70, Reunion Chair Dean Rider, MD’78, Regional Chair Chris Albanis, AB’96, MD’00, Editorial Committee Chair Diane Altkorn, MD’82 Diana Chung, MD’92 Lawrence Cutler, MD’80 Amy Derick, MD’02 Mark Ferguson, MD’77 Sanford A. Garfield, PhD’74 Melina Hale, PhD’98 David Holtzman, PhD’67, MD’68 Maga Jackson-Triche, AB’71, MD’75, MSH Julian Katz, MD’62 Michael W. Kaufman, MD’72 Si-hoi Lam, AB’76, MD’80 Dennis Lee, MD’91 Ernest E. Mhoon, MD’73 Doriane C. Miller, MD’83 Jacqueline Moline, AB’84, MD’88 Daniel Rosenblum, SB’62, MD’66 Patricia Simmons, MD’77 Donald Steiner, MD’56, SM’56 Jack Stockert, AB’05, MBA’10, MD’10 David Whitney, MBA’78, MD’80 Lifetime Members: L.D. Anagnostopoulos, SB’57, MD’61 Arnold B. Calica, SM’61, MD’75 Coleman Seskind, AB’55, SB’56, MD’59, SM’59 Russ Zajtchuk, SB’60, MD’63 34 sizes the role of demographic processes in evolution and disease, and stresses the importance of improving population health as a strategy for advancing the health of individuals. Perlman is professor emeritus in the Departments of Pediatrics and Pharmacological and Physiological Sciences at the University of Chicago. Paul S. Treuhaft, MD’68, retired from practicing orthopaedics at the Cleveland Clinic Lorain Institute in February 2012. Shortly thereafter, he moved to Sonoma County, California, to be closer to family, and to enjoy the temperate climate. In June 2013, Treuhaft accepted a position with National Imaging Associates (a subsidiary of Magellan Health Services) as a physician clinical reviewer. Treuhaft is an amateur woodworker who insists that mistakes are firewood (and not a disaster as they might be in orthopaedics!). He also enjoys gardening and cooking. His wife, Ann Rosmarin, designs landscapes professionally and also makes abstract art, including painting and prints. 1970s Mark Batshaw, MD’71, has been named physician-in-chief at Children’s National Medical Center in Washington, D.C. Batshaw will continue to serve in his previously appointed position as chief academic officer and director of the Children’s Research Institute. Batshaw also serves as chairman of pediatrics and associate dean for academic affairs at the George Washington University School of Medicine and Health Sciences. Batshaw is a developmental pediatrician and distinguished author of “Children with Disabilities,” the classic textbook now in its 7th edition. Under his leadership, NIH grants to Children’s Research Institute have increased tenfold. He continues to pursue NIH-funded research in gene therapy for birth defects and urea cycle disorders. Robert Gaynes, MD’79, is the author of “Germ Theory: Medical Pioneers in Infectious Diseases,” selected as one of Choice magazine’s Outstanding Academic Titles for 2012. Choice magazine is considered the most important publication for academic libraries in the United States. Gaynes is a professor of medicine (infectious diseases) at Emory University School of Medicine, where he also recently served as curator for the “Medical Treasures at Emory” exhibition. Audrius (Andy) Plioplys, MD’75, works full time in his art studio. His installation “Cosmic Consciousness” was featured at the Rockefeller Memorial Chapel. A portion of this exhibit, “Chromodynamics” (four paintings, each on a 5-by-12 canvas), continues on display in the lower level gallery. A former professor of neurology at the University of Toronto and the University of Illinois at Chicago, Plioplys merges neuroscience with art, producing large-scale works representing his metaphorical investigation of thinking and consciousness. His works are on permanent display throughout North America and in Europe. More information is available at www.plioplys.com. Nathan Szajnberg, MD’74, is publishing his developmental study of Ethiopian/Israeli children and their families, with whom he worked and studied while he was the Freud Professor of Psychoanalysis at the Hebrew University. “Sheba and Solomon’s Return: Ethiopian Children in Israel” portrays the inner lives of these children through their drawings and stories. The book also describes new findings in attachment of the children and parents, as well as some parents’ unique perceptual views of the world. Szajnberg received the Ticho Award in Psychoanalysis, which recognizes a psychoanalyst who has made significant contributions in the field. He also presented a paper on literature and psychoanalysis at the American Psychoanalytic Association meeting in Chicago. 1990s William A. McDade, PhD’88, MD’90, a board-certified anesthesiologist and researcher in sickle cell disease, was named president-elect of the Illinois State Medical Society (ISMS). McDade is also the deputy provost for research and minority issues at the University of Chicago, and has an active clinical practice in obstetrical and general anesthesia. He has been a member of ISMS since 1981, and is active in many other medical organizations. McDade currently serves as a director with the Accreditation Council for Graduate Medical Education, and he serves on the American Medical Association’s Council on Medical Education. Eric Holland, MD, PhD’95, is senior vice president and director of the Human Biology Division at the Fred Hutchinson Cancer Research Center and the University of Washington. Holland, an internationally renowned neurosurgeon and brain cancer researcher, was recruited from Memorial Sloan-Kettering Cancer Center in New York to establish world-class research programs on brain and other solid-tumor can- THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION cers in Seattle. Holland is a professor of neurological surgery, chair of neuro-oncology and director of the Nancy and Buster Alvord Brain Tumor Center at UW Medicine. Throughout his career, Holland has worked at the intersection of multiple disciplines to address the molecular basis of brain tumors and develop new approaches to their treatment. Prior to his arrival at Sloan-Kettering, where he was the founding director of the Brain Tumor Center, he conducted brain surgery and basic research at the University of Texas MD Anderson Cancer Center. He is a member of the National Academy of Sciences’ Institute of Medicine. Kathlyn Fletcher, MD’96, MA, was named 2013 Helen Dickie Woman Physician of the Year by the Wisconsin chapter of the American College of Physicians. The award honors an outstanding woman physician for exceptional patient care and contributions to medical education and research. She is associate professor of medicine at the Medical College of Wisconsin, and she sees patients at the Clement Zablocki VA Medical Center. She is the recipient of several teaching honors, including the Best Senior Faculty VA Teacher in 2010. She earned the Department of Medicine Award for Clinical Innovation in 2011 for starting the hospitalist service at the Zablocki VA Medical Center. 2000s Jesse Ehrenfeld, MD’04, has been named editor-in-chief of the Journal of Medical Systems. This bimonthly journal has a 36-year record as a leading journal in the area of health care computing and information systems. Ehrenfeld divides his time among clinical practice, research and teaching. He is an associate professor of anesthesiology, surgery and biomedical informatics at Vanderbilt University School of Medicine. He also serves as director of the Center for Evidence-Based Anesthesia, director of the Perioperative Data Systems Research Division, and director for Perioperative Quality, as well as speaker of the Massachusetts Medical Society. Andrew Flotten, MD’07, was recently selected as a resident representative on the Residency Review Committee (RRC) for the Transitional Year Internship at the Accreditation Council for Graduate Medical Education (ACGME). Flotten will enjoy the biannual meetings because they take place in Chicago and will give him opportunities to visit campus. He is a PYG-4 radiology resident. Joe Williams, MD’10, completed his residency in emergency medicine at Madigan Army Medical Center in Washington, where he received three of the four senior resident awards. He was honored with the Resident Research Award, 3rd Year Resident of the Year Award (chosen by fellow residents) and the Morris Award, given to the resident whose attending staff would most want to take care of their own family members. In Memoriam ALUMNI Allen S. Bursk, MD’57, died at age 81 on January 7, 2013. He attended the University of California, Los Angeles, and the University of Chicago Pritzker School of Medicine. An orthopaedic surgeon for 50 years at Los Angeles Orthopaedic Hospital, he was described by colleagues as a “doctor’s doctor.” His humor, kindness and gentle spirit will be missed by colleagues, family and friends. He is survived by Susan, his loving wife of 37 years; two sons, Hayden and Michael; and a daughter, Teresa. Leon A. Carrow, SB’45, MD’47, passed away on April 10, 2013, in Evanston, Illinois. He was 89. An Air Force veteran, Carrow joined the obstetrics and gynecology faculty at Northwestern Memorial Hospital in 1953, where he practiced until his 1991 retirement. He was a life board member of Northwestern Memorial Corporation and a consultant to the Rehabilitation Institute of Chicago for more than three decades. Survivors include his wife, Joan; a daughter; two stepdaughters; five grandchildren; and a great-grandson. Elsa Leiter Gordon, PhB’47, SB’50, MD’52, of Los Gatos, California, died after a lengthy struggle with Alzheimer’s disease on June 28, 2013, at age 85. A retired psychiatrist, Gordon was born in Chicago. She was a product of the University of Chicago educational system, beginning with the Laboratory Schools. She met her husband, Leon Gordon, PhB’47, SB’48, MD’52, in medical school at the University of Chicago. Originally studying pediatrics, Gordon turned to child and adolescent psychiatry and continued her education at Stanford University. Eventually settling in San Jose, California, Gordon opened a multispecialty mental health clinic, one of the first private facilities offering psychological services for children in northern California. She was a founder of the Eulau Center (now the Acknowledge Alliance), a children’s nonprofit agency. After her retirement, she spent much of her time with her 11 grandchildren. She also served as president of Temple Emanu-El San Jose and became a bat mitzvah at 70. Gordon was known for her graciousness and her kindness, as well as for her unending interest in helping others. Even in her diminished capacity at the end of her life, she still was observed trying to comfort other residents in the memory care facility where she spent the last few months of her life. Gordon also is survived by her four children. uchospitals.edu/midway Steven Ernst Gradwohl, MD’87, died on May 18, 2013, at age 51. Intelligent, gregarious and gifted in the art of primary care, he had so many fellow physicians as patients that he was affectionately known throughout the University of Michigan community as “the doctors’ doctor.” Gradwohl demonstrated an aptitude for science at a young age. An avid tennis player and excellent all-around athlete in high school, he was temporarily sidelined at age 16 by Hodgkin’s disease. His experience as a patient and his determination to regain his health inspired his interest in medicine. He was a biology honors student at Carleton College before attending the Pritzker School of Medicine on an Army scholarship. During his military service, he served stateside in Operation Desert Storm and earned the U.S. Army Surgeon General’s Physician Recognition Award, two Meritorious Service medals and two Army Commendation medals. Acting on a dream to practice medicine with classmate and dear friend, Linda Bjork Terrell, MD’87, Gradwohl and his family moved to Ann Arbor, Michigan. For the past two decades, he kept a busy general internal medicine practice at Ann Arbor’s Briarwood Medical Group, while also serving as a clinical assistant professor of internal medicine at the University of Michigan. He won the Medical School’s Outstanding Clinician Award in 2012 and was named several times as one of the Best Doctors in America. In addition to his wife and daughters, Gradwohl is survived by his parents, two sisters, beloved nieces and nephews and his dear yellow Labrador retriever, Ziggy. Joseph A. Parks, MD’43, passed away on February 6, 2013, in Santa Rosa, California. He was 94. A World War II Army veteran, Parks practiced radiology at hospitals across the country until he retired in 1988. He also volunteered as a member of Project HOPE, caring for needy patients and teaching medical professionals in Sri Lanka, Tunisia, Colombia and Nicaragua. He is survived by six daughters, two sons, 15 grandchildren and 11 great-grandchildren. F A C U LT Y Samir N. Hajj, MD, a professor of obstetrics and gynecology at the University of Chicago for more than two decades, died from metastatic colon cancer on August 28, 2013, at his home in San Diego. Hajj was a respected gynecological surgeon and a beloved teacher who was liked and admired by the residents. The annual Samir Hajj Honorary Lecture in Gynecology was created after his 2007 retirement, largely from funds donated by former residents and faculty. Hajj received his MD from the American University of Beirut. He completed a residency and fellowship in obstetrics and gynecology at the Boston Hospital for Women, now part of Harvard University-affiliated Brigham and Women’s Hospital, before returning to Lebanon. Hajj joined the American University of Beirut’s medicine faculty in 1963 and became the first non-American chairman of the Department of Obstetrics and Gynecology in 1973. In 1985, Hajj joined the University of Chicago as professor and section chief of gynecologic surgery. He was the author or co-author of more than 40 papers and six book chapters, and co-editor of the textbook “Clinical Postreproductive Gynecology.” He enjoyed reading, politics, the arts and taking groups of residents out for Lebanese food at the end of their month on the gynecology service. He is survived by his wife, Dorothy Farnworth Hajj; sister, Afaf Najib Hajj; daughters Dana Farnworth Hajj-Weaver, Karin Maya Hajj and Randa Suzanne Hajj; son, Ramzi Samir Hajj and his wife, Jennifer Marie Hajj; and one granddaughter, Ainsley Helena Hajj. Ivan Anthony D’Cruz, MD, died February 7, 2013, in Memphis, at age 77. D’Cruz received his MD from Bombay University and trained in Britain, becoming a member of the Royal College of Physicians of London. For 10 years beginning in 1974, he ran the ECHO Lab at Michael Reese Hospital and was on faculty at the University of Chicago. Later, he held professorships at the Medical College of Georgia and at the University of Tennessee. He wrote more than 200 publications and two books on echocardiography. Survivors include his wife, Maria, two children and three grandchildren. PROFESSOR EMERITUS Peter Richard Huttenlocher, MD, a pioneering neuroscientist and highly respected pediatric neurologist, died in Chicago of pneumonia and complications of Parkinson’s disease on August 15, 2013. He was 82. Huttenlocher was professor emeritus and former section chief of pediatric neurology at the University of Chicago Medicine. He was known internationally for his clinical skills and research, most notably groundbreaking studies on neural plasticity in children. “It would be hard to think of another discovery that is so central to our understanding of pediatric neurology,” said his friend and colleague, 2000 Nobel laureate Eric Kandel, MD, of Columbia University. Huttenlocher was the first researcher to describe the rapid increase in the connections between neurons in a child’s developing brain, followed by gradual “pruning” of little-used connections. His discoveries made a significant impact on early childhood education, emphasizing the benefits of early introduction of certain subjects to take advantage of periods of high neural plasticity. Huttenlocher’s other major contributions include studying the cognitive effects of focal brain injuries and the role of synapse generation in a child’s recovery from brain damage. He was an early authority on the diagnosis and treatment of children with Reye’s syndrome and was instrumental in making a connection between this disease and aspirin use. In 1987, he launched the first clinic in the United States for children with tuberous sclerosis, a rare neurologic disorder. He also conducted important research on seizure disorders, one of which, Alpers-Huttenlocher syndrome, was named after him and PHOTO BY JAMES BALLARD Peter R. Huttenlocher, MD, 1931-2013 Bernard Alpers. He published extensively and received numerous honors for his discoveries. Born in Germany, Huttenlocher earned his bachelor’s degree in philosophy from the University at Buffalo in 1953. Huttenlocher met his wife, Janellen Burns, PhD, the William S. Gray Professor Emeritus of Psychology at the University of Chicago, when they were freshmen in college. They married in June 1954. After earning his MD from Harvard Medical School in 1957, Huttenlocher interned at Harvard’s Peter Bent Brigham Hospital, completed his residency at Boston Children’s Hospital and Massachusetts General Hospital (MGH), and then undertook research fellowships at the National Institutes of Health and MGH. He was an assistant professor in pediatric neurology at Harvard from 1964 to 1966, followed by eight years at Yale University Medical School. In 1974, he moved to the University of Chicago as professor of pediatrics, adding neurology in 1976 and attaining emeritus status in 2003. Huttenlocher is survived by his wife; three children, Daniel, PhD, Anna, MD, and Carl; and four grandchildren, Eric, Jason, Annika and Kaia. MEDICINE ON THE MIDWAY FALL 2013 35 Joel Schwab, MD, 1945-2013 In Memoriam “He was genuinely interested in the students, and they were instantly won over by his combination of clinical expertise, devotion to his patients, communication skills and kindness.” Herbert T. Abelson, MD, George M. Eisenberg Professor Emeritus and former chair of pediatrics Joel Schwab, MD, with Babatunde (Tunde) Yerokun, MD’13, on Match Day 2013. oel Schwab, MD, a pediatrician and mentor to students and medical residents, died on Friday, June 21, 2013, of metastatic gastric cancer. He was 67 years old. Schwab was a role model for thousands of medical students and pediatric residents at the University of Chicago’s Pritzker School of Medicine and at Comer Children’s Hospital. Many students made the choice to devote their lives and careers to taking care of children based in large part on his example. Schwab served on the medical school’s curriculum and admissions committees and on the Department of Pediatrics’ promotions, awards and education committees. He directed the pediatric clerkship, rounded daily with students and residents when he was on service, delivered 30 or more lectures a year, helped teach the clinical skills class for second-year students and led small-group sessions for third-year students. He also served as director of the medical student performance evaluation at Pritzker since 2011. For residents, he often led morning report, the noon resident conference and the monthly pediatric attending case conference. He was a fixture in the outpatient clinic, and he was one of the first people that students and colleagues would turn to for advice when faced with a difficult diagnosis. “He also helped us pick the best students and residents for 15 years,” said Daniel Johnson, MD, associate professor of pediatrics and section chief of academic pediatrics at the University of Chicago Medicine. “He was crucial to picking the right people and then making them into excellent doctors, not just brilliant technicians but also caring, sensitive, communicative healers.” “The secret of his success was no secret,” said David Gozal, MD, chair of the Department of Pediatrics and physician-in-chief at Comer Children’s Hospital. “He cared for children as if they were his own. As a result, he was automatically adopted by his patients’ families.” “When their children got sick, the faculty, especially the other pediatricians, brought them in to see him,” Johnson said. “Joel Schwab was the pediatrician’s pediatrician.” Schwab grew up in Brooklyn, N.Y. In 1967, he earned his BA in zoology from the University of Michigan, where he met his wife, Gail Stein. He received his MD from New York Medical College in 1971. He completed his pediatric residency at Children’s Memorial Hospital in Chicago and was an assistant professor of pediatrics at Northwestern J 36 Joel Schwab, MD, examines a young patient. Colleagues called him “the pediatrician’s pediatrician.” University until 1986, when he came to the University of Chicago. Schwab’s mentoring brought him many awards. He was selected by the medical students for inclusion in their class composite photograph for 16 consecutive years, a coveted internal honor. In 1998, he received the Faculty Teaching Award and was voted Teacher of the Year by the pediatric residents. He received the Pritzker School of Medicine Outstanding Clinical Teaching Award and the Leonard Tow Humanism in Medicine Award in 2006. In 2011 he received the Gold Humanism Award. Most recently, an award acknowledging a physician teacher for excellence in mentorship was established this year and named in honor of Schwab. He was selected to be its first recipient at the annual residents awards ceremony, held on the day he died. The Pritzker School of Medicine Class of 2013 chose him as the speaker for their graduation ceremony. At that event, his last public lecture, Schwab described how the profession had changed since he first became a doctor and encouraged the nascent physicians to sustain their commitment to medicine. “You do need to worry about costs, and you do need to read the latest journals, but do not forget that medicine is also an endeavor of the heart,” he told them. “At the same time you are learning about disease and diagnosis and treatment, you are also learning about illness, the patient and yourself. “Become an excellent role model,” he advised. “Understand the influence your behavior will have. ... Be polite. And never forget: The patient comes first and is always the most important person in the equation.” Schwab is survived by his wife, Gail; daughters, Laura and Lynn; son, David; five grandchildren; and his brother, Jay. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION To make a contribution to the Joel Schwab Fund at the University of Chicago, please contact Ellen Clarke in Medicine & Biological Sciences Development, 1-773-834-2742 or eclarke@ mcdmail. uchicago.edu. Joseph J. Ceithaml, SB’37, PhD’41, 1916-2013 oseph J. Ceithaml, SB ’37, PhD’41, revered dean of students whose advocacy and mentorship influenced countless students at the University of Chicago and throughout the country, died on May 11, 2013. He was 96. As Dean of Students Emeritus for the Pritzker School of Medicine and the Biological Sciences Division from 1951 to 1986, Ceithaml was a central figure in shaping the character of medical and biological education at the University of Chicago. He was instrumental in building the medical school’s national reputation, attracting many of the nation’s best and most well-rounded students to the program and making Pritzker more accessible to students from less privileged backgrounds. “Dean Ceithaml made it possible for thousands of students to develop into outstanding doctors and scientists, and he was firmly committed to ensuring that students received financial aid,” said Holly J. Humphrey, MD’83, the Ralph W. Gerard Professor in Medicine and dean for medical education at Pritzker. “He was a kind and Joseph J. Ceithaml, circa 1949 generous man who placed student well-being at the top of his priority list.” During his 35 years as dean, Ceithaml, professor emeritus of biochemistry and molecular biology at the University of Chicago, shepherded the academic careers of 2,914 future physicians and 1,460 research biologists. He developed the Medical Scientist Training Program, obtaining federal funding in 1967 for what would become one of the leading programs in the country. He was an architect of Pritzker’s pass/fail system, designed to promote collaborative learning. He grew the medical school’s no-interest loan fund program from $25,000 in 1951 to more than $6 million in 1986. The Ceithaml Scholarship, named in his honor, funds the medical education of many students each year and continues to expand. Ceithaml was influential at the national level in efforts to expand the pool of applicants for medical schools. He fought the idea that the standard biologybased “pre-med” curriculum was a prerequisite and sought students with diverse interests, origins and socio-economic backgrounds. He also helped develop the centralized American Medical College Application Service through the Association of American Medical Colleges. Born in 1916, into a family of Czechoslovakian immigrants on the Southwest Side of Chicago, Ceithaml graduated from Lindblom High School as valedictorian. After graduating from the University of Chicago in 1937, he entered the biochemistry doctoral program. He completed his PhD in 1941 and married Ann Bednarik, a high school friend, the next year. During World War II, Ceithaml worked on a malaria research project based at the University of Chicago and run by the Office of Scientific Research and Development of the U.S. War Manpower Commission. In 1946, he was named an assistant professor of biochemistry at the University of Chicago. He also worked part time as a pre-med adviser. In 1948, he and his wife left Chicago for a post-doctoral fellowship at California Institute of Technology, where he worked with geneticist George Beadle — who would win the Nobel Prize for Physiology or Medicine in J PHOTOS COURTESY OF THE CEITHAML FAMILY Joseph J. Ceithaml, SB’37, PhD’41, shepherded the academic careers of 2,914 future physicians and 1,460 research biologists at the University of Chicago Pritzker School of Medicine and Biological Sciences Division. He always preferred to be called dean for students, and their well-being was his top priority. “He was a staunch advocate for the collaborative, collegial spirit that still encompasses our medical school today.” Holly J. Humphrey, MD’83, the Ralph W. Gerard Professor in Medicine and dean for medical education, Pritzker School of Medicine 1958 and become president of the University of Chicago in 1961. After completing his fellowship, Ceithaml returned to the University of Chicago. In 1950, he won the University’s Quantrell Award, the highest honor bestowed upon undergraduate teachers. The following year, he was named dean of students for medicine and biological sciences. He retired in 1986 at age 70. Ceithaml received several career honors but was particularly proud of the 1982 Gold Key Award, which recognizes outstanding and loyal service to the Biological Sciences Division and to the University of Chicago, and for having the medical student and alumni center named for him, just before he retired. Ceithaml, who always preferred to be called dean for students, was admired for his in-depth knowledge about every student and for his efforts to help students with academic, financial or personal problems. He tackled similar issues at the national level, serving as chairman of the Association of American Medical Colleges’ committee on medical student financing, from 1961 to 1964, and as vice chairman and chairman of the Group on Student Affairs, which he co-founded, from 1965 to 1969. He served on the board of directors of the National Resident Matching Program from 1967 to 1980, during the period when the computerized Match system was implemented. Ann, his wife of 43 years, died of cancer in 1985. Ceithaml is survived by his second wife, Mildred, and her son, Bob Husa; two children, Lenore and Eric; three grandchildren and three great-grandchildren. Members of the Pritzker School of Medicine and Biological Sciences Division community gathered September 12, 2013, in Rockefeller Memorial Chapel to celebrate his life and legacy. Read a 2006 Medicine on the Midway profile of Dean Ceithaml, written on the occasion of his 90th birthday, at uchospitals.edu/midway/ceithaml. The Joseph J. Ceithaml Scholarship Fund provides ﬁnancial assistance to students at the Pritzker School of Medicine. To make a donation, please visit medbsd.uchicago.edu/alumni/remembering-ceithaml. uchospitals.edu/midway MEDICINE ON THE MIDWAY FALL 2013 37 NonproďŹ t Organization U.S. Postage PAID Chicago, IL Permit No. 5179 950 East 61st Street WSSC 320 Chicago, IL 60637