The art and science of cancer care

A popular Ampersand program is preparing the physicians of the future to understand the scientific and social aspects of cancer.

by CHRIS WOOLSTON

As a PreHealth biology major, Mishka Narasimhan knows the finer details of cancer down to the molecule. Her familiarity with DNA, oncogenes, cancer cells, and antibodies will serve her well as she works to become an oncologist, but she’ll have to call on deeper, more personal insights to become a truly successful physician. Thanks to Hallmarks of Cancer and Patient Care — a two-year Ampersand program that explores the disease at every level — she feels up to the challenge.

As part of the program’s inaugural cohort, Narasimhan spent the spring semester of 2022 getting to know a group of cancer survivors. Over Zoom, the students and survivors discussed their days, shared worries and accomplishments, and, in a highlight for all, made art.

Anthony Smith, biology lecturer and coordinator of undergraduate research experiences, and Dinesh Thotala, now an associate professor of radiation oncology and director of cancer biology at the University of Oklahoma College of Medicine, introduced Hallmarks of Cancer and Patient Care in 2020 to fill a pressing need. Over a third of all Arts & Sciences undergraduates have their sights on a career in the health field, said Smith, who was himself a PreHealth biology major at WashU before earning a doctorate in microbiology and immunology at the University of Miami Miller School of Medicine. Smith went on to discover a love for teaching as a postdoctoral researcher at the University of Minnesota Medical School and returned to WashU as an assistant dean in Arts & Sciences.

Whether new undergrads aspire to geriatrics, pediatrics, or any health field in between, an understanding of cancer will be a part of the job. “If students are eventually going into healthcare, they’re going to interact with cancer at some point along their journey,” Smith said. “We wanted to help them develop the skills to be successful.” Hallmarks adds to Arts & Sciences’ growing array of offerings for students interested in medicine, including a multi-semester MedPrep program and anthropology courses on global health and the environment.

For the initial cohort, Smith and Thotala received piles of applications and personal essays from hopeful students, far outpacing the number of available slots. They narrowed the pool of applicants down to those who ticked every box: academic rigor, intellectual curiosity, and a desire to learn about every aspect of cancer. From that group, the final 20 students were selected.

While Smith and Thotala were surprised by the initial interest, it became clear that the program’s mission resonated with students. As part of their applications, many students wrote about their own experiences with cancer, including the loss of friends and relatives. “There is clearly a deep emotional connection to this program and this topic,” Smith said.

Like other Ampersand programs, Hallmarks gives first-year students a chance to dive into a particular topic in a small-group setting. The first two semesters cover the biology of cancer, including the mutations in healthy cells, the growth of tumors, and the underlying theories behind chemotherapy, radiation, and other treatments. In the third semester, students learn about the scientific method and the latest research on therapy, diagnosis, and other cutting-edge topics. In the fourth semester, Smith calls on a group of experts from Siteman Cancer Center and beyond to give students a fuller picture of the cancer community. “We have a lot of field trips and guest speakers, and it really opens the eyes of the students,” he said. “It’s not just about medical doctors. It’s nurses, social workers, dietitians, psychologists, and clergy. They can all make a meaningful difference to someone facing cancer.”

Students also have the chance to learn directly from survivors. From the outset, Smith wanted to inspire meaningful interactions between students and people who have personal experience with the disease. To reach that goal, he enlisted the help of Sarah Colby, coordinator of the Arts + Healthcare program at Barnes-Jewish Hospital, part of the WashU Medical Center.

Colby, a trained artist, is a fixture at the hospital, where she wheels a cart of paint, yarn, and other supplies from room to room, giving patients a break from their troubles and an outlet for creativity. “I see people at the hospital with all kinds of conditions, but there’s still something especially troubling about cancer. When you hear that word, your mind goes to the worstcase scenario. Art can be very helpful for those patients as a form of expression and diversion.”

To bring that approach to the Ampersand program, Colby worked closely with Rochelle Hobson, a hospice and oncology nurse who manages the Siteman Cancer Center’s Survivorship Program. Hobson reached out to her network to find a group of survivors who were interested in helping to train the next generation of physicians.

With Smith’s encouragement, Colby and Hobson built an art therapy support group that brought students and survivors together over paint, gel pens, and poetry. “The smallest interaction with someone can be incredibly important,” Colby said. “That’s a huge lesson for the students going forward if they want to be physicians.”

The images from the survivors spoke volumes. In her first session, Kathleen Stomps, who had just started chemotherapy for endometrial cancer, drew a dark, moody picture of an IV bag with the words “time passes with measured, poisonous drips.” Later, she decorated her box of art supplies with a collage of butterflies, Muhammad Ali, and the phrase “choose to be grateful.”

Not every student was an expert with a paintbrush, but they all brought a lot of energy and talent to the project, Colby said. “A lot of them are super creative. I’m so impressed, and I have so much hope for physicians of the future.”

The first round of Hallmarks took place during the pandemic, so face-to-face meetings between students and survivors weren’t possible. So, they turned to Zoom. Over the course of eight weeks, survivors converted their homes into miniature art studios using supplies Colby sent in the mail. In 90-minute sessions, the survivors and the students would craft mandalas, watercolors, and collages of family photos. “It felt like the survivors were in the room with us,” Narasimhan said. “We could all be vulnerable together.”

Stomps volunteered for the program partly because she wanted a respite from the routine of cancer treatment and the isolation of the pandemic. She was immediately struck by the students’ compassion and enthusiasm. “These students are really committed to becoming the best physicians possible,” said Stomps, who is now cancer free. “It was a short-term interaction, but it just blew me away.”

The art gave everyone a common purpose, but it also sparked conversations. Many of those discussions drifted toward everyday life. The students would talk about spring break plans or studying for finals; the survivors would talk about grandkids, hobbies, and fears. “It was beautiful and powerful,” Smith said.

The art therapy sessions played to the strengths of McKenzie Halpert, now a senior majoring in biology and minoring in psychological and brain sciences. “I was able to share my passion for art and connect with people using that form of selfexpression,” said Halpert, whose grandmother died of breast cancer a few months before the program launched in 2020. She recalls a powerful image from one survivor: a watercolor of a butterfly emerging in front of a sunrise. “It represented the feeling of optimism and how she’s looking forward,” Halpert said. “She had so much positive energy that she was putting out there and into her work.”

Halpert was so inspired by her time in the Ampersand program that, after she completed it, she began volunteering in the oncology unit at the Barnes-Jewish Center for Advanced Medicine. After graduation, she plans on going to medical school to become a physician.

Elina Deshpande is one of the students just starting their second year of the program. The sophomore feels deeply connected to the 19 other students in her cohort. The shared classes have created a bond that rarely happens in large lecture halls, she said.

Before she arrived at WashU, Deshpande saw herself eventually practicing general medicine, perhaps as a pediatrician or family doctor. “But after starting the program, I’ve had a shift,” she said. “I’m really fascinated by cancer and cancer biology. New things are always being presented, new questions are being asked, and new answers are being provided. So, now I’m thinking about becoming a cancer specialist, maybe a pediatric oncologist.”

Deshpande is looking forward to meeting and working with survivors in the spring. While she doesn’t have much skill with a paintbrush or pencil — her preferred artistic medium is dance — she anticipates that those interactions will give her a chance to understand how patients feel about their disease, their lives, and their treatment. “I’m minoring in Jewish, Islamic, and Middle Eastern studies, and I really want to see how culture and religion influences the ways people look at medicine,” she said.

Now a senior, Narasimhan looks back fondly on her time in Hallmarks, an experience she strongly recommends to incoming WashU students. “Anyone who is interested in becoming a doctor should apply for this program,” she said. “Humanity is so central to the practice of medicine.”

Ampersand programs, by the numbers

Whether they’re studying tumors, Shakespeare, or hip-hop, students in Ampersand programs gain an immersive introduction to an Arts & Sciences education. These one- or two-year programs for incoming freshmen offer group learning opportunities that go beyond the classroom. Here’s how the programs stack up.

16 unique Ampersand programs

offered during the 2023-2024 school year

4 programs involve domestic travel

6 programs involve international travel

4 programs involve original research

300-350 students participate in Ampersand programs each year artsci.wustl.edu/AmpersandPrograms

by CHRIS WOOLSTON

Arts & Sciences reached new heights in 2023, bringing in the most external grant funding in school history. Support from a wide variety of government agencies, private foundations, and other sponsors fueled a year of unprecedented discovery and growth across disciplines, said Deanna Barch, vice dean of research.

The Grants Administration Integrated Network, a program started in 2022 that supports Arts & Sciences researchers at every step of the process, has contributed to this success, Barch said. She also highlighted the ongoing efforts of the Research Development Office to promote collaboration and provide seed funding and pilot grants. The addition of Peter Kastor, the Samuel K. Eddy Professor, as associate vice dean of research (p. 6) will increase the school’s capacity to compete for grants moving forward, she said.

Barch noted that many of the funded projects last year involved collaboration within and beyond Arts & Sciences, a key component of strategic plans underway at both the school and university level. The Arts & Sciences Strategic Plan alone includes eight signature initiatives that have already attracted significant funding and produced new findings in quantum physics, psychology, and other fields. “The results speak for themselves,” Barch said. “We do particularly well in areas where we have faculty with convergent strengths.”

Ultimately, Barch said, credit for the grants and fellowships goes to the researchers themselves. “They’re the ones with the ideas, the creativity, and the motivation to write the proposals,” she said. Last year, 192 Arts & Sciences researchers received funding for 296 projects, adding up to a impressive $55 million in support.

In a year brimming with exciting projects, Barch pointed to several awards that reflect the varied contributions of Arts & Sciences researchers and the vast potential for the future.

Populist Rhetoric on Social Media and Its Effects on Democracies Around the World

Funded by the National Science Foundation

Principal investigators: Jacob Montgomery, professor of political science; Margit Tavits, the Dr. William Taussig Professor in Arts & Sciences; and Christopher Lucas, assistant professor of political science

Researchers are using this $571,000 grant to gather social media posts from tens of thousands of political candidates and hundreds of political parties from nearly 80 countries to get a fuller picture of the prevalence and impact of populist language. The project was born from seed funding provided by the Weidenbaum Center on the Economy, Government, and Public Policy.

CAREER Awards

Funded by the National Science Foundation

Principal investigators: Rachel Penczykowski, assistant professor of biology; Sheng Ran, assistant professor of physics; and Martha Precup, assistant professor of mathematics and statistics

These highly prized grants are reserved for junior faculty who have excelled at both research and mentorship. Penczykowski is using her award to investigate the factors that drive fungal infestations of common broadleaf weeds in the St. Louis area. Ran’s project continues his search for quantum materials with special characteristics that could be useful for next-generation electronics. Precup will use the grant to search for patterns within geometric data.

Linking Quantum Sensing Technologies Across Disciplines

Funded by the National Science Foundation

Principal investigators: Sophia Hayes, professor of chemistry; Kater Murch, the Charles M. Hohenberg Professor of Physics; and Erik Henriksen, associate professor of physics

Working with Sheretta Butler-Barnes, a professor at the Brown School, Hayes, Murch, and Henriksen will use this $3 million, five-year grant to create a quantum sciences and engineering graduate training program across the St. Louis region. The McKelvey School of Engineering will also be involved. The training program will focus on quantum sensing, a burgeoning field that uses atomic-level insights to track quantum properties of materials.

St. Louis Translational Fellowships in Education

Funded by the James S. McDonnell Foundation

Principal investigator: Andrew C. Butler, chair and associate professor of education

This $3.5 million grant will support the training of six postdoctoral fellows each year for six years. The two-year fellowships will include coursework, research, and experience working in school settings. The goal is to provide new PhDs with training that enables them to pursue a career conducting rigorous, collaborative, and equity-focused educational research.

Computational Cognitive Neuroscience Framework for Attentional Control Traits and States

Funded by the U.S. Department of Defense

Principal investigator: Todd Braver, the William R. Stuckenberg Professor in Human Values and Moral Development

Braver is the lead investigator on this multi-institutional, multinational project, expecteded to span five years with a total budget of $8.8 million. The team includes Julie Bugg, professor of psychological and brain sciences; Wouter Kool, assistant professor of psychological and brain sciences; and 12 other researchers from the U.S. and Australia. The project will use brain imaging technology including fMRI and EEG to better understand wandering minds and lapses in attention.

Time and Episodic Memory: Neuropsychology Meets Philosophy

Funded by the National Science Foundation

Principal investigator: Carl Craver, professor of philosophy and philosophy-neuroscience-psychology

This $280,000 grant funds a project that melds the fields of philosophy and neuroscience to explore how our memory of past events shapes our perception of time. In collaboration with York University in Toronto, Craver will study how people with episodic amnesia process and understand the passage of time. Craver hopes his research will be especially valuable for philosophers investigating our knowledge of time, scientists struggling to understand the nature of memory, and clinicians treating people with memory loss.