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Spring 2011

Robert C. Byrd Health Sciences Center • West Virginia University

Big

Questions Research Focus on

West Virginia Health

Cover

Lingqing Zhang, a researcher in the Non-linear Optical Microscopy core facility at the Health Sciences Center, is a part of the West Virginia University Center for Neuroscience. See page 7 for more.

wvuhealth Spring 2011 Vol. 2, Issue 1

Contents A publication of the Robert C. Byrd Health Sciences Center West Virginia University Morgantown, West Virginia www.hsc.wvu.edu Administration James P. Clements, PhD President, West Virginia University Christopher C. Colenda, MD, MPH Chancellor for Health Sciences Arthur Ross, MD Dean, School of Medicine Georgia L. Narsavage, PhD Dean, School of Nursing Patricia A. Chase, PhD Dean, School of Pharmacy Louise T. Veselicky, DDS, MSD Interim Dean, School of Dentistry Judie Charlton, MD Interim Chief Medical Officer WVU Healthcare Bruce McClymonds President and CEO, WVU Hospitals J. Thomas Jones President and CEO, WV United Health System Editorial Board Bill Case, Editor Heidi Specht, Creative Director Stephanie Bock Jay Coughlin Norman Ferrari, MD Amy Johns Misti Michael Gary Murdock Amy Newton Lynda B. Nine Tricia Petty Julia W. Phalunas Shelia Price, DDS Stacy Wise Contributors Bob Beverly Jeff Driggs Liz Ferrari Autumn Hill Angela Jones Leigh Limerick Mary Rivasio Minard Michelle Moore Lori Savitch

© 2011 West Virginia University

West Virginia University is governed by the West Virginia University Board of Governors and the West Virginia Higher Education Policy Commission. WVU is an Equal Opportunity/Affirmative Action Institution.

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Chancellor’s Message | Transforming Lives

4

HSC Report 2009–2011

COVER STORY 7

Big Questions

12

Tradition and Triumph

14

Surviving a Stroke

16

Reinventing Medical Education

18

Bus Stop

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Hand in Hand

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Joanna’s Gift

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Dr. Gus

Chancellor’s Message

The central ideas we agreed upon are summarized in its title: Transforming Lives—Eliminating Health Disparities. You can read the plan in great detail at www.hsc.wvu.edu/hsc2020.

Last year, as we celebrated 50 years of service to West Virginia and our professions, more than 250 members of our health sciences community participated in a broad discussion of our mission, our vision for the future, and our priorities. The result of the process was a 10-year strategic plan that encompasses all three of our campuses and all of our schools.

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Throughout this magazine, you will read the stories of people whose lives have been transformed for the better through their involvement with West Virginia University. You can also learn how we’re working in every corner of the state to enhance the wellbeing and quality of life of the people of West Virginia. The commitment we make today is about the future – about how we will build upon the strong foundation we have at WVU to meet the challenges of the next generation. One important – even historic – decision has already been made. We have begun the process of establishing a nationallyaccredited School of Public Health.

This is a bold goal. We have not altered the basic structure of our academic enterprise since 1960. For several generations, West Virginia’s public health statistics have been at the bottom of national rankings. The experience of other states demonstrates that establishment of public health schools has a real impact. We already have many of the needed resources in place. WVU offers master’s degrees in public health and school health education and a PhD program in public health sciences. Several community-based health programs developed at WVU are having national and international impact. This effort will require your support and collaboration as well. I hope that each of us will contribute whatever talent we have toward realization of this historic step forward. —Christopher C. Colenda, MD, MPH

HSC2020 Strategic Plan Contribute to the health of West Virginians through leading edge research programs that distinguish WVU HSC Goal 1: Attract and retain the “best and brightest� faculty, staff, and students Goal 2: Establish scientific infrastructure/partnerships that transform the research culture at HSC Goal 3: Use commercialization of intellectual property to stimulate and expand research resources

Promote a vibrant environment devoted to diversity, learning, and scholarship Goal 1: Become a national leader in developing inter-professional education and patient care model(s) Goal 2: Establish national and global collaborations to enhance our faculty, staff, and student experiences Goal 3: Reward nationally recognized leaders amongst faculty, staff, and students Goal 4: Dramatically enhance diversity and cultural competency among our faculty, staff, and students

Foster a culture of high purpose, accountability, and accomplishment Goal 1: Create an integrated academic health sciences system that includes all disciplines and campuses Goal 2: Build a management infrastructure that is nimble, transparent, and accountable Goal 3: Diversify financial resources to invest in our future Goal 4: Create an environment that values and promotes volunteerism

Raise the health status of West Virginians Goal 1: Create a dynamic partnership between healthcare systems and public health that improves the health status of West Virginians Goal 2: Establish a School of Public Health in order to transform the lives of West Virginians and eliminate health disparities Goal 3: Build a high quality workforce that meets the healthcare and public health needs of West Virginians

Deliver high quality, effective, patient-centered care

WVU HEALTH SCIENCES CENTER

Highlights

Ruth Kershner selected CASE Professor of the Year

2009-2011

Maier Foundation gift underwrites Charleston research chair Stroke Center by American WVU Heart Institute opens

WVU Hospitals Magnet recognition renewed 11/09

12/09

5/10 2/10

3/10

4/10

WVU ranked 5th in U.S. by American Academy of Family Practice

2009

US News & World Report lists WVU “top 10� for rural medicine and one of the best grad schools for nurse practitioners; in the 2012 book WVU ranks 7th in rural medicine. 4 | WVUhealth

School of Dentistry begins multiyear research project on oral health disparities, funded by $2.8 million in NIH grant support

CARDIAC program celebrates 100,000th student screening

Computer based learning center opens in Charleston Division

recertified by JCAHO; honored Heart Association

6/10

Doctorate in Nursing Practice program enrollment tops 50 in less than two years after accreditation

8/10

Cancer researchers led by Lan Guo, PhD, identify a gene pattern associated with lung cancer patients who are at high risk for recurrence of the disease

9/10

2010 WVU’s Morgantown hospitals and medical practices establish joint management as WVU Healthcare.

Arthur J. Ross, Jr., MD, named dean of School of Medicine

Private giving in 2009–10 increased almost 10 percent over the previous year. More than 7,400 donors provided $20.9 million to support HSC programs and students.

Pharmacy researcher Yon Rojanasakul, PhD, wins $1.4 million NIH grant to study potential lung damage to workers and consumers from inhaling carbon nanotubes

Spring 2011 | 5

Highlights, continued WVU Medical Office Building opens in Ranson

NIH provides Center for Neuroscience with $5.5 million to develop core research facilities

10/10

2010

WVUH–East’s City Hospital opens new cardiac catheterization lab

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Children’s Miracle Achievement Award is presented to Robert Gustafson, MD, chief of pediatric cardiothoracic surgery

11/10

2/11

3/11

2011

WVU and state celebrate First Humanism in Medicine Week

BIG QUESTIONS FOR RESEARCHERS, THERE IS ALWAYS A QUESTION TO BE ASKED by Angela Jones

At the West Virginia University Health Sciences Center, questions are being asked and answered on every corner of the campus. All four Schools – Medicine, Dentistry, Pharmacy, and Nursing – are abuzz with the quest for knowledge and for a cure. Our researchers are looking to cure diseases and reduce injuries that affect people of all ages, races, and genders. But most importantly, they’re looking at ailments that affect West Virginians most – from oral health to cancer and everything in between. And they’re not just doing this work in a lab in Morgantown. They’re working with communities across the state to help people in their own backyards.

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Can we do better for people with chronic diseases? Many chronic illnesses are exhausting. For the more than 90 million Americans who suffer from them, they cause troubling symptoms, progressive debility, and poor quality of life. Scheduling doctors’ appointments, going to doctors’ appointments, and managing prescriptions can be a full-time job for the patient or a caregiver. The economic burden of chronic illness is a staggering $1.3 trillion annually.

team of social workers, public health professionals, and WVU medical, nursing, and social work students in examining how well the healthcare system in rural areas serves people with chronic illnesses. “The study will provide a more comprehensive understanding of the socio-cultural context of living with and caring for adults with complex chronic illness in rural areas,” Dr. Buck said. “This information is critical to the efficiency

The burden can be even greater for people in rural areas of West Virginia, where access to care is often limited. In some places, patients require long trips to multiple doctors and healthcare providers in other parts of the state. Joy Buck, PhD, RN, a researcher in the WVU School of Nursing at the University’s Eastern Division in Martinsburg, is leading a multidisciplinary

of interventions that aim to reduce rural health disparities by preventing and reducing the human and economic burdens associated with these illnesses.”

The team will track patients and their caregivers for 18 months and will interview healthcare providers, social workers, family members, and others involved with the patient’s care to get an idea of how well the care being provided is working for the patient. After an initial in-depth interview, the team will do monthly follow ups to see how the patient is doing. If there have been changes in the patient’s condition, they will conduct new interviews. “We want to understand more about what types of care and services they receive – at home, at their healthcare providers’ offices, in hospitals, and elsewhere – and see how well it is aligned with what they really need and prefer,” Buck said.

How does the brain develop? Have you ever stopped to think about all the things that have to happen for a human brain to develop properly? “It’s mind blowing,” said Eric Tucker, PhD, assistant professor in the Department of Neurobiology and Anatomy and researcher in the WVU Center for Neuroscience. But take the brain of someone who is autistic or schizophrenic – what happened, or didn’t happen, during the development of that person’s brain? That’s what Dr. Tucker is trying to find out. His lab takes cellular, molecular, and genetic approaches to study the development of the forebrain, the frontal area of the brain that includes the cerebral cortex and basal ganglia. He uses techniques such as live-cell imaging, which allows him to watch the migration of young neurons and manipulate the factors that promote their movement. “Even subtle alterations in the placement of cortical neurons can lead to neurodevelopmental disorders like schizophrenia and autism,” Tucker said. “Our goal is to identify molecular mechanisms that underlie normal developmental processes and provide insight into how disruptions may result in neurological and psychiatric illnesses.” A variety of factors can disrupt proper brain development, including genetics, environmental exposures, and even stress. “If a mother experiences the right kind of stress at the wrong time, it could be catastrophic,” Tucker said. His work, however, focuses more on genetic influences and is a first step into what could eventually lead to a cure for these diseases. “It’s very far away. We’re still trying to understand the basic mechanisms involved in their pathology. We need a better grasp on those mechanisms before we can start working on targeted interventions,” Tucker said. 8 | WVUhealth

How do patients rate their health risks? Kimberly Kelly, PhD, wants to empower patients to make healthier lifestyle choices, to understand their disease states, and to be able to communicate with their physicians about those diseases. An associate professor in the WVU School of Pharmacy’s Department of Pharmaceutical Systems and Policy, Dr. Kelly focuses on three main populations in her cancer research: those who have a family history of cancer, those who live in Appalachia, and those who have had cancer and are at risk of recurrence. She concentrates mainly on breast, cervical, colorectal, and ovarian cancers. She’s trying to find out how people in elevated risk populations perceive their risks. For example, if a patient has a history of breast cancer, how does that change her view of getting a mammogram?

Or, if a patient has a high risk of cervical cancer, how does that influence her perception of Pap smears and vaccinations? To answer those questions, Kelly conducts a variety of research to obtain data from individuals. Her work includes data that’s collected from people in specific communities, population research across many groups and counties, and clinical-based research carried out in cooperation with physicians and patients. She collects information on objective risks – those that can be modeled or measured by scientists – and then compares it to the patients’ perceived risk. She takes this information and analyzes it to help improve patients’ health behaviors and improve their understanding through various mechanisms, such as genetic counseling, creation of brochures, or providing more health information. “I want those who are at high risk to understand their risk and do what they need to do in order to be healthy,” Kelly said. “This could be getting a cancer screening, or more importantly, not waiting to get a cancer screening, especially if they have a family history of cancer.”

Spring 2011 | 9

How do we protect athletes from concussions? In 2002, Bennet Omalu, MBBS, co-director of the Brain Injury Research Institute (BIRI) at WVU, made a discovery that would eventually rock professional sports. While examining the brain of deceased former Pittsburgh Steelers player Mike Webster, Dr. Omalu, a forensic neuropathologist pathologist, found it was riddled with chronic traumatic encephalopathy (CTE). The condition made the 50-year-old’s brain similar to that of an individual with advanced Alzheimer’s disease.

In the nearly nine years since, an unprecedented amount of light has been shone on concussions in athletes. In July 2010, Omalu and Julian Bailes, MD, co-director of BIRI and chairman of the WVU Department of Neurosurgery, announced that evidence of CTE had been found in the brain of an active professional football player. That player was Chris Henry, a member of the Cincinnati Bengals and former WVU Mountaineer who died in December 2009. The findings – and the interest of the national and international media in BIRI research – have forced the NFL and other professional leagues to reconsider how they treat head injuries. And the new understanding is being used to protect high school players here in the Mountain State. The West Virginia Secondary Schools Activities Commission (SSAC) used BIRI research during rules clinics it held with coaches and officials last summer. The group changed its return-to-play protocols for all high school sports, with a particular focus on football. “We had very positive reports. Our coaches, officials, and principals are all aware and educated. And they understand that this is a serious issue that needs to be addressed,” Gary Ray, executive director of the commission, said. “We appreciate Dr. Bailes and the role he played in giving us some direction on how to address this.” For Bailes, it’s a matter of making the sport he loves safer for everyone. “I truly believe that football is America’s greatest pastime. But we’ve got to do a better job of protecting players from concussions,” he said. “We’re on the right track, and it’s very rewarding to see organizations like the SSAC putting our work to good use.”

What’s causing tooth loss? When it comes to oral health in West Virginia, the statistics are staggering.

Dentistry, wants to reverse those trends. He’s planning to work with 800 West Virginia families to help study the early trajectory of oral disease from birth to age two.

One-third of children have untreated dental decay by age eight. One-third of adults under age 35 have lost at least six permanent teeth. And 44 percent of West Virginians 65 and older have lost all of their teeth compared to the national average of 20 percent.

The National Institutes of Health has provided a $2.8 million grant to fund his study of oral health disparities in northern Appalachia.

Richard Crout, DMD, PhD, associate dean for research in the WVU School of

“Once we isolate the cause or causes, we can better implement oral disease

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prevention programs, hopefully reducing the oral health disparity in Appalachia,” Dr. Crout, principal investigator, said. “The main cavity bug, Streptococcus mutans, may be more virulent in families with significant oral disease than in families with a low rate of oral disease. But that’s something we need to research more.” One thing research has shown, Crout said, is that good overall health cannot

How do your children grow? Why are an increasing number of children diagnosed with asthma? Why are more and more kids becoming obese? What are the links between environment and development? Researchers in the WVU Department of Pediatrics are joining those across the country to answer those questions and more as a part of the National Children’s Study. The generation-long study will examine the effects of environmental influences on the health and development of children across the United States. By following more than 100,000 children from before birth until age 21, researchers hope to improve the health and well-being of children everywhere. In Marion County, WVU is developing a partnership of local schools and agencies to assist the researchers in enrolling 1,000 women and children. Researchers will analyze how environmental influences interact with each other and what helpful and/or harmful effects they might have on children’s health. Soil, air, and water samples will be taken to see how their components affect a child’s health. Samples of blood, urine, and hair will be taken from mothers and their children to see what is shared between the two during pregnancy and in childhood. Environmental samples will be taken from daycare centers and other settings to see what kids are exposed to when they’re not at home. “By studying children through their different phases of growth and development, researchers will be better able to understand the role of these factors on health and disease,” said Lesley Cottrell, PhD, principal investigator. “The study will also allow scientists to find the differences that exist among groups of people in terms of their health, healthcare access, disease occurrence, and other issues, so that these differences or disparities can be addressed.”

be attained without good oral health. And one way to ensure that a person will have good oral health habits throughout his or her life is to introduce children to the dentist by their first birthday or when the first tooth comes in. “It’s likely that at this age, treatment will be more preventive and provide a more positive first dental visit experience. This would go a long way in reducing fear and be very helpful in getting larger numbers of people to go to the dentist,” Crout said.

“It is also critically important to get the word out to our people in the state of the importance of oral health. Not only will it keep their teeth, but it will also be very important for good systemic health. Brushing, flossing, and routine dental visits have never been more important.”

Spring 2011 | 11

Tradition and Triumph

Dental Education Begins with a Pledge by Michelle Moore

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A

manda Hughart wanted to be a dentist since she was a little girl in Big Chimney, W.Va. “Other kids were playing house,” Hughart said. “I was playing dentist.” The traditional ceremony that she attended at the end of two days of newstudent orientation at WVU’s School of Dentistry helped her realize that her dream was becoming a reality. The heart of the ceremony is the “Pledge of Professionalism” recited in unison by the incoming class. Each student is given a personalized pen to commemorate the occasion. One by one, students’ names are called, and they walk to the stage to sign a registry book, verifying their commitment to the professional standards of the school. “It’s a surreal, emotional experience,” said Wes Howard, a second-year dental student from Fayetteville, W.Va. “It was the beginning of the rest of our lives, as far as our professional careers go, especially signing the book and keeping the pen. For me, things like that mean a lot.”

Howard, who decided to attend dental The students know there is plenty school when he began his undergraduate of work to do before their time in work at WVU, described the ceremony dental school is finished. But with this as a triumph. “We spent so much time ceremony, they know the journey has in undergrad trying to get good grades, begun; they know what they have to do, write the essays, and go through the the expectations they must fulfill. interviews and the whole process,” he said. “Then, when you’re sitting in front “We use the occasion to underscore the principles of professionalism,” said Dr. of the podium hearing Dr. Price, it just Price. “They’re representing the school sort of brings everything into focus. and the dental profession at all times This made it real.” even when they’re attending a public Shelia Price, DDS, associate dean for event or out in the community. They admissions, recruitment, and access, represent everything that the School of said that the professionalism assembly Dentistry stands for and everything that is the cornerstone for the long-awaited the profession stands for.” start to their dental education. Price said that for some of the parents, “We flash their names and their this is the first time they have visited hometowns on the screen as they come the dental school and interacted with forward,” she said. “They’re in the faculty. Touring the school, attending spotlight. It’s a red carpet moment.” the assembly, and joining in the alumni association-sponsored reception That was certainly true for Hughart, afterward allows families to “really who is now finishing her first year of sense the faculty’s commitment to the dental study. “The professionalism students and to share in the celebration assembly really makes you feel like of our welcoming them.” you’re a part of something,” she said. “You’re not just a regular student anymore. You’re the best of the best, and this is your first step in.”

Spring 2011 | 13

Surviving a Stroke Time Is Brain by Mary Ravasio Minard

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“If I hadn’t come to WVU, I might not be sitting here talking to you today.”

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ohn Lako was watching a Sunday night Steelers game at his Jere, W.Va., home. But the 83-year-old retired coal miner just didn’t feel right: He had a strange sensation on the side of his neck, and his right hand would not stop jerking back and forth.

of the areas where blood was flowing –and not flowing – in his brain. He was diagnosed with an ischemic stroke, and the scans pinpointed the location of a clot blocking blood flow to his brain. He was given tPA, a medication that can significantly reduce the effects of stroke, reducing permanent disability if it’s delivered directly to a clot within three hours of the start of stroke symptoms.

He called to his wife, Sophie, who was sleeping in the other room. His words were not making sense. “I was talking mumbojumbo. At times I couldn’t talk right and at “By the time we got to the hospital, they times I could talk right,” he said. had already taken x-rays of John, and Sophie suspected her husband was having they had given him this medicine,” said The team doesn’t just serve patients who a stroke. She convinced him to let her call Sophie. “I was treated well … the doctors live close to Morgantown. WVU leads an ambulance. It was a critical, life saving and nurses were there all the time telling a network of hospitals and emergency decision. you what was happening. He couldn’t get providers who are working together to better treatment.” The emergency response team told the advance stroke care in communities across Lakos they were taking John to Ruby Time is brain when you’re having a stroke. the state. Emergency physicians treating a Memorial Hospital. The WVU Stroke “It’s not just getting to the hospital as fast patient with stroke symptoms can contact Team – which is on alert 24 hours a day, as possible by ambulance, but also getting the WVU Stroke Team at any hour for seven days a week – was waiting at the the treatment as quickly as possible. We consultations or possible transfer. door when Lako arrived at the Emergency have developed a stroke team over the last The WVU Stroke Center has earned Department. 10 years that has become an incredibly Primary Stroke Center certification from “More than 20 beepers go off when efficient machine, allowing us to treat The Joint Commission on Accreditation of they page the stroke team,” said WVU patients who otherwise wouldn’t have Healthcare Organizations and is a recipient Stroke Center Director Laurie Gutmann, gotten treatment,” Dr. Gutmann added. of the American Heart Association Silver MD. “That includes neurologists, the “We meet on a weekly basis to review our Performance Award. radiologists, the stroke nurse, the performance and discuss how we can Lako suffered minimal damage and now emergency room doctors and staff, the improve our processes of care. This is goes to physical therapy twice a week to pharmacy, the labs, all the different people how we ensure that patients get the best strengthen the use of his right hand. “I that are going to be involved in getting this possible outcomes. National studies have wouldn’t want to go any place else,” he said. patient to treatment as fast as possible.” shown that stroke care provided in a center “If I hadn’t come to WVU, I might not be Lako was hustled into a CT scan within 15 like this saves lives.” sitting here talking to you today.” minutes, where the team created images

Mr. Lako has been working to regain full function of his right hand. Below left is his signature a few hours after being admitted to Ruby Memorial Hospital, and at right is his signature today.

Spring 2011 | 15

REINVENTING MEDICAL EDUCATION A New Way to Teach and Learn by Michelle Moore

WVU’s

Eastern Division pairs third year students one-on-one with physicians in active practice. Students are involved in almost every patient encounter, whether it’s in the OR, delivery room, or office. When the doctors go on hospital rounds, the students go too. More than two-thirds of the physicians in Berkeley, Jefferson, and Morgan counties serve as teachers and mentors to the medical students, either in their private practices or at WVU’s Harpers Ferry Family Medicine Center.

“It’s an excellent experience for thirdand fourth-year students, to make them more self-directed and give them a taste of what real life is going to be like,” said Adrienne Zavala, MD, a recent graduate of the program who is now a resident in the Harpers Ferry Family Medicine Center. Rosemarie Cannarella Lorenzetti, MD, MPH, assistant dean of student services at the Eastern Division, said few other schools in the U.S. used

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this hands-on curriculum when WVU adopted it in 2003. Since then, several medical schools have adopted the model. “You’re seeing people on a personal level,” said Brittany Gusic, a thirdyear medical student from Wellsburg, W. Va. “It’s you, the patients, and the doctor, and you can do a lot more as far as interviewing patients and working with them. And the doctors very much want you to be involved. They want you to be doing things, even as a third-year.” Pediatrics, obstetrics/gynecology, and family medicine are taught together in one integrated six-month module. Surgery, internal medicine, psychiatry, and neurology are the components of a second six-month block. For two to four weeks each semester, they work in a hospital, the traditional training environment for medical students, to gain that additional experience. The intention is not to replace the standard learning environment of teaching hospitals, Dr. Cannarella Lorenzetti said. The program simply offers an alternative for learning medicine.

“It’s given me more time to read and learn, especially working so closely with the doctors,” Gusic said. “They are so helpful. If you have any kind of questions, they will always answer them, and they’re always there to teach you.” The 70 students who have graduated from the program have done well on high stakes exams and have qualified for competitive residency placements in both primary care and specialty fields. Alumni report that teaching by community preceptors, the opportunity to have more handson experiences, and the added responsibility for self-directed learning are the strongest advantages of the integrated curriculum. “We developed this program because we knew it matched the strengths of the people we have teaching,” Cannarella Lorenzetti said. “This is a great way to combine community immersion, a longitudinal approach to education, and one-on-one work with faculty.”

“It’s an excellent experience for third- and fourth-year students, to make them more self-directed and give them a taste of what real life is going to be like.” Adrienne Zavala, MD, resident Harpers Ferry Family Medicine Center

Spring 2011 | 13 17 Fall 2010

Bus Stop 1,147 women, 44 counties, and counting... by Heidi Specht

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ike many women, West Union, W. Va., resident Kim Ford has too little time and too few resources to spend much of either on herself. After a day spent cooking at the local diner, she returns home to a full house of family needing her attention. “My family is my life,” Kim noted, “and I take care of them.”

On a recent cold November morning Kim managed to find an hour for herself — and she chose to spend it on a bus parked outside the local senior center. Kim was on Bonnie’s Bus, a sophisticated mobile digital mammography vehicle operated by WVU’s Mary Babb Randolph Cancer Center. Kim knows that routine breast exams are essential to her health. “My grandmother had a full mastectomy when I was 13,” she recalled, “and my mother also was diagnosed and had a partial mastectomy. I know breast cancer is in my family.” In fact, breast cancer runs in many families throughout West Virginia, and 17 counties record breast cancer mortality rates above the national average. Thanks to the generosity of West Virginia natives Jo and Ben Statler, the Bonnie Wells Wilson Mobile Mammography Program was launched in 2009 to improve access to screening mammography throughout the state.

Since then, Bonnie’s Bus has brought this important care to 1,147 women in 44 West Virginia counties. Jo Statler started the program to remember and honor her mother, Bonnie Wells Wilson, whose life was cut short by undetected breast cancer. She wanted to save other West Virginia women from the same fate. The diner where Kim works doesn’t offer health insurance. “Insurance for my family would run about $900 per month – and that would be one of our entire paychecks,” she said. “If it wasn’t for the health department and this kind of thing, I couldn’t afford it. I would take care of my kids or my husband first.” West Virginia’s Breast and Cervical Cancer Screening Program works in close partnership with health departments throughout the state to help ensure that women like Kim can get regular mammograms on Bonnie’s Bus. Before the bus began visiting Doddridge County in 2009, Kim drove more than 30 winding miles to a hospital for a mammogram. This year, she was able to receive care in her own town. “Now I don’t have to miss work for this,” Kim said. “It’s so great that this bus comes into communities like this and has the funds to help people out.”

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HAND in HAND Education and determination by Amy Johns

Kisner McGraw treating a patient at the Hand and Upper Extremity Rehabilitation Center in Morgantown.

Carol Kisner McGraw is an occupational therapist and one of only 17 certified hand therapists in West Virginia.

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It’s easy to forget the wheelchair when you’re with Carol Kisner McGraw. That’s because the lively 45-year-old occupational therapist hasn’t let it stop her from doing exactly what she wanted to do. She has been skydiving, horseback riding, and snow skiing. Perhaps her greatest accomplishments have been earning two degrees from WVU and caring for patients in her own arm and hand therapy business. It’s not the life she had planned. Twenty years ago, she was a healthy young woman working in a car dealership in Morgantown. She was thinking about going to a career school and learning about computers. One day she felt sudden, excruciating pain and was unable to move her legs. She was diagnosed with a spontaneous epidural hematoma – an extremely rare condition, often with no known cause, in which the blood supply to the spinal cord is cut off. She had surgery and spent nearly two months in a rehabilitation hospital. “It was awful. You go from being totally independent and all that,” she explained. “I couldn’t get out of bed. I couldn’t do anything for myself. I couldn’t dress. I couldn’t bathe … nothing.” McGraw said she can’t say how or when she decided to move forward with her life, but she did. “I wasn’t going to stay home, and this took my life in a whole different direction.” An occupational therapist who worked with her at HealthSouth Mountainview Rehabilitation Hospital inspired McGraw to decide she could learn to help others. She earned a social work degree at WVU, then became a proud member of the first graduating class of occupational therapists at the School of Medicine in 1999.

It wasn’t easy. Even some faculty members wondered whether McGraw would be able to handle the physical challenges of the profession. Diana Middleton Davis – now an assistant professor in the WVU OT program – was McGraw’s classmate and friend. In the summer between their first and second years, she helped McGraw learn how to lift and move patients. McGraw’s efforts were good lessons in occupational therapy for both students. “The difficult thing for anyone who wants to be an OT is finding the confidence you need,” Davis says. “All students question whether they have the strength and the ability to help patients. All Carol needed was someone to assume she could do it and help her figure it out.” After graduation, McGraw spent about eight years working with patients at a rehab center, developing special expertise in hand therapy. She opened a private practice in Morgantown in 2009. The colorful and cheery therapy center was built with plenty of space to allow her to wheel around easily.

That helps her patients put their own conditions in perspective.” McGraw credits her WVU education with giving her the knowledge and skills necessary to succeed in the profession she loves and in the life she leads. She swims every day and in the summer she can be found riding her hand cycle on the trails in Morgantown. McGraw was married three years ago. Last year, on the 20th anniversary of her spinal cord injury McGraw threw what she themed a “blood clot party.” Her friends, family, and colleagues came to celebrate the life she’s built and the lives she’s touched since that frightening day.

“The best people that I know, the best friends that I have, the best things that I’ve done with my life, even my husband, have all happened since.”

“Carol really gives patients a sense of fortitude they need to overcome difficult situations. They see that she’s done it,” Davis said. “She admits she has challenges, but they’re never insurmountable.

Spring 2011 | 21

Gift

Joanna’s

J

oanna Adkins never had any doubt she would pursue a career in medicine.

“My pediatrician must have had good toys in her office, because I always said I wanted to be a doctor,” said Adkins, who completes her fourth year of medical school in May.

Adkins hails from West Virginia’s southern coalfields, an area whose residents are often underserved educationally and medically. Throughout her medical training at West Virginia University, Adkins has directed her efforts toward serving a similarly challenged population – Morgantown’s homeless. Thanks in part to the WVU Rural Scholars Program, the Pineville native has already established herself as an up-andcoming public health leader. The program recognizes and rewards outstanding medical students who want to practice family medicine in rural West Virginia. Participants are strongly encouraged to serve their communities through individual projects. Early on in her medical school years, Adkins volunteered for Multidisciplinary UnSheltered Homeless Relief Outreach of Morgantown, or MUSHROOM. The student-founded group sends teams of volunteers into city streets and parks, under bridges, and along riverbanks in search of those in need. Working their way through hidden parts of the city, the students offer food, water, clothing, and basic medical care to anyone they encounter living on the streets.

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by Leigh Limerick

MUSHROOM was organized by medical students and advised by School of Medicine faculty. But its volunteers come from across the university community, with backgrounds varying from medicine to ministry, journalism to social work. To date, MUSHROOM teams have logged over 2,200 client encounters. Through her four years of work with MUSHROOM, Adkins has regularly covered downtown Morgantown, making rounds to address the medical needs of homeless people living in nearconstant exposure to the elements. Still, Adkins recognized the potential for homeless patients who need hospital care to slip through the cracks of the healthcare system. “Sometimes it’s possible for a homeless person to go through their entire hospitalization and the treating doctor never knows they’re homeless,” she said. Early this year, as a result of her work, a group of medical students formed the Homeless Care Consult Team to ensure that homeless patients receive appropriate treatment both during and after their stay at Ruby Memorial Hospital. The consult team reviews the histories of each homeless patient to make sure treating providers are aware of the individual’s unique needs. “We’re addressing questions like, ‘Have they had a pneumonia shot? Have they had a TB test?’ These are things that wouldn’t be recommended for most people,” said Adkins.

“A 45 year-old person in good health should not have a pneumonia shot. A homeless person is at higher risk, so the recommendations change.” Continuing treatment after homeless patients are discharged can be daunting. Improper wound care or failure to follow instructions with medications could put someone back in a hospital bed, so consult team students accompany patients to follow-up appointments to help with aftercare. Gregory Juckett, MD, faculty advisor for MUSHROOM, credits Adkins’ example and enthusiasm for her work with inspiring him to get involved. “Every once in a while you encounter a student with a special gift or ability. Joanna’s gift is compassion for the poor,” said Dr. Juckett. “She has taught me more about homelessness than I’ve ever taught her. I expect her to be a future trailblazer for homeless care in the United States, if not the world.” To learn more about MUSHROOM or to volunteer, visit www.hsc.wvu.edu/som/ fammed/mushroom.

Spring Fall 2010 2011 | 19 23

Dr. Gus:

Mending Broken Hearts by Angela Jones

The Children’s Miracle Network, an international association of children’s hospitals and their supporters, selects a handful of health professionals each year for the Children’s Miracle Achievement Award. The award recognizes outstanding commitment to children’s health and notable work in every field of healthcare.

One of the three recipients in 2010 – and the only physician – was Robert Gustafson, MD, known as “Dr. Gus” to thousands of his young patients in West Virginia and around the world. Dr. Gustafson is the state’s only pediatric heart surgeon. A native of Keyser, W. Va., Gustafson completed his medical education, internship, and residency at WVU. Following a pediatric cardiac surgery fellowship at Children’s Hospital Medical Center in Boston, he joined the faculty at WVU in 1984.

“Dr. Gus is the cornerstone and essence of our mission to serve the children of West Virginia,” said Cheryl Jones, RN, director of WVU Children’s Hospital. “He is a visionary whose leadership has had a positive impact on children. In his career, he has had more than 4,200 patient discharges, including those from Africa, where he gives of his time and talent to repair the broken hearts of children.” Giovanni Piedimonte, MD, chair of the WVU Department of Pediatrics, said of Gustafson: “His reputation is built on more than just clinical skill. He is a friend, advisor, and confidante of young parents in their time of crisis. He creates lasting relationships with his patients as they grow and heal. He is a leader among our faculty and is respected and admired by our nurses and staff.” But Gustafson says he’s just doing his job – a job that he loves. “Helping children with heart problems is a way to leave a legacy for the future,” he said. “There’s nothing you can do in life better than to help someone else’s child get through a major problem with the outlook that that child will be normal,” he said. “The gratitude you get from the families is what it’s all about. It’s much more than an occupation.”

24 | WVUhealth

Caring for West Virginia’s children

Claire Moss recovering from successful brain surgery at WVU Children’s Hospital in Morgantown.

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WVU Health Magazine Spring 2011