Georgetown Medicine Fall/Winter 2015

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At the Intersection of

Faith & Healing

FROM THE ARCHIVES: AMPHITHEATER OF YONDER YEARS Times have changed as the Medical Center unveils the second half of the W. Proctor Harvey Clinical Teaching Amphitheater in October (pictured on back cover). In the meantime, help us identify the location, date and people in this photo from another era in Georgetown medical history. Send any information to: GeorgetownMedicineMagazine@georgetown.edu.

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At the Intersection of

Faith & Healing 10

How do Catholic, Jesuit values shape Georgetown’s medical education, research and patient care?

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AN EDUCATION FRAMED BY FAITH

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PUTTING FAITH & HEALING INTO PRACTICE

Faculty perspectives on teaching with faith in mind

Alumni reflect on the role of spirituality in patient care

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FAITH IN THE LAB Conversations with research scientists on matters of the spirit

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A THREAD OF HOPE The Lombardi Arts and Humanities prayer flag project

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Dear Friends, Welcome to the newest edition of Georgetown Medicine. In this issue, we take an in-depth look at Georgetown’s place as one of five Catholic medical schools in the country.

You will find fascinating content about the ways in which Jesuit principles guide activities in the Medical Center’s research, education, bioethics and patient care missions.

We explore the medical and nursing education experience at Georgetown through a Catholic, Jesuit lens.

We hear from bioethics leaders about the ways in which ethical concerns are taught. The practice of faith at Georgetown is explored in its many facets, Catholic and otherwise.

Our graduates leave Georgetown with top-notch clinical skills and a desire to make a difference. Two alumni—one a palliative care pediatrician, the other a neurosurgeon—reflect on the Edward B. Healton Catholic, Jesuit values they experienced during their medical education, and how these impact the patient care they provide every day.

Rather than being a limiting force, our Ignatian identity is a liberating one, opening doors to continued intellectual and spiritual inquiry and reflection. In that vein, we call your attention to the article by Dr. Mary Furlong, who writes about what it means to teach at a Stephen Ray Mitchell Catholic, Jesuit institution.

As you know, one of our core values is service to others. The Jesuit principle of cura personalis, or care of the whole person, is embedded in all of our activities. That principle comes through in this edition of the magazine, and we hope you enjoy it.

Cordially,

Edward B. Healton, M.D., MPH Executive Vice President for Health Sciences Executive Dean, School of Medicine

A publication for alumni and friends of Georgetown University Medical Center

Editor Jane Varner Malhotra

Contributors Daliha Aqbal (M’17) Bill Cessato Kate Corboy Elissa Ernst Mary Furlong (MS’91, M’95, R’00) Melissa Maday Meghan Murphy (M’11) Leigh Ann Renzulli Camille Scarborough Renee Twombly Kat Zambon

Design Director Robin Lazarus-Berlin, Lazarus Design

University Photographer Phil Humnicky

Executive Vice President for Health Sciences Edward B. Healton

Dean for Medical Education Stephen Ray Mitchell (W’86)

Georgetown Medicine is published by the Georgetown University Office of Advancement Communications. The magazine welcomes inquiries, opinions and comments from its readers. Address correspondence to GeorgetownMedicineMagazine@ georgetown.edu or: Jane Varner Malhotra, Editor Georgetown Medicine Office of Advancement P.O. Box 571253 Washington, DC 20057-1253 Contact alumni records for address changes: addup@georgetown.edu or 202-687-1994.

Stephen Ray Mitchell, M.D., MBA (W’86) Dean for Medical Education

For up-to-date information on Georgetown events and alumni news on campus and around the world, visit Georgetown Alumni Online: alumni.georgetown.edu. © 2015 Georgetown University Medical Center

Cover photo: © ERproductions Ltd

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News & Research

New Study Looks at Aging and Cancer

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hile cancer disproportionately affects older individuals, there is relatively little research funding devoted to exploring the relationship between cancer and aging. With the support of the National Cancer Institute (NCI), Georgetown Lombardi scientist Jeanne Mandelblatt will spend seven years investigating this underdeveloped field.

As the recipient of an NCI Outstanding Investigator Award, Mandelblatt will use the $6.4 million grant to conduct population science

same age and background without cancer. This will help us investigate how biobehavioral factors interact with cancer treatment to impact survivors’ outcomes,” says Mandelblatt. “We then hope to determine whether biological age can be used in clinical practice to identify patients at risk of losing function.”

Rather than viewing all elderly survivors as a monolithic group, Mandelblatt’s project acknowledges the distinction between a person’s “biological age” and one’s actual chronological age.

While two cancer survivors

The $6.4 million grant will support Mandelblatt’s continued leadership in cancer research, and help her train the next generation of scientists in aging-related cancer studies. research involving older cohorts of breast cancer survivors.

“Our research will begin by comparing the trajectory of physical and cognitive decline among older cancer survivors to the decline in those of the

may have been born the same year, differences in their lifestyles and biology can cause them to age at different rates.

Exercise, social support and genetic dispositions can impact the aging process, and

Georgetown Lombardi researcher Jeanne Mandelblatt

the differences may influence their odds of experiencing adverse treatment effects— important to consider when making decisions about therapy and long-term care.

Recently Mandelblatt led another NCI-funded study examining cognitive outcomes in older breast cancer patients.

That study, and a continuation award that will be funded shortly, form the basis for her current work.

As the country’s population ages, three-quarters of cancer survivors will be over age 60 in 2030, and they will be living longer than previous generations of survivors. With greater age comes a greater number of complications that may compound functional decline. Yet, perhaps because of these complications, the large majority of research has

targeted younger individuals.

Only four percent of NCIfunded projects focusing on cancer survivorship specifically examine outcomes in older individuals, and Mandelblatt sees the potential for her work to fill some of the gaps in existing knowledge.

“In the coming years, many older patients diagnosed with cancer will wish to reap the benefits of new cancer therapies. We need to have a greater understanding of how treatment will affect quality of life for individuals from all walks of life,” Mandelblatt says. “By gathering evidence about the links between biology, behavior and patient function, we can enable survivors to make better informed choices about treatment and reduce the burden of their cancer.” n

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Georgetown Leads New Reproductive Health Effort

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ith a $30 million grant from the U.S. Agency for International Development (USAID), the Institute for Reproductive Health (IRH) at Georgetown University Medical Center will lead a team of global health organizations to implement a new reproductive health initiative in developing countries.

By bringing together experts from FHI 360, Johns Hopkins Global Early Adolescent Study, Population Services International, Save the Children and Tearfund, the IRH-led Passages Project will strive to improve healthy timing and spacing of pregnancies among youth and first-time parents in Africa and Asia. Work supported by the grant began earlier this month.

“Early pregnancy and child marriage are a reality for millions of young women worldwide, curtailing their educational and vocational opportunities, leading to poor sexual and reproductive health outcomes and contributing to the intergenerational cycle of poverty,” says Rebecka Lundgren, director of the Passages Project and research director at IRH. “Enabling young women

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and men to live lives free of violence, coerced sex and unplanned pregnancy is essential if countries are to realize their development goals.”

Social norms enforced by peers, families and communities influence the way young people behave and think about sex, marriage

and intimate partner violence. Researchers on the Passages Project will develop and test scalable approaches to promote social norms that support healthy behaviors, such as the belief that men and women have equal rights and responsibility in family planning.

The Passages Project aims to transform social norms in developing countries.

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“Through the Passages Project, we are building on almost three decades of experience in developing evidence-based programs that address critical needs in sexual and reproductive health,” says Victoria Jennings, director of IRH. “The Passages approach —focusing on social norms and targeting individuals at transitional life moments—offers a unique opportunity to address significant development challenges.” n

Battling Alzheimer’s With Ingredient in Red Wine and Chocolate

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he largest nationwide clinical trial to study the long-term effects of high-dose resveratrol in people with mild-tomoderate Alzheimer’s disease found intriguing results.

The study showed that a biomarker that declines when the disease progresses was stabilized in people who took the purified form of resveratrol. Resveratrol is a naturally occurring compound found in foods such as red grapes, raspberries, dark chocolate and some red wines.

The results, recently published online in Neurology,

“This is a single, small study with findings that call for further research to interpret properly.”

The resveratrol clinical trial was a randomized, phase II, placebocontrolled, double blind study in patients with mild-to-moderate dementia due to Alzheimer’s disease.

An “investigational new drug” application for the study was required by the U.S. Food and Drug Administration to test the pure synthetic

© Goldfinch4ever/iStock

The highest does of resveratrol tested was one gram by mouth twice daily—equivalent to the amount found in about 1,000 bottles of red wine. “are very interesting,” says the study’s principal investigator R. Scott Turner, director of the Memory Disorders Program at Georgetown University Medical Center.

Turner cautions that the findings cannot be used to recommend resveratrol.

(pharmaceutical-grade) resveratrol, which is not available commercially in this form.

The investigators enrolled 119 participants for the oneyear study. The highest dose of resveratrol tested was one gram by mouth twice daily—

equivalent to the amount found in about 1,000 bottles of red wine.

Patients who were treated with increasing doses of resveratrol over 12 months showed little or no change in amyloid-beta40 (Abeta40) levels in blood and

cerebrospinal fluid. In contrast, those taking a placebo had a decrease in the levels of Abeta40 compared with their levels at the beginning of the study.

“A decrease in Abeta40 is seen as dementia worsens and Alzheimer’s disease progresses; still, we can’t conclude from this study that the effects of resveratrol treatment are beneficial,” Turner explains. “It does appear that resveratrol was able to penetrate the blood brain barrier, which is an important observation.” n

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Georgetown Advances Research on Cancer Therapy Revolution fter more than 30 years of research in the field, Michael Atkins, deputy director of

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predicts—drugs that will keep a cancer patient’s immune system switched on to attack tumors.

the Georgetown Lombardi Comprehensive Cancer Center, is confident that a cancer treatment is quickly becoming so promising that it will soon overtake use of chemotherapy and radiation, leading to a revolution in cancer care. These toxic treatments will be replaced by immunotherapy, he

“Patients such as President Carter can be optimistic that their disease could be controlled and even eliminated with these therapies,” says Atkins. “While advanced melanoma used to be a death sentence, new treatments based on research—including studies conducted at Georgetown Lombardi—have

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radically changed the outlook. Plus, side effects are minimal so that age is not a limitation.”

Immunotherapies of the type that President Carter is receiving have been shown to be effective in 20 different cancers, Atkins says—a fact that is revolutionizing the way cancer is treated. Many of these new drugs are yet to be approved, but are available as part of research protocols at Georgetown Lombardi.

The body’s immune system normally confronts cancer cells, but the body routinely turns that assault off in order to protect against chronic inflammation. Sometimes tumors themselves turn off the immune response and, when nothing exists in the body to stop them, the cancer cells grow and spread.

The future of cancer care will be immune system activators tailored for smokingrelated lung cancer, bladder cancer, head and neck cancer, triple negative cancer, and blood and immune system malignancies, among other tumor types, Atkins says.

“These are some of the most difficult cancers to treat today.

The irony is that the worst cancers are believed to be diseases that are best suited for the novel immunotherapy

approaches— there are more mutations for the immune system to attack.”

Atkins helped study the two big successes recognized to date in immunotherapy— treatment of melanoma and, recently, kidney cancer.

At the May meeting of the American Society of Clinical Oncology (ASCO), Alan Venook, M.D., chair of ASCO’s scientific program committee and oncologist at University of California, San Francisco, recognized Atkins as a seasoned immunotherapy expert: “He’s not someone who just jumped on the immunotherapy bandwagon, but someone who built the bandwagon.”

From Harvard Medical School, where he was a professor, and Dana Farber/ Harvard Cancer Center, where he led the kidney cancer program, Atkins came to Georgetown Lombardi in 2012 to build a team that would help usher in the coming era of cancer immunotherapy.

“I came to Georgetown Lombardi because I saw a relative vacuum in melanoma care and immunotherapy research and thus an opportunity to advance these disciplines here,” he says. “And I find the prospect of collaborating with the many fine investigators at this institution very energizing.”

Atkins helped pioneer the use of immunotherapy in

© Nir Levy/Shutterstock.com

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kidney cancer. He was the senior investigator in a study published in March in the Journal of Clinical Oncology that found the immunotherapy drug nivolumab produced long-lasting tumor control in some patients with advanced, treatment-resistant kidney cancer.

He and colleagues are currently exploring how to

integrate immunotherapies with standard treatments.

As the overall principal investigator on a recently opened national clinical trial, Atkins seeks to determine which treatment sequence leads to better long-term survival and overall quality of life in patients with BRAF mutation-driven melanoma.

Atkins also facilitated collaborations at Georgetown that have led to testing of other combination immunotherapy regimens in patients with a variety of cancers via the medical center’s Experimental Therapeutics program.

“With the proof of principle established that the reactivated immune system

can attack virtually any tumor type, and with a huge repertoire of immunotherapies available to precisely restore immune function in a particular cancer, the future of immunotherapy is bright,” Atkins says. “This is a great time in cancer research— and the rewards will soon be seen in treatment of a number of cancers.” n

New Enhancements at NHS Simulation Center

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or more than a decade, the O’Neill Family Foundation Clinical Simulation Center at the School of Nursing & Health Studies has offered educational opportunities to support clinical education— ranging from high-fidelity patient simulators to live standardized patients.

Now, with the recent addition of new software and

video monitoring capabilities, the 2,800-square-foot facility in St. Mary’s Hall has stepped up its commitment to innovative experiential education.

The upgrade allows faculty members, either in real time or via video, to monitor student engagement with standardized patients.

It also introduces into the simulation center an

electronic health record (EHR) system that is specifically geared toward student learning.

With the new system, Giffin and Sheahan explain, professors are able to create mock health records for diverse patient populations.

Then their students, working with the simulators and standardized patients, implement orders including

dispensing medication, and conduct patient evaluations such as a neurologic assessment of an adult female.

As part of the upgrade, four exam rooms have been outfitted with new video cameras that sync directly with the software system, allowing faculty members to review the students’ learning activities as they happen or at a later time. The completed health records —as well as corresponding videos—are checked by faculty for accuracy and completeness.

“Enhancing experiential learning is a key priority of our strategic plan,” says Patricia Cloonan, the school’s interim dean.

“This new technology in the simulation center is a big step in the right direction.” n

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University Names New Medical Center Executive Vice President

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hroughout his career, Georgetown University Medical Center’s new executive vice president and neurologist Edward Healton has worked to bridge academic medical centers and community-based settings.

Healton, who has served as chair and professor of neurology and rehabilitation medicine at Georgetown’s School of Medicine and MedStar Georgetown University Hospital since 2002, has also held leadership roles at MedStar National Rehabilitation Hospital (MedStar NRH).

“Dr. Healton is a trusted member of our community, and I am confident in his ability to work closely with our leadership team to lead the Medical Center through this time of transition,” says Georgetown President John J. DeGioia. “In his 14 years as a member of our community, he has proven himself a principled and effective executive, combining strengths as both a medical professional and organizational leader.”

Healton knew he wanted to be a doctor from the tender age of six. The product of a Jesuit medical education at Creighton University, Healton went on to do his residency in medicine at Harlem Hospital in New

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Edward Healton

“Dr. Healton is a trusted member of our community, and I am confident in his ability to work closely with our leadership team to lead the Medical Center through this time of transition.”

– Georgetown President John J. DeGioia York, and his neurology residency at Columbia University.

Later as senior associate dean, he oversaw the Columbia University College of Physician and Surgeons’ partnership with Harlem Hospital Center, where he then served as medical director.

“Being in both the university setting and in a public

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hospital community-based setting was exceptionally valuable and satisfying for me,” he says. “It reflects my priorities of public health, community health, health disparities and the engagement of the university in those areas.”

Before joining Georgetown in 2000, he served for 32

years at Harlem and Columbia, where he is now professor emeritus of clinical neurology.

The principle investigator on numerous studies, Healton published extensively on everything from communitybased health services to cerebrovascular disease and the neurological complications of systemic diseases,

© Sergey Nivens/Shutterstock.com

such as Vitamin B-12 deficiency and severe hypertension. He promoted collaborations between academic and clinical researchers that led to health solutions moving quickly from the lab to the patient.

As the new EVP, Healton will focus on improving the integration and execution of GUMC’s academic, research and clinical missions. He will address the changing dynamics of health care in a time of declining federal support for research, and pursue opportunities for the Medical Center to strategically strengthen its position for future growth, including the partnership with MedStar.

The Center for Brain Plasticity and Recovery offers a specific example of a successful collaboration, says Healton.

“The Center is taking an important clinical problem and looking at basic and translational research focused on stroke, the leading cause of disability in the country,” Healton says. Co-directed by GUMC and MedStar NRH researchers, the partnership includes space at both entities and joint funding.

“GUMC is really part of the broader community of academic medical centers facing changes in the way health care is organized and financed,” Healton notes.

“Our challenge is to find opportunities and build on our strengths in this new environment.” n

More Gray Matter in Bilingual Brains

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recent study published in the journal Cerebral Cortex suggests people who speak two languages have more gray matter in the executive control region of the brain.

Studies have shown that bilingual individuals perform better, compared with monolinguals, on tasks that require attention, inhibition and short-term memory, collectively termed “executive control.” This “bilingual advantage” is believed to arise from their long-term use and management of two spoken languages. However, the advantages are not observed in all studies, and even when they are, the mechanism is still under debate.

“Inconsistencies in the reports about the bilingual advantage stem primarily from the variety of tasks that are used in attempts to elicit the advantage,” says senior author Guinevere Eden, director for the Center for the Study of Learning at Georgetown University Medical Center. “Given this concern, we took a different approach and instead compared gray matter volume between adult bilinguals and monolinguals.

We reasoned that the experience with two languages and the increased need for cognitive control to use them appropriately would result in

brain changes in SpanishEnglish bilinguals when compared with Englishspeaking monolinguals. And in fact greater gray matter for bilinguals was observed in frontal and parietal brain regions that are involved in executive control.”

What about being bilingual leads to these advantages? To understand this question the team went one step further. “Our aim was to address whether the constant management of two spoken languages leads to cognitive advantages and the larger gray matter we observed in Spanish-English bilinguals, or whether other aspects of being bilingual, such as the large vocabulary associated with having two languages, could account for this,” explains Olumide Olulade, the study’s lead author and post-doctoral fellow at the Medical Center.

The researchers compared gray matter in bilinguals of American Sign Language (ASL) and spoken English with monolingual users of English.

Both ASL-English and Spanish-English bilinguals share qualities associated with

bilingualism, such as vocabulary size. But unlike bilinguals of two spoken languages, ASL-English bilinguals can sign and speak simultaneously, allowing the researchers to test whether the need to inhibit the other language might explain the bilingual advantage.

“Unlike the findings for the Spanish-English bilinguals, we found no evidence for greater gray matter in the ASL-English bilinguals,” Olulade says. “Thus we conclude that the management of two spoken languages in the same modality, rather than simply a larger vocabulary, leads to the differences we observed in the SpanishEnglish bilinguals.” n

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At the Intersection of

Faith & L

ast fall, I joined the team at Georgetown University to help share the stories of the incredible work happening at our Medical Center.

I had the privilege to attend the seventh annual convocation in November 2014, when Dr. Helen Mayberg received Georgetown University Medical Center’s highest honor, the Cura Personalis Award.

Professor of psychiatry, neurology and radiology at Emory University, Mayberg and a panel of Georgetown faculty experts explored clinical, social and ethical issues around the use of deep brain stimulation (DBS) for treatment-resistant depression.

To be honest, when I first heard the term “deep brain stimulation,” I thought it sounded like a fantastic scalp massage. However, this was going a little deeper.

Rabbi Rachel Gartner After years of studying neuroimaging to understand how depressed brains worked differently, Mayberg and a cross-disciplinary team, plus one patient who felt completely out of options, made the bold decision to try out a new method for treating major depressive disorder. They implanted a stimulating electronic

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device—like a pacemaker for the brain—in a precisely selected location (in the white matter tracts adjacent to the subgenual cingulate gyrus), and found successful results in four of six patients. Although brain implants were already in use to treat symptoms of Parkinson’s disease, DBS offered new hope for many with treatment-resistant depression.

Hundreds of thousands of people now have surgical brain implants to help alleviate the symptoms of a variety of disorders. At MedStar Georgetown University Hospital, surgeons have been performing deep brain stimulation for Parkinson’s patients for over ten years.

The concept of a sustained, surgically implanted electrical charging device for the brain was completely new to me at the time. The idea that it could be used to treat depression sounded like science fiction. I know many people who have suffered from mental illness in its varied forms and intensities. I couldn’t imagine anyone making the decision to try the solution of a battery-operated brain implant. And yet, the results were compelling, even when the ethics around the procedure raised many questions. Who is treatable?

What is the desired functional state of “normal?”

What happens when something goes wrong?

The more I learned that day, the more questions I had. What next for this frontier of electronic brain management? Would parents be able to someday modify sassy attitude from teenagers? Could an ill-intentioned political group flip a switch to make the population more compliant? How far would we go?

Healing How do Catholic, Jesuit values shape Georgetown’s medical education, research and patient care?

As the day came to a close, Georgetown’s Rabbi Rachel Gartner arrived to conclude the convocation with a prayer. She had opened the ceremony in the morning with a beautiful, simple blessing. By the time she returned in the afternoon, the people in attendance—faculty, students, clinicians, and university staff—were abuzz with the mind-splitting potential for this expanding technology. The rabbi’s words brought us back to solid ground, while simultaneously lifting the community to new heights. She spoke of the important work taking place in the health care field to shed light on the darkness of depression, which touches so many lives. She grew suddenly quiet, and then softly shared that she had lost her sister to depression the previous year. A powerful silence filled the auditorium.

Rabbi Gartner began her prayer: “For we know that the final destination of life, dear God, is in your hands, but much of the journey you have placed in ours. We are here to make the path as smooth and as beautiful as we can for one another. We are grateful for this day, which celebrates how far we’ve come and fortifies us for the hard work that lies ahead.

We pray this afternoon that you bless Dr. Mayberg, and all those here and everywhere engaged in the holy work of healing, with an ever-renewing love for their work and for humanity. In the words of Rambam: ‘Preserve the strength of their bodies and souls that they will ever be able to help and support rich and poor,

good and bad, enemy as well as friend. In the sufferer let them and let us all see only the human being.’

May all who suffer find a healing of body where possible, and a healing of spirit always, soon, speedily, without delay, and let us say, Amen.”

Dr. Helen Mayberg

The change in the room was palpable. Her sacred words brought a deeper meaning to the challenging work of depression research and care for the mentally ill. Framing the day—packed with futuristic, frightening yet hope-filled technological advances—with prayer was uniquely Georgetown.

Like other top institutions around the country, the university is blazing trails in medical innovation, but at this Jesuit, Catholic institution, the greater purpose of our work is not forgotten.

Jane Varner Malhotra Editor

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An Education F R A M E D BY FA IT H Georgetown’s Catholic, Jesuit identity draws applicants to the School of Medicine for reasons beyond the university’s cutting-edge research and science. Students are attracted to the school’s emphasis on the Jesuit principle of cura personalis, care for the whole person, and on the importance of serving society’s most vulnerable populations. Once here, students experience the school’s foundation of faith in their own unique ways.

Many people are surprised to learn that Georgetown is home to one of just five Catholic medical schools in the country. Georgetown University Medical Center embraces its role as a preeminent academic medical center that also values spirituality and ethics-centered leadership in an increasingly secularized profession. The commitment to caring for the whole person extends from the classroom—where clinicians-in-training study and discuss such topics as bioethics and moral decision-making—to opportunities in the community that prepare them to support and recognize individual spiritual journeys for both patient and practitioner. Faith, spirituality, service and ethics are key touchstones in Georgetown’s medical curriculum.

“Faith has a critical role for those who are truly humbled to have such sobering responsibility for the lives of our patients,” says Stephen Ray Mitchell, dean of medical education. He recently embraced Georgetown’s Jesuit roots by completing a retreat over a nine-month period to learn the spiritual exercises of St. Ignatius.

“And this Episcopalian pediatrician uses them daily,” he adds.

By Melissa Maday

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ETHICS THROUGH THE LENS OF FAITH Kevin Donovan, professor in pediatrics and director of the Edmund D. Pellegrino Center for Clinical Bioethics, considers it a special privilege to teach at a medical school where “faith and ethics are natural and valued parts of the conversation.”

He is keenly aware of the unique opportunity that Georgetown offers. In contrast, he previously studied and taught at the University of Oklahoma. “As a state school, naturally religion couldn’t play a part in the teaching of ethics unless it was just an overview of how it affects the way your patients respond,” he explains. “At Georgetown, we can introduce concepts, knowing that our students have different faith traditions or differing perspectives within the same faith, yet they will learn and understand the values of the institution.”

Donovan describes the literal interpretation of cura personalis, which commits Georgetown “to value those whom society doesn’t always value” and which has a profound influence on educating practitioners. “Our society is showing a tendency to disvalue the weakest, most vulnerable members of society. It is reflected in the way we treat patients across the gamut, from neonatal to the elderly,” he explains. “When we send a message that you are only as valuable as your usefulness to society, then people who have lived long and full lives and experience the normal impairments that come with age are made to feel that they are a burden rather than a contributor.”

He believes that countering this tendency has important implications in many areas: interpersonal relationships between doctors and patients, the delivery of health care to those in need, the protection of vulnerable patients and the consideration of every individual as a valuable human being. “I think that

Georgetown understands these priorities and teaches them,” he concludes.

All Georgetown medical students take Introduction to Clinical Ethics in their first year. In this course, students examine how medical professionalism, ethics and law set standards for physician role and behavior. They also look inward, reflecting on how principles of ethics influence their own character and behavior. The course includes a panel about religious traditions and patient care. In the spring of their second year, students take a module called Health Care Ethics, with the goal of facilitating and encouraging a deeper understanding of ethical reasoning and decision-making.

This two-fold approach has an important effect on students, says Donovan, with the second module building on the students’ recently acquired clinical experiences. “When we meet them in the first course, their realm of experience is narrow. Most have no clinical background yet,” he says. “But when we meet them in their second year and beyond, it becomes much more than a theoretical classroom discussion.”

at their disposal, including their training and experience, to make decisions for themselves and to help patients and families make good decisions.”

Georgetown helps student practitioners understand the difference between law and ethics, and how the two interact in patient care. Taylor explores the issue in her classes, which include online courses with students from across the country, by leading the group in a simulation of a challenging clinical ethics consult.

“Introducing ethics consults to graduate nursing students is an interesting exercise,” she explains. “Often they tell me that in their practice, everything is viewed through a legal lens. In my course, we

TEACHING DISCERNMENT For Carol Taylor, professor of nursing and senior clinical scholar at the Kennedy Institute of Ethics, cura personalis goes beyond caring for a person’s physical needs. Her goal is to teach practitioners like graduate nursing students who come from very different perspectives to be discerning about what people really need to flourish.

“Often the caregivers’ goal is high patient satisfaction, which prioritizes giving patients what they want,” says Taylor. “I try to suggest a very different role to them: bring your own nursing experience and your work with physician colleagues to the situation. Clinicians must feel equipped to use the resources

Kevin Donovan speaks at the 2015 Pellegrino Symposium, held in the Bioethics Research Library.

look at the same things through an ethical lens—how are humans going to be affected by the choices they make.”

Taylor and her students examine broad examples of ethical situations, such as those in war or genocide, and then look more specifically at how those principles impact them in a clinical setting. “Whether you’re looking globally or you’re looking at the individual patient

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and family, you have a role,” she tells her students. “If things aren’t working for people, and if good and wise people don’t speak up, nothing’s ever going to change.”

She believes that a clear understanding of bioethics is key to being a caring practitioner: “It’s all to empower our graduates. I remind them that every day they show up for practice, they literally hold the well-being of people in their

and purpose, love and relatedness, and forgiveness,” she says. “Oftentimes it’s the experience of illness that puts those questions in a much sharper relief. Your days here look shorter rather than longer.

‘Why am I here?’ becomes, ‘When I’m gone, will I matter to anyone?’ And, to the extent that we all make mistakes in our life, what forgiveness has to happen before we can be at peace as we confront death?”

nursing practice, no one ever held me accountable to identify a spiritual need and either respond or refer it appropriately. We haven’t begun to hold one another accountable for addressing spiritual needs. So it’s a huge opportunity.”

Taylor concludes that the role of spirituality and ethics is more important for health care practitioners graduating now than ever before: “Science is making so much more possible today, but it does not always equate to a better life. Health care professionals bridge vulnerable persons and this huge array of diagnostic and therapeutic options. I believe the role of walking with people and helping them make wise choices is more critical than ever before. That’s what I hope we’re doing well at Georgetown—preparing our graduates to be wise guides.”

WOMEN AND MEN FOR OTHERS

In the online graduate nursing program, Carol Taylor leads students around the country in a clinical ethics consult simulation.

hands. Who they choose to be will affect—and sometimes determine—how people are born, even if they’re born, how they live, suffer, age and die. And if they don’t think we need to be careful about how we step into people’s lives, they might want to do something other than become a health care professional.”

WISE GUIDES To teach students to address the needs of their patients beyond the physical, Taylor introduces what she defines as the universal spiritual needs.

“Independent of anyone belonging to a particular religious tradition, we all struggle with questions about meaning

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Contending with these universal spiritual needs for purpose, legacy and forgiveness undergirds much of Taylor’s work. In her teaching and writing, she speaks to what she describes as “the limits of the biomedical model” for patient care. “We are not just machines —organisms that exist at the molecular level. It is important to talk about biology and psychology, as well as social and spiritual models of health.”

Taylor believes the field is lagging in this area of understanding, which, on a positive note, offers great opportunity for engagement and education, especially at places like Georgetown where they are recognized and accepted. “In my entire

Since 1995, the School of Medicine has provided a service-learning program to help medical students recognize and address community health priorities.

Today, the now-required course has grown to include 200 students, 27 faculty team leaders and 29 community partners.

Service learning enables students to work with underserved and at-risk populations, in keeping with Georgetown’s mission.

“It was popular from the start,” says Jay Siwek, vice chair and professor in the department of family medicine at Georgetown. “We had to turn away students because we didn’t have enough slots. Every year we tried to piece together more funding, more community sites and more faculty.”

All first-year medical students take the service-learning course. They are hosted by community sites that serve non-native English speakers, those affected by domestic violence, school-aged children, the homeless, senior citizens and people with disabilities. The medical students

work as a group at a single site over the course of their first semester, building a deeper understanding of the complex factors that create health care challenges for the population in their community.

The personal relationships and connections help students understand issues like access to care and social determinants of health beyond textbook statistics.

ETHICS RESOURCES AND COOKIES When students do seek textbook statistics and other scholarly resources on ethics and faith-based medical and health care questions, they visit the university’s worldrenowned Bioethics Research Library.

Located in Healy Hall, the library serves the entire Georgetown community, in addition to outside researchers and practitioners. The collection began in 1971 as a few shelves of books collected by the university’s ethics scholars. As the interdisciplinary field of bioethics grew, so did the library. Today it is home to the world’s largest and most extensive collection of materials on ethics, medicine and biomedical research. The historic study space contains more than 100,000 books, journals, archival materials and digital objects covering the spectrum of religious, political and cultural perspectives developed globally.

The bioethics library features popular events such as the weekly “Cookie Friday” program hosted by Laura Bishop, head of academic programs at the Kennedy Institute of Ethics (KIE), with speakers discussing bioethics issues or cases. Recent topics have included organ and tissue donation, Ebola, the issue of coercion and genome sequencing. Podcasts are available for those who can’t attend. (http://podcast.genethx.org) Complementary to the KIE but housed at the Medical Center, the Edmund D. Pellegrino Center for Clinical Bioethics was established over

A MASS OF GRATITUDE Before Georgetown’s first-year medical students begin their Gross Anatomy course each fall, the chaplain leads the class in a blessing of the cadavers.

Over the course of the year, students work in small groups with the same body, slowly and respectfully uncovering a person’s medical story. In the spring, the students organize the Anatomical Donor Mass, a ceremony honoring those who have made the greatest gift: donating their bodies to science. Families and loved ones of the donors attend the multi-faith prayer service followed by a Mass. During the ceremony, students carry in a glowing candle to express their deep gratitude and respect for the donors, who have offered the aspiring physicians the opportunity to begin to know the human body by becoming their first patients.

two decades ago to focus on clinical care with roots in the Catholic, Jesuit tradition. With appointments spanning the Medical Center, the Pellegrino faculty members teach, conduct research and participate in patient care. The center provides ethics consultation service for MedStar Georgetown University Hospital, in addition to consulting for outside organizations like the Catholic Health Association.

In the field of professional education, the Pellegrino Center also supports Georgetown University’s worldrenowned Intensive Bioethics Course, offered for over 40 years through the KIE. The weeklong program brings policy makers, nurses, doctors,

researchers, hospital chaplains and institutional review board panelists to the Hilltop to grapple with some of the most profound moral issues they confront in their work. The course includes plenary lectures on key principles of bioethics, followed by small group discussions led by expert facilitators. Two half-days are devoted to lectures on diverse topics such as genomics, collaborative reproduction and neuroethics.

MINISTRY AT THE MEDICAL CAMPUS Medical students from a variety of faith traditions often turn to the Medical Center’s campus ministry program for support and fellowship, or to simply find a quiet, reflective space. The department

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focuses on caring for the spiritual needs of the students, and instilling a spirit of collaboration among graduate students of clinical medicine, medical research and nursing and health sciences. Students meet with the chaplains at the beginning of their first year, and the four chaplaincies—Catholic, Protestant, Jewish and Muslim—offer programming specifically for medical students.

Trained as a nurse early in his career and later a hospital chaplain at Georgetown, Fr. Sal Jordan, S.J., runs the Medical Center campus ministry today.

He conducts weekday noon Mass at the St. Ignatius Chapel in the MedDent building, leads student interfaith retreats, hosts the monthly “Pizza with the Padres” outreach event and enjoys one-on-one counseling with patients and students of all faiths.

“The job of chaplain must be flexible, so that I can be present here when a phone call comes, or there’s a knock at the door from someone in need,” says Fr. Jordan. “The healing ministry is such a sacred ministry and we are all called to that here. It’s very uplifting.”

As a Jesuit institution and thought leader in bioethics, the medical center strikes a balance to educate the next generation of practitioners who integrate cutting-edge science with the grounding principle of cura personalis, with faith as a welcome element.

“As part of our mission, Georgetown pays attention to those universal spiritual needs,” says Taylor. “And we invite each student to not only become a technical expert in the health profession, but to value being a responsible, compassionate and humane healer.” n

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Teaching in a Jesuit School of Medicine

By Mary A. Furlong (MS’91, M’95, R’00)

As a graduate of Georgetown University School of Medicine and as a past resident and current faculty member at the same institution, I feel a strong sense of loyalty. It has been a privilege to learn, train and teach at this Jesuit center. There is something special in the halls, in the classrooms, and at the bedside that is an unspoken inspiration as we care for our patients.

Although our student and faculty populations are religiously diverse, the Jesuit tradition of cura personalis is real on our campus. The students and faculty have a commitment to caring for the whole person; that commitment extends to our care of each other and our community. Our students want to make a difference in the lives of the patients they treat. As a Catholic institution, there are symbols of Catholicism in the classrooms and throughout the hospital, serving as reminders of our spirituality, regardless of religious preference, and of our commitment to put others ahead of ourselves.

As a professor of pathology in the School of Medicine, I am fortunate to teach students throughout their four years of training. Often our students share their reasons for choosing Georgetown University School of Medicine: the emphasis on social justice, a sense of advocacy and a higher purpose of serving those less fortunate.

These are core to our mission at Georgetown, evident in both the preclinical and clinical years. Even in the lecture hall, altruism and dedication to a humanistic medical education fosters responsible stewardship in practice.

Dr. Furlong and her faculty colleagues await the start of the 2015 White Coat Ceremony.

At Georgetown, our students seek service-oriented opportunities. They are required to complete 20 hours of community service; however many far exceed that number. Eager to learn and apply their knowledge through experience, students reach out to the community in a variety of ways through our medical curriculum, beginning in the first year with service learning. The course encourages “students to work directly with medically underserved people in the community, forming relationships with community partners and being exposed to culturally sensitive issues.” Participation in the studentdriven, free Hoya Clinic, extending health care to the area’s underserved population, has been a truly rewarding experience for our students. The School of Medicine’s Health Justice Scholar’s Tract is a unique longitudinal program

that provides opportunities throughout the four years of training for those who are interested in health rights. Students not only see patients in all parts of our city, but they also study how to improve care through research, reflection and scholarship.

These are just some of the ways that our students get involved and demonstrate their desire to go beyond the classroom and engage with our communities. There is so much more that happens on a daily basis as students take the time to listen, share, diagnose and treat their patients. Our community values human life and human dignity.

We believe in the Jesuit principle that every patient—with his or her own challenges—deserves individualized attention and respect, and we strive to work together to care for that patient. n

Mary A. Furlong is professor in the Department of Pathology and director of medical education at the medical school and at MedStar Georgetown University Hospital. After graduating from the School of Medicine in 1995, she stayed to complete her anatomic and clinical pathology residency at Georgetown. The beloved researcher, physician, professor and mentor has received four Golden Apple Awards from her students for “outstanding professional and personal qualities that enhance medical education” during her 15 years teaching at her alma mater.

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Putting

Faith & Healing

Into Practice

Jennifer Walter (M’07)

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After nine years working to complete her M.D.-Ph.D. in philosophy at Georgetown, Jennifer Walter penned an article for the AMA Journal of Ethics (formerly Virtual Mentor) titled “The Body and Blood of Medical School: One Student’s Perspective on Jesuit Education.” She highlighted the school’s emphasis on care for the whole patient, on how different religious traditions intersect with health care, and on a physician’s responsibility for society’s forgotten.

Walter completed her residency in pediatrics at the University of Chicago Comer Children’s Hospital in 2010, and then continued her studies as a Robert Wood Johnson Foundation Clinical Scholar at the University of Michigan, earning a Master of Health and Health Services Research. In 2012 she joined the University of Pennsylvania Perelman School of Medicine as an assistant professor of pediatrics, with her clinical work based at the Children’s Hospital of Philadelphia (CHOP). She has a joint appointment in the Perelman School of Medicine in the department of medical ethics and health policy and in CHOP’s department of medical ethics.

She recently spoke with Georgetown Medicine to reflect on the role of spirituality and faith in her work today.

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IN GOD’S HANDS The tiny newborn girl is small enough to fit in the palm of her father’s hand.

Fragile and weak, she was born preterm at just 24 weeks, and she came with complications.

With several serious anatomical abnormalities, the doctors say it’s unlikely that she will survive beyond infancy. Her parents listen with worry as a parade of clinical specialists come to them and describe a variety of complex procedures that may—or may not—extend the life of the child. There are grave risks, they explain, and likely continued discomfort for the struggling infant, with many questions remaining about what that life might be like if she does survive for some time beyond the surgeries.

Heartbroken and overwhelmed, the grieving parents turn to their deep well of religious faith. After considering the many options, together they explain to the clinicians that they are praying for a miracle, and they are putting themselves and their daughter in God’s hands.

The highly skilled medical specialists turn to each other in confusion. How will this solve anything? How is this even a way forward?

Some clinicians are unsure how to respond in this kind of situation, when families request an end to conversations about whether or not medical interventions are helping their child, explains

Jennifer Walter (M’07), a palliative care pediatrician and medical ethicist at Children’s Hospital of Philadelphia (CHOP).

“Statements from families describing a really strong religious faith become anxiety-provoking for many scienceminded, agnostic physicians,” she says.

In these kinds of circumstances, her Catholic, Jesuit medical training informs another approach.

“What we learned and appreciated as students at Georgetown is the importance of engaging families, respecting them, and hoping with them that there could be a miracle,” says Walter. “We don’t try to encourage them to think differently about their relationship with God. We engage our chaplaincy to work with families within their own faith systems, helping them identify the limits of their medical expectations while

humans have greater power than God does in these situations, we support them in their spiritual beliefs,” Walter says. “We also prepare them for the possibility that God can both continue to love them and support them and their child, but at the same time the child may not be healed.”

CARE ROOTED IN CURA PERSONALIS Walter credits her time in medical school at Georgetown with developing her ability to make sense of these difficult circumstances. The whole-patient approach informs her definition of what medicine includes—cura personalis means not only addressing traditional medical concerns but also the patients’ and families’ spiritual well-being. It also prompts health care providers to consider access to care and the social determinants of health.

“Statements from families describing a really strong religious faith become anxiety-provoking for many science-minded, agnostic physicians.”

—Jennifer Walter (M’07)

supporting them in their faithful beliefs and discussing with them where we think the limits of human intervention are.”

The limits are real, and Walter’s palliative care team works to build partnerships with families to help them remain grounded as they struggle to make loving decisions for their children.

“Instead of talking them out of hope for a miracle, or convincing them that

Georgetown’s emphasis on the Jesuit, Catholic commitment to social justice and caring for the poor is one that Walter continues to prioritize, even at a state-of-the art facility that offers cutting-edge care for the most complex medical conditions.

“While CHOP is a real quaternary care hospital, with an emphasis on treating children who require very complicated care, we also serve the

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surrounding area—a diverse community with many marginalized and vulnerable populations,” explains Walter. “I advocate for those patients in my own practice.

Thinking about ways in which being vulnerable in society impacts people’s access to health care, or how they engage in receiving health care, or how they are able to maintain children’s health and a family’s ability to provide complicated care to children who are sick—all of these sensitivities were raised at Georgetown.”

As Walter reflects back on her time in medical school, she appreciates that Georgetown offers the opportunity to learn about a variety of faith traditions and their influence on patient decisions.

In addition, she says, her work today is informed by the university’s focus on the human aspect of caring for people, as well as the ethics teachings. “We received a strong foundation at Georgetown, learning to think critically with our ethics education about how we identify the values of patients and then set them within the values of what’s considered ethically acceptable within the medical practice.”

This framework helps her guide families as they make these hard decisions.

“We’re often discussing with families in the most difficult situations what their values are, what role their religion or spirituality may play, and how they understand what’s most important to them,” she says.

Reconnecting wth Jesuit principles:

Finding Time to Listen I think that listening to our patients is something that we often want to do but aren’t sure how to do in a way that won’t take all of our time. We worry that if we ask open-ended questions, we might hear about information that we can’t act on, or we’re afraid we would be left talking to patients for hours.

But I think it’s our responsibility to make sure that what’s most important to families and patients is something that we’re aware of, especially if we’re caring for them in an ongoing way or as part of a serious illness.

The kinds of questions I often ask parents in these circumstances are: What are you hoping for? What are you worried about? What does it mean to be a good parent to your child at this point?

More often than not their answers are not long, but often their answers are surprising. Setting aside a few minutes to ask patients and families these questions may uncover a miscommunication that’s been ongoing where they don’t have information they need, or that they think they need, to really make the best decisions—or we learn of other elements in their lives that impact their ability to regain health. And while we may not be able to fix all of those things, we can at least address and acknowledge them.

The power of listening in those circumstances is incredibly healing.

— Jennifer Walter (M’07)

In some circumstances, putting a child in God’s hands means choosing not to pursue treatments that are more likely to cause harm than benefit to their child. With the support of the palliative care team, the parents can come to this difficult choice in good conscience.

“The family doesn’t feel they’ve had to

Walter credits her time in medical school at Georgetown with developing her ability to make sense of these difficult circumstances.

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betray their God, and they’ve made a loving decision for the child,” says Walter.

Recognizing the importance of living up to one’s religious beliefs, Walter sees that faith is often central to a family’s well-being. Caring for families using a broad approach that embraces spirituality builds successful partnerships, says Walter.

“It helps us support them in this horrible journey that they’re on.”

How do parents make it through?

Walter pauses.

“I don’t think any of these families think they can do it. But they have more coping skills and strengths than they realize.” n

The Neurosurgeon’s Prayer Meghan Murphy (M’11) Resident Neurological Surgeon, Mayo Clinic, Rochester, Minnesota

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owe to my grandparents, parents and siblings where I have been, where I am now and who I have become as a person of faith, a wife, a daughter, a friend and a physician.

I grew up going to public school but attending Catholic church and Sunday school weekly. For my parents, faith was an integral part of our family structure and their marriage, and set the foundation for our upbringing. Both sets of grandparents were strong in their faith, and service to God and others was a paramount part of life.

For my undergraduate education, I followed my sister to the University of Notre Dame. The incredible faith community led by the Holy Cross priests fostered my growing faith. After college, I was inspired to pursue medicine like my brother. I felt a calling to serve others through healing. Georgetown University School of Medicine matched my career goals—a strong academic tradition with the Jesuit ideals of service, humility and faith integrated into the practice of medicine.

As a medical student, I was able to attend Mass with some of my peers regularly in the medical school or in the hospital chapel. The Anatomical Donor Mass was an experience that stays with me. Today when I work in the cadaver lab as a resident, I say a prayer of gratitude for those who donate their bodies to

science and education—an incredible gift that serves so many others.

My faith played a role in choosing my specialty, as I sought guidance in where I was meant to go and which patients I was meant to serve. Through prayer, reflection and a lot of wisdom shared by family, friends and mentors, I chose neurosurgery. Now in my fifth year of residency at the Mayo Clinic in Rochester, Minnesota, I feel fortunate to be training with the highest caliber of surgeons, colleagues and support staff. I am grateful to the Franciscan tradition at Mayo Clinic, with the hospital at Saint Mary’s founded by the Sisters of St. Francis back in 1889. The patient-centered care embodied by the Mayo mission reflects how I want to practice medicine.

As my wise mother has always told me, you need faith in life. I feel that one needs faith as a physician to best serve patients and their families. The human body is an intricate and complex entity—the body’s physiology and anatomy play a role in healing, but the human spirit remains another variable that requires care. In the care of the whole person, both the pathophysiology and the spirit need to be addressed.

A foundation in faith can help connect physicians with patients in an essential way that supports healing.

I look to prayer before entering the

operating room—for difficult cases, for suffering patients, for strength in training. My path to Mayo through Notre Dame and Georgetown has fostered faith as an integral part of how I practice medicine. The Holy Cross and Jesuit traditions of service embody the purpose of physicians. I am thankful for my experiences, training and all the mentors who have given their time and energy to teach me.

Sometimes it is easy to be distracted by the challenges and demands of training. A faith tradition can help health care providers maintain much-needed composure, humility, strength and compassion. A prayer I keep in the pocket of my white coat is one that the Sisters have for hospital staff; it is a comfort and an inspiration.

O, Divine Healer, hear and receive our gratitude for our call to be a healing presence in the lives of those we serve. Bless each of us with your gift of healing for those we encounter and for ourselves as well. Amen. n

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Faith in the Lab

By Jane Varner Malhotra

Most of the research happening at Georgetown University on any given day is taking place at the Medical Center. With more than 400 scientists and 300 active clinical trials, GUMC is home to the university’s largest research enterprise. How does the Jesuit, Catholic tradition impact the pursuit of biomedical research on campus? Do religious values overly limit academic freedoms that

Š Nicolas Loran

researchers would have at other secular institutions?

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“I’ve had people ask me if the institution gets in the way of us doing things,” says Robert Clarke, dean for research at the Medical Center and professor of oncology at the Lombardi Comprehensive Cancer Center. “For me, it doesn’t.”

Clarke believes that people who choose to work at Georgetown accept that it may place some limitations on what they can do in their work, but that it’s not overly intrusive. For him, the benefits of the Jesuit approach far outweigh any perceived drawbacks.

“For example, we teach embryology in medical school but it’s taught from the biological and clinical perspective.

There’s no need to go beyond that to achieve the goals of the programs. But if someone wanted to come here to work on something that, say, required the creation of new cell lines from human embryos? Not gonna happen,” says Clarke matter-of-factly.

Adult stem cell research does take place at Georgetown, in the Department of Biochemistry and Molecular & Cellular Biology, in addition to groundbreaking stem-like cell research in the Center for Cell Reprogramming. Clarke notes that this kind of work—reprogramming normal cells to replace damaged tissues or organs in regenerative medicine, or even growing cells from an individual’s cancer to determine what the best treatment is —speaks to the doctrine rather than challenges it. Remarkable advances in personalized medicine have taken place at Georgetown as investigators have sought innovative alternatives to embryonic stem cell research.

So Clarke prefers the question, “How does the Jesuit environment allow you to do what you do better?”

“That’s the piece that you don’t get at other institutions,” explains Clarke. “How

Brother Diogo Escudero, who earned his Ph.D. in molecular cell biology at University of Miami, spent last summer on a research internship in Dr. Clarke’s lab.

does it increase the likelihood of a meaningful impact from your work?” The Jesuit ideals create an environment that supports intellectual inquiry, he says, and principles like cura personalis and “women and men for others” are not just nice slogans for the banners hanging around campus.

“At Georgetown, people here take these ideas seriously. It shows in the care we take of our students, our faculty and staff, our patients and the research that we do towards improving human health,” Clarke says.

“These values are framed in the context of the Jesuit tradition,” he adds, “But they are also entirely aligned with a humanistic view of the world. So even if you came in as an atheist or agnostic, or a person of a completely different faith, the Jesuit ideals are consistent with the core beliefs of many different human societies. And they’re not always explicit or encouraged at other institutions, but here at Georgetown they are.”

THE MORE WE KNOW… While many scientists avoid an outward expression of spirituality in the workplace, if you happen to also be a Franciscan Capuchin friar, there’s not much choice in

the matter. The long, brown hooded robe, tied at the waist with a white rope, offers a pretty big clue that you are part of a religious order.

For Brother Diogo Escudero, working in Clarke’s lab this summer has been a positive experience. Originally from Brazil, he now commutes by Metro each day from his residence at Catholic University to the lab in the Basic Science building at Georgetown’s Medical Center.

At first nervous about how people on campus and at work would react to his appearance in the traditional habit, so far he’s been pleasantly surprised.

“To be honest I was a little scared, walking in dressed like this, especially working in science,” Escudero explains.

“But people at Georgetown have been very friendly, asking me what I am—a priest, or a monk—and asking about things like evolution. I’ve had many conversations about faith and science.

It’s been a beautiful time here.”

He is working with Ayesha ShajahanHaq on a cancer study looking at exosomes. “These vesicles are secreted by cells in a lot of different scenarios, in both biologically normal scenarios and in cancer,” says Escudero. “We’re looking at

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differences between cancer cell lines for examples of what proteins are present in these vesicles. We hope to better understand their role in resistance to therapy and in the process the cancer’s spread—

and enjoys while he is working in the lab,” says Shajahan-Haq. “Also, I think we all behave a little better and hold back our tongues in his presence!” she adds with a smile.

Ayesha Shajahan-Haq and Brother Diogo Escudero discuss new findings in a breast cancer project.

the metastasis. There’s a lot of literature showing that cancer cells use this mechanism—shedding vesicles filled with proteins—to prepare the place that it wants to go. If we understand this process, we can understand cancer better.”

When Shajahan-Haq read his application for the internship, she was intrigued by Escudero’s excellent education, training, and publication record.

And his status as a Capuchin friar.

When he came for the interview, he was even more intriguing, she says.

“He has a calming, disarming demeanor—plus he is respectful, humble and funny. Not only is he an extremely hard worker, he is often the first to break the ice with others, and he never hesitates to poke a little fun at himself. I find Brother Diogo to be an ideal trainee. He listens, learns, questions, studies, participates, helps

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Escudero finds Georgetown a very accepting place, noting that people at the university are used to having members of religious communities working in the sciences. “Being a Jesuit school makes it easier, with scientists like Fr. Kevin FitzGerald here,” he says.

In the lab, Escudero says he finds great joy looking closely at God’s work.

“Scientists have such a beautiful call to make God’s greatness, his beauty, his wisdom known though the intricacy and the complexity of biology. It’s so beautiful how everything is connected.

The more we know, the less we know— which is kind of like faith.”

THE JESUIT AND THE CLONED SHEEP When two Scottish scientists cloned a sheep back in 1997, news reporters called Georgetown bioethics pioneer Dr. Edmund Pellegrino for his opinion

on the shocking breakthrough. He referred them to Fr. Kevin FitzGerald, S.J., who had just completed his Ph.D.s in bioethics and molecular genetics at Georgetown.

“The next morning I’m quoted on the front page of The New York Times, and I spend the following two weeks running around doing TV and radio interviews because suddenly I was an expert in cloning. That’s because nobody was an expert in cloning!” FitzGerald laughs.

He quickly learned a lot of cell biology and became enmeshed in the exploding field of bioethics.

Today at Georgetown FitzGerald is the Dr. David Lauler Chair of Catholic Health Care Ethics in the Pellegrino Center for Clinical Bioethics, and an associate professor in the Department of Oncology. Pope Francis appointed him to the Pontifical Council for Culture in 2014, and in 2015 he began a consulting appointment for the Catholic Healthcare Association on cutting edge ethics matters.

With all the late 90s hype around cloning, it was nearly 20 years before science really developed the technology to do what was promised, says FitzGerald. Today, he believes, we are on another threshold with genetic engineering. To explain the challenge, he takes us on a Jesuit visualization: Imagine a situation where the parents come in to the doctor’s office. They say “We’re pregnant for the first time! Yay!” Doctor says, “We’re going to test your developing child, at the fetal stage. And of course we don’t have to do amniocentesis or chorionic villi sampling anymore. No, no, no. We just take some of your blood, Mom, from your bloodstream because the child’s genetic material circulates in your bloodstream now and long after the baby is delivered.”

So we take that out and we test 20,000 plus genes and a lot of other regulatory areas

in the entire genome of that developing child. And we’re guaranteed to find at least 10 or 12 recognizable deleterious mutations.

So no child is perfect. Which imperfections do you want? And while you’re at it, what things would you like? What would you like to have us change?

Things can be changed?!

FitzGerald pauses. “We’re getting to the point where that may be possible,” he explains.

Nothing is 100% certain though, and there may be some risk. Even though we

will do all this genetic stuff, your child still won’t be perfect. It still won’t come out exactly the way you had planned it.

Because there’s this whole other level called epigenetics that regulates the genetics….

We are at a new frontier, says FitzGerald, and with affordable, fast whole genome sequencing, people will have a lot of information and options.

And so he asks, “To what end?”

“This is why the moral landscape is fractured—we have a lot of different ends out there. A lot of different people

Embrace the Suffering in Mercy In May, Brother Diogo Escudero spoke with a group of breast cancer survivors, the Georgetown Breast Cancer Advocates, to share his views on faith and science.

He told of his personal journey with God, including a call to the priesthood in his teens that he ignored, years of study, partying, and meaningless relationships while in graduate school, and an eventual calling to grow closer to God, which led him to join the Franciscans. He described it as a profound conversion experience that took place over a few months, a fire lit by a spark from a small book about living a simple faith by St Therese Lisieux, “The Little Flower.”

Escudero recalls a question from one of the participants about how to respond to weary cancer patients who want nothing to do with medicine, saying God will heal.

“When patients go to the doctor and keep hearing bad news, it’s normal for people to behave that way,” says Escudero. “Death is such an unknown in our lives.

It’s something we can’t escape. But for people in those situations with fear, medicine is there, and cancer is not the death sentence that it used to be.” He advised the advocates to embrace these patients with mercy, accepting the gift of God’s grace to be in a situation where they can touch people’s lives when they are most vulnerable, when disease like cancer causes such deep fear. He suggested they gently explain that God needs everyone to take care of themselves using all means available—including medicine.

And when in doubt, he says, turn to Scripture.

“God can certainly work miracles, and on occasions He does. But often He desires us to experience His healing and love through one another. The Old Testament—The Book of Sirach, Chapter 38 —says that God has given doctors wisdom, so use doctors when needed. God has given them the gift of knowledge and most importantly the compassion to see and treat a suffering person. The Gospels talk about our duty to care for every little person who is suffering. When you are taking care of that person, you are taking care of the suffering Christ.” n

Fr. Kevin FitzGerald, S.J.

with different ideas of what is good and bad for their developing child.”

To determine one’s worldview and where it is grounded, he suggests that faith offers answers. “Faith in the Catholic tradition is grounded in the acknowledgement of a relationship between ourselves and God, our creator, or whatever you call the ultimate, the infinite. In all the Abrahamic traditions, God calls us to engage on a personal level. This gives us a framework, beyond anything we can come up with on our own.”

FitzGerald sees religion and science as two essential lenses for viewing the important issues of our time. He anticipates growing questions about exploding bioethics topics such as synthetic biology, where scientists use living organisms to make products like spider silk from goat’s milk. Or the latest in neurotechnology, with new micro-implants and apps that assess and control brain function.

So how does a bioethicist sleep at night (besides counting cloned sheep)?

“Exhaustion!” laughs FitzGerald.

“Honestly, part of me enjoys waking up during the night, with my mind racing, and putting all these ideas together.” n

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A Thread of Hope

By Elissa Ernst

Step outside on the podium level of Georgetown Lombardi Comprehensive Cancer Center and you will see nurses, physicians, staff members and patients seated at round picnic-style tables, enjoying lunch, coffee, conversation, or an escape from the day. Just beyond, your attention is drawn to strings of brightly colored, rectangular fabric pieces fluttering in the breeze. Hanging between large pillars, the strands mark the perimeter of a labyrinth painted on the concrete floor, where the mother of a cancer patient quietly walks the winding path.

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he fabric squares overhead are adorned with simple inscriptions such as “love is the answer” or “never give up.” Some feature Bible verses, Buddhist mandalas, simple drawings or words of peace, hope and health. The prayer flags were installed this year by artist Lauren Kingsland through the Lombardi Arts and Humanities Program.

As a teenager, Kingsland was unable to engage in the type of activities that most young people enjoy. Seriously injured in an accident at 14, she spent time during her long recovery tending to her creative interests instead. Through the experience, she gained personal insight into the connection between the artistic process and healing. Art-making helped her get through a difficult period and put her on a future trajectory of helping others struggling to heal.

Now a professional artist with a master’s degree in applied healing arts, Kingsland is intimately involved with the cancer center’s arts program—an initiative launched in 1992 to introduce the arts as a tool for coping through self-expression. Kingsland spends two days a week at the cancer center engaging patients, family members and staff in art therapy in order to reduce stress and offer an alternative method of care and healing. She serves as a listening presence for those in the midst of challenging times.

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“My personal mission is to use fiber art as a tool for making something of beauty, for connecting deeply with our spiritual selves, and for fostering a community of wellness.” — Lauren Kingsland

On previous page: Kingsland and the mother of a cancer patient walk the labyrinth under the strands of prayer flags: “There are quotes, pictures, long prayers, short prayers, most in English and some in Korean, Nepalese, Spanish, and Arabic. Some are religious, most are not. All are heartfelt,” says the artist. Above: Kingsland helps a Lombardi patient’s family member begin her design.

“The prayer flag project for the labyrinth springs directly from the core ideas that get me up every day and give my life meaning,” says Kingsland. “My personal mission is to use fiber art as a tool for making something of beauty, for connecting deeply with our spiritual selves, and for fostering a community of wellness. What could be better than this project?”

Inscribing prayers on strands of cloth is an ancient practice that began in Nepal

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over 2000 years ago.

Adopted from Tibetan Buddhists, these flags have grown from their original purpose and religious association and are now embraced by various religions and organizations throughout the world, says Kingsland.

She explains that within the Tibetan Buddhist religion, the flags are sacred objects with prayers block-printed onto colorful pieces of silk that are hung

throughout the mountainside. As the flags age and begin disintegrating, the belief is that the wind will scatter the pieces throughout the land, and any area touched by them will become the recipient of the prayers inscribed upon them. While the Georgetown flags may not hang in a space as scenic as the Tibetan landscape, the roof of the hospital emergency room forming the connection between Lombardi and the School of Medicine is a location with meaning—and foot traffic.

Although the Georgetown project is non-denominational, it draws from the traditional Buddhist aim to benefit those who come in contact with the flags—both those who create the flags and those who view them.

Each patient, family member or staff person who chooses to participate in the project is given a colorful fabric square, markers, and the freedom to embellish it with a prayer, a drawing or anything of personal importance, says Kingsland. People have created over 150 flags so far, and the number continues to grow. The flags are approachable and meaningful to many.

“Articulating the desire for health, the desire for peace and making the prayer is important, and this is a non-sectarian way to do that while also being authentic.

Because it’s tangible, those participating have deliberately chosen to express whatever they write on the flag, either for themselves, for others, or for the world at large,” says Kingsland.

Several unexpected benefits have emerged from the project, she adds.

Creating a flag together offers an opportunity for a patient and their

Georgetown researcher James Baranuik (see page 39) and his Gulf War Illness study subject enjoy the fresh breeze and colorful inspiration under the prayer flags.

family members to jointly express their hope for healing. A mother of a gravely ill patient seized the occasion to not only make a flag with Kingsland but to also discuss the emotional toll the illness has taken. Perhaps most surprisingly for Kingsland, creating prayer flags has provided an outlet for those who have made it their profession to care for the ill—chief among them, nurses.

“I have seen a lot of nurses offer really heartfelt prayer for the health of their patients. Part of their training suggests that they create a little bit of

distance between themselves and their patients for protection and self-preservation, so this has been a way to allow them that emotional connection with patients and to have some expression of it, in a safe and controlled way,” says Kingsland.

Ultimately, Kingsland views these flags as a vehicle for personal engagement and engagement with the creative self.

“Everyone’s interpretation of the request to create a flag offers a snapshot that captures the person in that moment and time,” she says. “Making the flag doesn’t necessarily change anything about the illness or the set of

circumstances, but it does help people change how they think about the illness, and how they process it.” n Elissa Ernst is the director of development for Georgetown Lombardi Comprehensive Cancer Center. She can be reached at es349@georgetown.edu.

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ON CAMPUS

White Coat Ceremony 2015 N

early 200 members of the School of Medicine Class of 2019, representing seven countries, 26 states and the District of Columbia, received their white coats at the August ceremony, an annual tradition celebrating the start of the students’ careers in medicine.

With the Gaston Hall stage under construction, this year’s White Coat Ceremony took place outdoors, on the breezy podium behind the Med-Dent building.

The white coat symbolizes a doctor’s promise to heal and care for every patient, carrying out the Hippocratic Oath, which students say together at the conclusion of the ceremony.

“Reciting the Hippocratic Oath as a class, led by Dr. Knowlan, was a very powerful experience which I often reflect upon during difficult situations,” said Jenny Van Kirk (M’14), now an internal

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medicine resident at Duke who returned to Georgetown to coat her brother Patrick. “To this day, I keep a copy of the Hippocratic Oath in my own white coat pocket as a reminder of both the responsibility and privilege of the profession.”

“Today, one week after the feast of St. Ignatius, you join Georgetown’s community of scholars, healers and teachers dedicated to the Jesuit principle of cura personalis in which we commit to the formation of the whole person— mind, body and spirit,” said Stephen Ray Mitchell, dean of medical education, during his opening remarks.

Stephanie Woo (M’19) was inspired to study medicine at Georgetown after seeing this principle in action when her sister Jennifer (M’15) faced a medical emergency in 2013. “The greatest thing about Georgetown has been their support of Jenn throughout her diagnosis and treatment, which I thought was a living example of cura personalis,” she said.

“I am thrilled to be returning to Georgetown to coat my little sister Stephanie,” said Jennifer Woo, now a

preliminary medicine resident entering the radiation oncology program at Stanford. “She has been my number one support, not only during med school but also during my own journey through cancer treatment. My sister is an incredibly compassionate and loyal individual and I hope she will make Georgetown proud!”

While the class of 2019 will have a very different medical school experience

than he did, Donald Knowlan, emeritus professor of medicine, said that he expects it will be even more rewarding than his own. He encouraged students to be patient with themselves and always focus on putting their patients first. “In this new era of precision medicine, future physicians will need to be strong patient advocates and patient protectors,” he said. “Remember the patient, who needs you more now than ever.” n

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Finding Space to Practice Faith

By Daliha Aqbal (M’17)

I

STUDENT VOICE Our student columnist Daliha Aqbal (NHS’08, MS’12, M’17) is enjoying her third year of medical school, and looks forward to her next rotation in surgery. Above, Aqbal takes a quiet moment in the School of Medicine’s 24-hour dedicated Muslim prayer space, located in the Pre-Clinical Science Building.

Opened in May with a celebration and official blessing by Georgetown’s Muslim chaplain Imam Yahya Hendi, the new prayer room offers Medical Center students, faculty and staff a private place for prayer on campus.

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use my strong faith in God to help me stay focused in medical school. With so much uncertainty in medicine, my faith also helps me trust my decisions. For example, with respect to patient care, sometimes we may not have all the answers to ensure a patient’s health, but when I turn to my faith, I am reminded that ultimately there is a higher power that knows what’s best for the patient and for me. God has given me the power to heal and trusts me with it.

Georgetown is diverse, with many faith traditions represented by our student body, including students who practice atheism and agnosticism. I feel that no matter what beliefs you hold, everyone here at Georgetown feels a part of the community. For example, the chapel area in Med-Dent is a place for everyone no matter what faith you practice. As a Muslim, I have spent many moments performing my prayers

in a sacred space adjoining the main chapel, and talking with Father Sal. The chapel is a welcoming place of worship, love and peace for all.

Ever since my time as an undergradute, I have felt that Georgetown’s Jesuit identity provides a sense of community, respect and valuable interfaith dialogue. Despite the political scene sometimes portrayed in the media, being at Georgetown only instills positivity, growth, and understanding. We have interfaith prayers with our Jewish and Christian friends, and others of differing faiths.

Everyone is welcome at Georgetown and that’s what makes this place unique and special.

Seeing sick patients has helped me appreciate the preciousness of good health. One patient I had was recently married, had two children, and had just been diagnosed with stage 4 cancer. I really felt her pain that day. Every time

I feel that no matter what beliefs you hold, everyone here at Georgetown feels a part of the community.

she looked at her children who were in the exam room with her, tears rolled down her cheeks. I could see the fear and determination in her eyes—she wanted so badly to fight this disease in order to be with her children. The doctor and I comforted her as much as possible, knowing the severity of her cancer and the possible poor outcome.

I prayed for her and her family. The experience reinforced my faith, because I realized at that moment that life is so short and precious. This woman knew that and she wanted to live every moment she could with her family.

We have a finite amount of time to live on this beautiful Earth so we must try our hardest to be the best human

beings possible. Death is inevitable, but we have some sense of control over our lives. For whatever is out of our control, we must have faith that there is a higher presence taking charge and knowing what is best. That is now what I think about life’s true meaning. n

In the Med-Dent chapel, Daliha Aqbal speaks with Medical Center chaplain Fr. Sal Jordan, S.J. about her recent rotation in psychiatry.

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Reaching for the Stars with Dr. Rebecca Blue (M’08)

By Kate Corboy

r. Rebecca Blue’s journey to Georgetown began much earlier than most. By the age of seven, Blue knew she wanted to work for a space program and decided medicine was how she was going to get there. At eleven, she won a scholarship to attend space camp in Kansas, making her one of the youngest campers to ever attend. This experience solidified her interests in aerospace medicine and fueled her desire to learn as much as she could about space. She read book after book, worked odd jobs for two years and finally by age 14 had saved enough money to attend an advanced space camp at Johnson Space Center.

After earning her undergraduate degree in biology from Truman State University in Missouri, Blue began looking at medical schools, focusing on the East Coast, where she believed the best were concentrated. During her visit to Georgetown School of Medicine, she recalls very clearly the moment in the fishbowl that sold it for her.

“It was the speech on cura personalis that each prospective student hears,” she explains. “In that moment I began thinking to myself, ‘What kind of doctor do I want to be?’ I knew I loved science and could handle the academics, but what I really wanted was to learn more about treating the whole person, not just the disease.”

The school’s unique mission and guiding principle made Georgetown her top choice.

Like Blue’s path to Georgetown, her time as a student was just as unique. In her first and second years, she took classes on international culture and became interested in how medicine is practiced in other countries, and what are the expectations for care in different cultures. Curious about the role that physicians play to accommodate these

D

Left: Rebecca Blue takes a spin in a parabolic flight on a “ZeroG” aircraft. Above: The doctor stands in front of a crawler—the transport device from the shuttle to the launch pad.

differences in patient care, Blue applied for and received a Fulbright scholarship to study at the University College of Dublin in Ireland. The program required her to take a year off from medical school between her second and third years.

“Georgetown embraced my decision to go to Ireland,” she says. “Dr. Mitchell and other deans helped me organize a leave of absence and made sure that I had all the resources I needed to be successful.”

Through the Fulbright program, Blue was able to design her own study plan, focusing on international health

policy and the differences between countries. “At the time, there was a lot of activity in the health policy arena.

Ireland had opened its borders as a member of the European Union, and as a result was forced to develop its human protection and health laws specifically for children and immigrants,” she explains. Blue ultimately received her Higher Diploma in Social Policy before returning to Georgetown to finish her medical degree.

Through all of these experiences, her focus and commitment to becoming a flight surgeon had not wavered.

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focusing on triage coordination and emergency response planning, as well as some customer service with future passengers.

“My favorite part of my job is the number of incredible opportunities that have been given to me—even the training I have received,” says Blue.

“I’ve been put into spacesuits, space capsules, centrifuges and simulators.

I’ve undergone various water, winter and heat survival courses, and had parachute and flight training! Not to mention being sent all over the world for support and operational events.

In this line of work, we often catch ourselves saying, ‘I can’t believe they let us do this!’”

At this point in her career, Blue credits a great deal of her success to her experiences at Georgetown.

“Everyone at the School of Medicine was so accepting of the nontraditional way.

The faculty at Georgetown recognized and encouraged those differences and in my case, really

helped me to explore opportunities that I wouldn’t have been able to otherwise.”

In many ways, Blue’s Georgetown experience influences the way she conducts herself in her current roles.

“The education I received at Georgetown has helped me evaluate the kind of educator I want to be. I consciously try to recognize and embrace the differences in those I work with. The level of care and consideration you experience and learn at Georgetown is a rare thing, and it’s ultimately what sets Georgetowneducated physicians apart.” n

“In this line of work, we often catch ourselves saying, ‘I can’t believe they let us do this!’”

— Rebecca Blue (M’08)

Photos courtesy Rebecca Blue

Knowing that most successful flight surgeons were trained in one other field of medicine, she pursued a residency in emergency medicine. Blue matched at Orlando Regional Medical Center, which happened to be the primary response center for any space shuttle launch- or landing-related emergency at Kennedy Space Center in Cape Canaveral, Fla. In February of her first year of residency, she attended a training program at Kennedy Space Center for emergency responders for space flight.

Determined to find a way back to Kennedy, after much perseverance she secured herself a position on the Launch & Landing Medical Support Team.

In this role, Blue was present for the last nine shuttle launches there.

Blue went on to complete her residency in aerospace medicine at the University of Texas Medical Branch (UTMB), followed by two years at Johnson Space Center in Houston, Texas. There she helped provide medical support to the six astronauts living on the International Space Station (ISS) year round. Her team conducted routine medical conferences with the ISS astronauts to address potential concerns. Fire, toxic environment and decompression pose the biggest threats to an astronaut’s safety while in space, says Blue.

Presently, Blue wears a number of hats on a day-to-day basis. “I work as an emergency physician at Upstate Medical University in Syracuse, and I’m associated with the Preventative Medicine & Community Health Division at UTMB,” she says. “I mentor current residents in the UTMB aerospace program and serve as a research lead for aerospace medicine. And I’m a flight surgeon for Virgin Galactic, the first commercial spaceline.”

Blue’s work for Virgin Galactic includes helping improve vehicle safety,

Small Grants, Big Impact

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esearchers are familiar with the old scientific mantra “publish or perish,” but it leaves out a critical early step. Securing grant funding for research is imperative for early-career scientists to perform their own independent research. This funding allows them to think creatively and explore widely, working towards breakthrough discoveries that get published in prestigious journals and help them earn university tenure.

However, obtaining grants to produce research and publish results presents a real Catch-22.

“If you want to test novel ideas for the first time, you have to have research funding. Without a history of publications to rely on, it’s hard to obtain grants,” says Charbel Moussa, assistant professor in the department of neurology.

What makes the difference for many investigators? Small grants from philanthropic organizations, foundations and

the government, says Moussa.

“I have had a lot of small grants, many through Georgetown, and I can tell you they have been instrumental to my research,” says Moussa, who studies Alzheimer’s and Lou Gehrig’s diseases, and will be up for tenure in 2016.

He received the first Music for the Mind Award ($25,000) in 2011. That award, along with another $25,000 donation from a member of the Georgetown Board of Regents, helped Moussa repurpose an existing drug to treat dementia and Parkinson’s disease, leading to a $1.3 million Merck & Co. research grant, as well as support from the Alzheimer’s Association, Michael J. Fox Foundation and Cure Foundation.

He has since published more than 25 studies on a variety of neurodegenerative diseases.

“Philanthropy supported my research from bench to bedside,” Moussa says.

“Small grants are so critical to the

development of bigger grants. That is true at all career levels but is especially important early on.”

LATE NIGHTS IN THE LAB Georgetown neuroscientist Mark Burns says he owes his newly granted tenure to small grants he received early in his career.

In 2005 he received a $20,000 pilot award followed by a $16,000 foundation grant in 2006. These two Medical Center grants gave him unrestricted time to use a small animal MRI research tool at night—usually for seven hours at a stretch—to study if statins could affect cerebral blood flow as a way to treat Alzheimer’s disease.

The next year, a $25,000 pilot grant followed by a $10,000 award from a

Above: Neurology researcher Charlie Moussa speaks with School of Medicine alumni during a Reunion Weekend lab tour.

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philanthropic organization supported his study of the relationship between brain trauma and dementia, the results of which Burns published in Nature Medicine in 2009. He received a tenuretrack position and a Medical Center grant for $50,000 in 2009, which allowed him to finally establish an independent lab. Those seed grants helped generate

Ph.D., and a three-year postdoctoral fellowship. Afterwards, researchers spend three to five years as untenured research track faculty, working in a senior researcher’s lab while trying to establish their own line of investigation.

The next rung on the ladder is to be granted a tenure-eligible assistant professorship, which starts a seven-year

Neuroscientist Mark Burns discusses his findings at a Georgetown Partners in Research event.

“You can do a lot of research with $25,000.

And Georgetown understands that philanthropy strongly benefits emerging research and researchers.” — Mark Burns the critical preliminary data for a $2 million federal grant that Burns was awarded in 2013.

POST-DOCS AND JUNIOR FACULTY DO A LOT WITH A LITTLE Achieving a tenured position is an arduous journey. A researcher’s education takes at least 12 years—a four-year undergraduate degree, five years for a

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clock for earning a permanent university position. If tenure is not awarded during that time, the researcher must leave the tenure track.

“While we are doing our Ph.D. and postdoc work, and even as junior faculty, we are working in someone else’s lab, so our work is considered the property of the lab leader. We help drive the research and our names are on the

studies, but it is considered our mentor’s work,” Burns says.

In February, Burns told the Georgetown University Board of Regents that small grants awarded to junior faculty are “where you really get a bang for your buck. We are so desperate to establish our own independence that any money makes a big difference.

“You can do a lot of research with $25,000,” Burns says. “And Georgetown understands that philanthropy strongly benefits emerging research and researchers.” Among the grants Georgetown sponsors are Music for the Mind, Partners in Research, Dean’s Award and GU/MedStar partnership awards.

Burns’ recent research on the development of dementia in boxing professionals has so far only received $15,000 in funding from a single donor. However, those funds have led to intriguing findings that Burns is submitting for a large federal grant.

“Even established researchers like the small philanthropic grants,” he says with a grin.

THE EMERGING RESEARCHER’S LIFEBLOOD As an assistant professor in the Breast Cancer Program, Rebecca Riggins has parlayed smaller federal and foundational grants into bigger outside grants. While studying the mechanisms that foster resistance to cancer treatment drugs such as tamoxifen, Riggins’ first bid for a Breast Cancer Research Program Concept Award was a big test of her ideas. The competitive program, run by the Defense Department, reviews grant applications in a manner that obscures the researchers’ names, institutions and other identifying details to create a level playing field.

She won the $75,000 grant and those funds, as well as a $20,000 American

Cancer Society grant, led to a $400,000 Susan G. Komen for the Cure Career Catalyst Research Grant.

This was not the last time that small grants led Riggins to larger awards. A $15,000 grant from the USDA/District of Columbia Agricultural Extension Service led to a $150,000 National Institutes of Health (NIH) grant. After that, a $35,000 Georgetown Partners in Research award advanced her research further, setting her up for a $340,000 NIH grant. She was particularly thrilled to receive the Partners grant because it led her to look into a new area of research—glioblastoma.

Applying for the grants was not easy, Riggins says. Before she could start answering her research question,

Cancer researcher Rebecca Riggins welcomes members of the Georgetown Partners in Research program for a talk and tour in her lab.

she needed to generate the preliminary data to show the importance of her ideas and work through the

Alumni Plant the Seed

Grant Supports Gulf War Illness Research at Georgetown Georgetown alumni Jeanne (L’79) and Peter (C’67, L’70) Sullivan established the Sergeant Sullivan Center (SSC) almost five years ago in honor of their son Tom, a Marine Corps sergeant. While serving in Iraq in 2004-05, he developed early signs of what became a complex multi-symptom illness that military doctors struggled to diagnose. Tom died of complications from the illness in 2009.

The SSC funds research and advocates for improvements in the diagnosis, treatment and prevention of complex, deployment-related illnesses from toxic exposures. Last year the organization offered a $10,000 matching grant to support the work of Georgetown researcher James Baraniuk. His groundbreaking 2013 study found physical abnormalities in the brains of veterans exhibiting Gulf War Illness symptoms such as chronic fatigue and pain; he is now researching possible biomarkers for the illness.

“The Baraniuk study was a major step toward understanding the physiology of Gulf War Illness,” says SSC President Jeanne Sullivan. “We are pleased to support Dr. Baraniuk’s effort to identify biomarkers that will facilitate diagnosis and treatment. We also hope what is learned in this and related research will aid the veterans of our most recent wars in Iraq and Afghanistan who are suffering from unexplained physical ailments similar in some ways to those that Gulf War veterans face.” n

administrative detail all grants require, including budgets and regulatory forms.

Moreover, Riggins needed to make a “conceptual shift” as she moved from pilot studies to larger grants that will keep her laboratory running long-term.

“Pilot funding is great for projects with a defined question or a small set of questions that are relatively straightforward to ask,” she says. “Larger, multi-year awards are needed to support a research program exploring several directions at once.”

Riggins is happy to be where she is, especially after seeing several of her peers at the University of Virginia either opt out of academia from the beginning, or try unsuccessfully to obtain a tenure track position.

“It was a time of crashing and burning. In 2003, when we graduated, the federal budget started to fall, and many of our own mentors had a hard time getting and keeping funding,” she says. “It is a tough place to be, especially at the beginning, when you need lifeblood for your research. There are no guarantees and everyone is after the same pots of money, even the small awards. I count myself fortunate.” n

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Class Notes

1950s Joseph A. Feudi (M’54, R’56) passed away at his home in Loveladies, N.J., on Sept. 3, survived by his wife of 58 years, Margaret, and his five children and their families. Dr. Feudi practiced at Englewood Hospital and Medical Center for over 40 years. He enjoyed photography, beaching, attending the opera and boating with his children.

He was 89 years old.

Patrick Joseph Hennelly Jr. (M’54) passed away on July 5 at his home at the age of 89. His long career in medicine included work for the U.S. Public Health Service until his retirement in 1973, when he entered private practice in Norfolk, Va. Spirituality played an integral role in his life. He distributed communion to patients in hospitals and nursing homes.

He and his wife Ann recently celebrated their 61st wedding anniversary.

1960s Christopher Beatty (C’63, M’67) writes, “After 39 years of practice as a general surgeon in Port Jefferson, N.Y., I retired in June 2014. It’s been great fun.

Now, Lindsay and I have time to spend with our children, grandchildren and friends. Hope to see all my classmates from M’67 at our 50th reunion in 2017!”

Joseph A. Fortuna (C’65, M’69), father of Mary Fortuna Kuser (C’89), Joseph Fortuna Jr. (C’91) and Kevin Fortuna (C’93), died from complications of cancer in June in New Orleans, La. He was 71. Dr. Fortuna was a pioneer in the field of emergency medicine, a staunch advocate for healthcare in underserved populations, and an

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authority on the application of process management and quality control in medicine. He is survived by his wife Grace and his first wife, Mary (Runkle) Fortuna of Bethesda, Md. as well as five children and nine grandchildren.

Tomas A. O’Boyle (M’60, R’62) passed away on Aug. 22 surrounded by his family at his home in North Carolina.

Dr. O’Boyle specialized in pediatrics and worked in private practice in Scranton, Pa. for over 40 years. He is survived by his wife of nearly 50 years, Gretchen O’Boyle.

George I. Salerno (M’61) passed away on Nov. 3, 2013, writes his wife Ellen of Ft. Lauderdale, Fla. “George was involved with his class and we made several wonderful trips back to Georgetown for his reunions. For years during the ACP Conventions, we always took part in the Georgetown receptions,” she adds.

1970s Ellen C. McCormick (NHS’72, M’78) passed away in May after a short battle with cancer. Dr. McCormick practiced general surgery in Bay Shore, N.Y., for 30 years before retiring in 2012.

Clifton Titcomb (C’74, M’78), vice president and chief medical director of Hannover Life Reassurance Company of America, is currently serving as the 2014-5 president of the American Academy of Insurance Medicine.

1980s Robert A. Gregg (G’80) was appointed senior vice president of clinical and regulatory affairs at Rapid Pathogen Screening Diagnosis,

a developer, manufacturer and marketer of rapid point-of-care (POC) diagnostic tests.

Jon Morris (M’83) was recently honored as the 2015 recipient of the Edward C. Bradley, S.J., M.D. ’51 Medical Alumni Award by Saint Joseph’s University Alumni Medical Chapter.

Active in surgical practice and regularly published, Dr. Morris has dedicated his career to medical education. He is the vice chair for education and program director for general surgery at the Hospital of the University of Pennsylvania. At the University of Pennsylvania’s Perelman School of Medicine, he is the associate dean for student affairs and the inaugural Ernest F. Rosato-William Maul Measey Professor in Surgical Education.

1990s Deanna Attai (M’90) writes, “After nearly 20 years in private practice, I am currently an assistant clinical professor of surgery at the David Geffen School of Medicine at UCLA. I am also now serving as president of the American Society of Breast Surgeons.”

Tanya Hagen (MS’94, M’98) passed away in June. A native of Coronado, Calif., Dr. Hagen became a renowned physician and pioneer in the field of sports medicine in Pittsburgh, Pa.

For more class notes and to submit news of your own, visit alumni.georgetown.edu.

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REAR VIEW

AS SEEN FROM THE BACK ROW The second half of the W. Proctor Harvey Clinical Teaching Amphitheater gets finishing touches before the dedication ceremony, which takes place during the 2015 Medical Reunion Weekend in October.