Medicine on the Midway - Spring 2019

SPRING 2019

THE UNIVERSITY OF CHICAGO BIOLOGICAL SCIENCES DIVISION

Lifesaving advances

How UChicago Medicine’s revitalized transplantation program is expanding the pool of donors and recipients

Dear Colleagues,

L

Dean’s Letter

ast month, we hosted the exclusive Chicago screening of “Burden of Genius,” a documentary on the life of surgeon Thomas Starzl, MD, PhD, the “father of modern transplantation.” The compelling film features

our own John Fung, PhD’80, MD’82, who trained under Dr. Starzl and is now

Our faculty have been advancing medicine and pushing the

co-director of the University of Chicago Medicine Transplantation Institute.

Joining John in a panel discussion before the film were UChicago Medicine surgeons on the teams that completed two back-to-back heart, liver and kidney transplants in December.

As many of you know, the University of Chicago has a long and storied

boundaries of patient

history in medical breakthroughs. From finding a way to preserve blood to

care for generations.

discovering REM sleep to helping develop CAR T-cell therapy, our faculty have been advancing medicine for generations. Organ transplantation is no exception, since the field was born here more than a century ago. In this issue’s cover story, science writer Matt Wood traces advances over several decades leading up to today’s revitalized transplantation program. The story examines the unique combination of talent, resources and a culture of pushing the boundaries of patient care that made the two triple-organ transplants possible.

At the same time, it looks ahead to the future and how our Transplantation Institute aims to make these lifesaving procedures available to more patients.

It’s been just over a year since UChicago Medicine launched adult trauma care. The public health crisis of intentional violence and its traumatic aftereffects requires innovative approaches that knit together the strengths and resources of institutions, individuals and community-based organizations alike.

A $9.1 million gift from the Ellen & Robert Block Family Foundation and the Hassenfeld Family Foundation will support wraparound services and programs to help children and their families who have been critically injured or exposed to violence. The gift will integrate and expand clinical and community services under the Block Hassenfeld Casdin (BHC) Collaborative for Family Resilience.

We are most grateful for this generous gift and for the new opportunities offered by the BHC Collaborative to significantly expand trauma recovery programs and further strengthen the network of care and services on Chicago’s

Kenneth S. Polonsky, MD The Richard T. Crane Distinguished Service Professor Dean of the Biological Sciences Division and the Pritzker School of Medicine Executive Vice President for Medical Affairs The University of Chicago

South Side. The story is on Page 3.

Also in this issue, writer Stephan Benzkofer interviews Brian Callender, AB’97, AM’98, MD’04, about graphic medicine — the use of comics in patient care and medical education. The medium is gaining popularity not only as a tool for telling stories about what happens in medicine, but as a vibrant field of study. Indeed, the University library has an extensive graphic medicine collection. The story takes readers inside Callender’s course on graphic medicine for UChicago undergraduates.

You’ll also read about Biological Sciences Division researchers working on projects connecting parts of the brain to areas of the body where function has been lost, the nation’s first exascale computer coming to Argonne National Laboratory and our efforts to foster resilience in medical residents and prevent physician burnout.

As always, I hope you find this issue interesting and inspiring.

IN THIS ISSUE

C OV E R S T O R Y

Revitalizing transplantation

Spring 2019 Volume 72, No. 1 A publication of the University of Chicago Medicine and Biological Sciences Division.

Medicine on the Midway is published for friends, alumni and faculty of the University of Chicago Medicine, Biological Sciences Division and the Pritzker School of Medicine.

Under the direction of John Fung, PhD’80, MD’82, the Transplantation Institute at the University of Chicago Medicine consolidates surgical and medical transplant specialists into one unit. In December 2018, the team performed two triple-organ transplants in less than two days, bringing international attention to the organ transplant program. Learn how Fung and his colleagues are pushing the boundaries on these lifesaving procedures and building on the institution’s rich history of breakthroughs in transplantation.

Email us at momedit@uchospitals.edu Write us at Editor, Medicine on the Midway The University of Chicago Medicine 950 E. 61st St., WSSC 325 Chicago, IL 60637 The University of Chicago Pritzker School of Medicine and Biological Sciences Executive Leadership Kenneth S. Polonsky, MD, the Richard T. Crane Distinguished Service Professor, Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and Executive Vice President for Medical Affairs for the University of Chicago

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John Fung, PhD’80, MD’82

T. Conrad Gilliam, PhD, the Marjorie I. and Bernard A. Mitchell Distinguished Service Professor, Dean for Basic Science, Biological Sciences Division Sharon O’Keefe, President of the University of Chicago Medical Center Halina Brukner, MD, Interim Dean for Medical Education, Pritzker School of Medicine Editorial Committee Chair Jeanne Farnan, AB’98, MD’02, MHPE Chris Albanis, AB¡¡’96, MD¡¡’00 Lampis Anagnostopoulos, SB¡¡’57, MD¡¡’61 Arnold Calica, SM¡¡’61, MD¡¡’75 J. Palmer Greene, MS4 Rob Mitchum, PhD’07 Matt Present, MS4 David J. Press Jerrold Seckler, MD¡¡’68 Coleman Seskind, AB¡¡’55, SB¡¡’56, SM/MD¡¡’59 Alexandra Smith Jack Stockert, AB¡¡’05, MBA¡¡’10, MD¡¡’10 University of Chicago Medicine Marketing and Communications William “Skip” Hidlay, Senior Vice President, Chief Communications and Marketing Officer Anna Madrzyk, Editor Gretchen Rubin, Associate Editor Editorial Contributors Nancy Averett Emily Ayshford Stephan Benzkofer Kate Dohner John Easton Ashley Heher Bethany Hubbard Photo Contributors Benjamin Bitton Andy Goodwin Rob Hart Jean Lachat Medicine & Biological Sciences Alumni Association Pritzker School of Medicine Eddie Quinones Jason Smith Design Wilkinson Design

Ellen McGrew Rob Mitchum Angela Wells O’Connor Colleen Radzevich Gretchen Rubin Matt Wood Special Collections Research Center, University of Chicago Library Joe Sterbenc University of Chicago Photographic Archive Joel Wintermantle Nancy Wong

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26

A visual prosthetic system under development uses implants that stimulate the visual cortex.

F E AT U R E S

14 D E PA R T M E N T S

Pursuing his passion 13

From care to cures 21

Pharma CEO Jeffrey Leiden, AB’75, PhD’79, MD’81, focuses on transforming scientific advances into new therapies.

A gift from the storied Chicago Home for Incurables supports medical research at UChicago Medicine.

Drawing on experience 14

Mindful medicine 24

Graphic medicine empowers patients, medical students and physicians to tell personal stories about illness, health and caregiving through comics.

Wellness programming and other initiatives aim to prevent resident burnout.

Midway News

Pritzker News

Most powerful supercomputer in U.S. coming to Argonne 4

Four students who took unconventional paths to medical school 30

Pritzker retains high rankings from U.S. News & World Report 5

Match Day 2019 32

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BSD News Brain-computer interface may restore lost function 26 Scientists discover the first fossil of a hagfish 29 Researcher explores “the wild side of cities” on web series 29

M4s Saket Kumar, left, Olufemi Adams and Suellen Li meet their matches.

Your News 38 In Memoriam 39 1

U N I V E R S I T Y O F C H I C AG O M E D I C I N E

Midway News

UChicago Medicine trauma center reduces access disparities

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frican Americans in major U.S. cities are significantly more likely to live in “trauma deserts” with limited access to advanced emergency medical care, according to new research from the University of Chicago Medicine. The study, published in March in JAMA Network Open, also shows the medical center’s new Level 1 Adult Trauma Center led to a sevenfold reduction in Chicago’s access disparity.

The findings are the first to be released about the impact of UChicago Medicine’s adult trauma services, which started in May 2018.

“So much of the advocacy for the trauma center was framed in terms of racial equity,” said Elizabeth Tung, MD, SM’17, a primary care physician at UChicago Medicine and the paper’s first author.

“But we realized no previous studies had addressed trauma access through the lens of race/ethnicity — not just looking at Chicago, but comparing our city to other communities as well.”

PHOTOS BY ROB HART

BY ASHLEY HEHER

The University of Chicago Medicine’s new adult emergency department opened in December 2017, ahead of the launch of adult trauma services.

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The research team examined access to trauma care in Chicago, New York and Los Angeles using a geospatial analysis that compared the location of designated trauma centers with the racial and ethnic composition of the cities’ census tracts. The project included only Level 1 and Level 2 Trauma Centers.

Using a standard established in previous research from colleagues at other hospitals, the team defined a “trauma desert” as any urban community that is at least 5 miles away from advanced trauma care.

While many suburban and rural communities are

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

significantly farther away from trauma care, Tung said dense urban communities must be assessed differently.

“Five miles in a rural area is probably five minutes away, but in an urban area that same distance could be 15 minutes or it could be two hours away — it entirely depends on traffic congestion,” Tung said. “The kind of care in urban trauma also differs from that in rural areas — the types of trauma are generally different, the patient volume is higher and the injuries are more severe.”

More than 3,000 trauma patients have been treated since UChicago Medicine launched adult trauma services in May 2018.

In Chicago, the team found that 73 percent of census tracts with a mostly black population were located in trauma deserts. Until UChicago Medicine’s adult trauma center opened, residents of those communities had 8.5 times higher odds of being farther away from trauma care than people living in the city’s white-majority census tracts. The new trauma center reduced this disparity nearly sevenfold, to 1.6 times.

UChicago Medicine has provided pediatric trauma care at Comer Children’s Hospital since 1990; it ended its adult trauma program in 1988 and announced in 2015 that it would resume the service in response to community needs.

The researchers said they hope their findings highlight the lingering impact of structural inequality in U.S. cities. They said planning for new trauma centers, which require a significant financial investment, should include an assessment of how a new facility can help address racial equity.

UChicago co-authors on the study — Racial and Ethnic Disparities in Geographic Access to Trauma Care: A Multiple Methods Study of U.S. Urban Trauma Centers — include Tung; Selwyn Rogers Jr., MD, MPH, director of the trauma center; Monica Peek, MD, MPH, health disparities researcher; David A. Hampton, MD, trauma surgeon; and Marynia Kolak, PhD, MS, from the Center for Spatial Data Science.

Gift supports resilience collaborative for children and families who suffer trauma

COMMUNITY BENEFIT 2018 Annual Report

The University of Chicago Medicine provided more than $477 million in benefits and services to the community in fiscal 2018.

This investment included support for uncompensated care, medical education and medical research, as well as contributions to community groups for health-related activities.

Read more about the programs and partnerships that are promoting health equity and improving health and wellness on Chicago’s South Side in our 2018 Community Benefit Annual Report at uchicagomedicine. org/community.

A unique approach that provides trauma-informed

care for children and their families who are critically injured or exposed to violence on Chicago’s South Side is getting a big boost, thanks to a $9.1 million gift by the Ellen & Ronald Block Family Foundation and the Hassenfeld Family Foundation.

The gift will integrate and expand clinical and community services under the Block Hassenfeld Casdin (BHC) Collaborative for Family Resilience to help young patients and their families recover from the immediate and long-lasting effects of trauma caused by gun, domestic or sexual violence or child abuse.

The BHC Collaborative for Family Resilience is based on the premise that trauma caused by violence is best treated holistically — starting with personalized care of the child and family in the medical center, and continuing through discharge and recovery, even extending into the home, school and neighborhood — through a network of community resources.

“The genius of this program is that the community and medical center are true partners, each bringing their expertise, from working together on the initial design to making improvements along the way.

This kind of real change takes the efforts of so many people — respecting, trusting and supporting each other — and a commitment to the long term,” said Ellen Hassenfeld Block, a director of both donor philanthropies and a longtime trustee of the University of Chicago Medical Center.

The model represents a dramatic shift in trauma care: Psychosocial support is included in the emergency room, in tandem with medical care. And then, wraparound services travel with the child and family both in and beyond the hospital into the community. These may include mental-health and social-service support, health care navigation, help finding housing or child care, and much more.

PHOTO BY JOE STERBENC

BY ANGELA WELLS O’CONNOR

Ellen Hassenfeld Block is a member of the University of Chicago Medical Center Board of Trustees.

The structure was driven by the ideas and input of UChicago Medicine’s Community Advisory Council, which is made up of civic and faith-based leaders who provide guidance on key health concerns that affect residents of the South Side.

Key components involve: ■ Helping children navigate the hospital experience by providing 24/7 Child Life interventions in the UChicago Medicine Comer Children’s emergency room and support for children whose loved ones are treated at the Level 1 Adult Trauma Center.

■

■

Providing wraparound resources to support the holistic needs of children and families experiencing trauma and linking them to specialized, traumainformed counseling services, including Healing Hurt People-Chicago, a nationally recognized trauma intervention program that provides such services as group therapy and mentoring; the REACT program, which offers assessment, trauma-focused psychotherapy and medication management services for children; and other community-based social support.

Investing in community-based organizations that provide critical resources aimed at helping children, families and the community build long-term resiliency from trauma and violence.

Continuing medical education

Chicago Obesity Summit 2019

Chicago AYA Oncology Symposium

25th Annual Primary Care Orthopaedics

OBGYN Ultrasound Symposium

May 31, 2019 University of Chicago Gleacher Center 450 N. Cityfront Plaza Drive Chicago

May 31, 2019 University of Chicago Gleacher Center 450 N. Cityfront Plaza Drive Chicago

June 5–7, 2019 Millennium Knickerbocker Chicago 163 E. Walton Place Chicago

September 13–15, 2019 Hotel Chicago 333 N. Dearborn Street Chicago

DETAILS AND REGISTRATION

illinoisobesitysociety.org/ upcoming-events

cme.uchicago.edu

cme.uchicago.edu

voices.uchicago.edu/ obgynultrasound

INFORMATION

uchicagomedicine.org/midway

MEDICINE ON THE MIDWAY

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A R G O N N E N AT I O N A L L A B O R AT O R Y

Midway News

Nation’s first exascale computer coming to Argonne

BY ROB MITCHUM, PHD’07

The most powerful computer ever

PHOTO BY EDDIE QUINONES

built in the U.S. will make its home at Argonne National Laboratory in 2021.

Aurora, the United States’ first exascale computer, will combine unprecedented processing power with the growing potential of artificial intelligence to help solve the world’s most important and complex scientific challenges.

Aurora will be capable of a quintillion — or one billion billion — calculations per second, 50 times quicker than today’s most powerful supercomputers. But the impact of the system will go beyond faster and larger data processing to new frontiers of scientific inquiry, accelerating breakthroughs in cancer treatment, neuroscience and other fields.

Narayanan “Bobby” Kasthuri, MD, DPhil

Upon delivery, researchers will be able to use Aurora through the leadership computing facilities at Argonne, a U.S. Department of Energy (DOE) laboratory operated by the University of Chicago.

“The evolution of large-scale computation and the emergence of artificial intelligence as an effective

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tool are creating growing potential for transformative discoveries in many fields, including medicine, engineering and physics,” said University of Chicago President Robert J. Zimmer, PhD.

Mapping the brain, personalizing cancer treatment “Aurora will enable us to explore new frontiers in artificial intelligence and machine learning,” said Narayanan “Bobby” Kasthuri, MD, DPhil, assistant professor of neurobiology at the University of Chicago and researcher at Argonne.

Kasthuri’s research seeks to reverse engineer the mammalian brain, using powerful microscopes to photograph billions of cells and connections and supercomputers to reconstruct the brain’s intricate wiring. With such a map, scientists could ask questions about how the structure of the brain drives learning, behavior and illness, generating new therapies and insights into the nature of humanity. But a complete map of the estimated million billion connections of the human brain would be no less than the largest data set in human history, requiring extreme-scale computation to navigate.

“With the help of Aurora, I will be able to piece together millions of two-dimensional images, reconstructing the brain in three dimensions to create a map of the human brain,” Kasthuri said. “Imagine the game-changing possibilities of a resource where neuroscientists around the U.S., and ultimately around the world, utilize such technologies and infrastructure.”

The artificial intelligence capabilities of Aurora will boost a project addressing

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

another great biomedical challenge: the development of more effective, personalized treatments for cancer.

The CANcer Distributed Learning Environment (CANDLE), a DOE and National Cancer Institute collaboration, will study the relationship between key molecular pathways, clinical and preclinical drugs, and patient responses to create predictive models that enable patient-level decisions about the best therapy for each individual cancer.

“This will be the first time scientists have had a machine powerful enough to match the kind of computations the brain can do.”

Narayanan “Bobby” Kasthuri, MD, DPhil

The exascale power of Aurora will help researchers rapidly test complex models involving millions of variables, while its optimization for artificial intelligence allows machine learning to automatically select and refine the best-performing strategies.

“Devising ways of incorporating molecular and visual information to build more predictive models will help distinguish which tumors will respond to a given drug and those that won’t,” said CANDLE principal investigator Rick Stevens, PhD, professor of computer science and associate laboratory director for computing, environment and life sciences at Argonne. “With exascale computing, we have a chance to do that, and that will change the lives of millions of people.”

G R A D U AT E S C H O O L R A N K I N G S

Pritzker holds high rank in the country, tops in Illinois

T

he University of Chicago Pritzker School of Medicine retained top rankings in Illinois in U.S. News & World Report’s annual review of the country’s top medical schools. Of the 120 accredited medical schools surveyed, Pritzker placed No. 16 (up from No. 18 last year) for research and No. 18 (up from No. 39) for primary care training.

Pritzker remains the highest-ranking research and primary care medical school in the state, ahead of Northwestern University’s Feinberg School of Medicine (Nos. 19 and 35, respectively).

Among research-intensive schools, Pritzker tied with the University of Michigan-Ann Arbor and Vanderbilt University. In addition, Pritzker tied with the University of Pennsylvania, Johns

Hopkins University and the Mayo Clinic School of Medicine as the nation’s third-most-selective medical school. It ranked fourth in the country for average National Institutes of Health funding per faculty member ($312,500).

U.S. News also republished last year’s results for the nation’s 275 biological science programs, which are ranked every four years. The Biological Sciences Division’s doctoral programs tied for No. 13 with Rockefeller University and Washington University in St. Louis. The paleontology program, which draws from the Department of Organismal Biology and Anatomy and the inter-institutional Committee on Evolutionary Biology, remained the No. 1rated program in the country, as it has been for more than a decade.

The University of Chicago Pritzker School of Medicine Median total MCAT score

521 3.9

Median undergraduate GPA

SOURCE: U.S. NEWS & WORLD REPORT (2018 DATA)

It works both ways.

Required to take an IRA distribution?

Consider a contribution to UChicago.

If you own a traditional IRA and have reached the age of 70 and a half, you can make a qualified charitable distribution of up to $100,000 a year from an IRA account directly to the University. The distribution counts toward your annual IRA minimum withdrawal requirements and is effectively excluded from taxable income altogether. (Certain rules apply.)

Learn more.

Visit giftplanning.uchicago.edu/winwin Email giftplan@uchicago.edu Call 866.241.9802

uchicagomedicine.org/midway

“I find the strategy of a direct transfer to the University both fulfills my pledge contribution and minimizes my taxable income. It works.”

—Coleman Seskind, AB’55, SB’56, SM’59, MD’59

MEDICINE ON THE MIDWAY

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Getting to yes

BY MATT WOOD

How the revitalized transplant program at the University of Chicago Medicine aims to make lifesaving organ transplants available to as many patients as possible

PHOTO BY ASHLEY HEHER

Members of the transplant team with Daru Smith, one of two patients who received new hearts, livers and kidneys in back-to-back transplants in December.

From left, Michael Charlton, MBBS, co-director of the University of Chicago Medicine Transplantation Institute; Nir Uriel, MD, director of the heart failure and transplantation program; Smith; John Fung, PhD’80, MD’82, co-director of the Transplantation Institute; cardiologist Bryan Smith, MD’10; and cardiologist Gabriel Sayer, MD.

PHOTO PROVIDED BY VALLUVAN JEEVANANDAM, MD

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

an institution accustomed to historic achievements.

In a span of less than two days, surgeons completed two separate triple-organ transplants at the University of Chicago Medicine. The two 29-year-old patients, Sarah McPharlin of Grosse Pointe Woods, Michigan, and Daru Smith of Chicago, each received a heart, liver and kidney.

Smith’s surgery began at 3:07 p.m. on Dec. 19.

McPharlin’s commenced at 6:04 p.m. the next day, just 27 hours later. According to federal statistics, it was the first time a U.S. hospital had ever performed more than one of these complex procedures within one year.

“We never in our wildest dreams imagined both would take place at virtually the same time,” said John Fung, PhD’80, MD’82, a transplant surgeon and co-director of the UChicago Medicine Transplantation Institute. “Pulling this off can feel like trying to perform a high-wire ballet in the middle of running a marathon. But we were always confident in our patients as well as our team’s abilities.”

These cases are the 16th and 17th times this type of triple-organ transplant has been performed in this country — and six of those surgeries were at UChicago Medicine. No other institution in the world has performed more of these multi-organ procedures.

Perhaps no other institution has such a rich history of achievements in organ transplantation, but on the heels of two of its most extraordinary cases, the Transplantation Institute is looking to the future. With new leadership and an innovative new structure, the institute hopes to expand the range of organs and tissues it can transplant, the types of donor organs it can accept and which patients can receive them, making the lifesaving gift of organ transplants available to as many patients as possible.

A history of breakthroughs Organ transplantation began at the University of Chicago. Alexis Carrel, MD, a pioneer in cardiac surgery, developed the technique for joining severed ends of blood vessels together that made organ transplantation possible. He performed the first heart transplant, on a dog, at UChicago in 1904. The dog survived for two hours. In 1912, Carrel received the first Nobel Prize awarded in physiology or medicine for work done in America.

uchicagomedicine.org/midway

Christoph Broelsch, MD, performed the first liver transplant using a segment of a cadaver liver in the U.S. at UChicago in 1985. He also performed the first split-liver transplant, using one donor for two recipients, in the U.S. in 1988 and developed the technique for transplantation from a living donor. Broelsch’s team then performed the first successful living-donor liver transplant in the world PHOTO BY BENJAMIN BITTON

It was a stunning sequence of events, even for

at UChicago in November 1989, and, in 1993, a UChicago team performed the first liver transplant from an unrelated living donor, a close family friend of a 9-year-old boy with cystic fibrosis whose relatives were medically ineligible to donate.

Other advances expanded the opportunities for patients to receive an organ transplant. In 1997, a team led by ethicist Lainie Friedman Ross, assistant professor of pediatrics and associate director of the MacLean Center for Clinical Medical Ethics at the time, proposed the first paired kidney exchange program, which would allow two people who need kidney transplants and have willing but incompatible donors to exchange donor kidneys. Their protocol, published in The New England Journal of Medicine, was adapted for wider use and helped make possible nationwide exchanges involving many donors and recipients.

The breakthroughs continued to accumulate through the 1990s and into the current century, with several multiple-organ procedure milestones.

UChicago physicians performed the first two

Sarah McPharlin and Daru Smith walk laps in the Center for Care and Discovery while recovering from their surgeries. The two patients bonded during group physical therapy while waiting for their triple-organ transplants.

MEDICINE ON THE MIDWAY

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heart-kidney-pancreas transplants in Illinois (1995 and 1998), four heart-liver-kidney transplants (1999, 2001, 2003, and 2011) and hundreds of kidneypancreas procedures.

Alignment for the future

PHOTO BY ANDY GOODWIN

Amidst this kind of history, it’s not surprising that UChicago was uniquely prepared to pull off consecutive triple-organ transplants. Preparations for both procedures began months earlier. Nir Uriel, MD, director of heart failure, transplant and mechanical circulatory support at UChicago Medicine, who managed the medical care for the patients, began to assemble the surgeons, nurses and anesthesiologists to perform the transplants, plus the heart, liver and kidney specialists to care for them up to and after the procedures.

Transplant surgeon John Fung, PhD’80, MD’82, left, and liver specialist Michael Charlton, MBBS, are co-directors of the UChicago Medicine Transplantation Institute. The institute consolidates surgeons and medical specialists within a single unit, breaking down traditional academic silos.

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This unprecedented amount of coordination relied upon a unique organizational structure at UChicago that facilitates collaboration among transplant specialists of all stripes. At many medical centers, transplant expertise is housed within traditional academic departments, such as surgery and medicine, aligned with specific organ systems.

In the fall of 2016, UChicago Medicine created the Transplantation Institute to consolidate transplant surgeons and medical specialists within a single unit, recognizing the unique needs of transplant patients.

“The idea is that rather than embedding different elements of a transplant program within the Department of Surgery or Department of Medicine,

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

you pull it together in a cohesive way,” said Jeffrey Matthews, MD, the Dallas B. Phemister Professor and chair of surgery. “It was a new idea for the University of Chicago, but a model that had existed and proven to be successful at places like the Cleveland Clinic.”

Cleveland Clinic also factored into the search for a leader for the new institute. At the time, Fung was the director of Cleveland Clinic’s transplant center. After earning a medical degree and PhD in immunology from UChicago, he trained under Thomas Starzl, MD, PhD, “the father of modern transplantation,” at the University of Pittsburgh Medical Center. In Pittsburgh and Cleveland, Fung became a transplant pioneer in his own right, leading large-scale clinical trials, developing novel surgical techniques, refining organ donation procedures and publishing hundreds of research articles.

“After Dr. Starzl retired, John Fung was probably the most prominent liver transplant surgeon in the world,” Matthews said. “I was looking for somebody who would be the John Fung of the University of Chicago, never occurring to me that he might actually be interested in coming back here.

“When I heard that he might, we immediately put all hands on deck to make it happen,” Matthews said.

In the spring of 2017, Michael Charlton, MBBS, joined Fung as co-director of the Transplantation Institute. Charlton, an internationally renowned specialist in liver diseases and transplant medicine, also became director of the newly formed Center for Liver Diseases. The center was created to diagnose and treat the full range of chronic and acute liver diseases, many of which lead to transplants.

Together, he and Fung form a dyad that personifies the Transplantation Institute: a medical specialist and a surgeon scientist, working together in the same unit to provide transplant care for patients.

“One of the novel things about coming here was the institution’s willingness to set up a different structure, which was to break apart from the traditional academic silos that have existed here for 100 years,” Fung said.

“In the traditional silos you would do transplant part time, but you would do other things that the department wanted you to also do part time. That sort of diluted your efforts,” he said. “So we wanted committed people who all shared the same vision of building transplant, full time.” continued on page 11

Back-to-back transplants timeline TUESDAY, DECEMBER 18, 2018 3:15 p.m.

Organ offer call comes in for Daru Smith, 29, of Chicago, diagnosed with multisystem sarcoidosis.

5:09 p.m.

UChicago Medicine transplant team determines it will accept the organs.

5:30 p.m.

Doctors notify Smith he will be getting a new heart, liver and kidney.

DARU SMITH

WEDNESDAY, DECEMBER 19 12:30 p.m.

UChicago Medicine transplant teams travel to retrieve the organs.

2:30 p.m.

Smith is prepped for surgery.

3:07 p.m.

Smith’s surgery begins.

4:09 p.m.

Donor cross-clamp.

5:04 p.m.

Donor heart arrives at UChicago Medicine.

5:26 p.m.

Smith’s heart transplant begins. Valluvan Jeevanandam, MD, leads the 22-member surgical team.

7:00 p.m.

Heart transplant completed.

7:20 p.m.

Liver and kidney arrive at UChicago Medicine.

8:31 p.m.

Liver transplant begins. Talia Baker, MD, leads the surgical team.

11:46 p.m.

Liver transplant completed.

Daru Smith is enjoying spending time with his 4-year-old son, and exploring the possibility of becoming a motivational speaker.

WEDNESDAY, DECEMBER 19 11:54 p.m.

Organ offer call comes in for Sarah McPharlin, 29, of Michigan, who had her first heart transplant at age 12 as a result of a rare inflammatory heart condition.

THURSDAY, DECEMBER 20 2:40 a.m.

UChicago Medicine transplant team determines it will accept the organs.

3:20 a.m.

Doctors notify McPharlin she will be getting a new heart, liver and kidney.

THURSDAY, DECEMBER 20

SARAH MCPHARLIN

4:01 a.m.

Smith’s kidney transplant begins. Yolanda Becker, MD, leads the surgical team.

5:38 a.m.

Smith’s kidney transplant completed.

8:18 a.m.

Smith’s surgery ends, and he is moved to the ICU. 4:05 p.m.

UChicago Medicine transplant teams travel to retrieve the organs for McPharlin’s transplant.

4:10 p.m.

McPharlin is prepped for surgery.

6:04 p.m.

McPharlin’s surgery begins.

10:26 p.m.

Donor cross-clamp.

11:43 p.m.

Donor heart arrives at UChicago Medicine.

11:53 p.m.

McPharlin’s heart transplant begins. Valluvan Jeevanandam, MD, leads the 22-member surgical team.

FRIDAY, DECEMBER 21

Sarah McPharlin has been exploring the city with family and friends, and hopes to return to work as an occupational therapist.

uchicagomedicine.org/midway

1:42 a.m.

Heart transplant completed.

2:30 a.m.

Liver and kidney arrive at UChicago Medicine.

2:40 a.m.

Liver transplant begins. Talia Baker, MD, leads the surgical team.

6:56 a.m.

Liver transplant completed.

10:26 a.m.

Kidney transplant begins. Yolanda Becker, MD, leads the surgical team.

11:34 a.m.

Kidney transplant completed.

2:27 p.m.

McPharlin’s surgery ends, and she is moved to the ICU.

MEDICINE ON THE MIDWAY

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Back to the future Transplant pioneer John Fung, PhD’80, MD’82, returned to the University of Chicago to push the boundaries of organ transplantation

BY MATT WOOD

W

hen asked what kind of physician John Fung is, Jeffrey Matthews, MD, the Dallas B. Phemister Professor and chair of surgery, doesn’t hold back.

“He is one of the most thoughtful, graceful, kind individuals that I’ve ever met in surgery,” Matthews said. “The balance he brings to it of being able to push boundaries doing interesting, paradigm-shifting work — and yet at the same time being so human, so professional and so warm as a person — is very unusual.”

Fung brought these skills to the University of Chicago Medicine in 2016, when he was named chief of the Section of Transplant Surgery and inaugural director of the new Transplantation Institute. It was a homecoming for the surgeon, educator and researcher, who earned a medical degree and PhD in immunology from UChicago.

John Fung, PhD’80, MD’82, has more than 30 years of experience in transplantation. In 2015, he received the Starzl Prize in Surgery and Immunology from the University of Pittsburgh Medical Center, awarded annually to an international leader in organ transplantation.

After completing his residency at the University of Rochester, Fung moved to the University of Pittsburgh Medical Center (UPMC), where he honed his craft under the guidance of Thomas Starzl, MD, PhD. Starzl, widely known as “the father of modern transplantation,” performed the first human liver transplants in the 1960s and pioneered the use of modern immunosuppression drugs.

Over the next two decades at Pittsburgh, Fung cemented his reputation as a transplant pioneer in his own right. He led a large-scale clinical trial of tacrolimus, a groundbreaking immunosuppressive drug that paved the way for more widespread adoption of organ transplantation, and rose through the ranks to become chief of transplantation and serve as the inaugural Thomas E. Starzl Professor of Surgery at UPMC. He oversaw countless discoveries in transplantation immunology and contributed to more than 800 scientific publications during his tenure in Pittsburgh.

In 2004, Fung left UPMC for Cleveland Clinic, where he eventually led the health system’s transplant center. He continued to build upon his reputation in Cleveland, developing new minimally invasive liver surgery techniques and transplant procedures, instituting an intestinal transplant program, and using new preservation techniques for donor organs.

Fung is an advocate for offering liver transplants to some patients with acute alcoholic hepatitis or cancer, and he hopes to start an intestinal transplant program.

He also remained close to Starzl, who, in a letter of recommendation for a faculty position at Case Western Reserve University, echoed Matthews’ words. “John is a warm and humble individual who hardly seems to understand that his endowments are far beyond normal,” he wrote.

Fung credits Starzl for pushing him to redefine the boundaries of what is possible in organ transplantation.

PHOTO BY JEAN LACHAT

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

“He always said to me, ‘If you believe in something, make it work and then you can figure out the details of how it worked afterwards,’” Fung said. “It’s a simplistic explanation, but I’ve adopted that philosophy because I want to change the practice.”

continued from page 8

Expanding possibilities For Fung, building the transplant program means more than just increasing the volume of patients. He wants to make these lifesaving procedures available to more patients by expanding the possibilities, not only for how to perform organ transplants, but for who is eligible to receive them.

This means considering “high-risk” patients who would not otherwise get a transplant in the past.

For example, Fung is an advocate for offering liver transplants to patients with acute alcoholic hepatitis.

The standard practice has been to wait for these patients to have six months of sobriety before they can be added to the waiting list for a liver, for fear that they would relapse after transplant and ruin the new organ. But a landmark study published in The New England Journal of Medicine in 2011 shows that a subset of patients with no prior risk of liver disease and supportive social networks to help them remain sober after transplant can be successful candidates.

UChicago Medicine recently revised its sobriety policies to consider more of these patients. Their care is made possible by the multidisciplinary services of the Transplantation Institute, as liver experts, social workers and psychologists examine the patient’s psychiatric history, social support systems and likelihood to relapse after the life-threatening scare of drinking to the point of liver failure. The same teams help coordinate complex follow-up transplant care and counseling to maintain sobriety after surgery as well.

Fung also wants to offer liver transplants to more patients with such cancers as cholangiocarcinoma or neuro-endocrine tumors who might have been turned away in the past for fear that their cancer would recur. Fung believes these patients can be good candidates for transplant because new cancer drugs are more effective than ever, even if the patient relapses after transplant. Likewise, Uriel has been an early advocate for providing heart transplants for HIV-positive patients with heart failure now that antiretroviral drugs can effectively manage HIV/AIDS. Fung envisions a day when UChicago Medicine looks beyond the standard heart, lung, liver, pancreas and kidney procedures as well. He helped launch an intestinal transplant program at Cleveland Clinic and would like to start one in Chicago. He also wants to explore composite tissue transplants, such as the face, hand or uterus. These are the kinds of procedures that spark the imagination about what is possible in medical science, even at an institution uchicagomedicine.org/midway

that routinely makes significant breakthroughs. But to Fung, that’s the entirely the point.

“We can’t compete with the larger health systems in the area by sitting back and relying on a huge network of patients coming to us. We don’t have that luxury,” he said. “To me, the way that you build a program is to distinguish yourself, create a niche for yourself and have people come here for that reason.

“The results are pretty good across the city for the standard criteria cases. If we stuck to that, we would just be a competitor. I don’t want to do that. I want to offer something different,” Fung said.

Medical breakthroughs and new technology have also made it possible to use more donor organs that wouldn’t have been available in the past. Organs from hepatitis C-positive donors were typically rejected by most transplant teams in all but the most desperate of cases, due to concerns over the infection causing post-transplant organ loss. But a few select centers, including UChicago Medicine, have reconsidered that philosophy in light of new antiviral medications that effectively cure hepatitis C. PHOTO BY MATT WOOD

Ex vivo lung perfusion is a process that can expand the pool of donor lungs suitable for transplantation.

“Hepatitis C is the easiest thing we treat these days and we can cure almost everyone,” Charlton said. “So, if we take livers that are really healthy from young, heroic donors who had hepatitis C and offer them to patients who have life-threatening or quality of life-altering conditions, they can get a transplant much sooner.”

UChicago Medicine is also one of the first transplant centers in the U.S. to use a system called ex vivo lung perfusion (EVLP) to prepare donor lungs for transplant. Lungs are the most difficult organ to transplant because they are highly susceptible to infections in the late stages of the donor’s life. They can sustain damage during the process of recovering them from the donor or collapse after surgeons begin to ventilate them after transplant.

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PHOTO BY KAT CARLTON

futuristic, would expand the number of transplants by creating copies of a patient’s own kidney or using the building blocks from a non-immune-matched donor.

Sarah McPharlin hugs heart surgeon Valluvan Jeevanandam, MD, as her mother Dianne looks on.

Jeevanandam was the heart surgeon in all six heart-liverkidney transplants performed at UChicago Medicine.

Because of these challenges, only one out of five donors who give organs of any kind provide suitable lungs for transplant. EVLP is a process that expands the pool of lungs that can be transplanted by evaluating the viability of lungs that may not meet standard criteria for donation. The lungs are placed in a machine that circulates solution through them to establish normal tissue flow and gently re-inflates them in a controlled manner. More than 50 percent of lungs evaluated with the system can be used for transplant, significantly increasing the number of patients who can get a transplant.

PHOTO BY NANCY WONG

Daru Smith and Sarah McPharlin, three months after they each received a new heart, liver and kidney.

All the pieces in place

Further out on the horizon, research that could restore or even rebuild a failing kidney is underway at the Institute for Molecular Engineering. Jeffrey Hubbell, PhD, the Eugene Bell Professor in Tissue Engineering, is collaborating with scientists from Northwestern University to develop technology that can generate new, functional kidneys by stripping out cells and leaving only the structural scaffolding.

That scaffold could then be implanted into a recipient with new blood vessels and coaxed to grow cells that develop into new tissues. The technology, while

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

All of these factors — highly skilled medical staff, visionary leadership, cutting-edge science and technology, and close partnerships with community organizations — are hallmarks of UChicago Medicine across all disciplines. But this unique combination of talent and resources combined with a history and culture of pushing the boundaries of patient care made the two triple-organ transplant procedures possible.

“There are certainly other institutions out there that could have done those two procedures, but I feel strongly that for this kind of complex, dominoeffect surgery, you need somebody who’s been there before,” said Yolanda Becker, MD, professor of surgery and director of the kidney and pancreas transplantation program.

Becker, who performed the kidney transplants for McPharlin and Smith, has also served as president of the Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) board of directors, a division of the U.S. Department of Health and Human Services that develops national organ transplantation policy. She has seen the UChicago Medicine transplantation program evolve over the years since joining the faculty in 2010.

“We have had the pieces in place to do multi-organ transplants for a long time, but we’ve had different strengths at different times,” she said. “Now it has all come together at the same time, and we’re in a very good position to do some very new and innovative things.”

The University of Chicago Medicine may never again perform multiple triple-organ transplants within the same year, let alone in less than two days.

It was a stroke of luck that McPharlin and Smith were both on the waiting list in Chicago, that they both needed the same combination of organs and that they both found matching donors on consecutive days in December. But it certainly wasn’t luck that UChicago Medicine was prepared to save them.

“It’s a good feeling to be able to get to yes,” Becker said. “And I think that for complex medical and surgical procedures — in all disciplines, quite frankly — UChicago Medicine is a place where people work very hard to get to yes for the patient.”

ALUMNI PROFILE

Innovation that saves lives

Jeffrey Leiden AB’75, PhD’79, MD’81 PHOTO COURTESY OF VERTEX PHARMACEUTICALS

Jeffrey Leiden, AB’75, PhD’79, MD’81, translates scientific discoveries into transformative treatments

BY BETHANY HUBBARD

A

s an undergraduate at the University of Chicago, Jeffrey Leiden spent a life-changing summer in the molecular biology lab of Bernard Roizman, ScD. “It was a mind-blowing experience,” he said, “because you could see the future — that the next 20 years were going to be this revolution in molecular biology. That’s when I thought, ‘This is what I’m going to do. I want to take these molecular techniques and apply them to medicine and diseases.’”

For the past three decades, Leiden has done just that as a physician-scientist.

Leiden says his MD/PhD training gives him a deep understanding of both basic science and medicine. “When I got to the clinic, it was just a different world — that was the second time I sort of fell in love,” he said. “It’s worth the extra two to four years because it just trains you in a different way.”

Leiden began his career in academia at UChicago, where he was the Frederick H. Rawson Professor of Medicine and Pathology and served as chief of cardiology, then moved to Harvard Medical School and Brigham and Women’s Hospital. During this time, he also helped launch several biotechnology companies.

In 2000, he was offered an exciting opportunity: leave academia to run Abbott Laboratories’ global pharmaceutical business. uchicagomedicine.org/midway

“I was focused throughout my career on this notion of taking scientific breakthroughs and translating them into new therapies to treat disease,” he said. “I realized this was a unique opportunity to do what I had wanted to do all along.”

So, with his family’s support, he made the leap. With Leiden at the helm, Abbott launched several groundbreaking drugs, including Humira for rheumatoid arthritis and Kaletra for HIV. After six years, Leiden accepted the position of managing director at Clarus Ventures before joining Bostonbased Vertex Pharmaceuticals as a board member in 2009 and CEO in 2012.

“At Vertex, we only work on transformative medicines,” he said. “We look for very serious, life-threatening diseases and diseases in which we have a scientific insight that allows us to treat the underlying cause.”

Vertex has been successful in its mission, developing several cystic fibrosis drugs that, for the first time, address the disorder’s underlying biological defect.

“The hardest thing in this industry is to serially innovate — to make multiple medicines,” he said. “Only a handful of biotech companies have ever internally discovered and developed four or more medicines.

Vertex is one of them.”

The company also has pledged $50 million for STEAM (science, technology,

engineering, arts and mathematics) education for underserved students and young women. For Leiden, this commitment was shaped by his own personal experiences with the many mentors he’s had over the years, especially Arthur Rubenstein, MBBCh, former chair of the Department of Medicine.

“He was probably the single most important mentorship figure in my career,” said Leiden, who still keeps in touch with Rubenstein. “He’s just a remarkable person.”

“You can do more now in a week than I could in a year 20 years ago. The opportunity to turn these discoveries into new treatments has never been better.”

Jeffrey Leiden AB’75, PhD’79, MD’81

Leiden has nothing but fond memories looking back on his time at UChicago.

Not only did he excel academically — he was elected to several honor societies, including Alpha Omega Alpha and Phi Beta Kappa — but he had the freedom to pursue his scientific passion. “It was the best experience of my life,” he said.

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The medium is a powerful tool for storytelling and teaching around what happens in medicine — and the basis for a new field of academic study

BY STEPHAN BENZKOFER

I

n a remarkably short time, comics have grown up, sloughing off their superhero chains to become a respected medium for adults.

Now, boasting an impressive versatility, they’re coming to hospitals, medical schools and doctors’ offices near you.

This confluence of comics and medicine — coined graphic medicine in 2007 by U.K. physician Ian Williams — has become a vibrant area of study. Just as the works of Art Spiegelman, Chris Ware and Alison Bechdel have proven that comics can tell important stories about complex family relationships and the Holocaust, graphic medicine has flexed its muscles to deftly handle such emotional and weighty issues as illness and dying, and effectively deliver complex information to professionals and patients alike — even as it provides an insightful, unsparing critique of the health care system.

For Brian Callender, AB’97, AM’98, MD’04, an interest in capturing the patient experience first

Brian Callender, AB’97, AM’98, MD’04, leads a class exercise on body mapping during an undergraduate course on graphic medicine.

A hospitalist, Callender has a long-standing interest in the health humanities and narrative medicine.

PHOTO BY JEAN LACHAT

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

drew him to graphic medicine, but it was the impressive array of possibilities that prompted him to take up serious study of the burgeoning field.

Callender, assistant professor of medicine, is the co-director of the Scholarship and Discovery Global Health Track at the University of Chicago Pritzker School of Medicine and one of the core faculty at the University’s Stevanovich Institute on the Formation of Knowledge.

Long interested in the health humanities and narrative medicine, Callender’s curiosity about using comics in his work prompted him to talk with Hillary Chute, the comics scholar then at UChicago, who told him about the field. Callender was hooked.

He eagerly explains the strengths inherent in comics.

“Comics is a great way to tell the story of what happens in medicine and depict the experience of illness,” he said. “I am particularly struck by how illness affects an individual’s sense of time and space.”

For example, he said, imagine what a set of stairs looks like to a healthy person — simple access to the rooms above — versus how it appears to a person with a serious lung condition — a barrier that effectively cuts the individual’s home in half. “Illness often forces one to live in the present with their current symptoms while questioning the past and future,” Callender said. “With comics, one can really play around with the flow and pace of a narrative, or even parallel narratives, across particular spaces and time periods.”

Picture, he said, how different time feels for a busy physician or nurse in a hospital versus the patient confined to a hospital bed. “I think comics is the best medium to get that story across,” he said. And as a clinician, he is also interested in the practical use for comics in patient-care situations.

But Chute’s even more important contribution, possibly, was introducing Callender to Comic Nurse.

Pioneers in graphic medicine In 1994, MK Czerwiec (pronounced Sir-wick) started her nursing career at Illinois Masonic Medical Center in Chicago’s Lakeview neighborhood. She was assigned to the HIV/AIDS care unit at the height of the epidemic when there was no cure and the emphasis was on care.

The community hospital’s physicians and nurses were powerless to stop their neighbors and friends from dying.

“It was a very difficult time,” Czerwiec said. “And I was trying to figure out how to keep doing this difficult work and yet still stay connected.” She said she tried journaling, but found that the words didn’t come. She tried painting, but that also “didn’t capture the whole story.”

When the AIDS unit closed in 2000, it clearly marked a huge victory against a horrible disease, but it also left Czerwiec saddened as longtime co-workers went their separate ways. She struggled to express this bittersweet mix of emotions. “One day

uchicagomedicine.org/midway

Inoperable, from Mom’s Cancer

by Brian Fies In this image from Mom’s Cancer, Brian Fies creates a compelling visual metaphor of disease as a game. Drawing upon the childhood game of Operation, the image can be read from the patient’s perspective as the feeling of

being treated as if a diseased patient is merely a game for physicians to play.

The combination of words and pictures inherent to comics allows for bodily depictions of cancer linked to text that describes symptoms and

treatments, but also serves as a critique of specialization that fragments the body into different regions that “belong” to different teams of doctors at the expense of treating the patient as a whole person.

— Brian Callender, MD

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I sat down, and I basically stumbled into making a comic,” she said. “I realized that the combination of image and text in sequential fashion really helped me organize my thoughts. It just worked.”

She received supportive feedback and kept cartooning. “I felt like I’d found a medium where I

could really express myself,” she said. Comic Nurse was born. She went back to school to earn a master’s degree in medical humanities and bioethics from Northwestern University’s Feinberg School of Medicine, where she is now artist in residence and teaches seminars. She is also a senior fellow at the George Washington School of Nursing Center for Health Policy and Media Engagement.

Her 2017 graphic nonfiction book, Taking Turns: Stories from HIV/AIDS Care Unit 371, is not just a poignant memoir, but also a gripping oral history of the AIDS unit and that period in Chicago.

Czerwiec was a pioneer in graphic medicine, joining Ian Williams and other early adopters at the inaugural international graphic medicine conference in London in 2010. She brought the conference to Chicago in 2011, where she met Vineet Arora, MD, AM’03, assistant dean for scholarship and discovery.

2007

2009

2010

2011

Ian Williams, an English physician and author, launches graphicmedicine.org, coining the phrase graphic medicine in the process.

Michael J. Green, MD, and Kimberly R. Myers, PhD, both at Pennsylvania State University, begin teaching a graphic medicine course to fourth-year medical students.

Green and Myers publish a landmark article in The BMJ about the use of comics in medical education and patient care. The inaugural graphic medicine conference convenes in London, where many of the early pioneers in the field meet for the first time.

MK Czerwiec, who has been drawing and publishing work online as Comic Nurse since 2000, brings the graphic medicine conference to Chicago.

MK Czerwiec, left, known as Comic Nurse, teamed with Callender to teach a graphic medicine course.

She also has worked with UChicago Medicine faculty on projects using comics in patient and clinician education.

TI M EL I NE

Key events in the evolution of graphic medicine, which Graphic Medicine Manifesto defines as “the intersection of the medium of comics and the discourse of health care” and “an emerging area of interdisciplinary academic study.”

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Taking Turns: Stories from HIV/ AIDS Care Unit 371 (excerpt)

by MK Czerwiec In this short excerpt from Taking Turns: Stories from HIV/AIDS Care Unit 371, MK Czerwiec depicts the passing of a patient on an HIV/AIDs unit at the height of the AIDS epidemic in the 1990s. A particular strength of comics is the ability to depict space and time, which are both important aspects of the illness

“MK has become a wonderful friend and colleague to so many of us,” Arora said. “In the areas where improving care meant empowering nurses or patients, that’s where we found her tools to be very helpful.”

Arora, who is now associate chief medical officer for clinical learning environment at the University of Chicago Medicine, focuses on using novel learning techniques to improve the quality of care.

“We’ve all heard of death by PowerPoint,” she said. “A physician recently said to me that a noon lecture would be a good time for their lunch and nap.” So, Arora is always on the lookout for effective ways to get someone’s attention and convey complex information.

In other words, the perfect job for graphic medicine.

Simple, versatile and effective Arora first discovered Comic Nurse on Twitter and recruited Czerwiec to aid with a project to help a mentee who was working with her to improve handoffs. Some outpatient clinic patients fall through the cracks and miss the opportunity to meet their new primary care physician. As part of the 2012-14 study, Czerwiec created comics to include in a new, patient-centered transition packet. A 2015 paper in the Journal of General Internal Medicine reported the results: More than 45 percent more patients recalled receiving the packet — and the number correctly identifying their new doctor soared to 98 percent from 77 percent.

Arora was impressed. She asked Czerwiec to help with a National Institutes of Health-funded project empowering nurses to help hospital patients get a good night’s sleep.

experience. In these images, Czerwiec conveys, by varying the perspective, the bedside experience of a dying patient, his mother, and provider. The end panel, in depicting the now-sanitized room where a patient recently died, is an abrupt visual shift from the previous panels that mirrors the abrupt emotional shift expected of providers who will have to care for the next patient to occupy that bed.

— Brian Callender, MD

2012

2013

2015

2019

Czerwiec joins Williams as co-manager of graphicmedicine.org.

Annals of Internal Medicine starts a graphic medicine feature. The first installment, “Missed It,” is a riveting tale of a resident’s missed diagnosis that resulted in a patient’s death, written

by Green and drawn by Ray Rieck.

Graphic Medicine Manifesto is published. The volume establishes the principles of graphic medicine and begins to map the field.

10th annual graphic medicine conference will be held in July in Brighton, U.K.

uchicagomedicine.org/midway

, MK Czerwiec s, Ian William ier, rill Squ Susan Mer Green, Michael J. R. Myers, Kimberly T. Smith and Scott

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Your day will most likely look like this… dĞĂŵ ŵĞŵďĞƌƐ ǁŝůů ĐŚĞĐŬ ŽŶ LJŽƵ ƚŚƌŽƵŐŚŽƵƚ ƚŚĞ ĚĂLJ͘ /Ĩ LJŽƵ ŶĞĞĚ ŚĞůƉ͕ ƉƌĞƐƐ ƚŚĞ ĐĂůů ďƵƚƚŽŶ͘

dŚĞ ŶƵƌƐĞ ƉƌĂĐƚŝƚŝŽŶĞƌ ǁŝůů ĞǀĂůƵĂƚĞ LJŽƵ ĚĂŝůLJ͘

UChicago Medicine inpatient pamphlet This graphic-oriented guide for patients in the short-stay unit depicts the general hospital experience as a narrative. Callender worked on the project in collaboration with the Illinois Institute of Technology’s Institute of Design, with grant support from the Bucksbaum Institute for Clinical Excellence.

tŚŽ ǁŝůů / ƐĞĞ ƚŽĚĂLJ͍ tŚĂƚ ŝĨ / ŶĞĞĚ ŚĞůƉ͍

dŽŐĞƚŚĞƌ͕ ǁĞ ǁŝůů ŵĂŬĞ Ă ĐĂƌĞ ƉůĂŶ ĨŽƌ LJŽƵƌ ĚĂLJ͘

EƵƌƐĞ WƌĂĐƚŝƚŝŽŶĞƌ

EƵƌƐĞ

collection in the University of Chicago Library is one of the largest in the country.

18

/ Ăŵ ĂǀĂŝůĂďůĞ ĚƵƌŝŶŐ ƚŚĞ ŶŝŐŚƚ ŝĨ ŶĞĞĚĞĚ͘

tĞ ĚŽ ŶŽƚ ŬŶŽǁ LJĞƚ͕ ďƵƚ / ŽƌĚĞƌĞĚ ƐŽŵĞ ƚĞƐƚƐ ƚŽ ŚĞůƉ ƵƐ ĮŐƵƌĞ ƚŚĂƚ ŽƵƚ͘ tŚĂƚ ŝƐ ŵLJ ĚŝĂŐŶŽƐŝƐ͍ tŚĂƚ ĂƌĞ ŵLJ ƚƌĞĂƚŵĞŶƚ ŽƉƚŝŽŶƐ͍

KŶĐĞ ǁĞ ŚĂǀĞ Ă ĚŝĂŐŶŽƐŝƐ͕ ǁĞ ǁŝůů ƚĂůŬ ĂďŽƵƚ ƚƌĞĂƚŵĞŶƚƐ͕ ƐŝĚĞ ĞĨĨĞĐƚƐ͕ ĂŶĚ ƌĞĐŽǀĞƌLJ͘

^ŽŵĞƚŝŵĞƐ͕ ŐĞƚƚŝŶŐ Ă ĚŝĂŐŶŽƐŝƐ ĐĂŶ ƚĂŬĞ ƚŝŵĞ͘ tĞ ǁĂŶƚ ƚŽ ďĞ ƐƵƌĞ LJŽƵ ŐĞƚ ƚŚĞ ƌŝŐŚƚ ƚƌĞĂƚŵĞŶƚ͘

EƵƌƐŝŶŐ ƐƐŝƐƚĂŶƚ

EƵƌƐĞ WƌĂĐƚŝƚŝŽŶĞƌ

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Ask about your plan to leave the hospital and aftercare.

You also need to get rest.

/ ǁŽƵůĚ ƌĞĂůůLJ ůŝŬĞ ƚŽ ŐĞƚ ƐŽŵĞ ŐŽŽĚ ƌĞƐƚ ƚŽŶŝŐŚƚ͘ ĂŶ LJŽƵ ŚĞůƉ͍

The graphic medicine

EƵƌƐĞ

You will get a diagnosis and treatments.

tĞ ĐĂŶ ƚĂůŬ ĂďŽƵƚ ůŝŵŝƚŝŶŐ ŶŝŐŚƚƚŝŵĞ ŝŶƚĞƌƌƵƉƚŝŽŶƐ ƚŽ ŝŵƉƌŽǀĞ ƐůĞĞƉ͘

EŝŐŚƚ EƵƌƐĞ WƌĂĐƚŝƚŝŽŶĞƌ

ĂLJ EƵƌƐĞ WƌĂĐƚŝƚŝŽŶĞƌ

The SIESTA Project — Sleep for Inpatients: Empowering Staff to Act — also saw impressive results.

“The patients in the SIESTA unit where these comics were displayed and the nurses received training were much more likely to report no disruptions from nighttime vital signs or from medication,” Arora said. “Nighttime room entries dropped by 44 percent in the SIESTA unit.”

A third project, still in progress with two of her colleagues, aims to empower patients to ask to see electronic health records during their clinic visits.

“One of the things that’s amazing about graphic medicine is that the simple medium is so versatile in the work it can do,” Czerwiec said. “I think that’s

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

,Žǁ ĐĂŶ / ƚĂŬĞ ĐĂƌĞ ŽĨ ŵLJƐĞůĨ Ăƚ ŚŽŵĞ͍ ,Žǁ ĐĂŶ ŵLJ ĨĂŵŝůLJ ŚĞůƉ ŵĞ͍

'ƌĞĂƚ ƋƵĞƐƚŝŽŶƐ͊ tĞ ǁŝůů ƚĂůŬ ĂďŽƵƚ LJŽƵƌ ĚŝƐĐŚĂƌŐĞ ƉůĂŶ ĂŶĚ ǁĞ ĐĂŶ ŝŶĐůƵĚĞ LJŽƵƌ ĨĂŵŝůLJ ŝŶ ŽƵƌ ĐŽŶǀĞƌƐĂƚŝŽŶ͘

EƵƌƐĞ WƌĂĐƚŝƚŝŽŶĞƌ

partly responsible for the success of the graphic medicine movement, because it resonates with so many people from so many different perspectives.”

Callender, a hospitalist and medical director for the Advanced Practice Service’s short-stay unit at the University of Chicago Medicine, was concerned about patients’ understanding of the experience of being hospitalized. He worked on a patient education project in collaboration with the Illinois Institute of Technology’s Institute of Design — with grant support from UChicago’s Bucksbaum Institute for Clinical Excellence — to create a graphic-oriented guide that depicts the general hospital experience as a narrative. In follow-up surveys, more than 75 percent of patients who received the pamphlet

PHOTOS BY JEAN LACHAT

agreed it was easy to read and understand, improved understanding of the hospitalization and care team, and was visually appealing. An additional collaboration between radiation oncologist Daniel Golden, MD, MHPE, the Institute of Design and the Bucksbaum Institute to educate patients about radiation therapy recently won an award of distinction from the Center for Plain Language.

As part of the Comprehensive Care, Community and Culture Program’s Artful Living Program, Callender and social worker Kathryn West, AM’17, implemented a series of graphic medicine workshops in which patients create their own comics about their illness, life and community. They recently used a wellness graph exercise in one workshop that helped patients better understand how far they had progressed in their treatment, despite recent setbacks. On a large piece of paper, patients drew two axes, with time across the bottom on the x-axis and wellness on the y-axis.

“We initially struggled with how to define wellness,” Callender said. “Rather than give patients an arbitrary scale, we settled on letting them place their experiences and memories on a scale that they defined. By placing the experiences in relation to one another, the relative difference would indicate the magnitude of the experience.”

One patient had suffered significant injury from a 25-foot fall, with continuing health problems as a result. Callender said he thought the exercise

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not only helped this patient see how far he had progressed from the traumatic event, but also allowed him to envision a healthier future, which the patient had illustrated on his wellness chart as a sailboat on a lake.

Teaching graphic medicine With the support of the Stevanovich Institute on the Formation of Knowledge, Callender and Czerwiec teamed up to develop and teach an undergraduate course, Graphic Medicine: Concepts and Practice, during Winter Quarter 2019 that introduced the students to the wealth of graphic memoirs written by patients and caregivers. As part of the course, students also were required to pick up pencil and ink — or crayons — themselves.

“It’s not usual that in the first class of a college course they give you a box of crayons,” said Tirtzah Harris, a second-year creative writing major.

That’s by design.

“One of the reasons I very intentionally use crayons is that there’s an access point there where people pick up from where they left off in fifth grade or third grade,” Czerwiec said. “That’s another wonderful thing about this medium. It is a pretty low bar to entry as long as you can make clear what you’re trying to communicate.”

Czerwiec said that people are programmed to easily read the facial expressions and emotional symbols used in comics.

Jason Xiao, a fourth-year biological sciences major at the University of Chicago, strikes an iconic pose during the body-mapping project, above. The project was designed to help students confront their own health issues, while incorporating their weekly comic journaling work.

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SE L EC TED B I B L I O G R A P HY

Katie Akin, a senior majoring in English and political science, works on her body map during the course Graphic Medicine: Concepts and Practice.

Understanding Comics: The Invisible Art

by Scott McCloud (1993) A seminal academic work about storytelling and visual communication, this isn’t specifically about graphic medicine, but would be of interest to those looking to learn more and is a wonderful example of how complex ideas can be communicated through comics.

Mom’s Cancer

by Brian Fies (2006) Eisner Award-winning memoir about three adult siblings dealing with their mother’s illness.

Cancer Vixen: A True Story

by Marisa Acocella Marchetto (2007) A cartoonist at Glamour is diagnosed with breast cancer, prompting a series of strips in the magazine that were later published in book form.

Marbles: Mania, Depression, Michelangelo and Me

by Ellen Forney (2012) A graphic memoir about a woman living with bipolar disorder.

Graphic Medicine Manifesto

by MK Czerwiec, Ian Williams, Susan Merrill Squier, Michael J. Green, Kimberly R. Myers, and Scott T. Smith (2015) Essays — graphic and otherwise — establishing the principles of graphic medicine.

My Degeneration: A Journey Through Parkinson’s

by Peter Dunlap-Shohl (2015) Newspaper cartoonist is diagnosed with Parkinson’s disease at age 43.

Taking Turns: Stories from HIV/AIDS Care Unit 371

by MK Czerwiec (2017) Graphic memoir and oral history about a nurse working on the AIDS unit of a Chicago hospital at the height of the epidemic.

Why Comics: From Underground to Everywhere

by Hillary Chute (2017) An exploration and history of comics with chapters about specific areas, including superheroes, sex, and illness and disability.

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“You can communicate a tremendous amount of information with a pair of eyebrows,” she said.

To engage the class, many of whom are premed students, and demonstrate the full power of graphic medicine, Callender and Czerwiec assigned a bodymapping project that forced the students to confront their own health issues, while incorporating their weekly comic journaling work.

On the first day of the project, the students enthusiastically helped each other tear off lengths of heavy-duty brown construction paper, tape them to the walls and trace outlines of their bodies. Most opted for the standard, anatomic figure with arms and legs out, but one woman drew her arms akimbo, and one man opted for something closer to the dead body pose.

Immediately, experience and creativity began fleshing out the outlines.

Katie Akin’s body map sprouted a threedimensional nose, anxiety lightning radiated from the head and positive feelings emanated from the heart. Akin, a fourth-year English language and literature and political science major, later added scars and birthmarks she hadn’t thought about in a long time, and even her sister’s scar to her own arm.

“I was there when she got the injury, and I still feel kind of guilty about it,” she said.

More than one student commented how the body isn’t just a record of physical events but also of memories and emotions.

For Kelsey Hopkins, a fourth-year biochemistry major now applying to medical schools, the course was an opportunity to remind herself of why she wants to be a doctor.

“I didn’t know that graphic medicine was such a huge field before I started this class,” she said. “It is a unique way to share patients’ experiences.”

Jason Xiao, a fourth-year biological sciences major, had his classmate outline his body as he lay on the floor, arms and legs splayed out: the iconic crime scene visual.

PHOTO BY JEAN LACHAT

“The mapping reminded me of situations in which the body actually is outlined and examined in meticulous detail,” he said. “This evolved into the ‘dead body outline.’” He said that early choice continued to shape his perspective as the project progressed. For example, he drew memories, formed during his lifetime, leaving his body one by one.

Possibly the most widespread and most common examples of graphic medicine are the memoirs written by people diagnosed with diseases and their caregivers. It is in these works that Callender, Czerwiec and others say the medical community receives invaluable information about how diseases and treatments affect patients physically, emotionally and mentally, and insightful critiques of physicians, nurses and the hospital experience.

“Images have long been a part of medical practice and discourse,” Callender said. “The more recent addition of comics to medicine is a welcome contribution. These stories and images provide a broader depiction and critique that enriches the iconography and experience of medicine.”

The lessons were not lost on these future physicians.

“The class was cathartic, powerful both in the act of creating but also in relating to those who have gone through such life-changing experiences,” Xiao said.

T RAVELING EX HIBIT

“Graphic Medicine: Ill-Conceived and Well-Drawn!” sponsored by the U.S. National Library of Medicine, the world’s largest biomedical library, is on display at the National Institutes of Health. A banner exhibit will travel to 50 sites around the country. For more information, visit nlm.nih.gov/exhibition/graphicmedicine.

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

CHICAGO HOME FOR INCURABLES, BURLING AND WHITEHOUSE, ARCHITECTS. FROM INLAND ARCHITECT, VOL. 14, NO. 2, 1889. RYERSON & BURNHAM LIBRARIES, THE ART INSTITUTE OF CHICAGO.

A legacy of transforming care S

BY KATE DOHNER

uchicagomedicine.org/midway

ince it became formally affiliated with the University of Chicago in 1958, the Chicago Home for Incurables has contributed more than $35 million to support medical research, with an emphasis on chronic and incurable diseases. In June 2018, the Home transferred its total assets — $12.35 million — to the University of Chicago Medicine to support research related to these diseases.

Established in 1886, the Chicago Home for Incurables has a long and storied past, which began with a $625,000 bequest from Chicago philanthropist Clarissa C. Peck. At the time, it was the largest philanthropic donation ever made by a woman in the U.S. Upon Mrs. Peck’s death, her will was unsuccessfully contested by a self-proclaimed grandchild. An 1885 New York Times article luridly recounted the Peck family saga, which included denials of relationships and parentage, claims of coercion and even accusations of murder. (To read the full story, see “Is he the rightful heir,” January 28, 1885; available in the New York Times Article Archive: 1851–1980.) Despite this colorful family history, Clarissa Peck’s charity and her vision for the Chicago Home for Incurables came to fruition.

In 1898, the Home was built at 56th Street and Ellis Avenue — the location of the Young Memorial Building today — to care for individuals in Cook County with conditions that were then deemed “incurable,” including tuberculosis, rheumatism, paralysis and locomotor ataxia (known today as tabes dorsalis).

Additional philanthropic support for the construction and expansion of the Home was provided by Marshall Field, founder of the eponymous Chicagobased department store; Daniel B. Shipman, who made his fortune in the white lead industry; and Otto Young, a merchant and real estate mogul.

The Home accommodated 125 patients, who had access to lawns with shade trees and swinging hammocks, reading rooms and a parlor on every floor.

Patients were provided with wheelchairs, and male patients could go to a smoking room to “indulge to their hearts’ content in the use of their favorite brands.”

In a 1904 Chicago Tribune article, Harlow N. Higinbotham, former president of the Home, said, “I have never known an institution where there was such a spirit of camaraderie and cheerful content as exists there. It would not be suspected in a home where the qualification for entrance itself must be

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T IM E L IN E

1886

●

the incurability of the disease. Yet, from the moment of entrance, the patient finds quiet, rest, good food, good clothing, cleanliness and order.”

According to a 1914 article in the Daily Maroon, patients were also invited to attend athletic contests at Stagg Field free of charge, and several boasted that they had “never missed an athletic contest under favorable weather conditions.”

The Chicago Home for Incurables is established through a bequest from Clarissa Peck.

1898

●

The home is built at 56th Street and Ellis Avenue.

SPECIAL COLLECTIONS RESEARCH CENTER, UNIVERSITY OF CHICAGO LIBRARY

The Young Memorial Building is the only remaining structure from the original Home.

During the late 19th and early 20th centuries, scientific and medical discoveries led to significant progress in our understanding of various diseases.

However, the development of effective therapies lay further ahead in the future.

TUBERCULOSIS

1958

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The Chicago Home for Incurables becomes formally affiliated with the University of Chicago.

1961

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The Peck Pavilion, named for Clarissa Peck, is established to care for patients with diseases considered, or formerly considered, chronic or incurable.

The building remains part of the University’s medical campus today.

SPECIAL COLLECTIONS RESEARCH CENTER, UNIVERSITY OF CHICAGO LIBRARY

Dedicated in 1961, the Peck Pavilion at 58th Street and Drexel Avenue was devoted to research and treatment of the chronically ill.

2018

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The Chicago Home for Incurables transfers all of its assets to the University of Chicago to support continued medical research related to chronic diseases.

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The search for cures

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The Chicago Home for Incurables included a 68-bed ward dedicated to caring for patients with advanced cases of tuberculosis (TB), an infectious disease that typically affects the lungs but can attack any part of the body. Occupying the south wing of the home, the TB ward was established by Otto Young.

During this time, TB was a major threat to public health in North America and Europe. In the U.S., the incidence of TB in 1900 was 194 cases per 100,000 (compared to 2.8 per 100,000 in 2017).

In an effort to cure the disease and curb its spread, institutions called sanatoriums sprang up, providing patients with a regimen of good nutrition and access to fresh air, then considered the best treatment available.

In 1882, Robert Koch, a German physician and microbiologist, made a groundbreaking discovery: the identification of Mycobacterium tuberculosis, the bacterium that causes TB. Despite this demonstration of TB’s infectious nature, the sanatorium movement prevailed, with many continuing to believe that lifestyle factors, such as lack of fresh air, contributed to and aggravated the disease.

In the early 1900s, French bacteriologists Albert Calmette and Camille Guérin achieved the first success in developing a TB vaccine, known as bacille Calmette-Guérin (BCG) vaccine. Though the vaccine remains widely used throughout the world today, a landmark 1994 study showed it to be only 50 percent effective in reducing the risk of the disease.

In the 1920s, University of Chicago researcher Alexander A. Maximow, MD, provided a new understanding of TB when he reproduced the disease in lung tissue isolated from rabbits and traced its progression under the microscope. However, it wasn’t until the 1944 discovery of streptomycin — an

antibiotic used to treat bacterial infections — that a cure for TB became a reality. Subsequently, sanatoriums became obsolete, as patients with the disease no longer required multiyear periods of hospitalization.

Though treatable today, TB remains one of the top 10 causes of death worldwide, affecting nearly 10 million people annually, including half a million cases of antibiotic-resistant TB. While the rate of TB infection in the U.S. has declined nearly 90 percent since the early 1950s, the search continues for a vaccine that fully protects against the disease.

LOCO MOTOR ATAX IA

Locomotor ataxia, known today as tabes dorsalis, is a slow degeneration of the nerve cells and fibers that carry information to the brain. The condition results from an untreated syphilis infection and affects the nerves in the dorsal columns of the spinal cord. Symptoms generally do not appear until 20 to 25 years after the initial infection and include diminished reflexes, loss of coordination, episodes of intense pain, personality changes, dementia, deafness and visual impairment.

In 1912, Joseph Waldron Moore, MD, and Hideyo Noguchi, MD, of the Rockefeller Institute for Medical Research in New York (the Rockefeller University Hospital today) isolated the syphilis bacterium, establishing the disease as the cause of a condition then called “general paralysis of the insane.” Prior to this discovery, the origins of this condition eluded physicians.

By 1926, the prevalence of syphilis was as high as 35 percent among those of reproductive age.

Although the 1928 discovery of penicillin by Alexander Fleming, MBBS, led to dramatic reductions in the incidence of syphilis in the following decades, it is once again on the rise in the U.S. From 2013 to 2017, there was a 73 percent increase in cases of primary and secondary syphilis and a 153 percent increase in cases of congenital syphilis, whereby the disease is transmitted from a pregnant mother to her unborn child. In 2018, the number of babies born with syphilis reached a 20-year high. In response to these rising numbers, the Centers for Disease Control and Prevention called for educating physicians and nurses about symptoms, testing pregnant women considered at risk and developing a better diagnostic test.

Paving the way for modern medicine With scientific and medical progress came a shift in attitudes toward medical care. By the 1950s, the

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focus turned toward rehabilitating patients, rather than providing long-term care in facilities like the Chicago Home for Incurables.

Former Dean of the University’s Biological Sciences Division Lowell T. Coggeshall, MD, noted in a 1959 Chicago Tribune article: “Rehabilitation techniques developed, particularly during World War II, have completely altered the outlook for thousands of patients who would formerly have been confined to bed for the remainder of their lives.”

In response to these changing views, the Chicago Home for Incurables became formally affiliated with the University of Chicago in 1958, and subsequently contributed $1.5 million to construct a new three-story, 104-bed hospital. Named for Clarissa Peck, the Peck Pavilion was built in 1961 to care for patients with diseases considered, or formerly considered, chronic or incurable and for research to develop better treatments and even cures. Representing a new approach to medicine, the hospital employed physical therapists, social workers and psychiatrists tasked with rehabilitating patients. The Peck Pavilion remains part of the medical campus today.

Clarissa Peck’s $625,000 bequest was, at the time, the largest philanthropic gift made by a woman in the U.S.

The quest continues Since the Chicago Home for Incurables was founded, society has benefited from significant advances in science, medicine, public health and sanitation. From the time the Home was established until its closing in the late 1950s, the average life expectancy in the U.S. rose from 47 to 67 years.

Despite this progress, many challenges remain, as chronic medical conditions like diabetes, heart disease and obesity are on the rise. Today, nearly half of all Americans have at least one chronic disease.

Physicians and scientists continue to advance understanding and develop new solutions to medicine’s most perplexing problems. Their recent breakthroughs at UChicago Medicine — from helping amputees learn to control a robotic arm through electrodes implanted in the brain, to performing back-to-back triple-organ transplants, to creating models that predict the spread of the flu throughout the U.S. — would likely sound like science fiction to those who originally established the Home over a century ago.

The legacy of the Chicago Home for Incurables lives on in the pursuit of knowledge, lifesaving treatments and, ultimately, cures. And it all started with one woman’s foresight to make a bequest that would benefit others for years to come.

FROM SECOND PRESBYTERIAN CHURCH CHICAGO, 1842-1892.

JOSEPH REGENSTEIN LIBRARY, THE UNIVERSITY OF CHICAGO.

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G R A D U AT E M E D I C A L E D U C AT I O N

Battling burnout

BY EMILY AYSHFORD

PHOTOS BY JEAN LACHAT

Neurology resident Jumana Alshaikh, MD, finds it helpful to talk to other residents who have experienced the same stresses during training.

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hen Jumana Alshaikh, MD, was in the second year of her neurology residency at the University of Chicago Medicine, the long hours with patients and high stress level started to take a toll.

“It was just exhausting,” she said. “When you’re a junior resident, the demands are higher so you can learn. Many residents experience burnout at some point.”

Statistics show that Alshaikh is right. A recent study in the Journal of the American Medical Association found that 45 percent of residents experienced at least one symptom of burnout, and those who did were three times more likely to regret their decision to become a physician. As physicians continue on in their careers, nearly half of them experience burnout at some point. One study showed that female physicians reported burnout one and a half times as often as men.

For many decades, the rigors of residency were seen as a rite of passage and necessary for training. But a growing movement in medicine is focused on fostering wellness and resilience among physicians, and UChicago Medicine is encouraging these best practices.

The annual Resilience Week offers lectures, wellness activities and group discussions aimed at providing a toolbox of strategies for residents, fellows and attendings.

Every resident is invited to attend; participation is required for second-years.

Anita Blanchard, MD’90, said resident stress peaks during the second year, when trainees are managing work/life integration, team dynamics, complex care systems and challenging patient scenarios.

“What we’ve learned about burnout is that different people have different needs,“ said Blanchard, associate dean for graduate medical education, who instituted the program three years ago. “We want to provide a variety of ways of thinking about and coping with problems, so that residents can focus

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

How UChicago Medicine is giving residents the tools they need for resilience on self-care in addition to excellent patient care.

Physician leaders can go back to their own departments and create additional support.”

Resilience Week is just one of the approaches to improving well-being, which also include mental health resources through the Perspectives employee assistance program and expedited mental health appointments through the resident health program.

Creating organizational change Resilience Week 2019 began on a snowy day in January with guest speaker Bryan Bohman, MD’81.

Bohman is one of the founders of Stanford’s WellMD Center, which develops programs and interventions for physician well-being.

“Medicine is increasingly demanding, complex and difficult to manage,” Bohman told the audience.

“There was no countervailing force. There was nothing on the other side to help physicians cope.”

Burnout isn’t just having a bad day — it’s a psychological construct defined by feelings of cynicism, emotional exhaustion and a low sense of self-efficacy.

But Bohman found that many efforts to combat these issues placed the onus on physicians: eat right, exercise and get enough sleep. While self-care is important — Bohman himself plays tennis and ensures that he schedules time for family and friends without feeling guilty — he believes the real problem is systemic and organizational.

“We found you need to consider the workflows and processes that all add up to a system of clinical practice,” he said. “It all comes back to process improvement. You can work less or differently and produce more.”

He encouraged residents not to feel helpless, and instead, insist on organizational change as they move forward with their careers.

“You should demand to be treated right,” he said.

Realizing you are not alone Resilience Week programming also included emotional intelligence lectures, small group sessions, meditation, yoga, nutrition counseling and EPIC efficiency training.

Alshaikh, now in her fourth year, liked talking to residents in other departments. “They had

similar, stressful experiences,” she said. “It makes you realize there is nothing wrong with you when you experience burnout, and that other residents experience it as well.”

Blanchard hopes the program will act as a springboard for more wellness programming, reaching more hospital staff. “The well-being of every person who works at the University of Chicago Medicine is important,” she said.

The medical center is teaming with graduate medical education to launch an institutional approach to physician engagement that includes well-being activities, ease of clinical practice strategies and increased communication. This effort is led by Stephen Weber, MD, chief medical officer; Edward Naureckas, MD, medical staff president; Amber Pincavage, MD’07, resilience committee co-director, and Blanchard.

Encouraging an open culture This includes medical students. Wei Wei Lee, MD, MPH, assistant dean of students and director of wellness programs at the Pritzker School of Medicine, wants to help students not only avoid burnout, but also experience joy in their careers.

“Despite students coming into medical school with lower rates of stress and burnout than seen in the general population, they often experience higher rates of depression and anxiety,” Lee said. “We want to start a conversation about this right away, before it causes impairment.”

uchicagomedicine.org/midway

Facilitating this conversation is a wellness committee comprising students from each year of medical school. The committee develops programming to address emotional, spiritual, financial and physical health. First-year students are required to attend a panel discussion during which students, residents and faculty share their experiences with mental health and answer questions about how to navigate well-being during training and in practice.

“We want to create an open culture,” Lee said. For example, Pritzker is removing barriers for students to seek mental health appointments during busy times. “If you put off getting counseling, it’s a bad precedent for the rest of your career,” she said.

“Physicians have this ingrained culture of being caretakers, of not taking care of themselves. We are taught patients should come first. We’re telling students they need to carve out time for themselves.”

The wellness committee also hosts social events throughout the year to build community, such as picnics, baking competitions and panels on spirituality.

Discussion groups for thirdand fourth-year students enable them to talk over challenges, from navigating difficult team dynamics to dealing with a patient’s death.

“We want students to find meaning and joy in their work,” Lee said. “We not only want to help them figure out what they want in their career, but also to be sure they set healthy boundaries so they can find happiness in their practice and at home.”

Feeling like you have been heard As Alshaikh finishes up her training this year, she thinks she is finding that balance. “I try my best to get all my work done on my work days, so I don’t have to do anything related to work and medicine during my time off,” she said. Instead, she takes long walks around the city, and visits ethnic restaurants with her friends.

When she feels her stress levels rise, she seeks out conversations and support from her colleagues, family or friends.

“It’s important to talk about it,” she said. “When you feel like you’re heard, it helps you cope with the stess. It’s also important to take care of your health and well-being, as we often forget about ourselves and our needs when we are busy with the demands of residency training.”

Resilience Week activities include wellness activities such as yoga, lectures and group discussions. All residents are invited to attend, but participation is mandatory for residents in their second year, when stress is highest.

Guest speaker Bryan Bohman, MD’81, is one of the founders of Stanford’s WellMD Center, which develops programs and interventions for physician well-being.

Resilience Week was funded in part by grants from the Bucksbaum Institute for Clinical Excellence, the Joyce Foundation and generous alumni and community supporters.

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NEUROSCIENCE

Wired to see, touch, move Neuroscientists develop brain-computer interfaces to restore lost function

BY NANCY AVERETT

Leo Towle, PhD, has been working for 15 years on a project to develop a visual neural prosthetic that stimulates the visual cortex, enabling someone who is blind to see a thousand points of light.

PHOTO BY JOE STERBENC

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eo Towle, PhD, professor of neurology at the University of Chicago, has been working for 15 years on a project to develop a visual neural prosthetic that bypasses the eyes. He wanted to know what it would be like to walk around using one of these devices. So he built a mockup by drilling 1,000 holes the diameter of grains of rice into a thin metal sheet, attaching it to a piece of cardboard rolled into a cone shape. Towle then covered one eye, held the cone over the other, and walked out into the middle of the Midway Plaisance to discover what he could see.

“Crossing the Midway, I saw green dots to the sides from the lawn and a row of white dots up the middle from the sidewalk. The sky made light blue dots,” he said. “I could make out rough shapes of people. I couldn’t identify who they were, but I could probably avoid them.”

Towle’s homemade simulator was a stand-in for a high-tech system that he developed with Philip Troyk, PhD, of the Illinois Institute of Technology (IIT), and their teams. The system bypasses the eyes, and uses tiny implants to stimulate the visual cortex of the brain.

Towle leads a multidisciplinary team of UChicago faculty from neurosurgery, psychiatry, ophthalmology, neurophysiology and the Grossman Institute for Neuroscience, Quantitative Biology and Human Behavior that was awarded a $2.4 million, five-year grant from the National Institutes

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

of Health (NIH) to test the device — a visual neural prosthetic — on blind human subjects. He and his team are working closely with Troyk, the project’s principal investigator, professor of biomedical engineering at IIT and faculty associate in the section of neurosurgery at UChicago Medicine. In all, seven institutions were given subcontracts through IIT as part of a larger $11.8 million project funded by the White House BRAIN Initiative (Brain Research through Advancing Innovative Neurotechnologies).

Troyk and his team designed the radio-controlled implants — 10 of which could fit on a penny, each with 16 protruding electrodes smaller than the width of a human hair — that will stimulate the subjects’ visual cortices. These individuals also will wear glasses equipped with a cell phone-type camera connected to a small computer worn on a belt in a pouch. The computer will convert images from the camera into electrical impulses that will be transmitted to the brain implants through a device worn in a headband or baseball cap. “Even if somebody has been blind for 20 or 30 years,” Towle said, “we can stimulate the cortex and they will see a point of light. It’s like the visual cortex is unchanged and just waiting to be reawakened.”

Mind control Towle’s project is one of several at UChicago focused on connecting parts of the brain to areas of the body where function has been lost. Nicholas Hatsopoulos, PhD, who studies the motor cortex, and Sliman Bensmaia, PhD, who studies the sense of touch, are part of a team that was awarded a $3.4 million NIH grant to develop robotic arms that patients can control with their minds while also receiving sensory feedback from attached prosthetic hands. This new grant is part of a combined $7 million awarded to researchers at UChicago

uchicagomedicine.org/midway

Sliman Bensmaia, PhD, uses a rotating drum covered with strips of different fabrics, sandpapers and patterns to measure how the skin and nervous system respond to texture.

PHOTO BY JASON SMITH

and the University of Pittsburgh to continue their collaboration developing prosthetics with a brain-computer interface for paralyzed patients.

John Downey, PhD, a staff scientist in Bensmaia’s lab who formerly worked with the Pittsburgh team, will coordinate research activities. Neurosurgeon Peter Warnke, MD, will perform surgical procedures to implant the devices, and Raymond Lee, MD, a physical rehabilitation specialist from Schwab Rehabilitation Hospital in Chicago, will recruit subjects and provide guidance on the patient population.

Bensmaia and Hatsopoulos, both faculty in the Department of Organismal Biology and Anatomy, will focus on making the robotic hands perform more like real hands so their users could, say, pick up a cup of coffee, bring it to their lips, drink from it and then set it down. Getting a robotic arm/ hand combination to smoothly perform such a task requires figuring out how to combine signals from the somatosensory system and the motor cortex in such a way that the hands convey tactile signals to the brain that then guide how much force the brain tells the hands to apply — so the cup isn’t crushed or doesn’t slip out of the user’s grasp. In past experiments at Pittsburgh, one subject was able to do this using just his vision to guide the hand to the cup and grab it, but he had to concentrate hard to maintain enough force to hold onto it.

“In robotics, there are systems that control movement and other systems that control force,” Hatsopoulos said. “And so we’re now trying to do both, and, on the fly, switch from one mode to the other — if that’s even how the brain really works.”

Figuring out how the brain works in these areas — uncovering the basic science of the brain’s motor and somatosensory systems — is key to the entire project, the researchers say. “One of the things about neuroprosthetics is that it’s been carried out largely by engineers, and engineers are great at engineering, but the human nervous system works by different rules,” Bensmaia said. “One of our fundamental premises is to really look at the neural system and bring to bear what we understand about how the motor cortex works, how the somatosensory cortex works.”

As with the implant developed by Troyk’s team, Bensmaia and Hatsopoulos’s neuroprosthetic requires implanting electrodes in the brain. Tiny microarrays go into the areas that control movement and process the sense of touch from a natural limb.

The electrodes pick up activity in neurons as the patient thinks about moving his or her own arm

“ Having a human patient allows us to learn all kinds of things we couldn’t learn before. We can probe the quality of sensations being invoked by asking the patients what they feel. We can sculpt movements to make them more natural and precise. This opens a new world for us here at the University of Chicago.”

Sliman Bensmaia, PhD

to direct the robotic arm to move accordingly. The prosthetic hand is fitted with sensors to detect sensations of touch, such as pressing on individual fingertips, which in turn generate electrical signals that stimulate the appropriate areas of the brain.

Over the past nine years, Bensmaia’s lab has uncovered some fascinating aspects of the somatosensory system, such as how nerves encode texture: when the fingers move across a piece of fabric, vibrations are produced in the skin that create different patterns of activation in time in the nerve fibers of the hand; this “Morse code” is then sent as a message to the brain. “If you’re touching satin,” Bensmaia said, “the nerves send different Morse code-like patterns. Silk results in one pattern, satin in another.”

Hatsopoulos is a pioneer in the area of neural prosthetics to restore movement. As a postdoctoral researcher in the early 2000s, he worked in the lab of John P. Donoghue, PhD, executive director of the brain science program at Brown University.

The team made a groundbreaking discovery: how to decode motor neuron activity in real time. The investigators implanted electrodes into the brains of rhesus macaques and recorded neural activity as

The visual prosthetic system system is centered around tiny devices called wireless floating microelectrode arrays, discs about five millimeters in diameter with 16 electrode pins that are smaller than the width of a human hair.

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each monkey used a hand control to move a cursor around to different targets on a computer screen.

They then wrote a mathematical algorithm using a computer that converted the neural signals into a control signal that moved the cursor as the monkey thought about moving the cursor. Neurons in its brain would fire, the algorithm would decode those signals to estimate where the monkey intended to move its hand, and that intention signal would move the cursor.

Nicholas Hatsopoulos, PhD, and colleagues are developing robotic arms patients can control with their minds that receive sensory feedback from attached prosthetic hands.

PHOTO BY ROB HART

Towle’s research is supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under Award Number UG3NS095557. Bensmaia’s and Hatsopoulos’ research is funded

by National Institutes of Health grant UH3NS107714. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Restoring basic function At UChicago, Hatsopoulos has continued to refine this work. For instance, his lab recently showed that monkeys with amputated arms — the amputations were not done for the study but rather because the animals had suffered injuries — could increase the neural connections specific for reaching and grasping with the lost arm. The monkeys were trained to move a robotic arm and grasp a ball using only their thoughts, and the researchers recorded their neural activity, finding that the neural connections became more robust as the training progressed.

The finding has implications for humans with amputated limbs who receive robotic replacements.

Now with the new grant, Hatsopoulos and Bensmaia will work with humans at UChicago. The study subjects will be patients with tetraplegia, or paralysis from the neck down. They must be willing to undergo surgery for limited benefit; one problem that has yet to be solved is that the microarrays sometimes only last for a year or two.

Towle also is aware that his human subjects will also be taking a risk with, perhaps, not a lot of payoff. That’s especially true for the first volunteer, who will receive very few implants as a test of implant safety. The researchers will be working with this participant to see if the stimulation is changing the brain, before scaling up with later participants. Since each implant has 16 channels, the first patient in the study will see about 160 points of light. After careful evaluation of the

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

system’s safety, subsequent participants will receive increasing numbers of implants. Volunteers will be recruited from the Chicago Lighthouse, a social service organization for people who are blind or visually impaired, which is also providing space for testing the subjects.

Initially, the system will work only for people who were born with sight and lost it through injury or illness, because these patients have a fully developed visual cortex for processing images. Potential subjects will be asked to write an essay describing what their life is like now and how they think it might improve after the implants. “We’re going to look at it carefully to make sure they have realistic expectations,” Towle said.

Once a subject has the implants, the researchers will have to map the points of light — called phosphenes — that appear in that person’s normal field of vision. Perceptions of where these phosphenes appear differ from individual to individual. With the map, the investigators can program the computer so it knows which electrode to stimulate when the camera sees an image. After the points are mapped out, the subjects will begin to see outlines of shapes resembling the classic Lite-Brite toy, where you poke holes in a sheet of paper to reveal a pattern when light shines through.

“It’s a very rudimentary vision,” Towle said.

“By contrast the optic nerves each contain about 1.1 million nerve fibers going back to your brain, but for this first project we’re going to implant relatively few electrodes in a single hemisphere.

It will initially be like looking at a stadium scoreboard with most of the lights burned out. We will hopefully be adding more lights in the future.”

Still, the hope is that the subjects will eventually be able to recognize objects they need in their daily lives — doorways, a set of keys, a mobile phone or hazards like an oncoming automobile — and interact appropriately with them. The same is true for people with tetraplegia and others who have lost ability to move. Bensmaia and Hatsopoulos hope their devices will one day allow such patients to be able to dress and feed themselves.

“We’re trying for functional improvements,” Hatsopoulos said. “I like the analogy of the cochlear ear implant for deafness. It’s a success because it provides functional hearing. People with the implant can hear and understand language when people are speaking without having to read lips. They probably do not hear music the way we do, but they have basic functional hearing.”

O R G A N I S M A L B I O L O G Y A N D A N AT O M Y

Hagfish fossil shakes up vertebrate family tree

U

Tethymyxine tapirostrum, a 100-million-year-old, 12-inch-long fish embedded in a slab of Cretaceous period limestone, is believed to be the first detailed fossil of a hagfish.

PHOTO BY TETSUTO MIYASHITA, PHD, UNIVERSITY OF CHICAGO PHOTO COURTESY OF TETSUTO MIYASHITA, PHD

niversity of Chicago paleontologists have discovered the first detailed fossil of a hagfish — an eel-like carrion feeder of the ocean. The 100-million-year-old fossil reveals answers about when these ancient, jawless fish branched off the evolutionary tree from the lineage that gave rise to modern-day jawed vertebrates, including bony fish and humans.

The fossil, named Tethymyxine tapirostrum, is a 12-inch-long fish embedded in a Cretaceous period limestone slab from Lebanon.

It fills a gap in the fossil record and shows that hagfish are more closely related to the blood-sucking lamprey than to other fish.

This means that both hagfish and lampreys evolved their eel-like body shape and strange feeding systems after they branched off from the rest of the vertebrate line of ancestry about 500 million years ago.

“This is a major reorganization of the family tree of all fish and their descendants,” said Tetsuto Miyashita, PhD, a Chicago Fellow in the Department of Organismal Biology and Anatomy at UChicago who led the research. “This allows us to put an evolutionary date on unique traits that set hagfish apart from all other animals.” The findings were published in Proceedings of the National Academy of Sciences.

The slimy dead giveaway Modern-day hagfish are known for their bizarre, nightmarish appearance and unique defense mechanism. When harassed, they instantly turn the water around them into a cloud of slime, clogging the gills of would-be predators.

This ability to produce slime is what gave away the Tethymyxine fossil. Miyashita used an imaging technology called synchrotron scanning to identify chemical traces of soft tissue left behind in the limestone when the hagfish fossilized.

Read the full story and watch a video of a hagfish turning water into slime: uchicagomedicine.org/hagfish

The modern-day hagfish spews out slime to repel would-be predators.

E C O LO G Y A N D E VO L U T I O N

“Explore the Wild Side of Cities” on the new season of “Urban Nature” The second season of “Urban Nature,” the award-winning web series from Chicago PBS member station WTTW, is available for streaming. The digital series features University of Chicago evolutionary biologist Marcus Kronforst, PhD, exploring overlooked ecosystems and hidden wildlife in urban settings.

MIAMI

AUSTIN

C H I C AG O

If you Build It (a Nuclear Reactor), They (Crocodiles) Will Come

The Bat Bridges of Austin, Texas

The Forager

uchicagomedicine.org/midway

In season two, Kronforst hunts for crocodiles at a nuclear power plant near Miami, catches bats under a bridge in Austin, Texas, and makes a salad from plants gathered in a Chicago alley.

Find both seasons of “Urban Nature” at wttw.com/urbannature.

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Pritzker News

M AT C H DAY 2 0 1 9

The long and winding road to medical school

T

he decision to become a physician is not an easy one. Every member of the

BY GRETCHEN RUBIN

Class of 2019 had their own journey to medical school, made up of unique life experiences that shaped their choice.

Four students began non-traditional careers ahead of pursuing medicine — managing

food distribution in the Congo, directing community development in Afghanistan,

Fourth-year medical students Jon Fischer, left, Travis Wassermann, Jocelyn Wascher and Matt Present

editing manuscripts for the U.S. Army in Virginia and launching a magazine for a Chicago

PHOTO BY JEAN LACHAT

newspaper. Meet Jon Fischer, Travis Wassermann, Jocelyn Wascher and Matt Present.

Jocelyn Wascher

AGE: 29

Childhood dream

Making the connection

A writer. When I was little, I’d spy on my two brothers and then write short stories about them. As editor of the literary magazine at my high school, I wrote and edited stories and worked on layout. I loved it.

One of my first jobs was with ARMY magazine, where I edited articles by retired generals and other military. It was fun, but I got tired of sitting at a desk and craved something more dynamic and social. So, I volunteered at an emergency room and then took a job as a medical assistant. I observed that in medicine you hear people’s stories and analyze how they fit together. And that’s what I enjoyed most about writing.

Difficult advice I was an English major and thought I’d pursue a doctorate and go into academia.

But when I met with my advisor close to graduation, she said she saw me ‘out in the world’ before committing to a PhD. I was hurt at first, but it turned out to be a good thing. I decided to take four years off to ‘try everything.’

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or understand how medical school worked, I thought I’d need support and some handholding. The initial class work was harder for me than for many of my classmates. But I had more selfconfidence in my third year because of my previous experience with patients.

The next step

A good fit

I’m going into obstetrics and gynecology.

My research at Pritzker was geared to social justice and advocacy. I hope to use my literary skills to continue writing about these issues.

I liked Pritzker’s small size. As someone who didn’t come from a family of doctors

Jocelyn Wascher matched at the University of Chicago Medicine.

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Matt Present

AGE: 33

Childhood dream

high school. And by the time I finished my postbac, I would have taken close to a gap decade. But after doing some deep thinking, it didn’t seem so pie in the sky.

As a young child, I dreamed of being a professional basketball player, a teacher and a lawyer. From age 15 on, I wanted to be a writer. I never, for a moment, considered being a doctor.

Doing more good

Knowing people’s stories After college, I wrote a lot of stories while teaching English in a tiny Japanese fishing village. When I returned to Chicago, I got a job writing and editing satirical ad copy for Groupon. It was 2010, and Groupon was one of the few places a young writer could make a living. I followed my boss to the Chicago Sun-Times, where I served as founding editor for their business magazine. It became clear to me that I liked interacting with people and writing about them. But I started wondering, ‘Is it going to be journalism or something else?’

Travis Wassermann

Matt Present appeared on the PBS show, “In the Loop,” in 2013, when he was editor of the Chicago Sun-Times’ business magazine.

An eye-opening discovery

The next step

A close friend who had just matched for residency suggested I think about becoming a doctor, telling me, ‘Everything you describe about what you want in life fits with medicine.’ I was 27 and hadn’t had a science class since I was a junior in

Pediatrics. I did a sub-I in the Comer Children’s Hospital PICU and saw miracles happen there.

Matt Present matched at Golisano Children’s Hospital, University of Rochester Medical Center.

Childhood dream I knew I wanted to make a difference in the lives of people in a place of need. But I didn’t know what that meant for a career. I studied bioengineering in college without a clear sense of how it would fit into my future.

administrative work. Security was worsening in Afghanistan, sending some of my colleagues to look for work in the next crisis zone. I was married and had a baby.

Medicine was a more stable path that let me continue the face-to-face health work I’d come to love.

Meeting a need

The oldest in the class

I wanted to fill a niche that otherwise might go unfilled. This led to doing project management work for a socially conscious startup in Pakistan. After a major earthquake there, I tagged along as an interpreter for an American medical team.

That experience showed me firsthand the weight of health needs and the joy of meeting those needs in people’s lives.

I came back to the U.S. to get a master of public health degree and then headed to Afghanistan where I implemented humanitarian projects.

The next step

AGE: 37

An elder in the village of Karez-e Mir, north of Kabul, Afghanistan, shows Travis Wassermann where members of his community go to draw water.

Choosing medical school My favorite days in Kabul were when I was out in the communities, but I was spending much of my time doing

uchicagomedicine.org/midway

First-rate journalism and medicine both require you to earn people’s trust quickly, take in a lot of information at once and look at how patterns fit together to animate the story. In journalism, your work can help a lot of people, but just a little bit. As a doctor, I’ll help fewer people, but so much more.

Because of my experience and age, I had a different perspective. For some of the younger medical students, exams felt like life-or-death crises. I was able to help classmates see a bigger picture of how our training fit into our careers.

Emergency medicine, because it deals with the full breadth of physiology and pharmacology. The immediacy of need appeals to me, as it has throughout my career. Also, because I have two young kids and I’m older, a shorter residency is appealing.

Travis Wasserman matched at Loyola University Medical Center.

MEDICINE ON THE MIDWAY

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31

AGE: 31

Pritzker News

Jon Fischer

Childhood dream A pilot, so I would always have a window seat with cool views.

Observing health care I spent a college semester in Senegal, where I learned French and did international development work. I observed how the lack of good health care had a broad impact on development. My first job after graduation was in the Democratic Republic of the Congo doing food distribution logistics. I saw the positive effect that even a little health care can make.

This led me to pursue a master of public health degree in the U.S. with a plan to go back to Africa.

What it would take Jon Fischer takes a break while supervising food distribution to thousands of people in the town of Aba, Democratic Republic of the Congo, near the border of South Sudan, in April 2010.

Halfway through my master’s program, I got an internship doing a workflow project for an emergency room. I found the clinical work interesting and the doctor-patient relationship appealing.

I could see that being a doctor would enable me to be part of a bigger health care team and still care for the underserved. Still, I really had to think about it. Between a postbac, medical school, residency and fellowship, I’d add 10 years of training. But I had that gut feeling that I wanted to be a doctor.

The culture of Pritzker It was hard, but fun and collaborative. I loved the culture and my classmates. I can’t imagine any way it could have been better.

The next step I guess things came full circle because I am going into psychiatry and I am interested in caring for the underserved both in the U.S. and globally. My dream is to do medical education research in psychiatry here and apply it abroad.

Jon Fischer matched at University of Utahaffiliated Hospitals.

M AT C H DAY 2 0 1 9

It’s a match!

PHOTO BY JOEL WINTERMANTLE

Members of the Pritzker School of Medicine Class of 2019 will be heading to residency programs in 20 states and Washington, D.C. The most popular specialties are: internal medicine (17 students), pediatrics (9), psychiatry (9), emergency medicine (8), family medicine (7) and obstetrics and gynecology (6).

Eighteen students will stay at the University of Chicago Medicine for all or part of their training.

Eight are headed to the Northwestern University system. Other hospitals and health systems accepting several Pritzker applicants include the University of California (8), Harvard (6), and Columbia University, University of Minnesota, University of Washington and Yale University (3 each).

MS4s Alicia Canas, left, and Apra-Marie Watson share their excitement on Match Day.

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Gold Humanism Honor Society

T

he Gold Humanism Honor Society honors fourth-year students who exemplify compassionate patient care and serve as role models, mentors and leaders. Thirteen members of the Pritzker School of Medicine Class of 2019 — nominated by their classmates — were inducted in February.

Sarah Peters, MS4, was the student awardee of the Leonard Tow Humanism in Medicine Award. H. Barrett Fromme, MD, MHPE, professor of pediatrics, director of the pediatric hospitalist program and associate director of the pediatric residency program, was the Leonard Tow faculty awardee.

Nicola Orlov, LAB’97, MD’08, MPH, assistant professor of pediatrics, was the Arnold P. Gold Foundation Humanism in Medicine Award nominee.

The 2019 Pritzker School of Medicine Gold Humanism Honor Society inductees are, from left, first row: Natalie Francis, Alex Spacht, AB’12, Tae Yeon Kim, AB’13, Sarah Peters, Julia Baird, LAB’10. Middle row: Michael Harries, M.Ed., Rebecca Gieseker, Jocelyn Wascher, Matt Present. Back row: Femi Adams, Emily Foltz, Riley Brian, Cheyenne Smith.

Alpha Omega Alpha Honor Medical Society PHOTOS BY JEAN LACHAT

Members of the Pritzker Class of 2019 inducted into the Alpha Omega Alpha Honor Medical Society are, from left, first row: Michael Harries, M.Ed., Michael Fishman, Alex Spacht, AB’12, Cindy Zhang, Anya Bershad, PhD’17, Emily Foltz, Natalie Francis.

Back row: Palmer Greene, Jared Sokol, Riley Brian, Cheyenne Smith, Nora Taranto, Matthew Jones, AB’11, DPhil, Suellen Li. Not pictured: Kate Leonard.

F

ifteen members of the Pritzker School of Medicine Class of 2019 were inducted into the Alpha Omega Alpha (AΩA) Honor Medical Society in recognition of their academic excellence, leadership, compassion and fairness.

Each fall, AΩA medical students elect alumni based on their leadership and accomplishments to date; alumni are eligible 10 years after graduation. Faculty are elected based on their demonstrated commitment to scholarly excellence and medical education. Residents and fellows are elected for their continued achievement, promise and mentorship qualities. uchicagomedicine.org/midway

The Class of 2019 elected the following to the Illinois Beta chapter: Alumni: Charis Eng, AB’82, PhD’86, MD’88, chair of Cleveland Clinic’s Genomics Institute; and Paul Luning, MD’95, MPH, chief medical officer of PCC Community Wellness Center in Oak Park.

Faculty: Jason Alexander, MD, assistant professor, Department of Medicine; and Naoum Issa, MD, PhD, assistant professor, Department of Neurology.

Housestaff: Huda Adam, MBBS, Department of Pediatrics; Abdullah Pratt, MD’16, Department of Medicine; and Kinga Skowron, AB’09, MD’12,

Department of Surgery.

Bridget Wild, MD, assistant clinical professor, NorthShore University HealthSystem Department of Pediatrics, received the volunteer clinical faculty award, which recognizes a community physician who contributes with distinction to the education and training of clinical students.

AΩA Visiting Professor Lisa A. Cooper, MD, MPH, director of the Johns Hopkins Center for Health Equity, presented the Grand Rounds lecture: “From Health Disparities to Health Equity: Thinking Locally and Acting Globally.”

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Pritzker’s Scholarship and Discovery curriculum turns 10 PHOTO BY EDDIE QUINONES

Pritzker News

Every student a scholar

Riley Brian, MS4, is working on two clinical research studies with mentor Nora Jaskowiak, MD, professor of surgery.

BY GRETCHEN RUBIN

34

I

t’s no accident that 100 percent of Pritzker School of Medicine students engage in mentored research — a rate much higher than at other U.S. medical schools. The Scholarship and Discovery (S&D) curriculum team connects with first-year students soon after they arrive on campus.

“We get a sense of who they are and what scholarly area they are interested in,” said Vineet Arora, MD, AM’03, assistant dean for Scholarship and Discovery. “We want to align them with the right mentor.”

To make this happen, students fill out an online form detailing their interests in one of seven tracks: basic sciences, clinical research, social sciences, community health, global health, medical education and healthcare delivery sciences.

The S&D team recommends up to three possible mentors for each student. “We don’t make random connections,” she said. “We want to find harmony for the student and the mentor.”

In fact, students and faculty jokingly call this introduction the “eharmony” letter, after the online dating site. Riley Brian, MS4, said he and his

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

classmates appreciate the matches because “it gives us an ‘in’ rather than cold-calling faculty to look for projects and research.”

Brian’s interest in medical education led to a connection with mentor Maria Alkureishi, MD, associate professor of pediatrics, and his project “Evaluating the impact of clinical librarians on inpatient rounds.” His peer-reviewed article appeared in the Journal of the Medical Library Association and earned him an award for excellence during S&D’s Summer Research Forum and an Outstanding New Investigator Award from AAMC’s Central Group on Education Affairs.

After finishing the medical education project, Brian has redirected his scholarly efforts to two surgery clinical research studies in preparation for a residency in the specialty.

Arora said it’s not unusual for students to complete an S&D project with one mentor and then navigate to other mentors based on their specialty during their four years on campus. “Scholarship and Discovery is a continuum,” she said, calling it “a narrative from the time students arrive until they graduate.”

Scholarship and Discovery by the numbers

100%

of students participate in a mentored research project

85%

of students participated in the Summer Research Program*

86.2%

of students gave conference presentations*

■ American Diabetes Association ■ American Society of Hematology ■ Society for Academic Emergency Medicine ■ American Academy of Orthopaedic Surgeons ■ American Public Health Association

Research published

by S&D students in leading journals ■ Academic Medicine ■ JAMA Internal Medicine ■ PLOS ONE ■ Genes and Diseases ■ American Journal of Surgery

A decade of Scholarship and Discovery When the Scholarship and Discovery (S&D) curriculum launched in 2009 as part of the Pritzker Initiative, many medical students were already participating in the National Institutes of Health-funded Summer Research Program. But for most students, it was their only involvement in scholarly work.

“We want our graduates to become leaders in the medical field and make the next breakthroughs in everything from basic science to global medicine,” said Vineet Arora, MD, AM’03, emphasizing the University of Chicago’s mission to generate new knowledge, scholarly inquiry and lifelong learning.

Through S&D, every Pritzker student — beginning in the first year of medical school — completes at least one mentored scholarly project by the time of graduation.

Mentored research as an integral part of medical school curriculum is now catching on across the country — and Pritzker is at the forefront. S&D’s co-director, Rachel Wolfson, MD’00, leads the Scholarly Concentrations Collaborative, a coalition of more than 40 medical schools implementing and evaluating similar programs.

The four-year S&D curriculum was built on the strength of the Summer Research Program as well as innovations in such areas as community and global health at the medical school. At a time when other medical schools were taking on more students, Pritzker made a bold move to limit its class size to 88, ensuring that every student would have access to the mentoring and advising resources of its faculty.

“Ten years ago, we were part of a national movement to create leadership programs for scholarship in medical school,” Wolfson said. “Now we are leading the discussion on program development and studying the impact on students’ careers.”

PHOTO BY JOEL WINTERMANTLE

National awards for S&D students ■ American Heart Association Young

Investigator’s Award ■ Winner, Clinical Outcomes and Healthcare

Improvement category at the AMA’s 2015 Research Symposium ■ Fulbright/Fogarty Fellowship in Public Health

to conduct research in China for one year

National news coverage for S&D students in ■ The New York Times ■ Reuters

Maria Alkureishi, MD, left, Nicola Orlov, LAB’97, MD’08, MPH, biomedical reference librarian Debra Werner and medical student Riley Brian, who conducted research on the impact of medical librarians on inpatient rounds.

*10-year average

uchicagomedicine.org/midway

MEDICINE ON THE MIDWAY

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TH AN KS TO YOU OUR ALUMNI COMMUNITY HAS GROWN FR OM MORE TO MORE.

Since 2014, thousands of medical and biological sciences alumni have attended events, made gifts to support students and trainees, volunteered their time to help fellow and future alumni, and connected with the alumni community from wherever they called home. Every time you GO, GIVE, HELP, CONNECT, you build a stronger MBSAA community for future alumni, fellow alumni, and for you.

GO GIVE HELP CONNECT

FIND US ON SOCIAL:

@UChicagoMBSAA

medbsd.uchicago.edu

THE UNIVERSITY OF CHICAGO MEDICAL & BIOLOGICAL SCIENCES ALUMNI ASSOCIATION

M E D I C A L & B I O LO G I C A L S C I E N C E S A L U M N I A S S O C I AT I O N

Getting together, from coast to coast Nov. 13, 2018: Alumni and Biological Sciences Division trainees gather in Boston for the myCHOICE Trek Reception hosted by the MBSAA. A group of alumni also attended a performance by the Boston Symphony Orchestra that weekend.

Find more events on campus and around the country:

medbsd.uchicago.edu/ alumni/all-events

Sept. 15, 2018: Alumni volunteers at the 5th annual myCHOICE BSD Alumni Career Forum, below. Graduate students and postdocs had the opportunity to connect with 23 alumni to hear their insights on the process of translating a PhD from UChicago into a number of careers.

PHOTO BY ROB HART

PHOTO BY ROB HART

Check out our calendar!

Oct. 28, 2018: The Bernard B. Jacobs Theatre in New York City, where alumni gathered for an opening week performance of “The Ferryman” after lunch.

Feb. 10, 2019: During the MBSAA Afternoon at the Field Museum, guests tour the Field Museum’s extensive bird specimen collection with Shannon Hackett, PhD, Richard and Jill Chaifetz Associate Curator of Birds at the Field and associate chair of the Committee on Evolutionary Biology at the University of Chicago.

Sept. 15, 2018: Alumni panel at myCHOICE BSD Alumni Career Forum hosted by UChicagoGRAD, myCHOICE, and the University of Chicago Medical & Biological Sciences Alumni Association.

Feb. 28, 2019: Alumni Reception in Orange County, California, hosted by Martin Fee, MD’88.

uchicagomedicine.org/midway

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Your News

YO U R N E W S 2018-2019 ALUMNI COUNCIL Executive Committee Paul H. Rockey, MPH, MD’70 President Michael H. Silverman, MD’73 Immediate Past President Chris Albanis, AB’96, MD’00 Vice President Doriane C. Miller, MD’83 Alumni Awards and National Reunion Chair Karyl Kopaskie, AB’07, PhD’14 Chicago Partners Program Chair Jeanne Farnan, AB’98, MD’02, MHPE Editorial Committee Chair Baruch Solomon Ticho, PhD’87, MD’88 Regional Programs Chair Andrew Aronson, MD’69 Mark R. Aschliman, MD’80 Juliana Basko-Plluska, AB’04, MD Kenneth Begelman, MD’71 Courtney Kagan Burrows, PhD’15, MBA’17 Oliver G. Cameron, PhD’72, MD’74 Amy Derick, MD’02 Gail Farfel, PhD’93 Jonathan Fox, AB’79, PhD’85, MD’87 Keith A. Horvath, AB’83, MD’87 Lucy Lester, MD’72 Daniel Leventhal, SM’13, PhD’16 Howard Liang, PhD’92, MBA’01 Julie Mhlaba, MD’16 Abby Stayart, AB’97, PhD’12 Jack Stockert, AB’05, MBA’10, MD’10 William Weese, MD’69 Sydney Yoon, MD’86 Lifetime Members L.D. Anagnostopoulos, SB’57, MD’61 Arnold B. Calica, SM’61, MD’75 Coleman Seskind, AB’55, MD’59, SM’59 Rostik Zajtchuk, SB’60, MD’63 Student Representatives Olufemi E. Adams, MS4 Pritzker School of Medicine Ittai Eres, SM’17 Alyssa J. Harker Biological Sciences Division Resident Representatives Noura Choudhury, MD’16 Ava Ferguson Bryan, AM’10, MD’18

1950s Arnold Tanis, PhB’47, SB’49, MD’51, is the author of The Crazy, Wonderful Things Kids Say: Tales from the Singing Pediatrician. The book is a collection of stories and questions from three generations of Tanis’s patients. Tanis, or “Buddy” as his classmates may know him, practiced pediatrics for 54 years in Hollywood, Florida, before retiring at the age of 81. He is the co-founder of Pediatric Associates and served as president of the Florida Pediatric Society from 1986 to 1989. He is a past recipient of the University of Chicago Medical & Biological Sciences Alumni Association’s Distinguished Service Award.

1960s Lampis D. Anagnostopoulos, SB’57, MD’61, is the author of From One Life to the Next. The book is about his personal and professional life.

Anagnostopoulos did a rotating internship at Philadelphia General Hospital. He completed a residency in internal medicine at the University of Iowa Hospital and a National Institutes of Health fellowship in cardiology at Seton Hall Medical School before his fellowship in cardiology at the University of Chicago.

Anagnostopoulos served as a faculty member at Northwestern University.

In 1971, he opened a private practice in cardiovascular disease. He retired in 2013. He is a life member of the Alumni Council of the Medical & Biological Sciences Alumni Association.

Share news about your life and accomplishments:

tinyurl.com/ mbsaa-alumni-updates

38

Anita Blanchard, MD’90, associate dean for graduate medical education, and Bryan Bohman, MD’81, one of the founders of Stanford’s WellMD Center, find his medical school photo in the Class of 1981 composite. Bohman came to campus to speak during Resilience Week. Read the story on Page 24.

2019 Pritzker Reunion, June 7-8, 2019 Everyone’s invited!

1970s Nathan Szajnberg, AB’74, MD’74, published a new book, Jacob and Joseph, Judaism’s Architects and Birth of the Ego Ideal. The book surveys the major father-son myths in Western civilization, suggests the Jacob/Joseph relationship as a vibrant variation on the previous myths and discusses the implications for contemporary fatherson relationships. This is the sixth book that he has published. Szajnberg is the former Freud Professor at the Hebrew University.

1980s We want to hear from you!

Down memory lane

Gregory Germino, MD’83, received the Shaul Massry Distinguished Lecture award from the National Kidney Foundation. Germino is the deputy directory of the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health. He is an adjunct professor of medicine at Johns Hopkins University School of Medicine.

Thomas D. Huggett, MD’85, MPH, received the Family Physician of the Year Award in October 2018. The award is the highest honor given

New this year — all members of the Pritzker School of Medicine alumni community are invited back to campus for the 2019 Pritzker Reunion weekend.

The weekend includes special Milestone Reunion Class Celebrations and the Recent Alumni Reception at 10pin Bowling Lounge on Friday, campus events on Saturday, and the final celebration — a boat cruise that includes dinner, dancing, and a fireworks display over the Chicago skyline.

Milestone years: 1964, 1969, 1974, 1979, 1984, 1989, 1994, 1999, 2004, 2009, 2014. Register online at medbsd.uchicago.edu/alumni/reunion Already signed up? Follow @UChicagoMBSAA on Facebook and Twitter for Pritzker Reunion updates and to share your photos using #PSOMReunion.

Questions? Contact the University of Chicago Medical & Biological Sciences Alumni Association at (888) 303-0030 or alumni@bsd.uchicago.edu.

by the Illinois Academy of Family Physicians. Huggett is a physician at and the director of Mobile Health at Lawndale Christian Health Center in Chicago. He is an adjunct assistant clinical professor at the School of Public Health at the University of Illinois at Chicago.

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

COR REC TIO N Edward L.S. Jim, MD’55, retired from private practice in 1994, not 2017 as listed in the Fall 2018 issue of Medicine on the Midway. In addition, he was a fellow of the American College of Surgeons, a senior member of the American Head and Neck Society and past president of the Hawaiian Surgical Association.

IN MEMORIAM

Alfred J. Kahn, SB’40, PhD’43, MD’44, died on October 25, 2018.

He was 98 years old. An internist, Kahn was commissioned as a captain in the U.S. Army. After World War II ended, he went into private practice, then became head of the Spinal Cord Injury Service at Edward Hines Jr. Veterans Administration Hospital. Eventually he left clinical medicine to concentrate on research in epigenetics, alcohol addiction and developmental physiology. He spent the last 30 years of his life writing “Crisis in the Philosophy of Science,” a systems cosmology that encompassed everything from the origin of the universe to human consciousness. He was preceded in death by his parents, three siblings and his wife, Judith. He is survived by his son, James Kahn, AB’70, MD’74; his wife, Jill; and their three children.

1950s Attallah Kappas, MD’50, passed away on December 18, 2018. He was 92 years old. Kappas was a professor emeritus at The Rockefeller University and physician-in-chief emeritus at The Rockefeller University Hospital.

He was credited with discovering the molecular mechanism that causes jaundice in newborn babies and was a leading authority on diseases related to liver function and metabolism.

He was the head of the section of

metabolism and arthritis at the University of Chicago for 10 years.

Kappas was honored by the University of Chicago Medical & Biological Sciences Alumni Association with a Distinguished Service Award in 1975 and a Professional Achievement Award in 1995. He received a number of prestigious awards, including a Burroughs Wellcome Fund Special Award in Clinical Pharmacology, the ASPET Award for Distinguished Research in Experimental Therapeutics from the American Society for Pharmacology and Experimental Therapeutics, the American College of Physicians Award for Outstanding Contributions to Internal Medicine and the inaugural NIH Award for Excellence in Clinical Research. Kappas is survived by his three sons and many grandchildren.

Anthony Frederick Lalli, MD’54, died on January 10, 2019. He was 88 years old. Lalli completed his residency in radiology at the University of Chicago.

He is survived by his wife of 63 years, Donna, his two children and his grandchildren.

Edgar C. Bristow III, MD’56, died on September 30, 2018. He was 89 years old. After an internship at Stamford Hospital, Bristow served as a medical officer with the 4th Infantry Division and at Valley Forge Army Hospital.

He completed a residency in family practice at Atlantic City Medical Center in New Jersey. He worked at Atlantic City Hospital and Shore Memorial Hospital, where he served on several

committees. Bristow was on the board of the Atlantic County chapter of the American Red Cross and a life member of the American Academy of Family Physicians. He founded the Atlantic Audubon Society, Garden State Audubon Council and Friends of Forsythe National Wildlife Refuge.

Bristow was preceded in death by his former wife, Patricia, and his daughter Carol. He is survived by two children and his wife, Diane.

1960s Robert A. Dorn, SM’62, died on January 22, 2019. He is survived by his wife of 62 years, Marilyn, four children, and his grandchildren and great-grandchildren.

Bruce P. Hayden, PhD’68, died on September 10, 2018. Hayden was professor emeritus and former chair of environmental sciences at the University of Virginia. He was an alumnus of Pennsylvania State University and completed a postdoctoral program at the University of Wisconsin.

1970s Robert J. Markowitz, MD’70, died on December 27, 2018. Markowitz served as an officer and pediatrician in the U.S. Navy. He practiced pediatrics in Monroe, New York. Markowitz was preceded in death by his wife, Hope, and his brother. He is survived by his two children and grandchildren.

George Wu, MD’71, died on February 25, 2019. Wu emigrated from Shanghai, China, to the U.S. when he was four years old. Wu completed his residency in plastic and reconstructive surgery at Stanford University Medical Center and a hand surgery fellowship at Roosevelt Hospital. Wu served for two years as a physician in the U.S. Air Force. He established his private practice as a plastic and reconstructive surgeon, specializing in hand surgery, at St. Luke’s Hospital in San Francisco.

Wu volunteered with the Medical & Biological Sciences Alumni Association as an alumni ambassador, a host for the Help Our Students Travel (HOST) program and a class chair for Pritzker Reunion. He is survived by his wife of 44 years, Linda; his son, Jason; and his two grandsons.

In Memoriam

1940s

1980s Joseph Robert Gordon, MD’81, passed away at his home on October 9, 2018, with his loving family around him. He was 63 years old. Gordon was born in Oakland, California, to Leon A. Gordon, PhB’47, SB’48, MD’52, and Elsa Leiter Gordon, LAB’44, PhB’47, SB’50, MD’52, and was the grandson of Louis Leiter, SB 1919, SM’20, Rush MD’21, PhD’24, a former faculty member at the University of Chicago School of Medicine. He grew up in Los Gatos, California, and graduated from Stanford University in 1977. He was a fellow of the American College of Surgeons, practicing general surgery for over 35 years, and was honored as Teacher continued on page 40

Faculty

Thomas Nagylaki, PhD

T

homas Nagylaki, PhD, professor emeritus in the Department of Ecology and Evolution and a member of the Committee on Genetics, Genomics and Systems Biology, died on February 10, 2019, of complications from chronic liver disease. He was 75 years old.

Nagylaki studied theoretical population genetics — primarily, as he put it, the “formulation and analysis of models for geographical variation, random genetic drift, natural selection and gene conversion in multigene families.” Born in Hungary, Nagylaki graduated from McGill University with first-class honors in physics, then completed his PhD in physics in 1969 at the California Institute of Technology. In 1972, however, he switched fields, shifting his focus from physics to medical genetics, but preserving the mathematical component. He worked closely for three years with a pioneer in the field, James F. Crow, PhD, at the University of Wisconsin–Madison. In 1975, Nagylaki moved to the University of Chicago. He rose from assistant professor of biophysics and theoretical biology, to associate professor in 1977, to professor in 1983. In 1984, he changed departments, uchicagomedicine.org/midway

joining Molecular Genetics and Cell Biology. In 1989, he moved again, into the Department of Ecology and Evolution, which became his academic home for nearly 20 years.

Nagylaki authored two biomathematics textbooks that were designed to appeal to advanced college students with a gift for mathematics. Selection in One- and TwoLocus Systems, published in 1977, was based on one of his University of Chicago courses. His second textbook, published in 1992, was Introduction to Theoretical Population Genetics. It covered “areas of theoretical population genetics that can be investigated rigorously by elementary mathematical methods.” He served as an editor, member of the editorial board or member of the advisory board for three scientific journals and on the National Research Council’s Committee on DNA Forensic Science. He took emeritus status in 2008, but remained active. He authored a total of 122 academic papers, including 12 published after his formal retirement. His final paper, on which he spent two years and had 600 pages of notes, has been submitted for publication.

“ It was fascinating to be around Tom. In terms of sheer intellectual computing power, I’ve never run across anyone like him. He was drawn to theoretical projects that were difficult to prove, but he solved them with subtlety and creativity. His writing was exquisitely precise.”

Martin Kreitman, PhD Professor of Ecology and Evolution

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In Memoriam

continued from page 39

of the Year many times. He was a role model for his residents, esteemed by his colleagues and beloved by his many patients. Throughout his medical career, he was known for his kindness, skill, sensitivity and immeasurable

patience. Gordon loved Lake Tahoe and was an avid skier and cyclist, as well as a talented craftsman, particularly in woodworking and antique clock repair. A devoted husband and father, brother and uncle, he is survived by his

wife, Nancy; his children Mallorie (Josh Felsenfeld), Louis, Anna and Gabriel; his siblings, Jo Carol (Jonathan) Hiatt, Jennifer (Robert) Cohen and Marc Gordon (Sherri Burnett); and his nieces and nephews.

Former dean

Robert Uretz, SB’47, PhD’54

R “ Robert was just a very good guy. He was really nice, thoughtful, always fair.”

Robert Haselkorn, PhD Fanny L. Pritzker Distinguished Service Professor Emeritus Department of Molecular Genetics and Cell Biology

obert B. Uretz, PhD — an undergraduate and graduate student at the University of Chicago who became a professor, chair, dean and vice president — died on September 14, 2018, in Chicago. He was 94 years old. Uretz had a promising early career in science, but he also had a talent for organization and management. This gradually pulled him away from the laboratory and into a series of important administrative positions. His most influential roles were serving for six years as dean of the Biological Sciences Division and the Pritzker School of Medicine and vice president of the Medical Center in the late 1970s and early 1980s. He was one of the rare leaders of a major U.S. medical school who did not have a medical degree.

He accepted the job at a difficult time. In 1977, a hospitalwide task force reported a “massive backlog of needed renovations plus chronic shortages of space for both patient care and academic needs.” Uretz and colleagues formalized plans to improve the efficiency of care within the medical center and began raising the funds needed to expand and modernize the clinics. This work ultimately led to the construction of the 468-bed Bernard Mitchell Hospital, which opened in 1983.

Uretz was born in Chicago and graduated from John Marshall Metropolitan High School in the East Garfield Park

neighborhood. As a first lieutenant in the U.S. Army Air Force during World War II, he participated in meteorological and cosmic ray research for the military, assisting on flights to Alaska and South America. After the war, he graduated from the College with a bachelor’s degree in physics, completed his PhD in biophysics and joined the biophysics faculty. Uretz eventually served as chair of the Biophysics Department and was honored with the Ralph W. Gerard Professorship.

When he was still a graduate student, Uretz married an artist, Violet (Vi) Fogle, SB’39. She died in 2007. They had two children: Jane Elizabeth (Uretz) Miller and the late Alan Daniel Uretz. He spent his final 12 years at Montgomery Place, a continuing care retirement community near the University. Thanks to his administrative skills, he was elected president of the residents’ council and participated in various discussion and support groups. “He delighted in keeping up with the activities and interests of several generations,” Miller said. “Kind, diplomatic, and a thoughtful listener, he engaged people with his wide range of interests and quiet sense of humor.” He also is survived by two daughters-in-law, Jennifer Uretz and Marybeth Uretz; three grandsons; and two greatgrandsons. A celebration of his life was held in November at Montgomery Place.

Former dean

Donald West King, MD

D

onald West King, MD, the former Richard T. Crane Professor of Pathology, dean of the Biological Sciences Division and executive vice president of the University of Chicago Medical Center, died from complications of cancer at his home on October 27, 2018.

He was 91 years old. King had a long and distinguished career. He served in the Medical Corps of the U.S. Army, was a faculty member at Yale University, and was chair of pathology at the University of Colorado. He spent 15 years as chair of pathology at Columbia University in New York, where he established the largest department of its kind in the country.

King came to the University of Chicago in 1983. During his term as dean, he and colleagues were recognized for their efforts in building outstanding programs. King worked with biological sciences and medical faculty to establish a branch of the Howard Hughes Medical Institute, one of the largest philanthropies in the world, at the University and helped recruit promising young scientists. He was instrumental in

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

securing a substantial grant from the Markey Foundation to help develop the neurobiology program. He led renovation of the aging Billings Hospital into a modern research lab facility, even supplying a British wrought-iron gate and fence to enclose its former entrance.

After the standard five-year term as dean, King stepped down. Two years later, he became executive director of the American Registry of Pathology in Washington, D.C. In 2002, he joined the National Library of Medicine, part of the National Institutes of Health, as deputy director for research and education. After his retirement in 2009, King remained active, teaching human biology in the Mentoring in Medicine program for public and parochial schools in New York City.

He is survived by his wife of 66 years, Mary Elizabeth King, MD; their three children, Donald W. King (III), Katherine A. King and David L. King; and six grandchildren, Juliette, Jessica, Madeleine, Helen, Matteo and Emma. A memorial service was held at the First Presbyterian Church in New York on December 15, 2018.

Faculty

Anthony Montag, MD

A

nthony (Tony) Montag, MD, professor of pathology and associate dean for admissions at the Pritzker School of Medicine, died on November 9, 2018, after a long battle with prostate cancer. Montag began his education in a one-room schoolhouse in Woodbine, Iowa. He graduated Phi Beta Kappa from Iowa State University in three years with a degree in invertebrate zoology, followed by a medical degree and a residency in pathology at the Medical College of Wisconsin. He completed his clinical fellowship at the Harvardaffiliated Brigham and Women’s Hospital in Boston. He joined the University of Chicago faculty in 1985. His research focused on metastasis and the expression of steroid receptors in bone and soft tissue tumors. His clinical work centered on bone, soft tissue and gynecologic tumors.

“Tony was genuinely enthusiastic about research,” said Ernst Lengyel, MD, PhD, Arthur L. and Lee G. Herbst Professor and chair of obstetrics and gynecology. “He had the ability and experience to dig deeper, to come up with a diagnosis that other physicians might not see.” Michael Simon, MD, professor of orthopaedic surgery and rehabilitation medicine, said Montag also had a “huge impact” on medical students. “He knew them, knew their plans, their details,” Simon said. “And he was a good teacher, with a dry sense of humor and fun to be around.”

Montag received the Alpha Omega Alpha Honor Medical Society teaching award and was recognized as a clinical

“ He represented all that is great about the University of Chicago. He was not only an outstanding pathologist, but also an outstanding person — a quiet, selfless role model for us all.” peer mentor and a fellow of the Academy of Distinguished Medical Educators at Pritzker. He was a member and chair for Pritzker admissions committees and also served on regional and national committees. He was the author or co-author of nearly 200 scientific papers, case reports, book chapters and abstracts, primarily on gynecologic and bone cancers. He also contributed to his community, as an assistant scoutmaster for Boy Scouts of America Troop 512 and chair of property and finance at Hyde Park Union Church. In his rare free time, he could be found cycling around Chicago. He is survived by his wife, Katherine Leslie Griem, MD, a radiation oncologist; three children, Hugh, William and Caroline; four siblings; five nieces and nephews; and their children. A memorial service was held December 7 in Rockefeller Memorial Chapel.

Daniel A. Arber, MD Professor of pathology and chair, Department of Pathology

Faculty

Ting-Wa Wong, MD’57, PhD’68

T

ing-Wa Wong, MD’57, PhD’68, a highly respected member of the faculty who was consistently honored by medical students for her superb teaching, died at the age of 86 on January 4, 2019. Wong grew up in Hong Kong but came to the U.S. for college. She graduated at age 20 from the University of California, Berkeley, where she was a member of the Phi Beta Kappa Society. After medical school, she completed an internship at Barnes-Jewish Hospital at Washington University in St. Louis, followed by a pathology residency at the University of Chicago. She stayed at the University for the rest of her career, starting as a pathology instructor. After earning her PhD in organic chemistry, she returned to the faculty as an assistant professor in 1968 and was promoted to associate professor in 1973.

Wong was devoted to teaching medical students in their preclinical years. She was course coordinator of General and Cellular Pathology for nearly a decade, and continued to participate as a faculty member in the course. Her major interest, however, was Clinical Pathophysiology, a course that she began to teach in 1990. This all-consuming course, known for its carefully organized lectures and handouts, is one of the highlights of the Pritzker School of Medicine curriculum.

Wong also initiated and directed an accelerated summer histology course to help students in the Medical Scientist

uchicagomedicine.org/midway

Training Program begin their PhD research much earlier, and she developed a popular course for college non-biology majors on the origins of cancer.

Wong’s students appreciated the clarity and precision with which she explained even the most complicated medical concepts. She received numerous teaching awards, including election to the Alpha Omega Alpha Honor Medical Society. She also received the Humanism and Excellence in Pre-Clinical Teaching Award, the Basic Science Teaching Award (at least five times), the Distinguished Basic Science Teaching Award (at least four times) and the graduating seniors’ Favorite Faculty Award (more than 25 times). In 2006, she was named one of six inaugural members of Pritzker’s Academy of Distinguished Medical Educators. A scholarship award was established in her name in 2012. The Ting-Wa Wong, MD, PhD, Scholarship is bestowed each year on a student who has demonstrated exemplary performance and achievement in pathology.

“ You would be hard pressed to find someone that students liked better. They routinely gave her a standing ovation at the end of a course. She was one of the best educators we’ve ever had: very clear in her teaching, precise, up to date.”

Scott Stern, AB’80, MD’84 Professor of Medicine

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L A S T LO O K

Mother nurture This rare 1626 engraving by Spiegel presents a “blooming flower” fetus cradled within a uterus, the layers of which are peeled back to resemble petals. It was one of the works featured in a recent exhibit at the University of Chicago Library, “The Fetus in Utero: From Mystery to Social Media.” The exhibit was co-curated by Brian Callender, AB’97, AM’98, MD’04, and postdoctoral scholar Margaret Carlyle of the Stevanovich Institute on the Formation of Knowledge. See more images from the exhibit at bit.ly/fetus-in-utero.

DE FORMATO FOETU LIBER SINGULARIS AENEIS FIGURIS EXORNATUS, SPECIAL COLLECTIONS RESEARCH CENTER, THE UNIVERSITY OF CHICAGO LIBRARY.