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GrandRounds Spring 2010

Saint Louis University School of Medicine

Haiti

Faculty and alumni answer the call

Match Day 2010

Abdominal Transplant Has a New Chief

Clinic Caters to Latino Community


From the Dean | We now have a health care reform law. It isn’t perfect, but it has a number of good elements upon which we can build. The new law is likely to lead to many changes in the way American health care is delivered clinically with related changes in medical education and research. Several new faculty members who will be important in these aspects of SLU’s future are featured in this issue of Grand Rounds. Dr. Betsy Tuttle-Newhall joined SLU from Duke last September and leads our Abdominal Transplantation Program. Dr. Enrico Di Cera joined SLU from Washington University in January and leads our Department of Biochemistry and Molecular Biology. Dr. Michael Railey returned to SLU in January to lead our program in Multicultural Affairs. These new faculty members will help us adapt important aspects of our clinical, research and diversity missions to the principles of health care reform. Programs at SLU that align strongly with health care reform include the recent development of the SLU Center for Outcomes Research (SLUCOR) into an independent, degree-granting unit at the Medical Center. Dr. Tom Burroughs and his team will be excellent resources in what health care reform defines as comparative effectiveness research. In addition, several years ago Doisy College started a program on Interprofessional Education (IPE). The IPE program is being expanded to develop the type of collaborative care education that will align our students with the health reform era. IPE will be located in the exciting new interprofessional education building at the Medical Center that we have acquired. In December, SLU purchased from Tenet a 15,000-square-foot building behind the School of Nursing that previously housed an orthopedic clinic. Plans are moving forward with strong support from University President Lawrence Biondi, S.J., to renovate and expand this building to include excellent modern classrooms and a new standard patient simulation facility, as well as lounge and study areas that will welcome students from all the Health Sciences schools and centers. This building will be described in further detail in the next issue of Grand Rounds. With these new programs, our new leaders and the challenges of health care reform, this is a busy and productive time at SLU. I hope you’ll have a chance to visit soon and share in the excitement.

Grand Rounds is published biannually by Saint Louis University Medical Center Development and Alumni Relations. Grand Rounds is mailed to alumni and friends of the School of Medicine. Philip O. Alderson, M.D. Dean | Saint Louis University School of Medicine Vice President | Health Sciences Schwitalla Hall M268 1402 S. Grand Blvd. St. Louis, MO 63104-1028

On the cover

A close-up (full image printed here) of Leah Swartwout, M.D., (’03) with a group of orphans at the guest house where she stayed during her medical mission to Haiti. Swartwout was one of several SOM alumni and faculty members who traveled to Haiti to take care of the injured following the magnitude 7 quake on Jan. 12. See page 8

Grand Rounds Editorial Board

Terence A. Joiner, M.D. ’82 Philip O. Alderson, M.D. Edward J. O’Brien Jr., M.D. ’67 Thomas J. Olsen, M.D. ’79 Coordinator and writer

Marie Dilg | SW ’94

Designer

Dana Hinterleitner

GrandRounds

Contributors

Laura Geiser | A&S ’90 | Grad ’92 Nancy Solomon Carrie Bebermeyer | Grad ’06 Sara Savat | Grad ’04 David Chilenski | Cook ’98 | Grad ’10 Photo Credits

Steve Dolan | 2-7, 12, 14-19, back cover Robert Flood, M.D., Christian E. Paletta, M.D., Tim Rice, M.D., CRUDEM Foundation and New City Fellowship Church | cover, 1, 12-15 Kabance Photo | 20-23

Spring 2010

Vol. 8

No. 1

Saint Louis University School of Medicine

© 2010, Saint Louis University All rights reserved

For more information about the magazine or to submit story suggestions, please contact 314 | 977-8335 or grandrounds@slu.edu.

Philip O. Alderson, M.D. Dean | Saint Louis University School of Medicine Vice President | Health Sciences

Casa de Salud

A new clinic offers health care and hope to the Latino community. | page 6

standing outside the Doisy Research Center

Correction: In the Q&A with Kate Becker, executive director of the University Medical Group, in the Fall 2009 issue of Grand Rounds we failed to ackowledge the merger of the neurology and psychiatry departments. The 2007 merger was made to recognize the shared mission of understanding the nervous system and human behavior in the context of disease.

Answering the Call

New abdominal transplant chief sets her goals. | page 14

In Memoriam

Two of the world’s most respected geriatric researchers attack Alzheimer’s disease. | page 18

| page 8

Armand Brodeur, M.D., treated children with heart and humor. | page 12

page 2

No Fear of Rejection

SOM faculty and alumni head to Haiti in the aftermath of a devastating earthquake.

Vital Signs |

Alumni Pulse |

Poised for Discovery

Match Day

Members of the Class of 2010 celebrate their move to the next level. | page 20

page 2 page 22

Living the Mission | page 24 page 18

Profile of Philanthropy |

back cover


Di Cera

VitalSigns Researching Ways to Administer an Investigational Smallpox Vaccine

Scientists at SLU’s Center for Vaccine Development are leading an NIH-funded study to evaluate the most effective way to administer an investigational vaccine for smallpox. The research, conducted at five study centers across the nation, is funded by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health. The world was declared free of smallpox, which is highly contagious and potentially lethal, in 1980. However, concern continues about the clandestine use of smallpox as Frey a weapon of bioterrorism. “The United States government is making efforts to improve its ability to protect citizens in case of a possible bioterrorist attack,” said Sharon Frey, M.D., principal investigator and professor of infectious diseases. The study will compare two preparations of IMVAMUNE®, an investigational smallpox vaccine made by Bavarian Nordic, which is stored as both a liquid and a powder. The powder is combined with a liquid before it is given as a shot.

The study also will compare the body’s immune response when IMVAMUNE® is given subcutaneously and intradermally. “Typically less vaccine is needed to make an immune response when it is given intradermally,” Frey said. “If we find that giving the vaccine intradermally is safe and prompts an immune response that is as strong as when the vaccine is given subcutaneously, we potentially could protect more people with the same amount of vaccine.” Up to 240 volunteers are being recruited for the research study, which will be conducted at SLU, the University of Iowa, the University of Maryland, Emory University and Group Health Cooperative/Seattle.

Knutsen Leads Immunodeficiency Research Project

Alan Knutsen, M.D., professor of pediatric allergy and immunology, is leading the research associated with the Primary Immune Deficiency Treatment Consortium. This NIHfunded project was created to examine the best treatment options for several primary immunodeficiency diseases, including severe combined immunodeficiency (SCID), Wiskott-Aldrich Syndrome (WAS) and chronic granulomatous disease (CGD). The group also will conduct clinical trials to improve care for

children with primary immunodeficiency diseases. The group’s initial project will be to screen newborns in the Navajo Indian population for SCID. In addition, Knutsen will lead the Jeffrey Modell Diagnostic and Research Center that has been established at SSM Cardinal Glennon Children’s Medical Center. The program is funded with the aim of providing early and precise diagnosis for people who may have primary immunodeficiency diseases.

Bitter Melon Extract Attacks Breast Cancer Cells The

extract from a vegetable that is common in India and China shows promise in triggering a chain of events that kills breast cancer cells and prevents them from multiplying. Ratna Ray, Ph.D., professor in the department of pathology and lead researcher, said she was surprised that the extract from the bitter melon she cooks in stir-fry dishes inhibits the growth of breast cancer cells. “To our knowledge, this is the first report describing the effect of bitter melon extract on cancer cells,” Ray said. “Our result was encouraging. We have shown that bitter melon extract significantly induced death in breast cancer cells and decreased their growth and spread.”

Ray said she decided to study the impact of bitter melon extract on breast cancer cells because research by others has shown the substance lowers blood sugar and cholesterol Ray levels. Bitter melon extract is commonly used as a homeopathic medicine to treat diabetes in China and India, she said. Ray conducted her research using human breast cancer cells in vitro. The next step, she says, is to test bitter melon extract in an animal model to see if it plays a role in delaying the growth or killing of breast cancer cells. If those results are positive, human trials could follow. While it’s too early to know for sure whether bitter melon extract will help breast cancer patients, the question is worth studying, Ray said. “Cancer prevention by the use of naturally occurring dietary

substances is considered a practical approach to reduce the ever-increasing incidence of cancer. Studying a highrisk breast cancer population where bitter melon is taken as a dietary product will be an important area of future research,” Ray said. She cautioned against seeing bitter melon extract as a miracle cure for breast cancer. “Bitter melon is common in China and India, and women there still get breast cancer,” Ray said. Her research was published in the March 1 edition of Cancer Research.

‘Fake Pot’ Can Cause Seizures In one month’s

time, Anthony Scalzo, M.D., professor of toxicology, saw nearly 30 cases involving teenagers who were experiencing hallucinations, severe agitation, elevated heart rate and blood pressure, vomiting and, in some cases, tremors and seizures. All of these teens had smoked a dangerous, yet legal substance known as K2 or “fake weed.” Scalzo said that K2, an unregulated mixture of dried herbs, is growing in popularity because it is legal, purported to give a high similar to marijuana and believed to be natural and therefore safe. “K2 may be a mixture of herbal and spice plant products, but it is sprayed with a potent psychotropic drug and likely contaminated with an unknown toxic substance that is causing many adverse effects. These toxic chemicals are neither natural nor safe,” said Scalzo, who also directs the Missouri

Regional Poison Control Center at SSM Cardinal Glennon Children’s Medical Center. Scalzo said the symptoms, such as fast heart beat, dangerously elevated blood pressure, pale skin and vomiting suggest that K2 is affecting the cardiovascular system of users. It also is believed to affect the central nervous system, causing severe, potentially lifethreatening hallucinations and, in some cases, seizures. While JWH 018, a synthetic man-made drug similar to cannabis, may be responsible for the hallucinations, Scalzo suspects that there is another unknown toxic chemical being sprayed on K2. K2, also known as “spice,” has been sold since 2006 as incense or potpourri. It sells for approximately $30 to $40 per 3-gram bag, which is comparable in cost to marijuana, and is available to purchase on the Internet. “K2 use is not limited to the Midwest; reports of its use are cropping up all over the country,” Scalzo said. “I think K2 is likely a bigger problem than we’re aware of at this time.” Legislators in Missouri are considering a proposed ban of K2, which Scalzo supports. In the meantime, he says that parents should be on the lookout for warning signs such as agitation, pale appearance, anxiety or confusion due to hallucinations.

3

Railey

Biochemistry and Molecular Biology Chair Named

Enrico Di Cera, M.D., has been named the Alice A. Doisy Professor and chair of the department of biochemistry and molecular biology at the School of Medicine. “I’m thrilled such a distinguished scientist will lead the department through the next decade,” said William S. Sly, M.D., who has served as chair of the department of biochemistry and molecular biology since 1984 and will remain a professor in the department. Di Cera follows in the footsteps of department icons such as Sly, Nobel laureate Edward A. Doisy, M.D., founder of the department, and Robert Olson, M.D. “I have every confidence that Dr. Di Cera will lead the department of biochemistry and molecular biology to great future success and add to the luster that Dr. Doisy, Dr. Sly and others have brought to SLU,” said Philip O. Alderson, M.D., dean of the School of Medicine and vice president for health sciences. Di Cera comes to SLU from Washington University in St. Louis, where he was the Roy and Diana Vagelos Professor of Biochemistry and Molecular Biophysics. Di Cera is an expert in molecular enzymology and allostery, and brings to SLU a strong background in the basic sciences and translational research. He has extensively studied the structure, function and regulation of thrombin and how this enzyme promotes or prevents blood clots. He is the author of more than 180 peer-reviewed and invited articles, and three books. Di Cera says he plans to emphasize and build on the strengths of the department, while reaching out to researchers across campus to establish new collaborations and interactions. He foresees the department becoming a leader in structural enzymology and the molecular origins of disease.

Associate Dean of Multicultural Affairs Appointed

A former member of the School of Medicine family is returning as associate dean for multicultural affairs. Michael T. Railey, M.D., also will be an associate professor of family and community medicine. Railey, who most recently was director of research and medical services for the St. Louis County Department of Health, had been affiliated with SLU’s department of family and community medicine for 14 years. “Dr. Railey is the perfect fit for this job and will be able to take off running,” said Marilyn Maxwell, M.D. “He knows the SLU community because he was part of it for so many years. He connects so well with medical students and will be an asset to the University.” Railey served as an associate professor of community and family medicine from 2001 to 2006; assistant professor from 1996 to 2001; and assistant clinical professor from 1992 to 1996. He served as director of medical education for family and community medicine from 1996 to 2004, during which time he was faculty adviser for students. He also had been preceptor to family medicine residents in training from 1992 to 2006. Railey is a member of the board of directors of the Maternal, Child and Family Health Coalition of Metropolitan St. Louis and the St. Louis College of Pharmacy Alumni Association. He served as a member of the board of directors of the St. Louis Academy of Family Physicians from 1998 to 2002 and is the treasurer of the Mound City Medical Society, St. Louis. He received his medical degree from the University of Missouri-Columbia and completed his internship and residency in community and family medicine at the University of Florida, Gainesville. Railey fills the vacancy created by the June departure of George Rausch, Ed.D.

Grand Rounds Saint Louis University School of Medicine


VitalSigns

During precommencement ceremonies in May, members of the Class of 2010 will walk across the stage at Chaifetz Arena and into a world of uncertainty. The U.S. health care system is facing major changes that will challenge the traditional role of physicians and the relationship between doctor and patient. Is there a fundamental right to health care? Who should have access to care? What role should the federal government play? All are questions policymakers seek to answer as they reshape the system. In the January installment of the School of Medicine’s “Dialogue with the Dean” e-mail message, School of Medicine Dean Philip O. Alderson, M.D., asked alumni what advice they would give

In These Uncertain Times

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You must do what you love to do. Before you enter medical school, all you have to decide is whether you want to become a doctor. Then, open your mind. Learn as much about each field as you can. This learning process can sometimes be overwhelming. Eventually, you will choose a field that you feel is both challenging and rewarding. Maybe you will change your mind. Politics and reform will always be there. Change will come. We do not know what that will be. That is OK. Enjoy the journey. You will only pass this way once. Catherine E. Beal, M.D. ’82 | St. Louis

today’s medical students in these turbulent times. Here

are some of their responses:

Do not go into medicine for money or prestige. If you go into medicine to help people, usually one at a time, to learn new things and to help discover new things, then you will be content and satisfied. If you want money and prestige, you will be disappointed and unhappy. Heidi M. Sallee, M.D. ’95 | Kirkwood, Mo.

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Please learn as much as possible about our health care delivery system while in medical school. There comes a huge awakening to reality once you finish residency regarding how you will survive in a business that has an increasing number of patients and decreasing revenues. You go into medical school thinking you can save the world and have every intention of doing so much good for so many people. Keep that intention, but couple it with reality. Medicine is a noble profession but at the same time serves as a career for those who choose it, which means it will provide you and your family with an income that must be managed wisely. In an era of decreasing reimbursement, you will find it increasingly more difficult to achieve the lifestyle once enjoyed by the profession as more patients need to be seen just to pay the bills, let alone save for your future. Learn as much as you can about fiscal responsibility now because the debt that you will be saddled with will not go away quickly or painlessly. Make wise financial choices but always stay focused on what is most important in your career — the patient — and you will never go wrong. Michael J. Willing, M.D. ’97 | Cincinnati Plan to be a good doctor — whatever the circumstances. You, we, have no control over what will come in the future, but we can control how we respond. Being a doctor is still the best profession a person could ever wish to join. Study hard, enjoy school and look forward to helping your fellow man. I graduated from the SOM in 1969. I still can’t wait to get up in the morning to get to work. Best of luck in your endeavors. John C. O’Brien Jr., M.D. ’69 | Dallas

5

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chair of the department of obstetrics, gynecology and women’s health, has been selected to serve on a World Health Organization (WHO) panel that recommends ways to make pregnancy safer for women throughout the world. Artal is one of four medical experts from the United States to serve on IMPAC, Integrated Management of Pregnancy and Childbirth, a 93-person WHO panel that will review and update the standards of pregnancy care worldwide. IMPAC represents more than 50 counties and offers technical guidance to the World Health Organization on pregnancy. Artal Artal is internationally recognized for his expertise in high-risk pregnancies. A SLUCare obstetrician, Artal is director of obstetrics and gynecology for SSM St. Mary’s Health Center. “Each year, more than a half-million women around the world die needlessly during childbirth or because of complications during their pregnancies. In addition, more than 3.6 million babies die annually during their first month of life,” Artal said. “Most of these deaths — 98 percent — occur in developing countries and could be prevented if women received the quality prenatal treatment and care during childbirth.” Members of IMPAC will collaborate online to update and develop the best practices for pregnancy, childbirth, postpartum and newborn care.

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OB-GYN Chair Selected for WHO Panel Raul Artal, M.D.,

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University is launching a new research center that will be staffed by ex-Pfizer scientists to target medical problems that are common in the developing world, as well as other unmet medical needs. “The new research initiative, called the Center for World Health and Medicine, is another demonstration of SLU’s investment in the region,” said University President Lawrence Biondi, S.J. “Our decision reflects not only SLU’s commitment to keep talented and productive scientists in St. Louis, but the University’s commitment to pursue initiatives that are consistent with our Catholic, Jesuit mission.” Pfizer decided last year to refocus and consolidate its research efforts, a decision that will displace approximately 600 pharmaceutical scientists, representing a significant loss for the region. “While this event represents a major challenge for the St. Louis region, it also represents an opportunity to add a cohort of highly skilled scientists dedicated to research in areas consonant with the University mission,” added Raymond Tait, Ph.D., SLU’s vice president for research. “These are people who have expertise in moving scientific discoveries from the laboratory to the clinic. They also demonstrate an entrepreneurial spirit,” Tait said. “Of course we wanted to find a home for them.”

Initially, the new research center will hire about a dozen ex-Pfizer scientists, who are expected to start working at SLU in July. The center is part of a regional push to keep scientific talent in the area, a major priority of the St. Louis Regional Chamber and Growth Association and Coalition of Plant and Life Scientists, Tait added. In addition, it is consistent with recent initiatives under consideration by the State of Missouri aimed at providing support for research endeavors with the potential to spawn business development, such as the Missouri Science and Innovation Reinvestment Act. “As Father Biondi has indicated, the center dovetails with SLU’s Jesuit mission of service to others because it focuses on improving the health of those most in need, including people who live in the developing world, where health care is lagging,” Tait said. “To that end, the center will initially focus on medical conditions associated with high mortality in developing world countries, such as childhood diarrhea.” Finally, the scientists in the center are expected to bring unique skills that can yield synergies with research strengths already present at the University. “While it is too early to assess the impact of this initiative,” Tait said, “I fully expect that the impact will be positive for the University, the region and, ultimately, for the countries of the developing world.”

}

New Research Center to Target Drug Discovery Saint Louis

1) There is only one way you can go through the rigors of training, the endless task of continuing education, the paperwork, and the physical and psychological demands of being a physician. It is because you love it and can’t imagine doing anything else. If it is your life’s calling, it is not work, and every day is an opportunity, not something to dread. 2) If you enter into medicine with the anticipation or expectation of wealth, pick another field — not because a comfortable economic lifestyle is not possible but because it is the wrong endpoint, and you will always be disappointed no matter how much you make. 3) Don’t listen to anyone older than yourself talk about the good old days of medicine. You will live and practice in your own good old days. 4) Respect your patient’s time. It is as valuable as yours. 5) Never lie to your patients or hedge the truth, no matter how dire the news. Paul Busse, M.D. ’82 | St. Louis

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Look at all of the fields of medicine and choose the one that is of greatest interest to you. If you have no passion for the specialty chosen, your life in medicine will become difficult. On the contrary, if you are excited by the work you are doing, you will maintain your love of medicine and best serve your patients. Maintain a life outside of medicine. Make your family first in importance as you serve your patients. It is not necessary to neglect your family in order to be a good physician. Keep or develop an interest in the arts, skills in sports or hobbies. These interests will make you a better human being and a better physician. William M. Fogarty, M.D. ’60 | St. Louis

You can find more responses from alumni at medschool.slu.edu/alumni/ “Dialogue with the Dean” is a regular e-mail message sent from the dean to alumni. It provides alumni with an opportunity to share their comments about current health care initiatives and/or topics related to the School of Medicine. If you are not receiving Dialogue with the Dean, e-mail mdalumni@slu.edu.

Grand Rounds Saint Louis University School of Medicine


New clinic offers health care and hope to the Latino community.

left | Only about 3,000 square feet of the 6,000 square foot building have been renovated thus far. The facility includes meeting space, two medical exam rooms, a small lab, consultation rooms and office space. center | Members of the School of Medicine’s Casa Student Interest Committee: First-yearstudent Laketa Entzminger, second-year-student David Wilson, F. David Schneider, M.D., chairman of the department of family and community medicine, second-year-students Andrew Leinweber, Jill Zaveri, Ryan McDowell and Stephanie Jackson. right | The clinic waiting and conference area.

F

irst-year medical student Laketa A. Entzminger was heartbroken last April as she packed up the pharmacy at La Clinica in south St. Louis. For more than a decade the clinic provided lowcost health care to members of the Hispanic community who were either uninsured or underinsured. But the clinic was out of funds, and Entzminger was out of a volunteer opportunity that reinforced her reasons for applying to medical school. “I enjoyed being exposed to a culture other than my own,” said Entzminger, who had been a volunteer at La Clinica for seven months. “I also felt I was making a difference there. You can get overwhelmed by all the facts you have to absorb in medical school, but at the clinic it was just about you and the patients.” Although the money went away, Entzminger and others involved with the clinic knew the needs of the Latino community did not. In addition to La Clinica, Accion Social Comunitaria, another clinic that served a largely Hispanic population, also shut its doors last year. Between the two centers, volunteer physicians treated 10,000 to 12,000 patients annually. Where would these patients go now? Safety net providers absorbed as many of these patients as they could, but other patients — limited by their lack of understanding or comfort with the health care system — would be without services. Health care providers predicted these patients eventually would show up in emergency rooms and/or become chronically ill, which would increase pressure on an already strained system. Entzminger, along with other SLU student volunteers and Mary Ann Cook, director of La Clinica’s board, took their concerns to Bob Fox, a Saint Louis University trustee, and his wife, Maxine Clark, who had donated generously to La Clinica. They went to University President Lawrence Biondi, S.J., who, without hesitation, asked what SLU could do to help.

6

Low Rent—High Expectation

Ensuing discussions led to the creation of Casa de Salud (House of Health), a new clinic that opened in January on the southwest corner of Compton and Chouteau avenues. Casa is housed in an old auto parts shop bought by the University and previously used for storage. The University converted about half of the 6,000-square-foot building into a health care center where natural light overpowers the artificial. A colorful mural covers the walls of the reception area. Exam rooms are supersized to accommodate Latino patients who customarily bring their families along on doctor visits. The University rents the facility to Casa for a dollar a year and is the clinic’s founding and sustaining sponsor. “This initiative fulfills our mission of reaching out to help a seldom or never-served portion of our community,” Biondi said. Casa is staffed by five paid employees, dozens of undergraduate and graduate volunteers from Saint Louis University and Washington University in St. Louis, and volunteer physicians from both SLU and Wash U. It celebrated its grand opening on April 16. “Casa de Salud shows what great things St. Louis can accomplish when leaders like Bob Fox, our universities and community-minded supporting organizations work together,” said Philip O. Alderson, M.D., dean of the School of Medicine, vice president for health sciences and a member of Casa’s board of directors. Students from nearly all schools and programs at SLU’s Medical Center — nursing, clinical laboratory science, nutrition and dietetics, physical therapy and occupational therapy — volunteer and work on interprofessional teams to serve patients. “This approach will improve access and quality of care,” said Mary Ann Lavin, Sc.D., R.N., A.P.R.N., associate professor in the School of Nursing and Casa’s director of clinical services. “It

also provides students in various disciplines an opportunity to advance their knowledge and skills in collaborative practice and to learn to build bridges between health care professions.”

Making Connections

The many doctors and volunteers offering their services at Casa de Salud are finding more than just a new clinic — they are finding a different philosophy from La Clinica. Whereas La Clinica was a medical home to its patients by providing comprehensive health care to all ages, Casa de Salud provides episodic care and partners with the patients to facilitate their entrance into the larger health care system.

“We do not want to duplicate services that are already out there. We simply want to connect our patients to existing resources.” Stephanie O’Donnell

| Administrative Director of Casa

Casa’s target population also differs from La Clinica’s. Because federally funded clinics have a great capacity to serve prenatal women and children, Casa health care services are geared primarily toward adults. Casa will provide its patients with basic health care and treatment for minor injuries and illnesses. Patients can get physicals or flu shots, for example, but if a screening indicates a patient has hypertension, the blood pressure will be treated, a referral will be made to a health care institution where the patient can receive a continuity of care not possible with a volunteer physician base. “Connecting our patients to the larger community is key to our mission, but it will be a challenge,” said F. David Schneider, M.D., M.S.P.H., professor and chairman of the department of

family and community medicine. Schneider helped create Casa’s structure, serves on its board of directors and is overseeing the development of Casa de Salud’s new programs. “Because Latinos are such a small percentage of the population in St. Louis, there is no infrastructure in place to assist them. We have to build that infrastructure in order to make the referral process effective.”

A Warm Handoff

To build that infrastructure, Casa staff members are meeting with staff from health care providers throughout the metro area to exchange information about services and requirements. Casa also hopes to smooth the way with a navigator system. Students such as Entzminger, co-chair of the School of Medicine’s Casa de Salud student interest committee, serve as navigators who follow patients from the minute they walk in the door. When the patient is referred elsewhere, the navigator and patient will go over intake forms and procedures from that agency beforehand. The navigator may even escort the patient on the initial visit. “We like to think of this as a warm hand off,” said Stephanie O’Donnell, administrative director of Casa. In addition to basic medical services, Casa hopes to develop a range of programming that could include financial and health literacy to physical fitness and English classes. Casa also would like to create a referral center to connect immigrants to services such as banks and schools. “Our ultimate goal is to build a community center, taking a more holistic approach to health and wellness,” O’Donnell said. “But we don’t want to come in at this point and tell the community what it needs. We’ll offer health care to start and let the community tell us where to go next.”

Case de Salud is in need of more physician volunteers, especially those specializing in internal and family medicine. For information, contact Mary Ann Lavin, Sc.D., R.N., A.P.R.N., Casa’ clinical director at 314-762-1251.

Grand Rounds 7


2 Flood

answering the call

1 Flood

Robert Flood, M.D., associate professor of pediatrics

1 RICE

mid-January, health care professionals at Saint Louis

University’s Medical Center began mobilizing. They gathered

2 RICE

not prepared for what they saw when they arrived.

Others found hope in the most unexpected places. Here are some of the stories and images they brought home.

Rice

1 Tim Rice, M.D., poses with a group of boys from the orphanage next to the guest house where he stayed. 2 Keri Johnson, M.D. (’00), spends her limited downtime playing with one of the boys from the orphanage.

Flood 1 A Haitian toddler waits his turn to see one of the doctors at Hôpital SacréCoeur. 2 A Haitian girl smiles in the midst of the chaos.

8

1 Paletta

Paletta 1 Physicians triage a patient brought to the door of Hôpital Sacré-Coeur.

and director of pediatric emergency medicine at SSM Cardinal Glennon Children’s Medical Center and pediatric transport nurse Mary Laffey, were part of a team that left for Haiti in January to care for the injured at Hôpital Sacré-Coeur in Milot, a town about six hours from Port-au-Prince. The 74-bed hospital swelled to a 300-bed hospital as a steady stream of injured patients arrived by road and helicopter from the capital city. Men, women and children with crushed limbs, mangled extremities and open wounds who could not get in immediately waited patiently outside on dirty blankets. Flood said there was no time to think, only time to act.

“The strength the Haitians displayed will touch me forever.” FLOOD

Less than a day after the earthquake hit Haiti in

supplies, medication, food and funds. But still, some were

»


1 RICE

3 Paletta

Paletta

1 A Haitian boy strikes a pose in the middle of the rubble. 2 A team of physicians prepare to help a Haitian girl with severe leg injuries. 3 The injured were rushed by helicopter and trucks to Hôpital Sacré-Coeur.

Rice

“Haiti’s earthquake clearly is the biggest natural disaster of our lifetime; to fail to respond when asked would be unconscionable.” PALETTA

Tim Rice, M.D.,

2 RICE

»

1 A Haitian orphan with sickle cell anemia is seen by Rice’s team during the team’s stay in Las Cayes. The orphanage normally cares for 200 children but the number swelled to 300 after the quake. 2 Fourth-year medical student, Marie Miller comforts an abandoned child with cerebral palsy at the orphanage. 3 Keri Johnson, M.D. (’00) and Jessica Bowers, M.D. (’00) read through cards made for the orphans by children from their St. Louis church, New City Fellowship.

A day after Flood returned, associate professor of pediatrics and internal medicine, led a team of physicians — many of them School of Medicine alumni — to Les Cayes, a small city about four hours south of Port-au-Prince. Marie Miller, a fourth-year medical student, took time away from studies to join Rice’s team. Rice’s daughter, Diana, a junior at SLU’s Parks College of Engineering, Aviation and Technology and a licensed pilot, also took time off school to fly medical supplies to Haiti. Rice’s team worked out of Immaculate Conception Hospital and stayed in a building next to a Haitian orphanage.

3 RICE

1 Paletta

Christian E. Paletta, M.D., professor of surgery

and director of plastic and reconstructive surgery, received a call in the middle of the night from a physician-friend who was volunteering in Haiti. They needed plastic surgeons badly. The chaos in the immediate aftermath of the quake had fallen off, but thousands who survived were left with gaping, infected wounds that needed closure. Paletta, who had never been on a medical mission before, agreed to go in February. He was motivated by the opportunity to use his skills where they were so desperately needed and by the fact that his daughter, a cartographer for the United Nations, was in Haiti to map the terrain for proposed refugee camps. Like Flood, Paletta worked in Milot out of Hôpital Sacré-Coeur. He worked 12-hour days, going from room to room closing wounds and amputating limbs that couldn’t be saved.

2 Paletta

The School of Medicine has a special connection to Hôpital Sacré-Coeur. It is operated by the CRUDEM Foundation, which Theodore J. Dubuque Jr., M.D. (’52) once led. Dubuque began volunteering as a surgeon in Milot in 1986 and over the years helped transform the eight-bed clinic into a full hospital. Now thousands of physicians and volunteers, many from SLU, spend time at the hospital each year. For more information about Hôpital Sacré-Coeur, go to crudem.org.

Grand Rounds 11

medschool.slu.edu/alumni/

“I may have led the mission, but it was my colleagues back home who stepped up and covered my responsibilities that made the mission possible. They are the real heroes.” RICE

more


“You can do as much with penicillin as you can with a smile.”

Armand E. Brodeur, M. D., 1922-2009

by Nancy Solomon

Armand E. Brodeur, M.D., a founding father of pediatric radiology at Saint Louis University and SSM Cardinal Glennon Children’s Medical Center, lived by his words. During his nearly four decades with the University, Dr. Brodeur mixed a hefty dose of showmanship with the practice of pediatric medicine. He did his best to make the radiology department at Cardinal Glennon child-friendly.

12

A magician since high school and a member of the Society of American Magicians, Dr. Brodeur used razzle-dazzle to charm frightened children who were having X-rays. He wore cartoon-covered lab coats and decorated Glennon’s radiology suites so children could imagine they were entering a space ship or cartoon world. His efforts received national coverage in outlets including Reader’s Digest and Time magazine. “When I do magic and paint halls and wear corny jackets, it’s not because I haven’t grown up,” Dr. Brodeur was quoted as saying in a 1974 Time magazine article. “To stand tall in pediatrics, you have to do it on your knees.”

Doug Ries, who was president of Cardinal Glennon when Dr. Brodeur was director of radiology, said Dr. Brodeur lit up when he was with children. “He loved to be around kids,” Ries said. “He put himself through college by doing magic. He used that talent and skill in treating his patients and distracting them from medical procedures. He loved to dress up and would wear Star Wars and Snoopy outfits to put kids at ease.” Dr. Brodeur came to Saint Louis University as a medical school student in 1945 and was part of the Saint Louis University/Cardinal Glennon family for about 40 years. Dr. Brodeur helped create the pediatric radiology program at Cardinal Glennon and SLU. He was the hospital’s first chief of pediatric radiology and helped decide what imaging equipment to order when the hospital opened its doors in 1956. He served as director of radiology at Cardinal Glennon for 32 years and was chairman of the department of radiology at SLU from 1975-78 and department vice chairman and director of radiology at Cardinal Glennon until 1988. “He was one of those grand old men of the medical school and Cardinal Glennon, one of those patriarchs who had a dramatic impact on the lives of many during the last 50 years,” said Robert Heaney, M.D., senior associate dean of the Saint Louis University School of Medicine, who first met Dr. Brodeur as a resident at SLU more than 30 years ago. Dr. Brodeur built a second career as a media doctor who hosted his own medical show, “Doctor to Doctor,” on KMOXAM 1120 for many years and frequently served as an expert source for television and newspaper stories. Brodeur appeared on The David Letterman Show and was interviewed by Charles Kuralt, who called him “the gentle wizard.” Dr. Brodeur founded the National Association of Physician Broadcasters and taught physicians who attended American Medical Association meetings how to work with reporters. A professor emeritus of both radiology and of pediatrics, Dr. Brodeur was the author of two radiology textbooks and frequently wrote and lectured on diagnosing child abuse. As a radiologist, Dr. Brodeur was all too familiar with the broken bones that come from child abuse. He also developed techniques to reduce X-ray exposure of children to avoid injury to growing tissues. Dr. Brodeur was chairman of radiology and on the radiology staff from 1988 to 2004 at Shriner’s Hospital in St. Louis. He was the “life and soul” of the party, eager to regale guests with magic tricks, said Michael Wolverson, M.D., professor and chair of radiology at Saint Louis University. “He is responsible for me being here,” Wolverson said. “He was a very persuasive force in recruiting radiologists to Saint Louis University and did much to mentor them throughout their careers. He was one of a kind.” Dennis O’Connor, M.D., professor of pediatrics at the School of Medicine and a Cardinal Glennon pediatrician, called Dr. Brodeur a gifted teacher who started his day at 4:30 or 5 a.m. by checking the work of residents. “He was an excellent radiologist and always wanted to teach,” O’Connor said. “He spent a lot of time teaching the residents.” Dr. Brodeur was 87 years old when he died in December.

V ernon W. F ischer, Ph. D., 1923-2010 Vernon W. Fischer, Ph.D., a longtime professor of anatomy, neurobiology and pathology, died in February from an illness stemming from a stroke. He was 86. Dr. Fischer first came to the University in 1956 as a medical laboratory technician in the department of pathology. In 1967, he decided to pursue a lifelong wish to become a teacher and started his graduate studies in the pathology department. Dr. Fischer graduated with a master’s degree in 1969, a doctorate in 1972, and subsequently joined the department of anatomy and neurobiology where he served as a full-time faculty member until 1992 and a professor emeritus until 2002. “Dr. Fischer will be remembered as a dedicated educator, a loyal faculty member in the School of Medicine and a trusted colleague. He was a real role model.” said Daniel Tolbert, Ph.D., professor and director of SLU’s Center for Anatomical Sciences and Education.

C arrol L R. M arkivee, M. D., 1927-2010 Carroll R. Markivee, M.D., an alumnus and an associate professor of radiology at the School of Medicine for 17 years, died in February at the age of 82. Before joining the University, Dr. Markivee was a clinical assistant professor of radiology at Rush Medical School in Chicago. He also was on faculty at the University of Missouri Columbia, where he was chairman of the radiology department. He was acting director of the nuclear medicine section of the University of Missouri - Columbia and Truman VA Hospital and chief of the radiology service at Truman VA Hospital. Even with all of his professional commitments, Dr. Markivee found time for his hobby – the harmonica. Dr. Markivee was a longtime member of the Gateway Harmonica Club. He was also a Korean War veteran.

R aymond M. K eltner, M. D., 1929-2010 Raymond M. Keltner, M.D., professor emeritus of surgery, died March 20, after suffering a stroke on March 15. He was 80. Dr. Keltner’s research included studying improved techniques for cardiopulmonary bypass and kidney transplants. “A generation of surgeons was taught by chiefs of surgery like Dr. Keltner,” said Christian Paletta, M.D., director of plastic and reconstructive surgery at SLU. “It’s from the chiefs of surgery where you learn the most.” An avid auto racer, Dr. Keltner first came to SLU in 1968 as an assistant professor of surgery. That year he also was appointed chief of surgery at St. Louis City Hospital, where he served until its closing in 1985. He became an associate professor in 1971 and retired in 1994, when he became professor emeritus. Dr. Keltner was a line officer in the navy during the Korean War.

E dward R. G ravi S s , M. D., 1942-2010 Edward Richard Graviss, M.D., a pediatric radiologist at SSM Cardinal Glennon Children’s Medical Center and professor of radiology and pediatrics at the School of Medicine, died in April after battling pancreatic cancer. He was 67. Dr. Graviss was a member of the SOM faculty for 32 years and directed the department of diagnostic imaging at Cardinal Glennon from 1988 to 1999 and from 2002 to 2006. A highly skilled radiologist, Dr. Graviss performed interventional procedures on children, such as inserting catheters, which helped them avoid larger surgeries. He joined SLU as an assistant professor of radiology in 1976, and obtained a secondary appointment in pediatrics in 1977. He became an associate professor in both departments, and gained his full professorship in radiology in 1988 and in pediatrics and adolescent medicine in 1992.

Grand Rounds 13


of rejection

fear

A new chief is ready to take the abdominal transplant program to the next level. You can make some fairly safe assumptions about Janet E. “Betsy” Tuttle-Newhall, M.D., just by perusing her office on the 11th floor of Desloge Towers. She has three pairs of shoes on the floor, including a pair of brown, tiger print Uggs and a pair of black, thick-soled clogs. She favors function over fashion. She has a small clay urn on her bookshelf that holds the “Ashes of Problem Patients.” She has a sense of humor. On the bottom shelf is a slow cooker — empty of the chili she brought to a potluck dinner she hosted in the transplant office. She encourages teamwork. There’s a yoga mat rolled up behind her chair, a trickling Zen water fountain on the windowsill and a small bottle of eucalyptus incense on her desk. She strives for harmony and focus. On the wall is a framed apostolic blessing from Pope John Paul II citing Tuttle-Newhall for her compassion, kindness and ability to heal. She is respected and dedicated. Her desk is covered with lopsided piles of papers, journal articles, charts, graphs and a flurry of sticky notes. She has a lot on her plate.

Tuttle-Newhall has had a lot on her plate since September 2009 when she became professor of surgery in the School of Medicine and chief of the abdominal transplant program at Saint Louis University Hospital. The school and hospital formed a transplant advisory council nearly two years ago to enhance the abdominal program. Recruiting a surgeon with Tuttle-Newhall’s experience was a major step in the plan. “Dr. Tuttle-Newhall and I have enjoyed working together in the reorganization of both the liver transplant program, and the kidney and kidney-pancreas program,” said Bruce R. Bacon, M.D., professor of internal medicine, director of the division of gastroenterology and hepatology, and chair of the transplant advisory council. “Her knowledge about medical and surgical issues, as well as transplant policy and regulations, are major assets for our institution.” The medical school recruited Tuttle-Newhall from Duke University Medical Center in Durham, N.C., where she was the liver transplant director, abdominal transplant fellowship director, an associate professor and the primary pediatric abdominal transplant surgeon for more than 10 years. She has been a consultant for several U.S. Health Resources and Services Administrative initiatives to improve the nation’s organ donation and transplantation services. Currently, she is on the faculty of the HRSA’s Organ Donor Collaborative. Tuttle-Newhall has received six awards for patient care and teaching, including Duke’s Davison Society Excellence In Teaching Award, which is equivalent to the Golden Apple Award given annually by medical students at SLU. In 2006, she received the HRSA/Health and Human Services Medal of Honor for Organ Donation and Transplantation. Tuttle-Newhall is the author of more than 100 papers and book chapters. Clinical topics include malnutrition in liver transplant patients, treatment of the multi-organ donor, the current

status of living donor liver transplantation and complications caused by obesity in transplant patients. Her policy papers cover building a modern transplant center, institutional policies for the training and work environment, and best practices in organ donor management. All of this from a physician who initially rejected the idea of becoming a transplant surgeon.

JTN: I did my general surgery training at a few places (North

Carolina Baptist Hospital, West Virginia University) but finished at Harvard Medical School as a transplant resident at New England Deaconess Hospital in Boston. They had a huge transplant program there. I liked the work very much, but I was married, and I didn’t want the transplant lifestyle — being up three days in a row, phone calls at all hours. I wanted to have some private life.

GR: What happened to that plan? JTN: After I finished my residency, my husband and I went to

North Carolina, where he started his urology training, and I accepted a surgical critical care fellowship at the University of North Carolina. When that ended, the only jobs I could find were as a breast surgeon or a transplant fellow at Duke. I called my chief back in Boston and said, “What am I going to do? My husband’s here for four years. I want to do critical care, but I can’t find a job.” He told me to go over to Duke, take that fellowship and do what I was meant to do. He was right.

GR: What made you change your mind about the transplant lifestyle? JTN: I love the difference I make in patients’ lives, honoring

a donor’s gift and prolonging, as well as changing, lives. For example, one of the things I love about pediatrics is taking green little children and turning them into pink little children. A

Grand Rounds 15


Her first patient is child therapist William Randle. Tuttle-Newhall performed his double kidney transplant in November, the first double kidney transplant in the program’s history. (far right) | Tuttle-Newhall frequently consults with Erik Schadde, M.D., director of liver transplantation.

A Day in the Clinic | Tuttle-Newhall starts her day in the clinic going over lab results and medications with colleagues including Matthew Greulich, a third-year medical student on the first day of his transplant rotation, and Joan Feise, R.N., transplant coordinator.

GR: You’ve written about the steps needed to build a modern transplant transplant can work in some children practically overnight. Their eyes start out yellow when they’re sick, and almost immediately after transplantation, they get white. Their skin pinks up. Their moms will say, “Look! He has pink cheeks!” It’s really cool.

program. How does the program at SLU fare?

JTN: The first thing it takes is institutional vision and commitment, and we’ve got that. Next, it takes a team of dedicated personnel, and we’ve got that. The people here are outstanding. The first week on the job I was in the operating room performGR: What attracted you to Saint Louis University? ing a liver transplant, and the team was so enthusiastic — so enJTN: It’s a unique opportunity to build a transplant program. ergetic. I wasn’t used to that. Everybody wanted to know what Our ultimate goal is to create an independent center. We’re in I needed and how they could help. I went to Cardinal Glennon the homework phase now, but we have the institutional comfor surgery and needed some equipment from the hospital. No mitment, and that’s the hardest piece. I went to a transplant problem. They sent it through the tunnel, and I was good to go. advisory council meeting this morning, for example, and the The other element needed for a modern transplant program dean was there as well as the CEO and COO of Saint Louis is an aggressive clinical style. You have to be aggressive about University Hospital/Tenet. That shows the level of commitrecruiting patients and conveying your talents to referring ment we have here. physicians and referring facilities. We’ll be Also, this is a program with a great making that happen. I have a great team of Saint Louis University Hospital’s tradition. It’s supported by one of the best Abdominal Organ Transplant Program surgeons, nurse coordinators and adminishepatology departments in the country and trators. is one of the most established programs in a phenomenal nephrology group. We have And, probably the most important thing the region. In 2009, 112 patients received interventional nephrologists who are amazit takes to build a great center is patienttransplants: ing. They’re improving vascular access and and family-centered care. You want a pahelping us strategically plan treatment. I’ve 66 kidney (53 from cadavers tient to come through your door and know and 13 from living donors) never seen nephrologists do this before. It she is not a number. You want her to know means better outcomes for patients. you’re with her at the most frightening time 5 kidney-pancreas Being connected to Mid-America Transof her life and are willing to support her plant Services also is a big plus. They have family as well. 33 liver one of the best-performing organ procureGR: How would you describe your 8 liver-kidney ment agencies in the country. management style? The program was the first in Missouri to perform kidney-pancreas transplants and was the first in the state to use laparoscopic surgery to transplant kidneys. A majority of patients who undergo laparoscopic transplants are hospitalized for only one day. In 2009, the program earned a silver Medal of Honor for Organ Donation from the Health Resources and Services Administration. The medals are given to hospitals in which at least 75 percent of eligible donors actually donate an organ.

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JTN: Evolving. I know this will sound

stereotypical, but I believe women lead by sharing power and information. I think women are apt to utilize a team approach, and that’s what I intend to do. I’ve done some work for the National Quality Forum

on patient safety, and one of the forum’s leaders, Dr. Charles Denman, talks about the three Ts of leadership: truth, trust and teamwork. I keep those in mind as I try to figure out my style. It’s a difficult process, though, because I don’t have many role models. I’m a member of the Association of Women in Surgery, and I ask my colleagues for advice, but it’s still hard. You can’t just pick up the phone and call 20 women because they’re not there. There aren’t many females in administrative positions, or I should say as many as there should be. In the south you can’t find a female in hospital leadership. What we have here at Saint Louis University and the Hospital (Dawn Anuszkiewicz, COO, Crystal Haynes, CEO, and Kate Becker, CEO of the University Medical Group) is unusual and refreshing.

GR: Now that you’re a female in a leadership position, you’ll be a role model for your students and residents. JTN: I take that responsibility seriously. Women bring a different and useful perspective to surgery, but to be honest with you, I think surgery will suffer if some of the issues women face are not resolved appropriately. Half of all medical school students are women, and if they don’t see female chief residents in surgery and female attendings and female chairmen, what does that tell them? There’s a 27 percent attrition rate for women in surgery — 20 percent in men. If this keeps up there’s going to be a crisis when we retire. Bottom line — I don’t think you have to promote women in surgery just because they are women, but I don’t think you should negate them because they are women.

GR: Where do you find yourself most comfortable in your new job? JTN: I’m probably most comfortable in the operating room. It’s always a good place to be. You’re in control. The phone doesn’t ring. You can concentrate on what you love to do.

I also love teaching. Students have a tendency, if you’re doing it right, to keep you honest. They make you sit up and read the journals and defend your position. They don’t respect me because I’m a full professor or received tenure at Duke through the ranks. They respect me because I say what I mean and mean what I say.

GR: You’ve served on several HRSA and United Network of Organ Sharing committees to help improve organ donation and transplantation. What is being done to make sure the most organs are doing the most good? JTN: We know that with the number of people who die in the

United States each day and are eligible to be donors we could transplant the list appropriately — if we could get consent from patients and families. That’s a big if. When Tommy Thompson was secretary of Health and Human Services under President George W. Bush, one of the things he wanted to do was change how we fundamentally do “business” in organ donation and transplantation. You can’t transplant if people don’t donate. So, he brought everybody into the same room in 2003 and 2004: organ procurement people, transplant surgeons — including me — physicians, recipients, patients on the waiting list, donor families. It was probably the first time donor families had a seat at the table for a national discussion about transplant. The effort was effective. During the last five years we’ve had a 25 percent increase in the number of organs available to us, but we’ve reached a plateau. The question we face now is how to keep the improvement, the increase, going. Not an easy question, but we never stop looking for the answer. As we say in the collaborative, “The answer is in the room.” We just have to listen. Tuttle-Newhall moved to St. Louis with her husband, Philip M. Newhall, M.D., an assistant professor of surgery in the division of urology; their 9-year-old-daughter, Elizabeth Grace; their 6-year-old-son, Thomas; Tuttle-Newhall’s sister, Anne Tuttle, who is a nurse at SLU Hospital; two dogs and a cat.

Grand Rounds 17


When John E. Morley, M.D., and George T. Grossberg, M.D.,’75 run into one another in the faculty lounge they do more than discuss their research. They compare itineraries. Morley and Grossberg are among the School of Medicine’s most welltraveled scientists. Morley is an internationally known expert on aging, nutrition, male menopause and Alzheimer’s disease. An endocrinologist as well as a geriatrician, Morley is the recipient of multiple national awards for his leadership in geriatrics and is listed in the International Who’s Who in Medicine for his research on obesity. Grossberg is an internationally respected psychiatrist who started the first geriatric psychiatry program in Missouri and the state’s first Alzheimer’s disease brain bank. A past president of the International Psychogeriatric Association, Grossberg is a consultant to the pharmaceutical industry in developing protocols for central nervous system disorders in the elderly and is involved in a variety of basic, as well as clinical research projects on dementia. Both are frequent speakers at national and international symposia. Many months of the year they are out of town more days than they are in. The two have a playful competition over who has logged the most airline miles, with Grossberg claiming about 6 million and Morley trying to catch up. While Morley and Grossberg share a sense of humor, they are very serious about their work. In this feature, we focus on one aspect of their internationally recognized research: Alzheimer’s disease.

For John Morley, M.D.,

director of the division of geriatric medicine, Alzheimer’s disease stole the memories of many of his patients and broke the hearts of their families. Then his father-in-law became ill, and the fight became even more personal.

18

“It’s a horrible disease. We need to be able to cure it and help people function better,” Morley said. “Seeing the suffering of my wife as she cared for her father increased my determination to find a way to help people who are struggling with this terrible burden.” Morley and the team of physicians and scientists with whom he collaborates on Alzheimer’s research are attacking the disease on many fronts. In an animal model, they have shown that an antisense — a molecular compound — blocks messenger RNA from the genome. It triggers a process that prevents the overproduction of amyloid beta protein, stopping oxidative damage to brain cells and reversing learning deficits and memory loss.

The antisense doesn’t totally shut down amyloid beta protein, which last year SLU scientists showed is central to memory in normal brains. “Only when it’s overproduced do you get Alzheimer’s disease,” Morley said. He recently presented a session about his antisense research to a group of scientists in Stockholm. The next step is to develop an antisense drug for testing in people. Morley’s group also has developed a screening tool for dementia — the Saint Louis University Mental Status (SLUMS) examination — that appears to be better at identifying mild cognitive problems in the elderly than the more commonly used Mini Mental Status Examination. Both screening tools indicate to doctors when they should pursue further testing to diagnose dementia.

Translated into at least 10 languages, the SLUMS now is being used as the screening tool of choice by the U.S. Department of Veteran Affairs hospitals and is used widely across the country. Studies are under way to further validate its ability to predict mild cognitive impairment, which is a precursor to Alzheimer’s disease, Morley said. “Developing and testing the SLUMS is one of the major contributions we’ve made,” Morley said. Some of the work of Morley’s group focuses on the basics — nutrition and exercise. In a clinical trial, he is studying whether a supplement drink that is rich in nutrients and antioxidants can improve thinking and memory in patients who have early Alzheimer’s disease. A recent study by a medical student mentored by the geriatrics division showed that exercise improves the behavior of nursing home residents who have Alzheimer’s disease. “I’m interested in what controls brain behavior,”

Morley said. “When I became a geriatrician, a logical place for me to study was memory. More than 5 million people have Alzheimer’s disease, and we need to find a cure and better treatments for this illness.”

George Grossberg, M.D., points out that with

the exception of cancer trials, there are more research studies in various stages being conducted on Alzheimer’s disease than in any other area of health care. “Baby boomers are reaching a time when they are at risk; their parents are already there,” he states. “There’s a more urgent demand than ever before for prevention of and treatment for the disease.” Alzheimer’s disease cases in the United States are expected to double by 2050. Tackling Alzheimer’s on all fronts, Grossberg is leading six separate Alzheimer’s studies at SLU, addressing all stages of the disease. “This is the first time in the history of SLU’s medi-

G R A N T S at a Glance Ryan M. Teague, Ph.D., assistant professor of molecular microbiology and immunology, received a $1.8 million grant from the National Institutes of Health for the project, “Exploiting Dual-TCR for Rescue of CD8 T Cell Tolerance in Adoptive Immunotherapy.” Krista L. Lentine, M.D., assistant professor of internal medicine in the division of nephrology and SLUCOR, received a $1 million grant from the National Institute of Diabetes and Digestive and Kidney Diseases for the project, “Reducing Geographic Disparity in Transplant Access: Clinical and Economic Impact.” Jung San Huang, Ph.D., professor of biochemistry and molecular biology, received a $842,000 grant from the National Institute on Alcohol Abuse and Alcoholism for the project, “Development of a Novel TGF-best Antagonist for Treating Hepatic Fibrosis.” Patrick M. Stuart, Ph.D., associate research professor of ophthalmology, received a $697,000 grant from the National Eye Institute for the project, “Role of Apoptotic Molecules in Herpes Stromal Keratitis.” Michael I. Rauchman, M.D., associate professor of internal medicine, and biochemistry and molecular biology, received a $643,000 grant from the National Institutes of Health for the project, “Biochemical and Functional Studies of Sall1 in Kidney Development and TBS.”

cal school that we’ve had so many new, different and promising approaches for Alzheimer’s disease patients in all stages,” Grossberg said. “When people call, the chances are good that we’ll have a study they’ll fit into.” In addition to the aging of the baby boomer population, adults are living longer, making Alzheimer’s a top concern. Researchers hope that, by learning more about the early stages of the illness, they may be able to delay or prevent full Alzheimer’s. In one study aimed at prevention, Grossberg examines whether a medication may hinder enzymes that form damaging beta-amyloid plaques. He hopes it can help people who may be having a few “senior moments” before those issues develop into daily memory problems that affect their ability to function on a regular basis. Another study looks at whether gammaglobulin, made from the blood of several thousand healthy adults and containing naturally occurring human anti-amyloid antibodies, will defend the brain of Alzheimer’s disease patients against the damaging effects of beta amyloid, the protein that forms the core of plaques in the brain, in hopes of slowing the progression of the disease. While researchers pin their hopes on prevention, doctors know they don’t have enough options to offer to patients in middle and late phases of Alzheimer’s. Grossberg’s research also aims to find answers for those who already have the disease. In the end, Grossberg knows that his studies matter because they will affect the people we know and love.

Grand Rounds 19

»

Poised for Discovery

»

John E. Morley, M.D. Dammert Professor of Gerontology | Director of the Division of Geriatric Medicine | Joined SLU in 1989

George T. Grossberg, M.D. (’75) Samuel W. Fordyce Professor Director| Division of Geriatric Psychiatry Joined SLU in 1978

“When it comes to Alzheimer’s disease, if you ask somebody on the street, ‘Do you know someone with this disease?’ chances are good that they’ll know someone,” Grossberg said. “This is a disease that really affects people on a personal level.”

Writers Nancy Solomon and Carrie Bebermeyer contributed to this story.


Internal Medicine Jennifer Atlas

University of Texas Medical SchoolHouston

Ani Baghdassarian

University of California Irvine Medical Center  A Family Affair: Stephanie Do (right) opens her white envelope and shares the good news with her sister, Victoria Do. Stephanie Do matched in pediatrics at the University of Southern California.

Match Day On March 18, the excitement that filled the Redbirds Club at Busch Stadium in downtown St. Louis had nothing to do with the St. Louis Cardinals and everything to do with the School of Medicine’s Class of 2010. The Redbirds Club was the site of this year’s Match Day ceremonies, where members of the class ripped open their white envelopes to discover where they would continue the next phase of their medical studies. Emotions ran high during the traditional Match Day ritual.

Anesthesiology Nitin Anand

Rush University Medical Center-Ill.

Ankur Dave

Dermatology Saint Louis University School of Medicine

Rush University Medical Center-Ill. Saint Louis University School of Medicine

Courtney Tobin

Rush University Medical Center-Ill. University of Southern California

Emergency Medicine

Armen Kara

Monica Keeline

Beth Israel Deaconess Medical Center-Mass.

Fathima Kolonda

University of Illinois College of Medicine-Chicago

Rebecca Lee

University of California Los Angeles Medical Center

Andrew Lobonc

University of North Carolina Hospitals

Colby Parks

University of Wisconsin Hospital and Clinics

Tracy Pessin

University of Chicago Medical Center

Bradley Reel

Lackland Air Force Base-Texas

Krystal Scherrer

Saint Louis University School of Medicine

Tina Sharma

University of Chicago Medical Center

Matthew Vasko

William Beaumont Hospital-Mich.

Campbell Williams

Northwestern McGaw/NMH/ VA-Ill.

Dean Nair

Fairview Hospital-Ohio

Patrick Rose

University of Colorado School of Medicine-Denver Saint Louis University School of Medicine

Siri Kanmanthreddy

Providence Hospital-Washington, D.C.

Stephanie Frisch Julie Green

MaryBeth Huber

Brendan Levy

St. Johns Mercy Medical Center-Mo.

Shane Stephenson

St. Johns Mercy Medical Center-Mo.

Anjani Urban

St. Johns Mercy Medical Center-Mo.

General Surgery

Kevin Donahoe

Brigham Douglas

Maricopa Medical Center-Ariz.

Naval Medical Center-PortsmouthVa.

Timothy Havens

Saint Louis University School of Medicine

Nicholas Johnson

UIC/Mount Sinai Hospital Medical Center-Ill.

David Horwitz

Maricopa Medical Center-Ariz.

Jordan Jurgens

Christopher Johnston

Yvonne Bailey

Saint Louis University School of Medicine

Kenneth Bensch

Saint Louis University School of Medicine

Mirnela Byku

Johns Hopkins Hospital-Md.

Devin Callister

Stanford University Programs-Calif.

ChiaJin Chiou

Case Western/MetroHealth Medical Center-Ohio

James Crouch

Medical College of Wisconsin Affiliated Hospitals

Aaron Dolle

University of Tennessee College of Medicine-Memphis

Alex Farhat

University of California Irvine Medical Center

Nicholas Frederickson

University of Iowa Hospitals and Clinics

Asal Gharib

University of California Irvine Medical Center

“I was a little overwhelmed but ready for this long, long road to pay off,” said Kamilah Halmon, who matched in pediatrics at Inova Fairfax Hospital in Virginia. “Having my parents here was icing on the cake.” Sabrina Padgett

Saint Louis University School of Medicine

Janice Park

University of California Davis Medical Center

Sanjeevkumar Patel

Saint Louis University School of Medicine

Tomas Rios

University of Texas Medical SchoolHouston

Jia Shen

Emory University School of Medicine-Ga.

Anand Srivastava

University of Texas Southwestern Medical School-Dallas

Matthew Stotts

University of Colorado School of Medicine-Denver

John Yaft

University of Texas Southwestern Medical School-Dallas

Lu Yue

Kaiser Permanente-Southern California Region

Timothy Gong

Medicine/ER Medicine

Justin Halbe

SUNY Health Science Center Brooklyn-N.Y.

University of California Irvine Medical Center University of Wisconsin Hospital and Clinics

Garo Harmandayan

Kaiser Permanente-Southern California Region

Scott Hollingshaus

University of Utah Affiliated Hospitals

Shana Jagwani

Georgetown University HospitalWashington, D.C.

Yang Liu

Lackland Air Force Base-Texas

Adam Nordstrom

Medicine-Pediatrics Dianne Tran

Loma Linda University-Calif.

Medicine-Psychiatry Alexander Gamble

Jason Chu

Chad Nelson

Peter Morris

Boston University Medical Center

David Nguyen

University of Southern California

Eric Nordstrom

Rhode Island Hospital/Brown University

Bikram Padda

University of Kansas School of Medicine-Kansas City

Case Western/MetroHealth Medical Center-Ohio

Justin Larson

Mayo School of Graduate Medical Education-Ariz.

Barnes-Jewish Hospital-Mo.

Emory University School of Medicine-Ga.

Neurology Baback Arshi

Renee Hickey

Rush University Medical Center-Ill.

University of California Irvine Medical Center

University of Missouri-Kansas City Programs

University of Kansas School of Medicine-Wichita

University of Colorado School of Medicine-Denver

Kimberly Johnson

Regions Hospital/Health PartnersMinn.

Methodist Hospital-Houston

University of Southern California

Nicole Karis

Candace Nall

Ali Moazzam

Andrew Russell

Reinaldo Morales

Joseph Walter John Wilson

Jeffrey Van Eps Yee Wong

Loyola University Medical Center-Ill.

“I was pretty anxious,” said Matthew Vasko, who matched in anesthesiology at William Beaumont Hospital in Michigan. But I got my top choice and I’m excited. It’s where I’m from.”

Family Medicine Rachael Degurse

Palmetto Health Richland-S.C.

Jessica Grimes

University of Michigan HospitalsAnn Arbor

George Kryder

St. Lukes-Bethlehem-Pa.

University of Iowa Hospitals and Clinics

Cory Miller

St. Louis Children’s Hospital

Top Match States Missouri 35 graduates

University at Buffalo School of Medicine-N.Y.

St. Louis Children’s Hospital

Barnes-Jewish Hospital-Mo.

University of Southern California

Catherine Donnellan Melissa Fernandes

Tufts Medical Center-Mass.

Christopher Gibu

University of California Los Angeles Medical Center

Allison Snyder

Inova Fairfax Hospital-Va.

Christopher Spencer

“I didn’t stress, I just went with it,” said Joseph Walter, who will train in emergency medicine at Regions Hospital/Health Partners in Minnesota. “And it was good, it felt good!”

Kamilah Halmon Emily Harding

Yale-New Haven Hospital-Conn.

Radiology-Diagnostic Patrick Bacon

Geoffrey Hill

Childrens Hospital Los Angeles

University of Nebraska Affiliated Hospital

Gintien Huang

Saint Louis University School of Medicine

Henry Ford Health Sciences CenterMich.

Children’s National Medical CenterWashington, D.C.

University of Illinois-St. Francis Medical Center

St. Louis Children’s Hospital

University of California Irvine Medical Center

Ophthalmology Stroger/Cook County-Chicago-Ill. New York Eye and Ear Infirmary

Haumith Khan-Farooqi

Tulane University School of Medicine-La.

Rindha Reddy

Saint Louis University School of Medicine

Mohammad Ali Torab Parhiz SUNY Stony Brook-N.Y.

John Allerdice-Seddon Michael Azzam

University of Tennessee College of Medicine-Memphis

Jeffrey Coppage

University of Vermont/Fletcher Allen

Daniel Jones

Saint Louis University School of Medicine

Sarah Lewis

Paul Houser

Mandy Hyatt

Gerald Diaz

Lana Ismail

David Fjeldsted

Kathryn Leonard

Mark Franke

Harold Lochner

Wright Patterson Air Force BaseOhio

Katrina Lundquist

Stanford University Programs-Calif.

Kevin Pittinger

Indiana University School of Medicine

Kaiser Permanente-Southern California Region

Baylor College of Medicine-Houston

Daniel Holt

Barnes-Jewish Hospital-Mo.

Jarod Skouby

Madi Mikhayel

Saint Louis University School of Medicine

Saint Louis University School of Medicine

University of Colorado School of Medicine-Denver

Urology

Sarah Stack

Eric Strodtman Laura Tranel Victor Wong

Children’s Hospital of Orange County-Calif.

Abd-El-Rahman Abd-El-Barr

Henry Ford Health Sciences CenterMich.

Avinash Chennamsetty

William Beaumont Hospital-Mich.

Nicholas Kuntz

Duke University Medical CenterN.C.

Bradford Stevenson

Southern Illinois University School of Medicine and Affiliated Hospitals

Christopher Taylor

Katherine Fernandez

Plastic Surgery

Matthew Marino

University of Nevada Affiliated Hospitals-Las Vegas

University of Arkansas-Little Rock

Saint Louis University School of Medicine

University of Texas Southwestern Medical School-Dallas

Saint Louis University School of Medicine

University of Chicago Medical Center

Patrick Hawkins

Amanda Kimber

University of Kansas School of Medicine-Kansas City

Zachary Sisko

Barnes-Jewish Hospital-Mo.

Saint Louis University School of Medicine

University of Southern California

Richard Seagrave

Taylor Greenwood

Kimberly Simmons

Saint Louis University School of Medicine

Andrew Silver

University of New Mexico School of Medicine

David Chilenski contributed to this story.

California 26

20

Patrick Navolanic

Children’s Hospital-Oakland-Calif.

Blair Smith

Maricopa Medical Center-Ariz.

Loma Linda University-Calif. University of Wisconsin Hospital and Clinics

Erin Barker

University of Tennessee College of Medicine-Memphis

Ohio State University Medical Center

University of Texas Southwestern Medical School-Dallas

William Magnuson

Pediatrics

Case Western/MetroHealth Medical Center-Ohio University of Pittsburgh Medical Center Medical Education ProgramPa.

Radiation Oncology

Ted Ling

Stephanie Do

Raj Shree

Barnes-Jewish Hospital-Mo.

Saint Louis University School of Medicine

Adam Meyer

University of Vermont/Fletcher Allen

Chandra Shenoy

Marie Miller

Nathan Cannon

Bryanne Colvin

Brooke Schlappe

Psychiatry

Pathology

Harbor-University of California Los Angeles Medical Center

Saint Louis University School of Medicine

Loyola University Medical Center-Ill.

Barnes-Jewish Hospital-Mo.

Clare Rudolph

Otolaryngology

Karandev Rai

Joshua Sappington

Christopher Choi

Saint Louis University School of Medicine

Duy Le

University of Utah Affiliated Hospitals

University Hospitals-Columbia-Mo.

Oregon Health and Science University

Mayo School of Graduate Medical Education-Minn.

University of Texas Medical SchoolHouston

Lindsey Michaels

Neurological Surgery

Cade Lawrence

Meghana Kunkala

Tulane University School of Medicine-La.

Orthopaedic Surgery

Nicolin Neal

University of California San Diego Medical Center

Kaneez Ali

University of Iowa Hospitals and Clinics

Saint Louis University School of Medicine

Denver Health Medical Center

Obstetrics-Gynecology

Gretchen Oakley

Illinois 15

Grand Rounds 21

Texas 11


Alumni Pulse Pattillo and Alderson

Alumnus Honored at Reunion Weekend for Commitment to Promoting Women’s Health Roland Pattillo, M.D. (’59) truly exemplifies the Jesuit ideal of women and men for others. Nearly 40 years ago, he led a team of researchers who successfully cultivated cervical tissue cells outside the body. “Dr. Pattillo could have sought a patent for his work, but he and the others felt it was important the cells be made available to scientists worldwide so that vaccines could be studied,” said Philip O. Alderson, M.D., dean of the School of Medicine. And studied they were. Pattillo’s findings were used to develop a vaccine against the Human Papilloma Virus, which causes cervical, vulvar and vaginal cancers in women. His discoveries and his tireless promotion of women’s health led to his

selection as recipient of the 2009 Alumni Merit Award during Reunion Weekend in October. Pattillo received his bachelor’s degree from Xavier University in New Orleans in 1955 and became the third African-American student accepted to Saint Louis University School of Medicine. He completed his residency at the Medical College of Wisconsin and fellowships at Johns Hopkins and Harvard universities. The author of more than 100 peer-reviewed journal publications, one book and many book chapters, Pattillo was named by Atlanta Magazine as a 2002 Atlanta Top Doctor; received a medallion for his work by the Trophoblast Society; and was recognized by the Atlanta Business Chronicle in 2005 as a Health Care Hero. Pattillo, now director of gynecologic oncology at Morehouse School of

Medicine, serves as a strong force in women’s health and recently was considered a candidate for the position of U.S. Surgeon General. He is a long-time supporter of SLU School of Medicine and was the keynote speaker at the school’s 10th annual John H. Gladney, M.D., Diversity Award Dinner in 2009. Pattillo received more attention this spring when the book The Immortal Life of Henrietta Lacks was published. The book tells the story of Lacks, the 31-year-old African-American mother of five children whose death in 1951 provided scientists with the first “immortal” human cells grown in culture. Lacks’ cells have been directly responsible for the development of cures for polio and numerous other diseases, and they continue to be used to search for cures for leukemia and the cause of cancer. Pattillo was an important resource for the book’s author. He worked with the physician who initially cultivated Lacks’ cells in the lab, and Pattillo used the cells in his groundbreaking research.

below | Members of the Class of 1984 gather at the home of T. Martin Vollmar, M.D. (’84) and his wife, Kathy.

From Your Outgoing Association President Thomas J. Olsen, M.D. ’79 Just inside the main

bottom | Members of the Class of 1959 celebrated their 50-year reunion with a private dinner in DuBourg Hall. left | Roland A. Pattillo, M.D. (’59) recipient of the 2009 School of Medicine Alumni Merit Award with Dean Philip O. Alderson, M.D. right top | Reunion Weekend attendees gather in the lobby of the Edward A. Doisy Research Center for a tour. right bottom | Anthony J. Scalzo, M.D. (’79) professor of pediatrics and internal medicine, and director of SLU’s Clinical Simulation Center, gives alumni a tour of the state-of-the-art facilities in the Learning Resources Center. far right | Thomas Olsen, M.D. (’79) outgoing association president, welcomes fellow alumni at the 2009 reunion.

Reunion Weekend 2009 Camaraderie and celebration marked Reunion Weekend 2009 as alumni from across the United States gathered at the School of Medicine in October. Here are a few scenes from events on and off campus.

»

Plan now to attend this year’s celebration Oct. 21-23 and make your own memories. Classes ending in 0 and 5 will be enjoying their reunions.

entrance to the lobby of Saint Louis University Hospital there is a small alcove. In it there is a crucifix on the wall, and underneath it a small table. It would be possible for one to walk past the alcove without seeing it, especially if one were intent on getting to the information desk. Each week an arrangement of flowers is brought from the Fleur De Lis Gift Shop and displayed on the table. These arrangements are so beautiful that they draw one’s attention. As I hurried into the hospital early one morning this month, my eyes moved to the alcove and an arrangement of pink roses. I stopped and approached the table, smiling. I leaned forward to smell the roses. I heard a voice talking to me from across the lobby. “Doc, I’m glad you’re not too busy to stop and smell the roses,” said Tyrone Davis, who staffs the information desk. “You’re in such a hurry most of the time.” As I thought about Tyrone’s words, I had to agree with him. Most of us get so caught up in what we are doing in one part of our lives that we can forget or neglect the other parts. Physicians in particular are at risk of doing this. We can justify long hours away from home, away from loved ones, away from other responsibilities. We justify these by invoking a need to do just one more thing in the office or the hospital, send one more letter or read one more letter. Professionalism dictates that we care for our patients and put their needs ahead of our own. But professionalism also dictates that we seek balance in our lives and take care of ourselves. I often remind my patients of the advice we are given by flight attendants should oxygen masks come down from overhead during flight. We are told to put the mask on ourselves first and then to help others. We need to remember that we can be better physicians, better spouses, better friends and better parents if we allow ourselves opportunities to really appreciate the world around us at least once in a while. There should be things in our lives that make us just stop what we are doing. Stop in awe. Stop in wonder. Stop in thanks. These may be people we know, memories we have, beautiful art or music. Or, they may in fact be roses. The School of Medicine Alumni Association would like to thank Thomas J. Olsen, M.D. (’79) for his many years of leadership as alumni association president.

Saint Louis University School of Medicine Grand Rounds 23


Living the Mission Looking Forward It

is hard to imagine being anything but exhausted when trying to feed your newborn twins at 3 a.m., but rather than exhausted, Mark A. Terry, M.D. (’79) found himself inspired. Terry was feeding his twins while reading an ophthalmology journal perched between them on his lap. He was intrigued by an article about a Dutch researcher who was experimenting with a complicated partial corneal transplant technique in a monkey. At the time, it was unheard of to perform partial transplants of the internal layer of the cornea. Only full transplants were used to repair corneal swelling damage. “The potential was obvious to me, but I knew the procedure wouldn’t work in patients unless it could be vastly simplified,” he said. “The very next day I began investigating how to do that and how I could modify surgical instruments to make the procedure viable.” Terry not only made the procedure — endothelial keratoplasty (EK) — viable, he made it the standard of care now for many patients

whose corneas have been injured or affected by disease. Since he pioneered EK 10 years ago, nearly a million people throughout the world have had their vision restored through the procedure. Terry, professor of clinical ophthalmology at the Oregon Health Sciences University and director of corneal services at Devers Eye Institute in Portland, has one of the busiest corneal transplant practices in the United States. He performs more than 300 transplants a year, 80 percent of them using EK. About a quarter of his patients live outside the northwest, coming from as far away as Japan, Australia, Europe and South Africa for corneal transplant surgery. Although he was inspired by the Dutch researcher, Terry had been looking for a better way of transplanting corneas since the early 1980s during his residency and internship at the Naval Hospital in Oakland, Calif. At the time, the only therapy for corneal swelling from disease or injury was penetrating keratoplasty (PK), a transplant in which a patient’s damaged cornea is replaced with a full thickness donor corneal tissue. With PK, the full thickness of the cornea

24

is replaced even if only a one percent layer of the cornea is causing the swelling. “PK is a very frustrating therapy for surgeons,” Terry said. “Full thickness transplants require sutures that stay in for as long as a year. It can take up to two years for patients to achieve their best vision, and even a slight bump to the eye years after surgery can ruin everything.” After a year of laboratory work and protocol development, the Institutional Review Board gave Terry permission in 2000 to perform EK on one patient. Terry replaced only a thin layer of cells on the back surface of the patient’s cornea, and within just two weeks she had full vision. The procedure requires no corneal sutures, carries none of the complications that come with full thickness corneal replacements and requires very little postoperative care compared to PK. When Terry presented his results at national and international meetings, physicians were skeptical. But the evidence eventually won them over, and Terry has been invited by institutions and countries throughout the world to teach EK to their surgeons. Terry is especially focused on volunteering his time in developing countries, such as India, Cuba and China. “One option is to go to a city or town, perform 10 transplants and come home. That would help 10 patients,” he said. “Instead, I decided I could train 10 local surgeons who can go out and help thousands of patients. You magnify the patient benefits

enormously when you teach new surgical techniques.” Terry said EK is particularly helpful to surgeons treating patients who have to travel long distances to get to a clinic and oftentimes cannot journey back for follow-up care. Also, EK relies on surgical skill rather than expensive technology, which is hard to come by in underdeveloped countries. “Inevitably, when I return from a trip I receive e-mails from surgeons thanking me for changing their practices and changing their lives,” he said. “They feel so much better about performing a procedure that is safer than what they’ve done in the past.” While on his teaching trips, Terry often travels with his wife, Cindy, and his now11-year-old twins, Charlie and Nicholas. “International travel can sometimes be challenging, because Nick has cerebral palsy and is in a wheelchair; but it is worth it for our family!” he said. Terry’s devotion to his family is apparent when you ask about the surgical instruments he designed to perform EK. Breaking with the tradition of naming surgical instruments after the inventors, Terry worked with Bausch and Lomb Surgical to create the Cindy Scissors, the Charlie Insertion Forceps and the Nick Pick retraction hook, as well as six other specialized instruments for performing EK. “It’s a small tribute to pay to the people who supported me through all those nights and weekends while I was in the lab developing this procedure,” Terry said.

Grand Rounds Saint Louis University School of Medicine

Terry, by the way, was not the first in his family to graduate from the School of Medicine. His father, Robert T. Terry, M.D., graduated in 1948, and his uncle Richard M. Terry graduated in 1951.

The University loses... a devoted benefactor, Margaret McCormick Doisy the widow of Nobel

Laureate and founder of the department of biochemistry and molecular microbiology Edward A. Doisy, Ph.D., died in December. Mrs. Doisy was instrumental in providing the largest gift in Saint Louis University’s history for the construction of the Edward A. Doisy Research Center. “The Doisy legacy is immeasurable,” said University President Lawrence Biondi, S.J., who presided over Mrs. Doisy’s funeral Mass. “They truly helped make SLU into the modern research university it is today.” Mrs. Doisy had strong connections to Saint Louis University. She received her bachelor’s degree from SLU and was an administrative assistant in the School of Medicine. The Doisy name can be seen throughout SLU’s Medical Center. In addition to the Edward A. Doisy Research Center, Doisy Hall and the Margaret McCormick Doisy Learning Resources Center are named for the Doisys. The Edward and Margaret Doisy College of Health Sciences was endowed and dedicated by Mrs. Doisy in 2001. The department of biochemistry and molecular microbiology, where Dr. Doisy had taught

for five decades, was renamed the Edward A. Doisy Department, in his honor, in 1955.

a generous nature lover, Fern de Greeff

a centenarian who donated the funds to create a forest of color at the Doisy Research Center, died in January. She was the benefactor of the Fern and Russell de Greeff Park, an elaborately landscaped 9-acre respite on the medical center campus that includes a Zen garden, large fountain and many trees selected for their vibrant color in the fall.

an altruistic alumnus, James B. Peter, M.D. ’58

died in October due to complications with cancer. Dr. Peter and his wife, Joan, had been generous supporters of the research and education at the School of Medicine for many years. They donated $2 million to the University in 2007 to establish an endowed chair in

markyourcalendar

Terry with his wife, Cindy, and sons, Charlie and Nicholas, visit a wildlife habitat while traveling in China on one of his medical missions.

biochemistry and molecular biology. They made the gift in honor of their friend, William Sly, M.D., who became the first holder of the James B. and Joan C. Endowed Chair in Biochemistry and Molecular Biology. Dr. Peter had a varied and distinguished career in academic medicine and in business. He was founder and former chief executive officer of Specialty Laboratories, a leading hospital-focused clinical reference laboratory with more than 800 employees. He received the School of Medicine Alumni Merit Award in 1989.

In Memoriam

Donald Martin, M.D. (’20) Matthew Weis, M.D. (’24) Hollis Allen, M.D. (’26) Richard Becker, M.D. (’26) Clarence Eckert, M.D. (’27) Edward Bowdern, M.D. (’28) Louis Berard, M.D. (’34) Charles Jost, M.D. (’35) Louis Battista, M.D. (’36) William Duncan, M.D. (’39) Lee Allen, M.D. (’41) Francis Burns, M.D. (’41) John J. Collins Jr., M.D. (’57) John Sciortino, M.D. (’41) Charles Wilds, M.D. (’42) Everett Ellis, M.D. (’44)

Rollo Lange, M.D. (’45) John Mullins, M.D. (’45) Venedict Osetinsky, M.D. (’45) Robert Polley, M.D. (’45) John Sheedy, M.D. (’45) Kenneth Welty, M.D. (’45) Cecil Jones, M.D. (’46) P. Caputo, M.D. (’47) Harold Lankford, M.D. (’48) Edward Flynn, M.D. (’50) Adolph Motta, M.D. (’50) Edward Szewczyk, M.D. (’51) Martin Austin, M.D. (’52) Walter Bringaze, M.D. (’52) Goronwy Broun, M.D. (’52) Edgar Harrison, M.D. (’52) Donald Bandle, M.D. (’53) John Doolan, M.D. (’53) Francis Fahrner, M.D. (’53) Robert Hahn, M.D. (’53) Roxy Novario, M.D. (’54) Nicholas Mardesich, M.D. (’55) Robert Voorhees, M.D. (’55) Richard Laney, M.D. (’56) T. Regimbal, M.D. (’57) Philip Higgins, M.D. (’58) Eugenia Pierce Vest, M.D. (’58) Patrick Griffin, M.D. (’59) John Walter, M.D. (’60) Alan Belknap, M.D. (’64) A. Carabelli, M.D. (’65) Dennis Gray, M.D. (’70) Roger Leslie, M.D. (’71) Vernon Roden, M.D. (’71) James Tasse, M.D. (’73) Gail Lergner Clark, M.D. (’74) Michael Conley, M.D. (’75) Joseph Felker, M.D. (’75) Susan Shutt Forrest, M.D. (’83) Alexander Link, M.D. (’89) David Terry, M.D. (’90) Stephen Fitzgerald, M.D. (’92) Mencio Chez, M.D. (’95) Stacy Collins, M.D. (’98)

May 2 May 13 June 21-23 Aug. 1 Oct. 21-23

School of Medicine Events Digestive Disease Week Reception – New Orleans School of Medicine Precommencement New Resident Orientation White Coat Ceremony Medical School Reunion

May 1 May 6-8 May 22 June 1 June 4-5 June 12

Continuing Medical Education Programs Evidence-Based Methods to Preserve Brain Function and Prevent Alzheimer’s Disease Microsurgical Approaches to Intrinsic Brain Tumors Sleep Medicine for Primary Care Providers The 21st Annual Summer Geriatric Institute Autologous Breast Reconstruction The 3rd Annual Acute Stroke and Cerebrovascular Interventions

 For information on the CME programs, please call the SLU School of Medicine Show your school colors continuing medical education office at 314-977-7401. See updates and www.clubcolors.com/slu details about Practical Anatomy Workshop programs at pa.slu.edu. Travel with alumni For any other events, please contact the Alumni Relations Office at 314-977-8335 or visit medschool.slu.edu/alumni/ www.slu.edu/alumni/travel


Non-Profit Org. U.S. Postage

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St. Louis, MO Permit No. 134

GrandRounds

One N. Grand Blvd., SON 539

Spring 2010

St. Louis, MO 63103

Saint Louis University School of Medicine

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PROFILE OF PHILANTHROPY When Drs. Joyce (Devine) Woolsey (’55) and Robert M. Woolsey (’57) graduated from medical school, the field of neurology was considered rather dormant. “Neurologists were said to be physicians who knew everything and did nothing,” Robert Woolsey said. But the Woolseys saw it coming — an explosion in demand for physicians trained to investigate, diagnose and treat neurological disorders. After he finished his training at the University of Michigan, the National Hospital in London and the New York Neurological Institute, and she finished her training at Boston Children’s and City Hospital and the New England Medical Center, the Woolseys returned to Saint Louis University School of Medicine in 1962 where they met, married and helped build a nationally recognized department of neurology and psychiatry. “In 1962 it was just the two of us and the chairman (Louis Tureen, M.D.). Now the department is more than 50 faculty members strong,” Robert Woolsey said. Before his retirement in 2002, Robert Woolsey spent 45 years in the department, two of them as acting chairman. He organized the neurology residency program, which is fully accredited and offers training at four area hospitals. Joyce Woolsey was only the fifth woman to graduate from the School

of Medicine. When she began her career in the 1960s, she was one of only a handful of pediatric neurologists in the country. She developed the pediatric neurology department at SSM Cardinal Glennon Children’s Medical Center. Between the two of them, the Woolseys estimate they have trained more than 5,000 medical students and residents. “It makes us incredibly proud and happy that so many have gone into the field and are doing a great job,” Joyce Woolsey said. The Woolseys, whose daughter Kathleen (Woolsey) Bilderback (A&S, Cook ’91) also attended SLU, are members of the DuBourg Society and longtime supporters of the School of Medicine. “A thousand people applied to medical school, and they accepted me,” Robert Woolsey said. “The school enabled me to build my career and my life. I feel a strong need to give back. I hope all graduates of the medical school feel the same way.” The Woolseys also noted that the tuition students pay, though expensive, covers only a little more than half of what it costs the school to educate them. “I think it’s important to create opportunities for students who are smart enough and capable enough to attend medical school but lack the resources to do so. I wish we could give more,” Joyce Woolsey said.

Haiti

Faculty and alumni answer the call

T o learn more about giving opportunities and tax benefits that may be associated with your gift, contact the office of development at the School of Medicine at (314) 977-8303 or msalsic1@slu.edu.

Match Day 2010

Abdominal Transplant Has a New Chief

Clinic Caters to Latino Community


GrandRounds_Spring_2010