MUSC Catalyst 10-9-2015

October 9, 2015

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 34, No. 7

Inside New palliative care team boosts spirits PALLIATIVE CARE SPECIAL SECTION

7

Palliative care pediatric doctor has soft spot for children.

OUTPATIENT CANCER CENTER

9

New palliative care clinic to open this month.

4 Science Cafe 5 Meet Layne 8

Storm Ready

T H E C ATA ONLINE

LY S T

http:// www.musc. edu/ catalyst

BY DAWN BRAZELL Public Relations

On his landmark 29th birthday, Mark Smith celebrated in a hospital room, trying to find the will to live.

He wasn’t able to talk. He wasn’t eating or drinking.

Horrible mouth sores caused in part by his cancer chemotherapy treatments were making him miserable. He had been diagnosed with HIV in 2011, but went through a depression and stopped taking his medications.

“I really didn’t care and had given up,” he said, tearing up.

“I really didn’t care about life at that point.”

He developed CNS (central nervous system) lymphoma in December 2014. He went through several rounds of chemotherapy and dropped to a dangerously low weight.

There was one person, though, who wouldn’t let Smith (not his real name) give up. “My mama changed that for me. She made me talk. She’s been my

rock.”

She called his doctors to see what could be done to help him, and palliative care specialist Maribeth Bosshardt, M.D., was called in to help with symptom management.

She is one of several members on MUSC’s new palliative care team, which provides specialized medical care for people with serious illnesses.

She immediately set out to see if there was a combination of treatments that could relieve the pain from his mouth sores so he could talk and eat.

She also wanted to get him less sedated, and she added a medication to help with depression.

She watched him slowly improve. Thursday, July 9, was the first time he could give her a thumbs up, a sign she had been eagerly awaiting. Even better: “He spoke to me,” she said, grinning broadly. “It has been so rewarding to see him photo by Sarah Pack, Public Relations come through this and help give Dr. Maribeth Bosshardt finally gets a thumbs up from a cancer him hope.” patient when she asks how he’s feeling. It was just the sign See SPIRITS on page 9 she’d been waiting for.

Palliative care director envisions better quality of patient care

I

t’s not easy moving a horse and goats.

Just ask Pat Coyne, director of the new Palliative Care Program at the MUSC. He’s not looking forward to that part of his move.

What he does relish, though, is starting a program similar to the one he was with at Virginia Commonwealth University for 24 years.

To come to MUSC, he had to leave behind a thriving program and patients he had been following for more than a decade. “I’m leaving Richmond, and

I’m saying bye to patients who in theory shouldn’t even be here. Those were hard goodbyes. You’re kind of walking a journey with them.”

Now he and his palliative care team of eight, which includes adult and pediatric palliative care physicians, an advanced practice nurse, a nurse program coordinator, a social worker and a chaplain, will be walking that

See PALLIATIVE on page 6

2 THE CATALYST, Oct. 9, 2015

Medical Center

‘Making a difference every day’

MUHA EMPLOYEE OF THE YEAR

Employee of the Month Award Employee of the Month Jennifer Long, R.N. ART 5East “I was unable to properly use the Get Well Network to submit Jennifer Long’s name for consideration, but the care she provided to me and my family left such a fabulous impression on us, it was requisite of me to make this submission in some fashion. I hope this satisfies your requirements. I had previously met Jennifer on other admissions, but I had never been sick during any of those. This admission proved much different,and I was as sicker than anticipated. For three days, I was assigned to Jennifer.

Each day she provided the sound advice and encouragement needed for me to start moving forward, in addition to solid nursing care. Hand hygiene was ingrained, central line care was impeccable, and her physical assessments were sound. I typically liked to make my own bed and change my linens, and before I could offer up any resistance she had it done while I attended to my personal hygiene. Next, she noted some mouth sores and educated me and my wife about the uses of the various oral rinses and what to avoid. She even stepped beyond my expectations and ordered Miles Magic Mouthwash, which proved to be the agent that resolved the sores. But she did not stop there.

There was an almost continuous stream of oral care education, which helped

Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425.

843-792-4107 Fax: 843-792-6723 Editor: Cindy Abole catalyst@musc.edu Catalyst staff: Mikie Hayes, hayesmi@musc.edu Dawn Brazell, brazell@musc.edu J. Ryne Danielson, daniejer@musc.edu Helen Adams, adamshel@musc.edu Sarah Pack, packsa@musc.edu Jeff Watkins, watkinsj@musc.edu

me tremendously. Most significantly, on the second day that she had me as a patient, I spiked a fever at the very end of the shift. Almost surprisingly, she came in collected a set of vitals herself, contacted the treatment team and secured orders, and proceeded to draw blood cultures and treat my fever. Later, I would learn that the unit suffered a couple of callouts leaving them short and she was just helping out. She remained until 8 p.m. and had to return in the morning. When I asked her why she was staying, the answer could not have more perfect, “Well, you need to have the blood drawn, my coworkers need a little help, and we look out for one another up here.” With this simple action, she demonstrated that patient care coupled The Catalyst is published once a week.

Paid adver tisements, which do not represent an endorsement by MUSC or the State of South Carolina, are handled by Island Publications Inc., Moultrie News, 134 Columbus St., Charleston, S.C., 843-849-1778 or 843-958-7490. E-mail: sales@moultrienews.com.

photos by J. Ryne Danielson, Public Relations

with a sense of duty to your coworkers can and does result in better patient care.

It is my sincere hope that you give much consideration to this nomination. As the DAISY Award Chairman at the Ralph H.

ART 5East nurse Eileen Sandlin was named 2015 Employee of the Year by the medical center on Sept. 24. Sandlin received $500 from MUHA, a Crystal star statue and other gifts. Sandlin’s nomination highlighted her roles as a leader, nurse, mom and wife and her commitment to patient care.

Sandlin was among 10 finalists nominated which included Anita Shuler, Peds Respiratory Therapy; Katie Quinn, Adult ED; Stephanie Davey, Athletic Trainers; Timothy Price, ART Plant Maintenance; Liz Williams, Bone Marrow Transplant; Colleen Sacknievich, RT Children’s Endo/Devp/Gen; Tonya Svensson, Peds GI Clinic; Thomas Flathman, ART Safety & Security; and Theresa Ponessa, Psychiatry-Senior Care Unit.

Johnson VA Medical Center, I was more than impressed with her and see only a bright future for her.”

Nominated by Jamie M. Sicard, R.N. and Kathy Wanstall

Nominations currently being accepted for honorary degrees The Office of the President is accepting nominations for people to receive honorary degrees from MUSC, to be awarded at Commencement in May 2016.

MUSC’s honoarary degrees are aimed at recognizing and honoring distinguished individuals who have made an extraordinary and positive impact in education, science or health care on the state of South Carolina, MUSC or nationally.

In general, honorary degrees go to individuals in the following broad

categories: Contribution(s) to the nation; Contribution(s) to science; and Contribution(s) to the state or MUSC. Consider submitting nominations of candidates along with supporting materials such as letters, articles, curriculum vitae, etc., in the above mentioned categories. The nominations should be forwarded to Marcia Higaki, Office of the President, Colcock Hall, 179 Ashley Ave., MSC 001, higakimc@ musc.edu, no later than Oct. 30.

Nominations of MUSC alumni are generally discouraged.

THE CATALYST, Oct. 9, 2015 3

Cyber-awareness: laptop encryption is still key

BY MELANIE RICHARDSON

encryption sweep could take several hours to complete.

During this time, employees can continue to work as the encryption runs in the background. Once the encryption sweep has completed, the computer will resume to its normal level of performance.

OCIO Communications At MUSC, protecting data is critical to the success of our organization. Private information, such as HIPAA data; credit card numbers; personally identifiable information (PII) in the form of social security numbers, names, addresses, telephone numbers; and strategic corporate data would have profound implications for the organization, employees and patients if ever it were to be lost or stolen.

Encrypting your laptop is one of the most important steps you can take to protect your personal data and the University’s data if the device is lost or stolen. The South Carolina Department of Information Security’s Mobile Security Policy requires all institutionally– owned laptops to be encrypted. Additionally, any personally–owned laptop used to store MUSC protected information must also be encrypted.

Please note sensitive data should not be stored on end–user devices such as laptops or thumb drives unless there is an unavoidable business reason to do so. If you must store sensitive data on your laptop, you should only keep the minimum amount of data you need and you must have encryption enabled. Once you don’t need the data on your laptop anymore, delete it.

Does encryption change how I use my computer or applications?

You should not notice any difference when using your protected corporate computer. Applications won’t even notice the encryption process because it’s done automatically in memory.

Will I see encryption happening?

No. Encryption is transparent, automatic and happens in the background as files are saved.

For encryption software go to http://www.musc.edu/ laptopencryption When I encrypt what will happen?

Users should expect some heavy disk utilization during the initial encryption sweep of the file system.

Depending on the amount of data on the disk, the

For more information on encryption and other cyber security topics, visit beginswithme.musc.edu or visit one of the Information Security Awareness Pledge Centers located around campus. At the centers, you can also sign a pledge promising to follow good security practices. For those who sign a Cyber Security Awareness Pledge Card, a limited supply of promotional items will be available and pledgee names will also be entered into a drawing for two iPad tablets.

4 THE CATALYST, Oct. 9, 2015

New Science Cafe offers dinner with side of knowledge

BY J. RYNE DANIELSON Public Relations Kenneth Tew, Ph.D., D.Sc., presented at Charleston’s first Science Cafe, September 22 at Fish, a French–Asian fusion restaurant on King Street.

The Science Cafe, part of South Carolina’s SmartState program, is meant to bring innovative science to a lay audience. “It’s a way to share the research we’re doing with the community,” Tew said. “The Science Cafe has been going on in Columbia for the better part of two years, and we’re hoping it will be just as popular here.”

While his audience sipped antioxidant–rich cocktails, Tew, professor and John C. West Chairman of Cancer Research at the Medical University, apprised his audience of his research on antioxidants and the many misconceptions surrounding them.

“The thing about being a scientist,” Tew said, “is that at parties a lot of people come up to you and ask, ‘Should I drink red wine,’ or, ‘Should I eat red meat?’ I’m hoping this presentation will help answer some of those questions.”

In actuality, it all boils down to oxygen.

“Oxygen is an interesting molecule,” Tew explained. “It is critical for our existence, but it is an extraordinarily toxic substance. It’s nasty. It’s just bad for you.

“Why, then, if it’s so bad, is it so important? The reason is quite simple: The most efficient way to create energy is to use oxygen to break down our food.”

In effect, the very property that makes oxygen so toxic, its reactive nature, is the same property that makes it crucial to energy production in the mitochondria of human cells.

Free radicals are byproducts of that energy production process, called glycolysis, and are oxygen’s cousins.

These molecules, which contain a single unpaired electron, are highly reactive and cause damage to human cells.

“Free radicals are the bane of your existence,” Tew said. “They are bad for you. They are responsible for aging. They can cause mutations in DNA, arthritis, diabetes, even cancer. Free radicals are

responsible for a lot of the problems we have in human pathology.”

One free radical many people frequently encounter is hydrogen peroxide. Tew cautioned against hydrogen peroxide mouthwash or adhesive strips, which are popularly used to whiten teeth but can have harmful long term effects.

Tew recently conducted a trial to measure these harmful effects. By scraping buccal cells from the cheeks of participants, he measured significant damage to proteins that protect those cells from diseases like cancer.

“So the next time your dentist wants to use 20 to 25 percent hydrogen peroxide to whiten your teeth,” Tew said, “think very hard about whether you need that for your next date. There’s nothing wrong with using it every now and again, but don’t use it every day or in high concentrations.”

While the human body has enzymatic processes to eliminate free radicals, sometimes these processes go haywire and excessive amounts are allowed to build up. Some individuals may process free radicals better than others.

For that reason, the body needs antioxidants — molecules that inhibit the oxidation of other molecules by neutralizing free radicals such as superoxide (O2) or hydrogen peroxide (H2O2).

According to Tew, it’s all about chemistry. “If you can understand chemistry,” he said, “you can understand life.”

He explained that some elements like sulfur and selenium can accept unpaired electrons and cancel the effects of free radicals. Selenium tablets, for example, are popular antioxidant supplements.

These antioxidants, however, can be dangerous in excess. “Under oxidizing can be just as bad as over oxidizing,” Tew said. “It can make you more sensitive to some cancers. And it can knock out some proteins, such as p53, which protect you in other ways.”

He continued: “Too much of these antioxidants is really bad for you. Too little is really bad for you too. So, you have to find just the right amount. That,

photo by J. Ryne Danielson, Public Relations

Dr. Ken Tew shows his audience a glass of antioxidant-rich red wine. He says consuming foods containing antioxidants, like red wine, broccoli, or berries, is much safer than taking over-the-counter supplements, which can be dangerous in excess. in effect, is the take home message.”

The best way to get the proper amount of antioxidants, Tew said, is through the food we eat. Broccoli, for example, contains a sulfur–containing compound called sulforaphane, a powerful antioxidant shown to protect against some cancers.

Many vitamins, such as A, C and E, are antioxidants as well. While they are also available through food, there are many vitamin supplements on the market which contain many times the daily recommended dose. While the body will rid itself of excess levels of most vitamins, Tew cautioned that high levels of vitamin A can cause liver damage and softening of bone tissue, while high levels of vitamins C and E may abrogate many of the healthful effects of exercise.

“Exercise creates a lot of oxidative stress, which creates a natural antioxidant response in your body,” he explained.

“Taking antioxidants, however, cancels that out, and your body doesn’t respond in the same way.”

More bad news. “In 2012,” Tew said, “there was a collaboration involving a group in the UK that analyzed the results of 78 clinical trials. That’s a lot. They

concluded people who took antioxidant supplements, including both healthy people and those with chronic diseases, were more likely to die prematurely than those who did not.”

While it’s very difficult to make generalizations, he explained, that study concluded most supplements are not justified, and their use should be avoided.

“There are some caveats to that,” he said. “If you’re stressed, you’re traveling a lot, and you don’t have a good diet, it may not be a bad idea to take some supplements in moderation. But, don’t overdo it. If you’re like most people in Western civilization, you probably get most of what you need in your daily food. Just use common sense and be careful.”

The response to the Science Cafe — which Tew hopes will be the first of many — was overwhelmingly positive, with an impressive turnout and many in the audience staying afterward to ask questions and continue the discussion.

The next Science Cafe is already being planned and will feature researcher Joseph Helpern, Ph.D., a SmartState Endowed Chair in Brain Imaging.

THE CATALYST, Oct. 9, 2015 5

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6 THE CATALYST, Oct. 9, 2015

PALLIATIVE Continued from Page One journey with MUSC patients who need relief from the symptoms, pain and stress of a serious illness.

His timing couldn’t be better. Palliative care is the fastest growing area in medicine nationally right now. “Here, there’s a lot I can do. It’s starting fresh, and let’s see how we can change the system.”

An estimated 90 million Americans are living with serious illness, and this number is expected to more than double over the next 25 years. About 20 percent of all Medicare beneficiaries have five or more chronic conditions, and two–thirds of Medicare spending goes to cover their care.

Coyne, an advanced practice nurse, has been doing palliative care for more than 25 years. He did his thesis on cancer pain management in graduate school. “I saw a lot of suffering so I started looking into better pain management.”

He learned from that work that he had to get better at treating the whole person and the family versus just one symptom.

“I think I was doing palliative care before they even had a name for it.”

Given the growing trend, there’s a huge shortage of palliative care clinicians, so one of his top goals is to start a palliative care fellowship and offer training for residents and nurses to get them comfortable doing what he calls primary palliative care, which every clinician should know.

His team is there to handle the challenging, complex cases and help with the rising demand for this type of care as patients become more empowered in their medical care. Patients and families are demanding quality care and don’t want to suffer in their later years.

“Our population has gotten older and people are starting to talk more candidly about death and dying. Every staff person has seen someone die poorly, and our team wants to see that not happen.”

PALLIATIVE CARE CHOICES What does dying poorly mean to Coyne?

“Pain, shortness of breath, being on a machine you never wanted. Maybe being separated from family when you’d rather

photos by Sarah Pack, Public Relations MUSC Chaplain Terry Wilson, left, welcomes Pat Coyne, RN, who is the new director of MUSC’s Palliative Care Program. be at home. There can be a lot of issues going on. We can jump in and figure out what is the right thing to do right now.

It’s very complicated and it can change every day. They may look great today, but not tomorrow.”

Anthony Hale, palliative care program coordinator, said the group provides an extra layer of support for patients who have acute or chronic pain issues and for the primary medical team providing their treatment. There’s a misconception that palliative care is only for people who are dying. Hale, who used to work with patients awaiting a ventricular assist device (VAD) to support heart function, said he learned how much palliative care could help.

“Palliative care is about symptom management and symptom control. It’s not always about end of life.”

The team will assist patients who have acute or chronic pain issues, including renal disease, heart failure, MLS, muscular dystrophy, cancer, sickle cell, cystic fibrosis and respiratory failure, Hale said. “It’s huge. It’s a big umbrella of those we can help.”

Facing an aging population of patients over 65 who have multiple illnesses, hospitals need strong palliative care

programs, he said. “This just isn’t a nice thing to do — it’s a necessary service. The appeal to me is improving quality of life.

It was the same purpose of VAD therapy when I was working with the ventricular assist devices. It’s the ability to improve a family and patient’s quality of life and to help the staff with those transitions and goals of care.”

Regardless of the illness or condition, the earlier the team can get involved, the better.

Coyne said his team is good at thinking outside the box to improve a patient’s mobility and quality of life.

Studies show palliative care, especially when started early, can help patients live better and longer.

“We want to meet patients early in their disease process so we can walk the journey with them and make sure they have a partner as they go down the road with their family. People need to think about calling early in the disease versus the final days and hours.”

An advantage of the team is that members take a holistic view of patients and their family support systems.

“We’re looking at pain and shortness of breath, but we’re also looking at depression and anxiety. In our realm,

we’re looking at the physical person, we’re looking at the spiritual person, and we’re looking at their emotions. Is the family going bankrupt? Is the family able to care for their loved one? What support services do they need?”

Mary Catherine Dubois, the team’s social work case manager, said she was drawn to the work because it gives patients options earlier in their diagnosis when they still have choices affecting their care.

“The medical model can be about fixing the problem and finding a cure, and that’s always great if it can happen.

The palliative care model looks more to what the patient wants for quality of life and how to empower the patient to weigh their choices in terms of risks and benefits of various treatment options.”

She acts as an extra level of emotional support for families and patients as they wrestle with what can be complicated decisions and medical issues. Navigating Medicaid and disability requirements, for example, can be overwhelming, especially to patients in chronic pain.

“You can have it explained to you 20 times and still have questions.”

She’s excited to be involved on the ground floor as the program gets started.

The team meets each morning to get input from everyone, which she finds energizing. Then they go out to meet with their patients. “We are trained to put the options out on the table for patients and discuss the consequences of the various medical treatments. If you understand all the options, you can make a better choice. We’re improving the quality of life for the patient and the family. We’re trying to figure out what they want and make it happen.”

CREATING LEGACIES Coyne said no one person can handle everything from medical to social needs.

“You have a 40–year–old with two kids under the age of 18. Who’s helping them? If we only take care of the patient, we kind of let the whole thing fall apart.”

He recalls an Emergency Department case involving a 31–year–old patient who was involved in a car wreck and not expected to survive. “We were able to help them decide about whether he

See PALLIATIVE on page 7

THE CATALYST, Oct. 9, 2015 7

Palliative care doctor helps kids

BY HELEN ADAMS Public Relations Growing up in New Orleans with three siblings and more than 30 first cousins taught Conrad Williams, M.D., a self–described “reserved, quiet guy,” a lot about reading people.

“It was often hard to get a word in edgewise. I think I learned a lot about the non–verbal aspects of communication, which are often more important than spoken words,” Williams said.

He’ll use that skill in his new role as the first full–time palliative care pediatrician at MUSC’s Children’s Hospital.

Williams realized back in medical school that he wanted to do more than try to cure diseases. “I was always more interested in how the disease impacts the patient and the family, and what could be done to make their lives easier.”

A mentor told him about palliative care. “I’d never heard of it when I was a resident,” Williams said. “I’d heard of hospice care, and I thought that was only for old people who are dying.”

Palliative care involves improving quality of life for people of all ages dealing with serious illness. “Saying we’re out of options, there’s nothing more we can do — those words should never come out of your mouth whether you’re an intensive care doctor or a palliative care doctor. There is always something we can do,” Williams said.

Palliative care works best, he said, when doctors and families recognize early on that it might be helpful. “For example, if palliative care is involved at diagnosis of a life-threatening disease, we can build a relationship to help with managing symptoms, discussing goals of care and helping with complex medical decisions in partnership with the primary medical team and the family. We help to address the physical, social, practical, emotional and spiritual challenges that come with serious illness.”

Williams’ hiring is part of a larger effort to expand palliative care at MUSC. Palliative care is not a moneymaker.

Williams said insurance companies

Dr. Conrad Williams don’t adequately cover palliative care services, even though studies have found they improve patients’ quality of life and lower health care costs. That forces palliative care teams to rely on hospital support and philanthropy.

“MUSC has gone above and beyond supporting the palliative care program,” Williams said. “It’s willing to cover the cost because it is best for patients and families.”

Williams began seeing patients at MUSC’s Children’s Hospital on Sept. 8.

“The goal of our team is to get to know each individual patient and family and try to figure out what support they need on their journey.”

Williams said having a sick child has a huge impact on a family. “It challenges everything from spirituality to finances to practical issues, like how do I take off from work, how do I get to the hospital from two hours away?”

It’s familiar territory for Williams, who served as medical director of palliative care at Children’s National Health System in Washington, D.C. He and his wife, who’s also a doctor at MUSC, wanted to be in a smaller city, and Charleston, where they did their residencies, was the perfect fit.

Palliative care for children is a fairly new field. Williams has already worked with some of its pioneers and wanted to be part of a start–up. MUSC Children’s Hospital did have palliative care for children in the past, but did not have a doctor who focused on that full time.

Williams is excited to be the first.

PALLIATIVE Continued from Page Six should stay on a breathing machine, knowing that he would never wake up, and how to tell his 9– and 4–year–old children that their dad was dying.

We walked them through this whole process.”

But they didn’t stop there.

They did what he calls ‘legacy work’ so the children would have handprints of their father. They talked to school counselors so they knew what the kids were going through, and the social workers helped the wife figure out how the insurance would work so she wouldn’t lose her house. The wife, who still was in shock from her husband’s traumatic injury, needed help deciding when to stop treatment. “Somebody was walking with her and answering her questions and making sure she had the support on all these issues,” Coyne said.

On the other end of the spectrum is a person with cancer who needs to decide on the best course of treatment and what quality of life he will have. “Will he be able to take his grandchild fishing?

What do you do when you find you’re too exhausted to go to chemo? We walk patients through the risks and benefits and burdens of the choices. Our job is to help other clinicians and take this off their plates.”

He also believes families want to know the realities of their situation.

“I think a lot of decisions are made by patients who don’t understand the full impact. A doctor asks, ‘Do you want us to do everything?’ Who says no to that? But what they don’t realize is that ‘everything’ could mean living your last three weeks on a breathing tube in ICU. “I don’t think most people would say that’s the everything I wanted. My everything is I want to feel good and have a good quality of life and get the heck home and be with my family.”

Coyne said he likes to paint a picture of what’s coming down the road so people are informed about their illness and have good insight into the decisions they are making. “And then we should support their decisions, whether we agree with them or not.”

Part of the program he’s developing will include volunteers to help with legacy work. Legacy volunteers do a

variety of services, including creating keepsakes in the form of finger and handprints or locks of hair. They also record favorite family stories so they can be passed down to grandkids.

“I think about it, and I get teary–eyed.

I think about all the stories I’ve heard over the years from our volunteers,” he said about the program at VCU. “The legacy work has been really powerful and helps with bereavement...I think it helps to give them some closure in life. I find those stories to be powerful.”

In addition to recruiting volunteers for legacy work, Coyne said his team will target educational objectives.

“There’s a lot of education we need to do both on campus and in the state. My goal is that this place is going to be the national place in next few years. If you want to know about palliative care, this is going to be a center of excellence.”

As part of that center, his vision includes MUSC: q Opening a palliative care follow–up clinic to make it easier for patients to get care after discharge without having to be readmitted to the hospitals q Setting up an annual bereavement program q Providing training for nursing and medical students and residents q Providing educational resources for patients and staff q Assisting primary physicians in getting patients to map out a treatment plan based on a their wishes about medical interventions Though the POST document can be intimidating, Coyne knows something that many people don’t.

“Everybody wants to die in their sleep when they are in their 90s, but that only happens in 10 percent of the cases. The rest of us have to make decisions about what quality of life we want at the end of lives. We need to have the conversation while everyone is alert, oriented and happy.”

Sometimes Coyne and others on his team are asked why they have chosen what can be a sad line of work. Coyne said he’s honored to help patients at a critical time. “The work is tough, but the journey is worth it. The families are letting you into a real sacred space.”

8 THE CATALYST, Oct. 9, 2015

MUSC prepared for flooding, effects on patients, staff Staff Report

A pickup truck attempts to navigate through the rising waters after exiting the President Street garage on Oct. 1. Flash flooding combined with high tides hit downtown Charleston immediately causing dangerous conditions.

Y

photo provided

Left photo: Alyssa Hudspeth went back and forth between the Ronald McDonald House and MUSC to visit her newborn daughter, Isabella.

photo by Sharlene Atkins, Public Relations

bacteria. Standing water can be electrically charged from downed power lines,” Scheurer said.

If an area is still closed by authorities, stay out.

Water–damaged areas will need proper cleaning to avoid mold and mildew. A detailed guide to recovering from floods is posted on the National Wholesale Distributors website,” Scheurer said. For MUSC active emergency information, employees can visit www.musc. edu/medcenter/emergencyManagement/index.htm Mutz had this warning for families: “Please don’t let your children play in flood water. It is highly contaminated and should be washed off immediately.

This also applies to your pets."

Hudspeth doesn't have to worry about two–weekold Isabella playing in flood water any time soon.

They head back to Beaufort t, a little nervous but also ready to tell an amazing story about how Isabella not only survived being born prematurely but also being hospitalized during the worst flood in recent memory.

"We had a really great experience at MUSC — aside from the flooding," Hudspeth said.

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ou might think a mother who weathered a 1,000– year flood event in downtown Charleston while worrying about her newborn daughter’s breathing problems would be ready to race back home to Beaufort, now that the storms are over and her baby can breathe on her own. Not Alyssa Hudspeth.

“We’ve been nervous to go back to Beaufort because we’ve had such a good experience here at MUSC,” Hudspeth said. “Everyone knows our schedule and our baby’s schedule, and we’ve just grown to really trust MUSC.” The Medical University of South Carolina’s hospitals for children and adults worked to earn and keep that trust during a deluge that swamped streets, cars and some homes around the Lowcountry.

Patrick Cawley, M.D., is executive director and chief executive officer of the MUSC Medical Center. He said MUSC, the area’s level 1 trauma center, is known for its ability to cope with disasters and its dedicated team.

“I think the best thing about MUSC is that everyone gives extra in such situations, and there is a good give– and–take when it comes to decision making,” Cawley said. “We had many front line team members putting up great ideas. Many stayed to take care of patients long beyond the end of their normal shifts. Many stayed overnight so they could get back in to continue taking care of patients."

Cawley said MUSC has extensive emergency management policies and trains for crises such as widespread flooding so it can maintain a high level of care. He praised the efforts of Executive Nursing Director Robin Mutz, who was administrator on call, and Danielle Scheurer, M.D., the daily check–in coordinator who was responsible for updates on safety and operations. "They, in addition to the emergency management team, led the response," Cawley said.

"The entire group put in long hours, held update calls every four hours and maintained excellent levels of communication throughout.

"In such situations, there are always rumors flying, and the team combatted the majority of those," Cawley said. "The acknowledgments are far too many, as the entire MUSC Health team stepped up. This included individuals, as well as clinical departments and nonclinical departments as varied as Facilities, Parking, Risk Management and many more. I feel very confident as CEO in such situations, because we have the force of 13,000 people working hard.”

Scheurer said employees made a point of getting to work despite South Carolina’s state of emergency. “As a result, every patient got their needs met, and we were at full operation throughout. We were amazed at how everyone pitched in at all levels,” Scheurer said.

Now that the crisis is easing in the Charleston area, she said, it’s important to be careful in the flood’s aftermath. “Flood water is often contaminated with

THE CATALYST, Oct. 9, 2015 9

Palliative outpatient clinic to open at HCC Oct. 27 The Palliative Care Program will begin accepting outpatients at the Hollings Cancer Center Oct. 27.

The team will see patients who have a hematology or oncology diagnosis, as well as internal medicine patients in need of palliative care services.

Maribeth Bosshardt, M.D., a palliative care physician, will oversee the clinic, which will provide specialized medical care focused on the holistic health of patients, including their physical, psychosocial and spiritual needs. Palliative care allows the best quality of life by providing patients with relief from symptoms, pain, loss of function and the stress caused by serious illnesses.

SPIRITS

Conditions eligible for treament include: dementia; Parkinson’s disease; heart disease and congestive heart failure; renal disease; lung disease and chronic obstructive pulmonary disease; neurologic conditions, including Lou Gehrig’s disease, multiple sclerosis and cerebral vascular accident; malignancies; and any serious illness, regardless if it is curable, chronic or life threatening.

Patients eligible for this type care must meet one or more of the following criteria: presence of a serious, chronic illness; declining ability to complete activities of daily living; weight loss; multiple hospitalizations;

difficulty in controlling physical or emotional symptoms related to serious medical illness; patient, family or physician uncertainty regarding prognosis and/or goals of care; limited social support and a serious illness; patient, family or physician request for information regarding hospice appropriateness; and patient or family psychological or spiritual distress.

For information on the oncology criteria for palliative care, or to make referrals to the palliative care clinic, call 792-9300.

For more information about MUSC’s Palliative Care Program, call 792-6062.

Continued from Page One

Consulting with a physical therapist, Bosshardt is helping to set goals to enable him to be more active and stronger by discharge. She also is working with a social worker to build up the family support he’ll need.

To Bosshardt, age 29 is much too young to be giving up on life.

It’s one reason she loves her job.

Bosshardt, who started at MUSC last July, did her fellowship at Vanderbilt University in palliative care. The field had just been a two-week elective during her internal medicine residency training, but after her first day, she was hooked.

“I was so happy I thought I couldn’t do anything else. I felt like this was where I was called to be in medicine,” she said.

“I looked forward to going to work every day and felt I had made a very big impact for my patients and my families. Every patient who has an illness, their life has been turned upside down, but so has their family’s.”

As a resident, she was so busy that her main goal was to keep her head above water, she said. Doing palliative care allowed her to slow down. Her job requires her to get to know the patient well enough to know what brings them joy in life and what a good quality of life would mean for them. She also makes sure they understand which medical options are available to them, and they don’t get lost in the medical jargon.

Studies show having palliative care involved early in a patient’s treatment improves patient outcomes and patients’ perception of the care they received.

In cancer studies, it has been shown to help prolong life, she said. “People

photos by Sarah Pack, Public Relations Dr. Maribeth Bosshardt talks with physical therapist Amy Beitel to develop a discharge plan for patient Mark Smith. nationally are recognizing not only are we improving the care of patients, we’re helping to improve the overall quality of health care.”

Bosshardt said she also hopes the palliative care team can help relieve the burden of care on primary doctors, who may not have time to do the extensive communication that can be required for palliative care, a field that requires its practitioners to be trained in communication, she said.

“Doctors are spread thin. I found a field that allowed me to do exactly what I wanted to do when I went into medicine, and that’s to build relationships with patients and families.”

Take the next patient on her caseload,

for example. It was an 80-year-old woman who had a massive heart attack. It didn’t take Bosshardt long to learn that the woman wanted to be home and did not want invasive interventions. She arranged a family meeting and started the process to get hospice involved. She also met with her medical colleagues who are used to more of a “fixing” mode of care to help them understand the patient’s choices in her treatment plan, she said.

The role of the palliative care team, including social workers, is to coordinate a safe and comfortable discharge plan that honors the patient’s wishes. “It’s recognizing it’s OK to not want certain treatments and also having the family

and the medical team accept that. We are talking her through the options. It’s empowering the team and the patient.

We get to help her match up a medical plan that coincides with her goals at this time in her life.”

Bosshardt admits some days are tougher than others, but it’s worth it when she sees the results. “Even though you’re often dealing with sadness and loss, it’s so rewarding to see patients and families work through that and find hope where they are. It’s an awesome thing to be a part of.”

Not all palliative care cases are terminal, though that’s a common misconception. Some cases involve patients undergoing cancer treatment who may be cured, or who have a treatable illness, such as AIDS. She looks forward to Smith’s discharge, and has loved seeing his dramatic improvement.

“I hope he can get out of the hospital and feel better and go on with his life.”

Smith does, too.

His pain has lessened, and he’s talking and eating more. He’s making plans to have a crab leg dinner to really celebrate his birthday when he gets out of the hospital. He’s grateful to Bosshardt, who regularly checks in on him and is a consistent face in a constantly changing sea of specialists. “She’s been on top of things and made sure I’m not in pain.”

The extra support has been critical. It has given him hope again.

“I had really given up. I don’t want people to go through the same feeling that I have. I want people to understand that you can live.”

For information, call 792-6062.

10 THE CATALYST, Oct. 9, 2015

MUSC-Sodexo chefs take 1st place at event

Fred Bennett of Trident Health combined On Saturday, Sept. 26, MUSC claimed the forces to create a meal that crowned them title of 2015 champion at the Cooking Well champion of the Iron Chef Competition.

Invitational, part of the Southern Living Both events were made possible by Taste of Charleston weekend of events. presenting sponsor, Sodexo, and its quality Providence Orthopedic Hospital took of life services. Sodexo is the food service second place in the competition and partner for MUSC, Tidelands Health and Tidelands Health placed third. MUSC/ Trident Health. Metz Culinary is the food Sodexo Chef Brett Cunningham and his service partner for Providence Orthopedic team competed against eight other Gold Hospital.

Apple hospital teams as they demonstrated how to convert recipes into healthier versions Employee Wellness without sacrificing great taste. MUSC q October Monthly Mindful Challenge — achieved the Gold Apple in 2012 and has Susan Johnson Use water wisely: Hydrate without waste and been serving as a Center of Excellence for limit your water footprint. Find your starting the Working Well program. number here www.watercalculator.org/. Take the initial The team consisted of executive chef Brett survey at http://tinyurl.com/nn3zsdt.

Cunningham and chefs Martin Neeley, Ferando q Restaurant Recipe Makeover —11 a.m. to 1 p.m., Oct. Middleton and Katie Snekser.

The culinary event, now in its third year, was held in 14. Sodexo took two of Amen Street’s most popular partnership with MUSC Office of Health Promotion, dishes and performed a “recipe makeover.”

South Carolina Hospital Association, Greater Sodexo made adjustments to recipes to be closer to its Charleston Restaurant Association and the Culinary “mindful” criteria without compromising flavor. Kale Institute of Charleston, which manages the judging and salad with garlic vinaigrette and a mixed green salad competition. Judge Randy Williams, instructor with with goddess dressing will be offered as part of Sodexo’s the Culinary Institute, was impressed with the quality Celebrity Chef Series (University hospital cafeteria). and presentation of the plates this year. “Hospitals are q Employee Fitness Series: 4:15 to 4:45 putting the hospitality back into health care. I’ve been p.m.,Wednesday, Oct. 21 — Strength and Conditioning: judging for three years, and you guys have really stepped Weight lifting and cardiovascular combined. Helps tone up your game this year.” MUSC’s award winning muscles and strengthen lean muscles. Free day pass to menu consisted of a parma ham with figs appetizer, MUSC Wellness Center for participants. Participants entrée featuring seared pork tenderloin, confit, sweet should check in at membership desk for directions to potato cake and chimichurri jus and a deconstructed the class and receive their pass. Sign up at www.musc. banana split for dessert; it was gluten free and met strict edu/ohp/musc-moves/employee-fitness-signup.html nutritional and cost criteria. The Invitational was just q Worksite Screening — Thursday, Oct. 29, Colbert one of two events spotlighting hospital culinary arts at Education Center & Library, Room 107. This the Taste of Charleston weekend. On Friday night chef screening, valued at $350, is available to employees on Katie Lorenzen–Smith of Tavern and Table and chef the State Health Plan (including MUSC Health Plan) at no charge for the basic test. Employees/spouses without insurance can participate for $46. Register online at www.musc.edu/ohp/employee-wellness/worksitescreening.html. q Chair massages — Free massages are offered to employees midday Wednesdays. Check broadcast messages for new locations and times q Farmers Markets — Fresh fruits and vegetables are available from local farmers on Friday from 7 a.m. to 3:30 p.m. at the Horseshoe. Check out King of Pops and Angel Blends for their latest offerings.

Health at work

MUSC Urban Farm MUSC/Sodexo Executive Chef Brett Cunningham and Chefs Martin Neeley, Ferando Middleton and Katie Snekser were named champions at the 2015 Cooking Well Invitational event.

q Midday Work and Learn — 12:15 to 12:45 p.m., Tuesday q Early Bird Maintenance — 7:30 to 8:30 a.m., Wednesday q Sunset Work and Learn — 4 to 5 p.m., Thursday q Saturday Work and Learns — 9 to 11 a.m., Sept. 3 and Oct. 17

THE CATALYST, Oct. 2, 9, 2015 11

Speech language pathologist remembered for her dedication

CLASSIFIED PAGE

• Household Personal Items for MUSC employees are free.

BY MIKIE HAYES

All other classifieds are charged at rate below. Ads considered venture-making ads (puppy breeder, coffee business, home for sale, etc.) will be charged as PAID ADS •• PROOF OF ELIGIBILITY REQUIRED * NO MORE THAN 3 LINES * FREE ADS RUN 2 WEEKS ONLY!

Public Relations

PAID ADS are $3 per line ( 1 line = 35 characters) DEADLINE: TUESDAY – 10:00 AM * CLASSIFIED ADS CAN BE E-MAILED TO Chilton@postandcourier.com OR MAILED (134 Columbus St., Charleston SC 29403) Please call Crystal Hilton (843)937-4803 Office; (843)937-5410 Fax

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*Must provide Badge No. and Department of Employment for employees and Student I.D. Number for MUSC Students.

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eloved speech pathologist, Kathryn “Katy” Hufnagle, of Hollywood, South Carolina, passed away Sept. 20, at the age of 72. She had been involved at MUSC for nearly 30 years.

Hufnagle retired from MUSC faculty but stayed active with the MUSC Cleft Palate Clinic and the velopharyngeal insufficiency (VPI) Clinic.

She was also associated with the America Cleft Palate– Craniofacial Association and the American Speech Language and Hearing Association.

Described by colleagues as a "don't–bother–telling–me– no" advocate for children and Hufnagle families, Hufnagle was a steady supporter and counselor for children and families affected by cleft palate and other craniofacial birth defects; a key to survival for babies born in her geographic area; and a valued colleague for many who worked in this field with her many decades of service.

Hufnagle is survived by her husband of 48 years, Jon Hufnagle; son, Chris Hufnagle; daughter, Kammer Hufnagle and other family. Loved ones gathered to celebrate her life on Sept. 26 at Stono Ferry Plantation in Hollywood. Memorial contributions can be made to: The MUSC Cleft Palate Clinic, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425; Attn: Sherry Cannon “Katy Hufnagle started the Speech Language Pathology program and served as the director at MUSC 30 years ago. She hired many of the speech language pathologists that are still working at MUSC today. Katy was an exemplary clinician, mentor and advocate on many levels. Katy changed the lives of countless patients with Down syndrome and craniofacial disorders by setting high expectations and pushing new boundaries.

Katy served as a mentor for colleagues, physicians and students. She had a wealth of knowledge and a great gift for teaching. Katy retired as a full–time speech language pathologist several years ago and returned to MUSC part time. She always said her “work” never felt like work because she truly loved what she did each day. Katy always enjoyed playing a great round of golf or cheering on her grandsons at their baseball games.

Katy’s great smile and compassion for patients will be missed.”

Diane Andrews, MUSC Department of Speech Language Pathology

“In 1990, we were fortunate to be advised to take our six–month–old daughter who had Down syndrome to Katy for an initial screening. Little did we know the impact she would have on our whole family. She taught Trista to sight read 100 words by the time she was five.

Katy emphasized to us the importance of inclusion and even came to some of our IEP meetings to advocate for Trista. While Katy adored Trista, she never hesitated to push her beyond expectations. Her insistence on good presentation skills and clear speech for Trista set her on a path of future independence and employment.

Trista is 26 now, and thanks to Katy she can clearly communicate her needs, has excellent social skills and is employed at two preschools as an assistant. We will forever be thankful for the angel we met in 1990 ...her gracious spirit and giving heart created an ever lasting legacy!”

Rebecca Kutcher, parent of Trista “Katy will be dearly missed at MUSC. She was a fantastic and dedicated clinician who impacted countless children’s lives. She was a leader of the MUSC Craniofacial Anomalies team and a driving force behind the care of children with cleft lips and palates in South Carolina for decades. I had the pleasure of working closely with her on the VPI team (a group dedicated to speech problems found in children with palate abnormalities) for the last 10 years, where I witnessed her talent for connecting with children. I was always amazed at how she could work with a child for 10 minutes and substantially improve a child’s ability to communicate. She was a key point of contact for new mothers of children with clefts and likely saved thousands of infants from dehydration and feeding problems with her counseling of parents about how to effectively feed infants with clefts. She was a talented teacher of doctors, speech pathologists, and medical and graduate students as well. Fun, funny, and driven, she could always be relied upon for advice or an opinion. While I never met her grandchildren, I know from talking to her that they were her joy and her inspiration for the last several years.”

David R. White, M.D., Division of Pediatric Otolaryngology “Katy was a tremendous speech pathologist, mentor and advocate. She leaves behind a lasting legacy through the countless children she served.”

Melissa Montiel, Speech Language Pathology “Katy was a mentor to me not only in the art of speech pathology but also in how to establish a true bond with a patient. She was, in its true sense, a patient advocate, and I thank her for always being there for all of our craniofacial patients.”

Krishna Patel, M.D., Facial Plastic & Reconstructive Surgery

12 THE CATALYST, Oct. 9, 2015

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