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hopkinschildren’s Summer 2012

The Johns Hopkins Children’s Center MAGAZINE

Celebrating Bloomberg Children’s Center The new hospital launches a new era in pediatric medicine at Johns Hopkins

An Artful New World: A fritted façade and supersize rhinos and puffer fish __________________ A Family-Friendly Hospital: All-private rooms and meals “At Your Request”


Through a Child’s Eyes

On Stage for Others By Gavin Michel-Baird

When they asked me if I would introduce Mr. (Michael) Bloomberg at the dedication of Bloomberg Children’s Center, I said “Yes.”

Gavin Michel-Baird is a third-grader who lives in Edgewood, Md. He introduced New York City Mayor and Johns Hopkins alumnus Michael Bloomberg at the dedication of The Charlotte R. Bloomberg Children’s Center and Sheikh Zayed Tower at Johns Hopkins Hospital, where he shared the stage also with His Highness Sheikh Zayed bin Sultan bin Khalifa bin Zayed Al Nahyan, for whose grandfather the adult tower was named. Bloomberg and his sister, Marjorie Tiven, named the Children’s Center for their mother.

H O P K I N S  C HILD REN’ S | hopkinschildrens.org

Hopkins has really helped me, ever since I was born. I wanted to help them so they could make other kids feel better, too. For my speech, I practiced and practiced. It was a little tiring. Stepping out finally onto that stage, with everyone looking at me, was embarrassing. But I have been in plays at school. In kindergarten I played the mouse king. So I knew I had to use a big voice and sort of make an entrance. After a while it was fun. Mr. Bloomberg was very nice. And so was the Sheikh (Zayed). After I cut the ribbon for the building, the Sheikh took the scissors from me. I think it worried him that they were very sharp. They had told me confetti was going to come out of a cannon and I really wanted to see it. But we were facing the audience and it shot out from behind us over our heads. Mr. Bloomberg later helped me gather all of it. Now, it’s in my closet at home. At the end of everything, there was food and a party, but I just wanted to go to Taco Bell. It’s my favorite. I have seen the new building. I really like the big puffer fish and their little faces. There is a TV studio there for kids, too. I liked watching shows and playing with Wii when I was in the hospital, which was for a long time. I wanted Ms. Lynn (Mattis), my nurse at Hopkins, to be my date at the dedication. But she had to be in the clinic that day. I love her. She takes care of me. And I like Dr. (Carmen) Cuffari, one of my doctors. I was born with a hole in my stomach. But now I can eat and there are no more (GI) tubes. I had those until I was 5. Thank you! n


summer 2012

Places to play, like this “teen room,” are among patient- and family-friendly features of Bloomberg Children’s Center.

    d e p a r t m e n t s

 Celebrating our Centennial 1912-2012 100 Years of Discovery, Innovation and Caring      F e a t u r e s

Realizing the Promise

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    Will Bloomberg Children’s Center change

pediatric medicine?

Mat Edelson

The Art & Architecture

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of Bloomberg Children’s Center

 Fritted facades and supersize sculptures of

an ostrich, puffer fish and rhinos? Gary Logan

20  Flying High, Flying Low:

A Photo Journal

Through artworks, patients follow magical paths. Photography by Keith Weller

2 Director’s View

from bath house to bloomberg

3 Hopkins Scrapbook the day an era ended Elaine Freeman & Edith Nichols

30 Inside Bloomberg Children’s Center 32 more space for a premier ed A family-friendly environment, too. 34 niche cardiology services Designed with collaboration in mind. 36 kids only imaging Pediatric radiology finds a home. 37 a studio for cctv A modern venue for engaging patients. 39 meals at your request A new culinary wind is blowing at the Children’s Center.

40 People & Philanthropy A Dedication for the Future Gary Logan & Wendell Smith 48 family matters Ask Parents and They Will Build It Gary Logan 49 patient voices A Quieter, Homier Home Rebecca Manning S u mme r 2 0 1 2

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The Director’s View

From Bath House to Bloomberg In looking ahead at how pediatric medicine might change in our marvelous new building—The

George Dover, M.D. Director, Johns Hopkins Children's Center Given Professor of Pediatrics

Charlotte R. Bloomberg Children’s Center—it’s constructive to look back to our origins, which surprisingly were in a tiny two-story building known as the “Bath House.” In 1896 baths were considered therapeutic, so a bath house was renovated for children, making it Hopkins’ very first building for children. At the time we had no full-time pediatric faculty, training or research program. But in 1903, Harriet Lane Johnston willed funds for a hospital for invalid children, which resulted in the Harriet Lane Home opening in 1912 and the beginning of the first full-time academic department in pediatrics in this country. The melding of pediatric research and training with patient care followed and Hopkins became known for pioneering pediatric treatments. But by the late 1950s the Harriet Lane Home was outmoded and drawings were drafted for the Children’s Medical & Surgical Center (CMSC). Pediatric academic medicine at Hopkins thrived over the next half century, but like its predecessor the CMSC eventually outlived its space. Parents cited a lack of amenities and faculty inadequate research space. So, in 1998 plans ensued for a new building with a new challenge—how would we sustain the innovation that sustained the Harriet Lane Home and CMSC? We decided to remain independent but also part of this campus, which would allow us to do things in pediatrics a freestanding children’s hospital cannot do. We built in our capacity to do clinical trials, while knowing that what distinguishes us is not just how well we treat a particular disease but the people we attract and the innovations in pediatric medicine we develop. In the future we may have to look at preventing adult diseases as well as treating childhood diseases, which collaborative core labs, rather than single labs, will facilitate. Today we’re very grateful to all of our patients, families, staff and generous donors who collectively had a vision of what our new building should look like. Now we need to continue to set the standard for care by both attracting and teaching the very best and by adapting our research to the new realities. With your help, we know we can do that. Thank you. n

Hopkins Children’s is published by The Johns Hopkins Children’s Center Office of Communications & Public Affairs 901 S. Bond Street / Suite 550 Baltimore, md 21231 www.hopkinschildrens.org 410-502-9428 Kim Martin Director Gary Logan Editor Wendell Smith Assistant Editor & Senior Writer Julia McMillan, m.d. Peter Mogayzel, m.d. Cozumel Pruette, m.d. Medical Editors Mat Edelson Contributing Writer Max Boam Art Director Abby Ferretti Design Keith Weller, Kevin Webber Photography Naomi Ball Distribution Printed in the U.S.A. ©The Johns Hopkins University 2012

Give us feedback Send letters to Gary Logan at the above address or e-mail: glogan@jhmi.edu.

For more information To read more on the clinical services and programs covered in Hopkins Children’s, visit hopkinschildrens.org.

How you can help Call 410-516-4545

Cover photo by Keith Weller 2

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Hopkins Scrapbook

The Day an Era Ended On the 100th anniversary of the Children’s Center, a look back at the

closing days of the old Harriet Lane Home and the deep sense of loss felt by pediatricians who had worked there. By Elaine K. Freeman and Edith Nichols Courtesy Alan Mason Chesney Medical Archives

To this day, John Littlefield remembers the surprise he felt in the fall of 1973 when he arrived from Boston to become director of Pediatrics and found a group of wistful colleagues awaiting him. After a full decade of updating its pediatric facilities, Hopkins had just opened a new outpatient and emergency center for infants and children to replace the crumbling 62-year-old Harriet Lane Home where these pediatricians had worked. But instead of elation over their modernized quarters, the doctors were feeling nostalgia for what they were losing—the legendary Harriet Lane Home, scheduled for demolition in the spring. Indeed, the Harriet Lane Home had stood as a national icon. Named for its benefactress, the niece of former U.S. President James Buchanan who had married a Baltimorean, it had opened in 1912 as the first center for academic pediatrics in the United States. Offering specialized care for children and infants, as well as research and teaching, before pediatrics even existed at most hospitals, the historic facility inspired so much loyalty among pediatric residents who trained there that they referred to themselves as “Harriet Laners.” “The staff and even the trustees wanted some sort of commemoration,” Littlefield says, “at least a wake.” Littlefield, who’d been trained in internal medicine, not pediatrics, knew he had to show empathy. And so, he quickly organized an official goodbye. Turning to famed pediatric cardiologist Helen Taussig, who’d begun working in the Harriet Lane Home in 1930, he asked her to put together a 45-minute farewell. That program, billed as the Final Meeting in the Harriet Lane Home Amphitheater, took place on March 14, 1974, and was attended by more than

100 pediatricians, house officers, staff, and trustees. Shivering in the unheated amphitheater, they sat on hard wooden seats that served as bleachers—transfixed as five pediatric giants recounted stories of life in Harriet Lane through the years. Today, the memories of people who were there that day, and a transcript of the proceedings that appeared in the January 1975 Johns Hopkins Medical Journal, paint a picture of an event that marked the end of an era. The physicians Taussig invited to speak had all been pioneers in their pediatric specialties: 82-year-old Hugh Josephs in hematology; neonatologist Alexander J. “Buck” Schaffer; Leo Kanner, recognized as the father of child psychiatry; medical geneticist Barton Childs; and Taussig her-

Famed pediatric cardiologist Helen Taussig put together the program and started things off at the Final Meeting in the Harriet Lane Home, on March 14, 1974. More than 100 nostalgic Harriet Laners turned out, shivering in the unheated amphitheater.

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Hopkins Scrapbook

The featured speakers at the Final Meeting were all pediatrics pioneers: Helen Taussig, Hugh Josephs, “Buck” Schaffer, Leo Kanner, and Barton Childs.

self, a co-developer of the world-famous Blue Baby heart operation. “I remember being overwhelmed to hear some of my heroes speak, especially Buck Schaffer, who was Dr. Neonatologist to me,” recalls Alex Haller, pediatric surgeon-in-chief from 1964 to 1997. “I sat like a medical ‘bobby-soxer’ at the feet of my mentors.” David Valle, a serious amateur photographer who would go on to complete his residency at Hopkins, appreciated that something of a historical moment was happening. He drove up with his cameras from the NIH where he was working at the time. Photos he took that day illustrated the event’s transcript in The Johns Hopkins Medical Journal. “It was a chance to sit with my friends and mentors in a place that meant so much to me during my residency [in the 1960s],” says John Neff, later medical director of Seattle Children’s Hospital. “I would not have missed the event. That very amphitheater had been filled every Saturday morning for pediatric grand rounds. It was a high point of the week. It was terrifying for me as an intern to present a case there. We were expected to be succinct and include all of the pertinent patient information without notes.” “Nostalgia,” postulates Neff, “is built around valuable and memorable experiences that can never be repeated.” 4

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My colleagues and I may have grumbled at times about small budgets, poor equipment, and shabby quarters, but we were grateful for the one magnificent gift which outweighed everything else— the opportunity to work unhampered. – Leo Kanner, M.D. For Larry Pakula, who’d been on the house staff starting in 1957, the setting also brought back the hours he’d spent right there being exposed to his professors’ thinking as they debated and argued at grand rounds. “Then we’d all go on to the Doctors Dining Room for coffee. It was a great time,” Pakula says. But the Final Meeting “brought sadness that such intimacy was disappearing in medicine.” Taussig opened the program by introducing Hugh Josephs, who had interned under John Howland, the Harriet Lane Home’s chief from 1913 to 1927. What Josephs made clear were the changes that had occurred in 60 years in medicine itself. “Perhaps the most striking thing about the beginning,” he told the group, “was the lack of conveniences and equipment. There was no clinical laboratory to which one could send specimens for examination. Each intern did his own bacteriological work. Hematology consisted of a white count and, if indicated, a hemoglobin de-

termination. Blood chemistry was about to be invented as a part of research.” Josephs described typical cases from those early days: “Diarrhea was rampant in the summer.” The successful understanding and treatment of this condition, he said, “was the first great contribution of the workers at the Harriet Lane.” Pneumonia was the disease of winter. “We had no drug for that. We would wrap the babies up and put them out in the cold where they generally did well.” In the fall, there was typhoid. “The city water was safe, but these children had been with their parents picking fruit in the country and drank country water. Congenital syphilis, we saw at any time. We could recognize that across a room in a crowd.” Conquering rickets, Josephs said, was the second great triumph of Harriet Lane, “and for that very reason, largely unknown to you,” he told those assembled. Next up was Schaffer. “I came here feeling rather joyous and happy,” he said


Hopkins Scrapbook

Harriet Lane Home

Courtesy Alan Mason Chesney Medical Archives

to the group. Sitting in this room filled with pleasant memories, but faced with the imminent demolition of the old Harriet Lane Home, “I now confess to feeling something more intense than nostalgia.” He noted that he had “lived right smack in this building for four full years,” working “in the wards every morning and in the dispensary every afternoon. I spent the noon hour almost every day in this very amphitheater taking part in the staff conferences led by my remarkable chiefs. And I slept here, that is, until the alarm bell rang. We even took all of our exercise right here. The lone tennis court was right next to the HLH.” When 80-year-old Leo Kanner rose to speak, his reminiscences of his years as a Harriet Lane faculty member from 1931 to 1959 were emotional. “I have seen palatial hospitals compared to which the Harriet Lane was a dump,” Kanner said. “I have lectured and listened in resplendent modern halls compared to which the one at the Harriet Lane is the poor replica of a medieval contraption. Why is it, then, that in such surroundings I and many others thrilled at the thought of working at the Johns Hopkins Hospital and look back to our years there with unadulterated affection? ... My colleagues and I … may have grumbled at times about small budgets, poor equipment, and shabby quarters, but we were

grateful for the one magnificent gift which outweighed everything else—the opportunity to work unhampered, to develop and pursue our curiosities, to test our theories, and at all times to be true to ourselves.” Among the speakers, 58-year-old Barton Childs represented youth, but even he waxed nostalgic. “I’m delighted that we are using this room,” he said. “We’d have meetings here every day, and it was a place where you could be sure that you would see your friends and colleagues repeatedly. The only other place where that happened was in front of the only elevator in the building. And it was slow.” Did the Final Meeting achieve the effect Littlefield had hoped for? Childs’ closing remarks addressed that point: “I think it’s wonderful that we had this meeting, and I think it is a splendid thing that Dr. Littlefield proposed it. Not all new department chairmen would have the sensitivity to think about the feelings of people who had been in such a place, and I’m not sure that all new department heads would have had the self-assurance to be willing to sit around and listen to stories of the feats of the giants who preceded him.” “It was the right way to go,” Littlefield admits today. “A good opening gun for a new era.” n This article first appeared in Hopkins Medicine (Winter 2012).

“Harriet Laners” Forever The Harriet Lane Home was razed in 1974, but its name and what it represents in service and teaching have been preserved, insists Children’s Center Director George Dover: “The Harriet Lane Clinic, open and running for 100 years, is still serving the children of East Baltimore. Our training program always has been called the Harriet Lane Pediatric Residency Program, and its graduates will always be ‘Harriet Laners.’” The residents also continue to update the famed Harriet Lane Handbook, now available not just in print, not just online, but in a searchable “unbound” version. And this past spring, when the Children’s Center moved from the Children’s Medical and Surgical Center to the new Charlotte R. Bloomberg Children’s Center, Dover’s exhibit of the history of Pediatrics at Hopkins, starting with the Harriet Lane Home, moved with him—along with the copper clad doors from the old, slow elevators. n

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Realizing the Promise by Mat Edelson

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O

n the evening of April 12th, the Mayor of New York City stood before more than 1,400 dignitaries, donors, and doctors. They had all gathered for the dedication of The Charlotte R. Bloomberg Children’s Center, and His Honor, Charlotte’s son, Michael Bloomberg, was in fine form. In tones both hopeful and bar-setting, Bloomberg spoke of the promise of the impressive new 12-story edifice. “If this center will bring the youngest and most vulnerable patients the kind of care and comfort that they need; if it will increase the knowledge and experience of the greatest doctors and teachers; if it will inspire other institutions to do more and do better,” said Bloomberg, “then we all will be happy.” So what will it take to make all those ‘ifs’ go away? And how far can a new Children’s Center take Hopkins down that path?

The Charlotte R. Bloomberg Children's Center and, at left, neighboring Sheikh Zayed Tower.

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onsider what may eventually be called, simply, “The Choice.” When the history of this clinical building is written in a few generations, of all the decisions that will have woven its hopefully successful tale, perhaps none will have been more critical than the judgment to integrate the new children’s hospital into the existing East Baltimore campus. The choice of whether to go freestanding or remain physically part of the medical community was a matter of lengthy debate. According to Children’s Center Director George Dover, several off-campus sites were on the table, including a potential “Super Center” that would have combined the institutional knowledge and experience of both Hopkins and the University of Maryland in a central downtown location. Dover well understood the allure and prestige of a move to a freestanding structure. He notes that many of the country’s finest care centers for children have stand-alone status, including Children’s Hospital of Philadelphia (CHOP), D.C.’s Children’s National Medical Center, and Wilmington’s (DE) Nemours/DuPont Hospital for Children. Dover could have pushed in that direction, but feared that achieving breakaway status would negatively impact the kind of visionary medicine he felt bore the Hopkins stamp. In Dover’s mind, it came down to a single priority: Be the best, or be the biggest. From that vantage point, the call practically made itself. “We never designed this place to be the biggest,” says Dover. “In fact, the number of beds in this building is

The fact that we stayed in this environment is the major thing that will allow us to innovate. Sometimes it’s not what you do that’s important, but what you don’t do. – George Dover, m.d. 8

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smaller than D.C. Children’s, CHOP, and DuPont, our major competitors. We didn’t even try to get where they were.” Dover says limiting size directly affects quality of care, both now and in the future. Pushing up the bed count strictly to pump up the volume of patients could, in Dover’s opinion, fundamentally alter the Children’s Center’s century-old mission. “If we hired faculty to serve those additional beds, and they were working 100 percent of the time, clinically, they wouldn’t be innovating, they’d just be keeping up with the clinical demands,” Dover says. “We still want to hire physicians who can do both research and clinical work, but if we grow too big, our faculty won’t have the time to do both.” To Dover, freestanding status would have limited the fertile ground for seeding such breakthroughs, the research equivalent of moving from a beautiful botanical garden to a rooftop herbal planter. Dover cites the thoughts of the last Children’s Center director who opened a new hospital, Robert Cooke. In 1964 Cooke, in his dedication speech, worried that moving into the larger CMSC could trigger rapid growth, create silos, and weaken pediatrics’ long-standing reputation for collegiality with their adult medicine counterparts. “(Cooke said) that the culture depended upon people being close to each other, bumping into each other,” to create and nurture ideas, says Dover. “That without this closeness, the ‘aura’ around pediatrics could be threatened.” That concern resonated a halfcentury later as Dover contemplated the Children’s Center’s path. He decided to stay on the road well traveled. “The most important structural thing that will allow us to continue to innovate is being connected to the rest of the hospital,” he says. “Those eight stories that bridge the children’s tower and the adult tower; the fact we’re sitting on the same parcel as the Dome, across the street from the School of Public Health, down the block from the basic sciences and the School of Medicine, across the street from the new Armstrong Education building, and the fact that we stayed in this environment is the major thing that will allow us to innovate. Sometimes it’s not what you do that’s important, but what you don’t do.”


This environment is so stimulating, so rich, it feels so freeing. – patrice brylske, director of child life This continuing connection and sharing with adult medicine can be seen literally at the new hospital’s front door, where the Pediatric and Adult Emergency Departments stand side-by-side. But there’s more than symbolism at work here; there’s a direct benefit to pediatric emergency cases. “We put CT scanners, MRIs, and trauma bays between the Adult ED and the pediatric unit,” says Dover. “We don’t have enough patients coming solely to the pediatric unit to justify that, but when you combine the adult patients and pediatric patients it makes sense. So we can actually take some of the present technology and bring it closer to the bedside because we’re willing to share it with our adult colleagues.” The structure also offers a unification of sorts, which could well amp-up synergies between pediatric specialties. Between the modern David M. Rubenstein Child Health Building, opened in 2006, and the bridge-connected Bloomberg Children’s Center, nearly all of the pediatric clinical services have been joined together, or as Dover puts it, consolidated in a more focused fashion. “When you decide to build a building across the street exclusively for pediatric outpatients (Rubenstein), when you decide to build a tower exclusively for pedi-

atric inpatients, one of the things you do is bring the pediatric community even closer together,” Dover says. “Giving a sense of identity to pediatrics which will attract all these wonderful people into our building is a great idea, and because we’re so close to the adult side, we’re not separating ourselves. Once we made that choice, we began to see the opportunity to do some remarkable things.” In 2001, just as plans for the new Children’s Center were in their embryonic stages, the Institute of Medicine laid down a formidable gauntlet. Their report entitled: Crossing the Quality Chasm: A New Health System for the 20th Century, didn’t mince words. It condemned American medicine for being unresponsive to patient needs, uncoordinated in its application of care, and unnecessarily unsafe. The IOM’s report challenged institutions to improve in six areas and created a new buzzword for hospital administrators and faculty: Patient-Centered Care, or as the IOM put it, “providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.”

To say that the phrase—adapted to the more universal “Patient- and FamilyCentered Care”—has become the single guiding principle of the design and function of the new Children’s Center would be neither understatement nor hyperbole. There’s a microeconomics term called “The Second-Mover Advantage,” which may best explain where the Bloomberg Children’s Center stands as it opens its doors. Though Hopkins never claimed to be the first institution to practice patient- and family-centered care, they’ve used their “second-mover advantage” to learn from others’ successes (and mistakes) in the field. Pediatric faculty, staff, and administrators made numerous trips to facilities across the country, gleaning a multitude of ideas and creating a master “wish-list” of patient-centered initiatives. The result at this moment may well be the gold standard of patient-and familycentered care. Beautiful? Yes, so far as that term can apply to any structure made of concrete, steel, and glass. Lots and lots and lots of light-giving glass. But what’s most impressive, from its outer skin to its inner wiring, is how form and function combine to create a third, far more powerful element: Opportunity. It’s impossible to discuss the new S u mme r 2 0 1 2

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The CCSR is going to welcome the family in. It’s what we’ve always wanted to do, but in the past it wasn’t ideal because you had to have somebody else watch your patient while you got the parent. – christy richter, r.n. building with faculty and not have words such as “opportunity” and “promise” pepper their conversation. To a person, they see the structure through their professional prism and glimpse new ways of healing. Call it the potential beyond the amenity, but it’s everywhere one looks. For Child Life Director Patrice Brylske, those playful, oversized sculptures, the hundreds of pieces of fascinating art that dot the walls, the colorful playrooms on each floor, are more than just a delightful aesthetic; each is a potential conversation starter with a child, an entree for building trust and taking fear out of the hospital experience, which leads to better healing. “The old building restricted a lot of the lovely things we wanted to do for patients and families, but this environment is so stimulating, so rich, it feels so freeing,” says Brylske. “Now we have to challenge ourselves to use what’s in this beautiful building to support our work.” Part of her vision involves using the Great Room—a two story gym-size facility on the 11th and 12th floors—and other open spaces to expand Child Life’s creative arts program. “We have such diverse space now that we can accommodate a menagerie of artists, from music and art to dance, poetry and drama, elements that we didn’t have the space for before, to have that quality interaction with patients and families.” Brylske also mentions the private rooms that are the standard accommodations as being of great benefit to engaging children in play, especially those who aren’t mobile. The 205 private rooms are cited time and 10

HO PK INS  C HILD RE N’S | hopkinschildrens.org

Christy Richter, R.N., with Clinical Customer Service Representative Keya Keys.

again by staff as perhaps the key central element in improving all aspects of patient care. Many are quick to point out the family-friendly details such as on-demand room service, family lounges with microwave ovens and overnight beds. Pleasing amenities to be sure, but purposeful as well; keeping families on-site longer and close to their loved ones has numerous ancillary benefits. Sally Radovick, Director of Pediatric Endocrinology, sees the private rooms as offering the ideal educational space for parents who suddenly have to cope with a child’s life-changing illness. She points to children admitted because of life-threatening diabetic ketoacidosis, often the first sign that they have Type 1 Juvenile Diabetes. “An important aspect, during the acute phase, is to begin teaching (chronic disease

management),” says Radovick. “Learning about insulin dosing, what type I diabetes is, nutritional support…it’s critical for this initiation of self-care for the chronic state. Now, parents can stay with their child in a single room round the clock, and they can learn from the nursing staff and diabetes educators how to take care of this child, how to give the insulin injection, and participate in carbohydrate counting each meal, which was potentially more difficult to do in a room with two or more children.” Director of Pediatric Nephrology Barbara Fivush also credits the private rooms for fostering better staff-family/patient conversations. In just the short time the hospital has been open—the official start date was May 1st—Fivush says she can see and hear the change. “Our service has many chronically-


impaired patients with complicated emotional problems…the conversations can get pretty detailed, and I think we felt uncomfortable (in multi-family rooms) talking about their care,” Fivush says. “Now we have the privacy to really get to spend time with our families, which promotes the ability to communicate better because you don’t have to be concerned about who is listening and who else is in the room.” She adds, “I’ve just been on service in the new hospital this week, but I’m very impressed with the conversations we’re having, about non-adherence, why they got kidney failure from a certain drug, why that drug was given to them in the first place… so many topics that are not naturally easy to discuss unless the environment is open to that.” Private rooms also increase patient safety, a key element of the IOM’s pivotal report. “With private rooms, you don’t worry about cross-infection from roommates,” says pediatric pulmonologist Beryl Rosenstein, former long-time vice president for Medical Affairs at Johns Hopkins Hospital. In the old building, “we had to move patients around because of infection control issues. Now it’s simple; every patient is in their own little cocoon.” And many systems have been built around preserving the sanctity and safety of that little cocoon. Marlene Miller, director of the Division of Quality and Safety, notes that drug delivery has been completely revamped from stem to stern. The pediatric pharmacy is five times larger than its predecessor, there are separate rooms with separate pass-throughs for IV meds, and quiet space for the pharmacists to do their dosage calculations without being disrupted. Also, the medication distribution system has been redesigned with more frequent delivery of meds, more frequent removal of the discontinued meds, and bedside delivery of medication so there’s less distraction for the nurse. “She’s not in a med room with five other nurses all getting meds for their patients,” says Miller. “Her patient’s meds are right by the bedside.��� Keeping the nurse with their patients, especially those who are critically ill, is a win-win result of another amenity, Clinical Customer Service Representatives (CCSR).

In the past, PICU and NICU nurses would often be called away from their patients to meet families and instruct them on proper safety protocols before entering the rooms. Now, they can stay by the bedside, as the CCSR staff greet families at the entrance to each unit and prep them for their visit. “The CCSR is going to welcome the family in, show them how to wash their hands, and walk them down to the patient room,” says NICU nurse Christy Richter. “It’s what we’ve always wanted to do, but in the past it wasn’t ideal; you had to have somebody else watch your patient while you got the parent. That wasn’t really welcoming for anyone. But now their anxiety level will already be lower when they enter the room. And their hands will already be washed so we can get right to ‘here’s what’s going on with your baby.’ The continuity is just going to be better.” Continuity. Safety. Quality of care, notably Patient- and Family-Centered Care. Modern medicine lives by these buzzwords; together they form the mantra by which the new Bloomberg Children’s Center will attempt to create a standard of care that would make the IOM proud.

You go into it with a lot of humility and insecurity, really, about where the world is going, but you learn lessons for the future from the lessons from past experiences. – Ted chambers, pediatrics administrator

That’s as of today. But what about medicine 10, 20, 50 years from now? Will the new Bloomberg Children’s Center still be going strong when our children have children, or will time have passed it by? Put another way, will the faculty and staff have made their mark on medicine in Bloomberg Children’s Center, much as they did in the CMSC and Harriet Lane? Or could this next era for the Children’s Center become a grand experiment that ultimately yields disappointing results? If history is any indication, it’s hard to imagine the latter, especially given the thousands of planning hours put into envisioning the future of pediatric medicine. Still, playing clairvoyant is a daunting task. “You go into it with a lot of humility and insecurity, really, about where the world S u mme r 2 0 1 2

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With a live video feed from the OR, the upgraded echocardiography suite gives pediatric cardiologists like W. Reid Thompson, left, and Phil Spevak the advantage of interpreting images for surgeons in real time.

is going, but you learn lessons for the future from the lessons from past experiences,” admits veteran pediatrics administrator Ted Chambers. “One of the advantages Dr. Dover and I have is that we’ve been here for some time, so we’ve built up experiences that lead you to how you would shape the building and the future of the Children’s Center.” Indeed, a consulting group hired early in the process strongly suggested that Hopkins build a far smaller inpatient children’s hospital than what Dover and Chambers eventually delivered. The consultants based their recommendation on national data which showed pediatricians across the country were doing a better job at keeping kids from getting sick, and inpatient admissions were dropping. They thought they were seeing the big picture; Dover and Chambers thought otherwise. Pediatric cases, especially chronic ones, were getting more complicated. Numerous specialists and services were required, often beyond the scope and resources of most pediatric centers, but not Hopkins. So, by their thinking, while many centers will be seeing fewer inpatients in the years to come, Bloomberg Children’s Center will thrive by offering top-notch 12

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care to the most complex of cases. Physically that means having a building with the flexibility to handle those cases now and in the future. Expanded dedicated pediatric OR suites, designed to fit the specific needs of subspecialties including neurosurgery and cardiology, are both state-of-the-current-art and adaptable to technology that at least has been glimpsed on the horizon.

This lab is really set up with good hardware and software that has the capacity of seeing an image anywhere, at any time, from anyone. – phil spevak, M.D. “We’re going to be able to integrate robots into the system; the rooms are made to accommodate those kind of advances,” says neurosurgeon Ben Carson. “The only reason we don’t use robots right now in neurosurgery is they’re not quite fine enough. But once they become fine enough and

delicate enough, the kinds of things we’ll be able to do will be mind boggling.” Even the air that’s breathed throughout the hospital has the future in the mind. “The whole building is HEPA (high-efficiency particulate air) filtered. The air is cleaned in a way we never had in the old building,” says Chambers. Such filtering not only lets immune-compromised children stay safer, but it’s vital to emerging therapies. “The way the air handling system works, you can administer a drug in a certain room and it doesn’t leak out into the corridor or other areas,” Chambers says. “With gene transplantation, one of the lessons we learned is we needed a very special air handling system to administer the gene, because you didn’t want these genes just floating around anywhere.” There’s little doubt that as technology evolves, so too will the concept of the traditional children’s hospital. Expertise that is regionally based is on the verge of having a national and global reach, and Bloomberg Children’s Center is set up for that emerging world of telemedicine. Cardiologist Philip Spevak has built a NASA-esque imaging command center that coordinates numerous imaging modalities both in-


Nursing in a New World

house and to satellite sites to come. “This lab is really set up with good hardware and software that has the capacity of seeing an image anywhere, at any time, from anyone,” says Spevak. “That’s important in clinical care because expertise varies from center to center and pediatric cardiology program to program, and you even have expertise here in say, congenital heart cardiac imaging. So we can be an expert consultation service (to other centers) in a minute. We’re also using our center to train technologists at other hospitals.” Ben Carson sees a similar technological outreach from OR to overseas coming down the road: “The new operating rooms are very technologically advanced. I did nine cases last week, and to be able to record what you’re doing, with just a simple maneuver, have it sent to a central source where you can then upload it to your computer in your office, make slides, do various presentations, makes access to this information to other people much greater, so now it’s not just what you’re learning, it’s what you’re able to transmit to others… the fact that we’ll be able to communicate with medical centers in Nigeria, in Israel, in Dublin, in South America, in New Zealand, this is the wave of the future.”

Guaranteeing that future will take equal parts money and new faculty, and the new Children’s Center may well play a key role in attracting both researchers and trainees. “The National Institutes of Health is extremely pleased we have this new opportunity,” says Pediatric Allergy & Immunology Division Chief Robert Wood.“They now know we have the space and resources to conduct our studies in the best possible environment, which can only help to secure new funding opportunities.” “The opportunity to show current and future residents that the space in which they would be caring for patients conveys the high level of respect that this building does for patients is a wonderful message for us to be sending to applicants,” says Julia McMillan, vice chair for Education and director of the Pediatric Residency Program. “And for the residents who are here, now (through the transition from the CMSC) it says we knew the old space didn’t convey the respect we felt for our patients, and we fixed it. It took us a while, but now we’ve fixed it; it isn’t just something we talk about, it’s something we actually did.” It’s a change that could make history. n

before moving into The Charlotte R. Bloomberg Children’s Center, psychiatry nurses took patients, two at a time, to see their new unit. Amazed by its size and amenities, one young patient exclaimed, “I don’t know how anyone could be depressed over here. The view is so beautiful.” For pediatric nurse Jena Smith, the new home for her patients and their families indeed feels brighter and calmer. “I was so looking forward to coming over to the new building, to a world with less chaos and noise,” says Smith. In Bloomberg Children’s Center, gone are the old days of crowded patient rooms and corridors and the unrelenting cacophony of overhead paging, phones and multiple monitors. A quiet nurse-call system, sound-absorbing building materials, decentralized supply systems and allprivate rooms have created a soothing environment. “The new decentralized care environment with single rooms is remarkably better for children, families, and the nurses,” says Director of Pediatric Nursing Shelley Baranowski. “It provides a more comfortable experience for families and improves safety with less distractions and noise.” Via the new building’s Wi-Fi and realtime tracking technology, nurses and other specialists and essential equipment can be located instantly. With telemetry now in every playroom, patients can wear wireless monitors, allowing them to visit playrooms and walk the hallways. Sophisticated lighting systems make it easier for nurses to perform bedside procedures with even greater precision. Also, to complement the move to this new world, pediatric nurses last winter launched an interpersonal skills training program called the “Language of Caring: Heart-to-Heart Communication,” designed to improve communication between staff and families, a component of the Children’s Center’s commitment to patient- and family-centered care. n –Wendell Smith

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photo by kevin weber

The

and

e r u t c e t i rch omberg o l B f o s ’ n e r Child r e t n Ce

y Claude b d e ir p s in ade er A fritted faç rsize sculptures of puff n’s e re Monet? Sup os? A marriage of child fish and rhin ontemporary art? Just e v c classics and architects and artists ha e what did th he new Children’s t in mind for hat does it mean for w Center, and their families? patients and ogan by Gary L

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n sept.

21, 2009, Bridget Diveley’s breathing suddenly became heavy, which prompted a quick visit to her pediatrician, then to the local ED, and finally to Johns Hopkins Children’s Center where her parents heard the last thing they wanted to hear—their daughter might need a heart transplant. Debbie Long knew even before her daughter Emily’s birth that multiple cystic lesions had invaded her brain, a condition that would require repetitive surgeries throughout her life. Indeed, the now-18-year-old has undergone more than 90 operations by renowned pediatric neurosurgeon Ben Carson. A surgical procedure shortly after birth delayed for six years the liver transplant Sam Tiemann would eventually need to live, but during that time he and his parents spent countless hours, days and weeks in the Children’s Center, which had become their second home. These parents, like many parents of pediatric patients at the Children’s Center, came in crisis, fought through turbulent times, returned time and again for followup treatment. They knew of Hopkins long history of success in treating complex, lifethreatening conditions, and they met physicians and nurses committed to providing the best possible outcome for their child. They felt they were in good hands—the best hands—and were grateful for the continuing care their child received. But for all the compassion and clinical expertise the hospital contained, the building itself—the Children’s Medical & Surgical Center, or CMSC—did little to lighten their emotional burden. The CMSC, a linear tissue-box of a building erected in the early 1960s, served practical clinical purposes quite well for almost a half-century. But over the years the brick and mortar began to lose its luster and imagination, freshness and uniqueness, its personality—aesthetic dynamics today’s hospital designers say create and sustain human connections and help heal. The clinical staff more than made up for any design deficits in the building, but both families and staff knew the Children’s Center could be much more with a new structure and style, which led to a new 16

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building—The Charlotte R. Bloomberg Children’s Center—an artful design and a healing environment. “A growing body of evidence shows that you can create a hospital environment that connects with patients and families during a medical crisis, reduces their stress and anxiety, and enhances their health and wellbeing in a number of ways,” says Pediatrics Administrator Ted Chambers. “That’s what we set out to do through the art and design of this building.” One of the early goals was to make the new building approachable, but how do you do that with a structure twice the size of its predecessor? With, building designers decided, a curved façade covered by a Monet rainbow of paneled window boxes marked by countless brush strokes in the glass known as frit—the creation of installation artist Spencer Finch. The resulting effect is a translucent and shimmering curtain wall that constantly reflects and refracts the ever changing light of day. “From the beginning we were thinking about glass as an analog for water, how glass and water behave in similar ways, and what we could do with the glass so that it’s always changing,” says Finch. “Also, it’s a big building and it can be intimidating, but water has a certain softness and

A growing body of evidence shows that you can create a hospital environment that connects with patients and families during a medical crisis, reduces their stress and anxiety, and enhances their health and wellbeing in a number of ways. – pediatrics administrator ted chambers


photo by kevin weber

welcoming aspect to it.” At night, Finch adds, the frit and façade transform the Bloomberg Children’s Center into a glowing lantern—a snow globe filled with bustling activities: “There’s a certain amount of complexity in the design, and a feeling of activity and aliveness that reflects all the great stuff that happens here.” A long, two-story canopy, an expansive vehicular entry plaza a football field long, and a series of gardens and stonework were designed as welcome signs, too, adds consulting architect Allen Kolkowitz. “The overall frit helps dematerialize the façade, the gardens help soften your approach, and the canopy adds visual clarity and unifies the entry,” says Kolkowitz. “It is the point of arrival.” And what a point of arrival. A childlike rhino, atop the back of a larger parent rhino just outside the ground entrance to the Children’s Center—one of set designer Robert Israel’s 11 supersize sculptures in the building—curiously peers up past the canopy. And what does he or she see? A 22-foot-long orange ostrich dangling from the ceiling of a four-story atrium, a winged cubist cow jumping over a necklace of 28 moons, and a family of yellow puffer fish playing in an imaginary pool over the stairwell connecting the ground and main levels of the building. The idea for groups of creatures, Israel notes, came from Children’s Center Director George Dover, who cited his young patients’ great need for family connections during a hospital stay. “The Hopkins spaces became a fantastic opportunity to bring a sense of fun and playfulness to this very formidable institution,” says Israel. “So I started with very basic, block-like shapes, and made an effort to include pairs or groups to remind children that they are not alone.” “It is a playful response,” adds Kolkowitz. “Simply put, the sculptures are an attempt to make the hospital experience friendly and unintimidating.” But not in a frivolous way, adds art curator Nancy Rosen: “Visually the aesthetics are fresh, unique and thoughtful. They don’t fall back on simple clichés.” To be sure, visitors are curious as they spy a large blue egg atop a tall information S u mme r 2 0 1 2

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desk in the lobby. An ostrich egg? And what’s with the Escher-like artwork under the glass of an elliptical welcome desk in Bloomberg Children’s atrium lobby? The five orbs seemingly floating at the end of a corridor in front of a 28-foot marble wall on the main level? The book niches and wall art? Other artworks ranging from ceramic sculptures to collages, paintings, photographic prints and watercolors. And art as window screens? The three-foot tall egg was indeed delivered by the outsized ostrich and nestled into a notch on the spiraling, six-foot-high information desk. The desk itself, sculpted from an acrylic solid surface, is a clear and artful point of reception. “You’ll see that desk and the art, which is part of the entry experience,” says Kolkowitz. “You will want to get closer and it will sustain your interest as you get closer.” The lobby elliptical art under glass— Brooklyn artist Scott Teplin’s ink and watercolor drawing—reveals an intricate maze of canals, pools and ponds, rooms and water slides for young minds to follow, if they can. They’re also challenged to find objects hidden within the imaginary spaces. The illusionary three-dimensional orbs floating in space are the “Parallax Knots” of Brooklyn, N.Y. artist Thomas Burke’s acrylic on canvas paintings. They’re actually flat paintings, notes Rosen, but they’ll catch your eye as you’re walking down the main level corridor. “It will draw you down the hall and as you’re looking at the art the baby rhino, which comes up to the height of the main

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There’s a certain amount of complexity in the design, and a feeling of activity and aliveness that reflects all the great stuff that happens here. – Installation artist Spencer Finch level window, will be looking right at you,” says Rosen. “With all those saturated colors of the paintings and the baby rhino, this should be a happy conversation.” The book niches, glass-enclosed displays embedded in the walls at the elevator lobbies on each floor, contain colorful dioramas created by Baltimore artist Jennifer Strunge. Using recycled clothing and cloth, she populated each niche with fanciful creatures, including monkeys, bunnies and an octopus, reading children’s classics like “Goodnight Moon” and “The Secret Garden.” On the wall of each elevator lobby is a corresponding work of art—one of more than 300 such works of art in the building by over 30 artists—inspired by a theme, scene or story line in a particular book in the neighboring niche. This marriage of art and literature takes children by the hand on a journey to another time, another place, where they may face—but also overcome—perilous obstacles. California artist Terri Friedman, for example, was inspired by the determination and deep love of two characters in “Fly High, Fly Low,” which allowed them to rise above adversity. Regarding her painting in the family lounge on Level 4, she notes that “The sun’s rays over the water

represent hope, love and faith. Stormy skies are healed by the rays of the sun.” Similarly, Philadelphia artist Joy Feasley was inspired by an illustration in “King Stork” by Howard Pyle. Her painting on Level 12, she notes, imagines a dramatic castle and other magical places where “beauty is everywhere, even during the most frightening moments of the story.” Such artworks permeate Bloomberg Children’s Center, and the messages of courage and optimism they leave for young patients are like treasured messages in a bottle, buoyant and beloved. “We wanted the art in the building to celebrate the power of books as a means to promote healing,” explains Rosen. “But we’re not trying to be prescriptive about what you should read or see in a book. Everyone has their own imagination, everyone can see what they see. It’s an opportunity to explore and feel free.” The concept of window screen as art came to light when designers realized the walls of patient rooms leave little room for anything but medical equipment. An added inspiration was Baltimore’s folk tradition of painting doors and window screens, which explains why local landmarks like Camden Yards, the pagoda in Patterson Park, and the historic Shot Tower are featured on the


window shade in every patient room. You might feel like you’re sitting on a Baltimore row house front porch rather than in a hospital room. “We wanted designs that were both informative and illustrative,” says Jim Boyd, the artist who created the imagery for the window shades. “So we loaded the shades with lots of fun references and images peculiar to Baltimore.” While the designers were thinking themes like engagement and exploration in planning the art, they had openness and orientation in mind for the blueprint of the building itself. They gave the long corridors in the building large windows at their ends to break down the scale of the building, and off each elevator lobby they placed a glass-enclosed family lounge with views of the harbor, the city, the hospital exterior, constantly orienting visitors to where they are in the interior. Also, the predominant blue tones in the elevator lobbies, along patient floors and on the walkways of the bridge leading into Bloomberg Children’s Center—distinguished from the green tones of the neighboring Sheikh Zayed Tower for adult patients—immediately lets pediatric patients and their families know they are in the right place. Patients and parents need not feel lost or overwhelmed, explains Hopkins Facilities Vice President Sally MacConnell, but oriented, safe and secure: “We want people to know where they’re going and to feel as comfortable as possible through the building environment.” Adds Hopkins architect Michael Iati, “Why blanket a building with signage

when you can guide visitors via the design of the building itself.” The airy four-story atrium reinforces the feeling of openness, too. As in the bi-level Sheikh Zayed lobby, Bloomberg Children’s Center visitors are also welcomed by a flood of ambient lobby light, Grecian white marble, terrazzo floors, and the entry plaza’s gardens and reflecting pools bordering the new building. Observers point to sensations of stability and strength, support and trust, healing and hope. Meanwhile, the art does not so much stand alone as integrate and interact with this environment. At each turn a patient, family member or visitor in this aesthetic sea of insights and positive diversions discovers a different path and place, a new moment, a fresh journey that engages and enlivens their experience. You may ponder here. Take a trip. And if you have to come back, ponder some more. “From our collective point of view,” says Kolkowitz. “it’s all about expanding the experience of the patient and the family.” So, what is the experience like for patients like Bridget, Emily, Sam and their families? What does the art and building design say to them? How have they reacted? On her first visit to the new hospital Bridget immediately started dancing with the rhinos and then with the ostrich. Emily, a competitive swimmer herself, found herself floating among the puffer fish with pediatric neurosurgeon Ben Carson, and Sam got to play some B-ball with pediatric liver specialist Kathy Schwarz in the Level 10 elevator lobby that features the book “Hoops” by Walter Dean Myers.

Sam’s favorite quote from the book? “I got a lot of my dream but I got more than I dreamed of.” Indeed. n For more on patients’ reactions to the art and architecture of Bloomberg Children’s Center, see the photo journal beginning on page 20.

So I started with very basic, block-like shapes, and made an effort to include pairs or groups to remind children that they are not alone. – S et designer Robert Israel

Simply put, the sculptures are an attempt to make the hospital experience friendly and unintimidating. – Architect Allen Kolkowitz

Patients Make the Alphabet an Art Form Thanks to pediatric patients and Baltimore artist and MICA graduate Lauren P. Adams, several playful alphabets have made their way into the artwork of the new Bloomberg Children’s Center. Over the course of several workshops, Adams taught the youngsters how to make patterned cut-

outs using a process called papel picado, the folk art technique of folding and cutting paper popular in Mexico and other Latin American countries. To craft the final alphabet, Adams brought together many of the patients’ unique cut-outs to create 26 uppercase letters. The final

designs were then printed as color silk screens, under Adams’ supervision, by Baltimore Print Studios, and now hang at various locations throughout the Bloomberg Children’s Center, including outside Schaffer auditorium on the main level and near the children’s library on Level 3. n

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Children’s Center patients Simion Sarte, middle, and Gavin Michel-Baird boost their spirits playing in Sara’s Garden, while Child Life specialist Monica Gibson looks on.

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Flying High, Flying Low in an Artful New World

Through literary-themed artworks young patients follow paths to magical forests and secret gardens where they discover polar bears and puffer fish, tree spirits and themselves. Photography by Keith Weller S u mme r 2 0 1 2

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3, adventurer Alexa Lazarou, age 5, of Columbia, Md., sets her sails through artwork by Wellfleet, Mass., artist Timothy Woodman, who was inspired by the heroic journeys he found in “Around the World in 80 Days,” “Moby Dick” and “The Wizard of Oz.” Says Alexa, who was born at Johns Hopkins,“I’m curious about places, where we are and why we’re here.”

on bloomberg

The book niches embedded in the walls at the elevator lobbies on each floor contain colorful dioramas created by Baltimore artist Jennifer Strunge, who populated each niche with fanciful creatures reading children’s classics like “Goodnight Moon” and “The Secret Garden.” On the end wall of each elevator lobby is a corresponding work of art inspired by a book in the neighboring niche. This marriage of art and literature takes children on a journey to another time, another place, where they may face—but also overcome—perilous obstacles.

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a swimmer herself, 18-year-old Emily Long with pediatric neurosurgeon Ben Carson, joins a pool of puffer fish sculptures designed by set designer Robert Israel.

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10, patient Sam Tiemann, with pediatric hepatologist Kathy Schwarz, still has plenty of game after two liver transplants. His favorite quote from the book “Hoops” by Walter Dean Myers, which inspired the wall art by Thomas Allen: “I got a lot of my dream. But I got more than I dreamed of.” on bloomberg

to Bloomberg Children’s Center, pediatric heart transplant patient Bridget Diveley immediately started dancing with the 22-foot-long ostrich sculpture suspended from the ceiling of the hospital’s four-story atrium. Bridget is also a big fan of Dr. Seuss books, especially “The Cat in the Hat.” on her first visit

i got a lot of my dream. but i got more than i dreamed of.

—Walter Dean Myers “Hoops”

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on Bloomberg 4, patient Dominic Herrick’s spirits soar with artwork by El Cerrito, Ca., artist Terri Friedman, who was inspired by the theme of love overcoming adversity in Don Freeman’s book “Fly High, Fly Low.” Summing up his art, Friedman wrote, “The sun’s rays over the water represent hope, love and faith. Stormy skies are healed by the rays of the sun.” in the family lounge

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stormy skies are healed by the rays of the sun —Terri Friedman


patient elijah sponseller,

age 2, reads and reflects by the “Goodnight Moon� niche in Bloomberg Children's Center.

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at the Level 1 elevator lobby, 13-year-old Xzavier Eagan ponders the wintry magical world of “Polar Pink” by Pennsylvania artists Walter Martin and Paloma Munoz, who were inspired by “The Golden Compass” by Philip Pullman.

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p  ediatric patient and

middle-school cheerleader Brittany Falcone, top left, finds air time with New York artist Thomas Burke’s “Parallax Knots,” flat acrylic paintings that appear to be floating in space at the end of Bloomberg Children’s main level corridor.

“walking into bloomberg Children’s Center makes me feel like I’m arriving at a party with confetti falling off the windows,” says pediatric heart transplant patient Noah Thyberg, with pediatric cardiologist Janet Scheel.

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Inside Bloomberg Children's Center | Section Index 32 More Space for Premier ED 33 NICU Design with Less Movement in Mind 35 “Sweet Spot” Space in New ORs 36 Kids Only Imaging 39

Meals “At Your Request”

inside bloomberg

In the open and naturally-lit twostory infusion suite, pediatric oncologists Ken Cohen (left) and Don Small with pediatric oncology nurse manager Lisa Fratino. 30

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Inside Bloomberg Children's Center | Oncology

children’s center A Model for Continuity of Care By Gary Logan

For children with cancer, continuity of care is essential. That was the response of Pediatric Oncology Director Donald Small and his staff when asked years ago for input on the design of their unit in The Charlotte R. Bloomberg Children’s Center. So rather than just build an inpatient unit, why not add an adjacent pediatric oncology outpatient component? “From the point of view of our patients and their families, as well as our physicians, fellows, nurses and other staff, the improvement in continuity of care would be tremendous,” Small said at the time. The powers that be listened and connected the two units in the new Bloomberg Children’s Center. That means rather than taking a ten-minute walk across campus to check on a recently discharged patient in the outpatient clinic, staff now only have to walk down a hallway. “Perhaps someone on the outpatient side did not know what the patient’s condition was like on the inpatient side, whether the patient is better, worse or the same as when they were discharged,” Small says. “Now the inpatient team can easily help out with that evaluation by running over quickly to the outpatient clinic to see the patient and consult with staff.” The arrangement improves physician learning, too, Small explains. After discharge, fellows have a greater ability to see

their own patients and how the patient’s particular type of childhood cancer is responding to treatment. The adjacency, adds pediatric oncologist Ken Cohen, also means seamless movement of patients between inpatient and outpatient units, with the potential for reducing a hospital length of stay. “For the patient waiting to be admitted, we can start inpatient chemotherapy here in the outpatient infusion area and then move the patient down the hall when the room is ready,” says Cohen. “You don’t have to wait for the patient to get to the floor to do those kinds of things, which can mean the difference between an extra night in the hospital. For our patients, who are repetitively hospitalized, any night not in the hospital is a good night.” Other features in pediatric oncology include larger and all-private inpatient rooms and more-accessible treatment rooms. The outpatient side features an

open and naturally lit two-story infusion room, and more exam rooms to speed up patient flow and reduce wait times. Also, all of the nurses are specially trained in caring for children with cancer. “We’re the only unit in the area with a dedicated nursing staff who only take care of cancer patients,” Small says. Small adds that pediatric oncology in the Bloomberg Children’s Center continues its policy of seeing patients the same day as their call. “Pediatricians and parents may worry about how to get the child into the Hopkins system, but that’s something they don’t have to worry about,” Small says. “If they call the HAL line, my office, the outpatient clinic or inpatient unit, we will get them to the right place and see them that day.” n For more information, visit www.hopkinschildrens.org/oncology

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Inside Bloomberg Children's Center Emergency Medicine

More Space for a Premier ED Pediatric Emergency Medicine Director Douglas Baker couldn’t be happier with the space his department has in the new Bloomberg Children’s Center. After all, it is twice the size of the former Pediatric ED with private exam rooms in a child-friendly atmosphere. Also, it’s easily accessible with a convenient drop-off area by the front entrance and a covered 12-bay ambulance area at the rear. A covered pedestrian footbridge from the parking lot to the new hospital enhances access, too. “We asked for more space and easier ways for patients and families to get here, and we got what we asked for,” says Baker. “We acquired some other features, too, that greatly enhance the ability of our staff to care for patients.” Those features include enhanced imaging capabilities in the Pediatric ED that eliminate the need to shuffle patients to and from radiology for imaging. Now pediatric radiologists are on-site in the Pediatric ED during peak hours (8 a.m. – 11 p.m.), allowing the majority of imaging to be done on the spot in the ED. Roundthe-clock ultrasound and MRI help ensure responsible imaging by allowing the most appropriate examination to be used in every case, providing the best diagnostic information at the lowest possible radiation exposure. For example, Baker notes, a child’s suspected appendicitis can often be confirmed with an ultrasound. But because many EDs do not have an ultrasound specialist at all times, CT scans are often the 32

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At their new entrance, from left to right, pediatric emergency medicine physicians Elizabeth Hines, Karen Schneider, Bruce Klein, C. Jean Ogborn, Thuy Ngo, Douglas Baker, Mitchell Goldstein, and Jennifer Anders.

first-line imaging choice. “While CT scans can be very helpful, other radiation-free testing options are frequently just as useful diagnostic aids,” says Baker. “Our emergency medicine physicians and pediatric radiologists will continue to work together to identify diagnostic plans that minimize risk to our patients and maximize accuracy of care.” The experience and expertise of those clinicians also greatly influence care, adds Baker, who has been growing his staff— in fact tripling it—in the years leading up to the opening of Bloomberg Children’s Center. “We’ve been recruiting national leaders in pediatric emergency medicine,” Baker says, “to build a premier emergency medicine service and to ensure the best possible outcomes for our patients.” n —GL

Features > Separate triage rooms rather than

one triage space to reduce waiting times and enhance patient privacy

> All private exam rooms, a separate treatment room for minor emergencies, and two isolation rooms

> Dedicated pediatric trauma bays > Expert management of multi-system illness and trauma

> Nurses educated, trained and certified in pediatric emergency nursing

> A multidisciplinary Child Protection Team devoted to recognizing and treating victims of child abuse

> Dedicated Child Life specialists,

who help minimize psychological and emotional trauma

> Staff are members of the Pediatric

Emergency Care Applied Research Network (PECARN), who study treatment protocols and acute illness prevention


Inside Bloomberg Children's Center | Trauma & Burn

Seamless Care Tailored for Children In the old Children’s Center, pediatric trauma staff took care of children in trauma bays designed for adults. Also, MR imaging was located a floor below. But the new Charlotte R. Bloomberg Children’s Center features two dedicated state-of-the-art pediatric trauma bays and four adult trauma bays adaptable for children, with imaging modalities accessible on the same groundfloor level. “No longer do we have to put children on elevators to get imaging scans,” says Pediatric Trauma/Burn Program Coordinator Katie Manger. “We have 24/7 MRI and quicker access to care.” The new pediatric trauma bays also feature futuristic overhead booms that facilitate easy and quick access to trauma equipment. Also, with OR-like scrub rooms off the trauma bays, trauma surgeons can quickly perform emergency operations without transporting the patient to an OR. “We never have to leave the patient’s side,” says Pediatric Trauma/Burn Pro-

gram Manager Susan Ziegfeld. Features in the new burn inpatient unit, Ziegfeld and Manger add, include all-private rooms—important in minimizing infection risks—and two large dressing rooms with the latest equipment to minimize the pain associated with dressing changes. n —GL

The pediatric trauma/ burn team, from left to right, trauma surgeon Dylan Stewart, coordinator Katie Manger, manager Susan Ziegfeld, nurse practitioner Daniela Coelho, and social worker Mindi Lutwin.

For more information, call 888-kid-burn.

Inside Bloomberg Children's Center | Neonatology

NICU Design with Less Movement in Mind neonates, unnecessary movement is the enemy—a message neonatologist Sue Aucott took to heart in helping to design Hopkins new neonatal intensive care unit (NICU). Critical to safe and efficient transport, she stressed, is a close proximity between Labor & Delivery and the NICU—The Sutland/Pakula Family Newborn Critical Care Center. “Having the units apart adds an extra challenge to moving babies, especially critically ill newborns,” Aucott says. “The less movement for the babies the better.” In the new configuration the NICU and Labor & Delivery are within a whisper of each other on the eighth floor of the new clinical building, with the obstetric ORs as a connector so that high-risk neonates will be handed off to NICU staff immediately after delivery. Of course, more than proximity went into planning, says obstetrics Nurse Manager Joan Diamond: “Our For high-risk

In one of the new Labor & Delivery ORs, obstetrics Nurse Manager Joan Diamond with NICU Nurse Manager Sue Culp.

units were designed as the ultimate in care, with high-risk newborns in mind.” OB census screens on NICU computers allow staff to identify high-risk moms in Labor & Delivery. And well before delivery, a neonatologist or fellow meet with those mothers-to-be and familiarize them with the NICU to prepare for their newborn’s stay. When pre-term labor begins, OB staff text the NICU’s delivery room response team—a NICU resident, fellow, respiratory therapist and admissions nurse—to prepare to pick up the newborn. Another plus: Family-friendly amenities are prominent in the new units, including all-private rooms with sleeping facilities. “Parents who are more comfortable in their surroundings make it much easier for us to care for babies,” says NICU nurse manager Sue Culp. “With a private room and decreased stimulation, they really get to focus on their baby.” n —GL S u mme r 2 0 1 2

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Inside Bloomberg Children's Center Cardiology

Niche Services Under One Roof pediatric cardiologists and their patients in The Charlotte R. Bloomberg Children’s Center? “Exuberant space under one roof,” says Director Joel Brenner, noting that division facilities and faculty had been somewhat scattered and separate in its former space. But with an outpatient clinic and non-invasive imaging suite, fetal echo and heart transplant programs, and faculty offices housed together on the second floor of the new hospital, care will not only be cozier but more collaborative, too—and that means better care for a wider range of patients. “The new building was designed with collaboration and consultation in mind, and to provide services to an enormous range of patients in an area that is much more physically pleasing than our former space,” says Brenner, citing a comfortable family lounge adorned with artwork and tastefully decorated exam rooms. “Rather than treat only children, our division faculty have a greater capability to take care of all patients, from the fetus to the adult, with congenital heart conditions.” The new space includes six exam rooms, three treatment rooms for echo sedation, an exercise pulmonary function lab, private consult rooms for family discussions, and a room for resident education. The space facilitates pediatric cardiology services for a broad range of disorders, including arrhythmias, connective tissue and lipid disorders. “The key issue in pediatric cardiology these days is having the subspecialty niches,” Brenner says. Technology, as well as space, facilitates subspecialty care. Imaging features include an upgraded echocardiography suite with top-line equipment and an experienced staff that enhance diagnostics and collaboration with referring physicians. “We don’t want to have surprises when the child goes to the OR for heart surgery or the catheterization lab for an interventional procedure,” says Director of Pediatric Cardiology Imaging Phil Spevak.

What’s new for

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The new pediatric cardiac catheterization lab provides three-dimensional, highdefinition images to ensure accuracy and improve results for patients. For example, notes pediatric cardiologist Richard Ringel, patients with congenital heart disease often require periodic work on their pulmonary arteries, whose complex anatomy is not well captured on standard X-ray images. But three-D imaging allows better planning and execution of procedures like stenting and dilation of narrowed pulmonary vessels. “Three-dimensional imaging in the cath lab allows for even better precision when implanting stents in blood vessels with complex obstructions,” says Ringel. Concludes Brenner, “It’s an exciting time to be here. This space allows us to move into the next century.” n —GL For more information, visit www.hopkinschildrens.org/cardiology

The new pediatric cardiac catheterization lab, notes pediatric interventional cardiologist Richard Ringel, provides threedimensional, high-definition images to ensure accuracy and improve results for patients.

Features In Bloomberg Children’s Center, pediatric cardiologists provide services for a broad range of disorders, including—

> Arrhythmias > Congenital heart disease for children and adults

> Connective tissue disorders > Fetal heart problems > General cardiology disorders > Genetic heart disorders > Heart failure > Lipid disease > Ventricular disorders


Inside Bloomberg Children's Center | Surgery

In New ORs, Surgeons Find the “Sweet Spot” Unobstructed space and technological advances make the new operating rooms at Bloomberg Children’s Center ideal for minimally invasive procedures. For pediatric surgeons Fizan Abdullah, Jeffrey Lukish and Dylan Stewart, the Johns Hopkins Hospital adult operating rooms in which they tirelessly toiled for years seem from an era long, long ago. Though it’s been only weeks since they moved into Bloomberg Children’s Center, that was more than enough time to discover what they describe as futuristic customized pediatric surgical suites with overhead booms—rather than floor towers—designed to better position audio, video and minimally invasive instruments. “There’s a lot of hands-free video feed that allows us to do advanced laparoscopic surgery without the cumbersome nature of towers around the table,” says Lukish. “A lot of laparoscopic and telemedicine components have been built into some of

Pediatric surgeons Abdullah, Lukish and Stewart in one of the new pediatric ORs.

these ORs,” says Abdullah. “In the immediate future, laparascopic surgery will increasingly be a bread and butter component of our surgical expertise.” “Not only does the technology make our minimally invasive procedures simpler and more efficient,” adds Stewart, “it also facilitates teaching.” The pediatric surgeons also stress that the 600 square feet of space in each OR

represents the ideal “sweet spot” for operating on children. That space not only offers surgeons and OR nurses more elbow room, but patients safer transport in and out of the ORs. With pre-op and post-op care units adjacent to the operating rooms— rather than on different floors in their previous home—“Recovery,” says Stewart, “is a night and day difference from where we were.” n —GL

Inside Bloomberg Children's Center | Physical Rehabilitation

Another First in Outpatient Clinic Care and occupational therapists have long been proud of their service in the Children’s Center. They’ve provided comprehensive inpatient rehabilitation services through an interdisciplinary approach for a variety of childhood disorders, including burns, cystic fibrosis, Down syndrome, muscular dystrophy, and orthopedic injuries, among others. Working in an academic setting, they’ve also been able to help advance their field through participating in research on a wide range of issues stemming from impairment and limited function. But because of space limitations they’ve not been able to achieve one of their top priorities—an outpatient pediatric rehabilitation program. With the opening of The Charlotte R. Bloomberg Children’s Center May 1, however, that goal became

Pediatric physical

a reality, too. “This is our first outpatient physical rehabilitation clinic,” says Pediatric Rehabilitation Team Coordinator Julie Quinn. “That’s what we’re starting here.” “Here” is one corner of the second floor of the Bloomberg Children’s Center, where the spacious, state-of-the-art suite sits. Features include a kitchen area, a small gym and a larger main room for multiple activities and exercises to help patients regain strength and endurance. The benefits of such an in-hospital outpatient rehab clinic include improved continuity of care and patient-family convenience, Quinn notes. Oncology outpatients coming to the hospital weekly for medical follow-ups, for example, can schedule their physical therapy and occupational therapy at the same time. “Rather than send inpatients being

discharged somewhere else,” says Quinn, “patients can have their physical and occupational therapy here. Why send them outside?” The focus is on children and adolescents with significant medical conditions, like a serious orthopedic injury or cancer. The effects of medical treatments like chemotherapy and radiation treatment for childhood cancers—which can decrease core strength and endurance for patients—are targeted, too. “Evidence-based research has shown that those young children don’t regain what they once had without rehab intervention,” says Quinn. The clinic is staffed by four physical therapists, three occupational therapists, and a pediatric hand therapist. For more information, call 443-287-9262. n —GL S u mme r 2 0 1 2

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Inside Bloomberg Children's Center | Radiology

Imaging for Kids Only It wasn’t too long ago, Division of Pe-

diatric Radiology Director Thierry Huisman notes, that a 4-year-old would find himself in a radiology waiting room sitting next to an 85-year-old man, or a healthy child next to a sick child. That’s because pediatric radiologists shared space with their adult counterparts where they treated both inpatient and outpatients. Also, their offices and the imaging suites they used were dispersed throughout the hospital. In a sense, the division had no home. No more. Now housed on Level 4 of the new Charlotte R. Bloomberg Children’s Center, pediatric radiologists—for the first time—have their own dedicated space. “It’s much more convenient for parents and children to go to one place in a pediatric setting,” says Huisman. “They do not have to walk into a hospital set up for adults.” Another plus, Huisman notes, is pediatric radiology’s proximity to the pediatric intensive care unit (PICU), pediatric operating rooms, and pre-op and post-op care units, all of which are also on Level 4. That translates into safer transport of pediatric patients and a more rapid response from radiologists. Imaging is safer and more family friendly in the new suite, too, notes Huisman, pointing to separate waiting areas for inpatients and outpatients that reduce their risk of infection. Also, Children’s Center radiologists are using the newest imaging equipment optimized for low-dose radiation, thereby reducing exposure. Family-friendly initiatives include glassenclosed alcoves in the radiology suites to allow young patients to have visual contact with their parents while undergoing imaging. Also, dedicated “quiet rooms,” designed to have a calming, soothing effect on young children awaiting imaging, is helping them avoid general anesthesia. Huisman notes that over a recent twomonth period, 13 children scheduled for an imaging study under general anesthesia were able to complete their studies without it thanks to the quiet rooms and the 36

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support of the recently recruited full-time Child Life specialist in Pediatric Radiology. Having a radiologic reading room in the Pediatric Emergency Department, another first, facilitates greater interaction between pediatric radiologists conducting the studies and ED physicians. “This will greatly improve the quality of interpretation of imaging studies,” says Huisman, “which should make a big difference in service. We’re now a part of the ED team.” Huisman also notes that thanks to Johns Hopkins leadership’s support, he has been able to grow his division from three pediatric radiologists four years ago to more than six today. That means quicker referrals and more accurate imaging studies. “The leaders of Johns Hopkins Medicine made a clear statement that they wanted to offer children the best care possible by building a new high-end hospital and expanding its pediatric radiology expertise,” says Huisman. “The acquisition

of new faculty will mean much better end results and a much more enjoyable experience for patients and families.” n —GL

It’s much more convenient for parents and children to go to one place in a pediatric setting. They do not have to walk into a hospital set up for adults. – thierry huisman, M.D.

In the new CT suite for children only, (from left to right) pediatric radiologists Melissa Spevak, Thierry Huisman and Aylin Tekes.


Inside Bloomberg Children's Center | Child Life

This Room is Great R. Bloomberg Children’s Center will have something great to talk about after they stop by the two-story playroom on Level 11 near pediatric oncology. The so-called “Great Room,” notes Director of Child Life Patrice Brylske, is open to all pediatric patients but especially designed for children with cancer, who may be immune-compromised, as a place to play without risk of exposure from other children. With stairs leading to the child and adolescent psychiatry unit on Level 12, the Great Room also allows psychiatry patients easy access and uninterrupted use of the space. “In the new building, our children will have the freedom to play in a large open area without being exposed to the elements or restricted by them,” says Brylske. “It will open a new world in the hospital to them, and help normalize their experience here.” The 27-by-48-foot room has a basketball net, plenty of windows and closets

Patients in The Charlotte

for play supplies. Child Life specialists supervise the room and its children and guide them in recreational activities. Children and teens throughout Bloomberg Children’s Center have access to the Great Room, as well as multiple smaller playrooms throughout the building. n

At center in red and white stripes, Child Life Director Patrice Brylske and her staff of Child Life specialists look forward to activities in Bloomberg Children’s Center's two-story playroom.

—Wendell Smith

A Studio for CCTV In the former Children’s Center, CCTV (Children’s Center TV) was solely a remote operation, typically broadcasting from crowded playrooms. But today patients, families and visitors have a first-hand view of CCTV programming via Bloomberg Children’s Center’s glass-enclosed CCTV studio off the main level corridor. Now they can watch shows—like interviews with visiting celebrities or patient-directed talent shows—as they’re taking place. With live feeds to major play and assembly areas in the new hospital, including its auditorium and two-story playroom, CCTV has at last its own modern venue for entertaining and engaging patients. “For the first time we have an editing suite, studio lighting, backdrops and seating arrangements that can be rearranged to suit the occasion,” says Child Life Video Producer Carlos Harris. “And the studio’s central location makes it easier to get folks to stop by and say hello to our kids over the TV.”

Overseen by the Department of Child Life, CCTV features the videography of Harris and on-air talent of Child Life’s special events coordinator Annie Woods Beatson, who together with Child Life colleagues lead patients in the weekly and ever popular Hospital Bingo, host a cooking show and introduce Clown TV. Broadcast through the new interactive TigrNet system, CCTV programming not only provides diversions from what Beatson calls the “boredom and abnormality of being in a hospital,” but camaraderie and relief from a sense of isolation. “It is amazing how many of our patients, confined as they are to their beds or units, don’t realize that there are so many others undergoing care here,” says Beatson. “CCTV helps them see that they are far from being alone, which helps create a sense of community.” n —WS

Carlos Harris and Annie Woods Beatson welcome a patient to CCTV.

For more information on CCTV, contact the Department of Child Life at 410-516-6276. S u mme r 2 0 1 2

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Inside Bloomberg Children's Center | Patient Amenities

With TigrNet, TV is Much More than TV There was a time, Television Services Coordinator Tria Tucker says, when a woman would stop by a patient’s room with a cash box and sign-up form in hand for television service each day. And if you didn’t pay, Tucker notes, she would come back later and turn off the TV. “Not only that, but the TVs got poor reception and looked like they came from ‘The Flintstones’ era,” laughs Tucker. The days of per-diem fees and channel surfing a boxy 13-inch TV are long over, says Tucker, noting that television access in the Children’s Center for some time has been free and clear and the channel choices many. Now, in The Charlotte R. Bloomberg Children’s Center, television services are taking on a more futuristic and family-friendlier face. A new system called TigrNet not only offers extensive television programming through 26- and 32-inch flat-screen TV's, but interactive gateways to myriad healthcare resources related to the patient’s stay, like patient education videos and clinicians’ bios. Families no longer have to rely on printed materials for information about the hospital, their child’s care and their care team. Through TigrNet, a digital carousel of the Children’s Center’s expansive services are at their fingertips and a click away. “You can think of TigrNet as an instant patient portal to all of our amenities, resources and services,” says Tucker. “Patients have access to the Internet, e-mail and gaming using their television as the monitor, to their CaringBridge page for notes from friends and family at home, or to their patient education page where they can view videos prescribed by their clinician. All they have to do is click and watch, and they can leave their laptop or digital device at home.” When patients turn TigrNet on, Tucker explains, they’ll enter a personalized welcome page with their name, date and room number, and a customized Hopkins Children’s portal layered deep with resources and services specific to the hospital. They’ll see icons for access to basic TV, Internet, hospital services, and patient educa38

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Navigation tool in hand, television services coordinator Tria Tucker demonstrates the interactive TigrNet system now being used in Bloomberg Children’s Center.

tion. Rather than leaf through multiple brochures or a heavy hotel-like concierge guidebook in their room, patients navigate digital pages via a wireless keyboard or a hand-held nurse-call device at their bedside. And no instruction booklet needed. In the new hospital, customer service representatives familiarize patients and families to the system. While the interactive system offers an array of entertainment options, Director of Patient/Family and Visitor Services Mary Margaret Jacobs points to its ability to push tailored “on-demand” educational materials to the patient as its greatest value. TigrNet offers over 200 videos on subjects ranging from managing a chronic disease

to coping with your hospital stay. In a patient- and family-centered approach, the system also offers care-team pages to patients, putting a face on their healthcare providers. “So when a person on your medical team comes through the door,” Tucker explains, “you’ll know that person’s name and face, and their role on your team.” In the future, TigrNet may offer virtual access to a variety of hospital services, including Child Life, dietary, guest services, housekeeping, pastoral care, and pharmacy. Real-time patient/family surveys may be another application, allowing staff to respond to concerns pre-discharge. n —GL


Inside Bloomberg Children's Center | Patient Amenities

Meals “At Your Request” wind is blowing at Johns Hopkins. Now in Bloomberg Children’s Center, patients and families may order food a la carte and have it delivered to the bedside between the hours of 7 a.m. and 6:30 p.m. daily. The new on-demand dining service, “At Your Request,” is designed to improve both patients’ nutrition—and subsequently health outcomes—and families’ hospital experience. Pediatric patients are able to eat when they’re hungry and to choose from a child-friendly menu that includes pasta dishes, chicken tenders, cheese quesadillas, salads, and cold cereals. How does it work? Patients or their caretakers place orders over the phone to a nutrition call center, where trained operators with access to patients’ nutrition information assist them, either taking orders or offering alternatives if, for example, a patient is on an all-liquid diet or a sodium-restricted one. A service of the Department of Food and Clinical Nutrition at Johns Hopkins, “At Your Request” uses Sodexo’s menu management software, which automates patients’ nutrition records and clinically prescribed diet plans. The restaurant-style meals are prepared in a new hospital kitchen, overseen by the executive chef of patient services at Johns Hopkins, Jakob Fatica, and delivered by clinical nutrition assistants. “For our pediatric patients, meals will become a means for choice in an environment that is otherwise very structured,” says Project Manager Julie Branham, in the Department of Food and Clinical Nutrition. Parents or visitors are able to call in their own food orders, and have “guest trays” delivered to a patient’s room for a nominal fee. This allows them to remain with a child or enjoy a meal with him or her. Also, nurses continue to provide after-hour snacks and meals for hungry children. Nutrition Services keeps unit pantries and freezers stocked with food popular with children, like Lunchables and breakfast burritos. n —WS

A new culinary

Patient Services Executive Chef Jakob Fatica oversees "At Your Request."

“I’ve learned that one of the most crucial requirements as a librarian in a special library like ours is to follow the needs of the borrower and to be very aware of where they are emotionally.” – Gwen Rosen, Childen’s Center librarian

Reading by Skylight Visitors to the children’s and family resource library

in Bloomberg Children’s Center enter a sky-lit world designed to encourage exploration and contemplation, notes librarian Gwen Rosen. “We’re pleased to be in a new, fresh space, and one with a skylight,” says Rosen. “Walking into our beautiful new library is kind of a therapeutic experience and a very welcoming one.” And her role once patients arrive? “I’ve learned that one of the most crucial requirements as a librarian in a special library like ours is to follow the needs of the borrower and to be very aware of where they are emotionally,” says Rosen. Adjoining the new library is the new children's meditation room, a calming space that can be arranged for gatherings, individual prayer or pastoral care for families. “A spiritual place makes sense to a child,” says Ty Crowe, director of pastoral care at Johns Hopkins, “and this one has been designed with children’s spiritual needs in mind.” n —WS S u mme r 2 0 1 2

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People&Philanthropy | Section Index 42 A Vision Fulfilled 43 Stalwart Supporters 45 A Place for Play 46 A NICU Like None Other

people&philanthropy

Joining ribbon-cutter and patient Gavin Michel-Baird on stage are, left to right, Ronald R. Peterson, president of The Johns Hopkins Hospital, United Arab Emirates President Sheikh Khalifa bin Zayed Al Nahyan, Bloomberg Children’s Center donors Michael Bloomberg and his sister, Marjorie Tiven, at right. 40

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People&Philanthropy

A Dedication For the Future By Gary Logan and Wendell Smith

With the sounds of music and “lights, cameras, action” in the air, Children’s Center faculty and staff, dignitaries and donors, patients and families celebrate the opening of The Charlotte R. Bloomberg Children’s Center. Spotlights and studio lights overhead and jumbo screens lining a stage? Strolling musicians and ribbon dancers? Smiling men, women and children seemingly walking a red carpet? The making of a Hollywood film? A movie premier, perhaps? The grand opening of a theme park? Maybe a little bit of each and a whole lot more. This was about a big production, as well as a premier of sorts, and an opening, though not of a new theme park but of the state-of-the-art Charlotte R. Bloomberg Children’s Center and neighboring Sheikh Zayed Tower. A more promising future for children’s healthcare was the theme here at the official dedication April 12, and the faculty and staff, dignitaries and donors, patients and families had been waiting a long time for this moment. “People are so happy and excited, I think it’s wonderful,” said Pediatric Residency Program Director Julia McMillan. “It’s the culmination of a long process.” “It’s nice,” added pediatric gastroenterologist Maria OlivaHemker, “to finally see a facility as good as the people working here for our patients.” One of those patients, 9-year-old Gavin Michel-Baird, was among the first speakers. “When I was 9 months old, I was really, really sick, but my parents found the GI department here and because of that I’m not only here but I’m great,” he said. “The new Children’s Center will make it even better for kids and their families,” he added, introducing New York Mayor Michael Bloomberg, a Johns Hopkins graduate and the son of the late Charlotte R. Bloomberg.

“That the Children’s Center will bear the name of my mother is truly gratifying,” Bloomberg said. “My mother would want great advances in medicine and a whole bunch of children over the years walking out with a whole new lease on life.” Bloomberg went on to describe the new building as a worldclass hospital that would tie research, teaching and clinical care even more closely together at Hopkins and lead the way in defining new standards of care. Pointing to the building’s stimulating and soothing design, he added, “I don’t often give speeches in front of a pair of colorful rhinos. It is the signature defining touches from the great designer Robert Israel, among other artists represented here, who have all contributed to a unique and uplifting environment of support and healing.” Soon after local musicians and high school choirs filled the stage with dignitaries and donors as they unfolded a long blue and green ribbon representing Bloomberg Children’s Center and the Zayed Tower. Then, using the dissecting scissors used by “Blue Baby” operation collaborator Vivien Thomas, Gavin cut the ribbon, sending ribbons across the stage and into the audience with the announcement that “The doors are now open.” Watching from the audience, Assistant Director of Pediatric Nursing Dawn Luzetsky said, “All the hard work we put into this building is now a reality.” Pediatrician and donor Lawrence Pakula added, “There’s so much for the future here. I’m glad I’m alive to see this day. I could never have imagined this.” Who could? n S u mme r 2 0 1 2

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People&Philanthropy | Funding a Vision Donors, patient families, faculty and staff attended the 2006 groundbreaking for Bloomberg Children’s Center.

A Vision Fulfilled, a Promise Kept for the generations of medical luminaries who have made Johns Hopkins Children’s Center among the best in the world for sick and injured children, and to the philanthropists—large and small—who have supported and sustained them, and those in their care. As we enter a new era in a new home, The Charlotte R. Bloomberg Children’s Center, we recognize the individuals, families, corporations, financial institutions, communities and supportive boards that joined forces with leadership to build a facility that once again matches the world-class pediatric medicine that Johns Hopkins has pioneered since 1912.

We give thanks

When told in 1956 that the new director of the Department of Pediatrics, Robert Cooke, M.D., was going to build a new children’s hospital at Johns Hopkins to replace its aging 1912 Harriet Lane Home for Invalid Children, pediatric psychiatrist Leo Kanner famously replied, “That’s what they told me in 1929.” That was around the time he was recruited to Johns Hopkins to develop the nation’s first program in child psychiatry. The opening of The Charlotte R. Bloomberg Children’s Center in May 2012 fulfilled promises to a new generation of Johns Hopkins faculty and staff for a modern facility that matched the caliber of medicine practiced in the building that Cooke, indeed, helped make a reality in 1964: The Children’s Medical & Surgical Center (CMSC). Bloomberg Children’s Center grew out of a need recognized decades earlier, too. By the 1980’s, the practice of pediatric medicine, in all its modern complexities, had outgrown the space allotted and de42

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signed for in the CMSC, a model of its time. Dramatic advances in care and technology were necessitating ongoing renovations and retrofits of outmoded patient rooms and units. At an annual leadership strategy meeting at Johns Hopkins in the early 1990s, Director of Child Life Jerriann Wilson illustrated the struggles families, too, faced in CMSC. She presented a video of its cramped and noisy units and semi-private patients rooms, never designed for the modern volume of medical technology and monitors, or to accommodate families’ emotional needs for privacy or control in the hospital environment. “For us, it was like a light bulb came on, and we saw that we had to act,” says Johns Hopkins Children’s Administrator Edward Chambers, recalling the video, “and to find funding to make it possible.” So he and Hopkins Children’s Center Director Frank Oski, a fierce advocate for a new facility, set out to find potential sponsors. Oski’s efforts were cut short by cancer, which forced upon him an early retirement in 1995. Johns Hopkins Pediatric Hematologist George Dover became Oski’s successor in 1996. Dover, who had trained and practiced in CMSC, was well aware of its physical shortcomings by any modern American standard. A year later, he and the new chief executive for Johns Hopkins Medicine, Edward D. Miller, led an institution-wide push to engage a planner and develop a specific scenario for a new children’s hospital. Locations were generally agreed on and incorporated into a Campus Redevelopment Plan. Illustrative of the famous Johns Hopkins collaborations in adult and pediatric medicine, the new Children’s Center would share its foundations with a new adjacent adult cardiac and critical care tower. In 2006 ground was broken. The next year, construction began on a parcel of Johns Hopkins property, near the footprint of the old Harriet Lane Home. n


In addition to our naming donor, the following were leaders in giving to The Charlotte R. Bloomberg Children’s Center. Alex. Brown & Sons Charitable Foundation Mayer M. and William C. Baker Dana and Albert R. Broccoli Charitable Foundation The Bunting Family Foundation Children’s Cancer Foundation, Inc. Donna R. and Bradley E. Chipps, M.D. Clayton Baker Trust The Clayton Fund Constellation Energy Irene and John De Luca Rosetta and Matt DeVito Janet E. and Edward K. Dunn, Jr. Eliasberg Family Foundation Food Lion The Robert Garrett Fund for the Surgical Treatment of Children Meri and Phil Gibbs Harriet Lane Home Foundation Hospital For Consumptives of Maryland (Eudowood) Jacobson Family Stuart & Lynn Janney and Bessemer Trust Company, NA Robert and Janet Jacapraro A.B. Krongard Milton A. and Harriet F. Laitman Rand R. and Raymond A. Mason Anne M. Murphy, M.D., and Lawrence M. Nogee, M.D. Sutland/Pakula Family Carmine V. Petrone Nancy and Morris W. Offit Sadie’s Gift Mamie and Louis A. Sarkes, Jr. Sherry C. and Richard L. Sharp Molly and Mayo Shattuck Outback Steakhouse Turock Family Foundation Family and Friends of Sara Michele Wilhide The Women’s Board of The Johns Hopkins Hospital Lockhart Vaughan Foundation Wells Fargo Foundation Judith & M. Richard Wyman

People&Philanthropy | Funding a Vision

100th Anniversary Celebrating a Century of Care A hundred years ago, Johns Hopkins, first hospital for children opened. The Harriet Lane Home for Invalid Children was named for its benefactress, Harriet Lane Johnston, who with her husband Henry Johnston, a Baltimore banker, bequeathed funds to establish a hospital for chronically ill children. Their own sons died in childhood from then untreatable rheumatic heart disease. Since the Lane first opened its doors at Johns Hopkins Hospital, Nov. 21, 1912, pediatric medicine at Johns Hopkins has been translating laboratory science and clinical observation into groundbreaking therapies and discoveries for children. Hopkins pediatric research clinicians were instrumental in ending the childhood scourge that cut short the Johnston children’s lives. n —WS

Corporations and Community Groups Stalwart Supporters When Kids Helping Hopkins held its annual Kilometers for Kids 2K/5K walk/run for Johns Hopkins Children’s Center in April 2012, more than 150 children and adults turned out for the latest in the school-based philanthropy. Since it was launched in 1994 by Hernwood Elementary music teacher Anita Rozenel and her husband, thousands of school-age children, their families and neighbors have hosted runs, bake sales, contests and more, raising more than $1.4 million for the Children’s Center. Additonal groups and corporations recognized—on a plaque in Bloomberg Children's Center—for their contributions of $1 million and more to the hospital over the years are Children’s Miracle Network (CMN), WMAR-TV ABC2, CBS Radio's Mix 106.5 FM, Carroll Independent Fuel, Giant Food, Martin’s Food, Wal-Mart, Rite Aid, WaWa, Credit Unions for Kids and Griffith Energy Services, Inc. Their fundraising has supported the programs and services that improve the lives of Johns Hopkins pediatric patients and their families. “We are in their debt,” says Children’s Center Director Anita Rozenel, a music teacher at Hernwood ElGeorge Dover. “They have ementary School in Baltimore, with her husband, been stalwart supporters and the Sam, founded Kids Helping Hopkins, a school-based foundation upon which many program which has raised more than $1.4 million for the Children’s Center. support services here have been built.” n —WS S u mme r 2 0 1 2

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People&Philanthropy | Dedication Gala

Funding the Vision: A decade of philanthropic support is celebrated at donor galas and garden dedications, among other events.

I

n 2003, Johns Hopkins presented a certificate-of-need to the State of Maryland. “The need for academic medical centers to grow was apparent,” says Hopkins Children’s Center Director George Dover. “Yet our buildings were mid-20th century or earlier vintage. We had nowhere to go but new.” They presented plans, along with the financial justification for a new building, and received state approval that year, as well as significant funding. For Children’s Center and Johns Hopkins Medicine, the race was on for the private funding that would help make construction a reality. In the end, philanthropic contributions provided more than a third of the funding for the project. By the time the Bloomberg Children’s Center and companion adult tower opened in May 2012, they cost more than $1.1 billion. Philanthropic contributions took many forms, including a pledge in 2003 by The Women’s Board at Johns Hopkins Hospital, the largest in its nearly 80-year history. Two of the Children’s Center boards, The Robert Garrett Fund for the Surgical Treatment of Children and The Hospital for the Consumptives of Maryland (Eudowood) each pledged, and the third, The Harriet Lane Home for Invalid Children of Baltimore City, pledged as well. A landmark gift from the Children’s Cancer Foundation and founder Shirley Howard contributed to support a state-ofthe-art oncology inpatient unit, this in addition to contributions since 1979 to update CMSC’s pediatric oncology and neuro-

Johns Hopkins trustee Mark Rubenstein, with his wife, Robin, was honored with the naming of the two-story infusion suite after him in the new outpatient pediatric oncology unit in Bloomberg Children’s Center (see page 31).

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Johns Hopkins Medicine Trustee Mayo A. Shattuck III, who with his wife Molly supported the Shattuck Family Pediatric Burn Unit in Bloomberg Children’s Center, Maryland’s designated burn center for children (see page 33).

surgery units. The Alex Brown and Sons Charitable Foundation contributed, too. “The Children’s’ Center has always been there when colleagues, their children and the community have needed it,” said a trustee of the venerable institution’s charitable foundation in 2003. “We want to help ensure it always will be.” A large gift from the Sutland and Pakula family (who asked to remain anonymous at the time) to help support the neonatal intensive care unit in the new building, brought the Children’s Center halfway to its philanthropic goal for financing the building. Family and corporate gifts continued. Many supported playrooms, consultation rooms, a Great Room for kids, family lounges, the pediatric burn unit, the oncology infusion suite, operating rooms, gardens, libraries, conference rooms and more. n —WS

William C. Baker (right), CEO of the Chesapeake Bay Foundation, with his wife, Mayer, and Dean of the Bloomberg School of Public Health Michael Klag. The two-story “Great Room” in Bloomberg Children’s Center is a gift from the Bakers, the Clayton Fund, Inc., the Clayton Baker Trust and the Lockhart Vaughan Foundation, Inc. (see page 37).


People&Philanthropy | Green Space

Gardens to Calm the Soul In the courtyard entrance to The Charlotte R. Bloomberg Children’s Center and the Sheikh Zayed Tower are a series of gardens, tied together by walkways, benches, a reflecting pool and waterfall. A gift from longtime Children’s Center supporter Harriet Laitman and named in memory of her late husband and avid gardener Milton A. Laitman, the gardens help counterbalance the stresses of illness and hospitalization for patients, families and friends. Designed by landscape architects from Olin, the Milton A. and Harriet F. Laitman Memorial Garden was dedicated in May 2012.

Sara’s Garden will be a place of peace and hope for families. —Steve Wilhide

Children’s Center Director George Dover and his wife Barbara with Harriet Laitman, center, a longtime supporter of pediatric medicine at Johns Hopkins.

At the dedication of “Sara’s Garden,” June 8, Cheryl and Steve Wilhide with daughters Paige and Rachel.

A Place for Play in Sara’s Garden When their toddler, Sara, died in 1989 of complications related to her congenital heart condition, parents Steve and Cheryl Wilhide vowed to keep alive the love Sara gave and the hope she inspired. In the Children’s Center pediatric intensive care unit, where Sara was treated, they created a room for families, which they kept stocked with everything from coffee to toothpaste, to create a respite, a place of normalcy. And now, to help Sara’s message of hope live on, the Wilhides gave The Charlotte R. Bloomberg Children’s Center a whimsical garden for children. Located in its inner courtyard, nestled between the new and old buildings, “Sara’s Garden” is inspired by her favorite book “The Little Prince.” Designed by Olin, it offers little volcanoes for climbing and birds that children can move along a track. S u mme r 2 0 1 2

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People&Philanthropy | Funding a Vision

At the dedication of The Sutland/Pakula Family Newborn Critical Care Center on March 6, from left to right, Hopkins Children’s Center Director George Dover, Johns Hopkins Hospital and Health System President Ronald R. Peterson, donors Sheila S. Pakula and Lawrence Pakula, and Dean of the Medical Faculty and CEO of Johns Hopkins Medicine Edward D. Miller.

A NICU Like None Other The Sutland/Pakula Family Newborn Critical Care Center, the state-of-the-art, 45-bed neonatal intensive care unit (NICU) in Bloomberg Children’s Center, honors the generosity of the families who made it possible. The unit features a host of family-friendly amenities and all private rooms, a first for NICU patients at Johns Hopkins. It also houses a Neurosciences Intensive Care Nursery, providing comprehensive assessment and treatment for newborns who are at high risk of neurological injury or who have clinical evidence of developmental brain abnormalities. Additional gifts include an endowment to support faculty research and a professorship. Josephine and Frank Sutland, D.D.S, were longtime supporters of The Johns Hopkins University and its School of Medicine. The Sutlands’ daughter, Sheila Pakula, and her husband, Lawrence Pakula, are also generous supporters, particularly in the area of child health.

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People&Philanthropy | Funding a Vision

A Room with a View for Teens Chairman of Offit Capital Advisors Morris W. Offit, former Chairman of the Board of Johns Hopkins University, and his wife, Nancy, contributed funds for a playroom on the Adolescent Unit. The Nancy S. Offit Teen Room includes a pool table, basketball net and air hockey game as recreation for teens well enough to travel from their rooms.

Supporting State-of-the-Art Surgery Robert Garrett, IV, is a board member of The Robert Garrett Fund for the Surgical Treatment of Children, which has allocated millions to support Johns Hopkins’ pediatric general surgery program and the construction of both the Children’s Medical & Surgical Center and Bloomberg Children’s Center.

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“The colorful décor, the open views of Baltimore and the harbor from the inpatient floors help you forget you’re in a hospital.” – Aron

Family Matters

Katz, FAC member and parent

Ask Parents and They Will Build It by Gary Logan

F

or parents of Children’s Center patients, the last thing they wanted to hear as plans got underway for The Charlotte R. Bloomberg Children’s Center was “Build it and they will come.” The maxim Pediatrics Administrator Ted Chambers heard was, “Ask us and we’ll help build it.”

So he did just that through a series of surveys, focus groups, and interactive information sessions with parents and members of the Family Advisory Council (FAC). Wanting abundant information, he asked only one question—What do you want in a new children’s hospital? The answers were many, including an accessible children’s hospital with a grand entrance, a colorful façade with soft curves, and spacious family lounges with lots of natural light. An aesthetic warm and healing environment with fountains, gardens and modern art was on the list, too, as well as family amenities like kitchenettes, laundry and shower facilities on each floor. The rooms should be private with sleep sofas, and intensive care units like the NICU and PICU should offer parents sleeping accommodations, too. And greater dining options. One parent summed it up: “The Children’s Center should not feel like a hospital but rather a place where children and families can feel comfortable.” Looking at Bloomberg Children’s 48

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Center today, one might think parents wrote up the architectural plans, donned hard hats and constructed the new building themselves. Indeed, parents provided some valuable insights, but for the most part their wish list was the wish list of Children’s Center leaders. “They were very good meetings and we did have very forthcoming parent input,” says Patient- and Family-Centered Care Coordinator Barbara Hall, recalling parent focus groups. “For us, it was a matter of hearing their voice.” Chambers agrees, recalling a mom who started to cry when he told her focus group “we see you as our partners.” Unpredictably, he adds, such experiences enhanced the relationship with parents. “She had never heard that before. She never felt she was anything other than someone receiving information,” Chambers says. “Those were the kinds of experiences that gave us the ability to not just talk to parents but to listen to parents, too.” Such experiences also helped prompt

the Children’s Center’s 2007 patient- and family-centered care initiative, which led to the creation of a new FAC and achievements like family rounds and a full-time parent advisor on staff. While families have always had a presence at the Children’s Center, Chambers notes, never before had their ideas been solicited, considered and incorporated into policy to this extent. “We’ve had quite a lot of impact on operations and how families interact with staff,” says Pam Griffin, the Children’s Center’s full-time Parent Advisor. “Now family-centered care is in the forefront of an unbelievable number of conversations each day,” adds Children’s Center Director George Dover. “More and more we’re putting ourselves in the shoes of parents before making decisions.” So, what do these parents see in Bloomberg Children’s Center? “Being able to stay with your child in the intensive care unit is a tremendous blessing,” says FAC parent member Debbie Burton. “It’s so important to be able to be near your child at a time when he or she is most critical and scared and needs the reassurance of a parent.” “It’s beautiful, clean and bright with an abundance of natural light, and I love the original works of art,” says Howard County parent Anne Wills. “I think the building inspires hope and healing.” Adds FAC parent member Aron Katz, “The colorful décor, the open views of Baltimore and the harbor from the inpatient floors help you forget you’re in a hospital.” n


Patient Voices

A Quieter, Homier Home By Rebecca Manning

I was the first patient on the old adolescent unit to move into Bloomberg Children’s Center. When I saw my new room, I was speechless. I didn’t expect it to be that awesome.

The amenities are far better, even the food. You can mix and match and order what you like when you want it. And the technology is awesome. There’s a flat-screened TV with Netflix and access to the Web and, of course, Facebook. A special TV feature shows your care team, when they’re on service and what they do. In the old semiprivate rooms, you heard everything that was going on—conversations, alerts, monitors—24 hours a day. It was not a restful environment for any of us. But now all the rooms are private with sofa beds for parents. My mom says she sleeps better, too. It’s much quieter and homier here, which will enhance care. We just couldn’t get over how smooth the patient move was. My mother had joked before that we Rebecca Manning, 18, is a student at Stevenson University Baltimore County. After college, she wants to attend should set up lawn chairs to watch the chaos of people in medical school and create documentaries to help healthcare and equipment. But there was none of that. It was all providers better understand what life is like for patients with choreographed and well organized. And Johns Hop- chronic conditions. kins had presents for us. I liked the blanket, the little bag of toiletries and the book, “The Secret Garden,” which I’ll have to read soon. I had come to Johns Hopkins two weeks earlier with severe chest and abdominal pain. My IV line had been bent in a car accident and was causing all sorts of problems. I have a condition known as POTS (postural orthostatic tachycardia syndrome) and a host of other conditions, including ankylosing spondylitis, endometriosis, gastroparesis and scoliosis. My doctor, Peter Rowe, is fantastic. He makes me laugh and really listens to me. He specializes in diagnosing and managing complicated conditions like mine, so I feel more comfortable when he’s around. He always finds an answer. n

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Hopkins Children’s Office of Communications & Public Affairs 901 S.Bond Street / Suite 550 Baltimore, MD 21231

Build their bright future. Create your lasting legacy.

For nearly 100 years, the physicians and scientists of Johns Hopkins Children’s Center have pushed the boundaries of pediatric medicine and developed world-class care for the sickest children and their families. And generous supporters have been there with us every step of the way, beginning with Baltimore banker Henry Johnston and his wife, Harriet Lane Johnston, who established the first children’s hospital affiliated with an academic institution through a gift from their estate. If you also believe that all children deserve a bright and healthy future, there are many ways to create your own legacy to support the mission of Johns Hopkins Children’s Center. Some, like a bequest, don’t even require you to part with assets now; others provide you or a loved one with guaranteed income for life. Contact Richard Letocha in the Johns Hopkins Office of Gift Planning to learn more. 410-516-7954 | 800-548-1268 | giftplanning@jhu.edu | giving.jhu.edu/giftplanning

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