Medicine on the Midway - Summer 2012
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.
S U MME R 2012 Medicine Midway UNIVERSITY OF CHICAGO on the Biological Sciences Division Dr. James E. Bowman 1923-2011 The Longest Way Round Is the Shortest Way Home Dean's Letter E ven in repose, James E. Bowman, MD (1923-2011), continues to mentor. Pioneering African American physician-scientist, highly respected bioethicist, devoted father and grandfather -- Dr. Bowman was all these things. Mostly, though, he was a teacher. His full, rich life is an enduring lesson that all associated with the University of Chicago Medicine and Biological Sciences should study. As you read this edition of Medicine on the Midway, I invite you to consider Dr. Bowman's example and the pride with which we attach the University of Chicago name to his legacy. So many "I never met anyone with such boundless enthusiasm and deep-seated commitment. Yet he always seemed so modulated and paced." -- Rosita Ragin, assistant dean for multicultural and student affairs, about James E. Bowman 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 of our physicians and leaders can attest to his influence on their lives and careers that to name each would be difficult, if not impossible. But as we move through this period of change and growth on the medical campus, we are thankful for the steady hand he lent them and that they now lend us and our current class of students, residents and fellows. Knowingly or unknowingly, they benefit from Dr. Bowman's hard-won wisdom. Former Pritzker student Bruce A. Beutler, MD'81, can teach us about mentoring, as well. In an article by Dirk Johnson, the 2011 recipient of the Nobel Prize in Medicine for his research on the immune system explains how ego can be the enemy of progress. "To work effectively, things have to be casual," he says in reference to newly star-struck assistants. Beyond advice, Dr. Beutler offers some fond reminiscences of being born into a family of University of Chicago alumni, student life in windswept Hyde Park and the day the Nobel Committee called. Also in this edition: a talk with genomics pioneer Yusuke Nakamura, MD, PhD, the newest member of the Center for Personalized Therapeutics, led by Mark Ratain, MD. A surprising study, led by Peggy Mason, PhD, on rats and empathy gives us much to ponder about the human condition, and research on lungfish and the origin of walking and on the nature of evolution after mass extinctions gives us a glimpse of just how we got here. As this letter -- a first for me in Medicine on the Midway -- and the magazine's new look can attest, evolution is inevitable, even in Hyde Park. But given the solid guidance provided by professors and alumni like Dr. Bowman and Dr. Beutler, we progress eagerly and with confidence. Enjoy. TA B L E O F C O N T E N T S Cover Story 24 James E. Bowman, MD (1923-2011), has left an indelible mark on the University of Chicago -- and far beyond. The African American physician-scientist was a trailblazer, a mentor and an inspiration to many. His life seemed to reflect the essence of the old proverb, "The longest way round is the shortest way home." COVER PHOTO: COURTESY ARCHIVAL PHOTOGRAPH FILES, SPECIAL COLLECTIONS RESEARCH CENTER, UNIVERSITY OF CHICAGO LIBRARY Features 07 Bruce A. Beutler, MD'81, talks about the moment he heard the news about winning the Nobel Prize, life since that day and his time at the Pritzker School of Medicine. A generous donation invests in the promise of strong doctor-patient relationships. The Bucksbaum Institute for Clinical Excellence will train physicians to be role models in communication. Genomics expert Yusuke Nakamura, MD, PhD, joins Mark Ratain, MD, and the Center for Personalized Therapeutics to achieve a lofty goal: cure cancer. Kenan Onel, MD, PhD, and his team work to unravel the genetics of certain cancers. Where religion and medicine meet -- $2.6 million grant allows research into the role of spirituality in medicine. How to stop a "toxic missile" -- research backed by the Institute for Translational Medicine. Lungfish help change how evolutionary biologists think about the origins of walking. Research shows empathy-driven behavior in rodents. Vertebrate evolution: Heads or tails? Perfecting the art of diagnosis. Departments Letter from the Dean Midway News 2 Pritzker shines in top 10 of U.S. News & World Report rankings. 3 New hospital offers state-of-the-art environment for medical education. 4-6 Research news from the Forefront. 10 13 14 16 18 21 22 23 31 Pritzker News 32Leukemia researcher Clara Bloomfield, MD'68, returns to campus and reflects on her career and the "extremely smart people" she worked with here. 33 "The best day of medical school so far" -- simulation workshops. 34 Dean Humphrey's class a big hit. 35 Pritzker graduates lead as chief residents. 37 A perfect Match Day for Pritzker. 40 Reunion Weekend: Images from the festivities. 42-44 Class Notes: Hear from your classmates, near and far. 44-45 In Memoriam; Joseph B. Kirsner, MD, PhD, dies at age 102. Summer 2012 Volume 65, No. 1 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, 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, 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, dean for medical education, Pritzker School of Medicine Editorial Committee Chair Chris Albanis, AB'96, MD'00 Lampis Anagnostopoulos, SB'57, MD'61 Arnold Calica, SM'61, MD'75 Jerrold Seckler, MD'68 Coleman Seskind, AB'55, SB'56, SM/MD'59 Editor Ginny Lee-Herrmann Assistant Editor Anna Madrzyk Editorial Contributors Kevin Barrett Jamie Bartosch Wendy Cole Dianna Douglas Elizabeth Gardner Photo Contributors David Christopher Lloyd DeGrane Matt Friedman Dave Gresham (UT Southwestern) Tricia Koning Design Stacy Sweat Designs Dirk Johnson Darcy Lewis Anna Madrzyk Heather Mendelson Rob Mitchum Jean Lachat Yen-Chyi Liu Ulla Montan (Nobel Foundation) Bruce Powell Lauren Sallan Stephen Phillips Gretchen Rubin Anita Slomski Shanna Williams Matt Wood Biological Sciences Division Archives Medical & Biological Sciences Alumni Association Pritzker School of Medicine Archives University of Chicago Library Special Collections Research Center Email us at email@example.com Write us at: Editor, Medicine on the Midway The University of Chicago Medicine 950 E. 61st St., WSSC 334 Chicago, IL 60637 uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 1 PRITZKER SCHOOL OF MEDICINE Pritzker ranked in Top 10 The University of Chicago Pritzker School of Medicine was named one of the Top 10 medical schools in the nation in the most recent U.S. News & World Report Best Graduate Schools survey. Pritzker ranked No. 10, up from 12th last year and from 22nd in 2004. No other medical school in Illinois made the Top 10 list. Pritzker ranks second in the country on research funding per faculty member, according to the magazine. The average annual grant support per researcher from the National Institutes of Health is $328,000, second only to Stanford University. The medical school also has dramatically increased its ability to attract the best students, rising from 41st in the United States in 2004 to fourth most selective in the latest survey. "It is an honor to be considered one of the leading medical education programs in the country," said Kenneth S. Polonsky, MD, Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs at the University of Chicago. "It is gratifying to know that we scored near the top on the research achievements of our faculty as well as on student selectivity." Pritzker tied with two other medical schools, the University Midway News of Michigan at Ann Arbor and the University of Washington, for 10th place in the 2012 rankings of research-focused medical schools. U.S. News & World Report rankings are based on expert opinions about program excellence and statistical indicators that measure the quality of a school's faculty, research and students, such as faculty-to-student ratio and admission statistics. "The ranking of our school is one measure of the excellence of our students and faculty," said Holly J. Humphrey, MD'83, dean for medical education at Pritzker. "By bringing together bright, motivated students with a talented, world-class faculty, we enjoy an intellectually rich and stimulating environment for learning medicine." New hospital, new brand The University of Chicago Medicine is the medical center's new brand, unveiled earlier this year as preparation continues for the opening of the new hospital in the new year. The launch of the brand marks a new era in the academic medical center's decades-long history, as it seeks to strengthen the connection between the internationally renowned University of Chicago and its clinical programs. The University of Chicago Medicine Comer Children's Hospital also introduced a new, updated logo, strengthening its connection to the University and re-emphasizing its place as the center for children's specialized health care in Chicago. The University of Chicago Medicine unifies the commitment to compassionate, state-ofthe-art patient care with a renewed commitment by physicians, nurses, medical specialists, scientists, faculty and staff that medicine is at the core of the University's clinical, educational and scientific missions. 2 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION The University of Chicago Medicine's new hospital The facility will serve as the new core of the University of Chicago Medicine campus. 1 New hospital to offer Pritzker students even more educational opportunities A hospital for the future will open in early 2013 in the heart of the University of Chicago Medicine campus. The $700 million, state-of-the-art facility promises not only to transform patient care and drive new breakthrough treatments, but to enhance the education of the next generation of physicians. "The opening of the new hospital will give our students the opportunity to engage with sophisticated medical technologies in a digitally connected environment, thus helping them to more fully immerse themselves in the multidisciplinary nature of the practice of medicine," said Holly J. Humphrey, MD'83, dean for medical education at the University of Chicago Pritzker School of Medicine. The 10-story hospital is a design for the future with a modular layout and 200,000 square feet of expansion space that can be reconfigured over time to accommodate new innovations and technology. The integrated diagnostic and interventional platform includes cardiac, gastrointestinal, neurological and vascular services. An entire floor is devoted to cancer care. The vast surgical floor is programmed for 28 operating rooms with leading-edge technology. Two large hybrid ORs will accommodate multidisciplinary, collaborative teams for minimally invasive and complex procedures. "The new hospital features a state-ofthe-art technology and video integration platform that promises to transform surgical education through immersive learning, simulation and telementoring," said Jeffrey B. Matthews, MD, the Dallas B. Phemister Professor of Surgery, surgeon-in-chief and chair of the Department of Surgery. The new hospital is designed for patientand family-centered care. All 240 inpatient rooms are single occupancy and spacious enough to accommodate family for over- The new hospital is designed for patient- and family-centered care. All 240 inpatient rooms are single occupancy and spacious enough to accommodate family for overnight stays. night stays. Amenities include flat-screen TVs, wireless Internet and room service. The 1.2-million-square-foot facility, under construction since 2009, occupies the north end of two blocks along the south side of 57th Street from Cottage Grove to Drexel Avenues. Architecturally, the "wow" space is the seventh-floor Sky Lobby with its floorto-ceiling windows providing spectacular views of the Chicago skyline and the University campus. Rafael Vi�oly, the architect, also designed the University of Chicago Booth School of Business' striking Charles M. Harper Center. As magnificent as the new building is, however, it still is the presence of "our brilliant, dedicated faculty" that sets it apart, said Kenneth S. Polonsky, MD, 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. "Although our students will be learning and training in a highly advanced and new environment, what is also important to recognize is that they will continue to be taught by faculty who are entirely committed to their education," Humphrey said. "Regardless of venue, the Pritzker School of Medicine places great emphasis on providing students with a rigorous education, supported by invested, accomplished faculty who teach about the broad scope of medicine -- in both the basic and clinical sciences." 3 The $700 million, state-of-the-art hospital will be an ideal learning environment for the next generation of physicians. 2 Physicians, scientists and students in the new hospital will be equipped with the most advanced diagnostic tools, providing patients with targeted treatments and exceptional care. 3 The Sky Lobby will feature floor-to-ceiling glass walls, filling the space with natural light and providing panoramic views of the campus, Lake Michigan, Washington Park and downtown Chicago. 4 Central reception, as well as family waiting areas, dining and a chapel, will be in the breathtaking Sky Lobby on the seventh floor. uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 DIABETES H1N1 VIRUS Midway News "Immune memory" helps elderly fight off flu A typical seasonal strain of influenza hits the very young and very old the hardest. Not so with 2009's H1N1 virus, better known as swine flu. Meghan Sullivan, graduate student in immunology, is the co-author of a study that explains why the elderly had an advantage during that pandemic. While studying the failure of flu vaccines in the elderly, University of Chicago and Stanford University scientists discovered that even though older people have a harder time producing sufficient antibodies to fight off the flu, the antibodies they do produce are able to attack a more divergent range of influenza strains. "Someone who is 90 years old will naturally have more memories than a 20-year-old does, and the same holds true for immune memory," Sullivan said. Ultimately, this immune flexibility could be put to use to develop more effective vaccines for the elderly. Picturing a healthier lifestyle Several Pritzker School of Medicine students worked with Arshiya Baig, MD, MPH, assistant professor of medicine, on a pilot project to improve diabetes outcomes in the Chicago Latino community. Participants were given disposable cameras to take photos of their lives with diabetes -- a technique called "photovoice." These became a springboard for weekly group discussions on topics ranging from food choices to loss of a family member. "I think of photovoice as an easy mechanism for someone to convey emotions, experiences, losses, gains, without having to verbalize it," said Matthew Stutz, MS3, who helped analyze the photos. "By having a prop or a mechanism to share, I feel we can gain a lot more ground and depth and conversation." EMPOWERING TEENS Innovative approach to sexual health education Influencing teens to change their sexual behavior isn't easy. Melissa Gilliam, MD, MPH, professor of obstetrics-gynecology and pediatrics at the University of Chicago Medicine, and associate dean for diversity and inclusion, and Patrick Jagoda, PhD, Mellon postdoctoral fellow and instructor of new media at the University of Chicago Depart4 ment of English, worked with a group of high school students to create a transmedia game to get urban teens to rethink critical sexual and reproductive health issues affecting their lives (gamechanger.uchicago.edu). A transmedia game is a story that unfolds across multiple digital technologies, merging the online and real worlds. Young players were led through a series of puzzles and clues designed to encourage critical thinking and increase health literacy. The ultimate goal is to help disenfranchised teens feel empowered in making sexual health decisions. "We are studying whether playing games can shape social attitudes and transform behaviors," Gilliam said. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION GLOBAL WARMING Clues to climate change in seashells Associate Professor Catherine Pfister is the lead author of a study on finding evidence of climate change in mussel shells near Tatoosh Island off the coast of Washington. She worked with PhD candidate Sophie McCoy and Professor J. Timothy Wootton from the Department of Ecology and Evolution to analyze carbon and oxygen isotopes in shells from three different time periods: the past decade, 30 or 40 years ago, and more than 1,000 years ago. Carbon isotope values drop in conjunction with pH. The seashells from the last decade showed a precipitous drop in carbon isotope levels, just as previ- ous studies had shown a similar rapid decline in seawater pH levels. This ocean acidification is linked to increased carbon dioxide in the atmosphere. The findings confirmed the earlier measurements and demonstrated that shells might be used to measure historical pH levels when no instrumental record exists. C A N C E R P AT H W AY S NEUROSCIENCE Researching better ways to treat OCD Creating an animal model of a psychiatric disorder presents unique challenges. Researchers at the University of Chicago have developed a mouse model that closely parallels obsessive compulsive disorder (OCD) in humans and how patients respond to treatment. Nancy Shanahan, a postdoctoral researcher who has her PhD in neurobiology from the University of Chicago, is the lead author of a study on the first-of-its-kind OCD model, which could lead to more effective treatments. In creating the model, researchers pinpointed a single neurotransmitter receptor, found a specific region of the brain responsible for OCD-like symptoms, and identified the necessary time frame for treatments to take effect. "Now that we have this model, we actually could pursue these ideas for better treatments in a disease where there is only one successful therapy," said Stephanie Dulawa, PhD, assistant professor in the Department of Psychiatry and Behavioral Neuroscience and senior author of the study. MEDICINE ON THE MIDWAY SUMMER 2012 Putting the brakes on cancer How do organs know to stop growing, and how are those brakes lost in cancer? Back in the early 2000s, researchers identified a signaling pathway, called the "Hippo" pathway, that is a critical controller of tissue growth -- and a likely contributor to human cancers. But scientists still are looking for a way to turn this pathway on and off. Julian Boggiano, a graduate student in the laboratory of Richard Fehon, PhD, professor and chair of molecular genetics uchospitals.edu/midway and cell biology, and postdoctoral fellow Pamela Vanderzalm, PhD, discovered one of those pathway "switches," a protein called Tao-1, revealing a new component of how organ size is regulated. "This gives you another part of the pathway, and in terms of clinical relevance, it gives you something else to look at in diseases that might involve this pathway and possibly gives you a target to manipulate," Fehon said. 5 GENETICS AND EVOLUTION NEUROBIOLOGY Midway News Gambling like a "gateway drug," study suggests At any hour of the day or night, many of the customers sitting intently in front of a slot machine will also be smoking cigarettes or drinking a cocktail. Addictions to these pursuits tend to go hand in hand. Neurobiology graduate student Bryan Singer is co-author of a study on how the unpredictability of gambling may predispose the brain to drug addiction. Researchers working in the laboratory of Paul Vezina, professor in the Department of Psychiatry and Behavioral Neuroscience, tested whether gambling-like behavior influences the response to the drug amphetamine in an animal model. The results suggest that gambling -- and specifically, its random payoff -- may have properties similar to a "gateway drug" as an activity that can increase the abuse potential of drugs. Unpredictable rewards may prime the same brain areas hijacked by drugs of abuse, producing a stronger behavioral response, known in the field as sensitization, even upon first exposure to a stimulant drug. New genes on the block Evolutionarily recent genes are more likely to control brain development in humans, according to a new study co-authored by Patrick Landback, a graduate student in the laboratory of Manyuan Long, PhD, the Edna K. Papazian Distinguished Service Professor of Ecology and Evolution. By merging a database of gene age with gene transcription data from humans and mice, researchers looked for where young genes specific to each species were expressed. They found that a higher percentage of primate-specific young genes were expressed in the brain compared to mouse-specific young genes. Human-specific young genes also were more likely to be expressed in uniquely human brain structures, such as the neocortex and prefrontal cortex. As predicted, young human-specific genes in the brain were more likely to be turned on during fetal or infant development. The early activity of these genes suggests scientists should be looking at earlier developmental stages for genetic activity that ultimately shapes the complexity of the human brain. Contributing: Rob Mitchum, Dianna Douglas and Matt Wood 6 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Bruce A. Beutler talks about what it's been like since he won the award, the joy of intellectual discovery and his time at the University of Chicago BY DIRK JOHNSON Life after Nobel A s a first-year student at the University of Chicago Pritzker School of Medicine in 1977, Bruce A. Beutler remembers sitting through anatomy class in Abbott Hall and worrying whether he was going to succeed. "I really had to struggle," he said. "I was finding that medical school was really tough." It seems he mastered the material. Beutler, MD'81, recently was named a winner of the Nobel Prize in Medicine for discoveries that "revolutionized our understanding of the immune system," according to the Stockholm committee. As Beutler sees it, one of the biggest adjustments to life after winning the Nobel has been the need to gently remind colleagues, especially the younger researchers, not to treat him any differently than before. When assistants seem a bit star-struck, he reminds them to call him Bruce, not Dr. Beutler. uchospitals.edu/midway "To work effectively, things have to be casual," he said in a telephone interview from his home in Dallas. "We can't have all this fawning." Beutler now is at the University of Texas Southwestern Medical Center in Dallas, where he is the director of the Center for the Genetics of Host Defense. He recently took the post after leaving a professorship at the Scripps Research Institute in La Jolla, Calif. He and Jules A. Hoffmann won the Nobel for their research into how the immune system works, including the discovery of new receptor proteins that can recognize microorganisms and activate innate immunity --research that could lead to the development of new drugs that better treat disease. The prize was split between the two and the late Ralph Steinman for his findings on dendritic cells and their role in the activation and regulation of adaptive immunity. Their work has "opened up new avenues for the development of prevention and therapy against infections, cancer and inflammatory diseases," according to the Nobel Foundation. Continued on page 8 MEDICINE ON THE MIDWAY SUMMER 2012 7 PHOTO BY DAVE GRESHAM, UT SOUTHWESTERN Bruce A. Beutler receives the Nobel Prize in Medicine from King Carl XVI Gustaf of Sweden in Stockholm on December 10, 2011. Continued from page 7 A text from the Nobel Committee chair When fame arrived for Beutler, it was sometime around 2:30 a.m. on October 3, and he was alone in his La Jolla apartment. He had just returned from a conference in Hong Kong. He was jet-lagged and couldn't sleep. Restless, he clicked on his phone and noticed a message. It had been sent by G�ran Hansson, the chair of the Nobel Committee. The text began, "I have good news for you." When Beutler read more and learned that he had won the prize, he considered that he needed evidence from an independent source. He hurried over to his computer at the kitchen table, and surfed the Internet for news of the Nobel Prize winners. At first, he found nothing. He hit the refresh button. And there was his name. "It was very exciting," said Beutler, illustrating a penchant for understatement. 8 Almost instantly, his telephone was ringing and his computer was filling with messages. He did not bother even trying to go to sleep that night. He talked on the phone with his longtime administrative manager Betsy Layton (who immediately began weeping with joy); his brothers, Steven, MD'77, (also a physician and graduate of UChicago) and Earl; his sister Debbie; his mother, Bonnie; and his three sons, Daniel, 29, and Elliot, 27, who run a coffee shop in Seattle called Uncle Elizabeth's, and Jonathan, 24, who is pondering plans to become a farmer. When Beutler spoke on the phone to his girlfriend, Nadia Krochin, "she was so ecstatic and excited" he had difficulty understanding her. Word of the prize brought big cheers among pals and colleagues in Chicago. Beutler said he still has close ties to Barry G.W. Arnason, MD, the James Nelson and Louise Raymond Professor of Neurology at the Pritzker School of Medicine. He also pointed to the landmark research by Donald F. Steiner, MD, the A.N. Pritzker THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION PHOTO BY ULLA MONTAN � THE NOBEL FOUNDATION Distinguished Service Professor Emeritus of Medicine and Biochemistry and Molecular Biology, whose work has contributed greatly to understanding the mechanism of insulin secretion and the treatment of diabetes. And he spoke appreciatively of Anna Di Rienzo, PhD, a professor of human genetics at the University of Chicago, who collaborated with him on a research paper about the evolution of Toll-like receptors and whether such receptors are undergoing diversifying selection or purifying selection. They concluded the latter. For her part, Di Rienzo said she had been especially impressed by Beutler's openness to findings, even if they contradict their original hypotheses. "He's very willing to entertain new ideas." An important early mentor at UChicago was Patricia Gail Spear, PhD'69, who was a young faculty member when Beutler, as a medical student, approached her about working in her laboratory. "I honestly have no idea why he came to me," she said. "I was a pretty junior faculty member at the time." She was taken aback that a young student would be volunteering for work simply because he was curious. "He was different than most students," said Spear, who earned her PhD in virology at the University of Chicago in 1969 and now is an immunologist at Northwestern University's Feinberg School of Medicine. "He was a little geeky, and I don't mean that in a pejorative way. I mean, he'd go out with the others for a beer, and all that. But he wasn't a back-slapper. He was just very smart, very modest, always extremely polite in a way that was almost Old World. And he was intellectually driven." Bruce A. Beutler as a young Pritzker graduate and today, in his official Nobel portrait. "The University of Chicago is, of course, one of the very top medical schools. But it's very scientifically oriented. In that way, it's very different than most other schools." A family tradition The University of Chicago is a family tradition for the Beutlers. His parents met as undergraduate students. His father, the distinguished scientist Ernest Beutler, graduated from medical school at the University of Chicago, as did Bruce's brother, Steven. The elder Dr. Beutler was teaching at the medical school here when Bruce was born at Chicago Lying-in Hospital in 1957. As a measure of its esteem for his father, the American Society of Hematology gives an award in his honor, the Ernest Beutler Lecture and Prize. It recently was awarded to Janet Rowley, MD'48, the Blum-Riese Distinguished Service Professor of Medicine, Molecular Genetics and Cell Biology, and Human Genetics at the University of Chicago, and to Brian Druker, of Oregon Health and Science University, for advances in the diagnosis and treatment of chronic myeloid leukemia. In Beutler's view, the University of Chicago was the perfect place for his aspirations. "I went to medical school more to learn about science than anything else," he said. He found himself at home in a place where so many other medical students, like him, had been drawn more keenly to scientific discovery than to the vocation of a physician. "The University of Chicago is, of course, one of the very top medical schools," he said. "But it's very scientifically oriented. In that way, it's very different than most other schools." To Beutler, the joy of intellectual discovery has always trumped most other goals, such as great financial success. uchospitals.edu/midway "I've never had a high utility for money," said Beutler, who lives in a modest apartment without a telephone land line and drives a Prius. "As long as I had enough food to eat and a roof over my head, I would be quite happy." When he arrived at Pritzker in 1977, after doing his undergraduate work at the University of California, San Diego, Beutler was unprepared for the city's infamous winter weather. He recalls walking about a mile in the wicked cold one evening, wearing a thin coat, and no gloves or hat, and contemplating a strategy for survival. Should he cover his ears and risk frostbite to his hands? Or leave his hands in his pockets, endangering his ears? "I finally decided I could do better without ears than without hands," he said, "so I put my hands in my pockets." The scientist took his Chicago winter lesson seriously. He promptly made his way to a clothing store and bought some heavy winter gear. His days at UChicago brought plenty of challenge. Besides that anatomy class and the icy winds knifing off Lake Michigan, he said he'll never forget the exhaustion of working up to 30 hours without sleep during his junior and senior rotations on the wards. There are plenty of delightful memories, too, indulgences like deep-dish pizza at Giordano's on jaunts to the North Side, and the camaraderie at Jimmy's Woodlawn Tap. "We had some good times," he recalled. "Is Jimmy's still there?" Indeed, it is still here, and no doubt the Nobel Laureate would be welcomed back for a cold one. MEDICINE ON THE MIDWAY SUMMER 2012 9 D O C T O R - P AT I E N T R E L AT I O N S H I P Fostering communication skills in future Generous donation allows new institute to focus on crucial part of BY ANITA SLOMSKI espite stunning biomedical advances in recent years that have greatly altered the practice of medicine, the doctor-patient relationship is at the heart of excellent medical care. It's just that vital relationship that is the focus of the University of Chicago's new Bucksbaum Institute for Clinical Excellence, which was made possible by a $42 million gift from the Matthew and Carolyn Bucksbaum Family Foundation. The gift "offers the opportunity to bring a new level of rigor to the study of the doctor-patient relationship and clinical judgment," said President Robert J. Zimmer in the University's announcement of the Bucksbaum Institute last September. The Bucksbaums' gift has endowed the new institute, which will train not only medical students at the Pritzker School of Medicine, but also their professors. Headed by Mark Siegler, MD, the Lindy Bergman Distinguished Service 10 Carolyn "Kay" Bucksbaum and Mark Siegler, MD, executive director of the Bucksbaum Institute for Clinical Excellence Professor of Medicine, the Bucksbaum Institute will support the career development and activities of physicians at three career stages. "The ideal doctor-patient relationship develops early in training," said Matthew Sorrentino, MD, professor of medicine and associate director of the Bucksbaum Institute. "A major goal of the institute is to work with medical students both in educational programs and research endeavors aimed at promoting this relationship." The Bucksbaum Institute will provide individual students with research support, and three to five medical students each year will receive assistance with tuition and fees from the second to the fourth years of medical school. In addition, all medical students will be exposed to "best practices and the latest research on the doctor-patient relationship throughout the medical school curriculum through didactic teaching, symposiums and mentorship," said Sorrentino. Experienced clinicians also will benefit from a deeper understanding of a strong doctor-patient relationship and shared decision-making, said Sorrentino. Up to four junior faculty members each year will receive funding from the Bucksbaum Institute "to advance scholarship or to develop teaching or clinical programs relating to the doctor-patient relationship and clinical decision-making," he said. And one experienced physician-teacher will be recruited each year to serve for three years THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION PHOTO BY BRUCE POWELL physicians Leading the way Named as the inaugural Bucksbaum Faculty Fellows, two young physicians are finding ways to strengthen the bonds between doctors and their patients -- and improve health care BY ANITA SLOMSKI E medical education as a Bucksbaum Master Clinician, acting as a role model in the delivery of excellent clinical care and skilled doctor-patient communication. It was the relationship that Siegler had built with the Bucksbaum family that sparked the generous donation for the institute. It was a relationship built not only on "outstanding medical competence," Kay Bucksbaum said, but also compassion and communication -- something the family wanted to help teach many physicians. The Bucksbaum Institute is the result. The communication skills learned through the Bucksbaum Institute will undoubtedly have an impact far beyond the individual relationships forged between University of Chicago Medicine physicians and their patients and families. "Thirty percent of our graduates populate faculties of schools of medicine across the country, so they will carry what they learned at the Bucksbaum Institute to colleagues and medical students around the world," said Holly J. Humphrey, MD'83, dean for medical education. uchospitals.edu/midway ach time Monica Peek, MD, MPH, met with another group of African American women on the South Side of Chicago, she assumed she'd be talking about breast cancer and where to get free mammograms, as part of their training to become women's health advocates in their communities. But invariably, Peek's audience also would pepper her with questions about their blood sugar, why they weren't supposed to eat salt and whether heart palpitations are normal. Why weren't they asking their own physicians these questions, Peek, assistant professor of medicine, wanted to know. The women just shrugged and told Peek that she was easier to talk to than their own physicians. "Here I was trying to get these women to teach other women about breast cancer screening, but at the end of the day, they didn't feel empowered to talk to their own physicians," said Peek. The revelation prompted the physicianscientist to shift her research focus. Perhaps improving the way African Americans and their physicians communicated with each other would go a long way in reducing disparities in health care for this underserved patient population, Peek reasoned. Peek will be able to do just that type of research through a prestigious two-year fellowship from the Bucksbaum Institute for Clinical Excellence, a major new initiative of the University of Chicago dedicated to enhancing the doctor-patient relationship and shared decision-making. Peek's research will investigate whether addressing racial and cultural obstacles in the interactions patients have with their physicians will help ameliorate health disparities among African Americans with diabetes and other chronic diseases. Monica Peek, MD, MPH Alexander Langerman, MD Peek is one of the two physicians chosen as fellows at the new institute, which was made possible by a $42 million donation from the Matthew and Carolyn Bucksbaum Family Foundation. The donation was sparked by the positive relationship that the family had with their long-time physician, Mark Siegler, MD, the Lindy Bergman Distinguished Service Professor of Medicine and executive director of the institute. Also named as a Bucksbaum Faculty Fellow is Alexander Langerman, MD, assistant professor of surgery and a specialist in the care of patients with head and neck cancer. Advancing disease presents a challenge to the doctor-patient relationship, especially when patients have been referred because their cancer is terminal, Langerman said. "It can be very difficult for a physician devoted to battling a difficult disease to switch gears and talk about why treatment is no longer effective and to have conversations about end-of-life care," said Langerman. "But that is precisely the time when you most need to ramp up communication with patients because there are many things you can do to make their lives better in the time they have left, such as symptom management, control of pain and focusing on their personal goals." Open and honest communication between physicians and patients also can lead to better health outcomes at any stage of disease, Langerman said. "Will a good Continued on page 12 MEDICINE ON THE MIDWAY SUMMER 2012 11 The Bucksbaum Scholars Jasmine Taylor, MS3, left, Liese Pruitt, MS3, and Alex Ruby, MS3, were named the inaugural Bucksbaum Medical Student Scholars after a rigorous and competitive application process. The Bucksbaum scholarships help these students with tuition and fees from the second through the fourth years of medical school. Continued from page 11 relationship with your doctor cause your tumor to shrink? No. But it may help you get through chemotherapy with fewer side effects or allow your physician to pick up on warning signs of complications sooner." The difficulty, however, lies in objectively proving that patients' health improves when physicians spend more time talking to them or eliciting their care preferences. Numerous studies have attributed patients' better quality of life to strong doctorpatient relationships, but Langerman, who has done basic-science research in addition to clinical research, maintains that "the precision of that research isn't robust." His goal is to apply scientific principles to obtain the hard data that demonstrates to funding agencies and the medical community that the doctor-patient relationship is worthy of serious study. Learning to share information One of the biggest dividends of a strong doctor-patient relationship is the confidence it gives patients to help direct their medical care. "Patients who share in these 12 decisions are more apt to understand and trust their treatment plan, adhere to it and make necessary lifestyle changes, which produce better health outcomes," said Peek. But low-income African Americans with diabetes -- the patient population that Peek studies -- haven't always been willing to engage with their doctors. "African Americans have not always, as a group, been treated well by our health care institutions. Our country's legacy of unethical experimentation, segregated and under-resourced hospitals, and other such factors have led many African Americans to mistrust their doctors and to perceive -- real or not -- discrimination in their health care," said Peek. So they might not be forthcoming with their medical histories and lifestyles, and, lacking self-care skills, might avoid participating in decisions about their care. The results are plain enough: People who have diabetes and live on the South Side of Chicago have five times as many diabetes-related leg amputations as those with diabetes in white neighborhoods of Chicago and a much higher prevalence of diabetes than the rest of the city, according to Peek. To tackle the disparities in diabetes care among African Americans, Peek and other University of Chicago Medicine colleagues have created a multifaceted intervention effort at six health centers, two of which are part of the University of Chicago Medicine (the Primary Care Group and the Kovler Diabetes Center). Besides offering culturally tailored education on self-care of diabetes, the program coaches patients on how to make decisions with their physicians by asking questions, giving information, and expressing preferences for treatment. The program also has trained close to 100 providers since 2009 on patient-centered communications, cultural competency and shared decision-making. Preliminary results are promising, said Peek. The African Americans who have taken the classes improved self-monitoring of their glucose, regularly inspected their feet, and had better glucose control, and higher HDL cholesterol levels. While the benefits of a multidisciplinary approach to solving complex medical problems is clear, it also can present challenges for a patient looking for one clear voice about the road ahead. That has the potential to unwittingly silence patients' desires and decisions about their care. During his fellowship, Langerman plans to investigate how multidisciplinary care affects doctor-patient relationships. "When you have multiple physicians involved in providing treatment, all with different communication styles, the patient may perceive a lack of continuity of care and feel that no one really knows what he wants," Langerman said. His idea is to test several models to find the one that allows physicians and patients to freely exchange information and make decisions together. One way may be to involve the patient's primary care physician, who likely best knows the patient's values and goals, while another approach may be to have all the specialists unite in presenting various treatment options and their recommendations. "We want to give patients the ultimate in personalized medicine, targeting therapies not only to their genetic makeup, but also to their needs, desires and viewpoints," Langerman said. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION GENOMICS AND CANCER "I would like to cure cancer" Yusuke Nakamura, MD, PhD Renowned cancer researcher comes to UChicago with lofty goals BY DIRK JOHNSON B y landing renowned Japanese cancer researcher Yusuke Nakamura, the University of Chicago Medicine magnifies its potential for making scientific discoveries that lead to the development of lifesaving drugs. Widely known for his contributions to modern genomics, the 59-year-old Nakamura, MD, PhD, held a cabinet-level position as Secretary General of the Office of Medical Innovation in Japan. His recruitment is being hailed as a coup for the University, as well as a boon for bio-tech prospects in Chicago and throughout the nation. In an interview in his new office at the Knapp Center for Biomedical Discovery, Nakamura has a tone of modesty but fierce determination. He sets a very high bar. uchospitals.edu/midway "I would like to cure cancer," he says. "Some people respond to medicines while others do not. Why? I want to find out." A native of Osaka and the son of shopkeepers, Nakamura worked as a surgeon early in his career. He is still moved as he describes a case from more than 30 years ago, the suffering of a 27-year-old woman dying of cancer. "She pulled at my coat and cried in pain," he says softly. "I can still remember her crying." When his mother, Takako, died of colon cancer at age 64 in 1999, Nakamura vowed to focus on exploring science in the quest to identify the disease in people at much earlier stages. Nakamura, the author of nearly 1,200 research papers, was a professor of molecular medicine at Tokyo University's Human Genome Center. He earned his PhD in molecular genetics from Osaka University. In the 1980s, he spent five years at the Howard Hughes Medical Institute at the University of Utah, working as a research fellow and later as a faculty member. He returned to Japan in 1989 and later founded a biotech company, OncoTherapy Science. In accepting the offer to join the University of Chicago, Nakamura says he saw great promise here in turning discoveries into practical treatments. In particular, he points to the University's Center for Personalized Therapeutics, which hews treatments to individual genetic makeup. The director of the center, Mark Ratain, MD, the Leon O. Jacobson Professor of Medicine, who has collaborated with Nakamura on earlier major research projects, played a key role in the recruitment. "Some people respond to medicines while others do not. Why? I want to find out." Na k amu r a b el i e ve s h is specialties in genotype and discovery will complement Ratain's specialties in phenotype and development to produce major advances in the care and treatment of patients. The move to Chicago was triggered by the terrible Japa- nese earthquake, a tragedy that he says necessarily diverted government attention from most other matters, including his research mission as Secretary General of the Office of Medical Innovation. Nakamura says he is buoyed by his new prospects, in part, because bringing new drugs to market is a much more efficient process in the United States than in Japan. The key to earlier diagnoses and pharmacological advances, he says, lies in unlocking the puzzles of genetics, which can help serve as a roadmap for the production of new drugs, as well as modifications of clinical treatments. In Chicago, Nakamura will be joined in the coming months by eight or nine postdoctoral researchers now working in Japan. As it happens, he notes, only one of these researchers is a Japanese citizen; the others grew up in Malaysia, Korea, Sudan and Singapore, among other places. Nakamura has settled into an apartment in downtown Chicago with his wife and young son. He says he has admired the city for a long time. "Great architecture and good restaurants." With a reputation as a good cook himself, Nakamura joked that "the hand of a surgeon" can be useful in working around the stove. He is an avid fan of baseball, a big sport in Japan. He says he has already been told by some Chicagoans that he will have to choose a loyalty between the Cubs and the White Sox. Already accustomed to the lay of the land on the South Side, he says he is leaning toward the Sox. SUMMER 2012 MEDICINE ON THE MIDWAY 13 UND E R T HE M ACUTE MYELOID LEUKEMIA BY STEPHEN PHILLIPS A s a graduate student, Kenan Onel, MD, PhD, feared the fate of the medieval "scholastic" philosophers who contemplated arcane conundrums like "the number of angels who could dance on the head of a pin." "I was concerned about spending my life studying something so small it was irrelevant," said Onel. He needn't have worried. In 2009, Onel, associate professor of pediatrics at the University of Chicago Medicine, led a team that identified genetic mutations associated with therapy-related acute myeloid leukemia (t-AML), a deadly cancer affecting thousands of people each year. This leukemia occurs in patients who have previously beaten cancer. It is caused by the very treatment that drove their earlier recovery. Average life expectancy from diagnosis is less than 10 months. Comparing DNA from 80 t-AML patients with that of 150 healthy controls, Onel and his colleagues found genetic variations linked to t-AML in patients with chromosomal changes associated with certain chemotherapy drugs. Last year, he led a study, co-authored by University of Chicago graduate student Timothy Best and published in Nature Medicine , that employed a similar approach to identifying genetic variants associated with susceptibility to radiation therapy-induced second cancer among survivors of Hodgkin lymphoma. They hope ultimately to identify drug targets and biomarkers for genetic susceptibility. Screening for the latter could have a far-reaching impact in post-Hodgkin second cancers, in particular; Hodgkin is among the easiest cancers to treat, giving IC RO S CO P E CANCER RESEARCH Thinking big to unravel the genetics of cancer physicians latitude to modify their treatment in some cases in order to reduce the risk to patients of developing a second cancer. "As we have more success treating cancer, more people are at risk for these [second cancers]," said Michelle M. Le Beau, PhD, Arthur and Marian Edelstein Professor of Medicine and director of the University of Chicago Medicine Comprehensive Cancer Center. "Identifying them is critical. These are aggressive diseases that account for a significant proportion of overall cancer deaths," said Le Beau, who is a close collaborator on the t-AML project, along with Richard A. Larson, MD, director of the hematologic malignancies program. They also represent potent "model" systems through which to study cancer more broadly. "Years of epidemiologic research demonstrate conclusively these cancers are 100 percent caused by therapeutic exposure," said Onel. "They offer an extreme surrogate for the environmental exposures that occur in the natural world. This gives us insights into the general mechanisms behind cancer." His team, Le Beau, Larson and many 14 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Kenan Onel, MD, PhD, center, and his laboratory team: (back row) Timothy Best, left, Mark Sasaki, Eric Hungate, Sapana Vora, (front row) Imge Hular, left, and Kate Wolak. others, are working closely together to follow up the t-AML study, Onel said. The mapping of the human genome in 2003 raised hopes of a "genomic revolution" in which sequencing would illuminate the genetic profiles of different diseases, lighting the way to new, targeted therapies. Genome wide association studies (GWAS), whereby a person's DNA is scoured to identify genetic variations associated with particular conditions, were viewed as a key way to realize this vision. But while they have identified numerous genetic mutations linked to diseases, these associations have mostly been so weak as to be "meaningless," said Onel. The genomic revolution has been delayed. "The failure of most GWAS stem from their inability to adequately characterize environmental exposures," said Best, a graduate student in the University's Committee on Cancer Biology and a member of Onel's lab. By focusing on t-AML and postHodgkin second cancer, Onel and his team introduced a more nuanced approach. They could account not only for genetic factors, but also for environmental variables (something GWAS have hitherto been largely blind to) and the interplay between them -- so-called "exposure-driven genetic susceptibility." Using GWAS, Onel set out to capture the nature and nurture of cancer. uchospitals.edu/midway In the Nature Medicine study, his team analyzed a pool of patients exposed to a single, known toxin, but in which only a subset developed cancer as a result. They could ask the question, what was genetically different in the cohort that developed cancer versus the one that stayed healthy? "When you take strong potentiating events like chemo- or radiotherapy, you can pick out the genetic variants that play a strong role as a consequence," said Le Beau. "It's a unique approach that maximizes the power of GWAS at a time when people have become a little disenchanted with them." It also advances an emerging view of cancer that is moving away from segmenting it by organ of origin toward identifying cellular mechanisms that may be common across ostensibly disparate cancers. Onel and his team note in Nature Medicine that the variants linked to susceptibility to postHodgkin second cancer affect PRDM1, a gene "frequently lost in many cancer types," for example. "Although cancer is complex, we're seeing it converge on the same cellular pathways," said Le Beau. "Drugs you identify for one disease may be effective in others." Onel, who received his MD and PhD at Cornell University, had long aspired to attempt this sort of inquiry, but it was only when he arrived at the University of Chicago in 2004 that he found the resources to put his ideas into action. The University had painstakingly collected records of patients with t-AML, providing the raw material and impetus for his work. "It enabled us to do an experiment no one else could do," he said. For his part, Onel brought an irrepressible spirit, and a flair for collaboration and connecting the dots, say colleagues and students. "Ken thinks big and is extremely upbeat and positive in his approach to science," said Le Beau. "All our projects have multiple collaborators and the need to get samples from different labs," said Mark Sasaki, PhD'07, whom Onel helped advise toward his doctorate in cancer biology and who recently joined Onel's lab as a postdoctoral fellow in genomics, having completed a postdoctoral fellowship in neuroscience at the University of Oregon. "A lot of our ability to do them is Ken going to meetings, Ken talking to people. He really pushes the interdisciplinary aspect." In his latest venture, Onel has joined forces with Professor of Ecology and Evolution Chung-I Wu, PhD, in an intriguing and potentially groundbreaking study that is applying principles from evolutionary biology to cancer. By conceiving of cancer cells as analogous to any other population of organisms in facing selective pressures (competition between cells and the depredations of the body's natural defense mechanisms, for example) that shape their evolution, they hope to identify the genes that drive cancer development with greater precision. "It's an evolutionist meets a cancer biologist," said Wu. "I've learned so much from him and I hope he finds my perspective useful." To Onel, it's another piece of a complex puzzle. "Again, it is big picture," he said. "It is about how we get cancer; why some people get it and others don't. The t-AML studies gave us information about genetic predisposition in the context of environmental exposure; the evolution stuff will enable us to study the transition from normal to cancer. And ultimately they're going to connect." SUMMER 2012 PHOTO BY BRUCE POWELL MEDICINE ON THE MIDWAY 15 Researching where religion and medicine meet Program will support junior faculty doing research on the spiritual lives of U.S. physicians, and on the intersection of religion and spirituality with their clinical practices. The program will enroll four scholars each year for a two-year program of learning and research. The scholarship will cover 60 percent of the recipient's time at his or her home institution, and the scholars also will meet for workshops and retreats. The effort springs out of the University of Chicago's Program on Medicine and Religion (PMR), a collaboration between the Department of Medicine's MacLean Center for Clinical Medical Ethics and the Divinity School. PMR co-director Daniel Sulmasy, MD, PhD, says religion and medicine often seem to operate on parallel tracks. "Over the centuries there's been a growing distrust between religion and science, and as medicine got more successful, it maybe became too ready to think of itself as a self-sufficient practice," he said. "Sometimes we think that we can cure everything." The country's increasing religious diversity and the growing number of people who are not explicitly religious make it even more difficult for physicians to effectively address patients' spiritual needs, he added. Sulmasy also is the Kilbride-Clinton Professor of Medicine and Ethics in the Department of Medicine and Divinity School and associate director of the MacLean Center. Some physicians suffer from spiritual problems themselves, says Farr Curlin, MD, associate professor of medicine and PMR co-director. "Judging from my colleagues' and my own experience, doctors are having a harder time making sense of why their work is worthwhile and good," he said. "We think this malaise can be fruitfully diagnosed as a spiritual problem, and this project gives promising young faculty a chance to think about what's going wrong and what resources are there to put things right." Curlin said he believes it has been a mistake to treat spiritual and religious traditions as threats to scientific medicine that students need to be taught to keep out of their training and practice. For a study published in the Journal of General Internal Medicine in 2005, he and his colleagues surveyed more than a thousand practicing physicians regarding the role of religion and spirituality in their lives and work, and compared their responses with those of a sample of the general population. Fifty-five percent of the physicians said their religious beliefs influence their practice of medicine. However, the physicians were less likely than the general population to say they try to carry their religious beliefs over into all other dealings in life (58 percent vs. 73 percent), twice as likely to consider themselves spiritual but not religious (20 percent vs. 9 percent), and twice as likely to cope with major problems in life without relying on God (61 percent vs. 29 percent). The Templeton Foundation funds research into "the big questions" that occur at the intersection of science and spirituality. Kimon H. Sargeant, PhD, BY ELIZABETH GARDNER hough modern physicians may think of themselves primarily as treaters of the body and mind, there are times when they must consider the soul, particularly when their patients face death or a major medical crisis. Their own religious and spiritual beliefs (or lack of them) can't help but inform how they treat their patients. But it's rare that medical training addresses spirituality at all, and the role that the physician's spirituality plays in patient care is poorly understood. To help remedy that situation, the University of Chicago Medicine has launched a new program to help faculty scholars study the role of spirituality in medical practice and education. Supported by a $2.6 million grant from the John Templeton Foundation, the Medicine and Religion Faculty Scholars 16 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION The first cohort of Medicine and Religion Faculty Scholars was announced March 1. They are: Michael Balboni, PhD Instructor in Psychiatry, Dana-Farber Cancer Institute/Harvard University. Balboni is interested in how physicians' religious and spiritual characteristics affect the care they give to terminal cancer patients. He'll be studying the physicians who cared for 400 advanced cancer patients, and assessing both the spiritual well-being of the physicians and the medical outcomes for the patients. Balboni will look at such aspects as communication effectiveness, quality of life, receipt of palliative or aggressive care, and the cost of care. He plans to study not only oncologists, but primary care physicians, surgeons, and any other specialists who interacted with the patients. John J. Hardt, PhD Assistant Professor, Neiswanger Institute for Bioethics and Health Policy, Loyola University Chicago. Hardt plans to study how the spiritual tradition of the Jesuits informs the study of medicine, observing that Catholic medical education in the United States today is provided solely by Jesuit schools. "It's a spirituality immersed in the world, where one is called to find God in all things, including one's work, and for that reason alone, it offers much to the practice of medicine," Hardt said. "It takes our human condition, with all of its limits and failings, as the place where we encounter the divine." He's also interested in the Jesuits' explicit commitment to the poor and disenfranchised, which makes accessibility to health care a key issue for physicians trained in that tradition. Abraham Nussbaum, MD Assistant Professor, Psychiatry, University of Colorado School of Medicine. Nussbaum will look at our culture's "account of death," or the absence of one, and how that absence might contribute to the alienation widely felt among physicians. "We don't agree on what happens at death or after death, and that lack of concord leads to physicians feeling that their primary job is to prevent death for as long as possible," he said. An English major as an undergraduate, Nussbaum will build his research around key literary texts that deal with death, such as Don DeLillo's "White Noise," Leo Tolstoy's "The Death of Ivan Ilyich," and Michel Foucault's "The Birth of the Clinic." Aasim Padela, MD, MS Assistant Professor, Emergency Medicine, Department of Medicine, the University of Chicago. Padela is director of the Initiative on Islam and Medicine in the Program on Medicine and Religion, as well as a fellow of the Institute for Social Policy and Understanding, a think tank that does research and policy analysis connected with American and international Muslim communities. His work will focus on American Muslim physicians and how they negotiate their religious and professional identities. Using survey and interview methods, he will explore how they practice medicine in line with Islamic ideals and how they give their professional lives meaning. the foundation's vice president for human sciences, says most of its medicine-related funding has focused on patients or the general population rather than on physicians. He said the foundation welcomed the opportunity to support research in a relatively understudied area and that the University of Chicago's proposal was particularly strong. "Drs. Sulmasy and Curlin have a set of appealing and rare strengths, such as a strong track record of high-quality publications, an interest in spirituality and medicine broadly understood, a positive vision for the future of medicine, and the ability to write well," he said. uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 17 MEDICAL RESEARCH Defusing a toxic missile BY SHANNA WILLIAMS I t's a common catch-22 in the clinical research world that you can't get funding without preliminary data, but you also can't get preliminary data without funding. That's the situation Juliane Bubeck Wardenburg, MD, PhD, assistant professor of pediatrics and microbiology, found herself in when she embarked on a new series of studies of Staphylococcus aureus in 2008. Bubeck Wardenburg had a long-standing interest in Staphylococcus aureus (S. aureus), having dealt with the disease many times while treating pediatric patients during her residency and fellowship training programs at the University of Chicago. Over the years, she'd learned that in cases of pneumonia, the bacteria generated a toxin called a-toxin, which targeted lung cells in a very specific way. "You can think of the toxin almost like a missile," Bubeck Wardenburg explained. "It gets sent out from the bacteria, and it lands on the lung cell and assembles into a very elegant structure that resembles a mushroom. This structure then punctures the membrane of the cell, effectively destroying the cell." The phenomenon is incredibly efficient, which is why S. aureus infections often require hospitalization and surgery, and, in the most severe cases, result in death. Bubeck Wardenburg wanted to find out how the toxin was able to so accurately target and injure the lung cells. She had a hunch that it would be a vital part of find- ing new methods to treat pneumonia, as well as other S. aureus infections. Bubeck Wardenburg knew that in order to develop these ideas, she needed a pilot grant. "Pilot funding is intended to catapult an idea that's new, and then hopefully give it some legs so it can get farther in the clinical research process," she said. Bubeck Wardenburg applied for and was awarded a preclinical pilot study grant from the University of Chicago's Institute for Translational Medicine. The institute provides not only preclinical, but general science (such as human subject studies), community, and collaborative pilot study funding to clinical researchers at the University of Chicago. Those funding options have recently been expanded to include 18 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Physician researches mechanisms behind Staphylococcus aureus affiliate investigators at Rush University, NorthShore University HealthSystems, and the Illinois Institute of Technology. The $20,000 grant Bubeck Wardenburg received enabled her to find out just how the a-toxin was able to destroy healthy human lung cells. The key -- or rather, the "target" -- was a cell surface enzyme known as ADAM10. "ADAM10 acts as a receptor for the toxin," she said. "So if you eliminate ADAM10, the toxin doesn't act anymore. This sort of `homing device' for the toxin no longer works, and it can't locate and bind to the host cells." The initial studies from the Bubeck Wardenburg laboratory demonstrated this to be true in lung cells maintained in tissue culture -- a rather simple model uchospitals.edu/midway system that can shed light on features of disease. The discovery was precisely the sort of thing Bubeck Wardenburg hoped to find -- an observation that led to other questions and more ideas for preclinical studies. "In the pilot study, we wanted to find a system in which we could eliminate ADAM10, just like you can do in the cells in tissue culture," Bubeck Wardenburg said. "The thought was that if an animal doesn't have the target for the toxin in its lungs, it should be resistant to staphylococcal disease." Bubeck Wardenburg returned to the Institute for Translational Medicine in 2010 with a request for another round of pilot funding and this time was awarded a grant of $40,000. Once funding was secured, she began her second pilot study in earnest. "If you eliminate, or `knock out,' ADAM10 from the animal completely, the animal dies in utero," said Bubeck Wardenburg. "What that signifies is that ADAM10 is required for normal growth and development of an animal. So what we had to do was use a conditional knockout approach, picking ADAM10 as our specific genetic target in the lung cells and also as our specific target in skin cells (where the toxin causes injury as well). With this approach, ADAM10 is only eliminated in those tissues." Again, the pilot study went just as Bubeck Wardenburg had hoped, and in a shorter period of time than she'd anticipated. She and her team were able to Continued on page 20 MEDICINE ON THE MIDWAY SUMMER 2012 19 Continued from page 19 breed mice in two groups -- those without ADAM10 in the lung, and those without ADAM10 in the skin -- in the first seven months of funding. These mice led to some new potential treatment methods. "What we were able to then demonstrate was that when exposed to S. aureus, the mice without ADAM10 in the lung were resistant to deadly pneumonia infection, and the mice without ADAM10 in the skin were resistant to severe invasive skin disease," Bubeck Wardenburg said. Not only that, but Bubeck Wardenburg noted that the bacteria had an interesting effect on the natural function of ADAM10. "When the toxin binds to ADAM10, it activates a very specific function of ADAM10," she explained. "In a way, ADAM10 acts like a pair of scissors. Its natural function is to cut proteins that hold cells together so that they can separate and make room for new cells, allowing for normal cell turnover and growth." But the toxin seems to accelerate the "scissor function" of ADAM10, causing cells to cleave apart when there are no new cells available to replace them, resulting in further injury to tissue in the lungs or skin. Once Bubeck Wardenburg realized that the ADAM10 enzyme's role in S. aureus infection was twofold, it became clear that an enzyme inhibitor, which binds to ADAM10 and decreases its activity, might be a novel way of preventing or treating infection. She followed up the development of this theory by treating animals with a normal expression of ADAM10 in lung and skin cells with the enzyme inhibitor, and found that when they were exposed to S. aureus bacteria, they were well protected. "Usually when we think of drugs that we'd use to treat infections, those drugs target the bacteria," Bubeck Wardenburg said. "This approach has become very problematic, because bacteria can rapidly develop resistance to treatment. Antimicrobial resistance is a hot topic in the infectious disease world. Our new method targets the host. The host cells will not be able to resist the effects of the drug. They can't change at the rate bacteria can. So it's a very unique strategy." It is an exciting discovery, especially 20 Juliane Bubeck Wardenburg, MD, PhD, and research assistant Naoko Inoshima, PhD. when considering treatment for at-risk populations, such as intensive care patients, people with early signs of infection, or influenza patients who are susceptible to secondary infection. But as with any new clinical treatment method, development is not without its challenges. "There is an existing drug that has a preference to target ADAM10, but it was created for another purpose. So for treatment of infectious disease, it is currently suboptimal," Bubeck Wardenburg said. "There is actually an entire group of enzymes in the ADAM family, and they're all structurally similar. Not only will the new drug need to have a high potency, it will need to have high specificity as well. "A second, very big challenge is that if you're targeting the host, your intended goal is to shut down a process that the host's body needs to perform," Bubeck Wardenburg continued. "So it begs the question of safety in that, how long can you shut down ADAM10 before you start to see a negative effect on the host?" The results from Bubeck Wardenburg's two pilot studies have continued to advance along the translational research spectrum. A vaccine strategy that was developed as a result of the first pilot study, which targets the a-toxin secreted by the S. aureus bacteria, is close to clinical trial phase with a pharmaceutical sponsor company. In addition, Bubeck Wardenburg is in talks with the National Institutes of Health about drug development for the specific enzyme inhibitor that would shut down ADAM10 activity. "Targeting the host response is particularly interesting in this age of multipledrug resistance," said Dave Franz, former commander of the Army's Medical Research Institute of Infectious Diseases. "Getting it just right will be tricky, but if it can be done, Dr. Bubeck Wardenburg's work holds promise of even broader application." Her study on S. aureus bacteria and ADAM10 in lung cells was featured in Nature Medicine in October 2011. A separate study on the bacteria's interaction with skin cells was published in the Journal of Investigative Dermatology in May 2012. "Julie has made tremendous breakthroughs in a field that is of key importance for our understanding of a Staphylococcus aureus vaccine and the future development of vaccines that combat MRSA (methicillinresistant Staphylococcus aureus) infections," said Olaf Schneewind, MD, PhD, Louis Block Professor and chair of the Department of Microbiology at the University of Chicago. Bubeck Wardenburg said that were it not for the pilot funding from the Institute for Translational Medicine, none of this would have been possible. "The pilot funding enabled us to do something that was genetically complicated and allowed a new approach to the disease problem," Bubeck Wardenburg said. "This strategy, used in concert with a traditional course of antibiotics, could make a bigger impact. It could change the duration and severity of infection; it could reduce the number of hospitalizations and surgeries. This could completely change how we treat infections and the overall burden of the disease." If you'd like to learn more about the Institute for Translational Medicine and the pilot funding opportunities available, visit itm. uchicago.edu. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION PHOTO BY BRUCE POWELL EVOLUTIONARY BIOLOGY African lungfish use thin limbs to walk and lift their bodies. A small step for lungfish... BY ROB MITCHUM ...a big step for the evolution of walking "If you showed me the skeleton of this creature and asked me to make a bet on whether it walks or not, I would have bet it couldn't," said co-author Neil H. Shubin, PhD, the Robert R. Bensley Professor of Organismal Biology and Anatomy. The discover y suggests that many of the developments necessary for the transition from water to land could have occurred long before early tetrapods, such as Tiktaalik , took their first steps on shore. Lobe-finned ancestors of the lungfish as well as tetrapods could have evolved hind-limb propulsion and the ability to walk on the substrate at the bottom of a lake or marsh millions of years before limbs with digits and landdwelling animals appeared. "This shows us -- pardon the pun -- the steps that are involved in the origin of walking," Shubin said. "What we're seeing in lungfish is a very nice example of how bottom-walking in fish living in water can easily come about in a very tetrapod-like pattern." MEDICINE ON THE MIDWAY SUMMER 2012 T he eel-like body and scrawny "limbs" of the African lungfish would appear to make it an unlikely innovator for locomotion. But its improbable walking behavior, newly described by University of Chicago scientists, is changing how evolutionary biologists think about the origins of walking. Extensive video analysis, published in the Proceedings of the National Academy of Sciences, reveal that the African lungfish can use its thin pelvic limbs to not only lift its body off the bottom surface but also propel itself forward. Both abilities were previously thought to originate in early tetrapods, the limbed original land-dwellers that appeared later than the lungfish's ancestors. The observation reshuffles the order of evolutionary events leading up to terrestriality, the adaptation to living on land. It also suggests that fossil tracks long believed to be the work of early tetrapods could have been produced instead by lobe-finned ancestors of the lungfish. "The lungfish is in a really great and unique position in terms of how it is related to fishes and to tetrapods," said Heather King, a graduate student and lead author of the study. "Lungfish are very closely related to the animals that were able to evolve and come out of the water and onto land, but that was so long ago that almost everything except the lungfish has gone extinct." An African lungfish (Protopterus annectens) kept in the laboratory of study co-author Michael Coates, PhD, professor of organismal biology and anatomy, inspired King to study the species' ability to walk on its unusually thin limbs. King and her colleagues designed a special tank in which the motions of lungfish could be videotaped from the side and below for in-depth analysis. uchospitals.edu/midway 21 PHOTOS BY YEN-CHYI LIU NEUROBIOLOGY Rats helping rats Study shows rodents display empathy-driven behavior BY ROB MITCHUM mm, that dirty, double-crossin' rat," James Cagney snarls in the 1931 film "Blonde Crazy." The line later was widely misquoted as "You dirty rat," but no matter: Either way, it pretty much sums up what we think of rats. But when it comes to the real-life rodents, it turns out we're wrong. And that's why a clever study by a team of University of Chicago neurobiologists that showed rats feel empathy for fellow rats in distress made headlines around the world. "This is the first evidence of helping behavior triggered by empathy in rats," said Jean Decety, PhD, the Irving B. Harris Professor of Psychology and Psychiatry and Behavioral Neuroscience at the University of Chicago. "There are a lot of ideas in the literature showing that empathy is not 22 M unique to humans, and it has been well demonstrated in apes, but in rodents it was not very clear. We put together in one series of experiments evidence of helping behavior based on empathy in rodents, and that's really the first time it's been seen." The experiments were designed by first author Inbal Ben-Ami Bartal, a PhD candidate in psychology, with co-authors Decety and Peggy Mason, PhD, professor of neurobiology. The paper, "Empathy and pro-social behavior in rats," was published in the journal Science. For the study, one rat was held in a clear plastic tube with a door that can be nudged open from the outside. The second rat roamed free in the cage. Researchers observed that the free rat acted more agitated when its cage mate was trapped in the tube. And once the free rat figured out how to pop open the door, it would take action almost immediately upon placement in the test arena. "There was no other reason to take this action, except to terminate the distress of the trapped rats," Bartal said. "In the rat model world, seeing the same behavior repeated over and over basically means that this action is rewarding to the rat." In another experiment, two clear tubes were placed in the cage, one containing the cage mate, another containing a pile of chocolate chips. Though the free rat had the option of eating all the chocolate chips first, the rat was equally likely to free its cage mate before opening the chocolate container. "That was very compelling," Mason said. "It said to us that essentially helping their cage mate is on a par with chocolate. He can hog the entire chocolate stash if he wanted to, and he does not. We were shocked." Having an animal model of empathydriven behavior will now allow researchers to study the biological mechanisms that underlie empathy. The study "opens the path for elucidating aspects of the underlying neurophysiological mechanisms that were not accessible until now," Bartal said. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION PHOTOS BY DAVID CHRISTOPHER ORGANISMAL BIOLOGY "Head-first" diversity shown to drive vertebrate evolution BY ROB MITCHUM T he aftermath of a mass extinction is marked by an explosion of biodiversity. With a new analysis of two such adaptive radiations in the fossil record, researchers from the University of Chicago and the University of Oxford have discovered that surviving species try out a wide range of head shapes first. Why the head? The better to take advantage of the expanded menu suddenly available following the demise of their less fortunate peers, it seems. "It seems like resources, feeding and diet are the most important factors at the initial stage," said lead author Lauren Sallan, graduate student in the Department of Organismal Biology and Anatomy at the University of Chicago. "Strange heads show up first -- crushing jaws, animals with big teeth or with long jaws -- but they're all pretty much attached to the same body." The researchers analyzed the physical features of fossil fish that diversified around the time of two separate prehistoric mass extinction events. What they found contradicted previous models of adaptive radiations. "There hadn't been any tests of these things using fossils," said Sallan, who works in the laboratory of Professor of Organismal Biology and Anatomy Michael Coates, PhD. "You have all these analyses of diversification, yet not one of them goes back to the fossil record and says what's happening at this time period, and the next time period, and the one after that." Sallan and co-author Matt Friedman, PhD, lecturer in paleobiology at the University of Oxford and a former member of Coates' laboratory, used a method called geometric morphometrics to quantify differences in features such as body depth, fin position and jaw shape between species. Crucially, Sallan and Friedman separated head features from body features in their analysis, to better detect the timing of when each compartment showed a burst of diversity in the record. The results of the two analyses were in agreement: New heads came before new body types. "We have these two entirely separate radiations, and in both of them the pattern is heads first," Sallan said. While the new study offers two distinct examples of headfirst diversification separated by hundreds of millions of years, the universality of the model remains to be conclusively proven. "Evolution is really complex, and it's not really clear that there should be only one model," Sallan said. "It might be that this model might apply to fishes in certain time periods, or might apply to vertebrates, but a lot more investigation is needed to see whether that is actually true." The paper, "Heads or Tails: Staged Diversification in Vertebrate Evolutionary Radiations," was published online by the journal Proceedings of the Royal Society B. uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 23 PHOTOS BY LAUREN SALLAN AND MATT FRIEDMAN Heads or tails 24 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION James E. Bowman, MD, was a trailblazing African American physician-scientist, a pioneer in genetics and bioethics, and an inspiration to generations of minority students at the Pritzker School of Medicine. Writer Stephen Phillips spoke with Bowman's former colleagues, leaders whose lives he touched and his daughter Valerie Bowman Jarrett to report on the life and times of a "renaissance man." 1923-2011 t was a turbulent time. Social unrest and racial tension still simmered from the '60s, and a groundswell of activism was building around a serious blood disorder disproportionately affecting African Americans that would have a galvanizing effect on public health, from the bottom-up and the top-down. In 1970, there was no treatment for sickle cell anemia, and knowledge of how to manage it was rudimentary. For patients, life expectancy was about 20 years. Roughly one in 500 African Americans was born with the condition, noted Virginia Commonwealth University medical professor Robert B. Scott in the Journal of the American Medical Association that October. Yet funding was a fraction of that for less prevalent disorders afflicting other groups, he wrote. On the streets, the Black Panther Party took matters into its own hands, utilizing a newly available testing kit to mobilize screening in African American communities in Oakland, California, Chicago and elsewhere. "The Black Panther Party was putting uchospitals.edu/midway charts about genetic disease and images of sickle cells in their newspaper that circulated in working-class communities," said Alondra Nelson, associate professor of sociology at Columbia University and author of "Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination." And the rumblings hadn't gone unnoticed in the White House. In February 1971, President Richard Nixon designated sickle cell anemia one of two "critical areas" for urgent investment under his proposed "National Health Strategy." The other was cancer. The following year, he signed the National Sickle Cell Anemia Control Act, which authorized funding for screening, outreach Continued on page 26 MEDICINE ON THE MIDWAY SUMMER 2012 25 Continued from page 25 and research to "reverse the record of neglect on this dread disease." After decades of inaction, there was a headlong rush to tackle sickle cell anemia. And in the well-intentioned zeal to roll out mass testing and raise awareness, little attention was being paid to the accuracy of information disseminated to the public and the ethical implications of screening on the scale that was being embraced, said an outspoken professor of medicine and pathology from the University of Chicago. James E. B owman, MD, who died in September 2011 at 88, had just become the first tenured African American faculty member in medicine at the University. In journal articles and meetings with lead players, Bowman excoriated the conflation of sickle cell anemia with the more common sickle cell trait (in which just one predisposing gene, as opposed to the two needed to produce the disease, is present, and the person is healthy) that was fanning public alarm. Recently named director of the University's laboratories, he assailed crude testing practices. To improve understanding of test results, he called for more education and counseling. Clarice D. Reid, MD, former director of the National Heart, Lung, and Blood Institute's (NHLBI) Sickle Cell Disease Program, can still recall "the shock effect of his words. "Jim spoke out. It wasn't just about doing the right thing; you had to do it the right way. "Sickle cell was launched as a policy issue with no information about it in the general populace," Reid added. "Coming out of the civil rights movement, there was mistrust and 26 James E. Bowman, MD, had just become the first tenured African American faculty member in medicine at the University, when national attention was brought to the need to tackle sickle cell anemia. unrest in the black community, and now there's this disease. There was widespread hysteria and confusion between sickle cell disease and sickle cell trait. On top of that, we're trying to mount a national program." In Oakland, birthplace of the Panthers, Bertram H. Lubin, MD, now president and CEO of Children's Hospital & Research Center Oakland, was co-director of the Northern California Comprehensive Sickle Cell Center. "I thought, `This is nice, a community group doing screening,'" he recounted. "But there was no informed consent, and people who tested positive didn't know if they had disease or trait. Jim was furious. He thought the intentions were good, but the implementation was outrageous. And he wasn't shy about saying so." Bowman didn't confine his scrutiny to grassroots efforts. He castigated the government for propagating misinformation, and questioned the wisdom of aggressive screening programs underway in several states, cataloging instances of "genetic discrimination." These included hiking insurance premiums for people with sickle cell trait and dismissing black flight attendants with it, based on the misunderstanding they were unable to work at high altitude. "At the time, we were seeking to screen the whole world," Reid said. "Jim reminded us there were potential ethical issues and the right not to know your genetic status." It was a critique that had all the more impact for the person making it: a deeply engaged researcher committed to addressing the very issues they were raising. From 1973 through 1984, Bowman presided over the Comprehensive Sickle Cell Center at the University, one of 10 such centers nationwide dedicated to patient care, re s e a rc h a n d e du c at i on . Fu n d e d by t h e Nat i on a l Institutes of Health, a major educational publication from this center was "Sickle Cell Fundamentals," the 1975 book he wrote with colleague Eugene Goldwasser, PhD'50 (19222010), that became required reading by government-funded programs. "That was the Bible," said Reid. An informational film, based on the book and co-produced by Bowman, Goldwasser and filmmaker Mallory Pearce, garnered CINE (Council on International Nontheatrical Events) Golden Eagle Awards. Between 1972 and 1975, Bowman also served on six national committees concerned with sickle cell-related matters. He also helped organize a landmark sickle cell exhibition at the Museum of Science and Industry in Chicago. While there remains much to do, today sickle cell patients can live to 50 and older, thanks to improved knowledge of the condition and how to manage it. For all the contentiousness and missteps, Reid looks back on those early days fondly. "It was a time of people moving together toward a common goal," she recalled. "And to achieve that goal, you had to get around all the misinformation and disinformation." Bowman, she said, was "the renaissance man, the social conscience . . . and bridge between the science, medicine and ethics." His contributions reverberated beyond sickle cell. Olufunmilayo Olopade, MD, FACP, professor of medicine and human genetics, and director of the University of Chicago Medicine's Cancer Risk Clinic, credits Bowman with "informing" her advocacy for patient protection protocols adopted in hereditary cancer screening. And in the heady early days of genomics in the mid-1990s, Bowman, by then a senior scholar at the University of Chicago's MacLean Center for Clinical Medical Ethics, was recruited to the Ethical, Continued on page 28 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION The Bowman Society O COURTESY ARCHIVAL PHOTOGRAPH FILES, SPECIAL COLLECTIONS RESEARCH CENTER, UNIVERSITY OF CHICAGO LIBRARY ne of James E. Bowman's joys in his final years was the Bowman Society, founded in his honor in 2005 by William A. McDade, MD'90, PhD'88, associate professor of anesthesiology and critical care and deputy provost for research and minority issues at the University, as a resource for minority faculty and students. The group has blossomed, hosting a roster of distinguished speakers. A fixture at each meeting until his death, despite ill health, was Bowman himself, ever ready with a question or remark. "He'd always say hello, ask me about my research and encourage me," said Shamsideen Musa, MS4, a regular attendee. "He didn't want it to be something that was done for a short amount of time and then faded," said Melissa Gilliam, MD, MPH, professor of obstetricsgynecology and pediatrics, and associate dean for diversity and inclusion. "He wanted it established as something that creates long-term opportunities." uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 27 James E. Bowman was an internationally recognized expert on pathology, inherited blood diseases and population genetics. Continued from page 26 Legal and Social Issues Working Group of the Human Genome Project. Amid "reports of a gene for this or that condition," the air was thick with "genetic determinism," recalled chair Troy Duster, PhD, professor of sociology and bioethics at New York University. "Jim was the most vociferous voice. I used to tell my social science colleagues that on bioethics issues he was a better social scientist than some of them, because they didn't know a lot about the scientific aspects of disease, and tended to rely on published literature or physician colleagues. Jim understood the medical part, but was also sophisticated about the social and political underpinnings of medical decisions." Such insights were grounded 28 in Bowman's experience as an early geneticist confronting the ethical quandaries of genetic testing before the emergence of bioethics as a stand-alone discipline, and as an African American physician-scientist c on f ront i ng pre ju d i c e i n segregation-era America. The eldest of five, Bowman was born in then-segregated Washington, D.C., in 1923, and attended storied Dunbar High School. Bucking his father's wish that he follow him into dentistry, Bowman enrolled at Howard University College of Medicine. He completed his studies in three years (as part of an Army-sponsored expedited curriculum) in 1946, earning induction into the Alpha Omega Alpha Honor Medical Society as a leading member of his graduating class. Precluded by segregation from joining the army as an officer, he completed an internship at Howard's Freedmen's Hospital before moving to Chicago, where in 1947 he secured a residency in pathology at St. Luke's Hospital (now part of Rush University Medical Center). Bowman was the first black resident and made an immediate impression. In a 2006 interview for the UCLA-Johns Hopkins Oral History of Human Genetics Project, he recalled a friend's response on being told about the residency. "They said, `But you know you have to go in through the back door. . .' Well I said, `That's absolute nonsense. If I'm a resident. . . , I'm going to walk through the front door.' So the first day. . . I walked in the front door. . . All of a sudden, the Negro maids and janitors looked at me and stared at me and followed me down the hall. . . The next day, I walked in the front door, and there was a crowd of Negro janitors and maids. . . waiting to go in. . . with me. So I integrated the front door of St. Luke's Hospital!" After the residency, Bowman became pathology chief at Provident Hospital until 1953 when, amid the Korean War, he was drafted, opting to join the Army's Medical Nutrition Laboratory in Denver, Colorado, as pathology chief. He'd recently married Barbara Taylor (daughter of the first African American Chicago Housing Authority chief, Robert Rochon Taylor), who had completed a master's degree in education at the University of Chicago. When THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION COURTESY ARCHIVAL PHOTOGRAPH FILES, SPECIAL COLLECTIONS RESEARCH CENTER, UNIVERSITY OF CHICAGO LIBRARY the couple moved to Denver, Barbara taught at Colorado Women's College. When his service ended in 1955, neither he nor Barbara could stomach "anything that smacked of segregation," he recounted in the oral history. "We. . . said, `. . . Why don't we find a position overseas. . .?'" They decamped to Nemazee Hospital in Shiraz, Iran, where Bowman became chair of pathology. Barbara taught preschool and lectured in psychology and anthropology at the hospitalaffiliated medical school. "It completely changed the trajectory of his career," said his daughter, Valerie Bowman Jarrett, now a senior advisor to President Barack Obama and chair of the White House Council on Women and Girls. From this unlikely setting, Bowman bootstrapped himself into the forefront of the emerging field of genetics. It all began with a fateful encounter with a gravely ill little girl. Miraculously, following a blood transfusion, the child recovered. Bowman and his colleagues were mystified, he recalled in the 2006 interview. But a visit by Bowman to a market where he spotted fava beans provided the breakthrough. They were dealing with favism, a genetic condition in which consuming fava beans triggers a dangerous anemic reaction. Bowman led expeditions to collect blood samples from among Iran's ethnic groups to understand susceptibility to favism across different populations. The fieldwork offered a fascinating glimpse into different cultures, the genetic footprints of their movement and the evolutionary dynamics shaping genetics. uchospitals.edu/midway Bowman was a mentor. "He'd had a tough time himself and was bound and determined to make it easier for the next generation," said his daughter, Valerie Bowman Jarrett. "His office door was always open." Bowman immersed himself in the literature. "I taught myself," he said in the oral history. "It was partly biochemical genetics, anthropology, history. . . It was wonderful." He struck up correspondences with researchers worldwide, including Alf Alving, MD, who was at the University of Chicago, where researchers had linked the same genetic mutation involved in favism to a potentially fatal reaction to the antimalarial primaquine. Alving invited Bowman to look him up should he return to America. It was a formative time on the personal front, too, said Jarrett, born in Iran in 1956. "It strengthened my parents' relationship because they were so far from home and had to rely on each other. They also made lifelong friends they treasured deeply." In 1960, they left Iran for the University of London, where Bowman had won a fellowship at the Galton Institute, a pioneering training ground for geneticists. Here, he would finally "learn the genetics that I'd been reading about," he said in the 2006 interview. Returning to America in 1961, he took up Alving's offer. The calm but forthright manner that students and colleagues would come to know was on display in that initial conversation. "[Alving] said, `Dr. Bowman, I have a paper here I want you to read. . . What do you think of it?'" Bowman recalled in the 2006 interview. "I looked at the paper and I saw that their statistics were all wrong, and the conclusion. . . I called him up and I said, `Your paper is wrong.' He said, `What?'. . . And I went back and explained why it was wrong." Bowman subsequently was offered a dual appointment as assistant professor of medicine and pathology, and director of the University's blood bank. "A new era of genetic enlightenment occurred in the 1950s," said Alvin Tarlov, MD'56, former University of Chicago chair of medicine. "Jim was the expert on the clinical meaning of genetic disorders that affected red blood cells." Bowman's field studies in population genetics took him to Mexico, Ghana, Nigeria, Ethiopia and Uganda. From 1959 to 1967, he published eight papers in Nature, six as lead author. A summation of much of his research, "Genetic Variation and Disorders in Peoples of African Origin," came out in 1990 and was co-written with Robert F. Murray, Jr., now-retired chairman of the Department of Genetics and Human Genetics at Howard. But Bowman was never too busy to extend a helping hand to students. From 1986 to 1990, this mentoring was done in his capacity as Pritzker's assistant dean of students for minority affairs. "It was supposed to be a 20 percent commitment, but some days it took 100 percent of the time. He didn't compartmentalize," recalled colleague Rosita Ragin, now assistant dean for multicultural and student affairs. "He'd had a tough time himself and was bound and determined to make it easier for the next generation," said Jarrett. "His office door was always open." That door happened to be next to Pritzker's main lecture hall. And into it streamed a procession of students, many now leaders at the University. William A. McDade, MD'90, PhD'88, associate professor of anesthesiology and critical care and the University's deputy provost for research and minority issues, visited Room P117 as a precocious 20-year-old graduate student, clutching "Research in Progress," a catalog of research opportunities for the Biological Sciences Division. McDade, who was nearing the end of his first year in the Medical Scientist Training Program, emerged following a counseling session with a project selected that would set him on the path Continued on page 30 SUMMER 2012 MEDICINE ON THE MIDWAY 29 Continued from page 29 toward becoming a sickle cell expert himself. For Anita Blanchard, MD'90, associate professor of obstetrics-gynecology, the first member of her family to attend medical school, Bowman was a "lifeline." "He became like a second father," she said. "My father was wonderful, but he couldn't help with navigating medical school and a career as a physician. Dr. Bowman stepped in and did that." For Eric Whitaker, MD'93, MPH, executive vice president for strategic affiliations and associate dean for community-based research, Bowman "was the steady force amid the tumultuous times of becoming a doctor." He was a taskmaster too. "I was active in a lot of different organizations and ended up becoming national president of one of the largest medical students' organizations," Whitaker said. "His take was you're here to become a doctor; there's no such thing as an almost doctor." Jarrett recalled this side of her father from their chess games. "He was a very good player and would play me totally fair. It took me a long time to beat him, but when I finally did, I felt a great sense of accomplishment." She remembers a home in which public service was paramount (Barbara Bowman cofounded the Erikson Institute, a pioneer in early education), and expansive discussions reflected her father's "insatiable intellectual curiosity." "The conversation around our dining room table was always a spirited conversation. It wasn't for the faint-hearted; you had to come prepared to defend your positions." 30 University of Chicago Medicine Administrative Director Lynda Hale and James E. Bowman, MD, received Diversity Leadership Awards from the University in March 2011. B ow m an d ote d on B arbara, Valerie and granddaughter Laura Jarrett (a 2010 Harvard Law School graduate), whom he used to pick up daily from the University of Chicago Laboratory Schools. "He made us his highest priority, no matter what else was going on in his life," Jarrett said. Many mentees were drawn into the close-knit Bowman household in Hyde Park and its extended social circle. "Jim was not a parochial thinker," said Raphael C. Lee, MD, ScD, the Paul S. and Allene T. Russell Professor of Surgery, and professor of medicine and of organismal biology and anatomy. "He was very knowledgeable and thoughtful about extant matters of human health and rights around the world. "The Bowman house," Lee said, "was often a social gathering place for makers of political change in Chicago, including the Obamas, and that goes back decades." Bowman's wider influence is exemplified by his relationship with John W. Rogers Jr., CEO of Ariel Investments, the nation's largest minority-owned money management firm. Rogers was a 22-year-old trainee stockbroker at William Blair & Company when the Bowmans invested with him. They also backed Rogers when he came to them, two years later, with a "crazy idea" to strike out on his own. "Not only was I young, there had never been an African American mutual fund in Chicago," recalled Rogers. "But they said yes. I remember telling them what I was going to try to do. They couldn't have been more supportive. It meant a lot; it was a stamp of approval when I desperately needed it." Bowman joined Ariel's board, assiduously attending meetings for 25 years. He was a "moral compass," said Rogers. "He was committed to doing things right; there were going to be no questions." "My father used to joke any time I'd call him with an ethical dilemma: `If you need to pick up the phone and ask me, you know the answer is no,'" recalled Jarrett. In his final years, Bowman derived immense satisfaction from Jarrett's success. "He was very proud," Whitaker said. "Watching Barack Obama's rise with the help of his daughter was the capstone to a beautiful life." In 2008, Bowman's health began to falter. He was diagnosed with cancer. He battled it gamely, but finally succumbed on September 28, 2011. "I never met anyone with such boundless enthusiasm and deepseated commitment," Ragin said. "Yet he always seemed so modulated and paced." The spirit was intact to the end, she said. In the final days, Ragin visited his bedside. "I took his hand, and he grasped it firmly and raised it high. I said, `I know, Jimmy, we have a lot left to do. I'm on it.' Without a word, he made the effort, exhorting me." THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION PHOTO BY DAVID CHRISTOPHER T E C H N O L O G Y A N D I N N O V AT I O N The Art of the Diagnosis App provides "data-driven, evidence-based information" for diagnosis BY DARCY LEWIS S cott Stern, MD'84, has devoted much of his career to improving internal medicine diagnosis. A professor of medicine and assistant dean for technology and innovation in medical education at the Pritzker School of Medicine, Stern also serves dual roles as codirector of the junior clerkship in medicine and co-course director of the venerable Clinical Pathophysiology and Therapeutics (CPPT). And he is the lead author, along with Pritzker colleagues Adam Cifu, MD, and Diane Altkorn, MD'82, of "Symptom to Diagnosis: An Evidence-Based Guide," a standard textbook. Now Stern is the mastermind and chief medical advisor behind a mobile application to help physicians hone their diagnostic skills. Launched in 2011, Agile Diagnosis is built on the work of Stern, Cifu and Altkorn, and led by four alumni from the University of Chicago's Booth School of Business, including Agile Diagnosis Vice President of Business Development Scott Freedman, MBA'11. "We believe the timing is ripe for providers to have better data-driven, evidence-based information at their fingertips," Freedman said. "We provide interactive clinical algorithms that take the clinician from a generic chief complaint all the way to a leading hypothesis." The source of the app's content, of course, has been Stern, Cifu and Altkorn. "We needed to create extremely detailed algorithms, which was fun and natural to me," Stern said, noting an affinity going back to his own student days. Creating a good algorithm starts with an accurate information base, Stern said. At the clinical level, that means conducting a thorough physical exam. "People are good at pattern recognition, but of course have to learn the pattern first. Once they do, they can recognize a variation. In medicine this is likely to be the uncommon preuchospitals.edu/midway University of Chicago Medicine physicians Adam Cifu, MD, left, Scott Stern, MD'84, and Diane Altkorn, MD'82, developed the content for a new mobile application to help physicians hone their diagnostic skills. "We provide interactive clinical algorithms that take the clinician from a generic chief complaint all the way to a leading hypothesis." AgileDiagnosis sentation of a common disease, which all comes back to the physical exam," he said. "Learn to do it well, do it well every time and pay attention to the results, which are specific but not sensitive. We've come to rely heavily on labs, which are sensitive but not necessarily specific and too easy to misinterpret if you haven't done a good exam and history." The Agile Diagnosis app aims to level this playing field. "The app directs the physician which questions to ask, which physical exams to do and which imaging and labs to order," Freedman said. "It's like jumping into the thought process of an expert diagnostician." Startups always face long odds, but Agile Diagnosis has earned two prestigious votes of approval. In 2011 the company won a $25,000 first-place prize in the New Venture Challenge sponsored by Chicago Booth's Polsky Center for Entrepreneurship and a $50,000 grant from UChicagoTech's Innovation Fund, which supports the commercialization of promising research ideas. Agile's strategy has been to woo medical students. As of June 1, the app cost $100 per year, but users who convinced at least 20 people on their medical school campus -- students, residents or faculty members -- to sign up during the beta period received free lifetime access. The app now is being used in 150 medical schools in 10 countries, including users at 80 percent of U.S. medical schools. For more information about the app, visit agilediagnosis.com. MEDICINE ON THE MIDWAY SUMMER 2012 31 PHOTO BY LLOYD DEGRANE Renowned researcher talks about her work, time at Pritzker BY ELIZABETH GARDNER PHOTO BY BRUCE POWELL W hen Clara Bloomfield, MD'68, was just a girl playing pretend with her friends, she quickly discovered that she preferred giving shots to receiving them. That spark led Bloomfield on a path to be a physicianscientist, combining her interest in medicine and academics to become one of the world's leading leukemia and lymphoma researchers. During a recent visit to the University of Chicago to give the keynote address at a leukemia symposium, Bloomfield spoke with Medicine on the Midway about her work, her inspiration and her time at our medical school. Bloomfield comes from a family of academics: Her father was an economist, and her mother was an English and biology teacher who later became a lawyer. The bar was always set high. When she announced that she wanted to become a nurse, her mother suggested she become a doctor. Bloomfield did just that -- and more. Through her research and dogged advocacy, older leukemia patients are now treated and often cured, instead of automatically consigned to palliative care. She was one of the first to study how different types of cancer cells respond to treatment, helping lay the groundwork for personalized medicine. Bloomfield was elected to the Institute of Medicine of the National Academy of Sciences in 2000 for her work in changing the way the World Health Organization classifies cancers of What led to your interest in leukemia and lymphoma? I've always been interested in tackling problems that people were not successful tackling. When I was a child, any little children who got acute lymphoblastic leukemia would die. To see someone healthy and then die -- that was shocking to me as a child. I thought it would be cool to do something about that. Then, when I was doing a fellowship at the University of Minnesota, I analyzed 10 years' worth of data on patients with acute myeloid leukemia, and found that the longest survivor was a teenager who lasted 33 months. Here was something for me to do. I was going to cure leukemia. What do you remember most vividly about your time at the University of Chicago? There were extremely smart people here -- both students and faculty -- and we were a small class so you could really get to know the faculty. It was an exciting environment. The interns and residents who taught me, and then the ones I taught later, all made it an incredibly positive experience. Also, the curriculum was extremely academic, which many of the medical schools at the time were not. It was part of biological sciences. My biochemistry class wasn't biochemistry for doctors, but for biochemistry students. . . What advice do you have for young women entering medicine? I always sit in the front row because I can't see otherwise, and I want to see and hear every word. . . I recommend that students challenge everything they're taught. And for women, don't let others tell you what to do. You can't have people saying you can't sit in the front row. Pritzker News Clara Bloomfield, MD'68, tells young female medical students, "I always sit in the front row." the blood, from a morphological basis to a genetic one. And Bloomfield's research showed the existence of the Philadelphia chromosome in patients with acute lymphoblastic leukemia. That discovery built on the work of another distinguished researcher, the University of Chicago's Janet Rowley, who first described the Philadelphia chromosome and identified it as a distinctive marker for chronic myelogenous leukemia. (Rowley also introduced Bloomfield to the man who would later become her husband, molecular geneticist Albert de la Chapelle, MD, PhD.) Bloomfield, now Distinguished University Professor at Ohio State University, visited her alma mater in April to speak at the "Molecular and Translational Breakthroughs in Leukemia Research" symposium, held at the Knapp Center for Biomedical Discovery. She spoke about clinical use of molecular markers in curing acute myeloid leukemia. During her chat with Medicine on the Midway , Bloomfield discussed her research and her penchant for sitting in the front row. 32 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION "This was the best day of medical school so far" BY JAMIE BARTOSCH Simulation workshops for first-year students get tremendous response I t's easy to be dazzled by the state-ofthe-art technology in the new simulation workshops offered to first-year medical students at the University of Chicago Pritzker School of Medicine. But that doesn't impress Stephen Small, MD, associate professor of anesthesia and critical care, nearly as much as the impact the unique training will have on the clinical reasoning skills of these future physicians. The simulators teach students more than just technical skills -- put this tube here and that tube there. Students also learn critically important think-on-your-feet behavior, resource management, prioritization, and how to communicate and work as a team, said Small, director of UC Simulation at the University of Chicago Medicine. "We're not just training them to be interns in a few years. We're training them to be leaders. We're training them for success," Small said. "The ultimate outcome is better patient care." The workshops are the brainchild of Vikrant Jagadeesan, MS3, co-president of the Students for the Advancement of Technology in Medicine (SATIM) student organization. "I thought it would be more beneficial to preclinical students to participate in an experiential learning activity instead of the usual didactic format," he wrote in the "Pritzker Pulse." Jagadeesan and his fellow SATIM members took the idea to the staff at UC Simulation, a center serving the Biological Sciences Division, medical school, hospital, and internal and external University collaborators. (The center recently was awarded accreditation as a Level 1 Comprehensive Education Institute from the American College of Surgeons.) Small and simulation center staff members -- Saeed Richardson, associate director; uchospitals.edu/midway Stephen Small, MD, director of UC Simulation, works with Vikrant Jagadeesan, MS3, Wenjing Zong, MS3, and Asad Qadir, MS3, during their first year in medical school. Angela Blood, MPH, MBA, education specialist and simulation systems designer; and William Hrdina, technical specialist, as well as other BSD faculty and hospital staff including nurse educators -- were immediately on board. The first workshop was offered in May 2011, followed by a second workshop in November 2011 and a third in February 2012. The afternoon workshops last about five hours and allow roughly two dozen first-year students to train at five simulation stations: laparoscopic surgical skills, robotic surgical skills, ultrasound-guided central line placement, inter-professional team training, and clinical care vignettes using computerized mannequins in mock settings with actual devices, monitors and drugs. Until the advent of computerized mannequin simulators in the mid-1990s, critical care, anesthesia and emergency medicine were limited to learning on actual patients with real ongoing problems. Only recently have these tools become available to medical students. Today's high-tech computerized mannequins can be controlled by an out-of-sight teacher, who is capable of throwing all sorts of curve balls at students: What if the patient is obese? Just had a heart attack? Is taking five different medications? These and many other real-life factors that can complicate a procedure can be simulated in the training center. So can emergencies. If, during a simulated surgery, the students realize they're out of oxygen, they must think fast under pressure on how to get more oxygen. Where might the closest place be? Who would they call? Whose job is it to get it? "It provides real-time, decision-making training," Small said. "These mannequins have dozens of features. It adds a huge amount of realism and enables actual practice." Instructors can adjust the health conditions, monitor vital signs and respond to medicine administered by the students. For interns, residents and fellows, there's a debriefing session with the videotaped encounter, and sometimes a redo, using newly learned skills. Student feedback has been very positive. "The response from the students was tremendous. Some went so far as to say, `This was the best day of medical school so far,'" said Jagadeesan, noting there's now a waiting list for future sessions of the workshop. In view of the educational value in the simulation workshops, the focus is now on expanding the program. The equipment is expensive, however, and a single simulator can run into the six figures. There are additional needs for trained faculty instructors and appropriate space, Small said. In the meantime, interest in the simulation workshops has led to the creation of a new elective this spring, Technology and Medicine. "It's not just that the simulator is some cool thing to play with. This technology really advances our knowledge," Jagadeesan said. "The success so far has been beyond my wildest dreams." MEDICINE ON THE MIDWAY SUMMER 2012 33 Pritzker News Medical students flock to Dean Humphrey's class "The class allows for a lot of interaction with Dr. Humphrey, which has been an invaluable experience." BY ANNA MADRZYK Holly J. Humphrey, above left, MD'83, dean for medical education, started teaching Pritzker Morning Report in 2009. The course, which simulates resident rounds for fourth-year students, has been expanded to offer more sessions because it is so popular. H tion. So it should be no surprise that when Humphrey teaches a class at the Pritzker School of Medicine, seats fill quickly. Humphrey, dean for medical education, leads the Pritzker Morning Report, a twoweek course that simulates resident rounds and helps prepare fourth-year students for case-based learning. Pritzker Morning Report started in 2009, and was offered once a year. But the course has become so popular and Humphrey enjoys teaching it so much that PMR was expanded to three sessions for 2011-12. Students in the course learn how to present a clinical case in a morning reportstyle, problem-solving format. olly J. Humphrey, MD'83, is nationally recognized as a leader and innovator in medical educa- The sessions are moderated by the Pritzker Chiefs, fourth-year students selected by their peers to serve as class presidents and school leaders, with Dean Humphrey providing expert opinion on the cases. Manuel Diaz, MD'12, Grace Lee, MD'12, and Geoffrey Stetson, MD'12, were the 2011-12 chiefs. "The class allows for a lot of interaction with Dr. Humphrey, which has been an invaluable experience," Lee said. "Her ability to encourage us to think critically in front of our peers is what distinguishes her as an outstanding educator. "We learned so much from every case with her. Whether it was the historical context of a disease, how to read a chest X-ray or how to systematically think of a differential diagnosis, Dr. Humphrey demonstrated time and again how a master clinician and educator operates. She patiently and expertly imparted a wealth of knowledge and problem-solving skills to the class." The Morning Report course was offered in September, January and March to fourth-year students. But Humphrey and the chiefs wanted to give younger students an opportunity to learn from senior medical students, so the January session was open to second-year students for the first time. Humphrey is the winner of numerous teaching awards. She was twice honored by Pritzker students with the Hilger Perry Jenkins Teaching Award, which recognizes the most outstanding teaching and patient care. Graduating students have honored her 19 times as one of their favorite faculty-teachers. "She is thoughtful, humorous, approachable and inspiring, which is why the class has been so popular and successful," Lee said. 34 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Pritzker graduates shine as chief residents BY WENDY COLE At least nine other Pritzker graduates are completing their posts as chief residents this spring. They are: Grace Chong, MD'07, medicine-pediatrics, University of Chicago Medicine Jonathan Hron, MD'08, pediatrics, Children's Hospital Boston Matt Kalscheur, MD'08, internal medicine, University of Chicago Medicine Rachel (Sherman) Kerman, MD'08, physical medicine and rehabilitation, Rehabilitation Institute of Chicago/Northwestern University Troy Leo, MD'08, internal medicine, Stanford University Nicola (Meyer) Orlov, MD'08, MPH, pediatrics, University of Chicago Medicine Jennifer Pogoriler, MD'08, PhD'06, pathology, University of Chicago Medicine Chad Ritch, MD'06, MBA'06, urology, Columbia University Jessica (Buck) Ritch, MD'08, obstetrics-gynecology, Columbia University Colin Walsh, MD'08, internal medicine, Columbia University If you know of other Pritzker students who have recently been named to a chief resident position, please email firstname.lastname@example.org, so they can be included in future "Class Notes" pages. W hen Eric Stoltenberg, MD'08, was named chief resident at the University of Washington in the spring of 2011, he concedes he wasn't entirely sure what the scope of his new duties would mean. "I was happy and honored, but it turned out to be more demanding than I expected," he said recently, as his yearlong post was wrapping up. One of three chiefs in his training program, Stoltenberg, an anesthesiologist, directly oversaw about 35 residents who rotated through the University of Washington Medical Center. He spent about 15 hours a week on administrative, mentoring and recruiting duties on top of his regular clinical responsibilities. Some 30 emails a day needed his attention as a chief resident. But he's not complaining about the workload. "I've really enjoyed being an advocate for residents' concerns and collaborating more closely with faculty," he said. Becoming a chief resident at UW was more than an impressive recognition. It also was a hard-won victory for the Pritzker School of Medicine alumnus. Unlike many programs where faculty members select the chiefs, UW allows residents themselves to elect their chiefs. In Stoltenberg's class, there were six candidates on the ballot vying for three spots. His campaign highlighted his intent to change the call schedule so that residents worked three or four consecutive nights rather than a patchwork of overnights in any given month. "We implemented this and it has been well-liked," he said. While Stoltenberg is a standout, he's hardly alone. He's one of a dozen Pritzker alumni who just finished up their chief residency posts either at the University of Chicago or elsewhere. Holly J. Humphrey, MD '83, Pritzker's dean for medical education, hailed Stoltenberg and his fellow chief residents for the accomplishment. "To be named chief resident is a distinct honor for any medical trainee, as it indicates a high level of respect emanating from both peers and the leadership at the residency program. We are immensely proud of those many Pritzker graduates who go on to serve as chief residents." Stoltenberg, 32, says his years at Pritzker afforded him numerous leadership opportunities, paving the way for his success as a chief resident. "Because Pritzker is a small school, people learned to trust us more quickly and gave us more responsibility early on. When you get on that trajectory as a medical student, the better you will be in your career." Stoltenberg served as a teaching assistant for three classes during medical school, which further bolstered his commitment to leadership. Stephanie Y. Donald, MD'09, credits Pritzker with giving her the skill set needed to succeed as a chief resident in emergency medicine at Harbor-UCLA Medical Center. "I developed a way of thinking at Pritzker that helped enormously as a chief resident. I learned to step up and stand up for what I knew was right for patients," said Donald, 29. Next she'll be working toward a master's in public health at George Washington University, in addition to taking on a health policy fellowship and serving as an attending physician at GWU. At Brigham and Women's Hospital in B oston, Paul VanderLaan, MD'08, PhD'06, said he felt "a twinge of regret" as his duties as chief resident in pathology concluded. "It was a really gratifying experience to serve as a junior captain for my peers," said VanderLaan, 34. Pritzker's influence at UW won't disappear now that Stoltenberg is finished. The next group of chiefs includes Tim Miu, MD'09, an alumnus from the class behind him. "It's great that Pritzker will still be represented here when I'm done," said Stoltenberg. 35 uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 Pritzker News T Pritzker students awarded Schweitzer Fellowships wo Pritzker School of Medicine students selected for the prestigious Schweitzer Fellowship will spend the next year helping improve health and well-being in underserved Chicago communities. Christopher Castaneda, MS3, and Alisha Ranadive, MS3, were chosen from among a record number of applicants for the fellowship, named in honor of famed humanitarian and Nobel laureate Dr. Albert Schweitzer. The program gives students the opportunity to design and implement innovative yearlong projects to address serious health challenges in the community. Working in collaboration with community organizations, schools or clinics, each fellow will provide 200 hours of direct service. from a similar background is vital for a younger student trying to achieve similar success," Castaneda said. Ranadive, who previously taught at the Sherman School of Excellence in Chicago through the City Year (AmeriCorps) Program, will strive to strengthen the middle school's science curriculum by engaging students with hands-on learning activities. "It is well-documented that education can have a high impact on health outcomes," she said. Since the Chicago Area Schweitzer Fellowship Program began in 1996, 435 fellows not only have contributed more than 87,000 hours of service, but the majority remain engaged with helping people in underserved neighborhoods after the fellowships end. Alisha Ranadive, MS3 Christopher Castaneda, MS3 Castaneda will work to encourage high school students to excel in school and develop their interest in the life sciences. Increasing diversity in the health care workforce will improve access and culturally competent care in diverse, underserved communities. "Having a mentor who has had success and comes Medical students inducted into honor society 20 members of the Class of 2012 inducted into Gold Humanism Honor Society T wenty University of Chicago Pritzker School of Medicine fourthyear students were inducted into the Gold Humanism Honor Society this spring. The honored students are recognized for excellence in clinical care, leadership, compassion and dedication to service. The Gold Humanism Honor Society Class of 2012 members are Jessica Beaman, MPH, Manuel Diaz, Tien Dong, Adam Edelstein, Enrique Escalante, Laura Hodges, Sarah Horvath, Andrew Hughey, Chidubem Iloabachie, Kyle Karches, Philip Knollman, Grace Lee, Rebecca Levine, Andrew Levy, Patrick Lyons, Margaret (Moore) Nolan, MS, Laura Stephens, Geoffrey Stetson, Philippe-Gerard Tapon, and Maureen Willcox. The inductees were nominated by their peers and selected by a committee that includes faculty and medical school staff. The Pritzker School of Medicine established its chapter of the Gold Humanism Honor Society in 2005 to recognize senior medical students who "model, encourage and sustain the values of humanism and professionalism." 36 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Latrice Triplett, MD'12, left, and Michelle Stacey, MD'12, celebrate on Match Day. Looking forward, reflecting back Pritzker's Match Day elicits giddiness, joy and even a few tears BY DARCY LEWIS T his year's Pritzker School of Medicine graduates have something extra to cheer about: The Class of 2012 received its medical education from a Top 10 medical school. It is an honor that was celebrated at this year's Match Day, when fourth-year medical students throughout the country find out where they will be training for the next three to 10 years. Pritzker placed at No. 10, up from the 12th spot last year and from 22nd in 2004, in the latest U.S. News & World Report rankings of research-focused medical schools. "I get many letters from '70s and '80s alumni that start with `I was a student when this was a Top 10 medical school. . .' And now it is again," Holly J. Humphrey, MD'83, dean for medical education, told applauding students at Billings Auditorium during Match Day festivities on March 16, 2012. All 99 members of the Class of 2012 matched with a residency program. Of those, a third (33) will stay at the University of Chicago Medicine for all or some of their training. Other top destinations include the University of California, San Francisco (UCSF) (10), Northwestern-affiliated hospitals (7), and Harvard University-affiliated hospitals (6). Once again, internal medicine was the most frequently selected specialty, attracting 26 Pritzker students. Other popular specialContinued on page 38 uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 37 PHOTO BY BRUCE POWELL Pritzker News Marcus Dahlstrom, MD'12, shows off his Match Day letter. Katherine Given, MS2, gives Stephanie McCann, MD'12, a big hug on Match Day. Jessica Beaman, MD'12, beams with joy. Vadim Koshkin, MD'12, left, Shawn Patel, MS4, and Chidubem Iloabachie, MD'12, join in the celebration. Continued from page 37 ties were anesthesiology (7), orthopaedic surgery (7), general surgery (6), emergency medicine (5), psychiatry (5), and diagnostic radiology (5). Students wore class T-shirts designed by Ting-Wa Wong, MD'57, PhD'70, associate professor of pathology. The whimsical drawings depict the year-byyear metamorphosis of a medical student, from a bright-eyed first-year to a newly minted MD, in turtle form. "The turtle has the reputation of being steadfast and a winner at the end. The metamorphosis into a self-assured, insightful physician is complete," Wong said. Following brief remarks by Sharon O'Keefe, president of the University of Chicago Medical Center, this year's Pritzker Chiefs -- Manuel Diaz, MD'12, Grace Lee, MD'12, and Geoffrey Stetson, MD'12 -- narrated a slide show, "MS12 Through the Years," that elicited much laughter and applause. As the fateful hour approached, Joel Schwab, MD, director of medical school performance evaluation, called each student to receive his or her sealed envelope. The second-to-last student received a giant Hershey's bar along with the envelope, while the nail-biting anxiety of the final student's wait was eased by another tradition -- collecting the small kitty that made the rounds of classmates, faculty and staff earlier during the festivities. At precisely 11 a.m., the room's dead silence quickly gave way to a buzz of excitement, punctuated by screams, squeals and whoops, as students opened the envelopes. "The months and weeks leading up to Match Day are filled with great anticipation, stress and excitement for the momentous occasion that occurs when each student opens his or her Match Day envelope," Humphrey said. "As an educator, I am immensely proud. As an alumna, I still remember the moment with great clarity, and so I can empathize with our students' emotions." 38 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION PHOTOS BY BRUCE POWELL Colleen Denny, MD'12, hadn't planned on becoming a physician, but her time at the National Institutes of Health as a bioethics fellow led her on a path to the Pritzker School of Medicine. The road to becoming an MD Colleen Denny, MD'12, reflects on the juxtaposition of clinical medicine and public health BY DARCY LEWIS A s far as Colleen Denny, MD'12, is concerned, Match Day at the Pritzker School of Medicine is just right, in a Goldilocks, whew-what-a-relief kind of way. "I've heard some medical schools just have students come pick up their envelopes any time after noon on Match Day and that doesn't seem festive," she said. "I've also heard of schools that have each student read their match out loud as they open the envelope, which seems really stressful. "We get a nice balance between these two extremes," said Denny, who matched at the University of California, San Francisco (UCSF), in obstetrics-gynecology. Many of Denny's classmates probably dreamed of this moment for as long as they could remember, but her path to medicine was a bit less straightforward. "Medical school wasn't even on my radar," she said. "I thought the main reason to get an MD would be if I wanted a career as a primary care clinician, which I didn't." Instead, the Duke University alumna, who graduated in 2005 with a psychology degree and a neuroscience emphasis, worked as a National Institutes of Health bioethics fellow for three years after college. "We served as the ethics consult service for all of NIH -- any researcher can get a same-day consult, since we were always on call," she said. "The work was unbelievably fun and rewarding. I met so many MDs there doing public health advocacy that I began to see that medical school could be a helpful step for a variety of career paths." At the NIH, Denny worked closely with Ezekiel Emanuel, MD, PhD, a bioethicist, breast oncologist and former member of the Obama administration. Emanuel, whose brother is Chicago Mayor Rahm Emanuel, now is the Diane and Robert Levy University Professor at the University of Pennsylvania. Denny, who co-authored several papers with the bioethicist, explains how Emanuel became her role model. "I think about Zeke's career a lot, and how he worked as a clinician before using that clinical experience as he tried to fix the entire U.S. health-care system," she said. "When you practice first, you bring the voice of experience to your later public health work." Ob-gyn was a natural fit for Denny. "Medically, I enjoy the huge variety of conditions, from complicated pregnancies to infertility to cancers, but what I really love is talking to women and helping them through whatever hard choices they may face," she said. "And medicine is a great way in which to be actively involved in those choices and understand them from an epidemiological perspective as well." 39 uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 PHOTO BY BRUCE POWELL SNAPSHOTS FROM REUNION WEEKEND 2012 Pritzker News Members of the Pritzker Class of 2002 during their class celebration on Friday, June 1. Award winners pose with deans and alumni leaders. Leon R. Kass, LAB'54, SB'58, MD'62; Elliott Sigal, MD'81, PhD; Douglass Given, PhD'79, MD'80; and Ruth Covell, MD'62; along with Kenneth S. Polonsky, MD, the Richard T. Crane Distinguished Service Professor and Dean of the Biological Sciences Division and the Pritzker School of Medicine; Holly J. Humphrey, MD'83, dean for medical education at the Pritzker School of Medicine; Paul Rockey, MD'70, MPH, National Reunion Chair; James W. Vardiman, MD, professor of pathology, director of hematopathology, University of Chicago, who received the Gold Key Award for faculty service; and Robert M. Doroghazi, MD'77, president of the Medical & Biological Sciences Alumni Association. Not pictured: Gold Key Award recipient Robert L. Wollmann, PhD'68, MD'69, professor of pathology and director of neuropathology at the University. Friends reunite at the Alumni and Family Luncheon in the Courtyard on Saturday, June 2. For information about how to support groundbreaking research at the University of Chicago Medicine and Biological Sciences Division, please contact: Heather Mendelson at email@example.com. 40 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION PHOTOS BY TRICIA KONING F Alumni returned to campus in June to reconnect and celebrate accomplishments our alumni were honored with Distinguished Service Awards during this year's Reunion Weekend events. Pictured, left to right, are award winners Alumni take a hard-hat tour of the new hospital, which is opening in January 2013. uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 41 NEWS Class Notes Alumni, get the latest news and stay connected with your classmates through the new Medical & Biological Sciences Alumni Association (MBSAA) website at medbsd.uchicago.edu/ alumni. Is medicine still a good profession? Esteemed physician Paul Jordan, SB'41, MD'44, offered his views about whether medicine is still a good profession in a speech that he delivered recently. He graciously offered to allow Medicine on the Midway to post the entire essay online. It can be found at uchospitals.edu/paul-jordan.pdf. Jordan, who moved to Houston in 1964 and became a professor of surgery at Baylor College of Medicine, made a number of advancements to the art of surgery during his distinguished career, along with authoring close to 200 peer-reviewed articles in scientific journals. "Dr. Jordan's seven-decade perspective is both inspiring and insightful. Each period has, in its own way, been a golden age for a career in medicine. Today is no exception, and, I would argue, perhaps the most exciting time of all," said Jeffrey B. Matthews, MD, surgeon-in-chief, chair of the University of Chicago Medicine Department of Surgery and the Dallas B. Phemister Professor. up with medical news, watching sports on TV, and life with my beautiful wife, big mastiff named Zena, and kids and grandkids who come for visits. I am 93." Daniel Offer, MD'57, retired from Northwestern University on September 1, 2008. The next day he and his wife, Marjorie, moved to Seattle (Mercer Island) to be close to family. He is professor emeritus of psychiatry and behavioral sciences at Northwestern's Feinberg School of Medicine. He has been appointed to the Advisory Board of Mercer Island's Commission on Youth and Family Services. In July 2011, his latest book was published -- "The Leader: Psychological Essays" (Springer, New York, 2011). Sandy Schreiber, MD'58, writes, "Went on an around-the-world trip -- Amazon, Easter Island, New Guinea, Cambodia, China, India, Tanzania, Petra, Istanbul, London. My bucket list. It was thrilling." 1940s Harry Oberhelman, SB'46, MD'47, survived surgery for a ruptured abdominal aortic aneurysm and is back to work as medical director of the Stanford Hospital & Clinics International Medical Services program. He is 88. Janet Rowley, LAB'42, PhB'45, SB'46, MD'48, was recognized by the American Society of Hematology with the 2011 Ernest Beutler Lecture and Prize for significant advances in the diagnosis and treatment of chronic myeloid leukemia. This distinguished prize is named for another alumnus, the late Ernest Beutler, PhD'46, SB'48, MD'50, who was a physician-scientist for more than 50 years. Buel L. Sever, MD'43, shared this: "After graduation from UChicago, I interned at Merchant Marine Hospital in Seattle. Then as first lieutenant I transferred to Carlisle, Pennsylvania, for medical officers' training. Then back to Fort Lewis, Washington (Madigan Hospital). From there I was sent to Camp Kilmer, New Jersey, then in 1944 to England for a short time and then on to Germany to work on the hospital train, picking up injured soldiers from Germany to Paris to Belgium. ... It was dangerous travel -- overhead planes and bombs were a reality. The train passed concentration camps where most were more dead than alive. ... Memories haunt me to this day. In 1945, while working at an aid station, an army vehicle came to take me to Nuremberg to be a physician during the trial of the major war criminals. ... I was medically responsible for the 21 Nazi criminals on trial as well as caring for those on the jury. We never did find out how Hermann Goering got a hold of the cyanide he ingested the night before he was to be hanged in 1946. When the trials ended, I came home to my wife of six years, Luana (now married for 71 years!). We began a family in 1947, and after practicing in Pullman, Fort Lewis, and Tillicum, Washington, I found the perfect office to rent in Fircrest, Washington, in the early '50s -- the first doctor there. . . . I began by making house calls, then grew my family practice, surgery, and OB practice with time. . . . With the onset of managed care and other things that hindered a free practice of medicine, I retired in 1987 after 37 years. I enjoyed golf until several years ago when the arthritis got the better of my joints, but not before making seven holes-in-one. I enjoy reading, keeping Glenn R. Hodges, MD'67, delivered the baccalaureate address at Muskingum University in New Concord, Ohio, in May 2011. In recognition of his lifetime of achievement, the university bestowed upon him the honorary degree of doctor of humane letters. In his address, Hodges stressed the importance of finding a passion in life that motivates service to others. "We are here to serve all people, not just those who are like us," he said. Hodges is retired from a practice as an infectious disease specialist and faculty member of the University of Kansas Medical School. Dennis Wentz, MD'61, edited a book titled "Continuing Medical Education: Looking Back, Planning Ahead." A review in the Journal of the American Medical Association called the book "a comprehensive examination of the past, present, and potential future of CME" and "a must-read for anyone with responsibility for, or a keen interest in, CME." 1970s Eugene C. Corbett, Jr., MD'70, has been selected to receive the Jane F. Desforges Distinguished Teacher Award from the American College of Physicians. The award is bestowed upon a fellow or master of the college who has demonstrated "the ennobling qualities of a great teacher as judged by the acclaim and accomplishments of former students." Corbett teaches medicine at the University of Virginia. Mark L. Friedman, AB`73, MD'77, is co-founder and chief medical officer of First Stop Health (fshealth.com). Together with fellow Shorey House resident and entrepreneur Patrick Spain, AB'74, and Ken Anderson, Friedman is aiming to make health care simpler, more transparent, and less expensive. While practicing emergency medicine for the past 32 years, Friedman started four health care-related companies and wrote two books, "Everyday Crisis Management" (First Decision Press, 2002) and "Medical Care for the Uninsured" (Alpha / Penguin, 2008). His latest book, "A User's Guide to the Health Care System," will be available as an e-book and can be previewed at fshealth.com/blog/. Friedman recently was appointed assistant professor of emergency medicine at the new Frank Netter School of Medicine (Quinnipiac University). In his spare time, he enjoys bicycling, rowing, and racing sailboats. H. Eugene Hoyme, MD'76, chief pediatric medical officer at Sanford Children's Hospital, has two honors to share. In March 2011, he received the Joseph W. St. Geme, 1950s Shamay "Sam" Cotev, MD'57, wrote, "I am now fully retired from both clinical and academic involvement, but still occasionally active as advisor to our Ministry of Health in Israel. I am fully occupied, however, with family ties -- wife, Edna, four adult children, and 13 grandchildren -- and I love it! Best wishes to my teachers and classmates." Cotev is 80. Walter Eidbo, MD'56, has been retired for five years after 50 years of practicing as a general surgeon. John A. Jane, Sr., BA'51, MD'56, PhD'67, represented the University of Chicago at the inauguration of Teresa Sullivan as the eighth president of the University of Virginia. Jane is a professor of neurosurgery and director of the Neurosurgical Training Program at the University of Virginia, where he maintains an active surgical practice. He also is the editor of the Journal of Neurosurgery, Journal of Neurosurgery: Spine and Journal of Neurosurgery: Pediatrics. 1960s William C. Allen, MD'60, was recognized recently by Becker's Orthopedic, Spine & Pain Management Review, in its "125 Knee Surgeons and Specialists to Know." Allen is a professor emeritus of orthopaedic surgery at the University of Missouri School of Medicine. He has a professional interest in total joint replacement and sports medicine, and is a past president of the American Orthopaedic Society for Sports Medicine. 42 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION NEWS Jr., Education Award (a national award), presented by the Western Society for Pediatric Research at its annual meeting in Carmel, California. Then, after a national search, in August he was named president of Sanford Research/ USD (University of South Dakota). Joel Kleinman, SB'66, MD'73, PhD'74, deputy chief of the Clinical Brain Disorders Branch at the National Institute of Mental Health, was awarded the Leiber Prize for Schizophrenia Research by the Brain & Behavior Research Foundation. For more than three decades, he has built a unique collection of post-mortem human brains that has enabled pioneering studies into the molecular roots of schizophrenia -- and recently a landmark database that holds secrets to how genetic variation affects brain structure and function. William Lawson, MD'78, is investigating barriers that prevent minorities from receiving necessary mental health care. Lawson is chair of the Department of Psychiatry and Behavioral Sciences at Howard University Hospital and in Howard's College of Medicine. Through this joint five-year study with researchers at Dartmouth College, Lawson hopes to improve mental health and substance abuse services offered to African Americans. Stephen D. Nimer, MD'79, has been named the new director of the Sylvester Comprehensive Cancer Center. Nimer, the Alfred P. Sloan Chair in Cancer Research at Memorial Sloan-Kettering Cancer Center, assumed the key University of Miami Miller School of Medicine and UHealth-University of Miami Health System post this spring. Audrius V. Plioplys, MD'75, was honored in December at the 45th Excellence Award Dinner hosted by the Balzekas Museum of Lithuanian Culture for contributions to neuroscience, neurology and art, and for his dedication to preserving the memory of the victims of Soviet deportations. In addition to his art and research, for the past 20 years, he has dedicated himself to caring for children and young adults with severe cerebral palsy. Burton VanderLaan, MD'77, was named medical director for network effectiveness at Priority Health in Grand Rapids, Michigan, in December. He is a fellow of the American College of Physicians and is board certified in both internal medicine and oncology. 1990s GOING GREEN Do your prefer to receive your Medicine on the Midway via email? We would be glad to send you an electronic version and save some trees in the process. If you would like your next editions emailed, please send us a note at firstname.lastname@example.org. In addition to sending the note from your preferred email address, please include your full name and street address, so that we can confirm the switch to your email account. Brian Cole, MD'90, MBA'90, was recognized by Becker's Orthopedic, Spine & Pain Management Review, in its "125 Knee Surgeons and Specialists to Know." Cole is the head of the Cartilage Restoration Center at Rush University Medical Center. He also serves on the board of the American Academy of Orthopaedic Surgeons and spends time as a team physician for the Chicago White Sox and Chicago Bulls. Vincent S. DeGeare, MD'92, is an interventional cardiologist in Louisville, Kentucky. He and his wife, Doreen, have two teenage children, Eric and David. Jonathan Sherin, PhD'97, MD'98, has joined Volunteers of America, one of the nation's oldest and largest human service charities, in the newly created role of executive vice president for veterans affairs and chief medical officer. Sherin will guide the organization's continued expansion of services that target challenges facing veterans, including post-traumatic stress, depression, mild traumatic brain injury, substance abuse, homelessness, suicide, workforce development, and education. William P. Welbourne, MD'72, retired from his position as director and founding member of a medical group in rural upstate New York. He is working as a staff physician for the Department of Veterans Affairs. Gail Whitman-Elia, AB'71, MD'76, founder of the Advanced Fertility & Reproductive Endocrinology Institute in West Columbia, South Carolina, announced in January that she was opening a new center -- a 14,000-square-foot facility that is the most technologically advanced of its kind in the Southeast. extreme environmental and comparative physiology, as well as the history, personalities and stories of discovery associated with them. Laura Niklason, PhD'88, is a professor at Yale University and founder of Humacyte Inc. In October, Humacyte's new technology to create off-the-shelf human veins for use in lifesaving vascular surgeries was recognized by Popular Mechanics magazine as one of the "Breakthrough" innovations of 2011 that is "changing our world for the better." The development and function of these readily available bioengineered veins also were featured in the February 2011 edition of Science Translational Medicine. Larry Ozeran, MD'86, published a book, "H.I.T. or Miss: Lessons Learned from Health Information Technology Implementations." Along with his co-authors, he presents 17 actual (but anonymous) cases of health information technology (HIT) implementations -- highlighting specific failures and how they might have been avoided. Each chapter can generally be read by a busy professional in less than 15 minutes. Ozeran is president of Clinical Informatics Inc. He also serves as associate clinical professor in the Health Informatics Program at University of California Davis, chair of the Yuba-Sutter Healthcare Council; and as a member of the Cal eConnect Policy Advisory Group, the Physician Advisory Council for CalHIPSO, and the AMIA Public Policy Committee. Tej M. Singh, AB'89, MD'93, was selected by the Society for Vascular Surgery to participate in a key surgical rotation at Landstuhl Regional Military Center (LRMC) in Germany this past October. He volunteered his vascular surgical services and provided education to the medical staff at LRMC, a level 1 trauma center and the largest U.S. hospital outside of America, in order to better care for the wounded warriors from Iraq, Afghanistan and Libya. 1980s Robert A. Behar, LAB'81, AB'83, MD'87, MBA'11, wrote, "Life is good. After spending four years at Stanford, I moved to Houston and started a private practice in radiation oncology. This eventually led me to founding a general acute care hospital, which I currently administer. In the middle of all of this I got married and had two beautiful children. Last year, I went back to school to get an MBA at the UChicago business school. After 25 years in medicine I am slowly winding down my clinical practice to focus more on business and administration." Bruce A. Beutler, MD'81, not only received the Nobel Prize in Medicine in 2011, but also was awarded the Shaw Prize in Life Science and Medicine, another international award dedicated to furthering societal progress, enhancing quality of life, and enriching humanity's spiritual civilization. Richard Jacobson, PhD'80, MD'82, writes that after 20 years in Milwaukee, he has left academia and now is in practice in Charlotte as a staff physician at Novant Health/Presbyterian Medical Group. James Munis, AB'82, MD'86, recently published a physiology textbook through Oxford University Press/ Mayo Scientific Press titled "Just Enough Physiology." The book is written for a general audience as well as medical and scientific readers. It takes a rather unorthodox approach to medical education by highlighting 2000s Todd Cassese, MD'04, has been appointed assistant professor of medicine and director of the Clinical Arts and Science course at the Frank H. Netter, MD, School of Medicine at Quinnipiac University in Connecticut. A specialist in creating progressive curricula, he will oversee the clinical skills taught to first- and second-year medical students. "We'll be developing community service models that are going to help students become patient-centered primary care physicians," Cassese said, adding that medical students will see patients during all four years of medical school. Martha Gulati, SM'02, who completed her internship, residency, and cardiology fellowship at the University of Chicago, was honored for her commitment to women's heart health by Woman's Day magazine during the Red Dress Awards ceremony at Lincoln Center in New York City in February 2012. Gulati, who is Ohio State Medical Center's director of preventive cardiology and women's cardiovascular health, said, "I am honored to be among the women Continued on page 44 uchospitals.edu/midway MEDICINE ON THE MIDWAY SUMMER 2012 43 NEWS Continued from page 43 Class Notes receiving this award, and I hope my research has contributed to women being more aware of their risk for heart disease and how to prevent it." Jill Marie (Kapplinger) Huber, MD'08, received the 2011 LeeAnn McCaffrey, MD, Women in Medicine Award from the Mayo School of Graduate Medical Education in Rochester, Minnesota. The award recognizes excellence in the internal medicine residency program. After completing her residency at the Mayo Clinic in July 2011, Huber assumed a position in the Division of Primary Care Internal Medicine at the Mayo Clinic, Rochester. Sawsan (Susie) Salman Kara, AB'98, MD'02, writes that she is happily married with two young children and working as a general pediatrician in the San Francisco Bay Area. Amber T. Pincavage, MD'07, gave an oral research presentation titled "Risk of Resident Clinic Handoffs: Showing Up Is Half the Battle," based on her MERITS project at the 2011 Society of General Internal Medicine spring meeting. At the time she was ambulatory chief resident, internal medicine, at the University of Chicago Medicine. She now is assistant professor of medicine and co-clerkship director for internal medicine at the University. She is especially interested in primary care for underserved populations and internal medicine ambulatory training. Francisco Ponce, MD'04, is featured on a new medical website, Barrow50. org. Ponce is a neurosurgeon at the world-class Barrow Neurological Institute at St. Joseph's Hospital and Medical Center in Phoenix. He is focusing on the use of deep brain stimulation to treat depression and other conditions such as Alzheimer's disease. Sandra A. Weiss (D'Amore), MD'04, has joined the Christiana Care Center for Heart & Cardiovascular Health in Delaware. In addition to medical school, Weiss also completed her fellowship in cardiovascular medicine at the Pritzker School of Medicine at the University of Chicago. Melissa Weston, MD'11, is the first author of an article, "Factors influencing uptake of intrauterine devices among postpartum adolescents: a qualitative study," which appeared in the American Journal of Obstetrics & Gynecology. Joshua Williams, MD'11, published an article titled "Attention to Inpatients' Religious and Spiritual Concerns: Predictors and Association with Patient Satisfaction" in the July 2011 Journal of General Internal Medicine. In Memoriam Alwyn T. Andrew-Mziray, AB'94, MD'00, IMB'00, passed on suddenly at age 39 in Zanzibar, Tanzania, in February 2011. Andrew-Mziray had returned to his native Tanzania in 2009 to help pioneer the specialty of emergency medicine. His passion, energy, and enthusiasm played a critical role in co-founding the Lake Tanganyika Floating Health Clinic and establishing a new emergency department at Muhimbili National Hospital and an emergency medicine residency program at the Muhimbili University of Health and Allied Sciences, both in Dar es Salaam, Tanzania. These accomplishments represent a major step forward for emergency care in East Africa. Previously, Andrew-Mziray worked in health care banking on Wall Street, as a health care consultant and as principal at a private equity group that focused on global pandemics. He co-founded the American chapter of the Tanzanian AIDS organization WAMATA, and served on the board of Operation Smile in New York. Joseph H. Coggin, Jr., PhD'65, professor emeritus of microbiology and immunology at the University of South Alabama (USA) College of Medicine, died on August 21, 2011, at age 73. Coggin was well known in the medical community for his research into therapies and potential vaccines for cancer. He served as associate dean for basic medical sciences at USA and chair of microbiology and immunology. His research led to the development of potential cancer vaccines and cancer detection technology. Coggin's work was funded by the National Institutes of Health and the National Cancer Institute for more than 40 years. He also was section chief of tumor immunology for the Oak Ridge National Labs in Oak Ridge, Tennessee. Coggin is survived by his wife, Sharon Scroggs Coggin, four children, and seven grandchildren. Thomas Frew Ednie, AB'51, SB'53, MD'55, passed away on April 26, 2011, in Idaho. Ednie spent much of his career in the U.S. Air Force, including some years at Walter Reed Army Hospital in Washington, D.C., where he was chief of neuropsychiatric service for the largest inpatient psychiatric unit in the USAF. He also served as chair of the Neuro-Psychiatric Department of a teaching hospital at Travis Air Force Base. Following his retirement from the USAF, he worked for a brief period at Napa State Hospital in California before opening a private practice, which continued for six years. Ednie served two years as a Jesuit volunteer, working as a bus driver and maintenance man for the Colville Confederated Tribes at Paschal Sherman Indian School, as a means of catching his breath and realigning his life into something consistent with his later life goals. He chose to practice psychiatry in Sandpoint, Idaho, where there was great need. He retired after 15 years, following quadruple coronary bypass surgery in 1995. He is survived by his wife of nearly 59 years, Natalie (they married while they were both students at the University of Chicago), six children and 12 grandchildren. Allan M. Goldberg, PhB'45, MD'52, died November 13, 2011. He received a bachelor of philosophy degree with highest honors at the age of 17. He enlisted in the U.S. Navy, and served on the aircraft carrier USS Badoeng Strait, where he managed radar, sonar, and electrical activities. Upon his discharge, he received the WWII Victory Medal. After the war, he returned to the University, where he met Gretchen Hartmann, AB'47, SB'51, MD'52, and the pair married during their last year of medical school. Goldberg performed research in diabetes and used radioactive iodine from the Manhattan Project in Oak Ridge for treatment of thyroid disease. He also studied exfoliative cytology in the treatment of bowel cancer. Hartmann developed incomplete quadriplegia during her residency, and with family help, Goldberg cared for her at home for 40 years. After Hartmann's death in 1993, he donated a professorship in neurology at the University of Chicago in her memory. Goldberg had a private practice in internal medicine for four decades. While chief of medicine at Ingalls Hospital in Harvey, Illinois, in 1968, he built the first coronary care unit in the south suburban area. In 1996, he was a charter member of the Harper Society, a major philanthropic society at the University of Chicago. At the time of his death, he made major gifts in his beloved wife's memory, intended to support technology, patient care, and research at the University. Michael F. Golden, MD'58, of Phoenixville, Pennsylvania, died February 22, 2012, at age 80. Golden served in the U.S. Army during the Korean War and had his own practice in psychiatry for many years. He is survived by his children, Catherine Del Tito, Julie Golden, and William Golden; five grandchildren; one great-grandchild; and his sister, Margaret. Norman Graff, SB'47, MD'48, passed away on December 27, 2011, at his California home. Phyllis, his wife of 65 years, was at his side. Born in Chicago in 1921, he enlisted in the Army after graduation from Chicago Teachers College and served during the Korean War at a medical center for federal prisoners. Graff had a successful private practice of psychiatry in California for many years. He retired at 65, but then joined the Veterans Administration Hospital at Menlo Park to serve in the PTSD program for 10 years. He served as president of the Northern California Psychiatric Society, and received multiple honors, including a Distinguished Life Fellowship from the American Psychiatric Association. He was on the clinical faculty of Stanford University. Graff enjoyed sailing, painting, woodworking, photography, ceramics, music and world travel. His family was the most important thing in his life. He is survived by his children, their spouses, and eight grandchildren, in addition to his wife. Abhninav Kapur, MS3, died suddenly on March 25, 2012. A medical student, Kapur served on the executive board of the New Life Volunteering Society Free Health Clinic, a student-run free health clinic in Chicago's West Rogers Park neighborhood that serves a diverse, uninsured population. His international humanitarian work consisted of both scholarship and service, including community research in Hyderabad, India. While an undergraduate, he was a member of Engineers Without Borders, using his technical expertise to bring practical and sustainable contributions to communities worldwide. William A. Kisken, MD'58, passed away in January 2012, at age 79, at Gundersen Lutheran Medical Center in La Crosse, Wisconsin, the hospital to which he dedicated decades. Kisken was a medical pioneer who performed Wisconsin's first cadaver kidney transplant in 1965 and the state's first living-donor transplant. In 1970, he performed LaCrosse's first kidney transplant. Kisken retired in 1997. He missed medicine but had more time for such hobbies as carving, something that came naturally for the surgeon. He is survived by his wife, Mary; sons Peter, William and Tom; and daughter, Sara French, as well as other family members. Lloyd Kozloff, SB'43, PhD'48, an influential microbiologist, died March 10, 2012, of heart failure at his California home. He was 88. Born in Chicago in 1923, Kozloff earned his bachelor's degree in biochemistry when he was 19. After a stint in the Navy during World War II, he returned to the University of Chicago, where he earned his doctorate and immediately was asked to join the Biological Sciences Division faculty. He was promoted to full professor in 1961. Kozloff's work on bacteriophages helped lay the foundations of modern virology. He was a member of the "phage group," a network of scientists that included Nobel laureates Salvador Luria and James Watson. Kozloff's research focused on the biochemistry of virus replication and 44 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION helped pioneer the use of isotopic tracer techniques in biological systems. Throughout his career, he published 85 scientific papers in journals and 16 scientific reviews. In 1963, Kozloff joined the faculty of the University of Colorado Health Sciences Center in Denver as professor of microbiology. In 1967, along with two colleagues, he co-founded the Journal of Virology, a leading scientific periodical, which plans to publish an overview of his contributions. Kozloff moved to the University of California, San Francisco, Medical Center in 1980, where he served as dean of the graduate division from 1981 to 1991. He retired in 1993. In 2005, the University of Chicago's Medical & Biological Sciences Alumni Association honored him with the Distinguished Service Award for outstanding leadership and significant contributions to the Biological Sciences Division. He is survived by his wife, Bonnie, of 65 years; two brothers; four children; and six grandchildren. Richard "Rich" Lazar, MD'91, a spine surgeon, died on April 1, 2011, at age 52, from injuries sustained while skiing in Canada. Lazar was a partner in Colorado Springs Orthopedic Group. He was an avid sportsman and athlete who played junior hockey in Canada and captained the University of IllinoisChicago hockey team. His passion for skiing, golf, and outdoor adventures was second only to his love of family. He is survived by his wife of 27 years, Jennifer Simon, and his three sons, Gordon, Glenn, and Drew. Jack L. McCleery, MD'62, lost his battle with cancer on January 17, 2011, at age 74. In 30 years of practice in internal medicine at Dartmouth Hitchcock Medical Center (DHMC), McCleery had a major impact on the development of the Section of Gastroenterology. He was the first to introduce modern flexible endoscopy to the DHMC. Over the course of his career, he instituted innovative procedures, such as the specialized endoscopic technique of ERCP, which allows imaging and therapy of the bile ducts and pancreas, and had never before been performed in northern New England. McCleery had a special interest in caring for patients with inflammatory bowel disease, such as Crohn's and colitis, and he participated in a landmark study, published in the New England Journal of Medicine, that defined Crohn's disease severity. He served as chief of the Section of Gastroenterology at DHMC from 1988 to 1997, retiring in 1998. McCleery was a beloved teacher and mentor at Dartmouth Medical School, where he served on the admissions committee. He loved crossword puzzles, reading, golf, and playing the piano and guitar. He is survived by his wife, Virginia McCleery, his daughter, son, and four grandchildren. James S. Miles, MD'45, passed away in Jacksonville, Florida, on April 13, 2012, just before his 91st birthday. He graduated Phi Beta Kappa from Grinnell College in 1942 and enlisted in the Navy in 1941. After two years of active duty in the Navy's medical services, Miles returned to the University for his orthopaedic residency. In 1952, he joined the University of Colorado Medical School Department of Surgery, where he headed the Division of Orthopaedic Surgery. He served as chairman of the newly formed Department of Orthopaedics at the University of Colorado Medical Center from 1973 to 1986. Miles trained and mentored orthopaedic surgeons and consulted with medical schools around the world, helping them develop orthopaedic training programs. In 1986, he moved to San Diego, where he provided orthopaedic consultation at the Scripps Memorial Hospital and the San Diego Veterans Administration Hospital. He retired from professional practice in 2005 and moved to Amelia Island, Florida. Among his many interests were the history of medical education and Western history. He collaborated with the National Park Service, analyzing skeletal remains from the Anasazi ruins of Mesa Verde in southwestern Colorado. He is uchospitals.edu/midway Joseph B. Kirsner, MD, PhD, 1909-2012 Joseph B. Kirsner, the Louis Block Distinguished Service Professor of Medicine, died from kidney failure at his home in Chicago on July 7, 2012. He was 102. After coming to the University of Chicago in 1935, Kirsner helped transform the field of gastroenterology from an art into a science. He was a pioneer in understanding the immunology and genetics of inflammatory bowel disease and was one of the first to show the increased risk of colon cancer in patients with ulcerative colitis. He was also a mentor and a role model for physicians learning how to care for patients. Every gastroenterologist should feel "at least slightly indebted to Joe Kirsner," said Stephen B. Hanauer, MD, the Joseph B. Kirsner Professor of Medicine. survived by his wife, Carolyn, and Carolyn's daughters, Carol Delaney and Kristin Allen, their children, grandchildren and great grandchildren. He also is survived by his former wife, Jean Miles, and their children, Pat Miles Patterson, Dick Miles, Steve Miles, and Paul Miles, their children, and a great-grandchild. James W. Moulder, SB'41, PhD'44, died on May 6, 2011. A microbiologist at the University of Chicago for more than 40 years, Moulder performed groundbreaking research on many infectious and parasitic diseases, serving as chairman of the University's Bacteriology and Parasitology Department, and later the Microbiology Department. Moulder was a Guggenheim Foundation fellow and a senior Fulbright scholar at the University of Oxford. He received the Eli Lilly Award in bacteriology and immunology in 1954 and was editor of the Journal of Infectious Diseases from 1957 to 1968. After retirement from the University, which honored him as a professor emeritus in 1986, Moulder and his wife, Della, moved to Tucson, where he advised students and faculty at the University of Arizona until 1998. He received the Bergey Medal in 1999 for his lifelong contributions to the field of microbiology, including research that led to crucial advances in the prevention and treatment of yellow fever, malaria, and chlamydia. Outside the laboratory, Moulder enjoyed camping, world travel, classical music, and furniture making. He returned to the Chicago area several years after his wife's death to live closer to his daughter, Susan, and her family. Surviving are two children, John Moulder and Susan Perlman, their spouses, and five grandchildren. Richard Osband, MD'55, died January 11, 2012, at age 81. Following his internship, he served two years in the Air Force, stationed in Oklahoma. Osband had a private practice as an obstetrician-gynecologist for more than 42 years until his retirement in 2003. Survivors include his wife of 58 years, Shirley K. Osband, and his sister, two sons, two daughters, their spouses, and 15 grandchildren. Ogden Poole, SB'41, SM'49, died February 5, 2010, at age 91. He taught biology at Waukegan High School in Waukegan, Illinois, from 1945 to 1977, also serving as chairman of the science department for many years. After retirement, he was active in the Lake County Retired Teachers Association, which named him "Retired Teacher of the Year" in 1992. Poole was a key member of a committee that brought about the establishment of the Nature Preserve at Illinois State Beach Park along the shore of Lake Michigan. He is survived by his brother, the Rev. Charles Poole, and his sister-in-law, Evelyn Poole. David Simon, MD'77, formerly of Skokie, Illinois, died at home after a long illness, on January 31, 2012. He was surrounded by his family in San Diego, California. He is survived by his wife, Pam, and three children; his mother, Lee, and father, Myron; and his brother, Howard, sister-in-law Dana, and their three children. His sister, Jill Bernstein, preceded him in death. Eji Suyama, MD'50, died June 8, 2009, at age 89. He served during World War II in the 442nd Regimental Combat Team of the U.S. Army, which was comprised entirely of Japanese Americans. He was awarded the Silver Star for gallantry in action. He also gained status as an honorary Texan for helping rescue the "lost battalion," a surrounded Texas battalion, in one of the costliest military encounters in U.S. history in terms of percentage of casualties. He served as chief of surgery at the Maine Coast Memorial Hospital in Ellsworth, Maine, and later practiced at the Veterans Hospital in Fort Meade, South Dakota, until his second retirement in 2008. His family included his wife, Virginia, three daughters and three sons. On November 2, 2011, he was awarded posthumously the Congressional Gold Medal, the highest award given by Congress, which his daughter Sara Suyama accepted on his behalf. Norman R. Zinner, MD'58, passed away on April 15, 2012, at age 77. He established, and championed, the Ceithaml Scholarship Fund, a Pritzker School of Medicine loan program named in honor of Joseph J. Ceithaml, SB'37, PhD'41, dean of students from 1951 to 1986. Zinner is survived by his wife, Nancy, four children, one grandchild, and one sister. Former Faculty Alvin Markovitz, PhD, professor emeritus of biochemistry and molecular biology, died on April 7, 2012, at the age of 82. Markovitz was a longtime member of the Department of Microbiology at the University of Chicago. In 2001, he was honored with the Medical & Biological Sciences Alumni Association Gold Key Award for his outstanding and loyal service. He is survived by his wife, Harriet June, and three of his four children, Paula, AB'78, Ellen, AB'83, and Nancy, AB'85. He was predeceased by his daughter, Diane, AB'74. MEDICINE ON THE MIDWAY SUMMER 2012 45 Nonprofit Organization U.S. Postage Chicago, IL Permit No. 5179 PAID 950 East 61st Street WSSC 334 Chicago, IL 60637