Pulse Magazine Spring 2016

pulse Volume 14 Number 1

Spring 2016

High Tech Wonder 3D Printing Aids Heart Repair

PLUS: WHERE TWITTER MEETS MEDICINE • OUT OF THE (WHEEL) CHAIR • HUMANS OF NJMS

message from the dean

pulse

The Future of Medicine

VOLUME 14 NUMBER 1 SPRING 2016

“New theorem helps reveal tuberculosis’ secret”

RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY

“Stents, surgery equally durable, safe for reducing stroke risk” “How ‘farmacy’ practice, or using food as medicine, can change the world”

Dean

Robert L. Johnson, MD, FAAP’72 The Sharon and Joseph L. Muscarelle Endowed Dean

“Schooling first responders on terror; Rutgers offers course for med students”

Chief Operating Officer

Walter L. Douglas, Jr. Business and Circulation Manager

Iveth P. Mosquera Photo Editor

LaCarla Donaldson Senior Editor, Pulse

Eve Jacobs Contributing Writers

Merry Sue Baum Maryann Brinley Carla Cantor Genene W. Morris Design

Sherer Graphic Design Principal Photographer

Keith B. Bratcher, Jr. President NJMS Alumni Association

Paul J.P. Bolanowski, MD ’65 ALUMNI FOCUS

Director

Dianne Mink Administrative Assistant

Emily Birkitt KEEP IN TOUCH

Pulse is published twice a year by Rutgers New Jersey Medical School. We welcome letters to the editor and suggestions for future articles.

Send all correspondence to: Iveth P. Mosquera Business and Circulation Manager Rutgers New Jersey Medical School Medical Science Building, Room C -595 185 South Orange Avenue Newark, NJ 07103

One need not look much further than the headlines of various publications to know that Rutgers New Jersey Medical School and its people represent the future of medicine.

Indeed, our faculty and students have been singled out in the news recently for the groundbreaking work that they are doing in the areas of research, medical care and even terrorism preparedness. As a leader in health care, we are especially enthusiastic about our involvement with the recently announced Rutgers Health, another newsworthy initiative that, when implemented, stands to become one of the largest academic healthcare provider organizations in the nation. By taking a multi-professional approach, Rutgers Health promises to provide a vast array of services that will span the health care arena and include specialties like surgery, cardiology, and oncology as well as dentistry, nursing, pharmacy, social work, clinical psychology, and student health services, among other health professions.

It is heartwarming to helm a medical school where its people are excited by their work and by the possibilities that their endeavors hold—not just here in New Jersey, but throughout the world.

That excitement translates into some of the cutting-edge work highlighted in this issue of Pulse magazine. As we extend our warm welcome to John N. Kastanis, FACHE, the new president and chief executive officer of our teaching hospital, University Hospital, we invite you to read about him and some of the other newsworthy and highly accomplished people with whom we are proud to be affiliated.

As we approach the end of another school year and prepare to graduate a class of new physicians, we do so confident in their abilities to establish careers that continue New Jersey Medical School’s tradition of shaping the future of medicine and enhancing the quality of life for those who live in the state of New Jersey and beyond.

In health,

or via email to njmsmarketing@njms.rutgers.edu

ON THE COVER Pediatric cardiologist Kanwal M. Farooqi, an assistant professor in the NJMS Department of Pediatrics, displays a 3D printed model of an adult patient with heart failure.

PHOTO BY JOHN EMERSON

Robert L. Johnson, MD, FAAP’72 The Sharon and Joseph L. Muscarelle Endowed Dean Rutgers New Jersey Medical School

SPRING 2016

pulse FE ATURES

20

A Woman’s Work

The percentage of NJMS faculty who are women and full professors compares favorably with other medical schools nationwide, according to a recent AAMC ranking.

What exactly does that mean for women at NJMS?

26

Where Twitter Meets Medicine

Pathologist Valerie Fitzhugh has posted close to 40,000 tweets, many of them histological images, and has more than 1,300 followers. Twitter is an important tool in her teaching mission.

28

Out of the Chair

For those confined to a wheelchair, the robotic exoskeleton holds out the promise of greater mobility. Karen Nolan and her research team feel optimistic about the impact of this revolutionary technology.

31

A Daughter’s Death Motivates a Mother’s New Path

At a time when many people are in the prime of their careers, Deborah Horenstein is just beginning hers. She offers a unique perspective to patients and their families.

32

New Technology for Young Hearts

Kanwal Farooqi uses 3D printing to provide cardiac surgeons with models that more accurately depict the three-dimensional anatomy of the human heart.

34

Saving Lives Suddenly in Jeopardy

Dire health emergencies call for the skill and quick response of top specialists. The patients in this story never imagined they would require rapid, life-saving medical interventions.

D E PA RT M E N T S

2

FYI

6

A CLOSER LOOK

15 NJMS PEOPLE 36

ALUMNI FOCUS

40

ENDPAGE

Notable

FYI

It’s a Match!

NJMS Faculty to Serve on Medical Marijuana Panel Several NJMS faculty members have been

Match Day, Friday, March 18, proved to be another winner for fourth-year students of NJMS.

appointed by the State Health Department to

As usual, they matched to outstanding residency programs, including NYU School of Medicine,

a panel of physicians and other health profes-

Yale-New Haven Hospital, Hospital of the University of Pennsylvania, Tufts Medical Center,

sionals that will decide if New Jersey’s medical

Brigham & Women’s Hospital, Duke University Medical Center, University of Southern California,

marijuana program should open its doors to

Baylor College of Medicine, and, of course, Rutgers programs at NJMS and Robert Wood Johnson

more patients. The panel will determine if certain

Medical School. The school’s 96 percent match rate is, as usual, well above the national average.

medical conditions — including posttraumatic stress disorder, lupus, and chronic pain — should be added to the list of conditions for which medi-

State Board of Medical Examiners and clinical

cal marijuana is currently available.

assistant professor, Department of Radiology;

State residents with amyotrophic lateral sclerosis (ALS); multiple sclerosis; muscular dystrophy; inflammatory bowel disease, including Crohn’s disease; terminal cancer; or any other terminal illness with a prognosis of less than a year can get medical marijuana if a doctor has recommended it. Those with seizure disorders,

Alex Bekker, MD, professor and chair, Department of Anesthesiology; Petros Levounis, MD, associate professor and chair, Department of Psychiatry and an addiction medicine specialist; and Cheryl Kennedy, MD, associate professor and vice chair, clinical services, Department of Psychiatry and Department of Preventive Medicine.

hospital from 2000 to 2011. Their study, pub-

intractable muscular spasticity, and glaucoma qualify if conventional therapies have been tried and failed.

Individuals with HIV/AIDS and cancer can get medical marijuana in New Jersey if they suffer from severe and chronic pain, vomiting, nausea, and wasting syndrome.

lished in the Journal of Trauma and Acute Care

A 12-Year Look at Gunshot Injuries The Centers for Disease Control and Prevention (CDC) stopped studying the health effects of gun violence 20 years ago, so there is little recent data on gunshot injuries. However, David Livingston, MD, NJMS professor of surgery and University Hospital chief of trauma surgery, had

NJMS faculty members named to the committee

the foresight to initiate a long-term study of the

are: Stewart A. Berkowitz, MD, president of the

problem. He and his colleagues conducted an

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analysis of gunshot injury data collected at the

Surgery, revealed that a total of 6,613 gunshot wound patients were treated at the hospital during those years.

The study found that: 98 percent of these injuries were the result of handguns; 92 percent involved males; the number of gunshot injuries has been steadily increasing and the injuries have become more lethal over the years; and more people are getting shot in multiple parts of their bodies.

T O P : K E I T H B . B R AT C H E R , J R .

NJMS in the News In the past few months, faculty, residents, students and staff of Rutgers New Jersey Medical School (NJMS) have been prominently featured in local and national media. They have provided expertise on many issues. This is just a sampling of the places they’ve been seen and heard.

April 1, 2016: “Changing Attitudes About

February 10, 2016: “Climate change and

Opioid Prescriptions” on NJTV News; faculty

urbanization are spurring outbreaks of

source: Robert Johnson, The Sharon and

mosquito-borne diseases like Zika” in The

Joseph L. Muscarelle Endowed Dean, NJMS

Verge; faculty source: Eliseo Eugenin, Public

March 31, 2016: “Study: NJ Has Highest Rate of Autism” on NJTV News; faculty

February 4, 2016:

source: Walter Zahorodny

“Battle to keep

March 23, 2016: “N.J. panel may expand medical marijuana use” in Philly.com; faculty source: Cheryl Kennedy; Alex Bekker; Petros Levounis; Stewart A. Berkowitz

Award for Jean Anderson Eloy Jean Anderson Eloy, MD, professor and vice chair of otolaryngology–head and neck surgery at NJMS, is the 2016 recipient of the Edward J. Ill Physician’s Award. Eloy, who was featured with his brother Jean Daniel on the fall 2015 cover of Pulse magazine, also serves as NJMS director of rhinology and sinus surgery, director of otolaryngology research, and co-director of the endoscopic skull base surgery program. He holds

March 18, 2016: “Lead Fears Grow in Newark Schools, but the Problem Isn’t New” in The New York Times; faculty source: Steven Marcus; same topic: NBC New York, Philly.com; NJ.com; WCBS radio; ABC News; The Wall Street Journal March 18, 2016: “How One Family Saved for College, Graduate School” in U.S. News & World Report; NJMS student featured: Jilyan Decker

joint appointments as professor of neurological

March 9, 2016: “Guidelines needed for

surgery and professor of ophthalmology and

physicians treating venom allergy” in helio.

visual sciences at NJMS. He has published

com; faculty source: Priya J. Patel

more than 270 articles in peer-reviewed journals as well as numerous book chapters; and has made more than 230 scientific presentations at regional, national and international meetings as well as giving more than 160 invited lectures and oral presentations. His areas of research include

Health Research Institute at NJMS

February 25, 2016: “A Decade Later, Stents Durable for Stroke Prevention” in Medpage Today; faculty sources: Alice Sheffet; adjunct faculty: Thomas Brott; same topic: United Press International

crippling Zika virus out of NJ” in Asbury Park Press; faculty sources: Joseph Apuzzio, Rajendra Kapila January 28, 2016: “What pregnant women need to know about Zika virus pandemic” in NJ.com; faculty source: Rajendra Kapila February 29, 2016: “Schooling first responders on terror: Rutgers offers course for med students” in The Record; faculty source: Leonard Cole; same topic: New Jersey Business magazine and NJTV News; also “As mass casualties continue, hospitals keep honing their preparedness” in The Washington Post, December 25, 2015 February 23, 2016: “New Theorem helps reveal tuberculosis’ secret” in yourhoustonnews.com; faculty source: Marila Gennaro; same topic: The Times of India January 27, 2016: “Texting in the Dark Hits

endoscopic and open sinus surgery, minimally

Student Grades” in Forbes; faculty source:

invasive endoscopic skull base surgery, and

Xue Ming; same topic: Daily Mail (UK); CTV

studies of gender disparities in otolaryngology

News (Canada); NDTV (India); CNB News;

and other surgical specialties. Eloy serves on the

New Zealand Herald; parentherald.com;

NJMS Admissions Committee and the school’s

sciencedaily.com

faculty council, and is involved in resident training. He earned his medical degree from NJMS in 2002; and completed his residency at the Mount Sinai School of Medicine and a fellowship at the University of Miami/Jackson Hospital.

T O P L E F T: K E I T H B . B R AT C H E R , J R .

January 26, 2016: “Task Force urges doctors to screen new moms for depression” in NorthJersey.com; faculty source: Lisa Gittens-Williams

RUTGERS NEW JERSEY MEDICAL SCHOOL

3

Notable

FYI

and Brigham and Women’s Hospital. Bleich came to NJMS in 2004, where he has trained 12 fellows in endocrinology, diabetes, and metabolism; authored numerous papers; and has been awarded millions of dollars in research grant support for diabetes-related projects. In addition, he is president of the NJ Chapter of the American Association of Clinical Endocrinology; has served on the basic science Grant Review Panel for the American Diabetes Association (ADA) for five years; has chaired the ADA’s basic science Grant Review Panel and served on its National Research Policy Committee; and recently chaired the ADA’s National Awards Committee. He is also an executive board member of the Foundation for Diabetes Research of New Jersey.

New President and CEO for University Hospital

Newark community. “Hospitals gain much when

Increased Suicide in Head and Neck Cancer Patients

they are thoroughly integrated into the fabric of

The incidence of suicide is

the communities they serve,” he states. “I look

far higher in patients with

John N. Kastanis, FACHE, has recently come

forward to highlighting the breadth of services

head and neck cancer

onboard as President and CEO of University

we provide and understanding how we can be of

than the general popula-

Hospital, the primary teaching hospital and

even greater service to the city and the region.”

tion, according to a study

clinical research site of NJMS. Kastanis will lead a workforce of 3,400 full-time employees and 550 medical staff, and is responsible for a $600 million budget.

recently published online

Kastanis joins the hospital after four years as

by JAMA Otolaryngology-

leader of Temple University Hospital, where

Head & Neck Surgery.

he is credited with enhancing core operations, developing new clinical service lines, acquiring

Among University Hospital’s most widely

new medical and surgical technologies, growing

recognized programs are: the Center for Liver

market share, improving clinical efficiencies, and

Diseases, which has performed more than 1,000

guiding the hospital toward long-term financial

liver transplants since 1989; the Comprehensive

stability.

The rates were found to be highest among patients with cancers of the larynx and hypopharynx (the bottom part of the throat).

Richard Chan Woo Park, MD, an assistant

Stroke Center, which has been singled out by the

professor in the NJMS Department of Otolaryn-

Joint Commission for advanced certification; the

gology–Head and Neck Surgery, and colleagues

Heart Failure Care program, the only hospital in Northern New Jersey with the Commission’s advanced certification; and the Level One Trauma Center, which receives severely injured accident victims from throughout the region. In addition, University Hospital is the largest provider of charity care services in the state, representing about 25 percent of its patient case volume.

A Notable Honor David Bleich, MD, chief of the division of endocrinology, diabetes, and metabolism at NJMS, received the Physician of the Year Award from the Diabetes

Among his first goals at University Hospital,

Foundation, Inc (DFI) at its

Kastanis says, are to get to know the hospital’s

25th Anniversary Awards

medical professionals and staff, the medical

Dinner in April. He com-

school, and vendors, and to begin building

pleted his residency at Maimonides Medical Cen-

relationships with key members of the wider

ter and a fellowship at the Joslin Diabetes Center

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used data from the Surveillance, Epidemiology, and End Results (SEER) program to study the incidence rate, trends, and risk factors of suicide in patients with cancer of the head and neck.

Between 1973 and 2011, there were 350,413 cases of head and neck cancer nationwide. Data analyses revealed 857 suicides. There was a nearly 12-fold higher incidence of suicide in patients with hypopharyngeal cancer and a five-fold higher incidence in those with laryngeal cancer, which may be linked to changes in the ability to speak and/or swallow. The study’s authors say the increased rates of tracheostomy depen-

dence, difficulty swallowing, and/or gastrostomy (eating) tube dependence are likely factors in the

Looking Forward

higher suicide rates. “Additional research should

A fall 2016 symposium, entitled “First Line of Defense:

be devoted to the psychological toll that the

Protective Immunity at Barrier Surfaces,” scheduled

cancer, treatments, and resulting morbidity have

for September 13 and 14 in Newark, will be hosted by

on patients,” says Park.

the Institute for Infectious and Inflammatory Diseases at NJMS. Focusing on immune responses at the skin and mucosal surfaces, the symposium’s list of distinguished speakers includes

fighting Multiple Myeloma and Melanoma The Innovation Grants Program, jointly sponsored by New Jersey Health Foundation and The Nicholson Foundation, recently announced six awards to faculty at Rutgers University, Rowan

Drs. Dan Kaplan, Sarah Gaffen, Eric Pamer, Akiko Iwasaki, Alexander Rudensky, Chris Nagao, Jenny Kim, Dan Littman, Brian Kelsall, and David Artis from the U.S., as well as international researchers Drs. Adrian Hayday and Gunnar Hansson. For more information, email: Jennifer Yaney at jdalesan@njms.rutgers.edu or Amariliz Rivera at riveraam@njms.rutgers.edu.

University, and Stevens Institute of Technology.

The grants support innovative projects, which could lead to promising healthcare treatments

Howells and Welsh, together with Youyi Peng, a

and technologies. One of these grants was

bioinformatics expert at the Cancer Institute, are

awarded to the team of Richard Howells, PhD,

evaluating lead compounds that may be effective

a professor in the Department of Microbiology,

as novel therapies for multiple myeloma and

Biochemistry & Molecular Genetics at NJMS,

melanoma. They will evaluate their current lead

and William Welsh, PhD, a professor of bioinfor-

compound in vitro followed by in vivo studies for

matics in the Department of Pharmacology at

efficacy in mouse models. The team hopes to

Robert Wood Johnson Medical School. Howells

attract additional funding and/or investment at

has focused his research on opioids, opioid

the end of the initial one-year period to further

peptides, and opioid receptors. Welsh also serves

develop the anticancer compound(s).

as director of the division of chemoinformatics at the Rutgers Cancer Institute of New Jersey. Both researchers have extensive experience studying novel molecules for potential medicinal purposes.

The Launch of Rutgers Health

pertise of our university’s world-class educators, researchers, and clinicians, Rutgers Health will become the largest academic health care pro-

On April 6, the Rutgers University Board of

vider organization in New Jersey and a leader in

Governors authorized the creation of Rutgers

patient care to meet the challenges of the shifting

Health — an innovative, statewide academic

health care landscape.”

health care provider organization that will revolutionize patient care across New Jersey.

Brian Strom, executive vice president for health

Rutgers Health will become one of the first

and Health Sciences, will oversee the multiyear

academic health care provider organizations

development of Rutgers Health.

in the nation to integrate a full range of healthrelated specialties — including medicine, dentistry, pharmacy, nursing, and clinical psychology— in addition to more traditional fields, such as neurology, surgery, cardiology and

Richard Howells

L E F T: K E I T H B . B R AT C H E R , J R . ; R I G H T: N I C K R O M A N E N K O

affairs and chancellor of Rutgers Biomedical

“First and foremost, Rutgers Health will be about patients,” Strom says. “Ultimately, all Rutgers Health locations will represent a place patients can go to receive all of their care — to get well

oncology.

and to stay well. Physicians, nurses, dentists,

“Rutgers Health will bring together the critical

gists, and researchers will work together, creating

missions of all university clinical activities under

a leading academic health care provider organi-

one umbrella,” says Rutgers University President

zation distinguished by the quality and breadth

Robert Barchi. “Combining the talents and ex-

of patient services.”

pharmacists, social workers, clinical psycholo-

RUTGERS NEW JERSEY MEDICAL SCHOOL

5

a closer look at women in medicine and science

Growing Women Leaders

BY EVE JACOBS

M

edical schools nationwide have worked to diversify incoming classes for decades. While white male students made up the majority in most medical schools 30 years ago, that’s no longer the case. New physicians graduating in 2016 more closely reflect the general population of the U.S. and, more specifically, the population of the state and community where the school resides.

NJMS has made diversification of its student body a priority for many years — initiating programs that introduce, teach, and support middle, high school, and college students with an interest in medicine and science to become competitive medical school applicants. “Diversity is definitely one of our strengths,” says Sangeeta Lamba, MD, associate dean for education and professor, emergency medicine, “and gender is an aspect of diversity.”

However, it takes a long time for the “new faces” in medicine to be reflected in the faculty-leadership. Advancing through the ranks is neither fast nor simple; and often

prejudices exist among even the most highly educated.

In order to push the process along, NJMS recently founded a chapter of the Group on Women in Medicine and Science (GWIMS), a program initiated by the Association of American Medical Colleges. According to the AAMC Website, the purpose of GWIMS is “to advance the full and successful participation and inclusion of women within academic medicine by addressing gender equity, recruitment and retention, awards and recognition, and career advancement.”

Last fall, six female leaders sat down to lunch and hammered out the rudiments of a plan for GWIMS at NJMS. Three of them — Chantal Brazeau, MD, Vivian Bellofatto, PhD, and Anne Mosenthal, MD — are featured in this issue. Also present were Maria Soto-Greene, MD, vice dean of NJMS, professor of medicine, and director of the Hispanic Center of Excellence, who has played a major role in promoting diversity at NJMS; Seena Aisner, MD, professor,

pathology and laboratory medicine; and Lamba.

“We focused on the question, ‘What needs to be done to support women faculty at NJMS now?’” says Lamba.

Topping the list were networking receptions to bring women faculty members together and showcasing a female faculty member of the month, eventually building a “library” of women leaders at NJMS. At the largest networking event — in November 2015 — 80 women faculty attended. The reception was supported by the NJMS departments of surgery and emergency medicine, and sponsored by the Office of the Dean.

What do women faculty members at NJMS want? “Suggestions included more social networking events and information and discussion about work-life balance and resilience,” says Lamba. The medical school’s GWIMS chapter subsequently launched a Facebook page, allowing members to connect more easily, and is planning future get-togethers.

The NJMS leaders will also further grow a structure for mentoring and supporting women faculty members to become leaders; launch programs to support professional growth of women faculty; and host events that allow women faculty from diverse backgrounds to connect with each other.

The overall reaction to the recent networking event was: “This is great and we need to do more of this!”

That’s exactly what the GWIMS leaders —Mosenthal, who serves as chair of the mentoring committee for Rutgers Biomedical and Health Sciences; Soto-Greene, who has historically headed up efforts in diversity and inclusion for NJMS; and Lamba, whose energy helps drive change— will make happen for the women at NJMS. ●

(l-r) Karma Brown Warren, MD, assistant professor of emergency medicine, was the second “Faculty of the Month” spotlighted on the Website of the Group on Women in Medicine and Science (GWIMS). She is shown with Sangeeta Lamba, one of the leaders of the new GWIMS chapter.

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JOHN EMERSON

a closer look at a major grant for skin research

William C. Gause

Not Just Skin Deep

BY EVE JACOBS

A

$1 million grant from the MCJ Amelior Foundation in Morristown will be used to recruit an up-and-coming researcher in the field of skin research and set up a laboratory for the scientist at Rutgers New Jersey Medical School’s newly launched Institute for Infectious and Inflammatory Diseases (i3D).

“There is so much that is still unknown about chronic, inflammatory skin conditions such as acne, as well as how to better repair skin wounds and injuries,” says William C. Gause, director of i3D, based at New Jersey Medical School (NJMS). “Most current acne treatments focus largely on eradicating existing acne lesions and preventing new ones.

The research initiative that we are set to launch will look at the underlying causes.”

The skin is the largest organ of the human body and has many functions, among them serving as the body’s buffer against harmful environmental onslaughts, and helping to protect internal organs from injury. But sometimes the skin’s immune responses are the problem. While they can ward off miJOHN EMERSON

croorganisms, they can also set off a chain of reactions that result in chronic inflammation.

Acne is said to affect 80 percent of teens and young adults. It can persist well into adulthood, spreading lesions on the cheeks, forehead, chin, back, and chest that can take stubborn hold and leave scarring.

Until recently, it was thought that inflammation resulted from the presence of acne.

Now there is evidence that inflammation is present throughout the lifespan of the acne lesion and often precedes its development.

The effect of acne on mental and emotional well-being can be enormous—comparable to the life-changing consequences of a chronic disease such as diabetes, say social researchers. Those who have never battled with persistent skin eruptions are often unaware of their potentially devastating social impact— for both adolescents and adults. Selfconfidence is frequently eroded; engagement in work and social situations can be painful; and for teenagers, who often develop acne at a pivotal juncture in their lives, the setbacks

can be long-term and life-altering.

Current acne treatments can be highly effective; and one of these, isotretinonin, can even lead to a cure for some. But the primary oral treatments —isotretinonin (formerly marketed as Accutane), hormone therapy in the form of oral contraceptives, and antibiotics — all have significant associated side effects. Laser and light technology may provide a cure in the future, but there are currently no anticipated alternative drugs in the pipeline.

Gause himself directs a research lab at the NJMS Center for Immunity and Inflammation. “Dysfunction of the immune system is increasingly recognized as contributing to a broad spectrum of infectious and noninfectious diseases,” he explains. He has published his research and has been interviewed by Scientific American on the role of helminth worms (small parasites that live in human intestines, especially in the developing world) in protecting the body from harmful inflammation.

“When these parasites migrate through tissue, they can cause considerable damage by forcing themselves through cells and secreting damaging enzymes,” he says. “But helminth infection also triggers important wound healing components, which help the body to tolerate the parasite. It is these triggers produced by the parasites that we are interested in.”

Gause, who is also associate dean for research at NJMS, says that scientists have recently identified and cloned specific parasitic proteins that may act as triggers. Just as soil bacteria have been mined for antibiotics, helminth parasites are now being tested for expression of specific molecules that may help control harmful inflammation and promote wound healing. His laboratory is engaged in testing these recently discovered products.

The institute is currently planning a fall 2016 symposium on “barrier inflammation” to look at what’s new in the understanding of both healthy and diseased, or damaged, skin and mucosal tissues, including those in the lungs and intestines. ● RUTGERS NEW JERSEY MEDICAL SCHOOL

7

a closer look at the hpv vaccine, concussion, and zika virus

NJMS Experts Speak Out According to the Cambridge English Dictionary, an expert is a p ​ erson with “a high l​evel of k​ nowledge or ​skill in a p ​ articular s​ ubject.” At Rutgers New Jersey Medical School (NJMS), there are many experts practicing medicine in a broad spectrum of specialties and subspecialties. In the following article, three NJMS experts provide new and in-depth information about topics of particular interest.

Stopping Cervical Cancer

A

n end to cervical cancer is finally within reach, according to Mark Einstein, MD, MS, a specialist in women’s gynecological cancers and the new chair of obstetrics, gynecology, and women’s health at Rutgers New Jersey Medical School (NJMS). The 2016 schedule of recommended vaccines, issued recently by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC), includes several significant changes, among them the introduction of Gardasil 9®, a new HPV (human papillomavirus) vaccine that protects against infection with the four types 8

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of the virus covered by the first generation of Gardasil as well as five additional cancercausing HPV types. About a dozen— out of 200— types of HPV have been identified as causing cervical and other cancers.

“HPV is ubiquitous,” says Einstein.

“More than 80 percent of sexually active men and women will be infected with at least one type of HPV during their lives.”

In most cases, the virus causes no symptoms and no disease, and in more than 90 percent of cases, it becomes undetectable within a year. However, in the 10 percent where the virus persists, it can lead to cell changes; and

the risk of cervical cancer, and other cancers that affect the anogenital tract, rises. It can take 10 years or more for the infection to cause disease, “so we have a lot of opportunity to detect and stop it through traditional screening before it leads to cancer,” he says.

According to the National Cancer Institute (NCI), HPV causes virtually all cases of cervical cancer, which is almost always symptomless. It also causes 95 percent of anal cancers, 70 percent of oropharyngeal cancers, 65 percent of vaginal cancers, 50 percent of vulvar cancers, and 35 percent of penile cancers. Several non-cancer-causing types can lead to genital warts. Commonly, women and men are infected with more than one type.

“Anyone who has had any kind of sex can get HPV and pass it easily to a partner,” explains Einstein. The three-dose vaccine is recommended for both girls and boys ages 11 and 12, and can be given as young as age 9. Women can get vaccinated up to age 26, and most men up to age 21. Even though the majority of HPV-associated cancers occur in women, it is important to vaccinate both since the infection is transmitted between men and women.

“The HPV vaccine is a lifesaver,” says the cervical cancer specialist. “Combined with regular PAP and HPV tests to identify pre-cancerous lesions and in-office treatment for these lesions, we are in a position to end cervical cancer in the U.S. and the rest of the world.”

On February 22, researchers at the CDC released data showing that 10 years of vaccinating against HPV has cut infections of HPV types covered by the vaccine by 64 percent among teen girls in this country. Although a decline in genital warts (a measure of the vaccine’s effectiveness) was noted by investigators, it will actually take a decade or more to see if the reduction in viral infection translates into fewer cases of cancer. Experts have no doubt this will happen, but it will take some time.

However, vaccine rates in this country are “dismally low,” Einstein says. “Only about 42 percent of girls and 22 percent of boys

ages 13 to 17 have received the three doses that are recommended.”

The reasons for low vaccination rates are “obvious and not obvious,” he explains.

“This vaccine — unlike many others — is not mandated in order to attend school; parental consent is required to age 18 and many parents associate the vaccine with sexual activity (the point is to administer three doses as a preventative measure — before sexual activity begins); it is expensive compared with other vaccines; and there’s a large, well-organized anti-vaccine group in this country, despite millions of doses being administered with well-documented safety.”

HPV is the most common sexually transmitted infection in the U.S. About 14 million new genital HPV infections occur annually. Einstein has been an author on the original HPV vaccine guidelines in this country, as well as participating in the largescale trials for HPV vaccines.

Over the last 10 years, the FDA has approved three vaccines to prevent HPV infection: Gardasil® in 2006; Cervarix® in 2009; and Gardasil 9® in 2014. The vaccines prevent new HPV infections, but they are not designed to treat established infections or disease. HPV vaccines have also been approved in 120 other countries. “In some of the lowest income countries, such as Rwanda, vaccinaMark Einstein tion rates are far higher than in the U.S.,” Einstein says.

“And, sadly, in Newark, a lot of women have cervical cancer,” he continues. Some of the women plagued by the disease are new immigrants. Cervical cancer is particularly prevalent and damaging in sub-Saharan Africa and Southeast Asia and causes a “tremendous amount of morbidity, killing women in the prime of their lives.”

“The new Gardasil-9 vaccine can prevent 80 percent of cervical cancer. This vaccine is a L E F T: N I C K R O M A N E N K O ; R I G H T: J O H N E M E R S O N

no-brainer. According to the data, there is no downside and we could prevent disease that leads to a lot of morbidity,” Einstein states.

“As a doctor who treats women suffering from cervical cancer, I look forward to the day I never have to treat cervical cancer again.

With early vaccination and regular screening, we can essentially stop this disease.”

—EVE JACOBS

Heads Up

T

he movie Concussion, released late last year, focuses on the long-term effects of brain injury on professional football players. But the important takeaway is that a concussion can impact anyone at any time.

The number of concussions in the U.S. is estimated to be somewhere between 1.4 and 3.8 million yearly.

“Pinpointing an actual number is impossible because concussive injuries are highly underreported,” says Neil Jasey, MD, assistant professor of physical medicine and rehabilitation at Rutgers–New Jersey Medical School (NJMS) and director of Brain Injury Services at Kessler Institute of Rehabilitation in West Orange.

Studies show that nearly 50 percent of high school football, soccer, and hockey players do not admit to having an injury. Many student-athletes disregard symptoms and tough it out in order to remain competitive.

A concussion is a disruption in brain function caused by a blow to the head or jolt to the body. It may or may not involve a loss of consciousness. Symptoms vary and may include headaches; nausea; dizziness; sensitivity to light and noise; disorientation; sleep, memory, and balance problems; poor concentration; anxiety; behavioral changes; and depression, and, if left untreated, can lead to significant complications.

Part of the problem is that concussion can be difficult to diagnose. Magnetic resonance imaging (MRI) and computerized tomography (CT) scans may help rule out a skull fracture or bleeding, but they don’t detect the subtle changes in the brain that signal a concussion.

In 2012, 12 percent of all emergency room visits involved a concussion. Sports and recreational activities, including biking, account for more than 25 percent of all traumatic brain injuries in children between the ages of 5 and 19. Football has the highest concussion rate, followed by wrestling and cheerleading. Studies show that more than 40 percent of student athletes return to play too soon, which puts them at greater risk for long-term comNeil Jasey plications. Falls, motor vehicle accidents, and violence can also cause concussions.

It’s critical to have the injury evaluated, treated, and monitored in order to allow the brain to heal.

Early, specialized treatment that is tailored to the individual person’s needs has been shown to improve recovery and reduce the risk of future injury and long-term issues. “Once a student athlete sustains a concussion, he or she is four to six times more likely to incur a second brain injury, which can lead to more serious, lifelong impairments,” explains Jasey, who earned his MD from NJMS in 2003 and helped create the state’s concussion guidelines for injured student athletes.

The impact of repeated brain injury is the main story line of the movie Concussion. It calls attention to a neurodegenerative disease called chronic traumatic encephalopathy (CTE) that can develop years or even decades after someone has sustained multiple concussions, causing mild to severe memory, cognitive, speech, movement, and emotional issues, and violent or inappropriate behavior.

While prevalent among professional football players and boxers, others could be at risk.

Although the best protection against injury is prevention, it’s difficult to prevent a brain injury. “So far, no protective equipment has been proven to prevent Continued on page 10

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NJMS Experts Continued from page 9

concussions,” says Jasey. “However, helmets can help reduce the severity of an injury when biking, skating, skiing, or snowboarding; and companies are exploring better helmet design and technologies for football and other hard-hitting sports like lacrosse.”

For athletes, having a baseline and postinjury Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) is helpful. ImPACT is a computerized evaluation that takes about 25 minutes to complete.

The test should be administered by an athletic trainer, school nurse, athletic director, team doctor, or psychologist. Baseline tests are suggested every two years. If a concussion is suspected, the baseline report serves as a comparison.

Although every concussion injures the brain, most of the injuries are mild, and time and rest lead to full recovery. Symptoms usually appear right after the injury, but some may not show up for hours or even days. If a child or teen complains about symptoms, or if mild symptoms get worse, it’s time to head straight to the doctor. Patients do best when they are treated early by a physician who is experienced in treating concussions.

Reprinted with permission from Kessler Institute for Rehabilitation

Zika Virus and Pregnancy

T

he outbreak of the Zika virus in South America, Latin America, the Caribbean, and parts of Africa, and the probability that it will spread to most countries in the Americas, have sparked fear in pregnant women.

The virus, transmitted by mosquitoes, has been linked to thousands of babies born with small heads and underdeveloped brains.

Some countries have advised women not to become pregnant now, with health officials in El Salvador advising women of reproductive age there to delay pregnancy until 2018.

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The World Health Organization has predicted that the virus will probably spread to all countries in the Americas, except for Canada and Chile, because of the presence of the Aedes aegypti mosquito, which appears to be responsible for the Zika cases documented thus far. This type of mosquito thrives in tropical and subtropical climates.

While Zika cases have been diagnosed in this country, mosquito-transmission of the virus has not yet been reported in the mainland U.S. The cases diagnosed in this country to-date have been travel related. Mosquitoborne transmisJoseph Apuzzio sion of Zika virus has been reported in Puerto Rico, the U.S. Virgin Islands, and American Samoa.

According to the CDC, the Zika virus can be spread by a man to his sex partners.

In the cases where sexual transmission has been deemed “likely,” the men had Zika symptoms. However, the CDC says that the “virus can be transmitted before, during, and after symptoms develop.” A large percentage of cases will never be diagnosed, since the symptoms of infection tend to be mild in a majority of cases, and disappear without medical treatment in a few weeks.

“The CDC has stated that pregnant women who have visited the countries where the virus has been documented and then, within two weeks of the visit, have symptoms of the virus should consider that they’ve potentially contracted the virus,” says Joseph Apuzzio, MD, professor, obstetrics, gynecology and women’s health, and a specialist in the treatment of high-risk pregnancies. “Symptoms appear in only about 20 percent of infected individuals, so women who aren’t symptomatic — even though they’ve been bitten by mosquitoes carrying the virus — may be infected as well.” Symptoms include fever, rash, joint pain, muscle aches, and conjunctivitis.

A pregnant woman concerned that she might have contracted the Zika virus should immediately visit her obstetrical care providers, who will evaluate her and determine if blood testing is necessary, advises Apuzzio.

If a woman is tested, her blood specimens are sent to the CDC for analysis. There is no commercial test in the U.S. at this time to determine whether a woman is infected.

“Since the Zika virus infection during pregnancy has been associated with fetal microcephaly — which can cause a newborn to have an abnormally small head and serious developmental delays — obstetrical ultrasound examinations of the fetus should be performed periodically,” he explains.

While the chances of women living in the U.S. contracting the virus right now are low, the CDC recommends that pregnant women or those wishing to become pregnant, should not travel to the countries and territories believed to be experiencing large Zika outbreaks. “The most difficult part of this is the realization that it is not curable or reversible if a mother and fetus are infected,” Apuzzio states.

The physician advises using all of the tried-and-true methods of protecting oneself from bug bites: wearing long-sleeved shirts and pants; staying in places that have screens on windows and air-conditioning; using EPA-registered insect repellants; and staying away from mosquito breeding sites, like containers of standing water.

According to the CDC, Zika virus infection in a woman who is not pregnant would not pose a risk for birth defects in pregnancies that begin after the virus has cleared from her blood, says Apuzzio. That’s based on what is known about similar infections.

“Most likely, once a woman is infected with Zika virus, she is likely to be protected from a future Zika infection,” he says.

Any woman who is pregnant or contemplating pregnancy or whose partner has traveled or lived in an area with Zika virus should use condoms for vaginal, oral, and anal sex every time, or abstain from sex, until after delivering the baby, Apuzzio suggests. ●

K E I T H B . B R AT C H E R , J R .

a closer look at the quandary of a gsbs student Doreen Badheka (far right) with other founding members of the GSBS Alliance for Career Advancement

A Long and Winding Road

BY EVE JACOBS

I

n the 10 years since Doreen Badheka emigrated from her native India to settle in the U.S., her life has taken some unforeseen twists and turns. She came to this country to join her fiancé, a graduate student in structural engineering at New Jersey Institute of Technology in Newark, and to matriculate in a three-year Master’s degree program (with thesis) in cell biology at New York Medical College. The couple married not long after her arrival. No surprises so far.

In 2010, Badheka came to Rutgers Graduate School of Biomedical Sciences (GSBS), Newark, to pursue a doctoral degree in basic science research. After the required rotations through three different laboratories, she joined the lab of Tibor Rohacs, MD, PhD, in the Pharmacology and Physiology Department, studying the sensory Transient Receptor Potential (TRP) ion channels. Life was good — she found her colleagues to be collaborative, the research to be interesting, and, in 2015, she made her mark as second author on a cover-story in the journal Science Signaling. She was headed straight toward K E I T H B . B R AT C H E R , J R .

her goal. Like most basic science doctoral students, Badheka was focused on a position directing her own laboratory at a university—with the opportunity to teach the next generation of researchers.

But the world of academic research is changing rapidly. Deep cuts in National Institutes of Health (NIH) funding have translated into seriously diminished career opportunities for would-be academic scientists. Over the past few years, just 25 percent have found jobs directing research labs at a university.

When Badheka heard these figures, in the third year of her doctoral program and six years into her graduate studies, she says, “Reality sank in and I thought, ‘What are my options? I love research. What else can I do to stay close to it?’”

Her first foray out of the lab took her into the world of technology transfer via a year-long internship in the Rutgers Office of Research Commercialization, which she began in August 2013. “It gave research a whole different flavor for me,” she remembers.

“You fight for a patent, and you have to be in touch with everything that is currently out there or will soon be out there in that field.”

Inspired by this work, Badheka pondered her future. She thought, “My problem is shared by all basic science doctoral students.

We could research career options together.”

So, she built a team at GSBS, hand-picking fellow students who could help develop a program investigating “alternative” careers.

In 2014, the NIH selected seven institutions nationwide — among them GSBS in collaboration with the Rutgers Center for Innovative Ventures of Emerging Technologies (CIVET) — to figure out how to help redirect some basic science doctoral students into other related areas. “We need to come up with new nonacademic, non-research possibilities that will use the students’ scientific training,” says Stephen Garrett, PhD, associate dean of student affairs at GSBS. Interdisciplinary Job Opportunities for Biomedical Scientists — iJOBS — is the program that was initiated at Rutgers to address these issues. Almost simultaneously, Badheka launched the Alliance for Career Advancement (ACA), a student-run organization tackling the same issues as iJOBS. The group’s first event in March 2014 “focused on young faces in academia,” says Badheka. The message of the evening was: the traditional dream is still possible. “It was a huge success,” says Badheka.

One of the panelists, Mona Batish, PhD, an international student who graduated from the GSBS doctoral program, “won a big NIH grant, and is currently working on her research at the NJMS Public Health Research Institute,” says Badheka, who says she learned about Batish through Pulse magazine.

Since then, the ACA has sponsored a series of panel discussions on career opportunities outside of academia. All have been enthusiastically attended.

Continued on page 14

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a closer look at faculty and alumni volunteering worldwide

On the Road Again

BY GENENE W. MORRIS

E

ach year, Elmer David, MD, an associate professor of pediatrics at Rutgers New Jersey Medical School (NJMS), packs his bags and heads to his native Philippines.

There, for the next 10 days or so, he settles in one of the provinces and gets to work in a “small ecosystem” of 25 to 30 physicians, surgeons, anesthesiologists, nurses, and other volunteers with the goal of changing the course of people’s lives. Their work comes as part of Operation H.O.P.E. (Helping Other People Excel), a program of the Philippine American Group of Educators and Surgeons, whose three-pronged mission provides medical and surgical interventions to children with cleft lips, cleft palates, and other craniofacial anomalies; nutritional assistance; and education in the form of lectures on such topics as CPR/resuscitation and pediatric pain management.

His volunteerism brings him to differ-

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ent regions of the Philippines every year.

This past February, the pediatrician and neonatologist— on his 30th mission—found himself in Tarlac, a landlocked province of the Philippines some three hours north of Manila. As the group’s director of pediatrics, David says he functions as the mission’s “bookends,” handling — over the course of the mission—100 to 300 pre-op screenings on the front end to ensure that pediatric patients are healthy enough for surgery and, on the back end, conducting post-op examinations, making certain the patients are healing well. David, who immigrated to the U.S. when he was 14, also serves as translator between the patients and the surgeons.

The surgeries are provided free of charge to indigent patients who, otherwise, lack affordable options. Often, faced with surgical fees they can ill-afford, “They would rather eat and not starve,” says David.

Beyond fixing congenital malformations, the group’s purpose is to help patients “become functional members of society in the future,” says David. “If you do not fix the palate early, they will have a nasal sound when they talk, which makes it difficult for people to understand them.” Also, he says, without surgery it’s “a social concern because they’re embarrassed,” often becoming social outcasts. There’s also the matter of nourishment, David adds. “Babies with cleft lips or cleft palates tend to have nasal regurgitation which causes formula to come through their noses. I encounter a lot of malnourished babies.”

In preparation for missions, which are often the response to an invitation from a province, church, or local charity, the group sends a team months in advance to “make sure there’s electricity, running water, air conditioning, and a recovery room,” in the facility where they work, says David, who uses his own funds to buy supplies, antibiotics, and other medications.

Now in his 17th year as an Operation H.O.P.E. volunteer, David looks forward P H O T O S C O U RT E S Y O F E L M E R D AV I D

to the missions that typically bring out the same core group of people whose lives, he says, are as impacted as the people they’re helping. “People who join us return to their respective countries as changed people. They don’t complain as much.”

30+ Years on the Road

N

JMS Department of Pediatrics Chair Glenn J. Fennelly, MD ’87, MPH, can pinpoint the moment in time when his interest in global health was stoked. It was 1984 when, as a student at NJMS, he visited Nicaragua, which was facing threats on two fronts: guerilla warfare and the scourge of poliovirus.

“Poliovirus was still circulating among unvaccinated children in conflict-torn neighboring countries,” says Fennelly, noting “if poliovirus exists anywhere, we are at risk everywhere.” Having taken an oral polio booster, he traveled to Nicaragua to observe, among other things, the impact of ambitious public health initiatives such as cross-border immunization campaigns to combat paralytic poliomyelitis. Those campaigns, Fennelly says, contributed “to polio eradication in Central America shortly thereafter.” Stateside, Fennelly spent a lot of time shadowing revered NJMS professor and alum James M. Oleske, MD ’71, MPH, one of the first to identify AIDS in children. During that time, Fennelly says, Oleske was studying the safety of zidovudine (AZT) in infants when used in pregnant women to prevent mother-to-child HIV transmission, which led to significant gains in the world’s fight against the HIV pandemic.

“These experiences were the touchstone for my interests in pediatric infectious diseases and vaccine research and, more broadly, working to ensure that children anywhere have the same chance as children in the U.S. to be born safely and to thrive,” says Fennelly.

Since then, Fennelly has played a significant role on the global health stage, working with international initiatives like the President’s Emergency Plan for AIDS Relief (PEPFAR), which was formed during Presi-

dent George W. Bush’s administration. As a pediatrician and pediatric infectious disease expert who spent the 1980s and 1990s treating hundreds of children and young adults with AIDS in the Bronx, he saw firsthand the disparity between children in New York who had access to preventive and highly active antiretroviral therapies and those in low-and middle-income countries who had limited access to these interventions.

“By 2002, perinatally acquired cases of AIDS had plummeted by more than 90 percent from a decade earlier,” while HIV infection rates in low and middle income countries, where therapies were limited, grew, Fennelly says.

“I had the privilege of educating doctors and nurses throughout Vietnam in the country’s first Pediatric HIV Care and Treatment Centers during a scale-up between 2006 and 2008. At the time, women in Vietnam had the highest rate of risk in new HIV infections among all women in Asia, and cases of mother-to-child transmission were skyrocketing,” he says.

These days Fennelly is working with colleagues Karen Wei-Ru Lin, MD, MS, and Suzanne Willard, PhD, RN, from sister

Opposite page: Associate Professor of Pediatrics Elmer David on his annual trip to the Philippines to provide medical care to indigent patients free of charge Above: Elmer David is in his 17th year as a volunteer with Operation H.O.P.E. (Helping Other People Excel).

schools Rutgers Robert Wood Johnson Medical School and Rutgers School of Nursing, respectively, to identify priority areas in education and collaborative research with the University of Dodoma in Tanzania.

With a focus on preventing maternal and early infant death, their efforts will include a range of student and faculty collaborations.

In January, the New Jersey team traveled to the University of Dodoma, offering seminars and clinical teaching rounds to students.

As the world continues to face down wellstudied public health threats like malaria, tuberculosis, and HIV, and grapples with relatively unknown ones like Zika virus, Fennelly remains committed to his global health work, emphasizing once more: “If infections like these exist anywhere, we are at risk everywhere.”

The Next Generation of Global Health Leaders

W

hen NJMS graduate Nakul Raykar, MD ’10, MPH, took a break from his residency in general surgery at Beth Israel Deaconess Medical Center to work as a Paul Farmer Global Surgery Fellow in 2013, he knew he would spend his next two years doing meaningful work. After all, with a focus on developing a skillset necessary to treat conditions common in resource-poor settings, the fellowship, housed within Harvard Medical School’s Program in Global Surgery and Social Change, was created to train leaders to further promote surgical care, education, and research pertinent to global surgery.

“I was expecting to spend a full year in Haiti working on costing and wound care projects at the Partners-In-Health hospital,” said Raykar, referring to the non-profit founded by medical anthropologist and physician Paul E. Farmer, PhD, MD. But the fellowship had other plans for Raykar, plans that thrust the aspiring liver transplant surgeon smack-dab in the middle of the Lancet Commission on Global Surgery Project. It was a twist of fate that would Continued on page 14

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On the Road Again Continued from page 13

have Raykar traveling the globe, interacting with world leaders, and playing a lead role in the production of a landmark report aimed at strengthening health care systems in lowand middle-income countries throughout the world.

The commission was formed by the UK medical journal, The Lancet, in 2013 with Boston Children’s Hospital’s Plastic Surgeonin-Chief John G. Meara, MD, DMD, MBA—Raykar’s mentor and fellowship director— serving as one of three co-chairs.

The commission’s aim was “to develop the best evidence on the state of surgery worldwide, to study the economics of surgical and anesthesia care delivery, and to develop strategies for improving access,” according its website. With more than 500 individuals from 110 countries, the commission has expertise in surgery, anesthesia, obstetrics, oncology, health care policy, finance, economics, and research.

“The challenge with global health going back to the early 20th century is that it has not been focused on surgery,” and, most notably, not on building strong health systems, comments Raykar. Long considered too complicated and expensive to do in lowresource settings, “we have started to look at what surgery provides. And we realized that more than a third of all human disease requires some surgical expertise or evaluation.”

That the fellowship began its work with the commission just as Raykar came onboard was sheer serendipity. “I came in at the perfect time,” says Raykar, who spent a good portion of his fellowship traveling the world, conducting research, gathering data, and meeting with high-level policymakers, including ministers of health and finance as well as officials from the World Health Organization and the World Bank. In April 2015, the commission’s 32,000-word report, entitled “Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development,” was published.

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Raykar was one of the report’s four principal writers.

By serving as a roadmap, of sorts, for heads of state and other stakeholders to follow, the report expresses the vision of a new era when surgical interventions are seen not as a luxury but as an “integral, indivisible component of a properly functioning health system” everywhere. In addition to making more than 100 recommendations pertaining to health delivery, workforce training, information

Committed to fighting threats to public health worldwide, Glenn Fennelly, professor and chair of pediatrics, says: “If infections like tuberculosis, HIV, and Zika virus exist anywhere, we are at risk everywhere.” management, and finance, the report, notes Raykar, also offers “a structured, systematic framework for how to improve a health system, looking at five domains of surgical systems and health systems.”

Raykar opted to stay with the fellowship a third year to play a role in implementing the report — set to take place over 15 years. He and his team are currently working with the governments of Zambia, Cape Verde, and India.

As Raykar prepares to resume his residency in June, he has his sights set on a career working on health equity issues in the U.S. and beyond. In the meantime, he is grateful to have been part of the commission’s work and the life events leading to it. “I’m so thankful for my experiences at NJMS and the strong mentorship of Drs. Dorian Wilson, Anne Mosenthal, Caryl Heaton, and Winthrop Dillaway.” ●

Long & Winding Road Continued from page 9

Badheka says the format for the evenings has grown progressively more informal. Students particularly like “speed networking,” a concept not unlike speed dating. The idea is for one panelist and one student to chat for a short time, and then move on to another pairing. If there’s “chemistry,” the hope is that panelists, many from New Jersey’s pharmaceutical industries, will help students with their job search.

All four events in 2015 — including a panel from Bio NJ and an event featuring human resources professionals from Novartis — have been “awesome,” says Badheka.

“I’ve been on Cloud 9.”

This spring, Badheka hopes to successfully defend her dissertation and find a job.

Like any thoughtful leader, she has planned for this eventuality and has collaborated with team members who will carry on the work of the Alliance when she leaves.

In the meantime, a workshop planned for May will teach participants how to write a Linkedin profile to attract the attention of employers. A session with a professional photographer will follow. Badheka’s ideas flow fast and furiously as she looks ahead.

One program she envisions will host 10 mentors to come to the school for several hours with students signing up for half-hour mentoring sessions. Her team will meet with each student to go over resumes and discussion topics prior to the mentorship session.

“There’s been such interest in this program that we are already planning a second date,” she says.

What awaits Badheka after she earns her PhD? She doesn’t know yet. It could be post-doctoral work in her current lab. Or she might move on to do tech transfer or research in industry. Or she could happily envision a future in a university career development office. The founder of the Rutgers Alliance for Career Advancement sees an array of attractive career possibilities where before she saw just one. ● JOHN EMERSON

njms people…do you know?

Up-and-Coming Research Leaders AIM E E B EAULI EU

Finding Pieces to the Immune Puzzle

BY MARYANN BRINLEY

A

imee Melissa Beaulieu, PhD, fell in love with the unsolved mysteries of science when she was a college student at Colgate University. “I got involved in a chemistry lab during a summer program and with that first taste of bona fide research, I loved it. I absolutely loved it…the investigation of it… the puzzle solving…the real excitement of chasing down answers.”

The newest Rutgers New Jersey Medical School Chancellor Scholar, Beaulieu describes herself as a cellular immunologist who is “very interested in how the cells of the immune system protect against infection and promote wound healing in the aftermath.” She arrived in the Department of Microbiology, Biochemistry and Molecular Genetics on October 1, 2015, and calls her position in the Center for Immunity and Infection (CII), a division of the Institute of Infectious and Inflammatory Diseases (i3D) “an incredible opportunity with great support that allows me to explore interesting and riskier, cutting-edge areas of lymphocyte biology.” Her path to this career point has been “long but not necessarily straight,” she laughs.

After graduating from Colgate in 2000, she took a position at Pfizer as a medicinal chemist in a group interested in the mechanisms of the inflammatory process and diseases like arthritis. “That is where I got turned on to immunology and became fascinated, driven by basic curiosity about how the immune system works, how it causes K E I T H B . B R AT C H E R , J R .

disease and protects against disease.”

Three years later, in 2003, she went back to school for a PhD at Cornell University. “I wanted to focus on immunology because this is the thing that fascinates me the most.” As a doctoral student, she studied the “most lethal human bacteria, Mycobacterium tuberculosis (TB), and it was pretty exciting to work with this pathogen, given its devastating role in human health.”

After earning that PhD in 2009 in immunology and microbial pathogenesis, she did two post-docs at Memorial Sloan Kettering Cancer Center in New York where she discovered new regulatory pathways involved in anti-viral immunity by Natural Killer (NK) cells. These days her focus is on that subset of immune cells, “the lymphocytes we don’t usually consider when we think of the immune system, not the T or B cells,” but those NK cells, as well as the newly discovered innate lymphoid cells (ILCs), that function at the interface of innate and adaptive immunity. In addition to defense against viruses and certain types of cancer, “we know that innate lymphocytes are very important for maintaining barrier functions in the body under natural conditions as well as after infection in places like the gut, the lung and the skin.” Right now, she has a project studying influenza in the lungs, trying to understand how NK and innate lymphoid cells defend against it and promote healing. “A lot of what we know about the immune system

originated in the context of infectious disease but any knowledge we gain in one setting always informs another,” she explains.

Beaulieu is the recipient of numerous honors and awards including two National Institutes of Health/ National Institutes of Allergy and Infectious Disease (NIH/NIAID) Training Awards, and more recently, an NIH/NIAID K22 Career Transition Award.

Back at Colgate, she even won the Baldwin Greek Prize. “Yes, I was studying chemistry but also ancient Greek of all things,” she says. She is a member of the Society of Natural Immunity and the American Association of Immunologists, and her most recent publication in Nature Immunology, “The transcription factor Zbtb32 controls the proliferative burst of virus-specific NK cells responding to infection” exemplifies the current research focus of her lab.

“There are all kinds of pathogens we are always fighting off and certainly malignancy seems to be part and parcel of normal tissue growth. Our immune system is constantly weeding it out. It is really amazing what we don’t see and what never really comes to the point of being symptomatic but it’s definitely there,” Beaulieu says. “The reality is: the more we learn, the more we realize that our bodies are very busy.”

Even the commute from New York to New Jersey, which can be “long,” she laughs, especially on the way home from Newark to the upper east side of Manhattan, doesn’t dim her enthusiasm. “This NJMS Newark research group is so brilliant, with such highenergy. My fit couldn’t be more perfect. I absolutely love it.” ● RUTGERS NEW JERSEY MEDICAL SCHOOL

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njms people…do you know?

ELY ON OBAMEDO

Humans of NJMS

BY EVE JACOBS

W

hat does it mean to be a “human” of NJMS? The answer seems to be evident. But for Elyon Obamedo, second year medical student and budding photographer, the extended family of Rutgers New Jersey Medical School (NJMS) was in need of a better way to connect to one another and he had a vision of how to do that.

Photography speaks to him in a way that words do not. “Pictures are the conversation you would have if you already knew a person — really knew them,” he explains.

“You see people’s raw emotions, their vulnerabilities.”

Elyon’s parents emigrated from Nigeria to Lewisham, England, where Elyon was born, and then settled in New Jersey with their four children in 1996 when Elyon was 2 1/2-years old. His father, a computer

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network engineer and pastor, and mother, a registered nurse, founded the Ministry of the Word International and House of Prayer on Broad Street in Newark about 20 years ago.

It’s thriving and his father has become the full-time pastor there.

Elyon says his parents always valued education, but never pressured their children. “I learned to read when I was very young. My father and I always read together,” he remembers. Elyon did not need pressure to excel. He graduated from Union High School with a 4.2 average in biology. Additionally, he had a talent for art, so considered a career in architecture, but ended up graduating magna cum laude from Rutgers College, Newark, with a major in biology and a minor in chemistry.

It was his four-year stint as a runner

and hurdler for the Rutgers–Newark men’s track & field program that introduced him to the profession of medicine.“I worked with a trainer for many years and came to understand the body as a system, a whole,” he says. “Then I was injured severely enough that I couldn’t run and couldn’t perform.

I got to see the helping side of sports medicine.”

In addition, his father’s words increasingly made good sense to him: “He said to ‘choose a noble and respectable field. If you’re rich and successful, no one will remember that.

Do something that impacts and helps other people.’”

Doctoring seems to fit the bill; and orthopedics or some facet of sports-related medicine is high on Elyon’s current list. “But I’m keeping an open mind,” he says.

His “open mind” and artistic eye are at the heart of the Humans of NJMS Website that he created about a year ago. With a brandnew DSLR camera in-hand, Elyon started taking pictures—lots of pictures—in 2013.

He taught himself to use the camera and found that he loved the art of picture-taking.

He took pictures of people running, people laughing, people ruminating, the same person from many different angles. And what he started to see through his lens were raw emotions — what he calls “immediacy”— that were often not evident in everyday life.

“Diversity,” he says. “In Newark, we’re all about diversity— diversity of cultures, diversity of backgrounds, diversity of beliefs, diversity of emotions.”

Elyon sees the camera as a tool for letting people open up about their vulnerabilities. “It’s a way to establish twoway communication that is not bundled in bureaucracy,” he says. “The photos find the gems of interactions and capture something essential.”

Now that the Website is established and has 372 “likes,” Elyon is recruiting others to work on it with him. His goal is to make it a club of “like-minded students.”

“It’s about resonance—knowing you’re not alone in whatever you’re struggling with whether you’re a student or a patient,” he K E I T H B . B R AT C H E R , J R .

says. “It’s about getting to know people better— all kinds of people.” (l) Heather Wurtz smiles for photographer Elyon Obamedo; (bottom) The Humans of NJMS Website features life — in all its variety— at the medical school.

Heather Wurtz

H

eather Wurtz is one of the faces you see on Humans of NJMS. She and Elyon have become friends, unlikely friends.

He’s 23, just starting out; she’s 40- something, married and a mother of three. She’s from Minnesota; he’s from New Jersey. He’s African American; she’s white. He’s been in school most of his life; she took a 13-year break. The list goes on and on. But they are both second-year students at NJMS and both are seeking something beyond their professional training.

Her father was a neonatologist who, she remembers, was “passionate” about his work.

Her mother was admitted to medical school, but did not attend. “She supported her young family,” says Heather.” My childhood was great. We did a lot of biking and hiking.”

Heather was a psychology major at Grinnell College in Iowa—the alma mater of both her parents and her mother’s two sisters—and was on the swim team. It was where she met her husband. With an eye on medical school, she stayed on another year to work and take courses. Over the next two years, she moved to North Carolina, got married, and then moved to California, where she worked, took courses, prepared for the MCAT (Medical College Admission Test), and applied to medical schools. But it was not to be.

Her mother had a recurrence of metastatic breast cancer in 1999, and Heather decided the time was not right to begin such an arduous course of study. Over the next several years, her husband finished his PhD in organic chemistry at Cal Tech and they had their first child, Alexander. They then relocated to Switzerland for two years, where her husband did a postdoc and they had their second child, Lilly. The family returned to the U.S. in 2004, and had another daughter, Anna, in 2006. Meanwhile, Heather’s mother did well for 11 years before she died of her disease.

Elyon Obamedo, founder of the Humans of NJMS Website says: “The camera is a way to establish two-way communication that is not bundled in bureaucracy.

The photos find the gems of interactions and capture something essential.”

Heather says she always figured she would go back to school when the children were older, but she had more or less given up on the idea of doctoring. When her youngest child started first grade, she figured it was “now or never.”

“But I thought I was too old to start medical school. I thought that ship had sailed,” she says. It took a couple more years of college-level science classes, and a Princeton Review course, to prepare once again for the MCATs and to present a convincing case to the medical school admissions offices. “I took biochemistry, genetics, cell biology, the first semester of organic chemistry, microbiology, and I did very well.”

Everything fell into place— great MCAT scores, excellent marks, a supportive husband, and an admissions team at NJMS that recognizes the value of building an incoming class of talented individuals with diverse backgrounds. Passion for doctoring is high on their list of what counts most.

Heather joined the class of 2018, along with Elyon, who recognized they were

simpatico despite their obvious differences.

Heather says she sometimes feels like a parent to the students — her oldest child is 16 now. But she concedes that the other students don’t treat her any differently.

Anatomy class—where teams of students actually face mortality, many for the first time—is frequently the place that first-year students make their deepest connections.

Elyon and Heather were part of an anatomy study team and discovered new aspects of their humanity together. “He got to know me pretty well— and I got to know him,” she says.

As both struggle through the end of year two and contemplate their future lives as physicians, Heather and Elyon share the knowledge that for them what really counts is beyond the massive volume of information they have struggled to store in their brains.

It’s in the faces of those who will look to them in the future for excellent medical care and empathy, and also in the faces of all of the “humans” with whom they share their daily lives at NJMS. ● RUTGERS NEW JERSEY MEDICAL SCHOOL

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njms people…do you know?

THE CH UR R A NG O B R O THE R S

In My Brother’s Footsteps

BY EVE JACOBS

(l-r) Gustavo and Jose Churrango

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his is the story of two young men, born in Peru, who personify the life-changing potential of the American dream. As young children, they immigrated to the U.S. with their parents and settled in Newark. Twentyfive years later, Jose and Gustavo Churrango stand as notable examples of what can be achieved through determination, sheer hard work, and family support.

Jose, the oldest of four siblings (two boys, two girls), has an easy manner and ready smile. He was 10 years old when the family settled in Newark. He remembers that he “started to flourish in high school” at the

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Chad Science Academy whose founders worked to “create a symbol of hope in the heart of Newark that would provide inner city children with a good education and pride in their roots to help them succeed in the world.”

As one of those students, Jose excelled in the sciences, and ventured forth following his freshman high school year to participate in the Hispanic Center of Excellence at Rutgers New Jersey Medical School (NJMS).

This program seeks to improve the health of Latinos, as well as other underserved communities, by increasing the number of Lati-

nos in the health care professions, particularly medicine. For Jose, his post-freshman summer experiences were a real eye-opener.

“I shadowed surgeons performing procedures and took an anatomy course where I worked on a human cadaver. I was just 14 years old,” he says. He met Hispanic medical students and physicians, among them Professor of Medicine and Vice Dean Maria Soto-Greene, MD, an alum of Douglass College and a 1980 graduate of NJMS, who has served as director of the Hispanic Center of Excellence (HCOE) for more than 20 years.

K E I T H B . B R AT C H E R , J R .

“She was my role model and my inspiration,” he comments. “I saw someone who had had experiences similar to my own, who had become a success and was passionate to give back to her community.”

“That made it real. I saw for the first time that a career in medicine was reachable and possible for me,” he says. But coming from “a poor community with few resources,” he understood that in order to reach his goal, he would need ongoing support and guidance.

It was the HCOE that introduced the high school student to the possibility of attending Cornell University. “They took us to visit colleges and one of the trips was to Ithaca,” he says. “That trip made such an impression on me. I decided that’s where I wanted to go to college.”

Jose applied and was accepted to Cornell, where he majored in biology and Spanish literature, and minored in Latin American studies, graduating in 2001. With medical school always on his radar, he decided on a nontraditional route to get there.

“I knew medical school would be arduous, and I wanted to have the right mindset to start and complete my studies, and to pursue medicine as a career,” he says. So, he first spent two years studying public health at Columbia University’s Mailman School and then worked for more than a year at the Department of Health in New York before entering NJMS. That time between college and medical school “allowed me to gain a different perspective, a more global view of health care,” he explains, “and I saw the community perspective with a new set of eyes.”

In 2005, he began his arduous journey.

“School, home, eat, sleep, and get up and do it all again,” he states. “But medical school is an experience you will always remember.

And I understand now that medical education is an endless pursuit to gain an understanding of science and health.”

Now 37, Jose has a job lined up with a large, multidisciplinary group practice in Middletown, NY. “This will be my first official job after 11 years of medical training,” he says. He graduated from medical school

in 2009, finished a residency in internal medicine in 2013, and will complete a fellowship in gastroenterology in June — all at NJMS. His wife, Dorothy Castro, MD, whom he met during his freshman year at Cornell, also earned her degree from NJMS and is a hospitalist at University Hospital. “We did everything together,” he comments. “We complemented and supported each other.”

They are parents of an 8-month-old.

“The Hispanic Center of Excellence at NJMS has been family to me. They have been in my life for more than 20 years,” he states.

“We get a lot of clinical experience here compared with other places; we take care of very sick patients; and I don’t think the patient diversity can be matched in many places.”

“They believed in me,” he says simply.

“Sometimes that’s all you need. There were people here who believed that I would be able to do it,” and he did.

Jose’s younger brother, Gustavo, was 7 years old when the family settled in Newark.

He spoke no English, but quickly learned the language when he was enrolled in the public schools. “Seeing my brother doing the science-based summer programs at NJMS paved the way for me,” comments Gustavo.

So, as soon as he was of age, he decided to follow in his brother’s footsteps.

Gustavo attended Science High School in Newark, and like his brother, spent summers at NJMS involved in HCOE programs. He went on to Rutgers College, New Brunswick, where he majored in biology and minored in history. His MCAT scores were excellent, so he “applied everywhere,” but decided on NJMS. “It was in Newark; it was

familiar; and my brother and his wife were here,” he says.

While Gustavo liked every rotation, he decided on surgery, completing two years of a surgical residency at Westchester Medical Center in Valhalla, NY, before returning to Newark to once again follow in his brother’s footsteps. He will complete a residency in medicine in June and then begin a fellowship in gastroenterology at the University of Massachusetts.

Like his brother, he credits the HCOE and its director with “always helping to steer me in the right direction. Dr. Soto-Greene has always been there for me. She was very influential in me returning here for my residency.”

Having enough time for “patient interactions” is as high a priority for Gustavo as it is for Jose. It was what was missing for him in the practice of surgery. Gastroenterology will afford Gustavo the opportunity to establish relationships with many of his patients, as well as practicing the procedures required by this specialty, which he also enjoys.

He gives his NJMS education high marks.

“We get a lot of clinical experience here compared with other places; we take care of very sick patients; and I don’t think the patient diversity can be matched in many places,” he states.

Gustavo is married to fellow Rutgers College alum Dorothy Ann Churrango, now a school nurse, and they have a 2-year-old son and another child on the way.

Jose was the first one in the family to attend college and medical school, and Gustavo followed just a few years later. Now, like the Hispanic physicians who showed them that a career in medicine was, in fact, a possibility for immigrant children from Newark, they stand as stellar examples of what can be achieved.

Jose says he has learned that this profession is “not just about science and procedures,” but just as much about “giving good care, making a positive impact on whatever community I serve, and always spending time listening to patients and providing them with emotional support.” His brother Gustavo is right there with him. ● RUTGERS NEW JERSEY MEDICAL SCHOOL

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WO

A Woman’s

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n this presidential election year, Americans are enthralled with the steady stream of statistics produced by almost-constant polling. Perhaps a little less exciting, but interesting nonetheless,

are the numbers recently released by the Association of American Medical Colleges (AAMC) illustrating the faculty make-up of our nation’s medical schools. While 47 percent of current medical students are female, women professors are vastly outnumbered by men at medical schools across the country. However, their numbers are rising. In 2013 –14, women accounted for 21 percent of full professors —7 percentage points higher than 10 years earlier.

Where does Rutgers New Jersey Medical School stand?

Quite near the top, according to the AAMC’s recent report, “The State of Women in Academic Medicine: The

ORK

By E ve Ja cob s

JOHN EMERSON

Pipeline and Pathways to Leadership.” At number 19 on a list of 130, NJMS is way ahead of most U.S. medical schools, including such eminent institutions as Harvard, Yale, Stanford, and Johns Hopkins. But what does this figure mean to the NJMS women who hold the title of full professor? Pulse magazine interviewed several of them to hear their “take” on what it means to be a woman-leader in academic medicine in 2016.

A FEW OF THE WOMEN PROFESSORS AT NJMS: (l-r) Constancia Uy, MD; Vice Dean, Professor of Medicine, and ELAM graduate Maria Soto-Greene, MD; Professor Emeritus and ELAM graduate Carol Newlon, PhD, who served as chair of the Department of Microbiology and Molecular Genetics and associate dean for faculty affairs; Chantal Brazeau, MD; Vivian Bellofatto, PhD; Debra Heller, MD; Professor of Medicine and ELAM graduate Nancy Connell, PhD; Lisa Dever, MD. Not pictured: Anne C. Mosenthal, MD, and Vanessa Routh, PhD.

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CONS TANCIA UY, M D

LISA DE VE R, MD

It was 1968 — just after the Newark riots — when Constancia Uy joined the NJMS Department of Pediatrics, after graduating from the University of the Philippines’ medical school and completing a oneyear internship at Evan Deaconess Hospital in Milwaukee. She is the oldest of 16 siblings.

Residency was very demanding, she remembers, and that was followed by a fellowship in pediatric nephrology. Uy was the first fellow in her specialty in New Jersey and was recruited to join Children’s Hospital of New Jersey–United Hospitals Medical Center in Newark, which closed in 1997. During her time there, she served as interim chair of pediatrics and also held the positon of president-elect of its medical staff.

“There is a lot of kidney disease in children,” she says, but only 11 pediatric nephrologists in the entire state. Over the decades, she has dedicated much of her professional energies to preparing the next generation of physicians.

Constancia Uy She proudly points to 11 Golden Apple awards mounted on her office walls, a surefire indication that medical students appreciate her teaching. And in 2008, she was elected to the University’s Master Educators Guild, a small, select group of top teachers. Working with medical students and residents is “a great joy for me,” she says. “I love teaching.”

According to her daughter Natalie, a 2008 graduate of NJMS who followed Uy into pediatric nephrology after much soul-searching, “Teaching is what keeps my mother young.”

But leadership in academic medicine most often comes with a heavy dose of administrative responsibilities. Uy became her department’s first and only vice chair for clinical affairs in 2009, and prior to that, served as the medical school’s acting associate dean for student affairs for one year. “Women do have a harder time going up the ladder,” she states, “because they have been expected to take care of the children, the household, and the family. It’s a constant struggle to find time to do research and write papers.”

However, she managed to do it all, even taking on leadership roles outside the university as president of the Nephrology Society of New Jersey; president of the New Jersey Medical Women’s Association; president of the Philippine Pediatric Society in America; and secretary of the Academy of Medicine of New Jersey for six years. In 2004, she received a national award of excellence from Philippines President Gloria Macapagal-Arroyo, and that same year, received the New Jersey Woman of Achievement Award. Other awards have followed.

In my case, she says, “My parents moved to the U.S. to help raise our daughter and two sons, and that was a blessing. Women can do it all — it’s just harder.”

A native of the Lone Star State—where she was raised and educated from her undergraduate degree through chief resident in infectious diseases — Lisa Dever says she likely would have stayed put, but “I fell in love.” She followed husband Waldemar “Buzz” Johanson to New Jersey when he became professor and chair Lisa Dever of medicine at NJMS in 1992. Initially, research called to her and Dever worked on an animal model of pneumococcal meningitis for one year at Rockefeller University before beginning a job at the Veterans Affairs Medical Center in East Orange, where she stayed for 12 years.

“There I discovered my love for taking care of patients and I made a difficult decision not to do bench research,” she remembers. Clinical research became part of her portfolio, and she introduced new HIV drugs and antibiotics to veterans, and was part of the medical center’s cooperative trials on Gulf War illness. “The veterans are great patients, so altruistic,” she comments.

Shortly after their arrival in New Jersey, Johanson became ill, and the “set-hours and controlled job provided a work-family balance,” she says. “I could be there for him when I was needed.”

When Dever relocated to NJMS in 2005 to become the infectious disease fellowship director— not long after the death of her husband— she had already been on the medical school faculty for 11 years.

“This place is incredible for teaching clinical infectious disease,” she comments. “We have a lot of work and it’s challenging, but you can make a big difference on a day-to-day basis.”

Dever says she needed “a little push” to pursue a full professorship, and she was “very fortunate” to have had a mentor who did just that.

“Women are often self-effacing and tend to be very collaborative,” she observes. “We want to be seen as accommodating and we like to make everyone happy.” Humility was a lesson she had learned in her family as a young child.

“When we don’t talk about our accomplishments, it can be to our own detriment,” she says. “And we’re often not willing to voice our opinions. Women tend to serve. It’s what we do.”

Dever says there are many women faculty members in the Department of Medicine (although she thinks she is the only female clinician who is a full professor) and there is a lot of support among women for each other. “There is so much work to do here,” she says.

“We share a mission to our patients, to our students, and to each other.

People in the department help and nurture each other.”

Her advice to younger women: “Speak up. Join. Get involved. Have confidence in yourself and others will too. Be of service, but don’t allow yourself to be taken advantage of. And go after leadership positions.”

Even recently, she says, she needed a push from her department

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chair, Marc Klapholz, to take on the vice presidency of the Infectious Diseases Society of New Jersey. She is now president-elect. “As leaders, women offer unique qualities that can make a difference,” she states.

“Have confidence in your own self-worth.”

DEBR A HE L LER, M D For pathologist Debra Heller, doing what you love and maintaining a family life and work balance are key elements in a happy life. Hers has been very happy. Also essential are support systems — both family and professional. “Whether you are male, female, or eggplant, you need these supports,” she says, “but more so for women.”

Heller raised two sons, both of them now physicians. “We need men to be hands-on with kids,” she says. “I was lucky. My kids’ father was very hands-on. As I matured, I realized that being a house-person — whether male or female — is a tough job.”

Heller completed an obstetrics-gynecology residency in 1981, practiced for three years, and then did a second residency from 1985 to 1988 at Mount Sinai, specifically to become proficient in gynecologic pathology. That was followed by a gynecologic pathology fellowship “created for me,” she says. She also trained in pediatric/perinatal pathology, so she is specialized in both areas. “For a nerdy kid who loves to read books and write, pathology is a perfect match,” she says.

At NJMS, where Heller joined the faculty as an associate professor in 1997, she worked her way up the ladder with few impediments, becoming a full professor in 2000 and earning tenure in 2003. “I am a clinician and an educator, not a basic researcher,” she says, “but I am academically active.”

She has served on the NJMS admissions committee for several years, works with residents on research, teaches pathology to medical students, and always exhibits her complex and Debra Heller beautiful quilts in the University’s art show each year. “I like to work with my hands,” she says simply.

Being a woman has never been an impediment to what Heller set out to do, she says. “I never encountered a ‘no.’ I wanted to rise and fall by my own merits, and I have.” But mentors — for different things — all along the way, wonderful colleagues, and a “village” to provide back-up at home have been crucial to her professional success.

“My mother was achievement-oriented and pushed me,” she remembers. “No one ever told me I was the weaker sex until I reached college, and it never occurred to me.”

Heller says she has never experienced sexism in her medical career and “I haven’t witnessed it at all. It hasn’t been easy but I’ve worked hard and gotten everything that I’ve ever wanted professionally.”

JOHN EMERSON

C HANTAL BR AZE AU, MD As a professor of family medicine and psychiatry, Chantal Brazeau’s academic career “has always been a hybrid.” Born and raised in Canada, she earned her MD degree from the University of Ottawa in 1983, followed by a family medicine residency, which she started in Canada and completed in New Jersey. She then practiced in a family medicine group practice for five years before entering the NJMS psychiatry residency program, which she finished in 1995. “I have always enjoyed counseling people,” she says, “and people have always come to me with their problems. I provide psychiatry services in a family medicine setting.”

The teaching part of the job “grew on me,” she remembers. Empathy is a quality she tries to teach medical students, as well as self-care and the importance of the doctor-patient relationship. In 2001, she accepted the position of director of medical Chantal Brazeau student education for her department and in 2012 became the interim chair. “Education was my avenue to becoming a professor,” she says, “which is highly unusual.” However, along the way, she wrote and was awarded many training grants, and presents nationally on curriculum changes, burnout prevention, physician and medical student well-being, and survey-based research of medical students.

“Most of my work is in education,” she explains. “An educator’s portfolio — including samples from a period of years — was an important part of my promotion process.” In 2005, she took an active role in revamping the NJMS curriculum.

In April 2015, Brazeau graduated once again — this time from the Executive Leadership in Academic Medicine Program (ELAM) at Drexel University School of Medicine. It’s a year-long, part-time fellowship to help women faculty develop management and leadership skills, with particular attention paid to the unique challenges faced by women in medical, dental, and public health schools. Before applying, she had discussed the program with two NJMS faculty members who had completed the fellowship in prior years. Each fellow must be supported financially and mentored by her school.

“The experience was intense and really fabulous,” she says. Women come from all over the U.S, Canada, and South America. The 40 plus women who participate each year are organized into eight learning communities. “You develop a kinship with the women in your class, which does not end when the course is over.”

Participants also learn about finance, organizational dynamics, leadership styles, and “how to see the forest rather than the trees — a way of thinking about the bigger picture,” Brazeau explains. “You are required to organize interviews with leaders in your own school, which provide insights you would not ordinarily have.”

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Each participant takes on a major project. Brazeau developed a survey on faculty well-being and faculty retention and is in the process of analyzing survey results now. She will present her findings to NJMS administration and department chairs.

“The main objective is to give back to your school. We learned a lot about leadership differences between genders. Because only women attend, we were able to discuss things more easily than we could have with men,” she says. “It was definitely a journey of self-discovery.”

Money to support science is also getting scarce, she points out.

“This is what I tell would-be researchers. ‘If you have fire in your belly, then do it. But if you don’t have that passion, you can find an easier way to make a living.’”

“It’s tough to be a researcher and it’s getting harder,” she states.

However, Routh says she still feels passion for her research: “There is nothing more rewarding than constantly trying to understand new things and teaching young minds.”

VA N E SS A R OUTH, PhD

VIVIAN BE LLOFAT TO, PhD

A horse farm in the foothills of the Sierra Nevada Mountains in California seems an unlikely setting for the early, “formative” years of a laboratory scientist. But this valedictorian earned her Bachelor of Science degree at the University of California at Davis with the intent of applying to veterinary school. However her goals changed abruptly when she met Barbara Horwitz, “an inspirational teacher and a brilliant scientist.” After convincing Dr. Horwitz to accept her as a graduate student, Routh went on to earn her Master’s and doctoral degrees in physiology before moving to Maryland in 1993 with her then-husband.

In 1995, she came to Newark to join the lab of neuroscience researcher Barry Levin as a postdoctoral fellow, and except for a five-month stint as a visiting scientist in Aberdeen, Scotland, she’s called New Jersey home.

She credits “research funding luck,” incredible mentors, a highly supportive departmental chair, and sheer hard work for her rapid rise from assistant professor in 1998 to associate professor with tenure in 2003 to full professor in 2010.

The Department of Pharmacology, Physiology and Neurosciences is “50-50 men and women,” she says. “There’s no chauvinism here.

Women have not been underpaid in Vanessa Routh this department, and when we ask for resources, we get them. Our chairman — Andrew Thomas — is gender-blind.”

What she has noticed when she serves on committees is that there are fewer women at the medical school in leadership positions. This mirrors what she sees on a national level. “In a study section at the NIH, there are just 25 to 30 percent women,” she says. “I’ve gotten used to sitting in a room full of men. It hasn’t changed that much in 20 years.”

What really disturbs her is that women with children suffer in the research world. “When I consider women in my age group, most who succeeded in academia never had children,” she says. “The men my age all have kids and their partners have flexible jobs. The truth is that if you are a woman who wants to have a family, it will hold you back in the research world. I don’t know how that will get better.”

Vivian Bellofatto knew right away that science is “what I am,” she says.

“You see a tree and you think ‘how does this grow and sustain itself?’”

Her college mentor was a brilliant woman scientist, she remembers, and “also my idea of normal. She had a husband, children, a real house, and was always gracious, caring, kind, and out to make sure I learned about the wonderful world of scientific research.”

It was during a college summer that Bellofatto had the “incredible opportunity” to work at Rockefeller University, followed by a realization after college graduation that she craved the academic life. She went to Albert Einstein College of Medicine, which she describes as “a hub, a place where there were a lot of successful European women. I had a female advisor who was open to ideas, set up an excellent working environment, and demonstrated how to work effectively in an academic medicine environment.” Bellofatto earned her PhD in 1984 and published her first Proceedings of the National Academy of Sciences paper that same year.

She married halfway through graduate school and moved to Rockefeller University to do postdoctoral research. “It’s a visionary place, an environment that supports people to do the impossible--to look at the long-term goals of science.” She had her children there, and “stayed a long time. The supportiveness of my advisor was incredibly important and instrumental to my success.”

In 1995, Bellofatto came to NJMS. She says: “Harvey Ozer made all the difference. His attitude was when somebody wins, we all win.”

Ozer, who died in September 2015, served as professor and chair in the Department of Microbiology and Molecular Genetics starting in 1988, and was also senior associate dean for oncology programs.

Bellofatto says she moved up the ranks like her male colleagues.

“It never mattered that I was a woman. Intelligence and hard work mattered; gender did not.”

When her attorney husband began to work at home, it freed her in many ways. “He was the stay-at-home parent starting in 1995. He did Scouts, soccer coaching, community engagement, and doctors’ visits,” she states. “I couldn’t have had such a normal and happy family life otherwise.”

In 2005, Bellofatto became vice chair of research for the Department of Microbiology, Biochemistry and Molecular Genetics, and in 2009, she felt ready for a new challenge. She wanted to learn more about

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moving ahead as a leader, and was encouraged by Carol Newlon, who was chair of the department at that time, to enter the ELAM program, which she did in 2010. For her ELAM project, she worked with Andrew Thomas, senior associate dean at Rutgers Graduate School of Biomedical Sciences, to reconfigure the doctoral program to be more discipline-focused rather than department-focused, a change that has proven very successful. In 2014, Vivian Bellofatto Bellofatto became interim chair of her department.

“I put a lot of energy into being a good chair,” she says. “I try to create an environment where collaborations can develop, science moves forward, and people are free to pursue their goals. Seeing people in my department succeed is the measure of my success.”

What is her advice to women scientists? “Your partner choice is the most important thing in the world,” she says, “and being resilient is also crucial. And while it may be convenient to remain a sidekick, push yourself out into the world and always learn new things.”

ANN E M O SEN THA L, M D When Anne Mosenthal was named chair of the NJMS Department of Surgery in 2014, there were only six women surgery chairs in the more than 140 medical schools nationwide. Since then, the numbers have increased but not astronomically. When she graduated Dartmouth Medical School in 1985, there were 15 women in her class of 65 and “less than a handful of them chose surgery,” she says. “I remember being told, ‘Surgery is not for women.’” But Mosenthal was determined to defy the stereotypes, choosing a field where she would “take care of really sick and critically injured patients” and also teach up-and-coming surgeons.

At the University of Massachusetts, where she completed a general surgery residency in 1990, three of her fellow female surgery residents dropped out, leaving just two women in her year. “It was very tough,” she remembers. “You were required to suppress your personality and your femininity.” Mosenthal went on to complete fellowships in critical care and surgical endoscopy in 1992, and was recruited to NJMS that same year.

The surgery chair says she never had aspirations to be a leader. “I was so focused on the process. I spent a lot of energy fitting the mold.”

It is that very mold —“defined by men”— that she sees crumbling for both women and men. Mosenthal wants to help define a new path for future surgeons, one that allows concessions for “a life” outside of the profession, including raising a family.

“We need changes in promotion guidelines, a slower pace, for L E F T: J O H N E M E R S O N ; R I G H T: N I C K R O M A N E N K O

instance, that allows for having a family,” she offers. “That was never discussed when I was coming up.”

Mosenthal began to envision herself as a potential leader mid-career, first setting her sights on reshaping trauma care at University Hospital, the principal teaching site for NJMS. “When you find something you’re passionate about, you want to be a leader. You want to invest yourself in making certain things happen.” She collaborated with advanced practice nurse Patricia Murphy to create a palliative and end-of-life care program to address the unmet needs of trauma patients and their families, whose lives often change suddenly and radically. The team presented their work at national meetings, helping to define Mosenthal as a pioneer.

In 2010, with both of her own children in high school, Mosenthal applied to ELAM and began thinking that she could be a leader in a bigger way. “I hate when things are unfair,” she says. “Injustice propels me.” Shortly after completing the program, she became vice chair of surgery, learning the “business side” of academic medicine, and was also asked by the dean to head-up the strategic planning process for NJMS, which taught her the value of building a strong team. In 2011, she was suddenly thrust into the role of interim chair of surgery, which, she says, “was very strenuous and scary. Yesterday, I was everybody’s peer and then all of a sudden I was in charge.”

But she weathered the storm, proving herself hardy and effective, and was named chair of surgery in February 2014. Her initial departmental goals of creating financial stability Anne Mosenthal and a positive culture are well on their way. Now, she is working “to grow the department financially with sustainable programs, introduce more health care delivery research, and advance simulation training.”

Mosenthal can also direct more of her attention now to helping develop women leaders. “I am the only female full professor in the department, there are no female associate professors, only junior faculty,” she says. “We are missing an entire generation.”

“More women are choosing surgery, but few are advancing into leadership spots,” she states. She thinks that’s because women are opting out of the career ladder to raise a family; women are not perceived as in charge and not being given the same opportunities; an unconscious bias exists against women as leaders; and there is a perception among women that they have to be more masculine to succeed as leaders — with some being unwilling to do so.

Mosenthal is striving to redefine “a woman’s work.”

“While always being mindful I am here to support everyone in the department, I want first and foremost to be a role model for women,” she says. “I want to show women opportunities they may never even have considered and let them know that anything is possible.” ● RUTGERS NEW JERSEY MEDICAL SCHOOL

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#Where

Twitter

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Medicine

Associate Professor Valerie Fitzhugh is a pathologist and an educator. She says that she never forgets that each slide she views represents someone’s life. “If you look at it that way, you never take the easy route on a case. You always put 150 percent into it to get the best outcome possible for that patient.” Meet the doctor whose quest to help others understand the importance of pathology is resonating with people from all walks of life. By Genene W. Morris

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n any given day, millions of Twitter users worldwide log onto the social media site to — in 140 characters or less — connect with friends; wax philosophical; peddle goods and services; and even watch how the latest celebrity feud is playing out. It is here, in this vast, virtual universe, where Rutgers New Jersey Medical School (NJMS) Associate Professor Valerie Fitzhugh, MD, has carved out her own little nook, teaching histology to anyone who’s interested, championing the work of pathologists, and amassing an impressive following.

One might assume that when Fitzhugh joined Twitter some seven years ago, this educator, whose sister is a teacher-coach and whose twin brother is an elementary school principal, had set out from day one to use the site as a teaching platform. Not so, says Fitzhugh. That idea, the 2004 NJMS alum admits, sprang from the unlikeliest of sources: heavy weight boxing champion and legend Lennox Lewis.

Fitzhugh’s chance encounter with Lewis came on the eve of her 2011 nuptials to now-husband Raivo Kull. “I happened to be tweeting and Lennox Lewis tweeted that he was looking for people to follow. He said, ‘If you do something interesting, I’ll follow you.’”

Not one to back down from a challenge, the 2000 Rutgers CollegeNew Brunswick alum and former NCAA Division 1 fencing athlete who captained the Rutgers Women’s Fencing Team for two years, JOHN EMERSON

answered the call with a tweet of her own. “I said, ‘I’m a pathologist.’

And he goes, ‘What can you teach me?’ I responded, ‘I can teach histology. I can show pictures of cool diseases.’”

It was in that moment, Fitzhugh explains, her Twitter feed shifted its focus, eventually surpassing the pathologist’s own expectations.

Since then, Fitzhugh has garnered more than 1,300 followers from around the world. She has also proven to be quite prolific at tweeting, posting nearly 40,000 tweets, many of which include histologic images that resemble something that one might find in an art gallery.

Fitzhugh, whose work in the subspecialties of musculoskeletal pathology and cytopathology has her diagnosing tumors in the skeletal and mesenchymal organs of the body as well as detecting diseases present in body fluids and on Pap smears, uses Twitter mostly to demonstrate the important role that pathologists play in medicine and to share slides with followers — which include fellow pathologists and pathologistsin-training, as well as lay people. Her posts include such messages as: Dr. Valerie Fitzhugh @DrFNA

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Feb 18

Every time I touch a slide, I touch a life. #Pathology #Medicine #MyCalling  19

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Dr. Valerie Fitzhugh @DrFNA

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Feb 12

Nuclear pleomorphism in a well differentiated liposarcoma #MDM2WasAmplified  20

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Dr. Valerie Fitzhugh @DrFNA

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Feb 4

Adenoid cystic carcinoma #ImportantToRecognize #MyPoorCrackedSlide  16

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While many of Fitzhugh’s posts concern her work as a pathologist, other messages show Fitzhugh to be a fisherwoman and outdoor enthusiast who revels in her other roles as a wife to Kull, a mother to toddler Mari Kull, and a “sports nut.”

In fact, on the day of the Daytona 500, Fitzhugh — who is as comfortable providing commentary on soccer matches and football games as she is on tweeting about confounding diseases — made it clear that other priorities were foremost in her mind: Dr. Valerie Fitzhugh @DrFNA

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Feb 21

Pathology friends—the Daytona 500 runs today. There may be a few race tweets mixed in. Bear with me; we’ll be back to the science after.

Especially gratifying about what she does on Twitter, says Fitzhugh, are the connections she makes with lay people, who thank her for raising awareness about different diseases, and with pathologists-intraining, some of whom she’s wound up interviewing at NJMS. “It’s nice to see them and hear them say, ‘Hey, Dr. Fitzhugh. I remember you. I follow your posts. They are really great.’ That part is really cool.”

For all the fun she is having on Twitter, Fitzhugh prides herself most on being the kind of pathologist who views each slide not just as a clump of cells, but as a person whose life depends on expert and accurate readings. This sentiment can be traced back to her early days in medical school, she says, when she watched her mother battle colon cancer and, eventually, succumb to the disease. Though, Fitzhugh notes, the experience did not guide her decision to become a pathologist, it certainly influenced the kind of pathologist she would become. “It has made me a much better physician. As long as you remember that every slide represents someone’s life, you will always do the right thing. If you look at it that way, you never take the easy route on a case. You always put 150 percent into it to get the best outcome possible for that patient.”

Now that her site and following are well-established, Fitzhugh has expressed a desire to meet another famous figure, as noted in a post: Dr. Valerie Fitzhugh @DrFNA

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One of these days I would love to meet @POTUS and speak with him about pathology and how important we are.  2

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And what would she say, exactly, to the nation’s head of state?

“I would explain to him what it is that pathologists do, because people just don’t know. I think most patients don’t recognize that when they have surgery, there’s a doctor who diagnoses their diseases.

Or if they’ve had blood drawn, a doctor analyzes many of those blood tests,” Fitzhugh states. “I think everybody assumes when you say you’re a pathologist, you only work with dead patients. My work is almost entirely for living patients.” ● RUTGERS NEW JERSEY MEDICAL SCHOOL

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OU

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aren J. Nolan approaches her life as a senior research scientist in the Human Performance

and Engineering Laboratory at Kessler Foundation with an infectious enthusiasm. Spend a few minutes talking with her and you also sense frustration. That patients who have suffered strokes, traumatic brain injuries, or paralysis. The statistics (in the millions annually) and outcomes (often less than perfect) for these personal disasters are disheartening.

THE

TOF

may be normal for any professional working with

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R I A H C IN N BR N A A RY

BY M

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Nolan has studied all kinds of tools, techniques, and technologies from neuro-prosthetic interventions and ankle-foot orthotics to virtual reality with the goal of getting people up and walking. But, she admits, “Patients can get stuck in the chronic stage, never really getting back to a healthy, fully independent life.” This is a woman who earned her PhD in biomechanics and anatomy from the University of Toledo and completed a fellowship in biomechanics and outcomes research in 2007 from the University of Medicine and Dentistry of New Jersey, is recognized internationally in the field of motor rehabilitation, and can speak with real knowledge about things like metatarsal pressure in hemiplegic gait. So why does she get frustrated? “Because what we want for patients is healthy walking,” she says.

Lately, the Ekso GT, a wearable robotic exoskeleton made by Ekso Bionics, is cause for optimism in her lab. “This is a very exciting area of research for us.” She is just beginning her second clinical trial of the motorized, bionic backpack with leg sections that stretch down the outside, strapping at the thigh, below the knee, and at the foot. “We have been incredibly fortunate in the last 18 months to have received considerable grant funding for this technology. I like to do randomized, organized, clinical trials that are very translational…going right to the patient and clinician,” she explains. She considers it part of her job “to really change the world of rehabilitation, to implement technology that is meaningful” and will make a difference. In January, the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) allotted Kessler $2 million, with $1 million going to Nolan to continue what she started in a pilot study of 62 inpatients who had suffered acute strokes.

By focusing on the safety, feasibility and the efficacy of using this remarkable robot in the first trial, Nolan’s multi-disciplinary team got “great data on whether it could actually be implemented in a clinic.

I could have taken the robot into the lab and done gait analysis on patients, studying their muscle activation, their loading patterns, how it really affected the mechanics of walking,” she says. That’s the sort of thing she loves. But practically speaking, certain questions needed to be answered first. Could a physical therapist use the Ekso GT in an appropriate block of time? Would patients like it? Is it safe? Is it an effective tool to use for recovery? “Honestly, I wasn’t sure if someone who had just had a stroke would be happy getting strapped into a robot,” she states. They were. In fact, patients using the Ekso GT felt more balanced, stronger, and were better at independent walking even later when not wearing the robot.

COURTESY OF EKSO BIONICS

RUTGERS NEW JERSEY MEDICAL SCHOOL

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The answers she and her team got were so positive that the new trial aims to include 98 acute stroke survivors. Nolan, who is an associate professor in the Department of Physical Medicine and Rehabilitation at Rutgers New Jersey Medical School, a clinical research scientist at Children’s Specialized Hospital, and also a faculty member in biomedical engineering at the New Jersey Institute of Technology, will be able to investigate fully the “clinical outcomes, the neuro-physiological effects, the mechanics of walking, the kinematics, muscle activation, and loading parameters,” as well as how patients do in the long term. How will this technology, when used in the early stages of recovery— within a week after a stroke when the injured brain is the most pliable — affect recovery? “We really need to know what is happening at the level of the legs as well as how the brain is responding,” she explains. “How is this device affecting the signals going on in the brain and how can it

be mechanically adjusted to enhance the recovery process?” The grant also allows follow-up for five years with data collection at points along the way.

Wearing the exoskeleton provides upright postural support. “I’ve been in it and it feels good,” Nolan says. You stand up straight and balanced — with motors at the hips and knees, and adjustable springs at the ankles that are important for loading the foot. Even when the motors are decreased or powered off, the device will lift the weight of itself without pulling, so the lower limbs don’t feel heavy. Each side can also be programmed separately to allow for more or less help in cases of hemiplegia or one-sided weaknesses. “What we have seen in

“In rehabilitation medicine, Taking steps using the Ekso exoskeleton

there is a lot of technology emerging really fast.

We provide the evidence for what works.” —KAR EN J. NOLAN our work is that the Exoskeleton provides more step practice.” Because of the physical assistance of the robot, the patient can take more steps than a therapist could manually offer in a given block of time. “This just speaks to all the neuro-plasticity research about dosing and getting as much as possible in early recovery. The theory I am exploring is whether all this early intervention gait training in the correct plane of movement can get people up walking faster and correctly with better quality” on their own, Nolan explains.

“Unfortunately, in the inpatient setting after a stroke, the goal is just to get the patient up and walking. So they get up and start walking, but with compensation strategies and assistive devices to help with muscle weaknesses and range of motion,” Nolan says. “We provide braces, pharmacological interventions, different compensation devices, and different technologies, but we never really get the patient to that healthy, independent place…with full quality of life.”

Getting patients unstuck is the goal of her group. “We’ve got engineers, health scientists, biomechanics, physiatrists, neurologists, and physical therapists,” Nolan says proudly. “And, of course we have patients. It takes open-minded learning to see how these devices can make a difference. In rehabilitation medicine, there is a lot of technology emerging really fast. We provide the evidence for what works.” And she adds, “What I always say is that you can teach technique but you can’t really teach someone to be enthusiastic. The team that I work with is incredibly enthusiastic.” ●

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L E F T: J O D Y B A N K S - S M I T H

A

Initially, there was hope, but t a time when many people are in ultimately graft vs. host disease and severe the prime of their careers, Deborah infections overcame her and Ariella died Horenstein is just beginning hers. After in November 2007. Her family brought raising three children, she will become her back to Monsey and buried Ariella at a doctor at this stage of life — mainly a cemetery two blocks from their home. because of her youngest daughter, Ariella, Horenstein’s grief not only encomwho died at the age of 8 1/2 following a passed the loss of her beloved child, it bone marrow transplant in 2007. also included the loss of her constant “I chose to embark on this path to occupation. “For eight and half years, become a pediatrician because I felt 24 hours a day, seven days a week, I had I could offer a unique perspective to been involved in my daughter’s medical patients and their families, having been care. I realized that not only did I miss on the receiving end of medical care,” my daughter, I also missed the intellectual says Horenstein, a member of the 2016 challenge of seeking solutions to medical graduating class of Rutgers New Jersey problems.”

Medical School (NJMS). “Throughout A year after Ariella’s death, Horenstein Ariella’s illness, I saw what truly DEBORAH H OREN STEIN , MD’16 enrolled in Columbia University’s postexceptional physicians can do for a family baccalaureate premedical program, and with an ill child. I strive to be that kind of four years later was accepted as a first-year physician myself.” student at NJMS. Medicine was not on Horenstein’s “I decided to go to NJMS, in part, early trajectory. She was an economics because of its emphasis on humanism,” major at Barnard College and worked in Horenstein said. “The school places a finance during her early 20s. After having great deal of importance on compassion, children, she stayed at home with two respect and empathy, values to which I am young daughters, Shoshanna, now 21, deeply committed.” and Talya, 19.

By Carla Cantor At first, Horenstein thought she But then Ariella was born. She had would become a pediatric oncologist, but complicated medical problems from the start — low muscle tone and immune problems and, later, Crohn’s a third-year neurology rotation changed her focus. “It combined what disease and epilepsy. By the time she was 4, Ariella had seen more than I liked about oncology— long-term relationships with families, acute and chronic medical problems,” she said. “But I also liked figuring out 50 doctors in 12 areas of specialty.

“She had an immune dysfunction and a constellation of symptoms the puzzles of brain dysfunction and correlating the neuroimaging with that doctors had never seen,” Horenstein said. “Because of the intricacies the physical exam.” She will stay at NJMS for her pediatric residency of her case, I became an integral part of the medical team. The doctors and hopes to do a pediatric neurology fellowship beyond that.

This year Horenstein was inducted into the Arnold P. Gold relied heavily upon my input as I knew Ariella so well.”

Ariella received much of her treatment at Children’s Hospital of Humanism Honor Society, which recognizes medical students and Philadelphia, which required the family to commute from Fair Lawn, physicians for their excellence in clinical care, leadership, compassion, New Jersey, and later Monsey, New York, where they moved when and dedication to service. Twenty students out of 175 in the NJMS Ariella was 6. When her doctors determined Ariella would need a graduating class of 2016 have this distinction.

Andrew Berman, MD, NJMS professor of medicine, says bone transplant at Duke University Hospital, Horenstein moved to Durham, North Carolina with Ariella and her other two daughters, Horenstein exemplifies every character trait we think of when we reflect home schooling them with the help of her husband, Avrom, a manager on what humanism means. As the attending physician in the medical ICU, Berman supervised Horenstein during a rotation, and one case in financial systems technology.

Over the next year and a half, Ariella struggled with complications she was involved with in particular stood out: a patient with AIDS who from the transplant. “The apartment turned into a mini ICU. had not revealed his status to his family. “Intuitively, Deborah was able I administered her IV medications, did sterile dressing changes, to bring out the patient’s concerns and conflicts, relate to him on an drew her blood daily and managed the intricate details of her care,” emotional plane, while attending to his acute medical needs. She was Horenstein said. “Ariella had an amazing spirit — happy, laughing, an advocate for the patient’s voice. We could hear what he was thinking through her,” Berman said. “That’s humanism.” ● singing — despite enormous pain.”

A Daughter’s Death Motivates a Mother’s New Path

JOHN EMERSON

RUTGERS NEW JERSEY MEDICAL SCHOOL

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New Technology for Young Hearts

BY MARYANN BR INLEY

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s a young pediatric cardiologist who specializes in imaging, Kanwal M. Farooqi, MD, has the utmost respect for her mentors. A 2007 graduate

of New York Medical College, Dr. Farooqi spent six years training in pediatrics and pediatric cardiology at The Albert Einstein College of Medicine, Children’s Hospital at Montefiore. Then she spent a year at Mount Sinai Medical Center completing a non-invasive imaging fellowship learning about imaging technologies including cardiac magnetic resonance (MRI) and the “mainstay of diagnostic imaging in pediatric cardiology,” 2 dimensional (2D) echocardiography. “I have had wonderful mentors, some of the greatest out there,” she insists.

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Typically at most hospital centers with a congenital heart surgical program, a conference to discuss patients is held weekly. “The imaging specialist will try to communicate to the audience of cardiologists, surgeons and other imagers what the anatomical relationships are and what the issues during surgery may be,” Farooqi explains. “In pediatric cardiology, we utilize echocardiography and ‘sweeps’ of the heart, producing a series of 2D images to get a sense of the 3D anatomy. This can be tough in a complex patient.”

There is a gap that exists between the 2D images acquired and the 3 dimensional anatomic relationships that “we need to communicate to our audience, including the congenital heart surgeon.” Even the projection of 3D images on a 2D screen is limiting because individuals vary in their ability of “mental rotation.” Not everyone can “infer the spatial relationships.” Farooqi asks, “Can you truly consider this effectively communicating three dimensions? The answer is probably no.”

When she was at Mount Sinai, the congenital heart surgeon suggested that the ability to produce 3D printed models be brought inhouse, if possible. He didn’t want to wait until he was in the operating room to become more familiar with his patients’ anatomy. And previously, a heart model had been created by sending an image dataset to an outside company. So making 3 dimensional models of the heart is exactly what Farooqi set out to do. She relied on free trial versions of software to teach herself how to use cardiac MRI datasets to create virtual models for viewing on a computer. It took months. “We didn’t have a 3D printer so I went to a company who made my first one out of courtesy. It was crude compared to the ones I make now but I was very excited.”

After being awarded the Glorney-Raisbeck Fellowship in cardiovascular disease, a grant from the New York Academy of Medicine, Farooqi spent the following year fine-tuning her techniques. Working with a mentor at Mount Sinai, “We outlined the best technique to make a 3D model using a process called segmentation, basically taking the dataset and highlighting parts of it.” Then, with a grant from the Congenital Heart Disease Coalition in New Jersey, Farooqi was able to buy a refurbished desktop 3D printer, called the Mojo, for the hospital. Most printers are larger, many of them industrial sized. “I love the Mojo because we can recreate fine anatomical details using a desktop printer. Each model is unique…something new that I have created.” The scenario she envisions is “a patient with newly diagnosed congenital heart disease coming in one day and having the physical replica of his or her anatomy in hand in time for discussion at a surgical conference the next day.”

Since July 2015, Farooqi has been an assistant professor in the Department of Pediatrics at Rutgers New Jersey Medical School and she is currently window-shopping for a 3D printer for the medical school.

“The potential application of this technology for teaching is great.

I’d like to put together a library of congenital heart disease models.”

JOHN EMERSON

A 3D cardiac model, printed on the Mojo printer, of a child needing complex congenital heart surgery. The details of the complicated anatomic spatial relationships become readily apparent when the 3D model is presented, giving a clearer picture of possible surgical options.

She once tested the theory that people may not process 2D images presented to them into accurate 3D reconstructions in their minds.

Along with a mentor who is now at Stony Brook, Farooqi created clips of 2D cardiac MRI image datasets of patients with complex congenital heart disease and asked a group of physicians to choose the correlating 3D printed models. Could the hearts be correlated to their clips? Not with complete accuracy.

“What is so exciting now are the limitations we are crossing in medical imaging.” Winner of numerous awards and honors, Farooqi has published frequently in peer-reviewed journals and always brings her creativity and curiosity to her work in her mission to make it possible to “touch a heart.” She says, “My chief saw a rendering I made and said, ‘This is the future of imaging.’” ● RUTGERS NEW JERSEY MEDICAL SCHOOL

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Saving Lives Suddenly in

Neurosurgeon Ira Goldstein + patient Elaina Holden

Jeopardy

BY MERRY S UE BAUM

All in a Day’s Work Every year Elaina Holden goes to see neurosurgeon Ira Goldstein, MD. This visit is not for an annual check-up; in fact she doesn’t even make an appointment. The 29-year-old stops by to give the doctor an annual hug for saving her life.

Holden doesn’t remember much about the winter day Goldstein, associate professor of neurosurgery at Rutgers New Jersey Medical School (NJMS), became her physician. She does recall slipping— probably on black ice — as she was leaving home with a friend. As she fell, she hit her head on four cement steps and lost consciousness.

Holden’s friend immediately called the ambulance, and told the driver to go to the hospital where Holden works. However, the driver kindly but firmly stated that if her friend had any chance of survival at all, she would have to go to University Hospital (UH) in Newark, the primary teaching hospital for NJMS. It is the only Level I Trauma Center in northern New Jersey, the driver explained, and the doctors are highly specialized in acute emergency care. Goldstein was waiting for Holden at the emergency room door.

It turned out the young woman had fractured her temple bone in two places and had what is known as a “blow-out” fracture, meaning her orbital (eye socket) bone was also broken. Even more dangerous, however, was the epidural hematoma she had suffered — a buildup of blood between the skull and the brain. It’s the type of injury often seen when two football players’ heads clash, or when accident victims hit their heads. The blood pools inside the skull, putting dangerous pressure on the brain. An immediate, accurate diagnosis and the proper type of treatment are a must to avoid permanent brain damage, and in some cases, even death.

Goldstein wasted no time getting his new patient into surgery, where he performed a procedure to remove the clot. He created a bone 34

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flap, lifted it, suctioned out the clot and replaced the flap. The next morning, Holden was sitting up and talking. Her brain was completely intact and there were no adverse residual effects. She was on her way to a full recovery.

“The medical team was concerned about how I would react afterwards; they thought maybe I’d be depressed,” Holden recalls. “But I was just the opposite. I think I was high on life. Knowing that one minute you’re walking and talking, and the next minute your life can be taken from you, just like that, was a surreal experience. I now appreciate every little thing in life so much.”

Holden has gone back to her very busy life as a full-time X-ray technician and mother to her young son. She says Goldstein was very humble about the work he did, saying he was just doing his job. “I guess his job was to save my life that day,” she says. “I’ll be grateful to him forever.”

The Odds Were with Him Wayne Nash read the statistics and knew the odds: Only one in five people who go into cardiac arrest in the workplace survive. The chances of living increase, however, if there are automated external defibrillators, or AEDs, nearby. A human resources professional, Nash decided to have AEDs installed at the office in downtown Newark where he works, just in case the unthinkable happened. And it did.

Only a few weeks after the lifesaving equipment was in place, Nash himself went into sudden cardiac arrest during a meeting. He had no history or symptoms of heart disease and had no warning when the attack hit. His colleagues revived him with one of the new AEDs, and he was rushed to University Hospital. There Marc Klapholz, MD, professor and chair of medicine at NJMS, took over.

Nash had not regained consciousness by the time he arrived in the PHOTOS: JOHN EMERSON AND NICK ROMANENKO

Neonatologist Onajovwe Fofah + patients Michelle Callari and son Reid

Cardiologist Marc Klapholz + patient Wayne Nash

emergency room. After assessing the patient, Klapholz, who is also chief of cardiology services at University Hospital, decided Nash was a candidate for a treatment known as therapeutic hypothermia. This procedure lowers the core body temperature — to about 89.6 to 93.2 degrees — in patients who remain unconsciousness after being revived from cardiac arrest. The cardiologist explains that the initial rush of blood, after the heart is resuscitated, triggers a cascade of inflammatory responses that are harmful to brain tissue. Hypothermia slows the body’s metabolism and counteracts many of those destructive mechanisms, letting the brain “reset” itself to function normally again.

Nash remained in an induced coma, while the Cardiac Care Unit (CCU) nurses vigilantly monitored his condition. After two days, doctors began the rewarming phase of his treatment, slowly bringing his body temperature back to normal. On day five, Nash awoke with no neurological damage.

“Dr. Klapholz is the consummate caring physician, as well as a consummate human being,” says Nash. “The care I got was amazing.

Everyone — the technicians, nurses, everyone — was wonderful.”

Now back to the business of everyday living with his wife and daughter, Nash is extremely grateful he was one of the lucky few who beat the odds.

Baby, it’s Time When Michelle Callari realized her first baby was coming early, she was stunned. Five weeks before her due date, the attorney from Bergen County was in a Newark courtroom when her water broke. “I didn’t expect that at all. I wasn’t even sure what was happening,” she says.

Her paralegal did know and immediately called an ambulance. Minutes later Callari found herself en route to University Hospital, far from her husband, her doctor, and the hospital where she had planned to deliver.

She felt horribly alone and was terrified that the premature birth might mean lifelong problems for her child.

“The minute I got inside the hospital, one of the nurses gave me a hug and told me everything was going to be all right. I can’t tell you how comforting that was,” she says. Then she met Onajovwe Fofah, MD, assistant professor of pediatrics/neonatology at NJMS and chief of neonatology at the hospital, in the delivery room. He told her he would be caring for her baby. He also explained that he and his wife experienced the anguish of having a very premature infant, when his daughter was born at only 27 weeks and weighed barely two pounds.

“The compassion he showed me was like none that I ever experienced,” says Callari.

Fofah and his team work tirelessly to save the lives of fragile newborns, and it shows. The Neonatal Intensive Care Unit has a 95 percent survival rate for premature babies who weigh three pounds or less.

The physician visited the new mother twice each day while she was hospitalized — after first checking on the baby. That way, he could assure her that the newborn was doing well. During his hospital stay, the infant was placed on noninvasive ventilation for moderate to severe respiratory distress syndrome; treated with caffeine for apnea of prematurity; and was given intensive phototherapy for hyperbilirubinemia due to prematurity.

“All said, feeding him with mother’s milk helped prevent complications such as necrotizing enterocolitis and giving him Synagis (a prescription medication used to help prevent a serious lung disease caused by respiratory syncytial virus in children at high risk) prior to discharge were beneficial,” explains Fofah.

After his release, Reid continued to do well. Today he is a healthy, happy 2-year-old. “I’m proud to say my son was born at University Hospital,” Callari says. ● RUTGERS NEW JERSEY MEDICAL SCHOOL

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ALUMNI FOCUS

news of special interest to njms and gsbs graduates

Message from the

Alumni Association President

PAUL BOLANOWSKI, MD’65 ALUMNI ASSOCIATION PRESIDENT

Dear fellow alumni,

S

ince it has been quite some time since my last update, I would like to take this opportunity to share with you what the Alumni Association (AA) has been up to.

Throughout the past three years, postintegration, there have been multiple meetings with the Rutgers University Foundation (RUF) President, Nevin Kessler and members of his staff.

The meetings proved to be very instrumental in expressing the important role the Alumni Association has with the medical school and its students. Drs. George Heinrich and Joseph DiTrolio and I remained determined, yet reasonable, during our discussions with Rutgers to ensure a lasting future for the AA. Although some of the details required a substantial amount of time and attention to finalize, we were able to successfully negotiate a collaborative relationship with the Rutgers 36

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University Foundation. The new relationship with Rutgers allows the AA to continue its fundraising operations and carry out its goals to serve the medical school, its students and alumni, while following Rutgers’ policies and processes.

Some of the areas that we agreed upon included: continuance of our membership program, renewed management of phonathons to be held at NJMS featuring NJMS student callers, and involvement with the Annual Fund program. Despite all the new changes associated with the integration, we have been able to continue our tradition of supporting numerous student programs including: Orientation, Career Nights, Exit Interviews, Match day, Student Council, SHARE, the Student Family Health Care Center (SFHCC), International Study Grants, and our annual scholarship program. This past year, we also sponsored a holiday party for the 4th year students in December.

Working with the RUF provides us with other benefits as well. Our office has access to the Rutgers alumni and donor database and benefits, year-round, from the Telefund program. The RUF has recently hired a

Director of Annual Giving for Rutgers Biomedical and Health Sciences (RBHS) which allows for more customized and schoolspecific communication with alumni. The alumni office works with the new Director to coordinate and manage the annual fund program. In addition, the medical school now has its own dedicated Director of Development to carry-out fundraising initiatives and secure donations that benefit the medical school.

Following the integration with Rutgers University, the Alumni Association continues to remain as committed as ever to continue to maintain and build meaningful connections and relationships with alumni and support the medical school and its students. We hope that you have received copies of the new alumni newsletter Tempo and look forward to sharing the next issue with you. In addition to the newsletter, the Association is also excited to host the Annual Alumni Reunion gala at a new location—The Westin Jersey City Newport Hotel. Reunion weekend will take place this June 3– 4. For more information, please contact the alumni office at 973972-6864. We hope to see you there! ●

ANDREW HANENBERG

ALUMNI PROFILE

Failure Is Not Fatal

BY EVE JACOBS

J

udith Korek Amorosa, MD’70, knows something about failure, but the rewards of being a practicing radiologist, teacher, residency director, and researcher have far outweighed any early stumbling blocks in her career. On April 9, she and husband Louis Amorosa, also an NJMS alum, were awarded honorary medical degrees by Rutgers Robert Wood Johnson Medical School (RWJMS) for their more than 35 years of notable contributions.

While the memories of Amorosa’s early failures still cause her some pain, they are also at the heart of the person she has become. Her family emigrated from Hungary to settle in the U.S. when she was a child and she spoke no English, but managed to learn and excel in the inner city schools of Los Angeles. She describes her parents as having “no money, but a very high regard for education.” Her father spoke 12 languages, was “amazingly knowledgeable,” and lectured his children every day on a wide variety of topics, including current events, geography, and “everything else. I loved it,” she says. Her mother, an X-ray technician, was “not able to fulfill her dream of becoming a doctor, but she knew what she wanted for me. I was groomed to be a doctor from the moment I was born.”

There was never any question during Amorosa’s growing-up that she had what it would take to succeed in the competitive world of medical school. However, after graduating from Long Island University, she started medical school and found it very difficult. “I failed biochemistry,” she admits. “I had to come in front of the school’s Academic Standing Committee and then had to repeat the entire year. It was so humiliating.”

But the second time was the charm and

(l-r) Alumni awards from Robert Wood Johnson Medical School: Distinguished Alumni Award recipient, Kathryn Holloway, MD; Husseini K. Manji, MD, accepting Meritorious Service Award on behalf of Johnson & Johnson; and Honorary Alumni Award recipients, Judith Korek Amorosa, MD, and Louis F. Amorosa, MD

she sailed through. “I knew right away that now I could do it,” she remembers. She excelled in her clinical work and “loved surgery.” But there were just three women in her class of more than 100, and she figured that surgery would not be a practical choice for a woman. She chose pediatrics by default.

The choice was not a good one. “Within a week, I knew I had made a mistake,” she says. Amorosa finished her internship year, then started over in diagnostic radiology (a specialty she had not experienced as a medical student), which she loved immediately and was very good at. But looking back, she sees her initial choice of specialty as another failure.

The next years were extraordinarily busy for the up-and-coming radiologist and her husband, whom she met during their first year at NJMS. They married in 1969 and soon thereafter started their family. Their first child was born about six weeks after Amorosa began her residency. They had a second child at the tail-end of her residency, the third during her fellowship, and the fourth a few years later.

“But we made it work,” she says. “We were always very supportive of each other’s careers.” They moved a lot— settling for a year or two at a time closest to the job that was the most demanding. She credits her in-laws with a major role in making it all possible.

In 1980, Amorosa joined RWJMS to “accept the challenge of setting up a medical school program in radiology.” She did that with flying colors. Her husband, an endocrinologist specializing in diabetes, had joined the medical school faculty two years earlier and they had moved to Piscataway.

In 1984, she accepted a second charge—to set up a radiology residency program from scratch at the school. She accomplished that, too. Despite radiology not being part of the core curriculum, like medicine and surgery, the vast majority of medical students at the school elect to take the course — a great testament to her teaching.

“Teaching medical students and residents has been my greatest love,” Amorosa says.

Continued on page 38

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ALUMNI PROFILE “Their accomplishments mean a lot to me.”

She mentored most of the 250 medical students who have gone on over the years to become practicing radiologists.

Never one to turn down a challenge, she has recently ventured into the world of online teaching, developing and launching a “hybrid radiology clerkship — partly online and partly in the more traditional format,” which she launched a year and a half ago for third-year students. They’ve given it high marks. Now, she’s getting ready to introduce radiology online to first- and second-year medical students. “The promise for technology in medical education is tremendous,” she says.

Number two on Amorosa’s list of her top accomplishments is the training of residents — about 100 to date. “It’s been such incredible fun,” she says. “They are all so accomplished. Not one of them has not finished; they are all working.”

A shadow crosses her face, and then she smiles again. “I want to tell you a story,” she says. “It’s about how my own experience with failure inspired me many years later to help a resident who almost failed.”

“This was a student, a very good student from a major university,” she continues. “We have a rule here that if you don’t pass the USMLE3 by the second year of residency, you’re fired. This resident did not pass part 3; he was fired and became despondent.”

What Amorosa understood, and he did not, is that there is life and, often, great success on the other side of failure. She thought that if he were able to get some uninterrupted study-time, he could pass the test; and she asked him if he wanted to try. He said yes, and he concentrated on preparing for the exam. Her gut instinct proved right. He passed the exam and she was able to connect him with another residency program. Her great reward, she says, was watching him go from success to success. He is currently a chief of thoracic radiology at a major university medical center.

Also among her top accomplishments is initiating a major change in the practice 38

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of medicine. She explains: “When a doctor orders a test for belly pain, that doctor has to decide which tests are most appropriate.

I knew, for instance, when I came here, that the exam for gall bladder disease that was in-use was clumsy, and that ultrasound was better. But this was not general knowledge at the time.”

She launched and published a quarterly newsletter for 10 years, “an incredible amount of work,” to better inform practicing

“Teaching medical students and residents has been my greatest love.”

— JUDITH AMOROSA

radiologists about what was newest and best in the practice of diagnostic radiology. She also published an article in a highly reputed journal about how to inform “main street” radiologists about changes in practice. Since then, the American College of Radiology has established “appropriateness criteria” as guidelines to assist physicians to make the best imaging and treatment decisions for specific conditions. “You put in belly pain and the information pops up,” she says. “It’s made a big difference in treating patients.”

Number 4 on her list is her lung-cancer research. As a chest radiologist, she sees a lot of lung cancer. “My mother smoked three packs a day from the age of 9 to 87,” she says. “It was impossible to stop her.”

Amorosa became part of the National Lung Cancer Screening Trial when invited

by Joseph Aisner, MD, co-director of the thoracic oncology program at the Rutgers Cancer Institute of New Jersey. In 2010, the results were released, showing that CT scans are far better than chest X-rays for detecting lung cancer in its earliest, most treatable stages, thereby reducing mortality by 20 percent. “That’s a huge deal,” she says.

So what about hobbies? High on Amorosa’s list is a “major interest in medical

history.” In 1995, she published a biography of Wilhelm Conrad Roentgen, the physicist who discovered X-rays in 1895, and she is revising the text for inclusion in the German Roentgen Museum. “His role in medicine and physics is huge,” she states. “He was a terrible student, color blind, unfriendly, not a personable person. But he made an amazing contribution,” she states. “A movie is needed.”

Other plans for the future include writing a book about her mother, who “had an incredibly rough life,” and spending time with her four adult children, her grandchildren, and her husband, whom she describes as an excellent teacher, a beloved physician, a dynamic researcher, and an amazingly supportive partner.

The radiologist was inducted into the University’s inaugural class of 12 Master Educators on September 19, 2000. Teaching, she says, has been a major love of her life.

She points out that the Latin word docere, meaning to teach, lies at the root of the word doctor. That is who she is and that is what she hopes to continue to do. ●

Join the Alumni Association of

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Visit njms.rutgers.edu/alumni, click on Alumni and Alumni Association and then Online Membership Payment to pay your membership online.

The Lifetime Membership is being offered to our alumni as a means to perpetuate the goals of the Alumni Association and enable its members to sustain their support in a more meaningful way.

All categories of membership will afford you the opportunity to keep connected with us. You will continue to receive all membership benefits, including Pulse magazine, information about upcoming events and reunions, and on-site library privileges.

Alumni Association of NJMS, 185 South Orange Avenue, MSB–B504, Newark, NJ 07101–1709.

Photos are welcome. You can also send your news via e-mail to: njmsalum@njms.rutgers.edu or fax us at 973-972-2251.

ALUMNI AUTHOR PAT R IC K FOYE, MD ’92

The Tailbone Doctor

BY EVE JACOBS

P

atrick M. Foye, MD, also known as the Tailbone Doctor, focuses much of his medical practice on a relatively unknown part of the body that gets no respect. In humans, the coccyx (or tailbone) is small, but it can cause a whole lot of pain and suffering.

Professor and interim chair of the NJMS Department of Physical Medicine and Rehabilitation, Foye launched and runs the only Tailbone Pain Center in the U.S. “You could go to Paris for care,” he says, “but it’s an expensive trip and if your coccyx hurts, sitting for a long flight would be very painful.”

The coccyx gets little attention, unless it’s causing extreme pain. Located at the lowest end of the spine, the tailbone is misnamed since it’s not one, but three to five vertebral bones. The name is part of the problem, comments Foye. “Also, its variability can cause confusion since physicians may see more bone segments than they expect and then incorrectly think this is due to fracture,” he states in his recently published book, Tailbone Pain Relief Now. Foye established the specialized center 15 years ago after treating several patients with coccyx complaints. When he researched the medical literature, he was shocked. “Either patients were told it was all in their minds and were dismissed; or if the pain was bad enough, tailbone amputation was recommended,” he says. Surgery is rarely the right way to go, according to Foye. Surgical recovery takes six months to a year; and the location of the tailbone next to the anus means a high infection rate following surgery.

Foye’s interest in coccyx pain intersected with the internet boom of the late ’90s. As his proficiency treating the condition with

CLASS NOTES injectable medications grew, the tailbone doctor invented several new treatment techniques and published his work in medical journals. Word spread rapidly among physicians. However, it was a grateful patient — who had aggressively sought relief for two years before finding Foye — who insisted the tailbone doctor launch a website (www.

TailboneDoctor.com). Several years ago, Foye posted informational videos to a YouTube channel, which has garnered more than 300,000 views. These plus old-fashioned word of mouth have driven patient-visits to his center into the thousands each year.

“I’ve treated professional athletes, movie stars, musicians, construction workers, executives from Fortune 500 companies, and mothers who can’t play with their kids on the floor,” he says. His patients range in age from 3 to 90 plus.

Unrelenting severe pain at the lower tip of the spine while sitting is the primary complaint of his patients. Foye says that most X-rays of the lower spine are taken while the patient stands and rarely reveal coccyx problems. “An X-ray needs to be taken while the patient is sitting,” he explains, and may turn up a tailbone fracture or dislocation, an unstable tailbone joint, bone spurs, arthritis of the tailbone, or every once in a while, cancer or a bone infection. Mechanical pressure to the coccyx from a fall, giving birth, or prolonged sitting is commonly the cause.

Foye explains that a standard MRI of the lumbar area — a test often incorrectly ordered for tailbone pain— does not even include the coccyx; and that many coccyx pain patients are treated with physical therapy, which is often ineffective.

When the condition is properly diagnosed, treatments — including pillows that relieve pressure on the tailbone, local antiinflammatory steroid injections, oral antiinflammatory medicines, and nerve blocks or nerve ablation — are usually successful.

His book is one more avenue to reach a widespread population, Foye says. “While seeing a patient in person is always preferable, my end-goal is reaching as many tailbone pain sufferers as possible.” ●

1960s Thomas W. Kiernan, MD’67 is a staff gastroenterologist at the VA Medical Center, Augusta, GA as well as staff hepatologist at Augusta University, Augusta GA. Guy T. Selander, MD’61 is still working in Family Practice at age 80 and still loves what he does.

1970s David H. Brody, MD’74 has been serving on the Board of Directors of University Hospital, Newark since September 2014.

Calvin J. Maestro, Jr., MD’79 published a book, Leadership Lessons from History (a study guide written for physicians and other healthcare leaders).

Barry Maltzman, MD’70 was honored for forty years of service at University Hospital.

Albert L. Ray, MD’70 received the Philipp M. Lippe Award from the American Academy of Pain Medicine “for outstanding contributions to the social and political aspects of Pain Medicine,” 2009; the Felix Linetsky Award “for Excellence in Education,” 2012; the President’s Distinguished Service Awards from Southern Pain Society, 2002 and 2004, from the American Academy of Pain Medicine, 2004, and from the Florida Academy of Pain Medicine “for dedicated leadership, service, and loyalty to the medical profession and service to humanity,” 2015.

1980s James V. Fetten, MD’83 served as President of the Monroe County Medical Society in 2014.

Lauren D. LaPorta, MD’88 welcomed a daughter, Nataija Joy LaPorta. She traded the high powered career path for the mommy-track, cut back her hours and enjoys raising her bouncing baby teenager!

1990s Omaida C. Velazquez, MD’91, professor of surgery, radiology, and biochemistry and molecular biology, and David Kimmelman Endowed Chair in Vascular and Endovascular Surgery, was named chair of surgery at the University of Miami Miller School of Medicine.

2010s Mary E. Kelleher, MD’10 is working at the Bellevue adult outpatient psychiatric clinic in New York City and never has a dull day!

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endpage AM ATULLAH SAAFI R , M D ’1 6

Teacher, Translator, Long-Distance Traveler

BY EVE JACOBS

I

t was in the country of Senegal in West Africa that Amatullah Saafir decided her professional future. At 14, she left the U.S. and went abroad to travel and further her religious studies. She ended up staying in the country for four and a half years.

At 16, she began volunteering in a village clinic and witnessed the often life-changing effects of good medical care as well as the problems inherent in a medical system that was poorly funded. Because she had already been in Senegal for two years and had learned the language quickly, she served as a translator for sick patients seeking treatment from volunteer physicians, many from the U.S. She caught the “doctor bug” and that was that. She was inspired by the visiting doctors, but also observed aspects of health care there that disturbed her, among them an absence of protocols, sanitation problems, and a lack of funds to make things better. “I wanted to be able to help improve the medical care,” she says.

Saafir took an unusual route into college.

After growing up and attending elementary and middle schools in Jersey City, she decided not to take the conventional path to a high school diploma. She wanted something different. She researched her options and found a program— using self-help materials, books, and study guides — that she felt would adequately prepare her to enter college in the future; and she convinced her family that she could make it work. Always good at math and science, and disciplined in her studies, she completed all of the required courses and passed her exams.

When she returned to the U.S. from Senegal, she applied and was accepted to Essex County College, where she excelled in her courses, and then went on to finish her last two years at Rutgers in Newark. During 40

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her college years, Saafir’s desire to study medicine never wavered. However, she had had little experience navigating the American educational system.

It was the Northeast Regional Alliance (NERA) MedPrep Scholars Program— w hich she participated in during her college summers — that prepared her to apply and be admitted to medical school. This partnership among Rutgers New Jersey Medical School, Icahn School of Medicine at Mount Sinai Center for Multicultural and Community Affairs, Columbia University College of Physicians and Surgeons, and the Manhattan Staten Island Area Health Education Center helps prepare underrepresented and disadvantaged students to be competitive when applying to medical school. The program is offered locally through the NJMS Office for Diversity and Community Engagement.

“I took the MCAT preparation course and was able to use the materials they provided to continue preparing on my own for the test,” she remembers. “We also learned about the process of applying to medical school, which was very helpful.”

“The program made me feel comfortable at the medical school, even before I became a student there,” says Saafir. This was particularly important for her because she had married during the summer of her freshman year in college and gave birth in March of her sophomore year. When she began her studies at NJMS, her son Ahmad was 2. “I didn’t have time to hang out and socialize with other students after exams,” she says.

“I learned how to manage my time.”

Balancing motherhood with the rigorous academic program took a lot of drive and determination. Saafir says she was inspired by her mother, Lucinda, who raised three children and also excelled at her work, and

Amatullah Saafir

eventually became primary manager for a medical billing company. “My mother was inspiring,” she says.

Medical school has been “challenging,” Saafir states, adding that she was “a bit scared” at the beginning of her third year when she started working in the hospital.

Initially she wanted to specialize in surgery, but when she was introduced to general anesthesiology, “nothing compared with it.”

She had found her career.

In March, she matched with an anesthesiology residency at St. Joseph’s Regional Medical Center in Paterson, but will first spend an internship year in surgery at New York Medical College. Venturing out of her comfort zone for the first time in many years, she feels “excited but a little terrified.”

What does Saafir see ahead? “Academic medicine, definitely,” she says. “I love teaching.” Her experience includes teaching Arabic for a year in an elementary school and at a weekend school at a local mosque for several years. She also served as a teaching assistant in anatomy and physiology in the pre-matriculation program for select incoming first-year NJMS students.

But “frequent trips abroad” are right up there with teaching. Saafir has never forgotten her years in Senegal and what first inspired her to study medicine. This time around— after so many years preparing — she will bring along skills and knowledge that can impact health care in a way she could only imagine years ago. ● JOHN EMERSON

UNIVERSITY HOSPITAL THE PRINCIPAL TEACHING HOSPITAL FOR RUTGERS NEW JERSEY MEDICAL SCHOOL EXCELLENT MEDICINE. EXCELLENT CARE. UNIVERSITY HOSPITAL IS PROUD TO BE RANKED A TOP HOSPITAL IN NEW JERSEY AND TO RECEIVE SPECIAL RECOGNITION FOR THE TREATMENT OF n

Breast Cancer

n Congestive Heart Failure

n High Risk Pregnancy & Birth

n Pediatric Cancers

n Neurological Disorders

n Stroke

n Hip & Knee Replacement Surgery

n Coronary Artery Bypass Surgery

n Prostate Cancer

IN ADDITION, WE HAVE BEEN INDEPENDENTLY RECOGNIZED FOR EXCELLENCE By the American Heart Association/American Stroke Association for Performance Achievement for the treatment of Stroke and Heart Failure n By HealthGrades® with a 5-Star rating and its Neurosurgery Excellence Award n

n

In Trauma Care as northern New Jersey’s Level 1 Trauma Center

n As one of only two sites in the State for Liver Transplantation n For treatment of the deadliest form of Heart Attack by our

EMS, the only such recognition in the State

We’re very proud of this recognition and what it means for the care of our patients. It also means an exceptional opportunity for the education of the next generation of physicians in our role as the flagship teaching hospital for Rutgers New Jersey Medical School and the other schools of Rutgers Biomedical and Health Sciences. This partnership ensures highly trained professionals to meet the healthcare needs of New Jersey and beyond.

For more information about University Hospital, please call us at 973-972-4300 or go to our website at: www.uhnj.org 1

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