Giving Matters

WINTER 2018-2019

BETH ISRAEL DEACONESS MEDICAL CENTER

MAKING MIRACLES

SHOT ON LOCATION

PINGENUITY

SOLVING SEPSIS

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LIVING THE DREAM Phillomin Laptiste

PHILLOMIN LAPTISTE

LIVING THE DREAM What happens when a leader uses her KNOWLEDGE, her POWER, and her PASSION for the good of her community?

EVERYBODY WINS. For Phillomin “Philly” Laptiste, being the executive director of Bowdoin Street Health Center (BSHC) is more than a career—it’s part of her life story.

Throughout her more than 10-year tenure at the center, which is licensed

by Beth Israel Deaconess Medical Center (BIDMC) and has provided high-quality, comprehensive health care services to the residents of Dorchester’s Bowdoin-Geneva neighborhood for more than four decades, she has witnessed its extraordinary impact every day. But before Laptiste was in charge at BSHC, she entered its doors for the first time in a different capacity: as a terrified new mother.

Nearly 11 years ago, when Laptiste’s daughter Deanna was a year old, her grandmother brought her to BSHC for emergency care for a mysterious condition. When Laptiste arrived at the center, she found Deanna lethargic and surrounded by clinicians and family members. Despite not being a BSHC patient, Deanna received

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prompt attention, notably from physician Anthony Bonacci, M.D., who continuously followed up with Laptiste for the next 24 hours and later determined Deanna had ingested one of her grandfather’s blood pressure pills. Laptiste credits the center’s staff for saving her daughter’s life.

Several months later, in a twist of fate, BSHC was hiring. Laptiste’s impressive experience in nonprofit operations coupled with the fact that she was born and raised on Bowdoin Street made her stand out. This was her chance to fulfill her lifelong motto: “Don’t just dream of the person you want to be—become that person.” She joined BSHC in 2008 as manager of community health, eventually ascending to operations manager and associate director, before being promoted into her current role. Today Laptiste is a beacon of her community and one of the most recognizable faces at BIDMC, which presented her with its 2018

“Achiever” award in recognition of her countless contributions.

BSHC offers comprehensive primary and specialty care, as well as focused expertise in chronic disease management, to more than 11,000 patients annually, with patient volume rising consistently. As BowdoinGeneva’s largest employer, the center leads important community events and initiatives. “We have a dual mission,” explains Laptiste. “We deliver preventive and holistic care to our patients as well as programming to improve the well-being of our neighborhood.” The BSHC patient population reflects the community’s demographics: 43 percent African American and Caribbean Islanders, 40 percent Cape Verdean, 12 percent Latino, and 5 percent Caucasian and Vietnamese. Half of the residents live below the federal poverty level, many working in jobs that pay less than a living wage. “Bowdoin-Geneva is incredibly rich in culture and

Giving Matters | Beth Israel Deaconess Medical Center

diversity,” says Laptiste. “You can walk a block and hear four different languages. Everyone is welcome and receives culturally competent care at Bowdoin Street.”

Philanthropy played a vital role in the CHW program’s creation; a generous gift from the Casty family enabled BSHC to enact a pilot that paved the way for the hiring of three new CHWs.

Each of the center’s programmatic efforts is carefully tailored to neighborhood residents. “When you think about the population we serve, it’s important to consider the social determinants of health,” says Laptiste. “Things like education, financial stability, socioeconomic status, violence, trauma, and access to food and housing—or the lack thereof—impact health in powerful ways.” Laptiste has experienced violence herself: she lost her cousin Nicholas Trotman, whom she thought of as a brother, in 2011 when he was shot and killed on Olney Street, just blocks from her home. “I feared for my daughter’s safety and wanted to leave,” says Laptiste, who collapsed when she heard the news. “But at the same time I loved my job and felt an overwhelming duty to continue to help this community.”

Another vulnerable group of patients is expectant mothers. “Women of color face a high risk of maternal and infant mortality,” explains Laptiste.

Through the center’s prenatal program, Centering Pregnancy, Laptiste’s team conducts group classes that teach

BSHC established the Community Health Worker (CHW) Program to care for its most high-risk patients, who are often not engaged in their clinical care due to complex social circumstances, including violence, homelessness, and food insecurity.

CHWs provide relief through health system navigation and resource support. “I truly believe that health care is the universal access point for all things,” explains Laptiste. “For example, we have a diabetic patient who wasn’t taking her medication.

Her community health worker built a relationship with her and eventually discovered that the patient was having trouble with her medical insurance and was on the brink of being evicted. The community health worker helped her address these issues, and she is now able to adhere to her treatment plan.”

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When you think about the population we serve, it’s important to consider the social determinants of health. Things like education, financial stability, socioeconomic status, violence, trauma, and access to food and housing—or the lack thereof—impact health

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in powerful ways.

PHILLOMIN “PHILLY” LAPTISTE

valuable skills around self-care during pregnancy, preparing for the baby, and planning for motherhood. Evidence shows that the centering model leads to lower rates of preterm births and higher rates of successful breastfeeding.

A meaningful gift from Samantha and James David will allow this program to expand over the next several years.

BSHC is committed to building an environment that supports healthy living through food access. “When I started working at Bowdoin Street, this

area was considered a food desert,” says Laptiste. That has changed significantly, thanks in large part to her work to establish Bowdoin-Geneva’s first farmer’s market. “Doctors may tell their patients to eat vegetables, but they cannot make that lifestyle change unless it’s accessible,” says Laptiste.

“Access means having a store nearby that stocks fresh produce, the resources to buy it, and the knowledge how to prepare it.” Today, the health center offers cooking classes and nutrition counseling, as well as a healthy food prescription program, which provides Bowdoin Bucks—coupons that can be used at local stores, the farm stand, and Fresh Truck, a “mobile market” that brings fresh food to Bowdoin-Geneva once a week. This work is possible thanks to generous, longstanding support from the Krupp Family Foundation, whose mission is to invest in equal access to fresh food in under-resourced communities and whose commitment to BSHC has been transformational over many years.

“The incredible resilience of BowdoinGeneva residents is undeniable,” says Laptiste, who ran the Boston Marathon for two consecutive years in 2017 and 2018 for Team BIDMC, raising vital funds for BSHC. “We have had our fair share of struggle, but there are so many wonderful people who stayed here through it all and are committed to creating positive change.” Laptiste is one of those people. Her devotion to her community and to BSHC runs deep, and she’s determined to stay. Her hard work and passion have truly paid off— and she is just getting started. With the help of philanthropy from a number of generous, visionary supporters, she has mobilized impactful new initiatives at BSHC that are making a tangible difference in the lives of many. She has become the person she always dreamed of being. ■

Bowdoin Street Health Center in Dorchester’s Bowdoin-Geneva neighborhood.

Giving Matters | www.bidmc.org/giving

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LETTER from Kris Dear Reader, Beth Israel Deaconess Medical Center is an extraordinary place, and our commitment to innovation is something that sets us apart. This photo (left) of Chief Information Officer John D. Halamka, M.D., M.S., and me is from our Critical Voices event, where we celebrated the launch of our new Health Technology Exploration Center (HTEC) (see page 19), a groundbreaking initiative that aims to make health care more accessible, efficient, and integrated around the world.

HTEC is just one of the many examples of innovation at BIDMC, and many stories in this issue of Giving Matters touch on this concept. Get to know Bowdoin Street Health Center‘s Phillomin Laptiste and how giving sustains the center’s comprehensive approach to community health.

Learn about the insightful support of phenomenal research on the subconscious mind (page 12), a revolutionary—yet simple—potential treatment for sepsis (page 16), and novel cancer vaccines that have already shown astonishing results in certain patients (page 8). Meet special donors who have enabled a unique nurse practitioner residency program in critical care (page 17), a first-ofits-kind emergency department program for individuals suffering from addiction (page 7), and a large-scale effort to combat maternal mortality (page 5). In short: how philanthropy champions and drives innovation at its best!

Kristine C. Laping with John D. Halamka, M.D., M.S.

In the spirit of innovation, Giving Matters has undergone a complete redesign. I hope you enjoy the publication’s new look and feel, which is meant to reflect BIDMC’s leading-edge academic medical center environment. Thank you for being part of our BIDMC community. With your help, we achieved our seventh consecutive record-breaking year in fundraising in fiscal year 2018, with $107 million in support, which allows us to continue pushing the boundaries of medicine.

Sincerely, Kristine C. Laping Chief Development Officer

Giving Matters is published by the Office of Development at BIDMC. Kristine C. Laping Chief Development Officer (617) 667-7334 klaping@bidmc.harvard.edu Kate Gorman Senior Executive Director of External Relations (617) 667-7371 kjgorman@bidmc.harvard.edu Alexandra Molloy Senior Director of Leadership Communications (617) 667-7350 amolloy@bidmc.harvard.edu Kristina Talevi Senior Director of Marketing and Events (617) 667-7363 ktalevi@bidmc.harvard.edu

Managing Editor: Alexandra Molloy Editor: Allison Knee Writing: Kathryn Berger, Ava Berinstein, Lauren Carr, Sarah Jackson, Alexandra Molloy, Laura Sullivan Marketing: Samantha Hanman, Kristina Talevi Photography: BIDMC Archives, Lucien Capehart Photography, Danielle Duffey, James Dwyer, Joel Haskell, Theresa Johnson Herlihy Other photography courtesy of the BIDMC Archives, the Koch Family, the Crowley Family, Dhaval Oza, and the Rossini Family Design: Robert Chow, BIDMC, and kor group, Boston © 2018 BIDMC Volume 8, Issue 1

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Giving Matters | Beth Israel Deaconess Medical Center

MAKING

MIRACLES Grateful couple gives $3M to reduce maternal mortality

SCOTT SHAINKER, D.O., M.S.

When Annie Koch called Scott Shainker, D.O., M.S., in 2017, she had been on an emotional roller coaster ride for more than three years. After trying to conceive and suffering five miscarriages, she finally succeeded in getting pregnant—only to be told by her physician that the placenta had implanted abnormally, and the pregnancy placed her life in grave danger. Frantic, the Wichita, KS, resident and her husband, Chase Koch, turned to Google to search for a way to safely bring the baby into this world. That’s how they found Shainker and BIDMC. An expert in high-risk pregnancy, Shainker immediately knew it was serious. Annie’s ultrasound images indicated placenta accreta, a dangerous condition that develops when the placenta grows deeply into the uterine wall and requires an early delivery via C-section and a hysterectomy.

“Delivery with invasive placentation has a 5–7 percent risk of maternal mortality,” explains Shainker. “There are no maternal–fetal medicine facilities in Kansas specializing in the care that Annie needed.” After that fateful phone call, the couple decided to meet with Shainker in person, and figure out a plan to continue the pregnancy. “Talking to Dr. Shainker on the phone gave us a sense of peace,” says Annie. “Our baby had a chance.”

Two days later, the couple flew to Boston. They learned more about Shainker’s unique, multidisciplinary approach that spans from monitoring mothers with life-threatening placental disorders to delivering their babies via a complex surgery with specialists from various departments—obstetrics, urology, surgery, nursing, the blood

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bank, critical care, interventional radiology, and the Klarman Family Neonatal Intensive Care Unit (NICU).

“His impressive knowledge, skills, and team mentality gave us confidence,” says Chase.

Since founding the New England Center for Placental Disorders in 2013, Shainker has built the region’s premier integrated program. “Maternal death is higher in the U.S. than in any other developed nation in the world,” explains Shainker. “My goal is to reduce the morbidity and mortality rates associated with placental disorders in a significant way.” With referrals from across the northeast and patient visits from all over the country, Shainker is widely recognized for providing superior clinical care, but he doesn’t stop there. He is also actively engaged in research, education, and advocacy in the U.S. and overseas.

“A significant problem is late diagnosis, after the condition has become advanced,” says Shainker.

“Research to improve diagnostics is essential.” He is leading the charge by establishing the nation’s first multicenter placental biospecimen repository focused on placental disorders, which aims to identify a biomarker. This effort enables the collection and analysis of placental, urine, blood, and uterine samples from women with placenta accreta. Shainker is also working to develop the first animal model of the disease, to enable further study, and is exploring innovative artificial intelligence technologies to develop a novel diagnostic algorithm.

Six months after the phone call that brought them together, Shainker delivered the couple’s daughter at BIDMC. “He did what we were told

was impossible—he gave us a healthy girl and mother,” says Chase. Adds Annie: “BIDMC will always remain in our hearts because our family was completed there.” Grateful for the medical center’s life-changing care, the Kochs made an incredible gift of $3 million to support Shainker’s research and establish the Annie and Chase Koch Chair in the Department of Obstetrics and Gynecology, of which he will be the first incumbent.

“I admire Dr. Shainker’s extraordinary talent and drive,” says Hope Ricciotti, M.D., chair of the Department of

Annie and Chase Koch

Obstetrics and Gynecology. “This gift from the Koch family will be transformative in accelerating his pioneering research to revolutionize how invasive placentation research is performed.”

Shainker is optimistic about the new endowed chair’s implications for his important work.“This phenomenal gift catalyses my research—what would have taken me a decade can be accomplished in two years,” says Shainker. “Together we are going to save countless mothers’ and babies’ lives.” ■

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Q&A Kevin Hill, M.D., M.H.S. Director, Division of Addiction Psychiatry A nationally recognized leader in the science, policy, and treatment of substance use disorders (SUDs), Kevin Hill, M.D., M.H.S., provides direct patient care for those suffering from addiction and conducts clinical research on medications and behavioral interventions to improve treatment, particularly for marijuana dependence. He also is a consultant to the Boston Red Sox, the National Football League, and the National Basketball Association.

What is addiction psychiatry, and why is this work so important now?

Our division treats substance use disorders, the misuse of or dependence on a drug that is detrimental to a person’s health and well-being. The majority of our patients have alcohol or opioid addiction. With regard to opioids, I can’t stress the severity of the current epidemic enough—people are dying every day. But, despite what you may hear in the news, patients with these disorders can succeed in recovery.

It requires a comprehensive plan, including evidence-based treatment from experienced clinicians who are passionate about their work. Fortunately this organization has many passionate people. Our goal is to channel that passion into the best care possible.

How is your division tackling this urgent crisis?

It can take a village to support someone’s recovery from SUDs. Addiction doesn’t occur in a vacuum; we need to take into account all the other aspects of the patient’s health, including medical, psychosocial, associated illnesses, and even the stigma around these disorders and their treatment.

Our team works with community providers, clinics, and programs to help our patients access all supports possible.

We also have dedicated peer volunteers, people living in recovery from SUDs, who do inspiring work with patients

who want to talk to someone who has been through it before. Although addiction is a lifelong illness with significant health risks and consequences, it is also treatable, and we want to give every patient who is motivated a chance to get better.

Why is philanthropy critical in this effort?

Philanthropy can be a game-changer. Having my position supported in part by philanthropy when I arrived last year showed me that the hospital was taking this issue on in a very serious way and has been a tremendous asset to what I’ve already been able to do. I was so impressed by the Crowley gift (see right). It has allowed us to support Leslie Bosworth, M.S.W., L.I.C.S.W., a creative star in social work, who is implementing innovative programs that we wouldn’t have been able to do otherwise. It may take some time, but we hope to add more stars to our team—physicians, social workers, nurses. We want the right people. Philanthropy also allows us to do some very important things: educating on a wide scale, advancing clinical trials, and making evidencebased care better. I’ve had some mentors who have taught me not to think about boundaries in medicine but to think big in order to solve problems that extend outside of those boundaries. And that’s what we need to do here—think big.

This crisis and BIDMC’s environment offer an incredible opportunity to do that. ■

A Heartfelt Legacy Career-long health care delivery professionals, Lois J. and Sherwin Z. Goodblatt are passionate about helping BIDMC continue to grow its reputation as a national leader in cardiovascular medicine. The couple recently bequeathed a $1 million gift to facilitate transformational infrastructure upgrades in cardiac catheterization, which will perpetuate the extraordinary patient care, teaching, and research for which BIDMC is known. Planned gifts such as bequests can play a valuable role in strengthening your own long-term financial plans and can be simple, affordable ways to leave a lasting legacy at BIDMC. ■

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Lois and I both believe the best thing to do for mankind is to help others. We wanted to effect change in a meaningful and impactful way, and improve access to the latest and best equipment available for more patients.

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SHERWIN Z. GOODBLATT

To learn more about planned giving at BIDMC, please visit bidmc.giftplans.org.

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Giving Matters | Beth Israel Deaconess Medical Center

Hope from Heartbreak

Gift brings resources and compassion to those suffering from addiction Gay Crowley remembers her nephew, Tim (right), as a vibrant young man.

“He was bright, well-educated, and handsome, like a Brooks Brothers ad,” she says. Tim was a college graduate and business and home owner, who seemed to have it all together. He also struggled with addiction.

Tim’s suicide in 2017 left his family and friends devastated and searching for answers. “Tim desperately wanted to stop drinking,” says Crowley, but he was struggling to maintain his sobriety. The tipping point for him came in the wake of the 10-year anniversary of his father’s death. “My nephew knew he needed a medical detoxification facility, as withdrawal had caused him to suffer debilitating seizures in the past,” explains Crowley. Tim turned to his brother, asking him to drive him to a hospital to seek help. Together they visited various emergency rooms, however, they were continuously turned away or simply offered a list of detoxification centers to try calling.

“They tried hospital after hospital,” recalls Crowley, “but nobody wanted to deal with another addict.” Tim’s brother experienced firsthand the rejection and discrimination confronted by addicts, and Tim himself expressed he could not go through such judgement again.

Within days, he had taken his own life.

“I truly believe that he was trying his very best to fight this demon, but addiction is a powerful disease and its stigma is difficult to overcome,” says Crowley. “In the end, I think rejection brought Tim to a point of desperation.”

Determined to find a way to help other families, Crowley devoted herself to researching addiction support,

treatment, and recovery. “I feel strongly that if Tim went to an emergency room with an addiction specialist and a staff that had been educated on how to treat him with dignity—not as if his addiction was a choice—well, his outcome might have been different.”

In memory of her beloved nephew, Crowley made a meaningful $155,000 gift to establish a pilot program in BIDMC’s Emergency Department (ED) that has enabled its staff to respond in an organized, caring, and thoughtful way towards individuals suffering from addiction. The innovative pilot program

has funded a peer recovery initiative in the ED overseen by senior social worker Leslie Bosworth, M.S.W., L.I.C.S.W.; a physician education curriculum led by Bosworth and Kevin Hill, M.D., M.H.S. (see page 6); and resources for patients, including cell phones and transportation to detoxification facilities.

“Too many people like Tim are suffering and their families are suffering too,” says Crowley. “We have an incredible opportunity here to show compassion and create a significant and sustainable change in the world.” ■

NOT a Statistic

Sandie Rossini is committed to giving back and staying positive—even in the face of cancer

After being diagnosed with a highly aggressive brain tumor at 34, Sandie Rossini visited several local hospitals in 2013 and was told her malignant glioma was incurable. The mother of two feared she was out of options— until a team of experts at BIDMC gave her hope. “I am positive I made the right choice with BIDMC,” says Rossini.

“Because everyone on my care team treats me like a person, not a statistic.”

BIDMC soon became a second home to Rossini. Physicians and nurses who were once strangers now treated her like family. Neurosurgeon Ekkehard Kasper, M.D., Ph.D., operated and removed the vast majority of her frontal

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glioblastoma; however, additional therapy was needed. Her care plan— created by Eric Wong, M.D., director of the Neuro-Oncology Unit, and Kasper— included radiation, chemotherapy, CyberKnife radiation at the Keith C. Field CyberKnife Center, preventive medications, and drug infusions.

Throughout her journey, Rossini has remained positive while continuing to work as a writer and photographer and raise her two daughters, Calla, 11, and Lili, 13, with her husband, Matt. Today, her cancer has shrunk significantly, but she is not yet in full remission and visits BIDMC once every three weeks for chemotherapy. Rossini is devoted to

Sandie Rossini, left, and her family giving back to BIDMC: to date she has raised more than $35,000 for A Reason to Ride, an annual bike-a-thon to benefit cancer care and research at BIDMC. ■

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SHOT ON

LOCATION Funded by philanthropy, new Schwartz Family Facility takes leading cancer vaccine program to next level

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Giving Matters | Beth Israel Deaconess Medical Center

David Avigan, M.D.

When it comes to the complex process of producing therapeutic cancer vaccines, the expression “location is everything” takes on special meaning.

Ensuring the quality and consistency of any pharmaceutical product that will be used for testing in large numbers of human patients requires a specialized “clean” and controlled environment. The lifesaving cancer vaccines created at BIDMC’s new Immunotherapy Institute are no exception. That’s why the recent launch of the Randi and Brian Schwartz Family Cancer Immunotherapy and Cell Manipulation Facility, which brings this critical workspace to reality, is so auspicious. “This is a pivotal moment for the field of immunotherapy,” says David Avigan, M.D., co-director of the Immunotherapy Institute and executive director of the Schwartz Family Facility. “We are seeing significant results in our work, and the potential is very exciting. This incredible facility truly gives us the right place at the right time.”

Avigan’s team has played a pivotal role in the development of cellbased immunotherapy as a potent strategy to harness the body’s own natural defenses to effectively target cancer cells. In close collaboration with Jacalyn Rosenblatt, M.D., and Dina Stroopinsky, Ph.D., respectively medical director and scientific director of the Schwartz Family Facility, they developed a personalized cancer vaccine by combining the patient’s own tumor cells with potent teachers of the immune system known as dendritic cells. This fusedcell strategy has yielded dramatic results in patients with blood cancers; in early studies, the vaccine treatment has doubled the number of patients with multiple myeloma who achieve remission after primary therapy and has led to durable remission in more than 70 percent of patients with acute myeloid leukemia—a striking improvement over standard therapies. The Schwartz Family Facility will enable these researchers to capitalize on the promise of this work, allowing them to study vaccines in national clinical trials, combine their vaccines with other innovative treatments like CAR T-cells to maximize results, and engage in scientific collaboration with investigators around the world including supervising and teaching vaccine generation. “This facility is enhancing our ability to develop personalized immune-based treatments for patients and combine these efforts with many other strategies for maximum

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David Avigan, M.D., with Randi Schwartz

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impact,” says Avigan. “We wouldn’t have opened this facility nearly as quickly without support from private donors like Randi and Brian who understand its vital importance.”

Although not the recipient of a cancer vaccine herself, Randi Schwartz experienced firsthand Avigan’s compassionate and creative approach as a physician– scientist and quickly recognized its worth. Diagnosed with multiple myeloma, Schwartz did extensive research on centers nationwide specializing in its treatment. When a family friend introduced her to Avigan, the decision where to get her care was sealed. “I felt a deep personal connection to David and BIDMC,” says Schwartz, who travelled back and forth to Boston from her home in Florida for treatment. “I saw immediately that he was a comprehensive, thoughtful, intelligent person, who was incredibly present and never rushed. For me, that was an integral part of the type of care I was seeking.”

When she learned of Avigan’s efforts to develop a Good Manufacturing Practice facility at BIDMC and its important role in expanding his team’s research to impact more patients like her, she was determined to help. The lead gift to name the new space from Schwartz and her husband, Brian—along with numerous gifts from a wide range of donors similarly drawn to the value of the work

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of Avigan’s team (see right)—was instrumental in bringing it to fruition. Now the 3,400-square-foot suite will serve as the main site for an unprecedented Phase 3 cancer vaccine trial with 17 clinical centers nationwide, among many other promising therapeutic ventures. “Cancers like multiple myeloma are smart diseases,” says Schwartz. “It will take innovative thinking and many different approaches to

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This facility is enhancing our ability to develop personalized immunebased treatments for patients and combine these efforts with many other

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strategies for maximum impact.

DAVID AVIGAN, M.D.

continue finding more effective treatments, and ultimately cures. Someone has to do that work, and David has the foresight and collaborative nature to make those goals a reality.” ■

Giving Matters | Beth Israel Deaconess Medical Center

Beneficial Breakthrough HOWARD BLEICH, M.D. In 1967, when Howard Bleich, M.D., came to work at Beth Israel Hospital to pursue the revolutionary idea of integrating computers into medicine, little did he know the move would not simply change his life, but ultimately save it. In 1970, he and the late Warner Slack, M.D., co-founded the Division of Clinical Informatics at Beth Israel Hospital, and spent the next several decades leveraging information technology and computing to vastly improve patient care, teaching, and research. But a roadblock came in 2010, when Bleich was diagnosed with acute myeloid leukemia (AML), an aggressive blood cancer. One hematologist advised against curative treatment like chemotherapy since it rarely succeeds in older patients; instead, she suggested palliative care in an effort to improve his quality of life as the disease progressed. Wanting a second opinion, Bleich contacted Lowell Schnipper, M.D., then chief of oncology at BIDMC, who referred him to David Avigan, M.D., chief of the Section of Hematologic Malignancies and now co-director of BIDMC’s new Immunotherapy Institute.

“At the time, I didn’t know Dr. Avigan had developed a novel AML vaccine, that I would be the second patient to receive it, and that it would markedly improve my outcome,” says Bleich, who participated in an early study of the treatment, which is generated using the patients’ own leukemia cells combined with their own powerful immune-

Warner Slack, M.D., and Howard Bleich, M.D., in the early years of clinical informatics at BIDMC stimulating cells. Bleich’s incredible turnaround was not an isolated event; more than 70 percent of the study’s patients have remained in remission for more than five years. Today, Avigan and his team are testing the therapy in an international, multi-center clinical trial based at the Randi and Brian Schwartz Family Cancer Immunotherapy and Cell Manipulation Facility (see left). After a remarkable recovery and an illustrious 43-year career at BIDMC, Bleich is now enjoying retirement: savoring time

spent with his wife, Susan, and playing tennis when he can. “Older people with AML had a very low survival rate, but Dr. Avigan’s data are indicative of a major breakthrough,” says Bleich, who has supported the immunologist’s pioneering work annually since 2011.

“I cannot say enough about the thoughtful, compassionate care I received at BIDMC. Every physician and nurse was outstanding. They saved my life.” ■

A Wise Investment PAUL WEISMAN and Jacalyn Rosenblatt, M.D., co-directors of BIDMC’s new Immunotherapy Institute, nearly five years ago, he knew the physician–scientists’ research was an ideal fit for his giving philosophy. “When I first met David, two things were immediately obvious—he was super talented, and he was incredibly dedicated to his work,” says Weisman.

“This is exactly the type of person you want to meet as a philanthropist.”

As a seasoned financial portfolio manager, Paul Weisman excels at making strategic investment decisions that deliver optimal impact for his clients.

As a philanthropist, Weisman employs a similar approach in deciding where to direct his charitable funding. When he was introduced to David Avigan, M.D.,

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A longstanding donor to a wide variety of research areas throughout the medical center, Weisman has made several gifts to Avigan and Rosenblatt’s therapeutic cancer vaccine work, the most recent of which went toward the construction of the Randi and Brian Schwartz Family Cancer Immunotherapy and Cell Manipulation Facility (see left).

“This facility was yet another great example of how I could see tangible benefits and make a significant impact with a more modest amount of funding,” says Weisman. “This is the

type of project that excites me. BIDMC hasn’t seen the end of my giving.”

Funded almost entirely by philanthropy, the creation of the Schwartz Family Facility was essential to take the work of Avigan and Rosenblatt’s team to the next level. It will not only enable them to properly manufacture their cancer vaccines on a larger scale for use in major, multi-institution clinical trials, but it will also serve as a physical hub to unite the brightest minds in cancer immunotherapy. The intent is to eventually expand the use of the facility and its novel technology to other cancers, including solid tumors, and even other diseases. “This facility speaks to the level of talent at BIDMC doing this work and gives them the opportunity to stand out among their peers,” notes Weisman. “Projects like these burnish the medical center’s reputation and make it competitive in the research world.” ■

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The innovative methods we develop here may one day allow us to adjust other brain circuitry to control pain, epilepsy, Parkinson’s disease, and even such diseases as obesity and depression.

CLIFFORD B. SAPER, M.D., PH.D.

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Illustration by Sam Falconer

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Giving Matters | Beth Israel Deaconess Medical Center

DISCOVERY ON THE

BRAIN $1M Mathers Foundation grant helps researchers shed NEW LIGHT on impaired consciousness From ancient Mayans to modern-day neurologists, humans have spent millennia trying to unravel the mysteries of consciousness. The ability to be aware of our existence and surroundings springs from the brain—but how? Answering that age-old question drives the work of Clifford B. Saper, M.D., Ph.D., chair of BIDMC’s Department of Neurology and a leading expert in the brain’s basic arousal system, which is active when we are awake and turns off when we lose consciousness. With a major grant from the G. Harold and Leila Y. Mathers Foundation, Saper is now pursuing the ultimate challenge—understanding the mechanisms behind this complex system to find novel treatments for conditions like coma and stroke, and more.

In recent years, Saper and his colleagues made a breakthrough discovery of cell groups in the brain that participate in promoting wakefulness or sleep. “We are only scratching the surface on how these cells interact and what happens to them in a variety of diseases,” he says.

For example, little is known about what goes wrong in the brain when someone suffers a disorder of consciousness, such as coma. “It’s hard to realize that in 2018 we can’t accurately predict which patients will wake up eventually and which will remain in a vegetative state, after head injury, stroke, or other intracranial disasters,” Saper says.

To help doctors make these predictions, Saper and his team are conducting research to isolate the key structural brain components necessary for the recovery of consciousness.

The scientists recently showed that loss of consciousness in stroke results from damage to specific brain cells in a region called the parabrachial nucleus. They then used MRI scans to learn which parts of the brain functioned in concert with the parabrachial nucleus. “We found a specialized area in the frontal lobe—the orbito-insular area—that’s most closely tied to consciousness,” he says.

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A recent $1 million grant from the Mathers Foundation is enabling Saper and his BIDMC colleagues to clarify the relationship between the orbito-insular area and consciousness, how that connection contributes to the conscious state, and how damage to the connection results in unconsciousness. This innovative work includes studies that control neurons in genetically modified mice and analyses of functional MRI scans in humans.

According to Howard A. Chester, M.D., executive director of the Mathers Foundation, Saper’s brain research has been of interest to the renowned grantmaking organization for the past two decades. “Neuroscience projects have always been a core component of our research portfolio, and Dr. Saper is a preeminent neuroscience physician–researcher,” Chester says. “Our foundation has been pleased to award him three grants in total over the years. We have great confidence in his work and its translational potential to evolve to clinical application.”

The studies supported by the Mathers Foundation could help Saper achieve an ambitious objective: advancing noninvasive techniques to revive patients with impaired consciousness caused by stroke, tumors, or trauma, and reunite them with their families. He also believes these efforts could someday aid patients with other kinds of neurological conditions. “The innovative methods we develop here may one day allow us to adjust other brain circuitry to control pain, epilepsy, Parkinson’s disease, and even such diseases as obesity and depression,” he says.

“With the ongoing generosity of funders like the Mathers Foundation, we continue to make major steps toward these long-term goals.” ■

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PINGENUITY Lu’s instinctive approach to research leads to major discoveries in cancer and Alzheimer’s disease

of these findings thus far is an enzyme called peptidylprolyl cis/trans isomerase, which Lu discovered in the mid’90s with Tony Hunter, Ph.D., his postdoctoral mentor at the Salk Institute. Thankfully, they dubbed the enzyme Pin1 for Ping, the name Lu goes by. Enzymes like Pin1 control the function of biological processes by literally keeping proteins in “good shape,” and Lu recognized that they were on to something promising when his team further found that the Pin1 enzyme acts on a unique subset of proteins and plays a role in a variety of cancers. On the simplest level, the more Pin1 accumulates, the more active a wide range of cancer pathways become. “Dr. Gerberg Wulf, the first oncology fellow in my lab, found that this enzyme is highly expressed in breast cancer,” recalls Lu. “And that opened a door. In fact, in the end, we screened almost all the human body in 60 different tumor types, and it turned out that Pin1 is overexpressed in 60 to 70 percent of human cancer.”

KUN PING LU, M.D., PH.D.

Throughout his longstanding career in medical research, Kun Ping Lu, M.D., Ph.D., has trusted his instincts and pursued each lead as it surfaced, wending his way through a variety of complex biological systems and pathways.

But even as he moved from one phase naturally to the next, one guiding element has remained at the heart of his work—the patient. “The idea of research is a moving target,” says Lu, chief of the Division of Translational Therapeutics at BIDMC. “When you open a new field, there are a lot of unknowns, and we constantly have to think of ways to solve this problem or that problem to move the field forward. Even now, we are discovering something new every day, but our goal, ultimately, is to treat disease and improve health.”

On this circuitous path, Lu and his team have made some critical discoveries about the underpinnings of agerelated diseases that not only inform our understanding of how and why they develop but may shape their clinical management down the road. The most striking and fruitful

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But just finding a good therapeutic target doesn’t mean that it is, in turn, simple to find a viable therapy. The Pin1 enzyme causes only subtle changes to the shape of its target proteins and can make the mechanisms by which this whole pathway works elusive. In fact, despite active pursuit by academic laboratories and pharmaceutical companies, no effective Pin1 inhibitor yet exists. This is where Lu says his wife and longtime collaborator, Xiao Zhen Zhou, M.D., comes in. Also an established BIDMC researcher, Zhou has been instrumental in developing specialized screening techniques to identify chemical compounds that will keep Pin1’s enzymatic activity in check. “She takes on the harder, more challenging questions,” says Lu. “She is constantly there and knows this research upside down. First, she figures out how the enzyme works, and second, how to develop inhibitors. I think if we can find this inhibitor, we might have major impact on the treatment of disease.”

When Lu talks about treating disease, however, he doesn’t just mean the promising cancer drugs based on Pin1 that his team has been pursuing for the last five years, including ATRA, the first example of modern targeted cancer therapy (which they recently discovered works even more effectively against the enzyme when combined with arsenic!). Their search for antibodies that specifically detect misshapen proteins when the Pin1 enzyme is abnormally altered under disease conditions has also led to a completely unexpected and tremendously exciting discovery at the opposite end of the age-related disease spectrum—Alzheimer’s. Lu remembers when he first raised the possibility of a connection between cancer and Alzheimer’s, the scientific community thought the idea was outlandish; researchers in the two fields rarely interacted, and the dearth of crossover publications suggested a link was tenuous at best. But Lu was convinced, and through his lab’s work and others, the evidence began to mount.

After the atomic bomb was dropped on Hiroshima, cancer rates soared, but the incidence of what disease plummeted?

Alzheimer’s. If you knock out the Pin1 gene in mice, they don’t develop cancer but what do they get? Alzheimer’s.

Analyses of large clinical databases by Jane A. Driver, M.D., Lu’s former trainee and collaborator at Brigham and Women’s Hospital, subsequently have shown that if you have cancer, you are protected from Alzheimer’s by about

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60 percent—and vice versa. “Now finally the National Cancer Institute recognizes, yes, cancer and Alzheimer’s are both age-related diseases and are on opposite sides of the same coin,” says Lu. “And they cite Pin1 as a major driver of why.”

The pressing question for Lu then became how does Pin1 contribute to the development of Alzheimer’s and was there anything that could be done about it. Fortunately, with the timely and generous support of progressive funders including The Owens Family Foundation and the Alzheimer’s Association, he could veer from his established cancer path to pursue these questions. The answer lies in Pin1’s connection to tau, a protein that has been implicated in a range of neurodegenerative disorders including Alzheimer’s.

Lu’s team found that tau has something of a Jekyll and Hyde personality, occurring in two different orientations known as cis and trans. While the trans orientation is healthy and necessary for normal brain functioning, the cis version becomes misshapen and toxic, and can actually destroy brain cells, resulting in the detrimental protein “tangles” characteristic of Alzheimer’s. Pin1 acts like tau’s parole officer, keeping it from going “bad”.

that they created a critical foundation on which to build.

“This allowed us to generate better data and make a more convincing story to get a bigger grant, as well as to embark on risky new research projects,” he notes. “Without that, frankly, we could not do it.” With his trademark enthusiasm, Lu can barely contain his excitement on where things might lead, ever ready to pursue what’s next on the horizon in this field of constant change. “Basically, if it works, this will open a completely new idea of treating traumatic brain injury or Alzheimer’s disease,” he says of the new antibody. “Many clinical trials fail. So right now we need to make sure we have the diagnostic and have the target. Before, no one talked about targets for these diseases because we didn’t even know what caused the problem—but now we have found something important and we can start in a much better place.” ■

Tau protein strands

With the help of philanthropy, Lu and Zhou have been in hot pursuit of a new antibody that can detect and ultimately prevent when tau is poised to manifest its dark side and wreak havoc on the brain. “Since this illness takes

Kun Ping Lu, M.D., Ph.D., and Xiao Zhen Zhou, M.D.

at least a decade to develop, the major challenge to halting memory loss is to identify the initial period when the brain’s tau protein is transformed from ‘good guy’ to ‘bad guy’,” says Lu. “Our antibody can specifically detect this disease-causing tau transformation, while leaving healthy tau intact to carry out its important functions.” Because Alzheimer’s takes so long to develop, the researchers have turned to the more acute disease model of traumatic brain injury, which also exhibits the hallmark brain tangles.

They have demonstrated that tau’s sinister form appears soon after brain injury, with its levels dependent on the severity and frequency of the damage, providing the first direct evidence linking this condition with Alzheimer’s.

And most importantly, they have shown in mouse models that their antibody can prevent the accumulation of toxic cis-tau, stop neurodegeneration, and even restore brain function. Now with a $6 million grant from the National Institutes of Health, their goal is to tailor the antibody so that it can be tested in human patients and to develop cis-tau tests for identifying patients with brain injury and Alzheimer’s disease earlier and monitoring their response to antibody treatment.

Lu is quick to point out that although the initial donations to support their work in this area were more modest, they came from the heart and were no less important in

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SOLVING

SEPSIS MICHAEL DONNINO, M.D.

Open Philanthropy Project’s major gift spurs

LANDMARK TRIAL of promising therapy

Could vitamins save lives? BIDMC’s Michael Donnino, M.D., hopes to prove they can—with a new large-scale clinical trial of a simple “cocktail” of vitamins and steroids to treat sepsis, an often-deadly complication from infection.

Jumpstarted with a visionary $2.9 million gift from the Open Philanthropy Project, the landmark study aims to demonstrate that this combination therapy could change the standard of sepsis care. “If this works, as previous research suggests, it could save more than a million lives per year worldwide,” says Heather Youngs, program officer for scientific research at Open Philanthropy. “We chose to fund this trial because we believe it could accelerate the therapy’s adoption and impact.”

Each year almost 300,000 of the 1.7 million Americans who contract sepsis do not survive. With a clinical practice that spans both BIDMC’s intensive care unit and Emergency Department, Donnino has ample firsthand experience with the life-threatening response to infection, which is the third leading cause of death in hospitals. Patients of all kinds are at risk. “Sepsis may be the ultimate cause of death for patients with chronic diseases such as Parkinson’s or cancer,” notes Donnino. “But sepsis can lead to death and serious morbidity in young and healthy people as well.”

Despite a high mortality rate, sepsis still lacks a targeted therapy, with clinicians relying primarily on antibiotics and supportive care. Antibiotics, however, are not always effective in reversing disease, and Donnino’s mission is to remedy this situation. As director of BIDMC’s Center for Resuscitation Science, he leads a large multidisciplinary team—including Katherine Berg, M.D., Maureen Chase, M.D., M.P.H., Michael Cocchi, M.D., Anne Grossestreuer, Ph.D., Xiaowen Liu, Ph.D., Ari Moskowitz, M.D., and Catherine Ross, M.D.—whose sepsis work aims to develop

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alternative interventions that will improve patient survival and reduce organ damage.

The concept of using vitamins as an adjunct treatment builds on Donnino’s research of more than a decade.

Focusing on vitamin B1, or thiamine, levels in critically ill sepsis patients, he found that individuals with the disorder may be predisposed to a deficiency, which can have detrimental health effects. He postulated that giving thiamine to these patients might help improve metabolism when facing septic shock’s destructive cascade of symptoms, and this intervention showed potential benefit for those with thiamine deficiency in an initial clinical trial. Donnino became even more intrigued when Paul E. Marik, M.D., chief of pulmonary and critical care medicine at Eastern Virginia Medical School, called to share his own preliminary results: adding vitamin B to his “cocktail” treatment of vitamin C and corticosteroids substantially reduced mortality and organ injury in patients with severe sepsis.

With Open Philanthropy’s generous support, Donnino and Marik have now joined forces on a double-blind clinical trial across 12 hospitals—which Moskowitz will help lead—to test the combination of these three potentially synergistic yet safe interventions. “Because the drugs used in this therapy are inexpensive, widely available, and easy to administer, it is possible that this treatment could be used in hospitals globally,” says Youngs. “We believe people have equal value regardless of where they live, so we are attracted to opportunities like this one that improve lives worldwide.” Donnino, who is just as enthusiastic about the far-reaching promise of this BIDMC-led study, adds: “We have an opportunity to improve patient outcomes with this work. I am excited about what our results might mean for sepsis treatment.” ■

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The Essence of Daniel

BITS & PIECES

Generous gift establishes Tikkun olam–Humanitas giving program and nurse practitioner residency

Little updates on big happenings in the BIDMC community

The 79 days Nora and Raymond Wong spent at BIDMC were the worst of their lives, as they witnessed their beloved 22-year-old son Daniel fight an extraordinary battle against a rare disorder called new-onset refractory status epilepticus (NORSE). Despite round-the-clock care in BIDMC’s intensive care unit (ICU) and a myriad of drugs and treatments, nothing could save him.

Want to learn more or share one of your own?

Email development@bidmc. harvard.edu.

Daniel’s complex case prompted Daniel Talmor, M.D., M.P.H., chief of the Department of Anesthesia, Critical Care, and Pain Medicine to evaluate departmental practices and seek feedback from the Wongs, which served as a catalyst for innovation at BIDMC. In the months and years that followed, Talmor implemented a number of meaningful shifts, including establishing the multidisciplinary Neurosciences ICU. “We deeply respect Dr. Talmor’s desire to learn from our experience,” says Nora, executive director of the NORSE Institute.

Talmor is not the only one working to improve care for critical patients.

The Wongs have devoted considerable time and effort to advancing awareness, clinical understanding, and research around NORSE, spanning beyond BIDMC. Through the creation of the NORSE Institute, they have achieved significant milestones, including supporting the proposal of consensus definitions of the condition and launching a multi-center, prospective, observational study of patients with NORSE. In recognition of Talmor’s work and the compassionate care Daniel received, the Wongs made a generous gift of $500,000 to establish the Tikkun olam–Humanitas giving program. Inspired by the philosophies of Tikkun olam, meaning “to heal the world,” and Humanitas, a code of excellence, kindness, and education, this program will provide an opportunity for patients and family members to give to BIDMC in honor of its staff. “Tikkun olam–Humanitas represents the essence of Daniel,” says Nora. Adds Raymond, “He was driven to help others and create a more equitable world.”

At age 25, Dhaval Oza was diagnosed with a rare form of cancer that presented as a large mass in his chest.

To thank his care team—including Sidhu Gangadharan, M.D., Glenn Bubley, M.D., Michael Gavin, M.D., M.P.H., and Jonathan Hausmann, M.D.—Oza held a fundraiser for BIDMC in January 2018 on the two-year anniversary of his diagnosis. Now cancer-free, he is already planning another event to benefit the medical center.

Grateful parents Erica and Dale Lathrop raised more than $5,000 in a Planet Subaru “Pledge for Preemies” fundraiser to support BIDMC’s Klarman Family Neonatal Intensive Care Unit (NICU). The Lathrops’ twins, Hunter and Teagan, were two of the more than 1,200 high-risk infants treated in the NICU each year.

Daniel Talmor, M.D., M.P.H., with Nora and Raymond Wong The Wongs directed this lead gift to support critical care nurse practitioners at BIDMC through a post-graduate residency program that will give them a greater role in patient care in ICUs. Not only will this program be an opportunity for nurses to specialize in critical care— it will also enhance the patient and family experience. “This effort will redefine care delivery and the role of the nurse practitioner,” says Marsha Maurer, D.N.P., R.N., Cynthia and Robert J. Lepofsky Chief Nursing Officer and senior vice president of Patient Care Services.

“The transformational relationships between nurses and patients will enhance continuity of care at BIDMC and serve as a national model.”

With their generous gift, the Wongs would like to thank BIDMC’s sixth floor nursing staff that cared for Daniel. In particular, they would like to recognize the four nurses who asked to be assigned to Daniel repeatedly despite knowing that he would require additional time, effort, and emotional involvement well beyond the usual ICU patient: Stephanie Ferrara, R.N.; Susan Kelley, R.N.; Erica Rivituso, R.N.; and Liz Tangerini, R.N. “Raymond and I created this giving program to recognize the people who tried to save Daniel,” says Nora. “They represent what Tikkun olam–Humanitas means to us.” ■

To support the Tikkun olam–Humanitas giving program, please contact Rhea Brubaker at (617) 667-4582 or Rhea.Brubaker@ bidmc.harvard.edu.

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In May, BIDMC officially unveiled its newly renovated Labor and Delivery Unit with a small celebration for grateful patient families who contributed to the effort. The event was an opportunity to recognize caregivers in the Department of Obstetrics and Gynecology for their excellence and showcase the thoughtfully designed facility that will support their work to provide an unrivaled patient experience.

BIDMC researcher John Nelson Campbell, Ph.D., received a $1.62 million 2018 Pathway Initiator Award from the American Diabetes Association. This highly competitive grant will support Campbell’s basic research, which seeks to identify the brain cells governing hunger, digestion, and glucose metabolism.

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PALM BEACH 1

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MARCH 8, 2018 BIDMC’s annual Palm Beach celebration, co-chaired by Carol F. and Howard M. Anderson and Midge and Tom DeSimone, took a close look at the scientific and medical advances taking place within the Roberta and Stephen R. Weiner Department of Surgery, the Division of Cardiovascular Medicine, and the Berenson-Allen Center for Noninvasive Brain Stimulation. The event was hosted

by Joyce Kulhawik, Emmy Award– winning former CBS-Boston arts and entertainment critic.

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1 Tom and Midge DeSimone, Kevin Tabb, M.D., and Caron Tabb, Carol F. and Howard M. Anderson 2 Helaine B. Allen, Lois Silverman Yashar 3 Ted and Cynthia Berenson 4 Joyce Kulhawik, Robert Gerszten, M.D., Alvaro Pascual-Leone, M.D., Ph.D., Elliot Chaikof, M.D., Ph.D. 5 Thelma Linsey

BOSTON MARATHON 6

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APRIL 16, 2018 On Patriots’ Day, Team BIDMC’s 63 runners weathered heavy rain and windy conditions during the 122nd Boston Marathon. As an official non-profit partner of John Hancock, the dedicated group raised close to $675,000, its highest total ever.

10 6 Talia Burstein, Rami Burstein, Ph.D. 7 Michelle Peterson, Patty Keady 8 Sara McKinney 9 Phillomin Laptiste 10 Lauren Buckley and Family

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CRITICAL VOICES 11

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MAY 1, 2018 More than 300 people attended BIDMC’s Critical Voices event, hosted by the Board of Overseers, which showcased how technology is revolutionizing the world of health care and marked the launch of our new Health Technology Exploration Center (HTEC). The event featured a keynote by BID System Chief Information Officer and HTEC Executive Director John D. Halamka, M.D., M.S.; and a Q&A discussion with Michael D. Howell, M.D., M.P.H., chief clinical strategist at Google, and Diane Hessan, BIDMC trustee and chair of C Space.

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11 John D. Halamka, M.D., M.S. 12 Danielle Remis Hackel, Tom DeSimone 13 Douglas T. and Carol Linde 14 Alexa Boer Kimball, M.D., M.P.H., John A. Christoforo, Peter J. Healy, Ranch Kimball 15 Michael D. Howell, M.D., M.P.H., John D. Halamka, M.D., M.S., Diane Hessan

LEADERSHIP Giving Matters We are proud to announce the formation of the BIDMC LEADERSHIP GIVING SOCIETY Dedicated to recognizing the medical center’s most generous donors of $1,500 or more within the fiscal year (October 1–September 30), the BIDMC LEADERSHIP GIVING SOCIETY offers benefits at three distinct membership levels.

ADVOCATE

PARTNER

CHAMPION

$1,500–$4,999 annual giving • A subscription to our e-newsletter • Annual updates from leadership • Invitations to attend educational events • A personal contact at BIDMC

$5,000–$9,999 annual giving • Previously listed benefits • An invitation to attend an annual leadership and community gathering

$10,000–$49,999 annual giving • Previously listed benefits • Access to our Patient Liaison Program • An invitation to attend our annual showcase event

FOR MORE INFORMATION www.bidmc.org/leadershipgiving | leadershipgiving@bidmc.harvard.edu

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Office of Development 330 Brookline Avenue (OV) Boston, MA 02215

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WINTER 2018-2019

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