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July 13, 2012

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 30, No. 46

Doctors go extra mile to donate

BY DAWN BRAZELL Public Relations

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ometimes doctors become patients to help patients. That’s the case for three MUSC doctors who became bone marrow or what’s known as peripheral blood stem cell donors. These donors are critical to the 70 percent of people in need of a transplant who do not have a matching donor in their family. They are people such as ABC’s co-anchor Robin Roberts who recently went public with her need for just such a donation, turning to the National Marrow Donor Program for help. Cindy Kramer, R.N., lead blood marrow transplant coordinator at MUSC, collects cells for patients to send all over the world to whomever needs it. MUSC has had three doctors, William Jacobsen, Michelle Hudspeth and Eric Rovner, who have been willing to donate. “It’s an amazing thing that they do. They do it out of the goodness of their hearts. It’s doctors giving back.” Doctors obviously understand the need, but face busy schedules to be able to donate, said Jacobsen, a resident in emergency medicine. His department cooperated in supporting him being able to donate when he got the call that he was a match. The call was a shock for him. Jacobsen had a close friend organize a bone marrow drive in 2009 during his second year of medical school. “She kind of

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See DONOR on page 8

Dr. Michelle Hudspeth, right, gives her marrow recipient, Kathy Voigt, a hug.

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Dr. William Jacobsen said he was grateful his mother, Nancy, could come down to support him during his procedure. He encourages people to attend the bone marrow donor drive at MUSC, 11 a.m. to 2 p.m, July 24 at the Colbert Education Center & Library’s portico.

HEALTHLINKS Student volunteers connect patients and families to community resources.

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SANE PROGRAM Victim advocates, prosecutors preserve evidence of sexually assaulted patients.

s a transplant physician, Michelle Hudspeth, M.D., often tears up when she sees firsthand the raw emotion on transplant day as parents watch the bag of bone marrow be delivered and administered to their child. “That bag offers hope. The look in their eyes says it all. For the child and the family, that bag means everything. It means their child has a chance. It is rare that I don’t have tears in my eyes during the infusion.” Thousands of patients with blood cancers like leukemia and lymphoma, sickle cell and other life-threatening diseases need a bone marrow transplant. The Be The Match Registry provides access to 10 million potential donors and nearly 165,000 cord blood units. According to the program, nearly half of all patients in the U.S. in 2011 received the unrelated transplant they needed. Most patients, about 70 percent, do not have a matching donor in their family.

See DOCTORS on page 8 3

Health care law

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Meet Lonnie

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Employee Wellness

READ THE CATALYST ONLINE - http://www.musc.edu/catalyst


2 THE CATALYST, July 13, 2012

HealthLinks: Linking families to healthier futures Supporting HealthLinks are Layne Madden, from left, Anna Baur, McRae Hamer, Allyson Dodson and Daniel Tagge. Program coordinators are Anna Tecklenburg and Crysta Schaff. Students interested in volunteering may visit www. muschealth.com/volunteer and complete the HealthLinks application. The program is operated from 9 a.m. to 1 p.m., Monday through Wednesday, in the Pediatrics Primary Care Clinic. For information, call 792-3992 and leave a message or email healthlinks@musc.edu. The program ends Aug. 1 and will resume Sept. 15.

BY ANNA TECKLENBURG, CRYSTA SCHAFF HealthLinks HealthLinks, a new MUSC program that promotes family-centered care, recently started its pilot program in the Pediatric Primary Care clinic. The program uses student volunteers to connect MUSC patients and their families to non-medical resources in the community in order to improve their overall health and well-being. As South Carolina is still feeling the effects of the economic recession, many patients and families that once had access to basic services such as transportation, working utilities, child care programs, adult education or food, are finding that these services are harder to locate and access. Health literature continues to demonstrate the acute influence that social factors have on the biophysical health of an individual. A person’s location, mobility and opportunity within a given physical and social environment can directly influence that patient’s ability to prevent, manage and seek treatment for potential health concerns. With the help of student volunteers, patients will have the opportunity to better navigate services offered in their local communities. Katy Kuder, manager of Volunteer and Guest Services, supports the program. “MUSC will truly be providing holistic, family centered care that offers continuity in health care beyond the doctor’s office.” McRae Hamer is a College of Nursing student and a HealthLinks volunteer. “Nursing paradigm and theory stresses treating individuals and families with a multifaceted approach rooted in the social, economic, cultural and biological determinants of health,” she said. “Achieving positive health care outcomes requires more than simple referrals to seek additional services. Implementing a program to assist patients with identifying and navigating community resources is a huge step in the right direction." By having an avenue to research available services,

Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425. 843-792-4107 Fax: 843-792-6723 Editor: Kim Draughn catalyst@musc.edu Catalyst staff: Cindy Abole, aboleca@musc.edu Dawn Brazell, brazell@musc.edu

patients can leave their doctor visit with a means to treat the whole person – not just biophysical health but the economic, social and safety factors that influence health. Rhonda Lucas, nurse manager for the Pediatric Primary Care Clinic, said HealthLinks has been helpful to the patients in the clinic. “We are so appreciative of them providing services to the patients.” Not only will the volunteers give referrals for resources, they also will conduct follow-up phone calls to ensure that the patients are able to connect with the resources provided. Deborah Williamson, DHA, associate professor and associate dean for practice at the College of Nursing, said HealthLinks is a great opportunity for students to learn about the non-medical needs that contribute to health disparities and the available community resources to meet these needs. “As health professionals, we give advice and prescriptions for a medical condition, but we aren’t improving the

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.

health of the individual until we address basic needs such as food, housing and low literacy.” HealthLinks is being operated by a dynamic and highly-motivated team of students from the colleges of Medicine and Nursing. From the College of Medicine are Anna Baur, Layne Madden, Ellen Maher and Daniel Tagge; and from the College of Nursing, Caroline Dawson, Allyson Dodson, Hamer and Elsie Sabone. Their efforts have been critical to the launch of this program. In the fall, HealthLinks will open its applicant pool to include graduate, undergraduate and law students from local colleges and universities. MUSC President Ray Greenberg, M.D., Ph.D., conceptualized the idea of having the HealthLinks program operate out of MUSC, and medical director Patrick Cawley, M.D., has continued to champion the mission of HealthLinks and the efforts of the program’s developers and volunteers.

PERSON OF INTEREST

On June 30 at 1:18 p.m., this person of interest entered the Walton Research Building, 39 Sabin St., with the intent to commit a burglary. Video surveillance cameras show this person entering an office space where it was later reported items were missing. The items were an iPod, money and two credit cards. Anyone having knowledge about this person, should contact Sgt. Roger Owens of MUSC’s Public Safety Department at 792-4196.


THE CATALYST, July 13, 2012 3

Internal medicine physician interprets health law Editor’s note: The Catalyst’s Cindy Abole sat down with Bill Moran, M.D., to talk about the June 28 Supreme Court ruling on President Barack Obama’s health care law and how it affects consumers, the state of South Carolina and MUSC. Visit http://bit. ly/DrBillMoran. What was your reaction to the ruling on the nation’s health care law? It surprised many of us. I’ve been working with the Society of General Internal Medicine Health Policy Committee and most of us thought things would go a different way. Historically, we’ve been pushing for more than a century to get universal access for all Americans for basic health care services. This outcome pushes us a long way toward that goal. In South Carolina, there are almost a million uninsured people and we hope a large number will benefit from reform. What will be the changes? We’ll have to consider changing the

the people who don’t otherwise have insurance.

Division of General Internal Medicine director Dr. Bill Moran talks about the June 28 ruling on the health care law. Moran discussed how it affects consumers, South Carolina and MUSC as a health care provider and employer. delivery system, and we will need more primary care. The insurance industry has to respond. Everybody will have to respond. But the people who win are

What does the ruling mean? There were three aspects to President Obama’s plan that the Supreme Court was evaluating: 1) Did the court have any judicial oversight to the bill? Yes. 2) Was the individual mandate constitutional or can the federal government require individuals to purchase a health insurance product because the government requires it? This was the most controversial part of the bill. As an analogy, let’s look at auto insurance, which protects not just the driver of a vehicle, but the other driver who is hit. The law requires people to purchase a product (in this case, car insurance) that they may use or may not need. And most people won’t need it. Many uninsured individuals are young who work, but cannot afford health insurance because it is too expensive. 3) Is the bill, as it was written,

constitutional? If the mandate was constitutional, then the bill is constitutional. The bill includes a large expansion of Medicaid to insure adults who are at or below 137 percent of the poverty level. In S.C., Medicaid enrollment is 42 percent of the federal poverty level. By 2017, part of the Medicaid costs will revert back to the state. The bill provides leverage for states that participate in Medicaid funding. States have to participate in expansion, but the court said the federal government cannot force the states to expand Medicaid. It will be an interesting debate within the coming year whether billions of federal dollars that could come into the state by expanding Medicaid is worth it. Other ramifications: Because the mandate was found constitutional, pre-existing condition exclusions are not allowed and the lifetime $1 million cap for patients with chronic diseases is

See HEALTH on page 9


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Work program allows students to gain experience BY BILAN WILLIAMS Public Relations and summer program participant In a move that helps cultivate the work force of the future, MUSC accepted high school and college students from the Charleston County Summer Youth Program who allows them to gain professional work experience. MUSC President Ray Greenberg, M.D., Ph.D., praised the program. “Many kids in Charleston grow up in the shadow of MUSC and the College of Charleston, yet never set foot on either campus. It is a foreign environment for them, and we want them to feel like they belong.” Greenberg has first-hand knowledge with the relevance of making students feel welcome on campus. He cited his childhood in Chapel Hill, N.C., as one of the reasons for his decision. His father, Bernard G. Greenberg, Ph.D., taught at and served as the dean of the University of North Carolina School of Public Health. “I was lucky growing up. At an early age, I became acclimated with the campus and it felt like a second home.” The opportunity proved beneficial. Greenberg completed his undergraduate studies at UNC and later returned to the school to obtain a doctoral degree in epidemiology as well. “There is always a possibility that some may be interested in coming back for school or careers once the program is over. Exposing students to these opportunities is important for the future and the youth in Charleston.” MUSC has previously hosted summer programs for the local youth, but the program this year is much larger. Last year’s program had 10 students on campus compared to the 32 students serving six-week assignments this summer. The county accepts 100 students between the ages of 16 and 21 and allocates them as needed to different agencies. Rhonda Walters, an administrative assistant in the Office of Student Diversity, praised Greenberg’s decision to provide funding for the students. “He is a wonderful leader with great vision.” Walters also played a vital role in the process. She interviewed the students, instructed them on the code of conduct, helped them gather documents for Human Resources and introduced them to mentors on campus who could assist them if she was unavailable. Greenberg is delighted with the efforts of all employees involved in the program. “Everyone has a lot to do. Employees who have been willing to take on additional responsibilities are going above and beyond the call of duty, which is great.” Walters said the program gives MUSC a chance to do what it does best – provide leadership.

Sabrina Pierce, a student with the Charleston County Summer Youth Work Program, sorts through and shreds papers. Pierce is working in the Office of Student Programs. “I enjoy the chance to meet talented, smart and tenacious students who have a lot to offer. The experience is beneficial due to the opportunity to see leadership and professionalism, interact with others and build a network with MUSC that will last for years.”

NETWORKING FOR SUCCESS Greenberg and Walters are not the only ones happy with the success of the program. Grant Sineath, a third-year student at Clemson University, is working in the SCTR Center for Community Health Partnerships in the College of

Nursing. “I create thematic maps using data and computer programs to help people better visualize things. They are useful for teaching and outreach.” Sineath believes the experience is important because it provides an opportunity to see how a professional work environment truly operates. “I’ve already learned some insightful tips for the future. For example, the ability to network is a significant key to success.” He said he would recommend this program to others. “If the potential candidate is serious about their future and willing to learn, then they should give it a try.” Sabrina Pierce is another student who is glad to be a part of the program. A recent graduate of the Charleston County School of the Arts, she is working in the Office of Student Programs with Walters and her colleagues. “I answer and make phone calls, as well as enter information into databases and run errands as needed. I enjoy being in the office environment and experiencing different things for the future.” She said that she is also learning from her professional counterparts. Dorothea Gadsden also supervises Pierce in the Office of Student Programs. Gadsden has provided her with useful information. “We’ve gotten together to discuss college plans and even my next steps financially. It’s nice to have someone who has already been working in a professional environment offer advice. It’s a great experience.” Walters said she would be more than willing to continue her role in the process should MUSC maintain the initiative with Charleston County in the future. “I believe in this program and what it offers. More agencies around the county should provide this opportunity to young people. Most, if not all, of the students will take the skills they learn here and flourish. I think of our motto ‘Changing what’s possible,’ and I believe that this is changing what’s possible in our community.”

“I’ve already learned some insightful tips for the future. For example, the ability to network is a significant key to success.” Grant Sineath


THE CATALYST, July 13, 2012 5

MEET LONNIE

Lonnie Ferguson Department Safety & Security How long at MUSC 6 years How are you changing what’s possible at MUSC Promoting a positive image for all that MUSC has to offer Interesting fact about you I was a state trooper from 1984 - 1996. Dream vacation Swiss Alps, Greece, Germany, with my family A must-have in the pantry Boston cream pie Favorite war movie “Saving Private Ryan” Greatest moment in your life My wife saying yes to my marriage proposal Words of advice Be accountable for your actions. Favorite picnic food Fried chicken, boiled peanuts and watermelon


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Nurses take cases from exam room to courtroom BY ALLYSON BIRD Of The Post and Courier staff

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eeAnn Blanche arrived at the emergency room around midnight, painfully aware of people staring at the stranger wearing a badge beside her. A blond nurse with a pixie haircut, Janet Ward, came out to get her, to photograph Blanche’s bruises and to swab for DNA. Ward took notes as she asked Blanche for the details about what happened and asked her to change into a hospital gown. Blanche sat naked beneath the thin fabric in the tight, windowless room. Ward pulled out a plastic speculum and — knowing how daunting it must look to a woman who’s just been raped — she gave Blanche the usual speech: “Honey, don’t worry. I’m not going to meander.” Blanche’s 2010 case marked one of the first cases in the Lowcountry handled by the Sexual Assault Nurse Examiner program. The internationally recognized certification, shortened to SANE, restarted at MUSC two years ago. Before that, in what SANE nurses call “the dark ages,” one woman in North Charleston conducted all exams for the entire three-county area and beyond for more than a decade. SANE works to take rape cases from the exam room to the courtroom by training nurses how to care specifically for sexual assault patients. Victim advocates and prosecutors help along the way to preserve the patient’s dignity while also preserving evidence against the alleged attacker. So far, two cases have gone to court, and both have ended in convictions and prison sentences. Blanche spent about two hours in the cramped room at MUSC, as Ward collected evidence to send off in a cardboard box to the State Law Enforcement Division. At the end of the exam, Ward gave Blanche a round of antibiotics that made her retch. Then the nurse gave her a hug and sent her home The two women didn’t see each other again for a year, until 34-year-old Michael Christopher Andes’ trial. There, Ward testified about her exam, and Blanche testified about what happened some 20 hours earlier: Blanche’s roommate, a man she knew for five years and who outweighed her by 100 pounds, had forced his way into her bedroom and pulled off her pajama bottoms. Andes raped her and then sat on the side of her bed and urinated all over the room. Blanche usually shared that room with her then-9year-old daughter, but the girl stayed at her father’s house that night. Blanche took a hasty shower later that morning and then threw her daughter a 10th birthday party. Blanche had been out of work for a year and finally had the

photo by Grace Beahm of The Post and Courier

Using a blue light and glasses, Janet Ward, a nurse with the Sexual Assault Nurse Examiners program at MUSC, can see bodily fluids on a sexual assault victim. She is specially trained to collect physical evidence from rape cases that can lead to convictions in court. money to book a roller skating rink for the afternoon. “I had to do that for her,” she remembered Afterward, she told her mother what happened and called Goose Creek police. A Berkeley County jury late last year convicted Andes of first-degree criminal sexual conduct. He had been convicted previously of grand larceny, two counts of contributing to the delinquency of a minor and several counts of breaking into cars. He is serving a 12-year prison sentence at Lieber Correctional Institution. “It didn’t matter to me, at the end of the day, if he went to jail,” 32-year-old Blanche said at her Goose Creek home, months after the trial. “Did I want him to? Yes. What mattered was that they listened to me. It’s down on record that he did what he did. He had to listen to that. His family had to listen to bits and pieces of it. That’s what mattered to me.”

START TO FINISH What matters to Scarlett Wilson, the area’s chief prosecutor, is getting those cases to that point — into the courtroom and on to conviction. Rape cases are tough to try. Victims don't want to take the witness stand in a public courtroom, where

defense attorneys will pepper them with questions about every detail of the attack and often dredge up their past mistakes. To those victims, Wilson reasoned, the nurses and the hospitals represent “the system” at large. If their first experience with authorities only extends the trauma, they won’t stick with the case. “We had a couple of victims with particularly bad experiences who were good examples of why it was important,” Wilson said. She requested a meeting with MUSC almost immediately after becoming solicitor in 2007 and championed the SANE program until it officially launched three years later. Now, there’s a SANE nurse working at all times at MUSC, with two nurses devoted to the program fulltime and another eight trained nurses on-call. They pack work clothes and take separate cars to family outings. They panic when their cellphones lose reception. Some of the newer nurses stress about taking restroom breaks. Sometimes, they treat two or three patients in a day, and sometimes a week goes by without a single sexual assault case. The nurses spend those slow days catching

See EXAM on page 10


The Catalyst, July 13, 2012 7

EMPLOYEE WELLNESS T

aking short breaks during the work day has long been advocated by the medical profession. Research shows that people who sit too long during the day are at greater risk of health problems such as heart disease, type 2 diabetes and obesity. Benefits of taking several five to 15 minute breaks throughout the day include the following: Susan Johnson q Increased productivity and efficiency q Lowered blood pressure — the Mayo clinic recommends taking breaks for deep-breathing exercises. q Reduced stress — studies show that just a few minutes away from the computer significantly lowers stress. q Decreased chance of getting heart disease — work stress has been linked to heart disease, and taking frequent breaks alleviates stress. q Increased energy levels — some studies indicate that a nap or walk is more effective than several cups of coffee. q Reduced chance of getting repetitive stress syndrome and having eye strain. In addition to the need for breaks during work, there is evidence for the psychological and physiological effects of experiencing nature and the outdoors. Roger Ulrich, a professor and director of the Center for Health Systems and Design at Texas A & M University, found that viewing natural scenes or elements fosters stress recovery by evoking positive feelings, reducing negative emotions and blocking or reducing stressful thoughts. When viewing vegetation as opposed to urban scenes, test subjects exhibited lower alpha brain patterns, which are associated with being wakefully relaxed. A new lunch and learn series starting this week at the MUSC Urban Farm will provide MUSC employees and students an opportunity to take a healthy work break surrounded by natural and

Health at work

therapeutic scenery. Each Thursday from noon to 1 p.m., participants can enjoy a lunchtime demonstration or discussion about gardening, nutrition or sustainability while dining in a relaxing, stress-free setting. Additional opportunities to take a break at the farm include weekly Work and Learn sessions now on Thursdays from 9 to 10 a.m. and Saturdays from 9 – 11 a.m. Each Work and Learn includes an educational component, work chores to maintain the farm and a harvest with all participants taking a share home in return for their work or donating it on special outreach harvest days. Topics vary each week. This week the focus will be organic disease and pest controls — home remedies and plant maintenance. There also will be fresh watermelon and harvest during the Work and Learn. To learn more about the MUSC Urban Farm visit www.musc.edu/ urbanfarm or the Facebook page at www. facebook.com/muscurbanfarm. Employee Wellness events q MUSC Employee Fitness Series: Join Katie Blaylock for a free strength and conditioning class from 12:15 – 12:45 p.m., July 18. To sign up, send your name and email to: musc-empwell@ musc.edu. See MUSC Wellness Center membership desk upon arrival for sign-in and directions to the classroom. q Worksite screening: The July 19 screening is valued at $350 and is available to employees with the State Health Plan for $15 (covered spouses can participate for $15). Employees and spouses without this insurance can participate for $42. To register, go to www.musc.edu/medcenter/health1st and click on Worksite Screening. Contact Johnson at johnsusa@musc. edu for information on the Office of Health Promotion and Suzan Whelan at whela@musc.edu for additional information about Employee Wellness. Events, speakers, classes, or any other ideas are welcome.

Blood, platelet donors of all types needed by American Red Cross The American Red Cross has an emergency need for blood and platelet donors of all types. There is almost half the amount of readily available Red Cross blood now than there was at this point in time last year. Eligible donors with types O positive, O negative, A negative and B negative are encouraged to donate double red cells where available. Right now blood donations are not keeping pace with the demand for blood products. Many regular donors are busy or traveling and unavailable to give at

this time. With schools and families on vacation, it’s important to remember that patients don’t get a holiday from needing blood. During the month of July, all donors will be entered into a drawing for a $3,000 gift card. The American Red Cross blood donor room at MUSC is open from 10 a.m. to 4 p.m., Tuesday through Thursday, Room 279 of the university hospital. Appointments are encouraged but not necessary. To make an appointment or for more information, call the donor room at 792-1015.


8 THE CATALYST, July 13, 2012

DONOR

threatening diseases need a bone marrow transplant. There are two methods of donation: peripheral blood stem cells (PBSC), the kind that Jacobsen had, and a bone marrow harvest. His mother, Nancy, came down in April to give him support during the five-hour procedure. Jacobsen came to MUSC’s apheresis room, where blood was removed from a vein in one arm and passed through a blood cell separator machine, which collects PBSC. Plasma and red blood cells were returned to him through his other arm. “I’m proud of him,” she said. “I’m thrilled that he’s willing to do this. He’s a true doctor at heart.” Eric S. Rovner, M.D., a professor in the Department

of Urology, said he signed up as a donor when he was in medical school 25 years ago in New York. He got the call last year that he was a match and underwent the peripheral blood stem cell donation last summer. He said the donor process was essentially painless, well organized and orchestrated. “I think each doctor has to make their own decision for their own reasons. In my estimation, there is no downside to donation, and there is a substantial upside in being able to help another person who has no other options. It is rewarding and underscores the reason that many of us went to medical school in the first place.” Kramer said donors, between the ages of 18 to 60, are eligible for donation according to National Marrow Donor Program. “There is a one in four chance that each full sibling will be a perfect match. Seventy percent of patients turn to the registry for an unrelated matched donor because they do not have a sibling match. If you join the registry, you should be willing to help anyone who is in need of a blood and marrow transplant. ” People from different ethnic backgrounds, particularly African-American, are needed, but that’s not to discourage white donors because they just may have that rare human leukocyte antigen or HLA tissue typing that’s needed, she said. “You could be that one person out of 10 million people on the registry who does match. We do encourage all people, no matter what your ethnic background is, to register so that when I’m searching for my patient, I have a better chance of finding them a match. You could be that special person that we are searching for to help save a life.”

she didn’t feel a thing during the procedure. Needles were placed into her back hip bones multiple times to withdraw bone marrow. She donated close to two liters of bone marrow and opted at her request to receive back a transfusion of her own unit of blood afterwards. She went home that same day. She said she was sore for several days, but was able to return to work on Monday. “I would encourage absolutely everyone to join the registry, and of course doctors. We joined this profession to help and heal others. In a world of health care that is often tainted by red tape and insurance issues, this offers the chance to truly and simply help another person.” Hudspeth said she enjoyed getting to meet her recipient, Kathy Voigt, a 56-year-old wife and mother of three children. (Donors have the choice of meeting their recipients after a year following the procedure.) Voigt had relapsed acute myelogenous leukemia and the transplant meant that she was able to see her youngest son graduate from high school. Hudspeth got to meet her in 2006 and was surprised to find that they live only about two hours away from each other. “My daughter was obsessed with Elmo and Sesame

Street at the time. Her oldest daughter was working as Elmo at Sesame Place during the summer break from college. We met at Sesame Place and my daughter got her own special meet and greet with Elmo. As a mother myself, knowing that I was able to give another mother the chance to be there for her children means more than I can really put into words. I would donate again in a heartbeat.” As a transplant physician, Hudspeth performs bone marrow harvests for donors for the National Marrow Donor Program as well as bone marrow harvests for children who are donating for their brother or sister. She likes to be able to tell them that she has been through the very same procedure. “In particular, I think, and this is my hope, that it is somewhat comforting to the kids that the person doing the procedure has actually undergone the very same procedure. I think it is vitally important that our donors receive exceptional care.” Whenever she can, she encourages others to register. “When you have seen children die because they have no available donor, you will do anything in your power to prevent that from happening to anyone.”

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guilt-tripped me into it,” he said, smiling. “I didn’t think I’d ever be called.” In January, though, he got a call that he was a potential match and that they needed to do more testing. After he got over the shock, he found he was glad. Most people on the donor list never get called given the WATCH chance of being a match is one A VIDEO in 524. “After I heard about the potential, I was very excited http://bit.ly/ that it could happen. It’s just a TransplantProgram cool thing to be a part of.” Jacobsen, M.D., who’s been at MUSC since July 2011, said he thinks more people would register if they knew it just involved a cheek swab and that registering doesn’t mean they will have to follow through on the donation.“You can decide at any time you don’t want to do it anymore.” Jacobsen had to take shots for five days leading up to the procedure of a drug that would boost his blood cell counts. He had some discomfort and achiness, but nothing that would deter him from recommending that others do the same. A donor’s blood-forming cells return back to their normal levels within four to six weeks. “To be able to save someone’s life, there’s no comparison.” Thousands of patients with blood cancers like leukemia and lymphoma, sickle cell and other life-

DOCTORS

Nurses Amanda Walters, left, and Cindy Kramer monitor Dr. William Jacobsen as he donates peripheral blood stem cells.

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Hudspeth, director of the division of Pediatric Hematology/Oncology, recalls joining the registry as a first-year pediatric oncology fellow at Johns Hopkins Hospital. The hospital was having a bone marrow donor drive, and she knew she wanted to be a bone marrow transplant physician. “I was pregnant at the time and I almost put off joining that day, knowing that you can’t donate while pregnant. But I stopped, in between a million pages and doing procedures, to join.” She’s so grateful she did. Several months later on maternity leave with her daughter, she was called. It turns out that she was the only match in the registry for her recipient with them sharing a rare HLA-C allele. Most people on the donor list never get called given the chances of being a match are one in 524. Hudspeth underwent more testing and in April 2004 had a bone marrow harvest, choosing a spinal block for anesthesia instead of using general anesthesia since she still was nursing her daughter. Of the two types of donations, a peripheral blood stem cell procedure or the more extensive bone marrow harvest, Hudspeth had to undergo the latter but said


THE CATALYST, July 13, 2012 9

HEALTH Continued from Page Three removed. There is an increased emphasis in medical practice on prevention. In the Medicare program, preventative and screening services now have no co-payments or deductibles. There’s no disincentive to get preventive services. This is one of the biggest parts of the bill: moving health care from the back end (disease and illness management) to the front end (building a primary care system that supports prevention and early control of the disease). How is MUSC incorporating technology and other tools to support the law and improve patient care? MUSC has adopted Epic, the new electronic medical records system that was launched May 17. Using Epic, I can tell if the patient I see today has a mammogram and colonoscopy. Epic gives us the ability to manage an entire population and allows the health care industry to focus resources in bringing in patients who need our preventive care. Another issue is open access. We want patients telling us what’s going on with their health. We don’t want them to call in and leave a message. The medical staff needs to be more available on the front end of care. We want to prevent patients from going to the emergency department for a health problem that we could have managed within our primary care system. Technology helps us practice better using reminder prompts for health care team reviews and allows us to work together as a communicative, coordinated team. Our subspecialists, hospitalists and everyone can communicate together using the same medical record and that’s important to providing a higher level of quality patient care. How will the new health care law affect MUSC or change its workforce? One of the things about MUSC’s workforce, which is true of other academic health centers, is that we have a lot of specialists and not enough primary care physicians. Other industrialized countries have provider ratios of 40 to 50 percent primary care physicians compared to 50 percent specialists. In the U.S., primary care specialists are at about 25 to 30

percent and the number keeps dropping. The worry is that when new patients get insurance, there is a need for more primary care providers. When then Massachusetts Gov. Mitt Romney enacted health care reform in his state in 2006, there were immediate primary care physician shortages. About 300,000 patients couldn’t find primary care physicians. We need to change the structure of primary care medicine in how it’s delivered and fix the payment mechanism. As it stands now, primary care is at the bottom of physician payments. We have to fix that in order to build incentives and attract new primary care physicians. We also need to change the way we train medical professionals and work within interprofessional teams. Today, medicine works in complicated teams around a sophisticated, electronic infrastructure. We all need to be working together and recognizing people on these teams – pharmacists, nurses, therapists, medical assistants, registration staff and other specialists. Every component of the delivery system has to work together to provide the best level of care for our patient population. For employees, what can be done to reduce the cost of health insurance and other benefits? If MUSC doesn’t advocate for getting insurance costs under control, then the benefits employees get will continue to shrink. We need to think differently and be stewards of resource. We need to provide services that add value to patient care and not just provide services that increase our volume and revenue. That’s the fundamental challenge that delivery systems and insurers face. Employers are demanding a different kind of system of care. They are tired of large annual insurance costs that increase each year, while their employees get minimal raises. Employees want a different model: one that maximizes value for them and their dependents but doesn’t take every extra dollar out of their paycheck. Reform works toward helping us purchase services that add value to care instead of volume. MUSC, as a delivery system, has to think how to do this effectively. Our system is volume driven and we will have to rethink this strategy.

Employers see escalating premiums and workers see higher co-payments and deductibles. Is it possible that the health care bill will be repealed? Speaker of the House Rep. John Boehner has called to repeal the bill in the U.S. House of Representatives. A bill to repeal health care reform legislation was passed by the House earlier this year, but did not make it through the Senate. To repeal a bill, it must be passed by the House and the Senate with 60 votes and signed by the president. So the House, Senate and president must be aligned to repeal the bill. This is very unlikely in the current Congress but it’s definitely an issue in the upcoming presidential election.

Is it a good time for health care reform in America? Yes. Many of the changes with health reform are already in place. The country will move forward with establishing health exchanges. This will progress now that there are no additional barriers to health care reform. We need smart people to help put the needed changes in place and to respond to the mandates of the bill. At MUSC, we’re already realigning systems to do this, such as the patient-centered medical home in Internal Medicine and Family Medicine and soon in Pediatrics. Our leadership will focus on value-based services and realign its delivery systems to meet the challenges. It’s a good time to work and start a career in health care, and I am encouraged by health care reform efforts.


10 THE CATALYST, July 13, 2012

EXAM Continued from Page Six up on supplies, billing and the reams of paperwork required for every exam — to ensure both privacy and an airtight prosecution. Even Blanche’s experience in the cramped exam room less than two years ago now seems like the dark ages. MUSC recently dedicated a spacious room in its Clinical Sciences Building, with chairs, a privacy curtain and calming moss-green walls, specifically for SANE exams. The patients can refuse photographs, swabs or any other part of the exam, said Kathy Gill-Hopple, the MUSC’s forensic nursing coordinator. “The point is to give them control back, and that starts right there,” Gill-Hopple said. Patients range from the college student with limited memory of the drunken night before to the elderly woman raped by the man who broke into her house. Women whose husbands forced them to have sex come in reluctantly, and men attacked in jail cells come in shackled. Most often, the patient knows the alleged predator, said SANE nurse Nancy Hall. The commonality stops there. “Every time you come in for an exam, you never know what you're going to get,” Hall said. A patient can seek an exam a full five days after an alleged attack and can wait as long as a year to file a report with law enforcement. A nurse gives the same weight to each patient, from the woman assaulted by a stranger in a parking lot to the prostitute whose customer held her captive. “Our role is just for that right then, for her body and what she needs,” Hall said. “If she never tells another soul the rest of her life, or if it goes all the way to prosecution, we are there to help her.” Proper treatment of rape cases not only means improved patient care but better evidence to take to trial. Getting rape kits completed early, before DNA evidence deteriorates, makes a good offense against a good defense attorney. The two cases that have gone to trial since the program relaunched: Blanche’s case against Andes, and a Colleton County case that ended in a 25-year prison sentence.

A HAND TO HOLD Blanche spent two days testifying in the trial of her former roommate. Sometimes she wonders how she made it through those long hours on the witness stand while strangers listened to the details of the attack. She recognizes how much harder that testimony, and the entire year leading up to it, would have been without the support she found through strangers with a group she’d never heard of before that night at the hospital. The SANE process not only pages a nurse specifically trained to treat a rape patient but an advocate with

People Against Rape. That volunteer comes to hold the patient's hand, to walk her back to her car after the exam and to guide her through the legal process over the months or years to come. “I honestly do not know how well I would be right now if it was not for what they gave me,” Blanche said. Volunteers show up at the hospital but then spend the next month helping the patient cope, before referring her to a therapist, said People Against Rape executive director Melonea Marek. Then the advocates show up at court hearings, ready to hold a hand again. Marek remembers when, more than 10 years ago, hospitals across the Lowcountry trained SANE nurses and then, because of funding, the programs slowly, quietly faded away. She, like Wilson and the nurses, wants to see SANE programs at all local hospitals. “If you break your arm, you can walk into any hospital and get service,” Marek said. “It would seem to me that if you get raped, you could walk into any hospital and get service. There’s no reason for that not to happen in this town.” Especially since, at one time, a patient could go nearly anywhere in this town for a rape exam. The SANE program began in a few states nearly four decades ago, but those nurses lacked any network until the program became more widespread in the ‘90s. That’s when Faye LeBoeuf joined the team of the first certified nurses in the Lowcountry. Within a few years, though, all her colleagues gradually left the SANE program. At some hospitals, funding dried up; at others, nurses decided they couldn't handle the stress of such draining work at such unpredictable hours. LeBoeuf remembers praying that her pager would stay silent on Christmas. She remembers spending an entire weekend in tears as she worked 10 back-to-back cases Her four children ranged from age 3 to age 12 when she started. Her youngest was 17 when she stopped. She missed swim meets, karate belt ceremonies. “They knew Mom and the beeper,” LeBoeuf said. “Plenty of times, I thought about stopping. But I couldn't do it to the women — or the men.” She stopped in 2010, when MUSC renewed its commitment to SANE in earnest. LeBoeuf still works as a certified nurse midwife for mostly low-income women at the MUSC’s Women’s Health outpost tucked away in a North Charleston strip mall. She can’t help but resent the people who call SANE a new program. “It started here,” she said in an interview at her office. People from Charleston, Berkeley and Dorchester counties, as well as people from as far away as Georgia, made their way to LeBoeuf, the only person for miles who could perform a proper SANE exam.

YEARS AHEAD Staffed full time — by more than one person — the

RESOURCES MUSC: Report to the emergency room and request to see a SANE nurse or call 792-2300 and request to have the on-call SANE nurse paged. Those patients out of immediate crisis and instead seeking counseling may contact the MUSC National Crime Victim’s Center at 792-8209. People Against Rape: Call the 24-hour Crisis Hotline at 745-0144 where victims of sexual assault may seek medical support, counseling and more. The NorthCharleston-based organization accepts donations of food, clothing, shelter and transportation. The group also relies on volunteers to become victim advocates For information, visit peopleagainstrape.org. SANE program remains in its infancy. Local nurses hope for grant money to purchase a $35,000 camera that will collect stronger evidence in sexual assault cases. They hope to add more members to their own ranks and at other hospitals in the area. Patients who seek help anywhere but MUSC have to explain what happened at least one more time and then travel to SANE nurses downtown. Delays compromise evidence and also the patient's willingness to stick with the court process. A sexual assault victim spends the rest of her life recovering from the attack, said Debbie Browning, nursing director at MUSC’s Children’s Hospital. “If it happened at a gas station, she’s going to think about it every time she drives past a gas station,” Browning said. For LeeAnn Blanche, her daughter’s birthday reminds her of the attack. That’s the part Blanche resents the most. She avoids social gatherings that involve alcohol, remembering the stale beer on Andes' breath the night he raped her. Sometimes she looks in the mirror and wonders how anyone can ever find her pretty. But she hates the word “victim.” Blanche went back to work, kept up with her sexually transmitted disease testing and met with counselors and prosecutors regularly. She told her daughter the truth, because she wanted the girl to hear it from her and not from anyone else. “I think when you use the word ‘victim,’ you’re putting yourself into a category,” Blanche said. “Yes, I am a victim of what happened, but that's not what I’m going to be the rest of my life. I don’t want to use that as an excuse.” People ask her what happens after Andes’ 12-year sentence ends. Blanche said she’s content just knowing that she has 12 years to figure that out. Editor’s note: The article ran in the June 18 issue of the Post and Courier and is reprinted with permission.


THE CATALYST, July 13, 2012 11

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Scholars initiative accepting nominations for Advancement of Women Faculty Award A call for nominations is under way for the Women Scholars Initiative Award for Advancement of Women Faculty. The purpose of the award is to recognize the faculty member who best demonstrates excellence in his or her commitment to the advancement and promotion of women faculty at MUSC. This award will be announced during Faculty Convocation, and in addition to a commemorative plaque, the recipient will receive a monetary award from the MUSC Foundation To be eligible for this award, the nominee must be a full-time faculty member at MUSC.

Application materials include a completed nomination form; a one-page letter of support from the person making the nomination; two additional supporting letters; and the nominee’s bio that includes examples of their investment in faculty development. Nomination packets should be submitted as a PDF file to huttojm@ musc.edu no later than 5 p.m., July 13. Questions regarding the application process should be directed to Mary Mauldin, Ed.D., chair, Award Selection Committee. Visit http:// academicdepartments.musc.edu/ womenscholars/index.htm.


12 THE CATALYST, July 13, 2012


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