Jefferson Medical College - Alumni Bulletin Spring 2014

ALUMNI BULLETIN

J E FFE RS O N M E D I C A L CO LLEG E • TH OM A S J E FFE RS O N U N I V E RS IT Y • S PRIN G 2014

President Klasko Launches Plan for ‘One Jefferson’

Jeff at the Beach Join JMC alumni for a reception and buffet supper down at the shore!

Saturday, August 2, 2014 5:30 to 8:30 p.m.

Women’s Civic Club of Stone Harbor 96th Street and the Beach, Stone Harbor, NJ 08247 Special Guest Speaker: Robert H. Rosenwasser, MD Jewell L. Osterholm, MD, Professor and Chair Department of Neurological Surgery $25 per person RSVP by July 25 by calling 215-955-7750 or register online at Connect.Jefferson.edu/JeffattheBeach For more information, please call the phone number above or email alumni.support@jefferson.edu

Contents FEATURES 6 President Klasko Launches Plan for 'One Jefferson' 8 Superbugs Dodge Superdrugs as Antibiotic Resistance Spreads 14 A Change of Heart 16 Students Go "Beyond Our Walls" to Provide Service to the Community 18 Heads Up: Jefferson Focuses on Concussion

DEPARTMENTS 2 DEAN’S COLUMN 4 FINDINGS

Novel Agent Set for Unique Clinical Test in Inflammatory Breast Cancer

20 FACULTY PROFILE

Gerald R. Williams, Jr., MD: Shouldering Responsibility for Patients' Joints

22 SPOTLIGHT 23 DEVELOPMENT NEWS 25 CLASS NOTES 26 ALUMNI ASSOCIATION PRESIDENT’S MESSAGE 28 ALUMNUS PROFILE

10 Questions with . . . Steven A. Katz, MD ’84

30 IN MEMORIAM 33 BY THE NUMBERS

Jefferson Alumni Bulletin Spring 2014 Volume 63, Number 2 Senior Vice President and Chief Development and Alumni Relations Officer: Elizabeth Dale, EdD Editor: Gail Luciani Associate Editor:

Karen L. Brooks

Design: Jefferson Creative Services Bulletin Committee William V. Harrer, MD ’62 Chair James Harrop, MD ’95 Cynthia Hill, MD ’87 Larry Kim, MD ’91 Phillip J. Marone, MD ’57, MS ’07 Joseph Sokolowski, MD ’62

Quarterly magazine published continuously since 1922.

Address correspondence to: Editor, Alumni Bulletin Jefferson Medical College of Thomas Jefferson University 125 S. 9th Street, Suite 700 Philadelphia, PA 19107-4216 215-955-7920 Fax: 215-503-5084 Connect.Jefferson.edu Alumni Relations: 215-955-7750 The Jefferson community and supporters are welcome to receive the Alumni Bulletin on a regular basis; please contact the address above. Postmaster: send address changes to the address above.

ISSN-0021-5821 Cover photo by Jim Graham.

CS 14-1333

Copyright© Thomas Jefferson University.

All Rights Reserved.

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The Dean’s Column These are days of change, ever accelerating, and at times, almost relentless. We are called upon to accept change, but more than that, to actually seek it out. Invoking peripheral vision, we are expected to see things coming at us sideways and act proactively, even before they have come into full view. Perhaps standard fare in the rough and tumble of the business world, this embrace and anticipation of change has now barged into our realm of the medical academy.

The clarion call of ‘One Jefferson’ invites such change. Under the leadership of a new president, our university is being reunited with its flagship hospital, creating significant opportunities for greater alignment of hospital and physician practice operations. The organizational change is also reaching into the academic domain, with substantial restructuring of our education and research structures, informed by a university-wide perspective. All of this internal change will now position us to deal effectively with the substantial external change swirling about us.

In times of change, it is imperative to look for anchors. Our hospital and university communities have come together to articulate a set of common core values that can underpin mission, vision and strategic action: iSCORE — Innovation, Service Excellence, Collaboration, Ownership, Respect and Entrepreneurship. The power of this value set stems from the very process that led to it — broad input from diverse grassroots Jefferson constituencies.

Yet, this value set need not be limiting. Each of us can, and should, bring additional anchors to the fore.

At a recent One Jefferson management meeting, I offered two additional ‘guideposts’ that might frame our thinking about Jefferson’s path forward — stewardship and nobility — guideposts that can keep us grounded amidst all the change and underpin the iSCORE values themselves.

Stewardship has been characterized in different ways over the years. The nuances are informative. The basic definition for stewardship is the careful

management of something entrusted to one’s care. That which the steward is responsible for overseeing and protecting must be something worthy of caring and preservation. Some emphasize that stewards, neither owners nor users of the valuables themselves, are tasked with preserving them for others, now and in the future, without expectation of any reward. Native Americans took the concept one step further. In thinking about stewardship of the land, they viewed it as a sacred element whose upkeep is the responsibility of humanity. Thus, at its higher levels, stewardship captures a sense of selflessness and responsibility.

But beyond these dictionary-derived definitions, I would suggest that stewardship captures yet something more — an appreciation for historical significance, a realization that there is value in our inheritance, a humility that concedes that we have something to learn from those who preceded us. We must pay close attention to our histories — personal ones and those of our institutions. The positives must be embraced and trumpeted, with lessons to be learned from the negatives.

Our university archivist, Michael Angelo, has been a protector and cataloguer of Jefferson’s remarkable history, reminding us of what we must steward. Our medical college graduates, and those who taught them while here at Jefferson, constitute a truly magnificent grouping of thought leaders spanning our almost 200-year history. In too often focusing on a few — Gibbon, the pioneer of the heart-lung machine, the most frequent off the lips — we tend to forget that our legacy goes far, far deeper.

Please see just a sampling from his list to the right of this column.

Complementing stewardship of this rich Jefferson history and the ideals of those who made it happen, I suggest another guidepost: nobility. Our profession, the profession of medicine, is noble.

In the press and on the airwaves, there is a relentless barrage on the ‘failings’ of our healthcare system. All is conflated, and

no distinction is made between the delivery systems in need of repair and the caregivers and discoverers themselves.

The consequences are real and destructive. The squeeze on physicians is withering, not just in compensation, but in the very ability to practice our art and connect to our patients. The squeeze on physician-scientists is brutal, as funding cuts are inexorably leading to the loss of the next-generation of medical scientists.

What is being lost in all of this discourse are the daily miracles of cure and insight that continue to make American medicine second to none in the world. In the face of this onslaught, we must keep reminding ourselves, and anyone who will listen, of the nobility of our profession. Our profession is sacred, and it is noble — in the “state or quality of being exalted.”

We are the ultimate givers to humanity.

These two critical guideposts, stewardship and nobility, are intertwined.

We are stewards of the nobility of those that preceded us at Jefferson. Our very nobility has always been anchored in our dedicated stewardship, of Jefferson’s history and higher values. We will greet change, even run to it, but firmly rooted as stewards of Jefferson and our noble profession.

Mark L. Tykocinski, MD Anthony F. and Gertrude M. DePalma Dean Jefferson Medical College

SPRING 2014 3

Among our graduates and faculty were the ‘fathers’ of: American Gynecology Marion J. Sims, JMC 1835 American Physiology Robley Dunglison, JMC physiology professor American Neurology S. Weir Mitchell, JMC 1850 Physical and Rehabilitation Medicine Frank H. Krusen, JMC 1921

The list of surgical firsts goes on for pages. Among them were the many surgical instruments and techniques pioneered by: The ‘emperor of surgery' Samuel D. Gross, JMC 1828 The abdominal tourniquet for below the hip amputation Joseph Pancoast, JMC anatomy professor, 1860 The first successful cholecystotomy John Stough Bobbs, JMC 1849 The first successful brain surgery William W. Keen, JMC 1862 The first successful laryngotomy for cancer of the vocal cord Jacob da Silva Solis-Cohen, JMC laryngoscopy and diseases of chest professor, 1868 The first complete gastrectomy Phineas S. Conner, JMC 1861 A vena cava-pulmonary artery shunt that bypassed the defective right chambers of the heart of "Blue Babies” William Wallace Lumpkin Glenn, JMC 1938 The artificial tendon for hand rehabilitation James M. Hunter, JMC 1953

S. Weir Mitchell, JMC 1850

The artificial larynx to activate speech using lips and tongue motion Louis D. Lowry, JMC otolaryngology professor, 1981 The modern surgical stapler and the first articulating laparoscopic instruments that allows surgeons to choose a precise angle of cut Charles Klieman, JMC 1967 And recently, key members of the nation’s first full facial transplant team Edward J. Caterson, JMC/JCGS 2003; and Stephanie Caterson, JMC 1999

The Jefferson legacy in medical discovery goes well beyond the surgical disciplines: A standard test for color blindness William Thomson, JMC 1853 Recognition of the mosquito vector for yellow fever Carlos Finlay, JMC 1855 The first embossing typewriter for the blind John N. Farrar, JMC 1874 The Coplin Jar, standard storage unit for stained microscopic slides William M. Late Coplin, JMC 1886 Improved bronchoscopes and techniques for foreign body removal, by the ‘father of bronchoscopy’ Chevalier Jackson, JMC 1886

The first at-home self-treatment device for dialysis patients Norman Lasker, JMC medicine professor, 1972

The first radiographic diagnostic image of a fetus in utero Edward P. Davis, JMC 1888

Interleukin-2 and the HIV virus Robert C. Gallo, JMC 1963

Continuous spinal epidural William T. Lemmon, JMC 1921

Innovation has also been groundbreaking in the health services arena, for example:

REM sleep Eugene Aserinsky, JMC professor The renal hormone erythropoietetin Allan J. Erslev, Cadreza Foundation Director, 1953 A technique to record pre-natal electrocardiogram David M. Farrel, JMC 1928; Benjamin Kendall, JMC obstetrics professor, 1964 The Jefferson ventilator George J. Haupt, JMC 1948 Pioneering ultrasound technologies Barry B. Goldberg, JMC radiology professor Chevalier Jackson, JMC 1886

William W. Keen, JMC 1862

The modern military ambulance service Jonathan Letterman, JMC 1849 The first U.S. Navy hospital ship, USS Red Rover Ninian A. Pinckney, JMC 1833

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Findings Novel Agent Set for Unique Clinical Test in Inflammatory Breast Cancer A drug currently used to treat a type of lymphoma has shown surprising benefit in preclinical studies of inflammatory breast cancer, according to Massimo Cristofanilli, MD, director of the Jefferson Breast Care Center, professor of medical oncology at JMC and a researcher at Jefferson’s Kimmel Cancer Center.

The finding, published in the October 2013 issue of the Journal of Experimental Therapeutics and Oncology, has led to development of a phase 1/2 clinical trial at the Kimmel Cancer Center to test the agent, romidepsin (Istodax™), in combination with nab-paclitaxel (Abraxane™) chemotherapy for advanced inflammatory breast cancer.

“Because this kind of breast cancer is very difficult to treat, we hope this new combination of anticancer agents will change the outcome of this aggressive disease,” says Cristofanilli, the study’s senior investigator.

The study was conducted in collaboration with lead author Fredika Robertson, PhD, at the University of Texas M.D. Anderson Cancer Center, and was supported by a Promise Grant from the Susan G. Komen Foundation awarded to Cristofanilli and Robertson in 2008.

Inflammatory breast cancer is the most metastatic variant of locally advanced breast cancer. Although it accounts for between 2 and 5 percent of all breast cancers in the United States — and 13 percent of breast cancers globally — it is responsible for a disproportionate number of deaths from breast cancer.

One of the reasons for the lethality of inflammatory breast cancer is that early in the disease onset it produces emboli — small balls of cancer cells — that spread through the lymph system, causing the typical breast swelling. These aggregates of cancer cells are resistant to chemotherapy and radiation and are believed to be responsible for rapid metastasis.

Experiments in laboratory cells and in mice models of inflammatory breast cancer demonstrate that romidepsin is able to break the bonds that bind the cancer cells together, which then allows chemotherapy to effectively target single cancer cells.

Romidepsin is a histone deacetylase (HDAC) inhibitor, a new class of drugs that regulates gene transcription in a unique way.

This study tested two other HDAC inhibitors but found romidepsin offered the best results. The agent was approved for use to treat cutaneous T-cell lymphoma in 2009 and is undergoing clinical trials for use in other lymphomas.

“This study is a nice example of a transition from the laboratory to the clinic,” Cristofanilli says. “Our laboratory work suggested it might be helpful to treat inflammatory breast cancer, and now we are about to open a clinical trial to test that very promising possibility.”

Invasive tumor emboli, found in the lymph system of inflammatory breast cancer patients, are made up of clusters of cancer cells.

Tumor Emboli

Lymph System

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The cancer cells in a tumor embolus bind together and act as a shield against chemotherapy treatment.

The emboli are more resistant to therapy because they are clustered together and also have aggressive individual features.

The drug romidepsin (IsodaxTM) disrupts their ability to bind, making the cells less aggressive and more sensitive to nabpaclitaxel chemotherapy (AbraxaneTM).

Romidepsin

Nab-paclitaxel Chemotherapy

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President Klasko Launches Plan for ‘One Jefferson’ Stephen K. Klasko, MD, MBA, became president and chief executive officer of Thomas Jefferson University and TJUH System in September 2013, and he hasn’t slowed down since his arrival.

On April 10, 2014, he unveiled ambitious plans for the future to a group of 800 Jefferson managers in Philadelphia. "We have decided to create a totally transformed model around an entrepreneurial, academic 'One Jefferson,' " Klasko said at the event. This strategy for unifying the university, the hospital and all Jefferson practice plans known as “One Jefferson” will position us as the leader in revolutionizing health care nationwide.

The managers’ event was followed the next day by a One Jefferson Block Party on Lubert Plaza for all employees.

“In order for Jefferson to thrive in the ever-competitive academic medical center marketplace, we need to make sure everyone knows that today, we are different,” said Klasko. “We are changing the way we think about our organization and about how, as one, we’re positioning ourselves for an optimistic future.

At the center of it all is our ability to see Jefferson through a new lens — one of innovation, collaboration and transformation — so we’re ready to respond nimbly and quickly to the challenges that lie ahead.”

“Health is all we do” is Jefferson’s new mission. And with that in mind, our new vision is “to reimagine health care, health education and discovery to create unparalleled value.”

Klasko says that the future will be dismal if the healthcare industry doesn't significantly change how it operates by using smarter technology to improve the quality of care. That's why innovation is a top priority at Jefferson, so important that it joins academics, clinical care and philanthropy in our new four-pillar model.

Visit the new Jefferson Foundation website at Connect.Jefferson.edu

Photos by Bob Neroni

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Jefferson’s Blueprint for Strategic Action One Jefferson: Align clinical, educational and research missions to accelerate innovation.

Patients and Families First: Improve the health of our patients, families and community through comprehensive, personalized, cost effective, quality care.

Seamless Clinical Enterprise: Define the future of medical care.

High-Impact Science: Develop a research infrastructure and culture that incubates ideas and creates value.

Programs of Global Distinction: Integrate our tripartite missions to distinguish ourselves in selected areas of focus.

Forward-Thinking Education: Reinvent health sciences education to meet the needs of future delivery models.

Foundational Areas to Achieve Initiatives: Partnerships, diversity, technology, philanthropy.

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SUPERBUGS DODGE SUPERDRUGS AS ANTIBIOTIC RESISTANCE SPREADS

By Karen L. Brooks

Terrorism. Climate change. Civil unrest. A skinned knee.

STORY SUMMARY • Once viewed as wonder drugs, antibiotics are losing effectiveness, and drug-resistant infections are on the rise.

• Excessive use of antibiotics in both humans and farm animals has intensified the problem.

• Pharmaceutical companies lack incentives to develop new antibiotics, and the pipeline is running dry.

• Efforts to control the spread of infection, enforce proper use of antibiotics and encourage new drug development are essential to curb resistance.

One of these things is not like the others, but experts say in the future, minor cuts and scrapes could rank among more obvious threats to global human safety as antibiotic resistance spreads and even simple infections become untreatable.

Once heralded as medical miracles, antibiotics are losing clout. The number of deaths triggered annually worldwide by drug-resistant organisms already surpasses the number caused by terrorist attacks and natural disasters.

The U.S. Centers for Disease Control and Prevention estimates that bacteria

resistant to antibiotics infect 2 million Americans and kill 23,000 every year.

“We had a pre-antibiotic era, we’re in the antibiotic era and I don’t think it’s an understatement to say we’re heading toward a post-antibiotic era,” says Randi S. Silibovsky, MD, assistant professor of medicine and antibiotic stewardship clinician in Jefferson’s Division of Infectious Diseases. “Today, if you scratch yourself and get an infection, you can treat it. But in the future, we may have no treatment left, and that infection could become deadly.”

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How Resistance Happens

In A World Without Antibiotics…

What Could Kill You? • A simple scratch (before penicillin, one in nine skin infections killed) • Insect bites (scratching opens wounds, exposing them to microbes from under your fingernails) • Minor burns • A cold or the flu (pneumonia can strike if a virus compromises your immune system, and one-third of pneumonia cases kill without antibiotics) • Any kind of surgery (even minimally invasive procedures bring risk of infection) • Giving birth (natural childbirth killed five mothers out of every 1,000 before antibiotics — and cesarean sections, obviously, are a surgery) • Treatments like dialysis or a blood transfusion • Being hooked up to a ventilator • Catheter insertion • Implantation of any kind of medical device (new joints, new heart valves, pacemakers) • Getting a tattoo

Bacteria are survivors. Some are naturally impervious to certain antibiotics; when drugs kill off susceptible bacteria, the resistant strains left behind are free to multiply and share their survival strategies with other bacteria. Bacteria can also grow resistant through mutation, their genetic code changing to enable them to rebuff an antibiotic. The wrong medications — or those taken in inadequate doses or stopped too early — will not destroy the altered microbes.

Although resistance develops inevitably over time, its spread has been expedited by a preventable phenomenon: improper use of antibiotics. Physicians have been over-prescribing the drugs since mass production of penicillin began in the early 1940s. About half of all antibiotics prescribed are unnecessary — and the more often antibiotics are used, the more opportunities bacteria have to outsmart them.

A recent study in JAMA Internal Medicine found that physicians prescribe antibiotics in 60 percent of all sore throat cases, even though only about 10 percent involve strep, the specific bug requiring antibiotics. Another study found physicians prescribe antibiotics in 73 percent of bronchitis cases, even though the vast majority are viral. Broad-spectrum agents, which act against a wide range of bacteria including the “good” kind, are the most overused, potentially setting patients up for more serious infections with resistant bacteria later on.

Physicians should know better than to write superfluous prescriptions, right?

Unfortunately, say infectious disease experts, many patients demand antibiotics whenever they feel sick — and physicians comply to appease them.

“A doctor once told me, ‘I’m on the phone for 30 seconds if I agree to prescribe an antibiotic. But if I explain to the patient why they don’t need it, I’m on the phone for 20 minutes.’ That was very telling. Patients want medication, and doctors give in,” Silibovsky says.

William R. Short, MD, assistant professor of medicine in the Division of Infectious Diseases and infection control officer at Methodist Hospital, contrasts his peers’ reaction to his large outpatient HIV practice with their reaction to his work promoting antibiotic stewardship, saying

the difference reveals a lot about healthcare culture.

“Other healthcare professionals constantly say to me, ‘Oh, caring for HIV patients must be so sad.’ Why is it sad?

We have a remarkable 29 drugs available, and regimens are simpler than ever. I put someone on the right medication, and they can live a long, normal life with HIV. It’s not 1980 anymore,” he says.

“But when these same people see someone with a drug-resistant infection, they never say, ‘Wow, that’s sad.’

Physicians don’t see the urgency unless they are infectious disease specialists. We look at the community from a big-picture public health perspective, whereas other practitioners usually focus on individual cases. That’s why they are comfortable overprescribing antibiotics.”

The Trouble with Farms Excessive antibiotic use on farms — to prevent and treat infections among animals but even more so to accelerate growth and weight gain — has also empowered drug-resistant organisms.

Eighty percent of all antibiotics sold in the United States are used in meat and poultry production. The Food and Drug Administration has approved nearly 700 drugs for supplementing animal feed but, recognizing resistance as a growing threat, announced new guidelines in December 2013 to discourage their misuse. The guidelines ask animal drug manufacturers to change their labeling to prohibit the drugs’ “non-therapeutic” use to help livestock grow and require licensed veterinarians to approve certain drugs’ use on farms.

Critics say the policies contain obvious loopholes; the label adjustments are voluntary, and the line between “therapeutic” and “non-therapeutic” use is blurry.

“It’s not well documented yet that the widespread use of antibiotics in animal industry is driving antibiotic resistance, but there is a lot of speculation and new evidence showing that’s the case. Further FDA efforts to revise policies are important, because anywhere antibiotics are used extensively, we will see resistance,” says Kathleen E. Squires, MD, the W. Paul and Ida H. Havens Professor and Director of Infectious Diseases at Jefferson.

Many bills have proposed an absolute ban on antibiotic use in animals, but farmers and pharmaceutical companies

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have been able to deflect them. As far back as 1977, the FDA warned that excessive use of penicillin and tetracycline in livestock could promote new superbugs — but industry lobbyists crushed a recommended prohibition, and the FDA hasn’t pushed another ban since.

Threats and Consequences Patients are already dying from antibiotic-resistant infections, and resistant organisms are spreading at a rapid rate, even crossing international boundaries with ease.

“We’re having to recycle old drugs that may have severe adverse effects or use different pharmacokinetic principles of the drugs to overcome resistance, and in some cases we are only left with one or two last-line antibiotics that are very toxic to the kidneys. Patients cannot tolerate them.

Plus, they are intravenous, and putting in a central line brings its own set of complications. It’s madness,” Short says.

The biggest “superbug” threat, experts say, is from multi-drug-resistant gram-negative bacteria such as Enterobacteriaceae — a family that includes Salmonella and E. coli and is resistant to carbapenems, once the strongest group of antibiotics we had.

According to the CDC, about 9,000 drug-resistant infections from these

germs occurred last year. In 1998, there was just one case.

Another top concern is the highly contagious Clostridium difficile, which causes life-threatening diarrhea and kills more than 14,000 Americans a year.

Although there are still drugs that work against C. difficile, the bacteria are resistant to many antibiotics.

“People who are what I call ‘healthcare experienced’ are at the greatest risk of these infections: patients residing in nursing homes or other long-term care facilities, patients on hemodialysis, patients who have been hospitalized frequently or for a long time,” says Bryan D. Hess, MD ’06, a clinician in Jefferson’s Division of Infectious Diseases. “But healthy people could be susceptible, too.”

Short predicts a trend toward resistant bugs infecting more healthy individuals.

“A good example of the change that’s occurring is MRSA (methicillin-resistant Staphylococcus aureus), which back in the 1980s was strictly a hospital-associated bug. Over the past decade, MRSA has spread out into the community, which was unheard of in the past. This shows the bug’s evolution and puts into perspective how it’s spilling out into community.

I think it’s where we’re going with many superbugs,” he says.

In addition to threatening lives, drugresistant infections add significant costs to the U.S. healthcare system, requiring expensive and prolonged treatments and extended hospital stays. The exact economic burden is difficult to gauge, but estimates have reached $20 billion annually in direct healthcare costs, with additional societal costs from lost productivity as high as $35 billion.

Can’t We Just Make New Drugs?

Complicating resistance’s spread is the disturbingly low number of new antibiotics in the pipeline. FDA approvals of new antibiotics have dropped nearly 90 percent over the last 30 years. In the past 15 years, just 15 antibiotics have been approved — whereas in the preceding 15 years, there were 40.

Since resistance builds naturally over time, new antibiotics must continually replace old ones. But pharmaceutical companies’ efforts to develop new antibiotics decreased rapidly in the 1990s, when they started focusing more on drugs for chronic diseases, which are taken long term and promise greater profit.

Companies spend between $800 million and $1.7 billion on every new drug — a hefty expense for drugs that are taken for just weeks at a time and will eventually lose effectiveness.

Tomorrow’s Antibiotics: The Drug Pipeline Number of Antibacterial New Drug Application (NDA) Approvals vs. Year Intervals*

The number of new antibiotics developed and approved has steadily decreased in the past three decades, leaving fewer options to treat resistant bacteria.

Number of antibacterial drug NDA approvals

20

15

10

5

0

1980-1984 1985-1989 1990-1994 1995-1999 2000-2004 2005-2009 2010-2012

Year Interval * Intervals from 1980 to 2009 are five-year intervals; 2010-2012 is a three-year interval. Drugs are limited to systemic agents.

Data courtesy of the FDA's Center for Drug Evaluation and Research.

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“The pharmaceutical industry is not incentivized to develop antibiotics. These are for-profit companies looking for disease areas in which they can be first, second or third in developing a new kind of specialized drug and dominate the market,” Squires says.

Resistance has accelerated over time as antibiotics have become cheaper and more broadly prescribed. Signs of resistance against two newer antibiotics — linezolid, introduced in 2000, and daptomycin, introduced in 2003 — appeared within a few years.

Harnessing the Problem Fighting drug-resistant organisms requires preventing their spread and improving the use of antibiotics we already have — initiatives heavily promoted at Jefferson, where an antibiotic stewardship team supervises inpatient antibiotic administration, ensuring the drugs are used in the right

circumstances, at the right doses and for the right duration.

“There’s always been an infectious disease pharmacy specialist whose job was to monitor antibiotic use, but now we have an infectious disease physician leader. Physicians don’t want to take orders from pharmacists; they listen better to their peers,” says Phyllis R. Flomenberg, MD, associate professor of medicine and infection control officer.

Flomenberg stresses the importance of enforcing hand hygiene protocols in the hospital. “We have an anonymous task force observing and reporting people who don’t wash their hands properly. It’s an effective system for physicians — nobody wants to be on the ‘bad list,’” she says.

Hess emphasizes the precautions taken when a patient has a known drug-resistant organism. “Person-to-person spread is a big concern. Any patient identified as a carrier of a one of these organisms is placed on contact isolation and only

approached by people wearing gowns and gloves,” he says.

In January 2014, the Society for Healthcare Epidemiology of America, whose mission is to prevent infections in healthcare environments, issued new recommendations on what caregivers should wear. Although no one has found a concrete connection between hospital uniforms and infections, studies have detected bugs on the sleeves and pockets of coats and scrubs. One study found that a third of physicians’ neckties grew Staphylococcus aureus in the lab and determined the germs were drug resistant.

As a result, the new guidelines advise short sleeves, bare hands and white coats that are laundered at least once a week — and taken off during physical exams — as well as the removal of ties, watches and rings.

“Wearing the appropriate protection is not just important for clinicians. A critical piece is educating family members,

Antibiotic Deployment Tetracycline Chloramphenicol Vancomycin Ampicillin

Streptomycin Sulfonamides Penicillin

Erythromycin Methicillin

Cephalosporins

Daptomycin Linezoid

1930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005

Chloramphenicol Sulfonamides Penicillin Streptomycin Tetracycline

Ampicillin

Vancomycin

Methicillin Cephalosporins

Erythromycin

Antibiotic Resistance Observed The year each antibiotic was deployed is depicted above the timeline; the year resistance was observed is depicted below.

The appearance of resistance does not necessarily indicate that a given antibiotic has lost all clinical utility.

Linezoid Daptomycin

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What Bacteria Present the Greatest Threat?

The Centers for Disease Control and Prevention has classified drug-resistant bacteria into three categories: urgent, serious and concerning.

Urgent Threats Carbapenem-resistant Enterobacteriaceae (CRE) Clostridium difficile (C. diff) Drug-resistant Neisseria gonorrhoeae

Serious Threats Multidrug-resistant Acinetobacter Drug-resistant Campylobacter Fluconazole-resistant Candida (a fungus) Extended spectrum ß-lactamase-producing Enterobacteriaceae (ESBL) Vancomycin-resistant Enterecoccus (VRE) Multidrug-resistant Pseudomonas aeruginosa Drug-resistant non-typhoidal Salmonella Drug-resistant Salmonella typhi Drug-resistant Shigella Methicillin-resistant Staphylococcus aureus (MRSA) Drug-resistant Streptococcus pneumonia Drug-resistant tuberculosis

Concerning Threats Vancomycin-resistant Staphylococcus aureus (VRSA) Erythromycin-resistant Group A Streptococcus Clindamycin-resistant Group B Streptococcus

who never want to wear gowns when visiting and don’t understand that it’s for the benefit of the greater community,” Short says.

Scientists are testing new methods of fighting superbugs, such as combining substances like silver with antibiotics to make them more powerful. Other researchers are using genetic sequencing of bacteria to help develop new germkilling drugs, and some aren’t looking to kill the bugs at all, but rather to make them less harmful. Since bacteria only cause infections when their population has grown to a certain level, called a quorum, scientists are trying to disrupt the chemical signals the germs use to communicate.

Entities such as the U.S. Biodefense Advanced Research and Development Agency, the National Institutes of Allergy and Infectious Diseases and the Department of Defense are encouraging the development of new antibiotics by offering funding opportunities. In July 2012, President Barack Obama signed the Generating Antibiotic Incentives Now, or GAIN, Act, which extends by five years the exclusivity period during which certain antibiotics can be sold without generic competition. And in December 2013, bipartisan House of Representatives members introduced a bill to provide a fast-track route to FDA approval for promising new antibiotics. The bill would allow the FDA to approve

Estimated number of illnesses and deaths in America caused by antibiotic resistance every year: 2,049,442 illnesses 23,000 deaths antibiotics needed for life-threatening infections based on data from smaller clinical trials — an incentive that could save companies a lot of money.

“Bacteria are not going to go away and are actually an important part of our lives. We need bacteria on our skin to protect us from the environment and inside our bodies to assist our metabolic processes,” Squires says. “But if we get to the point where we have dangerous bacteria that are resistant to all the antibiotics we have, people will simply keep dying. We need to find new ways to treat them.”

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From blood pressure medication for seniors to cancer screenings, changing healthcare guidelines can be confusing for patients and physicians alike.

By Gail Luciani

Photo by Ed Cunicelli

A Change of Heart

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For more than 30 years,

physicians told patients of all ages to strive for a blood pressure reading below 140/90; many even prescribed multiple medications to help their patients reach that target number. But new guidelines released at the end of 2013 suggest that patients over 60 years of age can have higher blood pressure measures before starting treatment to lower it.

“In the past, blood pressure guidelines were based on expert opinion, not data,” says Lawrence Ward, MD ’99, associate professor and vice chair for clinical practice and quality in the Department of Medicine. “All across health care, the goal is to get guidelines in line with evidence.”

The committee that released the guidelines, composed of 17 academics, spent more than five years reviewing evidence before making the new recommendations. It determined that there was not enough evidence for the previous blood pressure target and that there were risks associated with the medications used to bring the numbers down. Empaneled in 2008 by the National Heart, Lung and Blood Institute as the Eighth Joint National Committee, its mission was to create evidence-based recommendations. However, in 2013 the institute announced that it was shifting responsibility for developing clinical guidelines to the American Heart Association (AHA) and the American College of Cardiology. Other guidelines committees accepted the change, but the Eighth Joint National Committee did not.

To release its findings, the committee published its report online in the Journal of the American Medical Association in December 2013 as an independent group.

According to members of the committee, the recommendations were written with the primary care physician in mind. “These are universal guidelines, so it’s important for all physicians to be up to date on them,” says Ward. For hard-to-manage cases, physicians can refer patients to experts who specialize in treating complex or treatmentresistant hypertension.

Producing clinical guidelines is complicated and can cause contention among healthcare professionals, so it is no surprise there is disagreement about

the new blood pressure guidelines in the medical community. “I just get anxious when people hear that they don’t need as much medicine, and they can allow their blood pressure to drift up,” says Mariell Jessup, MD, AHA president, on the organization’s website. “One in three people in this country has hypertension, and it’s a silent killer.

I don’t think this is the time, when we have rising levels of diabetes and obesity, to be less vigilant about it.”

The AHA maintains its recommendation of initiating treatment — starting with lifestyle changes and then medication as needed — at 140/90 until age 80, then at 150/90. High blood pressure is undertreated and underdiagnosed, and patients with high blood pressure often face serious cardiovascular problems such as stroke, heart attack or heart failure.

The AHA and the American College of Cardiology released four cardiovascular treatment guidelines for healthcare providers in November 2013. This year they will update high blood pressure guidelines, taking into account the new report that was published in JAMA, the evidence review it was based on and an update of that review. Until then, they will recognize the hypertension guidelines published in 2004 by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, as the national standard.

To complicate the issue, blood pressure numbers often are used to evaluate the quality of patient care. They may even affect physician payments. It’s not unusual for patients to question whether physicians are trying to help people live healthier lives or make the numbers look good. Often patients are suspicious about the roles of pharmaceutical and insurance companies, how physicians are paid for performance and the intricacies of the Affordable Care Act. “I’ve certainly had my share of patients who ask questions about changing guidelines, but I believe that it’s important to be open to their concerns and questions,” says Ward. “I’m a minimalist when it comes to prescribing medication, and I actively work toward reducing drugs whenever possible, so my patients tend to trust me. But it’s also important to do basic counseling about the plan of care.”

Physicians can reinforce the message that changing guidelines are a good thing because they are based on new evidence.

Both sides agree that more research is needed to establish hypertension goals for different age groups.

Comprehensive Hypertension Center Now at Jefferson In late 2013, the American Society of Hypertension named the Jefferson Hypertension Program in the Department of Medicine a Comprehensive Hypertension Center, one of only five in the country.

Ward and Bonita Falkner, MD, professor of medicine and pediatrics, lead the program, which employs a multidisciplinary approach that combines specialists in primary care, nephrology, cardiology and endocrinology as well as pharmacists.

“We work with patients to identify what’s behind their persistently high blood pressure, evaluate whether the medications and doses they’re taking are appropriate and help fine-tune their medications to come up with the most effective combination and doses,” says Ward. “Some medications, foods or supplements can actually worsen high blood pressure or prevent high blood pressure medications from working effectively.”

“Patients need to know that their lack of control over their hypertension is often not their fault,” says Falkner.

“Sometimes diet, exercise and the most common medications just can’t get it under control, especially in patients with a strong family history.

Our Center can work with these patients to meet their goals and avoid many of the common side effects.”

For more information about the Center, please visit Hospitals.Jefferson.edu/hypertension or call 215-955-HiBP (4427).

16 JEFFERSON JEFFERSON MEDICAL MEDICAL COLLEGE COLLEGE ALUMNI ALUMNI BULLETIN BULLETIN 16

“Be

JeffHEALTH volunteers in Akarambi, Rwanda. Pictured are, top row: Komal Soin, MD '10; members of the Munyantanage family; Ellen Plumb, MD '10; James Plumb, MD ’74; and Andre Munyantanage, adviser and facilitator of Akarambi Project Management Committee; bottom row: Eva Cantor, MD '13; Theodonata Tuyisenge, a Rwandan medical exchange student; Devesh Upadhya, MD '13; and Aaron Martin, MD ’13.

SPRING 2014 17

Students Go

eyond Our Walls” to Provide Service to the Community “When you choose medicine, you choose to give,” says third-year JMC student Nikos Svoronos. “There is an amazing amount of good that needs to be done in the world.”

Svoronos volunteers for Refugee Health Partners and is just one of the hundreds of students who volunteer in community service programs available at Jefferson. “I chose this program because I’m interested in global health,” he says. “I see working with refugees as a chance to work in global health at home.”

Founded in 2008 and run by students, Refugee Health Partners is a collaboration with the Department of Family and Community Medicine, the Nationalities Services Center, the Jefferson Center for Refugee Health and other community partners. Its projects address social and cultural determinants of the health and physical wellbeing of the refugee community in Philadelphia.

“Community service has long been a core component of our commitment to the communities we serve,” says Mark Tykocinski, MD, Anthony F. and Gertrude M. DePalma Dean. “This kind of outreach allows us to touch the lives of both our local community and, through JeffHEALTH, go far beyond and into the global community.”

Jefferson’s community service programs give students an opportunity to help patients today while becoming caring clinicians who will engage in the communities they touch in the future. The largest programs include JeffHOPE, which treats Philadelphia’s underserved men, women and children through student-run clinics, and JeffHEALTH, which links communities in Africa to improved health resources.

“Health care in the 21st century is evolving, with an increasing emphasis on interpersonal qualities where empathy plays a role,” says Tykocinski. “The impact of these programs is even more profound as it is a part of our strategy to attract the best students and prepare them to become the best physicians.”

Student activities include charitable fundraisers and collection drives, medical care, advocacy and education, health fairs, screening and testing, tutoring and mentoring programs with children, tree planting and community gardens, musical performances, clowning and interpretation services. And they all make a difference in people’s lives.

Third-year student Anthony Parendo volunteers with JeffSEES, which provides eye health outreach to various communities in the Philadelphia area. “I can see the joy in my patients’ eyes when we are handing out something as simple as reading glasses.

They can read again,” Parendo says.

See how JMC students have distinguished themselves as leaders in commitment to community service. Watch a short film at Connect.Jefferson.edu/beyondourwalls.

18 18 JEFFERSON JEFFERSON MEDICAL MEDICAL COLLEGE COLLEGEALUMNI ALUMNIBULLETIN BULLETIN

SPRING 2014 19

Heads Up:

Jefferson Focuses on Concussion

By Gail Luciani

A

car accident. A fall. Or something as simple as standing up and hitting your head on a shelf.

Concussion can be brought on by just about any activity. According to the Traumatic Brain Injury Foundation, concussion is the most underreported, underdiagnosed and underestimated head injury in the country.

The number of cases ranges in the millions, and nearly 4 million athletes of all ages suffer concussions every year.

With the current spotlight on concussions and their treatment, Jefferson, the Rothman Institute and Wills Eye Hospital have collaborated to create the Jefferson Comprehensive Concussion Center. “We offer a comprehensive set of services in one location, including sports medicine, neurology, physical and vestibular therapy and cognitive occupational therapy,” says Robert Franks, DO, a clinician at the Rothman Institute and medical co-director of the Center.

STORY SUMMARY

• Concussion is the most underreported, underdiagnosed and underestimated head injury.

• A multidisciplinary collaboration in the Delaware Valley has resulted in a new comprehensive concussion center.

• Children, adolescents and adults can get help with every aspect of diagnosis, treatment and recovery all at one accessible location.

Located at the Philadelphia Navy Yard, the 7,000-square-foot facility is the first of its kind in the Delaware Valley. It is among the few concussion centers in the nation that provide clinical care in neuro-ophthalmology, neuroradiology, psychiatry and complex rehabilitation at one facility.

“Our sports docs are specialty trained to shepherd athletes of all ages through their recovery, including how and when to return to play in a safe, healthy manner,” says medical co-director Mijail Serruya, MD, PhD, a cognitive neurologist at Jefferson.

“We evaluate and treat patients who have had concussions from mechanical falls, vasovagal syncope, seizures and other causes. We help manage the headache, sleep disturbance, cognitive and mood changes and dysequilibrium that frequently accompany concussion. We also teach patients clinical self-hypnosis.”

Services at the Center include sports concussion management, full neuropsychological testing, nerve block injections, optometrics, vestibular therapy and physical/occupational therapy as well as cognitive and ocular therapy. The facility has soundproof testing areas, lightcontrolled rooms and a dedicated rehab wing for vestibular, cognitive and physical therapies. “We have a full-time patient advocate who can help our patients smoothly move through the complex medical system so that they can heal faster and more completely,” says Linda Mazzoli, director of the Center. “We can help patients advocate for themselves in getting the medical, financial, school and workplace support they need.”

Jefferson Comprehensive Concussion Center at a Glance • Physicians can call 267-463-2300 to speak with members of the staff.

• Physicians can refer patients 10 or older with remote or recent concussions.

• Staff can evaluate and treat patients seeking worker’s compensation for worksite concussions or from motor vehicle accidents.

• The Center is located in the Corporate Center of the Philadelphia Navy Yard just off of Interstate 95, has free parking and is convenient to the Philadelphia International Airport.

• Patients can self-refer by calling 800-JEFFNOW.

Theodore Taraschi, PhD, vice president of research at Jefferson, was integral to the planning of the Center and worked closely with Franks in its development. “Besides being the best place in the Philadelphia area for treating concussions, it will also be a center for scientific research into concussions,” says Taraschi. Recent research indicates that even mild concussions in childhood sports, inappropriately treated, are putting patients at risk for serious, long-term health problems.

20 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN

Jefferson Faculty Gerald R. Williams, Jr., MD:

Shouldering Responsibility for Patients’ Joints For as long as he can remember, Gerald Williams Jr., MD, not only knew he would become a physician, but specifically an orthopaedic surgeon. “Maybe it’s because I was constantly getting knocked down and run over — I played a lot of sports growing up,” he says.

Williams’ intrigue never wavered. After graduating from the Temple University School of Medicine and completing his training at the University of Texas Health Science Center, he spent 16 years on the shoulder and elbow service at the University of Pennsylvania before joining Jefferson in 2007 as a professor of orthopaedic surgery at JMC and director of the Rothman Institute’s Division of Shoulder and Elbow Surgery.

An expert in shoulder replacement, arthroscopy and dislocations, Williams is past chair of the CME Courses Committee and incoming second vice president for the Academy of Orthopaedic Surgeons and past president of American Shoulder and Elbow Surgeons, the Pennsylvania Orthopaedic Society and the Philadelphia Orthopaedic Society. He has authored or co-authored nearly 200 publications, including three volumes of “Disorders of the Shoulder: Diagnosis and Management,” a standard clinical reference for adult shoulder disorders.

Williams is currently the only physician in his family, but that will change soon. His daughter, Alexis, is a third-year JMC student hoping to pursue orthopaedics. “She’s very dedicated, but I warn her it’s hard to have a work-life balance in this field. It’s not impossible, but it’s hard,” Williams says. Wife Robin and son Mark, an investment banker, round out the family.

What is your teaching philosophy?

In the operating room, I give fellows and residents increased responsibility over time — but I always remain hands-on. My patients are mine, and it is on me to get them the best results.

My everyday challenge is teaching people how to become great surgeons without compromising the trust I have with my patients.

My teaching responsibilities do not end when trainees move on.

Every other year, some of my partners and I get together with a group of our former fellows and their families. We also connect through social networking, and many of them will email or call me when they have questions about a case.

What advice would you give to medical students interested in orthopaedic surgery?

I would tell them to take a good look at their motives. They need to see taking care of patients as the best and most important part of the job, because there are a lot of hassles in medicine, and practicing is not as fun as it used to be. But as long as they get fulfillment on a basic level from interacting with patients and making their lives better, they’ll be fine. With all the aggravation

happening in medicine today, our ability to help patients is the one piece that will keep doctors happy.

What is your role in research?

When I was doing basic science, I mostly studied rotator cuff tendon healing. Now, most of my research is clinical and focused on joint replacement. I am also working on comparing outcomes and resource allocation for the same procedures performed on the same types of patients but in different environments. If there’s going to be any money saved in medicine, we need to take patients who don’t require all the intricate services and technologies available in a tertiary-care hospital and move them to a lower-cost setting. I am looking at data to determine whether that affects outcomes.

I have also been interested in biomechanics and device development for my entire career. I initially collaborated with Johnson & Johnson, which then bought DePuy — and now I’ve been designing DePuy’s shoulder prosthetics product line for about 15 years.

Recently, the United States has seen an increase in the marketing of orthopaedic procedures and implants directly to patients. How do you feel about the influx of joint replacement marketing professionals?

Marketing is everywhere in every field, including medicine. My job is to help patients understand the extent of their problems, explain their options and give them an idea of what they can expect from those options so they can make an informed decision. I work hard to make sure my patients don’t make decisions that are unduly influenced by factors that are not medical issues. I am my patients’ best advocate.

Where do you see your field going in the next five years?

Insurance companies have already begun to prioritize cost in managing their product lines. Value in medicine has been defined

by Michael Porter, a leader in competitive strategy and professor at Harvard, as outcomes over cost. Proving the value of what we do will become more important than ever, and I believe we will move to a value equation to determine physician pay. To be successful in the coming years, we will need to document our outcomes — not just patient satisfaction with issues like ease of appointments but also pre- and post-operative scores — while simultaneously controlling costs. If you’re not in a practice that encourages you to study, record and improve your outcomes, then in the future, you will likely struggle to succeed.

— Karen L. Brooks

SPRING WINTER2014 2014 21

Photo by Ed Cunicelli

22 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN

Spotlight Jefferson Researcher Wins Award Named for Nobel Prize Winner Jeffrey L. Benovic, PhD, professor and chair of the Department of Biochemistry and Molecular Biology and the Thomas Eakins Endowed Professor at Jefferson, received the 2014 Julius Axelrod Award in Pharmacology by the American Society for Pharmacology and Experimental Therapeutics in April 2014. The award, named after the 1970 Nobel Prize winner in Physiology or Medicine, recognizes outstanding scientific contributions in research and mentoring in pharmacology.

Benovic’s investigations have opened up an entirely new field of study. He has advanced understanding of how G protein-coupled receptor function is regulated and conducted a groundbreaking demonstration of the biochemical mechanism of GPCR desensitization by G protein-coupled receptor kinases and arrestins. He discovered, purified and cloned G protein-coupled receptor kinase 2 and characterized how it functioned in collaboration with arrestins to desensitize the receptors in a reconstituted biochemical system. He ultimately discovered that ß-arrestins interact with clathrin to promote receptor internalization — one of the core paradigms in GPCR biology today.

His studies in the model organism C. elegans have uncovered new roles for arrestins in the development of aging.

Benovic is director of the Molecular Pharmacology and Structural Biology PhD Program at Jefferson and leader of the Cancer Cell Biology and Signaling Program at the Kimmel Cancer Center. His contributions to predoctoral and postdoctoral training have been recognized by awards from the Jefferson Graduate School of Biomedical Sciences and the Jefferson Postdoctoral Association.

Photo by Kevin Monko

Stephen Klasko, MD, MBA, Guest Speaker at TEDxPhiladelphia Jefferson President and CEO Stephen Klasko was one of 20 thought leaders invited to present at this year’s TEDxPhiladelphia, a daylong multidisciplinary conference that examined the theme Philadelphia: The New Workshop of the World.

Speaking from the future, Klasko compared the evolution of health care to that of consumer industries and “what we forget to teach in medical school.” He also previewed a major initiative at Jefferson that will allow patients to access physicians from their smartphones any time of the day through telehealth.

Klasko explained that Jefferson is leveraging big data, integrating knowledge gained from the realms of finance and sports to understand things better. “In 2014, we really will become the first truly entrepreneurial medical center,” said Klasko. “How? As Yogi Berra might have said, ‘I can tell you about the future in one word: Big Data.’”

SPRING 2014 23

DEVELOPMENT NEWS Dear Jefferson Alumni, It is a privilege and an honor to serve as Jefferson’s Senior Vice President and Chief Development and Alumni Relations Officer during this pivotal time in health care. A 190-year tradition of excellence coupled with the dynamic leadership of President and CEO Stephen Klasko, MD, MBA, positions Jefferson to take the lead in revolutionizing American health care during this era of rapid and farreaching change.

With Dr. Klasko at the helm, thousands of our colleagues and constituents collaborated on a blueprint for strategic action that was formally unveiled on April 10. We aim to unify the hospital, the university and the practice plans to create “One Jefferson” that will be the global front-runner in the integration of healthcare delivery, research and education.

As our plans for Jefferson’s future unfold, my team at the Jefferson Foundation is embarking upon an exciting journey to enable Jefferson to fully optimize its philanthropic potential in every arena and to strengthen an engaged alumni association. This is my third post as a chief development officer for a major institution, and I am proud of the programs put in place during my tenure to support and engage alumni.

I want the Jefferson Foundation to be one of the very best of its kind; the importance of alumni cannot be underestimated, and I am committed to investing resources to ensure that the role of the Foundation is one of service to alumni.

To that end, our team has begun a search for an associate vice president of alumni relations to partner with me in creating programs and initiatives that will serve all Jefferson alumni.

We have the right ingredients for success.

Our legacy spanning nearly two centuries, the dedicated people of Jefferson — our trustees, our faculty and staff, our alumni — and our innovative, entrepreneurial approach to health care form the foundation we need for our upcoming comprehensive fundraising campaign.

I look forward to meeting you and I encourage you to email me your thoughts, ideas and comments about setting the strategic direction for Jefferson’s alumni association. Please feel free to reach out to me at elizabeth.dale@jefferson.edu or 215-503-5138. For routine matters related to alumni relations, please contact Cory Miller, interim director of alumni relations, at cory.miller@jefferson.edu or 215-955-6929.

Elizabeth Dale, EdD Senior Vice President and Chief Development and Alumni Relations Officer

Stephen Klasko, MD, MBA, Jefferson's president and CEO; Sam Lindner, JMC Class of 2014; and Elizabeth Dale, EdD, senior vice president and chief development and alumni relations officer, at the scholarship dinner held Feb. 26, 2014. The annual event honors Jefferson’s benefactors and offers an opportunity for them to get to know scholarship recipients. Lindner, one of this year’s Benjamin and Mary Siddons Measey Foundation Scholarship recipients, spoke to the 120 attendees about the importance of scholarship support in realizing his dreams. This academic year, Jefferson awarded an estimated $10,332,538 in need and merit-based financial aid to 1,072 students throughout the University, which is 29 percent of Jefferson students.

24 24 JEFFERSON JEFFERSON MEDICAL MEDICAL COLLEGE COLLEGE ALUMNI ALUMNI BULLETIN BULLETIN

George Fritz Blechschmidt, MD ’58,

made provisions in his estate for the establishment of the G. Fritz Blechschmidt, MD Professorship in Clinical Skills Education as well as an endowed scholarship for a Jefferson Medical College student displaying the greatest financial need.

Be a Guardian Angel You too can leave a legacy of care through a bequest to Jefferson.

A gift to Jefferson in your will or trust enables you to support our mission of reimagining health care, health education and discovery to create unparalleled value and quality. Bequests do not cost you any cash flow during your lifetime, and are easy to modify or revoke if your situation changes.

THOMAS JEFFERSON UNIVERSITY AND HOSPITALS

To learn more about a bequest or other giving options, please contact:

Fritz Ruccius Chief Philanthropic Officer, Planned Giving (215) 955-8733 frederick.ruccius@jefferson.edu jefferson.plannedgiving.org

SPRING 2014 25

ClassNotes ’46

Henry A. Seidenberg continues to practice dynamic psychotherapy and psychoanalysis after 60 years. He is a faculty member at the Institute for Psychoanalysis of Chicago, where he previously served as dean for 17 years and interim director for two years. He lives in Winnetka, Ill.

’48

Robert K. Finley, Jr., retired from practicing surgery in 1993 but continued to provide patient care overseas on a volunteer basis for the next 15 years, including in Hangzhou, China, from 1995 to 2006. Other countries in which he provided medical services include Jamaica, Kenya and Rwanda. Finley lives in Oregonia, Ohio.

’49

Erwin R. Smarr reports that after triple bypass surgery two years ago, he is still enjoying an active life and playing golf and piano. Smarr lives in Chapel Hill, N.C.

’54

Henry William Pletcher lives in Poughkeepsie, N.Y., and writes that he is proud of his granddaughter, Maj. Meghan Raleigh, MD ’02, a family practice physician stationed at Fort Belvoir in Virginia.

Philadelphia in 1998. He lives in Dumfries, Va., but spends winters in Florida.

and are looking forward to attending his 50th JMC reunion in 2015.

’62

’66

Richard A. Ulrich lives in Bonaire, Ga., and is still practicing ophthalmology.

Alan S. Bricklin is almost completely retired, working six or seven hours a week signing out GI biopsies. He published a novel about espionage called “Crossword” that is set in the closing months of World War II. Bricklin lives in Calabasas, Calif.

’67

’70

Richard E. Goldberg and Erin Lally, MD ’11, participated in a symposium at the James A. Michener Art Museum called, “In A Relationship: Art, Science and Medicine” on April 5, 2014.

In their presentation, Lally, currently a resident at Wills Eye Hospital, related her experiences climbing Mt. Everest to the oil painting “Thin Air” by Goldberg.

’63

Thomas S. Patricoski and his wife, Marie, split their time between homes in Illinois and Florida. When in Florida, they volunteer at a senior citizens’ clinic and homeless shelter. In Illinois, they are involved with home health care in the Chicago area.

’64

Stanley C. Foster continues to practice radiology at Georgetown University Hospital. His son Jonathan is also a radiologist and practices in New York. Foster has six grandchildren and reports that he is happy to live near three of them in Washington.

Stuart B. Brown continues to practice pediatric neurology full time at the Joe DiMaggio Children’s Hospital in Hollywood, Fla. He lives in Miami and reports that he recently had dinner with fellow JMC alumni Norman Jablon, MD ’59, and Joseph Rosen, MD ’61.

Eli O. Meltzer has retired from patient care and clinical research activities after more than 40 years with the Allergy and Asthma Medical Group and Research Center in San Diego. He is still involved as a consultant to the pharmaceutical and biotech industries and in medical education. He writes that his professional life “has been truly intellectually stimulating and emotionally rewarding” and that he hopes to see many classmates at their 50th JMC reunion in September.

’61

’65

’55 Rachmel Cherner lives in Ambler, Pa., and is still practicing and writing articles about endocrinology at age 83.

’59

Allen E. Chandler retired as a lieutenant general in the U.S. Army Medical Corps in 1995 and as medical director for the City of

William B. Wood retired in 2013 at the age of 75 and keeps busy with his 13 grandchildren. He and his wife live in Wayzata, Minn.,

Stanton I. Moldovan writes that his son, Wayne, is finishing a neurology residency at the University of Colorado School of Medicine and will join his practice in July. Moldovan and his wife, Cheryl, live in Houston but will begin spending more time at their second home in Kiawah, S.C., playing golf and walking on the beach.

James M. Sumerson is enjoying retirement and recently returned from a trip to Australia, New Zealand and Tasmania. Sumerson lives in Cherry Hill, N.J. Don C. Weiser works at Midwest Institute for Clinical Research, where he says he hopes to “find the next blockbuster drug.”

Weiser lives in Indianapolis, Ind.

’68

Robert J. Risimini retired in July 2013 after 40 years of practicing pediatrics and family medicine. He also spent 35 years in medical education, the last six of which he was dean of student affairs at the Camden campus of the University of Medicine and Dentistry of New Jersey’s Robert Wood Johnson Medical School. Risimini lives in Mannington, N.J.

’69

Louis B. Balizet retired in June 2013 after practicing medical oncology for 38 years.

He is active with Physicians for a National Health Program and Health Care for All Colorado, two organizations advocating for single-payer universal health care. Balizet lives in Pueblo, Colo.

Lawrence S. Miller has been appointed to the Centers for Medicare and Medicaid Services’ technical expert panel on functional status quality measures in post-acute care. He lives in Los Angeles and continues to present in UCLA’s annual intensive course in geriatric medicine on the topic, “physical examinations: proper techniques.”

David R. Pashman is a clinical associate professor of orthopaedic surgery at the University of Pennsylvania. He lives in Rydal, Pa., and enjoys his work and spending time with his six grandchildren.

’71

James G. McBride is still in solo private practice but says he is taking more time off to devote to the Atlas Society and other libertarian organizations.

McBride lives in Bethlehem, Pa. Joseph L. Seltzer retired in June 2013 from practicing anesthesiology and says he loves it. Seltzer lives in Malvern, Pa.

’72

A. James Behrend retired from practicing general vascular surgery in March 2014. He and his wife, Pat, live in El Cajon, Calif., but will now spend summers in Portland, Ore., to be near their youngest grandchildren. Behrend says he looks forward to flyfishing in his retirement.

Anthony J. Calabrese continues to practice gastroenterology and play saxophone and clarinet with the Bayside Big Band. He lives in continued on page 27

26 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN

Alumni Association President’s Message

Ode to a Mentor I started junior year at JMC believing my destiny was to be a hand surgeon. Then I began my rotation in medicine at Lankenau Medical Center. On the first day, I opened the chart of a woman with Crohn’s disease.

Though initially I was overwhelmed by her complex story, a dignified senior attending soon appeared and introduced himself as Dr. Franz Goldstein. He proceeded to pull up a chair and provide a mini-symposium on the topic of inflammatory bowel disease.

He thanked me for listening and helping in the care of his patient. Instantly I knew that this was a scholar and a gentleman.

As a senior, I returned to Lankenau for an elective in GI. Dr. Goldstein took me under his wing and became my mentor. I was spellbound by the way he interacted with each patient. He listened well and responded with caring, detailed explanations. We even went to radiology to watch patients drink barium as it coursed through the small bowel. Every word, every action reflected his empathy and commitment. I eagerly anticipated daily rounds, realizing that I walked in the shadow of a living encyclopedia.

After completing a fellowship in gastroenterology, I joined the Lankenau staff as his associate and eventual partner. He never referred to me as his junior partner. He never treated me like a ‘woman doctor.’ I was his respected colleague. Over the years, I became fascinated by Franz the man. He was methodical, punctual and calm. He could quote the medical literature from the 1930s to the present. He had a love of opera and literature, and he spoke five languages without an accent. He and his wife tended to their yard, which looked like Longwood Gardens.

It wasn’t until the eve of his 90th birthday that I had the honor of hearing his life story. Sadly, he was the only member of his family to escape war-torn Germany, but he was always thankful to those who helped him to survive and begin a new life.

With only three semesters of college, he emigrated to the U.S. in 1947. Fate led him to find work as a technician in the Jefferson research lab of Dr. John Gibbon.

After his own intense study, Franz would discover how to measure blood gases while using ether to sedate dogs undergoing surgery. This major breakthrough on the path to successful use of the heartlung machine led to his first paper in 1950, co-authored with Dr. Gibbon.

Franz would then graduate first in his Jefferson Class of 1953 and begin his lifelong commitment to research and clinical practice. After residency, he completed fellowships simultaneously in pulmonary and gastroenterology. He joined the staff of Jefferson and later became chief of GI at Lankenau. In time, he was recognized nationally and internationally with multiple awards and served as president of the American College of Gastroenterology and the Bockus Society. He completed his career at the age of 82 with 143 papers and publications.

On more than one occasion, young Franz had looked death in the face.

When I asked about his long hours as chief resident while juggling two fellowships, he said, “After so many years of misery, anything would be better!” He had survived the devastation of war and appreciated every day he had the chance to make the world a better place.

Never one to call attention to himself, he always lavished other people with praise. When I spoke of his paper with Dr. Gibbon, he referred to himself as a lowly lab tech. “I did what I could. This was just a small step. I greatly admired Dr. Gibbon.”

In his last weeks, Franz still quoted the literature. While he rested in the infirmary of his retirement home, I told him I could have used his help with an unusual case of Crohn’s disease. He lamented that the initial paper in 1939 credited both Crohn and Ginsberg, but eventually only

Crohn was recognized for describing the condition. Always making sure that credit was shared.

Most remarkable in those final days was his reminder to be honest. He recollected a time in his early practice when a physician offered patients hope with a charlatan therapy. Integrity was his hallmark.

After reminiscing for some time, Franz recalled an epiphany he had during the war. He promised himself that he would never get ahead at the expense of another person. “As I look back, I worked hard and I never hurt anybody in the process. I never did anything I have to be ashamed of. I never expected anyone to donate anything to me or do anything for me. I knew that if I wanted to make a new life, I’d have to do it for myself. I hope I helped a few people along the way.” We know he changed the lives of thousands, and often took on cases when others had given up.

Last November, I said goodbye to my dear friend and mentor, and the Jefferson community lost a shining star. Franz Goldstein was brilliant, refined and humble. Grateful for his new life, he devoted his time, talent and energy to the art of healing. It was painful to look back so he focused on the future. In fact, it wasn’t until I read his death notice that I learned his sister’s name was Marianne.

Marianne T. Ritchie, MD ’80 President, JMC Alumni Association

SPRING 2014 27

continued from page 25 Arnold, Md., and enjoys spending time with his two grandchildren.

Robert E. Steward, Jr., lives in Philipsburg, Pa., and continues to practice general surgery at Clearfield Hospital in Clearfield, Pa.

’73

Paul A. Bialas was honored by the Pennsylvania Chapter of the American College of Physicians with the Laureate Award at the organization’s annual dinner in Hershey, Pa., in December 2013.

The ACP’s highest honor, the award recognizes senior fellows for excellence and peer approval in the field of internal medicine.

Bialas holds dual appointments as clinical professor of medicine and clinical professor of family and community medicine at Penn State. He is an adjunct clinical professor of medicine at Lake Erie College of Medicine, where he teaches part time along with his wife, Deborah, a certified registered nurse practitioner.

They practice general internal medicine together in Warren, Pa.

’74

Joel C. Rosenfeld is professor of surgery at Temple University School of Medicine and senior associate dean for the Temple/St. Luke’s regional medical school in Bethlehem, Pa.

’76

John S. Liggett, Jr., is “semiretired and loving it” after many years as a pediatric pulmonologist and hospitalist. He lives in Lima, Ohio, and sends his warmest regards to his JMC classmates.

’77

Stanley P. Solinsky retired in February 2014 after 30 years of full-time ob-gyn practice in New London, Conn. He looks forward to relaxing and playing with his grandchildren and says he will miss some aspects of working in medicine, “but not the stress.”

’79

Robert S. Djergaian is medical director at Banner Good Samaritan Rehabilitation Institute in Phoenix, where he lives.

Sandra Willingmyre writes that she enjoys working at the VA in South Tucson, Ariz.

’83

Richard J. Greco is part owner and consultant for TouchMD, a touchscreen patient education system. He lives in Savannah, Ga.

’84

Evan Y. Liu graduated from the Widener University School of Law in 2006 and is an attorney at Feldman Shepherd in Philadelphia. He has been named a “SuperLawyers Rising Star” by Thomson Reuters since 2011.

’85

David S. Seres received the 2014 Excellence in Nutrition Education Award from the American Society for Nutrition in recognition of his work as a nutrition advocate and educator for more than 25 years.

In addition to clinical duties as director of medical nutrition at New York Presbyterian Hospital, Seres is an associate professor of medicine and directs the nutrition curriculum for the Columbia University College of Physicians and Surgeons, gives monthly talks to clinical staff of the surgical intensive care unit and provides annual lectures to the medical and surgical house staff on proper use and evaluation of nutrition in patient care. He also regularly lectures in local, national, and international venues. Seres lives in New York City.

’86

Andrew R. Bradbury is a colonel in the Idaho National Guard and a scout master in his church. He lives in Rexburg, Idaho, and is medical director of student health services at Brigham Young University-Idaho.

Hans M. Haupt has been director of cardiothoracic surgery at Phoenixville Hospital in Phoenixville, Pa., for 10 years and is a faculty member in the University of Pennsylvania’s Department of Surgery. He lives in Bryn Mawr, Pa., and has three children, Grace, Lily and Henry.

Jane A. Weida has been elected 2014 president of the American Academy of Family Physicians Foundation. She also serves on the steering committee for the second “Future of Family Medicine Project,” sponsored by the seven national family medicine organizations to examine the challenges and opportunities facing family medicine today and define a path forward in the changing U.S. healthcare landscape. Weida lives in Lititz, Pa.

’87

Michael L. Cohan lives in Chicago and continues to work in the same multispecialty practice he has been part of for 20 years. He recently helped to build a new dialysis center in Villa Park, Ill., and serves as the facility’s medical director.

’88

Christine Gerber received the 2013 Lewis Blackman Award from the South Carolina Hospital Association, which is the highest honor the state confers on its physicians. Gerber and her practice partner were honored for their work in the birthing programs where they practice — Georgetown Hospital in Georgetown, S.C., and Waccamaw Community Hospital in Murrells Inlet, S.C. Their accomplishments have included leading the adoption of protocols that resulted in a decrease in the number of preterm deliveries and increases in the number of breastfed babies.

Gerber lives in Pawleys Island, S.C., with her husband, Randy, and son, Christopher.

’89

William V. Harrer III lives in Lecanto, Fla., and is chief of

staff at Seven Rivers Regional Medical Center.

’91

Pamela Tecce Johnson recently was appointed associate program director of the radiology residency at Johns Hopkins Hospital.

Johnson lives in Baltimore.

Howard S. Pittle and his wife, Naomi, keep busy in Pittsburgh with their children, Harrison and Merritt. Pittle’s family practice includes visits at personal care facilities and several nursing homes, for one of which he serves as medical director.

’07

David Anderson completed his orthopaedic residency at Jefferson and the Rothman Institute in 2012 and his fellowship in spine surgery at the Cleveland Clinic in 2013. He joined OrthoCarolina in Charlotte, N.C., as an attending spine surgeon in August 2013 and married his wife, Rebecca, two months later.

Post-Graduate ’72

Terren M. Himelfarb is still in solo urological practice and has four granddaughters. He lives in Baltimore and writes that his entire family is doing well.

’88

Michael and Paula Giudici have both taken academic positions at the University of Iowa. Michael is professor of medicine and director of arrhythmia services in the Division of Cardiology, and Paula is associate professor of dermatology. They live in Iowa City.

’91 Frederick D. Ayers lives in Allendale, N.J., and has been director of ultrasound at Bergen Community College for 17 years.

28 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN

Alumnus Profile 10 Questions with . . .

Steven A. Katz, MD ’84 In 1988, months following the birth of their second son, Seth, Steven Katz, MD ’84, and his wife, Sharon, noticed he wasn’t developing like his older brother. His movements were jerky. He was growing at a slower pace. He wasn’t making noises.

Two years of appointments with pediatricians and neurologists followed and finally led to a diagnosis when Seth was 3 years old. A genetic test revealed he had Angelman syndrome.

Named after a British pediatrician who first described it in 1965, Angelman syndrome is a neurogenetic disorder characterized by developmental delay, lack of speech, seizures, walking and balance disorders, frequent smiling and a happy demeanor.

Katz, an emergency medicine physician for EmCare, a national staffing agency, saw two ways he could react to the diagnosis.

“I realized this could stymie me or I could embrace it and do everything I could to make a difference. So I got involved. I used the fact that I had a career with unconventional hours to my advantage. I realized that medicine was a means to an end,” he said.

Since 1997, Katz has served as an officer or director with the Angleman Syndrome Foundation (ASF). The Foundation recognized him in 2007 with the Harry and Audrey Angelman Award. In 2008, he received EmCare’s highest clinician award, the Commitment to Care Award, for his work with the ASF. Research funded by the ASF has hit several milestones in the past 15 years. Scientists have isolated the Angelman syndrome gene (Ube3a) on chromosome 15. DNA methylation testing and increased awareness have led to children being diagnosed at an earlier age. Still, though, about half of children are initially misdiagnosed with cerebral palsy or autism.

“You used to see kids have such physical disability.

Now diagnoses can be made earlier. They can get early intervention services, and there is tremendous improvement in their development. Using iPads, children can learn to communicate and are much more functional than even 10 years ago.”

Several clinical trials are ongoing to understand the Ube3a gene and to develop effective therapies to improve the lives of people like Seth. Katz is hopeful the work will ultimately lead to an end of Angelman syndrome.

“With all of the technology in genetics, I’m optimistic we are going to find a cure,” he said.

Read more about the disorder at www.angelman.org

1. W hen you were 5, what did you want to be when

you grew up?

I wanted to be a pediatrician. A distant cousin (now well into his late 80s or early 90s) was my pediatrician and my role model. I thought he had the coolest job. He took care of people and had the knowledge and expertise to make you at ease with your care and knew all of the tricks to examine children. It took until I went through medical school until I realized pediatrics wasn’t for me.

2. W hat drew you to your specialty?

It is one of the few specialties in medicine through which you can get the instant gratification that comes with making a difference in someone’s life. In addition, you don’t need to advertise for patients — they come regardless of the time, day or night. Finally, I was attracted to the lifestyle of working specified hours with down time when you weren’t on call.

3. W hat don’t people know about your field that you

wish they did know?

I always say about emergency medicine that it is rote repetition 98 percent of the time with sheer, adrenalinerush terror the other 2 percent of the time.

4. What advice would you give to your 25-year-old self?

When I was 25, I had already been through the Penn State/ Jefferson program. I was already a resident, married, with a baby on the way. I would probably tell my 25-yearold self that this is going to be a long haul. Stay the course, and there will be rewards, both personally and professionally, in the end.

5. What is your biggest pet peeve?

Emergency medicine is a team effort. From the physicians to the nurses to the techs and other support staff, everyone has an important role in the patients’ care and their emergency department experience. My greatest pet peeve is when people don’t pull their weight. The least little lackadaisical attitude could mean life or death or it could sour the patient on the entire effort. In this era of microscopic scrutiny to patient satisfaction in the ED, everyone needs to put forth 100 percent when they are doing patient care. I always say nobody wakes up in the morning and says “I feel like going to the emergency department and spend four to six hours of my day.” So it behooves us to make the experience as smooth as possible for every single patient.

SPRING WINTER 2014 2014

29

Photo by Je rey Leeser

6. What is the biggest challenge in your

eld?

I think in 2014, the biggest challenge is the external metrics that are imposed on emergency physicians.

My door-to-doctor and throughput times are routinely measured and compared to averages. This cuts down on the personalized care patients deserve in the ED. Someone can always do it faster or cheaper and hospitals are using this as a tool to cut their overhead, I feel to the detriment to patient care.

7.

If you had a theme song, what would it be?

I am a self-described “deadhead.” So I think my theme song would be the song “The Wheel” by the Grateful Dead.

Basically the lyrics read in part “the wheel keeps turning and you can’t slow down, you can’t let go and you can’t hold on, you can’t go back and you can’t stand still.” That’s how I try to live my life — always moving forward.

8. What is your highest priority for the coming years?

As cliché as it is to say, my highest priority for the next ve years is to transition out of medicine into life after medicine. My career has been very good to me, but the increasing oversight and decreasing time for patient interaction has made it tougher and tougher for me to do my job.

In addition, the hours and time commitments have made it into a younger man’s eld.

9.

10.

What is the best decision you ever made?

While I was at Je erson, my roommate Jonathan Daitch, MD ’84, threw a party in Shawnee, Pa., where he introduced me to Sharon. The best decision I ever made was to marry her.

To me, family and family time are everything. My decision to get married preceded my decision to pursue a career in emergency medicine by days. I felt as if everything was falling into order, and I have never regretted a moment of it more than 30 years later.

Who is your personal hero and why?

My personal hero is my son Seth. He lives his life so simply.

He is happy all of the time. I can honestly say that I have seen him cry only a handful of times in over 25 years, and he is never sad. He lives his life to the fullest every day, and I truly believe that he doesn’t have a care in the world. That being said, I am doing everything in my power to make his life as good for him as humanly possible.

— Stacey Miller

30 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN

InMemoriam ’42

Arthur Steitz, 98, died Dec. 15, 2013, in Burlington County, N.J. A World War II veteran and family physician, Steitz had a 45-year career that included everything from house calls to emergency medicine. In 1947, he opened a family practice in Mount Holly, N.J., where he saw patients for $1.50 a visit and made $2 house calls that included delivering babies. In 1964, he became one of the founders of the Department of Family Practice at Memorial Hospital of Burlington County, now Virtua Memorial Hospital.

Nine years later, he went into emergency medicine and eventually landed in Southern Ocean County, N.J., near his summer home in Harvey Cedars, Long Beach Island. He was a competitive sailor, racing lightning boats with his family at Barnegat Light Yacht Club, where he served as 25th Commodore in 1960. He also was an avid bird-watcher who traveled to the Amazon River and Papua, New Guinea, for sightings with his wife, Marion, who predeceased him in 2011 after 69 years of marriage. Steitz is survived by a daughter, Constance; a son, J. Arthur; a sister, Elizabeth; and 10 grandchildren and greatgrandchildren. Another daughter, Maryann, died in 1990.

’44 William G. Johnson, of Venice, Fla., died Aug. 31, 2013. Johnson enrolled at JMC in 1941 and after Pearl Harbor was inducted into the U.S. Army Specialized Training Program. He served an internship at Atlantic City General Hospital before becoming a regular Army physician and served from 1944 to 1947 at Fort Sam Houston in San Antonio, Texas, and at Fort

Knox, Ky. He was honorably discharged as a captain in 1947 and completed a three-year residency in radiology at Jefferson. He began working as chief of radiology at Easton Hospital in 1951 and remained there for the rest of his career.

Johnson is survived by his wife of 69 years, Victoria, and two sons, Michael and Jeffrey.

He was predeceased by his daughter, Gail.

’49 Roy Korson, 90, died Aug. 24, 2013, in Shelburne, Vt. Korson completed his pathology residency at Mary Fletcher Hospital in Burlington, Vt. He served in the U.S. Army Medical Corps during the Korean War before dedicating his career to clinical pathology at Fletcher Allen Hospital and teaching at the University of Vermont College of Medicine (UVM).

He was a research fellow in the U.S. Public Health Service at Columbia University and UVM and was the recipient of a Research Cancer Career Development Award. He was also a visiting scientist at the Postgraduate Medical School in London. His interest in the basic mechanisms of carcinogenesis led to many publications as well as involvement with the Vermont Division of the American Cancer Society, for which he served two terms as president, and also his membership in the ACS National Board of Directors.

Korson received many teaching awards, including two “Teacher of the Year” awards at UVM. In 2012, he and his wife, Lorraine, established the Roy and Lorraine Korson Green and Gold Professorship in the Department of Pathology at UVM. Korson served for many years as treasurer of the medical staff at

Fletcher Allen Health Care.

Korson is survived by his wife; sister, Ruth; brother, Donald; and several nieces and nephews.

’52 Matthew G. Brown, 85, died Dec. 8, 2011, in Winchester, Va. For 47 years, Brown was a family physician with a solo practice in Sharon, Pa. An attending physician at Sharon Regional Health System, he served as president of its medical staff.

In 1973, he became a Charter Fellow of the American Academy of Family Physicians. He was certified by the American Board of Family Practice every six years up to 2003. A longtime member of the American Medical Joggers Association, he competed in 216 distance races and completed 49 marathons including eight Boston Marathons. Brown is survived by his wife, Ruth, and their four children and six grandchildren.

His father, Walter E. Brown, MD, also graduated from JMC.

’54 John Melvin Patterson, 87, died Aug. 20, 2013, in Tupelo, Miss. Patterson completed an internship at Baptist Memorial Hospital in Memphis, Tenn., before moving to Pontotoc, Miss., where he practiced in the same office for his entire 48-year career. He began practicing during a time when it wasn't unusual for patients to have the same physician from birth to death and made house calls, set broken bones, performed appendectomies and delivered babies.

He was named Mississippi's Family Physician of the Year in 1992. Patterson served as chief of staff at Pontotoc Community Hospital and was a member of the courtesy staff of North Mississippi Medical Center.

He was on the board of the University of Mississippi Medical Center; district director of the Mississippi Academy of Family Physicians; and president of the Family Health Foundation of Mississippi. He had a brief career in the theater, playing the role of the doctor in the final scene of “Arsenic and Old Lace” at Pontotoc Community Theater in 2008. He is survived by his sister, Dot; daughters, Claire, Mary and Patti; and grandchildren, Alyson, Robert, Raynor, Brennan, Rena, John Michael and Anna. He was preceded in death by his wife, Maxine, and a sister, Helon.

Lewis P. Scott III, 86, died May 16, 2013, in Gaithersburg, Md. Scott served in the U.S. Naval Medical Corps from 1954 to 1956 and was a pediatric cardiologist at Children’s Hospital in Washington, D.C., from 1964 until his retirement in 1992. He is survived by his wife, Ethel; twin sister, Emily; four children; 14 grandchildren; and two great-grandchildren.

’56 Wallace T. Miller, Sr., 81, of Philadelphia, died of metastatic lymphoma June 23, 2013. Miller was a clinical radiologist and teacher during the half-century he served on the staff of the Hospital of the University of Pennsylvania. He took top honors in his field, including the 1997 Gold Medal Award from the Radiological Society of North America. He was the first recipient of the I.S. Ravdin Award, which recognizes outstanding clinicians at HUP. His former residents established a scholarship in his name at Penn, and a chair of radiology was created in his name. Miller served an internship at City Hospital in Akron, Ohio, before

SPRING 2014 31

becoming a radiological resident at HUP. Finishing his residency in 1960, he was a member of the HUP staff for a year before serving for two years in the U.S. Navy at the Naval Hospital in Portsmouth, Va. He then returned to HUP, where he practiced until retiring in 2012. He held various positions in radiology, including department vice chairman and chief of the chest division. In 1972, he became a professor of radiology in the School of Medicine. He was a member of various medical societies and national committees as well as the author of three medical textbooks and 20 textbook chapters.

His 130 published papers include several that are considered seminal works in diagnostic radiology. He is survived by his wife of 56 years, Betty; two sons, a daughter; 10 grandchildren; and one great-grandchild.

’57 John R. Prehatny, 82, of Wynnewood, Pa., died Feb. 1, 2014. A longtime professor of surgery at Jefferson, Prehatny served as a mentor to many residents and students. He completed an internship in surgery at Methodist Hospital and a residency at JMC and later served as chief resident at Philadelphia General Hospital.

During 49 years of practice beginning in 1964, Prehatny rose from instructor in surgery at the University of Pennsylvania School of Medicine to chairman of the Department of Surgery at Methodist. From 1978 to 1997, he was clinical professor of surgery at Jefferson before being named emeritus professor. In 2004, he became an adjunct professor at Drexel University College of Medicine. Prehatny received many honors, including an award from Drexel College of

Medicine for excellence in teaching in September 2013.

On the day he died, he taught a group of medical students gathered around his hospital bed at Jefferson. He is survived by his wife of 58 years, Helene; five children, Charlene, John, Linda, Lorraine and Barbara; 21 grandchildren; three greatgrandchildren; and two sisters, Martha and Irene.

’58 Jerome L. Sandler, 80, died Sept. 12, 2013, at home in Potomac, Md. Sandler served his internship and surgical residency at Jefferson. Shortly after opening his practice, he joined the U.S. Army and served as a military surgeon for two years. He was a past chairman of the surgery departments at Prince George’s General Hospital and Shady Grove Adventist Hospital in Rockville, Md., and specialized in diseases including breast cancer.

He helped develop the cancer committee at Shady Grove. He was a former president of the Washington Academy of Surgery.

He belonged to the Washington Hebrew Congregation. With his family, Sandler helped raise more than $3.5 million for pulmonary fibrosis research; his daughter Lisa died from the disease in 2007. He is survived by his wife of 56 years, Froma; two children, Glenn and Lauren; a brother, Steven C. Sandler, MD ’65; and five grandchildren.

’59 David Meckler, of Akron, Ohio, died June 21, 2013. Meckler served an internship at City Hospital and a residency program at Children's Hospital in Akron, Ohio. After his residency, Meckler and his family moved to Bunker Hill Air Force Base in Peru, Indiana, where he served

James F. Burke, Jr., MD ’66, Longtime Jefferson Faculty Member James F. Burke, Jr., MD ’66, of Jenkintown, Pa., died March 10, 2014. Past chief of the Division of Nephrology at Jefferson and the first Beatrice F. Nicoletti Professor of Nephrology, Burke spent virtually his entire career at Jefferson. He obtained his degree from JMC in 1966, interned at Thomas Jefferson University Hospital and then returned for his residency in medicine and fellowship in nephrology after two years in the U.S. Navy.

As an intern, he had the “great fortune” of meeting Norman Lasker, MD, director of the dialysis unit. Lasker’s charisma, skill and passion infused Burke, leading him to choose nephrology as his specialty – a “decision I never regretted,” he often said.

When he finished his fellowship, Burke joined Lasker as associate director of the dialysis unit. In 1982, Burke became director of dialysis and transplant services while serving as director of the acute dialysis unit. He became acting director of the Division of Nephrology in 1989 and director three years later. He left the position in 2006 but returned to the division soon after.

Burke’s clinical research focused on the medical management of renal transplant patients but he also held a keen interest in hypertension, renal failure and the kidney disease glomerulonephritis. In 1994, he radically changed the treatment regimen for kidney transplant patients with an article in the New England Journal of Medicine; the research showed that patients needed far less of the immunosuppressive drug cyclosporine A than physicians normally prescribed.

Burke retired in June 2011 to pursue his passions for travel and golf. He and his wife, Diane, explored all seven continents together. In addition to Diane, he is survived by two daughters, Laura and Jennifer; two sons, Dylan and James; seven siblings; and seven grandchildren.

32 JEFFERSON MEDICAL COLLEGE ALUMNI BULLETIN

Franklin J. Chinn, Sr., MD ’52; his wife, Lily; and two of their children, Bertram (MD ’87) and Rebecca (MD ’93) attended Jefferson’s annual scholarship dinner in 2011 to meet Aileen Butera, a JMC student and beneficiary of the Franklin J. Chinn, MD ’52, and Lily L. Chinn Scholarship Fund.

Franklin J. Chinn, Sr., MD ’52 Franklin J. Chinn, Sr., 88, of Carmichael, Calif., died March 10, 2014. Following a tour of military duty as a flight surgeon, Chinn returned to his hometown of Sacramento, where he practiced family medicine for 59 years. He was on staff and served on various medical committees at Mercy Hospital and Sutter Community Hospitals. He also was a volunteer clinical professor of family medicine at the UC Davis School of Medicine.

Chinn remained active in the JMC community for his entire life, including attending the annual CME skip trip in Lake Tahoe in February 2014, just weeks before his death. In 2010, his five children — three of whom are JMC alumni — established the Franklin J. Chinn, MD ’52, and Lily L. Chinn Scholarship Fund, one of the largest scholarships in JMC’s history.

Chinn is survived by his wife of 59 years, Lily; three sons, Franklin Jr., MD ’82; Bertram, MD ’87; and Norman; two daughters, Susan, MD; and Rebecca, MD ’93; nine grandchildren, Courtney, Marissa, Franklin III, Nathaniel, Lily, Lauren, Helen, Norah and Abigail; two sisters, Florence and Carolyn; one brother, Holland; and many nieces, nephews, grandnieces, grandnephews, great-grandnieces and greatgrandnephews. He was preceded in death by his parents and three brothers, Allen, Leland and Gallant.

as the only pediatrician to 3,000 children of Air Force personnel at the base. He received a medal for providing meritorious service and superior medical care. After being honorably discharged, Meckler and his family moved back to Ohio and he joined the staff of the Children's Medical Group of Akron. He also served on the staff of Akron Children's Hospital. He retired from Children's Medical Group in August 2005 after 41 years and found a new hobby as a gourmet chef. He also was an avid reader and a crossword puzzle expert.

He is survived by his wife, Nancy; two sons, Robert and Steven; two daughters, Kathryn and Amy; and seven grandchildren, Tyler, Nathan, Sarah, Ben, Lily, Karli and Griffin.

’64 Joseph R. Mariotti, 82, of Pinole, Calif., died Oct. 5, 2013.

Mariotti served in the U.S. Army from 1953 to 1955. After completing a residency in orthopaedics in Miami, he moved his family to the small, rural town of Pinole and started his 35-year medical practice in San Pablo, Calif., at Brookside Medical Center. He volunteered as team physician for Pinole Valley High School for 32 years. Mariotti co-founded the Pinole Historical Society and was an environmentalist and conservationist, serving on the Save Contra Costa Shoreline Committee, Hercules Environmental Resources Committee, Urban Creek Council, East Bay Regional Parks Advisory Committee, Contra Costa County Plastic Recycling Advisory Committee, Coastal Clean-Up, West Contra Costa Environmental Education Committee, Friends of Pinole Creek Watershed and Contra Costa County Historical Landmarks Advisory Committee.

He also served on the Pinole City Council and the Pinole Planning Commission. He founded the Pinole-Sudan Relief Organization, visited Ethiopian refugee camps in 1985 and traveled to Bhutan in 1993 to work as the only orthopaedic surgeon for the remote Himalayan country for a month.

Mariotti loved to travel and with his family visited more than 40 countries, many by bicycle. He founded the Pinole-Shaoxing (China) Friendship Committee and over the years, he and his wife, Gretchen, housed more than a dozen foreign exchange students at their home. Mariotti was predeceased by his wife. He is survived by his children, Cari, Paul, Melinda and Eric, MD ’93; and grandchildren, Rachel, Rebecca, Brett, Davis, Maxton and Aidan, who fondly referred to him as Grampy (and often Grumpy).

’95 Lawrence James Hyland, 56, of Essexville, Mich., died of cancer Nov. 29, 2013. Hyland was a pathologist who completed residencies at the Hospital of the University of Virginia, Temple University Hospital and Jefferson. He served his community at Bay Pathology and Flint Pathology in Michigan. Hyland enjoyed spending time at his cottage in Tawas, Mich., as well as at the Jersey Shore. He had a passion for lacrosse and was instrumental in bringing lacrosse to the Bay City area. He is survived by his wife of 26 years, Susan; four children, Elizabeth, David, Rachel and John; his mother, Marie; six brothers, Steven, Timothy, Daniel, Christopher, Michael and James; and many nieces and nephews.

WINTER 2014 33

THE

By Numbers Match Day 2014 • • • On March 21, 245 fourth-year Jefferson Medical College students celebrated Match Day and learned where they will perform their residency training.

“This is one of those landmark days in your lives — you open an envelope to see your next vista,” JMC Dean Mark Tykocinski, MD, said. “Whether you are thrilled or not with your match, remember it is but one fork in a career road that has many forks in it.”

Here is a list of JMC's 2014 graduating student matches.

Speciality

*Matches

Speciality

*Matches

Internal Medicine (Categorical)

56

Neurology

4

Family Medicine

28

Otolaryngology

4

Pediatrics

20

Pathology

4

Emergency Medicine

18

Medicine (Preliminary)

3

Anesthesiology

15

Surgery (Preliminary)

3

Orthopaedic Surgery

15

Dermatology

2

Obstetrics/Gynecology

12

Neurosurgery

2

Ophthalmology

12

Physical Medicine & Rehab

2

Surgery (Categorical)

11

1

Radiology-Diagnostic

9

Family Medicine/ Psychiatry Combined

Urology

7

Medicine/Emergency 1 Medicine Combined

Psychiatry

6

Pediatric Neurology

Medicine/Pediatrics Combined

4 *Number of students with known residency plans as of March 2014.

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