Medicine on the Midway, Spring 2013
Medicine on the Midway is published for friends, alumni and faculty of the University of Chicago Medicine, the University of Chicago Division of Biological Sciences and the Pritzker School of Medicine.
MEDICINE MIDWAY UNIVERSITY OF CHICAGO on the S P R I NG 2013 Biological Sciences Division A leader in surgical ethics Peter Angelos, MD, PhD, heads a program that examines ethical questions facing surgeons Dean’s Letter Dear Colleagues, T The proﬁle of Peter Angelos, MD, PhD, in this edition touches on some ethical questions surgeons face, the answers to which are neither readily apparent nor easily parsed. But Angelos is committed to tackling them. Kenneth S. Polonsky, MD The Richard T. Crane Distinguished Service Professor Dean of the Biological Sciences Division and the Pritzker School of Medicine Executive Vice President for Medical Aﬀairs The University of Chicago he University of Chicago Medicine is a thought leader on medical ethics. From the late Dr. James E. Bowman’s struggles over the ethical issues raised by proposals to identify carriers of sickle cell trait to Dr. Mark Siegler’s multiyear study of the implications of using living liver donors, our doctors have helped guide physicians and surgeons through the tough ethical choices that come up in the course of delivering routine patient care. Very much in the University of Chicago mold is Peter Angelos, MD, PhD, the Linda Kohler Anderson Professor of Surgery and the subject of this issue’s cover story. Angelos, a practicing surgeon, also holds a doctorate in philosophy. The associate director of the MacLean Center for Clinical Medical Ethics, he heads the first program in the nation dedicated to the study of surgical ethics. The profile starting on page 14 touches on some questions surgeons face, the answers to which are neither readily apparent nor easily parsed. But Angelos is committed to tackling them, and his former fellows occupy important positions in academic departments of surgery here and abroad, spreading the benefits of the University of Chicago Medicine’s rigorous training in clinical ethics. Our rich history of mentoring also is apparent in a fascinating story beginning on page 12 about three generations of cancer research into a genetic mutation associated with a form of acute myeloid leukemia (AML). From Janet D. Rowley, LAB’42, PhB’44, SB’46, MD’48, the Blum-Riese Distinguished Service Professor of Medicine, Molecular Genetics and Cell Biology, and Human Genetics, to Michelle M. Le Beau, PhD, the Arthur and Marian Edelstein Professor of Medicine, to a third physician-scientist, Megan McNerney, MD’07, PhD’05, University of Chicago researchers have worked for four decades to pinpoint the gene in question, CUX1, and its role in the development of AML. With the help of the Institute for Genomics and Systems Biology, they are closer than ever to an answer. Also in this issue, we revisit the successful opening of the Center for Care and Discovery and take a look at the leading-edge technology that benefits our patients on a daily basis and helps train the next generation of clinicians. There also is a discussion on the AAMC Innovation Awardwinning research by Amber Pincavage, MD’07, aimed at improving patient handoffs in resident clinics, and we examine the Pritzker School of Medicine’s success in attracting underrepresented minorities, who graduate from Pritzker at significantly higher rates than the national average for medical schools. Sadly, we note the passing of two distinguished faculty members, Donald Rowley, SB’45, SM’50, MD’50, professor emeritus in the Department of Pathology and the Committee on Immunology, a pioneer in immune system research and inventor of the gel electrode, and Elwood V. Jenson, PhD’44, the Charles B. Huggins Distinguished Service Professor Emeritus in the Ben May Department for Cancer Research and the Department of Biochemistry and Molecular Biology, known worldwide for his research on how steroid hormones exert their influence through specific receptors in target cells. Both epitomized the thirst to create new knowledge that is emblematic of the University of Chicago spirit. TA B L E O F C O N T E N T S Cover Story 14 Many of the ethical quandaries surgeons face are distinct to surgery. As the Linda Kohler Anderson Professor of Surgery and associate director of the MacLean Center for Clinical Medical Ethics, Peter Angelos, MD, PhD, directs the ﬁrst program in the nation dedicated to the study of surgical ethics. COVER PHOTO: BRUCE POWELL PHOTOGRAPHED IN THE CENTER FOR CARE AND DISCOVERY Features 06 Our new hospital: A ﬂoor-by-ﬂoor tour of the University of Chicago Medicine Center for Care and Discovery. 22 Amber Pincavage, MD’07, and colleagues win a national award for a new protocol for ambulatory resident clinic handoﬀs. 12 How four decades of research led University of Chicago scientists to pinpoint a genetic abnormality that plays a central role in many cases of therapy-related myeloid leukemia. 25 It’s Match Day anxiety times two when students who met and fell in love in medical school enter the residency match as a couple. 20 Why the Pritzker School of Medicine does a better job than most of its peer institutions of attracting and graduating underrepresented minority (URM) students. Kevin White, PhD Matthew Zegarek, MS4, and Samantha Smith, MS4, matched at Yale-New Haven Hospital. Departments Letter from the Dean Pritzker News Midway News 23 Named professorships honor Holly J. Humphrey, MD’83, and T. Conrad Gilliam, PhD 30 Class Notes: Hear from your classmates, near and far 24 Alpha Omega Alpha Medical Honor Society awards 33 In Memoriam 2 Big gifts support ‘big data’ 3 International prize for diabetes research 24 Pritzker’s youngest MD/PhD now a resident 5 Bucksbaum Institute names Master Clinician 27 Match Day 2013 results 2 Pritzker moves up to No. 8 in medical school rankings 10 Sea creatures and neuroscience Elwood V. Jensen, PhD’44, 1920-2012 Donald Rowley, SB’45, SM’50, MD’50, 1923-2013 28 Pritzker Poetry Contest 11 CT scans for bird mummies MEDICINE MIDWAY UNIVERSITY OF CHICAGO on the S P RI NG 2 0 1 3 Biological Sciences Division Spring 2013 Volume 66, 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, the Richard T. Crane Distinguished Service Professor, Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago T. Conrad Gilliam, PhD, the Marjorie I. and Bernard A. Mitchell Distinguished Service Professor, dean for research and graduate education, Biological Sciences Division Sharon O’Keefe, president of the University of Chicago Medical Center Holly J. Humphrey, MD’83, the Ralph W. Gerard Professor in Medicine, dean for medical education, Pritzker School of Medicine uchospitals.edu/midway Editorial Committee Chair Chris Albanis, AB’96, MD’00 Lampis Anagnostopoulos, SB’57, MD’61 Arnold Calica, SM’61, MD’75 Melina Hale, PhD’98 Noah Schwartz, MS1 Jerrold Seckler, MD’68 Coleman Seskind, AB’55, SB’56, SM/MD’59 Madeleine Shapiro, MS3 Jack Stockert, AB’05, MBA’10, MD’10 Editors Ginny Lee-Herrmann Anna Madrzyk Email us at firstname.lastname@example.org Write us at Editor, Medicine on the Midway The University of Chicago Medicine 950 E. 61st St., WSSC 334 Chicago, IL 60637 Editorial Contributors Kevin Barrett John Easton Elizabeth Gardner Caroline Kraft Darcy Lewis Photo Contributors Rozenn Bailleul-LeSuer David Christopher Brian Coats/UT Southwestern Medical Center Megan Doherty Robert Kozloff Jean Lachat Dmitri Novikov, PhD Linda Lepp Anna Madrzyk Ellen McGrew Michael McHugh Eileen Norris Stephen Phillips Gretchen Rubin Matt Wood Molly Woulfe Bruce Powell Anna Ressman Thomas Rossiter Harvey Tillis Medical & Biological Sciences Alumni Association Pritzker School of Medicine Archives University of Chicago Library Special Collections Research Center Design Stacy Sweat Designs MEDICINE ON THE MIDWAY SPRING 2013 1 PRITZKER SCHOOL OF MEDICINE Midway News Pritzker moves up to No. 8 in medical school rankings The University of Chicago’s Pritzker School of Medicine jumped two spots to No. 8 in the 2014 edition of U.S. News & World Report’s annual “Best Graduate Schools” ranking guide. Pritzker has been on a steady climb over the past decade, rising from 22nd in 2004 to 10th last year. The school is ranked third in the nation in research funding and fourth in selectivity, according to the latest survey. “We’re very proud of the world-class research our faculty does in seeking innovations to many of the most difficult challenges in medicine today, and that drive for discovery attracts some of the highest caliber of students in the nation,” said Kenneth S. Polonsky, MD, Dean of the Biological Sciences Division and the Pritzker School of Medicine and executive vice president for Medical Affairs at the University of Chicago. “It’s very gratifying, but also inspiring, to be recognized as one of the top medical schools in the U.S.” Pritzker tied with Columbia University, Duke University and the University of Michigan, Ann Arbor, for 8th place in rankings of research-focused medical schools. No other Illinois school made the top 15. Pritzker’s average annual grant support per faculty member from the National Institutes of Health is $286,800, behind only Stanford University and the University of California, San Diego, according to the magazine. Holly J. Humphrey, MD’83, the Ralph W. Gerard Professor in Medicine and dean for medical education at Pritzker, attributes the school’s rising trajectory in part to its focus on enhancing student recruitment through such measures as investing in scholarship programs and a focus on diversity. The school maintains one of the lowest student-to-faculty ratios in the nation. “Our school’s mission statement is that we are here to develop students into leaders and innovators in science and medicine for the betterment of humanity,” Humphrey said. “Developing leaders takes a lot of one-on-one mentoring and support. We pride ourselves on our low student-faculty ratio and believe that the mentorship we provide our students is key to their future success.” PHILANTHROPY Gifts to boost University of Chicago as hub for biomedical ‘big data’ T wo major gifts will enhance the University of Chicago’s leadership in biomedical computation by assembling experts in the field and furnishing them with the tools to use “big data” to understand disease and solve today’s health-related challenges. These two gifts will fund initiatives that preview a much larger plan at the University that will include multiple data-driven discovery programs to improve health and medical care. Karen and Jim Frank, president and CEO of Wheels Inc., pledged $9 million to provide start-up funds to establish an Institute for Computational Biology and Medicine, which will serve as a hub for the collection, analysis and distribution of biomedical and health care information, ranging from genomic data to de-identified electronic medical records. 2 Karen and Jim Frank, left, and Carole and Gordon Segal Carole and Gordon Segal, the founders of Crate & Barrel, made a substantial pledge to support the Pancreatic Cancer Genomic Medicine Initiative, which will use genetic information to improve assessment, decision-making and treatment for pancreatic cancer patients. “Our vision is to define disease at the genetic and molecular level with much greater specificity than is currently available,” said Kenneth S. Polonsky, MD, Dean THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION of the Biological Sciences Division and the Pritzker School of Medicine and executive vice president for Medical Affairs at the University of Chicago. “This will require access to gigantic data sets, innovative manipulation of those data, and vast computing power. These generous gifts from our trustees and their families will further the University of Chicago’s leadership in biomedical computation, a field that promises to transform the practice of medicine.” O R G A N I S M A L B I O L O G Y A N D A N AT O M Y DIABETES RESEARCH Bell wins top honor Why our sense of touch is a lot like hearing W hen we run our fingers across a textured surface, complex high-frequency vibrations are produced in the skin. A new study shows that these vibrations produce corresponding oscillations in the afferents, or nerve fibers, that carry information from the skin receptors to the brain. Sliman Bensmaia, PhD, assistant professor of organismal biology and anatomy, and his colleagues — former undergraduates Matthew Best, AB’11, and Emily Mackevicius, BS’11, and postdoctoral scholar Hannes Saal, PhD — found the precise timing and frequency of these neural responses convey specific messages about texture to the brain, much like the frequency of vibrations on the eardrum conveys information about sound. Researchers have known for years that these afferents respond to skin vibrations, but they studied their responses using so-called sinusoidal waves — perfectly uniform vibrations that can be produced in a lab. For this study, published in the Journal of Neuroscience, Bensmaia and his team used a vibratory motor that can produce any complex vibration they want. “In this paper, we showed that the timing of spikes evoked by naturalistic vibrations matters,” Bensmaia said. Researchers could someday use this model of timing and frequency of afferent responses to simulate the sensation of texture for an amputee. It could also be used for haptic rendering, or producing the tactile feel of a virtual object on a touchscreen, such as turning an iPad into a device for reading Braille, or controlling robotic surgery. “We’re trying to build a theory of what makes things feel the way they feel,” Bensmaia said. “This is the beginning of a story that’s really going to change the way people think about the somatosensory system.” uchospitals.edu/midway Graeme I. Bell, PhD, the Louis Block Distinguished Service Professor of Medicine and Human Genetics and an investigator at the University of Chicago Medicine Kovler Diabetes Center, has been awarded the 2012 Manpei Suzuki International Prize for Diabetes Research for his pioneering work in understanding the role of genetics in the Graeme I. Bell, PhD diagnosis and treatment of diabetes. Bell was recognized, according to the selection committee, for his “extensive and groundbreaking contributions over many years to many landmark discoveries in diabetes research utilizing the powerful technologies of molecular biology and genetics.” The prize is the world’s largest award for diabetes research. R E S E A R C H AWA R D S NSF winners announced The Biological Science Division recognizes eight BSD and three Physical Sciences Division (PSD) students who are among the University of Chicago winners of 2013 National Science Foundation graduate research fellowships. The fellowships provide three years of stipend and partial tuition support. The students are: Hussein Al-Asadi and Dallas Krentzel, evolutionary biology; Jenna Christensen, cell and molecular biology; Vu Dinh, Ryan Mork and Guillermina Ramirez-San Juan, biophysical sciences; Molly Evans, biochemistry and molecular biology; and Molly Gallagher, Evan Koch, Elizabeth Sander and Alexander White, ecology and evolution. LEADERSHIP O’Keefe honored Sharon O’Keefe, president of the University of Chicago Medical Center, has been named to Modern Healthcare’s list of the top 25 women in health care. In announcing the award, Modern Healthcare commented: “While Ms. O’Keefe only joined the University of Chicago Medical Center as Sharon O’Keefe president in February 2011 . . . her successful shepherding to completion of the University’s recently opened Center for Care and Discovery, a $700 million, 1.2 million-squarefoot medical center on the city’s South Side, shows she got off to a fast start in her new job.” O’Keefe also is one of 30 recipients of the Becker’s Healthcare inaugural Leadership Awards honoring health-care executives who have made “remarkable contributions” to their organizations and communities. MEDICINE ON THE MIDWAY SPRING 2013 3 HUMAN GENETICS Midway News ‘Tree of Life’ to tangled shrub Researcher develops software to show how populations change over time, based on modern DNA BY MATT WOOD J onathan Pritchard, PhD, professor of human genetics, studies the nature of human genetic variations by combining methods from evolutionary biology and statistics. Intrigued by recent research on the Neanderthal genome that suggests more interbreeding with Homo sapiens than previously thought, he developed a software model called TreeMix that can depict gene flow between different groups within the same species over time, based on modern DNA. “If you try to make a tree of population histories within a species, there’s always the possibility that you’ve got genes flowing from one branch to another,” Pritchard said. The name of the software refers to the classic “tree of life” drawings Charles Darwin sketched to show how species evolve through natural selection. “Populations can interbreed, so if they’re geographically together or if there’s movement from one place to another, then this tree representation is not necessarily going to be a good way of representing history,” Pritchard said. The software compares how often variants of a particular gene from different populations appear in the same species. It then calculates how closely groups are related, and when in their history they separated to form a genetically distinct 4 basenji breeds of dogs trace a large portion of their DNA (9 percent and 25 percent, respectively) back to wolves after domestication, meaning that these breeds interbred with wolves again after humans had Jonathan Pritchard, PhD, begun to domesticate dogs. professor of human genetics “What I like about this is that it’s starting to give us some resolution on relationthe branches are the key, show- ships that are just much more ing migration events where a complicated than you can previously separate population capture using the standard tree mixed with another, rejoining approach,” Pritchard said. to form a new group at a later He gave another example, point in time. of the Mozabite people who Pritchard and his colleagues live in Algeria. Their DNA is tested the model using DNA largely a mixture of European from 55 human populations and Middle Eastern ancestry, and 82 dog breeds, and already but they also mixed with have found some interesting sub-Saharan African ancesresults. For example, boxer and tors at various points in their history. The new model can represent the complex relationships among all of these backgrounds, whereas the traditional tree-based method would just show a primary relationship to Middle Easterners. Another group of researchers has already used Pritchard’s software to show a link between Denisovans, an extinct relative of Neanderthals found in Siberia, and Papuans in the South Pacific. It doesn’t make geographic sense right away, but much like DNA evidence has revolutionized criminal investigations, advanced genetic analysis like Pritchard’s can change what we think about human history as well. “What I like about this is that it’s starting to give us some resolution on relationships that are just much more complicated than you can capture using the standard tree approach.” population or breed. The resulting graph looks less like tree branches and more like a tangled shrub or mass of vines. The trunk of the shrub represents the major relationships between the groups, and the largest branches represent distinct populations as they develop over time from left to right on the graph. But those tangled vines that crisscross THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION BUCKSBAUM INSTITUTE ECOLOGY & EVOLUTION Bishop named Master Clinician Humans and chimps share genetic strategy in battle against pathogens The Bucksbaum Institute for Clinical Excellence has named stem cell transplant specialist Michael R. Bishop, MD, as its second Master Clinician. During his three-year appointment, Bishop will mentor faculty and student scholars in ways to improve crucial doctor-patient communication skills and clinical care — hallmarks of the Bucksbaum Institute. Bishop is a professor of medicine and director of the hematopoietic stem cell transplantation program at the University Michael R. Bishop, of Chicago Medicine. He joins vascular surgeon Ross Milner, MD MD, associate professor of surgery and co-director of the aortic diseases program, who last fall was named the first Bucksbaum Institute Master Clinician. The Institute also named 12 Senior Faculty Scholar appointees for 2013-14: Halina Brukner, MD; Linda Druelinger, MD; Scott Eggener, MD; Savitri Fedson, MD; H. Barrett Fromme, MD, MHPE; Melissa Gilliam, MD, MPH; Nora Jaskowiak, MD; William McDade, MD’90, PhD’88; Sonali M. Smith, MD; David H. Song, MD, MBA’09; Christopher Straus, MD’92, AB’88; and Monica Vela, MD’93. The Senior Faculty Scholars will work with and help train and advise Bucksbaum Institute Medical Student, Junior Faculty and Associate Junior Faculty Scholars. CHICAGO BIOMEDICAL CONSORTIUM Three students awarded grants Three University of Chicago graduate students have been named 2013 Chicago Biomedical Consortium (CBC) Scholars. The students, all PhD candidates, are Michelle Beaton, molecular metabolism and nutrition; Michael S. Werner, molecular genetics and cell biology; and James T. Payne, SM’11, chemistry. Each CBC Scholar receives a grant of $4,000 per year for up to two years for academic pursuits. The CBC Scholar Program provides a leadership forum for students from the CBC universities — the University of Chicago, Northwestern University and the University of Illinois at Chicago — to advance the mission of fostering collaboration and excellence. Each university nominates up to three outstanding graduate students for the program each year. The Chicago Biomedical Consortium is supported by the Searle Funds at The Chicago Community Trust. uchospitals.edu/midway A genome-wide analysis searching for evidence of long-lived balancing selection — where the evolutionary process acts not to select the single best adaptation but to maintain genetic variation in a population — has uncovered at least six regions of the genome where humans and chimpanzees share the same combination of genetic variants. The finding, discovered by University of Chicago researchers and published in Science, suggests that in these regions, human genetic variation dates back to a common ancestor with chimpanzees millions of years ago, before the species split. It also highlights the importance of the dynamic co-evolution of human hosts and their pathogens in maintaining genetic variation. “When we looked for genetic clues pointing to examples of balancing selection, we found strong evidence for at least six such regions and weaker evidence for another 119 — many more than we expected,” said study author Molly Przeworski, PhD’00, professor of human genetics and of ecology and evolution. “We don’t yet know what their functions are,” she said. There are clues that they are involved in host-pathogen interactions, “but which pathogens, what immune processes,” she said, “we don’t know.” The researchers used genetic data from 10 chimpanzees from Western Africa and 59 humans from sub-Saharan Africa who were part of the 1000 Genomes Project. The scientists looked for cases in which genetic variations that arose in the ancestor of humans and chimpanzees have been maintained through both lines. The fact that variations in these regions of the genome have persisted for so long argues that they “must have been functionally important over evolutionary time,” said Ellen Leffler, a PhD candidate in Przeworski’s laboratory and first author of the study. “Our results imply that dynamic co-evolution of human hosts and their pathogens has played an important role in shaping human variation,” Przeworski said. “This highlights the importance of a different kind of selection pressure in human evolution.” MEDICINE ON THE MIDWAY SPRING 2013 5 O U R N E W H O S P I TA L Midway News Tour the Center for Care The University of Chicago Medicine’s 1.2 million-square-foot new hospital is one of the most advanced clinical and surgical centers in the country. The space is designed to enhance collaborative, orrative, patient-centered care. A FLOOR-BY-FLOOR GUIDE The Center for Care and Discovery is dedicated to complex specialty care with a focus on cancer, digestive diseases, neuroscience, advanced surgery, advanced cardiovascular diagnostic and treatment services, and high-tech medical imaging. Dining options include Wolfgang Puck Express, a full-size Starbucks and Hyde Park Marketplace. State-of-the art videoconferencing system allows for real-time sharing of biopsy images with surgeons in the operating room. 1 Rooftop garden planted with 100,000 drought-resistant plants. 5 4 3 2 100,000 square feet for future technology or additional patient rooms. 100,000 square feet for future technology or additional patient rooms. GREEN ROOF 9 suites for advanced imaging and interventional procedures, including cardiac and neuro. 12 rooms dedicated to gastrointestinal and pulmonary procedures. DIAGNOSTIC SUITES EXPANSION SPACE EXPANSION SPACE PATHOLOGY LABORATORY ENTRANCE RETAIL AND DINING VIEW FROM NORTH CENTER FOR CARE AND DISCOVERY HIGHLIGHTS SKY LOBBY is the heart of the hospital, a light-ﬁlled and welcoming space for patients, families and staﬀ. 77 6 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION ADVANCED TECHNOLOGY for such diagnostic and interventional procedures as endoscopic ultrasound and endoscopic retrograde cholangiopancreatography. 5 and Discovery HELIPAD 21 operating rooms equipped with leading-edge technology for hybrid and minimally invasive surgeries, including two da Vinci surgical systems. Floor-to-ceiling windows provide panoramic views of downtown Chicago and the University of Chicago campus. Includes family waiting area, chapel and food court. 7 6 Patient rooms are located on ﬂoors 8, 9 and 10. All patient rooms are private and telemetrycapable. Technology includes continuous brain wave monitoring and portable CT imaging. 8 36 oncology rooms and a 28-bed unit for patients receiving blood and bone marrow stem cell transplants. 10 9 The U University of Chicago Medicine Center for Care and Discovery Cente O Op en February 2013 Open: Architecture A rchi ﬁrms: Rafael Viñoly Ar Architects and Cannon Design, Co Consulting Architects C ost: $700 million Cost: HEMATOLOGY/ONCOLOGY PATIENT ROOMS BY THE NUMBERS NEURO-INTENSIVE CARE UNIT 10 Stories SKY LOBBY 1.2 Million SURGERY square feet 240 Patient rooms 21 Operating rooms 52 ICU beds Sources: University of Chicago Medicine, Rafael Viñoly Architects; Architectural renderings by Rafael Viñoly Architects; Photos by Thomas Rossiter and Bruce Powell; Informational graphic by Stacy Sweat Designs The University of Chicago Medicine S. MARYLAND AVE. PATIENT ROOMS are spacious enough to accommodate families for extended stays and equipped with comfortable furniture and ﬂat-screen TVs. 8 9 Center for Care and Discovery Duchossois Center for Advanced Medicine Knapp Center for Biomedical Discovery Gordon Center for Integrative Science KEY University of Chicago Medical Campus Comer Children’s Hospital THE UNIVERSITY OF CHICAGO 10 Bernard Mitchell Hospital uchospitals.edu/midway MEDICINE ON THE MIDWAY SPRING 2013 7 CENTER FOR CARE AND DISCOVERY Midway News Technology transforms the teaching environment BY GRETCHEN RUBIN P eering over a surgeon’s shoulder to see what is happening in the operative field has long been part of a medical student’s experience. So too, has straining for a line of sight to the small fixed monitor showing images fed from the video camera affixed to the lead surgeon’s cap. “Those days are gone,” said University of Chicago Medicine surgeon Kevin Roggin, MD, associate professor of surgery at the Pritzker School of Medicine, program director of the general surgery residency and associate program director of the surgical oncology fellowship. “The new surgical suites in the Center for Care and Discovery are designed to easily share information with all the learners in the room.” Large video screens in the 21 operating rooms of the new hospital not only display a high-definition image of the operative field — transmitted by cameras mounted on overhead surgical lights — but also CT and MR scans, pathology, the patient’s medical records, and even the operative checklist. “All these data sources have always been available to surgeons, but not necessarily in the surgical suite and not easily seen by everyone,” Roggin said. “The video screens have transformed the environment. Now everything is there and shared with a push of a button.” Roggin and the medical students he works with felt the transformation immediately during the first surgeries performed in the Center for Care and Discovery the week after it opened on February 23, 2013. Vikrant Jagadeesan, MS3, was halfway through his surgery clerkship when the service moved to the spacious surgical suites in the new hospital. One of the first operations he participated in involved a 8 PHOTO BY BRUCE POWELL Cameras mounted overhead enable high-deﬁnition images of the operative ﬁeld to be displayed on large video screens. Patient rooms enhance teaching F or Rimas Lukas, MD, assistant professor of neurology and co-director of the neurology clerkship at the University of Chicago Medicine, taking his students on rounds used to involve visiting several floors in the hospital, including the cardiac unit where acute stroke patients were cared for if they needed telemetry. In the Center for Care and Discovery, every neuroscience inpatient room on the eighth floor is equipped for telemetry and high-level neuromonitoring. The rooms are adjacent to the Neuro-Intensive Care Unit, which has continuous brain wave monitoring and portable CT imaging capabilities. multidisciplinary team of surgeons including Roggin; urologist Norm Smith, MD, associate professor of surgery; and vascular surgeon Ross Milner, MD, associate profes- THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION “Having all of this technology available on one floor allows the team to be more efficient and gives me more time for teaching,” Lukas said. Lukas believes the thoughtful design of the patient rooms also lends itself to a better experience for the medical team and the patient. “Because the patient rooms are private and large, it’s much easier for us to complete a full and reliable neurological exam,” he explained. “And the quiet environment is more conducive to having in-depth, serious conversations with patients and families.” sor of surgery and co-director of the aortic diseases program. “The room was crowded, but no one was crowded out,” Jagadeesan said. “All I had to do was turn my head and look at the screens. Any number of staff and students could have watched the procedure, every step of the way, from beginning to end, with no impairment to the process.” During the surgery, Roggin used one of the overhead cameras to take an intraoperative still frame of the mass in the patient’s abdomen. Milner clicked a picture of his reconstruction. The attending physicians will use these photos for future talks to trainees and colleagues. “This will be very helpful for learning, especially for cases that are complex or rare,” Jagadeesan said. Ellen Rebman, MS3, described the experience of looking at a frozen section from an intraoperative biopsy that was projected on one of the new monitors during her first surgery in the new hospital. “The video screens have transformed the environment. Now everything is there and shared with a push of a button.” Kevin Roggin, MD “We simultaneously could see what the pathologists were looking at under their microscope,” she said, “and listen to them interpret the pathology. As we were seeing the microscopic detail of the mass we had just removed, we were still directly engaged in a procedure that could completely change this patient’s life trajectory. “I can still remember the image on the screen,” Rebman added. “I won’t forget it.” Examining the pathology, communicating the results and discussing the diagnosis in real time, without leaving the operating room, add a new dimension to teaching at the University of Chicago Medicine, Roggin said. “It brings the pathologist into the suite. And it blends everything together.” uchospitals.edu/midway Mapping the microbiome of the new hospital An innovative study aims to prevent hospital-acquired infections nationwide BY MATT WOOD F or marine ecologist Jack Gilbert, PhD, the opening of the Center for Care and Discovery presented an irresistible opportunity to understand how bacteria are introduced into a new hospital, colonize and are transmitted. Gilbert, assistant professor of ecology and evolution at the University of Chicago and environmental microbiologist at Argonne National Laboratory, is interested in identifying the avenues that enable microbial transmission in a hospital environment. By mapping all the bacterial traffic, it may be possible to identify routes that could be taken by disease-causing bacteria. The goal of the Jack Gilbert, PhD Hospital Microbiome Project: to improve patient care and prevent hospital-acquired infections, which cause 100,000 deaths in the U.S. each year. “Ninety-nine percent of bacteria are good — even in a hospital,” Gilbert said in an article published by Arete, a University of Chicago research development program. “We’re going to determine how good and bad bacteria co-exist in a hospital, and how the good can keep out the bad.” And so, armed with ordinary cotton swabs, Gilbert and his team began cataloging the bacterial species growing in the new hospital months before the building opened to patients, staff and visitors. The Center for Care and Discovery is the first hospital to open its doors to a research project of this type, Gilbert said. “Univer- Jack Gilbert, PhD, collecting a sample from the operating room ﬂoor before the building opened. sity of Chicago Medicine leaders should be applauded,” he said. “They are enabling pioneering science that has the potential to save lives of patients everywhere.” Last June, Gilbert and his team collected samples from 32 locations in the hospital construction site, including floors, countertops, water fountains, and even the team’s shoes before and after the tour. They extracted DNA from these samples, amplified the genes and sequenced them using Argonne’s next-generation gene sequencer. Over the next two years, they’ll collect and sequence another 15,000 samples from the Center for Care and Discovery, staff and patients who consent to participate in the confidential study. Gilbert and his colleagues also will be collecting samples from a U.S. Army hospital in Germany for similar study. The study will track more than 100,000 species of bacteria, making it one of the largest microbial surveys ever conducted. The findings are being shared at hospitalmicrobiome.com. MEDICINE ON THE MIDWAY SPRING 2013 9 Midway News NEUROBIOLOGY Under the sea Sequencing the genome of the world’s weirdest creatures BY MATT WOOD O ctopus, squid and other cephalopods fascinate with their weird and wonderful features, such as prehensile arms that regenerate when amputated and special organs that change skin color to match their environments. These remarkable creatures also have highly developed brains and nervous systems that provide excellent models for the study of basic neuroscience. An understanding of the genomics underlying their unique features would have applications across many areas of science, from neurobiology to materials science and bioengineering. A group of scientists from around the world recently formed a consortium to tackle this project and assemble complete genomes of ten different cephalopod species. Clifton Ragsdale, PhD, University of Chicago associate professor of neurobiology, is one of the founders of the Cephalopod Sequencing — or CephSeq — Consortium, and chair of its steering committee. He acknowledged that cephalopod researchers are at square one when it comes to this kind of genetic analysis, but the project will build momentum. “Once there’s a good assembly of one of the genomes, then the others will be much easier,” he said. Ragsdale and Carrie Albertin, a PhD candidate in his laboratory, are working on the genome for Octopus bimaculoides, a small, brown octopus found in the Pacific Ocean off the coast of California and Mexico. Their contribution to the project will be sequencing and assembling transcriptomes for the octopus, which will yield a near complete set of mRNA sequences (that is, for the protein coding genes) expressed in target tissues. Albertin isolated 19 different tissues from 10 various embryonic stages, brain tissue and glands of the octopus, which recently have been sequenced at the University of Chicago Genomics Facility, a shared, high-performance computing center on campus. The University of Chicago Center for Research Informatics will support the bioinformatics computing analysis. Studying cephalopods at a molecular and genetic level has broad applications for both medical science and technology. For instance, the ability of the octopus to regenerate its arms if they’re amputated is more than a neat trick. The arms of an octopus are highly complex, with large nerve cords running down them that — taken together — have more neurons than its brain. Regenerating an arm means not just regenerating skin and muscle, but this complicated nervous THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION system as well. Learning more about how this happens could provide insight into regenerative medicine for humans. Materials scientists who study biology for clues on solving engineering problems are also very interested in how cephalopods use different organs and proteins to change their skin color. And of course, learning more about the animals themselves will help researchers understand how cephalopods are responding to environmental change and overfishing. Ragsdale said the CephSeq Consortium is a unique opportunity because it can lead to so many unexpected insights. “You can never quite tell when you do this basic research when it’s going to lead somewhere exciting, but cephalopod research certainly has worked well for neurophysiology and for materials science,” he said. O R I E N TA L I N S T I T U T E E X H I B I T Winging it CT scans unwrap mysteries of bird mummies BY MOLLY WOULFE T his dinner is fit for a long-dead king. The roast goose at the Oriental Institute Museum is 3,500 years old. Computed tomography (CT) scans courtesy of the University of Chicago Medicine’s Department of Radiology show this mummified main course was plucked and cleaned as neatly as a Thanksgiving turkey. The cook even left giblets inside “and a bundle of linen to keep its shape,” guest curator Rozenn Bailleul-LeSuer said. “Between Heaven and Earth: Birds in Ancient Egypt” pairs bird mummies with CT scans. Visitors can view five mummies along with 2- and 3-D images that re-imagine the birds in their prime. Thanks to the noninvasive technology, “we were able to identify species, ages and conditions of the birds,” said chief curator Jack Green, PhD. Millions of migrating birds that visited the Nile Valley left an impact on Egyptian culture. The Egyptians domesticated geese, worshipped bird deities, and mummified birds en masse to carry prayers to the gods. Venerated species included the falcon and ibis. Hawks, kestrels, owls, quails and waterfowl are recurring figures in reliefs and objects of daily life. The 40 artifacts on display include bird-motif amulets, a duck-shaped vase and a boomerang-like “throwstick” for hunting waterfowls. Doctoral candidate Bailleul-LeSuer, researching the socio-economic aspects of birds in Egypt, was planning the show when Mid-coronal section microCT scan PHOTO BY ROZENN BAILLEUL-LESUER A small mummy, probably a common kestrel PHOTO BY ANNA RESSMAN uchospitals.edu/midway she spied a cache of 29 bird mummies in the OI collection. Most were wrapped, prompting Bailleul-LeSuer to ask if the contents could be scanned at the medical center. Michael W. Vannier, MD, professor of radiology, who supervised the scan of a 3,000-year-old human mummy for a 2009 exhibit, spearheaded this foray into avian anatomy. Members of his team practiced on specimens loaned by the Field Museum of Natural History before tackling the artifacts. On the plus side, deceased birds don’t squirm and radiation dosage is irrelevant. “You can take all the time you need,” said team member Charles Pelizzari, PhD, associate professor of radiation and cellular oncology. Yet there were challenges. CT scanners are designed for human-sized subjects. Adjusting a 256-slice scanner on a tiny sparrow “is very tricky,” said Pelizzari, director of the Section of Medical Physics. “We scanned the little guys over and over again until we found the right protocol.” Curators brought the mummies in for their scans during patient lulls on two days in 2011. The specialists deployed a clinical CT scanner and a micro CT scanner for finer resolution. It took minutes to acquire hundreds of images, and weeks to process and analyze the data. The medical experts optimized scanning parameters, effectively restoring desiccated organs and skeletal remains to produce 3-D images. The Oriental Institute will submit its findings to a database that tracks animal remains and the civilizations that preserved them. Meanwhile, Pelizzari is game for more projects that merge art, history, science and forensics. The bird’s-eye view into the past “was really cool,” he said. “Between Heaven and Earth: Birds in Ancient Egypt” continues through July 28 at the Oriental Institute Museum, 1155 E. 58th St., Chicago. For details, visit oi.uchicago.edu. MEDICINE ON THE MIDWAY SPRING 2013 11 A four-decade search points to a new type of How a series of ﬁndings by three generations of scientists led to a pivotal discovery about leukemia PHOTO BY DMITRI NOVIKOV, PHD BY JOHN EASTON R esearchers from Kevin White’s laboratory in the University of Chicago’s Institute for Genomics and Systems Biology (IGSB) have pinpointed a genetic abnormality that plays a central role in many cases of therapy-related myeloid leukemia. The discovery advances a search that began in 1973. Janet D. Rowley, LAB’42, PhB’44, SB’46, MD’48, then an associate professor of medicine, submitted a fiveparagraph letter about an odd discovery to The Lancet. Rowley, now the Blum-Riese Distinguished Service Professor of Medicine, Molecular Genetics and Cell Biology, and Human Genetics at the University of Chicago, described two patients whose bone marrow cells showed “deficiencies” of chromosome 7. Both had been treated for blood diseases that came back after treatment. “Whether the loss of part or all of chromosome 7 is fortuitous or not,” she had written, “can only be determined by examination of additional patients.” The search was on. By 1981, Rowley and colleagues had medical histories and blood cells from 26 patients who developed acute 12 PHOTO BY BRUCE POWELL Megan McNerney, MD’07, PhD’05, instructor of pathology, and Kevin White, PhD, the James and Karen Frank Family Professor of Human Genetics and professor of ecology and evolution, and director of the Institute for Genomics and Systems Biology. myeloid leukemia (AML) a few years after previous cancer treatment. Twenty of these patients had leukemic cells that had lost all or part of chromosome 7. Many also had changes in chromosome 5. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION These cases were troubling. The medicines used to treat the initial disease seemed to lead to more serious disease a few years later. Even aggressive chemotherapy did not help; most patients died within a year. Baton Pass No. 1 The researchers B y 1986, Michelle M. Le Beau, PhD, now the Arthur and Marian Edelstein Professor of Medicine and director of the University of Chicago Medicine Comprehensive Cancer Center, who had trained with Rowley, was leading the effort. Her team had 62 patients with treatment-triggered AML and limited the search to the long arm of chromosome 7, known as 7q. Most of those patients had received alkylating agents, chemotherapy drugs that bind to DNA and interfere with replication. By the mid-1990s, new tools were helping the team narrow the focus. They now had hundreds of patients. Most of the samples were missing all of chromosome 7, but 81 had lost only part of chromosome 7. This helped focus the search to a region known as 7q22. Still, this smaller region included more than 2 million base pairs, enough to contain 50 genes. Plus, there was a new wrinkle: in no patient were both versions of a specific gene in the target region abnormal. There always seemed to be one functional copy. Scientists had learned, however, that loss of just one copy of a gene may be damaging enough. The remaining copy could be normal but unable to meet the demand. Geneticists call this haploinsufficiency. Baton Pass No. 2 I n 2009, Megan McNerney, MD’07, PhD’05, doing a residency in clinical pathology and working in White’s lab in the IGSB, pulled together collaborators to identify the gene whose loss “malfunction” drives the loss of 7q22. McNerney first produced higher-resolution data from 35 leukemia patients with focused abnormalities on chromosome 7. Working with other IGSB scientists, she then combed through region 7q22, and a gene known to regulate many other genes stood out. This gene, CUX1, was expressed at low levels in patient samples with loss of one copy. uchospitals.edu/midway Janet D. Rowley, LAB’42, PhB’44, SB’46, MD’48 In 1973, Rowley describes two patients with recurrent blood diseases whose bone marrow cells showed “deﬁciencies” involving chromosome 7. The search is on. Michelle M. Le Beau, PhD By 1986, Le Beau, who trained with Rowley, is leading the investigation. Over the next decade, Le Beau and colleagues narrow the focus to a region known as 7q22. So McNerney, collaborating with another White lab postdoctoral student, Xiaoyue Wang, PhD, created fruit flies with only a single copy of CUX1. Samples from the flies’ blood revealed abnormalities characteristic of leukemia. Next, working with John M. Cunningham, MD, professor of pediatrics, physiology, and stem cell research, chief of pediatric hematology/oncology and director of hematopoietic stem cell transplantation at the University of Chicago Medicine Comer Children’s Hospital, they developed mice whose blood-forming cells were deficient in CUX1. These mice quickly developed features of leukemia. There may be other genes in the commonly deleted sequence “that play a role in disease pathogenesis,” the study authors wrote, but “this is the first biological confirmation of a haploinsufficient myeloid tumor suppressor gene on chromosome band 7q22. … Changes in CUX1 levels may have important phenotypes during hematopoiesis and deleterious consequences when altered.” The study was published in February in Blood. Megan McNerney, MD’07, PhD’05 Beginning in 2009, McNerney and team comb through 7q22 and discover a haploinsuﬃcient myeloid tumor suppressor gene implicated in therapy-related leukemia. “ The identification of this gene underscores the value of the integrated approach we are trying to promote in the IGSB,” White said. “By harnessing next generation sequencing technology and advanced algorithms to identify the gene, then moving to animal model systems and complementary patient data to validate the discovery, Dr. McNerney and the team she worked with have done an incredible job of solving a difficult long-standing puzzle in a short amount of time. Her experience here is a model for what we want clinical fellows working in the IGSB to achieve.” The discovery also presents clinical options. “If we learn how CUX1 is regulated, we could tweak its expression or hit the pathway downstream or find ways to influence its activity,” Le Beau said. “We may also find ways to use CUX1 testing to predict who is at risk prior to the initial treatment and to change the therapy for those patients.” Le Beau notes that this integrated approach to tackling leukemia was made possible by funding from the Cancer Research Foundation. MEDICINE ON THE MIDWAY SPRING 2013 13 14 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Under the leadership of Peter Angelos, MD, PhD, the University of Chicago teaches surgeons how to navigate the ethical quandaries distinct to their ﬁeld ON SURGICAL ETHICS BY STEPHEN PHILLIPS t was supposed to be a routine parathyroidectomy. But, not long into the procedure, the young surgeon found a suspicious nodule in one of the lobes of his patient’s thyroid. Without delay, he removed the lobe and sent it to the lab for analysis. The results were called directly into the operating room: Cancer. The logical next step would have been to remove the remaining lobe. But Peter Angelos, MD, PhD, checked himself. This was not without ramification. There was a small chance the patient, a minister, would be left permanently hoarse. He’d need replacement thyroid hormone for the rest of his life. Would the patient sanction the procedure? It hadn’t been among the contingencies discussed before the surgery. Angelos left the operating room to consult with the patient’s family. The minister’s family was adamant that he wouldn’t want Angelos to proceed — not without discussing it with him first. Angelos was concerned, but heeded the family’s wishes. The minister was thankful Angelos hadn’t pressed ahead. “I told him he needed another operation,” Angelos recalled. “He said, ‘I understand, but I’m glad no one made that decision for me.’” The ultimate outcome of the case — removal, without complication, of the patient’s entire thyroid (albeit after a second operation) — was unremarkable in view of what had been discovered. But more than 15 years later, Angelos looks back on the ethical questions that were posed along the way. As chief of endocrine surgery at the University of Chicago Medicine and professor at the Pritzker School of Medicine, Angelos, 50, is a world-renowned expert in the surgical treatment of disorders of the endocrine organs, such as the thyroid and parathyroid, including cancer. Procedures like parathyroidectomies are his bread and butter. But as the Linda Kohler Anderson Professor of Surgery and associate director of the MacLean Center for Clinical Medical Ethics, Angelos also directs the first program in the nation dedicated to the study of surgical ethics. Each year, under his aegis, the University teaches a cohort of residents, fellows and mid-career surgeons how to navigate Continued on page 16 uchospitals.edu/midway midw wa MEDICINE ON MED N THE MI MIDWAY Y SPRING S NG 2013 15 PHOTO BY BRUCE POWELL Peter Angelos, MD, PhD, speaks in March 2012 as part of the Named Professor Lecture Series. The audience included Kenneth S. Polonsky, MD, Dean of the Biological Sciences Division and the Pritzker School of Medicine and executive vice president for Medical Aﬀairs at the University of Chicago, and Mark Siegler, MD, director of the MacLean Center for Clinical Medical Ethics and executive director of the Bucksbaum Institute for Clinical Excellence. Continued from page 15 A 2011-12 fellow credits the surgical ethics program with “completely changing the way I think.” 16 the ethical quandaries distinct to surgery. The case from the 1990s encapsulates several of these issues. For starters, Angelos’ decision to excise the lobe on which he found the nodule is grounded in the distinct nature of informed consent in surgery, in which patients sign a pre-operative form explicitly empowering the surgeon to exercise his professional judgment. On the other hand, Angelos balked at removing the second lobe, seeking counsel from surrogates for the patient before proceeding, underscoring the imperative to respect the autonomy of an anesthetized patient who cannot express his own wishes. Finally, the possible side effect of lifelong hoarseness, an especially bitter blow for a patient whose livelihood relied on his voice, crystallized the gravitas of surgery’s defining act: opening a person up while they are incapacitated to re-engineer their organs — an action both drastically restorative but inherently risky. This coupling of great power with grave responsibility is captured in an oft-cited THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION remark by sociologist Charles L. Bosk, PhD’76, MA’74, in a landmark study of how surgeons manage mistakes, “Forgive and Remember,” written while he was a graduate student at the University. “When the patient of an internist dies,” Bosk wrote, “the natural question his colleagues ask is, ‘What happened?’ When the patient of a surgeon dies, his colleagues ask, ‘What did you do?’” And it’s a reason why, as Bosk noted, “postgraduate training of surgeons is above all things an ethical training.” Of all the mistakes trainees might make, particular opprobrium is reserved for “normative errors” — those involving ethical breaches such as covering up an error — Bosk wrote. “Subordinates are harshly disciplined when they violate the ethical standards of the discipline. They are promoted and accepted into the ranks as colleagues on the basis of their ethical fitness.” Still, Angelos deems the concept of surgical ethics as a distinct field of study “revolutionary.” While traditional training of surgeons “This gives surgeons a new language … and an awareness of the inﬂuences that ought to be shaping their decisions,” Angelos said. has been tacitly ethical, surgical ethics represents an effort to reframe issues that historically have been approached as matters of professionalism or surgical judgment in explicitly ethical terms. “This gives surgeons a new language with which to talk about things and an awareness of the influences that ought to be shaping their decisions,” Angelos said. “Being a better surgeon is not just about being technically better. It’s about appreciating the implications of what we do in the OR.” The University’s surgical ethics fellows undergo intensive instruction in philosophy and ethics. To help them tie philosophical and ethical principles back to real life, they are immersed in practical case studies and participate in an ethics consultation service, offering counsel to faculty members confronting ethical dilemmas in their everyday work. Karen M. Devon, MD, a 2011-12 fellow, credited the program with “completely changing the way I think.” She has returned to the University of Toronto, where she is an assistant professor of surgery, to institute a surgical ethics curriculum for residents there. Angelos is raising questions and opening up a dialogue, said Bosk, now professor of sociology and medical ethics at the University of Pennsylvania. “It’s a great thing to watch.” Recasting issues in ethical terms opens up more of a dialogue with patients, a critical function as patients become more uchospitals.edu/midway PHOTO BY BRUCE POWELL Peter Angelos, MD, PhD, an expert on endocrine surgery, talks with patient Jeﬀrey Guylay of Sun Valley, Idaho, at a postoperative checkup. involved in decision-making, Angelos said. “If a patient is really sick, whether to put them through an operation is a question of surgical judgment. But it also has ethical aspects because it needs to take account of their desired outcome.” The distinct way innovation is introduced in surgery is another core focus of the program. Whereas new drugs must demonstrate efficacy through strictly regulated trials and secure FDA approval before they may be generally prescribed, the development of novel surgical protocols frequently has occurred independent of such controls. “Take any surgical standard of care we now have — appendectomy, cholecystectomy, hepatectomy, neurosurgery, the great developments in thoracic and cardiovascular surgery, laparoscopic surgery, minimally invasive surgery and on — and trace them back, you find they are the result of professional self-regulation, innovations surgeons have made with oversight from their colleagues,” said Mark Siegler, MD, the Lindy Bergman Distinguished Service Professor of Medicine, director of the MacLean Center, and a long-standing member of the American College of Surgeons’ ethics committee. Moreover, extending some of the checks and balances governing innovation in other branches of medicine, such as placebocontrolled studies, to surgery is challenging, Angelos has written. In a 2003 paper in the American Journal of Bioethics, he noted, for example, that sham surgery, the surgical version of a placebo, is an invasive procedure with real risk, and that it entails a considerably more elaborate pretense than simply administering a sugar pill in a drug study — factors that make it difficult to use more than sparingly. But in a field in which iterative “tweaks” on established procedures or adaptations to accommodate physical differences between patients are commonplace, it may be unclear when an action constitutes outright experimentation for which explicit patient consent must be sought, Bosk, Angelos and others have observed. Such uncertainties place formal ethics instruction at a premium, Angelos said. Angelos’ background may make him uniquely qualified to provide this. His first encounter with philosophy and ethics came as a teenager through a class he took at the local State University of New York campus in upstate New York, where he grew up. “The concept of studying actions and that some were better than others was powerful,” he recalled. Angelos was hooked. Inspired by his physician father, he gravitated toward medicine while still in high school. Spurning offers from both Harvard University and the Massachusetts Institute of Technology, Angelos enrolled in the combined six-year BA/MD program at Boston University, where he soon felt the pull of surgery, his father’s specialty. But he kept up his interest in ethics, making philosophy his undergraduate minor. After Angelos completed his bachelor’s degree, he decided to continue his study Continued on page 18 MEDICINE ON THE MIDWAY SPRING 2013 17 PHOTO BY BRUCE POWELL Peter Angelos, MD, PhD, introduces two men who inﬂuenced his career trajectory: his father, surgeon S. Peter Angelos, MD, left, and Mark Siegler, MD. Continued from page 17 Angelos is “ideally suited to launch the new ﬁeld of surgical ethics,” Siegler said. 18 of philosophy by pursuing a PhD. Yet he struggled initially with how to apply his philosophical training to surgery. A formative influence in connecting the dots was David L. Nahrwold, MD, former chief of surgery at Northwestern University, where Angelos did his residency. As a young surgeon in the early 1960s, Nahrwold landed a fellowship in the lab of renowned physiologist Morton I. Grossman, MD, PhD, at the University of California, Los Angeles. “What I observed as a surgeon in a physiology department was that when [Grossman] would get together with professors from other disciplines, they’d generate ideas they could never have come up with on their own,” he recounted. In charge of admissions to the surgical residency program at Northwestern, Nahrwold made it a point to look out for nonconventional applicants who could bring knowledge from other fields to surgery. “I thought Peter could be an enormous resource for surgery in this country if he persisted and everything was orchestrated THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION to get him on the faculty someplace.” There was the small matter of the PhD though. Angelos had yet to finish it. His dissertation, “The Moral Responsibility of the Physician: A Philosophical Examination,” had been deemed “too applied”; he’d been asked to rewrite it. Now, he was entering the notoriously grueling surgical residency program designed to steel trainees to the rigors of surgical practice. Nahrwold arranged for Angelos to devote the residency’s research year to retooling his dissertation. To that end, Angelos enrolled in the clinical medical ethics fellowship program at the MacLean Center. Angelos finished his residency (Northwestern) and PhD (Boston University) in 1995. He then completed a yearlong fellowship in endocrine surgery at the University of Michigan. Nahrwold recruited him to Northwestern immediately after. At Northwestern, Angelos built a busy surgical practice and devised an ethics curriculum for surgical residents that became an early model for how ethics teaching could be undertaken in a surgical residency. He rose to become associate professor of surgery and chief of endocrine surgery. But something nagged at him. “We’d meet maybe once a year, and always return to the question of how he could better incorporate his training and interest in ethics into his clinical work,” recalled Siegler. Angelos’ acceptance in 2006 of a professorship at the Pritzker School of Medicine with an associate directorship in the MacLean Center offered him a platform. But Angelos and Siegler had something more in mind. “As we’d talk over the years, what came to us was the idea of developing this field of surgical ethics that had hardly been examined before, and establishing the first program in the nation at the University,” recounted Siegler. A history of surgical ethics The program Angelos established builds on a long-standing tradition of innovation in what would now be considered surgical ethics at the University of Chicago. For example, the way surgeons and Paternalism no more he doctor-patient relationship has undergone transformation over the past half-century. In a 2008 World Journal of Surgery paper, Peter Angelos, MD, PhD, cites the results of surveys conducted 14 years apart at Chicago’s former Michael Reese Hospital, polling physicians on whether they informed patients of a cancer diagnosis. In 1961, 88 percent said they did not; in 1975, 98 percent said they did. The shift illustrates the demise of so-called “paternalism” — what was once viewed as wellintentioned discretion (“saving patients from themselves”) now is viewed as overweening professional condescension. ethicists at the University of Chicago approached the first U.S. living-donor liver transplant in 1989 is considered an exemplar of responsible, thoughtful surgical innovation. Though living-donor liver transplants are widely accepted now, at the time there were concerns that the procedure could become “the first operation with a 200-percent mortality” — donor and recipient, Siegler recounted in a 2007 lecture. The University embarked on two-plus years of due diligence, consulting widely and formulating robust protections for living liver donors. This process culminated in the publication of a paper in the New England Journal of Medicine three months before the first living-donor liver transplant was performed. The paper presented a new ethical model to analyze surgical innovations before they are introduced. This scrupulousness ultimately cost the University of Chicago the prestige of being the first in the world to perform the surgery, noted Siegler, a prime mover behind the deliberations and co-author of the journal article. But it was instrumental in establishing the procedure in surgical practice, he said. “It was the Chicago protocol series of 40 cases that allowed the world to learn the techniques, to modify them and go forward.” While not as visible to the outside world, uchospitals.edu/midway innovations introduced by Angelos to the way surgeons work at the University of Chicago Medicine could have similarly far-reaching effects. Once a month, surgeons now fold an ethics discussion into the mortality and morbidity conferences they hold weekly to review difficult cases. “This is truly unique,” said Devon, the “It’s become a part of our daily activity to put things in an ethical framework,” said Jeﬀrey B. Matthews, MD, chair of surgery at the University of Chicago Medicine. former fellow. “The idea of having a bunch of surgeons discussing medical complications and including cases where an ethical issue is the focus is more progressive than you might imagine. It has become part of the surgical culture at the University of Chicago.” The innovation has been a lever for embedding ethical considerations into surgical practice more generally. “It’s become part of our daily activity to put things in an ethical framework,” said Jeff rey B. Matthews, MD, the Dallas B. Phemister Professor of Surgery and chair of surgery. Angelos’ personal example also has been pivotal in this. In 2011, his colleagues nominated Angelos to receive the Pritzker School of Medicine’s Faculty Physician Peer Role Model Award. “He’s articulate, approachable, curious and not judgmental,” said Matthews. “I’ve seen the discussion of ethics get sanctimonious; Peter is very non-judgmental. He’s nuanced and helps people think through problems. It makes the program feel real, not theoretical.” This equanimity was on display the time Angelos’ father watched him in action during his early days as a surgeon. Angelos was directing a procedure in which a resident was using a laparoscope when a “sudden flood of blood” appeared on the monitor, obscuring the view, recalled S. Peter Angelos, MD. “The resident said, ‘Dr. Angelos, you’ve got to get over on this side, so you can take care of this.’” “Peter said, ‘Now, you’re a surgeon, you’re going to learn how to do this. Just take 10 seconds to get your wits together.’ He walked her through things, but didn’t take over. He was patient, didn’t yell or lose his temper, and he didn’t get excited about a misadventure.” This comports with the vision Siegler and others had in the 1970s, which led to the creation of the MacLean Center: a new breed of “clinical” medical ethicist, who would bring a practitioner perspective to an ethics field then dominated by non-medical professionals. “Clinical ethicists have to demonstrate they are practitioners involved in the clinical mission, and Peter does that in an exemplary way. His clinical skills and judgment, technical abilities, and relationship with his patients are all of the first order,” Siegler said. “He was ideally suited to launch the new field of surgical ethics.” MEDICINE ON THE MIDWAY SPRING 2013 19 PHOTO BY BRUCE POWELL Robert Sanchez, MS2, Jason Espinoza, MS4, Jennifer Jones, MS2, and Christopher Smyre, MS1 A model approach to diversity Pritzker graduates many more underrepresented minority students than the national average. A new study explains why. BY MICHAEL MCHUGH T he Pritzker School of Medicine’s commitment to diversity made a big impression on undergraduate Robert Sanchez when he attended a medical school fair at Yale University. Three years later, he still had the Pritzker flyer he picked up that day. Sanchez, MS2, credits the leadership of Holly J. Humphrey, MD’83, dean for medical education, and the rest of the administration with living up to the commitment that inspired him to choose Pritzker. “I wanted to be at a place that had different students who were diverse, who had experiences similar to my own but who also came from different backgrounds,” he said. Diversity has become a hot-button issue in the health care industry, as changing demographics have led to physicians treating patients from increasingly diverse backgrounds. And those rolls are likely to grow as medical insurance becomes available to millions more patients through the Affordable Care Act. Historically, medical schools have done a poor job recruiting 20 and graduating underrepresented minority students. “The health of the population will be aided and improved by having a health care workforce that is more similar to the population itself demographically,” Humphrey said. Pritzker has done a better job than most of its peer institutions in attracting and graduating underrepresented minority (URM) students. In 2011, for example, 18 percent of Pritzker’s matriculating students were URMs, which the school defines as African-Americans, Mexican-Americans, Puerto Ricans, and Native Americans. The Association of American Medical Colleges also collects national data on the amount of diversity among national matriculants, including ethnic and racial characteristics. While definitions of what constitutes underrepresentation in medicine vary by school and region, the amount of diversity in national matriculants is still strikingly lower than that found at the Pritzker School of Medicine. The reasons Sanchez chose Pritzker over other top institutions are echoed in the findings of a qualitative study of current and former students. “The Minority Student Voice at One Medical School: THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Lessons for All?” by Humphrey and colleagues was published in the January 2013 issue of Academic Medicine. A key component in Pritzker’s approach to diversity is the mandatory course on health care disparities. The six-week course exposes first-year medical students to the types of inequities in health care they are likely to face as doctors and begins to prepare them to communicate across various cultures. The course made a big impact on Sanchez. “For me, it was the symbolism and representation that it meant,” he said. “I realized during my time at Yale, and working with the different administrations there, that having such a course takes a lot of effort. It takes a lot of time, and it takes leadership from the top.” The study found the support system between students within the classroom is a key contributor to success among minority students. Underlying the noncompetitive environment is the pass/fail system, an alternative system of evaluation that doesn’t pit students against their peers. Outside the classroom, a variety of school-supported student groups, regular interactions with faculty and staff during which students can raise issues of concern, and Humphrey’s ongoing meetings with the Student National Medical Association all demonstrate Pritzker’s commitment to diversity, Sanchez said. “There is nothing like having a diverse group of engaged students who are respectful of others’ opinions and yet feel free to ask the questions to which they need answers.” Monica B. Vela, MD’93, associate dean for multicultural aﬀairs, Pritzker School of Medicine And that institutional support helps relieve some of the pressure minority students can feel as being representative of their ethnicity or background. “As a student coming from an underrepresented background, you want to be able to share your experiences, but you also don’t want it to be your responsibility to educate the other students on the importance of diversity,” Sanchez said. “That’s going to burn me out as a student. That’s not my job. My job as a student is to work on becoming a doctor.” While Humphrey’s study found many supportive factors that help underrepresented minority students find success at Pritzker, there are some obstacles. One barrier that Pritzker and other medical schools are working to overcome is the lack of underrepresented minority faculty members. “We’re always searching for mentors, but there are limited numbers,” said Sanchez. To address the issue, the University tapped Melissa Gilliam, MD, MPH, professor of obstetrics/gynecology and pediatrics, to be associate dean for diversity and inclusion in the Biological Sciences uchospitals.edu/midway Student honored for leadership F rom their first days at Pritzker, students are immersed in an environment that values diversity. That’s exactly what Ndang Azang-Njaah, MS3, was looking for in a medical school. “I didn’t grow up in a very diverse environment,” said AzangNjaah, who is from northern Maryland. “I really wanted to make sure it was reflected in the school I chose.” Pritzker student organizations offer a wide variety of service opportunities that address health care disparities from different angles. So far, Azang-Njaah, in partnership with his colleagues, has installed drywall with Habitat for HumanNdang Azangity in storm-ravaged Mississippi; talked Njaah, MS3 about obesity, diabetes and hypertension at a Native American conference in South Dakota; co-led a nutrition-based workshop at Chicago Public Schools; and served as co-president of the HIV Intervention and Prevention Corps. In 2011, as a fellow with the Chicago Area Schweitzer Fellowship Program, he designed a project with the Chicago Family Health Center to promote nutrition and chronic disease awareness among patients at a South Side clinic. Azang-Njaah was chosen last fall to receive the prestigious Herbert W. Nickens Scholarship — one of only six awarded nationally by the Association of American Medical Colleges (AAMC). The scholarship recognizes third-year students “who have shown leadership in efforts to eliminate inequities in medical education and health care and have demonstrated leadership efforts in addressing educational, societal, and health care needs of minorities in the United States.” His experiences at Pritzker have strengthened Azang-Njaah’s commitment to working with underserved populations. “For training I am considering internal medicine-pediatrics, and hoping to be able to do a primary care focus within that field in an underserved community here or abroad,” he said. Division and hospital at the start of 2012. This past September, Brenda Battle, RN, BSN, MBA, was named assistant dean for diversity and inclusion and vice president for care delivery innovation at the University of Chicago Medicine. “The big picture goal is to have a more diverse physician workforce and to have a learning environment that is noted for openness to diverse points of view,” Humphrey said. “This is especially important in medicine where patients come to us from very diverse backgrounds.” MEDICINE ON THE MIDWAY SPRING 2013 21 A A M C I N N O V AT I O N A W A R D Pritzker News Making clinic handoffs safer Pritzker team wins a national award for its innovative, patient-oriented model BY ELIZABETH GARDNER P atients in an ambulatory clinic staffed by University of Chicago Medicine residents see a new doctor every two years. Each senior typically hands off 100 patients to a rising second-year resident. As crucial as the system is for training young physicians nationwide, it also can be a recipe for missed appointments, untimely follow-up and tenuous physician-patient relationships. A model to improve patient handoffs in resident clinics developed by Amber Pincavage, MD’07, and two recent Pritzker School of Medicine graduates recently won one of only three national Readiness for Reform Healthcare Innovation Challenge Awards awarded by the Association of American Medical Colleges (AAMC). Their project was entitled “Engineering PatientOriented Clinic Handoffs in an Urban Residency Ambulatory Practice.” Pincavage, assistant professor of medicine and co-director of the medicine clerkship, recalled her own handoff experience. “The patients would ask, ‘How long are you going to be here?’ because some of them had had a lot of different physicians,” Pincavage said. “Sometimes they would delay coming in, and they’d run out of their medications and bad 22 PHOTO BY JEAN LACHAT Amber Pincavage, MD’07, supervises internal medicine residents who staﬀ an ambulatory clinic at the University of Chicago Medicine. things would happen. When I became ambulatory chief resident, I decided I wanted to work on this process and improve it.” P i n c av a g e f o c u s e d o n high-risk patients most likely to get lost during the handoff process or suffer adverse medical consequences from gaps in care. These include, for example, patients with multiple complicated medical problems. Preliminary research showed that while almost all of those patients were properly scheduled to see their new doctor soon after the handoff, 29 percent missed the appointment. Twenty percent of high-risk patients were lost to follow-up within six months of the handoff, and one in four had an emergency room visit THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION or a hospital stay during the three-month period after the handoff. Just as worrisome, almost half the residents said they didn’t perceive a patient as “theirs” until they saw them in clinic. Pincavage expects to publish results shortly, showing that the new protocol has substantially improved follow-up and the health of residents’ patients. NAMED PROFESSORSHIPS Patient-focused model for handoﬀs The new model for ambulatory resident clinic handoﬀs developed by Amber Pincavage, MD’07, and her team addresses: Communication Outgoing residents prepare a written sign-out on patients and review the information face to face with new residents. Scheduling High-risk patients receive a regular appointment schedule throughout their care with a resident and priority in scheduling when the new resident takes over. No-shows for the initial appointment are automatically rescheduled once. Contact New residents call their high-risk patients and introduce themselves, ask about problems, follow up on pending tests and ensure medications are reﬁlled. All new patients receive letters from both residents informing them of the change. The letters include some professional and personal background on the new physician, including a photo and even a phonetic pronunciation of the resident’s name. Appreciation Each time they have to change doctors, patients receive a certiﬁcate recognizing the important role they play in resident education. Pincavage focused on highrisk patients most likely to get lost during the handoff process. Her co-authors are Megan Prochaska, MD’11, now an internal medicine resident at the University of Chicago Medicine; Marcus Dahlstrom, MD’12, internal medicine resident at the University of California, San Francisco; Wei Wei Lee, MD, MPH, assistant professor of uchospitals.edu/midway medicine; Lisa Vinci, MD, MS, associate professor of medicine and medical director of the Primary Care Group; and Julie Oyler, MD’01, assistant professor of medicine and associate program director of the internal medicine residency. Pincavage’s mentor in the field of handoff research is Vineet Arora, MD, MA’03, associate professor of medicine, assistant dean for scholarship and discovery and associate program director of the internal medicine residency. Their work was funded by the Picker Institute-Gold Foundation Challenge Grant, and the Bucksbaum Institute for Clinical Excellence and Graduate Medical Education Committee at the University of Chicago. Deans Humphrey, Gilliam honored H olly J. Humphrey, MD’83, dean for medical education at the University of Chicago Pritzker School of Medicine and a nationally recognized leader in medical education scholarship, has been named the Ralph W. Gerard Professor in Medicine. Humphrey served as director of the internal medicine residency program for 14 years before moving to her current position in 2003. She has launched numerous initiatives at Pritzker, including a sweeping curriculum reform effort, advising and mentoring programs, and the Bowman Society, which explores issues of health care disparities and provides mentoring for minority students, residents and faculty. Humphrey also was instrumental in the development of new pipeline programs to Holly J. Humphrey, MD’83 prepare underrepresented minority students for careers in medicine. She is the editor of “Mentoring in Academic Medicine” (2010), a member of the board of trustees of the American Board of Internal Medicine Foundation, former president of the Association of Program Directors of Internal Medicine (APDIM) and a Master of the American College of Physicians. Conrad Gilliam, PhD, professor in human genetics and dean for research and graduate education in the Biological Sciences Division, has been named the Marjorie I. and Bernard A. Mitchell Distinguished Service Professor. Gilliam is an authority on the identification and characterization of heritable mutations that affect the nervous system. As dean, he is responsible for the strategic planning and quality control of research and graduate education throughout the BSD. He also is a senior fellow at the Computation Institute and the Institute for Genomics and Systems Biology and a Pritzker Fellow. T. Conrad Gilliam, PhD Gilliam came to the University in 2004 from Columbia University, where he was a professor in the departments of genetics and development, and psychiatry, and director of the Columbia Genome Center since 2000. MEDICINE ON THE MIDWAY SPRING 2013 23 AMONG PEERS ALPHA OMEGA ALPHA MEDICAL HONOR SOCIETY Pritzker News Now a resident, Sho Yano, MD’12, PhD’12, blends in for the ﬁrst time — and likes it. BY DARCY LEWIS N early a year into his residency in pediatric neurology at the University of Chicago Medicine, Sho Yano, MD’12, PhD’12, believes his patients and their families see him as simply another competent, caring member of the pediatric neurology team. Yano, the youngest person ever to receive a medical degree from the Pritzker School of Medicine, relishes the relative anonymity. “I don’t make a habit of telling patients my age and they don’t ask,” he said. “To them, I’m just their doctor and I like that.” At 22, Yano no longer stands out among fellow residents as he did when he entered Pritzker at 12, or Loyola University Chicago at 9. “I’ve wanted to be treated as a peer since I was in college — that’s a courtesy everyone deserves,” he said. “My colleagues know how old I am, but that doesn’t affect my professional life.” Of course, the rigors of residency offer an equalizing influence. Yano has completed a variety of rotations including general pediatrics, specialty pediatrics and some clinic rotations, including adolescent medicine, pediatric pulmonology and ambulatory pediatrics. And he has faced the inescapable reality that not all patients survive. “I lost a patient in the NICU,” he said. “I’d had training in how to cope, but nothing can really prepare you for a death.” Despite the pain of losing his tiny patient, Yano remains convinced that pediatric neurology is where he belongs. “In neurology, many kids have conditions we cannot cure and intervening is actually the wrong thing to do,” he said. “But we can 24 AOA induction T PHOTO BY ROBERT KOZLOFF Sho Yano, MD’12, PhD’12, in the Newborn Intensive Care Unit at the University of Chicago Medicine Comer Children’s Hospital. always use a team-based approach to do many things for the whole person and the family long term.” With his PhD in molecular genetics and cell biology, Yano sees his ultimate path at the crossroads of science and medicine. “In my PhD program, I worked on DNA replication in E. coli, which has almost no clinical relevance but was an interesting basic science project,” he said. “I still want to be a medical scientist specializing in pediatric neurology. Now I just have to figure out to apply these skills to neurology problems.” THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION he University of Chicago Alpha Omega Alpha Medical Honor Society Class of 2013 has announced faculty, housestaff and alumni award winners. This year, three of the honorees are from the University of Chicago Medicine Department of Obstetrics/Gynecology: Sabrina Holmquist, MD, MPH, assistant professor and director of the third-year medical student clerkship in obstetrics/gynecology; Samantha Pace, MD, fourth-year resident; and Michael J. Hughey, MD, clinical educator at the affiliated NorthShore University Health System. Hughey received the Volunteer Clinical Faculty Award, which recognizes a community physician for teaching excellence. “It’s unusual for a small department such as ours to have so many people honored at one time,” said Sandra Valaitis, MD’89, chief of gynecology/reconstructive pelvic surgery. “We are very proud of this recognition and feel this is a reflection of the dedication to teaching that our residents and faculty provide to Pritzker students.” AOA students also elected Daniel Rubin, MD, assistant professor of anesthesia; housestaff Juan Camilo Barreto-Andrade, MD, and Sherise Ferguson, MD’06, both of the Department of Surgery; and alumni Donald D. Brown, MD’56, MS’56, Department of Embryology, Carnegie Institution of Science; and James E. Bradner, MD’99, Department of Medical Oncology, Dana-Farber Cancer Institute Department of Surgery. A list of the 2013 inductees, announced last fall, can be found at pritzker.uchicago.edu/ current/students/aoa.shtml. M AT C H D AY 2 0 1 3 A Match made in Medical school Seconds before they open their envelopes. PHOTOS BY BRUCE POWELL Fourth-year students enter the couples match hoping it’s not ’til residency do they part BY EILEEN NORRIS H olly J. Humphrey, then a fourth-year medical student, could feel the tension in the auditorium. She and her classmates at the Pritzker School of Medicine were waiting to hear where they would be accepted for residency training. For Humphrey, this was professional, but it was also personal. Her husband was a medical student at the University of Illinois at Chicago. They were about to learn if the next several years would be spent together or apart. uchospitals.edu/midway She opened her envelope: The University of Chicago, her first choice. She hurried to a telephone and paged her husband, Duane Follman. “I think I got him on the first try,” she said. They were ecstatic: He had matched at the University of Chicago, too. “You have the worst-case scenario in your mind,” Follman said recently. “We were newly married, so there were a lot of implications if we didn’t get into the same program at the same institution. We would have never seen each other. By the grace of God, we did. It was surreal. I was Molly Naunheim, MS4, and Kevin Choo, MS4, matched together at the University of California, San Francisco. still pinching myself two days later. There weren’t very many couples matching in those days, but we took a risk and it worked for us.” That was 1983. Humphrey is now the Ralph W. Gerard Professor in Medicine and dean for medical education at Pritzker. Follman, MD, is a cardiologist in Hinsdale, Ill. For new physicians, Match Day continues to be an anxious time. The match process can be enormously stressful, but it’s even more tense for couples who want to Continued on page 26 MEDICINE ON THE MIDWAY SPRING 2013 25 Continued from Page 25 Pritzker News be in the same program — or at least in the same city. The partners identify themselves to the National Resident Matching Program (NRMP) and submit rank order lists. The algorithm treats the two lists as a unit, matching the couples to the highest pair of program choices where both partners obtain a match. Each year, approximately 16,000 U.S. medical school students participate in the Main Residency Match, along with 20,000 independent applicants competing for the roughly 26,000 residency positions available. Match Day is the ultimate nail-biter, almost up there with a marriage proposal. For many couples who date through medical school, the decision to enter the match can make or break the relationship. David Hwang, MD’11, a second-year pathology resident at Harvard Universityaffiliated Brigham and Women’s Hospital in Boston, says he has seen couples who were on the fence about their relationship part ways because of the huge commitment required to enter the couples match. Hwang and his wife Nancy Wang, MD’11, a neurology resident at Brigham and Harvard-affiliated Massachusetts General Hospital in Boston, met in the anatomy lab their first year at Pritzker. They married during their last year of medical school. Brigham was their first choice. “On Match Day, we opened each other’s envelopes because it was too nerve-wracking to look at our own,” said Hwang. “We were lucky and it worked out that we got our first choice,” said Wang. Last year, Pritzker had six pairs of students participating in the couples match. For Patrick Lyons, MD’12, and Maureen Willcox, MD’12, Match Day was a mix of emotions. The moment it was clear medical school was winding down, a new life called. The couple, who have been together for 4½ years, had a certain level of confidence in the process. “The couples match is certainly a learn-as-you-go process, but internal medicine, where we both entered, is a couples-friendly field,” said Willcox. Most programs scheduled their residency interviews on the same day. “I was even asked by more than one institution, good- 26 PHOTO BY DAVID CHRISTOPHER Maureen Willcox, MD’12, and Patrick Lyons, MD’12, are internal medicine residents at the University of Chicago Medicine. PHOTO COURTESY OF HOLLY J. HUMPHREY, MD’83 Holly J. Humphrey, MD’83, and her husband, cardiologist Duane Follman, MD, and their three children. The decision to try to match as a couple can make or break a relationship. naturedly of course, when I planned to propose,” Lyons said. They matched together at the University of Chicago Medicine, which has been “terrific,” Lyons said. “The program administration and the chief residents have been wonderful about helping us match up vacations and days off, and we’ve been able to maximize our time away from work together. It’s incredibly comforting to know how supported we are by our program.” THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Trying to enter a competitive specialty or a smaller program can pose challenges for couples. Kevin Choo, MS4, and Molly Naunheim, MS4, who have dated for 2½ years, matched at the University of California, San Francisco, their first choice, on March 15. They knew it wasn’t a sure thing. Both are in highly competitive fields — Choo in orthopaedic surgery, Naunheim in otolaryngology. “Absolutely, we worried about it,” Naunheim said. Naunheim said they picked schools that were strong in both specialties to improve their chances of matching together in their chosen programs. To raise their odds, they did rotations at each of the top four programs on their preference list. “We think that gave us a better chance of admission,” said Choo. “They knew us and our work.” Choo didn’t find the match application process itself all that taxing. “One of the comforts is you can’t really influence the process other than doing well and trusting your instincts during interviews,” he said. “But, for sure, we got caught up in the emotion of the day and learning where we’ll be living for the next five years.” The couple planned to take a longanticipated vacation to Italy before beginning the next phase of their medical careers together. “It’s going to be a great place to train,” said a happy, relieved Choo, “and to be with Molly.” It’s a match! PHOTOS BY BRUCE POWELL California, here she comes. Marcia Faustin, MS4, will train in family medicine at the University of California, San Diego. A ll 82 members of the Pritzker School of Medicine Class of 2013 matched with a residency program — and in keeping with a national trend, nearly half will be going into primary care. Internal medicine once again was the most frequently selected specialty, attracting 21 Pritzker students. Other popular specialties were pediatrics (11), family medicine (6), obstetrics-gynecology (6) and general surgery (5). Students, along with their family and friends, packed Billings Auditorium on Match Day, described by University of Chicago Medical Center President Sharon O’Keefe as a cross between the NFL Draft, March Madness and Harry Potter’s sorting hat. The largest group (19) will stay at the University of Chicago Medicine for all or uchospitals.edu/midway Students watch a slide show of their four years at the Pritzker School of Medicine. some of their training. The other hospitals accepting the most Pritzker students to their categorical/ advanced programs were Northwestern University-affiliated hospitals (4), Duke University Medical Center (3), Harvard University-affiliated hospitals (3), UCLA Medical Center (3), University of California, San Diego (3), University of California, San Francisco (3), University of ColoradoDenver (3), University of Pittsburgh Medical Center (3), University of Utah (3), University of Washington (3) and Yale-New Haven Hospital (3). Kenneth S. Polonsky, MD, Dean of the Biological Sciences Division and the Pritzker School of Medicine and executive vice president for Medical Affairs at the University of Chicago, reminded students that they are graduating from a medical school that placed No. 8 in the latest U.S. News & World Report rankings. “Just remember us, and carry with pride that you graduated from Pritzker,” Polonsky said. “It’s a passport to the very best opportunities in the country.” MEDICINE ON THE MIDWAY SPRING 2013 27 ANNUAL POETRY CONTEST Pritzker PritzkerNews News An ode to compassion A s an undergraduate humanities student at Gonzaga University, Lindsay Poston, MS1, had no interest in medicine. She thought doctors were cold and calculating. She wanted to go into social work. A health care ethics class, followed by an internship shadowing physicians, changed all that. “The time I spent with the doctors in palliative care really made it clear that medicine was not just about fixing the human body, but about accompanying people on their journey and restoring the dignity that is really stripped away by poverty and illness,” she said. Poston is the winner of the 2012-13 Pritzker Poetry Contest for her poem, “One More Cut,” inspired by her experiences at the palliative care center. The mission of the poetry contest, now in its second year, is to foster compassionate care and enhance the caregiver-patient relationship. More than 110 poems were submitted, a 20 percent increase from last year. The contest was started by Rama D. Jager, MD, clinical assistant professor of ophthalmology and visual science, who provided financial support for this year’s awards. Last year’s open poem entry winner, Joshua Williams, MS4, and James Woodruff, MD, associate dean of students, coordinated this year’s contest. “Poetry offers a relatively unique opportunity to explore very personal aspects of human interaction, like compassion, through a medium that permits one to publicly celebrate a personal sentiment,” Woodruff said. To read all the winning poems, see duchess.bsd.uchicago.edu/poetry. To watch a video of Lindsay Poston reading her winning entry, please go to uchospitals.edu/news/ features/pritzker-poetry.html. First place winner: Six-word poem entry Fear by Gini Fleming, MD, with Donald Fleming Alone, I see darkness. Stay near. First place winner: Open Poem Entry One More Cut by Lindsay Poston, MS1 Memory slits grimace, recalling days she was the clown And days she sang the Morning Star with a voice that rang strong and clear as the morphine drip now pinned through ﬂailing forearm, thinned enough to show two bones. Belly scars inscribe a life, of babies born, then ovaries torn, of kidneys lost and gained. And with the newest cut, she’s lost a knee that bounced those giggling babes, a leg that danced the days she sang. Where once that sturdy leg was bent, fresh stitches stretch ﬂesh ‘round bone’s end. Drip runs dry, the Morning Star fades. One grandchild on the phone, ﬁghting doctors, calling home. Saying three weeks left — unless they carve out something new. Amidst murmurs of some-ectomy, anesthetized, she speaks her plea: They just cut, cut, cut, it ain’t nothin’ new. They just cut, cut, cut where the bad cells grew. Doctor, no, I’m tired, I’m through. One more cut ain’t gonna heal, one more cut ain’t gonna do. P R I T Z K E R C O M M U N I T Y I N V O LV E M E N T New addition to the Pritzker Free Clinic family Altaf Kaiseruddin, MD, left, clinical assistant professor of family medicine and medical director of the IMAN Free Clinic, a program of the Inner-City Muslim Action Network, helps Pritzker students hone their clinical skills during an examination. The clinic provides free, accessible and holistic health care to a diverse patient population on Chicago’s South Side. 28 THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION GOLD HUMANISM HONOR SOCIETY Fourth-year students inducted, teachers honored Seventeen fourth-year students were inducted in March into the Gold Humanism Honor Society, which honors medical students who consistently demonstrate excellence in clinical care, leadership, compassion and dedication to service. Joel Schwab, MD, professor of pediatrics and former clerkship director of pediatrics, and Toussaint Mears-Clarke, MS4, received the Leonard Tow Humanism in Medicine Award. Also honored was Mari Egan, MD, MHPE, assistant professor of family medicine and director of medical student education in the Department of Family Medicine, who was the 2012 AAMC Humanism in Medicine nominee. A list of the 2013 GHHS members, announced last fall, is at pritzker.uchicago.edu/current/students/ gold.shtml. C O L L A B O R AT I O N LCME Grants awarded for multidisciplinary projects The Neubauer Family Collegium for Culture and Society has selected its inaugural list of 18 research projects for the coming year, including two initiatives involving faculty members from the Pritzker School of Medicine. Formed last year through a $26.5 million gift in honor of Joseph Neubauer, MBA’65, and Jeanette Lerman-Neubauer, the Neubauer Collegium supports research into large-scale questions that require expertise and perspectives of many disciplines at the University of Chicago. Game Changer Chicago (GCC) Design Lab is a collaboration between Melissa Gilliam, MD, MPH, professor of obstetrics/gynecology and pediatrics, and chief of family planning and contraceptive research, and Patrick Jagoda, PhD, assistant professor of English. The project explores the use of games and digital media to study sexuality, gender, reproductive health, and structural inequalities in urban communities. The second Pritzker-related project, which will explore fundamental issues related to health as a human right, brings together faculty members from several disciplines, including Evan Lyon, MD, assistant professor of medicine, and Renslow Sherer Jr., MD, professor of medicine. uchospitals.edu/midway Pritzker accreditation renewed The Pritzker School of Medicine has been reaccredited by the Liaison Committee on Medical Education (LCME). In announcing the accreditation renewal, the LCME noted Pritzker’s strengths, including an atmosphere of collegiality that fosters innovative and interdisciplinary scholarship, a research infrastructure that encourages and supports student participation, effective student wellness and faculty advising programs, and the Pritzker faculty’s demonstrated commitment to research productivity and success at securing outside funding. The next accreditation survey will take place during the 2020-21 academic year. MEDICINE ON THE MIDWAY SPRING 2013 29 NEWS Class Notes Alumni, get the latest news and stay connected with your classmates through the Medical & Biological Sciences Alumni Association (MBSAA) website at medbsd.uchicago.edu/alumni. REUNION IS COMING UP JUNE 6-8 Attention alumni emeriti and those from the Classes of 1963, 1968, 1973, 1978, 1983, 1988, 1993, 1998, 2003 and 2008. Reunion is coming up in June 2013. So that you stay up to date, be sure to submit your current contact information at medbsd.uchicago.edu/alumni/get-involved/update-your-info. 1940s Janet D. Rowley, LAB’42, PhB’44, SB’46, MD’48, the Blum-Riese Distinguished Service Professor of Medicine, Molecular Genetics and Cell Biology, and Human Genetics at the University of Chicago, has been awarded the Albany Medical Center Prize in Medicine and Biomedical Research for 2013. Rowley shares the $500,000 prize, one of the largest for medicine and science discoveries in the U.S., with two other physician-scientists. The three recipients were chosen for their groundbreaking research that led to the development of a new generation of highly focused cancer drugs, beginning with imatinib (Gleevec) for leukemia. Also this spring, Rowley was named to the first class of fellows of the American Association for Cancer Research Academy. 1950s Edward Paloyan, MD’56, is a winner of the 2013 Centennial Medallion from the Hinsdale Hospital Foundation. The honor is awarded every two years to a leader from the medical staff and from 2012-13 ALUMNI COUNCIL Robert Doroghazi, MD’77, President Anthony Cutilletta, MD’68, Immediate Past President Rene Mora, PhD’88, MD’89, Vice President Paul R. Rockey, MD’70, Reunion Chair Arnold B. Calica, SM’61, MD’75, Regional Chair Michael H. Silverman, MD’73, Chicago Partners Chair Chris Albanis, AB’96, MD’00, Editorial Committee Chair Dianne Altkorn, MD’82 Diana Chung, MD’92 Lawrence Cutler, MD’80 Mark Ferguson, MD’77 Melina Hale, PhD’98 David Holtzman, PhD’67, MD’68 Maga Jackson-Triche, AB’71, MD’75, MSH Julian Katz, MD’62 Si-hoi Lam, AB’76, MD’80 Dennis Lee, MD’91 Jacqueline Moline, AB’84, MD’88 Dean Rider, MD’78 Patricia Simmons, MD’77 Donald Steiner, MD’56, SM’56 Jack Stockert, AB’05, MBA’10, MD’10 Leo van der Reis, MD’54 David Whitney, MBA’78, MD’80 Lifetime Members: Lampis D. Anagnostopoulos, SB’57, MD’61 Coleman Seskind, AB’55, SB’56, MD’59, SM’59 Russ Zajtchuk, SB’60, MD’63 30 the community. “Dr. Paloyan is one of the most highly respected members of our medical staff,” said Gary Lipinski, MD, regional vice president and chief medical officer. “His many years of ongoing clinical excellence and compassionate bedside care are a model for all physicians.” Paloyan, a surgical endocrinologist, has been affiliated with Adventist Hinsdale Hospital for more than 25 years. 1970s Stanley Schwartz, MD’73, is now an emeritus professor of medicine at the Perelman School of Medicine at the University of Pennsylvania after 32 years with the institution, having also directed the diabetes program at the Philadelphia Heart Institute. Now in private practice, Schwartz is the recipient of a National Institutes of Health grant to add to knowledge on the genetics of latent autoimmune diabetes in adults (LADA). Schwartz spends his time writing, teaching, seeing patients, and most of all having fun. 1980s Nobel laureate Bruce A. Beutler, MD’81, has been elected to the American Academy of Arts and Sciences. The esteemed organization, founded in 1780, recognizes leading “thinkers and doers” of each generation. Beutler is the director of the Center for the Genetics of Host Defense and a Regental Professor at UT Southwestern Medical Center in Dallas. He shared the 2011 Nobel Prize in Physiology or Medicine for his research on innate immunity. Anna Lysakowski, AB’76, PhD, professor of anatomy and cell biology at the University of Illinois at Chicago, was recently named a United States Fulbright fellow for 2013-14 for her work in studying the organization of the vestibular sensory apparatus through a combination of structural, functional, and molecular approaches. She also was recently inducted as a fellow of the American Association of Anatomists. Lysakowski held a postdoctoral appointment at the University of Chicago from 1985 to 1990. Fuki Marie Hisama, MD’88, is an associate professor in the Division of Medical Genetics of the University of Washington Department of Medicine. She is the medical director of the largest adult genetic medicine clinic in the country and directs the University of Washington residency program in medical genetics. In 2012, she organized and moderated the March of Dimes Presidential Plenary Session (on the genetics of aging and progeroid syndromes) at the American College of Medical Genetics annual meeting. Hisama’s career in genetics is featured in an exhibit at the Pacific Science Center in Seattle. In her spare time, she enjoys hiking with her family and their hounds in the beautiful parks of the Pacific Northwest. Juliet Spelman, MD’88, has moved her private psychiatric practice to Libertyville, Illinois. Spelman shares that she has been married for eight years and has a daughter who is a freshman in high school and a joy to parent. 1990s Gina Kim Song, SB’94, MD’98, reports that she is married with three wonderful children. Song manages three physicians in private practice in Saint Charles, Illinois. Song’s specialty is pediatrics. James E. (Jay) Bradner, MD’99, was named to The Atlantic magazine’s 2012 list of “Brave Thinkers.” Bradner, assistant professor and cancer researcher at Harvard Medical School and the Dana-Farber Cancer Institute, was cited for his “revolutionary” open-source approach to developing new drugs. After discovering a molecule that, in laboratory models, appears to trick some cancer cells into becoming normal cells, Bradner chose to give the molecule’s structure to other scientists rather than pursue private development. “I would be greatly satisfied if the example of this research contributed to a change in the culture of drug discovery,” Bradner told The Atlantic. 2000s Marni Hillinger, MD’08, is finishing her term as chief resident for 2012-13 in the Department of Rehabilitation Medicine at New York-Presbyterian THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Hospital. In December 2012, Hillinger was recognized as one of Columbia University’s Physicians of the Year Award winners. Jun Y. Matsui, MD’08, has accepted a prestigious fellowship at the Washington University Orthopedics Peterson Hand Center in St. Louis next year. F A C U LT Y N E W S Neil Shubin, PhD, University of Chicago evolutionary biologist, connects the dots between astronomical events and the human species in his new book, “The Universe Within: Discovering the Common History of Rocks, Planets, and People” (190 pages, Pantheon). Shubin, the Robert R. Bensley Distinguished Service Professor of Organismal Biology and Anatomy and associate dean for academic strategy, pulls together data from geology, biochemistry and anatomy, which he interweaves with personal tales of scientific exploration and discovery, to trace the impact of cosmic events on the human body. The book is a followup to Shubin’s 2008 bestseller, “Your Inner Fish.” Stacy Tessler Lindau, MD, MA, associate professor of obstetrics/ gynecology and medicinegeriatrics, has received the 2013 Vision and Impact Award from the Midwest Region of the American Committee for the Weizmann Institute of Science. The organization recognized Lindau for her work helping women and girls cope with sexual health problems following cancer treatment, and for her research on such topics as female aging and sexuality, urban population health improvement and fairness in health care. She is the director of the Program in Integrative Sexual Medicine (PRISM) at the University of Chicago Medicine and director of the South Side Health and Vitality Studies at the University of Chicago Urban Health Initiative. In Memoriam Class Notes F A C U LT Y Ira Wool, MD’53, PhD’54, the A.J. Carlson Professor of Biochemistry and Molecular Biology, died October 23, 2012, in Chicago. He was 87. Wool was a pioneer in the study of the structure and function of the ribosome. A demolition specialist during World War II, he attended Syracuse University on a football scholarship. He joined the University faculty in 1957, and maintained his laboratory for more than 50 years. Wool received many distinguished awards, including the Federal Republic of Germany’s Alexander von Humboldt Special Fellowship in 197375, the Pierce Immunotoxin Award in recognition of his major contribution to the understanding of immunotoxin function and design in 1992, and the Distinguished Service Award from the University of Chicago Alumni Association in 2003. He served on editorial boards for scientific journals and on advisory committees for the National Institutes of Health, American Heart Association, and American Cancer Society. He was author of more than 260 published papers and contributed regularly to standard textbooks in his discipline. He traveled as a visiting scientist and professor around the world, including a year at the Max Planck Institute in Berlin. Avidly involved in the visual arts, he assembled one of the premier collections of artists’ books in the country. Wool’s enthusiasm for and commitment to young artists sustained many at the start of their careers, including one of his sons. Survivors include his wife, Barbara Mirecki, AB’71, two sons and a brother. ALUMNI Marvin Calmenson, MD’38, died January 12, 2013, at age 98. He was a renowned and highly respected surgeon in the Sherman Oaks, California, area for more than 46 years, having served at the Providence Tarzana Medical Center (Tarzana), Valley Presbyterian Hospital (Van Nuys), and Sherman Oaks Community Hospital (Sherman Oaks). He is survived by his wife of 63 years, Teddi, four children, three grandchildren and three greatgrandchildren. Arthur C. Connor, MD’43, died January 3, 2013, at age 92. A Chicago-area orthopaedist, Connor served as a U.S. Navy physician for 20 years before going into private practice. He was active in the American Academy of Orthopaedic Surgeons, having contributed to its 75th anniversary celebration festivities. He is survived by his wife, Noelle, his brother, Harry, and seven children. Gene W. Farthing, MD’40, died December 9, 2012, in Springfield, Missouri. He was 98. Though he began his medical training at the University of Missouri School of Medicine, he completed his medical degree and his residency at the University of Chicago. He returned to Springfield in 1941 to work in private practice until his retirement at age 72. Survivors include his wife of 70 years, Nancy, and their three children, seven grandchildren and six great-grandchildren. M. Richard Koenigsberger, MD’59, passed away at home on February 17, 2013, at age 79. Born in Guatemala, he received his bachelor’s degree in chemistry from Stanford University. Immediately following his medical training, Koenigsberger was among the first to serve as a Peace Corps volunteer physician in Togo in West Africa. After his return to the U.S., he took a post in pediatrics and neurology at Columbia University from 1968 to 1980, later serving at the University of Medicine and Dentistry of New Jersey before returning to Columbia in 2000. Koenigsberger is remembered for his active and effective teaching style, a mix of colorful humor and professional rigor. His academic credentials were further represented by his appointment and service as an examiner for the American Board of Pediatric Neurology. He is survived by his wife, Dorcas, three children and a granddaughter. Richard A. Forney, MD’39, died December 13, 2012, at age 98. A proud native of Boise, Idaho, Forney returned to the area after medical school. A general and thoracic surgeon, he served in the U.S. Air Force during World War II as a lieutenant colonel and flight surgeon in the Medical Corps, serving in Africa and Italy. After the war, Forney developed a rich career, including public service as president of the American College of Surgeons, a fellow in the International Society of Surgery, and a member of the American Medical Association and Idaho Medical Association. An avid traveler, Forney served as a volunteer lecturer in surgery at Avicenna Hospital in Kabul, Afghanistan, and spent his free time as a big-game hunter. His vast collection was donated to Zoo Boise. He is survived by his wife of 13 years, Virginia, and three children. James Edward Levin, PhD’87, MD’88, passed away unexpectedly at age 55 while traveling for business on February 10, 2013. Levin earned a doctorate in genetics and a medical degree from the University, after which he completed his residency at the University of Michigan and fellowships in pediatric infectious diseases and medical informatics at the University of Minnesota. After his training, Levin settled into his permanent home in Pittsburgh, Pennsylvania, at Children’s Hospital of Pittsburgh. Levin was lauded by his colleagues as the hospital’s “moral compass,” an “unflappable” physician committed to his patients and his duties as chief medical information officer of the institution. He is survived by his wife Regina, two children and three siblings. Aidan W.K. Ip, AB’75, MD’79, died suddenly on January 28, 2013, at the age of 60. Ip received his bachelor’s degree in biology from the University of Chicago, as well as his medical degree. He completed his internship and residency at St. Louis Children’s Hospital, after which he went into private practice in St. Louis as a pediatrician. Survivors include his wife, Susan, two children and five siblings. Richard H. Moy, MD’57, passed away on February 15, 2013, at age 82 in Springfield, Illinois. Moy leaves behind a legacy of pioneering cancer research. While at the National Institutes of Health from 1958 to 1960, he was part of a team that produced the first cure of a carcinoma with chemotherapy. Moy later served at the University of Chicago — as an instructor, assistant professor, and later associate professor — through 1969. He was then recruited as the founding dean, provost, and professor of medicine at the Southern Illinois University School of Medicine, from which he retired in 1993. Among his many achievements and awards, Moy received the Distinguished Service Award from the University of Chicago and the Gold Medallion from the American Lung Association, and on September 20, 1993, Illinois Governor Jim Edgar declared Richard H. Moy, MD, Day. Moy was also the recipient of the Lincoln Laureate — the highest honor given by the state of Illinois — in 2006. A Civil War enthusiast and classical music aficionado, Moy is survived by his two sons and two grandchildren. Dwight Raymond Smith, SB’46, MD’47, died October 18, 2011, in Silver Spring, Maryland. He was 87. An Air Force veteran, Smith started a surgical practice in 1959, where he worked for more than 40 years. He was on staff at three local hospitals until his 2002 retirement, including Washington Adventist Hospital, where he chaired the surgery department for a term. He is survived by his companion, Marilyn Suzuki, a daughter, two sons and a sister. Leo Sadow, SB’50, MD’51, died January 27, 2013, at age 88. He was a senior training analyst at the Chicago Institute for Psychoanalysis and clinical professor at the University of Illinois College of Medicine. A veteran of World War II, he is the author of many articles in the field of psychoanalysis and recipient of several teaching awards. He was deeply and loyally connected to the University of Chicago, said his wife, Carol Sonnenschein Sadow. Other survivors include his children, Barbara S. Miller, AB’77, JD’83, Mona Sadow Teitelbaum and Rebecca Sadow Chodes; stepchildren Edward Sonnenschein and Paul Sonnenschein; and 11 grandchildren. Lynne Stettbacher, MD’62, passed away on September 17, 2012, at age 75 in Edwardsburg, Michigan. Upon graduating from the University in 1962, Stettbacher completed her internal medicine residency at Moffit Hospital at the University of California. She furthered her medical training in hematology at Rush University Hospital and St. Luke’s Presbyterian Hospital in Chicago. Stettbacher practiced preventive medicine and addiction medicine in Fort Wayne, Indiana. During her retirement, she was a passionate supporter of local arts organizations and police and fire agencies. 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 email@example.com. 32 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. THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION Donald A. Rowley, SB’45, SM’50, MD’50, 1923-2013 onald A. Rowley, MD’50, a pioneer in discovering how the immune system functions and the inventor of the gel electrode, a crucial tool that monitors cardiac activity, died at home on February 24, 2013, of congestive heart failure. He was 90. Rowley, professor emeritus in the Department of Pathology and the Committee on Immunology at the University of Chicago, was a wide-ranging and imaginative researcher. He made a series of fundamental discoveries that had a significant impact on the basic understanding of the immune system as well as on many clinical specialties, including cancer immunology, organ transplantation and cardiovascular disease. “Don Rowley was someone who did productive original research in many fields,” said immunologist Hans Schreiber, MD, DMSc, PhD, University of Chicago professor of pathology and Rowley’s former student. “He had the capacity to dig into many different areas, ask the important questions, design elegant experiments to answer them and then shift his attention to new problems.” His best-known discovery came outside his chosen field. At the time there were no tools to monitor heartbeats over long periods. Rowley and a colleague converted a pocket watch into a portable pulse counter and built tiny electrical sensors that could be glued reliably to the chest — the first gel electrodes. This simple device heralded the birth of ambulatory cardiology. In the late 1960s, Rowley and his graduate student were the first to describe the function of a previously unrecognized cell type, a component of the adaptive immune system, for its “adherent, accessory or antigenpresenting capacity.” This was a rare blood cell that could recognize elements of foreign tissue and present D Donald A. Rowley, SB’45, SM’50, MD’50 The Donald and Janet Rowley Scholarship Fund aids undergraduates at the University of Chicago. To make a donation online, please visit give.uchicago.edu/drrowley. these antigens to B and T lymphocytes, which play a major role in the body’s adaptive immune response. Rowley also demonstrated the critical role of the spleen in antibody production and was co-developer of a highly targeted way to suppress the immune system’s attack on transplanted organs. Born in Minnesota, Rowley served in World War II in a U.S. Army program that trained physicians. After the war, he returned to the University of Chicago, where he met his future wife, fellow medical student Janet Davison, while ice-skating. He received his master’s degree in pathology and his doctor of medicine degree in 1950. After an internship at the U.S. Public Health System’s Marine Hospital in Chicago, Rowley served as an assistant surgeon for the Public Health System’s National Institute of Allergy and Infectious Diseases. In 1954, he returned to the University of Chicago’s pathology department. He served as director of the La Rabida Children’s Hospital and Research Center from 1978 to 1981, and as director of research at the La RabidaUniversity of Chicago Institute from 1973 to 1987. A prolific author, Rowley published more than 100 research papers, many in leading journals, as well as several book chapters. In 1993, Rowley moved to emeritus status but remained active in the laboratory into his late 80s, publishing several papers in 2012. He continued to do research until the end, meeting with a colleague the day before he died to discuss a project. Rowley and his family have a deep connection with the University of Chicago. He is survived by his wife, Janet D. Rowley, LAB’42, PhB’44, SB’46, MD’48, the Blue-Riese Distinguished Service Professor of Medicine, Molecular Genetics and Cell Biology, and Human Genetics; three of their four sons: David, professor of geophysicial sciences at the University, Robert and Roger; five grandchildren; and his sister, Alice Panzer. Elwood V. Jensen, PhD’44, 1920-2012 lwood V. Jensen, PhD’44, known worldwide for his pioneering research on how steroid hormones exert their influence through specific receptors in target cells, died from pneumonia December 16 in suburban Cincinnati. He was 92. Jensen was the Charles B. Huggins Distinguished Service Professor Emeritus in the Ben May Department for Cancer Research and the Department of Biochemistry and Molecular Biology at the University of Chicago. His discoveries led to the development of drugs that can enhance or inhibit the effects of hormones, earning him many honors, including membership in the National Academy of Sciences in 1974 and the Lasker Award in 2004 for outstanding contributions to basic and clinical medical research. “Jensen’s revolutionary discovery of estrogen receptors is beyond doubt one of the major achievements in biochemical endocrinology of our time,” said Eugene R. DeSombre, PhD, professor emeritus in the Ben May Department for Cancer Research. Jensen grew up in Ohio and graduated from Wittenberg College in 1940. He entered a graduate chemistry program at the University of Chicago, completing his PhD in 1944. Working with estradiol, Jensen found that hormones bind to a receptor protein within the cell. This hormone-receptor complex then travels to the cell nucleus, where it regulates gene expression. From the late 1950s to the 1970s, Jensen published a series of major and highly original discoveries, including identifying the estrogen receptor in cells of the uterus — the first receptor found for any steroid E uchospitals.edu/midway Elwood V. Jensen, PhD’44 To make a gift in memory of Dr. Elwood V. Jensen to support the Ben May Department for Cancer Research at the University of Chicago Medicine, please visit give.uchicago.edu/ drjensen. hormone; devising a reliable test for the presence of estrogen receptors in breast cancer cells, and showing that women with receptor-rich breast cancers often have remissions following removal of the sources of estrogens. By the early 1970s, Jensen and a colleague found that most women with cancers that contain large amounts of estrogen receptors could benefit from treatment with tamoxifen, a compound that blocks some of the effects of the hormone. The FDA approved tamoxifen for breast cancer treatment in 1977 and for breast cancer prevention in 1990. “We were glad,” Jensen recalled, “we could do something that helped patients with breast cancer, to know that our basic research findings could be extended to the clinical management of patients with this terrible disease.” In 1947, Jensen joined the University of Chicago as an assistant professor of surgery, where he worked closely with Charles Huggins, who would win the Nobel Prize in 1966 for his work on hormones and prostate cancer. Huggins “taught me medicine,” Jensen wrote in Nature Medicine in 2004, “and I taught him some chemistry.” Jensen was one of the original members of the Ben May Laboratory for Cancer Research and became director in 1969. In 1983, he moved to Zurich to serve as medical director of the Ludwig Institute for Cancer Research. After returning to the U.S., he conducted research at the National Institutes of Health and Cornell Medical College. He joined the University of Cincinnati in 2002 as its George J. and Elizabeth Wile Chair in Cancer Research and continued his research there until late 2011. Jensen retained a strong relationship with the University of Chicago. He was honored at a 2001 symposium marking the 50th anniversary of the Ben May Department for Cancer Research, and in 2004 when his Lasker Award was announced. Jensen is survived by his wife, Peggy; daughter Karen Jensen, MD’77, a radiologist; and son Thomas Jensen, AB’68, MBA’78. MEDICINE ON THE MIDWAY SPRING 2013 33 NonproďŹ t Organization U.S. Postage PAID Chicago, IL Permit No. 5179 950 East 61st Street WSSC 334 Chicago, IL 60637